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Anazco D, Acosta A, Cathcart-Rake EJ, D'Andre SD, Hurtado MD. Weight-centric prevention of cancer. Obes Pillars 2024; 10:100106. [PMID: 38495815 PMCID: PMC10943063 DOI: 10.1016/j.obpill.2024.100106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 02/29/2024] [Accepted: 02/29/2024] [Indexed: 03/19/2024]
Abstract
Background The link between excess adiposity and carcinogenesis has been well established for multiple malignancies, and cancer is one of the main contributors to obesity-related mortality. The potential role of different weight-loss interventions on cancer risk modification has been assessed, however, its clinical implications remain to be determined. In this clinical review, we present the data assessing the effect of weight loss interventions on cancer risk. Methods In this clinical review, we conducted a comprehensive search of relevant literature using MEDLINE, Embase, Web of Science, and Google Scholar databases for relevant studies from inception to January 20, 2024. In this clinical review, we present systematic reviews and meta-analysis, randomized clinical trials, and prospective and retrospective observational studies that address the effect of different treatment modalities for obesity in cancer risk. In addition, we incorporate the opinions from experts in the field of obesity medicine and oncology regarding the potential of weight loss as a preventative intervention for cancer. Results Intentional weight loss achieved through different modalities has been associated with a reduced cancer incidence. To date, the effect of weight loss on the postmenopausal women population has been more widely studied, with multiple reports indicating a protective effect of weight loss on hormone-dependent malignancies. The effect of bariatric interventions as a protective intervention for cancer has been studied extensively, showing a significant reduction in cancer incidence and mortality, however, data for the effect of bariatric surgery on certain specific types of cancer is conflicting or limited. Conclusion Medical nutrition therapy, exercise, antiobesity medication, and bariatric interventions, might lead to a reduction in cancer risk through weight loss-dependent and independent factors. Further evidence is needed to better determine which population might benefit the most, and the amount of weight loss required to provide a clinically significant preventative effect.
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Affiliation(s)
- Diego Anazco
- Precision Medicine for Obesity Program, Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Andres Acosta
- Precision Medicine for Obesity Program, Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | | | | | - Maria D. Hurtado
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Department of Medicine, Mayo Clinic, Jacksonville, FL, USA
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Cathcart-Rake EJ, Ruddy KJ, Tevaarwerk AJ, Jatoi A. Breast cancer and gender-affirming hormone therapy for transgender and gender-diverse (TGD) individuals. Maturitas 2024; 181:107913. [PMID: 38262089 PMCID: PMC10872221 DOI: 10.1016/j.maturitas.2024.107913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 12/01/2023] [Accepted: 01/06/2024] [Indexed: 01/25/2024]
Abstract
Transgender and gender-diverse (TGD) individuals are at risk for breast cancer, but are less likely to undergo screening mammograms and appear to suffer poorer cancer-related outcomes than cisgender women. Gender-affirming hormone therapy (GAHT) may be lifesaving for TGD individuals from the perspective of affirming their core identities; however, the effects of GAHT on cancer development, progression, and outcomes are poorly understood.
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Affiliation(s)
| | - Kathryn J Ruddy
- Department of Medical Oncology, Mayo Clinic, Rochester, MN, United States of America
| | - Amye J Tevaarwerk
- Department of Medical Oncology, Mayo Clinic, Rochester, MN, United States of America
| | - Aminah Jatoi
- Department of Medical Oncology, Mayo Clinic, Rochester, MN, United States of America
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Cathcart-Rake EJ, Tevaarwerk AJ, Haddad TC, D'Andre SD, Ruddy KJ. Advances in the care of breast cancer survivors. BMJ 2023; 382:e071565. [PMID: 37722731 DOI: 10.1136/bmj-2022-071565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
Abstract
Breast cancer survivors may experience significant after effects from diagnoses of breast cancer and cancer directed therapies. This review synthesizes the evidence about optimal management of the sequelae of a diagnosis of breast cancer. It describes the side effects of chemotherapy and endocrine therapy and evidence based strategies for management of such effects, with particular attention to effects of therapies with curative intent. It includes strategies to promote health and wellness among breast cancer survivors, along with data to support the use of integrative oncology strategies. In addition, this review examines models of survivorship care and ways in which digital tools may facilitate communication between clinicians and patients. The strategies outlined in this review are paramount to supporting breast cancer survivors' quality of life.
