Evaluation of the Pathways for Survivors program to address breast cancer survivorship associated distress (Preprint)

2021 ◽  
Author(s):  
Saumya Umashankar ◽  
Matina Elise Mamounas ◽  
Madeline Matthys ◽  
Edward Kenji Hadeler ◽  
Emily Claire Wong ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Psychological Impact ◽  
Reference Population ◽  
Anxiety And Depression ◽  
Measurement Information ◽  
Behavioral Strategies ◽  
Breast Cancer Patients ◽  
Patient Reported

UNSTRUCTURED Purpose: Breast cancer patients not infrequently experience escalation of anxiety after completing curative treatment. This study evaluated the acceptability and psychological impact of a one-day workshop emphasizing behavioral strategies involving intention and self-efficacy. Methods: Breast cancer survivors attending a one-day Pathways for Survivors workshop, provided feedback, and completed electronic quality of life (QOL) questionnaires at baseline, 1- and 6-weeks, and 6-months post workshop. Attendees’ baseline QOL scores were compared to follow up (FUP) scores. Scores from patients receiving routine FUP care were also compiled as a reference population. Results: Seventy-seven patients attended one of nine workshops. Mean satisfaction was 9.7/10 with the workshop, and 9.96/10 with the moderator. Participants’ baseline mean Patient-Reported Outcomes Measurement Information System (PROMIS) anxiety and depression scores were 57.8±6.9 and 55.3±7.5, significantly higher than routine FUP care patients (49.1±8.3 and 47.3±8 respectively). PROMIS anxiety and depression scores decreased and Happiness Index Profile (HIP-10), measuring intention and resiliency, increased significantly at 1- and 6-week FUPs. Conclusions: Pathways for Survivors was favorably received. Anxiety and depression decreased significantly at 1- and 6-weeks post workshop and remained below baseline at 6 months. Increased HIP-10 scores support that patients incorporated skills from the workshop. A one-day workshop led by a lay moderator significantly improved several psychological measures, suggesting it may be a useful and time-efficient strategy to improve QOL in breast cancer survivors. We are investigating whether an abbreviated “booster” of the intervention at a later date could further improve and maintain QOL gains.

scholarly journals Evaluation of the Pathways for Survivors program to address breast cancer survivorship associated distress

2021 ◽  
Author(s):  
Saumya Umashankar ◽  
Matina Elise Mamounas ◽  
Madeline Matthys ◽  
Edward Kenji Hadeler ◽  
Emily Claire Wong ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Psychological Impact ◽  
Reference Population ◽  
Anxiety And Depression ◽  
Measurement Information ◽  
Behavioral Strategies ◽  
Breast Cancer Patients ◽  
Patient Reported

Abstract Purpose: Breast cancer patients not infrequently experience escalation of anxiety after completing curative treatment. This study evaluated the acceptability and psychological impact of a one-day workshop emphasizing behavioral strategies involving intention and self-efficacy.Methods: Breast cancer survivors attending a one-day Pathways for Survivors workshop, provided feedback, and completed electronic quality of life (QOL) questionnaires at baseline, 1- and 6-weeks, and 6-months post workshop. Attendees’ baseline QOL scores were compared to follow up (FUP) scores. Scores from patients receiving routine FUP care were also compiled as a reference population.Results: Seventy-seven patients attended one of nine workshops. Mean satisfaction was 9.7/10 with the workshop, and 9.96/10 with the moderator. Participants’ baseline mean Patient-Reported Outcomes Measurement Information System (PROMIS) anxiety and depression scores were 57.8 ± 6.9 and 55.3 ± 7.5, significantly higher than routine FUP care patients (49.1 ± 8.3 and 47.3 ± 8 respectively). PROMIS anxiety and depression scores decreased and Happiness Index Profile (HIP-10), measuring intention and resiliency, increased significantly at 1- and 6-week FUPs.Conclusions: Pathways for Survivors was favorably received. Anxiety and depression decreased significantly at 1- and 6-weeks post workshop and remained below baseline at 6 months. Increased HIP-10 scores support that patients incorporated skills from the workshop. A one-day workshop led by a lay moderator significantly improved several psychological measures, suggesting it may be a useful and time-efficient strategy to improve QOL in breast cancer survivors. We are investigating whether an abbreviated “booster” of the intervention at a later date could further improve and maintain QOL gains.

A pilot study of the Pathways program to address fear of recurrence and reduce distress among breast cancer survivors.

