scholarly journals The Intersection of Cancer, Geriatrics, and Gerontology: A Multidisciplinary Approach Across the Cancer Continuum

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 298-299
Author(s):  
Jessica Krok-Schoen
Keyword(s):  
Older Adults ◽  
Health Outcomes ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Sleep Problems ◽  
Geriatric Oncology ◽  
Biological Aging ◽  
Patients With Cancer ◽  
Low Health Literacy ◽  
Cancer Experience

Abstract Despite the majority of cancer survivors being older adults, the connection between oncology, geriatrics, and gerontology remains unexplored. Our symposium will provide insights across the cancer continuum from prevention through survivorship as well as a comprehensive view of the connection between gerontological and geriatric factors in oncology. Specifically, we will discuss the biopsychosocial and behavioral factors among older adults with cancer, their effect on health outcomes, and how researchers and clinicians can intervene to improve health outcomes. The first abstract by Dr. Cadet found that despite a lack of knowledge of options and harms of cancer screening among older adults with low health literacy, there was a desire to understand more to better their health. The second abstract by Dr. Bhattacharyya found that older patients with cancer experience high levels of social isolation, loneliness, and fear that are heightened by individual and technology-based barriers to telehealth. The third abstract by Dr. Carroll found that breast cancer survivors with good sleep quality had less accelerated biological aging than those with sleep problems. The fourth abstract by Dr. Krok-Schoen utilized one of the largest datasets of older women, the Women’s Health Initiative, and found multiple gerontological and geriatric factors associated with physical activity among older female cancer survivors. Closing this symposium is Dr. Guida, a Program Director at the National Cancer Institute (NCI), who will profile the current research efforts, programmatic priorities, and current funding in aging and cancer. These multidisciplinary researchers and clinicians will provide a comprehensive symposium regarding geriatric oncology.

scholarly journals Biological Aging in Breast Cancer Survivors and the Role of Sleep

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 299-299
Author(s):  
Judith Carroll
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Sleep Problems ◽  
Functional Decline ◽  
Well Being ◽  
Telomerase Activity ◽  
Biological Aging ◽  
Epigenetic Aging ◽  
After Cancer

Abstract Although cancer treatments can prolong life, they may lead to long-term changes in physical health and well-being. The lasting symptoms experienced after cancer treatment include greater fatigue, pain, cognitive complaints, and functional decline. Cancer and its related cytotoxic treatments are proposed to directly altering biological aging pathways. Our recent findings support this hypothesis, suggesting that women with breast cancer exposed to therapy have alterations in indicators of biological aging, including elevated DNA damage, reduced telomerase activity, and more rapid epigenetic aging. There was variability in risk for signs of biological aging, and given the high prevalence of sleep problems among breast cancer survivors, we sought to examine whether healthy sleep might be protective. Results suggest that those with good sleep quality had less accelerated biological aging than those with sleep problems. Results point to healthy sleep as a modifiable target to protect women with breast cancer from experiencing biological aging.

scholarly journals How Is Geriatric Assessment Used in Clinical Practice for Older Adults With Cancer? A Survey of Cancer Providers by the American Society of Clinical Oncology

2020 ◽  
pp. OP.20.00442
Author(s):  
William Dale ◽  
Grant R. Williams ◽  
Amy R. MacKenzie ◽  
Enrique Soto-Perez-de-Celis ◽  
Ronald J. Maggiore ◽  
...  
Keyword(s):  
Older Adults ◽  
Geriatric Assessment ◽  
Online Survey ◽  
Task Force ◽  
Statistical Significance ◽  
Geriatric Oncology ◽  
Perceived Barriers ◽  
Patients With Cancer ◽  
Change Behavior ◽  
American Society

