Cancer-related Side Effects Research Articles

Anti-cancerous effect of corn silk: a critical review on its mechanism of action and safety evaluation.

Cancer is a broad collection of diseases that can begin in almost any organ or tissue of the body. Corn silk is the hair-like stigmata of female maize flowers which is generally discarded as waste from maize cultivation. The current study targets the anti-cancer potential of corn silk and its bioactive compounds namely, polyphenols, flavonoids, and sterols. The polyphenols and flavonoids like quercetin, rutin, apigenin and beta-sitosterol are a range of compounds from corn silk which were investigated for their anticancer effect. Corn silk showed apoptotic and antiproliferative effects in cancer cells through different signalling pathways, essentially the serine/threonine kinases (Akt)/lipid kinases (PI3Ks) pathway. The study revealed that corn silk compounds target immune cell responses, induce cell cytotoxicity, and upregulate the expression of proapoptotic genes p53, p21, caspase 9, and caspase 3 in certain cancer cell lines including HeLa cervical cancer cells, MCF-7 breast cancer cells, PANC-02 pancreatic cancer cells and Caco-2 colon cancer cells. Flavonoids derived from corn silk enhance T cell mediated immune response and decrease inflammatory factors. Corn silk bioactive compounds were found to reduce the side effects of cancer therapy. Antioxidants of corn silk, quercetin and rutin help in reducing the nephrotoxicity of chemotherapeutic drugs. The study also suggests that corn silk has anti-cancerous potential as it targets tumour suppression and inhibits metastasis A dose of 500mg/kg body weight of corn silk has been found safe for human consumption. Corn silk extract can be used as a preventive or therapeutic step to cure cancer. The anti-cancer property, mechanism and role of corn silk in controlling cancer-related side effects have been critically reviewed providing new scope for the use of corn silk in cancer therapy.

Goals and goal perceptions in patients with advanced stage lung cancer: a mixed methods study

Goals provide insight into what is important to an individual. We describe the development and application of a mixed methods approach to elicit goals and perceptions about goals in patients with advanced cancer. Patients receiving first-line treatment for advanced lung cancer participated in semi-structured interviews about their goals. Participants self-generated goals, then selected and ranked their three most important goals and provided Likert scale ratings of goal-related perceptions (e.g., attainability, locus of control). Independent raters coded goals into content domains. One month later, participants reported perceived progress toward goals and facilitators of and barriers to progress. Participants (N = 75, Mage = 64.5years, 59% female) identified goals across eight domains: social/role/relationship, everyday/practical, leisure/pleasure, psychological/existential/spiritual, major life changes or achievements, cancer treatment response/disease outcomes, palliative outcomes, and behavioral health improvement. Of all goals identified (N = 352), 72% of patients had at least one social/role/relationship goal, 68% had a leisure/pleasure goal, and 29% had a cancer treatment response goal. On average, participants considered their goals to be attainable, perceived a high degree of control over reaching goals, anticipated making "some" progress in the short term, and perceived a high likelihood of reaching goals in the future. Facilitators of progress included mental fortitude, feeling physically well, and social support. Barriers included cancer-related side effects, practical challenges, and COVID-19. A majority of participant goals focused on meaningful engagement and living well. Goals were largely viewed as attainable and under participants' control. Cancer clinicians may consider how to support patients in working toward valued goals in conjunction with oncology care.

Abstract 3226: Sleep disruption among prostate cancer survivors by metastatic disease status

