bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of recommended post-treatment services for adolescent and young adult Hodgkin lymphoma survivors.
Authors: Hahn Erin Elizabeth , Wu Yi-Lin , Garcia Delgadillo Jazmine , Munoz-Plaza Corrine E. 
Published: February 2017

107 Background: Adolescent and young adult (AYA) Hodgkin lymphoma survivors are at high risk for long-term and late effects. Post-treatment guidelines are available from the National Comprehensive Cancer Network (NCCN) and others; however, adherence to these guidelines is unknown. The purpose of this study was to identify AYA Hodgkin survivors from an integrated health care system and examine use of post-treatment services. Methods: We identified patients diagnosed between 2000 and 2010, ages 15 to 39. We identified use of NCCN recommended services (oncology visits, labs, CT) and non-recommended services (PET scan, CT after first year). Multivariate logistic regression was used to identify associations between receipt of recommended services within first 12 months post-treatment (oncology visits, labs, CT) and patient (gender, race/ethnicity) and cancer characteristics (stage, diagnosis age, diagnosis year). Results: We identified 354 patients (see table). Almost all had recommended oncology visits within the first 5 years (96%); 70% received recommended labs. Two-thirds received a recommended CT scan within 12 months post- treatment. However, 47% received a non-recommended CT in year 2 and 35% in year 3, and 33% received a non-recommended PETs. Overall, 48% received all recommended care within the first 12 months. Diagnosis year was significant in regression, with those diagnosed 2000-2005 less likely to receive recommended care than those diagnosed 2006-2010 (OR = 0.007, p < .0001). Conclusions: Less than half of patients received recommended care within the first year post-treatment. These results will inform development of effective programs to meet survivors’ needs. Next steps include exploring risk-stratified patterns of care in long-term survivors. [Table: see text]
Our act on fertility preservation for young breast cancer patients in our single institute.
Authors: Kojima Yasuyuki , Tsuchiya Kyoko , Nishijima Chie , Suzuki Nao , Tsugawa Koichiro 
Published: February 2017

109 Background: Along with increasing number of newly diagnosed Japanese breast cancer patients, the number of breast cancer survivors in reproductive age is also increasing. Among newly diagnosed Japanese breast cancer patients, 3182(6.6%) are under age 40 in 2011, which was 1610 in 2006. In our institute, we have been cooperating with gynecologists and providing fertility preservation program since 2010. Our aim is to access our team management, clinical impact and outcome of fertility preservation among young breast cancer patients in our institute. Methods: A patient, 1)without distant metastasis, 2)systemic chemotherapy and/or hormonal therapy planned, 3)within reproductive age and 4)willing to preserve fertility, will be referred to oncofertility clinic. Chart review was done retrospectively. Results: Ninety-five patients had consultation to the oncofertility clinic between April 2010 and April 2015. The average age at consultation was 34.1(range 22-44). Almost all patient had invasive cancer; cStage0:4%, cStageI:31%, cStageII:53%, cStageIII:11%. Fifty-five percent had estrogen receptor (ER) positive/HER2 negative, 31% had ER positive/HER2positive, 2% had ER negative/HER2 positive and 12% had ER negative/HER2 negative breast cancer. Forty-five had counseling without any procedure, 22 underwent ovarian tissue cryopreservation, 17 underwent embryo cryopreservation and 8 underwent oocyte cryopreservation. Because observation period is still short, we haven’t had any case that got pregnant or delivered, yet. Conclusions: The number of patient who choose to underwent fertility preservation is increasing. We have actually started facing proposition, when we shall lay aside adjuvant therapy and let them plan to be conceived. Taking risk into account, we are now evaluating the safety of cancer treatment and outcome of each procedure which undergone multidisciplinary deliberate decision-making process.
Impact of stress on diabetes self-management in cancer survivors.
Authors: James Janey , Coppa Natalie , Rosenberg Alexandra , Wisnivesky Juan P. , Lin Jenny J 
Published: February 2017

