bluuebunny/crossref_metadata_2025_split huggingface dataset:
The feasibility and utility of a protein sparing modified fast (PSMF) in obese endometrial cancer survivors: A pilot study.
Authors: Lawler Thomas Patrick , Kavanagh Mary Beth , Nagel Christa Irene , Ruckstuhl Kristen Taylor , Singh Sareena , Resnick Kimberly Erin 
Published: February 2017

170 Background: Endometrial cancer affects 50,000 women a year. Obesity plays a significant role in the pathogenesis of endometrial cancer. Obese endometrial cancer survivors (ECS) are at significant lifetime risk of diabetes, cardiovascular disease (CVD), recurrence and death. There are no prospective studies examining the role of diet only in attempting to achieve weight loss in obese ECS. Protein sparing modified fast (PSMF), an approach to rapid weight loss, has been used to treat obesity in a safe manner. A pilot study is underway to investigate the feasibility of a PSMF for weight loss in this high risk population. Methods: To date, seven obese (BMI > 30kg/m^2) ECS have been placed on a PSMF under the supervision of a physician and dietitian. Patients provided demographic information and Obesity Quality of Life (OQOL) questionnaire. Comprehensive metabolic panel with lipid panel and biomarkers of inflammation were drawn. Patients were instructed to eliminate carbohydrate containing foods and to augment with 1.2g/kg of protein per obesity-adjusted ideal body weight. Primary objectives are: total weight loss, subject retention, compliance, side effects, QOL and alterations in markers of obesity and inflammation. Results: The median age of the patient group was 56 years. Median baseline weight was 292.4 pounds (185.9-369). Median BMI was 44.5 kg/m2 (37.5-61.4). Mean baseline leptin level was 54.3 ng/ml (normal: 2.5-21.8). Mean baseline C-reactive protein level, a strong marker for CVD, was 4.574 (high risk for CVD > 3). At 4 weeks median percent body weight lost was -6.48% (5.19%-7.00%). At 3 months the median loss nearly doubled to -13% (8.31%-14.11%). Significant reduction in CRP and leptin occurred in 2 patients: mean decrease was 3.9 and 28 points respectively. Conclusions: Our early data demonstrate that significant weight loss in obese endometrial cancer survivors is achievable in a standard outpatient gynecologic oncology practice. While long term follow up data and elucidation of the true significance of improvement in serum inflammatory markers are needed, we do know that even a 5-10% loss of body weight can lead to substantial improvement in CVD and diabetes risk.
Health care satisfaction among older cancer survivors.
Authors: Halpern Michael T. , Urato Matthew , Kent Erin E. 
Published: February 2017

18 Background: Cancer survivors experience unique challenges in receiving needed health care services. There is little information on individual-level factors affecting satisfaction with health care services among survivors. Methods: This study used satisfaction ratings provided by cancer survivors in the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Medicare Survey linked to data from NCI’s SEER Program (SEER-CAHPS). CAHPS data on self-reported general and mental health status and five composite measures of satisfaction with health care interactions (customer service, doctor communications, getting care quickly, getting needed care, and getting prescription drugs) were linked to patient sociodemographic and cancer characteristics from SEER. Medicare beneficiaries diagnosed with cancer in SEER regions 1997-2011 participating in CAHPS Medicare Survey > 1 year after cancer diagnosis were included. The study included individuals alive > 1 year following CAHPS completion, at least age 66, and diagnosed with non-metastatic breast, colorectal, lung, or prostate cancer. Analyses were performed separately by cancer type. Results: Among 23,969 cancer survivors with linked SEER-CAHPS data, higher general health was associated with higher satisfaction for all survivors except those diagnosed with lung cancer; higher mental health predicted higher satisfaction only among lung and prostate cancer survivors. Higher education predicted lower satisfaction among breast cancer survivors. Non-white survivors generally had lower satisfaction, although results were mixed. Among breast and prostate cancer survivors, fee-for-services Medicare (vs. Medicare advantage) was associated with lower customer service satisfaction but higher satisfaction with getting prescription drugs. Breast cancer patients diagnosed with stage 3 disease reported greater satisfaction than did those diagnosed at stage 1. Conclusions: Factors associated with health care satisfaction ratings for cancer survivors showed substantial variations by cancer types. Programs to improve survivorship care and outcomes need to be tailored to survivors’ clinical and sociodemographic characteristics.
Parenting experiences of cancer survivors with young children in the 2012 LIVESTRONG Survey for People Affected by Cancer.
Authors: Whitney Robin L. , Bell Janice , Reed Sarah C. , Blackmon Emma , Kim Katherine K. , Joseph Jill G. 
Published: February 2017

