Journal of Cancer Survivorship最新文献

{"title":"Visualizing cancer and survivorship with generative AI?-an exploration of breast, prostate, and pancreatic cancer imagery.","authors":"Miguel Varela-Rodríguez, Stefanie Plage","doi":"10.1007/s11764-025-01843-z","DOIUrl":"https://doi.org/10.1007/s11764-025-01843-z","url":null,"abstract":"<p><strong>Purpose: </strong>Generative Artificial Intelligence (GAI) is transforming visual communication in the context of cancer survivorship, presenting opportunities to innovate advocacy while also posing risks for social representation. This study explores how GAI visualizes cancer and survivorship, focusing on its ability to reflect diverse experiences and its limitations.</p><p><strong>Methods: </strong>We analyzed 262 images generated by Dall-E and Stable Diffusion using prompts related to breast, prostate, and pancreatic cancer. A mixed-methods approach examines how GAI utilizes cancer signifiers, visualizes the impact of cancer on individuals, and represents people with cancer.</p><p><strong>Results: </strong>GAI frequently reproduces cancer tropes, such as prescriptive positivity, and fails to depict medical treatments or embodied experiences unless explicitly prompted. AI-generated images predominantly featured White, female subjects, particularly in breast cancer contexts, reflecting broader biases in public discourse. While GAI tools can produce inclusive visuals, achieving this requires users to have nuanced knowledge of cancer and survivorship, limiting accessibility for lay GAI users.</p><p><strong>Conclusions: </strong>GAI can support cancer communication but risks perpetuating stereotypes and excluding less visible experiences of cancer. Our findings offer practical insights to support the design of advocacy materials and campaigns, particularly through improved prompt literacy and inclusive image generation strategies.</p><p><strong>Implications for cancer survivors: </strong>Inclusive and respectful visual representation is critical for capturing the diverse realities of cancer survivorship, which in turn affects the wellbeing of cancer survivors and carers. Collaborative efforts among researchers, advocates, and GAI developers are necessary to improve datasets and foster accessible tools, ensuring that GAI supports rather than undermines cancer survivorship advocacy.</p>","PeriodicalId":15284,"journal":{"name":"Journal of Cancer Survivorship","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Network analysis of core symptom changes in lung cancer survivors: a longitudinal study.","authors":"Jiang Zhang, Xijuan Zhao, Guolong Zhang, Jiang Wu, Qiongyao Guan, Zheng Tian, Yingchun Zeng","doi":"10.1007/s11764-025-01844-y","DOIUrl":"https://doi.org/10.1007/s11764-025-01844-y","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the dynamic changes and to identify core symptoms using network analysis in lung cancer survivors before, during, and after radiotherapy using a longitudinal approach.</p><p><strong>Methods: </strong>This study recruited 234 lung cancer survivors from a prospective and longitudinal study in a tertiary cancer hospital of China from January 2023 to October 2024. M.D. Anderson Symptom Inventory of lung cancer module (MDASI-LC) and Hospital Anxiety and Depression Scale (HADS) were used to measured physical and psychological symptoms at the time of pre-radiotherapy, the end of radiotherapy, and 4 weeks after radiotherapy, respectively. Network analysis was performed using R software version 4.3.2 to identify the core symptoms.</p><p><strong>Results: </strong>A total of 234 lung cancer survivors are treated with radiotherapy; participants were included with an average age of 59.2 years, predominantly male (78.2%), representing various lung cancer subtypes and stages. Before radiotherapy, poor appetite was identified as the core symptom. At the end of radiotherapy, shortness of breath emerged as the central symptom, likely driven by radiation-induced respiratory complications. Four weeks after radiotherapy, fatigue became the most significant symptom. Psychological networks revealed depressive symptoms of lack of optimism as core before radiotherapy, panic as central at the end of treatment, and tension as predominant post-radiotherapy.