Undergoing Cancer Treatment Research Articles

The psychological impacts of positivity in pediatric oncology patients

Despite technological developments in the health field, the physical, emotional and social impacts of childhood cancer diagnosis are still enormous and long-lasting, as it manifests itself at a stage of life that is critical to human development. Therefore, this study sought to investigate the psychological impacts of positivity in pediatric oncology patients. A cross-sectional, qualitative study was conducted with children undergoing cancer treatment followed by the pediatric oncology sector of a reference hospital of the Unified Health System (SUS), in Pernambuco, from September 2021 to August 2023. Data collection was carried out through semi-structured audio-recorded interviews with the participants' consent, transcribed in full and analyzed according to Laurence Bardin's content analysis technique. Ten children participated in the study, four females and six males, aged between 8 and 12 years, an average of 9.9 years. The results pointed to the protective function of positivity in the face of stressful events, as a psychic strengthener linked to the adaptive management of limitations and difficulties arising from pediatric oncology treatment.

Psychometric properties of the Turkish Version General Self-Efficacy Scale in children and adolescents with cancer

ObjectivesThe study aimed to evaluate the validity and reliability of the Turkish version of the General Self-Efficacy Scale in children and adolescents aged 8–18 undergoing cancer treatment. MethodsThe sample of this methodological and descriptive study consisted of 128 children and adolescents between the ages of 8 and 18 in the pediatric hematology-oncology wards and outpatient units of a university hospital. The study was implemented in a university hospital in Turkey between March 2023 and November 2023. Data were collected through face-to-face interviews with children and adolescents attending the clinic or outpatient clinic. Data were collected using the information form and General Self-Efficacy Scale psychometric tests, Cronbach's alpha, Test-retest, validity and reliability analysis). Item-total score correlation was used. ResultsIn the exploratory factor analysis, Kaiser Meyer Olkin was p 0.77, for which Bartlett's test of sphericity was significant (p < 0.001). Exploratory factor analysis revealed a ten-item unidimensional structure with satisfactory representation. Item-total score correlations of the scale ranged between 0.32 and 0.52. In the confirmatory factor analysis, the model fit indices of this scale were obtained as follows: χ2/sd = 1.36, Goodness-of-Fit Index = 0.94, Comparative Fit Index = 0.92, Adjusted Goodness-of-Fit Index = 0.90, and Cronbach alpha value, indicating the internal consistency of the entire scale, was 0.76. ConclusionsThe scale is a valid and reliable tool for assessing self-efficacy in children and adolescents between the ages of eight and eighteen undergoing cancer treatment. Practice implicationsThe study will provide precious information for experimental interventions and follow-up studies to assess the self-efficacy of children and adolescents with cancer.

Evaluation of Contractile Function Using Human iPS Cell-derived Cardiomyocytes

Cardiotoxicity induced by anti-cancer drugs is a significant concern for patients undergoing cancer treatment. Some anti-cancer drugs can damage cardiac muscle cells directly or indirectly, potentially leading to severe heart failure. Various risk factors, including the type and dosage of chemotherapy agents as well as patient background, contribute to the development of cardiotoxicity. Human-induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs), which enable patient-specific toxicity prediction, hold great promise in this regard. However, the practical implementation of hiPSC-CMs-based prediction of anti-cancer drug-induced cardiotoxicity still faces hurdles. One major challenge involves establishing and optimizing experimental systems for evaluating contractile dysfunction, the ultimate output of heart failure, using hiPSC-CMs. Such efforts are currently underway globally, focusing on tailoring functional evaluation systems to the characteristics of hiPSC-CMs. In this paper, we provide an overview of the contraction mechanisms of cardiac cells and introduce a method of measuring contraction that we have developed, and discuss the current status of contractile function evaluation methods using hiPSC-CMs.

The caregiver's experience of childhood cancer treatment in South Africa.