189 Background: When a parent is diagnosed with cancer, family functioning may be disrupted, placing children at risk. Little is known, however, about the parenting experiences of cancer survivors. Methods: Among cancer survivors with children age ≤ 20 years at diagnosis (n = 2,375) in the 2012 LIVESTRONG Survey for People Affected by Cancer, we used logistic regression to model the odds that 1) children were not fully emotionally supported or that 2) cancer affected survivors’ ability to provide care for their children. Odds ratios (OR) and 95% confidence intervals (CI) were calculated. Predictors included age of youngest child at diagnosis ( ≤ 10 years versus 11-20 years), survivor report of high distress, and confidence obtaining emotional support. Models also controlled for important sociodemographic covariates. Results: Among survivors, 50% reported that their children were not fully emotionally supported, and 58% reported that cancer affected their ability to provide care for their children. Significant predictors of children not being fully emotionally supported included: government insurance (OR 1.5; 95% CI 1.0-2.1); annual income ≤ $60,000 (OR 1.6; 95% CI 1.3-2.1); being retired (OR 1.7; 95% CI 1.2-2.4); or female (OR 1.4; 95% CI 1.1-1.7). Significant predictors of cancer interfering with the ability to provide care for children included: female sex (OR 2.2; 95% CI 1.8-2.7), survivor report of high distress (OR 1.6, 95% CI 1.4-2.0), having a child ≤ 10 years (OR 2.5; 95% CI 2.0-3.2), or a child who was not fully emotionally supported (OR 1.5; 95% CI 1.3-1.9). Survivors with confidence in their ability to obtain emotional support were less likely to report that cancer interfered with their ability to provide care (OR 0.8; 95% CI 0.6-0.9). Conclusions: Many cancer survivors with young children at diagnosis report that cancer or its treatment affects their ability to provide care, or that their children are not fully emotionally supported. Increased attention to the psychosocial needs of parenting cancer survivors is warranted, particularly among women, those with public insurance, lower incomes, children ≤ 10 years and survivors who report high distress levels or inadequate emotional support.
Evaluation of an interactive portal for breast cancer survivors: Use, satisfaction, and preliminary effects.
Authors: Kuijpers Wilma , Groen Wim G , Oldenburg Hester SA , Wouters Michel W.J.M. , Aaronson Neil K , van Harten Wim H 
Published: February 2017

200 Background: MijnAVL is an interactive portal that includes patient education, an overview of appointments, access to the electronic medical record (EMR), patient-reported outcomes plus feedback and physical activity support. The aim of this feasibility study was to evaluate use, satisfaction and preliminary effects among breast cancer survivors. Methods: We included women currently or recently treated for breast cancer with curative intent. At baseline, they completed a questionnaire on sociodemographics, expectations of MijnAVL and three effect measures: patient activation (PAM), quality of life (SF-36), and physical activity (IPAQ). MijnAVL could be used noncommittally for 4 months. Log data were collected retrospectively and participants completed questions on satisfaction and effect measures. This process was conducted twice, to be able to improve MijnAVL iteratively. Results: We included 92 women (mean age 49.5 years, 59% on-treatment). Mean number of logins was 8.7 and mean duration 13.1 minutes. Overview of appointments (80% of participants) and access to the EMR (90%) were most frequently used and most appreciated. Website user satisfaction was rated 3.8 on a 1-5 scale on average and participants were primarily positive about the accessibility of information. We did not find an effect on the PAM. For the SF-36, we found significant improvements on the role functioning – emotional (65.3 to 78.5, p< .01), mental health (69.8 to 76.5, p< .01) and social functioning (71.2 to 80.5, p< .01) domains. Median vigorous physical activity significantly increased from 0 to 360 MET-minutes per week (p< .05); levels of walking and moderate physical activity did not change significantly over time. These effects were not related to the intensity of use of MijnAVL. Conclusions: This study showed that user experiences were positive and that exposure to MijnAVL resulted in improvements on three quality of life domains and vigorous physical activity. More tailored, interactive features might be needed to substantially change empowerment, quality of life and physical activity. Research with a controlled design and possibly a more sensitive measure for patient empowerment are needed to substantiate our findings.
Psychological benefits of theater-depicting cancer treatment.
Authors: Carlson Samantha , Jones Becky , Grossheim Linda , Mirro Joseph 
Published: February 2017

