cancer survivors

癌症幸存者
  • 文章类型: Journal Article
    目标:尽管多发性骨髓瘤(MM)生存率有所改善,长期存活者的心血管结局数据仍然缺乏.
    方法:这项回顾性病例对照研究利用韩国国家健康保险服务数据库(2009-2020)比较MM患者与对照组之间的心血管疾病(CVD)发病率。关注长期(>5年)幸存者。根据出生年份和性别建立了初步病例队列(n=15,402例MM患者)和匹配的对照队列(n=123,216例无MM患者)。在1:1倾向得分匹配之后,最终匹配的队列每个包括15,402名参与者。
    结果:病例和对照组的平均年龄相当(66.2±11.5岁与66.1±11.3年),性别,年龄分布,和合并症。通过8年的随访,CV事件的累积发生率(12.5%vs.22.1%)和CVD风险在病例队列中显著较低。5年的里程碑分析显示,队列之间的CVD发病率存在显着差异(7.8%[病例队列]与9.8%[对照组]),不同年龄段和性别的差异,在病例队列中,年龄<50岁的患者中CVD风险显著增高(P<0.001).
    结论:这些发现强调需要对MM长期存活者进行警惕的CVD监测,特别是那些在第一次诊断时年龄<50岁的人。
    结论:本研究强调了将心血管监测和风险管理纳入MM幸存者长期护理的重要性,重点关注年轻患者和个性化干预措施。
    OBJECTIVE: Despite improvements in multiple myeloma (MM) survival rates, data on cardiovascular outcomes in long-term survivors remain lacking.
    METHODS: This retrospective case-control study utilized the Korean National Health Insurance Service database (2009-2020) to compare the incidence of cardiovascular disease (CVD) between patients with MM and a matched control group, focusing on long-term (> 5 years) survivors. A preliminary case cohort (n = 15,402 patients with MM) and a matched control cohort (n = 123,216 patients without MM) were established based on birth year and sex. Following 1:1 propensity score matching, the final matched cohorts each comprised 15,402 participants.
    RESULTS: The case and control cohorts were comparable in mean age (66.2 ± 11.5 years vs. 66.1 ± 11.3 years), sex, age distribution, and comorbidities. By the 8-year follow-up, the cumulative incidence of CV events (12.5% vs. 22.1%) and CVD risk were significantly lower in the case cohort. The 5-year landmark analysis revealed significant differences in CVD incidence between the cohorts (7.8% [case cohort] vs. 9.8% [control cohort]), with variations across age groups and sex, highlighting a significantly higher CVD risk among patients aged < 50 years in the case cohort (P < 0.001).
    CONCLUSIONS: These findings underscore the need for vigilant CVD monitoring in MM long-term survivors, particularly those aged < 50 years at first diagnosis.
    CONCLUSIONS: This study highlights the importance of integrating cardiovascular monitoring and risk management into long-term care for MM survivors, with a focus on younger patients and personalized interventions.
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  • 文章类型: Case Reports
    弥漫性内源性脑桥胶质瘤是预后通常小于1年的致死性肿瘤。很少报道5年或更长时间的幸存者病例。此病例报告重点介绍了一个9.5年的幸存者的旅程,她接受了3轮局灶性放疗;她经历了6年的无进展生存后第一轮,但最终死于疾病。尸检显示有利的IDH1突变和H3K27M的缺失。此病例重申了广泛分子分析在弥漫性脑桥脑胶质瘤中的重要性,并探讨了对反应积极且长期缓解的患者进行再次照射的潜在益处。
    Diffuse intrinsic pontine gliomas are lethal tumors with a prognosis generally less than 1 year. Few cases of survivors of 5 years or more have been reported. This case report highlights the journey of a 9.5-year survivor who underwent 3 rounds of focal radiotherapy; she experienced 6 years of progression-free survival following the first round but ultimately succumbed to her disease. An autopsy revealed a favorable IDH1 mutation and the absence of H3K27M. This case reiterates the importance of extensive molecular analyses in diffuse intrinsic pontine gliomas and explores the potential benefit of re-irradiation in patients with positive responses and long periods of remission.
