Search Results (92)

The literature on the qualitative experiences of patients with non-Hodgkin lymphoma (NHL) is limited. Qualitative interviews were conducted to investigate participants’ experiences with two types of NHL (diffuse large B-cell lymphoma [n = 20] and mantle cell lymphoma [n = 10]) and evaluate the comprehensiveness of patient-reported outcome (PRO) measures. Fatigue, tiredness, body aches, night sweats, lethargy, headache, appetite loss, altered taste, and weakness were the most frequent and bothersome symptoms. Key impacts were decreased physical performance, restricted activity, sadness, distress, fear of recurrence, and worry about future. Most participants expressed positive opinions about the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire–Core 30 (EORTC QLQ-C30) (n = 22/28), EORTC QLQ-NHL-High Grade Module 29 (EORTC QLQ-NHL-HG29) (n = 12/16), EORTC QLQ-NHL-Low Grade Module 20 (EORTC QLQ-NHL-LG20) (n = 8/12), and Functional Assessment of Cancer Therapy–Lymphoma (FACT-Lym) (n = 10/14), considering them relevant to their experiences (22/27, 13/15, 9/13, and 10/12, respectively). All measures adequately captured their experiences with NHL (QLQ-C30: n = 26/26, NHL-HG29: n = 14/14, NHL-LG20: n = 11/11, and FACT-Lym: n = 12/13). These findings provide a valuable framework for informing the selection of appropriate PRO measures in NHL clinical trials and identifying potentially meaningful trial endpoints. Full article

Background/Objectives: Mindfulness has been identified as a protective factor in promoting adaptive psychological outcomes among cancer patients, yet the mechanisms linking mindfulness to fundamental existential beliefs, such as basic hope, remain underexplored. In addition, mediational processes underlying these relationships remain understudied. Building on the theoretical framework of Acceptance and Commitment Therapy, we tested a serial multiple mediation model in which illness acceptance and fear of recurrence sequentially mediated the association between mindfulness and basic hope. Methods: Adult patients diagnosed with pelvic cancer (N = 273) who were undergoing oncological treatment completed questionnaires measuring mindfulness, illness acceptance, fear of recurrence, and basic hope. Mediation analysis was used to examine multiple mediation effects. Results: Illness acceptance also functioned as a single mediator between mindfulness and basic hope. In contrast, fear of recurrence was not a mediator between mindfulness and basic hope. The main finding was the serial mediation pathway through illness acceptance and fear of recurrence. The indirect effects showed that mindfulness was positively associated with illness acceptance dimensions—life satisfaction during illness, reconciliation with the disease, and self-distancing from the disease—which, in turn, were negatively associated with fear of recurrence, ultimately relating to higher levels of basic hope. Conclusions: The findings highlight the critical role of acceptance- and fear-related processes in sustaining basic hope among cancer patients and suggest that mindfulness-based interventions may foster adaptive adjustment to illness. Implications for clinical practice include integrating mindfulness and acceptance-focused strategies to enhance hope and support emotional well-being in patients coping with cancer. Full article

Introduction: Distress during pediatric magnetic resonance imaging (MRI) neuroimaging can compromise scan quality and negatively impact children’s experiences. This review aimed to systematically synthesize biomarkers and psychological factors associated with distress in children, adolescents, and young adults undergoing neuroimaging. Methods: This systematic review was conducted according to PRISMA and AMSTAR-2 guidelines and preregistered in OSF. A systematic search was performed in six electronic databases, including observational articles published between 2000 and 2025 that assessed distress during MRI and functional MRI (fMRI). Data extraction and risk of bias assessment (QUIPS tool) were performed independently by two reviewers. Results: Ten studies (n = 558) examining distress during neuroimaging were included in this review. Distress was assessed through subjective self- and parent-reports, objective physiological measures, and qualitative interviews. Overall, distress levels were low to moderate; most participants tolerated scans well, though younger age, male sex, parental anxiety, procedure length, and chronic illness were associated with greater discomfort. Noise, immobility, and boredom emerged as the most frequent triggers, while strategies such as distraction, age-appropriate information, and reducing waiting times were perceived as helpful. Among participants with cancer, scan-related anxiety was closely linked to fear of recurrence and perceived stress. Risk of bias across studies was moderate to high, particularly in domains of attrition and statistical reporting. Conclusions: Distress during scanning is driven by anticipatory and parental anxiety, procedure length, and chronic illness. Biomarkers (e.g., cortisol, blood pressure) showed inconsistent links with subjective distress, highlighting the need for integrated measures. Full article

