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Cheng TYD, Chaudhari PV, Bitsie KR, Striley CW, Varma DS, Cottler LB. The HealthStreet Cancer Survivor Cohort: a Community Registry for Cancer Research. J Cancer Surviv 2024; 18:366-374. [PMID: 35089522 PMCID: PMC9329490 DOI: 10.1007/s11764-022-01173-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2022] [Indexed: 10/19/2022]
Abstract
PURPOSE This report describes a cancer survivor cohort from a community engagement program and compares characteristics and willingness to participate in health research between the cancer survivors and non-cancer community members. METHODS Among 11,857 members enrolled in HealthStreet at the University of Florida (10/2011-03/2020), 991 cancer survivors were identified and 1:1 matched to control members without cancer on sex, age, and zip code. Demographics, body weight, height, social determinants of health, history of cancer, and willingness to participate in research were recorded by Community Health Workers as a part of the baseline Health Needs Assessment. RESULTS Among the cancer survivors, 71.6% were female and 19.2% lived in rural areas with a mean age of 56.7 years in females and 60.8 years in males. At baseline, 44.7% received a cancer diagnosis within 5 years, while 15.8%, more than 20 years. Cancer survivors (vs. matched non-cancer controls) were less likely to be Black (31.1% vs. 63.6%) but more likely to be divorced, separated, or widowed (49.5% vs. 41.2%), be normal/underweight (34.0% vs. 25.6%) and have health insurance (80.0% vs. 68.6%; all p < 0.05). Cancer survivors versus matched controls reported higher rates of ever being in a health research study (32.4% vs. 24.9%) and interest in participating in studies ranging from minimal risk to greater-than-minimal risk. CONCLUSIONS Cancer survivors from this community engagement program agnostic to cancer types and treatment are diverse in geography, race, and social determinants of health and can be a valuable resource for observational, interventional, and biospecimen research in cancer survivorship.
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Affiliation(s)
- Ting-Yuan David Cheng
- Department of Epidemiology, College of Public Health and Health Professions & College of Medicine, University of Florida, 2004 Mowry Road, 4th Floor, P.O. Box 100231, Gainesville, FL, 32610, USA.
| | - Piyush V Chaudhari
- Department of Epidemiology, College of Public Health and Health Professions & College of Medicine, University of Florida, 2004 Mowry Road, 4th Floor, P.O. Box 100231, Gainesville, FL, 32610, USA
| | - Kevin R Bitsie
- Department of Epidemiology, College of Public Health and Health Professions & College of Medicine, University of Florida, 2004 Mowry Road, 4th Floor, P.O. Box 100231, Gainesville, FL, 32610, USA
| | - Catherine W Striley
- Department of Epidemiology, College of Public Health and Health Professions & College of Medicine, University of Florida, 2004 Mowry Road, 4th Floor, P.O. Box 100231, Gainesville, FL, 32610, USA
| | - Deepthi S Varma
- Department of Epidemiology, College of Public Health and Health Professions & College of Medicine, University of Florida, 2004 Mowry Road, 4th Floor, P.O. Box 100231, Gainesville, FL, 32610, USA
| | - Linda B Cottler
- Department of Epidemiology, College of Public Health and Health Professions & College of Medicine, University of Florida, 2004 Mowry Road, 4th Floor, P.O. Box 100231, Gainesville, FL, 32610, USA
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Jackson SR, Chambers S, Leslie S, Patel MI. Prostate cancer, online health information and communication technology - Bibliometric analysis of field with research frontiers. PATIENT EDUCATION AND COUNSELING 2023; 115:107887. [PMID: 37453268 DOI: 10.1016/j.pec.2023.107887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 05/24/2023] [Accepted: 07/06/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVES The purpose of this study is to conduct the first bibliometric analysis which examines eHealth communication technologies in prostate cancer care, and the utilization of internet-based health information and communication technology by men with prostate cancer. METHODS Original articles were extracted from the Science Citation Index Expanded (SCI-E) on Web of Science (WOS) and analyzed concerning their distributions. Quantitative guidance directed investigation of findings from previous studies and trending issues within the field. The WOS, VOSViewer and CiteSpace IV were used for information analysis. RESULTS 302 articles were included in the final analysis. There has been a 165 % increase in productivity over the past decade. The leading country by publication was the USA (145 articles = 48.02 %). Journals which published the highest number of original articles were the Journal of Medical Internet Research (6.95 %), and Patient Education and Counseling (4.64 %). DISCUSSION AND PRACTICE IMPLICATIONS The field of research which examines utilization and impacts of internet-based health information on men with prostate cancer is growing and diverse. Research frontiers are 'Information quality and diversity', 'eHealth literacy', 'decision making', and 'survivorship and advanced disease'. Clinicians should be aware of several significant limitations which exist within the current field of research.
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Affiliation(s)
| | - Suzanne Chambers
- Faculty of Health Sciences, Australian Catholic University, Sydney, 40 Edward St, North Sydney, NSW 2060, Australia; Faculty of Health, University of Technology, Sydney, 15 Broadway, Ultimo, NSW 2007, Australia; St Vincent's Health Network, Sydney, 390 Victoria St, Darlinghurst, NSW 2010, Australia
| | - Scott Leslie
- RPA Institute of Academic Surgery, Royal Prince Alfred Hospital, Sydney, 145 Missenden Rd, Camperdown, NSW 2050, Australia; Faculty of Health and Medicine, University of Sydney, Sydney, Camperdown, NSW 2006, Australia
| | - Manish I Patel
- Department of Urology Westmead Hospital, University of Sydney, Sydney, Cnr Hawkesbury Road, Darcy Rd, Westmead, NSW 2145, Australia
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Vaz-Luis I, Masiero M, Cavaletti G, Cervantes A, Chlebowski RT, Curigliano G, Felip E, Ferreira AR, Ganz PA, Hegarty J, Jeon J, Johansen C, Joly F, Jordan K, Koczwara B, Lagergren P, Lambertini M, Lenihan D, Linardou H, Loprinzi C, Partridge AH, Rauh S, Steindorf K, van der Graaf W, van de Poll-Franse L, Pentheroudakis G, Peters S, Pravettoni G. ESMO Expert Consensus Statements on Cancer Survivorship: promoting high-quality survivorship care and research in Europe. Ann Oncol 2022; 33:1119-1133. [PMID: 35963481 DOI: 10.1016/j.annonc.2022.07.1941] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 07/26/2022] [Accepted: 07/29/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The increased number of cancer survivors and the recognition of physical and psychosocial challenges, present from cancer diagnosis through active treatment and beyond, led to the discipline of cancer survivorship. DESIGN AND METHODS Herein, we reflected on the different components of survivorship care, existing models and priorities, in order to facilitate the promotion of high-quality European survivorship care and research. RESULTS We identified five main components of survivorship care: (i) physical effects of cancer and chronic medical conditions; (ii) psychological effects of cancer; (iii) social, work and financial effects of cancer; (iv) surveillance for recurrences and second cancers; and (v) cancer prevention and overall health and well-being promotion. Survivorship care can be delivered by structured care models including but not limited to shared models integrating primary care and oncology services. The choice of the care model to be implemented has to be adapted to local realities. High-quality care should be expedited by the generation of: (i) focused and shared European recommendations, (ii) creation of tools to facilitate implementation of coordinated care and (iii) survivorship educational programs for health care teams and patients. The research agenda should be defined with the participation of health care providers, researchers, policy makers, patients and caregivers. The following patient-centered survivorship research areas were highlighted: (i) generation of a big data platform to collect long-term real-world data in survivors and healthy controls to (a) understand the resources, needs and preferences of patients with cancer, and (b) understand biological determinants of survivorship issues, and (ii) develop innovative effective interventions focused on the main components of survivorship care. CONCLUSIONS The European Society for Medical Oncology (ESMO) can actively contribute in the efforts of the oncology community toward (a) promoting the development of high-quality survivorship care programs, (b) providing educational material and (c) aiding groundbreaking research by reflecting on priorities and by supporting research networking.
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Affiliation(s)
- I Vaz-Luis
- Breast Cancer Unit, Medical Oncology Department, Gustave Roussy-Cancer Campus, Villejuif; UMR 981, Prédicteurs moléculaires et nouvelles cibles en oncologie, Gustave Roussy-Cancer Campus, Villejuif, France.
