bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient utilization of supportive care services identified through the Athena Breast Health Questionnaire System.
Authors: Wong Emily Claire , Kaplan Celia , Shumay Dianne , Leykin Yan , Van't Veer Laura , Stover-Fiscalini Allison , Esserman Laura , Melisko Michelle 
Published: February 2017

226 Background: Psychological wellbeing and lifestyle changes are important factors in long-term health of cancer survivors. As part of the Athena Breast Health Network, the UCSF Breast Care Center (BCC) incorporated an electronic health questionnaire system (HQS) that collects patient-reported data on physical and psychological symptoms, medical conditions, family history, and lifestyle to identify patients’ supportive care needs. Methods: Through a semi-automated process, patients whose HQS responses meet pre-established thresholds are referred to Psycho-Oncology, social work, genetic counseling, and Onco-Fertility. Referrals generated within the HQS are signed and routed by clinicians at the time of a BCC visit. When patients decline appointments with these services, staff members document reasons within the electronic medical record (EMR). A retrospective chart review identified patients who did not receive supportive care services to which they were referred and a qualitative analysis was performed. Results: From 7/1/14-12/31/14, 525 patients completed an HQS and agreed to have their data used for research. The table summarizes referral information. 45 patients referred to Psycho-Oncology did not complete an appointment. Of these, ten did not respond to phone contact to schedule visits. 35 were reached, but declined an appointment. 25 (71.4%) were not ready to make an appointment; 5 (14.3%) cited distance as a primary barrier; 3 (8.6%) were satisfied with the psychological services they were receiving elsewhere; and 2 (5.7%) did not have insurance coverage. Reasons women disregarded referrals for genetic counseling and fertility are being evaluated. Conclusions: HQS can assist in identifying patient supportive care needs, but despite automation of referrals, many patients do not follow through to use supportive care and clinical resources. Timing and resource accessibility may be key. Through analysis of reasons for non-utilization, we hope to better tailor the delivery of supportive care services, when indicated, to better serve patient needs. [Table: see text]
Using eye-tracking to quantify the impact of prostate cancer treatments on male libido: A pilot study.
Authors: Skead Charlenn , Tsang Vivian , Palmer-Hague Jaime L , Wassersug Richard J , Nasiopoulos Eleni , Kingstone Alan 
Published: February 2017

231 Background: Eye-tracking research has demonstrated that heterosexual men with normal testosterone levels attend visually to features of women associated with fertility, notably their breast size and waist to hip ratio. As such, eye-tracking data can serve as an implicit measure of a man’s libido. Many treatments for prostate cancer (PCa)—in particular androgen deprivation therapy (ADT)—depress sexual interest in men, but there is no objective measure of the intensity of this effect. Here we explore whether eye-tracking can be used to quantify the impact of PCa treatments on men’s libido. Methods: We used an IRB-approved deception protocol to explore the validity of eye-tracking technology for assessing the level of sexual interest of PCa patients and normal controls. Three age-matched groups of heterosexual men aged 50 years and older were recruited. They were: PCa patients using ADT, PCa patients not using ADT, and healthy controls. Unaware that their eye movements were being tracked, all were exposed to photographs of female models, either fully clothed (neutral) or minimally clothed (sexy). Number and duration of eye fixations on target areas of the female models’ bodies were recorded. Results: Trends observed in our preliminary data suggest that men on ADT exhibit differential patterns of visual attention to sexual stimuli compared to men in the other two groups. Although confirmation with a larger sample size is required, such shifts in attention may provide an objective measure of the influence of cancer treatments on the libido of PCa patients. Conclusions: Eye-tracking technology may provide a reliable and objective technique for measuring the libido of cancer patients. Such data could help patients be better informed about psychological side effects when making treatment decisions. They could also lead to ways to both study and reduce the impact of PCa treatments on men’s sexual interest.
Racial and ethnic variation in baseline health-related quality of life scores prior to prostate cancer treatment.
Authors: Reading Stephanie R. , Porter Kimberly R. , Slezak Jeffrey M. , Chien Gary W. , Jacobsen Steven J. 
Published: February 2017

