bluuebunny/crossref_metadata_2025_split huggingface dataset:
Illness perception and concordance between prostate cancer survivors and caregivers and adherence to self-management behaviors.
Authors: Pantaleon Karisma , Chan Courtney , Yuan Ying , Lin Jenny J. 
Published: June 2022

e24002 Background: Illness beliefs are important determinants of self-management behaviors (SMBs). Spousal or informal caregiver involvement improves clinical outcomes in non-cancer survivors with chronic diseases. However, very little is known about the influence that caregivers have on comorbid disease SMBs in cancer survivors. In this study, we aim to understand and identify concordance in illness beliefs and perceptions between caregivers and prostate cancer survivors and to determine their impact on hypertension (HTN) SMBs. Methods: Survivors and their caregivers completed surveys assessing their beliefs and perceptions and SMBs regarding survivors’ HTN. Both survivors and caregivers answered the Brief Illness Perception Questionnaire (BIPQ) to assess beliefs and perceptions of survivors’ HTN. The BIPQ score is a sum of eight questions with a higher sum score indicating a more threatening view of the illness. Survivors reported adherence to SMBs using the Medication Adherence Report Scale (MARS) and Hypertension Self-Care Activity Level Effects (HSCALE). MARS scores >4.5 were considered adherent. The HSCALE isdivided into five sub-scores – diet, physical activity, smoking behavior, weight management and alcohol intake and each was score was dichotomized. Cohen’s Kappa statistic assessed concordance between survivor and caregiver dyad responses to the BIPQ. Logistic regression assessed associations between survivor and caregiver BIPQ scores and odds of SMB adherence. Results: This analysis included 55 dyads. Mean age of survivors was 70.4 years ± 9.6; 12 (22%) were Black, 36 (65%) were White, 2 (4%) were Asian and 3 (5%) were other race. Mean age of caregivers was 64.4 years ± 10.5, 9 (16%) self-identified as Black, 35 (64%) White, 2 (4%) Asian and 3 (5%) other race. Survivors and caregivers had fair agreements about how much HTN affected survivors’ lives (k = 0.147, p = 0.008), how concerned survivors are about their HTN k = 0.130, p = 0.014), and HTN’s emotional impact on survivors (k = 0.185, p = 0.002). However, survivor-caregiver concordance about HTN had no significant impact on survivors’ SMBs. In contrast, caregivers’ beliefs about HTN was associated with survivors’ SMB such that a 1-point increase in caregiver’s BIPQ score was associated with 8% increase in the odds of survivors’ self-reported weight adherence (p = 0.0314). Survivors’ HTN beliefs were not associated with adherence to SMBs. Conclusions: Caregivers have a significant influence on prostate cancer survivors’ adherence to weight-related SMB, demonstrating that it is important to also educate caregivers who support cancer survivors with chronic comorbidities. Future analysis will include a larger cohort to better understand the interrelationship between caregivers’ illness beliefs and survivors’ SMBs and may help clinicians better direct interventions to improve survivorship outcomes.
Geriatric assessment as a predictor of survival among older Indian patients with cancer.
