bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of brief-focused cognitive behavioral therapy in the reduction of cancer-related distress and emotive problems: A comparative study.
Authors: Rossi Alessandro , Marconi Maria , Mannarini Stefania , Minelli India , Bianchi Silvia , Verusio Claudio 
Published: May 2020

e24169 Background: In recent years, there was an increase of cognitive-behavioral therapy (CBT) oriented brief-focused psychological intervention protocols for the reduction of cancer-related emotive difficulties that oncological patients have to face almost every day and that could have a negative impact on medical treatment (Di Matteo, Lepper & Croghan, 2006; NCCN, 2015). Thus, this study aimed to determine the effectiveness of a 10-session brief CBT (B-CBT-P) compared with a control group (CG). Methods: Participants ( n = 67; mean age = 63.11, SD = 12.1, 35 female) enrolled at the Oncology Day Hospital at the “Presidio Ospedaliero” of Saronno, ASST Valle Olona, Italy who undertook (B-CBT-P: n = 34) or non-undertook (CG: n = 33) a psychotherapy intervention – with one of two different psychologists (authors MM and MI) to avoid potential biases. Participants were tested with the Distress Thermometer and the Problem List (DT&PL) at the baseline (T1; overall McDonald’s omega = .90), at the end of the 10-sessions B-CBT-P (T2; overall McDonald’s omega = .89). Results: A multilevel-multivariate repeated measure regression analysis was performed – controlling for age, type and localization of tumor, and therapist. In line with psychotherapy protocol, results showed no statistical significant changes for ‘practical problems’ ( p = 0.0497 ns), ‘spiritual problems’ ( p = 0.321 ns), and ‘physical problems’ ( p = 0.206). Results revealed a statistical significance reduction of ‘relationships problems’ ( p = 0.015; pooled Cohen’s d = 0.341), ‘emotive problems’ ( p = 0.012; pooled Cohen’s d = 0.349), and the distress thermometer ( p = 0.008; pooled Cohen’s d = 0.373). Conclusions: Considering that emotive and relational problems, as well as distress, occurs frequently among oncological patients, this study is into an important area. Results suggest that B-CBT-P is statistically and clinically effective to improve the emotive and relational sphere of oncological patients. However, the small effect sizes found suggest that these short protocols may not be sufficient to bring important changes in the patient's life. This study opens up to the idea of improving these protocols so that the cancer patient can improve his quality of life – even with a few psychotherapy sessions.
Factors influencing patients’ decision to undergo scalp cooling in breast and gynecological cancer.
Authors: Elliott Elizabeth , Fracci Sarah , Lee Mary , Ferris Morgan , Rychlik Karen , Potkul Ronald , Lo Shelly S. , Thilges Sarah 
Published: May 2020

e24175 Background: Chemotherapy-induced alopecia is a common and distressing side effect associated with the treatment of breast cancer (BC) and gynecological cancer (GC). Scalp cooling (SC) during chemotherapy decreases hair loss; why patients opt in or out of SC is unknown. A pilot study was conducted to determine reasons for opting in or out of SC. Methods: Patients at Loyola University's Cardinal Bernardin Cancer Center with BC and GC who were offered SC from 4/11/18 to 6/26/19 were asked to complete a survey ranking the importance of pre-specified factors behind their decision to (or not) pursue SC. The study was approved by the IRB. Chi-squared and Fisher’s exact tests were used on categorical variables; Wilcoxon rank sum test was used on continuous variables to determine any difference between those who opted in or out of SC. Results: 23/31 patients who were offered SC completed the survey (n = 12 [52.2%] opted to pursue SC, n = 11 [47.8%] opted out of SC). The average patient age was 51. Among patients who opted to pursue SC, maintenance of a sense of “normalcy” ranked as the most important factor behind their decision, followed by the impact of hair loss on children and family. Among the patients who opted not to pursue SC, patients ranked the cost of SC as the most important factor behind their decision. There were no statistically significant differences between patients who opted to pursue SC and those who did not in age, cancer type, relationship status, income, ethnicity, employment status away from the home, or presence of children or partners living in the home. Conclusions: Maintenance of a sense of “normalcy” and cost of treatment were the most important reasons behind patients’ decision to undergo or not undergo SC. Data from this pilot study will be used in a larger prospective study to inform how reasons for and expectations of SC impact distress and QOL.
Use of artificial intelligence for analyzing emotion vs patient global impression of change of melanoma treatments.
Authors: Su Ashley , Dupuis Léonie , Jueng Jeremy , Kunadia Anuj , Brooks Ian , Sinha Ritika , Siddiqui Fahad , Maner Brittany , Harding Tanner , Burton Vernon , Dellavalle Robert , Seyffert Jennifer , Solomon James A. 
Published: May 2020

