Displaying publications 1 - 20 of 35 in total

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  1. Mohamed Hussin NA, Mohd Sabri NS
    Support Care Cancer, 2023 Oct 27;31(12):659.
    PMID: 37889352 DOI: 10.1007/s00520-023-08060-3
    Caregiving for cancer patients can cause stress among family caregivers. Caregiving stress is also associated with guilt as they cannot provide adequate care for cancer patients. However, guilt among family caregivers of cancer patients is poorly understood. This qualitative study aimed to explore the dynamics of guilt feelings in families that care for cancer patients. This study involved 45 family caregivers of cancer patients. Thematic data analysis was conducted. There were six themes emerging. Caregiving can be challenging, guilt and blame, guilt due to lack of self-capacity, guilt for neglecting others, no guilt at all, and discussion of guilt and blame as a caregiver. This study offers insight into social workers regarding the challenges and experiences faced by family caregivers of cancer patients. Appropriate health interventions and support should be provided to family caregivers of cancer patients to improve their well-being.
  2. Su TT, Azzani M, Tan FL, Loh SY
    Support Care Cancer, 2018 May;26(5):1617-1624.
    PMID: 29209834 DOI: 10.1007/s00520-017-3987-y
    PURPOSE: This study aimed, firstly, to assess the determinants of return to work (RTW), secondly, to explore the amount of annual wage loss, and finally, to discover the determinants of wage loss among breast cancer (BC) survivors.

    METHODS: A cross-sectional study design was used in this research. The data was collected via interview using a validated questionnaire. Logistic regression models were developed to discover the significant determinants of RTW and of wage loss among BC survivors.

    RESULTS: A total of 256 BC survivors were included in this study. The analysis showed that there was a 21% loss of or reduction in mean income within 1 year after diagnosis. The significant predictors of RTW are being a government employee, having reduced wages or wage loss, and if the case had been diagnosed 1 year or more ago. Being a private sector employee and having a late stage of cancer was a barrier to RTW. The main risk factors for reduced wages or wage loss were belonging to the age group of 40-59 years, being of Chinese or Indian ethnicity, having low educational status, and not returning to work. However, belonging to the higher monthly income group (earning > RM 2000) is a protective factor against the risk of reduced wages or wage loss.

    CONCLUSIONS: Non-RTW and wage loss after diagnosis of BC may result in the survivors experiencing a significant financial burden. Assessment of these patients is becoming more crucial because more women participate in the workforce in Malaysia nowadays and because BC is managed using multiple treatment modalities with their consequences could lead to long absences from work.

  3. Gan GG, Leong YC, Bee PC, Chin E, Teh AK
    Support Care Cancer, 2015 Aug;23(8):2399-406.
    PMID: 25876158 DOI: 10.1007/s00520-015-2614-z
    BACKGROUND: Complementary and alternative medicine (CAM) is often used by cancer patients, but not many studies had been published on the prevalence of CAM use in patients with hematological cancers. This study aims to determine the prevalence of CAM and type of CAM used in this group of patients in a multiracial and multicultural country.

    PATIENTS AND METHODS: This is a cross-sectional survey carried out in two hospitals in Malaysia. Patients with underlying hematological cancers were asked to complete the questionnaires on CAM and the Hospital Anxiety and Depression Scale.

    RESULTS: A total of 245 patients participated. The prevalence of CAM use was 70.2 %. The most common types of CAM used are biological-based therapies (90.2 %) and mind-body interventions (42 %). Vitamin and diet supplements (68.6 %) and folk/herb remedies (58 %) are the most common biological-based therapies used. There is no significant association of CAM use with age, gender, education level, and household income. Female patients are more likely to use more than one CAM therapies. The most common reason reported for CAM use was to boost immunity (57 %) and cure (24 %). Majority of patients (65 %) felt CAM was effective, and 60 % did not inform their physicians regarding CAM usage.

