bluuebunny/crossref_metadata_2025_split huggingface dataset:
Integrating cancer-related employment assessments into oncology care.
Authors: Nellis Rebecca , Morales Joanna , Bryant Monica 
Published: February 2017

224 Background: This presentation will provide oncology healthcare professionals with information and tools to help navigate their patients through the employment-related legal and practical issues that arise after a cancer diagnosis. These issues include working though treatment and/or taking time off work for treatment and recovery, deciding whether or not to disclose their diagnosis, returning to the workplace, managing side effects on-the-job and maintaining income. The Institute of Medicine (IOM) has called on healthcare teams to address the whole patient and warned that failing to address employment and financial concerns may threaten a patient's health. Methods: Attendees will be given information about state and federal laws that may apply to patients in the workplace, including protections against discrimination and access to reasonable accommodations. Attendees will also learn about the different needs of individuals along the continuum of care. Results: Healthcare professionals can play a meaningful role in helping patients navigate these decisions around work. Cancer and Careers surveyed oncology professionals about their patients’ work-related issues and 77.56% said their patients are asking for guidance on working through treatment (2009-2015). Seventy-seven percent of oncology healthcare professionals surveyed by Triage Cancer said it was important to include employment issues in distress screening tools, but only 25% felt comfortable or very comfortable in answering patients’ questions about the Americans with Disabilities Act (ADA), a primary tool in assisting patients navigate work and cancer. Healthcare professionals surveyed after attending a similar event responded that (a) 99.5% would recommend a similar event to others; (b) 98% said the information received can be applied to their daily patient interactions; and (c) 97.1% rated the overall usefulness of information as good or excellent. Similar responses can be expected from attendees of this presentation. Conclusions: It is critical for oncology healthcare professionals to receive education in this area, because they are uniquely positioned to help patients navigate balancing cancer and work, provided they receive appropriate training and resources.
Was it worth it (WIWI)? An OHSU Knight Cancer Institute retrospective analysis of patient satisfaction following radiotherapy.
Authors: Fain Robert , Chen Yiyi , Rana Shushan Rajesh , Dang Julie , Haly Ashley , Franklin Angel , Mirly Brandy , Lockart Jennifer , Applegate-King Kristin , Wade Michelle , Bedtelyon Sarah , Daffe Racky , Park Byung , Thomas Charles R. 
Published: February 2017

225 Background: Existing data on patient satisfaction after radiotherapy (RT) is scarce. The specific aim of this analysis is to describe the clinical experience for cancer patients (pts) completing a course of RT at OHSU’s Knight Cancer Institute. Methods: The records of 200 OHSU pts that completed a 5-item “Was It Worth It (WIWI)?” questionnaire highlighting pt satisfaction were reviewed. These data were collected upon the completion of treatment and, if available, first follow-up (f/u). Univariate analysis & logistic regression modeling were performed on pt demographic and treatment characteristics to ascertain predictors of satisfaction. Results: 200 pts (M = 174; F = 26) completed the questionnaire on their last day of treatment and 60 upon their first f/u. The median elapsed days of treatment was 34. The median days from end of RT to f/u were 46 (range: 17-302). More pts were treated for curative intent (73%) than palliative (27%). 71% and 90% stated RT was ‘worth it’ at end of treatment and at first f/u, respectively. Upon therapy completion, 52% were ‘uncertain’ if quality of life (QOL) improved. However, at first f/u, 58% reported improved QOL. Temporal differences in treatment time favored morning treatment time over evening being ‘worthwhile’ (77% vs 61%; p = 0.015). This difference remained significant on multivariate analysis (p = 0.02). Longer elapsed days conferred higher likelihood of treatment being ‘worthwhile’ compared to ‘uncertain’ (30 days vs 24 days; p = 0.023), also significant on multivariate analysis (p = 0.029). Treatment time and elapsed days were not predictive of improved QOL. Age, gender, race, marital status, employment, treatment intent or modalities, treatment delays, distance travelled, insurance type, anatomic site of treatment, and cancer stage, did not predict pt satisfaction. Conclusions: RT as being ‘worthwhile’ was associated with morning treatment times and total duration of treatment as measured by total elapsed days. Among variables analyzed, there were no significant predictors of improved QOL. The majority of patients are satisfied with RT but there is room for improvement with those treated in afternoon or in shorter durations.
Assessing the quality of life of non–Hodgkin lymphoma survivors: A population-based study.
Authors: Holland Rebecca Anne , Bird Brian Richard , Cahill Mary , Murphy Conleth G. , O'Reilly Seamus , O'Connor Emily , Boyce Maria , Crotty Rory 
Published: February 2017

