Psycho‐Oncology最新文献

{"title":"Mapping Psychosocial Determinants for Cancer Onset: An Umbrella Review.","authors":"M Masiero, E Tomezzoli, C Marzorati, G Pagani, R Pietrobon, S Mattioli, L Teixeira, P Dorangricchia, M Serra-Blasco, A García-Serra, C Ochoa-Arnedo, D Monzani, B Caci, G Miale, G Pravettoni","doi":"10.1002/pon.70597","DOIUrl":"10.1002/pon.70597","url":null,"abstract":"<p><strong>Background: </strong>Despite the growing body of literature suggesting that psychosocial factors contribute to cancer susceptibility, the existing evidence remains heterogeneous, and it is unclear which domains show the most consistent associations. Systematically mapping this literature helps inform the integration of psychosocial factors into cancer risk assessment and management frameworks, alongside behavioural risk factors.</p><p><strong>Methods: </strong>To synthesise existing evidence on psychosocial factors associated with cancer onset, we conducted an umbrella review within the EU-funded iBeChange project (ID:101136840). Following Joanna Briggs Institute (JBI) methodology, PRISMA 2020 and SWiM guidelines, we included systematic reviews and meta-analyses examining psychosocial exposures in relation to cancer risk or incidence. Searches were conducted in PubMed, Embase, and Scopus, and methodological quality was assessed using ROBIS.</p><p><strong>Results: </strong>Forty-one reviews were included. Across psychosocial domains, the consistency of evidence varied considerably. Depression showed the most robust low-risk-of-bias evidence, particularly for lung and overall cancer risk. Adverse childhood experiences showed high concordance across reviews with a dose-response gradient, though all reviews were rated at high risk of bias. Urbanicity, composite socioeconomic status, and anxiety showed moderate or variable patterns, while stressful life events, socioeconomic indicators, and coping strategies were characterised by low consistency and very high heterogeneity. Evidence for psychiatric diagnoses and psychological distress was limited to single reviews. Approximately one third of the included reviews were rated at low risk of bias.</p><p><strong>Conclusions: </strong>This umbrella review identifies psychosocial domains that should be considered in relation to cancer risk, providing a foundation for expanding prevention models beyond traditional behavioural risk factors towards multidimensional, psychosocially informed approaches. Lower-consistency domains should not be prematurely dismissed, as current evidence gaps may reflect methodological limitations rather than true absence of effect. Further high-quality longitudinal studies are needed to clarify underlying mechanisms and support the integration of psychosocial factors into cancer prevention strategies.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"35 9","pages":"e70597"},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13570670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inflammatory Correlates and Prospective Associations of Cancer-Related Fatigue: A Systematic Review and Meta-Analysis.","authors":"Lina Wu, Xingyu Xiong, Zhaohui Zhang, Shouzhen Cheng","doi":"10.1002/pon.70598","DOIUrl":"10.1002/pon.70598","url":null,"abstract":"<p><strong>Background: </strong>Cancer-related fatigue (CRF) is a prevalent and disabling symptom across the cancer continuum and is increasingly conceptualized as a biobehavioral symptom with inflammatory underpinnings. However, evidence linking specific circulating inflammatory biomarkers to CRF remains fragmented and inconsistent.</p><p><strong>Aims: </strong>To compare biomarker-CRF associations across cross-sectional and prospective observational studies.</p><p><strong>Methods: </strong>PubMed, Web of Science, Cochrane Library, Embase, Scopus, and PsycINFO were searched from inception to 17 November 2025. Random-effects meta-analyses were stratified by study design and effect-size metric; non-comparable estimates were synthesized narratively. Certainty was assessed using GRADE.