    CONCLUSION: In view of the high prevalence of CAM use in patients with hematological cancers, it is important that the physicians play an active role in seeking information from patients and to monitor possible drug-vitamin-herbal interactions.

  4. Tang WZ, Yusuf A, Jia K, Iskandar YHP, Mangantig E, Mo XS, et al.
    Support Care Cancer, 2022 Dec 17;31(1):55.
    PMID: 36526859 DOI: 10.1007/s00520-022-07506-4
    OBJECTIVE: This study was conducted to examine the factors associated with stigma in breast cancer women.

    METHODS: PubMed, Embase, the Cochrane Library, Web of Science, and two Chinese electronic databases were electronically searched to identify eligible studies that reported the correlates of stigma for patients with breast cancer from inception to July 2022. Two researchers independently performed literature screening, data extraction, and risk of bias assessment. R4.1.1 software was used for statistical analysis.

    RESULTS: Twenty articles including 4161 patients were included in the systematic review and meta-analysis. Results showed that breast cancer stigma was positively correlated with working status, type of surgery, resignation coping, depression, ambivalence over emotional expression, and delayed help-seeking behavior and negatively correlated with age, education, income, quality of life, social support, confrontation coping, psychological adaptation, self-efficacy, and self-esteem. Descriptive analysis showed that breast cancer stigma was positively correlated with intrusive thoughts, body image, anxiety, and self-perceived burden but negatively correlated with a sense of coherence, personal acceptance of the disease, sleep quality, cancer screening attendance and doctor's empathy.

    CONCLUSION: Many demographic, disease-related, and psychosocial variables are related to breast cancer stigma. Our view can serve as a basis for health care professionals to develop health promotion and prevention strategies for patients with breast cancer.

  5. Chanthawong S, Lim YH, Subongkot S, Chan A, Andalusia R, Ahmad Bustamam RS, et al.
    Support Care Cancer, 2019 Mar;27(3):1109-1119.
    PMID: 30112718 DOI: 10.1007/s00520-018-4400-1
    PURPOSE: Recent studies suggested that olanzapine, together with dexamethasone and serotonin-3 receptor antagonist (5HT3RA), is effective in preventing chemotherapy-induced nausea and vomiting (CINV) following highly emetogenic chemotherapy (HEC). This regimen is particularly useful in Southeast Asia (SEA) countries where resources are limited. We aimed to evaluate the cost-effectiveness of incorporating olanzapine into standard antiemetic regimens for the prevention of CINV in patients receiving HEC among SEA countries.

    METHODS: Using a decision tree model, clinical and economic outcomes associated with olanzapine-containing regimen and standard antiemetic regimen (doublet antiemetic regimen: dexamethasone+first generation 5HT3RA) in most SEA countries except in Singapore (triplet antiemetic regimen: dexamethasone+first generation 5HT3RA + aprepitant) for CINV prevention following HEC were evaluated. This analysis was performed in Thailand, Malaysia, Indonesia, and Singapore, using societal perspective method with 5-day time horizon. Input parameters were derived from literature, network meta-analysis, government documents, and hospital databases. Outcomes were incremental cost-effectiveness ratio (ICER) in USD/quality-adjusted life year (QALY) gained. A series of sensitivity analyses including probabilistic sensitivity analysis were also performed.

    RESULTS: Compared to doublet antiemetic regimen, addition of olanzapine resulted in incremental QALY of 0.0022-0.0026 with cost saving of USD 2.98, USD 27.71, and USD 52.20 in Thailand, Malaysia, and Indonesia, respectively. Compared to triplet antiemetic regimen, switching aprepitant to olanzapine yields additional 0.0005 QALY with cost saving of USD 60.91 in Singapore. The probability of being cost-effective at a cost-effectiveness threshold of 1 GDP/capita varies from 14.7 to 85.2% across countries.

    CONCLUSION: The use of olanzapine as part of standard antiemetic regimen is cost-effective for the prevention of CINV in patients receiving HEC in multiple SEA countries.

