bluuebunny/crossref_metadata_2025_split huggingface dataset:
A feasibility study using a touchscreen tool in the AYA population.
Authors: Espenschied Jonathan R. , Wolfson Julie Anna , Bogardus Alicia , Chen Yanjun , Folbrecht Jeanelle , Wong Florence Lennie , Rosenthal Joseph , Patel Sunita K. 
Published: March 2020

9575 Background: Adolescent and young adults (AYA) 15 to 39 years present unique health care needs; however, barriers to communication of treatment-related and psychosocial difficulties exist. We hypothesized that a tailored AYA Touchscreen Tool (AYATT) in cancer patients/survivors would facilitate patient-provider communication, toward the larger goal of timely intervention. As a first step, we evaluated the feasibility of such a tool, operationally defined as an 80% acceptance and completion rate. Methods: Eligible City of Hope AYA patients receiving treatment and follow up care for oncologic or hematologic disease were systematically approached for study participation. Target accrual to assess feasibility was set at 50 participants. Consented patients completed a concise AYATT battery, mostly standardized measures, assessing access to care (CHIS), needs, neurocognitive function (BRIEF-A, CogState), and other quality of life (PedsQL) issues. Patients and clinical/support staff completed satisfaction and ease-of-use surveys to further evaluate feasibility. Results: 54 participants were accrued over 8 weeks, with a 96% completion rate exceeding our primary feasibility criteria. At the time of participation: Mean age=26.2 years; Range 15.3 to 38.9 years. Acceptability was high with positive responses throughout the survey. Based on patient responses, the AYATT helped 52% remember issues they had, or have, with their care or treatment; 39% were encouraged to discuss medical issues with their care team that they might not have discussed; 92% found it a useful way to communicate with their health care team; and 98% would recommend that other patients use AYATT. A separate survey from 31/36 clinical/support staff reported AYATT had minimal negative impact in clinic or patient care, increased communication, and was useful in maintaining/improving care. Conclusions: The aggregate findings from this feasibility study support utilizing a tailored touchscreen device in the AYA oncology population. Predictably, high levels of computer knowledge in our AYA cohort may account for the success and acceptance of using such a tool. These results provide evidence for further exploration and continued use in the AYA clinic and patient care setting.
ALGA: A cancer patient profiling tool to improve physician-patient communication—An analysis in breast cancer patients.
Authors: Pravettoni Gabriella , Gandini Sara , Curigliano Giuseppe , Gorini Alessandra , Mazzocco Ketti , McVie J. Gordon , Munzone Elisabetta 
Published: March 2020

9582 Background: Considerable improvement of communication between physicians and patients (pts) will need to occur as personalised medicine becomes the norm. An accurate profile of the pt’s cognitive and psychological status should help the physician shape his language and his messages to maximise the pt’s understanding of her management options. To this aim a computerized tool (ALGA questionnaire) has been created and validated. Methods: The validation process produced a questionnaire with 4 main factors: Health State Perception, Psychological, Psychosocial and Cognitive aspects. To test its ability to discriminate between healthy people and pts, ALGA has been administered to 50 newly diagnosed primary Breast Cancer (BC) pts prior to their first visit with the oncologist to discuss their adjuvant treatment, and to 50 healthy women (age range:20-60), using an iPad. Results: A multivariate analysis showed a significant difference between BC pts and healthy women relatively to the four aforementioned broad areas: Psychosocial (F(1,56)=13.42, p<.001), Cognitive (F(1,56)=6.53, p<.01), and Psychological Aspect (F(1,56)=2.77, p=.05). ALGA detected pts with higher levels of anxiety and depression. Pts tended to ruminate more than healthy subjects. Finally, pts showed higher level of positive Health State Perception, suggesting a dissociation between cancer illness and general health. Cognitive and Psychological aspects and Health State Perception interacted with participants’ level of education (respectively: F(1,56)=12.23, p<.001; F(1,56)=4.58, p<.05; F(1,56)=7.9, p<.05). Starting from this results a personal profile for each pt was created. Conclusions: The ALGA confirmed ability to discriminate between healthy people and BC pts, and is a good tool to create a personal pt’s profile with which physicians can empower patient with tailored knowledge. Starting from ALGA questionnaire, a smart environment is being implemented as a decision support infrastructure to help communication, interaction and information delivery process from doctor to patient, influencing patient’s quality of life and satisfaction.
Discussions regarding reproductive and sexual health among young adult survivors of cancer.
Authors: Wang Ying , Chen Leo , Cheung Winson Y. 
Published: March 2020

