Supportive Care in Cancer最新文献

{"title":"Navigating care: understanding cancer patients' experiences with systemic radionuclide therapy.","authors":"Johannes Starkbaum, Solenn Thircuir, Florian Winkler, Erich Griessler","doi":"10.1007/s00520-025-09380-2","DOIUrl":"10.1007/s00520-025-09380-2","url":null,"abstract":"<p><p>Neuroendocrine tumors (NETs) are widely considered to be a rare disease, often diagnosed at a late stage due to the variety of symptoms. Systemic radionuclide therapy (SRT) with Lutathera (177Lu-Dotatate) is a promising treatment for this disease. However, little is known about patients' experiences with this approach and the radioactivity involved. Based on seven semi-structured interviews, this qualitative study explores how cancer patients perceive their journey to SRT, and the treatment and care they receive in clinics specialized in the delivery of 177Lu-Dotatate to target tumors. The interviews were conducted in France between 2020 and 2021. Six interviews included patients receiving SRT, and one was held with a patient representative for NETs. Three key themes emerged from the analysis: challenges in accessing SRT, including geographic and institutional barriers; the psychological and social impact of radiation-related isolation; and the role of patient-centered care in fostering trust and well-being. Patients reported difficulties navigating the healthcare system, emotional distress due to isolation during treatment, and the importance of support in mitigating these challenges. These findings highlight the need for increased access to SRT, as well as of patient-centered approaches to the various challenges directly and indirectly associated with SRT.</p>","PeriodicalId":22046,"journal":{"name":"Supportive Care in Cancer","volume":"33 4","pages":"325"},"PeriodicalIF":2.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11950005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spiritual care in outpatient oncology: a qualitative study of focus groups with cancer center chaplains.","authors":"Kelsey B White, Petra J Sprik, Bronwen Jones, George Fitchett","doi":"10.1007/s00520-025-09369-x","DOIUrl":"10.1007/s00520-025-09369-x","url":null,"abstract":"<p><strong>Purpose: </strong>To provide a preliminary description of the scope and nature of spiritual care services in outpatient oncology settings.</p><p><strong>Methods: </strong>Qualitative thematic analysis of data collected from three focus groups with chaplains representing 13 unique cancer centers.</p><p><strong>Results: </strong>Eight of 13 chaplain respondents (61.5%) reported that they provided spiritual care exclusively and in a full-time capacity to a cancer center; the remaining 5 (38.5%) had additional inpatient responsibilities. Chaplains visited between 4 and 10 patients per day depending on departmental policies and case acuity. Respondents identified patients for care in a wide variety of ways and described it as a time-intensive aspect of their job. Chaplains noted providing traditional spiritual care and developing innovative strategies/techniques. Most spiritual care relationships were long-term and often focused on medical decision-making. Chaplains commonly faced organizational challenges and identified priorities for strengthening spiritual care integration in outpatient cancer care.</p><p><strong>Conclusion: </strong>The results indicate that the provision of spiritual care in cancer centers differs widely, with chaplains frequently facing challenges with system integration. While chaplains consistently strive to build relationships with clinicians and effectively manage clinic workflows, more collaboration and strategic alignment are needed between chaplains, clinicians, and administrators to develop and advocate for outpatient oncology spiritual care.</p>","PeriodicalId":22046,"journal":{"name":"Supportive Care in Cancer","volume":"33 4","pages":"322"},"PeriodicalIF":2.8,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of a previous diagnosis of cancer and/or cardiovascular disease with current physical activity levels in Korean adults.","authors":"Ki-Yong An, Fernanda Z Arthuso, Spencer J Allen, Stephanie M Ntoukas, Kerry S Courneya","doi":"10.1007/s00520-025-09377-x","DOIUrl":"https://doi.org/10.1007/s00520-025-09377-x","url":null,"abstract":"<p><strong>Purpose: </strong>A diagnosis of cancer (CAN) and/or cardiovascular disease (CVD) may influence physical activity levels; however, no study has examined the independent and combined associations of a CAN and CVD diagnosis with physical activity. The purpose of the present study was to examine the associations of the occurrence, order, and timing of a CAN and/or CVD diagnosis with physical activity in Korean adults.