The moderating role of social support on depression and anxiety for gastric cancer patients and their family caregivers

<div><p>Background</p><p>There is a consensus that cancer care should go beyond physical care as cancer patients and their family caregivers experience psychological burden, financial difficulty, as well as social relation issues. The current study aimed to investigate the moderating impact of social support on depression and anxiety of cancer patients and their family caregivers.</p><p>Methods</p><p>Gastric cancer patients and their family caregivers who visited a university medical center in Seoul were approached for participation in the study. Fifty-two pairs of adult patients and caregivers participated in the study. Along with demographic information and the physical condition of the patients, such as pre-operation cancer stage and the type of gastrectomy, social support, depression, and anxiety were measured for patients and caregivers, respectively.</p><p>Results</p><p>In the first round of analysis, patients’ depression was associated with age, while patients’ anxiety was related to income. On the other hand, caregivers’ depression was not associated with patients’ health and living arrangement. In the second round of analysis to examine the moderating effect of social support, patients’ income and social support were related to depression and anxiety, but the interaction of income and social support was only observed for anxiety. For caregivers, no interaction effects were found. Social support decreased the negative effects of low income status on the patients.</p><p>Conclusion</p><p>While the income of the families with cancer cannot be adjusted in the short-term, their experience of social support can be managed by a proper support system. Diverse implications in medical settings are discussed.</p></div

Moderating effects of social support on Caregivers’ depression and anxiety.

<p>Moderating effects of social support on Caregivers’ depression and anxiety.</p

Moderating effects of social support on patients’ depression and anxiety.

<p>Moderating effects of social support on patients’ depression and anxiety.</p

Patients’ social support and anxiety by income group.

<p>Patients’ social support and anxiety by income group.</p

Predictors of patient’s depression and anxiety.

<p>Predictors of patient’s depression and anxiety.</p

Predictors of Caregiver’s depression and anxiety.

<p>Predictors of Caregiver’s depression and anxiety.</p

Characteristics of the participants.

<p>Characteristics of the participants.</p

Gut hormone changes after surgery by reconstruction types.

<p>RY, subtotal gastrectomy with Roux-en-Y gastrojejunostomy; BI, subtotal gastrectomy with gastroduodenostomy; GLP-1, glucagon-like peptide-1; GIP, glucose-dependent insulinotropic polypeptide; PYY, Peptide YY.</p

A randomized controlled trial of Roux-en-Y gastrojejunostomy vs. gastroduodenostomy with respect to the improvement of type 2 diabetes mellitus after distal gastrectomy in gastric cancer patients

<div><p>The purpose of this study is to compare the effect of diabetes control induced by Roux-en-Y gastrojejunostomy(RY) vs Billroth-I reconstruction(BI) after distal gastrectomy in patients with early gastric cancer(EGC) and type 2 diabetes(T2DM). Forty EGC patients with T2DM, aged 20–80 years, who were expected to undergo curative distal gastrectomy were randomized 1:1 to RY(n = 20) or BI(n = 20). Diabetes medication status, biochemical and hormonal data including blood glucose, HbA1c, insulin, C-peptide, HOMA-IR, ghrelin, leptin, GLP-1, PYY, and GIP were evaluated for 12 months after surgery. Although pre- and postoperative 12-month fasting and postprandial glucose levels did not show a significant difference, HbA1c, C-peptide, and HOMA-IR levels were significantly improved at 12 months after surgery in both BI and RY groups. Sixty percent of RY patients and 20% of BI patients decreased their medication satisfying FBS<126 mg/dL and HbA1c<6.5% and 5% of BI patients stopped their medication satisfying the criteria of FBS<126 mg/dL and HbA1c<6.0%. The improvement patterns were more sustainable with less fluctuation in RY than in BI. On hormonal analysis, ghrelin and leptin levels were decreased and PYY and GIP levels were increased at 12 months after surgery in both groups without significant difference according to the reconstruction type and diabetic improvement status except ghrelin. In gastric cancer surgery, RY reconstruction showed better and more durable diabetes control compared to BI during the first year after surgery. Gastric cancer surgery led to decreased ghrelin and leptin and increased PYY and GIP, which might have a role in improving insulin resistance and glucose homeostasis.</p></div

Diabetic control status and medication changes after surgery.

<p>Diabetic control status and medication changes after surgery.</p