bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cardiovascular late effects among endometrial cancer survivors in a cohort study.
Authors: Soisson Sean Patrick , Ganz Patricia A. , Rowe Kerry G. , Wan Yuan , Deshmukh Vikrant , Newman Michael , Fraser Alison M , Smith Ken R , Hanson Heidi , Stanford Joseph B , Werner Theresa Louise , Setiawan Veronica , Hashibe Mia 
Published: March 2017

131 Background: Endometrial cancer is the second most common cancer among female cancer survivors in the US, with an estimated 757,000 endometrial cancer survivors in 2016. Cardiovascular disease is the leading cause of death among endometrial cancer survivors. Cardiovascular disease risk may be increased among endometrial cancer survivors due to shared risk factors such as obesity or because of cancer treatment. Because of the high overall survival rate and the large number of endometrial cancer survivors, studies that examine late effects among endometrial cancer survivors are critical. Methods: Cohorts of 3,337 endometrial cancer survivors diagnosed between 1997 and 2012, and 19,420 age-matched cancer-free women were identified using the Utah Population Database. All ICD-9 diagnosis codes were collected from the state’s two largest healthcare systems and statewide ambulatory surgery and inpatient visits. Diagnoses were collapsed into cardiovascular system disorders according to the Healthcare Cost and Utilization Project’s Clinical Classification Software. Cox regression models were used to estimate hazard ratios (HR) at 1-5 years and 5-10 years after cancer diagnosis. Models were adjusted for race/ethnicity, baseline BMI, and baseline Charlson Comorbidity Index. Results: Approximately 89.4% of cancer cases were diagnosed with stage I or stage II disease. At 1-5 years after diagnosis, the highest risks among endometrial cancer survivors were observed for phlebitis and thrombophlebitis (HR: 3.36, 99% CI: 1.96-5.77), lymphatic diseases (HR: 1.89, 99% CI: 1.64-2.19), pulmonary heart disease (HR: 1.82, 99% CI: 1.36-2.43), hypotension (HR: 1.64, 99% CI: 1.18-2.29), and atrial fibrillation (HR: 1.61, 99% CI: 1.25-2.06). At 5-10 years, elevated risk persisted for these and 17 out of 66 additional outcomes among the endometrial cancer survivors. Conclusions: Endometrial cancer survivors in this population are at higher risk for various long term cardiovascular outcomes compared to cancer-free women. This study presents sufficient evidence to suggest that increased monitoring is necessary for women diagnosed with endometrial cancer in the first several years after diagnosis, and out to ten years as well.
Cancer rehabilitation outpatient consultation: Patient characteristics, symptom burden and quality of life.
Authors: Gutierrez Carolina 
Published: March 2017

136 Background: Cancer rehabilitation focuses on the functional and psychological needs of cancer survivors. Patient-reported outcomes have been increasingly used as part of the standard of care during clinical encounters. We review characteristics that patients present to their outpatient cancer rehabilitation consultation at a large academic hospital. Methods: Patients presenting for their first outpatient cancer rehabilitation consultation completed a paper copy of the PROMIS-10 (Patient Reported Outcomes Measurement Information System) instrument immediately prior to meeting with the physician. It includes 10 items evaluating quality of life, social life, functional activity, mental health, pain, and fatigue. A caregiver or health care provider could provide assistance in completing the form. Patient-reported outcomes were analyzed as part of an IRB-approved protocol. Data were analyzed using descriptive statistics and the “PROMIS Scoring Global Short Form v1.0 and v1.1” (12/16/2010). T-Score distributions are standardized such that a 50 represents the average (mean) for the US general population, and the standard deviation around that mean is 10 points. Results: Twenty-seven patients presented for consultation (63% women, 37% men) from 3/2014 through 6/2015 with an average age of 54.5 (44-76 range). Disease types included 52% brain tumors, 33% breast, 5% prostate, and 1% of each of the following: melanoma, myelofibrosis, and multiple myeloma. For our population, the physical health subscale score was 11.51 with a T-Score 38.6, standard error 4.1, a T-Score more than one standard deviation below the population mean. The mental health subscale was 11.92 with a T-Score 43.5, standard error 3.6, representing less than one standard deviation below the mean. The global health score was 28.55, which fell 2 standard deviations below the population mean. Conclusions: Compared to the US population mean, cancer survivors presenting for a cancer rehabilitation consultation had lower physical health than mental health. Our findings suggest the importance of screening cancer survivors for physical impairments and providing interventions focused on functional recovery.
Late effects among head and neck cancer survivors in Utah cancer survivorship study.
Authors: Kawakita Daisuke , Abdelaziz Sarah , Chen Yuji , Rowe Kerry G. , Wan Yuan , Deshmukh Vikrant , Newman Michael , Fraser Alison M , Smith Ken R , Monroe Marcus , Hashibe Mia 
Published: March 2017