</p><p><strong>Conclusions: </strong>This study highlights the dynamic evolution of core symptoms in lung cancer survivors undergoing radiotherapy. Findings underscore the importance of early interventions targeting appetite and psychological distress, as well as post-treatment strategies to address fatigue and emotional tension. Integrating physical and psychological care through symptom network analysis can guide personalized management approaches, improving patient quality of life and treatment outcomes.</p><p><strong>Implications for cancer survivors: </strong>Integrating dynamic symptom management strategies that address evolving physical and psychological challenges, such as appetite, fatigue, and emotional tension, can significantly enhance quality of life and treatment outcomes for lung cancer survivors undergoing radiotherapy.</p>","PeriodicalId":15284,"journal":{"name":"Journal of Cancer Survivorship","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and preliminary efficacy of an artificial intelligence-based cancer survivorship care plan service using digital platforms: a single-arm prospective pilot study.","authors":"Soo Hyun Kim, Shin-Young Park, Sung Mook Lim, Hyemin Yi","doi":"10.1007/s11764-025-01848-8","DOIUrl":"https://doi.org/10.1007/s11764-025-01848-8","url":null,"abstract":"<p><strong>Purpose: </strong>This study tested the feasibility and preliminary efficacy of an artificial intelligence (AI)-based survivorship care plan (SCP) service (named \"quality of life [QOL] + intervention\") for posttreatment breast cancer survivors using digital platforms.</p><p><strong>Methods: </strong>A single-arm prospective pilot study was conducted, and 38 posttreatment breast cancer survivors in South Korea were enrolled. The QOL + intervention consisted of 1) collection of patient-reported outcomes data from survivors via a mobile app, 2) automated generation of SCP via a website, and 3) in-person SCP review and counseling. Feasibility was assessed using study participation rate, retention rate, mobile app access rate, task completion rate, intervention satisfaction, etc. Preliminary efficacy was evaluated using changes in patient-provider interaction, patient activation, cancer survivors' self-efficacy, and QOL from baseline to 1 week after the intervention.</p><p><strong>Results: </strong>Feasibility assessment showed promising results, with a 70.7% participation rate, an 89.5% retention rate, an 88.2% mobile app access rate, a 91.2% task completion rate, and an 88.2% satisfaction rate. The QOL + intervention improved patient activation (p = 0.051, effect size = 0.29), self-efficacy (p = 0.040, effect size = 0.31), and QOL (p = 0.010, effect size = 0.42). However, no significant change occurred in patient-provider interaction after the intervention (p = 0.098).</p><p><strong>Conclusions: </strong>The QOL + intervention was feasible and preliminarily effective in improving patient outcomes among posttreatment breast cancer survivors in South Korea. To obtain robust evidence, large-scale randomized controlled trials are warranted in future studies.</p><p><strong>Implications for cancer survivors: </strong>Survivorship care can be enhanced via AI-based digital technology. Trial registration KCT0009302.</p>","PeriodicalId":15284,"journal":{"name":"Journal of Cancer Survivorship","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of home-based exercise program on patients with aplastic anemia treated with allogeneic hematopoietic stem cell transplantation: a non-randomized trial.","authors":"Menghua Ye, Chenyi Xu, Xiaoxue Tan, Min Cao, Min Xu","doi":"10.1007/s11764-025-01824-2","DOIUrl":"https://doi.org/10.1007/s11764-025-01824-2","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to assess the adherence and safety of the home-based exercise program in patients with aplastic anemia (AA) who are undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT). Additionally, it aims to determine whether this program can enhance patients' quality of life (QoL), alleviate fatigue, increase exercise tolerance, and reduce psychological stress.</p><p><strong>Methods: </strong>This study involved 80 patients with AA from the Hematology Department of a comprehensive tertiary hospital. All participants met the British Committee for Standards in Haematology (BCSH) diagnostic criteria, were aged 18-65 years, and had undergone allo-HSCT within the past 1-12 months. All patients were enrolled within 100 days post-transplant discharge. The control group received standard exercise nursing care, while the intervention group completed a 12-week home-based exercise program. Adherence and safety were monitored during the intervention, and QoL, fatigue level, exercise tolerance, and psychological distress were assessed at baseline (T0), week 4 (T1), week 8 (T2), and week 12 (T3).