The risks of the new morbidities acquired during pediatric onco-critical care and their life-shortening effects

Abstract Objective: The authors investigated the functional status at ICU admission and at hospital discharge, and the impact of dysfunctions on survivors' lifespan. Method: Single-center retrospective cohort. The FSS (Functional Status Scale) was calculated at ICU admission and at hospital discharge. A new morbidity was defined as an increase in FSS ≥ 3. Results: Among 1002 patients, there were 855 survivors. Of these, 194 (22.6%) had died by the end of the study; 45 (5.3%) had a new morbidity. Means in the motor domain at admission and discharge were 1.37 (SD: 0.82) and 1.53 (SD 0.95, p = 0.002). In the feeding domain, the means were 1.19 (SD 0.63) and 1.30 (SD 0.76), p = 0.002; global means were 6.93 (SD 2.45) and 7.2 (SD 2.94), p = 0.007. Acute respiratory failure requiring mechanical ventilation, the score PRISM IV, age < 5 years, and central nervous system tumors were independent predictors of new morbidity. New morbidity correlated with lower odds of survival after hospital discharge, considering all causes of death (p = 0.014), and was independently predictive of death (Cox hazard ratio = 1.98). In Weibull models, shortening in the life span of 14.2% (p = 0.014) was estimated as a new morbidity. Conclusions: New morbidities are related to age, disease severity at admission, and SNC tumors. New morbidities, in turn, correlate with lower probabilities of survival and shortening of the remaining life span. Physical rehabilitation interventions in this population of children may have the potential to provide an increase in lifespan.

Physical activity of children with cancer during the COVID-19 pandemic: what were the most relevant studies published from August 2019 to July 2021? / Actividad física em niños con cáncer durante la covid-19: ¿cuáles fueron las publicaciones más relevantes entre agosto de 2019 y julio de 2021? / Atividade física de crianças com câncer durante a covid-19: o que foi publicado de mais relevante entre agosto de 2019 e julho de 2021?

ABSTRACT This study aims to investigate up-to-date scientific information about physical activity, COVID-19, and childhood cancer. This study is an integrative review. Research was conducted in the Science Direct database, using keywords in three different combinations. In total, 50 publications classified as the most relevant of each keyword combination were selected, 26 eligible publications were reached from August 2019 to July 2021, of which nine were duplicates. When exclusion criteria were applied, 11 complete studies were selected. The level of physical activity (PA) of children diagnosed with cancer or those who survived cancer is low. Changes due to the COVID-19 pandemic include the decrease in the level of PA and the increase in the use of technological devices. The minimum PA recommendations for this population vary but some evidence supports its importance and benefits in minimizing the adverse effects arising from cancer and from the performed medical treatment. Exercise-based interventions should be chosen and carried out considering the type of cancer and the stage of treatment the child is in due to the evidence of its effectiveness.

RESUMEN Este estudio tiene como objetivo investigar, en la base de datos ScienceDirect, la información científica actualizada sobre actividad física, COVID-19 y cáncer infantil, mediante una revisión integradora, en la cual se utilizaron las palabras clave en tres combinaciones diferentes. Se seleccionaron cincuenta publicaciones clasificadas como las más relevantes de cada combinación, y se alcanzaron 26 publicaciones elegibles en el periodo entre agosto de 2019 y julio de 2021, de las cuales nueve fueron textos duplicados. Al aplicar los criterios de exclusión, se seleccionaron 11 artículos completos. El nivel de actividad física (AF) de los niños diagnosticados de cáncer o supervivientes de cáncer es bajo, y entre los cambios provocados por la pandemia de la COVID-19 se encuentran la disminución del nivel de AF y el aumento en el uso de dispositivos tecnológicos. Las recomendaciones mínimas de AF para esta población varían entre sí, sin embargo, existe evidencia que respalda su importancia y los beneficios en la minimización de los efectos adversos derivados del propio cáncer y del tratamiento médico realizado. Las intervenciones basadas en ejercicios, para la cual ya existe evidencia de efectividad, deben elegirse y llevarse a cabo teniendo en cuenta el tipo de cáncer y la etapa de tratamiento en la que se encuentra el niño.