  6. Islam T, Musthaffa S, Hoong SM, Filza J, Jamaris S, Cheng ML, et al.
    Support Care Cancer, 2021 May;29(5):2631-2638.
    PMID: 32968861 DOI: 10.1007/s00520-020-05776-4
    PURPOSE: Wider breast cancer (BC) treatment options, short consultation time with physicians, lack of knowledge, and poor coping skills at the time of diagnosis may affect patients' decisions causing treatment delays and non-adherence. To address this gap, a breast care nurse video orientation program was started. Our aim was to evaluate the video on patients' knowledge, satisfaction, and treatment adherence.

    METHODS: The video was developed using the BC delay explanatory model. A self-administered pre- and post-survey on 241 newly diagnosed BC patients in University Malaya Medical Center was performed. The Wilcoxon matched paired signed rank test was used to evaluate patients' pre and post perceived knowledge using a Likert scale 0 to 4 (0 = "no knowledge," 4 = "a great degree of knowledge"). Treatment adherence among participants were measured after 1-year follow-up.

    RESULTS: Eighty percent of the patients reported that the video met or exceeded their expectations. In total 80.5% reported that the video was very effective and effective in improving their perspective on BC treatments. There was improvement in perceived knowledge for treatment options (mean scores; M = 0.93 versus M = 2.97) (p < 0.001) and also for perceived knowledge on types of operation, information on chemotherapy, radiotherapy, hormone therapy, healthy diet, physical activity after treatments, and care of the arm after operation(p < 0.001). In total 89.4%, 79.3%, and 85.9% adhered to surgical, chemotherapy, and radiotherapy recommended treatment, respectively.

    CONCLUSION: The video improved patients' perceived knowledge and satisfaction. The program improved access not only to new BC patients but also the public and found sustainable using the YouTube platform.

  7. Lim RJ, Nik Nabil WN, Chan SY, Wong YF, Han LX, Gong JY, et al.
    Support Care Cancer, 2019 Sep;27(9):3491-3498.
    PMID: 30675667 DOI: 10.1007/s00520-019-4646-2
    PURPOSE: More than 80% head and neck cancer patients endured radiotherapy-induced xerostomia which impacts their quality of life (QoL). This observational study evaluated the effect of herbal treatment on head and neck cancer patients' xerostomia and QoL.

    METHODS: Head and neck cancer patients were recruited from July 2016 till March 2017 at National Cancer Institute, Ministry of Health, Malaysia. All study participants continued their standard oncology surveillance. Treatment group participants additionally received Chinese herbal treatment. The assessments included unstimulated salivary flow rate (USFR), stimulated salivary flow rate (SSFR), and QoL questionnaire.

    RESULTS: Of 42 recruited participants, 28 were in the treatment group and 14 were in the control group. Participants were mainly Chinese (71.4%), stage III cancer (40.5%), and had nasopharynx cancer (76.2%). The commonly used single herbs were Wu Mei, San Qi, and Tian Hua Fen. Sha Shen Mai Dong Tang, Liu Wei Di Huang Wan, and Gan Lu Yin were the frequently prescribed herbal formulas. The baseline characteristics, USFR, SSFR, and QoL between control and treatment groups were comparable (p > 0.05). USFR between control and treatment groups were similar throughout the 6-month study period. SSFR for the treatment group significantly improved from 0.15 ± 0.28 ml/min (baseline) to 0.32 ± 0.22 ml/min (p = 0.04; at the 3rd month) and subsequently achieved 0.46 ± 0.23 ml/min (p = 0.001; at the 6th month). The treatment group had better QoL in terms of speech (p = 0.005), eating (p = 0.02), and head and neck pain (p = 0.04) at the 6th month.

    CONCLUSION: Herbal treatment may improve xerostomia and QoL in post-radiotherapy head and cancer patients.

