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Background: Racial disparities in sleep are well‐documented. However, evidence‐based options for addressing these disparities are lacking in cancer populations. To inform future research on sleep interventions, this study aims to understand racial differences in treatment responses to acupuncture and cognitive behavioral therapy for insomnia (CBT‐I) among Black and White cancer survivors. Methods: We conducted a secondary analysis of a comparative effectiveness trial evaluating acupuncture versus CBT‐I for insomnia in cancer survivors. We compared insomnia severity, sleep characteristics, and co‐morbid symptoms, as well as treatment attitudes, adherence, and responses among Black and White participants. Results: Among 156 cancer survivors (28% Black), Black survivors reported poorer sleep quality, longer sleep onset latency, and higher pain at baseline, compared to White survivors (all p < 0.05). Black survivors demonstrated lower adherence to CBT‐I than White survivors (61.5% vs. 88.5%, p = 0.006), but their treatment response to CBT‐I was similar to white survivors. Black survivors had similar adherence to acupuncture as white survivors (82.3% vs. 93.4%, p = 0.16), but they had greater reduction in insomnia severity with acupuncture (−3.0 points, 95% CI −5.4 to 0.4, p = 0.02). Conclusion: This study identified racial differences in sleep characteristics, as well as treatment adherence and responses to CBT‐I and acupuncture. To address racial disparities in sleep health, future research should focus on improving CBT‐I adherence and confirming the effectiveness of acupuncture in Black cancer survivors. [ABSTRACT FROM AUTHOR]

Background: Chronic pain negatively affects sleep; it is unclear whether pain relief from acupuncture contributes to sleep quality improvements in cancer survivors. This study aimed to evaluate the effect of acupuncture versus usual care on sleep quality among cancer survivors with comorbid sleep disturbance and chronic musculoskeletal pain. Methods: Sleep outcome data from the Personalized Electroacupuncture Versus Auricular Acupuncture Comparative Effectiveness (PEACE) randomized clinical trial were analyzed. Electroacupuncture or auricular acupuncture was compared with usual care for sleep quality improvement over 10 weeks of treatment among cancer survivors with clinically significant sleep disturbance and chronic musculoskeletal pain at baseline. Sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI) global score. Results: Among 268 participants (mean [standard deviation (SD)] age, 61.4 [12.6] years; 191 women [71.3%]; mean [SD] baseline PSQI global score, 10.3 [3.3] points), electroacupuncture and auricular acupuncture resulted in greater reductions in the PSQI global score from baseline to 10 weeks in comparison with usual care: 1.42 points (95% confidence interval [CI], 0.45–2.38; p =.004) and 1.59 points (95% CI, 0.62–2.55; p =.001), respectively. The improvement in sleep quality for the acupuncture groups was sustained for 24 weeks from randomization. Furthermore, a greater proportion of patients in the electroacupuncture and auricular acupuncture groups had clinically meaningful improvement in sleep quality compared to the usual care group (41.0% and 42.9% vs. 21.4%; p =.044). Conclusions: Among cancer survivors with comorbid sleep disturbance and chronic pain, electroacupuncture and auricular acupuncture produced a clinically relevant and persistent improvement in sleep quality. These findings suggest that acupuncture may be an evidence‐based nonpharmacologic intervention to improve sleep health for cancer survivors with pain. Plain Language Summary: This study analyzed the sleep quality data from a published randomized clinical trial that evaluated the effect of electroacupuncture or auricular acupuncture versus usual care on pain relief among people who survived cancer.This analysis included a prespecified subgroup of 268 participants with co‐occurring sleep disturbance and chronic musculoskeletal pain at baseline and found that patients who used acupuncture for pain relief demonstrated greater improvements in sleep quality compared with patients who received usual care.Sleep quality improvement by acupuncture was sustained after the treatment ended. Among cancer survivors with comorbid sleep disturbance and chronic pain, both electroacupuncture and auricular acupuncture improved sleep quality compared to usual care. The improvement in sleep quality by acupuncture treatment was sustained to 24 weeks after randomization. [ABSTRACT FROM AUTHOR]