e24177 Background: The link between melanoma patients’ emotions and their impressions of treatments response are poorly understood. With the rise of social media, patients use online platforms to communicate their concerns related to melanoma treatments. In this study, we utilize real-world data collected from social media with search terms focused on treatment-specific Patients’ Global Impression of Change (PGIC) compared with their emotions. We aim to identify and focus melanoma patient perspective trends to improve patient-centered care. Methods: Social media data mining of search terms were extracted from millions of publicly available interactions on Twitter and other online platforms from May/2008 to January/2020 using Crimson Hexagon (database of real-time social media posts). Results: For chemotherapy posts, the top three emotions by volume were negative alongside negative PGIC “worse” (Worse/Sadness 700, Worse/Fear 596, Worse/Disgust 403, and “decline” (Decline/Sadness 262, Decline/Fear 186, Decline/Disgust 57). Interestingly, Sadness, Fear, and Disgust were as prevalent alongside positive PGIC “well” and “cured” (Well/Sadness 3577, Well/Fear 2545, and Well/Disgust 1770; Cured/Sadness 518, Cured/Disgust 275, and Cured/Fear 167). For Keytruda treatment posts, emotions in negative PGIC “worse” were (Worse/Fear 117, Worse/Anger 68, Worse/Sadness 6). In positive PGIC “well”, results were (Well/Fear 880, Well/Sadness 366, Well/Anger 186). Further analysis will compare these emotional sentiments with a spectrum of PGIC terms and specific types of melanoma treatments. Conclusions: To our knowledge, this is the first investigation of online patient melanoma treatments associated with PGIC terms. The findings indicate a trend of negative emotions even when patients have reported wellness or being cured by treatment. While treatments may be effective, patients are not necessarily satisfied. Correlating changes in emotions with perceived changes in disease severity can provide insight into patient perspectives, which has implications in translating clinical response and a need for continued emotional support in patients with treatment response.
Use of a patient-preferences shared-decision-making encounter tool in clinical practice for patients with non-Hodgkin’s lymphoma.
Authors: Wujcik Debra , Mehta Amitkumar N. , Corona Rachel , Cook Felice , Dudley Matthew , Dudley William 
Published: May 2020

