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. It should also be highlighted that the psychological impact of cancer may not always be negative and many people will not experience problems with depression and anxiety. In addition, those who accessed services mentioned that there is a lack of suitable long-term emotional support. 2016;25:627. British Journal of Cancer - Nature 2017;35(11):664 e661664.e669. Delay in the treatment of cancer can have adverse consequences on outcome, Previous meta-analyses of high validity studies have found evidence supporting a continuous relation between delay and mortality or local control, Despite its foundational importance, we lack standardised estimates of the effect of treatment delay for most treatment indications, This systematic review considered seven major cancer types (bladder, breast, colon, rectum, lung, cervix, and head and neck) and three treatment modalities (surgery, systemic treatment, and radiotherapy), The data consistently show that a four week treatment delay is associated with increased mortality; further mortality was reported with longer delays, Policies focused on minimising system level delays in cancer treatment initiation could improve population level survival outcomes. Systematic reviews demonstrate there is a preponderance of studies from the United States, which include a high number of studies focusing on female patients with breast cancer [40]. We investigated seven cancers that together represent 44% of all incident cancers globally10: five common cancers (bladder, breast, colon, rectum, lung); cervical cancer, given its global importance as the fourth most common cancer diagnosis among women; and head and neck cancer (a major burden in middle income settings), for which there is an established association between delay and mortality.10 We selected these cancers by balancing representativeness with comprehensiveness. https://doi.org/10.1186/s12885-019-6181-4, DOI: https://doi.org/10.1186/s12885-019-6181-4. Psycho-Oncology. Privacy This article summarizes reviews the metabolic . Predictors of emotional distress a year or more after diagnosis of cancer: a systematic review of the literature. Two reviewers screened abstracts by using Covidence systematic review software (Veritas Health Innovation, Melbourne, Australia). Death or Debt? In Scotland, the prevalence of depression was found to be highest in patients with lung cancer (13%), followed by gynaecological cancer (11%), breast cancer (9%), colorectal cancer (7%), and genitourinary cancer (6%) [28]. Additionally, potential opportunities for second opinions could result in more effective or appropriate care, especially where variation in practice or outcomes exist across providers. 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. A key factor is the presence of pre-existing mental health problems and their severity. At diagnosis, the psychological health of patients should be considered alongside their physical health and sources of support offered. Article We included studies if they specifically reported on the impact of delay for a well defined cancer indication. In a report by CLIC (Cancer and Leukaemia in Childhood) Sargent which surveyed 146 young people with cancer, keeping in touch with friends and family, talking to others with similar experiences and access to the internet in hospital were reported to help maintain mental health during cancer treatment [50]. Common screening methods for depression include semi-structured diagnostic interviews, the Hospital Anxiety and Depression Scale - depression subscale (HADS-D) and Center for Epidemiologic Studies Depression Scale (CESD), which are designed to measure the severity of depressive symptoms. Mitchell AJ, Ferguson DW, Gill J, Paul J, Symonds P. Depression and anxiety in long-term cancer survivors compared with spouses and healthy controls: a systematic review and meta-analysis. 2013;14(8):72132. Daniel J. Smith BMC Cancer 19, Article number: 943 ( 2019 ) Cite this article 66k Accesses 213 Citations 35 Altmetric Metrics Abstract Background A cancer diagnosis can have a substantial impact on mental health and wellbeing. Journal Rankings on Oncology - Scimago Journal & Country Rank Cancer, an international interdisciplinary journal of the American Cancer Society, publishes high-impact, peer-reviewed original articles and solicited content on the latest clinical research findings. A meta-analyses of 15 studies meeting a number of quality criteria, including the use of diagnostic interviews, found that the estimated prevalence of depression varied across treatment settings (5 to 16% in outpatients, 4 to 14% in inpatients, 4 to 11% in mixed outpatient and inpatient samples, and 7 to 49% in palliative care) [2]. Article To evaluate the impact of our validity criteria on study findings, we undertook a sensitivity analysis and included studies that could be considered of borderline validity. For surgery, this is a 6-8% increase in the risk of death for every four week delay. The journal creates a "market place" for breast cancer topics which cuts across all the usual . Factors that may contribute to depression and anxiety among people living with and beyond cancer. Risk of suicide after cancer diagnosis in England. PubMed European Journal of Cancer Care | Hindawi ED is often a symptom of another health problem or health-related factor. International Journal of Cancer Research and Treatment. BMJ Open. . Individuals who have previously engaged in suicidal behaviour are likely to be particularly vulnerable. For example, our results suggest a 4% increased risk of death for a two week delay for breast cancer surgery (1.082weeks/4weeks; appendix 2). 