bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quality of life and current needs of cancer survivors enrolled in Humanitas Research Hospital's survivorship care model.
Authors: Lorenzi Elena , Morello Lucia , Giordano Laura , Agostinetto Elisa , Grosso Camille , Nicolosi Matteo , Garassino Isabella Maria Giovanna , Cavina Raffaele , Mazza Rita , Carlo-Stella Carmelo , Santoro Armando 
Published: May 2018

170 Background: While there are different studies investigating the quality of life (QoL) of cancer patients (pts) during active treatment, few studies report QoL of cancer survivors (CS) after at least 5 years (yrs) from achieving complete remission. We have investigated QoL and concerns about physical\psychological symptom of CS enrolled in our survivorship program from April 2015 to December 2016. Methods: We included pts > 18 yrs affected by hematologic or solid tumors after at least 5 yrs from achieving complete remission. A cross-sectional survey was carried out using validated scales: Cancer Survivors Survey of Needs subscale and a single-item measure of global QoL perception. Results: We analyzed data from 178 CS. The median age was 62 yrs (52 yrs at diagnosis), 70% were females. The most frequent histological types were breast (50%), colorectal (11%) and hematologic tumors (16%). Most pts received both chemotherapy and radiation therapy. With a median observation time of 139 months, the 10-yrs cumulative incidence of second neoplasm and cardiac adverse event was 8% and 7% respectively. 133 pts (65%) reported a good QoL (score > 3). The most frequent symptoms reported were weight changes (77%), memory\concentration deficit (65%), dental\mouth problems (61%). The most common physical\psychological symptoms were fear of relapse (83%), genetic counseling (68%), living with uncertainty (66%). A positive statistically significant association (p < 0.05) was observed between previous hormonal therapy and the following concerns (score ≥2): sleep disturbance (42% vs 35%); weight gain (31% vs 24%), osteoporosis (35% vs 18%), living with uncertainty (44% vs 38%). Female reported more fear of relapse (p 0.023) and sense of uncertainty (p 0.006) than males. 92% of pts have fully or partially adhered to the survivorship care plan. Conclusions: Most CS have a good QoL perception but we observed a high percentage of pts with a low score indicating different needs to be addressed. Pts treated with hormonal therapy are at higher risk of having both physical and psychological concerns. So far, the compliance of pts with the program was high.
Development of novel emoji scale to measure patient-reported outcomes in cancer patients.
Authors: Thompson Carrie A. , Novotny Paul J , Bartz Alicia , Yost Kathleen J. , Sloan Jeff A. 
Published: May 2018

174 Background: Patient-reported outcomes (PROs), including physical function and quality of life (QOL), are important outcomes in cancer patients. Emoji are a near-universal, popular form of communication, understandable by diverse populations, including those with low health literacy. We aimed to explore whether emoji could be a valid, reliable scale for assessing PROs in cancer patients. Methods: To develop the emoji scale, 5 emoji faces were selected from the Apple emoji dictionary by study authors. 20 cancer patients participated in a card-sorting exercise to rank the emoji from negative to positive; 19 out of 20 selected the same order, which exceeded Coomb’s criteria for being a valid ordinal scale. Patients were recruited from Mayo Clinic practices. Eligibility included: adult patients with a diagnosis of lymphoma, multiple myeloma, brain, pancreatic, breast, and ovarian cancer within the past 5 years; life expectancy of > 6 months; and own an iPhone version ≥ 5.0. All patients were provided with an Apple Watch and downloaded the study app. Baseline PRO data was collected on the iPhone, including single-item linear analog self-assessments (LASA) and emoji scales for fatigue, physical function, emotional well-being, and overall QOL. Results: From 2/2017-8/2017, 294 eligible patients were recruited. 25% were male, and median age was 53 years (range 20-79). The median time since diagnosis was 8.4 months (range 0-60); 63% were on active therapy, 27% were in observation post-treatment, and 10% had not been treated. All patients were “extremely” confident filling out forms, 99% had used a computer in the past 12 months, and 27% had ever used a smart watch. Emoji responses were significantly associated with validated measures of PROs; the Spearman correlations between the ordinal emoji scales and LASAs were -0.83 for fatigue, 0.72 for physical well-being, 0.72 for emotional well-being, and 0.77 for overall QOL (all p < 0.0001). Of the 75 patients who have completed the study thus far, 92% reported they would use emoji scales again and 89% would recommend that others use emoji scales. Conclusions: A novel ordinal emoji scale is strongly associated with accepted measures of PROs in cancer patients and should be studied further.
Marijuana/tobacco use and patient-reported outcomes (PROs) in adult survivors of childhood cancer.
Authors: Huang I-Chan , Klosky James L. , Bhakta Nickhill , Hudson Melissa M. , Robison Leslie L. 
Published: May 2018

