bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implementation of an exercise behavior change clinic for men with prostate cancer: Baseline results.
Authors: Weller Sarah , Spillane Maria , Pollock Phil , Sundar Monita , Goldenberg Larry , Hedden Lindsay , Higano Celestia S. 
Published: March 2017

169 Background: Regular physical activity (PA) and resistance training (RT) has been shown to improve the health of prostate cancer survivors (PCS), however participation rates are low. To address survivorship needs and support behaviour change, the Prostate Cancer Supportive Care (PCSC) program implemented an Exercise Physiology (EP) clinic using one-on-one exercise counselling. Our objective was to understand the PA and RT characteristics of PCS and examine the effect of an EP clinic on behaviour change. Methods: After enrolment in the PCSC program, PCS were offered a consultation with an Exercise Physiologist. Subsequent consultations occurred at 3, 6 and 12 months. Clinical data collected at each consultation included physical measures, stage of change (TTM), current exercise (GLTEQ and exercise summary), fatigue (FACIT Fatigue and SIFIR), barriers and facilitators to exercise and a safety screening (PAR-Q+). Information was used during the EP clinic to set PA goals and create an action plan for behaviour change, reviewed each visit. Results: 71 PCS, median age 67 (range 50-86) attended the EP clinic between July 2015 and August 2016. 76% had received primary treatment and 24% were on active surveillance. At first consultation, 63% had an at-risk health profile, with an average BMI of 27kg/m2 (overweight), average waist circumference of 102.6cm (high) and insufficient PA, with only 15% meeting both PA and RT guidelines (150 mins moderate-to-vigorous PA and 2 RT sessions weekly). Average reported fatigue was moderate (4/10 on SIFIR). Stage of change (TTM) showed 44% of PCS at pre-contemplation, contemplation or preparation stages and 54% at action or maintenance stages. Self-reported barriers to exercise included lack of time (24%), laziness (19.7%) and fatigue (18%), while exercising with a spouse/friend/team was the main facilitator to exercise (16.9%). Conclusions: The baseline PA and RT levels of EP clinic PCS is similar to population norms in that the majority of PCS are not meeting current guidelines. Our results demonstrate that the implementation of an EP clinic is feasible. Future follow-up of this cohort will evaluate whether the program creates sustainable PA behaviour change in PCS.
A prospective study on contraceptives used by reproductive-aged patients with breast cancer and the assessment of information.
Authors: Lakhdissi Asmaa , Berrada Narjiss , Bellahammou Khadija , Akkar Othman , Mustapha El Kabous , Akla Sarra , Ougellit Sihame , Mrabti Hind , Errihani Hassan 
Published: March 2017

173 Background: For reproductive-aged breast cancer (BC) patients, contraception is needed during and after treatment. Few data are available concerning the methods used in the real life and the comprehension of patients. The main objective of our study was to describe the contraceptive practice and to identify the need of information for these patients. Methods: We conducted a survey in young BC patients treated at the National Institute of Oncology Rabat–Morocco. We analyzed the contraceptive methods used. Then, we assessed the level of information and counseling about contraception for this population. The SPSS 10.0 software was used for statistical analysis. Results: 72 patients respond to the survey. The mean age was 41.4 ± 6.3 years. 79.2% had localized disease. 97.2 % were under treatment. The sexual activity was maintained in 69.4%. The contraceptive methods used before the diagnosis and after the announcement are summarized in the Table. 52 pts were informed that the hormonal contraception were not recommended. 86.5% had this information from doctors. 67.3% were informed at the moment of announcement of diagnosis, 17.6% at the consultation of surgery, 29.4% before starting chemotherapy, 35.3% during chemotherapy and 17.6% at the end of treatment. After information about the contraceptive methods, 50 % used a masculine condom, 15.7% had a copper IUD, 18.6% used external ejaculation, 14.3% on patient had a tubal ligation and 14.3% didn’t use a contraception method. 66% patients of patients had not asked about contraceptive methods. The reasons: abstinence: 31.3%, the disease is more important than the contraception: 14.6%. Conclusions: Our study found that there is a lack of information concerning contraception for young BC patients. A contraceptive counseling is highly needed to decrease the risk of pregnancy during treatment. [Table: see text]
Magnesium oxide supplements for the treatment of post-chemotherapy sleep disturbance.
Authors: Carson Cindy Alberts 
Published: March 2017