</p><p><strong>Results: </strong>Forty-two studies (11,629 participants) were included. Cross-sectional CRF was positively associated with C-reactive protein (CRP; r = 0.30, 95% CI 0.21-0.38). Positive associations were also observed for interleukin-6 (IL-6; r = 0.17, 95% CI 0.06-0.29) and tumor necrosis factor (TNF; r = 0.13, 95% CI 0.01-0.24). Interleukin-1 receptor antagonist was likewise associated with CRF (IL-1ra; r = 0.23, 95% CI 0.09-0.36). Prospectively, CRP was associated with subsequent CRF in odds ratio (OR = 1.20, 95% CI 1.05-1.37) and standardized regression syntheses (β = 0.26, 95% CI 0.09-0.43). Evidence for IL-6, TNF, IL-1β, and IL-8 was less stable or inconclusive. Certainty was high for four evidence bodies, moderate for four, low for one, and very low for one.</p><p><strong>Conclusion: </strong>Current evidence supports systemic inflammation as a clinically relevant biological correlate of CRF, with CRP/hsCRP showing a comparatively more replicable signal across study designs. However, observational evidence does not establish causality or clinical utility. Standardized longitudinal and intervention studies are needed to evaluate temporal relationships, predictive performance, and clinical applicability.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"35 9","pages":"e70598"},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13562817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148930918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improvements in Health-Related Quality of Life After Financial Navigation Among Cancer Survivors.","authors":"Austin R Waters, Bridgette Thom, Allison M Deal, Camille R Murray, Kevin Pignone, Michelle L Manning, Mindy Gellin, Neda R Padilla, Lisa P Spees, Arrianna Marie Planey, Katherine E Reeder-Hayes, Donald L Rosenstein, Stephanie B Wheeler","doi":"10.1002/pon.70605","DOIUrl":"10.1002/pon.70605","url":null,"abstract":"<p><strong>Background: </strong>Financial toxicity is associated with worse health outcomes among cancer survivors. It is unknown if financial navigation (FN) can meaningfully improve the health of survivors experiencing financial toxicity.</p><p><strong>Aims: </strong>This analysis assesses changes in health-related quality of life (HRQoL) among cancer survivors receiving an FN intervention.</p><p><strong>Methods: </strong>A single-arm Type II Hybrid Implementation-Effectiveness clinical trial was conducted at eight clinical oncology sites in North Carolina. Cancer survivors within five years of diagnosis or living with advanced disease with a COmprehensive Score for financial Toxicity (COST-FACIT) score of < 23, and the ability to read and understand English were recruited to receive the Lessening the Impact of Financial Toxicity (LIFT) intervention, which included a comprehensive intake and at least one check-in with a trained navigator. Participants completed the Patient-Reported Outcomes Measurement Information System (PROMIS) Global Physical and Mental Health, Anxiety, Depression, and Psychosocial Illness Impact-Positive measures.</p><p><strong>Results: </strong>A total of N = 86 cancer survivors received the LIFT FN intervention and completed baseline and follow-up surveys. Receipt of LIFT FN was associated with statistically significant improvements in measures of global mental health (change: 1.72, 95% CI: 0.07, 3.38), depression (change: -2.07, 95% CI: -3.90, -0.25), and anxiety (change: -3.33, 95% CI: -5.42, -1.24). From baseline to follow-up, mean depression scores clinically improved from \"mild\" to \"within normal limits,\" and mean anxiety scores clinically improved from \"moderate\" to \"mild.\"</p><p><strong>Conclusions: </strong>Our findings demonstrate that receipt of FN decreased anxiety and depression and improved global mental health. Findings highlight the crucial role of FN in cancer care.</p><p><strong>Trial registration: </strong>NCT04931251.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"35 9","pages":"e70605"},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13595495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Qualitative Exploration of the Decision Not to Take Part in Colorectal Cancer Screening Among Women Living in Lower Socio-Economic Areas.","authors":"Nicholas Clarke, Lucy Hayden, Alan Smith, Linda Sharp, Christian von Wagner, Therese Mooney, Pamela Gallagher","doi":"10.1002/pon.70600","DOIUrl":"10.1002/pon.70600","url":null,"abstract":"<p><strong>Background: </strong>Organized colorectal (CRC) screening programmes offer an opportunity to reduce the burden of the disease on populations. CRC screening participation among women is substantially lower than breast or cervical cancer screening. Uptake is also lower in areas of greater deprivation which could exacerbate inequalities in CRC; however, few studies have been conducted with women resident in lower socio-economic areas who were invited for screening but did not participate. The aim of this study was to explore women's decisions not to take part in Ireland's population-based BowelScreen programme.