Authors: Rao Abhijith Rajaram , Ramaswamy Anant , Kumar Sharath , Gattani Shreya , Dhekale Ratan , Krishnamurthy Jyoti , Mahajan Sarika , Daptardar Anuradha , Deodhar Jayita , Nookala Manjunath , Goud Supriya , More Sucheta , Nakti Dipti , Mudliya Chetan , Menon Nandini Sharrel , Patil Vijay Maruti , Gota Vikram , Banavali Shripad Dinanath , Prabhash Kumar , Noronha Vanita 
Published: June 2022

e24012 Background: ASCO guidelines recommend that geriatric assessment (GA) should be performed in all older adults with cancer. However, GA is labor- and time-intensive, hence the uptake is poor, especially in crowded resource poor-settings. There are no data correlating GA with overall survival (OS) outcomes from the Indian subcontinent. Methods: A prospective observational study in the geriatric oncology clinic of the Tata Memorial Hospital in Mumbai, India. Patients aged 60 years and above, with cancer who underwent a GA were enrolled. The domains assessed included: function (basic and instrumental activities of daily living, timed-up-and-go), nutrition (body mass index, unintentional weight loss, mini-nutritional assessment), comorbidities, cognition, psychological (depression, anxiety), social support, and medication (polypharmacy and potentially inappropriate medications). Patients with > 2 deranged GA domains were considered frail. Results: Between June 2018 and January 2022, 909 patients were enrolled. The median age was 69 (IQR, 60-88) years. Common malignancies included lung (40%), esophagus (21%) and head and neck (11%); 53% had metastatic disease. 80% had > 2 impaired domains in GA patients had vulnerabilities in a median of 3 (IQR, 0-5) domains. Median OS in fit patients based on the GA was 17.5 (95% CI, 13.9-21.0) months vs 12.1 (95% CI, 10.1-14.0) months in frail patients, (HR 0.66; 95% CI, 0.49-0.88, p = 0.005), which remained significant after adjusting for age, sex, and stage (HR, 0.71; 95% CI: 0.53-0.94, p = 0.021). In the multivariate analysis (Table), the domains that were predictive of survival were nutrition (HR: 0.65, 95% CI: 0.47-0.92, p = 0.014), cognition (HR: 0.65; 95% CI: 0.46-0.91, p = 0.012) and fatigue (HR: 0.74, 95% CI: 0.56-0.98, p = 0.038). Conclusions: In older Indian patients with cancer, GA is a powerful prognosticator of survival. In settings where a complete GA is not possible, nutrition, cognition, and fatigue should be the minimum domains assessed. Clinical trial information: CTRI/2020/04/024675. [Table: see text]
Outcome and surveillance pattern in older GIST population.
Authors: Ho Thanh P. , Siontis Brittany L , Thiels Cornelius A , Grotz Travis Edward , Okuno Scott H. , Robinson Steven Ian 
Published: June 2022

e24016 Background: Recent studies of patients (pts) with gastrointestinal stromal tumor (GIST) have included an older patient population. The majority of these have focused on treatment, but little is known regarding the optimal duration of surveillance following surgery for localized disease. Methods: We conducted a retrospective study of pts age 70 years (yrs) and above (≥) at diagnosis (dx), who underwent surgery for their localized GIST. Charts were reviewed of GIST diagnosed between 1992 to 2016, to allow at least 5 yrs for surveillance, if performed. Demographics were analyzed and pts were risk stratified using modified NIH criteria. Results: We identified 42 pts with a median age of 74 yrs (70 to 89 yrs) at dx. The majority of pts were male (31, 74%) and non-Hispanic White (37, 88%). Most pts had gastric GIST (25, 60%). The median resected tumor was 47 mm (range 6 to 190). Thirty-nine of 42 pts had margin status documented R0 resection. The median overall survival for all pts was 7.9 yrs (1.1 to 17.7), with median recurrence free survival 5.6 yrs (1.1 to 13.7). Only 4 of 16 (25%) pts died from GIST recurrence, and all were detected under 5 yrs from surgery. Fourteen of 34 pts (41%) who survived over 5 yrs from resection had extended surveillance imaging. Demographics and risk stratification are shown in Table. None of the 16 low risk pts developed recurrence, including 6 (38%) whose surveillance imaging continued beyond 5 yrs. Among 7 intermediate risk pts, only 1 pt (14%) extended surveillance imaging beyond 5 yrs. Two intermediate risk pts (29%) developed recurrence and were symptomatic at dx. One intermediate risk pt died from GIST metastasis within 1 yr from surgery. Seven of 19 (37%) high risk pts had surveillance imaging beyond 5 yrs following surgical resection. Seven high risk pts (37%) developed recurrence within median 5.6 yrs (1.6 to 13.7) from surgery; five of these were detected on imaging. In the high risk pts with recurrence, 5 had received adjuvant imatinib and 2 declined any systemic therapy. Three pts (16%) in the high risk cohort died from GIST. Conclusions: In this cohort of pts age ≥ 70 yrs with resected GIST, the majority of pts were symptomatic at relapse. Older pts who undergo surgery for low risk GIST may not require extended surveillance. Fit, older pts with high risk GIST may benefit from extended surveillance imaging, even if they received adjuvant imatinib.[Table: see text]
Understanding women’s perspectives on breast cancer is essential for early breast cancer diagnosis and to avoid diagnosis delay: A mixed method study.