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Kochan DC, Novotny PJ, Cathcart-Rake EJ, Orme JJ, Tevaarwerk AJ, Ruddy KJ, Childs DS. An evaluation of the effect of lithium on taxane-induced neuropathy. Support Care Cancer 2023; 31:299. [PMID: 37097406 DOI: 10.1007/s00520-023-07775-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 04/20/2023] [Indexed: 04/26/2023]
Abstract
PURPOSE No medications are known to protect against chemotherapy-induced peripheral neuropathy (CIPN). Pre-clinical models suggest that lithium may lessen taxane-induced neuropathy. Our aim was to use clinical data to assess whether concurrent lithium usage decreased the frequency or severity of CIPN in patients receiving taxane chemotherapy. METHODS A retrospective analysis was performed using the electronic health record at Mayo Clinic to identify all patients prescribed concurrent lithium and paclitaxel. Four controls were matched to each case based on clinical variables. Neuropathy severity was graded from available patient and clinician reports. Rates of any neuropathy, dose reduction for CIPN, and treatment discontinuation for CIPN were compared. Conditional regression analysis was performed with propensity score matching. RESULTS Six patients, receiving concurrent lithium and paclitaxel, were included in the analysis, and compared to 24 control cases. A similar number of paclitaxel cycles were administered to both groups. Any neuropathy was experienced by 33% (2/6) of patients receiving lithium and 38% (9/24) patients who did not receive lithium (p = 1.000). There was no difference in neuropathy severity (p = 0.8565), rate of chemotherapy dose reduction (17% vs. 17%, p = 1.000), or treatment discontinuation (17% vs 4%, p = 0.3655) for CIPN. In the propensity score analysis, the odds ratio for developing any neuropathy was 0.63 (95% confidence interval, 0.06 to 6.96, p = 0.7079). CONCLUSIONS Lithium does not appear to significantly lessen the risk of neuropathy for patients receiving paclitaxel. IMPLICATIONS FOR CANCER SURVIVORS Targeted approaches for preventing CIPN are desperately needed. Despite sound scientific rationale, the current study did not identify neuroprotective properties of lithium.
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Affiliation(s)
- David C Kochan
- Department of Oncology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Paul J Novotny
- Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | | | - Jacob J Orme
- Department of Oncology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Amye J Tevaarwerk
- Department of Oncology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Kathryn J Ruddy
- Department of Oncology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Daniel S Childs
- Department of Oncology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.
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Cathcart-Rake EJ, Kling JM, Carroll EF, Davidge-Pitts C, Le-Rademacher J, Ridgeway JL, Gonzalez CA, Jatoi A. Understanding Disparities: A Case Illustrative of the Struggles Facing Transgender and Gender Diverse Patients With Cancer. J Natl Compr Canc Netw 2023; 21:227-230. [PMID: 36791758 DOI: 10.6004/jnccn.2023.7005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
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Cathcart-Rake EJ, Ruddy KJ. Vaginal Estrogen Therapy for the Genitourinary Symptoms of Menopause: Caution or Reassurance? J Natl Cancer Inst 2022; 114:1315-1316. [PMID: 35854417 DOI: 10.1093/jnci/djac113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 05/25/2022] [Indexed: 11/13/2022] Open
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Cathcart-Rake EJ, Sanft T, Tevaarwerk AJ. Weight gain after breast cancer diagnosis: It's complicated…. Cancer 2022; 128:3152-3154. [PMID: 35781699 DOI: 10.1002/cncr.34343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/17/2022] [Accepted: 05/18/2022] [Indexed: 11/09/2022]
Affiliation(s)
| | - Tara Sanft
- Smilow Cancer Center, Yale University, New Haven, Connecticut, USA
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Jahan N, Cathcart-Rake EJ, Ruddy KJ. Late Breast Cancer Survivorship: Side Effects and Care Recommendations. J Clin Oncol 2022; 40:1604-1610. [PMID: 35226513 PMCID: PMC9113203 DOI: 10.1200/jco.22.00049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors' suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in the Journal of Clinical Oncology, to patients seen in their own clinical practice.
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Affiliation(s)
- Nusrat Jahan
- Division of Medical Oncology, Mayo Clinic, Rochester, MN
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Cathcart-Rake EJ, Zahrieh D, Smith D, Young S, McCue S, O'Connor A, Thomé S, Lacouture M, Register T, Piens J, Friday BB, Loprinzi CL. Natural history of nasal vestibulitis associated with paclitaxel, docetaxel, and other chemotherapy agents: a Minnesota Cancer Clinical Trials Network (MNCCTN) study. Support Care Cancer 2021; 29:6253-6258. [PMID: 33851235 DOI: 10.1007/s00520-021-06190-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 03/30/2021] [Indexed: 01/19/2023]
Abstract
PURPOSE To describe the natural history of nasal vestibulitis in patients receiving taxane chemotherapy, including incidence, severity, and associated symptoms. METHODS Eligible patients with minimal or no baseline nasal symptoms were enrolled in this natural history study at initiation of a new chemotherapy regimen. Patients completed nasal symptom logs each time they received a chemotherapy dose. This manuscript reports upon the patients who received paclitaxel, docetaxel, or non-taxane non-bevacizumab chemotherapy. The proportions of patients within each cohort reporting any treatment-emergent nasal symptoms were estimated, with corresponding exact 95% confidence intervals. A cumulative incidence function was estimated within the chemotherapy cohorts to calculate the cumulative incidence rate of treatment-emergent nasal vestibulitis, treating death and disease progression as competing risks. RESULTS Of the 81 evaluable patients, nasal symptoms were reported by 76.5% (58.8%, 89.3%) receiving paclitaxel, 54.2% (32.8%, 74.5%) receiving docetaxel, and 47.8% (26.8%, 69.4%) receiving non-taxane and non-bevacizumab chemotherapy. Of the three pairwise chemotherapy group comparisons, both the tests comparing the cumulative incidence function between the paclitaxel and non-taxane non-bevacizumab chemotherapy cohorts and between the paclitaxel and docetaxel cohorts achieved statistical significance at the 5% level with a higher incidence of treatment-emergent nasal vestibulitis in the paclitaxel cohort in both comparisons (P = 0.026 and P = 0.035, respectively). These significant differences were retained in the cumulative incidence function regression analysis controlling for age, smoking history, allergies, and asthma. Most patients in the paclitaxel cohort reported nasal symptoms as moderate or severe (56%). CONCLUSION Patients receiving paclitaxel chemotherapy experience a high incidence of nasal symptoms.