The increase in cancer incidence and mortality is challenging current cancer care delivery globally, disproportionally affecting low‐ and middle‐income countries (LMICs) when it comes to receiving evidence‐based cancer prevention, treatment, and palliative and survivorship care. Patients in LMICs often rely on traditional, complementary, and integrative medicine (TCIM) that is more familiar, less costly, and widely available. However, spheres of influence and tensions between conventional medicine and TCIM can further disrupt efforts in evidence‐based cancer care. Integrative oncology provides a framework to research and integrate safe, effective TCIM alongside conventional cancer treatment and can help bridge health care gaps in delivering evidence‐informed, patient‐centered care. This growing field uses lifestyle modifications, mind and body therapies (eg, acupuncture, massage, meditation, and yoga), and natural products to improve symptom management and quality of life among patients with cancer. On the basis of this review of the global challenges of cancer control and the current status of integrative oncology, the authors recommend: 1) educating and integrating TCIM providers into the cancer control workforce to promote risk reduction and culturally salient healthy life styles; 2) developing and testing TCIM interventions to address cancer symptoms or treatment‐related adverse effects (eg, pain, insomnia, fatigue); and 3) disseminating and implementing evidence‐based TCIM interventions as part of comprehensive palliative and survivorship care so patients from all cultures can live with or beyond cancer with respect, dignity, and vitality. With conventional medicine and TCIM united under a cohesive framework, integrative oncology may provide citizens of the world with access to safe, effective, evidence‐informed, and culturally sensitive cancer care. [ABSTRACT FROM AUTHOR]

Background: Cancer-related cognitive impairment is a prevalent, disruptive condition potentially exacerbated by sleep disturbances. The current study was performed to evaluate the effects of acupuncture versus cognitive behavioral therapy for insomnia (CBT-I) on objective and subjective cognitive function in cancer survivors with insomnia.Methods: Using data from a randomized clinical trial (160 survivors) that compared acupuncture versus CBT-I for insomnia occurring in cancer survivors, the authors analyzed cognitive outcomes and their relationship to insomnia symptoms. Analysis was limited to 99 patients who reported baseline cognitive difficulties. Interventions were delivered over 8 weeks. Objective attention, learning, and memory were evaluated using the Buschke Selective Reminding Test. Subjective cognitive function was assessed using the Brown Attention-Deficit Disorder Scales. Insomnia symptoms were assessed using the Insomnia Severity Index. All outcomes were collected at baseline, week 8, and week 20.Results: From baseline to week 8, acupuncture produced statistically significant within-group improvements in objective attention (Cohen D, 0.29), learning (Cohen D, 0.31), and memory (Cohen D, 0.33) that persisted to week 20 (all P < .05), whereas CBT-I produced a statistically significant within-group improvement in objective attention from baseline to week 20 (Cohen D, 0.50; P < .05); between-group differences were not statistically significant. Both interventions produced statistically significant within-group improvements in subjective cognitive function at weeks 8 and 20 compared with baseline (all P < .001); between-group differences were not statistically significant. In the acupuncture group, patients with clinically meaningful responses with regard to insomnia symptoms demonstrated a significantly greater improvement in subjective cognitive function compared with those without clinically meaningful insomnia responses (P = .006).Conclusions: Among cancer survivors with insomnia, both acupuncture and CBT-I produced significant improvements in objective and subjective cognitive function. However, the effect sizes varied and only survivors in the acupuncture group demonstrated a significant relationship between cognitive and sleep outcomes. These preliminary findings warrant further investigation to guide the personalized management of patients with cancer-related cognitive impairment. [ABSTRACT FROM AUTHOR]

