Experiences Of Cancer Survivors Research Articles

Feasibility Trial of an Online Expressive Writing Intervention for Young Adult Cancer Survivors.

Purpose: Many young adult (YA) breast cancer survivors (BCS) experience psychosocial distress during and after treatment, but do not utilize supportive care resources to maximize their health outcomes. The purpose of this pilot study was to test the feasibility and acceptability of a brief, internet-based expressive writing (EW) intervention intended to improve psychosocial health among YA BCS. Methods: Thirty YA BCS were remotely recruited via a hospital patient database and randomly assigned to the EW (n = 20) or neutral writing (n = 10) group. The EW intervention included delivery of positive messages and a weekly 30-minute EW activity for 3 weeks. Feasibility, acceptability, patient-reported satisfaction, and health outcomes were evaluated at baseline and 1-month follow-up. Results: The database-focused recruitment strategies (40% response) appeared to be feasible. Almost all (93%) participants adhered to at least one writing task and 67% to at least two writing tasks. Participants perceived the study as enjoyable and helpful for reducing stress. The difference in QOL of the intervention versus control group was medium to large (d = 0.73). Conclusion: This is the first study to test the feasibility of an internet-based EW for YA BCS. The online EW pilot intervention demonstrated evidence of feasibility and acceptability to YA BCS; its potential to improve health outcomes should be evaluated in an adequately powered prospective randomized controlled trial (RCT). Online EW may be offered to YA BCS in low-resource settings to address their unique physical and psychological challenges.

Beyond breast cancer: An exploration of the experiences of middle-aged female breast cancer survivors in Australia

ObjectivesMiddle-aged women (i.e., aged 40–65 years) who live with, through and beyond breast cancer (survivors) are an under-researched population, particularly within an Australian context. The unmet needs reported within this population include fatigue, psychological distress, body image concerns, early-onset menopause, and a lack of information on these issues. This study explores how the experiences of breast cancer survivorship impact the lives of Australian middle-aged women. Study designQualitative analysis of written comments in an open text field of a survey completed by 644 women reporting breast cancer in the middle-aged cohort of the Australian Longitudinal Study of Women's Health gathered between 1996 and 2013. Data was collected from any participants who reported breast cancer in any survey. Researchers conducted a thematic analysis using consensus coding on data and identified key themes. Main outcome measuresAny data where participants described their experiences of breast cancer survivorship. ResultsThis cohort reported a unique experience of breast cancer survivorship due to their age group. Analysis developed the following themes: the middle-aged context of breast cancer; care and support, body changes, overcoming fears and maintaining balance; and finding a ‘new normal’. ConclusionsBreast cancer survivorship is a diverse experience. For many it involves chronic limitations and challenges. Investigation and application of survivorship care plans in Australia could benefit breast cancer survivors by including multidisciplinary health professionals in their care. Unmet needs and psychological distress were described by participants rather than biomedical concerns. Further recommendations include development of online support groups providing access to rehabilitation professionals, especially for otherwise isolated rural women.

A scoping review capturing financial experiences of cancer survivors: Are we on the same page?

348 Background: There is great variation in how post-treatment financial consequences have been conceptualized and measured. This scoping review characterized the terms and measures used to capture the financial experiences of post-treatment cancer survivors. Methods: Reported according to PRISMA-ScR, electronic searches for published literature were conducted using Ovid MEDLINE, Embase.com, Web of Science Core Collection, Cochrane Central via Ovid, and ClinicalTrials.gov in March 2024. Eligible articles were U.S.-based empirical studies conducted with adult (≥18 years) cancer survivors (≥ 6 months post-treatment). Studies were managed using Covidence systematic review software. Results: Two coders screened 2452 titles and abstracts; 502 met inclusion criteria. Initial full-text review identified 127 articles for co-investigator assessment. Each article was evaluated for eligibility and quality by two investigators; 84 met criteria. Many terms were used, including financial hardship, burden, toxicity, stress/distress, worry, problems, impact, economic burden, difficulty, strain, and perceived financial security. Financial hardship and burden were most prevalent and often used interchangeably, categorized within material, psychological, and behavioral domains. Financial stress/distress , and financial worry , were consistently conceived as the psychological aspect of financial burden/hardship. Financial problems , strain , difficulty , impact , and economic burden were mainly measured using items pertaining to material/behavioral domains of financial consequences. Financial toxicity typically described the totality of effect of direct and indirect costs of cancer/treatment on one’s quality of life. Terms and definitions likely differed due to wide variation in the measures used; 47 measures were used. The most common tools included items from the Medical Expenditure Panel Survey Experiences with Cancer Survivorship Supplement (N= 20), the Comprehensive Score for Financial Toxicity (N= 13), and the National Health Interview Survey (N= 11). Conclusions: Findings suggest a general lack of consensus regarding the conceptualization and measurement of the financial experiences of cancer survivors. Financial hardship and burden were often used interchangeably, with financial toxicity capturing the greater encompassing effect of financial consequences of cancer. Future work is needed to arrive at a consensus that distinguishes between these critical outcomes.

