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Cancer patients are among the most vulnerable populations during and after a disaster. We evaluated the impact of treatment interruption on the survival of women with gynecologic cancer in Puerto Rico following Hurricanes Irma and María.
Methods:
A retrospective cohort study among a clinic-based sample of women with gynecological cancer diagnosed between January 2016 and September 2017 (n = 112) was done. Women were followed from their diagnosis until December 2019, to assess vital status. Kaplan-Meier survival curves and Cox proportional hazards models were performed.
Results:
Mean age was 56 (± 12.3) years; corpus uteri (58.9%) was the most common gynecologic cancer. Predominant treatments were surgery (91.1%) and chemotherapy (44.6%). Overall, 75.9% were receiving treatment before the hurricanes, 16.1% experienced treatment interruptions, and 8.9% died during the follow-up period. Factors associated with treatment interruption in bivariate analysis included younger age (≤55 years), having regional/distant disease, and receiving > 1 cancer treatment (P < 0.05). Crude analysis revealed an increased risk of death among women with treatment interruption (HR: 3.88, 95% CI: 1.09-13.77), persisting after adjusting for age and cancer stage (HR: 2.49, 95% CI: 0.69-9.01).
Conclusions:
Findings underscore the detrimental impact of treatment interruption on cancer survival in the aftermath of hurricanes, emphasizing the need for emergency response plans for this vulnerable population.
It can be painful to witness the toll of cervical cancer on women offered next-to-no treatment options. Persons with cervixes who acquire the disease in places like Africa or Southeast Asia often experience a brutal life trajectory. In the absence of highly trained professionals, sophisticated medical facilities, and expensive surgical or radiation equipment, most cervical cancer patients in lower-income countries are sent home to die. These deaths can be protracted and lonely, with little access to palliative care. What’s more, the stigma of the disease – associated with “dirty” female reproductive organs and the smell of advanced cancer – can lead to social banishment in a sufferer’s final days. In higher-income countries, greater availability of treatment is still no guarantee of equity. Low-income patients in the United States are often cut off from insurance once cancer goes into remission, excluding them from critical follow-up. Pockets of inequity, the rural–urban divide, and inconsistent access to care mean women from affluent countries die inexcusably from a preventable cancer. The inhumane circumstances cervical cancer sufferers face worldwide remind us of this mission’s urgency.
This study was conducted to determine the relationship between religious attitudes of Muslim women with gynecologic cancer and mental adjustment to cancer.
Methods
Designed as a descriptive relational study, this study was conducted with 123 patients with gynecologic cancer. A personal information form, prepared in accordance with the literature, the Religious Attitude Scale (RAS), and the Mental Adjustment to Cancer Scale (MACS) were used as data collection tools. The data were assessed using descriptive statistics, Pearson's correlation analysis, and linear regression analysis.
Results
A positive correlation was determined between the RAS score and the fighting spirit subscale of the MACS (r = 0.65, p < 0.001). A negative correlation was found between the helplessness/hopelessness and anxious preoccupation subscales of the MACS and the RAS score (r = −0.40, p < 0.001; r = −0.30, p < 0.001, respectively).
Significance of results
The present results are helpful in understanding the influence of religious attitudes on the mental adjustment to gynecologic cancer patients. The results can serve as a reference for nursing education and clinical healthcare practice. Palliative healthcare providers can participate in improved care by recognizing spiritual needs and by advocating for attention to spiritual needs as a routine part of cancer care.
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