Hope-based intervention for individuals susceptible to colorectal cancer: a pilot study

Individuals undergoing genetic testing for hereditary colorectal cancer (HCRC) are prone to develop psychological problems. This study investigated the short-term efficacy of a hope-based intervention program in increasing hope levels and decreasing psychopathology among HCRC genetic testing recipients. A longitudinal study was carried out on HCRC genetic testing recipients recruited by the Hereditary Gastrointestinal Cancer Registry. Participants joined a hope-based intervention program consisting of six sessions of weekly closed group therapy. Psychological questionnaires were administered immediately before the first and after the last sessions of the program measuring hope, anxiety and depression levels of the participants. There were 22 participants (7 men and 15 women) at a mean age of 49.4 ± 9.6 years. Women tended to have higher level of anxiety than men at pre-intervention. Paired sample t tests were conducted. Hope levels increased significantly from pre- to post-intervention (pre-total hope score = 5.56; post-total hope score = 6.07; t(1) = -0.281, p < 0.05). Anxiety level also decreased significantly from pre- to post-intervention (pre-anxiety score = 7.38; post-anxiety score = 5.90; t (1) = 2.35, p < 0.05). Our findings imply that hope-based intervention program would be effective in enhancing hope in HCRC genetic testing recipients. The program may also be more effective in alleviating anxiety than depression in these individuals. © 2012 The Author(s).published_or_final_versio

On pairwise comparison matrices that can be made consistent by the modification of a few elements

Pairwise comparison matrices are often used in Multi-attribute Decision Making forweighting the attributes or for the evaluation of the alternatives with respect to a criteria. Matrices provided by the decision makers are rarely consistent and it is important to index the degree of inconsistency. In the paper, the minimal number of matrix elements by the modification of which the pairwise comparison matrix can be made consistent is examined. From practical point of view, the modification of 1, 2, or, for larger matrices, 3 elements seems to be relevant. These cases are characterized by using the graph representation of the matrices. Empirical examples illustrate that pairwise comparison matrices that can be made consistent by the modification of a few elements are present in the applications

Association of genomic domains in BRCA1 and BRCA2 with prostate cancer risk and aggressiveness

Pathogenic sequence variants (PSV) in BRCA1 or BRCA2 (BRCA1/2) are associated with increased risk and severity of prostate cancer. Weevaluated whether PSVs inBRCA1/2 were associated with risk of overall prostate cancer or high grade (Gleason 8+) prostate cancer using an international sample of 65 BRCA1 and 171 BRCA2 male PSV carriers with prostate cancer, and 3,388 BRCA1 and 2,880 BRCA2 male PSV carriers without prostate cancer. PSVs in the 30 region of BRCA2 (c.7914+) were significantly associated with elevated risk of prostate cancer compared with reference bin c.1001c.7913 [HR = 1.78; 95% confidence interval (CI), 1.25-2.52; P = 0.001], as well as elevated risk of Gleason 8+ prostate cancer (HR = 3.11; 95% CI, 1.63-5.95; P = 0.001). c.756-c.1000 was also associated with elevated prostate cancer risk (HR = 2.83; 95% CI, 1.71-4.68; P = 0.00004) and elevated risk of Gleason 8+prostate cancer (HR = 4.95; 95% CI, 2.12-11.54; P = 0.0002). No genotype-phenotype associations were detected for PSVs in BRCA1. These results demonstrate that specific BRCA2 PSVs may be associated with elevated risk of developing aggressive prostate cancer. Significance: Aggressive prostate cancer risk in BRCA2 mutation carriers may vary according to the specific BRCA2 mutation inherited by the at-risk individual.Peer reviewe

Experience of Southern Chinese: New challenges in treating young female breast cancer patients at child-bearing age, a call for multi-disciplinary collaboration

Compared with western populations, Southern Chinese, especially those residing in Hong Kong, are experiencing increasing breast cancer incidence and also a younger onset of breast cancer. Combating this problem and treating young women with breast cancer poses specific challenges and complicated considerations. With reference to the postponement in the age of marriage and reproduction in modern societies, the issue of fertility after breast cancer, especially for high-risk young patients, is one significant quality of life concern that cannot be underestimated as a secondary medical topic. While the issue has its significance and is confronting front-line breast cancer care teams of different disciplines, related research is mostly on Caucasians. In cultures where the traditional expectation on women for child-bearing is still prominent, young breast cancer patients may endure significant distress over fertility options after breast cancer. There is a lack of related data on Asian breast cancer survivors at child-bearing age, which calls for a pressing need to encourage qualitative groundwork, case reports, and cohort experiences in hope for providing insight and arouse research interest. In order to provide a long-term comprehensive multidisciplinary management service with encouragement to encompass prospects for a positive future among young breast cancer survivors, relevant disciplines need to collaborate and work efficaciously together both on clinical and research aspects of cancer-related fertility issues.link_to_OA_fulltex

What made her give up her breasts: a qualitative study on decisional considerations for contralateral prophylactic mastectomy among breast cancer survivors undergoing BRCA1/2 genetic testing

