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NCT Number: NCT06944262

Assessment of Cancer-related Post-traumatic Stress in Patients and Caregivers in the Year Following Diagnosis, and Identification of Their Expectations of Personalized Support - CANDYSTRESS

The impact of cancer on the lives of patients and their caregivers is undeniable. In addition to the potentially traumatic aspects (i.e., creating a very violent emotional shock) linked to the announcement of the disease and the various stages of the care pathway (effects of treatment, announcement of a cancer recurrence), even before the onset of the disease, patients and their caregivers may have been directly or indirectly confronted with traumatogenic events (e.g., childhood abuse, sudden death). They may therefore be more likely to develop a stress-related mental disorder in their lifetime. The question of the accumulation of traumatic events, the identification of groups of people at risk of developing symptoms of distress, and the management of these symptoms is therefore crucial. In addition, the mutual influence within the patient-caregiver dyad in terms of emotional adjustment, and its evolution throughout the cancer care pathway, are key elements to be considered in these issues.

The CandyStress project is based on a partnership with patients, their caregivers and carers to identify the needs of patient-caregiver dyads at risk of cancer-related post-traumatic stress disorder (Ca-PTS). Longitudinal screening for Ca-PTS in the year following cancer diagnosis will be carried out to identify the characteristics of at-risk dyads who could benefit from long-term support. The aim of this project is to identify the potential need for targeted support and the desired format of this support. This is a preliminary step in identifying needs and the context conducive to the implementation of personalized support, but in no way an evaluation of the effectiveness of an intervention.

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Observational

Primary location

Centre Oscar Lambret, Lille, Nord, France

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Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Part 1. Diagnosis of Ca-PTS

Patient inclusion criteria:

  • Male or female, 18 years of age or older,
  • recently (<4 months) diagnosed with breast, gynecological, testicular or digestive cancer at the time of the announcement visit (i.e., the announcement to the patient of the treatment plan after the initial multidisciplinary consultation meeting in the cancer center - in accordance with the Cancer Plan),
  • with cancer requiring oncological treatment,
  • starting oncology treatment at the Oscar Lambret Center,
  • with no Central Nervous System (CNS) metastases,
  • with a PRONOPALL score ≤3 (favorable prognosis group, Bourgeois et al., 2017) or expected survival greater than 6 months,
  • who have given signed consent to participate in the study and are covered by French social security,
  • able to identify a caregiver (i.e., a family member, friend or other person who has helped care for them since diagnosis).
  • equipped with a computer or tablet equipped with a webcam and an internet connection, for the online questionnaire - the webcam is only necessary if the participant wants the IGE to be present via video on the computer, if they prefer the video to be made over the phone, in which case they must also be equipped with a smartphone enabling video calls.

Inclusion criteria

for caregivers:

  • Male or female, 18 years of age or older,
  • designated by the patient as their primary caregiver (i.e. "a family member, friend or other person who has helped care for you since diagnosis"),
  • have given their signed consent to participate in the study.
  • equipped with a computer or tablet equipped with a webcam and an internet connection, for the online questionnaire - the webcam is only necessary if the participant wishes the IGE to be present via video on the computer, if he/she prefers the video to be made over the phone, in which case it is also necessary to be equipped with a smartphone enabling video calls.

Part 2. Gathering expectations for personalized support and its components.

In addition, 3 types of focus groups will be set up remote :

Focus groups with patients from local associations, as well as patient partners of the Oscar Lambret Center and patients from Part 1 if they are interested.

Inclusion criteria

for patient focus groups:

  • Men or women of legal age who have or have had cancer,
  • Members of a local patient association or of the Oscar Lambret Center's "patient partners" committee,
  • Or have participated in part 1 (Ca-PTS screening, once the 3 steps have been completed),
  • Equipped with a computer or tablet with camera and internet connection,
  • Have given their consent to take part in the study.

Focus group with caregivers from local associations as well as "partner caregivers" from the Oscar Lambret Center and caregivers from part 1 if they are interested.

Inclusion criteria

for "caregiver" focus groups:

  • Men or women of full age who are, or have been, caregivers of a cancer patient,
  • members of a local caregivers' association,
  • or having participated in part 1 (Ca-PTS screening, once the 3 steps have been completed),
  • Equipped with a computer or tablet with camera and internet connection,
  • Having given their consent to take part in the study.

Focus groups with hospital medical and paramedical staff as well as non-hospital caregivers involved in the medical in the medical and psychological follow-up of patients.

Inclusion criteria

for caregiver focus groups:

  • Member of the medical and paramedical staff of the Oscar Lambret Center
  • Or non-hospital staff involved in the medical or psychological care of patients,
  • Professionals not involved in the present study,
  • Equipped with a computer or tablet with camera and internet connection
  • Having given their consent to participate in the study

Exclusion criteria

Part 1. Diagnosis of Ca-PTS

Non inclusion criteria for patients :

  • Patients with meningeal or cerebral metastases,
  • Patients with cancer recurrence,
  • Patients suffering from a psychiatric or neurological disorder likely to impair their ability to reason or judge (in particular psychotic disorder, autism spectrum disorder, intellectual disability),
  • Patients with a psychological or physical incapacity to answer questionnaires, certified by medical staff,
  • Patients subject to a custodial sentence, guardianship or protection of vulnerable adults,
  • Presence of CNS metastases (risk of cognitive impairment preventing completion of questionnaires).

