Cancer Research and Treatment

Original Articles

Which Chemotherapy-Related Terms were Difficult for Cancer Patients, and Who Would Have the Most Difficulties?: Mangyeong Lee, Nayeon Kim, Ho-Young Kim, Ayoung Lee, Junghee Yoon, Juhee Cho; Received May 22, 2024 Accepted December 2, 2024 Published online December 3, 2024; DOI: https://doi.org/10.4143/crt.2024.485 [Accepted]

Abstract PDF: Purpose
This cross-sectional study aimed to examine which chemotherapy (CTx) terms were most difficult to understand for cancer patients and identify vulnerable patient populations who might need extra support to understand the terms.
Materials and Methods
We listed 56 CTx-related terms based on the experts’ review, then 300 cancer patients and their caregivers completed a questionnaire that assessed literacy in CTx terms (LCT), functional health literacy, and empowerment. Descriptive analysis was performed to examine which CTx-related terms were most difficult for them. Logistic regression analyses were performed to identify factors associated with LCT level.
Results
Of the total 300 people, 162 (54.0%) were in the low-scoring (LS) group in LCT. LS group had a higher proportion of males, lower monthly income, and lived at the province, compared to the high scoring (HS) group. The participants tended to have difficulties in understanding terms related to blood count, risk of infection, and symptoms written in Sino-Korean. In the multivariable logistic regression, male participants (Adjusted Odds Ratio [aOR] = 2.59, 95% confidence interval [CI]: 1.48–4.62), those with no cancer-related information-seeking (aOR = 4.32, 95% CI: 1.75–12.33), and those with low empowerment (aOR = 3.07, 95% CI: 1.83–5.23) were more likely to have a low level of LCT.
Conclusion
There were still linguistic health literacy challenges faced by cancer patients and their caregivers, specifically in understanding chemotherapy-related terms. Minimizing medical jargon and Sino-Korean terms and empowering patients to be ready for treatment are necessary.

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Breast cancer

Impact of Social Support during Diagnosis and Treatment on Disease Progression in Young Patients with Breast Cancer: A Prospective Cohort Study: Danbee Kang, Seri Park, Hyo Jung Kim, Seok Won Kim, Jeong Eon Lee, Jonghan Yu, Se Kyung Lee, Ji-Yeon Kim, Seok Jin Nam, Juhee Cho, Yeon Hee Park; Cancer Res Treat. 2024;56(1):125-133. Published online September 4, 2023; DOI: https://doi.org/10.4143/crt.2023.673

Abstract PDF PubReader ePub: Purpose
We evaluated the association between changes in social support after cancer treatment and recurrence-free survival (RFS) in such patients using a prospective cohort study.
Materials and Methods
Data were obtained from a prospective cohort study (NCT03131089) conducted at Samsung Medical Center (2013-2021). The primary outcome measure was RFS. Social support was measured using the social and family well-being (SFWB) domain of the Functional Assessment of Cancer Therapy-General. We calculated the changes in SFWB scores before and during treatment and the hazard ratio for RFS by comparing such changes.
Results
The mean±standard deviation (SD) age of the patients was 35±3.9 years, and 71.5% and 64.8% of the patients were married and had children, respectively. The mean±SD SFWB score at baseline was 20.5±5.0 out of 26. After cancer treatment, 35.9%, 10.3%, and 53.8% of the participants had increasing, unchanged, and decreasing SFWB scores, respectively. The decreasing SFWB score group had a higher risk of mortality or recurrence than the increasing group. Risk factors for the decreasing score were the presence of children during diagnosis.
Conclusion
In this cohort, changes in social support after treatment were associated with RFS in young patients with breast cancer. Health professionals should develop family interventions to help them receive proper social support.

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General

Effectiveness of Self-Assessment, TAilored Information, and Lifestyle Management for Cancer Patients’ Returning to Work (START): A Multi-center, Randomized Controlled Trial: Danbee Kang, Ka Ryeong Bae, Yeojin Ahn, Nayeon Kim, Seok Jin Nam, Jeong Eon Lee, Se Kyung Lee, Young Mog Shim, Dong Hyun Sinn, Seung Yeop Oh, Mison Chun, Jaesung Heo, Juhee Cho; Cancer Res Treat. 2023;55(2):419-428. Published online November 8, 2022; DOI: https://doi.org/10.4143/crt.2022.939

Abstract PDF Supplementary Material PubReader ePub

Purpose
We developed a comprehensive return to work (RTW) intervention covering physical, psycho-social and practical issues for patients newly diagnosed and evaluated its efficacy in terms of RTW.
Materials and Methods
A multi-center randomized controlled trial was done to evaluate the efficacy of the intervention conducted at two university-based cancer centers in Korea. The intervention program comprised educational material at diagnosis, a face-to-face educational session at completion of active treatment, and three individualized telephone counseling sessions. The control group received other education at enrollment.
Results
At 1-month post-intervention (T2), the intervention group was more likely to be working compared to the control group after controlling working status at diagnosis (65.4% vs. 55.9%, p=0.037). Among patients who did not work at baseline, the intervention group was 1.99-times more likely to be working at T2. The mean of knowledge score was higher in the intervention group compared to the control group (7.4 vs. 6.8, p=0.029). At the 1-year follow-up, the intervention group was 65% (95% confidence interval, 0.78 to 3.48) more likely to have higher odds for having work.
Conclusion
The intervention improved work-related knowledge and was effective in facilitating cancer patients’ RTW.

