bluuebunny/crossref_metadata_2025_split huggingface dataset:
The unmet needs of GI cancer patients: A call to action.
Authors: Raymond Martha ,   GI Cancers Alliance
Published: May 2018

167 Background: Gastrointestinal (GI) cancers are the most common and deadliest type of cancer in the United States. Understanding the need for increased GI cancer patient education, the GI Cancers Alliance created an online unmet needs survey with goals that included: determining gaps in support services, better understanding needs in patient education, and gaining insight into psychosocial concerns. Methods: 507 GI cancer survivors completed the anonymous survey. The qualitative/quantitative survey was open for a 6 week period during October & November 2016. Survey respondents reported being diagnosed with one of the following GI cancer primary tumor types: Esophagus (6%), Liver (8%), Bile Duct (7%), Pancreas (6%), Gallbladder (2%), Stomach (16%), Ileum (3%), Appendix (3%), GI Carcinoid Tumor (2%), Colon (25%), Rectum (13%), Anus (6%), Did not know primary location (3%). Results: Of the 507 respondents, 84% of patients/survivors reported difficulty adjusting to a new normal as a GI cancer survivor. 59% reported they did not have adequate support (family, friends, professional, spiritual or thru advocacy organizations) to help cope with their diagnosis. Anxiety (67%), Fear (66%) and Depression (59%) were common emotions reported during the cancer continuum. Less than half (40%) of respondents described themselves as empowered patients, comfortable advocating for themselves regarding their healthcare and treatment decisions. 92% of patients surveyed did not have a Survivorship Care Plan (SCP). More than half (52%) of all respondents had not heard of or didn’t know the purpose of having a SCP. Conclusions: Our data underscores the unmet needs of GI cancer survivors, including gaps in support services and patient education. As an initial step to help meet these needs, we created a customizable SCP specific to GI cancers and will launch an online GI Cancer Resource Library. Future directions include systematic distribution of the SCP and continued expansion of GI cancer education and empowerment initiatives.
A brief intervention for chemobrain: Results from a pilot study.
Authors: Bennett Jennifer 
Published: May 2018

171 Background: Up to 75 percent of breast cancer survivors (BCS) who were treated with chemotherapy report difficulty with cognition, including word finding problems and an inability to attend or multitask. The phenomenon of chemotherapy-related cognitive impairment is often referred to as “Chemobrain.” Chemobrain negatively affects one’s family and social and professional lives. In addition, anxiety and depression – commonly found in breast cancer survivors –negatively affect one’s cognition. An intervention for chemobrain needs to also address these psychological disorders in order to increase the quality of life of BCS. Methods: BCS who completed chemotherapy in the past 5 years and complained of subsequent cognitive decline were recruited for an intervention that included mindfulness and cognitive rehabilitation. Mindfulness has been shown to help with attention and to decrease depression and anxiety. The intervention was given in a class setting and met once/week for 1.5 hours for 6 weeks. Participants completed a brief neuropsychological battery pre- and post-intervention. Results: Immediately post-intervention, all participants (n = 11, mean age = 53.7 years, 100% female) reported increased cognitive functioning as measured by FACT-Cognitive Function, with a mean increase of 27.7 points (p < 0.01, d= 1.82). Ninety-one percent of participants reported decreased depression as measured by PHQ-9, with a mean decrease of 4.7 points (p = 0.02, d= 0.82). These improvements were sustained 3 months post-intervention in cognitive functioning (p < 0.01, d= 2.04) and depression (p < 0.01, d = 1.39). Improved performance was also found in verbal fluency (p = 0.02, d= 0.87) and executive functioning as measured by Trail Making Test B (p = 0.02, d= 0.82). No improvement was detected in verbal learning or processing speed. Conclusions: Breast cancer survivors with chemobrain can recover cognitive functioning and decrease levels of depression relatively quickly with an intervention that combines mindfulness and cognitive rehabilitation. This recovery can be sustained for at least 3 months post-intervention. Additional research is needed to investigate how long recovery can be maintained and if the same intervention can help other cancer survivors.
The influence of an androgen deprivation therapy educational program on dyadic quality and intimacy for prostate cancer patients and their partners.
Authors: Wibowo Erik , Wassersug Richard J , Robinson John W , Matthew Andrew , McLeod Deborah L , Walker Lauren M 
Published: May 2018