</p><p><strong>Results: </strong>Exercise adherence exceeded 70%, with no adverse events reported. Repeated measures analysis revealed that QoL scores and 6MWD increased over time for both groups. At weeks 4, 8, and 12 of the intervention, the experimental group exhibited significantly higher QoL scores and 6MWD compared to the control group, with the differences being statistically significant. Both groups demonstrated a decrease in fatigue and psychological distress scores as the intervention progressed. At weeks 4, 8, and 12, the experimental group reported significantly lower levels of fatigue and psychological distress than the control group, with these differences also reaching statistical significance and a small to moderate effect size.</p><p><strong>Conclusions: </strong>Home-based exercise is feasible for patients with AA undergoing allo-HSCT and showed an improvement in QoL, fatigue, exercise tolerance, and psychological status, which can serve as an effective adjuvant therapy during the post allo-transplant rehabilitation process.</p><p><strong>Implications for cancer survivors: </strong>This study provides a new perspective and method for the long-term rehabilitation of AA patients following allo-HSCT.</p>","PeriodicalId":15284,"journal":{"name":"Journal of Cancer Survivorship","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial and ethnic disparities in financial toxicity among cancer survivors: implications for equity in survivorship care.","authors":"Noah Hammarlund, Molly Jacobs","doi":"10.1007/s11764-025-01817-1","DOIUrl":"https://doi.org/10.1007/s11764-025-01817-1","url":null,"abstract":"<p><strong>Introduction: </strong>Financial toxicity (FT) represents a significant challenge for cancer survivors, disproportionately affecting racial and ethnic minorities. This study examines income and wealth changes among cancer survivors and explores the implications for survivorship care equity.</p><p><strong>Methods: </strong>We analyzed longitudinal cohort data from the Medical Expenditure Panel Survey (2018-2021) to examine how cancer diagnoses (prostate, colon, lung, or breast cancer) affect income and wealth. Fixed effects regression controlled for unobserved individual differences, isolating the impact of cancer. We used interaction terms to explore racial and ethnic disparities and applied Heckman models to test the robustness of the results to potential selection bias.</p><p><strong>Results: </strong>Of the 5409 respondents, 229 (4.23%) reported a diagnosis of one of the targeted cancers. Cancer diagnosis was associated with a 14.44 percentage point reduction in income and a 15.94 percentage point reduction in wealth. Hispanic cancer survivors saw a 42.27 percentage point reduction in income and 36.83 percentage points in wealth, while Black cancer survivors saw reductions of 20.99 percentage points in income and 19.98 percentage points in wealth. These disparities persisted across different model specifications.</p><p><strong>Conclusion: </strong>This study provides robust estimates of the financial impact of cancer, revealing significant and disproportionate financial burdens among Black and Hispanic survivors. These findings underscore the need for integrating financial health assessments into survivorship care to address inequities and improve quality of life.</p><p><strong>Implications for cancer survivors: </strong>Our findings indicate that cancer is associated with significant reductions in income and wealth, with disproportionate burdens observed among Black and Hispanic survivors. These results highlight the need for greater attention to financial well-being in survivorship care, especially for systemically marginalized groups.