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Purpose: Improved survivorship in cancer patients leads to new challenging issues including potential impairment of quality of life, sexual function, and fertility. The aim of this study was to assess sexual dysfunction (SD) and psychological distress in female cancer survivors who underwent fertility preservation in the past in comparison to reviewed healthy control data from other published studies. Additionally, our focus was on the difference in SD between women with current desire to get pregnant and already completed family planning. Methods: In this prospective study, 53 female cancer survivors who underwent fertility preservation at time of cancer diagnosis between 2010 and 2020 were invited to a gynecological exam, laboratory assessment, and two questionnaires (Female Sexual Function Index (FSFI) and Hospital anxiety and depression scale (HADS)) in 2022. These scores were compared to results in the literature of healthy controls and depending on anti-Mullerian-hormone (AMH) levels, current desire to have a child, and age. Results: After a mean follow-up time of 70 ± 50 months, SD was detected in 60.4% (n = 32) of the 53 included patients. Normal results regarding HADS-D/anxiety and HADS-D/depression were found in 88.7% and 94.3% of patients, respectively. At time of follow-up, 69.9% (n = 40) regained regular menstrual cycles, 52.6% (n = 20) < 40 years showed a diminished ovarian reserve with AMH levels < 1.1 ng/ml and 28.3% (n = 15) suffered from infertility. Conclusion: Female cancer survivors may be at risk for SD. Cancer patients should be informed about possible sexual dysfunction already at the start of cancer treatment and during follow-up. In addition, contraception needs to be addressed if regular cycles occur as more than two-thirds of the women regained regular menstrual cycles. [ABSTRACT FROM AUTHOR]

To examine whether female cancer survivors are more likely to pursue care for infertility after cancer than women without cancer. Population-based cohort study involving detailed interviews regarding reproductive history. Not applicable. Female cancer survivors aged 22–45 years, who were at least 2 years after a cancer diagnosis between the ages of 20 and 35 years (n = 1,036), and age-matched comparison women with no cancer history (n = 1,026). History of cancer vs. no history of cancer. Each cancer survivor was randomly matched to a comparison woman, who was assigned an artificial age at cancer diagnosis equal to that of her match. Matching was repeated 1,000 times. Outcomes of visiting a doctor for help becoming pregnant or undergoing fertility treatment were modeled using Cox proportional hazards regression, comparing survivors after a cancer diagnosis to age-matched comparison women, adjusted for race, income, residence, education, and parity. Only 25.5% of cancer survivors reported meeting their desired family size before a cancer diagnosis. The median time from diagnosis to interview among survivors was 7 (interquartile range 5–11) years. Cancer survivors were more likely to report having no children (32.6%) at the interview compared with women with no cancer history (19.5%). Survivors were not more likely to visit a doctor for help becoming pregnant compared with women without a cancer history, matched on birth year and followed by the age at which cancer survivors received their diagnosis (hazard ratio [HR] 1.16, 95% simulation interval [SI] 0.78–1.74). Compared with cancer-free women, cancer survivors had similar probabilities of pursuing any treatment (adjusted HR [aHR] 0.88, 95% SI 0.46–1.56), using hormones or medications (aHR 0.86, 95% SI 0.46–1.63), or undergoing intrauterine insemination (aHR 1.26, 95% SI 0.40–5.88) to conceive. Cancer survivors were slightly more likely to pursue surgical interventions to become pregnant (HR 1.55, 95% SI 0.67–3.71). Of those who visited a doctor but declined to pursue fertility treatment, one-quarter of women reported declining treatment due to cost. Cancer survivors did not use fertility treatments at higher rates than the general population. Further counseling and education surrounding fertility options are recommended for young adult female cancer patients after treatment is completed. [ABSTRACT FROM AUTHOR]