“You Can’t Influence Illness, But You Can Influence Everything Else”: Women’s Diverse Experiences of Important Resilience Aspects in the Context of Breast Cancer

Resilience comprises positive adaptation to stress and has been extensively studied in the context of breast cancer. Nevertheless, specific experiences of breast cancer survivors in relation to resilience are unknown. The aim of this study was to explore the diverse experiences of important resilience aspects in breast cancer survivors. We conducted semi-structured interviews with 25 breast cancer survivors residing in Sweden. We used thematic analysis to analyze the data. We identified three themes relevant for resilience, each containing several subthemes: “I will try to keep the spirits up”: Struggling with agency in the face of uncontrollability, “You know that you are not alone”: Social support and collective survivorship for better and for worse, and “I try to leave that behind me”: Conceptualizing cancer as a closed chapter or a constant. Thus, having agency in relation to one’s thoughts, feelings, treatment, health, and daily functioning, having support from others, and conceptualizing breast cancer as a closed chapter were interpreted as important aspects of resilience.

What's in a pledge? A qualitative analysis of a global public marketing campaign to support cancer survivors at work.

212 Background: Employment provides both integral psychological and financial benefits to cancer survivors and their caregivers. Yet cancer survivors often face employment disruptions, leading to worse financial hardship and deteriorated quality of life. In 2023, an advertising and public relations company launched the “Working with Cancer” global initiative, calling on companies across the globe to reduce the stigma of cancer in the workplace by pledging their commitment to building the most open, supportive and “recovery-forward” work cultures for their employees. This study examines the company pledges made in the “Working with Cancer” campaign. Methods: We performed a cross-sectional, qualitative analysis of Working with Cancer campaigns for companies. In January 2024, we identified all campaigns through web scraping. Data from a total of 1,151 employer campaign pledges were extracted, and we recorded several variables including the company location, business sector, number of employees, the pledge signer and title/role, and the action/pledge the company stated they will take to support cancer survivors at work. Campaign pledges were imported into ATLAS.ti where we performed a content analysis. Results: We collected 1,151 company campaigns in total, 46 of which (4%) were Fortune 500 companies. Of the Fortune 500 companies (n=46), themes described the commitment to taking care of employees including the offering of comprehensive benefits including include paid leave for both patients and caregivers, guaranteed pay, and mental wellbeing support. Several companies described specific initiatives their organization provided, and many described how reducing the stigma of cancer at work required an open dialogue between all employees in an organization. In addition, companies pledged to know their own specific policies, make their employees aware of their commitment, and track their progress in improving the work experiences of cancer survivors. Conclusions: Employers play a significant role in the healthcare decisions made by employees, and are increasingly responsible for determining health plan benefits, providing resources and navigating care, and otherwise supporting employees as they navigate the complexities of a healthcare system. This global initiative provides a unique opportunity to identify issues related to working with cancer, and intervene at the employer level. More research is needed on employer-led initiatives to improve employment outcomes in cancer survivors and caregivers.

"We don't do any of these things because we are a death-denying culture": Sociocultural perspectives of Black and Latinx cancer caregivers.