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted with women resident in lower socio-economic areas, who had not participated in BowelScreen. Deductive thematic analysis, guided by the Theoretical Domains Framework (TDF: 14 domain version), using the framework approach was conducted.</p><p><strong>Results: </strong>Fifteen women from lower socio-economic areas in Ireland who had not participated in BowelScreen were interviewed. Six TDF domains were identified as influencing non-participation; (1) Environmental Context and Resources; stressful life events and lack of healthcare professional recommendations, (2) Memory, Attention and Decision Making; delayed decision making and deciding screening is not personally relevant, (3) Knowledge; poor knowledge negating need for screening, (4) Emotions; disgust, embarrassment and fear, (5) Skills; low self-efficacy and instruction complexity, and (6) Social influence; did not encourage testing or was overridden by emotion and poor knowledge.</p><p><strong>Conclusions: </strong>Greater consideration should be given to the targeting of interventions towards specific determinants of non-participation within subgroups of the population, in particular non-participant women living within lower socio-economic areas. Tackling environmental stressors, emotional factors, lack of healthcare professional support and the perception that feeling healthy equates with not needing screening could help improve CRC screening uptake among women living in low socioeconomic areas.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"35 9","pages":"e70600"},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13595476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive Trajectories and Associated Factors in Prostate Cancer Survivors Over a 3-Year Prospective Study.","authors":"Adriana Costa, Milton Severo, Catarina Lopes, Natália Araújo, Augusto Ferreira, Carolina Lopes, Susana Pereira, Nuno Lunet","doi":"10.1002/pon.70604","DOIUrl":"10.1002/pon.70604","url":null,"abstract":"<p><strong>Objective: </strong>To identify and characterize cognitive trajectories over 3 years in men with prostate cancer (PCa) and their associated sociodemographic, clinical, and treatment-related factors.</p><p><strong>Methods: </strong>This study included 454 men with PCa from the NEON-PC cohort. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), before treatment and at 1- and 3-year follow-ups. Probable cognitive impairment (PCI) was defined using age- and education-adjusted cut-offs. Model-based clustering and clinical interpretability were used to identify cognitive trajectories. Adjusted odds ratios (aORs) were estimated using multinomial logistic regression.</p><p><strong>Results: </strong>Four cognitive trajectories were identified: (1) consistently high (highest scores throughout follow-up); (2) moderate-stable (stable intermediate scores); (3) moderate-downward (intermediate baseline scores and declining over the follow-up); and (4) consistently low (lowest baseline scores). PCI prevalence increased over time in the moderate-downward trajectory (8.1%-33.3%, p < 0.001) and remained high in the consistently low trajectory (29.8%-32.6%, p = 0.537). Compared with the consistently high trajectory, age (≥ 75 vs. ≤ 65: OR = 4.00; 95% CI: 1.61-9.93), education (≥ 10 vs. ≤ 4 years: aOR = 0.02; 95% CI: 0.01-0.06), and depressive symptoms (per one-point increase in the Hospital Anxiety and Depression Scale: aOR = 1.12; 95% CI: 1.01-1.24) were associated with the consistently low trajectory. Androgen deprivation therapy (ADT) was associated with the moderate-downward trajectory (aOR = 2.33; 95% CI: 1.01-5.36).</p><p><strong>Conclusions: </strong>Four distinct cognitive trajectories were identified among men with PCa over 3 years, with worse trajectories associated with sociodemographic, psychological distress, and treatment-related factors.