Purpose: We assessed factors that affect the utilization of sperm cryopreservation before 2021, when patients covered expenses, and the influence on quality of life. Methods: Between 2011 and 2021, testicular cancer survivors (TCS) at our clinic completed a questionnaire, including EORTC QLQ-TC26, covering sperm cryopreservation, sociodemographic details, post-treatment births, and artificial insemination. Results: After 5.7 ± 3.0 years, 279 participants (64%) responded to the questionnaire. Among them, 33% (91/279) of testicular cancer survivors chose sperm cryopreservation prior to treatment, with 11% (10/91) using it for insemination. Conversely, 2% (3/188) without cryopreservation reported unfulfilled desire to have children. Univariate analysis showed TCS with cryopreservation were younger (30.6 ± 7.1 (35 (21–59)) vs. 42.4 ± 10.9 (48 (22–81)) years; p = 0.001), had a lower BMI (24.2 ± 3.3 vs. 26.6 ± 4.6 kg/m2; p = 0.009) and a lower Charlson Score (> 3: 36% vs. 60%; p < 0.001). Multivariate analysis revealed older age (≥ 37 years: OR 13.1 (5.5–31.2), p < 0.001) and lower education (middle school or less: OR 3.3 (1.6–6.9), p = 0.001) as independent factors associated with not undergoing cryopreservation. Regarding quality of life, multivariate analysis identified a lower infertility anxiety score (OR 4.3 (2.0–9.0), p < 0.001) and higher age (≥ 44 years: OR 5.4 (2.6–11.3); p < 0.001) as predictors for the absence of prior cryopreservation. Conclusions: Age and education seem to impact the choice of undergoing paid sperm cryopreservation. Urologists should inform testicular cancer patients about costs and coverage. Importantly, the occurrence of unmet desires for parenthood is minimal among those who forego cryopreservation. [ABSTRACT FROM AUTHOR]

Purpose: Race and Hispanic ethnicity data can be challenging for central cancer registries to collect. We evaluated the accuracy of the race and Hispanic ethnicity variables collected by the Utah Cancer Registry compared to self-report. Methods: Participants were 3,162 cancer survivors who completed questionnaires administered in 2015–2022 by the Utah Cancer Registry. Each survey included separate questions collecting race and Hispanic ethnicity, respectively. Registry-collected race and Hispanic ethnicity were compared to self-reported values for the same individuals. We calculated sensitivity and specificity for each race category and Hispanic ethnicity separately. Results: Survey participants included 323 (10.2%) survivors identifying as Hispanic, a lower proportion Hispanic than the 12.1% in the registry Hispanic variable (sensitivity 88.2%, specificity 96.5%). For race, 43 participants (1.4%) self-identified as American Indian or Alaska Native (AIAN), 32 (1.0%) as Asian, 23 (0.7%) as Black or African American, 16 (0.5%) Pacific Islander (PI), and 2994 (94.7%) as White. The registry race variable classified a smaller proportion of survivors as members of each of these race groups except White. Sensitivity for classification of race as AIAN was 9.3%, Asian 40.6%, Black 60.9%, PI 25.0%, and specificity for each of these groups was > 99%. Sensitivity and specificity for White were 98.8% and 47.4%. Conclusion: Cancer registry race and Hispanic ethnicity data often did not match the individual's self-identification. Of particular concern is the high proportion of AIAN individuals whose race is misclassified. Continued attention should be directed to the accurate capture of race and ethnicity data by hospitals. [ABSTRACT FROM AUTHOR]