232 Background: To compare the racial and ethnic variations in baseline health-related quality of life (HRQOL) scores among men newly-diagnosed with prostate cancer prior to their prostate cancer treatment. Methods: Male members of the Kaiser Permanente of Southern California (KPSC) health plan, newly-diagnosed with prostate cancer, completed the five-domain specific Expanded Prostate Index Composite (EPIC-26) health-related quality of life (HRQOL) questionnaire between March 1, 2011 and August 31, 2013 (n=2,225). The five EPIC-26 domain scores (sexual, bowel, hormonal, urinary incontinence and urinary irritation) were compared across racial and ethnic subgroups and multiple logistic regression analyses were used to assess the association, adjusting for socio-demographic and clinical characteristics. Results: Within each racial and ethnic subgroup,higher baseline HRQOL scores were seen on the bowel, hormonal, urinary incontinence and urinary irritation domains (median score range: 87.5 – 100) as compared to the sexual domain (median score range: 49.3 – 62.5). Asian or Pacific Islander men were less likely to be above the sample median on the sexual (OR=0.51; 95% CI [0.36, 0.74]; p<0.001) and urinary incontinence domains (OR=0.65; 95% CI [0.46, 0.92]; p=0.015) as compared to the non-Hispanic white men. No additional statistically significant differences (p<0.05) were identified. Conclusions: These data suggest that few differences exist in baseline HRQOL scores across racial and ethnic subgroups among men newly-diagnosed with prostate cancer in an integrated health care organization. This finding provides important insight into the pre-treatment HRQOL status among these men with which to interpret HRQOL changes during and after prostate cancer treatment.
Impact of chemotherapy on health-related quality of life among ethnically diverse breast cancer survivors treated with breast-conserving therapy.
Authors: Amora Aseel Veronica , Tano Jessika , Conde Francisco A. 
Published: February 2017

237 Background: Breast cancer (BC) is the most common cancer among women in the U.S. Public awareness and advances in BC screening have resulted in more women being diagnosed with early stage BC and treated with breast-conserving therapy (BCT) (lumpectomy followed by radiation therapy). Depending on prognostic factors and recurrence risk, systemic chemotherapy may be prescribed. Purpose of this study was to examine the impact of chemotherapy on quality of life (QOL) and needs of BC survivors treated with BCT for early stage BC. Methods: A list of 750 breast cancer survivors, aged 18 or older and who completed breast-conservation therapy for stages 0-II from 2001 - 2010, was obtained from a hospital’s tumor registry. Consent form and questionnaires, including a demographic questionnaire, City of Hope’s quality of life survey, and an investigator-developed questionnaire to assess for needs of cancer survivors, were mailed. T-test was used to compare mean subscales and overall QOL scores between those who received chemotherapy and those who did not. Frequencies and percentages were used to summarize the needs of BC survivors. Results: 119 completed surveys were received. Majority of respondents were Asians (56.3%), Caucasians (21.8%) and mixed ethnicity (13.4%). 55 patients received BCT plus systemic chemotherapy and 64 received BCT alone. Those who received systemic chemotherapy scored significantly lower on psychological subscale (p< 0.01), social subscale (p= 0.04), and overall QOL (p= 0.03) compared to survivors treated with BCT alone. Regarding needs, BC survivors want to learn about nutrition (40.3%), pain management (39.5%), improving memory (37.8%), and physical activity (33.6%). Conclusions: Although chemotherapy may decrease the risk of recurrence for early stage BC, lasting effects of treatment can negatively impact QOL. Understanding the impact of chemotherapy on various domains of QOL can be beneficial to patients and healthcare providers when discussing the risks and benefits of adjuvant systemic therapy. Further interventions are needed to improve QOL and address the needs among BC survivors treated with breast-conserving therapy.
Psychotropic and stimulant medication (PSM) use among testicular cancer survivors (TCS): A multi-institutional clinical study of 680 patients given cisplatin-based chemotherapy (CHEM) (NCI 1R01 CA157823-02).
Authors: Case-Eads Somer , Travis Lois B. , Fung Chunkit , Sesso Howard D. , Feldman Darren R. , Vaughn David J. , Hamilton Robert James , Johnson Eileen , Peterson Derick R , Fossa Sophie D. , Einhorn Lawrence H. , Beard Clair 
Published: February 2017

