Gynecologic Cancer Survivors Research Articles

Lower Limb Lymphedema Awareness among Gynecological Cancer Patients: An International Survey Supported by the European Network of Gynecological Cancer Advocacy Groups (ENGAGe) Group.

Patient awareness of postoperative lymphedema in the field of gynecologic oncology has been poorly documented in the international literature. We wished to capture and document the awareness among gynecological cancer survivors about postoperative lymphedema, including aspects such as the adequacy of perioperative counseling, management, and quality of life. A web-based survey comprising 25 multiple-choice questions was distributed to gynecological cancer advocacy groups within the European Network of Gynecological Cancer Advocacy Groups (ENGAGe) group. The survey was validated in a pilot group of gynecological patients prior to distribution. Overall, 386 women from 20 countries completed the questionnaire. Only half of the patients (n = 211) knew what lymphedema is, whereas 52% of the respondents stated that they were never informed at their pre-operative assessment about the potential risk of developing lymphedema. Fifty-three percent of those women who were informed about the risk and management of lymphedema received information through self-initiative, connecting mainly with patient groups or online. Approximately 84% of patients with lymphedema reported that they informed their doctor about their symptoms. Ninety-four patients (55.3%, which is not 55% of the 386) were treated for lymphedema. Forty-five women out of 136 reported that lymphedema significantly affected their everyday lives. We report a large lack of awareness and a significant gap of knowledge about the risks and treatment options related to postoperative lymphedema among gynecological cancer survivors. Institutional practice routines and awareness among professionals need to be urgently recalled and adapted to adequately inform and support gynecological cancer patients.

Figure it out on your own: a mixed-method study on pelvic health survivorship care after gynecologic cancer treatments.

Pelvic health issues after treatment for gynecological cancer are common. Due to challenges in accessing physiotherapy services, exploring virtual pelvic healthcare is essential. This study aims to understand needs, preferences, barriers, and facilitators for a virtual pelvic healthcare program for gynecological cancer survivors. A multi-center, sequential mixed-methods study was conducted. An anonymous online survey (N=50) gathered quantitative data on pelvic health knowledge, opportunities, and motivation. Focus groups (N=14) explored patient experiences and consensus on pelvic health interventions and virtual delivery. Quantitative data used descriptive statistics, and focus group analyses employed inductive thematic analysis. Findings were mapped to the capability, opportunity, and motivation (COM-B) behavior change model. Participants reported lacking knowledge about pelvic health interventions and capability related to the use of vaginal dilators and continence care. Barriers to opportunity included lack of healthcare provider-initiated pelvic health discussions, limited time in clinic with healthcare providers, finding reliable information, and cost of physical therapy pelvic health services. Virtual delivery was seen favorably and may help to address motivational barriers related to embarrassment and frustration with care. Awareness of pelvic healthcare is lacking among people treated for gynecological cancer. Virtual delivery of pelvic health interventions is perceived as a solution to enhance access while minimizing travel, cost, embarrassment, and exposure risks. A better understanding of the pelvic health needs of individuals following gynecological cancer treatments enables the development of tailored virtual pelvic health rehabilitation interventions which may improve access to pelvic health survivorship care.

The level of cancer-related concerns and affecting factors in Turkish cancer survivors: A cross-sectional study.

To examine and compare the level of cancer-related concerns and affecting factors between cancer survivors who completed their treatment and those still receiving treatment. The study has a cross-sectional comparative design. Convenience sampling was used and the study included 350 Turkish cancer survivors. Data were collected between March and June 2022 online with a descriptive characteristics form and the Assessment of Survivor Concerns. Obtained data were analysed with numbers, percentages, mean values, t-test and multiple linear regression analysis. The cancer survivors who completed their treatment had a significantly higher level of concerns than those who were still on treatment. Female cancer survivors, cancer survivors with less than 5-year time elapsing after diagnosis and gynaecological cancer survivors with completed cancer treatment can also have a higher level of cancer-related concerns. Cancer survivors who have completed their treatment have a higher level of concerns than those who still receive treatment. Gender, time elapsing after diagnosis and type of cancer affect the level of concerns. Nurses should evaluate psychosocial care and needs of cancer survivors in addition to their physical care. Raising awareness about the concerns of the cancer survivors with completed treatment in addition to those still receiving treatment and providing holistic care to them can reduce their concerns. It is of great importance to be aware of the factors likely to increase cancer-related concerns during and after cancer treatment. This study identifies cancer-related concerns in cancer survivors who completed or were still receiving treatment and provides a comparison with other studies in the literature. We have adhered to STROBE statement using STROBE checklist for cross-sectional studies. There was no patient or public involvement.

