Medicine and Health Sciences Commons^™

Further Validation Of The Perceptions Of Uncertainties In Genome Sequencing Scale Among Patients With Cancer Undergoing Tumor Sequencing, Kendall L. Umstead, Rachel Campbell, Christine E. Napier, Nicole Bartley, Megan C. Best, Phyllis N. Butow, Barbara B. Biesecker

IES Papers and Journal Articles

It is important to understand how individuals perceive uncertainties and the consequent impact on their psychological well-being and health behavior. The Perceptions of Uncertainties in Genome Sequencing (PUGS) scale measures clinical, affective, and evaluative uncertainties about information from sequencing. The PUGS scale has been shown to be valid and reliable among individuals receiving results about their genomes. This study assessed whether its validity generalized to patients with cancer undergoing tumor sequencing. Exploratory factor analysis (EFA) was conducted on data from the Molecular Screening and Therapeutics Program (n = 310) to identify a measurement model. Confirmatory factor analysis (CFA) was …

The Impact Of Covid-19 On Cancer Patients, Their Carers And Oncology Health Professionals: A Qualitative Study, P Butow, P E. Havard, Z Butt, I Juraskova, H Sharpe, H Dhillon, L Beatty, P Beale, M Cigolini, B Kelly, R J. Chan, L Kirsten, Megan Best, J Shaw

IES Papers and Journal Articles

Objective: Cancer patients, carers and oncology health professionals have been impacted by the COVID-19 pandemic in many ways, but their experiences and psychosocial responses to the pandemic are still being explored. This study aimed to document the experience of Australians living with cancer, family carers, and Oncology health professionals (HPs) when COVID-19 first emerged.

Methods: In this qualitative study, participants (cancer patients currently receiving treatment, family carers and HPs) completed a semi-structured interview exploring their experiences of COVID-19 and the impact it had on cancer care. Participants also completed the Hospital Anxiety and Depression Scale (patients) and the Depression, Anxiety …

Validation Of The Knowledge Of Genome Sequencing (Kogs) Scale In Cancer Patients, P Butow, C Napier, R Campbell, N Bartley, Megan Best, M L. Ballinger

IES Papers and Journal Articles

Introduction: The Knowledge of Genome Sequencing (KOGS) questionnaire was recently developed to measure knowledge of genomic sequencing (GS), with preliminary psychometric data supporting its reliability and validity. The aim of this study was to test the reliability and validity of the KOGS in a larger sample, and to confirm its utility in a cancer setting.

Methods: The Genetic Cancer Risk in the Young (RisC) study recruits participants with a personal history of cancer, to investigate heritable cancer causes and future cancer risk using germline GS. Participants (n = 261) in a psychosocial substudy of RisC completed a questionnaire after consent …

Cancer Patient Knowledge About And Behavioral Intentions After Germline Genome Sequencing, Christine E. Napier, Grace Davies, Phyllis N. Butow, Timothy E. Schlub, Megan C. Best, Nicci Bartley, Ilona Juraskova, Bettina Meiser, Katherine M. Tucker, Barbara B. Biesecker, David M. Thomas, Mandy L. Ballinger, Members Of The Pigeon Project

IES Papers and Journal Articles

Objectives: Germline genome sequencing (GS) is becoming mainstream in cancer diagnosis and risk management. Identifying knowledge gaps and determinants of health behavior change intentions will enable effective targeting of educational and management strategies to translate genomic findings into improved cancer outcomes.

Methods: Probands diagnosed with cancer of likely genetic origin that consented to but not yet undergone GS, and their biological relatives, completed a cross-sectional questionnaire assessing GS knowledge and hypothetical intention to change behaviors.