| | - M Masiero
- Department of Oncology and Hemato-Oncology, University of Milano, Milan; Applied Research Division for Cognitive and Psychological Science, Istituto Europeo di Oncologia, Milan
| | - G Cavaletti
- Experimental Neurology Unit, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - A Cervantes
- Department of Medical Oncology, INCLIVA, Biomedical Research Institute, University of Valencia, Valencia; CIBERONC, Instituto de Salud Carlos III, Madrid, Spain
| | | | - G Curigliano
- Department of Oncology and Hemato-Oncology, University of Milano, Milan; Division of Early Drug Development, Istituto Europeo di Oncologia, IRCCS, Milan, Italy
| | - E Felip
- Vall d'Hebron University Hospital, Barcelona, Spain
| | - A R Ferreira
- Breast Unit, Champalimaud Clinical Center, Champalimaud Foundation, Lisbon; Catolica Medical School, Universidade Católica Portuguesa, Lisbon, Portugal
| | - P A Ganz
- UCLA Jonsson Comprehensive Cancer Center and UCLA Fielding School of Public Health, Los Angeles, USA
| | - J Hegarty
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - J Jeon
- Exercise Medicine Center for Cancer and Diabetes Patients (ICONS), Department of Sport Industry, Cancer Prevention Center, Yonsei Cancer Center, Shinchon Severance Hospital, Yonsei University College of Medicine, Yonsei University, Seoul, Korea
| | - C Johansen
- Centre for Cancer Late Effect Research (CASTLE), Department of Oncology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - F Joly
- Department of Medical Oncology, Centre François Baclesse, U1086 Anticipe, Unicaen Normandy Universtity, Caen, France
| | - K Jordan
- Department for Hematology, Oncology and Palliative Medicine, Ernst von Bergmann Hospital, Potsdam; Department of Medicine V, Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany
| | - B Koczwara
- Flinders Medical Centre and Flinders University, Adelaide, Australia
| | - P Lagergren
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; Department of Surgery and Cancer, Imperial College London, London, UK
| | - M Lambertini
- Department of Medical Oncology, U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova; Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy
| | - D Lenihan
- International Cardio-Oncology Society, Tampa, USA
| | - H Linardou
- Fourth Oncology Department & Comprehensive Clinical Trials Center, Metropolitan Hospital, Athens, Greece
| | | | - A H Partridge
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA
| | - S Rauh
- Department of Medical Oncology, Centre Hospitalier Emile Mayrisch, Esch, Luxembourg
| | - K Steindorf
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - W van der Graaf
- Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam; Department of Medical Oncology, Erasmus MC Cancer institute, Erasmus University Medical Center, Rotterdam
| | - L van de Poll-Franse
- Division of Psychosocial Research & Epidemiology, Department of Psycological Research, The Netherlands Cancer Institute, Amsterdam; Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht; CoRPS-Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - G Pentheroudakis
- European Society for Medical Oncology (ESMO), Lugano, Switzerland
| | - S Peters
- European Society for Medical Oncology (ESMO), Lugano, Switzerland
| | - G Pravettoni
- Department of Oncology and Hemato-Oncology, University of Milano, Milan; Applied Research Division for Cognitive and Psychological Science, Istituto Europeo di Oncologia, Milan
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NANDITHA CK, RAJAN MP. AN ADAPTIVE PHARMACOKINETIC OPTIMAL CONTROL APPROACH IN CHEMOTHERAPY FOR HETEROGENEOUS TUMOR. J BIOL SYST 2022. [DOI: 10.1142/s0218339022500188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The mathematical study of cancer received great attention in recent years. The theoretical and numerical investigations of models employed for studying the growth of cancer cells and treatment of cancer can help the clinical practitioners in adapting new strategies to face the challenges posed by the deadly disease. Chemotherapy is the most common method of treatment for cancer. The resistance of tumor cells toward the administered drug and the toxic effect of anti-cancer agents on healthy cells are major hurdles to the success of therapy. In this paper, we study this as an optimal control problem in which the amount of drug injected is taken as control. The evolution of different types of cells — sensitive tumor cells, resistant tumor cells and normal cells — under treatment are analyzed. The pharmacokinetics of the drug is also incorporated into the mathematical model. We propose a treatment protocol that assures the death of a maximum number of tumor cells but also manages to keep the normal cells at a sufficient level. We also validated our theoretical results numerically.
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Affiliation(s)
- C. K. NANDITHA
- School of Mathematics, Indian Institute of Science Education and Research Thiruvananthapuram, Vithura, Thiruvananthapuram 695551, India
| | - M. P. RAJAN
- School of Mathematics, Indian Institute of Science Education and Research Thiruvananthapuram, Vithura, Thiruvananthapuram 695551, India
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Carnahan LR, Rauscher GH, Watson KS, Altfeld S, Zimmermann K, Ferrans CE, Molina Y. Comparing the roles of social context, networks, and perceived social functioning with health-related quality of life among self-reported rural female cancer survivors. Support Care Cancer 2021; 29:331-340. [PMID: 32361830 PMCID: PMC7606329 DOI: 10.1007/s00520-020-05497-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 04/23/2020] [Indexed: 12/21/2022]
Abstract
PURPOSE Rural women, compared to urban, experience worse survivorship outcomes, including poorer health-related quality of life (QOL). There is a need to characterize the role of multilevel social factors that contribute to QOL, including context, networks, and functioning. Our objectives were to (1) use latent class analysis to identify distinct classes of social context and social networks and (2) examine how multilevel social factors (context, networks, and functioning) are associated with health-related QOL. METHODS We recruited self-identified rural survivors to the Illinois Rural Cancer Assessment (2017-2018), via community-based sampling methods, and participants completed the survey online, by phone, or on paper. We used latent class analysis to generate multidimensional variables for contextual and network factors. We next modeled each social factor sas a predictor in separate, bivariable linear regressions for the QOL outcomes, followed by multivariable, adjusted regressions. RESULTS For our first objective, there were three classes each of county-level contexts (1, highly rural, socioeconomically disadvantaged, and mostly lacking in cancer-related services; 2, mostly rural, moderately disadvantaged, and underserved; 3, mostly metropolitan, less disadvantaged, and most-resourced) and social networks (1, no caregivers; 2, only spousal caregivers with whom they communicated daily; 3, multiple caregivers with varying daily communication). For our second objective, among all social factors, only functioning was associated with better mental health-related QOL. No factors were associated with physical health-related QOL. CONCLUSIONS Our findings suggest a rich diversity of social context and networks among rural female cancer survivors, and social functioning is particularly important for mental health-related QOL.
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Affiliation(s)
- Leslie R Carnahan
- Division of Community Health Sciences, School of Public Health, University of Illinois at Chicago, 1603 W. Taylor St., MC 923, Chicago, IL, 60612, USA.
- Center for Research on Women and Gender, University of Illinois at Chicago, Rm 536A, 1640 W. Roosevelt Rd., MC 980, Chicago, IL, 60608, USA.
| | - Garth H Rauscher
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, 1603 W. Taylor St., MC 923, Chicago, IL, 60612, USA
| | - Karriem S Watson
- Division of Community Health Sciences, School of Public Health, University of Illinois at Chicago, 1603 W. Taylor St., MC 923, Chicago, IL, 60612, USA
- University of Illinois Cancer Center, 914 S. Wood St., Chicago, IL, 60612, USA
| | - Susan Altfeld
- Division of Community Health Sciences, School of Public Health, University of Illinois at Chicago, 1603 W. Taylor St., MC 923, Chicago, IL, 60612, USA
| | - Kristine Zimmermann
- Division of Community Health Sciences, School of Public Health, University of Illinois at Chicago, 1603 W. Taylor St., MC 923, Chicago, IL, 60612, USA
- Center for Research on Women and Gender, University of Illinois at Chicago, Rm 536A, 1640 W. Roosevelt Rd., MC 980, Chicago, IL, 60608, USA
| | - Carol E Ferrans
- Department of Biobehavioral Health Sciences, College of Nursing, University of Illinois at Chicago, 845 S. Damen Ave., Chicago, IL, 60612, USA
| | - Yamilé Molina
- Division of Community Health Sciences, School of Public Health, University of Illinois at Chicago, 1603 W. Taylor St., MC 923, Chicago, IL, 60612, USA
- Center for Research on Women and Gender, University of Illinois at Chicago, Rm 536A, 1640 W. Roosevelt Rd., MC 980, Chicago, IL, 60608, USA
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Mulder RL, van Kalsbeek RJ, Hudson MM, Skinner R, Kremer LCM. The Critical Role of Clinical Practice Guidelines and Indicators in High-Quality Survivorship After Childhood Cancer. Pediatr Clin North Am 2020; 67:1069-1081. [PMID: 33131535 DOI: 10.1016/j.pcl.2020.07.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Childhood cancer survivors are at significant risk for late cancer treatment-related morbidity and mortality. Physicians involved in the care of childhood cancer survivors should be aware of these specific health problems and provide high-quality, long-term follow-up care to preserve and improve survivors' health. The steps required to achieve high-quality care include synthesizing evidence (systematic reviews are helpful in this regard), developing clinical policy from evidence into evidence-based clinical practice guidelines, disseminating and implementing clinical practice guidelines, and evaluating their impact on quality of care and survivor health outcomes with quality indicators. This article describes these cornerstones of evidence-based medicine.
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Affiliation(s)
- Renée L Mulder
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.
| | | | - Melissa M Hudson
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA; Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Roderick Skinner
- Department of Paediatric and Adolescent Haematology/Oncology, Great North Children's Hospital, Newcastle University Centre for Cancer, Newcastle upon Tyne, UK
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Bravery B, Loughnan S, Murphy M. Depression treatment research in people with cancer does not reflect cancer prevalence: findings from a systematic review. EVIDENCE-BASED MENTAL HEALTH 2020; 23:155-160. [PMID: 32788165 PMCID: PMC10231615 DOI: 10.1136/ebmental-2020-300145] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 07/06/2020] [Accepted: 07/10/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND One in six people with cancer will develop depression at some point in their care. Untreated depression affects quality of life, cancer care satisfaction and healthcare expenditure. Treatments for this vulnerable heterogenous population should be evidence based and specific. A common sentiment is that psychiatric research does not reflect the prevalence of patients with cancer and comorbid depression and is biased towards certain cancers, but this has not been empirically shown. STUDY SELECTION AND ANALYSIS A systematic review of studies on psychological and pharmacological treatments for depression in people with cancer was conducted. Of 4621 papers identified from a search of PubMed and PsycINFO up to 27 June 2020, 84 met inclusion criteria (eg, adults with cancer; depression diagnosis; treatment study) and comprised 6048 participants with depression with cancer. FINDINGS Cancer types are not proportionally represented in depression research in accordance with their incidence. Breast cancer is over-represented (relative frequency in research 49.3%, but 11.7% of global cancer). Cancers of the head and neck and bone and soft tissue were close to parity. All other cancers are under-represented. Representativeness varied 40-fold across different cancers. CONCLUSIONS The evidence base for depression treatments is dominated by a single cancer. Given heterogeneity in cancer populations (eg, stage of illness; psychological impact; cancer treatments), it is possible that depression treatments may not have the same benefits and harms across all cancers, impeding the ability to offer people with different cancers the best depression treatment. While the dominant opinion within this research field is that a cancer bias exists, this is the first study to demonstrate as such.