Citations

Citations to this article as recorded by

Supporting Life Adjustment in Patients With Lung Cancer Through a Comprehensive Care Program: Protocol for a Controlled Before-and-After Trial
Wonyoung Jung, Alice Ahn, Genehee Lee, Sunga Kong, Danbee Kang, Dongok Lee, Tae Eun Kim, Young Mog Shim, Hong Kwan Kim, Jongho Cho, Juhee Cho, Dong Wook Shin
JMIR Research Protocols.2024; 13: e54707. CrossRef
A visualized and bibliometric analysis of cancer vocational rehabilitation research using CiteSpace
Zebing Luo, Xuejia Liu, Chujun Chen
Work.2024; : 1. CrossRef
Psychosocial Adjustment Experiences Among Nasopharyngeal Carcinoma Survivors
Jie Jiang, Ming-Hui Yan, Yu-Ying Fan, Jun-E Zhang
Cancer Nursing.2023;[Epub] CrossRef

4,419 View
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Lung and Thoracic cancer

Psychometric Validation of the Korean Version of the Cancer Survivors’ Unmet Needs (CaSUN) Scale among Korean Non–Small Cell Lung Cancer Survivors: Danbee Kang, Genehee Lee, Sooyeon Kim, Heesu Nam, Sunga Kong, Sungkeun Shim, Jae Kyung Lee, Wonyoung Jung, Sumin Shin, Hong Kwan Kim, Jae Ill Zo, Young Mog Shim, Dong Wook Shin, Juhee Cho; Cancer Res Treat. 2023;55(1):61-72. Published online February 23, 2022; DOI: https://doi.org/10.4143/crt.2021.1583

Abstract PDF PubReader ePub

Purpose
The purpose of the study was to validate the Korean version of Cancer Survivors’ Unmet Needs (CaSUN) scale among non–small cell lung cancer survivors.
Materials and Methods
Participants were recruited from outpatient clinics at the Samsung Medical Center in Seoul, South Korea, from January to October 2020. Participants completed a survey questionnaire that included the CaSUN. Exploratory and confirmatory factor analysis and Pearson’s correlations were used to evaluate the reliability and validity of the Korean version of the CaSUN (CaSUN-K). We also tested known-group validity using an independent t test or ANOVA.
Results
In total, 949 provided informed consent and all of which completed the questionnaire. Among the 949 patients, 529 (55.7%) were male; the mean age and median time since the end of active treatment (standard deviation) was 63.4±8.8 years and the median was 18 months. Although the factor loadings were different from those for the original scale, the Cronbach’s alpha coefficients of the six domains in the CaSUN-K ranged from 0.68 to 0.95, indicating satisfactory internal consistency. In the CFA, the goodness-of-fit indices for the CaSUN-K were high. Moderate correlations demonstrated the convergent validity of CaSUN-K with the relevant questionnaire. More than 60% of the participants reported information-related unmet needs, and the CaSUN-K discriminated between the needs reported by the different subgroups that we analyzed.
Conclusion
The CaSUN-K is a reliable and valid measure for assessing the unmet needs in a cancer population, thus this tool help population to receive timely, targeted, and relevant care.

Citations

Citations to this article as recorded by

Supporting Life Adjustment in Patients With Lung Cancer Through a Comprehensive Care Program: Protocol for a Controlled Before-and-After Trial
Wonyoung Jung, Alice Ahn, Genehee Lee, Sunga Kong, Danbee Kang, Dongok Lee, Tae Eun Kim, Young Mog Shim, Hong Kwan Kim, Jongho Cho, Juhee Cho, Dong Wook Shin
JMIR Research Protocols.2024; 13: e54707. CrossRef
Validity and Reliability of a Simplified Chinese Version of Cancer Survivors' Unmet Needs Scale (CaSUN)
Xiaojingyuan Xu, Xiaoyun Liang, Shiquan Yin
Psycho-Oncology.2024;[Epub] CrossRef
Unmet Supportive Care Needs after Non-Small Cell Lung Cancer Resection at a Tertiary Hospital in Seoul, South Korea
Junhee Park, Wonyoung Jung, Genehee Lee, Danbee Kang, Young Mog Shim, Hong Kwan Kim, Ansuk Jeong, Juhee Cho, Dong Wook Shin
Healthcare.2023; 11(14): 2012. CrossRef
Kanserden Kurtulanların Karşılanmayan İhtiyaçları Ölçeğinin Türkçeye Uyarlanması: Geçerlik ve Güvenirlik Çalışması
Gülyeter Erdoğan Yüce, Gamze Muz, Ayser Döner
Hacettepe Üniversitesi Hemşirelik Fakültesi Dergisi.2023; 10(3): 264. CrossRef
Psychometric properties of the Slovenian version of the Cancer Survivors’ Unmet Needs (CaSUN-SL) measure in post-treatment cancer survivors
Špela Miroševič, Polona Selič-Zupančič, Judith Prins, Vesna Homar, Zalika Klemenc-Ketiš
BMC Psychology.2022;[Epub] CrossRef

