STRENGTH Expansion

Study Overview
=================
Brief Summary
-----------------
Patients seen in the EGMDC (Esophageal and Gastric Multidisciplinary Clinic) for treatment planning who are recommended to receive neoadjuvant treatment followed by surgery at UCCC Metro will be offered enrollment into the study. Patients will complete the self-assessments outlined below on provided tablet computers during UCCC visits. If unable to complete assessments in person they will be e-mailed via REDCap Survey to the patient to complete individually.

Detailed Description
-----------------
Patients with esophageal (EC) and gastroesophageal junction (GEJC) cancers who are seen in the Esophageal and Gastric Multidisciplinary Clinic (EGMDC) for treatment planning and are recommended to receive neoadjuvant therapy and plan to receive treatment at UCCC Metro will be offered enrollment into the study. Patients will complete the patient reported assessments focused on QOL and physical activity on provided tablet computers during UCCC visits at specified time points. If unable to complete assessments in person they will be e-mailed to the patient via REDCap to complete. Additional data regarding dosing of chemotherapy, radiation, nutrition and surgical outcomes will be collected.

Official Title
-----------------
Expansion And Evaluation Of The University Of Colorado Strength (Striving To Reactivate Esophageal And Gastric Health) Prehabilitation Program

Conditions
-----------------
Esophageal Cancer, Gastroesophageal Junction Cancer

Intervention / Treatment
-----------------
* Other: STRENGTH


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Provision to sign and date the consent form Age ≥ 18 years Receiving treatment according to the STRENGTH pathway Diagnosed with esophageal(EC)/gastroesophageal junction cancer(GEJC) stage IB-IIIB Planning to receive neoadjuvant treatment followed by surgery at University of Colorado Cancer Center (UCCC) Metro Ability to complete surveys online via an emailed REDCap survey link if unable to complete in person Exclusion Criteria: Inability to read English and complete questionnaires independently Per the investigator, unable to comply with study criteria or assessments Inability to receive and complete REDCap survey online

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Qualifying Subjects<br>Patients seen in the EGMDC for treatment planning who are recommended to receive neoadjuvant treatment followed by surgery at UCCC Metro | Other: STRENGTH<br>* Patients with esophageal (EC) and gastroesophageal junction (GEJC) cancers who are seen in the Esophageal and Gastric Multidisciplinary Clinic (EGMDC) for treatment planning and are recommended to receive neoadjuvant therapy and plan to receive treatment at UCCC Metro will be offered enrollment into the study. Patients will complete the patient reported assessments focused on QOL and physical activity on provided tablet computers during UCCC visits at specified time points. If unable to complete assessments in person they will be e-mailed to the patient via REDCap to complete. Additional data regarding dosing of chemotherapy, radiation, nutrition and surgical outcomes will be collected.<br>* Other names: STRIVING TO REACTIVATE ESOPHAGEAL AND GASTRIC HEALTH;|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 Score | The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire is a validated patient self-reported tool. It assesses nine multi-item scales: five functional scales (physical, role, cognitive, emotional and social); three symptom scales (fatigue, pain, and nausea and vomiting); and a global health and quality-of-life scale. There are also several single-item symptom measures. Patients self-report using a 4-point Likert scale. Raw scores are transformed to a 0-100 scale, with higher scores representing better functioning/QOL and greater symptom burden. | pre-treatment baseline and 6 months post-surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes in Weight | Documented by dietitian | 9 months | 
| Malnutrition Scores | This will be assessed by the dietitian on a scale of Mild, Moderate or Severe. | 9 months | 
| Dysphagia Score | This will be assessed by the dietitian on a scale of Mild, Moderate or Severe. | 9 months | 
| PRO CTCAE Scores | The Patient Reported Outcome Common Terminology Criteria for Adverse Events will measure the significance of adverse events, by the patient's determination. A library of 78 symptomatic AEs was developed for patient self-reporting. The toxicities chosen for self-reporting include symptomatic toxicities that can be reasonably reported from the patient perspective such as pain, fatigue, nausea, and cutaneous side effects. Most symptoms are characterized based upon key attributes: presence/absence, frequency, severity, and/or interference with usual or daily activities. Patients assess toxicities on a 5-point Likert scale with a recall period of the past 7 days. | 9 months |