Survivorship Care Research Articles

EHealth Platforms Facilitate Prostate Cancer Shared Care: A Systematic Review.

Prostate cancer survivorship care is essential for the early identification of cancer recurrence and progression and the monitoring of adverse effects. Prostate cancer survivorship programs have enabled care to be shared between specialists using digital healthcare platforms. We systematically reviewed the literature to examine if prostate cancer survivorship care had been successfully digitalised. English language articles were searched on PubMed, Embase, and Cochrane Libraries. The search terms included combinations of "eHealth", "digital health", "prostate cancer", "shared care", and related keywords (studies published between [1 January 1946 and 20 March 2023]). Our search strategy yielded 1722 publications, of which 17 studies were included in our final review. Diverse eHealth interventions (web platforms, apps, patient portals) for digital prostate cancer shared care enabled communication, symptom management, and holistic assessment, with potential for reducing anxiety, enhancing outcomes, and increasing engagement. The studies (9 months to 5 years duration) involved participants across different care phases (16 to 3521 participants). We identified ten eHealth platforms, which provided successful symptom tracking, needs assessment, and communications. The platform-based interventions improved some aspects of communication, symptom management, and care delivery. The ongoing clinical need for a robust digital platform that caters to all domains of shared care was identified. eHealth will certainly play a central role in digital prostate cancer shared care, providing better health outcomes and care delivery. Future larger studies in this field should address the implementation barriers, including cost-effectiveness and primary care remuneration. It is also crucial to refine application useability and workflow, focusing on standardization and patient-centred approaches.

Breast cancer survivorship among younger patients: challenges and opportunities-narrative review.

Young women with breast cancer (YWBC) face unique survivorship challenges due to being diagnosed at a more vulnerable stage in life and receiving gonadotoxic and/or antiestrogen therapy during their reproductive years. The purpose of this article is to elaborate on these challenges and demonstrate how specialized supportive care programs tailored specifically for YWBC, can greatly facilitate the provision of interventions to address these challenges. The databases used were PubMed and Medline. Articles included those that involve young women with breast cancer and survivorship care needs. Compared to older breast cancer patients, YWBC generally require more aggressive treatments and are more likely to have a hereditary basis for their disease. Common challenges include childbearing concerns, premature menopause, body image issues, excessive fear of cancer recurrence, difficulties with intimate relationships, and financial toxicity. A possible solution to addressing these needs are longitudinal care in a specialized supportive care program, such as the PYNK Program for Young Women with Breast Cancer in Toronto, Ontario, Canada. Examples of such interventions include fast-tracking fertility preservation, aggressive management of symptoms of iatrogenic menopause, peer support groups, as well as individualized psycho-social support for the patient and her family. By addressing the unique needs of this population, supportive care programs can play a crucial role in empowering young women with breast cancer to cope with the physical, emotional, and practical challenges they may face during and after treatment. The limitation lies in resource availability and funding for sustainability. Ongoing research is required to better understand the needs of YWBC patients in survivorship and ensure the sustainability of programs designed to address these challenges.

797. A COMPARATIVE ANALYSIS ON THE EFFECTIVENESS OF DIFFERENT TREATMENT MODALITIES FOR ESOPHAGEAL CARCINOMA; A SYSTEMATIC REVIEW