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Breast cancer

Fear of Cancer Recurrence and Its Negative Impact on Health-Related Quality of Life in Long-term Breast Cancer Survivors: Thi Xuan Mai Tran, So-Youn Jung, Eun-Gyeong Lee, Heeyoun Cho, Na Yeon Kim, Sungkeun Shim, Ho Young Kim, Danbee Kang, Juhee Cho, Eunsook Lee, Yoon Jung Chang, Hyunsoon Cho; Cancer Res Treat. 2022;54(4):1065-1073. Published online December 8, 2021; DOI: https://doi.org/10.4143/crt.2021.835

Abstract PDF Supplementary Material PubReader ePub

Purpose
Fear of cancer recurrence (FCR) is a common psychological issue in breast cancer (BC) survivors during early survivorship but whether the same is true among long-term survivors has yet to be empirically evaluated. This study investigated FCR level, its associated factors, and impact on quality of life (QoL) in long-term BC survivors.
Materials and Methods
Participants included women diagnosed with BC between 2004 and 2010 at two tertiary hospitals. Survey was conducted in 2020. The study measured FCR with the Fear of Cancer Recurrence Inventory and other patient-reported outcomes, including depression and cancer-related QoL. Logistic regression was used to identify factors associated with FCR, and structural equation modeling was conducted to explore the impact of FCR on other outcomes.
Results
Of 333 participants, the mean age at diagnosis was 45.5, and 46% experienced FCR. Age at diagnosis ≤ 45 (adjusted odds ratio [aOR], 2.64; 95% confidence interval [CI], 1.51 to 4.60), shorter time since diagnosis (aOR, 1.75, 95% CI, 1.08 to 2.89), and having a history of recurrence (aOR, 2.56; 95% CI, 1.16 to 5.65) was associated with more FCR. FCR was significantly associated with an increased risk of depression (β=0.471, p < 0.001) and negatively impacted emotional functioning (β=–0.531, p < 0.001). In addition, a higher FCR level may impair overall health-related QoL in long-term BC survivors (β=–0.108, p=0.021).
Conclusion
Ten years after diagnosis, long-term BC survivors still experienced a high level of FCR. Further, the negative impact of FCR on QoL and increased depression risk require an FCR screening and appropriate interventions to enhance long-term BC survivors' QoL.

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International Journal of Women's Health.2024; Volume 16: 229. CrossRef
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Meidi Xiong, Yuping Cheng, Ying Luo, Chao Fang, Hongmei Yao, Qianqian Liu, Fang Lu, Xuan Li, Ziying Bie, Jinbing Bai, Chunhua Zhang
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Viktorya Voskanyan, Chiara Marzorati, Diana Sala, Roberto Grasso, Ricardo Pietrobon, Iris van der Heide, Merel Engelaar, Nanne Bos, Augusto Caraceni, Norbert Couspel, Montse Ferrer, Mogens Groenvold, Stein Kaasa, Claudio Lombardo, Aude Sirven, Hugo Vachon
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Validation of Korean Version of the COmprehensive Score for financial Toxicity (COST) Among Breast Cancer Survivors: Sungkeun Shim, Danbee Kang, Nayeon Kim, Gayeon Han, Jihyun Lim, Hyunsoo Kim, Jeonghyun Park, Mankyung Lee, Jeong Eon Lee, Seok Won Kim, Jonghan Yu, Byung Joo Chae, Jai Min Ryu, Seok Jin Nam, Se Kyung Lee, Juhee Cho; Cancer Res Treat. 2022;54(3):834-841. Published online October 13, 2021; DOI: https://doi.org/10.4143/crt.2021.784

Abstract PDF Supplementary Material PubReader ePub

Purpose
Little is known about the impact of financial toxicity in disease-free breast cancer survivors. We aim to validate the COmprehensive Score for financial Toxicity in Korean (COST-K) and evaluate financial toxicity among disease-free breast cancer survivors.
Materials and Methods
We conducted linguistic validation following a standardized methodology recommended by Functional Assessment of Chronic Illness Therapy multilingual translation (FACITtrans). For psychometric validation, we conducted a cross-sectional survey with 4,297 disease-free breast cancer survivors at a tertiary hospital in Seoul, Korea between November 2018 and April 2019. Survivors were asked to complete the COST-K and European Organization for Research and Treatment of Cancer Quality of Life Core 30 (EORTC QLQ-C30) questionnaires. The test-retest reliability, internal consistency, and validity of the COST-K were assessed using standard scale construction techniques.
Results
The COST-K demonstrated good internal consistency, with a Cronbach’s α of 0.81. The test-retest analysis revealed an intraclass correlation coefficient of 0.78. The COST-K had moderate correlation (r=–0.60) with the financial difficulty item of the EORTC QLQ-C30 and week correlation with the items on acute and chronic symptom burdens (nausea/vomiting, –0.18; constipation, –0.14; diarrhea, –0.14), showing good convergent and divergent validity. The median COST-K was 27 (range, 0 to 44; mean±standard deivation [SD], 27.1±7.5) and about 30% and 5% of cancer survivors experienced mild and severe financial toxicity, respectively. Younger age, lower education, lower household income was associated with higher financial toxicity.
Conclusion
The COST-K is a valid and reliable instrument for measuring financial toxicity in disease-free breast cancer survivors. Considering its impact on the health-related quality of life, more studies need to be conducted to evaluate financial toxicity in cancer survivors and design interventions.