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  • 文章类型: Case Reports
    一个团队对两名青少年和年轻成人(AYA)癌症幸存者进行了半结构化访谈,并制定了有关财务毒性(FT)和医疗保健过渡(HCT)的病例报告。这些报告发现HCTs较差。
    A team conducted semistructured interviews and developed case reports about financial toxicity (FT) and healthcare transitions (HCTs) with two adolescent and young adult (AYA) cancer survivors. These reports found poor HCTs f.
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  • 文章类型: Journal Article
    目的:本研究的目的是评估癌症病史的存在是否构成遭遇不利的健康结果和功能限制的风险。此外,该研究还旨在确定癌症幸存者的特定特征,这些特征与健康状况不佳和残疾的风险增加有关。
    方法:本研究利用了2017-18年印度纵向老龄化研究(LASI)的数据。这项研究的分析样本量为65,562名年龄在45岁及以上的老年人。我们专注于被诊断患有癌症的人,即,癌症幸存者,并将他们的健康结果与具有相似社会经济和人口统计学特征的相似组(没有癌症病史)的健康结果进行了比较。描述性统计和逻辑回归模型用于评估解释变量对癌症幸存者的调整效果。
    结果:结果显示,癌症幸存者的总人数为673/100.000老年人,城市地区(874/100.000)高于农村地区(535/100.000)。43.7%的幸存者报告自评健康状况差,大约34.0%的癌症幸存者报告抑郁症,而在没有癌症病史的老年人中,这种患病率要低得多。很久以前被诊断患有癌症的人经历不良SRH的可能性大大降低,抑郁症,与最近诊断的患者相比,生活满意度降低。
    结论:该研究强调了自诊断以来的时间和癌症部位数量等因素在影响幸存者健康结果中的重要性。此外,社会经济因素,比如财富和医疗保险,似乎在癌症幸存者的健康状况中发挥作用。
    结论:医疗保健政策应认识到癌症的长期影响,并优先提供长期生存护理。这可能涉及建立生存诊所或专门的医疗中心,为癌症幸存者提供专门的护理。在整个生存过程中满足他们的独特需求。
    OBJECTIVE: The objective of this study is to evaluate whether the presence of a cancer history constitutes a risk for encountering unfavourable health outcomes and functional limitations. Moreover, the study also aims to identify specific attributes of cancer survivors that are associated with an increased risk of experiencing poor health and disability.
    METHODS: This study has utilized data from Longitudinal Ageing Study in India (LASI) conducted in 2017-18. The analytical sample size for this study was 65,562 older individuals of age 45 years and above. We have focused on individuals diagnosed with cancer, i.e., cancer survivors, and compared their health outcomes to those of a similar group (without a cancer history) with similar socioeconomic and demographic features. Descriptive statistics and logistic regression models were used to assess the adjusted effect of explanatory variables on cancer survivors.
    RESULTS: The result shows that the overall number of cancer survivors is 673 per 100.000 older adults and is higher in Urban areas (874 per 100.000) than in rural areas (535 per 100.000). 43.7% of the survivors reported poor self-rated health, and around 34.0% of cancer survivors reported depression, while this prevalence was much lower among older adults without a cancer history. Individuals who were diagnosed with cancer a long time ago have a significantly lower likelihood of experiencing poor SRH, depression, and diminished life satisfaction in comparison to those diagnosed more recently.
    CONCLUSIONS: The study highlights the importance of factors such as time since diagnosis and the number of cancer sites in influencing health outcomes among survivors. Additionally, socioeconomic factors, such as wealth and access to health insurance, appear to play a role in the health status of cancer survivors.
    CONCLUSIONS: Healthcare policies should recognize the long-term impact of cancer and prioritize the provision of long-term survivorship care. This may involve establishing survivorship clinics or dedicated healthcare centres that provide specialized care for cancer survivors, addressing their unique needs throughout the survivorship continuum.
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  • 文章类型: Case Reports
    背景:妊娠期间膀胱肿瘤的治疗是一种罕见的临床情况。膀胱平滑肌肉瘤是一种罕见的组织学类型的膀胱肿瘤,也是视网膜母细胞瘤(RB)幸存者中罕见的继发性癌症。然而,没有妊娠期间RB相关膀胱平滑肌肉瘤的报道.