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Affiliation(s)
- Benjamin Bravery
- School of Medicine, The University of Notre Dame Australia, Darlinghurst, New South Wales, Australia
| | - Siobhan Loughnan
- Clinical Research Unit for Anxiety and Depression (CRUfAD) at St Vincent's Hospital, UNSW, Darlinghurst, New South Wales, Australia
| | - Michael Murphy
- Clinical Research Unit for Anxiety and Depression (CRUfAD) at St Vincent's Hospital, UNSW, Darlinghurst, New South Wales, Australia
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Viljoen B, Chambers SK, Dunn J, Ralph N, March S. Deciding to Enrol in a Cancer Trial: A Systematic Review of Qualitative Studies. J Multidiscip Healthc 2020; 13:1257-1281. [PMID: 33149597 PMCID: PMC7603415 DOI: 10.2147/jmdh.s266281] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 09/01/2020] [Indexed: 01/01/2023] Open
Abstract
Background Clinical trials are essential for the advancement of cancer treatments; however, participation by patients is suboptimal. Currently, there is a lack of synthesized qualitative review evidence on the patient experience of trial entry from which to further develop decision support. The aim of this review is to synthesise literature reporting experiences of participants when deciding to enrol in a cancer clinical trial in order to inform practice. Methods A systematic review and meta-synthesis of qualitative studies were conducted to describe the experiences of adult cancer patients who decided to enrol in a clinical trial of an anti-cancer treatment. Results Forty studies met eligibility criteria for inclusion. Three themes were identified representing the overarching domains of experience when deciding to enrol in a cancer trial: 1) need for trial information; (2) trepidation towards participation; and (3) justifying the decision. The process of deciding to enrol in a clinical trial is one marked by uncertainty, emotional distress and driven by the search for a cure. Conclusion Findings from this review show that decision support modelled by shared decision-making and the quality of a shared decision needs to be accompanied by tailored or personalised psychosocial and supportive care. Although the decision process bears similarities to theoretical processes outlined in decision-making frameworks, there are a lack of supportive interventions for cancer patients that are adapted to the clinical trial context. Theory-based interventions are urgently required to support the specific needs of patients deciding whether to participate in cancer trials.
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Affiliation(s)
- Bianca Viljoen
- Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Springfield, Brisbane, Australia.,Cancer Council Queensland, Brisbane, Australia.,School of Nursing & Midwifery, University of Southern Queensland, Toowoomba, Australia
| | - Suzanne K Chambers
- Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Springfield, Brisbane, Australia.,Cancer Council Queensland, Brisbane, Australia.,Faculty of Health, University of Technology Sydney, Sydney, Australia.,Australian and New Zealand Urogenital and Prostate Cancer (ANZUP) Trials Group, Sydney, NSW, Australia.,Prostate Cancer Foundation of Australia, Sydney, NSW, Australia.,Exercise Medicine Research Institute, Edith Cowan University, Perth, WA, Australia
| | - Jeff Dunn
- Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Springfield, Brisbane, Australia.,Cancer Council Queensland, Brisbane, Australia.,Faculty of Health, University of Technology Sydney, Sydney, Australia.,Australian and New Zealand Urogenital and Prostate Cancer (ANZUP) Trials Group, Sydney, NSW, Australia
| | - Nicholas Ralph
- Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Springfield, Brisbane, Australia.,School of Nursing & Midwifery, University of Southern Queensland, Toowoomba, Australia.,Faculty of Health, University of Technology Sydney, Sydney, Australia.,Australian and New Zealand Urogenital and Prostate Cancer (ANZUP) Trials Group, Sydney, NSW, Australia
| | - Sonja March
- Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Springfield, Brisbane, Australia.,School of Psychology and Counselling, University of Southern Queensland, Springfield, Brisbane, Australia
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Gritz ER, Talluri R, Fokom Domgue J, Tami-Maury I, Shete S. Smoking Behaviors in Survivors of Smoking-Related and Non-Smoking-Related Cancers. JAMA Netw Open 2020; 3:e209072. [PMID: 32614423 PMCID: PMC7333020 DOI: 10.1001/jamanetworkopen.2020.9072] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
IMPORTANCE The population of cancer survivors is rapidly growing in the US. Tobacco smoking is associated with many cancers; however, whether cigarette smoking behaviors among cancer survivors vary according to cancer type-that is, smoking-related cancers (SRCs) vs non-smoking-related cancers (NSRCs)-remains unclear. OBJECTIVES To examine cigarette smoking prevalence and behaviors (ie, continuing or quitting smoking) among cancer survivors and to compare them between survivors of SRCs and NSRCs. DESIGN, SETTING, AND PARTICIPANTS This study was a cross-sectional analysis of the 2017 National Health Interview Survey, a household survey of civilian US residents who were aged 18 years or older. The National Health Interview Survey is population based and is representative of the US population. Data analysis was performed from June to October 2019. MAIN OUTCOMES AND MEASURES The primary outcomes were prevalence of current cigarette smoking among cancer survivors and prevalence of continuing smoking and quitting smoking after a cancer diagnosis. Secondary outcomes included factors associated with continued smoking vs quitting smoking after a cancer diagnosis. RESULTS A total of 26 742 respondents (mean [SD] age, 50.97 [18.61] years; 14 646 women [51.76%]) to the 2017 National Health Interview Survey were included in this study. Of the 3068 individuals (9.42%) in the study population who had cancer, 589 (19.96%) were SRC survivors, 2297 (74.50%) were NSRC survivors, 168 (4.96%) were survivors of both SRC and NSRC, and the remaining 14 (0.58%) had missing information about the type of cancer. Four hundred forty-nine SRC survivors (54.08%) were women, compared with 1412 NSRC survivors (54.30%). Ninety-six SRC survivors (15.69%) and 151 NSRC survivors (7.99%) were younger than 45 years. Overall, 372 cancer survivors (13.16%) were current smokers. Current smoking prevalence was higher among survivors of SRCs (145 survivors [19.78%]) compared with NSRC survivors (251 survivors [10.63%]). Among cancer survivors, 309 current smokers at cancer diagnosis (43.96%) reported having successfully quit smoking and 372 (56.04%) reported continuing smoking. Among the continuing smokers, 176 (56.49%) reported an unsuccessful quit attempt in the last 12 months. After cancer diagnosis, SRC survivors had higher odds of continued smoking compared with NSRC survivors (odds ratio [OR], 2.10; 95% CI, 1.12-3.93; P = .02). Men (OR, 1.93; 95% CI, 1.05-3.57; P = .04), those with angina pectoris (OR, 5.40; 95% CI, 1.33-21.91; P = .02), and those with chronic bronchitis (OR, 2.55; 95% CI, 1.05-6.19; P = .04) had higher odds of continued smoking, whereas Hispanic participants (compared with non-Hispanic white participants: OR, 0.18; 95% CI, 0.05-0.68; P = .01) and married participants (compared with never married participants: OR, 0.33; 95% CI, 0.12-0.96; P = .04) had lower odds of continued smoking. CONCLUSIONS AND RELEVANCE These findings suggest that compared with NSRC survivors, SRC survivors may be at higher risk of being cigarette smokers at cancer diagnosis and of continuing smoking afterward. Although smoking cessation interventions are critically important for all cancer survivors, special efforts should target survivors of SRCs.
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Affiliation(s)
- Ellen R. Gritz
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston
| | - Rajesh Talluri
- Department of Data Science, The University of Mississippi Medical Center, Jackson
| | - Joël Fokom Domgue
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston
| | - Irene Tami-Maury
- Department of Epidemiology, Human Genetics, and Environmental Sciences, The University of Texas Health Science Center at Houston School of Public Health, Houston
| | - Sanjay Shete
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston
- Division of Cancer Prevention and Population Science, The University of Texas MD Anderson Cancer Center, Houston
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10
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Arem H, Mama SK, Duan X, Rowland JH, Bellizzi KM, Ehlers DK. Prevalence of Healthy Behaviors among Cancer Survivors in the United States: How Far Have We Come? Cancer Epidemiol Biomarkers Prev 2020; 29:1179-1187. [PMID: 32409489 PMCID: PMC7778877 DOI: 10.1158/1055-9965.epi-19-1318] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 01/07/2020] [Accepted: 03/12/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The 16.9 million cancer survivors in the United States are at increased risk for comorbidities and recurrence. However, this risk may be attenuated by a healthy lifestyle. This study describes health behaviors by cancer history to inform behavior change priorities. METHODS We analyzed 2013-2017 data from the National Health Interview Survey. There were 164,692 adults, of whom 12,648 reported a cancer history. We calculated prevalence of smoking, physical activity, alcohol consumption, body mass index (BMI), and sleep duration by cancer history, age, and cancer site. We conducted logistic regression to determine odds of meeting lifestyle recommendations by cancer history. RESULTS Overall, those with a cancer history were less likely to report current smoking (14.1% vs. 16.8%) and moderate/heavy drinking (18.8% vs. 21.9%) than those without a cancer history. However, a lower percentage of cancer survivors met physical activity guidelines (14.2% vs. 21.1%) or reported a healthy BMI (31.6% vs. 34.7%) compared with those without a cancer history. Cancer survivors were more likely to report excessive sleep (6.8% vs. 3.6%). In adjusted logistic regression, survivors were more likely to meet recommendations on smoking, physical activity, and BMI but were less likely to meet alcohol recommendations; meeting sleep recommendations did not differ by cancer history. CONCLUSIONS While cancer survivors had lower prevalence of smoking and moderate/heavy drinking, they also had lower prevalence of physical activity and healthy BMI, and reported longer sleep duration. Regression analyses suggested survivors only showed poorer behaviors for alcohol. IMPACT Targeted health promotion interventions among cancer survivors are needed.
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Affiliation(s)
- Hannah Arem
- GW Milken Institute School of Public Health, Department of Epidemiology, Washington D.C.
- GW Cancer Center, Washington D.C
| | - Scherezade K Mama
- Department of Kinesiology, College of Health and Human Development, The Pennsylvania State University, University Park, Pennsylvania
| | - Xuejing Duan
- GW Milken Institute School of Public Health, Department of Biostatistics, Washington D.C
| | | | - Keith M Bellizzi
- Human Development and Family Sciences, University of Connecticut, Storrs, Connecticut
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11
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Rowland JH, Gallicchio L, Mollica M, Saiontz N, Falisi AL, Tesauro G. Survivorship Science at the NIH: Lessons Learned From Grants Funded in Fiscal Year 2016. J Natl Cancer Inst 2020; 111:109-117. [PMID: 30657942 DOI: 10.1093/jnci/djy208] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 10/01/2018] [Accepted: 11/08/2018] [Indexed: 01/26/2023] Open
Abstract
Federal investment in survivorship science has grown markedly since the National Cancer Institute's creation of the Office of Cancer Survivorship in 1996. To describe the nature of this research, provide a benchmark, and map new directions for the future, a portfolio analysis of National Institutes of Health-wide survivorship grants was undertaken for fiscal year 2016. Applying survivorship-relevant terms, a search was conducted using the National Institutes of Health Information for Management, Planning, Analysis and Coordination grants database. Grants identified were reviewed for inclusion and categorized by grant mechanism used, funding agency, and principal investigator characteristics. Trained pairs of coders classified each grant by focus and design (observational vs interventional), population studied, and outcomes examined. A total of 215 survivorship grants were identified; 7 were excluded for lack of fit and 2 for nonresearch focus. Forty-one (19.7%) representing training grants (n = 38) or conference grants (n = 3) were not coded. Of the remaining 165 grants, most (88.5%) were funded by the National Cancer Institute; used the large, investigator-initiated (R01) mechanism (66.7%); focused on adult survivors alone (84.2%), often breast cancer survivors (47.3%); were observational in nature (57.3%); and addressed a broad array of topics, including psychosocial and physiologic outcomes, health behaviors, patterns of care, and economic/employment outcomes. Grants were led by investigators from diverse backgrounds, 28.4% of whom were early in their career. Present funding patterns, many stable since 2006, point to the need to expand research to include different cancer sites, greater ethnoculturally diverse samples, and older (>65 years) as well as longer-term (>5 years) survivors and address effects of newer therapies.