</p><p><strong>Methods: </strong>Korean adults who reported current physical activity and a previous CAN and/or CVD diagnosis in the Korea National Health and Nutrition Examination Survey between 2014 and 2019 were included in the study. Analysis of covariance and multinomial logistic regression were used to examine associations.</p><p><strong>Results: </strong>Overall, 29,434 (90.1%) were diagnosed with neither disease, 1,591 (4.9%) with CAN only, 1,493 (4.6%) with CVD only, and 137 (0.4%) with both diseases. Participants diagnosed with CAN only reported more leisure-time and moderate physical activity than those diagnosed with neither disease and CVD only; and more walking than those diagnosed with neither disease, CVD only, and both diseases. Participants diagnosed with CVD only reported walking less than those diagnosed with neither disease. Participants diagnosed with both diseases reported no vigorous activity and less strength exercise than neither disease and CVD only. Few associations were found for the order and timing of diagnosis.</p><p><strong>Conclusions: </strong>Korean adults diagnosed with CAN only reported more physical activity than those diagnosed with CVD only, both diseases, and even neither disease. Understanding the differential impact of a disease diagnosis on physical activity may identify potential intervention strategies.</p>","PeriodicalId":22046,"journal":{"name":"Supportive Care in Cancer","volume":"33 4","pages":"324"},"PeriodicalIF":2.8,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacist-led deprescribing interventions for cancer patients in a specialist palliative care setting.","authors":"Ciarán McAdam, Eimear O'Dwyer, Kieran Dalton","doi":"10.1007/s00520-025-09341-9","DOIUrl":"10.1007/s00520-025-09341-9","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to determine the prevalence of potentially inappropriate medications (PIMs) among adult cancer patients in palliative care, the rate at which physicians implemented pharmacists' deprescribing recommendations, and some cost implications of deprescribing.</p><p><strong>Methods: </strong>Medication reconciliation was performed for each eligible patient, with both the OncPal deprescribing guideline and clinical judgement applied to identify PIMs. PIM prevalence was evaluated for each medication class. The physician recommendation implementation rate and medication cost savings were calculated.</p><p><strong>Results: </strong>In the 48 included patients, 25.2% of medications were PIMs (mean 2.4/patient) - with 86.7% OncPal-defined PIMs, most commonly vitamins, medications for gastro-oesophageal reflux disease (GORD), and lipid-modifying agents. Pharmacist deprescribing recommendations were implemented 71.7% of the time, equivalent to 1.7 fewer medications per patient. The 28-day cost was €948.27 for deprescribed PIMs. Implementation rates varied based on patient admission type, with a significantly higher (p<0.05) rate in those admitted for end-of-life care (83.3%) versus symptom control (65.1%) and respite (30%) admissions. Recommendations to deprescribe GORD medications had a significantly lower rate of implementation (26.7%) compared to all other medications (p<0.0001).</p><p><strong>Conclusion: </strong>This study underscores the benefits of pharmacist-led deprescribing in inpatient palliative care, resulting in cost savings and reduced medication burden. There is a notable need for proactive deprescribing before reaching inpatient care. Different deprescribing rates across medication types highlight the significance of reviewing medications which may have a role in symptom management. The omission of some medications from OncPal emphasises the importance in refining future deprescribing guidelines in palliative care.</p>","PeriodicalId":22046,"journal":{"name":"Supportive Care in Cancer","volume":"33 4","pages":"321"},"PeriodicalIF":2.8,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11946936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening for psychological distress in cancer care: prevalence and predictive factors among Italian patients using the Concerns and Help Identifier for Medical Patients Checklist.","authors":"Cormio Claudia, Rieti Erika, Lagattolla Fulvia, Milella Pietro, Romito Francesca, Mirenghi Claudia, De Summa Simona, Vitale Elsa, Fontana Roberta, Mongelli Lorenzo, Mitchell Alex, Acquati Chiara","doi":"10.1007/s00520-025-09385-x","DOIUrl":"https://doi.org/10.1007/s00520-025-09385-x","url":null,"abstract":"<p><strong>Purpose: </strong>Psychological distress is highly prevalent among cancer patients. Although several scientific and professional organizations developed guidelines and tools for screening, implementation barriers in cancer care persist. Therefore, it seems to be critical to effectively introduce tools and triage systems that can identify patients' source of distress. The study aims to investigate prevalence and predictors of psychological distress experienced by a mixed sample of adult cancer patients using the Italian version of the Concerns and Help Identifier for Medical Patients (CHIMP_C) Checklist, in order to quickly detect distress.