This study explored the treatment-related, financial and psychological experiences of caregivers during cancer treatment of their children in South Africa's (SA) public and private sectors. In this exploratory study, three focus groups were conducted with caregivers of children undergoing cancer treatment in SA's public healthcare sector. A fourth small focus group with two parents in the private sector was conducted online. A mixed-methods approach was employed using a combination of thematic analysis and grounded theory. Of the 20 public sector caregivers, many expressed frustration at the number of visits to primary healthcare clinics before being referred. Caregivers had difficulties coping with and accepting the diagnosis, alongside managing continued care for the child and other children at home. Support received by family and community members was varied. Financial strain was an important concern. The two private sector parents indicated greater levels of support and no financial hardship, but expressed similar levels of emotional stress. These caregiver experiences indicate that improvements are urgently needed in the recognition of childhood cancer symptoms at primary healthcare level in SA. They also highlight a need for increased financial support from government through social grants, travel allowances and nutritional support.

Tumor Response Evaluation Using iRECIST: Feasibility and Reliability of Manual Versus Software-Assisted Assessments.

To compare the feasibility and reliability of manual versus software-assisted assessments of computed tomography scans according to iRECIST in patients undergoing immune-based cancer treatment. Computed tomography scans of 30 tumor patients undergoing cancer treatment were evaluated by four independent radiologists at baseline (BL) and two follow-ups (FU), resulting in a total of 360 tumor assessments (120 each at BL/FU1/FU2). After image interpretation, tumor burden and response status were either calculated manually or semi-automatically as defined by software, respectively. The reading time, calculated sum of longest diameter (SLD), and tumor response (e.g., "iStable Disease") were determined for each assessment. After complete data collection, a consensus reading among the four readers was performed to establish a reference standard for the correct response assignments. The reading times, error rates, and inter-reader agreement on SLDs were statistically compared between the manual versus software-assisted approaches. The reading time was significantly longer for the manual versus software-assisted assessments at both follow-ups (median [interquartile range] FU1: 4.00 min [2.17 min] vs. 2.50 min [1.00 min]; FU2: 3.75 min [1.88 min] vs. 2.00 min [1.50 min]; both p < 0.001). Regarding reliability, 2.5% of all the response assessments were incorrect at FU1 (3.3% manual; 0% software-assisted), which increased to 5.8% at FU2 (10% manual; 1.7% software-assisted), demonstrating higher error rates for manual readings. Quantitative SLD inter-reader agreement was inferior for the manual compared to the software-assisted assessments at both FUs (FU1: ICC = 0.91 vs. 0.93; FU2: ICC = 0.75 vs. 0.86). Software-assisted assessments may facilitate the iRECIST response evaluation of cancer patients in clinical routine by decreasing the reading time and reducing response misclassifications.

Real-world use and clinical impact of an electronic patient-reported outcome tool in patients with solid tumors treated with immuno-oncology therapy

BackgroundUtilization of electronic patient-reported outcome (ePRO) tools to monitor symptoms in patients undergoing cancer treatment has shown clinical benefits. Tennessee Oncology (TO) implemented an ePRO platform in 2019, allowing patients to report their health status online. We conducted a real-world, multicenter, observational, non-interventional cohort study to evaluate utilization of this platform in adults with solid tumors who initiated immuno-oncology (IO) therapy as monotherapy or in combination at TO clinics.MethodsPatients initiating IO therapy prior to platform implementation were included in a historical control (HC) cohort; those initiating treatment after implementation were included in the ePRO cohort, which was further divided into ePRO users (platform enrollment ≤ 45 days from IO initiation) and non-users. Data were extracted from electronic medical records; patients were followed for up to 6 months (no minimum follow up). Outcomes included patient characteristics, treatment patterns, duration of therapy (DoT), and overall survival (OS).ResultsData were collected for 538 patients in the HC and 1014 in the ePRO cohort; 319 in the ePRO cohort were ePRO users (uptake rate 31%). Baseline age was higher, more patients had stage IV disease at diagnosis, and more received monotherapy (82 vs 52%, respectively) in the HC vs the ePRO cohort. Median follow-up was 181.0 days (range 0.0–182.6) in the HC and 175.0 (0.0–184.0) in the ePRO cohort. Median DoT of index IO regimen was 5.1 months (95% confidence interval [CI], 4.4–NE) in the HC cohort vs not estimable (NE) in the ePRO cohort. Multivariable regression adjusting for baseline differences confirmed lower risk of treatment discontinuation in the ePRO vs HC cohort: hazard ratio (HR) 0.83 (95% CI, 0.71–0.97); p < 0.05. The estimated 6-month OS rate was 65.5% in the HC vs 72.4% in the ePRO cohort (p < 0 .01). Within the ePRO cohort, DoT of index IO regimen and OS did not differ between users and non-users. In ePRO users, patient platform use was durable over 6 months.ConclusionImprovements in DoT and OS were seen after ePRO platform implementation. Conclusions are limited by challenges in separating the impact of platform implementation from other changes affecting outcomes.

