bluuebunny/crossref_metadata_2025_split huggingface dataset:
M-palliative care link: Improving symptom control and information exchange among specialists and local health workers treating late-STAGE Tanzanian cancer patients.
Authors: Miesfeldt Susan , Ngoma Twalib Athumani , Mushi Beatrice , Ngoma Mamsau , Mahuna Habiba , Morse Robert , Ho Yun Xian , Quinn Erin , Lambden Kaley Xian , Sagan Sarah , Mmari Joshua , Mmbaga Elia , Lucas Frances L 
Published: May 2020

e24146 Background: Lack of effective end-of-life symptom control among late-stage cancer patients is a Tanzanian public health priority, calling for innovative community-based solutions. Mobile health technology holds promise; however, existing resources are limited and access to palliative care specialists is poor. This work aimed to develop a secure mobile-/web-based symptom assessment/control communication system (m-Palliative Care Link; mPCL) that extends access to a limited number of palliative care specialists (hereafter, specialists). mPCL is based on the existing patient-focused African Palliative care Outcome Scale (POS), adapted for mobile symptom assessment, and is designed to support end-of-life care coordination among specialists, patients/caregivers, and local health workers (LHWs) (i.e., user groups). Methods: In partnership with Tanzanian specialists, mPCL was developed following a user-centered design process. mPCL prototype usability testing was conducted with 5-7 participants per user group and included a combination of hands-on observations as well as collection of feedback on ease-of-use and recommendations for modifications. User input was incorporated into the mPCL prototype iteration, tested via field study with 45 late-stage cancer patients discharged from Ocean Road Cancer Institute in Dar es Salaam. A brief mPCL usability/utility survey, including closed- and open-ended survey items, was conducted with field study participants from user groups at six weeks. Results: Prototype usability test participants successfully used the application and indicated that it would be very helpful. Recommendations from usability testing included redesign data collection tools, simplify patient/caregiver application, and broaden clinical data access. Six-week field study survey data showed that a significant majority (range: 68-100%) of specialists and patients “definitely agreed” that mPCL improved patient-provider communication, symptom-based care, care access, both quality of life and care, and reduced need for travel. Nearly all specialists and patients (93% and 98%, respectively) reported that mPCL was easy to use. Conclusions: mPCL promises to assess and address the symptom-control needs of late-stage cancer patients. Due to its reliance on existing technology/personnel, mPCL should be sustainable and scalable among cancer patients and those with other chronic diseases in low resource settings.
A single-arm, prospective, multicenter study on the efficacy and safety of low-dose transdermal fentanyl patch in opioid-naive patients with moderate to severe cancer pain.
Authors: Liu Yong , Li Qing , Yu Yang , Wang Jie Jun , Shi Han Ping 
Published: May 2020

