1
|
Singh A, Gallaway MS, Rascon A. A comparison of chronic conditions and health characteristics between cancer survivors and non-cancer survivors. Chronic Illn 2024; 20:349-359. [PMID: 37724026 PMCID: PMC11046444 DOI: 10.1177/17423953231180191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
Abstract
OBJECTIVE Cancer survivors have unique healthcare needs. An important consideration for survivorship is chronic diseases and health risk factors. The purpose of this study is to describe demographics, risk factors, and comorbid health conditions in adult cancer survivors. METHOD We analyzed 2019 Arizona Behavioral Risk Factor Surveillance System data to compare cancer survivors to non-cancer survivors (aged 18 or older) to assess differences between the two populations. Adjusted and unadjusted population-based estimates and 95% confidence intervals were calculated, and multivariable logistic regression models were performed. RESULTS Eight thousand nine-hundred and twenty (8920) respondents (1007 survivors; 7913 non-cancer survivors) were included. Compared to non-cancer survivors, cancer survivors were more likely to be female, 65 years and older, non-Hispanic white, veterans, and less likely to be employed. Survivors had higher rates of coronary heart disease, stroke, chronic obstructive pulmonary disease, kidney disease, hypertension, arthritis, multiple chronic conditions, being overweight, and being a former smoker. Survivors were more likely to report fair/poor health than non-cancer survivors. DISCUSSION These findings can be used by healthcare and public health practitioners to evaluate the programmatic efforts and resources, implement targeted interventions toward cancer survivors, and improve health and quality of life.
Collapse
Affiliation(s)
- Anjin Singh
- Arizona Department of Health Services, 150 N. 18 Ave, Phoenix, AZ, 85007
- CDC Foundation, 600 Peachtree St NE #100, Atlanta, GA, 30308
| | - Michael Shayne Gallaway
- Arizona Department of Health Services, 150 N. 18 Ave, Phoenix, AZ, 85007
- Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA, 30333
| | - Addey Rascon
- Arizona Department of Health Services, 150 N. 18 Ave, Phoenix, AZ, 85007
| |
Collapse
|
2
|
Leraas HJ, Beckhorn C, Washabaugh C, Thamby J, Greenup R, Haines K, Allen L, Tracy E. Where Are the Children? A Thematic Analysis of State, Territory, and Tribal Organization Comprehensive Cancer Control Plans. J Pediatr Surg 2024; 59:129-133. [PMID: 37858391 DOI: 10.1016/j.jpedsurg.2023.09.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 09/07/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND The Center for Disease Control's Comprehensive Cancer Control Program (CCCP) funds initiatives in fifty states, the District of Columbia, seven U.S. territories, and seven tribal organizations to prevent and control cancer. These initiatives influence policy, care, research, and advocacy for cancer treatment. We performed an analysis of CCCP plans for states, U.S. territories, and tribal organizations to understand the extent of inclusion of pediatric cancer care. METHODS We conducted a thematic and quantitative analysis of CCCP plans for states, U.S. territories, and tribal organizations. Plans were assessed by two reviewers and scored for discussion of cancer prevention, risk factors, early detection and screening, treatment and innovation, access, barriers to care, and survivorship in childhood cancer. RESULTS Plans from fifty states, the District of Columbia, seven territories, seven tribal organizations, and one Pacific Regional (USAPI) plan were reviewed, for a total of sixty-six plans. Up-to-date CCCP plans were available through the CDC or state websites for 74% of states, 57% of territories, and 71% of tribal organizations; older plans were available for all groups without up-to-date CCCP plans. While all plans referenced children, most did so in the context of childhood exposures influencing adult cancer risks (e.g., sun, tobacco, HPV). Few plans contained a section dedicated to childhood cancer (30% states, 14.3% territories, 14.3% tribes). A minority of plans specifically discussed early detection and screening (14% states, 0% territories, 14.3% tribes), treatment and innovation (32% states, 0% territories, 28.6% tribes), access to cancer care (38% states, 28.6% territories, 28.6% tribes), reducing barriers to cancer care (28% states, 42.9% territories, 28.6% tribes), and pediatric cancer survivorship (42% states, 0% territories, 28.6% tribes). CONCLUSIONS Promoting inclusion of pediatric cancer in CCPs will help to standardize pediatric cancer care, eliminate treatment disparities across state lines, and allow for comprehensive understanding of pediatric oncology. LEVEL OF EVIDENCE Level IV.
Collapse
Affiliation(s)
| | | | | | - Julie Thamby
- Duke University School of Medicine, Durham, NC, USA
| | - Rachel Greenup
- Yale University, Department of Surgery, New Haven, CT, USA
| | - Krista Haines
- Duke University Department of Surgery, Durham, NC, USA
| | - Laura Allen
- Children's Cancer Partners of the Carolinas, Spartanburg, SC, USA
| | | |
Collapse
|
3
|
Franzoi MA, Degousée L, Martin E, Semedo PM, Aupomerol M, Soldato D, Di Meglio A, Chiodi C, Barbier A, Chaouachi H, Renvoisé N, Boinon D, Fasse L, Ribeiro J, Le-Provost JB, Arvis J, Lazorthes C, di Palma M, de Jesus A, Raynard B, Pagès A, Delaloge S, Pistilli B, Scotté F, Vaz-Luis I. Implementing a PROACTive Care Pathway to Empower and Support Survivors of Breast Cancer. JCO Oncol Pract 2023; 19:353-361. [PMID: 37307673 DOI: 10.1200/op.23.00016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 03/15/2023] [Accepted: 04/21/2023] [Indexed: 06/14/2023] Open
Abstract
PURPOSE Optimal comprehensive survivorship care is insufficiently delivered. To increase patient empowerment and maximize the uptake of multidisciplinary supportive care strategies to serve all survivorship needs, we implemented a proactive survivorship care pathway for patients with early breast cancer at the end of primary treatment phase. METHODS Pathway components included (1) a personalized survivorship care plan (SCP), (2) face-to-face survivorship education seminars and personalized consultation for supportive care referrals (Transition Day), (3) a mobile app delivering personalized education and self-management advice, and (4) decision aids for physicians focused on supportive care needs. A mixed-methods process evaluation was performed according to the Reach, Effectiveness, Adoption, Implementation and Maintenance framework including administrative data review, pathway experience survey (patient, physician, and organization), and focus group. The primary objective was patient-perceived satisfaction with the pathway (predefined progression criteria for pathway continuation ≥70%). RESULTS Over 6 months, 321 patients were eligible for the pathway and received a SCP and 98 (30%) attended the Transition Day. Among 126 patients surveyed, 77 (66.1%) responded. 70.1% received the SCP, 51.9% attended the Transition Day, and 59.7% accessed the mobile app. 96.1% of patients were very or completely satisfied with the overall pathway, whereas perceived usefulness was 64.8% for the SCP, 90% for the Transition Day, and 65.2% for the mobile app. Pathway implementation seemed to be positively experienced by physicians and the organization. CONCLUSION Patients were satisfied with a proactive survivorship care pathway, and the majority reported that its components were useful in supporting their needs. This study can inform the implementation of survivorship care pathways in other centers.