  8. Zhou Y, Che CC, Chong MC, Zhao H, Lu Y
    Support Care Cancer, 2023 May 30;31(6):361.
    PMID: 37249639 DOI: 10.1007/s00520-023-07826-z
    PURPOSE: Literature on marital self-disclosure interventions for cancer patients lacks consistency in methodology and content. Moreover, the impact of such interventions on physical and psychological health, marital relationships, and self-disclosure ability is controversial. This review aims to systematically analyze the studies of marital self-disclosure intervention, synthesize the structure and topics of marital self-disclosure, and summarize and evaluate its effects on improving physical and psychological outcomes and marital relationships in cancer patients and their spouses.

    METHOD: This systematic review used the preferred reporting items of Systematic Reviews and Meta-Analyses (PRISMA). We conducted a systematic review of randomized controlled and quasi-experimental studies published from the establishment of the database to October 2022. Marital self-disclosure interventions were conducted with both cancer patients and their spouses. Studies published in a language other than English or Chinese, and studies below a quality grade of C were excluded. Data were extracted through a standardized data collection form, and two reviewers independently extracted and evaluated the data. The quality of the included studies was assessed using the Cochrane Handbook of Systematic Reviews of Interventions, and a third reviewer adjudicated in case of disagreement. The data were synthesized by vote counting based on direction of effect according to the Synthesis Without Meta-analysis (SWiM) reporting guideline.

    RESULTS: Thirteen studies were included in the review. Based on quality evaluation, three studies were categorized as grade A (good), and ten studies were grade B (moderate). Seven studies reported moderate rates of participant refusal and attrition. The structure and topics of marital self-disclosure varied across different studies. The five studies had various prespecified disclosure topics, such as fear of cancer recurrence, benefit finding, and emotional distress. The overall results suggest that marital self-disclosure interventions can improve physical and psychological health, enhance marital relationships, and increase self-disclosure ability.

    CONCLUSION: The limited number of studies, small sample sizes, diverse intervention strategies, and methodological heterogeneity weakened the evidence base for the effectiveness of marital self-disclosure interventions. Therefore, further high-quality randomized controlled trials (RCTs) are recommended to confirm the effectiveness of such interventions. These studies should also evaluate the interventions' long-term impact, analyze optional topics and methods, identify key features, and explore the development of the best intervention program.

  9. Tan BK, Chua SS, Chen LC, Chang KM, Balashanker S, Bee PC
    Support Care Cancer, 2020 Jul;28(7):3237-3247.
    PMID: 31734798 DOI: 10.1007/s00520-019-05133-0
    PURPOSE: Suboptimal adherence to tyrosine kinase inhibitors (TKIs) contributes to poor clinical outcomes in chronic myeloid leukemia (CML). This randomised controlled trial (RCT) aimed to evaluate the impact of a medication management service (MMS) on adherence to TKIs and clinical outcomes.

    METHODS: A parallel RCT was conducted in two hospitals in Malaysia, where 129 CML patients were randomised to MMS or control (usual care) groups using a stratified 1:1 block randomisation method. The 6-month MMS included three face-to-face medication use reviews, CML and TKI-related education, two follow-up telephone conversations, a printed information booklet and two adherence aids. Medication adherence (primary outcome), molecular responses and health-related quality of life (HRQoL) scores were assessed at baseline, 6th and 12th month. Medication adherence and HRQoL were assessed using medication possession ratio and the European Organisation for Research and Treatment in Cancer questionnaire (EORTC_QLQ30_CML24) respectively.

    RESULTS: The MMS group (n = 65) showed significantly higher adherence to TKIs than the control group (n = 64) at 6th month (81.5% vs 56.3%; p = 0.002), but not at 12th month (72.6% vs 60.3%; p = 0.147). In addition, a significantly higher proportion of participants in the MMS group achieved major molecular response at 6th month (58.5% vs 35.9%; p = 0.010), but not at 12th month (66.2% vs 51.6%; p = 0.092). Significant deep molecular response was also obtained at 12th month (24.6% vs 10.9%; p = 0.042). Six out of 20 subscales of EORTC-QLQ30-CML24 were significantly better in the MMS group.