e24192 Background: Non-Hodgkin lymphoma (NHL) is the fourth leading cause of cancer in the United States with 77,240 new cases and 19,940 deaths annually. Treatment options are numerous and driven by patient’s molecular profile, risk, preferences/goals, and ability to tolerate treatment. Aligning physician-patient goals of care and integrating patient preferences into a shared-decision making (SDM) model allows patients and providers to select treatment consistent with medical science and personalized to each patient. This project evaluates feasibility of a patient preferences (PP) SDM encounter tool using technology to facilitate SDM at treatment decision (TD) for patients with NHL. Methods: To date, 45 patients with NHL at a TD making point were recruited from two sites to complete a tablet-based PPSDM encounter tool. The tool includes questions about needs, decision making preferences, values and goals of care. Results are reviewed by the provider and used to facilitate SDM in treatment selection during the clinical encounter. Patients also completed measures to assess satisfaction with the TD, patient activation, and perceived achievement of desired role in SDM at 3 weeks and 3 months post TD. Results: Participants are mean age 66 years (range 23-86), 53% male, and 98% white. 47% (n = 45) preferred that their doctor share responsibility with them when deciding which treatment was best for them. 69% said they would like to make the TD together with family and close friends and 69% agreed that their spouse was the most important person in helping make a TD. 51% said spirituality did not play a part in their TD. When asked how they liked to get medical information, 67% said they wanted all the facts, but not the prognosis. 87% said they had identified a medical surrogate to make decisions, yet 31% had an advanced directive on file. 64% agreed their cancer was curable and 84% agreed that a treatment goal was to get rid of all cancer. 73% of providers used the PPSDM results in conversation with the patient and 53% indicated their patient management changed based on the PPSDM results. There was 24% concordance between patient and provider perception of how TD were made. Conclusions: Collecting patient preferences, values, and care goals prior to the clinical visit using technology is feasible in busy clinics. Although most providers used the PPSDM results and over half changed their management plan, there was low concordance between patient and provider perceptions. Final analysis will include 3 week and 3 month measures of patient activation and satisfaction.
Depression in cancer: An evaluation of patient education resources.
Authors: Li Jim (Zhang Hao) , Wang Mingyang , Ingledew Paris-Ann 
Published: May 2020

e24194 Background: In recent years, there has been increasing awareness surrounding mental health and depression among cancer patients. Concurrently, the internet has cemented its role as a mainstay source of health information for the general public. However, little is known about the quality of online resources addressing depression specifically in cancer patients. Therefore, we aim to systematically evaluate the quality of such information. Methods: The term "depression in cancer patients" was searched online using the search engine Google and the meta-search engines Dogpile and Yippy. A set of predetermined inclusion and exclusion criteria was applied to all search results, which yielded 48 websites for inclusion. An evidence-based rating tool was then used to score the websites based on the six domains of Affiliation, Accountability, Interactivity, Structure & Organization, Readability, and Content Quality. The results were analyzed using descriptive statistics. Results: Of the 48 websites evaluated, 50% were commercial. In terms of accountability measures, 63% of websites disclosed authorship, 54% cited one or more reliable sources, and 38% were updated within the last two years. Although in-site search engines and video support were found in 94% and 52% of websites respectively, the presence of other interactive features were considerably lower. The average readability was at a grade 12.3 level using the Flesch-Kincaid scale and 11.3 using the SMOG Index, both of which were significantly higher than the traditionally recommended grade-six level ( p < 0.0001 for both). The most commonly covered topics were symptoms and treatment – found on 87% and 83% of websites respectively. Prevention and prognosis were not covered by any of the websites. Content accuracy was generally high among covered topics. Conclusions: Many websites addressing depression in cancer have poor authorship disclosure, attribution, and currency. Additional interactive features should be encouraged to facilitate user-friendliness. Poor readability may pose a barrier for patient comprehension, indicating a need for health care providers to proactively guide patients to suitable resources. Despite high content accuracy in other topics, prevention and prognosis are seldom covered. Our results could help guide the development of new patient education materials and better inform health care providers about the limitations of available online resources. Future research should aim to elucidate reasons contributing to difficult readability levels and identify topics that patients need additional information in.
Gender and time estimation as novel potent indicators of emotional concerns in cancer patients.
Authors: Yanchev Asen , Ivanova Martina , Donev Ivan , Dimitrova Eleonora , Conev Nikolay Vladimirov 
Published: May 2020