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. Studies demonstrate that depression tends to be highest during the acute phase and decreases following treatment, but again this likely differs depending on the type of cancer and prognosis [21]. The primary reason for exclusion at the screening stage was lack of relevance to the study question. The timely delivery of radical radiotherapy: guidelines for the management of unscheduled treatment interruptions. Frimley Health NHS Foundation Trust: Specialist Doctor in Community Medicine. Conclusions Cancer treatment delay is a problem in health systems worldwide. 2017. 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). 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. Eligibility criteria for selecting studies Curative, neoadjuvant, and adjuvant indications for surgery, systemic treatment, or radiotherapy for cancers of the bladder, breast, colon, rectum, lung, cervix, and head and neck were included. 2014;4(3):e003901. Estimates for systemic treatment varied (hazard ratio range 1.01-1.28). Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. Time to adjuvant chemotherapy and survival in non-small cell lung cancer: a population-based study, Association of delayed adjuvant chemotherapy with survival after lung cancer surgery, A population-based study of the impact of delaying radiotherapy after conservative surgery for breast cancer, Adjuvant chemoradiation therapy for cervical cancer and effect of timing and duration on treatment outcome, Clinical impact of prolonged diagnosis to treatment interval (DTI) among patients with oropharyngeal squamous cell carcinoma, Association of survival with shorter time to radiation therapy after surgery for US patients with head and neck cancer, Prognostic value of wait time in nasopharyngeal carcinoma treated with intensity modulated radiotherapy: a propensity matched analysis, The Effect of Waiting Times for Postoperative Radiotherapy on Outcomes for Women Receiving Partial Mastectomy for Breast Cancer: a Systematic Review and Meta-Analysis, Intervals longer than 20 weeks from breast-conserving surgery to radiation therapy are associated with inferior outcome for women with early-stage breast cancer who are not receiving chemotherapy. The authors found depression to be more likely among younger and more socially disadvantaged individuals. Iatrogenic distress is also commonly reported amongst patients, which could increase the risk of experiencing later problems with depression and anxiety, including post-traumatic stress disorder [20]. Desire for psychological support in cancer patients with depression or distress: validation of a simple help question. 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. Adjuvant and neoadjuvant systemic treatment indications varied more widely in effect (hazard ratio range 1.01-1.28). Erectile dysfunction (ED) is often a symptom . We note that a delay of less than four weeks should not be justified as safe based on our findings. In the same study of ovarian cancer patients, depression was highest before treatment (25%) and during treatment (23%), and reduced following treatment (13%). Small purple diamonds represent the hazard ratio for each study and whiskers represent 95% confidence interval. However, despite its foundational importance, we lack standardised estimates of the effect of treatment delay on survival for most treatment indications. Self-management: enabling and empowering patients living with cancer as a chronic illness. Third-generation aromatase inhibitors (AIs) are the mainstay of treatment in hormone receptor (HR)-positive breast cancer. Heterogeneity between studies was evaluated using the I2 test. In addition, 73% of the patients with depression were not receiving treatment for their mental health. Does delay of adjuvant chemotherapy impact survival in patients with resected stage II and III colon adenocarcinoma? J Clin Oncol. being able to get an erection, but not having it last long enough for sex. The stigma surrounding both mental illness and certain types of cancer, such as lung cancer, can lead to feelings of guilt and shame, which could contribute to the onset of depression. Dissemination to study participants is not applicable. Cancer Treat Rev. Casellas-Grau A, Ochoa C, Ruini C. Psychological and clinical correlates of posttraumatic growth in cancer: a systematic and critical review. Barnett K, Mercer SW, Norbury M, Watt G, Wyke S, Guthrie B. HR=hazard ratio, Summary of characteristics for studies investigating surgical treatment, Summary of characteristics for studies investigating systemic treatment and radiotherapy. This is often related to a combination of poor communication, a lack of consideration of psychological concerns and disjointed care [14, 20]. For background and to support our argument, we synthesise existing systematic reviews relating to cancer and common mental disorders, focusing on depression and anxiety. Background . Mortality