Background: Supportive care is a critical component of the treatment of cancer patients that is underutilized; patient lack of information about these services is an important barrier. Mobile technologies may be useful tools for delivering information, but cancer patient use of and interest in using them to learn about supportive care services have not been described. This study evaluates factors associated with cancer patient use of mobile technologies and interest in smartphone applications for information delivery about supportive care. Methods: We conducted a cross‐sectional survey among cancer patients from one urban academic hospital and 11 community hospitals. Patients self‐reported use of mobile technologies and interest in smartphone applications. Multivariate logistic analysis was used to identify determinants of mobile technology use and smartphone interest. Results: Among 631 participants, 466 (74%) reported regular use of mobile devices and 242 (39%) expressed an interest in supportive care information via smartphone applications. Patients under 45 were more likely to use a mobile device (Adjusted Odds Ratio [AOR] 6.8, 2.8‐16.9 95% CI, P < 0.001) and were interested in smartphone applications for delivery of information (AOR 3.2, 1.8‐5.9 95% CI, P < 0.001). Non‐white patients had similar use of mobile technology compared to whites but reported greater interest in smartphone application‐based information (AOR 3.4, 2.1‐5.5 95% CI, P < 0.001). Conclusion: Many patients expressed interest in smartphone application‐based information about supportive care services, especially those who are younger and non‐white. Future studies should investigate the characteristics of patients and smartphones applications that will optimize information delivery through a mobile technology platform. This study assesses the demographic and treatment‐related characteristics associated with mobile technology use and smartphone application interest in a mixed patient population from academic and community settings. It was found that age and race impact mobile technology use and interest in smartphone applications with younger and non‐white populations expressing an interest in smartphones at three times the reference group. [ABSTRACT FROM AUTHOR]

Anxiety and depression are prevalent among cancer patients, with significant negative impact. Many patients prefer herbs for symptom relief to conventional medications which have limited efficacy/side effects. We identified single-herb medicines that may warrant further study in cancer patients. Our search included PubMed, Allied and Complementary Medicine, Embase, and Cochrane databases, selecting only single-herb randomized controlled trials between 1996 and 2016 in any population for data extraction, excluding herbs with known potential for interactions with cancer treatments. One hundred articles involving 38 botanicals met our criteria. Among herbs most studied (≥6 randomized controlled trials each), lavender, passionflower, and saffron produced benefits comparable to standard anxiolytics and antidepressants. Black cohosh, chamomile, and chasteberry are also promising. Anxiety or depressive symptoms were measured in all studies, but not always as primary endpoints. Overall, 45% of studies reported positive findings with fewer adverse effects compared with conventional medications. Based on available data, black cohosh, chamomile, chasteberry, lavender, passionflower, and saffron appear useful in mitigating anxiety or depression with favorable risk-benefit profiles compared to standard treatments. These may benefit cancer patients by minimizing medication load and accompanying side effects. However, well-designed larger clinical trials are needed before these herbs can be recommended and to further assess their psycho-oncologic relevance. [ABSTRACT FROM AUTHOR]

Background: Although poor adherence to hormonal therapies such as aromatase inhibitors (AIs) is widely documented, to the authors' knowledge less is known regarding whether health beliefs predict treatment nonadherence. The objective of the current study was to evaluate the relationship between health beliefs (perceived susceptibility to breast cancer, perceived benefits of AI treatment, and perceived barriers to AI treatment) and adherence to AIs.Methods: Postmenopausal women with early-stage, estrogen receptor-positive breast cancer who were currently receiving treatment with an AI completed the 3-factor Health Beliefs and Medication Adherence in Breast Cancer scale and questionnaires concerning their demographics and symptoms. Adherence data (treatment gaps and premature discontinuation) were abstracted from participants' medical charts. Logistic regression analyses were conducted to evaluate the relationship between health beliefs and adherence.Results: Among 437 participants, 93 (21.3%) were nonadherent. Those who perceived greater barriers to their AI treatment were more likely to demonstrate AI nonadherence behaviors by the end of their treatment period compared with those who reported fewer barriers to AI therapy (adjusted odds ratio, 1.71; 95% confidence interval, 1.03-2.86 [P = .04]). In contrast, perceived susceptibility to cancer recurrence and perceived benefits of AIs did not appear to predict AI adherence. Minority individuals were found to have lower perceived susceptibility to breast cancer recurrence and higher perceived barriers to AI treatment (P<.05 for both).Conclusions: Greater perceived barriers appeared to predict nonadherence to AIs. Interventions addressing women's negative beliefs regarding the challenges of AI treatment are needed to help optimize adherence in survivors of breast cancer. Cancer 2017;169-176. © 2016 American Cancer Society. [ABSTRACT FROM AUTHOR]