227 Background: Non-Hodgkin Lymphoma survival in Ireland has improved significantly over recent years. However, little survivorship research has been conducted in this country. The aim of this study is to assess the quality of life (QOL) in an Irish population of Non-Hodgkin Lymphoma (NHL) survivors. Methods: High–grade NHL survivors treated in 2 University Hospitals participated in this cross–sectional study by completing the validated Lymphoma specific Functional Assessment of Cancer Therapy (FACT–Lym) questionnaire and Symptom Index–18. Scales were measured using a score from 1 (not at all) to 4 (very much). Raw data was transformed to linear scores, with high scores indicating a higher level of functioning. Linear regression analysis was used to compare scores according to time since diagnosis. Results: Of 87 questionnaires, 47 were completed and returned by NHL survivors (54% response rate). QOL scores improved from time of diagnosis, with the exception of 4–5 years where scores decreased before again improving in the following years. After adjusting for age and sex, statistically significant differences were identified 5+ years after diagnosis in emotional, functional wellbeing and global FACT-Lym scores when compared to 1-2 years after diagnosis. Conclusions: QOL improves post diagnosis with a transient decrease at year 4-5 which may represent anxiety prior to being declared ‘cured’ or being discharged from follow–up. Our small, mostly private patient population reported higher QOL than larger government insured American groups (Smith et. al. Health status and quality of life among Non-Hodgkin lymphoma survivors. Cancer. 2009.). Patients reported on–going symptoms after treatment ended. These findings may help to develop a focused cancer survivorship programme in the future. [Table: see text]
Quality of life in thyroid cancer: Physician perceptions.
Authors: James Benjamin Christopher , Aschebrook-Kilfoy Brisa , Kaplan Sharone , Kaplan Edwin L , Angelos Peter , Grogan Raymon 
Published: February 2017

228 Background: In a multicenter cohort of over 1,200 patients, we have shown that thyroid cancer survivors report a decrease in quality of life (QoL) that is significant and equal to other common cancers. While these findings are striking, there have been no studies assessing physician perceptions regarding how a diagnosis of thyroid cancer affects QoL. We hypothesize that there is a large discrepancy between what physicians perceive the diagnosis and treatment of thyroid cancer has on QoL and what patients report. Methods: Physicians were recruited from two national organizations. A 37-question survey was administered evaluating demographic and treatment-related information as well as questions specific to perceptions of patient satisfaction with various aspects of treatment, complications and overall effects on QoL. Responses were categorized into physical, psychological, social and outcomes. Regression analysis was performed to determine trends in physician perceptions. Results: 105 physicians completed the survey. The majority of participants were endocrine surgeons (n=59, 56.2%), followed by endocrinologists (n= 31, 29.5%), general surgeons (n=8, 7.6%), otolaryngologists (n=2, 1.9%), and medical oncologists (n=1, 1%). The mean number of years in practice was 18.78 years (n=80). There was no difference in response by physician specialty. There was no difference in physician perception on psychological and social effects of thyroid cancer compared to those reported by patients (p=0.643). However, regarding physical concerns, physicians report significantly lower rates of physical concerns than reported by patients with regards to fatigue (p<0.01), weight gain (p<0.01), voice changes (p=0.0427), and heat/cold intolerance (p<0.01). Conclusions: There is a discrepancy between physician perceptions on the effect of thyroid cancer on QoL in thyroid cancer survivors and what these survivors report. As such, there needs to be greater awareness about the effects of thyroid cancer on QoL. In order to better assess and monitor QoL in thyroid cancer survivors, a validated thyroid cancer-specific survivorship care plan incorporating these findings should be created to better assess and monitor patients with a diagnosis of thyroid cancer.
Health-related quality of life (HRQL) in Hodgkin lymphoma (HL): A systematic review (SR).
Authors: Linendoll Nadine , Saunders Tully , Burns Rebecca , Nyce Jonathan , Wendell Kristen , Evens Andrew M. , Parsons Susan K. 
Published: February 2017