RESUMO O objetivo deste trabalho é investigar, na base de dados Science Direct, informações científicas sobre atividade física, covid-19 e câncer infantojuvenil, através de uma revisão integrativa, utilizando três combinações de palavras-chave. Cinquenta publicações mais relevantes de cada combinação de palavras-chave foram selecionadas, e chegou-se a 26 artigos elegíveis no período compreendido entre agosto de 2019 e julho de 2021, dos quais nove eram textos duplicados. Aplicando-se os critérios de exclusão, foram selecionados 11 estudos completos. Constatou-se que o nível de atividade física (AF) de crianças com câncer ou sobreviventes do câncer é baixo e que entre as mudanças causadas pela pandemia de covid-19 estão a diminuição do nível de AF e o aumento do uso de dispositivos tecnológicos. As recomendações mínimas de AF para essa população variam, entretanto há evidências que sustentam sua importância e seus benefícios ao minimizar os efeitos adversos oriundos do próprio câncer e do tratamento médico realizado. As intervenções baseadas em exercícios, para as quais já há evidência de eficácia, devem ser escolhidas e realizadas a partir do tipo de câncer e na fase do tratamento em que a criança está.

Transformation and Breaking of Cancer Metaphyor: Study on Self-narrative of Cancer Patients / 中国医学伦理学

After cancer became the number one public enemy threatening global life and health in the 20th century, it was given various negative metaphors. As cancer mortality rates rise, cancer metaphors gradually spread to various corners of society and cause public panic. In the 1970s, China and the United States each appeared a female cancer survivor, Lin Guo and Susan Sontag. Both of them noticed the dual marginalization faced by cancer patients in China and the United States in social and medical fields during their own cancer and treatment processes. To reverse the situation of cancer patients, they actively engaged in social actions. Their actions not only helped to enhance the subjectivity and initiative of cancer patients, but also downplayed the growing fear of cancer in Chinese and American society at that time due to cancer metaphors. Based on the personal diaries and biographies of Lin Guo and Sontag, this paper elaborated on how these two women transformed and broke the metaphor of cancer in different social cultures and reconstructed the social significance of cancer from their life experiences such as family and upbringing environment, educational and work experiences, cancer and treatment.

¿La Respuesta Psicofisiológica de Estrés-Relajación es la Misma en todas las Pacientes Sobrevivientes de Cáncer? / Is the Psychophysiological Stress-Relaxation Response the Same in all Cancer Survivors?

Resumen Un sobreviviente de cáncer padece continuamente manifestaciones autonómicas debidas a la enfermedad, su tratamiento oncológico, y el estrés psicológico con que se enfrenta continuamente. Una de las medidas psicofisiológicas utilizada para la valoración del estrés es la disminución de la temperatura periférica. En contraparte, los procedimientos psicológicos de relajación para el manejo de estrés buscan incrementar la temperatura. Sin embargo, se desconoce si esta respuesta es igual en todas pacientes. El objetivo de esta investigación fue examinar los cambios de temperatura durante un protocolo de estrés psicosocial y relajación en pacientes sobrevivientes de cáncer de mama. Adicionalmente, se evaluó el autorreporte de dolor y su interferencia con el funcionamiento psicosocial. Los resultados mostraron variaciones de temperatura periférica en las pacientes; sin embargo, no todas las pacientes presentaron el mismo patrón de temperatura, encontrando 3 subgrupos de pacientes, cuyas trayectorias lineales de temperatura permitieron generar un pronóstico afectivo para el manejo de estrés. Por autorreporte, no se encontraron diferencias psicosociales entre los subgrupos, aunque sí se encontró una asociación inversa entre la interferencia del sueño y la temperatura periférica. Se concluye que la temperatura periférica permite distinguir a las pacientes que se les dificulta el manejo del estrés psicosocial de aquellas que se benefician de los procedimientos psicológicos de relajación.