    方法:一名37岁孕妇,在婴儿期有RB病史,在妊娠第17周时出现肉眼血尿。膀胱镜检查显示膀胱左侧壁有一个40毫米的乳头状肿瘤。在妊娠的第25周,她接受了经尿道膀胱肿瘤切除术,病理诊断为膀胱平滑肌肉瘤,RB1表达缺失。在妊娠的第31周,她剖腹产。分娩后一个月(允许子宫复旧),她接受了膀胱部分切除术,标本中没有残留的平滑肌肉瘤组织。
    结论:我们报道了一例RB相关的膀胱平滑肌肉瘤,在妊娠期间和之后均得到了成功治疗。
    BACKGROUND: Management of a bladder tumor during pregnancy is an uncommon clinical situation. Leiomyosarcoma of the urinary bladder is a rare histological type of bladder tumor and a rare secondary cancer in survivors of retinoblastoma (RB). However, there has been no report of RB-associated bladder leiomyosarcoma during pregnancy.
    METHODS: A 37-year-old pregnant woman with a medical history of RB in infancy presented with gross hematuria at the 17th week of gestation. Cystoscopy revealed a 40-mm papillary tumor on the left lateral wall of the urinary bladder. At the 25th week of gestation, she underwent transurethral resection of the bladder tumor, and the pathological diagnosis was bladder leiomyosarcoma with loss of RB1 expression. At the 31st week of gestation, she gave birth by caesarean section. One month after the delivery (to allow for involution of the uterus), she underwent partial cystectomy, and the specimen contained no residual leiomyosarcoma tissue.
    CONCLUSIONS: We have reported a case of RB-associated bladder leiomyosarcoma that was successfully treated during and after pregnancy.
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    文章类型: Case Reports
    一名被诊断为乙状结肠癌的60岁男子被送往我们医院。CT扫描显示多发肝转移。患者接受15个疗程的FOLFIRI化疗和15个疗程的FOLFIRI加Cmab化疗。经过这种治疗,多发性肝转移消失,并进行腹腔镜乙状结肠切除术。两个月后,在肝段(S1)发现复发性病变,并进行了5个疗程的FOLFIRI加Cmab化疗。虽然CEA水平有所下降,肿瘤大小保持不变。因此,进行了肝脏部分切除术,随后18个疗程的FOLFIRI化疗。之后,患者在没有化疗的情况下随访了一年.然而,大约一年后,在肝段S5和S6中观察到复发。对这2个病灶进行了右叶切除术,然后再进行16个疗程的FOLFIRI化疗。化疗停止了,然后患者在没有化疗的情况下作为门诊患者进行随访;没有复发。
    A 60-year-old man diagnosed with sigmoid colon cancer was admitted to our hospital. A CT scan revealed multiple liver metastases. The patient was administered 15 courses of FOLFIRI chemotherapy and 15 courses of FOLFIRI plus Cmab chemotherapy. After this treatment, multiple liver metastases disappeared, and laparoscopic resection of the sigmoid colon was performed. Two months later, a recurrent lesion was found in the liver segment(S1), and 5 courses of FOLFIRI plus Cmab chemotherapy were performed. Although the CEA level decreased, the tumor size remained unchanged. Therefore, partial resection of the liver was performed, followed by 18 courses of FOLFIRI chemotherapy. After that, the patient was followed for a year without chemotherapy. However, about 1 year later, recurrence was observed in liver segments S5 and S6. A right lobectomy was performed for these 2 lesions, and then 16 more courses of FOLFIRI chemotherapy were performed. The chemotherapy was discontinued, and the patient was then followed up as an outpatient without chemotherapy; there has been no recurrence.
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  • 文章类型: Journal Article
    目的:对骨骼的辐射和烷化剂的暴露会增加儿童癌症幸存者患骨癌的风险,但骨组织放射剂量低于10Gy的风险以及特定类型化疗的剂量-反应关系存在不确定性.