2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 206-206
Author(s):  
Edward Kenji Hadeler ◽  
Emily Claire Wong ◽  
Matina Elise Mamounas ◽  
Carrie D'andrea ◽  
Greg Hicks ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Race And Ethnicity ◽  
Breast Cancer Survivors ◽  
Fear Of Recurrence ◽  
Behavioral Strategies ◽  
Breast Cancer Patients ◽  
Acceptance And Action Questionnaire ◽  
And Coping ◽  
The Impact

206 Background: Breast cancer patients endorse anxiety and fear of recurrence for years after diagnosis. The Pathways for Survivors is a one-day program intended to address this distress by teaching cognitive behavioral strategies that improve self-efficacy, communication, attitude, and coping. The workshop incorporates an evidence-based program developed by authors/researchers Greg Hicks and Rick Foster, which has been adapted for the breast cancer survivorship population. Methods: Patients who had completed their acute phase of care were invited to attend the workshop. Attendees were asked to complete a series of questionnaires either on paper or electronically at baseline, 1 week and 6 weeks following the program and were consented to have their data used for research. Questionnaires included evaluation of program content and moderator quality, as well as measures to assess the impact of the Pathways intervention including the PROMIS Anxiety and Depression Short Forms, and the Acceptance and Action Questionnaire (AAQ-II). Results: Three sessions were held between 9/2015-9/2016. A total of 27 patients participated (6 in the first, 13 in the second, 8 in the third). Mean age of participants was 49 (range 28-65) years old. Race and ethnicity was: 63% White, 11% Asian, 4% Pacific Islander, 11% other, and 15% Hispanic/Latina (total > 100% due to a patient reporting more than one race/ethnicity). The table below summarizes the change in these scores over time. Evaluations showed that patients were extremely satisfied with the program and moderator, receiving average ratings of 9.6/10 and 10/10, respectively. Conclusions: The Pathways workshop was well received and appears to have at least a short-term impact on breast cancer survivors’ anxiety, depression, and psychological flexibility. [Table: see text]

Patient reported outcomes in older breast cancer survivors.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 12072-12072
Author(s):  
Sharon H. Giordano ◽  
Kai-Ping Eric Liao ◽  
Liang Li ◽  
Daria Zorzi ◽  
Mariana Chavez-MacGregor ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Endocrine Therapy ◽  
Breast Cancer Survivors ◽  
Symptom Burden ◽  
Breast Cancer Patients ◽  
Initial Mailing ◽  
Stage Disease ◽  
Patient Reported ◽  
Regional Disease

12072 Background: The majority of breast cancer patients are age 66 years or older at diagnosis, yet little is known about the symptom burden of older breast cancer survivors. Methods: Using the same process as for SEER-Medicare, data from the Texas Cancer Registry (TCR) and Medicare claims were linked. From this TCR-Medicare dataset, patients age 65 years and older at diagnosis, with localized or regional breast cancer, diagnosed in 2012 and 2013, and still alive in 2018 were identified. To assess long-term outcomes, a mailed survey, which included selected questions from the NCI’s PRO-CTCAE question bank, was sent to 4591 eligible patients along with a $10 gift card. Non-responders were sent a follow-up questionnaire at 4-6 weeks and 8-10 weeks after initial mailing. The percentage reporting symptoms, overall and by treatment received, are described. Results: 1594 survivors completed the questionnaire (35% response rate). Median time from diagnosis to survey completion was 67 months. 70% of responders were age 65-74, 26% age 75-84, and 3% age 85+ at diagnosis. 84% were non-Hispanic white, 6% black, and 9% Hispanic. 77% had localized stage disease and 23% had regional disease at diagnosis. 58% had lumpectomy, 36% had mastectomy, and 2% reported no surgery. 77% had ER+ breast cancer. 28% received adjuvant chemotherapy. 48% had Part D claims for adjuvant endocrine therapy. PROs are reported in Table, overall and by use of chemotherapy and endocrine therapy. Conclusions: Older breast cancer survivors, particularly those who were treated with chemotherapy, experience a high symptom burden. [Table: see text]

scholarly journals Fatigue among Long-Term Breast Cancer Survivors: A Controlled Cross-Sectional Study

Cancers ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1301
Author(s):  
Saskia W. M. C. Maass ◽  
Daan Brandenbarg ◽  
Liselotte M. Boerman ◽  
Peter F. M. Verhaak ◽  
Geertruida H. de Bock ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Logistic Regression ◽  
General Practitioner ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Breast Cancer Diagnosis ◽  
Reference Population ◽  
Cross Sectional ◽  
Symptoms Of Depression

