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The European Journal of Cancer Care aims to encourage comprehensive, multiprofessional cancer care across Europe and internationally.
Chief Editor Prof. David Weller is currently the Professor of General Practice at the University of Edinburgh and leads the Cancer and Primary Care Research International Network (Ca‐PRI). His research focuses on primary and secondary health care, and early detection of cancer.
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Patient Experiences of a Telehealth Multidisciplinary Cancer Rehabilitation Programme: Qualitative Findings from the [email protected] Feasibility Study
Purpose. Multidisciplinary rehabilitation programmes providing exercise, nutrition support, education, and peer support can effectively meet the rehabilitation needs of upper gastrointestinal (UGI) cancer survivors. This study aimed to explore the experiences of participants who engaged in a telehealth, multidisciplinary rehabilitation programme for UGI cancer survivors. Methods. This single-arm feasibility study recruited participants who completed curative treatment for UGI cancer. Participants (n = 10, male = 9) aged 58–76 years were 5–17 months postsurgery. A 12-week telehealth rehabilitation programme was delivered via video call, consisting of group resistance training, remotely monitored aerobic training, 1 : 1 dietary counselling, 1 : 1 physiotherapy support, and group education sessions. Independent researchers conducted semistructured interviews at postintervention assessments. Transcripts were analysed using reflexive thematic analysis (RTA). Results. RTA of participant transcripts generated three overarching themes: (1) [email protected] impacted psychosocial and physical needs by addressing a broad and meaningful gap in services, (2) paving a pathway towards prosperity, and (3) contrasting experiences with using technology. Participants’ preferences and recommendations for future telehealth programmes were discussed. Conclusions. A telehealth multidisciplinary rehabilitation programme supported participants in physical and psychosocial recovery. Qualitative analysis identified an important ongoing need for some in-person care and provided detailed insights into participant experiences during telehealth-delivered rehabilitation.
Prevalence of Cachexia in Cancer Patients
Introduction. Cachexia is a syndrome characterized by the loss of musculoskeletal mass, with or without adipose mass, which cannot be reversed by nutritional support. In Chile, there are no data on cachexia in cancer patients that allows for decision making on better interdisciplinary management. In this study, the prevalence of cachexia in inpatient and outpatient cancer patients was investigated. Methods. An observational, descriptive, and cross-sectional study was carried out. Eighty-six inpatients and outpatients were evaluated. Cachexia was evaluated by applying the miniCASCO tool, its weight by bioimpedance, and inflammation by blood parameters. Comparisons and correlations were made considering as the threshold for statistical significance. Results. Forty patients met the inclusion criteria, 35% were men and 65% were women. In all, 27.5% of patients had cachexia secondary to cancer. Of the total number of patients with the syndrome, approximately 45.4% had mild cachexia, 36.3% had severe cachexia, and 18.1% had moderate cachexia. In addition, there was a significant positive correlation and moderately strong (r = 0.7209) match between the final scores and the stage of cancer. Conclusion. The prevalence of cachectic patients is reported for the first time through the application of the miniCASCO tool. A moderate positive match was detected between the final miniCASCO score and the stages of cancer patients. Finally, an early discovery of cachexia would allow therapeutic interventions aimed at improving the prognosis of cancer patients.
Effect of CCR2-V64I on the Susceptibility of Patients to Cancer
Background. Results from the studies investigating the impact of CC chemokine receptor 2 (CCR2) polymorphism on the risk of cancers are diverse. An updated meta-analysis was conducted to access the relationship between cancer risk and CCR2-V64I polymorphism. Methods. We performed a meta-analysis using STATA 11.0 based on a comprehensive retrieval in WanFang Data, PubMed, China National Knowledge Infrastructure, EMBASE, and Web of Science databases up to January 20, 2023. Results. We included 23 studies in our analysis. Overall, we found CCR2-V64I polymorphism was remarkably related to cancer risk (OR = 1.39, 95% CI = 1.14–1.70, and for A vs G; OR = 1.87, 95% CI = 1.30–2.70, and for AA vs GG; OR = 1.35, 95% CI = 1.03–1.78, and for GA vs GG; OR = 1.45, 95% CI = 1.11–1.90, and for AA + GA vs GG; OR = 1.69, 95% CI = 1.20–2.37, and for AA vs GA + GG). In the ethnicity subgroup analysis, the relevancy between CCR2-V64I polymorphism and an increased cancer risk was discovered among Asians (OR = 1.57, 95% CI = 1.30–1.91, and for A vs G; OR = 2.30, 95% CI = 1.64–3.24, and for AA vs GG; OR = 1.35, 95% CI = 1.10–1.67, and for GA vs GG; OR = 1.52, 95% CI = 1.25–1.87, and for AA + GA vs GG; OR = 2.21, 95% CI = 1.58–3.08, and for AA vs GA + GG). In addition, the subgroup analysis in the light of cancer types demonstrated that CCR2-V64I polymorphism was strongly correlated with bladder cancer (OR = 3.04, 95% CI = 1.09–8.45, and for AA vs GG; OR = 2.84, 95% CI = 1.07–7.09, and for AA vs GA + GG) and oral cancer (OR = 1.83, 95% CI = 1.39-2.42, and for A vs G; OR = 2.04, 95% CI = 1.47–2.85, and for GA vs GG; OR = 2.03, 95% CI = 1.48–2.79, and for AA + GA vs GG). Conclusion. The meta-analysis suggested that CCR2-V64I polymorphism might be a high-risk factor for cancers among Asians, especially for bladder and oral cancers.