PURPOSE: For patients with cancer who are older than 65 years, the 2018 ASCO Guideline recommends geriatric assessment (GA) be performed. However, there are limited data on providers’ practices using GA. Therefore, ASCO’s Geriatric Oncology Task Force conducted a survey of providers to assess practice patterns and barriers to GA. METHODS: Cancer providers treating adult patients including those ≥ 65 years completed an online survey. Questions included those asking about awareness of ASCO’s Geriatric Oncology Guideline (2018), use of validated GA tools, and perceived barriers to using GA. Descriptive statistics and statistical comparisons between those aware of the Guideline and those who were not were conducted. Statistical significance was set at P < .05. RESULTS: Participants (N = 1,277) responded between April 5 and June 5, 2019. Approximately half (53%) reported awareness of the Guideline. The most frequently used GA tools, among those aware of the Guideline and those who were not, assessed functional status (69% v 50%; P < .001) and falls (62% v 45%; P < .001). Remaining tools were used < 50% of the time, including tools assessing weight loss, comorbidities, cognition, life expectancy, chemotherapy toxicity, mood, and noncancer mortality risk. GA use was two to four times higher among those who are aware of the Guideline. The most frequent barriers for those who reported being Guideline aware were lack of resources, specifically time (81.7%) and staff (77.0%). In comparison, those who were unaware of the Guideline most often reported the following barriers: lack of knowledge or training (78.4%), lack of awareness about tools (75.2%), and uncertainty about use of tools (75.0%). CONCLUSION: Among providers caring for older adults, 52% were aware of the ASCO Guideline. Some domains were assessed frequently (eg, function, falls), whereas other domains were assessed rarely (eg, mood, cognition). Guideline awareness was associated with two to four times increased use of GA and differing perceived barriers. Interventions facilitating Guideline-consistent implementation will require various strategies to change behavior.

Impact of religious and spiritual beliefs on neuroendocrine function and health outcomes in breast cancer survivors

2015 ◽  
Author(s):  
◽  
Jennifer M. Hulett
Keyword(s):  
Breast Cancer ◽  
Mental Health ◽  
Health Outcomes ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Empirical Support ◽  
Subjective Health ◽  
Physical And Mental Health ◽  
Spiritual Beliefs ◽  
Objective Evidence

[ACCESS RESTRICTED TO THE UNIVERSITY OF MISSOURI AT AUTHOR'S REQUEST.] Background: Breast cancer survivors rely on religious and spiritual beliefs to cope with breast cancer survivorship. Previous data have shown that religious and spiritual beliefs were associated with health outcomes. However, a gap in the literature has been a lack of objective evidence linking psychosocial variables with physiological outcomes. Purpose: The purpose of this study was to examine relationships between and among religious and spiritual variables, subjective health outcomes, and neuroendocrine-mediated cortisol activity in breast cancer survivors. Design: This was an exploratory, feasibility, and cross-sectional studyMethod: Subjective measures were: religious/spiritual variables (Brief Multi-dimensional Measures of Religiousness/Spirituality), subjective health (SF-36v2 Health Outcomes), and personality traits (NEO-FFI-3 Personality Inventory). Objective measures included salivary cortisol, blood pressure, pulse, respirations, and body mass index. The sample consisted of female breast cancer survivors (n=41). Results: Positive spiritual beliefs and forgiveness were related to better mental health. Positive congregational support was related to better physical and mental health. Positive spiritual experiences were associated with healthier cortisol activity patterns. Conscientiousness was associated with less healthy cortisol patterns. Subjective health perceptions were not associated with cortisol activity. Conclusion: Data supported a psychoneuroimmunological model of health in which spiritual variables were related to subjective health outcomes. Positive spiritual beliefs and conscientiousness were associated with neuroendocrine-mediated cortisol activity; although, more empirical support is required.

Prospective change in 25-OH vitamin D levels over long-term follow-up and health outcomes in breast cancer survivors.