Results: Probands (n = 348; 57% university educated) and relatives (n = 213; 38% university educated) had moderate GS knowledge levels, with greater knowledge associated …

Longitudinal Patterns In Fear Of Cancer Progression In Patients With Rare, Advanced Cancers Undergoing Comprehensive Tumour Genomic Profiling, Phyllis Butow, Fabiola Müller, Christine E. Napier, Nicci Bartley, Mandy L. Ballinger, Barbara Biesecker, Ilona Juraskova, Bettina Meiser, Timothy E. Schlub, David M. Thomas, David Goldstein, Megan C. Best, Members Of The Pigeon Project

IES Papers and Journal Articles

Introduction: Fear of cancer progression (FCP) impacts quality of life and is a prevalent unmet need in patients diagnosed with advanced cancer, particularly as treatment options are reduced. We aimed to identify longitudinal patterns in FCP over 6 months in patients with advanced cancer receiving comprehensive tumour genomic profiling (CTGP) results, and their correlates.

Methods: Patients with pathologically confirmed metastatic disease (∼70% rare cancers) receiving or post their last line of standard therapy completed questionnaires at T0 (prior to CTGP), T1 (immediately post CTGP results) and T2 (2 months later).

Results: High stable (N = 52; 7.3%) and low/moderate …

Effectiveness Of Online Communication Skills Training For Cancer And Palliative Care Health Professionals: A Systematic Review, Melissa N. Berg, Irene Ngune, Penelope Schofield, Lisa Grech, Ilona Juraskova, Michelle Strasser, Zoe Butt, Georgia K.B Halkett

Nursing Papers and Journal Articles

Objective: To determine the reported effect of online communication skills training (CST) on health professional (HP) communication skills and patient care outcomes in cancer and palliative care.

Methods: Primary research published in English between January 2003 and April 2019 was identified in bibliographic databases including Medline, Embase and Proquest (Prospero: CRD42018088681). An integrated mixed-method approach included studies describing a CST intervention and its effect, for cancer or palliative care HPs, delivered online or blended with an online component. Included studies' outcomes were categorised then findings were stratified by an evaluation framework and synthesised in an effect direction plot. Risk of …

Advanced Cancer Patient Preferences For Receiving Molecular Profiling Results, Megan Best, Phyllis Butow, Chris Jacobs, Ilona Juraskova, Jacqueline Savard, Bettina Meiser, David Goldstein, Mandy Ballinger, Nicci Bartley, Christine Napier, Grace Davies, David Thomas, Kathy Tucker, Timothy Schlub, Ainsley J. Newson

IES Papers and Journal Articles

Objective: This study aimed to discern preferences for receiving somatic molecular profiling (MP) results in cancer patients who have given consent to undergo testing.

Methods: We conducted a mixed‐methods study to explore patients’ views on which MP results they would like to receive and why. Advanced cancer patients (n=1299) completed questionnaires after giving consent to participate in a parent genomics study and undergoing MP. A subset of patients (n=20) participated in qualitative interviews.

Results: Almost all (96%) participants were interested in receiving results which would direct cancer treatment (i.e. were actionable). A smaller majority wanted to access results which were …

Education And Assessment Of Psycho-Existential Symptoms To Prevent Suicidality In Cancer Care, David W. Kissane

Medical Papers and Journal Articles

Clinicians acknowledge awkwardness and lack of skills in assessing suicidal symptoms. This requires increased education, screening for psycho-existential symptoms, and the therapeutic targeting of key symptoms. Assessment of hopelessness, pointlessness, low morale, entrapment, anhedonia, loss of control, loss of roles, and the wish to die prove extremely helpful in recognising a suicidal patient. Use of a screening tool for psycho-existential symptoms aids this recognition and empowers referral for treatment. Communication skills training increases each clinician’s skill and provides a strategic sequence to explore symptoms that mediate suicidal thinking. Network analysis research to identify core symptoms suggests that hopelessness, pointlessness, and …

Contralateral Prophylactic Mastectomy For Unilateral Breast Cancer In Women At Average Risk: Systematic Review Of Patient Reported Outcomes, Amilee Srethbhakdi, Meagan E. Brennan, Geaty Hamid, Kathy Flitcroft

Medical Papers and Journal Articles

Objective: The rate of contralateral prophylactic mastectomy (CPM) in women with early, unilateral cancer is relatively high and is increasing around the world a previous study. Women choose this option for many reasons other than reducing their risk of future cancer, including symmetry, reasons related to breast reconstruction and attempting to manage fear of recurrence. This systematic review evaluated patient‐reported quality of life outcomes following CPM.