9588 Background: Infertility and sexual dysfunction can result from many cancer treatments and may become a source of significant distress for young adult cancer survivors. Our aims were to 1) characterize the frequency in which reproductive and sexual health discussions occur in a population-based cohort of young cancer patients and 2) identify clinical factors associated with such discussions. Methods: Patients aged 20 to 39 years who were diagnosed with solid tumors from 2006 to 2008, evaluated at any 1 of 5 regional cancer centers in British Columbia, Canada and alive at 2 or more years after their initial diagnosis were included. Demographics, tumor and treatment characteristics, and information on patient-physician conversations were analyzed. Using regression models, we explored the relationships between clinical factors and whether or not discussions had occurred. Results: A total of 397 patients were identified: median age was 35 years (IQR 31-38), 28% were men, 88% had ECOG 0, and 73% reported being in a relationship. Tumor sites included breast (50%), testicular (27%), gynecological (17%), and colorectal (6%). A significant proportion of patients received chemotherapy and radiation that posed the potential risk of infertility or sexual dysfunction. However, only 224 (56%) and 24 (6%) of individuals had a discussion about reproductive and sexual health, respectively, within the first month of their diagnosis. At 6 months, an additional 25 (6%) and 16 (4%) patients had discussed these concerns with their physicians. Age, gender, ECOG, relationship status, and type of chemotherapy and radiation were not correlated with whether or not discussions had occurred (all p>0.05). In regression models, tumor site was associated with differences in reproductive and sexual health discussions between patients and physicians (Table). Conclusions: Among young adult survivors of cancer, fertility and particularly sexual function are inadequately addressed during discussions near the time of initial cancer diagnosis. [Table: see text]
RESTART: Rehabilitation Evaluation in Survivors of Testicular Cancer after Radical Treatment—Pilot study effect on HADS-anxiety subscore.
Authors: White Jeff D. , Rustin Gordon J. S. , Harrington Jennifer , Hewitt Chris , White Sandra , Young Teresa , Lawless Claire , McCartney Elaine , Abbas Vivienne , Brannan Christine , Somerville Lesley , Thomson Nicola , Winterbotham Melanie , Paul James ,   National Cancer Research Institute's Testis Clinical Studies and Palliative & Supportive Care Groups
Published: March 2020

9590 Background: Most testis cancer (TC) patients are cured, but some experience significant physical and psychological consequences. Multi-dimensional rehabilitation programmes have largely been studied in breast cancer, with positive effects on physical and psychological well being. The needs of young males are likely to be significantly different. Addressing the ‘Survivorship agenda’, we performed a study of the feasibility, composition and acceptability of a rehabilitation programme for TC patients. Methods: TC patients, aged >16, who had completed all radical treatment within the preceding 8 weeks, with no major cardio-respiratory problems were eligible. The 6 week multi-dimensional programme consisted of the following; exercise, psychological wellbeing, nutrition, finance, fertility, return to work and follow up. Primary end point was change in the HADS anxiety sub-score from pre (Week 1) to post the programme (Week 6). To detect with 90% power at the 10% 1-sided level of statistical significance a within patient change of 1.5 in the HADS anxiety sub-score (assuming a within patient SD of 3), 26 evaluable participants were required. Secondary objectives were the effect on QOL, HADS depression, exercise capacity and BMI. Results: 35 patients were recruited in 5 cohorts between Feb 2012 and Nov 2012 from 2 UK Cancer Centres; 32 patients were evaluable for the primary end point. Mean age at registration was 38 years (SD =10.45). 94% of the evaluable participants attended 5 or more sessions (30/32 participants). Participant feedback; 36.7% rated their overall score as 10 out of 10, with 93% of participants rating the programme ≥8. Conclusions: A multi-faceted rehabilitation programme appears deliverable and acceptable in TC patients. The study demonstrates a positive effect with a reduction in HADS anxiety score following participation. Having established the feasibility of this programme, a RCT of the programme vs. standard care is planned. Clinical trial information: ISRCTN77608320. [Table: see text]
Anthropometric change among breast cancer survivors provided a behaviorally based weight loss intervention.
Authors: Dittus Kim , Bunn Janice , Paul Zachary , Harvey-Berino Jean 
Published: March 2020