Cancer is an enormous public health burden among Black and Latinx cancer survivors, and they are at risk of facing barriers to accessing cancer treatment and support in the United States. This study explored the unique challenges and experiences faced by Black and Latinx cancer survivors through the lens of their caregivers, including the specific cultural, social, and systemic factors that influence cancer survivorship experience and quality of life within these communities in the United States. We used a qualitative descriptive design for the study, and conducted 6 focus group discussions (3 Latinx and 3 Black groups) with a total of 33 caregivers of cancer survivors, (Mean age = 63 years). Data were analyzed using inductive content analysis. We identified 3 main themes: (1) families as (un)stressors in survivorship such as the vitality of social connections and families as unintended burden; (2) responses after diagnosis specifically whether to conceal or accept a diagnosis, and (3) experiencing health care barriers including communication gaps, biased prioritizing of care, and issues of power, trust, and need for stewardship. The findings align with previous research, highlighting the complex interplay between cultural, familial, and healthcare factors in cancer survivorship experiences within underserved communities. The study reiterates the need for culturally tailored emotional, physical, financial, and informational support for survivors and their caregivers. Also, to improve quality of life, the study highlights a need to strengthen mental health and coping strategies, to help address psychological distress and improve resilience among survivors and their caregivers.

Abstract B144: Conceptual framework on health behaviors and experiences of Sub-Saharan African immigrant prostate cancer survivors

Abstract Background: Sub-Saharan African immigrants (SSAI) in the United States (US) constitute one of the fastest-growing segments of the immigrant population. Between 2010 and 2018, the SSAI population in the US increased by 53%, significantly outpacing the 12% growth rate for the overall foreign-born population in the US during that period. We define SSAI as the 2 million individuals living in the US originally from the region of the African continent located south of the Saharan desert. Despite their growing numbers, little is published about the extent to which SSAI adapt to health behaviors more common in the US or remain immersed in the values, beliefs, and practices reflective of their country of origin. Importantly, no study has comprehensively examined the social determinants of health factors among this population and its influence on health-seeking behaviors and decision-making regarding prostate cancer care and treatment. Aim: This study seeks to better understand the lived experiences, unmet needs and the impact of migration on the quality of life of SSAI cancer survivors in the US. Methods. We employ a qualitative approach guided by grounded theory. Selective sampling was used to identify potential participants from a database obtained via the Florida and Minesota cancer registries. We proceeded to conduct in-depth interviews with 16 cancer survivors recruited from the two caner registries. Results. We developed a conceptual framework illuminating the full range of social, behavioral, environmental, and structural factors associated with the experiences of SSAI prostate cancer survivors. From the data, the post diagnosis experiences of study participants can be categorized into three domains: 1) health behaviors; 2) treatment decision and antecedents; 3) challenges of being an immigrant. Characteristics of health behaviors include using informal care teams for social support and second opinions before treatment. Selective disclosure of diagnosis, changes to diet, exercise and searching for information about the diseases were other manifestation of behavior. While some participants made decisions about treatment soon after diagnosis, others took a more deliberative approach and relied on faith and family for social support. Some challenges in terms of being an immigrant include knowledge gaps about the US health system, lack of health insurance and transportation to hospital during treatment. Implication for public health practice. Some of the unmet needs of study participants include transportation cost to and from hospital for radiotherapy and other treatment and reducing the high out of pocket cost for co-payment and drugs. The knowledge deficit about navigating the US health system can be addressed through community-based intervention in partnerships with immigrant groups, advocacy organizations and faith-based organizations. The focus of this intervention should be to educate and empower SSAI men on how to navigate the US health system and be more assertive about their health needs and desires for treatment during doctor’s visit. Citation Format: Ernie Kaninjing, Gladys Asiedu, Kaitlin Van Voorhis, Daniel Lee, Rakinya Hinson, Mary Ellen Young. Conceptual framework on health behaviors and experiences of Sub-Saharan African immigrant prostate cancer survivors [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B144.

