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CAS clinical risk factors and treatment outcomes: 2012;26(2):16277. 2023 BioMed Central Ltd unless otherwise stated. Effective treatment and management strategies may also differ according to the demographic group affected. 2017;28(8):19649. Symptoms of ED include. Given evidence derived from cancers representing almost half of all patients, the precautionary principle (acting to avoid or diminish harm in the face of scientific uncertainty) should be used when determining acceptable waiting times for treatment where data are limited.8 Too few studies were found for most indications to perform a risk of publication bias assessment with funnel plots. 75 and 52% of people with cancer with moderate and severe distress, respectively, had not talked to a mental health professional, with the cost of treatment a potential barrier. Implementing personalized pathways for cancer follow-up care in the United States: proceedings from an American Cancer SocietyAmerican Society of Clinical Oncology summit. 2014;4(3):e003901. Ann Oncol. The heightened anxiety observed post-treatment may be due to reduced clinical consultations and support following treatment, potential transfer to a palliative setting, and fear of recurrence. The risk factors for depression in cancer patients undergoing chemotherapy: a systematic review. Two high validity studies providing delay estimates across multiple treatment modalities for these tumour types suggest an impact of delay in treatment initiation in these settings (cervical cancer mortality for each four week delay: hazard ratio 1.04, 95% confidence interval 1.02 to 1.0754; stage III non-small cell cancer: 1.03, 1.01 to 1.06).55 While the negative impact of treatment interruptions on survival outcomes is well documented for these tumours,565758 evidence is insufficient about the exact impact of a delay in starting treatment, which given its importance, should be an urgent research priority. 2012;15(2):1207. Conclusions Cancer treatment delay is a problem in health systems worldwide. Self-management interventions that have shown promise include education, monitoring, teaching and counselling to help patients manage the short- and long-term physical and psychosocial effects of cancer [48]. Surgery findings were consistent, with a mortality risk for each four week delay of 1.06-1.08 (eg, colectomy 1.06, 95% confidence interval 1.01 to 1.12; breast surgery 1.08, 1.03 to 1.13). Journal of Cancer Treatment and Diagnosis Publications http://www.cancertreatmentjournal.com/old-issues.php?journal=jctd&&v=3&&i=1&&y=2019&&m=January Article Full-text available January 2019. Research is urgently needed into the possible impacts of long-term and late effects of cancer treatment on mental health and how these may be prevented, as increasing numbers of people live with and beyond cancer. 2011;20(5):52531. Provided by the Springer Nature SharedIt content-sharing initiative. Journal Info Current Issue Jul-Sep 2022 - Volume 5 - Issue 3 Editor-in-Chief: Dr. Vanita Noronha ISSN: 2590-3233 Online ISSN: 2590-3225 Frequency: 4 Issues Per Year eTOC Alert Current Issue Highlights Musings My experience as a matchmaker Chandrasekharan, Arun Cancer Research, Statistics, and Treatment. However, the mental health needs of people with cancer, with or without a prior psychiatric history, are often given little attention during and after cancer treatment, which is primarily focused on monitoring physical health symptoms and side effects. Mental distress and health care use among survivors of adolescent and young adult cancer: a cross-sectional analysis of the National Health Interview Survey. PubMedGoogle Scholar. Learn more Reprints This Cancer journal offers a professional quality Reprint Service that enables users to have reprints delivered to their door at an affordable value. Eur J Oncol Nurs. Impact Factor: 1.795 5-Year Impact Factor: 2.489. No high validity studies were found for delay between diagnosis and start of neoadjuvant therapy for rectal cancer or for four other curative radiotherapy indications (table 2). Administrative, technical, or material support: TPH, WDK, AA. NHS England. We included studies if they specifically reported on the impact of delay for a well defined cancer indication. Niedzwiedz, C.L., Knifton, L., Robb, K.A. Read our author guidelines Journal profile The European Journal of Cancer Care aims to encourage comprehensive, multiprofessional cancer care across Europe and internationally. Two reviewers screened abstracts by using Covidence systematic review software (Veritas Health Innovation, Melbourne, Australia). Many countries have experienced deferral of elective cancer surgery and radiotherapy, and reductions in the use of systemic treatments67 because systems have reassigned healthcare resources to pandemic preparedness.8 The lack of high quality data on the impact of deferred and delayed cancer treatment has meant that the impact of covid-19 lockdown measures on patterns of care and subsequent outcomes has not been robustly quantified. Curr Opinion Supportive Palliative Care. We performed the statistical analysis using the R package metafor (R Foundation for Statistical Computing, Vienna, Austria). 