Collapse
Affiliation(s)
- Maria Alice Franzoi
- Cancer Survivorship Group, INSERM Unit 981, Gustave Roussy, Villejuif, France
| | - Lena Degousée
- Breast Oncology Unit, Gustave Roussy, Villejuif, France
| | - Elise Martin
- Cancer Survivorship Group, INSERM Unit 981, Gustave Roussy, Villejuif, France
- CNRS-UAR3683 MSH Paris-Saclay, Gif sur Yvette, France
| | | | | | - Davide Soldato
- Cancer Survivorship Group, INSERM Unit 981, Gustave Roussy, Villejuif, France
| | - Antonio Di Meglio
- Cancer Survivorship Group, INSERM Unit 981, Gustave Roussy, Villejuif, France
| | - Camila Chiodi
- Cancer Survivorship Group, INSERM Unit 981, Gustave Roussy, Villejuif, France
| | - Aude Barbier
- Cancer Survivorship Group, INSERM Unit 981, Gustave Roussy, Villejuif, France
| | - Hajer Chaouachi
- Supportive Care and Patient Pathway Department, Gustave Roussy, Villejuif, France
| | - Nathalie Renvoisé
- Supportive Care and Patient Pathway Department, Gustave Roussy, Villejuif, France
| | - Diane Boinon
- Supportive Care and Patient Pathway Department, Gustave Roussy, Villejuif, France
| | - Léonor Fasse
- Supportive Care and Patient Pathway Department, Gustave Roussy, Villejuif, France
| | - Joana Ribeiro
- Breast Oncology Unit, Gustave Roussy, Villejuif, France
| | | | - Johanna Arvis
- Cancer Survivorship Group, INSERM Unit 981, Gustave Roussy, Villejuif, France
| | | | - Mario di Palma
- Supportive Care and Patient Pathway Department, Gustave Roussy, Villejuif, France
| | - Anne de Jesus
- Patient Committee, Gustave Roussy, Villejuif, France
| | - Bruno Raynard
- Supportive Care and Patient Pathway Department, Gustave Roussy, Villejuif, France
| | - Arnaud Pagès
- Biostatistics and Epidemiology Department, Gustave Roussy, Villejuif, France
| | | | | | - Florian Scotté
- Supportive Care and Patient Pathway Department, Gustave Roussy, Villejuif, France
| | - Ines Vaz-Luis
- Cancer Survivorship Group, INSERM Unit 981, Gustave Roussy, Villejuif, France
- Breast Oncology Unit, Gustave Roussy, Villejuif, France
- Supportive Care and Patient Pathway Department, Gustave Roussy, Villejuif, France
| |
Collapse
|
4
|
Millar MM, Herget KA, Ofori-Atta B, Codden RR, Edwards SL, Carter ME, Belnap B, Kirchhoff AC, Sweeney C. Cancer survivorship experiences in Utah: an evaluation assessing indicators of survivors' quality of life, health behaviors, and access to health services. Cancer Causes Control 2023; 34:337-347. [PMID: 36723708 PMCID: PMC10367944 DOI: 10.1007/s10552-023-01671-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 01/14/2023] [Indexed: 02/02/2023]
Abstract
PURPOSE The 2016-2020 Utah Comprehensive Cancer Prevention and Control Plan prioritized strategies to address cancer survivorship experiences. In this paper we present estimates for nine indicators evaluating these priorities, trends over time, and assess disparities in survivorship experiences across demographic subgroups. METHODS We surveyed a representative sample of Utah cancer survivors diagnosed between 2012 and 2019 with any reportable cancer diagnosis. We calculated weighted percentages and 95% confidence intervals (CI) for each indicator. We assessed change over time using a test for trend across survey years in a logistic regression model and used Rao-Scott F-adjusted chi-square tests to test the association between demographic characteristics and each survivorship indicator. RESULTS Most of the 1,793 respondents (93.5%) reported their pain was under control, 85.7% rated their overall health as good, very good, or excellent, but 46.5% experienced physical, mental, or emotional limitations. Only 1.7% of survivors aged 75 or older were current smokers, compared to 5.8% of 65-74-year-olds and 7.9% of survivors aged 55-74 (p < 0.006). No regular physical activity was reported by 20.6% and varied by survivor age and education level. The proportion who received a survivorship care plan increased from 34.6% in 2018 to 43.0% in 2021 (p = 0.025). However, survivors under age 55 were significantly less likely to receive a care plan than older survivors. CONCLUSION This representative survey of cancer survivors fills a gap in understanding of the cancer survivorship experience in Utah. Results can be used to evaluate and plan additional interventions to improve survivorship quality of life.
Collapse
Affiliation(s)
- Morgan M Millar
- Utah Cancer Registry, University of Utah, Salt Lake City, UT, USA.
- Division of Epidemiology, University of Utah, Salt Lake City, UT, USA.
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.
| | | | | | - Rachel R Codden
- Utah Cancer Registry, University of Utah, Salt Lake City, UT, USA
- Division of Epidemiology, University of Utah, Salt Lake City, UT, USA
| | - Sandra L Edwards
- Utah Cancer Registry, University of Utah, Salt Lake City, UT, USA
| | | | - Brad Belnap
- Utah Department of Health and Human Services, Utah Cancer Control Program, Salt Lake City, UT, USA
| | - Anne C Kirchhoff
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
- Department of Pediatrics, University of Utah, Salt Lake City, UT, USA
| | - Carol Sweeney
- Utah Cancer Registry, University of Utah, Salt Lake City, UT, USA
- Division of Epidemiology, University of Utah, Salt Lake City, UT, USA
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| |
Collapse
|
5
|
Rohan E, Kuiper N, Bowen SA, Mast DK, House M, French C, Tharpe FS, Henley SJ, Wanliss E, Puckett M. Pairing Project ECHO and patient navigation as an innovative approach to improving the health and wellness of cancer survivors in rural settings. J Rural Health 2022; 38:855-864. [PMID: 35611881 PMCID: PMC10961889 DOI: 10.1111/jrh.12682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE We conducted a 12-month pilot study of 2 complementary strategies for improving rural cancer survivorship outcomes: (1) Project ECHO, a telementoring model to increase knowledge and skills about cancer survivorship among multidisciplinary health care provider teams in rural areas and (2) patient navigation (PN) services to connect rural cancer survivors with resources for enhancing health and wellness. METHODS We recruited 4 CDC-funded National Comprehensive Cancer Control Program sites to implement Project ECHO and PN interventions for a defined rural population in each of their jurisdictions. Sites received ongoing technical assistance and a stipend to support implementation. We conducted a mixed-methods evaluation consisting of quantitative performance monitoring data and qualitative interviews with site staff to assess implementation. FINDINGS Site teams delivered 21 cancer survivorship ECHO sessions to rural providers resulting in 329 participant encounters. Almost all (93%) ECHO participants reported enhanced knowledge of cancer survivorship issues, and 80% reported intent to apply learnings to their practices. Site teams engaged 16 patient navigators who navigated 164 cancer survivors during the study period. Successful implementation required strong partnerships, clear avenues for recruitment of rural providers and cancer survivors, and activities tailored to local needs. Fostering ongoing relationships among sites through community of practice calls also enhanced implementation. CONCLUSIONS Sites successfully implemented a novel approach for enhancing care for cancer survivors in rural communities. Pairing Project ECHO to address structural barriers and PN to address individual factors affecting survivorship may help bridge the health equity gap experienced by cancer survivors in rural communities.