Abstract A cancer survivor continually suffers from autonomic manifestations due to the disease, their cancer treatment, and the psychological stress they continually face. One of the psychophysiological measures used to assess stress is the decrease in peripheral temperature. In contrast, psychological relaxation procedures for stress management seek to increase temperature. However, it is unknown if this response is the same in all patients. This research examined breast cancer survivors' temperature changes during psychosocial stress and relaxation protocol. Additionally, self-reported pain and its interference with psychosocial functioning were evaluated. The results showed peripheral temperature variations in the patients; however, not all patients presented with the same temperature pattern, finding three subgroups of patients whose linear temperature trajectories allowed generating an affective prognosis for stress management. By self-report, no psychosocial differences were found between the subgroups, although an inverse association between sleep interference and peripheral temperature was found. It is concluded that peripheral temperature distinguishes patients who find it challenging to manage psychosocial stress from those who benefit from psychological relaxation procedures.

Relationship between Late Effects and Social Distress in Head and Neck Cancer Survivors More Than One Year After Radiation Therapy

Purpose: To investigate the relationship between late effects and social distresses in head and neck cancer survivors more than one year after radiotherapy. Method: An existing subset of head and neck cancer-specific quality of life scale was used to assess late effects and social distresses in survivors who had completed radiotherapy for more than 1 year. Descriptive statistics were performed for each social distresses and symptom, and were analyzed their association. Results: Seventy-three people responded to the survey. All patients had some symptoms. The most prevalent and severe late effect was dry mouth (79.5%). In addition, the most prevalent social distress was trouble with social eating (87.7%), and the most severe was speech problems. There was a significant positive correlation between late effects and social distresses. Social distresses were associated with dysphagia and sticky saliva and a history of surgery. Conclusion: Head and neck cancer survivors may have multiple late effects and social distresses at the same time, and there are a need for a comprehensive assessment of the impact of symptoms in the outpatient setting.

Factors affecting quality of life of cervical cancer patients: A multivariate analysis

Objective: The aim of good management for cancer survivors should not be limited to only clinical care, but rather it should also include best quality of life (QOL). The objective of this study was to find out various factors affecting QOL in cervical cancer patients so that by modifying these factors, the best QOL can be provided to them. Materials and Methods: This was a prospective cohort study conducted in the Department of Obstetrics and Gynaecology and Department of Radiotherapy, King George's Medical University (KGMU), Lucknow, from May 2015 to July 2016. The cases were selected from patients visiting the outpatient department or who were admitted to the Department of Obstetrics and Gynaecology and Department of Radiotherapy, KGMU. The data information was collected in the form of face-to-face interview using European Organization for Research and Treatment of Cancer general cancer QOL Score 30 (EORTC QLQ C-30) and EORTC QOL questionnaire cervical cancer module (QLQ CX-24) questionnaire. Results: QOL was assessed in 85 patients. Health-related QOL was separately studied in terms of overall general QOL and cancer cervix-specific QOL, and various factors affecting QOL were studied by multivariate analysis. Conclusion: Education, tobacco use, degree of differentiation of tumor, and size of tumor were the independent factors found to have statistically significant effect on QOL of cervical cancer survivors

Cancer Survivors and Returning to Work Perspectives from Occupational Health Physicians in Korea

