bluuebunny/crossref_metadata_2025_split huggingface dataset:
Importance of surgical role on anxiety of patients with breast cancer: Twelve-month follow-up prospective study.
Authors: Park Sungmin , Lee Sekyung , Bae Soo Youn , Lee Jeong Eon , Kim Seok Won , Nam Seok Jin , Cho Juhee 
Published: February 2017

195 Background: Breast cancer diagnosis and treatment often produce stress in patients.Anxiety is one of the most prevalent psychological symptoms perceived by breast cancer patients. This study aims to evaluate the temporal patterns of anxiety and find factors associated with persistent anxiety during breast cancer treatment. Methods: This is prospective cohort study. Between July 2010 and July 2011, we recruited patients with non-metastatic breast cancer who were expected to receive adjuvant chemotherapy (N = 411) from two cancer hospitals in Seoul, Korea. Trained researchers interviewed participants and the patients also completed questionnaires on quality of life at enrollment (before surgery), 2 weeks, 3 months, 6 months and 12 months post-surgery. Anxiety was measured using the Hospital Anxiety and Depression Scale (HADS). Borderline and abnormal levels of HADS scores were classified into the abnormal group for comparison purposes. Results: The mean age of the participants was 46.4 (±7.9) years. Preoperatively, 44.5 % (183/411) of the patients showed abnormal anxiety. The proportion of the subnormal anxiety group significantly decreased after surgery (P < .01) and this phenomenon continued until the 12 month follow-up point. Patients experienced renewed anxiety at 12 months when the main adjuvant therapies were finished. Socioeconomic factors were not associated with persistent anxiety. Pain, breast, and arm symptoms were significantly higher in the persistently abnormal group, especially at postoperative 6months and 12months. Conclusions: Anxiety disorder was common in patients who were diagnosed with breast cancer (44.5%). Surgery was a major relieving factor of anxiety, and patients who finished their main adjuvant treatment experienced renewed anxiety. Surgeons should be the main detectors and care-givers with respect to psychological distress in breast cancer patients. To reduce persistent anxiety, caring for the patient’s physical symptoms is important.
Neurocognitive function and psychological distress in young adults (YA) with cancer.
Authors: Edelstein Kim , D'Agostino Norma Mammone , Pond Gregory Russell , Aubin Sylvie , Matthew Andrew , Gupta Abha A. , Kavan Petr , Crump Michael , Bedard Philippe L. , Schuh Andre C. , Hodgson David C. , Wahl Kate , Simpson Rebecca , Vuong Te , Muanza Thierry , Batist Gerald , Bernstein Lori J. 
Published: February 2017

199 Background: Cancer treatment is associated with neurocognitive sequelae and changes in structural and functional brain imaging in older adults, even if they do not receive central nervous system directed therapy. Because the brain continues to develop into the 3rd decade of life, YA (age 18-39 yrs) may also be vulnerable to neurocognitive dysfunction. In YA, cancer disrupts acquisition of developmental milestones and is associated with psychological distress. This study aims to characterize neurocognitive functions and its relation to psychological distress in YA. Here we present baseline results of our longitudinal study. Methods: In this prospective, inception-cohort study, we recruited 3 groups of YA from ambulatory oncology clinics: YA with cancers (YAC; lymphoma, breast, gynecology, gastrointestinal, genitourinary, sarcoma) who required chemotherapy (YAC+, n = 55), YAC who do not require it (YAC-, n = 31), and healthy YA (HYA, n = 54). Participants completed a 2-hr battery of standardized neurocognitive tests and validated self-report questionnaires. YAC were assessed within 3 months of diagnosis, and YAC+prior to chemotherapy. Test scores were converted to age-corrected scaled scores and transformed to z-scores (mean 0, SD 1). A global neurocognitive function score and 6 domain scores were evaluated. Results: There were no group differences in neurocognitive domains (ANOVA, all p-values > .1), or in the number of impaired test scores (defined as z < -1). YAC+ reported greater symptoms of somatic distress (p = .001) and anxiety (p = .004) than both HYA and YAC-. Symptoms were unrelated to neurocognitive performance (ρ < .16 for all). However, each group had poorer memory compared to population norms (1-sample t-tests: YAC+ p = .007; YAC- p = .047; HYA p = .023). Conclusions: Prior to treatment, neurocognitive functions of YAC were not different from HYA, suggesting that cancer itself is not a neurocognitive risk factor in YA. It is important to use appropriate control groups, rather than relying on normative data for comparison. We continue to follow this cohort to document neurocognitive function and distress over time, and to identify risk factors that contribute to outcomes in YA.
Feasibility and preliminary efficacy of an interactive portal for lung cancer patients.
Authors: Groen Wim G , Kuijpers Wilma , Oldenburg Hester SA , Wouters Michel W.J.M. , Aaronson Neil K , van Harten Wim H 
Published: February 2017