e24195 Background: Psychological stress is frequent after a cancer diagnosis. Thus screening is crucial for detecting it. The emotion thermometers (ETs) are validated screening tools and have five dimensions (distress, anxiety, depression, anger, and need‐for‐help). Methods: Time estimation was assessed in 374 chemonaïve patients with solid tumors by evaluating each subject’s prospective estimation of how quickly one minute passed compared to the actual time. ETs were used at the beginning of treatment to evaluate level of psychological stress of each patient. A multivariate analyses of covariance was run for the ETs as dependent variables with the addition of the following covariates: age and time estimation and gender as a fixed factor. Results: There were significant negative correlations between values of ETs and time estimation except anger. Women exhibited significantly faster time estimation than men. Using Pillai’s Trace, we found that there was a significant effect of gender and fast time estimation on reported values of ETs (V = 0.06, F (5,366) = 4.96, p < .001; V = 0.05, F (5,366) = 3.84, p = .002, respectively). The covariate, time estimation, was significantly related to reported values of all ETs. There was also a significant effect of relationship on the gender and reported values of all ETs, except for depression and need-for-help after controlling for the effect of age and time estimation. Planned contrasts revealed that female are significantly more distressed, anxious and less angry when compared to males. Conclusions: Gender and time estimation are novel potent indicators of emotional concerns in cancer patients prior to starting chemotherapy.
The DISCO app: A pilot test of an electronic patient intervention to reduce the financial burden of cancer through improved cost communication.
Authors: Hamel Lauren M. , Dougherty David W. , Hastert Theresa A. , Seymour Erlene Kuizon , Kim Seongho , Assad Hadeel , Phalore Jasminder , Eggly Susan 
Published: May 2020

e24197 Background: Financial toxicity, the burden of treatment cost, affects 30-50% of people with cancer in the United States. Although experts recommend patients and oncologists discuss treatment cost to identify patients who need assistance, cost discussions occur in fewer than half of cancer treatment discussions. We pilot-tested the feasibility and efficacy of the Discussions of Cost (DISCO) App, a patient communication intervention designed to improve cost discussions and other financial toxicity-related outcomes during and following oncology treatment consultations. The DISCO App provides an individualized list of cost-related questions patients can ask their oncologist, specific to a patient’s economic situation. Methods: While waiting to see their oncologist, newly diagnosed patients with breast or lung cancer (n=32) used the DISCO App on an iPad. Clinic visits were videorecorded and patients completed pre- and post-intervention measures of self-efficacy for managing treatment costs, self-efficacy for interacting with oncologists, cost-related distress, and perceptions of the DISCO App. A trained coder observed the recordings to determine the presence of a cost discussion, the cost-related topic, and any emergent factors. Results: Findings showed increases in patients’ self-efficacy for managing treatment costs (p=.02) and interacting with oncologists (p=.001). Cost-related distress decreased but not significantly (p=.20). Patients reported the DISCO App was understandable (M=4.5 out of 5), useful as they talked with their oncologist (M=4.0), and 84% of patients reported needing less than 15 minutes to use the DISCO App. Most (94%) interactions were videorecorded (in two cases technical difficulties prevented videos from being collected); all (100%) of the videorecorded interactions included a cost discussion. The most frequently discussed topics were: insurance, time off from work, and financial navigation. Frequently, the oncologist asked the patient for his/her question list and discussed/answered the questions. Conclusions: Findings suggest the DISCO App is feasible to implement in the clinic and effective in improving patient-oncologist cost discussions and financial toxicity-related outcomes. Patient acceptance of the DISCO App and oncologist engagement suggested the intervention prompted cost discussions. Next steps include conducting a longitudinal randomized controlled trial to determine the effectiveness of the DISCO App on financial toxicity, and other outcomes. Clinical trial information: NCT03676920 .
Video conferencing long distance caregivers during oncology appointments: Implications for clinical practice.
Authors: Blackstone Eric , Park Sumin , Krishnamurthi Smitha S. , Bajor David Lawrence , Mazanec Polly , Day Kim , Douglas Sara L 
Published: May 2020