2015;41(8):71424. Purpose To determine to what extent head and neck cancer (HNC) survivors participate in health behaviors (HBs) recommended by the National Cancer Center Network (NCCN). The lead author affirms that the manuscript is an honest, accurate, and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as originally planned (and, if relevant, registered) have been explained. Cancer. In the UK, money spent on research into the biology of cancer was more than five times than that spent on Cancer Control, Survivorship and Outcomes during 2017/18 [53]. For example, an eight week delay in breast cancer surgery would increase the risk of death by 17% (=1.088weeks/4weeks) and a 12 week delay would increase the risk by 26% (=1.0812weeks/4weeks). 1), but these are not well understood [1], and require further research. 2013;31(6):78293. If no, we asked Were the reported results appropriately adjusted for any differences in the relevant prognostic factors? If yes, the study was classified as high validity; if no, the study was classified as not high validity. Achieving world-class cancer outcomes: a strategy for England 2015-2020 - progress report 2016-2017. A four week delay in treatment is associated with an increase in mortality across all common forms of cancer treatment, with longer delays being increasingly detrimental. Twenty eight studies were population or registry based, and six were institutional reports. Thus, a dynamic and continuous process of self-regulation is established. [47]. Risk of suicide within 1 year of cancer diagnosis. Cancer treatments including immunotherapy and chemotherapy may induce depression through particular biological mechanisms, such as inflammatory pathways, and some medications used to treat chemotherapy-induced nausea can reduce dopaminergic transmission, which is implicated in the development of depressive symptoms [16]. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Impact Factor is the most common scientometric index, which is defined by the number of citations of papers in two preceding years divided by the number of papers published in those years. For example, limited evidence suggests that the impact of delay can vary according to stage, often with consistently greater mortality impact with earlier stage disease.1617182555 Additionally, our results can only be applied to the range of delay considered in the studies we evaluated. The estimated prevalence of depression was found to be 3% in patients with lung cancer, compared to 31% in patients with cancer of the digestive tract, when diagnostic interviews were used [21]. Cook SA, Salmon P, Hayes G, Byrne A, Fisher PL. Esophageal cancer is a prevalentcommon digestive tract tumor in the worldworldwide. At diagnosis, the psychological health of patients should be considered alongside their physical health and sources of support offered. We searched three key electronic databases: Medline, PsycINFO and CINAHL (Cumulative Index to Nursing and Allied Health Literature) for relevant reviews (favouring those using systematic methods) using the following search terms: (neoplasm OR carcinoma OR tumo*r OR cancer) AND (depression OR anxiety) AND review. METHODS: A review of a prospectively maintained registry of PSM patients undergoing Cytoreductive Surgery and Hyperthermic Intra-peritoneal . Journal impact factor : 1.00 Average acceptance to publication time (5-7 days) Average article processing time (30-45 days) Less than 5 volumes 30 days 8 - 9 volumes 40 days 10 and more volumes 45 days Editorial Board Editor-in-Chief Maria Jose Molina Garrido Director Unit of Cancer Hospital Virgen de la Luz Spain Douglas P. Malinowski BD Fellow We acknowledge that treatment delays are multifactorial in cause and that patients should not start treatment before they are medically fit to do so, and have had completed all appropriate evaluations, however these data strongly support efforts to minimise system level delays. National Estimates of Financial Toxicity in Persons with Newly-Diagnosed Cancer. We also emphasise that few studies considered the impact of immortal time bias on delay; this could be done through a landmark analysis for survival. 