1
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Rainer QC, Dubin JM, Balaji NC, Troesch V, Terry W, Monga V, Clifford L, Shoag J, Greer A, Nackeeran S, Rodriguez AA, Patel P, Paz L, Kava BR, Alperstein W, Pearlman AM, Ramasamy R. Sexual Dysfunction Among Adolescent and Young Adult Men Diagnosed with Cancer. J Adolesc Young Adult Oncol 2023; 12:93-100. [PMID: 35319264 DOI: 10.1089/jayao.2021.0211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: Adolescent and young adult (AYA) cancer patients frequently demonstrate sexual dysfunction; however, there is a lack of data quantifying the severity and frequency. Methods: Males aged 18-39 years, diagnosed with cancer of any kind and who were scheduled to begin, were actively receiving, or had completed cancer treatment within 6 months, were offered validated surveys during their oncology appointment. These surveys included the International Index of Erectile Function (IIEF-6), Masturbation Erection Index (MEI), 36-Item Short Form Survey, and 5-point Likert scales to assess their desire and ability to engage in sex and masturbation. Results: Forty subjects completed the IIEF survey with a mean score of 17.7 ± 11, erectile dysfunction (ED) prevalence accordingly was 58%. Thirty-eight subjects completed the MEI with a mean score of 25.3 ± 5.3, ED prevalence was again 58%. Age and IIEF scores demonstrated a statistically significant (p < 0.05, n = 38) Pearson's correlation coefficient of 0.40, patients younger than 30 years had an ED prevalence of 72% (mean IIEF 13), whereas patients aged 30 years and older had an ED prevalence of 45% (mean IIEF 22). All treatment modalities had ED rates >30%: chemotherapy demonstrated the highest prevalence at 64% (mean IIEF 17), whereas radiation therapy had the lowest prevalence at 33% (mean IIEF 23). Conclusion: This study demonstrates that the prevalence of sexual dysfunction among male AYA patients undergoing treatment for cancer is high. AYA oncologists should discuss potential sexual health concerns when treating this population. The exact cause of ED (non-organic vs. organic) within this group should be explored further.
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Affiliation(s)
- Quinn Carroll Rainer
- Department of Urology, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Justin Michael Dubin
- Department of Urology, Miller School of Medicine, University of Miami, Miami, Florida, USA.,Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | | | - Victoria Troesch
- Department of Urology, University of Texas Southwestern, Dallas, Texas, USA.,Department of Urology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - William Terry
- Department of Pediatrics, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Varun Monga
- Department of Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Lindsey Clifford
- Department of Oncology, The University of Iowa Holden Comprehensive Cancer Center, Iowa City, Iowa, USA
| | - Jamie Shoag
- Department of Pediatric Hematology and Oncology, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Aubrey Greer
- Department of Urology, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Sirpi Nackeeran
- Department of Urology, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | | | - Premal Patel
- Department of Urology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Lisa Paz
- Department of Urology, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Bruce Richard Kava
- Department of Urology, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Warren Alperstein
- Department of Pediatric Hematology and Oncology, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Amy Marcia Pearlman
- Department of Urology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Ranjith Ramasamy
- Department of Urology, Miller School of Medicine, University of Miami, Miami, Florida, USA
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2
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Morino T, Shinohara Y, Niu Q, Shimoura K, Tabata A, Hanai A, Ogawa M, Kato T, Tanimukai H, Tsuboyama T, Matsuoka M, Adachi S, Aoyama T. Perception Gap in Health-Related Quality of Life Between Young Adult Survivors of Childhood Cancer and Their Family. J Adolesc Young Adult Oncol 2021; 10:735-739. [PMID: 33691481 DOI: 10.1089/jayao.2020.0232] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Young adult survivors of childhood cancer may have a perception gap with their families. Patients aged 18-39 years after treatment of cancer and their families (28 pairs) completed a survey that contained questions on health-related quality of life using the 36-item short form survey. There was a significant difference in the role-social component score (mean difference -2.23; p = 0.04) with family reporting higher scores than patients. Families may overestimate the social function of cancer survivors, emphasizing the importance of the long-term follow-up by taking into account the risk of a gap (IRB approval No.: R2257-1).