Purpose: As the life expectancy of cancer survivors continues to improve, cancer survivors start or resume their life roles as caregivers themselves. We aim to assess the associations between caregiving, cancer diagnosis, and self-reported well-being. Methods: Data were obtained from the Behavioral Risk Factor Surveillance System (BRFSS) 2016, 2018, and 2020. Outcomes included self-reported general health, physical health, mental health, depression, physical inactivity, and poor sleep. Weighted multivariable logistic regression models were used to calculate self-reported well-being's adjusted odds ratio (aOR). Results: Comparable to the proportion of caregivers in the general population, approximately 1 out of 5 cancer survivors were caregivers to others. Individuals with dual roles were significantly more likely to report poor general health (aOR = 2.45; 95%CI: 1.46–4.11), physical health (aOR = 2.17; 95%CI: 1.32–3.56), mental health (aOR = 2.47; 95%CI: 1.31–4.64), depression (aOR = 1.64; 95%CI: 1.15–2.41), physical inactivity (aOR = 1.56; 95%CI: 1.05–2.31), and poor sleep (aOR = 1.48; 95%CI: 1.00–2.19) than the general population. Differential impacts of an additional cancer diagnosis on the well-being of caregivers were observed by sex, race, and time since cancer diagnosis. Conclusions: Nearly four million cancer survivors in the USA are concomitant caregivers. Individuals with dual roles reported diminished well-being across a variety of measures than caregivers only. Implications for Cancer Survivors: Significant unmet health and psychosocial needs exist among individuals with dual roles. Our findings urge for increased awareness of this additional role/responsibility in cancer survivors and provide direct evidence for healthcare providers and policymakers to develop substantial support from the structural level. [ABSTRACT FROM AUTHOR]

Purpose: We aimed to determine the availability of existing web-based educational materials on breast cancer survivorship and assess their readability and understandability. Methods: We identified materials eligible for review in two ways: (1) reviews of websites of major cancer-related organizations (e.g., American Cancer Society); (2) Google searches for breast cancer survivorship, breast cancer, breast cancer follow-up care, and cancer survivorship. We measured Flesch-Kincaid and New Dale Readability of existing breast cancer and breast cancer survivorship materials. Readability grade levels 5 to 8 were considered ideal to acceptable. We used the Patient Education Materials Assessment Tool (PEMAT) to measure the understandability of 53 videos and 152 written materials, such as booklets and manuals. A resource was considered understandable and/or actionable if it scored ≥ 70% on either the understandability section or the actionability section of the PEMAT. Results: We identified a total of 205 existing materials including brochures, booklets, facts sheets, websites, and videos in English. The average Flesch-Kincaid grade score of written educational materials was 9.7 (range 3.5–16.4), which translates to a 9th grade reading level. According to the New Dale-Chall readability assessment, most of the materials were in the 9 to 10 grade level range. The average PEMAT score was 88.6% (range 56–100%). Conclusion: Patient educational materials are available online as printable, written materials, and videos and they focus on a wide selection of survivorship-related topics. Most of the breast cancer educational materials that are available online were above an 8th grade reading level. The PEMAT results, however, suggest that materials are easy to understand regarding word choice and style, use of numbers, organization, layout and design, and use of visual aids. Implications for Cancer Survivors: Understandable patient education materials are essential for guiding breast cancer survivors towards improving their health outcomes and optimizing their quality of life. [ABSTRACT FROM AUTHOR]

Nurses play a key role in providing integrated supportive care to cancer patients for their various needs. Efforts should be made to identify the competencies required for nurses providing integrated supportive care to cancer survivors, evaluate the competence level with reliable and reasonable tools, and continuously improve them. In Phase 1, the items of the scale were developed through a literature review and by conducting a focus group interview. In Phase 2, the validity and reliability of the scale were analyzed. A total of 504 nurses participated. Data were analyzed using item analysis, exploratory factor analysis, confirmatory factor analysis, Pearson's correlation with other scales, internal consistency, and split-half reliability. The developed scale consisted of 22 items. These items were grouped into five subscales and labeled as professionalism enhancement, care coordination, comprehensive nursing needs assessment, providing tailored information and education, and recurrence surveillance and secondary cancer prevention. Confirmatory factor analysis supported good convergent and discriminant validities. The criterion validity was verified. The internal consistency of the scale measured by Cronbach's α was 0.91. The developed scale is expected to be used as an instrument to identify cancer survivor integrated supportive care competencies of nurses in practice. [ABSTRACT FROM AUTHOR]

