bluuebunny/crossref_metadata_2025_split huggingface dataset:
Physical activity communication between oncology providers and patients with early stage breast, colon or prostate cancer.
Authors: Nyrop Kirsten A , Deal Allison Mary , Williams Grant Richard , Guerard Emily Jean , Pergolotti Mackenzi , Muss Hyman B. 
Published: February 2017

171 Background: National guidelines recommend that patients with a cancer diagnosis engage in regular physical activity (PA) to reduce cancer-related fatigue, maintain quality of life and physical function, and improve overall prognosis and survival. This study investigates oncology provider communications about PA during routine clinic visits with early stage breast, colon or prostate cancer patients. Methods: Retrospective chart review for documentation of communications (inquiries or recommendations) pertaining to PA in clinician notes and after visit patient summaries. Mixed methods analysis. Results: In a 1-month period, 55 oncology providers had 361 encounters (clinic visits) with early stage cancer patients. Of these encounters, 35% included a provider communication about “physical activity”, “exercise” or “activity”. Encounters with a medical oncologist resulted in a PA communication 55% of the time as compared to 20% of encounters with other clinician specialties (p < 0.0001). Older patients were more likely than younger patients to have a PA communication (p < 0.001). When the encounter was with a patient who was being seen for surveillance, chemotherapy or endocrine treatment, the rate of PA communications was significantly higher (46%, 37%, 58% respectively) as compared to when the visit was during radiation treatment or surgery (6%, 19% respectively) (p < 0.0001). Four PA themes emerged from our analysis of provider communications: (1) level and types of engagement in PA, (2) restrictions on PA either by the provider or perceived by patients, (3) encouragement or recommendations, or (4) relationships between PA and weight, nutrition, pain, and fatigue. There were no significant differences in PA communication rates by clinician gender, clinician training, patient gender, patient race, or disease site. Conclusions: This study shows it is feasible for oncology providers to have PA communications during routine clinic visits; however, the frequency of PA communications varies among providers. Interventions are needed to remind all oncology providers to encourage of their patients with early stage cancer to be physically active.
Weight control strategies in breast cancer patients: A systematic review.
Authors: LeVasseur Nathalie , Clemons Mark J. , Mazzarello Sasha , Vandermeer Lisa , Jones Lee , Joy Anil Abraham , Smith Stephanie , Hutton Brian , Hilton John Frederick 
Published: February 2017

179 Background: Obesity remains an underestimated contributor to global cancer incidence and cancer-related mortality. Accumulating evidence suggests excessive energy intake and suboptimal levels of physical activity may be important after the diagnosis of cancer and may influence recurrence and overall survival(OS). Objective: Conduct a systematic review to evaluate data from randomized trials of weight control strategies used in breast cancer patients. Methods: A systematic search of Medline, Embase and the Cochrane Register of Controlled Trials through April 2015 was performed. Randomized trials of weight management strategies in breast cancer patients were sought. Outcomes studied included; change in weight, BMI and waist circumference, disease-free survival, recurrence-free survival and OS survival. Random effects meta-analyses were planned provided that included studies were considered to be clinically and methodologically homogenous. Results: Of 2876 abstracts, 312 were retained for review of the full texts. Overall 43 publications describing 40 studies met inclusion criteria. Of 12,801 enrolled patients, 11,597 had breast cancer. Fifteen studies consisted of dietary interventions, 17 consisted of exercise interventions and 8 consisted of both dietary and exercise interventions. Endpoints included: changes in weight (32 studies, 7,861 pts), BMI (12 studies, 1,886 pts), waist circumference (10 studies, 702 pts), recurrence-free survival (4 studies, 6105 pts) and overall survival (2 studies, 3,330 pts). Network meta-analyses of available data are in progress. Study results suggest that weight control strategies including dietary and exercise interventions were effective at reducing weight, BMI and waist circumference. Two large studies showed statistically significant recurrence-free survival benefits with weight control strategies and one showed OS benefit with an exercise intervention. Conclusions: Data from included trials suggest benefits of weight control strategies to decrease weight, BMI and waist circumference. Few trials have been designed to detect PFS or OS benefits. Larger trials are warranted to better define the role of weight control strategies in the management of breast cancer patients.
Changes in biomarkers and DNA methylation in breast cancer survivors enrolled in the ENERGY weight loss trial: A pilot study.
Authors: Demark-Wahnefried Wendy , Rock Cheryl L , Sedjo Rebecca L. , Toriola Adetunji , Liu Jingxia , Byers Tim , Ganz Patricia A. , Cui Xiangqin , Tiwari Hemant , Absher Devin , Colditz Graham A. 
Published: February 2017

