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Nash SH, Dilley J, Siekaniec C, O'Brien D, Avila R, Quinn J. Needs assessment of cancer survivors in Alaska. Cancer Causes Control 2022; 33:1453-1463. [PMID: 36183311 PMCID: PMC9526813 DOI: 10.1007/s10552-022-01636-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 09/21/2022] [Indexed: 11/25/2022]
Abstract
Purpose Little is known about cancer survivors’ needs in Alaska. To address this knowledge gap, the Alaska Cancer Partnership conducted a needs assessment survey; our objectives were to identify unmet needs of Alaska’s cancer survivors; identify survivor sub-populations that might benefit from targeted interventions or programming; and develop recommendations for public health and community organizations and healthcare providers for addressing cancer survivors’ unmet needs. Methods Cancer survivors were identified using data from the Alaska Cancer Registry. A random sample of 2,600 individuals was selected to receive the survey, which assessed unmet needs across the following domains: information needs and medical care issues; quality of life; emotional and relationship issues related to cancer diagnoses; and support services. We calculated descriptive statistics for survey responses and assessed demographic predictors of unmet needs using Poisson regression. Results We received 335 survey responses, for a response of 13.7%. Only 29.9% of cancer survivors expressed that all their needs were met. The most highly ranked unmet needs were as follows: help to reduce stress in life; to know doctors were coordinating care; and managing concerns about cancer coming back. After adjustment, men, adults younger than 65 at diagnosis, Alaska Native people, survivors still receiving or who had recently received care, and people who had to travel 50+ miles for most of their care had significantly greater unmet needs than their comparison groups. Conclusion This assessment provided some of the first information regarding the needs of Alaska’s cancer survivors. These results will be used by Alaska Cancer Partnership members across the state to inform healthcare delivery, programs, and public health messaging to support survivors.
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Affiliation(s)
- Sarah H Nash
- Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA.
- Department of Epidemiology, University of Iowa, 145 N Riverside Drive, Iowa, IA, 52242, USA.
| | - Julia Dilley
- Multnomah County and Oregon Health Authority, Public Health Division, Program Design and Evaluation Services (PDES), Portland, OR, USA
| | - Claire Siekaniec
- Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | - David O'Brien
- State of Alaska, Division of Public Health, Health Analytics and Vital Records Section, Anchorage, AK, USA
| | - Rosa Avila
- State of Alaska, Division of Public Health, Health Analytics and Vital Records Section, Anchorage, AK, USA
| | - Jessica Quinn
- State of Alaska, Division of Public Health, Section of Chronic Disease Prevention and Health Promotion, Anchorage, AK, USA
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Johnston EA, van der Pols JC, Ekberg S. Needs, preferences, and experiences of adult cancer survivors in accessing dietary information post-treatment: A scoping review. Eur J Cancer Care (Engl) 2020; 30:e13381. [PMID: 33377564 DOI: 10.1111/ecc.13381] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 10/13/2020] [Accepted: 11/18/2020] [Indexed: 01/08/2023]
Abstract
INTRODUCTION To support provision of healthy lifestyle information tailored to patients' needs and preferences, this review maps adult cancer survivors' self-reported needs, preferences, and experiences accessing dietary information post-treatment. METHODS A scoping review of research published within the past decade conducted using PRISMA-ScR guidelines. Seven databases were searched in June 2020. RESULTS Of 15,973 articles identified, 57 met eligibility criteria. Studies most frequently included survivors of breast cancer (49%), persons aged 40+ years (95%), ≤5 years post-diagnosis (54%), and residing in North America (44%). Cancer survivors commonly identified needing information regarding healthy eating, particularly practical skills, and support in changing dietary behaviours. Preferences included specific recommendations, direct communication with healthcare professionals, and peer support from other cancer survivors. In practice, survivors frequently reported receiving generic advice from healthcare professionals, limited dietary follow-up, and lack of referral to support. Unmet needs in healthcare settings led to dietary information-seeking elsewhere; however, survivors indicated difficulty identifying credible sources. Personal beliefs and desire for involvement in care motivated dietary information-seeking post-treatment. CONCLUSION Cancer survivors' experiences accessing dietary information post-treatment do not align with needs and preferences. Less is known about survivors who are young adults, >5 years post-diagnosis, and living in rural areas.
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Affiliation(s)
- Elizabeth A Johnston
- School of Exercise and Nutrition Sciences, Queensland University of Technology (QUT), Kelvin Grove, QLD, Australia
| | - Jolieke C van der Pols
- School of Exercise and Nutrition Sciences, Queensland University of Technology (QUT), Kelvin Grove, QLD, Australia
| | - Stuart Ekberg
- School of Psychology and Counselling, Queensland University of Technology (QUT), Kelvin Grove, QLD, Australia
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Efficacy of Emu Oil Transfersomes for Local Transdermal Delivery of 4-OH Tamoxifen in the Treatment of Breast Cancer. Pharmaceutics 2020; 12:pharmaceutics12090807. [PMID: 32854385 PMCID: PMC7558379 DOI: 10.3390/pharmaceutics12090807] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 08/14/2020] [Accepted: 08/20/2020] [Indexed: 12/11/2022] Open
Abstract
Oral tamoxifen used in the prevention and treatment of ductal carcinoma in situ (DCIS) (estrogen-positive) patients has limited acceptance, due to its adverse side effects. The efficacy of tamoxifen is related to its major metabolite, 4-hydroxytamoxifen. Local transdermal therapy of 4-hydroxytamoxifen to the breast might avert the toxicity of oral tamoxifen, while maintaining efficacy. We aim to study the skin irritancy, as well as to evaluate the efficacy of the developed transfersome formulations, with/without emu oil, using a syngeneic mouse model of breast cancer. We also quantified tamoxifen/4-hydroxytamoxifen concentrations in blood plasma and performed histopathology. The skin irritancy test showed that the pure emu oil and transfersome formulations with or without the emu oil did not cause skin irritancy in the animals studied. A sensitive and specific LC–MS/MS method for the quantification of tamoxifen and 4-hydroxytamoxifen was developed and validated. Studies on tumor volume and necrosis (histopathology) using the breast cancer mouse model showed that the 4-OHT transfersomal formulations, with and without emu oil, showed comparable efficacy with that of orally administered tamoxifen. However, the transfersomal formulations, with and without emu oil, resulted in significantly lower (10.24 ± 0.07 and 32.45 ± 0.48 ng/mL, respectively) plasma concentrations of 4-hydroxytamoxifen, compared to the oral tamoxifen (TAMX) group (634.42 ± 7.54 ng/mL). This study demonstrated the potential use of emu oil in a local transdermal formulation for the treatment of breast cancer and its reduced adverse effects.