Authors: Sankar Uma V , Warrier Narayanankutty Edavalath , T S Rakhi , Wilson Roshna 
Published: June 2022

e24036 Background: Breast Cancer is the most common cancer in women worldwide. Since 2017, MVR Cancer Centre is a tertiary care hospital, New national guidelines focused on clinical breast exam and mammogram require that women be aware of and seek care for breast concerns. Therefore, this study aims to understand women’s perspective on breast cancer diagnosis. Methods: Sequential explanatory method was used to satisfy the objectives of the study. A crossectional survey was conducted to conveniently sampled women aged 30 and older to assess women’s perspectives on breast cancer and care-seeking behavior. We did a qualitative interview among selected breast cancer women to know about the reasons of delayed diagnosis and treatment delay. Results: Among 378 women with a median age of 49 (IQR: 34–62) years, 73% have heard of cancer and 30% have received self-breast examination. Women self-evaluated their knowledge of breast cancer (from 1-none to 10-extremely knowledgeable) with a median response of 3 (IQR: 1–4). Only 24% felt they knew any signs or symptoms of breast cancer. Encouragingly, 42% of women were fairly-to-very confident they would notice changes in their breasts, with 22% of women practicing self-breast examination and 8% reporting they had received a past breast exam. Overall, 64% said they would be somewhat-to-very likely to seek care if they noticed breast changes, with 98% noting severity of symptoms as a motivator. However, altered sexuality (43%), fear of losing a breast - Womanhood(70%) and fear of a poor diagnosis (48%) were most frequent barriers to care seeking. In assessing knowledge of risk factors, about 70% of women did not know any risk factors for breast cancer whereas 12% of women believed long term contraceptive use a risk factor. However, 37% and 35% of women did not think that family history or being older were risk factors, respectively. Social recognition as woman, existence of womanhood, cost of treatment and related financial burden and fear of complications and death are the themes emerged from the qualitative study. Conclusions: The success of efforts to improve early diagnosis in a setting without population-based screening depends on women being aware of breast cancer signs and symptoms, risks, and ultimately seeking care for breast concerns. Unfortunately, most women said they would seek care if they noticed a severity in the signs and symptoms of cancer, but the low levels of cancer knowledge, symptoms, and common risk factors highlight the need for targeted community education and awareness campaigns.
Characterizing genitourinary exam disruptions in women presenting to a sexual health after cancer program.
Authors: Satish Sanjana , Pon Fay , Calfa Carmen Julia , Perez Alejandra T. , Rojas Kristin E. 
Published: June 2022

e24048 Background: While treatment-related sexual health sequelae are documented using validated patient-reported outcome measures, the anatomic changes associated with cancer treatment are not well described, which may lead to an underestimation of the severity of these symptoms. To fill this knowledge gap and improve the management of these anatomic disruptions, we sought to objectively report the genitourinary findings of women presenting to a sexual health after cancer program over one year. Methods: At their first visit, patients undergo a thorough history and physical with a focus on the genitourinary exam. Patient demographics, primary symptoms, and treatment history were retrospectively collected and correlated to vaginal assessment scale (VAS) scores of female cancer patients presenting to the MUSIC (Menopause, Urogenital, Sexual Health and Intimacy Clinic) Program at an NCI-designated cancer center. Results: Between 2020-2021, 104 female cis-gender women with a median age of 46 (range 19-75) at diagnosis were seen. 56% identified as Hispanic/Latinx. Mean age was 47 (19-75), and most were treated for breast (80%) or gynecologic (10%) cancer. Primary complaints included vaginal dryness (53%), painful sex (45%), low desire (36%), hot flashes (22%), problems with orgasm (5%), urinary symptoms (10%), chronic pelvic pain (4%), or a need for complex contraceptive counseling (1%). Of those where a VAS was performed (n = 89), patients were found to have mild or moderate/severe loss of rugae (78%), loss of elasticity (84%), loss of vascularity (86%), and/or dryness (88%). Alarmingly, almost half were found to have some element of vaginal stenosis on exam, either vaginal scarring/adhesions (6%), foreshortened vagina (13%), or a narrowed introitus (47%) (Table). Conclusions: In an initial consult of women seeking care for sexual health after cancer treatment, the most common concerns were vaginal dryness, painful sex, and low desire. Despite only approximately half reporting either dryness or painful sex, most were found to have genitourinary disruptions in anatomy at presentation, including vaginal stenosis. The presence of vaginal stenosis in sexual health survivors who did not undergo pelvic radiation deserves future study as these findings often present as a complete inability to have penetrative intercourse.[Table: see text]
The patient's needs before and six months after the initiation of breast cancer treatment: A prospective study in 600 breast cancer patients.