</p>","PeriodicalId":15284,"journal":{"name":"Journal of Cancer Survivorship","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of live-remote exercise on quality of life and other health-related outcomes in cancer survivors: a randomised controlled trial.","authors":"Melissa Kotte, Kate A Bolam, Renske Altena, Prue Cormie, Yvonne Wengström, Sara Mijwel","doi":"10.1007/s11764-025-01845-x","DOIUrl":"https://doi.org/10.1007/s11764-025-01845-x","url":null,"abstract":"<p><strong>Purpose: </strong>Exercise following cancer treatment has been shown to improve health-related quality of life (HRQoL) and other important health outcomes, yet barriers to participation prevent many cancer survivors from exercising according to recommendations. Live-remote exercise methods could improve accessibility; however, evidence on their efficacy is limited. The EX-MED Cancer Sweden randomised controlled trial compared the effects of a 12-week live-remote online exercise intervention to usual care in adult cancer survivors.</p><p><strong>Methods: </strong>Two hundred adults who had completed curative treatment for breast, prostate, or colorectal cancer were randomised to a 12-week live-remote online exercise intervention or a usual care control group. Intervention effects on the primary outcome overall HRQoL (EORTC-QLQ-C30) and secondary outcomes cardiorespiratory fitness (CRF), muscle strength, physical function, body composition, and other patient-reported outcomes were determined by comparing changes from baseline to 3 (primary timepoint) and 6 months between groups.</p><p><strong>Results: </strong>No significant effect was observed on overall HRQoL. However, live-remote exercise resulted in significant improvements at 3 months on the physical functioning domain of HRQoL (p ≤ 0.001), five-times sit-to-stand (p = 0.003), and moderate-vigorous physical activity levels (p ≤ 0.001) as well as estimated VO_{2 max} (p = 0.045), and upper body strength (p = 0.010) at 3 and 6 months. No significant differences were observed between the groups on lower body strength, handgrip strength, fatigue, or the other functional domains or symptoms of the EORTC-QLQ-C30.</p><p><strong>Conclusions: </strong>A 12-week live-remote exercise intervention did not lead to improvements in overall HRQoL; however, it did result in significant benefits in physical function, CRF, and upper body strength in adults treated for breast, prostate, or colorectal cancer. These findings add to the limited evidence on the effects of virtually supervised exercise for cancer survivors.</p><p><strong>Implications for cancer survivors: </strong>EX-MED Cancer Sweden addresses common exercise barriers for cancer survivors while providing the benefits of supervised exercise.</p><p><strong>Trial registration: </strong>NCT05064670, Trial registered on October 1, 2021, https://clinicaltrials.gov/ct2/show/NCT05064670.</p>","PeriodicalId":15284,"journal":{"name":"Journal of Cancer Survivorship","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with cancer-related pain among Utah cancer survivors.","authors":"Rachel R Codden, Blessing S Ofori-Atta, Marjorie E Carter, Kimberly A Herget, Jennifer A Doherty, Anne C Kirchhoff, Morgan M Millar","doi":"10.1007/s11764-025-01840-2","DOIUrl":"https://doi.org/10.1007/s11764-025-01840-2","url":null,"abstract":"<p><strong>Purpose: </strong>To identify clinical and sociodemographic factors associated with cancer-related pain among Utah cancer survivors 2-5 years after diagnosis.</p><p><strong>Methods: </strong>Participants include 2232 Utah cancer survivors diagnosed with invasive cancers at ages 18 + who responded to a probability-based sample survey administered by the Utah Cancer Registry from 2018 to 2023. Participants self-reported cancer-related pain status and methods of pain control. We calculated counts and percentages and used logistic regression to identify sociodemographic and clinical factors associated with cancer-related pain. All analyses were weighted to account for complex survey sample design and age-adjusted to the Utah cancer survivor population.</p><p><strong>Results: </strong>Twenty-two percent of survivors reported currently experiencing physical pain caused by their cancer or cancer treatment. Of those reporting pain, 24% reported their pain was not under control, 40% indicated their pain was under control with medication, and 36% reported it was under control without medication. The most frequently used pain control methods were nonopioid analgesics (49%) and physical activity (37%). In multivariable models, younger survivors, those either underweight or obese, survivors of breast cancer, and those facing material financial hardships were more likely to report cancer-related pain.