bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Bon Secours St. Francis Cancer Survivorship Program: A model for community-based multidisciplinary survivorship care.
Authors: Bomar Kaitlin , Vickery Nicole , Duggan Meagan , Redenz Tina , Lukker Tracey , Jensen Kristin , Paciarelli Eugene , Dillard Terra , Siegel Robert D. , Crosswell Hal E. 
Published: February 2017

45 Background: In 1974, Giulio D' Angio,MD, stated “Cure Is Not Enough” and the concept of Survivorship was ignited. Multidisciplinary survivorship clinics have since become a mainstay of many pediatric cancer programs; few such clinics exist in adult cancer programs, especially in community practice. We report on the development of a survivorship care plan and a community-based clinic designed to provide guideline-driven after care for cancer survivors. Methods: An overview of the vision and mission of the Bone Secours St. Francis Cancer Center Survivorship Program is provided. Descriptive analysis of the components and metrics of success are provided, in the context of accrediting organizations requirements for current and future goals for survivorship care. Results: BSSF, which is a non-academic, community-based cancer program, and receives over 1300 referrals annually from a referral population of 1.32 million in 10 counties. St. Francis , accredited by both the Commission on Cancer and National Accreditation Program for Breast Centers, has been providing cancer‐related services to the Upstate South Carolina region for a decade. The survivorship program at St. Francis is a STAR‐certified program and is a patient‐centered service provided in a comprehensive and coordinated multidisciplinary team approach, including integrated psychologic care. A custom survivorship care plan was developed and efforts, including successes and barriers, to implementation of plans for all cancer survivors in accordance with CoC and NAPBC goals are addressed. Conclusions: The BSSF Cancer Center Survivorship Program has developed a practical, yet comprehensive SCP, which is risk-adapted and guideline-driven in order to provide customized survivorship education and monitoring. The MDC provides comprehensive evaluations and recommendations in order to maximize health and well-being of patients navigating life after cancer diagnosis and treatment. Our efforts have demonstrated that survivorship clinics of this nature can be established and successful in a non-academic community setting.
Using Canadian administrative data to evaluate primary and oncology care of breast cancer patients post-treatment: Subset of the CanIMPACT Study.
Authors: McBride Mary L , Groome Patti , Turner Donna , Jorgensen Margaret , Kendell Cynthia , Porter Geoff , Jiang Li , Krzyzanowska Monika , Lofters Aisha , Moineddin Rahim , Grunfeld Eva , Winget Marcy 
Published: February 2017

5 Background: CanIMPACT is a multi-provincial Canadian research team funded to identify and address key issues faced by cancer patients and providers at the intersection of primary and specialist oncology care. Canada has national healthcare standards, but provincial/territorial healthcare delivery systems. One facet will use administrative data from the population-based, publicly-funded healthcare system to evaluate issues during pre-diagnosis, treatment, and post-treatment survivorship for breast cancer patients. For the survivorship phase, we aim to conduct the following analyses and compare across provinces: 1) Utilization of physician services overall and by specialty, including oncologists, non-oncology specialists, and primary care; 2) Assessment of adherence to ASCO and Canadian follow-up guideline for breast cancer care, use of surveillance breast imaging, and metastatic investigations; 3) Assessment of adherence to recommended care of chronic illness and preventive care; 4) Quantification of the cost of follow-up overall and by specialty; 5) Comparison of inter- and intra-provincial variation for all outcomes by health administrative region and for vulnerable groups (age ≥ 75 at diagnosis, northern/rural/remote, low income, immigrants), and examine the effect of continuity of primary care and chronic disease on post-treatment care. Methods: Patients will be identified from provincial cancer registries and linked to data extracted from: outpatient physician service claims, hospital inpatient and outpatient data, and cancer facility medical records. Results: Participating provinces have finalized the core questions and detailed protocols, and assessed data comparability. They are in the process of obtaining the required ethics and data access approvals, and data acquisition for processing and analysis. Conclusions: Results will address existing information gaps that can be used to improve transition and care across the cancer care trajectory. Importantly, results will be combined with those of a CanIMPACT qualitative study to inform design of a pragmatic randomized trial focused on improving coordination and quality of care.
Survivors' narratives of the value of cancer survivorship care plans and clinical services.
Authors: Palos Guadalupe R. , Hebdon Megan , McComb Sara , Wagner Richard W , Rodriguez Maria Alma 
Published: February 2017