175 Background: In 2017, the National Academy of Medicine reported adverse physical and psychosocial outcomes associated with marijuana use, and an increased risk of marijuana use among those who use tobacco. However, the association of marijuana and/or tobacco use with PROs has not been well-studied in survivors of childhood cancer. Methods: A random sample (stratified on self-reported smoking status) of 287 adult survivors of childhood cancer was selected from the St. Jude Lifetime Cohort Study. Chemotherapy and radiotherapy were abstracted from medical records. Marijuana use was self-reported and classified as past/current vs. never use. Current tobacco use was determined using serum cotinine concentrations by liquid chromatography tandem mass spectrometry. PROs were evaluated by physical and mental component summary (PCS and MCS) scores from the Medical Outcomes Study SF-36. Linear regression was used to evaluate associations of marijuana and tobacco use with PROs after adjusting for covariates, and the results were stratified by treatment modality. Results: Survivors’ mean age at study participation was 33.6 years (SD = 9.1), mean years from diagnosis was 24.2 (SD = 6.2). 61.3% used marijuana and 39.4% were current tobacco users. 79.3% of the tobacco users had marijuana use. Marijuana and tobacco were independently associated with lower PCS (βs = -3.1 and -2.9, respectively, p’s < 0.05) and MCS (βs = -3.3 and -3.2, respectively, p’s < 0.01). Among survivors who received chemotherapy, marijuana and tobacco were associated with lower PCS (β = -4.3, p < 0.01; β = -2.8, p < 0.05, respectively) and MCS (βs = -4.8 and -3.1, respectively, p’s < 0.05). In survivors who received radiotherapy, marijuana, but not tobacco, use was associated with lower PCS (β = -3.6, p < 0.05) and MCS (β = -4.6, p < 0.05). Among those who received neither chemotherapy nor radiotherapy, each substance was independently associated, but not significantly, with lower PCS and MCS. Conclusions: Among adult survivors of childhood cancer, marijuana users likely co-used tobacco, and both substances were independently associated with lower PROs. When associations with treatment exposures were assessed, different profiles of PRO scores were identified.
The Detroit Research on Cancer Survivors (ROCS) study: A focus on outcomes after cancer in a racially diverse patient population.
Authors: Beebe-Dimmer Jennifer Lynn , Albrecht Terrance Lynn , Ruterbusch Julie J. , Baird Tara , Hastert Theresa A. , Harper Felicity W. K. , Schwartz Kendra L. , Simon Michael S. , Schwartz Ann G. 
Published: May 2018

177 Background: Although we continue to make progress in reducing the incidence and mortality for most cancers in the United States, African Americans (AA) continue to experience higher cancer incidence rates and have worse survival than other populations. The causes of these poorer outcomes, from higher mortality to poorer quality of life, in AA cancer survivors are not well understood. The Detroit ROCS study was initiated to improve our understanding of the experience of AAs living with cancer. Methods: 1,000 AA and non-Hispanic white (NHW) patients with primary lung, female breast, prostate or colorectal cancer diagnosed on or after January 1, 2013, and/or treated at the Karmanos Cancer Institute in Detroit, MI were recruited to participate in a cohort study with planned follow-up for 4 years. At baseline, participants completed a web-based survey to gather information about their medical history, family history of cancer, treatment and medication use, behavioral risk factors and self-assessed quality of life. Statistical analyses were performed to examine racial differences in the distribution of patient characteristics including comorbid conditions, stage at diagnosis, first course treatment and reported health-related quality of life (HRQOL). Results: The majority of patients were AA (60%) and female (61%), with a median age at diagnosis of 60 years. AAs were older, more likely to report use of cigarettes and alcohol and report a greater number of comorbidities compared with NHW patients; they were less educated and less likely to be employed full time or married (all p-values < 0.001). AA patients reported poorer overall HRQOL compared with NHW patients (p-value < 0.001). Controlling for marital status and employment attenuated the observed racial differences in mean HRQOL scores across all measured domains. Conclusions: We observed significantly lower self-reported HRQOL among AA cancer survivors compared with NHW, which could be partially explained by differences in specific socioeconomic factors but interestingly, not the presence of multiple comorbidities. Future research efforts will evaluate the relative contribution of social and financial support to HRQOL in AAs.
Lifestyle and outcomes after gastrointestinal cancer: A prospective cohort study (LOGIC).
Authors: Savoie Marissa Barbara , Van Loon Katherine , Laffan Angela , Bocobo Andrea Grace , Zhang Li , Paciorek Alan T , Atreya Chloe Evelyn , Anwar Mekhail , Rowen Tami , Smith James F , Shumay Dianne , Kenfield Stacey A. , Chan June M. , Venook Alan P. , Van Blarigan Erin 
Published: May 2018

