scholarly journals Exploring the employment readiness and return to work status of breast cancer patients and related factors

2021 ◽  
Vol 8 (4) ◽  
pp. 426-431
Author(s):  
Wenmin Hou ◽  
Qiaoping Li ◽  
Xiangyu Liu ◽  
Yingchun Zeng ◽  
Andy SK. Cheng
2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 10549-10549
Author(s):  
Jennifer A. Ligibel ◽  
Lori J. Pierce ◽  
Catherine M. Bender ◽  
Tracy E Crane ◽  
Christina Marie Dieli-Conwright ◽  
...  

10549 Background: Obesity and related factors are increasingly associated with increased risk of developing and dying from cancer. The American Society of Clinical Oncology (ASCO) conducted a survey of cancer patients to assess their experience in receiving recommendations and referrals related to weight, diet and exercise as a part of their cancer care. Methods: An online survey was distributed to potential participants between March and June 2020 via ASCO channels and patient advocacy organizations, with an estimated reach of over 25,000 individuals. Eligibility criteria included being 18 years, living in the US, and having been diagnosed with cancer. Logistic regression was used to determine factors associated with recommendation and referral patterns. Results: In total, 2419 individuals responded to the survey. Most respondents were female (75.5%), 61.8% had an early-stage malignancy, 38.2% had advanced disease, and 49.0% were currently receiving treatment. Breast cancer was the most common cancer type (36.0%). Average BMI was 25.8 kg/m2. The majority of respondents consumed £2 servings of fruits and vegetables per day (50.9%) and exercised £2 times per week (50.4%). Exercise was addressed at most or some oncology visits in 57.5% of respondents, diet in 50.7%, and weight in 28.4%. Referrals were less common: 14.9% of respondents were referred to an exercise program, 25.6% to a dietitian and 4.5% to a weight management program. In multiple regression analyses, racial and ethnicity minority respondents were more likely to receive advice about diet (Odds Ratio [OR] 1.92, 95% CI 1.56-2.38) and weight (OR 1.64, 95% CI 1.23-2.17) compared to non-Hispanic whites, individuals diagnosed with cancer in the past 5 yrs (vs > 5 yrs) were more likely to receive advice about exercise (OR 1.48, 95% CI 1.23-1.79), and breast cancer patients were more likely to receive advice about exercise (OR 1.37, 95% CI 1.11-1.68) and weight (OR 1.46, 95% CI 1.03-2.07) than other cancer patients. Overall, 74% of survey respondents had changed their diet or exercise after cancer diagnosis. Respondents reporting that their oncologist spoke to them about increasing exercise or eating healthier foods were more likely to report a change in behavior than those whose oncologists did not (exercise: 79.6% vs 69.0%, P < 0.001; diet 81.1% vs 71.4%, P < 0.001). Respondents whose oncologist had spoken to them about exercise were more likely to exercise > 2 times per week compared to respondents whose oncologists did not address exercise (53.5% vs 44.1%, P < 0.001). Conclusions: In a national survey of oncology patients, slightly more than half of respondents reported attention to diet and exercise during oncology visits. Provider recommendations for diet and exercise were associated with positive changes in these behaviors. Additional attention to diet and exercise as part of oncology visits is needed to help support healthy lifestyle change in cancer patients.


2014 ◽  
Vol 40 (7) ◽  
pp. 818-823 ◽  
Author(s):  
K. Ikeda ◽  
Y. Ogawa ◽  
C. Kajino ◽  
S. Deguchi ◽  
S. Kurihara ◽  
...  

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 1078-1078
Author(s):  
Christof Vulsteke ◽  
Alena Pfeil ◽  
Barbara Brouwers ◽  
Matthias Schwenkglenks ◽  
Robert Paridaens ◽  
...  

1078 Background: Recently we described the impact of genetic variability on severe toxicity in breast cancer patients receiving (neo-) adjuvant FEC chemotherapy (Annals of Oncology 2013, In Press). We now further assessed the impact of a wide range of patient-related factors on FEC toxicity in routine clinical setting. Methods: Patients with early breast cancer receiving (neo-)adjuvant 6 cycles FEC or sequential 3 cycles of FEC and 3 cycles D were retrospectively evaluated through electronic chart review for febrile neutropenia (primary endpoint; CTC 3.0). Age at diagnosis, body mass index, body surface area, number of cycles received, germline genetic polymorphisms, and baseline biochemical variables (white blood cell count, absolute neutrophil count, platelets, aspartate aminotransferase, alanine aminotransferase, total bilirubin and creatinine) were available for most patients (missing data <10%). All patients had follow up for progression free survival (PFS) and overall survival (OS). Multivariate logistic regression analysis was performed including univariate associates of outcome with a p-value <0.25. Results: We identified 1,031 patients treated between 2000-2010 with 6x FEC (n=488) or 3x FEC followed by 3x D (n=543). 174 (16.9%) patients developed febrile neutropenia during FEC. After logistic regression analysis febrile neutropenia was found to be significantly associated with carriers of the rs45511401 variant T-allele in the MRP1 gene found in 12% of patients (p= 0.03, OR1.99, CI 1.07-3.71) and with increasing serum creatinine values (p=0.05 OR 4.58/CI 0.99-20.98); all other investigated patient-related parameters were not retained by the model. At a mean follow up of 5.2 years, the occurrence of febrile neutropenia was not correlated with PFS and OS. Conclusions: In this study, only the baseline level of serum creatinine and germline genetic polymorphisms in the MRP-1 gene were predictive for the occurrence of febrile neutropenia in patients receiving FEC chemotherapy. The occurrence of febrile neutropenia did not seem to impact on outcome.