234 Background: AlthoughHL is highly curable with well-established treatment regimens, the impact on patients' HRQL from diagnosis through survivorship is unclear. This SR aimed to: (1) describe the literature on HRQL in HL, (2) assess the quality of these studies and (3) identify gaps for future research. Methods: We performed a PRISMA-guided SR on HRQL in HL patients. Identified articles were double-screened and data extracted; quality was evaluated using a 6-point scale adapted from published HRQL SR. Results: Sixty-two articles published between 1986- 2014 met inclusion criteria. These included 50 (81%) cross-sectional studies and 12 (19%) longitudinal studies of which three were embedded in randomized trials (RTC). Only two of the RCTs followed patients from diagnosis into survivorship; three additional longitudinal studies began assessments at diagnosis. The majority (75%) of longitudinal studies were performed over the last decade. The sample size of HL patients varied considerably with only five (41%) longitudinal studies including >50 patients. On average, patients in the cross sectional studies were 10-plus years off treatment. Multidimensional HRQL was assessed in 40 studies, single HRQL domains in 21 studies, and symptoms, including fatigue, in 24 studies. Quality varied by study design. Conclusions: The number and quality of studies on HRQL in HL have increased over time. To capture HRQL trajectory from diagnosis through survivorship, we recommend that future research include prospective, longitudinal randomized design across treatment and time. [Table: see text]
Health behaviors in survivors of aggressive NHL.
Authors: Rosenthal Allison Claire , Maurer Matthew J. , Allmer Cristine , Ansell Stephen Maxted , Farooq Umar , Habermann Thomas Matthew , Link Brian K. , Witzig Thomas E. , Yost Kathleen J. , Cerhan James Robert , Thompson Carrie A. 
Published: February 2017

236 Background: Patients (pts) with aggressive lymphoma are generally treated with curative intent and many become long-term survivors. There is little data on health behaviors after lymphoma diagnosis and their effect on QOL and long-term outcomes. Methods: Lymphoma pts were prospectively enrolled within 9 months of diagnosis in the University of Iowa/Mayo Clinic SPORE Molecular Epidemiology Resource (MER) and systematically followed. We measured QOL (FACT-G) and health behaviors (tobacco/alcohol use; diet/exercise habits) 3 years after diagnosis. For this study, “survivor” was defined as alive at 3 years from diagnosis with no active disease or treatment within the previous year. Results: From 2002-2012, 671 patients with aggressive lymphoma were enrolled, met survivor definition, and completed 3-year QOL and health behavior questionnaires. At 3-years, 31% of female (F) and 48% of male (M) reported a history of tobacco use for 6+ months. Of these, 13% of F and 7% of M were still smoking; 52% reported decreased use from baseline. 66% reported no change in alcohol intake at 3-years while 25% of F and 34% of M reported decreased intake. 60% often chose whole grains and 65% get 2+ servings of vegetables daily. 42% of F and 38% of M “somewhat” believed diet could change the course of their lymphoma. Most pts endorsed no significant change in diet as a result of diagnosis. Those who made changes did so primarily out of concern for “health problems other than cancer”. Overweight/obese responders were 72% pre- and 66% post-treatment. A desire to lose weight was reported by 55% of pts. 14% of F and 23% of M often engaged in regular physical activity (PA). Nearly 50% reported a decrease in PA. Pts with advanced stage (p = 0.006), age > 60 (p = 0.001), ECOG PS > 2 (p = 0.04), and worse prognostic score (p = 0.006) were more likely to report decreased PA since diagnosis. 68% of F and 61% of M intend to become more active in the next months. Regular PA (p = < 0.0001) was associated with higher QOL, while increased alcohol intake was associated with lower QOL (p = 0.009) at 3 years. Conclusions: Many survivors of aggressive NHL strive to adopt healthy behaviors and these behaviors are associated with higher QOL. Interventions aimed at emphasizing these behaviors may have potential to improve long-term outcomes and QOL.
Exploring factors influencing sexual satisfaction among breast cancer survivors: The role of sexual communication.
Authors: Lawsin Catalina Rosario , Ballard Angela 
Published: February 2017

