'More stressful than cancer': Treatment Experiences Lived During Hurricane Maria among Breast and Colorectal Cancer Patients in Puerto Rico

Background

This study explored experiences in cancer care and disruption after Hurricanes Irma and Maria's aftermath in Puerto Rico (PR).

Methods

A total of three focus groups were conducted among breast and colorectal cancer patients diagnosed six months before the disaster.

Results

The most prevalent themes were (a) barriers related to their cancer treatment, (b) facilitators related to their cancer treatment, and (c) treatment experiences during the hurricane. Participants discussed struggles regarding their experience with treatment and access to care during and after Hurricanes Irma and Maria and how household limitations due to lack of electricity and water deter their intention to continue their treatment. Moreover, stressors directly linked with the disaster were the most challenging to cope with.

Conclusions

Our study identifies the hardships experienced by cancer patients living during a disaster. Similarly, our study highlights the impending need to address in future emergency plans the individual and system needs of cancer patients in active treatment to minimize the delay in continuing cancer care.

Abstract PO-106: “More stressful than cancer”: Treatment experiences lived during Hurricane Maria among breast and colorectal cancer patients in Puerto Rico

Background: In September 2017, Hurricanes Irma and Maria devastated the Caribbean region, among them, the US territory of Puerto Rico (PR), with estimates indicating between 800 and 8,500 excess deaths related to the hurricane through the end of December 2017. This detrimental impact on human life is added to massive infrastructure and economics loss. Few studies have assessed the impact of natural disasters on chronic diseases such as cancer, since it remains uncertain how such a disruption will affect access to treatment especially those patients with breast and colorectal cancer, two of the most common cancers in incidence and mortality in PR. Therefore, the objective of this study is to evaluate factors associated with cancer care disruption and time since continuation of care in the aftermath of Hurricanes Irma and Maria. For this, we partnered with the Puerto Rico Central Cancer Registry, one of the oldest registries in America, to develop a systematic methodology to use this registry to recruit cancer patients for population-based science research.

Methods: We used a qualitative design through focus groups with cancer patients to accomplish the proposed objective. A modified grounded theory approach was used for data collection and analysis. The inclusion criteria for participating in this focus groups were the following: (1) patients ≥ 40 years old being diagnosed with breast or colorectal cancer between March-September 2017; (2) being under active cancer treatment before, during and after September 2017, and (3) lived and received treatment in PR during the aftermath of the events. Results: The most emerging topics discussed were the participants experience with their treatment during the hurricane which ranges from provisions taken prior the hurricane, such as more stocking up on medications or make earlier appointments with oncologists or providers. Although most participants described that their treatment was not affected, individual discussions led to the researchers to infer that their treatment might be delayed due to the disasters. Barriers (e.g. communication, transportation, and basic utility services (electricity and water)) were also discussed by the study participants in relation to how the lack of these will deter or interfere with access or treatment. It was mentioned that stressors related to the impact of the hurricane where more difficult to overcome, than being in active treatment during this period. Conclusions: Although participants discussed struggles in regards their experience with treatment and access to care during and after the hurricane, were stressors directly linked with the disasters which were most difficult to cope. Our data highlights the impending need to address in future emergency plans individual and system needs of cancer patients in active treatment to minimize the delay in the continuation of care.

Citation Format: Yara Sánchez-Cabrera, Yahisha Cardona-Cintrón, Marievelisse Soto-Salgado, Karen J. Ortiz-Ortiz, Troy Quast, María E. Fernández, Vivian Colón-López. “More stressful than cancer”: Treatment experiences lived during Hurricane Maria among breast and colorectal cancer patients in Puerto Rico [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-106.

Abstract A021: Tobacco and e-cigarette use in a sample of young men 18-24 in Mayagüez, Puerto Rico: The Youth Prevention Program

Background: Smoking is the number one preventable cause of death in the world. In Puerto Rico, 11.3% of the general population reported being current smokers. The majority are men who started smoking at a young age. In addition to cigarette smoking, it is important to monitor the new and potentially dangerous trend of e-cigarette use, which has doubled ever since 2014. This study aimed to determine the prevalence and patterns of current cigarette and lifetime e-cigarette use in a sample of young men 18-24 years old from the Youth Prevention Program (YPREV). Methods: A cross-sectional study among 318 young men was implemented in 2017. Bivariate analysis comparing cigarette and e-cigarette use by selected characteristics were conducted. Results: More than half of the participants reported having smoked cigarettes during the last 30 days. Approximately 39.3% of the participants reported the use of e-cigarette in their lifetime, with 76.9% of the participants indicating trying e-cigarettes for the first time after starting college. When exploring the association between selected characteristics and current cigarette smoking, participants who reported low perceived risk of HIV infection are more likely to smoke cigarettes (p-value >0.01). In relation to e-cigarette, participants who reported being employed were more likely to use e-cigarettes (p-value=0.012). Moreover, participants who belong to the minority serving institution, reported less use of cigarettes and e-cigarettes ever than those part of the community. Conclusions: As YPREV aimed to expand their prevention services to young men in the Western region of Puerto Rico, strategic alliances for the development of multidisciplinary interventions for cigarette and e-cigarette use will be necessary, which will help develop targeted prevention strategies, primarily among freshmen college students in the Western region of Puerto Rico.

Citation Format: Nashaly M Saldaña-Santiago, Jorge Rodríguez-Lebrón, Yara Sánchez-Cabrera, Edna Acosta-Pérez, Vivian Colón-López. Tobacco and e-cigarette use in a sample of young men 18-24 in Mayagüez, Puerto Rico: The Youth Prevention Program [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr A021.