2017. Supportive care guidelines Group of Cancer Care Ontario Program in evidence-based care: the treatment of depression in cancer patients: a systematic review. 2018;361:k1415. About this Journal. 2018;26(5):158595. Journal of Cancer Epidemiology publishes studies related to population-based research on cancer etiology, prevention, surveillance, and survivorship and in the areas of descriptive, analytical, and molecular epidemiology etc. The earliest evidence of cancer treatment . This analysis reports the impact of delay in curative treatment on the risk of death across the seven major tumour types: bladder, breast, colon, rectum, lung, cervix, and head and neck, and across all three major treatment modalities (surgery, systemic treatment, and radiotherapy). Methods Participants identified through the tumor registries at the Abramson Cancer Center (ACC), University of Pennsylvania and affiliated sites. Adequacy of the National Quality Forums colon cancer adjuvant chemotherapy quality metric: is 4 months soon enough? The evidence for pharmacological treatment of depression with antidepressants is mixed - there are very few studies in this area and those that exist are of low quality [41]. The UK Top living with and beyond cancer research priorities. The prevailing paradigm has been around access to new treatments to improve outcomes, but from a system level, gains in survival might be achieved by prioritising efforts to minimise the time from cancer diagnosis to initiation of treatment from weeks to days. A systematic review and meta-analysis study focusing on patients with ovarian cancer found that anxiety tended to be higher following treatment (27%) and during treatment (26%), and was lowest pre-treatment (19%) [23]. The prevalence of long-term symptoms of depression and anxiety after breast cancer treatment: a systematic review. Association of androgen deprivation therapy and depression in the treatment of prostate cancer: A systematic review and meta-analysis. Impact Factor: 3.734: CiteScore: 5.1: Acceptance Rate: 17%: Time to first decision: 5 days: For Authors. Rates of depression were relatively similar following treatment (18%), during treatment (15%) and pre-treatment (17%), with the 95% confidence intervals for these estimates largely overlapping. Part of SVK is funded by a NHS Research Scotland (NRS) Senior Clinical Fellowship (SCAF/15/02), the Medical Research Council (MC_UU_12017/13 & MC_UU_12017/15) and Scottish Government Chief Scientist Office (SPHSU13 & SPHSU15). Purple diamonds represent the hazard ratio for each study and whiskers represent 95% confidence interval. Several indications were considered safe to be delayed by 10-12 weeks with no predicted impact on outcome, including all colorectal surgery. Dissemination to study participants is not applicable. Harnett CE. Its integrated, multidisciplinary coverage . Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. To effectively manage and treat depression and anxiety among people with cancer, symptoms must first be identified. Journal Metrics. PURPOSE Cancer-related lymphedema (LE) is an incurable condition associated with lymph-involved cancer treatments and is an increasing health, quality of life (QOL), and cost burden on a growing cancer survivor population. Simard S, Thewes B, Humphris G, Dixon M, Hayden C, Mireskandari S, Ozakinci G. Fear of cancer recurrence in adult cancer survivors: a systematic review of quantitative studies. In the UK NHS, current targets for the initiation of primary definitive treatment have been set at 31 days from the decision to treat date; this does not include the lag between receiving a diagnosis and having a surgical or radiation oncology consultation for treatment.960 At a population level, differences in lead times to treatment of even two or three weeks could be a factor in why survival outcomes differ across health systems and needs further investigation. A sensitivity analysis of studies that had been excluded because of lack of information on comorbidities or functional status did not change the findings. Clinical Medicine Insights: Oncology is an international, peer-reviewed, open access journal that focuses on all aspects of cancer research and treatment, in addition to related genetic, pathophysiological and epidemiological . About this journal Editor spotlight Options for decreasing delay after diagnosis