Citations

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Severity of Financial Toxicity for Patients Receiving Palliative Radiation Therapy
Jeremy P. Harris, Eric Ku, Garrett Harada, Sophie Hsu, Elaine Chiao, Pranathi Rao, Erin Healy, Misako Nagasaka, Jessica Humphreys, Michael A. Hoyt
American Journal of Hospice and Palliative Medicine®.2024; 41(6): 592. CrossRef
Financial Toxicity in Radiation Oncology: Impact for Our Patients and for Practicing Radiation Oncologists
Victoria S. Wu, Xinglei Shen, Janet de Moor, Fumiko Chino, Jonathan Klein
Advances in Radiation Oncology.2024; 9(3): 101419. CrossRef
Measures of financial toxicity in cancer survivors: a systematic review
L. B. Thomy, M. Crichton, L. Jones, P. M. Yates, N. H. Hart, L. G. Collins, R. J. Chan
Supportive Care in Cancer.2024;[Epub] CrossRef
Validation of the COmprehensive Score for Financial Toxicity (COST) in Vietnamese patients with cancer
Binh Thang Tran, Dinh Duong Le, Thanh Gia Nguyen, Minh Tu Nguyen, Minh Hanh Nguyen, Cao Khoa Dang, Dinh Trung Tran, Le An Pham
PLOS ONE.2024; 19(6): e0306339. CrossRef
Comprehensive Score for Financial Toxicity and Health-Related Quality of Life in Patients With Cancer and Survivors: A Systematic Review and Meta-Analysis
Stevanus Pangestu, Fanni Rencz
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Association between financial toxicity and health-related quality of life of patients with gynecologic cancer
Yusuke Kajimoto, Kazunori Honda, Shiro Suzuki, Masahiko Mori, Hirofumi Tsubouchi, Kohshiro Nakao, Anri Azuma, Takashi Shibutani, Shoji Nagao, Takahiro Koyanagi, Izumi Kohara, Shuko Tamaki, Midori Yabuki, Lida Teng, Keiichi Fujiwara, Ataru Igarashi
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Financial Toxicity Following Cancer in a Middle-Income Country with a Pluralistic Health System: Validation of the COST Questionnaire
Veni V. Sakti, Mahmoud Danaee, Cheng-Har Yip, Ros S. A. Bustamam, Marniza Saad, Gin Gin Gan, Jerome Tan, Yueh Ni Lim, Flora L.T. Chong, Murallitharan Munisamy, Farahida Mohd Farid, Boon Lui Sew, Yek-Ching Kong, Nishalini Muniandy, Nirmala Bhoo-Pathy
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Financial Toxicity Among Breast Cancer Patients
Yi Kuang, Xiaoyi Yuan, Zheng Zhu, Weijie Xing
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Heterogeneity of financial toxicity and associated risk factors for older cancer survivors in China
Mingzhu Su, Siqi Liu, Li Liu, Fang Wang, Jiahui Lao, Xiaojie Sun
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Evaluation of financial toxicity and associated factors in female patients with breast cancer: a systematic review and meta-analysis
Yusuf Çeli̇k, Sevilay Şenol Çeli̇k, Seda Sarıköse, Hande Nur Arslan
Supportive Care in Cancer.2023;[Epub] CrossRef
Validity of the COmprehensive Score for financial Toxicity (COST) in patients with gynecologic cancer
Yusuke Kajimoto, Takashi Shibutani, Shoji Nagao, Satoshi Yamaguchi, Shiro Suzuki, Masahiko Mori, Hirofumi Tsubouchi, Kohshiro Nakao, Anri Azuma, Takahiro Koyanagi, Izumi Kohara, Shuko Tamaki, Midori Yabuki, Lida Teng, Kazunori Honda, Ataru Igarashi
International Journal of Gynecologic Cancer.2022; : ijgc-2022-003410. CrossRef

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General

Validation of the Korean Version of the Patient-Reported Outcomes Measurement Information System 29 Profile V2.1 among Cancer Survivors: Danbee Kang, Youngha Kim, Jihyun Lim, Junghee Yoon, Sooyeon Kim, Eunjee Kang, Heesu Nam, Sungkeun Shim, Mangyeong Lee, Haesook Bok, Sang-Won Lee, Soo-Yong Shin, Jin Seok Ahn, Dongryul Oh, Juhee Cho; Cancer Res Treat. 2022;54(1):10-19. Published online April 9, 2021; DOI: https://doi.org/10.4143/crt.2020.1200