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"35 9","pages":"e70604"},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13559050/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148920893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Referral and Activity in Specialist Psycho-Oncology Services: A Survey of Provision in England and Scotland.","authors":"Anna Lagerdahl, Vanessa Bútorová","doi":"10.1002/pon.70613","DOIUrl":"10.1002/pon.70613","url":null,"abstract":"<p><strong>Background: </strong>Distress is a common, clinically significant response to cancer, yet specialist psycho-oncology provision varies across the UK, and national service-level data on staffing, access and activity are lacking.</p><p><strong>Aims: </strong>To provide an updated picture of referral, access, workforce and activity of specialist psycho-oncology services across the UK.</p><p><strong>Methods: </strong>A cross-sectional service survey distributed UK-wide via professional networks used an 18-item questionnaire capturing staffing, referrals, waiting times, activity and outcome measures for 2022/2023. Activity was expressed per specialist whole-time equivalent (WTE); reporting followed STROBE.</p><p><strong>Results: </strong>Twenty-five psychology-led NHS psycho-oncology services participated, all in England and Scotland. All had Level 4 provision but only 40% had Level 3. Each WTE served a mean of 1530 new cancer diagnoses, saw 83 new patients and delivered 446 attended appointments (mean 7 sessions per patient). 8.4% of patients were referred for specialist support, below the ∼25% estimated to need it. Eighty-three percent of services judged their referrals to under-represent need. Mean waits were 21 days (urgent) and 3.4 months (routine); services without a dedicated senior leadership post tended to wait longer (median routine 4 vs. 3 months; urgent 30 vs. 10 days).</p><p><strong>Conclusions: </strong>Specialist psycho-oncology services in England and Scotland are understaffed, with long waits and inequitable access, even among psychology-led services. Senior leadership may support shorter waits but must be matched by balanced staffing across Levels 3 and 4. Workforce investment, inclusive referral pathways, a cancer-specific psychological wellbeing measure, and embedding specialist support where it is absent are needed to deliver equitable care.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"35 9","pages":"e70613"},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13586979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Making Interventions More Effective: Changes in Theoretical Constructs During Delivery of a Peer-Led Physical Activity Program for Breast Cancer Survivors.","authors":"Bernardine M Pinto, Madison Kindred, Victoria R DeScenza, Shira Dunsiger","doi":"10.1002/pon.70616","DOIUrl":"10.1002/pon.70616","url":null,"abstract":"<p><strong>Objective: </strong>Theory-based physical activity (PA) interventions improve moderate to vigorous physical activity (MVPA) among breast cancer survivors, yet limited research has examined when psychosocial changes occur during intervention delivery. Understanding temporal changes in theoretical constructs during PA adoption may enhance intervention delivery and outcomes. The purpose of this study is to examine longitudinal changes in self-efficacy, self-regulation and affect (intrapersonal constructs from Social Cognitive Theory) and social support (interpersonal construct) during a 12-week theory-based PA program (webMFT) and their association with participants' active minutes (measured by Fitbit) over 12 weeks and intervention engagement (receipt of 12 weekly peer coaching calls).</p><p><strong>Methods: </strong>In a randomized controlled trial with 61 participants, 30 were randomized to receive webMFT (mean age = 58.1 [SD = 8.55], 1.40 years post-diagnosis [SD = 0.5], 80% Stage 0-1 cancer, 80% White) delivered by 10 peer coaches. Only the webMFT participants were assessed; the comparison group (MVPA Tracking) was not included in the analyses. webMFT participants received a Fitbit tracker and weekly PA coaching calls tailored to Fitbit PA data. At baseline, 4, 8 and 12 weeks, they completed questionnaires assessing multidimensional self-efficacy (task, coping, scheduling), self-regulation skills, affective response and social support for PA. Mixed effects regression models examined changes in constructs and their association with Fitbit active minutes/week and intervention engagement.