</p><p><strong>Methods: </strong>In 2023, 240 adult cancer patients undergoing chemotherapy at the Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Tumori \"Giovanni Paolo II\" in Bari completed the Emotion Thermometers (ET) and the CHIMP_C Checklist. Socio-demographic and clinical factors were collected from medical records. Pearson and Spearman correlations, chi-square tests, and binomial logistic regressions were performed to investigate prevalence and predictors of psychological distress.</p><p><strong>Results: </strong>Most participants were female (68.3%), with breast cancer being the most common diagnosis (28.7%). Our findings revealed a significant prevalence of distress (49.58%, with DT scores ≥ 5). Notably, emotional and personal concerns emerged as key predictors and risk factors for elevated ET scores.</p><p><strong>Conclusion: </strong>The combined use of the CHIMP_C Checklist alongside the Emotion Thermometers (ET) could suggest a way for clinicians to identify multifaceted factors contributing to psychological distress in cancer patients during active treatment. This approach not only is focused on facilitating the initiation of timely psychological interventions but also can improve patient access to comprehensive therapeutic programs, thereby enhancing overall quality of care.</p>","PeriodicalId":22046,"journal":{"name":"Supportive Care in Cancer","volume":"33 4","pages":"323"},"PeriodicalIF":2.8,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Core preoperative symptoms and patients' symptom experiences in oral cancer: a mixed-methods study.","authors":"Yu Zhang, Jingya Yu, Tingting Liu, Lixia Kuang, Xiaoqin Bi","doi":"10.1007/s00520-025-09370-4","DOIUrl":"10.1007/s00520-025-09370-4","url":null,"abstract":"<p><strong>Aims: </strong>Patients with oral cancer frequently experience a substantial symptom burden, especially during the preoperative phase, which is typically marked by increased anxiety, pain, and functional impairments. This study aimed to construct contemporaneous symptom networks and investigate symptom experiences of patients with preoperative oral cancer in China.</p><p><strong>Methods: </strong>This study employed a mixed-methods design that integrated a cross-sectional study with qualitative research. Data were collected from 527 patients with oral cancer at the Department of Head and Neck Oncology in a tertiary hospital between September 2023 and May 2024 in China. The MD Anderson Symptom Inventory for Head and Neck Cancer (MDASI-H&N) was used to assess the prevalence and severity of the cancer-related symptoms. Symptom networks were constructed using the networktools, qgraph, and Bootnet packages in R, with centrality indices calculated to identify core symptoms within the network. Qualitative data were analyzed using content analysis with NVivo software to extract themes, thereby providing a comprehensive understanding of patients' symptom experiences.</p><p><strong>Results: </strong>Distress (89.56%) and sadness (63.95%) were the most prevalent and severe symptoms, respectively. Two distinct symptom clusters emerged: the Emotional-Sleep Symptoms Cluster (Cluster 1) and Eating Disorder Symptoms Cluster (Cluster 2). Difficulty swallowing or chewing (r_s = 0.87, r_b = 102) and disturbed sleep (r_s = 0.64, r_b = 77) exhibited the highest centrality indices, indicating that these symptoms were more likely to co-occur with others within the network. Additionally, fatigue had the most significant negative impact on quality of life (r =  - 0.16).</p><p><strong>Conclusion: </strong>This study identified core symptoms through preoperative symptom network analysis and offered valuable insights into the lived experiences of patients with oral cancer regarding their symptoms. These findings serve as a foundation for personalized targeted treatment strategies designed to improve symptom management and enhance quality of life in oral cancer care.</p>","PeriodicalId":22046,"journal":{"name":"Supportive Care in Cancer","volume":"33 4","pages":"319"},"PeriodicalIF":2.8,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11937163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A nomogram for predicting cancer-related cognitive impairment in lung cancer patients from a nursing science precision health model perspective.","authors":"Lei Ye, Xiaoyu Xu, Lijuan Liu, Fangmei Chen, Guanghui Xia","doi":"10.1007/s00520-025-09383-z","DOIUrl":"https://doi.org/10.1007/s00520-025-09383-z","url":null,"abstract":"<p><strong>Purpose: </strong>The nursing science precision health (NSPH) model considers identifying the biological basis of symptoms in order to develop precise intervention strategies that ultimately improve the overall health of the symptomatic individual. This study sought to construct a nomogram for predicting cancer-related cognitive impairment (CRCI) in patients with lung cancer within the context of the NSPH model.