The lived experience of people affected by cancer: A global cross-sectional survey protocol.

A diagnosis of cancer impacts the person's physical and mental health and the psychosocial and financial health of their caregivers. While data on the experience of living with cancer is available, there is a dearth of data from persons in low- and middle-income countries (LMICs). The perspectives of other impacted individuals also remain understudied (e.g., bereaved family members), as well as the impact on survivors and their families over time. The objective of this study is to describe the psychosocial and financial impact of cancer on people diagnosed with cancer as a child, adolescent or adult, their families/caregivers, and the family members of those who have died from cancer, in high-income countries (HICs) and LMICs. This study is an observational, descriptive, quantitative study. Data will be collected anonymously via a digital online cross-sectional survey distributed globally by the World Health Organization (WHO) via the LimeSurvey software. Participants will include (a) adults aged 18+ who have been diagnosed with cancer at any age, who are currently undergoing cancer treatment or who have completed cancer treatment; (b) adult family members of individuals of any age with a cancer diagnosis, who are currently undergoing cancer treatment or who have completed cancer treatment; and (c) bereaved family members. Participants will be anonymously recruited via convenience and snowball sampling through networks of organisations related to cancer. Survey results will be analysed quantitatively per respondent group, per time from diagnosis, per disease and country. Results will be disseminated in peer-reviewed journals and at scientific conferences; a summary of results will be available on the WHO website. This study will suggest public health interventions and policy responses to support people affected by cancer and may also lead to subsequent research focusing on the needs of people affected by cancer.

The development of an augmented reality application for exercise prescription within paediatric oncology: App design and protocol of a pilot study.

Background: Children and young people with cancer face barriers when engaging with exercise, such as treatment-related side effects, psychosocial burdens and lack of individualised provisions. Digital health tools, such as smartphone applications, have emerged as a promising driver to support healthcare provisions in exercise prescription among patients. It is vital to explore how such technologies can be developed more effectively in order to strengthen the evidence supporting their use and for more appropriate implementation within healthcare. This study aims to explore user experiences, preferences and suggested improvements from healthy children and young people aged 9-21 years. Methods: An augmented reality (AR) application was specifically developed for children and young people aged 9-21 years undergoing cancer treatment and a protocol for a pilot study was designed. The target sample of this pilot study is 90 healthy children and young people aged 9-21 years. Practical 30-min workshops will be conducted encouraging participants to engage with the smartphone app. Focus groups will explore participant experiences, preferences, and suggested improvements. Data will be analysed deductively with apriori themes derived from the semi-structured interviews. Discussion: Obtaining user experiences, preferences and suggested improvements is especially important for the development of novel apps, such as those prescribing exercise and using algorithms and augmented reality software. Results from this study will directly influence the development of an augmented reality application, which will also be applied within a long-term trial in paediatric oncology.

Survey of the association between tooth extraction and development of medication-related osteonecrosis of the jaw in patients undergoing cancer treatment with bone-modifying agents.

