Journal of Cancer Survivorship最新文献

{"title":"Prevalence of and factors associated with clinically important levels of fatigue, pain, and insomnia in survivors of cancer: a population-based cross-sectional study.","authors":"Anne Katrine Graudal Levinsen, Susanne Oksbjerg Dalton, Erik Jakobsen, Ismail Gögenur, Michael Borre, Robert Zachariae, Peter Christensen, Søren Laurberg, Peter de Nully Brown, Lisbet Rosenkrantz Hölmich, Christoffer Johansen, Susanne K Kjær, Lonneke van de Poll-Franse, Trille Kristina Kjaer","doi":"10.1007/s11764-025-01851-z","DOIUrl":"https://doi.org/10.1007/s11764-025-01851-z","url":null,"abstract":"<p><strong>Purpose: </strong>To identify risk factors and patient characteristics in survivors who report clinically important fatigue, pain, and insomnia.</p><p><strong>Methods: </strong>Cross-sectional study including 39,374 survivors of breast, prostate, lung, colon, rectum cancer, melanoma, and lymphoma diagnosed at age 40 or older between Jan 2010 and Dec 2019. Prevalences and odds ratios (ORs) with 95% confidence intervals (CI) for clinically important fatigue, pain, and insomnia by sociodemographic, clinical, and lifestyle factors were calculated.</p><p><strong>Results: </strong>Among all survivors, 42% reported clinically important fatigue, pain, or insomnia, and 21% reported concurring symptoms. Prevalences were highest in women, survivors of breast and lung cancer, with short education, low income, comorbidity, obesity, and smokers. Adjusted analyses showed increased odds in women (OR fatigue 1.46, 95% CI 1.39-1.54; OR pain 1.62, 95% CI 1.55-1.70; OR insomnia 2.11, 95% CI 1.99-2.24), survivors with comorbidity (OR fatigue 2.97, 95% CI 2.78-3.18; OR pain 2.13, 95% CI 2.00-2.27; OR insomnia 1.67, 95% CI 1.55-1.80), smokers (OR fatigue 1.96, 95% CI 1.80-2.13; OR pain 1.67, 95% CI 1.55-1.81; OR insomnia 1.46, 95% CI 1.33-1.60), and survivors with obesity (OR fatigue 1.92, 95% CI 1.80-2.06; OR pain 2.21, 95% CI 2.08-2.35; OR insomnia 1.32, 95% CI 1.22-1.42).</p><p><strong>Conclusions: </strong>Clinically important fatigue, pain, or insomnia are common in survivors of cancer, and two in five report two or all three late effects. Report of these symptoms is associated with social and clinical vulnerability factors.</p><p><strong>Implication for cancer survivors: </strong>Management of survivorship care requires targeted consideration of the complexity and overall impact of these late effects.</p>","PeriodicalId":15284,"journal":{"name":"Journal of Cancer Survivorship","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293777","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":"\"Let's talk about risk\": co-designing a pathway to assess, communicate and act on individual risk of long-term toxicities after breast cancer.","authors":"Maria Alice Franzoi, Carlota Santolaya, Elise Martin, Leonor Fasse, Pascal Rouby, Marie Sophie Minot-This, Antonio Di Meglio, Ines Vaz-Luis","doi":"10.1007/s11764-025-01826-0","DOIUrl":"https://doi.org/10.1007/s11764-025-01826-0","url":null,"abstract":"<p><strong>Purpose: </strong>Survivors of breast cancer (BC) may endure significant and persistent post-treatment burdens that negatively impact overall quality of life. We previously developed risk prediction algorithms to identify individual patient profiles at increased risk for long-term toxicities. To prepare for the implementation of these risk algorithms in routine care, we performed a study to assess preferences, catalysts, and barriers concerning communication of individual risk of long-term BC toxicities. The goal was to co-design a pathway for risk assessment, communication, and management starting at diagnosis.</p><p><strong>Methods: </strong>A co-design study was performed using a participatory research framework and qualitative methods. Two phases of focus groups (FG) were conducted to assess the perspective of patients and providers through an iterative process of Exploration, Consultation, Prioritization, Integration and Co-design. Discussions were guided by four main questions: Who should communicate the risk? When should the risk be communicated? How should the risk be communicated? What information should be communicated, and care proposed?. FG discussions were recorded, pseudo-anonymized, transcribed and evaluated through a thematic content analysis. Results were reported following the consolidated criteria for reporting qualitative research (COREQ).