12074 Background: Fatigue after breast cancer treatment is a major health problem that is very difficult to treat. Our aim was to determine whether the early introduction of focused rehabilitation from the start of the cancer treatment is associated with the frequency of fatigue in breast cancer patients. Methods: The subjects of our prospective study were 600 female breast cancer patients (26-65 (mean 52) years of age), who participated in the pilot study on the individualized integrated rehabilitation of breast cancer patients in 2019-2022 and were followed for at least six months. The control group included 300 patients and the intervention group 300 patients. The patients completed three questionnaires (EORTC QLQ - C30, B23 and NCCN): before and six months after the beginning of cancer treatment. The control group obtained the same rehabilitation as was offered to all breast cancer patients in our hospital before the start of our study. The multidisciplinary rehabilitation team reviewed the documentation of all the patients from the intervention group before six months after the beginning of treatment and recommended appropriate interventions according to the patient's problems. The integrated rehabilitation coordinator referred patients for additional treatments in compliance with the institute’s new clinical pathway (psychologist, general practitioner, nutritional treatment, physical rehabilitation, kinesiologist-guided online exercises, gynaecologist, analgesia, vocational rehabilitation). Data on the patients’ demographics, disease extent, cancer treatment and complaints reported in questionnaires were collected. This data and the frequency of fatigue six months after the beginning of treatment in both groups of patients were analysed using the chi-square and ANOVA test. Results: There were no differences between the control and the intervention group of patients in terms of age, education, disease extent, surgical procedures, systemic cancer treatment, or radiotherapy. There were no differences between the groups in the prevalence of fatigue before the start of treatment. Before the cancer treatment, 50% of the patients in both groups reported fatigue, while moderate or severe fatigue was reported in the intervention and control groups in 9% and 10% (p = 0.69), respectively. Six months after the beginning of cancer treatment, fatigue was reported in the intervention and control groups in 66% and 70% (p = 0.38), respectively. However, moderate or severe fatigue were reported in the intervention and control groups in 17% and 26% (p = 0.02), respectively. Conclusions: Early integrated rehabilitation is associated with a lower prevalence of moderate or severe fatigue in breast cancer patients in comparison to the control group six months after the beginning of cancer treatment.
Background: Tobacco related illnesses are important public health issues worldwide. Cigarette smoking effects cancer risk and cardiovascular risk. Smoking cessation confers substantial benefits on health. Our aim was to determine whether the early introduction of integrated rehabilitation from the beginning of cancer treatment is associated with the smoking cessation in breast cancer patients. Material and Methods: The subjects of our prospective study were 467 female breast cancer patients (29-65 (mean 52) years of age), who participated in the pilot study on the individualized integrated rehabilitation of breast cancer patients in 2019-2022 and were followed for at least one year. The control group included 282 patients and the intervention group 185 patients. The patients completed three questionnaires (EORTC QLQ - C30, B23 and NCCN) before and one year after the beginning of cancer treatment. The control group obtained the same rehabilitation as was offered to all breast cancer patients in our hospital before the start of our prospective study. The multidisciplinary rehabilitation team reviewed the documentation of all the patients from the intervention group before and one year after the beginning of cancer treatment and recommended appropriate interventions according to the patient’s difficulties. The integrated rehabilitation coordinator referred patients for additional interventions in compliance with the institute’s clinical pathway (psychologist, general practitioner, clinical nutritionist, physical rehabilitation, kinesiologist-guided online exercises, gynecologist, analgesia, vocational rehabilitation). Smokers were referred to a smoking cessation workshop organized by a health promotion center within community health centres. Data on the patients’ demographics, disease extent, cancer treatment and prevalence of tobacco smoking before and one year after the beginning of cancer treatment were collected and analysed using the chi-square and ANOVA test. Results: There were no differences between the control and the intervention group of patients in terms of age, education, disease extent, surgical procedures, systemic cancer treatment, or radiotherapy. There were no differences between the groups in the prevalence of smoking before the treatment. Before the cancer treatment, smoking was present in the intervention and control group in 22% and 27% (p=0.22), respectively. However, one year after the beginning of cancer treatment, smoking was less common in the intervention group in comparison to the control group of patients (p=0.004). Smoking was present in the intervention and control group in 10% and 20%, respectively. Conclusions: Early integrated rehabilitation helps the smoking cessation in breast cancer patients. Citation Format: Nikola Besic, Zlatka Mavric, Anamarija Mozetic, Tina Zagar, Vesna Homar, Nena Kopcavar Gucek, Andreja Cirila Skufca Smrdel, Jana Knific, Simona Borstnar, Mateja Kurir Borovcic, Lorna Zadravec Zaletel, Natasa Kos, Branka Strazisar, Denis Mastnak Mlakar, Nina Kovacevic, Vedran Hadzic, Bojan Pelhan, Marko Sremec, Tina Rozman, Romi Cencelj-Arnez. Early integrated rehabilitation helps smoking cessation in 467 breast cancer patients – a comparison between the intervention and control group in a prospective study [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P6-05-31.
