Introduction: Research on the impact of cancer on close relationships brings up conflicting results. This systematic review collects empirical evidence on the research questions whether a cancer diagnosis in general or the type of cancer affects the divorce rate.Materials and Methods: This systematic review was conducted according to the guidelines of the Cochrane Collaboration and the PRISMA statement. The following electronic databases were searched: Web of Science, Ovid SP MEDLINE, PsycINFO, PsyINDEX, CINAHL, ERIC. Risk of bias assessment was performed with the preliminary risk of bias for exposures tool template (ROBINS-E tool). The grading of methodological quality was assessed with the Newcastle-Ottawa Scale.Results: Of 13,929 identified records, 15 were included in the qualitative synthesis. In 263,616 cancer patients and 3.4 million healthy individuals, we found that cancer is associated with a slightly decreased divorce rate, except for cervical cancer, which seems to be associated with an increased divorce rate.Discussion: According to this systematic review, cancer is associated with a tendency to a slightly decreased divorce rate. However, most of the included studies have methodologic weaknesses and an increased risk of bias. Further studies are needed.

Objective: More than one in 10 cancer patients care for dependent children. It is unclear whether this status makes a difference in terms of the distress and associated problems they experience, or whether it is linked to differences in the need for or utilization of psychosocial support.Methods: Secondary analysis of a cross‐sectional German study in National Comprehensive Cancer Centers using self‐report standardized questionnaires administered to inpatients. Patients living with dependent children (n = 161) were matched by age and sex with a subsample of 161 cancer patients not living with dependent children. The resulting sample was tested for between‐group differences in Distress Thermometer (DT) scores and the corresponding DT Problem List. Additionally, between‐group differences in measures of the need for and utilization of psychosocial support were examined.Results: More than 50% of all patients suffered from clinically relevant distress. Patients living with dependent children reported significantly more practical (p < 0.001, η²p = 0.04), family (p < 0.001, η²p = 0.03), and emotional problems (p < 0.001, η²p = 0.01). Although reporting a greater need for psychological support, parents with cancer were not found to more frequently utilize any type of psychosocial support.Conclusions: The specific problems and needs of parents with cancer who care for dependent children are currently not sufficiently addressed in the clinical care pathways. All families should be helped to establish open and honest communication as well as understand the available support systems and what they can provide. Tailored interventions should be implemented for highly distressed families.

Introduction: In urological oncology, the physical and psychological effects of cancer and its treatment post-discharge highlight the importance of follow-up psycho-oncology consultations. This study examines their utilisation and identifies predictors in urological cancer patients after inpatient care. Methods: A prospective, single-centre clinical observational study was conducted. Inpatients with urological cancer and ≥5 points on the Distress Thermometer and/or request for psycho-oncological support were recruited, offered an initial psycho-oncology consultation, and can attend up to five online or on-site appointments within 3 months of discharge. The following variables were collected: socio-demographics, psycho-oncological baseline documentation (PO-BADO), psychosocial distress (Distress Thermometer with problem list), anxiety and depressive symptoms (GAD-2 and PHQ-2), and performance status (ECOG). Results: A total of 501 patients were screened, 139 were included, and 108 were analysed. Twenty five patients used psycho-oncological follow-up care (n = 16 online). The final hierarchical model predicting the use of follow-up psycho-oncological support included the two predictors: age (OR 0.93, 95% CI 0.90–0.96) and anxiety (OR 1.60, 95% CI 1.11–2.44). Conclusion: Nearly 1 in 4 urological cancer patients use follow-up psycho-oncology consultations, mostly online. Predictors for this usage are younger age and higher levels of anxiety. To improve care, (1) online services reduce barriers; (2) older patients require support with these services; and (3) screening specifically for depression is crucial to ensure that follow-up appointments are scheduled as a mandatory part of hospitalisation.