e24149 Background: The efficacy and safety of low-dose fentanyl transdermal patch (TDF) in the treatment of opioid-naive patients with moderate-to-severe cancer pain has no tyet been confirmed. There are little international studies, and none in mainland China. The aim of this study was to explore the effect and tolerability of low dose of TDF in opioid-naive patients with Chinese moderate-to-severe cancer pain, and evaluate the influence on quality of life and cognitive function. Methods: A prospective, single-arm, non-randomized, open-label, multicenter trial was conducted with 285 opioid-naivepatients with moderate-to-severe cancer pain in 14 tertiary hospitals in mainland China. The initial analgesic dose of TDF was 12.5 µg/h, pain assessment (pain score, pain relief and pain response rate) was performed every 3 days for a total of 9 cycles.Adverse reactions and events were monitored over 24 days. In the meantime, quality of life and cognitive function of patient were evaluated with EORTC QLQ-C30 and MMSE. Results: 285 patients with 267(92.00%) completed the trial were enrolled. The average age was 60 (range 28-87) and the average effective therapeutic dose was 6.3±6.08mg.The total pain relief rate was 98.12% (mean pain score ±SD, 5.7±0.89 vs 3.9±1.28; P < 0.001). The efficacy of low-dose TDF on pain relief was consistent in groups separated by gender (p < 0.001), age (p < 0.001), types of cancer (p < 0.001), and baseline pain intensity (p < 0.001). There were 79 patients (29.59%) in the low-dose subgroup, and the pain response rate of the low-dose subgroup was better than other dose groups within one week (p = 0.0018).The adverse effects were mild. The most common adverse reactions are constipation 7.87%, followed by nausea 11.24%, vomiting 4.12%, drowsiness 1.87% and urine retention 1.5%.There was no difference in the incidence of adverse reactions between the low-dose subgroup and the other groups (p > 0.05). Meanwhile, TDF improved the quality of life of patients with moderate-to-severe cancer pain (mean± SD: 46.44±16.96 vs. 67.04±18.02;p < 0.05), without impairing cognitive function(mean ±SD, 29.13±1.54 vs. 28.98±1.99; p > 0.05). Conclusions: Low-dose TDF is effective for opioid-naive patients with moderate-to-severe cancer pain. Adverse reactions are mild and the quality of life of patients is improvedwith little losson cognitive function. Further randomized controlled studies are warranted to investigate the value of low-dose TDF in the treatment of opioid intolerant cancer pain. Clinical trial information: ChiCTR-ONC-17014080 .
Concomitant limb cryocompression and scalp cooling to reduce paclitaxel-induced neuropathy and alopecia.
Authors: Sundar Raghav , Magarajah Gayathiri , Ow Samuel Guan Wei , Chan Gloria , Choo Joan , Eng Lim Siew , Wong Andrea , Vijayan Joy , Hairom Zarinah , Ang Emily , Paxman Richard , Wilder-Smith Einar , Thakor Nitish , Lee Soo-Chin , Bandla Aishwarya 
Published: May 2020

e24157 Background: Scalp cooling is an FDA approved method to mitigate chemotherapy-induced alopecia (CIA) caused by paclitaxel. Chemotherapy-induced peripheral neuropathy (CIPN) is a dose limiting toxicity of paclitaxel. Several recent randomized studies have suggested limb hypothermia as a mechanism to ameliorate paclitaxel-induced neuropathy. The safety, tolerability and feasibility of concomitant limb hypothermia and scalp cooling to prevent these two common adverse effects of paclitaxel has not been previously studied. Methods: A proof-of-concept study was conducted in breast cancer patients receiving weekly paclitaxel chemotherapy. Each subject underwent concomitant scalp and four-limb cryocompression with each chemotherapy infusion (3 hours) for a maximum of 12 cycles. Limb cryocompression was administered at cyclic pressure (5-15 mmHg) and temperatures starting at 11°C (established as lowest tolerable temperature in a separate healthy volunteer study) and adjusted according to patient tolerability. Skin surface temperature and tolerance scores were recorded. CIPN was assessed via EORTC Quality of Life Questionnaire-CIPN before (QOLpre), after completion (QOLpost) and 3-months post chemotherapy (QOL3m). Results: Fifteen patients enrolled in the study, of which 14 completed all 12 cycles of concomitant scalp cooling and limb cryocompression during chemotherapy without any side effects barring transient erythema over the limbs. None had intolerance to scalp cooling. Eight patients safely tolerated 12 cycles of cryocompression at 11°C. Of the remaining, 6 completed all 12 cycles at device temperatures ranging from 14-25°C. One patient withdrew at the 6th cycle, finding 25°C intolerable. Median QOLpre was 19 (range 17-19), QOLpost 20 (18-29) (p = 0.04, Wilcoxon signed-rank) and QOL3m was 19 (18-21) (vs QOLpre; p = 1). QOL showed no significant differences from pre-chemotherapy to 3 months post-chemotherapy suggesting preservation of nerve function. Conclusions: Delivery of concomitant scalp cooling and limb cryocompression is feasible, safe and generally well-tolerated. Future limb hypothermia trials should not preclude patients from undergoing scalp-cooling concomitantly to reduce CIA. Clinical trial information: NCT03248193 .
Evaluation of immune-related adverse events (irAE): Utilizing the patient-reported outcomes of the common terminology criteria for adverse events (PRO-CTCAE) in a phase II study of ipilimumab (ipi) in men with castration-sensitive prostate cancer (CSPC).
Authors: Vargas Pivato de Almeida Daniel , Anderson Justine , Danila Daniel Costin , Morris Michael J. , Slovin Susan F. , Abida Wassim , Dayan Erica Simone , Curley Tracy , Arauz Gabrielle , Baser Raymond E , Scher Howard I. , Autio Karen A. 
Published: May 2020