175 Background: While every cancer patient suffers from anxiety and sleep disturbance during cancer treatment, many physicians do not recognize that these problems can continue long after treatment has ended. Many cancer patients feel increased anxiety immediately after treatment ends when they find themselves “on their own,” without the protection of the medical armamentarium. The fear of recurrence, uncertainty about the future, a sense of vulnerability, awareness of mortality, and grief for the loss of a disease-free life all contribute to anxiety and sleep disturbance long term. Magnesium has been used for sleep induction and relaxation for centuries. The primary mechanism by which sleep is enhanced is by muscle relaxation. Magnesium induces muscle relaxation by preventing calcium from binding to troponin, parvalbumin, myosin, and calmodulin, thereby blocking muscle contraction. High levels of free magnesium competitively bind these proteins, and the slow dissociation of bound magnesium provides prolonged relaxation. It is for this reason that magnesium has a long history of use as a tocolytic in labor, as an adjunct to asthma treatment, and as a powerful laxative. Methods: 23 patients in a primary care practice reported continued anxiety and difficulty with sleep initiation following chemotherapy and/or radiation for various forms of cancer. Rather than use SSRIs, benzodiazepines, or sleep medications, all patients were started on an over the counter 1,000 mg magnesium oxide supplement, taken 1 hour before bedtime for 2 weeks. Results: Four patients dropped out before the end of the study period due to magnesium-induced diarrhea. 19 patients completed the 2-week study. Of these, 14 reported a noticeable reduction of sleep latency and an improvement in sleep quality. 11 also reported a subjective sense of reduced anxiety overall. 5 reported an improvement in nocturnal leg cramps, which had been interfering with sleep quality. Conclusions: Overall, magnesium proved to be a well-tolerated treatment for sleep disturbance and anxiety in the majority of the patients studied.
Growing Healing Touch as supportive cancer care in western New York.
Authors: Hess Suzanne M , Beaupin Lynda M. 
Published: March 2017

176 Background: Healing Touch (HT) is a specific energy medicine modality that incorporates several techniques to balance the human energy field to help promote healing. It is a safe and non-invasive therapy that complements traditional, standard care and is recognized by NIH’s National Center for Complementary and Integrative Health. HT was first introduced to cancer survivors at our NCI-designated Comprehensive Cancer Center in 2013. We demonstrate HT is well-received and easy to integrate into traditional cancer care. Methods: A Certified Healing Touch Practitioner taught pediatric survivors and families HT techniques, as well as trained staff and volunteers to participate in the pilot program and to offer HT sessions throughout the year. Results: See Table. Qualitative analysis of participant’s feedback indicate benefits in the following themes: 1. Physical Symptom Relief 2. Emotional Issue Relief 3. Spiritual/Grief Support 4. Recommendation to Other Patients. Conclusions: Healing Touch is an energy medicine modality that is easy to teach, simple to integrate into routine cancer care, and beneficial for caregivers and survivors alike. [Table: see text]
Prospective study of work limitations in cancer patients (pts) undergoing curative chemotherapy (CT).
Authors: Tevaarwerk Amye , Buhr Kevin A , Conkright William A. , Onitilo Adedayo A. , Robinson Emily G. , Hegeman Robert B. , Ahuja Harish G. , Kwong Roger W. , Nanad Ranveer , Dennee Alexandra , Burkard Mark E. , Wiegmann Douglas , Wisinski Kari Braun , Sesto Mary E 
Published: March 2017

18 Background: Impaired work performance that when significant leads to decreased productivity (work limitations) contribute to the “financial toxicity” of cancer treatment. Factors influencing work limitations and employment outcomes are poorly understood for cancer pts. We prospectively examined the proportion of cancer pts with significant increases in work limitations during curative treatment (co-primary endpoint). Methods: Eligible pts were ≥ 18 years, employed, intended to work during or after end of treatment (EOT), and had received ≤ 1 CT cycle. The Work Limitations Questionnaire (WLQ) survey was administered (baseline [BL], EOT, 3 and 6-months post EOT) to determine change in work limitations (WLQ index scale: 0 = no limitations to 28.6 = limited all of the time). “Significantly affected” pts had > 5-point increase in WLQ - an increase associated with decreased work productivity. Descriptive statistics (estimates with 95% confidence intervals [CI]; means with standard deviations [SD]) were calculated. A two-factor ANOVA (pt, timepoint) was used for analysis of WLQ changes over time. Results: 120 pts enrolled 5/2013 - 10/2015 at 8 sites (85 breast, 16 colon, 19 other). 110 took 1+ surveys: median age 50 (range 24-69), 92 (84%) female, 105 (96%) White; 93 (85%) had surgery, 110 (100%) CT, 57 (52%) RT. The mean increase in WLQ index from BL to EOT was +4.4 (95% CI [+2.1,+6.8], p < 0.001). A total of 44% were “significantly affected” by treatment (37/85, 95% CI [33%,55%]). WLQ index decreased at 3 and 6-mos (as compared to BL or EOT, see table). Conclusions: Among largely White pts getting CT, 44% experienced a significant increase in work limitations from BL to EOT. An improvement in group WLQ scores was noted after EOT. Analysis of factors (e.g., job type, education, symptoms) most associated with work limitations is underway to assist in prospectively identifying at-risk pts. [Table: see text]
Is cancer information exchanged on social media scientifically accurate?
Authors: Warunek Molli , Gage-Bouchard Elizabeth 
Published: March 2017