Gender role conflicts experienced by Indonesian women with gynecological cancer: A phenomenological study.

Gynecological cancer and its treatments can lead to sexual problems, potentially disrupting the gender role performance of women. Sexuality and gender roles are context-specific, yet these issues remain unexplored in the Indonesian context. This study aimed to explore the gender role conflicts experienced by Indonesian women having gynecological cancer. A qualitative design with a phenomenology approach was utilized in this study. Data were collected through individualized, face-to-face, in-depth interviews conducted from 1 April to 30 December 2022 with 22 women diagnosed with gynecological cancer who had undergone treatments at the Dharmais Cancer Hospital, Jakarta, Indonesia. Data were analyzed using thematic analysis. Three themes were developed: 1) challenges in fulfilling female gender roles after having cancer diagnosis and therapies, 2) emotional struggles related to gender role conflicts, and 3) efforts to cope with gender role conflicts. The study sheds light on how sexual complications due to gynecological cancer and its treatments extend beyond physical issues. A deeper layer of problems around sexual dysfunctions among gynecological cancer survivors is often rooted in traditional gender-role expectations. Nurses should have a comprehensive and contextual understanding of the unique experiences of women living with gynecological cancer to facilitate a positive adaptation to their cancer journey.

Developing an educational resource for gynecological cancer survivors and their caregivers: A methods and experience paper

Le présent article fait ressortir la nécessité de mieux informer les survivantes de cancer gynécologique (CG) et leurs proches aidants. Il vise à décrire le partenariat établi entre les patientes, les cliniciens et les chercheurs pour concevoir une ressource d’information fondée sur l’expérience et les données probantes. L’élaboration de cette ressource d’information a fait appel à plusieurs méthodes de recherche. Elle s’est déroulée en cinq étapes : 1) réunion de l’expertise nécessaire; 2) revue de la littérature; 3) ébauche de la ressource; 4) mise à l’essai; 5) diffusion de la ressource. La diversité des partenaires apportait l’expertise nécessaire à l’utilisation de multiples méthodes de recherche ayant produit des résultats utiles à chaque étape. Grâce à cette combinaison (partenariat diversifié et multiples méthodes de recherche), on a élaboré une ressource utile pour répondre à un manque observé par les utilisateurs des connaissances. La combinaison des caractéristiques décrites dans le présent article vient combler une lacune dans la procédure utilisée par les cliniciens et les chercheurs désireux d’élaborer des ressources d’information fondées à la fois sur l’expérience et la pratique.

Developing an educational resource for gynecological cancer survivors and their caregivers: A methods and experience paper.

Building upon the need for greater education, identified by gynecological cancer survivors and their caregivers, the objective of this paper is to describe our patient-clinician-researcher partnership to develop an evidence- and experiential-based educational resource. We engaged in five phases using multiple research methods: 1) assembling the essential expertise, 2) reviewing the literature, 3) drafting the resource, 4) testing the resource, and 5) disseminating the resource. Our diverse partnership provided expertise toward multiple research methods that produced results useful for each successive phase. This combination - a diverse partnership and multiple research methods - resulted in a useful resource to fulfill a gap identified by knowledge users. The combined features described in our paper fill a procedural gap for clinicians and researchers intending to develop educational resources that are empirically and experientially founded.

Pelvic Floor Therapy and Initial Interventions for Pelvic Floor Dysfunction in Gynecologic Malignancies.