Authors: Kurir Borovcic Mateja , Mavric Zlatka , Zagar Tina , Homar Vesna , Kopcavar Gucek Nena , Skufca Smrdel Andreja Cirila , Knific Jana , Borstnar Simona , Marinko Tanja , Zadravec Zaletel Lorna , Kos Natasa , Strazisar Branka , Slapar Tatjana , Mastnak Mlakar Denis , Kovacevic Nina , Hadzic Vedran , Pelhan Bojan , Sremec Marko , Rozman Tina , Besic Nikola 
Published: June 2022

e24062 Background: Our aim was to determine the frequency of health-related problems faced by breast cancer patients before and six months after the initiation of breast cancer treatment. Methods: This prospective study involved 600 female breast cancer patients (26-65 years, mean 52), who participated in the pilot study in the novel individualized integrated rehabilitation programme in 2019-2022 and were followed for at least six months. The patients completed three questionnaires (EORTC QLQ - C30, B23 and NCCN) before the initiation of cancer treatment and six months after. The patients received neoadjuvant chemotherapy in 22% of the cases, tumorectomy in 53%, mastectomy in 39%, breast reconstruction in 27%, sentinel node biopsy in 67%, lymphadenectomy in 23%, external beam radiotherapy in 73%, chemotherapy in 45%, anti-HER-2 therapy in 11% and hormonal therapy in 74% of the cases. Data on the patients’ demographics, disease extent, cancer treatment and problems reported in the questionnaires were collected and analysed using descriptive analysis. Results: The problems reported by patients before the initiation of cancer treatment and after six months are presented in Table. In 14 out of 22 parameters, the frequency of problems increased in the six months after the initiation of treatment: fatigue, insomnia, lymphedema, shoulder movement impairment, disturbing scars, heart problems, hot flashes/sweating, gynaecological problems, sexual problems, body image worries, inappropriate nutrition, pain in the shoulder or arm, alopecia and concerns about returning to work. On the other hand, the frequency of problems decreased six months after the initiation of cancer treatment in 6 out of 22 parameters. Our patients less often had depression or anxiety, were too little physically active, smoked, consumed alcohol or used food supplements than before. Conclusions: Six months after the initiation of breast cancer treatment patients have more problems than at the time before treatment.[Table: see text]
Randomized controlled trial (RCT) of symptom screening with targeted early palliative care (STEP) versus usual care in patients with advanced cancer.
Authors: Zimmermann Camilla , Pope Ashley , Hannon Breffni , Krzyzanowska Monika K. , Rodin Gary , Li Madeline , Howell Doris , Knox Jennifer J. , Leighl Natasha B. , Sridhar Srikala S. , Oza Amit M. , Prince Rebecca M. , Lheureux Stephanie , Hansen Aaron Richard , Dhani Neesha C. , Liu Geoffrey , Bedard Philippe L. , Chen Eric Xueyu , Swami Nadia , Le Lisa W 
Published: June 2022

e24084 Background: To direct limited specialized palliative care resources to patients in greatest need, we developed STEP (Symptom screening with Targeted Early Palliative care). STEP entails symptom screening (ESAS-r) at each oncology clinic visit and triggered alerts (for moderate-high physical and psychological symptoms) to a nurse who calls the patient to offer a palliative care clinic (PCC) visit. We conducted a phase III RCT to assess the impact of STEP versus usual care on quality of life and other patient-reported outcomes (PROs). Methods: Adults with advanced cancer were recruited from medical oncology clinics at the Princess Margaret Cancer Centre, Toronto, Canada. Consenting patients with oncologist-assessed ECOG 0-2 and estimated survival of 6-36 months were enrolled and block randomized (stratified by tumour site and symptom severity) to STEP or usual care. Participants completed measures of quality of life (FACT-G7), depression (PHQ-9), symptom control (ESASr-CS), and satisfaction with care (FAMCARE-P16) at baseline, 2, 4 and 6 months. The primary outcome was FACT-G7 at 6 months, with a planned sample size of 261/arm. Results: From 8/2019 to 3/2020, 69 patients were enrolled: 33 randomized to STEP and 36 to usual care. The trial was then halted permanently due to the COVID-19 pandemic, owing to substantial changes to elements of STEP (shift to virtual symptom screening and palliative care) and usual care (shift to virtual oncology care). Median age was 64 years (range 25-87) and 62% (43/69) were women; study arms were balanced at baseline except gender, with more women randomized to STEP. Within the STEP arm, 20 (61%) participants triggered a nurse’s call to offer a PCC visit, of whom 13 attended the clinic at least once. All outcomes tended to be better in the STEP arm compared to usual care, particularly depression and satisfaction with care at 6 months; however, results were not statistically significant (Table). Conclusions: STEP holds promise for improving quality of life and other PROs in patients with advanced cancer and effectively directing early palliative care towards those who need it most. In response to the pandemic, an online version of STEP has been developed and a further trial is in progress. Clinical trial information: NCT03987906. [Table: see text]
Preclinical study of OQL051, a gut-restricted CDK4/6 inhibitor for chemotherapy-induced diarrhea.