due to cancer treatment delay: systematic review and meta Links to Cancer Journals | OncologyPRO - ESMO Journal of cancer treatment & diagnosis Latest Journal Impact IF 2021-2022 | Trend, Prediction, Ranking, Key Factor Analysis Academic Accelerator Journal's Impact IF Journal of cancer treatment & diagnosis Last updated on Jun 03, 2022 [2022-06-03] Journal of cancer treatment & diagnosis The one high validity study for breast cancer adjuvant radiotherapy did not show an effect, although a clear effect of delay on local control has been described (hazard ratio for each month of delay 1.08, 95% confidence interval 1.02 to 1.14); longer delays (eg, >20 weeks) have been associated with worse breast cancer specific survival.4748. et al. The experience of being diagnosed, particularly if the diagnosis has been delayed, can be a significant source of distress and can impact on illness acceptance [14]. Overall, there are a lack of high-quality studies into the mental health of people with cancer following treatment and among long-term survivors, particularly for the less prevalent cancer types and younger people. Smith HR. Using diagnostic interviews, the prevalence of depression during treatment was found to be 14%, 9% in the first year after diagnosis and 8% a year or more after treatment in a meta-analysis of 211 studies [21]. 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]. This wide variation is due to several factors including the treatment setting, type of cancer included and method used to screen for symptoms (e.g. 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]. 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. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the Government of Ontario, the National Institute for Health Research, or the Department of Health and Social Care. Effective treatment and management strategies may also differ according to the demographic group affected. 2011;20(5):52531. This article is built on a literature review conducted by CLN and LK for a project on Supporting the mental and emotional health of people with cancer funded by the Big Lottery Fund when CLN was an employee of the Mental Health Foundation in Scotland during 2017. Figure 2, figure 3, figure 4 show summary results for all indications, with pooled estimates displayed for treatment site combinations where more than one high validity study exists. Many osteosarcoma tumors start at the end of long leg bones including the tibia and femur near the knee or . Cancer-related lymphedema risk factors, diagnosis, treatment, and The risk of suicide among people with cancer is higher than the general population for certain diagnoses that tend to have poorer prognoses, such as mesothelioma and lung cancer, especially in the first 6 months after diagnosis [12, 13]. Eligibility: (a) diagnosis and treatment HNC; (b) aged 18 to 70 years; (c) . Risk of suicide within 1 year of cancer diagnosis. Palliat Med. Halliwell E, Main L, Richardson C. The fundamental facts: the latest facts and figures on mental health: mental Health Foundation; 2007. This assumption was required to estimate per unit time mortality impact of delay from studies that use a variety of wait time representations. Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare: no support from any organisation for the submitted work; unrestricted research funding for an unrelated project from Roche (TPH); no other relationships or activities that could appear to have influenced the submitted work. A hazard ratio for overall survival was estimated for each four week increase in delay. 2013;25(4):791800. Editor: Markman, Maurie (Philadelphia, PA) . A variety of factors are likely to interact to influence the development of depression and anxiety among people with cancer (summarised in Fig. Funding: There was no project specific funding for this work. 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. Few studies have focused specifically on younger cancer survivors and more research is needed in this area. Compared to the general population, the prevalence of anxiety and depression is often higher among people with cancer, but estimates vary due to a number of factors, such as the type and stage of cancer. Achieving world-class cancer outcomes: a strategy for England 2015-2020. Health behaviors among head and neck cancer survivors | Journal of Implementing personalized pathways for cancer follow-up care in the United States: proceedings from an American Cancer SocietyAmerican Society of Clinical Oncology summit. Google Scholar. Cook SA, Salmon P, Hayes G, Byrne A, Fisher PL. Support Care Cancer. Ann Oncol. Depression and anxiety may hinder cancer treatment and recovery, as well as quality of life and survival. 