Background: Personal history of cancer is an independent risk factor for lung cancer but is omitted from existing lung cancer screening eligibility criteria. In this study, we assess the lung cancer risk among cancer survivors and discuss potential implications for screening. Methods: This was a retrospective, secondary analysis of data from the Surveillance, Epidemiology and End Results (SEER) registry and the MD Anderson Cancer Center (MDACC). We estimated the standardized incidence ratios (SIRs) for lung cancer by site of first primary cancer using data from SEER. We assessed the lung cancer risk among head and neck cancer survivors from MDACC using cumulative incidence and compared the risk ratios (RR) by individuals' screening eligibility status. Results: Other than first primary lung cancer (SIR: 5.10, 95% CI: 5.01–5.18), cancer survivors in SEER with personal history of head and neck cancer (SIR: 3.71, 95% CI: 3.63–3.80) had the highest risk of developing second primary lung cancer, followed by bladder (SIR: 1.86, 95% CI: 1.81–1.90) and esophageal cancers (SIR: 1.78, 95% CI: 1.61–1.96). Head and neck cancer survivors had higher risk to develop lung cancer compared to the National Lung Screening Trial's subjects, (781 vs. 572 per 100,000 person‐years, respectively). Head and neck cancer survivors ineligible for lung cancer screening seen at MDACC had significantly higher lung cancer risk than head and neck cancer survivors from SEER (RR: 1.9, p < 0.001). Conclusion: Personal history of cancer, primarily head and neck cancer, is an independent risk factor for lung cancer and may be considered as an eligibility criterion in future lung cancer screening recommendations. [ABSTRACT FROM AUTHOR]

Abstract Objective It has long been documented that cognitive behavioral therapy (CBT) has positive impacts on improving mental health (MH) and quality of life (QoL) in the general population, but investigations on its effect on cancer survivors remain limited, especially for QoL outcomes. The purpose of this meta‐analysis is to investigate the effects of CBT as compared to control on cancer patients' MH and QoL outcomes. Control is defined in this study as standard therapy, waitlist control, and active/alternative therapy. Methods In total, 154 clinical trials creating a sample size of 1627 individuals were collected. Analysis focusing on MH and QoL excluded 29 clinical trials resulting in a final analysis of 132 clinical trials (and 1030 effect sizes). R Statistical Software (version 4.2.2) and the robumeta package were utilized to complete analysis, which entailed robust variance estimation (RVE) in intercept‐only meta‐regression, and univariate meta‐regression (for moderator analysis). Results Across 132 clinical trials and 1030 effect size estimates, we identified that CBT moderately improves MH and QoL in cancer patients d = 0.388, 95% CI 0.294–0.483, p

Abstract Purpose Healthy cancer survivorship involves patients' active engagement with preventative health behaviors and follow‐up care. While clinicians and patients have typically held dual responsibility for activating these behaviors, transitioning some clinician effort to technology and health coaches may enhance guideline implementation. This paper reports on the acceptability of the Shared Healthcare Actions & Reflections Electronic systems in survivorship (SHARE‐S) program, an entirely virtual multicomponent intervention incorporating e‐referrals, remotely‐delivered health coaching, and automated text messages to enhance patient self‐management and promote healthy survivorship. Methods SHARE‐S was evaluated in single group hybrid implementation‐effectiveness pilot study. Patients were e‐referred from the clinical team to health coaches for three health self‐management coaching calls and received text messages to enhance coaching. Semi‐structured qualitative interviews were conducted with 21 patient participants, 2 referring clinicians, and 2 health coaches to determine intervention acceptability (attitudes, appropriateness, suitability, convenience, and perceived effectiveness) and to identify important elements of the program and potential mechanisms of action to guide future implementation. Results SHARE‐S was described as impactful and convenient. The nondirective, patient‐centered health coaching and mindfulness exercises were deemed most acceptable; text messages were less acceptable. Stakeholders suggested increased flexibility in format, frequency, timing, and length of participation, and additional tailored educational materials. Patients reported tangible health behavior changes, improved mood, and increased accountability and self‐efficacy. Conclusions SHARE‐S is overall an acceptable and potentially effective intervention that may enhance survivors' self‐management and well‐being. Alterations to tailored content, timing, and dose should be tested to determine impact on acceptability and outcomes.