137 Background: Sites of head and neck are associated with chewing, swallowing and speaking. As for treatment of head and neck cancer (HNC), we have to consider organ preservation as well as clinical outcomes. Although non-surgical treatments have been preferred in recent years, complications after treatment have been a concern. The aim of this study was to evaluate the late effects in a cohort of HNC survivors in Utah compared to a matched cohort of cancer free individuals. Methods: Up to 5 cancer free individuals were matched to each HNC survivor on birth year, sex, birth state, and follow up time. Electronic medical records and statewide ambulatory and inpatient surgery data were used to identify late effects over two time periods: 1-5 and 5-10 years after cancer diagnosis. Cox proportional hazards models were used to estimate the risks of late effects. We adjusted for matching factors, race and number of hospital visit. Results: In this study, 2,432 HNC survivors and 12,149 matched controls were enrolled. More than 80% cases had loco-regional disease and a histological type of squamous cell carcinoma. Hazard ratio (HR) for second primary HNC was notably increased among HNC survivors for both 1-5 years (HR: 1498.46; 95% confidence interval (CI), 158.58-14159.69) and 5-10 years (HR: 1509.62; 95% CI, 147.94-15404.15) post cancer diagnosis. And, HRs for respiratory disease, including respiratory system, lung cancer and pneumoniae, were also increased among HNC survivors for both 1-5 years and 5-10 years post cancer diagnosis. As for hearing loss, HNC survivors had a increased HR for 1-5 years post cancer diagnosis (HR: 5.90; 95% CI, 2.67-13.01) and this association was consistent for 5-10 years post cancer diagnosis (HR: 5.01; 95% CI, 2.06-12.18). Conclusions: In this study, we found HNC survivors have notable associations with second primary HNC, smoking related respiratory disease, and hearing loss which might be associated with chemotherapy when compared to cancer free subjects.
Prevalence of vitamin D insufficiency and falls in older cancer patients.
Authors: Zhang Xiaotao , Sun Ming , Shah Jay Bakul , Dinney Colin P.N. , Popat Uday R. , Champlin Richard E. , Valero Vicente , Tripathy Debu , Hedberg Ann-Marie , Edwards Beatrice Jara-Almonte 
Published: March 2017

138 Background: More than 60% of cancer patients are older adults. Such patients undergo age and cancer therapy related changes. Older adults also have geriatric risk factors for falls such as frailty, cognitive impairment (mild cognitive impairment [MCI] and dementia), and malnutrition-including vitamin D deficiency. Objective: To assess the prevalence of vitamin D insuffiency and risk factors for falls in older cancer patients. Retrospective cohort study. Methods: Patients underwent prospective data collection and retrospective analysis. Patients underwent a comprehensive geriatric assessments, including cognitive, functional, nutritional, physical, and comorbidity assessment. Vitamin D was assayed. Bone densitometry was performed. Analysis: Descriptive statistics, and multivariable logistic regression. Results: We enrolled 318 patients and 305 patients with complete data were included for final analysis. Patients were undergoing active cancer care. Patients had gastrointestinal, urologic, breast, lung and gynecologic cancers. The mean age was 78.4 ± 6.9 years. Low bone mass and osteoporosis were very common (80%) in this cohort. Twenty-six percent had one or more falls in the preceding six months. Dementia and mild cognitive impairment were seen in 33% and 37% of patients, and 53% presented frailty. In 256 patients, 48.8% (n = 125) had Vitamin D insufficiency ( < 30 ng/ml). In univariate analysis, co-morbidity (p = 0.05), frailty (p < 0.01), and cognitive impairment (0 = 0.02) were significantly associated with falls, while in multivariate analysis, frailty remained significantly associated with falls (OR = 3.51, 95%CI = 1.88, 6.52). Conclusions: Older cancer patients have a high prevalence of falls, osteoporosis and vitamin D insufficiency, raising the possibility of injurious falls (fractures). Frailty was found to be the most prominent risk factor for falls in this cohort. Greater awareness and targeted interventions such as vitamin D replacement, physical therapy, nutrition interventions, and therapy for low bone mass/osteoporosis will be effective preventing injurious falls.
Patient screening tool as input to the survivorship summary of care plan appointment.
Authors: Robinson Patricia A. , Trosman Julia Rachel , Khosla Pam , Perez Claudia B. , Shrestha Shakuntala , Garcia Sofia F. , Rosenberg Carol A. , Boecher Stephanie , Macias Javier , Berardi Rosa , Penedo Frank J. , Kircher Sheetal Mehta , Slocum Megan , Weldon Christine B. 
Published: March 2017