9591 Background: A majority of women with breast cancer are overweight or obese. Weight gain and loss of lean body mass often accompany chemotherapy. Excess weight is associated with increased risk of recurrence and decreased overall survival. Our aim was to determine the feasibility of a behavioral based weight loss intervention for breast cancer survivors who did and did not receive chemotherapy and to determine if additional resistance training enhances weight loss. Methods: Women with a BMI of 26-50 and stage I-III breast cancer were recruited for a 6 mo weight loss program which included individualized calorie reduction, 300 min of weekly exercise and a weekly online “chat”. Resistance training consisted of 2x/wk 30 min resistance exercises. Anthropometric measures; kcal measured by 24-hr recalls; and physical activity measured by accelerometer were assessed. Results: Seventy-four women were recruited and 52 completed post testing. The average age was 54 and average time since diagnosis was 33 mos. The average BMI at study initiation was 33 kg/m2. Overall the survivors lost 5.9 kg (6.7 % of baseline weight). Based on paired t-test evaluation weight, BMI and % body fat were all significantly lower after the intervention for completers and when using intent to treat analysis. There were no differences between groups for anthropometric change. The kcal deficit was significant for the chemo + wt loss + resistance (274kcal) and the no chemo (327kcal) groups but not the chemo+ wt loss group (196kcal). Exercise did not significantly increase between the baseline and post testing. Conclusions: Breast cancer survivors lose significant amounts of weight with a standard behaviorally based weight loss intervention. Receipt of chemotherapy did not influence ability to lose weight. Resistance training may increase weight loss while decreasing amount of fat free mass lost. Supervised exercise may be needed to achieve increases in exercise. Clinical trial information: NCT01482702. [Table: see text]
Gaps in survivorship care plan delivery and potential benefits to survivorship care.
Authors: Forsythe Laura Pence , Parry Carla , Alfano Catherine M. , Kent Erin E. , Leach Corinne , Haggstrom David , Ganz Patricia A. , Aziz Noreen , Rowland Julia Howe 
Published: March 2020

9594 Background: Survivorship care plans (SCPs), consisting of a treatment summary and follow-up plan, are intended to promote coordination of post-treatment cancer care. Yet, little is known about the provision of these documents by oncologists to primary care physicians (PCPs). This study compared self-reported oncologist provision and PCP receipt of treatment summaries and follow-up plans, characterized oncologists who reported consistent provision of these documents to PCPs, and examined associations between PCP receipt of these documents and survivorship care. Methods: A nationally representative sample of medical oncologists (N=1130) and primary care physicians (PCPs; N=1020) were surveyed regarding follow-up care for breast and colon cancer survivors using the cross-sectional Survey of Physician Attitudes Regarding the Care of Cancer Survivors (SPARCCS) in 2009. Results: Nearly half of oncologists reported always/almost always providing treatment summaries, while 20.2% reported always/almost always providing SCPs (treatment summary + follow-up plan). Approximately one-third of PCPs indicated always/almost always receiving treatment summaries, while 13.4% reported always/almost always receiving SCPs. Oncologists who reported training in late and long-term effects of cancer and use of electronic medical records were more likely to report SCP provision (p<0.05). PCP receipt of SCPs was associated with better PCP-reported care coordination, physician-physician communication, and confidence in survivorship care knowledge compared to receipt of neither treatment summaries nor SCPs (p<0.05). Conclusions: Providing SCPs to PCPs may enhance survivorship care coordination, physician-physician communication, and PCP confidence in caring for survivors. However, a minority of oncologists report routinely delivering SCPs to PCPs. Considerable progress will be necessary to achieve sharing of SCPs among oncologists and PCPs.
Perceptions of benefits and harms of alcohol consumption as predictors of alcohol cessation in adult cancer survivors.
Authors: Liu Geoffrey , Pringle Dan , Espin-Garcia Osvaldo , Niu Chongya , Mahler Mary , Halytskyy Oleksandr , Charow Rebecca , Lam Christine , Shani Ravi M. , Villeneuve Jodie , Tiessen Kyoko , Brown M Catherine , Alibhai Shabbir M.H. , Howell Doris , Jones Jennifer M. , Xu Wei , Selby Peter , Eng Lawson 
Published: March 2020