181 Background: In 2014, an ASPO position statement was released calling for action regarding cancer survivors’ needs for weight management. Reduction of body weight is hypothesized to affect several cancer-related biological pathways. Methods: The Exercise and Nutrition to Enhance Recovery and Good health for You (ENERGY) trial is the largest weight loss trial completed to date among breast cancer survivors. In it, 692 stage Ic-IIIc breast cancer survivors were randomized to an intensive, group-based weight loss intervention with 26 contacts over one year or to a non-intensive intervention with two contacts over the same time period. Results recently reported in JCO showed significantly greater weight loss in the intensive intervention arm compared to the non-intensive arm. A pilot study exploring baseline to 6-month changes in gene methylation and expressed biomarkers was undertaken in 30 chemo-naïve, post-menopausal, non-Hispanic white women who participated in this study. Results: Several significant differences in mean change scores (standard error) between the intensive vs. non-intensive groups were noted, i.e., insulin: -4.19(0.80) vs. 0.42 (1.01)/p = 0.0016; c-peptide: -0.49(0.14) vs. 0.40(0.19)/p = 0.0009; leptin: -15.73(1.79) vs. 2.53(1.78)/p < 0.0001; adiponectin:leptin ratio: 0.67(0.15) vs. 0.010(0.064)/p = 0.0007; homeostasis model of insulin resistance (HOMA-IR): 20.00(4.65) vs. 9.57(5.00)/p = 0.0003; sex hormone binding globulin 20.45(4.61) vs. 8.65(8.00)/p = 0.023; and Follistatin-Related Protein-3 (FSTL3): 0.48(0.19) vs. -0.88(0.55)/p = 0.0497. While effects were in the direction hypothesized for c-reactive protein, interleukin-6, vascular endothelial growth factor, and tumor necrosis factor no significant differences were noted. Significant differences in DNA methylation also were noted for genes encoding for Follistatin Related Protein (corresponds to FSTL3), and those on hormonal/growth pathways (e.g., AMOTL1, ESR, EGR3), inflammatory pathways (e.g., TNFRS10A/TRAIL-R1, C14orf106), and metabolic pathways (e.g., ZBED3, GABRA). Conclusions: While results are based on a small sample and not corrected for multiple testing, they provide evidence that weight loss affects several biomarkers and pathways that impact cancer and which warrant further investigation. Clinical trial information: NCT01112839.
Depression and smoking patterns among head and neck cancer patients in an inner city minority population.
Authors: Poola Harsha Vardhan , Thekkekara Romy , Udayagiri Venkata Sravani , Patel Urjeet , Goldberg David , Rosen Fred R. 
Published: February 2017

184 Background: Continued smoking among head and neck cancer patients(HNCP) is associated with poor prognosis. These patients (pts) experience highest rates of depressive symptoms of all oncology patients. Smoking and depression are among factors that influence long term quality of life in these pts. Methods: HNCP were evaluated for patterns of smoking and depression at our Hospital. Survey using a standardized questionnaire about smoking patterns and depression using PHQ9 was employed. Pts were stratified as nonsmokers, ex-smokers (quit > 6 mo), recent smokers ( < 6 mo), and current smokers ( < 7 days). EMR was reviewed for sociodemographic variables, stage (stg), diagnosis (Dx) date, treatment(Rx) modality. The cohort was followed till 7/31/2015 to assess disease recurrence and survival. Results: 39 pts were interviewed. Mean age at Dx was 56 +/-7 yrs. 82% were men. 46% were African American, 36% Caucasians(cau) and 8% Hispanics. 74% had stg IV disease at Dx. 76.9% were recent/current smokers at Dx. At 280 days from Dx, 41% continued smoking; decrease in smoking was statistically significant (p value: .000). 52% of smokers with stg III/IV cancer quit smoking while pts with stg I/II continued to smoke. Continued smoking was higher in Cau (p = 0.038). Mild to severe depression was seen in 56% of pts. Higher rates of depression were noted among smokers (62%) with stage III/IV disease; though it was not statistically significant. Complete response to Rx was seen in 82% and recurrence in 20.5%. No difference in outcomes based on smoking patterns was noted. Conclusions: Although smoking rates at Dx were comparable to literature, our pts had higher rates of continued smoking and depression. Dx and stg appear to be important factors in smoking cessation. SSRIs have been prophylactically used to reduce rates of depression in these pts. Studies are needed to determine if they can be used with the same success in minority population. Larger studies are also needed to assess the role of smoking cessation as a strategy to prevent depression among minority population.
Exploring correlates of quality of life in older family caregivers to cancer patients.
Authors: Cuthbert Colleen Ann , King-Shier Kathryn , Ruether Joseph D. , Tapp Dianne , Culos-Reed S. Nicole 
Published: February 2017

