bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cancer survivorship in gulf countries: A systematic review.
Authors: Hameed Maha , Ashraf Aqsa , Faisal Muhammad Salman 
Published: June 2022

e24046 Background: Cancer survivors have been increasing worldwide due to advancements in early cancer detection, chemo-hormonal therapy, and improved supportive care with an estimated four-to-five-fold increase in cancer burden in Gulf countries by the year 2040. Cancer survivorship deals with the host of challenges that cancer leaves in its wake. We seek to explore the experience of Gulf countries' cancer survivors and identify the gaps that need to be addressed. Methods: A systematic review of current evidence regarding cancer survivorship in the 6 Gulf countries (inclusive of Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates) was conducted according to the PRISMA 2020 checklist, without restricting to a starting date. We searched five major online databases: Embase, Cochrane, PubMed, SciELO, and Web of Science. Twenty-two articles were reviewed for the inclusion of predefined domains of cancer survivorship (Nekhlyudov et al, JNCI 2019). Results: Most of the studies included were published in Saudi Arabia (63.6%), followed by UAE (13.6%), Oman (9.1%), Bahrain (4.5%), Kuwait (4.5%), and Qatar (4.5%). Data within the included studies encompassed 9 domains of survivorship, of which clinical structure was reported most consistently (95.5%), followed by surveillance and management of physical and psychosocial effects (77.3% and 68.2% respectively). The most frequently reported domain, clinical structure, refers to the type of healthcare delivery environment offered, patient education, availability of necessary specialty care and subsequent healthcare professionals, access to care, the functionality of available healthcare information systems (e.g., electronic medical records and telehealth) and whether opportunities for research participation was offered to patients. Comparatively, the three domains health promotion (27%), patient experience (27%), and surveillance and management of chronic medical conditions (13%) were reported least frequently. Conclusions: Cancer survivorship in Gulf countries is currently in its infancy, evidenced by a paucity of literature on the topic. This systematic review assesses domains explored by available studies, finding a significant focus on clinical structure. Gaps in literature particularly within the surveillance and management of chronic medical conditions in cancer survivor patients need to be addressed in future research.[Table: see text]
Gender and weight change, skeletal muscle index(SMI) change, and survival in advanced non-small cell lung cancer(NSCLC) patients(pts.) receiving platinum chemotherapy.
Authors: Fidler Mary Jo J. , Shah Palmi , Moudgalya Hita , Batus Marta , Borgia Jeffrey Allen , Bonomi Philip D. 
Published: June 2022

e24080 Background: Significantly longer OS has been reported in advanced NSCLC pts. who gained weight or maintained (skeletal muscle mass) SMI during treatment with platinum containing chemotherapy. None of these studies evaluated the relationship between OS and both weight and SMI. Sex specific distributions are described for cachexia and muscle wasting. Methods: The objective of this retrospective study was to evaluate the relationships between OS and both weight gain and SMI maintenance during front line chemotherapy in advanced NSCLC pts. Weight and SMI measurements(cm2/m2) were done at baseline and at 6, 12, & 24 weeks. OS was estimated using the Kaplan-Meier method. The associations of weight and SMI with overall survival were assessed using Kaplan-Meier, log-rank test and proportional hazards regression. Results with p < 0.05 were reported as significant. Results: Characteristics for the 88 patients were: median age – 64 years, women – 57%, caucasian – 68%, black – 25%, and adenocarcinoma histology – 63%. Weight gain (i.e., > 0%) and > 5% weight gain were observed in 50% and 11.3% of the patients, respectively. For all 88 patients the hazard ratio(HR) for OS in patients with > 0% vs < 0% weight change was 0.544 (p = 0.0164), and the HR for OS for weight > 5% vs < 5% was 0.469 (p = 0.099). The HR for OS in men for > 0% vs < 0% weight gain was 0.421(p = 0.031), and HR for OS > 5% vs < 5% weight gain was 0.421 (p = 0.031). The same analyses in women showed no significant differences. Increases in SMI > 0% and > 5% SMI were found in 48% and 35% of patients, respectively. Maintenance of SMI defined as > - 1.3% was observed in 25% of pts. The HR for OS in men with SMI maintenance versus loss was 0.230 (p = 0.031), and the HR for OS in men with SMI increase > 5% vs < 5% was 0.219 (p = 0.0267). Neither SMI gain nor maintenance were significantly related to OS in the entire patient group or in women. Conclusions: In patients treated with first line platinum doublet, as a group there were no significant relationships between weight changes or SMI changes and OS. The observation that either weight gain or SMI maintenance was associated with longer OS in men only is based on data from a small number of patients. However, if larger studies show similar results, these findings could have implications for clinical and translational research in cachexia.
Physical and psychological symptom burden in patients newly diagnosed with solid organ cancers in a tertiary care centre in India.
Authors: Batra Atul , kumar akash , Pramanik Raja , Khurana Sachin , Pushpam Deepam , Bakhshi Sameer , Sharma Atul , Gogia Ajay , Malik Prabhat Singh 
Published: June 2022