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Affiliation(s)
- Tappei Morino
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yuki Shinohara
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Qian Niu
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kanako Shimoura
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ami Tabata
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Akiko Hanai
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Medical Sciences Innovation Hub Program, Institute of Physical and Chemical Research (RIKEN), Yokohama, Japan
| | - Masahiro Ogawa
- Faculty of Rehabilitation, Kobe Gakuin University, Kobe, Japan
| | - Toshihiro Kato
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hitoshi Tanimukai
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Department of Palliative Medicine, Kyoto University Hospital, Kyoto, Japan
| | - Tadao Tsuboyama
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,School of Health Sciences, Bukkyo University, Kyoto, Japan
| | - Mari Matsuoka
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Soichi Adachi
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tomoki Aoyama
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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3
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Lockwood BJ, Ntukidem OL, Ehrman SE, Schnell PM, Klemanski DL, Bhatnagar B, Lustberg M. Palliative Care Referral Patterns for Adolescent and Young Adult Patients at a Comprehensive Cancer Center. J Adolesc Young Adult Oncol 2020; 10:109-114. [PMID: 32706607 DOI: 10.1089/jayao.2020.0081] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Palliative care (PC) serves a valuable role throughout the disease trajectory for adolescents and young adults (AYAs) living with cancer. A 3-year retrospective chart review was performed to characterize AYA PC referral patterns in patients aged 18-39 years to identify strategies for improving PC access. Despite known benefits, AYA referrals to PC during oncologic treatment occurred only for a small percentage of eligible patients (8.4%), largely occurred in the inpatient setting (73%), and were more likely in specific cancer types with high symptom burden and/or poor survival, with the greatest penetrance noted in lung cancer (51%).
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Affiliation(s)
- Bethany J Lockwood
- Division of Palliative Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Olanipekun L Ntukidem
- Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Sarah E Ehrman
- Division of Palliative Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Patrick M Schnell
- Division of Biostatistics, The Ohio State University, Columbus, Ohio, USA
| | - Dori L Klemanski
- Patient Services Administration, The Ohio State University, Columbus, Ohio, USA
| | - Bhavana Bhatnagar
- Division of Hematology, and The Ohio State University, Columbus, Ohio, USA
| | - Maryam Lustberg
- Division of Medical Oncology, The Ohio State University, Columbus, Ohio, USA
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4
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Emerson MA, Reeder-Hayes KE, Tipaldos HJ, Bell ME, Sweeney MR, Carey LA, Earp HS, Olshan AF, Troester MA. Integrating biology and access to care in addressing breast cancer disparities: 25 years' research experience in the Carolina Breast Cancer Study. Curr Breast Cancer Rep 2020; 12:149-160. [PMID: 33815665 DOI: 10.1007/s12609-020-00365-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Purpose of Review To review research on breast cancer mortality disparities, emphasizing research conducted in the Carolina Breast Cancer Study, with a focus on challenges and opportunities for integration of tumor biology and access characteristics across the cancer care continuum. Recent Findings Black women experience higher mortality following breast cancer diagnosis, despite lower incidence compared to white women. Biological factors, such as stage at diagnosis and breast cancer subtypes, play a role in these disparities. Simultaneously, social, behavioral, environmental, and access to care factors are important. However, integrated studies of biology and access are challenging and it is uncommon to have both data types available in the same study population. The central emphasis of Phase 3 of the Carolina Breast Cancer Study, initiated in 2008, was to collect rich data on biology (including germline and tumor genomics and pathology) and health care access in a diverse study population, with the long term goal of defining intervention opportunities to reduce disparities across the cancer care continuum. Summary Early and ongoing research from CBCS has identified important interactions between biology and access, leading to opportunities to build greater equity. However, sample size, population-specific relationships among variables, and complexities of treatment paths along the care continuum pose important research challenges. Interdisciplinary teams, including experts in novel data integration and causal inference, are needed to address gaps in our understanding of breast cancer disparities.