186 Background: Family caregivers (FCs) have negative impacts to their physical and emotional health, and poorer quality of life (QoL) compared to non-caregivers. Most research on FCs has included heterogeneous samples, therefore little is known about specific groups such as older (age 60+) FCs. Older persons are at increased risk for health problems, may have co-morbidities, and be socially isolated. Understanding factors related to QoL may lead to interventions targeted to older FCs. The purpose of this study was to examine factors associated with QoL in older FCs to cancer patients. Methods: The data for this study are from a larger survey of FCs aged 60+, recruited from a hospital-based cancer facility. FCs were included if their care recipient had breast, prostate or colorectal cancer. QoL was measured using the MOSF-36. Analyses using descriptive statistics and Pearson’s correlations were conducted. Results: n = 168 participants consented, with n = 129 surveys returned. The majority of participants were female (60.5 %), 70 yrs old (sd 7.4), had at least a college diploma (65.2 %), were spouses of the patient 92.2%, and retired (60.5%). Mean caregiving hours per week was 24.2 (sd 26.3). Mean time as a caregiver was 31 months (45.9). The majority of patients were on treatment (75.2%) and were 71.3 yrs old (sd 7.5). The Physical Component Summary (PCS) of the MOSF-36 was significantly correlated with gender r = -.24, social support r = .25, sleep quality r = -.47, depression r = -.51, state anxiety r = -.40, and trait anxiety r = -.45 (all p’s < .01). There were significant correlations between the Mental Component Summary (MCS) and social support r = .40, sleep quality r = -.40, depression r = -.77, gender r = -.25, state anxiety r = -.72, and trait anxiety r = -.71 (all p’s < .01). The MCS was correlated with caregiving hours, r = -.197 (p < .05), however, not with patient treatment status. The PCS was not correlated with caregiving hours or patient treatment status. Conclusions: Consistent with previous FC research across different diseases, QoL was associated with gender, caregiving hours per week, social support, sleep quality, depression, and anxiety. Interventions for older FCs of cancer patients could be targeted to specific factors of overall QoL.
Quality of life difficulties in partners of young breast cancer survivors.
Authors: Champion Victoria , Cohee Andrea A , Monahan Patrick , Stump Timothy E. , Miller Kathy , Wagner Lynne , Cella David , Sledge George 
Published: February 2017

188 Background: Although breast cancer is more commonly diagnosed in post-menopausal women, there are a significant number of survivors diagnosed at age 45 or younger. Compared to older survivors, younger survivors have significantly more problems with depression sexual functioning, marital satisfaction, and overall well-being, but there is little research on the partners of these younger survivors. The purpose of this study is to determine if the partners of young survivors experience more problems with depression, sexual functioning, marital satisfaction, and overall well-being than partners of age-matched controls. Methods: Survivors and partners (n=227) were enrolled in a large cross-sectional study, executed through the ECOG-ACRIN Cancer Research Group. Eligibility for survivors included being 45 or under at diagnosis, 3 to 8 years from treatment without a breast cancer recurrence, and with similar chemotherapy treatment regimens. Survivors identified age-matched acquaintance controls without breast cancer. These age matched controls and their partners (n=170) were also included. All groups completed a survey assessing demographic characteristics, depression, sexual functioning (enjoyment and difficulty), marital satisfaction, and overall well-being. The partners of both young survivors and acquaintance controls were compared on all study variables adjusting for demographic variables. Results: Partners of young survivors reported significantly more depression (effect size [ES] = -0.23, p=.0199), worse sexual functioning as indicated by lower enjoyment (ES= 0.32, p=.0019) and more sexual difficulty (ES= -0.24, p=.0164), lower marital satisfaction (ES=0.24, p=.0189), and lower overall well-being (ES= 0.40, p=.0001). Conclusions: Partners of breast cancer survivors suffer from problems similar to breast cancer survivors. Further research is needed to fully understand the impact of a breast cancer diagnosis on both the partner as well as the survivor, especially when problems exist that are related to the dyadic relationship.
"Hot Girls Pearls" and other coping strategies for women experiencing adverse effects from endocrine therapy in the treatment of breast cancer.
Authors: Halley Meghan , Beryl Louise , Gillespie Katherine , Rendle Katharine , May Suepattra Grace , Frosch Domnick L 
Published: February 2017