178 Background: Androgen deprivation therapy (ADT) is a common treatment for advanced prostate cancer (PCa), but ADT typically impairs men’s sexual function and couples’ relationships. We offer an educational program to help PCa patients and their partners manage ADT related side effects and to maintain a strong dyadic relationship while the patient is on ADT. Methods: Patients and partners attended a one time 1.5 hour ADT Class. Patients received a copy of the book Androgen Deprivation Therapy: An essential guide for men with prostate cancer and their partners (DEMOS Health, NY), which covers how to manage ADT side effects and make healthy lifestyle changes. We emphasize the importance of physical exercise in preventing or reducing many of the side effects of ADT. 79 couples (patients = 68.8±7.5 years old, partners = 64.9±8.8 years old; relationship duration = 34.6±16.4 years) completed the Dyadic Adjustment Scale, the Personal Assessment of Intimacy in Relationships, and the Godin Leisure-Time Exercise questionnaires at baseline and again 2-3 months later to assess their relational intimacy and dyadic quality. At baseline 73% of patients either had not started or been on ADT for < 3 weeks. Results: Attending the ADT Educational Program was associated with improved dyadic adjustment and relational intimacy but age, relationship duration, baseline strain in the relationship and physical exercise all influence these effects. Specifically, dyadic cohesion improved in patients ≥68 years old. Recreational intimacy increased in patients ≤60 years old and for those in a relationship ≥50 years. Recreational intimacy also improved in partners who had been in a 20-49 years relationship or those reporting at baseline little strain in their relationship. Dyadic cohesion was maintained in participants who increased their frequency of physical exercise. For the above results, all P < 0.05. Conclusions: The ADT Educational Program improves dyadic cohesion and relational intimacy for some patients and partners but age, relationship duration, baseline quality of the relationship, and physical exercise frequency appear to influence the effectiveness of the program.
Breast cancer survivors' self-reported outcomes following an end of treatment group intervention.
Authors: Chaput Genevieve , Barrette Maria , DiLalla Vanessa , Williams Tristan , Yu Olivia , Robitaille AndreAnne 
Published: May 2018

18 Background: The merit of supporting and educating breast cancer survivors (BCS) about survivorship issues such as cognitive dysfunction, body image concerns and fear of recurrence following treatment completion is well recognized. Though the majority of BCS appear to adjust fairly well in the long term, the transition from active treatments to survivorship is often described as distressing. While individualized interventions are typically not sustainable, group interventions provide an opportunity to inform BCS about potential late and long-term effects from cancer treatments in a supportive environment. BCS were offered an end of treatment educational group intervention (EOT). The EOT consists of a survivorship education session delivered by an MD and RN, a kit containing patient resources, as well as a survivorship care plan (SCP). BCS caregivers are welcomed to attend the EOT. This study aimed to assess BCS’ satisfaction, confidence level in managing their health, and intent to use the information received at the EOT. Methods: 18 EOTs have been provided to 83 BCS (group size range: 4 to 8 BCS, caregiver attendees not included). Participants completed a brief Likert-scale survey on a voluntary basis after the EOT. Variables of interest for included reported satisfaction, confidence and intent to use information received during the EOT. Descriptive statistics were utilized to analyze collected data. Results: Completed surveys were received from 69 participants (response rate 83.1%). To the survey question: “The survivorship information I received was helpful”, 72% (50) and 26% (18) responded strongly agreed and agreed, respectively. The majority of participants reported “Feeling better prepared for the next steps regarding their care” following the EOT (60% (42) strongly agreed; 33% (23) agreed). Lastly, the majority (78%) stated they were “very likely” to use the EOT information. Conclusions: Current evidence has demonstrated the feasibility and patient-related benefits of educational interventions within the field of survivorship. Our results suggest group-based interventions are efficient and effective for addressing the supportive and informational needs of BCS after treatment completion.
Single center experience of dermatologic and oncologic surveillance patterns for late stage melanomas that progressed from early stage melanoma.
Authors: Song Jung Min , Marcus Joel Daniel , Stanek Carolyn , McNamara Michael J. , Gastman Brian , Tarhini Ahmad A. , Funchain Pauline 
Published: May 2018