140 Background: A review of the literature failed to identify a screening tool specific to the unique needs of cancer survivors. The Coleman Supportive Oncology Collaborative (CSOC) developed a tool to evaluate psychosocial, physical and practical concerns, and emotional distress for concurrent use during the cancer survivorship visit. Based on pilot results of the tool, minor modifications were made and tested. Methods: The CSOC (v.3) survivorship tool was used in patients (n = 49) who had completed their adjuvant therapy at one of two safety net hospitals in Chicago, IL. The CSOC v.3 screening tool items (n = 44) include: PHQ4, fear of another cancer or recurrence, financial, social and religious concerns, nutritional concerns, physical concerns, lifestyle risk factors, and treatment/care concerns. Results: The most common patient concerns included: fear of another cancer 53% (26/49), tingling in my hands/feet 53% (26/49), concerns about diet 51% (25/49), pain 51% (25/49), sleep 51% (25/49), dry skin 47% (23/49); endorsement of these concerns were not significantly associated. Of the 44 items, 16 were reported by at least 30% of patients, and 3 items were reported by less than 10% of patients. There was an average of 15 items/concerns noted by patients with a maximum of 27 items and a minimum of 5 items. Clinicians (n = 7) reported the use of the screening tool results aided the survivorship appointment discussion, directing the focus to reported patient’s concerns. Conclusions: Survivors continue to experience multiple concerns and distress, thus they may benefit from a comprehensive tool that is tailored to capture their unique survivorship needs. Administration of the tool at the beginning of the survivorship appointment provided the framework for the patient’s appointment narrative. An additional study is planned to compare use of the tool versus current practice at a large academic center.
Heart rate variability (HRV) training for symptom control in cancer survivors.
Authors: O'Rourke Mark Allen , Stokes Sherry , Regina Franco , Susko Kerri , Hendry William , Anderson Annie , Sofge Jameson , Ginsberg Jay , Burch James 
Published: March 2017

148 Background: Late effects of cancer and its treatment include pain, fatigue, stress, and depression, all mediated by autonomic dysfunction. Heart Rate Variability (HRV) coherence is an established measure of optimal autonomic function. HRV coherence is achieved when the heart beat-to-beat intervals increase and decrease with respiration in a smooth rhythm. High coherence is associated with improved mood, cognition, executive function, and optimal pulmonary gas exchange. Cancer survivors have lower HRV than controls. Low HRV has been associated with early mortality, inflammation, and other adverse intermediary outcomes. HRV biofeedback (HRV-B) training improves HRV coherence, restores autonomic health, and reduces the above symptoms. HRV-B is non-pharmacologic, inexpensive, and self-maintained. This report describes a feasibility study of HRV-B in symptomatic cancer survivors. Methods: In a randomized, waitlist-controlled clinical trial, 179 were screened, 35 enrolled and 31 completed the protocol. Participants in the intervention arm received weekly HRV-B training up to six weeks. Outcome measures assessed at baseline (pre) and after week six (post) included HRV coherence plus the Brief Pain Inventory (BPI), Multi-Dimensional Fatigue Inventory (MFI), Perceived Stress Scale (PSS) and Beck Depression Inventory II (BDI-II). Data analyzed using linear-mixed models for repeated measures (SAS Proc Mixed). Results: Conclusions: Delivering HRV Biofeedback training to cancer survivors is feasible in a clinical setting. This study provides preliminary evidence that HRV-B training for cancer survivors improves HRV and reduces pain, fatigue, stress, and depression. HRV-B training has potential for symptom control in cancer survivors. Controlled, multisite studies are indicated.[Table: see text]
Subgroups of survivors with distinct aggravating factors associated with chemotherapy-induced neuropathy (CIN) in the feet.
Authors: Mastick Judy , Mausisa Grace , Mazor Melissa , Paul Steven M. , Cooper Bruce A. , Smoot Betty , Topp Kimberly , Abrams Gary , Chen Lee-may , Chesney Margaret , Kober Kord , Conley Yvette , Levine Jon , Miaskowski Christine 
Published: March 2017