2010 ◽  
Vol 28 (15_suppl) ◽  
pp. 6111-6111
Author(s):  
S. K. Taylor ◽  
M. Ennis ◽  
N. S. Hood ◽  
M. Graham ◽  
K. I. Pritchard ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Vitamin D ◽  
Health Outcomes ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Vitamin D Levels ◽  
Long Term Follow Up ◽  
25 Oh Vitamin D

scholarly journals An epigenetic aging analysis of randomized metformin and weight loss interventions in overweight postmenopausal breast cancer survivors

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Jamaji C. Nwanaji-Enwerem ◽  
Felicia Fei-Lei Chung ◽  
Lars Van der Laan ◽  
Alexei Novoloaca ◽  
Cyrille Cuenin ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Weight Loss ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Controlled Trial ◽  
Postmenopausal Breast Cancer ◽  
Biological Aging ◽  
Epigenetic Aging ◽  
Epigenetic Age ◽  
Registration Number

AbstractMetformin and weight loss relationships with epigenetic age measures—biological aging biomarkers—remain understudied. We performed a post-hoc analysis of a randomized controlled trial among overweight/obese breast cancer survivors (N = 192) assigned to metformin, placebo, weight loss with metformin, or weight loss with placebo interventions for 6 months. Epigenetic age was correlated with chronological age (r = 0.20–0.86; P < 0.005). However, no significant epigenetic aging associations were observed by intervention arms. Consistent with published reports in non-cancer patients, 6 months of metformin therapy may be inadequate to observe expected epigenetic age deceleration. Longer duration studies are needed to better characterize these relationships.Trial Registration: Registry Name: ClincialTrials.Gov.Registration Number: NCT01302379.Date of Registration: February 2011.URL:https://clinicaltrials.gov/ct2/show/NCT01302379

Efficacy of subcutaneous testosterone on menopausal symptoms in breast cancer survivors.

2014 ◽  
Vol 32 (26_suppl) ◽  
pp. 109-109 ◽  
Author(s):  
Rebecca L. Glaser ◽  
Anne E. York ◽  
Constantine Dimitrakakis
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Rating Scale ◽  
Sleep Problems ◽  
Pilot Trial ◽  
Estrogen Therapy ◽  
Menopausal Symptoms ◽  
Hormone Deficiency ◽  
Urogenital Symptoms

109 Background: Menopausal symptoms can be severe in breast cancer survivors in whom estrogen therapy is contraindicated. Our previous pilot trial demonstrated that testosterone (T) combined with anastrozole (A) in subcutaneous implants provided therapeutic T levels without elevating estradiol. Our current goal was to document the clinical effect of T+A combination implants (no estrogen) on menopausal symptoms. Methods: This IRB approved study was designed to prospectively follow breast cancer survivors (stage 0-4) treated with subcutaneous T+A, for breast cancer recurrence. The therapeutic effectiveness of T on the relief of psychological, somatic and urogenital symptoms was documented using the validated, self administered, 11 item Menopause Rating Scale. Patients completed the survey prior to and following therapy. Results: Over 950 T/T+A pellet insertions have been performed in breast cancer survivors since 2006. Since 4/2013, 72 patients have been enrolled in the study. T dosing is weight based. Implants are inserted at 3-month intervals on average. Therapeutic T levels were confirmed without elevation of estradiol in any postmenopausal survivor. There have been no cancer recurrences in up to 8 years of therapy. A single patient with active metastatic disease at enrollment developed ascites. There was statistically significant improvement (P < 0.0001) in psychological symptoms (depression, irritability/aggression, anxiety), somatic symptoms (hot flashes/sweating, heart discomfort, sleep problems/insomnia, physical exhaustion, impaired memory, joint/muscular pain) and urogenital symptoms (vaginal dryness, bladder problems/incontinence, sexual problems). Conclusions: Testosterone in combination with an aromatase inhibitor, delivered by subcutaneous implant, was extremely effective for the relief of hormone deficiency symptoms in breast cancer survivors. Furthermore, this supports testosterone’s therapeutic effect via the androgen receptor. [Table: see text]

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