Abstract PDF Supplementary Material PubReader ePub

Purpose
The purpose of the study was to validate the Korean version of Patient-Reported Outcomes Measurement Information System 29 Profile v2.1 (K-PROMIS-29 V2.1) among cancer survivors.
Materials and Methods
Participants were recruited from outpatient clinics of the Comprehensive Cancer Center at the Samsung Medical Center in Seoul, South Korea, from September to October 2018. Participants completed a survey questionnaire that included the K-PROMIS-29 V2.1 and the European Organisation for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30). Principal component analysis and confirmatory factor analysis (CFA) and Pearson’s correlations were used to evaluate the reliability and validity of the K-PROMIS-29 V2.1.
Results
The mean age of the study participants was 54.4 years, the mean time since diagnosis was 1.2 (±2.4) years, and 349 (87.3%) completed the entire questionnaire. The Cronbach’s alpha coefficients of the seven domains in the K-PROMIS-29 V2.1 ranged from 0.81 to 0.96, indicating satisfactory internal consistency. In the CFA, the goodness-of-fit indices for the K-PROMIS-29 V2.1 were high (comparative fit index, 0.91 and standardized root-mean-squared residual, 0.06). High to moderate correlations were found between comparable subscales of the K-PROMIS-29 V2.1 and subscales of the EORTC QLQ-C30 (r=0.52-0.73).
Conclusion
The K-PROMIS-29 V2.1 is a reliable and valid measure for assessing the health-related quality of life domains in a cancer population, thus supporting their use in studies and oncology trials.

Citations

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Sujin Kim, Yeonsoo Jang, JiYeon Choi, Kijun Song, Jae-kwan Song, Mona Choi
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Lung Cancer

Conditional Survival of Surgically Treated Patients with Lung Cancer: A Comprehensive Analyses of Overall, Recurrence-free, and Relative Survival: Dong Wook Shin, Jong Ho Cho, Jung Eun Yoo, Juhee Cho, Dong Woog Yoon, Genehee Lee, Sumin Shin, Hong Kwan Kim, Yong Soo Choi, Jhingook Kim, Jae Ill Zo, Young Mog Shim; Cancer Res Treat. 2021;53(4):1057-1071. Published online March 9, 2021; DOI: https://doi.org/10.4143/crt.2020.1308

Abstract PDF PubReader ePub

Purpose
Survival probability changes over time in cancer survivors. This study examined conditional survival in patients undergoing curative resection for non-small cell lung cancer (NSCLC).
Materials and Methods
Five-year conditional recurrence-free survival (CRFS), conditional overall survival (COS), and conditional relative survival (CRS) up to 10 years after surgery were calculated in patients who underwent NSCLC resection from 1994 to 2016. These rates were stratified according to age, sex, year of diagnosis, pathological stage, tumor histology, smoking status, comorbidity, and lung function.
Results
Five-year CRFS increased from 65.6% at baseline to 90.9% at 10 years after surgery. Early differences in 5-year CRFS according to stratified patient characteristics disappeared, except for age: older patients exhibited persistently lower 5-year CRFS. Five-year COS increased from 72.7% to 78.3% at 8 years and then decreased to 75.4% at 10 years. Five-year CRS increased from 79.0% at baseline to 86.8% at 10 years. Older age and higher pathologic stage were associated with lower 5-year COS and CRS up to 10 years after surgery. Female patients, those with adenocarcinoma histology, non-smokers, patient without comorbidities and had good lung function showed higher COS and CRS.
Conclusion
CRFS improved over time, but significant risk remained after 5 years. CRS slightly improved over time but did not reach 90%, suggesting significant excess mortality compared to the general population. Age and stage remained significant predictors of conditional survival several years after surgery. Our conditional survival estimates should help clinicians and patients make informed treatment and personal life decisions based on survivorship status.

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Talib Chaudhry, Vaishnavi Krishnan, Andrew E. Donaldson, Zachary M. Palmisano, Sanjib Basu, Nicole M. Geissen, Justin M. Karush, Gillian C. Alex, Jeffrey A. Borgia, Michael J. Liptay, Christopher W. Seder
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Health-Related Quality of Life in Non-Hodgkin Lymphoma Survivors: A Prospective Cohort Study: Danbee Kang, Juhee Cho, Im Ryung Kim, Mi Kyung Kim, Won Seog Kim, Seok Jin Kim; Cancer Res Treat. 2018;50(4):1051-1063. Published online November 9, 2017; DOI: https://doi.org/10.4143/crt.2017.207