Background: Fatigue is the most common symptom negatively affecting the quality of life of patients with cancer. The objective of the current study was to evaluate the preliminary efficacy and safety of 10.6-μm infrared laser moxibustion for cancer-related fatigue (CRF).Methods: The authors conducted a randomized, placebo-controlled trial among 78 patients with cancer who were diagnosed with CRF. The group treated with infrared laser moxibustion received 10.6 μm of infrared laser moxibustion on the ST36 (bilateral), CV4, and CV6 acupoints. Each participant received a 20-minute treatment session 3 times per week for 4 weeks. The sham group received the same treatment duration on the same acupoints, but without infrared laser output. The outcome was change in fatigue as measured by the Chinese version of the Brief Fatigue Inventory between groups at week 4 with additional evaluation at week 8 for durability of treatment effects. A mixed effects model was used to evaluate the difference in treatment effect over time.Results: Among those randomized, 61 patients (78%) completed the entire study. At the end of the intervention, the individuals in the group treated with the laser were found to have significantly less fatigue than those in the sham group (3.01 vs 4.40; P = .002). The improvement in fatigue persisted to week 8, favoring the group treated with laser moxibustion (3.03 vs 4.26; P = .006). Laser moxibustion was safe, with 3 cases of mild local erythema that resolved without medical intervention reported.Conclusions: Infrared laser moxibustion appeared to be safe and efficacious for improving CRF in a Chinese patient population. Larger studies in more racial/ethnically diverse populations are needed to confirm the benefit of this technique for fatigue in patients with cancer. Cancer 2016;122:3667-72. © 2016 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. [ABSTRACT FROM AUTHOR]

BACKGROUND Breast cancer survivors on aromatase inhibitors often experience joint pain as a side effect of their treatment; qualitative investigations suggest that this arthralgia may cause women to feel that they are aging faster than they should be. To facilitate further study of this experience, the Penn Arthralgia Aging Scale (PAAS) was developed. This report describes the development and validation of the PAAS in a racially diverse sample of breast cancer survivors suffering from joint pain. METHODS The items of the scale were developed from a content analysis of interviews with patients. The scale was pilot-tested, and modifications were made on the basis of patient feedback. Subsequently, 596 breast cancer survivors who endorsed joint pain completed the 8-item PAAS. The factor structure (with exploratory factor analysis), the internal consistency, and the convergent, divergent, and incremental validity were examined. RESULTS The resulting scale had a 1-factor structure with strong internal consistency (Cronbach's α = .94) and demonstrated both convergent and divergent validity: the PAAS was significantly correlated with joint pain severity ( rs = 0.55, P < .01) and had a small and nonsignificant correlation with actual age ( rs = -0.07, P = .10). The PAAS was also found to explain incremental variance in anxiety, depression, and pain interference outcomes. CONCLUSIONS These findings suggest that the PAAS produces reliable and valid scores that capture perceptions of aging due to arthralgia among breast cancer survivors. With further research, the PAAS may advance our understanding of how perceptions of aging may affect breast cancer survivors' emotional, behavioral, and clinical outcomes. Cancer 2015;121:2808-2813. © 2015 American Cancer Society [ABSTRACT FROM AUTHOR]

BACKGROUND: Complementary and alternative medicine (CAM) incorporates treatments used by cancer survivors in an attempt to improve their quality of life. Although population studies have identified factors associated with its use, to the best of the authors knowledge, assessment of why patients use CAM or the barriers against its use have not been examined to date. METHODS: The authors conducted a cross-sectional survey study in the thoracic, breast, and gastrointestinal medical oncology clinics at an academic cancer center. Clinical and demographic variables were collected by self-report and chart abstraction. Attitudes and beliefs were measured using the validated Attitudes and Beliefs about CAM (ABCAM) instrument. This instrument divides attitudes and beliefs into 3 domains: expected benefits, perceived barriers, and subjective norms. RESULTS: Among 969 participants (response rate, 82.7%) surveyed between June 2010 and September 2011, patient age ≤65 years, female sex, and college education were associated with a significantly greater expected benefit from CAM (P<.0001 for all). Nonwhite patients reported more perceived barriers to CAM use compared with white patients (P<.0001), but had a similar degree of expected benefit (P5.76). In a multivariate logistic regression analysis, all domains of the ABCAM instrument were found to be significantly associated with CAM use (P<.01 for all) among patients with cancer. Attitudes and beliefs regarding CAM explained much more variance in CAM use than clinical and demographic variables alone. CONCLUSIONS: Attitudes and beliefs varied by key clinical and demographic characteristics, and predicted CAM use. By developing CAM programs based upon attitudes and beliefs, barriers among underserved patient populations may be removed and more patient centered care may be provided. [ABSTRACT FROM AUTHOR]