57 Background: Providers in primary care practice can benefit from having a better understanding of cancer survivors’ perceptions of the value of survivorship treatment summaries and care plans. Our objective was to qualitatively explore survivors’ perceptions of care received in dedicated outpatient clinics for survivors of breast, genitourinary (GU), and head/neck cancers. Methods: This study was conducted from August 8, 2014 to October 2, 2014 in 3 clinics, selected on variation in infrastructure, patient populations, and disease site. A convenience sample of survivors scheduled for an appointment in these clinics was eligible. Semi-structured interviews were conducted by research staff trained in qualitative methodology. Demographic and clinical data were collected. Groups explored a) experience with care/services, b) value of care plan, service coordination and clinic operations and c) gaps/strengths in transition to clinics. Descriptive statistics were used to summarize and analyze demographic and clinical data. Discussions were transcribed verbatim with confirmation of themes among a team of researchers. Results: A total of 36 survivors, X= 62.3 (SD = 10.9) years, were interviewed. Of these 27.8% breast survivors, 38.9% head/neck, and 33.3% GU, with X= 8.33 (SD = 5.83) years since their cancer diagnosis. Of these, 80.5% were Caucasian, 8.3% Hispanic/Latino, and 5.6% Asian/Pacific Islander, and 5.6% African-American. 61.1% were male and 78.6% married or living with someone. Survivors cited concerns about inconsistency in methods used to distribute care plans to survivors, inadequate communication about the purpose of the care plan, and vague recall of receiving care plans. Survivors reported the value of receiving survivorship care were “having an awareness of what’s up the road, establishing a constant relationship with their provider and addressing gaps in care”. Conclusions: The value of offering survivorship care is supported by the narratives of these survivors. Additional training and education on effective communication about survivorship care plans may be useful to oncology specialists and primary care providers.
Developing infrastructure to improve research and care for cancer survivors: A pilot study.
Authors: Rosenberg Shoshana M. , Ligibel Jennifer A. , Meyerhardt Jeffrey A. , Jacobsen Eric D. , Garber Judy Ellen , Nekhlyudov Larissa , Bunnell Craig A. , Walsh Sarah , Partridge Ann H. 
Published: February 2017

61 Background: Despite a growing number of clinical trials and supportive care programs for cancer survivors, recruitment of patients (pts) for these opportunities during the survivorship phase of care is challenging. We piloted a program to systematically share available research studies and supportive care programs with pts as part of their treatment summary and survivorship care plan (TS/SCP) visit at our institution. Methods: Between 3/2015-8/2015, pts seen in the Adult Survivorship Program who had not previously received a TS/SCP were provided with one that included a list of survivorship research studies and care programscustomized to their diagnosis. Survivorship providers discussed the opportunities and recorded whether the pt was interested in relevant studies and placed referrals to study staff. Following the visit, we tracked study enrollment and surveyed pts about their experience. Results: 50/56 (89%) pts who participated in the pilot responded to the survey.Median age was 51 (range: 26-73); 78% were female; 54% were survivors of breast cancer; 42%, lymphoma; 2%, breast and lymphoma; 2%, colorectal cancer. Only 34% knew what a TS/SCP was before their visit; however 96% said having a TS/SCP would be helpful when visiting a primary care or other provider; 92% said the TS/SCP visit and document had or will help with knowledge of research opportunities and supportive care interventions. 90% responded that the study information they received was useful; 44% were interested in at least 1 study and would follow-up with a research coordinator. Of the 30 survivors eligible for ≥ 1 study, 5 have enrolled to date. Conclusions: This pilot program demonstrated that the systematic sharing of relevant clinical studies and supportive care programming as part of a TS/SCP visit is feasible and well-received by cancer survivors. Expansion of this novel program should help to enhance clinical research accrual for cancer survivors as well as ensure awareness of available supportive care interventions.
Late-stage lung cancer patient preferences about chemotherapy treatment adverse side effects.
Authors: Islam K. M , Ryan June , Fetrick Ann , Ganti Apar Kishor 
Published: February 2017

93 Background: Patients’ preferences regarding treatment adverse events are not systematically considered when choosing a treatment for stage lung cancer. Further, there is no clinical guide for patients or physicians on how to integrate patient preferences of adverse events in treatment and care decisions. Although it is assumed that most cancer patients prefer either an active or a shared role in decision making, particularly in late stage cancers. Our specific aim of this abstract is: Aim: Determine whether individual patients’ preferences, characteristics, and treatment experiences affect the meaning of chemotherapy treatment success. Methods: We have completed two years of our three-year research using a mixed method study design, which includes focus groups, cross-sectional, prospective, and randomized experimental designs. We initially selected three cancer centers in Nebraska and one in South Dakota for patient and provider recruitment. Currently, we have six cancer centers participating in this multi-center Patient Centered Outcomes Research. Results: Four focus groups were conducted with 36 participants that included patients, family members and caregivers and oncology providers. Patients and caregivers confirmed that survival alone is not their measure of lung cancer treatment success Definition of treatment success should emphasize effective clinical guidance throughout treatment, symptom management, functionality, and quality of life Definition of treatment success evolves over time, appearing to be linked to patients’ experiences with chemotherapy. Participants advocated for better patient-provider communication practices as well as the expanded use of patient navigation and new patient orientation programs. Conclusions: Late stage lung cancer patients have definite opinions about the impact of adverse treatment effects on their quality of life.
Cancer survivorship in Germany: Education of GPS—Why and how?
Authors: Schilling Georgia , Niebling Wilhelm , Mack-Hennes Angelika , Arnold Dirk 
Published: February 2017

