Browsing Over 21 Presentations
Presentation Topic- Psycho-oncology
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- Psycho-oncology
1438P - Effects of tamoxifen on cognitive functions in premenopausal patients with breast cancer: A cross-sectional study
- Valeria Ferencz (Budapest, Hungary)
Abstract
Background
Cognitive side-effects of selective estrogen receptor modulators is a topic of great interest, but the phenomenon has remained less understood. Estrogen receptors are found with significant density in brain regions associated with cognition (e.g., prefrontal cortex, hippocampus), and the benefits of estrogen on cognition are well known. Whether tamoxifen acts as an antiestrogen or estrogen agonist is tissue-specific. It has mainly been studied in peripheral tissues, not in the brain, so less is known about the effect of tamoxifen on cognitive domains.We aimed to investigate the effects of tamoxifen on domain-specific cognitive functions in a cross-sectional study.
Methods
We assigned 45 premenopausal women who were operated on with hormone receptor-positive early breast cancer and treated with tamoxifen and GnRh-antagonist. Neuropsychological assessment contained measurement of complex working memory (Counting Span Test), executive functions (Berg’s Card Sorting Test, Go-No Go Task, Verbal Fluency Tasks), visuo-
Results
Here, we show that the premenopausal treated group had a higher performance than the healthy controls on the shifting component of the executive function task (Berg’s Card Sorting Test). There were no difference between groups' performance on complex working memory, visuo-spatial memory, verbal learning and memory task, and both of groups showed evidence of implicit learning. Groups did not differ from each other in anxiety, depression and perceived/subjective cognitive function.
Conclusions
Our findings suggest that tamoxifen affects specifically cognitive functions such as set-shifting related to dorsolateral prefrontal cortex and anterior cingulate cortex.
Legal entity responsible for the study
Semmelweis University.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
1439P - Sexual health in long-term breast cancer survivors: A comparative study
- Solveig Katrine Smedsland (Oslo, Norway)
Abstract
Background
Sexual challenges are frequently reported by women diagnosed with breast cancer (BC), but knowledge of their long-term sexual health is limited. We aimed to compare sexual health among BC survivors (BCSs) eight years after diagnosis to that of population controls, and to explore the effects of age and systemic BC treatment.
Methods
Women aged 20-65 years when diagnosed with early BC in 2011-2012 were identified by the Cancer Registry of Norway (n=2803) and invited to participate in a questionnaire survey. In total, 1241 BCSs responded and were eligible to this study. Controls were similar aged women (n=17751 of the 36395 invited) from the Trøndelag Health Study. Sexual health was measured by subscales from the EORTC QLQ-BR23 (sexual enjoyment and sexual function) scored from 0-100, and from the Sexual Activity Questionnaire (sexual discomfort) scored from 0-6. Linear regression analyzes with adjustments for sociodemographic variables were performed.
Results
Compared to similar aged controls: • Sexual enjoyment was poorer (B -14.4, CI -16.4, -12.5) and discomfort higher (B 1.0, CI 0.9, 1.1) among BCSs in total • There were no differences in sexual health when assessing BCSs diagnosed at postmenopausal age (≥ 55 years) • BCSs with current use of endocrine treatment had poorer sexual function (B -11.9, CI -14.7, -9.1), poorer enjoyment (B -17.6, CI -21.4, -13.9) and higher discomfort (B 1.4, CI 1.2, 1.7) • BCSs treated with adjuvant chemotherapy had poorer sexual function (B -11.1, CI -12.7, -9.5), poorer enjoyment (B -16.7, CI -19.0, -14.5) and higher discomfort (B 1.3, CI 1.1, 1.4) • BCSs formerly treated with aromatase inhibitor had poorer sexual function (B -10.1, CI -12.9, -7.4), poorer enjoyment (B -16.9, CI -21.0, -12.9) and higher discomfort (B 1.3, CI 1.0, 1.5).
