Journal Article Annotations
2018, 1st Quarter
Annotations by Elie Isenberg-Grzeda, MD, and Carlos Fernandez-Robles, MD
Type of study: 12-month prospective longitudinal study
The finding: Pre-treatment anxiety can predict post-treatment Major depression in patients with Head and Neck cancer.
Strength and weaknesses: The strengths of the study are its sample size, the broad number of contributing factors included in the design and the easy applicability to daily clinical practice; weakness lies on the unfortunate attrition of most severely ill patients and the type of sample which limits the ability to generalize to other populations.
Relevance: This study follows 233 patients diagnosed with first occurrence head and neck cancer for 12 months, and correlates different baseline metrics with the development of major depression. Findings showed that advanced disease, surgical treatment only and presence of anxiety disorder and high anxiety scores on HADS were predictors of major depression in this population. Additionally, it found that those suffering from depression also had a more mediocre quality of life. These findings can help clinicians promptly identify those patients at risk for MDD in this population and guide development of more effective screening mechanisms.
Type of study: Review of literature
The finding: Employers play an essential role in the return to work of cancer survivors, with communication, companies’ policies, knowledge of the cancer experience, balance of interests and employers’ attitudes exerting significant influence.
Strength and weaknesses: The strength of this study is its novelty of the idea/design, the use of multiple databases, and the inclusion of both, the survivor and the employer perspective. The limitations lay on the number of studies selected, the subjective nature of the material, the constraints imposed by the variability of work laws on is global applicability, and finally, the novel methodology used still pending validation.
Relevance: Return to work after cancer treatment is perceived a critical aspect of survivorship and improves quality of life. Cancer survivors face many physical limitations that may limit their ability to work and reduce their productivity. This review looks at the factors facilitating or impeding the reincorporation to the workforce of this patients from both perspectives and highlights areas where interventions (geared towards employers) can enhance work participation in cancer survivors.
Type of study: Cohort study
The finding: Using a large Norwegian national database, the authors found that survivors of child, adolescent, and young adult cancer had higher rates of prescription of anxiolytics and hypnotics.
Strength and weaknesses: The main strength was the use of a national database, which allowed the authors to identify a large sample and match with age-matched controls. The main limitation is that because of the use of a database, the authors could only infer on the indications for hypnotic and anxiolytic prescription. The authors did not study non-pharmacologic interventions.
Relevance: It is well known that survivors of childhood, adolescent, and young adult cancers are at higher risk for psychological sequelae and difficulty with adjustment following their cancer. This study demonstrated that this population is prescribed anxiolytics and hypnotics at higher rates than the general population. Given the risks of anxiolytics and hypnotics, clinicians must be aware that this population represents a particularly high risk group, and efforts should be made to explore all treatment options—pharmacologic and nonpharmacologic—if or when survivors of childhood, adolescent, and young adult cancers present to clinical attention.