Collapse
Affiliation(s)
- Elizabeth Rohan
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | | | | | | | - Cynthia French
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Felicia Solomon Tharpe
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - S. Jane Henley
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Ena Wanliss
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Mary Puckett
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| |
Collapse
|
6
|
Ligibel JA, Bohlke K, May AM, Clinton SK, Demark-Wahnefried W, Gilchrist SC, Irwin ML, Late M, Mansfield S, Marshall TF, Meyerhardt JA, Thomson CA, Wood WA, Alfano CM. Exercise, Diet, and Weight Management During Cancer Treatment: ASCO Guideline. J Clin Oncol 2022; 40:2491-2507. [PMID: 35576506 DOI: 10.1200/jco.22.00687] [Citation(s) in RCA: 155] [Impact Index Per Article: 77.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
PURPOSE To provide guidance on exercise, diet, and weight management during active cancer treatment in adults. METHODS A systematic review of the literature identified systematic reviews and randomized controlled trials evaluating the impact of aerobic and resistance exercise, specific diets and foods, and intentional weight loss and avoidance of weight gain in adults during cancer treatment, on quality of life, treatment toxicity, and cancer control. PubMed and the Cochrane Library were searched from January 2000 to May 2021. ASCO convened an Expert Panel to review the evidence and formulate recommendations. RESULTS The evidence base consisted of 52 systematic reviews (42 for exercise, nine for diet, and one for weight management), and an additional 23 randomized controlled trials. The most commonly studied types of cancer were breast, prostate, lung, and colorectal. Exercise during cancer treatment led to improvements in cardiorespiratory fitness, strength, fatigue, and other patient-reported outcomes. Preoperative exercise in patients with lung cancer led to a reduction in postoperative length of hospital stay and complications. Neutropenic diets did not decrease risk of infection during cancer treatment. RECOMMENDATIONS Oncology providers should recommend regular aerobic and resistance exercise during active treatment with curative intent and may recommend preoperative exercise for patients undergoing surgery for lung cancer. Neutropenic diets are not recommended to prevent infection in patients with cancer during active treatment. Evidence for other dietary and weight loss interventions during cancer treatment was very limited. The guideline discusses special considerations, such as exercise in individuals with advanced cancer, and highlights the critical need for more research in this area, particularly regarding diet and weight loss interventions during cancer treatment.Additional information is available at www.asco.org/supportive-care-guidelines.
Collapse
Affiliation(s)
| | - Kari Bohlke
- American Society of Clinical Oncology, Alexandria, VA
| | - Anne M May
- University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | | | | | | | | | | | | | | | | | | | | | - Catherine M Alfano
- Northwell Health Cancer Institute and Feinstein Institutes for Medical Research, New York, NY
| |
Collapse
|
7
|
Alfano CM, Oeffinger K, Sanft T, Tortorella B. Engaging TEAM Medicine in Patient Care: Redefining Cancer Survivorship From Diagnosis. Am Soc Clin Oncol Educ Book 2022; 42:1-11. [PMID: 35649204 DOI: 10.1200/edbk_349391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
New approaches to cancer survivorship care must address the rising number of survivors who need complex care; the need to personalize care to improve health equity; workforce shortages and clinician knowledge deficits about the long-term and late effects of cancer; the need to engage and coordinate oncology, primary care, and a large multidisciplinary team of subspecialists and programs to meet survivors' needs; and the need to control costs and deliver better value. This review proposes eight core tenets of an evolved standard of care to meet these needs by starting at diagnosis and continuing throughout oncology and into follow-up to: (1) facilitate team medicine by connecting oncology, primary care, subspecialists and programs, researchers, and patients and caregivers; (2) educate patients and support them in self-management; (3) mitigate toxicities; (4) manage comorbidities; (5) promote healthy behaviors and wellness; (6) improve health equity; (7) provide clear personalized follow-up; and (8) provide ongoing opportunities for participation in research as the standard of care. Strategies to successfully implement this care are discussed from the perspectives of oncology, primary care, and health care administration.
Collapse
Affiliation(s)
- Catherine M Alfano
- Northwell Health Cancer Institute, New York, NY.,Institute of Health System Science, Feinstein Institutes for Medical Research, New York, NY
| | - Kevin Oeffinger
- Duke University, Durham, NC.,Duke Cancer Institute, Durham, NC
| | - Tara Sanft
- Smilow Cancer Hospital at Yale New Haven, Yale Cancer Center, New Haven, CT
| | - Brooke Tortorella
- Northwell Health Cancer Institute, New York, NY.,Institute of Health System Science, Feinstein Institutes for Medical Research, New York, NY
| |
Collapse
|
8
|
Jefford M, Howell D, Li Q, Lisy K, Maher J, Alfano CM, Rynderman M, Emery J. Improved models of care for cancer survivors. Lancet 2022; 399:1551-1560. [PMID: 35430022 PMCID: PMC9009839 DOI: 10.1016/s0140-6736(22)00306-3] [Citation(s) in RCA: 76] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 01/23/2022] [Accepted: 02/10/2022] [Indexed: 12/24/2022]
Abstract
The number of survivors of cancer is increasing substantially. Current models of care are unsustainable and fail to address the many unmet needs of survivors of cancer. Numerous trials have investigated alternate models of care, including models led by primary-care providers, care shared between oncology specialists and primary-care providers, and care led by oncology nurses. These alternate models appear to be at least as effective as specialist-led care and are applicable to many survivors of cancer. Choosing the most appropriate care model for each patient depends on patient-level factors (such as risk of longer-term effects, late effects, individual desire, and capacity to self-manage), local services, and health-care policy. Wider implementation of alternative models requires appropriate support for non-oncologist care providers and endorsement of these models by cancer teams with their patients. The COVID-19 pandemic has driven some changes in practice that are more patient-centred and should continue. Improved models should shift from a predominant focus on detection of cancer recurrence and seek to improve the quality of life, functional outcomes, experience, and survival of survivors of cancer, reduce the risk of recurrence and new cancers, improve the management of comorbidities, and reduce costs to patients and payers. This Series paper focuses primarily on high-income countries, where most data have been derived. However, future research should consider the applicability of these models in a wider range of health-care settings and for a wider range of cancers.