BACKGROUND: This study was conducted from an occupational health perspective to document cancer survivors' ability to return to work, the role of clinical care, and the current status of effective return-to-work. METHODS: This cross-sectional study was conducted to evaluate the experiences and opinions of occupational health physicians (OHPs) regarding cancer survivors' return-to-work. A self-reported survey was conducted from December 30, 2015, to January 30, 2016, targeting 337 OHPs. Questions included: 1) treatment experiences of survivors in the words of OHPs, 2) current status of the assessments of fitness for work of cancer survivors, 3) experiences associated with workplace and treatment, and 4) problems of returning to work and overcoming system. RESULTS: Only 25% of the respondents said that they had experience treating cancer survivors, and the average number of patients was 12.6 per annum, which indicated that few cancer survivors were treated. Eleven cases included conducting assessment of fitness for work. There were 17 respondents who did not treat cancer survivors. Both those who had and did not have experience in treating survivors showed higher musculoskeletal system disorders (53.8 vs. 63.5) than cancer (15.5 vs. 11.2) in terms of frequency of the diseases in the assessment of fitness for work. Most respondents said that OHPs evaluate the current role appropriately and preferred OHPs in the future. They responded that OHPs found it difficult to treat cancer survivors, and it was psychologically tough to communicate with them (61.4%). Regarding the association of patient rehabilitation with workplaces, 48.9% said that workplaces provide inadequate support. CONCLUSION: As a preliminary study, we found that OHPs were found to have little experience in treating cancer survivors and undergo difficulties owing to poor collaboration with workplaces and communication with patients. This study will provide basic data for future studies to promote cancer survivors' return to workplaces.

Status of Exercise and Related Factors in Survivors of Breast Cancer

Purpose: The present study aimed to clarify the status of exercise and related factors among survivors of breast cancer. Methods: Questionnaires were distributed to survivors of breast cancer. The question items addressed the status of exercise participation, knowledge about the effects of exercise and need for support. Factors associated with exercise participation were analyzed using logistic regression analysis. Results: Among 293 valid responses (rate, 84.2%). Fifty-eight point four percent participated in exercise and 41.3% decreased exercise participation after being diagnosed with breast cancer. Furthermore, 91.9% needed support from health care providers regarding exercise. About 70% of respondents were aware that exercise improves sleep, but <50% knew that exercise ameliorates symptoms associated with breast cancer. Among seven factors, age, employment status and chemotherapy were associated with exercise status. Conclusion: Breast cancer survivors who are younger, employed and undergoing chemotherapy might not participate in exercise. The preventive effects of exercise on breast cancer and the importance of continuing daily exercise should be promoted. Health care providers should provide support for patients to participate in exercise considering the influence of treatment and physical capabilities.

Pain management for cancer survivors / 体力科学

From the start, World Health Organization has proposed that palliative medicine is applicable early in the course of illness. However, regrettably, palliative care has been usually provided to patients in the advanced cancer stage, as a terminal care. Recently, palliative medicine begins at the time-point when patients are diagnosed with cancer. In response to change in clinical settings of palliative medicine, cancer pain management has also changed. Considering long-term cancer treatment periods and increasing numbers of cancer survivors, cancer pain management should be recommended based on not only non-opioid pharmacotherapy but also the exercise/rehabilitation medicine and the cognitive-behavioral therapy. Especially, the exercise/rehabilitation medicine can provide beneficial effects on both pain management and cancer treatment itself: Sarcopenia is closely associated with poor prognosis of cancer and debilitating complications of chemotherapy. Further, non-sarcopenia patients can maintain their quality of life higher and show less fatigue during cancer treatment periods. To accomplish such favorable effects for cancer patients and cancer survivors, cancer pain should be managed adequately.

Patient, cured, victim or survivor of urological cancer? A qualitative study / Paciente, curado, vítima ou sobrevivente de câncer urológico? Um estudo qualitativo / ¿Paciente, curado, víctima o sobreviviente de cáncer urológico? Un estudio cualitativo *

ABSTRACT Purpose: to describe the meanings that patients attribute to the term cancer survivor and to analyze the identities assumed by them according to their experience with the disease. Methods: qualitative study with a narrative method, theoretical framework of the medical anthropology and identity concept. The study included 14 participants, men and women, diagnosed with urologic cancer. The semi-structured interviews were performed at the individual's home, after confirming participation. Results: eight participants assumed to be survivors, but five also assumed at least one other identity, in addition to cancer survivor. In contrast, among the six who defined themselves as cured, only one indicated another identity. Four considered themselves as victims and only two as cancer patients. However, the latter - cancer patient and victim - assumed at least one other associated identity. Conclusions: allowing patients to reflect on themselves and their experience with the disease, as well as attributing themselves a new identity, will be directly related to the wellbeing and momentum the survivor is going through. Therefore, it can direct care in the cancer survivorship phase according to each survivor's individual context.

