bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patients’ perceptions of early palliative oncology care: A qualitative analysis.
Authors: Hannon Breffni , Swami Nadia , Krzyzanowska Monika , Leighl Natasha B. , Oza Amit M. , Moore Malcolm J. , Rodin Gary , Tannock Ian , Zimmermann Camilla 
Published: March 2020

e20639 Background: Early palliative care referral is encouraged for patients with advanced cancer. However, little is known about patients’ perceptions of the impact and relevance of early referral. We conducted a qualitative study in which patients with advanced cancer were interviewed following completion of a randomized controlled trial comparing early palliative care with standard oncology care. Our aim was to delineate what, in the opinion of patients, were the respective roles of the oncology and palliative care teams in an outpatient setting. Methods: We conducted qualitative interviews with patients following completion of a cluster randomised controlled trial of early versus routine palliative care referral. Participants were recruited from 24 medical oncology clinics at a comprehensive cancer center. Selective sampling was employed to ensure equivalent numbers of participants from intervention vs. control arms, male vs. female, age ≥60 vs. <60 years, with high vs. low self-reported quality of life, and with high vs. low satisfaction with care. Forty-eight patients (26 intervention and 22 control) with advanced lung, breast, gynecological, gastrointestinal and genitourinary cancers completed interviews lasting 25 to 90 minutes. Control patients were asked about the role of oncology; intervention patients were asked about both teams. Interviews were recorded, transcribed and analysed using NVivo. A grounded theory approach was used to explore emerging themes. Results: Several themes emerged in relation to the contrast between oncology (OC) and palliative care (PC) including (1) the focus of the consultation, with OC tending to focus on cancer or treatment options while PC was regarded as being more holistic, including physical, psychological and family domains; (2) the model of care delivery, with OC described as being clinician-led and time-limited, in contrast with PC where time was more flexible and the patient set the agenda; and (3) the complementary nature of early palliative care alongside standard oncology care in terms of overall well-being. Conclusions: From a patient perspective, palliative care and medical oncology have distinct and complementary roles, supporting the relevance of early referral.
Developing a culturally and linguistically responsive survivorship care plan for breast cancer.
Authors: Ashing Kimlin Tan , Rosales Monica , Serrano Mayra , Fulcher Gingi , Paz Isaac Benjamin , Weitzel Jeffrey N. , Lai Lily L. ,   African American Cancer Coalition, Latina Breast Cancer Taskforce
Published: March 2020

e20651 Background: African and Latina-American breast cancers patients (BCA) experience the greatest morbidity and mortality, suggesting a critical need for improved surveillance and quality care. The Institute of Medicine (IOM) and the Commission on Cancer (CoC) recommend that survivors receive personalized Treatment Summaries and Survivorship Care Plans (TSSCP) in order to facilitate best practice in clinical surveillance and follow-up care. This TSSCP template development study joined advocacy, scientific and medical communities to comprise a diverse advisory council (AC, N=38) to inform the development of the TSSCP-AA (African American) and TSSCP-S (Latino) templates targeting BCA. This abstract reports on the development, and presents the TSSCP-AA and TSSCP-S. Methods: The overall study was guided by the Shared Care and Psychooncology Models, and Contextual Model of Health Related Quality of Life. The AC provided input into the culturally relevant modifications of the American Society of Cancer Oncology (ASCO) TSSCP template to create the TSSCP-AA and TSSCP-S. Health care professionals enlisted from cancer centers and community hospitals (n=51) evaluated the TSSCP-AA and TSSCP-S templates on the following domains: content, clarity, utility, and cultural and socioecological responsiveness. Results: AC input revealed that the clinical (i.e., comorbidities) and cultural contexts (i.e., language, spirituality) must inform TS and SCP, respectively. Preliminary evaluation analyses documented that health professionals rated our TSSCP-AA and TSSCP-S templates as excellent to outstanding on content, clarity, utility, cultural responsiveness, and socioecological responsiveness (p<0.01). Conclusions: The evaluation results imply that the TSSCP-AA and TSSCP-S templates achieved cultural responsiveness with high acceptability and utility among professionals and survivors. We created both paper and electronic versions of theTSSCP-AA andTSSCP-S (English and bilingual English-Spanish formats) for providers to create individualized TSSCPs. Further, our TSSCP development approach can be adopted for TSSCP template development targeting ethnic/linguistic minority cancer survivors.
Purified dry extract of Paullinia cupana (guaraná) (PC-18) for chemotherapy-related fatigue in patients with solid tumors: An early discontinuation study.
Authors: del Giglio Adriana Braz , Lerner Tatiana Goberstein , Paiva Henrique Soares , Azevedo Renata Guise Soares , tuma Guariento Ricardo , Goldman Cecilia , Carelli Bruno , Schindler Fernanda , Pianowski Luiz , Cruz Felipe Melo , Del Giglio Auro 
Published: March 2020