251 Background: Changes to sexual wellbeing after cancer treatment can impact sexual satisfaction, depending on sexual function and relationship satisfaction. While communication has been shown to be a critical component of supportive relationships, it is unclear how it impacts sexual satisfaction, particularly amongst cancer survivors. This study aims to develop a model to understand factors of sexual satisfaction amongst breast cancer (BC) survivors and explore the role of communication. Methods: Adult (18+) BC survivors were invited to participate in an online survey via Register4. Measures included: demographics, the PROMIS Global Satisfaction with Sex Life Scale, Female Sexual Function Index, Sexual Self-Disclosure Questionnaire, The Dyadic Sexual Communication Scale, Dyadic Adjustment Scale, the Hospital Anxiety and Depression Scale. Research questions were addressed using correlations and a hierarchical Multiple Linear Regression. Results: 238 BC survivors (ave age=53) reported lower levels of sexual function within this sample when compared to other studies (FSFI M =17.96, SD =10.39). Higher levels of education (r=.17), dating or de facto relationships (r=.19) and living separately(r=.23), younger age (r=-.16) and shorter relationship length (r=-.14) were associated with higher levels of sexual satisfaction (p<.01). Education level, sexual function and sexual communication explained 78.5% of the variance in sexual satisfaction. There was a significant interaction of sexual function and sexual communication where the effect of high levels of sexual communication was increased at high levels of sexual function compared to lower levels of sexual function (β=.101, p=.005). Conclusions: Sexual function and communication play a significant role in sexual satisfaction amongst BC survivors. While many strategies to improve sexual function may be handled by women themselves, others require effective sexual communication with their partners. These results highlight the need for interventions to teach patients effective sexual communication after sexual changes due to cancer treatment.
How clinicians make decisions regarding surveillance and treatment of colorectal cancer (CRC) patients.
Authors: Cuddy Amanda , Van Loon Katherine , You Y. Nancy , Hu Chung-Yuan , Francescatti Amanda Beth , Greenberg Caprice Christian , Venook Alan P. , Schrag Deborah , Chang George J. 
Published: February 2017

263 Background: The goal of post-treatment surveillance of CRC patients is to identify recurrences among patients eligible for salvage surgery or palliative chemotherapy. However, patient ineligibility for treatment of recurrence may contribute to variation in surveillance practices. The aim of this study was to evaluate patient factors that affect clinician decisions regarding surveillance and salvage treatment eligibility among CRC patients. Methods: A custom 41-item survey was developed, incorporating modified criteria for adult comorbidity evaluation. A convenience sample of physicians who treat CRC was recruited from the ALLIANCE GI Cancer Committee. All participants completed an anonymous written survey of objective and subjective information about salvage treatment eligibility and the impact on surveillance in these patients. Results: Respondents were medical oncologists (n = 16; n = 11 with > 10 yrs experience) and surgical oncologists (n = 4). Patients with average comorbidity were considered ineligible for curative salvage surgery at median age 85 yrs (IQR: 80, 90), life expectancy 3 yrs (IQR: 2, 4.8) or ECOG ≥ 2 (IQR: 2,3). Patients were considered ineligible for palliative chemotherapy at median age 90 (IQR: 80, 92.5), life expectancy ≤ 2 years (IQR: 1.5, 3) or ECOG status ≤ 3 (IQR: 3, 3). Patients with above average comorbidity were considered ineligible for salvage surgery at median age 80 yrs (IQR: 75, 80) and palliative chemotherapy at median age 80 yrs (IQR: 75, 85). 8 comorbidities were identified by > 75% of the respondents as determinants of treatment ineligibility. 12 respondents (60%) indicated follow-up of patients ineligible for treatment should be continued based on patient desire, ongoing management of late effects, and continuity of care. However, a majority (n = 15) responded that clinic visits only should be continued without further testing. Conclusions: Considerable agreement was observed regarding patient characteristics that lead to ineligibility for treatment of recurrent disease. This information can aid shared clinical decision-making for post-treatment surveillance strategies and may potentially reduce variation in surveillance practice.
The True NTH Prostate Cancer Survivorship Care programme: Development and evaluation of a model for delivering follow-up care to men with prostate cancer.
Authors: Richardson Alison , Frankland Jane , Brodie Hazel , Cooke Deborah , Pickering Ruth , Gage Heather , Foster Rebecca , Foster Claire 
Published: February 2017