182 Background: Recent data suggests a greater proportion and greater absolute number of thin (T1) melanomas contribute to melanoma death than thicker melanomas (Whiteman et al., J Invest Dermatol 2015). NCCN guidelines for early stage melanoma, defined as stages IA-IIA, suggest at least yearly skin check and H&P, but do not specify if dermatologic and/or oncologic surveillance should be pursued. Methods: We reviewed internal and external records of 16 consecutive patients with new, non-de novo diagnoses of unresectable stage III or IV melanoma undergoing active cancer treatment, i.e. late stage melanoma, from 2016-2017 that had progressed from a preceding primary early stage (IA-IIA) melanoma. Results: Primary early stage melanomas were diagnosed a median of 10.5 years (range, 4 to 29) prior to advanced disease progression. Two of 16 patients (13%) had oncologic follow up. Seven (44%) had continuous dermatology follow-up, of which 6 (38%) were followed only by dermatology. Only one patient had both dermatology and oncology follow-up at the time of progression. Follow up could not be determined for 8 patients due to lack of sufficient records, it is notable however that these 8 (50%) were not following dermatology or oncology at the time of progression. Conclusions: Only a small minority of patients who progressed from early stage melanoma to advanced stage melanoma requiring treatment were followed regularly by medical oncology, despite half having at least regular dermatology follow-up. We conclude that survivorship plans are important for early stage melanomas, and there is a need to effectively educate a larger early stage melanoma population about the infrequent but real oncologic issue of progressing to late stage melanoma.
Increased access for and enhancement of cancer (ca) patients (pts) participation (par) in clinical trials (cts) by alleviation of financial toxicity.
Authors: Mitchell Edith P. , Dornsife Dana 
Published: May 2018

24 Background: Prognosis for pts is increasing as a result of advances in cts. However, the degree to which cancer caused financial problems may influence ca pts par in cts and negatively impact quality of life. Excess financial burden of cts par, may include finding an appropriate trial, traveling to the trial site, travel costs, lodging and medical expenses. The Lazarex Cancer Foundation (LCF) was founded in 2006 with mission to improve care, giving hope, dignity, and life to advanced ca pts by providing assistance with options and costs to cts par, community outreach, and education. LCF developed processes to removing the barriers to cts par by improving equitable access to cancer care, increasing cts enrollment, retention and minority par, and increasing cts referrals. Methods: To determine the extent of benefit of LCF, we conducted a retrospective analysis of LCF beneficiaries participating in cts by reviewing and summarizing the number of pts, states and countries of residence, age, type of cancer, location and distance to cts site, type of assistance, and number of advocacy/outreach. Results: From 1/01/2010 – 12/31/2016 2179 pts were assisted financially; age range 1-102 yrs, median 50-60; (43%) male, (53%) female, (3.4%) undeclared. (6.4%) were African American, 10.3% Hispanic, 3.6 Asian Pacific Islander, other minority 2.1, and Caucasian 72.7%;total minority 22.5%. Pts resided in 50 states with largest CA , TX , MA , and FL. Cts were at 199 sites – 43 NCI CCC, 7 NCI DCC and 149 other cancer centers. Most common diagnoses were breast, leukemia, colorectal cancers. type tumors. Median household income was $75,000. Financial assistance to travel to and living expenses at the cts site was the most frequently identified need. Conclusions: Relieving pts of financial burden allows greater access to and participation in cancer clinical trials. Further research and greater resources are needed to define patient needs and determine methods to eliminate barriers to enrollment and retention investigate coverage thresholds that minimize adverse financial outcomes and identify ca pts at greatest risk for financial toxicity to increase par in cts.
Impact of immigration status on health behaviors and perceptions in cancer survivors.
Authors: Liu Sophia Yijia , Lu Lin , Balaratnam Karmugi , Pringle Dan , Mahler Mary , Niu Chongya , Naik Hiten , Tiessen Kyoko , Hon Henrique , Brown M Catherine , Selby Peter , Howell Doris , Xu Wei , Alibhai Shabbir M.H. , Jones Jennifer M. , Liu Geoffrey , Eng Lawson 
Published: May 2018