IntroductionAs cancer survival rates increase, it has become crucial to pay attention to the long-term quality of life of survivors, including sexual functioning. The quality of sexual life and fear of cancer progression are often unmet needs, significantly impacting cancer patients’ overall quality of life. In this study, we investigate these factors in Romanian female cancer patients and highlight their relationship with mental health and demographic variables.MethodsThis study included 242 Romanian female cancer patients who completed questionnaires assessing sexual functioning (EORTC QLQ-SHQ22), fear of cancer progression (FoP-Q), depression (PHQ-9), and anxiety (GAD-7). We examined these relationships using descriptive, exploratory, and regression analyses.ResultsAround 50% of patients reported impairments in sexual satisfaction and pain during sex. Lower sexual satisfaction increased sexual dysfunction, and heightened fear of cancer progression (FCP) were associated with depression, anxiety, younger age, lower education, rural residence, and unmarried status.DiscussionThis study reveals a complex interplay between sexual health, fear of cancer progression, and psychological well-being among female cancer survivors in Romania. Addressing sexual concerns, providing psychoeducation, promoting coping with the fear of progression, and utilizing interdisciplinary interventions are essential to improving these patients’ overall quality of life. These findings underscore the need for integrated care approaches that consider both physical and psychological dimensions of cancer survivorship.

Adult survivors of childhood brain tumors often present with cognitive deficits that affect their quality of life. Studying brain structure and function in brain tumor survivors can help understand the underlying mechanisms of their cognitive deficits to improve long-term prognosis of these patients. This study analyzed voxel-based morphometry (VBM) derived from T1-weighted MRI and the amplitude of low-frequency fluctuation (ALFF) from resting-state functional magnetic resonance imaging (rs-fMRI) to examine the structural and functional alterations in 35 brain tumor survivors using 35 matching healthy individuals as controls. Compared with healthy controls, brain tumor survivors had decreased gray matter volumes (GMV) in the thalamus and increased GMV in the superior frontal gyrus. Functionally, brain tumor survivors had lower ALFF values in the inferior temporal gyrus and medial prefrontal area and higher ALFF values in the thalamus. Importantly, we found concurrent but negatively correlated structural and functional alterations in the thalamus based on observed significant differences in GMV and ALFF values. These findings on concurrent brain structural and functional alterations provide new insights towards a better understanding of the cognitive deficits in brain tumor survivors.

Background: To promote physical activity in post-treatment cancer survivors, a mobile application WExercise was developed using the Multi-Process Action Control Framework. It contains 10 weekly online lesson to facilitate reflective, regulatory, and reflexive processes to help participants to form and sustain physical activity behavior. Objectives: To test the usability and acceptability of WExercise in post-treatment cancer survivors. Methods: This study involved four phases: (1) preparing application content, (2) expert panel review (comprising oncology healthcare workers, exercise specialists, and behavior change researchers), (3) developing the app, and (4) usability test. The usability test was conducted cross-sectionally using direct observation of application navigation tasks, a quantitative survey, and qualitative interviews among 10 post-treatment cancer survivors. Results: In Phase 2, the expert panel rated the application highly on relevance, accuracy, comprehensiveness, meaningfulness, and easiness to understand (average score = 3.83 out of 4). The application was developed accordingly. In Phase 4, the System Usability Score was 75 %, greater than the cut-off point. Participants gave the items assessing acceptance of the application positive ratings (e.g., satisfaction = 4.30 out of 5). Based on the performance and feedback, the application was modified, including adjusting the font size and improving the visualization of buttons. Conclusion: Overall, experts and potential users considered the application relevant, usable, and acceptable. It has the full potential for further testing in a larger trial for its effectiveness in promoting physical activity in cancer survivors.