This study aimed to verify whether tooth extraction before the administration of bone-modifying agents (BMA) was effective in preventing the onset of medication-related osteonecrosis of the jaw (MRONJ). This retrospective study included patients with a history of receiving BMA for cancer treatment. The patients were classified into three groups based on the timing of tooth extraction: no tooth extraction before the onset of MRONJ, tooth extraction before the administration of BMA, and tooth extraction after the administration of BMA. The incidence of MRONJ was compared between the groups. Fisher's exact test and Bonferroni correction were used to test for differences in proportions between the three groups. The total number of subjects was 123. Twenty-four patients (19.5%) developed MRONJ. The incidence rates were 12.3% (10/81), 17.9% (5/28), and 64.3% (9/14) in the non-extraction group, the extraction before BMA administration group, and the extraction after BMA administration group, respectively, showing statistically significant differences between the extraction after BMA administration group and the non-extraction groups and between the extraction after BMA administration group and the extraction before BMA administration group (p < 0.001, p = 0.0049). On the other hand, there was no statistically significant difference in incidence between the non-extraction and the extraction before BMA administration group (p = 0.5274). Tooth extraction before the administration of BMA is effective in preventing the onset of MRONJ in patients receiving BMA for cancer treatment. Prevention of MRONJ development in patients receiving BMA for cancer treatment contributes to the maintenance of patients' quality of life.

Physical Exercise Intervention for Children Undergoing Cancer Treatment: A Scoping Review

Aims: This research aimed to explore articles regarding physical exercise for children undergoing cancer treatment. Method: The research method used is scoping review. The process of doing a scoping review involves several steps, including developing research questions, establishing criteria for inclusion, a comprehensive search strategy, literature screening and selection, organizing data, and compiling, summarizing, and presenting the findings. The inclusion criteria encompassed full-text papers, namely randomized controlled trials or quasi-experimental research, published in English during the past decade (2014–2023). Pubmed, CINAHL, Scopus, and Proquest are used as search engines and database searches. Selected articles were extracted into charting data, analyzed with descriptive approaches, and the results reported. Results: The results found 14 articles, which were then categorized into three physical exercise programs, such as integrated physical exercise, technology-based physical exercise, and multimodal exercise. Outcomes obtained are cardiorespiratory fitness, motor performance, cancer-related fatigue, and quality of life. Conclusion: The side effects of cancer treatment in children may be mitigated through the implementation of physical exercise programs. This scoping review can be a consideration for optimizing pediatric nursing services by adding physical exercise interventions to the rehabilitation protocol as a supportive treatment for children who are currently undergoing cancer treatment.

Pediatric oncology provider perspectives and patient/family perceptions of chemotherapy-induced nausea and vomiting management: Experiences at an academic medical center.

Chemotherapy-induced nausea and vomiting (CINV) is common in children undergoing cancer treatment, and significantly impacts quality of life. Clinical practice guidelines (CPGs) have been developed to guide CINV management, though many patients do not receive guideline-concordant care. Few studies have examined provider perspectives on CINV management or preferred improvement approaches, or pediatric patient perception of CINV control. A cross-sectional study of pediatric oncology providers was conducted at a large freestanding children's hospital. Providers completed an anonymous online survey about CINV control in patients admitted for scheduled chemotherapy, and their knowledge and utilization of CINV CPGs. A survey of English and Spanish-speaking pediatric oncology patients admitted for scheduled chemotherapy was conducted to assess CINV management, with key demographics used to understand association with perceptions and adherence to antiemetic guidelines. For providers, 75% of respondents felt CINV management could be moderately or extremely improved, significantly more so by chemotherapy prescribers and pediatric medical residents than nurses. Over half of respondents did not have awareness of CINV CPGs, particularly pediatric medical residents. For patients, nausea was reported to be extremely well controlled in 44% of cases, and vomiting extremely well controlled in 50% of cases. There were no significant differences in patient-reported CINV across demographics, when considering emetogenicity of chemotherapy received, or concordance to guidelines. Implementing education in this area may help to improve provider comfort, and ultimately, the patient experience. Future studies will expand upon this novel patient perception, and develop and evaluate CINV management interventions.