Collapse
Affiliation(s)
- Michael Jefford
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia.
| | - Doris Howell
- Princess Margaret Cancer Research Institute, Toronto, ON, Canada
| | - Qiuping Li
- Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Karolina Lisy
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia
| | | | - Catherine M Alfano
- Northwell Health Cancer Institute, Lake Success, NY, USA; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA; Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Meg Rynderman
- Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Jon Emery
- Centre for Cancer Research, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia
| |
Collapse
|
9
|
Still Lost in Transition? Perspectives of Ongoing Cancer Survivorship Care Needs from Comprehensive Cancer Control Programs, Survivors, and Health Care Providers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19053037. [PMID: 35270729 PMCID: PMC8910165 DOI: 10.3390/ijerph19053037] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 02/24/2022] [Accepted: 02/27/2022] [Indexed: 12/03/2022]
Abstract
Public health agencies have played a critical role in addressing the complex health and mental health needs of cancer survivors. We conducted a mixed-methods evaluation via a Web-based survey (n = 51) and focus groups (n = 11) with National Comprehensive Cancer Control Program (NCCCP) recipients and interviews (n = 9) with survivors, health care providers (HCPs), and patient navigators to explore these audiences’ cancer survivorship information needs and strategies to improve resource dissemination. Participants revealed a need for tailored resources and support for survivors on healthy lifestyle, post-treatment survivorship concerns, psychosocial health, and navigating the health system. HCP needs included education on survivorship care plans and care coordination to facilitate the transition between oncology and primary care. HCPs were survivors’ most trusted source for information; however, participants noted difficulties engaging HCPs in survivorship care. These findings can help public health practitioners focus their efforts to better meet the needs of cancer survivors and their HCPs.
Collapse
|
10
|
Castiel M, Morgan JC, Naaman S. The evolving role of the Women's Health Specialist in cancer prevention and survivorship. Menopause 2021; 29:104-113. [PMID: 34964725 DOI: 10.1097/gme.0000000000001878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
IMPORTANCE AND OBJECTIVE This review provides a framework for primary care physicians, internists, family doctors, NP's, PA's, and oncologists caring for women-henceforth referred to as Women's Health Specialists-to identify and screen patients who may be at high risk for inherited cancer syndromes; an intervention referred to as previvorship care. For women who undergo risk-reducing oophorectomy, survivorship care is critical to optimizing quality of life thereafter. In this paper, we review management of the unique survivorship needs and management options for women at risk for or with a cancer diagnosis, highlighting the importance of interdisciplinary care. METHODS To review the available previvorship and survivorship management strategies, a Pub Med search was performed using keywords "survivorship," "genetics," "cancer," "menopause," "hormone therapy," "screening" in addition to review of guidelines, position statements and expert, and committee opinions from the American College of OBGYN, the American Society of Clinical Oncology, The North American Menopause Society, the National Comprehensive Cancer Network , and the American Society for Reproductive Medicine. DISCUSSION AND CONCLUSION Women's Health Specialists are in a unique position to identify and screen women who may be at risk for inherited cancer syndromes as well as provide necessary survivorship management following transition from their oncologists' care.
Collapse
|
11
|
Nathan NH, Bakhsheshian J, Ding L, Mack WJ, Attenello FJ. Evaluating Medicaid expansion benefits for patients with cancer: National Cancer Database analysis and systematic review. J Cancer Policy 2021; 29:100292. [PMID: 35559947 PMCID: PMC8276859 DOI: 10.1016/j.jcpo.2021.100292] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 04/28/2021] [Accepted: 06/03/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND Insurance status modifies healthcare access and inequities. The Affordable Care Act expanded Medicaid coverage for people with low incomes in the United States. This study assessed the consequences of this policy change for cancer care after expansion in 2014. METHODS National Cancer Database (NCDB) public benchmark reports were queried for each malignancy in 2013 and 2016. Furthermore, a systematic search [PubMed, Embase, Scopus and Cochrane] was performed. Data on insurance status, access to cancer screening and treatment, and socioeconomic disparities in these metrics was collected. RESULTS Two-tailed analysis of the NCDB revealed that 14 out of 18 eligible states had a statistically significant increase in Medicaid-insured patients with cancer after expansion. The average percentage increase was 51 % (13.2-204 %). From the systematic review, 229 studies were identified, 26 met inclusion. All 21 relevant articles reported lower uninsured rates. The average increase of Medicaid-insured patients was 77 % (9.5-230 %) and the average decrease of uninsured rates was 55 % (13.4-73 %). 15 out of 21 articles reported increased access to care. 16 out of 17 articles reported reductions in inequities. CONCLUSION Medicaid expansion in 2014 increased the number of insured patients with cancer. Expansion also improved access to screening and treatment in most oncologic care, and reduced socioeconomic disparities. Further studies evaluating correlative survival outcomes are needed. POLICY SUMMARY This study informs debates on expansion of Medicaid in state governments and electorates in the United States, and on health insurance reform broadly, by providing insight into how health insurance can benefit people with cancer while revealing how less insurance coverage could harm patients with cancer before and after their diagnosis. This study also contributes to discussions of health insurance mandates, subsidized coverage for people with low incomes, and covered healthcare services determinations by public and private health insurance providers in other countries.
Collapse
Affiliation(s)
- Neal H Nathan
- Keck School of Medicine, University of Southern California, 1975 Zonal Avenue, Los Angeles, CA, 90033, USA.
| | - Joshua Bakhsheshian
- Department of Neurological Surgery, Keck School of Medicine, University of Southern California, 1200 North State Street, Suite 3300, Los Angeles, CA, 90033, USA.
| | - Li Ding
- Department of Preventative Medicine, Keck School of Medicine, University of Southern California, 2001 North Soto Street, Los Angeles, CA, 90032, USA.
| | - William J Mack
- Department of Neurological Surgery, Keck School of Medicine, University of Southern California, 1200 North State Street, Suite 3300, Los Angeles, CA, 90033, USA.
| | - Frank J Attenello
- Department of Neurological Surgery, Keck School of Medicine, University of Southern California, 1200 North State Street, Suite 3300, Los Angeles, CA, 90033, USA.