PurposeYoung adult (YA) cancer survivors have high rates of adverse health and psychosocial outcomes. This risk-stratified, multicenter, randomized controlled trial (RCT) compared a self-management survivorship intervention to usual care in YA survivors with symptoms of cancer-related distress, insomnia, fatigue, pain, and/or depression.MethodsEligibility included age 18-39 at diagnosis with an invasive malignancy in the previous 1-5 years. Baseline assessment determined "high need" participants, with 2-5 elevated targeted symptoms. We randomized high need participants to intervention or usual care and offered intervention participants a survivorship clinic visit, which included mutually decided action plans for symptoms. Follow-up calls at 1 and 3 months after the clinic visit reviewed action plan progress. Outcomes compared rates of improved symptoms for intervention vs usual care at 6 months and 12 months.ResultsN = 344 completed baseline assessment, with n = 147 (43%) categorized as high need and randomized. Of n = 73 randomized to the intervention, n = 42 (58%) did not attend their survivorship clinic visit. In intent-to-treat analyses, aggregate symptom scores did not differ between arms, though distress improved for 46% in the intervention arm at 6 months compared to 18% in usual care (p = 0.03) among those with elevated distress at baseline.ConclusionsDistress improved for YAs who received self-management survivorship care. However, the study demonstrates a need for alternative strategies for providing YA survivorship care.Trial registrationNCT02192333 IMPLICATIONS FOR CANCER SURVIVORS: While YA survivors demonstrate some improved distress when provided survivorship care, to make care accessible and effective, they require options such as remote delivery of care.

PurposeTo examine the perspectives of medical and nursing health professionals concerning their roles and responsibilities in providing dietary and exercise advice to cancer survivors, and referrals to allied health professionals.MethodsAn integrative review. PubMed, CINAHL, PsycINFO, Embase, Web of Science databases, and bibliographies of relevant studies were searched from December 2011 to June 2021. All studies were eligible for inclusion. The Mixed-Methods Appraisal Tool (MMAT) was used to critically appraise included studies. Data were extracted and synthesised regarding the perspectives of medical and nursing health professionals on their roles, responsibilities, barriers, and facilitators.ResultsTwenty-one studies involving 3401 medical and nursing health professionals and 264 cancer survivors of diverse cancer types were included. Ten quantitative, nine qualitative, and two mixed-methods studies were eligible. All included studies met at least 80% of the quality criteria in the MMAT. Major findings include the following: (1) medical and nursing health professionals were unclear on their roles in providing dietary and exercise advice to cancer survivors but agreed they play a key role in referrals to dietitians and exercise professionals; (2) most cancer survivors valued the involvement of their general practitioner when receiving dietary and exercise advice.ConclusionAlthough medical and nursing health professionals understand that referrals to allied health professionals form part of their role, there is a lack of clarity regarding their roles to provide dietary and exercise advice to cancer survivors. Future studies should address barriers and facilitators of dietary and exercise advice and referral by medical and nursing health professionals.

Abstract Background Evaluating the effects of cancer diagnosis and treatment on a patient’s overall well-being is crucial and health-related quality of life (HRQoL) is a reliable metric for assessing this impact. Little is known about HRQoL among cancer survivors across various stages and treatments. The study examined individual and clinical factors influencing HRQoL among cancer survivors. Methods A cross-sectional study was conducted in two specialised cancer care hospitals in Dhaka, Bangladesh. Cancer-diagnosed adults receiving treatment at selected hospitals from January to May 2022 were enrolled. The 5-level EuroQol-5 Dimensions version (EQ-5D-5L) instrument was used to collect HRQoL data. HRQoL scores were derived using UK value sets. The investigation used a multivariable Tobit regression model to determine the association between independent variables and HRQoL scores. Results A total of 607 adult patients were enrolled, with 55% being females and 66% aged 36 to 64 years. Reported health problems in five EQ-5D domains include mobility (11%), self-care (11%), usual daily activities (19%), pain/discomfort (21%), and anxiety/depression (46%). Patients with throat, brain, lung, blood, and liver cancer had lower utility scores. Advanced-stage cancer survivors had lower utility scores (β = -49 units, 95% codfidence interval [CI]: -0.75 to -0.22) compared to early-stage survivors. Physically inactive survivors had lower utility scores by 0.41 units (95% CI: -0.51 to -0.30) compared to their counterparts. Private hospital patients had higher utility scores, whereas patients belonged to poor socioeconomic groups scored worse than wealthier ones. Conclusions This study highlights the impact of clinical and individual characteristics on HRQoL among cancer survivors. These findings advocate for an enhanced Bangladeshi cancer patient care model through timely interventions or programs, early detection or diagnosis, tailored treatments, and the promotion of physical activity to bolster HRQoL outcomes.