Authors: Tyler Robert Claude , Zeng Wenqin , Li Wenxi , Chen Liping , Liu Shilan , Zhang Shiyi 
Published: June 2022

e24085 Background: Chemotherapy-induced diarrhea (CID) is a potentially life-threatening AE (incidence 50-80% with 5FU/irinotecan). Chemotherapy dose reduction or discontinuation is often required. Cyclin-dependent kinases 4/6 (CDK4/6) regulate cell cycle G1/S transition and can induce a “pharmacological quiescence”. Transient administration of a gut-restricted CDK4/6 inhibitor, prior to chemotherapy may slow/inhibit intestinal stem/epithelial cell cycling and thus, be prophylactic for CID. Methods: OQL051 (OQL), a gut restricted CDK4/6 inhibitor, was studied in MCF7 cells treated with OQL (2x serial dilution, max 10 µM) to measure cell proliferation inhibition. Colo205 cells were treated with OQL 2x serial dilution (25 µM max) to determine the protective effect of OQL on 5-FU. Measurements were performed using Cell Titer -Glo Luminescent cell Viability and caspase 3/7 assay kits. OQL PK was studied in Balb/c mice given OQL, 50 mg/kg intra-gastrically. Blood samples were collected at pre- and 0.25, 0.5, 1, 2, 4, and 6 h post-dosing. Tissues (jejunum/colon) were collected at 0.5, 2, and 6 h after OQL (n = 3/collection). Plasma and tissues were analyzed for OQL by LC-MS. CID (5FU model) was studied in 5 groups of Balb/c mice (n = 5/grp) given OQL vehicle (OQLV) +0.9%NaCl saline (NaCl), OQLV +5FU (175 mg/kg) and OQL+5FU at 3 OQL doses (25, 50, and 100 mg/kg) orally prior to 5FU injection. CID (irinotecan) model) was studied in Balb/c mice given OQL+ Irinotecan at 2 OQL doses (25 and 50 mg/kg, n = 5/ dose) plus IP Irinotecan. OQLV or OQL were given orally prior to IP Irinotecan. Diarrhea and intestine tissue damage were analyzed to evaluate the efficacy. Results: OQL treated MCF7 cells showed conc.-dependent growth inhibition (IC50 0.81 uM). Colo205 cells treated with 5-FU (10 µM) suppressed cell proliferation (60% @ 48 h). Pre-treatment with OQL decreased 5-FU inhibition/apoptosis in a dose-dependent manner. Jejunum and colon OQL conc. were 300x > plasma (AUC 12017, 10515 vs 32 ng·h/g). OQL decreased CID (5FU) grades and protected the intestinal epithelium. On day 6 post-treatment, the OQL group had mice normal (80%) and mild intestinal damage (20%) vs. OQLV group had mice normal (20%), mild intestinal damage (20%), and severe intestinal damage (60%). In the Irinotecan model, OQL showed efficacy similar to the 5FU model. On day 7 post-treatment, OQL had 40% of mice normal and 60% with mild tissue damage (grade 1) vs. OQLV with 0% normal, 40% mild, and 60% with severe intestinal damage. Histology showed intestinal tissues /epithelial cells had less edema, inflammation, and necrosis after OQL vs. OQLV. Conclusions: An oral CDK4/6 inhibitor, OQL051, was restricted to the intestinal lining and reduced 5FU intestinal cell apoptosis, necrosis, and inflammation. In a preclinical model, prophylactically used OQL051 improved not only diarrhea but also intestine damage status which supports the potential for a prophylactic CID treatment.