Spirituality: its Dynamics and Purpose in Nursing a Person With a New Diagnosis of Cancer

e18552 Background: Cancer is the 2nd most common cause of death in the country, eclipsed only by heart disease. Cancer care is increasingly characterized by financial toxicity related to high-cost treatments, though it is unknown whether other chronic conditions impose similar financial harms. Methods: We conducted a retrospective analysis of the Health and Retirement Study participants interviewed between 2012-2018. This is a national, longitudinal survey conducted every two years of adults 50 and older and their spouses. We used fixed effect regression models to compare changes in financial debt among households with new diagnosis of cancer, other major chronic conditions (diabetes, stroke, or heart disease), and no new health diagnosis (or health shock). Since more affluent households may respond to health shocks differently, we estimated separate comparisons for households above versus below median wealth in 2012, prior to new health conditions. We assessed use of any non-housing financial debt, credit card debt, and home equity lines of credit among the subset of homeowning households. Results: In this study of 14,153 households, average age at interview was 62 years, with 43% male, 70% White, 22% Black, 13% Hispanic, and 70% with up to high school education. Of this population, 25% held credit card debt, 70% owned a home, 18% had a home equity line of credit, and 9% used a home equity line of credit. Among households with below median wealth when they entered the study in 2012 ( < $23,000 in $2016), a new cancer diagnosis was associated with a 4.7 percentage point increase in financial debt (12.5% effect size, p < 0.05). Participants diagnosed with a chronic condition (heart condition, stroke or diabetes) were 3.6 percentage points more likely to develop financial debt (9.6%, p < 0.05) compared to households that did not develop a new chronic condition. Such differences were eliminated in participants in a house with above median wealth. There was no difference in credit card debt, availability of home equity line of credit, or use of home equity line of credit for participants with a new diagnosis. Conclusions: New diagnosis of cancer or a chronic condition were associated with increased financial debt for older Americans living in a household that were below median wealth.

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New diagnosis of cancer and the risk of subsequent cerebrovascular events

Neurology ◽

10.1212/wnl.0000000000005636 ◽

2018 ◽

Vol 90 (23) ◽

pp. e2025-e2033 ◽

Cited By ~ 5

Author(s):

Babak B. Navi ◽

George Howard ◽

Virginia J. Howard ◽

Hong Zhao ◽

Suzanne E. Judd ◽

...

Keyword(s):

Confidence Interval ◽

Cancer Diagnosis ◽

Hazard Ratio ◽

Cerebrovascular Event ◽

Study Visit ◽

Baseline Study ◽

Cerebrovascular Events ◽

Diagnosis Of Cancer ◽

New Diagnosis

ObjectiveWe aimed to evaluate the association between cancer and cerebrovascular disease in a prospective cohort study with adjudicated cerebrovascular diagnoses.MethodsWe analyzed participants from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study who were 45 years and older and had Medicare coverage for 365 days before their baseline study visit. Participants with a history of cancer or cerebrovascular events were excluded. The time-dependent exposure was a new diagnosis of malignant cancer identified through Medicare claims algorithms. Participants were prospectively followed from their baseline study visit (2003–2007) through 2014 for the outcome of a neurologist-adjudicated cerebrovascular event defined as a composite of stroke (ischemic or hemorrhagic) or TIA. Cox regression was used to evaluate the association between a new cancer diagnosis and subsequent cerebrovascular events. Follow-up time was modeled in discrete time periods to fulfill the proportional hazard assumption.ResultsAmong 6,602 REGARDS participants who met eligibility criteria, 1,149 were diagnosed with cancer during follow-up. Compared to no cancer, a new cancer diagnosis was associated with subsequent cerebrovascular events in the first 30 days after diagnosis (hazard ratio 6.1, 95% confidence interval 2.7–13.7). This association persisted after adjustment for demographics, region of residence, and vascular risk factors (hazard ratio 6.6, 95% confidence interval 2.7–16.0). There was no association between cancer diagnosis and incident cerebrovascular events beyond 30 days. Cancers considered high risk for venous thromboembolism demonstrated the strongest associations with cerebrovascular event risk.ConclusionA new diagnosis of cancer is associated with a substantially increased short-term risk of cerebrovascular events.