</p><p><strong>Results: </strong>Increases in total self-efficacy, scheduling self-efficacy, positive affect and social support from family and friends were significantly associated with participants' PA over 12 weeks. There were no significant associations between changes in self-regulation skills, task or coping self-efficacy with PA. Improvements in total self-efficacy, scheduling self-efficacy, self-regulation, affective response and family social support were positively associated with intervention engagement.</p><p><strong>Conclusions: </strong>Participants' self-efficacy, specifically, for scheduling PA, positive affect and social support for PA adoption and intervention engagement merit future examination.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"35 9","pages":"e70616"},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13613989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Embrace Pain-A Randomized Controlled Trial of Online Acceptance and Commitment Therapy for Painful Chemotherapy-Induced Peripheral Neuropathy in Cancer Survivors.","authors":"Daniëlle L van de Graaf, Paul Lodder, Tom Smeets, Marije L van der Lee, Hester R Trompetter, Karlein M G Schreurs, Elin Børøsund, Lise Solberg Nes, Floortje Mols","doi":"10.1002/pon.70608","DOIUrl":"10.1002/pon.70608","url":null,"abstract":"<p><strong>Introduction: </strong>Chemotherapy-induced peripheral neuropathy (CIPN) is a common and persistent side effect of chemotherapy, with up to 30% of patients reporting symptoms 6 months post-treatment. Painful CIPN can impair sleep, mood, and physical functioning. We evaluated \"Embrace Pain,\" an online Acceptance and Commitment Therapy (ACT) based self-help intervention that may be of support for cancer survivors with chronic painful CIPN.</p><p><strong>Methods: </strong>The Embrace Pain Randomized Controlled Trial (RCT) compared ACT with a waiting list condition (WLC) using a two-armed randomized design. Adults (≥ 18 years) with painful CIPN ≥ 6 months post-chemotherapy were randomized to an 8-week guided online ACT program or WLC. Primary outcome was pain interference (Multidimensional Pain Inventory, MPI). Secondary outcomes included pain catastrophizing, psychological flexibility, CIPN severity, pain intensity, and quality of life (QoL). Linear mixed models and criteria for clinically significant change were used to evaluate outcomes from baseline to 3-month follow-up.</p><p><strong>Results: </strong>112 participants were included (57 ACT, 55 WLC). No significant treatment effect was observed for the primary outcome, pain interference, with ACT not outperforming the WLC over time. However, more ACT participants showed clinically significant improvement in pain interference at 3-month follow-up (47.4% vs. 23.6%) than WLC participants, and exploratory analyses showed greater reductions in pain catastrophizing in the ACT group. No between-group differences were found for psychological flexibility, CIPN severity, pain intensity, or QoL.</p><p><strong>Discussion: </strong>Online ACT did not demonstrate a significant treatment effect on pain interference in those with painful CIPN. Exploratory findings suggest potential benefits for pain catastrophizing and clinically meaningful improvement in pain interference for some participants. Larger studies are needed to confirm these findings.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"35 9","pages":"e70608"},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing Existential Distress Through Compassion: Feasibility and Preliminary Effects of Compassion With You (COMwithU), a Compassion-Based Intervention for Patients With Cancer.","authors":"Yeonkyu Choi, Jang Sub Kim, Hyejeong Ahn, Soowan Han, Min Cheol Seo, Jae Hyun Ryou, Da Eun Kim, Yoosuk An, Bhumsuk Keam, Tae-Yong Kim, Eun Seoung Yu, Hye Yoon Park","doi":"10.1002/pon.70580","DOIUrl":"10.1002/pon.70580","url":null,"abstract":"<p><strong>Background: </strong>Cancer-related distress extends beyond anxiety and depression to existential suffering, including loss of meaning, helplessness, uncertainty, and relational strain. Compassion-based interventions in psycho-oncology are promising, but existential outcomes such as demoralization and spiritual well-being have rarely been examined. Compassion With You (COMwithU) is a brief, five-session compassion-based intervention that centers on cultivating self-compassion, supported by the therapist's compassionate presence and by practices of extending compassion toward others.