Management of worry about recurrence in breast cancer survivors.

2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 21-21
Author(s):  
Dean Alden Shumway ◽  
Rebecca Leinberger ◽  
Kent A. Griffith ◽  
Brian Zikmund-Fisher ◽  
Sarah T. Hawley ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Management Strategies ◽  
Risk Information ◽  
Prescribe Medication ◽  
Breast Cancer Patients ◽  
Medical Oncologists ◽  
Multiple Variable ◽  
Worry About Recurrence

21 Background: Worry about recurrence is a significant concern for breast cancer survivors. We explored physicians‘ confidence and practices in identifying and managing worry. Methods: We surveyed a random sample of 1,500 surgeons and medical oncologists drawn from the AMA Masterfile in 2012. Physician responses to questions regarding their confidence were stratified by practice specialty and compared using the Wilcoxon rank-sum test. Correlates of use of each strategy for managing worry were modeled using multiple variable logistic regression. Results: 896 physicians (59.7%) responded: 498 surgeons and 398 medical oncologists, of whom 85.5% saw breast cancer patients. 62% reported initiating discussions regarding worry about recurrence. Overall, medical oncologists reported more confidence than surgeons in their ability to present risk information to patients, identify survivors with high levels of worry, and help patients manage their worry (p<0.001). Of note, 40.2% of physicians reported low levels of confidence managing worries surrounding recurrence. Confidence presenting risk information was significantly associated with treatment volume, which was highest with >50 cases/year. Surgeons who routinely followed breast cancer survivors for >3 years reported higher confidence; no such correlation existed among medical oncologists, but >90% of this group routinely followed patients for >3 yrs. Female physicians were significantly more likely to report being able to identify survivors with high levels of worry. Practice in an academic setting demonstrated associations with increased confidence. Use of worry management strategies varied by specialty. Medical oncologists were more likely to prescribe medication, address concerns in detail themselves, or refer to a psychologist or social worker. Longer follow-up was associated with increased likelihood of physicians addressing concerns themselves. Conclusions: A sizeable minority of physicians lack confidence in their ability to identify and manage worry in cancer survivors. Medical oncologists and surgeons differ significantly in their approach to worry management, suggesting that greater attention toward this issue in training and continuing education may be warranted.

scholarly journals Provider perspectives on presenting risk information and managing worry about recurrence among breast cancer survivors

2014 ◽  
Vol 24 (5) ◽  
pp. 592-600 ◽  
Author(s):  
Nancy K. Janz ◽  
Rebecca L. Leinberger ◽  
Brian J. Zikmund-Fisher ◽  
Sarah T. Hawley ◽  
Kent Griffith ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Risk Information ◽  
Provider Perspectives ◽  
Worry About Recurrence

Development of second primary cancers in breast cancer survivors.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 257-257
Author(s):  
Hong Kyu Jung ◽  
Jihyoun Lee ◽  
Zisun Kim ◽  
Min Hyuk Lee ◽  
Ilkyun Lee
Keyword(s):  
Breast Cancer ◽  
Endometrial Cancer ◽  
Thyroid Cancer ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Second Primary ◽  
Primary Cancer ◽  
Second Primary Cancer ◽  
Breast Cancer Patients ◽  
Second Primary Cancers

257 Background: Breast cancer survivors have slightly increased risk of second primary cancers. Importance of screening for second cancers has been raised due to increased survival in those populations. Not only having genetic risk such as BRCA mutation, but also treatment-related risk presents. The most common second primary cancer is breast cancer. Colon cancer, uterine cancer, and ovarian cancer showed increased cumulative incidence. In this study, we assessed development second primary cancers in breast cancer survivors. Methods: Medical record of breast cancer patients was reviewed retrospectively in three tertiary medical institutions. Available data of ICD-9 record after breast cancer diagnosis was evaluated. Diagnosis of second primary breast cancer was excluded in evaluation. Results: Since Jan 1989 to Jan 2014, available medical records were reviewed in breast cancer patients(N = 5880) in three institutions(one urban and the other two rural institutions). Cumulative incidence of overall second primary cancers was 4.57%. Among 269 second primary cancers, thyroid cancer(44.2%) was most common second primary cancer, followed by gastric cancer(10.0%). Gastric cancers were more common in rural institution than urban area(14.2 % vs 5.5%), while incidence of thyroid cancer is elevated in urban institution(57.8% vs 31.9%). Among 9 patients who has been diagnosed endometrial cancer, 7 patients had history of selective estrogen receptor modulator(tamoxifen or toremifen) treatment. Development of lung cancer was not related to breast cancer radiation treatment(4 of 15 patients). Leukemia after breast cancer treatment was diagnosed in 5 patients (8.5% of second primary cancers), three of them were adult T cell leukemia and two of them were acute myeloid leukemia. Conclusions: Incidence of cancer in general population was reflected to development of second primary cancer in breast cancer survivors. Endocrine treatment was related increased incidence of endometrial cancer, respectively. Application of personalized cancer screening plan would be important in this patient group.