203 Background: The number of cancer survivors in the United States is increasing and estimated to exceed 13 million. Consequently, the quality of life of these patients and their family members has become a high priority. The best interventions to decrease distress, improve coping and quality of life for survivors are poorly understood but are becoming an important focus of research. We therefore, undertook a prospective pilot study using a questionnaire to measure the emotional impact of a play depicting cancer treatment on cancer survivors and their family members. This research project was reviewed and approved by the West Michigan Cancer Center Institutional Review Board (IRB). Methods: The emotional feelings and perceived levels of coping were measured and compared before and after the play. Statistical analyses of responses included chi-square and t-tests for continuous variables, or Fisher’s test or Wilcoxon’s test where parametric assumptions were not met. Results: A total of 60 survivors and 49 family members completed the research questionnaire. The most promising finding was that a majority of survivors and family members 51.0% (n = 50) felt they were coping better (p < 0.0001) after the play. Of the survivors, 73.0% said the play reflected their experiences and 78.0% felt it was helpful dealing with their emotions. Overall, 94.0% of those attending the play requested additional theater performances. Conclusions: Our preliminary data demonstrates that theater depicting cancer treatment has a strong emotional impact and potential therapeutic effects for cancer survivors and family members. Increased feelings of coping with the diagnosis occurred following the play. Attendees also felt less alone (59.5%) and more hopeful (53.4%) after the play.
Psychosocial distress screening and the survivorship care plan in the community oncology setting.
Authors: Dolezal Milana V. , Prishtina Mary , Ridgley Luanne , Hart-Inkster Beverly , Christensen Kimberly , Orange Dana 
Published: February 2017

206 Background: Alta Bates Summit Medical Center (ABSMC) is a Commission on Cancer (CoC) accredited comprehensive community oncology program in the San Francisco Bay Area with an annual adult cancer program of approximately 1700 patients. To satisfy CoC accreditation standards 3.2 (Psychosocial Distress Screening) and 3.3 (Survivorship) the cancer survivorship program has a collaborative nurse-led and primary oncologist-led model utilizing Journey Forward software for survivorship care plans (SCP) and the Distress Tool (DT). National standards include distress screening as an important assessment in cancer care, in order to provide interventions Methods: The self reporting DT was sent to adult cancer patients prior to a survivorship visit. Oncology nurse navigator and oncologist reviewed the DT and discussed concerns with the patient. Patients scoring 5 or greater on DT were referred to psychosocial services. Interventions based on patients’ needs include the Cancer Transitions Program(CTP), support groups and classes. Results: 100 patient charts were reviewed for DT and SCP. 95% of patients were female; 5% were male. Patients ranged in age from 22 to 92 years. 36 patients were enrolled in the 2015 CTP and 63% of those participants had completed SCP. Conclusions: The prevalence of psychosocial distress in our community oncology practice was lower than expected, in part due to the robust supportive care environment that patients actively partake in at the Cancer Center. Implementing the DT also improved patient and clinician communication resulting in more timely intervention. [Table: see text]
Patient distress and survival in palliative radiotherapy.
Authors: Habboush Jacob , Shannon Robert P. , Hollant Laeticia , Single Megan Paige , Gaines Katherine , Smart Bridget , Buskirk Steven J. , Vallow Laura , Tzou Katherine S. , Ko Stephen , Peterson Jennifer Layton , Biers Heather , Day Atiya , Miller Robert Clell 
Published: February 2017