11 Background: Few studies have evaluated the impact of stress on diabetes self- management among cancer survivors. We undertook this study to assess factors associated medication adherence and diabetes self-management in a cohort of diabetic patients with recently-diagnosed early-stage cancer. Methods: We recruited diabetes patients recently diagnosed with early-stage breast, prostate, lung or colorectal cancer on at least one oral hypoglycemic agent and used the Impact of Event Scale (IES) to assess the subjective distress caused by cancer. The 15-item IES consists of 2 subscales assessing avoidant and intrusive feelings about cancer. We measured medication adherence using the 8-item Morisky Medication Adherence Scale, and diabetes self-management behaviors were evaluated using the Summary of Diabetes Self-Care Activities. Participants were surveyed at baseline and after 3 months. Descriptive and univariate analyses were used to assess baseline factors associated with diabetes self-management at 3 months. Results: Of the 36 participants recruited to date, 20 (56%) were male. At baseline, 70% reported adherence to their diabetes medications which dropped to 63% at 3 months. There were no gender differences between IES scores at baseline; however, at 3 months women were more stressed (p = 0.02) and had more intrusive thoughts (p = 0.005) about cancer. Higher baseline total IES scores were associated with lack of a general healthy diet (p = 0.01). Patients who had trouble falling asleep from thoughts about cancer felt more hassled sticking to their diabetes medication treatment at 3 months (p = 0.02). Those who had dreams about cancer (p = 0.007) and those who tried to stay away from reminders about cancer (p = 0.04) were more likely to forget their diabetes medications when travelling. Lastly, patients who felt that the cancer wasn’t real were more likely to have difficulty remembering to take medications (p = 0.03). Conclusions: Cancer survivors with comorbid diabetes who have higher stress are less likely to follow a healthy diet and more likely to report trouble with taking their diabetes medications. Providers should be aware of the impact of stress caused by cancer to better support diabetes self-management among early cancer survivors.
Survival and fertility in women with malignant peritoneal mesothelioma.
Authors: Bates Gleneara Elizabeth , Taub Robert N. , Jin Zhezhen , Ramos-Jimenez Elvia , Ali Saba Imran , Hashmi Anisah Khurshid , Bressler Yaakov , Bressler Toby , Hesdorffer Mary , Kluger Michael D. 
Published: February 2017

111 Background: The prognosis of malignant peritoneal mesothelioma (MPM) has improved over the past decade in patients undergoing operative extirpation and intraperitoneal chemotherapy (IC). This study investigates the time from diagnosis to treatment intervention in premenopausal women and its impact on fertility and childbearing options. Methods: A retrospective analysis of 195 patients diagnosed with peritoneal mesothelioma between 1995 and 2015. Patients with unresectable or bicavity disease were not excluded. Kaplan-Meier curves and univariate cox proportional hazards model were used to estimate survival and significant treatment and prognosis factors. Results: The median survival time of all peritoneal mesothelioma patients (n = 195) was 3.21 years with (95% CI: 2.38- 5.53), with median follow-up of 3.44 years (SD = 3.4, minimum = 0.014 and maximum = 16.752) years from first operation. Patient set included 111 men (57%) and 84 women (43.1%) with female sex having favorable survival [HR: 0.442 95% CI: 0.296-0.659), p < 0.001] of 110.1 months with (95% CI: lower bond: 48.3). Of these women, their mean age at diagnosis was 52 years, (SD = 14.5, minimum = 14.7 – maximum = 79.9), with a mean time of 8.20 months from diagnosis to the start of treatment (SD = 18.6, minimum = 0 and maximum = 128.6 months). Overall survival of premenopausal women (N = 23) during follow-up was 72.2% (SE = 27.8%). Mean age at time of diagnosis was 34.7 years, (SD = 9.26, minimum = 14.7, maximum = 48.1), with a mean time of 10.6 months from diagnosis to treatment (SD = 17.9, minimum = 0.63, maximum = 86.7). Of the 195 patients who received a full treatment course, 66 (33.8% CI: 95%) were still alive at the median follow-up, of those alive 37 are female: 7 are premenopausal and have presented with gynecological symptoms, and 17 are premenopausal and have presented with abdominal discomfort. Conclusions: This data suggests that women preparing for treatment of MPM should not be precluded from exploring fertility options. With a mean time of 10.6 months from diagnosis to treatment, it is possible for premenopausal women to take advantage of fertility preservation before starting treatment.
Fertility Attitudes and Cancer Treatment Study (FACTS).
Authors: Flink Dina M , Kellar-Guenther Yvonne , Sheeder Jeanelle , Kondapalli Laxmi A 
Published: February 2017