Background: Fatigue is the most common and persistent symptom among women in the first five years after a breast cancer diagnosis. However, long-term prevalence of fatigue, among breast cancer survivors, needs further investigation. Aim: To compare fatigue experienced by long-term breast cancer survivors with that in a reference population and to evaluate the determinants of that fatigue. Design and Setting: A cross-sectional cohort study of 350 breast cancer survivors ≥5 years after diagnosis and a reference population of 350 women matched by age and general practitioner. Method: Fatigue was measured using the Multidimensional Fatigue Inventory (MFI-20), and a sum score of >60 (multidimensional fatigue) was the primary outcome. Logistic regression was applied to compare the prevalence of multidimensional fatigue between the survivor and reference populations, adjusted for body mass index (BMI) and for cardiovascular and psychological variables. Odds ratios (ORs) and 95% confidence intervals (95%CIs) were estimated. Logistic regression was applied to evaluate the determinants of multidimensional fatigue among the survivors. Results: Breast cancer survivors (median 10 years after diagnosis), more often experienced multidimensional fatigue than the reference population (26.6% versus 15.4%; OR, 2.0 [95%CI, 1.4–2.9]), even after adjusting for confounders. The odds of multidimensional fatigue were also higher among survivors with symptoms of depression (32.2% versus 2.7%; OR, 17.0 [95%CI, 7.1–40.5]) or anxiety (41.9% versus 10.1%; OR, 6.4 [95%CI, 3.6–11.4]). Conclusion: One in four breast cancer survivors experience multidimensional fatigue and fatigue occurs more frequently than in women of the same age and general practitioner. This fatigue appears to be associated with symptoms of depression and anxiety.

Patient-reported sexual function of breast cancer survivors with genitourinary syndrome of menopause after fractional CO2 laser therapy

Menopause ◽  
2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Allison M. Quick ◽  
Filadelfiya Zvinovski ◽  
Catherine Hudson ◽  
Andrew Hundley ◽  
Cynthia Evans ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Sexual Function ◽  
Cancer Survivors ◽  
Laser Therapy ◽  
Co2 Laser ◽  
Breast Cancer Survivors ◽  
Genitourinary Syndrome Of Menopause ◽  
Fractional Co2 Laser ◽  
Patient Reported ◽  
Genitourinary Syndrome

scholarly journals Quality of life and mental health in breast cancer survivors compared with non-cancer controls: a study of patient-reported outcomes in the United Kingdom

2020 ◽  
Author(s):  
Helena Carreira ◽  
Rachael Williams ◽  
Harley Dempsey ◽  
Susannah Stanway ◽  
Liam Smeeth ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Primary Care ◽  
Cancer Survivors ◽  
Patient Reported Outcomes ◽  
Breast Cancer Survivors ◽  
Patient Reported ◽  
History Of ◽  
History Of Cancer

Abstract Purpose There is limited high-quality evidence on quality of life, anxiety, and depressive symptoms in breast cancer survivors and women with no history of cancer. We aimed to address this by comparing patient-reported outcomes between breast cancer survivors and women with no history of breast cancer. Methods Breast cancer survivors and women with no prior cancer were selected from the UK Clinical Practice Research Datalink GOLD primary care database, which includes population-based primary care electronic health record data. Breast cancer survivors and controls were frequency matched by age and primary care practice. Outcomes were assessed with validated instruments via postal questionnaire. Linear and logistic regression models were fitted to estimate adjusted associations between breast cancer survivorship and outcomes. Results A total of 356 breast cancer survivors (8.1 years post diagnosis) and 252 women with no prior cancer participated in the study. Compared with non-cancer controls, breast cancer survivors had poorer QoL in the domains of cognitive problems (adjusted β (aβ) = 1.4, p = 0.01), sexual function (aβ = 1.7, p = 0.02) and fatigue (aβ = 1.3, p = 0.01), but no difference in negative feelings, positive feelings, pain, or social avoidance. Breast cancer survivors had higher odds of borderline-probable anxiety (score ≥ 8) (adjusted OR = 1.47, 95%CI:1.15–1.87), but no differences in depression. Advanced stage at diagnosis and chemotherapy treatment were associated with poorer QoL. Conclusions Compared with women with no history of cancer, breast cancer survivors report more problems with cognition, sexual function, fatigue, and anxiety, particularly where their cancer was advanced and/or treated with chemotherapy. Implications for Cancer Survivors Breast cancer survivors with more advanced disease and/or treated with chemotherapy should be closely monitored and, when possible, offered evidence-based intervention for fatigue, cognitive dysfunction, and sexual problems.

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