Abstract B083: Community-based knowledge-to-action translation to improve early detection of prostate cancer among Black individuals

Abstract Introduction: Black individuals have 70-80% higher incidence and 120% higher mortality from prostate cancer when compared to all other groups in the US. This is the largest racial disparity in cancer-related mortality in the US and has persisted over the last five decades despite improvements in the diagnosis and treatment of prostate cancer. Our previous work demonstrated that intensified screening practices could reduce prostate cancer mortality among Black individuals. Challenges impede the translation of these findings into real-world interventions and practices. The objective of this study was to design a patient-centered and culturally tailored knowledge toolkit to improve the knowledge and awareness of prostate-specific antigen (PSA) testing in Black individuals to facilitate informed shared-decision making between Black patients and primary care providers. Methods: Using a community-partnered participatory research approach, we convened a working group of Black prostate cancer survivors and community advocates, and clinicians, researchers, and health communications specialists. During monthly meetings, the working group followed Graham’s Knowledge-to-Action framework to synthesize information from: 1) peer-reviewed literature on the use of shared decision-making aids; 2) interviews conducted by our research team with Black individuals regarding barriers and facilitators to access PSA testing; and 3) community input on PSA testing and prostate cancer early detection. We then facilitated four iterative design sessions with the working group to develop recommendations for toolkit content, framing, and format. Results: With the working group, we designed a comprehensive set of resources to increase knowledge and awareness of PSA testing for early detection of prostate cancer among Black individuals. The design framework includes detailed recommendations on the content, framing, and format for resources contained in the toolkit. Recommendations encompass: 1) interactive web-based documents that cover comprehensive information about prostate cancer risk and screening; 2) printable shared decision-making documents that present evidence-based information about the use of PSA testing to guide conversations between Black individuals and their primary care providers; and 3) educational videos focused on prostate cancer fundamentals and dispelling common misconceptions about prostate cancer risk and screening, with content delivered by Black prostate cancer survivors and interviews with Black providers and prostate cancer researchers. Conclusion: This study addressed the need for a community-developed approach to increasing knowledge and awareness about prostate cancer screening and early detection in an accessible, culturally tailored, and accurate manner. We used a collaborative process that centered the experiences of Black prostate cancer survivors and advocates in the design of a toolkit that can facilitate decision-making discussions between Black individuals and their care providers for use of PSA testing for prostate cancer screening. Citation Format: Jenney R. Lee, Sung Min Kim, Yohali Burrola- Mendez, Dante' Morehead, Marty Chakoian, Michael Ware, Kojo Ward, Floyd Gossett, Vida Henderson, Patricia Egwuatu, Burcu Darst, John Masembe, Erika M. Wolff, Yaw A Nyame. Community-based knowledge-to-action translation to improve early detection of prostate cancer among Black individuals [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B083.

Abstract B165: Psychosocial support needs of racially diverse sexual and gender diverse cancer survivors: a systematic review and call for more intersectional research

Abstract Background: Due to discrimination and marginalization, sexual and gender diverse (SGD) cancer survivors in the U.S. experience inequities across the cancer care continuum, including in prevention, screening, treatment, and survivorship care, compared with their cisgender- heterosexual counterparts. Despite calls to reduce cancer inequities among SGD populations, disparities in access to psychosocial support remain persistent, especially for racially diverse SGD cancer survivors. SGD cancer survivors experience minority stressors, which have been linked to higher levels of social isolation, weaker social networks, and poorer mental health outcomes. Purpose: This scoping review critically evaluates the literature on psychosocial support among SGD cancer survivors and describes the cancer-specific psychosocial support needs and experiences of SGD people using an intersectional lens. Methods: A systematic search was conducted in CINAHL®, Medline/PubMed®, PsycINFO, and SocINDEX. Research articles were retrieved from peer-reviewed, primary research studies and (1) published between 2013 and the present day, (2) available online in full text, and (3) written in English. Articles excluded were not related to the study’s purpose, non-peer-reviewed work such as editorial papers and dissertations, or other literature reviews. The databases and key search terms were identified in consultation with a medical librarian. Criteria for the review process followed PRISMA guidelines. The Covidence Systematic Review Tool was used for record screening, the full-text review was conducted manually, and qualitative analysis was employed to extract themes by one researcher. Results: Our literature search revealed 16 studies that met the review criteria. Of these, 6 were quantitative, 5 were qualitative, and 5 were mixed methods. Themes included (1) recognition and inclusion of unique social networks like chosen families by providers and oncology care systems, (2) barriers to psychosocial support such as identity (non)disclosure and negative assumptions from providers, (3) diverse sources of psychosocial support, comprising family, peers, community, providers, and institutions, (4) support needs may present differently depending on the cancer type, (5) the role of coping mechanisms and resilience strategies to navigate minority stressors, and (6) gaps in understanding the role of intersectionality in psychosocial support. Conclusion: Addressing the structural lack of psychosocial support for SGD people navigating cancer care in the U.S. is critical to reducing health disparities among the population. Future research should prioritize intersectionality and resilience frameworks to better understand the nuanced experiences of SGD cancer survivors and inform targeted interventions that promote holistic well-being and equitable access to care. Citation Format: John A. Fuller. Psychosocial support needs of racially diverse sexual and gender diverse cancer survivors: a systematic review and call for more intersectional research [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B165.

