WorldWideScience

Sample records for adult aya cancer

  1. A mutational comparison of adult and adolescent and young adult (AYA) colon cancer.

    Science.gov (United States)

    Tricoli, James V; Boardman, Lisa A; Patidar, Rajesh; Sindiri, Sivasish; Jang, Jin S; Walsh, William D; McGregor, Paul M; Camalier, Corinne E; Mehaffey, Michele G; Furman, Wayne L; Bahrami, Armita; Williams, P Mickey; Lih, Chih-Jian; Conley, Barbara A; Khan, Javed

    2018-03-01

    It is possible that the relative lack of progress in treatment outcomes among adolescent and young adult (AYA) patients with cancer is caused by a difference in disease biology compared with the corresponding diseases in younger and older individuals. There is evidence that colon cancer is more aggressive and has a poorer prognosis in AYA patients than in older adult patients. To further understand the molecular basis for this difference, whole-exome sequencing was conducted on a cohort of 30 adult, 30 AYA, and 2 pediatric colon cancers. A statistically significant difference in mutational frequency was observed between AYA and adult samples in 43 genes, including ROBO1, MYC binding protein 2 (MYCBP2), breast cancer 2 (early onset) (BRCA2), MAP3K3, MCPH1, RASGRP3, PTCH1, RAD9B, CTNND1, ATM, NF1; KIT, PTEN, and FBXW7. Many of these mutations were nonsynonymous, missense, stop-gain, or frameshift mutations that were damaging. Next, RNA sequencing was performed on a subset of the samples to confirm the mutations identified by exome sequencing. This confirmation study verified the presence of a significantly greater frequency of damaging mutations in AYA compared with adult colon cancers for 5 of the 43 genes (MYCBP2, BRCA2, PHLPP1, TOPORS, and ATR). The current results provide the rationale for a more comprehensive study with a larger sample set and experimental validation of the functional impact of the identified variants along with their contribution to the biologic and clinical characteristics of AYA colon cancer. Cancer 2018;124:1070-82. © 2017 American Cancer Society. © 2017 American Cancer Society.

  2. Clinical application of genomic profiling to find druggable targets for adolescent and young adult (AYA) cancer patients with metastasis

    International Nuclear Information System (INIS)

    Cha, Soojin; Lee, Jeongeun; Shin, Jong-Yeon; Kim, Ji-Yeon; Sim, Sung Hoon; Keam, Bhumsuk; Kim, Tae Min; Kim, Dong-Wan; Heo, Dae Seog; Lee, Se-Hoon; Kim, Jong-Il

    2016-01-01

    Although adolescent and young adult (AYA) cancers are characterized by biological features and clinical outcomes distinct from those of other age groups, the molecular profile of AYA cancers has not been well defined. In this study, we analyzed cancer genomes from rare types of metastatic AYA cancers to identify driving and/or druggable genetic alterations. Prospectively collected AYA tumor samples from seven different patients were analyzed using three different genomics platforms (whole-exome sequencing, whole-transcriptome sequencing or OncoScan™). Using well-known bioinformatics tools (bwa, Picard, GATK, MuTect, and Somatic Indel Detector) and our annotation approach with open access databases (DAVID and DGIdb), we processed sequencing data and identified driving genetic alterations and their druggability. The mutation frequencies of AYA cancers were lower than those of other adult cancers (median = 0.56), except for a germ cell tumor with hypermutation. We identified patient-specific genetic alterations in candidate driving genes: RASA2 and NF1 (prostate cancer), TP53 and CDKN2C (olfactory neuroblastoma), FAT1, NOTCH1, and SMAD4 (head and neck cancer), KRAS (urachal carcinoma), EML4-ALK (lung cancer), and MDM2 and PTEN (liposarcoma). We then suggested potential drugs for each patient according to his or her altered genes and related pathways. By comparing candidate driving genes between AYA cancers and those from all age groups for the same type of cancer, we identified different driving genes in prostate cancer and a germ cell tumor in AYAs compared with all age groups, whereas three common alterations (TP53, FAT1, and NOTCH1) in head and neck cancer were identified in both groups. We identified the patient-specific genetic alterations and druggability of seven rare types of AYA cancers using three genomics platforms. Additionally, genetic alterations in cancers from AYA and those from all age groups varied by cancer type. The online version of this article

  3. Patterns of unmet needs in adolescent and young adult (AYA) cancer survivors: in their own words.

    Science.gov (United States)

    Wong, Alex W K; Chang, Ting-Ting; Christopher, Katrina; Lau, Stephen C L; Beaupin, Lynda K; Love, Brad; Lipsey, Kim L; Feuerstein, Michael

    2017-12-01

    Categorization of the needs of AYA cancer survivors is primarily based on quantitative analyses of epidemiological and observational research. The present study classified the phenomenological experiences of AYA survivors based on their own language. A systematic approach for selecting qualitative studies of unmet needs in AYA cancer survivors was used. Following selection based on quality, survivor statements were entered verbatim and thematic analysis was conducted using NVivo qualitative research software. A total of 1993 AYA cancer survivors (post-treatment) were included in 58 studies (78% individual interviews). Mean age was 27.6 with an average of 8.6 years post-primary treatment. The organizational framework reported in this study was based on a heterogeneous group of cancer types. Thirteen themes including symptoms, function, reproductive health, emotional well-being, health management, health care system, social interaction, romantic relationships, cancer disclosure, normalcy, career development and employment, and school and fiscal concerns were identified. Forty-eight subthemes were also identified covering such areas as fertility, integrative health services, advice for cancer disclosure, family interaction, and insurance challenges. Direct analysis of text identified many common unmet needs similarly reported in the quantitative literature. The phenomenological data also provided a breakdown of unmet needs into subthemes or elements of unmet needs. This information can help form the basis for a personalized, valid, and reliable evaluation tool of the range of unmet needs in AYA survivors.

  4. AYAs Are Not Alone: Confronting Psychosocial Challenges of Cancer

    Science.gov (United States)

    Adolescents and young adults with cancer have unique and specific psychosocial needs. Getting support to meet those needs is critical for enabling AYAs to adapt and cope as they navigate the course of their illness and beyond.

  5. Assessment of psychological distress among Asian adolescents and young adults (AYA) cancer patients using the distress thermometer: a prospective, longitudinal study.

    Science.gov (United States)

    Chan, Alexandre; Poon, Eileen; Goh, Wei Lin; Gan, Yanxiang; Tan, Chia Jie; Yeo, Kelvin; Chua, Annabelle; Chee, Magdalene; Law, Yi Chye; Somasundaram, Nagavalli; Kanesvaran, Ravindran; Ng, Quan Sing; Tham, Chee Kian; Toh, Chee Keong; Lim, Soon Thye; Tao, Miriam; Tang, Tiffany; Quek, Richard; Farid, Mohamad

    2018-04-11

    Since few studies have investigated whether the Distress Thermometer (DT) in Asian adolescent and young adult (AYA) cancer patients (between 15 and 39 years), we investigated the appropriateness of the DT as a screening tool for psychological symptom burden in these AYA patients and to evaluate AYA patients' distress across a trajectory of three time points longitudinally over a 6-month period. This was a prospective, longitudinal study. Recruited Asian AYA patients were diagnosed with lymphomas, sarcomas, primary brain malignancies, or germ cell tumors. Patients completed the DT, PedsQL Generic Core Scales, and the Rotterdam Symptom Checklist. Data were analyzed using STATA version 15. Approximately half of the patients experienced clinically significant DT distress (distress score ≥ 4) early in their cancer journey with 43.1% patients presenting with distress at time of diagnosis and 47.7% patients 1 month after diagnosis. Among AYA patients > 24 years old, worry (68.3%), insurance/financial issues (61%), treatment decisions (43.9%), work/school issues (41.5%), nervousness (41.5%), and sadness (41.5%) were the top five identified problems. On the other hand, the top five identified problems among AYA ≤ 24 years were worry (54.2%), nervousness (41.7%), bathing/dressing problems (37.5%), work/school issues (33.3%), and fatigue (33.3%). DT scores were significantly associated with certain psychological symptom burden items such as worry (p psychological distress in AYA cancer patients with clinically significant distress being identified in the early phases of the cancer journey.

  6. Validation of modified forms of the PedsQL generic core scales and cancer module scales for adolescents and young adults (AYA) with cancer or a blood disorder.

    Science.gov (United States)

    Ewing, Jane E; King, Madeleine T; Smith, Narelle F

    2009-03-01

    To validate two health-related quality of life (HRQOL) measures, the PedsQL Generic Core and Cancer Module adolescent forms (13-18 years), after modification for 16-25-year-old adolescents and young adults (AYA) with cancer or a blood disorder. AYA patients and nominated proxies were recruited from three Sydney hospitals. Modified forms were administered by telephone or in clinics/wards. Analyses included correlations, factor analysis, and analysis of variance of known-groups (defined by the Memorial Symptom Assessment Scale). Eighty-eight patients and 79 proxies completed questionnaires. Factor structures consistent with those of the unmodified forms confirmed construct validity. Cronbach's alpha ranged 0.81-0.98. Inter-scale correlations were as hypothesized, confirming discriminant validity. Statistically significant differences between groups with mild, moderate, and severe symptoms (P < 0.05) confirmed clinical validity. These modified forms provide reliable and valid measures of HRQOL in AYA with cancer or a blood disorder, suitable for clinical trials, research, and practice.

  7. Unmet Support Service Needs and Health-Related Quality of Life among Adolescents and Young Adults with Cancer: The AYA HOPE Study

    Directory of Open Access Journals (Sweden)

    Ashley Wilder Smith

    2013-04-01

    Full Text Available Introduction: Cancer for adolescents and young adults (AYA differs from younger and older patients; AYA face medical challenges while navigating social and developmental transitions. Research suggests that these patients are under- or inadequately served by current support services, which may affect health-related quality of life (HRQOL.Methods: We examined unmet service needs and HRQOL in the National Cancer Institute’s Adolescent and Young Adult Health Outcomes and Patient Experience (AYA HOPE study, a population-based cohort (n=484, age 15-39, diagnosed with cancer 6-14 months prior, in 2007-2009. Unmet service needs were psychosocial, physical, spiritual, and financial services where respondents endorsed that they needed, but did not receive, a listed service. Linear regression models tested associations between any or specific unmet service needs and HRQOL, adjusting for demographic, medical and health insurance variables.Results: Over one-third of respondents reported at least one unmet service need. The most common were financial (16%, mental health (15%, and support group (14% services. Adjusted models showed that having any unmet service need was associated with worse overall HRQOL, fatigue, physical, emotional, social, and school/work functioning, and mental health (p’s<0.0001. Specific unmet services were related to particular outcomes (e.g., needing pain management was associated with worse overall HRQOL, physical and social functioning (p’s<0.001. Needing mental health services had the strongest associations with worse HRQOL outcomes; needing physical/occupational therapy was most consistently associated with poorer functioning across domains.Discussion: Unmet service needs in AYAs recently diagnosed with cancer are associated with worse HRQOL. Research should examine developmentally appropriate, relevant practices to improve access to services demonstrated to adversely impact HRQOL, particularly physical therapy and mental

  8. Online group-based cognitive-behavioural therapy for adolescents and young adults after cancer treatment: a multicenter randomised controlled trial of Recapture Life-AYA.

    Science.gov (United States)

    Sansom-Daly, Ursula M; Wakefield, Claire E; Bryant, Richard A; Butow, Phyllis; Sawyer, Susan; Patterson, Pandora; Anazodo, Antoinette; Thompson, Kate; Cohn, Richard J

    2012-08-03

    peer and caregiver support in enhancing the effectiveness of this skills-based intervention is also discussed. The innovative videoconferencing delivery method Recapture Life uses has the potential to address the geographic and psychological isolation of adolescents and young adults as they move toward cancer survivorship. It is expected that teaching AYAs coping skills as they resume their normal lives after cancer may have long-term implications for their quality of life. ACTRN12610000717055.

  9. Online group-based cognitive-behavioural therapy for adolescents and young adults after cancer treatment: A multicenter randomised controlled trial of Recapture Life-AYA

    Directory of Open Access Journals (Sweden)

    Sansom-Daly Ursula M

    2012-08-01

    -based programs in an online modality are highlighted, and the role of both peer and caregiver support in enhancing the effectiveness of this skills-based intervention is also discussed. The innovative videoconferencing delivery method Recapture Life uses has the potential to address the geographic and psychological isolation of adolescents and young adults as they move toward cancer survivorship. It is expected that teaching AYAs coping skills as they resume their normal lives after cancer may have long-term implications for their quality of life. Trial Registration ACTRN12610000717055

  10. Clinical Trials Offer a Path to Better Care for AYAs with Cancer

    Science.gov (United States)

    The slow progress against adolescent and young adult cancers is due, in part, to this populations lack of participation in clinical trials. Researchers are testing innovative ways to enroll more AYAs in clinical trials—using expanded access, patient navigation, community outreach, and collaborations between academic and community doctors.

  11. Remission rate of acute lymphoblastic leukemia (all) in adolescents and young adults (aya)

    International Nuclear Information System (INIS)

    Vallacha, A.; Haider, G.; Kumar, D.

    2018-01-01

    To determine the remission rate in adolescent and young adult (AYA) patients with acute lymphoblastic leukemia (ALL). Study Design:Descriptive study. Place and Duration of Study:Department of Oncology, Jinnah Postgraduate Medical Centre (JPMC), Karachi from January, 2016 to March, 2017. Methodology:Adolescent and young adult (AYA) patients aged 15-39 years, newly diagnosed with acute lymphoblastic leukemia from January, 2016 to March, 2017. Diagnosis was confirmed by bone marrow trephine biopsy and immuno-phenotyping. All the patients were treated with daunorubicin, vincristine, prednisone, and L-asparaginase in the induction phase. The response evaluation was done on day 35 of the induction phase and the remission rate was assessed by the bone marrow examination. Results:Of the total 50 AYA patients diagnosed with ALL, 41 patients could complete induction phase and 9 patients died during the first week of induction, therefore excluded from the study. Forty (97.8%) patients were <35years of age, 28 (68.3%) were male, of female 10 (24.4%) were housewives, 33 (80.5%) patients belonged to Sindh, 28 (68.3%) presented with fever and body ache, 17 (41.5%) patients had precursor B cell type ALL, with 7 (17.1%) patients had hemoglobin of <7 g/dL,11 (26.8%) patients had white cell count of >30x10/sup 9//L, platelet count of <20x103/mu L in 6 (14.6%) patients and complete morphological remission was reported in 29 (70.7%) patients. Conclusion:The remission induction rate was 70.7% in the adolescents and young adults with acute lymphoblastic leukemia at the study centre. (author)

  12. Introduction to Adolescent and Young Adult Cancers

    Science.gov (United States)

    Cancer researchers, advocates, and a cancer survivor introduce the topic of adolescent and young adult (AYA) cancers, covering distinct aspects of cancer in these patients and research questions to answer.

  13. Psychosocial outcomes and interventions among cancer survivors diagnosed during adolescence and young adulthood (AYA): a systematic review

    Science.gov (United States)

    Barnett, Marie; McDonnell, Glynnis; DeRosa, Antonio; Schuler, Tammy; Philip, Errol; Peterson, Lisa; Touza, Kaitlin; Jhanwar, Sabrina; Atkinson, Thomas M.; Ford, Jennifer S.

    2016-01-01

    Purpose A cancer diagnosis during adolescence or young adulthood (AYA; defined as ages 15–39) generates unique medical and psychosocial needs as developmental milestones are simultaneously impacted. Past research highlights that AYAs’ experiences and psychosocial outcomes are different, and more research and attention is needed. We aimed to identify and synthesize literature regarding psychosocial outcomes, unique needs, and existing psychosocial interventions pertaining to individuals diagnosed with cancer exclusively during AYA, and to highlight areas for future research. Methods A systematic literature search was conducted using MEDLINE (via PubMed), EMBASE, Cochrane, Web of Science, and PsycINFO (via OVID). Grey literature was searched using key term variations and combinations. Overall, 15,301 records were assessed by two independent reviewers, with 38 studies meeting inclusion criteria. Results Data synthesis of the 38 articles was organized by four main themes based on quality of life and survivorship: physical well-being (7 studies), psychological well-being (8 studies), social well-being (9 studies), and survivorship care (14 studies). The paucity of studies for such broad inclusion criteria highlights that this population is often combined or subsumed under other age groups, missing needs unique to these AYAs. Conclusions AYA cancer survivors’ experiences are nuanced, with interacting variables contributing to post-treatment outcomes. AYAs require age-appropriate and flexible care, informational needs and treatment-related education that foster autonomy for long-term survivorship, as well as improved follow-up care and psychological outcomes. Implications for Cancer Survivors By incorporating these findings into practice, the informational and unmet needs of AYAs can be addressed effectively. Education and programming is lacking specific and general subject matter specific to AYAs, incorporating ranging needs at different treatment stages. PMID

  14. Weight-Related Correlates of Psychological Dysregulation in Adolescent and Young Adult (AYA) Females with Severe Obesity

    Science.gov (United States)

    Gowey, Marissa A.; Reiter-Purtill, Jennifer; Becnel, Jennifer; Peugh, James; Mitchell, James E.; Zeller, Meg H.

    2016-01-01

    Objective Severe obesity is the fastest growing pediatric subgroup of excess weight levels. Psychological dysregulation (i.e., impairments in regulating cognitive, emotional, and/or behavioral processes) has been associated with obesity and poorer weight loss outcomes. The present study explored associations of dysregulation with weight-related variables among adolescent and young adult (AYA) females with severe obesity. Methods Fifty-four AYA females with severe obesity (MBMI=48.71 kg/m2; Mage=18.29, R=15–21 years; 59.3% White) completed self-report measures of psychological dysregulation and weight-related constructs including meal patterns, problematic eating behaviors, and body and weight dissatisfaction, as non-surgical comparison participants in a multi-site study of adolescent bariatric surgery outcomes. Pearson and bivariate correlations were conducted and stratified by age group to analyze associations between dysregulation subscales (affective, behavioral, cognitive) and weight-related variables. Results Breakfast was the most frequently skipped meal (consumed 3–4 times/week). Eating out was common (4–5 times/week) and mostly occurred at fast-food restaurants. Evening hyperphagia (61.11%) and eating in the absence of hunger (37.04%) were commonly endorsed, while unplanned eating (29.63%), a sense of loss of control over eating (22.22%), eating beyond satiety (22.22%), night eating (12.96%), and binge eating (11.11%) were less common. Almost half of the sample endorsed extreme weight dissatisfaction. Dysregulation was associated with most weight-related attitudes and behaviors of interest in young adults but select patterns emerged for adolescents. Conclusions Higher levels of psychological dysregulation are associated with greater BMI, problematic eating patterns and behaviors, and body dissatisfaction in AYA females with severe obesity. These findings have implications for developing novel intervention strategies for severe obesity in AYAs that may

  15. Weight-related correlates of psychological dysregulation in adolescent and young adult (AYA) females with severe obesity.

    Science.gov (United States)

    Gowey, Marissa A; Reiter-Purtill, Jennifer; Becnel, Jennifer; Peugh, James; Mitchell, James E; Zeller, Meg H

    2016-04-01

    Severe obesity is the fastest growing pediatric subgroup of excess weight levels. Psychological dysregulation (i.e., impairments in regulating cognitive, emotional, and/or behavioral processes) has been associated with obesity and poorer weight loss outcomes. The present study explored associations of dysregulation with weight-related variables among adolescent and young adult (AYA) females with severe obesity. Fifty-four AYA females with severe obesity (MBMI = 48.71 kg/m(2); Mage = 18.29, R = 15-21 years; 59.3% White) completed self-report measures of psychological dysregulation and weight-related constructs including meal patterns, problematic eating behaviors, and body and weight dissatisfaction, as non-surgical comparison participants in a multi-site study of adolescent bariatric surgery outcomes. Pearson and bivariate correlations were conducted and stratified by age group to analyze associations between dysregulation subscales (affective, behavioral, cognitive) and weight-related variables. Breakfast was the most frequently skipped meal (consumed 3-4 times/week). Eating out was common (4-5 times/week) and mostly occurred at fast-food restaurants. Evening hyperphagia (61.11%) and eating in the absence of hunger (37.04%) were commonly endorsed, while unplanned eating (29.63%), a sense of loss of control over eating (22.22%), eating beyond satiety (22.22%), night eating (12.96%), and binge eating (11.11%) were less common. Almost half of the sample endorsed extreme weight dissatisfaction. Dysregulation was associated with most weight-related attitudes and behaviors of interest in young adults but select patterns emerged for adolescents. Higher levels of psychological dysregulation are associated with greater BMI, problematic eating patterns and behaviors, and body dissatisfaction in AYA females with severe obesity. These findings have implications for developing novel intervention strategies for severe obesity in AYAs that may have a multidimensional

  16. ENRICH: A promising oncology nurse training program to implement ASCO clinical practice guidelines on fertility for AYA cancer patients.

    Science.gov (United States)

    Vadaparampil, Susan T; Gwede, Clement K; Meade, Cathy; Kelvin, Joanne; Reich, Richard R; Reinecke, Joyce; Bowman, Meghan; Sehovic, Ivana; Quinn, Gwendolyn P

    2016-11-01

    We describe the impact of ENRICH (Educating Nurses about Reproductive Issues in Cancer Healthcare), a web-based communication-skill-building curriculum for oncology nurses regarding AYA fertility and other reproductive health issues. Participants completed an 8-week course that incorporated didactic content, case studies, and interactive learning. Each learner completed a pre- and post-test assessing knowledge and a 6-month follow-up survey assessing learner behaviors and institutional changes. Out of 77 participants, the majority (72%) scored higher on the post-test. Fifty-four participants completed the follow-up survey: 41% reviewed current institutional practices, 20% formed a committee, and 37% gathered patient materials or financial resources (22%). Participants also reported new policies (30%), in-service education (37%), new patient education materials (26%), a patient navigator role (28%), and workplace collaborations with reproductive specialists (46%). ENRICH improved nurses' knowledge and involvement in activities addressing fertility needs of oncology patients. Our study provides a readily accessible model to prepare oncology nurses to integrate American Society of Clinical Oncology guidelines and improve Quality Oncology Practice Initiative measures related to fertility. Nurses will be better prepared to discuss important survivorship issues related to fertility and reproductive health, leading to improved quality of life outcomes for AYAs. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  17. Adolescents and Young Adults with Cancer

    Science.gov (United States)

    ... a Doctor and Hospital View this video on YouTube. Experts in the field of adolescent and young adult (AYA) cancers and cancer survivors answer the ... trials. Fertility Preservation Options View this video on YouTube. ... on fertility is a special concern for young cancer patients. It is important to talk with ...

  18. Threading the cloak: palliative care education for care providers of adolescents and young adults with cancer.

    Science.gov (United States)

    Wiener, Lori; Weaver, Meaghann Shaw; Bell, Cynthia J; Sansom-Daly, Ursula M

    2015-01-09

    Medical providers are trained to investigate, diagnose, and treat cancer. Their primary goal is to maximize the chances of curing the patient, with less training provided on palliative care concepts and the unique developmental needs inherent in this population. Early, systematic integration of palliative care into standard oncology practice represents a valuable, imperative approach to improving the overall cancer experience for adolescents and young adults (AYAs). The importance of competent, confident, and compassionate providers for AYAs warrants the development of effective educational strategies for teaching AYA palliative care. Just as palliative care should be integrated early in the disease trajectory of AYA patients, palliative care training should be integrated early in professional development of trainees. As the AYA age spectrum represents sequential transitions through developmental stages, trainees experience changes in their learning needs during their progression through sequential phases of training. This article reviews unique epidemiologic, developmental, and psychosocial factors that make the provision of palliative care especially challenging in AYAs. A conceptual framework is provided for AYA palliative care education. Critical instructional strategies including experiential learning, group didactic opportunity, shared learning among care disciplines, bereaved family members as educators, and online learning are reviewed. Educational issues for provider training are addressed from the perspective of the trainer, trainee, and AYA. Goals and objectives for an AYA palliative care cancer rotation are presented. Guidance is also provided on ways to support an AYA's quality of life as end of life nears.

  19. Sociodemographic disparities in survival for adolescents and young adults with cancer differ by health insurance status.

    Science.gov (United States)

    DeRouen, Mindy C; Parsons, Helen M; Kent, Erin E; Pollock, Brad H; Keegan, Theresa H M

    2017-08-01

    To investigate associations of sociodemographic factors-race/ethnicity, neighborhood socioeconomic status (SES), and health insurance-with survival for adolescents and young adults (AYAs) with invasive cancer. Data on 80,855 AYAs with invasive cancer diagnosed in California 2001-2011 were obtained from the California Cancer Registry. We used multivariable Cox proportional hazards regression to estimate overall survival. Associations of public or no insurance with greater risk of death were observed for 11 of 12 AYA cancers examined. Compared to Whites, Blacks experienced greater risk of death, regardless of age or insurance, while greater risk of death among Hispanics and Asians was more apparent for younger AYAs and for those with private/military insurance. More pronounced neighborhood SES disparities in survival were observed among AYAs with private/military insurance, especially among younger AYAs. Lacking or having public insurance was consistently associated with shorter survival, while disparities according to race/ethnicity and neighborhood SES were greater among AYAs with private/military insurance. While health insurance coverage associates with survival, remaining racial/ethnic and socioeconomic disparities among AYAs with cancer suggest additional social factors also need consideration in intervention and policy development.

  20. Applying Social Network Analysis to Identify the Social Support Needs of Adolescent and Young Adult Cancer Patients and Survivors.

    Science.gov (United States)

    Koltai, Kolina; Walsh, Casey; Jones, Barbara; Berkelaar, Brenda L

    2018-04-01

    This article examines how theoretical and clinical applications of social network analysis (SNA) can inform opportunities for innovation and advancement of social support programming for adolescent and young adult (AYA) cancer patients and survivors. SNA can help address potential barriers and challenges to initiating and sustaining AYA peer support by helping to identify the diverse psychosocial needs among individuals in the AYA age range; find strategic ways to support and connect AYAs at different phases of the cancer trajectory with resources and services; and increase awareness of psychosocial resources and referrals from healthcare providers. Network perspectives on homophily, proximity, and evolution provide a foundational basis to explore the utility of SNA in AYA clinical care and research initiatives. The uniqueness of the AYA oncology community can also provide insight into extending and developing current SNA theories. Using SNA in AYA psychosocial cancer research has the potential to create new ideas and pathways for supporting AYAs across the continuum of care, while also extending theories of SNA. SNA may also prove to be a useful tool for examining social support resources for AYAs with various chronic health conditions and other like groups.

  1. Information needs of adolescent and young adult cancer patients and their parent-carers.

    Science.gov (United States)

    McCarthy, Maria C; McNeil, Robyn; Drew, Sarah; Orme, Lisa; Sawyer, Susan M

    2018-05-01

    This study aimed to explore health-related information needs of adolescent and young adults (AYAs) and their parent-carers and to examine demographic and clinical variables associated with unmet information needs, including patient activation. In a national cross-sectional study, 196 Australian AYAs diagnosed with cancer between 15 and 25 years and within 24 months of diagnosis and 204 parent-carers reported on total and unmet needs for cancer and health-related information. Fifty-one percent of AYAs were male, 81% had completed treatment and 86% were treated in adult hospitals. AYAs and parents reported high levels of total need for information. The mean number of unmet needs was 5.63 and 6.82 for AYAs and parents, respectively. AYAs reported the highest unmet needs in relation to their cancer (e.g. late effects and cancer recurrence, and having children in the future). The highest unmet parent information needs were related to medical information about their child as well as information on financial issues for their children and themselves. Unmet information need was associated with psychological distress (posttraumatic stress symptoms) for AYAs and parents. Patient activation was negatively associated with unmet information needs for AYAs. Demographic and treatment variables were not significantly associated with information needs. These findings indicate the importance of information needs for AYAs and their carers. The association between patient activation and information needs suggests that promoting young people's engagement with healthcare is a key opportunity within AYA care. Parent information needs and associated emotional distress additionally highlight the importance of family-centered care.

  2. Unmet need for healthcare services in adolescents and young adults with cancer and their parent carers.

    Science.gov (United States)

    Sawyer, Susan M; McNeil, Robyn; McCarthy, Maria; Orme, Lisa; Thompson, Kate; Drew, Sarah; Dunt, David

    2017-07-01

    Cancer in adolescents in and young adults (AYA) has the potential to disrupt health, well-being and developmental trajectories. This study aimed to describe the healthcare support service needs of AYAs with cancer and parent carers and to explore the association of unmet need and emotional distress. As part of a national Australian survey of 15-25 year olds with cancer and a nominated parent carer, 196 AYAs reported total and unmet need for 10 clinical services and 204 parents reported on their child's and their own healthcare service needs. Proportions of total and unmet need for specific clinical services are reported. The association of unmet service needs and distress (measured using the Posttraumatic Stress Disorder Checklist) was also examined. AYAs and parent carers expressed high total need for clinical services during treatment. Leading AYA unmet needs were for an exercise therapist (37%), genetic counsellor (30%), dietitian (26%), peer support group (26%) and educational and vocational advisor (24%). After treatment, AYAs and parents had fewer total needs. However, 60% of AYA and 38% of parents had two or more unmet needs, similar to during treatment. Female gender and receiving treatment in an adult setting were significantly associated with unmet need for clinical services. After treatment, higher distress levels in AYAs and parents were associated with two or more unmet service needs. AYAs and parents had high levels of total and unmet service need, which were associated with greater emotional distress. These results highlight opportunities to re-orientate services to better meet AYA and parent needs.

  3. Prevalence and impact of severe fatigue in adolescent and young adult cancer patients in comparison with population-based controls.

    Science.gov (United States)

    Poort, Hanneke; Kaal, Suzanne E J; Knoop, Hans; Jansen, Rosemarie; Prins, Judith B; Manten-Horst, Eveliene; Servaes, Petra; Husson, Olga; van der Graaf, Winette T A

    2017-09-01

    The current study determined the prevalence of severe fatigue in adolescent and young adult (AYA) cancer patients (aged 18-35 years at diagnosis) consulting a multidisciplinary AYA team in comparison with gender- and age-matched population-based controls. In addition, impact of severe fatigue on quality of life and correlates of fatigue severity were examined. AYAs with cancer (n = 83) completed questionnaires including the Checklist Individual Strength (CIS-fatigue), Quality of Life (QoL)-Cancer Survivor, Hospital Anxiety and Depression Scale (reflecting psychological distress), and the Cancer Worry Scale (reflecting fear of cancer recurrence or progression). The vast majority of participants had been treated with chemotherapy (87%) and had no active treatment at the time of participation (73.5%). Prevalence of severe fatigue (CIS-fatigue score ≥35) in AYAs with cancer (48%, n = 40/83) was significantly higher in comparison with matched population-based controls (20%, n = 49/249; p fatigued AYAs with cancer reported lower QoL compared to non-severely fatigued AYAs with cancer (p fatigue severity (p fatigue based on a validated cut-off score was highly prevalent in this group of AYAs with cancer. QoL is significantly affected by severe fatigue, stressing the importance of detection and management of this symptom in those patients affected by a life-changing diagnosis of cancer in late adolescence or young adulthood.

  4. ‘Reaching Out’: international models for transitional care for teenage and young adult cancer patients

    Directory of Open Access Journals (Sweden)

    Charlotte Weston

    2018-05-01

    Full Text Available Background: This article will give an overview of ‘Reaching Out’, a project to identify international models of transitional care for adolescent and young adult (AYA cancer patients. Aims: •\tExplore provision of AYA cancer care in a different cultural context •\tIdentify new models of care for supporting transition between paediatric, AYA and adult care, and between acute and primary care •\tIdentify relevant resources and service designs that could be adapted for use in AYA services in the UK Methods: Three-week observational visit in a range of international healthcare settings. Findings: Similarities and differences between Australian and UK healthcare systems were observed. Models of care using a range of resources, including structured health and wellbeing programmes, were identified to support transitional care. Models of collaborative working across organisations were observed. The implementation of innovative programmes to improve efficiency of services and limit unnecessary impact on patient time and finances were identified, including the use of Skype for collaborative consultations between acute and community healthcare providers. Conclusions: Recommendations to benefit AYA patients with an improved range of supportive, holistic services and improved person-centred care include: •\tJoint AYA nursing posts between AYA centres to support transition •\tStructured AYA post-treatment health and wellbeing programme •\tProgramme of creative wellbeing projects to support transition at the end of treatment Scope use of Skype appointments within the AYA service Implications for practice: Observing service provision and healthcare practice in an international setting provides the opportunity to improve cross-cultural competence, which is essential to culturally competent care. Cross-cultural competence supports the improvement of patient care through experiential learning, sharing of ideas and connecting with others. The

  5. The Experience of Adolescents and Young Adults Treated for Cancer in an Adult Setting: A Review of the Literature.

    Science.gov (United States)

    Marshall, Steve; Grinyer, Anne; Limmer, Mark

    2018-02-13

    The purpose of this review is to explore the literature on the experience of adolescents and young adults (AYAs) having cancer treatment in an adult setting, rather than on a specialist adolescent cancer unit. The integrative review method was used to explore the current literature. Primary research on the topic was located systematically and then synthesized into a thematic narrative. The experience of AYAs undergoing treatment in an adult setting was generally negative. This can be attributed to three themes: feeling isolated in the adult setting; the lack of empathy from staff working in the adult setting; and the inappropriateness of the adult environment for this age group. As many AYAs with cancer will continue to have treatment in adult settings, staff working in this environment should be aware of the negative experience of this cohort and the impact this can have on a vulnerable group of patients. Staff could consider simple ways of improving the AYA experience, such as connecting AYA patients with their peers to reduce isolation; adapting their approach to take account of the unique emotional needs of this age group; and considering ways of making the environment more welcoming and age-appropriate.

  6. Contributors and Inhibitors of Resilience Among Adolescents and Young Adults with Cancer

    Science.gov (United States)

    Yi-Frazier, Joyce P.; Wharton, Claire; Gordon, Karen; Jones, Barbara

    2014-01-01

    Purpose: Self-perceived resilience may enable coping and mitigate poor psychosocial outcomes among adolescent and young adult (AYA) patients with cancer. In order to inform the development of resilience-promoting interventions, we aimed to: (1) describe AYA patient-reported resilience and (2) identify AYA patient-reported contributors and inhibitors of resilience. Methods: The “Resilience in Adolescents and Young Adults with Cancer” study was a prospective longitudinal mixed-methods study. Consecutive Caucasian patients aged 14–25 years old enrolled 14–60 days following their diagnosis of cancer and completed one-on-one semi-structured interviews both at the time of enrollment and 3–6 months later. Constant comparative analyses identified salient themes describing modifiable contributors and inhibitors to patient-perceived resilience. Results: Seventeen patients (85% of those approached) enrolled in the study. The mean age was 17 years (SD=2.6) and 53% were female. All patient definitions of resilience inferred an ability to handle adversity. Five themes emerged as predominant contributors or inhibitors of resilience: (1) stress and coping; (2) goals, purpose, and planning; (3) optimism; (4) gratitude and meaning; and (5) connection and belonging. Merged analyses suggested that AYA resilience was a balance that may be enabled by promoting certain skills. Conclusion: AYA patients with cancer perceive resilience as a balance. Learned skills in stress management, goal-setting, and benefit-finding may empower AYAs during their cancer experience, in turn improving long-term psychosocial outcomes. PMID:25969794

  7. Age-Specific Patient Navigation Preferences Among Adolescents and Young Adults with Cancer.

    Science.gov (United States)

    Pannier, Samantha T; Warner, Echo L; Fowler, Brynn; Fair, Douglas; Salmon, Sara K; Kirchhoff, Anne C

    2017-11-23

    Patient navigation is increasingly being directed at adolescent and young adult (AYA) patients. This study provides a novel description of differences in AYA cancer patients' preferences for navigation services by developmental age at diagnosis. Eligible patients were diagnosed with cancer between ages 15 and 39 and had completed at least 1 month of treatment. Between October 2015 and January 2016, patients completed semi-structured interviews about navigation preferences. Summary statistics of demographic and cancer characteristics were generated. Differences in patient navigation preferences were examined through qualitative analyses by developmental age at diagnosis. AYAs were interviewed (adolescents 15-18 years N = 8; emerging adults 19-25 years N = 8; young adults 26-39 years N = 23). On average, participants were 4.5 years from diagnosis. All age groups were interested in face-to-face connection with a navigator and using multiple communication platforms (phone, text, email) to follow-up. Three of the most frequently cited needs were insurance, finances, and information. AYAs differed in support, healthcare, and resource preferences by developmental age; only adolescents preferred educational support. While all groups preferred financial and family support, the specific type of assistance (medical versus living expenses, partner/spouse, child, or parental assistance) varied by age group. AYAs with cancer have different preferences for patient navigation by developmental age at diagnosis. AYAs are not a one-size-fits-all population, and navigation programs can better assist AYAs when services are targeted to appropriate developmental ages. Future research should examine fertility and navigation preferences by time since diagnosis. While some navigation needs to span the AYA age range, other needs are specific to developmental age.

  8. Cancer-Related Fatigue in Adolescents and Young Adults After Cancer Treatment: Persistent and Poorly Managed.

    Science.gov (United States)

    Spathis, Anna; Hatcher, Helen; Booth, Sara; Gibson, Faith; Stone, Paddy; Abbas, Laura; Barclay, Matt; Brimicombe, James; Thiemann, Pia; McCabe, Martin G; Campsey, Rachel; Hooker, Louise; Moss, Wendy; Robson, Jane; Barclay, Stephen

    2017-09-01

    Cancer-related fatigue is the most prevalent and distressing symptom experienced by adolescents and young adults (AYAs). An electronic survey was undertaken to ascertain current fatigue management and perceptions of its effectiveness. Eighty-five percent of responders (68/80) experienced fatigue, and it was worse more than 1 year after cancer treatment ended, compared to fatigue management. Although advice to exercise was the most frequent intervention, the greatest impact of fatigue was on the ability to exercise and most did not find exercise advice helpful. Early intervention is warranted, supporting AYAs to persevere with increasing activity.

  9. Psychometric Evaluation of an Adolescent and Young Adult Module of the Impact of Cancer Instrument

    NARCIS (Netherlands)

    Husson, O.; Zebrack, B.J.

    2017-01-01

    PURPOSE: To develop and evaluate a new instrument that measures unique aspects of long-term survivorship for people diagnosed with cancer as Adolescent and Young Adult (AYA), not measured by existing tools. METHODS: A new candidate instrument-the Impact of Cancer for Adolescent and Young Adult

  10. Model of care for adolescents and young adults with cancer: the Youth Project in Milan

    Directory of Open Access Journals (Sweden)

    Chiara Magni

    2016-08-01

    Full Text Available Adolescents and young adults (AYA with cancer form a particular group of patients with unique characteristics, who inhabit a so-called no man’s land between pediatric and adult services. In the last ten years, the scientific oncology community has started to pay attention to these patients, implementing dedicated programs. A standardized model of care directed towards patients in this age range has yet to be developed and neither the pediatric nor the adult oncologic systems perfectly fit these patients’ needs. The Youth Project of the Istituto Nazionale Tumori in Milan, dedicated to adolescents and young adults with pediatric-type solid tumors, can be seen as a model of care for AYA patients, with its heterogeneous multidisciplinary staff and close cooperation with adult medical oncologists and surgeons. Further progress in the care of AYA cancer patients is still needed to improve their outcomes.

  11. [Usefulness of social and educational approach in adolescents and young adults with cancer: The Lille team's experience].

    Science.gov (United States)

    Jacquot, Julie; Delbarre-Philippart, Marie; Bricout, Hélène; Lervat, Cyril; Carbonnelle, Guillaume; Leblond, Pierre; Defachelles, Anne-Sophie; Penel, Nicolas; Sudour-Bonnange, Hélène

    2016-12-01

    Within the second "Cancer plan" 2009-2013, the French national institute of cancer (INCa) recommended the implementation of programs dedicated to adolescents and youngs adults (AYA) with cancer. In this context and in parallel to the specific medical care developed for AYA, the Oscar-Lambret center created a psycho-social-educational team including among others a social worker (SW) and a special educational teacher (SET), offering multidisciplinary qualifications and views. The social approach, realized as a pair by SW-SET, takes into account every aspect of each AYA (family, academic, career/professional, personal, cultural aspects…). We expose the first 2 years' experience of this special program for AYA through diagnosis to remission time. For this period, 164 AYA were seen by the social professionals, with a total of 602 consultations in the unit. The number of these consultations depended on the needs of AYA and their family. Nevertheless, only 10 AYA required no further intervention (6.1 %). The study highlights that the social interventions are most frequently about scolarity, work and disability recognition. These 2 years of experience of the SW-SET team offered a way to reflect upon our values and our culture, and on the role of the social worker in a medical setting. Each AYA has a personal story, which affects significantly the way to overcome the challenges that come with the disease. Our findings underscore the need for AYA with cancer to have access to personalized supportive care, encouraging them in pursing their personal goals and rewarding themselves. Copyright © 2016 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

  12. Assessing the psychosocial needs and program preferences of adolescents and young adults with cancer.

    Science.gov (United States)

    Barakat, Lamia P; Galtieri, Liana R; Szalda, Dava; Schwartz, Lisa A

    2016-02-01

    Adolescents and young adults (AYA) are a developmentally distinct cancer group, vulnerable to psychosocial late effects and with a range of unmet psychosocial needs. We sought to better understand psychosocial care needs and program preferences to inform development of more easily accessible and effective AYA psychosocial programs. AYA on and off treatment for cancer (n = 111, ages 12-25 years) were approached during an outpatient clinic visit and completed a survey as part of a quality improvement initiative. The survey comprised an open-ended question on challenges related to cancer and treatment and closed-ended questions on access to and preference for various services and programs. Qualitative analyses were used to summarize themes for most significant challenges, and descriptive statistics were used for closed-ended questions. Most common themes for challenges included treatments and associated physical changes, barriers to pursuit of academic/vocational goals, and social isolation. For preferred program focus, AYA ranked highest increasing strength and endurance/reintegration into sports and dealing with physical changes resulting from treatment. AYA's preferred modalities for program delivery were one-on-one/in person and message boards/Facebook. Most of the sample indicated that lack of awareness prevented their accessing available programs. New information was identified that can be used to address access barriers and to offer AYA psychosocial programs in formats that might improve interest and accessibility. Ongoing evaluation of AYA psychosocial programs is recommended to determine acceptability, feasibility, and effectiveness to meet the evolving needs of AYA patients with cancer.

  13. Development of cancer needs questionnaire for parents and carers of adolescents and young adults with cancer.

    Science.gov (United States)

    Carey, Mariko L; Clinton-McHarg, Tara; Sanson-Fisher, Robert William; Shakeshaft, Anthony

    2012-05-01

    In order to improve the service delivery for the parents and carers of adolescents and young adults (AYAs) with cancer, it is important to develop measures which assess the specific issues and concerns faced by this group. The aims of this study were to describe the development and acceptability of a measure of unmet needs of parents and carers of AYA cancer survivors and to assess the prevalence of unmet needs among the respondents. A literature search and focus groups with consumers and health professionals were used to inform item development. AYA cancer survivors and their parents and carers were identified from seven hospitals in Australia. Parents and carers who consented for their contact details to be released to the research team were sent a paper-and-pencil questionnaire. One mailed reminder and one phone call reminder were made to non-responders. The unmet needs survey consisted of eight domains and 150 items: (1) cancer treatment staff, (2) cancer treatment centre, (3) study, (4) work, (5) information, (6) feelings, (7) relationships and (8) daily life. Eighty-three parents and carers completed the survey. The mean number of high or very high unmet needs reported was 24, with information needs among the most prevalent high/very high unmet needs. The questionnaire developed has demonstrable face and content validity and acceptability. Unmet needs are prevalent among parents and carers of AYA cancer survivors, suggesting the need for further psychometric testing of the measure.

  14. Disparities in Adolescent and Young Adult Survival After Testicular Cancer Vary by Histologic Subtype: A Population-Based Study in California 1988–2010

    Science.gov (United States)

    Mujahid, Mahasin; Srinivas, Sandy; Keegan, Theresa H.M.

    2016-01-01

    Purpose: Testicular cancer is the most common cancer among adolescent and young adult (AYA) men 15–39 years of age. This study aims to determine whether race/ethnicity and/or neighborhood socioeconomic status (SES) contribute independently to survival of AYAs with testicular cancer. Methods: Data on 14,249 eligible AYAs with testicular cancer diagnosed in California between 1988 and 2010 were obtained from the population-based California Cancer Registry. Multivariable Cox proportional hazards regression was used to examine overall and testicular cancer-specific survival and survival for the seminoma and nonseminoma histologic subtypes according to race/ethnicity, census-tract level neighborhood SES, and other patient and clinical characteristics. Results: Compared with White AYAs, Hispanic AYAs had worse overall and testicular cancer-specific survival (hazard ratio [HR], 1.21; 95% confidence interval [CI], 1.07–1.37) and Black AYAs had worse overall survival (HR, 1.41; 95% CI, 1.01–1.97), independent of neighborhood SES and other demographic and clinical factors. Racial/ethnic disparities in survival were more pronounced for nonseminoma than for seminoma. AYAs residing in middle and low SES neighborhoods experienced worse survival across both histologic subtypes independent of race/ethnicity and other factors, while improvements in survival over time were more pronounced for seminoma. Longer time to treatment was also associated with worse survival, particularly for AYAs with nonseminoma. Conclusion: Among AYAs, race/ethnicity, and neighborhood SES are independently associated with survival after testicular cancer. Variation in disparities by histologic type according to demographic factors, year of diagnosis, and time to treatment may reflect differences in prognosis and extent of treatment for the two histologies. PMID:26812451

  15. Disparities in Adolescent and Young Adult Survival After Testicular Cancer Vary by Histologic Subtype: A Population-Based Study in California 1988-2010.

    Science.gov (United States)

    DeRouen, Mindy C; Mujahid, Mahasin; Srinivas, Sandy; Keegan, Theresa H M

    2016-03-01

    Testicular cancer is the most common cancer among adolescent and young adult (AYA) men 15-39 years of age. This study aims to determine whether race/ethnicity and/or neighborhood socioeconomic status (SES) contribute independently to survival of AYAs with testicular cancer. Data on 14,249 eligible AYAs with testicular cancer diagnosed in California between 1988 and 2010 were obtained from the population-based California Cancer Registry. Multivariable Cox proportional hazards regression was used to examine overall and testicular cancer-specific survival and survival for the seminoma and nonseminoma histologic subtypes according to race/ethnicity, census-tract level neighborhood SES, and other patient and clinical characteristics. Compared with White AYAs, Hispanic AYAs had worse overall and testicular cancer-specific survival (hazard ratio [HR], 1.21; 95% confidence interval [CI], 1.07-1.37) and Black AYAs had worse overall survival (HR, 1.41; 95% CI, 1.01-1.97), independent of neighborhood SES and other demographic and clinical factors. Racial/ethnic disparities in survival were more pronounced for nonseminoma than for seminoma. AYAs residing in middle and low SES neighborhoods experienced worse survival across both histologic subtypes independent of race/ethnicity and other factors, while improvements in survival over time were more pronounced for seminoma. Longer time to treatment was also associated with worse survival, particularly for AYAs with nonseminoma. Among AYAs, race/ethnicity, and neighborhood SES are independently associated with survival after testicular cancer. Variation in disparities by histologic type according to demographic factors, year of diagnosis, and time to treatment may reflect differences in prognosis and extent of treatment for the two histologies.

  16. Parental perspectives on a behavioral health music intervention for adolescent/young adult resilience during cancer treatment: report from the children's oncology group.

    Science.gov (United States)

    Docherty, Sharron L; Robb, Sheri L; Phillips-Salimi, Celeste; Cherven, Brooke; Stegenga, Kristin; Hendricks-Ferguson, Verna; Roll, Lona; Donovan Stickler, Molly; Haase, Joan

    2013-02-01

    This article describes parental perspectives on the helpfulness and meaningfulness of a behavioral health music therapy intervention targeted to adolescents/young adults (AYA) with cancer undergoing stem cell transplantation. We demonstrate how qualitative methods may be used to understand critical aspects of an intervention and mechanisms by which the intervention impacts the target AYA outcomes of resilience and quality of life. A qualitative descriptive design was used to obtain parents' perspectives. A maximum-variation purposive sampling technique was used to sample 16 parents whose AYA had been randomized to the intervention group. A semistructured open-ended interview was conducted between 100 and 160 days after the AYA's transplant. Results were grouped into three categories: (1) helpfulness and meaningfulness of the intervention to AYA adjustment to the transplantation experience; (2) helpfulness and meaningfulness of the intervention for parents; and (3) AYA ability to participate in the intervention during the acute phase of transplant. Parents observed and interacted with their AYA who participated in a targeted behavioral intervention. Thus, parents were able to describe mechanisms through which the intervention was helpful and meaningful for the AYA and indirect personal benefits for themselves. The results suggest the importance of the targeted outcomes identified in the Resilience in Illness Model and mechanisms of action in the Contextual Support Model of Music Therapy, and identify approaches for future study. Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  17. Preferences for support services among adolescents and young adults with cancer or a blood disorder: a discrete choice experiment.

    Science.gov (United States)

    Goodall, Stephen; King, Madeleine; Ewing, Jane; Smith, Narelle; Kenny, Patricia

    2012-10-01

    Life-threatening illnesses in young people are traumatic for patients and their families. Support services can help patients and families deal with various non-medical impacts of diagnosis, disease and treatment. The aim of this study was to determine which types of support are most valued by adolescents and young adults (AYA) with cancer or blood disorders and their families. A discrete choice experiment (DCE). Separate experiments were conducted with AYA and their carers. Completed surveys were returned by 83 patients and 78 carers. AYA preferred emotional support for themselves (either by counsellors and/or peers), emotional support for their family, financial support and assistance returning to school/work over services relating to cultural and spiritual needs. Covariate analysis indicated female AYA were more likely than males to prefer emotional support, while males were more likely to prefer assistance returning to work/school. Carers preferred emotional support for their AYA and assistance returning to school/work. Like AYA, they were indifferent about services relating to cultural and spiritual needs. Providing the types of support services that people prefer should maximise effectiveness. This study suggests that AYA patients require support services that included financial aid, assistance returning to work/study, emotional support for themselves and for their family. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  18. Predictors of unmet needs and psychological distress in adolescent and young adult siblings of people diagnosed with cancer.

    Science.gov (United States)

    McDonald, F E J; Patterson, P; White, K J; Butow, P; Bell, M L

    2015-03-01

    Predictors of psychological distress and unmet needs amongst adolescents and young adults (AYAs) who have a brother or sister diagnosed with cancer were examined. There were 106 AYAs (12-24 years old) who completed questionnaires covering demographics, psychological distress (Kessler 10), unmet needs (Sibling Cancer Needs Instrument) and family relationships (Family Relationship Index; Adult Sibling Relationship Questionnaire; Sibling Perception Questionnaire (SPQ)). Three models were analysed (demographic variables, cancer-specific variables and family functioning variables) using multiple linear regression to determine the role of the variables in predicting psychological distress and unmet needs. Unmet needs were higher for AYA siblings when treatment was current or a relapse had occurred. Higher scores on the SPQ-Interpersonal subscale indicating a perceived decrease in the quality of relationships with parents and others were associated with higher levels of distress and unmet needs. The age and gender of the AYA sibling, whether it was their brother or sister who was diagnosed with cancer, the age difference between them, the number of parents living with the AYA sibling, parental birth country, time since diagnosis, Family Relationship Index, Adult Sibling Relationship Questionnaire and the SPQ-Communication subscale did not significantly impact outcome variables. These results highlight the variables that can assist in identifying AYA siblings of cancer patients who are at risk and have a greater need for psychosocial assistance. Variables that may be associated with increased distress and unmet needs are reported to assist with future research. The results are also useful in informing the development of targeted psychosocial support for AYA siblings of cancer patients. Copyright © 2014 John Wiley & Sons, Ltd.

  19. Small Numbers, Big Challenges: Adolescent and Young Adult Cancer Incidence and Survival in New Zealand.

    Science.gov (United States)

    Ballantine, Kirsten R; Watson, Heidi; Macfarlane, Scott; Winstanley, Mark; Corbett, Robin P; Spearing, Ruth; Stevanovic, Vladimir; Yi, Ma; Sullivan, Michael J

    2017-06-01

    This study was undertaken to determine cancer survival and describe the unique spectrum of cancers diagnosed among New Zealand's adolescents and young adult (AYA) population. Registrations for 1606 15-24 year olds diagnosed with a new primary malignant tumor between 2000 and 2009 were obtained from the New Zealand Cancer Registry and classified according to AYA diagnostic group and subgroup, age, sex, and prioritized ethnicity. Age-standardized incidence rates (IRs) per million person years and 5-year relative survival ratios were calculated. Cancer incidence was 228.6 per million for adolescents aged 15-19 years and 325.7 per million for young adults aged 20-24 years. Overall IRs were consistent across all ethnic groups but there were unique ethnic differences by tumor group including a higher incidence of bone tumors, carcinoma of the gastrointestinal tract, and gonadal germ cell tumors among Maori, a higher incidence of leukemia among Pacific peoples, and a higher incidence of melanoma among non-Maori/non-Pacific peoples. Five-year relative survival for adolescents (75.1%) and AYA overall (80.6%) appeared poorer than had been achieved in other high-income countries. Maori (69.5%) and Pacific (71.3%) AYA had lower 5-year survival compared to non-Maori/non-Pacific peoples (84.2%). The survival disparities observed require further investigation to identify and address the causes of these inferior outcomes. The newly established AYA Cancer Network Aotearoa has been tasked with improving cancer survival and care and ensuring equality of access for New Zealand AYAs with cancer.

  20. Psychometric Evaluation of an Adolescent and Young Adult Module of the Impact of Cancer Instrument.

    Science.gov (United States)

    Husson, Olga; Zebrack, Bradley J

    2017-03-01

    To develop and evaluate a new instrument that measures unique aspects of long-term survivorship for people diagnosed with cancer as Adolescent and Young Adult (AYA), not measured by existing tools. A new candidate instrument-the Impact of Cancer for Adolescent and Young Adult (IOC-AYA) cancer survivors-was developed and administered to AYA cancer survivors aged 18-35 years who were 15-29 years old when diagnosed with cancer. Psychometric properties of newly derived scales were assessed. Factor analyses of items derived seven new and specific subscales: Social Life; Uncertainties, Worries and Wonders; Cognitive Function; Sense of Purpose/Life Goals; Identity; Health Behaviors; and Health Literacy. Two separate and conditional subscales were formed: Relationship Concerns (partnered/unpartnered) and Having Children (at least one child/no children). Internal consistency measurements for these subscales ranged from 0.70 to 0.90. Expected associations within and among IOC-AYA subscales and standardized measures of quality of life were observed. Psychometric analyses indicated that this initial version of the IOC-AYA measures distinct and relevant constructs for survivors diagnosed with cancer in adolescence and young adulthood. Future work is needed to confirm the responsiveness to change and further validate the instrument in multiple and representative samples. Use of the IOC-AYA instrument in research and clinical practice will inform the development of psychosocial and supportive care interventions that not only minimize or prevent long-term deleterious effects of cancer but also promote positive adaptation, resilience, and the achievement of age-specific developmental tasks.

  1. The burden of cancer in 25-29 year olds in New Zealand: a case for a wider adolescent and young adult age range?

    Science.gov (United States)

    Ballantine, Kirsten R; Utley, Victoria; Watson, Heidi; Sullivan, Michael J; Spearing, Ruth

    2018-01-19

    New Zealand currently defines the adolescent and young adult (AYA) group for cancer services as young people 12-24 years of age, while other countries favour a designation of 15-29 years. This study was undertaken to compare cancer incidence and survival among 25-29 year olds to New Zealand's younger AYA population and to assess survival for our 15-29 year population against international benchmarks. Diagnostic and demographic information for cancer registrations between 2000 and 2009 for 25-29 year olds was obtained from the New Zealand Cancer Registry. Incidence rates (IR) and five-year relative survival estimates were calculated according to AYA diagnostic group/sub-group, sex and prioritised ethnicity. 1,541 new primary malignant cancers were diagnosed (IR: 588 per million). Five-year relative survival was 85%, but was significantly lower for Māori and Pacific peoples (both 77%) compared to non-Māori/non-Pacific peoples (88%). In the overall 15-29 year AYA cohort, disease-specific outcomes for bone tumours (46%) and breast cancer (64%) were inferior to international standards. New Zealand 25 to 29 year olds are at twice the risk of developing cancer as those 15-24 years. Given that the survival disparities identified were remarkably consistent with those for younger AYA, consideration should be given widening New Zealand's AYA age range.

  2. Post-Traumatic Growth and Resilience in Adolescent and Young Adult Cancer Patients: An Overview

    NARCIS (Netherlands)

    Greup, Suzanne R.; Kaal, Suzanne E. J.; Jansen, Rosemarie; Manten-Horst, Eveliene; Thong, Melissa S. Y.; van der Graaf, Winette T. A.; Prins, Judith B.; Husson, Olga

    2018-01-01

    The aim of this study was to provide an overview of the literature on post-traumatic growth (PTG) and resilience among adolescent and young adult (AYA) cancer patients. A literature search in Embase, PsychInfo, PubMed, Web of Science, Cochrane Library, and Cinahl was carried out. Thirteen articles

  3. Music's relevance for adolescents and young adults with cancer: a constructivist research approach.

    Science.gov (United States)

    O'Callaghan, Clare; Barry, Philippa; Thompson, Kate

    2012-04-01

    Music is one of the most widely used activities amongst young people, significant in personal and group identity, motivation, physical release, and emotional support. Adolescents and young adults with cancer (AYA) require specialized care because of intensified challenges related to developmental vulnerability, treatment toxicity effects, and slower improvements in survival rates compared to other age groups. To advance effective supportive care for AYA, understanding their thoughts about music is necessary. This study examines AYAs' perspectives about music's role in their lives. A constructivist research approach with grounded theory design was applied. Twelve people, 15 to 25 years old, known to onTrac@PeterMac Victorian Adolescent & Young Adult Cancer Service, participated. Respondents completed a brief music demographic questionnaire and participated in a semi-structured interview. Qualitative inter-rater reliability was integrated. Participants mostly reported music's calming, supportive, and relaxing effects, which alleviated hardship associated with their cancer diagnoses. Themes encompassed: music backgrounds, changed "musicking", endurance and adjustment, time with music therapists, and wisdom. Music provided supportive messages, enabled personal and shared understandings about cancer's effects, and elicited helpful physical, emotional, and imagery states. Music therapy could also promote normalized and supportive connections with others. A musician, however, struggled to get music "back" post-treatment. Supportive music-based strategies were recommended for other AYA and their health care providers. Music can signify and creatively enable AYAs' hope, endurance, identity development, and adjustment through cancer treatment and post-treatment phases. Health professionals are encouraged to support AYAs' music-based self-care and "normalized" activities.

  4. Assessing and optimizing health-related quality of life during and after cancer treatment in adolescents and young adults

    Directory of Open Access Journals (Sweden)

    Szalda D

    2014-12-01

    Full Text Available Dava Szalda,1 Esther Kim,2 Jill P Ginsberg1,2 1Division of Oncology, The Children's Hospital of Philadelphia, 2Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA Abstract: Adolescent and young adults (AYAs with cancer have needs unique from their pediatric or adult counterparts at diagnosis, during treatment, and throughout survivorship care. Healthcare teams may find it difficult to assess and manage the complex psychosocial needs of AYA patients, however, attention to the multi-faceted care of the AYA oncology patient may directly affect health outcomes and quality of life. Comprehensive AYA care therefore must be maximized during treatment and in transition to survivorship care by including assessments of general health, sexual health, mental health, health behaviors, and conversations concerning transition to survivorship and adulthood with AYA patients. Identifying and treating issues that arise in the AYA population may help promote adherence to treatment, engagement in follow-up care, and ultimately quality of life for this unique group of patients. Keywords: quality of life, sexual health, health behaviors, mental health, transition, survivorship

  5. Cancer in Older Adults

    Science.gov (United States)

    ... Home > Navigating Cancer Care > For Older Adults For Older Adults A full-text transcript is available. More than ... Advanced Cancer For Children For Teens For Young Adults For Older Adults Aging and Cancer Cancer Care Decisions for ...

  6. Parental Perspectives on a Behavioral Health Music Intervention for Adolescent/Young Adult Resilience during Cancer Treatment: Report from the Children’s Oncology Group

    Science.gov (United States)

    Docherty, Sharron L.; Robb, Sheri L.; Phillips-Salimi, Celeste; Cherven, Brooke; Stegenga, Kristin; Hendricks-Ferguson, Verna; Roll, Lona; Stickler, Molly Donovan; Haase, Joan

    2012-01-01

    Purpose This paper describes parental perspectives on the helpfulness and meaningfulness of a behavioral health music therapy intervention targeted to adolescents/young adults (AYA) with cancer undergoing stem cell transplantation. We demonstrate how qualitative methods may be used to understand critical aspects of an intervention and mechanisms by which the intervention impacts the target AYA outcomes resilience and quality of life. Methods A qualitative descriptive design was used to obtain parents’ perspectives. Maximum variation purposive sampling was used to sample 16 parents whose AYA had been randomized to the intervention group. A semi-structured, open-ended interview was conducted between 100 and 160 days following their AYA’s transplant. Results Results are grouped into three categories: (1) helpfulness and meaningfulness of the intervention to AYA adjustment to the transplantation experience; (2) helpfulness and meaningfulness of the intervention for parents; and (3) AYA ability to participate in the intervention during acute phase of transplantation. Conclusions Parents observed and interacted with their AYA who participated in a targeted, behavioral intervention. Thus parents were able to describe mechanisms through which the intervention was helpful and meaningful for the AYA and indirect personal benefits for themselves. The results suggest the importance of the targeted outcomes identified in the Resilience in Illness Model and mechanisms of action in the Contextual Support Model of Music Therapy and identifies approaches for future study. PMID:23332481

  7. Second Primary Malignant Neoplasms and Survival in Adolescent and Young Adult Cancer Survivors.

    Science.gov (United States)

    Keegan, Theresa H M; Bleyer, Archie; Rosenberg, Aaron S; Li, Qian; Goldfarb, Melanie

    2017-11-01

    Although the increased incidence of second primary malignant neoplasms (SPMs) is a well-known late effect after cancer, few studies have compared survival after an SPM to survival of the same cancer occurring as first primary malignant neoplasm (PM) by age. To assess the survival impact of SPMs in adolescents and young adults (AYAs) (15-39 years) compared with that of pediatric (cancer in 13 Surveillance, Epidemiology and End Results regions in the United States diagnosed from 1992 to 2008 and followed through 2013. Data analysis was performed between June 2016 and January 2017. Five-year relative survival was calculated overall and for each cancer occurring as a PM or SPM by age at diagnosis. The impact of SPM status on cancer-specific death was examined using multivariable Cox proportional hazards regression. A total of 15 954 pediatric, 125 750 AYAs, and 878 370 older adult patients diagnosed as having 14 cancers occurring as a PM or SPM were included. Overall, 5-year survival after an SPM was 33.1% lower for children, 20.2% lower for AYAs, and 8.3% lower for older adults compared with a PM at the same age. For the most common SPMs in AYAs, the absolute difference in 5-year survival was 42% lower for secondary non-Hodgkin lymphoma, 19% for secondary breast carcinoma, 15% for secondary thyroid carcinoma, and 13% for secondary soft-tissue sarcoma. Survival by SPM status was significantly worse in younger vs older patients for thyroid, Hodgkin lymphoma, non-Hodgkin lymphoma, acute myeloid leukemia, soft-tissue sarcoma, and central nervous system cancer. Adolescents and young adults with secondary Hodgkin lymphoma (hazard ratio [95% CI], 3.5 [1.7-7.1]); soft-tissue sarcoma (2.8 [2.1-3.9]); breast carcinoma (2.1 [1.8-2.4]); acute myeloid leukemia (1.9 [1.5-2.4]); and central nervous system cancer (1.8 [1.2-2.8]) experienced worse survival compared with AYAs with the same PMs. The adverse impact of SPMs on survival is substantial for AYAs and may partially

  8. Improved nutrition in adolescents and young adults after childhood cancer - INAYA study.

    Science.gov (United States)

    Quidde, J; von Grundherr, J; Koch, B; Bokemeyer, C; Escherich, G; Valentini, L; Buchholz, D; Schilling, G; Stein, A

    2016-11-08

    Multimodality treatment improves the chance of survival but increases the risk for long-term side effects in young cancer survivors, so-called" Adolescents and Young Adults"(AYAs). Compared to the general population AYAs have a 5 to 15-fold increased risk of cardiovascular morbidity. Thus, improving modifiable lifestyle risk factors is of particular importance. The INAYA trial included AYAs between 18 and 39 years receiving an intensified individual nutrition counseling at four time points in a 3-month period based on a 3-day dietary record. At week 0 and 12 AYAs got a face-to-face counseling, at week 2 and 6 by telephone. Primary endpoint was change in nutritional behavior measured by Healthy Eating Index - European Prospective Investigation into Cancer and Nutrition (HEI-EPIC). Twenty-three AYAs (11 female, 12 male, median age 20 years (range 19-23 years), median BMI: 21.4 kg/m 2 (range: 19.7-23.9 kg/m 2 ) after completion of cancer treatment for sarcoma (n = 2), carcinoma (n = 2), blastoma (n = 1), hodgkin lymphoma (n = 12), or leukemia (n = 6) were included (median time between diagnosis and study inclusion was 44 month). The primary endpoint was met, with an improvement of 20 points in HEI-EPIC score in 52.2 % (n = 12) of AYAs. At baseline, median HEI-EPIC score was 47.0 points (range from 40.0 to 55.0 points) and a good, moderate and bad nutritional intake was seen in 4.3, 73.9 and 21.7 % of AYAs. At week 12, median HEI-EPIC improved significantly to 65.0 points (range from 55.0 to 76.0 points) (p ≤ 0.001) and a good, moderate and bad nutritional intake was seen in 47.8, 52.2 and 0 % of AYAs. No change was seen in quality of life, waist-hip ratio and blood pressure. Intensified nutrition counseling is feasible and seem to improve nutritional behavior of AYAs. Further studies will be required to demonstrate long-term sustainability and confirm the results in a randomized design in larger cohorts. Clinical trial identifier

  9. Tailoring the delivery of cancer diagnosis to adolescent and young adult patients displaying strong emotions: An observational study of two cases

    Directory of Open Access Journals (Sweden)

    Live Korsvold

    2016-04-01

    Full Text Available Delivering the bad news of a cancer diagnosis to adolescent and young adult (AYA patients who display strong emotions is particularly challenging not the least because AYAs are at a vulnerable developmental stage. Due to the lack of research on how to personalize the delivery of bad news to AYA patients’ emotions we report a case study of the communicative behavior of oncologists in two such consultations to describe the complexity of the phenomena at study. We audio-recorded and transcribed consultations where oncologists delivered cancer diagnoses to nine AYAs aged 12–25 years. Two of these patients displayed particularly strong emotional behavior (anger, fear, and sadness and were chosen as cases. An interpretative analysis in three steps was applied to investigate the oncologists’ communicative behavior when delivering bad news. The focus was on how the oncologists responded to the strong but different emotional behaviors of the AYAs. We also related the oncologists’ communicative behavior to elements from a widely used protocol for delivering bad news. We found that the oncologists applied five communication strategies: elicit patient perspective, provide information, respond to patient's expression of emotion (acknowledging and containing emotions, encourage commitment to treatment, and provide hope. The findings illustrate how oncologists’ communicative behavior may be tailored to individual expressions of emotions in AYA cancer patients.

  10. Strategies to improve adherence to treatment in adolescents and young adults with cancer: a systematic review

    Directory of Open Access Journals (Sweden)

    Robertson EG

    2015-07-01

    Full Text Available Eden G Robertson,1,2 Claire E Wakefield,1,2 Kate H Marshall,2 Ursula M Sansom-Daly1–3 1Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, University of New South Wales, Kensington, NSW, Australia; 2Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, 3Sydney Youth Cancer Service, Prince of Wales/Sydney Children's Hospital, Randwick, NSW, Australia Purpose: Adolescents and young adults (AYAs with cancer have higher rates of nonadherence to treatment relative to younger and older cancer patients. Efforts to improve adherence in this population are therefore increasing. This review aimed: 1 to synthesize recommendations and strategies used to improve treatment adherence in AYAs with cancer, and 2 to summarize the available evidence supporting the efficacy of adherence-promoting strategies for AYAs with cancer.Methods: We conducted a systematic review with two stages: 1 a narrative stage, to analyze expert recommendations, and 2 an evaluative stage, to summarize quantitative evidence for interventions. Four electronic databases were searched for studies involving AYAs, aged 10–39 years, with cancer, published from 2005 to 2015. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA guidelines were used to ensure quality of the review. The Delphi list was used to assess study quality.Results: Nine articles were identified in the narrative stage of the review. For the evaluative stage, out of 113 screened abstracts, only one eligible intervention was identified. Common themes of adherence-promoting strategies were grouped into five domains: developmental, communication, educational, psychological well-being, and logistical/management strategies. Strategies to address developmental stage and to improve communication were the most highly recommended to improve adherence. Few strategies focused on the role of the patient in adherence. One

  11. A reflection on the work of Gianni Bonadonna from the viewpoint of the global challenge of adolescents and young adults with cancer.

    Science.gov (United States)

    Barr, Ronald D; Bleyer, W Archie

    2017-11-23

    Adolescents and young adults (AYAs - ages 15 to 39) constitute approximately 40% of the world's population and contribute an estimated one million new cases of cancer annually, the great majority in low- and middle-income countries (LMICs). In high-income countries (HICs) cancer is the commonest cause of disease-related death in AYAs, though overall 5-year survival rates now exceed 80%. A very different circumstance likely holds in LMICs, but accurate assessments are not readily available.Breast cancer accounts for 40% of tumours in female AYAs and this age group includes the peak incidence of Hodgkin lymphoma. The late Professor Gianni Bonadonna contributed importantly to improved survival in patients with these two diseases. Accordingly, he would be justifiably proud of the advances in AYA oncology that are being made in Italy, especially the impact of his colleagues at the Istituto Nazionale dei Tumori (INT). The initiatives of the Associazione Italiana Ematologia Pediatrica and the Società Italiana Adolescenti con Malattie Onco-ematologiche are particularly noteworthy, with the accomplishment of productive collaboration between paediatric and adult cancer care providers serving as a model for other countries to emulate.Exporting these advances can be successful through the vehicle of "twinning": establishing sustainable cooperation between institutions in HICs and partners in LMICs. Colleagues in Monza and at INT have been leaders in such programmes for decades. Cancer in AYAs remains a global challenge to which Gianni Bonadonna surely would have risen with enthusiasm and leadership while securing measurable achievements.

  12. Advance Care Planning Discussions with Adolescent and Young Adult Cancer Patients Admitted to a Community Palliative Care Service: A Retrospective Case-Note Audit.

    Science.gov (United States)

    Fletcher, Sophie; Hughes, Rachel; Pickstock, Sarah; Auret, Kirsten

    2018-02-01

    Adolescents and young adults (AYA) with cancer are a cohort requiring specialized healthcare models to address unique cognitive and physical challenges. Advance care planning (ACP) discussions likely warrant age-appropriate adaptation, yet, there is little Australian research data available to inform best practice for this group. The goal of this work is to inform future models of ACP discussions for AYA. Retrospective medical record audit of AYA patients and an adult comparison group, diagnosed with a malignancy and referred to a community hospice service, in Western Australia, in the period between January 1, 2012 and December 1, 2015. Information was collected regarding end-of-life care discussions, documentation of agreed plan of care, and care received. Twenty-seven AYA and 37 adult medical records were reviewed. Eighteen (66.7%) AYA patients died at home, compared with 19 (51.4%) adults (p = 0.028). Desire to pursue all available oncological therapies, including clinical trials, was documented for 14 (51.9%) AYA patients compared with 9 (24.3%) of the adult group (p = 0.02). Eleven AYA patients (40.7%) received chemotherapy during the last month of life compared with two (5.4%) adults (p = 0.001). The results indicate that end-of-life care preferences for this unique cohort may differ from those of the adult population and need to be captured and understood. An ACP document incorporating a discussion regarding goals of care, preferred location of care, preference for place of death, and consent to future intervention, including cardiopulmonary resuscitation and prompts for review, could assist in pursuing this objective.

  13. Psychological morbidities in adolescent and young adult blood cancer patients during curative-intent therapy and early survivorship.