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Affiliation(s)
- Marc A Emerson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC, USA.,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Katherine E Reeder-Hayes
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Heather J Tipaldos
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Mary E Bell
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Marina R Sweeney
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC, USA
| | - Lisa A Carey
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - H Shelton Earp
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Andrew F Olshan
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC, USA.,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Melissa A Troester
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC, USA.,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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5
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Tong EK, Wolf T, Cooke DT, Fairman N, Chen MS. The Emergence of a Sustainable Tobacco Treatment Program across the Cancer Care Continuum: A Systems Approach for Implementation at the University of California Davis Comprehensive Cancer Center. Int J Environ Res Public Health 2020; 17:E3241. [PMID: 32384731 PMCID: PMC7246517 DOI: 10.3390/ijerph17093241] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 04/27/2020] [Accepted: 04/28/2020] [Indexed: 12/25/2022]
Abstract
Tobacco treatment is increasingly recognized as important to cancer care, but few cancer centers have implemented sustainable tobacco treatment programs. The University of California Davis Comprehensive Cancer Center (UCD CCC) was funded to integrate tobacco treatment into cancer care. Lessons learned from the UCD CCC are illustrated across a systems framework with the Cancer Care Continuum and by applying constructs from the Consolidated Framework for Implementation Research. Findings demonstrate different motivational drivers for the cancer center and the broader health system. Implementation readiness across the domains of the Cancer Care Continuum with clinical entities was more mature in the Prevention domain, but Screening, Diagnosis, Treatment, and Survivorship domains demonstrated less implementation readiness despite leadership engagement. Over a two-year implementation process, the UCD CCC focused on enhancing information and knowledge sharing within the treatment domain with the support of the cancer committee infrastructure, while identifying available resources and adapting workflows for various cancer care service lines. The UCD CCC findings, while it may not be generalizable to all cancer centers, demonstrate the application of conceptual frameworks to accelerate implementation for a sustainable tobacco treatment program. Key common elements that may be shared across oncology settings include a state quitline for an adaptable intervention, cancer committees for outer/inner setting infrastructure, tobacco quality metrics for data reporting, and non-physician staff for integrated services.
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Affiliation(s)
- Elisa K. Tong
- Department of Internal Medicine, University of California, Davis, Sacramento, CA 95817, USA
| | - Terri Wolf
- Comprehensive Cancer Center, University of California, Davis, Sacramento, CA 95817, USA; (T.W.); (N.F.); (M.S.C.J.)
| | - David T. Cooke
- Department of Surgery, University of California, Davis, Sacramento, CA 95817, USA;
| | - Nathan Fairman
- Comprehensive Cancer Center, University of California, Davis, Sacramento, CA 95817, USA; (T.W.); (N.F.); (M.S.C.J.)
| | - Moon S. Chen
- Comprehensive Cancer Center, University of California, Davis, Sacramento, CA 95817, USA; (T.W.); (N.F.); (M.S.C.J.)
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6
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Munsie C, Ebert J, Joske D, Ackland T. The Benefit of Physical Activity in Adolescent and Young Adult Cancer Patients During and After Treatment: A Systematic Review. J Adolesc Young Adult Oncol 2019; 8:512-524. [PMID: 31090475 DOI: 10.1089/jayao.2019.0013] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Cancer and its associated therapies can severely impact the physical and psychosocial functioning of adolescent and young adults (AYAs), both during treatment and well into survivorship. Physical activity during and after cancer treatment could be beneficial to the AYA population, although this cohort has received little scientific attention. A systematic search of the literature was conducted to investigate current exercise interventions in AYA-specific populations. Studies were eligible for inclusion if >50% of the study population was aged between 15 and 25 years and the study included a physical activity intervention during or after cancer treatment. Studies were critically appraised using the Cochrane Risk of Bias tool. Six articles were identified as meeting the criteria, of which 2 were nonrandomized controlled studies and 4 were pilot studies, comprising a total of 135 AYA participants. The quality of studies was variable across all assessed domains. Direct comparison on intervention outcomes was not possible due to the heterogeneity of the studies; however, trends emerged on the feasibility, acceptability, and potential positive impact of physical activity in this cohort. This review highlights the lack of high-quality studies aimed to improve physical and psychosocial functioning in AYA patients across the cancer continuum. Physical activity interventions in this cohort appear to be feasible; however, larger randomized controlled trials are warranted to investigate the direct impact of interventions on health outcomes in this cohort.
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Affiliation(s)
- Claire Munsie
- School of Human Sciences, University of Western Australia, Perth, Australia.,WA Youth Cancer Service, Perth, Australia.,Sir Charles Gairdner Hospital, Perth, Australia
| | - Jay Ebert
- School of Human Sciences, University of Western Australia, Perth, Australia
| | - David Joske
- Sir Charles Gairdner Hospital, Perth, Australia
| | - Timothy Ackland
- School of Human Sciences, University of Western Australia, Perth, Australia
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7
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Church EC, Banks R, Wilson B, Arfons L, Perez F, Jump R. Improving pneumococcal vaccine uptake in veterans with chronic lymphocytic leukemia through a virtual clinic. ACTA ACUST UNITED AC 2018; 25:e95-e98. [PMID: 29507501 DOI: 10.3747/co.25.3756] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Through a "virtual clinic," we used the electronic medical record to identify and intervene upon patients with chronic lymphocytic leukemia (cll) who were not current for pneumococcal vaccines. Within 180 days, 100/160 patients (62%) received the recommended pneumococcal vaccine. A virtual clinic may improve vaccination rates among high-risk patient populations.