RESUMO Objetivo: descrever os significados que os pacientes atribuem ao termo sobrevivente do câncer e analisar as identidades assumidas por eles de acordo com sua experiência com a doença. Métodos: estudo qualitativo com método narrativo, referencial teórico da antropologia médica e conceito de identidade. O estudo incluiu 14 participantes, homens e mulheres, diagnosticados com câncer urológico. As entrevistas semiestruturadas foram realizadas na residência dos indivíduos, após confirmação da participação. Resultados: oito participantes assumiram ser sobreviventes, mas cinco também assumiram pelo menos uma outra identidade, além de sobrevivente do câncer. Em contraste, entre os seis que se definiram como curados, apenas um indicou outra identidade. Quatro se consideraram como vítimas e apenas dois como pacientes com câncer. No entanto, os últimos - paciente com câncer e vítima - assumiram pelo menos uma outra identidade associada. Conclusões: permitir que os pacientes reflitam sobre si mesmos e sobre sua experiência com a doença, além de se atribuírem uma nova identidade, estará diretamente relacionado com o bem-estar e o momento pelo qual o sobrevivente está passando. Portanto, pode direcionar o cuidado na fase de sobrevivência ao câncer de acordo com o contexto individual de cada sobrevivente.

RESUMEN Objetivo: describir los significados que los pacientes atribuyen al término sobreviviente del cáncer y analizar las identidades asumidas por ellos de acuerdo con su experiencia con la enfermedad. Métodos: estudio cualitativo con método narrativo, referencial teórico de la antropología médica y concepto de identidad. El estudio incluye 14 participantes, hombres y mujeres, diagnosticados con cáncer urológico. Las entrevistas semiestructuradas fueron realizadas en la residencia de los individuos, después de la confirmación de la participación. Resultados: ocho participantes asumieron ser sobrevivientes, pero cinco también asumieron por lo menos otra identidad, además de sobreviviente del cáncer. En contraste, entre los seis que se definieron como curados, solo uno indicó una identidad diferente. Cuatro se consideraron como víctimas y solo dos como pacientes con cáncer. Sin embargo, los últimos - paciente con cáncer y víctima - asumieron por lo menos otra identidad asociada. Conclusiones: permitir que los pacientes reflexionen sobre sí mismos y sobre su experiencia con la enfermedad, además de atribuirse una nueva identidad, estará directamente relacionado con el bienestar y el momento por el cual el sobreviviente está pasando. Por lo tanto, puede direccionar el cuidado en la fase de sobrevivencia al cáncer de acuerdo con el contexto individual de cada sobreviviente.

Association Between Health Behaviors and Family History of Cancer in Cancer Survivors: Data From the Korean Genome and Epidemiology Study

BACKGROUND: We compared health behaviors, including current smoking, alcohol drinking, regular exercise, obesity, and abdominal obesity, among Korean cancer survivors with and without family history of cancer. METHODS: This study included 5,247 cancer survivors with family history of cancer (1,894 with and 3,353 without), who were recruited from the Health Examinee cohort. Health behaviors were identified using questionnaire. Adjusted ORs (aORs) between health behaviors and family history of cancer were estimated by multivariate logistic regression analysis adjusted for sociodemographic factors. All analyses were conducted separately according to sex. RESULTS: Prevalence of current smoking, alcohol drinking, no regular exercise, obesity, and abdominal obesity was 16.3%, 48.3%, 36.0%, 31.3%, and 42.3% in male cancer survivors and 1.7%, 20.6%, 43.8%, 28.5%, and 72.5% in female, respectively. Health behaviors in male cancer survivors with and without family history of cancer were not significantly different after being adjusted for other covariates (aOR = 1.04, 95% CI = 0.75–1.44 for current smoking; aOR = 0.96, 95% CI = 0.76–1.22 for current drinking; aOR = 0.85, 95% CI = 0.66–1.10 for regular exercise; aOR = 0.96, 95% CI = 0.73–1.25 for obesity; aOR = 0.97, 95% CI = 0.75–1.25 for abdominal obesity). In female cancer survivors, there were no significant differences in health behaviors according to family history of cancer (aOR = 0.76, 95% CI = 0.44–1.32; aOR = 1.11, 95% CI = 0.94–1.31; aOR = 0.99, 95% CI = 0.87–1.14; aOR = 0.99, 95% CI = 0.85–1.16; aOR = 0.93, 95% CI = 0.80–1.10, respectively). CONCLUSIONS: We identified no significant differences in health behaviors according to family history of cancer in cancer survivors. More studies should be conducted to identify correlations between family history of cancer and prognosis in cancer survivors.