include increasing specialist workforce capacity through training initiatives or overcoming these challenges through technological developments. We note that a delay of less than four weeks should not be justified as safe based on our findings. Similar to Neal and colleagues, this was defined as an analysis or subanalysis of patients clearly including or excluding patients with short diagnosis to treatment interval (eg, less than four weeks) or poor outcomes (eg, death within four to eight weeks of diagnosis).12. Please note: your email address is provided to the journal, which may use this information for marketing purposes. For this analysis, we included 12 studies that were excluded in the primary analysis solely because of the lack of reporting or adjustment for comorbidity or functional status. Systemic therapies for GC, including chemotherapy, targeted therapy and immunotherapy, have evolved significantly in the past few years. Delay in the treatment of cancer can have adverse consequences on outcome. Boland L, Bennett K, Connolly D. Self-management interventions for cancer survivors: a systematic review. Editing Services Article Outreach This Cancer journal works hard to maximize the impact of published research. CLN, LK, SVK, KAR and DJS interpreted the findings. Even though it is considered to be a well-tolerated therapy, AI-induced musculoskeletal symptoms are common and may be accused for treatment discontinuation. In evaluating the validity of our findings, we note the coherence of overall mortality and cancer specific endpoints (local control, cancer specific survival, disease-free survival) for all past meta-analyses of high validity studies.12347 We also note major detrimental effects of prolonged waiting times on cancer specific survival outcomes in 13 of 15 studies included in our meta-analysis that reported cancer survival outcomes alongside overall survival.141622282930313233343536383946 These studies span seven treatment indications. Walker J, Hansen CH, Martin P, Symeonides S, Ramessur R, Murray G, Sharpe M. Prevalence, associations, and adequacy of treatment of major depression in patients with cancer: a cross-sectional analysis of routinely collected clinical data. Article Shapiro CL. PubMed Effective communication is crucial in cancer care due to the sensitive nature of the information and the psychosocial impact on patients and their families. We undertook a post hoc sensitivity analysis to evaluate the impact of the stringent validity criteria on findings. CA Cancer J Clin. Psycho-oncology. In light of these results, policies focused on minimising system level delays in cancer treatment initiation could improve population level survival outcomes. Social support buffers against anxiety and depressive symptoms in patients with cancer only if support is wanted: a large sample replication . Prioritising research into cancer treatment delays, Counting the invisible costs of covid-19: the cancer pandemic. The graph shows the changes in the impact factor of Journal of Cancer Treatment & Diagnosis and its the corresponding percentile for the sake of comparison with the entire literature. . PubMed 2018;131(10):118799 e1185. We found no significant effect for the single high validity study of adjuvant radiotherapy after breast conserving surgery (0.98, 0.88 to 1.09). For example, at the beginning of the pandemic the UK NHS59 created a short term surgical prioritisation algorithm. However, these studies demonstrate that psychotherapy, psychoeducation and relaxation training may have small to medium short-term effects on relieving emotional distress and reducing symptoms of anxiety and depression, as well as improving health-related quality of life. We qualitatively assessed the magnitude of observed differences, and the P value was considered when interpreting these differences. This is often related to a combination of poor communication, a lack of consideration of psychological concerns and disjointed care [14, 20]. All studies were retrospective observational comparisons. 2017;13(29):271931. More broadly, in non-pandemic times, health systems have developed pathways and targets for intervals from the time of diagnosis to receipt of treatment within National Cancer Control Plan frameworks that do not have a strong empirical basis.9. A representative study of young adult cancer survivors aged 15 to 39years in the United States demonstrated that moderate (23% vs 17%) and severe (8% vs 3%) mental distress were significantly higher in those living with cancer for at least 5 years after diagnosis, compared to controls [31]. