Introduction – With heightened public awareness, earlier detection, and better treatment, the number of breast cancer survivors continues to grow. Many of these cancer survivors have physical, psychological, social, spiritual, and financial challenges that require coordinated, comprehensive care. Patient involvement programs that focus on education and health promotion may help breast cancer survivors to manage their symptoms and take better control of their health. At the University of Maryland, a collaborative group developed the Cancer Survivorship Patient Engagement Toolkit (CaS-PET). CaS-PET includes the following components: survivorship care plans, online support program (learning modules and discussion board), and ongoing communication between providers and patients using a patient portal. The main aim of the study is to test the preliminary impact of the CaS-PET using a small sample. Methods – After IRB approval, 30 cancer survivors at the University of Maryland Marlene and Stuart Greenebaum Comprehensive Cancer Center who were within 6 months of completion of active treatment were enrolled in a prospective pilot study that used a single group pre-post design. The outcome measures included changes in quality of life, fear of recurrence, impact of cancer, dietary and exercise behaviors, and selected cancer symptoms. In addition, participants' demographic characteristics, as well as Internet and patient portal experiences were also assessed at baseline. Currently, baseline surveys are completed and the 3-month follow-up data collection is ongoing. Results – Among the total of 30 patients, 15 (50%) were breast cancer survivors. The median age was 57.2+13 years and all were female. Ten survivors were African American (66.7%). Most survivors received combination of surgery, chemotherapy, and radiation treatments. At baseline, the mean scores for the positive impact and negative impact of cancer were 3.69 (range, 1-5, higher means more positive) and 2.57 (1-5, higher means more negative) respectively. Among various physical and mental cancer symptoms, breast cancer patients frequently experience lack of energy, pain, bloating, sadness, and constipation. The mean score for fear of recurrence was 14.16 +6.4 (range of 6-24, higher means more fear). The average scores for fat and fruit/vegetable consumption were 17.7+6.0 and 7.6+4.1, respectively, which indicated a diet high in fat and calories and low in fruit and vegetables. Discussion – This baseline assessment shows breast cancer survivors experience significant residual symptoms following completion of active therapy. Many patients are fearful of recurrence and struggle with other negative impacts of cancer. However, patients have also found positives in their experiences. Participants have expressed enjoyment and benefit of the CaS-PET study. Full outcomes will be available in early September 2019. Citation Format: Rosenblatt PY, McQuaige M, Miller K, Nahm E-S, Hertsenberg L. Quality of life, fear of recurrence, impact of cancer, and dietary habits in breast cancer patients during the early survivorship period - Initial data from the pilot Cas-PET (Cancer Survivorship Patient Engagement Toolkit) study [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-12-14.
Cancer is a disease that predominantly affects older adults. The median age at diagnosis is 66 years and 62% of the 15.5 million American cancer survivors are age ≥65 years. Provision of supportive care after treatment is critical to this group due to their complex care needs; however, limited resources are available to them. As increasing numbers of older survivors adopt technology, digital health programs have significant potential to help them improve their health and communicate with their providers. Previously, we developed/tested a digital Cancer Survivorship Patient Engagement Toolkit program for older adults, CaS-PET Silver. The aim was to examine the preliminary impact of CaS-PET Silver on older survivors’ health outcomes. This was a 2-armed RCT with two observations (baseline, 8 weeks) on a sample of 60 survivors age ≥65 years (mean age, 70.1±3.8), who were treated with curative intent within 12 months from enrollment (02/2020-01/2022, COVID-19 pandemic). Outcomes included health-related quality of life (HRQoL), self-efficacy for coping with cancer, symptom burden, health behaviors, and patient-provider communication. Data were analyzed using descriptive statistics, linear mixed models, and content analysis. The majority of participants were black (68.3%, n=41) and female (56.6%, n=34). At 8 weeks, CaS-PET Silver group showed significantly improved physical HRQoL (p < .001, ES=0.64) and symptom burden (p=.053, ES= -0.41). Self-efficacy (ES=0.56), mental HRQoL (ES=0.26), and communication (ES=0.40) showed a tendency to improve. Most participants reported benefits from the program on health management (mean, 19.41±2.6 [3–21]). Further research is needed with larger, diverse older cancer populations.
Introduction - Cancer survivors may have physical, psychological, social, spiritual, and financial challenges that require coordinated, comprehensive care. Patient involvement programs that focus on education and health promotion help survivors to manage their symptoms and take better control of their total health. At the University of Maryland, a collaborative group developed the Cancer Survivorship Patient Engagement Toolkit (CaS-PET) which includes survivorship care plans, education on health topics, discussion boards, and ongoing communication between providers and patients using a patient portal. A study was performed to test the feasibility and preliminary impact of the CaS-PET program. Methods - After IRB approval, 30 cancer survivors at the University of Maryland Marlene and Stuart Greenebaum Comprehensive Cancer Center who were within 6 months of completion of active treatment were enrolled in a prospective pilot study of the CaS-PET that used a single group pre-post (3 month) design. The outcome measures included changes in quality of life, fear of recurrence, impact of cancer, dietary and exercise behaviors, and selected cancer symptoms. Participants’ demographic characteristics, internet/patient portal experience, and eHealth literacy was collected at baseline. Results - Among the 30 total participants, 15 (50%) were breast cancer survivors. Of the breast cancer participants, the median age was 57.2±13 years, 66.7% (n=10) were African American, and all were female. 13/15 (86%) participants completed the program and post questionnaires. After the CaS-PET program, participants had improved adherence to treatment (p=0.019), fruit and vegetable consumption (p=0.039), and trend to improved physical activity score (p=0.069). Tests related to psychosocial aspects of health did not show improvement. PrePostTest StatisticP valueAdherence to treatment25.223.2t=-2.7670.019Fruit and veg consumption9.712.4t=2.3110.039Physical Activity total MET5.16.7t=1.9950.069Global distress index0.90.9t=0.1890.853Fear of recurrence15.016.4t=0.8060.435 Discussion - The Cancer Survivorship Patient Engagement Toolkit (CaS-PET) was successfully administered to breast cancer survivors. Improvements in adherence, diet, and a trend towards improved physical activity were noted at the 3 month time point. While measured changes in fear of recurrence, impact of cancer, and symptom burden did not show significant changes, patients reported to investigators positive experiences from the program. Further longitudinal designed studies are needed with a larger sample and across different age groups. Citation Format: Paula Rosenblatt, Lindsey Hertsenberg, Hyojin Son, Mary McQuaige, Kenneth Miller, Eun Shim Nahm. Use of cancer survivorship patient engagement toolkit (CaS-PET) in breast cancer patients [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P2-13-11.
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