Monitoring the efficacy of antibiotic therapy in febrile pediatric oncology patients with bacteremia using infrared spectroscopy of white blood cells-based machine learning

Bacteremia refers to the presence of bacteria in the bloodstream, which can lead to a serious and potentially life-threatening condition. In oncology patients, individuals undergoing cancer treatment have a higher risk of developing bacteremia due to a weakened immune system resulting from the disease itself or the treatments they receive. Prompt and accurate detection of bacterial infections and monitoring the effectiveness of antibiotic therapy are essential for enhancing patient outcomes and preventing the development and dissemination of multidrug-resistant bacteria. Traditional methods of infection monitoring, such as blood cultures and clinical observations, are time-consuming, labor-intensive, and often subject to limitations.This manuscript presents an innovative application of infrared spectroscopy of leucocytes of pediatric oncology patients with bacteremia combined with machine learning to diagnose the etiology of infection as bacterial and simultaneously monitor the efficacy of the antibiotic therapy in febrile pediatric oncology patients with bacteremia infections. Through the implementation of effective monitoring, it becomes possible to promptly identify any indications of treatment failure. This, in turn, indirectly serves to limit the progression of antibiotic resistance.The logistic regression (LR) classifier was able to differentiate the samples as bacterial or control within an hour, after receiving the blood samples with a success rate of over 95 %. Additionally, initial findings indicate that employing infrared spectroscopy of white blood cells (WBCs) along with machine learning is viable for monitoring the success of antibiotic therapy. Our follow up results demonstrate an accuracy of 87.5 % in assessing the effectiveness of the antibiotic treatment.

Beta-blocker adjunct therapy as a prospective anti-metastatic with cardio-oncologic regulation.

The prevailing treatment stratagem in cancer therapy still challenges the dilemma of a probable metastatic spread following an initial diagnosis. Including an anti-metastatic agent demands a significant focus to overrule the incidence of treatment failures. Adrenergic stimulation underlying the metastatic spread paved the way for beta blockers as a breakthrough in repurposing as an anti-metastatic agent. However, the current treatment approach fails to fully harness the versatile potential of the drug in inhibiting probable metastasis. The beta blockers were seen to show a myriad of grip over the pro-metastatic and prognostic parameters of the patient. Novel interventions in immune therapy, onco-hypertension, surgery-induced stress, induction of apoptosis and angiogenesis inhibition have been used as evidence to interpret our objective of discussing the potential adjuvant role of the drug in the existing anti-cancer regimens. Adding weight to the relative incidence of onco-hypertension as an unavoidable side effect from chemotherapy, the slot for an anti-hypertensive agent is necessitated, and we try to suggest beta-blockers to fill this position. However, pointing out the paucity in the clinical study, we aim to review the current status of beta blockers under this interest to state how the drug should be included as a drug of choice in every patient undergoing cancer treatment.

The Prospective Effect of Green Tea versus Pomegranate Peels Extracts on Submandibular Salivary Glands of Albino Rats after Methotrexate Administration (Histological and Immunohistochemical Study).

There is curiosity in the use of substances that can stop cell damage. Antioxidants are substances that can prevent free radicals from damaging cells, and they can be used to treat and avoid a wide variety of illnesses. The current investigation set out to evaluate the histological changes brought on by a single high dose of methotrexate in the submandibular glands of rats treated with green tea and pomegranate peel extract, both are well-known as antioxidants. Forty-eight healthy Albino rats were used in the current study. Animals were divided into six groups. Group 1: Vehicle group which is control group, Group 2: methotrexate treated group, Group 3: green tea control group, Group 4: pomegranate peel extract control group, Group 5: green tea + methotrexate group, and Group 6: pomegranate peel extract + methotrexate group. Rats of all groups were left 1 week after the end of the treatment. Cervical dislocation was used to kill all of the rats. Samples were gained from the rats' submandibular salivary glands of different groups for histological and immunohistochemical evaluation. Green tea + methotrexate group showed improvement in the histological picture of the submandibular salivary gland compared to methotrexate group and the pomegranate peel extract + methotrexate group. The antioxidant activity of green tea is more potent than that of pomegranate peels extract in blocking methotrexate that induced cytotoxicity in the submandibular salivary glands of rats. As a result, it can be administered to people undergoing cancer treatment as a safeguard for their salivary glands.