Objective: To characterize the distribution of FCR severity across survivorship time intervals in bladder cancer survivors. Methods: A cross-sectional study of 79 patients utilized the validated 9-item FCR Inventory-Short Form (FCRI-SF) to assess overall FCR severity. Primary analysis employed Spearman’s correlation coefficient to evaluate the relationship between time elapsed since the first procedure and total FCR scores. Patients were stratified into four temporal groups (<1, 1–2, 2–5, and >5 years). Inter-group variability in FCR scores was assessed using Levene’s test for equality of variances. Subgroup analyses compared FCR scores across clinical subgroups, including tumor grade and smoking history, using the Mann–Whitney U test. Multivariate logistic regression identified independent predictors of clinically significant FCR (total score ≥13). Results: Median patient age was 72.0 years (IQR 66.0–78.0), with a median of 24.0 months post-diagnosis. Clinically significant FCR (score ≥13) was prevalent in 55.7% of the cohort. Spearman correlation analysis revealed no significant relationship between months elapsed and FCR severity (rho = 0.068, p = 0.552). Patients in the 12–24 month window exhibited the highest variability (Levene’s test, p = 0.058), representing a period of clinical divergence. High-Grade disease and smoking cessation motivated by diagnosis were associated with higher FCR scores. In the multivariate logistic regression model, history of tumor recurrence was the sole independent predictor of clinically significant FCR (aOR 3.28, 95% CI 1.11–9.68, p = 0.031), whereas age and gender were not significantly associated. Conclusions: FCR severity did not demonstrate a significant association with time elapsed since diagnosis in this cross-sectional sample. The 1–2 year interval demonstrated greater inter-individual variability in FCR scores. Findings highlight the need for long-term, structured survivorship support, particularly targeting the 12–24 month post-diagnosis window. Full article

Background/Objectives: Although illness perception has been examined in oncology populations, there is a lack of empirical studies focusing specifically on post-treatment thoracic cancer patients and on the mechanisms through which illness perception relates to fear of cancer recurrence and generalized anxiety. In particular, prior research has rarely tested meaning-making and changes in beliefs and goals as mediating factors. This study aimed to examine the mediating roles of meaning-making and changes in beliefs and goals within a serial multiple mediation model between illness perception, fear of recurrence, and generalized anxiety. Method: A cross-sectional study was conducted with 284 thoracic cancer patients (149 men and 135 women) who had completed treatment. Participants completed validated self-report measures assessing illness perception, meaning-making, changes in beliefs and goals, fear of cancer recurrence, and generalized anxiety. Hierarchical regression analyses and serial multiple-mediation models based on path analysis were employed to examine direct and indirect associations among variables. Results: Negative illness perception was positively associated with fear of recurrence and generalized anxiety, while positive illness perception predicted lower levels of both outcomes. Path analyses revealed that meaning-making and changes in beliefs and goals jointly mediated the relationships between illness perceptions and psychological distress. Specifically, adaptive meaning-making and belief–goal restructuring were associated with lower fear of recurrence and generalized anxiety, whereas maladaptive forms were associated with higher levels of both outcomes. Conclusions: Findings indicate that both negative and positive illness perceptions influence post-treatment emotional adjustment in thoracic cancer patients through mediation effects. Based on the meaning-making model, interventions targeting maladaptive illness perceptions, promoting meaning-making, and supporting adaptive changes in personal beliefs and goals may reduce fear of recurrence and anxiety. These results support the incorporation of meaning-centered strategies into psychosocial oncology care, emphasizing cognitive–motivational cognitive-motivational factors as critical targets for improving emotional well-being in cancer survivorship. Full article

Fear of cancer recurrence (FCR) is a significant but understudied concern among parents of childhood cancer survivors. This study quantitatively characterized parental FCR and explored potential demographic and clinical correlates among parents of children treated for cancer. Parents (N = 192) completed the Fear of Cancer Recurrence Inventory-Parent Short Form (FCRI-Parent) and provided demographic information. Clinical variables were obtained from medical chart review. Associations between FCR and demographic or clinical variables were analyzed using t-tests, ANOVAs, and Pearson’s correlations. Parents reported a mean FCR score of 18.64 (SD = 8.73), with 42.2% of parents endorsing FCR above a score of 22. Parental FCR significantly varied by parent race, education, and spirituality. Higher FCR was also significantly negatively correlated with child age, time since diagnosis, and time since treatment completion. Parents of children with central nervous system tumors or hematological malignancies endorsed significantly higher FCR compared to parents of children with solid tumors. Findings build on previously identified psychosocial needs for parents of children treated for cancer by quantitatively describing parental FCR and exploring subgroups that may be at increased risk for FCR. Tailored interventions, including strategies that support spiritual coping, may help mitigate FCR among at-risk parents. Full article