211 Background: Distress is known to be elevated in patients receiving cancer therapy, such as palliative radiotherapy (PRT). Many patients will experience distress during treatment and it is not always addressed in part due to a lack of guidance regarding the significance of distress. Methods: All RT patients in our clinic are asked to complete a patient reported distress (PRD) survey during treatment course. PRD forms consist of 30 categorical questions that assess distress subscales. Patients have the option to rate each question from 1 (low distress) to 5 (high distress). The survey also includes the National Comprehensive Cancer Network distress thermometer, which allows patients to rate overall distress level from 0 (no distress) to 10 (extreme distress). Patients’ records were retrospectively reviewed to abstract the needed information to assess survivorship. Results: 270 patients were included from 01/18/2012-08/07/2015. Overall PRD was analyzed as a continuous and a categorical variable (low: 0-3, moderate: 4-6, high: 7-10). Continuous and categorical variable PRD did not show a correlation of distress to survival (P = 0.26) and (P = 0.10) respectively. A correlation was noted in moderate distress category (RR: 1.51, P = 0.034), however, this was not noted in high distress category (RR: 1.25, P = 0.33). There was no statistical significant correlation with the adjusted variables. Patients with primary site of gastrointestinal cancer had worst prognosis (RR: 1.34, P: 0.14), while hematological origin had best prognosis (RR: 0.35, P: 0.038).Age had the strongest correlation with survival, as older patients receiving RT had poorer survival (RR: 1.13, P: 0.079). Conclusions: This study suggests that PRD is not predictive of survival in PRT. The primary goal of PRT is to improve quality of life (QoL) by assessing, anticipating and alleviating suffering; not necessarily improve survival. It also demonstrated that the most common stressors were related to reversible short-term side effects of RT such as fatigue and pain rather than long-term stressors related to daily activities and social measures which might affect QoL. It is imperative to explore assessment tools to mitigate suffering and improve strategies to enhance QoL in all medical disciplines.
Measuring knowledge gained for young breast cancer survivors and co-survivors.
Authors: Atkinson Lori , Esser Michelle , Singh Nirmala , Rowe Jean , McCann Megan , Lewis Stacy , Sutliff Medha 
Published: February 2017

213 Background: Cancer impacts not just the survivor, but those caring for her. Young Survival Coalition (YSC) is the premier global organization dedicated to critical issues in young breast cancer survivors (YBCS) and co-survivors. In 2015, targeted programming was introduced at YSC’s Northeast Regional Symposium. Prior to the event, YSC crafted pre- and post-surveys to measure knowledge gained through the Symposium as an intervention for YBCS and co-survivors. Methods: YSC disseminated pre- and post-event evaluations via online surveys. The pre-survey was sent to registrants (240; 75 completed), and the post-survey was sent to attendees (178; 99 completed). The surveys were designed to measure baseline and increased knowledge in the 4 areas presented at the Symposium: Sex and Intimacy (S&I), Practical Matters (PM), Resiliency and Communication. Questions included demographics, diagnosis, identification as YBCS/co-survivor and baseline knowledge in the 4 areas. Questions in the post-survey followed the same format and measured knowledge gained from the Symposium. Results: In pre-survey data, YBCS and co-survivors most wanted knowledge and resources in S&I and PM. Seventy-five percent reported S&I as a challenge since diagnosis, and 51% stated communication in relationships was difficult. Twenty-two percent felt they did not have the resources they needed to address PM, while 20% felt unsure about what resources they needed. Following the Symposium, 74% felt that they had tools and resources to help in their everyday life as it relates to S&I after the Symposium. Sixty-seven percent reported gaining knowledge they did not have prior to attending. S&I as it relates to YBCS (partnered or single) and rebuilding self-confidence were areas where more information was desired. Seventy-five percent indicated they received information on PM of which they were unaware prior to attending. Follow-up care, financial concerns and career were areas where more information was desired. Conclusions: YBCS and their co-survivors are in need of support and information that is targeted and easily accessible. YSC will continue crafting specific programming for YBCS and co-survivors and measuring the knowledge of both to stay current with their needs.
Emotional/psychological characteristics of women diagnosed with breast cancer following treatment: Participation versus nonparticipation in survivorship programs.
Authors: Swiger Kathleen Dickerson , Guglielmino Janine , Labban Jeffrey D. , Rugo Hope S. , Anders Carey K. , Hanson Arin Ahlum , Henry Catherine Creme 
Published: February 2017