2013 ◽  
Vol 23 (4) ◽  
pp. 516-526 ◽  
Author(s):  
Huguette A. M. Désiron ◽  
Peter Donceel ◽  
Angelique de Rijk ◽  
Elke Van Hoof

2020 ◽  
Author(s):  
Shengyu Pu ◽  
Ke Wang ◽  
Yang Liu ◽  
Xiaoqin Liao ◽  
Heyan Chen ◽  
...  

Abstract BackgroundPrevious research results on the predictive factors of neoadjuvant chemotherapy (NCT) efficacy in breast cancer are inconsistent, suggesting that the ability of a single factor to predict efficacy is insufficient. Combining multiple potential efficacy-related factors to build a model may improve the accuracy of prediction. This study intends to explore the clinical and biological factors in breast cancer patients receiving NCT and to establish a nomogram that can predict the pathologic complete response (pCR) rate of NCT.MethodsWe selected 165 breast cancer patients receiving NCT from July 2017 to May 2019. Using pretreatment biopsy materials, immunohistochemical studies to assess estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER-2), and Ki-67 expression. The correlation between biological markers and pCR was analyzed. These predictors were used to develop a binary logistic regression model with cross-validation and to show the established predictive model with a nomogram.ResultsThe nomogram for pCR based on lymphovascular invasion, anemia (HB≤120 g/L), ER, Ki67 expression levels and NCT regimen had good discrimination performance (area under the curve [AUC], 0.758; 95% confidence interval [CI], 0.675-0.841) and calibration coordination. According to the Hosmer-Lemeshow test, the calibration chart showed satisfactory agreement between the predicted and observed probabilities. The final prediction accuracy of cross-validation was 76%.ConclusionsWe developed a nomogram based on multiple clinical and biological covariations that can provide an early prediction of NCT response and can help to quickly assess the individual benefits of NCT.


2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 120s-120s ◽  
Author(s):  
M. Mutebi ◽  
O. Olasehinde ◽  
P. Kingham ◽  
C. Boutin-Foster ◽  
A. Pusic

Background: Breast cancer is one of the leading causes of premature death in women in East Africa. The majority of patients are diagnosed with advanced cancers (stage III and IV) which results in more cancer deaths. Even after a diagnosis of breast cancer, many patients do not complete their treatment. The reasons why delays in diagnosis and treatment occur are multilevel, involving a combination of both patient related factors, such as sociocultural reasons like stigma or fatalism, or the use of alternative medicine. Financial factors play a big role as many patients have to pay out of pocket for their health expenditure. System related factors such as a lack of resources for the diagnosis or treatment, lack of health worker knowledge leading to misdiagnosis with inappropriate treatment and poor referral pathways, also contribute to delays in care. Aim: To understand the experience of breast cancer patients in East Africa, to determine the facilitators and barriers to diagnosis, treatment and follow-up of breast cancer. Methods: 28 patients in Kenya and Tanzania who had completed at least a year of initial treatment were invited to participate in the study. A qualitative exploratory study was done using semistructured, in-depth interviews. Grounded theory was then used to analyze and develop themes that emerged from these narratives. Results: For these patients who had completed at least a year of treatment, the cost of treatment and expenses incurred was a major concern. Family disintegration emerged as a significant theme following cancer diagnosis. There was a prevalence of stigma around breast cancer and patients would not disclose their status to others in the community for fear of being ridiculed, pitied or isolated. A number of patients used alternative medicine resulting in delays in treatment. Family support, support groups and spirituality played a major role in facilitating the completion of initial care and in reducing psychological morbidity. System factors such as poor referral pathways, and inappropriate treatment emerged as minor themes. Conclusion: The sociocultural aspects of breast cancer need to be addressed to ensure comprehensive management of breast cancer patients and completion of treatment. As programs in the region, mainly run by governments, aim to improve the financial access to treatment, it would be critical to include efforts aimed at stigma reduction and interventions focusing on the sociocultural reintegration of these patients.


2020 ◽  
Author(s):  
shengyu pu ◽  
ke wang ◽  
yang liu ◽  
xiaoqin liao ◽  
heyan chen ◽  
...  