42 Background: Increasing use of prostate specific antigen (PSA), improvements in treatment and aging population have led to the escalating incidence of prostate cancer. 5 year survival rate is relatively high and men who have completed treatment require long-term follow-up to detect recurrence or progression of disease, monitor adverse effects of treatment and identify and address psychosocial needs. Studies demonstrate men have a range of unmet physical and psychosocial needs, and health services are struggling to cope with the growing numbers. Changes is critical for long-term sustainability of the health system in many developed nations Methods: This presentation presents a model of follow up care centered on remote surveillance of PSA combined with promoting patient self-management. This initiative is part of the True NTH programme of developments initiated in the UK with funding from Movember Foundation and Prostate Cancer UK. Traditional face to face clinic follow up consultations are replaced with: patient directed individually tailored care and surveillance programme which involves: a 4 hour preparatory patient workshop, remote assessment of unmet needs and symptoms and surveillance of PSA, patient information resources, survivorship care plan, communication of treatment summary and management plan to primary care, and rapid recall system for assessment in secondary care should the need arise. The care programme is mediated through clinician and patient access to an IT portal enabling communication. Results: The second part of the presentation will describe the evaluation protocol. A historical cohort design is comparing a group of men receiving clinic follow up care (N = 300) with men enrolled on the care programme (N = 300) in 3 centers. Patient-reported outcomes are collected at baseline, 4 months and 8 months. Health economic evaluation will compare costs of clinic based follow up with those of the care programme from both a health service and patient perspective. Conclusions: The evaluation will generate data on impact, acceptability and cost of this model of follow-up care.
A new survivorship model for adolescents and young adults (AYA).
Authors: Barthel Erin Marie , Karim Sabrina , Kiernan Elizabeth , Spencer Katherine , Murphy-Banks Rachel , Burns Rebecca , Lin Mingqian , Linendoll Nadine , Saunders Tully , Parsons Susan K. 
Published: February 2017

43 Background: The AYA population is a growing group of cancer survivors, currently exceeding 600,000 in the US, with 70,000 new diagnoses each year. These survivors experience deficits in general health, mental health, and functional status. Unfortunately, many are lost to follow-up after the completion of active therapy. They lack clarity about where to go for care and why such care is needed. To further complicate this, many have not established a primary care provider (PCP). Methods: We present a model of survivorship care tailored to the AYA population. Our clinic has dedicated physical space and is staffed by pediatric- and adult-trained oncologists. Survivors are paired with age-matched peer navigators to guide them through the logistics of follow-up care and assist with age- related transitions in education, housing, and insurance. Additionally, we have established a new model of survivorship care, introduced immediately at the end of active therapy, utilizing a staged curriculum, survivorship care plans, and point-of-care health-related quality of life assessment. Results: Fifty-five unique patients seen in 182 visits provided data for this report. The median age was 26 years (range 18-40). Twenty-nine (53%) of the patients were female. The majority of patients (58%) had been treated for a hematologic malignancy. One third of patients had completed college (31%). Most were employed (71%), but a majority still lived with their parents (64%). The majority of patients had more than one late effect (62%). Twenty-three (43%) reported mental health symptoms, including anxiety, mood swings, or sleep problems. Conclusions: A survivorship clinic with tailored programs for AYAs is feasible and necessary. In our sample, many AYA survivors have late effects and almost half reported psychosocial distress. Clinicians need to monitor this age group closely to ensure that patients are not lost to follow-up as they transition from active treatment to survivorship care and from pediatric to adult-based care. Our clinic provides an integrated medical home for the AYA survivor that continues to care for them when active treatment comes to completion and provides ongoing care coordination with PCPs and subspecialists to co-manage their complex health issues.