186 Background: Cancer patients and their caregivers are increasingly using social media as a platform to share cancer experiences, connect with support, and exchange cancer-related information. Yet, little is known about the nature and scientific accuracy of cancer-related information exchanged on social media. Methods: We conducted a content analysis of 12 months of data from 18 publically available Facebook pages hosted by parents of children with Acute Lymphoblastic Leukemia (n = 15,852 posts), and extracted all exchanges of medically-oriented cancer information. We systematically coded for themes in the nature of cancer-related information exchanged on personal Facebook pages, and two oncology experts independently evaluated the scientific accuracy of each post. Results: Of the 15,852 total posts, 171 posts contained medically-oriented cancer information. The most frequent type of cancer information exchanged was information related to treatment protocols and health services use (35%) followed by information related to side effects and late effects (26%), medication (16%), medical care-giving strategies (13%), alternative and complementary therapies (8%), and other (2%). Overall, 67% of all cancer information exchanged was deemed medically/scientifically accurate, 19% was not medically/scientifically accurate, and 14% described unproven treatment modalities. Conclusions: These findings highlight the potential utility of social media as a cancer-related resource, but also indicate that providers should focus on recommending reliable, evidence-based sources to patients and caregivers.
Final Journey: A reference booklet for families of dying patients.
Authors: Zachariah Finly , Mooney Stefanie , Banerjee Chandana , Buga Sorin , Freeman Bonnie 
Published: March 2017

189 Background: Family members will carry the memory of the death of their loved-one with them for the rest of their lives. If they perceive their loved-one suffered as they died there is a risk they will develop Post Traumatic Stress Disorder or other psychological dysfunctions. It is crucial the family be educated and holistically supported during the dying process. Health care providers and care givers require information that will enable them to act as patient advocates and work effectively with families toward the common goal of a peaceful death. Resources that provide basic explanations, suggestions for care, open communication, and prepare families and care givers about the dying process are essential. Methods: Final Journey is a patient and family centric booklet developed based on the CARES tool, which is a guide to help medical teams better care for the dying and their family. CARES stands for comfort, airway, restlessness and delirium, emotional and spiritual support, and self-care. Final Journey details in each section what patients and families may experience, helps families understand what constitutes suffering, and suggests what families can do to help their loved ones. Results: There is a need for education tools that are easily understood, pertinent, and made accessible to help improve the dying experience for all parties involved. Final Journey helps assure families are informed and more emotionally prepared. Furthermore, the booklet expands the available resources available to medical providers, allowing them to more effectively address the challenges of caring for the dying. Final Journey will be available as a free download from the Department of Supportive Care Medicine website. Conclusions: We anticipate utilization of the Final Journey booklet will improve knowledge and understanding for health care providers, care givers, and families regarding a normal dying process and how to distinguish this from suffering, provide them suggestions on how to offer support and comfort during the dying process, promote communication between health care providers, care givers, and families of dying patients and supply resources and information on the importance of self-care when working with a dying patient.
Community and health system partnership.
Authors: Harris Madeline G. , Di Piazza Rebecca M. , Tunagur Alia , Sellers Susan E. , Noles Kristen G. , Carpenter John T. 
Published: March 2017

190 Background: Breast cancer survivors face physical, psychological, medical, social, cultural and spiritual challenges. Services to address these needs are frequently not available or if available unknown. We sought to determine whether formation of a community-based comprehensive breast cancer survivorship program was feasible. Methods: After months of relationship building, the Women’s Breast Health Fund of the Community Foundation of Greater Birmingham (CFGB), awarded funding to support a systematic assessment of available services in the region. Survivors, their loved ones, providers and other national models of care were surveyed and interviewed. Focus groups including a Lesbian, Bisexual, Gay, Transgender, Queer (LGBTQ) group were held. Aggregated results were presented in monthly meetings to executive level hospital administrators from all health systems in the area, the UAB School of Nursing and CFGB. Results: Survivors seek advice from other survivors more than any other source. Gaps in services exist. Breast cancer survivors were often unaware of existing services. Services were not available to some cultural/ethnic groups or loved ones; staff of some services were not culturally sensitive to the needs of survivors. Some services were available to all, while others require payment. There was no source of authoritative, evidence-based information on breast cancer survivorship except for a few providers. After 12 months the group of executives from all health systems committed to support the formation of a community-based comprehensive breast cancer survivorship program designed to assist breast cancer survivors, their loved ones and institutions by providing reliable information about services. Conclusions: Breast cancer survivors, providers, and local health systems all support the development of a comprehensive breast cancer survivorship program. We feel that it will address unmet needs of breast cancer survivors, allowing each institution to address needs for individual patients. By using the breast cancer survivorship program to assess individual needs and to provide information about services for identified needs, we expect repetitive services will be reduced and quality of life for breast cancer survivors will improve.
Psychosocial distress in lymphoma survivors at 3 years’ follow-up.
Authors: Rosenthal Allison Claire , Maurer Matthew John , Allmer Cristine , Ansell Stephen Maxted , Farooq Umar , Habermann Thomas Matthew , Link Brian K. , Witzig Thomas E. , Yost Kathleen J. , Cerhan James Robert , Thompson Carrie A. 
Published: March 2017