197 Background: While endocrine therapy can significantly improve outcomes for women with hormone receptor-positive breast cancer, as few as 50% of patients take the medication as prescribed. Studies have shown that physical side effects contribute to non-adherence with hormone therapy. This study draws on prospective, qualitative interviews with patients to identify coping strategies patients employ to manage concerns over current and anticipated side effects, and suggests methods for encouraging adherence. Methods: Interviews were conducted with breast cancer patients (n = 41) at four time points throughout their treatment, resulting in over 150 patient narratives. Using a grounded theory approach, data were coded and analyzed to identify influential factors in decision-making. Here we present data from a subset of our participants (n = 18) focused on the role of side effects in patients' endocrine therapy decision-making. Results: Patients expressed a variety of concerns about current and anticipated side effects associated with endocrine therapy. Our data suggest five categories of coping strategies participants employed to manage these concerns: 1) emphasizing control over their choice to remain adherent; 2) focusing on a future free from side effects and cancer instead of current concerns or discomfort; 3) "familiarizing" side effects to make current and potential treatment risks feel less strange and/or intimidating; 4) making lifestyle changes to mitigate physical discomfort; and 5) seeking help from both medical and social sources. Patients often described using these multiple strategies to help navigate the functional, social and physical responses to side effects, and remain adherent to their treatment regimen. Conclusions: Our data describe the diverse coping strategies employed by women to manage current or anticipated side effects, and maintain adherence to prescribed endocrine therapy. Discussion of these different coping strategies by clinicians with patients may help to improve adherence rates by personalizing approaches to managing side effects.
Survivorship workshop delivery to primary care providers.
Authors: Chaput Genevieve , Hendricks Kristin , D'Souza Vinita , Khan Sarah , Naismith Laura 
Published: February 2017

2 Background: There are approximately 15 million cancer survivors (CS) in North America. In addition to higher risk of recurrence, over 50% of CS are afflicted with late effects. CS are burdened with more medical conditions than the general population. CS visit specialists during treatment, and 75% of them also see their primary care provider (PCP) during and after treatments. Despite their integral role in survivorship care, PCP lack survivorship knowledge and have low confidence regarding CS care, supporting the urgent need to educate them about CS issues and surveillance needs. This study aimed to assess the educational benefit of a survivorship workshop targeting PCP in Montreal, Canada. Methods: An accredited workshop based on NCCN’s 8 common survivor issues was developed and delivered to 155 PCP at 5 sites. Matched pre and post surveys were designed using Likert scale and short-answer questions, and were completed on a voluntary basis by PCP. Specific outcome measures were based on the first 3 levels of Kirkpatrick’s learning model: satisfaction, knowledge, and behaviour. Data analysis included an open-coding approach to identify major themes of qualitative data. Ethics approval was granted. Results: Response rate was 64%. 95% indicated high satisfaction and relevancy of content for primary care. Using t-tests to compare pre and post responses, results were statistically significant for both “list 2 standards of survivorship” and “name 2 late-effects of cancer treatment” survey items, indicating an increase in both standards and late effects identified post workshop. 99% expressed behavioural intent to incorporate survivorship information into practice. Conclusions: Much research has focused on identifying PCP barriers to optimal survivorship care delivery such as limited topic proficiency, yet further efforts are warranted to close that knowledge gap. Our findings revealed increased knowledge of CS issues and surveillance needs post workshop. 3 months survey data is being collected to evaluate for actual practice changes and willingness to manage specific CS issues (i.e. treating depression). A second workshop targeting cardiovascular health promotion interventions has been created: delivery is anticipated early 2016.
Examining the relationship between multiple primary cancers and psychological distress: A systematic literature review.
Authors: Belcher Sarah M. , Hausmann Emilie A. , Klem Mary Lou , Cohen Susan M. , Donovan Heidi AS , Schlenk Elizabeth A. 
Published: February 2017

