bluuebunny/crossref_metadata_2025_split huggingface dataset:
A survivorship program to improve quality of life of Hispanic/Latino breast cancer (BC) survivors.
Authors: Nahleh Zeina A. , Heydarian Rosalinda , Dwivedi Alok , Pasillas Rebecca , Sanchez Luis , Liss Danielle 
Published: March 2017

183 Background: We sought to determine whether Hispanic BC survivors in El Paso, TX would benefit from participating in a comprehensive multidisciplinary cancer survivorship program, by improvement of performance using the validated questionnaires: 1) Patient Health Questionnaire 9(PHQ9), 2) General Anxiety Disorder 7 (GAD 7), and SF36 Health related quality of life (HRQOL) questionnaires. Methods: After IRB approval, we recruited consecutive patients within the first 5 years post-diagnosis with Stages I-III BC and have completed active therapy. The program was staffed by an oncologist, a nurse practitioner, a nutritionist and a clinical psychologist. Survivors were seen every 3 months and questionnaires obtained. They were provided with a personalized treatment summary, dietary advices, in-depth one on one psychological assessment and interventions and an 8 week course based on Mindfulness Based Stress Reduction (MBSR). Results: 94 patients were recruited, 60 completed 12 months follow ups, and 33 completed 2 years follow ups. 91% were Hispanics. Mean age 55 years. 31% of participants were younger than 50 years. Stage 1 BC 38%, Stage 2 43% and stage 3 19%.75% received chemotherapy; and 74% received endocrine therapy. At baseline, PSC representing the mean for the SF-36 QOL Physical Health was 45.75, and the MSC for Mental Health was 43.7, both below the population norm (50.0). Mean scores for GAD7 was 7.3 and for PHQ9 7.62, both abnormal (< 5). At 12 months PSC 46.02, MSC 46.1, GAD7 was 4.92; and PHQ9 was 5. At 24 months, PSC 45.65; MSC 47.02; GAD7 4.88; and PHQ9 4.52. Patients older than 50 years who attended the MBSR courses showed the most improvement in MSC and PHQ scores. Conclusions: BC survivors, predominantly Hispanics, benefited from participating in this program with improved mental SF36- HRQOL, a significant and long - lasting improvement in anxiety and depression at 12months and 24 months. Future efforts should focus on programs targeting younger cancer survivors who did not appear to derive a significant benefit overall. Also, additional efforts are needed to address physical -health related quality of life in cancer survivorship programs by introducing, as an example, exercise and pain control interventions.
Partners of young breast cancer survivors: A cross-sectional evaluation of psychosocial issues and mental health.
Authors: Borstelmann Nancy , Rosenberg Shoshana M. , Gelber Shari I. , Meyer Meghan E , Ruddy Kathryn Jean , Schapira Lidia , Come Steven E. , Borges Virginia F. , Cadet Tamara , Maramaldi Peter , Partridge Ann H. 
Published: March 2017

184 Background: While evidence of the challenges of cancer caregiving has been growing, scant research addresses the experience of partners of young adults with cancer. These individuals and their relationships may be particularly vulnerable to stress, especially when managing the complexity of cancer care and survivorship with their partner. We sought to evaluate psychosocial concerns and mental health in the partners of young survivors of early stage breast cancer (BC). Methods: We invited partners of young women w/BC diagnosed at age ≤ 40 yrs enrolled in a prospective cohort study to participate in a one-time survey evaluating psychosocial concerns including quality of life, coping, social support, financial insecurity, partnership concerns, parenting concerns, anxiety and depression. Logistic regression was used to explore predictors of anxiety (score > 8 on Hospital Anxiety and Depression Scale (HADS)). Results: Most respondents (284/289) were male, with median age 43 yrs (range 27-65). The median time of survey completion was 62 months (range 16 -114) after their partner’s dx. Respondents were mostly white (93%), working full time (94%), and college educated (78%); 29% reported some financial stress, 74% were parenting children < 18 yrs, and 32% reported at least a fair amount of relationship concern. 42% (106/250) had anxiety (39/289 respondents (13%) had incomplete/missing HADS). In univariable analyses, lower education, working full time, parenting concerns, insufficient social support and maladaptive coping were associated (p < .05) with anxiety. In the multivariable model, only maladaptive coping remained significantly associated with anxiety (p < .01, OR = 2.32 (95% CI: 1.22, 4.39)). Conclusions: Partners of young BC survivors who used less constructive/more maladaptive coping strategies experience negative mental health outcomes after tx has ended. Caregivers’ anxiety may have implications for both their own and survivors’ health and QOL. Future interventions might focus on the development of constructive coping strategies to enhance adjustment and role effectiveness in dealing with the impact of cancer.
Caregiver preferences for increasing patient survival in advanced melanoma.
Authors: Hauber A. Brett , González Juan M. , Posner Joshua , Lees Michael 
Published: March 2017