Abstract Background Previous research results on the predictive factors of neoadjuvant chemotherapy (NCT) efficacy in breast cancer are inconsistent, suggesting that the ability of a single factor to predict efficacy is insufficient. Combining multiple potential efficacy-related factors to build a model may improve the accuracy of prediction. This study intends to explore the clinical and biological factors in breast cancer patients receiving NCT and to establish a nomogram that can predict the pathologic complete response (pCR) rate of NCT.Methods We selected 165 breast cancer patients receiving NCT from July 2017 to May 2019. Using pretreatment biopsy materials, immunohistochemical studies to assess estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER-2), and Ki-67 expression. The correlation between biological markers and pCR was analyzed. These predictors were used to develop a binary logistic regression model with cross-validation and to show the established predictive model with a nomogram.Results The nomogram for pCR based on lymphovascular invasion, anemia (hemoglobin≤120 g/L), ER, Ki67 expression levels and NCT regimen had good discrimination performance (area under the curve [AUC], 0.758; 95% confidence interval [CI], 0.675-0.841) and calibration coordination. According to the Hosmer-Lemeshow test, the calibration chart showed satisfactory agreement between the predicted and observed probabilities. The final prediction accuracy of cross-validation was 76%.Conclusions We developed a nomogram based on multiple clinical and biological covariations that can provide an early prediction of NCT response and can help to quickly assess the individual benefits of NCT.


2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 550-550
Author(s):  
Bavanthi Balakrishnar ◽  
Alexander M. Menzies ◽  
Sayed Sahanawaz Ali ◽  
Shang Heng Yeap ◽  
Bo Gao ◽  
...  

550 Background: Tamoxifen is a prodrug. Its principal active metabolite endoxifen is a product of cytochrome P450 2D6 (CYP2D6) metabolism. The CYP2D6 gene is highly polymorphic with a number of relatively common reduced function alleles. The aim of this study was to determine whether plasma endoxifen levels were reflected by CYP2D6 genotype or adverse effects in individuals taking tamoxifen. Methods: Plasma endoxifen was measured by High Performance Liquid Chromatography / Mass Spectroscopy in 90 breast cancer patients taking 20mg tamoxifen per day. Ten CYP2D6 single nucleotide polymorphisms were assessed to designate four putative CYP2D6 functional categories: ultra-rapid (UM), extensive (EM), intermediate (IM) and poor (PM) metabolizers. CYP2D6 inhibitor use and adverse effects were documented. The study was part of an ongoing Australian trial of tamoxifen dose escalation. Results: There was marked variation in plasma endoxifen levels across the cohort (mean 27.6 nM, SD 14.3). Endoxifen levels were significantly associated with metabolizer categories (p<0.001, r= -0.44), but were not distinctive between categories. For example, in the EM category (n=46) endoxifen levels ranged from 3.8-72.2 nM (mean 32.6 nM) with levels in the lowest quartile (3.8-19.7 nM) substantially overlapping the PM category (n=11); 6.1-24.7 nM. Consistent with an impact of non-CYP2D6 genotype related factors on endoxifen levels, endoxifen was significantly lower in 18 patients taking CYP2D6 inhibitor medications (p=0.005). There was no association between endoxifen levels and vasomotor symptoms or other adverse effects of tamoxifen. Conclusions: Endoxifen levels were highly variable in patients taking standard dose tamoxifen, and not predicted by CYP2D6 genotype or adverse effects. Therapeutic monitoring of endoxifen levels may be a useful approach to assess tamoxifen activity.


2021 ◽  
Vol 30 (4) ◽  
pp. 42-51
Author(s):  
Hoang Ha Linh ◽  
Le Xuan Hung ◽  
Pham Quang Thai ◽  
Hoang Thi Hai Van ◽  
Do Thi Thanh Toan ◽  
...  

A cross-sectional study on 170 breast cancer patients to describe nutritional status of breast cancer patients and the related factors at Vietnam National Cancer hospital in 2019-2020. The results revealed that overweight and obesity were the most common problem among breast cancer survivors. Up to 38% of studied patients are diagnosed as overweight or obesity using BMI classification; 84.71% are overweight while 80% of the studied subjects had central obesity. Alcohol abuse and surgery treatment were the factors worsening the risk of malnutrition of the study subjects (OR = 8.2 and 13.6, respectively). Low frequency of meat consumption (<1-3 times/week) has a higher risk of malnutrition than those who used meat daily (OR = 88.6). In addition, the age group, physical activities, chemotherapy and menopausal status affected the overweight and obesity status of breast cancer survivors (OR= 2.5, 10.7, 20.3 and 4.1, respectively). Low frequency consumption of vegetables increased the risk of overweight (OR=3.2). It is necessary to assess and screen the nutritional status for hospitalized patients immediately before treatment. Food intake and nutritional status of patients should also be paid attention in order to improve general health status and treatment outcome of breastcancer patients.


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