    CONCLUSIONS: The MMS improved CML patients' adherence to TKI as well as achieved better clinical outcomes.

    TRIAL REGISTRATION: Clinicaltrial.gov (ID: NCT03090477).

  10. Liew AC, Peh KK, Tan BS, Zhao W, Tangiisuran B
    Support Care Cancer, 2019 Dec;27(12):4515-4524.
    PMID: 30911917 DOI: 10.1007/s00520-019-04724-1
    PURPOSE: This observational study aimed to compare the outcome and health-related quality of life (HRQOL) amongst breast cancer patients using Chinese herbal medicine (CHM) and those not using CHM during chemotherapy.

    METHODS: A prospective, non-randomised longitudinal study was conducted in two government integrated hospitals over an 8-month period. Early-stage breast cancer patients who were (1) either already using complementary and alternative medicine (CAM) or not and (2) who were on a regime of 5-fluorouracil, epirubicin, and cyclophosphamide were included in the study. Patients who agreed to receive CHM were assigned to receive individualised CHM prescriptions deemed suitable for the individual at a particular time. Those who were not willing to take Chinese herbal medicines (CHM) were assigned to the non-CHM control group. Blood profile and chemotherapy-induced AE were recorded whilst HRQOL assessment was done using the EORTC QLQ-C30 questionnaire on first, third, and sixth cycles.

    RESULTS: Forty-seven patients [32 female vs. 1 male, p = 0.31; mean year of age: 52.2(SD = 7.6), p = 0.28)}] were recruited during the study period. Demographics of both groups were comparable. Fifty percent of respondents reported using some kind of CAM before chemotherapy. Diet supplements (40.6%) were the most common CAM used by the respondents. The study showed that patients using CHM had significantly less fatigue (p = 0.012), nausea (p = 0.04), and anorexia (p = 0.005) during chemotherapy. There were no significant differences in patients' HRQOL (p = 0.79). There were no AEs reported during the study.

    CONCLUSION: The use of CHM as an adjunct treatment with conventional chemotherapy have been shown to reduce fatigue, nausea, and anorexia in breast cancer patients but did not reduce chemotherapy-associated hematologic toxicity. The sample size of this study was not powered to assess the significance of HRQOL between two groups of patients.

  11. Yip KC, Lai LL, Ngu ST, Chong RS, Yahya A, See MH
    Support Care Cancer, 2023 Sep 27;31(10):593.
    PMID: 37752312 DOI: 10.1007/s00520-023-08033-6
    Seeking health information is an important step for cancer patients to understand their condition and facilitate treatment. It also helps them deal with the unknown and aid in recovery. Therefore, it is vital to understand the factors that drive health information-seeking behavior. This study aims to achieve that objective in a localized context by surveying 421 breast cancer patients in an urban teaching hospital. The patients were presented with a 5-point questionnaire that explored their demography, health status, information-seeking behavior, and literacy level. The prevalence of health information-seeking initiatives reported was 60%. Patients with higher education (OR 3.31; 95% CI (1.39-7.87), p = 0.01), having their own business or were self-employed (OR 4.68; 95% CI (1.03-21.24), p = 0.046), and in a Medium 40 (M40) income level (OR 2.31; 95% CI (1.09-4.88), p = 0.03) and Top 20 (T20) level were more likely to seek health information. The mean e-Health Literacy Score (eHEALS) was 28.01 ± 5.0, with healthcare professionals having the highest level of trust (mean 4.22 ± 0.79) and most useful resource score (mean 4.21 ± 0.78). Even though Google was the most popular online search tool used by respondents, most of them seldom (23.77%) or had never (34.34%) discussed the online information they found with healthcare professionals. In conclusion, it is still best for patients to appraise the sought-after information with experts to avoid misinformation and treatment delay.
  12. Azzani M, Roslani AC, Su TT
    Support Care Cancer, 2016 10;24(10):4423-32.
    PMID: 27225528 DOI: 10.1007/s00520-016-3283-2
    BACKGROUND: In Malaysia, the healthcare system consists of a government-run universal healthcare system and a co-existing private healthcare system. However, with high and ever rising healthcare spending on cancer management, cancer patients and their families are likely to become vulnerable to a healthcare-related financial burden. Moreover, they may have to reduce their working hours and lose income. To better understand this issue, this study aims to assess the financial burden of colorectal cancer patients and their families in the first year following diagnosis.

