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e13616 Background: COVID-19 posed new challenges in patient care and led to an increase in teleoncology. This paper analyzes telemedicine communication skills of millennial medical students of the postgraduate program of Clinical Oncology at Universidad del Salvador, Buenos Aires. Methods: Student assessment was based on a video call interaction with simulated patients in two stations (30 minutes each) of the Virtual Observational Standard Clinical Examination (V-OSCE), implemented in November 2020. Students received virtual communication guidelines and participated in training sessions to use the video call platform. All interactions were recorded. Assessment items (Table). Results: A total of 25 students were evaluated: 1 (4%) was ineligible due to network connection issues; 24 (96%) participated in both interactions. We analyzed 48 interactions in total. Opening: 6/48 interactions completed all five required items. Most recurring problems: not checking for patient’s previous experience with teleoncology (37/48) and not providing an alternative communication channel in case of technical difficulties (40/48). Middle: the results were similar to in-person interaction observed in previous exams, 35/48 interactions completed all required items. End: 16/48 interactions completed both items. In 32/48 the student did not check for patient understanding of the information provided. Only 3/48 interactions completed all 12 items. Conclusions: A) The V-OSCE is a useful tool to practice and evaluate teleoncology communication skills. B) The Middle Moment of the interactions was similar to an in-person interaction. However, the Opening and End of the interview were more challenging. The most critical struggles being: checking for patient’s previous experience in teleoncology, providing an alternative communication channel in case of technical difficulties and checking for patient understanding. C) COVID-19 established new forms of communication that are likely to remain even after the pandemic has ended. It is important to address this demand for online communication skills in medical education curricula.[Table: see text]

e24189 Background: Most cancer narratives are provided by skilled American and British writers (Broyard, Hitchens, Jobs, Kalanithi, Pausch, Sacks, Sontag or Wishart). This paper highlights the voice of ordinary Latin American patients who wrote about their experience. Methods: Between February 2, 2019 and March 3, 2019, the first author encouraged cancer patients to narrate their experience with the disease for an online literary contest (“ www.oncologiaesperanzadora.com ”). After studying all submissions, we grouped attitudes, feelings, metaphors and descriptions used in different domains related to the course of the disease. A text-mining study was conducted to identify the context of keywords in each of the domains. Results: In total, 224 literary works were submitted to the contest. Characteristics of the population: sex F/M: 184/40; age at time of contest: 53 yo (18-82); time between diagnosis and submission to contest: 8 y (1-73); country of origin: Argentina (201), other countries (23); diagnosis: breast (130), hematological (15), colorectal (13), melanoma (6), lung (5), head and neck (5), kidney (3), other (47). The table shows keywords found in each of the domains. Conclusions: 1) Cancer patients are willing to share their story if they are given the opportunity. 2) Through the narratives of the disease, it is possible to study its impact on patients’ lives and the different coping strategies. 3) Reading the experience of patients with the disease in their own voice is a valuable instrument for medical education. [Table: see text]

11002 Background: Caring for transgender patients requires specific knowledge and skills. Medical schools spend less than 5 hours on average training for treatment of LGBT patients (Obedin-Maliver, JAMA, 306 (9), 971). This paper assesses the knowledge on the topic and skills of postgraduate Oncology students from Universidad del Salvador at the Observational Standard Clinical Examination (OSCE) 2019 (JCO 34 (15), Abstract e18150, 2017). Methods: At one of the stations of OSCE 2019, students had thirty minutes to complete a clinical record of a simulated transman patient with ovarian cancer stage IIIC. Based on the real case of Robert Eads, actors were trained with the documentary on his life “Southern Comfort”. Students were assessed on: A) knowledge of the transman condition, B) use of preferred gender pronoun by the patient, C) discontinuation of testosterone treatment, D) recommendation of genetic study, E) treatment of ovarian cancer according to NCCN guidelines, F) moral discomfort with LGBT patient care. All interviews were filmed or recorded by an observer. All films, recordings and clinical records were reviewed to rate the students' performance. Results: A total of 25 postgraduate Oncology students took the OSCE 2019. Assessment: A) 5/25 (20%) lacked knowledge of the transman condition, B) 3/25 (12%) did not use the patient's preferred gender pronoun, C) 17/25 (68%) discontinued testosterone, D) 23/25 (92%) requested genetic study, E) all students treated ovarian cancer according to NCCN guidelines, F) none expressed moral discomfort with LGBT patient care. Conclusions: 1) It is feasible to assess the knowledge and skills required for treatment of transgender patients in Oncology. 2) We found shortcomings of student's medical training regarding transgender patients: one in five did not understand the patient's condition, three did not use the patient´s preferred gender pronoun during the interview and more than half suspended the necessary hormone therapy for their condition. 3) This emphasizes the need to deepen our medical and communication skills in order to assist the transgender population and should be included in future ASCO-ASH milestones for specialty accreditation.