Abstract Background Esophageal carcinoma; sixth most common cancer worldwide, presents a significant clinical challenge due to its aggressive nature and often late-stage diagnosis, resulting in poor prognosis and limited treatment options. Various treatment modalities, including surgery, chemotherapy, radiation therapy, immunotherapy, and targeted therapy, are utilized in clinical practice. However, the optimal treatment strategy remains uncertain, as the comparative effectiveness of these modalities is not well-defined. Past studies have provided conflicting evidence, necessitating a comprehensive evaluation to guide clinical decision-making. Therefore, this systematic review aims to compare the efficacy and safety of different treatment modalities for esophageal carcinoma, with the objective of informing evidence-based treatment approaches and improving patient outcomes. Methods Total 350 publications from PubMed, EMBASE, Cochrane, Google Scholar and Semantic Scholar databases were identified on the effectiveness of different treatment modalities for esophageal carcinoma between 2000 and 2024. Following deduplication, two independent reviewers initially screened the articles for eligibility with titles and abstracts, and then, with complete articles. Bias assessment using GRADE guidelines for observational studies was done. Non-English studies, case-series/case-reports/essays/book-chapters/conference-abstracts/editorials/thesis/dissertations and studies without full-texts were excluded. Results Overall, the effectiveness of each treatment modality for esophageal carcinoma depends on various factors, including tumor stage, histology, patient characteristics, and treatment regimen. Combination approaches, such as chemoradiotherapy or multimodal therapy, are often used to maximize treatment efficacy and improve patient outcomes. Conclusion Multidisciplinary collaboration, personalized treatment approach, integration of novel therapies, such as immunotherapy and targeted therapy, into standard treatment regimens, survivorship care and advocate for further research to identify optimal treatment sequencing, identify predictive biomarkers of treatment response, and explore novel therapeutic targets to improve outcomes for patients with esophageal carcinoma is recommended.

Is cancer back?-psychological issues faced by survivors of breast cancer.

Breast cancer survival rates have shown notable improvements over the years thanks to advancements in detection, treatment modalities, and supportive care. However, survivors often encounter challenges when reintegrating into daily life and managing persistent physical and psychological concerns. This review article aims to delve into the multifaceted emotional complexities faced by survivors, encompassing a spectrum of issues from fear of recurrence to body image insecurities, thus emphasizing the imperative for comprehensive support. Articles were reviewed through searches of PubMed and through searches of the author's own file. We will examine not only the risk factors contributing to heightened psychological distress but also the periods of vulnerability and the most common unmet needs encountered by these individuals. Additionally, we will discuss various psychological interventions and strategies designed to promote resilience and enhance the quality of life post-diagnosis. Furthermore, we will underscore the pressing need for ongoing, specific research endeavors aimed at addressing the long-term psychological impacts of cancer recurrence on survivorship. By shedding light on these critical aspects, we aim not only to provide insight into the challenges faced by survivors but also to advocate for the importance of integrating comprehensive psychological support into survivorship care. Through this thorough exploration, we seek to empower both survivors and healthcare professionals alike, facilitating a deeper understanding of the complexities inherent in the breast cancer survivorship journey. Ultimately, our aim is to highlight the crucial aspects that must be considered by healthcare professionals in providing holistic care to breast cancer survivors.

Sexual health after breast cancer: a clinical practice review.

Breast cancer (BC) diagnoses not only present physical challenges but profoundly affect survivors' psychosocial well-being leading to sexual health challenges. This clinical practice review aimed to discuss the current literature and outline the knowledge gaps related to care for sexual health after BC, including survivors' sexual health concerns, as well as available prospective surveillance programs. Current literature on the sexual health challenges of BC survivors was identified and sorted into contributing factors, treatments and interventions, and practice recommendations. This evidence was then used to identify gaps in the literature and make recommendations for future research. BC survivors experience a variety of physical symptoms, such as pain during sex or dyspareunia, which impair sexual well-being. Additionally, dissatisfaction with sexual function may arise due to psychosocial stressors (e.g., depression or body image concerns) and the inverse may worsen psychological well-being. Treatments can have lasting effects that may impact sexual function, often reciprocally related to physical and psychosocial factors. Current treatments for sexual dysfunction involve topical products for vaginal symptoms (e.g., creams, pH-balanced gels, hyaluronic acid or vitamin E suppositories, natural oils, topical estrogen, or lubricants) and various counseling and educational interventions (e.g., mental health counseling, sex therapy, or couples-based psychotherapy). There is a general lack of research considering the ways in which intersectional concerns can impact sexual health experiences after BC. Existing studies do not often consider potential differences in needs that may arise due to ethnicity, age, or socioeconomic background. To address these limitations a significant paradigm shift in survivorship care. This requires moving beyond disease management towards a more holistic, comprehensive, patient-centered approach prioritizing comfort and sexual well-being.

