The Interplay between Housing Environmental Attributes and Design Exposures and Psychoneuroimmunology Profile—An Exploratory Review and Analysis Paper in the Cancer Survivors’ Mental Health Morbidity Context

Adult cancer survivors have an increased prevalence of mental health comorbidities and other adverse late-effects interdependent with mental illness outcomes compared with the general population. Coronavirus Disease 2019 (COVID-19) heralds an era of renewed call for actions to identify sustainable modalities to facilitate the constructs of cancer survivorship care and health care delivery through physiological supportive domestic spaces. Building on the concept of therapeutic architecture, psychoneuroimmunology (PNI) indicators—with the central role in low-grade systemic inflammation—are associated with major psychiatric disorders and late effects of post-cancer treatment. Immune disturbances might mediate the effects of environmental determinants on behaviour and mental disorders. Whilst attention is paid to the non-objective measurements for examining the home environmental domains and mental health outcomes, little is gathered about the multidimensional effects on physiological responses. This exploratory review presents a first analysis of how addressing the PNI outcomes serves as a catalyst for therapeutic housing research. We argue the crucial component of housing in supporting the sustainable primary care and public health-based cancer survivorship care model, particularly in the psychopathology context. Ultimately, we illustrate a series of interventions aiming at how housing environmental attributes can trigger PNI profile changes and discuss the potential implications in the non-pharmacological treatment of cancer survivors and patients with mental morbidities.

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Cancer Survivorship Care in Colombia: Review and Implications for Health Policy

Hispanic Health Care International ◽

10.1177/15404153211001578 ◽

2021 ◽

pp. 154041532110015

Author(s):

Oscar Yesid Franco-Rocha ◽

Gloria Mabel Carillo-Gonzalez ◽

Alexandra Garcia ◽

Ashley Henneghan

Keyword(s):

Health Care ◽

Health Policy ◽

Cancer Survivors ◽

Cancer Survivorship ◽

Policy Development ◽

Care Delivery ◽

Developed Countries ◽

The United States ◽

Survivorship Care ◽

Cancer Symptoms

Introduction: The number of cancer survivors is increasing in Colombia, and health policy changes are necessary to meet their unmet needs and improve their health outcomes. Similar trends have been identified in developed countries, and positive changes have been made. Methods: We conducted a narrative review to provide an overview of Colombia’s social structure, health care system, and health care delivery in relation to cancer, with recommendations for improving cancer survivorship in Colombia based on the model of survivorship care in the United States. Results: We proposed general recommendations for improving cancer survivors’ care including (1) recognizing cancer survivorship as a distinct phase of cancer, (2) strengthening methods and metrics for tracking cancer survivorship, (3) assessing and monitoring cancer symptoms and quality of life of cancer survivors, (4) publishing evidence-based guidelines considering the social, economic, and cultural characteristics of Colombian population and cancer survivors’ specific needs. Conclusion: These recommendations could be used to inform and prioritize health policy development in Colombia related to cancer survivorship outcomes.

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Current practice patterns and gaps in guideline-concordant breast cancer survivorship care

Journal of Cancer Survivorship ◽

10.1007/s11764-021-01152-1 ◽

2021 ◽

Author(s):

Eden R. Brauer ◽

Elisa F. Long ◽

Laura Petersen ◽

Patricia A. Ganz

Keyword(s):

Breast Cancer ◽

Cancer Survivors ◽

Cancer Survivorship ◽

Late Effects ◽

Breast Cancer Survivors ◽

Practice Patterns ◽

Survivorship Care ◽

Care Guidelines ◽

Composite Scores

Abstract Purpose Breast cancer-specific survivorship care guidelines for the more than 3.8 million survivors in the U.S. are available, but implementation in clinical practice remains challenging. We examined current practice patterns and factors associated with guideline-concordant survivorship care among oncologists. Methods A national sample of medical oncologists, recruited using two databases, participated in a survey focused on practice patterns for breast cancer survivorship care. A “survivorship care composite score” was calculated for each respondent based on provision of services recommended in the survivorship guidelines. Descriptive statistics and multivariable linear regression analyses examined associations between physician and practice characteristics and composite scores. Results The survey was completed by 217 medical oncologists, with an overall response rate of 17.9% and eligibility rate of 56.9% for those who responded. Oncologists reported high engagement in evaluation of disease recurrence (78%). Performed less frequently were the provision of survivorship care plans (46%), assessment of psychosocial long-term and late effects (34%), and screening for subsequent cancers (34%). Lack of survivorship care training (p = 0.038) and not routinely informing patients about potential late effects (p = 0.003) were significantly associated with poorer survivorship care composite scores. Conclusions Despite the availability of disease-specific survivorship care guidelines, adherence to their recommendations in clinical practice is suboptimal. Survey results identified key gaps in survivorship care for breast cancer survivors, particularly related to subsequent primary cancers and psychosocial long-term and late effects. Implications for Cancer Survivors Improving the delivery of comprehensive survivorship care for the growing population of breast cancer survivors is a high priority. Disease-specific clinical guidelines for cancer survivorship provide valuable recommendations, but innovative strategies are needed to integrate them into the care of long-term breast cancer survivors.