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Affiliation(s)
- E C Church
- Department of Medicine, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - R Banks
- Geriatric Research, Education and Clinical Center at the Louis Stokes Cleveland Department of Veterans Affairs Medical Center (lscvamc), Cleveland, Ohio
| | - B Wilson
- Geriatric Research, Education and Clinical Center at the Louis Stokes Cleveland Department of Veterans Affairs Medical Center (lscvamc), Cleveland, Ohio
| | - L Arfons
- Specialty Care Center of Innovation, lscvamc, Cleveland, Ohio.,Division of Hematology and Oncology; and
| | - F Perez
- Geriatric Research, Education and Clinical Center at the Louis Stokes Cleveland Department of Veterans Affairs Medical Center (lscvamc), Cleveland, Ohio.,Division Infectious Diseases and HIV Medicine, Department of Medicine at Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - R Jump
- Geriatric Research, Education and Clinical Center at the Louis Stokes Cleveland Department of Veterans Affairs Medical Center (lscvamc), Cleveland, Ohio.,Specialty Care Center of Innovation, lscvamc, Cleveland, Ohio.,Division Infectious Diseases and HIV Medicine, Department of Medicine at Case Western Reserve University School of Medicine, Cleveland, Ohio
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8
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Jach R, Pabian W, Spaczyński R, Szamatowicz J, Zbroch T, Knapp P, Smolarczyk R, Kolawa W, Bodnar L, Kurzawa R, Zawirska D, Krzakowski M, Radowicki S, Fijuth J, Wielgoś M, Wysocki P, Kozioł K, Zalewski K, Warzocha K, Hałaburda K, Rdwan M, Radwan P, Jabłoński MJ, Kojs Z, Wołczyński S, Pawelczyk L, Kluz T, Lukaszuk K. Recommendations of the Fertility Preservation Working Group in Oncological, Hematological and Other Patients Treated With Gonadotoxic Therapies "ONCOFERTILITY" (GROF) of the Polish Society of Oncological Gynecology. J Adolesc Young Adult Oncol 2017; 6:388-395. [PMID: 28657411 DOI: 10.1089/jayao.2017.0039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Robert Jach
- 1 Department of Endocrinologic Gynecology and Gynecology, University Hospital in Krakow , Krakow, Poland
| | - Wojciech Pabian
- 1 Department of Endocrinologic Gynecology and Gynecology, University Hospital in Krakow , Krakow, Poland
| | - Robert Spaczyński
- 2 Gynaecology and Obstetrics Clinical Hospital of K. Marcinkowski Medical University in Poznań , Poznań, Poland
| | | | - Tomasz Zbroch
- 4 Artemida-Gynaecology, Endocrinology and Reproductive Medicine Centre , Białystok, Poland
| | - Paweł Knapp
- 3 Medical University of Białystok , Białystok, Poland
| | - Roman Smolarczyk
- 5 Princess Anna Mazowiecka Clinical Hospital in Warsaw , Warsaw, Poland
| | - Wojciech Kolawa
- 6 G. Narutowicz Municipal Specialist Hospital in Krakow , Krakow, Poland
| | | | | | - Daria Zawirska
- 1 Department of Endocrinologic Gynecology and Gynecology, University Hospital in Krakow , Krakow, Poland
| | | | | | - Jacek Fijuth
- 10 Oncological Haematology Centre in Łódź , Łódź, Poland
| | | | - Piotr Wysocki
- 1 Department of Endocrinologic Gynecology and Gynecology, University Hospital in Krakow , Krakow, Poland
| | | | | | | | | | - Michał Rdwan
- 15 GAMETA Infertility Treatment Clinic , Rzgów, Poland
| | - Paweł Radwan
- 15 GAMETA Infertility Treatment Clinic , Rzgów, Poland
| | | | - Zbigniew Kojs
- 17 Oncology Centre-M. Skłodowska-Curie Institute , Krakow, Poland
| | | | - Leszek Pawelczyk
- 2 Gynaecology and Obstetrics Clinical Hospital of K. Marcinkowski Medical University in Poznań , Poznań, Poland
| | - Tomasz Kluz
- 18 Department of Obstetrics and Gynecology, Fryderyk Chopin University Hospital No 1, Faculty of Medicine, Rzeszow University , Rzeszow, Poland
| | - Krzysztof Lukaszuk
- 10 Oncological Haematology Centre in Łódź , Łódź, Poland,11 Medical University of Warsaw , Warsaw, Poland,12 "nOvum" Medical Clinic , Warsaw, Poland,13 Świętokrzyskie Oncology Centre , Kielce, Poland
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9