Understanding the Experience of Cancer Survivorship Among Pediatric and Adolescent Cancer Survivors and Their Parents Through Camera Lenses: A Photovoice Study.

Although the relative survival rate of childhood cancer has increased substantially in recent years, the pursuit of successful outcomes is often accompanied by negative impacts on pediatric and adolescent cancer survivors and their parents' physical and psychological well-being. However, little is known about their experiences during the period of cancer survivorship. This study aimed to gain an understanding of the experience of cancer survivorship among pediatric and adolescent cancer survivors and their parents. This study utilized a descriptive qualitative study employing the photovoice design. From September 2022 to March 2023, 17 pediatric and adolescent cancer survivors (9-18years), who had completed active treatment at least 6months before recruitment, participated in this study. A total of 217 photographs submitted by survivors and their parents and the interview data, were thematically analyzed to identify themes and subthemes. The analysis revealed five prominent themes: indelible marks, struggling with late effects, striving to return to normalcy, the strength of support, and living in the moment and hope for the future. The findings shed light on the experiences of pediatric and adolescent cancer survivors and their parents throughout the cancer journey, elucidating the influence on both negative and positive aspects. Additionally, the study highlighted that photovoice facilitated self-reflection, the discovery of values, and the recognition of strengths and can be a therapeutic strategy for pediatric and adolescent cancer survivors and their parents in further research.

Experiences of unemployed and/or work-disabled cancer survivors who have pursued to return to paid employment: a focus group study.

To explore experiences of unemployed and/or work-disabled cancer survivors who have pursued to return to paid employment. Four digital focus group interviews were conducted with 16 cancer survivors (< 10 years post-diagnosis) who have pursued to return to work within the last 2 years. Interview topics included motivations, facilitators of and barriers to job seeking, and returning to and maintaining paid employment. Interview audio recordings were transcribed verbatim and analyzed using conventional content analyses. Participants were mostly female (94%), and the majority had successfully returned to paid employment (56%). Both intrinsic factors (e.g., sense of purpose, social interactions) and extrinsic factors (e.g., financial necessity) motivated their return to paid employment. During job seeking, participants experienced facilitators including support, personal qualities (e.g., life experience), and trial workplaces. Barriers included inadequate support, perceived employer discrimination, and work ability uncertainty. Returning to and maintaining employment was facilitated by flexible work, supportive colleagues, and intrinsic drive, while barriers included side effects (e.g., fatigue) and overly demanding work. Unemployed and/or work-disabled cancer survivors are generally motivated to return to paid employment by both intrinsic and extrinsic factors, but uncertainty about their ability and inadequate support may hinder this. These findings highlight the need for trial workplaces, support during every phase of return to paid employment, and a flexible, supportive workplace. Tailored interventions addressing the needs identified in this study are urgently needed. The recommendations provided offer strategies for various stakeholders to enhance support for unemployed and work-disabled cancer survivors.

Post-traumatic Growth Experiences of Breast Cancer Survivors: A Grounded Theory Approach

Post-traumatic Growth Experiences of Breast Cancer Survivors: A Grounded Theory Approach

"Just for pregnant women, not for you": a qualitative evaluation of the sexual and reproductive healthcare experiences of transgender and gender diverse cancer survivors.