This review provides evidence-based updates for the first-line management approaches for pelvic floor disorders in patients with gynecologic malignancies, as well as important provider considerations when referring for pelvic floor physical therapy. Currently, there is strong evidence to recommend pelvic floor muscle training as initial treatment for urinary incontinence and for pelvic organ prolapse; some evidence to recommend a more targeted pelvic floor muscle training program for fecal incontinence; and mostly expertise-based evidence to recommend vaginal gels or estrogen to aid with dyspareunia causing sexual dysfunction. More research is greatly needed to understand the role of overactive pelvic floor muscles in survivors with chronic pelvic pain and the treatment of post-radiation pelvic complications such as vaginal stenosis and cystitis. While pelvic floor disorders are common concerns in gynecologic cancer survivors, there are evidence-based initial noninvasive treatment approaches that can provide relief for many individuals.

Expectations and needs of gynecological cancer survivors at the end of primary cancer treatment: A convergent mixed methods study.

Gynecological cancer (GC) survivors desire holistic, person-centred, supportive care interventions to address their unmet needs after treatment. The development of such interventions requires an understanding of both the expectations and needs of GC survivors. The purpose of this study was to understand GC survivors' expectations and needs for post treatment, and to consider how their expectations and needs converge and diverge to inform care. A convergent mixed-methods design (QUAL+quant) was used. Qualitative data were collected via 1:1 telephone interviews. Quantitative data were collected using the Cancer Survivors' Unmet Needs measure. Twenty-four individuals participated. Survivors' expectations for interventions after treatment included the implementation and outcomes of interventions and were grouped into two themes: Wrestling the unknown and Trusted information strengthens capacity. The most common unmet needs were related to existential survivorship. However, mixed-methods analysis revealed participants primarily expected to have their informational needs met in post-treatment interventions. Study findings illuminate GC survivors' expectations and needs after treatment, and the importance of analyzing both when planning and providing care. Clinicians may use these findings to develop and refine interventions to address unmet needs of GC survivors.

Hormone replacement therapy in gynecological cancer survivors and BRCA mutation carriers: a MITO group survey.

Early iatrogenic menopause in gynecological cancer survivors and BRCA mutation (BRCAm) carriers undergoing risk-reducing salpingo-oophorectomy (RRSO) is a major health concern. Hormone replacement therapy (HRT) is the most effective remedy, but remains underused in clinical practice. The Multicenter Italian Trials in Ovarian cancer and gynecologic malignancies (MITO) group promoted a national survey to investigate the knowledge and attitudes of healthcare professionals regarding the prescription of HRT. The survey consisted of a self-administered, multiple-choice 45-item questionnaire, available online to all MITO members for 2 months starting from January 2022. A total of 61 participants completed the questionnaire (47 out of 180 MITO centers; compliance: 26.1%). Most respondents were female (73.8%), younger than 50 years (65.6%), and gynecologic oncologists (55.7%), working in public general hospitals (49.2%). An 84.4% of specialists actively discuss HRT with patients and 51.0% of patients ask the specialist for an opinion on HRT. The rate of specialists globally in favor of prescribing HRT was 22.9% for ovarian cancer, 49.1% for cervical cancer, and 8.2% for endometrial cancer patients. Most respondents (70.5%) believe HRT is safe for BRCA-mutated patients after RRSO. Nearly 70% of physicians prescribe systemic HRT, while 23.8% prefer local HRT. Most specialists recommend HRT for as long as there is a benefit and generally for up to 5 years. Real-world data suggest that many healthcare professionals still do not easily prescribe HRT for gynecological cancer survivors and BRCA mutation carriers after RRSO. Further efforts are required to implement the use of HRT in clinical practice and to support both clinicians in recommending HRT and patients in accepting it.