    Science.gov (United States)

    Muffly, Lori S; Hlubocky, Fay J; Khan, Niloufer; Wroblewski, Kristen; Breitenbach, Katherine; Gomez, Joseline; McNeer, Jennifer L; Stock, Wendy; Daugherty, Christopher K

    2016-03-15

    Adolescents and young adults (AYAs) with cancer face unique psychosocial challenges. This pilot study was aimed at describing the prevalence of psychological morbidities among AYAs with hematologic malignancies during curative-intent therapy and early survivorship and at examining provider perceptions of psychological morbidities in their AYA patients. Patients aged 15 to 39 years with acute leukemia, non-Hodgkin lymphoma, or Hodgkin lymphoma who were undergoing curative-intent therapy (on-treatment group) or were in remission within 2 years of therapy completion (early survivors) underwent a semistructured interview that incorporated measures of anxiety, depression, and posttraumatic stress (PTS). A subset of providers (n = 15) concomitantly completed a survey for each of the first 30 patients enrolled that evaluated their perception of each subject's anxiety, depression, and PTS. Sixty-one of 77 eligible AYAs participated. The median age at diagnosis was 26 years (range, 15-39 years), 64% were male, and 59% were non-Hispanic white. On-treatment demographics differed significantly from early-survivor demographics only in the median time from diagnosis to interview. Among the 61 evaluable AYAs, 23% met the criteria for anxiety, 28% met the criteria for depression, and 13% met the criteria for PTS; 46% demonstrated PTS symptomatology. Thirty-nine percent were impaired in 1 or more psychological domains. Psychological impairments were as frequent among early survivors as AYAs on treatment. Provider perceptions did not significantly correlate with patient survey results. AYAs with hematologic malignancies experience substantial psychological morbidities while they are undergoing therapy and during early survivorship, with more than one-third of the patients included in this study meeting the criteria for anxiety, depression, or traumatic stress. This psychological burden may not be accurately identified by their oncology providers. © 2016 American Cancer Society.

  14. Kids, Adolescents, and Young Adults Cancer Study-A Methodological Approach in Cancer Epidemiology Research

    International Nuclear Information System (INIS)

    Link, N. L.; Maurer, E.; Largent, J.; Kent, E.; Sender, E.; Culver, H. A.; Morris, R. A.; Sender, E.

    2009-01-01

    Advances have been made in treatment and outcomes for pediatric cancer. However adolescents and young adults (AYAs) with cancer have not experienced similar relative improvements. We undertook a study to develop the methodology necessary for epidemiologic cancer research in these age groups. Our goal was to create the Kids, Adolescents, and Young Adults Cancer (KAYAC) project to create a resource to address research questions relevant to this population. We used a combination of clinic and population-based ascertainment to enroll 111 cases aged 0-39 for this methodology development study. The largest groups of cancer types enrolled include: breast cancer, leukemia, lymphoma, and melanoma. The overall participation rate is 69.8% and varies by age and tumor type. The study included patients, mothers, and fathers. The methods used to establish this resource are described, and the values of the resource in studies of childhood and young adult cancer are outlined.

  15. Trends in Cancer Mortality Among Adolescents and Young Adults in Brazil.

    Science.gov (United States)

    Balmant, Nathalie Vieira; de Souza Reis, Rejane; de Oliveira Santos, Marceli; Pinto Oliveira, Julio; de Camargo, Beatriz

    2017-06-01

    Adolescents and young adults (AYA) with cancer comprise an intermediate age group between pediatric and adult oncology, and have a spectrum of different types of cancers. Survival among this group has not improved as much as in younger children with cancer. The aim of this study was evaluate the trends in cancer mortality of AYA aged 15-29 years in Brazil. Data were extracted from the Atlas of Cancer Mortality databases from 1979 to 2013. Age-specific mortality rates were calculated based on the deaths from each type of cancer and the period via a direct method using the proposed world population age groups. To identify significant changes in the trends, we performed joinpoint regression analysis. The mortality rates per million were 54 deaths in those aged 15-19 years, 61 deaths in those aged 20-24 years, and 88 deaths in those aged 25-29 years. Leukemias, lymphomas, and central nervous system (CNS) tumors occurred at high rates in all age groups. Rates of cervical cancer were highest in those aged 25-29 years. There were significant increases in mortality trends in the North and Northeast regions for all tumor groups, especially CNS tumors. A small decrease in the mortality rate from lymphomas was observed in the South and Southeast regions. Mortality in Brazilian AYA was slightly higher than in other studies conducted throughout the world. When separated by tumor type, Brazil presents a specific pattern, with high mortality from cervical cancer.

  16. Spending on Hospital Care and Pediatric Psychology Service Use Among Adolescents and Young Adults With Cancer.

    Science.gov (United States)

    McGrady, Meghan E; Peugh, James L; Brown, Gabriella A; Pai, Ahna L H

    2017-10-01

    To examine the relationship between need-based pediatric psychology service use and spending on hospital care among adolescents and young adults (AYAs) with cancer. Billing data were obtained from 48 AYAs with cancer receiving need-based pediatric psychology services and a comparison cohort of 48 AYAs with cancer not receiving services. A factorial analysis of covariance examined group differences in spending for hospital care. Pending significant findings, a multivariate analysis of covariance was planned to examine the relationship between need-based pediatric psychology service use and spending for inpatient admissions, emergency department (ED) visits, and outpatient visits. Spending for hospital care was higher among AYAs receiving need-based pediatric psychology services than in the comparison cohort (p psychology services. The behavioral and psychosocial difficulties warranting need-based pediatric psychology services may predict higher health care spending. © The Author 2017. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  17. A Diversified Recruitment Approach Incorporating Social Media Leads to Research Participation Among Young Adult-Aged Female Cancer Survivors.

    Science.gov (United States)

    Gorman, Jessica R; Roberts, Samantha C; Dominick, Sally A; Malcarne, Vanessa L; Dietz, Andrew C; Su, H Irene

    2014-06-01

    Purpose: Cancer survivors in their adolescent and young adult (AYA) years are an understudied population, possibly in part because of the high effort required to recruit them into research studies. The aim of this paper is to describe the specific recruitment strategies used in four studies recruiting AYA-aged female cancer survivors and to identify the highest yielding approaches. We also discuss challenges and recommendations. Methods: We recruited AYA-aged female cancer survivors for two studies conducted locally and two conducted nationally. Recruitment strategies included outreach and referral via: healthcare providers and clinics; social media and the internet; community and word of mouth; and a national fertility information hotline. We calculated the yield of each recruitment approach for the local and national studies by comparing the number that participated to the number of potential participants. Results: We recruited a total of 534 participants into four research studies. Seventy-one percent were diagnosed as young adults and 61% were within 3 years of their cancer diagnosis. The highest-yielding local recruitment strategy was healthcare provider and clinic referral. Nationally, social media and internet outreach yielded the highest rate of participation. Overall, internet-based recruitment resulted in the highest number and yield of participants. Conclusion: Our results suggest that outreach through social media and the internet are effective approaches to recruiting AYA-aged female cancer survivors. Forging collaborative relationships with survivor advocacy groups' members and healthcare providers also proved beneficial.

  18. The Benefits and Burdens of Cancer: A Prospective Longitudinal Cohort Study of Adolescents and Young Adults.

    Science.gov (United States)

    Straehla, Joelle P; Barton, Krysta S; Yi-Frazier, Joyce P; Wharton, Claire; Baker, Kevin Scott; Bona, Kira; Wolfe, Joanne; Rosenberg, Abby R

    2017-05-01

    Adolescents and early young adults (AYAs) with cancer are at high risk for poor outcomes. Positive psychological responses such as benefit-finding may buffer the negative impacts of cancer but are poorly understood in this population. We aimed to prospectively describe the content and trajectory of benefit- and burden-finding among AYAs to develop potential targets for future intervention. One-on-one semistructured interviews were conducted with English-speaking AYA patients (aged 14-25 years) within 60 days of diagnosis of a noncentral nervous system malignancy requiring chemotherapy, 6-12 and 12-18 months later. Interviews were coded using directed content analyses with a priori schema defined by existing theoretical frameworks, including changed sense of self, relationships, philosophy of life, and physical well-being. We compared the content, raw counts, and ratios of benefit-to-burden by patient and by time point. Seventeen participants at one tertiary academic medical center (mean age 17.1 years, SD = 2.7) with sarcoma (n = 8), acute leukemia (n = 6), and lymphoma (n = 3) completed 44 interviews with >100 hours of transcript-data. Average benefit counts were higher than average burden counts at each time point; 68% of interviews had a benefit-to-burden ratio >1. Positive changed sense-of-self was the most common benefit across all time points (44% of all reported benefits); reports of physical distress were the most common burden (32%). Longitudinal analyses suggested perceptions evolved; participants tended to focus less on physical manifestations and more on personal strengths and life purpose. AYAs with cancer identify more benefits than burdens throughout cancer treatment and demonstrate rapid maturation of perspectives. These findings not only inform communication practices with AYAs but also suggest opportunities for interventions to potentially improve outcomes.

  19. Adolescents and young adults with cancer: aspects of adherence – a questionnaire study

    Directory of Open Access Journals (Sweden)

    Kleinke AM

    2018-05-01

    Full Text Available Anne Marie Kleinke, Carl Friedrich Classen Oncology and Hematology Unit, Children’s Hospital, University Medicine Rostock, Rostock, Germany Purpose: For adolescents and young adults (AYAs, a cancer diagnosis represents an extraordinary strike in a vulnerable phase of life. They have special needs that the medical system has to take into consideration, and they exhibit a lower degree of therapy adherence than both older and younger patients. The purpose of this study was first to analyze the adherence of AYAs with cancer compared to a group of older patients and, second, to determine correlated parameters, with focus on the psychosocial interaction between physicians and patients. Patients and methods: In 2012, a complete 1 year cohort of patients reported, by use of a questionnaire, to the Rostock clinical cancer registry, and a group of older patients were invited to answer a multi-item set of questionnaires on a volunteer basis, leading to a population-based cross-sectional analysis. This included a bias due to non-answering which is unavoidable in such a setting. The questionnaire consisted of well-established standard questionnaires, a questionnaire on adherence that has just recently been published, and a self-written questionnaire focusing on patient–physician relationship. The responses were analyzed for our current study. Results: Gender, religion, education, age, anxiety, family atmosphere, or physician–patient relationship were not significantly correlated to adherence in AYAs. However, markedly more AYAs, as compared to the older patients group, considered breaking off therapy and reported suboptimal communication with the physicians. Only the perceived physical illness could be identified as a factor related to adherence among the AYA group.Conclusion: Our findings confirm the need for more focused approaches to serve the special needs of AYAs, with particular attention on specific items that showed up discriminating AYAs from

  20. Psychological outcomes and health beliefs in adolescent and young adult survivors of childhood cancer and controls.

    Science.gov (United States)

    Kazak, Anne E; Derosa, Branlyn Werba; Schwartz, Lisa A; Hobbie, Wendy; Carlson, Claire; Ittenbach, Richard F; Mao, Jun J; Ginsberg, Jill P

    2010-04-20

    PURPOSE The purpose of this study was to compare adolescent and young adult (AYA) pediatric cancer survivors and peers without a history of serious illness on psychological distress, health-related quality of life (HRQOL), health beliefs; examine age at diagnosis and cancer treatment intensity on these outcomes; and examine relationships between number of health problems and the outcomes. PATIENTS AND METHODS AYA cancer survivors (n = 167) and controls (n = 170), recruited during visits to a cancer survivorship clinic and primary care, completed self-report questionnaires of distress, health problems, and health beliefs. For survivors, providers rated treatment intensity and health problems. Results There were no statistically significant differences between survivors and controls in psychological distress or HRQOL. Cancer survivors had less positive health beliefs. Survivors diagnosed as adolescents had significantly greater psychological distress and fewer positive health beliefs than those diagnosed earlier. Survivors with the highest level of treatment intensity had greater anxiety and fewer positive health beliefs than those with less intense treatments. Provider report of current health problems related to survivors' beliefs and mental HRQOL only, whereas patient report of health problems correlated significantly with most psychosocial outcomes and beliefs. CONCLUSION AYA cancer survivors did not differ from peers in psychological adjustment but did endorse less adaptive health beliefs. Survivors diagnosed during adolescence and who had more intensive cancer treatments evidenced poorer psychosocial outcomes. Beliefs about health may be identified and targeted for intervention to improve quality of life, particularly when patient perceptions of current health problems are considered.

  1. Assessment of psychosocial outcomes in adolescents and young adults with cancer: a systematic review of available instruments

    Directory of Open Access Journals (Sweden)

    Wakefield CE

    2013-02-01

    Full Text Available Claire E Wakefield,1,2 Pandora Patterson,3 Fiona E J McDonald,3 Helen L Wilson,1,2 Esther Davis,3 Ursula M Sansom-Daly2,41School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, NSW, Australia; 2Centre for Children's Cancer and Blood Disorders, Sydney Children's Hospital, Sydney, NSW, Australia; 3CanTeen, Sydney, NSW, Australia; 4School of Psychology, University of New South Wales, Sydney, NSW, AustraliaPurpose: Given the burgeoning body of research relating to the psychosocial needs of adolescents and young adults (AYAs with cancer, this review aimed to evaluate the psychometric properties and appropriateness of the instruments available for use in this unique population. Specifically, we reviewed published instruments developed to assess psychological distress (depression, anxiety, stress, and fear of recurrence, psychological growth (resilience, posttraumatic growth, and benefit finding, unmet needs, coping, quality of life, identity, and mindfulness-based practices and skills in AYAs with cancer. Given the dearth of validated instruments targeting AYAs with cancer, this review also provides a summary of promising measures yet to be formally validated in this population.Methods: Five electronic databases were searched by a team of six researchers, and studies involving AYAs (who have or have had cancer aged 15–30 years, and published between 1982 and 2012 were reviewed. Of 410 abstracts, 7 instruments were identified as validated in this population, with a further 19 identified as promising.Results: While there are numerous scales to assess psychosocial outcomes in cancer, few have been specifically validated for AYAs affected by cancer, particularly in the domains of psychological distress, psychological growth, coping, unmet needs, and identity. There are relatively more instruments validated, or promising, for assessment of quality of life than scales for other domains.Conclusion: In the AYA context

  2. Preliminary development and psychometric evaluation of an unmet needs measure for adolescents and young adults with cancer: the Cancer Needs Questionnaire - Young People (CNQ-YP).

    Science.gov (United States)

    Clinton-McHarg, Tara; Carey, Mariko; Sanson-Fisher, Rob; D'Este, Catherine; Shakeshaft, Anthony

    2012-01-30

    Adolescents and young adult (AYA) cancer survivors may have unique physical, psychological and social needs due to their cancer occurring at a critical phase of development. The aim of this study was to develop a psychometrically rigorous measure of unmet need to capture the specific needs of this group. Items were developed following a comprehensive literature review, focus groups with AYAs, and feedback from health care providers, researchers and other professionals. The measure was pilot tested with 32 AYA cancer survivors recruited through a state-based cancer registry to establish face and content validity. A main sample of 139 AYA cancer patients and survivors were recruited through seven treatment centres and invited to complete the questionnaire. To establish test-retest reliability, a sub-sample of 34 participants completed the measure a second time. Exploratory factor analysis was performed and the measure was assessed for internal consistency, discriminative validity, potential responsiveness and acceptability. The Cancer Needs Questionnaire - Young People (CNQ-YP) has established face and content validity, and acceptability. The final measure has 70 items and six factors: Treatment Environment and Care (33 items); Feelings and Relationships (14 items); Daily Life (12 items); Information and Activities (5 items); Education (3 items); and Work (3 items). All domains achieved Cronbach's alpha values greater than 0.80. Item-to-item test-retest reliability was also high, with all but four items reaching weighted kappa values above 0.60. The CNQ-YP is the first multi-dimensional measure of unmet need which has been developed specifically for AYA cancer patients and survivors. The measure displays a strong factor structure, and excellent internal consistency and test-retest reliability. However, the small sample size has implications for the reliability of the statistical analyses undertaken, particularly the exploratory factor analysis. Future studies with a

  3. Patterns of care and outcomes in adolescent and young adult acute lymphoblastic leukemia: a population-based study.

    Science.gov (United States)

    Muffly, Lori; Alvarez, Elysia; Lichtensztajn, Daphne; Abrahão, Renata; Gomez, Scarlett Lin; Keegan, Theresa

    2018-04-24

    Adolescents and young adults (AYAs, 15-39 years) with acute lymphoblastic leukemia (ALL) represent a heterogeneous population who receive care in pediatric or adult cancer settings. Using the California Cancer Registry, we describe AYA ALL patterns of care and outcomes over the past decade. Sociodemographics, treatment location, and front-line therapies administered to AYAs diagnosed with ALL between 2004 and 2014 were obtained. Cox regression models evaluated associations between ALL setting and regimen and overall survival (OS) and leukemia-specific survival (LSS) for the entire cohort, younger AYA (<25 years), and AYAs treated in the adult cancer setting only. Of 1473 cases, 67.7% were treated in an adult setting; of these, 24.8% received a pediatric ALL regimen and 40.7% were treated at a National Cancer Institute (NCI)-designated center. In multivariable analyses, front-line treatment in a pediatric (vs adult) setting (OS HR = 0.53, 95% confidence interval [CI], 0.37-0.76; LSS HR = 0.51, 95% CI, 0.35-0.74) and at an NCI/Children's Oncology Group (COG) center (OS HR = 0.80, 95% CI, 0.66-0.96; LSS HR = 0.80, 95% CI, 0.65-0.97) were associated with significantly superior survival. Results were similar when analyses were limited to younger AYAs. Outcomes for AYAs treated in an adult setting did not differ following front-line pediatric or adult ALL regimens. Our population-level findings demonstrate that two-thirds of AYAs with newly diagnosed ALL are treated in an adult cancer setting, with the majority receiving care in community settings. Given the potential survival benefits, front-line treatment of AYA ALL at pediatric and/or NCI/COG-designated cancer centers should be considered. © 2018 by The American Society of Hematology.

  4. Cancer in adolescents and young adults in north Netherlands (1989-2003) : increased incidence, stable survival and high incidence of second primary tumours

    NARCIS (Netherlands)

    van Gaal, J. C.; Bastiaannet, E.; Schaapveld, M.; Otter, R.; Kluin-Nelemans, J. C.; de Bont, E. S. J. M.; van der Graaf, W. T. A.

    Background: Lack of survival improvement in adolescents and young adults (AYA) with cancer has led to increased awareness of this young population. Design: We carried out a population-based study of incidence and survival of primary tumours and second primary tumours in patients aged 12-24 in north

  5. Cancer in adolescents and young adults: Who remains at risk of poor social functioning over time?

    Science.gov (United States)

    Husson, Olga; Zebrack, Bradley J; Aguilar, Christine; Hayes-Lattin, Brandon; Cole, Steve

    2017-07-15

    The objective of the current study was to examine social functioning among adolescents and young adults (AYAs) within the first 2 years after a cancer diagnosis and compare their scores with population norms and identify trajectories of social functioning over time and its correlates. A multicenter, longitudinal study was conducted among 215 AYA patients with cancer aged 14 to 39 years. A total of 141 patients completed a self-report measure of social functioning within the first 4 months of diagnosis and again at 12 months and 24 months later. AYA patients with cancer were found to have significantly worse social functioning scores around the time of diagnosis (52.0 vs 85.1; Pcancer who had consistently low social functioning were more often off treatment at the time of follow-up, reported more physical symptoms and higher levels of distress at baseline and follow-up, and perceived less social support at baseline compared with the other 3 groups. Although improved over time, social functioning still was found to be compromised 24 months after the primary diagnosis. Nearly one-third of these patients remain at risk of poor social functioning. Reducing physical symptoms and psychological distress and enhancing social support by interventions during the period after treatment may potentially help these young survivors to better reintegrate into society. Cancer 2017;123:2743-51. © 2017 American Cancer Society. © 2017 American Cancer Society.

  6. Body Image Discomfort of Adolescent and Young Adult Hematologic Cancer Survivors.

    Science.gov (United States)

    Zucchetti, Giulia; Bellini, Simona; Bertolotti, Marina; Bona, Francesca; Biasin, Eleonora; Bertorello, Nicoletta; Tirtei, Elisa; Fagioli, Franca

    2017-06-01

    This study focuses on body image discomfort (BID) of 50 adolescent and young adult (AYA) hematologic cancer survivors (age range 15-23; 52% males). The study results were obtained through data from a self-report questionnaire: the Body Uneasiness Test. Findings differed according to gender: a greater proportion of females were in the Risk category of impaired body image than males (χ 2  = 5.258, p < 0.05). No significant body image differences were found according to the type of diagnosis or to the length of survival. To manage survivors' BIDs and to improve their quality of life, assessing BID in AYA cancer survivors is important for identifying those who might be in need of additional supportive care or a program.

  7. A retrospective study of treatment and prophylaxis of ifosfamide-induced hemorrhagic cystitis in pediatric and adolescent and young adult (AYA) patients with solid tumors.

    Science.gov (United States)

    Saito, Yoshimasa; Kumamoto, Tadashi; Makino, Yoshinori; Tamai, Ikumi; Ogawa, Chitose; Terakado, Hiroyuki

    2016-09-01

    Ifosfamide (IFO) is considered an essential drug for the treatment of pediatric, adolescent and young adult patients with solid tumors. Hemorrhagic cystitis (HC) is one of the dose-limiting toxicity of IFO. However, there are insufficient evidence for risk factor and supportive care of IFO-induced HC. In this retrospective study, patients (daily IFO dosage was 1.2-3.0 g/m(2). HC occurred in 14/425 IFO-based chemotherapy cycles (3.3%). The daily IFO dosages (mean ± SD) in patients with or without HC were 2.23 ± 0.58 g/m(2) and 1.85 ± 0.50 g/m(2), respectively (P = 0.006). Only one of the nine patients who developed IFO-induced HC had experienced this complication in a subsequent cycle of treatment. The incidence of IFO-induced HC may be associated with the dosage of IFO. When administering IFO higher than 2.0 g/m(2)/day, the volume of hydration, dosage of mesna and duration of mesna infusion should be increased to prevent HC. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  8. A review of mobile applications to help adolescent and young adult cancer patients

    Directory of Open Access Journals (Sweden)

    Wesley KM

    2015-08-01

    Full Text Available Kimberly M Wesley,1 Philip J Fizur2 1Department of Psychology, St Jude Children's Research Hospital, Memphis, TN, 2Department of Psychology, La Salle University, Philadelphia, PA, USA Objective: To review research articles utilizing mobile applications with adolescent and young adult (AYA cancer patients. Materials and methods: We identified articles via online searches and reference lists (eg, PsycInfo, PubMed. Articles were reviewed by two study team members for target population, stated purpose, technological utilization, sample size, demographic characteristics, and outcome data. Strengths and weaknesses of each study were described. Results: Of 19 identified manuscripts, six met full inclusion criteria for this review (four smartphone applications and two tablet applications. One additional article that included an application not specific to oncology but included AYA patients with cancer within the target sample was also reviewed. Uses of these applications included symptom tracking, pain management, monitoring of eating habits following bone marrow transplant, monitoring of mucositis, and improving medication management. Utility results from pilot studies are presented. Conclusion: Mobile applications are growing in number and increasingly available to AYAs with and without chronic illness. These applications may prove useful in helping to support AYAs throughout their cancer treatment and beyond. However, few applications provide empirical data supporting their utility. Numerous strengths and benefits of these applications include increased accessibility to educational resources and self-management strategies, more frequent physical and emotional symptom tracking, and increased access to peer support. Despite these strengths, numerous limitations are identified, highlighting the need for future research in this area. Keywords: adolescent, young adult, cancer, smartphone, mobile, applications

  9. Symptoms and Symptom Clusters Identified by Adolescents and Young Adults With Cancer Using a Symptom Heuristics App.

    Science.gov (United States)

    Ameringer, Suzanne; Erickson, Jeanne M; Macpherson, Catherine Fiona; Stegenga, Kristin; Linder, Lauri A

    2015-12-01

    Adolescents and young adults (AYAs) with cancer experience multiple distressing symptoms during treatment. Because the typical approach to symptom assessment does not easily reflect the symptom experience of individuals, alternative approaches to enhancing communication between the patient and provider are needed. We developed an iPad-based application that uses a heuristic approach to explore AYAs' cancer symptom experiences. In this mixed-methods descriptive study, 72 AYAs (13-29 years old) with cancer receiving myelosuppressive chemotherapy used the Computerized Symptom Capture Tool (C-SCAT) to create images of the symptoms and symptom clusters they experienced from a list of 30 symptoms. They answered open-ended questions within the C-SCAT about the causes of their symptoms and symptom clusters. The images generated through the C-SCAT and accompanying free-text data were analyzed using descriptive, content, and visual analyses. Most participants (n = 70) reported multiple symptoms (M = 8.14). The most frequently reported symptoms were nausea (65.3%), feeling drowsy (55.6%), lack of appetite (55.6%), and lack of energy (55.6%). Forty-six grouped their symptoms into one or more clusters. The most common symptom cluster was nausea/eating problems/appetite problems. Nausea was most frequently named as the priority symptom in a cluster and as a cause of other symptoms. Although common threads were present in the symptoms experienced by AYAs, the graphic images revealed unique perspectives and a range of complexity of symptom relationships, clusters, and causes. Results highlight the need for a tailored approach to symptom management based on how the AYA with cancer perceives his or her symptom experience. © 2015 Wiley Periodicals, Inc.

  10. Creating a standardized process to offer the standard of care: continuous process improvement methodology is associated with increased rates of sperm cryopreservation among adolescent and young adult males with cancer.

    Science.gov (United States)

    Shnorhavorian, Margarett; Kroon, Leah; Jeffries, Howard; Johnson, Rebecca

    2012-11-01

    There is limited literature on strategies to overcome the barriers to sperm banking among adolescent and young adult (AYA) males with cancer. By standardizing our process for offering sperm banking to AYA males before cancer treatment, we aimed to improve rates of sperm banking at our institution. Continuous process improvement is a technique that has recently been applied to improve health care delivery. We used continuous process improvement methodologies to create a standard process for fertility preservation for AYA males with cancer at our institution. We compared rates of sperm banking before and after standardization. In the 12-month period after implementation of a standardized process, 90% of patients were offered sperm banking. We demonstrated an 8-fold increase in the proportion of AYA males' sperm banking, and a 5-fold increase in the rate of sperm banking at our institution. Implementation of a standardized process for sperm banking for AYA males with cancer was associated with increased rates of sperm banking at our institution. This study supports the role of standardized health care in decreasing barriers to sperm banking.

  11. Clinical Trial Participation and Time to Treatment Among Adolescents and Young Adults With Cancer: Does Age at Diagnosis or Insurance Make a Difference?

    Science.gov (United States)

    Parsons, Helen M.; Harlan, Linda C.; Seibel, Nita L.; Stevens, Jennifer L.; Keegan, Theresa H.M.

    2011-01-01

    Purpose Because adolescent and young adult (AYA) patients with cancer have experienced variable improvement in survival over the past two decades, enhancing the quality and timeliness of cancer care in this population has emerged as a priority area. To identify current trends in AYA care, we examined patterns of clinical trial participation, time to treatment, and provider characteristics in a population-based sample of AYA patients with cancer. Methods Using the National Cancer Institute Patterns of Care Study, we used multivariate logistic regression to evaluate demographic and provider characteristics associated with clinical trial enrollment and time to treatment among 1,358 AYA patients with cancer (age 15 to 39 years) identified through the Surveillance, Epidemiology, and End Results Program. Results In our study, 14% of patients age 15 to 39 years had enrolled onto a clinical trial; participation varied by type of cancer, with the highest participation in those diagnosed with acute lymphoblastic leukemia (37%) and sarcoma (32%). Multivariate analyses demonstrated that uninsured, older patients and those treated by nonpediatric oncologists were less likely to enroll onto clinical trials. Median time from pathologic confirmation to first treatment was 3 days, but this varied by race/ethnicity and cancer site. In multivariate analyses, advanced cancer stage and outpatient treatment alone were associated with longer time from pathologic confirmation to treatment. Conclusion Our study identified factors associated with low clinical trial participation in AYA patients with cancer. These findings support the continued need to improve access to clinical trials and innovative treatments for this population, which may ultimately translate into improved survival. PMID:21931022

  12. Post-Traumatic Growth and Resilience in Adolescent and Young Adult Cancer Patients: An Overview.

    Science.gov (United States)

    Greup, Suzanne R; Kaal, Suzanne E J; Jansen, Rosemarie; Manten-Horst, Eveliene; Thong, Melissa S Y; van der Graaf, Winette T A; Prins, Judith B; Husson, Olga

    2018-02-01

    The aim of this study was to provide an overview of the literature on post-traumatic growth (PTG) and resilience among adolescent and young adult (AYA) cancer patients. A literature search in Embase, PsychInfo, PubMed, Web of Science, Cochrane Library, and Cinahl was carried out. Thirteen articles met the pre-defined inclusion criteria. Qualitative interview studies showed that AYA cancer patients report PTG and resilience: PTG is described by AYA cancer patients in terms of benefit finding, including changing view of life and feeling stronger and more confident, whereas resilience is described as a balance of several factors, including stress and coping, goals, optimism, finding meaning, connection, and belonging. Quantitative studies showed that sociodemographic and clinical characteristics were not associated with PTG. Enduring stress was negatively, and social support positively, associated with PTG. Symptom distress and defensive coping were negatively and adaptive cognitive coping was positively associated with resilience. Both PTG and resilience were positively associated with satisfaction with life and health-related quality of life (HRQoL). Resilience was found to be a mediator in the relationship between symptom distress and HRQoL. Two interventions aiming to promote resilience, a stress management and a therapeutic music video-intervention, were not successful in significantly increasing overall resilience. Most AYA cancer patients report at least some PTG or resilience. Correlates of PTG and resilience, including symptom distress, stress, coping, social support, and physical activity, provide further insight to improve the effectiveness of interventions aimed at promoting these positive outcomes and potentially buffer negative outcomes.

  13. Empowerment in adolescents and young adults with cancer: Relationship with health-related quality of life.

    Science.gov (United States)

    Kaal, Suzanne E J; Husson, Olga; van Duivenboden, Saskia; Jansen, Rosemarie; Manten-Horst, Eveliene; Servaes, Petra; Prins, Judith B; van den Berg, Sanne W; van der Graaf, Winette T A

    2017-10-15

    The difficulties adolescents and young adults (AYAs) encounter during a cancer experience may result in a reduction in or absence of empowerment. The aims of the current study were to assess levels of empowerment and associated (demographic, clinical, or psychological) factors and examine the association between empowerment and health-related quality of life (HRQOL) among AYA patients with cancer. Patients aged 18 to 35 years at time of cancer diagnosis and who were seen by 1 of the members of the specialized multidisciplinary AYA team of the Radboud University Medical Center were invited to complete questionnaires regarding empowerment; HRQOL; and sociodemographic, clinical, and psychological characteristics (autonomy, coping, unmet social support needs, and psychological distress). A total of 83 AYA patients completed the questionnaires. The mean age of the participants at the time of diagnosis was 27.5 years. The vast majority had been treated with chemotherapy (86%), had a more advanced stage of disease, and had completed treatment at the time of participation (74%). The mean empowerment level was 154.1 (standard deviation, 17.8) with a range of 114 to 200. Multivariate analysis demonstrated that the autonomy subscales of self-awareness (β = .35), capacity for managing new situations (β = .19), and social support (β = .35) were found to be positively associated with empowerment. Coping difficulties (β = -.19) were found to be negatively associated with empowerment. Empowerment was independently associated with physical (β = .31), psychological (β = .50), social (β = .39), religious (β = .33), and total HRQOL (β = .52; all Pempowerment were associated with low levels of autonomy and social support, female sex, and coping difficulties among AYA patients with cancer. Recognizing these patients as candidates for empowerment interventions ultimately could help to improve HRQOL in late adolescence and young adulthood. Cancer 2017;123:4039-47. © 2017 The

  14. Prevalence and predictors of post-traumatic stress symptoms in adolescent and young adult cancer survivors: a 1-year follow-up study.

    Science.gov (United States)

    Kwak, Minyoung; Zebrack, Brad J; Meeske, Kathleen A; Embry, Leanne; Aguilar, Christine; Block, Rebecca; Hayes-Lattin, Brandon; Li, Yun; Butler, Melissa; Cole, Steven

    2013-08-01

    Post-traumatic stress symptoms (PTSS) have been identified as a meaningful indicator of distress in cancer survivors. Distinct from young adult survivors of childhood cancer, young people diagnosed with cancer as adolescents and young adults (AYAs) face unique psychosocial issues; however, there is little published research of PTSS in the AYA population. This study examines prevalence and predictors of PTSS among AYAs with cancer. As part of a longitudinal study of AYAs with cancer, 151 patients aged 15-39 years completed mailed surveys at 6 and 12 months post-diagnosis. Severity of PTSS was estimated at 6 and 12 months post-diagnosis. Multiple regression analyses were conducted to investigate the predictive effects of socio-demographic and clinical characteristics on changes in PTSS over time. At 6 and 12 months, respectively, 39% and 44% of participants reported moderate to severe levels of PTSS; 29% had PTSS levels suggestive of post-traumatic stress disorder. No significant differences in severity of PTSS between 6 and 12 months were observed. Regression analyses suggested that a greater number of side effects were associated with higher levels of PTSS at 6 months. Currently receiving treatment, having surgical treatment, diagnosis of a cancer type with a 90-100% survival rate, remaining unemployed/not in school, and greater PTSS at 6 months were associated with higher levels of PTSS at 12 months. Post-traumatic stress symptoms were observed as early as 6 months following diagnosis and remained stable at 12-month follow-up. The development of early interventions for reducing distress among AYA patients in treatment is recommended. Copyright © 2012 John Wiley & Sons, Ltd.

  15. Empowerment in adolescents and young adults with cancer: Relationship with health‐related quality of life

    Science.gov (United States)

    Kaal, Suzanne E.J.; Husson, Olga; van Duivenboden, Saskia; Jansen, Rosemarie; Manten‐Horst, Eveliene; Servaes, Petra; Prins, Judith B.; van den Berg, Sanne W.

    2017-01-01

    BACKGROUND The difficulties adolescents and young adults (AYAs) encounter during a cancer experience may result in a reduction in or absence of empowerment. The aims of the current study were to assess levels of empowerment and associated (demographic, clinical, or psychological) factors and examine the association between empowerment and health‐related quality of life (HRQOL) among AYA patients with cancer. METHODS Patients aged 18 to 35 years at time of cancer diagnosis and who were seen by 1 of the members of the specialized multidisciplinary AYA team of the Radboud University Medical Center were invited to complete questionnaires regarding empowerment; HRQOL; and sociodemographic, clinical, and psychological characteristics (autonomy, coping, unmet social support needs, and psychological distress). RESULTS A total of 83 AYA patients completed the questionnaires. The mean age of the participants at the time of diagnosis was 27.5 years. The vast majority had been treated with chemotherapy (86%), had a more advanced stage of disease, and had completed treatment at the time of participation (74%). The mean empowerment level was 154.1 (standard deviation, 17.8) with a range of 114 to 200. Multivariate analysis demonstrated that the autonomy subscales of self‐awareness (β = .35), capacity for managing new situations (β = .19), and social support (β = .35) were found to be positively associated with empowerment. Coping difficulties (β = ‐.19) were found to be negatively associated with empowerment. Empowerment was independently associated with physical (β = .31), psychological (β = .50), social (β = .39), religious (β = .33), and total HRQOL (β = .52; all Pempowerment were associated with low levels of autonomy and social support, female sex, and coping difficulties among AYA patients with cancer. Recognizing these patients as candidates for empowerment interventions ultimately could help to improve HRQOL in late adolescence and young adulthood. Cancer

  16. Cancer in adolescents and young adults in countries with limited resources.

    Science.gov (United States)

    Magrath, Ian; Epelman, Sidnei

    2013-08-01

    Cancer in adolescents and young adults (AYA) represents a higher fraction of all cancer in countries that are still undergoing a demographic transition. Such countries tend to have much younger populations, and therefore unless they have a particularly low incidence of cancer in this age group, will have a higher burden of cancer (absolute number of cases with cancer) in AYA. Cancers in AYA are comprised of the tail end of the incidence curve of cancers that have their peak incidence, or occur almost exclusively in childhood, the beginning of the incidence curve of cancers that primarily affect the elderly, and a third set of cancers that have their peak incidence (or are at least common) in the AYA age group (e.g., testicular cancer, sarcomas, melanoma, thyroid cancer). Many, but not all, of these cancers require radiation or cancer surgery, but the poorest countries do not have a sufficient number of radiation therapy units and surgical oncologists, or indeed medical and pediatric oncologists, to deal with the burden of cancer they face. The AYA age group is particularly important, both with regard to their contribution to the economy now and in the future (the majority are in the "working" age-group defined as 15-64 years), as well as their important role in caring for their families. Moreover, some of these cancers are eminently curable with chemotherapy alone, and more could be cured by simply improving the efficiency of existing health services and providing education and training to both the public as well as oncologists and other specialists required for the care of AYA (although such individuals will not necessarily be exclusively concerned with this age group). Of particular importance is the detection and diagnosis of cancer patients at the earliest possible time in the course of their disease. Avoiding delays in initiating therapy, which are partly due to the poverty and lack of education of the public as well as to a failure on the part of primary

  17. Perceived impact of cancer among adolescents and young adults: Relationship with health-related quality of life and distress

    NARCIS (Netherlands)

    Husson, O.; Zebrack, B.J.

    2017-01-01

    OBJECTIVE: To examine whether perceptions of the impact of cancer are related to health-related quality of life (HRQoL) and psychological distress among survivors of cancer in adolescence and young adulthood (AYA). METHODS: One hundred seventy-three AYA cancer survivors (aged 18-35 and 15-29 years

  18. Initial Evaluation of an Electronic Symptom Diary for Adolescents with Cancer

    OpenAIRE

    Baggott, C; Gibson, F; Coll, B; Kletter, R; Zeltzer, P; Miaskowski, C

    2012-01-01

    Background: The delivery of optimal care depends on accurate communication between patients and clinicians regarding untoward symptoms. Documentation of patients’ symptoms necessitates reliance on memory, which is often imprecise. We developed an electronic diary (eDiary) for adolescents and young adults (AYAs) with cancer to record symptoms. Objective: The purpose of this paper is to describe the utility of an eDiary designed for AYAs with cancer, including dependability of the mobile applic...

  19. Health-related quality of life of adolescent and young adult patients with cancer in the United States: the Adolescent and Young Adult Health Outcomes and Patient Experience study.

    Science.gov (United States)

    Smith, Ashley Wilder; Bellizzi, Keith M; Keegan, Theresa H M; Zebrack, Brad; Chen, Vivien W; Neale, Anne Victoria; Hamilton, Ann S; Shnorhavorian, Margarett; Lynch, Charles F

    2013-06-10

    Adolescents and young adults (AYAs) diagnosed with cancer face numerous physical, psychosocial, and practical challenges. This article describes the health-related quality of life (HRQOL) and associated demographic and health-related characteristics of this developmentally diverse population. Data are from the Adolescent and Young Adult Health Outcomes and Patient Experience (AYA HOPE) study, a population-based cohort of 523 AYA patients with cancer, ages 15 to 39 years at diagnosis from 2007 to 2009. Comparisons are made by age group and with general and healthy populations. Multiple linear regression models evaluated effects of demographic, disease, health care, and symptom variables on multiple domains of HRQOL using the Pediatric Quality of Life Inventory (PedsQL) and the Short-Form Health Survey 12 (SF-12). Overall, respondents reported significantly worse HRQOL across both physical and mental health scales than did general and healthy populations. The greatest deficits were in limitations to physical and emotional roles, physical and social functioning, and fatigue. Teenaged patients (ages 15 to 17 years) reported worse physical and work/school functioning than patients 18 to 25 years old. Regression models showed that HRQOL was worse for those in treatment, with current/recent symptoms, or lacking health insurance at any time since diagnosis. In addition, sarcoma patients, Hispanic patients, and those with high school or lower education reported worse physical health. Unmarried patients reported worse mental health. Results suggest that AYAs with cancer have major decrements in several physical and mental HRQOL domains. Vulnerable subgroups included Hispanic patients, those with less education, and those without health insurance. AYAs also experienced higher levels of fatigue that were influenced by current symptoms and treatment. Future research should explore ways to address poor functioning in this understudied group.

  20. Recruitment of representative samples for low incidence cancer populations: Do registries deliver?

    Directory of Open Access Journals (Sweden)

    Sanson-Fisher Rob

    2011-01-01

    Full Text Available Abstract Background Recruiting large and representative samples of adolescent and young adult (AYA cancer survivors is important for gaining accurate data regarding the prevalence of unmet needs in this population. This study aimed to describe recruitment rates for AYAs recruited through a cancer registry with particular focus on: active clinician consent protocols, reasons for clinicians not providing consent and the representativeness of the final sample. Methods Adolescents and young adults aged 14 to19 years inclusive and listed on the cancer registry from January 1 2002 to December 31 2007 were identified. An active clinician consent protocol was used whereby the registry sent a letter to AYAs primary treating clinicians requesting permission to contact the survivors. The registry then sent survivors who received their clinician's consent a letter seeking permission to forward their contact details to the research team. Consenting AYAs were sent a questionnaire which assessed their unmet needs. Results The overall consent rate for AYAs identified as eligible by the registry was 7.8%. Of the 411 potentially eligible survivors identified, just over half (n = 232, 56% received their clinician's consent to be contacted. Of those 232 AYAs, 65% were unable to be contacted. Only 18 AYAs (7.8% refused permission for their contact details to be passed on to the research team. Of the 64 young people who agreed to be contacted, 50% (n = 32 completed the questionnaire. Conclusions Cancer registries which employ active clinician consent protocols may not be appropriate for recruiting large, representative samples of AYAs diagnosed with cancer. Given that AYA cancer survivors are highly mobile, alternative methods such as treatment centre and clinic based recruitment may need to be considered.

  1. Adverse obstetric and perinatal outcomes following treatment of adolescent and young adult cancer: a population-based cohort study.

    Directory of Open Access Journals (Sweden)

    Fatima A Haggar

    Full Text Available To investigate obstetric and perinatal outcomes among female survivors of adolescent and young adult (AYA cancers and their offspring.Using multivariate analysis of statewide linked data, outcomes of all first completed pregnancies (n = 1894 in female survivors of AYA cancer diagnosed in Western Australia during the period 1982-2007 were compared with those among females with no cancer history. Comparison pregnancies were matched by maternal age-group, parity and year of delivery.Compared with the non-cancer group, female survivors of AYA cancer had an increased risk of threatened abortion (adjusted relative risk 2.09, 95% confidence interval 1.51-2.74, gestational diabetes (2.65, 2.08-3.57, pre-eclampsia (1.32, 1.04-1.87, post-partum hemorrhage (2.83, 1.92-4.67, cesarean delivery (2.62, 2.22-3.04, and maternal postpartum hospitalization>5 days (3.01, 1.72-5.58, but no excess risk of threatened preterm delivery, antepartum hemorrhage, premature rupture of membranes, failure of labor to progress or retained placenta. Their offspring had an increased risk of premature birth (<37 weeks: 1.68, 1.21-2.08, low birth weight (<2500 g: 1.51, 1.23-2.12, fetal growth restriction (3.27, 2.45-4.56, and neonatal distress indicated by low Apgar score (<7 at 1 minute (2.83, 2.28-3.56, need for resuscitation (1.66, 1.27-2.19 or special care nursery admission (1.44, 1.13-1.78. Congenital abnormalities and perinatal deaths (intrauterine or ≤7 days of birth were not increased among offspring of survivors.Female survivors of AYA cancer have moderate excess risks of adverse obstetric and perinatal outcomes arising from subsequent pregnancies that may require additional surveillance or intervention.

  2. Adolescent and Young Adult Patient Engagement and Participation in Survey-Based Research: A Report From the "Resilience in Adolescents and Young Adults With Cancer" Study.

    Science.gov (United States)

    Rosenberg, Abby R; Bona, Kira; Wharton, Claire M; Bradford, Miranda; Shaffer, Michele L; Wolfe, Joanne; Baker, Kevin Scott

    2016-04-01

    Conducting patient-reported outcomes research with adolescents and young adults (AYAs) is difficult due to low participation rates and high attrition. Forty-seven AYAs with newly diagnosed cancer at two large hospitals were prospectively surveyed at the time of diagnosis and 3-6 and 12-18 months later. A subset participated in 1:1 semistructured interviews. Attrition prompted early study closure at one site. The majority of patients preferred paper-pencil to online surveys. Interview participants were more likely to complete surveys (e.g., 93% vs. 58% completion of 3-6 month surveys, P = 0.02). Engaging patients through qualitative methodologies and using patient-preferred instruments may optimize future research success. © 2015 Wiley Periodicals, Inc.

  3. Regulatory barriers to clinical trial enrollment of adolescent and young adult oncology patients.

    Science.gov (United States)

    Felgenhauer, Judy; Hooke, Mary C

    2014-06-01

    Adolescent and young adult (AYA) patients with cancer may face unique challenges if they and their families wish to participate in clinical oncology trials. Regulatory guidelines and funding requirements put in place to protect patients may actually raise barriers to enrollment in clinical trials. Hospital age guidelines may need to be readdressed to better suit the needs of AYA patients. Finally, the creation of the National Clinical Trials Network will provide new opportunities for pediatric and medical oncologists to collaborate in the care of AYA patients. Copyright © 2014 by the American Academy of Pediatrics.

  4. Pattern of hematological malignancies in adolescents and young adults in Bangladesh.

    Science.gov (United States)

    Hasan, Md Mahbub; Raheem, Enayetur; Sultana, Tanvira Afroze; Hossain, Mohammad Sorowar

    2017-12-01

    The adolescent and young adult (AYA) age group (15-39 years) bears distinct characteristics in terms of cancer biology, long-term health and treatment-related complications and psychosocial aspects. The overall scenario of cancer including hematological malignancies (HMs) is largely unknown in Bangladesh, where a significant proportion of people (44% of total population) belong to AYA age group. This study aims to describe the patterns of HM among AYA in the context of Bangladesh METHODS: Two previously published datasets (on hematological malignancies and childhood and adolescent cancer) were merged to construct a comprehensive dataset focusing exclusively on HMs in AYA age group. Univariate descriptive statistics were calculated and bivariate association were tested using Pearson's Chi-square test. A total of 2144 diagnosed HM related cases over a period of 2007-2014 were analyzed. Acute myeloid leukemia (AML) was the most frequent HM (35.1%) in AYAs, which was followed by acute lymphoblastic leukemia (ALL) and chronic myeloid leukemia (CML) constituting 22.7% and 20.8%, respectively. Among lymphomas, Non-Hodgkin lymphoma (NHL) constituted 13.9% of all HMs while 4.6% was for Hodgkin's lymphoma (HL). This is the first attempt to provide a glimpse on the pattern and distribution of HMs among AYA in Bangladesh. Future studies are essential to get a better insight on the epidemiology, biology, potential risk factors and treatment outcomes for the AYA age group. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. The History and Accomplishments of the LIVESTRONG Young Adult Alliance.

    Science.gov (United States)

    Mathews-Bradshaw, Beth; Johnson, Rebecca; Kaplan, Stuart; Craddock, Kelli; Hayes-Lattin, Brandon

    2011-03-01

    This article outlines the history, background, and accomplishments of the LIVESTRONG Young Adult Alliance. The LIVESTRONG Young Adult Alliance, a program of the Lance Armstrong Foundation, was developed as a vehicle for a strategic plan designed to implement the Adolescent and Young Adult Oncology Progress Review Group (AYAO PRG) recommendations. The AYAO PRG was co-sponsored by Lance Armstrong Foundation and the National Cancer Institute (NCI); both LIVESTRONG and NCI provide strategic oversight and guidance to the Alliance. Highlights and accomplishments: The Alliance accomplishments include the publication of disease-specific retrospective analyses, funding of an AYA cohort study and biorepository proposal, publication of two position statements on guidelines for care of AYAs with cancer and training for AYA oncology health professionals, promotion of an international charter of rights for AYA cancer patients, creation and distribution of a survey to college health professionals, creation and implementation of a Cancer Centers Working Group and Institutional Review Board Toolkit, and continued growth and collaboration through an annual meeting. The growth and success of the Alliance has coincided with the growth of AYA oncology as a field. The collaborative environment of the Alliance draws together a diverse group of individuals united in the effort to increase survival rates and improve the quality of life for adolescents and young adults diagnosed with cancer.

  6. Cardiovascular disease incidence in adolescent and young adult cancer survivors: a retrospective cohort study.

    Science.gov (United States)

    Keegan, Theresa H M; Kushi, Lawrence H; Li, Qian; Brunson, Ann; Chawla, X; Chew, Helen K; Malogolowkin, Marcio; Wun, Ted

    2018-06-01

    Few population-based studies have focused on cardiovascular disease (CVD) risk in adolescent and young adult (AYA; 15-39 years) cancer survivors and none have considered whether CVD risk differs by sociodemographic factors. Analyses focused on 79,176 AYA patients diagnosed with 14 first primary cancers in 1996-2012 and surviving > 2 years after diagnosis with follow-up through 2014. Data were obtained from the California Cancer Registry and State hospital discharge data. CVD included coronary artery disease, heart failure, and stroke. The cumulative incidence of developing CVD accounted for the competing risk of death. Multivariable Cox proportional hazards regression evaluated factors associated with CVD and the impact of CVD on mortality. Overall, 2249 (2.8%) patients developed CVD. Survivors of central nervous system cancer (7.3%), acute lymphoid leukemia (6.9%), acute myeloid leukemia (6.8%), and non-Hodgkin lymphoma (4.1%) had the highest 10-year CVD incidence. In multivariable models, African-Americans (hazard ratio (HR) = 1.55, 95% confidence interval (CI) = 1.33-1.81; versus non-Hispanic Whites), those with public/no health insurance (HR = 1.78, 95% CI = 1.61-1.96; versus private) and those who resided in lower socioeconomic status neighborhoods had a higher CVD risk. These sociodemographic differences in CVD incidence were apparent across most cancer sites. The risk of death was increased by eightfold or higher among AYAs who developed CVD. While cancer therapies are known to increase the risk of CVD, this study additionally shows that CVD risk varies by sociodemographic factors. The identification and mitigation of CVD risk factors in these subgroups may improve long-term patient outcomes.

  7. Sexuality and romantic relationships in young adult cancer survivors: satisfaction and supportive care needs.

    Science.gov (United States)

    Geue, Kristina; Schmidt, Ricarda; Sender, Annekathrin; Sauter, Siegfried; Friedrich, Michael

    2015-11-01

    In recent years, psycho-oncology has focused more and more on adolescents and young adults with cancer (AYA). Many studies have concentrated on fertility issues in AYAs, but romantic relationships and sexuality have only been researched to a limited extent. This cross-sectional study examined AYAs' quality of relationships and sexuality satisfaction thereby identifying sex differences. Ninety-nine cancer patients (N = 33 males) diagnosed between 15 and 39 years who were in a romantic relationship at the time of the survey completed questionnaires on their relationship (Partnership Questionnaire), sexuality (Life Satisfaction Questionnaire), and sexuality needs (Supportive Care Needs Survey). Test for mean differences and regression analyses to determine associated variables were performed. Seventy-six percent of AYAs (N = 75) rated their relationship quality as high. About 64% of patients reported having less sexual intercourse since diagnosis, more women than men (72% vs. 45%; p = .011). The need for support was strongest for changes in sexual feelings (N = 38; 38.3%). Duration of relationship (β = -0.224), being on sick leave (β = 0.325), and satisfaction with sexuality (β = 0.409) were associated with satisfaction with relationship (R(2)  = 0.256). Satisfaction with sexuality (R(2)  = 0.344) was regressed on physical function (β = 0.419), satisfaction with relationship (β = 0.428), and male gender (β = -0.175). Sexuality need (R(2)  = 0.436) was associated with fatigue (β = 0.232) and satisfaction with sexuality (β = -0.522). Although they reported high satisfaction with their relationships, AYA patients experienced sexual problems and need support with sexual issues. As a substantial proportion of patients felt stressed because of sexual changes, communication and interventions addressing post-cancer sexuality, particularly in women, are indicated. Copyright © 2015 John Wiley & Sons, Ltd.

  8. Health promotion and psychological interventions for adolescent and young adult cancer survivors: A systematic literature review.

    Science.gov (United States)

    Bradford, Natalie Katrina; Chan, Raymond Javan

    2017-04-01

    The effects of cancer and treatment have severe and long lasting negative impacts on quality of life. Adolescents and Young Adults (AYA) have high survival rates but may not reach their full life potential because of these consequences. This review aims to identify, appraise and synthesise the effects of health promotion and psychological interventions for AYA after cancer treatment. The review was undertaken using the preferred reporting items for systematic reviews and meta-analyses guidelines. Included studies were identified though a range of electronic databases through to May 2016. Studies were critically appraised using the Cochrane Risk of Bias tool. Seventeen studies, comprising a total of 2314 participants aged 13-39years were included in this review. Participants in 15 studies were survivors of childhood cancer, with only two studies specifically recruiting survivors of cancer diagnosed during young adulthood. Ten studies were randomised controlled trials (RCTs); the remaining seven were before and after studies. The quality of studies was variable across all appraised domains; risk of bias was evident in regards to recruitment, measures of exposure and outcomes, confounding factors, attrition and lost-to follow-up. Studies evaluated a range of health promotion and psychological interventions to improve health related and process outcomes. Eleven studies reported modest positive outcomes, with psychological and physical activity interventions achieving greater success compared to general health promotion interventions. This review highlights the lack of high-quality studies for optimising the health and well-being of AYA cancer survivors. No conclusive evidence favouring specific interventions were identified, although recommendations for future studies are made. Interventions delivered face-to-face and those that facilitate peer-to-peer support hold promise. Harnessing social media and technology to deliver interventions is likely to increase and these

  9. Preliminary development and psychometric evaluation of an unmet needs measure for adolescents and young adults with cancer: the Cancer Needs Questionnaire - Young People (CNQ-YP

    Directory of Open Access Journals (Sweden)

    Clinton-McHarg Tara

    2012-01-01

    Full Text Available Abstract Background Adolescents and young adult (AYA cancer survivors may have unique physical, psychological and social needs due to their cancer occurring at a critical phase of development. The aim of this study was to develop a psychometrically rigorous measure of unmet need to capture the specific needs of this group. Methods Items were developed following a comprehensive literature review, focus groups with AYAs, and feedback from health care providers, researchers and other professionals. The measure was pilot tested with 32 AYA cancer survivors recruited through a state-based cancer registry to establish face and content validity. A main sample of 139 AYA cancer patients and survivors were recruited through seven treatment centres and invited to complete the questionnaire. To establish test-retest reliability, a sub-sample of 34 participants completed the measure a second time. Exploratory factor analysis was performed and the measure was assessed for internal consistency, discriminative validity, potential responsiveness and acceptability. Results The Cancer Needs Questionnaire - Young People (CNQ-YP has established face and content validity, and acceptability. The final measure has 70 items and six factors: Treatment Environment and Care (33 items; Feelings and Relationships (14 items; Daily Life (12 items; Information and Activities (5 items; Education (3 items; and Work (3 items. All domains achieved Cronbach's alpha values greater than 0.80. Item-to-item test-retest reliability was also high, with all but four items reaching weighted kappa values above 0.60. Conclusions The CNQ-YP is the first multi-dimensional measure of unmet need which has been developed specifically for AYA cancer patients and survivors. The measure displays a strong factor structure, and excellent internal consistency and test-retest reliability. However, the small sample size has implications for the reliability of the statistical analyses undertaken

  10. Hacking the hospital environment: young adults designing youth-friendly hospital rooms together with young people with cancer experiences.

    Science.gov (United States)

    Boisen, Kirsten A; Boisen, Anne; Thomsen, Stine Legarth; Matthiesen, Simon Meggers; Hjerming, Maiken; Hertz, Pernille Grarup

    2015-12-09

    There is a need for youth-friendly hospital environments as the ward environment may affect both patient satisfaction and health outcomes. To involve young people in designing youth-friendly ward environment. We arranged a design competition lasting 42 h (Hackathon). Students in architecture, design, engineering, communication and anthropology participated (27 young adults) - forming eight groups. Adolescents and young adults (AYA) with current or former cancer experience participated as sparring partners. We provided workspace and food during the weekend. The groups presented their products to a jury and relevant stakeholders. The groups created eight unique design concepts. The young designers were extremely flexible listening to ideas and experiences from the young patients, which led to common features including individual and flexible design, privacy in two-bed wardrooms and social contact with other hospitalized AYA. The winning project included an integrated concept for both wardrooms and the AYA day room, including logos and names for the rooms and an 'energy wall' in the day room. A hackathon event was an effective mode of youth participation. The design concepts and ideas were in line with current evidence regarding pleasing hospital environment and youth-friendly inpatient facilities and may be applicable to other young patients.

  11. Adolescents and Young Adults With Cancer: Oncology Nurses Report Attitudes and Barriers to Discussing Fertility Preservation.

    Science.gov (United States)

    Nobel Murray, Alexandra; Chrisler, Joan C; Robbins, Mark L

    2016-08-01

    Fertility issues have been found to be an important topic for adolescents and young adults (AYAs) with cancer. Medical technology has made fertility preservation (FP) increasingly effective for postpubertal patients whose treatment course may inhibit their future ability to achieve biologic parenthood. Oncology providers' recommendations have been shown to vary, potentially affecting patients' decision-making processes regarding FP. This study was designed to assess oncology nurses' recommendations for patients to consider FP options and to explore what patient-related factors may influence discussion of FP with AYAs with cancer. 116 oncology nurses participated in this study and were randomized to read one of four vignettes about a patient whose proposed treatment course could affect his or her fertility. Participants' recommendations to partake in FP were analyzed to test for differences by patient age and gender. Open-ended responses to questions about their experiences as oncology nurses were analyzed descriptively. Nurses strongly recommended that all patients explore FP options before the start of treatment. Oncology nurses endorsed stronger opinions that young adult female patients should be given independent decision-making power to delay treatment for FP, compared to male and female adolescent patients and young adult male patients. Participants mentioned barriers to discussions that included concerns about exacerbating negative emotions and the decision-making capacity of young patients.

  12. Being Young and Getting Cancer

    DEFF Research Database (Denmark)

    Sperling, Cecilie; Petersen, Gitte Stentebjerg; Hølge-Hazelton, Bibi

    2017-01-01

    Purpose: Cancer is the leading cause of nonaccidental deaths among adolescents and young adults (AYAs). In Denmark, there are substantial gaps in knowledge concerning how AYAs with cancer perceive their diagnostic and therapeutic trajectory and report health-related outcomes. The aim of this study......) “Time before treatment,” (2) “Being told about your illness,” (3) “Being a young patient,” (4) “Your treatment,” (5) “Receiving help living with and after Cancer,” and (6) “How are you feeling today?.” One hundred one items were specifically developed for this study, while 50 were standardized validated...... is to describe the development of a questionnaire targeting AYAs with cancer aiming to evaluate treatment and survivorship from the perspective of the patients. Methods: Identification of themes and development of items included in the questionnaire were based on a synthesis of literature and qualitative...

  13. Comparison of survival of adolescents and young adults with hematologic malignancies in Osaka, Japan.

    Science.gov (United States)

    Nakata-Yamada, Kayo; Inoue, Masami; Ioka, Akiko; Ito, Yuri; Tabuchi, Takahiro; Miyashiro, Isao; Masaie, Hiroaki; Ishikawa, Jun; Hino, Masayuki; Tsukuma, Hideaki

    2016-01-01

    The survival gap between adolescents and young adults (AYAs) with hematological malignancies persists in many countries. To determine to what extent it does in Japan, we investigated survival and treatment regimens in 211 Japanese AYAs (15-29 years) in the Osaka Cancer Registry diagnosed during 2001-2005 with hematological malignancies, and compared adolescents (15-19 years) with young adults (20-29 years). AYAs with acute lymphoblastic leukemia (ALL) had a poor 5-year survival (44%), particularly young adults (29% vs. 64% in adolescents, p = 0.01). Additional investigation for patients with ALL revealed that only 19% of young adults were treated with pediatric treatment regimens compared with 45% of adolescents (p = 0.05). Our data indicate that we need to focus on young adults with ALL and to consider establishing appropriate cancer care system and guidelines for them in Japan.

  14. The Age Conundrum: A Scoping Review of Younger Age or Adolescent and Young Adult as a Risk Factor for Clinical Distress, Depression, or Anxiety in Cancer.

    Science.gov (United States)

    Lang, Michael J; David, Victoria; Giese-Davis, Janine

    2015-12-01

    This scoping review was conducted to understand the extent, range, and nature of current research on adolescents and young adults (AYA) with cancer and distress, depression, and anxiety (DDA). This information is necessary to find and aggregate valuable data on the AYA population embedded in generalized studies of DDA. Keyword searches of six relevant electronic databases identified 2156 articles, with 316 selected for abstract review and 40 for full text review. Full-text reviews and data extraction resulted in 34 studies being included, which ranged widely in design, sample size, age-range categorization, analysis methods, DDA measurement tool, overall study rigor, and quality of evidence. Studies very seldom reported using theory to guide their age categorization, with only four studies giving any rationale for their age-group definitions. All 34 studies found a significant association between at least one DDA construct and the younger age group relative to the older age groups at some point along the cancer trajectory. However, age as an independent risk factor for DDA is still unclear, as the relationship could be confounded by other age-related factors. Despite the wide range of definitions and effect sizes in the studies included in this review, one thing is clear: adolescents and young adults, however defined, are a distinct group within the cancer population with an elevated risk of DDA. Widespread adoption of a standard AYA age-range definition will be essential to any future meta-analytical psycho-oncology research in this population.

  15. Diagnostic timeliness in adolescents and young adults with cancer: a cross-sectional analysis of the BRIGHTLIGHT cohort.

    Science.gov (United States)

    Herbert, Annie; Lyratzopoulos, Georgios; Whelan, Jeremy; Taylor, Rachel M; Barber, Julie; Gibson, Faith; Fern, Lorna A

    2018-03-01

    Adolescents and young adults (AYAs) are thought to experience prolonged intervals to cancer diagnosis, but evidence quantifying this hypothesis and identifying high-risk patient subgroups is insufficient. We aimed to investigate diagnostic timeliness in a cohort of AYAs with incident cancers and to identify factors associated with variation in timeliness. We did a cross-sectional analysis of the BRIGHTLIGHT cohort, which included AYAs aged 12-24 years recruited within an average of 6 months from new primary cancer diagnosis from 96 National Health Service hospitals across England between July 1, 2012, and April 30, 2015. Participants completed structured, face-to-face interviews to provide information on their diagnostic experience (eg, month and year of symptom onset, number of consultations before referral to specialist care); demographic information was extracted from case report forms and date of diagnosis and cancer type from the national cancer registry. We analysed these data to assess patient interval (time from symptom onset to first presentation to a general practitioner [GP] or emergency department), the number of prereferral GP consultations, and the symptom onset-to-diagnosis interval (time from symptom onset to diagnosis) by patient characteristic and cancer site, and examined associations using multivariable regression models. Of 1114 participants recruited to the BRIGHTLIGHT cohort, 830 completed a face-to-face interview. Among participants with available information, 204 (27%) of 748 had a patient interval of more than a month and 242 (35%) of 701 consulting a general practitioner had three or more prereferral consultations. The median symptom onset-to-diagnosis interval was 62 days (IQR 29-153). Compared with male AYAs, female AYAs were more likely to have three or more consultations (adjusted odds ratio [OR] 1·6 [95% CI 1·1-2·3], p=0·0093) and longer median symptom onset-to-diagnosis intervals (adjusted median interval longer by 24 days [95

  16. Brief Introduction of NCCN Clinical Practice Guidelines for Adolescent and Young Adult Oncology

    Directory of Open Access Journals (Sweden)

    HUANG Xin-en

    2014-09-01

    Full Text Available Cancer is always a main factor threatening human’s health and life, and its incidence and mortality are gradually increasing in recent years. However, some advances have been made with the unremitting efforts and exploration human made and the improvement is mainly made in cancer treatment of young children and older adults, while little in adolescent and young adult (AYA patients, who are generally defined as individuals of 15 to 39 years old at the time of initial cancer diagnosis due to many factors. To highlight the issues of this unique population, National Comprehensive Cancer Network (NCCN absorbs a large amount of information and previous researches and develops a set of clinical practice guidelines. Though the guidelines are more supportive care guidelines than treatment guidelines, they give us the opportunity to learn the latest international developments in AYA treatment and more survival chance for the treatment of AYA patients.

  17. Disparities in location of death of adolescents and young adults with cancer: A longitudinal, population study in California.

    Science.gov (United States)

    Rajeshuni, Nitya; Johnston, Emily E; Saynina, Olga; Sanders, Lee M; Chamberlain, Lisa J

    2017-11-01

    Patients with a terminal illness should have access to their chosen location of death. Cancer is the leading cause of non-accidental death among adolescents and young adults (AYAs; those aged 15-39 years). Although surveys have suggested that a majority of these patients prefer a home death, to the authors' knowledge, little is known regarding their barriers to accessing their preferred location of death. As a first step, the authors sought to determine, across a large population, 20-year trends in the location of death among AYA patients with cancer. Using the Vital Statistics Death Certificate Database of the California Office of Statewide Health Planning and Development, the authors performed a retrospective, population-based analysis of California patients with cancer aged 15 to 39 years who died between 1989 and 2011. Sociodemographic and clinical factors associated with hospital death were examined using multivariable logistic regression. Of 30,573 AYA oncology decedents, 57% died in a hospital, 33% died at home, and 10% died in other locations (eg, hospice facility or nursing facility). Between 1989 and 1994, hospital death rates decreased from 68.3% to 53.6% and at-home death rates increased from 16.8% to 35.5%. Between 1995 and 2011, these rates were stable. Those individuals who were more likely to die in a hospital were those aged deaths occurred in a hospital, with a 5-year shift to more in-home deaths that abated after 1995. In-hospital deaths were more common among younger patients, patients of minority race/ethnicities, and those with a leukemia or lymphoma diagnosis. Further study is needed to determine whether these rates and disparities are consistent with patient preferences. Cancer 2017;123:4178-4184. © 2017 American Cancer Society. © 2017 American Cancer Society.

  18. Predictors of Posttraumatic Stress Symptoms Among Adolescent and Young Adult Survivors of Childhood Cancer: Importance of Monitoring Survivors' Experiences of Family Functioning.

    Science.gov (United States)

    Kamibeppu, Kiyoko; Murayama, Shiho; Ozono, Shuichi; Sakamoto, Naoko; Iwai, Tsuyako; Asami, Keiko; Maeda, Naoko; Inada, Hiroko; Kakee, Naoko; Okamura, Jun; Horibe, Keizo; Ishida, Yasushi

    2015-11-01

    The purpose of this study was to identify factors associated with posttraumatic stress symptoms (PTSS) among Japanese long-term childhood cancer survivors (CCSs). Subjects comprised 185 adolescent and young adult (AYA) CCSs who completed anonymous self-report questionnaires. Attending physicians also completed an anonymous disease/treatment data sheet. Mean age of survivors was approximately 8 years at diagnosis and 23 years at participation. Multiple regression analysis showed that family functioning, satisfaction with social support, being female, and interactions between family functioning and gender and age at the time of diagnosis were associated with PTSS among survivors. This study revealed family functioning as the most predictive factor of PTSS among AYA CCSs in Japan. Even when the survivor may have unchangeable risk factors, family functioning can potentially moderate the effects on PTSS. Thus, it is crucial for health professionals to carefully monitor and attend to survivors' experiences of family functioning to mitigate PTSS. © The Author(s) 2015.

  19. Racial disparities in the survival of American children, adolescents, and young adults with acute lymphoblastic leukemia, acute myelogenous leukemia, and Hodgkin lymphoma.

    Science.gov (United States)

    Kahn, Justine M; Keegan, Theresa H M; Tao, Li; Abrahão, Renata; Bleyer, Archie; Viny, Aaron D

    2016-09-01

    Race-based survival in children and adolescents with hematologic malignancies has been a national challenge for decades. Large-scale investigations of age- and race-based survival trends over time in these patients have not previously been reported. The objective of this study was to investigate whether race- and age-related differences in pediatric and adolescent and young adult (AYA) leukemia and lymphoma survival persist and to what extent these differences have changed over time. Using the Surveillance, Epidemiology, and End Results program, this study investigated the outcomes of black and white (1975-2012; n = 27,369) and white and Hispanic (1992-2012; n = 20,574) children (0-14 years old) and AYAs (15-39 years old) with acute lymphoblastic leukemia (ALL), acute myelogenous leukemia (AML), and Hodgkin lymphoma (HL). Estimates of 5- and 10-year relative survival were compared over time. Trends showed a convergence of survival for white and black children with ALL but a divergence in survival for AYA patients. Hispanic children and AYAs both suffered inferior outcomes. Trends for AML revealed persistent survival differences between black and white children and suggested worsening disparities for AYAs. Survival trends in HL revealed sustained survival differences between black and white AYA patients, whereas no differences were found in Hispanic and white patient outcomes for AML or HL. Although survival for children and AYAs with ALL, AML, and HL has improved over the past 4 decades, differences persist between black, white, and Hispanic children and AYAs; survival disparities between black and white children with ALL have been nearly eliminated. Strategies aimed at identifying causality and reducing disparities are warranted. Cancer 2016. © 2016 American Cancer Society. Cancer 2016;122:2723-2730. © 2016 American Cancer Society. © 2016 American Cancer Society.

  20. [Does consumption of tobacco, alcohol, and cannabis in adolescents and young adults with cancer affect the use of analgesics during hospitalizations?].

    Science.gov (United States)

    Bertrand, A; Boyle, H; Moreaux, J; Guillot, L; Chvetzoff, G; Charbonnel, J-F; Marec-Berard, P

    2016-04-01

    The specificities of adolescents and young adults (AYAs) aged 15-25 years with cancer are now well recognized. Dedicated care was initiated in 2012 in France under the leadership of the INCa (National Cancer Institute). Research on supportive care and particularly pain management are still rare. This study aimed to evaluate the consumption of toxic substances (tobacco, cannabis, alcohol) in AYAs with cancer as well as its progression during the month following the diagnosis and to analyze its influence on opioid analgesic prescriptions during treatment. This is a prospective study including all new patients aged 15-25 years in two centers between January and June 2013. Data on consumption of psychoactive substances were obtained during an individual interview with a questionnaire. National surveys were used to compare this cohort with the general population. Data on opioid treatments were collected from the computerized prescription software and computerized patient record. Thirty-seven AYAs were eligible and 30 were included; 67% of them were male and the median age was 18.7 years. The questionnaire on tobacco, alcohol, and cannabis consumption at diagnosis was well accepted. Consumption profiles were comparable to the general population. Changes in behavior were observed during the 1st month after diagnosis, with a decrease or cessation of consumption, particularly among young people. This study showed differences in the use and requirements for opioid analgesics during hospitalization according to these consumption data. Prevention and support for AYAs who are regular consumers of toxic substances must be organized during initial care in oncology. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  1. A Fitbit and Facebook mHealth intervention for promoting physical activity among adolescent and young adult childhood cancer survivors: A pilot study.

    Science.gov (United States)

    Mendoza, Jason A; Baker, K Scott; Moreno, Megan A; Whitlock, Kathryn; Abbey-Lambertz, Mark; Waite, Alan; Colburn, Trina; Chow, Eric J

    2017-12-01

    Physical activity (PA) may be important for preventing chronic diseases for adolescent and young adult (AYA) childhood cancer survivors. Randomized controlled trials (RCTs) of PA interventions for AYA survivors are sparse, but necessary to determine effective programs for increasing PA among this population. Thus, we conducted a pilot RCT, testing the feasibility of a mobile health (mHealth) intervention to promote PA among AYA survivors. We recruited 14- to 18-year-olds who were ≥1-year post cancer therapy from Seattle Children's Hospital. The 10-week intervention consisted of a wearable PA-tracking device (Fitbit Flex) and a peer-based virtual support group (Facebook group). Research staff helped set step goals and awarded badges weekly. Controls received usual care. Baseline assessments occurred before randomization and follow-up assessments occurred during weeks 8-10 of the intervention period. Feasibility criteria are defined below. Qualitative interviews assessed acceptability. Exploratory outcomes included PA, quality of life, and motivation for PA. All feasibility criteria were met: we recruited 60 survivors, intervention participants wore the Fitbit on the majority (71.5%) of intervention days, and ≥90% of all participants completed questionnaires. Qualitative data confirmed intervention acceptability. Exploratory analyses found no significant adjusted group differences for change in moderate-to-vigorous PA (4.4 vs. 5.0 min/day; P = 0.92) or sedentary time (-4.5 vs. 1.0 min/day; P = 0.73), comparing intervention subjects to controls. Some modest differences were found for select subscales of quality of life and motivation for PA. This mHealth PA intervention was feasible and acceptable to AYA childhood cancer survivors and warrants a fully powered RCT. © 2017 Wiley Periodicals, Inc.

