Key points The unprecedented pandemic crisis has caused serious changes in the medical care for cancer patients, thereby mandating research studies to focus and understand the psychosocial issues faced by paediatric cancer patients during the pandemic lockdown in India. Paediatric cancer patients irrespective of diagnosis and treatment status were assessed for psychosocial issues (N = 103) and distress (n = 74). Caregivers were chosen as the primary respondents except for distress score in order to obtain data with better clarity and comprehension. The data was summarized using descriptive statistics; chi square analysis was adopted to find the association between psychosocial issues and outcome variables; multivariate logistic regression was used to find the predictors of treatment status and distress. Paediatric cancer patients experienced significant physical and psychological issues pertaining to the unprecedented pandemic lockdown and its associated changes with the cancer treatment and interruptions.
Context:Overall cure rates for pediatric acute lymphoblastic leukemia (ALL) have improved; however, the neuropsychological sequelae of ALL treatment have not been adequately documented in India.Aims:The present study assesses the immediate effects of ALL treatment on neuropsychological functioning, at the Regional Cancer Center in Chennai, South India.Materials and Methods:Newly diagnosed with ALL patients (n = 24) (aged 6–15 years; 13M:11F) registered between March 2008 and February 2009 were included. Patients who had received high-dose methotrexate (HD-MTX) and cranial radiotherapy (CRT) as part of their treatment were enrolled for the study. Neurocognitive assessments were done to assess various functions such as performance intelligence, visuo-perception, visuo-spatial, perceptual organization, processing speed, planning, working memory, and immediate verbal memory (IVM) (Malin's intelligence scale); verbal fluency (ideation fluency test) and verbal attention (vigilance test). Three assessments were done during induction (baseline), after re-induction phase (second) and during the maintenance phase (third).Results:The patients performed significantly worse in the third assessment (mean duration from diagnosis 17.48 months) on performance intelligence quotient (PIQ), visuo-perception, visuo-spatial, processing speed, planning, IVM, verbal attention, and verbal fluency (P < 0.05), there were no significant changes observed in visuo-perceptual organization and working memory (P > 0.05). Significant difference was observed between age groups 6 and 10 (41.7%) and 11–15 years (58.3%) in perceptual organization, verbal fluency, and verbal attention (P < 0.05) and no gender difference was observed across the three assessments (P > 0.05).Conclusions:Combining HD MTX and CRT had an immediate effect on neuropsychological sequelae among the children with ALL, however, long-term evaluation is recommended to study the long-term effects.
Background The COVID-19 pandemic lockdown has posed numerous unique challenges for cancer patients, families and healthcare workers. However, the reports on psychosocial issues associated with such situations are scarce. This study aims to determine the psychosocial issues faced by cancer patients during COVID-19 pandemic lockdown. Methods Cancer patients irrespective of diagnosis and treatment status were assessed for fear of progression (FOP), distress and quality of life (QOL) using Fear of Progression- Short Form, Distress Thermometer and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ C30) 30, respectively. The demographics, disease and treatment related details were obtained from case record form. Psychological issues and concerns were collected using a structured interview. Descriptive statistics, Mann Whitney U-test and Linear Regression were performed using SPSS ver 20.0. Results Among the 219 patients, 118 (52.5%) had either interruption in their on-going cancer treatment or the initiation of cancer treatment was delayed as a result of COVID-19 lockdown. Overall, 74% of the patients experienced distress, 55.3% experienced FOP and 58% had low global health status. Pain followed by fatigue remained as major issues among patients during lockdown. Interruption in treatment and logistical issues were strongly associated with increased distress (p = 0.026) and FOP (p = 0.004). Global health status (p = 0.037), emotional functioning (p = 0.000), social functioning (p = 0.000) and financial concerns (p = 0.046) differed significantly between patients with and without treatment interruption. Age (β = -0.159), mode of transport (β = -0.135), challenges in meeting daily needs (β = -0.245) and being out-casted by the society (β = -0.227) predicted distress. Conclusion More than half of the patients had interruptions in their treatment as a result of COVID-19 lockdown. Cancer patients have had increased physical and psychological concerns as a result of the pandemic situation and its associated changes. Specific guidelines ought to be framed for providing continued and holistic cancer care for patients during such lockdown.
In a given time, 55% of smokers and 50% of smokeless tobacco users think of quitting tobacco. However, only 3-5% successfully quit without professional support. This study aims to assess the quit status and challenges of tobacco users enrolled in tobacco cessation clinic at a regional cancer center. Totally, 171 tobacco users above 18 years were enrolled in the TCC between January 2015 and December 2015. All the users were contacted by a psychologist via telephone after 6 months from their first visit for gauging the status of tobacco use, associated challenges for quitting and reasons for not quitting. Nicotine dependence was assessed using the Fagerstrom scale for nicotine dependence for smokers and smokeless tobacco users, separately. Readiness to quit tobacco scale was used to assess the motivational stages of readiness to change. Based on level of nicotine dependence and motivational stage, cessation interventions were provided. On follow-up, 91 (53.2%) were successfully contacted, 72 (42.1%) could not be contacted and 8 (4.6%) had expired. Twenty-six (28.5%) tobacco users had quit and 15 (16.4%) were able to remain abstinent for less than 6 months. Only 5 (12.1%) reported physical challenges and 13 (31.7%) reported psychological challenges while reducing tobacco or quitting. Tobacco cessation provided by trained professionals in a cancer setting has been found to be highly effective in quitting. Close follow-up at regular intervals is mandated to help tobacco users manage cravings and withdrawal symptoms, to assist in achieving quit status.
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