e23173 Background: “The suicide rate in cancer patients is twice that observed in the general population in the United States” (JNCI vol 100, 24, page 1750, 2008). This paper focuses ona population with great psychological risk: cancer patients (Pt) with previous suicide attempts (SA) or a family history of suicide (FS); both grouped under SAFS for the purpose of this study. Methods: Between 9/26/2012 and 11/28/2018 all new patients (Pt) admitted to IOHM filled out a Past Medical History Form (PMHF) (ASCO 2013 ABST. e17539) with their preexisting clinical conditions. The database was locked and anonymized. Those with a history of SAFS before cancer diagnosis were selected. Results: Out of 15,617 Pt, 184 Pt (1.2%) were SAFS(141 Pt were SA, 39 Pt were FS and 4 Pt were both). The relative risk ofSA was ten times larger for those with FS. Psychiatric Medication: Antipsychotics: 15Pt (8%), Antidepressants: 23 Pt (12%) and Benzodiazepines 45 Pt(24%), No treatment 101 Pt (55%). Population Characteristics: Sex: F:144 Pt . M: 40 Pt. Age: 56y (r = 26-88). Tumor Dx: Breast (65 Pt ) - Gastrointestinal (24 Pt) - Urological (21 Pt ) - Lung (21 Pt ) -Gynecological (19 Pt) - Hematological (11 Pt) -Head &Neck (8 Pt) - Endocrine (7 Pt) - Other (8 Pt). Stages: Early (0-I-II-III): 130 Pt, Advanced: 54 Pt. Ob-Gyn history:25 Pt (17%) nulliparous, 18 Pt (12%) with one child, 77 Pt (53%) with 2 or 3 children and 24 Pt (17%) with more than 3 children; 62 Pt (43%) had previous abortions. Average severe comorbidities (respiratory and psychiatric) was 3 per Pt (r = 0-18). Toxic habits: Smoking: 120 Pt (65%), Alcohol: 37 Pt (20%) and Illicit Drugs: 4 Pt (2%). Follow-up: 19 months (r = 0-70). No Pt had any SA, or commited suicide, during the follow-up.Living patients:177 (96%). Conclusions: 1) In our vast cohort, 184 Pt (1.2%) were identified as highly vulnerable psychiatric Pt due to SAFS. 2) Given the high psychological risk and stressful cancer diagnosis, 83 Pt (45%) were prescribed psychiatric drugs. 3) Follow-up of SAFS Pt by a multidisciplinary team is requiredfor adequate Pt and family support.

e18150Background: In the last 30 years the Objective Structured Clinical Examination (OSCE) has gained popularity as an objective assessment tool of medical skills. In 2014 the 39 ASCO/ASH curricul...

e18151Background: Empathy is defined as "The ability to understand another's experience, to communicate and confirm that understanding with the other person and to then act in a helpful manner" (Me...

Objetivo: estudiar las asociaciones entre las dimensiones de percepción de enfermedad y la calidad de vida, evaluando el rol modulador del distrés psicológico en pacientes con cáncer de mama e identificando cuáles de dichas dimensiones explicaba en mayor medida la variabilidad en los distintos aspectos de la calidad de vida. Método: setenta y cinco pacientes fueron evaluadas con el Cuestionario de Percepción de Enfermedad Breve y el Cuestionario de Calidad de Vida de la Organización Europea para la Investigación y el Tratamiento de Cáncer (EORTC QLQC30). Se calcularon correlaciones bivariadas y parciales para evaluar las asociaciones entre las dimensiones de percepción de enfermedad y distintos aspectos de la calidad de vida, controlando por una medida de distrés. Posteriormente, se ha realizado un análisis de regresión lineal para evaluar las dimensiones de percepción de enfermedad que podrían explicar la variabilidad en la calidad de vida. Resultados: si bien se encontraron asociaciones significativas entre las subescalas de percepción de enfermedad y calidad de vida, la mayoría de ellas perdían su significación cuando se controlaba por distrés. En los modelos de regresión, las variables que mejor predecían la variabilidad de la calidad de vida fueron el diagnóstico psicopatológico y el distrés. Conclusiones: de acuerdo a los resultados del presente estudio, el distrés psicológico y el diagnóstico psicopatológico fueron las dos variables que más explicaban la variabilidad de la calidad de vida. Por tal motivo se hace imprescindible profundizar en el rol de dichas variables en la calidad de vida y en la morbimortalidad asociada a ellas. Objective: To evaluate the associations between the illness perception dimensions and quality of life, assessing the modulatory role of psychological distress in patients with breast cancer, identifying which of these dimensions explained further variability in the different aspects of the quality of life. Methods: Seventy-five patients were evaluated with the Brief Illness Perception Questionnaire and the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ-30). We calculated bivariate and partial correlations to evaluate the associations between the illness perception dimensions and different aspects of quality of life, controlling for a distress measure. Subsequently, we performed linear regression analysis to evaluate the illness perception dimensions that could explain the variability in the quality of life scores. Results: Although significant associations between subscales of perception of illness and quality of life were found, most of them lost their significance when controlled by distress. In the regression models, variables that best predicted the variability in the quality of life were psychopathological diagnostic and distress. Conclusions: According with the study results, psychological distress and psychopathological diagnostic were the two variables that explained better the variability in the quality of life. For this reason it is essential to learn more about the role of these variables on the quality of life and morbidity and mortality associated with them.

