The Growing Pains of Cancer Survivors: A Call for a Paradigm of Interdisciplinary Care

Work provides satisfaction and stability to young adult cancer survivors. However, progressive health changes because of cancer may compromise safety and diminish functional ability. The purpose of this study was to describe long-term young adult cancer survivors’ work experiences and describe their interactions with occupational and environmental health professionals (OEHPs) within the workplace. Cancer survivors were recruited from the Los Angeles County Cancer Surveillance Program. Professional organizations provided access to OEHPs. Constructivist grounded theory guided individual semi-structured interviews during data collection and analysis. Processes of interaction between cancer survivors and OEHPs found to influence work included revealing the survivor-self, sustaining work ability, gatekeeping (employment opportunities, return to work), and accessing support. OEHPs appeared to facilitate survivors’ work ability in the long term if services were available, services were known to survivors, and survivors revealed needs. Educating workers about OEHP services throughout cancer experiences and survivorship could ultimately improve interactivity and provide supportive work environments.

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Need For Improved Skin Cancer Surveillance in Pediatric Cancer Survivors

American Journal of Clinical Dermatology ◽

10.1007/s40257-016-0241-1 ◽

2016 ◽

Vol 18 (2) ◽

pp. 165-168 ◽

Cited By ~ 2

Author(s):

Divya Sharma ◽

Thomas Lee ◽

Adam J. Friedman ◽

Kelley Pagliai Redbord

Keyword(s):

Skin Cancer ◽

Cancer Survivors ◽

Pediatric Cancer ◽

Cancer Surveillance ◽

Pediatric Cancer Survivors

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Training Lay Health Workers to Promote Post-Treatment Breast Cancer Surveillance in African American Breast Cancer Survivors: Development and Implementation of a Curriculum

Journal of Cancer Education ◽

10.1080/08858190902973085 ◽

2009 ◽

Vol 24 (4) ◽

pp. 267-274 ◽

Cited By ~ 2

Author(s):

Hayley Thompson ◽

Tiffany Edwards ◽

Deborah Erwin ◽

Susan Lee ◽

Dana Bovbjerg ◽

...

Keyword(s):

Breast Cancer ◽

African American ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Health Workers ◽

Post Treatment ◽

Cancer Surveillance ◽

Lay Health Workers

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Routine preventive care and cancer surveillance in long-term survivors (LTS) of colorectal cancer: Results from NSABP Protocol LTS-01

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.6500 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. 6500-6500

Author(s):

H. Kunitake ◽

P. Zheng ◽

G. Yothers ◽

S. Land ◽

L. Fehrenbacher ◽

...

Keyword(s):

Colorectal Cancer ◽

Cancer Screening ◽

Cancer Survivors ◽

Preventive Care ◽

Pap Smear ◽

Cancer Surveillance ◽

Screening Tests ◽

Colorectal Cancer Survivors ◽

Long Term Survivors

6500 Background: Little is known about the use of routine preventive care and cancer surveillance in long-term colorectal cancer survivors. NSABP LTS-01 is a study that examines the use of such services in long-term colorectal cancer survivors previously treated in NSABP adjuvant trials. Methods: Long-term colorectal cancer survivors (≥ 5 years) were recruited from five completed NSABP treatment trials (Protocols C-05, C-06, C-07, R-02, R-03) at 65 study sites. A survey battery for long-term survivors of colorectal cancer (LTS-01) was developed. A 1:4 comparison cohort case-matched by age, gender, race, and education was created from the 2005 National Health Interview Survey. Contingency tables and multivariate models were used to compare cohorts and determine predictors of preventive care and cancer surveillance. Results: 649 LTS-01 patients (625 colon, 24 rectal) completed the interview; 57% male, mean age 66.1yr (SD 10.5), median survival 8 yrs. LTS-01 patients were more likely to have a usual source of healthcare than the NHIS cohort (98% vs. 93%, p < 0.0001). The number of ER visits in the previous 12 months was not significantly different between the two groups. LTS-01 patients were more likely to have received a flu shot in the past 12 months (68% vs. 42%, p < 0.0001) and were also more likely to have undergone cancer screening by Pap smear (67% vs. 54%, p < 0.001), mammogram (85% vs. 71%, p < 0.001), and PSA test (84% vs. 75%, p < 0.001). For CRC surveillance, 3% did not have a colonoscopy, 13% had not had a CEA test, and 34% did not have a CT scan in the last 5 years. The best predictor of the receipt of these cancer screening tests was the presence of health insurance (OR 2.6–4.5). No factor was uniformly associated with colorectal cancer surveillance. Conclusions: Long-term survivors of colorectal cancer achieve better routine preventive care including cancer screening than the general population. However in these stage II and stage III cancer patients cancer surveillance is variably performed. No significant financial relationships to disclose.