138 Background: Communication with breast cancer patients is crucial within individualised integrated rehabilitation, where the patients are at the centre of the provided health care services. Anonymous surveys could be used as one of the tools to check the needs of patients, the effectiveness of various aspects of the interventions offered and to obtain valuable feedback from patients. Our aim was to determine which manner of conducting anonymous surveying among breast cancer patients would be most suitable for improving the health service of individualized integrated rehabilitation. Methods: The subjects of our prospective study were 600 females (29-65 (mean 52) years of age), who participated in the pilot study on the individualized integrated rehabilitation of breast cancer patients receiving treatment at Institute of Oncology Ljubljana in 2019-2022. Questionnaires of implemented surveys were anonymous with different manners of distribution and on three different topics. The first survey was conducted via standard post sending questionnaires on papers to the patients to inquire about their satisfaction with the provided services after the conclusion of their treatment. The second survey was conceded via email, sending online questionnaires to inquire about appropriateness of interventions and patients' opinions about spa treatment. The third survey was conducted half via email and half via text message on mobile phone (SMS) to inquire about the most suitable terms of the regular physical activity during oncological treatment. The survey response rate was calculated as the number of valid surveys received (numerator) divided by the number of surveys distributed (denominator). If all questions were not answered, the survey was invalid. Results: There was a significant difference in the response rate of the patients to the anonymous surveys, depending on the manner of distribution of the survey. The response rate of patients who got questionnaires by regular mail were 51%, 28% and 13% if received by e-mail and 27% if sent via SMS. The difference in the response rate in the survey on physical activity, received by email or by SMS, was statistically significant (p= 0,0026). Conclusions: The highest response rate of breast cancer patients was received by sending the questionnaires via regular post. Clinical trial information: V3-1906. [Table: see text]
e24062 Background: Our aim was to determine the frequency of health-related problems faced by breast cancer patients before and six months after the initiation of breast cancer treatment. Methods: This prospective study involved 600 female breast cancer patients (26-65 years, mean 52), who participated in the pilot study in the novel individualized integrated rehabilitation programme in 2019-2022 and were followed for at least six months. The patients completed three questionnaires (EORTC QLQ - C30, B23 and NCCN) before the initiation of cancer treatment and six months after. The patients received neoadjuvant chemotherapy in 22% of the cases, tumorectomy in 53%, mastectomy in 39%, breast reconstruction in 27%, sentinel node biopsy in 67%, lymphadenectomy in 23%, external beam radiotherapy in 73%, chemotherapy in 45%, anti-HER-2 therapy in 11% and hormonal therapy in 74% of the cases. Data on the patients’ demographics, disease extent, cancer treatment and problems reported in the questionnaires were collected and analysed using descriptive analysis. Results: The problems reported by patients before the initiation of cancer treatment and after six months are presented in Table. In 14 out of 22 parameters, the frequency of problems increased in the six months after the initiation of treatment: fatigue, insomnia, lymphedema, shoulder movement impairment, disturbing scars, heart problems, hot flashes/sweating, gynaecological problems, sexual problems, body image worries, inappropriate nutrition, pain in the shoulder or arm, alopecia and concerns about returning to work. On the other hand, the frequency of problems decreased six months after the initiation of cancer treatment in 6 out of 22 parameters. Our patients less often had depression or anxiety, were too little physically active, smoked, consumed alcohol or used food supplements than before. Conclusions: Six months after the initiation of breast cancer treatment patients have more problems than at the time before treatment.[Table: see text]
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