708P The Empower Pathway: An audit of the first 150 patients. Enhanced personalised care of testicular cancer survivors

708P The Empower Pathway: An audit of the first 150 patients. Enhanced personalised care of testicular cancer survivors

Providing Survivorship Care for a Young Adult With a History of Blood Cancer

Adolescents and young adults (AYAs) with a history of cancer are at an increased risk for late effects from their cancer treatment and have higher rates of long-term morbidity and mortality compared to their age-matched peers. As a result, this vulnerable population needs attentive follow-up care, end-organ surveillance, and secondary cancer screening; however, a history of cancer can often become buried on a problem list or not addressed at all. This case report illustrates an AYA survivor of classic Hodgkin lymphoma who relocates to a new city and establishes care with a new primary care provider (PCP). The PCP's awareness of a prior cancer diagnosis and the previous treatment regimen is a critical component in providing comprehensive care. In this case, the PCP's first step is to reach out and collaborate with oncology providers to gather an accurate treatment summary and then consult evidence-based guidelines to develop a plan of care. Based on the patient's previous treatment with chemotherapy adriamycin, bleomycin, vinblastine, and dacarbazine, the PCP orders recommended testing, reviews results, and provides subsequent counseling on health promotion and psychosocial wellness. This case illustrates strategies healthcare providers can use to provide coordinated, evidence-based care for AYA cancer survivors.

697P The Empower Pathway overview: An innovative approach to delivering personalised care for testicular cancer survivors

697P The Empower Pathway overview: An innovative approach to delivering personalised care for testicular cancer survivors

Factors impacting hospitalisation and related health service costs in cancer survivors in Australia: Results from a population data linkage study in Queensland (COS-Q).

The global economic cost of cancer and the costs of ongoing care for survivors are increasing. Little is known about factors affecting hospitalisations and related costs for the growing number of cancer survivors. Our aim was to identify associated factors of cancer survivors admitted to hospital in the public system and their costs from a health services perspective. A population-based, retrospective, data linkage study was conducted in Queensland (COS-Q), Australia, including individuals diagnosed with a first primary cancer who incurred healthcare costs between 2013 and 2016. Generalised linear models were fitted to explore associations between socio-demographic (age, sex, country of birth, marital status, occupation, geographic remoteness category and socio-economic index) and clinical (cancer type, year of/time since diagnosis, vital status and care type) factors with mean annual hospital costs and mean episode costs. Of the cohort (N = 230,380) 48.5% (n = 111,820) incurred hospitalisations in the public system (n = 682,483 admissions). Hospital costs were highest for individuals who died during the costing period (cost ratio 'CR': 1.79, p < 0.001) or living in very remote or remote location (CR: 1.71 and CR: 1.36, p < 0.001) or aged 0-24 years (CR: 1.63, p < 0.001). Episode costs were highest for individuals in rehabilitation or palliative care (CR: 2.94 and CR: 2.34, p < 0.001), or very remote location (CR: 2.10, p < 0.001). Higher contributors to overall hospital costs were 'diseases and disorders of the digestive system' (AU$661 m, 21% of admissions) and 'neoplastic disorders' (AU$554 m, 20% of admissions). We identified a range of factors associated with hospitalisation and higher hospital costs for cancer survivors, and our results clearly demonstrate very high public health costs of hospitalisation. There is a lack of obvious means to reduce these costs in the short or medium term which emphasises an increasing economic imperative to improving cancer prevention and investments in home- or community-based patient support services.

CN48 Pilot evaluation of RCC4Nurses to enhance nursing education and practice in survivorship care of people with advanced renal cell carcinoma in Europe

CN48 Pilot evaluation of RCC4Nurses to enhance nursing education and practice in survivorship care of people with advanced renal cell carcinoma in Europe

Post-Treatment Experiences of Reproductive Concerns Among Young Breast Cancer Survivors: A Descriptive Phenomenological Study