Comprehensive social, psychological and behavior intervention of Shanghai Cancer Rehabilitation Club / 上海预防医学

Cancer survivors are faced with physical, emotional, mental, social relationship, vocational, economic and other challenges with the diagnosis and treatment of cancer.Those challenges would last for their whole cancer survivorship.In this case cancer has become a chronic disease.It is one of the most promising models that cancer rehabilitation organizations involving in community management and self-management of cancer patients.The comprehensive social, psychological and behavior intervention of Shanghai Cancer Rehabilitation Club has achieved positive results.It should be considered to summa-rize, evaluate and promote the intervention mode further.

Management of long-term breast cancer survivors in Korea

Breast cancer is the second most common cancer of Korean women population. Due to the marked development of early detection as well as treatment techniques, the number of long-term survivors from breast cancer has been rapidly increasing. As the cancer survivors from other cancers do, breast cancer survivors also have various kinds of health problems. Diverse treatment modalities including anti-cancer hormonal therapy for breast cancer are related with wide range of long-term and late effects such as lymphedema, vasomotor symptoms, skin and musculoskeletal problems, and cardiac toxicity. Many breast cancer survivors also exposed to the increased risk of secondary cancer as well as comorbidities such as diabetes, dyslipidemia, and osteoporosis. In addition, many breast cancer survivors tend to suffer from the fear of recurrence, depression, and anxiety, even after the completion of cancer treatment. To meet the complex needs of breast cancer survivors, comprehensive medical as well as psychosocial supports seem essential. However, those needs have been frequently neglected, because oncologists usually focus on cancer treatment and do not have enough time to manage the various health problems. Integrated care on the basis of intimate and interactive communication between oncologists and primary care physicians could be a desirable way of satisfying the unmet needs of breast cancer survivors and thus, improving their quality of life.

Management of long-term colorectal cancer survivors in Korea

Colorectal cancer (CRC) is the third most common cancer in Korea. Its average growth rate has been 3.7% annually from 1999 to 2013. The 5-year relative survival rate is 75.6%. The number of CRC survivors is expected to increase steadily because of its high incidence and survival rate. Because CRC survivors are at risk for recurrence, metachronous cancer, and other cancers, they should be checked regularly. Recommended surveillance includes history-taking and physical examination, colonoscopy, carcinoembryonic antigen testing, and computed tomography. Routine complete blood counts, liver function test, and positron emission tomography are not recommended. CRC survival, which is associated with Lynch syndrome and familial adenomatous polyposis, is also related to a higher risk of other cancers such as gastrointestinal and gynecologic cancers. Additional surveillance should be taken. CRC survivors could complain of general health problems such as cancer-related fatigue and psychosocial/cognitive dysfunction, in addition to treatment-related problems including bowel/urologic/sexual dysfunction, peripheral neuropathy, and ostomy care. They are also at greater risk of cardiovascular diseases. The primary care physician should counsel CRC survivors about their health problems and make an effort to address these concerns. Primary care physicians should try to communicate with CRC survivors and all specialists for clinical follow-up care.

Pregnancy in breast cancer survivor with anthracycline induced cardiomyopathy.