Conclusions
There were no differences in sexual health when comparing BCSs diagnosed at postmenopausal age with similar aged controls - a reassuring finding for postmenopausal women diagnosed with BC. Premenopausal age, adjuvant chemotherapy, current endocrine therapy, and former aromatase inhibitor therapy are risk factors for sexual health challenges in long-term BCSs. During follow-up, special attention with regards to sexual health should be given to BCSs with these risk factors.
Legal entity responsible for the study
National Advisory Unit of Late Effects After Cancer Treatment.
Funding
The Norwegian Breast Cancer Society.
Disclosure
All authors have declared no conflicts of interest.
1440P - Experience of Tunisian young adult cancer patients
- Ahmed Anas Haouari (Tunis, Tunisia)
Abstract
Background
Young adult patients may live differently the cancer experience in terms of disease acceptance, psychological impact, relationships and future projections. We aimed to investigate the experience of young adult patients in the Tunisian context.
Methods
Patients aged 20 - 40 years treated for cancer regardless of type and stage (n=104) were asked to complete a questionnaire in April 2022. The survey included themes about: socioeconomic and psychological impact of cancer, coping strategies, relationships, sexuality and future plans.
Results
We interviewed 78 women (75%) and 26 men (25%); mean age was 33 years old. Thirty-three patients (31.7%) lost their jobs because of sick leaves. Sixty patients (57.7%) revealed financial difficulties. Sadness (54.8%) was the most frequent reaction to disease announcement followed by denial (18.3%) and anger (5.8%). Thirteen patients (12.5%) refused to be informed about disease stage. However, 86 (84.3%) used internet to know more about prognosis and treatment. Spiritual practices were reported by 81.7% of patients. Twenty-three patients (22.1%) reported negative partner reaction: separation (12.5%), indifference (6.7%) and pitiful attitude ( 2.9%). Forty-two patients (40.4%) felt less physically attractive. Negative impact on sexuality was noted in 44.2% of cases. Most fears reported by patients were: recurrence or progression (48%), infertility (48%), leaving their children (12.5%) and dying at young age (8.6%). Forty-three patients (41.3%) reported less self- confidence which was impacted by financial difficulties (OR: 2.77 [1.12-6.87]), physical changes (OR :0.18 [0.07-0.45]) and sexuality (OR: 0.17 [0.06-0.48]). Sixty-three patients (60.6%) preferred not to share same waiting room or day hospital with elderly patients because principally of pitiful comments from others. More psychological care was demanded by 23% of patients. Seventy-eight patients (75%) continued to make future plans mainly patients under 30 (OR: 0.2 [0.04-0.96]). Immigration intention to developed countries was reported by 47.1% of patients because mostly of better health system (61.5%).
Conclusions
Young patients with cancer faced several social and psychological consequences of cancer and may need a dedicated care pathway.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
1441P - Young females at risk for pre-donation worries and lower psychological well-being before haematopoietic stem cell donation
- Jeanette Winterling (Huddinge, Sweden)
Abstract
Background
Physical risks from hematopoietic stem cell donation have been well described, but less is known about psychological aspects of becoming a stem cell donor. In a cross-sectional national survey study, we investigate pre-donation worries and investigate associations between characteristics of prospective donors and psychological well-being.
Methods
A questionnaire was sent to 345 consecutive potential adult stem cell donors at all six Swedish stem cell transplantation centres, from April 2019 to May 2020. The questionnaire consisted of study-specific questions regarding pre-donation worries about the recipient and themselves as donors, the Hospital Anxiety and Depression Scale (HADS) and the SF12 health survey. Multiple linear regression models were used to examine the association between donor characteristics;
Results
With a response rate of 61%, 210 participants were included; 47% related and 53% unrelated to the recipient. Of participants, 39% reported great worry about the recipient and 12% great worry about themselves as potential donors. 21% reported increased anxiety (>8 on HADS-A) and 6% increased symptoms of depression (>8 on HADS-D). Participants’ mean SF12 mental health score was 49.5, below the 52.9 average of the Swedish population. In multivariable regression models, great worry about oneself (2.6 points), lower age (0.8 points /10 years) and female gender (1.2 points) were associated with increased HADS-A score. Great worry about oneself (-4.3 points), lower age (-2.1 points/ 10 years) and female gender (-2.6 points) were associated with lower SF-12 mental health score. No significant association between included variables and HADS-D depression score was found.