e12571 Background: In the last 15 years at least 17 ASCO publications, 2 NCNN guidelines y 2 INC (Instituto Nacional del Cancer-Argentine) publications evaluated the necessity of genetic counseling...

e20636 Background: In the History of medicine, the most desired qualities in a doctor have changed over time. The objective of the following paper is to analyze which qualities do our patients (Pt) consider most important in their doctors. Methods: Between Oct 15th and Nov 15th, 2012, 1003 out of 3,795 Pt who were assisted at the IOHM were given the option to partake in an anonymous survey which evaluated the qualities they valued the most in their doctor, such as: knowledge, experience, honesty, sympathy, availability, humility, humanity or other. Each Pt was asked to pick the three they thought most important. Answers were gathered and analyzed according to frequency distribution. Results: A total of 845 out of 1003 (84%) Pt elected to participate. Population characteristics: Sex: fem: 332, male: 207, left blank (LB): 306. Mean age 58y (range 18 – 94). Married: 355, unmarried: 211, LB: 279. Children: Yes 460 No/LB: 385. Highest educational level achieved: primary studies:186, high school: 348, university: 216. LB: 98. Employed: 382, retired: 240, unemployed: 112, LB 111. The following results are expressed as a percentage of 845 Pt. The most valued qualities in a doctor were: knowledge (51%), honesty (44%), humanity (43%), availability (32%), experience (31%), humility (19%), sympathy (18%), others (3%). Although the most important quality was always knowledge, there was a marked difference between sexes: women valued humanity more than honesty (Chi square p=0.001) while men believed honesty (Chi square p=0.001) and experience (Chi square= 0.01) were more important than humanity. Conclusions: These results showed that there is no set of qualities that is valued above all others. Even though knowledge was always the most important, the value of the other six characteristics depends in great measure from the individual condition of the patients (such as sex, age and stage of the disease). However as the Pt usually do not have the skills to evaluate the Dr’s knowledge, honesty and humanity remains the most valued personal conditions.

e20657 Background: In a previous study (Gercovich et al., 2011) we found that several dimensions of Illness Perception predicted some aspects of Quality of Life. The present study introduces Psychological Distress as a variable to assess the modulatory role it plays in the association between Illness Perception dimensions and Quality of Life in patients with breast cancer, identifying which of these two variables explain further variability in the different aspects of Quality of Life. Methods: A cohort of seventy-five patients was evaluated with the Brief Illness Perception Questionnaire, the Hospital Anxiety and Depression Scale and the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ-30). We calculated bivariate and partial correlations to evaluate the associations between the illness perception dimensions and different aspects of quality of life, controlling these associations by the psychological distress measure. Subsequently, we performed linear regression analysis to evaluate which of these two variables better explains the variability in the quality of life scores. Results: Although significant associations between subscales of perception of illness and quality of life were found, most of them lost their significance when controlled by distress. In the regression models, variables that predicted the variability in the quality of life best were psychopathological diagnostic and distress. Conclusions: According to the study results, psychological distress and psychopathological diagnostic were the two variables that better explained the variability in the quality of life. For this reason it is essential to learn more about the role these variables play on the quality of life and on the morbidity and mortality associated to them.