</p><p><strong>Conclusion: </strong>Twenty-two percent of Utah cancer survivors experienced pain related to their cancer or cancer treatment. For some, this pain is well managed, but approximately a quarter have uncontrolled pain.</p><p><strong>Implications for cancer survivors: </strong>Cancer-related pain is not solely associated with clinical features, and the findings here can guide clinicians and researchers toward a better understanding of the needs of cancer survivors and tailor pain management treatments to this unique population.</p>","PeriodicalId":15284,"journal":{"name":"Journal of Cancer Survivorship","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fatigue and diabetes self-management among operable pancreatic cancer survivors with comorbid diabetes: comparative propensity analysis.","authors":"Hsuan-Ju Kuo, Yun-Jen Chou, Hui-Ying Yang, Shiow-Ching Shun","doi":"10.1007/s11764-025-01838-w","DOIUrl":"https://doi.org/10.1007/s11764-025-01838-w","url":null,"abstract":"<p><strong>Purpose: </strong>Operable pancreatic cancer survivors with diabetes experience fatigue and engage less in diabetes self-management, which could lead to worse health-related outcomes. However, little is known about the impact of having both diseases on aspects of fatigue and diabetes self-management. This study aimed to compare characteristics of fatigue and diabetes self-management between operable pancreatic cancer (OPC) survivors with diabetes and people who have diabetes without OPC.</p><p><strong>Methods: </strong>This is a cross-sectional study with a total of 207 participants with diabetes (57 OPC survivors and 150 without OPC). Fatigue and diabetes self-management were measured by the Fatigue Symptom Inventory and the Summary of Diabetes Self-Care Activities, respectively. Data were matched by age, gender, and diabetes treatment using propensity analysis. We used generalized estimating equations to compare the fatigue characteristics and diabetes self-management between the two groups.</p><p><strong>Results: </strong>The final analysis included 98 participants with diabetes (49 OPC survivors and 49 without OPC) after propensity score matching. OPC survivors with diabetes perceived higher fatigue interference in general daily activities, work activities, and enjoyment of life and performed fewer diet and foot self-management compared to people who had diabetes without OPC.</p><p><strong>Conclusions: </strong>OPC survivors with diabetes perceived more fatigue interference and engaged less in healthy eating and foot care. Future longitudinal studies should focus on examining the interplay between fatigue and diabetes self-management during the perioperative period.</p><p><strong>Implications for cancer survivors: </strong>Future interventions addressing perceived fatigue interference and barriers to daily healthy eating and foot care are crucial for OPC survivors with diabetes.</p>","PeriodicalId":15284,"journal":{"name":"Journal of Cancer Survivorship","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of the right to be forgotten for childhood or breast cancer survivors: results of a quasi-experimental study in France.","authors":"Nicolas Bougas, Tienhan Sandrine Dabakuyo Yonli, Emerline Assogba, Nadia Haddy, Florent De Vathaire, Asmaa Janah, Morgane Michel, Aurelie Bourmaud, Hugo Jeanningros, Moreno Ursino, Renaud Debailly, Agnes Dumas","doi":"10.1007/s11764-025-01830-4","DOIUrl":"https://doi.org/10.1007/s11764-025-01830-4","url":null,"abstract":"<p><strong>Purpose: </strong>Cancer survivors have reported difficulties in accessing loan-related insurance, in particular for a home loan. In France, a law called \"the Right To Be Forgotten\" (RTBF) was adopted in 2017 to counter this \"financial toxicity\" of cancer. Since then, eight other European countries have adopted or implemented legislation inspired by the French RTBF. Several patients' organizations in Europe have called for an extension of the RTBF across all European countries. The aim of this study was to evaluate the effects of the RTBF on the reduction of survivors experiencing difficulties in obtaining loan-related insurance after cancer in France.</p><p><strong>Method: </strong>A quasi-experimental study was conducted using different sources of recruitment to enroll breast and childhood cancer survivors (cases) and individuals without a history of cancer (controls). Difficulties in accessing loan-related insurance reported by cancer survivors and controls before and after the adoption of the law (2010-2022) were collected using an online questionnaire and compared between groups. Groups were matched using propensity scores on age, sex, the amount of insured capital, and health-related variables. The effect of the RTBF's adoption was estimated using a conditional logistic regression.