Background/Objectives: Endocrine therapy (ET) is a common treatment for hormone-dependent breast cancer and is associated with a significant reduction in recurrence and mortality rates. However, the decision to initiate endocrine therapy is a critical and often distressing juncture for patients. The need to weigh its survival benefits against the potential burden of side effects, including mood changes, pain, muscle stiffness, and fatigue, can render this decision-making phase a source of significant distress. The present systematic review aimed to identify and synthesize the sociodemographic and psychosocial predictors of the decision-making process related to ET adherence among women with breast cancer. Methods: A systematic literature search was conducted in three electronic databases—PubMed Central, ProQuest, and Scopus—to identify studies examining the association between sociodemographic and psychosocial factors and the decision-making process regarding ET among women with breast cancer. Inclusion criteria encompassed cross-sectional studies published between 2000 and 2025. Data were extracted and analyzed to identify recurring predictors across studies. The findings were synthesized through a narrative synthesis. Results: Twelve cross-sectional studies met the inclusion criteria, comprising a total of 8510 women diagnosed with breast cancer and undergoing ET. Ten studies (83%) identified sociodemographic variables—such as age, marital status, educational level, and ethnicity—as significant predictors of decision-making. Moreover, nine studies (75%) reported psychosocial factors, including quality of life (QoL), fear of progression, infertility concerns, and social support, as influential in the decision to initiate or continue ET. Specifically, the decision to adhere to ET is generally supported by younger age, higher education, better perceived quality of life, and greater social support. Conversely, it is hindered by lower income, lower education, fertility concerns related to marital status, and diminished quality of life. Conclusions: The findings of this review indicate that both sociodemographic and psychosocial factors play key roles in shaping women’s decisions regarding adherence to ET. Understanding these predictors can facilitate decision-making and inform the development of targeted interventions aimed at improving treatment adherence and supporting patient-centered care in breast cancer treatment. The focus on decision-making processes, rather than on adherence rates, is what distinguishes this review from other systematic reviews. Full article

Background and Objectives: Bladder cancer (BC) represents a significant global health burden, ranking as the tenth most commonly diagnosed malignancy worldwide, with an incidence rate of 5.6 per 100,000 person-years annually. The research team aimed to summarize evidence on specialized nursing-led interventions for bladder cancer management across the disease continuum. Materials and Methods: This scoping review used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) methodology to search four databases from January 2018 to November 2025. Results: This concise but informative scoping review of 20 studies revealed substantial clinical and patient-reported benefits from specialized nursing interventions. Enhanced recovery after surgery (ERAS) protocols incorporating structured nursing care demonstrated a 35% reduction in postoperative complications. Integrated nursing interventions during postoperative intravesical therapy significantly improved patient satisfaction, treatment compliance, and self-efficacy while reducing anxiety and depression. Digital health platforms, including internet-based and mobile applications, proved effective in reducing caregiver burden, enhancing disease knowledge, and improving coping strategies. Preoperative stoma education and postoperative ostomy care management significantly improved self-efficacy, stoma care knowledge, and overall health-related quality of life. Psychosocial interventions, including cognitive behavioral therapy and mindfulness-based approaches, demonstrated significant improvements in quality of life and reductions in fear of recurrence, depression, and anxiety. However, a critical evidence gap exists regarding bladder cancer-specific mental health interventions. Conclusions: Specialized nursing-led care plays a critical role in strengthening clinical and assistive practice in bladder cancer. Evidence from this scoping review shows that nursing-led interventions significantly improve clinical outcomes, patient satisfaction, symptom management, and quality of life across all phases of bladder cancer care while reducing caregiver burden and enhancing psychological well-being for both patients and families, reinforcing the value of integrating specialized nursing roles into routine bladder cancer management. Full article