9595 Background: Survivorship programs are being developed at many cancer centers, addressing secondary prevention and healthy lifestyle issues. We evaluated whether perceptions regarding the harms and benefits of alcohol use influenced alcohol cessation or recidivism in adult cancer survivors. Methods: 531 cancer patients of all subtypes were surveyed at a comprehensive cancer center for their alcohol habits before and after cancer diagnosis and their perception of benefits/harms for continued drinking. Multivariate logistic regression models evaluated the association of each variable with change in alcohol consumption after diagnosis adjusted for significant socio-demographic and clinico-pathological covariates. Results: Among 325 current drinkers at diagnosis, 55% quit or cut down their alcohol consumption 1 year after diagnosis, while 16% of 95 ex-drinkers at diagnosis restarted drinking at 1 year. Negative perceptions of the effects of alcohol on the individual patient were strongly associated with cessation: the adjusted odds ratio (aOR) of quitting were significant for a perceived negative effect on quality of life (aOR=2.2, p=0.006), survival (aOR=3.8, p=1.3E-5), fatigue (aOR=3.1, p=4.6E-5) or an increased chance in self-harm (aOR=2.6, p=0.01). Perceptions of how alcohol affected the average cancer patient had similar associations. While perceptions did not influence alcohol recidivism rates, receiving chemotherapy was the only variable associated with continued abstinence (aOR=5.5, p=0.007). Although only 8% of patients received alcohol cessation information from an oncologist, it had the greatest impact on cessation (aOR=6.6, p=0.006), an association not seen with other information sources or other healthcare providers. Conclusions: Perception to the negative effects of alcohol use on their health in cancer survivors strongly predicted for alcohol cessation. The oncologist had a most significant counselling role for alcohol cessation.
The unmet needs of cancer survivors and their preferences for discussing them with oncologists and general practitioners (GPs).
Authors: Webber Kate , Girgis Afaf , Bennett Barbara Kaye , Bonaventura Antonino , Boyle Frances M. , Koh Eng-Siew , Friedlander Michael , Segelov Eva , Goldstein David 
Published: March 2020

9602 Background: Cancer survivors experience a range of post-treatment issues which are not well met by current services. This study explores the unmet needs of adult cancer survivors and their levels of comfort in addressing issues with oncologists and GPs. Methods: A cross-sectional survey was mailed to adult cancer survivors 4 years from diagnosis from 6 oncology units. Self-report data were obtained ranking physical, psychological and practical areas of importance to survivors; unmet needs in these areas; and the providers with whom they were happy to discuss each issue. Descriptive statistics were obtained regarding needs and preferences. Univariate and multivariate logistic regression analyses assessed demographic and clinical variables associated with 4 or more unmet care needs. Results: 228 surveys were returned (response rate 50.5%). Respondents had a mean age of 59.3 years (range 32-87), 71.5% were female, with most common primary cancers being breast (71.5%), colorectal (13.9%), prostate (4.5%) and ovarian (2.2%). The most commonly reported unmet needs were information about late effects (50.3%), managing fatigue (41.7 %), genetic risk to family (34.7%), reassurance (32.0 %) and diet (31.4 %). The median number of unmet needs was 4 (range 0-23). On univariate analysis, female gender, younger age and tertiary education were associated with greater unmet needs (p<0.001, p=0.01 and p=0.02). On multivariate analysis higher education (p=0.04) remained independently associated. Conclusions: Cancer survivors report significant unmet care needs, and their comfort levels for discussing them varies between providers. Some key issues are not entrusted to either oncologists or GPs. Models of care for survivors must address these potential deficits in care. [Table: see text]
Bridging to survivorship in breast cancer: How BMI weighs in.
Authors: Espirito Janet L. , Turnwald Brian , Harrell Robyn K. , Bhowmik Debajyoti , Denduluri Neelima , Brooks Barry Don , Hoverman J. Russell , Beveridge Roy A. , Patt Debra A. 
Published: March 2020