Methods: A literature search of MEDLINE, PubMed and PsycINFO was performed to February 2019. Abstracts and full‐text articles were assessed for eligibility according to pre‐determined criteria. Data were extracted into evidence tables for analysis. …

The Association Between Hysterectomy And Ovarian Cancer Risk: A Population-Based Record-Linkage Study, Suzanne C. Dixon-Suen, Penelope M. Webb, Louise F. Wilson, Karen Tuesley, Louise M. Stewart, Susan J. Jordan

Health Sciences Papers and Journal Articles

Background: Recent studies have called into question the long-held belief that hysterectomy without oophorectomy protects against ovarian cancer. This population-based longitudinal record-linkage study aimed to explore this relationship, overall and by age at hysterectomy, time period, surgery type, and indication for hysterectomy.

Methods: We followed the female adult Western Australian population (837 942 women) across a 27-year period using linked electoral, hospital, births, deaths, and cancer records. Surgery dates were determined from hospital records, and ovarian cancer diagnoses (n¼1640) were ascertained from cancer registry records.We used Cox regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the …

Systematic Review And Meta-Analysis Of Patient Reported Outcomes For Nurse-Led Models Of Survivorship Care For Adult Cancer Patients, Leanne Monterosso, Violet Platt, Max Bulsara, Melissa Berg

Nursing Papers and Journal Articles

Purpose: This systematic review aimed to determine the effectiveness of nurse-led cancer survivorship care, compared with existing models of care, on patient reported outcomes for cancer survivors.

Methods: Randomised and non-randomised controlled trials and controlled before-after studies published in English between 1 January 2007 and 28 July 2017 were identified in bibliographic databases including Medline, Pubmed and PsychINFO. Included studies described nurse-led cancer care after treatment to adults (age ≥18 years) <2 years post treatment completion. Risk of bias was assessed using Joanna Briggs Institute’s tools and meta-analysis was undertaken.

Results: Twenty one publications were included describing 15 tumour-specific trials involving 3278 survivors of breast (n = 5), gynecological (n = 3), head and neck (n = 2), colorectal …

Heat Shock Proteins As Modulators And Therapeutic Targets Of Chronic Disease: An Integrated Perspective, Adrienne L. Edkins, John T. Price, A Graham Pockley, Gregory L. Blatch

Health Sciences Papers and Journal Articles

Many heat shock proteins (HSPs) are essential to survival as a consequence of their role as molecular chaperones, and play a critical role in maintaining cellular proteostasis by integrating the fundamental processes of protein folding and degradation. HSPs are arguably among the most prominent classes of proteins that have been broadly linked to many human disorders, with changes in their expression profile and/or intracellular/extracellular location now being described as contributing to the pathogenesis of a number of different diseases. Although the concept was initially controversial, it is now widely accepted that HSPs have additional biological functions over and above their …

Existential Distress In Cancer: Alleviating Suffering From Fundamental Loss And Change, Sigrun Vehling, David Kissane

Medical Papers and Journal Articles

A severe life threatening illness can challenge fundamental expectations about security, interrelatedness with others, justness, controllability, certainty, and hope for a long and fruitful life. That distress and suffering but also growth and mastery may arise from confrontation with an existentially threatening stressor is a long‐standing idea. But only recently have researchers studied existential distress more rigorously and begun to identify its distinct impact on health care outcomes. Operationalizations of existential distress have included fear of cancer recurrence, death anxiety, demoralization, hopelessness, dignity‐related distress, and the desire for hastened death. These focus in varying emphasis on fear of death, concern …