e24081 Background: Assessment of physical and psychological symptoms using patient-reported outcome (PRO) scales is an often overlooked aspect in oncological practice in resource constrained settings. We assessed the pattern of symptoms at diagnosis in solid organ cancers using an innovative smart device based delivery of the Edmonton Symptom Assessment Scale (ESAS). Methods: We assessed PROs using ESAS at diagnosis in adult patients diagnosed with solid organ cancers at a large tertiary care centre in New Delhi, India from September 2021 to January 2022. The ESAS was delivered to patient's smart phone as a text message that provided a unique link to complete the questionnaire in Hindi or English, as preferred by the patient. Symptom severity was categorized into physical, psychological, and total symptom domains and the scores were further classified as none to mild (0-3) or moderate to severe (4-10). Univariate and Multivariate logistic regression analyses were performed to determine predictive factors. Results: Text message with ESAS completion link was sent to 653 consecutive patients, of whom 509 (77.9%) completed the questionnaire during the study period. The median age was 52 years and 53.2 % were males. The primary cancer site was lung, breast, gastrointestinal, and others in 27.7%, 28.1%, 14.4%, and 29.8%, respectively. Pain (59.1%) and tiredness (57.8%) constituted the maximum physical symptom scores in moderate and severe category. Patients with lung cancer had most physical symptoms categorised in moderate and severe compared with other cancers (P = 0.03), while psychological symptoms were more likely to be moderate to severe females (P = 0.01). In the multivariable logistic regression analysis after adjusting for measured confounders, primary cancer site (lung vs others) and sex (female vs male) were significant predictors for moderate and severe physical and psychological symptoms, respectively. Conclusions: A simple mobile-based ESAS delivery system can help in collecting PRO data to assess symptom burden in patients diagnosed with cancer. The symptom burden assessment can aid in providing personalised symptom-directed measures to improve the quality of life of patients with cancer.
Outcomes of a resilient living program for patients with advanced cancer and their caregivers.
Authors: Pachman Deirdre R. , Chesak Sherry , Cutshall Susanne M , Mandrekar Jayawant , Rummans Teresa A , Clark Matthew M , Lapid Maria I 
Published: June 2022

e24087 Background: Patients with advanced cancer and their caregivers experience a substantial amount of distress. Limited research suggests that mindfulness-based interventions may improve quality of life and reduce anxiety. The virtually delivered Resilient Living program consisted of online modules, a print journal, and a total of 4 virtual training sessions focused on techniques for managing stress and building resilience (mindful presence, uplifting emotions, reframing experiences through principles of gratitude, compassion, acceptance, meaning, and forgiveness). The current pilot study was performed to assess the feasibility of the virtual Resilient Living Program for patients with advanced cancer and their caregivers, as well as preliminary effects on anxiety and related outcomes. Methods: Eligible patients included those age ≥18 years with a diagnosis of advanced cancer with expected prognosis > 6 months. Feasibility was defined as consent of at least 25% of eligible patients and their caregivers. Adherence was defined as 75% of the enrolled participants completing at least 3 of the 4 Resilient Living sessions. The primary outcome measure was anxiety as measured by the GAD-7; others included stress (PSS), quality of life (LASA), sleep (ISI), resiliency (Resiliency Scale), and fatigue (PROMIS-Fatigue SF). Results: Seventy-two eligible patients were referred to the study, of these 33 patients enrolled (46% enrollment), 15 also had a caregiver enroll. Thirty participants completed at least 3 virtual sessions (63% adherence). Data was collected at baseline, week 5 (after 2 session), week 9 (after 4 sessions), and week 12 (1 month after completion) for patients and caregivers. There were statistically significant improvements in anxiety at weeks 5, 9 and 12 (i.e., p < 0.05). Other results are outlined in the table. Conclusions: Virtual participation in the Resilient Living Program is feasible and acceptable for patients with advanced cancer and their caregivers. Data from this pilot study suggest that the program may positivity impact anxiety, stress, sleep, quality of life and resiliency. A larger randomized prospective clinical trial is warranted to confirm these preliminary findings. Clinical trial information: NCT04480008. [Table: see text]
Increased risk of venous thrombosis in breast cancer patients receiving chemotherapy treatment after COVID-19.
Authors: Ausheva Tatiana V. , Katelnitskaya Oksana V. , Kit Oleg I. , Frantsiyants Elena M. , Vladimirova Liubov Yu , Zakharchenko Viktoria R. , Kaplieva Irina V. , Shatova Iuliana S. , Ardzha Anna Yu 
Published: June 2022