To identify opportunities to improve sexual and reproductive health (SRH) care for transgender and gender diverse (TGD) cancer survivors by describing (1) challenges experienced when navigating SRH care and (2) strategies to help overcome these challenges. We enrolled a purposive sample of 17 adult TGD cancer survivors and 5 co-survivors. We aimed for a diverse sample across cancer experience, age, racial/ethnic background, sexual orientation, and gender identity. We conducted 90-min individual interviews via videoconference and used reflexive thematic analysis, guided by a focus on three social determinants of health. Themes describing challenges were as follows: (1) Cancer treatment's impact on sexual health was insufficiently addressed by cancer care providers; (2) fertility-related information and conversations were complicated by gendered expectations and ultimately did not meet survivors' needs; (3) feeling excluded and uncared-for in healthcare settings due to gendered language and lack of supportive services that met their needs; and (4) TGD survivors commonly reported high financial burden, negatively impacting their access to care. Strategies to overcome these challenges were (1) a solid social support network that can be integrated into the care team to meet the unique SRH needs of TGD survivors and (2) gender-affirming healthcare providers and environments to address SRH care needs and concerns. TGD survivors and co-survivors desire improved access to gender-affirming SRH care in cancer survivorship. Key opportunities to improve gender-affirming SRH care in cancer survivorship include fostering and engaging TGD survivors' support networks and implementing system-level changes in cancer care settings.

Characterization of chronic pain, pain interference, and daily pain experiences in adult survivors of childhood cancer: a report from the Childhood Cancer Survivor Study.

Although survivors of childhood cancer are at an increased risk, little is known about the prevalence of chronic pain, associated interference, and daily pain experiences. Survivors (N = 233; mean age = 40.8 years, range 22-64 years; mean time since diagnosis = 32.7 years) from the Childhood Cancer Survivor Study completed pain and psychosocial measures. Survivors with chronic pain completed 2-week, daily measures assessing pain and psychological symptoms using mHealth-based ecological momentary assessment. Multivariable-modified Poisson and linear regression models estimated prevalence ratio estimates (PR) and mean effects with 95% confidence intervals (CI) for associations of key risk factors with chronic pain and pain interference, respectively. Multilevel mixed models examined outcomes of daily pain and pain interference with prior day symptoms. Ninety-six survivors (41%) reported chronic pain, of whom 23 (24%) had severe interference. Chronic pain was associated with previous intravenous methotrexate treatment (PR = 1.6, 95% CI 1.1-2.3), respiratory (PR = 1.8, 95% CI 1.2-2.5), gastrointestinal (PR = 1.6, 95% CI 11.0-2.3), and neurological (PR = 1.5, 95% CI 1.0-2.1) chronic health conditions, unemployment (PR = 1.4, 95% CI 1.0-1.9) and clinically significant depression and anxiety (PR = 2.9, 95% CI 2.0-4.2), as well as a diagnosis of childhood Ewing sarcoma or osteosarcoma (PR = 1.9, 95% CI 1.0-3.5). Higher pain interference was associated with cardiovascular and neurological conditions, unemployment and clinical levels of depression and/or anxiety, and fear of cancer recurrence. For male, but not female survivors, low sleep quality, elevated anxiety, and elevated depression predicted high pain intensity and interference the next day. A substantial proportion of childhood cancer survivors experience chronic pain and significant associated interference. Chronic pain should be routinely evaluated, and interventions are needed.

Considerations for Evaluating Older Adults with Cancer for Depression: A Qualitative Survey of Experts

ABSTRACT Objectives The objective of this study was to engage national experts in geriatric psychiatry and oncology in qualitative interviews to develop consensus regarding how older adult cancer survivors (OACS) experience depressive symptoms, and how best to assess OACs for depression. Methods Expert clinicians in geriatric oncology disciplines were interviewed about approaches to assessing depression in OACs. Interviews were audio-recorded and transcribed, and conducted until thematic saturation was achieved. Thematic Content Analysis was utilized to identify key themes. Results Experts (N = 8) were board certified geriatric psychiatrists and oncologists with specialization in geriatric medicine. Two conceptual domains were identified: Key indicators of depression in OACs (e.g. anhedonia; loss of meaning and purpose; loneliness and social withdrawal) and unique considerations for depression assessment in OACs (e.g. alternative phrasing to “depression,” disentangling mood and cancer or treatment-related side effects). Conclusions The approaches identified tended to depart from traditional diagnostic criteria for depression. Clinical implications Results provide additional insight into the limitations of existing depression measures for OACs. The themes and practices identified in the present study suggest that a revised measure of depression for OACs may be useful. Future research will continue to shed light on best practices for depression assessment in OACs.