    METHODS: Data on patient costs were collected prospectively in the first year following diagnosis by using a self-administered questionnaire and telephone interviews at three time points for all four stages of colorectal cancer. The patient cost data consisted of direct out-of-pocket payments for medical-related expenses such as hospital stays, tests and treatment and for non-medical items such as travel and food associated with hospital visits. In addition, indirect cost data related to the loss of productivity of the patient and caregiver(s) was assessed. The patient's perceived level of financial difficulty and types of coping strategy were also explored.

    RESULT: The total 1-year patient cost (both direct and indirect) increased with the stage of colorectal cancer: RM 6544.5 (USD 2045.1) for stage I, RM 7790.1 (USD 2434.4) for stage II, RM 8799.1 (USD 2749.7) for stage III and RM 8638.2 (USD 2699.4) for stage IV. The majority of patients perceived paying for their healthcare as somewhat difficult. The most frequently used financial coping strategy was a combination of current income and savings.

    CONCLUSION: Despite the high subsidisation in public hospitals, the management of colorectal cancer imposes a substantial financial burden on patients and their families. Moreover, the majority of patients and their families perceive healthcare payments as difficult. Therefore, it is recommended that policy- and decision-makers should further consider some financial protection strategies and support for cancer treatment because cancer is a very costly and chronic disease.

  13. Ting CY, Teh GC, Yu KL, Alias H, Tan HM, Wong LP
    Support Care Cancer, 2020 Apr;28(4):1703-1715.
    PMID: 31292755 DOI: 10.1007/s00520-019-04975-y
    PURPOSE: This study examined the prevalence of financial toxicity (FT) and associated factors among urologic cancer patients. The association between FT and health-related quality of life (HRQoL) was also investigated.

    METHODS: A total of 429 respondents diagnosed with urologic cancers (prostate cancer, bladder and renal cancer) from Sarawak General Hospital and Subang Jaya Medical Centre in Malaysia were interviewed using a structured questionnaire. Objective and subjective FT were measured by catastrophic health expenditure (healthcare-cost-to-income ratio greater than 40%) and the Personal Financial Well-being Scale, respectively. HRQoL was measured with the Functional Assessment of Cancer Therapy - General 7 Items scale.

    RESULTS: Objective and subjective FT were experienced by 16.1 and 47.3% of the respondents, respectively. Respondents who sought treatment at a private hospital and had out-of-pocket health expenditures were more likely to experience objective FT, after adjustment for covariates. Respondents who were female and had a monthly household income less than MYR 5000 were more likely to experience average to high subjective FT. Greater objective FT (OR = 2.75, 95% CI 1.09-6.95) and subjective FT (OR = 4.68, 95% CI 2.63-8.30) were associated with poor HRQoL.

    CONCLUSIONS: The significant association between both objective and subjective FT and HRQoL highlights the importance of reducing FT among urologic cancer patients. Subjective FT was found to have a greater negative impact on HRQoL.

  14. Longo CJ, Fitch MI, Banfield L, Hanly P, Yabroff KR, Sharp L
    Support Care Cancer, 2020 Oct;28(10):4645-4665.
    PMID: 32653957 DOI: 10.1007/s00520-020-05620-9
    PURPOSE: Financial toxicity related to cancer diagnosis and treatment is a common issue in developed countries. We seek to systematically summarize the extent of the issue in very high development index countries with publicly funded healthcare.