Purpose: This study examined the relationships among fear of cancer recurrence (FCR), unmet healthcare needs, and quality of life (QOL) among breast cancer survivors post-treatment, particularly within the Thai cultural and healthcare context, where limited research has been conducted. Methods: A cross-sectional descriptive correlational design with purposive sampling was used. A total of 122 breast cancer survivors, 1–5 years prior, were recruited from the Breast Clinic and Chemotherapy Unit at the National Cancer Institute. Instruments included a demographic questionnaire, the FCR Inventory Short Form, the Cancer Survivors’ Unmet Needs measure, and the EORTC QOL-C30 with the breast cancer module (QLQ-BR23). Cronbach’s α ranged from 0.82 to 0.92. Data were analyzed using descriptive statistics, Spearman’s rank correlation, and Pearson’s correlation coefficient. Results: Participants reported moderate levels of FCR (M = 13.39, SD = 4.50), low unmet healthcare needs (M = 25.63, SD = 14.82), and moderate overall QOL (M = 54.82, SD = 0.22). FCR was negatively correlated with overall QOL (r = −0.248, p <0.01) and functional QOL (r = −0.242, p < 0.01). Unmet healthcare needs were also negatively correlated with overall QOL (r = −0.261, p < 0.01). Multiple linear regression analysis revealed that both FCR and unmet healthcare needs had a significantly negative relationship with overall QOL (p < 0.05). Conclusions: FCR and unmet healthcare needs independently impair QOL among breast cancer survivors. Early, culturally appropriate survivorship care in Asian contexts is essential to address these needs and improve QOL. Full article

Background: Radspherin^® is a novel α-emitting radiopharmaceutical administered intraperitoneally following complete cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) for peritoneal metastases. It delivers short-range radiation aimed at eliminating residual microscopic disease. This qualitative study explored how participants with colorectal cancer experienced participating in an early-phase clinical trial involving CRS-HIPEC followed by Radspherin^®. Materials and Methods: Semi-structured interviews were conducted with ten participants enrolled in a phase 1/2a trial involving CRS-HIPEC and intraperitoneal Radspherin^®. The analysis was guided by a phenomenological and interpretive approach using reflexive thematic analysis. Results: Participants expressed a strong sense of motivation and hope tied specifically to receiving Radspherin^®, which they perceived as an opportunity to improve their prognosis. Many also viewed participation as a contribution to future cancer research. None attributed complications or side effects to Radspherin^®. Clear and supportive verbal communication from healthcare professionals was highly valued, while the written information was described as overwhelming. Despite fears of recurrence, most participants remained optimistic about regaining a meaningful life. While experiences with Radspherin^® were largely positive, participants also described pain, fatigue, and prolonged recovery related to CRS-HIPEC, including ongoing functional and psychosocial challenges. Conclusions: Participants associated Radspherin^® with hope and a therapeutic benefit but did not link it to their adverse events. Their willingness to participate in experimental treatment was shaped by trust in clinicians, clear communication, and a desire for extended survival. However, the burden of CRS-HIPEC-related side effects underscores the importance of tailored follow-up and support. Full article

Background: Despite advances in diagnosis and treatment, the psychosocial impact of skin cancer remains relatively underexplored. The aim of this study was to explore the emotional experiences of people diagnosed with melanoma and cutaneous squamous cell carcinoma (SCC) and their evolution over time. Methods: A qualitative study was conducted using semi-structured interviews. Purposive sampling was employed, taking into account gender, age, tumour type and tumour stage. Interviews were audio-recorded, transcribed verbatim and analysed thematically. Results: Thirty-six patients were recruited (18 with melanoma and 18 with SCC). Overall, 61.1% were men and the mean age was 63.8 years (SD 10.8). The analysis revealed three main themes: feelings, relationships and life changes. Patients in both groups experienced a range of emotions following diagnosis, such as anxiety, relief and fear of recurrence. Family dynamics played a crucial role in patients’ experiences, acting as both a source of support and a cause of concern. The diagnosis prompted changes in everyday life, affecting work, daily activities and patients’ sense of identity. Conclusions: The diagnosis of melanoma or SCC has a profound emotional and existential impact on patients. Personalised care is crucial to address their evolving concerns and information needs. Further research is needed on the long-term impact of skin cancer and the benefits of psycho-oncological support. Incorporating patients’ perspectives into current skin cancer guidelines should be considered. Full article

The study aimed to understand how patients with liver cancer experience and adapt to the fear of cancer recurrence, providing insights into psychological processes and strategies that can inform psycho-oncology research and interventions. In-depth interviews were conducted with 13 patients with liver cancer from December 2019 to February 2020 and analyzed using Colaizzi’s phenomenological method. Four theme clusters emerged: (1) “Inevitable reality of recurrence,” which highlighted the acceptance of recurrence; (2) “Amplified fears,” which reflected heightened emotional distress; (3) “Changes in daily life driven by fear,” which illustrated lifestyle changes driven by uncertainty; and (4) “Living with fear,” which described adaptive strategies and resilience. The findings highlight the need for targeted psycho-oncological approaches to address the fear of cancer recurrence in patients with liver cancer, supporting the development of resilience and enhancing their overall quality of life. Further research is essential to design tailored strategies that reduce psychological distress and promote long-term survivorship. Full article