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Affiliation(s)
| | - Lisa Gallicchio
- Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD
| | - Michelle Mollica
- Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD
| | - Nicole Saiontz
- Office of the Director, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD
| | - Angela L Falisi
- Office of the Director, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD
| | - Gina Tesauro
- Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD
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12
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Hallgren E, Hastert TA, Carnahan LR, Eberth JM, Mama SK, Watson KS, Molina Y. Cancer-Related Debt and Mental-Health-Related Quality of Life among Rural Cancer Survivors: Do Family/Friend Informal Caregiver Networks Moderate the Relationship? JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2020; 61:113-130. [PMID: 32009469 PMCID: PMC7117869 DOI: 10.1177/0022146520902737] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Social connectedness generally buffers the effects of stressors on quality of life. Is this the case for cancer-related debt among rural cancer survivors? Drawing on a sample of 135 rural cancer survivors, we leverage family/friend informal caregiver network data to determine if informal cancer caregivers buffer or exacerbate the effect of cancer-related debt on mental-health-related quality of life (MHQOL). Using data from the Illinois Rural Cancer Assessment, a survey of cancer survivors in rural Illinois, we estimate the association between cancer-related debt and MHQOL and whether informal caregiver network size and characteristics moderate this association. Over a quarter of survivors (27%) reported cancer-related debt, and those who did reported worse MHQOL. However, this association only held for survivors who had an informal caregiver network. These findings supplement what is already known about the role of social connectedness in cancer survivors' health outcomes. We offer possible explanations for these findings.
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Affiliation(s)
| | - Theresa A Hastert
- Wayne State University, Detroit, MI, USA
- Karmanos Cancer Institute, Detroit, MI, USA
| | | | | | | | - Karriem S Watson
- University of Illinois at Chicago, Chicago, IL, USA
- University of Illinois Cancer Center, Chicago, IL, USA
| | - Yamilé Molina
- University of Illinois at Chicago, Chicago, IL, USA
- University of Illinois Cancer Center, Chicago, IL, USA
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Narayan V, Harrison M, Cheng H, Kenfield S, Aggarwal R, Kwon D, McKay R, Hauger R, Hart N, Conzen S, Borno H, Jim H, Dicker A, Dorff T, Moslehi J, Mucci L, Parsons JK, Saad F, Soule H, Morgans A, Ryan CJ. Improving research for prostate cancer survivorship: A statement from the Survivorship Research in Prostate Cancer (SuRECaP) working group. Urol Oncol 2020; 38:83-93. [DOI: 10.1016/j.urolonc.2019.10.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 07/16/2019] [Accepted: 10/08/2019] [Indexed: 12/26/2022]
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Bastian TD, Burhansstipanov L. Sharing Wisdom, Sharing Hope: Strategies Used by Native American Cancer Survivors to Restore Quality of Life. JCO Glob Oncol 2020; 6:161-166. [PMID: 32031445 PMCID: PMC6998019 DOI: 10.1200/jgo.19.00215] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2019] [Indexed: 12/17/2022] Open
Abstract
PURPOSE The purpose of this study was to gain insight into the experiences of Native American cancer survivors in navigating life after cancer and what resources and strategies survivors found useful for coping and achieving optimal quality of life (QoL) after diagnosis (the terms "Native Americans" and "Natives" are used interchangeably in this article to describe American Indians and Alaska Natives). The research questions were What advice and words of wisdom do Native cancer survivors prioritize in messages to other Native cancer survivors? and What do those messages reveal about how Native cancer survivors interpret, experience, and restore QoL after diagnosis? METHODS This study used a qualitative phenomenologic descriptive study design. Researchers used thematic analysis to identify themes related to peer advice and QoL from transcripts of semi-structured interviews with 52 geographically and clinically diverse Native cancer survivors in the United States. RESULTS Survivors' lived experiences directly informed their advice to other survivors, which was characterized by four themes: listen to your body, advocate for yourself, embrace your culture and spirituality, and share your story. A deeper look into the origins of those messages revealed challenges survivors face balancing their responsibility to care for themselves while simultaneously embracing cultural values of selflessness. CONCLUSION Providers and researchers should work with Native cancer survivors to identify and leverage existing community strengths in ways that support all aspects of a survivors' QoL rather than limiting support to a single QoL domain (eg, physical, spiritual, mental/emotional, or social issues). Interventions should ensure that supports and services align with survivors' cultural values and attend to competing responsibilities to optimize QoL.
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15
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A meta-review of qualitative research on adult cancer survivors: current strengths and evidence gaps. J Cancer Surviv 2019; 13:852-889. [DOI: 10.1007/s11764-019-00803-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 08/19/2019] [Indexed: 12/22/2022]
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16
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Krok-Schoen JL, Bernardo BM, Elena JW, Green PA, Hoover E, Peng J, Anderson GL, Caan B, Johnson LG, Paskett ED. An Environmental Scan of Biopsychosocial and Clinical Variables in Cohort Studies of Cancer Survivors. Cancer Epidemiol Biomarkers Prev 2019; 28:1621-1641. [PMID: 31315912 PMCID: PMC6774809 DOI: 10.1158/1055-9965.epi-18-0541] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 07/25/2018] [Accepted: 07/10/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND An inventory of cancer survivorship cohorts is necessary to identify important gaps in what is being studied among cancer survivors. METHODS We conducted an environmental scan of cancer survivor cohorts to determine the scope and scale of information collected on demographic, biopsychosocial, and selected clinical variables from cancer survivors. Cohorts were eligible for inclusion in the environmental scan if the study was conducted in the United States, reported in English, and consisted of data collected from cancer survivors postdiagnosis and followed for at least 1 year. RESULTS Out of the 131 cohorts identified, 62 were eligible. There were 23 cancer sites represented, and more than half of the studies included breast cancer survivors (n = 34). The next most commonly included cancers were leukemia (n = 22) and lymphoma (n = 23). The majority (n = 59) collected information on clinical characteristics and basic diagnostic information, patient demographic characteristics (n = 57), patient-reported symptoms (n = 44), lifestyle (n = 45), and psychologic characteristics (n = 42). Half collected biospecimens (n = 35) and biomarkers (n = 35); fewer collected CAM use (n = 19) and social characteristics (n = 27). CONCLUSIONS Extensive data are available in cancer cohorts to study important questions relevant to cancer survivors. Cohorts should consider collecting information on social and environmental factors, as well as biospecimen collection and biomarker analyses, and should include survivors from cancer sites less likely to be studied. IMPACT This information can assist researchers in understanding the types of information currently being gathered from cancer survivors for further analysis and identify areas where more research is needed.
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Affiliation(s)
- Jessica L Krok-Schoen
- Division of Medical Dietetics and Health Sciences, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, Columbus, Ohio
- Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio
| | | | - Joanne W Elena
- Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences, NCI, NIH, Bethesda, Maryland
| | - Paige A Green
- Basic Biobehavioral and Psychological Science Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, NCI, NIH, Bethesda, Maryland
| | - Elise Hoover
- Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences, NCI, NIH, Bethesda, Maryland
| | - Juan Peng
- Center for Biostatistics, The Ohio State University, Columbus, Ohio
| | - Garnet L Anderson
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Bette Caan
- Division of Research, Kaiser Permanente of Northern California, Oakland, California
| | - Lisa G Johnson
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Electra D Paskett
- Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio.
- Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, Ohio
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, Ohio
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Uzu M, Nonaka M, Miyano K, Sato H, Kurebayashi N, Yanagihara K, Sakurai T, Hisaka A, Uezono Y. A novel strategy for treatment of cancer cachexia targeting xanthine oxidase in the brain. J Pharmacol Sci 2019; 140:109-112. [PMID: 31155393 DOI: 10.1016/j.jphs.2019.04.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 03/12/2019] [Accepted: 04/01/2019] [Indexed: 01/25/2023] Open
Abstract
Cancer cachexia is a systemic wasting syndrome characterized by anorexia and loss of body weight. The xanthine oxidase (XO) inhibitor febuxostat is one of the promising candidates for cancer cachexia treatment. However, cachexic symptoms were not alleviated by oral administration of febuxostat in our cancer cachexia model. Metabolomic analysis with brains of our cachexic model showed that purine metabolism was activated and XO activity was increased, and thus suggested that febuxostat would not reach the brain. Accordingly, targeting XO in the brain, which controls appetite, may be an effective strategy for treatment of cancer cachexia.
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Affiliation(s)
- Miaki Uzu
- Division of Cancer Pathophysiology, National Cancer Center Research Institute, Tokyo, 104-0045, Japan
| | - Miki Nonaka
- Division of Cancer Pathophysiology, National Cancer Center Research Institute, Tokyo, 104-0045, Japan
| | - Kanako Miyano
- Division of Cancer Pathophysiology, National Cancer Center Research Institute, Tokyo, 104-0045, Japan
| | - Hiromi Sato
- Laboratory of Clinical Pharmacology and Pharmacometrics, Graduate School of Pharmaceutical Sciences, Chiba University, Chiba, 260-8675, Japan
| | - Nagomi Kurebayashi
- Department of Cellular and Molecular Pharmacology, Juntendo University Graduate School of Medicine, Tokyo, 113-8421, Japan
| | - Kazuyoshi Yanagihara
- Division of Biomarker Discovery, Exploratory Oncology Research & Clinical Trial Center, National Cancer Center, Chiba, 277- 8577, Japan
| | - Takashi Sakurai
- Department of Cellular and Molecular Pharmacology, Juntendo University Graduate School of Medicine, Tokyo, 113-8421, Japan
| | - Akihiro Hisaka
- Laboratory of Clinical Pharmacology and Pharmacometrics, Graduate School of Pharmaceutical Sciences, Chiba University, Chiba, 260-8675, Japan
| | - Yasuhito Uezono
- Division of Cancer Pathophysiology, National Cancer Center Research Institute, Tokyo, 104-0045, Japan; Division of Supportive Care Research, Exploratory Oncology Research & Clinical Trial Center, National Cancer Center, Tokyo, 104-0045, Japan; Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, Tokyo, 104-0045, Japan.