| |
Collapse
|
12
|
Gallicchio L, Tonorezos E, de Moor JS, Elena J, Farrell M, Green P, Mitchell SA, Mollica MA, Perna F, Gottlieb Saiontz N, Zhu L, Rowland J, Mayer DK. Evidence Gaps in Cancer Survivorship Care: A Report from the 2019 National Cancer Institute Cancer Survivorship Workshop. J Natl Cancer Inst 2021; 113:1136-1142. [PMID: 33755126 DOI: 10.1093/jnci/djab049] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 03/01/2021] [Accepted: 03/19/2021] [Indexed: 12/26/2022] Open
Abstract
Today, there are more than 16.9 million cancer survivors in the United States; this number is projected to grow to 22.2 million by 2030. While much progress has been made in understanding cancer survivors needs and in improving survivorship care since the seminal 2006 Institute of Medicine report From Cancer Patient to Cancer Survivor: Lost in Transition, there is a need to identify evidence gaps and research priorities pertaining to cancer survivorship. Thus, in April 2019, the National Cancer Institute convened grant-funded extramural cancer survivorship researchers, representatives of professional organizations, cancer survivors, and advocates for a one-day in-person meeting. At this meeting, and in a subsequent webinar aimed at soliciting input from the wider survivorship community, evidence gaps and ideas for next steps in the following six areas, identified from the 2006 Institute of Medicine report, were discussed: surveillance for recurrence and new cancers, management of long-term and late physical effects, management of long-term and late psychosocial effects, health promotion, care coordination, and financial hardship. Identified evidence gaps and next steps across the areas included the need to understand and address disparities among cancer survivors, to conduct longitudinal studies as well as longer-term (>5 years post-diagnosis) follow-up studies, to leverage existing data, and to incorporate implementation science strategies to translate findings into practice. Designing studies to address these broad evidence gaps, as well as those identified in each area, will expand our understanding of cancer survivors' diverse needs, ultimately leading to the development and delivery of more comprehensive evidence-based quality care.
Collapse
Affiliation(s)
- Lisa Gallicchio
- Clinical and Translational Epidemiology Branch, Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute
| | - Emily Tonorezos
- Office of Cancer Survivorship, Division of Cancer Control and Population Sciences, National Cancer Institute
| | - Janet S de Moor
- Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute
| | - Joanne Elena
- Clinical and Translational Epidemiology Branch, Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute
| | - Margaret Farrell
- Division of Communications and Marketing, Office of the Director, National Institutes of Health
| | - Paige Green
- Basic Biobehavioral and Psychological Sciences Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute
| | - Sandra A Mitchell
- Outcomes Research Branch, Health Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute
| | - Michelle A Mollica
- Outcomes Research Branch, Health Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute
| | - Frank Perna
- Health Behaviors Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute
| | - Nicole Gottlieb Saiontz
- Office of the Director, Division of Cancer Control and Population Sciences, National Cancer Institute
| | - Li Zhu
- Statistical Research and Applications Branch, Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute
| | - Julia Rowland
- Smith Center for Healing and the Arts, Washington DC
| | - Deborah K Mayer
- School of Nursing, University of North Carolina at Chapel Hill; University of North Carolina Lineberger Comprehensive Cancer Center
| |
Collapse
|
13
|
Townsend JS, Jones MC, Jones MN, Waits AW, Konrad K, McCoy NM. A Case Study of Early-Onset Colorectal Cancer: Using Electronic Health Records to Support Public Health Surveillance on an Emerging Cancer Control Topic. JOURNAL OF REGISTRY MANAGEMENT 2021; 48:4-11. [PMID: 34170890 PMCID: PMC9231638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Electronic health records (EHRs) are increasingly being used to support public health surveillance, including in cancer, where many population-based registries can now accept electronic case reporting. Using EHRs to supplement cancer registry data provides the opportunity to examine in more detail emerging issues in cancer control, such as the increasing incidence rates of early onset colorectal cancer (CRC). The purpose of this study was to evaluate the feasibility of a public health organization partnering with a health system to examine risk factors for early-onset CRC in a community cancer setting, and to further understand challenges with using EHRs to address emerging topics in cancer control. We conducted a mixed-methods evaluation using key informant interviews with public health practitioners, researchers, and registry staff to generate insights on how using EHRs and partnering with health systems can improve chronic disease surveillance and cancer control. A data quality assessment of variables representing risk factors for CRC and other clinical characteristics was conducted on all CRC patients diagnosed in 2016 at the participating cancer center. The quantitative assessment of the EHR data revealed that, while most chronic health conditions were well documented, around 25% of CRC patients were missing information on body mass index, alcohol, and tobacco use. Key informants offered ideas and ways to overcome challenges with using EHR data to support chronic disease surveillance. Their recommendations included the following activities: engaging EHR vendors in the development of standards, taking leadership roles on workgroups to address emerging technological issues, participating in pilot studies and task forces, and negotiating with EHR vendors so that clinical decision support tools built to support public health initiatives are freely available to all users of those EHRs. Although using EHR data to support public health efforts is not without its challenges, it soon could be an important part of chronic disease surveillance and cancer control.
Collapse
Affiliation(s)
- Julie S. Townsend
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | - Amy W. Waits
- Northside Hospital Cancer Institute, Atlanta, Georgia
| | | | - Natasha M. McCoy
- National Association of Chronic Disease Directors, Decatur, Georgia
| |
Collapse
|
14
|
Emerging Role of Integrative Medicine in Hematologic Malignancies: a Literature Review and Update on Current Trends in Complementary Medical Practices in Hematologic Cancers. Curr Hematol Malig Rep 2020; 14:328-336. [PMID: 31209644 DOI: 10.1007/s11899-019-00526-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE OF REVIEW This review discusses the emerging role of integrative hematology. It reinforces the growing interest of CAM among patients, and the importance of provider knowledge and participation in discussions with patients about the subject. The main question asked in this review, "Is there evidence for the use of integrative medicine practices in the field of malignant hematology?" is answered by examining current research and providing relevant summaries. RECENT FINDINGS Data suggests that practices such as meditative movement, exercise, nutrition and supplements and touch therapy can be used for symptom alleviation, preventive measures, and novel treatment development. Integrative hematology is a needed part of complete patient care, and it is the role of providers to be knowledgeable and open to ensure patients are engaging in practices that are evidence-informed and safe. More studies are needed in the field in order to make concrete and robust recommendations.