242 Background: Testicular cancer (TC) is the most common cancer in men aged 15-40, with survival rates after diagnosis > 95%. Testicular cancer survivors (TCS) are known to be at increased risk for certain acute and chronic medical conditions, but few studies have examined barometers of their psychological health. The objective is to characterize the prevalence of PSM use and associations with demographics, health behaviors, and treatment-associated toxicities among TCS. Methods: TCS aged < 50 years at first-line CHEM completed a questionnaire regarding co-morbidities and prescription drug use, including PSMs. For co-morbidities, peripheral neuropathy (PN) responses of ‘a little’, “quite a bit”, or “very much” were scored ‘yes.’ Fisher’s exact test was used to examine the significance of various associations. Results: Among the first 680 consecutively enrolled TCS, median age at TC diagnosis was 31y (range, 15-49y) and median time since CHEM completion was 52mo (range 12-360mo). 85 TCS (12.5%) reported PSM use, including antidepressants (N = 65 [76.5%]), anxiolytics (N = 23 [27%]), and stimulants (N = 21 [25%]) with 20 TCS on ≥ 2 PSMs (23%). Compared to non-users, more PSM users were unemployed (11.8% vs. 4.4%%; P < .01), self-rated their health as fair/poor (12.2% vs 4%; P < .01), and had gained > 20lb since CHEM (39.8% vs 23.4%;P < .01). PSM users were more likely to have tinnitus (49.4% vs. 36.4%; P < 0.04), both tinnitus and PN (43.5% vs. 27.2%; P < 0.01), cardiovascular disease (26.2% vs. 15.6%; P < .02), and greater use of prescription medications for pain control (20% vs. 4.7%; P < 0.01), hypertension (16.5% vs. 7.1%; P < 0.01), diabetes (8.3% vs. 2.9%; P < 0.02), and testosterone replacement (10.6% vs. 5.0%; P = 0.048). Conclusions: Future studies should aim for identification of high-risk patients in need of intensified preventive and therapeutic interventions.
Androgen deprivation therapy educational program: A Canadian true nth initiative.
Authors: Wibowo Erik , Walker Lauren M , Wilyman Shawn , Matthew Andrew , McLeod Deborah L , Wassersug Richard J , Robinson John W. 
Published: February 2017

243 Background: Androgen deprivation therapy (ADT) is commonly prescribed for advanced prostate cancer (PCa) patients, but ADT has many side effects that can impair patients’ quality of life. In various Canadian cities, we are running an educational program to help PCa patients and their partners deal with the side effects of ADT, and maintain a strong relationship with each other while on ADT. Methods: Patients, who are about to start or have been on ADT, and their partners are invited to attend an educational program. Each patient is given a copy of the book Androgen Deprivation Therapy: An essential guide for men with prostate cancer and their partners (Wassersug et al., 2014) and attends a 1.5 hour educational class, where they learn strategies for managing ADT side effects and how to effectively make healthier lifestyle changes using goal-setting exercises. At the end of the class, participants are given the option to attend a monthly follow-up session. To evaluate the effectiveness of the program, participants are asked to complete questionnaire package before attending the class and again 2-3 months later. Results: As of August 2015, 179 patients and 113 partners have attended the ADT Educational Program at Victoria, Vancouver, and Calgary. About 40% of patients returned for the follow-up session. 62 attendees participated in the research evaluation portion of the program. Uniquely designed for this study, the questionnaire package assesses ADT side effect frequency, bother associated with side effects, use of management strategies, and self-efficacy regarding side effect management. An assessment of physical activity and relationship adjustment, and feedback about the class are also included. Conclusions: Patients and partners appreciate being informed about ADT side effects managements and how to make healthier lifestyle changes while on ADT. It remains to be seen how effective the program is in limiting the bother from ADT side effects and helping couples maintain a strong dyadic relationship in the fact of the challenges brought on by ADT. Good enrollment in the in-person program in the 3 cities has propelled the development of the program in Halifax and Toronto starting in fall 2015, and an online version to be available in early 2016.
The evidence base in support of breast cancer surveillance guidelines: Flying without a net?
Authors: Baxi Shrujal S. , Yeahia Rubaya , Korenstein Deborah 
Published: February 2017