    METHODS: We identified articles published Jan 1, 2005, to March 7, 2019, describing financial burden/toxicity experienced by cancer patients and/or informal caregivers using OVID Medline Embase and PsychInfo, CINAHL, Business Source Complete, and EconLit databases. Only English language peer-reviewed full papers describing studies conducted in very high development index countries with predominantly publicly funded healthcare were eligible (excluded the USA). All stages of the review were evaluated in teams of two researchers excepting the final data extraction (CJL only).

    RESULTS: The searches identified 7117 unique articles, 32 of which were eligible. Studies were undertaken in Canada, Australia, Ireland, UK, Germany, Denmark, Malaysia, Finland, France, South Korea, and the Netherlands. Eighteen studies reported patient/caregiver out-of-pocket costs (range US$17-US$506/month), 18 studies reported patient/caregiver lost income (range 17.6-67.3%), 14 studies reported patient/caregiver travel and accommodation costs (range US$8-US$393/month), and 6 studies reported financial stress (range 41-48%), strain (range 7-39%), or financial burden/distress/toxicity among patients/caregivers (range 22-27%). The majority of studies focused on patients, with some including caregivers. Financial toxicity was greater in those with early disease and/or more severe cancers.

    CONCLUSIONS: Despite government-funded universal public healthcare, financial toxicity is an issue for cancer patients and their families. Although levels of toxicity vary between countries, the findings suggest financial protection appears to be inadequate in many countries.

  15. Ng T, Toh MR, Cheung YT, Chan A
    Support Care Cancer, 2015 Nov;23(11):3193-200.
    PMID: 25791392 DOI: 10.1007/s00520-015-2700-2
    PURPOSE: The aim of this study is to evaluate the perspectives of Asian oncology practitioners on the physical and psychosocial issues experienced by breast cancer survivors (BCS), current survivorship care practices, and the barriers to follow-up care.

    METHODS: This was a cross-sectional survey study. Oncology practitioners were recruited from a major cancer center in Singapore and through two regional cancer meetings that took place in Singapore and Malaysia in 2013.

    RESULTS: A total of 126 oncology practitioners from various Southeast Asian countries, mostly nurses (58.7 %) and physicians (37.3 %), were recruited. The majority of the respondents agreed that fatigue (78.4 %) and anxiety (69.1 %) were the most common physical and psychosocial problems experienced by BCS. Monitoring for physical and treatment-related adverse effects (80.7 %) and reviewing patients' noncancer medical history (65.3 %) were the most practiced aspects of follow-up care. Compared with the other practitioners, the physicians were more likely to communicate with other healthcare professionals (adjusted OR = 4.24, 95 % CI 1.54 to 11.72; p = 0.005). Most of the respondents also agreed that patient-specific barriers were the main impediments to follow-up care.

    CONCLUSION: This study provides insights into the various aspects of breast cancer survivorship care from the perspectives of oncology practitioners and shows that survivorship care is relatively inadequate in Asia. There is a need for new survivorship care models to meet the needs of Asian BCS and to complement the unique healthcare systems of Asia.

  16. Abdullah NN, Idris IB, Shamsuddin K, Abdullah NMA
    Support Care Cancer, 2020 Apr;28(4):1891-1899.
    PMID: 31359181 DOI: 10.1007/s00520-019-05007-5
    PURPOSE: Gastrointestinal (GI) cancer has emerged as a major health problem. Cancer patients receive informal care from their families beyond formal care. There has been little evidence showing how the health-related quality of life (HRQOL) of the caregivers differs from that of the GI patients in Malaysia. A cross-sectional study was conducted in three referral hospitals in Malaysia. The objectives of this study were to determine the HRQOL of GI cancer patients and their family caregivers, and assess whether there is any significant relationship between the demographic factors, and the physical component summary (PCS) and mental component summary (MCS) scores for patients and caregivers.