Abstract PDF Supplementary Material PubReader ePub

Purpose
We evaluated health-related quality of life (HRQOL) in long-term survivors of indolent and aggressive non-Hodgkin lymphoma (NHL).
Materials and Methods
TheHRQOLwas assessed by the European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire Core 30 (EORTC QLQ-C30) at diagnosis in NHL patients between 2008 and 2011, and follow-up evaluation was conducted from June 2014 to February 2015 using EORTC QLQ-C30 and the quality of life in cancer survivors (QOL-CS) questionnaire. We used linear mixed models to compare changes in HRQOL between indolent and aggressive NHL over time.
Results
The HRQOL of long-term survivors with aggressive NHL improved to the similar level of indolent NHL during the follow-up survey. However, survivors of NHL were found to fear the probability of relapse and second malignancy, and the degree of fear was not different between survivors with aggressive stage I/II or III/IV NHL (p > 0.05). Furthermore, a half of survivors reported impaired sense of psychosocial well-being regardless of aggressiveness and stage during follow-up survey. More than 65% of survivors thought they did not receive sufficient support from others, and patients who had financial difficulties at diagnosis were more frequently associated with suffering from insufficient support. Impaired physical and cognitive functioning at diagnosis was significantly associated with lack of life purpose in long-term survivors.
Conclusion
The HRQOL of aggressive NHL survivors improved to a similar level to that of indolent NHL. However, the majority of survivors still had fear of relapse, and psychosocial well-being remained unmet needs.

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Azza Ayad, Reham Khedr, Asmaa Hamoda, Nahla Elnabarawy, Elhamy Rifky, Tamer Diab, Eman El Desouky, Leslie Lehmann, Alaa Elhaddad
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Bhasker Amatya, Michael Dickinson , Fary Khan
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Åsa Lindberg, Christian Winther Eskelund, Alexandra Albertsson‐Lindblad, Arne Kolstad, Anna Laurell, Riikka Räty, Kirsten Grønbæk, Christian Hartmann Geisler, Mats Jerkeman
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Mohamad S. Alabdaljabar, Urshila Durani, Carrie A. Thompson, Louis S. Constine, Shahrukh K. Hashmi
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Patient’s Cognitive Function and Attitudes towards Family Involvement in Cancer Treatment Decision Making: A Patient-Family Caregiver Dyadic Analysis: Dong Wook Shin, Juhee Cho, Debra L. Roter, So Young Kim, Jong Hyock Park, Hyung Kook Yang, Hyun Woo Lee, Sun-Seog Kweon, Yune Sik Kang, Keeho Park; Cancer Res Treat. 2018;50(3):681-690. Published online July 4, 2017; DOI: https://doi.org/10.4143/crt.2017.201

Abstract PDF PubReader ePub

Purpose
Older patient populations commonly have cognitive impairment, which might impact decisional capacity. We examined patients and family caregivers preferences for family involvement in treatment decision making assuming different level of cognitive impairment, and sought to explore the factors associated with the preferences and the degree to which patients and family members agree on preferences.
Materials and Methods
A total of 358 elderly cancer patient and caregiver dyads were recruited from the 11 cancer centers in Korea andwere asked to express their preferences forfamily involvement in treatment decision making using hypothetical scenarios with three different levels of cognitive status (intact, mild impairment, and severe impairment).
Results
Both patients and family caregivers preferred greater family dominance in treatment decision makingwith the increasing the level of cognitive impairment (39.7%, 60.9%, and 86.6% for patients and 45.0%, 66.2%, and 89.7% for caregivers in each scenarios). Patient and family caregiver concordance in decisional control preference was small for all three scenarios (weighted κ=0.32, κ=0.26, and κ=0.36, respectively). Higher patient education was associated with preference for patient dominance in treatment decision in conditions of both mild and severe cognitive impairment. The association of higher patient education and patient-caregiver preference concordance was positive with intact cognition, while it was negative with severe cognitive impairment.
Conclusion
Decision control preferences were affected by hypothesized cognitive status of the patients. Findings from our study would be helpful to develop effective strategy for optimizing family involvement in cancer treatment decision in the context of deteriorating cognitive function of the patients.