Abstract Introduction: Advances in cancer screening, diagnosis, and treatment have resulted in an increasing population of cancer survivors, many of whom experience persistent cancer-related side effects. Multiple studies have found that cancer survivors report poorer sleep than the general population. More than 3 million men in the US are prostate cancer survivors, yet few existing studies have focused on sleep in this population, especially among men with metastatic disease. Thus, a better understanding of sleep problems among prostate cancer survivors could help characterize how sleep affects the quality of life among men with prostate cancer. Aim: To describe sleep behaviors and problems among prostate cancer survivors overall and specifically among those with metastatic disease. Methods: Self-reported sleep data, including sleep disruption, sleep apnea, and insomnia, were obtained from the 2018 Prostate Cancer Follow-up Survey (PCFS) administered to participants of the Health Professionals Follow-Up Study with a diagnosis of prostate cancer. We evaluated each item individually and calculated a score for clinical insomnia using the validated Women’s Health Initiative Insomnia Rating Scale (range 1-20; score >10 indicative of clinically relevant insomnia). Descriptive analyses on sleep measures were conducted overall and stratified by metastatic disease. We utilized multivariable linear regression models to compare metastatic disease status and insomnia score, adjusting for age, race, body mass index, physical activity, smoking, and other health information. Results: Of 2,431 men (median age: 83 years) who completed the 2018 survey, 87 had metastatic disease, de novo or men who progressed after diagnosis. Sleep disturbances were relatively common in this population. Among all men with prostate cancer, 33% (n=290) reported waking up several times a night five or more times a week, 14% (n=337) rated their sleep quality as restless, and 15% (n=368) reported a clinical diagnosis with sleep apnea. The Insomnia Rating Scale scores were relatively high among all prostate cancer survivors with a mean score of 9.0 (95% CI 6.0-12.0). Scores significantly differed by metastatic disease status and men with metastatic disease had scores that were 1.30 (95% CI 0.19-2.41) points higher than men without metastatic disease. Conclusion: The growing global number of prostate cancer survivors with metastatic disease and the potentially high prevalence of negative cancer-related quality of life effects pose pressing challenges to health systems. Our findings suggest that sleep disturbances are common among prostate cancer survivors. Men with metastatic disease had poorer sleep overall and higher rates of clinical insomnia than men without metastatic disease. These results could highlight the importance of sleep among men with prostate cancer and could increase the clinical treatment of sleep problems. Citation Format: Alaina H. Shreves, Lorelei Mucci, Unnur Valdimarsdottir, Sarah Markt, Kathryn Penney. Sleep disruption among prostate cancer survivors by metastatic disease status [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 3226.

Breast Cancer Patients' Experiences with Online Group-Based Physical Exercise in a COVID-19 Context: A Focus Group Study.

In patients with breast cancer, physical exercise reduces the toxicity of treatment; however, this physical exercise must meet a set of criteria, such as being guided by knowledgeable instructors. Thus, the aim of this study was to explore the perceptions of female breast cancer patients regarding the impact of an online physical exercise programme in the context of the COVID-19 pandemic. Nineteen female breast cancer patients participated in four focus group interviews as part of a qualitative study using a thematic analysis between December 2020 and May 2021. Three major themes emerged: “Experiences and perceptions of online physical exercise with breast cancer”; “Incorporating exercise-based activity for cancer-related side effects”; and “Increasing self-esteem and empowerment”. Online, live-streamed, and supervised group activities help breast cancer patients engage and prevent the recurrence of cancer-related side effects, as well as to control COVID-19-related fear and provide an alternative to promote mental health-related quality of life.

Lifestyle and Pain following Cancer: State-of-the-Art and Future Directions.

This review discusses chronic pain, multiple modifiable lifestyle factors, such as stress, insomnia, diet, obesity, smoking, alcohol consumption and physical activity, and the relationship between these lifestyle factors and pain after cancer. Chronic pain is known to be a common consequence of cancer treatments, which considerably impacts cancer survivors’ quality of life when it remains untreated. Improvements in lifestyle behaviour are known to reduce mortality, comorbid conditions (i.e., cardiovascular diseases, other cancer, and recurrence) and cancer-related side-effects (i.e., fatigue and psychological issues). An inadequate stress response plays an important role in dysregulating the body’s autonomic, endocrine, and immune responses, creating a problematic back loop with pain. Next, given the high vulnerability of cancer survivors to insomnia, addressing and treating those sleep problems should be another target in pain management due to its capacity to increase hyperalgesia. Furthermore, adherence to a healthy diet holds great anti-inflammatory potential for relieving pain after cancer. Additionally, a healthy diet might go hand in hand with weight reduction in the case of obesity. Consuming alcohol and smoking have an acute analgesic effect in the short-term, with evidence lacking in the long-term. However, this acute effect is outweighed by other harms on cancer survivors’ general health. Last, informing patients about the benefits of an active lifestyle and reducing a sedentary lifestyle after cancer treatment must be emphasised when considering the proven benefits of physical activity in this population. A multimodal approach addressing all relevant lifestyle factors together seems appropriate for managing comorbid conditions, side-effects, and chronic pain after cancer. Further research is needed to evaluate whether modifiable lifestyle factors have a beneficial influence on chronic pain among cancer survivors.