Life Experience of Survivors of Gynecologic Cancers: A Survey Conducted in Italy

Background: The study of health-related quality of life in survivors of gynecologic cancers is becoming increasingly important as 1.5 million survivors of gynecologic cancer in the United States and more are expected due to advances in diagnosis and treatment. This project investigated the perceived needs and lived experiences of survivors of gynecological cancer to help design supportive activities to be implemented in clinical practice. Methods: Patients were recruited in hospitals or through social media and responded to an online survey that was addressed to patients in Italy, specifically in Sicily, Puglia, and Campania. Patients with ovarian, endometrium, or cervix cancer were recruited among women attending Cannizzaro Hospital and Alleanza Contro il Tumore Ovarico (Alliance Against Ovarian Cancer) members. Results: Body image perception was changed in 82.3% of respondents, whereas familial relationships were described as changed by 27.5% of women. In 69.6% of patients, sexual habits were hindered by changes in the body, depression, pain, and awkwardness. Physicians informed patients about sexuality changes related to cancer extensively in 16.7% of cases and briefly in 19.6% of cases. The advice of a clinical sexologist was considered potentially helpful by 31.4% of patients and not potentially helpful by 47.1%, whereas 21.6% of patients had no opinion. Conclusions: Although sexual habits are often changed by cancer, women surviving gynecological cancer rarely seek medical advice in this area. Physicians should be trained to inform patients and to promote referrals to sexologists. Keywords: Gynecological cancer, quality of life, sexual activity

Life Experience of Survivors of Gynecologic Cancers: A Survey Conducted in Italy.

The study of health-related quality of life in survivors of gynecologic cancers is becoming increasingly important as 1.5 million survivors of gynecologic cancer in the United States and more are expected due to advances in diagnosis and treatment. This project investigated the perceived needs and lived experiences of survivors of gynecological cancer to help design supportive activities to be implemented in clinical practice. Patients were recruited in hospitals or through social media and responded to an online survey that was addressed to patients in Italy, specifically in Sicily, Puglia, and Campania. Patients with ovarian, endometrium, or cervix cancer were recruited among women attending Cannizzaro Hospital and Alleanza Contro il Tumore Ovarico (Alliance Against Ovarian Cancer) members. Body image perception was changed in 82.3% of respondents, whereas familial relationships were described as changed by 27.5% of women. In 69.6% of patients, sexual habits were hindered by changes in the body, depression, pain, and awkwardness. Physicians informed patients about sexuality changes related to cancer extensively in 16.7% of cases and briefly in 19.6% of cases. The advice of a clinical sexologist was considered potentially helpful by 31.4% of patients and not potentially helpful by 47.1%, whereas 21.6% of patients had no opinion. Although sexual habits are often changed by cancer, women surviving gynecological cancer rarely seek medical advice in this area. Physicians should be trained to inform patients and to promote referrals to sexologists.

Gynecological cancer survivors' experiences with sexual health communication in nurse-led follow-up consultations.

Gynecological cancer and its treatment may cause sexual difficulties in terms of physical and psychosocial health. Considering the essential role that nurses play in cancer care, they are well positioned to be ideal providers for addressing sexual health concerns in the follow-up phase of gynecological cancer. The aim of this study was to gain in-depth knowledge of how gynecological cancer survivors experience sexual health communication in nurse-led follow-up consultations. Using a qualitative hermeneutic approach, we conducted individual semi-structured interviews with 17 women from five different hospitals in Norway between April 4, 2022, and June 2, 2022. The women participated in a large intervention study on cancer follow-up that included sexual health as one of several topics addressed by trained nurses in three consultations in the first year of follow-up. A five-stage Gadamerian-inspired research method was utilized for data collection and analysis. We identified three themes: (1) the importance of nurses listening to the women's own perceptions of sexuality, (2) post-treatment sexual challenges influence the women's need to communicate about sexual health, and (3) nursing communication can help women regain their sexual health. Women who have undergone treatment for gynecological cancer find communication with trained nurses regarding sexual health beneficial. We recommend integration of trained nurses in the follow-up team. The nurses should adjust communication according to each gynecological cancer survivor's unique understanding of sexuality and inform women with sexual health concerns at that end of treatment, that sexual health can improve during follow-up.