</p><p><strong>Results: </strong>Out of 552 matched respondents (1:3 case-control ratio), difficulties in accessing loan-related insurance were reported by 65% of cases vs. 16% of controls before the RTBF and by 35% of cases vs. 15% of controls after the RTBF (P < .0001). The likelihood of experiencing difficulties in obtaining a loan was significantly decreased (β =  - 0.29; OR = 0.74; P = 0.01) after the RTBF. In subgroup analyses, the results remained significant solely for childhood cancer survivors.</p><p><strong>Conclusions: </strong>Despite a significant decrease in the proportion of cancer survivors experiencing difficulties after the adoption of the RTBF, there are possible difficulties in the law's implementation, dissemination, and usage, in particular for adult cancer survivors.</p><p><strong>Implications for cancer survivors: </strong>The RTBF may alleviate cancer survivors' difficulties in accessing loan-related insurance with a possible impact in decreasing the financial toxicity of cancer, both from a subjective and an objective point of view.</p>","PeriodicalId":15284,"journal":{"name":"Journal of Cancer Survivorship","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-perceived muscular strength and its correlation with physical, mental, and emotional health status in long-term breast cancer survivors: a cross-sectional study.","authors":"Francisco Álvarez-Salvago, Jose Medina-Luque, Maria Figueroa-Mayordomo, Clara Pujol-Fuentes, Sandra Atienzar-Aroca, José Daniel Jiménez-García, Palmira Gutiérrez-García, Cristina Estornut, Cristina Molina-García","doi":"10.1007/s11764-025-01819-z","DOIUrl":"https://doi.org/10.1007/s11764-025-01819-z","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to explore the association between different levels of self-perceived muscular strength and health status among long-term breast cancer survivors (LTBCSs), as well as to determine the factors that predict self-perceived muscular strength during this phase of long-term survivorship.</p><p><strong>Methods: </strong>A cross-sectional study was conducted with 80 LTBCSs, classified into three groups based on self-perceived muscular strength levels: very poor/poor (1-2), average (3), and good/very good (4-5). Variables analyzed, measured ≥ 5 years post-diagnosis, included other aspects of physical fitness, physical activity (PA) levels, pain, cancer-related fatigue (CRF), mood state, and health-related quality of life (HRQoL). ANOVA, Mann-Whitney U, and chi-square tests were performed, along with correlation and multiple regression analysis. Cohen's d was used to calculate effect sizes.</p><p><strong>Results: </strong>Among LTBCSs, 37.5% reported very poor/poor self-perceived muscular strength, 32.5% average, and 30% good/very good levels. Participants with lower self-perceived muscular strength exhibited declines in physical fitness, greater inactivity, higher pain levels, elevated CRF, mood disturbances, and reduced HRQoL (all p < 0.05). Regression analysis identified \"general physical fitness\" (β = 0.32; p = 0.01), \"cardiorespiratory endurance\" (β = 0.40; p < 0.01), \"global health status\" (β = 0.16; p = 0.04), and \"breast symptoms\" (β = - 0.16; p = 0.04) as significant predictors of higher self-perceived muscular strength (r² adjusted = .573).</p><p><strong>Conclusion: </strong>Good/very good levels of self-perceived muscular strength were observed in just 30% of LTBCSs. Those with lower self-perceived muscular strength exhibited more significant physical, mental, and emotional decline ≥ 5 years post-diagnosis. The combination of \"general physical fitness,\" \"cardiorespiratory endurance,\" \"global health status,\" and \"breast symptoms\" accounts for 57.3% of the variance in self-perceived muscular strength levels among LTBCSs.</p><p><strong>Implications for cancer survivors: </strong>Targeted interventions addressing self-perceived muscular strength could help mitigate long-term physical and emotional sequelae.</p>","PeriodicalId":15284,"journal":{"name":"Journal of Cancer Survivorship","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}