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Sean N. Halpin, Gabriel Alain, Aaron Seaman, Erin E. Stevens, Hui Zhao, Mackenzie E. Fowler, Qiuyang Zhang, Tamara Cadet, Minzhi Ye, Jessica L. Krok-Schoen
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Nicole L. Henderson, Tanvi Padalkar, Garrett Bourne, Emma K. Hendrix, Courtney P. Williams, J. Nicholas Odom, Kristen Triebel, Gabrielle B. Rocque
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Chaonan Jiang, Li Liu, Ye Wang, Liangzheng Wu, Wenxia Zhang, Xiaodan Wu
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Semra Ozdemir, Sean Ng, Isha Chaudhry, Chetna Malhotra, Eric Andrew Finkelstein
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Samar J. Melhem, Shereen Nabhani-Gebara, Reem Kayyali
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Laura M.L. Tielemans, Kirsten D. van Heugten, Marije E. Hamaker, Inez C. van Walree
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Chia Jie Tan, Melinda Si Yun Tan, Chandramouli Nagarajan, Wee Joo Chng, Yen-Lin Chee, Melissa Ooi, Lawrence Cheng Kiat Ng, Yunxin Chen, Joanne Su Yin Yoong, Xin Yi Wong, Wei-Ying Jen
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Deborah A. Levine, Andrzej T. Galecki, Brenda L. Plassman, Angela Fagerlin, Lauren P. Wallner, Kenneth M. Langa, Rachael T. Whitney, Brahmajee K. Nallamothu, Lewis B. Morgenstern, Bailey K. Reale, Emilie M. Blair, Bruno Giordani, Kathleen Anne Welsh-Bohme
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Chiara Acquati, Judith H. Hibbard, Ellen Miller-Sonet, Anao Zhang, Elena Ionescu
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Factors influencing family involvement in treatment decision-making for older patients with cancer: A scoping review
Bea L. Dijkman, Marie Louise Luttik, Hanneke Van der Wal-Huisman, Wolter Paans, Barbara L. van Leeuwen
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Clizia Cincidda, Serena Oliveri, Virginia Sanchini, Gabriella Pravettoni
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Ni Gong, Qianqian Du, Hongyu Lou, Yiheng Zhang, Hengying Fang, Xueying Zhang, Xiaoyu Wu, Ya Meng, Meifen Zhang
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Dong Wook Shin, Keeho Park, Ansuk Jeong, Hyung Kook Yang, So Young Kim, Mihee Cho, Jong Hyock Park
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PLOS ONE.2019; 14(3): e0212967. CrossRef

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Validation of the Korean Version of the Quality of Life–Cancer Survivors (QOL-CS-K) Questionnaire in Lymphoma Survivors: Juhee Cho, Danbee Kang, Im Ryung Kim, Won Seog Kim, Betty Ferrell, Seok Jin Kim; Cancer Res Treat. 2018;50(1):204-211. Published online March 30, 2017; DOI: https://doi.org/10.4143/crt.2017.091

Abstract PDF Supplementary Material PubReader ePub

Purpose
The objective of this study was to validate the Korean version of the Quality of Life–Cancer Survivors (QOL-CS-K) in a sample of lymphoma survivors.
Materials and Methods
We conducted a cross-sectional survey of lymphoma survivors who had survived for at least 24 months since diagnosis. Participants were recruited at the outpatient clinics and at a hospital event in a tertiary hospital in Seoul, Korea. Survivors were asked to complete the QOLCS-K and the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30) questionnaires. To determine test-retest reliability, a second questionnaire was sent to participants who completed the first questionnaire adequately. Exploratory factor analysis and Pearson’s correlations were used for evaluating reliability and validity of the QOL-CS-K.
Results
Among 257 survivors, 245 (95.3%) completed all questionnaires and had no missing data. The mean age of study participants was 52.2 years, 54.9% were men, and the mean time since diagnosis was 4.0±1.6 years. The Cronbach’s α for the overall QOL-CS-K was 0.90, and the α coefficients for each subscale ranged from 0.73 to 0.83. The test and retest reliability was 0.88. Moderate correlations were found between comparable subscales of the QOL-CS-K and subscales of the EORTC QLQ-C30 (r=0.51-0.55) except for the spiritual well-being subscale of the QOL-CS-K, which did not correlate with any of the EORTC QLQ-C30 subscales (–0.08 to 0.16).
Conclusion
The QOL-CS-K is a reliable and valid scale for measuring the QOL in long-term lymphoma survivors.

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Family Avoidance of Communication about Cancer: A Dyadic Examination: Dong Wook Shin, Jooyeon Shin, So Young Kim, Hyung-Kook Yang, Juhee Cho, Jung Ho Youm, Gyu Seog Choi, Nam Soo Hong, BeLong Cho, Jong-Hyock Park; Cancer Res Treat. 2016;48(1):384-392. Published online March 13, 2015; DOI: https://doi.org/10.4143/crt.2014.280

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Purpose
This study aimed to examine the following questions: to what extent do patients and caregivers perceive their family members to be avoidant of communication regarding patient’s cancer, and to what extent do these perceptions interrelate; and how do such perceptions influence their own and each other’s communication behaviors, communication outcome, mental health, and quality of life. Materials and Methods A national survey was performed with 990 patient-caregiver dyads (participation rate, 76.2%). To examine the dyadic interaction, we developed linked patient and family member questionnaires, including the Family Avoidance of Communication about Cancer (FACC) scale. Results The mean scores (standard deviations) of patient- and caregiver-perceived FACC were low at 10.9 (15.5) and 15.5 (17.5), respectively (p < 0.001), and concordance was low, a well (Spearman’s rho, 0.23). Patient-perceived FACC was associated with lower levels of disclosure and behaviors of holding back communication, as well as lower levels of mental health outcome and quality of life. The same was true for caregivers (all p < 0.05). Patient-perceived FACC was associated with caregiver holding back, caregiver’s depression level, and caregiver quality of life (all p < 0.05). Both patient- and caregiver-perceived FACC were independently associated with communication difficulty within the family. Conclusion Future research would benefit from the measurement of FACC from both patients and caregivers, and promote family intervention to enhance openness to communication, which would be helpful for improving mental health and quality of life for both patients and caregivers.