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Hughes RE, Holland LR, Zanino D, Link E, Michael N, Thompson KE. Prevalence and Intensity of Pain and Other Physical and Psychological Symptoms in Adolescents and Young Adults Diagnosed with Cancer on Referral to a Palliative Care Service. J Adolesc Young Adult Oncol 2016; 4:70-5. [PMID: 26812554 DOI: 10.1089/jayao.2014.0015] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE While adolescent and young adult (AYA) oncology is recognized as a distinct specialty, there remains a paucity of literature documenting symptomatology in this cohort. This study aimed to identify the prevalence, severity, and mechanism of pain and other symptoms in AYA patients referred to a palliative care service in a specialist Australian cancer center. METHODS A retrospective design analyzed the case file data of 33 eligible AYA patients aged 15-25 years old at diagnosis and two randomly selected control groups of patients >25 years old: unmatched and matched for diagnosis and sex. All cases were referred to the palliative care service between July 2009 and June 2012. Descriptive statistics, analysis of Edmonton Symptom Assessment Scale (ESAS) and Edmonton Classification System of Cancer Pain (ECS-CP) data, and non-parametric tests were performed. RESULTS The most common malignancies among the AYA patients were sarcoma and hematological cancers. All AYA patients reported pain syndrome on the ECS-CP compared with 85% of the matched controls (p=0.018). An age group effect was found for mechanisms of pain (p=0.035). A trend toward more neuropathic pain among AYA cases was also found (59% vs. 39%). The most common ESAS symptoms in AYAs were pain (91%), diminished well-being (76%), fatigue (75%), and decreased appetite (67%). CONCLUSION AYA cancer patients appear to experience a unique symptom profile with high symptom prevalence and complexity. Further research is warranted to identify determinants and inform integration of supportive and palliative care services for this unique patient cohort.
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Affiliation(s)
- Rachel E Hughes
- 1 ONTrac at Peter Mac, Victorian Adolescent and Young Adult Oncology Service, Peter MacCallum Cancer Centre , East Melbourne, Victoria, Australia
| | - Lucy R Holland
- 1 ONTrac at Peter Mac, Victorian Adolescent and Young Adult Oncology Service, Peter MacCallum Cancer Centre , East Melbourne, Victoria, Australia
| | - Diana Zanino
- 2 Centre for Biostatistics and Clinical Trials, Peter MacCallum Cancer Centre , East Melbourne, Victoria, Australia
| | - Emma Link
- 2 Centre for Biostatistics and Clinical Trials, Peter MacCallum Cancer Centre , East Melbourne, Victoria, Australia
| | | | - Kate E Thompson
- 1 ONTrac at Peter Mac, Victorian Adolescent and Young Adult Oncology Service, Peter MacCallum Cancer Centre , East Melbourne, Victoria, Australia
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10
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Sperling CD, Petersen GS, Hølge-Hazelton B, Graugaard C, Winther JF, Gudmundsdottir T, Ahrensberg J, Schmiegelow K, Boisen KA, Olsen PR, Heerdegen ACIS, Sonnenschein ES, Knudsen JL. Being Young and Getting Cancer: Development of a Questionnaire Reflecting the Needs and Experiences of Adolescents and Young Adults with Cancer. J Adolesc Young Adult Oncol 2016; 6:171-177. [PMID: 27654508 DOI: 10.1089/jayao.2015.0063] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE Cancer is the leading cause of nonaccidental deaths among adolescents and young adults (AYAs). In Denmark, there are substantial gaps in knowledge concerning how AYAs with cancer perceive their diagnostic and therapeutic trajectory and report health-related outcomes. The aim of this study is to describe the development of a questionnaire targeting AYAs with cancer aiming to evaluate treatment and survivorship from the perspective of the patients. METHODS Identification of themes and development of items included in the questionnaire were based on a synthesis of literature and qualitative interviews with AYAs in an iterative process involving both a professional advisory panel and a youth panel. During the development process, items were validated through cognitive interviews. RESULTS The final questionnaire contained 151 closed- and open-ended items divided into 6 sections regarding: (1) "Time before treatment," (2) "Being told about your illness," (3) "Being a young patient," (4) "Your treatment," (5) "Receiving help living with and after Cancer," and (6) "How are you feeling today?." One hundred one items were specifically developed for this study, while 50 were standardized validated indexes. The questionnaire combined different types of items such as needs, preferences, experiences, and patient-reported outcomes. CONCLUSION This is one of few developed questionnaires aiming to evaluate the perspective of AYAs with cancer through their whole cancer trajectory. Results from the questionnaire survey are intended for quality improvements and research in AYA cancer care. The study highlights the importance of an extensive patient involvement in all steps of a questionnaire development process.
