Cancer-related symptoms as mediators between treatment and functional capacity in adolescents and young adults (AYAs) with cancer
Refereed conference paper presented and published in conference proceedings
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AbstractBackground: The functional capacity of AYA patients is often disrupted by the intersection between the cancer experience and important early-life transitions. This study aimed to identify clinical/treatment risk factors of functional capacity in Chinese AYA cancer patients, and examine the mediatory effects of cancer-related symptoms.
Methods: We recruited AYAs (15 to 39 years old) diagnosed with cancer from a tertiary hospital in Hong Kong. They completed the Life Functioning Questionnaire to report their functional capacity in performing work/school and home activities. The predictive characteristics are symptom burden (Rotterdam Symptom Checklist), cognitive symptoms (CCSS-Neurocognitive Function Questionnaire) and psychological symptoms (Brief Symptom Inventory-18). General linear models were used to identify predictive characteristics of functional capacity, adjusted for age and sex. Mediation analysis was performed to examine indirect effects of symptoms on functional outcomes.
Results: This analysis included 120 AYA cancer patients (45.8% male; mean [SD] age 32.0 [5.9] years). Patients with breast cancer (16.7%) reported more functional disruption at work (Est=5.28, SE=1.18, P<0.001) than patients with hematological malignancies, sarcomas, and other solid tumors. Patients treated with surgery (Est= -1.11, SE=0.44, P =0.014) and chemotherapy (Est =1.05, SE=0.47, P =0.027) reported poor home functioning. Physical symptoms (Est= 0.09, SE=0.03, P <0.001), psychological symptoms (Est=0.10, SE=0.03, P =0.001) and cognitive symptoms (Est= 0.36, SE=0.09, P <0.001) were significantly associated with poorer work functioning. Mediation analyses showed that physical symptoms (ß= 1.01, SE= 0.39, P <0.001) and cognitive symptoms (ß= 0.87, SE= 0.36, P <0.001) are strong mediators between chemotherapy and poor work functioning. Psychological symptoms mediated the relationship between chemotherapy and home functioning (ß= 0.87, SE= 0.29, P <0.001).
Conclusion: Cancer-related symptoms are potential mediators between treatment and poor functional capacity in AYAs with cancer. Our work supports the importance of timely and effective symptom management during the cancer care continuum. (Funder: Health and Medical Research Fund/Ref 09202846)
Methods: We recruited AYAs (15 to 39 years old) diagnosed with cancer from a tertiary hospital in Hong Kong. They completed the Life Functioning Questionnaire to report their functional capacity in performing work/school and home activities. The predictive characteristics are symptom burden (Rotterdam Symptom Checklist), cognitive symptoms (CCSS-Neurocognitive Function Questionnaire) and psychological symptoms (Brief Symptom Inventory-18). General linear models were used to identify predictive characteristics of functional capacity, adjusted for age and sex. Mediation analysis was performed to examine indirect effects of symptoms on functional outcomes.
Results: This analysis included 120 AYA cancer patients (45.8% male; mean [SD] age 32.0 [5.9] years). Patients with breast cancer (16.7%) reported more functional disruption at work (Est=5.28, SE=1.18, P<0.001) than patients with hematological malignancies, sarcomas, and other solid tumors. Patients treated with surgery (Est= -1.11, SE=0.44, P =0.014) and chemotherapy (Est =1.05, SE=0.47, P =0.027) reported poor home functioning. Physical symptoms (Est= 0.09, SE=0.03, P <0.001), psychological symptoms (Est=0.10, SE=0.03, P =0.001) and cognitive symptoms (Est= 0.36, SE=0.09, P <0.001) were significantly associated with poorer work functioning. Mediation analyses showed that physical symptoms (ß= 1.01, SE= 0.39, P <0.001) and cognitive symptoms (ß= 0.87, SE= 0.36, P <0.001) are strong mediators between chemotherapy and poor work functioning. Psychological symptoms mediated the relationship between chemotherapy and home functioning (ß= 0.87, SE= 0.29, P <0.001).
Conclusion: Cancer-related symptoms are potential mediators between treatment and poor functional capacity in AYAs with cancer. Our work supports the importance of timely and effective symptom management during the cancer care continuum. (Funder: Health and Medical Research Fund/Ref 09202846)
Acceptance Date23/09/2022
All Author(s) ListChung Tin Justin Ma, Herbert Ho Fung Loong, Wing Tung Ip, Junfeng Zhang, Alex Wing Kwan Leung, Chun Kit Ngan, Chi Kong Li, Yin Ting Cheung
Name of ConferenceEuropean Society for Medical Oncology (ESMO) Asia Congress 2022
Start Date of Conference02/12/2022
End Date of Conference04/12/2022
Place of ConferenceSingapore
Country/Region of ConferenceSingapore
Proceedings TitleAnnals of Oncology
Series TitleSupportive care
Year2022
Month11
Volume Number33
Issue NumberSuppl. 9
PublisherElsevier
Place of PublicationSwitzerland
Pages1542 - 1542
LanguagesEnglish-United States
KeywordsAdolescents and Young Adults, Functional capacity, Symptom burden, Cognitive symptoms, Psychological symptoms