  2. Barriers and Facilitators of Healthy Diet and Exercise Among Adolescent and Young Adult Cancer Survivors: Implications for Behavioral Interventions.

    Science.gov (United States)

    Wu, Yelena P; Yi, Jaehee; McClellan, Jessica; Kim, Jonghee; Tian, Tian; Grahmann, Bridget; Kirchhoff, Anne C; Holton, Avery; Wright, Jennifer

    2015-12-01

    This study uses qualitative methods to identify barriers to and facilitators of exercise and healthy eating among adolescent and young adult (AYA) cancer survivors (survivors currently aged 18-39 years and diagnosed with cancer anytime in their lives), as reported by survivors and their primary supporters. Survivors (M(age) = 27.6 years, SD = 6.6 years) had completed active cancer therapy. Survivors and supporters (i.e., nominated by survivors as someone who was a main source of support) attended separate focus group sessions (five survivor focus groups, five supporter focus groups) and were asked to complete a self-reported questionnaire assessing demographic and cancer history and engagement in exercise and healthy eating. In total, 25 survivors and 19 supporters participated. The three overarching themes identified were barriers to exercise and healthy eating (e.g., lack of resources, negative thoughts and feelings, negative social and environmental influences), facilitators of exercise and healthy eating (e.g., cognitive motivators, tools for health behavior implementation, social relationships), and intervention implications (e.g., informational needs, desire for social support). AYA cancer survivors and their supporters identified barriers to and facilitators of healthy lifestyle behaviors, which should be considered when designing interventions to improve the long-term health of survivors.

  3. Cancer: Unique to Older Adults

    Science.gov (United States)

    ... A to Z › Cancer › Unique to Older Adults Font size A A A Print Share Glossary Unique ... group with other older people with the same type of cancer. Researchers have found that support groups ...

  4. Decision-making by adolescents and parents of children with cancer regarding health research participation.

    Science.gov (United States)

    Read, Kate; Fernandez, Conrad Vincent; Gao, Jun; Strahlendorf, Caron; Moghrabi, Albert; Pentz, Rebecca Davis; Barfield, Raymond Carlton; Baker, Justin Nathaniel; Santor, Darcy; Weijer, Charles; Kodish, Eric

    2009-09-01

    Low rates of participation of adolescents and young adults (AYAs) in clinical oncology trials may contribute to poorer outcomes. Factors that influence the decision of AYAs to participate in health research and whether these factors are different from those that affect the participation of parents of children with cancer. This is a secondary analysis of data from validated questionnaires provided to adolescents (>12 years old) diagnosed with cancer and parents of children with cancer at 3 sites in Canada (Halifax, Vancouver, and Montreal) and 2 in the United States (Atlanta, GA, and Memphis, TN). Respondents reported their own research participation and cited factors that would influence their own decision to participate in, or to provide parental authorization for their child to participate in health research. Completed questionnaire rates for AYAs and parents were 86 (46.5%) of 185 and 409 (65.2%) of 627, respectively. AYAs (n = 86 [67%]) and parents (n = 409 [85%]) cited that they would participate in research because it would help others. AYAs perceived pressure by their family and friends (16%) and their physician (19%). Having too much to think about at the time of accrual was an impediment to both groups (36% AYAs and 47% parents). The main deterrent for AYAs was that research would take up too much time (45%). Nonwhite parents (7 of 56 [12.5%]) were more apt to decline than white parents (12 of 32 [3.7%]; P < .01). AYAs identified time commitment and having too much to think about as significant impediments to research participation. Addressing these barriers by minimizing time requirements and further supporting decision-making may improve informed consent and impact on enrollment in trials.

  5. Development of a text messaging system to improve receipt of survivorship care in adolescent and young adult survivors of childhood cancer.

    Science.gov (United States)

    Casillas, Jacqueline; Goyal, Anju; Bryman, Jason; Alquaddoomi, Faisal; Ganz, Patricia A; Lidington, Emma; Macadangdang, Joshua; Estrin, Deborah

    2017-08-01

    This study aimed to develop and examine the acceptability, feasibility, and usability of a text messaging, or Short Message Service (SMS), system for improving the receipt of survivorship care for adolescent and young adult (AYA) survivors of childhood cancer. Researchers developed and refined the text messaging system based on qualitative data from AYA survivors in an iterative three-stage process. In stage 1, a focus group (n = 4) addressed acceptability; in stage 2, key informant interviews (n = 10) following a 6-week trial addressed feasibility; and in stage 3, key informant interviews (n = 23) following a 6-week trial addressed usability. Qualitative data were analyzed using a constant comparative analytic approach exploring in-depth themes. The final system includes programmed reminders to schedule and attend late effect screening appointments, tailored suggestions for community resources for cancer survivors, and messages prompting participant feedback regarding the appointments and resources. Participants found the text messaging system an acceptable form of communication, the screening reminders and feedback prompts feasible for improving the receipt of survivorship care, and the tailored suggestions for community resources usable for connecting survivors to relevant services. Participants suggested supplementing survivorship care visits and forming AYA survivor social networks as future implementations for the text messaging system. The text messaging system may assist AYA survivors by coordinating late effect screening appointments, facilitating a partnership with the survivorship care team, and connecting survivors with relevant community resources. The text messaging system has the potential to improve the receipt of survivorship care.

  6. Stages of Adult Primary Liver Cancer

    Science.gov (United States)

    ... Treatment Liver Cancer Prevention Liver Cancer Screening Research Adult Primary Liver Cancer Treatment (PDQ®)–Patient Version Treatment ... are different types of treatment for patients with adult primary liver cancer. Different types of treatments are ...

  7. Evaluating Questionnaires Used to Assess Self-Reported Physical Activity and Psychosocial Outcomes Among Survivors of Adolescent and Young Adult Cancer: A Cognitive Interview Study.

    Science.gov (United States)

    Wurz, Amanda; Brunet, Jennifer

    2017-09-01

    Physical activity is increasingly being studied as a way to improve psychosocial outcomes (e.g., quality of life, self-efficacy, physical self-perceptions, self-esteem, body image, posttraumatic growth) among survivors of adolescent and young adult (AYA) cancer. Assessing levels of and associations between self-reported physical activity and psychosocial outcomes requires clear, appropriate, and relevant questionnaires. To explore how survivors of AYA cancer interpreted and responded to the following eight published questionnaires: Leisure Time Exercise Questionnaire, Exercise Self-Efficacy Scale, Physical Self-Description Questionnaire, Rosenberg Global Self-Esteem Scale, Multidimensional Body-Self Relations Questionnaire, Posttraumatic Growth Inventory, Functional Assessment of Cancer Therapy-General (FACT-G), RAND 36-Item Health Survey 1.0 (RAND-36), cognitive interviews were conducted with three men and four women age 18-36 years who were diagnosed with cancer at age 16-35 years. Initially, the first seven questionnaires listed above were assessed. Summaries of the interviews were prepared and compared across participants. Potential concerns were identified with the FACT-G; thus, a second interview was conducted with participants to explore the clarity, appropriateness, and relevance of the RAND-36. Concerns identified for the FACT-G related mostly to the lack of relevance of items pertaining to cancer-specific aspects of quality of life given that participants were posttreatment. No or few concerns related to comprehension and/or structure/logic were identified for the other questionnaires. In general, the questionnaires assessed were clear, appropriate, and relevant. Participants' feedback suggested they could be used to assess self-reported physical activity and varied psychosocial outcomes in studies with survivors of AYA cancer, either with or without slight modifications.

  8. The Description Of 1 Liter Of Tears Written By Aya Kito

    OpenAIRE

    Yendie, Rizka

    2011-01-01

    Tulisan ini membahas arti dari judul novel 1 liter of Tears. Novel ini dibuat berdasarkan diary sang penulis Aya Kito dalam berjuang melawan penyakit yang tidak ada obatnya yaitu Spinocerebellar Ataxia (SCA), penyakit yang menyerang sel-sel penopang sel saraf. Awalnya penderita merasakan tubuhnya melemah. Berangsur-angsur kemampuan motorik penderita menurun. Sampai-sampai Aya-chan mengalami kesulitan menelan makanan, berbicara dan bahkan tersenyum. Aya-chan mulai merasakan gejala penyakit...

  9. Opening end-of-life discussions: how to introduce Voicing My CHOiCES™, an advance care planning guide for adolescents and young adults.

    Science.gov (United States)

    Zadeh, Sima; Pao, Maryland; Wiener, Lori

    2015-06-01

    Each year, more than 11,000 adolescents and young adults (AYAs), aged 15-34, die from cancer and other life-threatening conditions. In order to facilitate the transition from curative to end-of-life (EoL) care, it is recommended that EoL discussions be routine, begin close to the time of diagnosis, and continue throughout the illness trajectory. However, due largely to discomfort with the topic of EoL and how to approach the conversation, healthcare providers have largely avoided these discussions. We conducted a two-phase study through the National Cancer Institute with AYAs living with cancer or pediatric HIV to assess AYA interest in EoL planning and to determine in which aspects of EoL planning AYAs wanted to participate. These results provided insight regarding what EoL concepts were important to AYAs, as well as preferences in terms of content, design, format, and style. The findings from this research led to the development of an age-appropriate advance care planning guide, Voicing My CHOiCES™. Voicing My CHOiCES™: An Advanced Care Planning Guide for AYA became available in November 2012. This manuscript provides guidelines on how to introduce and utilize an advance care planning guide for AYAs and discusses potential barriers. Successful use of Voicing My CHOiCES™ will depend on the comfort and skills of the healthcare provider. The present paper is intended to introduce the guide to providers who may utilize it as a resource in their practice, including physicians, nurses, social workers, chaplains, psychiatrists, and psychologists. We suggest guidelines on how to: incorporate EoL planning into the practice setting, identify timepoints at which a patient's goals of care are discussed, and address how to empower the patient and incorporate the family in EoL planning. Recommendations for introducing Voicing My CHOiCES™ and on how to work through each section alongside the patient are provided.

  10. Impact of latency time on survival for adolescents and young adults with a second primary malignancy.

    Science.gov (United States)

    Goldfarb, Melanie; Rosenberg, Aaron S; Li, Qian; Keegan, Theresa H M

    2018-03-15

    The adverse impact of second primary malignancies (SPMs) on survival is substantial for adolescents and young adults (AYAs; ie, those 15-39 years old). No studies have evaluated whether the latency time between the first malignancy (the primary malignancy [PM]) and the SPM affects cancer-specific survival (CSS). A multivariate Cox proportional hazards regression with Surveillance, Epidemiology, and End Results data for 13 regions from 1992 to 2008 was used to ascertain whether the latency time (1-5 vs ≥ 6 years) to the development of an SPM affected the CSS and overall survival with respect to either the PM or SPM for AYAs with common SPMs. The majority of 1515 AYAs with an SPM had their PM diagnosed between the ages of 26 and 39 years (74.2%) and an SPM diagnosed within 1 to 5 years (72.9%) of the PM's diagnosis. Overall, AYAs that developed an SPM 1 to 5 years after the diagnosis (vs ≥ 6 years) had an increased risk of death from cancer (hazard ratio [HR], 2.52; 95% confidence interval [CI], 1.92-3.29) as well as any cause (HR, 2.60; 95% CI, 2.04-3.32). Specifically, for AYAs with an SPM that was leukemia or a colorectal, breast, or central nervous system malignancy, a shorter latency time (1-5 years) from their PM diagnosis was associated with an overall significantly increased risk of death (2.6-fold) from either their PM or that particular SPM. However, latency did not appear to affect the CSS with respect to either the PM or SPM for AYA patients with a lymphoma or sarcoma SPM. Most AYAs who develop an SPM do so within 1 to 5 years of their primary cancer diagnosis, and they have an increased risk of death from cancer in comparison with AYAs with an SPM developing after longer survivorship intervals. Cancer 2018;124:1260-8. © 2017 American Cancer Society. © 2017 American Cancer Society.

  11. Patient-Reported Measures of Hearing Loss and Tinnitus in Pediatric Cancer and Hematopoietic Stem Cell Transplantation: A Systematic Review

    Science.gov (United States)

    Stark, Daniel; Rosenberg, Abby R.; Johnston, Donna; Knight, Kristin; Caperon, Lizzie; Uleryk, Elizabeth; Frazier, A. Lindsay; Sung, Lillian

    2016-01-01

    Purpose: We identified studies that described use of any patient-reported outcome scale for hearing loss or tinnitus among children and adolescents and young adults (AYAs) with cancer or hematopoietic stem cell transplantation (HSCT) recipients. Method: In this systematic review, we performed electronic searches of OvidSP MEDLINE, EMBASE, and…

  12. Communication About Prognosis With Adolescent and Young Adult Patients With Cancer: Information Needs, Prognostic Awareness, and Outcomes of Disclosure.

    Science.gov (United States)

    Mack, Jennifer W; Fasciano, Karen M; Block, Susan D

    2018-04-23

    Purpose Communication about prognosis affects decisions patients and family members make about cancer care, and most patients say they want to know about their chances of cure. We sought to evaluate experiences with prognosis communication among adolescents and young adults (AYAs) with cancer. Patients and Methods We surveyed 203 AYAs with cancer age 15 to 29 years (response rate, 74%) treated at Dana-Farber Cancer Institute and their oncologists. Patients were approached within 6 weeks of diagnosis and asked to report on their prognosis communication preferences and experiences, their beliefs about likelihood of cure, and psychosocial outcomes of communication, such as trust (using an item from the Trust in Physician Scale), peace of mind (using select items from the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale), and anxiety and depression (using the Hospital Anxiety and Depression Scale). Oncologists were asked to report the patient's likelihood of cure. Results Most patients (83%, 167 of 203 patients) considered prognostic information to be extremely or very important. Patients who reported having received more extensive prognostic disclosure had higher odds of trust in the oncologist (odds ratio [OR], 1.30; 95% CI, 1.01 to 1.67; P = .05), peace of mind (OR, 2.13; 95% CI, 1.29 to 3.51; P = .002), and hope related to physician communication (OR, 1.27; 95% CI, 1.01 to 1.59; P = .04), after adjusting for patient sex, age, race or ethnicity, prognosis, and diagnosis. Disclosure was also associated with lower distress related to knowing about prognosis (OR, 0.65; 95% CI, 0.44 to 0.95; P = .03). However, a majority of patients (62%) reported prognostic estimates that exceeded those reported by physicians (McNemar P < .001). Conclusion Most AYAs with cancer value receiving prognostic information, which is positively associated with aspects of well-being. However, most overestimate chances of cure relative to oncologists, highlighting the

  13. Sociodemographic disparities in the occurrence of medical conditions among adolescent and young adult Hodgkin lymphoma survivors.

    Science.gov (United States)

    Keegan, Theresa H M; Li, Qian; Steele, Amy; Alvarez, Elysia M; Brunson, Ann; Flowers, Christopher R; Glaser, Sally L; Wun, Ted

    2018-06-01

    Hodgkin lymphoma (HL) survivors experience high risks of second cancers and cardiovascular disease, but no studies have considered whether the occurrence of these and other medical conditions differ by sociodemographic factors in adolescent and young adult (AYA) survivors. Data for 5,085 patients aged 15-39 when diagnosed with HL during 1996-2012 and surviving ≥ 2 years were obtained from the California Cancer Registry and linked to hospitalization data. We examined the impact of race/ethnicity, neighborhood socioeconomic status (SES), and health insurance on the occurrence of medical conditions (≥ 2 years after diagnosis) and the impact of medical conditions on survival using multivariable Cox proportional hazards regression. Twenty-six percent of AYAs experienced at least one medical condition and 15% had ≥ 2 medical conditions after treatment for HL. In multivariable analyses, Black HL survivors had a higher likelihood (vs. non-Hispanic Whites) of endocrine [hazard ratio (HR) = 1.37, 95% confidence interval (CI) 1.05-1.78] and circulatory system diseases (HR = 1.58, CI 1.17-2.14); Hispanics had a higher likelihood of endocrine diseases [HR = 1.24 (1.04-1.48)]. AYAs with public or no insurance (vs. private/military) had higher likelihood of circulatory system diseases, respiratory system diseases, chronic kidney disease/renal failure, liver disease, and endocrine diseases. AYAs residing in low SES neighborhoods (vs. high) had higher likelihood of respiratory system and endocrine diseases. AYAs with these medical conditions or second cancers had an over twofold increased risk of death. Strategies to improve health care utilization for surveillance and secondary prevention among AYA HL survivors at increased risk of medical conditions may improve outcomes.

  14. Pediatric advance care planning (pACP) for teens with cancer and their families: Design of a dyadic, longitudinal RCCT.

    Science.gov (United States)

    Curtin, Katherine B; Watson, Anne E; Wang, Jichuan; Okonkwo, Obianuju C; Lyon, Maureen E

    2017-11-01

    Cancer is the leading cause of disease-related death for adolescents and young adults (AYAs) in the United States. Parents of AYAs with life-threatening illnesses have expressed the desire to talk to their children about end of life (EOL) care, yet, like caregivers of adult patients, struggle to initiate this conversation. Building Evidence for Effective Palliative/End of Life Care for Teens with Cancer is a longitudinal, randomized, controlled, single-blinded clinical trial aimed at evaluating the efficacy of FAmily CEntered disease-specific advance care planning (ACP) for teens with cancer (FACE-TC). A total of 130 dyads (260 subjects) composed of AYAs 14-20years old with cancer and their family decision maker (≥18years old) will be recruited from pediatric oncology programs at Akron Children's Hospital and St. Jude Children's Research Hospital. Dyads will be randomized to either the FACE-TC intervention or Treatment as Usual (TAU) control. FACE-TC intervention dyads will complete three 60-minute ACP sessions held at weekly intervals. Follow-up data will be collected at 3, 6, 12, and 18months post-intervention by a blinded research assistant (RA). The effects of FACE-TC on patient-family congruence in treatment preferences, quality of life (QOL), and advance directive completion will be analyzed. FACE-TC is an evidenced-based and patient-centered intervention that considers QOL and EOL care according to the AYA's representation of illness. The family is involved in the ACP process to facilitate shared decision making, increase understanding of the AYA's preferences, and make a commitment to honor the AYA's wishes. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Graft-Versus-Host Disease in Adolescents and Young Adults (15-24 Years Old) After Allogeneic Hematopoietic Stem Cell Transplantation for Acute Leukemia in First Complete Remission.

    Science.gov (United States)

    Vignon, Marguerite; Andreoli, Annalisa; Dhédin, Nathalie; Lengliné, Etienne; Masson, Emeline; Robin, Marie; Granier, Clémence; Larghero, Jérôme; Schlageter, Marie-Hélène; de Latour, Régis Peffault; Socié, Gérard; Boissel, Nicolas

    2017-06-01

    Adolescents and young adults (AYAs) with cancer are a unique group of patients in terms of disease incidence and biology, outcome, and psychosocial needs. This study aims to correlate the risk of graft-versus-host disease (GvHD) and age in a population of children and young adults with acute leukemia undergoing hematopoietic stem cell transplantation (HSCT) in first complete remission (CR). We analyzed the outcome of 153 consecutive children (<15 years), AYAs (15-24 years), and adults (25-35 years) with lymphoblastic or myeloid acute leukemia in first CR who underwent HSCT with matched donors after myeloablative conditioning. GvHD prophylaxis was methotrexate and cyclosporine A (CsA) in all patients. The cumulative incidence of grade II-IV acute GvHD (aGvHD) was significantly higher in AYA patients than in children (subdistribution hazard ratio (SHR), 2.04, p = 0.005) or adults (SHR 1.59, p = 0.048). Both gut and skin aGvHD occurred more frequently in AYA patients. Increasing CsA blood levels with age could not fully account for this difference. No difference in terms of grade III-IV aGvHD was observed. Chronic GvHD was more frequent in AYAs (SHR 2.81, p = 0.007) and adults (SHR 2.31, p = 0.033) than in children. No difference in terms of nonrelated mortality and overall survival was observed among the age subgroups. Since GvHD occurrence is strongly correlated to quality of life, specific attention should be paid to AYAs undergoing HSCT. Further studies should investigate the reasons for the excess of GvHD observed in this population.

  16. Facing the Maze: Young Cancer Survivors' Return to Education and Work-A Professional Expert Key Informant Study.

    Science.gov (United States)

    Pedersen, Kaspar Jessen; Boisen, Kirsten Arntz; Midtgaard, Julie; Elsbernd, Abbey; Larsen, Hanne Baekgaard

    2018-03-13

    An insufficient transition to normal life after cancer treatment in adolescent and young adults (AYAs) may lead to decreased occupational and educational opportunities throughout a survivor's lifespan. Key informant interviews were used to access unique knowledge of the healthcare, educational, and social systems. We used key informant interviews with professionals representing disciplines from healthcare, educational, and social systems (n = 15). Informants were recruited through purposive sampling and snowball sampling. Interviews were analyzed thematically using Malterud's Systematic Text Condensation and verified by member checking. We found four major themes: the impact of late effects, navigating the system, social reintegration, and the drive of youth. Although legal frameworks are often in place to assist AYA cancer survivors, navigating the public, educational, and social systems is a complex task and many AYAs do not have the required skill set or energy. Furthermore, AYA survivors often feel different from their peers and misunderstood by their surroundings, which may hinder reintegration into normal social life. In Scandinavia, healthcare and education are free of charge with equal access for all, primarily funded by government taxes. Therefore, insurance status and tuition fees should not constitute barriers for returning to education and work. However, this study finds that the public and educational systems are complex to navigate, and that AYAs face trouble mobilizing the energy to receive needed support.

  17. Challenges faced in the treatment of acute lymphoblastic leukemia in adolescents and young adults

    Directory of Open Access Journals (Sweden)

    Levine SR

    2016-02-01

    Full Text Available Selena R Levine,1 Jennifer L McNeer,2 Michael S Isakoff1 1Center for Cancer and Blood Disorders, Connecticut Children’s Medical Center and University of Connecticut School of Medicine, Hartford, CT, 2Section of Pediatric Hematology/Oncology, University of Chicago Comer Children's Hospital, Chicago, IL, USA Abstract: The survival rate for children with acute lymphoblastic leukemia (ALL has dramatically improved over the last 50 years. However, for those in the adolescent and young adult (AYA age-group of 15–30 years with ALL, there has not been the same degree of improvement. Historically, pediatric and adult providers have utilized different treatment approaches based on clinical trials. However, studies that have compared the outcome of AYA patients with ALL treated on pediatric or adult clinical trials have generally shown substantially better outcomes for this patient population treated with the pediatric trials. Additionally, hematopoietic stem cell transplantation has been considered as part of intensified therapy for AYA patients with ALL. Herein, we review the outcomes with chemotherapy alone and with hematopoietic stem cell transplantation, and explore the challenges faced in determining the ideal therapy for the AYA population of patients. Keywords: adolescent young adult oncology, leukemia, hematopoietic stem cell transplantation

  18. Perceived impact of cancer among adolescents and young adults: Relationship with health-related quality of life and distress.

    Science.gov (United States)

    Husson, O; Zebrack, B J

    2017-09-01

    To examine whether perceptions of the impact of cancer are related to health-related quality of life (HRQoL) and psychological distress among survivors of cancer in adolescence and young adulthood (AYA). One hundred seventy-three AYA cancer survivors (aged 18-35 and 15-29 years at time of diagnosis) completed a mailed survey assessing impact of cancer (IOC-AYA), HRQoL (SF-36), and distress (BSI-18). Hierarchical linear regression models analyzed the independent effects of perceived impacts of cancer on HRQoL and distress after controlling for clinical and sociodemographic characteristics. Multivariate analyses also examined the extent to which positive and negative perceptions attenuated the effects of control variables on HRQoL and distress. Being unemployed or not in school, and self-reported health problems were significantly associated with worse physical HRQoL. Mental HRQoL and psychological distress appeared as a function of reporting both positive and negative impacts of cancer; mental health outcomes were better in AYAs reporting more positive and less negative impact of cancer in their lives. Perceived impact of cancer, in both positive and negative ways, attenuated the effects of sociodemographic and clinical factors on mental HRQoL and psychological distress. Results suggest that mental HRQoL and psychological distress, but not physical HRQoL, are a function of survivors' perceptions of how cancer has affected them and continues to affect them in both positive and negative ways. Findings suggest that opportunities for AYA cancer survivors to reframe or better understand the context of cancer in their lives may result in improved mental health outcomes. Copyright © 2016 John Wiley & Sons, Ltd.

  19. Stories That Heal: Understanding the Effects of Creating Digital Stories With Pediatric and Adolescent/Young Adult Oncology Patients.

    Science.gov (United States)

    Laing, Catherine M; Moules, Nancy J; Estefan, Andrew; Lang, Mike

    The purpose of this philosophical hermeneutic study was to determine if, and understand how, digital stories might be effective therapeutic tools to use with children and adolescents/young adults (AYA) with cancer, thus helping mitigate suffering. Sixteen participants made digital stories with the help of a research assistant trained in digital storytelling and were interviewed following the completion of their stories. Findings from this research revealed that digital stories were a way to have others understand their experiences of cancer, allowed for further healing from their sometimes traumatic experiences, had unexpected therapeutic effects, and were a way to reconcile past experiences with current life. Digital stories, we conclude, show great promise with the pediatric and AYA oncology community and we believe are a way in which the psychosocial effects of cancer treatment may be addressed. Recommendations for incorporating digital stories into clinical practice and follow-up programs are offered.

  20. Malignant central nervous system tumors among adolescents and young adults (15-39 years old) in 14 Southern-Eastern European registries and the US Surveillance, Epidemiology, and End Results program: Mortality and survival patterns.

    Science.gov (United States)

    Georgakis, Marios K; Papathoma, Paraskevi; Ryzhov, Anton; Zivkovic-Perisic, Snezana; Eser, Sultan; Taraszkiewicz, Łukasz; Sekerija, Mario; Žagar, Tina; Antunes, Luis; Zborovskaya, Anna; Bastos, Joana; Florea, Margareta; Coza, Daniela; Demetriou, Anna; Agius, Domenic; Strahinja, Rajko M; Themistocleous, Marios; Tolia, Maria; Tzanis, Spyridon; Alexiou, George A; Papanikolaou, Panagiotis G; Nomikos, Panagiotis; Kantzanou, Maria; Dessypris, Nick; Pourtsidis, Apostolos; Petridou, Eleni T

    2017-11-15

    Unique features and worse outcomes have been reported for cancers among adolescents and young adults (AYAs; 15-39 years old). The aim of this study was to explore the mortality and survival patterns of malignant central nervous system (CNS) tumors among AYAs in Southern-Eastern Europe (SEE) in comparison with the US Surveillance, Epidemiology, and End Results (SEER) program. Malignant CNS tumors diagnosed in AYAs during the period spanning 1990-2014 were retrieved from 14 population-based cancer registries in the SEE region (n = 11,438). Age-adjusted mortality rates were calculated and survival patterns were evaluated via Kaplan-Meier curves and Cox regression analyses, and they were compared with respective 1990-2012 figures from SEER (n = 13,573). Mortality rates in SEE (range, 11.9-18.5 deaths per million) were higher overall than the SEER rate (9.4 deaths per million), with decreasing trends in both regions. Survival rates increased during a comparable period (2001-2009) in SEE and SEER. The 5-year survival rate was considerably lower in the SEE registries (46%) versus SEER (67%), mainly because of the extremely low rates in Ukraine; this finding was consistent across age groups and diagnostic subtypes. The highest 5-year survival rates were recorded for ependymomas (76% in SEE and 92% in SEER), and the worst were recorded for glioblastomas and anaplastic astrocytomas (28% in SEE and 37% in SEER). Advancing age, male sex, and rural residency at diagnosis adversely affected outcomes in both regions. Despite definite survival gains over the last years, the considerable outcome disparities between the less affluent SEE region and the United States for AYAs with malignant CNS tumors point to health care delivery inequalities. No considerable prognostic deficits for CNS tumors are evident for AYAs versus children. Cancer 2017;123:4458-71. © 2017 American Cancer Society. © 2017 American Cancer Society.

  1. Optimal therapy for acute lymphoblastic leukemia in adolescents and young adults.

    Science.gov (United States)

    Schafer, Eric S; Hunger, Stephen P

    2011-05-31

    Although the survival rate for adolescents and young adults (AYA) with acute lymphoblastic leukemia (ALL) has steadily improved over the past several decades, it still lags behind that of younger children. This Review explores the reasons for this discrepancy and potential solutions, focusing on patients aged 15-22 years. Recent studies that compared the outcome of AYA patients with ALL treated on pediatric or adult clinical trials have shown substantially better outcomes for this patient population obtained with the pediatric trials. Excellent early results have been obtained for patients with ALL aged up to 40-60 years who were treated in adult study groups with pediatric-based regimens. Targeting biological and socio-political features unique to AYA ALL has reduced the 'AYA gap' and has provided the foundation for basic science and translational and clinical AYA initiatives that are charged with the task of discovering further methods to improve the outcome of AYA with ALL.

  2. Multimethod Assessment of Medication Nonadherence and Barriers in Adolescents and Young Adults With Solid Organ Transplants.

    Science.gov (United States)

    Eaton, Cyd K; Gutierrez-Colina, Ana M; Quast, Lauren F; Liverman, Rochelle; Lee, Jennifer L; Mee, Laura L; Reed-Knight, Bonney; Cushman, Grace; Chiang, Gloria; Romero, Rene; Mao, Chad; Garro, Rouba; Blount, Ronald L

    2018-03-17

    To (a) examine levels of medication nonadherence in adolescent and young adult (AYA) solid organ transplant recipients based on AYA- and caregiver proxy-reported nonadherence to different medication types and the medication-level variability index (MLVI) for tacrolimus, and (b) examine associations of adherence barriers and AYA and caregiver emotional distress symptoms with reported nonadherence and the MLVI. The sample included 47 AYAs (M age = 16.67 years, SD = 1.74; transplant types: 25% kidney, 47% liver, 28% heart) and their caregivers (94 total participants). AYAs and caregivers reported on AYAs' adherence barriers and their own emotional functioning. Nonadherence was measured with AYA self- and caregiver proxy-report and the MLVI for tacrolimus. The majority of AYAs and caregivers denied nonadherence, with lower rates of nonadherence reported for antirejection medications. In contrast, 40% of AYAs' MLVI values indicated nonadherence to tacrolimus. AYAs and caregivers who verbally acknowledged nonadherence had more AYA barriers and greater caregiver emotional distress symptoms compared with those who denied nonadherence. AYAs with MLVIs indicating nonadherence had more barriers than AYAs with MLVIs indicating adherence. Multimethod nonadherence evaluations for AYA transplant recipients should assess objective nonadherence using the MLVI, particularly in light of low reported nonadherence rates for antirejection medications. Assessments should include adherence barriers measures, given associations with the MLVI, and potentially prioritize assessing barriers over gauging nonadherence via self- or proxy-reports. Caregiver emotional distress symptoms may also be considered to provide insight into family or environmental barriers to adherence.

  3. Nursing young people with cancer: What is "different" about it?

    Science.gov (United States)

    Morgan, Sue; Soanes, Louise

    2016-12-01

    Nursing Adolescents and Young Adults (AYA) with cancer is a relatively new specialty, with much work having been undertaken across Europe. As this evolving specialty develops, nurses are required to develop networks, learn from each other and help to shape services across countries. Describing the cancer journey, this paper looks at the literature and, merging it with over 20years of experience, describes 'what is different' about looking after this group of young people. Looking at the specific issues about caring for AYA, including those issues that are pertinent in this age range: i.e. education/employment, fertility, body image, peers, family relationships, it discusses the development of specific services for this cohort of patients; one that is centred around the young person and their friends and families. Taking into account the need to develop multidisciplinary teams, it also highlights the needs of nurses who work in these teams, the education, skills and attributes needed to develop gold standard services for these challenging young people. The further development of nursing networks internationally is urged in order to share practice and expertise, nurture teams and bring the AYA with cancer into sharp focus. Copyright © 2016 Société Française du Cancer. All rights reserved.

  4. Cancer in young adults with ischemic stroke.

    Science.gov (United States)

    Aarnio, Karoliina; Joensuu, Heikki; Haapaniemi, Elena; Melkas, Susanna; Kaste, Markku; Tatlisumak, Turgut; Putaala, Jukka

    2015-06-01

    Cancer is a risk factor for ischemic stroke. Little is known about cancer among young adults with ischemic stroke. We studied the frequency of cancer and its association with long-term risk of death among young patients with first-ever ischemic stroke. 1002 patients aged 15 to 49 years, registered in the Helsinki Young Stroke Registry, and with a median follow-up of 10.0 years (interquartile range 6.5-13.8) after stroke were included. Historical and follow-up data were derived from the Finnish Care Register and Statistics Finland. Survival between groups was compared with the Kaplan-Meier life-table method, and Cox proportional hazard models were used to identify factors associated with mortality. One or more cancer diagnosis was made in 77 (7.7%) patients, of whom 39 (3.9%) had cancer diagnosed prestroke. During the poststroke follow-up, 41 (53.2%) of the cancer patients died. Median time from prestroke cancer to stroke was 4.9 (1.0-9.5) years and from stroke to poststroke cancer was 6.7 (2.7-10.9) years. Poststroke cancer was associated with age>40 years, heavy drinking, and cigarette smoking. The cumulative mortality was significantly higher among the cancer patients (68.6%, 95% confidence interval 52.0%-85.3%) compared with patients without cancer (19.7%, 95% confidence interval 16.3%-23.2%). Active cancer at index stroke, melanoma, and lung/respiratory tract cancer had the strongest independent association with death during the follow-up when adjusted for known poststroke mortality prognosticators. Cancer, and especially active cancer and no other apparent cause for stroke, is associated with unfavorable survival among young stroke patients. © 2015 American Heart Association, Inc.

  5. Building a National Framework for Adolescent and Young Adult Hematology and Oncology and Transition from Pediatric to Adult Care: Report of the Inaugural Meeting of the "AjET" Working Group of the German Society for Pediatric Oncology and Hematology.

    Science.gov (United States)

    Escherich, Gabriele; Bielack, Stefan; Maier, Stephan; Braungart, Ralf; Brümmendorf, Tim H; Freund, Mathias; Grosse, Regine; Hoferer, Anette; Kampschulte, Rebecca; Koch, Barbara; Lauten, Melchior; Milani, Valeria; Ross, Henning; Schilling, Freimut; Wöhrle, Dieter; Cario, Holger; Dirksen, Uta

    2017-06-01

    Adolescents and young adults (AYAs) with hemato-oncological problems constitute a heterogenous group with characteristic particularities, specific needs, and age-related clinical and unique psychosocial features. Strong collaboration between pediatric and adult hemato-oncology settings is essential to address their needs appropriately. This is not only true for patients who first become ill during adolescence or young adulthood, but equally so for people who contract hemato-oncological diseases congenitally or as younger children and who are now becoming old enough to leave the pediatric setting and have to transit into "adult" medical care. Efforts to create environments that meet the specific needs of the AYA population affected by hemato-oncological diseases have been initiated in many countries. Due to international variations between societies in general and healthcare infrastructures in particular, the challenges posed to creating such environments vary considerably from country to country. Aiming at addressing these on a national basis for Germany, a dedicated Working Group on Adolescents, Young Adults, and Transition (Arbeitsgemeinschaft Adoleszenten, junge Erwachsene, Transition, AjET) was established. This meeting report depicts the content and discussions of the first interdisciplinary conference on treatment, transition, and long-term follow-up in AYAs with cancer or chronic/inborn hematological diseases. The AjET group of the German Society for Pediatric Oncology and Hematology (GPOH) intends to increase the national awareness for AYAs; strengthen the collaboration of pediatric and adult care givers; and initiate, promote, and coordinate collaborative activities in the fields of basic and translational research, clinical care, and long-term follow-up aimed at improving the current situation.

  6. The relationship between unmet needs and distress amongst young people with cancer.

    Science.gov (United States)

    Dyson, Gavin J; Thompson, Kate; Palmer, Susan; Thomas, David M; Schofield, Penelope

    2012-01-01

    Most psychosocial research in cancer has been restricted to paediatric or older adult populations. This study aimed to explore psychological distress and unmet needs in adolescents and young adults (AYA) with cancer and identify predictors of distress among demographic and illness characteristics and supportive care needs. Fifty-three patients between 16 and 30 years completed a cross-sectional survey, administered shortly after presentation to an AYA oncology service and within 4 months of diagnosis. Measures included the Beck Depression Inventory-Fast Screen (BDI-FS), State-Trait Anxiety Inventory-State Form (STAI-S) and the Supportive Care Needs Survey. Level of distress-related sypmtomatology in this population was based on previous work, whereby a cut-off score of 4 or greater was used for the BDI-FS, and one standard deviation above the sample population mean was used for the STAI-S. Prevalence of distress (25%) was lower than that found previously in AYA with cancer. Physical and daily living needs were the most frequently unmet needs overall, followed by psychological needs, health system and information needs and care and support needs. Lastly, being pre-treatment predicted increased depression and state anxiety, while having treatment post-surgery predicted reduced state anxiety. After controlling for treatment status, however, the main predictors of depression and state anxiety were physical and daily living needs and health system and information needs, respectively. Lower levels of distress and unmet psychological needs were related to the few participants (17%) in this study who were pre-treatment, when distress was most likely. However, physical needs and information needs, which are almost inevitable throughout treatment and beyond, were more important predictors of distress. Further exploration must consider the psychosocial difficulties underlying this association and the needs of AYA at transitions between critical periods in their cancer journey

  7. Influence of insurance and marital status on outcomes of adolescents and young adults with acute lymphoblastic leukemia.

    Science.gov (United States)

    Fintel, Andrew E; Jamy, Omer; Martin, Mike G

    2015-06-01

    Although outcomes for adolescents and young adults (AYA) with acute lymphoblastic leukemia (ALL) are worse when treated according to adult rather than pediatric protocols, one criticism is that this may be due to the emancipation of young adults. Using case listing session of Surveillance, Epidemiology, and End Results (SEER) 18 (1973-2010), we examined outcomes for AYA with ALL defined similar to Cancer and Leukemia Group B (CALGB) 10,403 criteria (age 18-30) predicated on marital and insurance status as surrogates for emancipation (limiting analysis to 2007-2010). Analyses were conducted with SEER*Stat 8.1.2, Microsoft Excel 2007, and GraphPad Prism 6. Comparisons were made by the Fisher exact test and log rank test (Mantel-Cox); all P values were 2-sided. Although age (24 and younger vs. 25 and older) was predictive of median overall survival (OS) (not reached vs. 33; P = .0029) (3-year OS 66% vs. 49%), social factors were not. Three-year OS for insured versus uninsured patients was 61% versus 50%, and median OS was not reached versus 30 months (P = .2334). Three-year OS for single versus married patients was 62% versus 55%, with median OS not reached for both groups (P = .1084). Insurance status and marriage did not influence outcomes for AYA with ALL, suggesting that intrinsic differences in disease and disease-specific therapies are more important than social issues. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. A content analysis of emotional concerns expressed at the time of receiving a cancer diagnosis: An observational study of consultations with adolescent and young adult patients and their family members.

    Science.gov (United States)

    Korsvold, Live; Mellblom, Anneli Viktoria; Finset, Arnstein; Ruud, Ellen; Lie, Hanne Cathrine

    2017-02-01

    Little is known about the emotional concerns expressed by adolescent and young adult (AYA) patients in consultations when a diagnosis of cancer is delivered. Here, we investigated the content of such concerns and how health care providers respond to them. We audio-recorded nine consultations with AYA cancer patients (ages: 12-25 years) at the time of diagnosis. We have previously identified and coded 135 emotional concerns and the responses to these in the nine consultations using the Verona Coding Definitions of Emotional Sequences (VR-CoDES) framework. Here, we used qualitative content analysis to study these emotional concerns and categorize them according to overarching themes. We then quantitatively explored associations between the themes of the concerns and whether the responses to them varied according to their themes. We identified four themes for the content of concerns: "Side-effects/late-effects" (39%), "What happens in the near future/practical aspects" (16%), "Fear" (27%) and "Sadness" (17%) (e. g. crying, sighing or other sounds that expressed sadness). Health care providers' responses did not appear to vary according to the different themes of concerns, but typically consisted of providing medical information. The content analysis revealed that patients and family members expressed a wide range of emotional concerns. Health care providers tended to respond to the content-aspect of the concerns, but did rarely explicitly acknowledge the affective-aspect of the concerns. The effect of responses to patients' emotional concerns in the important first consultations about the cancer diagnosis and planned treatment should be investigated in future studies. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Rezension zu: Ruth Ayaß: Kommunikation und Geschlecht. Stuttgart: W. Kohlhammer Verlag 2008

    Directory of Open Access Journals (Sweden)

    Michaela Goll

    2009-03-01

    Full Text Available Ruth Ayaß gibt in der vorliegenden Einführung einen Überblick über den Forschungsstand und die wesentlichen Diskussionsstränge zum Thema Kommunikation und Geschlecht. Sie zeigt dabei, ob und wie sich männliche von weiblichen Gesprächstilen unterscheiden lassen und wie verschiedene Geschlechter erst interaktiv, nämlich durch kommunikative Prozesse, erzeugt werden. Der Band eignet sich hervorragend als Lehrbuch in soziologischen und sprachwissenschaftlichen Studiengängen, bietet aber auch für die konstruktivistische Genderforschung wichtige Anknüpfungspunkte.

  10. Dietary intake and nutritional status in cancer patients: comparing adults and older adults

    OpenAIRE

    Gómez Valiente da Silva, Henyse; Fonseca de Andrade, Camila; Seixas Bello Moreira, Annie

    2014-01-01

    Objective: Evaluate the nutrient intake and nutritional status of food in cancer patients admitted to a university hospital, with comparison of adult and older adult age category Methods: Cross-sectional study. This study involved cancer patients admitted to a hospital in 2010. Dietary habits were collected using a Brazilian food frequency questionnaire. Participants were divided in two groups: adults or older adults and in 4-cancer category: hematologic, lung, gastrointestinal and others. Bo...

  11. Queensland Youth Cancer Service: A Partnership Model to Facilitate Access to Quality Care for Young People Diagnosed with Cancer.

    Science.gov (United States)

    Bradford, Natalie K; Henney, Roslyn; Walker, Rick; Walpole, Euan; Kennedy, Glen; Nicholls, Wayne; Pinkerton, Ross

    2018-06-01

    Global recognition of the need to improve outcomes for adolescents and young adults (AYA) with cancer has led to the development of specific oncology programs and services. In Australia, Youth Cancer Services (YCS) are now established across the country. While each service has been shaped by nationally agreed principles, program development has been influenced by local policy and geographic differences. Queensland is a vast state with a widely dispersed population; coordination of cancer services for young people across this landscape presents unique challenges. The Queensland YCS (QYCS) work in a consultative partnership model with primary treating teams, across both pediatric and adult tertiary cancer services. Understanding how cancer services approach challenges and service development can provide guidance for other developing services. In this article, we describe the goals and development of QYCS and review the outcomes achieved in the service to date. We reviewed referral data and retrieved statewide clinical activity from the web-based data system. We compared these data with cancer registry data to identify disparities and areas for service development. While the service has achieved notable outcomes, challenges remain. These include recruitment of appropriately skilled and trained health professionals for this newly developing area of oncology. In addition, there is an ongoing need to advocate for this relatively small patient group, and to promote awareness and understanding of the need for AYA-specific services. With the dispersed population and concentration of services in metropolitan Brisbane, identifying and testing new innovative models, including telehealth, to reach all AYA diagnosed with cancer regardless of location of care are priorities.

  12. Initial evaluation of an electronic symptom diary for adolescents with cancer.

    Science.gov (United States)

    Baggott, Christina; Gibson, Faith; Coll, Beatriz; Kletter, Richard; Zeltzer, Paul; Miaskowski, Christine

    2012-12-11

    The delivery of optimal care depends on accurate communication between patients and clinicians regarding untoward symptoms. Documentation of patients' symptoms necessitates reliance on memory, which is often imprecise. We developed an electronic diary (eDiary) for adolescents and young adults (AYAs) with cancer to record symptoms. The purpose of this paper is to describe the utility of an eDiary designed for AYAs with cancer, including dependability of the mobile application, the reasons for any missing recorded data, patients' adherence rates to daily symptom queries, and patients' perceptions of the usefulness and acceptability of symptom data collection via mobile phones. Our team developed an electronic symptom diary based on interviews conducted with AYAs with cancer and their clinicians. This diary included daily severity ratings of pain, nausea, vomiting, fatigue, and sleep. The occurrence of other selected physical sequelae was assessed daily. Additionally, patients selected descriptors of their mood. A 3-week trial of the eDiary was conducted with 10 AYA cancer patients. Mobile phones with service plans were loaned to patients who were instructed to report their symptoms daily. Patients completed a brief questionnaire and were interviewed to elicit their perceptions of the eDiary and any technical difficulties encountered. Overall adherence to daily symptom reports exceeded 90%. Young people experienced few technical difficulties and reported benefit from daily symptom reports. Symptom occurrence rates were high and considerable inter- and intra-patient variability was noted in symptom and mood reports. We demonstrated the utility of an eDiary that may contribute insight into patients' symptom patterns to promote effective symptom management.

  13. Home care to Older adult with cancer

    International Nuclear Information System (INIS)

    Villagra, J; Castro, C; Meneses, S.

    2004-01-01

    Objective: Home care of the elderly with cancer. After the development of a program of oncology home care and over a period of five years, we believe that the evaluation allows us to have our proposal and challenges in the continuity of the program. This evidence is based in our old advanced Uruguayan population, and consequently increase this cancer population, we should define which pointed toward our objective, in order to get the best quality life. After one year with a project based on general rules, the evidence threw an evaluation, that we should review the model of care with which we were working. We continue to Auto-care model Dorothea Orem. The main objective became q uality of life : Take care as the primary Older Adult; Specific care their cancer to become symptomatic secondary complications to the evolution of tumor biology; Secondary prevention of cause therapeutic effect; Family integration, without changing the pace of life that the elderly had before being with cancer. Nursing challenge: Maintain autonomy achieved in these 5 years. Deepen the social equilibrium that we are committed daily between patient and family.Do not miss the professionalism achieved today.Proposal for nursing: Consider a wide field of nursing and for this achievement is need knowledge of 2nd level of community work, knowledge Clinical knowledge in Oncology Nursing, autonomy in decision making. For older adults with cancer: No out of its middle. Maintain priority habits and customs. Do not let it lose their self-esteem with their own values. Caution changes must take care to better manage the evolution of their illness. Conclusion: Oncology nursing is a specialty. Without this formation will be ever more away the development of these programs in our environment, or fall in applying for only economic convenience, losing professionalism. Our population is increasing

  14. Gaps in nutritional research among older adults with cancer

    Science.gov (United States)

    Presley, Carolyn J.; Dotan, Efrat; Soto-Perez-de-Celis, Enrique; Jatoi, Aminah; Mohile, Supriya G.; Won, Elizabeth; Alibhai, Shabbir; Kilari, Deepak; Harrison, Robert; Klepin, Heidi D.; Wildes, Tanya M.; Mustian, Karen; Demark-Wahnefried, Wendy

    2016-01-01

    Nutritional issues among older adults with cancer are an understudied area of research despite significant prognostic implications for treatment side effects, cancer-specific mortality, and overall survival. In May of 2015, the National Cancer Institute and the National Institute on Aging co-sponsored a conference focused on future directions in geriatric oncology research. Nutritional research among older adults with cancer was highlighted as a major area of concern as most nutritional cancer research has been conducted among younger adults, with limited evidence to guide the care of nutritional issues among older adults with cancer. Cancer diagnoses among older adults are increasing, and the care of the older adult with cancer is complicated due to multimorbidity, heterogeneous functional status, polypharmacy, deficits in cognitive and mental health, and several other non-cancer factors. Due to this complexity, nutritional needs are dynamic, multifaceted, and dependent on the clinical scenario. This manuscript outlines the proceedings of this conference including knowledge gaps and recommendations for future nutritional research among older adults with cancer. Three common clinical scenarios encountered by oncologists include (1) weight loss during anti-cancer therapy, (2) malnutrition during advanced disease, and (3) obesity during survivorship. In this manuscript, we provide a brief overview of relevant cancer literature within these three areas, knowledge gaps that exist, and recommendations for future research. PMID:27197919

  15. Childhood height, adult height, and the risk of prostate cancer

    DEFF Research Database (Denmark)

    Bjerregaard, Lise Geisler; Aarestrup, Julie; Gamborg, Michael

    2016-01-01

    PURPOSE: We previously showed that childhood height is positively associated with prostate cancer risk. It is, however, unknown whether childhood height exerts its effects independently of or through adult height. We investigated whether and to what extent childhood height has a direct effect...... on the risk of prostate cancer apart from adult height. METHODS: We included 5,871 men with height measured at ages 7 and 13 years in the Copenhagen School Health Records Register who also had adult (50-65 years) height measured in the Danish Diet, Cancer and Health study. Prostate cancer status was obtained...... through linkage to the Danish Cancer Registry. Direct and total effects of childhood height on prostate cancer risk were estimated from Cox regressions. RESULTS: From 1996 to 2012, 429 prostate cancers occurred. Child and adult heights were positively and significantly associated with prostate cancer risk...

  16. Uncovering the Biology of Cancers in Adolescents and Young Adults

    Science.gov (United States)

    Evidence suggests that some adolescent and young adult cancers may have unique genetic and biological features. Researchers are trying to better understand the biology of these cancers in order to identify potential therapeutic targets.

  17. Adult Primary Liver Cancer Treatment (PDQ®)—Patient Version

    Science.gov (United States)

    Treatment of liver cancer in adults depends on the stage. Treatment options include hepatectomy, liver transplant, ablation, electroporation therapy (EPT), embolization therapy, targeted therapy, and/or radiation therapy. Learn more about treatment for the different stages of liver cancer.

  18. Social Media: Support for Survivors and Young Adults With Cancer.

    Science.gov (United States)

    Walton, AnnMarie L; Albrecht, Tara A; Lux, Lauren; Judge Santacroce, Sheila

    2017-10-01

    Social media use is ubiquitous among young adults. Young adults with cancer must make important decisions about where, what, and how to share information on social media. Oncology nurses are in a unique position to start conversations about the risks and benefits of social media use. This column aims to review a variety of social media platforms that may be used by young adults with cancer and provide guidance to nurses on initiating open dialogue with young adults about social media usage. 
.

  19. Young adult cancer survivors and work: a systematic review.

    Science.gov (United States)

    Stone, Dawn S; Ganz, Patricia A; Pavlish, Carol; Robbins, Wendie A

    2017-12-01

    Sixty-three percent of cancer survivors continue to work, or return to work after treatment. Among this population, work ability and challenges encountered in the workplace by young adult cancer survivors have not been well established. The purposes of the study are to describe what is currently known about work-related issues for young adult cancer survivors diagnosed between ages 15 and 39, to identify gaps in the research literature, and to suggest interventions or improvements in work processes and occupational settings. A narrative review of articles using PubMed, CINAHL, and PsychInfo was conducted without date limitations. Search phrases included young adult cancer survivors, long-term cancer survivors, young adults affected by cancer, further combined with key terms employment, work, and occupationally active. Inclusion criteria for publications were young adult cancer survivors initially diagnosed between the ages of 15 and 39, data about work or employment was presented, and articles written in English. Twenty-three publications met the inclusion criteria. Work-related issues included the potential for reduced work productivity from cancer-changed physical and cognitive functional ability that affected income, and resulted in distress. Coping style, support systems, and changing perspectives about work and life in general were also influential on career decisions among young adult cancer survivors. More research is needed to study interventions to better manage health changes in young adult cancer survivors within the context of the workplace. Since financial hardship has been shown to be especially high among young cancer survivors, employment is essential to ensure payment of cancer-associated costs and continued medical care. While young adult cancer survivors may initially grapple with cancer-related physical and psychosocial changes that impact work productivity or influence choice of occupation, employment appears to enhance overall quality of life.

  20. Occupational Therapy Use by Older Adults With Cancer

    Science.gov (United States)

    Pergolotti, Mackenzi; Cutchin, Malcolm P.; Weinberger, Morris; Meyer, Anne-Marie

    2014-01-01

    Occupational therapy may significantly improve cancer survivors’ ability to participate in activities, thereby improving quality of life. Little is known, however, about the use of occupational therapy services by adults with cancer. The objective of this study was to understand what shapes patterns of occupational therapy use to help improve service delivery. We examined older (age >65 yr) adults diagnosed with breast, prostate, lung, or melanoma (skin) cancer between 2004 and 2007 (N = 27,131) using North Carolina Central Cancer Registry data linked to Medicare billing claims. Survivors who used occupational therapy within 1 yr before their cancer diagnosis were more likely to use occupational therapy after diagnosis but also experienced the highest levels of comorbidities. Survivors with Stage 4 cancers or lung cancer were less likely to use occupational therapy. These findings suggest possible disparities in utilization of occupational therapy by older adults with cancer. PMID:25184473

  1. Occupational therapy use by older adults with cancer.

    Science.gov (United States)

    Pergolotti, Mackenzi; Cutchin, Malcolm P; Weinberger, Morris; Meyer, Anne-Marie

    2014-01-01

    Occupational therapy may significantly improve cancer survivors' ability to participate in activities, thereby improving quality of life. Little is known, however, about the use of occupational therapy services by adults with cancer. The objective of this study was to understand what shapes patterns of occupational therapy use to help improve service delivery. We examined older (age >65 yr) adults diagnosed with breast, prostate, lung, or melanoma (skin) cancer between 2004 and 2007 (N = 27,131) using North Carolina Central Cancer Registry data linked to Medicare billing claims. Survivors who used occupational therapy within 1 yr before their cancer diagnosis were more likely to use occupational therapy after diagnosis but also experienced the highest levels of comorbidities. Survivors with Stage 4 cancers or lung cancer were less likely to use occupational therapy. These findings suggest possible disparities in utilization of occupational therapy by older adults with cancer. Copyright © 2014 by the American Occupational Therapy Association, Inc.

  2. No excess fatigue in young adult survivors of childhood cancer

    NARCIS (Netherlands)

    Langeveld, N. E.; Grootenhuis, M. A.; Voûte, P. A.; de Haan, R. J.; van den Bos, C.

    2003-01-01

    Clinical reports suggest that many survivors of childhood cancer experience fatigue as a long-term effect of their treatment. To investigate this issue further, we assessed the level of fatigue in young adult survivors of childhood cancer. We compared the results with a group of young adults with no

  3. Barriers and facilitators to sexual and reproductive health communication between pediatric oncology clinicians and adolescent and young adult patients: The clinician perspective.

    Science.gov (United States)

    Frederick, Natasha N; Campbell, Kevin; Kenney, Lisa B; Moss, Kerry; Speckhart, Ashley; Bober, Sharon L

    2018-04-26

    Sexual and reproductive health (SRH) is identified by adolescent and young adult (AYA) patients with cancer as an important but often neglected aspect of their comprehensive cancer care. The purpose of this study was to investigate the attitudes and perceptions of pediatric oncology clinicians towards discussing SRH with AYAs, and to understand perceived barriers to effective communication in current practice. Pediatric oncology clinicians (physicians, certified nurse practitioners, and physician assistants) participated in semi-structured qualitative interviews investigating attitudes about SRH communication with AYAs and barriers to such conversations. Twenty-two clinicians participated from seven institutions in the Northeastern United States. Interviews were audio-recorded, transcribed, and coded using a thematic analysis approach. Interviews with pediatric oncology clinicians revealed the following five primary themes: the role for pediatric oncology clinicians to discuss SRH, the focus of current SRH conversations on fertility, the meaning of "sexual health" as safe sex and contraception only, clinician-reported barriers to SRH conversations, and the need for education and support. Communication barriers included lack of knowledge/experience, lack of resources/referrals, low priority, parents/family, patient discomfort, clinician discomfort, time, and lack of rapport. Clinicians identified resource and support needs, including formal education and SRH education materials for patients and families. Although the study participants identified a role for pediatric oncology clinicians in SRH care for AYA patients with cancer, multiple barriers interfere with such discussions taking place on a regular basis. Future efforts must focus on resource development and provider education and training in SRH to optimize the care provided to this unique patient population. © 2018 Wiley Periodicals, Inc.

  4. Young people, adult worries: Randomized controlled trial and feasibility study of the internet-based self-support method "Feel the ViBe" for adolescents and young adults exposed to family violence

    NARCIS (Netherlands)

    Rosmalen-Nooijens, K.A. van; Lo Fo Wong, S.H.; Prins, J.B.; Lagro-Janssen, T.

    2017-01-01

    BACKGROUND: Adolescents and young adults (AYAs) are of special interest in a group of children exposed to family violence (FV). Past-year prevalence of exposure to FV is known to be highest in AYAs and has severe consequences. Peer support is an effective approach to behavior change and the Internet

  5. Adolescents and Young Adults' Perceptions of Electronic Cigarettes as a Gateway to Smoking: A Qualitative Study in Switzerland

    Science.gov (United States)

    Akre, Christina; Suris, Joan-Carles

    2017-01-01

    Electronic cigarettes (ECs) acting as a gateway to smoking traditional cigarettes (TCs) is a growing public health concern of EC use among youths. To gather the opinions and perceptions of adolescents and young adults (AYAs) on whether and how EC can act as a gateway to smoking TC among youths. A qualitative method included 42 AYAs. Participants…

  6. Patterns of family management for adolescent and young adult brain tumor survivors.

    Science.gov (United States)

    Deatrick, Janet A; Barakat, Lamia P; Knafl, George J; Hobbie, Wendy; Ogle, Sue; Ginsberg, Jill P; Fisher, Michael J; Hardie, Thomas; Reilly, Maureen; Broden, Elizabeth; Toth, Jennifer; SanGiacomo, Nicole; Knafl, Kathleen A

    2018-04-01

    Little is known about how families systemically incorporate the work of caring for adolescent and young adult (AYA) survivors of childhood brain tumors who often remain dependent on their families well into adulthood. The primary aim of this study was to develop a typology of family management (FM) patterns for AYA survivors. The secondary aims were to compare them with FM patterns previously described for children with chronic health conditions and to validate the patterns using quantitative and qualitative data. Guided by the Family Management Styles Framework, a sequential, mixed-methods design was used to gather quantitative data from 186 mothers (primary caregivers) and 134 AYA survivors. FM patterns (family focused; somewhat family focused; somewhat condition focused; and condition focused) were identified using cluster analysis of data from the Family Management Measure. FM patterns were found to be similar to those for children with chronic health physical conditions and were significantly related to maternal quality of life, survivor quality of life (health-related quality of life [self- and mother proxy report]), cancer-related variables (treatment intensity, medical late effects), and family functioning in theoretically meaningfully ways. Significant demographic characteristics included private insurance and AYA survivors' engagement in school or employment. Qualitative analysis of data from 45 interviews with mothers from the larger sample provided additional support for and elaborated descriptions of FM patterns. Identification of FM patterns moves the science of family caregiving forward by aggregating data into a conceptually based typology, thereby taking into account the complex intersection of the condition, the family, and condition management. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  7. Risk of thyroid cancer, brain cancer, and non-Hodgkin lymphoma after adult leukemia

    DEFF Research Database (Denmark)

    Nielsen, Sune F; Bojesen, Stig E; Birgens, Henrik S

    2011-01-01

    Patients with childhood leukemia surviving into adulthood have elevated risk of developing thyroid cancer, brain cancer, and non-Hodgkin lymphoma (NHL); these risks cannot automatically be extrapolated to patients surviving adult leukemia. We tested whether survivors of adult leukemia...... are at increased risk of developing thyroid cancer, brain cancer, and NHL. We included the entire adult Danish population (14 years of age or older), in a 28-year follow-up period from 1980 through 2007, composed of 6 542 639 persons; during this period, 18 834 developed adult leukemia, 4561 developed thyroid...... cancer, 13 362 developed brain cancer, and 15 967 developed NHL. In nested studies using Cox regression models on individual participant data, we found that, after adult leukemia, the multivariate adjusted hazard ratios were 4.9 (95% confidence interval [CI], 2.8-8.5) for thyroid cancer, 1.9 (95% CI, 1...

  8. Racial and Ethnic Disparities in the Incidence and Trends of Soft Tissue Sarcoma Among Adolescents and Young Adults in the United States, 1995-2008.

    Science.gov (United States)

    Hsieh, Mei-Chin; Wu, Xiao-Cheng; Andrews, Patricia A; Chen, Vivien W

    2013-09-01

    The aim of this study was to examine racial/ethnic disparities in the incidence rates and trends of soft tissue sarcoma (STS) by gender, age, and histological type among adolescents and young adults (AYAs) aged 15-29 years. The 1995-2008 incidence data from 25 population-based cancer registries, covering 64% of the United States population, were obtained from the North American Association of Central Cancer Registries. The Surveillance, Epidemiology and End Results AYA site recode and International Classification of Diseases for Oncology, 3rd Edition, were adopted to categorize STS histological types and anatomic groups. Age-adjusted incidence rates and average annual percent change (AAPC) were calculated. The incidence of all STSs combined was 34% higher in males than females (95% CI: 1.28, 1.39), 60% higher among blacks than whites (95% CI: 1.52, 1.68), and slightly higher among Hispanics than whites. Compared with whites, blacks had significantly higher incidence of fibromatous neoplasms, and Hispanics had significantly higher incidence of liposarcoma. Whites were more likely to be diagnosed with synovial sarcoma than blacks. Black and Hispanic males had significantly higher Kaposi sarcoma incidence than white males. The AAPC of all STSs combined showed a significant decrease from 1995 to 2008 (AAPC=-2.1%; 95% CI: -3.2%, -1.0%). However, after excluding Kaposi sarcoma, there was no significant trend. The incidence rates of STS histological types in AYAs vary among racial/ethnic groups. The declining trends of STS are due mainly to decreasing incidence of Kaposi sarcoma in all races/ethnicities. Research to identify factors associated with racial/ethnic disparities in AYA STS is necessary.

  9. Central nervous system tumours among adolescents and young adults (15-39 years) in Southern and Eastern Europe: Registration improvements reveal higher incidence rates compared to the US.

    Science.gov (United States)

    Georgakis, Marios K; Panagopoulou, Paraskevi; Papathoma, Paraskevi; Tragiannidis, Athanasios; Ryzhov, Anton; Zivkovic-Perisic, Snezana; Eser, Sultan; Taraszkiewicz, Łukasz; Sekerija, Mario; Žagar, Tina; Antunes, Luis; Zborovskaya, Anna; Bastos, Joana; Florea, Margareta; Coza, Daniela; Demetriou, Anna; Agius, Domenic; Strahinja, Rajko M; Sfakianos, Georgios; Nikas, Ioannis; Kosmidis, Sofia; Razis, Evangelia; Pourtsidis, Apostolos; Kantzanou, Maria; Dessypris, Nick; Petridou, Eleni Th

    2017-11-01

    To present incidence of central nervous system (CNS) tumours among adolescents and young adults (AYAs; 15-39 years) derived from registries of Southern and Eastern Europe (SEE) in comparison to the Surveillance, Epidemiology and End Results (SEER), US and explore changes due to etiological parameters or registration improvement via evaluating time trends. Diagnoses of 11,438 incident malignant CNS tumours in AYAs (1990-2014) were retrieved from 14 collaborating SEE cancer registries and 13,573 from the publicly available SEER database (1990-2012). Age-adjusted incidence rates (AIRs) were calculated; Poisson and joinpoint regression analyses were performed for temporal trends. The overall AIR of malignant CNS tumours among AYAs was higher in SEE (28.1/million) compared to SEER (24.7/million). Astrocytomas comprised almost half of the cases in both regions, albeit the higher proportion of unspecified cases in SEE registries (30% versus 2.5% in SEER). Similar were the age and gender distributions across SEE and SEER with a male-to-female ratio of 1.3 and an overall increase of incidence by age. Increasing temporal trends in incidence were documented in four SEE registries (Greater Poland, Portugal North, Turkey-Izmir and Ukraine) versus an annual decrease in Croatia (-2.5%) and a rather stable rate in SEER (-0.3%). This first report on descriptive epidemiology of AYAs malignant CNS tumours in the SEE area shows higher incidence rates as compared to the United States of America and variable temporal trends that may be linked to registration improvements. Hence, it emphasises the need for optimisation of cancer registration processes, as to enable the in-depth evaluation of the observed patterns by disease subtype. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Improving Access to Standardized Fertility Preservation Information for Older Adolescents and Young Adults with Cancer: Using a User-Centered Approach with Young Adult Patients, Survivors, and Partners to Refine Fertility Knowledge Transfer.

    Science.gov (United States)

    Tam, Seline; Puri, Natasha; Stephens, Derek; Mitchell, Laura; Giuliani, Meredith; Papadakos, Janet; Gupta, Abha A

    2016-09-27

    Adolescent and young adult (AYA) cancer patients under 40 should be made aware of their fertility risks and preservation options throughout their care. However, discussions on fertility preservation (FP) do not routinely occur. With a dearth of FP resources, oncology providers may lack knowledge around FP. Thus, informational needs can be unmet, leading to anxiety and distress in patients. Provision of pertinent and timely information can help patients cope better with their diagnosis. FP pamphlets were developed for men and women with cancer. A cross-sectional in-house survey, using convenience sampling, evaluated the pamphlets' effectiveness and measured ease of understanding, acceptability, and perceived utility. Patients and partners were also asked to provide recommendations and complete the Short Test of Functional Health Literacy in Adults (S-TOFHLA) measuring health literacy level. This helps determine if health literacy influences perception of pamphlet effectiveness. All participants (n = 56) reviewed both pamphlets. Fifty-four participants (96 %) found the pamphlet for men useful, while 29 participants (52 %) improved their male fertility knowledge. The pamphlet for women was useful for 52 participants (93 %) and improved knowledge in 35 (63 %) of them. Although the majority of participants had adequate health literacy (98 %), there was insufficient sample diversity to determine if health literacy influenced the pamphlet's effectiveness. Participants indicated preference in receiving verbal (73 %) and written (66 %) information over watching videos or in-class education. They recommended including fertility clinics, financial resources, and statistics in the brochures. These FP pamphlets were concluded as effective in supporting patients in making FP decisions.

  11. Acute lymphoblastic leukemia in adolescents and young adults.

    Science.gov (United States)

    Burke, Patrick W; Douer, Dan

    2014-01-01

    The cure rate of acute lymphoblastic leukemia (ALL) in children is 80%, compared to less than half in adults. A major proportion of this cure rate drop occurs in adolescents and young adults (AYAs). The age range defining this population varies between studies, biological characteristics are different from both younger children and older adults, and AYAs are treated either by pediatric or adult oncologists, who often apply different treatment approaches to the same ALL patient population. The outcome of AYAs aged 15-21 years treated by more contemporary pediatric protocols is similar to that of younger children but is inferior when using adult regimens. This motivated studying AYA patients, including those above the age of 21 years, with pediatric or 'pediatrics-inspired' regimens that intensified nonmyelosuppressive drugs such as vincristine, steroids and asparaginase, with very promising preliminary results. Discovering new mutations in AYA ALL will help stratify patients into risk subgroups and identify targets for novel agents. This, together with fine-tuning pediatric chemotherapy principles will hopefully finally decrease the cure rate gap between children and AYAs - and even older adults. © 2014 S. Karger AG, Basel.

  12. Dietary intake and nutritional status in cancer patients; comparing adults and older adults.

    Science.gov (United States)

    Gómez Valiente da Silva, Henyse; Fonseca de Andrade, Camila; Bello Moreira, Annie Seixas

    2014-04-01

    Evaluate the nutrient intake and nutritional status of food in cancer patients admitted to a university hospital, with comparison of adult and older adult age category. Cross-sectional study. This study involved cancer patients admitted to a hospital in 2010. Dietary habits were collected using a Brazilian food frequency questionnaire. Participants were divided in two groups: adults or older adults and in 4-cancer category: hematologic, lung, gastrointestinal and others. Body Mass Index evaluated nutritional status. A total of 86 patients with a mean age of 56.5 years, with 55% males and 42% older adults were evaluated. The older adult category had a higher frequency of being underweight (24.4% vs 16.3%, p cancer, nor with nutritional status. The food intake, macro and micronutrients ingestion is insufficient among cancer individuals. Food intake of older adults was inferior, when compared to the adult category. There was a high prevalence of BMI excess in the adult group and a worst nutritional status in the older adult category. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  13. The need for control, safety and trust in healthcare: A qualitative study among adolescents and young adults exposed to family violence

    NARCIS (Netherlands)

    Rosmalen-Nooijens, K.A.W.L. van; Lo Fo Wong, S.H.; Prins, J.B.; Lagro-Janssen, A.L.M.

    2017-01-01

    OBJECTIVE: Adolescents and young adults (AYA) exposed to family violence are in need of professional healthcare. However, only one-third of them seek professional help. METHODS: This study investigates healthcare needs of twelve AYA exposed to family violence. Semi-structured face-to-face interviews

  14. Symptom burden among young adults with breast or colorectal cancer.

    Science.gov (United States)

    Sanford, Stacy D; Zhao, Fengmin; Salsman, John M; Chang, Victor T; Wagner, Lynne I; Fisch, Michael J

    2014-08-01

    Cancer incidence has increased among young adults (YAs) and survival rates have not improved compared with other age groups. Patient-reported outcomes may enhance our understanding of this vulnerable population. In a multisite prospective study, patients completed a cancer symptom inventory at the time of enrollment (T1) and 4 weeks to 5 weeks later (T2). YAs (those aged ≤ 39 years) with breast or colorectal cancer were compared with older adults (those aged ≥ 40 years) with breast or colorectal cancer with regard to symptom severity, symptom interference, changes over time, and medical care. Participants included 1544 patients with breast cancer (96 of whom were YAs) and 718 patients with colorectal cancer (37 of whom were YAs). Compared with older adults, YAs with breast cancer were more likely to report moderate/severe drowsiness, hair loss, and symptom interference with relationships at T1. YAs with colorectal cancer were more likely to report moderate/severe pain, fatigue, nausea, distress, drowsiness, shortness of breath, and rash plus interference in general activity, mood, work, relationships, and life enjoyment compared with older adults. Compared with older adults, shortness of breath, appetite, and sore mouth were more likely to improve in YAs with breast cancer; vomiting was less likely to improve in YAs with colorectal cancer. Referrals for supportive care were few, especially among patients with colorectal cancer. YAs with breast cancer were somewhat more likely to be referred to nutrition and psychiatry services than older patients. YAs reported symptom severity, symptom interference, and variations over time that were distinct from older patients. Distinctions were found to differ by diagnostic group. These findings enhance the understanding of symptom burden in YAs and inform the development of targeted interventions and future research. © 2014 American Cancer Society.

  15. Symptom distress in older adults following cancer surgery.

    Science.gov (United States)

    Van Cleave, Janet H; Egleston, Brian L; Ercolano, Elizabeth; McCorkle, Ruth

    2013-01-01

    Symptom distress remains a significant health problem among older adults with cancer following surgery. Understanding factors influencing older adults' symptom distress may lead to early identification and interventions, decreasing morbidity and improving outcomes. We conducted this study to identify factors associated with symptom distress following surgery among 326 community-residing patients 65 years or older with a diagnosis of thoracic, digestive, gynecologic, and genitourinary cancers. This secondary analysis used combined subsets of data from 5 nurse-directed intervention clinical trials targeting patients after surgery at academic cancer centers in northwest and northeastern United States. Symptom distress was assessed by the Symptom Distress Scale at baseline and at 3 and 6 months. A multivariable analysis, using generalized estimating equations, showed that symptom distress was significantly less at 3 and 6 months (3 months: P psychological, treatment, and function covariates. Thoracic cancer, comorbidities, worse mental health, and decreased function were, on average, associated with increased symptom distress (all P cancer, comorbidities, mental health, and function may influence older adults' symptom distress following cancer surgery. Older adults generally experience decreasing symptom distress after thoracic, abdominal, or pelvic cancer surgery. Symptom management over time for those with thoracic cancer, comorbidities, those with worse mental health, those with decreased function, and those 75 years or older may prevent morbidity and improve outcomes of older adults following surgery.