De novo Metastatic Breast Cancer Arising in Young Women: Review of the Current Evidence

Women with metastatic breast cancer remains a heterogeneous group of patients with different prognostic outcomes and therapeutic needs. Young women with de novo metastatic breast cancer (dnMBC) represent a peculiar population with respect to tumor biology, prognosis, clinical management and survivorship issues. Overall, these patients are able to attain long-term survival with a proper management of both primary tumor and distant metastases. On the other hand, they are also at higher risk of experiencing a deterioration in their quality of life (QoL) due to primary cancer-related side effects. Young women are also likely to harbor germline pathogenic variants in cancer predisposition genes which could affect treatment decisions and have a direct impact on the lives of patients’ relatives. The loco-regional management of the primary tumor represents another thorny subject, as the surgical approach has shown controversial effects on the survival and the QoL of these patients.This review aims to provide an update on these issues to better inform the clinical management of dnMBC in young women.

Safety, Precautions, and Modalities in Cancer Rehabilitation: an Updated Review.

Purpose of ReviewProviding rehabilitation to patients with cancer can be challenging due to the medical complexity associated with the illness and its treatments. This article provides the reader with a summary of frequently encountered medical conditions in the cancer population and associated safety considerations and precautions. An update on treatment modalities commonly used for symptom management is also presented.Recent FindingsCancer and cancer treatments can cause changes in multiple organ systems. Special considerations and precautions are necessary to provide safe and effective rehabilitation. Physical modalities can be used as monotherapy or adjunct to treatment for common cancer-related side effects with recent studies noting benefit with a variety of modalities.SummaryDetailed assessment of the cancer patient is necessary before implementing a rehabilitation program. Understanding cancer and side effects of treatments, including newer options, are necessary to provide safe care.

Acupuncture as a Complementary Therapy for Cancer Care: Acceptability and Preferences of Patients and Informal Caregivers

Acupuncture can effectively manage cancer-related side effects, for both patients undergoing treatment and for cancer survivors. It may also be effective in managing physiological and psychological symptoms common among informal caregivers of cancer patients. The aim of this survey was to explore the acceptability and preferences of cancer patients, cancer survivors, and their informal caregivers in relation to acupuncture. The survey was conducted from 20th November to 27th November 2018. The questionnaire was developed to explore acceptability and preferences, including motivation, symptoms to be addressed, and practical issues (location, cost, etc.), in relation to acupuncture. The survey response rate was 94.5% in cancer patients and cancer survivors and 100% in caregivers. Acceptability of acupuncture was 34.5% (n = 40/116) and 48.0% (n = 26/54) in cancer patients and caregivers, respectively. About 52.5% (n = 21/40) of patients preferred to undergo acupuncture at the day center clinic, whereas caregivers had no specific preference. Patients and cancer survivors would use acupuncture for symptoms of fatigue (60%), listlessness (57.5%), and pain (47.5%). Informal caregivers expressed an interest in using acupuncture for their pain, stress, and sleeping difficulties 48.0% (n = 26/54). Cancer patients, cancer survivors, and informal caregivers would accept acupuncture as a complementary therapy. This openness and preference to acupuncture provide the foundations for this complementary therapy to be incorporated into holistic and supportive cancer care, both for patients and those supporting them.

The Molecular Targets of Cannabinoids in the Treatment of Cancer and Inflammation.

In this review, we discuss the emerging evidence for the effectiveness of cannabinoids in the treatment of cancer and inflammation. The remarkable effects of this study will help in supporting the traditional evidence for their successful application in the treatment of pain and cancer-related side effects. We searched Pub Med (132 articles) and Google scholar (9 articles) databases and gathered the clinical (4 articles), and preclinical (28 articles) studies, reports on cell culture models (30 articles), and other original and review articles (78 articles) related to inflammation, cancer, and cannabinoids. Cannabinoids are described in three different forms, comprising endo- phyto- and synthetic compounds that exert biological effects. The molecular and cellular pathways of endogenous cannabinoids in the maintenance of homeostasis are well documented. In addition to classical cannabinoid receptors type 1 and 2, Vanilloid receptors and G protein-coupled receptor 55 were identified as common receptors. Subsequently, the effectiveness of phyto- and synthetic cannabinoids mediated by cannabinoid receptors has been demonstrated in the treatment of inflammatory diseases, including neurodegenerative diseases as well as gastrointestinal and respiratory inflammations. Another accepted property of cannabinoids is their anti-cancer effects. Cannabinoids were found to be effective in the treatment of lung, colorectal, prostate, breast, pancreas, and hepatic cancers. The anti-cancer effects of cannabinoids were characterized by their anti-proliferative property, inhibition of cancer cell migration, suppression of vascularization, and induction of apoptosis. The current review provides an overview of the role of the endocannabinoid system in the mediation of physiological functions and the type and expression of cannabinoids receptors under physiological and pathological conditions. In addition, the molecular pathways involved in the effects of cannabinoids and the effectiveness of cannabinoids in the treatment of inflammations and cancers are highlighted.