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Affiliation(s)
| | - David Zahrieh
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, 55905, USA
| | - Deanne Smith
- Department of Medical Oncology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Susan Young
- Department of Medical Oncology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Shaylene McCue
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, 55905, USA
| | - Amanda O'Connor
- Department of Medical Oncology, Mayo Clinic-Mankato, Mankato, MN, 56001, USA
| | - Stephan Thomé
- Department of Medical Oncology, Mayo Clinic-Mankato, Mankato, MN, 56001, USA
| | - Mario Lacouture
- Dermatology Service, Memorial Sloan Kettering Cancer Institute, 1275 York Ave, New York, NY, 10065, USA
| | - Terra Register
- Department of Medical Oncology, Mayo Clinic-Albert Lea, Albert Lea, MN, 56007, USA
| | - Jill Piens
- Department of Medical Oncology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Bret B Friday
- Essentia Health Cancer Center, 420 East First St, Duluth, MN, 55805, USA
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Cathcart-Rake EJ, Ruddy KJ, Bleyer A, Johnson RH. Breast Cancer in Adolescent and Young Adult Women Under the Age of 40 Years. JCO Oncol Pract 2021; 17:305-313. [PMID: 33449828 DOI: 10.1200/op.20.00793] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
In the United States, one in 196 women is diagnosed with breast cancer under the age of 40 years. Adolescents and young adults (AYAs), of age 15-39 years at diagnosis, experience a number of unique challenges when confronting breast cancer. The incidence of invasive breast cancer has increased among AYA women in the United States since 2004, and most of this change is due to an increase in young women diagnosed with distant disease. AYAs are more likely than older women to present with aggressive subtypes and advanced disease, and they often require systemic staging at diagnosis. Clinical trials should be considered whenever possible, particularly in AYAs with locally advanced or metastatic disease at diagnosis and those with disease progression or recurrence. A significant proportion of AYAs carry germline cancer predisposition mutations, which necessitates prompt genetic testing for all AYAs at diagnosis and may influence choice of local therapy. Suppression of ovarian function, as an adjunct to chemotherapy, may improve breast cancer survival in AYAs. To provide optimal care for AYAs with breast cancer, clinicians should engage multidisciplinary teams that offer fertility preservation, genetic counseling, physical and occupational therapy, nutrition, and psychosocial support, along with medical expertise in tailoring cancer-directed therapy and symptom management toward young women.
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Affiliation(s)
| | | | - Archie Bleyer
- St Charles Health System, Central Oregon Health and Science University, Portland, OR
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Patel SR, Zayas J, Medina-Inojosa JR, Loprinzi C, Cathcart-Rake EJ, Bhagra A, Olson JE, Couch FJ, Ruddy KJ. Real-World Experiences With Yoga on Cancer-Related Symptoms in Women With Breast Cancer. Glob Adv Health Med 2021; 10:2164956120984140. [PMID: 33473331 PMCID: PMC7797571 DOI: 10.1177/2164956120984140] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 08/13/2020] [Accepted: 12/08/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose Integrative therapies such as yoga are potential treatments for many psychological and physical symptoms that occur during and/or after treatment for cancer. The purpose of the current study was to evaluate the patient-perceived benefit of yoga for symptoms commonly experienced by breast cancer survivors. Methods 1,049 breast cancer survivors who had self-reported use of yoga on a follow up survey, in an ongoing prospective Mayo Clinic Breast Disease Registry (MCBDR), received an additional mailed yoga-focused survey asking about the impact of yoga on a variety of symptoms. Differences between pre- and post- scores were assessed using Wilcoxon Signed Rank Test. Results 802/1,049 (76%) of women who were approached to participate, consented and returned the survey. 507/802 (63%) reported use of yoga during and/or after their cancer diagnosis. The vast majority of respondents (89.4%) reported some symptomatic benefit from yoga. The most common symptoms that prompted the use of yoga were breast/chest wall pain, lymphedema, and anxiety. Only 9% of patients reported that they had been referred to yoga by a medical professional. While the greatest symptom improvement was reported with breast/chest wall pain and anxiety, significant improvement was also perceived in joint pain, muscle pain, fatigue, headache, quality of life, hot flashes, nausea/vomiting, depression, insomnia, lymphedema, and peripheral neuropathy, (all p-values <0.004). Conclusion Data supporting the use of yoga for symptom management after cancer are limited and typically focus on mental health. In this study, users of yoga often reported physical benefits as well as mental health benefits. Further prospective studies investigating the efficacy of yoga in survivorship are warranted.
