Cognitive Function and Emotional Vulnerability in Metastatic Breast Cancer: Moderating Effects of Age and Social Support

9581 Background: Previous metastatic breast cancer trials have shown lower overall survival among African American (AA) women. Studies have also shown links between higher comorbidities and lower levels of social support and survival. Whether these factors differ by race and ethnicity is not known. Methods: Breast cancer patients enrolling in a phase III cooperative group metastatic breast cancer trial completed a self-administered survey measuring psychosocial and socio-demographic factors and comorbidities. Results were analyzed by self-identified race/ethnicity and evaluated by other measured variables. Results: 703 out of 799 patients completed the survey (88%). Questions were answered by greater than 95% of participants. The table shows differences broken down by Race/Ethnicity. AA and Hispanic (H) patients were more likely to have trouble paying for medications and have incomes less than 15K per year. AA were less likely to be married, and had lower levels of social support. Differences in income did not mediate these social support differences. Marital status did not mediate lower social support for AA (p=0.79) but did so for whites (p<0.001) Conclusions: Compliance with the questionnaire was quite high. Differences in social support by race were apparent and were mediated by different factors according to race. Future efforts will analyze the impact of these factors on survival and as mediators for potential racial and ethnic differences in survival. [Table: see text]

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A qualitative study of the experiences of women with metastatic breast cancer

Palliative & Supportive Care ◽

10.1017/s1478951508000382 ◽

2008 ◽

Vol 6 (3) ◽

pp. 249-258 ◽

Cited By ~ 41

Author(s):

Ruvanee P. Vilhauer

Keyword(s):

Breast Cancer ◽

Social Support ◽

Metastatic Breast Cancer ◽

Qualitative Study ◽

Daily Activity ◽

Metastatic Breast ◽

Physical Symptoms ◽

Online Support Group ◽

Rich Description ◽

Experiences Of Women

ABSTRACTObjective:My objective was to investigate the experiences of women diagnosed with metastatic breast cancer.Method:I did a qualitative study based on interview data. Fourteen women with metastatic breast cancer were recruited into a larger study of online support group use. Participants were interviewed by phone.Results:The women indicated that they experience distress because of concerns about body image, declines in aspects of their sexual lives, and worries about the effect of stress on their illness. The stress that worries these women comes from fear of dying, fear of disease progression and debilitation, the loss of their future, and practical concerns. The women were also likely to experience a decline in daily activity after being diagnosed with metastatic disease. They become less active because of the physical symptoms of the illness and the side effects of treatments, the medicalization of their lifestyle, their desire to avoid stressful situations, the constraints imposed by their social world, and the need to maintain disability benefits. Although women are often in need of emotional and material support from others after they are diagnosed, social support can decrease, both because women find it difficult to be open about the difficulties they face and because the responses of others are not adequately supportive. Distress and declines in daily activity and social support can feed into each other to create a vicious circle.Significance of results:This paper makes a significant contribution to the literature by providing a rich description of how metastatic breast cancer affects women. Further research, with more diverse samples, is needed in this understudied area.

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Social Support and Salivary Cortisol in Women With Metastatic Breast Cancer

Psychosomatic Medicine ◽

10.1097/00006842-200005000-00007 ◽

2000 ◽

Vol 62 (3) ◽

pp. 337-345 ◽

Cited By ~ 161

Author(s):

Julie M. Turner-Cobb ◽

Sandra E. Sephton ◽

Cheryl Koopman ◽

Jane Blake-Mortimer ◽

David Spiegel

Keyword(s):

Breast Cancer ◽

Social Support ◽

Metastatic Breast Cancer ◽

Salivary Cortisol ◽

Metastatic Breast

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47 The impact of supportive-expressive group therapy (SEGT) as an intervention on health-related outcomes and social support for people with advanced disease: a systematic review

BMJ Supportive & Palliative Care ◽

10.1136/bmjspcare-2018-mariecurie.47 ◽

2018 ◽

Vol 8 (3) ◽

pp. 377.2-378

Author(s):

Eva Bei ◽

Nuriye Kupeli ◽

Bridget Candy

Keyword(s):

