Although research has emerged documenting the psychosocial impact of family care for cancer patients, few efforts capture the multi-dimensional nature of cancer caregiving stress, particularly among socioeconomically diverse samples. Utilizing data collected from cancer caregivers at a non-urban, Southern US site and an inner-city, Northeastern US site (N=233), the present study identified predictors of multiple dimensions of caregivers' subjective stress (i.e. emotional appraisals of care demands). Various indicators representing the sociodemographic context of care, cancer care demands, and psychosocial resources were found to exacerbate or buffer caregivers from feelings of exhaustion, role entrapment, and loss of intimacy with the cancer patient. The multivariate regression model also emphasized the diffuse yet potent role care recipient mood problems and caregiver mastery/optimism have on multiple dimensions of subjective stress. The findings offer a number of recommendations for future research and practice focused on informal cancer care.

This study tested the hypothesis that various components of the stress process model were related to negative outcomes (depression, guilt, negative health) in cancer caregivers. This study also tested the hypothesis that psychosocial resources (mastery, socioemotional support) mediated the relationship between the various domains of the stress process model and negative outcomes. A total of 238 cancer caregivers were recruited from radiation medicine clinics at the University of Maryland Greenebaum Cancer Center (n = 186) and the University of Minnesota Cancer Center (n = 52). A comprehensive interview battery was administered. A multivariate regression found that primary subjective stressors were the strongest predictors of depression and negative health impact. A path analysis indicated that mastery mediated the relationship between role captivity and negative health impact. These results emphasize the importance of multidimensional assessment in cancer caregiving. The findings also suggest refinements to the stress process model when examining family cancer care.

The results emphasize the need to consider the context of cancer care when analyzing the stress process. When faced with employment, women appear particularly at risk for emotional distress and greater perceived care demands. Utilizing tools that identify cancer caregivers at risk based on work, gender, or other contextual variables may inform the development and targeting of clinical interventions for this population.

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Few studies examine how cancer caregiving stress "proliferates," or how stress related to care provision spreads and influences other aspects of life. These other aspects of life are called secondary stressors and may include perceptions of family support, financial strain, or the caregiver's schedule. In the current study, data on sociodemographic background, care demands, and psychosocial stress were collected from 186 cancer caregivers. A multivariate regression analysis was used to identify factors reliably related to secondary stressors. Role overload appeared to exacerbate multiple secondary stressors, whereas socioemotional support protected caregivers against all dimensions of secondary stress. These empirical results are among the first on predictors of secondary stress in cancer caregiving, and they may inform future descriptive and clinical examinations of the stress process in cancer caregiving families.

BackgroundThe study objectives were to transition in-person colorectal cancer multidisciplinary clinic (MDC) to a telehealth MDC (tele-MDC) format and to assess early outcomes. MethodsA colorectal tele-MDC was devised, in which patients used remote-access technology while supervised by a clinician. The team consisted of surgeons, medical oncologists, radiation oncologists, radiologists, and pathologists. Outcomes were assessed with patient and provider surveys, using a 5-point Likert scale (higher = more favorable). ResultsA total of 18 patients participated in the tele-MDC. Surveyed patients (n=18) and physicians (n=19) were satisfied with the quality of care (mean Likert = 4.93, 4.53, respectively), and low standard deviations (range 0-1.03) across all questions reflected homogeneity in satisfaction with the metrics surveyed. ConclusionsThis pilot study demonstrates that a functional colorectal cancer tele-MDC is a feasible alternative to inperson MDC during the coronavirus disease 2019 (COVID-19) pandemic, with the potential for a high degree of patient and physician satisfaction.

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Purpose: To treat multiple targets with a single IMRT plan with automatic field matching and different sets of angles for each target. In the treatment of head‐and‐neck (HN) malignancies with IMRT for example, the traditional approach is to deliver 7–9 IMRT fields matched with a static half‐beam blocked supraclavicular field. However, significant cold and hot spots are frequently observed near the field junction. We have developed a technique to generate a single IMRT plan that eliminates the need for beam matching and reduces excess irradiation of normal tissue. Method and Materials: Direct aperture optimization (DAO) [1, 2] is an inverse planning technique where the MLC delivery constraints are incorporated into the plan optimization. By defining the initial apertures prior to optimization, the IMRT fields are limited in the search space for the MLC leaves, which served as a seeding solution. The fields are restricted so as to prevent them from exceeding the beam's eye view of their assigned targets. With this approach a single IMRT plan can be generated for multiple targets with different sets of gantry angles and automatic field matching. Results: Using DAO and defining the initial MLC aperture technique can produce a single IMRT plan for multiple targets without field matching. In the case of HN, 7 to 9 fields were assigned to the primary tumor, upper neck, and a portion of the lower neck nodes. An anterior and a posterior field were assigned to the mediastinum and a portion of the lower neck nodes. The resulting single isocenter IMRT plans were delivered without the need to junction fields. Conclusions: By using different beam arrangements, a single IMRT HN plan can be generated to treat multiple targets with needing to match fields.