9605 Background: Obesity and depression complicate survivorship in early stage breast cancer (BC) by having a direct impact on survival and morbidity among patients (pts) who complete treatment (tx). The prevalence of obesity after BC tx in the community and concordance with BC tx type is poorly described, but important as we characterize risks of tx and optimize goals for survivorship care planning. Methods: We queried the electronic health record (EHR), iKnowMed, from a large network of community oncology practices for pts diagnosed with stage I-III BC from 2007-2010 with at least 5 office visits and follow up through 11-2012 for our retrospective study. We excluded pts who developed metastatic disease or died. We stratified pts by chemotherapy (CT) utilization (yes/no), hormone receptor (HR) status, age, and documented body mass index (BMI) at first office visit and annually. We evaluated changes in BMI characteristics by tx cohort. Results: We identified 8,506 pts with a documented BMI at first office visit and 1, 2, and 3 years (yrs) thereafter. 4369 (51% of the total) pts received adjuvant CT and 4137 (49%) did not. 6897 pts (81%) were HR positive. Baseline BMI between tx cohorts were similar, though the prevalence of overweight (31%) and overweight or obese (68%) is high. Percent change of BMI at 3 yrs varied significantly between T cohorts (p<0.01) with greater rise among the cohorts who received CT in comparison to those who did not. Pts receiving CT were 46% more likely to have a 5 point or more increase in BMI at 3 yrs compared to pts that did not receive CT (OR 1.46, CI[1.08-1.96]). A stronger association for BMI increase of at least 0.5 points at 3 yrs (OR 1.53, CI [1.4-1.7]) was also observed amongst pts who received CT compared to those that did not. HR positive pts were less likely than HR negative or unknown pts to increase their BMI by at least 0.5 points (OR 0.84, p<0.01), but there was no difference at detecting a difference of 5 points in BMI (OR 0.88, p=0.49). Conclusions: With 3 yrs of follow up, overweight and obese status is remarkably common among BC survivors in the community and appears to be more prevalent after CT tx. Determinants of obesity require further study and point to necessary intervention to improve the health of early stage BC pts.
Body mass index (BMI) and its impact on quality of life (QOL) in childhood leukemia survivors.
Authors: Blaes Anne Hudson , Baker Kevin Scott , Lee Jill Lunsford , Moen Catherine , Mulrooney Daniel A. , Vankina Srilakshmi , Vogel Rachel Isaksson , Kunin-Batson Alicia 
Published: March 2020

9606 Background: Obesity after childhood cancer carries implications for survivors’ future health risks; however little is known about the impact of weight after treatment on QOL. Methods: Adult survivors of childhood leukemia in remission (51% male) completed the Health Related QOL Short Form (SF-36) between 2006-2012. Standard BMI cut points were assessed at the time of survey completion. 97% received treatment with chemotherapy, 55.6% stem cell transplant (SCT), 27.8% were in remission from a second cancer. The impact of demographic (age at diagnosis, current age, gender), treatment [radiation therapy, SCT, total body irradiation (TBI), cranial radiation, disease characteristics, history of relapse] were explored. For each subscale, linear regression models were performed. All statistical tests were two-sided, P-values < 0.05 considered statistically significant. Results: 73 survivors diagnosed at a median age of 9.0 (1.0-27.0) years and surveyed at a median of 17.4 (2.5-34.7) years later completed SF-36. 75.6% had received a median dose of 1800 (800-8750) cGy of radiation. The distribution of BMI was underweight <18.5 (9.6%), normal 18.5-24.9 (42.5%), overweight 25-29.9 (27.4%), or obese >30 (20.6%). Consistent with previous studies, those who received whole brain radiation had greater BMI at the time of survey than those who did not receive radiation and those who received TBI (F=2.52, p=0.065). In analyses adjusted for age at diagnosis and time since diagnosis, the reported vitality (fatigue) for those who were obese (mean 45.0+/-8.9) or underweight (45.8+/-9.5) was significantly lower (p=0.002) than normal (55.7+/-10.4) or overweight (50.4+/-10.0), and those who were underweight (39.0+/-13.3) also reported poor physical functioning (endurance and strength) (p=0.038) compared with the others (52.3+/-8.1 normal weight, 49.5+/-11.7 overweight, 47.1+/-9.0 obese). Conclusions: Weight management in leukemia survivors is problematic with 48% of our sample being overweight or obese. Weight status is associated with QOL, impacting survivors’ fatigue and physical functioning. Interventions to help survivors achieve a healthy weight after cancer treatment are needed, and may lead to improvements in QOL.