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Distress screening for patients with a history of cancer during the COVID-19 pandemic.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e13537 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e13537-e13537

Author(s):

Brooke Worster ◽

Lauren Waldman ◽

Gregory D. Garber ◽

Subecha Dahal ◽

Adam F Binder ◽

...

Keyword(s):

Best Practice ◽

Cancer Center ◽

Cutoff Score ◽

Distress Screening ◽

Time Period ◽

History Of ◽

Diagnosis Of Cancer ◽

New Diagnosis ◽

Future Work ◽

The Impact

e13537 Background: Although a diagnosis of cancer is widely accepted as resulting in significant levels of distress, distress itself cannot be considered benign and screening for distress is considered a best practice metric for patients receiving oncological care. Endorsed by NCCN, the Distress Thermometer (DT) considers a cutoff score of 4 or greater to identify patient with clinically relevant levels of distress. We hypothesized that the COVID-19 pandemic would manifest with higher levels of stress and anxiety in most persons by compounding the distress experienced by patients with a diagnosis of cancer. Methods: Patients with a new diagnosis of cancer underwent distress screening with the DT prior to a clinical appointment at a NCI-designated academic cancer center. Patients who scored 4 or higher were discussed at an Interprofessional Supportive Medicine patient conference or referred to oncology social work for appropriate evaluation and therapeutic care. By mid-March 2020, the SKCC catchment area was under a public health emergency with limited access to non-essential healthcare; therefore, we present data from 1/1-3/15/20 (pre-pandemic), 3/16-6/7/20 (pandemic peak with 2000+ daily cases in late April and peak daily deaths 300+ in May), and 6/8-8/30/20 (daily cases generally less than 700 except for occasional levels of 1000-in July and daily deaths less than 40 daily). Results: In the pre-pandemic time period, 60% of patients assessed reported a score of 4 or higher. During the subsequent periods—the first pandemic peak and the first post-pandemic period—the incidence of an elevated distress screen (4 or higher) was relatively stable at about 30%. Conclusions: Contrary to expectations, the DT screen identified less patient distress during the pandemic compared to pre-pandemic. Our results may be due to multiple factors—changes in processes and procedures to prioritize DT screening as pandemic risk became more apparent; an increased use of telemedicine; and the compounding of new, non-cancer related stressors resulting in the greater resiliency noted in disaster psychology. For example, during the first pandemic peak when the majority of patients were seen via telemedicine, the opportunity afforded by telemedicine for safety and decreased risk for COVID-19 infection may have reduced the overall distress experience. In addition, the compounding of stressors—the diagnosis of cancer, the risk of the pandemic, and its economic and financial stressors—may have influenced distress perception. Future work incorporating multiple distress assessment points may help better understand the impact of the layers of stress experienced by persons with cancer.[Table: see text]

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Abstract WMP53: New Diagnosis of Cancer and the Risk of Subsequent Arterial Thromboembolic Events

Stroke ◽

10.1161/str.50.suppl_1.wmp53 ◽

2019 ◽

Vol 50 (Suppl_1) ◽

Author(s):

Babak B Navi ◽

George Howard ◽

Virginia J Howard ◽

Hong Zhao ◽

Suzanne E Judd ◽

...