2014;23(2):12130. Impact Factor: 3.734: CiteScore: 5.1: Acceptance Rate: 17%: Time to first decision: 5 days: For Authors. Cancer and comorbid anxiety was also unequally distributed; in the least advantaged groups around 12% had both conditions, compared to 7% among the most advantaged [35]. Google Scholar. PubMed Hui D, Glitza I, Chisholm G, Yennu S, Bruera E. Attrition rates, reasons, and predictive factors in supportive care and palliative oncology clinical trials. Six studies undertook cubic spline analysis and the results are compatible with log linear effects with the range of wait times considered here (four weeks to 16 weeks).151921264145 Moreover, the previous meta-analyses by Biagi and colleagues and Raphael and colleagues suggest a reasonable fit of a log linear relation to delay.12 If a linear relation with delay exists (rather than log linear), the degree of difference in the two models is expected to be sufficiently small to allow use of a log linear model for the specific purposes of modelling the impact of delay on mortality between four and 16 weeks (appendix 2). Learn more Psycho-Oncology. A lack of outward physical symptoms in ovarian cancer also means that self-monitoring is difficult [23]. 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. PubMed Central being able to get an erection sometimes, but not every time you want to have sex. Cite this article. Lancet Oncol. 2013;7(3):30022. There are also a lack of studies covering populations from low- and middle-income countries [34]. CMB is supported as the Canada Research Chair in Population Cancer Care. Psycho-oncology. Journal of Cancer Research | Cancer Research Articles - crimsonpublishers Fear of recurrence is one of the most commonly reported issues and an important area of unmet need for cancer survivors [24]. People who have previously used psychiatric services may be particularly vulnerable and at greater risk of mortality following a cancer diagnosis [4]. Sargent CLIC. Such figures translate into significant population level excess mortality. It is likely that collaborative care interventions which involve partnership between psychiatry, clinical psychology and primary care, overseen by a care manager are likely to be most effective in the management and treatment of depression amongst people with cancer [44]. Emerging cancer trends among young adults in the USA: analysis of a population-based cancer registry. being unable to get an erection at any time. Journal of Skin Cancer publishes clinical and translational research on the detection, diagnosis, prevention, and treatment of skin malignancies. Clinical Lung Cancer is a peer-reviewed bimonthly journal that publishes original articles describing various aspects of clinical and translational research of lung cancer.Clinical Lung Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of lung cancer. Kissane DW. Depression and anxiety among people living with and beyond cancer: a growing clinical and research priority. Our findings cannot be directly applied to other cancer specific treatment indications, or to subgroups or single patients with treatment indications considered here. Psycho-Oncol. 2019;120:8407. 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]. Among those with no previous psychiatric history, a diagnosis of cancer is associated with heightened risk of common mental disorders, which may adversely affect cancer treatment and recovery, as well as quality of life and survival [3]. We emphasise that the hazard ratio calculated in this study might be converted to shorter (eg, each week or each day) or longer units. CA Cancer J Clin. The PRISMA (preferred reporting items for systematic reviews and meta-analyses) guidelines were followed.11 We used Ovid Medline to carry out the search (appendix 1). Individual behaviours are associated with prostate cancer (PC) progression. Just over 40% of the young people who took part did not access support for their mental health needs. Rodin G, Lloyd N, Katz M, Green E, Mackay JA, Wong RK. Our findings could therefore underestimate the impact of delay on mortality. Eur J Oncol Nurs. For resectable GC, perioperative chemotherapy has become . The global challenge of cancer | Nature Cancer SUBMIT PAPER. Editing Services Article Outreach This Cancer journal works hard to maximize the impact of published research. A sensitivity analysis of studies that had been excluded because of lack of information on comorbidities or functional status did not change the findings. Further research that includes the less common types of cancer is required, as well as the inclusion of younger people and populations from low- and middle-income countries. PubMedGoogle Scholar. TPH holds a research chair provided by the Ontario Institute for Cancer Research through funding provided by the Government of Ontario (#IA-035). Psychological and Behavioral Approaches to Cancer Pain Management Supportive Care in Cancer 2022-2023 Journal's Impact IF is 3.359. 2015;9(4):150914. Terms and Conditions, The Guardian. 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. Common reactions immediately after the diagnosis are shock and denial, frequently followed by depression, anxiety and/or anger. 2020. Dissemination to participants and related patient and public communities: We plan to disseminate the results to patient organisations. 2018;379(25):243850. Google Scholar. Cancers | Free Full-Text | Navigating Intercultural Medical - MDPI Ethical approval: No ethical approval was required as this was a systematic review and meta-analysis of previously conducted studies. 2015;82(1):1008. The National Cancer Research Institute (NCRI) in the UK have also recently highlighted research into the short-term and long-term psychological impacts of cancer and its treatment as a key priority, following surveys of over 3500 patients, carers, and health and social care professionals [55].
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