185 Background: Patients with advanced cancer and their caregivers may often accept shorter life expectancy to ensure higher quality of remaining months of life. Our objective was to elicit caregiver preferences for quality-adjusted survival associated with treatments for advanced melanoma using a discrete-choice experiment. Methods: Adults in Germany and Sweden caring for people with diagnoses of advanced melanoma completed a web-enabled, discrete-choice experiment. The survey presented caregivers with a series of 10 choice questions, each including three profiles – a pair of hypothetical melanoma treatments and standard of care. Each profile was defined by survival time (24 months, 12 months, 6 months), severity (mild, moderate, severe) of melanoma symptoms, nausea and vomiting, diarrhea, skin problems, and out-of-pocket cost. Treatment profile pairs in choice questions were based on an experimental design with known statistical properties. Standard of care was constant across all choice questions. Regression analysis related respondents’ choice to treatment characteristics and estimate preference weights in each country. Results: 188 respondents in Germany and 202 in Sweden completed the survey. Caregivers choices were consistent with accepting tradeoffs among efficacy, symptom severity, severity of toxicities and cost. Severity of melanoma symptoms was the most important outcome for Swedish caregivers and was approximately as important as survival time for German caregivers. German caregivers placed positive value on each additional month of survival regardless of symptom severity. In Sweden, additional months of survival were of positive value to caregivers except when melanoma symptoms were severe or patients experienced severe nausea, vomiting, and diarrhea concurrently. In all cases where additional months of survival had positive value, the incremental value of each additional month diminished as overall survival increased. Conclusions: Additional months of life with severe symptoms or toxicities may not be viewed as unambiguously good outcomes. Quality of survival is not only a key consideration, but may determine whether a given treatment for melanoma is considered better or worse than standard of care.
The forgotten children.
Authors: Kuo Chris , Kent Paul , Ording Jeff 
Published: March 2017

188 Background: The “forgotten children” of pediatric cancer are the siblings. There is a dearth of literature published on the effects of cancer on the siblings’ psychosocial state. Despite significant improvements made in the survival of pediatric cancer patients, the psychosocial health of the siblings remains the same. We hope to shed light on siblings, as well as recognize the emotional and psychological toll they endure as the “forgotten children.” Methods: Selective, narrative review of psychosocial consequences of being the siblings of children with cancer was performed from January 1980 through October 2016 using key words: pediatrics, oncology, psychosocial care, siblings, forgotten children, psycho-oncology, bereavement, caregivers. Results: Compared with siblings of children with other chronic illnesses, siblings of children with cancer endure more emotional distress and adaptive difficulties. From the moment the diagnosis is given, until their sibling’s death, siblings of children with cancer are unmoored. Throughout the cancer trajectory, they are isolated from support systems both inside and outside the family. They experience a wide spectrum of emotional turmoil from intrusive thoughts (anger, unworthiness, jealously, fear, loneliness or guilt), to post-traumatic growth (appreciation of life, desire to pay back society, greater self-knowledge). Since 1990s, various qualitative and quantitative studies have been published for siblings of children with cancer, but little has changed since these reports. Siblings continue to be the “forgotten children” in the family and their needs remain unmet. Siblings endure various distresses throughout the different stages of cancer trajectory. The complexity of the roots of their distress requires meticulous attention to dissect and unravel. Conclusions: Research on the psychosocial well-being for siblings of children with cancer remains limited. Consistencies with screening and supportive interventions continue to be lacking. A standardized screening tool with early interventional services should be implemented. Additionally, interdisciplinary awareness of the siblings’ psychosocial issues should be increased in order to shed light to their invisibility. The goal is to remember the “forgotten children.”
Supportive oncology and survivorship care: Initial impact of the Coleman Supportive Oncology Collaborative.
Authors: Trosman Julia Rachel , Weldon Christine B. , Rosenberg Carol A. , Gerhart James , Garcia Sofia F. , Dale William , Patel Urjeet , Khosla Pam , Lo Shelly S. , Macias Javier , Robinson Patricia A. , Danciu Oana Cristina , Boecher Stephanie , Berardi Rosa , Diaz Aidnag , Penedo Frank J. 
Published: March 2017