Keyword(s):

Thromboembolic Events ◽

Diagnosis Of Cancer ◽

Arterial Thromboembolic Events ◽

New Diagnosis

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A study of US-based Indian and Pakistani population with cancer diagnosis reported in the SEER database from 1988 to 2002

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.20116 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 20116-20116

Author(s):

A. Hossain ◽

A. Sehbai ◽

J. Abraham

Keyword(s):

Cancer Incidence ◽

Asian Population ◽

Vital Statistics ◽

World Health ◽

Cancer Society ◽

Pakistani Population ◽

Breast And Cervical Cancer ◽

Diagnosis Of Cancer ◽

Health Organization ◽

New Diagnosis

20116 Background: Southeast Asian population comprises about 1.5% of the US population and one of the rapidly growing ethnic groups. This is the first study in US-based Indian and Pakistani patients with new diagnosis of cancer analyzing the epidemiologic data. Methods: SEER cancer incidence database have reported cancer incidence from 13 SEER registries from 1973 to 2002. Frequency sessions were performed and descriptive parameters were calculated regarding age, sex, marital status, vital statistics, stage, grade, tumor sites and other diagnostic tests employed. Results: About 11% of the estimated Indian and Pakistani population live in the 13 SEER registry areas. A total of 4,229 cases were reported since 1988 in this subcategory, which is about 0.03% of the total reported cases. 2148 (50.8%) were male and 2081 (49.2%) were female (p = 0.821). Average age at diagnosis was 51 years in male and 53 years in female (p = 0.7295). Table shows the incidence of different cancers compiled from American Cancer Society (ACS) (2005)1, SEER2 and World Health Organization (WHO) (2002)3 databases. Conclusions: Oral cavity cancer in males, and Breast and cervical cancer in females are common malignancies in India and Pakistan. Our study shows that prostate and breast cancer are most common in males and females in US-based Indian and Pakistani population respectively. Immigrants change their demographics regarding cancers and these differences could be attributed to multiple factors. This data may also have implications in terms of earlier screening of cancer in this population and earlier intervention. [Table: see text] No significant financial relationships to disclose.

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Bleeding linked with new diagnosis of cancer

Nature Reviews Cardiology ◽

10.1038/s41569-019-0288-9 ◽

2019 ◽

Vol 16 (12) ◽

pp. 700-700

Author(s):

Gregory B. Lim

Keyword(s):

Diagnosis Of Cancer ◽

New Diagnosis

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Children’s experiences of being diagnosed with cancer at the early stages of treatment; an interpretive phenomenological analysis

Clinical Child Psychology and Psychiatry ◽

10.1177/1359104518788400 ◽

2018 ◽

Vol 24 (1) ◽

pp. 3-18 ◽

Cited By ~ 3

Author(s):

Jill Mant ◽

Angela Kirby ◽

Kathy J Cox ◽

Amos Burke

Keyword(s):

Clinical Practice ◽

Interpretative Phenomenological Analysis ◽

Qualitative Methodology ◽

Phenomenological Analysis ◽

Interpretive Phenomenological Analysis ◽

Children And Families ◽

Structured Interviews ◽

Future Studies ◽

Diagnosis Of Cancer ◽

New Diagnosis

Being given a diagnosis of cancer is a significant and highly distressing event for both children and their families, but little research has been done to explore and understand children’s feelings. This study aims to understand from the child’s perspective what it feels like to be told you have cancer, with the hope that increased understanding can lead to improved communication and support for children and families. The study uses qualitative methodology. Six children aged 8–12 years with a new diagnosis of cancer took part in two semi-structured interviews at least one week apart. The interviews were conducted using the draw and write technique. The results were analysed using interpretative phenomenological analysis. The report describes the five super-ordinate themes that were identified; initially I felt shocked and scared, chemo is an awful thing, please talk to me; the more I know the better I feel, I will accept treatment and quickly get used to it because I know I will get better and, finally, my family are vital. Implications for clinical practice are discussed. The report highlights the research limitations and areas for future studies.

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Association between misty mesentery with baseline or new diagnosis of cancer: a matched cohort study

Clinical Imaging ◽

10.1016/j.clinimag.2017.12.006 ◽

2018 ◽

Vol 50 ◽

pp. 57-61

Author(s):

Sivan G. Marcus ◽

Susana Candia ◽

Marc D. Kohli ◽

John Mongan ◽

Ronald J. Zagoria ◽

...