</p><p><strong>Methods: </strong>A cohort of 252 patients with lung cancer was prospectively collected and randomly divided into training and validation cohorts in a 7:3 ratio. The least absolute shrinkage and selection operator (LASSO) regression method optimized variable selection, followed by multivariate logistic regression to develop a model, which subsequently formed the basis for the nomogram. The nomogram's discrimination and calibration were evaluated using a calibration plot, the Hosmer-Lemeshow test, and the receiver operating characteristic curve (ROC). Decision curve analysis (DCA) quantified the net benefits of the nomogram across various threshold probabilities.</p><p><strong>Results: </strong>Five pivotal variables were incorporated into the nomogram: age (≥ 65 years), treatment, education level, albumin, and platelet-to-lymphocyte ratio (PLR). The area under the ROC curve (0.970 for the training cohort and 0.973 for the validation cohort) demonstrated the nomogram's excellent discriminative ability. Calibration curves closely aligning with ideal curves indicated accurate predictive capability. Moreover, the nomogram exhibited a positive net benefit for predicted probability thresholds ranging from 1 to 98% in DCA.</p><p><strong>Conclusion: </strong>Key risk factors, including advanced age (≥ 65 years), low education level, combined chemotherapy, low albumin, and high PLR, were significantly associated with higher CRCI incidence. This nomogram model has good performance and can help identify CRCI with high accuracy in lung cancer patients.</p>","PeriodicalId":22046,"journal":{"name":"Supportive Care in Cancer","volume":"33 4","pages":"320"},"PeriodicalIF":2.8,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing safety and feasibility of virtual reality intervention in patients with lung cancer: a pilot study.","authors":"Rosalba Hernandez, Harris Nisar, Thenkurussi Kesh Kesavadas, Mackenzie C McGee, Gregory J Gerstner, Angela Martinez, Carter Boyce, Sadia Anjum Ashrafi, Elizabeth L Addington, Alicia K Matthews, Safa Elkefi, Judith T Moskowitz","doi":"10.1007/s00520-025-09338-4","DOIUrl":"https://doi.org/10.1007/s00520-025-09338-4","url":null,"abstract":"<p><strong>Purpose: </strong>Lung cancer, the leading cause of cancer deaths, severely impacts psychological well-being, worsened by the stigma of smoking behavior. This study evaluated the safety, acceptability, and preliminary efficacy of customized virtual reality (VR) software for people with lung cancer, focusing on its potential to enhance mental health in patient care.</p><p><strong>Methods: </strong>Patients with lung cancer undergoing concurrent chemotherapy and radiation therapy were enrolled in our phase 1 single-arm proof-of-concept trial. Participants were immersed in our new Joviality™ VR program during the pre-medication phase of their treatment and engaged in a 25-min 3D session to learn about identifying and benefiting from positive emotions. Participants recorded motion-related symptoms and discomfort using the Simulator Sickness Questionnaire before and after exposure. Pain, anxiety, and fatigue were also captured. Utility measures assessed immersion, interaction with virtual objects, hardware usability, and program navigation ease.</p><p><strong>Results: </strong>Eleven patients enrolled, mean age of 65.8 (± 5.3) years, 72.7% male, 72.7% non-Hispanic White. Only 18.2% had prior VR experience. Participants reported a high sense of presence in the VR environment, scoring 5.26 out of 7, while the system usability score of 78.2 indicated excellent ease of use. Promising safety trends showed no exacerbation of motion sickness, while significant improvements were observed in anxiety (p = 0.04), fatigue (p = 0.03), and pain for preliminary efficacy.</p><p><strong>Conclusion: </strong>VR shows promise as an adjunct for enhancing mental health in lung cancer care. Findings suggest feasibility, safety, and early efficacy in reducing psychological distress and symptom burden, warranting investigation in larger-scale trials to confirm benefits.