112 Background: Approximately 140,000 people under 45 year old are diagnosed with cancer annually in the US. Survivorship is high and many of these individuals desire future fertility. Although fertility preservation (FP) services are increasing, utilization rates remain low. Methods: We conducted a 2-phase study to identify factors for FP decisions among newly diagnosed males and females receiving fertility consultation, 18-45 years old. Phase 1 was a chart review; Chi-square and t-tests were used to determine potential factors associated with FP decision. Phase 2 consisted of face-to-face interviews. Content analysis was used to identify relevant themes associated with reasons, priorities, support, and satisfaction for FP decision. Results: In Phase 1, 108 charts were reviewed; FP utilization rate was 50%. Those who chose FP were more likely to be male (73.6% vs. 26.4%, p < 0.001), Caucasian (90.6% vs. 9.4%, p = 0.042), have a solid tumor (98.1% vs. 1.9% p = 0.032), and a shorter time from diagnosis to fertility consult (29.5 vs. 58.8 days, p = 0.017). Age, relationship, education, parity, or treatment plan did not differ with FP decision. In phase 2, we assessed reasons why patients chose FP; 27 participants were interviewed. Primary reasons for choosing FP were: future fertility and access to FP services. Main reasons for not choosing FP were: concerns with future conception and lack of access to FP services. Cost ranked 4thamong reasons to not choose FP; however 50% of patients overcame the cost to prioritize future fertility. Males top priorities were: future parenthood, cancer treatment, and survivorship QOL. Females top priorities were: future parenthood, decisional conflict, and cancer treatment. Patients greatest concerns with FP were: birth defects, future conception, and success of FP. Conclusions: Future fertility is a priority for newly diagnosed young adults. All patients should receive a referral to a reproductive specialist, regardless of patient factors or diagnosis. While patients expressed feeling well-informed to make FP decisions following fertility consult, some still had concerns with the safety and success of FP. Adequate FP consultation should include discussion of all treatment options and concerns for FP.
Novel intervention for decision support and distress in female cancer survivors considering fertility preservation.
Authors: Bradford Andrea Michele , Covarrubias Laura , Schover Leslie R. , Woodard Terri Lynn 
Published: February 2017

114 Background: Treatment-related infertility is a source of long-term psychological distress in cancer survivors, particularly among women. Decisions about fertility preservation (FP) are made under conditions of high stress and time pressure, which may contribute to the relatively low uptake of FP among women with cancer. Little is known about the effect of interventions to support the decision-making process and reduce fertility-related distress in cancer survivors considering FP. We describe the design and preliminary data from a randomized trial to determine whether incorporating psychological assessment and intervention into the standard FP consultation enhances satisfaction with decision-making and psychosocial outcomes. Methods: We developed a brief intervention for women referred to our institution’s oncofertility service for consideration of FP. The intervention focuses on values clarification for decision support, identification of unmet psychosocial needs, and mindfulness and acceptance-based skills. Participants were randomized to usual care (consultation with a reproductive endocrinologist and nurse) or the intervention (usual care plus a 1-hour visit with a psychologist and two follow-up calls). Outcomes included feasibility measures and measures of decisional conflict (Decisional Conflict Scale) and satisfaction with the FP program (Client Satisfaction Questionnaire-8). Results: All 14 participants randomized to date have completed baseline and 1-month assessments. The mean age was 32 (SD = 7.5, range 20-44), and the majority were nulliparous (n = 9, 64%). All 7 intervention participants completed at least 1 follow-up call, and 5 (71%) completed both follow-up calls. Across all participants, Decisional Conflict Scale scores decreased from baseline (M = 24.8, SD = 17.2) to 1 month (M = 22.2, SD = 16.3). Overall satisfaction with the program at 1 month was high (M = 29 out of a possible 32). Conclusions: Incorporating a psychological assessment and intervention into a standard FP consultation appears feasible and may improve levels of decisional conflict over time. Women appeared to find the intervention helpful when contemplating FP.
Hepatic adenoma among adult survivors of childhood cancer.
Authors: Tonorezos Emily S. , Barnea Dana , Abou-Alfa Ghassan K. , Bromberg Jacqueline , D'Angelica Michael Ian , Sklar Charles A. , Oeffinger Kevin C. 
Published: February 2017