With earlier diagnosis and improved treatment modalities and management of breast cancer patients, survival is improving. An increasing number of survivors are in the reproductive age group; however a neglected medical area is contraceptive advice, failure of which can result in unwanted pregnancy and further medical complications. An undiagnosed pregnancy in a breast cancer survivor with known anthracycline- induced cardiomyopathy is presented here.

Experiences of cancer survivors who use a palliative day care salon on a university campus

<b>Objectives</b>: The purpose of this qualitative study was to examine the experiences of cancer survivors who used a palliative day care salon on a university campus. <b>Method</b>: Semi-structured interviews were conducted with ten cancer survivors; thereafter, we performed content analysis. <b>Results</b>: Ten categories were identified. The following were identified as motives to participate in the activities of the salon: (1) need for spiritual support, (2) desire to discover the meaning of life. The following experiences were described regarding the salon: (3) a place to express emotions openly, (4) a place to engage in activities as one pleases, (5) a place to communicate with others and express one’s true feelings, (6) a place that instills vigor as a result of expert advice. The following changes were identified after participation: (7) adopting an appropriate lifestyle, (8) improvement in image during the recurrence of cancer and towards the end of one’s life, (9) better family and social relationships, (10) a broader range of activities and uplifted sense for playing their roles. <b>Discussion</b>: Cancer survivors require support. In the salon, they could openly express their true feelings about their experiences of cancer and readily accepted one another. Further, their perceptions and attitudes toward life were being transformed through an enhanced sense of self-awareness. This transformation was facilitated by free activities on the university campus, an assurance of physical and psychological safety, and an indication of an outlet for such transformation.

Dietary Intake Status among Korean Female Breast Cancer Survivors / 대한지역사회영양학회지

OBJECTIVES: We aimed to evaluate dietary intake among female breast cancer survivors in a cross-sectional study. METHODS: A total of 127 women who had breast cancer surgery at least 6 months before baseline were included. Dietary intake of female breast cancer survivors was assessed through self-reported 3 day-dietary records. To compare dietary intake between breast cancer survivors and general female population without cancer, we selected the 1:4 age matched women from the 2011 Korean National Health and Nutrition Examination Survey (KNHANES). In the KNHANES, participants were asked about their dietary intake using the 24-hour dietary recalls. We also examined whether dietary intake varied by age group, cancer stage, or time since surgery among breast cancer survivors. We used the generalized linear model to compare their dietary intakes. RESULTS: Intakes of total energy, beta-carotene, folate, vitamin C, plant iron and fruits were lower among breast cancer survivors with longer time since surgery compared to those with shorter time (p < 0.05). Breast cancer patients with higher stage at diagnosis tended to consume less legumes (p = 0.01) than those with lower stage. When we compared dietary intake between breast cancer survivors and the general female population without cancer, breast cancer survivors were more likely to consume most of macro- and micro-nutrients in larger quantity (p < 0.05) and adhere to healthier diet characterized by higher intakes of legumes, seed and nuts, vegetables and fishes and shells than the general female population who never had been diagnosed with cancer (p < 0.05). CONCLUSIONS: Our study results suggested that the intakes of nutrients and foods varied by time since surgery and cancer stage among breast cancer survivors and dietary intakes among breast cancer survivors differed from that in the general population. Further prospective studies are warranted to explore the association between dietary intakes of specific food items and survival among Korean breast cancer survivors.

Prevalence of the Components of Metabolic Syndrome in Childhood Cancer Survivors / 임상소아혈액종양