25 Background: There are a growing number of breast cancer survivors, and they are often followed by primary care providers (PCP). With limited specialized cancer knowledge, PCPs may rely on guidelines (GL), but surveillance recommendations vary based on source. The data informing post-treatment surveillance is limited. We reviewed the evidence in support of varying breast cancer surveillance recommendations found in national GLs. Methods: We included breast cancer GLs containing surveillance recommendations from professional societies and government organizations in North America, the UK, and Europe (2010-5). We used online search engines and organization websites to identify GLs. Surveillance testing recommendations were recorded; relevant citations for each recommendation were identified and classified by evidence type. Results: We identified 6 breast cancer GLs from US, UK, and Europe; all recommended mammography. Other recommendations varied, with contradictory recommendations regarding MRI and US. Overall, 13 systematic reviews (SR) were cited; 9 related to mammography. One SR of MRI and one of mammography were cited by 2 GLs; remaining SRs were each cited by 1 GL. Other references included 34 primary studies, 9 narrative reviews and 11 older GLs. Among 23 surveillance testing recommendations from the 6 GLs, the highest level of supporting evidence was a SR in 44% and a primary study in 22%; the remainder cited no direct evidence. At times, the same citation supported contradictory recommendations in different guidelines. Conclusions: Evidence for surveillance recommendations is often low-level and cited references vary across GLs; the same evidence is used to support contradictory recommendations. Better evidence and its more consistent application would facilitate high quality breast cancer survivorship care.
Risk of secondary cancers after breast conserving therapy in Japan.
Authors: Shiraishi Kenshiro , Shinozaki Tomohiro 
Published: February 2017

256 Background: There is a growing body of evidence that vast majority of patients with early breast cancer who underwent breast conserving therapy (BCT) live their longer ‘cancer survivor’ lives through modern sophisticated treatment. Accordingly, second malignancies after BCT are on the rise, which are sticky dilemmas accompanied by additional anxiety and need for further medical care. Investigation of secondary malignancies should be made the first priority in Japan as the world's top country for longevity. Methods: In order to investigate the second malignancies after BCT, a cohort study was conducted based on our database from 1982 to mid-2015. Actuarial rates of second malignancies, overall (OS) and cause-specific survival (CSS), were calculated by using the Kaplan-Meier method. We calculated standardized incidence ratios (SIR) for each cancer type corresponding to the national registry. Results: 1,557 patients (49.5%) were followed-up for more than 10 years. At a median follow-up of 113 months, 180 patients had developed a second malignancy. The increases in risk were for leukemia (SIR: 3.89 (1.76–6.84)) and ovarian cancer (SIR: 3.65 (2.26–5.38)). Trends toward increased risk was seen in reno-ureteral cancer (SIR: 2.25 (0.96–4.08)) and endometrial cancer (SIR: 1.59 (0.92–2.43)) though it was not statistically significant. No increased risk was observed for other gastrointestinal and genitourinary cancer, malignant melanoma, lymphoma, thyroid or head and neck cancer. Overall 10-year cumulative incidence of OS was 93.3%, and overall 10-year cumulative incidence of CSS was 95.0%. Overall 10-year incidence of secondary cancer was 5.9%. A total number of secondary malignancies within 10 years was 157 and this number explained 84.4% of all cases observed during follow-up. Secondary cancers continued to occur afterward, and cumulative incidence at 15- and 20-years were 8.4% , and 9.6%, respectively. Conclusions: Secondary cancers after BCT continue to arise as long as patients survive. Given its nature of life-threatening to cancer survivors, attending care team must pay persistent attention to secondary malignancies especially in Japan with the longest life-span.
Preparing nurses for cancer survivorship care.
Authors: McCabe Mary S. , Economou Denice , Grant Marcia 
Published: February 2017