From helplessness to self help: Breast cancer surviorship in India.

2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 208-208 ◽  
Author(s):  
Rebecca DeSouza ◽  
Shona Milon Nag ◽  
Rama Sivaram ◽  
Anupama Dutt Mane
Keyword(s):  
Breast Cancer ◽  
Side Effects ◽  
Cancer Survivors ◽  
Support Group ◽  
Breast Cancer Survivors ◽  
Social Stigma ◽  
Lifestyle Changes ◽  
Social Health ◽  
Annual Conference ◽  
Breast Cancer Patients

208 Background: In The Indian Scenario, a diagnosis of cancer is accompanied with social stigma and emotional upheavals, especially in breast cancer patients. They are typically thinking: “I would be less of a woman,” “I don’t know if people understand me,” “I feel isolated from myself, my family and my friends,” “Would I be normal again?” “Do I know how to help myself?” or “What will happen in the future, to my kids, to my husband?” Methods: All of these concerns are not always addressed by the medical professions. To address these issues, the Indian Breast Cancer Survivors Conference was organized as an annual conference with an attendance of 200-250 breast cancer survivors from the state of Maharashtra, India. The conference would address the psychological, emotional and social distress experienced by the patients with an aim from living a longer life to living a better and fulfilled life. Results: The emphasis of the sessions were educational (with recent updates on the surgical, medical and radiation therapy aspects of breast cancer treatment), practical (emphasized important issues like side-effects of treatment, patient advocacy, complementary therapies, spirituality, lifestyle changes, etc.), and entertaining. The summary and outcomes of the last 5 annual survivorship conferences will be described and enumerated. Results of questionnaires administered during the last 2 conferences and addressing health behavior patterns of survivors will be presented. Conclusions: We can evaluate through post conference support group discussions and conference feedback, qualify patient psychological and social health as 1) Physical:There are side effects but I choose to go on; 2) Mental: There are times that I am low, depressed, anxious, scared, guilty, but this is my new normal; 3) Emotional:Little things upset me, angry quickly but I am dealing with it; 4)Spiritual:Moved away from bargaining with God to accepting, from rituals to spiritual; 5) Social:don’t hesitate to reach out for support and to support; and 5) Intellectual:Knowledge is power, so I have learned to ask, to question, and then to decide. Achieving psychological and social health is the effort of the patient, the treating team and the support group.

scholarly journals Breast Cancer Patients’ Treatment Choices and Outcomes in a Naturopathic Clinic

2017 ◽  
Vol 2 (1) ◽  
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Cancer Patients ◽  
Breast Cancer Survivors ◽  
Disease Status ◽  
Tumor Burden ◽  
Water Soluble ◽  
Breast Cancer Patients ◽  
Treatment Choices ◽  
History Of

In this study we gathered data in July 2016 by means of questionnaires from breast cancer survivors following initial consult in a naturopathic clinic. Most patients surveyed had previously or concurrently had total surgical resection of their tumor burden, followed by at least 36 treatments of intravenous nutrients, including water -soluble vitamins and minerals. We compare those having a history of surgery with those not having that history. We also compare outcomes among those having a history of radiation therapy and those without, as well as those having a history of chemotherapy and those without. Some of those in remission chose to return for follow-up intravenous nutrients once per month after achieving remission from their cancers. We compare the different cohorts, among the various stages of cancer, for treatment choices and disease status. 97 total cancer survivors responded fully and promptly to the questionnaires. 37 of those were breast cancer patients.

scholarly journals Breast Cancer Support Group at Ocean Road Cancer Institute in Dar es Salaam

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 178s-178s
Author(s):  
S. Nyagabona ◽  
F. Rubagumya ◽  
A. Longombe ◽  
A. Manirakiza ◽  
T. Maniragaba ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Cancer Patients ◽  
Support Group ◽  
Breast Cancer Survivors ◽  
Psychosocial Support ◽  
Cancer Education ◽  
Developed Countries ◽  
Breast Cancer Patients ◽  
Cancer Support