BACKGROUND: Childhood cancer survivors have been reported to have an increased risk of prevalence of metabolic syndrome compared to the normal population. The purpose of this study was to investigate the prevalence of the components of metabolic syndrome in childhood cancer survivors in a single institute.METHODS: The study included survivors who had survived for at least 5 years after off chemotherapy without evidence of recurrence. We measured body mass index (BMI), triglycerides (TG), high-density lipoprotein (HDL)-cholesterol, systolic and diastolic blood pressure, and fasting glucose.RESULTS: We investigated 58 childhood cancer survivors, median age 5.4 years (range, 0.1-17.2 years) at diagnosis and median follow-up time elapsed after off chemotherapy 7.4 years (range, 4.7-18.6 years). The frequency of metabolic syndrome was 3.4%. The prevalence of each component was: obesity, 17.2%; elevated TG level, 46.6%; low HDL cholesterol, 34.5%; elevated blood pressure, 1.7%; and elevated fasting glucose, 9.3%, respectively. Sixty nine percentage of survivors had at least 1 abnormal component of metabolic syndrome. The increased TG level was found more frequently in obese subjects than normal weight subjects.CONCLUSION: We observed the high incidence of increased TG level in childhood cancer survivors. It is necessary to be closely monitored the components of metabolic syndrome in childhood cancer survivors, in order to prevent them from cardiovascular diseases and improve their health outcomes.

Prevalence of the Components of Metabolic Syndrome in Childhood Cancer Survivors / 임상소아혈액종양

BACKGROUND: Childhood cancer survivors have been reported to have an increased risk of prevalence of metabolic syndrome compared to the normal population. The purpose of this study was to investigate the prevalence of the components of metabolic syndrome in childhood cancer survivors in a single institute. METHODS: The study included survivors who had survived for at least 5 years after off chemotherapy without evidence of recurrence. We measured body mass index (BMI), triglycerides (TG), high-density lipoprotein (HDL)-cholesterol, systolic and diastolic blood pressure, and fasting glucose. RESULTS: We investigated 58 childhood cancer survivors, median age 5.4 years (range, 0.1-17.2 years) at diagnosis and median follow-up time elapsed after off chemotherapy 7.4 years (range, 4.7-18.6 years). The frequency of metabolic syndrome was 3.4%. The prevalence of each component was: obesity, 17.2%; elevated TG level, 46.6%; low HDL cholesterol, 34.5%; elevated blood pressure, 1.7%; and elevated fasting glucose, 9.3%, respectively. Sixty nine percentage of survivors had at least 1 abnormal component of metabolic syndrome. The increased TG level was found more frequently in obese subjects than normal weight subjects. CONCLUSION: We observed the high incidence of increased TG level in childhood cancer survivors. It is necessary to be closely monitored the components of metabolic syndrome in childhood cancer survivors, in order to prevent them from cardiovascular diseases and improve their health outcomes.

The correlates of unemployment and its association with quality of life in cervical cancer survivors / 부인종양

OBJECTIVE: Little is known regarding cervical cancer survivors' employment status, which represents social integration of cancer survivors as a pivotal domain of long-term quality of life. The goal of this study was to assess the correlates of unemployment and evaluate the impact on the comprehensive quality of life in cervical cancer survivors. METHODS: We enrolled 858 cervical cancer survivors from the gynecologic oncology departments of multi-centers in Korea. Factors associated with unemployment were identified using multivariate logistic regression analyses. We assessed different health-related quality of life domains with multivariate-adjusted least-square means between cervical cancer survivors who currently work and do not. RESULTS: After diagnosis and treatment, the percentage of unemployed survivors increased from 50.6% to 72.8%. Lower income (adjusted odds ratio [aOR], 1.97; 95% confidence interval [CI], 1.38 to 2.81), medical aid (aOR, 1.58; 95% CI, 1.05 to 2.38), two or more comorbidities (aOR, 1.80; 95% CI, 1.12 to 2.90), current alcohol drinkers (aOR, 2.33; 95% CI, 1.54 to 3.52), and employed at the time of diagnosis (aOR, 10.72; 95% CI, 7.10 to 16.16) were significantly associated with unemployment. Non-working groups showed significant differences with respect to physical functioning, role functioning, depression, and existential well-being. CONCLUSION: The proportion of unemployed cervical cancer survivors seems to increase, with low-income status and the presence of medical aid negatively being associated with employment, in addition to other comorbidities and previous working status. Effort should be made to secure the financial status of cervical cancer survivors.