</p><p><strong>Methods: </strong>This single-arm feasibility study evaluated COMwithU in adult patients with cancer using a pre-post-1-month follow-up design. The intervention comprised five individual 60-min sessions delivered in person or via videoconferencing. Primary outcomes were feasibility and acceptability. Secondary outcomes included anxiety, depression, spiritual well-being, demoralization, self-compassion, and intolerance of uncertainty. Linear mixed models examined changes across baseline, post-intervention, and follow-up.</p><p><strong>Results: </strong>Of 44 participants who started the intervention, 37 attended at least 3 of 5 sessions, yielding a completion rate of 84.1%. Among 34 full completers, 31 (91.2%) completed the post-intervention assessment, and 30 (88.2%) completed the follow-up. Helpfulness was rated highly (mean 4.63/5). Anxiety, depression, spiritual well-being, demoralization, and self-compassion improved significantly, whereas intolerance of uncertainty did not change significantly. Among participants above the demoralization cutoff at baseline, 68.0% showed reliable improvement, and 56.0% achieved clinically significant change by follow-up.</p><p><strong>Conclusions: </strong>COMwithU demonstrated good feasibility, high acceptability, and promising preliminary effects in patients with cancer. The strongest effects were observed for demoralization and spiritual well-being. Further randomized controlled trials should directly assess self-compassion, relational compassion processes, and existential outcomes.</p><p><strong>Trial registration: </strong>This study was registered at the Clinical Research Information Service (CRIS), Republic of Korea (Registration number: KCT0010315).</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"35 9","pages":"e70580"},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Service and Suffering: Comparative Analyses of Health-Related Quality of Life Among Veteran and Civilian Cancer Survivors.","authors":"Qaidar Alizai, Odysseas P Chatzipanagiotou, Areesh Mevawalla, Azza Sarfraz, Meher Angez, Rida Ejaz, Abdulaziz Elemosho, Sebastian Ekenze, R Connor Chick, Timothy M Pawlik","doi":"10.1002/pon.70596","DOIUrl":"10.1002/pon.70596","url":null,"abstract":"<p><strong>Background: </strong>Veterans report greater comorbidity and psychosocial burden but have enhanced healthcare access through the Veterans Health Administration (VHA). We sought to characterize health-related quality of life (HRQoL) differences between veteran and civilian cancer survivors.</p><p><strong>Methods: </strong>We analyzed cancer survivors from the 2017-2022 Behavioral Risk Factor Surveillance System. Outcomes included fair/poor general health, poor physical health, poor mental health, and activity-limiting poor health. Sex-stratified, survey-weighted Poisson regression with robust variance estimated incidence rate ratios (IRRs) for day-count outcomes and prevalence ratios (PRs) for binary outcomes, controlling for sociodemographic and clinical covariates.</p><p><strong>Results: </strong>Among 65,613 survivors (32,710 men; 32,903 women), 11,213 men (34.3%) and 753 women (2.3%) were veterans. Male veterans were older than civilian men (≥ 75 y: 54.4% vs. 25.9%), less likely to be employed (20.1% vs. 39.6%) or be college graduates (41.9% vs. 47.5%), and frequently reported history of cerebrovascular accident (9.8% vs. 5.7%) or coronary artery disease (25.4% vs. 15.9%) (all p < 0.001). Compared with female civilians, female veterans reported no differences in education, employment status, or history of chronic conditions (p > 0.05). Among female cancer survivors, veteran status was associated with higher prevalence of poor physical-health (aPR 1.35, 95% CI 1.02-1.77) and poor mental-health (aPR 1.45, 95% CI 1.06-1.98). Among males, veteran status was not associated with poor physical or mental health (all p > 0.05).</p><p><strong>Conclusions: </strong>The findings highlight the importance of sex-responsive survivorship care integrating chronic-disease management, mental-health support, and social-risk screening across VHA and civilian systems.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"35 9","pages":"e70596"},"PeriodicalIF":3.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13552728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148913263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}