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Lovelace DL, McDaniel LR, Golden D. Long-Term Effects of Breast Cancer Surgery, Treatment, and Survivor Care. J Midwifery Womens Health 2019; 64:713-724. [PMID: 31322834 DOI: 10.1111/jmwh.13012] [Citation(s) in RCA: 146] [Impact Index Per Article: 29.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 03/11/2019] [Accepted: 03/27/2019] [Indexed: 01/13/2023]
Abstract
Women are increasingly surviving breast cancer, but up to 90% experience unexpected long-term sequelae as a result of treatment. Symptoms may include physical, functional, emotional, and psychosocial changes that can dramatically alter the quality of life for breast cancer survivors. Primary care clinicians, including midwives, are likely to care for these women and should be familiar with common symptoms, treatment, and best practices to avoid permanent dysfunction. A holistic approach to assessment, treatment, and referral as needed is the most effective strategy. Although women experience significant changes after breast cancer treatment, many fail to receive thorough assessment of their symptoms, education about interventions, and treatment options to optimize health promoting strategies. Disparities exist in treatment availability, options, and survivorship. Long-term physical changes include anatomic changes, chronic pain, phantom breast pain, axillary web syndrome, and lymphedema. In addition, women may have decreased strength, aerobic capacity, mobility, fatigue, and cognitive dysfunction. Emotional and psychosocial changes include depression, anxiety, fatigue, concerns about body image, and issues with sexuality. Treatment should be multifactorial based on thorough assessment of symptoms and can include medication, exercise, counseling, physical and occupational therapy, and alternative and complementary therapies. Primary care and gynecologic clinicians are well positioned to provide thorough evaluation, education, treatment, and referral for the most common sequelae of mastectomy and breast cancer treatments.
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Louison R, Lee J, Roe V, Ghosh C. Effects of a holistic, patient-centered approach on breast cancer relative dose intensity. ADVANCES IN INTEGRATIVE MEDICINE 2019. [DOI: 10.1016/j.aimed.2018.06.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Frawley J, Peng W, Sibbritt D, Ward L, Lauche R, Zhang Y, Adams J. Is there an association between women's consultations with a massage therapist and health-related quality of life? Analyses of 1800 women aged 56-61 years. J Bodyw Mov Ther 2016; 20:734-739. [PMID: 27814852 DOI: 10.1016/j.jbmt.2016.04.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 03/19/2016] [Accepted: 03/25/2016] [Indexed: 01/22/2023]
Abstract
BACKGROUND The use of complementary and alternative medicine (CAM) is commonplace in Australia with massage being a popular CAM modality. METHODS This is a sub-study from the Australian Longitudinal Study on Women's Health (ALSWH). A total of 2120 mid-age (56-61 year old) women who consulted a CAM practitioner were invited to participate in this study. The Short-Form (SF-36) questionnaire was used to measure women's health-related quality of life. RESULTS A total of 1800 women returned the questionnaire generating a response rate of 85.0%. Overall, 912 (50.7%) women visited a massage therapist in the previous 12 months. Women with lower quality of life scores in terms of bodily pain (p = 0.012) and/or emotional health (p = 0.029) were more likely to consult a massage therapist than those with higher scores. CONCLUSION The implications of these associations are important for informing healthcare providers in providing effective and coordinated care for patients with pain and mood symptoms.
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Affiliation(s)
- Jane Frawley
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia.
| | - Wenbo Peng
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - David Sibbritt
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Lesley Ward
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK
| | - Romy Lauche
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia; Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, 45276, Essen, Germany
| | - Yan Zhang
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia; Department of Family Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Jon Adams
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
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Sulenes K, Freitas J, Justice L, Colgan DD, Shean M, Brems C. Underuse of Yoga as a Referral Resource by Health Professions Students. J Altern Complement Med 2015; 21:53-9. [DOI: 10.1089/acm.2014.0217] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Kari Sulenes
- School of Professional Psychology, Pacific University, Hillsboro, OR
| | - Jillian Freitas
- School of Professional Psychology, Pacific University, Hillsboro, OR
| | - Lauren Justice
- School of Professional Psychology, Pacific University, Hillsboro, OR
| | | | - Margaret Shean
- School of Professional Psychology, Pacific University, Hillsboro, OR
| | - Christiane Brems
- School of Professional Psychology, Pacific University, Hillsboro, OR
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