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New insights into the risk of breast cancer in childhood cancer survivors treated with chest radiation: A report from the Childhood Cancer Survivor Study (CCSS) and the Women's Environmental Cancer and Radiation Epidemiology(WECARE) Study.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.18_suppl.cra9513 ◽

2012 ◽

Vol 30 (18_suppl) ◽

pp. CRA9513-CRA9513 ◽

Cited By ~ 5

Author(s):

Chaya S. Moskowitz ◽

Joanne F. Chou ◽

Suzanne L. Wolden ◽

Jonine L. Bernstein ◽

Jyoti Malhotra ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Survivors ◽

Childhood Cancer ◽

Cumulative Incidence ◽

Childhood Cancer Survivors ◽

Population Based ◽

Cancer Surveillance ◽

Brca1 And Brca2 ◽

First Degree Relatives ◽

Mutation Carriers

CRA9513 Background: The risk of breast cancer (BC) by age 50 among women treated for childhood cancer with chest radiation therapy (RT) and how this risk compares with that of BRCA1 and BRCA2 (BRCA1/2) mutation carriers is unknown. Methods: We evaluated the risk of BC in a cohort of 1268 female 5-yr childhood cancer survivors treated with chest RT and estimated the cumulative incidence of BC non-parametrically treating death as a competing risk. The cumulative incidence of BC in BRCA1/2 mutation carriers was estimated with the kin-cohort method using data from 4570 female first-degree relatives of women diagnosed with unilateral BC (probands) participating in the WECARE Study. Absolute Excess Risks (AERs) were estimated using population-based data from the SEER program. Results: With a median follow-up of 26 yrs (range 5-39) for the CCSS cohort, 175 women were diagnosed with BC at a median age of 38 yrs (range 24-53) and a median latency of 23 yrs (range 7-38); the overall cumulative incidence of BC by age 50 was 24% (95% confidence interval [CI] 20-28%) and among Hodgkin lymphoma survivors was 30% (95% CI 25-35%). In comparison, among first-degree relatives of WECARE Study probands 324 were diagnosed with BC (median age at diagnosis, 55 yrs (range 26-90)). The estimated cumulative incidence by age 50 was 31% (95% CI 16-47%) and 10% (95% CI 2-23%) in carriers of BRCA1 and BRCA2 mutations, respectively. The population cumulative incidence of BC is 4% by age 50. Among the childhood cancer survivors, AERs for BCs diagnosed per 10,000 person-years of observation were respectively 34 (95% CI 18-52), 27 (95% CI 11-45), and 95 (95% CI 78-112) among women treated with 10-19 Gy (23%), 20-29 Gy (17%), and 30+ Gy (56%) of chest RT. Conclusions: Women treated for childhood cancer with chest RT have a substantial risk of BC comparable to BRCA1/2 mutation carriers and considerably greater than that of the general population. Women treated with 10-19 Gy RT had an increased excess risk warranting consideration of breast cancer surveillance strategies similar to the current recommendations for women treated with > 20 Gy.

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