  16. Occupational Therapy Use by Older Adults With Cancer

    OpenAIRE

    Pergolotti, Mackenzi; Cutchin, Malcolm P.; Weinberger, Morris; Meyer, Anne-Marie

    2014-01-01

    A retrospective cohort study of 27,131 older adults diagnosed with cancer between 2004 and 2007 found that survivors who used occupational therapy after diagnosis also had the highest levels of comorbidities.

  17. Distress among young adult cancer survivors: a cohort study.

    Science.gov (United States)

    Yanez, Betina; Garcia, Sofia F; Victorson, David; Salsman, John M

    2013-09-01

    Being diagnosed with cancer as a young adult can lead to significant psychological distress and impaired quality of life. Compared to children and older adults diagnosed with cancer, fewer studies have addressed psychological distress among young adult cancer survivors. This study sought to identify the prevalence of, and factors associated with, distress among young adult cancer survivors (ages 18-39). Young adult cancer survivors (N = 335, mean age = 31.8, women = 68.4%) were recruited from an online research panel and stratified by cohort (time postactive treatment: 0-12, 13-24, and 25-60 months). Participants completed measures assessing demographic and clinical characteristics, global impact of cancer, cancer-related education and work interruption, and cancer-specific distress using the impact of event scale (IES). The mean score on the IES (M = 31.0, range = 0-75) was above the cut point of 20, suggesting clinically elevated distress. Analysis of covariance revealed significant main effects for cohort, global impact and cancer-related education/work interruption, and an interaction between cohort and cancer-related education/work interruption on distress. Although there was no significant effect of education/work interruption on distress for those in the 0-12 month cohort (p = .88), survivors in the 13-24 and 25-60 month cohorts reporting education/work interruption were significantly more distressed than those not reporting education/work interruption in the respective cohorts (p cancer survivors face unique challenges. These data underscore the importance of attending to cancer-related distress beyond the completion of treatment and may help inform targeted interventions to prevent or reduce significant distress and related sequelae in this population.

  18. Manifestasi Kebutuhan Bertingkat Tokoh Aya Kito Dalam Novel One Liter of Tears Melalui Pendekatan Psikologi Humanistik Abraham Maslow

    OpenAIRE

    RACHMAWATI, DEVI SHINTA

    2013-01-01

    Novel is one of literary fiction exciting and in demand by today's society. Novel One Liter of Tears can be analyzed through a variety of approaches one through the psychological approach, in this case the approach of humanistic psychology of Abraham Maslow. This study answers the formulation of the problem, namely, how the needs of multilevel manifestation Aya character in the novel One Litre of Tears through the approach of humanistic psychology of Abraham Maslow. Analyzed from the humanist...

  19. Childhood body mass index and risk of adult pancreatic cancer

    DEFF Research Database (Denmark)

    Nogueira, Leticia; Stolzenberg-Solomon, Rachael; Gamborg, Michael

    2017-01-01

    incident pancreatic cancer cases from 1968-2012. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Cox proportional hazard regressions. Results: During 8,207,015 person-years of follow-up, 1,268 pancreatic cancer cases were diagnosed. Childhood BMI z-scores at ages 7-13 years were......Background: Excess weight in adulthood is one of the few modifiable risk factors for pancreatic cancer, and height has associations as well. This leads to question whether body weight and height in childhood are associated with adult pancreatic cancer. Objective: To examine if childhood body mass...... from 7-13 years is positively and linearly associated with adult pancreatic cancer; the higher the BMI, the higher the risk. Excess childhood BMI may be indicative of processes initiated early in life that lead to this cancer. Prevention of childhood adiposity may decrease the burden of pancreatic...

  20. Posttraumatic stress symptoms in adult survivors of childhood cancer

    NARCIS (Netherlands)

    Langeveld, N. E.; Grootenhuis, M. A.; Voûte, P. A.; de Haan, R. J.

    2004-01-01

    Background. Previous research suggests that posttraurnatic stress disorder (PTSD) is present in survivors of childhood cancer. The aim of the current study was to explore posttraurnatic stress symptoms in a sample of young adult survivors of childhood cancer. In addition, the impact of demographic,

  1. Illness appraisals and health-related quality of life in adolescents and young adults with allergies and asthma.

    Science.gov (United States)

    Hullmann, Stephanie E; Eddington, Angelica R; Molzon, Elizabeth S; Mullins, Larry L

    2013-01-01

    The current study sought to: 1) assess differences in levels of physical and mental health-related quality of life (HRQOL), illness uncertainty, and intrusiveness in adolescents and young adults (AYAs) with allergies and asthma, as well as 2) examine the effect of illness appraisals on HRQOL. Participants were undergraduate students with self-reported allergies (n=74) and asthma (n=74) who completed the Mishel Uncertainty in Illness Scale (MUIS), the Illness Intrusiveness Scale (IIS), and the SF-36 Health Survey Questionnaire. Paired t-tests indicated that AYAs with allergies reported higher levels of illness uncertainty and poorer mental HRQOL than AYAs with asthma; the groups did not differ on reported levels of illness intrusiveness or physical HRQOL. Hierarchical regressions were conducted to examine the relationship between illness appraisals and HRQOL. Results revealed that poorer mental HRQOL was associated with higher illness uncertainty in AYAs with allergies and higher illness intrusiveness in AYAs with asthma. Poorer physical HRQOL was associated with higher illness uncertainty in AYAs with asthma and higher illness intrusiveness in AYAs with allergies and asthma. The current examination suggests that illness appraisals may be differentially related to HRQOL in AYAs with allergies compared to those with asthma.

  2. Risk of thyroid cancer, brain cancer, and non-Hodgkin lymphoma after adult leukemia

    DEFF Research Database (Denmark)

    Nielsen, Sune F; Bojesen, Stig E; Birgens, Henrik S

    2011-01-01

    .2-3.1) for brain cancer, and 3.3 (95% CI, 2.5-4.4) for NHL. Corresponding hazard ratios after childhood leukemia were 10.4 (95% CI, 0.4-223) for thyroid cancer, 7.2 (95% CI, 2.0-26) for brain cancer, and 6.5 (95% CI, 0.4-110) for NHL. Patients with adult leukemia have excess risk of thyroid cancer, brain cancer......Patients with childhood leukemia surviving into adulthood have elevated risk of developing thyroid cancer, brain cancer, and non-Hodgkin lymphoma (NHL); these risks cannot automatically be extrapolated to patients surviving adult leukemia. We tested whether survivors of adult leukemia...... are at increased risk of developing thyroid cancer, brain cancer, and NHL. We included the entire adult Danish population (14 years of age or older), in a 28-year follow-up period from 1980 through 2007, composed of 6 542 639 persons; during this period, 18 834 developed adult leukemia, 4561 developed thyroid...

  3. Occupational Therapy for Adults With Cancer: Why It Matters

    OpenAIRE

    Pergolotti, Mackenzi; Williams, Grant R.; Campbell, Claudine; Munoz, Lauro A.; Muss, Hyman B.

    2016-01-01

    Adults with cancer may be at risk for limitations in functional status and quality of life (QOL). Occupational therapy is a supportive service with the specific mission to help people functionally engage in life as safely and independently as possible with the primary goal of improving QOL. Unfortunately, for people with cancer, occupational therapy remains underused. The overall purpose of this review is to provide an understanding of what occupational therapy is and its relevance to patient...

  4. Occupational Therapy for Adults With Cancer: Why It Matters.

    Science.gov (United States)

    Pergolotti, Mackenzi; Williams, Grant R; Campbell, Claudine; Munoz, Lauro A; Muss, Hyman B

    2016-03-01

    Adults with cancer may be at risk for limitations in functional status and quality of life (QOL). Occupational therapy is a supportive service with the specific mission to help people functionally engage in life as safely and independently as possible with the primary goal of improving QOL. Unfortunately, for people with cancer, occupational therapy remains underused. The overall purpose of this review is to provide an understanding of what occupational therapy is and its relevance to patients with cancer, highlight the reasons to refer, and, last, provide general advice on how to access services. ©AlphaMed Press.

  5. Patient characteristics and outcomes in adolescents and young adults with classical Philadelphia chromosome-negative myeloproliferative neoplasms.

    Science.gov (United States)

    Boddu, Prajwal; Masarova, Lucia; Verstovsek, Srdan; Strati, Paolo; Kantarjian, Hagop; Cortes, Jorge; Estrov, Zeev; Pierce, Sherry; Pemmaraju, Naveen

    2018-01-01

    Little is known about the outcomes of Philadelphia-negative myeloproliferative neoplasms (MPNs) in adolescents and young adults (AYA). We reviewed all patients with essential thrombocythemia (ET), polycythemia vera (PV), and myelofibrosis (MF) treated at our institution from 1988 to 2016 who were aged 16 to 39 years (AYA) and described their outcomes in comparison to older MPN population. Of 2206 patients, 185 (8.3%) were identified as AYA: 105 (57%) ET, 43 (23%) PV, and 37 (20%) MF. The median age was 33 years [range, 16-39], and median follow-up time 3 years [range, 0.04-25]. JAK2 allele burdens were significantly lower among AYA JAK2V617F-mutated patients in both PV (p = 0.001) and MF (p = 0.005). Seven percent of MPN AYA patients were diagnosed with a thrombotic event at, or prior to, diagnosis. Over the short median follow-up, 4 thrombotic (PV = 1, MF = 3) and 3 leukemia (ET = 2, MF = 1) events occurred. In multivariate analysis, AYA did not predict for thrombotic or transformational events across three cohorts. In the MF cohort, there was a reduced frequency of negative prognostic variables of anemia (p = 0.011) and leukocytosis (p = 0.048) in AYA when compared with non-AYA. Overall survival was significantly superior in the AYA cohorts in all three MPN groups, namely MF (p < 0.001), PV (p < 0.001), and ET (p = 0.002). Our findings suggest that MPN AYA patients exhibit an indolent clinical phenotype characterized by favorable survival outcomes.

  6. Cancer treatment decision-making among young adults with lung and colorectal cancer: a comparison with adults in middle age.

    Science.gov (United States)

    Mack, Jennifer W; Cronin, Angel; Fasciano, Karen; Block, Susan D; Keating, Nancy L

    2016-09-01

    Our aim is to understand experiences with treatment decision-making among young adults with cancer. We studied patients with lung cancer or colorectal cancer in the Cancer Care Outcomes Research and Surveillance Consortium, a prospective cohort study. We identified 148 young adult patients aged 21-40 years who completed baseline interview questions about cancer treatment decision-making; each was propensity score matched to three middle adult patients aged 41-60 years, for a cohort of 592 patients. Patients were asked about decision-making preferences, family involvement in decision-making, and worries about treatment. An ordinal logistic regression model evaluated factors associated with more treatment worries. Young and middle-aged adults reported similar decision-making preferences (p = 0.80) and roles relative to physicians (p = 0.36). Although family involvement was similar in the age groups (p = 0.21), young adults were more likely to have dependent children in the home (60% younger versus 28% middle-aged adults, p Young adults reported more worries about time away from family (p = 0.002), and, in unadjusted analyses, more cancer treatment-related worries (mean number of responses of 'somewhat' or 'very' worried 2.5 for younger versus 2.2 for middle-aged adults, p = 0.02.) However, in adjusted analyses, worries were associated with the presence of dependent children in the home (odds ratio [OR] 1.55, 95% CI = 1.07-2.24, p = 0.02), rather than age. Young adults involve doctors and family members in decisions at rates similar to middle-aged adults but experience more worries about time away from family. Patients with dependent children are especially likely to experience worries. Treatment decision-making strategies should be based on individual preferences and needs rather than age alone. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  7. Overweight duration in older adults and cancer risk

    DEFF Research Database (Denmark)

    Arnold, Melina; Freisling, Heinz; Stolzenberg-Solomon, Rachael

    2016-01-01

    Recent studies have shown that cancer risk related to overweight and obesity is mediated by time and might be better approximated by using life years lived with excess weight. In this study we aimed to assess the impact of overweight duration and intensity in older adults on the risk of developing...

  8. Acute lymphoblastic leukemia in adolescents and young adults.

    Science.gov (United States)

    Ribera, Josep-Maria; Oriol, Albert

    2009-10-01

    Today, long-term survival is achieved in more than 80% of children 1 to 10 years old with acute lymphoblastic leukemia (ALL). However, cure rates for adults and adolescents and young adults (AYA) with ALL remain relatively low, at only 40% to 50%. Age is a continuous prognostic variable in ALL, with no single age at which prognosis deteriorates markedly. Within childhood ALL populations, older children have shown inferior outcomes, whereas younger adults have shown superior outcomes among adult ALL patients. The type of treatment (pediatric-based versus adult-based) for AYA has recently been a matter of debate. In this article the biology and treatment of ALL in AYA is reviewed.

  9. PROVIDING AFFORDABLE HIGHER EDUCATION TO RURAL GIRLS IN INDIAN PUNJAB: A CASE STUDY OF BABA AYA SINGH RIARKI COLLEGE

    Directory of Open Access Journals (Sweden)

    RANJIT SINGH GHUMAN

    2013-12-01

    Full Text Available The paper highlights a case study of a rural girls college located in a remote village of Gurdaspur district in Indian Punjab. The idea of this unique college was conceptualised by one Baba Aya Singh, a social and religious activist, from a village near the college way back in 1925. It was really a revolutionary idea because female education in India, particularly higher education, was a distant dream at that time. The college was, however, started with only 14 rural girls after about half-a-century when the great visionary Baba Aya Singh had a dream to educate the rural girls. Access to and affordability of higher education is the uniqueness of this college. The student has to pay only Rs. 5800 (about US $ 65 per annum, which includes both the tuition fee and boarding and lodging. It is equally significant to note that the entire expenses of the college are met by this and the produce of agricultural land of the college. The college does not take any outside help. The meritorious senior class students teach the junior class students. The college in its own humble, but significant, way made a revolutionary contribution to the education of poor rural girls who, otherwise, would not have dreamt of college education. Apart from, class-room teaching and bookish knowledge, the students are taught social, ethical and management skills in a most natural manner. The product of the college has proved to be the agents of change and rural transformation.

  10. A social-ecological model of readiness for transition to adult-oriented care for adolescents and young adults with chronic health conditions.

    Science.gov (United States)

    Schwartz, L A; Tuchman, L K; Hobbie, W L; Ginsberg, J P

    2011-11-01

    Policy and research related to transition to adult care for adolescents and young adults (AYAs) has focused primarily on patient age, disease skills and knowledge. In an effort to broaden conceptualization of transition and move beyond isolated patient variables, a new social-ecological model of AYA readiness for transition (SMART) was developed. SMART development was informed by related theories, literature, expert opinion and pilot data collection using a questionnaire developed to assess provider report of SMART components with 100 consecutive patients in a childhood cancer survivorship clinic. The literature, expert opinion and pilot data collection support the relevance of SMART components and a social-ecological conceptualization of transition. Provider report revealed that many components, representing more than age, disease knowledge and skills, related to provider plans for transferring patients. SMART consists of inter-related constructs of patients, parents and providers with emphasis on variables amenable to intervention. Results support SMART's broadened conceptualization of transition readiness and need for assessment of multiple stakeholders' perspectives of patient transition readiness. A companion measure of SMART, which will be able to be completed by patients, parents and providers, will be developed to target areas of intervention to facilitate optimal transition readiness. Similar research programmes to establish evidence-based transition measures and interventions are needed. © 2011 Blackwell Publishing Ltd.

  11. Treatment of Head and Neck Cancer in Adults - Health Professional Version

    Science.gov (United States)

    Find information about prognosis, staging, and treatment for adult head and neck cancer sites: hypopharynx, larynx, lip and oral cavity, neck cancer with occult primary, nasopharynx, oropharynx, paranasal sinus and nasal cavity, and salivary gland cancer.

  12. Adult Liver Cancer Symptoms, Tests, Prognosis, and Stages (PDQ®)—Patient Version

    Science.gov (United States)

    Hepatocellular carcinoma is the most common type of adult primary liver cancer. The Barcelona Clinical Liver Cancer (BCLC) Staging System is used to stage liver cancer. Learn more about risk factors, signs and symptoms, tests to diagnose, prognosis, and stages of adult primary liver cancer.

  13. Adoption consideration and concerns among young adult female cancer survivors.

    Science.gov (United States)

    Gorman, Jessica R; Whitcomb, Brian W; Standridge, Daniel; Malcarne, Vanessa L; Romero, Sally A D; Roberts, Samantha A; Su, H Irene

    2017-02-01

    We compared adoption consideration between female young adult cancer survivors and women of the same age in the general US population, hypothesizing that cancer survivors who desired children would report greater interest in adoption than an age-adjusted general population sample who desired children. After age-standardizing the cancer survivor cohort to match the age distribution of the 2006-2010 National Survey for Family Growth (NSFG), we estimated adoption consideration among women age 18-35 years who wanted a (another) child in the two cohorts overall and within age groups. We assessed characteristics and concerns related to adoption consideration among cancer survivors. Among cancer survivors, 81.6 % (95 % CI 75.7-87.6) reported that they would consider adoption compared to 40.3 % (95 % CI 40.3-40.3) of women in the general population. While over 80 % of the cancer survivor sample reported that they would consider adoption, only 15 % of cancer survivors reported no concerns about adoption. The most common concerns were desire for a biological child (48 %), expense (45 %), adoption agency candidacy (41 %), and needing more information (39 %). We observed a twofold higher interest in adoption when comparing the cancer survivor with the general population, suggesting that adoption is a consideration for many young women who have survived cancer. Adoption is an important family-building option for those who want to have a child but are unable to or choose not to have a biological child. However, young adult survivors may need more support to understand and navigate this process.

  14. Health Literacy: Cancer Prevention Strategies for Early Adults.

    Science.gov (United States)

    Simmons, Robert A; Cosgrove, Susan C; Romney, Martha C; Plumb, James D; Brawer, Rickie O; Gonzalez, Evelyn T; Fleisher, Linda G; Moore, Bradley S

    2017-09-01

    Health literacy, the degree to which individuals have the capacity to obtain, process, and understand health information and services needed to make health decisions, is an essential element for early adults (aged 18-44 years) to make informed decisions about cancer. Low health literacy is one of the social determinants of health associated with cancer-related disparities. Over the past several years, a nonprofit organization, a university, and a cancer center in a major urban environment have developed and implemented health literacy programs within healthcare systems and in the community. Health system personnel received extensive health literacy training to reduce medical jargon and improve their patient education using plain language easy-to-understand written materials and teach-back, and also designed plain language written materials including visuals to provide more culturally and linguistically appropriate health education and enhance web-based information. Several sustainable health system policy changes occurred over time. At the community level, organizational assessments and peer leader training on health literacy have occurred to reduce communication barriers between consumers and providers. Some of these programs have been cancer specific, including consumer education in such areas as cervical cancer, skin cancer, and breast cancer that are targeted to early adults across the cancer spectrum from prevention to treatment to survivorship. An example of consumer-driven health education that was tested for health literacy using a comic book-style photonovel on breast cancer with an intergenerational family approach for Chinese Americans is provided. Key lessons learned from the health literacy initiatives and overall conclusions of the health literacy initiatives are also summarized. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  15. Screening for thyroid cancer in survivors of childhood and young adult cancer treated with neck radiation.

    Science.gov (United States)

    Tonorezos, Emily S; Barnea, Dana; Moskowitz, Chaya S; Chou, Joanne F; Sklar, Charles A; Elkin, Elena B; Wong, Richard J; Li, Duan; Tuttle, R Michael; Korenstein, Deborah; Wolden, Suzanne L; Oeffinger, Kevin C

    2017-06-01

    The optimal method of screening for thyroid cancer in survivors of childhood and young adult cancer exposed to neck radiation remains controversial. Outcome data for a physical exam-based screening approach are lacking. We conducted a retrospective review of adult survivors of childhood and young adult cancer with a history of neck radiation followed in the Adult Long-Term Follow-Up Clinic at Memorial Sloan Kettering between November 2005 and August 2014. Eligible patients underwent a physical exam of the thyroid and were followed for at least 1 year afterwards. Ineligible patients were those with prior diagnosis of benign or malignant thyroid nodules. During a median follow-up of 3.1 years (range 0-9.4 years), 106 ultrasounds and 2277 physical exams were performed among 585 patients. Forty survivors had an abnormal thyroid physical exam median of 21 years from radiotherapy; 50% of those with an abnormal exam were survivors of Hodgkin lymphoma, 60% had radiation at ages 10-19, and 53% were female. Ultimately, 24 underwent fine needle aspiration (FNA). Surgery revealed papillary carcinoma in seven survivors; six are currently free of disease and one with active disease is undergoing watchful waiting. Among those with one or more annual visits, representing 1732 person-years of follow-up, no cases of thyroid cancer were diagnosed within a year of normal physical exam. These findings support the application of annual physical exam without routine ultrasound for thyroid cancer screening among survivors with a history of neck radiation. Survivors with a history of neck radiation may not require routine thyroid ultrasound for thyroid cancer screening. Among adult survivors of childhood and young adult cancer with a history of radiation therapy to the neck, annual physical exam is an acceptable thyroid cancer screening strategy.

  16. Psychological, social, and behavioral issues for young adults with cancer.

    Science.gov (United States)

    Zebrack, Brad J

    2011-05-15

    Theories of human development suggest that, although all cancer patients experience a common set of life disruptions, they experience them differently, focus on different issues, and attach different levels of importance to different aspects of the experience depending on the time in life at which they were diagnosed. During the critical developmental transition from childhood to adulthood, older adolescents and young adults in particular have typical concerns with establishing identity, developing a positive body image and sexual identity, separating from parents, increasing involvement with peers and dating, and beginning to make decisions about careers or employment, higher education, and/or family. Accordingly, cancer-related issues such as premature confrontation with mortality, changes in physical appearance, increased dependence on parents, disruptions in social life and school/employment because of treatment, loss of reproductive capacity, and health-related concerns about the future may be particularly distressing for adolescents and young adults. Psychosocial and behavioral interventions for young adult cancer patients and survivors often involve assisting these individuals in retaining or returning to function in significant social roles, such as spouse, parent, student, worker, or friend. Successful interventions will enable these young people to overcome the detrimental impact of a health crisis and strengthen the internal and external coping resources available to them. © 2011 American Cancer Society

  17. Estimating cancer risks to adults undergoing body CT examinations

    International Nuclear Information System (INIS)

    Huda, W.; He, W.

    2012-01-01

    The purpose of the study is to estimate cancer risks from the amount of radiation used to perform body computed tomography (CT) examination. The ImPACT CT Patient Dosimetry Calculator was used to compute values of organ doses for adult body CT examinations. The radiation used to perform each examination was quantified by the dose-length product (DLP). Patient organ doses were converted into corresponding age and sex dependent cancer risks using data from BEIR VII. Results are presented for cancer risks per unit DLP and unit effective dose for 11 sensitive organs, as well as estimates of the contribution from 'other organs'. For patients who differ from a standard sized adult, correction factors based on the patient weight and antero-posterior dimension are provided to adjust organ doses and the corresponding risks. At constant incident radiation intensity, for CT examinations that include the chest, risks for females are markedly higher than those for males, whereas for examinations that include the pelvis, risks in males were slightly higher than those in females. In abdominal CT scans, risks for males and female patients are very similar. For abdominal CT scans, increasing the patient age from 20 to 80 resulted in a reduction in patient risks of nearly a factor of 5. The average cancer risk for chest/abdomen/pelvis CT examinations was ∼26 % higher than the cancer risk caused by 'sensitive organs'. Doses and radiation risks in 80 kg adults were ∼10 % lower than those in 70 kg patients. Cancer risks in body CT can be estimated from the examination DLP by accounting for sex, age, as well as patient physical characteristics. (authors)

  18. [Nodular gastritis and gastric cancer in young adult].

    Science.gov (United States)

    Kamada, Tomoari; Shiotani, Akiko; Haruma, Ken

    2012-10-01

    Nodular gastritis is a popular endoscopic gastritis in H. pylori-positive children and young adults. The endoscopic findings of nodular gastritis were mainly characterized by a unique, small granulated pattern in the antrum of the stomach. The cases of gastric cancer with nodular gastritis showed the same characteristics: all were diagnosed histologically as the diffuse-type and were located in the corpus with H. pylori infection. We recommended that endoscopists should carefully examine not only the antrum but also the corpus in patients with nodular gastritis, and H. pylori should be eradicated as soon as possible to prevent gastric cancer.

  19. Posttraumatic stress symptoms in adult survivors of childhood cancer.

    Science.gov (United States)

    Langeveld, N E; Grootenhuis, M A; Voûte, P A; de Haan, R J

    2004-06-01

    Previous research suggests that posttraumatic stress disorder (PTSD) is present in survivors of childhood cancer. The aim of the current study was to explore posttraumatic stress symptoms in a sample of young adult survivors of childhood cancer. In addition, the impact of demographic, medical and treatment factors on survivors' posttraumatic stress symptoms was studied. Participants were 500 long-term survivors of childhood cancer. The median age at follow-up was 24 years (age range, 16- 49 years, 47% female). To assess symptoms of posttraumatic stress, all participants completed the Impact of Event Scale (IES), a self-report instrument consisting of two subscales, intrusion and avoidance. Twelve percent of this sample of adult survivors of childhood cancer had scores in the severe range, indicating they are unable to cope with the impact of their disease and need professional help. Twenty percent of the female survivors had scores in the severe range as compared with 6% of the male survivors. Linear regression models revealed that being female, unemployed, a lower educational level, type of diagnosis and severe late effects/health problems were associated with posttraumatic stress symptoms. The results indicate that, although the proportion of survivors reporting symptoms is well within the proportions found in the general population, a substantial subset of survivors report symptoms of posttraumatic stress. This finding supports the outcomes reported previously that diagnosis and treatment for childhood cancer may have significant long-term effects, which are manifested in symptoms of posttraumatic stress. The investigated factors could explain posttraumatic stress symptoms only to a limited extent. Further research exploring symptoms of posttraumatic stress in childhood cancer survivors in more detail is clearly warranted. From a clinical perspective, health care providers must pay attention to these symptoms during evaluations in the follow-up clinic. Early

  20. Recruiting Young Adult Cancer Survivors for Behavioral Research

    Science.gov (United States)

    Horowitz, Santina; Marcus, Bess

    2012-01-01

    Young adults have been dramatically underrepresented in cancer survivorship research. One contributing factor is the difficulty recruiting this population. To identify effective recruitment strategies, the current study assessed the yield of strategies used to recruit young survivors for an exercise intervention including: clinic-based recruitment, recruitment at cancer-related events, mailings, telephone-based recruitment, advertising on the internet, radio, television and social networking media, distributing brochures and word-of-mouth referrals. When taking into account the strategies for which we could track the number of survivors approached, recruitment at an oncology clinic was the most productive: 38 % of those approached were screened and 8 % enrolled. When evaluating which strategy yielded the greatest percentage of the sample, however, mailings were the most productive. Given widespread use of the internet and social networking by young adults, investigators should also consider these low-cost recruitment strategies. PMID:22810954

  1. [Endocrine consequences in young adult survivors of childhood cancer treatment].

    Science.gov (United States)

    Leroy, C; Cortet-Rudelli, C; Desailloud, R

    2015-10-01

    Endocrine complications (particularly gonadal, hypothalamic-pituitary and metabolic) of childhood cancer treatments are common in young adults. Gonadal damage may be the result of chemotherapy or radiotherapy. Fertility preservation must be systematically proposed before initiation of gonadotoxic treatment if only the child is eligible. Hypothalamic-pituitary deficiency is common after brain or total-body irradiation, the somatotropic axis is the most sensitive to irradiation. Pituitary deficiency screening must be repeated since this endocrine consequence can occur many years after treatment. Hormone replacement must be prudent particularly in case of treatment with growth hormone or steroids. Metabolic syndrome, diabetes and cardiovascular damage resulting from cancer treatments contribute to the increase of morbidity and mortality in this population and should be screened routinely even if the patient is asymptomatic. The multidisciplinary management of these adults must be organized and the role of the endocrinologist is now well established. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  2. Recruiting young adult cancer survivors for behavioral research.

    Science.gov (United States)

    Rabin, Carolyn; Horowitz, Santina; Marcus, Bess

    2013-03-01

    Young adults have been dramatically underrepresented in cancer survivorship research. One contributing factor is the difficulty recruiting this population. To identify effective recruitment strategies, the current study assessed the yield of strategies used to recruit young survivors for an exercise intervention including: clinic-based recruitment, recruitment at cancer-related events, mailings, telephone-based recruitment, advertising on the internet, radio, television and social networking media, distributing brochures and word-of-mouth referrals. When taking into account the strategies for which we could track the number of survivors approached, recruitment at an oncology clinic was the most productive: 38 % of those approached were screened and 8 % enrolled. When evaluating which strategy yielded the greatest percentage of the sample, however, mailings were the most productive. Given widespread use of the internet and social networking by young adults, investigators should also consider these low-cost recruitment strategies.

  3. Diffusion-weighted MRI of adult male pelvic cancers

    International Nuclear Information System (INIS)

    Lim, K.S.; Tan, C.H.

    2012-01-01

    Magnetic resonance imaging (MRI), with its superior soft-tissue delineation, plays a pivotal role in the staging and surveillance of cancers affecting adult males, in particular, rectal, urinary bladder, and prostate cancers. There has been much recent interest in the complementary roles of diffusion-weighted imaging (DWI) for imaging of pelvic cancers. DWI measures the diffusivity of water molecules in biological tissue. Cancer, with its high cellular density and nuclear:cytoplasmic ratio, and extracellular disorganization, typically shows significant restricted diffusivity compared with surrounding normal tissue. In theory, diffusivity of water molecules may vary according to degree of tumour aggressiveness and changes in cell density and extracellular fluid content after treatment. Information regarding these variations may be used to study the histological grades of cancers and their response to treatment. In this article, we present the currently available evidence on the potential roles of DWI for the assessment of pelvic cancers in men, and demonstrate with imaging examples how this knowledge may be applied to daily clinical practice.

  4. Participation in Daily Activities of Young Adults with High Functioning Autism Spectrum Disorder

    Science.gov (United States)

    McCollum, Mary; LaVesser, Patti; Berg, Christine

    2016-01-01

    Young adults with an autism spectrum disorder (ASD) struggle to assume adult roles. This research assessed the feasibility of using the Adolescent and Young Adult Activity Card Sort (AYA-ACS) with emerging adults with high functioning ASD. Two phases were utilized during this research: (1) comparing the activity participation reported by emerging…

  5. Executive Functioning, Barriers to Adherence, and Nonadherence in Adolescent and Young Adult Transplant Recipients.

    Science.gov (United States)

    Gutiérrez-Colina, Ana M; Eaton, Cyd K; Lee, Jennifer L; Reed-Knight, Bonney; Loiselle, Kristin; Mee, Laura L; LaMotte, Julia; Liverman, Rochelle; Blount, Ronald L

    2016-08-01

    OBJECTIVE : To evaluate levels of executive functioning in a sample of adolescent and young adult (AYA) transplant recipients, and to examine executive functioning in association with barriers to adherence and medication nonadherence.  METHOD : In all, 41 caregivers and 39 AYAs were administered self- and proxy-report measures.  RESULTS : AYA transplant recipients have significant impairments in executive functioning abilities. Greater dysfunction in specific domains of executive functioning was significantly associated with more barriers to adherence and greater medication nonadherence.  CONCLUSION : AYA transplant recipients are at increased risk for executive dysfunction. The assessment of executive functioning abilities may guide intervention efforts designed to decrease barriers to adherence and promote developmentally appropriate levels of treatment responsibility. © The Author 2015. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  6. Cardiovascular Disease in Survivors of Adolescent and Young Adult Cancer

    DEFF Research Database (Denmark)

    Rugbjerg, Kathrine; Mellemkjaer, Lene; Boice, John D

    2014-01-01

    BACKGROUND: Cardiovascular disease has emerged as a serious late effect in survivors of adolescent and young adult cancer, but risk has not been quantified comprehensively in a population-based setting. METHODS: In the Danish Cancer Registry, we identified 43153 1-year survivors of cancer diagnosed...... at ages 15 to 39 years (1943-2009) and alive in 1977; from the Danish Civil Registration System, we randomly selected a comparison cohort of the same age and sex. Subjects were linked to the Danish Patient Register, and observed numbers of first hospitalizations for cardiovascular disease (International......-sided. RESULTS: During follow-up, 10591 survivors (24.5%) were discharged from the hospital with cardiovascular disease, whereas 8124 were expected (RR = 1.30; 95% confidence interval [CI)] = 1.28 to 1.33; P cardiovascular disease per 100000...

  7. Oral administration of Lactobacillus plantarum strain AYA enhances IgA secretion and provides survival protection against influenza virus infection in mice.

    Directory of Open Access Journals (Sweden)

    Yosuke Kikuchi

    Full Text Available The mucosal immune system provides the first line of defense against inhaled and ingested pathogenic microbacteria and viruses. This defense system, to a large extent, is mediated by the actions of secretory IgA. In this study, we screened 140 strains of lactic acid bacteria for induction of IgA production by murine Peyer's patch cells. We selected one strain and named it Lactobacillus plantarum AYA. We found that L. plantarum AYA-induced production of IL-6 in Peyer's patch dendritic cells, with this production promoting IgA(+ B cells to differentiate into IgA-secreting plasma cells. We also observed that oral administration of L. plantarum AYA in mice caused an increase in IgA production in the small intestine and lung. This production of IgA correlated strongly with protective ability, with the treated mice surviving longer than the control mice after lethal influenza virus infection. Our data therefore reveals a novel immunoregulatory role of the L. plantarum AYA strain which enhances mucosal IgA production and provides protection against respiratory influenza virus infection.

  8. The characteristics of lung cancer in young adults

    International Nuclear Information System (INIS)

    Cahajlova, R.; Kasan, P.; Cerna, M.; Martak, M.; Vesela, M.; Denkova, L.; Svihelova-Liskova, Z.; Dordayova, L.; Cavarga, I.

    2016-01-01

    Purpose: We create characteristics of lung cancer in young adults using the own group of patients and published data. Patients and methods: 23 young adults (from 23 to 39 years old) were treated at our oncology department from May 2006 till february 2016. Monitored characteristics were mean age, gender, histological type of tumor, mutation status, anatomical location, the incidence of cancer in the family and abuse of cigarettes. Results: The group consists of 23 patients aged from 23 to 39 years, including 12 women and 11 men. Histologically, 21 patients had diagnosis of adenocarcinoma (91.3 %), one squamous cell cancer and one small cell lung cancer. In 4 patients was found ALK mutation, one patient had an activating EGFR mutation (deletion of exon 19), 1 patient had detected ROS-1 mutation. The mutation status was unknown in 13 cases. 16 subjects were diagnosed at stage IV of disease. Nevertheless, the majority of them were in good performance status. 8 patients were smokers (34.8 %). Lung cancer were documented in relatives of 2 patients. Except for one subject, all patients had at least one treatment regimen (surgery, radiotherapy, chemotherapy, targeted therapy). Conclusion: Lung adenocarcinoma was strongly dominant histological type of cancer in our patients´ group. The superiority of adenocarcinoma histology has been confirmed by other published studies, too. 8 patients were smokers, there was slight women prevalence. The mutation status was examined in the low percentage of patients. However, we can see 4 ALK positive tumors, 1EGFR and one ROS-1 positive tumor. 16 patients were in stage IV at the time of diagnosis. Despite of this fact, their performance status was satisfactory to start the oncology treatment. (author)

  9. Protecting an adult identity: A grounded theory of supportive care for young adults recently diagnosed with cancer.

    Science.gov (United States)

    Soanes, Louise; Gibson, Faith

    2018-05-01

    For adolescents and young adults living in high-income countries cancer remains the most common disease-related death. Increasing survival rates and projected longevity are positive outcomes, although long-term consequences of cancer and/or its treatment will likely increase the global burden of cancer. In low and middle-income countries the impact and needs of young adults with cancer are largely unknown and require further attention. However, universal studies have revealed that cancer-related needs for this group are multifactorial, complex and largely unmet. In response to these findings, the body of work on supportive care for young adults with cancer is growing. Yet, there is no published research in the context of the United Kingdom, regarding the role young adults play in managing their supportive cancer care needs. To explore the experience, purpose and meaning of supportive cancer care to young adults recently diagnosed with cancer. Using constructivist grounded theory, data were collected in one to one interviews with eleven young adults (seven women and four men aged 19-24 years) being treated for cancer in two English hospitals. Data were analyzed using open and focused coding, constant comparison, theoretical coding and memoing, and this enabled construction of a subjective theory. Young adults in this study interpreted cancer as an interruption to the events, experiences and tasks forming the biographical work of their adult identity. Data analysis led to the construction of the theory, 'protecting an adult identity: self in relation to a diagnosis of cancer in young adulthood'. This theory arose from three categories: fragility of self, maintaining self in an altered reality and mobilizing external resources. Young adults faced the loss of their early adult identity. Interpreting cancer as a temporary interruption, they sought to re-establish their identity by directly and indirectly managing their supportive care needs. These findings contribute to

  10. Preparing childhood cancer survivors for transition to adult care: The young adult perspective.

    Science.gov (United States)

    Frederick, Natasha N; Bober, Sharon L; Berwick, Lexie; Tower, Mary; Kenney, Lisa B

    2017-10-01

    Childhood cancer survivors (CCSs) remain at risk for developing treatment-associated health conditions as they age; however, many do not obtain recommended follow-up, putting them at unnecessary risk for morbidity. Educational interventions targeted at providing survivors with the knowledge and skills necessary for healthcare independence might improve adherence and outcomes as they transition care to the adult medical system. To identify informational needs, educational preferences, and support that young adult CCSs perceive as beneficial for transition from pediatric to adult medical care. Sixteen young adult CCSs (ages 22-39 years) who have transitioned to adult care participated in focus groups led by a trained moderator and analyzed using a thematic analysis approach. Four major themes emerged: (1) education preferences-pediatric oncology provider as the primary source of information and guidance, enhanced by other formats, and early and ongoing engagement in education; (2) family role in transition-desire for independence and acknowledgement of need for ongoing parental support; (3) expectations for adult providers, such as close relationships, open communication, and care coordination; and (4) knowledge deficits regarding disease/treatment history, risk for long-term complications, and navigation of the adult medical system. Transition education as described by young adult CCSs should be a developmentally appropriate process beginning in early adolescents, primarily administered by pediatric oncology providers, and delivered in multiple formats. While healthcare independence is a goal for young adult CCSs, all stakeholders must recognize that families and providers continue to have an important role supporting survivors with transition logistics and medical decision-making. © 2017 Wiley Periodicals, Inc.

  11. Managing an Older Adult with Cancer: Considerations for Radiation Oncologists

    Directory of Open Access Journals (Sweden)

    Sanders Chang

    2017-01-01

    Full Text Available Older adults with cancer present a unique set of management complexities for oncologists and radiation oncologists. Prognosis and resilience to cancer treatments are notably dependent on the presence or risk of “geriatric syndromes,” in addition to cancer stage and histology. Recognition, proper evaluation, and management of these conditions in conjunction with management of the cancer itself are critical and can be accomplished by utilization of various geriatric assessment tools. Here we review principles of the geriatric assessment, common geriatric syndromes, and application of these concepts to multidisciplinary oncologic treatment. Older patients may experience toxicities related to treatments that impact treatment effectiveness, quality of life, treatment-related mortality, and treatment compliance. Treatment-related burdens from radiotherapy are increasingly important considerations and include procedural demands, travel, costs, and temporary or permanent loss of functional independence. An overall approach to delivering radiotherapy to an older cancer patient requires a comprehensive assessment of both physical and nonphysical factors that may impact treatment outcome. Patient and family-centered communication is also an important part of developing a shared understanding of illness and reasonable expectations of treatment.

  12. Adolescent and adult risk factors for testicular cancer.

    Science.gov (United States)

    McGlynn, Katherine A; Trabert, Britton

    2012-04-17

    The incidence of testicular cancer has been increasing over the past several decades in many developed countries. The reasons for the increases are unknown because the risk factors for the disease are poorly understood. Some research suggests that in utero exposures, or those in early childhood, are likely to be important in determining an individual's level of risk. However, other research suggests that exposure to various factors in adolescence and adulthood is also linked to the development of testicular cancer. Of these, two adult occupational exposures-fire fighting and aircraft maintenance--and one environmental exposure (to organochlorine pesticides) are likely to be associated with increased risk of developing testicular cancer. By contrast, seven of the identified factors--diet, types of physical activity, military service, police work as well as exposure to ionizing radiation, electricity and acrylamide--are unlikely to increase the risk of developing testicular cancer. Finally, seven further exposures--to heat, polyvinyl chloride, nonionizing radiation, heavy metals, agricultural work, pesticides and polychlorinated biphenyls as well as marijuana use--require further study to determine their association with testicular cancer.

  13. Trajectories of social isolation in adult survivors of childhood cancer.

    Science.gov (United States)

    Howard, A Fuchsia; Tan de Bibiana, Jason; Smillie, Kirsten; Goddard, Karen; Pritchard, Sheila; Olson, Rob; Kazanjian, Arminee

    2014-03-01

    Long-term childhood cancer survivors may be at increased risk for poor social outcomes as a result of their cancer treatment, as well as physical and psychological health problems. Yet, important challenges, namely social isolation, are not well understood. Moreover, survivors' perspectives of social isolation as well as the ways in which this might evolve through young adulthood have yet to be investigated. The purpose of this research was to describe the trajectories of social isolation experienced by adult survivors of a childhood cancer. Data from 30 in-depth interviews with survivors (9 to 38 years after diagnosis, currently 22 to 43 years of age, 60 % women) were analyzed using qualitative, constant comparative methods. Experiences of social isolation evolved over time as survivors grew through childhood, adolescence and young adulthood. Eleven survivors never experienced social isolation after their cancer treatment, nor to the present day. Social isolation among 19 survivors followed one of three trajectories; (1) diminishing social isolation: it got somewhat better, (2) persistent social isolation: it never got better or (3) delayed social isolation: it hit me later on. Knowledge of when social isolation begins and how it evolves over time for different survivors is an important consideration for the development of interventions that prevent or mitigate this challenge. Assessing and addressing social outcomes, including isolation, might promote comprehensive long-term follow-up care for childhood cancer survivors.

  14. The 'lost tribe' reconsidered: Teenagers and young adults treated for cancer in adult settings in the UK.

    Science.gov (United States)

    Marshall, Steve; Grinyer, Anne; Limmer, Mark

    2018-04-01

    Although the UK has pioneered the development of specialist adolescent cancer units, the majority of teenagers and young adults (TYAs) continue to be treated at their local hospital or at a cancer centre alongside adults of all ages. This study aimed to elicit young people's views on this experience of having cancer treatment in an adult setting. Seventeen participants who had been treated for cancer in an adult hospital between the ages of 15 and 24 were recruited via cancer charities and social media. Telephone interviews were conducted with the participants and the resulting data were analysed using thematic analysis. Already feeling out of sync as a TYA with cancer, participants felt out of place in the adult setting. Four factors contributed to this negative experience: a lack of affinity with older patients; the challenging issues in the adult setting; the absence of empathy towards TYAs by staff; and the unsuitability of the environment for adolescents. Staff working with TYAs with cancer in the adult setting should be aware of the potentially detrimental impact of this environment on this cohort of patients, and consider ways of adapting and modifying their approach. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.

  15. Suboptimal Vitamin D levels among adult survivors of childhood cancers

    Directory of Open Access Journals (Sweden)

    Denise A. Rokitka

    2016-07-01

    Full Text Available Purpose: Vitamin D plays an important role in many bodily systems, with increasing evidence suggesting its importance for the prevention of chronic diseases and cancer. The identification of vitamin D levels in childhood cancer survivors becomes, therefore, particularly relevant, given that optimizing levels may contribute to the prevention of secondary malignancies and chronic diseases.Methods: A cross - sectional analysis of serum 25 - hydroxyvitamin D levels among adult survivors of childhood cancers living in New York State and surrounding areas (n = 139 was performed. Independent variables included gender, race/ethnicity, cancer site, year of diagnosis, past medical and surgical history, prior radiation therapy; prior chemotherapy, age at diagnosis, age at last clinic visit, year of last clinic visit, height, weight, body mass index, and vitamin D supplementation.Results: Overall, 34% of survivors were vitamin D deficient (< 20 ng/ml, 39% were classified as insufficient (20 - 29 ng/ml and 27% (≥ 30 ng/ml were classified as having sufficient levels. Despite vitamin D supplementation among 41 patients, 68.3% continued to have insufficient or deficient levels. Participants with a BMI > 25 demonstrated lower levels of vitamin D (p < 0.05. Vitamin D levels did not vary by age group, race, ethnicity, diagnosis, or years since diagnosis.Conclusion: Given the growing awareness of the role of vitamin D and the documented late effects of treatment for childhood cancers, the high prevalence of vitamin D deficiency within the childhood cancer survivor population is of concern. Vitamin D represents an important target for surveillance and intervention to help improve long - term outcomes of childhood cancer survivors.

  16. Adult testicular cancer: Two decades of Saudi national data.

    Science.gov (United States)

    Abomelha, Mohammed

    2017-01-01

    There is a paucity of data regarding testicular cancer among Saudis as well as the nonexistent of published national data. Furthermore, a substantial increase of the incidence of testicular cancer among Saudis was lately noted. The aim of the study is to determine the trends and patterns of testicular cancer among adult Saudis using national data over a period of 20 years. The national database of the Saudi Cancer Registry (SCR) on testicular cancer over the last two decades was studied including epidemiological and histological patterns. The 1004 cases of testicular cancer among adult Saudis reported by the SCR will be the subject of this study. From 1994 to 2013, 1004 cases of testicular cancer among adult Saudis were reported to the SCR, with a steadily significant increase in incidence rate reaching an annual rate of 94 cases in 2013. Age of the patients ranged 15-93 years with a mean of 34.5 years. The most affected age group was 20-34 years, where 51% of all testicular cancer accumulated. Around 85% of testicular cancer is germ cell tumors, while paratesticular and gonadal stromal tumors represent 15%. Of all testicular cancer, seminomas were seen in 40.7%, nonseminomas in 44.6%. Notably, 70.4% of the cases in the first decade were seminomas, while in the second decade 65.9% of the cases were nonseminomas. The subtypes of the nonseminomas were a mixed tumor in 51.6%, embryonal carcinoma in 19.9%, yolk sac tumor in 12.3%, germinomas in 6.7%, teratomas in 6%, and choriocarcinomas in 3.6%. Lymphomas (34.7%) and rhabdomyosarcomas (23.6%) are on the top of the paratesticular tumor group. The Surveillance Epidemiology and End Results summary stage of seminomas was localized in 61.6%, regional in 19.8%, and distant in 12.6%, while of nonseminomas was 48%, 15.5%, and 28.5%, respectively. Localized and distant status of seminomas improved over the studied period by 12% and 4% respectively, while this trend was not seen in nonseminomas. The incidence rate is on rising

  17. Current lifestyle of young adults treated for cancer in childhood.

    Science.gov (United States)

    Evans, S E; Radford, M

    1995-05-01

    The aim of this study was to look at the current lifestyle of young adult survivors of childhood cancer between the ages of 16 and 30 years to document their achievements and expose any psychosocial problems. Sixty six young adult survivors were contacted and asked if they and their siblings (16-30 years) would take part in a lifestyle study; 48 patients and 38 sibling controls were interviewed. This took the form of a structured lifestyle questionnaire, a self esteem questionnaire (Oxford Psychologists Press), and an unstructured interview. Fifty five per cent of patients achieved five or more A-C grades at 'O' level/GCSE compared with 62% of siblings and a national average of 30%. Despite that these patients were significantly less likely to go on to higher education than their siblings. The two groups were equally employable and earning similar salaries. There were three cases of known employer prejudice. A slightly higher percentage of patients than siblings had their driving licence. Seventeen patients felt their appearance had changed and eight felt that they had a residual physical mobility problem. Both groups were socially active and equally likely to partake in competitive sports. There was no overall difference in the self esteem of the two groups. In general the survivors of childhood cancer were coping well in their young adult life and achieving the same lifestyle goals as their siblings. However, significant problems have been identified.

  18. Adult Primary Liver Cancer Treatment (PDQ®)—Health Professional Version

    Science.gov (United States)

    Adult primary liver cancer includes hepatocellular carcinoma (HCC) and cholangiocarcinoma. Treatments include surveillance, surgery, liver transplant, ablation therapy, embolization therapy, targeted therapy, and radiation therapy. Get comprehensive information about liver cancer and treatment in this clinician summary.

  19. Joking about cancer as an avoidance strategy among US adults.

    Science.gov (United States)

    Carcioppolo, Nick; John, Kevin K; Jensen, Jakob D; King, Andy J

    2017-12-13

    Findings from years of research on fear appeals suggest that individuals with low efficacy utilize avoidance strategies when they perceive a significant threat-a process called fear control. Some research suggests that joking could be an avoidance strategy. The current study identifies conditions in which people are more likely to joke about colorectal cancer and explores how this behavior may be associated with screening avoidance. Older adults (N = 209) recruited from eight different worksites completed a survey measuring fear appeal constructs and enactment of colorectal cancer-related joking. Results of a moderated mediation analysis suggest that men were more likely to joke about colorectal cancer than women, particularly if they perceived significant threat but had limited self-efficacy, signifying fear control. Results support prior fear appeal research, suggesting that an increase in joking behavior concerning colorectal cancer may be indicative of screening avoidance, and describe belief-based mechanisms that explain differences between biological sex and joking. Published by Oxford University Press 2017. This work is written by US Government employees and is in the public domain in the US.

  20. Adult survivors of childhood cancers' identity disclosures in the workplace.

    Science.gov (United States)

    Martinez, Larry R; Hebl, Michelle R

    2016-04-01

    Recent medical advances have resulted in unprecedented increases in the number and vitality of employed adult survivors. These survivors must make decisions about whether or not to disclose their identities to others. The purpose of this study was to examine the characteristics that are related to cancer survivorship disclosure in workplace settings (perceived organizational support, centrality of survivorship to one's self-concept, and the degree to which family and friends know about one's survivor status) and an important organizational consequence: intentions to leave one's job. A total of 151 adult survivors of childhood cancer completed an online survey. Extent of disclosure of one's identity as a cancer survivor was negatively associated with turnover intentions. Furthermore, organizational support, identity centrality, and disclosure outside of work were all related to disclosure in the workplace. Relative weight analysis revealed that disclosure outside of work was the most strongly related to disclosure at work. Finally, there were indirect relations such that disclosure mediated the relations among organizational support, identity centrality, and disclosure outside of work and turnover intentions. Survivors who were more open about their cancer survivor status at work had fewer intentions to leave their organizations. Importantly, although some antecedents to disclosure were personal characteristics, organizations can also encourage identity disclosure demonstrating that they are related to of work retention. While disclosure in the workplace is a complex decision to make, the relationship with work retention may reflect that disclosure is more likely to occur in an existing positive work environment or that disclosure itself may contribute to a positive work environment where employees tend to remain. The specific factors that trigger both disclosure and retention require further study although they are clearly related.

  1. Towards an Ontology-driven Framework to Enable Development of Personalized mHealth Solutions for Cancer Survivors' Engagement in Healthy Living.

    Science.gov (United States)

    Myneni, Sahiti; Amith, Muhammad; Geng, Yimin; Tao, Cui

    2015-01-01

    Adolescent and Young Adult (AYA) cancer survivors manage an array of health-related issues. Survivorship Care Plans (SCPs) have the potential to empower these young survivors by providing information regarding treatment summary, late-effects of cancer therapies, healthy lifestyle guidance, coping with work-life-health balance, and follow-up care. However, current mHealth infrastructure used to deliver SCPs has been limited in terms of flexibility, engagement, and reusability. The objective of this study is to develop an ontology-driven survivor engagement framework to facilitate rapid development of mobile apps that are targeted, extensible, and engaging. The major components include ontology models, patient engagement features, and behavioral intervention technologies. We apply the proposed framework to characterize individual building blocks ("survivor digilegos"), which form the basis for mHealth tools that address user needs across the cancer care continuum. Results indicate that the framework (a) allows identification of AYA survivorship components, (b) facilitates infusion of engagement elements, and (c) integrates behavior change constructs into the design architecture of survivorship applications. Implications for design of patient-engaging chronic disease management solutions are discussed.

  2. Rationale for a pediatric-inspired approach in the adolescent and young adult population with acute lymphoblastic leukemia, with a focus on asparaginase treatment

    Directory of Open Access Journals (Sweden)

    Carmelo Rizzari

    2014-09-01

    Full Text Available In the last two decades great improvements have been made in the treatment of childhood acute lymphoblastic leukemia, with 5-year overall survival rates currently approaching almost 90%. In comparison, results reported in adolescents and young adults (AYAs are relatively poor. In adults, results have improved, but are still lagging behind those obtained in children. Possible reasons for this different pattern of results include an increased incidence of unfavorable and a decreased incidence of favorable cytogenetic abnormalities in AYAs compared with children. Furthermore, in AYAs less intensive treatments (especially lower cumulative doses of drugs such as asparaginase, corticosteroids and methotrexate and longer gaps between courses of chemotherapy are planned compared to those in children. However, although favorable results obtained in AYAs receiving pediatric protocols have been consistently reported in several international collaborative trials, physicians must also be aware of the specific toxicity pattern associated with increased success in AYAs, since an excess of toxicity may compromise overall treatment schedule intensity. Cooperative efforts between pediatric and adult hematologists in designing specific protocols for AYAs are warranted.

  3. Transcutaneous electric nerve stimulation (TENS) for cancer pain in adults.

    Science.gov (United States)

    Hurlow, Adam; Bennett, Michael I; Robb, Karen A; Johnson, Mark I; Simpson, Karen H; Oxberry, Stephen G

    2012-03-14

    Cancer-related pain is complex and multi-dimensional but the mainstay of cancer pain management has predominantly used a biomedical approach. There is a need for non-pharmacological and innovative approaches. Transcutaneous Electric Nerve Stimulation (TENS) may have a role in pain management but the effectiveness of TENS is currently unknown. This is an update of the original review published in Issue 3, 2008. The aim of this systematic review was to determine the effectiveness of TENS for cancer-related pain in adults. The initial review searched The Cochrane Library, MEDLINE, EMBASE, CINAHL, PsychINFO, AMED and PEDRO databases in April 2008. We performed an updated search of CENTRAL, MEDLINE, EMBASE, CINAHL and PEDRO databases in November 2011. We included only randomised controlled trials (RCTS) investigating the use of TENS for the management of cancer-related pain in adults. The search strategy identified a further two studies for possible inclusion. One of the review authors screened each abstract using a study eligibility tool. Where eligibility could not be determined, a second author assessed the full paper. One author used a standardised data extraction sheet to collect information on the studies and independently assess the quality of the studies using the validated five-point Oxford Quality Scale. The small sample sizes and differences in patient study populations of the three included studies (two from the original review and a third included in this update) prevented meta-analysis. For the original review the search strategy identified 37 possible published studies; we divided these between two pairs of review authors who decided on study selection; all four review authors discussed and agreed final scores. Only one additional RCT met the eligibility criteria (24 participants) for this updated review. Although this was a feasibility study, not designed to investigate intervention effect, it suggested that TENS may improve bone pain on movement in a

  4. Impersonal, interpersonal, and hyperpersonal social support: cancer and older adults.

    Science.gov (United States)

    Robinson, James D; Turner, Jeanine

    2003-01-01

    Although cancer occurs throughout the life span, many of the most frequently occurring types of cancer increase as we grow older. In fact, only cardiovascular disease accounts for more deaths in adults 65 years of age and older. One of the ways that cancer patients cope or adapt to their illness is through socially supportive communicative interactions and relationships. Cutrona and Russell (1990) argued that social support is multidimensional and suggested that social support is most effective when the support needs of the individual are consistent with the type of social support being offered by the support provider. From the communicative perspective, the notion of optimal matching between the types of social support desired and the type of social support offered is extended to include the type of relationship between the communicants. In addition, it is argued that computer-mediated social support can be superior to face-to-face social support. This article attempts to identify some of the conditions under which this is true.

  5. Quality of life, self-esteem and worries in young adult survivors of childhood cancer

    NARCIS (Netherlands)

    Langeveld, N. E.; Grootenhuis, M. A.; Voûte, P. A.; de Haan, R. J.; van den Bos, C.

    2004-01-01

    This study assessed quality of life, self-esteem and worries in young adult survivors of childhood cancer compared to a group of young adults with no history of cancer. The impact of demographic, medical and treatment factors and self-esteem on survivors' quality of life and worries was studied.

  6. Use of Lactobacillus plantarum as Starter Culture and Its Influence on Physicochemical, Microbiological, and Sensory Characteristics of Kunnu-Aya Produced from Sorghum and Tigernut

    Directory of Open Access Journals (Sweden)

    O. A. Olaoye

    2017-01-01

    Full Text Available Kunun-aya is a traditional nonalcoholic beverage in the northern part of Nigeria, normally prepared from cereals. In this investigation Lactobacillus plantarum, isolated from fermenting kunun, was applied as starter culture during production of kunun-aya from varying combinations of sorghum and tigernut. The quality attributes of the product indicated increase in ash and protein contents of product inoculated with starter culture (PISC over the uninoculated control sample (UCS. The highest values of 4.43% and 6.95% were recorded for ash and protein, respectively, in the product from fifty percent each of sorghum and tigernut (50SOR/50TIG. Titratable acidity was higher in PISC compared to UCS; the 50SOR/50TIG sample had the highest value of 0.92. The PISC recorded reduced counts of Salmonella, coliforms, and Staphylococci. The SCIS were preferred by panellists in the sensory attributes of appearance, aroma, taste, mouthfeel, and general acceptability. It was concluded that the use of L. plantarum as starter culture in the production of kunun-aya was advantageous as a result of enhanced nutritional, sensory, and microbial qualities recorded compared to UCS. Reduction in Salmonella, coliforms, and Staphylococci in PISC may be of public health significance. This on quality improvement of the traditional beverage has not been previously reported.

  7. Changes in Awareness of Cancer Risk Factors among Adult New Zealanders (CAANZ): 2001 to 2015

    Science.gov (United States)

    Richards, R.; McNoe, B.; Iosua, E.; Reeder, A. I.; Egan, R.; Marsh, L.; Robertson, L.; Maclennan, B.; Dawson, A.; Quigg, R.; Petersen, A.-C.

    2017-01-01

    Behaviour change, specifically that which decreases cancer risk, is an essential element of cancer control. Little information is available about how awareness of risk factors may be changing over time. This study describes the awareness of cancer risk behaviours among adult New Zealanders in two cross-sectional studies conducted in 2001 and…

  8. Prospective study of falls and risk factors for falls in adults with advanced cancer.

    LENUS (Irish Health Repository)

    Stone, Carol A

    2012-06-10

    Retrospective studies of inpatients with cancer suggest that a cancer diagnosis confers a high risk of falls. In adults with advanced cancer, we aimed to prospectively document the incidence of falls, identify the risk factors, and determine if falls in this population occur predominantly in older patients.

  9. Prostate cancer in senior adults: over- or undertreated?

    Science.gov (United States)

    Berger, Ingrid; Böhmer, Franz; Ponholzer, Anton; Madersbacher, Stephan

    2009-01-01

    Despite the widespread use of prostate specific antigen for early prostate cancer (PCa) detection in younger men, PCa is still as disease of the elderly as 2/3 of incident cases are detected in men older than 65 years and 25% are older than 75 years at diagnosis. Opportunistic screening for PCa is not recommended for men with a life expectancy of less than 10 years. The therapeutic strategy for senior adults is driven by tumour stage/aggressiveness, co-morbidity and chronological age. Elderly patients with low/intermediate risk tumours - particularly those with a life expectancy of less than 10 years - are best managed by watchful waiting. Senior adults with intermediate/high risk tumours and a life expectancy of >10 years may benefit from curative local therapy such as radical prostatectomy or combined external beam irradiation/androgen ablation therapy. For elderly patients with metastatic disease, androgen deprivation remains the mainstay of therapy, intermittent androgen ablation is a promising approach.

  10. [Refusal of treatments by an adult cancer patient].

    Science.gov (United States)

    Dauchy, Sarah; Faivre, Jean-Christophe; Block, Véronique; Metzger, Maude; Salleron, Julia; Charles, Cécile; Adam, Virginie

    2018-03-01

    Refusal of treatment questions the treatment's adequacy as well as the quality of the care relationship. A rigorous analysis of these situations is necessary in order to respect the patient's fundamental right to decide for him/herself while preventing a potential loss of chance. This paper proposes practical guidelines for assessment and management of the refusal of treatment by adult cancer patients. The French Association for Supportive Care in Cancer and the French Society for Psycho-Oncology formed a task force that applied a consensus methodology to draft guidelines. We propose five guidelines: (1) be informed of the conditions most often associated with refusal of treatment so as to reinforce adequate support measures; (2) understand the complexity of the process of refusal and accurately identify what is precisely refused; (3) apply an approach of systematic analysis to refusal, to try and increase the possibilities of finding an agreement while reinforcing the respect of the patient's position; (4) establish a legal procedure to address refusal of treatment that safeguards the stakeholders when no accord can be found; and (5) know the indications for ethical collective decision-making. A systematic assessment procedure of treatment refusal is necessary in order to ensure that all the physical, psychological and contextual aspects of it are taken into account, and to provide patients with the best treatment possible. The setting of good care relationship, the improvement of communication skills training and of comprehensive multidisciplinary care are all crucial elements in the prevention of these situations. Copyright © 2018 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

  11. Frailty Index Developed From a Cancer-Specific Geriatric Assessment and the Association With Mortality Among Older Adults With Cancer.

    Science.gov (United States)

    Guerard, Emily J; Deal, Allison M; Chang, YunKyung; Williams, Grant R; Nyrop, Kirsten A; Pergolotti, Mackenzi; Muss, Hyman B; Sanoff, Hanna K; Lund, Jennifer L

    2017-07-01

    Background: An objective measure is needed to identify frail older adults with cancer who are at increased risk for poor health outcomes. The primary objective of this study was to develop a frailty index from a cancer-specific geriatric assessment (GA) and evaluate its ability to predict all-cause mortality among older adults with cancer. Patients and Methods: Using a unique and novel data set that brings together GA data with cancer-specific and long-term mortality data, we developed the Carolina Frailty Index (CFI) from a cancer-specific GA based on the principles of deficit accumulation. CFI scores (range, 0-1) were categorized as robust (0-0.2), pre-frail (0.2-0.35), and frail (>0.35). The primary outcome for evaluating predictive validity was all-cause mortality. The Kaplan-Meier method and log-rank tests were used to compare survival between frailty groups, and Cox proportional hazards regression models were used to evaluate associations. Results: In our sample of 546 older adults with cancer, the median age was 72 years, 72% were women, 85% were white, and 47% had a breast cancer diagnosis. Overall, 58% of patients were robust, 24% were pre-frail, and 18% were frail. The estimated 5-year survival rate was 72% in robust patients, 58% in pre-frail patients, and 34% in frail patients (log-rank test, P older adults with cancer, a finding that was independent of age, sex, cancer type and stage, and number of medical comorbidities. The CFI has the potential to become a tool that oncologists can use to objectively identify frailty in older adults with cancer. Copyright © 2017 by the National Comprehensive Cancer Network.

  12. How do I best manage insomnia and other sleep disorders in older adults with cancer?

    Science.gov (United States)

    Loh, Kah Poh; Burhenn, Peggy; Hurria, Arti; Zachariah, Finly; Mohile, Supriya Gupta

    2016-11-01

    Insomnia is common in older adults with cancer, with a reported prevalence of 19-60% in prior studies. Cancer treatments are associated with increased risk of insomnia or aggravation of pre-existing insomnia symptoms, and patients who are receiving active cancer treatments are more likely to report insomnia. Insomnia can lead to significant physical and psychological consequences with increased mortality. We discuss physiological sleep changes in older adults, and illustrated the various sleep disorders. We present a literature review on the prevalence and the effects of insomnia on the quality of life in older adults with cancer. We discuss the risk factors and presented a theoretical framework of insomnia in older adults with cancer. We present a case study to illustrate the assessment and management of insomnia in older adults with cancer, comparing and contrasting a number of tools for sleep assessment. There are currently no guidelines on the treatment of sleep disorders in older adults with cancer. We present an algorithm developed at the City of Hope Comprehensive Cancer Center by a multidisciplinary team for managing insomnia, using evidence-based pharmacologic and non-pharmacologic interventions. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Development and validation of the BRIGHTLIGHT Survey, a patient-reported experience measure for young people with cancer.

    Science.gov (United States)

    Taylor, Rachel M; Fern, Lorna A; Solanki, Anita; Hooker, Louise; Carluccio, Anna; Pye, Julia; Jeans, David; Frere-Smith, Tom; Gibson, Faith; Barber, Julie; Raine, Rosalind; Stark, Dan; Feltbower, Richard; Pearce, Susie; Whelan, Jeremy S

    2015-07-28

    Patient experience is increasingly used as an indicator of high quality care in addition to more traditional clinical end-points. Surveys are generally accepted as appropriate methodology to capture patient experience. No validated patient experience surveys exist specifically for adolescents and young adults (AYA) aged 13-24 years at diagnosis with cancer. This paper describes early work undertaken to develop and validate a descriptive patient experience survey for AYA with cancer that encompasses both their cancer experience and age-related issues. We aimed to develop, with young people, an experience survey meaningful and relevant to AYA to be used in a longitudinal cohort study (BRIGHTLIGHT), ensuring high levels of acceptability to maximise study retention. A three-stage approach was employed: Stage 1 involved developing a conceptual framework, conducting literature/Internet searches and establishing content validity of the survey; Stage 2 confirmed the acceptability of methods of administration and consisted of four focus groups involving 11 young people (14-25 years), three parents and two siblings; and Stage 3 established survey comprehension through telephone-administered cognitive interviews with a convenience sample of 23 young people aged 14-24 years. Stage 1: Two-hundred and thirty eight questions were developed from qualitative reports of young people's cancer and treatment-related experience. Stage 2: The focus groups identified three core themes: (i) issues directly affecting young people, e.g. impact of treatment-related fatigue on ability to complete survey; (ii) issues relevant to the actual survey, e.g. ability to answer questions anonymously; (iii) administration issues, e.g. confusing format in some supporting documents. Stage 3: Cognitive interviews indicated high levels of comprehension requiring minor survey amendments. Collaborating with young people with cancer has enabled a survey of to be developed that is both meaningful to young

  14. Socioeconomic Impacts on Survival Differ by Race/Ethnicity among Adolescents and Young Adults with Non-Hodgkin's Lymphoma

    International Nuclear Information System (INIS)

    Kent, E. E.; Largent, J. A.; Ziogas, A.; Sender, J. A.; Culver, H. A.; Morris, R. A.; Sender, L. S.; Ziogas, A.; Culver, H. A.; Sender, L. S.; Culver, H. A.

    2010-01-01

    Shorter survival has been associated with low socioeconomic status (SES) among elderly non-Hodgkin's lymphoma (NHL) patients; however it remains unknown whether the same relationship holds for younger patients. We explored the California Cancer Registry (CCR), to investigate this relationship in adolescent and young adult (AYA) NHL patients diagnosed from 1996 to 2005. A case-only survival analysis was conducted to examine demographic and clinical variables hypothesized to be related to survival. Included in the final analysis were 3,489 incident NHL cases. In the multivariate analyses, all-cause mortality (ACM) was higher in individuals who had later stage at diagnosis (P<.05) or did not receive first-course chemotherapy (P<.05 ). There was also a significant gradient decrease in survival, with higher ACM at each decreasing quintile of SES (P<.001). Overall results were similar for lymphoma-specific mortality. In the race/ethnicity stratified analyses, only non-Hispanic Whites (NHWs) had a significant SES-ACM trend ( P<.001). Reduced overall and lymphoma-specific survival was associated with lower SES in AYAs with NHL, although a significant trend was only observed for NHWs

  15. Childhood body mass index and the risk of prostate cancer in adult men

    DEFF Research Database (Denmark)

    Aarestrup, J; Gamborg, M; Cook, M B

    2014-01-01

    BACKGROUND: Prostate cancer aetiology is poorly understood. It may have origins early in life; previously we found a positive association with childhood height. The effects of early life body mass index (BMI; kg m(-2)) on prostate cancer remain equivocal. We investigated if childhood BMI...... to the Danish Cancer Registry. Cox proportional hazards regressions were performed. RESULTS: Overall, 3355 men were diagnosed with prostate cancer. Body mass index during childhood was positively associated with adult prostate cancer. The hazard ratio of prostate cancer was 1.06 (95% confidence interval (CI): 1...

  16. "Perhaps I will die young." Fears and worries regarding disease and death among Danish adolescents and young adults with cancer. A mixed method study

    DEFF Research Database (Denmark)

    Hølge-Hazelton, Bibi; Timm, Helle U; Graugaard, Christian

    2016-01-01

    worries about death; hereof, more than half of them expressed quite a bit or very much. The analysis showed significant gender differences, whereas age and duration of disease did not have any significant impact on such thoughts. Q2: One third had not talked to anybody about his or her worries. Q3...... about dying; (Q2) with whom, if anyone, they had shared those worries; and finally, (Q3) how fears and worries influenced their daily life. The emphasis will be on Q3. METHODS: A 151-item questionnaire (including two closed- and one open-ended questions about fears of death and dying) was distributed...... dying, but one third of them had not talked to anybody about those thoughts. It is an important clinical point that young age does not preclude fears and worries about dying in AYAs with cancer....

  17. Treatment of Head and Neck Cancer in Adults - Patient Version

    Science.gov (United States)

    Find diagnosis, staging, and treatment information for these head and neck cancers: hypopharynx, larynx, lip and oral cavity, neck cancer with occult primary, nasopharynx, oropharynx, paranasal sinus and nasal cavity, and salivary gland cancer.

  18. A comparison of heterosexual and LGBTQ cancer survivors' outlooks on relationships, family building, possible infertility, and patient-doctor fertility risk communication.

    Science.gov (United States)

    M Russell, Andrea; Galvin, Kathleen M; Harper, Maya M; Clayman, Marla L

    2016-10-01

    Little research about cancer-related infertility has examined the experiences and needs of lesbian, gay, bisexual, transgender, or queer (LGBTQ) cancer survivors. This research seeks to understand how LGBTQ survivors are similar to or different from heterosexual survivors with respect to cancer treatments' effects on relationships, plans for parenthood, and fertility preservation decision making. Semi-structured telephone interviews conducted with adolescent or young adult (AYA) cancer survivors (n = 56) were coded for themes. Interviews consisted of questions about pre- and post-diagnosis thoughts about relationships, parenthood, possible infertility, and how information about fertility risks was received. While LGBTQ (n = 22) and heterosexual (n = 34) survivors reported similar challenges when dating post-diagnosis, heterosexual survivors were more likely to report fertility concerns as affecting romantic relationships (p LGBTQ survivors seemed more open to raising non-biological children or not becoming a parent than heterosexual survivors. LGBTQ survivors generally reported being satisfied with or indifferent to the information that they were given regarding fertility loss, despite reporting receiving similar amounts of information as compared to heterosexual patients (p LGBTQ patients' views on relationships, parenthood, and family building seemed to result in less distress when faced with infertility. However, interventions facilitating information exchange about dating, fertility risks, and family building options may be valuable to LGBTQ and heterosexual cancer survivors. LGBTQ cancer survivors may display more adaptive coping with respect to relationships and fertility loss. Oncology professionals may want to proactively introduce positive coping strategies to reduce distress among AYA cancer survivors at risk for infertility.

  19. Psychological factors impacting transition from paediatric to adult care by childhood cancer survivors.

    Science.gov (United States)

    Granek, Leeat; Nathan, Paul C; Rosenberg-Yunger, Zahava R S; D'Agostino, Norma; Amin, Leila; Barr, Ronald D; Greenberg, Mark L; Hodgson, David; Boydell, Katherine; Klassen, Anne F

    2012-09-01

    Childhood cancer survivors require life-long care focused on the specific late effects that may arise from their cancer and its treatment. In many centers, survivors are required to transition from follow-up care in a paediatric cancer center, to care provided in an adult care setting. The purpose of this study was to identify the psychological factors involved in this transition to adult care long-term follow-up clinics. Qualitative interviews were conducted with ten paediatric survivors still in paediatric care, as well as 28 adult survivors of whom 11 had transitioned successfully to adult care (attended three long-term follow-up (LTFU) appointments consecutively); ten who failed to transition (attended at least one LTFU appointment as an adult, but were inconsistent with subsequent attendance); and seven who had never transitioned (did not attend any LTFU care as an adult). Line-by-line coding was used to establish categories and themes. Constant comparison was used to examine relationships within and across codes and categories. Two overall categories and four subthemes were identified: (1) Identification with being a cancer survivor included the subthemes of 'cancer identity' and 'cancer a thing of the past' and; (2) Emotional components included the subthemes of 'fear and anxiety' and 'gratitude and gaining perspective'. The analysis revealed that the same factor could act as either a motivator or a hindrance to successful transition in different survivors (e.g., fear of recurrence of cancer might be a barrier or a facilitator depending on the survivor's life experience). Psychological factors are an important consideration when preparing cancer survivors for transition to adult long-term follow-up care. Identifying and addressing the individual psychological needs of childhood cancer survivors may improve the likelihood of their successful transition to adult care.