    METHODS: A total of 323 dyads of GI cancer patients and their caregivers completed the Medical Outcomes Study 12-item Short Form (MOS SF-12) questionnaire to measure their HRQOL during face-to-face interviews. The analyses were performed using SF-12 scoring software to compute PCS and MCS scores (HRQOL parameters). The independent t test, one-way ANOVA, and the Pearson correlation test were conducted to determine the demographic factors related to the HRQOL of the dyads.

    RESULTS: The caregivers had higher scores in all domains for the SF-12 than the patients. There were significant differences found in the MCS scores of the patients according to ethnicity, origin of cancer, duration of cancer, and surgery. None of these factors had a significant relationship with the caregivers' HRQOL.

    CONCLUSION: Caregivers had better HRQOL than cancer patients. Early intervention for cancer patients in the form of counselling and personalised pain management may enhance the HRQOL of patients.

  17. Rajah HDA, Chan CMH, Kong YC, Wong LP, Bustaman RS, Ho GF, et al.
    Support Care Cancer, 2021 Oct;29(10):5811-5819.
    PMID: 33742239 DOI: 10.1007/s00520-021-06148-2
    INTRODUCTION: Delivery of supportive cancer care is often deemed a low priority in resource-limited settings. We aimed to explore the sources of emotional distress, the related support and the unmet needs of cancer survivors in Malaysia, where cancer survivorship services are presently limited.

    METHOD: Twenty focus group discussions were conducted with 102 cancer patients from diverse ethnic and socioeconomic backgrounds. Thematic analyses were performed.

    RESULTS: Patient narratives suggested that emotional distress arose from direct and indirect stressors. Direct stressors comprised physical and cognitive side effects of cancer surgery and therapies, and fear of recurrence. Indirect stressors included worry over dependent family members, financial distress following cancer, working with cancer and lack of practical support at home. Distress from altered physical appearances, fear of recurrence and lack of practical support were mainly raised by women, implying that men and women may have disproportionate emotional needs. Emotional support largely came from informal sources including self, family, friends and religion. While formal emotional support from professional counsellors and cancer support groups was acknowledged as important, it appeared to be largely lacking. Unmet needs in coping with fear of recurrence, financial distress, workplace discrimination and household chores were particularly highlighted.

    CONCLUSION: The unmet needs revealed in this study provide insights to initiate actionable changes to improve the emotional wellbeing of people living with cancer in settings where cancer survivorship services are still in its infancy.

  18. Chanmekun SB, Zulkifli MM, Muhamad R, Mohd Zain N, Low WY, Liamputtong P
    Support Care Cancer, 2022 Jan;30(1):401-411.
    PMID: 34297219 DOI: 10.1007/s00520-021-06417-0
    PURPOSE: Management of female sexual dysfunction (FSD) is vital for women with breast cancer due to the devastating consequences, which include marital disharmony and reduced quality of life. We explore healthcare providers' (HCPs) perceptions and experiences in managing FSD for women living with breast cancer using a phenomenological approach.

    METHODS: This qualitative study was conducted using a face-to-face interview method with HCPs from two tertiary hospitals in North East Malaysia. The interviews were recorded, transcribed verbatim, and transferred to NVivo ® for data management. The transcriptions were analyzed using thematic analysis.

    RESULTS: Three key barriers were identified through the thematic analysis: a scarcity of related knowledge; the influence of socio-cultural ideas about sex; and the specialty-centric nature of the healthcare system. Most HCPs interviewed had a very narrow understanding of sexuality, were unfamiliar with the meaning of FSD, and felt their training on sexual health issues to be very limited. They viewed talking about sex to be embarrassing to both parties that are both to HCPs and patients and was therefore not a priority. They focused more on their specialty hence limited the time to discuss sexual health and FSD with their patients.

    CONCLUSION: Therefore, interventions to empower the knowledge, break the socio-cultural barriers, and improve the clinic settings are crucial for HCPs in managing FSD confidently.

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