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Oncologists’ Experience with Patients with Second Primary Cancer and the Attitudes toward Second Primary Cancer Screening: A Nationwide Survey: Dong Wook Shin, Juhee Cho, Hyung Kook Yang, So Young Kim, Boram Park, BeLong Cho, Hyung Jin Kim, Young Jun Lee, Deog-Yeon Jo, Jong Hyock Park; Cancer Res Treat. 2015;47(4):600-606. Published online February 12, 2015; DOI: https://doi.org/10.4143/crt.2014.162

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Purpose
Screening for second primary cancer (SPC) is one of the key components to survivorship care. We aim to evaluate the oncologists’ experience with SPCs and assess the current practice, perceived barriers, and recommendations related to SPC screening. Materials and Methods A nationwide survey was conducted with a representative sample of 496 Korean oncologists. A questionnaire based on the findings from our previous qualitative study was administered. Results More than three-fourths of oncologists (76.3%), who participated in the study, had experience with SPC patients. Over half of them (51.9%) stated that it was an embarrassing experience. While the current management practice for SPC varies, most oncologists (80.2%) agreed on the necessity in proactively providing information on SPC screening. A short consultation time (52.3%), lack of guidelines and evidence on SPC screening (47.7%), and patients’ lack of knowledge about SPCs (45.1%) or SPC screening (41.4%) were most frequently reported as barriers to providing appropriate care for managing SPC. Oncologists recommended the development of specific screening programs or guidelines in accordance to the type of primary cancer (65.9%), the development of an internal system for SPC screening within the hospital (59.7%) or systematic connection with the national cancer screening program (44.3%), and education of oncologists (41.4%) as well as patients (48.9%) regarding SPC screening. Conclusion Many oncologists reported the occurrence of SPC as an embarrassing experience. Given the variations in current practice and the lack of consensus, further studies are warranted to develop the optimal clinical strategy to provide SPC screening for cancer survivors.

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Cardiovascular risk and undertreatment of dyslipidemia in lung cancer survivors: A nationwide population-based study
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Jung‐won Lim
Asian Social Work and Policy Review.2020; 14(3): 172. CrossRef
Second Primary Cancer after Treating Gastrointestinal Cancer
Jeong Youp Park
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The Dyadic Effects of Family Cohesion and Communication on Health-Related Quality of Life: The Moderating Role of Sex
Jung-won Lim, En-jung Shon
Cancer Nursing.2018; 41(2): 156. CrossRef
Physicians’ attitudes towards the media and peer-review selection of the ‘best cancer doctor’: comparison of two different selection methods
Dong Wook Shin, Juhee Cho, Hyung Kook Yang, So Young Kim, Soohyeon Lee, Eun Joo Nam, Joo Seop Chung, Jeong-Soo Im, Keeho Park, Jong Hyock Park
BMJ Open.2018; 8(5): e019067. CrossRef

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Oncologist Perspectives on Rare Cancer Care: A Nationwide Survey: Dong Wook Shin, Juhee Cho, Hyung Kook Yang, So Young Kim, Su Hyun Lee, Beomseok Suh, Hee-Young Shin, Hyun Joo Lee, Dae Ghon Kim, Jong Hyock Park; Cancer Res Treat. 2015;47(4):591-599. Published online January 5, 2015; DOI: https://doi.org/10.4143/crt.2014.086

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Purpose
In response to the challenges and difficulties imposed by rare cancers, multi-stakeholder initiatives dedicated to improving rare cancer care was launched, and several recommendations were made by professional societies. However, these primarily reflect the view of the advocates and supporters, and may not represent the views of the “average” clinician or researcher. In this study, we sought to investigate perceived difficulties with regard to rare cancer care and potential solutions endorsed by oncologists.
Materials and Methods
A representative sample of 420 oncologists recruited in 13 cancer centers participated in a nationwide survey.
Results
Oncologists faced various difficulties in treatment of patients with rare cancers, including the lack of clinical practice guidelines (65.7%) and personal experience (65.2%), lack of approved treatment options (39.8%), and reimbursement issues (44.5%). They were generally supportive of recent recommendations by multi-stakeholder initiatives as well as professional societies for development of clear clinical practice guidelines (66.0%), flexible reimbursement guidelines (52.9%), and a national rare cancer registry (47.4%). However, there was only moderate endorsement for referrals to high-volume centers (35.5%) and encouragement of off-label treatments (21.0%).
Conclusion
Insights into the general attitudes of oncologists gained through our nationwide survey of representative samples would be helpful in development of clinical practices and public health policies in rare cancer treatment and research.

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Dong Wook Shin, Juhee Cho, Hyung Kook Yang, So Young Kim, Soohyeon Lee, Eun Joo Nam, Joo Seop Chung, Jeong-Soo Im, Keeho Park, Jong Hyock Park
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The Lancet Oncology.2017; 18(8): 1022. CrossRef

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