PurposeThe long-term fertility impact of cancer treatments is a significant concern for young breast cancer survivors. These reproductive concerns often become a persistent source of stress, negatively affecting their quality of life. This study aims to explore the reproductive concerns experienced by young breast cancer survivors post-treatment and the factors influencing their perceptions. MethodsThis phenomenological study utilized semi-structured interviews to collect data. Eighteen participants were recruited from a tertiary hospital in Mainland China. The interviews were transcribed verbatim and analysed using Colaizzi's method. ResultsData analysis revealed five themes and fourteen subthemes: (1) multiple emotional burdens interwoven with concerns about fertility; (2) concerns about risks associated with reproduction; (3) dilemma of childrearing; (4) the significance of reproduction; (5) support needs from family, peers, and professionals. ConclusionsYoung breast cancer survivors in China face significant challenges related to reproductive issues. Reproductive health is a crucial aspect of breast cancer survivorship care. Healthcare providers must be attentive to the reproductive concerns of survivors, recognize the importance of multidimensional support for positive adaptation, and offer tailored and ongoing interventions to manage reproductive health in young breast cancer survivors.

729P Patterns of survivorship care of cervical cancer patients with or without HIV infection in Botswana 2015-2022

729P Patterns of survivorship care of cervical cancer patients with or without HIV infection in Botswana 2015-2022

Integrating pastoral care and appreciative inquiry for sex trafficking survivors: A framework for healing

Integrating appreciative inquiry (AI) and pastoral care may help address the complex issues of commercial sexual exploitation and sex trafficking. This article explores the benefits of incorporating AI principles into pastoral care for survivors of commercial sexual exploitation and sex trafficking. Commercial sexual exploitation and trafficking involve exploitation, degradation, and violence, making them complex issues. By understanding the sex trade, we can recognise that prostitution is an act of exploitation. Some scholars believe that prostitution and human trafficking are interconnected, with a focus on exploiting the poor, especially women and children. Commercial sexual exploitation can cause mental, emotional, and spiritual distress. Survivors require comprehensive aftercare to address their spiritual, self-esteem, and dignity needs. Organisational development-based AI is constructive and strength-based. Appreciative inquiry promotes positive development, community and individual strength, and resilience by re-contextualizing narratives and envisioning brighter futures. The use of AI could improve pastoral care and holistic rehabilitation. Pastoral caregivers using AI can promote reconciliation, development, and rehabilitation. Using strengths-based strategies, pastoral care practitioners can help survivors regain agency and purpose. Survivors receive spiritual support through the Appreciative Way, which combines contemplative spirituality and inquiry. Narrative exploration can help trauma survivors envision a bright future based on love and resilience. This study suggests that AI principles may benefit pastoral care recipients who have experienced commercial sexual exploitation and sex trafficking. Pastoral caregivers can help survivors regain dignity, calling, and well-being by implementing an appreciative healing approach.Contribution: The article sheds light on the dehumanising consequences of sex trafficking on vulnerable populations in South Africa, particularly women and children. This article aims to explain how AI concepts can be applied to Practical Theology. Specifically, this article will demonstrate how the Appreciative Way can be utilised in pastoral care for healing from sex trafficking trauma.

Beyond treatment: navigating existential reflections in the cancer survivorship journey

This narrative review explores the intricate intersection of cancer survivorship and existential reflections, acknowledging the profound impact on the overall well-being and quality of life for survivors. As advances in treatment increase survival rates, understanding the psychosocial aspects of survivorship becomes crucial. This review examines how existential concerns evolve through the phases of survivorship, focusing on themes such as fear of recurrence, reassessment of life priorities, and the quest for renewed purpose. It also investigates the influence of social support, cultural and spiritual beliefs, and mental health on these reflections. By evaluating existing support services and interventions, the review highlights successful strategies and identifies areas for improvement. Recommendations are proposed for integrating existential considerations into survivorship care, emphasizing the need for comprehensive, culturally sensitive support to enhance survivors' quality of life and foster resilience and personal growth.

Policy Brief – Survivorship is cancer survivorship the poor cousin of cancer control within the EBCP?