27 Background: Although the 2006 IOM report on Cancer Survivorship calls for the education of health professionals, few formal programs have been instituted and evaluated. This NCI R25 grant focused on the preparation of nurses to provide comprehensive survivorship care. The program included didactic and interactive sessions, as well as goal development focused on plans for implementation of survivorship activities post course. This abstract will describe the goal analysis at 6, 12, and 18 months post course provided by the 113 nurses in the first two courses. Methods: Goals focused on survivorship activities to be implemented at the home institution/practice. Goals were coded using the results-based S.M.A.R.T. framework and they could have more than one code if they reflected multiple activities. Goal achievement was measured using a 5 point scale with 0 = never started, 1 = stopped or cancelled, 2 = Stalled, 3 = In Process or 4 = Completed at 6, 12 and 18 months post course. Results: A total of 403 goals were coded for the first 2 courses. The most frequent goal for both courses was Professional Education (23.1%, 21%). The second most frequent goal was -Institution of Survivorship Care (13%, 9.8%). The third most frequent goal for Course 1 was Evaluation of Survivor Needs. For course 2 the third most frequent goals were Evaluation of Survivor Needs and Team Development. Goal achievements for course 1: 70% completed or in process, 4.4% stalled or stopped and 25% never started. Course 2: 62% completed or in process, 18.3% stalled or stopped and 20% never started. Conclusions: While participants from our 2 first courses represented a variety of academic and community settings, their goals were quite similar and reflected the basic need for staff education and plans for clinical services. Barriers to success were met by approximately 29% of the participants in Course 1 & approximately 38% in Course 2. These data demonstrate that Survivorship remains in the early stages as a formal period of care and ongoing development of experts/resources continues to be needed. Identification of barriers and facilitators to address them is critical.
The role of a geriatrician in a cancer center.
Authors: Korc-Grodzicki Beatriz , Sun Sung W. , Shahrokni Armin , Alexander Koshy , Kim Soo Jung , McMillan Sincere , Bosl George J. 
Published: February 2017

39 Background: Older adults are likely to have coexisting health conditions, polypharmacy and functional limitations. The geriatrician may have a pivotal role in risk assessment, prevention and treatment of comorbidities and addressing geriatric syndromes. The purpose of this study is to describe the growth and development of, and the role of a Geriatrics Service (GS) in a cancer center. Methods: A GS was founded in MSKCC in 2009. Since then it has grown to provide inpatient (IP) and outpatient (OP) care for older adults undergoing cancer diagnosis, surveillance or active treatment. It offers preoperative evaluations, geriatric assessment (GA) and follow-up shared- care. Recently, a Transitional Care Management (TCM) program was established for patients at increased risk of rehospitalization. The GS strives to develop an interprofessional educational geriatrics curriculum and to participate in quality and research projects focused on cancer and aging. Results: Between 2009 and 2014 a total of 6679 new patients were evaluated by the GS. 16% of the patients were 65-75, 70% were 76-85 and 14% were older than 85. 46% were male and 84% were white. 15% were IP and 85% were OP consultations. 13% of the OP consults were for GA, the rest were preoperative evaluations. All patients seen preoperatively who are admitted after surgery, are followed postoperatively by the IP geriatrics team. In total, 4 Geriatricians, 2 Geriatric Nurse Practitioners (GNP) and 3 RNs were recruited. The number of follow-up visits increased from 143 in 2009 to 733 in 2014. The new TCM program based on close communication between the IP and OP GNP has been successful in keeping frail patients from frequent rehospitalizations. Noon conferences on geriatrics for the house staff, a biannual course on “Advancing Nursing Expertise in the Care of Older Adults with Cancer” and a monthly interprofessional meeting for the discussion of Geriatric Clinical Complex Cases (GCCC) are ongoing. Research has focused on risk assessment and the use of telemedicine in geriatric patient care. Conclusions: The establishment of a GS in a cancer center was very well received and embraced by the oncologists showing an unmet need in the care of the older cancer patient. The potential reproducibility beyond the cancer center will be discussed.