BACKGROUND Although fatigue, sleep disturbance, depression, and anxiety are associated with pain in breast cancer patients, it is unknown whether acupuncture can decrease these comorbid symptoms in cancer patients with pain. The objective of this study was to evaluate the effect of electroacupuncture (EA) on fatigue, sleep, and psychological distress in breast cancer survivors who experience joint pain related to aromatase inhibitors (AIs). METHODS The authors performed a randomized controlled trial of an 8-week course of EA compared with a waitlist control (WLC) group and a sham acupuncture (SA) group in postmenopausal women with breast cancer who self-reported joint pain attributable to AIs. Fatigue, sleep disturbance, anxiety, and depression were measured using the Brief Fatigue Inventory (BFI), the Pittsburgh Sleep Quality Index (PSQI), and the Hospital Anxiety and Depression Scale (HADS). The effects of EA and SA versus WLC on these outcomes were evaluated using mixed-effects models. RESULTS Of the 67 randomly assigned patients, baseline pain interference was associated with fatigue (Pearson correlation coefficient [ r]=0.75; P < .001), sleep disturbance ( r=0.38; P=.0026), and depression ( r=0.58; P < .001). Compared with the WLC condition, EA produced significant improvements in fatigue ( P=.0095), anxiety ( P=.044), and depression ( P=.015) and a nonsignificant improvement in sleep disturbance ( P=.058) during the 12-week intervention and follow-up period. In contrast, SA did not produce significant reductions in fatigue or anxiety symptoms but did produce a significant improvement in depression compared with the WLC condition ( P=.0088). CONCLUSIONS Compared with usual care, EA produced significant improvements in fatigue, anxiety, and depression; whereas SA improved only depression in women experiencing AI-related arthralgia. Cancer 2014;120:3744-3751. © 2014 American Cancer Society. [ABSTRACT FROM AUTHOR]

BACKGROUND Shared decision-making (SDM) has been linked to important health care quality outcomes. However, to the authors' knowledge, the value of SDM has not been thoroughly evaluated in the field of radiation oncology. The objective of the current study was to determine the association between SDM and patient satisfaction during radiotherapy (RT). The authors also explored patient desire for and perception of control during RT, and how these factors relate to patient satisfaction, anxiety, depression, and fatigue. METHODS A cross-sectional survey of 305 patients undergoing definitive RT was conducted. Patients self-reported measured variables during the last week of RT. Relationships between variables were evaluated using chi-square analyses. RESULTS Among study participants, 31.3% of patients experienced SDM, 32.3% perceived control in treatment decisions, and 76.2% reported feeling very satisfied with their care. Patient satisfaction was associated with perceived SDM (84.4% vs 71.4%; P < .02) and patient-perceived control (89.7% vs 69.2%; P < .001). Furthermore, the perception of having control in treatment decisions was associated with increased satisfaction regardless of whether the patient desired control. Increased anxiety (44.0% vs 20.0%; P < .02), depression (44.0% vs 15.0%; P < .01), and fatigue (68.0% vs 32.9%; P < .01) were reported in patients who desired but did not perceive control over their treatments, compared with those who both desired and perceived control. CONCLUSIONS The findings of the current study emphasize the value of SDM and patient-perceived control during RT, particularly as it relates to patient satisfaction and psychological distress. Regardless of a patient's desire for control, it is important to engage patients in the decision-making process. Cancer 2014;120:1863-1870. © 2014 American Cancer Society. [ABSTRACT FROM AUTHOR]