Keyword(s):

Cohort Study ◽

Matched Cohort ◽

Matched Cohort Study ◽

Diagnosis Of Cancer ◽

New Diagnosis

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P477 Italian real-life study evaluating the long-term effectiveness of vedolizumab for the treatment of inflammatory bowel disease: the elderly cohort

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjz203.606 ◽

2020 ◽

Vol 14 (Supplement_1) ◽

pp. S419-S422

Author(s):

D Pugliese ◽

G Privitera ◽

A Armuzzi

Keyword(s):

Inflammatory Bowel Disease ◽

Adverse Events ◽

Bowel Disease ◽

Real Life ◽

Treatment Persistence ◽

Diagnosis Of Cancer ◽

Inflammatory Bowel ◽

New Diagnosis

Abstract Background Vedolizumab (VDZ) is the first biological therapy for Inflammatory Bowel Disease (IBD) tested, in pivotal trials, on patients up to 80 years old and has usually been presented as a safer choice in frail patients. However, real-world data on the effectiveness and safety of VDZ in elderly (≥ 65 years) are scarce. The aim of this study is to explore the effectiveness and safety of VDZ in a large real-life cohort of elderly IBD patients, with a 2 years follow-up. Methods The Long-term Italian Vedolizumab Effectiveness (LIVE) study included CD and UC patients started on VDZ from April 2016 to June 2017 at 40 centres of the Italian Group for the study of inflammatory bowel disease (IG-IBD). Patients were prospectively followed-up to June 2019. Co-primary endpoints were to evaluate cumulative VDZ treatment persistence and safety. Results Of 966 patients, 174 (18%; 81 CD, 93 UC) were ≥ 65 years old at enrolment. Mean disease duration at baseline was 10.9 years ± SD10 (CD 12.5 ± 11, UC 9.6 ± 9). VDZ was used as a first biologic therapy in 78 patients (44.8%). 25 patients (14.4%) had a history of previous cancer. The majority of CD patients had a stricturing behaviour (45, 55.6%) and had already undergone surgery (41, 49.4%). 48 UC patients (51.6%) had extensive colitis. Moderate-to-severe endoscopic activity was present in 80% of CD and in 92% of UC, according to SES-CD and endoscopic Mayo score, respectively. Cumulative VDZ treatment persistence at 12 and 24 months was 71.8% (71.6% CD and 72.0% UC) and 54% (54.2% CD and 53.8%% UC), respectively. 52.9% (40 CD; 52 UC), 4.0%, 3.5%% and 2.9% of patients were on concomitant steroids at baseline, 6, 12, and 24 months, respectively. Clinical remission at 12 and 24 months was achieved in 28.7% (31 CD and 29 UC) and in 31.6% (25 CD and 30 UC) of patients. Mean C-reactive protein was 15.6 mg/l ± SD 20 (CD 15.9 ± 21; UC 15.2 ± 19) at baseline and dropped to 8.4 mg/l ± 10 (CD 8.0 ± 8, UC 8.9 ± 11) at 12 months and to 5.9 mg/l ± 6 (CD 5.8 ± 5, UC 6 ± 7) at 24 months. Dose escalation was necessary for 20.3% and 24.7% of patients within the first 12 and 24 months. 44 adverse events were reported: 16 infections.,6 new diagnosis of cancer/dysplasia (2 colon, 1 kidney, 1 prostate, 1 lung, 1 melanoma), 4 arthritis, 3 skin rash, 2 drug-induced cholestasis,11 miscellaneous. 11 patients (6.3%) underwent VDZ withdrawal because of adverse events (6 new diagnosis of cancer/dysplasia; 4 infections; 1 cholestasis). One patient died for pneumonia complications. Conclusion In this preliminary analysis of the largest reported real-world cohorts of elderly IBD patients treated with VDZ, up to 55% of patients persisted on therapy after two years; an acceptable safety profile was observed throughout the entire follow-up period.

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