e24174 Background: Incorporation of the PRO-CTCAE during chemotherapy is associated with fewer ER visits and improved survival. Limited data exist using this tool to capture irAE in immunotherapy trials. We collected select PRO-CTCAEs in a clinical trial evaluating an immune checkpoint inhibitor (ICI) in patients (pts) with CSPC. Methods: Cohort A (Coh A) enrolled de novo metastatic CSPC; Cohort B (Coh B) enrolled recurrent CSPC after radical prostatectomy (RP). Treatment consisted of 4 doses of ipi and 8 months of androgen deprivation therapy (ADT) in Coh A & B, and RP in Coh A. PRO-CTCAEs were collected at each ipi or ADT administration, and during follow-up. PRO-CTCAE items included abdominal pain, diarrhea, fatigue, anorexia, nausea, vomiting, rash and pruritus, with the correspondent attributes of frequency (freq), severity (sev), interference (int), and presence. Results: 16 pts were treated (Coh A: 7; Coh B: 9) with 181 matched pairs of PRO-CTCAE and CTCAE. The study was terminated early for an unfavorable risk:benefit ratio. PRO-CTCAE completion at required visits was 85.4% in Coh A and 98.1% in Coh B. Cohen’s kappa coefficients was lowest for pruritus (k = 0.10, slight agreement) and highest for rash (k = 0.64, moderate agreement). CTCAE captured diarrhea in 10 pts, 4 of whom received steroids. 75% (3/4) of pts receiving steroids graded diarrhea as ‘frequently’ or ‘almost constantly’ on the PRO-CTCAE while 66.7% (4/6) of those who did not receive steroids reported the same frequency. Conclusions: IrAE were more commonly reported and of higher grade by patients using the PRO-CTCAE as compared to clinician reporting, consistent with existing literature in non-ICI studies. Diarrhea as reported by the PRO-CTCAE did not associate with steroid use in this small trial. Further studies are needed to evaluate irAE using PRO-CTCAEs and the potential role in management of these toxicities. Clinical trial information: NCT02020070 . [Table: see text]
Cannabis and cancer: Examining the use and perceived benefits in an Irish cancer cohort.
Authors: coyne zac , Cowzer Darren , Hennessy Maeve , Linehan Anna , Hennessy Bryan T. , Grogan William , Breathnach Oscar S. , Morris Patrick G. 
Published: May 2020

e24178 Background: Medicinal cannabis is currently approved for symptom control in cancer patients. There is limited evidence to suggest cannabis is efficacious in the treatment of cancer. In this study we aim to characterise the extent of cannabis use in patients receiving anti-cancer therapies and what impact they think cannabis use has on their cancer. Methods: An anonymous survey was distributed to patients with cancer attending the Beaumont Hospital Oncology Day Unit for anti-cancer therapy over a period of 4 weeks. Results: 175 patients completed the survey. 166 (95%) of patients said they would be comfortable talking to their oncologist about cannabis use. 161 (92%) felt their oncologist should prescribe cannabis as part of their cancer treatment. 17% thought cannabis would cure their cancer. 38% thought cannabis would slow the growth of their cancer and 33% thought cannabis would treat cancer related symptoms. 42 (24%) of all patients had tried some form of cannabis at least once in their life. 26 (15%) were actively taking CBD (Cannabidiol) oil as part of their treatment independently of any healthcare professional guidance. More females (15) were taking CBD compared to males (11). A higher proportion of patients < 50 years (14) were taking CBD during their treatment. 30% of patients using CBD had breast cancer and 23% had a primary CNS malignancy. Of the patients taking CBD, 20 (77%) patients felt it would cure or slow cancer growth and 10 (38%) patients believed it would help with cancer related symptoms. Conclusions: Patients with cancer appear to have a positive attitude towards cannabis as part of their treatment despite limited evidence to support this. With the increasing availability of cannabis-based products globally, medical oncologists must now take into consideration patient’s attitude towards cannabis while treating their cancer. [Table: see text]
Streamlining survivorship care plan (SCP) creation and delivery to primary care providers in poor, rural, and minority patients.
Authors: Tawfik Bernard , Jaffe Shoshana Adler , Oomen-Hajagos Jamina , Mohler Lisa , San Gil Inigo , Kano Miria Adler , Ryan Shawnia R , Abernathy Janet , Wiggins Charles , Sussman Andrew , Dayao Zoneddy R. 
Published: May 2020