193 Background: National standards recommend distress screening as part of cancer care. While many patients report improved quality of life after cancer treatment concludes there remains a population who experience ongoing anxiety and depressive symptoms. We sought to describe psychosocial distress in lymphoma survivors and frequency of visits to mental health providers (MHP). Methods: Lymphoma patients were prospectively enrolled within 9 months of diagnosis in the University of Iowa/Mayo Clinic SPORE Molecular Epidemiology Resource and systematically followed. Brief Profile of Mood States (POMS) and State Trait Anxiety Inventory (STAI) were administered 3 yrs after diagnosis. Lower scores on POMS indicated more distress. A higher score on STAI indicated more anxiety, and a score ≥ 40 was considered clinically significant. Pts were asked if they ever saw a MHP due to their lymphoma. Results: Between 2002-2012, 2465 lymphoma pts age 18-91 (10% 18-40, 54% 41-65, and 36% > 65) were enrolled, met survivor definition, and completed 3-yr POMS and STAI questionnaires. 57% were male. 40% had aggressive and 60% had indolent lymphoma. The median score on STAI 1 (state) was 32 (range 20-76) and on STAI 2 (trait) was 31 (range 20-77). Median POMS total mood disturbance (TMD) score was 88 (range 1-100). 8% of pts reported seeing a MHP. 609 pts (25%) had clinically significant anxiety by STAI 1, 73 (12%) of whom saw a MHP. Those who reported clinically significant anxiety on STAI were more likely to be younger, unemployed, unmarried, and less likely to have seen a MHP. Anxiety levels were similar between those with aggressive lymphoma and indolent lymphoma regardless of treatment. Higher distress levels, measured by TMD, were more often reported by those who were unemployed or over age 65 while there was no association with lymphoma subtype, marital status, or choice of therapy. Conclusions: Clinically significant anxiety was reported in 25% of 3-yr survivors of lymphoma and was associated with younger age, unmarried status, and unemployment. Higher distress levels were associated with older age, and unemployment. However, only 8% of our cohort was seen by a MHP. Identifying distress and appropriately referring to a MHP is important for the optimal care of lymphoma survivors.
Evaluating an educational intervention to alleviate distress among men with newly-diagnosed prostate cancer and their partners.
Authors: Hedden Lindsay , Wassersug Richard J , Mahovlich Sarah , Pollock Phil , Sundar Monita , Bell Robert H , Goldenberg Larry , Higano Celestia S. 
Published: March 2017

194 Background: Diagnoses of cancer distress both patients and their partners. Providing accurate information about diagnosis and treatment options promotes active and informed decision-making and can decrease distress and anxiety. We sought to determine whether an education session alleviated distress for both prostate cancer (PC) patients and their partners, and whether their partner’s attendance at the session, as well as specific disease, treatment, and socio-demographic characteristics affect changes in distress levels. Methods: The session consists of a 90-minute didactic presentation, followed by an 8- to 10-minute private session with a urologist and radiation oncologist. We assessed distress using the Distress Thermometer (DT) and compared pre- and post-session distress, and change in distress between patients and partners using matched and unmatched t-tests. We also assessed before-the-session anxiety using the Generalized Anxiety Disorder measure (GAD), and decisional certainty using the Decisional Conflict Scale. Results: 71 patients and 48 partners participated in the study. Attending the session led to a significant reduction in median DT score for both patients (4.0 to 3.0, p = 0.0009) and partners (5.0 vs. 4.0, p = 0.0176). Partners reported higher distress both before and after the session compared to patients (4.9 vs. 3.8, p = 0.025 pre-session and 4.2 vs. 3.1, p = 0.032 post-session). The presence of a partner at the session did not appear to affect patients’ pre- or post-session distress nor the success of the session at alleviating distress. Sociodemographic and clinical characteristics had little effect on distress levels. Conclusions: Our study demonstrates that an interdisciplinary education session is equally effective at alleviating distress for both PC patients and their partners. These results can be used to guide the development of supportive care programs more broadly in terms of their ability to address the physiological and psychological needs of PC patients and their families.