Research CommunicationOBJECTIVE: This qualitative study retrospectively examined the experience and psychological impact of contralateral prophylactic mastectomy (CPM) among Southern Chinese females with unilateral breast cancer history who underwent BRCA1/2 genetic testing. Limited knowledge is available on this topic especially among Asians; therefore, the aim of this study was to acquire insight from Chinese females' subjective perspectives. METHODS: A total of 12 semi-structured in-depth interviews, with 11 female BRCA1/BRCA 2 mutated gene carriers and 1 non-carrier with a history of one-sided breast cancer and genetic testing performed by the Hong Kong Hereditary Breast Cancer Family Registry, who subsequently underwent CPM, were assessed using thematic analysis and a Stage Conceptual Model. Breast cancer history, procedures conducted, cosmetic satisfaction, pain, body image and sexuality issues, and cancer risk perception were discussed. Retrieval of medical records using a prospective database was also performed. RESULTS: All participants opted for prophylaxis due to their reservations concerning the efficacy of surveillance and worries of recurrent breast cancer risk. Most participants were satisfied with the overall results and their decision. One-fourth expressed different extents of regrets. Psychological relief and decreased breast cancer risk were stated as major benefits. Spouses' reactions and support were crucial for post-surgery sexual satisfaction and long-term adjustment. CONCLUSIONS: Our findings indicate that thorough education on cancer risk and realistic expectations of surgery outcomes are crucial for positive adjustment after CPM. Appropriate genetic counseling and pre-and post-surgery psychological counseling were necessary. This study adds valuable contextual insights into the experiences of living with breast cancer fear and the importance of involving spouses when counseling these patients.link_to_OA_fulltex

A retrospective study on surveillance behaviours and prophylasix after genetic testing for hereditary breast and ovarian cancer among high-risk Chinese females

This journal supplement is Meeting Abstracts of the 34th SABCSPoster Session 2 - Epidemiology, Risk, and Prevention: Familial Breast Cancer - Genetic Testing: abstract no. P2-13-08BACKGROUND: Research in the West has shown that the uptake rates of surveillance and prophylaxis may be different in BRCA mutation carriers and non carriers and this may vary between different ethnicities. To date there is limited comprehensive data available for the behavioural pattern of Asian cohorts. The present on-going study is the first to investigate the behavioural impact and medical compliance of Chinese high risk females who had undergone BRCA1/2 genetic testing up to 1.5 years after genetic testing. METHODS: 88 females with personal or family breast …link_to_OA_fulltextThe 34th Annual San Antonio Breast Cancer Symposium (SABCS 2011), San Antonio, TX., 6-10 December 2011. In Cancer Research, 2011, v. 71 n. 24 suppl., p. 307

Psychosocial characteristics of Hong Kong Chinese females undertaking genetic counselling and testing for hereditary breast and ovarian cancers

Oral Presentation 2 - Risk and Prevention & Prognosis and Response Prediction: no. OP2-1Conference Theme: Cutting edge with integrative collaboratio

A qualitative study on psychosocial impact of contralateral prophylactic mastectomy among breast cancer female patients who underwent BRCA1 and BRCA2genetic testing in Hong Kong China

Introduction: To thoroughly examine the psycho-social impact of contralateral prophylactic mastectomy (CPM) among Hong Kong Chinese females with contralateral breast cancer history who underwent BRCA1/2 genetic testing. This aims to be first study of its kind in Chinese patients. Material and Methods: 11 female BRCA1/BRCA 2 mutated gene carriers and 1 non-carrier with history of contralateral breast cancer and genetic testing performed by the Hong Kong Hereditary Breast Cancer Family Registry subsequently underwent CPM. They were surveyed by a face-to-face or telephone interview. Breast cancer history, types of prophylactic mastectomy and reconstruction, overall and cosmetic satisfaction, pain, body image and sexuality issues, cancer risk perception, with emphasis on exploring their perceptions were discussed. Retrieval of medical record using a prospective database was also obtained. Results: Half of the participants who had CPM also underwent reconstruction. Most participants were satisfied with the overall results and 75% (9/12) thought they made the right decision. Onefourth of participants (3/12) expressed different extent of regrets. All opted for prophylaxis due to their reservation on the efficacy of surveillance. Most participants rated psychological relief and decreased breast cancer risk as major benefits. Sexually-inactive single participants appeared to adjust better to the cosmetic results of the surgery. Spouses’ reactions and support were crucial for postsurgery sexual satisfaction. Conclusions: Thorough education on cancer risk and realistic expectation of surgery outcomes are crucial for positive adjustment after CPM. Proper genetic and pre-and post-surgery psychological counseling were necessary and beneficial from patients’ point of view. It may be helpful to involve spouses when counseling these patients

Across Culture and Health Systems: Asia (Hong Kong)

This chapter will discuss the approach given to patients and their families with hereditary colorectal cancer in Hong Kong. The workflow utilized by the Hereditary Gastrointestinal Cancer Registry as well as social and cultural issues unique to Hong Kong will be presented. Genetic counseling, testing, support, and economics of these will also be presented