  20. Body mass index in childhood and adult risk of primary liver cancer

    DEFF Research Database (Denmark)

    Berentzen, Tina Landsvig; Gamborg, Michael; Holst, Claus

    2014-01-01

    BACKGROUND & AIMS: Childhood overweight increases the risk of early development of non-alcoholic fatty liver disease, which may predispose to carcinogenesis. We investigated if childhood body size during school ages was associated with the risk of primary liver cancer in adults. METHODS: A cohort......-specific reference. Information on liver cancer was obtained from the National Cancer Registry. Hazard ratios and 95% confidence intervals (95% CI) of liver cancer were estimated by Cox regression. RESULTS: During 6,963,105 person-years of follow-up, 438 cases of primary liver cancer were recorded. The hazard ratio...... hepatitis, alcohol-related disorders, and biliary cirrhosis. CONCLUSIONS: Higher BMI in childhood increases the risk of primary liver cancer in adults. In view of the high case fatality of primary liver cancer, this result adds to the future negative health outcomes of the epidemic of childhood overweight...

  1. Personality and psychological distress among older adult, long-term cancer survivors.

    Science.gov (United States)

    Deimling, Gary T; Albitz, Casey; Monnin, Kara; Renzhofer Pappada, Holly T; Nalepa, Elizabeth; Boehm, Melinda Laroco; Mitchell, Claire

    2017-01-01

    This research examines a model of how personality (Five-Factor Model) is related to adjustment to cancer in later life in terms of the presence of continuing cancer-related worry and depression among older adult, long-term cancer survivors. Data from an NCI-funded study with 275 older adult (age 60+), long-term (5+ years) survivors of breast, prostate, and colorectal cancer were examined. Regression analyses identified neuroticism as the strongest predictor of cancer-related worry along with continuing cancer-related symptoms. For depression, three personality dimensions (neuroticism, conscientiousness, and agreeableness) were significant predictors. Findings suggest the importance of considering the central role that survivors' personality characteristics play in understanding cancer-related worries and depression. Understanding these dispositional characteristics is key for social workers and health-care practitioners in counseling survivors experiencing these common mental health effects.

  2. Stomach cancer screening in the adult health study population

    International Nuclear Information System (INIS)

    Akiyama, Mitoshi; Yamakido, Michio; Otake, Masanori; Belsky, J.L.; Pastore, J.O.

    1978-04-01

    Examinations for parietal cell antibody (PCA) were performed on 1334 subjects of the Adult Health Study (AHS), Hiroshima, during a 1-year period. Findings revealed PCA in 112 subjects (8.4%), but no difference in frequency was noted by sex. The relationship of PCA to age showed the positive rate to be significantly higher in those age 50 or over than in those under 50. No correlation was noted between estimated A-bomb exposure dose and PCA frequency. PCA was found in 58 (11.6%) of the 502 cases presenting achlorhydria on tubeless gastric analysis, and particularly in the age 50 and over group, PCA was demonstrated in 43 (14.2%) of the 302 subjects presenting achlorhydria, which is a significant difference compared with the under 50 age group in which PCA was demonstrated in 15 (7.5%) of 200 such subjects. PCA was detected in 11 (7.2%) of 152 subjects with abnormal, or low, serum pepsinogen levels and in 20 (16.3%) of 123 subjects with high levels. The frequency of positive PCA was higher in patients diagnosed on upper gastrointestinal (GI) series as atrophic gastritis than in patients diagnosed as some other gastric disorder. PCA was negative in both of the two cases in whom a definite diagnosis of stomach cancer was established. However, in light of the finding of abnormal Diagnex Blue (DB) tests and positive PCA at a high frequency in the gastritis group and reports that gastritis provides the groundwork for stomach cancer, it is considered that care should be taken in cases with findings of abnormal DB test, abnormal serum pepsinogen levels, and positive PCA. (author)

  3. Towards a new conceptualization of depression in older adult cancer patients: a review of the literature

    Science.gov (United States)

    Saracino, Rebecca M.; Rosenfeld, Barry; Nelson, Christian J.

    2016-01-01

    Objectives Identifying depression in older adults with cancer presents a set of unique challenges, as it combines the confounding influences of cancer and its treatment with the developmental changes associated with aging. This paper reviews the phenomenology of depression in older adults, and individuals diagnosed with cancer. Method PsychInfo, PubMed, Web of Science, and Google Scholar databases were searched for English-language studies addressing the phenomenology, symptoms, or assessment of depression in older adults and those with cancer. Results The Diagnostic and Statistical Manual for Mental Disorders (DSM) criteria that appear to be relevant to both older adults and cancer patients are anhedonia, concentration difficulties, sleep disturbances, psychomotor retardation/agitation, and loss of energy. Possible alternative criteria that may be important considerations included constructs such as loss of purpose, loneliness, and irritability in older adults. Among cancer patients, tearfulness, social withdrawal, and not participating in treatment despite ability to do so were identified as potentially important symptoms. Conclusions Current DSM criteria may not adequately assess depression in older cancer patients and alternative criteria may be important to inform the understanding and identification of depression in this population. Enhancing diagnostic accuracy of depression is important as both the over-diagnosis and under-diagnosis is accompanied with significant costs. Thus, continued research exploring the phenomenology and identifying effective indicators of depression in older cancer patients is needed. PMID:26312455

  4. Treatment of Acute Myeloid Leukemia in Adolescent and Young Adult Patients

    Directory of Open Access Journals (Sweden)

    Guldane Cengiz Seval

    2015-03-01

    Full Text Available The objectives of this review were to discuss standard and investigational treatment strategies for adolescent and young adult with acute myeloid leukemia, excluding acute promyelocytic leukemia. Acute myeloid leukemia (AML in adolescent and young adult patients (AYAs may need a different type of therapy than those currently used in children and older patients. As soon as AML is diagnosed, AYA patient should be offered to participate in well-designed clinical trials. The standard treatment approach for AYAs with AML is remission induction chemotherapy with an anthracycline/cytarabine combination, followed by either consolidation chemotherapy or stem cell transplantation, depending on the ability of the patient to tolerate intensive treatment and cytogenetic features. Presently, continuing progress of novel drugs targeting specific pathways in acute leukemia may bring AML treatment into a new era.

  5. A DASH dietary pattern and the risk of colorectal cancer in Canadian adults

    OpenAIRE

    Jones-McLean, E.; Hu, J.; Greene-Finestone, L. S.; de Groh, M.

    2015-01-01

    Introduction: Colorectal cancer (CRC) is a high incidence cancer affecting many Canadian adults each year. Diet is important in the etiology of CRC with many dietary components identified as potential risk factors. The Dietary Approaches to Stop Hypertension (DASH) diet is a well-established pattern to characterize overall eating. The purpose of this study was to characterize a DASH pattern within the Canadian context and to assess its relationship to the risk of CRC in Canadian adults. Metho...

  6. Memories of Parent Behaviors and Adult Attachment in Childhood Cancer Survivors.

    Science.gov (United States)

    Lehmann, Vicky; Hagedoorn, Mariët; Gerhardt, Cynthia A; Keim, Madelaine C; Guthrie, Lory; Sanderman, Robbert; Tuinman, Marrit A

    2017-03-01

    Childhood cancer is stressful for the entire family. Preoccupation and anxiety surrounding the child's illness may result in parents of children with cancer being overprotective or less emotionally responsive toward their children. Such parenting in response to a negative life event like childhood cancer may cause survivors to be more insecurely attached than healthy peers, which could have downstream effects on survivors' romantic relationships later in life. Therefore, we examined survivors' perspectives on parent behaviors, adult attachment, and marital status among adult survivors of childhood cancer relative to controls. One hundred forty-nine young adult survivors and 149 matched controls (M age  = 28, range 20-40) indicated their relationship status (single vs. partnered) and completed standardized questionnaires assessing memories of upbringing (warmth, overprotection, rejection) and adult attachment (avoidance, anxiety). Adult survivors of childhood cancer remembered mothers and fathers as emotionally warmer (d = 0.53/0.30), and mothers as less rejecting than controls (d = 0.30). Adult attachment was overall similar between survivors and controls, but partnered survivors reported particularly low attachment-related anxiety. Childhood cancer was related to higher mother and father warmth, which were associated with lower attachment-related avoidance and in turn with a greater likelihood of being in a relationship. Adult childhood cancer survivors did not remember their parents as overprotective, but reported more positive parenting relative to controls; and similar adult attachment and relationship status. The results were unexpected, but offer novel insights for future prospective studies, which are necessary to better understand psychosocial late effects of childhood cancer.

  7. Childhood and adult cancer in twins: evidence from the Utah genealogy.

    Science.gov (United States)

    Neale, Rachel E; Mineau, Geraldine; Whiteman, David C; Brownbill, Pat A; Murphy, Michael F G

    2005-05-01

    Evidence suggests that the in utero environment may contribute to subsequent development of cancers in childhood and adulthood. Raised levels of estrogen during pregnancy may be the primary in utero etiologic factor. Mothers of twins have higher estrogen levels during pregnancy than mothers of singletons, therefore, assessment of cancer risk in twins may be informative. We conducted a retrospective cohort study of cancer among twin and singleton newborns selected from the Utah Population Database, matched on birth year and sex. Cancer diagnoses were determined by linkage with the Utah state cancer register. Relative rates of all cancers in childhood and in adulthood in twins compared with singletons, and for specific cancers including testicular, breast and melanoma, were calculated using Poisson regression. Twin (35,271) and singleton (74,199) births were identified, among whom there were 336 and 691 cancer diagnoses, respectively. The relative risk (RR) of childhood cancer in twins compared with singletons was 0.82 [95% confidence interval (CI) 0.55-1.24] and of adult cancer was 1.06 (0.92-1.22). We found nonsignificant increases in risk among adult twins for cancers of the breast, prostate, testis, lymphatic system, thyroid, and large bowel. The largest departures from unity were for testicular cancer (RR 1.47; 95% CI, 0.73-2.95) and melanoma (RR 0.67; 95% CI, 0.42-1.06). These results are consistent with the body of evidence suggesting that twins have a reduced risk of cancer in childhood. Although there is no overall differential in adult cancer risk, these data support the hypothesis that the in utero environment may play an important role in specific cancers.

  8. Diet Quality and Cancer Outcomes in Adults: A Systematic Review of Epidemiological Studies

    Science.gov (United States)

    Potter, Jennifer; Brown, Leanne; Williams, Rebecca L.; Byles, Julie; Collins, Clare E.

    2016-01-01

    Dietary patterns influence cancer risk. However, systematic reviews have not evaluated relationships between a priori defined diet quality scores and adult cancer risk and mortality. The aims of this systematic review are to (1) describe diet quality scores used in cohort or cross-sectional research examining cancer outcomes; and (2) describe associations between diet quality scores and cancer risk and mortality. The protocol was registered in Prospero, and a systematic search using six electronic databases was conducted through to December 2014. Records were assessed for inclusion by two independent reviewers, and quality was evaluated using a validated tool. Sixty-four studies met inclusion criteria from which 55 different diet quality scores were identified. Of the 35 studies investigating diet quality and cancer risk, 60% (n = 21) found a positive relationship. Results suggest no relationship between diet quality scores and overall cancer risk. Inverse associations were found for diet quality scores and risk of postmenopausal breast, colorectal, head, and neck cancer. No consistent relationships between diet quality scores and cancer mortality were found. Diet quality appears to be related to site-specific adult cancer risk. The relationship with cancer mortality is less conclusive, suggesting additional factors impact overall cancer survival. Development of a cancer-specific diet quality score for application in prospective epidemiology and in public health is warranted. PMID:27399671

  9. Why Is Cancer More Depressing for Men than Women among Older White Adults?

    Science.gov (United States)

    Pudrovska, Tetyana

    2010-01-01

    Using data from two waves of the Wisconsin Longitudinal Study (N = 8,054), I examine gender differences in psychological adjustment to cancer among older white adults. Results from different types of longitudinal models reveal that cancer has more adverse psychological implications for men than women. Men's higher levels of depression are reduced…

  10. Reproductive status in adult male long-term survivors of childhood cancer

    NARCIS (Netherlands)

    Tromp, K.; Claessens, J. J. M.; Knijnenburg, S. L.; van der Pal, H. J. H.; van Leeuwen, F. E.; Caron, H. N.; Beerendonk, C. C. M.; Kremer, L. C. M.

    2011-01-01

    This study assessed the long-term effects of cancer therapies on reproductive status in adult male childhood cancer survivors, evaluated the treatment-related risk factors for hypergonadotropic hypogonadism and assessed the association between the FSH levels and the later need for assisted

  11. Reproductive status in adult male long-term survivors of childhood cancer

    NARCIS (Netherlands)

    Tromp, K.; Claessens, J.J.M.; Knijnenburg, S.L.; Pal, H.J. van der; Leeuwen, F.E. van; Caron, H.N.; Beerendonk, C.C.M.; Kremer, L.C.

    2011-01-01

    BACKGROUND: This study assessed the long-term effects of cancer therapies on reproductive status in adult male childhood cancer survivors, evaluated the treatment-related risk factors for hypergonadotropic hypogonadism and assessed the association between the FSH levels and the later need for

  12. Comprehension of a Colon Cancer Pamphlet among American Adults at Least 50 Years of Age

    Science.gov (United States)

    Liu, Chiung-ju

    2010-01-01

    Objective: The purpose of this study was to identify determinants of comprehension of an educational pamphlet on colon cancer, by adults at least 50 years of age living in the United States. Design: Data were analysed from the "2003 National Assessment of Adult Literacy" survey. The survey was designed to assess functional English…

  13. Adult height and risk of breast cancer: a possible effect of early nutrition

    OpenAIRE

    Nilsen, T I Lund; Vatten, L J

    2001-01-01

    The relationship of breast cancer to early reproductive development and height suggests that fetal and childhood nutrition may be important in its aetiology. Caloric restriction sufficient to reduce adult height may reduce breast cancer risk. During World War II (WWII) there was a marked reduction in average caloric intake in Norway that resulted in greater nutritional diversity. We hypothesized that a positive association between height and risk of breast cancer would be stronger among women...

  14. Developing a new instrument to assess the impact of cancer in young adult survivors of childhood cancer.

    Science.gov (United States)

    Zebrack, Brad

    2009-09-01

    Thirty years of psychosocial oncology research have detailed issues having significant impact in both pediatric and adult populations; yet, few studies have captured the subtle and unique ways in which cancer impacts, disrupts and in some instances promotes the growth and development of adolescents and young adults with a cancer history. This paper reports the initiation of an effort to assess the impact of cancer in this young survivor population through the development of a new Impact of Cancer (IOC) instrument. 64 young adults aged 18-39 years and treated for a pediatric malignancy participated in face-to-face interviews and responded to questions prompting them to describe the impact of cancer on their physical, psychological, social and spiritual/existential well-being. Intent of analysis was to organize data into meaningful sub-categories from which to develop a set of candidate survey items that assess a range of problems, issues and changes that long-term survivors ascribe to their cancer experience. A total of 82 candidate survey items represented content across 11 topical domains including Body, Health and Body image, Treatment and Health Care, Having Children, Identity, Talking and Thinking About Cancer, Meaning of Cancer, Memory and Thinking, Finances, Family and Relationships, Socializing, and Life Goals. Assessing the instrument's psychometric properties in a large representative group of young cancer survivors is the next step for further development of such a measure. Once established, a valid and reliable Impact of Cancer instrument has the potential for identifying salient survivorship issues in a clinical setting.

  15. Body image disturbance in adults treated for cancer - a concept analysis.

    Science.gov (United States)

    Rhoten, Bethany A

    2016-05-01

    To report an analysis of the concept of body image disturbance in adults who have been treated for cancer as a phenomenon of interest to nurses. Although the concept of body image disturbance has been clearly defined in adolescents and adults with eating disorders, adults who have been treated for cancer may also experience body image disturbance. In this context, the concept of body image disturbance has not been clearly defined. Concept analysis. PubMed, Psychological Information Database and Cumulative Index of Nursing and Allied Health Literature were searched for publications from 1937 - 2015. Search terms included body image, cancer, body image disturbance, adult and concept analysis. Walker and Avant's 8-step method of concept analysis was used. The defining attributes of body image disturbance in adults who have been treated for cancer are: (1) self-perception of a change in appearance and displeasure with the change or perceived change in appearance; (2) decline in an area of function; and (3) psychological distress regarding changes in appearance and/or function. This concept analysis provides a foundation for the development of multidimensional assessment tools and interventions to alleviate body image disturbance in this population. A better understanding of body image disturbance in adults treated for cancer will assist nurses and other clinicians in identifying this phenomenon and nurse scientists in developing instruments that accurately measure this condition, along with interventions that will promote a better quality of life for survivors. © 2016 John Wiley & Sons Ltd.

  16. Multiple health behavior change in adults with or at risk for cancer: a systematic review.

    Science.gov (United States)

    Green, Amanda C; Hayman, Laura L; Cooley, Mary E

    2015-05-01

    To identify components of efficacious interventions for multiple health behavior change (MHBC) in adult cancer survivors or adults at high risk for cancer. A systematic review of MHBC interventions was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework. Ten studies met inclusion criteria. Most studies changed at least 2 health behaviors. Diet, exercise, and smoking cessation were consistently changed with in-person interventions. Longer duration interventions using phone or mail contact had a positive association with changing diet and exercise. MHBC interventions positively influenced behavior change in adults with cancer and those at high risk for cancer. Future studies should focus on increasing dissemination and implementation of efficacious interventions.

  17. Impact of Cancer on Romantic Relationships Among Young Adults: A Systematic Review.

    Science.gov (United States)

    Rabin, Carolyn

    2018-04-24

    The aim of this review was to determine the impact of a cancer diagnosis and history on young adults' ability to initiate and maintain romantic relationships. MedLine and PsycInfo databases were used to identify articles that address dating, romantic relationships, or marriage among 18- to 45-year-old cancer survivors. Twenty-one relevant articles were identified. Findings indicate that young adult cancer survivors struggle with when/how to disclose their cancer history to potential partners, are delayed in initiating their first romantic relationships, have fewer romantic relationships than peers, and are less likely than peers to marry. Young survivors report that their cancer experience impacts their long-term relationships in both positive and negative ways. In summary, young survivors face significant barriers to establishing and maintaining romantic relationships. Those who have difficulty establishing romantic relationships may benefit from receiving additional support from other sources, including family members, friends, and (in some cases) mental health professionals.

  18. Awareness and perceptions regarding common cancers among adult population in a rural area of Puducherry, India.

    Science.gov (United States)

    Veerakumar, Arumugam Mariappan; Kar, Sitanshu Sekhar

    2017-01-01

    Awareness regarding cancer signs and symptoms and their screening and treatment method was low in India. To assess the awareness level of common cancers, perception regarding prevention and treatment of common cancers, association between sociodemographic variables with the awareness level of common cancers in the adult population. A cross-sectional study was conducted among 299 adults from the field practice areas of Our Rural Health Centre, Puducherry, during April-May 2014. Using systematic random sampling, 299 adults were interviewed through a pretested semi-structured questionnaire. Data were entered into EpiData version 3.1 and were analyzed by Statistical Package for Social Sciences version 20. Chi-square test was used. Nearly, 64% were in the age group of ≥40 years, the majorities were females (56.2%) and 64% were in lower socioeconomic class. Symptoms reported majorities were unusual bleeding (41.6%), followed by nagging cough (34.1%). Risk factors reported majorities were smoking (65%), chewing tobacco (59%) followed by alcohol use (46.5%). Only 10% reported cancer could be diagnosed early and 27% perceived cancer could be preventable. Only 6% perceived cancer could be cured fully. The adequate awareness level regarding lung and oral cancer were 14%, but breast and cervical cancer were <5%. The younger age group (<40 years) had more adequate awareness level compared to age group ≥40 years ( P < 0.05). The awareness level of common cancers was very poor. Vigorous health education program should improve the status of early diagnosis and proper treatment for common cancers such as oral, breast, and cervical cancer.

  19. An international ecological study of adult height in relation to cancer incidence for 24 anatomical sites.

    Science.gov (United States)

    Jiang, Yannan; Marshall, Roger J; Walpole, Sarah C; Prieto-Merino, David; Liu, Dong-Xu; Perry, Jo K

    2015-03-01

    Anthropometric indices associated with childhood growth and height attained in adulthood, have been associated with an increased incidence of certain malignancies. To evaluate the cancer-height relationship, we carried out a study using international data, comparing various cancer rates with average adult height of women and men in different countries. An ecological analysis of the relationship between country-specific cancer incidence rates and average adult height was conducted for twenty-four anatomical cancer sites. Age-standardized rates were obtained from GLOBOCAN 2008. Average female (112 countries) and male (65 countries) heights were sourced and compiled primarily from national health surveys. Graphical and weighted regression analysis was conducted, taking into account BMI and controlling for the random effect of global regions. A significant positive association between a country's average adult height and the country's overall cancer rate was observed in both men and women. Site-specific cancer incidence for females was positively associated with height for most cancers: lung, kidney, colorectum, bladder, melanoma, brain and nervous system, breast, non-Hodgkin lymphoma, multiple myeloma, corpus uteri, ovary, and leukemia. A significant negative association was observed with cancer of the cervix uteri. In males, site-specific cancer incidence was positively associated with height for cancers of the brain and nervous system, kidney, colorectum, non-Hodgkin lymphoma, multiple myeloma, prostate, testicular, lip and oral cavity, and melanoma. Incidence of cancer was associated with tallness in the majority of anatomical/cancer sites investigated. The underlying biological mechanisms are unclear, but may include nutrition and early-life exposure to hormones, and may differ by anatomical site.

  20. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... Directives Using Trusted Resources Cancer Types Adolescents and Young Adults with Cancer Reports, Research, and Literature Cancers ... Cancers Cancers by Body Location Childhood Cancers Adolescent & Young Adult Cancers Metastatic Cancer Recurrent Cancer Research NCI’s ...

  1. Collaboration and Networking

    NARCIS (Netherlands)

    Husson, O.; Manten-Horst, E.; Graaf, W.T.A. van der

    2016-01-01

    Awareness of the need for collaboration across pediatric and adult cancer to care for adolescents and young adults (AYAs) arose from the recognition of the unique characteristics of AYAs with cancer. Neither pediatric nor adult oncology hospital departments are able to provide age-appropriate care

  2. Blood trihalomethane levels and the risk of total cancer mortality in US adults

    International Nuclear Information System (INIS)

    Min, Jin-Young; Min, Kyoung-Bok

    2016-01-01

    Background: Although animal data have suggested the carcinogenic activity of trihalomethanes (THMs), there is inconsistent evidence supporting the link between THM exposure and cancers in humans. Objectives: We investigated the association between specific and total blood THM levels with the risk of total cancer mortality in adults. Methods: We analyzed data from the 1999–2004 Third National Health and Nutrition Examination Survey and the Linked Mortality File of the United States. A total of 933 adults (20–59 years of age) with available blood THM levels and no missing data for other variables were included. Four different THM species (chloroform, bromodichloromethane (BDCM), dibromochloromethane (DBCM) and bromoform) were included, and the codes associated with cancer (malignant neoplasm) were C00 through C97, based on the underlying causes of death listed in the International Classification of Disease 10the Revision. Results: Compared with adults in the lowest DBCM, bromoform, and total brominated THM tertiles, those in the highest DBCM, bromoform, and total brominated THM tertiles exhibited adjusted hazard ratios (HR) of total cancer mortality of 4.97 (95% confidence interval (CI) = 1.59–15.50), 4.94 (95% CI = 1.56–15.61), and 3.42 (95% CI = 1.21–15.43) respectively. The risk of total cancer mortality was not associated with increases in blood chloroform and total THM levels. Conclusions: We found that the baseline blood THM species, particularly brominated THMs, were significantly associated with total cancer mortality in adults. Although this study should be confirm by other studies, our findings suggest a possible link between THM exposures and cancer. - Highlights: • Trihalomethanes (THM) are classified as either probable or possible carcinogens. • Limited evidence on the link between THM and the incidence of cancer in humans. • We investigated the association between blood THM levels and the risk of total cancer mortality. • High

  3. Occupational Therapists With Oncology Exposure: Perceived Needs on Adults and Older Adults With Cancer-Related Cognitive Impairments.

    Science.gov (United States)

    Ulfers, Sara S; Berg, Christine

    2017-07-01

    Cancer-related cognitive impairments (CRCI) can limit participation in meaningful activities before, during, and after cancer treatment. This study explored occupational therapists' perceived knowledge gaps and needs regarding CRCI in adults and older adults. An online survey was sent to a convenience sample of 60 practitioners at facilities throughout the continuum of care and 176 directors and faculty in accredited occupational therapy programs. Using a snowball sampling approach, recipients were asked to forward the survey to other occupational therapists. One hundred seven occupational therapists participated. The majority (92%) responded that it would be beneficial to attend a face-to-face continuing education program; preferences for the content and design of a continuing competency seminar are described. These findings support the development and delivery of continuing competence programs tailored toward occupational therapists' CRCI knowledge needs.

  4. Innovative fertility preservation strategies and programs for young adults with cancer

    Directory of Open Access Journals (Sweden)

    Johnson RH

    2016-01-01

    Full Text Available Rebecca H Johnson Division of Pediatric Hematology/Oncology, Department of Pediatrics, Mary Bridge Hospital, MultiCare Health System, Tacoma, WA, USA Abstract: Preservation of fertility is a key issue for young adults newly diagnosed with cancer. Up to 90% of cancer patients under the age of 45 are at risk for fertility impairment following cancer therapy. Cancer patients who are not offered fertility preservation (FP and those who become infertile following therapy may experience long-term psychosocial distress. This review summarizes the numerous effective strategies for preserving fertility, including sperm banking, electroejaculation, and testicular sperm extraction in males and cryopreservation of embryos or oocytes in females. This paper also highlights novel methods currently in development, such as gonadal tissue cryopreservation and in vitro maturation of gametes. In women, anti-Mullerian hormone is emerging as an accurate marker of ovarian reserve, and the use of gonadotropin releasing hormone analogs to protect fertility is increasingly well validated. Although national guidelines mandate FP counseling and referral prior to the start of cancer therapy for patients with reproductive potential, only a minority of young cancer patients in the USA currently take steps to preserve fertility prior to the start of therapy. Some cancer centers across the USA are developing institutional strategies to support FP, resulting in increased utilization of fertility services by newly diagnosed cancer patients. Keywords: young adult, cancer, fertility preservation, program, oocyte, sperm

  5. Clusters of Adolescent and Young Adult Thyroid Cancer in Florida Counties

    Directory of Open Access Journals (Sweden)

    Raid Amin

    2014-01-01

    Full Text Available Background. Thyroid cancer is a common cancer in adolescents and young adults ranking 4th in frequency. Thyroid cancer has captured the interest of epidemiologists because of its strong association to environmental factors. The goal of this study is to identify thyroid cancer clusters in Florida for the period 2000–2008. This will guide further discovery of potential risk factors within areas of the cluster compared to areas not in cluster. Methods. Thyroid cancer cases for ages 15–39 were obtained from the Florida Cancer Data System. Next, using the purely spatial Poisson analysis function in SaTScan, the geographic distribution of thyroid cancer cases by county was assessed for clusters. The reference population was obtained from the Census Bureau 2010, which enabled controlling for population age, sex, and race. Results. Two statistically significant clusters of thyroid cancer clusters were found in Florida: one in southern Florida (SF (relative risk of 1.26; P value of <0.001 and the other in northwestern Florida (NWF (relative risk of 1.71; P value of 0.012. These clusters persisted after controlling for demographics including sex, age, race. Conclusion. In summary, we found evidence of thyroid cancer clustering in South Florida and North West Florida for adolescents and young adult.

  6. Safety, efficacy, and clinical utility of asparaginase in the treatment of adult patients with acute lymphoblastic leukemia

    Directory of Open Access Journals (Sweden)

    Koprivnikar J

    2017-03-01

    Full Text Available Jamie Koprivnikar, James McCloskey, Stefan Faderl Division of Leukemia, John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, NJ, USA Abstract: Adults with acute lymphoblastic leukemia (ALL are known to have inferior outcomes compared to the pediatric population. Although the reasons for this are likely manyfold, the agents utilized and the increased intensity of pediatric treatments compared to adult treatments are likely significant contributing factors. Asparaginase, an enzyme that converts asparagine to aspartic acid, forms the backbone of almost all pediatric regimens and works by depleting extracellular asparagine, which ALL cells are unable to synthesize. Asparaginase toxicities, which include hypersensitivity reactions, pancreatitis, liver dysfunction, and thrombosis, have hindered its widespread use in the adult population. Here, we review the toxicity and efficacy of asparaginase in adult patients with ALL. With the proper precautions, it is a safe and effective agent in the treatment of younger adults with ALL with response rates in the frontline setting ranging from 78% to 96%, compared to most trials showing a 4-year overall survival of 50% or better. The age cutoff for consideration of treatment with pediatric-inspired regimens is not clear, but recent studies show promise particularly in the adolescent and young adult population. New formulations of asparaginase are actively in development, including erythrocyte-encapsulated asparaginase, which is designed to minimize the toxicity and improve the delivery of the drug. Keywords: PEG-asparaginase, ALL, chemotherapy, pegaspargase, AYA, pediatric 

  7. Building the bridge between rhabdomyosarcoma in children, adolescents and young adults : The road ahead

    NARCIS (Netherlands)

    Van Gaal, J. Carlijn; De Bont, Eveline S. J. M.; Kaal, Suzanne E. J.; Versleijen-Jonkers, Yvonne; van der Graaf, Winette T. A.

    Rhabdomyosarcoma (RMS) is a rare type of soft tissue sarcoma that mainly affects children, but also occurs in adolescents and (young) adults (AYA). Despite dramatic survival improvements reported by international study groups in children over the past decades, the awareness of a dismal outcome for

  8. Acute lymphoblastic leukemia in adolescents and young adults – from genomics to the clinics

    Directory of Open Access Journals (Sweden)

    Kenderian SS

    2013-04-01

    Full Text Available Saad Sirop Kenderian, Mark R Litzow Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA Abstract: Acute lymphoblastic leukemia (ALL in adolescents and young adults (AYA represents a unique and challenging disease entity. Despite the recent improvement of survival in this population over the last decade, it is still lagging behind the excellent cure rates obtained in pediatric ALL. This special population of AYA receives care from pediatric as well as adult hematologists and can be treated on pediatric or adult protocols. There is a substantial difference in disease biology, response to chemotherapy, and allogeneic stem cell transplantation between pediatric and AYA patients. This review discusses current controversies in the management of AYA, outcomes following treatment with pediatric and adult protocols, and the role of allogeneic stem cell transplantation. It focuses on the unique clinical, biological, and socioeconomic characteristics of this population that might partly explain the inferior outcomes. This review also explores recent advances in genomic profiling and emerging treatments in ALL. Keywords: novel agents, monoclonal antibodies, stem cell transplantation, bone marrow transplantation, Philadelphia positive ALL, genomic profile

  9. Perspectives on music therapy in adult cancer care: a hermeneutic study.

    Science.gov (United States)

    Olofsson, Anne; Fossum, Bjöörn

    2009-07-01

    To explore perspectives on music therapy as a nursing intervention in adult cancer care and to expand and integrate knowledge and understanding about music therapy as an adjunctive intervention in adult cancer nursing care. Published nursing articles. Medical and nursing journals have reported on research related to music and its effect as a nursing intervention. However, this research often lacks a musical context (i.e., knowledge and understanding from a musical perspective). Music therapy is not a consistent concept. Perspectives on the meanings of music therapy vary according to knowledge and scientific orientation. The perspective may influence the character and methodology of the music therapy intervention as well as the understanding of its results. To fully develop music therapy as an adjunct intervention in adult cancer care, interdisciplinary cooperation between nurses and music therapists should be supported on clinical and educational levels.

  10. Palliative therapy in adults with cancer: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Angelita Visentin

    Full Text Available ABSTRACT Objective: To characterize the socioeconomic and clinical profile of adult cancer patients in palliative therapy. Method: Cross-sectional study in an oncology hospital in Paraná, with 124 adult patients who started palliative therapy in the period from Jan. 2 to June 30, 2015. Results: Of the participating population, 60.5% were women, 68.5% white, 48.4% married, 72.6% catholic and with income of one to two minimum wages. Non-smokers, 45.2%, non-alcoholics 75%, and 92% had Performance Status 1 and 2. The predominant primary diagnosis was breast cancer, with previous chemotherapy and radiotherapy. The sites of metastasis were lung/mediastinum/bronchi and lymph nodes. Conclusion: The socioeconomic and clinical context characterized the profile of adult patients in palliative therapy. The demand arising from the increase in cases of advanced cancer requires nursing care at all stages of treatment.

  11. Young adult cancer survivors' follow-up care expectations of oncologists and primary care physicians.

    Science.gov (United States)

    Hugh-Yeun, Kiara; Kumar, Divjot; Moghaddamjou, Ali; Ruan, Jenny Y; Cheung, Winson Y

    2017-06-01

    Young adult cancer survivors face unique challenges associated with their illness. While both oncologists and primary care physicians (PCPs) may be involved in the follow-up care of these cancer survivors, we hypothesized that there is a lack of clarity regarding each physician's roles and responsibilities. A self-administered survey was mailed to young adult cancer survivors in British Columbia, Canada, who were aged 20 to 39 years at the time of diagnosis and alive at 2 to 5 years following the diagnosis to capture their expectations of oncologists and PCPs in various important domains of cancer survivorship care. Multivariate logistic regression models that adjusted for confounders were constructed to examine for predictors of the different expectations. Of 722 young cancer survivors surveyed, 426 (59%) responded. Among them, the majority were White women with breast cancer. Oncologists were expected to follow the patient's most recent cancer and treatment-related side effects while PCPs were expected to manage ongoing and future cancer surveillance as well as general preventative care. Neither physician was perceived to be responsible for addressing the return to daily activities, reintegration to interpersonal relationships, or sexual function. Older survivors were significantly less likely to expect oncologists (p = 0.03) and PCPs (p = 0.01) to discuss family planning when compared to their younger counterparts. Those who were White were significantly more likely to expect PCPs to discuss comorbidities (p = 0.009) and preventative care (p = 0.001). Young adult cancer survivors have different expectations of oncologists and PCPs with respect to their follow-up care. Physicians need to better clarify their roles in order to further improve the survivorship phase of cancer care for young adults. Young adult cancer survivors have different expectations of their oncologists and PCPs. Clarification of the roles of each physician group during follow-up can

  12. Nutrition in adult and childhood cancer: role of carcinogens and anti-carcinogens.

    Science.gov (United States)

    Mosby, Terezie T; Cosgrove, Maeve; Sarkardei, Samiramis; Platt, Karl L; Kaina, Bernd

    2012-10-01

    There is no doubt that diet is one of the main modifiable risk factors for many degenerative diseases, including cancer. More than 30% of adult cancers can be prevented or delayed by diet, being physically active and having a healthy body weight. Plant-based foods, including fruit, vegetables, and whole grains, a favorable omega-6/omega-3 polyunsaturated fatty acids ratio, and fish consumption have a protective effect against cancer. On the contrary, a low intake of fruit and vegetables, high intake of red and processed meat, high intake of sodium, alcohol consumption, a diet rich in refined carbohydrates, and a high intake of total fat may increase risk of cancer. Furthermore, calorie restriction and having a body/mass index on the lower end of the normal range can significantly decrease or delay the onset of cancers. Most studies were performed on adults and thus the role of diet in childhood cancer is less well-understood. In the past, diet was not considered to play any role in its etiology in children. However, nowadays there is a growing body of evidence that prolonged and frequent breastfeeding, the maternal diet during pregnancy and vitamin intake during pregnancy, may impart benefit for reduced cancer risk in children. Usually, decades of healthy dietary habits are needed to see significant difference in cancer risk. Therefore, diet choices and diet preparation starting early in life deserve more attention. Here we review data focusing on which dietary factors, including food-borne carcinogens, affect the onset of cancers in adults and stress out the potential role of diet in childhood cancer prevention.

  13. A randomized trial of a Facebook-based physical activity intervention for young adult cancer survivors.

    Science.gov (United States)

    Valle, Carmina G; Tate, Deborah F; Mayer, Deborah K; Allicock, Marlyn; Cai, Jianwen

    2013-09-01

    Over half of young adult cancer survivors do not meet physical activity (PA) guidelines. PA interventions can enhance health and quality of life among young adult cancer survivors. However, few exercise interventions have been designed and tested in this population. This study evaluated the feasibility and preliminary efficacy of a 12-week, Facebook-based intervention (FITNET) aimed at increasing moderate-to-vigorous intensity PA compared with a Facebook-based self-help comparison (SC) condition. Young adult cancer survivors (n = 86) were randomly assigned to the FITNET or SC group. All participants were asked to complete self-administered online questionnaires at baseline and after 12 weeks. Seventy-seven percent of participants completed postintervention assessments, and most participants reported using intervention components as intended. Participants in both groups would recommend the program to other young adult cancer survivors (FITNET, 46.9 vs. SC, 61.8 %; p = 0.225). Over 12 weeks, both groups increased self-reported weekly minutes of moderate-to-vigorous PA (FITNET, 67 min/week (p = 0.009) vs. SC, 46 min/week (p = 0.045)), with no significant difference between groups. Increases in light PA were 135 min/week greater in the FITNET group relative to the SC group (p = 0.032), and the FITNET group reported significant weight loss over time (-2.1 kg, p = 0.004; p = 0.083 between groups). Facebook-based intervention approaches demonstrated potential for increasing PA in young adult cancer survivors. Social networking sites may be a feasible way for young adult cancer survivors to receive health information and support to promote PA and healthy behaviors.

  14. Physical activity and cancer prevention: awareness and meeting the recommendations among adult Saudis.

    Science.gov (United States)

    Amin, Tarek Tawfik; Al-Hammam, Abudllah Mohammed; AlMulhim, Nasser Abdullah; Al-Hayan, Mohammed Ibrahim; Al-Mulhim, Mona Mohammed; Al-Mosabeh, Modhahir Jawad; Al-Subaie, Mohammed Ali; Al-Hmmad, Qassem Ahmed; Al-Omran, Ahmed Adi

    2014-01-01

    There is a scarcity of information about the proportion of the adult Saudi population that meet the recommended guidelines of physical activity (PA) to reduce cancer risk. Moreover, their awareness about the role of PA in cancer prevention is unclear. This cross-sectional study aimed at estimating the proportion of adult Saudis meeting the PA guidelines, specifically those recommended by American Cancer Society (ACS) for cancer prevention, and to assess the public awareness about the role of PA in cancer prevention. Using a multistage sampling method, 2,127 adult Saudis of both genders were recruited from 6 urban and 4 rural primary health care centers in Al Hassa, Saudi Arabia. Participants were personally interviewed to gather information about their sociodemographic characteristics, searching activity about PA and cancer, and the time spent in leisure time PA (moderate and vigorous)/week using the Global Physical Activity Questionnaire with show cards. Finally, items about the role of PA in cancer risk reduction were inquired. Of the included participants, 11.6% met the recommendations for cancer prevention (≥ 45 minutes of moderate-vigorous PA activity/≥ 5 days/week or 225 minutes/week). Multivariate regression showed that being male (AOR=1.49, CI=1.09-2.06), cancer prevention. Only 11.4% of the sample indicated correctly the frequency and duration of PA required for an average adult to be physically active and while >70% of them indicated the role of PA in prevention of hypertension, coronary heart disease and lowering elevated blood cholesterol, only 18.6% and 21.7% correctly mentioned the role of PA in reducing colon and breast cancer risk, respectively. Poor knowledge was found among those with less than college education and aged ≥ 50 years. The level of knowledge was significantly positively correlated with total leisure time PA of the participants. A minority of adult Saudis in Al Hassa was aware about the role of PA in cancer prevention and

  15. Awareness of risk factors for cancer among Omani adults--a community based study.

    Science.gov (United States)

    Al-Azri, Mohammed; Al-Rasbi, Khadija; Al-Hinai, Mustafa; Davidson, Robin; Al-Maniri, Abdullah

    2014-01-01

    Cancer is the leading cause of mortality around the world. However, the majority of cancers occur as a result of modifiable risk factors; hence public awareness of cancer risk factors is crucial to reduce the incidence. The objective of this study was to identify the level of public awareness of cancer risk factors among the adult Omani population. A community based survey using the Cancer Awareness Measure (CAM) questionnaire was conducted in three areas of Oman to measure public awareness of cancer risk factors. Omani adults aged 18 years and above were invited to participate in the study. SPPSS (ver.20) was used to analyse the data. A total of 384 participated from 500 invited individuals (response rate =77%). The majority of respondents agreed that smoking cigarettes (320, 83.3%), passive smoking (279, 72.7%) and excessive drinking of alcohol (265, 69%) are risks factors for cancer. However, fewer respondents agreed that eating less fruit and vegetables (83, 21.6%), eating more red or processed meat (116, 30.2%), being overweight (BMI>25) (123, 32%), doing less physical exercise (119, 31%), being over 70 years old (72, 18.8%), having a close relative with cancer (134, 34.9%), infection with human papilloma virus (HPV) (117, 30.5%) and getting frequent sunburn during childhood (149, 38.8%) are risk factors for cancer. A significant association was found between participant responses and their educational level. The higher the educational level, the more likely that respondents identified cancer risk factors including smoking (paware of the common risk factors for cancer. It may be possible to reduce the incidence of cancers in Oman by developing strategies to educate the public about these risk factors.

  16. Familial aggregation of childhood and adult cancer in the Utah genealogy.

    Science.gov (United States)

    Neale, Rachel E; Stiller, Charles A; Bunch, Kathryn J; Milne, Elizabeth; Mineau, Geraldine P; Murphy, Michael F G

    2013-12-15

    A small proportion of childhood cancer is attributable to known hereditary syndromes, but whether there is any familial component to the remainder remains uncertain. We explored familial aggregation of cancer in a population-based case-control study using genealogical record linkage and designed to overcome limitations of previous studies. Subjects were selected from the Utah Population Database. We compared risk of cancer in adult first-degree relatives of children who were diagnosed with cancer with the risk in relatives of children who had not had a cancer diagnosed. We identified 1,894 childhood cancer cases and 3,788 controls; 7,467 relatives of cases and 14,498 relatives of controls were included in the analysis. Relatives of children with cancer had a higher risk of cancer in adulthood than relatives of children without cancer [odds ratio (OR) 1.31, 95% confidence interval (CI) 1.11-1.56]; this was restricted to mothers and siblings and was not evident in fathers. Familial aggregation appeared stronger among relatives of cases diagnosed before 5 years of age (OR 1.48, 95% CI 1.13-1.95) than among relatives of cases who were older when diagnosed (OR 1.22, 95% CI 0.98-1.51). These findings provide evidence of a generalized excess of cancer in the mothers and siblings of children with cancer. The tendency for risk to be higher in the relatives of children who were younger at cancer diagnosis should be investigated in other large data sets. The excesses of thyroid cancer in parents of children with cancer and of any cancer in relatives of children with leukemia merit further investigation. Copyright © 2013 UICC.

  17. The Adolescent and Young Adult with Cancer: A Developmental Life Course Perspective.

    Science.gov (United States)

    Docherty, Sharron L; Kayle, Mariam; Maslow, Gary R; Santacroce, Sheila Judge

    2015-08-01

    Using a Life Course Health Development framework, this article summarizes what is known about the impact of cancer and its treatment on the biopsychosocial world of the adolescent and young adult. Published peer reviewed literature, web-based resources, and cancer-related professional organizations' resources. Adolescents and young adults with cancer, between 15 and 29 years of age, have emerged as a distinct group requiring specialized care. The demands of cancer and its treatment are often directly counter to the developmental needs of this age group and often alter those life course experiences that contribute to resilience, thriving, and flourishing. Providing high-quality care to this age group requires a depth of understanding of the complexity of factors that merge to influence the developmental life course. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Exercise for cancer cachexia in adults:Executive summary of a Cochrane Collaboration systematic review

    OpenAIRE

    Grande, Antonio Jose; Silva, Valter; Maddocks, Matthew

    2015-01-01

    BACKGROUND: Cancer cachexia is a complex syndrome characterized by an ongoing loss of skeletal muscle mass and progressive functional impairment. A proactive management approach is recommended, including physical exercise to maintain function via modulation of muscle metabolism, insulin sensitivity and levels of inflammation. The review aimed to determine the safety, acceptability and effectiveness of exercise in adults with cancer cachexia. Secondary aims, subject to the data availability, w...

  19. Formalized exercise program for paediatric and young adult cancer survivors

    Directory of Open Access Journals (Sweden)

    Karen Y. Wonders

    2017-09-01

    Full Text Available Survival rates of childhood cancer patients has steadily increased through the years, making it necessary to develop strategies aimed at long term improvements to quality of life. This paper presents a formalized exercise program for paediatric cancer survivors, based on current risk-based exercise recommendations, with the primary goal of helping families return to a normal life that emphasizes overall wellness and physical activity. Background Children tend to respond better to anti-cancer treatments, including chemotherapy. Research indicates that proper nutrition and regular physical activity will help a paediatric cancer survivor continue to grow and develop properly, however, at present, there is no standard of care with regards to this subject. Aims To create a fun and supportive atmosphere that encourages movement and healthy eating for the participants while increasing participant knowledge regarding proper nutrition and exercise.

  20. Survivorship Care in Reducing Symptoms in Young Adult Cancer Survivors

    Science.gov (United States)

    2017-10-13

    Breast Carcinoma; Cancer Survivor; Depression; Fatigue; Leukemia; Lymphoma; Malignant Bone Neoplasm; Malignant Digestive System Neoplasm; Malignant Female Reproductive System Neoplasm; Malignant Male Reproductive System Neoplasm; Pain; Sleep Disorder; Soft Tissue Sarcoma

  1. Trajectories of social isolation in adult survivors of childhood cancer

    OpenAIRE

    Howard, A. Fuchsia; Tan de Bibiana, Jason; Smillie, Kirsten; Goddard, Karen; Pritchard, Sheila; Olson, Rob; Kazanjian, Arminee

    2013-01-01

    Purpose Long-term childhood cancer survivors may be at increased risk for poor social outcomes as a result of their cancer treatment, as well as physical and psychological health problems. Yet, important challenges, namely social isolation, are not well understood. Moreover, survivors' perspectives of social isolation as well as the ways in which this might evolve through young adulthood have yet to be investigated. The purpose of this research was to describe the trajectories of social isola...

  2. Trends in Adult Cancer-Related Emergency Department Utilization: An Analysis of Data From the Nationwide Emergency Department Sample.

    Science.gov (United States)

    Rivera, Donna R; Gallicchio, Lisa; Brown, Jeremy; Liu, Benmei; Kyriacou, Demetrios N; Shelburne, Nonniekaye

    2017-10-12

    The emergency department (ED) is used to manage cancer-related complications among the 15.5 million people living with cancer in the United States. However, ED utilization patterns by the population of US adults with cancer have not been previously evaluated or described in published literature. To estimate the proportion of US ED visits made by adults with a cancer diagnosis, understand the clinical presentation of adult patients with cancer in the ED, and examine factors related to inpatient admission within this population. Nationally representative data comprised of 7 survey cycles (January 2006-December 2012) from the Nationwide Emergency Department Sample were analyzed. Identification of adult (age ≥18 years) cancer-related visits was based on Clinical Classifications Software diagnoses documented during the ED visit. Weighted frequencies and proportions of ED visits among adult patients with cancer by demographic, geographic, and clinical characteristics were calculated. Weighted multivariable logistic regression was used to examine the associations between inpatient admission and key demographic and clinical variables for adult cancer-related ED visits. Adult cancer-related ED utilization patterns; identification of primary reason for ED visit; patient-related factors associated with inpatient admission from the ED. Among an estimated 696 million weighted adult ED visits from January 2006 to December 2012, 29.5 million (4.2%) were made by a patient with a cancer diagnosis. The most common cancers associated with an ED visit were breast, prostate, and lung cancer, and most common primary reasons for visit were pneumonia (4.5%), nonspecific chest pain (3.7%), and urinary tract infection (3.2%). Adult cancer-related ED visits resulted in inpatient admissions more frequently (59.7%) than non-cancer-related visits (16.3%) (P adults, breast, prostate, and lung cancer were the most common cancer diagnoses presenting to the ED. Pneumonia was the most common

  3. Enhancing Psychosocial Outcomes for Young Adult Childhood CNS Cancer Survivors: Importance of Addressing Vocational Identity and Community Integration

    Science.gov (United States)

    Strauser, David R.; Wagner, Stacia; Wong, Alex W. K.

    2012-01-01

    The purpose of this study was to examine the relationship between vocational identity, community integration, positive and negative affect, and satisfaction with life in a group of young adult central nervous system (CNS) cancer survivors. Participants in this study included 45 young adult CNS cancer survivors who ranged in age from 18 to 30 years…

  4. Cervical Cancer Screening Among Adult Women in China, 2010

    Science.gov (United States)

    Wang, Baohua; He, Minfu; Chao, Ann; Engelgau, Michael M.; Saraiya, Mona; Wang, Limin

    2015-01-01

    Introduction. Cervical cancer is one of the most commonly diagnosed cancers among women in China. The World Health Organization (WHO) recommends routine screening for cervical cancer, and the WHO Global Monitoring Framework suggests that every nation monitors cervical cancer screening. However, little information is available on cervical cancer screening behavior among women in China. Methods. We used data from the 2010 China Chronic Disease and Risk Factor Surveillance System that included 51,989 women aged 18 years and older. We report the proportion of women who reported ever having had a Papanicolaou (Pap) test, stratified by sociodemographic characteristics and geographic region. Multivariable logistic regression modeling was performed to adjust for potential confounders. Results. Overall, 21% of 51,989 women reported having ever had a Pap test. The highest proportion was reported among women aged 30–39 years (30.1%, 95% confidence interval, 26.8%–33.4%). In all geographic regions, women in rural areas were consistently less likely than women in urban areas to report having had a Pap test. Among women who reported ever having a Pap test, 82% reported having the most recent test in the past 3 years. Factors associated with reporting ever having a test were being aged 30–49 years, higher education, being married, and having urban health insurance. Conclusion. Our results indicate that screening programs need to be strengthened along with a more intense focus on specific demographic groups. National cervical cancer screening guidelines and comprehensive implementation strategies are needed to make screening services available and accessible to all women. Implications for Practice: This study is the largest nationwide and population-based assessment of self-reported history of Pap test for cervical cancer screening in China. This article describes cervical cancer screening behavior among women and examines key demographic and geographic factors. Only one

  5. Teenagers and young adults with cancer in Europe: from national programmes to a European integrated coordinated project

    DEFF Research Database (Denmark)

    Stark, D; Bielack, S; Brugieres, L

    2016-01-01

    Over 14 000 patients aged 15-24 are estimated to be diagnosed with cancer in the European Union (EU) each year. Teenagers and young adults (TYA) often fall down gaps between children's and adults cancer services. The specific challenges of providing optimal care to them are described, but we...... Network for Cancer Research in Children and Adolescents programme (ENCCA), a specific European Network for Teenagers and Young Adults with Cancer has held a series of scientific meetings, including professionals, patients and caregivers. This group has proposed unanswered research questions and agreed key...

  6. Hypothyroidism after cancer and the ability to meet reproductive goals among a cohort of young adult female cancer survivors.

    Science.gov (United States)

    Chin, Helen B; Jacobson, Melanie H; Interrante, Julia D; Mertens, Ann C; Spencer, Jessica B; Howards, Penelope P

    2016-01-01

    To determine whether developing hypothyroidism after cancer treatment is associated with a decreased probability of women being able to meet their reproductive goals. A population-based cohort study. Not applicable. A total of 1,282 cancer survivors, of whom 904 met the inclusion criteria for the analysis. None. Three outcomes that may indicate reduced fertility, which include failure to achieve desired family size, childlessness, and not achieving pregnancy after at least 6 months of regular unprotected intercourse. We used data from the Furthering Understanding of Cancer Health and Survivorship in Adult (FUCHSIA) Women's Study to examine the association between being diagnosed with hypothyroidism after cancer and meeting reproductive goals. After adjusting for age and other potential confounders, women reporting hypothyroidism after cancer treatment were twice as likely to fail to achieve their desired family size (adjusted odds ratio [aOR] 1.91; 95% confidence interval [CI], 1.09, 3.33) and be childless (aOR 2.13; 95% CI, 1.25, 3.65). They were also more likely to report having unprotected intercourse for at least 6 months without conceiving (aOR 1.37; 95% CI, 0.66, 2.83). Although cancer treatments themselves are gonadotoxic, it is important to consider other medical conditions such as hypothyroidism that occur after cancer treatment when counseling patients on the risks for impaired fertility or a shortened reproductive window. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  7. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... Using Trusted Resources Cancer Types Adolescents and Young Adults with Cancer Reports, Research, and Literature Cancers by ... Cancers by Body Location Childhood Cancers Adolescent & Young Adult Cancers Metastatic Cancer Recurrent Cancer Research NCI’s Role ...

  8. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... Information Advance Directives Using Trusted Resources Cancer Types Adolescents and Young Adults with Cancer Reports, Research, and ... of Cancers Cancers by Body Location Childhood Cancers Adolescent & Young Adult Cancers Metastatic Cancer Recurrent Cancer Research ...

  9. Adolescent and adult risk factors for testicular cancer

    Science.gov (United States)

    McGlynn, Katherine A.; Trabert, Britton

    2014-01-01

    The incidence of testicular cancer has been increasing over the past several decades in many developed countries. The reasons for the increases are unknown because risk factors for the disease are poorly understood. Some research suggests that exposures in utero or in early childhood are likely to be important in determining an individual's level of risk. However, other research suggests that exposure to various factors in adolecence and adulthood are also linked to the development of testicular cancer. Of these, two occupational exposures—firefighting and aircraft maintenance—and one environmental exposure (to organochloride pesticides) are likely to be associated with increased risk of developing testicular cancer. By contrast, six of the identified factors—diet, types of physical activity, military service as well as exposure to ionizing radiation, electricity and acrylamide—are unlikely to increase the risk of developing testicular cancer. Finally, seven further exposures—to heat, polyvinylchloride, nonionizing radiation, heavy metals, agricultural work, pesticides and polychlorinated biphenyls as well as marijuana use—require further study to determine their association with testicular cancer. PMID:22508459

  10. Understanding parenting concerns in cancer survivors with minor and young-adult children.

    Science.gov (United States)

    Inhestern, Laura; Bultmann, Johanna Christine; Beierlein, Volker; Möller, Birgit; Romer, Georg; Koch, Uwe; Bergelt, Corinna

    2016-08-01

    Parents with cancer are concerned about the impact of their disease on their children. However, parenting concerns and associated factors in cancer survivors have not previously been analyzed. The purpose of this study is to examine parenting concerns and to test a path model for understanding parenting concerns in cancer survivors. In a cross-sectional study, a total of 1416 parents with cancer (mean age 47.5years, 74% women) having minor or young-adult children were recruited through two cancer registries. Parenting concerns were assessed using the Parenting Concerns Questionnaire. Structural equation modeling (SEM) was used to analyze the associations between social support, parenting confidence, emotional distress, family functioning and parenting concerns. Mothers reported higher total parenting concerns than fathers (peffects of emotional distress and parenting confidence on parenting concerns. Family dysfunctioning was associated with lower concerns. An indirect association between social support and parenting concerns was identified. Parenting concerns in cancer survivors display the need for interventions and after care programs that focus on affected families with minor and young adult children. The results of the structural path model illustrate the associations between psychological and interactional factors. Supporting parents with cancer in their parenting confidence and strengthen social support and family functioning may not only reduce the long-term burden on the parents themselves but also the burden on the entire family. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Using Social Media to Target Cancer Prevention in Young Adults: Viewpoint.

    Science.gov (United States)

    Sarkar, Urmimala; Le, Gem M; Lyles, Courtney R; Ramo, Danielle; Linos, Eleni; Bibbins-Domingo, Kirsten

    2018-06-05

    Focusing on primary cancer prevention can reduce its incidence. Changing health behaviors is critical to cancer prevention. Modifiable cancer risk factors include lifestyle behaviors related to vaccination, physical activity, weight control and maintenance, alcohol consumption, and tobacco use. These health habits are often formed in young adulthood, a life stage which currently intersects with the growing population of digital natives whose childhood occurred in the internet era. Social media is a critical communication medium to reach this population of digital natives. Using a life course perspective, the purpose of this viewpoint paper is to describe the current landscape of nascent research using social media to target cancer prevention efforts in young adults and propose future directions to strengthen the scientific knowledge supporting social media strategies to promote cancer prevention behaviors. Leveraging social media as a health promotion tool is a promising strategy to impact modifiable behavioral risk factors for cancer and warrants further research on developing effective communication strategies in young adults to prevent cancer in the future generations. ©Urmimala Sarkar, Gem M Le, Courtney R Lyles, Danielle Ramo, Eleni Linos, Kirsten Bibbins-Domingo. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 05.06.2018.

  12. Cancer in children and young adults born after assisted reproductive technology

    DEFF Research Database (Denmark)

    Sundh, Karin Jerhamre; Henningsen, Anna-Karina A; Källen, Karin

    2014-01-01

    STUDY QUESTION: Do children and young adults born after assisted reproductive technology (ART) have an increased risk of cancer? SUMMARY ANSWER: Children born after ART showed no overall increase in the rate of cancer when compared with children born as a result of spontaneous conception. WHAT...... IS KNOWN ALREADY: Children born after ART have more adverse perinatal outcomes, i.e. preterm births, low birthweights and birth defects. Previous studies have shown divergent results regarding the risk of cancer among children born after ART. STUDY DESIGN, SIZE, DURATION: A retrospective Nordic population...... group of children born after spontaneous conception. This control group was almost 4-fold the size of the ART group (n = 358 419) and matched for parity, year of birth and country. Data on perinatal outcomes and cancer were obtained from the National Medical Birth Registries, the Cancer Registries...

  13. Practical review of immunizations in adult patients with cancer.

    Science.gov (United States)

    Ariza-Heredia, Ella J; Chemaly, Roy F

    2015-01-01

    Compared with the general population, patients with cancer in general are more susceptible to vaccine-preventable infections, either by an increased risk due to the malignancy itself or immunosuppressive treatment. The goal of immunizations in these patients is therefore to provide protection against these infections, and to decrease the number of vulnerable patients who can disseminate these organisms. The proper timing of immunization with cancer treatment is key to achieving better vaccine protection. As the oncology field continues to advance, leading to better quality of life and longer survival, immunization and other aspects of preventive medicine ought to move to the frontline in the care of these patients. Herein, we review the vaccines most clinically relevant to patients with cancer, as well as special cases including vaccines after splenectomy, travel immunization and recommendations for family members.

  14. PO-58 - Cardiovascular risk profile in survivors of adult cancer - results from the general population study.

    Science.gov (United States)

    Panova-Noeva, M; Hermanns, I M; Schulz, A; Laubert-Reh, D; Zeller, T; Blankenberg, S; Spronk, H M; Münzel, T; Lackner, K J; Ten Cate, H; Wild, P S

    2016-04-01

    The advancements in cancer treatment and detection of early cancer have resulted in steady increase of adult cancer survivors over the years. However, due to the long term toxic effects of chemotherapy and radiotherapy, the incidence of cardiovascular diseases (CVD) is increasing in survivors. Identifying risk factors and interventions to reduce the excess burden of CVD in this vulnerable population is urgently needed. To investigate the cardiovascular risk factors (CVRFs), inflammation and coagulation profile in cancer survivors from a large population-based study. Presence of CVRFs and laboratory markers have been compared in individuals with (n=1,359) and without (n=13,626) history of cancer. Standard laboratory profile, including blood glucose and lipid profile, has been evaluated in 15,010 individuals from the Gutenberg Health Study (GHS). Coagulation factors, D-dimer and von Willebrand factor (vWF) activity were available in N=4,993. The individuals with history of cancer were older compared to no history of cancer with mean age of 61,5years and 54.4years, respectively (pprofile showed cancer survivors with lower erythrocyte, platelet and white blood cell counts and higher C-reactive protein (CRP), glucose, HbA1c and triglycerides levels (pprofile in individuals with history of cancer from a well characterized population-representative adult sample. It gives evidence for higher prevalence of CVRFs, particularly diabetes in this vulnerable population. Markers of inflammation as CRP and fibrinogen and vWF activity were higher in cancer survivors independent of the cardiovascular risk profile. These results underline the increased risk of CVD and need for development of cardio-oncology programs offering cardiovascular prevention. © 2016 Elsevier Ltd. All rights reserved.

  15. Many Survivors of Adolescent and Young Adult Cancers Have Chronic Health Problems

    Science.gov (United States)

    A 2012 study showed that people who’d had cancer as adolescents and young adults were more likely to be current smokers, be obese, have various chronic conditions, be disabled, and have poor mental and physical health. The findings highlight the importance of addressing the special needs and concerns of this population.

  16. Fall-risk prediction in older adults with cancer: an unmet need.

    Science.gov (United States)

    Wildes, Tanya M; Depp, Brittany; Colditz, Graham; Stark, Susan

    2016-09-01

    Falls in older adults with cancer are more common than in noncancer controls, yet no fall-risk screening tool has been validated in this population. We undertook a cross-sectional pilot study of the Falls Risk Questionnaire (FRQ) in 21 adults aged ≥65 receiving systemic cancer therapy. Participants completed the FRQ, geriatric assessment measures, and a measure of fear-of-falling. The recruitment rate was 87.5 %, with 95.2 % completion of the FRQ and additional geriatric assessment and quality of life measures. The FRQ correlated significantly with the Timed Up and Go test (Pearson r 0.479, p = 0.028). In addition, the FRQ score correlated directly with fear-of-falling and inversely with QOL, particularly physical health and neurotoxicity subscales. In conclusion, the FRQ was feasible in older adults receiving cancer therapy and correlates with measures of physical performance, functional status, and fear-of-falling. The FRQ may prove to be a valuable fall-risk screening tool to implement fall-prevention interventions in this vulnerable population of older adults with cancer.

  17. Delphi Study to Determine Rehabilitation Research Priorities for Older Adults With Cancer.

    Science.gov (United States)

    Lyons, Kathleen Doyle; Radomski, Mary Vining; Alfano, Catherine M; Finkelstein, Marsha; Sleight, Alix G; Marshall, Timothy F; McKenna, Raymond; Fu, Jack B

    2017-05-01

    To solicit expert opinions and develop consensus around the research that is needed to improve cancer rehabilitation for older adults. Delphi methods provided a structured process to elicit and prioritize research questions from national experts. National, Web-based survey. Members (N=32) of the American Congress of Rehabilitation Medicine completed at least 1 of 3 investigator-developed surveys. Not applicable. In the first survey, participants identified up to 5 research questions that needed to be answered to improve cancer rehabilitation for older adults. In 2 subsequent surveys, participants viewed the compilation of questions, rated the importance of each question, and identified the 5 most important questions. This generated priority scores for each question. Consensus scores were created to describe the degree of agreement around the priority of each question. Highest priority research concerns the epidemiology and measurement of function and disability in older adult cancer survivors; the effects of cancer rehabilitation interventions on falls, disability, participation, survival, costs, quality of care, and health care utilization; and testing models of care that facilitate referrals from oncology to rehabilitation providers as part of coordinated, multicomponent care. A multipronged approach is needed to fill these gaps, including targeted funding opportunities developed with an advisory panel of cancer rehabilitation experts, development of a research network to facilitate novel collaborations and grant proposals, and coordinated efforts of clinical groups to advocate for funding, practice change, and policy change. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  18. Vitamin D supplementation for prevention of cancer in adults

    DEFF Research Database (Denmark)

    Bjelakovic, Goran; Gluud, Lise Lotte; Nikolova, Dimitrinka

    2014-01-01

    in predominantly elderly community-dwelling women. Vitamin D₃ supplementation decreased cancer mortality and vitamin D supplementation decreased all-cause mortality, but these estimates are at risk of type I errors due to the fact that too few participants were examined, and to risks of attrition bias originating...

  19. Wnt signaling in adult intestinal stem cells and cancer

    Czech Academy of Sciences Publication Activity Database

    Krausová, Michaela; Kořínek, Vladimír

    2014-01-01

    Roč. 26, č. 3 (2014), s. 570-579 ISSN 0898-6568 R&D Projects: GA ČR GAP305/12/2347; GA ČR GAP305/11/1780 Institutional support: RVO:68378050 Keywords : Wnt * intestine * cancer Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 4.315, year: 2014

  20. Marriage and divorce among young adult cancer survivors.

    Science.gov (United States)

    Kirchhoff, Anne C; Yi, Jaehee; Wright, Jennifer; Warner, Echo L; Smith, Ken R

    2012-12-01

    We examined marital outcomes among cancer survivors diagnosed during early adulthood from the 2009 Behavioral Risk Factor Surveillance System dataset. Eligible participants were ages 20-39 years. Of the 74,433 eligible, N = 1,198 self-reported a cancer diagnosis between the ages of 18 and 37, were ≥2 years past diagnosis, and did not have non-melanoma skin cancer. The remaining N = 67,063 were controls. Using generalized linear models adjusted for age, gender, race, and education, we generated relative risks (RR) and 95 % confidence intervals (95 % CI) to examine survivor status on indicators of ever married, currently married, and divorced/separated. Survivors were slightly older than controls [33.0 (SD = 3.8) vs. 30.0 (SD = 4.0); p divorce/separation than controls (18 % vs. 10 %; RR = 1.77, 95 % CI 1.43-2.19). Divorce/separation risk persisted for female survivors (RR 1.83, 95 % CI 1.49-2.25), survivors ages 20-29 (RR 2.57, 95 % CI 1.53-4.34), and survivors ages 30-39 (RR 1.62, 95 % CI 1.29-2.04). The emotional and financial burdens of cancer may lead to marital stress for younger cancer survivors. Young survivors may face a higher risk of divorce; support systems are needed to assist them in the years following diagnosis.

  1. Prevalence and predictors of risky and heavy alcohol consumption among adult siblings of childhood cancer survivors.

    Science.gov (United States)

    Lown, E Anne; Mertens, Ann C; Korcha, Rachael A; Leisenring, Wendy; Hudson, Melissa M; Greenfield, Thomas K; Robison, Leslie L; Zeltzer, Lonnie K

    2013-05-01

    To describe alcohol consumption patterns and risk factors for risky and heavy alcohol use among siblings of childhood cancer survivors compared with survivors and national controls. Secondary analysis of prospectively collected data from two national surveys was performed including a cohort of 3034 adult siblings of childhood cancer survivors (age 18-56 years) and 10,398 adult childhood cancer survivors, both from the Childhood Cancer Survivor Study, plus 5712 adult participants from the population-based National Alcohol Survey. Cancer-related experiences, self-reported current health, and mental health were examined in relation to alcohol consumption patterns including heavy and risky drinking. Adult siblings of childhood cancer survivors were more likely to be heavy drinkers (OR adj = 1.3; 1.0-1.6) and risky drinkers (OR adj = 1.3; 1.1-1.6) compared with controls from a national sample. Siblings were also more likely to drink at these two levels compared with survivors. Factors associated with heavy drinking among siblings included being 18-21 years old (OR adj = 2.9; 2.0-4.4), male (OR adj = 2.3; 1.7-3.0), having a high school education or less (OR adj = 2.4; 1.7-3.5), and drinking initiation at a young age (OR adj = 5.1; 2.5-10.3). Symptoms of depression, (OR adj = 2.1; 1.3-3.2), anxiety (OR adj = 1.9; 1.1-3.3), and global psychiatric distress (OR adj = 2.5; 1.5-4.3) were significantly associated with heavy alcohol use. Siblings of children with cancer are more likely to be risky and heavy drinkers as adults compared with childhood cancer survivors or national controls. Early initiation of drinking and symptoms of psychological distress should be identified during early adolescence and effective sibling-specific interventions should be developed and made available for siblings of children with cancer. Copyright © 2012 John Wiley & Sons, Ltd.

  2. Family Caregiver Knowledge, Patient Illness Characteristics, and Unplanned Hospital Admissions in Older Adults With Cancer.

    Science.gov (United States)

    Geddie, Patricia I; Wochna Loerzel, Victoria; Norris, Anne E

    2016-07-01

    To explore factors related to unplanned hospital admissions and determine if one or more factors are predictive of unplanned hospital admissions for older adults with cancer.
. A prospective longitudinal design and a retrospective chart review.
. Adult oncology outpatient infusion centers and inpatient units at Orlando Regional Medical Center in Florida.
. A convenience sample of 129 dyads of older adults with cancer and their family caregivers. 
. Family caregiver demographic and side effect knowledge data were collected prospectively during interviews with family caregivers using a newly developed tool, the Nurse Assessment of Family Caregiver Knowledge and Action Tool. Patient demographic and clinical data were obtained through a retrospective chart review. Descriptive statistics and logistic regression analyses were used to evaluate data and examine relationships among variables.
. Patient illness characteristics; impaired function; side effects, such as infection, fever, vomiting, and diarrhea; family caregiver knowledge; and unplanned hospital admissions.
. Unplanned hospital admissions were more likely to occur when older adults had impaired function and side effects, such as infection, fever, vomiting, and diarrhea. Impaired function and family caregiver knowledge did not moderate the effects of these side effects on unplanned hospital admissions. 
. Findings suggest that the presence of impaired function and side effects, such as infection, fever, vomiting, and diarrhea, predict unplanned hospital admissions in older adults with cancer during the active treatment phase. Side effects may or may not be related to chemotherapy and may be related to preexisting comorbidities. 
. Nurses can conduct targeted assessments to identify older adults and their family caregivers who will need additional follow-up and support during the cancer treatment trajectory. Information gained from these assessments will assist nurses to provide practical and

  3. PROMs for pain in adult cancer patients: a systematic review of measurement properties.

    Science.gov (United States)

    Abahussin, Asma A; West, Robert M; Wong, David C; Ziegler, Lucy E

    2018-05-17

    Pain is one of the most devastating symptoms for cancer patients. One-third of patients who experience pain do not receive effective treatment. A key barrier to effective pain management is lack of routine measurement and monitoring of pain. Patient-Reported Outcome Measures (PROMs) are recommended for measuring cancer pain. However, evidence to guide the selection of the most appropriate measure to identify and monitor cancer pain is limited. A systematic review of measurement properties of PROMs for pain in cancer patients is needed to identify the best validated measure for adoption to an electronic platform. Systematically review measurement properties of PROMs used for adult cancer patients to measure pain and, as a secondary goal, investigate the evidence of validated mobile health (mHealth) applications used to measure pain (registration number: CRD42017065575). Medline, EMBASE and CINAHL were systematically searched in March 2018 for studies examining measurement properties for PROMs for pain in adult cancer patients. Both of the methodological quality of the studies and their results were appraised using the COSMIN checklist and specific measurement properties criteria respectively. Sixteen studies evaluating eight instruments were included. No studies using a PROM in a mHealth application were identified. The methodological quality of the measurement properties ranged between poor and fair. No instrument showed strong positive evidence for all the evaluated measurement properties. Based on the available evidence, the Brief Pain Inventory-Short Form (BPI-SF) had the strongest evidence to support its selection for the measurement of cancer pain. The BPI-SF was the best performing measure across all proprieties evaluated through COSMIN. Better quality validation studies of PROMs for cancer pain are needed to explore the full range of measurement properties. Utilising mHealth applications for measuring pain for cancer patients is an innovative approach worth

  4. Thyroid cancer after x-ray treatment of benign disorders of the cervical spine in adults

    Energy Technology Data Exchange (ETDEWEB)

    Damber, Lena; Johansson, Lennart; Johansson, Robert; Larsson, Lars-Gunnar [Univ. Hospital, Umeaa (Sweden). Oncology Centre

    2002-02-01

    While there is very good epidemiological evidence for induction of thyroid cancer by radiation exposure in children, the risk for adults after exposure is still uncertain, especially when concerning relatively small radiation doses. A cohort of 27415 persons which in 1950 through 1964 had received x-ray treatment for various benign disorders in the locomotor system (such as painful arthrosis and spondylosis) was selected from three hospitals in Northern Sweden. A proportion of this cohort, consisting of 8144 persons (4075 men and 4069 women), had received treatment to the cervical spine and thereby received an estimated average dose in the thyroid gland of about 1 Gy. Standard incidence rates (SIR) were calculated by using the Swedish Cancer Register. In the cervical spine cohort, 22 thyroid cancers were found versus 13.77 expected (SIR 1.60; CI 1.00-2.42). The corresponding figures for women were 16 observed cases versus 9.60 expected cases (SIR 1.67; CI 0.75-2.71). Most thyroid cancers (15 out of 22) were diagnosed >15 years after the exposure. In the remaining part of the total cohort, i.e. those without cervical spine exposure, no increased risk of thyroid cancer was found (SIR 0.98; CI 0.64-1.38). The study strongly suggests that external radiation exposure of adults at relatively small doses increases the risk of thyroid cancer but also that this increase is very much lower than that reported after exposure in children.