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18
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Beebe-Dimmer JL, Albrecht TL, Baird TE, Ruterbusch JJ, Hastert T, Harper FWK, Simon MS, Abrams J, Schwartz KL, Schwartz AG. The Detroit Research on Cancer Survivors (ROCS) Pilot Study: A Focus on Outcomes after Cancer in a Racially Diverse Patient Population. Cancer Epidemiol Biomarkers Prev 2019; 28:666-674. [PMID: 30482875 PMCID: PMC6449184 DOI: 10.1158/1055-9965.epi-18-0123] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 06/04/2018] [Accepted: 11/20/2018] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND African Americans are often diagnosed with advanced stage cancer and experience higher mortality compared with whites in the United States. Contributing factors, like differences in access to medical care and the prevalence of comorbidities, do not entirely explain racial differences in outcomes. METHODS The Detroit Research on Cancer Survivors (ROCS) pilot study was conducted to investigate factors related to short- and long-term outcomes among patients with cancer. Participants completed web-based surveys, and mailed saliva specimens were collected for future genetic studies. RESULTS We recruited 1,000 participants with an overall response rate of 68%. Thirty-one percent completed the survey without any interviewer support and the remaining participated in an interviewer-administered survey. Seventy-four percent provided a saliva specimen and 64% consented for tumor tissue retrieval. African American survivors required more interviewer support (P < 0.001); however, their response rate (69.6%) was higher than non-Hispanic whites (65.4%). African Americans reported poorer overall cancer-related quality of life compared with non-Hispanic whites, measured by FACT-G score (P < 0.001), however, this relationship was reversed after controlling for socioeconomic factors, marital status, and the presence of comorbidities. CONCLUSIONS In this pilot study, we demonstrated that a web-based survey supplemented with telephone interviews and mailed saliva kits are cost-effective methods to collect patient-reported data and DNA for large studies of cancer survivors with a high proportion of minority patients. The preliminary data collected reinforces differences by race in factors affecting cancer outcomes. Our efforts continue as we expand this unique cohort to include more than 5,000 African American cancer survivors. IMPACT Formal investigation of factors influencing adverse outcomes among African American cancer survivors will be critical in closing the racial gap in morbidity and mortality.
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Affiliation(s)
- Jennifer L Beebe-Dimmer
- Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan.
- Department of Oncology, School of Medicine, Wayne State University, Detroit, Michigan
| | - Terrance L Albrecht
- Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan
- Department of Oncology, School of Medicine, Wayne State University, Detroit, Michigan
| | - Tara E Baird
- Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan
- Department of Oncology, School of Medicine, Wayne State University, Detroit, Michigan
| | - Julie J Ruterbusch
- Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan
- Department of Oncology, School of Medicine, Wayne State University, Detroit, Michigan
| | - Theresa Hastert
- Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan
- Department of Oncology, School of Medicine, Wayne State University, Detroit, Michigan
| | - Felicity W K Harper
- Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan
- Department of Oncology, School of Medicine, Wayne State University, Detroit, Michigan
| | - Michael S Simon
- Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan
- Department of Oncology, School of Medicine, Wayne State University, Detroit, Michigan
| | - Judith Abrams
- Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan
- Department of Oncology, School of Medicine, Wayne State University, Detroit, Michigan
| | - Kendra L Schwartz
- Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan
- Department of Family Medicine, School of Medicine, Wayne State University, Detroit, Michigan
| | - Ann G Schwartz
- Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan
- Department of Oncology, School of Medicine, Wayne State University, Detroit, Michigan
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19
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Health-related quality of life, symptom burden, and comorbidity in long-term survivors of acute promyelocytic leukemia. Leukemia 2018; 33:1598-1607. [DOI: 10.1038/s41375-018-0325-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 10/11/2018] [Accepted: 10/24/2018] [Indexed: 12/18/2022]
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20
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Geerse OP, Lakin JR, Berendsen AJ, Alfano CM, Nekhlyudov L. Cancer survivorship and palliative care: Shared progress, challenges, and opportunities. Cancer 2018; 124:4435-4441. [DOI: 10.1002/cncr.31723] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 07/19/2018] [Accepted: 07/23/2018] [Indexed: 12/19/2022]
Affiliation(s)
- Olaf P. Geerse
- Department of Pulmonary Diseases University Medical Center Groningen, University of Groningen Groningen the Netherlands
- Ariadne Labs Brigham and Women’s Hospital, Harvard T. H. Chan School of Public Health Boston Massachusetts
| | - Joshua R. Lakin
- Ariadne Labs Brigham and Women’s Hospital, Harvard T. H. Chan School of Public Health Boston Massachusetts
- Department of Medicine Brigham and Women’s Hospital Boston Massachusetts
- Department of Psychosocial Oncology and Palliative Care Dana‐Farber Cancer Institute Boston Massachusetts
| | - Annette J. Berendsen
- Department of General Practice and Elderly Medicine University Medical Center Groningen, University of Groningen Groningen the Netherlands
| | | | - Larissa Nekhlyudov
- Department of Medicine Brigham and Women’s Hospital Boston Massachusetts
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21
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Thong MS, Mols F, Doege D, van de Poll-Franse L, Arndt V. Population-based cancer survivorship research: Experiences from Germany and the Netherlands. J Cancer Policy 2018. [DOI: 10.1016/j.jcpo.2018.02.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Mazumdar M, Moshier EL, Özbek U, Parsons R. Ten Essential Practices for Developing or Reforming a Biostatistics Core for a NCI Designated Cancer Center. JNCI Cancer Spectr 2018; 2:pky010. [PMID: 31360841 PMCID: PMC6649702 DOI: 10.1093/jncics/pky010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 02/11/2018] [Accepted: 03/06/2018] [Indexed: 01/17/2023] Open
Abstract
There are 69 National Cancer Institute (NCI) designated Cancer Centers (CCs) in the United States. Biostatistical collaboration is pivotal in cancer research, and support for a cancer biostatistics shared resource facility (C-BSRF) is included in the award. Although the services and staff needed in a C-BSRF have been outlined in general terms and best practices for biostatistical consultations and collaboration in an academic health center have been agreed upon, implementing these practices in the demanding setting of cancer centers interested in pursuing or maintaining NCI designation remains challenging. We surveyed all C-BSRF websites to assess their organizational charts, governance, size, services provided, and financial models and have identified 10 essential practices for the development of a successful C-BSRF. Here, we share our success with, and barriers to, implementation of these practices. Showcasing development plans for these essential practices resulted in an NCI score of "Excellent to Outstanding" for our C-BSRF in 2015, and performance metrics in 2016-2017 demonstrated notable improvement since our original Cancer Center Support Grant (CCSG) application in 2014. We believe that the essential practices described here can be adapted and adjusted, as needed, for CCs of various sizes and with different types of cancer research programs.
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Affiliation(s)
- Madhu Mazumdar
- Institute for Healthcare Delivery Science, Mount Sinai Health System, New York, NY
- Center for Biostatistics, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY
- Biostatistics Shared Resource Facility, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Erin L Moshier
- Center for Biostatistics, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY
- Biostatistics Shared Resource Facility, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Umut Özbek
- Center for Biostatistics, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY
- Biostatistics Shared Resource Facility, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Ramon Parsons
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY
- Medicine, Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY
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Nekhlyudov L, Ganz PA, Arora NK, Rowland JH. Going Beyond Being Lost in Transition: A Decade of Progress in Cancer Survivorship. J Clin Oncol 2017; 35:1978-1981. [PMID: 28437163 PMCID: PMC5676953 DOI: 10.1200/jco.2016.72.1373] [Citation(s) in RCA: 97] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Affiliation(s)
- Larissa Nekhlyudov
- Larissa Nekhlyudov, Brigham & Women’s Hospital, Boston, MA; Patricia A. Ganz, Fielding School of Public Health, Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA; Neeraj K. Arora, Patient-Centered Outcomes Research Institute, Washington, DC; and Julia H. Rowland, National Cancer Institute, Bethesda, MD
| | - Patricia A. Ganz
- Larissa Nekhlyudov, Brigham & Women’s Hospital, Boston, MA; Patricia A. Ganz, Fielding School of Public Health, Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA; Neeraj K. Arora, Patient-Centered Outcomes Research Institute, Washington, DC; and Julia H. Rowland, National Cancer Institute, Bethesda, MD
| | - Neeraj K. Arora
- Larissa Nekhlyudov, Brigham & Women’s Hospital, Boston, MA; Patricia A. Ganz, Fielding School of Public Health, Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA; Neeraj K. Arora, Patient-Centered Outcomes Research Institute, Washington, DC; and Julia H. Rowland, National Cancer Institute, Bethesda, MD
| | - Julia H. Rowland
- Larissa Nekhlyudov, Brigham & Women’s Hospital, Boston, MA; Patricia A. Ganz, Fielding School of Public Health, Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA; Neeraj K. Arora, Patient-Centered Outcomes Research Institute, Washington, DC; and Julia H. Rowland, National Cancer Institute, Bethesda, MD
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Nekhlyudov L, Birken S, Mayer D. Living with advanced cancer and the role of the primary care provider: The missing piece in the survivorship discourse. Eur J Cancer Care (Engl) 2017; 26. [DOI: 10.1111/ecc.12708] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2017] [Indexed: 12/25/2022]
Affiliation(s)
- L. Nekhlyudov
- Department of Medicine; Brigham & Women's Hospital; Harvard Medical School; Boston MA USA
| | - S.A. Birken
- Department of Health Policy and Management; Gillings School of Global Public Health; Chapel Hill NC USA
| | - D.K. Mayer
- The University of North Carolina at Chapel Hill School of Nursing; UNC Lineberger Comprehensive Cancer Center; Chapel Hill NC USA
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Takahashi M. Cancer survivorship: current status of research, care, and policy in Japan. Jpn J Clin Oncol 2016; 46:599-604. [PMID: 27162321 DOI: 10.1093/jjco/hyw057] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2015] [Accepted: 04/06/2016] [Indexed: 12/14/2022] Open
Abstract
Progress in early detection and treatment has been changing cancer into a chronic illness, and this has initiated an imperative shift in focus among healthcare providers, researchers and policy makers in many countries, including Japan, to cancer survivorship issues rather than mere survival. This article reviews the history of the cancer survivorship concept and examines how the concept has been integrated into cancer policy in Japan. It also discusses the characteristics of survivorship research and briefly reviews the current status of research and care, both in Japan and globally, regarding five important survivorship topics: developing measures for long-term complications and delayed effects, interpersonal relationships, lifestyle modifications and health promotion, sexuality and fertility, and work-related issues. Cooperation with practitioners and researchers in areas outside the medical fields will be indispensable to promote survivorship research and care practice. Also, the importance of collaboration with cancer survivors for developing support systems and policy measures related to survivorship cannot be emphasized enough.