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Advances in the earlier detection of cancer and improved cancer treatments means that people are now living longer with cancer, presenting a significant global challenge. 2017;26(12):200718. Article 31, 2023 PDF (1229KB) Accessed 27 June 2019. The total number of people who are alive within 5 years of a cancer diagnosis was estimated to be 43.8 million in 2018 for 36 cancers across 185 countries [5], and in the United States alone, the number of cancer survivors is projected to rise exponentially from 15.5 million in 2016 to 26.1 million in 2040 [6]. Treatment should be based on patient preference and also take into account potential adverse side effects [44]. TPH is the corresponding author and attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted. However, in this meta-analysis the included participants were primarily women with breast cancer and there are a lack of studies covering other cancer types. Twenty five of 34 identified studies were from the USA, though no significant heterogeneity was detected compared with other countries. Studies that focus on prevention are minimal and research covering low- and middle-income populations is limited. 2019;76(1):5160. Acquisition, analysis, or interpretation of data: TPH, WDK, ST, MJ, GAP, EHJ, DEO, CMB, RS, AA. A key barrier affecting research progress in this area is funding [52]. 2018;27(3):791801. Psycho-Oncology. Patients may not disclose psychiatric symptoms because of the stigma surrounding mental health conditions [37]. Crossing the quality chasm: a new health system for the 21st century. 2014;1(5):3201. NACS seeks to impart highly relevant and timely information to a broad audience of oncology and related specialists . Nead KT, Sinha S, Yang DD, Nguyen PL. Treatment delays could be due to patient factors (eg, need for cardiac workup, postoperative wound infection), disease factors (eg, need for additional imaging investigations), or system factors (eg, waiting for an operating room date, a central line insertion, or a specialist consultation). Am J Med. The main purpose of this discussion is to highlight the need to minimise system level delays. For example, for head and neck surgery the hazard ratio was 1.06 (95% confidence interval 1.04 to 1.08) and for breast partial or complete mastectomy the hazard ratio was 1.08 (1.03 to 1.13). 2018;142(10):198693. Delays of up to eight weeks and 12 weeks further increase the risk of death. Studies that investigated the therapeutic benefit of intentional moderate delay between completion of neoadjuvant therapy for rectal cancer and surgery were excluded given potential confounding by indication. Factors associated with medical status such as elements of socioeconomic status or insurance status might also be confounding factors; we found that 91% and 82% of identified studies accounted for these, respectively, though this does not completely rule out the possibility of residual confounding. In addition, those who accessed services mentioned that there is a lack of suitable long-term emotional support. Publication bias was not tested given the small number of studies identified for each indication. Internationally, some countries have released national guidance on prioritisation of surgical treatments for cancer, which do not appear to be supported by the results of this study. Pooled effects were estimated using DerSimonian and Laird random effect models. Journal h-index : 4 ; Journal cite score : 1.05 ; Average Acceptance to publication time (5-7 days) Average Article processing time Less than 5 volumes 30 days 8 - 9 volumes 40 days 10 and more volumes 45 . The funders had no role in the study design; collection, analysis and interpretation of data; the writing of the article; and in the decision to submit it for publication. Patients that survived a longer wait might have less aggressive tumours, biasing the delay effect towards the null. 2013;24(4):895900. Only English language articles were considered and searches were limited to the years 2012 to 2017 and updated during February 2019. National Cancer Research Institute. The year 2000 was selected to be comprehensive, while limiting reports to those reflective of contemporary practice as much as possible. Article However, patients valued having the option to talk about their emotions, but they preferred to choose with whom and when. The Royal College of Radiologists. J Cancer Policy. Few studies have focused specifically on younger cancer survivors and more research is needed in this area. Cancer Cytopathology, a journal of the American