Focus on Multi-targeted Role of Curcumin: a Boon in Therapeutic Paradigm.

Curcumin is a polyphenolic compound that exhibited good anticancer potential against different types of cancers through its multi-targeted effect like the termination of cell proliferation, inflammation, angiogenesis, and metastasis, thereby acting as antiproliferative and cytotoxic in nature. The present review surveys the various drug combination tried with curcumin or its synthetic analogues and also the mechanism by which curcumin potentiates the effect of almost every drug. In addition, this article also focuses on aromatherapy which is gaining much popularity in cancer patients. After thoroughly studying several articles on combination therapy of curcumin through authenticated book chapters, websites, research, and review articles available at PubMed, ScienceDirect, etc., it has been observed that multi-targeted curcumin possess enormous anticancer potential and, with whatever drug it is given in combination, has always resulted in enhanced effect with reduced dose as well as side effects. It is also capable enough in overcoming the problem of chemoresistance. Besides this, aromatherapy also proved its potency in reducing cancer-related side effects. Combining all the factors together, we can conclude that combination therapy of drugs with curcumin should be explored extensively. In addition, aromatherapy can be used as an adjuvant or supplementary therapy to reduce the cancer complications in patients.

1812MO Effects of oncologic rehabilitation during adjuvant endocrine therapy in overweight or obese patients with breast cancer

Treatment with adjuvant endocrine therapy (ET) in patients with breast cancer (BC) increases the risk of becoming less physically active and weight gain. A high body mass index (BMI) and physical inactivity are both independently associated with a higher risk of cancer-related side-effects and mortality. Effects of oncologic rehabilitation on physical activity (PA) in this specific patient population is unknown. This study investigated whether oncologic rehabilitation increased PA in patients receiving adjuvant ET for BC.

“Taylor-Made Qi Gong Approach”, A Pilot Study Controlled for Patient in Integrative Oncology Therapy: Evaluation of Time Result and/or Efficacy of “Taylor-Made Qi Gong Approach” (TMQG) than “Not Taylor-Made One (NTMQG)” on Patients with Cancer Undergoing Chemotherapy or in Follow Up – A Preliminary Perspective

Qi Gong, like an ancient form of health maintenance of Traditional China Medicine, is applied to effectively give an integrative support on patients with cancer. The diagnosis and treatment of cancer are associated with significant changes in quality of life (QOL) and side effects. The effects of Qi Gong in treating common cancer-related side effects, including nausea, pain, fatigue, anxiety, inflammation, depressive symptoms and improving overall QOL are confirmed in literature [1-5]. Qi Gong includes many techniques (e.g. self-massages, movements, meditations, breath controlling and mindfulness) and managing physical body, breath and mind (consciousness). Most include more forms, “Family-styles” and only very few are able to combine significantly “body-breath-mind”. Furthermore, only for 2 or 3 are available an Evidence Base Medicine-track records. Actually, the efficacy of Qi Gong is currently achievable in long/med time and depends on: i) time-training, especially homely, ii) correct sequence and iii) steadiness.

Physical exercise effects on metastasis: a systematic review and meta-analysis in animal cancer models.