Non-inclusion criteria for caregivers:

  • Caregivers suffering from a psychiatric or neurological disorder likely to impair their ability to reason or exercise judgment judgment (in particular psychotic disorder, autism spectrum disorder intellectual disability), or for whom there is a suspicion (not there is a suspicion (no additional examination is prescribed to confirm this criterion, which remains self-declaratory).
  • Caregivers with a psychological or physical inability to answer questionnaires, or for whom there is a suspicion suspicion (no further tests are required to confirm this criterion which remains self-reported).
  • Caregivers subject to a custodial sentence, guardianship or protection guardianship or protection of vulnerable adults.

Part 2. Collection of expectations for personalized support and its components.

Non-inclusion criteria for patients and caregivers who participated in the screening part of the Ca-PTS :

  • Failure to complete all measurement times (T0, T1, T2)

Non-inclusion criteria for focus groups (patients, caregivers): none

Treatment and study plan

Primary outcomes

  1. PTSD Checklist for DSM-5 (PCL5)

    Time frame: measured in the month following the announcement of the cancer treatment, then 6 months and 12 months later - in patients and their caregiver

    total score (0-80) reflects the severity of Post Traumatic Stress Disorder (PTSD) symptoms. A score threshold > 32 has been validated as reflecting probable PTSD

Secondary outcomes

  1. self reported general physical condition

    Time frame: from baseline (in the month following the announcement of the cancer treatment) to 6 months and 12 months later

    answer to the item "How do you feel physically impaired at the moment?" (likert scale from 0: "not at all" to 10: "absolutely")

  2. perception of the general physical condition in the other dyad member

    Time frame: from baseline (in the month following the announcement of the cancer treatment) to 6 months and 12 months later

    answer to the item:: "To what extent do you think your loved one feels physically diminished at the moment? " (likert scale from 0: "not at all" to 10: "absolutely")

  3. self reported distress

    Time frame: from baseline (in the month following the announcement of the cancer treatment) to 6 months and 12 months later

    answer to the item "To what extent do you feel psychologically distressed at the moment? " ((likert scale from 0: "not at all" to 10: "absolutely")

  4. perception of the distress in the other dyad member

    Time frame: from baseline (in the month following the announcement of the cancer treatment) to 6 months and 12 months later

    answer to the item: "To what extent do you think your loved one feels psychologically distressed at the moment? " (likert scale from 0: "not at all" to 10: "absolutely")

  5. self reported physical pain (only in patients)

    Time frame: from baseline (in the month following the announcement of the cancer treatment) to 6 months and 12 months later

    answer to the item "to what extent are you currently experiencing physical pain?" (likert scale from 0: "not at all" to 10: "absolutely")

  6. exposure to potentially traumatic events

    Time frame: from baseline (in the month following the announcement of the cancer treatment) to 6 months and 12 months later

    self reported Life Event Checklist for DSM-5 (LEC-5). The total score is 0 to 48. The higher the score, the more the participant reports traumatic events.

  7. post traumatic stress disorder (PTSD)

    Time frame: from baseline (in the month following the announcement of the cancer treatment) to 6 months and 12 months later

    PTSD checklist for DSM 5 (PCL-5). The total score (0-80) reflects the severity of the PSTD symptoms, and a cut off of 32 a possible PTSD.

  8. anxiety symptoms

    Time frame: : from baseline (in the month following the announcement of the cancer treatment) to 6 months and 12 months later

    Generalized Anxiety Disorder (GAD7). The overall score ranges from 0 to 21. Scores of 5, 10 and 15 represent thresholds for mild, moderate and severe anxiety respectively

  9. depressive symptoms

    Time frame: from baseline (in the month following the announcement of the cancer treatment) to 6 months and 12 months later

    Patient Health Questionnaire (PHQ9). The total score ranges from 0 to 27, with a score of 10 or more indicating moderate depression.

  10. social support

    Time frame: from baseline (in the month following the announcement of the cancer treatment) to 6 months and 12 months later

    Social Support Questionnaire SSQ6. Higher SSQ6 scores reflect greater satisfaction with the level of social support.

  11. difficulties in emotion regulation

    Time frame: from baseline (in the month following the announcement of the cancer treatment) to 6 months and 12 months later

    Difficulties in Emotion Regulation Scale Short Form (DERS SF). The higher the score, the greater the difficulty of emotional regulation.

  12. resilience

    Time frame: from baseline (in the month following the announcement of the cancer treatment) to 6 months and 12 months later

    Resilience Resources Scale (RSS). The total score ranges from 12 to 60. Higher scores reflect greater resilience

  13. Questions about potential personalized support

    Time frame: baseline

    Participants will be asked whether they personally feel the need for psychological support to manage their symptoms, and whether they would be willing to engage in such support. If so, they will be asked to specify when they think this support should be offered, and in what form These answers will be collected using open-ended questions.

  14. Socio-demographic factors

    Time frame: at inclusion (i.e in the month following the announcement of the cancer treatment) - for patients and caregivers

    age, gender, marital status, socio-professional category, level of education

Sponsors and collaborators

Lead sponsor

Lille University

Other

Collaborators

  • Centre Oscar Lambret, Lille, France

Registry information

Official study title

Évaluation de la détresse Post-traumatique Relative au Cancer Dans l'année Suivant le Diagnostic Chez Les Patients et Les Aidants et Identification de Leurs Attentes Envers un Accompagnement personnalisé

Acronym: CANDYSTRESS

Important dates

Study start
2025
Primary completion
2027
Study completion
2028
First posted
Apr 25, 2025
Registry last updated
Apr 25, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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