117 Background: Hepatic adenoma is a rare and poorly understood benign epithelial neoplasm. Because of the potential for spontaneous hemorrhage, rupture, or malignant transformation; hepatic adenoma over 5 cm require resection. In the general population, the prevalence of hepatic adenoma is estimated at 1 in 100,000 and identified predominantly in obese females on oral contraceptives. An increased risk for hepatic adenoma among adult survivors of childhood and young adult cancer has not been previously reported Methods: Cancer diagnosis and treatment, as well as demographic factors, medications, and comorbidities, were collected from the medical chart among patients with pathological confirmation of hepatic adenoma. All cases were patients diagnosed with a non-hepatic cancer before the age of 40 and seen at Memorial Sloan Kettering Cancer Center. Results: Twelve cases of hepatic adenoma were pathologically confirmed; seven patients (58%) had more than one adenoma. Eleven (92%) cases were female. The most common preceding cancer diagnosis was leukemia (N = 4; 33%). Five (42%) had undergone allogeneic hematopoietic cell transplant with total body irradiation (TBI) as part of their preconditioning regimen. Cases were not as a rule obese; median body mass index was 22.2 kg/m2 (range, 17.6-31.0 kg/m2). All eleven females had a history of current or prior hormone therapy with estrogen and progesterone; the single male case was hypogonadal as a result of radiation therapy to the testes during treatment for acute myelogenous leukemia (AML) and was receiving testosterone therapy at the time of chart review. Eight patients (67%) had hypothyroidism and two (17%) were taking anti-epileptic drugs. Only two patients (17%) were monitored radiographically following biopsy; seven patients (58%) underwent hepatic resection and three (25%) underwent embolization. No patient had significant blood loss or has been observed to undergo malignant transformation, although follow-up is ongoing. Conclusions: Adult survivors of childhood and young adult cancer, particularly females with a history of current or prior hormone therapy, may be at increased risk for hepatic adenoma. Further investigation of this potentially morbid condition is warranted.
Utilization of sperm banking in men undergoing chemotherapy for testis cancer.
Authors: Brames Mary J. , Einhorn Lawrence H. , Case-Eads Somer , Sonnenburg Daniel 
Published: February 2017

122 Background: Testicular cancer is the most common carcinoma in men ages 18-35. Eighty percent of patients with metastatic disease will be cured with cisplatin based chemotherapy. However, approximately 40% of patients receiving chemotherapy will have permanent azospermia or oligospermia, impairing future fertility. Sperm banking prior to chemotherapy is an effective method of maintaining fertility. This retrospective study was performed to assess utilization and results from sperm banking, as well as the barriers to its use. Methods: Patients 18 and older who were 1-year post chemotherapy were given a 5-item questionnaire on follow-up visit. The questionnaire included a mix of quantitative and qualitative questions. Results: 200 patients with metastatic testicular cancer including patients who started initial chemotherapy at other institutions, enrolled in the study and all completed the questionnaire. 139/200 (70%) chose not to bank sperm: 71 (51%) of those were not interested, 25 (18%) declined due to desire to start immediate chemotherapy, 24 (17%) were not offered, 6% of those not offered were from Indiana University, 12 (9%) declined due to cost, and 7 (5%) answered "other". The average age at cancer diagnosis of patients who banked sperm was 28.4 as opposed to 32.6 for patients who did not bank sperm (p = 0.003). The percentage of patients who had children before their diagnosis was 21% in the sperm banking group and 50% in the group that did not (p = 0.0002). Sixty-one (30%) chose to bank sperm, 11 of 61 patients (18%) utilized the banked sperm. 9 of 11 (82%) that utilized the banked sperm resulted in successful paternity: 3 of 9 (33%) produced twins. There were no birth defects. Conclusions: Sperm banking provides the opportunity for paternity in testicular cancer patients. However, the majority of these patients chose not to bank sperm or was not offered the opportunity. A range of factors such as time, emotional state, patient age, disease stage, prior children, institutional practices, and cost all influence whether sperm banking is offered and taken up. Physicians and patients need to be aware of the potential benefit of sperm banking.
Preliminary results from the Sexual Therapy and Rehabilitation after Treatment for Ovarian Cancer (START-OC) study.
Authors: Bober Sharon L. , Blackmon Jaime E. , Recklitis Christopher J. , Wright Alexi A. 
Published: February 2017