e20680 Background: Paullinia cupana (guaraná) is an Amazonian plant that has been previously shown to be effective in treating chemotherapy-related fatigue (CRF) in patients with breast cancer. We aimed to evaluate the efficacy of a purified dry extract of P. cupana (PC-18) in patients with various solid tumors treated with chemotherapy. Methods: We included 40 patients with solid tumors who showed increases in their Brief Fatigue Inventory (BFI) questionnaire scores after one week of systemic chemotherapy. PC-18 was administered at 37.5 mg by mouth two times per day (PO bid), starting after one week of chemotherapy, for three weeks (induction phase). Patients who had an improvement in or stabilization of their BFI scores were randomized to receive either PC-18 at the same dose or placebo for the following three weeks (maintenance phase). Results: After PC-18 treatment, the BFI fatigue scores improved or stabilized in 36 out of the 40 patients (mean BFI score difference = 2.503; 95% CI: 1.716 – 3.375, P = 0.0002). Three weeks after randomization (16 patients on PC-18 and 17 on placebo), we observed no significant differences in the BFI, FACIT, HADS, and PSQI scores between patients randomized to PC-18 versus placebo. Conclusions: We conclude that the PC-18 extract is effective for the treatment of CRF in patients with a variety of solid tumors. A conditioning effect, which was observed in patients with early positive effects of PC-18 on CRF, may explain the better than expected fatigue scores of the placebo-treated patients.
More positive attitude and less symptom burden for male smokers with lung cancer.
Authors: Niu Zhimin , Wang Yongsheng 
Published: March 2020

e20692 Background: Cigarette smoking causes many kinds of cancer, and it is more closely related with lung cancer, rather than other cancers. Smoking is the leading cause of lung cancer and ninety percent of the smokers are male in China, but there is little published data concerning the psychological responses in the male smokers with lung cancer and its influence on the symptom burden. The aim of the study is to verify the hypothesis that male smokers with lung cancer have more positive attitude and less symptom burden, comparing to male non-smokers. Methods: 194 men with cancer in West China Hospital, Sichuan, China, were assessed by self-administered questionnaire. Psychological response was measured by the Chinese version of Mini-Mental Adjustment to Cancer scale (Mini-MAC), and symptom burden was measured by the physical symptom distress scale from the Rotterdam Symptom Checklist (RSCL). Results: We found that smokers with lung cancer got higher scores in Positive Attitude and less symptom burden than non-smokers. Patients with degrees lower than high school got higher scores of positive attitude comparing to college graduate patients (p=0.038). Smokers with lung cancer who knew the potential carcinogenicity of cigarette showed less negative emotion (p=0.011). The psychological response was not affected by age, clinical stage, cell type, smoking duration and amount. Conclusions: Our study suggests that smokers with lung cancer have more positive attitude and less symptom burden, and prone to accept subsequent treatment.
Advanced gynecologic cancer patients and healthy parents: Emotional distress and information given to their children.
Authors: Rodriguez-Morera Anna , Limonero Joaquin T. , Barretina Pilar 
Published: March 2020