Exploration of Stress and Inflammatory Biomarkers Among Non-Hispanic Black and Hispanic Cancer Survivors.

To evaluate associations among social determinants of health (SDOH), stress, interleukin-6 (IL-6), and quality of life among non-Hispanic Black and Hispanic cancer survivors. Individuals who had completed cancer treatment and did not identify as White (N = 46) were recruited through community partnerships in western Massachusetts and a state cancer registry. This descriptive cross-sectional study used questionnaires and morning salivary samples to collect data between June 2022 and September 2023. Most participants were breast cancer survivors, were female, identified as African American or Black, and reported moderate levels of stress and low physical activity. Cortisol levels were higher among African American or Black participants, those with lower body mass index, and those with less consumption of fruit and vegetables. Higher symptom experience was associated with higher IL-6 levels. No associations were identified between IL-6 and cortisol or perceived stress and cortisol levels. Incorporating SDOH in self-reported outcomes, including health behaviors and associated biologic indicators, can facilitate early identification and interventions to improve symptom experience and health outcomes of cancer survivors.

Voices of Black men: reflecting on prostate cancer survivorship care plans.

This study addresses the critical issue of survivorship care for Black prostate cancer survivors. The aim was to explore their awareness of survivorship care plans to improve prostate cancer care and survivorship within this high-risk group. Utilizing a thematic analysis approach, we conducted in-depth interviews focused on analyzing post-treatment experiences of Black prostate cancer survivors by applying interpretive explanations to data collected from participants. Participants reported a significant gap in survivorship care plan communication post-treatment, as these plans were seldom discussed. Survivors highlighted the adoption of post-treatment strategies and self-education as means to enhance their comprehension of the survivorship process. Black survivors demonstrated an intrinsic motivation, after feeling "discarded," to find suitable resources to enhance their survivorship care for a better quality of life. The prioritization of post-treatment care for Black prostate cancer survivors is important. By offering comprehensive post-treatment education, improving symptom transparency, and establishing safe spaces for open discussion, the quality of life of Black survivors may be substantially improved. There is a pressing need for dynamic post-treatment care coordination tailored to Black prostate cancer survivors. A lack of crucial post-treatment education for this population that experiences disproportionate burden of prostate cancer may exacerbate cancer health disparities. Addressing this care coordination gap may improve support systems, survivor well-being, and better cancer outcomes.

Testing effectiveness and implementation of a standardized approach to sexual dysfunction screening among adolescent and young adult-aged survivors of childhood cancer: A type I hybrid, mixed methods trial protocol: Effectiveness of sexual dysfunction screening among AYA cancer survivors: a study protocol.

Approximately 20-50% of adolescent and young adult-aged childhood cancer survivors (AYA-CCS) experience sexual dysfunction (SD), although this healthcare need is widely underrecognized. Previous research from both AYA-CCS patients and their providers report that SD needs are unaddressed despite patient desires for SD discussions to be incorporated as part of their care. Patients and providers agree that standardized use of a patient-reported outcome measure may facilitate SD discussions; an SD screening approach was developed with patient and provider input. This study will measure the effectiveness of a standardized SD screening intervention and assess implementation outcomes and multilevel barriers and facilitators to guide future research. This multi-site, mixed methods, type 1 effectiveness-implementation hybrid trial will be evaluated using a pre-post design (NCT05524610). The trial will enroll 86 AYA-CCS (ages 15-39) from two cancer centers in the United States. The SD intervention consists of core fundamental functions with a "menu" of intervention options to allow for flexibility in delivery and tailoring in variable contexts. Effectiveness of the intervention on facilitating SD communication will be measured through patient surveys and clinical data; multivariable logistic regression will be used for the binary outcome of self-reported SD screening, controlling for patient-level predictors. Implementation outcomes will be assessed using mixed methods (electronic health record abstraction, patient and provider surveys, and provider interviews. Quantitative and qualitative findings will be merged using a joint display to understand factors affecting intervention success. Identification and treatment of SD in AYA-CCS is an important and challenging quality of life concern. The type 1 hybrid design will facilitate rapid translation from research to practice by testing the effects of the intervention while simultaneously identifying multilevel barriers and facilitators to real-world implementation. This approach will inform future testing and dissemination of the SD screening intervention.