Ab. No. 24 Role of Physical Rehabilitation Strategies Used in Dysphagia Management in Head and Neck Cancer Survivors- A Systematic Review

Introduction: Dysphagia is a common complication in head and neck cancer (HNC) patients who have undergone cancer treatment. Such patients have disrupted swallowing problems with decreased swallowing function even after 5 years post treatment. Rehabilitation strategies have been designed to enhance the mechanics of swallowing to achieve long lasting improvements. To quantitatively assess the previous research studies and to derive conclusion about various physical rehabilitation strategies focusing in decreasing dysphagia problems and improving Quality of Life (QOL) in Cancer survivors. Relevance: Systematic review shall help summarize existing research and contribute to informed, efficient, and reliable knowledge synthesis which will guide evidence-based decision-making in clinical practice, and research prioritization. Materials and Methods: Electronic search was conducted in Scopus, PubMed, PEDro, and COCHRANE databases. Studies that met the inclusion criteria were evaluated using PEDro scale and Modified McMaster Critical review form for quality appraisal. A descriptive synthesis was undertaken due to heterogeneity of the included studies. Analysis and Results: Total of 17 studies were assessed for Risk of Bias which comprised of 15 clinical trials, 1 Case Series, 1 Case Report that applied swallowing exercises, manoeuvres, Neuromuscular Electrical stimulation (NMES), to the HNC survivors. The outcomes highlighted improvement in swallowing, the oral intake status and QOL as assessed by various swallow/oral intake scales, radiographic examination and QOL scales. Conclusion: The review recommends application of swallowing exercises, manoeuvres, to HNC survivors however, authors speculate diminished use of NMES in such cases. It’s recommended that a well-designed larger sample size with randomization and double blinding would generate better evidence for combined utilization of NMES along with swallowing exercise for HNC survivors. Implications: This systematic review helps to know the lacunae in treatment and how we could strengthen the evidence.

Herbal Therapies in Cancer Patients: Managing Side Effects and Improving Quality of Life

Introduction: This comprehensive review explores the role of herbal therapies in managing the side effects of cancer treatments and enhancing the quality of life for cancer patients. As conventional cancer treatments often induce a myriad of adverse effects, ranging from nausea and fatigue to pain and emotional distress, the integration of herbal therapies has gained attention as a potential complementary approach. Methods: The review synthesizes existing literature, drawing upon both preclinical and clinical studies, to evaluate the efficacy and safety of various herbs in alleviating common side effects associated with cancer therapies. Special emphasis is placed on the potential benefits of herbal interventions in addressing physical symptoms, such as nausea and pain, as well as psychological and emotional challenges faced by cancer patients. Furthermore, the review explores the mechanisms of action behind these herbal interventions and potential synergies with conventional treatments. Insights into patient perspectives and experiences with herbal therapies contribute to a holistic understanding of their impact on overall well-being. Conclusion: By providing a critical analysis of the current state of knowledge, this review aims to guide healthcare professionals, researchers, and patients in making informed decisions regarding the integration of herbal therapies into cancer care, ultimately improving the supportive care and quality of life for individuals undergoing cancer treatment.

Evidence of validity of the Brazilian version of the Cancer Behavior Inventory - Brief Version.

To analyze the validity evidence of the Brazilian version of the Cancer Behavior Inventory - Brief Version. Methodological study, conducted between November and December 2021, with 140 patients undergoing hospital cancer treatment in João Pessoa, Paraíba, Brazil. Psychometric analyses were performed in the adapted version, using exploratory factor analysis and correlation with correlated constructs. A two-factor and 10-item model was evidenced. The cumulative variance explained about 61% the shared variance of the items. Satisfactory values were observed for the factors in the analyses of composite reliability (0.89 and 0.91, respectively), internal consistency (0.86 and 0.91, respectively) and ORION (0.89 and 0.85, respectively). The expected correlations of self-efficacy with quality of life (convergent) and with anxiety and depression (divergent) were evident. The Brazilian version of the instrument showed evidence of validity, being considered reliable to assess the self-efficacy of patients undergoing cancer treatment.

Awareness and interest in cannabis use for cancer management among cancer survivors.