Background and context: Breast cancer is a common type of cancer among women worldwide, with about 2 million new cases diagnosed in the yearly. It is the second common cancer and leading cause of cancer mortality among women in Tanzania, after cervical cancer. More than 70% of breast cancer patients in developed countries are diagnosed at early stages, whereas in low and middle-income countries, only 20%–60% of patients are diagnosed early. Physician in developed countries consults on average 15-20 breast cancer patients daily, while in developing countries the number triples. This high load does not allow a treating physician to spend ample time with patients explaining hence leaving patients not informed about their diagnosis, side effects of treatments and even living with the physical, emotional and psychological challenges of their disease. Residents at the Ocean Road Cancer Institute (ORCI), initiated a patient support group targeting breast cancer patients for feasibility. Aim: Provide forum for patients with same diagnosis to share common challenges Provide peer emotional, psychosocial support and cancer education Organize activities that will help to spread awareness to the community Initiate projects to improve socioeconomic status of breast cancer survivors in Tanzania Strategy/Tactics: Involved the ORCI administration from the beginning Involved the academic and research unit of ORCI Residents prepared session curriculum and teaching materials Sessions took place once a month Sessions were two hours long divided into three components, where the first is introduction of participants, then survivors led discussions or lectures prepared by an expert in the topic and lastly closing remarks by a physician Breakfast was provided Program/Policy process: Open membership for all breast cancer patients Physician lead face to face peer discussions Institutional acknowledgment of the support group Provision of primary registry of patients for follow-up Provision of a link to other social organizations Outcomes: Increase knowledge of cancer in general and breast cancer in particular A total of seven sessions were held to date For each session, participation ranged from 30-50 breast cancer survivors, and on average attendance was 4 sessions out of 7 Topics covered over a period of seven months included Coping with a cancer diagnosis and treatment Living with cancer and its changes to daily life Exercise Nutrition Breast cancer general knowledge Collaboration with other stake holders including IST secondary school students who initiated breast prosthesis knitting club What was learned: A need to reach out and give psycho-social support to ORCI patients Through education we can improve treatment adherence Possible partners are available if we reach out Exist a need to address misconceptions in the community so as to avoid stigma to patients.

Feasibility of group follow-up visit for breast cancer survivors

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 19603-19603
Author(s):  
C. O. Ruud ◽  
K. Francis ◽  
C. Stephens ◽  
M. H. Rajab
Keyword(s):  
Breast Cancer ◽  
Patient Satisfaction ◽  
Cancer Survivors ◽  
Cancer Patients ◽  
Social Worker ◽  
Breast Cancer Survivors ◽  
Breast Cancer Patients ◽  
Group Visit ◽  
Follow Up Care

19603 Background: The ASCO 2006 guidelines specify that regularly scheduled follow-up care of breast cancer survivors should be the standard. Follow up care is a “teachable moment” to train survivors in positive habits. A group visit model at the Cleveland Clinic proved feasible and improved patient satisfaction for other diseases. Our objectives include assessing the feasibility of an adapted group follow-up visit for the care of breast cancer patients and patient satisfaction. Methods: A feasibility study targeting breast cancer patients who completed primary therapy and were scheduled for a routine appointment. We mailed letters inviting patients to a follow-up group visit. Patients were divided into 3 groups, each scheduled for a separate (90–120 minute). During the first half of the visit, participants were divided into three groups; 5-minute physician exam, nurse review of medications and vital signs, and instruction by a social worker. Groups were rotated. During the second half the doctor, nurse, and social worker met with all participants in one room starting with an educational presentation about fatigue and exercise. Each participant was subsequently interviewed by the physician in the presence of their peers. Shared complaints were investigated first. Patients rated their satisfaction with the different parts of the visit on a scale of 1–5. Participants were surveyed pre- and post- education session and asked if they would participate again. Participants were allowed to bring a family member or friend. Results: 29 (29.6 %) out of 98 consented and 22 (22.5%) attended;10 in first visit, 5 in second visit and 7 in last visit. Average age 61±8, ranged from 46–72 years. Most participants were satisfied with all parts of the group visit, except two in the first group were less satisfied with the check in process and moving between rooms. Comparing the pre- vs. post- educational session surveys showed an improved understanding of the importance of fatigue or exercise. 17 (77%) out of 22 participants agreed to participate in another group visit. Conclusion: Group visit format is feasible and provides patient satisfaction. No significant financial relationships to disclose.