e24181 Background: The number of cancer survivors is rapidly climbing due to increased screening and improved treatment. Survivorship Care Plans (SCPS) summarize the patients’ treatment and is a communication tool between oncologists and primary care physicians (PCP)s. Creation and delivery of the SCPs has been labor intensive and costly for many healthcare systems and a previous paper based system at our institution was ineffective. The University of New Mexico Comprehensive Cancer Center (UNMCCC) treats a unique population of lower socioeconomic status (SES) (poverty rate 19.7%), rural (22.6%) and minority (Native Americans and Hispanics constitute 10.4% and 48% of the population respectively) patients in a large rural state. Methods: Beginning March 2019, UNMCCC initiated a process for creation and delivery of SCPs through the Electronic Medical Record (EMR). EMRs are not designed to delivery SCPs to patients and PCPs, so EMR functions were creatively repurposed. Upon identification of eligible patients, providers would place an electronic SCP order through the EMR. Designated staff then partially completes the SCPs based on medical record review while the EMR imports demographics, PCP, cancer and stage. Then the EMR flags SCPs ready for delivery and the provider edits, approves and prints the SCP for the patient at the next encounter. Once printed, the EMR alerts medical records to send the SCP to the PCP via mail or EMR routing. Results: 282 SCPs were ordered, 222 (78.7%) were created and 86 (38.7%) given to patients after definitive therapy of Breast (77.9%), Colorectal (7.0%), Gynecological (9.3%) and Prostate Cancer (5.8%). Of 72 SCPs eligible to be sent to PCPs, 48 (66.7%) were successfully mailed or sent via EMR, 13 (18.1%) had PCP discrepancies, 6 (8.3%) had no PCP and 5 (6.9%) had PCPs in systems which do not accept unsolicited records. Conclusions: The UNMCCC cares for low SES, rural and minority patients and was able to create and deliver SCPs to a significant number of patients and PCPs. Future process steps will involve creating tailored SCPs for other diagnoses, resolving PCP discrepancy issues and creating an EMR alert for PCPs when they receive an SCP. Additionally, assessment of both patient and PCP perceptions is ongoing.
Effect of adolescent and young adult cancer placements on advanced communication skills.
Authors: Hatcher Helen , Magrath Cameron , Hatcher Debbie Critoph 
Published: May 2020

e24182 Background: Communication with adolescent and young adult cancer (AYA) patients and their families can be challenging and requires extensive skills, often developed over time. Medical students can be afraid to encounter such challenges and treating teams can be protective of these vulnerable patients. Therefore, medical students can have little contact and experience communicating with AYA putting them at a disadvantage. We have developed a special study module (SSM) for students with the AYA multi-disciplinary team to promote student awareness of the unique challenges of communicating with AYA patients and provide essential skills for later practice. We present the findings from the first year of this module. Methods: Students at the University of Cambridge were offered a 6-week placement with the AYA cancer service. This involved shadowing members of the multi-professional cancer team and time on the AYA ward to talk with patients and their families in order to practice triadic communication skills. Mid-placement, an experiential learning experience with simulated patients focused on triadic interviews was also offered in line with our local clinical communication skills courses. After the module students were questioned about how they felt this had affected their practice and knowledge of communicating with AYA with cancer. Results: 12 students enrolled for the SSM over the year. All students found the placement widened their communication skills as well as their knowledge of AYA cancers and treatments. 4 main areas of learning were evident. 1.The problems faced by AYA patients as they try to establishing independent adult identities in the midst of severe illness or at the end of life and the implications for the triadic interview. 2. Information sharing during patient denial. 3. The AYA perspective: desire for control and their difficulty of communicating. 4.Challenges of communicating well in emotionally-charged situations. Conclusions: Experiential learning during the placement highlighted techniques for balancing both patient and parental involvement during consultations to maximise efficacy of information gathering. AYA cancer placements provide opportunities to develop advanced communication skills and can be augmented with experiential learning.
Individual and community respite as supportive care for adult cancer patients, their caregivers and their families.
Authors: Schankweiler Marcella 
Published: May 2020