</p><p><strong>Results: </strong>Six FG were conducted between July 2022 and August 2023, with a total of 28 participants (8 patients and 20 providers). Results revealed a strong willingness to discuss the risk of long-term toxicities, particularly for patients who would present with a higher risk of toxicities. However, this willingness was contingent on the implementation of supportive care pathways that offer personalized communication strategies and risk mitigation approaches tailored to each patient's need.</p><p><strong>Conclusions: </strong>This study found that both patients and providers are interested in, and willing to engage in, the assessment, communication and mitigation of long-term toxicities from the time of diagnosis. To address this need in routine care, a tailored pathway was co-designed and will undergo formal testing in a hybrid Type 3 effectiveness/implementation clinical trial (NCT06479057).</p><p><strong>Implications for cancer survivors: </strong>This study assessed the needs, preferences and expectations of patients and providers for implementing a care pathway to assess, communicate and mitigate the risk of long-term toxicities after breast cancer treatment using risk prediction algorithms.</p>","PeriodicalId":15284,"journal":{"name":"Journal of Cancer Survivorship","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274999","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":"Employing skin self-examination and fear of cancer recurrence management in early-stage melanoma follow-up: evaluation of the MELACARE intervention in a randomised controlled trial.","authors":"Sara Mølgaard Hansen, Christoffer Johansen, Nadine A Kasparian, Mia Klinten Grand, Pernille Envold Bidstrup, Lisbet Rosenkrantz Hölmich","doi":"10.1007/s11764-025-01841-1","DOIUrl":"https://doi.org/10.1007/s11764-025-01841-1","url":null,"abstract":"<p><strong>Purpose: </strong>The MELACARE intervention aimed to evaluate a nurse-led follow-up program incorporating skin self-examination (SSE) education and psychosocial support to address fear of cancer recurrence (FCR) in early-stage melanoma survivors. This study assessed the MELACARE intervention's impact on FCR, psychological well-being, SSE performance, and healthcare usage compared to standard physician-led follow-up.</p><p><strong>Methods: </strong>A two-group randomised controlled trial was conducted at Herlev and Gentofte Hospital, Denmark. Participants included 153 patients with surgically treated melanoma (stages IA-IIA). Patients were randomised to either the MELACARE intervention (n = 78) or a control group provided treatment as usual (n = 75). The intervention involved nurse-led sessions focusing on SSE techniques and metacognitive strategies. Outcomes included FCR (primary), distress, anxiety, depression, health-related quality of life (HRQoL), patient activation, and SSE frequency and confidence (secondary) at 6 months.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov (NCT05253872).</p><p><strong>Results: </strong>At 6 months, the mean of the primary outcome FCR was lower in the intervention compared to the control groups, but the difference was not statistically significant (- 0.86 [- 3.34;1.62]). Intervention patients reported higher HRQoL (18% [3;32]) and patient activation (0.43 [0.15;0.71]) as the only significant secondary outcomes. Confidence in SSE was higher in the intervention group, with most performing SSE at recommended intervals.</p><p><strong>Conclusions: </strong>The MELACARE intervention may improve HRQoL and patient activation but did not reduce FCR. High fidelity of delivery and patient adherence highlight its potential utility.</p><p><strong>Implications for cancer survivors: </strong>The MELACARE approach empowers melanoma survivors through structured SSE education and psychosocial support. Future analyses will investigate long-term safety and efficacy.</p>","PeriodicalId":15284,"journal":{"name":"Journal of Cancer Survivorship","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275000","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 a physical activity intervention on sleep among cancer survivors in a randomized controlled trial within the Cancer Prevention Study-3 cohort.","authors":"Charlie Zhong, Mariah Landry, Scott Whalen, Amber Grant, Ananya G Reddy, Sidney M Donzella, Anita R Peoples, Alpa V Patel, Erika Rees-Punia","doi":"10.1007/s11764-025-01837-x","DOIUrl":"https://doi.org/10.1007/s11764-025-01837-x","url":null,"abstract":"<p><strong>Purpose: </strong>Poor sleep is a long-term sequela of cancer and its treatment. Moderate-to-vigorous physical activity (MVPA) is associated with improved health outcomes among cancer survivors and has been suggested as a nonpharmacological method to improving sleep. We evaluated the efficacy of a MVPA intervention to improve sleep among cancer survivors.