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Disease & prevention > Case 10 colorectal cancer survivorship > Flashcards

Case 10 colorectal cancer survivorship Flashcards

1
Q

What is a cancer survivor?

A
  • individual considered survivor from time of diagnosis through the balance of their life.
  • Remain survivor till end of life.
  • Can continue to function during/ after overcoming disease.
  • Family members, friends and caregivers are also impacted by the survivorship experience
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2
Q

What does surviviorship of colorectal cancer depend on?

A
  • stage of the cancer at diagnosis
  • age and overall health of the patient
  • type of treatment received.
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3
Q

Why is is the population of survivors increasing?

A
  • Demographics: population ageing, Westernised lifestyle. Incidence increasing.
  • Improved treatments: better & more targeted cancer treatments. Survival increasing
  • Early detection: colorectal cancer screening (in NL since 2014). Survival increasing.
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4
Q

What is the incidence of colorectal cancer?

A

Incidence rates highest in more developed regions & highest in Western Europe

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5
Q

What is the mortality of colorectal cancer?

A

Mortality rates (far) lower than incidence rates & lowest in Western Europe

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6
Q

What is the prevalence of CC?

A

Prevalence highest in more developed regions & highest in Western Europe

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7
Q

What is the situation in NL with regards to CC?

A

In NL: increasing number of new patients & deaths but the # of survivors is also increasing?

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8
Q

*What is the patient journey?

A

See image

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9
Q

What are the short term consequences of CC disease/treatment?

A
  • Pain, fatigue, nausea, skin irritation, other side effects of chemo & radiation
  • Diarrhea, constipaiton, other gastrointestinal symptoms
  • Emotional distress, anxiety and depression
  • Surgery related complications: discomfort after surgery, bleeding, infection, blood clots
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10
Q

What are the long term consequences of CC disease/treatment?

A
  • Increased risk of developing other types of cancer, such as bladder, kidney, and pancreatic cancer
  • Chronic gastrointestinal problems (e.g. stoma)
  • Financial/ work related issues
  • Psychological effects→ PTSD, fear of recurrence, depression
  • Sexual dysfunction and fertility issues
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11
Q

**What is the psychosomatic impact of diagnosis & treatment of CC?

is this not same as another fc?

A
  • Emotional functioning problems (anxiey & depression, fatigue)
  • physical funcitioning problems (nerve damage after chemo)
  • sexual functioning problems
  • social functioning problems (work-related issues, financial difficulties)
  • bowel functioning problems (pain, constipation, incontinence, etc)
  • stoma (incl body image issues)

All of these decrease QoL!

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12
Q

What is QoL?

A

individual’s perception of their position in life in context of culture & value systems in which they live & in relation to their goals, expectations, standards & concerns

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13
Q

What are difficulties with QoL?

A
  • Abstract definition (you can’t see someone’s quality of life)
  • Related to health but also aspects independent of health (autonomy, freedom, etc)
  • Individually, social, culturally determined.
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14
Q

What does QoL incorporate?

A
  • Physical ehealth
  • Psychological state
  • Level of independence
  • Social relationships
  • Personal beliefs
  • Personal environment
    ⇒ when related to health and related domains = health-related quality of life
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15
Q

When are theoretical models used?

A
  • To better define construct
  • To define relevant concepts
  • To identify determinants and outcomes
  • To improve healthcare & research
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16
Q

***How can you measure QoL with questionnaires?

A
17
Q

What are potential targets for intervention?

A
  • prevention/reduction of negative consequences of disease & treatment
  • To decrease burden on healthcare services & socioeconomic system

=> enhance quantity and quality of life after cancer

18
Q

What is the ICF model?

A

designed to provide a standardised framework for describing an individual’s functioning, including any impairments, activity limitations, and participation restrictions.

19
Q

What is the purpose of the ICF model?

A
  • To define & classify functioning in multiple dimensions
  • To provide a universal language
  • To improve compatibility & exchangeability of data
    E.g. between countries, time periods, scientific disciplines, etc.
20
Q

What is meant by the purpose of defining and classifying functioning in multiple dimensions in the ICF model?

A
  • Understanding of functioning in broad health-related context
  • Conceptual basis for defining/meausring disability and its determinants
  • => paradigm shift from biomedical to biopsychosocial view
21
Q

What is meant by the purpose of providing a universal language in the ICF model?

A
  • Standardized, systematic description & classification
  • Facilitates improved (interdisciplinary) communication
22
Q

What is the structure of the ICF model?

A

2 main parts:
* Functioning & disability
* Contextual factors

Each part has several components or domains
* Part 1: body functions & structures; activities; participation
* Part 2: environmental factors; personal factors

Components are further subdivided
* Subdivision in chapters and items or categories
* Qualifiers used for classification

Look at diagram of this!

