Psychological aspects in patients with advanced cancer receiving lifelong systemic treatment: protocol for a scoping review

Abstract

IntroductionA better understanding of the molecular, genetic and immunological characteristics of cancer and the introduction of new systemic treatment regimens in the last decades, has led to better treatment outcomes and increased survival rates for patients with previously short lived cancers. However, there is no uniform description to refer to this growing group of patients with advanced cancer who now respond to new systemic treatments for longer periods. Furthermore, little is known about the unique psychological challenges these patients face, living with ongoing uncertainty about the course of their disease and life expectancy. The objective of this scoping review is to identify the psychological aspects experienced by, and the definitions used to refer to patients with advanced cancer receiving lifelong systemic treatment.Methods and analysisThis review will be among the first to summarise literature on the psychological issues in the growing group of advanced cancer patients undergoing long-term systemic treatment. Articles will be retrieved from six databases (MEDLINE, Embase, Web of Science, PsycINFO, CINAHL and the Cochrane Database of Systematic Reviews) and reviewed for eligibility by two investigators independently. Definitions and psychological challenges will be extracted and narratively summarised following a descriptive approach. Furthermore, results will contribute in providing a uniform definition for this patient group, and help to identify knowledge gaps to give direction to further research in this field.Ethics and disseminationNo ethical approval is required. The results of the scoping review will be submitted for publication to a scientific journal and presented at relevant conferences.

A new landscape in illness uncertainty: A systematic review and thematic synthesis of the experience of uncertainty in patients with advanced cancer receiving immunotherapy or targeted therapy

“…A recent scoping review of the psychosocial experiences of this population by Kolsteren and colleagues 10 concluded that uncertainty is the most prominent concern for this population at present but found no studies which examined it. Our review found two studies 6,36 which explored uncertainty qualitatively, but none quantitatively.…”

“…As a result, many patients receiving IT or TT find themselves navigating a life characterized by an uncertain but terminal prognosis, for months or years 5–7 . This new treatment landscape has led to increasing calls to action from clinicians for an improved understanding of the experience of uncertainty and its impact on advanced cancer patients receiving IT or TT 5,7–10 . The predominant theory of illness uncertainty is Mishel's (1988 11 ) Uncertainty in Illness Theory, which defines uncertainty as “the inability to determine the meaning of illness‐related events” and accurately predict health outcomes.…”

“…[5][6][7] This new treatment landscape has led to increasing calls to action from clinicians for an improved understanding of the experience of uncertainty and its impact on advanced cancer patients receiving IT or TT. 5,[7][8][9][10] The predominant theory of illness uncertainty is Mishel's (1988 11 ) Uncertainty in Illness Theory, which defines uncertainty as "the inability to determine the meaning of illness-related events" and accurately predict health outcomes. This theory describes how patients process and assign meaning to illness-related stimuli such as symptoms or SEs.…”

Psychosocial Aspects of Living Long Term with Advanced Cancer and Ongoing Systemic Treatment: A Scoping Review

“…The reporting of this review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) reporting guidelines [ 17 , 18 ]. In this section, we provide a brief summary of these steps as an extensive description of the protocol has been previously published [ 19 ].…”

Psychosocial Care after Cancer Diagnosis: Recent Advances and Challenges

“…Indeed, psychosocial aspects are not limited to cancer patients but also to their caregivers, families, friends, and beyond colleagues and employers. As the impact on patients and their loved ones’ well-being and quality of life is expected to be considerable, it is crucial to examine these psychosocial outcomes to be able to support patients in their coping [ 9 ].…”