    方法:12个欧洲国家为一项巢式病例对照研究提供了228例病例和228名匹配对照,该研究由69,460名5年儿童癌症幸存者组成。计算了不同程度的累积辐射暴露和特定类型化疗的累积剂量下发展为骨癌的几率(OR)。计算过量OR以研究任何剂量-反应关系的形状和程度。
    结果:与未暴露骨组织相比,暴露于1-4Gy的骨组织相关的OR为4.8倍(95%CI,1.2至19.6),而暴露于5-9Gy的骨组织相关的OR为9.6倍(95%CI,2.4至37.4)。对于≥40Gy的剂量,OR随着辐射剂量的增加而线性增加(Ptrend<.001),最高可达78倍(95%CI,9.2至669.9)。对于累积烷化剂剂量为10,000-19,999和≥20,000mg/m2,辐射调整的OR分别为7.1(95%CI,2.2至22.8)和8.3(95%CI,2.8至24.4),分别,每个人都有独立的贡献,异环磷酰胺,和环磷酰胺.其他细胞毒性与骨癌无关。
    结论:据我们所知,我们首次证明,骨组织暴露于1~9Gy的累积辐射剂量后,患骨癌的风险增加了5~10倍.超过10,000mg/m2的烷基化剂将风险增加7至8倍,特别是在丙卡巴嗪之后,异环磷酰胺,和环磷酰胺.这些显著升高的风险应用于制定/更新临床随访指南和生存护理计划。
    Radiation to the bone and exposure to alkylating agents increases the risk of bone cancer among survivors of childhood cancer, but there is uncertainty regarding the risks of bone tissue radiation doses below 10 Gy and the dose-response relationship for specific types of chemotherapy.
    Twelve European countries contributed 228 cases and 228 matched controls to a nested case-control study within a cohort of 69,460 5-year survivors of childhood cancer. Odds ratios (ORs) of developing bone cancer for different levels of cumulative radiation exposure and cumulative doses of specific types of chemotherapy were calculated. Excess ORs were calculated to investigate the shape and extent of any dose-response relationship.
    The OR associated with bone tissue exposed to 1-4 Gy was 4.8-fold (95% CI, 1.2 to 19.6) and to 5-9 Gy was 9.6-fold (95% CI, 2.4 to 37.4) compared with unexposed bone tissue. The OR increased linearly with increasing dose of radiation (Ptrend < .001) up to 78-fold (95% CI, 9.2 to 669.9) for doses of ≥40 Gy. For cumulative alkylating agent doses of 10,000-19,999 and ≥20,000 mg/m2, the radiation-adjusted ORs were 7.1 (95% CI, 2.2 to 22.8) and 8.3 (95% CI, 2.8 to 24.4), respectively, with independent contributions from each of procarbazine, ifosfamide, and cyclophosphamide. Other cytotoxics were not associated with bone cancer.
    To our knowledge, we demonstrate-for the first time-that the risk of bone cancer is increased 5- to 10-fold after exposure of bone tissue to cumulative radiation doses of 1-9 Gy. Alkylating agents exceeding 10,000 mg/m2 increase the risk 7- to 8-fold, particularly following procarbazine, ifosfamide, and cyclophosphamide. These substantially elevated risks should be used to develop/update clinical follow-up guidelines and survivorship care plans.