We examined the awareness, interest, and information sources relating to cannabis use for cancer management (including management of cancer symptoms and treatment-related side effects) and determined factors associated with cancer survivors' awareness and interest in learning about cannabis use for cancer management. This was a cross-sectional study of adult cancer survivors (N = 1886) receiving treatment at a comprehensive cancer center. Weighted prevalence and multivariable logistic regression analyses were conducted. Among cancer survivors, 88% were aware and 60% were interested in learning about cannabis use for cancer management. Common sources of information to learn about cannabis use for cancer management were cancer doctors/nurses (82%), other patients with cancer (27%), websites/blogs (26%), marijuana stores (20%), and family/friends (18%). The odds of being aware of cannabis use for cancer management was lower among male compared to female survivors (adjusted odds ratio [AOR]: 0.61; 95% confidence interval [CI]: 0.41-0.90), non-Hispanic Blacks compared to non-Hispanic Whites (AOR: 0.36; 95% CI: 0.21-0.62), and survivors who do not support the legalization of cannabis for medical use compared to those who do (AOR: 0.10; 95% CI: 0.04-0.23). On the other hand, the odds of being interested in cannabis use for cancer management was higher among non-Hispanic Blacks compared to non-Hispanic Whites (AOR: 1.65; 95% CI: 1.04-2.62), and among cancer survivors actively undergoing cancer treatment compared to patients on non-active treatment (AOR: 2.25; 95% CI: 1.74-2.91). Awareness of cannabis use for cancer management is high within the cancer survivor population. Results indicated health care providers are leading information source and should receive continued medical education on cannabis-specific guidelines. Similarly, tailored educational interventions are needed to guide survivors on the benefits and risks of cannabis use for cancer management.

Mindfulness-Based Group Medical Visits: Strategies to Improve Equitable Access and Inclusion for Diverse Patients in Cancer Treatment.

Mindfulness-based interventions (MBIs) are supported by clinical practice guidelines as effective non-pharmacologic interventions for common symptoms experienced by cancer patients, including anxiety, depression, and fatigue. However, the evidence predominately derives from White breast cancer survivors. Racial and ethnic minority patients have less access to integrative oncology care and worse cancer outcomes. To address these gaps, we designed and piloted a series of mindfulness-based group medical visits (MB-GMVs), embedded into comprehensive cancer care, for racially and ethnically diverse patients in cancer treatment. As a quality improvement project, we launched a telehealth MB-GMV series for patients undergoing cancer treatment, delivered as four weekly 2-hour visits billable to insurance. Content was concordant with evidence-based guidelines and established MBIs and adapted to improve cultural relevance and fit (eg, access-centered, trauma-informed, with inclusive communication practices). Program structure was adapted to address barriers to participation, with ≥50% slots per series reserved for racial and ethnic minority patients. Intake surveys incorporated a demographic questionnaire and symptom assessments. Evaluations were sent following the visits. In our first ten cohorts (n = 78), 80% of referred patients enrolled. Participants were: 22% Asian, 14% Black, 17% Latino, 45% non-Latino White; 65% female; with a median age of 54years (range 27-79); and 80% had metastatic cancer. Common baseline symptoms included lack of energy, difficulty sleeping, and worrying. Most patients (90%) attended ≥3 visits. On final evaluations, 87% patients rated the series as "excellent"; 81% "strongly agreed" that they liked the GMV format; and 92% would "definitely" recommend the series to others. Qualitative themes included empowerment and connectedness. Telehealth GMVs are a feasible, acceptable, and financially sustainable model for increasing access to MBIs. Diverse patients in active cancer treatment were able to participate and reported high levels of satisfaction with this series that was tailored to center health equity and inclusion.

THE ROLE OF AGE-FRIENDLY HEALTH CARE IN OLDER ADULTS WITH CANCER

Abstract It is estimated that 51% of cancer incidence worldwide occurs among adults aged 65 years and older. The care of older adults diagnosed with cancer is complex due to an interplay of biopsychosocial factors, including comorbidities, geriatric syndromes, functional status, nutritional health and socioeconomic characteristics. Working within an age-friendly model of care is important in ensuring the complexity of ageing is taken into consideration, while understanding what matters most to the patient undergoing cancer treatment. Age-friendly models of care such as the 4Ms framework (Mentation, Mobility, Medications, and (what) Matters) are gaining support across the globe, but little is known of the use of age-friendly models of care in cancer care. This scoping review aimed to understand the current state of age-friendly care in cancer care and to highlight how age-friendly models can be implemented in cancer care to improve the experience of treatment for older adults.