180 Background: The number of individuals living after a diagnosis of gastrointestinal (GI) cancer is increasing. Emerging data suggest modifiable lifestyle factors impact survival after colorectal cancer (CRC), however very little is known about survivorship in other GI cancers. Given the common thread of multimodality therapy among many GI cancer survivors, there is a paucity of data on sexual function, fertility, anxiety/depression, changes in comorbidities, and quality of life after cancer treatment. Additionally, existing cohort studies of GI survivors are primarily European, and further data are needed from survivor populations in the US . Methods: Patients of the University of California, San Francisco GI Oncology Survivorship Clinic who are designated disease-free are recruited by mail or in clinic. We send secure online questionnaires to participants every six months for five years and annually thereafter. At varying intervals, questionnaires solicit sociodemographics, diet, physical activity, fertility, medical and smoking history, fear of cancer recurrence, sexual health, quality of life, psychological well-being, and sleep quality. Pathoclinical disease characteristics, treatment, and recurrence status are abstracted from the medical record at baseline and updated annually. Results: Between February and August 2017, 111 patients were enrolled; 68% of participants completed ≥1 and 57% completed all baseline questionnaires. Most patients had a history of colon cancer (52%, n = 58) or rectal cancer (31%, n = 34). Other diseases include: anal cancer (12%, n = 13), gastrointestinal stromal tumor (3%, n = 3), and other GI cancers (3%, n = 3). Fifty-eight percent of patients were female, 76% identified as white and median age at diagnosis was 55 (range 20-81). Median time from initial GI cancer diagnosis to study entry was 27 months. Following the initial recruitment wave of established patients, the average rate of enrollment is ~3 patients/week. Conclusions: Results from this ongoing cohort study will improve our understanding of modifiable risk factors for GI cancer recurrence and key survivorship issues related to psychological well-being, sexual function, fertility management, and quality of life.
Adult cancer survivorship referrals for hereditary cancer genetic testing.
Authors: Walcott Farzana L. , Kaltman Rebecca Davidson , Hatcher Elizabeth , Ha Cam , Biagi Tara , Stark Elizabeth , McHenry Allison , Barbour April 
Published: May 2018

183 Background: Genetic testing for hereditary cancer syndromes is underutilized among cancer patients. Cancer survivorship clinics may identify individuals at risk for hereditary cancer. We present the number of referrals from George Washington (GW) Adult Cancer Survivorship Clinic (ACS) to the GW Ruth Paul Hereditary Cancer Program (RPHCP) to demonstrate the feasibility of identifying high risk individuals in cancer survivorship. Methods: We reviewed the number of patients seen at the GW ACS and subsequent referrals to the GW RPHCP for genetic counseling/testing. An IRB approved research registry was used for retrieval of the data. The ACS clinic is staffed by a physician internist trained in clinical cancer genetics and a nurse practitioner trained in cancer survivorship. Results: 261 patients were seen in ACS from January 1, 2016, to September 30, 2017. Twenty patients (7.6%) were referred to RPHCP based on personal/family cancer history. Three patients were not consented for the research registry, leaving a total of 17 patients for this analysis. Fifteen (88.2%) patients were referred by the physician and 2/17 (11.7%) were referred by the nurse practitioner. Sixteen patients had genetic testing (94.1%) and results were: 5/16 (31.2%) positive, 6/16 (37.5%) negative, and 3/16 (18.7%) had a variant of unknown significance (VUS). Results on 2 patients are pending. One patient deferred testing. Of the 17 patients referred, 14/17 (82.3%) had personal/family history of cancer and had seen an oncologist. Cancer sites and germline mutations identified were: bilateral breast cancer and bladder cancer (BRCA2), prostate cancer (MUTYH), breast and ovarian cancer (BRCA1), endometrial cancer (APC). One patient without cancer was referred by an oncologist for a previously identified familial MLH1 mutation, and was positive. Conclusions: Cancer survivorship clinics may identify individuals appropriate for genetic testing for hereditary cancer syndromes. This is likely an underestimate as not all cancer patients are seen in survivorship clinic. Systematic capture of personal and family history of cancer in cancer survivors may enhance utilization of genetic testing services among cancer survivors and identification of high risk individuals.
Utilization of a web-based survivorship and supportive oncology training curriculum for clinicians.
Authors: Penedo Frank J. , Roggenkamp Betty , Rosenberg Carol A. , Trosman Julia Rachel , Robinson Patricia A. , Knightly Eileen , Pasquinelli Mary , Khosla Paramjeet , Bowman Anne , Lillis Teresa , Gerhart James , Slocum Megan , Garcia Sofia F. , Berardi Rosa , Martin Joanna , Lo Shelly S. , Weldon Christine B. 
Published: May 2018