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Affiliation(s)
| | | | - Bibi Hølge-Hazelton
- 2 University Hospital Zealand and The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen , Copenhagen, Denmark
| | - Christian Graugaard
- 3 Department of Clinical Medicine, Center for Sexology Research, Aalborg University , Aalborg, Denmark
| | - Jeanette Falck Winther
- 4 Danish Cancer Society Research Center , The Danish Cancer Society, Copenhagen, Denmark
| | | | - Jette Ahrensberg
- 5 The Research Unit for General Practice, Aarhus University , Aarhus, Denmark
| | - Kjeld Schmiegelow
- 6 Pediatrics and Adolescent Medicine, University Hospital Rigshospitalet , Copenhagen, Denmark
| | - Kirsten A Boisen
- 7 Center of Adolescent Medicine, University Hospital Rigshospitalet , Copenhagen, Denmark
| | - Pia Riis Olsen
- 8 Department of Oncology, Aarhus University Hospital , Aarhus, Denmark
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11
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Abstract
PURPOSE Most adolescent and young adult (AYA)-aged childhood cancer survivors develop physical and/or psychosocial sequelae; however, many do not receive long-term follow-up (LTF) critical for screening, prevention, and treatment of late effects. To develop a health services research agenda to optimize care models, we conducted qualitative research with LTF providers examining existing models, and successes and challenges in maintaining survivors' connections to care across their transition to adulthood. METHODS We interviewed 20 LTF experts (MDs, RNs, social workers, education specialists, psychologists) from 10 Children's Oncology Group-affiliated institutions, and analyzed data using grounded theory and content analysis techniques. RESULTS Participants described the complexity of survivors' healthcare transitions. Survivors had pressing educational needs in multiple domains, and imparting the need for prevention was challenging. Multidisciplinary LTF teams focused on prevention and self-management. Care and decisions about transfer were individualized based on survivors' health risks, developmental issues, and family contexts. An interplay of provider and institutional factors, some of which were potentially modifiable, also influenced how transitions were managed. Interviewees rarely collaborated with community primary care providers to comanage patients. Communication systems and collective norms about sharing care limited comanagement capacity. Interviewees described staffing practices, policies, and informal initiatives they found reduced attrition. CONCLUSIONS Results suggest that survivors will benefit from care models that better connect patients, survivorship experts, and community providers for uninterrupted LTF across transitions. We propose research priorities, framing attrition from LTF as a public health concern, transition as the central challenge in LTF, and transition readiness as a multilevel concept.
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Affiliation(s)
- Mary S Mouw
- 1 Cancer Control Education Program, UNC-Lineberger Comprehensive Cancer Center, University of North Carolina , Chapel Hill, North Carolina.,2 Department of Health Behavior, UNC Gillings School of Global Public Health , Chapel Hill, North Carolina
| | - Eleanor A Wertman
- 2 Department of Health Behavior, UNC Gillings School of Global Public Health , Chapel Hill, North Carolina
| | - Clare Barrington
- 2 Department of Health Behavior, UNC Gillings School of Global Public Health , Chapel Hill, North Carolina
| | - Jo Anne L Earp
- 2 Department of Health Behavior, UNC Gillings School of Global Public Health , Chapel Hill, North Carolina
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12
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Swartz MC, Basen-Engquist KM, Markham C, Lyons EJ, Cox M, Chandra J, Ater JL, Askins MA, Scheurer ME, Lupo PJ, Hill R, Murray J, Chan W, Swank PR. Psychometric Analysis of the Three-Factor Eating Questionnaire-R18V2 in Adolescent and Young Adult-Aged Central Nervous System Tumor Survivors. J Adolesc Young Adult Oncol 2016; 5:278-85. [PMID: 27042872 DOI: 10.1089/jayao.2015.0058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
PURPOSE Adolescent and young adult (AYA)-aged central nervous system (CNS) tumor survivors are an understudied population that is at risk of developing adverse health outcomes, such as obesity. Long-term follow-up guidelines recommend monitoring those at risk of obesity, thus motivating the need for an eating behavior questionnaire. An abbreviated online version of the Three-Factor Eating Questionnaire (TFEQ-R18v2) has been developed, but its applicability to this population is not yet known. This study investigated the instrument's factor structure and reliability in this population. METHODS AYA-aged CNS tumor survivors (n = 114) aged 15-39 years completed the TFEQ-R18V2 questionnaire online. Confirmatory factor analysis was used to examine the fit of the three-factor structure (uncontrollable eating, cognitive restraint, and emotional eating [EE]) and reliability (internal consistency of the TFEQ-R18v2). Associations between the three factors and body mass index (BMI) were assessed by linear regression. RESULTS The theorized three-factor structure was supported in our population (RMSEA = 0.056 and CFI = 0.98) and demonstrated good reliability (α of 0.81-0.93). EE (β = 0.07, 95% CI 0.02-0.13) was positively associated with BMI, whereas the other two subscale scores were not. CONCLUSION The TFEQ-R18v2 instrument holds promise for research and clinical use among AYA-aged CNS tumor survivors. The instrument may be a useful tool for researchers to develop tailored weight management strategies. It also may be a valuable tool for clinicians to monitor survivors who are at risk of obesity and to facilitate referral. Our results also suggest that EE in this population should be further investigated as a potential target for intervention.