Collapse
|
15
|
Oh SA, Yea JW, Park JW, Park J. Use of a head-tilting baseplate during volumetric-modulated arc therapy (VMAT) to better protect organs at risk in hippocampal sparing whole brain radiotherapy (HS-WBRT). PLoS One 2020; 15:e0232430. [PMID: 32348379 PMCID: PMC7190113 DOI: 10.1371/journal.pone.0232430] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 04/14/2020] [Indexed: 11/19/2022] Open
Abstract
PURPOSE Coplanar arcs are used with limited arc range to prevent direct beam entrance through the lens, which is challenging for satisfactory planning of hippocampal sparing in whole brain radiotherapy (HS-WBRT) with VMAT. We evaluated the dosimetric impact of applying a head-tilting technique during VMAT, which allows unrestricted use of the arc range. METHODS AND MATERIALS Twenty patients with multiple brain metastases who had received two computed tomography (CT)-simulation sessions between January 2016 and December 2018 were included. One session was delivered in a traditional supine position; the other was delivered with a tilting acrylic supine baseplate (MedTec, USA) to elevate the patients' head by 40°. For each patient, a VMAT without (sVMAT) and with head-tilting (htVMAT) plan was generated. Conformity index (CI), homogeneity index (HI), and organ at risk (OAR) dose were evaluated. The Wilcoxon-signed test was used to compare the effect between two plans. RESULTS The mean CI was 0.860±0.007 and 0.864±0.008 (p<0.05), and mean HI was 0.179±0.020 and 0.167±0.021 (p<0.05) for sVMAT and htVMAT, respectively. The mean dose to the hippocampus (9.91±0.30 Gy) was significantly lower in htVMAT than in sVMAT (10.36±0.29 Gy, P<0.05). htVMAT was associated with significantly reduced mean dose to the parotid gland, and right and left lens (4.77±1.97 Gy vs. 5.92±1.68 Gy, p<0.05; 3.29±0.44 Gy vs. 7.22±1.26 Gy, p<0.05; 3.33±0.45 Gy vs. 6.73±1.01 Gy, p<0.05, respectively). CONCLUSION This is the first study to demonstrate that the head-tilting technique might be useful for HS-WBRT planning with VMAT. This method could remove the limitations associated with the arc range, resulting in improved dose distribution and conformity, while sparing healthy organs, including the hippocampus, lens, and parotid gland.
Collapse
Affiliation(s)
- Se An Oh
- Department of Radiation Oncology, Yeungnam University Medical Center, Daegu, South Korea
| | - Ji Woon Yea
- Department of Radiation Oncology, Yeungnam University Medical Center, Daegu, South Korea
- Department of Radiation Oncology, Yeungnam University College of Medicine, Daegu, South Korea
| | - Jae Won Park
- Department of Radiation Oncology, Yeungnam University Medical Center, Daegu, South Korea
- Department of Radiation Oncology, Yeungnam University College of Medicine, Daegu, South Korea
| | - Jaehyeon Park
- Department of Radiation Oncology, Yeungnam University Medical Center, Daegu, South Korea
- Department of Radiation Oncology, Yeungnam University College of Medicine, Daegu, South Korea
- * E-mail:
| |
Collapse
|
16
|
Mollica MA, Falisi AL, Geiger AM, Jacobsen PB, Lunsford NB, Pratt-Chapman ML, Townsend JS, Nekhlyudov L. Survivorship objectives in comprehensive cancer control plans: a systematic review. J Cancer Surviv 2020; 14:235-243. [PMID: 31953645 PMCID: PMC11057023 DOI: 10.1007/s11764-019-00832-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 10/29/2019] [Indexed: 11/25/2022]
Abstract
PURPOSE Over a decade ago, the National Academy of Medicine (NAM) recommended that states develop, implement, and evaluate plans that include consideration of survivorship care. The purpose of this study was to review comprehensive cancer control plans in the USA, specifically to identify the inclusion of cancer survivorship-focused goals and objectives and examine alignment of survivorship-focused objectives with the NAM recommendations. METHODS Plans from 50 states, 7 territories, 5 tribal organizations, and the District of Columbia were reviewed to assess inclusion of survivorship goals and objectives. One territory plan was excluded because it did not include a survivorship-focused goal or objective (final n = 62). Objectives were assigned to domains based on NAM survivorship recommendations. RESULTS Plans included between 1 and 19 survivorship-related objectives. Of the 345 survivorship objectives extracted and analyzed, the most prevalent domains addressed were raising awareness, survivorship care plans, healthcare professional capacity, and models of coordinated care. Employment-related concerns, developing and implementing quality measures, and investments in research were not frequently included in objectives. CONCLUSIONS Comprehensive cancer control plans represent an important strategy that may reduce the impact of cancer and its treatment. State, territorial, and tribal coalitions can use these results to systematically focus future survivorship efforts on areas relevant to their region and population. IMPLICATIONS FOR CANCER SURVIVORS The growing number of survivors requires broad-ranging policy strategies. Future efforts are needed to assess the implementation and impact of plan strategies to improve the overall wellness of cancer survivors.
Collapse
Affiliation(s)
- Michelle A Mollica
- Division of Cancer Control and Population Sciences, Healthcare Delivery Research Program, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD, 20892-9762, USA.
| | - Angela L Falisi
- Division of Cancer Control and Population Sciences, Healthcare Delivery Research Program, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD, 20892-9762, USA
| | - Ann M Geiger
- Division of Cancer Control and Population Sciences, Healthcare Delivery Research Program, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD, 20892-9762, USA
| | - Paul B Jacobsen
- Division of Cancer Control and Population Sciences, Healthcare Delivery Research Program, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD, 20892-9762, USA
| | - Natasha Buchanan Lunsford
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Mandi L Pratt-Chapman
- George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Julie S Townsend
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | |
Collapse
|
17
|
Tralongo P, Surbone A, Serraino D, Dal Maso L. Major patterns of cancer cure: Clinical implications. Eur J Cancer Care (Engl) 2019; 28:e13139. [DOI: 10.1111/ecc.13139] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 06/26/2019] [Accepted: 07/18/2019] [Indexed: 01/01/2023]
Affiliation(s)
| | | | - Diego Serraino
- Cancer Epidemiology Unit Centro di Riferimento Oncologico di Aviano (CRO) IRCCS Aviano Italy
| | - Luigino Dal Maso
- Cancer Epidemiology Unit Centro di Riferimento Oncologico di Aviano (CRO) IRCCS Aviano Italy
| |
Collapse
|
18
|
Dal Maso L, Panato C, Guzzinati S, Serraino D, Francisci S, Botta L, Capocaccia R, Tavilla A, Gigli A, Crocetti E, Rugge M, Tagliabue G, Filiberti RA, Carrozzi G, Michiara M, Ferretti S, Cesaraccio R, Tumino R, Falcini F, Stracci F, Torrisi A, Mazzoleni G, Fusco M, Rosso S, Tisano F, Fanetti AC, Sini GM, Buzzoni C, De Angelis R. Prognosis and cure of long-term cancer survivors: A population-based estimation. Cancer Med 2019; 8:4497-4507. [PMID: 31207165 PMCID: PMC6675712 DOI: 10.1002/cam4.2276] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 05/06/2019] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Increasing evidence of cure for some neoplasms has emerged in recent years. The study aimed to estimate population-based indicators of cancer cure. METHODS Information on more than half a million cancer patients aged 15-74 years collected by population-based Italian cancer registries and mixture cure models were used to estimate the life expectancy of fatal tumors (LEFT), proportions of patients with similar death rates of the general population (cure fraction), and time to reach 5-year conditional relative survival (CRS) >90% or 95% (time to cure). RESULTS Between 1990 and 2000, the median LEFT increased >1 year for breast (from 8.1 to 9.4 years) and prostate cancers (from 5.2 to 7.4 years). Median LEFT in 1990 was >5 years for testicular cancers (5.8) and Hodgkin lymphoma (6.3) below 45 years of age. In both sexes, it was ≤0.5 years for pancreatic cancers and NHL in 1990 and in 2000. The cure fraction showed a 10% increase between 1990 and 2000. It was 95% for thyroid cancer in women, 94% for testis, 75% for prostate, 67% for breast cancers, and <20% for liver, lung, and pancreatic cancers. Time to 5-year CRS >95% was <10 years for testis, thyroid, colon cancers, and melanoma. For breast and prostate cancers, the 5-year CRS >90% was reached in <10 years but a small excess remained for >15 years. CONCLUSIONS The study findings confirmed that several cancer types are curable. Became aware of the possibility of cancer cure has relevant clinical and social impacts.