Abstract B054: Impact of health behaviors, health outcomes, and socioeconomic status on sleep duration among gynecologic cancer survivors

Abstract Background: Emerging evidence suggests sleep duration may be associated with health outcomes among cancer survivors. There have been few studies analyzing sleep among gynecologic cancer survivors (GCS). We defined GCS as respondents who reported being told they had a form of gynecologic cancer (cervical, endometrial, and ovarian cancer) in their life. This study aimed to explore the associations between health outcomes, health behaviors, and socioeconomic status (SES) on sleep duration in GCS. Methods: We used the 2016-2020 Behavioral Risk Factor Surveillance System (BRFSS) datasets to evaluate the impacts of health outcomes, health behaviors, and SES on sleep duration among GCS. We categorized sleep duration into Short Sleep Duration (<7 hours) (SSD), Long Sleep Duration (>8 hours) (LSD), and Optimal Sleep Duration (7-8 hours) (OSD). Bivariate analyses including chi-square tests, were used to examine associations between health outcomes, behaviors, SES, and sleep duration. A multivariable ordinal logistic regression model was produced to assess the adjusted odds ratios (aOR) for sleep duration, considering health outcomes, behaviors, and SES, while controlling for confounders. Results: Our sample (N=10222) was primarily composed of cervical (n=8856) followed by endometrial (n=1198) and ovarian (n=168) cancer survivors. Most of the sample was 65+ years old (65.93%), followed by the age categories 40-64 years old (32.17%) and 18-39 years old (1.90%). Regarding race, most of the sample was non-Hispanic White (95.68%), followed by non-Hispanic Black (2.54%) and Hispanic (1.78%). We found significant associations between health outcomes, health behaviors, and SES in relation to sleep duration among GCS. GCS who reported depression had higher odds of both LSD (aOR=1.93, 95% CI: 1.45-2.58) and SSD (aOR=1.57, 95% CI: 1.29-1.92). GCS engaging in exercise were more likely to report LSD (aOR=1.53, 95% CI: 1.15-2.04). Current smokers had an increased likelihood of SSD (aOR=1.47, 95% CI: 1.11-1.95). Unemployment was associated with an increased likelihood of LSD (aOR=2.67, 95% CI: 1.87-3.82). Additionally, GCS with incomes <$25,000 had significantly higher odds of SSD compared to GCS earning >$75,000 (aOR=1.82, 95% CI: 1.38-2.39). For health outcomes, GCS with fair/poor health were significantly more likely to report SSD compared to GCS with excellent health (aOR=1.63, 95% CI: 1.20-2.20). GCS experiencing 14 or more poor health days in a month also had higher odds of SSD (aOR=1.31, 95% CI: 1.11-1.55). Finally, GCS residing in rural areas had an association with SSD (aOR=1.22, 95% CI: 1.03-1.44) in comparison to GCS residing in urban areas. Discussion: Our findings illustrate a complex interplay of health outcomes, health behaviors, and SES contributing to sleep duration among GCS. This underscores the crucial need to address sleep duration to improve health outcomes, reduce disparities, and increase quality of life for all GCS. Opportunities for future research include sleep hygiene interventions that may mitigate these effects and improve sleep among GCS. Citation Format: LaShae D. Rolle, Maurice J. Chery, Alyssa Mercadel, Matthew P. Schlumbrecht, Sophia H.L. George, Tracy E. Crane. Impact of health behaviors, health outcomes, and socioeconomic status on sleep duration among gynecologic cancer survivors [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B054.

Abstract A020: Examining the dietary patterns & quality of life among Latina breast and gynecologic cancer survivors in Avanzado Juntas