151 Background: CIN is the most prevalent neurologic complication of cancer treatment. Inter-individual variability exists in survivors’ reports of the factors that aggravate CIN in their feet. The purpose of this study was to identify groups of survivors with CIN in their feet based on distinct aggravating factors and evaluate for differences in demographic, clinical, symptom characteristics and quality of life (QOL) based on group membership. Methods: Cancer survivors (n = 403) who received a platinum and/or a taxane and rated their altered sensation/pain in their feet at > 3 on 0-10 scale were enrolled and completed study questionnaires, including a list of 22 factors that could make pain worse. Medical records were reviewed and sensory and motor tests were done. Latent class analysis was used to identify groups of survivors based on the occurrence rates for aggravating factors. Differences among the groups were evaluated using parametric and nonparametric statistics. Results: Three groups were identified based on occurrence rates for aggravating factors in the feet (i.e., Activity and Temperature (40.2%), Activity (25.8%), Few Factors (34.0%)). No differences were found among the groups in demographic characteristics, or sensory (light touch, temperature, pain, vibration) and motor (Timed Up and Go, Fullerton Assessment of Balance) tests. Compared to the Few Factors group, the other two groups had higher BMI, worse foot pain, poorer functional status and sleep, more depressive symptoms, and lower QOL. Survivors who received a platinum compound were more likely to be in the Activity and Temperature group. Those that received a taxane compound were more likely to be in the Few Factors or Activity groups. Conclusions: Survivors who reported a higher occurrence of aggravating factors had a higher symptom burden and poorer QOL. Objective measures did not differ among the groups. Aggravating factors associated with the CTX received supports previous work in that the survivors who received platinum drugs noted cold temperatures aggravated their CIN. Findings suggest that subgroups of survivors can be identified based on their reports of CIN aggravating factors.
Comparing diets for weight loss and improvement in biomarkers in men with prostate cancer on surveillance: A pilot study.
Authors: Benson Sharon 
Published: March 2017

159 Background: Weight loss is recommended for treatment of prostate cancer, yet the most efficacious diet is not clear. The diet should improve biomarkers for prostate cancer, not increase risk of other chronic diseases, and be acceptable for long term use. Ascertaining appropriate dietary treatment for men on surveillance is crucial in preventing future cardiovascular disease, which is the leading cause of death in these men. Methods: Men with prostate cancer on surveillance and/or with untreated biochemical relapse followed 2 diets for 8 weeks of weight loss with random assignment to the order: (1) the diet recommended by the Prostate Cancer Foundation (PCF); (2) a plant-based, olive oil diet (PBOO), which included 3 tablespoons of extra virgin olive oil/ daily. After completing both diets, participants selected one of the diets for 6 months of follow-up (FU). Results: 30 started the protocol; 12 dropped out, 11 due to diet compliance (n = 3 PBOO; n = 8 PCF); 18 completed the 8 weeks of both diets and are reported here. Mean age: 66.6 + 5.9; baseline BMI: 30.9 + 2.7 kg/m2. Thirteen of the 18 have chosen the PBOO for FU. Conclusions: These results suggest a benefit with the PBOO diet in lowering insulin and glucose, and improving insulin function compared to the PCF diet. Despite similar weight loss, energy intake was higher on the PBOO diet. In addition, the PBOO diet was preferred over the PCF diet for long-term use. [Table: see text]
Training a survivorship care workforce with a novel web-based training curriculum.
Authors: Weldon Christine B. , Trosman Julia Rachel , Roggenkamp Betty , Boecher Stephanie , Robinson Patricia A. , Penedo Frank J. , Garcia Sofia F. , Lillis Teresa , Berardi Rosa , Macias Javier , Gerhart James , Shrestha Shakuntala , Khosla Pam , Lo Shelly S. , Dale William , Kircher Sheetal Mehta , Rosenberg Carol A. 
Published: March 2017