The aim of this study was to explore the longitudinal relationship between death anxiety (DA) and fear of cancer recurrence (FCR) in women newly diagnosed with breast cancer at baseline and 3 months post-discharge. A total of 426 women with breast cancer completed the Templer’s Death Anxiety Scale and the Fear of Cancer Recurrence Inventory at hospital discharge and 3 months later. Cross-lagged panel analysis (CLPA) was used to describe the relationship of the two variables (DA and FCR) over time and identify the optimal intervention symptom nodes for breast cancer patients in different stages. The findings suggest that the specific symptoms of DA, known as “cognition”, predict the subsequent symptom development for a variety of mental health problems in the network structure. The “Psychological distress” symptom in FCR is the most susceptible to other symptoms. In addition, death-related cognition may be a bridge symptom that connects the co-occurrence of DA and FCR. Death-related “time awareness” is the optimal symptom node for intervention in early-stage breast cancer patients, while it is “cognition” in advanced patients. The death-related cognition and emotional regulation of death may be the best target for interventions among breast cancer patients, considering their DA coincides with FCR. The best intervention for patients with early-stage breast cancer may be the time awareness of death, while it may be more effective for patients with advanced cancer to be educated about disease and death, as well as to enhance correct perception. Full article

In this segment of the Palliative Care Unit case series, we introduce a patient with a long history of oncological treatments for recurrent breast cancer. After active treatments and a global control of the neoplasm, disease progression made the patient access different lines of chemotherapies, even asking for them in anticipation of a few advantages in the balance between benefits and risks. When the patient decided to permanently discontinue chemotherapy, she felt she had disrupted her values. Also, as a reaction to breaking bad news without estimating alternative paths, she considered her deteriorating condition as the sole criterion for assisted dying in another country. Could this be a self-consistent choice for this patient, so determined to find and pursue possibilities in treatment previously? Should this clue respond precisely to the patient’s needs? This contribution’s objective is to debate possibilities of patient self-determination and dignity at the end of life by integrating psychological support, palliative care, and legal–ethical awareness. This case study presents multidisciplinary team work through some key turning points. This team work was carried out in a national context that is currently inconclusive regarding assisted suicide, since active euthanasia is illegal. At the same time, the national Constitutional Court (242/2019) recently opened the possibility of eventual medically assisted suicide under certain circumstances. In this case, health professionals considered this context and tried to delve deeply into respecting the patient’s identity in order to determine when and if the exceptional circumstances were met. This case highlights the ethical sense of end-of-life accompaniment, which when conducted by physicians, nurses, and psychologists together can lead to effective support and allow patients to maintain their identity and to express themselves respecting not only their fears but also their vision of themselves as human beings. A first key turning point was, for instance, taking into account the patient’s history and values, and a subsequent one was supporting the patient in exploring healthcare services and related end-of-life support. In a further key turning point, the patient was helped in engaging with physicians in order to understand types of continuous care, as well as the timing and expected results of sedation. Finally, she chose a healthcare service where she could spend the end of her life in fulfillment of her values. Overall, this case report illustrates how integrating psychological support, palliative care, and legal–ethical awareness can promote patient self-determination and dignity at the end of life. Full article

Fear of cancer recurrence (FCR) is a frequent and distressing concern among colorectal cancer (CRC) survivors, often exerting a profound impact on psychological well-being, daily functioning, and treatment adherence. While several clinical and sociodemographic factors have been linked to FCR, the potential role of pet companionship has not been systematically investigated in this population. This cross-sectional study included 167 patients with CRC, assessing FCR with the Fear of Cancer Recurrence Inventory–Short Form (FCRI-SF), psychological distress with the DASS-21, and quality of life with the FACT-G. More than half of the participants (62.3%) met the threshold for high FCR. Multivariable logistic regression revealed that female sex, higher educational attainment, and increased depressive and anxiety symptoms were independently associated with greater odds of high FCR. Conversely, better overall quality of life was linked to lower FCR, with each additional FACT-G point reducing the likelihood of high fear by 5%. Notably, pet ownership emerged as a robust protective factor: pet owners demonstrated approximately one-quarter the odds of high FCR compared with non-owners. Subgroup analyses suggested that this protective effect was particularly evident among women and patients with fewer children, groups potentially more vulnerable to social isolation. These findings highlight pet ownership as a novel factor associated with reduced FCR in CRC patients and suggest potential directions for supportive interventions integrating companion animals into survivorship care. Full article