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Problem-solving skills training in adult cancer survivors: Bright IDEAS-AC.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e24109 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e24109-e24109

Author(s):

Katia Noyes ◽

Olle Jane Sahler ◽

Alaina Zapf ◽

Rachel Depner ◽

Alissa Huston ◽

...

Keyword(s):

Quality Of Life ◽

Clinical Trial ◽

Problem Solving ◽

Cancer Survivors ◽

Cancer Survivorship ◽

Skills Training ◽

Survivorship Care ◽

Problem Solving Skills ◽

Adult Cancer Survivors

e24109 Background: Cancer patients experience significant distress throughout treatment and especially during transition back to normal life with greater burden on socially disadvantaged patients and those with medical comorbidities. Patient stressors can interfere with their ability to make reasoned and timely decisions about survivorship care and lead to poor quality of life and low physical and social functioning. This pilot effectiveness-implementation study examined the impact and feasibility of offering the Bright IDEAS system of Problem-Solving Skills Training (PSST) to adult cancer survivors to help them and their caregivers cope more successfully with decision making and distress. Methods: Patients with breast (21), prostate (9) or colorectal (20) cancer who completed their definitive cancer treatment within the last 6 months and had their cancer survivorship visit were recruited from two regional cancer centers and affiliated community oncology clinics. Patients with an NCCN distress level > 2 were randomly assigned to either care as usual (CAU) or 8 weekly PSST sessions provided by a trained therapist in person or remotely. Patients were invited but not required to include a supportive other (n = 17). Patient and caregiver assessments at baseline (T1), end of intervention/3 months (T2), and 3 months post intervention/6 months (T3) focused on problem-solving skills (SPSI-25), distress (HADS) and quality of life (FACT). We also collected healthcare utilization data. We compared outcome changes T1-T2 and T1-T3, by study arm, using t-tests. Multivariate regression analysis identified subgroups of patients with positive and negative responses to skills training. Results: Average age of the participants was 63 years (45 to 87) with racial and ethnic distributions representative of the local population (88% white). Two thirds were women (n = 32), one third of the patients were recruited and received therapy fully remotely due to COVID-19-related protocol changes. Patients who received PSST reported a reduction in dysfunctional problem-solving style and improvement in constructive style while problem-solving skills of CAU patients trended in the opposite direction. Patients in the PSST arm also reported significant reduction in anxiety and depression and improvement in cancer-specific quality of life (p < 0.05) that was sustained at 6 months. Patients in the PSST arm reported lower use of hospital and ED services compared to CAU patients (p = 0.07). Better improvement in outcomes was driven by lower problem-solving skills at baseline. Conclusions: Despite the logistical complexity of running a clinical trial during quarantine, patients and caregivers in the PSST arm demonstrated meaningful improvement in distress and quality of life. The evidence from this pilot study will help guide development of a future multi-site randomized clinical trial of the effect of PSST on cancer survivorship care and outcomes. Clinical trial information: NCT03567850.

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ReCAP: ASCO Core Curriculum for Cancer Survivorship Education

Journal of Oncology Practice ◽

10.1200/jop.2015.009449 ◽

2016 ◽

Vol 12 (2) ◽

pp. 145-145 ◽

Cited By ~ 24

Author(s):

Charles L. Shapiro ◽

Paul B. Jacobsen ◽

Tara Henderson ◽

Arti Hurria ◽

Larissa Nekhlyudov ◽

...

Keyword(s):

Literature Review ◽

Cancer Survivors ◽

Core Curriculum ◽

Care Delivery ◽

Core Competencies ◽

Real Life ◽

Well Being ◽

Survivorship Care ◽

Environmental Scan ◽

Adult Cancer Survivors

CONTEXT AND QUESTION(S) ASKED: The number of cancer survivors is increasing exponentially. Currently there about 15 million cancer survivors, and by 2025, there will be nearly 20 million. Who will provide survivorship care, what are evidenced-based or best care practices, what are best methods to disseminate this information and assess its impact on physician practice, and what are the most cost-effective health care delivery models to serve the majority of survivors? SUMMARY ANSWER: The ASCO Survivorship Committee in collaboration with the ASCO Professional Development Committee developed a core curriculum and core competencies for physicians, allied health professionals, training programs, and policymaking organizations. Adapted from Institute of Medicine recommendations for survivorship care, the core curriculum and competencies include the following subheadings: surveillance for recurrence and second malignancies, long-term and late effects, health promotion and prevention, psychosocial well-being, special populations including adolescent and young adult survivors, older adult cancer survivors, caregivers of cancer survivors and communication and care coordination. METHODS: An environmental scan (a process that systematically surveys and interprets relevant data to identify opportunities and barriers) for survivorship was performed. Although survivorship content exists in various courses, conferences, guidelines, and Web-based applications, the information is incomplete and not easily found. Hence, there was a need for this content to be easy to access and available in one place. Content experts formulated the individual sections based on the environmental scan and their knowledge of the various subheadings. BIAS, CONFOUNDING FACTOR(S), DRAWBACKS: Both an environmental scan and a comprehensive literature review have standard methodologies. The differences are in scope; an environmental scan is more like an overview, and the standard literature review is more granular. For this article, we felt that environmental scan better served the purpose of developing a survivorship core curriculum and competencies. REAL-LIFE IMPLICATIONS: Survivorship care is one the most challenging problems oncologists face today and in the near future. Fundamental to the relatively new field of survivorship care is this core curriculum and competencies, which provide the framework necessary to generate appropriate referrals depending on local practices and expertise.