The Effect Of Self-Selected Complementary Therapies On Cancer Patients' Quality Of Life And Symptom Distress: A Prospective Cohort Study In An Integrative Oncology Setting, N J. Stomski, A Petterson, L J. Kristjanson, Elizabeth Lobb, M B. Phillips, A Williams, P Morrison, D Joske

Medical Papers and Journal Articles

Objective: To examine the effectiveness of a multifaceted complementary therapies intervention, delivered in a systematic manner within an Australian public hospital setting, on quality of life and symptom distress outcomes for cancer patients.

Methods: Adults receiving treatment for any form of cancer were eligible to participate in this study. Self-referred participants were offered a course of six complementary therapy sessions. Measures were administered at baseline, and at the third and sixth visit. The primary outcomes were quality of life and symptom distress. Linear mixed models were used to assess change in the primary outcomes.

Results: In total, 1376 cancer patients …

The Improving Rural Cancer Outcomes Trial: A Cluster-Randomised Controlled Trial Of A Complex Intervention To Reduce Time To Diagnosis In Rural Cancer Patients In Western Australia, Jon D. Emery, Victoria Gray, Fiona M. Walter, Shelley Cheetham, Emma J. Croager, Terry Slevin, Christobel Saunders, Timothy Threlfall, Kirsten Auret, Anna K. Nowak, Elizabeth Geelhoed, Max Bulsara, C D'Arcy J. Holman

Health Sciences Papers and Journal Articles

Background: Rural Australians have poorer survival for most common cancers, due partially to later diagnosis. Internationally, several initiatives to improve cancer outcomes have focused on earlier presentation to healthcare and timely diagnosis. We aimed to measure the effect of community- based symptom awareness and general practice-based educational interventions on the time to diagnosis in rural patients presenting with breast, prostate, colorectal or lung cancer in Western Australia.

Methods: 2_2 factorial cluster randomised controlled trial. Community Intervention: cancer symptom awareness campaign tailored for rural Australians. GP intervention: resource card with symptom risk assessment charts and local cancer referral pathways implemented through …

Clinical Consultations And Investigations Before And After Discontinuation Of Endocrine Therapy In Women With Primary Breast Cancer, Derrick Lopez, Anna Kemp-Casey, Christobel Saunders, Elizabeth Roughead, Frances Boyle, Max Bulsara, David Preen

Health Sciences Papers and Journal Articles

Objective: Although clinical trials recommend that women with hormone-dependent primary breast cancer remain on endocrine therapy for at least 5 years, up to 60% discontinue treatment early. We determined whether these women had consulted with clinicians or had investigations for cancer recurrence or metastasis around the time they discontinued endocrine therapy, and whether clinical contact continued after discontinuation.

Methods: We performed case-control and cohort studies of women from the 45 and Up Study who were diagnosed with invasive primary breast cancer between January 2003 and December 2008, and who had ≥12 months of anastrozole, exemestane, letrozole or tamoxifen subsequently dispensed. …

The Women's Wellness After Cancer Program: A Multisite, Single-Blinded, Randomised Controlled Trial Protocol, D Anderson, C Seib, D Tjondronegoro, J Turner, L Monterosso, A Mcguire, J Porter-Steele, W Song, P Yates, N King, L Young, K White, K Lee, S Hall, M Krishnasamy, K Wells, S Balaam, A Mccarthy

Nursing Papers and Journal Articles

Background: Despite advances in cancer diagnosis and treatment have significantly improved survival rates, patients post-treatment-related health needs are often not adequately addressed by current health services. The aim of the Women’s Wellness after Cancer Program (WWACP), which is a digitised multimodal lifestyle intervention, is to enhance health-related quality of life in women previously treated for blood, breast and gynaecological cancers.