“IF I AM OLD, YOU CAN NOT TELL ME THAT I HAVE JUST BREAST CANCER PATIENT”: A PHENOMENOLOGICAL STUDY

“IF I AM OLD, YOU CAN NOT TELL ME THAT I HAVE JUST BREAST CANCER PATIENT”: A PHENOMENOLOGICAL STUDY Abstract Objective: This study aimed to investigate the post-surgery experiences of elderly breast cancer survivors. Methods: Semi-structured interviews were conducted with 12 elderly breast cancer patients (&gt; 65) after surgery. To evoke the themes illuminating these women's experiences, we employed phenomenological analysis. Results: Three main themes emerged as a result of the research: "This is not ideal at this age but there is nothing I can do," "I am no longer self-sufficient," and "We are different, I am old." For elderly women, the phrase "removing the breast" is difficult to hear. Most elderly people could not even look at or touch the area. They asserted, however, that being healthy is more crucial than caring about one's physical appearance given one's age. They were unable to care for themselves, carry out independent daily tasks, or clean the house. It had a significant impact on the elderly to be dependent on others for these tasks. Those who were assisted felt grateful; those who were not supported felt helpless. The elderly were burdened more because of their age and various health issues. On the other hand, elderly patients who underwent cancer surgery experienced a fear of passing away. The elderly wanted information or assistance with their issues, but they were unsure of where to turn. Conclusion: Elderly breast cancer patients experience different issues due to the particular challenges of old age. Based on this knowledge, members of the healthcare team should follow a different roadmap than the particular strategy for performing breast cancer surgery on elderly patients. Cancer diagnosis, breast loss, the physical burden of comorbidity, the psychological burden of dependency, and the inability to care for oneself should all be considered when providing care and treatment for elderly individuals. Keywords: Breast cancer surgery; elderly patients; experience; geriatric oncology; phenomenology.

Experiences of underrepresented adolescent and young adult (AYA) cancer survivors engaging in research-related activities.

10073 Background: Adolescent and young adult (AYA) cancer survivors are an age-defined cohort (15-39 years at diagnosis) confronting unique biopsychosocial needs throughout their cancer experience. Underrepresented (sexual and gender minority [SGM] and/or Black, Indigenous, and People of Color [BIPOC]) AYAs face additional challenges associated with discrimination, mistrust of providers, and culturally incongruent services. As a result, many underrepresented AYAs experience suboptimal oncological care and disparate outcomes when compared to cis-gendered heterosexual and/or white peers. This study explored the experiences of underrepresented AYA cancer survivors engaging in research-related activities. Methods: This study is part of a larger Patient Centered Outcomes Research Institute (PCORI)-funded project that is evaluating multilevel facilitators and barriers to oncological care and research for underrepresented AYA cancer survivors. With support from five academic cancer centers and five community-based organizations supporting AYAs across the US, we have assembled an intersectional community advisory panel (CAP) of 10 AYAs who identify as BIPOC and/or SGM. Together with the CAP, a semistructured interview guide was developed, and from January to February 2024, we conducted video interviews. Data were analyzed using thematic analysis of verbatim transcribed interview scripts. The CAP assisted the investigative team in the analyses and interpretation of data. Results: Of the 20 participants interviewed, roughly 70% identified as BIPOC, 40% as SGM, and 10% as both BIPOC and SGM. Participants included underrepresented AYA cancer survivors who, prior to this specific study, had or had not participated in cancer-related research. Three major themes affecting underrepresented AYAs and engagement in research-related activities were discovered, and included: 1) Layering of identities, culture, and stigma; 2) The role of trusted conduits in facilitating engagement; and 3) Beyond compensation: reasons of pursuance. Conclusions: The resultant themes illuminate multilevel facilitators and barriers to research engagement among underrepresented AYA cancer survivors. Findings will assist in guiding researchers, oncology care providers and program administrators both in academic and community settings in the design of inclusive and equitable cancer care delivery programs for underrepresented AYA cancer survivors.