27 Background: Health behaviors including smoking cessation, physical activity (PA) and alcohol moderation are key aspects of cancer survivorship. Disparities in health literacy and cancer screening behaviors have been reported between immigrant and native-born cancer patients. However, disparities in health behaviors in cancer survivorship has not been explored. We compared health behaviors and perceptions about these behaviors between immigrant and native-born cancer survivors. Methods: Adult cancer patients from Princess Margaret Cancer Centre (Toronto, Canada) were surveyed on their smoking, PA, and alcohol habits and perceptions of the effects of these behaviors on quality of life (QoL), 5-year survival, and fatigue. Multivariable models evaluated the effect of immigration status on behaviors and perceptions. The effect of originating from a Western vs. non-Western country was also evaluated. Results: Of 1275 patients, 27% self-identified as foreign-born. At 1 year before diagnosis (baseline), 17% smoked, 69% were physically inactive, and 58% consumed alcohol. Although immigration status was not associated with smoking at baseline (P > 0.05), immigrants were less likely to perceive that smoking was harmful on QoL (adjusted odds ratio [aOR] 0.58, P = 0.008), survival (aOR 0.56, P = 0.002), and less so for fatigue (aOR 0.75, P = 0.11). Immigrants were less likely to meet PA guidelines at baseline (aOR = 0.70, P = 0.08), and perceive that PA improved fatigue (aOR 0.62, P = 0.04) and survival (aOR 0.64, P = 0.08). Immigrants were also less likely to drink alcohol at baseline (aOR = 0.47, P = 0.001), but alcohol perceptions did not differ between immigrants and native-born. Those from non-Western countries were less likely to smoke (aOR 0.63, P = 0.03), drink alcohol (aOR 0.48, P = 0.006), or meet PA guidelines at baseline (aOR 0.44, P = 0.006). Conclusions: Immigrants were less likely to perceive continued smoking as harmful and less likely to be aware of the benefits of PA. Patients from non-Western countries were less likely to meet PA guidelines, but were also less likely to smoke or drink at baseline. Culturally tailored counselling should be considered for immigrants who smoke or are physically inactive at baseline.
Evaluating effectiveness in an urban comprehensive cancer survivorship program.
Authors: Berry Emily , Pruitt Sandi , Borton Eric , Rodriguez Aurelio , Argenbright Keith Edward 
Published: May 2018

35 Background: Advances in early detection and treatment has led to a growing cancer survivor population, many of whom have encountered devastating effects as a result of diagnosis and treatment. While this phase of care represents a distinct opportunity, evidence-based cancer survivorship programs are often only associated with large cancer centers or academic medical centers and are limited in scope because they are costly and poorly reimbursed. Moncrief Cancer Institute established its program using a community-based model to provide a patient-centered solution, offering evidence-based multidisciplinary services to survivors regardless of diagnosis, treatment provider, socioeconomic status, or insurance coverage. To improve sustainability, we intend to advance data available to insurers and policy makers to encourage service reimbursement. We are developing a comprehensive, linked data repository designed to facilitate effectiveness research for our cancer survivorship program. Methods: Focusing on patients affiliated with the safety-net health system, we use their tumor registry as the sampling frame. These data are then matched with the clinical services database for the survivorship program to create an intervention group, participants, and a matched comparison group of nonparticipants. The established cohort is then matched to electronic medical record data from JPS. Results: Data has been extracted and linked at the patient level, and scrubbed and de-identified for analysis. A total of 8,325 cancer patients were identified from the registry, of these 467 were survivorship program participants. Preliminary analysis is comparing participants to nonparticipants and characterizing program participation. Once completed, analysis will extend to surrogate measures for effectiveness, evaluating impact on healthcare utilization and screening/surveillance uptake. Conclusions: Our approach has created a tool to facilitate a better understanding of survivorship care. With this, we can provide novel evidence regarding participation in a comprehensive cancer survivorship program among urban safety-net healthcare system patients and evaluate impact at the patient and healthcare system levels.
Survivorship care delivery: From a consultative clinic to an integrative program based on patient outcome and resource analyses.
Authors: Schreffler Kevin , DelCampo Carol , Hayes Dawn , Meyer Donna L. , Miller Bryan , Sickles Amy , Jones Mildred , Tamim Hiba 
Published: May 2018