201 Background: “MijnAVL” is an interactive portal for cancer patients that includes patient education, an overview of appointments, access to the electronic medical record, patient-reported outcomes and related feedback, and tailored physical activity support. The aim of this study was to evaluate MijnAVL’s feasibility and preliminary efficacy among lung cancer patients. Methods: We included individuals currently or recently treated for lung cancer with curative intent (surgery or radiotherapy). 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. After this period, log data were collected retrospectively and participants completed questions on satisfaction and the effect measures. Results: We included 37 patients (mean age 59.6 years). The mean number of logins was 11.2 with a mean duration of 12.9 minutes. Eighty-nine percent of patients indicated that MijnAVL was easy to use and 82% was positive about using it. Many patients (69%) indicated that MijnAVL was a valuable addition to the care they received and 56% indicated that it helped them to have more control over their health. All features were frequently used and rated 7 or higher on a 10 point scale. Website user satisfaction was rated, on average, 3.9 on a 5 point scale. Patient activation decreased over time from 64.8 to 59.4 (p= 0.049), meaning patients felt less activated. For the SF-36, we found no significant changes over time. In general, levels of physical activity did not change, although vigorous physical activity tended to increase over time (from median of 0 to 360 MET-minutes per week (p= .053)). Conclusions: These results indicate that using MijnAVL is feasible in lung cancer patients. Most users indicated that MijnAVL was useful and easy to use. The efficacy of the patient portal could not be substantiated, which could be due to small sample size, the intervention itself, the (insensitivity of) outcome measures, or a combination of these. Further research is needed to find effective ways to improve and adequately measure patient empowerment in lung cancer survivors.
Understanding patient distress on day +100 of allogeneic stem cell transplant.
Authors: Padrnos Leslie Jane , Kosiorek Heidi , Slack James L. , Khera Nandita 
Published: February 2017

204 Background: Allogeneic hematopoietic cell transplantation (HCT) is a medically complicated treatment modality used for various hematologic malignancies. Patterns and predictors of distress in post- transplant setting in a contemporary cohort of patients are not well-understood. Methods: 67 patients transplanted between 12/5/12- 4/21/15 completed National Comprehensive Cancer Network Distress Thermometer as part of their long term follow up clinic evaluation on day+100 after HCT. Demographic, socioeconomic and clinical outcome data were analyzed. A score ≥ 4 was considered distressed. Results: Mean age of patients was 50.8 years (range 20-72). Most patients were married or living with their significant other (83%), half were college graduates (58%), and half were employed full time (50%). 21 patients (31%) reported a distress score ≥ 4. Distressed patients reported increased problems with treatment decisions (15% vs 2%, p<0.05) and ability to have children (16% vs 0%, p<0.05). Physically, distressed patients were more likely to report fatigue (85% vs 44%, p <0.05), pain (60% vs 24%, p<0.05) and difficulty getting around (25% vs 7% p<0.05) Distressed patients were likely to report at least 1 emotional problem (N=16, 76%), and nearly a quarter reported ≥ 4 emotional problems (N=5, 24%). Specifically, sadness (25% vs 7%, p<0.05) and worry (64% vs 26%, p <0.01) were more common in distressed patients. Distressed patients had a longer length of hospitalization for transplant (30.8 days vs 24.9 p<0.001) and more hospitalized days during the first 100 days (34.9 vs 28.7 p<0.01). Conclusions: Approximately 30% of allogeneic HCT patients suffer significant distress at Day100 post-transplant. Distressed patients report problems with a variety of factors, including emotional, physical, family and practical issues that may impact function, compliance and quality of life. Higher number of hospitalized days is associated with increased distress and could be used to identify patients who may benefit from stress monitoring. Periodic screening of distress in HCT patients can help identify interventions to help improve patient reported outcomes.
Bridging the gap in psychosocial care in cancer survivorship: A pilot project evaluating psychosocial interventions through telemedicine.
Authors: Bomar Kaitlin , Willingham Elizabeth , Dillard Terra , Dingman Chad M , Humphries Crystal , Kindall Stacey , Hegedus Patricia D. , Bearden James D. , Crosswell Hal E. 
Published: February 2017

