Integrative Oncology Care of Symptoms of Anxiety and Depression in Adults With Cancer: SIO-ASCO Guideline Summary and Q&amp;A

Carlson, Linda E.; Ismaila, Nofisat; Addington, Elizabeth L.; Asher, Gary N.; Bradt, Joke; Mehta, Ashwin; Rowland, Julia H.

doi:10.1200/op.23.00358

Cited by 5 publications

(2 citation statements)

References 26 publications

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“…Recent recommendations by the Association for Clinical Oncology and the Society of Integrative Oncology (ASCO and SIO) for post-treatment depression in cancer patients include mindfulness-based interventions as integrative interventions that have a high level of evidence. This same recommendation refers to treating anxiety in cancer survivors [ 59 ]. A systematic review based on 21 studies from 1980 to 2017 of depression-related psychological interventions in head and neck cancers has revealed the greatest empirical support for psychotherapy (CBT) and psychoeducation [ 60 ].…”

Section: Discussionmentioning

confidence: 99%

Low Post-Treatment Quality of Life and the High Incidence of Pain Are Common and Significantly Exacerbated in Depressed Head and Neck Patients Treated with Definitive Accelerated Radiotherapy

Heyda,

Księżniak-Baran,

Wygoda

et al. 2023

Cancers

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(1) Background: The goal of this study is to evaluate psychological tolerance and health-related quality of life (QOL) in head and neck (HN) cancer patients treated with definitive accelerated radiotherapy (DART). (2) Methods: 76 recurrence-free patients eligible for the study, who were treated with DART in the CAIR-2 phase III clinical study (median of follow-up = 47 months), completed EORTC QLQ-C30 with the H&N35 module, Hospital Anxiety and Depression Scale (HADS) and Visual–Analog Scales (VAS) of pain in HN and the neck/arm areas. (3) Results: The most dominant symptoms measured with QLQ-C30 were as follows: fatigue (44/100), sleeplessness (39/100), financial problems (38/100) and pain (32/100). Within the H&N35, the highest scores were reported on the subscales of sticky saliva (60/100), mouth dryness (65/100) and increased intake of painkillers (50/100). Pain (VAS) was reported by 87% (HN area) and 78% (shoulder area) of the patients, with a mean score of 3/10. One-third of the patients reported depressive moods (HADS ≥ 15 points) with an average score of 12.5/42 p. The depressed group, who smoked more as compared to the non-depressed group before DART (96% vs. 78%) and required steroids treatment (85% vs. 58%) during DART, also scored significantly worse on 23 of the 35 subscales of QLQ-C30 and H&N35 and experienced more intense pain (VAS). Women and less-advanced patients scored better in several aspects of quality of life. (4) Conclusions: Patients treated with DART struggle with low quality of life and persistent treatment-related symptoms including constant pain. HNC survivors, especially those who are depressed, may require additional psychosocial, rehabilitation and medical intervention programmes.

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Section: Discussionmentioning

confidence: 99%

Low Post-Treatment Quality of Life and the High Incidence of Pain Are Common and Significantly Exacerbated in Depressed Head and Neck Patients Treated with Definitive Accelerated Radiotherapy

Heyda,

Księżniak-Baran,

Wygoda

et al. 2023

Cancers

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“…Mindfulness-based interventions (MBIs) are recommended for symptoms of anxiety and depression in adults undergoing cancer treatment by the Society for Integrative Oncology-American Society of Clinical Oncology (SIO-ASCO). 13 Common MBIs in healthcare include mindfulness-based stress reduction (MBSR), mindfulness-based cancer recovery (MBCR) and Center for Mind-Body Medicine (CMBM) training. 14 - 17 Many MBIs were designed for and researched among primarily White, racially homogenous populations, and critiqued for neglecting cultural and historic roots of meditation practices, lack of cultural sensitivity, and cultural appropriation.…”

Section: Introductionmentioning

confidence: 99%

Mindfulness-Based Group Medical Visits: Strategies to Improve Equitable Access and Inclusion for Diverse Patients in Cancer Treatment