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Affiliation(s)
- Shruti R Patel
- Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Jacqueline Zayas
- Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Medicine and the Mayo Clinic Medical Scientist Training Program, Rochester, Minnesota
| | | | - Charles Loprinzi
- Department of Medical Oncology, Mayo Clinic, Rochester, Minnesota
| | | | - Anjali Bhagra
- Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Janet E Olson
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - Fergus J Couch
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Kathryn J Ruddy
- Department of Medical Oncology, Mayo Clinic, Rochester, Minnesota
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Cathcart-Rake EJ, Sangaralingham LR, Henk HJ, Shah ND, Riaz IB, Mansfield AS. A Population-based Study of Immunotherapy-related Toxicities in Lung Cancer. Clin Lung Cancer 2020; 21:421-427.e2. [PMID: 32446852 PMCID: PMC7486993 DOI: 10.1016/j.cllc.2020.04.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 03/17/2020] [Accepted: 04/03/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Population-level data regarding incidences of immune-related adverse events (irAEs) are lacking. This study evaluated the frequencies of irAEs among patients with non-small-cell lung cancer (NSCLC) who received immune checkpoint inhibitors. PATIENTS AND METHODS Administrative claims data from a large United States commercial insurance database (OptumLabs Data Warehouse) were used to retrospectively identify patients with NSCLC between January 1, 2015 and December 31, 2017 who received a programmed death-ligand 1/programmed cell death protein-1 (PD(L)-1) inhibitor. Cumulative risks for irAEs were estimated at 1, 3, 6, 9, and 12 months after initiation of a PD-(L)1 inhibitor. Additionally, associations between patient characteristics and frequency of irAEs were investigated utilizing multivariate logistic modeling. RESULTS The risk of developing any irAE was 52.5% (95% confidence interval, 49.9%-55.2%) after 12 months in 3164 patients with NSCLC who initiated a PD-(L)1 inhibitor (median age, 69.0 years; 1763 [55.7%] males; 1401 [44.3%] females). Cumulative risks of irAEs increased over time: pneumonitis was recorded in 2.5% of patients 1 month after initiation of treatment, and increased to 14.3% after 9 months. Risks of hypophysitis and pericarditis were 3.6% and 1.7% at 9 months, respectively. Patients who received PD-(L)1 inhibitors in the first line had lower frequencies of irAEs (hazard ratio, 0.77; 95% confidence interval, 0.67-0.87). CONCLUSION Our findings suggest that the frequencies of some irAEs may be higher than the rates reported in the pivotal trials that led to United States Food and Drug Administration approvals for PD-(L)1 inhibitors. These real-world data refine provider and patient expectations for outcomes in a broader population beyond what is observed in clinical trials.
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Affiliation(s)
| | - Lindsey R Sangaralingham
- OptumLabs, Cambridge, MA; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN
| | | | - Nilay D Shah
- OptumLabs, Cambridge, MA; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN; Division of Health Care Policy and Research, Mayo Clinic, Rochester, MN
| | - Irbaz Bin Riaz
- Division of Medical Oncology, Mayo Clinic, Rochester, MN
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Zayas J, Ruddy KJ, Olson JE, Couch FJ, Bauer BA, Mallory MJ, Yang P, Zahrieh D, Athreya AP, Loprinzi CL, Cathcart-Rake EJ. Real-world experiences with acupuncture among breast cancer survivors: a cross-sectional survey study. Support Care Cancer 2020; 28:5833-5838. [PMID: 32253604 DOI: 10.1007/s00520-020-05442-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 03/27/2020] [Indexed: 12/17/2022]
Abstract
PURPOSE The purpose of this study was to evaluate acupuncture use among breast cancer survivors, including perceived symptom improvements and referral patterns. METHODS Breast cancer survivors who had used acupuncture for cancer- or treatment-related symptoms were identified using an ongoing prospective Mayo Clinic Breast Disease Registry (MCBDR). Additionally, Mayo Clinic electronic health records (MCEHR) were queried to identify eligible participants. All received a mailed consent form and survey including acupuncture-related questions about acupuncture referrals, delivery, and costs. Respondents were also asked to recall symptom severity before and after acupuncture treatment and time to benefit on Likert scales. RESULTS Acupuncture use was reported among 415 participants (12.3%) of the MCBDR. Among MCBDR and MCEHR eligible participants, 241 women returned surveys. A total of 193 (82.1%) participants reported a symptomatic benefit from acupuncture, and 57 (24.1% of participants) reported a "substantial benefit" or "totally resolved my symptoms" (corresponding to 4 and 5 on the 5-point Likert scale). The mean symptom severity decreased by at least 1 point of the 5-point scale for each symptom; the percentage of patients who reported an improvement in symptoms ranged from 56% (lymphedema) to 79% (headache). The majority of patients reported time to benefit as "immediate" (34%) or "after a few treatments" (40.4%). Over half of the participants self-referred for treatment; 24.1% were referred by their oncologist. Acupuncture delivery was more frequent in private offices (61.0%) than in hospital or medical settings (42.3%). Twelve participants (5.1%) reported negative side effects, such as discomfort. CONCLUSIONS Acupuncture is commonly utilized by patients for a variety of breast cancer-related symptoms. However, patients frequently self-refer for acupuncture treatments, and most acupuncture care is completed at private offices, rather than medical clinic or hospital settings.
