Abstract P1-09-14: Improved outcome of breast cancer survivors participating in a multidisciplinary cancer survivorship program at Texas Tech University Health Sciences in El Paso, TX
Authors: Nahleh Zeina , Pasillas Rebecca , Dwivedi Alok , Nasrazadani Azadeh , Heydarian Rosalinda , Sanchez Luis , Mallawaarachchi Indika , Ochoa Cecilia , Saltzstein Edward 
Published: May 2015

Introduction: Breast Cancer (BC) survivors in El Paso, TX include a majority of Hispanics. We have previously reported that these survivors have decreased mental and physical health related Quality of Life (QOL). We sought to determine whether BC survivors would benefit from participating in a comprehensive multidisciplinary BC Survivorship Program at the Garbar Breast Care Center (GBCC), as determined by improvement of performance on the following validated questionnaires: 1) Patient Health Questionnaire 9(PHQ9), 2) General Anxiety Disorder 7 (GAD 7), and SF36 QOL questionnaires. Methods: After IRB approval, we recruited consecutive patients at our institution over 6 months starting October, 2013, and who are within the first 5 years post-diagnosis with Stages I-III BC and have completed surgery, chemotherapy and/or radiation therapy. Survivors were enrolled in the survivorship program staffed by an oncologist, a nurse practitioner, a nutritionist and a clinical psychologist. They participate in individual as well as group sessions. Survivors are initially screened for depression and generalized anxiety disorder using PHQ9 and GAD 7, in addition to assessing the patient’s QOL at baseline, and every 3 months. Survivors are provided with a personalized summary of all received treatment and follow up care plans; dietary counselling and individual meal plans, in addition to in-depth psychological assessment and an intervention using Mindfulness Based Stress Reduction. Results: 47 patients have been recruited so far and all but one completed baseline questionnaires;17 and 7 respectively had 3 and 6 months follow up visits. 94% were Hispanics. Mean age 54 years. 38% of participants were younger than 50 years of age; Stage 1 BC (36%), Stage 2 (36%), and stage 3 (28%) . 80% received chemotherapy ; and 68% had hormone receptor positive BC and received endocrine therapy. The scores at baseline were : PCS representing the mean for the SF-36 QOL Physical Health was 46.0, and the MCS for Mental Health was 44.0, both below the population norm (50.0). Mean scores for GAD 7 was 7.54 and for PHQ 9 7.33, both abnormal (&lt;5 on PHQ9 and GAD 7 are considered normal scores). At 3 months the scores were as follows: PCS 49.71, MCS 45.34, both improved (the higher the better); GAD7 5.18; and PHQ9 6.82 (both improved, the lower the better). At 6 months, same favorable trend continues: PCS 50.07 [SD 5.54, 44.29-53.35]; MCS 49.66 [SD 7.73, 38.93-62.41]; GAD7 5.00 (SD 3.70); and PHQ9 4.57 (SD 3.64).

Conclusion: BC survivors are benefiting from participating in the new BC Survivorship Program launched at Texas Tech in El Paso, TX. They have experienced improved mental and physical health related QOL, improved anxiety and depression by GAD7, and PHQ9, with scores reaching near normal values at 6 months into the program which continues to enroll BC survivors. This program represents a culturally appropriate model for Hispanic BC survivors. It is expected to continue to improve the quality of life of these patients, empower them in their transition from cancer treatment to survivorship and lead to improved psychosocial adjustment and normal social functioning with significant implication not only on survivors, but also on their families and the community.

Citation Format: Zeina Nahleh, Rebecca Pasillas, Alok Dwivedi, Azadeh Nasrazadani, Rosalinda Heydarian, Luis Sanchez, Indika Mallawaarachchi, Cecilia Ochoa, Edward Saltzstein. Improved outcome of breast cancer survivors participating in a multidisciplinary cancer survivorship program at Texas Tech University Health Sciences in El Paso, TX [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P1-09-14.