e20704 Background: Describe relationship between advanced gynaecologic cancer (AGC) patients and healthy parents emotional distress (ED) and information amount related to the disease they give to their children. Methods: We studied 28 children, aged between 5 and 18 years, whose mothers had AGC, 13 breast (72.2%), 2 cervix (11.1%) & 3 ovarian (16.7%). Interview with numerical scale from 1 to 10 points was used to assess the amount of children's information described by parents. Hospitality Ansiety Depression Scale (HADS) was used to assess parents ED. Parents and children older than 12 years gave Informed Consent. Results: 18 mothers diagnosed of AGC were included. They added up to a total of 31minor children (M=1.7;SD=0.7) 3 of them, younger than 5 years old were excluded. Emotional distress of parents did not significantly correlate with the number of minor children they had. In the other hand, depression symptoms increased with the duration of disease, for patients and healthy parents (rho=0.5,p<.01;rho=0.6,p<.01) also when patient's functional capacity decreased (rho=-0.4,p<.05;rho=-0.5,p<.05). Mothers gave the information in 60.7% of the cases, 35.7% both parents shared this task. Anxiety among patients (M=10.21;SD=5.4) and healthy parents (n=13,M=8.8;SD=4.8) had not significant correlation with the amount of information given (n=28,rho=-0.01,p>0.05;n=19,rho=-0.2,p>.05). Patients (M=7.3;SD=4.2) and healthy parents (n=13,M=5.2;SD=3.1) depression grade did not correlate with the amount of information children had (n=28,rho=0.2,p>.05;n=18,rho=-0.1,p>.05). Information given by mothers was slightly higher (M=6.8; SD=2.3), it was the same for sons and daughters (U=93.5,p>.05). Yet, fathers tended to give more information to daughters (M=6.2; SD=1.8;U=22.5,p=0.06). Information given by patients and healthy parents was concordant (rho=0.5;p<.05). Conclusions: AGC patients and healthy parents ED is not related with the information amount parents give to their children. We must be aware of the need to provide support to fathers during mothers’ disease in order to ease communication with the children, taking into account that mothers are who mainly give information to their children.
The incidence of anxiety and depression in adult cancer outpatients in an area of social deprivation.
Authors: Chapman Hannah Louise , Melcher Lucinda , Shute Justin 
Published: March 2020

e20709 Background: Psychological distress is common in cancer patients and negatively impacts patient quality of life. Untreated depression predicts early death in patients with advanced cancer. Anxiety and depression may be unrecognised in cancer patients as symptoms can be mistakenly attributed to the underlying malignancy. We assessed the incidence of anxiety and depression in patients attending two hospitals located in areas of significant social deprivation and ethnic diversity. Methods: Patients attending the oncology department at North Middlesex University Hospital and Princess Alexandra Hospital during a one week period were invited to complete a questionnaire. We collected socio-demographic data. The rest of the questionnaire consisted of the Hospital Anxiety and Depression Scale (HADS). HADS is a 14 question, validated screening tool. Total scores range from 0-42, but can be divided into two subscales: HADS-D for depression and HADS-A for anxiety. Interpretation is based primarily on cut-off scores suggested by the test’s authors. In a previously reported non-clinical sample, mean total HADS was 9.82, HADS-D 3.68 and HADS-A 6.14. Results: 96 patients completed the questionnaire. 64 out of 96 patients (67%) were aged between 50 and 79 years. The majority were of white UK ethnicity. The most common types of cancer were breast and colorectal. Seventy five patients (78%) had a ‘normal’ total HADS (≤14). The mean scores for total HADS, HADS-D and HADS-A were 10.53, 4.61 and 5.93, respectively. On the HADS-A subscale, 14 patients had mild anxiety, 12 had moderate and 2 patients had severe anxiety. Depression scores were slightly lower: 12 patients had mild depression and 4 had moderate depression. No patient had severe depression. Only 6 (6%) patients reported taking anti-depressant medication. Conclusions: We demonstrate lower levels of anxiety and depression in a mixed group of cancer patients than previously reported. We explore the possible causes for this difference. Thresholds set to identify ‘cases’ in a non-clinical population may be too high for cancer patients. HADS is a useful screening tool in oncology patients but should be combined with clinical assessment to improve sensitivity and specificity.
Sorafenib (SFB) low dose in octogenarians with advanced or inoperable (a/i) HCC: Toxicity and efficacy evaluation.
Authors: Carreca Ignazio Ugo ,   A.I.R.O.N.A.-i.a.o.r.g..-S.I.C.O.G.
Published: March 2020