ABSTRACT Purpose While patients often use the internet as a medium to search for and exchange health-related information, little is known about the extent to which patients use social media to discuss side effects related to medications. We aim to understand the frequency and content of side effects and associated adherence behaviors discussed by breast cancer patients related to using aromatase inhibitors (AIs), with particular emphasis on AI-related arthralgia. Methods We performed a mixed methods study to examine content related to AI associated side effects posted by individuals on 12 message boards between 2002 and 2010. We quantitatively defined the frequency and association between side effects and AIs and identified common themes using content analysis. One thousand randomly selected messages related to arthralgia were coded by two independent raters. Results Among 25 256 posts related to AIs, 4589 (18.2%) mentioned at least one side effect. Top-cited side effects on message boards related to AIs were joint/musculoskeletal pain (N = 5093), hot flashes (1498), osteoporosis (719), and weight gain (429). Among the authors posting messages who self-reported AI use, 12.8% mentioned discontinuing AIs, while another 28.1% mentioned switching AIs. Although patients often cited severe joint pain as the reason for discontinuing AIs, many also offered support and advice for coping with AI-associated arthralgia. Conclusion Online discussion of AI-related side effects was common and often related to drug switching and discontinuation. Physicians should be aware of these discussions and guide patients to effectively manage side effects of drugs and promote optimal adherence. Copyright © 2013 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The article examines various issues in the field of adult cancer survivorship, such as the increasing number of young adult survivors of childhood cancer, the translational research needed to promote care of cancer survivors, and the measures that must be taken by primary and specialty care providers in the management of the survivors. It discusses the evolution of care plan initiatives for cancer survivors. It also discusses the importance of survivorship phase of care in cancer care.

The article reports on the study that evaluates the perceived onset, characteristics and risk factors of aromatase inhibitors (AI)-related arthralgia (AIA) among breast cancer patients. It found that 47% of patients have attributed AI as a cause of their arthralgia, while 74% of patients have recognized the onset of AIA within three months of starting medication. It indicated that AIA began within the first three months of therapy in most patients.

Objective: An effective and safe alternative treatment to hormone replacement therapy for hot flashes is needed for cancer patients. Interventions targeting the triggering mechanisms of hot flashes hold promise. Increases in core body temperature are a precursor of most hot flashes in women, and similar findings in prostate cancer patients undergoing androgen deprivation therapy would support further research in this area. We present preliminary findings of physiological changes in a prostate cancer patient with frequent hot flashes. Methods: Physiological changes in sternal skin conductance, heart rate, and core body temperature were continuously measured during two 3.5 h laboratory sessions. Perceived characteristics of hot flashes were recorded in a diary. Results: Five hot flashes were reported during laboratory sessions. Severity and bother ratings were low. All hot flashes were accompanied by large increases in sternal skin conductance and moderate increases in heart rate. Core body temperature increased 0.11–0.32°C prior to and fell 0.23–0.44°C following the peak increase in skin conductance. Conclusions: This case study suggests that hot flashes in men may be preceded by increases in core body temperature. Identification of behavioral factors that raise core body temperature may lead to specific treatment strategies to reduce the frequency of hot flashes. Copyright © 2008 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

A response from the author of the article "Chinese acupuncture patients' experiences and beliefs regarding acupuncture needling sensation?an exploratory survey" in a 2014 issue is presented.

Complementary and alternative medicine or therapies (CAM) are frequently used by skin cancers patients. Patient's self-administration of CAM in melanoma can reach up to 40%-50%. CAMs such as botanical agents, phytochemicals, herbal formulas ("black salve") and cannabinoids, among others, have been described in skin cancer patients. The objective of this review article was to acknowledge the different CAM for skin cancers through the current evidence, focusing on biologically active CAM rather than mind-body approaches. We searched MEDLINE database for articles published through July 2022, regardless of study design. Of all CAMs, phytochemicals have the best in vitro evidence-supporting efficacy against skin cancer including melanoma; however, to date, none have proved efficacy on human patients. Of the phytochemicals, Curcumin is the most widely studied. Several findings support Curcumin efficacy in vitro through various molecular pathways, although most studies are in the preliminary phase. In addition, the use of alternative therapies is not exempt of risks physicians should be aware of their adverse effects, interactions with standard treatments, and possible complications arising from CAM usage. There is emerging evidence for CAM use in skin cancer, but no human clinical trials support the effectiveness of any CAM in the treatment of skin cancer to date. Nevertheless, patients worldwide frequently use CAM, and physicians should educate themselves on currently available CAMs., (© 2022 Wiley Periodicals LLC.)