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ASCO Clinical Evidence Review on the Ongoing Care of Adult Cancer Survivors: Cardiac and Pulmonary Late Effects—Review Summary

Journal of Oncology Practice ◽

10.1200/jop.0748501 ◽

2007 ◽

Vol 3 (4) ◽

pp. 233-235 ◽

Cited By ~ 1

Keyword(s):

Cancer Survivors ◽

Late Effects ◽

Clinical Evidence ◽

Adult Cancer Survivors ◽

Evidence Review ◽

Ongoing Care

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Age and Cancer Treatment Are Related to Receiving Treatment Summaries and Survivorship Care Plans in Female Young Adult Cancer Survivors

Journal of Adolescent and Young Adult Oncology ◽

10.1089/jayao.2017.0003 ◽

2017 ◽

Vol 6 (4) ◽

pp. 573-578 ◽

Cited By ~ 2

Author(s):

Ksenya Shliakhtsitsava ◽

Sally A. D. Romero ◽

Brian W. Whitcomb ◽

Jessica R. Gorman ◽

Samantha Roberts ◽

...

Keyword(s):

Young Adult ◽

Cancer Survivors ◽

Cancer Treatment ◽

Survivorship Care Plans ◽

Survivorship Care ◽

Treatment Summaries ◽

Care Plans ◽

Young Adult Cancer Survivors ◽

Adult Cancer Survivors ◽

Young Adult Cancer

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“Breaking the Silence” to Improve Cancer Survivorship Care for First Nations Peoples

International Journal of Qualitative Methods ◽

10.1177/1609406918774133 ◽

2018 ◽

Vol 17 (1) ◽

pp. 160940691877413

Author(s):

Wendy Gifford ◽

Roanne Thomas ◽

Gwen Barton ◽

Viviane Grandpierre ◽

Ian D. Graham

Keyword(s):

Health Care ◽

First Nations ◽

Cancer Survivorship ◽

Health Care Providers ◽

Large Scale ◽

Care Delivery ◽

Survivorship Care ◽

Care Providers ◽

Community Based ◽

Knowledge To Action

There is a significant knowledge-to-action gap in cancer survivorship care for First Nations (FN) communities. To date, many approaches to survivorship have not been culturally responsive or community-based. This study is using an Indigenous knowledge translation (KT) approach to mobilize community-based knowledge about cancer survivorship into health-care programs. Our team includes health-care providers and cancer survivors from an FN community in Canada and an urban hospital that delivers Cancer Care Ontario’s Aboriginal Cancer Program. Together, we will study the knowledge-to-action process to inform future KT research with Indigenous peoples for improving health-care delivery and outcomes. The study will be conducted in settings where research relations and partnerships have been established through our parent study, The National Picture Project. The inclusion of community liaisons and the continued engagement of participants from our parent study will foster inclusiveness and far-reaching messaging. Knowledge about unique cancer survivorship needs co-created with FN people in the parent study will be mobilized to improve cancer follow-up care and to enhance quality of life. Findings will be used to plan a large-scale implementation study across Canada.

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Mental health among nonelderly adult cancer survivors: A national estimate

Cancer ◽

10.1002/cncr.32988 ◽

2020 ◽

Vol 126 (16) ◽

pp. 3768-3776

Author(s):

Xu Ji ◽

Janet R. Cummings ◽

Jordan Gilleland Marchak ◽

Xuesong Han ◽

Ann C. Mertens

Keyword(s):

Mental Health ◽

Cancer Survivors ◽

Adult Cancer Survivors

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Providing Care for Cancer Survivors in Integrated Health Care Delivery Systems: Practices, Challenges, and Research Opportunities

Journal of Oncology Practice ◽

10.1200/jop.2011.000312 ◽

2012 ◽

Vol 8 (3) ◽

pp. 184-189 ◽

Cited By ~ 41

Author(s):

Jessica Chubak ◽

Leah Tuzzio ◽

Clarissa Hsu ◽

Catherine M. Alfano ◽

Borsika A. Rabin ◽

...

Keyword(s):

Health Care ◽

Cancer Survivors ◽

Health Care Delivery ◽

Exploratory Study ◽

Care Delivery ◽

Delivery Systems ◽

Integrated Health Care ◽

Survivorship Care ◽

Integrated Health ◽

Health Care Delivery Systems

Exploratory study suggests an awareness of cancer survivorship care in integrated health care delivery systems, although approaches to providing such care vary across systems.

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