215 Background: Psychosocial distress is a well‐recognized consequence of cancer therapy, but psychosocial care for cancer survivors remains fragmented. Through the use of telemedicine, establishing an integrated, information technology‐based infrastructure between community‐based cancer programs may enhance coordination of survivorship care and increase psychosocial distress screening and intervention. We describe a one year pilot program intended to bridge institutional and geographic gaps in psychosocial intervention for cancer survivors through the use of telemedicine. Methods: There are 17 Commission on Cancer-accredited sites in South Carolina-only 31% of sites routinely conduct distress screening. This SC Cancer Alliance-supported pilot was designed as a quality care improvement project between two community-based cancer programs. The development and execution of the telemedicine project will be described. A survey-based, qualitative assessment of patient satisfaction with psychosocial intervention with between both physical and virtual counselling was performed and scored. Results: All patients seen in survivorship clinics at both institutions received psychosocial distress screening. By the end of the pilot project, 9 cancer survivors from the Spartanburg area were identified as having significant psychosocial distress, participated in counselling and reported on their experiences. Patients were seen either via face-to-face and/or virtual encounters. Counselling sessions performed via telemedicine were well accepted and that there was no difference in patient satisfaction as compared to face-to-face sessions. Anecdotal experiences and comments will be highlighted. Conclusions: Our pilot project demonstrates that psychosocial screening and intervention via telemedicine is feasible and may be effective at reducing psychosocial distress in cancer survivors. Psychosocial intervention via telemedicine may serve as a viable method of providing counselling services to resource poor areas, but significant barriers exist, including reimbursement, institutional variations in screening and care and information technology.
Health care utilization among long-term cancer survivors.
Authors: Rajotte Emily Jo , Heron Leslie , Syrjala Karen Leslie , Baker Kevin Scott 
Published: February 2017

22 Background: Survivors of adult cancer face lifetime health risks that are dependent on their cancer, cancer treatment exposures, comorbid health conditions, and lifestyle behaviors. A shared care model, including planned and formal transition of the cancer survivor from the oncologist to the primary care physician needs to be established to ensure appropriate care. Methods: As a LIVESTRONG Survivorship Center of Excellence Network member, the Survivorship Program at the Fred Hutchinson Cancer Research Center has established an outpatient clinic at the Seattle Cancer Care Alliance to meet the clinical needs of cancer survivors. Before their survivorship-focused clinic appointment, adult cancer survivors are asked to complete a comprehensive survey that includes questions on health care utilization. Results: Between August 2013 to December 2014, 142 clinic patients completed the survey. They were 70.4% female, mean age 48 years (SD 16.3, range 22-83) and 21.1% breast cancer, 30.2% leukemia/lymphoma, and 17.6% reproductive cancer survivors. Patients were a mean of 7.8 years (SD 9.5, range 0-43) from their cancer diagnosis at the time of clinic appointment. 70.4% reported receiving oncology care and 87.3% primary care within the 12 months before their survivorship visit. Forty percent reported more than 12 clinic visits in the past year in which they saw a physician, nurse practitioner or physician assistant compared with 6.5 clinic visits in the general population based on CDC, National Health Care Survey reference data. 41.5% had one or more visits to a hospital emergency or urgent care facility within the last year, compared with 39.4% in the CDC NHCS survey. Conclusions: Cancer survivors seen in a Survivorship Clinic utilize healthcare at a much higher rate than the general population. A shared-care model for cancer survivors, including a delineation of roles and specific points of communication, between the oncologist and the primary care physician may help address issues surrounding over-utilization. A cancer treatment summary and a survivorship care plan may be valuable tools to facilitate this shared care approach.
The TRUMPET registry: Assessing clinical outcomes and quality of life in patients with castration-resistant prostate cancer and their caregivers.
Authors: Flanders Scott C , Lin Daniel W. , Karsh Lawrence Ivan , Shevrin Daniel H. , Shore Neal D. , Symanowski James Thomas , Quinn David I. , Otermat Gretchen , Starzyk Kathryn , Brown Bruce , Francis Peter St. John , Wong Elaine Karol , Wu Jun , Wilson Samuel D , Penson David F. 
Published: February 2017