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  • 文章类型: Journal Article
    背景:对癌症复发的恐惧(FCR)是癌症幸存者必须处理的最大问题之一。高水平的FCR的特点是对癌症相关事件的侵入性思考和重新体验这些事件,避免癌症的提醒,和高度警惕,类似于创伤后应激障碍(PTSD)。眼动脱敏和再处理(EMDR)治疗集中在这些图像和记忆上。它可有效减少PTSD,并可有效减少高水平的FCR。目的:本研究的目的是探讨EMDR对乳腺癌和结直肠癌幸存者中严重FCR的有效性。方法:采用多基线单病例实验设计(n=8)。在基线阶段和治疗阶段每天重复测量FCR,治疗后,在3个月的随访中。参与者回答了癌症担忧量表(CWS)和对癌症复发的恐惧,荷兰语版本(FCRI-NL)五次,即在每个阶段的开始和结束时(基线,治疗,治疗后,和后续行动)。该研究在clinicaltrials.gov(NL8223)上进行了前瞻性注册。结果:对FCR的每日问卷进行了视觉分析和Tau-U效应大小计算。基线与治疗后的加权平均Tau-U评分为.63(p<.01),表明大的变化,基线和随访之间的0.53(p<0.01),表明适度的变化。从基线到随访,CWS和FCRI-NL-SF的得分显着降低。结论:EMDR治疗作为FCR的潜在有效治疗方法,结果似乎很有希望。建议进一步研究。
    对癌症复发(FCR)有高度恐惧的患者通常会对(未来)癌症相关事件产生侵入性记忆和图像。眼动脱敏和再处理(EMDR)治疗可以集中在这些入侵上。发现EMDR疗法对于经历高FCR的患者是有希望的疗法。
    Background: Fear of cancer recurrence (FCR) is one of the greatest problems with which cancer survivors have to deal. High levels of FCR are characterized by intrusive thoughts about cancer-related events and re-experiencing these events, avoidance of reminders of cancer, and hypervigilance, similar to post-traumatic stress disorder (PTSD). Eye movement desensitization and reprocessing (EMDR) therapy focuses on these images and memories. It is effective in reducing PTSD and may be effective in reducing high levels of FCR.Objective: The aim of the present study is to investigate the effectiveness of EMDR for severe FCR in breast and colorectal cancer survivors.Method: A multiple-baseline single-case experimental design (n = 8) was used. Daily repeated measurements for FCR were taken during the baseline phase and treatment phase, post-treatment, and at the 3 month follow-up. Participants answered the Cancer Worry Scale (CWS) and the Fear of Cancer Recurrence Inventory, Dutch version (FCRI-NL) five times, i.e. at the start and at the end of each phase (baseline, treatment, post-treatment, and follow-up). The study was prospectively registered at clinicaltrials.gov (NL8223).Results: Visual analysis and effect size calculation by Tau-U were executed for the daily questionnaire on FCR. The weighted average Tau-U score was .63 (p < .01) for baseline versus post-treatment, indicating large change, and .53 (p < .01) between baseline and follow-up, indicating moderate change. The scores on the CWS and FCRI-NL-SF decreased significantly from baseline to follow-up.Conclusion: The results seem promising for EMDR therapy as a potentially effective treatment for FCR. Further research is recommended.
    Patients who experience high fear of cancer recurrence (FCR) often have intrusive memories and images about (future) cancer-related events.Eye movement desensitization and reprocessing (EMDR) therapy can focus on these intrusions.EMDR therapy is found to be a promising therapy for patients experiencing high FCR.
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  • 文章类型: Journal Article
    目的:放射治疗(RT)是儿童和成人头颈癌脑血管(CV)疾病的公认危险因素。我们的目的是研究脑RT是否会增加成人原发性脑肿瘤(PBT)的CV疾病风险。
    方法:我们回顾性地确定了1975年至2006年间诊断为幕上PBT的成年人,并在治疗后至少随访10年。我们分析了人口统计,临床,和放射学特征,特别注意CV事件。我们还描述了CV事件,血管危险因素,在一项横断面研究中,对研究时存活的受照射患者进行了颅内动脉修饰。
    结果:共有116名患者,接受RT(暴露组)治疗,纳入85例未经照射的患者(未照射组)。受照射的PBT患者的卒中发生率高于未暴露组(42/116(36%)vs7/85(8%);p<0.001),缺血性卒中(27/116(23%)vs6/85(7%);p=0.004)和出血性卒中(12/116(10%)vs1/85(1%);p=0.02)的患病率较高。在受照射的组中,肿瘤靠近WillisPolygon的患者更有可能发生卒中(p<0.016).横断面研究中包括了44名活着的接受过照射的患者。在这个子群中,与普通人群(9%)相比,颅内动脉狭窄更为普遍(11/45,24%).
    结论:在接受头颅RT治疗的长期存活的PBT患者中,卒中患病率增加。
    结论:CV事件在接受脑RT治疗的PBT长期存活者中常见。我们提出了一份清单,以指导接受RT治疗的成人PBT的晚期CV并发症的管理。
    Radiotherapy (RT) is a recognized risk factor for cerebrovascular (CV) disease in children and in adults with head and neck cancer. We aimed to investigate whether cerebral RT increases the risk of CV disease in adults with primary brain tumors (PBT).