127 Background: For ovarian cancer (OC) survivors, serious sexual dysfunction is one of the most distressing long-term side effects of treatment, with up to 90% survivors reporting a loss of interest in sexual activity for years after diagnosis. Despite the prevalence and magnitude of the problem, treatment-related sexual dysfunction and accompanying psychological distress are not addressed for most survivors. There is a critical need to address these problems for OC survivors. Methods: We are currently piloting a novel psychosexual intervention to help women manage sexual changes and improve sexual functioning after ovarian cancer treatment. Guided by Self-Determination Theory, this group-based intervention also aims to enhance women’s self-efficacy to address problems. Eligibility criteria include: OC diagnosis, functional ability, and sexual dysfunction. Women participate in a single half-day workshop, complete questionnaires, and engage in a booster telephone session. Detailed workshop evaluations are collected to assess women’s feedback of the group session. This study is currently enrolling. Results: To date, 369 women have been contacted, of which 45 (12.2%) have attended or are scheduled to attend a group session. Preliminary feedback data indicate high favorability of the group session; 100% of the women (N = 16) agreed or strongly agreed that the content of the group session was easy to understand and that the group session gave helpful information for addressing treatment-related sexual problems. Additionally, 100% of participants agreed that they were satisfied with the group session and enjoyed participating in it. Conclusions: Preliminary data show that women report multiple benefits from the session content and are highly satisfied with the group session. However, low response rates raise several questions with regard to timing and recruitment of a sexual health intervention after OC treatment. Next steps include quantitative analyses of changes in sexual function, sexual knowledge, and sexual self-efficacy consequent to the group intervention. Clinical trial information: NCT02287519.
Bridging the gap: The design of a survivorship curriculum for interspecialty collaboration.
Authors: Ozokwelu Emmanuel , Sisler Jeffrey James , Sussman Jonathan , Mukherjee Som , Mowat Stephanie , Ens Anita , Moser Cheryl , Konrad Gerald , Gingerich Joel Roger 
Published: February 2017

13 Background: Interspecialty learning between trainees from different postgraduate training programs is unusual in Canada. Primary care providers (PCPs) have an increasing role in the provision of survivorship care in collaboration with cancer specialists (ONC), but coordination of care is often lacking and avenues for joint learning and interaction among these physicians are limited during residency. We are piloting a learning suite (LS) for PCP and ONC trainees in MB, ON & BC as part of a pan-Canadian study on integration of care between primary and cancer specialty care. Methods: Using Kern’s Six-Step Approach to Curriculum Design, a national team of experts conducted surveys and focus groups with postgraduate program directors, cancer survivors, and trainees. We set learning objectives as informed by the needs assessment and used constructive alignment to build the curriculum in a blended learning format: online, workshop and clinical. We are assessing inter-disciplinary learning outcomes comparing pre and post results on a modified Readiness for Interprofessional Learning Scale (M-RIPLS) in three pilot sites in 2015 with about 40 family medicine and oncology trainees. Results: Learning materials have been developed for a mixed audience of trainees. The interactive, one hour online session addresses cancer epidemiology, the domains of survivorship care, and specific issues in follow-up care for three cancer types, as well as province-specific survivorship initiatives. This is followed by a two hour, case-based learning workshop that focuses on collaboration and shared care. A clinical experience in cancer follow-up clinics concludes the LS. In PCP training sites without a nearby cancer centre, trainees are able to review videos of actual transitional appointments and follow-up clinics and of the cancer centre/oncologist perspective on shared care. Pilots are ongoing in 2015 with national rollout in 2016. Conclusions: We expect that learning together in residency will impact on attitudes towards interspecialty collaboration in the care of cancer survivors. This interspecialty, blended learning curriculum will enhance the place of survivorship training in the postgraduate education of Canadian physicians.