Mishra,

Leung,

Chao

et al. 2024

Global Advances in Integrative Medicine and Health

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Background Mindfulness-based interventions (MBIs) are supported by clinical practice guidelines as effective non-pharmacologic interventions for common symptoms experienced by cancer patients, including anxiety, depression, and fatigue. However, the evidence predominately derives from White breast cancer survivors. Racial and ethnic minority patients have less access to integrative oncology care and worse cancer outcomes. To address these gaps, we designed and piloted a series of mindfulness-based group medical visits (MB-GMVs), embedded into comprehensive cancer care, for racially and ethnically diverse patients in cancer treatment. Methods As a quality improvement project, we launched a telehealth MB-GMV series for patients undergoing cancer treatment, delivered as four weekly 2-hour visits billable to insurance. Content was concordant with evidence-based guidelines and established MBIs and adapted to improve cultural relevance and fit (eg, access-centered, trauma-informed, with inclusive communication practices). Program structure was adapted to address barriers to participation, with ≥50% slots per series reserved for racial and ethnic minority patients. Intake surveys incorporated a demographic questionnaire and symptom assessments. Evaluations were sent following the visits. Results In our first ten cohorts (n = 78), 80% of referred patients enrolled. Participants were: 22% Asian, 14% Black, 17% Latino, 45% non-Latino White; 65% female; with a median age of 54 years (range 27-79); and 80% had metastatic cancer. Common baseline symptoms included lack of energy, difficulty sleeping, and worrying. Most patients (90%) attended ≥3 visits. On final evaluations, 87% patients rated the series as “excellent”; 81% “strongly agreed” that they liked the GMV format; and 92% would “definitely” recommend the series to others. Qualitative themes included empowerment and connectedness. Conclusion Telehealth GMVs are a feasible, acceptable, and financially sustainable model for increasing access to MBIs. Diverse patients in active cancer treatment were able to participate and reported high levels of satisfaction with this series that was tailored to center health equity and inclusion.

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Re-imagining metastatic breast cancer care delivery: a patient-partnered qualitative study

Roberson,

Henricks,

Woods

et al. 2023

Support Care Cancer

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Purpose While significant progress in metastatic breast cancer (MBC) treatment has prolonged survival and improved prognosis, there remain substantial gaps in providing patient-centered supportive care. The specific care delivery needs for metastatic cancer differ from that of early-stage cancer due to the incurable nature and lifelong duration of the condition. The objective of this study was to assess how patients living with MBC would re-imagine cancer care delivery. Methods This qualitative study was conducted in partnership with patient-led organizations Guiding Researchers and Advocates to Scientific Partnerships (GRASP) and Project Life, a nonprofit, online wellness community founded by patients with MBC for patients living with MBC. Virtual semi-structured interviews (n = 36) were conducted with Project Life members purposively sampled from the groups’ overall membership. The interview guide contained items surrounding patients’ lived experiences of MBC, greatest unmet needs related to care, and perspectives on virtual wellness community involvement. Interviews were coded using two-stage deductive and inductive analysis. Results Three major themes for re-imagining cancer care delivery were identified, including holistic care, information needs, and conceptual shifts. Within these several subthemes emerged with patients re-imagining referrals to non-oncological services, caregiver support, acceptance of integrative medicine, streamlined clinical trial enrollment, curated quality patient resources, MBC-specific terminology and approaches, long-term life and goal-of-care planning, and patient-centered voice throughout. Conclusion People living with metastatic cancers have specific supportive care needs. These findings highlight patient-driven areas for re-imagination that are most salient for individuals with MBC.

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Integrative Oncology Care of Symptoms of Anxiety and Depression in Adults With Cancer: SIO-ASCO Guideline Summary and Q&A

Abstract: This SIO-ASCO guideline Q&A provides guidance on integrative oncology care of symptoms of anxiety and depression in adult patients with cancer

Cited by 5 publications

References 26 publications

Low Post-Treatment Quality of Life and the High Incidence of Pain Are Common and Significantly Exacerbated in Depressed Head and Neck Patients Treated with Definitive Accelerated Radiotherapy

Low Post-Treatment Quality of Life and the High Incidence of Pain Are Common and Significantly Exacerbated in Depressed Head and Neck Patients Treated with Definitive Accelerated Radiotherapy

Mindfulness-Based Group Medical Visits: Strategies to Improve Equitable Access and Inclusion for Diverse Patients in Cancer Treatment

Re-imagining metastatic breast cancer care delivery: a patient-partnered qualitative study

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