e20656 Background: As it is very important for Doctors, Patients (Pt) and Family to know everything related to end of life we thought it was unavoidable to develop a survey for that purpose. Methods: Between Oct 15th and Nov 15th, 2012, 1003 Pt out of 3795 Pt that were assisted at the IOHM were given the option to participate in an anonymous survey about diagnosis, prognosis, efficacy and toxicity of treatments, as well as interest in palliative care (PC), clinical investigation (CI), psychological support (PS), spiritual care (SC) for an eventual situation of coping with the end of life dilemma. Results: A total of 845 out of 1,003 (84%) Pt elected to participate. Population: Sex: fem: 332, male: 207, left blank (LB): 306. Mean age 58y (range 18 – 94). Married: 355, unmarried: 211, LB: 279. Children Yes 460 No/LB: 385. Highest educational level achieved: primary Studies:186, high School: 348, universitary:216. LB: 98. Employed:382, retired: 240, unemployed: 112, LB 111. Disclosed diagnostic and stage of disease: 470 (56%). The following results are expressed as a percentage of 845 pt: Are aware of the diagnostic (82%); Pt interested in knowing everythingabout their prognosis (85%) or their treatment’s efficacy (67%) or toxicity (52%). Pt interested in: PC (85%), CI (80%), PS (74%), SC (58%). If they were to choose a place for dying: 40% chose to die in the hospital, 30% at home, 29% did not answer and 1% was indifferent. It was possible to detect a marked increase in the amount of answers with regards to last wishes as the stage of the disease worsened (Chi square= 0.011). Pt were asked to rate the survey: 95% considered it good or very Good, 56% found it useful, 36% thought it necessary, while 23% would recommend it. Conclusions: 1) Most of the pt know their diagnosis, would like to know their prognosis and need to know everything about efficacy and toxicity of treatments. 2) 40% of the pt would prefer to die in the hospital, but analyzing this choice at earlier stages of disease may be inappropriate. 3) PC and CI are of interest to both sexes but women are more likely to request PS and SC. 4) Although the survey was considered good by 95% of pt and more than 50% found it useful, only 23% would recommend it, which speaks about the sensitive quality of these topics.

e20504 Background: Many previous studies argue that the Adjustment Disorder is the most prevalent mental syndrome in patients with cancer. However the research about the psychological treatment for this disorder is scarce. The aim of this study was to evaluate the efficacy of psychological treatments in Adjustment Disorder for oncological patients. We systematically reviewed the randomized controlled trials of psychological interventions for this specific population. Previous related reviews include less specific studies in terms of patients and interventions selected. Methods: Electronic searches were carried out. To identify randomized studies that were published up to 2012, we have searched in the following databases: PubMed, PsycINFO and the Cochrane Central Register of Controlled Trials. The search strategy included the following terms: cancer, adjustment disorder, oncology, psychotherapy, psychosocial interventions and stress. Additionally, we have searched in Scholar Google to find gray literature. The study designs, participants, treatments and outcome characteristics of the studies were coded and evaluated by two independent researchers, following the established selection and inclusion criteria. Results: Following the criteria, we found only one randomized study about the efficacy of psychological treatment for Adjustment Disorder in cancer patients, published in 1998. Conclusions: Considering that the Adjustment Disorder is the most prevalent mental illness in cancer patients, the lack of evidence about the efficacy of psychological treatment represents a significant public health issue. This review reveals that such lack of evidence exists, indicating a serious need of increasing studies about psychological treatments for this specific population.

9038 Background: More than half the total number of oncological patients may die due to the disease’s progression, and at some point in time the oncologist must communicate that the disease is terminal. This is the hardest conversation (HC) of a clinical oncologist. The following paper’s objective is to determine whether or not the treatments applied to patients, and their evolution, are affected by having had the HC. Methods: All patients who died due to progression of the disease in 2011 were selected for this study. Both medical histories and applied treatments were evaluated. All doctors were interviewed to establish when the HC had taken place. The distribution of variables was analyzed and both populations compared. Results: Between January 2011 and December 2011, 110 patients who met the previous criteria were studied. Population characteristics: Sex (Female: 52 pts; Male: 58 pts). Median age at the time of death: 61 years (Range: 27-88). Patients were divided in two groups: A (terminal status of the disease had been discussed; 70 pts) and B (terminal status of the disease had not been discussed; 40 pts). Both groups were similar in diagnosis, age and previous treatments. During the post HC evolution, three elements were categorized according to the table below. Conclusions: 1 – The conviction, ethical sense and strength of will of the doctor are determining factors when related to his or her capacity to talk with the patient about the terminal aspect of the disease. 2 – The chemotherapy treatments applied during the last two months of life are similar in both groups. 3 – The percentage of patients that died at their homes under palliative care was remarkably higher amongst those who had been informed than those who had not been informed. [Table: see text]

e19567 Background: In the last decade the interest to know the modulating factors of the quality of life in oncological patients has grown. Previous researches suggest that the illness perception i...