Physical exercise is considered a well-tolerated adjuvant therapy to mitigate cancer-related side effects, but its impact on metastasis is unclear. The present systematic review and meta-analysis aimed to summarize the evidence on the effects of exercise on metastasis in animal cancer models. A systematic search was conducted to identify controlled studies in animals analyzing the impact of exercise interventions on any marker of metastasis incidence or severity. The pooled mean differences (PMD) were calculated for those endpoints for which a minimum of three studies used the same assessment method. We also calculated the pooled odds ratio (OR) of metastases. Twenty-six articles were included in the systematic review, of which 12 could be meta-analyzed. Exercise training in murine cancer models did not significantly modify the number of metastatic foci (PMD = - 3.18; 95% confidence interval [CI] - 8.32, 1.97; p = 0.23), the weight of metastatic tumors (PMD = - 0.03; 95% CI - 0.10, 0.04; p = 0.41), or the risk of developing metastasis (OR = 0.64; 95% CI 0.10, 4.12; p = 0.64). These findings suggest that exercise has no overall influence on any marker of cancer metastasis incidence or severity in animal models. However, the wide methodological heterogeneity observed between studies might be taken into account and the potential exercise effects on metastasis development remain to be determined in pediatric tumors.

Pre-radiotherapy daily exercise training in non-small cell lung cancer: A feasibility study.

To examine the feasibility of an individual, supervised, structured moderate-to-high intensity cycle ergometer exercise training immediately before radiotherapy in patients undergoing concomitant chemoradiotherapy for locally advanced non-small cell lung cancer (NSCLC). Lung cancer is the most common form of cancer. Despite significant advancements in therapy and supportive care it is still the leading cause of cancer-related death worldwide. Randomized controlled study design; patients with NSCLC receiving concomitant chemoradiotherapy were recruited and randomly assigned to either the exercise (EXE) or the control (CON) group. Exercise training consisted of 20min moderate-to-high intensity aerobic interval training 5 times per week (Mon-Fri) prior to radiotherapy. Secondary outcomes were assessed at baseline and after 7 weeks: peak oxygen consumption (VO2peak), functional capacity (6MWD), pulmonary function (FEV1), psychosocial parameters (quality of life (FACT-L), anxiety and depression (HADS)) and cancer-related side effects (reported daily). Fifteen patients were included. All patients completed a baseline test, while 13 patients were eligible for a posttest. The recruiting rate was 44.1% and the overall attendance rate to exercise was 90.0% with an adherence rate to full exercise participation of 88.1%. No adverse events or any unexpected reactions were observed during the exercise sessions. No significant differences were observed within or between groups from baseline to post intervention in any of the secondary outcomes. This study demonstrated 'proof of principle' that daily moderate-to-high intensity cycle ergometer exercise was feasible, safe and well tolerated among newly diagnosed patients with locally advanced NSCLC undergoing concomitant chemoradiotherapy. Larger randomized controlled trials are warranted.

A review of home-based physical activity interventions for breast cancer survivors.

As breast cancer relative survival continues to increase, many breast cancer patients face many issues, including recurrence of cancer and cancer-related side effects that impact several aspects of their quality of life. With breast cancer patients living longer, there is more of a concern for negative breast cancer outcomes. Although physical activity is an affordable and relatively convenient way to improve breast cancer outcomes, only about one-third of breast cancer survivors engage in the recommended level of physical activity. This article reviews articles published to date to examine whether home-based physical activity interventions are effective in improving physical activity and other outcomes among breast cancer survivors who have completed primary therapy for the disease. The present review is based upon bibliographic searches in PubMed and CINAHL and relevant search terms. Articles published in English from 1980 through February 28, 2019 were identified. A total of 360 article citations were identified in PubMed and non-duplicates in CINAHL. After screening the abstracts or full texts of these articles and reviewing the references of previous review articles, 20 studies that met the eligibility criteria. Three of the studies were pre-/post-test trials and 17 were randomized controlled trials. home-based exercise programs are effective in improving physical activity among breast cancer survivors who have completed primary therapy for the disease. Home-based exercise programs such as walking programs offer a convenient and affordable option for women who wish to increase their physical activity and maintain a healthy lifestyle.