    We retrospectively identified adults with a supratentorial PBT diagnosed between 1975 and 2006 and with at least 10 years follow-up after treatment. We analyzed demographic, clinical, and radiological features with special attention to CV events. We also described CV events, vascular risk factors, and intracranial artery modifications in a cross-sectional study of irradiated patients alive at the time of the study.
    A total of 116 patients, treated with RT (exposed group), and 85 non-irradiated patients (unexposed group) were enrolled. Stroke was more frequent in irradiated PBT patients than in the unexposed group (42/116 (36%) vs 7/85 (8%); p < 0.001), with higher prevalence of both ischemic (27/116 (23%) vs 6/85 (7%); p = 0.004) and hemorrhagic (12/116 (10%) vs 1/85 (1%); p = 0.02) stroke. In the irradiated group, patients with tumors near the Willis Polygon were more likely to experience stroke (p < 0.016). Fourty-four alive irradiated patients were included in the cross-sectional study. In this subgroup, intracranial arterial stenosis was more prevalent (11/45, 24%) compared to general population (9%).
    Stroke prevalence is increased in long-surviving PBT patients treated with cranial RT.
    CV events are frequent in long survivors of PBT treated with cerebral RT. We propose a check list to guide management of late CV complications in adults treated with RT for PBT.
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  • 文章类型: Journal Article
    背景:癌症患者经常在网上搜索有关其健康状况的信息。癌症患者的叙述已成为提供信息和教育的一种方式,也是改善疾病应对的有效方法。
    目的:我们调查了受癌症影响的人如何看待癌症患者的叙述,以及这些故事是否有可能改善他们在癌症旅程中的应对。此外,我们反思了我们的共同创意公民科学方法是否有助于获得有关癌症生存故事的知识并提供同伴支持。
    我们通过与利益相关者使用定量和定性研究方法(即,癌症患者,他们的亲戚,朋友和健康专业人士)。
    方法:癌症生存故事的可理解性和感知益处,应对,对故事的情绪反应和故事的有益特征。
    结果:癌症生存故事被认为是可理解和有益的,它们可能支持受癌症影响的人的积极情绪和应对。与利益相关者一起,我们确定了引起积极情绪并且被认为特别有用的四个主要特征:(1)对生活的积极态度,(2)鼓励癌症旅行,(3)应对日常挑战的个人应对策略和(4)公开共享的漏洞。
    结论:癌症生存故事可能支持受癌症影响的人的积极情绪和应对。公民科学方法适用于识别癌症生存故事的相关特征,并且可能成为应对癌症的人们的有用教育同伴支持资源。
    我们采用了一种共同创新的公民科学方法,其中公民和研究人员在整个项目中同样参与。
    BACKGROUND: Cancer patients often search for information about their health conditions online. Cancer patient narratives have established themselves as a way of providing information and education but also as an effective approach to improving coping with the disease.
    OBJECTIVE: We investigated how people affected by cancer perceive cancer patient narratives and whether such stories can potentially improve coping during their own cancer journeys. Additionally, we reflected on whether our co-creative citizen science approach can contribute to gaining knowledge about cancer survival stories and providing peer support.
    UNASSIGNED: We applied a co-creative citizen science approach by using quantitative and qualitative research methods with stakeholders (i.e., cancer patients, their relatives, friends and health professionals).
    METHODS: Understandability and perceived benefits of cancer survival stories, coping, emotional reactions to the stories and helpful characteristics of the stories.
    RESULTS: Cancer survival stories were considered intelligible and beneficial, and they potentially support positive emotions and coping in people affected by cancer. Together with the stakeholders, we identified four main characteristics that evoked positive emotions and that were considered especially helpful: (1) positive attitudes towards life, (2) encouraging cancer journeys, (3) individual coping strategies for everyday challenges and (4) openly shared vulnerabilities.
    CONCLUSIONS: Cancer survival stories potentially support positive emotions and coping in people affected by cancer. A citizen science approach is suitable for identifying relevant characteristics of cancer survival stories and may become a helpful educational peer support resource for people coping with cancer.
    UNASSIGNED: We adopted a co-creative citizen science approach, wherein citizens and researchers were equally involved throughout the entire project.
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