97 Background: General Practitioners (GP) play a pivotal role in caring for patients with malignant diseases in screening and detection, additional supporting care whilst treatment, and (long-term) follow-up. They often do not feel to be qualified enough for this task, and as well claim to lack support by specialists. This is a well-known problem, already addressed by the Institute of Medicine a few years ago. As an increasing number of patients will be diagnosed with cancer – and will survive for many years, following curatively intended treatment or with a chronic cancer disease, Cancer Survivorship was identified as the area of utmost importance. The relevance of this field was underlined by the disappointing results of the simple question we asked GPs: “When and how often should the tumor markers CEA, CA 15.3, and PSA be assessed during standardized follow-up of patients with early breast cancer, colorectal cancer or prostate cancer?”. Only one out of 30 answered it correctly. Together with the State Chamber of Medicine of Südbaden, we started an education program for GPs to improve this critical interface. Methods: During a full day training, we provided an educational program covering the most relevant topics in Cancer Survivorship: physical long-term sequelae and late complications after multimodal therapy strategies, their prevention and treatment; fatigue and self management, reasonable complementary and alternative medicine; management of chronic pain syndromes, recommendations for tertiary prevention, physical activities, nutrition and a guideline conform follow-up. Training was completed by a knowledge test and an overall evaluation. Results: All participants welcomed this newly implemented training program and considered it as very useful for their daily practice. Further support was urgently requested by the GPs, preferably in the format of (defined) Survivorship Care plans and follow-up schedules. Conclusions: GPs need more support and information in Cancer Survivorship. Widespread trainings programs should be developed and offered, in close collaboration with the respective State Chambers of Medicine and cancer specialists, and GPs, and further improve the outpatient care of cancer survivors.
Personalized medicine as a model of care to improve patient outcomes, communication, and reduce cost.
Authors: Millis Sherri Z. , Davis John M , Ratliff Stephanie Marie , Ray Melissa Lorraine , Schroeder Wendy M , Townsend Tim , LoBello Janine R , Demeure Michael J. , Staren Edgar Donald 
Published: February 2017

e270 Background: Cancer treatment based on an individual’s tumor profiling has been associated with increased time to progression. Despite this, adoption has been impeded by various technical, financial, legislative, and ethical issues. Implementation of a personalized medicine program into a healthcare system with a goal of improving patient outcomes includes clinician and patient education, increased tumor profiling of patients, data sharing/analysis, expanded research, and billing/reimbursement practices. Methods: A personalized medicine program was implemented at a hospital system. Measures of physician practice included attendance at genomic medicine education sessions, utilization of genetic/genomic tests, enrollment of patients into clinical trials, modifications in billing practices, and submission of data for analysis. Reimbursement of off-label pharmaceutical agents as well as use of aggregate data to inform treatment and enrollment in biomarker-based clinical trials was recorded. Frequency of genetic and/or genomic tests relative to physician and patient education and access to research opportunities was also assessed. Early patient outcomes, overall costs of care, access to clinical trials, and changes in knowledge and communication are also being monitored. Results: Although analysis is ongoing, the initial assessment indicates an increased utilization of genetic and genomic tests, clarity in billing practices, improved reimbursement for off label therapies, and consumption of educational opportunities from clinicians to patients/caregivers. Analysis of the first year implementation will be reported, including evaluation of preliminary results relative to quality of life and survivorship. Conclusions: Preliminary analysis of data from implementation of a personalized medicine program indicates that utilizing relevant education, research, aggressive billing and reimbursement processes, and IT infrastructure, can provide patients with the individual therapies which reduce cost and improve survivorship.
"3 Steps 4 Health" in survivorship.
Authors: Fonfa Ann , Waldman Helayne 
Published: February 2017