Abstract Purpose: Cancer survivor guidelines encourage plant-based eating patterns to improve diet quality. Studies examining diet and cancer survivorship among Latina/Hispanic cancer survivors (BGCS) are limited, and few intervention efforts have targeted this historically underserved community. Avanzado Juntas (AJ) was developed with and for Latina/Hispanic breast and gynecologic cancer (BGSC) survivors to promote weight loss, improve diet quality, and increase physical activity. These analyses describe pre and post-intervention dietary intake quality among AJ participants. Methods: The 16-week AJ intervention was adapted from the evidence-based Moving Forward intervention for African American breast cancer survivors leveraging focus group data and collaborating with our Community Advisory Board (previously presented). AJ was then pilot tested in a randomized trial with 35 Latina/Hispanic BGCS. To be eligible, women had to have a BMI > 25 kg/m2, be diagnosed with non-metastatic breast or gynecologic cancer, and have completed treatment (except hormonal). Participants completed surveys, ASA 24-hour diet recall (x2), and a physical assessment at baseline and post-intervention. Women were then randomized to an interventionist (IG) or self-guided (SG) arm. Both groups received a program workbook. The IG group also received in-person education/supervised exercise classes, cooking classes, and text messaging. Diet quality was scored using the Healthy Eating Index (HEI). Scores were compared within and between groups using the Wilcoxon rank sign test with a non-parametric analysis of differences. Notably, the AJ pilot began just as the COVID-19 pandemic began, paused, and then was restarted with safety measures in place. Results: Following the AJ intervention, the IG group reported increased greens and beans (p=.01), higher total protein (p=.008), and reduced added sugars (p=.04) consumption compared to the SG group. Within IG, significant improvements were observed for total vegetables (p=.03), greens and beans (p=.002), and refined grains (p=.03); total HEI Score approached significance (p=.07) . Conversely, in the SG group, significant increases in refined grains (p=.03) )and added sugar consumption (p=.04) was observed post-intervention. Conclusion: These differences suggest the efficacy of the guided intervention relative to the self-guided intervention. Results are of particular interest given the timing during the Pandemic and reflect the concerted effort of participants to purchase and prepare healthy foods. AJ is an example of how culturally relevant interventions and tools can promote diet quality improvements. Future efforts will examine adherence to cancer survivors guidelines and consider ways to integrate this type of programming within existing community resources. . Citation Format: Sandra I. Contreras, Marina Feffer, AnaKaren Manriquez Prado, Alexis Visotcky, Sailaja Kamaraju, Staci Young, Patricia Sheean, Melinda Stolley. Examining the dietary patterns & quality of life among Latina breast and gynecologic cancer survivors in Avanzado Juntas [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A020.

Sexual quality of life after gynaecological cancer: what young women want.

Psychosexual distress is known to be a common complication of treatment for gynaecological cancer (GC), affecting the sexual quality of life (SQoL) for an increasing number of young gynaecological cancer survivors (YGCS). The SQoL in YGCS study aimed to identify strategies that are acceptable and helpful to YGCS in protecting and improving SQoL, using a salutogenic approach. A qualitative study was undertaken with young women aged 18-45 and pre- or perimenopausal at diagnosis. Semi-structured interviews were conducted on Zoom and a thematic analysis of transcripts was completed in NVivo. Fifteen interviews with YGCS revealed three themes for strategy development: psychosexual education, psychosocial support, and healthcare policy and strategy to establish SQoL as standard care in gynaecologic oncology. The strategies put forward by YGCS showed the need for a holistic, patient-centric, and multidisciplinary approach to SQoL. A better understanding of the strategies acceptable to YGCS, including the importance of using a trauma-informed approach to communication and care, can help healthcare providers play a vital role in protecting and improving SQoL.

Redefining sexual health after gynaecological cancer: Lived experiences from Gynea, a digital rehabilitation programme.

Gynaecological cancer illness and treatment have a significant impact on women's sexual health and concerns regarding sexual health are known to be an unmet need in survivors. The digital support programme Gynea was designed to enhance women's health, including sexual health, after gynaecological cancer treatment. This study aimed to explore how cancer survivors experienced participation in Gynea. This is a phenomenological hermeneutic study. Individual, in-depth semi-structured interviews were conducted to explore lived experiences. Twenty women were interviewed after completing the Gynea programme. The transcripts were analysed using Lindseth and Norberg's phenomenological hermeneutic method. Three main themes (with subthemes) emerged from the analysis: (1) A silent existential trauma; (2) Redefining sexual health; (3) Communicating with a partner about sexuality. The women redefined sexual health rather than just being sexual intercourse, being a rediscovery of the body. The women's increased awareness and understanding of their own sexual health empowered their communication about their sexuality with their partners. This was important for regaining sexual health and intimacy in their relationships. Participation in Gynea helped to strengthen the women's sexual integrity. Knowledge and support empowered them to take care of their sexual needs and communicate these with their partners. Healthcare services and nurses need to be aware that sexual health is an existential state of being, in which good sexual health does not necessarily equate to sexual function, but rather to sexual empowerment. Digital support with nurse guidance can support women in caring for their sexual health after cancer illness by thematizing sexual health with a holistic approach and should be part of the medical treatment. Twenty gynaecological cancer survivors contributed by sharing their experiences from the sexual health module in Gynea.