16 Background: The Commission on Cancer (CoC) standard 3.3 requires survivorship care plan (SCP) delivery to patients who complete treatment with curative intent. The Coleman Supportive Oncology Collaborative (CSOC) is focused on improving supportive and survivorship care through tools, processes and training of health professionals. Methods: A collaborative of 30+ clinicians (faculty) from 25 institutions (academic, community and safety net), funded by The Coleman Foundation, reviewed existing supportive oncology and survivorship care training for content, availability, and cost. They developed a unique fundamental survivorship care training curriculum. Results: Although SCP dissemination training is available, it lacks 1+ attributes: <15 minutes to complete; online access; and CME/CEU credit at no cost. Utilizing existing guidelines and literature, the CSOC identified survivorship (9), palliative (11) and distress (6) modules supporting CoC requirements developed by 2+ expert faculty. Standardized modules include references and a slide presentation with links to additional training, guidelines and literature. Modules were reviewed by The National Comprehensive Cancer Network (NCCN) scientists, and edited. Audio was recorded by faculty. Tech assistance aligned video, graphics and narrated audio into a MP4 (movie) format. Survivorship modules include: Cancer Survivorship Defined, Patient Needs at Survivorship Visit and Coc Requirements for SCPs; Cancer Survivor Care; Survivorship Factors (Lifestyle & Behavior, Psychosocial Challenges and Late and Long Term Effects); Cancer Survivors’ Screening and Prevention Strategies; and Genetic Testing for Patients, Families and Survivors. The NCCN Education Portal published the training (https://education.nccn.org/supportive-oncology-care) available publicly (w CME/CEU) for no charge. Conclusions: Various forms of survivorship training for health professionals exist, but they lack needed attributes. The CSOC developed 9 concise survivorship training modules for NCCN’s education portal, with CME/CEU credit available at no cost to participants. CSOC will collect feedback from training enrollees to determine effectiveness and future training needs.
Self-monitoring and reminder texts to increase physical activity after colorectal cancer (Smart Pace): A pilot trial.
Authors: Van Blarigan Erin , Van Loon Katherine , Kenfield Stacey A. , Chan June M , Fukuoka Yoshimi , Laffan Angela , Mitchell Emily , Chan Hilary , Rodriguez-Jaquez Daniela , Meyerhardt Jeffrey A. , Venook Alan P. 
Published: March 2017

166 Background: Colorectal cancer (CRC) survivors can improve their quality-of-life (QOL), and potentially survival, by engaging in physical activity. The aim of this pilot randomized controlled trial (RCT) is to determine the feasibility of a technology-based physical activity intervention for CRC survivors. Methods: 40 CRC survivors will be randomized (1:1) to a 12-week physical activity intervention (Fitbit Flex, daily text messages) or usual care. Eligible individuals must: 1) have stage I-III colon or rectal adenocarcinoma; 2) have completed therapy; 3) be considered cancer-free; 4) be English speaking; 5) have no contraindications to moderate physical activity; 6) engage in < 150 min/week of moderate physical activity; and 7) have Internet and a phone that can receive text messages. Our primary outcomes are adherence (e.g., Fitbit wear time, text response rate) and acceptability assessed via survey. Secondary outcomes include change in physical activity via 7-days of ActiGraph GT3X+ accelerometers and QOL. Results: We have screened 350 individuals with stage I-III CRC at the University of California, San Francisco (UCSF) for eligibility. Of these, 181 (52%) were not eligible [non-English speaking (46%), ≥ 150 min/week of physical activity (22%), contraindications to physical activity (22%), not cancer-free (7%), did not own a mobile phone (2%)]. We invited the remaining 169 eligible CRC survivors to participate by mail, e-mail, phone, or in clinic; 76 (45%) actively declined and 59 (35%) did not respond after up to 3 contact efforts. As of October 2016, 34 CRC survivors have been randomized to intervention (n = 16) or control (n = 18). These individuals are: 55% female; 64% Non-Hispanic White; 73% have a 4-y college degree; and 64% work full-time. The median (IQR) age and BMI are: 56 (50, 65) y and 26.4 (23.2, 32.4) kg/m2, respectively. Conclusions: The results of this pilot study will inform a definitive RCT to determine whether a technology-based physical activity intervention improves QOL and survival after CRC diagnosis. Funding: This research was supported by the NIH (K07CA197077, KL2TR000143), Mt. Zion Health Fund and UCSF Helen Diller Family Comprehensive Cancer Center.