Cancer Society, publishes original research and other articles of interest to cytopathology, cytology, and pathology professionals as it relates to topics concerning the etiology of cancer, and its diagnosis and prevention. The mental health of people living with and beyond cancer in its various types and stages is an important and growing research and clinical priority. Our analysis aims to provide robust evidence to guide national policy making, specifically the prioritisation and organisation of cancer services, by investigating the association between delays in receipt of cancer treatment and mortality. This left 34 studies with unique populations for inclusion (fig 1, table 1, table 2).13141516171819202122232425262728293031323334353637383940414243444546 These studies included 1272681 patients, with a sample size ranging from 174 to 420792 (appendix 3). Behavioural scores, comprised of multiple risk factors, allow assessment of the combined impact of multiple behaviours. For reference, the prevalence of clinical depression and anxiety in men aged over 65years is less than 9 and 6%, respectively [26]. Cochrane Database Syst Rev. NSCLC=non-small cell lung cancer, Forest plot of hazard ratios for association of each four week delay in radical and adjuvant radiotherapy and overall survival by cancer site. The Guardian. Common reactions immediately after the diagnosis are shock and denial, frequently followed by depression, anxiety and/or anger. The research suggests that optimizing the timing of cancer screenings and therapy sessions, in line with circadian rhythms, could enhance the precision of diagnosis and elevate the effectiveness of treatment regimens. In particular, we highlight the lack of high-quality research into the mental health of long-term cancer survivors, the potential impact of long-term and late effects of cancer treatment, and the few studies focused on prevention. Benefits to authors Article 2019;28(4):86371. volume19, Articlenumber:943 (2019) Eligibility: (a) diagnosis and treatment HNC; (b) aged 18 to 70 years; (c) . Howell D, Harris C, Aubin M, Olson K, Sussman J, MacFarlane J, Taylor C, Oliver TK, Keller-Olaman S, Davidson JR, et al. J Clin Oncol. Ball H, Moore S, Leary A. Int J Cancer. Cordova MJ, Riba MB, Spiegel D. Post-traumatic stress disorder and cancer. Rodin G, Lloyd N, Katz M, Green E, Mackay JA, Wong RK. HR=hazard ratio, Summary of characteristics for studies investigating surgical treatment, Summary of characteristics for studies investigating systemic treatment and radiotherapy. Hazard ratios were assumed to be log linear in relation to overall survival and were converted to an effect for each four week delay. Depression and anxiety may hinder cancer treatment and recovery, as well as quality of life and survival. For example, automated treatment contouring and planning is increasingly standardised and reduces the radiotherapy preparation time to hours rather than days.61 Satellite centres might improve capacity for treating patients, as can reconfiguration of existing infrastructure to high volume super specialised services, or single entry models and team based care.62 Innovations in surgical technique could also minimise morbidity and reduce time to adjuvant therapy.6364. The longer-term psychological impact of cancer has received comparatively little research. This is likely due to several factors, including lack of awareness and identification of psychiatric symptoms, an absence of support available or offered, lack of evidence around effective treatments, stigma, and patient preference. McCorkle R, Ercolano E, Lazenby M, Schulman-Green D, Schilling LS, Lorig K, Wagner EH. Only Open Access Journals Only SciELO Journals Only WoS Journals Kaul S, Avila JC, Mutambudzi M, Russell H, Kirchhoff AC, Schwartz CL. Of these, 241 were excluded, most commonly because they were not high validity studies (n=100), they included the wrong patient population (n=36), or the wrong study design (n=26). Foster C, Calman L, Richardson A, Pimperton H, Nash R. Improving the lives of people living with and beyond cancer: generating the evidence needed to inform policy and practice. Drafting of the manuscript: TPH, AA, WDK. Cancer. The long-term (those that begin during treatment and continue afterwards) and late effects of cancer treatment (those that begin after treatment is completed), such as secondary cancers, infertility, chronic pain and insomnia, are likely to affect the mental wellbeing of cancer survivors, potentially contributing to depression and anxiety [6].

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