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      Effect of a patient education and rehabilitation program on anxiety, depression and quality of life in muscle invasive bladder cancer patients treated with adjuvant chemotherapy

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          Abstract

          This study aimed to investigate the effect of a patient education and rehabilitation program (PERP) on anxiety, depression, and quality of life in muscle invasive bladder cancer (MIBC) patients underwent adjuvant chemotherapy.

          One hundred and thirty MIBC patients about to receive adjuvant chemotherapy with 4-cycle gemcitabine and cisplatin (GC) regimen (16 weeks) were consecutively enrolled and randomly allocated into PERP group and control group as 1:1 ratio. Hospital Anxiety and Depression Scale (HADS) anxiety and depression scores and Quality of Life Questionnaire (QLQ-C30) scores were assessed before treatment (W0) and after treatment (W16).

          After 16-week treatment, PERP group exhibited decreased HADS anxiety score ( P = .036), ΔHADS anxiety score (W16-W0) ( P < .001) and percentage of anxiety patients ( P = .019) compared to control group. And PERP group presented with numerically reduced HADS depression score but without statistical significance ( P = .076) compared to control group, while lower ΔHADS depression score (W16-W0) ( P = .014) and percentage of depression patients ( P = .015) compared to control group. As to quality of life, QLQ-C30 global health status score ( P = .032), Δglobal health status score (W16-W0) ( P = .003) and Δfunctional score (W16-W0) ( P = .005) were higher in PERP group compared to control group. However, no difference of QLQ-C30 functional score ( P = .103), QLQ-C30 symptom score ( P = .808) or Δsymptom score (W16-W0) ( P = .680) was observed between two groups.

          PERP relieves anxiety, depression and improves quality of life in MIBC patients underwent adjuvant chemotherapy.

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          Most cited references15

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          Bladder cancer.

          Ashish Kamat, Noah M Hahn, Jason Efstathiou … (2016)
          Bladder cancer is a complex disease associated with high morbidity and mortality rates if not treated optimally. Awareness of haematuria as the major presenting symptom is paramount, and early diagnosis with individualised treatment and follow-up is the key to a successful outcome. For non-muscle-invasive bladder cancer, the mainstay of treatment is complete resection of the tumour followed by induction and maintenance immunotherapy with intravesical BCG vaccine or intravesical chemotherapy. For muscle-invasive bladder cancer, multimodal treatment involving radical cystectomy with neoadjuvant chemotherapy offers the best chance for cure. Selected patients with muscle-invasive tumours can be offered bladder-sparing trimodality treatment consisting of transurethral resection with chemoradiation. Advanced disease is best treated with systemic cisplatin-based chemotherapy; immunotherapy is emerging as a viable salvage treatment for patients in whom first-line chemotherapy cannot control the disease. Developments in the past 2 years have shed light on genetic subtypes of bladder cancer that might differ from one another in response to various treatments.
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            A systematic review of neoadjuvant and adjuvant chemotherapy for muscle-invasive bladder cancer.

            Joshua J Meeks, Joaquim Bellmunt, Bernard Bochner … (2012)
            Muscle-invasive bladder cancer (MIBC) is a disease with a pattern of predominantly distant and early recurrences. Neoadjuvant cisplatin-based combination chemotherapy has demonstrated improved outcomes for MIBC. To review the data supporting perioperative chemotherapy and emerging regimens for MIBC. Medline databases were searched for original articles published before April 1, 2012, with the search terms bladder cancer, urothelial cancer, radical cystectomy, neoadjuvant chemotherapy, and adjuvant chemotherapy. Proceedings from the last 5 yr of major conferences were also searched. Novel and promising drugs that have reached clinical trial evaluation were included. The major findings are addressed in an evidence-based fashion. Prospective trials and important preclinical data were analyzed. Cisplatin-based neoadjuvant combination chemotherapy is an established standard, improving overall survival in MIBC. Pathologic complete response appears to be an intermediate surrogate for survival, but this finding requires further validation. Definitive data to support adjuvant chemotherapy do not exist, and there are no data to support perioperative therapy in cisplatin-ineligible patients. Utilization of neoadjuvant cisplatin is low, attributable in part to patient/physician choice and the advanced age of patients, who often have multiple comorbidities including renal and/or cardiac dysfunction. Trials are using the neoadjuvant paradigm to detect incremental pathologic response to chemobiologic regimens and brief neoadjuvant single-agent therapy to screen for the biologic activity of agents. Copyright © 2012 European Association of Urology. Published by Elsevier B.V. All rights reserved.
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              Are gold standard depression measures appropriate for use in geriatric cancer patients? A systematic evaluation of self-report depression instruments used with geriatric, cancer, and geriatric cancer samples.