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Affiliation(s)
- Miyako Takahashi
- Division of Cancer Survivorship Research, Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan
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Pergolizzi JV, Zampogna G, Taylor R, Gonima E, Posada J, Raffa RB. A Guide for Pain Management in Low and Middle Income Communities. Managing the Risk of Opioid Abuse in Patients with Cancer Pain. Front Pharmacol 2016; 7:42. [PMID: 26973529 PMCID: PMC4771925 DOI: 10.3389/fphar.2016.00042] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 02/15/2016] [Indexed: 11/18/2022] Open
Abstract
Most patients who present with cancer have advanced disease and often suffer moderate to severe pain. Opioid therapy can be safe and effective for use in cancer patients with pain, but there are rightful concerns about inappropriate opioid use even in the cancer population. Since cancer patients live longer than ever before in history (and survivors may have long exposure times to opioid therapy), opioid misuse among cancer patients is an important topic worthy of deeper investigation. Cancer patients with pain must be evaluated for risk factors for potential opioid misuse and aberrant drug-taking behaviors assessed. A variety of validated screening tools should be used. Of particular importance is the fact that pain in cancer patients changes frequently, whether it is related to their underlying disease (progression or remission), pain related to treatment (such as painful chemotherapy-induced peripheral neuropathy), and concomitant pain unrelated to cancer (such as osteoarthritis, headache, or back pain). Fortunately, clinicians can use universal precautions to help reduce the risk of opioid misuse while still assuring that cancer patients get the pain therapy they need. Another important new “tool” in this regard is the emergence of abuse-deterrent opioid formulations.
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Affiliation(s)
- Joseph V Pergolizzi
- Department of Medicine, Johns Hopkins University School of MedicineBaltimore, MD, USA; Department of Anesthesiology, Georgetown University School of MedicineWashington, DC, USA; Department of Pharmacology, Temple University School of MedicinePhiladelphia, PA, USA
| | | | | | - Edmundo Gonima
- Anesthesiologist, Pain and Palliative Care, Pain Specialist in Hospital Militar Bogota, Colombia
| | - Jose Posada
- Psychiatry, Colombian National Board of Narcotics Bogota, Colombia
| | - Robert B Raffa
- Department of Pharmaceutical Sciences, Temple University School of Pharmacy Philadelphia, PA, USA
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Jacobsen PB, Rowland JH, Paskett ED, Van Leeuwen F, Moskowitz C, Katta S, Wollins D, Robison LL. Identification of Key Gaps in Cancer Survivorship Research: Findings From the American Society of Clinical Oncology Survey. J Oncol Pract 2016; 12:190-3. [PMID: 26907451 DOI: 10.1200/jop.2015.009258] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Paul B Jacobsen
- Moffitt Cancer Center, Tampa, FL; National Cancer Institute, Bethesda, MD; The Ohio State University, Columbus, OH; Netherlands Cancer Institute, Amsterdam, the Netherlands; Memorial Sloan Kettering Cancer Center, New York, NY; American Society of Clinical Oncology, Alexandria, VA; and St Jude Children's Research Hospital, Memphis, TN
| | - Julia H Rowland
- Moffitt Cancer Center, Tampa, FL; National Cancer Institute, Bethesda, MD; The Ohio State University, Columbus, OH; Netherlands Cancer Institute, Amsterdam, the Netherlands; Memorial Sloan Kettering Cancer Center, New York, NY; American Society of Clinical Oncology, Alexandria, VA; and St Jude Children's Research Hospital, Memphis, TN
| | - Electra D Paskett
- Moffitt Cancer Center, Tampa, FL; National Cancer Institute, Bethesda, MD; The Ohio State University, Columbus, OH; Netherlands Cancer Institute, Amsterdam, the Netherlands; Memorial Sloan Kettering Cancer Center, New York, NY; American Society of Clinical Oncology, Alexandria, VA; and St Jude Children's Research Hospital, Memphis, TN
| | - Flora Van Leeuwen
- Moffitt Cancer Center, Tampa, FL; National Cancer Institute, Bethesda, MD; The Ohio State University, Columbus, OH; Netherlands Cancer Institute, Amsterdam, the Netherlands; Memorial Sloan Kettering Cancer Center, New York, NY; American Society of Clinical Oncology, Alexandria, VA; and St Jude Children's Research Hospital, Memphis, TN
| | - Chaya Moskowitz
- Moffitt Cancer Center, Tampa, FL; National Cancer Institute, Bethesda, MD; The Ohio State University, Columbus, OH; Netherlands Cancer Institute, Amsterdam, the Netherlands; Memorial Sloan Kettering Cancer Center, New York, NY; American Society of Clinical Oncology, Alexandria, VA; and St Jude Children's Research Hospital, Memphis, TN
| | - Sweatha Katta
- Moffitt Cancer Center, Tampa, FL; National Cancer Institute, Bethesda, MD; The Ohio State University, Columbus, OH; Netherlands Cancer Institute, Amsterdam, the Netherlands; Memorial Sloan Kettering Cancer Center, New York, NY; American Society of Clinical Oncology, Alexandria, VA; and St Jude Children's Research Hospital, Memphis, TN
| | - Dana Wollins
- Moffitt Cancer Center, Tampa, FL; National Cancer Institute, Bethesda, MD; The Ohio State University, Columbus, OH; Netherlands Cancer Institute, Amsterdam, the Netherlands; Memorial Sloan Kettering Cancer Center, New York, NY; American Society of Clinical Oncology, Alexandria, VA; and St Jude Children's Research Hospital, Memphis, TN
| | - Leslie L Robison
- Moffitt Cancer Center, Tampa, FL; National Cancer Institute, Bethesda, MD; The Ohio State University, Columbus, OH; Netherlands Cancer Institute, Amsterdam, the Netherlands; Memorial Sloan Kettering Cancer Center, New York, NY; American Society of Clinical Oncology, Alexandria, VA; and St Jude Children's Research Hospital, Memphis, TN
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Prevalence and factors related to smoking and smoking cessation 6 months following a cancer diagnosis: a population-based study. J Cancer Surviv 2016; 10:645-53. [PMID: 26758587 DOI: 10.1007/s11764-015-0510-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 12/25/2015] [Indexed: 09/29/2022]
Abstract
PURPOSE Limited research has examined smoking amongst recent cancer survivors or the relative contribution of factors on smoking behaviour. This study aimed to describe amongst recent Australian cancer survivors (i) prevalence of smoking by cancer type, (ii) characteristics associated with continued smoking following diagnosis, (iii) intention to quit among those who continue to smoke and (iv) characteristics associated with quitting following diagnosis. METHOD Cross-sectional data were analysed from 1299 cancer survivors diagnosed with their first primary cancer recruited from two Australian cancer registries in Australia between 2006 and 2008. RESULTS Of participants, 8.6 % reported current smoking. Participants who were younger and single or widowed reported higher odds of current smoking. Participants who had a certificate/diploma or tertiary education reported lower odds of smoking. Among current smokers, 53 % intended to quit in the future. Lung cancer survivors reported more than four times the odds of quitting smoking since diagnosis compared to other cancer types. CONCLUSION Of recent Australian cancer survivors who were smokers, 14% reported that they never expected to quit smoking [corrected]. IMPLICATIONS FOR CANCER SURVIVORS Smoking following a cancer diagnosis is associated with increased risk of mortality and further morbidity. There is a need to target cessation efforts towards survivors who are younger, without a partner and with a low level of education.
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Barbui T, Björkholm M, Gratwohl A. Cancer survivorship programs: time for concerted action. Haematologica 2015; 99:1273-6. [PMID: 25082784 DOI: 10.3324/haematol.2014.104059] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Hematologists, specialists in cancer survivorship and patient advocates met in Bergamo, Italy (Nov 14–16, 2013) to highlight the physical, mental, psychosocial and financial challenges faced by cancer survivors and their families. Gaps in research and resources were all too apparent. This planned meeting perspective, not a formal consensus statement, reflects the key points mentioned by the participants during the discussions and the personal view of the authors. It proposes urgent action in key areas to ensure that people surviving cancer will suffer fewer long-term health problems than their predecessors and to contain costs.
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Affiliation(s)
- Tiziano Barbui
- Research Foundation and Hematology, Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | - Magnus Björkholm
- Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Alois Gratwohl
- Haematology, Medical Faculty, University of Basel, Switzerland
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Yu XQ, Luo Q, Smith DP, Clements MS, O'Connell DL. Prostate cancer prevalence in New South Wales Australia: a population-based study. Cancer Epidemiol 2014; 39:29-36. [PMID: 25530551 DOI: 10.1016/j.canep.2014.11.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 11/24/2014] [Accepted: 11/29/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Information on the current and future numbers of Australian men living with prostate cancer is limited. We describe a method for estimating complete prevalence of prostate cancer to provide a measure of the burden of prostate cancer in Australia. METHODS Prostate cancer data from the New South Wales (NSW) Central Cancer Registry were used with PIAMOD (Prevalence and Incidence Analysis MODel) software to estimate future prostate cancer prevalence in NSW. We first fitted parametric incidence and survival models then used the modelled incidence and survival estimates to calculate complete prevalence. The estimated and projected prevalence incorporate past observed trends and take into account different assumptions about future survival trends. These models were validated against observed prevalence from the counting method. RESULTS Based on data for 1996-2007, the number of men living with prostate cancer in NSW was estimated to rise by 59% to 73%, from 38,322 in 2007 to 60,910-66,160 in 2017. The increasing incidence rates and the ageing population were the major contributors to this estimated increase. Validation suggested that these projections were reasonable, as the estimated prevalence in 1996-2007 was in good agreement with the corresponding prevalence calculated using the direct counting method, and the incidence models were supported by the recent data on prostate-specific antigen testing. CONCLUSIONS As the number of men living with prostate cancer is expected to increase dramatically in the next decade in Australia, representing a significant challenge to the health system, careful planning and development of a healthcare system able to respond to this increased demand is required. These projections are useful for addressing the challenge in meeting the cancer care needs of men with prostate cancer.