Conclusions
A small proportion of potential haematopoietic stem cell donors report great pre-donation worries. Greater pre-donation worry about oneself, lower age and female gender are independently associated with lower psychological well-being.
Legal entity responsible for the study
Uppsala University, Sweden.
Funding
Swedish Cancer Society.
Disclosure
All authors have declared no conflicts of interest.
1442P - Prevalence and factors associated with professional burnout in Polish oncologists: A nationwide survey by Young Oncologists Section of Polish Society of Clinical Oncology
- Pawel Sobczuk (Warsaw, Poland)
Abstract
Background
High rates of burnout are observed among healthcare professionals, which could have negative consequences on personal and organizational levels. We aimed to evaluate the burnout prevalence and factors associated with burnout oncologists in Poland.
Methods
A survey was conducted using the validated Maslach Burnout Inventory - Human Services Survey (MBI-HSS) and additional work/lifestyle questions. Descriptive statistics, parametric and nonparametric tests, and multivariate logistic regression were used to identify factors associated with burnout.
Results
211 physicians participated in the study. The majority were females (71.6%) and ≤40- years of age (70.1%). Clinical oncology/hematology was the most common specialization (79.6%). The median time of working in cancer care was 10 years (range 1-45), and 30.8% of participants were in-training. 65.9% have reported a subjective feeling of burnout. Based on the MBI-HSS, 74.9% showed evidence of burnout (burnout subdomains: depersonalization 37.0%; emotional exhaustion 64.5%; low accomplishment 43.1%), with no differences between specialization (oncology/hematology - 75.6%, radiotherapy - 72.1%), career stage, gender or age groups. The most commonly reported symptoms of burnout were feeling of excessive workload (71.9%) and lack of energy (71.1%). The main feeling associated with work were anxiety (55.7%), nervousness (36.4%), and indifference (32.0%). Lack of work/life balance was the only significant factor associated with the risk of burnout in logistic regression (RR 2.6; 95%CI 1.3-5.4). Only 20.9% had access to psychological support in their workplace; however, 70.1% wished to have it, mainly through individual consultations (56.4%). Three main factors impacting burnout in cancer care workers were: bureaucracy/administrative duties overload (63.2%), a high number of patients (49.1%), and poor work culture (40.4%).
Conclusions
Burnout is common among medical and radiation oncologists in Poland. There is a high need for psychological support and organizational changes in the workplace to reduce risk and mitigate the adverse effects of burnout among healthcare professionals.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
P. Sobczuk: Financial Interests, Personal, Travel grant: Novartis; Financial Interests, Personal, Travel Grant: MSD, Pierre Fabre, BMS; Financial Interests, Personal, Invited Speaker: Swixx BioPharma, BMS, Gilead; Financial Interests, Personal, Stocks/Shares: CelonPharma; Non-Financial Interests, Leadership Role, Board Member, Chair of Young Oncologists Section: Polish Society of Clinical Oncology. A. Gawlik-Urban: Financial Interests, Personal: BMS, Novartis. D.S. Sigorski: Financial Interests, Personal: Astellas; Financial Interests, Personal, Invited Speaker: Gilead, Novartis. A. Brodziak: Financial Interests, Personal: Novartis, Sanofi, Merck, Servier, Astra Zeneca, IQVIA; Financial Interests, Personal, Invited Speaker: Janssen. J. Kiszka: Financial Interests, Personal, Invited Speaker: Amgen, Gilead; Financial Interests, Personal: Novartis. M.N. Osmola: Financial Interests, Personal: Angelini Pharma, Novartis; Financial Interests, Personal, Invited Speaker: Gilead. K.E. Machulska-Ciuraj: Financial Interests, Personal, Other: Novartis, BMS, Pfizer. M. Wilk: Financial Interests, Personal, Invited Speaker: Bayer, Janssen, Amgen, Pfizer; Financial Interests, Personal, Other: Bayer, Amgen, Pfizer.
