Abstract P1-11-20: Patient reported supportive care needs in a dedicated advanced breast cancer center
Authors: SJ Geske, TJ Pluard, C Amazu, R Holden
Journal: Cancer Research (2019)

Abstract Background: As of January 1st, 2017 nearly 154,794 women in the US will be living with metastatic breast cancer (MBC) and rates are expected to increase. Additionally, 58.3% of individuals with MBC, and their caregivers, believe that people with MBC have unique informational, emotional and physical needs that are unmet. However, there are still few research studies examining these needs. Methods: In October of 2016, the Koontz Center for Advanced Breast Cancer was established in Kansas City, MO. Supportive services assume a large role in this center to assist in caring for the whole person and improving quality of life. During the initial consult, the patient meets with the medical oncologist, psychologist, social worker, nutritionist, exercise physiologist and chaplain. All patients complete forms assessing multiple domains that may influence the patient's treatment and outcomes. We use the PROMIS (Patient-Reported Outcome Measurement Information System) measures to assess sleep, physical function, fatigue and pain interference, the Daily Spiritual Experience Scale (DSES) to assess spiritual concerns, the DSM-5 Self-Rated Level 1 Cross-Cutting Symptom Measure-Adult to assess mental health concerns and Koontz Center forms to assess social work and nutritional concerns. The following data is from assessments collected through May of 2018. Results: Eighty-two individuals were included in the analysis. The mean age was 60.1 (SD=10.6) and 98% (n=80) were female. A majority were white, non-Hispanic (88%; n=71). Sleep related impairment was mild for 27 (33.8%) individuals, moderate for 22 (27.5%) and severe for 3 (3.8%). For physical function, 12 (14.8%) individuals had mild, 32 (39.5%) moderate and 19 (23.5%) severe impairment. Twelve (15%) individuals had mild, 25 (31.3%) moderate and 6 (7.5%) severe symptoms of fatigue. For pain interference, 14 (17.3%) individuals had mild, 24 (29.6%) moderate and 9 (11.1%) severe symptoms. The average DSES score was 12.6 (SD=6.8) out of 36 with lower scores indicating stronger spiritual satisfaction. The top three mental health concerns were anxiety (n=47; 58.8%), depression (n=40; 50%) and somatic symptoms (n=38; 47.5%). Seventeen percent (n=14) reported concern over weight and 30% (n=24) reported losing weight over the past two weeks. The top three areas individuals reported needing assistance in were finding financial resources (n=16; 20.5%), help at home (n=11; 14.1%) and insurance questions (n=10; 12.8%). The top four areas individuals reported needing support in were information on support groups (n=20; 25.6%), managing stress (n=20; 25.6%), coping with cancer diagnosis (n=14; 17.9%) and communicating with children about cancer (n=14; 17.9%). Also, 38% (n=28) endorsed wanting information about an advanced directive. Changes across age and symptom complexes were also noted and will be presented. Conclusion: The data indicate that there are a wide variety of physical, spiritual, nutritional, social and psychological concerns for those coping with a MBC diagnosis. Future treatment of those with MBC should integrate supportive services to address these symptoms. Citation Format: Geske SJ, Pluard TJ, Amazu C, Holden R. Patient reported supportive care needs in a dedicated advanced breast cancer center [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-11-20.