Using the Risk Assessment Index to predict mortality and quality of life in breast and gynecologic cancer patients.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 239-239
Author(s):  
Ellen Ormond ◽  
Jeffrey Borrebach ◽  
Stefanie C Altieri Dunn ◽  
Andrew Bilderback ◽  
G J. Van Londen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cancer Patients ◽  
Gynecological Cancer ◽  
Gynecologic Cancer ◽  
Hospital Utilization ◽  
Assessment Index ◽  
Frail Patients ◽  
Breast And Gynecologic Cancer ◽  
Gynecologic Patients

239 Background: Cancer patients vary considerably in health status making it challenging to evaluate the risk of complications from cancer treatment. To aid oncologists in identifying patients with highest risk for adverse outcomes, we investigated the Risk Assessment Index (RAI), a validated tool used to assess frailty in patients prior to elective surgery. We assessed whether the RAI could serve to predict mortality, hospital utilization, and quality of life in cancer patients. Methods: Participants were breast and gynecological cancer patients treated at UPMC Magee Women’s Cancer Center who completed the RAI between July 2016 and December 2017. Patients completed patient reported outcomes (PROs) during each visit including the Short Form (SF)-12, Edmonton Symptom Assessment, anxiety and depression screens, and MD Anderson Symptom Inventory (MDASI) and were analyzed up to 180 days from the RAI date. Mortality was assessed at 90, 180, and 365-day intervals, and hospital utilization was assessed within 90-days of RAI. Results: There were 1,764 unique breast and gynecological cancer patients. Significant correlations between the RAI and mortality were observed for both groups with frail patients having higher rates of mortality at each interval. Frailty was associated with higher rates of hospitalization compared to non-frail patients (31% vs 20%, p = 0.05 & 50% vs 34%, p = 0.02 for breast and gynecologic patients, respectively). Frailty correlated with fair/poor ratings on the SF-12 for breast and gynecologic patients (r = 0.13, p = 0.01; r = 0.37 p < 0.001, respectively). On the Edmonton, frailty correlated with lower ratings of well-being in breast cancer patients (r = 0.11, p = 0.012) and higher symptom burden in gynecological patients (r = 0.23, p = 0.01). No correlations were observed between the RAI and anxiety or depression. For gynecologic patients, there were significant correlations between the RAI and MDASI with frail patients having higher rates of pain, fatigue, appetite, diarrhea, and memory. Conclusions: We demonstrated that the RAI is correlated with mortality, self-reported quality of life, and hospitalizations in breast and gynecologic cancer patients. Using this tool to risk-stratify patients may help to guide shared decision-making discussions and provide appropriate treatment and/or supportive services for this vulnerable population.

The Exploration of Health-Related Quality of Life

2016 ◽  
Vol 26 (1) ◽  
pp. 114-131 ◽  
Author(s):  
Shu-Fen Wu ◽  
Hong-Yi Tong ◽  
Yuen-Yee kan ◽  
Sheng-Hui Su ◽  
Meng-Chi Lee ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cancer Patients ◽  
Gynecological Cancer ◽  
Gynecologic Cancer ◽  
Symptom Distress ◽  
Life Questionnaire ◽  
European Organization ◽  
Eortc Qlq ◽  
Distress Scale

The purpose of this study was to explore quality of life (QoL) and the factors influencing QoL in gynecological cancer patients. One hundred sixty-seven patients with gynecologic cancers were recruited from a district hospital in Southern Taiwan. The instruments used included the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 Version 3.0 in Chinese (EORTC QLQ-C30), the Symptom Distress Scale, and demographic characteristics and disease-related variables. The results showed that the mean score for the QLQ-C30 was 61.13 ( SD = 22.71). In the stepwise regression model, two factors predicted overall global QoL: symptom distress (33.8%) and current occupation (2.2%). These predictors accounted for 36.0% of the total variance. These results showed that symptom distress was a predictor of QoL. This study provides a reference for use when designing improved educational care programs that reduce patient symptom distress and enhance gynecologic cancer patients’ QoL.

Feasibility of a telemedicine lifestyle-based rehabilitation program (HEAL) for gynecologic cancer patients.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e24033-e24033
Author(s):  
Nathalie Dauphin McKenzie ◽  
Nnamdi Ifekandu Gwacham ◽  
Julie W. Pepe ◽  
Sarfraz Ahmad ◽  
James Erasmus Kendrick ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Cancer Survivors ◽  
Social Integration ◽  
Stress Management ◽  
Cancer Patients ◽  
Gynecologic Cancer ◽  
Lifestyle Medicine ◽  
Rehabilitation Team