CIFeR: A novel Clinician-lead Intervention to address Fear of cancer Recurrence (FCR) in breast cancer survivors.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 12115-12115
Author(s):  
Jia Liu ◽  
Kim Tam Bui ◽  
Anastasia Serafimovska ◽  
Belinda Emma Kiely ◽  
Mun Ngah Hui ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Response Rate ◽  
Early Stage ◽  
Local Treatment ◽  
Unmet Need ◽  
Fear Of Cancer Recurrence ◽  
Breast Cancer Patients ◽  
The Mean

12115 Background: FCR affects 50-70% of cancer survivors. There are no validated oncologist-delivered FCR interventions. This multicentre, single-arm study sought to determine the helpfulness, feasibility and efficacy of an oncologist-delivered FCR intervention. Methods: Women were invited to participate if they had completed local treatment, chemotherapy and/or HER2 targeted therapy for early stage breast cancer and had a FCR score >0 on the 42-item FCR Inventory. The brief intervention, delivered by their medical oncologist at routine follow-up, entailed 1) FCR normalisation; 2) provision of personalised prognostic information; 3) take-home education sheet on recurrence symptoms; and 4) advice on managing worry. Consultations were audio-recorded. FCR, need for help, depression and anxiety were assessed before the intervention (T0), and at one week (T1) and three months (T2) after the intervention. Satisfaction with the intervention was assessed at T1. The primary outcome was participant-rated helpfulness. Secondary outcomes included feasibility (response rate, time taken for intervention) and efficacy. Results: Five oncologists delivered the intervention to 61 women (255 women invited; response rate 24%). The mean age was 57 ± 13 years. The mean time since breast cancer diagnosis was 2.5 ± 1.3 years. Forty-three (72%) were on adjuvant hormonal therapy. Overall, 58 women (95%) found the intervention helpful and 59 (98%) would recommend it to others. FCR severity, and the proportion of women with clinically significant FCR decreased significantly over time. There were no significant changes in unmet need, depression, or anxiety. Forty (66%) of consultations were recorded. Mean consultation length was 22 minutes (range 12-37 minutes) and mean intervention length was 9 minutes (3-20 minutes). The intervention was perceived as useful and feasible by oncologists, all of whom have used components of the intervention to help manage FCR in other breast cancer patients. Conclusions: A brief oncologist-delivered intervention to address FCR is helpful and feasible, and has shown preliminary efficacy in reducing FCR. Plans for an implementation study amongst oncologists in Australia are underway. Clinical trial information: ACTRN12618001615279 . [Table: see text]

Nutritional status of breast cancer patients and the related factors at Vietnam National Cancer hospital in 2019-2020

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 ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Nutritional Status ◽  
Cancer Survivors ◽  
Cancer Patients ◽  
Breast Cancer Survivors ◽  
Low Frequency ◽  
Overweight And Obesity ◽  
Breast Cancer Patients ◽  
Related Factors ◽  
Cancer Hospital

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.

scholarly journals Communicating Risks of Adjuvant Chemotherapy for Breast Cancer: Getting Beyond the Laundry List

2019 ◽  
Vol 15 (2) ◽  
pp. e98-e109 ◽  
Author(s):  
Eden R. Brauer ◽  
Elisa F. Long ◽  
Joy Melnikow ◽  
Peter M. Ravdin ◽  
Patricia A. Ganz
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Focus Groups ◽  
Cancer Survivors ◽  
Late Effects ◽  
Breast Cancer Survivors ◽  
Theoretical Domains Framework ◽  
Long Term Effects ◽  
Medical Oncologists

PURPOSE: According to the Institute of Medicine, high-quality cancer care should include effective communication between clinicians and patients about the risks and benefits, expected response, and impact on quality of life of a recommended therapy. In the delivery of oncology care, the barriers to and facilitators of communication about potential long-term and late effects, post-treatment expectations, and transition to survivorship care have not been fully defined. PATIENTS AND METHODS: We collected qualitative data through semistructured interviews with medical oncologists and focus groups with breast cancer survivors and applied the Theoretical Domains Framework to systematically analyze and identify the factors that may influence oncologists’ communication with patients with breast cancer about the long-term and late effects of adjuvant therapy. RESULTS: Eight key informant interviews with medical oncologists and two focus groups with breast cancer survivors provided data. Both oncologists and patients perceived information on long-term effects as valuable in terms of improved clinical communication but had concerns about the feasibility of inclusion before treatment. They described the current approaches to communication of therapy risks as a brief laundry list that emphasized acute adverse effects and minimized more long-term issues. We describe the barriers to communication about potential long-term effects from the perspectives of both groups. CONCLUSION: This study provides insight into oncologists’ communication with patients with breast cancer regarding the potential long-term and late effects of adjuvant chemotherapy and about setting realistic expectations for life after treatment. Opportunities to improve oncologists’ communication about the potential toxicities of therapy, particularly regarding long-term and late effects, should be examined further.

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