e24106 Background: Immune suppression and coagulopathy development in cancer patients receiving chemotherapy determines a high incidence of complications, including venous thrombosis, and mortality from COVID-19 infection. There are still no explicit data on managing cancer patients when anticancer treatment is resumed after coronavirus disease. According to clinical guidelines for the prevention of venous thromboembolic complications in cancer patients receiving chemotherapy, patients with breast cancer are classified as having a low risk of these complications and do not require prophylactic anticoagulation. The purpose of this study was to assess the parameters of the blood coagulation system and the frequency of venous thrombosis in breast cancer patients with chemotherapy resumption after coronavirus disease. Methods: The study included 30 patients receiving anticancer medical therapy for breast cancer after COVID-19. Anticancer treatment was resumed no earlier than 4 weeks after clinical recovery, absence of SARS-CoV-2 RNAs in nasopharyngeal swabs, infiltrative lung damage according to a chest CT scan, exclusion of venous thrombosis by a lower extremity venous ultrasound. Control group included 20 breast cancer patients without a history of COVID-19. Stage I tumors were registered in 26.6% in the main group vs 15% controls; II - 40% vs 60%; III - 20% vs 15%. Some patients were diagnosed with distant metastases (stage IV- 13.3% vs 10%). Results: Initially, before chemotherapy resumption in the main group, half of the patients had elevated levels of fibrinogen and D-dimer compared with the control group (66.7% vs. 35%, p > 0.05). After a cycle of chemotherapy, a significant difference in the coagulation system parameters was noted (73.3% vs 30%). A lower extremity venous ultrasound after the end of the therapy cycle in the main group showed venous thrombosis in 3 patients (catheter-related n = 2, distal vein thrombosis of the lower extremities n = 1), while no venous thrombotic complications were detected in the control group (10% vs. 0%). Conclusions: Breast cancer patients after coronavirus disease 2019 have hemostasis abnormalities and higher risk of venous thrombosis, and the resumption of anticancer treatment increases the incidence of thrombotic complications. COVID-19 should be considered an additional risk factor of venous thrombosis in cancer patients and requires reconsideration of indications for prophylactic anticoagulation when resuming anticancer treatment for patients with breast cancer.
Prevalence, symptom management, and reporting of cannabis use among invasive cancer patients.
Authors: Brasky Theodore M , Newton Alison M , Conroy Sara , Adib Anita , Adley Neema C , Strassels Scott A , Hays John L. , Cooper Ziva D , Wagener Theodore L , Krok-Schoen Jessica L. 
Published: June 2022

e24114 Background: Interest in the use of cannabis-based products, including marijuana (products containing ≥0.3% tetrahydrocannabinol [THC]) and cannabidiol (CBD; containing < 0.3% THC) for cancer symptom management, is increasing. Preliminary studies suggest that marijuana and CBD products are effective in alleviating common cancer- or treatment-related symptoms. Few studies have reported on the magnitude of cannabis use among cancer patients, but data remain limited to states with legalized non-medical (i.e., recreational) use. Further, none have assessed the prevalence of CBD use in cancer patients. The reasons for cannabis-based product use and patient attitudes towards discussing use with their physicians are not well understood. Methods: We report preliminary results from an ongoing anonymous cross-sectional study of cannabis use among patients attending 8 clinics at the Ohio State University Comprehensive Cancer Center. Eligible patients were diagnosed with invasive cancer and treated in the past 12 months. Between July 2021 and January 2022, 771 patients were contacted and 639 (82.9%) agreed to participate. Participants answered a validated, extensive cannabis-focused questionnaire and were remunerated with a gift card. We report here frequencies and prevalence proportions of cannabis-based product use, and cannabis-related behaviors and attitudes on reporting use with cancer providers. Missing values were included in the denominator of prevalence calculations, thereby making estimates conservative. Results: Participants were equally distributed by sex, White (86.4%), and resided within Ohio (90.3%). Among 433 patients who reported age, the median was 47 years (IQR 38-53). The prevalence of current cannabis-based product use was 15.2% (97/639), with overall prevalence of 6.9% for exclusive marijuana use, 1.7% exclusive CBD use, and 5.2% poly-use. Among current users, patients primarily reported inhaling or ingesting cannabis products; fewer reported topical or other applications. The top 5 reported reasons for cannabis use were to treat stress, improve sleep, reduce pain, improve appetite, and to treat depression. Among current users, 66% reported that their cancer care team was aware of their cannabis use, 17.5% reported none of their healthcare providers were aware, and 15.4% reported a medical professional unaffiliated with their cancer care was aware. A large proportion (86.6%) felt comfortable discussing cannabis with their treating physician. Conclusions: Our results indicate current cannabis-based product use for symptom relief among a sizeable minority of adults with cancer in a state where only medicinal marijuana is legalized. Further research is needed to characterize provider perspectives and communication about reported cannabis use among their patients.
Pilot study of a text messaging-integrated and Chatbot-interfaced self-management program for symptom control in GI cancer patients undergoing chemotherapy.
Authors: Wen Kuang-Yi , Gomaa Sameh , Schnoll Max , Zhan Tingting , Bashir Babar , Posey James 
Published: June 2022