e20719 Background: HCC accounts for approximately 90% of all primary liver cancers, and is the fifth most common cancer in the world. So far prognosis of AHCC is very poor, particularly if consider very elderly pts. Treatment with SFB at standard dose may results in untolerable toxicity especially in very old people with HCC Cancer Aim of the study is to investigate if SFB at reduced dose is efficient and tolerable in octogenarian people with HCC. Methods: 30 patients,16 male and 14 female with AHCC histologically proven were enrolled; mean age was 79. Main Inclusion Criteria: Child-Pugh A or B; adequate liver, hematological, and renal function; informed writed consent acquired. Comprehensive Geriatric Assessment (CGA) according to Balducci’s classification and PFS (ECOG) not greater then 1 were considered as well. Serum CgA, VEGF and αFP were evaluated at baseline. Response evaluation were according to RECIST. Results: Pts received SFB 400 mg p.o., daily until intolerable ADRs or progression disease No discontinuation of treatment was needed for all pts; only 6 pts experienced severe ADRs not discontinued treatment withdrawal was needed. Pts with good OS (median value:11mths) showed also lower values of serum CgA and VEGF better than pts with poor prognosis. This outcome is under investigation. Conclusions: SFB could be administered with “not inferiority criteria vs SFP std treatment. Even if increased age is poor prognostic factor for tolerability, the reduction of dose don’t seem to reduce the efficacy of treatment in this group of patients. On the other hand the minimization of ADRs positively affects the quality of life. Further data were needed to assess how the lower values of serum CgA and VEGF levels, could play a role as new prognostic factors in HCC advanced or inoperable in octogenarian people.
Cognitive function in breast cancer and lymphoma patients receiving chemotherapy: An ongoing nationwide University of Rochester Cancer Center (URCC) Community Clinical Oncology Program (CCOP) observational study with 1,200 patients and controls.
Authors: Janelsins Michelle Christine , Mustian Karen Michelle , Yao Song , Heckler Charles E. , Palesh Oxana , Ontko Mary , Dakhil Shaker R. , Smiskol Paul , Melnik Marianne , Gross Howard M. , Ahles Tim , Ambrosone Christine B. , Morrow Gary R. 
Published: March 2020

TPS9647 Background: Chemotherapy-related cognitive impairment (CRCI) is a major concern for up to 75% of cancer patients that can negatively affect quality of life. Studies which have objectively assessed cognitive function (CF) in patients suggest that chemotherapy is associated with declines in multiple domains. A large, prospective longitudinal study with age- and gender- paired healthy controls is needed to confirm and expand these findings, to identify etiological mechanisms of CRCI, and to identify the best assessment methods for detecting CRCI. Methods: We are conducting a nationwide prospective observational study (N=1,200), conducted through the URCC CCOP Research Base and 23 CCOPs. The primary aim is to test the hypothesis that breast cancer and lymphoma patients receiving chemotherapy will have greater impairments in CRCI over time than a control comparison group. Breast cancer (stage I-IIIc) and lymphoma patients (intermediate/high grade disease) meet the following eligibility: 1) chemotherapy naïve, 2) ≥21 years of age, 3) no CNS disease, 4) scheduled to receive a standard course of chemotherapy, and 5) no concurrent radiation. Healthy control participants meet eligibility criteria 1-3 and are the same gender and age as paired patients. CF is assessed at pre-chemotherapy (Assess. 1), post-chemotherapy (Assess. 2), and 6 months post-chemotherapy in patients; their paired controls are assessed at the same time intervals. CF is measured via: 1) Computer-based CANTAB neuropsychological (NP) battery (assessing memory (primary aim), verbal memory, sustained attention, processing speed, and executive function (secondary aims)), 2) paper-based objective NP assessment (secondary aims), 3) phone-based objective NP assessment (tertiary aims), and 4) Single item, patient-reported CF (tertiary aims). Blood is collected at Assess. 1 and 2 to explore inflammatory and genetic mechanisms. 807 participants have been enrolled in 21 months. Funding: U10CA037420-26 Supp. MCJ; U10CA037420, GRM; & URCC/RPCI Grant, MCJ & CBA. Clinical trial information: NCT01382082.
Evaluating unconscious bias: Speaker introductions at an international oncology conference.
Authors: Duma Narjust , Durani Urshila , Woods Cynthia Brooke , Kankeu Fonkoua Lionel Aurelien , Cook Joselle , Wee Christopher , Fuentes Harry E , Gonzalez-Velez Miguel , Murphy Martina Cathryn , Jain Shikha , Marshall Ariela Lucy , Graff Stephanie L. , Knoll Miriam 
Published: March 2020