2 Background: The Institute of Medicine (IOM) and Commission on Cancer (CoC) recommend supportive oncology and survivorship care. The Coleman Supportive Oncology Collaborative (CSOC) aims to improve quality of supportive care and survivorship in Chicago. Methods: CSOC includes 35 institutions (cancer centers, support and hospice), structured in two design teams (Distress & Survivorship and Palliative). Participants identified opportunities and gaps in supportive and survivorship care in an iterative development of: screening tools, follow-up processes, provider training, and quality metrics to assess CSOC impact. Six process improvement sites (2 safety-net, 3 academic & 1 public) reviewed patient charts at baseline and Q1 2015, compared by Fisher’s exact test. Results: Eight metrics contained patient data at the 2 time points; improvements were seen in 6/8 metrics. Conclusions: CSOC successfully developed supportive oncology, survivorship screening, and care processes aligned with IOM and CoC standards. Significant improvements were shown after implementation in diverse settings. Ongoing work will continue to evaluate the impact of the CSOC on patient care. [Table: see text]
Patient distress assessment in a VA oncology clinic: A quality improvement project.
Authors: Jayani Reena , Kumar Geetika , Markert Ronald , Heard Amy 
Published: March 2017

203 Background: Distress in oncology patients (pts) has a negative impact on quality of life, survival, and healthcare satisfaction. Higher distress is related to lower compliance with treatment and follow-up. The 2012 American College of Surgeons Commission on Cancer (CoC) standard of care for oncology pts included an assessment for distress. A screening process for distress allows the healthcare team to address these issues early and refer to appropriate resources. This project was initiated to meet National Comprehensive Cancer Network (NCCN) and CoC standard of care; identify distress in veterans with cancer; and address these concerns. Presented here are preliminary results. Methods: Pts who attended the Tuesday oncology clinic at the Dayton VAMC were given the NCCN Distress Thermometer (DT) during triage. The treating physician addressed problems identified. The Wilcoxon Signed Rank Test and the Friedman Test were used. Results: DTs were completed by 232 pts from March to September 2016. Mean age was 68, 93% male, 83% white, 54% married, and 93% without PTSD. The distress level was not different from T1 through T3. Number of problems decreased over three time periods, and Referrals to nutrition, mental health, and social work services increased over time (see Table). Conclusions: Although over time periods we found no decrease in distress scores, there was a decline in number of problems. The mean distress score at all but Time 4 was <4, which is considered mild distress. The mean distress score at T4 was 4.36 (n=14), suggesting that the few pts who return to clinic more than three times may be experiencing more difficult personal and environmental circumstances. This pt sample ranged from those undergoing intensive cancer treatment (e.g., chemotherapy) to less intensive treatment (e.g., hormone injections) to those who completed treatment. As this tool was implemented only on one clinic day, some time points were missed if a pt was seen on a different day. [Table: see text]
Dermal biomarkers in cancer patients: Monitoring subjective health objectively
Authors: Li David G , LeCompte Gabrielle , Mo Lihong , Weintraub Miranda , Irwin David , Cecchi Gary , Matecki Amy 
Published: March 2017