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Affiliation(s)
- Jacqueline Zayas
- Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Medicine and the Mayo Clinic Medical Scientist Training Program, Rochester, MN, 55905, USA.
| | - Kathryn J Ruddy
- Department of Medical Oncology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Janet E Olson
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, 55905, USA
| | - Fergus J Couch
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Brent A Bauer
- Department of General Internal Medicine, Mayo Clinic, Rochester, MN, 55905, USA
| | - Molly J Mallory
- Department of General Internal Medicine, Mayo Clinic, Rochester, MN, 55905, USA
| | - Ping Yang
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, 55905, USA
| | - David Zahrieh
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, 55905, USA
| | - Arjun P Athreya
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN, 55905, USA
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Gast KC, Cathcart-Rake EJ, Norman AD, Eshraghi L, Obidegwu N, Nichols HB, Rosenberg S, Su HI, Stewart EA, Couch FJ, Vachon CM, Ruddy KJ. Regimen-Specific Rates of Chemotherapy-Related Amenorrhea in Breast Cancer Survivors. JNCI Cancer Spectr 2019. [DOI: 10.1093/jncics/pkz081] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Young women who have not begun or completed their desired childbearing at the time of diagnosis with breast cancer often wish to understand and minimize their risk of chemotherapy-related amenorrhea (CRA). However, the incidence of CRA after regimens that do not include either an anthracycline or a cyclophosphamide is poorly studied. For patients with human epidermal growth factor receptor 2–positive disease, anthracycline- and cyclophosphamide-sparing regimens (eg, carboplatin/taxane) are common (in combination with human epidermal growth factor receptor 2–directed therapy). In this study, accrued in collaboration with Army of Women, menstrual data were analyzed for 151 breast cancer survivors (median age = 41 years at diagnosis, and median time between last chemotherapy and survey = 62.5 months). Last menstrual period was before the last chemotherapy dose in 51% of the 86 participants who received anthracycline/cyclophosphamide/taxane, in 42% of the 43 who received only taxane/cyclophosphamide, and in 13% of the 15 who received carboplatin/taxane. This study suggests that carboplatin/taxane causes less CRA than cyclophosphamide-based regimens.
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Affiliation(s)
- Kelly C Gast
- See the Note section for the full list of authors’ affiliations
| | | | - Aaron D Norman
- See the Note section for the full list of authors’ affiliations
| | - Leah Eshraghi
- See the Note section for the full list of authors’ affiliations
| | | | - Hazel B Nichols
- See the Note section for the full list of authors’ affiliations
| | | | - H Irene Su
- See the Note section for the full list of authors’ affiliations
| | | | - Fergus J Couch
- See the Note section for the full list of authors’ affiliations
| | - Celine M Vachon
- See the Note section for the full list of authors’ affiliations
| | - Kathryn J Ruddy
- See the Note section for the full list of authors’ affiliations
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Gast KC, Cathcart-Rake EJ, Norman A, Eshraghi L, Obidegwu N, Couch F, Vachon C, Ruddy KJ. Accuracy of self-reported cancer treatment data in young breast cancer survivors. J Patient Rep Outcomes 2019; 3:24. [PMID: 31041547 PMCID: PMC6491527 DOI: 10.1186/s41687-019-0114-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 04/02/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Patient-reports of cancer treatments are sometimes used in oncology research and clinically when medical records are unavailable. We aimed to evaluate the accuracy of patient recall in this setting. MATERIALS AND METHODS Participants were recruited through an email request from the Dr. Susan Love Research Foundation Army of Women seeking women diagnosed with breast cancer under age 50 and within the past ten years, self-reporting to have been treated with chemotherapy. After informed consent, participants received a web-based survey that inquired about use of and type of chemotherapy and endocrine therapy received. Medical records were reviewed, and discrepancies were defined as patient-report of a different class of drug than documented in the medical record, failing to report a documented class of drug, or responding "don't know." RESULTS Of 171 eligible participants, completed questionnaires and medical records were available for 102 (60%). Median age at diagnosis was 41 years (range 25-49), and median time from diagnosis was 65.5 months (range 7-131). Ninety-two percent had completed college. Receipt of chemotherapy was documented in the medical records of 100% of these women who self-reported a personal history of chemotherapy, and there was also 98% concordance regarding receipt of endocrine therapy (yes vs. no). However, discrepancies were identified in 29% of patients regarding chemotherapy types. Time since diagnosis did not increase the likelihood of discrepancies. CONCLUSION Highly educated young women diagnosed with breast cancer more than five years prior accurately report whether or not they received broad systemic treatment categories. However, self-reports regarding specific drugs should be confirmed by medical record review.