              Christian J. Nelson, Christina Cho, Alexandra Berk … (2010)
              Geriatric issues in cancer are becoming prominent. Depression is a significant concern for both the elderly and patients with cancer, yet identifying depression in these patients is difficult and often leads to under-recognition. We conducted a systematic review to determine which depression instruments are appropriate for use in geriatric patients with cancer. We identified the most commonly used self-report depression instruments. We then used the criteria established in the US Food and Drug Administration Draft Guidance on Patient-Reported Outcome Measures to determine the extent of validation evidence of these measures in geriatric cancer populations. Finally, we determined which instruments captured depressive symptoms that are common among elderly patients with cancer. Eight measures were selected as the most commonly used instruments. These were the Beck Depression Inventory-II, Brief Symptom Inventory-18, Center for Epidemiologic Studies-Depression Scale, Geriatric Depression Scale-15, Hospital Anxiety and Depression Scale, Patient Health Questionnaire-9, Profile of Mood States-Short Form, and Zung Self-Rating Depression Scale. Many have been validated for use with geriatric adults and patients with cancer; however, data addressing content validity and responder definition were lacking. To date, there is no validation information for geriatric patients with cancer. Furthermore, symptom profile analysis revealed that these measures do not identify many symptoms signaling depression in geriatric patients with cancer. The validation evidence for use of common depression instruments in geriatric patients with cancer is lacking. This, and the possibility that these measures may not assess common depressive symptoms in geriatric patients with cancer, questions the adequacy of these scales in this population.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Medicine (Baltimore)
                Journal ID (iso-abbrev): Medicine (Baltimore)
                Journal ID (publisher-id): MEDI
                Title: Medicine
                Publisher: Wolters Kluwer Health
                ISSN (Print): 0025-7974
                ISSN (Electronic): 1536-5964
                Publication date Collection: November 2019
                Publication date (Electronic): 01 November 2019
                Volume: 98
                Issue: 44
                Electronic Location Identifier: e17437
                Affiliations
                [a ]Department of Urology Surgery
                [b ]Department of Thoracic Surgery, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430014, China.
                Author notes
                [∗ ]Correspondence: Qing Zhang, Department of Thoracic Surgery, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, 26, Shengli Street, Jiang’an District, Wuhan 430014, China (e-mail: dizhuo775395555@ 123456163.com ).
                Article
                Publisher ID: MD-D-19-04836 Accession ID: 17437
                DOI: 10.1097/MD.0000000000017437
                PMC ID: 6946406
                PubMed ID: 31689748
                SO-VID: 2857567e-7fb3-403f-871e-1ae2a4195ef7
                Copyright © Copyright © 2019 the Author(s). Published by Wolters Kluwer Health, Inc.
                License:

                This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0

                History
                Date received : 19 June 2019
                Date revision received : 20 August 2019
                Date accepted : 11 September 2019
                Categories
                Subject: 6500
                Subject: Research Article
                Subject: Observational Study
                Custom metadata
                OPEN-ACCESS TRUE

                Keywords: adjuvant chemotherapy,anxiety and depression,muscle invasive bladder cancer,patient education and rehabilitation program,quality of life
                Data availability:
                Keywords: adjuvant chemotherapy, anxiety and depression, muscle invasive bladder cancer, patient education and rehabilitation program, quality of life

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