Hula as a physical activity and social support intervention for sustained activity in female breast and gynecologic cancer survivors

BackgroundPhysical activity improves health and psychosocial functioning for people who have been diagnosed with cancer. Native Hawaiians face disparities for some cancers, including breast cancer. Delivering culturally grounded interventions has the potential to improve enjoyment and adherence to the intervention. We sought to test the adherence and impact of a 6 month randomized wait-list controlled trial of hula.MethodsIn this randomized wait-list controlled design people who had been diagnosed with breast or gynecologic cancers were invited to participate with other cancer survivors in a group based setting. Participants were randomized to begin hula immediately or after six months. Attendance was collected and heart-rate measured three times per session. In addition, demographic data, self-report psychosocial data, and biological data (findings will be reported elsewhere) were collected at three time points: baseline, 6 months, and 12 months. The study included six months of hula, twice per week, 60 min each session. In addition, participants committed to practice 60 min per week at home.ResultsParticipants in the study (n = 42) attended, on average, 72% of the sessions. Significant increase in moderate physical activity (d = 0.50, p = 0.03) was observed in the intervention versus control group. For the measures of intra-individual changes pre-and post-intervention, an increase in total physical activity were seen in the intervention group (d = 0.69, p = 0.003), daily caloric intake decreased (d = −0.62, p = 0.007), and a reduction in waist circumference (d = −0.89, p = 0.0002) that was sustained six months after completion of the intervention. Psychosocially, cognitive functioning significantly declined from baseline to 12 months (d = −0.50, p = 0.03), with role functioning improving (d = 0.55, p = 0.02), social constraints increasing (d = 0.49, p = 0.03), and financial difficulties improving (d = −0.55, p = 0.02).ConclusionSustainable physical activity is crucial to improve both the survival and quality of life of cancer survivors. Culturally grounded interventions, such as hula have the potential to increase the maintenance of physical activity. In addition, they create a support group where the benefits of people who have all experienced cancer can gather and garner those benefits of social support, too. This study was registered as a clinical trial through the National Cancer Institute (NCT02351479).Clinical trial registrationClinicaltrails.gov, NCT02351479.

The relationships between stress, coping strategies, and quality of life among gynecologic cancer survivors.

Many studies have reported that gynecologic cancer diagnosis, surgery, adjuvant therapy, and survivorship can be extremely stressful for many people during their cancer journey, and most cancer survivors have experienced stress after cancer, which impacts their quality of life. Importantly, healthy stress management will assist patients in overcoming obstacles in their lives and enhance both the quality of life and the cancer adjustment process. This study aimed to investigate the relationships between stress, coping strategies, and quality of life among gynecologic cancer survivors and to assess the mediating effects of coping on the relationship between quality of life and stress. A series of regression models and Sobel test were conducted to investigate whether coping strategies mediated the relationship between stress and quality of life. Stress was a predictor of quality of life. Acceptance was the mediator between stress and quality of life. Tailored programs that foster coping strategies, such as the strategy of acceptance, to reduce stress and maintain quality of life in this vulnerable group need to be developed.

Prophylactic complex physiotherapy in gynecologic cancer survivors: patient-reported outcomes based on a lymphedema questionnaire

ObjectiveLower extremity lymphedema secondary to cancer treatment impacts quality of life for gynecological cancer survivors. Complex decongestive physiotherapy is applied when lymphedema is diagnosed, but prophylactic physiotherapy is not yet...

Predictors of sexual distress in gynecologic cancer survivors (2241)

Predictors of sexual distress in gynecologic cancer survivors (2241)