{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:53:15Z","timestamp":1786978395567,"version":"build-2736575974"},"reference-count":19,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T00:00:00Z","timestamp":1762300800000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Psycho-Oncology"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Study objective<\/jats:title>\n                    <jats:p>Patients with cancer living in regions of war face significant quality of life (QoL)\u2010related concerns, both cancer\u2010 and war\u2010related. This study examined the correlation between narratives of patients referred to an integrative oncology (IO) program in northern Israel and heart rate variability (HRV) measurements.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The study was nested within an ongoing prospective, randomized controlled trial, assessing IO interventions on QoL\u2010related concerns among patients with cancer undergoing chemotherapy. Patients reporting cancer\u2010 and war\u2010related concerns were eligible for study inclusion. Narratives from two open\u2010ended questions addressing personal and health\u2010related effects of the war were analyzed qualitatively using ATLAS.Ti software for systematic coding; and baseline electrocardiogram conducted for HRV measurement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Analysis of 125 patient narratives identified many war\u2010related experiences and emotions, most significantly stress, fear, anxiety, distress, sadness, loneliness, and reduced daily functioning. In 36 patients (28.8%), a significant association was found between war and cancer\u2010related concerns (e.g., pain, appetite, gastro\u2010intestinal and emotional distress, insomnia). HRV analysis suggested a correlation between expressing both cancer\u2010 and war\u2010related concerns with higher Power high\u2010frequency (HF) [correlation: 0.24 (0.01, 0.44),\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.039]; Power lower frequency (LF) [correlation: 0.27 (0.06, 0.47),\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.015]; and autocorrelation slope [0.25 (0.05, 0.44);\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.015].\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients with cancer\u2010 and war\u2010related concerns reported a significant impact of the war on health, especially QoL cancer\u2010related concerns. Baseline HRV analysis suggests that those expressing both groups of concerns showed increased sympathetic and para\u2010sympathetic activity. Further research is needed to examine the impact of war on cancer care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pon.70327","type":"journal-article","created":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T02:01:37Z","timestamp":1762394497000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["<i>Chemotherapy Under Fire<\/i>\n                    : Narratives of Patients With Cancer During Wartime"],"prefix":"10.1002","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4058-3672","authenticated-orcid":false,"given":"Eran","family":"Ben\u2010Arye","sequence":"first","affiliation":[{"name":"Ruth and Bruch Rappaport Faculty of Medicine Technion\u2010Israel Institute of Technology  Haifa Israel"},{"name":"Integrative Oncology Program The Oncology Service; Lin, Carmel, and Zebulun Medical Centers Clalit Health Services  Haifa Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orit","family":"Gressel","sequence":"additional","affiliation":[{"name":"Ruth and Bruch Rappaport Faculty of Medicine Technion\u2010Israel Institute of Technology  Haifa Israel"},{"name":"Integrative Oncology Program The Oncology Service; Lin, Carmel, and Zebulun Medical Centers Clalit Health Services  Haifa Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yael","family":"Keshet","sequence":"additional","affiliation":[{"name":"Department of Sociology Western Galilee Academic College  Acre Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0021-088X","authenticated-orcid":false,"given":"Jan","family":"Vagedes","sequence":"additional","affiliation":[{"name":"ARCIM Institute Research Institute  Filderstadt Germany"},{"name":"Department of Neonatology University Hospital Tuebingen University Tuebingen  T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noah","family":"Samuels","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Center for Integrative Complementary Medicine Shaare Zedek Medical Center Hebrew University of Jerusalem  Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vika","family":"Schachter","sequence":"additional","affiliation":[{"name":"Ruth and Bruch Rappaport Faculty of Medicine Technion\u2010Israel Institute of Technology  Haifa Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Galit","family":"Galil","sequence":"additional","affiliation":[{"name":"Integrative Oncology Program The Oncology Service; Lin, Carmel, and Zebulun Medical Centers Clalit Health Services  Haifa Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meirav","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Unit of Gynecologic Oncology Department of Obstetrics and Gynecology Carmel Medical Center  Haifa Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sameer","family":"Kassem","sequence":"additional","affiliation":[{"name":"Ruth and Bruch Rappaport Faculty of Medicine Technion\u2010Israel Institute of Technology  Haifa Israel"},{"name":"Department of Internal Medicine Lady Davis Carmel Medical Center  Haifa Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,5]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2025.6215"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjonc\u20102023\u2010000252"},{"issue":"2","key":"e_1_2_13_4_1","first-page":"153","article-title":"Exploring Psychosocial Needs of Young Women With Breast Cancer in a Country With Crisis: A Mixed\u2010Methods Study","volume":"80","author":"Hasan S.","year":"2025","journal-title":"Medical Journal of Malaysia"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434\u2010025\u201017239\u20103"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2012.02.011"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/082585979100700202"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctim.2006.03.006"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11136\u2010013\u20100387\u20108"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.3621"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049732305276687"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11031\u2010011\u20109201\u20105"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/milmed\/usz325"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1109\/CogSIMA49017.2020.9216076"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.3390\/children12060660"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.3390\/bioengineering8100138"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10877\u2010013\u20109545\u20103"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph22040588"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.26719\/2025.31.2.101"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.26719\/2025.31.4.235"}],"container-title":["Psycho-Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pon.70327","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T04:27:23Z","timestamp":1764131243000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pon.70327"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11]]},"references-count":19,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1002\/pon.70327"],"URL":"https:\/\/doi.org\/10.1002\/pon.70327","archive":["Portico"],"relation":{},"ISSN":["1057-9249","1099-1611"],"issn-type":[{"value":"1057-9249","type":"print"},{"value":"1099-1611","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11]]},"assertion":[{"value":"2025-09-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70327"}}