19 Background: A challenge in supportive oncology, integral to patient care, is training the health professional workforce. A collaborative funded by The Coleman Foundation of 30+ clinicians (faculty) from 25 institutions (academic, community & safety net) developed a unique fundamental survivorship care (Weldon JCO 2017) and supportive oncology training curriculum (Trosman JNCCN 2017). Methods: Using data from The National Comprehensive Cancer Network Continuing Education team, we analyzed utilization of survivorship and supportive oncology education courses using simple frequencies. Results: Over 3200 courses were completed (pretest, course, post-test, evaluation) and 4850 accessed. Nurses completed 56%, physicians 15%, social workers/psychologists/support staff 14%, advance practice clinicians 8%, and various roles for the rest. Courses in table. Conclusions: NCCN’s education portal achieved strong utilization from a variety of healthcare professionals in these courses. The Coleman Supportive Oncology Collaborative supports improvement in supportive care with tools, processes and training and will continue to update/offer courses through this portal.[Table: see text]
Impact of cancer survivorship care plans (SCPs) on health outcomes and health care delivery: A systematic review.
Authors: Jacobsen Paul B. , Derosa Antonio P. , Henderson Tara O. , Mayer Deborah , Moskowitz Chaya S. , Paskett Electra D. , Rowland Julia Howe 
Published: May 2018

2 Background: In 2006, the Institute of Medicine recommended that patients at or near completion of active treatment be provided with a SCP (treatment summary, relevant health information, and follow-up care plan) to improve care delivery and outcomes in the post-treatment period. We systematically reviewed published research to determine if SCPs have a positive impact on health outcomes and healthcare delivery. Methods: Randomized and nonrandomized studies evaluating patient-reported outcomes, healthcare utilization, and disease outcomes after delivery of SCPs were identified by searching MEDLINE, Embase, PsycINFO, and Cochrane Library. Data were extracted by independent raters and summarized based on qualitative synthesis. Results: Eleven nonrandomized and 13 randomized studies met inclusion criteria. Variability was evident across studies in cancer diagnoses, timing of SCP delivery in relation to treatment completion, SCP delivery method and recipients, SCP content, SCP-related counseling, and outcomes assessed. Findings from nonrandomized studies yielded descriptive information only on outcomes such as satisfaction with care and reactions to SCPs. Among randomized studies, findings were near uniformly negative for the impact of SCPs on the most commonly assessed outcomes (physical, functional, and psychological well-being); findings were positive in single studies for other outcomes including amount of information received, satisfaction with care, and physician implementation of recommended survivorship care. Conclusions: Existing research provides minimal evidence that SCPs improve quality of life in cancer survivors. Possible explanations include heterogeneity in study designs and the low likelihood that SCP delivery alone would influence distal health outcomes. Findings are very limited but more positive for proximal outcomes (e.g., information received) and for care delivery, especially when SCPs are accompanied by counseling to prepare survivors for future clinical encounters. In light of current findings, future research should focus to a greater extent on evaluating ways to ensure SCP recommendations are subsequently implemented as part of ongoing care.
Nutrition services for men with prostate cancer: A health professional survey.
Authors: McLaughlin Kaity , Hedden Lindsay , Pollock Phil , Higano Celestia S. , Murphy Rachel A 
Published: May 2018