BackgroundThere is an increasing number of cancer survivors, including children, adolescents, young adults, individuals of working age, and the elderly, within the Belgian and European population. Yet, survivorship care and rehabilitation are often treated as an afterthought in care organisation. This not only directly affects the quality of life of survivors and carers, but also puts the sustainability of the healthcare and social security systems at risk.MethodsWe analysed the ongoing Europe Beating Cancer Plan (EBCP) to identify the actions supporting survivorship (care) developments, then compared their weight in the EBCP to the other domains of cancer control. Following this analysis, and comparison with related ongoing projects, and current infrastructure in Belgium, several unmet needs were identified.ConclusionTo better address these unmet needs, we recommend that Belgium incorporates survivorship care and long-term follow-up in clinical guidelines and care pathways, and considers including indicators related to cancer survivorship in the planning and design of quality insurance schemes, including certification of comprehensive cancer centres. Furthermore, we suggest further investment and support for research and knowledge exchange in the field of survivorship.

Clinical health outcomes of Ebola virus disease survivors eight years post recovery: a cross-sectional study in Sierra Leone.

The West African Ebola virus disease (EVD) epidemic that occurred between 2013-2016 resulted in >28,000 confirmed cases and >11,000 fatalities. Thousands of survivors necessitate an understanding of the long-term health effects and future medical needs of these patients. A cross-sectional study of 595 EVD survivors from Sierra Leone and 403 close contacts (n=998). An in-person survey conducted between November 2021 and March 2022 included demographics, clinical health symptomology assessment of each organ system and a reproductive health assessment including sexual dysfunction question sets. The frequency of each disorder was examined and the association of each disorder with EVD survival was assessed. Of 12 number of symptom types, five were reported by >50% of EVD survivors (Ocular, Neurological, Constitutional, Genitourinary, Dermatological), and all but one were reported by >40% of EVD survivors. Symptom types associated with EVD survival included ENT symptoms (AOR: 8.75, 95% CI: 5.63 - 13.60, p < 0.001), ocular symptoms (AOR: 7.18, 95% CI: 5.02 - 10.25, p < 0.001), dermatological symptoms (AOR: 4.16, 95% CI: 3.06 - 5.65, p < 0.001) and cardiovascular symptoms (AOR: 2.96, 95% CI: 2.12 - 4.13, p < 0.001). The West Africa EVD epidemic resulted in a high prevalence of persistent health issues among disease survivors. Continued support for survivor services in West Africa is crucial, and future outbreak response planning should include dedicated funding to ensure adequate care for survivors, both during the acute phase of infection and throughout the post recovery period.

Optimizing resistance training intensity in supportive care for survivors of breast cancer: velocity-based approach in the row exercise.

Resistance training mitigates side effects during and after cancer treatment. To provide a new approach for precisely and safely assessing and prescribing the intensity of resistance training in supportive cancer care, the purpose of this study was to evaluate the load-velocity relationship during the row exercise in women survivors of breast cancer. Twenty women survivors of breast cancer who had undergone surgery and had completed core breast cancer treatment within the previous 10years completed an incremental loading test until the one repetition maximum (1RM) in the row exercise. The velocity was measured during the concentric phase of each repetition with a linear velocity transducer, and their relationship with the relative load was analyzed by linear and polynomial regression models. A strong relationship was observed between movement velocity and relative load for all measured velocity variables using linear and polynomial regression models (R2 > 0.90; SEE < 6.00%1RM). The mean velocity and mean propulsive velocity of 1RM was 0.40 ± 0.03m·s-1, whereas the peak velocity at 1RM was 0.64 ± 0.07m·s1. In women survivors of breast cancer, monitoring movement velocity during the row exercise can facilitate precise assessment and prescription of resistance training intensity in supportive cancer care.

Effectiveness of Family Coping Interventions in Improving Problem-Solving Skills in the Care of Children and Adolescent Cancer Survivors during and after Treatment: A Scoping Review.