Collapse
Affiliation(s)
- Luigino Dal Maso
- Cancer Epidemiology UnitCentro di Riferimento Oncologico di Aviano (CRO) IRCCSAvianoItaly
| | - Chiara Panato
- Cancer Epidemiology UnitCentro di Riferimento Oncologico di Aviano (CRO) IRCCSAvianoItaly
| | | | - Diego Serraino
- Cancer Epidemiology UnitCentro di Riferimento Oncologico di Aviano (CRO) IRCCSAvianoItaly
| | - Silvia Francisci
- National Center for Prevention and Health PromotionItalian National Institute of Health (ISS)RomeItaly
| | - Laura Botta
- Evaluative Epidemiology Unit, Department of Preventive and Predictive MedicineFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
| | - Riccardo Capocaccia
- Cancer Epidemiology UnitCentro di Riferimento Oncologico di Aviano (CRO) IRCCSAvianoItaly
| | - Andrea Tavilla
- National Center for Prevention and Health PromotionItalian National Institute of Health (ISS)RomeItaly
| | - Anna Gigli
- Institute for Research on Population and Social PoliciesNational Research CouncilRomeItaly
| | - Emanuele Crocetti
- Romagna Cancer RegistryIstituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS and Azienda Usl della RomagnaMeldola (Forlì)Italy
| | - Massimo Rugge
- Veneto Tumour RegistryAzienda ZeroPaduaItaly
- Department of Medicine (DIMED)University of PaduaPaduaItaly
| | - Giovanna Tagliabue
- Lombardy Cancer Registry-Varese Province, Cancer Registry Unit, Department of ResearchFondazione IRCCS Istituto Nazionale TumoriMilanItaly
| | - Rosa Angela Filiberti
- Liguria Cancer Registry, Clinical EpidemiologyIRCCS Policlinico San MartinoGenovaItaly
| | - Giuliano Carrozzi
- Modena Cancer Registry, Public Health DepartmentAUSL ModenaModenaItaly
| | - Maria Michiara
- Parma Cancer Registry, Oncology UnitAzienda Ospedaliera Universitaria di ParmaParmaItaly
| | - Stefano Ferretti
- Romagna Cancer Registry ‐ Section of Ferrara. Local Health UnitUniversity of FerraraFerraraItaly
| | - Rosaria Cesaraccio
- North Sardinia Cancer RegistryAzienda Regionale per la Tutela della SaluteSassariItaly
| | | | - Fabio Falcini
- Romagna Cancer RegistryIstituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS and Azienda Usl della RomagnaMeldola (Forlì)Italy
| | - Fabrizio Stracci
- Public Health Section, Department of Experimental MedicineUniversity of PerugiaPerugiaItaly
| | | | | | - Mario Fusco
- Cancer Registry of ASL Napoli 3 SudNapoliItaly
| | - Stefano Rosso
- Registro Tumori PiemonteProvincia di Biella CPOBiellaItaly
| | - Francesco Tisano
- Cancer Registry of the Province of SiracusaLocal Health Unit of SiracusaSiracusaItaly
| | - Anna Clara Fanetti
- Sondrio Cancer Registry, Epidemiology unitATS della MontagnaSondrioItaly
| | | | - Carlotta Buzzoni
- Tuscany Cancer RegistryClinical and Descriptive Epidemiology Unit, Cancer Prevention and Research Institute (ISPO)FlorenceItaly
- AIRTUM DatabaseFlorenceItaly
| | - Roberta De Angelis
- Department of Oncology and Molecular MedicineItalian National Institute of Health (ISS)RomeItaly
| |
Collapse
|
19
|
Cherry MG, Salmon P, Byrne A, Ullmer H, Abbey G, Fisher PL. Qualitative Evaluation of Cancer Survivors' Experiences of Metacognitive Therapy: A New Perspective on Psychotherapy in Cancer Care. Front Psychol 2019; 10:949. [PMID: 31118912 PMCID: PMC6506788 DOI: 10.3389/fpsyg.2019.00949] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 04/09/2019] [Indexed: 01/22/2023] Open
Abstract
Background Preliminary evidence suggests that metacognitive therapy (MCT), a brief, process-focused psychological intervention, alleviates distress in cancer survivors. In a longitudinal qualitative study nested in an open trial of MCT for cancer survivors, we explored how patients understood, experienced and applied MCT. Methods Patients received six MCT sessions. Consenting patients provided semi-structured interviews post-intervention (n = 19), and at 3- and 6-months follow-up (n = 14 and 10 respectively). Interviews were audio-recorded and transcribed. Analysis followed a constant comparison approach. Results Participants felt “overwhelmed” by worry before starting MCT and doubted that such brief therapy could help. Their accounts focused on feeling “challenged” to think differently by the psychologist. Those completing therapy were enthusiastic about it. They described having learned that thoughts are “only thoughts,” that feelings of worry or sadness are a normal part of life, and that they were in control of whether and how they engaged with thoughts. Consequently, most described a sense of freedom to live free from worry. A minority described being unable to apply MCT to certain thoughts. Two patients who withdrew before completing MCT did not describe having learned what MCT was intended to achieve. Conclusion MCT is an acceptable brief intervention for distressed cancer survivors. Feeling challenged to understand the processes maintaining their distress was central to their enthusiasm for it, irrespective of their presenting difficulties. Implications for Cancer Survivors The complexity of emotional distress in cancer survivors can potentially be addressed using a transdiagnostic model which focuses on the psychological processes which maintain distress.