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Affiliation(s)
- Kelly C. Gast
- Mayo Clinic, Department of Internal Medicine, 200 First Street SW, Rochester, MN 55095 USA
| | | | - Aaron Norman
- Mayo Clinic, Biomedical Statistics and Informatics, 200 First Street SW, Rochester, MN 55095 USA
| | - Leah Eshraghi
- Dr. Susan Love Research Foundation, 16133 Ventura Boulevard, Suite 1000, Encino, CA 91436 USA
| | - Nwamaka Obidegwu
- Dr. Susan Love Research Foundation, 16133 Ventura Boulevard, Suite 1000, Encino, CA 91436 USA
| | - Fergus Couch
- Mayo Clinic, Department of Laboratory Medicine and Pathology, 200 First Street SW, Rochester, MN 55095 USA
| | - Celine Vachon
- Mayo Clinic, Health Sciences Research, 200 First Street SW, Rochester, MN 55095 USA
| | - Kathryn J. Ruddy
- Mayo Clinic, Department of Oncology, 200 First Street SW, Rochester, MN 55095 USA
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Gast KC, Cathcart-Rake EJ, Norman A, Eshragi L, Obidegwu N, Yost K, Nichols HB, Rosenberg S, Su HI, Stewart E, Couch F, Vachon C, Ruddy KJ. Abstract P1-12-10: Regimen-specific rates of chemotherapy-related amenorrhea in breast cancer survivors. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p1-12-10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Chemotherapy can damage the ovaries and cause amenorrhea, a surrogate for infertility. Young women often wish to understand and minimize their risk of chemotherapy-related amenorrhea (CRA). However, the incidence of CRA with regimens that do not include either an anthracycline or cyclophosphamide is poorly studied. For patients with HER-2 positive disease, these anthracycline and cyclophosphamide-sparing regimens (e.g., docetaxel-carboplatin) are common (in combination with Her-2 directed therapy) in both the neoadjuvant and adjuvant settings.
Methods: Women diagnosed with breast cancer under age 50 and within the past 10 years were recruited through a Dr. Susan Love Research Foundation Army of Women e-mail blast. Those who provided their contact information were mailed a consent form and medical record authorization form. Participants then received a web-based survey that inquired about receipt of and type of chemotherapy (including date of last dose) and date of last menstrual period (LMP). Patient-reported LMP was compared to date of final chemotherapy dose to determine if the LMP occurred before (defined as “CRA”) or after the last chemotherapy dose. When available, medical record data was used in place of survey data regarding type of chemotherapy used. Exclusion criteria included: LMP prior to diagnosis date, receipt of multiple chemotherapy regimens or no chemotherapy regimens, receipt of ovarian suppression medications (which interfere with interpretation of menstrual data), surgical menopause prior to or at the same time as diagnosis, a cancer diagnosis more than 10 years prior, incomplete menstrual data on the survey, report of an unknown chemotherapy regimen, and no date available for the last chemotherapy dose without an LMP within a month prior to survey completion. Fisher Exact test was used to compare CRA rates between regimens. Rates after two anthracycline-sparing regimens (taxane/cyclophosphamide; taxane/carboplatin) were compared to rates after anthracycline/cyclophosphamide/taxane.
Results: 273 women consented to participate in this study, 258 of whom filled out the web survey. 151 of them were eligible for this analysis with a median age at diagnosis of 41 (range 24-49) and a median time from last chemotherapy dose to survey of 62.5 months (range 2-138). CRA occurred in 51.2% of the 86 participants who received an anthracycline, cyclophosphamide, and a taxane, in 41.9% of the 43 participants who received only a taxane and cyclophosphamide (p=0.35), and in 13.3% of the 15 participants who received carboplatin with a taxane (p=0.01). When the 11 patients who were <12 months since last chemotherapy were excluded, CRA rates changed minimally. Age did not differ by regimen, but median time since chemotherapy was shorter in the taxane/carboplatin group (35 months vs. 68 months). Trastuzumab with or without pertuzumab was administered in 100% of patients who received carboplatin/taxane, in 23.3% of patients who received taxane and cyclophosphamide, and in 22.1% of patients who received anthracycline/cyclophosphamide/taxane.
Conclusions: This study suggests that carboplatin/taxane may be substantially less gonadotoxic than cyclophosphamide-based (neo)adjuvant regimens. Further research is necessary to confirm these findings.
Citation Format: Gast KC, Cathcart-Rake EJ, Norman A, Eshragi L, Obidegwu N, Yost K, Nichols HB, Rosenberg S, Su HI, Stewart E, Couch F, Vachon C, Ruddy KJ. Regimen-specific rates of chemotherapy-related amenorrhea in breast cancer survivors [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-12-10.