e273 Background: As patient advocates we have spent years gathering and sharing information about simple, natural strategies to reduce risk of treatment-related toxicities and strengthen the immune system in survivorship. Sadly it is well known that many suffer long-term toxicities and are at higher risk for secondary cancers. Survivorship plans are created to help people move forward with their lives; we suggest the “3 Steps 4 Health” program as an addition. Methods: We created a simple 3-step program that absolutely anyone with cancer can incorporate into their own healthful protocol as they move into complete recovery. Since it involves no tools and can be used at the level that an individual is at the time they start, we consider it appropriate for all. Further, we cannot see any objection from the oncologist or staff members. Step 1: Eat one more fruit and one more vegetable every day. This is helpful since studies show few Americans are getting enough fruits or vegetables. The National Cancer Institute considers “Five a Day” a minimum. We want to get people started on the correct path simply and easily. Step 2: Take a walk around the room or neighborhood depending on ability and health status. This has been shown by many studies to help anyone with cancer, undergoing treatment, or in recovery. We are not asking people to become athletes; we are involving them in a plan to improve their health. Step 3:Seven deep breaths in a stressful situation or at bedtime. This step is important to reduce stress and encourage relaxation. Results: As patient advocates, we conduct no research; we scour journals for studies supporting our evidence-based concept. There are now many studies showing the value of one or more of the three steps. Rarely does research examine the concept as a whole. We believe this will occur soon. Conclusions: Every step moves people forward into better health. We believe taking these first steps will lead to more healthful behaviors, better ability to handle conventional cancer treatments, and an easier recovery. In this era of interest in immune response, it makes perfect sense for each individual to strive to be their personal best. Clearly, the “3 Steps 4 Health” program is a beginning at an important time for those who have survived cancer. We will share some of the studies that led us to this position.
Can we improve on patient, caregiver, and family engagement for better outcomes?
Authors: Korber Kenneth E 
Published: February 2017

e289 Background: Use of multimedia characters have been a mainstay of commercial consumer marketing for decades; albeit to the detriment of healthy lifestyle and purchasing choices. Methods: We set out to change this paradigm by providing a socially-beneficial multimedia character concept as a community outreach engagement tool AND to provide a health champion for at-risk pediatric patient cohorts, their caregivers, and families. Results: A children's book series was written with the hypothesis that tested whether combining music and health would be a positive and measureable tool for audience engagement. A secondary goal was to create a platform wherenby this notion could be leveraged in multiple therapeutic areas and across multi-disciplinary professional groups. Conclusions: The Musical Adventures of Grace ((ISBN 978-1-68097-094-4) has been produced and is being integrated into two curricula: (i) a national music immersion education program for cognitive | neurophysiological | emotional wellness, and (ii) as a classroom-clinic longitudinal tool for elevating awareness of healthy living and reinforced choices in families at-risk for cardiovascular disease. This new model can be adapted to multiple challenges of childhood cancer nad will contribute to clinicians' communication armamentarium.
Mind-body medicine epigenetic technique (MET) and TP53AIP1 gene expression.
Authors: Munoz Francisco Ventura 
Published: February 2017

e292 Background: This is a pilot study update on the potential of MET to up-regulate TP53AIP1 gene expression correlated with the up-regulation TP53 gene expression in patients diagnosed with breast cancer. Methods: The selection process for the study participants was nonrandom. The following was the eligibility criteria. 1.) Inclusion Criteria: Breast Cancer, Stages II, III. 2.) Exclusion Criteria: Cognitively impaired, weak or ill. The study utilized two groups. Each group was assigned two research participants. Group One received one session of MET. Group Two received two sessions of MET. Each MET session was approximately 25-35 minutes in duration. Blood samples were taken at baseline and post-MET sessions to provide evidence in gene expression changes. For Group Two, the post-MET session blood draw was done 7 days after baseline. 1.) Primary Endpoint: To determine whether MET can up-regulate TP53AIP1 gene expression. 2.) Secondary Endpoint:To determine whether there is a correlation between up-regulated TP53AIP1 gene expression and up-regulated TP53 gene expression. The blood samples were sent to genomics labs at the Childrens Hospital of Los Angeles and the University of Nevada Las Vegas for mRNA extraction and microarray analysis. The gene expression was measured by DNA microarray results using the “PrimeView gene chip” and “Partek Genomics Suite” statistical software. Results: For three participants, there was no statistical or biologically significant up-regulation in TP53AIP1 gene expression. However, one participant from Group 1 evidenced a biologically significant up-regulation of TP53AIP1 gene expression along with a biologically significant up-regulation of TP53 gene expression. One major limitation of these findings is the statistical insignificance of the results due to the small number of participants. Conclusions: This pilot study evidenced the up-regulation of TP53AIP1 gene expression potentially due to MET and provided evidence supporting the established correlation between TP53 and TP53AIP1 gene expression that could induce apoptosis. This study also provided a foundation for a larger study with more participants.