e24033 Background: General health related factors such as obesity, unhealthy diets disproportionate with sugary and highly processed foods, inactivity, and smoking have repeatedly been shown to negatively impact survival and quality of life outcomes in cancer survivors. The Healthy Eating Active Lifestyle (HEAL) – GYN “rehabilitation” cancer program was developed to provide intensive group lifestyle training on exercise, nutrition, sleep, social integration, and stress management via a telemedicine platform. The aim of this study was to determine the feasibility of such an intervention and its tolerability, in addition to its impact on short-term quality of life for gynecologic cancer patients. Methods: HEAL – GYN consists of 8 weekly group sessions offering experiential instruction and personalized goal setting for patients with diagnosis of gynecologic cancer. Components are drawn from the tenets of lifestyle medicine. An oncologist certified in lifestyle medicine along with a multidisciplinary rehabilitation team addressed diet, physical activity, strategies for sleep and stress management, smoking cessation, and alcohol intake. The intervention included training to address unmet psychologic, emotional, physical, sexual, social, and spiritual needs common to cancer survivors. American College of Lifestyle Medicine questionnaires were administered, utilizing Likert scales (1-5) in a pre- and post- fashion to assess improvements in physical activity levels, dietary habits, sleep hygiene, and quality of life. Medical records were reviewed including anthropometric data. Results: 26 patients have enrolled thus far, and we report outcomes on the first 20 participants. The mean age was 58.8 years; 22 were Caucasian, and 7 were on maintenance therapies for gynecologic cancers. Average total severity of reported symptoms (scale = 100 points) on a general medical symptom questionnaire (MSQ) decreased by 22% (61 vs 48). Eight patients reported increased perceived levels of health and 6 had stable perception of health. There were also notable improvements from baseline in item assessments of eating behavior (34%), perceived stress (20%), and resilience (21%). Patients also reported a notable trend towards improvement in anxiety (35%) and depression (34%), as well as social integration and connectedness (30%). 100% of participants would “highly recommend the program” and none complained of stress or altered mood associated with online instruction. Conclusions: The telemedicine HEAL – GYN peri-habilitation program is feasible and well tolerated. In addition, the program may improve quality of life and may prevent further decline for those on treatment or maintenance therapy. These preliminary findings support continued investigation of a telemedicine healthy lifestyle peri-habilitative program.

The relationship between symptom prevalence, body image, and quality of life in Asian gynecologic cancer patients

2017 ◽  
Vol 27 (1) ◽  
pp. 69-74 ◽  
Author(s):  
Irene Teo ◽  
Yin Bun Cheung ◽  
Timothy Yong Kuei Lim ◽  
Rama Padmavathi Namuduri ◽  
Victoria Long ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Body Image ◽  
Cancer Patients ◽  
Gynecologic Cancer ◽  
Symptom Prevalence ◽  
The Relationship

Baseline characteristics of breast and gynecological cancer patients enrolled in the trial of a multidisciplinary survivorship care model in an Asian national ambulatory cancer center.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 37-37
Author(s):  
Yu Ke ◽  
Patricia Soek Hui Neo ◽  
Grace Meijuan Yang ◽  
Shirlynn Ho ◽  
Yee Pin Tan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Usual Care ◽  
Cancer Patients ◽  
Gynecological Cancer ◽  
Life Questionnaire ◽  
Survivorship Care ◽  
Care Model ◽  
Care Needs ◽  
Baseline Characteristics

37 Background: Accessible Cancer Care to Enable Support for Cancer Survivors (ACCESS) is a multidisciplinary survivorship care model launched at the National Cancer Centre Singapore (NCCS) in 2019. ACCESS employs routine distress and problem screening to triage cancer patients with varying care needs and complexities for tailored care. Here, we described the study design to evaluate ACCESS, and reported the baseline characteristics of our study cohort to characterize the profile of prospective target recipients of the new care model. Methods: A cluster randomized controlled trial was initiated to assess the effectiveness of ACCESS on quality of life and symptom burden, with each cluster unit defined at the oncologist level. Clusters were randomized in a 1:1 ratio to receive ACCESS or usual care. Eligible patients were ≥21 years, newly diagnosed with breast or gynecological cancer, and receiving follow-up care in NCCS. Patients were followed up for one year and patient-reported outcomes were collected every three months using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 and Rotterdam Symptom Checklist. Results: By May 2021, 91 patients and 89 patients in the usual care and ACCESS arm were recruited, respectively. Both groups (usual care vs. ACCESS) had comparable mean age (56.2±10.9 vs. 56.2±10.7, P = 0.998) and racial composition (P = 0.760). Employment status was similar in both arms (48.4% vs. 56.2% employed, P = 0.293) and most patients were covered by health insurance (89.8% vs. 88.1%, P = 0.920). At baseline, patients in both arms had comparable mean quality of life scores (65.1±19.8 vs. 66.9±17.6, P = 0.51) and reported high physical, role, emotional, cognitive, and social functioning levels (all mean scores > 70). No statistically significant differences in physical symptom and psychological distress levels were observed. Prevalent symptoms reported included fatigue (82.4% vs. 71.9%), pain (68.1% vs. 55.1%), and insomnia (57.1% vs. 55.1%). Almost half of the cohort reported financial difficulties (45.1% vs. 46.1%). Conclusions: Comparable baseline characteristics suggested the absence of systematic differences in care needs and demand among patients cared by different oncologists. Despite high functioning statuses at baseline, participants reported impaired quality of life with active physical and financial problems. These results support our hypothesis that routine screening would be valuable to identify such problems promptly for management via standardized care pathways. Results from this ongoing trial will determine the effectiveness of ACCESS on quality of life and functional recovery through treatment and survivorship. Clinical trial information: NCT04014309.

Quality of Life Symptoms and Their Effect on Outcomes of Gynecologic Cancer Patients

2020 ◽  
Vol 156 (3) ◽  
pp. e22-e23
Author(s):  
L. Driskill ◽  
T. Castellano ◽  
Kai Ding ◽  
R. Ruskin ◽  
M. Rowland ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cancer Patients ◽  
Gynecologic Cancer
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