Breast Cancer ◽

Social Support ◽

Metastatic Breast Cancer ◽

Group Therapy ◽

Full Text ◽

Advanced Disease ◽

Metastatic Breast ◽

Free Text ◽

Health Related

IntroductionSEGT has been found to be a valuable manualised model of therapy for reducing emotional distress facilitating the person’s management of the disease-related symptoms and improving quality of life in cancer populations (Butler et al. 2009; Classen et al. 2001; Lemieux et al. 2007). The fundamental domains covered by this model include promoting emotional expression confronting existential issues and optimising social support (Classen et al. 2001; Spiegel Bloom and Yalom 1981). Despite trials there are to our knowledge no systematic reviews that have sought to critic and pool evidence from all Randomised Controlled Trials (RCTs) on SEGT for people with advanced disease.AimsTo critique and pool the evidence from RCTs on the effectiveness of SEGT as a palliative care intervention for patients with advanced disease.MethodsFour databases (Pubmed Medline CINAHL PsycINFO) conference proceedings and grey literature were searched for relevant studies in April 2018. A combination of MeSH and free-text terms on SEGT and end-of-life were used. Key review processes will be undertaken in duplicate. If appropriate meta-analysis will be considered.ResultsThe search identified unique 2291 citations. Screening these identified 27 potential relevant studies. Following full text review and contact with the authors of not-available full text papers five RCTs on SEGT met our inclusion criteria.ConclusionsThis review is at data extraction phase it will be completed by September. Further understanding of the quality of evidence impact of SEGT on health-related outcomes and social support will allow conclusion to be made for clinical practice.References. Butler LD, Koopman C, Neri E, Giese-Davis J, Palesh O, Thorne-Yocam KA, Dimiceli S, Chen X, Fobair P, Kraemer HC, Spiegel D. Effects of supportive-expressive group therapy on pain in women with metastatic breast cancer. Health Psychology2009;28(5):579–587.. Classen C, Butler LD, Koopman C, Miller E, DiMiceli S, Giese- Davis J, Fobair P, Carlson RW, Kraemer EC, Spiegel D. Supportive-expressive group therapy and distress in patients with metastatic breast cancer: A randomized clinical intervention trial. Archives of General Psychiatry2001;58:494–495.. Lemieux J, Beaton ED, Hogg-Johnson S, Bordeleau JL, Hunter J, Goodwin PJ. Responsiveness to change to change due to supportive-expressive group therapy improvement in mood and disease progression in women with metastatic breast cancer. Qual Life Res2007;16:1007–1017.. Spiegel D, Bloom JR, Yalom I. Group support for patients with metastatic cancer. A randomized outcome study. Archives of General Psychiatry1981;38:527–533.

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Prospective study comparing self-administered geriatric assessment to provider’s routine clinical assessment of older patients with metastatic breast cancer treated at community oncology practices.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.12029 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. 12029-12029

Author(s):

Rino S. Seedor ◽

Caitlin R. Meeker ◽

Bianca Lewis ◽

Elizabeth A. Handorf ◽

Kelly A. Filchner ◽

...

Keyword(s):

Breast Cancer ◽

Social Support ◽

Metastatic Breast Cancer ◽

Prospective Study ◽

Geriatric Assessment ◽

Metastatic Breast ◽

Timed Up And Go ◽

High Detection Rate ◽

Ecog Ps ◽

A Prospective Study

12029 Background: Geriatric Assessment (GA) is recommended for evaluating an older cancer patient’s (pt) fitness for treatment. We conducted a prospective study evaluating the current gaps that exist in the assessment of older pts with metastatic breast cancer (MBC) in community practices (CP). Methods: Self-administered validated GA was compared to provider assessment (PA) of MBC pts ≥ 65-years-old treated at CP in the US. Providers were blinded to the GA results until their evaluation was completed. Differences in PA vs GA detected abnormalities were assessed using McNemar’s test. The effect of patient/provider factors on the rate of abnormalities not identified was assessed using regression models, clustering by provider and adjusting for the number of prior pts seen. Results: 100 pts were enrolled across 9 CP (median age 73.9, (65-90)). GA detected a total of 356 abnormalities in 96/100 (96%) pts, of which 223 required immediate interventions. African American and widowed/single pts were more likely to have abnormalities identified by GA. On average PA did not identify abnormalities detected by validated GA in 2 of 8 domains. 73% of functional status, 86% of social support, 44% of nutritional, and 96% of cognitive abnormalities detected by GA were not identified by PA (all P < 0.0001). Providers with more years of clinical experience were more likely to identify abnormalities (compared to < 5 years (y) in practice: 5-10 y in practice, p = 0.149; 11-15 y in practice, p = 0.028; > 15 y in practice, p = 0.017). GA had the most significant impact on pts with decreased ECOG PS (p = 0.045). Pts found to have an abnormal Timed Up and Go (TUG) test were more likely to have additional abnormalities in other domains (mean 4.3 vs 2.1, Wilcoxon p < 0.001), and more abnormalities not identified by the PA (p < 0.001). Providers were “surprised” by GA results in 33% of cases, mainly with cognitive or social support findings, and reported plans for management change for 40% of pts based on GA findings. Conclusions: Including a GA in the care of older pts with MBC in CP is beneficial as validated GA has a high detection rate of abnormalities not detected by PA.

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