Advanced Cancer
Conditions
Keywords
Advanced cancer, Early integration, Palliative rehabilitation
Brief summary
The purpose of this study is to identify whether patients with newly diagnosed advanced cancer benefit from a 12-week palliative rehabilitation program integrated with standard oncology treatment.
Detailed description
300 patients with newly diagnosed advanced cancer are planned to be enrolled. They wil be randomized at a 1:1 ratio to standard oncology treatment or standard oncology treatment plus a 12-week individually customized palliative rehabilitation program. The intervention takes place in a specialized palliative setting and is planned after an individual consultation with the patient and his relatives. It can be adjusted during the 12 weeks according to the patient's symptoms and needs. All or part of the palliative rehabilitation program is organized as weekly group sessions at the hospital. The group sessions consist of lectures and debates followed by physical training. Professionals involved in the group sessions are doctors, nurses, physiotherapists, psychologists, occupational therapists, social workers, dietitians, and a priest. If needed, the patient and/or his relatives can also be offered individual sessions. All contacts with the patients or his relatives during the 12 weeks are registered in order to document the intervention retrospectively. The intervention is evaluated using questionnaires. All participants receive a questionnaire at baseline and after 6 and 12 weeks. The questionnaire consists of EORTC-QLQ-C30 (a validated questionnaire developed to assess the quality of life of cancer patients) and HADS (the validated Hospital Anxiety and Depression Scale). At baseline the questionnaire is extended with the question: Which of the following problems/ symptoms do you need help with the most?. The patients can choose between 12 defined problems matching 12 of the scales of EORTC-QLQ-C30 or none of the above. The answer given by the patient is labeled The Primary Problem.
Interventions
BEHAVIORALPalliative rehabilitation
12-week individually customized, specialized palliative rehabilitation program
Sponsors
Bispebjerg Hospital
Danish Cancer Society
Vejle Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Participants must: * be diagnosed with non-resectable cancer less than 8 weeks before inclusion. For patients with prostate cancer they must be refered to systemic oncology treatment for the first time less than 8 weeks before inclusion. * be fit to receive standard oncology treatment and accepting treatment * read and understand Danish * sign informed consent
Exclusion criteria
* contact with a specialized palliative unit within the last year before inclusion * unability to cooperate in the study * missing informed consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Effect of the intervention on The Primary Problem chosen by the patient. | 6 and 12 weeks | Comparing change from baseline to the weighed average of the 6 and 12-week follow-up of the scale in EORTC-QLQ-C30 that correlates to The Primary Problem of the patient (measured as area under the curve (AUC) of the change). If the patient has not chosen a Primary Problem the same measurement is done with the general health related quality of life scale. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Effect of the intervention on all symptoms and problems present in the EORTC-QLQ-C30 Questionnaire | 6 and 12 weeks | Comparing change from baseline to the weighed average of the 6 and 12 week follow-up of all the scales of EORTC-QLQ-C30 (measured as area under the curve (AUC) of the change). |
| Effect of the intervention on worries and symptoms of anxiety and depression | 6 and 12 weeks | Comparing HADS-scores in the two arms |
| All cause mortality | 3 months after last data collection | Comparing mortality in the two arms using Kaplan-Meier survival curve. |
| Economic consequences | 3 months after last data collection | Comparing health related expenses in the two arms using register information about admissions to hospitals, visits with family doctors, emergency rooms etc. |
Countries
Denmark
Outcome results
None listed