A survivorship program to improve quality of life of Hispanic/Latino breast cancer (BC) survivors.

Abstract

183 Background: We sought to determine whether Hispanic BC survivors in El Paso, TX would benefit from participating in a comprehensive multidisciplinary cancer survivorship program, by improvement of performance using the validated questionnaires: 1) Patient Health Questionnaire 9(PHQ9), 2) General Anxiety Disorder 7 (GAD 7), and SF36 Health related quality of life (HRQOL) questionnaires. Methods: After IRB approval, we recruited consecutive patients within the first 5 years post-diagnosis with Stages I-III BC and have completed active therapy. The program was staffed by an oncologist, a nurse practitioner, a nutritionist and a clinical psychologist. Survivors were seen every 3 months and questionnaires obtained. They were provided with a personalized treatment summary, dietary advices, in-depth one on one psychological assessment and interventions and an 8 week course based on Mindfulness Based Stress Reduction (MBSR). Results: 94 patients were recruited, 60 completed 12 months follow ups, and 33 completed 2 years follow ups. 91% were Hispanics. Mean age 55 years. 31% of participants were younger than 50 years. Stage 1 BC 38%, Stage 2 43% and stage 3 19%.75% received chemotherapy; and 74% received endocrine therapy. At baseline, PSC representing the mean for the SF-36 QOL Physical Health was 45.75, and the MSC for Mental Health was 43.7, both below the population norm (50.0). Mean scores for GAD7 was 7.3 and for PHQ9 7.62, both abnormal (< 5). At 12 months PSC 46.02, MSC 46.1, GAD7 was 4.92; and PHQ9 was 5. At 24 months, PSC 45.65; MSC 47.02; GAD7 4.88; and PHQ9 4.52. Patients older than 50 years who attended the MBSR courses showed the most improvement in MSC and PHQ scores. Conclusions: BC survivors, predominantly Hispanics, benefited from participating in this program with improved mental SF36- HRQOL, a significant and long - lasting improvement in anxiety and depression at 12months and 24 months. Future efforts should focus on programs targeting younger cancer survivors who did not appear to derive a significant benefit overall. Also, additional efforts are needed to address physical -health related quality of life in cancer survivorship programs by introducing, as an example, exercise and pain control interventions.