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Affiliation(s)
- Maria C Swartz
- 1 Division of Rehabilitation Sciences, The University of Texas Medical Branch , Galveston, Texas
| | - Karen M Basen-Engquist
- 2 Department of Behavioral Science, The University of Texas MD Anderson Cancer Center , Houston, Texas
| | - Christine Markham
- 3 Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas
| | - Elizabeth J Lyons
- 1 Division of Rehabilitation Sciences, The University of Texas Medical Branch , Galveston, Texas
| | - Matthew Cox
- 2 Department of Behavioral Science, The University of Texas MD Anderson Cancer Center , Houston, Texas
| | - Joya Chandra
- 4 Division of Pediatrics, The University of Texas MD Anderson Cancer Center , Houston, Texas
| | - Joann L Ater
- 4 Division of Pediatrics, The University of Texas MD Anderson Cancer Center , Houston, Texas
| | - Martha A Askins
- 4 Division of Pediatrics, The University of Texas MD Anderson Cancer Center , Houston, Texas
| | | | - Philip J Lupo
- 5 Department of Pediatrics, Baylor College of Medicine , Houston, Texas
| | - Rachel Hill
- 6 Department of Hematology & Oncology, Cook Children's Medical Center , Fort Worth, Texas
| | - Jeffrey Murray
- 6 Department of Hematology & Oncology, Cook Children's Medical Center , Fort Worth, Texas
| | - Wenyaw Chan
- 7 Department of Biostatistics, The University of Texas Health Science Center at Houston School of Public Health , Houston, Texas
| | - Paul R Swank
- 3 Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas
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13
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Wigfall LT, Bynum SA, Brandt HM, Friedman DB, Bond SM, Lazenby GB, Richter DL, Glover SH, Hébert JR. Cervical Cancer Prevention Knowledge and Abnormal Pap Test Experiences Among Women Living with HIV/AIDS. J Cancer Educ 2015; 30:213-9. [PMID: 24928481 PMCID: PMC4266621 DOI: 10.1007/s13187-014-0688-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Cervical cancer prevention knowledge deficits persist among women living with HIV/AIDS (WLHA) despite increased risk of developing cervical dysplasia/cancer. We examined associations between WLHA's cervical cancer prevention knowledge and abnormal Pap test history. We recruited 145 urban and rural WLHA from Ryan White-funded clinics and AIDS service organizations located in the southeastern USA between March 2011 and April 2012. For this analysis, women who reported a history of cervical cancer (n = 3) or had a complete hysterectomy (n = 14) and observations with missing data (n = 22) were excluded. Stata/IC 13 was used to perform cross-tabulations and chi-squared tests. Our sample included 106 predominantly non-Hispanic Black (92%) WLHA. Mean age was 46.3 ± 10.9 years. Half (50%) had ≤ high school education. One third (37%) had low health literacy. The majority (83 %) had a Pap test <1 year ago, and 84 % knew that WLHA should have a Pap test every year, once two tests are normal. Many (68%) have had an abnormal Pap test. Abnormal Pap test follow-up care knowledge varied. While 86% knew follow-up care could include a repeat Pap test, only 56% knew this could also include an HPV test. Significantly, more women who had an abnormal Pap test knew follow-up care could include a biopsy (p = 0.001). For WLHA to make informed/shared decisions about their cervical health, they need to be knowledgeable about cervical cancer care options across the cancer control continuum. Providing WLHA with prevention knowledge beyond screening recommendations seems warranted given their increased risk of developing cervical dysplasia/neoplasia.