Protocol for the \u201cChemobrain in Motion \u2013 study\u201d (CIM \u2013 study): a randomized placebo-controlled trial of the impact of a high-intensity interval endurance training on cancer related cognitive impairments in women with breast cancer receiving first-line chemotherapy

BackgroundUp to 80% of breast cancer patients suffer from Cancer Related Cognitive Impairments (CRCI). Exercise is suggested as a potential supportive care option to reduce cognitive decline in cancer patients. This study will investigate the effects of a high-intensity interval endurance training (HIIT) on CRCI in breast cancer patients. Potentially underlying immunological and neurobiological mechanisms, as well as effects on patients’ self-perceived cognitive functioning and common cancer related side-effects, will be explored.MethodsA single-blinded randomized controlled trial will be carried out. The impact of HIIT on CRCI will be compared to that of a placebo-intervention (supervised myofascial release training). Both interventions will be conducted simultaneously with the patients’ first-line chemotherapy treatment typically lasting 12–18 weeks. Fifty-nine women with breast cancer will be included in each of the two groups. The study is powered to detect (α = .05, β = .2) a medium effect size difference between the two groups (d = .5) in terms of patients’ change in cognitive testing performances, from baseline until the end of the exercise-intervention. The cognitive test battery, recommended by the International Cancer and Cognition Task Force to assess CRCI, will be used as primary measure. This includes the Hopkins Verbal Learning Test (learning/verbal memory), the Controlled Oral Word Association Test (verbal fluency) and the Trail-Making-Test A/B (attention/set-switching). The following endpoints will be assessed as secondary measures: Go-/No-Go test performance (response inhibition), self-perceived cognitive functioning, serum levels of pro- and antiinflammatory markers (tumor necrosis factor alpha, Interleukin-6, Interleukin-1 alpha, Interleukin-1 beta, C-reactive protein, Interleukin-1 receptor antagonist and Interleukin-10), serum levels of neurotrophic and growth factors (brain-derived neurotrophic factor, insulin-like growth factor 1 and vascular endothelial growth factor), as well as common cancer-related side effects (decrease in physical capacity, fatigue, anxiety and depression, sleep disturbances, quality of life and chemotherapy compliance).DiscussionThis study will provide data on the question whether HIIT is an effective supportive therapy that alleviates CRCI in breast cancer patients. Moreover, the present study will help shed light on the underlying mechanisms of potential CRCI improving effects of exercise in breast cancer patients.Trial registrationDRKS.de, German Clinical Trials Register (DRKS), ID: DRKS00011390, Registered on 17 January 2018.

Translating Research into Community Practice: The Healthy Living after Cancer Partnership Project.

There is now considerable evidence for physical activity and,increasingly, for weight control interventions in survivors of themore prevalent cancers, especially breast cancer. However, inAustralia, as in most developed countries, such interventions are notincorporated into routine cancer care. The Healthy Living afterCancer (HLaC) project seeks to bridge this evidence-to-practicedivide. HLaC is an Australian National Health & Medical ResearchCouncil-funded Partnership Project involving collaboration betweenuniversity cancer researchers and four state-based Cancer Councils(cancer control advocacy and support organizations similar to theAmerican Cancer Society). The HLaC project, conducted from 2015to 2019, is evaluating the implementation of an evidence-based,6-month, telephone-delivered program targeting physical activity,healthy eating, and weight control among cancer survivors (of anycancer type following treatment with curative intent). The programis offered by the Cancer Councils free of charge via their telephone-based cancer support and information service. Cancer survivors canself-refer or be referred by a treating health professional. Screening,pre- and post-program assessment, and program delivery are all implemented by Cancer Council staff and nurses.In this phase IV dissemination and implementation study (single-group, pre-post design with assessments at baseline and 6 months)(1), primary outcomes relate to program implementation: adoption(referral sources), reach (number of participants) and retention, fidelity of implementation, participant and staff satisfaction, and fixed and recurrent costs of program delivery. Secondary outcomes are patient-reported and validated measures of physical activity and dietary intake/behavior, weight, quality of life, cancer-related side-effects, and fear of recurrence.To date, over 500 cancer survivors have been referred, with 89%screened as eligible and 91% consenting. Among the first 440 to complete the pre-program assessment, 88% were female (most with breast cancer); mean age was 55 years (SD 5 11); with meanBMI 5 29 kg/m2(SD 5 6). Among the first nearly 200 program completers (57% completion rate), significant (P < 0.05) and clinically meaningful improvements have been seen in all secondary patient-reported outcomes.This University-Cancer Council collaboration provides an opportunity for national dissemination of an evidence-based intervention to support healthy living among cancer survivors. Preliminary analysis of service-level outcomes suggests the program is feasible to deliver,with analysis of patient-reported outcomes showing it produces improvements in outcomes important to patients, clinicians, and public health. The end-of-program evaluation, including economic analysis, will provide the practice-based evidence needed to inform decisions regarding program sustainability.