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Affiliation(s)
- KC Gast
- Mayo Clinic, Rochester, MN; Dr. Susan Love Research Foundation, Encino, CA; University of North Carolina, Chapel Hill, NC; Dana Farber Cancer Institute, Boston, MA; University of California San Diego, San Diego, CA
| | - EJ Cathcart-Rake
- Mayo Clinic, Rochester, MN; Dr. Susan Love Research Foundation, Encino, CA; University of North Carolina, Chapel Hill, NC; Dana Farber Cancer Institute, Boston, MA; University of California San Diego, San Diego, CA
| | - A Norman
- Mayo Clinic, Rochester, MN; Dr. Susan Love Research Foundation, Encino, CA; University of North Carolina, Chapel Hill, NC; Dana Farber Cancer Institute, Boston, MA; University of California San Diego, San Diego, CA
| | - L Eshragi
- Mayo Clinic, Rochester, MN; Dr. Susan Love Research Foundation, Encino, CA; University of North Carolina, Chapel Hill, NC; Dana Farber Cancer Institute, Boston, MA; University of California San Diego, San Diego, CA
| | - N Obidegwu
- Mayo Clinic, Rochester, MN; Dr. Susan Love Research Foundation, Encino, CA; University of North Carolina, Chapel Hill, NC; Dana Farber Cancer Institute, Boston, MA; University of California San Diego, San Diego, CA
| | - K Yost
- Mayo Clinic, Rochester, MN; Dr. Susan Love Research Foundation, Encino, CA; University of North Carolina, Chapel Hill, NC; Dana Farber Cancer Institute, Boston, MA; University of California San Diego, San Diego, CA
| | - HB Nichols
- Mayo Clinic, Rochester, MN; Dr. Susan Love Research Foundation, Encino, CA; University of North Carolina, Chapel Hill, NC; Dana Farber Cancer Institute, Boston, MA; University of California San Diego, San Diego, CA
| | - S Rosenberg
- Mayo Clinic, Rochester, MN; Dr. Susan Love Research Foundation, Encino, CA; University of North Carolina, Chapel Hill, NC; Dana Farber Cancer Institute, Boston, MA; University of California San Diego, San Diego, CA
| | - HI Su
- Mayo Clinic, Rochester, MN; Dr. Susan Love Research Foundation, Encino, CA; University of North Carolina, Chapel Hill, NC; Dana Farber Cancer Institute, Boston, MA; University of California San Diego, San Diego, CA
| | - E Stewart
- Mayo Clinic, Rochester, MN; Dr. Susan Love Research Foundation, Encino, CA; University of North Carolina, Chapel Hill, NC; Dana Farber Cancer Institute, Boston, MA; University of California San Diego, San Diego, CA
| | - F Couch
- Mayo Clinic, Rochester, MN; Dr. Susan Love Research Foundation, Encino, CA; University of North Carolina, Chapel Hill, NC; Dana Farber Cancer Institute, Boston, MA; University of California San Diego, San Diego, CA
| | - C Vachon
- Mayo Clinic, Rochester, MN; Dr. Susan Love Research Foundation, Encino, CA; University of North Carolina, Chapel Hill, NC; Dana Farber Cancer Institute, Boston, MA; University of California San Diego, San Diego, CA
| | - KJ Ruddy
- Mayo Clinic, Rochester, MN; Dr. Susan Love Research Foundation, Encino, CA; University of North Carolina, Chapel Hill, NC; Dana Farber Cancer Institute, Boston, MA; University of California San Diego, San Diego, CA
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Cathcart-Rake EJ, Breitkopf CR, Kaur J, O'Connor J, Ridgeway JL, Jatoi A. Teaching Health-Care Providers to Query Patients With Cancer About Sexual and Gender Minority (SGM) Status and Sexual Health. Am J Hosp Palliat Care 2019; 36:533-537. [PMID: 30599758 DOI: 10.1177/1049909118820874] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
End of life is difficult for all patients but sexual and gender minorities (SGM) are prone to isolation and loneliness, especially if their SGM status is unknown or unaccepted. In oncology clinics, where goals of care discussions about end of life are integral and frequent, querying patients about their SGM status and sexual health is of particular importance. The American Society of Clinical Oncology recently released a position statement that called for greater focus on SGM populations with the goal of reducing and eventually eliminating disparities in cancer care within this group. An important first step in addressing such disparities is learning how best to train cancer health-care providers to ask patients about their SGM status and about sexual health in general. This article summarizes the mandate for understanding cancer issues in SGM populations and the dearth of cancer-related data within this group. This article also describes an ongoing 3-part study intended to build a mini curriculum with the goal of helping cancer health-care providers to ask patients with cancer about SGM status and to ask all patients with cancer about sexual health issues. The results of this ongoing study could potentially improve end-of-life care for subgroups of patients.
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Affiliation(s)
| | | | - Judith Kaur
- 3 Department of Medical Oncology, Mayo Clinic, Jacksonville, FL, USA
| | - Jennifer O'Connor
- 4 Department of Medical Oncology Clinical Research, Mayo Clinic, Rochester, MN, USA
| | - Jennifer L Ridgeway
- 5 Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
| | - Aminah Jatoi
- 1 Department of Medical Oncology, Mayo Clinic, Rochester, MN, USA
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Cathcart-Rake EJ, Zemla T, Jatoi A, Weaver KE, Neuman H, Kazak AE, Carlos R, Gansauer L, Unger JM, Pajewski NM, Kamen C. Acquisition of sexual orientation and gender identity data among NCI Community Oncology Research Program practice groups. Cancer 2018; 125:1313-1318. [PMID: 30561776 DOI: 10.1002/cncr.31925] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Revised: 11/12/2018] [Accepted: 11/13/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND Sexual and gender minority individuals face numerous cancer-related inequities, many of which appear to be underreported. However, to the best of the authors' knowledge, no one has assessed rates of acquisition of sexual orientation and gender identity (SOGI) data within community oncology settings. METHODS Community oncology practices that were part of the NCI Community Oncology Research Program (NCORP) network were asked whether they routinely collected SOGI information and coded this information in their electronic medical records. The proportion of practice groups reporting routine collection of sexual and/or gender minority information was calculated. Potential associations between the collection of SOGI information and practice group-level and state-level characteristics (from Gallup poll data) were also provided. RESULTS Twenty-four percent of the responding NCORP practice groups reported routine collection of sexual orientation information, and 10% reported collection of gender identity information. Practices located in western regions of the United States, practices in states with higher proportions of sexual and gender minority-identifying individuals, and practices with lower proportions of non-Hispanic patients were more likely to ask patients about sexual orientation and/or gender identity. CONCLUSIONS US oncology practices that participate in research do not frequently collect SOGI information from patients with cancer. Educational initiatives should inform oncology staff and providers about the importance of collecting gender identity and sexual orientation information to improve existent disparities faced by sexual and gender minority patients.