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Affiliation(s)
- Xue Qin Yu
- Cancer Research Division, Cancer Council New South Wales, Sydney, Australia; Sydney School of Public Health, the University of Sydney, Sydney, Australia.
| | - Qingwei Luo
- Cancer Research Division, Cancer Council New South Wales, Sydney, Australia
| | - David P Smith
- Cancer Research Division, Cancer Council New South Wales, Sydney, Australia; Griffith Health Institute, Griffith University, Gold Coast, QLD, Australia
| | - Mark S Clements
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Nordic Information for Action eScience Center, Stockholm, Sweden; Swedish e-Science Research Centre, KTH, Department of Mechanics, Stockholm, Sweden
| | - Dianne L O'Connell
- Cancer Research Division, Cancer Council New South Wales, Sydney, Australia; Sydney School of Public Health, the University of Sydney, Sydney, Australia; School of Public Health and Community Medicine, University of NSW, Sydney, Australia; School of Medicine and Public Health, University of Newcastle, Newcastle, Australia
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Halpern MT, Viswanathan M, Evans TS, Birken SA, Basch E, Mayer DK. Models of Cancer Survivorship Care: Overview and Summary of Current Evidence. J Oncol Pract 2014; 11:e19-27. [PMID: 25205779 DOI: 10.1200/jop.2014.001403] [Citation(s) in RCA: 121] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION This article, derived from a Technical Brief prepared for the Agency for Healthcare Research and Quality, presents an overview on current models of care for survivors of adult-onset cancer who have completed active treatment. METHODS This article integrates reviewed literature on background, context, research gaps, and future research directions for survivorship care models. We also conducted a systematic literature review of current evidence from studies of survivorship care models. RESULTS Our systematic review identified nine empirical studies of survivorship care models, covering multiple models types and illustrating the heterogeneity in this field. The literature review indicated considerable heterogeneity in models of survivorship care, components of models, survivor populations, and target outcomes. Models of survivorship care are highly individualized to the institution or setting where they are provided. "Usual care" is often uncoordinated and highly varied across cancer survivors and within cancer programs. Anticipated shortages in the oncology workforce may require the expanded use of nurse practitioners and physician assistants and shared care with primary care providers to deliver survivorship care to the growing number of survivors. Concerns associated with survivorship care models include payment considerations, adequacy of training, and the potential for lack of coordination and fragmented care. CONCLUSION There is substantial variation in survivorship care models. The optimal nature, timing, intensity, format, and outcomes of survivorship care models are uncertain and require further research. Specific research questions need to be addressed by the survivorship community to better understand the advantages and limitations of survivorship models.
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Affiliation(s)
- Michael T Halpern
- RTI International, Washington, DC, and Research Triangle Park, NC; and University of North Carolina-Chapel Hill, Chapel Hill, NC
| | - Meera Viswanathan
- RTI International, Washington, DC, and Research Triangle Park, NC; and University of North Carolina-Chapel Hill, Chapel Hill, NC
| | - Tammeka S Evans
- RTI International, Washington, DC, and Research Triangle Park, NC; and University of North Carolina-Chapel Hill, Chapel Hill, NC
| | - Sarah A Birken
- RTI International, Washington, DC, and Research Triangle Park, NC; and University of North Carolina-Chapel Hill, Chapel Hill, NC
| | - Ethan Basch
- RTI International, Washington, DC, and Research Triangle Park, NC; and University of North Carolina-Chapel Hill, Chapel Hill, NC
| | - Deborah K Mayer
- RTI International, Washington, DC, and Research Triangle Park, NC; and University of North Carolina-Chapel Hill, Chapel Hill, NC
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Peiffer AM, Creer RM, Linville C, Olson J, Kulkarni P, Brown JA, Riddle DR, Robbins ME, Brunso-Bechtold JE. Radiation-induced cognitive impairment and altered diffusion tensor imaging in a juvenile rat model of cranial radiotherapy. Int J Radiat Biol 2014; 90:799-806. [PMID: 24991879 DOI: 10.3109/09553002.2014.938278] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
PURPOSE To assess the long-term effects of fractionated whole brain irradiation (fWBI) using diffusion tensor imaging (DTI) and behavior in a pediatric rodent model for the clinical presentation of adult pediatric cancer survivors. MATERIALS AND METHODS Five-week-old, male F344xBN rats were randomized to receive 0, 5, or 6.5 Gy fractions biweekly for 3 weeks, resulting in Sham, Irradiated-30 (IR-30) and IR-39 Gy total dose groups. Magnetic Resonance Imaging occurred at 1, 3, 6 and 9 months with behavioral assessment at 10-11 months post-fWBI. RESULTS Irradiation reduced brain size (p < 0.001) and body weight (p < 0.001) proportionate to dose. At 1 month post-fWBI and throughout follow-up, diffusion was reduced in IR-30 and IR-39 relative to shams (p < 0.001). IR-30 but not IR-39 rats were impaired relative to Shams on the reversal trial of the Morris Water Maze (p < 0.05), and IR-30 rats preferred a striatum- mediated strategy (p < 0.06). CONCLUSIONS Hippocampal performance was impaired in IR-30 but not IR-39 animals. While gross size differences exist, white matter integrity is preserved in rats after fWBI at 5 weeks. This significant departure from childhood cancer survivors and single fraction rodent studies where white matter degradation is a prominent feature are discussed.
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Affiliation(s)
- Ann M Peiffer
- Department of Radiation Oncology, Wake Forest School of Medicine , Winston-Salem, NC
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Skolarus TA, Hawley ST. Prostate cancer survivorship care in the Veterans Health Administration. Fed Pract 2014; 31:10-17. [PMID: 30369784 PMCID: PMC6201257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The burden of prostate cancer among Veterans is substantial with over 200,000 survivors and 12,000 new diagnoses annually. Most men live with rather than die from this common and expensive disease making prostate cancer survivorship care especially important. In addition, the symptom burden after prostate cancer treatment can be substantial, last well into survivorship and lead to reduced quality of life and greater use of services. For these reasons, it is increasingly recognized that cancer survivorship care is similar to chronic disease management in requiring a combination of primary care providers and cancer specialists to deliver care over long periods of time. Because of its leadership in chronic disease care and the proportion of older men served, the Veterans Health Administration (VHA) is well positioned to become one of the national leaders in prostate cancer survivorship care. However, best practices and portfolios of quality indicators for prostate cancer survivorship care remain underdeveloped. More broadly, there is a limited consensus about who (primary care providers or prostate cancer specialists - urologists, radiation and medical oncologists) has primary responsibility for prostate cancer surveillance, and who manages the often substantial and lingering treatment-related side effects. Unclear roles and regional variation in the VHA cancer specialist workforce also complicate delivery of quality survivorship care. Ultimately, the design and implementation of tools to facilitate the delivery of optimal cancer survivorship care in VHA rests upon understanding how responsibility for survivorship care is managed and the barriers to quality survivorship care. Due to the expanding population of Veteran prostate cancer survivors, improving their quality of survivorship care through effective use of the VHA's provider workforce and latest telemedicine initiatives has potential to transform the national efficiency and effectiveness of cancer specialty care delivery.
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Affiliation(s)
- Ted A. Skolarus
- Dow Division of Health Services Research, Department of Urology, University of Michigan
- Division of Oncology, Department of Urology, University of Michigan
- VA HSR&D Center for Clinical Management Research, VA Ann Arbor Healthcare System, University of Michigan
| | - Sarah T. Hawley
- VA HSR&D Center for Clinical Management Research, VA Ann Arbor Healthcare System, University of Michigan
- Department of Internal Medicine, University of Michigan
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Skolarus TA, Wolf AMD, Erb NL, Brooks DD, Rivers BM, Underwood W, Salner AL, Zelefsky MJ, Aragon-Ching JB, Slovin SF, Wittmann DA, Hoyt MA, Sinibaldi VJ, Chodak G, Pratt-Chapman ML, Cowens-Alvarado RL. American Cancer Society prostate cancer survivorship care guidelines. CA Cancer J Clin 2014; 64:225-49. [PMID: 24916760 DOI: 10.3322/caac.21234] [Citation(s) in RCA: 292] [Impact Index Per Article: 29.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Accepted: 04/14/2014] [Indexed: 12/15/2022] Open
Abstract
Prostate cancer survivors approach 2.8 million in number and represent 1 in 5 of all cancer survivors in the United States. While guidelines exist for timely treatment and surveillance for recurrent disease, there is limited availability of guidelines that facilitate the provision of posttreatment clinical follow-up care to address the myriad of long-term and late effects that survivors may face. Based on recommendations set forth by a National Cancer Survivorship Resource Center expert panel, the American Cancer Society developed clinical follow-up care guidelines to facilitate the provision of posttreatment care by primary care clinicians. These guidelines were developed using a combined approach of evidence synthesis and expert consensus. Existing guidelines for health promotion, surveillance, and screening for second primary cancers were referenced when available. To promote comprehensive follow-up care and optimal health and quality of life for the posttreatment survivor, the guidelines address health promotion, surveillance for prostate cancer recurrence, screening for second primary cancers, long-term and late effects assessment and management, psychosocial issues, and care coordination among the oncology team, primary care clinicians, and nononcology specialists. A key challenge to the development of these guidelines was the limited availability of published evidence for management of prostate cancer survivors after treatment. Much of the evidence relies on studies with small sample sizes and retrospective analyses of facility-specific and population databases.