1443P - Intimate partner violence in cancer patients: An SOS call
- Ines Lajnef (Tunis, Tunisia)
Abstract
Background
Intimate partner violence (IPV) is a critical problem worldwide. The subject remains a taboo especially in Arab countries were reported IPV prevalence ranged from 6% to 59%. Data about the combination of IPV and cancer is missing. The aim of the present study was to measure the frequency and types of IPV among patients with cancer and evaluate risk factors.
Methods
The study was a cross sectional, questionnaire-based study, conducted between January and April 2022, including 141 patients treated with cancer regardless of gender, site, or stage. We developed the study questionnaire by adapting items from the “WHO multi-country questionnaire on violence against women” and “The Women’s Experiences with Battering Scale”. Odds ratio (OR) and Spearman tests were performed to assess the impact of several factors associated with the reported IPV.
Results
Median age was 50.8 yo, 38.3% were male cancer patients. Patient reported to have a highschool or university educational level (EL) in 76% and a stable job at the moment of the study in 49%. IPV prevalence was 24.8%, we observed 5 cases of torture (3%). The most common forms of violence were: placing severe restriction on certain types of food in 21% of cases, psychological violence (absence of kindness and critsism) in 20%, exposing intimate information about the patient health status in 17%, ignoring and not speaking to the patient in 13.5%, putting restrictions on visiting relatives in 9.2%, verbal assault in 9.2%, physical violence in 7.9%. There was no difference in the incidence of IPV neither in the forms of violence between man and women. The only difference of reported IPV forms between man and women was “divorce threats”, observed in 9% of women vs 0% in man (p=0.02). We observed a significant correlation between IPV prevalence and disease stage (34.6% M1 vs 19.1% M0, p=0,04, OR=2.2 [1-4.8]), patient’s EL (48.5% none-primary school vs 17.6%, p=0.01, OR= 4.4 [1.8-10.2]) and being under cancer therapy (30.9% vs 11.4%, p=0.013, OR=3.4 [1.2-9.7]).
Conclusions
Patients were shown to be victims of several forms of IPV regardless of gender and highly correlated with a low educational level and disease stage. Implementation of both; intervention strategies to take care of victims and preventive strategies supporting patients and their partners is needed.
Legal entity responsible for the study
Boussen Hamouda.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
1444P - Cancer diagnosis communication: The perspective of oncologists, patients and caregivers
- Chiara Paratore (Orbassano, Italy)
Abstract
Background
Effective cancer communication can improve patients’ awareness about health status, build trusting relationship and handle emotional distress. We aimed to describe the perspectives of doctors, patients and caregivers on cancer diagnosis communication and on its implications.
Methods
In April 2022, a survey about cancer diagnosis communication was conducted across three institutions in Piedmont, Italy. Three different questionnaires with similar items were administered to patients, caregivers and oncologists. We included patients affected by solid tumours without restriction for histology and stage. We performed a descriptive analysis as pivotal evaluation for designing an observational multicentre study.
Results
52 subjects were recruited: 9 patients, 6 caregivers, 37 oncologists; median age 37 yrs old; 29 (56%) females. Oncologists’ communicative skills were rated as adequate and completely satisfying by 33 (89%) and 2 (5%) physicians, respectively. Communication experience with doctors was described as adequate and completely satisfying by 6 (40%) and 9 (60%) by the group of patients-caregivers, respectively. End of life and progression disease communication were the most stressful topics according to 18 (49%) and 7 (19%) oncologists. In 94% of cases, doctors and patients-caregivers agreed that the setting, time available and language used were adequate for the dialogue. Interruptions during visits were considered relevant by 31 (84%) doctors and 1 caregiver only. More than 90% of interviewed reported that doctors verified the patient's level of awareness about disease before starting communication. 25 (68%) oncologists inquired what clinical details patients would like to receive. Oncologists provided a potential proper time to discuss with patients about their concerns according to 13 (87%) patients-caregivers and 33 (81%) doctors. 16 (43%) oncologists followed training courses on communication and 8 (22%) provided cancer communication with psycho-oncologists (up to 4 times per year).