e19594 Background: Even though the study of psychological aspects associated to oncological diseases has seen an important development in the past few years, there is little objective evidence of t...

e16530 Background: The study of doctor-patient communication has received an increasing interest in the past decade. Most of the studies have been centered in the communication characteristics and ...

e20742 Background: Recent studies suggest that women diagnosed with breast cancer and treated with adjuvant chemotherapy may suffer cognitive deterioration. These studies, however, present a number of limitations including a small sample of patients, retrospective evaluation of cognitive skills, lack of cognitive-function measurements previous to the chemotherapy and a lack of evaluation of psycho-pathological factors that could potentially influence on the cognitive function of the subjects. The aim of this study is to present the preliminary results of a prospective study about the impact of conventional adjuvant chemotherapy on a series of cognitive domains in adult women diagnosed with breast carcinoma, monitoring frequent psycho-pathological variables such as anxiety and depression. Methods: The present is a cohort, observational study. It includes patients with a diagnosis of stage I and II breast carcinoma, treated with standard chemotherapy and able to give their consent. The protocol has 3 stages of evaluation. First evaluation: a basal measurement between diagnosis and the first chemotherapy course. The second and third evaluations are done at 8 and 14 months respectively after the first one. Each patient has been studied using a neuro-psychological battery of 17 different tests which evaluate the following cognitive domains: global cognitive functioning, intelligence, memory, language and executive functions. The levels of anxiety and depression were studied simultaneously. Further tests will be done for related samples, so as to compare changes within a group. Results: Up to date 14, patients have completed the basal battery of tests. We expect to find differences in the cognitive functions of the patients treated with adjuvant chemotherapy. The aforementioned differences will be controlled with psycho-pathological measurements. Conclusions: The present study will allow us to evaluate in a prospective and exhaustive way cognitive deficiencies in women with breast carcinoma treated with adjuvant chemotherapy. In addition, the use of psycho-pathological instruments will allow monitoring and understanding the neuro-psychological results in a more reliable way. No significant financial relationships to disclose.

20616 Background: The Hospital Anxiety and Depression Scale (HADS) is an instrument widely used to evaluate psychiatric symptomatology in patients diagnosed with cancer. However there is not a vali...

20569 Background: Although there has been an important development of psycho-oncology during the past few years, there is little objective evidence regarding the usefulness of psychotherapy in term...

18515 Background: Psychological distress is a widespread phenomenon in cancer patients (pts.) Notwithstanding, its recognition and the threshold criteria for referral to a specialized unit are still problematic in clinical practice. Correspondingly, the aim of this study was to explore how much psychological distress (PD) is expected by the oncologists, how much distress is actually present in these pts., and finally how many of them are detected as having significant problems and referred to the mental health unit (MHU). Methods: Three sources of data were compared for the purpose of this study. Firstly, a survey to the practicing oncologists (n =18) was carried out in order to establish the rate of PD expected by them. Secondly, a consecutive sample of 259 pts. was evaluated in the waiting room with the Hospital Anxiety and Depression Scale (HADS) for establishing an estimation of the actual rate of PD in this population. Finally, 115 pts. from the MHU were studied for determining the rate and the accuracy of the referral made by the oncologists. Results: Sixty one percent of the surveyed oncologists considered that 75% or more of their pts would need psychological assistance. The waiting room sample evaluated with the HADS showed that 74.9% of patients surpassed the cutoff score (11 points) for either anxiety or depression, or both. Despite this, less than 5% of the total population of the clinic was referred to the MHU. From this sample, 38.3% of the pts. scored below the cutoff line. The proportion of pts. who exceeded the cutoff score for depression was significantly higher in the MHU sample. Conclusions: Most of the oncologists expect a high rate of PD in their patients, and even overestimate it. Actual rates of anxiety and depression were also high. On the contrary, the rate of referral to specialized mental health treatment was extremely low and the pts. referred were not necessarily highly disturbed. Depression is probably better recognized than anxiety by oncologists. In conclusion, both quantitative and qualitative problems were detected in the referral to the MHU, regardless the awareness of the oncologists about PD. No significant financial relationships to disclose.

8246 Background: The aim of this study was to explore and rank the most important fears that BCP experience during treatment. Methods: We studied pt's fear through 18 printed cards that had a given...