25 Background: Nutrition is a key part of prostate cancer (PC) survivorship for management of PC, treatment side effects, and overall health. The Prostate Cancer Supportive Care (PCSC) Program is one of only a few PC survivorship programs in Canada that provide nutrition support as part of standard care. A survey was conducted as part of a broader needs assessment to understand health care professionals’ (HCPs) perspectives on nutrition services for men with PC and inform nutrition programs. Methods: An online survey was administered to British Columbia (BC) HCPs caring for men with PC including urologists, radiation oncologists, medical oncologists, registered dietitians and researchers. We used purposive sampling to identify relevant HCPs. HCPs were asked about the importance of oncological nutrition services and how they should be delivered to men with PC. We summarized the percent agreement for each question and across professions then thematically analyzed qualitative data. Results: Of the 56 HCPs invited to participate in the survey, 38 (68%) responded. The majority (61%) agreed that men with PC require more nutritional support. HCPs indicated nutrition services should be offered multiple times throughout survivorship and facilitated through online resources, individual consultations with registered dietitians and consecutive group education sessions. Most (75%) urologists, radiation oncologists and medical oncologists responded that weight management should be the focus for nutrition services, whereas 90% of dietitians responded that nutrition for reducing the risk of PC progression should be the focus. The main themes that arose from the survey suggested that nutrition services should be available in different forms to facilitate individual needs and adapted based on cultural and community settings. Conclusions: HCPs confirm that there is an unmet need for nutrition services for men with PC in BC as existing services prioritize and offer services for cancer-related weight loss. Special consideration should be given to the focus of nutrition service provided, and when and how it is offered. These results will inform the development of additional resources for men with PC to support their nutritional needs.
Analysis of weight trends over time in female survivors with triple negative breast cancer.
Authors: Hansra Damien Mikael , Rollins Rebecca , Rados Karen , Johnson Anita , Ramey Johnathan , Pannell Rachel , McKnight John Edward , Randolph Kimberly , Pabbathi Haritha , Ninan Mary , Alvarez Ricardo H. 
Published: May 2018

28 Background: Triple-negative breast cancer (TNBC) is a subtype of breast cancer (BC) with unique clinical-pathological & prognostic characteristics. Studies have shown obesity to be risk factor for TNBC. Furthermore, patients (pts) with BC and overweight/obesity have a worse prognosis. Here we investigate body mass index (BMI) & weight trends among BC survivors. Methods: A retrospective review BC pts at Cancer Treatment Centers of America Atlanta from 2012-10/27/17. Definition of a survivor: pts who have completed definitive therapy with no evidence of disease. Survivor BMI & weight gain (kg) calculated from chart review. Weight gain in kg was recorded post chemotherapy, at 3, 6, 9, 12 month follow up. Inclusion: Pts with ER-PR-HER2- (TNBC), adults > 18 yo, pts who completed chemo (neoadjuvant or adjuvant) & surgery +/- radiation. Exclusion: Pts who died, had relapsed local disease or metastatic disease; missing BMI data; currently on chemotherapy; who did not receive chemotherapy; missing continuous BMI data or pathology report; lost to follow up. Results: 1756 BC pts with stage IA-IIIC identified, 300 pts identified as TNBC. A total of 134 patients met full inclusion/exclusion survivorship criteria. Average age of survivors = 52 (range 25-76). Stage: I = 38%; II = 50%, III = 12%. BMI categories: 0% underweight (BMI < 18.5 kg/m2), 15% normal weight (BMI 18.5 to < 25 kg/m2), 18% overweight (BMI 25 to < 30 kg/m2), 55% obese (BMI ≤30 kg/m2), 12% morbid obesity (BMI ≤ 40 kg/m2). Average BMI for all survivors = 32.23 +/-0.59 kg/m2 (range 19-52 kg/m2); post chemotherapy weight change = 0.53 +/-0.41 kg; at 3 month follow up = -0.16 +/-0.51 kg; at 6 month = -0.02 +/-0.54 kg; at 9 month follow up 1.20 +/-0.59 kg; at 12 month follow up = 2.25 +/-0.61 kg. BMI by stage: I = 32.81 +/- 1.00 kg/m2; II = 32.12 +/- 0.91 kg/m2; III = 32.44 +/- 1.27 kg/m2. Conclusions: In our study, female survivors with TNBC present with obesity and gain weight after chemotherapy. Also, weight gain continues at 9 & 12 months post definitive treatment. Survivors with TNBC should be treated with intensive weight loss interventions given that overweight/obesity is a risk factor for recurrence, worse prognosis, & cardiovascular events.