e24183 Background: When a young adult (ages 24 to 55) is diagnosed with cancer, the entire family is traumatized. The psychosocial, emotional, economic and spiritual concerns become forefront and often, the family unit is unable to cope with a potentially devastating outcome. Respite becomes helpful in in addressing these traumas by providing a haven for honest, open dialogue about coping with today and preparing for an uncertain future. Each patient and family are provided a seven-day respite experience to a mutally selected destination suitable for travel and congruent with the family's psychosocial needs at the time with limited programming and schedule flexibility. Methods: Respite impact will be presented with qualitative and quantitative outcome measures provided by the treating clinicians. Using a multidisciplinary approach as outlined by a FPS program committee comprised of nominating oncologists, nurses, social workers and patient coordinators, these measurements are gathered both pre and post respite and gauge the patient/caregivers/children ability to cope with cancer after respite experiences. Further, the treating clinician observes and assesses said parties' ability to cope upon respite completion and return to clinic. Results: See table below. Conclusions: Studies support that respite is critical as complementary therapy in treatment protocol in the adult population segment with young families. Care-free, cost-free organized respite helps improve one's overall coping with a cancer diagnosis, improves the families' psychosocial health, results in increased communication and strengthened relationships as a family unit, reduces anxiety and improves patient compliance with future treatment protocol. FPS has also studied the impact of group respite v. individual respite and documents that a group setting lessens anxiety, strengthens relationships and promotes communication with peer support. Best practices from this respite program can assist in both short term and long term psychosocial and mental health of patients and their families so to optimize coping and healing related to cancer. [Table: see text]
Quality assessment of online hepatocellular carcinoma patient education materials.
Authors: Li Jim (Zhang Hao) , McLeod Jane , Ingledew Paris-Ann 
Published: May 2020

e24184 Background: Hepatocellular carcinoma (HCC) is the fourth-leading cause of cancer-associated death in the world, claiming nearly 800,000 lives each year globally. Concurrently, an increasing number of patients are using the Internet as a source of health information. However, limited research has been done on assessing the quality of HCC websites. Therefore, we aim to systematically evaluate the quality of online HCC information to illuminate its current strengths and limitations. Methods: The term “hepatocellular carcinoma” was searched using Google, Dogpile, and Yippy. The overall highest-ranked 100 (“top 100”) websites were extracted based on pre-specified inclusion and exclusion criteria. A validated, evidence-based tool was used to evaluate their quality based on several benchmarks such as website affiliation, accountability, interactivity, structure & organization, readability, and content quality. Results were evaluated using descriptive and inferential statistics. Results: The search yielded over 1,100 websites. Of the top 100 websites, 53% were commercial in nature. Although 95% disclosed ownership, other measures of accountability were poor – only 30% identified their author(s), 42% cited sources, and 33% were updated within the past two years. Average readability was judged to be at a grade 11.8 level using the Flesch-Kincaid grading system, and 10.4 using the SMOG index. Both estimates were significantly higher than the traditionally recommended grade-six level ( p < 0.0001 for both). Prognosis, prevention, and incidence were the least commonly covered topics (33%, 46%, and 50% respectively). All other topics were covered with “mostly accurate” or “completely accurate” information by over 70% of websites (Table). Overall, non-commercial websites were higher in quality compared to their commercial counterparts ( p < 0.002). Conclusions: Content accuracy is generally high. However, authorship disclosure, attribution, currency, and coverage in certain topics are deficient among many HCC websites. Additionally, difficult readability may pose a barrier for patient comprehension. Healthcare professionals should be aware of the limitations of online HCC information, in order to proactively guide patients to suitable resources and advocate for improvements in patient education materials. [Table: see text]