205 Background: Breast cancer is the most prevalent malignancy among women worldwide. Increased levels of oxidative stress are associated with breast cancer incidence. This study assesses physical, behavioral, and subjective health correlates of oxidative stress and associations between oxidative stress and breast cancer stage. Methods: Current and previous breast cancer patients were asked to participate in this cross-sectional study. After assessing Electronic Medical Record (EMR), a sample of 149 patients met the inclusion criteria. A final sample of 102 (68%) were enrolled. Patients’ skin carotenoid scores (SCS), a dermal measure of oxidative stress, were recorded. Patient demographics, physical health (breast cancer stage, treatment status, weight, height) health behaviors (smoking status, diet) and subjective health (anxiety and self-rated health) were ascertained. Results: No correlation between breast cancer stage and SCS was found. SCS was associated with behavioral health, weight and height (p<0.05), a finding consistent with previous research. A multivariate linear regression analysis, controlling for all covariates, found the two subjective health measures to be associated with SCS scores; the presence of anxiety was associated with lower SCS scores, a novel finding (β=-0.48, 95% CI -0.93, -0.035). Moreover, self-rated health was inversely correlated with SCS, showing those with lower self-reported quality levels paradoxically had higher levels of SCS (β=19.89, 95% CI 6.12, 33.67). Conclusions: Although oxidative stress as measured by SCS may not be associated with breast cancer staging, future research should explore the causal relationship between oxidative stress and subjective stress. Results suggest an unknown biochemical mechanism linking increased levels of oxidative stress with lower subjective health scores. Findings of the study indicate the possibility of utilizing SCS as an objective correlate to gauge an individual’s subjective stress levels in order to optimize cancer treatment.
A pilot study of the Pathways program to address fear of recurrence and reduce distress among breast cancer survivors.
Authors: Hadeler Edward Kenji , Wong Emily Claire , Mamounas Matina Elise , D'andrea Carrie , Hicks Greg , Esserman Laura , Melisko Michelle 
Published: March 2017

206 Background: Breast cancer patients endorse anxiety and fear of recurrence for years after diagnosis. The Pathways for Survivors is a one-day program intended to address this distress by teaching cognitive behavioral strategies that improve self-efficacy, communication, attitude, and coping. The workshop incorporates an evidence-based program developed by authors/researchers Greg Hicks and Rick Foster, which has been adapted for the breast cancer survivorship population. Methods: Patients who had completed their acute phase of care were invited to attend the workshop. Attendees were asked to complete a series of questionnaires either on paper or electronically at baseline, 1 week and 6 weeks following the program and were consented to have their data used for research. Questionnaires included evaluation of program content and moderator quality, as well as measures to assess the impact of the Pathways intervention including the PROMIS Anxiety and Depression Short Forms, and the Acceptance and Action Questionnaire (AAQ-II). Results: Three sessions were held between 9/2015-9/2016. A total of 27 patients participated (6 in the first, 13 in the second, 8 in the third). Mean age of participants was 49 (range 28-65) years old. Race and ethnicity was: 63% White, 11% Asian, 4% Pacific Islander, 11% other, and 15% Hispanic/Latina (total > 100% due to a patient reporting more than one race/ethnicity). The table below summarizes the change in these scores over time. Evaluations showed that patients were extremely satisfied with the program and moderator, receiving average ratings of 9.6/10 and 10/10, respectively. Conclusions: The Pathways workshop was well received and appears to have at least a short-term impact on breast cancer survivors’ anxiety, depression, and psychological flexibility. [Table: see text]
Improvement in sexual function after ovarian cancer: Sexual therapy and rehabilitation after treatment for ovarian cancer (START-OC).
Authors: Bober Sharon L. , Recklitis Christopher J. , Michaud Alexis L. , Wright Alexi A. 
Published: March 2017