23
Q

Who is the ICF model used by?

A
  • healthcare providers & researchers to assess & describe individual’s functioning
  • develop treatment plans
  • evaluate the effectiveness of interventions
  • monitor changes in health status over time
  • policymakers to develop policies and programs that
  • promote inclusion & participation of individuals with disabilities in society
24
Q

How is functioning defined in the ICF model?

A

Positive aspects of interaction between individual in certain health state and the individual’s contextual factors

25
Q

What are the 3 domains part of functioning in the ICF model?

A

Body functions and structures:
* physio/psychological functions of body systems & anatomical body parts
* Biological perspective of functioning

Activities:
* Execution of a task or action by an individual
* Individual perspective of functioning

Participation:
* Involvement in a life situation
* Societal perspective of functioning

26
Q

How is disability defined in the ICF model?

A

Negative aspects of interaction between individual in certain health state and the individuals contextual factors

27
Q

What are the 3 domains part of functioning problems in the ICF model?

A

Impairment in body functions & structures
* Problems in body functions and structures such as a signfication deviation or loss (e.g. loss of limb or impaired functioning of skeletal muscle)

Activity limitations
* Difficulties an individual may have in executing activities (e.g. limited ability to walk or dress)

Participation restrictions
* Problems an individual may experience in involvement in life situations
* (e.g. restricted capacity to work or participate in sports)

28
Q

*How are contextual factors defined in the ICF model?

A
29
Q

What are ICF qualifiers?

A

describe & classify level of functioning or disability, occurring within certain context

30
Q

What is the biopsychosocial framework of the ICF?

A

Bio-psychosocial view of human functioning:

  • Framework to characterise functioning & disability in particular context
  • Functioning in relation to health, environment and person
  • => broader than traditional biomedical view0

look at diagram

31
Q

How can the biopsychosocial framework of the ICF be used to study QOL and functioning of colorectal cancer survivors?

A
  • Biological factors, such as the cancer itself, treatments received, and any comorbid conditions, can have a significant impact on the physical functioning of colorectal cancer survivors. By considering these factors, researchers can better understand how the cancer and its treatment may impact the survivor’s ability to perform activities and participate in society.
  • Psychological factors, such as anxiety, depression, and coping strategies, can also impact the QOL and functioning of colorectal cancer survivors. By assessing these factors, researchers can better understand how psychological factors may impact the survivor’s ability to adapt to life after cancer and perform daily activities.
  • Social factors, such as social support, financial resources, and access to healthcare, can also impact the QOL and functioning of colorectal cancer survivors. By considering these factors, researchers can better understand how social factors may influence the survivor’s ability to participate in society and access the resources they need to support their recovery.
  • Overall, biopsychosocial framework of the ICF can provide a comprehensive and holistic understanding of the factors that impact the QOL and functioning of colorectal cancer survivors. By considering all of these factors together, researchers can develop interventions that address the unique needs of each individual survivor and improve their health and well-being over the long term
32
Q

What is cancer survivorship research?

A
  • Encompasses the physical, psychosocial and economic consequences of cancer diagnosis and its treatment among survivors of cancer.
  • Includes issues related to healthcare delivery, access and follow up care
  • Focuses on the health and life of a person with a history of cancer beyond the acute diagnosis and treatment phase.
33
Q

What does ICF based research approach facilitate?

A
  • Development of conceptual models
  • Definition of outcome measures
  • Selection of measurement tools
  • Identification of variables for analysis
  • Interpretation of study findings
34
Q

What is acute survivorship?

A
  • Focus is on cancer diagnosis & cancer treatment
  • usually from diagnosis till end of treatment
35
Q

what is extended survivorship?

A
  • focus is on short term effects of cancer & treatment
  • early post-treatment phase (up to 2-5 yrs)
36
Q

What is permanent survivorship?

A
  • focus is on long-term effects of cancer & treatment
  • late post treatment phase (>2-5 yrs)
37
Q

What are the dimensions of functioning?

A
  1. physical functioning
  2. cognitive functioning
  3. emotional funcitoning
  4. social functioning
  5. occupational functioning
  6. self-care functioning
  7. communication functioning
38
Q

What are the dimensions of functioning?

A
  1. physical functioning
  2. cognitive functioning
  3. emotional funcitoning
  4. social functioning
  5. occupational functioning
  6. self-care functioning
  7. communication functioning
39
Q

What are the dimensions of quality of life?

A

QoL after cancer diagnoses encopasses several important domains:
* physical fufnctioning
* emotional functioning
* cognitive functioning
* social funxtioning
* role functioning
* overall quality of life - global assessment of functioning in all domains of life

Disease & prevention (10 decks)

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