(1) Context: Cancer triggers significant changes in family dynamics. It is noteworthy that coping and problem-solving skills, particularly in situations involving cancer in children and adolescents, have not been adequately explored in the context of family adaptation. This study aims to analyze the effectiveness of family interventions in coping to improve problem-solving skills in parents and/or caregivers of children and adolescents during and after oncological treatment. (2) Methods: This is a scoping review following the recommendations of the Joanna Briggs Institute and the Systematic Reviews and Meta-Analyses Extension for Scoping Review (PRISMA-ScR), from 2014 to 2024, in the databases LILACS, CINAHL, SCOPUS, Web of Science, and PUBMED. (3) Results: Forty-five studies were eligible. Coping strategies were categorized as follows: (1) positive attitudes (including a sense of courage and hope, family support to enhance resilience, and future planning), (2) caregiver empowerment (involving acceptance of diagnosis, emotional distancing, and coping through religiosity), and (3) communication skills (encompassing professional communication, horizontal dialogue with healthcare teams, and sincere communication with friends and family). (4) Conclusions: Over time, families develop coping and problem-solving strategies that influence changes in family functioning patterns, aiding them in accepting, reinterpreting, and reframing ideas and feelings associated with neoplasia.

Survivorship preparedness and activation among survivors of lymphoma.

Taking an active role in managing post-treatment care has emerged as a key aspect of promoting a successful transition into survivorship and is associated with better patient outcomes. In this study, we focus on two key aspects of active self-management, activation and preparedness. Activation was defined as understanding one's role in the care process and having the knowledge, skill, and confidence to take on a role in managing self-care. Preparedness was defined as the extent to which individuals perceived they had sufficient information about what to expect after cancer treatments are completed. The study goal was to characterize survivorship preparedness and activation among lymphoma survivors within 5years of treatment completion in New Jersey and examine the association of sociodemographic, medical, care transition experiences, practical concerns, and psychosocial factors with activation and preparedness. One hundred and one Hodgkin lymphoma or non-Hodgkin lymphoma survivors who had completed treatment within 5years completed a survey of survivorship care experiences (response rate = 34.12%). Approximately 60% of survivors reported high activation, with similar percentages for higher preparedness. Less activated survivors were significantly (p < .05) younger, married, resided in a more deprived geographic area, and reported more fatigue and information needs. Less activated survivors reported recalling that their providers were significantly (p < .05) less likely to discuss long-term side effects, psychosocial needs, risk-reducing lifestyle recommendations, and how to manage other medical concerns. Fewer care transition practices were most strongly associated with lower preparedness. A significant proportion were not activated for survivorship, and both activation and preparedness were strongly associated with providers' survivorship transition practices. Implementing programs to foster more activation and preparedness for lymphoma survivorship care would benefit from education about recommended follow-up care and healthy lifestyle practices. Providers should routinely ask about their patients' confidence and preparedness for survivorship and provide referrals for appropriate care as needed.

Exploring patients and caregivers needs and experiences in oncological physiotherapy: a call for collaborative care

PurposeThis study explores whether the full potential of physiotherapy is reaching cancer patients and their caregivers at all stages of the oncological process, aiming to identify gaps and opportunities for improving care.MethodsThe World Cafe co-design methodology facilitated discussions among cancer patients and caregivers. This dynamic, inclusive, and engaging approach fostered diverse perspectives and deeper insights through collaborative and flexible discussions. Sessions were recorded, transcribed, and qualitatively analyzed.ResultsSixteen participants were involved (eight cancer survivors and eight caregivers). The mean age of cancer survivors was 63.8 years, while the average age of caregivers was 59.3 years. Breast cancer was the most prevalent diagnosis among patients, and most caregivers had lost their family members to cancer. Analysis revealed two primary themes: “feeling cared for” and “the role of physiotherapy in the oncological process.” Key findings highlight the need for more humanized healthcare, with professionals providing support through effective communication and empathy. Significant gaps were detected in both systematic referrals to physiotherapists and their integration into care teams. Testimonies highlighted the lack of knowledge about the full potential of physiotherapy in oncology, hindering access. There was also a demand for recognizing specialized oncological physiotherapists.ConclusionsThese findings highlight significant gaps in physiotherapy care for cancer survivors and caregivers, including unmet needs due to the lack of information, resources, and effective communication. Future efforts should focus on increasing the visibility of physiotherapy, integrating specialized physiotherapists into oncology teams, and enhancing the emotional education of healthcare professionals to provide more humanized care.