210 Background: Sexual dysfunction is a distressing long-term effect after ovarian cancer (OC), affecting up to 90% of survivors for years. Despite its prevalence, treatment-related sexual dysfunction is underrecognized and undertreated for OC survivors. We developed and tested a brief, psychoeducational intervention for managing sexual dysfunction after OC. Methods: 45 OC survivors with sexual dysfunction received a single half-day group intervention that included sexual health education, relaxation and cognitive behavioral therapy (CBT) skills to address sexual symptoms and a single tailored telephone booster call 4 weeks post-group. Assessment measures were completed at 4 time points: Baseline 1, Baseline 2 (after an 8 week no-treatment run-in period), and 2 and 6 months post-intervention. The Female Sexual Function Index (FSFI) assessed sexual functioning and the Brief Symptom Inventory (BSI-18) captured psychological distress. Results: Analyses examined changes from Baseline 1 to subsequent time points. Between Baseline 1 and 2 there were no significant changes on study measures, indicating no natural improvement during the run-in period. In contrast, Total FSFI scores improved significantly from Baseline 1 to the 2 month (n = 45, p < .005) and 6 month (n = 35, p < .05) follow-ups. Effect sizes were moderately large indicating a significant improvement in women’s sexual function post- intervention (d = .5) that was sustained for at least 6-months (d = .4). BSI-18 scores were also significantly improved at the 2 -month (p < .005) and 6 month (p < .01) time-points, compared to Baseline 1. Conclusions: Improvements in overall sexual functioning and psychological distress were observed 2 months post-intervention and maintained at 6 month follow-up, suggesting preliminary efficacy of the intervention in reducing sexual dysfunction in OC survivors. Next steps include collection of additional follow-up data on participants. A randomized trial of START-OC is warranted. Clinical trial information: NCT02287519.
A feasibility study of a new smartphone application for patients with cancer.
Authors: Kitano Atsuko , Shimizu Chikako , Uchitomi Yosuke , Boku Narikazu , Ohi Jun , Sawai Noriko , Tokonabe Yoshie , Fujitomo Takashi , Matsuda Yuta , Sakurai Naomi , Fujiwara Yasuhiro 
Published: March 2017

211 Background: Smartphone-applications have been used for self-care, but not all applications have a sufficient level of efficacy. We evaluated the feasibility of a new smartphone application (the App) which has two main functions—diary function and SNS function—and investigated the characteristics of active users. Methods: Patients who visited the Breast and Medical Oncology or GI Medical Oncology divisions at National Cancer Center Hospital were recruited between March and April in 2016. Participants could use the App for 28 days. Web-based survey was performed before and 28 days after using the App. The primary endpoint was Daily Active User (DAU) rate (the number of daily log-in user divided by the number of patients who completed installation). A mean DAU rate higher than 20% was predetermined as feasible. The secondary endpoints were daily diary function user rate, daily SNS function user rate, and overall user rate and change of Edmonton Symptom Assessment System Revised Japanese version (ESAS-r-j) before and after the App use. “Active user” was defined as a participant who used the AppeWe more than median active days for diary or SNS function. Duration of App use was counted from the date of installation to the date of last use, and overall user rate was calculated by Kaplan Meier method. Results: One-hundred and four patients (96%) completed the App installation and answered the first survey. All patients were followed for 28 days. The mean DAU rate was 50.9%. Active diary function user rate was 53% and active SNS function user rate was 40%. Overall user rate was 87.5%. Diary function was used more frequently by male patients than female, and non-breast cancer patients. SNS function was used more frequently by unemployed patients than others, and by patients younger than 40 y/o. We could evaluate the change of ESAS-r-j score in 80 patients who answered the second survey. There was a significant improvement of depression score among patients who were single and who had metastatic disease. Conclusions: The App was considered feasible. Gender, cancer type, job status, and age may influence the behavior of the App use. The App may improve patients’ psychological symptoms, but further investigations are warranted to reveal the clinical utility of the App.