Exploring the Use of a Digital Platform for Cancer Patients to Report Their Demographics, Disease and Therapy Characteristics, Age, and Educational Disparities: An Early-Stage Feasibility Study.

INTRODUCTION: The increasing burden of cancer, the development of novel therapies, and the COVID-19 pandemic have made cancer care more complex. Digital innovation was then pushed toward developing platforms to facilitate access to cancer care. Age, education, and other disparities were, however, shown to limit the use of the digital health innovation. The aim of this early-stage feasibility study was to assess whether Greek cancer patients would register at CureCancer and self-report their demographics, disease and therapy characteristics, and socioeconomic issues. The study was organized by the Hellenic Society of Medical Oncology. METHODS: Patients from nine cancer centers were invited to register on the CureCancer platform and complete an anonymous questionnaire on demographics, disease and therapy characteristics, and socioeconomic issues. Patients were also encouraged to upload, in a secure area for them, their medical files and share them with their physicians. They were then asked to comment on their experience of registration and how easy it was to upload their medical files. RESULTS: Of the 159 patients enrolled, 144 (90.56%) registered, and 114 of those (79.16%) completed the questionnaire, suggesting that the study is feasible. Users' median age was 54.5 years, and 86.8% of them were university and high school graduates. Most patients (79.8%) reported their specific type of cancer diagnosis, and all reported their therapy characteristics. Breast and lung cancers were the most common. A total of 87 patients (76.3%) reported being on active cancer therapy, 46 (40.4%) had metastatic disease, and 51 (44.7%) received supportive care medications. Eighty-one (71.05%) patients received prior cancer therapies, and twenty-seven recalled prior supportive care medications. All patients reported visiting non-oncology Health Care Professionals during the study. Nineteen of 72 (26.39%) patients who worked prior to cancer diagnosis changed work status; 49 (42.98) patients had children under 24 years; and 16 (14%) patients lived alone. Nine (7.9%) patients were members of patient associations. Registration was "much/very much" easy for 98 (86.0%) patients, while 67 (58.8%) had difficulties uploading their files. Patients commented on the well-organized data access, improved communication, feeling safe, medication adherence, interventions from a distance, and saving time and money. Over 80% of patients "preferred the digital way". DISCUSSION: A total of 114 patients succeeded in registering on the digital platform and reporting their demographics, disease and therapy characteristics, and socioeconomic issues. Age and educational disparities were disclosed and highlighted the need for educational programs to help older people and people of lower education use digital innovation. Health care policy measures would support patients' financial burden associated with work changes, living alone, and children under 24 years old at school or college. Policy actions would motivate patients to increase their participation in patient associations. According to the evidence DEFINED framework, the number of patients, and the focus on enrollment, engagement, and user experience, the study fulfills actionability level criterion 1.

Factors associated with anxiety and depression in cancer patients: Demographic factors and the role of demoralization and satisfaction with care.

OBJECTIVE: Anxiety and depression are common in cancer patients and seem to affect quality of life, treatment compliance and even survival. Defining factors related to anxiety and depression and exploring the role of demoralization and satisfaction with care, could contribute to the improvement of patients' quality of life and quality of health services as well. METHODS: A convenience sample of 150 cancer inpatients and outpatients from two oncology centers, with various types of solid tumors, participated in a prospective cross-sectional observational study. The psychometric tools used were the Greek versions of the Hospital Anxiety and Depression Scale, FAMCARE-Patient Scale and Oncology Palliative Care (FAMCARESCALE) and Demoralization Scale (DEMORALIZATION SCALE II, DS-II). RESULTS: Patients mean age was 62 years (20-85 years) and 89 patients (59.3%) were women. Among patients, 33% had breast, 24% gastrointestinal and 15% lung cancer. Eighty-two patients (54.7%) had metastatic disease. Women showed higher rates of anxiety (p = 0.054). Anxiety was inversely related to age (p = 0.043) and positively correlated with time since diagnosis (p = 0.076). Unmarried patients presented with higher rates of depression (p = 0.026). Multiple linear regression showed a statistically significant impact of Demoralization factor 'Meaning and Purpose' on anxiety (p < 0.001, R2  = 36.3%) and depression (p < 0.001, R2  = 49%). Moreover, higher educational level (p = 0.038, R2  = 3.1%) is related to higher levels of anxiety and higher scores of FAMCARESCALE factor-Information/interaction with the health care professionals, is related to lower levels of depression (p = 0.008, R2  = 2.7%). CONCLUSIONS: The results highlight the significant impact of demoralization on anxiety and depression in cancer patients. Early recognition of demoralization and early referral to mental health professionals will hopefully alleviate the mental burden of cancer patients.

Malignant Transformation of Schneiderian Papilloma Presenting With Progressive Binocular Diplopia and Blepharoptosis.

Sinonasal tumors arising from Schneiderian papillomas, most frequently associated with squamous cell carcinoma (SCC), are rare and often present with non-specific symptoms, even in an advanced stage. Herein, we report the case of a 61-year-old male who presented with a four-month history of progressive binocular diplopia, blepharoptosis, and amblyopia, and upon the essential diagnostic work-up he was subsequently diagnosed with SCC arising from an SP. Surgical management was not warranted due to the extent of the disease, so induction chemotherapy with cisplatin and 5-fluorouracil (5-FU) was commenced, followed by definitive concurrent chemoradiotherapy (CRT). The patient was still alive at 25 months after his first presentation, receiving supportive care. Our case highlights the importance of early recognition of neuro-ophthalmological disorders related to sinonasal carcinomas, as diagnostic delay may lead to both functional complications and higher morbidity.