e24198 Background: Distance Caregivers (DCGs) – caregivers living > 1 hour away from the patient – face unique challenges regarding frustration at receiving second hand information about the patient’s condition and uncertainty regarding how to assist the patient. Videoconferencing allows DCGs to connect for the patient’s oncology appointments while avoiding costly travel expenses and time away from work and family. Methods: 441 patient-DCG dyads enrolled in a randomized controlled trial at a large, urban comprehensive cancer center. Patients of all cancer types were eligible if they had monthly oncologist appointments. DCGs were randomized to one of three arms. Arm 1 – received four monthly videoconference coaching sessions with a nurse or social worker, connected for the patient’s oncology appointments, and had access to a website designed for DCGs; Arm 2 – connected for the patient’s oncology appointments over four months and had access to the DCG website; Arm 3 – received access to the DCG website. To evaluate the impact on clinical practice, outpatient oncology appointments were timed. Helpfulness of the intervention was rated from 0-10 with higher scores representing greater amounts of helpfulness. Descriptive statistics, ANOVA, and Pearson’s correlation were conducted to describe features, determine group differences, and identify relationships among variables. Results: Mean helpfulness ratings were 9.06 (patients), 9.30 (local caregivers), 9.08 (DCGs), and 7.98 (oncologists). Average appointment times (in minutes) for Arm 1, Arm 2, and Arm 3 were 19.63 (SD = 7.69), 21.34 (SD = 9.95), and 17.80 (SD = 10.20), respectively. Arm 2 had significantly longer appointments than Arm 3 (mean difference: 3.54, p = .025). No relationships were found between length of appointment time and helpfulness ratings. Conclusions: The videoconferencing intervention was well-received by oncologists, patients, and DCGs. Appointments were longest in Arm 2, followed by Arm 1, then Arm 3 (control). It makes sense that connecting an additional person lengthened the meetings, but it was noteworthy that Arm 2 was longest. DCGs in Arm 2 (who did not have the coaching) likely had more unanswered questions that were discussed with the oncologist compared to Arm 1 DCGs. Cancer centers should consider this when implementing videoconferencing technology. Clinical trial information: NCT02666183 .
A phase III, randomized, double-blind study of adjuvant cemiplimab versus placebo post-surgery and radiation therapy (RT) in patients (pts) with high-risk cutaneous squamous cell carcinoma (CSCC).
Authors: Rischin Danny , Fury Matthew G. , Lowy Israel , Stankevich Elizabeth , Han Hyunsil , Porceddu Sandro 
Published: May 2020

TPS10084 Background: CSCC is the second most common skin cancer. While the surgical cure rate for CSCC is > 95%, a proportion of pts are considered to have high risk for recurrence as assessed by immune status, primary disease stage, extent of nodal involvement, presence of extracapsular extension, and prior treatment. Post-operative RT is recommended for pts with high-risk features, but relapse with locoregional recurrence or distant metastases may still occur. This study evaluates the efficacy of cemiplimab, a human anti‒PD-1 monoclonal antibody, as an adjuvant therapy for pts with CSCC with high-risk features, after surgery and RT. Methods: This randomized, placebo-controlled, double-blind, multicenter, Phase 3 study will evaluate cemiplimab as an adjuvant treatment for pts with high-risk CSCC, based on surgical and clinicopathologic findings, who have completed surgery and post-operative RT (NCT03969004). Immunocompromised pts were excluded. The trial will enrol 412 pts from about 100 sites in North America, Europe, and Asia-Pacific regions. Pts with at least one of the following high-risk features are eligible: a) nodal disease with extracapsular extension b) in-transit metastases c) T4 lesion d) perineural invasion, and e) recurrent CSCC with at least one other risk factor. In Part 1 (blinded), pts will be randomized 1:1 to receive cemiplimab 350 mg or placebo intravenously every 3 weeks (Q3W) for up to 48 weeks. In optional Part 2 (unblinded), pts in the placebo arm who experience disease recurrence or pts in the cemiplimab arm who experience disease recurrence ≥3 months after completion of 48-week treatment in Part 1 will be eligible to receive open-label cemiplimab 350 mg Q3W for up to 96 weeks. Key objectives are to compare disease-free survival (primary) as well as overall survival, freedom from locoregional relapse, and distant relapse (secondary) of adjuvant cemiplimab vs placebo in pts with high-risk CSCC. This study is currently open for enrollment. Clinical trial information: NCT03969004.