</p>","PeriodicalId":22046,"journal":{"name":"Supportive Care in Cancer","volume":"33 4","pages":"318"},"PeriodicalIF":2.8,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Walking inability in children during early treatment of acute lymphoblastic leukaemia: incidence and risk factors.","authors":"Emma den Hartog, Marta Fiocco, Inge M van der Sluis, Patrick van der Torre, Wim J E Tissing, Emma J Verwaaijen","doi":"10.1007/s00520-025-09365-1","DOIUrl":"10.1007/s00520-025-09365-1","url":null,"abstract":"<p><strong>Purpose: </strong>Acute lymphoblastic leukaemia (ALL) and its treatment cause side effects in paediatric patients which increase the risk of walking inability, limiting functional independence and quality of life. However, the incidence of walking inability, the time until onset and potential risk factors are unknown.</p><p><strong>Methods: </strong>We retrospectively retrieved data in ALL patients (≤ 18 years). Walking inability was defined as the incompetence to walk independently from diagnosis until the end of early treatment. A Kaplan-Meier analysis was conducted to estimate the time until walking inability. To assess the effect of risk factors, we estimated a Cox regression model and performed a landmark analysis.</p><p><strong>Results: </strong>In total, 226 patients (age median, 5.5 years; interquartile range, 3.4-11.7) were included. Walking inability was experienced by 15.0% at diagnosis and 28.3% during induction/consolidation1. Age at diagnosis (hazard ratio (HR) 0.901; 95% confidence interval (CI) 0.847-0.959) was a risk factor during induction/consolidation1. The landmark analysis at end of induction identified age at diagnosis (HR 0.898; 95% CI 0.830-0.971), delta weight-to-height Z-score (HR 0.577; 95% CI 0.410-0.812) and duration of hospitalizations (HR 1.076; 95% CI 1.005-1.152) as risk factors during consolidation1.</p><p><strong>Conclusion: </strong>Fifteen percent experienced walking inability at diagnosis and 28.3% temporarily stopped walking during early treatment. This is concerning because walking inability leads to isolation and loss of independence. Patients with younger age, decreasing weight and longer hospitalizations during the first month of treatment were at highest risk. Informing patients and parents about the occurrence of walking inability and studies on physiotherapy and nutritional interventions are indicated.</p>","PeriodicalId":22046,"journal":{"name":"Supportive Care in Cancer","volume":"33 4","pages":"317"},"PeriodicalIF":2.8,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between frailty and depression in Chinese elderly prostate cancer patients following radical surgery: the mediating effect of sleep disturbances.","authors":"Wenguang Liang, Xiaoping Chen, Cuicui Zeng, Huiting Zhang, Huiying Qin, Mengxiao Jiang","doi":"10.1007/s00520-025-09374-0","DOIUrl":"https://doi.org/10.1007/s00520-025-09374-0","url":null,"abstract":"<p><strong>Objective: </strong>Depression is an important factor affecting long-term outcomes in prostate cancer patients. Frailty and sleep quality are associated with depressive symptoms, but the pathways through which frailty and sleep quality affect depression remain unclear. The aim of this study was to investigate the relationship between frailty and depression in older Chinese patients after radical prostate cancer surgery and to explore whether sleep disturbances mediate the effect of frailty on depression.</p><p><strong>Methods: </strong>A cross-sectional study was conducted with 277 elderly prostate cancer patients who underwent radical prostatectomy at a tertiary oncology center in Southern China (January 2022-March 2024). Inclusion criteria required ≥ 3 months postoperative recovery. Standardized instruments were administered: FRAIL Scale for frailty assessment, Pittsburgh Sleep Quality Index (PSQI) for sleep evaluation, and PHQ-9 for depression screening, supplemented by demographic questionnaires.</p><p><strong>Results: </strong>Clinically relevant depressive symptoms (PHQ-9 ≥ 5) were identified in 18.4% (n = 51). Depression scores showed positive correlations with frailty (r = 0.521, p < 0.01) and negative correlations with sleep quality (r = -0.521, p < 0.01). Mediation analysis revealed frailty directly predicted depression (β = 0.349, p < 0.001) and indirectly through sleep impairment (β = 0.119, p < 0.001), with the indirect pathway accounting for 25.43% of the total effect (95% CI:0.059-0.191).</p><p><strong>Conclusion: </strong>Elderly prostate cancer survivors exhibit heightened post-prostatectomy depression risks. Frailty acts as a dual-pathway predictor-directly exacerbating depressive symptoms and indirectly via sleep deterioration. These findings advocate for multidimensional interventions targeting frailty management and sleep optimization to improve mental health outcomes in this vulnerable cohort.</p>","PeriodicalId":22046,"journal":{"name":"Supportive Care in Cancer","volume":"33 4","pages":"315"},"PeriodicalIF":2.8,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}