216 Background: Women diagnosed with breast cancer responded to an 80-question online assessment to determine their education, information, and support needs. All responses were self-reported, including those about treatment stage, emotional/psychological characteristics, and level of emotion experienced. Methods: A total of 1,443 responses were analyzed. Responses from 776 women (53.8%) who reported participation in survivorship programs were compared to responses from 667 women (46.2%) who did not report participation. On a scale of none, low, moderate, or high, respondents rated the degree to which they experienced anxiety, fear, anger, worry, sadness, and confusion following treatment. Examination of histograms revealed that emotion ratings were not normally distributed. Therefore, differences in ratings between the two groups were tested using Mann-Whitney U analyses, a nonparametric alternative to the independent samples t-test. Results: Respondents who participated in survivorship programs reported significantly higher ratings of emotional experience for anxiety (p < .001), fear (p = .004), worry (p = .002), sadness (p < .001), and confusion (p = .005). A similar trend was observed for anger, which approached significance (p = .051). Overall, survivorship program participants reported more intense experiences of negative emotions following treatment than did non-participants. Conclusions: Self-referral to survivorship programs may reflect continued patient concerns about diagnosis and prognosis, offering insights into patient populations with greater need for support following completion of treatment. Availability of programs and heterogeneity of disease characteristics and treatment may impact these results. The difference in ratings supports the importance of continued monitoring and evaluation of the emotional/psychological needs of women diagnosed with breast cancer following treatment, and especially of those women participating in survivorship programs.
Psychosocial outcomes among cancer survivors who receive a treatment summary or survivorship care plan.
Authors: Reed Sarah C. , Bell Janice , Whitney Robin L. , Blackmon Emma , Kim Katherine K. , Joseph Jill G. 
Published: February 2017

217 Background: Treatment summaries (TSs) and survivorship care plans (SCPs) were expected to bridge patient-provider communication challenges and better address the unique needs of cancer survivors. While interest in TSs and SCPs has been growing, acceptance and implementation has been slow and findings from studies of their effectiveness have been mixed, overall. Our study examines independent associations of receipt of TSs and SCPs with psychosocial outcomes of cancer survivors. Methods: The study sample included survivors completing the 2012 LIVESTRONG Survey for People Affected by Cancer (n = 5,156). Logistic regression was used to model three distinct psychosocial outcomes: having relationship concerns (yes/no), distress (defined as a rating of 6 or higher on the NCCN Distress Thermometer), and moderate or severe cancer-specific worry (yes/no) as functions of TS receipt, SCP receipt and important confounding variables (age, sex, race/ethnicity, marital status, employment, income, education and health insurance). Results: Among cancer survivors, only 51% received a TS and only 16% received a SCP. Survivors who received a TS or SCP had significantly lower odds of relationship concerns (TS: OR = 0.62; 95% CI 0.52, 0.75; SCP: OR = 0.73; 95% CI 0.57, 0.94); distress (TS: OR = 0.74; 95% CI 0.65, 0.85; SCP: OR = 0.81; 95% CI 0.68, 0.97); and moderate or severe cancer-specific worry (TS: OR = 0.76; 95% CI: 0.67-0.85; SCP: OR = 0.78; 95% CI: 0.67-0.92). Other covariates consistently associated with psychosocial concerns included younger age, being unemployed and income ≤ $60,000. Conclusions: Many cancer survivors do not receive a TS or SCP. Receipt of either document was associated with reporting better psychosocial outcomes, suggesting that TSs and SCPs may not be reaching cancer survivors with psychosocial health problems. Survivors with psychosocial concerns may benefit from targeted survivorship care.