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Affiliation(s)
| | - Tyler Zemla
- Division of Biostatistics, Mayo Clinic, Rochester, Minnesota
| | - Aminah Jatoi
- Department of Oncology, Mayo Clinic, Rochester, Minnesota
| | - Kathryn E Weaver
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Heather Neuman
- Department of Surgery, University of Wisconsin, Madison, Wisconsin
| | - Anne E Kazak
- Nemours Center for Healthcare Delivery Science, Nemours Children's Health System, Wilmington, Delaware
| | - Ruth Carlos
- Department of Radiology, University of Michigan, Ann Arbor, Michigan
| | - Lucy Gansauer
- Spartanburg Medical Center, Spartanburg, South Carolina
| | - Joseph M Unger
- SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Nicholas M Pajewski
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Charles Kamen
- Cancer Control Unit, University of Rochester, Rochester, New York
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Cathcart-Rake EJ, Smith D, Zahrieh D, Loprinzi CL. Rose geranium in sesame oil nasal spray: a treatment for nasal vestibulitis? BMJ Support Palliat Care 2018; 10:411-413. [PMID: 30377210 DOI: 10.1136/bmjspcare-2018-001569] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 08/29/2018] [Indexed: 11/04/2022]
Abstract
OBJECTIVES As a rose geranium in sesame oil spray product has been anecdotally noted to improve nasal vestibulitis symptoms, this study was designed to assess whether patients with nasal vestibulitis associated with cancer-directed therapy experienced symptomatic improvements from it. METHODS Patients with breast cancer, prescribed rose geranium nasal spray, were identified by looking at pharmacy records and patient diagnosis at Mayo Clinic Rochester. Patient medical information, as well as documentation of symptoms, were gleaned from medical charts. Questionnaires were sent to patients regarding their experiences. RESULTS Of the 40 patients with breast cancer who were prescribed rose geranium nasal spray, 100% were receiving cancer-directed therapy: 58 % were receiving taxane chemotherapy; others received a variety of cytotoxic and targeted therapy treatments. Twenty patients who had used the spray product returned surveys. Patient-reported nasal symptoms included bleeding (90%), dryness (86%), pain (81%), scabbing (67%) and sores (52%); patients consistently reported symptoms at a higher proportion than did healthcare providers. All patients who used the rose geranium nasal spray reported symptomatic benefit; one reported a little benefit, 11 (55%) reported moderate benefit and eight (40%) reported dramatic or complete resolution of symptoms. The therapy was well tolerated in most patients. CONCLUSIONS Rose geranium in sesame oil nasal spray appears to improve patient-reported nasal symptoms associated with cancer-directed therapy.
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Affiliation(s)
| | - Deanne Smith
- Department of Medical Oncology, Mayo Clinic, Rochester, Minnesota, USA
| | - David Zahrieh
- Department of Health Sciences Research, Cancer Statistics, Mayo Clinic, Rochester, Minnesota, USA
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Zandvakili I, Conboy CB, Ayed AO, Cathcart-Rake EJ, Tefferi A. Ruxolitinib as first-line treatment in secondary hemophagocytic lymphohistiocytosis: A second experience. Am J Hematol 2018; 93:E123-E125. [PMID: 29417621 DOI: 10.1002/ajh.25063] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 01/31/2018] [Accepted: 02/05/2018] [Indexed: 11/11/2022]
Affiliation(s)
- Inuk Zandvakili
- Department of Internal Medicine; Mayo Clinic; Rochester Minnesota
| | - Caitlin B. Conboy
- Department of Internal Medicine; Mayo Clinic; Rochester Minnesota
- Division of Hematology; Mayo Clinic; Rochester Minnesota
| | - Ayed O. Ayed
- Division of Hematology; Mayo Clinic; Rochester Minnesota
| | | | - Ayalew Tefferi
- Division of Hematology; Mayo Clinic; Rochester Minnesota
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Cathcart-Rake EJ, Lightner DJ, Quevedo FJ, Ertz DC, Jatoi A. Cancer in Transgender Patients: One Case in 385,820 Is Indicative of a Paucity of Data. J Oncol Pract 2017; 14:270-272. [PMID: 29257720 DOI: 10.1200/jop.2017.027714] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Cathcart-Rake EJ, Ruddy KJ. Disparities in Adjuvant Endocrine Therapy. J Natl Compr Canc Netw 2017; 15:1559-1561. [PMID: 29223993 DOI: 10.6004/jnccn.2017.7057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Cathcart-Rake EJ, Hilliker DR, Loprinzi CL. Chemotherapy-induced neuropathy: Central resolution of a peripherally perceived problem? Cancer 2017; 123:1898-1900. [PMID: 28257145 DOI: 10.1002/cncr.30650] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 01/31/2017] [Accepted: 02/02/2017] [Indexed: 11/06/2022]
Affiliation(s)
| | - Daniel R Hilliker
- Department of Psychiatry and Psychology, Mayo Clinic Minnesota, Rochester, Minnesota
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