  5. Thyroid cancer after x-ray treatment of benign disorders of the cervical spine in adults

    International Nuclear Information System (INIS)

    Damber, Lena; Johansson, Lennart; Johansson, Robert; Larsson, Lars-Gunnar

    2002-01-01

    While there is very good epidemiological evidence for induction of thyroid cancer by radiation exposure in children, the risk for adults after exposure is still uncertain, especially when concerning relatively small radiation doses. A cohort of 27415 persons which in 1950 through 1964 had received x-ray treatment for various benign disorders in the locomotor system (such as painful arthrosis and spondylosis) was selected from three hospitals in Northern Sweden. A proportion of this cohort, consisting of 8144 persons (4075 men and 4069 women), had received treatment to the cervical spine and thereby received an estimated average dose in the thyroid gland of about 1 Gy. Standard incidence rates (SIR) were calculated by using the Swedish Cancer Register. In the cervical spine cohort, 22 thyroid cancers were found versus 13.77 expected (SIR 1.60; CI 1.00-2.42). The corresponding figures for women were 16 observed cases versus 9.60 expected cases (SIR 1.67; CI 0.75-2.71). Most thyroid cancers (15 out of 22) were diagnosed >15 years after the exposure. In the remaining part of the total cohort, i.e. those without cervical spine exposure, no increased risk of thyroid cancer was found (SIR 0.98; CI 0.64-1.38). The study strongly suggests that external radiation exposure of adults at relatively small doses increases the risk of thyroid cancer but also that this increase is very much lower than that reported after exposure in children

  6. "She Was a Little Social Butterfly": A Qualitative Analysis of Parent Perception of Social Functioning in Adolescent and Young Adult Brain Tumor Survivors.

    Science.gov (United States)

    Wilford, Justin; Buchbinder, David; Fortier, Michelle A; Osann, Kathryn; Shen, Violet; Torno, Lilibeth; Sender, Leonard S; Parsons, Susan K; Wenzel, Lari

    Psychosocial sequelae of diagnosis and treatment for childhood brain tumor survivors are significant, yet little is known about their impact on adolescent and young adult (AYA) brain tumor survivors. Interviews were conducted with parents of AYA brain tumor survivors with a focus on social functioning. Semistructured interviews were conducted with English- and Spanish-speaking parents of AYA brain tumor survivors ≥10 years of age who were >2 years postdiagnosis, and analyzed using emergent themes theoretically integrated with a social neuroscience model of social competence. Twenty parents representing 19 survivors with a survivor mean age 15.7 ± 3.3 years and 10.1 ± 4.8 years postdiagnosis were interviewed. Several themes relevant to the social neuroscience social competence model emerged. First, parents' perceptions of their children's impaired social functioning corroborated the model, particularly with regard to poor social adjustment, social withdrawal, impaired social information processing, and developmentally inappropriate peer communication. Second, ongoing physical and emotional sequelae of central nervous system insults were seen by parents as adversely affecting social functioning among survivors. Third, a disrupted family environment and ongoing parent psychosocial distress were experienced as salient features of daily life. We document that the aforementioned framework is useful for understanding the social impact of diagnosis and treatment on AYA brain tumor survivorship. Moreover, the framework highlights areas of intervention that may enhance social functioning for AYA brain tumor survivors.

  7. Relationship between cancer-related traumatic stress and family milestone achievement in adolescent and young adult survivors of childhood cancer.

    Science.gov (United States)

    Tillery, Rachel; Beal, Sarah J; Thompson, Aimee N; Pai, Ahna L H

    2018-06-01

    Late physical and emotional effects of cancer treatment pose a burden for adolescent and young adult survivors of childhood cancer, including family milestone achievement. This brief report examined links between ongoing cancer-related post-traumatic stress symptoms (CR-PTSS) and family milestone achievement. Survivors (n = 51; M age  = 24.73, SD = 8.20) completed CR-PTSS and family formation questionnaires. Descriptive statistics, univariate parameter-constraints, and correlation analyses examined relations among study variables. Ongoing intrusive thoughts and hyperarousal were negatively linked to family identity development and family achievement. Findings from the present study provide support that ongoing CR-PTSS may be a barrier to family formation. © 2018 Wiley Periodicals, Inc.

  8. Primary care for young adult cancer survivors: an international perspective

    DEFF Research Database (Denmark)

    Hølge-Hazelton, Bibi; Blake-Gumbs, Lyla; Miedema, Baujke

    2010-01-01

    health insurance in Denmark, The Netherlands, and Canada but not in the US. Once the YAC has completed acute treatment and follow-up care, they often return to the care of the FPs who may potentially be expected to deal with and take action upon any possible medical, mental health, and psychosocial...... issues the YA cancer patient may present with. The role of the FP in follow-up care seems to be very limited. CONCLUSIONS: YACs in the western world seem to have comparable medical and psychosocial problems. However, the nature of health insurance is such that it impacts differently on the care...... continuing medical education (CME) initiatives, and an enhanced cooperative effort between those delivering and coordinating cancer care....

  9. PROSTATE CANCER SCREENING: PSA TEST AWARENESS AMONG ADULT MALES.

    Science.gov (United States)

    Obana, Michael; O'Lawrence, Henry

    2015-01-01

    The overall purpose of this study was to determine whether visits to the doctor in the last 12 months, education level, and annual household income for adult males increased the awareness of prostate-specific antigen (PSA) tests. The effect of these factors for the knowledge of PSA exams was performed using statistical analysis. A retrospective secondary database was utilized for this study using the questionnaire in the California Health Interview Survey from 2009. Based on this survey, annual visits to the doctor, higher educational levels attained, and greater take-home pay were statistically significant and the results of the study were equivalent to those hypothesized. This also reflects the consideration of marketing PSA blood test screenings to those adult males who are poor, uneducated, and do not see the doctor on a consistent basis.

  10. Cancer and non-cancer health effects from food contaminant exposures for children and adults in California: a risk assessment

    Directory of Open Access Journals (Sweden)

    Vogt Rainbow

    2012-11-01

    Full Text Available Abstract Background In the absence of current cumulative dietary exposure assessments, this analysis was conducted to estimate exposure to multiple dietary contaminants for children, who are more vulnerable to toxic exposure than adults. Methods We estimated exposure to multiple food contaminants based on dietary data from preschool-age children (2–4 years, n=207, school-age children (5–7 years, n=157, parents of young children (n=446, and older adults (n=149. We compared exposure estimates for eleven toxic compounds (acrylamide, arsenic, lead, mercury, chlorpyrifos, permethrin, endosulfan, dieldrin, chlordane, DDE, and dioxin based on self-reported food frequency data by age group. To determine if cancer and non-cancer benchmark levels were exceeded, chemical levels in food were derived from publicly available databases including the Total Diet Study. Results Cancer benchmark levels were exceeded by all children (100% for arsenic, dieldrin, DDE, and dioxins. Non-cancer benchmarks were exceeded by >95% of preschool-age children for acrylamide and by 10% of preschool-age children for mercury. Preschool-age children had significantly higher estimated intakes of 6 of 11 compounds compared to school-age children (p Conclusions Dietary strategies to reduce exposure to toxic compounds for which cancer and non-cancer benchmarks are exceeded by children vary by compound. These strategies include consuming organically produced dairy and selected fruits and vegetables to reduce pesticide intake, consuming less animal foods (meat, dairy, and fish to reduce intake of persistent organic pollutants and metals, and consuming lower quantities of chips, cereal, crackers, and other processed carbohydrate foods to reduce acrylamide intake.

  11. Non-small cell lung cancer in young adults: presentation and survival in the English National Lung Cancer Audit.

    Science.gov (United States)

    Rich, A L; Khakwani, A; Free, C M; Tata, L J; Stanley, R A; Peake, M D; Hubbard, R B; Baldwin, D R

    2015-11-01

    Non-small cell lung cancer (NSCLC) in young adults is a rare but devastating illness with significant socioeconomic implications, and studies of this patient subgroup are limited. This study employed the National Lung Cancer Audit to compare the clinical features and survival of young adults with NSCLC with the older age groups. A retrospective cohort review using a validated national audit dataset. Data were analysed for the period between 1 January 2004 and 31 December 2011. Young adults were defined as between 18 and 39 years, and all others were divided into decade age groups, up to the 80 years and above group. We performed logistic and Cox regression analyses to assess clinical outcomes. Of a total of 1 46 422 patients, 651 (0.5%) were young adults, of whom a higher proportion had adenocarcinoma (48%) than in any other age group. Stage distribution of NSCLC was similar across the age groups and 71% of young patients had stage IIIb/IV. Performance status (PS) was 0-1 for 85%. Young adults were more likely to have surgery and chemotherapy compared with the older age groups and had better overall and post-operative survival. The proportion with adenocarcinoma, better PS and that receiving surgery or chemotherapy diminished progressively with advancing decade age groups. In our cohort of young adults with NSCLC, the majority had good PS despite the same late-stage disease as older patients. They were more likely to have treatment and survive longer than older patients. © The Author 2015. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  12. Children and young adults with parents with cancer: a population-based study

    Directory of Open Access Journals (Sweden)

    Syse A

    2012-03-01

    Full Text Available Astri Syse1, Gjøril B Aas1, Jon H Loge2,31Cancer Registry of Norway, 2Oslo University Hospital, 3University of Oslo, Oslo, NorwayBackground: Today many people are choosing to have children later in life. Additionally, the use of sophisticated diagnostic tools and screening modalities has increased over recent years. Because of these factors, cancer is being diagnosed more frequently during the child-rearing years. Sociodemographic and cancer-related information on families and minor (0–18 years and young adult (YA (19–25 years children experiencing parental cancer is scarce, but this information is vital for healthcare initiatives aimed toward those potentially adversely affected. Therefore, the aim of this study was to describe features of families and minor and YA children affected by parental cancer in a nationwide population.Methods: Complete Norwegian birth cohort data were obtained from national registries. Descriptive prevalence and incidence statistics were collected for parents and minor and YA children. Logistic regression models were used to assess factors likely to influence parental death.Results: Every year around 0.3% of all families with children under the age of 18 years encounter parental cancer, and 3.1% of minors and 8.4% of YAs have a parent who has been diagnosed with cancer. This study found skin, breast, testicular, and colorectal cancers were the most common forms of cancer diagnosed. The sociodemographic features of those affected were fairly similar to those of the general population. One in five children experienced parental death from cancer; parental death was more often paternal than maternal and was most common in parents diagnosed with leukemia or brain, colorectal, and lung tumors. Deaths are uncommon among parents without cancer.Conclusion: Adequate assistance for minor and YA children affected by parental cancer requires knowledge of their number and characteristics. Parental cancer is more common than

  13. Risk of Cancer among Commercially Insured HIV-Infected Adults on Antiretroviral Therapy

    Directory of Open Access Journals (Sweden)

    Jeannette Y. Lee

    2016-01-01

    Full Text Available The objective of this study was to explore the cancer incidence rates among HIV-infected persons with commercial insurance who were on antiretroviral therapy and compare them with those rates in the general population. Paid health insurance claims for 63,221 individuals 18 years or older, with at least one claim with a diagnostic code for HIV and at least one filled prescription for an antiretroviral medication between January 1, 2006, and September 30, 2012, were obtained from the LifeLink® Health Plan Claims Database. The expected number of cancer cases in the general population for each gender-age group (60 years was estimated using incidence rates from the Surveillance Epidemiology and End Results (SEER program. Standardized incidence ratios (SIRs were estimated using their 95% confidence intervals (CIs. Compared to the general population, incidence rates for HIV-infected adults were elevated (SIR, 95% CI for Kaposi sarcoma (46.08; 38.74–48.94, non-Hodgkin lymphoma (4.22; 3.63–4.45, Hodgkin lymphoma (9.83; 7.45–10.84, and anal cancer (30.54; 25.62–32.46 and lower for colorectal cancer (0.69; 0.52–0.76, lung cancer (0.70; 0.54, 0.77, and prostate cancer (0.54; 0.45–0.58. Commercially insured, treated HIV-infected adults had elevated rates for infection-related cancers, but not for common non-AIDS defining cancers.

  14. Risk of Cancer among Commercially Insured HIV-Infected Adults on Antiretroviral Therapy

    International Nuclear Information System (INIS)

    Lee, J. Y.

    2016-01-01

    The objective of this study was to explore the cancer incidence rates among HIV-infected persons with commercial insurance who were on antiretroviral therapy and compare them with those rates in the general population. Paid health insurance claims for 63,221 individuals 18 years or older, with at least one claim with a diagnostic code for HIV and at least one filled prescription for an antiretroviral medication between January 1, 2006, and September 30, 2012, were obtained from the Life Link® Health Plan Claims Database. The expected number of cancer cases in the general population for each gender-age group (<30, 30-39, 40-49, 50-59, and >60 years) was estimated using incidence rates from the Surveillance Epidemiology and End Results (SEER) program. Standardized incidence ratios (SIRs) were estimated using their 95% confidence intervals (CIs). Compared to the general population, incidence rates for HIV-infected adults were elevated (SIR, 95% CI) for Kaposi sarcoma (46.08; 38.74-48.94), non-Hodgkin lymphoma (4.22; 3.63-4.45), Hodgkin lymphoma (9.83; 7.45-10.84), and anal cancer (30.54; 25.62-32.46) and lower for colorectal cancer (0.69; 0.52-0.76), lung cancer (0.70; 0.54, 0.77), and prostate cancer (0.54; 0.45-0.58). Commercially insured, treated HIV-infected adults had elevated rates for infection-related cancers, but not for common non-AIDS defining cancers.

  15. Patient-oncologist alliance as protection against suicidal ideation in young adults with advanced cancer.

    Science.gov (United States)

    Trevino, Kelly M; Abbott, Caroline H; Fisch, Michael J; Friedlander, Robert J; Duberstein, Paul R; Prigerson, Holly G

    2014-08-01

    Young adults with cancer are at an increased risk of suicidal ideation. To the authors' knowledge, the impact of the patient-oncologist alliance on suicidal ideation has not been examined to date. The current study examined the relationship between the patient-oncologist therapeutic alliance and suicidal ideation in young adults with advanced cancer. A total of 93 young adult patients (aged 20 years-40 years) with incurable, recurrent, or metastatic cancer were evaluated by trained interviewers. Suicidal ideation was assessed with the Yale Evaluation of Suicidality scale, dichotomized into a positive and negative score. Predictors included diagnoses of major depressive disorder and posttraumatic stress disorder, physical quality of life, social support, and use of mental health and supportive care services. The Human Connection Scale, dichotomized into a strong (upper third) and weak (lower two-thirds) therapeutic alliance, assessed the strength of the patients' perceived oncologist alliance. Approximately 22.6% of patients screened positive for suicidal ideation. Patients with a strong therapeutic alliance were found to be at reduced risk of suicidal ideation after controlling for confounding influences of cancer diagnosis, Karnofsky performance status, number of physical symptoms, physical quality of life, major depressive disorder, posttraumatic stress disorder, and social support. A strong therapeutic alliance was also associated with a reduced risk of suicidal ideation after controlling for mental health discussions with health care providers and use of mental health interventions. The patient-oncologist alliance was found to be a robust predictor of suicidal ideation and provided better protection against suicidal ideation than mental health interventions, including psychotropic medications. Oncologists may significantly influence patients' mental health and may benefit from training and guidance in building strong alliances with their young adult patients.

  16. Who cares for adolescents and young adults with cancer in Brazil?

    Science.gov (United States)

    Martins, Helena T G; Balmant, Nathalie V; de Paula Silva, Neimar; Santos, Marceli de O; Reis, Rejane de S; de Camargo, Beatriz

    2017-09-06

    Approximately 6% of all cancers arise in adolescents and young adults. Currently, the ward type best placed to treat this patient group remains controversial. The aim of this study was to evaluate exactly where adolescents and young adults with cancer are treated in Brazil. Data were extracted from 271 Brazilian hospital-based cancer registries (2007-2011), including all five national regions (North, Northeast, Midwest, South, and Southeast). Variables included gender, age, ethnicity, National Code of Health Establishment, hospital unit state, and region. Tumors were classified according to the World Health Organization classification for adolescents and young adults with cancer. Odds ratios with 95% confidence intervals were computed by unconditional logistic regression. Most patients were managed on medical oncology wards, followed by pediatric oncology and then by non-specialist wards. Of patients aged 15-19 years, 49% were managed on pediatric wards; most of the older patients (96%; aged 20-24) were managed on adult wards. Patients were more likely to be seen in medical oncology wards as their age increased (OR=2.03 [1.98-2.09]), or if they were based in the South (OR=1.50 [1.29-1.73]). Conversely, bone tumors were less likely to be treated (decreased OR) on medical oncology wards, regardless of age, gender, and region. An elevated risk of treatment on medical oncology wards was observed for older patients and those treated in the South. Bone tumors were generally treated in pediatric oncology wards, while skin cancers were treated in medical oncology wards, regardless of age, gender, and region. Published by Elsevier Editora Ltda.

  17. Spinal cord stimulation for cancer-related pain in adults.

    Science.gov (United States)

    Peng, Lihua; Min, Su; Zejun, Zhou; Wei, Ke; Bennett, Michael I

    2015-06-29

    This is an update of a review first published in The Cochrane Library in Issue 3, 2013. Cancer-related pain places a heavy burden on public health with related high expenditure. Severe pain is associated with a decreased quality of life in patients with cancer. A significant proportion of patients with cancer-related pain are under-treated. There is a need for more effective control of cancer-related pain. Spinal cord stimulation (SCS) may have a role in pain management. The effectiveness and safety of SCS for patients with cancer-related pain is currently unknown. This systematic review evaluated the effectiveness of SCS for cancer-related pain compared with standard care using conventional analgesic medication. We also appraised risk and potential adverse events associated with the use of SCS. This is an update of a review first published in The Cochrane Library in Issue 3, 2013. The search strategy for the update was the same as in the original review. We searched the following bibliographic databases in order to identify relevant studies: the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library; MEDLINE; EMBASE; and CBM (Chinese Biomedical Database) in October 2014. We also handsearched relevant journals. There were no language restrictions. We planned to include randomised controlled trials (RCTs) that directly compared SCS with other interventions with regards to the effectiveness of pain management. We also planned to include cross-over trials that compared SCS with another treatment. We planned to identify non-randomised controlled trials but these would only be included if no RCTs could be found. The literature search for the update of this review found 121 potentially eligible articles. The initial search strategy yielded 430 articles. By scrutinising titles and abstracts, we found 412 articles irrelevant to the analytical purpose of this systematic review due to different scopes of diseases or different methods of intervention

  18. Assessment of depression and anxiety in adult cancer outpatients: a cross-sectional study

    International Nuclear Information System (INIS)

    Jadoon, Nauman A; Munir, Waqar; Shahzad, Mohammad A; Choudhry, Zeshan S

    2010-01-01

    The prevalence of anxiety and depressive disorders in cancer patients and its associated factors in Pakistan is not known. There is a need to develop an evidence base to help introduce interventions as untreated depression and anxiety can lead to significant morbidity. We assessed the prevalence of depression and anxiety among adult outpatients with and without cancer as well as the effect of various demographic, clinical and behavioral factors on levels of depression and anxiety in cancer patients. This cross-sectional study was carried out in outpatient departments of Multan Institute of Nuclear Medicine and Radiotherapy and Nishtar Medical College Hospital, Multan. Aga Khan University Anxiety and Depression Scale (AKUADS) was used to define the presence of depression and anxiety in study participants. The sample consisted of 150 diagnosed cancer patients and 268 participants without cancer (control group). The mean age of cancer patients was 40.85 years (SD = 16.46) and median illness duration was 5.5 months, while the mean age of the control group was 39.58 years (SD = 11.74). Overall, 66.0% of the cancer patients were found to have depression and anxiety using a cutoff score of 20 on AKUADS. Among the control group, 109 subjects (40.7%) had depression and anxiety. Cancer patients were significantly more likely to suffer from distress compared to the control group (OR = 2.83, 95% CI = 1.89-4.25, P = 0.0001). Performing logistic regression analysis showed that age up to 40 years significantly influenced the prevalence of depression and anxiety in cancer patients. There was no statistically significant difference between gender, marital status, locality, education, income, occupation, physical activity, smoking, cancer site, illness duration and mode of treatment, surgery related to cancer and presence of depression and anxiety. Cancers highly associated with depression and anxiety were gastrointestinal malignancies, chest tumors and breast cancer. This study

  19. Adult prostate sarcoma: the M. D. Anderson Cancer Center Experience.

    Science.gov (United States)

    Sexton, W J; Lance, R E; Reyes, A O; Pisters, P W; Tu, S M; Pisters, L L

    2001-08-01

    Sarcoma of prostate origin is rare. Historically, long-term survival rates for adult patients with prostate sarcoma are poor. We analyzed the experience of 1 institution with prostate sarcoma during the last 3 decades. The records of 21 patients with prostate sarcoma were reviewed to identify symptoms at presentation, diagnostic procedures, presence and development of metastases, staging evaluation, histological subtype, grade and size of the primary tumor, and treatment sequence, including surgery, and preoperative and postoperative therapies. Several clinicopathological variables were assessed for prognostic importance. Most patients presented with urinary obstruction. The diagnosis of prostate sarcoma was usually established with ultrasound guided biopsy or transurethral resection. Histological subtypes were leiomyosarcoma in 12, rhabdomyosarcoma in 4, malignant fibrous histiocytoma in 1 and unclassified sarcoma in 4 patients. At last followup, 8 patients had no evidence of disease after a median of 81.5 months (range 10 to 197). The remaining 13 patients died of sarcoma (median survival 18 months, range 3 to 94). The 1, 3 and 5-year actuarial survival rates for all 21 patients were 81%, 43% and 38%, respectively. Factors predictive of long-term survival were negative surgical margins (p = 0.0005) and absence of metastatic disease at presentation (p = 0.0004). Tumor size and grade, and the histological subtype of prostate sarcoma had no significant influence on actuarial survival. The long-term disease specific survival rate for adults with prostate sarcoma is poor. Early diagnosis and complete surgical resection offer patients the best chance for cure.

  20. Web-based cognitive rehabilitation for survivors of adult cancer: A randomised controlled trial.

    Science.gov (United States)

    Mihuta, Mary E; Green, Heather J; Shum, David H K

    2018-04-01

    Cognitive dysfunction associated with cancer is frequently reported and can reduce quality of life. This study evaluated a Web-based cognitive rehabilitation therapy program (eReCog) in cancer survivors compared with a waitlist control group. Adult cancer survivors with self-reported cognitive symptoms who had completed primary treatment at least 6 months prior were recruited. Participants completed telephone screening and were randomly allocated to the 4-week online intervention or waitlist. Primary outcome was perceived cognitive impairment assessed with the Functional Assessment of Cancer Therapy-Cognitive Function version 3. Secondary outcomes were additional measures of subjective cognitive functioning, objective cognitive functioning, and psychosocial variables. Seventy-six women were allocated to the intervention (n = 40) or waitlist (n = 36). A significant interaction was found on the instrumental activities of daily living measure of self-reported prospective memory whereby the intervention group reported a greater reduction in prospective memory failures than the waitlist group. Interaction trends were noted on perceived cognitive impairments (P = .089) and executive functioning (P = .074). No significant interactions were observed on other measures of objective cognitive functioning or psychosocial variables. The Web-based intervention shows promise for improving self-reported cognitive functioning in adult cancer survivors. Further research is warranted to better understand the mechanisms by which the intervention might contribute to improved self-reported cognition. Copyright © 2017 John Wiley & Sons, Ltd.

  1. Hypothyroidism after cancer and the ability to meet reproductive goals among a cohort of young adult female cancer survivors

    Science.gov (United States)

    Chin, Helen B.; Jacobson, Melanie H.; Interrante, Julia D.; Mertens, Ann C.; Spencer, Jessica B.; Howards, Penelope P.

    2015-01-01

    Objective To determine if developing hypothyroidism after cancer treatment is associated with a decreased probability of women being able to meet their reproductive goals. Design A population-based cohort study. Setting Not applicable. Patients A total of 1,282 cancer survivors participated in the study, of which 904 met the inclusion criteria for the analysis. Intervention(s) None. Main Outcome Measure(s) Three outcomes that may indicate reduced fertility, which include: failure to achieve desired family size, childlessness, and not achieving pregnancy after at least 6 months of regular unprotected intercourse. Results We used data from the Furthering Understanding of Cancer Health and Survivorship in Adult (FUCHSIA) Women’s Study to examine the association between being diagnosed with hypothyroidism after cancer and meeting reproductive goals. After adjusting for age and other potential confounders, women reporting hypothyroidism after cancer treatment were twice as likely to fail to achieve their desired family size (adjusted odds ratio (adjusted odds ratio (aOR)) = 1.91, 95% CI: 1.09, 3.33) and be childless (aOR = 2.13, 95% CI: 1.25, 3.65). They were also more likely to report having unprotected intercourse for at least 6 months without conceiving (aOR = 1.37, 95% CI: 0.66, 2.83). Conclusion Although cancer treatments themselves are gonadotoxic, it is important to consider other medical conditions, such as hypothyroidism, that occur after cancer treatment when counseling patients on the risks for impaired fertility or a shortened reproductive window. PMID:26474733

  2. Cognitive side effects of cancer therapy demonstrate a functional role for adult neurogenesis.

    Science.gov (United States)

    Monje, Michelle; Dietrich, Jörg

    2012-02-14

    Cancer therapies frequently result in a spectrum of neurocognitive deficits that include impaired learning, memory, attention and speed of information processing. Damage to dynamic neural progenitor cell populations in the brain are emerging as important etiologic factors. Radiation and chemotherapy-induced damage to neural progenitor populations responsible for adult hippocampal neurogenesis and for maintenance of subcortical white matter integrity are now believed to play major roles in the neurocognitive impairment many cancer survivors experience. Copyright © 2011 Elsevier B.V. All rights reserved.

  3. The feasibility of using conversational agent technology to improve problem-solving and coping skills of young adults with cancer

    Directory of Open Access Journals (Sweden)

    von Friederichs-Fitzwater M

    2011-04-01

    Full Text Available Marlene M von Friederichs-Fitzwater1, Frederick J Meyers21Division of Hematology/Oncology, Internal Medicine, 2School of Medicine, University of California Davis, Sacramento, CA, USAObjective: Young adults with cancer have unique psychosocial needs and often lack the problem-solving and coping skills for effective resolution. We conducted a study to clarify these needs and then developed and tested an educational intervention to coach young adults with cancer in problem-solving and coping skills using a new conversational agent technology that uses a multi-media format to simulate face-to-face encounters.Methods: We qualitatively assessed online focus groups and chat rooms with 45 young adults with cancer and used the results to develop and test an online 15-minute educational prototype using a new conversational agent technology with 49 young adults (18–35 years of age with cancer.Results: Young adults with cancer are most concerned about reproductive issues, emotional issues, communicating with healthcare providers, and the risks and benefits of treatments. The study participants found the I-COPE prototype to be useful, easy to use, and worth recommending to others. They wanted to have more video segments about the experiences of other young adults with cancer; more video segments of actual procedures and treatments; more Internet links to information and resources; and more opportunities to interact with the conversational agent.Conclusion: New conversational agent technology is useful in coaching problem-solving and coping skills to empower young adults with cancer.Practice implications: New conversational agent technology is a useful tool in patient education and skill development, particularly among young adults.Keywords: young adult cancer patients, conversational agent technology, problem-solving, coping, self-efficacy, survivorship

  4. The information needs of adult cancer survivors across the cancer continuum: A scoping review.

    Science.gov (United States)

    Fletcher, Chloe; Flight, Ingrid; Chapman, Janine; Fennell, Kate; Wilson, Carlene

    2017-03-01

    To provide an updated synthesis of the literature that investigates the self-reported information needs of people diagnosed with cancer across the cancer continuum. We conducted a scoping review of the literature published from August 2003 to June 2015 and expanded an existing typology summarizing the information needs of people diagnosed with cancer. The majority of the included studies (n=104) focused on questions relevant to the diagnosis/active treatment phase of the cancer continuum (52.9%) and thus the most frequently identified information needs related to this phase (33.4%). Information needs varied across the continuum and the results highlight the importance of recognising this fact. People diagnosed with cancer experience discrete information needs at different points from diagnosis to survival. Much of the research conducted in this area has focused on their information needs during the diagnosis and treatment of cancer, and literature relating to information needs following completion of treatment is sparse. Further research is needed to discern the specific nature of the treatment concerns and identify the information needs that survivors experience during recurrence of cancer, metastasis or changes in diagnosis, and the end of life phase of the cancer continuum. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  5. Surgical Consideration for Adolescents and Young Adults With Cervical Chordoma.

    Science.gov (United States)

    Zhong, Nanzhe; Yang, Xinghai; Yang, Jian; Meng, Tong; Yang, Cheng; Yan, Wangjun; Xiao, Jianru

    2017-05-15

    Retrospective study. The aim of this study was to compare the clinical outcomes between adolescent and young adult (AYA) patients and old adult patients with cervical chordoma who were treated surgically and present the surgical consideration for adolescents and young adults with cervical chordoma. With predominance in senior patients, chordoma is distinctively rare in AYAs. Because of the rarity of AYA chordoma, individual case report represents most of the literature on this disease entity on mobile spine and lack of long-term follow up, which leads to the paucity of clinical evidence for treatment planning and prognosis prediction. A retrospective study was conducted to investigate the prognosis of AYA patients with cervical chordoma who were treated surgically. We collected the clinical data of these patients and their older counterparts, and further compared the prognosis of the patients in different age groups. To estimate survival curves, Kaplan-Meier method was used, and significance was assessed using a log-rank test. Forty consecutive patients with chordoma of the cervical spine treated in our institution were included in the study. Two groups were identified according to age. Group 1 comprised children and adolescents (age ≤ 25 yrs; n = 9) and Group 2 comprised adults (age > 25 years; n = 31). In comparison, Group 1 was featured by significantly higher rate of recurrence and shorter overall survival, although no difference found in the surgical modality between two groups. There is a dismal prognosis in young patients with chordoma, and thus support the notion that as radical a total en bloc spondylectomy (TES) of the lesions as possible may benefit the overall survival of these young patients. Although the ensuing neurological deficits may be devastating, it will be worth sacrificing if the life expectancy of these young patients is prolonged. 4.

  6. Active Transportation in Adult Survivors of Childhood Cancer and Neighborhood Controls

    Science.gov (United States)

    Slater, Megan E.; Kelly, Aaron S.; Sadak, Karim T.; Ross, Julie A.

    2015-01-01

    Purpose Childhood cancer survivors (CCS) are at high risk of treatment-related late effects, including cardiovascular disease and diabetes, which can be exacerbated by inadequate physical activity (PA). Previous PA interventions targeting CCS have focused on the domain of leisure-time/recreational PA. Active transportation, another domain of PA, has not been described in CCS. Therefore, this study aimed to identify active transportation behaviors, barriers, and correlates in adult CCS. Methods We recruited 158 adult CCS and 153 controls matched on age, sex, and neighborhood for a survey regarding active transportation behaviors and perceptions. Linear and logistic regression models accounting for correlation among matched participants were used. Results Adult CCS engaged in similar levels of active transportation as controls (2.72 vs. 2.32 hours/week, P=0.40) despite perceiving greater health-related barriers (1.88 vs. 1.65 (measured on four-point Likert scale), P=0.01). Marital/relationship status (odds ratio (OR)=0.30, 95% confidence interval (CI)=0.11–0.81), planning/psychosocial barriers (OR=0.15, 95% CI=0.04–0.53), and perceived neighborhood walkability (OR=2.55, 95% CI=1.14–5.66) were correlates of active transportation among adult CCS, while objective neighborhood walkability (OR=1.03, 95% CI=1.01–1.05) was a correlate among controls. Conclusions Results suggest adult CCS and controls utilize active transportation at approximately equal levels. Factors other than health, including perceived neighborhood walkability, appear to influence active transportation behaviors to a greater degree in adult CCS. Implications for Cancer Survivors Interventions might consider promoting active transportation as a way to incorporate more PA into the daily lives of adult CCS. Such interventions will not be widely successful, however, without existing or improved neighborhood walkability/bikeability. PMID:25809159

  7. Metabolic Mediators of the Association Between Adult Weight Gain and Colorectal Cancer: Data From the European Prospective Investigation into Cancer and Nutrition (EPIC) Cohort.

    NARCIS (Netherlands)

    Aleksandrova, Krasimira; Schlesinger, Sabrina; Fedirko, Veronika; Jenab, Mazda; Bueno-de-Mesquita, Bas; Freisling, Heinz; Romieu, Isabelle; Pischon, Tobias; Kaaks, Rudolf; Gunter, Marc J; Dahm, Christina C; Overvad, Kim; Rostgaard-Hansen, Agnetha Linn; Tjønneland, Anne; Trichopoulou, Antonia; Bamia, Christina; Lagiou, Pagona; Agnoli, Claudia; Mattiello, Amalia; Bradbury, Kathryn; Khaw, Kay-Tee; Riboli, Elio; Boeing, Heiner

    2017-01-01

    Evidence indicates that gaining weight in adult life is associated with an elevated risk of colorectal cancer; however, biological mechanisms that may explain this association remain unclear. We evaluated the mediation effect of 20 different biomarkers on the relationship between adult weight gain

  8. Cancer Information Seeking Among Adult New Zealanders: a National Cross-Sectional Study.

    Science.gov (United States)

    Richards, Rosalina; McNoe, Bronwen; Iosua, Ella; Reeder, Anthony; Egan, Richard; Marsh, Louise; Robertson, Lindsay; Maclennan, Brett; Dawson, Anna; Quigg, Robin; Petersen, Anne-Cathrine

    2018-06-01

    Organisations seeking to establish themselves as leading cancer information sources for the public need to understand patterns and motivators for information seeking. This study describes cancer information seeking among New Zealanders through a national cross-sectional survey conducted in 2014/15 with a population-based sample of adults (18 years and over). Participants were asked if they had sought information about cancer during the past 12 months, the type of information they sought, what prompted them to look for information and ways of getting information they found helpful. Telephone interviews were completed by 1064 participants (588 females, 476 males, 64% response rate). Of these, 33.8% of females and 23.3% of males (total, 29.2%) had searched for information about cancer over the past year. A search was most frequently prompted by a cancer diagnosis of a family member or friend (43.3%), a desire to educate themselves (17.5%), experience of potential symptoms or a positive screening test (9.4%), family history of cancer (8.9%) or the respondent's own cancer diagnosis (7.7%). Across the cancer control spectrum, the information sought was most commonly about treatment and survival (20.2%), symptoms/early detection (17.2%) or risk factors (14.2%), although many were general or non-specific queries (50.0%). The internet was most commonly identified as a helpful source of information (71.7%), followed by health professionals (35.8%), and reading material (e.g. books, pamphlets) (14.7%).This study provides a snapshot of cancer information seeking in New Zealand, providing valuable knowledge to help shape resource delivery to better meet the diverse needs of information seekers and address potential unmet needs, where information seeking is less prevalent.

  9. Decision-making and cancer screening: a qualitative study of older adults with multiple chronic conditions.

    Science.gov (United States)

    Gross, Cary P; Fried, Terri R; Tinetti, Mary E; Ross, Joseph S; Genao, Inginia; Hossain, Sabina; Wolf, Elizabeth; Lewis, Carmen L

    2015-03-01

    To understand how older persons with multiple chronic conditions (MCC) approach decisions about cancer screening. We conducted interviews with adults >65 years old with at least two chronic conditions who were taking ≥five medications daily. Patients were first asked how age and multimorbidity influence their cancer screening decisions. After showing them an educational prompt that explained the relationship between life expectancy and the benefits of cancer screening, respondents were then asked about screening in the context of specific health scenarios. Using grounded theory, three independent readers coded responses for salient themes. Sample size was determined by thematic saturation. Most respondents (26 of 28) initially indicated that their overall health or medical conditions do not influence their cancer screening decisions. After viewing the educational prompt, respondents described two broad approaches to cancer screening in the setting of increasing age or multi-morbidity. The first was a "benefits versus harms" approach in which participants weighed direct health benefits (e.g. reducing cancer incidence or mortality) and harms (e.g. complications or inconvenience). The second was a heuristic approach. Some heuristics favored screening, such as a persistent belief in unspecified benefits from screening, value of knowledge about cancer status, and not wanting to "give up", whereas other heuristics discouraged screening, such as fatalism or a reluctance to learn about their cancer status. When considering cancer screening, some older persons with MCC employ heuristics which circumvent the traditional quantitative comparison of risks and benefits, providing an important challenge to informed decision making. Copyright © 2014 Elsevier Inc. All rights reserved.

  10. Engagement of young adult cancer survivors within a Facebook-based physical activity intervention.

    Science.gov (United States)

    Valle, Carmina G; Tate, Deborah F

    2017-12-01

    Few studies have examined how young adult cancer survivors use online social media. The objective of this study was to characterize Facebook engagement by young adult cancer survivors in the context of a physical activity (PA) intervention program. Young adult cancer survivors participated in one of two Facebook groups as part of a 12-week randomized trial of a PA intervention (FITNET) compared to a self-help comparison (SC) condition. A moderator actively prompted group discussions in the FITNET Facebook group, while social interaction was unprompted in the SC group. We examined factors related to engagement, differences in engagement by group format and types of Facebook posts, and the relationship between Facebook engagement and PA outcomes. There were no group differences in the number of Facebook comments posted over 12 weeks (FITNET, 153 vs. SC, 188 p = 0.85) or the proportion of participants that reported engaging within Facebook group discussions at least 1-2 days/week. The proportion of participants that made any posts decreased over time in both groups. SC participants were more likely than FITNET participants to agree that group discussions caused them to become physically active (p = 0.040) and that group members were supportive (p = 0.028). Participant-initiated posts elicited significantly more comments and likes than moderator-initiated posts. Responses posted on Facebook were significantly associated with light PA at 12 weeks (β = 11.77, t(85) = 1.996, p = 0.049) across groups. Engagement within Facebook groups was variable and may be associated with PA among young adult cancer survivors. Future research should explore how to promote sustained engagement in online social networks. ClinicalTrials.gov identifier: NCT01349153.

  11. Safety of cabazitaxel in senior adults with metastatic castration-resistant prostate cancer

    DEFF Research Database (Denmark)

    Heidenreich, Axel; Bracarda, Sergio; Mason, Malcolm

    2014-01-01

    BACKGROUND: Cabazitaxel/prednisone has been shown to prolong survival versus mitoxantrone/prednisone in patients with metastatic castration-resistant prostate cancer (mCRPC) that has progressed during or after docetaxel. Subsequently, compassionate-use programmes (CUPs) and expanded-access progra......-CSF, especially at cycle 1 and in men aged > or =75 years, is important and improves tolerability in senior adults treated with cabazitaxel....

  12. Radiation-induced thyroid cancer in children and adult population, living in contaminated territories after the Chernobyl accident

    International Nuclear Information System (INIS)

    Parshkov, E.; Sokolov, V.; Proshin, A.; Barnes, J.

    2003-01-01

    Results of the analysis of own and literature data on the occurrence and development of radiation-induced thyroid cancer are presented. Analysis involved distribution of the thyroid cancer incidence among 1 million children and 3 millions adults, living in the radioactively contaminated territories of Russia by age and sex. The main attention was paid to the understanding of latency period of spontaneous and radiation-induced cancer, comparison of oncological pathology features in children and adults, and the role of screening in the increase of incidence rate parameters. Analysis permitted to offer new interpretation of several previously known facts and to make new statements on the induction and development of radiogenic thyroid cancer, in particularly, on far more significant increase of the thyroid cancer incidence in adults, living in the contaminated territories, than it was considered earlier

  13. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... Cancer Reports, Research, and Literature Cancers by Body Location/System Childhood Cancers Late Effects of Childhood Cancer ... to Z List of Cancers Cancers by Body Location Childhood Cancers Adolescent & Young Adult Cancers Metastatic Cancer ...

  14. Cancer incidence and mortality among young adults aged 20-39 years worldwide in 2012: a population-based study.

    Science.gov (United States)

    Fidler, Miranda M; Gupta, Sumit; Soerjomataram, Isabelle; Ferlay, Jacques; Steliarova-Foucher, Eva; Bray, Freddie

    2017-12-01

    To date, the burden of cancer among young adults has rarely been studied in depth. Our aim was to describe the scale and profile of cancer incidence and mortality worldwide among 20-39 year-olds, highlighting major patterns by age, sex, development level, and geographical region. We did a population-based study to quantify the burden of young adult cancers worldwide. We defined young adult cancers as those occurring between the ages of 20 and 39 years because these individuals will have passed puberty and adolescence, but not yet experienced the effects of hormonal decline, immune response deterioration, or organ dysfunction associated with chronic health conditions. Global, regional, and country-specific (n=184) data estimates of the number of new cancer cases and cancer-associated deaths that occurred in 2012 among young adults were extracted in four 5-year bands from the International Agency for Research on Cancer's GLOBOCAN 2012 for all cancers combined and for 27 major types as defined by the International Classification of Disease, tenth revision. We report the number of new cancer cases and cancer-associated deaths overall and by sex alongside corresponding age-standardised rates (ASR) per 100 000 people per year. We also present results using four levels of the Human Development Index (HDI; low [least developed], medium, high, and very high [most developed]), which is a composite indicator for socioeconomic development comprising life expectancy, education, and gross national income. 975 396 new cancer cases and 358 392 cancer-associated deaths occurred among young adults worldwide in 2012, which equated to an ASR of 43·3 new cancer cases per 100 000 people per year and 15·9 cancer-associated deaths per 100 000 people per year. The burden was disproportionally greater among women and the most common cancer types overall in terms of new cases were female breast cancer, cervical cancer, thyroid cancer, leukaemia, and colorectal cancer; in terms of

  15. Does cognitive decline decrease health utility value in older adult patients with cancer?

    Science.gov (United States)

    Akechi, Tatsuo; Aiki, Sayo; Sugano, Koji; Uchida, Megumi; Yamada, Atsuro; Komatsu, Hirokazu; Ishida, Takashi; Kusumoto, Shigeru; Iida, Shinsuke; Okuyama, Toru

    2017-05-01

    Cognitive decline is common among older adults with cancer. The present study aimed to investigate the impact of cognitive decline on health utility value in older adults suffering from cancer. Consecutive patients aged 65 years or older with a primary diagnosis of malignant lymphoma or multiple myeloma were recruited. Patients were asked to complete the EuroQoL-5 (EQ-5D) scale to measure health utility and the Mini-Mental State Examination to assess cognitive decline. The potential impact of cognitive decline was investigated with univariate analysis. A multivariate regression analysis was conducted to control for potential confounding factors. Complete data were obtained from 87 patients, 29% of whom had cognitive decline. The mean ± SE EQ-5D score for patients with cognitive decline was significantly lower than that for those without cognitive decline (0.67 ± 0.04 vs 0.79 ± 0.03, t = 2.38, P = 0.02). However, multiple regression analysis showed that cognitive decline was not significantly associated with EQ-5D scores. Female sex and lower performance scores (worse physical condition) were significantly associated with EQ-5D scores. Cognitive decline may be involved in decreased health utility value in older adult patients with cancer. However, this effect does not seem to be independent, and the patient's physical condition may be a relevant confounding factor. © 2016 The Authors. Psychogeriatrics © 2016 Japanese Psychogeriatric Society.

  16. Deep venous thrombosis after orthopedic surgery in adult cancer patients.

    Science.gov (United States)

    Lin, P P; Graham, D; Hann, L E; Boland, P J; Healey, J H

    1998-05-01

    Patients with cancer and patients undergoing major orthopedic procedures are two groups at risk of deep venous thrombosis (DVT). The objective was to determine the rate of venous thromboembolic disease in patients with a malignant neoplasm and major orthopaedic surgery of the lower limb. The study included 169 patients. All patients were given knee-high intermittent pneumatic compression devices for prophylaxis. Postoperative surveillance for thrombosis was performed on all patients with venous duplex doppler ultrasonography. Proximal DVT occurred in 24 of 169 patients (14.2%). One patient (0.6%) developed a symptomatic, nonfatal pulmonary embolus (PE). The development of DVT was not associated with age, sex, type of surgery, type of neoplasm, location, or pathologic fracture. The addition of anticoagulant medication such as warfarin did not significantly reduce the rate of DVT in a subset of 54 patients. In three patients, the DVT occurred only in the contralateral limb, and in four patients, there were bilateral DVTs. When intermittent compression boots were used for prophylaxis in conjunction with ultrasound screening, the risk of proximal DVT was substantial (14.2%), but the rate of symptomatic PE was low (0.6%).

  17. Comparison of differentiated thyroid cancer in children and adolescents (≤20 years) with young adults.

    Science.gov (United States)

    Alzahrani, Ali S; Alkhafaji, Dania; Tuli, Mahmoud; Al-Hindi, Hindi; Sadiq, Bakr Bin

    2016-04-01

    Age is a major prognostic factor in differentiated thyroid cancer (DTC). It is not clear if paediatric DTC has a different histopathological profile and outcome than DTC in adult patients age. To assess whether DTC in children and adolescents differs from young age group by comparing paediatric DTC (age ≤ 20) with DTC in patients >20 to age. We studied all cases of paediatric DTC seen during the period 1998-2011. We compared this group with a large sample of 213 consecutive adult patients in the age group >20 to age 17 years (range, 8-20)] and 213 young adult patients [median age 33 years (range, 20·5-44·9)]. There was no difference in gender distribution, tumour subtypes, size and tumour multifocality, but there was a significantly higher rate of extrathyroidal extension [40/75 (53·3%) vs 81/213 (38·0%), P = 0·03], lymph node [57/73 (78%) vs 102/183 (55·7%), P adult groups. Kaplan-Meier analysis showed a higher risk of persistent/recurrent disease in the paediatric group than adults (log-rank test 0·03). However, there was no mortality secondary to DTC in both groups. Paediatric DTC is distinct from DTC in the young adults (age >20 to <45 years). It is characterized by a higher rate of extrathyroidal extension, lymph node and distant metastases and a higher risk of persistent/recurrent DTC. © 2015 John Wiley & Sons Ltd.

  18. Adult self-image and well-being after testicular cancer: The role of agency and meaning.

    Science.gov (United States)

    Ryan, Sean J; Hoyt, Michael A

    2018-08-01

    Cancer during young adulthood can limit the extent to which one adopts an adult self-image. However, the relationship of adult self-image to cancer-related adjustment remains unexplored. The current study examines relationships of adult self-image and social/emotional well-being and job-related problems in young testicular cancer survivors. Factors thought to facilitate future-oriented goals (i.e. agency and meaning) are examined as intermediary processes. Testicular cancer survivors (N = 171) between the ages of 18 and 29 completed questionnaire measures of adult self-image, agency, sense of meaning and indicators of adjustment. Social and emotional well-being were measured by the Functional Assessment of Cancer Therapy-General. Job problems were assessed using the EORTC's testicular cancer supplement (EORTC QLQ-TC26). Path model results revealed direct associations of survivors' adult self-image with social (β = .20, p image and well-being indicators. Finally, the relationship between adult self-image and job problems was only significant for those who were employed or in school (β = -.19, p image might be useful in identifying risk for poor adjustment. Interventions that target agency and meaning might facilitate developmental goals.

  19. Double Jeopardy? Age, Race, and HRQOL in Older Adults with Cancer

    Directory of Open Access Journals (Sweden)

    Keith M. Bellizzi

    2012-01-01

    Full Text Available Understanding the post-treatment physical and mental function of older adults from ethnic/racial minority backgrounds with cancer is a critical step to determine the services required to serve this growing population. The double jeopardy hypothesis suggests being a minority and old could have compounding effects on health. This population-based study examined the physical and mental function of older adults by age (mean age = 75.7, SD = 6.1, ethnicity/race, and cancer (breast, prostate, colorectal, and gynecologic as well as interaction effects between age, ethnicity/race and HRQOL. There was evidence of a significant age by ethnicity/race interaction in physical function for breast, prostate and all sites combined, but the interaction became non-significant (for breast and all sites combined when comorbidity was entered into the model. The interaction persisted in the prostate cancer group after controlling for comorbidity, such that African Americans and Asian Americans in the 75–79 age group report lower physical health than non-Hispanic Whites and Hispanic Whites in this age group. The presence of double jeopardy in the breast and all sites combined group can be explained by a differential comorbid burden among the older (75–79 minority group, but the interaction found in prostate cancer survivors does not reflect this differential comorbid burden.

  20. Double Jeopardy? Age, Race, and HRQOL in Older Adults with Cancer

    International Nuclear Information System (INIS)

    Bellizzi, K. M.; Aziz, N. M.; Rowland, J. H.; Arora, N. K.

    2012-01-01

    Understanding the post-treatment physical and mental function of older adults from ethnic/racial minority backgrounds with cancer is a critical step to determine the services required to serve this growing population. The double jeopardy hypothesis suggests being a minority and old could have compounding effects on health. This population-based study examined the physical and mental function of older adults by age (mean age=75.7, SD=6.1), ethnicity/race, and cancer (breast, prostate, colorectal, and gynecologic) as well as interaction effects between age, ethnicity/race and HRQOL. There was evidence of a significant age by ethnicity/race interaction in physical function for breast, prostate and all sites combined, but the interaction became non-significant (for breast and all sites combined) when co morbidity was entered into the model. The interaction persisted in the prostate cancer group after controlling for co morbidity, such that African Americans and Asian Americans in the 75-79 age group report lower physical health than non-Hispanic Whites and Hispanic Whites in this age group. The presence of double jeopardy in the breast and all sites combined group can be explained by a differential co morbid burden among the older (75-79) minority group, but the interaction found in prostate cancer survivors does not reflect this differential co morbid burden.

  1. Exercise for cancer cachexia in adults: Executive summary of a Cochrane Collaboration systematic review.

    Science.gov (United States)

    Grande, Antonio Jose; Silva, Valter; Maddocks, Matthew

    2015-09-01

    Cancer cachexia is a complex syndrome characterized by an ongoing loss of skeletal muscle mass and progressive functional impairment. A proactive management approach is recommended, including physical exercise to maintain function via modulation of muscle metabolism, insulin sensitivity and levels of inflammation. The review aimed to determine the safety, acceptability and effectiveness of exercise in adults with cancer cachexia. Secondary aims, subject to the data availability, were to compare effectiveness according to the characteristics of the study intervention or population. We sought randomised controlled trials (RCTs) in adults meeting international criteria for cancer cachexia, comparing a programme of exercise as a sole or adjunct intervention to usual care or an active control. CENTRAL, MEDLINE, EMBASE, DARE and HTA, ISI Web of Science, LILACS, PEDro, SciVerse SCOPUS, Biosis Previews PreMEDLINE and Open Grey databases were searched up to June 2014. Two authors independently assessed studies for eligibility. We screened 3154 separate titles and abstracts, and reviewed 16 full-texts. Corresponding authors were contacted to determine if samples met cachexia staging criteria. Most authors did not explore this concept. No trial met review eligibility criteria. We were unable to perform a meta-analysis to determine any effects from exercise intervention. Despite a strong rationale for the use of exercise, there is insufficient evidence to determine safety and effectiveness in patients with cancer cachexia. Findings from ongoing studies are awaited. Assessment of cachexia domains, ideally against international criteria, is required for future trials of exercise and supportive care interventions.

  2. Cancer-Related Worry and Physical Well-Being in the Context of Perceived Stress in Young Adults with Testicular Cancer.

    Science.gov (United States)

    Darabos, Katie; Hoyt, Michael A

    2017-06-01

    Uncertainty associated with cancer can foster future-focused worry and ultimately diminish physical well-being, especially among young adult survivors. Stress perceptions might exacerbate the association of worry and physical well-being. Young adults with testicular cancer (N = 171) completed measures of physical well-being, perceived stress, and future cancer-related worry. Perceived stress and future worry were both negatively associated with physical well-being. Perceived stress moderated the relationship; more perceived stress was related to lower physical well-being in those with high worry. Interventions aimed at worry reduction might benefit from reducing global stress perceptions.

  3. Multicentre study of treatment outcomes in Australian adolescents and young adults commencing dialysis.

    Science.gov (United States)

    Krischock, Leah; Kennedy, Sean E; Hayen, Andrew

    2017-12-01

    The aim of the study is to improve the understanding of outcomes and complications of dialysis in adolescents and young adults (AYA) to inform decisions about dialysis modality in this patient population. Registry data on Australian AYA aged 13 to 20 years who commenced dialysis between 1/1/2000 and 31/12/2013 were retrieved from the Australia and New Zealand Dialysis and Transplantation Registry and analyzed to determine associations between demographic characteristics, dialysis modality and outcomes. During the study period 300 AYA commenced dialysis at a median age of 17.2 years (IQR 15.6 to 18.6 years). Haemodialysis (HD) was the initial dialysis modality in 201 patients (67%). No significant differences between AYA receiving HD and peritoneal dialysis (PD) were noted in patient gender, age, race, primary renal disease, treating centre type, remoteness of residential area, lateness of referral or period of study. Mean haemoglobin levels were lower in the HD group (P = 0.005) and significantly fewer HD patients attended school full time compared to patients managed on PD (P = 0.002 first year; P = 0.05 second year). Dialysis modality choice does not appear to be influenced by patient characteristics nor dialysis outcomes. Future research is required to examine the reasons that HD is preferred over PD and to determine the optimal method of dialysis for this age group. © 2016 Asian Pacific Society of Nephrology.

  4. Antiretroviral Treatment Adherence: Knowledge and Experiences among Adolescents and Young Adults in Soweto, South Africa

    Directory of Open Access Journals (Sweden)

    Stefanie Hornschuh

    2017-01-01

    Full Text Available Human immunodeficiency virus (HIV management of adolescents and young adults (AYAs is particularly pertinent to sub-Saharan Africa, where the pediatric HIV burden is marked. Antiretroviral treatment (ART adherence is a major challenge for AYAs. This qualitative study explored knowledge and experiences of adherence amongst AYAs attending treatment at the Perinatal HIV Research Unit (PHRU, Soweto, South Africa. Four focus group discussions (FGDs and eight in-depth interviews (IDIs were conducted with HIV-infected 15–25-year-old ART recipients. Transcripts were coded thematically. Participants (n=26 were aged median 18.5 years, 59.1% female and 69.2% virally suppressed <400 cp/ml. Three main themes emerged during FGDs and IDIs: (i correct knowledge about how to be adherent, benefits, and nonadherence consequences, (ii social, personal, and medication-related barriers to adherence, and (iii reminder, concealment, and motivational strategies to optimize adherence. Interventions to improve AYA adherence could focus on practical strategies, including status disclosure and medication concealment.

  5. How Can Pharmacists Support STI Prevention and Treatment Among Female Adolescents and Young Adults?

    Directory of Open Access Journals (Sweden)

    Olufunmilola Abraham

    2017-04-01

    Full Text Available Sexual and reproductive health is a critical focus area for adolescents and young adults (AYAs. Of the 20 million newly diagnosed Sexually Transmitted Infections (STIs annually, nearly half of them are contracted by young people between the ages of 15 to 24. It has become increasingly necessary to improve awareness and prevention of STIs during adolescent years. The knowledge gained through appropriately relevant sexual and reproductive health education may persist as adolescents transition into adulthood. Community pharmacists interact with AYAs frequently and are therefore well positioned to engage this vulnerable population in conversations about their sexual and reproductive health through use innovative and interactive technologies. For instance, mobile applications are easily accessible to AYAs and can allow pharmacists to disseminate relevant medication information to smartphone users that download adolescent-tailored mobile applications. Although many medication adherence apps are currently available on the market, none of these apps are tailored towards sexual reproductive health information for female AYAs. A mobile-based program designed to provide a pharmacist-guided sexual and reproductive health education to female AYAs may help to address the lapses in current adolescent-aged school health classes. In the future, usage of this intervention would improve the accuracy and comprehension of female adolescents and young adults’ awareness and knowledge of their sexual and reproductive health. As a result, further research should be conducted to develop mobile applications conducive to adolescent and young adults to address sexual and reproductive health issues. Conflict of Interest We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received, employment, gifts, stock holdings or

  6. Adolescent and Young Adult Use of Social Media for Health and Its Implications.

    Science.gov (United States)

    Hausmann, Jonathan S; Touloumtzis, Currie; White, Matthew T; Colbert, James A; Gooding, Holly C

    2017-06-01

    To determine how adolescents and young adults (AYAs) use social media to share health information and to assess attitudes toward using social media to obtain health information and communicate with medical providers. A cross-sectional study of AYAs, 12 years or older, attending a primary care adolescent and young adult clinic. Participants completed an anonymous survey about health-related social media use, personal health, and communication with their health care team. Of the 244 patients approached, 204 enrolled (83.6% participation rate). Almost all (98%) had used social media within the prior month, but only 51.5% had shared health information in these networks. These participants shared about mood (76.2%), wellness (57.1%), and acute medical conditions (41.9%). Those with self-reported poor health were more likely to share health information than other groups. Privacy was the most important factor determining which platform to use. Only 25% thought that social media could provide them with useful health information. Few AYAs connected with their health care team on social media and most did not want to use this method; texting was preferred. AYAs maintain their privacy on social media regarding their health. Those with self-perceived poor health are more likely to share health information, potentially biasing online content and impairing the generalizability of social media research. AYAs do not view social media as a useful source of health information, which may limit the utility of public health messages through these platforms, and it may not be adequate for communication between patients and their health care team. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  7. Prostate cancer in young adults-Seventeen-year clinical experience of a single center.

    Science.gov (United States)

    Huang, Tzu-Hao; Kuo, Junne-Yih; Huang, Yi-Hsiu; Chung, Hsiao-Jen; Huang, William J S; Wu, Howard H H; Chang, Yen-Hwa; Lin, Alex T L; Chen, Kuang-Kuo

    2017-01-01

    In the general population, prostate adenocarcinoma affects predominately older men. If fact, most current guidelines suggest that males over the age of 50 years should undergo prostate cancer screening. However, the clinical behavior and prognosis of prostate cancer in young adults is not well defined. The aim of this study was to evaluate the clinical behavior, pathological characteristics, and prognosis of prostate cancer in young adults. We retrospectively reviewed the records of young patients (age, ≤50 years) in our hospital with prostate adenocarcinoma between 1997 and 2013. We compared data including initial presentation, cancer cell type, Gleason score, disease stage, prostate-specific antigen (PSA) level, prostate volume, treatment, and survival between patients both younger and older than 50 years. Data were analyzed using the Kaplan-Meier method to assess survival. Twenty-six patients were enrolled in our study, accounting for 0.55% of all patients with a diagnosis of prostate cancer at our facility. All 26 patients had a pathology diagnosis of adenocarcinoma, with a mean age on diagnosis of 46.8±2.8 years (range, 39-50 years). On initial presentation, patients older than 50 years more frequently displayed lower urinary tract symptoms (LUTS) than younger patients (62.3% vs. 30.4%, p=0.008). There was no statistical difference in histological grade, disease stage, PSA level, overall survival, and biochemical-free survival between the two groups. The result of our investigation indicated that prostate adenocarcinoma patients younger than 50 years had similar histological grade, disease stage, PSA level, overall survival, and biochemical-free survival as the older population. However, patients younger than 50 years with prostate cancer less frequently showed initial symptoms of LUTS. Copyright © 2016. Published by Elsevier Taiwan LLC.

  8. Overtreatment of young adults with colon cancer: more intense treatments with unmatched survival gains.

    Science.gov (United States)

    Kneuertz, Peter J; Chang, George J; Hu, Chung-Yuan; Rodriguez-Bigas, Miguel A; Eng, Cathy; Vilar, Eduardo; Skibber, John M; Feig, Barry W; Cormier, Janice N; You, Y Nancy

    2015-05-01

    Colon cancer is increasing among adults younger than 50 years. However, the prognosis of young-onset colon cancer remains poorly defined given significant age-related demographic, disease, and treatment differences. To define stage-specific treatments and prognosis of colon cancer diagnosed in young adults (ages 18-49 years) vs older adults (ages 65-75 years) outside of the clinical trial setting while accounting for real-world age-related variations in patient, tumor, and treatment factors. A nationwide cohort study was conducted among US hospitals accredited by the American College of Surgeons Commission on Cancer. Participants were 13 102 patients diagnosed as having young-onset colon adenocarcinoma aged 18 to 49 years and 37 007 patients diagnosed as having later-onset colon adenocarcinoma aged 65 to 75 years treated between January 1, 2003, and December 31, 2005, and reported to the National Cancer Data Base. Patients who underwent surgical resection and postoperative systemic chemotherapy of curative intent. The primary end point was stage-specific relative survival, an objective measure of survival among patients with cancer, adjusting for baseline mortality rates and independent of the data on cause of death. The secondary end point was stage-specific likelihood of receiving postoperative systemic chemotherapy. Most young-onset colon cancer was initially seen at advanced stages (61.8% had stage III or IV). After adjusting for patient-related and tumor-related factors, young patients were more likely to receive systemic chemotherapy, particularly multiagent regimens, at all stages relative to those with later-onset disease. These odds ratios were 2.88 (95% CI, 2.21-3.77) for stage I, 3.93 (95% CI, 3.58-4.31) for stage II, 2.42 (95% CI, 2.18-2.68) for stage III, and 2.74 (95% CI, 2.44-3.07) for stage IV. The significantly more intense treatments received by younger patients were unmatched by any survival gain, which was nil for stage II (relative risk, 0

  9. Mechanisms in Psychosocial Interventions for Adults Living with Cancer: Opportunity for Integration of Theory, Research, and Practice

    Science.gov (United States)

    Stanton, Annette L.; Luecken, Linda J.; MacKinnon, David P.; Thompson, Elizabeth H.

    2013-01-01

    Objective: The diagnosis and treatment of cancer are highly stressful experiences that can profoundly affect emotional and physical well-being. Hundreds of longitudinal investigations that identify risk and protective factors for psychological and physical adjustment in adults living with cancer and numerous randomized controlled psychosocial…

  10. Sleep Duration across the Adult Lifecourse and Risk of Lung Cancer Mortality : A Cohort Study in Xuanwei, China

    NARCIS (Netherlands)

    Wong, Jason Y Y; Bassig, Bryan A.; Vermeulen, Roel; Hu, Wei; Ning, Bofu; Seow, Wei Jie; Ji, Bu Tian; Downward, George S; Katki, Hormuzd A; Barone-Adesi, Francesco; Rothman, Nathaniel; Chapman, Robert S.; Lan, Qing

    Sufficient sleep duration is crucial for maintaining normal physiological function and has been linked to cancer risk; however, its contribution to lung cancer mortality is unclear. Therefore, we evaluated the relationship between average sleep duration in various age-periods across the adult

  11. No damaging effect of chemotherapy in addition to radiotherapy on the thyroid axis in young adult survivors of childhood cancer

    NARCIS (Netherlands)

    van Santen, Hanneke M.; Vulsma, Thomas; Dijkgraaf, Marcel G.; Blumer, Regje M. E.; Heinen, Richard; Jaspers, Monique W. M.; Geenen, Maud M.; Offringa, Martin O.; de Vijlder, Jan J. M.; van den Bos, Cor

    2003-01-01

    Late effects of treatment for childhood cancer on the thyroid axis are ascribed predominantly to radiotherapy. Whether chemotherapy has an additional detrimental effect is still unclear. Our aim was to evaluate this effect in young adult survivors of a broad spectrum of childhood cancers. The

  12. Evaluation of the Quality of Life in Adult Cancer Survivors (QLACS scale for long-term cancer survivors in a sample of breast cancer survivors

    Directory of Open Access Journals (Sweden)

    Foley Kristie

    2006-12-01

    Full Text Available Abstract Background This paper evaluates psychometric properties of a recently developed measure focusing on the health-related quality of life (HRQL of long-term cancer survivors, the Quality of Life in Adult Survivors scale (QLACS, in a sample of breast cancer survivors. This represents an important area of study, given the large number of breast cancer patients surviving many years post diagnosis. Methods Analyses are based on an 8-year follow-up of a sample of breast cancer survivors who participated in an earlier study conducted in 1995. Participants were re-contacted in 2003 and those who were reachable and agreed to participate (n = 94 were surveyed using a variety of measures including the QLACS. Additional follow-up surveys were conducted 2 weeks and one year later. Psychometric tests of the QLACS included test-retest reliability, concurrent and retrospective validity, and responsiveness. Results The QLACS domain and summary scores showed good test-retest reliability (all test-retest correlations were above .7 and high internal consistency. The Generic Summary Score showed convergent validity with other measures designed to assess generic HRQL. The Cancer-Specific Summary score exhibited divergent validity with generic HRQL measures, but not a cancer-related specific measure. The QLACS Cancer-Specific Summary Score demonstrated satisfactory predictive validity for factors that were previously shown to be correlated with HRQL. The QLACS generally demonstrated a high level of responsiveness to life changes. Conclusion The QLACS may serve as a useful measure for assessing HRQL among long-term breast cancer survivors that are not otherwise captured by generic measures or those specifically designed for newly diagnosed patients.

  13. Older adults' attitudes about continuing cancer screening later in life: a pilot study interviewing residents of two continuing care communities

    Directory of Open Access Journals (Sweden)

    Walter Louise C

    2006-08-01

    Full Text Available Abstract Background Individualized decision making has been recommended for cancer screening decisions in older adults. Because older adults' preferences are central to individualized decisions, we assessed older adults' perspectives about continuing cancer screening later in life. Methods Face to face interviews with 116 residents age 70 or over from two long-term care retirement communities. Interview content included questions about whether participants had discussed cancer screening with their physicians since turning age 70, their attitudes about information important for individualized decisions, and their attitudes about continuing cancer screening later in life. Results Forty-nine percent of participants reported that they had an opportunity to discuss cancer screening with their physician since turning age 70; 89% would have preferred to have had these discussions. Sixty-two percent believed their own life expectancy was not important for decision making, and 48% preferred not to discuss life expectancy. Attitudes about continuing cancer screening were favorable. Most participants reported that they would continue screening throughout their lives and 43% would consider getting screened even if their doctors recommended against it. Only 13% thought that they would not live long enough to benefit from cancer screening tests. Factors important to consider stopping include: age, deteriorating or poor health, concerns about the effectiveness of the tests, and doctors recommendations. Conclusion This select group of older adults held positive attitudes about continuing cancer screening later in life, and many may have had unrealistic expectations. Individualized decision making could help clarify how life expectancy affects the potential survival benefits of cancer screening. Future research is needed to determine whether educating older adults about the importance of longevity in screening decisions would be acceptable, affect older adults

  14. "I Got My Diagnosis on a Yellow Post-it Note": Young Adult Cancer Patients' Experiences of the Process of Being Diagnosed With Cancer.

    Science.gov (United States)

    Hauken, May Aasebø; Hølge-Hazelton, Bibbi; Larsen, Torill M B

    2018-06-01

    Cancer in young adults is rare but young adult cancer patients (YACPs) are at an increased risk of severe physical and psychosocial impairments during cancer treatment and survivorship. However, little is known about the onset of this process. The aim of this study was to explore how young cancer survivors experience the process of being diagnosed with cancer. A qualitative method founded on a phenomenological-hermeneutical approach was used and included in-depth interviews with 20 young adult survivors (aged 24-35 years) with different cancer diagnoses, analyzed by Systematic Text Condensation. The participants' experiences of the diagnosis process were elaborated according to 3 main themes: (1) "I felt something was wrong, but…," (2) "The traumatic uncertainty," and (3) "The day my world collapsed." The findings indicate that the YACPs experienced a diagnosis of cancer as a highly traumatic and long-lasting process, characterized by lack of information and uncertainty. The findings indicate that healthcare professionals do not acknowledge the vulnerable phase of life and transitional challenges of YACPs. The findings highlight the need to raise awareness of cancer in young adulthood in the public and in the primary healthcare system, to shorten the diagnosis process, and to clarify responsibility for age-related information and psychosocial follow-up during the diagnosis process. Further research is highly warranted.

  15. Living with Symptoms: A Qualitative Study of Black Adults with Advanced Cancer Living in Poverty.

    Science.gov (United States)

    Yeager, Katherine A; Quest, Tammie E; Vena, Catherine; Sterk, Claire E

    2018-02-01

    Cancer is associated with disease-related and treatment-related symptoms. Little is known about the symptom experience of black individuals with advanced cancer especially those with limited financial resources. Therefore, the purpose of this study was to explore the symptom experience of black adults with advanced cancer living in poverty. This qualitative descriptive study focused on the perspectives of the participants experiencing at least two symptoms related to cancer. A purposive sample of 27 individuals receiving care at a public hospital in a southeastern city participated in the study. Semi-structured audiotaped interviews were conducted by two research interviewers. Content analysis was used to develop themes to describe the symptom experience. Two main themes emerged in terms of the participants' symptom experiences: (1) "living in pain," which included the overwhelming experience of pain, both physical and emotional, and (2) "symptoms associated with functioning in everyday life." Participants frequently used the context of activities in their daily lives to explain symptoms, including the effect of symptoms on the activities of eating, moving and doing, and communicating. People with advanced cancer work to negotiate a high frequency of multiple distressful symptoms of severe-to-moderate severity. Information gained from this study can help guide research in symptom science and provide direction for clinicians working with this minority group. Copyright © 2017 American Society for Pain Management Nursing. All rights reserved.

  16. Masculine norms about emotionality and social constraints in young and older adult men with cancer.

    Science.gov (United States)

    Darabos, Katie; Hoyt, Michael A

    2017-04-01

    Beliefs that men should restrict their display of emotions, or restrictive emotionality, might contribute to adjustment to cancer and this might be sensitive to social receptivity to disclosure. The present research examined relationships of restrictive emotionality, social constraints, and psychological distress in young adults with testicular cancer (N = 171; Study 1) and older men with prostate cancer (N = 66; Study 2). Study 1: positive associations were observed for social constraints and restrictive emotionality with depressive symptoms. Social constraints moderated the relationship, such that high restrictive emotionality was associated with higher depressive symptoms in those with high constraints. Study 2: only social constraints (and not restrictive emotionality) was positively associated with depressive symptoms and cancer-related intrusive thoughts. The social constraints × restrictive emotionality interaction approached significance with depressive symptoms, such with high social constraints low restrictive emotionality was associated with higher depressive symptoms compared to those with less constraints. No significant associations were found for intrusive thoughts in either study. Findings demonstrate unique relationships with psychological distress across the lifespan of men with cancer given perception of constraints and adherence to masculine norms about emotionality.

  17. Development of a Primary Care-Based Clinic to Support Adults With a History of Childhood Cancer: The Tactic Clinic.

    Science.gov (United States)

    Overholser, Linda S; Moss, Kerry M; Kilbourn, Kristin; Risendal, Betsy; Jones, Alison F; Greffe, Brian S; Garrington, Timothy; Leonardi-Warren, Kristin; Yamashita, Traci E; Kutner, Jean S

    2015-01-01

    Describe the development and evolution of a primary-care-based, multidisciplinary clinic to support the ongoing care of adult survivors of childhood cancer. A consultative clinic for adult survivors of childhood cancer has been developed that is located in an adult, academic internal medicine setting and is based on a long-term follow-up clinic model available at Children's Hospital Colorado. The clinic opened in July 2008. One hundred thirty-five patients have been seen as of April 2014. Referrals and clinic capacity have gradually increased over time, and a template has been developed in the electronic medical record to help facilitate completion of individualized care plan letters. A primary care-based, multidisciplinary consultative clinic for adults with a history of childhood cancer survivor is feasible and actively engages adult primary care resources to provide risk-based care for long-term pediatric cancer survivors. This model of care planning can help support adult survivors of pediatric cancer and their primary care providers in non-academic, community settings as well. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Cancer Risk-Promoting Information: The Communication Environment of Young Adults.