241 Background: Patient care in castration-resistant prostate cancer (CRPC) is complex, with varying treatment patterns due to differences in therapies, patient characteristics, and physician practices. The impact of such patterns on clinical outcomes and quality of life (QoL) represent a contemporary medical issue. This study aims to improve the understanding of clinical outcomes and QoL of patients with CRPC and their caregivers. Methods: TRUMPET is a prospective, observational, multi-center study of patients with CRPC in the United States. Approximately 2000 patients and their caregivers (if eligible) will be enrolled over 24 months from IRB-approved urology and oncology sites. Eligible patients with CRPC include those with life expectancy of ≥ 6 months initiating the first active course of anti-cancer treatment for M0 or M1. A 48-month observation period will follow the last patient enrolled. Primary objectives are to describe longitudinal patterns of care, disease assessment methods, treatment decisions, treatment settings, physician referral patterns, and CRPC patient characteristics associated with these. Patient-reported health-related QoL (HRQoL) instruments will assess the effects of CRPC and its management on patient perception of key aspects of HRQoL. The following will be administered at baseline and follow-up: SF-12v2 Health Survey, Functional Assessment of Cancer Therapy–Prostate, Brief Pain Inventory-Short Form, and Memorial Anxiety Scale for Prostate Cancer (prostate-specific antigen anxiety subscale). In a patient sub-study, work productivity and treatment satisfaction will be described using the Work Productivity and Activity Impairment (WPAI) Questionnaire: Specific Health Problem and Service Satisfaction Scale for Cancer Care. Caregiver QoL and productivity will be captured with the Caregiver Quality of Life Index–Cancer and the Caregiver-modified WPAI Questionnaire. Results: As of August 21, 2015, 60 sites were active, with 63 patients and 39 caregivers enrolled. Conclusions: Outcomes from the TRUMPET study will describe treatment patterns, QoL, and health care resources associated with patient management in CRPC. Clinical trial information: NCT02380274.
Association of anxiety and depressive symptoms with differing needs among recent breast cancer (BC) survivors.
Authors: Palmer Steven C , DeMichele Angela , Schapira Marilyn M. , Glanz Karen , Blauch Abigail , Pucci Donna A. , Jacobs Linda A. 
Published: February 2017

244 Background: Although unmet needs are associated with general distress in long term BC survivors, it is unclear is different needs are associated with specific outcomes such as anxiety and depression among recent BC survivors. Such work may provide insight into the interventions needed to improve outcomes early in survivorship for patients. Methods: Eligibility included non-metastatic BC treated < 1 year prior. Prior to an initial survivorship visit, participants completed a PRO symptom measure and reported unmet need for assistance for symptoms experienced. Overall unmet need and unmet need domains (physical, psychosocial, sexual, hormonal) were examined. Anxiety and depressive symptoms were assessed using the HADS. Results: Participants (N = 137) were primarily white (72%), middle-aged (M = 55 yr), and treated for Stage I (47%) or II (38%) BC. Anxiety (M = 5.57, SD = 4.08) and depression (M = 3.21, SD = 3.33) were in the normal range, on average. 29% and 13% met “caseness” (i.e., above criteria for significant elevation) for anxiety and depression, respectively. Caseness for anxiety and depression were not significantly related to demographic variables, time from end of treatment, disease characteristics or treatment exposures (all p > 0.05). Meeting criteria for depression was associated with greater overall unmet need (M = 6.11 vs. M = 2.11, p < 0.001) and need in the physical (M = 2.66 vs. M = 0.83; p < 0.001) and psychosocial (M = 2.56 vs. M = 0.49; p < 0.001) domains, but unrelated to unmet sexual or hormonal needs (all p > 0.05). Meeting criteria for anxiety was associated with greater unmet need in the hormonal (M = .47 vs. M = 0.17; p < 0.05) and psychosocial (M = 1.33 vs. M = 0.55; p < 0.002) domains, but unrelated to unmet overall, physical or sexual needs (all p > 0.05). Conclusions: Unmet needs relate differentially to anxiety and depression in recent BC survivors. In particular, depression is associated with more than 3 times the number of unmet physical needs, while anxiety is associated with more than 2.5 times the number of unmet hormonal needs. Assessing psychosocial outcomes in the absence of unmet needs may represent a missed opportunity for intervention to improve outcomes for specific groups of survivors.
Life satisfaction regarding the ability to have children among female cancer survivors.
Authors: Howards Penelope P , Fothergill Amy , Spencer Jessica B , Mertens Ann 
Published: February 2017