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Affiliation(s)
- Lisa T Wigfall
- Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC, 29208, USA,
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14
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Sharp LK, Carvalho P, Southward M, Schmidt ML, Jabine LN, Stolley MR, Gerber BS. Electronic Personal Health Records for Childhood Cancer Survivors: An Exploratory Study. J Adolesc Young Adult Oncol 2014; 3:117-122. [PMID: 25276495 DOI: 10.1089/jayao.2013.0039] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Purpose: Childhood cancer survivors have complex healthcare needs that may be effectively communicated using electronic personal health records. This study explores the knowledge, interest, and attitudes of a sample of survivors and some of their caregivers towards electronic personal health records (ePHRs). Methods: This descriptive study was conducted in a pediatric hematology-oncology clinic and associated survivorship clinic with a convenience sample of caregivers of survivors who were <14 years old and survivors ≥14 years old along with their caregivers when present. A semi-structured interview was conducted with survivors and some caregivers to understand their knowledge, interest, and attitudes towards adoption of ePHRs. Results: Interviews were completed with 11 caregivers of young survivors, four survivors alone, and five survivor-caregiver dyads. Survivors ranged in age at diagnosis from 1 to 17 years old. Among the ethnically diverse sample, approximately half of the nine survivors and 25% of 16 caregivers reported having some knowledge of ePHRs. Eighty-nine percent (8/9) of the survivors and 81% (13/16) of the caregivers reported that they were somewhat or very comfortable using the internet. All nine survivors and 75% of caregivers were interested in the adoption of ePHRs. Data security and privacy were the primary concerns expressed. Conclusions: Interest in adoption of ePHRs to manage cancer survivorship-related health information was high. Most felt that the privacy and security concerns would not prevent adoption. Additional research is needed on larger and more representative samples of survivors to understand what types of support and education are needed to effectively implement ePHRs.
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Affiliation(s)
- Lisa K Sharp
- Section of Health Promotion Research, Department of Medicine, University of Illinois at Chicago , Chicago, Illinois
| | - Priscilla Carvalho
- Section of Health Promotion Research, Department of Medicine, University of Illinois at Chicago , Chicago, Illinois
| | - Matthew Southward
- Section of Health Promotion Research, Department of Medicine, University of Illinois at Chicago , Chicago, Illinois
| | - Mary Lou Schmidt
- Section of Pediatric Hematology-Oncology, Department of General Pediatrics, University of Illinois at Chicago , Chicago, Illinois
| | - Leslie N Jabine
- Department of General Pediatrics, University of Illinois at Chicago , Chicago, Illinois
| | - Melinda R Stolley
- Section of Health Promotion Research, Department of Medicine, University of Illinois at Chicago , Chicago, Illinois
| | - Ben S Gerber
- Section of Health Promotion Research, Department of Medicine, University of Illinois at Chicago , Chicago, Illinois. ; Center for Management of Complex Chronic Care, Jesse Brown VA Medical Center , Chicago, Illinois
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15
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Erickson JM, Adelstein KE, Letzkus LC. A Feasibility Study to Measure Physical Activity, Fatigue, Sleep-Wake Disturbances, and Depression in Young Adults During Chemotherapy. J Adolesc Young Adult Oncol 2014; 3:37-41. [PMID: 24669357 DOI: 10.1089/jayao.2013.0028] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Little is known about the physical activity (PA) of young adults (YAs) during cancer therapy. In this feasibility study, 14 YAs (20-34 years old) completed a six-minute walk test, recorded their steps per day for one week, and answered weekly self-reports about physical activity, fatigue, sleep-wake disturbances, and depression during one cycle of chemotherapy. Findings suggest YAs are willing to complete a PA study during chemotherapy and have variable sleep and activity schedules. Their symptoms varied in severity, with highest scores for fatigue. Studies to improve PA in YAs during chemotherapy are warranted to manage short- and long-term treatment effects.
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Affiliation(s)
- Jeanne M Erickson
- University of Virginia School of Nursing , Charlottesville, Virginia
| | | | - Lisa C Letzkus
- University of Virginia School of Nursing , Charlottesville, Virginia
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16
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Abstract
An 18-year-old male with a history of Charcot-Marie-Tooth disease (CMT) presented with metastatic Ewing sarcoma to the lungs. He had been followed by several healthcare professionals who ascribed his enlarging 23 cm gluteal mass to his CMT. The patient experienced a significant delay in diagnosis, not uncommon in sarcoma. This case explores the various system and cognitive errors that contributed to this delay.
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Affiliation(s)
- Ines B Menjak
- Department of Internal Medicine, University of Toronto , Toronto, Ontario, Canada
| | - Abha Gupta
- Hospital for Sick Children , Toronto, Ontario, Canada
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