Collapse
Affiliation(s)
- Mary Gemma Cherry
- Department of Psychological Sciences, Institute of Psychology, Health and Society, University of Liverpool, Liverpool, United Kingdom.,The Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom
| | - Peter Salmon
- Department of Psychological Sciences, Institute of Psychology, Health and Society, University of Liverpool, Liverpool, United Kingdom.,The Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom
| | - Angela Byrne
- Department of Psychological Sciences, Institute of Psychology, Health and Society, University of Liverpool, Liverpool, United Kingdom.,The Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom
| | - Helen Ullmer
- Department of Psychological Sciences, Institute of Psychology, Health and Society, University of Liverpool, Liverpool, United Kingdom.,The Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom
| | - Gareth Abbey
- Department of Psychological Sciences, Institute of Psychology, Health and Society, University of Liverpool, Liverpool, United Kingdom.,The Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom
| | - Peter L Fisher
- Department of Psychological Sciences, Institute of Psychology, Health and Society, University of Liverpool, Liverpool, United Kingdom.,The Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom
| |
Collapse
|
20
|
Park J, Yea JW. Whole brain radiotherapy using four-field box technique with tilting baseplate for parotid gland sparing. Radiat Oncol J 2019; 37:22-29. [PMID: 30947477 PMCID: PMC6453806 DOI: 10.3857/roj.2019.00059] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 02/22/2019] [Accepted: 03/12/2019] [Indexed: 12/27/2022] Open
Abstract
PURPOSE The aim of this study is to evaluate the efficacy and feasibility of four-field box whole brain radiotherapy (FB-WBRT) with tilting baseplate by comparing bilateral WBRT (B-WBRT). METHODS AND MATERIALS Between March 2016 and September 2018, 20 patients with brain metastases underwent WBRT using the four-field box technique. WBRT is performed with a dose of 30 Gy in 10 fractions daily. Two computed tomography simulations per person were performed. One was in the traditional supine position for B-WBRT and the other by applying the tilting acrylic supine baseplate to elevate the head by 40° for FB-WBRT. The B-WBRT used the field-in-field technique, which is the most commonly used method in our institution. The FB-WBRT comprised anterior, posterior, and bilateral beams. A wedge was applied in anterior and posterior fields to compensate for skull convexity. RESULTS The average of Dmean of both parotid glands was 10.2 Gy (range, 3.8 to 17.8 Gy) in B-WBRT and 5.4 Gy (range, 2.0 to 11.7 Gy) in FB-WBRT (p < 0.05). Compared to B-WBRT, FB-WBRT reduced the mean dose of the right and left parotid glands from 10.1 Gy to 4.9 Gy and from 10.4 Gy to 5.8 Gy, respectively (p < 0.05). Further, V5, V10, V15, V20, and V25 for the parotid gland decreased significantly in FB-WBRT (p < 0.05). The Dmax and Dmean of lens decreased according to the dose-volume histogram. CONCLUSION Compared to B-WBRT, FB-WBRT with a tilting baseplate is a simple and effective method that takes feature of noncoplanar beam to protect the parotid gland.
Collapse
Affiliation(s)
- Jaehyeon Park
- Department of Radiation Oncology, Yeungnam University College of Medicine, Daegu, Korea
| | - Ji Woon Yea
- Department of Radiation Oncology, Yeungnam University College of Medicine, Daegu, Korea
| |
Collapse
|
21
|
Park J, Park JW, Yea JW. Non-coplanar whole brain radiotherapy is an effective modality for parotid sparing. Yeungnam Univ J Med 2019; 36:36-42. [PMID: 31620610 PMCID: PMC6784623 DOI: 10.12701/yujm.2019.00087] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 12/25/2018] [Accepted: 12/26/2018] [Indexed: 12/03/2022] Open
Abstract
Background The purpose of this study was to evaluate the efficacy and feasibility of non–coplanar whole brain radiotherapy (NC–WBRT) for parotid sparing. Methods Fifteen cases, previously treated with WBRT were selected. NC–WBRT plans were generated. The beam arrangement for the non–coplanar plans consisted of superior anterior, right, and left beams. After generation of the non–coplanar plans a field–in–field technique was applied to the bilateral parallel opposed beams in order to reduce maximum dose and increase dose homogeneity. The NC–WBRT plans were subsequently compared with the previously generated bilateral WBRT (B–WBRT) plans. A field–in–field technique was also used with the B–WBRT plans according to our departmental protocol. As per our institutional practice a total dose of 30 Gy in 10 fractions of WBRT was administered 5 days a week. Results The mean dose to the parotid gland for the two different plans were 16.2 Gy with B–WBRT and 13.7 Gy with NC–WBRT (p<0.05). In the NC–WBRT plan, the V5Gy, V10Gy, V15Gy, V20Gy, and V25Gy of the parotid were significantly lower (p<0.05) than those of the B–WBRT plan. The Dmax of the lens was also lower by 10% with NC–WBRT. Conclusion The use of NC–WBRT plans could be a simple and effective method to reduce irradiated volumes and improve the dose–volume parameters of the parotid gland.
Collapse
Affiliation(s)
- Jaehyeon Park
- Department of Radiation Oncology, Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Korea
| | - Jae Won Park
- Department of Radiation Oncology, Yeungnam University College of Medicine, Daegu, Korea
| | - Ji Woon Yea
- Department of Radiation Oncology, Yeungnam University College of Medicine, Daegu, Korea
| |
Collapse
|
22
|
Hayes NS, Hohman K, Vinson C, Pratt-Chapman M. Comprehensive cancer control in the U.S.: summarizing twenty years of progress and looking ahead. Cancer Causes Control 2018; 29:1305-1309. [PMID: 30569331 PMCID: PMC6322840 DOI: 10.1007/s10552-018-1124-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 12/12/2018] [Indexed: 10/27/2022]
Abstract
In order to celebrate the accomplishments of the Centers for Disease Control and Prevention's (CDC) National Comprehensive Cancer Control Program (NCCCP), the Comprehensive Cancer Control National Partners (CCCNP) developed this Special Issue on Cancer Causes and Control. This, the third Special Issue on Comprehensive Cancer Control (CCC), is a reflection of 20 years of building successful partnerships to prevent and control cancer; planning and implementing strategic cancer control; collaborating to address national cancer prevention and control priorities; evaluating efforts; sharing successes; and, in later years, serving as a model for global cancer control planning and implementation. The CDC currently supports cancer control planning and implementation in all 50 states, the District of Columbia, eight tribes or tribal organizations, and seven Pacific Island Jurisdictions and U.S. territories through the NCCCP. CCC is an approach that brings together multi-sector partners to address the cancer burden in a community collectively by leveraging existing resources and identifying and addressing cancer related issues and needs. The Comprehensive Cancer Control National Partnership (CCCNP), a partnership of national organizations, has been committed to supporting comprehensive cancer control efforts since 1999. We summarize the efforts described in this Special Issue. We also describe opportunities and critical elements to continue the momentum for comprehensive cancer control well into the future.
Collapse
Affiliation(s)
- Nikki S Hayes
- Centers for Disease Prevention and Control, Atlanta, Georgia, USA.
| | - Karin Hohman
- Strategic Health Concepts, Arvada, Colorado, USA
| | - Cynthia Vinson
- National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | | |
Collapse
|