37 Background: Delivery of survivorship care plan (SCP) using a multidisciplinary approach is optimal (Hewitt et al., 2006). However, many institutions experience implementation barriers (Dulko et al., 2013). The pilot study aim compared the effectiveness of two SCP delivery methods (extended vs. brief) on self-reported confidence in disease management (breast cancer). Secondary aim evaluated timeliness and patient/provider burden. Methods: Quasi-experimental pre- and post-survey design with control group (brief explanation/ delivery of SCP) and treatment group (comprehensive consultative visit). Pretesting included distress screening and self-efficacy survey. Post-testing included self-efficacy survey, tracking of referral activity, and patient satisfaction. Time study data and process mapping were included. Descriptive data analyses and Mixed ANOVA; significance set p < .05. Results: 73 eligible patients identified (age 61.93 ±11.6 years), 36 completing pre/post testing, and 62% declined consultative visit. At pre-testing, 45% rated distress > 3 [emotional (58%), physical (50%), nutritional (30%)]. Post-testing showed 94% compliance with support service referral(s). 89% felt understanding improved, 66% found SCP helpful, 59% said SCP prepared them for transition, and 77% were satisfied. Time main effect was significant for self-efficacy, Wilks Lambda = .89, F (1,34) = 4.2, p = .048. Follow-up paired-samples t-test showed significant improvement in consultative group, t (21) = -2.56, p = .018. Group differences not significant, but both groups demonstrated positive change (7% consultative; 4% control). Time study data revealed overall time spent per patient was 3.7 hours for consultative group vs. 2.2 hours for control group. New process change to integrative model reduced time by 65%. Conclusions: Both SCP delivery methods demonstrated improved patient confidence in managing disease and positive satisfaction. However, the extended visit did not yield outcomes justifying the increased program cost and resource. The pilot fostered a multidisciplinary approach to SCP delivery and yielded a process for improved timeliness and optimal delivery model.
Cardiovascular disease-related chronic conditions among Veterans Affairs colorectal cancer survivors: A matched case-control analysis.
Authors: Zullig Leah L. , Smith Valerie , Lindquist Jennifer , Williams Christina D. , Weinberger Morris , Provenzale Dawn , Jackson George L. , Kelley Michael J. , Danus Susanne , Bosworth Hayden B 
Published: May 2018

4 Background: The growing number of colorectal cancer (CRC) survivors often have multiple chronic conditions. Comparing CRC survivors and matched non-cancer controls, our objectives were to determine the odds of CRC survivors being diagnosed with CVD-related chronic conditions and their likelihood of control during the year after CRC diagnosis. Methods: We retrospectively identified patients diagnosed with non-metastatic CRC in the Veterans Affairs (VA) healthcare system from fiscal years 2009-2012 and matched each with up to 3 non-cancer control patients. We used logistic regression to assess differences in the likelihood of being diagnosed with CVD-related chronic conditions and control between CRC survivors and non-cancer controls. Results: We identified 9,758 CRC patients and matched them to 29,066 non-cancer controls. At baseline, 69.4% of CRC survivors and their matched controls were diagnosed with hypertension, 52.4% with hyperlipidemia, and 36.7% with diabetes. Compared to matched non-cancer controls, CRC survivors had 57% higher odds of being diagnosed with hypertension (OR = 1.57, 95% CI = 1.49-1.64) and 12% higher odds of poor blood pressure control (OR = 1.12, 95% CI 1.06-1.18) in the subsequent year. Compared to matched non-cancer control patients, CRC survivors had half the odds of being diagnosed with hyperlipidemia (OR = 0.50, 95% CI = 0.48-0.52) and higher odds of LDL control (OR 1.14, 95% CI 1.06-1.23). There were no significant differences between groups for diabetes diagnoses or control. Conclusions: Compared to non-cancer controls, CRC survivors have: 1) greater likelihood of being diagnosed with hypertension and worse blood pressure control in the year following diagnosis; 2) lower likelihood of being diagnosed with hyperlipidemia or LDL control; and 3) comparable diabetes diagnoses and control. There may be a need for hypertension control interventions targeting cancer survivors.