Conclusions
Oncologists, patients and caregivers reported a discrete satisfaction regarding cancer communication experience, although this data requires further validation on a larger observational study.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
1445P - Family dynamics of pediatric oncology patients in a level III clinic in the city of Cali
- Valeria Santa Ovalles (Cali, Colombia)
Abstract
Background
Cancer is usually visualized in the body and how it is affected; however, family dynamics and its relationship with adherence to treatment and its impact on mental health are not very visible, due to the disease itself, the multiple aggressive treatments to combat it, and the context in which the subject is immersed. Therefore, the objective of this study was to analyze the family dynamics of pediatric oncology patients in an III-level clinic in the city of Cali, Colombia.
Methods
Simultaneous mixed study with 80 patients between 2 and 18 years of age with oncological diagnosis and their families. Discourse content analysis was performed on the clinical records; following the SRQR protocol for qualitative studies.
Results
Five categories were found around which the family dynamics were organized: reactions to pediatric cancer diagnosis, family alterations in the face of pediatric cancer, emotional impact on the caregiver's life, spirituality as a coping strategy in childhood cancer, and coping with death: building a new meaning of life. A different emerging subcategory from the literature related to the detriment of the oncologic process and mental health was social/cultural violence.
Conclusions
The oncological treatment goes beyond the disease or physiological affectations; the recording of family dynamics allows the incorporation of family changes about the diagnosis and the evolution of the treatment, which contribute to the physical and mental recovery of the patient.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
1446P - Barriers and facilitators for genetic/epigenetic screening trials attendance in healthy populations at high-risk for cancer: A qualitative study
- Serena Oliveri (Milan, Italy)
Abstract
Background
For several tumors the possibility to detect suspected lesions in early stages could make a difference between life and death. New directions in research projects and cancer screening trials (CST) aimed at stratifying populations at high risk (HR) for cancer by integrating omics, imaging data and epidemiologic risk factors. A comprehensive understanding of factors that hinder or enhance participant’s adherence to these trials is needed, to also improve the criteria and approach to returning results. The aims are a) identify facilitators and barriers influencing HR populations’ adherence to CST; b) compare the effect of constructs from the Health Belief Model (HBM) and the Theory of Planned Behaviors (TPB) on the decision-making process.
Methods
3 Focus Group Discussions (FGDs) were conducted with 1st-degree relatives of cancer patients (N=18). Transcripts from the FGDs were analyzed using NVivo software to perform thematic analysis.
Results
Preliminary results identified two main facilitators and two main barriers. The facilitators were: a) the availability of a structured prevention program in association with the genetic/epigenetic returning of result; b) the reception of detailed information and counseling concerning the probabilistic/uncertain nature of genetic/epigenetic data. The barriers were: a) the psychological impact of “negative” screening results on participants and their families; b) younger age and related perception of personal risk. Social norms and perceived behavioral control (TPB) seem not crucial constructs in the decision-making process, whereas constructs such as knowledge, perceived susceptibility, perceived seriousness, preventive behaviors and cues to actions (HBM) might explain HR subject’s adherence to cancer screening trials.
Conclusions
Technological advances in (epi)genetics, diagnostic technologies and clinical trials for cancer screening must be matched by parallel advances on how we support the informed choices, essential to public participation. Our study contributes to the promise of 4P medicine personalizing preventive screening interventions at the psychosocial dimension, as well as biological dimension.
Legal entity responsible for the study
AD Istituto Europeo di Oncologia (IEO).
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.