e24117 Background: Chemotherapy treatments are increasingly provided in the outpatient setting. Patients are expected to monitor and manage a range of diverse and complicated side-effects without readily accessible clinical support. The overall goal of this study is to address the gap in continuity of care during outpatient chemotherapy through the integration of an innovative text messaging system with a Chatbot interface in the real-time monitoring and proactive management of side-effects among gastrointestinal (GI) cancer patients undergoing IV chemotherapy. Methods: Real-time chemotherapy-associated side effects monitoring supportive system (RT-CAMSS) was iteratively developed with patient-centered inputs and evidence-based and theory-guided information to address chemotherapy knowledge, self-care symptom management skills, emotional support, doctor-patient communication, and nutritional and physical activity suggestions. We conducted a single-arm 2-month pilot study, in which GI patients undergoing chemotherapy received two intervention text messages per week and a weekly CTCAE-based symptom assessment delivered through Chatbot interface with tailored feedback. Baseline and post-intervention patient-reported outcome follow-up surveys were collected. Results: 45 eligible patients were approached and 34 consented and enrolled (76% consenting rate). The mean age was 61 (±12). 56% were females and 61.8% were non-Hispanic White. The most frequent cancer type was pancreatic cancer (53%), followed by colon cancer (35%). 27 participants completed the post-intervention follow up (79% retention rate)..Functional wellbeing subscale of the FACT instrument showed significant improvement from baseline to 2 month ( p < 0.05). 27 participants responded to the weekly Chatbot-interfaced symptom assessment at least once (79% feasibility rate). The most frequent reported symptom collected from Chatbot assessment was constipation (50%), followed by weight loss (35%) and fatigue (32%). Post-intervention open-ended satisfaction survey found that participants perceived the intervention easy to use with helpful information. Conclusions: Communication via mobile technologies is highly scalable for improving health services. The study provides preliminary evidence of engagement, acceptability and benefits of RT-CAMSS, which should be evaluated in a controlled clinical trial.
Baseline preferences for digital information engagement in patients with breast cancer by age and status of diagnosis.
Authors: Hu Bonnie , Isakoff Steven J. , Glieberman Eva , O'Rourke Emily , Spring Laura , Moy Beverly , Bardia Aditya , Said Maya , Peppercorn Jeffrey M. 
Published: June 2022

e24119 Background: The need for improvement in education and decision-making support for patients with breast cancer is well documented. Digital health applications offer potential to address these needs through widely available smartphone technology. Understanding patients’ baseline preferences for information sources, breast cancer-related topics of interest, and current use of smartphones and how these interests may differ based on demographic and clinical factors can inform the development of a patient-centered digital navigation tool. Methods: As part of a pilot trial of the Outcomes4Me breast cancer navigation app, we conducted a baseline cross-sectional survey of patients presenting for routine breast cancer care at an academic medical center and community-based sites. Eligible patients had invasive breast cancer of any stage and were actively in treatment. Survey-specific questions addressed sources of cancer information and informational needs. Analysis is descriptive with statistical comparisons based on Fisher’s exact test. Results: Ninety out of 107 patients in the pilot trial completed the survey items of interest. The majority of patients were over age 50 (59%) and 35% had stage IV disease. Baseline reported uses for mobile devices included text (67%), email (61%), phone (47%), social media (41%), accessing the internet (18%), and apps (12%). Only 7% of patients noted using mobile apps for navigating disease and treatment options. When asked to rank the importance of cancer information sources, 88% and 42% of patients reported relying heavily on their oncologist and the rest of the care team, respectively. Forty percent of patients relied at least moderately on the internet for health information and 27% on online support groups, with patients < age 50 more likely than those > age 50 to rely on online support groups for health information (41% vs 17%, P = 0.02). The most common educational needs reported were side effects (79%), followed by prognosis (72%), healthy lifestyle (71%), treatment options (70%), general breast cancer news and research (67%), information about their current cancer status (59%), potential clinical trials (44%), and costs of treatment (14%). Patients with metastatic breast expressed greater interest in information about clinical trials compared to those without metastatic disease (64% vs 36%, P = 0.01), and less interest in information about prognosis (54% vs. 81%, P = 0.01). Conclusions: Despite reliance on their oncologist and oncology team for information, patients report multiple unmet educational needs related to their disease and treatment options. While a substantial percentage of patients with breast cancer turn to the internet for information, there is untapped potential to use mobile devices to improve patient education and awareness of treatment options, including clinical trials.