10503 Background: Gender bias can be reinforced through the use of gender-subordinating language and differences in the forms of address. We examined how professional titles were used during speakers’ introductions at the American Society of Clinical Oncology (ASCO) Annual Meeting. Methods: A retrospective observational study of video-archived speaker introductions at the 2017 and 2018 ASCO annual meetings was conducted. Data were extracted by mixed-gender coders. Professional address was defined as professional title followed by full name or last name. Multivariable logistic regressions were used to identify factors associated with the form of address. Results: 2511 videos were reviewed and 812 met inclusion criteria. Regarding speakers’ characteristics, 530 (65%) were non-Hispanic white (NHW), 743 (92%) held a MD or MD-PhD degree, and 484 (60%) were an associate or full professor. Female speakers were less likely to receive a professional address compared to male speakers (61% vs. 81%, p < 0.001). Female speakers were more likely to be introduced by first name only (17% vs. 3%, p < 0.001). Males were less likely to use a professional address when introducing female speakers compared to male speakers (53% vs. 80%, p < 0.01). No gender differences in professional address were observed for female introducers (p = 0.13). Male introducers were more likely to address female speakers by first name only compared to female introducers (24% vs. 7%, p < 0.01). In a multivariable regression including gender, race, degree, and academic rank, male speakers were more likely to receive a professional address compared to female speakers (OR: 2.67, 95%CI: 1.81-3.94, p < 0.01). Black speakers of both genders were less likely to receive a professional address compared to NHW (OR: 0.10, 95%CI: 0.01-0.53, p < 0.01). Female gender was a predictor for a non-professional form of address (first name only) (OR: 9.50, 95%CI: 4.38-20.62, p < 0.01). Conclusions: When introduced by men, female speakers were less likely to receive a professional address and more likely to be introduced by first name only compared to male speakers. Selective use of forms of address may strengthen gender bias; more research is needed to explore the causes of this disparity and its influence.
The higher school of oncology: An educational program adopting the western oncology experience in Russia.
Authors: Baron Ekaterina , Sittig Michelle , Gushchin Vadim 
Published: March 2020

10512 Background: Disparities in current global oncology care are a major concern for many societies. Two-year oncological training in Russia is deficient in evidence-based medicine (EBM) and effective patient communication skills, despite the fact that these dictate the ability to provide optimal cancer care. We report a 3.5-year sustained program aimed at implementing Western-oriented education among young Russian oncologists to combat these educational deficiencies. Methods: The Higher School of Oncology (HSO) is a 5-year national competitive program established to supplement the traditional 2-year Russian oncology curriculum with an emphasis on patient communication, critical appraisal of oncologic articles, multidisciplinary cancer care, and program development. A total of 35 PGY1-4 residents (8-9 residents annually) have enrolled in the program. Expatriate Russian physicians practicing in the US led 140 online educational seminars with journal clubs and clinical case presentations. Communication skills were evaluated by an independent private educational group. Results: Significant improvement of EBM knowledge was marked among HSO residents, from inability to explain basic concepts to practicing and teaching EBM. Beginning in the 3rd year of the program, residents organized educational courses and conducted journal clubs for HSO and non-HSO colleagues. Residents of the program had higher patient communication scores compared to that of residents of standard Russian programs. HSO residents promoted the spread and popularization of EBM and a patient-centered approach among attending physicians, improving the quality of cancer care. The HSO also triggered imitation of similar projects in other residency programs. Conclusions: The HSO project has pioneered EBM training and led to systemic changes in cancer patient care for Russian oncologists. This model has shown success and may be useful in overcoming global medical educational disparities in other specialties and in other countries facing similar challenges.