The Development of Ambulatory Cancer Care in the UK: A Scoping Review of the Literature
Introduction. Ambulatory Care (AC), where patients receive inpatient cancer treatment on an outpatient basis, was introduced into the United Kingdom (UK) National Health Service (NHS) in 2004. Although now well established within some services, the development of AC across the NHS is yet to be described. We report findings of a scoping review that set out to understand the provenance of the clinical pathway, whilst exploring drivers for the development of AC in the UK. Methods. Using scoping review methods, database citation, and grey literature, searches were undertaken to map the storyline of AC’s development internationally. The Joanna Briggs Institute guidance was followed; this included consultation with six professionals considered critical to the development of AC. Results. From the 57 records identified between 1979 and 2022, four domains were identified through a narrative synthesis that reflected the following drivers for AC: financial; optimisation of bed capacity; advances in technology and supportive care; and professional motivation to improve patient experience. Conclusion. We report the first descriptive analysis of the international development of AC, locating the UK cancer service within its commissioning, operational, and philosophical foundations. The review additionally highlights limited research exploring the experience of the AC model from the patients’ perspective.
Multimodal Exercise in Older Patients with Advanced Pancreatic Cancer Undergoing First-Line Chemotherapy: A Case Series Examining Feasibility and Preliminary Efficacy
Purpose. Exercise is emerging as an adjunct therapy to cancer treatment; however, its role in older patients with advanced pancreatic cancer undergoing first-line chemotherapy is unclear. The aim of this study was to primarily provide evidence on feasibility with an exploratory examination of the initial efficacy of exercise in this clinical setting. Materials and Methods. Six patients aged 60–75 years with de novo or recurrent advanced pancreatic cancer undergoing first-line chemotherapy consented to participate in twice-weekly exercise that included resistance and aerobic training and boxing-related activities for up to 12 weeks. Patients were monitored for attendance, adherence, and adverse events. Body composition, muscle strength, functional ability, patient-reported outcome measures, and patient-reported experience measures were assessed at baseline and/or postintervention. Results. Of the 6 patients, 1 withdrew after baseline testing and 5 attended 42%–95% of planned sessions and adhered to 28%–83% of the prescribed exercise. There were no serious exercise-emergent adverse events. All 5 patients increased or maintained lean mass (0.1%–4.4%) and 4 reduced fat mass (−0.4%–−8.6%). Improvements were observed in 4 or all 5 patients for muscle strength (7.1%–75%), 5 times sit-to-stand (1.3%–21.4%), 6-m backward walk (16.5%–35.8%), and patient-reported outcomes. Furthermore, all patients perceived exercise as very helpful in managing their cancer and expressed a strong willingness to continue exercise in the future. Conclusion. A multimodal exercise program appears feasible with potential physical and psychological benefits for older patients with advanced pancreatic cancer undergoing first-line chemotherapy. Further research including a larger sample size is warranted.
Prognostic Analysis on Different Tumor Sizes for 14634 Hepatocellular Carcinoma Patients
Aim. This study investigated the effect of tumor size and other factors on the survival and prognosis of hepatocellular carcinoma (HCC). Methods. All HCC populations based on the National Cancer Institute’s SEER database to receive from 2010 to 2016 were employed in the study. Results. This study enrolled a total of 14,634 HCC. Among them, 1,686 patients had tumors ≤ 2 cm, 6,169 patients had tumors 2–5 cm, and 6,779 patients had tumors > 5 cm. The results using univariate analysis showed that all factors were significant prognostic factors for overall survival and specific survival. Patients with tumor size ≤ 2 cm were more likely to survive, while patients with tumor size > 5 cm had a lower survival rate. Patients who had surgery or surgery plus chemotherapy had a higher chance of survival in stages I-II, and the survival rate declined smoothly during the 80 months. The change rate of the mortality rate increased rapidly during the period of 1–12 cm; afterwards, the mortality rate’s HR was basically and smoothly maintained at a high level. Conclusions. Tumor size was positively correlated with the mortality rate of HCC. Survival rates were greater in patients with tumors ≤ 2 cm who underwent surgery or surgery plus chemotherapy. Patients with HCC in the early stage had a higher survival probability particularly when they had experienced surgery or surgery plus chemotherapy.