Mind-Body Therapies in Cancer: What Is the Latest Evidence?

Many people living with cancer use complementary therapies, and some of the most popular are mind-body therapies (MBTs), including relaxation and imagery, hypnosis, yoga, meditation, tai chi and qigong, and art therapies. The efficacy of these modalities was reviewed by assessing recent findings in the context of cancer care. These therapies show efficacy in treating common cancer-related side effects, including nausea and vomiting, pain, fatigue, anxiety, depressive symptoms and improving overall quality of life. Some also have effects on biomarkers such as immune function and stress hormones. Overall studies lack large sample sizes and active comparison groups. Common issues around clearly defining treatments including standardizing treatment components, dose, intensity, duration and training of providers make generalization across studies difficult. MBTs in cancer care show great promise and evidence of efficacy for treating many common symptoms. Future studies should investigate more diverse cancer populations using standardized treatment protocols and directly compare various MBTs to one another.

Cancer-related side effects and diabetes self-management.

152 Background: Cancer survivors often experience cancer and treatment-related side effects and may also have comorbidities that may further impact their quality of life. Little is known about how cancer-related side effects and health status impact survivors’ beliefs and management of comorbidities. We undertook this study to assess the relationship between cancer-related side effects and diabetes (DM) self-management behaviors (SMB) and beliefs in cancer survivors with comorbid diabetes. Methods: We recruited diabetes patients recently diagnosed with early-stage breast or prostate cancer who were taking at least one oral hypoglycemic agent. Side effects for prostate cancer survivors were assessed using the Expanded Prostate Cancer Index Composite; side effects for breast cancer survivors were assessed using a standardized questionnaire for hormonal therapy-related side effects. Patients were asked to rate their overall health status and about the perceived impact of cancer treatment on DM. We measured DM medication adherence using the 8-item Morisky Medication Adherence Scale, and DM SMB were evaluated using the Summary of Diabetes Self-Care Activities. Descriptive and univariate analyses were used to assess factors associated with DM SMB. Results: Of the 52 patients recruited, 32 (62%) were male. Twenty-four (46%) patients reported cancer or treatment related side effects, with most (21, 88%) being moderately or severely bothered by these symptoms. Of these patients, 20 (83%) reported non-adherence to their DM medications and 18 (71%) reported checking their fingersticks &lt; 5 times a week. Yet most patients (20, 84%) felt that their diabetes care was at least equally as important as their cancer care. Neither the presence nor severity of side effects was associated with DM SMB. However, patients who reported poorer overall health status were more likely to be worried about the impact of cancer treatment on diabetes management (75% vs. 25%, p &lt; 0.01). Conclusions: Many cancer survivors report moderate to severe treatment-related side effects, although severity of side effects was not found to be associated with DM SMB. Further effort should focus on addressing survivors’ concerns about the impact of cancer treatment on comorbid disease management.

Quality of life and disease understanding: impact of attending a patient-centered cancer symposium.

To evaluate the impact of a patient-centered symposium as an educational intervention on a broad population of cancer patients. We developed a comprehensive patient symposium. Through voluntary questionnaires, we studied the impact of this cancer symposium on quality of life, cancer-specific knowledge, and symptom management among cancer patients. Symposium attendees were provided surveys prior to and 3 months following the educational intervention. Surveys included (1) EORTC-QLQ-C30; (2) disease understanding tool developed for this conference; (3) validated disease-specific questionnaires. Changes over time were assessed using McNemar's tests and paired t-tests for categorical and continuous variables, respectively. A total of 158 attendees completed the pre-convention survey. Most respondents reported at least “quite a bit” of understanding regarding treatment options, screening modalities, symptomatology, and cancer-related side effects. Attendees endorsed the least understanding of disease-related stress, risk factors, fatigue management, and legal issues related to disease/treatment. At 3 months, there was improvement in understanding (12 of 14 areas of self-reported knowledge especially regarding nutrition, and stress/fatigue management). However, no significant change was seen in QLQ-C30 functioning, fatigue, pain, or insomnia. A patient symposium, as an educational intervention improves a solid knowledge base amongst attendees regarding their disease, increases knowledge in symptom management, but may be insufficient to impact QoL as a single intervention.