    Science.gov (United States)

    McCloud, Rachel F; Kohler, Racquel E; Viswanath, K

    2017-09-01

    Young adulthood represents a time of myriad transitions, which leave young adults (YAs) more susceptible to the influences of cancer risk-promoting information. The tobacco, alcohol, indoor tanning, and food and beverage industries engage in aggressive marketing strategies through both traditional and social media to target this age group to consume their products, which have known links to cancer. Despite this barrage of messaging, detailed data are lacking on the communication behaviors of subgroups of this diverse age group, particularly those from low SES. This paper explores the available data on media usage among YAs and describes the cancer risk-promoting information environment, with a focus on communication inequalities and their implications for cancer research and control. Nationally representative data on media consumption patterns indicate that the majority of YAs access a diverse range of traditional and social media platforms, but these data do not fully describe differences at the intersection of age and important factors such as SES, gender, race/ethnicity, or urban/rural residence. Meanwhile, risk-promoting information is heavily marketed to YAs across media, with an increasing focus on using social media sites to normalize products and evade marketing restrictions. Gaps in the available data on YAs' media consumption behaviors, coupled with aggressive risk-promoting marketing strategies toward YAs, may impede cancer control efforts. Relationships between exposure to various cancer risk-promoting information, concurrent risk behaviors, SES disparities, and communication inequalities should be investigated to develop innovative and effective control programs and policies to promote cancer control in this important group. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  19. Good death in elderly adults with cancer in Japan based on perspectives of the general population.

    Science.gov (United States)

    Akechi, Tatsuo; Miyashita, Mitsunori; Morita, Tatsuya; Okuyama, Toru; Sakamoto, Masaki; Sagawa, Ryuichi; Uchitomi, Yosuke

    2012-02-01

    To investigate concepts relevant to a good death in elderly adults with cancer. Cross-sectional. Japan. A national sample of 2,595 adults, including 466 aged 70 to 79. An anonymous questionnaire covering 18 domains (physical and psychological comfort, dying in a favorite place, good relationship with medical staff, maintaining hope and pleasure, not being a burden to others, good relationship with family, physical and cognitive control, environmental comfort, being respected as an individual, life completion, natural death, preparation for death, role accomplishment and contribution to others, unawareness of death, fighting against cancer, pride and beauty, control over the future, and religious and spiritual comfort) and two additional concepts (pokkuri (sudden death) and omakase (leaving the decisions to a medical expert) was completed. The difference in importance of the concept between two age groups (40-69 and 70-79) was investigated using effect sizes (ESs). Clinically significant differences in the concept of good death were observed for two domains and one component: not being a burden to others (ES = -0.24), role accomplishment and contribution to others (ES = 0.29), and omakase (leaving the decisions to a medical expert; ES = 0.60). Only a few differences in the concept of good death existed between elderly and younger adults. When caring for terminally ill elderly Japanese adults, medical staff should acknowledge that some elderly adults value the traditional paternalistic attitude of physicians and that not all people want to be actively involved in decision-making. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

  20. Comparison of isolates and antibiotic sensitivity pattern in pediatric and adult cancer patients; is it different?

    Science.gov (United States)

    Prabhash, K; Bajpai, J; Gokarn, A; Arora, B; Kurkure, P A; Medhekar, A; Kelkar, R; Biswas, S; Gupta, S; Naronha, V; Shetty, N; Goyel, G; Banavali, S D

    2014-01-01

    Infection is a common cause of mortality and morbidity in cancer patients. Organisms are becoming resistant to antibiotics; age appears to be one of the factors responsible. We analyzed common organisms and their antibiotic sensitivity pattern in the correlation with age. This is a single institutional, retrospective analysis of all culture positive adult and pediatric cancer patients from January 2007 to December 2007. For statistical analysis, Chi-square test for trend was used and P values were obtained. Of 1251 isolates, 262 were from children 12 years of age). Gram-negative organisms were predominant (64.95) while Gram-positive constituted 35.09% of isolates. The most common source in all age groups was peripheral-blood, accounting to 47.8% of all samples. The most common organisms in adults were Pseudomonas aeruginosa (15.3%) while in children it was coagulase negative Staphylococcus aureus (19.8%). Antibiotic sensitivity was different in both groups. In pediatric group higher sensitivity was seen for Cefoparazone-sulbactum, Cefipime, Amikacin, and Tobramycin. No resistance was found for Linezolid. The isolates in both children and adults were predominantly Gram-negative though children had proportionately higher Gram-positive organisms. High-dose cytarabine use, cotrimoxazole prophylaxis, and frequent use of central lines in children especially in hematological malignancies could explain this observation. Children harbor less antibiotic resistance than adults; Uncontrolled, cumulative exposure to antibiotics in our community with increasing age, age-related immune factors and variable bacterial flora in different wards might explain the higher antibiotic resistance in adults. Thus age is an important factor to be considered while deciding empirical antibiotic therapy.

  1. 3-Tesla MRI Response to TACE in HCC (Liver Cancer)

    Science.gov (United States)

    2016-08-22

    Adult Primary Hepatocellular Carcinoma; Advanced Adult Primary Liver Cancer; Localized Resectable Adult Primary Liver Cancer; Localized Unresectable Adult Primary Liver Cancer; Stage A Adult Primary Liver Cancer (BCLC); Stage B Adult Primary Liver Cancer (BCLC)

  2. Predictors of marriage and divorce in adult survivors of childhood cancers: a report from the Childhood Cancer Survivor Study.

    Science.gov (United States)

    Janson, Christopher; Leisenring, Wendy; Cox, Cheryl; Termuhlen, Amanda M; Mertens, Ann C; Whitton, John A; Goodman, Pamela; Zeltzer, Lonnie; Robison, Leslie L; Krull, Kevin R; Kadan-Lottick, Nina S

    2009-10-01

    Adult survivors of childhood cancer can have altered social functioning. We sought to identify factors that predict marriage and divorce outcomes in this growing population. This was a retrospective cohort study of 8,928 > or = 5-year adult survivors of childhood malignancy and 2,879 random sibling controls participating in the Childhood Cancer Survivor Study. Marital status, current health, psychological status, and neurocognitive functioning were determined from surveys and validated instruments. Survivors were more likely to be never-married than siblings [relative risk (RR), 1.21; 95% confidence interval (95% CI), 1.15-1.26] and the U.S. population (RR, 1.25; 95% CI, 1.21-1.29), after adjusting for age, gender, and race. Patients with central nervous system tumors were at greatest risk of not marrying (RR, 1.50; 95% CI, 1.41-1.59). Married survivors divorced at frequencies similar to controls. In multivariable regression analysis, nonmarriage was most associated with cranial radiation (RR, 1.15; 95% CI, 1.02-1.31 for > 2,400 centigray). In analysis of neurobehavioral functioning, nonmarriage was associated with worse task efficiency (RR, 1.27; 95% CI, 1.20-1.35), but not with emotional distress, or problems with emotional regulation, memory, or organization. Physical conditions predictive of nonmarriage included short stature (RR, 1.27; 95% CI, 1.20-1.34) and poor physical function (RR, 1.08; 95% CI, 1.00-1.18). Structural equation modeling suggested that cranial radiation influenced marriage status through short stature, cognitive problems, and poor physical function. Childhood cancer survivors married at lower frequencies compared with peers. Patients with central nervous system tumors, cranial radiation, impaired processing efficiency, and short stature were more likely to never marry. Divorce patterns in survivors were similar to peers.

  3. Active transportation in adult survivors of childhood cancer and neighborhood controls.

    Science.gov (United States)

    Slater, Megan E; Kelly, Aaron S; Sadak, Karim T; Ross, Julie A

    2016-02-01

    Childhood cancer survivors (CCS) are at high risk of treatment-related late effects, including cardiovascular disease and diabetes, which can be exacerbated by inadequate physical activity (PA). Previous PA interventions targeting CCS have focused on the domain of leisure-time/recreational PA. Active transportation, another domain of PA, has not been described in CCS. Therefore, this study aimed to identify active transportation behaviors, barriers, and correlates in adult CCS. We recruited 158 adult CCS and 153 controls matched on age, sex, and neighborhood for a survey regarding active transportation behaviors and perceptions. Linear and logistic regression models accounting for correlation among matched participants were used. Adult CCS engaged in similar levels of active transportation as controls (2.72 vs. 2.32 h/week, P = 0.40) despite perceiving greater health-related barriers (1.88 vs. 1.65 (measured on four-point Likert scale), P = 0.01). Marital/relationship status (odds ratio (OR) = 0.30, 95 % confidence interval (CI) = 0.11-0.81), planning/psychosocial barriers (OR = 0.15, 95 % CI = 0.04-0.53), and perceived neighborhood walkability (OR = 2.55, 95 % CI = 1.14-5.66) were correlates of active transportation among adult CCS, while objective neighborhood walkability (OR = 1.03, 95 % CI = 1.01-1.05) was a correlate among controls. Results suggest adult CCS and controls utilize active transportation at approximately equal levels. Factors other than health, including perceived neighborhood walkability, are related to active transportation behaviors to a greater degree in adult CCS. Interventions might consider promoting active transportation as a way to incorporate more PA into the daily lives of adult CCS. Such interventions will not be likely successful, however, without existing or improved neighborhood walkability/bikeability.

  4. A Case of Advanced Descending Colon Cancer in an Adult Patient with Intestinal Malrotation

    Directory of Open Access Journals (Sweden)

    Yoshifumi Nakayama

    2016-01-01

    Full Text Available This report presents an operative case of advanced descending colon cancer in an adult patient with intestinal malrotation. A 63-year-old Japanese male was suffering from left side abdominal pain, abdominal distension, and constipation. An endoscopic examination revealed an advanced tumor in the descending colon. Computed tomography (CT of the abdomen revealed the thickening of the descending colon wall and superior mesenteric vein rotation. An opaque enema detected severe stenosis of the descending colon. An abdominal X-ray examination revealed the dilation of the colon and small intestine with niveau. At the insertion of an ileus tube, the C-loop of the duodenum was observed to be absent and the small intestine was located on the right side of the abdomen. After the decompression of the bowel contents, laparotomy was performed. Descending colon cancer was observed to have directly invaded the left side of the transverse colon. Left hemicolectomy, lymph node dissection, and appendectomy were performed. The patient had an uneventful recovery and was discharged from the hospital on the 16th day after surgery. This report presents a rare operative case of descending colon cancer in an adult patient with intestinal malrotation.

  5. Workplace experiences and turnover intention among adult survivors of childhood cancer.

    Science.gov (United States)

    Crom, Deborah B; Ness, Kirsten K; Martinez, Larry R; Hebl, Michelle R; Robison, Leslie L; Hudson, Melissa M; Brinkman, Tara M

    2018-03-17

    The purpose of this study was to investigate workplace experiences and turnover intention (consideration of leaving or changing a job) and to examine factors associated with turnover intention among survivors. Adult survivors of childhood cancer with a history of employment (n = 289) completed measures of workplace experiences (n = 50, 18-29 years; n = 183, 30-44 years; n = 56; > 45 years of age at follow-up). Turnover intention was assessed using three items from the Job Satisfaction Scale. Responses were dichotomized as reflecting high vs. low turnover intention. Path analysis was used to estimate the influence of demographic characteristics, treatment exposures (cranial radiation therapy [CRT]), and workplace experiences on turnover intention. Thirty percent of survivors reported high turnover intention (95% CL, 25 to 36%). Exposure to CRT (P = 0.003), older attained age (P workplace discrimination (P = 0.008), and having lower continuance (P discrimination, mediated through job satisfaction, also influenced survivors' reported intent to leave their jobs. One third of adult survivors of childhood cancer report turnover intention, which is related to their cancer treatment, but more temporally proximal, workplace discrimination. Additional research is needed to understand the consequences of turnover intention among survivors. Survivors and their health care providers should be aware of legislative policies related to workplace discrimination (e.g., American with Disabilities Act) and related implications for job turnover.

  6. The association of physical activity with all-cause, cardiovascular, and cancer mortalities among older adults.

    Science.gov (United States)

    Wu, Chen-Yi; Hu, Hsiao-Yun; Chou, Yi-Chang; Huang, Nicole; Chou, Yiing-Jenq; Li, Chung-Pin

    2015-03-01

    To evaluate the association of physical activity with all-cause, cardiovascular, and cancer mortalities among older adults. A study sample consisting of 77,541 community-dwelling Taipei citizens aged ≥ 65 years was selected based on data obtained from the government-sponsored Annual Geriatric Health Examination Program between 2006 and 2010. Subjects were asked how many times they had physical activity for ≥ 30 min during the past 6 months. Mortality was determined by matching cohort identifications with national death files. Compared to subjects with no physical activity, those who had 1-2 times of physical activity per week had a decreased risk of all-cause mortality [hazard ratio (HR): 0.77; 95% confidence interval (CI): 0.71-0.85). Subjects with 3-5 times of physical activity per week had a further decreased risk of all-cause mortality (HR: 0.64; 95% CI: 0.58-0.70). An inverse dose-response relationship was observed between physical activity and all-cause, cardiovascular, and cancer mortality. According to stratified analyses, physical activity was associated with a decreased risk of mortality in most subgroups. Physical activity had an inverse association with all-cause, cardiovascular, and cancer mortality among older adults. Furthermore, most elderly people can benefit from an active lifestyle. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Symptom Levels in Care-Seeking Bangladeshi and Nepalese Adults With Advanced Cancer

    Directory of Open Access Journals (Sweden)

    Richard Reed Love

    2017-06-01

    Full Text Available Purpose: Three-fourths of patients with advanced cancer are reported to suffer from pain. A primary barrier to provision of adequate symptom treatment is failure to appreciate the intensity of the symptoms patients are experiencing. Because data on Bangladeshi and Nepalese patients’ perceptions of their symptomatic status are limited, we sought such information using a cell phone questionnaire. Methods: At tertiary care centers in Dhaka and Kathmandu, we recruited 640 and 383 adult patients, respectively, with incurable malignancy presenting for outpatient visits and instructed them for that single visit on one-time completion of a cell phone platform 15-item survey of questions about common cancer-associated symptoms and their magnitudes using Likert scales of 0 to 10. The questions were taken from the Edmonton Symptom Assessment System and the Brief Pain Inventory instruments. Results: All but two Bangladeshi patients recruited agreed to study participation. Two-thirds of Bangladeshi patients reported usual pain levels ≥ 5, and 50% of Nepalese patients reported usual pain levels ≥ 4 (population differences significant at P < .001. Conclusion: Bangladeshi and Nepalese adults with advanced cancer are comfortable with cell phone questionnaires about their symptoms and report high levels of pain. Greater attention to the suffering of these patients is warranted.

  8. Brain Cancer Stem Cells in Adults and Children: Cell Biology and Therapeutic Implications.

    Science.gov (United States)

    Abou-Antoun, Tamara J; Hale, James S; Lathia, Justin D; Dombrowski, Stephen M

    2017-04-01

    Brain tumors represent some of the most malignant cancers in both children and adults. Current treatment options target the majority of tumor cells but do not adequately target self-renewing cancer stem cells (CSCs). CSCs have been reported to resist the most aggressive radiation and chemotherapies, and give rise to recurrent, treatment-resistant secondary malignancies. With advancing technologies, we now have a better understanding of the genetic, epigenetic and molecular signatures and microenvironmental influences which are useful in distinguishing between distinctly different tumor subtypes. As a result, efforts are now underway to identify and target CSCs within various tumor subtypes based on this foundation. This review discusses progress in CSC biology as it relates to targeted therapies which may be uniquely different between pediatric and adult brain tumors. Studies to date suggest that pediatric brain tumors may benefit more from genetic and epigenetic targeted therapies, while combination treatments aimed specifically at multiple molecular pathways may be more effective in treating adult brain tumors which seem to have a greater propensity towards microenvironmental interactions. Ultimately, CSC targeting approaches in combination with current clinical therapies have the potential to be more effective owing to their ability to compromise CSCs maintenance and the mechanisms which underlie their highly aggressive and deadly nature.

  9. Adults surviving lung cancer two or more years: A systematic review.

    Science.gov (United States)

    Rhea, Deborah J; Lockwood, Suzy

    Lung cancer has had a low survival rate throughout the years. Some studies have shown that psychological variables such as hardiness and resiliency may play a role in the meaningfulness of survival among lung cancer patients. The objective of this systematic review was to synthesize the best available evidence on the experiences of surviving lung cancer (including psychological/affective well-being dimensions such as resiliency, optimism, quality of life, and coping strategies) in adults over the age of 18, two or more years after diagnosis. The review considered adults (18 years and older) who have survived lung cancer two or more years post diagnosis.The review included studies that examined the experiences (including psychological/affective well-being dimensions such as resiliency, optimism, quality of life, and coping strategies) of surviving lung cancer two or more years post diagnosis.The review considered patients' experiences of surviving lung cancer post two years diagnosis, including the examination of specific psychological/affective well-being aspects such as resiliency, optimism, quality of life and coping strategies.The review included quantitative descriptive studies and qualitative studies. A search for published and unpublished studies in English language from January 1999 through December 2010 was undertaken in multiple databases including MEDLINE, CINAHL, ProQuest and Psyc INFO. Assessment of methodological quality of studies was undertaken using critical appraisal tools from the Joanna Briggs Institute. Data was extracted using the Joanna Briggs Institute Data Extraction forms. Results were presented in a narrative format as the synthesis of qualitative or quantitative data was not appropriate. 13 studies were included in the review: one mixed methods study (including a qualitative research component) and 12 quantitative studies.The qualitative component of the included mixed methods study identified five findings related to the meaningfulness

  10. Cognitive Changes After Adjuvant Treatment in Older Adults with Early-Stage Breast Cancer.

    Science.gov (United States)

    Lange, Marie; Heutte, Natacha; Noal, Sabine; Rigal, Olivier; Kurtz, Jean-Emmanuel; Lévy, Christelle; Allouache, Djelila; Rieux, Chantal; Lefel, Johan; Clarisse, Bénédicte; Leconte, Alexandra; Veyret, Corinne; Barthélémy, Philippe; Longato, Nadine; Tron, Laure; Castel, Hélène; Eustache, Francis; Giffard, Bénédicte; Joly, Florence

    2018-06-22

    Group-based trajectory modeling is particularly important to identify subgroups of patients with pathological cognitive changes after cancer treatment. To date, only one study has explored cognitive trajectories in older patients with cancer. The present article describes objective cognitive changes before to after adjuvant treatment in older adults with early-stage breast cancer (EBC) after adjuvant treatment compared with healthy controls. Participants were patients ≥65 years of age with newly diagnosed EBC and healthy controls (age-, sex-, and education-matched). The pretreatment assessment was conducted before adjuvant therapy, and the post-treatment assessment after the end of the first adjuvant treatment. Objective cognitive changes before to after treatment were evaluated based on the Reliable Change Index for cognitive decline accounting for cognitive impairment status. The sample consisted of women newly diagnosed with EBC ( n  = 118) and healthy controls ( n  = 62). Five patterns of changes before to after treatment were identified based on the presence of cognitive decline and cognitive impairment. The distribution of these five change patterns was statistically significant ( p  = .0001). Thirty-six percent of patients had phase shift changes, 31% without initial objective cognitive impairment developed impairment, 15% had a normal aging, 12% had a nonpathological decline, and 6% experienced accelerated cognitive decline. This study described for the first time objective cognitive changes before to after treatment of older adults with EBC immediately after the end of adjuvant treatment. A longer-term remote follow-up of adjuvant treatment is needed to better understand the cognitive trajectories of older patients with EBC. The Oncologist IMPLICATIONS FOR PRACTICE: After the end of adjuvant treatment, 31% of older adults with early-stage breast cancer without initial objective cognitive impairment developed impairment, and 6% experienced

  11. Trends in colorectal cancer incidence among younger adults-Disparities by age, sex, race, ethnicity, and subsite.

    Science.gov (United States)

    Crosbie, Amanda B; Roche, Lisa M; Johnson, Linda M; Pawlish, Karen S; Paddock, Lisa E; Stroup, Antoinette M

    2018-06-22

    Millennials (ages 18-35) are now the largest living generation in the US, making it important to understand and characterize the rising trend of colorectal cancer incidence in this population, as well as other younger generations of Americans. Data from the New Jersey State Cancer Registry (n = 181 909) and Surveillance, Epidemiology, and End Results program (n = 448 714) were used to analyze invasive CRC incidence trends from 1979 to 2014. Age, sex, race, ethnicity, subsite, and stage differences between younger adults (20-49) and screening age adults (≥50) in New Jersey (NJ) were examined using chi-square; and, we compared secular trends in NJ to the United States (US). Whites, men, and the youngest adults (ages 20-39) are experiencing greater APCs in rectal cancer incidence. Rates among younger black adults, overall, were consistently higher in both NJ and the US over time. When compared to older adults, younger adults with CRC in NJ were more likely to be: diagnosed at the late stage, diagnosed with rectal cancer, male, non-white, and Hispanic. Invasive CRC incidence trends among younger adults were found to vary by age, sex, race, ethnicity, and subsite. Large, case-level, studies are needed to understand the role of genetics, human papillomavirus (HPV), and cultural and behavioral factors in the rise of CRC among younger adults. Provider and public education about CRC risk factors will also be important for preventing and reversing the increasing CRC trend in younger adults. © 2018 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  12. The role of patients' families in treatment decision-making among adult cancer patients in the Sultanate of Oman.

    Science.gov (United States)

    Al-Bahri, A; Al-Moundhri, M; Al-Mandhari, Z; Al-Azri, M

    2018-04-17

    There are limited numbers of studies available in Middle Eastern Arabic countries regarding participation of family ‎members in cancer treatment decision-making (TDM). The aim of this study was to evaluate the role of family members' ‎in TDM among ‎adult Omani cancer ‎patients. A cross-sectional study was conducted in two main teaching hospitals. All adult Omani patients who were diagnosed with cancer and their nominated family members were invited to ‎participate. A tool developed by Cancer Care Outcomes Research and ‎Surveillance Consortium was used to identify the level of family involvement in TDM. A weighted kappa (k) was significant (p time of diagnosis ‎(OR = 3.10; 95% CI: 1.37-7.03). Oncologists in Oman should be aware of the strong family involvement in TDM to allow a successful cancer treatment. © 2018 John Wiley & Sons Ltd.

  13. Neighborhood and Family Environment of Expectans Mothers May Influence Prenatal Programming of Adult Cancer Risk: Discussion and an Illustrative DNA Methylation Example

    Science.gov (United States)

    Childhood stressors including physical abuse predict adult cancer risk. Prior research portrays this finding as an indirect mechanism that operates through coping behaviors, including adult smoking, or through increased toxic exposures during childhood. Little is known about pote...

  14. Quality of life, self-esteem and worries in young adult survivors of childhood cancer.

    Science.gov (United States)

    Langeveld, N E; Grootenhuis, M A; Voûte, P A; de Haan, R J; van den Bos, C

    2004-12-01

    This study assessed quality of life, self-esteem and worries in young adult survivors of childhood cancer compared to a group of young adults with no history of cancer. The impact of demographic, medical and treatment factors and self-esteem on survivors' quality of life and worries was studied. Participants were 400 long-term survivors (LTS) of childhood cancer (age range 16-49 years, 45% female) who had completed treatment an average of 16 years previously and 560 persons (age range 16-53 years, 55% female) with no history of cancer. All participants completed the MOS-24 (Medical Outcome Study Scale), a Worry questionnaire consisting of three scales (cancer-specific concerns, general health concerns, present and future concerns), and the Rosenberg Self-Esteem Scale. Small to moderate differences were found in mean MOS-24 scores between the LTS group and controls (range effect sizes -0.36-0.22). No significant difference was found in the mean self-esteem scores between LTS and controls. Female LTS had more cancer-specific concerns than male LTS. In several related areas of general health, self-image and dying, the LTS group reported less worries than controls, but LTS worried significantly more about their fertility, getting/changing a job and obtaining insurance's. Multiple linear regression analysis revealed that female gender, unemployment, severe late effects/health problems and a low self-esteem were predictors of worse quality of life in survivors. In addition, age at follow-up, unemployment, years since completion of therapy and a low self-esteem were associated with a higher degree of survivors' worries. Quality of life and the level of self-esteem in LTS of childhood cancer is not different from their peers. Although many LTS worried not more or even less about health issues than their peers, they often are concerned about some present and future concerns. The investigated factors could explain poor quality of life and worries only to a limited extent

  15. Burden of Geriatric Events Among Older Adults Undergoing Major Cancer Surgery.

    Science.gov (United States)

    Tan, Hung-Jui; Saliba, Debra; Kwan, Lorna; Moore, Alison A; Litwin, Mark S

    2016-04-10

    Most malignancies are diagnosed in older adults who are potentially susceptible to aging-related health conditions; however, the manifestation of geriatric syndromes during surgical cancer treatment is not well quantified. Accordingly, we sought to assess the prevalence and ramifications of geriatric events during major surgery for cancer. Using Nationwide Inpatient Sample data from 2009 to 2011, we examined hospital admissions for major cancer surgery among elderly patients (ie, age ≥ 65 years) and a referent group age 55 to 64 years. From these observations, we identified geriatric events that included delirium, dehydration, falls and fractures, failure to thrive, and pressure ulcers. We then estimated the collective prevalence of these events according to age, comorbidity, and cancer site and further explored their relationship with other hospital-based outcomes. Within a weighted sample of 939,150 patients, we identified at least one event in 9.2% of patients. Geriatric events were most common among patients age ≥ 75 years, with a Charlson comorbidity score ≥ 2, and who were undergoing surgery for cancer of the bladder, ovary, colon and/or rectum, pancreas, or stomach (P geriatric event had a greater likelihood of concurrent complications (odds ratio [OR], 3.73; 95% CI, 3.55 to 3.92), prolonged hospitalization (OR, 5.47; 95% CI, 5.16 to 5.80), incurring high cost (OR, 4.97; 95% CI, 4.58 to 5.39), inpatient mortality (OR, 3.22; 95% CI, 2.94 to 3.53), and a discharge disposition other than home (OR, 3.64; 95% CI, 3.46 to 3.84). Many older patients who receive cancer-directed surgery experience a geriatric event, particularly those who undergo major abdominal surgery. These events are linked to operative morbidity, prolonged hospitalization, and more expensive health care. As our population ages, efforts focused on addressing conditions and complications that are more common in older adults will be essential to delivering high-quality cancer care. © 2016 by

  16. Post-traumatic stress symptoms and post-traumatic growth in 223 childhood cancer survivors: predictive risk factors

    Directory of Open Access Journals (Sweden)

    Marta eTremolada

    2016-02-01

    Full Text Available With modern therapies and supportive care, survival rates of childhood cancer have increased considerably. However, there are long-term psychological sequelae of these treatments that may not manifest until pediatric survivors are into adulthood. The prevalence of post-traumatic stress disorder (PTSD in young adult survivors of childhood cancer ranges from 6.2% to 22%; associated risk factors are young age at the assessment, female gender, low education level and some disease-related factors. The aim of this study was to investigate, in adolescent and young adult (AYA survivors of childhood cancer, the incidence and severity of post-traumatic stress symptoms (PTSS, and to identify the risk factors and the associated post-traumatic growth (PTG index.Participants were 223 AYA cancer survivors recruited during follow-up visits in the Oncohematology Clinic of the Department of Child and Woman’s Health, University of Padua. Data were collected from self-report questionnaires on PTSS incidence, PTG mean score, perceived social support, and medical and socio-demographic factors. Ex-patients’ mean age at the assessment was 19.33 years (SD = 3.01, 15-25, 123 males and 100 females, with a mean of years off-therapy of 9.64 (SD=4.17. Most (52.5% had survived an hematological disorder and 47.5% a solid tumor when they were aged, on average, 8.02 years (SD=4.40.The main results indicated a moderate presence of clinical (≥9 symptoms: 9.4% and sub-clinical PTSS (6-8 symptoms: 11.2%, with the avoidance criterion most often encountered. Re-experience symptoms and PTG mean score were significantly associated (r=0.24 p=0.0001. A hierarchical regression model (R2 = 0.08; F = 1.46; p = 0.05 identified female gender (β = 0.16; p = 0.05 and less perceived social support (β = -0.43; p = 0.05 as risk factors to developing PTSS. Another hierarchical regression model assessed the possible predictors of the PTG total score (R2 = 0.36; F = 9.1; p = 0.0001, with

  17. Validation and application of a death proxy in adult cancer patients.

    Science.gov (United States)

    Mealing, Nicole M; Dobbins, Timothy A; Pearson, Sallie-Anne

    2012-07-01

    PURPOSE: Fact of death is not always available on data sets used for pharmacoepidemiological research. Proxies may be an appropriate substitute in the absence of death data. The purposes of this study were to validate a proxy for death in adult cancer patients and to assess its performance when estimating survival in two cohorts of cancer patients. METHODS: We evaluated 30-, 60-, 90- and 180-day proxies overall and by cancer type using data from 12 394 Australian veterans with lung, colorectal, breast or prostate cancer. The proxy indicated death if the difference between the last dispensing record and the end of the observational period exceeded the proxy cutoff. We then compared actual survival to 90-day proxy estimates in a subset of 4090 veterans with 'full entitlements' for pharmaceutical items and in 3704 Australian women receiving trastuzumab for HER2+ metastatic breast cancer. RESULTS: The 90-day proxy was optimal with an overall sensitivity of 99.3% (95%CI: 98.4-99.7) and a specificity of 97.6% (95%CI: 91.8-99.4). These measures remained high when evaluated by cancer type and spread of disease. The application of the proxy using the most conservative date of death estimate (date of last dispensing) generally underestimated survival, with estimates up to 3 months shorter than survival based on fact of death. CONCLUSIONS: A 90-day death proxy is a robust substitute to identify death in a chronic population when fact of death is not available. The proxy is likely to be valid across a range of chronic diseases as it relies on the presence of 'regular' dispensing records for individual patients. Copyright © 2011 John Wiley & Sons, Ltd. Copyright © 2011 John Wiley & Sons, Ltd.

  18. Dealing with chemotherapy-related symptoms at home: a qualitative study in adult patients with cancer.

    Science.gov (United States)

    Coolbrandt, A; Dierckx de Casterlé, B; Wildiers, H; Aertgeerts, B; Van der Elst, E; van Achterberg, T; Milisen, K

    2016-01-01

    Given that chemotherapy treatments are done mostly in an outpatient setting, patients with cancer must deal with treatment-related symptoms mainly at home. Evidence suggests that they often feel left alone or unprepared to do so. This qualitative study explores how patients deal with chemotherapy-related symptoms in their home, which factors and ideas influence their self-management and what role professional caregivers play. One-off, semi-structured interviews were held with 28 adult patients with cancer being treated with chemotherapy. Using a Grounded Theory approach, we cyclically collected and analysed data to come to a thorough understanding of the major conceptual themes and their interconnections. Dealing with chemotherapy-related symptoms involves a process of experiencing and learning how side effects unfold over time and how to deal with them. Patients express very personal symptom experiences and symptom-management styles, which are shaped by personal factors (e.g. coping with cancer and cancer treatment, perceived level of control) and environmental factors (e.g. professionals' attitude, information resources). Improving symptom self-management support requires active exploration of the personal symptom experience and symptom-management style. Professional care should be tailored to the patient's perspective and should address personal and environmental determinants of their behaviour. © 2015 John Wiley & Sons Ltd.

  19. Predictors of Complementary and Alternative Medicine Use among California Adults with Cancer and other Chronic Conditions

    Directory of Open Access Journals (Sweden)

    Michael S. Goldstein

    2007-01-01

    Full Text Available Background: Population-based data about utilization of complementary and alternative medicine (CAM among those with chronic conditions is lacking.Objective: To describe whether CAM use by California adults with cancer and other chronic conditions reflects condition specific patterns or a general tendency to use CAM modalities.Methods: Interviews of 9,187 respondents including all participants with cancer from a prior representative survey of California households, and a stratified sample of all other respondents. Almost 74% of the respondents reported at least one chronic health problem.Results: Use of all forms of CAM among those with chronic health problems is high. Those with a diagnosis of cancer are more likely to use prayer, dietary supplements, and support groups, and less likely to use CAM providers and special diets. Overall, individuals diagnosed with most chronic problems use a similar set of CAM modalities. Demographic correlates of CAM use differ in their impact and vary according to what type of CAM is being used.Conclusions: Clinicians should be aware that while a diagnosis of cancer is associated with a greater use of some forms of CAM, overall patterns of CAM use are similar to those with most other chronic problems.

  20. Predictors of Complementary and Alternative Medicine Use among California Adults with Cancer and other Chronic Conditions

    Directory of Open Access Journals (Sweden)

    Michael S. Goldstein

    2007-01-01

    Full Text Available Background Population-based data about utilization of complementary and alternative medicine (CAM among those with chronic conditions is lacking. Objective To describe whether CAM use by California adults with cancer and other chronic conditions reflects condition-specific patterns or a general tendency to use CAM modalities. Methods Interviews of 9,187 respondents including all participants with cancer from a prior representative survey of California households, and a stratified sample of all other respondents. Almost 74% of the respondents reported at least one chronic health problem. Results Use of all forms of CAM among those with chronic health problems is high. Those with a diagnosis of cancer are more likely to use prayer, dietary supplements, and support groups, and less likely to use CAM providers and special diets. Overall, individuals diagnosed with most chronic problems use a similar set of CAM modalities. Demographic correlates of CAM use differ in their impact and vary according to what type of CAM is being used. Conclusions Clinicians should be aware that while a diagnosis of cancer is associated with a greater use of some forms of CAM, overall patterns of CAM use are similar to those with most other chronic problems.

  1. Awareness of lifestyle risk factors for cancer and heart disease among adults in the UK.

    Science.gov (United States)

    Sanderson, Saskia C; Waller, Jo; Jarvis, Martin J; Humphries, Steve E; Wardle, Jane

    2009-02-01

    To examine and compare awareness of lifestyle risk factors for cancer and heart disease in a single UK representative sample. Two open-ended questions about cancer and heart disease risk factors were included in a population-based survey of 1747 adults. Responses were coded for four lifestyles with established links to both diseases: smoking, eating an unhealthy diet, drinking excessive alcohol and physical inactivity. Awareness of lifestyle risk factors was low for both diseases, although higher for heart disease than cancer. The average number identified by respondents was 2.1 (heart disease) and 1.4 (cancer). The strongest predictor was education (both pUnhealthy lifestyles make a significant contribution to ill health and mortality. Increased public awareness of the links between lifestyles and commonly feared diseases might help people understand the potential health consequences of their actions and encourage them to make much-needed lifestyle changes. Efforts are needed to improve public health messages about how lifestyle risk factors impact on the chances of developing these important diseases.

  2. A DASH dietary pattern and the risk of colorectal cancer in Canadian adults.

    Science.gov (United States)

    Jones-McLean, E; Hu, J; Greene-Finestone, L S; de Groh, M

    2015-03-01

    Colorectal cancer (CRC) is a high incidence cancer affecting many Canadian adults each year. Diet is important in the etiology of CRC with many dietary components identified as potential risk factors. The Dietary Approaches to Stop Hypertension (DASH) diet is a well-established pattern to characterize overall eating. The purpose of this study was to characterize a DASH pattern within the Canadian context and to assess its relationship to the risk of CRC in Canadian adults. Unconditional multiple logistic regression with control for confounding variables was performed using data from the National Enhanced Cancer Surveillance Study. Dietary intake was captured for this case-control study through a food frequency questionnaire (FFQ) and categorized into a DASH score ranging from 0 to 10 representing a poor to a strong DASH pattern respectively. Consuming a strong DASH pattern of eating (score ≥ 8) was not common in the 3161 cases and 3097 controls. Overall, only 10.8% of men and 13.6% of women had a strong DASH pattern. Multivariate analysis demonstrated a trend for decreasing risk of CRC in men with increasing DASH scores (p value for trend = .007). Men with a strong DASH score had a 33% reduction in risk of CRC compared to those with a low DASH score. There were no significant trends for women for CRC or for colon or rectal cancers separately. Our findings are similar to other researchers suggesting a benefit with a strong DASH pattern associated with a decreased risk of CRC, especially in men. Research should further investigate our gender-based differences.

  3. A DASH dietary pattern and the risk of colorectal cancer in Canadian adults

    Directory of Open Access Journals (Sweden)

    E. Jones-McLean

    2015-03-01

    Full Text Available Introduction: Colorectal cancer (CRC is a high incidence cancer affecting many Canadian adults each year. Diet is important in the etiology of CRC with many dietary components identified as potential risk factors. The Dietary Approaches to Stop Hypertension (DASH diet is a well-established pattern to characterize overall eating. The purpose of this study was to characterize a DASH pattern within the Canadian context and to assess its relationship to the risk of CRC in Canadian adults. Methods: Unconditional multiple logistic regression with control for confounding variables was performed using data from the National Enhanced Cancer Surveillance Study. Dietary intake was captured for this case-control study through a food frequency questionnaire (FFQ and categorized into a DASH score ranging from 0 to 10 representing a poor to a strong DASH pattern respectively. Results: Consuming a strong DASH pattern of eating (score ≥ 8 was not common in the 3161 cases and 3097 controls. Overall, only 10.8 % of men and 13.6 % of women had a strong DASH pattern. Multivariate analysis demonstrated a trend for decreasing risk of CRC in men with increasing DASH scores (p value for trend = .007. Men with a strong DASH score had a 33% reduction in risk of CRC compared to those with a low DASH score. There were no significant trends for women for CRC or for colon or rectal cancers separately. Conclusion: Our findings are similar to other researchers suggesting a benefit with a strong DASH pattern associated with a decreased risk of CRC, especially in men. Research should further investigate our gender-based differences.

  4. A narrative review of the occurrence of posttraumatic stress responses in adolescent and young adult cancer survivors

    Directory of Open Access Journals (Sweden)

    Vuotto SC

    2015-02-01

    Full Text Available Stefanie C Vuotto,1 Katia M Perez,2 Kevin R Krull,1 Tara M Brinkman1 1Department of Epidemiology and Cancer Control, St Jude Children’s Research Hospital, Memphis, 2Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA Abstract: Adolescent and young adult cancer survivors may experience posttraumatic stress responses following cancer diagnosis or treatment. The current paper reviews 23 studies reporting the occurrence of posttraumatic stress symptoms (PTSS and posttraumatic stress disorder (PTSD, and associated predictors of these outcomes in adolescent and young adult cancer survivors. Results indicate considerable variability among prevalence estimates of PTSD (0%–34.8% and PTSS (4.4%–78%. Measurement inconsistencies limiting the ascertainment of reliable prevalence and risk estimates are discussed in the context of the reviewed literature. Specifically, differences in assessment measures utilized, the timing of assessment relative to diagnosis, the criteria used to define the outcome, and identification of the precipitating traumatic event may account for discrepancies in prevalence and risk estimates across studies. The application of specific PTSD diagnostic criteria to a survivorship population is discussed. Empirically supported interventions utilizing cognitive behavioral therapy approaches for the treatment of PTSS in adolescent and young adult cancer survivors are identified. Keywords: posttraumatic stress, adolescent and young adult, cancer survivors

  5. Barriers and facilitators to successful transition from pediatric to adult inflammatory bowel disease care from the perspectives of providers.

    Science.gov (United States)

    Paine, Christine W; Stollon, Natalie B; Lucas, Matthew S; Brumley, Lauren D; Poole, Erika S; Peyton, Tamara; Grant, Anne W; Jan, Sophia; Trachtenberg, Symme; Zander, Miriam; Mamula, Petar; Bonafide, Christopher P; Schwartz, Lisa A

    2014-11-01

    For adolescents and young adults (AYA) with inflammatory bowel disease (IBD), the transition from pediatric to adult care is often challenging and associated with gaps in care. Our study objectives were to (1) identify outcomes for evaluating transition success and (2) elicit the major barriers and facilitators of successful transition. We interviewed pediatric and adult IBD providers from across the United States with experience caring for AYAs with IBD until thematic saturation was reached after 12 interviews. We elicited the participants' backgrounds, examples of successful and unsuccessful transition of AYAs for whom they cared, and recommendations for improving transition using the Social-Ecological Model of Adolescent and Young Adult Readiness to Transition framework. We coded interview transcripts using the constant comparative method and identified major themes. Participants reported evaluating transition success and failure using health care utilization outcomes (e.g., maintaining continuity with adult providers), health outcomes (e.g., stable symptoms), and quality of life outcomes (e.g., attending school). The patients' level of developmental maturity (i.e., ownership of care) was the most prominent determinant of transition outcomes. The style of parental involvement (i.e., helicopter parent versus optimally involved parent) and the degree of support by providers (e.g., care coordination) also influenced outcomes. IBD transition success is influenced by a complex interplay of patient developmental maturity, parenting style, and provider support. Multidisciplinary IBD care teams should aim to optimize these factors for each patient to increase the likelihood of a smooth transfer to adult care.

  6. Long-term population-based divorce rates among adult survivors of childhood cancer in Britain.

    Science.gov (United States)

    Frobisher, Clare; Lancashire, Emma R; Winter, David L; Taylor, Aliki J; Reulen, Raoul C; Hawkins, Michael M

    2010-01-01

    Previously from the British Childhood Cancer Survivor Study (BCCSS) it was seen that adult survivors of childhood cancer were less likely to marry than the general population. The objectives of this study were to assess the number of childhood cancer survivors from the BCCSS who were currently divorced or separated, examine factors associated with marriage dissolution and compare survivor divorce rates to population rates. The BCCSS is a population-based cohort of 18,119 individuals diagnosed with cancer aged 0-14 years between 1940 and 1991, and survived at least 5 years. 14,539 were alive, aged 16 years or over and eligible to receive a questionnaire, which ascertained marital status. From 8,155 survivors, who were aged at least 20 years at questionnaire completion, the proportions currently divorced and divorced or separated were 13.5% and 18.1%, respectively. Only current age, educational attainment and age at marriage were associated with divorce, and for divorce and separation status only age at marriage (P divorced (odds ratio (OR) (95% confidence intervals (95% CI)): 0.94 (0.81-1.10)). However, the survivors overall (OR (95% CI): 0.82 (0.72-0.94)), and separately for those diagnosed with non-Hodgkin lymphoma (OR (95% CI): 0.55 (0.34-0.89)) and leukaemia (OR (95% CI): 0.70 (0.52-0.95)), were less likely to be currently divorced or separated than the general population. It is reassuring that survivors do not experience more divorce than the general population, and that no cancer or treatment factors were shown to be associated with marriage dissolution. Copyright 2009 Wiley-Liss, Inc.

  7. Telehealth in older adults with cancer in the United States: The emerging use of wearable sensors.

    Science.gov (United States)

    Shen, John; Naeim, Arash

    2017-11-01

    As the aging and cancer populations in the world continue to increase, the need for complements to traditional geriatric assessments and the logical incorporation of fast and reliable telehealth tools have become interlinked. In the United States, studies examining the use of telehealth for chronic disease management have shown promising results in small groups. The implementation of health technology on a broader scale requires older adults to both accept and adapt such innovation into routine medical care. Though the commercial and recreational use of new technology has increased in older individuals, the transition into creating a smart and connected home that can interface with both patients and healthcare professionals is in its early phases. Current limitations include an inherent digital divide, as well as concerns regarding privacy, data volume, rapid change, cost and reimbursement. The emergence of low-cost, high-fidelity wearable sensors with a spectrum of clinical utility may be the key to increased use and adaptation by older adults. An opportunity to utilize wearable sensors for objective and real-time assessment of older patients with cancer for baseline functional status and treatment toxicity may be on the horizon. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. A case of adult congenital laryngeal cleft asymptomatic until hypopharynx cancer treatment.

    Science.gov (United States)

    Shimizu, Kotaro; Uno, Atsuhiko; Takemura, Kazuya; Ashida, Naoki; Oya, Ryohei; Kitamura, Takahiro; Takenaka, Yukinori; Yamamoto, Yoshifumi

    2018-06-01

    Laryngeal cleft is an anomaly of failed posterior closure of the larynx. Most cases are diagnosed and need treatment early in life due to respiratory and swallowing problems. We report an unusual case of a 66-year-old man with an asymptomatic laryngeal cleft until treatment for hypopharyngeal cancer. During concurrent chemoradiotherapy (CCRT), despite reduced tumor volume, he presented severe dysphagia and dyspnea, followed by severe pneumonia twice. Because CCRT had to be discontinued, a pharyngolaryngectomy was performed for the cancer treatment. The resected specimen showed total removal of the tumor and a total longitudinal cleft of the cricoid cartilage, classified as a type III laryngeal cleft by the Benjamin and Inglis' classification. A review of computed tomography images indicated that the redundant mucosa from bilateral edges closed the separation of the posterior cricoid cartilage and narrowed the laryngeal airway during CCRT. Adult presentations of laryngeal cleft are quite rare with only ten reported cases in English literature; the present case is of the oldest patient. Undiagnosed cases with laryngeal cleft may exist asymptomatically or without severe symptoms. The awareness of this condition may increase its diagnosis as a cause of diseases such as aspiration and recurrent pneumonia even in adult patients. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Recommendations for breast cancer surveillance for female survivors of childhood, adolescent, and young adult cancer given chest radiation: a report from the International Late Effects of Childhood Cancer Guideline Harmonization Group

    NARCIS (Netherlands)

    Mulder, Renée L.; Kremer, Leontien C. M.; Hudson, Melissa M.; Bhatia, Smita; Landier, Wendy; Levitt, Gill; Constine, Louis S.; Wallace, W. Hamish; van Leeuwen, Flora E.; Ronckers, Cécile M.; Henderson, Tara O.; Dwyer, Mary; Skinner, Roderick; Oeffinger, Kevin C.

    2013-01-01

    Female survivors of childhood, adolescent, and young adult (CAYA) cancer who were given radiation to fields that include breast tissue (ie, chest radiation) have an increased risk of breast cancer. Clinical practice guidelines are essential to ensure that these individuals receive optimum care and

  10. Cancer and frailty in older adults: a nested case-control study of the Mexican Health and Aging Study

    Science.gov (United States)

    Pérez-Zepeda, Mario Ulises; Cárdenas-Cárdenas, Eduardo; Cesari, Matteo; Navarrete-Reyes, Ana Patricia; Gutiérrez-Robledo, Luis Miguel

    2016-01-01

    Purpose Understanding how the convergence between chronic and complex diseases—such as cancer—and emerging conditions of older adults—such as frailty—takes place would help in halting the path that leads to disability in this age group. The objective of this manuscript is to describe the association between a past medical history of cancer and frailty in Mexican older adults. Methods This is a nested in cohort case-control study of the Mexican Health and Aging Study. Frailty was categorized by developing a 55-item frailty index that was also used to define cases in two ways: incident frailty (incident >0.25 frailty index score) and worsening frailty (negative residuals from a regression between 2001 and 2012 frailty index scores). Exposition was defined as self-report of cancer between 2001 and 2012. Older adults with a cancer history were further divided into recently diagnosed (10 years from the initial diagnosis). Odds ratios were estimated by fitting a logistic regression adjusted for confounding variables. Results Out of a total of 8022 older adults with a mean age of 70.6 years, the prevalence of a past medical history of cancer was 3.6 % (n = 288). Among these participants, 45.1 % had been diagnosed with cancer more than 10 years previously. A higher risk of incident frailty compared to controls [odds ratio (OR) 1.53 (95 % confidence interval (CI) 1.04–2.26, p = 0.03); adjusted model OR 1.74 (95 % CI 1.15–2.61, p = 0.008)] was found in the group with a recent cancer diagnosis. Also, an inverse association between a remote cancer diagnosis and worsening frailty was found [OR = 0.56 (95 % CI 0.39–0.8), p = 0.002; adjusted model OR 0.61 (95 % CI 0.38–0.99, p = 0.046)]. Conclusions Cancer is associated with a higher frailty index, with a potential relevant role of the time that has elapsed since the cancer diagnosis. Implications for cancer survivors Cancer survivors may be more likely to develop frailty or worsening of the health status at an

  11. Moderating effects of perceived growth on the association between fear of cancer recurrence and health-related quality of life among adolescent and young adult cancer survivors.

    Science.gov (United States)

    Cho, Dalnim; Park, Crystal L

    2017-01-01

    We examined whether (1) fear of cancer recurrence was related to lower health-related quality of life and (2) perceived growth moderated the link between fear of recurrence and health-related quality of life. About 292 adolescent and young adult cancer survivors (diagnosed with cancer at ages 15-34) completed a cross-sectional survey. Fear of recurrence was related to poorer physical and mental health-related quality of life. The negative association between fear of recurrence and mental health-related quality of life was moderated by perceived growth. Fostering perceived growth may mitigate the adverse associations of fear of recurrence and health-related quality of life.

  12. Family Communication, Risk Perception and Cancer Knowledge of Young Adults from BRCA1/2 Families: a Systematic Review.

    Science.gov (United States)

    Young, Alison L; Butow, Phyllis N; Vetsch, Janine; Quinn, Veronica F; Patenaude, Andrea F; Tucker, Katherine M; Wakefield, Claire E

    2017-12-01

    Understanding challenges in familial communication of cancer risk has informed genetic service delivery. Parent-child interactions have received considerable attention, but few studies focus on young adulthood experiences within BRCA1/2 families. Young adults are approaching, or at a life stage where awareness of hereditary cancer risk is vital for informed choice of risk management options. This review assesses family communication, risk perception and cancer knowledge held by 18-40 year old individuals who have a parent with a BRCA1/2 gene mutation or carry the gene mutation themselves. Thirteen papers met the inclusion criteria. One utilized a 'mixed methods' methodology and the remaining used a qualitative approach. Findings were synthesized into themes and reported narratively. In general, parents are communicating openly about genetic risk with young adult offspring, but there is evidence that some young adults are withholding information from their parents about their own test results. Risk perception is influenced by a family history of cancer, childbearing plans and health providers' advice. Misconceptions about genetic risk appear to be common and gaps in hereditary cancer knowledge are evident. It is unclear whether incorrect knowledge was passed from parents to offspring. Health providers need to provide developmentally appropriate services for emerging adults (18-25 years old), with particular support in navigating through risk management options.

  13. The prevalence of depression and anxiety among Chinese adults with cancer: a systematic review and meta-analysis

    Science.gov (United States)

    2013-01-01

    Background A lot of empirical studies have been conducted to evaluate the prevalence of depression and anxiety among Chinese adults with cancer. We aimed to conduct a meta-analysis in order to evaluate the prevalence and odds ratios of depression and anxiety in Chinese adults with cancer compared with those without. Methods The three most comprehensive computerized Chinese academic databases-CNKI, Wangfang and Vip databases-were systematically screened through September 2012. PubMed and Web of Science (SCIE) were also searched from their inception until September 2012 without language restrictions, and an internet search was also used. Case–control studies assessing the prevalence of depression and anxiety among Chinese adults with cancer were analyzed. Study selection and appraisal were conducted independently by three authors. The non-weighted prevalence, pooled random-effects estimates of odds ratio (OR) and 95% confidence intervals (CI) were all calculated. Results Seventeen eligible studies with a total of 3497 subjects were included. The prevalence of depression and anxiety were significantly higher in adults with cancer compared with those without (Depression: 54.90% vs. 17.50%, OR = 7.85, 95% CI = 5.56-11.07, P = 0.000; Anxiety: 49.69% vs. 18.37%, OR = 6.46, 95% CI = 4.36-9.55, P = 0.000), the same situation was also observed in subgroup of control groups, assessment methods and cancer types. Although no difference of depression was observed in studies utilizing clinical diagnosis compared with self-report, the OR of anxiety in adults with cancer compared with those without was higher in studies utilizing clinical diagnosis (OR = 8.42, 95% CI = 4.83-14.70) than self-reports (OR = 5.83, 95% CI = 3.64-9.34). The ORs of depression and anxiety in cancer patients compared with disease group (Depression: OR = 6.03, 95% CI = 4.23-8.61; Anxiety: OR = 4.40, 95% CI = 3.05-6.36) were lower than in those

  14. Economic assessment of postoperative pain control strategies for treatment of adult patients with cancer

    Directory of Open Access Journals (Sweden)

    Rafael Freitas dos Santos

    Full Text Available Summary Objective: The authors performed an economic assessment of opioids currently being used for control of postoperative pain relating to the surgical treatment of cancer (fentanyl and sufentanil within the Brazilian Unified Health System (SUS, in the Portuguese acronym. Method: The assessment was based on the perspective of the government, in order to collaborate with the promotion of effectiveness in public policies of health, and to optimize the allocation of public resources into health. A cost-effectiveness analysis was performed using data collected from the Brazilian Unified Health System and information from literature review, in order to build a decision tree on the alternatives for control of postoperative pain related to cancer treatment among adult patients. The outcomes considered were: effectiveness of postoperative analgesia and occurrence of nausea and vomit in the 48 hour period after surgery, and additional 24-hour cycles in patient follow-up. A univariate sensitivity analysis was conducted in order to verify robustness of the model estimated. Results: Literature review showed a limited number of studies directly comparing fentanyl and sufentanil for control of postoperative pain. The adoption of sufentanil (cost = U$ 25.72 / outcome = 1.6 VAS points was dominant in relation to the use of fentanyl (cost = U$ 32.58 / outcome = 2.6 VAS points. The estimated model showed robustness in relation to changes in the parameters analyzed. Conclusion: Sufentanil presented higher cost-effectiveness ratio in relation to fentanyl for control of postoperative pain in surgeries related to cancer treatment among adult patients in the Brazilian Unified Health System.

  15. Effects of Promotional Materials on Attitudes and Fear towards Colorectal Cancer Screening among Chinese Older Adults: An Experimental Study.

    Science.gov (United States)

    Leung, Doris Y P; Chen, Joanne M T; Lou, Vivian W Q; Wong, Eliza M L; Chan, Aileen W K; So, Winnie K W; Chan, Carmen W H

    2017-07-13

    Colorectal cancer (CRC) screening is a cost-effective prevention and control strategy. However, the promotion of CRC screening for older adults may be difficult because reading CRC prevention information may evoke embarrassment, fear, and anxiety towards the screening procedure and cancer diagnosis. This study aims to (1) examine the effects of three promotional materials for CRC screening on the attitudes toward CRC screening tests (screening interest, screening effectiveness, and trust in the screening results) and cancer fear, and (2) to explore the interaction effect of cancer fear with screening effectiveness and trust in the screening results on screening interest of the three screening tests (fecal occult blood test (FOBT), flexible sigmoidoscopy, and colonoscopy) among Chinese older adults. A total of 114 community-dwelling older adults were asked to look at the corresponding promotional materials (pamphlet, cartoon, and video) of one of the three study groups. The pamphlet and video represent convention strategies and the cartoon represents an innovative strategy. No significant difference was observed in the screening interest and cancer fear across groups. FOBT was the most preferred screening modality. The video group has a large proportion agreed screening effectiveness of flexible sigmoidoscopy than pamphlet and cartoon groups and trusted in the screening results for FOBT and flexible sigmoidoscopy than the pamphlet group. Logistic regression results showed that the effect of trust in the screening results on screening interest for colonoscopy was greater among participants with higher cancer fear than those with lower cancer fear level. In conclusion, the three promotional groups had produced similar results in their attitudes toward CRC screening and cancer fear. The use of cartoons may be a comparable approach with conventional methods in the promotion of CRC screening. Additional components that can arouse fear and boost response efficacy

  16. Health-related quality of life in young men with testicular cancer: validation of the Cancer Assessment for Young Adults (CAYA).

    Science.gov (United States)

    Hoyt, Michael A; Cano, Stefan J; Saigal, Christopher S; Stanton, Annette L

    2013-12-01

    Patient-reported outcome instruments are needed to measure health-related quality of life (HRQOL) in young adults with cancer. The purpose of this project was to establish a conceptual model and measurement instrument for assessment of HRQOL in young men with testicular cancer. Patient interviews and a literature review were used to develop a conceptual framework of biopsychosocial domains of cancer-related quality of life and an initial pool of questionnaire items. Items were piloted and refined. Revised items were administered to a sample (N = 171) of young (ages 18-29) men with testicular cancer and repeated 4 weeks later. Rasch measurement methods guided item reduction and scale construction. Traditional psychometric analyses were also performed to allow for comparison with existing measures. The conceptual framework included seven biopsychosocial domains: physical, sexual, intrapersonal, cognitive-emotional, social-relational, educational-vocational-avocational, and spiritual to form independent scales of the resulting questionnaire, the Cancer Assessment for Young Adults-Testicular (CAYA-T). Each scale fulfilled Rasch and traditional psychometric criteria (i.e., person separation index, 0.34-0.82; Cronbach's alpha, 0.70-0.91; and an expected pattern of convergent and discriminant validity correlations). The CAYA-T can be used to assess HRQOL across a comprehensive set of domains as identified by young men with cancer. It passes strict psychometric criteria and has potential as a useful research and clinical tool. The CAYA-T has potential research and clinical value for addressing inter-related aspects of HRQOL in young adult men with cancer. The measure may assist with assessing and monitoring HRQOL across a range of domains and contributing to more comprehensive assessment of biopsychosocial needs of young adults.

  17. Clustering of health behaviours in adult survivors of childhood cancer and the general population.

    Science.gov (United States)

    Rebholz, C E; Rueegg, C S; Michel, G; Ammann, R A; von der Weid, N X; Kuehni, C E; Spycher, B D

    2012-07-10

    Little is known about engagement in multiple health behaviours in childhood cancer survivors. Using latent class analysis, we identified health behaviour patterns in 835 adult survivors of childhood cancer (age 20-35 years) and 1670 age- and sex-matched controls from the general population. Behaviour groups were determined from replies to questions on smoking, drinking, cannabis use, sporting activities, diet, sun protection and skin examination. The model identified four health behaviour patterns: 'risk-avoidance', with a generally healthy behaviour; 'moderate drinking', with higher levels of sporting activities, but moderate alcohol-consumption; 'risk-taking', engaging in several risk behaviours; and 'smoking', smoking but not drinking. Similar proportions of survivors and controls fell into the 'risk-avoiding' (42% vs 44%) and the 'risk-taking' cluster (14% vs 12%), but more survivors were in the 'moderate drinking' (39% vs 28%) and fewer in the 'smoking' cluster (5% vs 16%). Determinants of health behaviour clusters were gender, migration background, income and therapy. A comparable proportion of childhood cancer survivors as in the general population engage in multiple health-compromising behaviours. Because of increased vulnerability of survivors, multiple risk behaviours should be addressed in targeted health interventions.

  18. The Use of Complementary and Alternative Medicine Among California Adults With and Without Cancer

    Directory of Open Access Journals (Sweden)

    Michael S Goldstein

    2005-01-01

    Full Text Available This article examines the extent and correlates of complementary and alternative medicine (CAM use among a population-based sample of California adults that is highly diverse in terms of sociodemographic characteristics and health status. As a follow-up to a state-wide health survey of 55 428 people, 9187 respondents were interviewed by phone regarding their use of 11 different types of CAM providers, special diets, dietary supplements, mind–body interventions, self-prayer and support groups. The sample included all participants in the initial survey who reported a diagnosis of cancer, all the non-white respondents, as well as a random sample of all the white respondents. The relation of CAM use to the respondents' demographic characteristics and health status is assessed. CAM use among Californians is generally high, and the demographic factors associated with high rates of CAM use are the same in California as have been found in other studies. Those reporting a diagnosis of cancer and those who report other chronic health problems indicate a similar level of visits to CAM providers. However, those with cancer are less likely to report using special diets, and more likely to report using support groups and prayer. Health status, gender, ethnicity and education have an independent impact upon CAM use among those who are healthy as well as those who report suffering from chronic health problems, although the precise relation varies by the type of CAM used.

  19. Mental health among young adult survivors of childhood cancer and their siblings including posttraumatic growth.

    Science.gov (United States)

    Kamibeppu, Kiyoko; Sato, Iori; Honda, Misato; Ozono, Shuichi; Sakamoto, Naoko; Iwai, Tsuyako; Okamura, Jun; Asami, Keiko; Maeda, Naoko; Inada, Hiroko; Kakee, Naoko; Horibe, Keizo; Ishida, Yasushi

    2010-12-01

    Few studies have addressed the mental health status of young adult childhood cancer survivors (CCSs) and their siblings (SIBs). This paper focuses on depression, anxiety, posttraumatic stress symptoms (PTSS), and posttraumatic growth (PTG) among Japanese CCSs and their SIBs. Adolescent and young adult CCSs (n=185), in remission for more than 1 year, their SIBs (n=72), and general controls (CONTs) (n=1,000) completed anonymous self-report questionnaires for depression, anxiety, PTSS, and PTG. The physicians in charge also completed an anonymous disease/treatment data sheet. CCSs were approximately 8 years old at diagnosis and approximately 23 years old at the time of the survey. Their diagnoses included leukemia (57%), lymphoma (12%), and solid tumors (30%). Thirty-eight percent underwent surgery and 25% received stem cell transplantation. No significant differences were found between CCSs and CONTs in terms of depression and anxiety. CCSs had significantly more PTSS and had remarkably greater PTG compared to CONTs. Although no significant differences were found between SIBs and CONTs regarding depression, anxiety, or PTSS, female SIBs exhibited greater PTG compared to female CONTs. To empower CCSs, they should be evaluated periodically regarding PTSS and PTG and should be provided appropriate care and feedback. The fact that the mental health status of young adult SIBs was similar to CONTs at 15 years after their siblings' diagnoses may help reassure parents who worry about mental health among the siblings of an affected child during and after his/her treatment.

  20. The Content and Quality of Health Information on the Internet for Patients and Families on Adult Kidney Cancer.

    Science.gov (United States)

    Alsaiari, Ahmed; Joury, Abdulaziz; Aljuaid, Mossab; Wazzan, Mohammed; Pines, Jesse M

    2017-12-01

    The Internet is one of the major sources for health information for patients and their families, particularly when patients face serious life-threatening conditions such as kidney cancer in adults. In this study, we evaluate the content and quality of health information on adult kidney cancer using several validated instruments. We accessed the three most popular search engines (Google, Yahoo, Bing), using two terms: "kidney cancer" and "renal cell carcinoma," and reviewed the top 30 hits. After exclusion of duplicated websites, websites targeting health care professionals, and unrelated websites, 35 websites were included. Content was assessed using a 22-item checklist adapted from the American Cancer Society. We assessed website quality using the DISCERN questionnaire, HONcode and JAMA benchmark criteria, readability using three readability scores, and ALEXA for global traffic ranking systems. The average website had 16 of 22 content items while 6 websites fulfilled all 22 items. Among all websites, the average DISCERN quality score was 42 out of 80, 15 (42.8 %) of websites had HONcode certification, and only 3 (8.5 %) fulfilled all JAMA benchmark criteria. The average website readability was at the ninth grade reading level. The content and quality of health-related information on the Internet for adult kidney cancer are variable in comprehensiveness and quality. Many websites are difficult to read without a high school education. A standardized approach to presenting cancer information on the Internet for patients and families may be warranted.

  1. In a unique position or squeezed out? The professional roles of general practitioners in cancer care in general and of young adult cancer patients in particular

    DEFF Research Database (Denmark)

    Hølge-Hazelton, B.; Christensen, I.

    2009-01-01

    BACKGROUND: Exploring experiences of general practitioners (GPs), regarding roles in cancer care of young adults (YAs). METHODS: Ten qualitative interviews with GPs were theoretically analyzed against professional characteristics. FINDINGS: The GPs tended to make general statements, using everyday...... to relevant theory, and get a clearer vision of the content of the professional aspects of their work Udgivelsesdato: 2009...

  2. Type 2 Diabetes and Risk of Incident Cancers in China: A Prospective Study among 0.5 Million Chinese Adults.

    Science.gov (United States)

    Pan, Xiong-Fei; He, Meian; Yu, Canqing; Lv, Jun; Guo, Yu; Bian, Zheng; Yang, Ling; Chen, Yiping; Wu, Tangchun; Chen, Zhengming; Pan, An; Li, Liming

    2018-01-03

    Using data from the China Kadoorie Biobank study, we conducted a prospective investigation on the association between type 2 diabetes mellitus (T2DM) and cancer risk in Chinese adults. A total of 508,892 participants (mean (standard deviation) age = 51.5 (10.7) years) without prior cancer diagnosis at baseline (2004-2008) were included. We documented 17,463 incident cancer cases during follow-up until December 31, 2013. Participants with T2DM had increased risks of total and certain site-specific cancers, and the hazard ratio (HR) was 1.13 (95% confidence interval (CI): 1.07, 1.19) for total cancer, 1.51 (1.29, 1.76) for liver cancer, 1.86 (1.43, 2.41) for pancreatic cancer, and 1.21 (1.01, 1.47) for female breast cancer. The associations were largely consistent when doctor-diagnosed and screen-detected T2DM were analyzed separately, except for colorectal cancer (HR = 0.91 (95% CI: 0.73, 1.13) for doctor-diagnosed T2DM, and HR = 1.44 (95% CI: 1.18, 1.77) for screen-detected T2DM). In participants without prior diagnosis of T2DM, higher random blood glucose levels were positively associated with risk of total cancer, liver cancer, and female breast cancer (all P for trend ≤0.02). In conclusion, T2DM is associated with an increased risk of new-onset cancer in China, particularly cancers of the liver, pancreas, and female breast. © The Author(s) 2018. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  3. Diet, Physical Activity, Marital Status and Risk of Cancer: A Case Control Study of Adults from Riyadh, Saudi Arabia.

    Science.gov (United States)

    AlSaeed, Eyad Fawzi; Tunio, Mutahir A

    2017-09-01

    We aimed to compare the dietary habits, engagement in various sports, smoking habits, marital status and other demographic characteristics, between cancer patients and healthy adults (control) at our institute, Riyadh, Saudi Arabia. A cross-sectional descriptive study was conducted on 500 participants (237 cancer patients and 263 healthy adults). A well-structured questionnaire was given to these participants regarding the life style, dietary habits, and marital status through interviews. Mean age of whole cohort was 39.3 years (range: 14-85). Among the cancer patients, breast cancer was predominant (45.6%). Compared to controls, higher percentage of married (72.6% vs. 55.5%) and divorced (10.2% vs.4.2%) was noticed in cancer patients (P = 0.002). In cancer patients, majority were unemployed (housewives = 49.3%; retired = 16.0%) as compared to controls (housewives = 14.1%; retired = 2.0%) P = 0.0001. Use of computer laptops/tablets and internet surfing was significantly higher in controls as compared to cancer patients (80.3% vs. 42.2%) P = 0.0001. Similarly, cancer patients started smoking at early age and were relatively heavy smokers with P = 0.03 and P = 0.001 respectively. Cancer patients consumed < 3 cups of coffee/day as compared to control (42.4% vs. 21.5%) P = 0.02. More cancer patients got married at early age between 11-20 years (58.7% vs. 37.7%) P = 0.01. Unemployment, marital status, lack of nutritional knowledge through internet, heavy smoking, heavy coffee consumption and early age at marriage were associated with the risk of various cancers in both genders.

  4. Continuous quality improvement intervention for adolescent and young adult HIV testing services in Kenya improves HIV knowledge.

    Science.gov (United States)

    Wagner, Anjuli D; Mugo, Cyrus; Bluemer-Miroite, Shay; Mutiti, Peter M; Wamalwa, Dalton C; Bukusi, David; Neary, Jillian; Njuguna, Irene N; O'Malley, Gabrielle; John-Stewart, Grace C; Slyker, Jennifer A; Kohler, Pamela K

    2017-07-01

    To determine whether continuous quality improvement (CQI) improves quality of HIV testing services for adolescents and young adults (AYA). CQI was introduced at two HIV testing settings: Youth Centre and Voluntary Counseling and Testing (VCT) Center, at a national referral hospital in Nairobi, Kenya. Primary outcomes were AYA satisfaction with HIV testing services, intent to return, and accurate HIV prevention and transmission knowledge. Healthcare worker (HCW) satisfaction assessed staff morale. T tests and interrupted time series analysis using Prais-Winsten regression and generalized estimating equations accounting for temporal trends and autocorrelation were conducted. There were 172 AYA (Youth Centre = 109, VCT = 63) during 6 baseline weeks and 702 (Youth Centre = 454, VCT = 248) during 24 intervention weeks. CQI was associated with an immediate increase in the proportion of AYA with accurate knowledge of HIV transmission at Youth Centre: 18 vs. 63% [adjusted risk difference (aRD) 0.42,95% confidence interval (CI) 0.21 to 0.63], and a trend at VCT: 38 vs. 72% (aRD 0.30, 95% CI -0.04 to 0.63). CQI was associated with an increase in the proportion of AYA with accurate HIV prevention knowledge in VCT: 46 vs. 61% (aRD 0.39, 95% CI 0.02-0.76), but not Youth Centre (P = 0.759). In VCT, CQI showed a trend towards increased intent to retest (4.0 vs. 4.3; aRD 0.78, 95% CI -0.11 to 1.67), but not at Youth Centre (P = 0.19). CQI was not associated with changes in AYA satisfaction, which was high during baseline and intervention at both clinics (P = 0.384, P = 0.755). HCW satisfaction remained high during intervention and baseline (P = 0.746). CQI improved AYA knowledge and did not negatively impact HCW satisfaction. Quality improvement interventions may be useful to improve adolescent-friendly service delivery.

  5. Experiences of aromatherapy massage among adult female cancer patients: A qualitative study.

    Science.gov (United States)

    Ho, Simone S M; Kwong, Alice N L; Wan, Karen W S; Ho, Rosita M L; Chow, Ka Ming

    2017-12-01

    To explore the experiences towards aromatherapy massage use, and to examine the perceived benefits and adverse effects of aromatherapy massage among adult female cancer patients. A qualitative research design was used. Fifteen women with cancer were recruited for semi-structured interviews. Sample recruitment was undertaken through cancer self-help groups and referrals of a private aromatherapy clinic by convenience sampling. The interview data were analysed by thematic analysis. All participants had a positive experience towards aromatherapy massage. The perceived benefits of aromatherapy massage included physical and psychological dimensions: overall comfort, relaxation, reduced pain, muscular tension, lymphoedema and numbness, improved sleep, energy level, appetite and mood. Interestingly, a few participants reported that aromatherapy massage helped to enhance self-acceptance and coping with their altered torso. No adverse effects were reported. The findings focused on four main themes that emerged: (i) an immediate effect that brings all-round comfort and reconnection to daily life; (ii) a pleasurable moment to forget the disease with aroma as a booster; (iii) a pampering experience of being cared for with a sense of dignity preserved; and (iv) communicating with the failing body. This study contributed by providing a better understanding in aromatherapy massage from female cancer patients' perspective which adds to the existing body of knowledge. The implications for nursing practice, education and future research were suggested. Aromatherapy massage seems to have both physical and psychological benefits for women with cancer. The findings elucidated a wide range of benefits that are perceived in such complex intervention, and the contextual factors that may influence these perceived benefits. This will inform future nurse-led quantitative research in the clinical setting. The study highlights the importance of touch towards a caring relationship and the

  6. Urinary thiocyanate concentrations are associated with adult cancer and lung problems: US NHANES, 2009-2012.

    Science.gov (United States)

    Shiue, Ivy

    2015-04-01

    Links between environmental chemicals and human health have emerged but the effects from perchlorate, nitrate and thiocyanate were unclear. Therefore, it was aimed to study the relationships of urinary perchlorate, nitrate and thiocyanate concentrations and adult health conditions in a national and population-based study. Data was retrieved from US National Health and Nutrition Examination Surveys, 2009-2012, including demographics, blood pressure readings, self-reported health conditions and urinary perchlorate, nitrate and thiocyanate concentrations. Analyses included chi-square test, t test survey-weighted logistic regression models and population attributable risk estimation. There were no clear associations between urinary perchlorate concentrations and adult health conditions, although people with hearing loss and diabetes could be at the borderline risk. Urinary thiocyanate concentrations were significantly associated with emphysema (odds ratio (OR) 2.70 95% confidence intervals (CI) 1.91-3.82, P cancer (OR 1.21 95%CI 1.06-1.39, P = 0.008), chronic bronchitis (OR 1.23 95%CI 1.10-1.52, P = 0.003), wheezing (OR 1.24 95%CI 1.05-1.46, P = 0.011), coughing (OR 1.19 95%CI 1.03-1.37, P = 0.018) and sleep complaints (OR 1.14 95%CI 1.02-1.26, P = 0.019). The population attributable risks accounted for 3.3% (1.8-5.3%), 1.9% (0.6-3.5%), 1.2% (0.5-2.6%), 2.2% (0.5-4.1%), 1.8% (0.3-6.2%) and 1.3% (0.2-2.4%) for emphysema, cancer, chronic bronchitis, wheezing, coughing and sleep complaints, respectively. In addition, there was an inverse association observed between urinary nitrate level and heart failure. This is for the first time observing significant risk effects of urinary thiocyanate concentrations on adult cancer and lung problems, although the causality cannot be established. Elimination of such environmental chemical in humans should be included in future health policy and intervention programs.