214 Background: The incidence of multiple primary cancers (MPC) in cancer survivors is increasing. However, little is known about the psychological effects of MPCs on cancer survivors. The purpose of this systematic review was to synthesize the evidence regarding the impact of MPC on psychological distress in cancer survivors. Methods: Relevant studies were identified in PubMed database (up to June 2015). Non-English articles were excluded. Two independent evaluators reviewed articles for relevancy and data extraction. Data was organized and recorded using a coding log with exclusionary rationale, a PRISMA flow diagram, and a standardized table of evidence. Effect sizes (ES) were calculated using Cohen’s d to measure relationship magnitude and direction. Results: Of the 543 potentially relevant articles identified, four articles met criteria and were retained for analysis. Different quality of life (QOL) measures were used to assess psychological distress across studies, so ES were calculated for individual studies. There were consistently small but significant ES found for the impact of MPC on distress. When compared to survivors of a single cancer: one study found lower global QOL and higher total stress (ES, 0.1430 and 0.3653); one study reported that those with MPC were more likely to experience frequent mental distress and sleep problems (ES, 0.1404 and 0.2235); and one study found that those with MPC had lower global QOL and emotional function and greater anxiety and depressive symptoms (ES range, 0.1026 - 0.3215). Finally, the one study that evaluated suicidal ideation in survivors of childhood cancers did not find a higher incidence among those with MPC. Conclusions: The ES noted in the four studies suggest a small but significant increase in psychological distress in survivors of MPC compared to survivors of a single cancer. Clinicians should be aware of this at-risk population when screening for distress in cancer survivors. Additional studies that control for care transition points known to increase distress are warranted to explore the impact of MPC on psychological distress over time. Additionally, as the science in this area grows, it will be necessary to reevaluate the literature.
Substance use, psychological distress, and quality of life (QOL) in adolescent and young adult (AYA) cancer patients with hematologic malignancies in early survivorship.
Authors: Hlubocky Fay J. , Muffly Lori S. , GOmez Jocelyn , Breitenbach Kate , Lappe Mary , Stock Wendy , Daugherty Christopher 
Published: February 2017

219 Background: Prior research identifies both the physical and psychological effects of cancer treatments as significant predictors of substance use among AYA. However, the prevalence of substance use and its effect on QOL and psychological well-being of AYA hematologic survivors has not been described. Methods: AYA patients (15-40 years at diagnosis) of acute leukemia, aggressive non-Hodgkin lymphoma, Hodgkin lymphoma undergoing curative intent therapy (on-treatment cohort) or 2 year completion of therapy and in remission (early survivor cohort) completed following measures: depression (CES-D), state anxiety (STAI-S), PTSD (PCL-C), QOL (FACIT-G). Semi-structured interviews evaluated substance use. Results: 62 AYA (26 on-treatment, 36 early survivors) were interviewed. For total population: median age at dx 26y (15-40); 64% male; 59% Ca; 79% college/post educ; 41% income <$75,000y; 52% and 48% lymphoma/ leukemia dx, respectively. Overall, 52% AYA reported the current use of a substance (ex. alcohol, nicotine, illicit drug). Of these, 49% AYA reported alcohol use; 20% reported nicotine use; 31% reported illicit drug use (ex. marijuana). AYA who used alcohol had poorer QOL (79±15 v 84±18,p=.02). AYA who used nicotine had higher STAI-S anxiety (44±13 v33±10, p=.01) and CES-D depression (30±16 v 15±8,p<.00). Nicotine use was associated with severe illness-related PTSD symptoms (57±26 v 28±10, p<.00). Also, AYA with illicit drugs use had greater CES-D (20±13 v 11±9, p=.03) and moderate PTSD (41±18 v 29±12, p=.01). On-treatment AYA were more likely to deny current use of illicit drugs (58% v 41%, p=.02) than early survivors. Conclusions: AYAs with hematologic malignancies report substance use negatively impacting QOL thus warranting the need for future age-specific psychological interventions.