</p><p><strong>Methods: </strong>We conducted a randomized controlled trial among 415 cancer survivors embedded within the Cancer Prevention Study-3 cohort. Survivors were randomized to a year-long, web-based MVPA program. MVPA was assessed via hip-worn actigraphy at baseline, 3 months, 6 months, and 1 year. We evaluated sleep through the SATED sleep health questionnaire, PROMIS Sleep Disturbance Scale, and device-measured duration and efficiency. An intent-to-treat (ITT) analysis was performed, and secondary analyses were conducted based on measured MVPA levels with generalized additive mixed-effects models.</p><p><strong>Results: </strong>Survivors reported similar sleep health and patterns to the general US population. We observed no significant changes to sleep between treatment groups in ITT models. Though not statistically significant, there appeared to be heterogeneity based on baseline sleep disturbance (moderate-to-severe sleep disturbance: β_SATED = 0.73 (95% CI - 0.09, 1.60) vs mild-to-normal sleep disturbance: β_SATED = - 0.26 (95% CI - 0.57, 0.05)). Participants that engaged in more MVPA at the end of the trial reported better sleep health (p-value = 0.04) and less sleep disturbances (p-value = 0.11).</p><p><strong>Conclusions: </strong>The MVPA intervention was more effective at improving sleep among survivors with sleep disturbances at baseline. Increasing MVPA improved sleep among cancer survivors IMPLICATIONS FOR CANCER SURVIVORS: Increasing MVPA among cancer survivors with sleep disturbances may be a viable strategy for improving sleep.</p>","PeriodicalId":15284,"journal":{"name":"Journal of Cancer Survivorship","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258173","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":"Partnership and fatherhood outcomes in young men diagnosed with cancer: a nationwide register-based study.","authors":"Line Bentsen, Helle Pappot, Kirsten Tryde Macklon, Lone Schmidt, Ditte Vassard","doi":"10.1007/s11764-025-01849-7","DOIUrl":"https://doi.org/10.1007/s11764-025-01849-7","url":null,"abstract":"<p><strong>Purpose: </strong>A cancer diagnosis during young adulthood can impact identity, relationships, and family building. While young men with cancer face fertility risks, data on fatherhood and partnership outcomes remain limited. This study aimed to examine the hazard ratios (HRs) for fatherhood and partnership formation in young men diagnosed with cancer compared to age-matched comparisons.</p><p><strong>Methods: </strong>This nationwide register-based study, based on the DANAC II cohort, included men diagnosed with cancer at 18-39 years (1978-2016) and age-matched male comparisons. Cox regression models estimated HRs of fatherhood and partnership formation, adjusting for time of diagnosis or study entry, immigration status, and pre-diagnosis children.</p><p><strong>Results: </strong>Among 16,913 men with cancer and 1,353,040 comparisons, those with cancer had a lower HR of fatherhood (0.88 [95% confidence interval (CI) 0.86-0.91]), the lowest among men with lymphoma, central-nerve system (CNS), and gastrointestinal cancers. Fatherhood probabilities improved over time, with older men showing the greatest gains. Among men who were single at diagnosis or study entry, the HR for partnership formation was similar to the comparison group (1.03 [95% CI 0.99-1.07]), except for those with gastrointestinal or CNS cancers.</p><p><strong>Conclusions: </strong>Fatherhood HRs were generally lower than in comparisons, varying by cancer group, age, and diagnosis period. However, single men diagnosed with cancer typically formed partnerships similar to the comparisons.</p><p><strong>Implications for cancer survivors: </strong>The lower probability of fatherhood highlights the need for and importance of oncofertility counseling, timely fertility preservation referrals, and follow-up care tailored to cancer groups and age at diagnosis.</p>","PeriodicalId":15284,"journal":{"name":"Journal of Cancer Survivorship","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258174","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":"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}