  7. Urothelial cancer of bladder in young versus older adults: clinical and pathological characteristics and outcomes.

    Science.gov (United States)

    Telli, Onur; Sarici, Hasmet; Ozgur, Berat Cem; Doluoglu, Omer Gokhan; Sunay, Mehmet Melih; Bozkurt, Selen; Eroglu, Muzaffer

    2014-09-01

    Bladder urothelial carcinoma is rare in young adults and occurs more commonly in older individuals. The aim of this study was to compare the clinical behavior, pathologic characteristics, and prognosis of urothelial carcinoma of urinary bladder in young versus older adults. A retrospective review of our records between 2007 and 2013 identified 56 patients (42 males and 14 females) with transitional cell carcinoma of the bladder who were less than 40 years old. Clinical and pathological parameters of patients who were less than 40 years of age were compared with those of a series of patients older than 40 years of age (the control group) during the same period. A survival analysis was performed using the Kaplan-Meier method and log-rank test, and Cox regression was performed to identify clinical parameters that affected the clinical outcomes. The mean age was 29.21 years (range, 5-40 years) for patients less than 40 years old and 61.66 years (range, 41-75) for those older than 40 years. The mean follow-up was 40.26 months (range, 12-65 months) for young patients and 42.57 months (range, 12-72 months) for the older patients. Young bladder cancer patients had smaller-sized tumors (less than 3 cm), less high-grade cancers, higher papillary urothelial neoplasms of low malignant potential, and low-grade tumors than patients older than 40 years. Multivariate logistic regression analysis predicted tumor recurrence in young patients with high-grade tumors [odds ratio (OR), 1.959; 95% confidence interval (CI), 1.235-2.965; p = 0.046] and tumors larger than 3 cm (OR, 1.772; 95% CI, 1.416-1.942; p = 0.032). The 5-year overall survival rate was 100% for young patients and 88.1% for older patients. No difference was observed in the recurrence-free (p = 0.321) and progression-free (p = 0.422) survival rates between the two groups. We concluded that although the clinical stage distribution, natural history, and outcomes of bladder urothelial cancer in young adults are

  8. Ketamine for pain in adults and children with cancer: a systematic review and synthesis of the literature.

    Science.gov (United States)

    Bredlau, Amy Lee; Thakur, Rajbala; Korones, David Nathan; Dworkin, Robert H

    2013-10-01

    Chronic cancer pain is often refractory and difficult to treat. Ketamine is a medication with evidence of efficacy in the treatment of chronic pain. This article presents a synthesis of the data on ketamine for refractory cancer pain in adults and children. There are five randomized, double-blind, controlled trials of ketamine use in cancer pain that demonstrate improvement in pain for some patients. There are six prospective, uncontrolled trials in cancer pain that also demonstrate improvement in pain scores for some patients. There are no randomized, controlled trials in children with cancer pain, although there are a few studies reflecting improved pain control with ketamine for children with cancer pain. Adverse events for adults on ketamine are most commonly somnolence, feelings of insobriety, nausea/vomiting, hallucinations, depersonalization/derealization, and drowsiness. However, when ketamine is combined with benzodiazepines, feelings of insobriety, hallucinations, and depersonalization/derealization are not reported. Children on ketamine have had few reported adverse effects, which include sedation, anorexia, urinary retention, and myoclonic movements. Recommended ketamine infusion dosages are from 0.05 to 0.5 mg/kg/h (intravenous or subcutaneous). Recommended oral dosages of ketamine are 0.2-0.5 mg/kg/dose two to three times daily with a maximum of 50 mg/dose three times daily. Despite limitations in the breadth and depth of data available, there is evidence that ketamine may be a viable option for treatment-refractory cancer pain. Wiley Periodicals, Inc.

  9. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... with Cancer Reports, Research, and Literature Cancers by Body Location/System Childhood Cancers Late Effects of Childhood ... A to Z List of Cancers Cancers by Body Location Childhood Cancers Adolescent & Young Adult Cancers Metastatic ...

  10. Mendelian randomisation analysis provides no evidence for a relationship between adult height and testicular cancer risk.

    Science.gov (United States)

    Levy, M; Hall, D; Sud, A; Law, P; Litchfield, K; Dudakia, D; Haugen, T B; Karlsson, R; Reid, A; Huddart, R A; Grotmol, T; Wiklund, F; Houlston, R S; Turnbull, C

    2017-09-01

    Observational studies have suggested anthropometric traits, particularly increased height are associated with an elevated risk of testicular cancer (testicular germ cell tumour). However, there is an inconsistency between study findings, suggesting the possibility of the influence of confounding factors. To examine the association between anthropometric traits and testicular germ cell tumour using an unbiased approach, we performed a Mendelian randomisation study. We used genotype data from genome wide association studies of testicular germ cell tumour totalling 5518 cases and 19,055 controls. Externally weighted polygenic risk scores were created and used to evaluate associations with testicular germ cell tumour risk per one standard deviation (s.d) increase in genetically-defined adult height, adult BMI, adult waist hip ratio adjusted for BMI (WHRadjBMI), adult hip circumference adjusted for BMI (HIPadjBMI), adult waist circumference adjusted for BMI (WCadjBMI), birth weight (BW) and childhood obesity. Mendelian randomisation analysis did not demonstrate an association between any anthropometric trait and testicular germ cell tumour risk. In particular, despite good power, there was no global evidence for association between height and testicular germ cell tumour. However, three SNPs for adult height individually showed association with testicular germ cell tumour (rs4624820: OR = 1.47, 95% CI: 1.41-1.55, p = 2.7 × 10 -57 ; rs12228415: OR = 1.17, 95% CI: 1.11-1.22, p = 3.1 × 10 -10 ; rs7568069: OR = 1.13, 95% CI: 1.07-1.18, p = 1.1 × 10 -6 ). This Mendelian randomisation analysis, based on the largest testicular germ cell tumour genome wide association dataset to date, does not support a causal etiological association between anthropometric traits and testicular germ cell tumour aetiology. Our findings are more compatible with confounding by shared environmental factors, possibly related to prenatal growth with exposure to these risk factors

  11. Systematic Review of Occupational Therapy and Adult Cancer Rehabilitation: Part 1. Impact of Physical Activity and Symptom Management Interventions.

    Science.gov (United States)

    Hunter, Elizabeth G; Gibson, Robert W; Arbesman, Marian; D'Amico, Mariana

    This article is the first part of a systematic review of evidence for the effectiveness of cancer rehabilitation interventions within the scope of occupational therapy that address the activity and participation needs of adult cancer survivors. This article focuses on the importance of physical activity and symptom management. Strong evidence supports the use of exercise for cancer-related fatigue and indicates that lymphedema is not exacerbated by exercise. Moderate evidence supports the use of yoga to relieve anxiety and depression and indicates that exercise as a whole may contribute to a return to precancer levels of sexual activity. The results of this review support inclusion of occupational therapy in cancer rehabilitation and reveal a significant need for more research to explore ways occupational therapy can positively influence the outcomes of cancer survivors. Part 2 of the review also appears in this issue. Copyright © 2017 by the American Occupational Therapy Association, Inc.

  12. The need for control, safety and trust in healthcare: A qualitative study among adolescents and young adults exposed to family violence.

    Science.gov (United States)

    van Rosmalen-Nooijens, Karin A W L; Lo Fo Wong, Sylvie H; Prins, Judith B; Lagro-Janssen, Antoine L M

    2017-06-01

    Adolescents and young adults (AYA) exposed to family violence are in need of professional healthcare. However, only one-third of them seek professional help. This study investigates healthcare needs of twelve AYA exposed to family violence. Semi-structured face-to-face interviews using purposive sampling to reach diversity. Open thematic coding was used to identify the most important themes. Participants experienced emotional problems, distrusted others and felt unsafe as an important consequence of their exposure to family violence. All participants expressed a need for help, but as help involved informing others, they considered it unsafe. Trust, safety and control regarding healthcare interventions emerged as vital needs. The anonymity of the Internet was considered as offering safeguards in seeking and receiving help. Trust, safety and control regarding healthcare interventions emerged as vital needs for AYA exposed to family violence. The great importance of being in control of healthcare interventions has not been reported earlier. A personal bond can lower the need for control. To comply with the three basic needs, healthcare providers should grant AYA as much control as possible while still monitoring patient safety. The Internet can be an important resource for offering low-threshold professional and peer support. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Long-term mental wellbeing of adolescents and young adults diagnosed with venous thromboembolism: results from a multistage mixed methods study.

    Science.gov (United States)

    Højen, A A; Sørensen, E E; Dreyer, P S; Søgaard, M; Larsen, T B

    2017-12-01

    Essentials Long-term mental wellbeing of adolescents and young adults with venous thromboembolism is unclear. This multistage mixed methods study was based on Danish nationwide registry data and interviews. Mental wellbeing is negatively impacted in the long-term and uncertainty of recurrence is pivotal. The perceived health threat is more important than disease severity for long-term mental wellbeing. Background Critical and chronic illness in youth can lead to impaired mental wellbeing. Venous thromboembolism (VTE) is a potentially traumatic and life-threatening condition. Nonetheless, the long-term mental wellbeing of adolescents and young adults (AYAS) with VTE is unclear. Objectives To investigate the long-term mental wellbeing of AYAS (aged 13-33 years) diagnosed with VTE. Methods We performed a multistage mixed method study based on data from the Danish nationwide health registries, and semistructured interviews with 12 AYAS diagnosed with VTE. An integrated mixed methods interpretation of the findings was conducted through narrative weaving and joint displays. Results The integrated mixed methods interpretation showed that the mental wellbeing of AYAS with VTE had a chronic perspective, with a persistently higher risk of psychotropic drug purchase among AYAS with a first-time diagnosis of VTE than among sex-matched and age-matched population controls and AYAS with a first-time diagnosis of insulin-dependent diabetes mellitus. Impaired mental wellbeing was largely connected to a fear of recurrence and concomitant uncertainty. Therefore, it was important for the long-term mental wellbeing to navigate uncertainty. The perceived health threat played a more profound role in long-term mental wellbeing than disease severity, as the potential life threat was the pivot which pointed back to the initial VTE and forward to the perception of future health threat and the potential risk of dying of a recurrent event. Conclusion Our findings show that the long

  14. A state of the science on influential factors related to sun protective behaviors to prevent skin cancer in adults

    Directory of Open Access Journals (Sweden)

    Amy F. Bruce, MSN, RN, NE-BC

    2017-07-01

    Full Text Available Skin cancer rates have risen over the past decades, making it imperative that adults understand the need for protection from sun exposure. Though some risk factors have been identified as predictive for skin cancers, there is a lack of synthesized information about factors that influence adults in their decisions to engage in sun protective behaviors. The purpose of this paper is to present the current state of the science on influential factors for sun protective behaviors in the general adult population. A rigorous literature search inclusive of a generally White, Caucasian, and non-Hispanic adult population was performed, and screening yielded 18 quantitative studies for inclusion in this review. Findings indicate that modifiable and non-modifiable factors are interdependent and play a role in sun protective behaviors. This study resulted in a proposed conceptual model for affecting behavioral change in sun protection including the following factors: personal characteristics, cognitive factors, family dynamics, and social/peer group influences. These factors are introduced to propose tailored nursing interventions that would change current sun protective behavior practice. Key implications for nursing research and practice focus on feasibility of annual skin cancer screening facilitated by advanced practice nurses, incorporating the identified influential factors to reduce skin cancer risk and unnecessary sun exposure.

  15. Speeding up PET/MR for cancer staging of children and young adults

    Energy Technology Data Exchange (ETDEWEB)

    Aghighi, Maryam; Pisani, Laura Jean; Sun, Ziyan; Klenk, Christopher; Madnawat, Himani; Owen, Daniel; Quon, Andrew; Moseley, Michael; Daldrup-Link, Heike E. [Stanford University, Department of Radiology, Molecular Imaging Program at Stanford, Stanford, CA (United States); Fineman, Sandra Luna [Stanford University, Department of Pediatrics, Lucile Packard Children' s Hospital, Stanford, CA (United States); Advani, Ranjana [Stanford University, Department of Medicine, Stanford Hospital, Stanford, CA (United States); Von Eyben, Rie [Stanford University, Department of Radiation and Oncology, Stanford, CA (United States)

    2016-12-15

    Combining {sup 18}F-FDG PET with whole-body MR for paediatric cancer staging is practically feasible if imaging protocols can be streamlined. We compared {sup 18}F-FDG PET/STIR with accelerated {sup 18}F-FDG PET/FSPGR for whole-body tumour imaging in children and young adults. Thirty-three children and young adults (17.5 ± 5.5 years, range 10-30) with malignant lymphoma or sarcoma underwent a {sup 18}F-FDG PET staging examination, followed by ferumoxytol-enhanced STIR and FSPGR whole-body MR. {sup 18}F-FDG PET scans were fused with MR data and the number and location of tumours on each integrated examination were determined. Histopathology and follow-up imaging served as standard of reference. The agreement of each MR sequence with the reference and whole-body imaging times were compared using Cohen's kappa coefficient and Student's t-test, respectively. Comparing {sup 18}F-FDG PET/FSPGR to {sup 18}F-FDG PET/STIR, sensitivities were 99.3 % for both, specificities were statistically equivalent, 99.8 versus 99.9 %, and the agreement with the reference based on Cohen's kappa coefficient was also statistically equivalent, 0.989 versus 0.992. However, the total scan-time for accelerated FSPGR of 19.8 ± 5.3 minutes was significantly shorter compared to 29.0 ± 7.6 minutes for STIR (p = 0.001). F-FDG PET/FSPGR demonstrated equivalent sensitivities and specificities for cancer staging compared to {sup 18}F-FDG PET/STIR, but could be acquired with shorter acquisition time. (orig.)

  16. Knowledge, attitudes, and preventive practices about colorectal cancer among adults in an area of Southern Italy

    Directory of Open Access Journals (Sweden)

    Marinelli Paolo

    2008-06-01

    Full Text Available Abstract Background Colorectal cancer (CRC is the second most commonly diagnosed cancer for both sexes in developed countries. This study assessed the knowledge, attitudes, and preventive practices regarding CRC of adults in Italy. Methods A random sample of 1165 adults received a self-administered questionnaire on socio-demographic characteristics; knowledge regarding definition, risk factors, and screening; attitudes regarding perceived risk of contracting CRC and utility of screening tests; health-related behaviors and health care use; source of information. Results Only 18.5% knew the two main modifiable risk factors (low physical activity, high caloric intake from fat and this knowledge was significantly associated with higher educational level, performing physical activity, modification of dietary habits and physical activity for fear of contracting CRC, and lower risk perception of contracting CRC. Half of respondents identified fecal occult blood testing (FOBT as main test for CRC prevention and were more knowledgeable those unmarried, more educated, who knew the main risk factors of CRC, and have received advice by physician of performing FOBT. Personal opinion that screening is useful for CRC prevention was high with a mean score of 8.3 and it was predicted by respondents' lower education, beliefs that CRC can be prevented, higher personal perceived risk of contracting CRC, and information received by physician about CRC. An appropriate behavior of performing FOBT if eligible or not performing if not eligible was significantly higher in female, younger, more educated, in those who have been recommended by physician for undergo or not undergo FOBT, and who have not personal history of precancerous lesions and familial history of precancerous lesions or CRC. Conclusion Linkages between health care and educational systems are needed to improve the levels of knowledge and to raise CRC screening adherence.

  17. A French national breast and thyroid cancer screening programme for survivors of childhood, adolescent and young adult (CAYA) cancers - DeNaCaPST programme.

    Science.gov (United States)

    Demoor-Goldschmidt, Charlotte; Drui, Delphine; Doutriaux, Isabelle; Michel, Gérard; Auquier, Pascal; Dumas, Agnès; Berger, Claire; Bernier, Valérie; Bohrer, Sandrine; Bondiau, Pierre-Yves; Filhon, Bruno; Fresneau, Brice; Freycon, Claire; Stefan, Dinu; Helfre, Sylvie; Jackson, Angela; Kerr, Christine; Laprie, Anne; Leseur, Julie; Mahé, Marc-André; Oudot, Caroline; Pluchard, Claire; Proust, Stéphanie; Sudour-Bonnange, Hélène; Vigneron, Céline; Lassau, Nathalie; Schlumberger, Martin; Conter, Cécile Faure; de Vathaire, Florent

    2017-05-12

    Survival of childhood, adolescent and young adult (CAYA) cancers has increased with progress in the management of the treatments and has reached more than 80% at 5 years. Nevertheless, these survivors are at great risk of second cancers and non-malignant co-morbidities in later life. DeNaCaPST is a non-interventional study whose aim is to organize a national screening for thyroid cancer and breast cancer in survivors of CAYA cancers. It will study the compliance with international recommendations, with the aim, regarding a breast screening programme, of offering for every woman living in France, at equal risk, an equal screening. DeNaCaPST trial is coordinated by the INSERM 1018 unit in cooperation with the LEA (French Childhood Cancer Survivor Study for Leukaemia) study's coordinators, the long term follow up committee and the paediatric radiation committee of the SFCE (French Society of Childhood Cancers). A total of 35 centres spread across metropolitan France and la Reunion will participate. FCCSS (French Childhood Cancer Survivor Study), LEA and central registry will be interrogated to identify eligible patients. To participate, centers agreed to perform a complete "long-term follow-up consultations" according to good clinical practice and the guidelines of the SFCE (French Society of Children Cancers). As survival has greatly improved in childhood cancers, detection of therapy-related malignancies has become a priority even if new radiation techniques will lead to better protection for organs at risk. International guidelines have been put in place because of the evidence for increased lifetime risk of breast and thyroid cancer. DeNaCaPST is based on these international recommendations but it is important to recognize that they are based on expert consensus opinion and are supported by neither nonrandomized observational studies nor prospective randomized trials in this specific population. Over-diagnosis is a phenomenon inherent in any screening program and

  18. Cancer incidence in adults living in the vicinity of nuclear power plants in France, based on data from the French Network of Cancer Registries.

    Science.gov (United States)

    Desbiolles, Alice; Roudier, Candice; Goria, Sarah; Stempfelet, Morgane; Kairo, Cécile; Quintin, Cécile; Bidondo, Marie-Laure; Monnereau, Alain; Vacquier, Blandine

    2018-03-01

    Nuclear power plants (NPPs) release toxic emissions into the environment that may affect neighboring populations. This ecologic study was designed to investigate the possibility of an excess incidence of cancer in the vicinity of French NPPs by examining the incidence by municipality of 12 types of cancer in the population aged 15 years and older during the 1995-2011 period. Population exposure to pollution was estimated on the basis of distance from towns of residence to the NPP. Using regression models, we assessed the risk of cancer in a 20-km zone around NPPs and observed an excess incidence of bladder cancer (Relative Risk (RR), 95% Credibility Interval (95% CI)) in men and women (RR men  = 1.08; 95% CI: 1.00, 1.17 and RR women  = 1.19; 95% CI: 1.02, 1.39). Women living within the 20-km proximity areas had a significantly reduced risk of thyroid cancer (RR women  = 0.86; 95% CI: 0.77, 0.96). No excess risk of hematologic malignancies in either sex was seen. The higher than expected incidence of bladder cancer may be due to an excess incidence localized around the Flamanville NPP and the nearby La Hague nuclear waste treatment center, which is a source of chemical contaminants, many (including arsenic) of them known risk factors for bladder cancer. Differences in medical practices could explain the reduced risk of thyroid cancer. In this first study of adults living near NPPs in France, cancer incidence is significantly higher than in the references populations for one of the cancer types studied: bladder cancer. © 2017 UICC.

  19. Distribution of Proliferating Bone Marrow in Adult Cancer Patients Determined Using FLT-PET Imaging

    International Nuclear Information System (INIS)

    Hayman, James A.; Callahan, Jason W.; Herschtal, Alan; Everitt, Sarah; Binns, David S.; Hicks, Rod J.; Mac Manus, Michael

    2011-01-01

    Purpose: Given that proliferating hematopoietic stem cells are especially radiosensitive, the bone marrow is a potential organ at risk, particularly with the use of concurrent chemotherapy and radiotherapy. Existing data on bone marrow distribution have been determined from the weight and visual appearance of the marrow in cadavers. 18 F-fluoro-L-deoxythymidine concentrates in bone marrow, and we used its intensity on positron emission tomography imaging to quantify the location of the proliferating bone marrow. Methods and Materials: The 18 F-fluoro-L-deoxythymidine positron emission/computed tomography scans performed at the Peter MacCallum Cancer Centre between 2006 and 2009 on adult cancer patients were analyzed. At a minimum, the scans included the mid-skull through the proximal femurs. A software program developed at our institution was used to calculate the percentage of administered activity in 11 separately defined bony regions. Results: The study population consisted of 13 patients, 6 of whom were men. Their median age was 61 years. Of the 13 patients, 9 had lung cancer, 2 had colon cancer, and 1 each had melanoma and leiomyosarcoma; 6 had received previous, but not recent, chemotherapy. The mean percentage of proliferating bone marrow by anatomic site was 2.9% ± 2.1% at the skull, 1.9% ± 1.2% at the proximal humeri, 2.9% ± 1.3% at the sternum, 8.8% ± 4.7% at the ribs and clavicles, 3.8% ± 0.9% at the scapulas, 4.3% ± 1.6% at the cervical spine, 19.9% ± 2.6% at the thoracic spine, 16.6% ± 2.2% at the lumbar spine, 9.2% ± 2.3% at the sacrum, 25.3% ± 4.9% at the pelvis, and 4.5% ± 2.5% at the proximal femurs. Conclusion: Our modern estimates of bone marrow distribution in actual cancer patients using molecular imaging of the proliferating marrow provide updated data for optimizing normal tissue sparing during external beam radiotherapy planning.

  20. Acquisition of Social Support and Linguistic Characteristics of Social Media Posts About Young Adult Cancer.

    Science.gov (United States)

    Warner, Echo L; Ellington, Lee; Kirchhoff, Anne C; Cloyes, Kristin G

    2018-04-01

    Social media (SM) is a burgeoning source of social support for young adults (YAs). We explored the language used to communicate about YA cancer on Instagram and for indicators of social support (i.e., number of likes and comments). Instagram posts using #youngadultcancer were randomly selected (N = 50). Text and hashtags were collected, and posts were coded for gender (female and male), treatment status (active treatment and survivorship), type of user (individual and organization), and caregiver status (yes and no). Indicators of social support, valence (e.g., positive vs. negative terms), and lexical content (e.g., emotional terms and pronouns) were measured using Yoshikoder and Linguistic Inquiry Word Count and compared by gender, treatment status, type of user, and caregiver status. Survivors' posts had more likes compared to those in active treatment (mean: 54.5 vs. 32.3, p = 0.03). Individuals' posts had more comments than those of organizations (mean: 5.3 vs. 1.2, p = 0.01). More positive (30%) than negative (13%) terms were used by survivors (p Instagram users communicate about YA cancer and whether the language they use garners social support. Studying online language use may help YA patients, caregivers, and organizations use SM to gain social support.

  1. The Health Behavior Information Needs and Preferences of Teenage and Young Adult Cancer Survivors.

    Science.gov (United States)

    Pugh, Gemma; Hough, Rachael E; Gravestock, Helen L; Jackson, Sarah E; Fisher, Abigail

    2017-06-01

    This study aimed to establish teenage and young adult cancer survivors (TYACS') specific interest in receiving information on physical activity, diet, smoking, and alcohol consumption and their preferences regarding the delivery, format, and timing of such health behavior information. TYACS aged 13-25 years were invited to complete a questionnaire assessing the advice they had received in the past and their preferences on when and how health behavior information should be delivered. A total of 216 TYACS (mean age: 20 years; mean age at diagnosis: 16 years) completed the questionnaire. Approximately 40% of TYACS received no advice on physical activity and diet, and more than half (54%) received no advice on weight management. The majority (>70%) reported receiving no advice on smoking or alcohol consumption. Interest in receiving lifestyle advice was high overall (71%) but varied across behaviors, with TYACS reporting a greater level of interest in receiving advice on health protective behaviors (physical activity and diet) than health risk behaviors (smoking and alcohol consumption) (∼85% vs. ∼15%, respectively). TYACS reported seeking health behavior information from health professionals and were most interested in information delivered online or in the form of a mobile app. Similar proportions (18%-29%) felt health behavior information should first be provided before, during, immediately after, and post-treatment. It is evident that there is a need to develop lifestyle interventions in a range of formats available to TYACS throughout the care pathway to address the health behavior information needs of young people with cancer.

  2. Marriage, employment, and health insurance in adult survivors of childhood cancer.

    Science.gov (United States)

    Crom, Deborah B; Lensing, Shelly Y; Rai, Shesh N; Snider, Mark A; Cash, Darlene K; Hudson, Melissa M

    2007-09-01

    Adult survivors of childhood cancer are at risk for disease- and therapy-related morbidity, which can adversely impact marriage and employment status, the ability to obtain health insurance, and access to health care. Our aim was to identify factors associated with survivors' attainment of these outcomes. We surveyed 1,437 childhood cancer survivors who were >18 years old and >10 years past diagnosis. We compared our cohort's data to normative data in the Medical Expenditure Panel Survey and the U.S. Census Bureau's Current Population Surveys. Respondents were stratified by hematologic malignancies, central nervous system tumors, or other solid tumors and by whether they had received radiation therapy. Most respondents were survivors of hematologic malignancies (71%), white (91%), and working full-time (62%); 43% were married. Compared with age- and sex-adjusted national averages, only survivors of hematologic malignancies who received radiation were significantly less likely to be married (44 vs. 52%). Full-time employment among survivors was lower than national norms, except among survivors of hematologic malignancies who had not received radiation therapy. The rates of coverage of health insurance, especially public insurance, were higher in all diagnostic groups than in the general population. While difficulty obtaining health care was rarely reported, current unemployment and a lack of insurance were associated with difficulty in obtaining health care (P unmarried, unemployed, and uninsured experience difficulty accessing health care needed to address long-term health concerns.

  3. HPV-Induced Field Cancerisation: Transformation of Adult Tissue Stem Cell Into Cancer Stem Cell.

    Science.gov (United States)

    Olivero, Carlotta; Lanfredini, Simone; Borgogna, Cinzia; Gariglio, Marisa; Patel, Girish K

    2018-01-01

    Field cancerisation was originally described as a basis for multiple head and neck squamous cell carcinoma (HNSCC) and is a pre-malignant phenomenon that is frequently attributable to oncogenic human papillomavirus (HPV) infection. Our work on β-HPV-induced cutaneous squamous cell carcinomas identified a novel Lrig1+ hair follicle junctional zone keratinocyte stem cell population as the basis for field cancerisation. Herein, we describe the ability for HPV to infect adult tissue stem cells in order to establish persistent infection and induce their proliferation and displacement resulting in field cancerisation. By review of the HPV literature, we reveal how this mechanism is conserved as the basis of field cancerisation across many tissues. New insights have identified the capacity for HPV early region genes to dysregulate adult tissue stem cell self-renewal pathways ensuring that the expanded population preserve its stem cell characteristics beyond the stem cell niche. HPV-infected cells acquire additional transforming mutations that can give rise to intraepithelial neoplasia (IEN), from environmental factors such as sunlight or tobacco induced mutations in skin and oral cavity, respectively. With establishment of IEN, HPV viral replication is sacrificed with loss of the episome, and the tissue is predisposed to multiple cancer stem cell-driven carcinomas.

  4. Trends in Obesity Prevalence in Adults With a History of Cancer: Results From the US National Health Interview Survey, 1997 to 2014.

    Science.gov (United States)

    Greenlee, Heather; Shi, Zaixing; Sardo Molmenti, Christine L; Rundle, Andrew; Tsai, Wei Yann

    2016-09-10

    Obesity after a diagnosis of specific cancers has been associated with worse prognosis. We examined the trend in obesity prevalence among cancer survivors in the United States in the past two decades and compared trends with those of adults without a history of cancer. This was a population-based nationally representative sample of 538,969 noninstitutionalized US adults 18 to 85 years old with and without a history of cancer who participated in annual cross-sectional National Health Interview Surveys from 1997 to 2014. Obesity was defined as body mass index ≥ 30 kg/m(2) for non-Asians and body mass index ≥ 27.5 kg/m(2) for Asians. Among 32,447 cancer survivors identified, the most common cancer diagnoses were breast (n = 6,948), prostate (n = 3,984), and colorectal (n = 2,546). From 1997 to 2014, the prevalence of obesity increased from 22.4% to 31.7% in cancer survivors and from 20.9% to 29.5% in adults without a history of cancer (P for trend history of cancer compared with those without a history of cancer (all P for interaction < .001). The estimated rate of annual increase in obesity prevalence was 3.1% in female and 3.7% in male colorectal cancer survivors, 3.0% in breast cancer survivors, and 2.1% in prostate cancer survivors (all P < .001). In subgroup analyses, populations with the highest rates of increasing obesity burden were colorectal cancer survivors, breast cancer survivors, and non-Hispanic blacks. From 1997 to 2014, obesity increased more rapidly among adult cancer survivors compared with the general population. Colorectal and breast cancer survivors and non-Hispanic blacks were identified as being at the highest risk for obesity. © 2016 by American Society of Clinical Oncology.

  5. Breast cancer in relation to childhood parental divorce and early adult psychiatric disorder in a British birth cohort.

    Science.gov (United States)

    Lokugamage, A U; Hotopf, M; Hardy, R; Mishra, G; Butterworth, S; Wadsworth, M E J; Kuh, D

    2006-09-01

    Jacobs and Bovasso reported (Psychological Medicine 2000, 30, 669-678) that maternal death in childhood and chronic severe depression in adulthood were associated with subsequent breast cancer. We have examined the effects of parental loss in childhood and psychiatric disorder in adult life on breast cancer risk using a national birth cohort study. Eighty-three cases of breast cancer were diagnosed in a study of 2253 women followed from birth to age 59 years. Cox proportional hazards models were used to test whether breast cancer rates were higher in women who experienced parental death and divorce before age 16, psychiatric disorders between 15 and 32 years, symptoms of anxiety and depression at 36 years, or use of antidepressant medication at 31 or 36 years than in women who did not have these experiences. There was no overall association between parental death, parental divorce or psychiatric disorder and the incidence of breast cancer. There was some evidence that women with more severe psychiatric disorders between the ages of 15 and 32 years were more likely to develop breast cancer early. The interaction between parental divorce and severe psychiatric disorder was non-significant (p=0.1); however, the group who experienced both these events had an increased breast cancer risk compared with those who experienced neither [hazard ratio (HR) 2.64, 95% confidence interval (CI) 1.13-6.19]. Our study does not provide strong support for the hypothesis that early loss or adult psychiatric disorders are associated with breast cancer. A meta-analysis is needed that uses data from all available cohort studies and investigates possible interactive effects on breast cancer risk.

  6. Social inequalities in oral cancer literacy in an adult population in a multicultural deprived area of the UK.

    Science.gov (United States)

    Al-Kaabi, Rasha; Gamboa, Ana B O; Williams, David; Marcenes, Wagner

    2016-09-01

    To report the level and correlates of oral cancer literacy in a deprived area of the UK. This study is part of the East London Oral Health Inequality Study, which included a representative sample of adults 16-65 (n = 2343) years old living in Waltham Forest, Redbridge and Barking and Dagenham in 2009-10. This cross-sectional study adopted a multi-stage, stratified, random sampling approach. Data were collected through home visits by trained examiners and interviewers. Hierarchical logistic regression modelling was adopted. Only 26.7% participants were aware that a small lesion in the mouth can develop into oral cancer, and 39.5% were aware that early treatment could prevent a lesion from developing into oral cancer. Adjusted odds ratios confirmed the social gradient in awareness that a small lesion in the mouth can develop into oral cancer, even after adjusting for age, gender and ethnicity. Inequalities in awareness that a small lesion in the mouth can develop into oral cancer were significantly attenuated after forcing education level into the equation. Interestingly, adjusting for education cancelled the difference previously observed between manual/routine and professional/managerial occupations. Oral cancer literacy is poor among adults in Outer North East London, and we have identified particularly vulnerable sub-populations. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. Self-reported memory problems in adult-onset cancer survivors: effects of cardiovascular disease and insomnia.

    Science.gov (United States)

    Jean-Pierre, Pascal; Grandner, Michael A; Garland, Sheila N; Henry, Elizabeth; Jean-Louis, Girardin; Burish, Thomas G

    2015-07-01

    Cancer and its treatments can deleteriously affect memory. Cardiac function and insomnia can exacerbate memory problems. To examine the relationships among cardiovascular disease, insomnia, and self-reported memory problems (SRMP) in adult-onset cancer survivors. We included data from participants (41-64 year-old) of the 2007-2008 National Health and Nutrition Examination Survey, a nationally representative probability sample of the civilian, non-institutionalized population of the US. We excluded participants with brain cancer/stroke history since these conditions are expected to cause cognitive problems. Using binary logistic regression, we determined the prevalence of SRMP relative to cardiac problems and insomnia by weighting our results proportionally. We adjusted for predictors of memory problems: age, sex, race, education and general health. The sample included 2289 adults (49% females), 9% with a cancer history. The results pertain only to cancer survivors. Those with insomnia were 16 times as likely to have SRMP. Only insomnia symptoms (OR, 15.74; 95% CI, 1.73-143.30; p Insomnia accounted for 18.8% of the association between cardiac issues and SRMP, demonstrating mediation (Sobel p insomnia were not associated with SRMP (p > 0.05). We could not determine severity and time-related changes in SRMP. Likelihood of SRMP was higher in cancer survivors with a history of cardiovascular disease and insomnia symptoms. Future studies are needed to delineate the cardiac-insomnia-memory interrelationships. Copyright © 2015 Elsevier B.V. All rights reserved.

  8. A Decision Aid to Promote Appropriate Colorectal Cancer Screening among Older Adults: A Randomized Controlled Trial.

    Science.gov (United States)

    Lewis, Carmen L; Kistler, Christine E; Dalton, Alexandra F; Morris, Carolyn; Ferrari, Renée; Barclay, Colleen; Brewer, Noel T; Dolor, Rowena; Harris, Russell; Vu, Maihan; Golin, Carol E

    2018-07-01

    Concerns have been raised about both over- and underutilization of colorectal cancer (CRC) screening in older patients and the need to align screening behavior with likelihood of net benefit. The purpose of this study was to test a novel use of a patient decision aid (PtDA) to promote appropriate CRC screening in older adults. A total of 424 patients ages 70 to 84 y who were not up to date with CRC screening participated in a double-blinded randomized controlled trial of a PtDA targeted to older adults making decisions about whether to undergo CRC screening from March 2012 to February 2015. Patients were randomized to a targeted PtDA or an attention control. The PtDA was designed to facilitate individualized decision making-helping patients understand the potential risks, benefits, and uncertainties of CRC screening given advanced age, health state, preferences, and values. Two composite outcomes, appropriate CRC screening behavior 6 mo after the index visit and appropriate screening intent immediately after the visit, were defined as completed screening or intent for patients in good health, discussion about screening with their provider for patients in intermediate health, and no screening or intent for patients in poor health. Health state was determined by age and Charlson Comorbidity Index. Four hundred twelve (97%) and 421 (99%) patients were analyzed for the primary and secondary outcomes, respectively. Appropriate screening behavior at 6 mo was higher in the intervention group (55% v. 45%, P = 0.023) as was appropriate screening intent following the provider visit (61% v. 47%, P = 0.003). The study took place in a single geographic region. The appropriate CRC screening classification system used in this study has not been formally validated. A PtDA for older adults promoted appropriate CRC screening behavior and intent. Clinicaltrials.gov, registration number NCT01575990. https://clinicaltrials.gov/ct2/show/NCT01575990?term=epic-d&rank=1.

  9. Risk of Late Mortality and Second Malignant Neoplasms among 5-Year Survivors of Young Adult Cancer: A Report of the Childhood, Adolescent, and Young Adult Cancer Survivors Research Program

    International Nuclear Information System (INIS)

    Zhang, Y.; Spinelli, J. J.; Gotay, C.; McBride, M. L.; Zhang, Y.; Spinelli, J. J.; Goddard, K.

    2012-01-01

    We conducted a population-based retrospective study to assess the long-term risks of overall and cause-specific mortality and second malignant neoplasm (SMN) among survivors of young adult cancer compared to the risk in British Columbia (BC) population and to evaluate the effects of demographic and clinical factors on risk. 1248 5-year survivors of young adult cancer diagnosed 1970-1995 between 20 and 24 years of age were identified from the BC Cancer Registry and followed to the end of 2007. Standardized mortality ratios (SMRs) and standardized incidence ratios (SIRs) were calculated. The Cox proportional hazards model was used to estimate the effects of different demographic and disease-related characteristics on the risk of death and SMN. A total of 138 deaths and 62 SMNs were observed during follow-up. The overall SMR was 5.9 (95% CI 4.9-6.9) and the absolute excess risk was 5.3 per 1,000 person-years. The overall SIR was 3.0 (95% CI 2.3-3.8). Treatment with radiation resulted in increased risks of death and SMN. These observed increased risks emphasize the importance of prevention, surveillance, and treatment of late effects in survivors of young adult cancers.

  10. The relationship between nutritional status and handgrip strength in adult cancer patients: a cross-sectional study.

    Science.gov (United States)

    Alkan, Şenay Burçin; Artaç, Mehmet; Rakıcıoğlu, Neslişah

    2018-02-09

    Malnutrition is a common complication in head, neck and lung cancer patients, particularly in cases of gastrointestinal system (GIS) cancer. Therefore, an assessment of malnutrition is crucial for early nutritional interventions. It was conducted as a cross-sectional study to evaluate nutritional status of adult cancer patients. The nutritional status of 104 cancer patients (52 GIS and 52 non-GIS cancer cases) using a Patient-Generated Subjective Global Assessment (PG-SGA), handgrip strength, certain anthropometric measurements and food consumption in and outside of the hospital were assessed. The percentages of malnutrition were 64.6 and 64.3% in the male patients with and without GIS cancer, respectively. They were 61.9 and 45.8% in the female patients with GIS and without GIS cancer, respectively. However, no significant difference was found between these two groups according to the malnutrition classification, PG-SGA score, handgrip strength and other anthropometric measurements (p > 0.05). The daily energy and protein intakes (per body weight) of the female patients in the hospital were significantly lower than those outside (p Cancer patients could be provided with nutritional education, and arrangements could be made with hospital nutritional services in order to prevent malnutrition.

  11. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... Directives Using Trusted Resources Cancer Types Adolescents and Young Adults with Cancer Reports, Research, and Literature Cancers by ... Cancers Cancers by Body Location Childhood Cancers Adolescent & Young Adult Cancers Metastatic Cancer Recurrent Cancer Research NCI’s Role ...

  12. Sex-specific associations between birth weight and adult primary liver cancer in a large cohort of Danish children

    DEFF Research Database (Denmark)

    Zimmermann, Esther; Berentzen, Tina L.; Gamborg, Michael

    2016-01-01

    Whether the prenatal period is critical for the development of adult primary liver cancer (PLC) is sparsely investigated. Recently, attention has been drawn to potential sex-differences in the early origins of adult disease. We investigated the association between birth weight and adult PLC...... separately in men and women, using a large cohort of 217,227 children (51% boys), born from 1936 to 1980, from the Copenhagen School Health Records Register, and followed them until 2010 in national registers. Hazard ratios (95% confidence intervals) of PLC (30 years or older) were estimated by Cox...... regression models stratified by birth cohort. During 5.1 million person-years of follow-up, 185 men and 65 women developed PLC. Sex modified the association between birth weight and adult PLC (p-value for interaction=0.0005). Compared with a sex-specific reference group of birth weights between 3.25-3.75 kg...

  13. Life Satisfaction and Psychological Well-Being of Older Adults With Cancer Experience: The Role of Optimism and Volunteering.

    Science.gov (United States)

    Heo, Jinmoo; Chun, Sanghee; Lee, Sunwoo; Kim, Junhyoung

    2016-09-01

    Promoting health and well-being among individuals of advancing age is a significant issue due to increased incidence of cancer among older adults. This study demonstrates the benefits of expecting positive outcomes and participating in volunteer activities among older adults with cancer. We used a nationally representative sample of 2,670 individuals who have experienced cancer from the 2008 wave of the Health and Retirement Study. We constructed a structural equation model to explore the associations of optimism, volunteerism, life satisfaction, and psychological well-being. The level of optimism was a significant predictor of volunteerism, which in turn affected life satisfaction and psychological well-being. The level of engagement in volunteer activities was found to have significant path coefficients toward both life satisfaction and psychological well-being. Our study provides evidence that older adults who have experienced cancer and maintained a positive outlook on their lives and engaged in personally meaningful activities tended to experience psychological well-being and life satisfaction. © The Author(s) 2016.

  14. Radiotherapy for tongue cancer in young adults less than 40 years

    International Nuclear Information System (INIS)

    Yoshida, Ken; Koizumi, Masahiko; Inoue, Toshihiko; Inoue, Takehiro; Yamazaki, Hideya; Kagawa, Kazufumi; Teshima, Teruki; Shimizutani, Kimishige; Furukawa, Souhei; Murayama, Shigeyuki; Nose, Takayuki; Tanaka, Eiichi

    1996-01-01

    Purpose/Objective: Radiotherapy for tongue cancer in young adults less than 40 years is studied, retrospectively. Some reports say young tongue cancer patient has worse prognosis. We investigate treatment results of them treated in our department, compared with elder patients. Materials and Methods: Our department registered 1289 patients with tongue cancer during 26 years between Jan. 1967 and Dec. 1992. One hundred and eighty-eight patients were under 40 years old. One hundred and forty-eight patients were primarily treated by radiotherapy. Follow-up terms are among 2 and 25 years (median; 15 years). They consisted of 99 males and 49 females. They were divided into 3 age groups, 3 teenagers, 39 twenties, and 106 thirties. The youngest was 18 years old. T and N categories were T1: 33, T2: 77, T3: 34, T4: 4, N0: 111, N1: 25, N2: 4, and N3: 8 patients, respectively. One hundred and twenty patients were treated only with radiotherapy. Twenty-four and 4 patients were treated with chemotherapy and surgery adding to radiotherapy respectively. Radiotherapy consisted of 29 external, 60 brachytherapy, and 59 both. One hundred and nineteen brachytherapies consisted of Ir: 66, Ra: 50, Ir+Ra: 1, and Au: 2. Eighty-one patients with T1 or2N0M0 treated only by radiotherapy were compared with the similar 454 patients more and equal to 40 years old. Results: The 5-and 10-year survival rates of 148 patients were 69% and 65%, respectively. The 5-and 10-year local control rates were 77% and 76%, respectively. The 5-year survival rates of T1, T2, T3, and T4 patients were 90%, 70%, 50%, and 43%, respectively. The corresponding 10-year survival rates were 81%, 66%, 50%, and 43%, respectively. The 5-year local control rates were 87%, 79%, 71%, and 25%, respectively. With respect to T1 or 2N0M0 patients, the 5-and 10-year local control rates were 80% and 75% under 40 years old, 77% and 73% over 40 years old patients. (p=0.99) The 5-and 10-year cause-specific survival rates were 79% and 72

  15. Geriatric Assessment of Older Adults With Cancer During Unplanned Hospitalizations: An Opportunity in Disguise.

    Science.gov (United States)

    Mariano, Caroline; Williams, Grant; Deal, Allison; Alston, Shani; Bryant, Ashley Leak; Jolly, Trevor; Muss, Hyman B

    2015-07-01

    that hospitalized older adults with cancer have high levels of functional deficits on GA. These deficits are under-recognized and poorly managed by hospital-based clinicians in a tertiary care setting. Incorporation of GA measures during a hospital stay is a way to improve outcomes in this population. ©AlphaMed Press.

  16. Association between adult otitis media and nasopharyngeal cancer: A nationwide population-based cohort study

    International Nuclear Information System (INIS)

    Huang, Wen-Yen; Lin, Che-Chen; Jen, Yee-Min; Lin, Kuen-Tze; Yang, Muh-Hwa; Chen, Chang-Ming; Chang, Ying-Nan; Sung, Fung-Chang; Kao, Chia-Hung

    2012-01-01

    Purpose: To determine whether the diagnosis of otitis media (OM) in adults is associated with an increased risk for the subsequent development of nasopharyngeal cancer (NPC) using a nationwide population-based retrospective study. Methods and materials: We selected 13,513 adult patients that had been previously diagnosed with OM between 2000 and 2005 from the Taiwan Longitudinal Health Insurance Database 2000 as the study cohort, and randomly extracted the data of 135,130 participants matched by sex, age, and baseline year for the comparison cohort. The follow-up period was terminated upon developing NPC, withdrawal from the national health insurance system, or the end of 2009. Cumulative incidences and hazard ratios (HRs) of NPC development were determined. Results: The subsequent NPC incidence rates in the OM and comparison cohorts were 6.41 and 0.58 per 10 000 person-years, respectively (adjusted HR, 11.04; 95% CI, 7.68–5.87; P < 0.0001). The NPC risk for males was significantly higher than that for females (adjusted HR = 3.24; 95% CI, 2.16–4.85). In both female and male patients, the diagnosis of OM was associated with a significantly increased risk for NPC (adjusted HR, 11.91 vs. 10.78, respectively). Among the OM cohort, 62 participants were subsequently diagnosed with NPC, with 71% of them occurring within 1 year following the diagnosis of OM. However, even after 5-year follow-up, the OM cohort still displayed a higher risk for NPC (adjusted HR = 2.50). Stratified by the frequency of OM episodes, more than one episode per year had a significantly greater risk of developing NPC, compared with the comparison cohort (HR = 29.22; 95% CI, 20.19–42.27). Conclusion: We found that adult OM is a warning sign for the development of NPC in Taiwan, with approximately an 11-fold higher risk for adult OM patients. We recommend that OM patients undergo follow-up examinations for at least 5 years. To extrapolate our findings, further studies are warranted in other

  17. Factors influencing the provision of End of Life care for adolescents and young adults with advanced cancer: a scoping review protocol

    OpenAIRE

    Edwards, Deborah Jayne; Carrier, Judith Angela Kathryn; Gillen, Elizabeth; Hawker, Clare; Sutton, Joanne; Kelly, Daniel M.

    2013-01-01

    The objective of this review is to locate and describe literature relating to EoL care provision to adolescents and young adults with cancer. The specific areas of investigation will include:\\ud - Care service provision in adolescents and young adults with cancer during the EoL phase of care\\ud - Experiences and perceptions of adolescents and young adults with cancer during the EoL phase of care\\ud - Experience and perceptions of the health professionals and family members involved in their c...

  18. FSH-FSHR3-stem cells in ovary surface epithelium: basis for adult ovarian biology, failure, aging, and cancer.

    Science.gov (United States)

    Bhartiya, Deepa; Singh, Jarnail

    2015-01-01

    Despite extensive research, genetic basis of premature ovarian failure (POF) and ovarian cancer still remains elusive. It is indeed paradoxical that scientists searched for mutations in FSH receptor (FSHR) expressed on granulosa cells, whereas more than 90% of cancers arise in ovary surface epithelium (OSE). Two distinct populations of stem cells including very small embryonic-like stem cells (VSELs) and ovarian stem cells (OSCs) exist in OSE, are responsible for neo-oogenesis and primordial follicle assembly in adult life, and are modulated by FSH via its alternatively spliced receptor variant FSHR3 (growth factor type 1 receptor acting via calcium signaling and the ERK/MAPK pathway). Any defect in FSH-FSHR3-stem cell interaction in OSE may affect folliculogenesis and thus result in POF. Ovarian aging is associated with a compromised microenvironment that does not support stem cell differentiation into oocytes and further folliculogenesis. FSH exerts a mitogenic effect on OSE and elevated FSH levels associated with advanced age may provide a continuous trigger for stem cells to proliferate resulting in cancer, thus supporting gonadotropin theory for ovarian cancer. Present review is an attempt to put adult ovarian biology, POF, aging, and cancer in the perspective of FSH-FSHR3-stem cell network that functions in OSE. This hypothesis is further supported by the recent understanding that: i) cancer is a stem cell disease and OSE is the niche for ovarian cancer stem cells; ii) ovarian OCT4-positive stem cells are regulated by FSH; and iii) OCT4 along with LIN28 and BMP4 are highly expressed in ovarian cancers. © 2015 Society for Reproduction and Fertility.

  19. Relationships between social isolation, neighborhood poverty, and cancer mortality in a population-based study of US adults.

    Science.gov (United States)

    Fleisch Marcus, Andrea; Illescas, Alex H; Hohl, Bernadette C; Llanos, Adana A M

    2017-01-01

    Social isolation is an important determinant of all-cause mortality, with evidence suggesting an association with cancer-specific mortality as well. In this study, we examined the associations between social isolation and neighborhood poverty (independently and jointly) on cancer mortality in a population-based sample of US adults. Using data from the Third National Health and Nutrition Examination Survey (NHANES III; 1988-1994), NHANES III Linked Mortality File (through 2011) and 1990 Census, we estimated the relationship between social isolation and high neighborhood poverty and time-to-cancer death using multivariable-adjusted Cox proportional hazards models. We examined the associations of each factor independently and explored the multiplicative and additive interaction effects on cancer mortality risk and also analyzed these associations by sex. Among 16 044 US adults with 17-23 years of follow-up, there were 1133 cancer deaths. Social isolation (HR 1.25, 95% CI: 1.01-1.54) and high neighborhood poverty (HR 1.31, 95% CI: 1.08-1.60) were associated with increased risk of cancer mortality adjusting for age, sex, and race/ethnicity; in sex-specific estimates this increase in risk was evident among females only (HR 1.39, 95% CI: 1.04-1.86). These associations were attenuated upon further adjustment for socioeconomic status. There was no evidence of joint effects of social isolation and high neighborhood poverty on cancer mortality overall or in the sex-stratified models. These findings suggest that social isolation and higher neighborhood poverty are independently associated with increased risk of cancer mortality, although there is no evidence to support our a priori hypothesis of a joint effect.

  20. Two-Dimensional Speckle Tracking Echocardiography Detects Subclinical Left Ventricular Systolic Dysfunction among Adult Survivors of Childhood, Adolescent, and Young Adult Cancer

    Directory of Open Access Journals (Sweden)

    Anthony F. Yu

    2016-01-01

    Full Text Available Two-dimensional speckle tracking echocardiography (2DSTE provides a sensitive measure of left ventricular (LV systolic function and may aid in the diagnosis of cardiotoxicity. 2DSTE was performed in a cross-sectional study of 134 patients (mean age: 31.4±8.8 years; 55% male; mean time since diagnosis: 15.4±9.4 years previously treated with anthracyclines (mean cumulative dose: 320±124 mg/m2, with (n=52 or without (n=82 mediastinal radiotherapy. The prevalence of LV systolic dysfunction, defined as fractional shortening < 27%, LV ejection fraction (LVEF < 55%, and global longitudinal strain (GLS ≤ 16%, was 5.2%, 6.0%, and 23.1%, respectively. Abnormal GLS was observed in 24 (18% patients despite a normal LVEF. Indices of LV systolic function were similar regardless of anthracycline dose. However, GLS was worse (18.0 versus 19.0, p=0.003 and prevalence of abnormal GLS was higher (36.5% versus 14.6%, p=0.004 in patients treated with mediastinal radiotherapy. Mediastinal radiotherapy was associated with reduced GLS (p=0.040 after adjusting for sex, age, and cumulative anthracycline dose. In adult survivors of childhood, adolescent, and young adult cancer, 2DSTE frequently detects LV systolic dysfunction despite a normal LVEF and may be useful for the long-term cardiac surveillance of adult cancer survivors.

  1. Palliative care experiences of adult cancer patients from ethnocultural groups: a qualitative systematic review protocol.

    Science.gov (United States)

    Busolo, David; Woodgate, Roberta

    2015-01-01

    The objective of this review is to synthesize the best available evidence on palliative care experiences of adult cancer patients from ethnocultural groups.More specifically, this systematic review seeks to answer the following questions:1. What are the palliative care experiences of adult cancer patients from diverse ethnocultural groups?2. What meanings do adult patients with cancer from diverse ethnocultural groups assign to their experiences with palliative care? Globally, over 20.4 million people need palliative care services annually. The majority of these people (19 million) are adults, with 34% of them being patients diagnosed with cancer. With the current increase in the aging population, especially in developed countries, the number of adults requiring palliative care is expected to rise. Furthermore, how palliative care is offered and received continues to be shaped by culture and ethnicity. Likewise, culture and ethnicity influence how palliative care patients experience diseases like cancer, and seek and utilize palliative care services. Also, healthcare providers sometimes find it challenging to address the palliative care needs of patients from different ethnocultural groups. Sometimes these challenges are believed to be due to cultural incompetence of the care provider. When palliative care patients and their providers differ in their perception of care needs and how to address them, negative palliative care experiences are likely to ensue. Therefore, as the demand for palliative care increases, and ethnocultural factors continue to affect palliation, it is important to gain a better understanding of palliative care experiences of patients from different ethnocultural groups.The terms culture and ethnicity have been defined and used differently in literature which sometimes lead to confusion. Ethnicity has been defined as distinctive shared origins or social backgrounds and traditions of a group of people that are maintained between generations and

  2. Barriers and Facilitators of Transition from Pediatric to Adult Long-Term Follow-Up Care in Childhood Cancer Survivors.

    Science.gov (United States)

    Rosenberg-Yunger, Zahava R S; Klassen, Anne F; Amin, Leila; Granek, Leeat; D'Agostino, Norma M; Boydell, Katherine M; Greenberg, Mark; Barr, Ronald D; Nathan, Paul C

    2013-09-01

    Despite the risk for late effects in adult survivors of cancer in childhood or adolescence, many survivors fail to transition from pediatric to adult long-term follow-up (LTFU) care. The purpose of this study was to identify the barriers and facilitators of transition from pediatric to adult LTFU care. In this qualitative study, 38 Canadian survivors of cancer in childhood or adolescence, currently aged 15-26 years, were interviewed using semi-structured, open-ended questions. Participants belonged to one of four groups: pre-transition (n=10), successful transition (n=11), failed to transition (n=7), and transitioned to an adult center but then dropped out of adult care (n=10). A constructivist grounded theory approach was used to analyze the interview data. This approach consisted of coding transcripts line by line to develop categories and using constant comparison to examine relationships within and across codes and categories. Interviewing continued until saturation was reached. Three interrelated themes were identified that affected the transition process: micro-level patient factors (e.g., due diligence, anxiety), meso-level support factors (e.g., family, friends), and macro-level system factors (e.g., appointments, communication, healthcare providers). Factors could act as facilitators to transition (e.g., family support), barriers to transition (e.g., difficulty booking appointments), or as both a barrier and a facilitator (e.g., anxiety). This study illustrates the interaction between multiple factors that facilitate and/or prevent transition from pediatric to adult LTFU cancer care. A number of recommendations are presented to address potential macro-level system barriers to successful transition.

  3. Public awareness of warning signs and symptoms of cancer in oman: a community-based survey of adults.

    Science.gov (United States)

    Al-Azri, Mohammed; Al-Hamedi, Ibtisam; Al-Awisi, Huda; Al-Hinai, Mustafa; Davidson, Robin

    2015-01-01

    The majority of deaths from cancer occur in low and middle income countries, partly due to poor public awareness of the signs and symptoms of cancer. A community based survey using the Cancer Awareness Measure (CAM) questionnaire was conducted in three different communities in Oman. Omani adults aged 18 years and above were invited to participate in the study. A total of 345 responded from 450 invited participants (response rate=76.7%). The majority of respondents were unable to identify the common signs and symptoms of cancer identified in the CAM (average awareness was 40.6%). The most emotional barrier to seeking help was worry about what the doctor might find (223, 64.6%); a practical barrier was too busy to make an appointment (259, 75.1%) and a service barrier was difficulty talking to the doctor (159, 46.1%). The majority of respondents (more than 60% for seven out of ten symptoms) would seek medical help in two weeks for most signs or symptoms of cancer. Females were significantly more likely than males to be embarrassed (pawareness of the signs and symptoms of cancer in Oman. This might leads to earlier diagnosis, improved prognosis and reduced mortality from cancer.

  4. Body mass index, waist circumference, type 2 diabetes mellitus and risk of liver cancer for U.S. adults

    Science.gov (United States)

    Campbell, Peter T.; Newton, Christina C.; Freedman, Neal D.; Koshiol, Jill; Alavanja, Michael C.; Beane Freeman, Laura E.; Buring, Julie E.; Chan, Andrew T.; Chong, Dawn Q.; Datta, Mridul; Gaudet, Mia M.; Gaziano, J. Michael; Giovannucci, Edward; Graubard, Barry; Hollenbeck, Albert R.; King, Lindsey; Lee, I-Min; Linet, Martha; Palmer, Julie; Petrick, Jessica L.; Poynter, Jenny N.; Purdue, Mark; Robien, Kim; Rosenberg, Lynn; Sahasrabuddhe, Vikrant; Schairer, Catherine; Sesso, Howard D.; Sigurdson, Alice; Stevens, Victoria L.; Wactowski-Wende, Jean; Zeleniuch-Jacquotte, Anne; Renehan, Andrew G.; McGlynn, Katherine A.

    2016-01-01

    Incidence rates for liver cancer have increased threefold since the mid-1970s in the United States in parallel with increasing trends for obesity and type 2 diabetes mellitus (T2DM). We conducted an analysis of baseline body mass index (BMI), waist circumference (WC), and T2DM with risk of liver cancer. The Liver Cancer Pooling Project maintains harmonized data from 1.57 million adults enrolled in 14 U.S.-based prospective studies. Cox regression estimated hazard ratios (HR) and 95% confidence intervals (CI) adjusted for age, sex, study center, alcohol, smoking, race, and BMI (for WC and T2DM). Stratified analyses assessed whether the BMI-liver cancer associations differed by hepatitis sera-positivity in nested analyses for a subset of cases (n=220) and controls (n=547). After enrollment, 2,162 incident liver cancer diagnoses were identified. BMI, per 5 kg/m2, was associated with higher risks of liver cancer, more so for men (HR: 1.38; 95% CI: 1.30 to 1.46) than women (HR: 1.25; 95% CI: 1.17 to 1.35; p-interaction: 0.02). WC, per 5 cm, was associated with higher risks of liver cancer, approximately equally by sex (overall, HR: 1.08; 95% CI: 1.04 to 1.13). T2DM was associated with higher risk of liver cancer (HR: 2.61; 95% CI: 2.34 to 2.91). In stratified analyses, there was a null association between BMI and liver cancer risk for participants who were sera-positive for hepatitis. This study suggests that high BMI, high WC, and T2DM are associated with higher risks of liver cancer and that the association may differ by status of viral hepatitis infection. PMID:27742674

  5. Impact of cancer and chemotherapy on autonomic nervous system function and cardiovascular reactivity in young adults with cancer: a case-controlled feasibility study.

    Science.gov (United States)

    Adams, Scott C; Schondorf, Ronald; Benoit, Julie; Kilgour, Robert D

    2015-05-18

    Preliminary evidence suggests cancer- and chemotherapy-related autonomic nervous system (ANS) dysfunction may contribute to the increased cardiovascular (CV) morbidity- and mortality-risks in cancer survivors. However, the reliability of these findings may have been jeopardized by inconsistent participant screening and assessment methods. Therefore, good laboratory practices must be established before the presence and nature of cancer-related autonomic dysfunction can be characterized. The purpose of this study was to assess the feasibility of conducting concurrent ANS and cardiovascular evaluations in young adult cancer patients, according to the following criteria: i) identifying methodological pitfalls and proposing good laboratory practice criteria for ANS testing in cancer, and ii) providing initial physiologic evidence of autonomic perturbations in cancer patients using the composite autonomic scoring scale (CASS). Thirteen patients (mixed diagnoses) were assessed immediately before and after 4 cycles of chemotherapy. Their results were compared to 12 sex- and age-matched controls. ANS function was assessed using standardized tests of resting CV (tilt-table, respiratory sinus arrhythmia and Valsalva maneuver) and sudomotor (quantitative sudomotor axon reflex test) reactivity. Cardiovascular reactivity during exercise was assessed using a modified Astrand-Ryhming cycle ergometer protocol. Our feasibility criteria addressed: i) recruitment potential, ii) retention rates, iii) pre-chemotherapy assessment potential, iv) test performance/tolerability, and v) identification and minimizing the influence of potentially confounding medication. T-tests and repeated measures ANOVAs were used to assess between- and within-group differences at baseline and follow-up. The overall success rate in achieving our feasibility criteria was 98.4 %. According to the CASS, there was evidence of ANS impairment at baseline in 30.8 % of patients, which persisted in 18.2 % of patients

  6. Impact of cancer and chemotherapy on autonomic nervous system function and cardiovascular reactivity in young adults with cancer: a case-controlled feasibility study

    International Nuclear Information System (INIS)

    Adams, Scott C.; Schondorf, Ronald; Benoit, Julie; Kilgour, Robert D.

    2015-01-01

    Preliminary evidence suggests cancer- and chemotherapy-related autonomic nervous system (ANS) dysfunction may contribute to the increased cardiovascular (CV) morbidity- and mortality-risks in cancer survivors. However, the reliability of these findings may have been jeopardized by inconsistent participant screening and assessment methods. Therefore, good laboratory practices must be established before the presence and nature of cancer-related autonomic dysfunction can be characterized. The purpose of this study was to assess the feasibility of conducting concurrent ANS and cardiovascular evaluations in young adult cancer patients, according to the following criteria: i) identifying methodological pitfalls and proposing good laboratory practice criteria for ANS testing in cancer, and ii) providing initial physiologic evidence of autonomic perturbations in cancer patients using the composite autonomic scoring scale (CASS). Thirteen patients (mixed diagnoses) were assessed immediately before and after 4 cycles of chemotherapy. Their results were compared to 12 sex- and age-matched controls. ANS function was assessed using standardized tests of resting CV (tilt-table, respiratory sinus arrhythmia and Valsalva maneuver) and sudomotor (quantitative sudomotor axon reflex test) reactivity. Cardiovascular reactivity during exercise was assessed using a modified Astrand-Ryhming cycle ergometer protocol. Our feasibility criteria addressed: i) recruitment potential, ii) retention rates, iii) pre-chemotherapy assessment potential, iv) test performance/tolerability, and v) identification and minimizing the influence of potentially confounding medication. T-tests and repeated measures ANOVAs were used to assess between- and within-group differences at baseline and follow-up. The overall success rate in achieving our feasibility criteria was 98.4 %. According to the CASS, there was evidence of ANS impairment at baseline in 30.8 % of patients, which persisted in 18.2 % of patients

  7. Stomach cancer screening in the adult health study population, Hiroshima, 1971--1972

    Energy Technology Data Exchange (ETDEWEB)

    Akiyama, M; Yamakido, M; Otake, M; Belsky, J L; Pastore, J O; Kawamoto, S; Okawa, T; Dock, D S

    1978-04-01

    Examinations for parietal cell antibody (PCA) were performed on 1334 subjects of the Adult Health Study (AHS), Hiroshima, during a 1-year period. Findings revealed PCA in 112 subjects (8.4%), but no difference in frequency was noted by sex. The positive rate was significantly higher in those age 50 or over. No correlation was noted between estimated A-bomb exposure dose and PCA frequency. PCA was found in 58 of the 502 cases presenting achlorhydria on tubeless gastric analysis, and particularly in the age 50 and over group, PCA was demonstrated in 43 of the 302 subjects presenting achlorhydria. PCA was detected in 11 of 152 subjects with low, serum pepsinogen levels and in 20 of 123 subjects with high levels. The frequency of positive PCA in subjects presenting achlorhydria and abnormal (low or high) serum pepsinogen levels was 19 in 100, higher than 7 in 106 in those subjects in whom gastric acidity and serum pepsinogen levels were both normal. The frequency of positive PCA was higher in patients diagnosed on upper gastrointestinal (GI) series as atrophic gastritis than in patients diagnosed as some other gastric disorder. PCA was negative in both of the two cases in whom a definite diagnosis of stomach cancer was established. However, in light of the finding of abnormal Diagnex Blue (DB) tests and positive PCA at a high frequency in the gastritis group and reports that gastritis provides the groundwork for stomach cancer, care should be taken in cases with findings of abnormal DB test, abnormal serum pepsinogen levels, and positive PCA.

  8. Development of a Colorectal Cancer Screening Intervention for Iranian Adults: Appling Intervention Mapping

    Science.gov (United States)

    Besharati, Fereshteh; Karimi-Shahanjarini, Akram; Hazavehei, Seyed Mohammad Mehdi; Bashirian, Saeid; Bagheri, Fahimeh; Faradmal, Javad

    2017-08-27

    Background: While the incidence rate of the colorectal cancer (CRC) has been increasing over the last three decades in Iran, very limited interventions to increase CRC screening have been developed for Iranian population. The purpose of this study was to describe the use of Intervention Mapping (IM) for applying theory and evidence and considering local contexts to develop a CRC screening program among adults in Iran. Materials and Methods: From April 2014 to July 2016 following the IM process, six steps were formulated and implemented. First a need assessment was conducted involving relevant stakeholders and using focus groups discussions (n=10), individual interviews (n=20), and a household survey (n= 480). Then a matrix of change objectives was developed for each behavioral outcome and theoretical methods and their practical applications were identified to guide intervention development and implementation. A multi-component intervention was developed and piloted. Decision on suitable parts of intervention was made based on feedback of pilot study. Finally, evaluation plan including process and outcome evaluation was generated and conducted to inform future scale up. Results: The needs assessment highlighted factors affecting CRC screening including knowledge, self efficacy, social support and perceived benefit and barriers (financial problems, fear of detection of cancer and etc). Results of needs assessment were used to develop next steps IM. The program utilized methods like information delivery, modeling, and persuasion. Practical applications included video presentation, group discussion, role playing and postcards.This program was assessed through a cluster-randomized controlled trial. Results showed that there were significant differences in CRC screening uptake between intervention groups and control (Pintervention addressing CRC screening among Iranian population. Creative Commons Attribution License

  9. Cultural factors associated with the intent to be screened for prostate cancer among adult men in a rural Kenyan community

    Directory of Open Access Journals (Sweden)

    Kinyao Mutua

    2017-11-01

    Full Text Available Abstract Background The aim of this study was to determine cultural factors associated with prostate cancer screening intent among adult Kenyan African men. Methods A cross-sectional quantitative study with an analytic design was carried out in a randomly selected sample of 155 adult men aged 25–98 years living in a rural community in Kenya. Constructs from the Theory of Planned Behaviour were used to guide this study. A 5 -point Likert scale was used to assess fatalistic beliefs, fear, perceived benefits, and family influence. A structured questionnaire was used to collect quantitative data at the household level. Results Only 2.4% of the study participants had been screened for prostate cancer. About 2/3rd (64% of the participants felt that they were at risk of getting prostate cancer; 44% intended to be screened within the following 6 months. Mean scores on a 5-point Likert scale indicated: strong beliefs in the benefits of prostate screening (4.2 (±SD .8, men aged over 40 were not perceived to be at risk of getting prostate cancer (1.3 ± .6, relatively high fatalistic beliefs of prostate cancer screening (3.6 (±SD .8, high degree of fear or apprehension of prostate cancer screening (3.2 (±SD 1.2, and a high level of influence of family members in prostate cancer screening (3.9 (±SD 1.0. The Wald criterion demonstrated that only family influence made a significant contribution to the intent to screen for prostate cancer (p = 0.031. Age, education, marital status, fatalism, fear, and benefit of screening were not associated with the intent to screen for prostate cancer. Conclusions Strong beliefs of the benefits of prostate screening tended to be surpassed by relatively high fatalistic beliefs and fear or apprehension in prostate cancer screening. The family plays an important role in influencing decision making related to prostate cancer screening in Africans.

  10. Using a community advisory board to develop a serious game for older adults undergoing treatment for cancer.

    Science.gov (United States)

    Loerzel, Victoria; Clochesy, John; Geddie, Patricia

    2018-02-01

    Older adults undergoing treatment for cancer are at risk for serious complications such as chemotherapy-induced nausea and vomiting (CINV). Older adults are often overwhelmed by information and under-manage cancer treatment-related side effects. New educational strategies such as serious gaming may help teach or reinforce key symptom self-management strategies. This paper describes how a community advisory board of older adults, their caregivers, and oncology nurses were consulted to develop a serious game for CINV. A formative evaluation process using a community advisory board (CAB) and a series of three focus groups were used to develop this serious game about managing CINV at home. The formative evaluation process and involvement of the CAB allowed researchers to learn about the experience of having CINV from an older adult perspective. Common themes related to CINV onset, severity and self-management formed the basis for the serious games' script and scenarios. Themes were validated and CAB members provided feedback on a game prototype. Feedback from CAB members indicated that the serious game was realistic and reflective of their CINV experience. Including older adults in the development of a serious game was instrumental in creating a relevant educational opportunity. Serious gaming should be considered as a way to add to the educational experiences of older adults as generic teaching methods may not address the needs of all age groups. Exploring for new ways to emphasize key points related to symptom management and prioritize learning may impact outcomes for older adults. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Differences in fatigue severity in a sample of adult cancer patients.

    Science.gov (United States)

    Gonzalez, Velda J; Tofthagen, Cindy S; Chen, Xusheng; Pedro, Elsa; Saligan, Leorey N

    2017-04-05

    To describe differences in fatigue severity in a sample of adult Puerto Rican patients during and postcancer treatments. Hispanics, including Puerto Ricans, are an understudied population who are under-represented in clinical trials, especially in symptom research. Although symptom management is a clinical priority in oncology care, treatment-related differences in Puerto Rican cancer patients' report of fatigue severity have not been well described. A cross-sectional survey was conducted from data of self-report of 138 Puerto Rican patients during and postcancer treatments at two ambulatory facilities located in San Juan, Puerto Rico. Fatigue severity was assessed using the Fatigue subscale from the Functional Assessment of Cancer Therapy-Fatigue quality of life questionnaire Spanish version. Differences in fatigue severity across type of treatment (radiation therapy, chemotherapy, combined radiation chemotherapy and post-treatment) were evaluated using nonparametric (Kruskal-Wallis and Mann-Whitney test) statistical tests. The majority of the participants had prostate (33%) and breast (32%) cancers and were receiving radiation therapy (43%) or chemotherapy (28%). The Kruskal-Wallis test showed that there was a statistically significant difference in fatigue scores between the different four treatment conditions, χ 2 (3) = 39.1, p = .001 with patients on combined radiation chemotherapy or chemotherapy alone experiencing more severe fatigue. Findings from the current study suggest that type of treatment is a key component of the symptom burden of fatigue among the Puerto Rican oncology population. Specially, patients receiving combined therapy or chemotherapy alone were at increased risk for experiencing severe fatigue, compared to radiation therapy and post-treatment patients. With the worldwide increase in migration of Puerto Rican families, nurses need to recognise that type of treatment is a key component of the symptom burden of fatigue among the Puerto

  12. The association between adult attained height and sitting height with mortality in the European prospective investigation into cancer and nutrition (EPIC)

    NARCIS (Netherlands)

    Sawada, Norie; Wark, Petra A.; Merritt, Melissa A.; Tsugane, Shoichiro; Ward, Heather A.; Rinaldi, Sabina; Weiderpass, Elisabete; Dartois, Laureen; His, Mathilde; Boutron-Ruault, Marie Christine; Turzanski-Fortner, Renée; Kaaks, Rudolf; Overvad, Kim; Redondo, María Luisa; Travier, Noemie; Molina-Portillo, Elena; Dorronsoro, Miren; Cirera, Lluis; Ardanaz, Eva; Perez-Cornago, Aurora; Trichopoulou, Antonia; Lagiou, Pagona; Valanou, Elissavet; Masala, Giovanna; Pala, Valeria; Peeters, Petra H M; Van Der Schouw, Yvonne T.; Melander, Olle; Manjer, Jonas; Silva, Marisa Da; Skeie, Guri; Tjønneland, Anne; Olsen, Anja; Gunter, Marc J.; Riboli, Elio; Cross, Amanda J.

    2017-01-01

    Adult height and sitting height may reflect genetic and environmental factors, including early life nutrition, physical and social environments. Previous studies have reported divergent associations for height and chronic disease mortality, with positive associations observed for cancer mortality

  13. Association between Adult Height and Risk of Colorectal, Lung, and Prostate Cancer : Results from Meta-analyses of Prospective Studies and Mendelian Randomization Analyses

    <