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Affiliation(s)
- Ted A Skolarus
- Assistant Professor of Urology, Department of Urology, University of Michigan, Research Investigator, HSR&D Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI
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Ringash J. Facing head and neck cancer deaths head on: Lessons for survival. Cancer 2014; 120:1446-9. [DOI: 10.1002/cncr.28585] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Accepted: 12/25/2013] [Indexed: 11/09/2022]
Affiliation(s)
- Jolie Ringash
- The Princess Margaret Cancer Centre and The University of Toronto; Toronto Canada
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Skolarus LE, Burke JF, Brown DL, Freedman VA. Understanding stroke survivorship: expanding the concept of poststroke disability. Stroke 2013; 45:224-30. [PMID: 24281223 DOI: 10.1161/strokeaha.113.002874] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Limitations in essential daily activities are common among older adults after stroke, but little is known about restrictions in their ability to participate in valued social activities. We sought to broaden our understanding of disability after stroke by characterizing poststroke participation restrictions and investigating the extent to which they are accounted for by differences in physical and cognitive capacity, aphasia/dysarthria, depressive, and anxiety symptoms. METHODS Data from the 2011 National Health and Aging Trends Study (NHATS) were used to identify 892 self-reported stroke survivors aged≥65 years. One-to-one propensity matching was performed on demographics and comorbidities to create a matched sample. Participation restrictions were defined as reductions/absence in social activities valued by respondents because of their health or functioning. Physical and cognitive capacity, depressive and anxiety symptoms were measured by validated scales and aphasia/dysarthria by a single question. Comparisons using survey-weighted χ2 tests and logistic regression were made. RESULTS Stroke survivors had more participation restrictions (32.8% versus 23.5%; odds ratio, 1.59; 95% confidence interval, 1.28-1.95; P<0.01) than controls. Differences between stroke survivors and controls in any participation restriction and several components (attending religious service, clubs/classes, and going out for enjoyment) were eliminated after adjusting for physical capacity. Depressive and anxiety symptoms and aphasia/dysarthria were independent predictors of participation restrictions. CONCLUSIONS Stroke survivors have more participation restrictions than can be accounted for by sociodemographic profiles and comorbidity burden. Future work aimed at improving physical capacity, reducing depressive and anxiety symptoms, and improving aphasia/dysarthria has potential to enhance participation.
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Affiliation(s)
- Lesli E Skolarus
- From the Stroke Program (L.E.S., J.F.B., D.L.B.) and Institute for Social Research (V.A.F.), University of Michigan, Ann Arbor; and Center for Clinical Management and Research, Ann Arbor, VA (J.F.B.)
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LeMasters T, Madhavan S, Sambamoorthi U, Kurian S. A population-based study comparing HRQoL among breast, prostate, and colorectal cancer survivors to propensity score matched controls, by cancer type, and gender. Psychooncology 2013; 22:2270-82. [PMID: 23606210 PMCID: PMC4892175 DOI: 10.1002/pon.3288] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Revised: 02/21/2013] [Accepted: 03/04/2013] [Indexed: 11/10/2022]
Abstract
BACKGROUND Objectives were to compare health-related quality of life (HRQoL) between breast cancer survivors, prostate cancer survivors (PCS), and colorectal cancer survivors (CCS) to matched controls, stratified by short and long-term survivors, by cancer type, and gender. METHODS By using the 2009 Behavioral Risk Factor Surveillance System, propensity scores matched three controls to adult survivors >1 year past diagnosis (N = 11,964) on age, gender, race/ethnicity, income, insurance status, and region of the USA Chi-square tests and logistic regression models compared HRQoL outcomes (life satisfaction, activity limitations, sleep quality, emotional support, general, physical, and mental health). RESULTS Although all cancer survivors reported worse general health (p < 0.000) and more activity limitations (p < 0.004) than controls, these disparities decreased among long-term survivors. Short-term PCS and male CCS were more likely to report worse outcomes across additional domains of HRQoL than controls, but PCS were 0.61, 0.63, and 0.70 times less likely to report activity limitations, fair/poor general health, and 1-15 bad physical health days in the past month than male CCS. Breast cancer survivors and female CCS were 2.12 and 3.17, 1.58 and 1.86, and 1.49 and 153, respectively, times more likely to report rarely/never receiving needed emotional support, 1-15 bad mental health days in the past month, and not receiving enough sleep 1-15 days in the past month than PCS and male CCS. CONCLUSIONS Cancer survivors experience worse HRQoL than similar individuals without a history of cancer and the severity of affected HRQoL domains differ by time since diagnosis, cancer type, and gender.
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Affiliation(s)
- Traci LeMasters
- West Virginia University, School of Pharmacy, Department of Pharmaceutical Systems and Policy, Morgantown, WV, USA
| | - Suresh Madhavan
- West Virginia University, School of Pharmacy, Department of Pharmaceutical Systems and Policy, Morgantown, WV, USA
| | - Usha Sambamoorthi
- West Virginia University, School of Pharmacy, Department of Pharmaceutical Systems and Policy, Morgantown, WV, USA
| | - Sobha Kurian
- West Virginia University, Mary Babb Randolph Cancer Center, Morgantown, WV, USA
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Mulder RL, Hudson MM, Skinner R, Kremer LCM. Health problems in survivors of childhood cancer: the need for international collaboration in long-term follow-up care. Future Oncol 2013; 9:1667-70. [PMID: 23734706 DOI: 10.2217/fon.13.107] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Renée L Mulder
- Department of Pediatric Oncology, Emma Children's Hospital/Academic Medical Center, Amsterdam, The Netherlands
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McCabe MS, Bhatia S, Oeffinger KC, Reaman GH, Tyne C, Wollins DS, Hudson MM. American Society of Clinical Oncology statement: achieving high-quality cancer survivorship care. J Clin Oncol 2013; 31:631-40. [PMID: 23295805 DOI: 10.1200/jco.2012.46.6854] [Citation(s) in RCA: 331] [Impact Index Per Article: 30.1] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Affiliation(s)
- Mary S McCabe
- Memorial Sloan-Kettering Cancer Center, New York, NY, USA
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Nekhlyudov L, Greene SM, Chubak J, Rabin B, Tuzzio L, Rolnick S, Field TS. Cancer research network: using integrated healthcare delivery systems as platforms for cancer survivorship research. J Cancer Surviv 2012; 7:55-62. [PMID: 23239136 DOI: 10.1007/s11764-012-0244-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2012] [Accepted: 09/22/2012] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Much progress has been made in cancer survivorship research, but there are still many unanswered questions that can and need to be addressed by collaborative research consortia. METHODS Since 1999, the National Cancer Institute-funded HMO Cancer Research Network (CRN) has engaged in a wide variety of research focusing on cancer survivorship. With a focus on thematic topics in cancer survivorship, we describe how the CRN has contributed to research in cancer survivorship and the resources it offers for future collaborations. RESULTS We identified the following areas of cancer survivorship research: surveillance for and predictors of recurrences, health care delivery and care coordination, health care utilization and costs, psychosocial outcomes, cancer communication and decision making, late effects of cancer and its treatment, use of and adherence to adjuvant therapies, and lifestyle and behavioral interventions following cancer treatment. CONCLUSIONS With over a decade of experience using cancer data in community-based settings, the CRN investigators and their collaborators are poised to generate evidence in cancer survivorship research. IMPLICATIONS FOR CANCER SURVIVORS Collaborative research within these settings can improve the quality of care for cancer survivors within and beyond integrated health care delivery systems.
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Affiliation(s)
- Larissa Nekhlyudov
- Department of Population Medicine Harvard Medical School/Harvard Pilgrim Health Care Institute Department of Medicine Harvard Vanguard Medical Associates, Boston, MA 02215, USA.
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Elena JW, Travis LB, Simonds NI, Ambrosone CB, Ballard-Barbash R, Bhatia S, Cerhan JR, Hartge P, Heist RS, Kushi LH, Lash TL, Morton LM, Onel K, Pierce JP, Robison LL, Rowland JH, Schrag D, Sellers TA, Seminara D, Shu XO, Thomas NE, Ulrich CM, Freedman AN. Leveraging epidemiology and clinical studies of cancer outcomes: recommendations and opportunities for translational research. J Natl Cancer Inst 2012. [PMID: 23197494 DOI: 10.1093/jnci/djs473] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
As the number of cancer survivors continues to grow, research investigating the factors that affect cancer outcomes, such as disease recurrence, risk of second malignant neoplasms, and the late effects of cancer treatments, becomes ever more important. Numerous epidemiologic studies have investigated factors that affect cancer risk, but far fewer have addressed the extent to which demographic, lifestyle, genomic, clinical, and psychosocial factors influence cancer outcomes. To identify research priorities as well as resources and infrastructure needed to advance the field of cancer outcomes and survivorship research, the National Cancer Institute sponsored a workshop titled "Utilizing Data from Cancer Survivor Cohorts: Understanding the Current State of Knowledge and Developing Future Research Priorities" on November 3, 2011, in Washington, DC. This commentary highlights recent findings presented at the workshop, opportunities to leverage existing data, and recommendations for future research, data, and infrastructure needed to address high priority clinical and research questions. Multidisciplinary teams that include epidemiologists, clinicians, biostatisticians, and bioinformaticists will be essential to facilitate future cancer outcome studies focused on improving clinical care of cancer patients, identifying those at high risk of poor outcomes, and implementing effective interventions to ultimately improve the quality and duration of survival.
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Affiliation(s)
- Joanne W Elena
- Clinical and Translational Epidemiology Branch, DCCPS 6130 Executive Blvd, rm 5136 Bethesda, MD 20892, USA.
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Abstract
Although obesity is a well-known risk factor for several cancers, its role on cancer survival is poorly understood. We conducted a systematic literature review to assess the current evidence evaluating the impact of body adiposity on the prognosis of the three most common obesity-related cancers: prostate, colorectal, and breast. We included 33 studies of breast cancer, six studies of prostate cancer, and eight studies of colo-rectal cancer. We note that the evidence overrepresents breast cancer survivorship research and is sparse for prostate and colorectal cancers. Overall, most studies support a relationship between body adiposity and site-specific mortality or cancer progression. However, most of the research was not specifically designed to study these outcomes and, therefore, several methodological issues should be considered before integrating their results to draw conclusions. Further research is urgently warranted to assess the long-term impact of obesity among the growing population of cancer survivors.
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Affiliation(s)
- Niyati Parekh
- Department of Nutrition, Food Studies and Public Health, New York University, New York, NY 10003, USA
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