Background: With over 65,000 new cases per year in Germany, prostate cancer (PC) is the most common cancer in men in Germany. Localized PC is often treated by radical prostatectomy and has a very good prognosis. Postoperative quality of life (QoL) is significantly influenced by the side effects of surgery. One possible approach to improve QoL is postoperative symptom monitoring using ePROMs (electronic patient-reported outcome measures) to accurately identify any need for support. Methods: The PRO-P (“Influence of ePROMS in surgical therapy of PC on the postoperative course”) study is a randomized controlled trial employing 1:1 randomization at 6 weeks postoperatively, involving 260 patients with incontinence (≥ 1 pad/day) at six participating centers. Recruitment is planned for 1 year with subsequent 1-year follow-up. PRO-monitoring using domains of EPIC-26, psychological burden, and QoL are assessed 6, 12, 18, 24, 36, and 52 weeks postoperatively. Exceeding predefined PRO-score cutoffs triggers an alert at the center, prompting patient contact, medical consultation, and potential interventions. The primary endpoint is urinary continence. Secondary endpoints refer to EPIC-26 domains, psychological distress, and QoL. Aspects of feasibility, effect, and implementation of the intervention will be investigated within the framework of a qualitative process evaluation. Discussion: PRO-P investigates the effect on postoperative symptom monitoring of a structured follow-up using ePROMs in the first year after prostatectomy. It is one of the first studies in cancer surgery investigating PRO-monitoring and its putative applicability to routine care. Patient experiences with intensified monitoring of postoperative symptoms and reflective counseling will be examined in order to improve primarily urinary continence, and secondly other burdens of physical and psychological symptoms, quality-of-life, and patient competence. The potential applicability of the intervention in clinical practice is facilitated by IT adaption to the certification standards of the German Cancer Society and the integration of the ePROMs survey via a joint patient portal. Positive outcomes could readily translate this complex intervention into routine clinical care. PRO-P might improve urinary incontinence and QoL in patients with radical prostatectomy through the structured use of ePROMs. Trial registration: ClinicalTrials.gov NCT05644821. Registered on 09 December 2022.

Urological cancers are associated with reduced quality of life and high psychological burden, yet affected patients receive less psychosocial support than other cancer groups. Electronic health literacy (eHL) may facilitate independent access to resources, but its role for psychological outcomes and quality of life in this group is unclear. This study examined associations between eHL, psychological symptoms, and quality of life during transition from inpatient to outpatient care. A prospective, single-centre observational study was conducted. Eligible inpatients (urological cancer, Distress Thermometer ≥5 and/or request for psycho-oncological support) received an initial psycho-oncology consultation and completed surveys during inpatient treatment (T1) and three months later (T2). Measures included socio-demographics, PO-BADO, eHL (eHEALS), distress, depression (PHQ-2), anxiety (GAD-2), and quality of life (EORTC QLQ-C30). Of 108 patients completing T1, 71 completed T2. After controlling for age, eHL was not significantly associated with distress, depression, anxiety, or quality of life. Age did not moderate these relationships. In this sample, eHL showed no significant associations with psychological outcomes or quality of life. However, higher age was linked to lower eHL, suggesting that older patients may face barriers to digital health engagement. Age-related differences in eHL should be considered when designing digital support services for urological cancer patients.

Zusammenfassung: Hintergrund: Kommunikation und interprofessionelle Zusammenarbeit mit krebskranken Patient:innen ist herausfordernd. Ein strukturiertes Kommunikationstraining ist bisher nicht in die ärztliche Weiterbildung integriert. Ziel der Studie war es, die Machbarkeit eines 80 Unterrichtseinheiten (UE) umfassenden interprofessionellen Kommunikationstrainings (IKT), wie im Nationalen Krebsplan empfohlen, an einer Klinik mit uroonkologischem Schwerpunkt zu prüfen. Methode: Eine Bedarfsanalyse wurde mittels Fokusgruppen und Einzelinterviews durchgeführt. Die Lernziele wurden mit (inter)nationalen Lernzielkatalogen abgestimmt. Das IKT wurde mittels des „six-step approach“ nach Kern und „design-based research“ erarbeitet. Die Inanspruchnahme und die Akzeptanz wurden evaluiert. Das IKT umfasste 6 Präsenzworkshops (50 UE) und eine Teamsupervision (10 UE). Für das individuelle arbeitsplatzbasierte Training (20 UE) wurden 6 definierte Settings identifiziert: Visite, Übergabe, Befundmitteilung, Aufnahme- und Entlassgespräch sowie ein Wunschsetting. Ergebnis: Die ärztliche Teilnahmequote an den Präsenzworkshops war 83,0 %, die pflegerische 58,3 %. Die Inanspruchnahme des arbeitsplatzbasierten Trainings lag bei 97 %. Die Ärzt:innen evaluierten das IKT sehr positiv (in Schulnoten Mittelwert [MW] 1,2 ± 0,4). Alle Teilnehmenden fühlten sich auf die Gespräche mit Patient:innen und Angehörigen besser vorbereitet. Zur Verstetigung wurden Ärzt:innen zu Mentoren ausgebildet. Schlussfolgerung: Die Implementierung eines IKT von 80 UE Umfang ist an einer urologischen Klinik erfolgreich durchführbar und führt u. a. durch eine Mentorenausbildung zu einer nachhaltigen Verbesserung der Kommunikationskultur.