The finding:
This study examined a cohort of 338,009 patients with a first primary malignancy diagnosis, to examine the relationship between the use of Aspirin, NSAIDs, both or none, and the occurrence of newly diagnosed depression, anxiety, and stress-related disorders within one year of cancer diagnosis. The use of aspirin alone was associated with a lower rate of these disorders, particularly in women.

Strength and weaknesses:
This study’s strengths are the population-based design with a large sample size and comprehensive information regarding covariables that permit a thorough statistical analysis. However, it is essential to keep in perspective that this study cannot control over-the-counter medication use, the effect of unknown and unmeasured confounders. While the study excluded patients with documented pre-existing psychiatric disorders, eliminating this cofounding factor, some patients possibly have unregistered psychiatric disorders that could impact the results.

Relevance:
Inflammation has been linked with the development of specific psychiatric disorders. Cancer patients have a high burden of cancer-induced systemic inflammation. Pre-clinical studies have shown that low-dose aspirin might counteract central nervous system-related impact in a mouse model of breast cancer. This study is the first to examine aspirin’s protective effects in the development of depression, anxiety, and stress-related disorders, which could help assess future risk on newly diagnosed patients and inform future research on the topic.

Type of study (EBM guide):
Cohort study

The finding:
Mindfulness-based interventions improved short and medium-term anxiety, depression, and health-related quality of life. These interventions had little to no benefit in either disorder long-term.

Strength and weaknesses:
This is a soundly designed meta-analysis, with a large number of trials and well-outlined quality assessment that and included a large number of quality trails and had a rigorous method for assessing quality and observing biases across included studies. The resulting size permitted for subgroup analyses. As in any meta-analysis, it is impossible to determine that findings were related exclusively to the interventions examined. The fact that breast cancer studies accounted for almost half of the trials limits interpretation of results across genders and other specific cancer populations, such as hematopoietic stem cell transplant patients.

Relevance:
The findings of this meta-analysis support the use of mindfulness-based interventions in patients with all cancer types for treatment and adjuvant treatment of anxiety and depressive symptoms, particularly for the short and medium-term. The findings of this study add a tool to the armamentarium of interventions available for this vulnerable population. It also highlights the positive impact on the quality of life of cancer patients of these interventions and can inform future research on the topic.

Type of study (EBM guide):
Systematic review or meta-analysis

The finding:
From a systematic review of the literature, the authors found psychosocial oncology providers reported lower rates of burnout compared to their oncology healthcare provider peers. Exposure to patient recovery, higher job satisfaction, greater engagement in work, opportunities to debrief traumatic experiences, low moral distress, and finding meaning in the work were associated with lower levels of burnout.

Strength and weaknesses:
Standard methodology was used for conducting the systematic review. Risk of bias was generally low among studies, and quality of methodology among individual studies was high. Several limitations were noted: The sample sizes of individual studies were generally small; different definitions and different measurement tools for burnout were used in the various studies, which limited the authors’ ability to compare outcomes between studies. Cut-off scores for burnout may not be valid, and newer studies are focusing on the burnout-engagement continuum rather than categorical outcomes defined by a threshold score.

Relevance:
Oncology healthcare providers are at risk for burnout given the high emotional intensity of the work. Most of the work on burnout in oncology providers has focussed on medical oncologists and nurses. Very little work has looked at burnout in psychosocial oncology providers despite the emotional heaviness inherent to the work. This study found lower rates of burnout among psychosocial oncology clinicians compared to their peers working in oncology, and a number of factors were associated with this. These factors can be incorporated at the institutional level to try improve burnout among all clinicians working in oncology.

Type of study (EBM guide):
Systematic review or meta-analysis

This narrative review highlights the issue of the acceleration of ageing in patients with cancer. Cancer and cancer treatments can accelerate cognitive decline, frailty, functional decline, and chronic disease. The authors discuss these issues and postulated mechanisms to explain this phenomenon. Given that accelerated ageing can significantly negatively impact quality of life, these concerns must be at the forefront of our conversations with older patients who are considering cancer treatments.

Type of study (EBM guide):
Other (enter a free text description on the document)