248 Background: Some cancer treatments can cause sub-fertility in female cancer survivors, which has led to recommendations that all reproductive-aged cancer patients receive fertility counseling at the time of cancer diagnosis. However, little is known about how reproductive-aged cancer survivors feel about their quality of life with respect to their ability to have children. Methods: The FUCHSIA Women’s Study recruited reproductive-aged (22-45 years) female cancer survivors diagnosed with cancer between the ages of 20-35 years, who were at least 2 years post-diagnosis (median 7). All reportable malignant cancers and in situ breast cancer diagnosed from 1990 to 2009 in Georgia were eligible. Participants (n = 1,282) completed a detailed interview about their reproductive history including questions about their feelings about their ability to get pregnant and to have more children as well as their comfort with assisted reproductive technology (ART). Women were classified as premenopausal or menopausal, which included surgical and non-surgical menopause. Results: At the time of the interview, 31% of the study participants did not have a child. Overall, childless women were less likely to feel that having a biologic child was important (46%) than women who had a child (89%). However, 61% of childless, premenopausal women wanted to have a biologic child in the future, and 89% of menopausal women without children reported that they would have liked to have a child if they could. Menopausal women without children were more likely to report being comfortable with the idea of using ART to become pregnant (67% vs. 38% of menopausal women with children). A quarter of premenopausal women without children indicated that they would be dissatisfied with life if they were unable to have a child, and 10% of menopausal women without children indicated they were dissatisfied with life because they could not have children. Conclusions: In general, women without children were more likely to report a poorer quality of life with respect to their reproductive potential. However, our results suggest there is a complex relation between women’s reproductive desires and their feelings about their actual situation.
The “little big things”: A qualitative study of ovarian cancer survivors and their experiences with the health care system.
Authors: Tergas Ana Isabel , Angarita Ana , Cristello Angelica , Lippitt Melissa , Nickles Fader Amanda , Long Kara 
Published: February 2017

252 Background: Navigating a complex and ever-changing health care system can be stressful and detrimental to psychosocial well-being for patients with serious illness. This study explored women’s experiences navigating the health care system during treatment of ovarian cancer. Methods: Focus groups moderated by trained investigators were conducted with ovarian cancer survivors at an academic cancer center. Personal experiences with cancer treatment, provider relationships, barriers to care, and the health care system were explored. Sessions were audiotaped, transcribed, and coded using grounded theory. Subsequent one-on-one interviews were conducted to further evaluate common themes. Results: Sixteen ovarian cancer survivors with a median age of 59 years participated in the focus group study.Provider consistency, personal touch, and patient advocacy positively impacted care experience.Treatment with a known provider, who was well acquainted with the individual’s medical history, was deemed an invaluable aspect of care. Negative experiences that burdened patients, referred to as the “Little Big Things”, included systems-based challenges: scheduling, wait times, pharmacy, transportation, parking, financial, insurance and discharge. Consistency, a “care-team” approach, effective communication, and efficient connection to resources were suggested as ways to improve patients’ experiences. Conclusions: Systems-based challenges were perceived as burdens to ovarian cancer survivors. The role of a consistent, accessible care team and efficient delivery of resources in the care of women with ovarian cancer should be explored further.