Methods: A single-blinded, multi-centre randomized controlled trial recruited a total of 330 women within 24 months of completion of chemotherapy (primary or adjuvant) and/or radiotherapy. Women were randomly assigned to either usual care or intervention using computer-generated permuted-block randomisation. The …

Adaptation Of International Guidelines On Assessment And Management Of Cancer Pain For The Australian Context, M Lovell, T Luckett, F Boyle, J Stubbs, J Phillips, P Davidson, I Olver, J Von Dincklage, M Agar

Nursing Papers and Journal Articles

Aim: To develop clinical practice guidelines for screening, assessing and managing cancer pain in Australian adults.

Methods: This three phase project utilised the ADAPTE approach to adapt international cancer pain guidelines for the Australian setting. A Working Party was established to define scope, screen guidelines for adaptation, and develop recommendations to support better cancer pain control through screening, assessment, pharmacological and non-pharmacological management, and patient education. Recommendations with limited evidence were referred to Expert Panels for advice before the draft guidelines were opened for public consultation via the Cancer Council Australia Cancer Guidelines Wiki platform in late 2012. All comments …

Do Patients With Long-Term Side Effects Of Cancer Treatment Benefit From General Practitioner Support? A Literature Review, I Ngune, M Jiwa, A Mcmanus, J Hughes

Medical Papers and Journal Articles

Background: Alongside specialist cancer clinics, general practitioners have an important role in cancer patients’ follow-up care, yet no literature summarises the nature, extent and impact of their involvement. This paper addresses this issue through a review of the literature.

Methods: Studies were sourced from six academic databases - AustHealth (n = 202), CINAHL (n = 500), the Cochrane Library (reviews and trials; n = 200), Embase (n = 368), PHCRIS (n = 132) and PubMed/Medline (n = 410). Studies that focused on interventions designed for patients receiving follow-up care and reported cancer care provided by a general practitioner delivered alongside …

How Do Patients With Advanced Cancer Cope With An Uncertain Disease Trajectory? Implications For Grief Counselling, Elizabeth A. Lobb

Health Sciences Papers and Journal Articles

A growing number of cancer patients are living longer with incurable disease. This paper describes strategies that patients use to cope with the uncertain trajectory of their disease. Twenty-seven patients with a prognosis of 12 months were recruited from the oncology and palliative care service at three metropolitan Sydney hospitals. A semi-structured face-to-face interview was conducted, which was audiotaped and transcribed verbatim. The patients coped with the uncertain trajectory of their disease through avoidance, maintaining a normal life, comparing themselves favourably with others in a similar situation and remaining positive. Participants indicated that they did not wish referral for psychological …

The "Specter" Of Cancer: Exploring Secondary Trauma For Health Professionals Providing Cancer Support And Counseling, Lauren Breen, Moira O'Connor, Lauren Y. Hewitt, Elizabeth Lobb

Health Sciences Papers and Journal Articles

Health professionals are vulnerable to occupational stress and tend to report high levels of secondary trauma and burnout; this is especially so for those working in “high-death” contexts such as cancer support and palliative care. In this study, 38 health professionals (psychologists, social workers, pastoral carers/chaplains, nurses, group facilitators, and a medical practitioner) who provide grief support and counseling in cancer and palliative care each participated in a semistructured interview. Qualitatively, a grounded theory analysis revealed four themes: (a) the role of health professionals in supporting people who are experiencing grief and loss issues in the context of cancer, (b) …

The Role Of Notch Receptors And Ligands In Regulation Of Immune Responses, Gerard F. Hoyne

Health Sciences Papers and Journal Articles

Notch signalling has an important role in the immune system in directing cell fate decisions in a range of diverse cell types. We are beginning to obtain a better understanding of the roles that the different Notch ligands and receptors play in both cellular differentiation of precursor cells and the regulation of immune responses by mature lymphocytes in the periphery. This review will examine the key findings that have emerged in relation to function of Notch in differentiation of T cells, B cells and dendritic cells and how modulation of Notch signalling seems to have potential for therapeutic applications in …