Background: We investigated the inequalities in health-related quality of life (HRQoL) among cancer survivors in Korea, focusing on income and education levels. The slope index of inequality (SII) and relative index of inequality (RII) were utilized to analyze these disparities. Methods: Data from the Korea National Health and Nutrition Examination Survey (KNHANES) conducted between 2007 and 2021 was analyzed. The HRQoL was assessed using the EQ-5D questionnaire, which included five problem areas: mobility, self-care, usual activity, pain/discomfort, and anxiety/depression. Logistic regression was employed to calculate the odds ratios (ORs) for each education and income level, indicating the probability of reporting problems. Furthermore, the slope index of inequality (SII) and relative index of inequality (RII) were calculated to evaluate the inequalities in HRQoL. Results: Among the 3396 cancer survivors, a considerable proportion reported pain/discomfort (29.6%) and mobility problems (21.1%). The logistic regression results demonstrated a higher likelihood of experiencing problems in all five EQ-5D items among individuals with lower income or education levels. Specifically, compared to the high-income group, the adjusted ORs for mobility problems were 2.19, 1.64, and 1.08 for the low, low-medium, and medium–high-income groups, respectively (p-value < 0.05). Notably, significant income inequalities in HRQoL problems were observed, with the greatest disparities seen in self-care and usual activity problems, as indicated by the SII and RII values. Conclusion: Socioeconomic disparities in HRQoL exist among cancer survivors in Korea, particularly related to income levels. Addressing the financial burdens of cancer treatment for individuals with low-income levels may help improve their HRQoL and mitigate these inequalities. [ABSTRACT FROM AUTHOR]

Purpose: Physical activity (PA) has been shown to improve quality of life (QoL) in predominantly White cancer survivors. Very few studies have examined the association between PA and QoL among Black breast cancer survivors (BCS). We investigated the association between PA and multiple QoL domains and the effects of race on the proposed association in a racially diverse group of BCS. Methods: This was an exploratory study using secondary data from a completed 12-month randomized controlled trial (RCT). Mixed effects models were tested on a subset of participants in the control and exercise groups of the RCT. The primary outcomes were changes in the QoL domains (baseline to 12 months post baseline). Results: There were 173 participants included in this analysis, averaging 59 years of age; about 33% of the participants were Black women. There were no significant differences in the QoL outcomes between the control and exercise groups at 12 months post baseline. Race was not a significant moderator. Exercise improved emotional/mental wellbeing and body image as it relates to social barriers at 12 months post baseline in Black and White BCS, but the changes in these outcomes were only statistically significant in White BCS (p < 0.05). Conclusions: Results show that exercise can improve multiple QoL domains over time in Black BCS. However, the significance of the effect on QoL was isolated to White BCS. The small sample size in Black women could constrain the statistical significance of observed effects. Future studies are warranted to assess associations between exercise and QoL in larger samples of Black women. [ABSTRACT FROM AUTHOR]

Black breast cancer survivors (BCS) in comparison with White BCS are more likely to experience suboptimal quality of life (QoL). QoL is a multi-dimensional concept that focuses on different aspects of well-being (e.g., emotional well-being). There is limited evidence on the perspectives and experiences of QoL (e.g., the influence of breast cancer on QoL) and the QoL concerns (e.g., negative perceptions of body appearance) among Black BCS. The purpose of this study was to explore the QoL experiences and QoL concerns of Black BCS. Primary data was collected in semi-structured interviews and analyzed using a thematic analysis. A narrative approach (detailed stories or life experiences of a small group of people) was used to better understand the research topic among the target group. Ferrell's Conceptual Framework on QoL in Breast Cancer was used to guide the development of the interview questions, codes, and themes. There were 10 Black BCS, averaging 58 years of age. Two coders achieved a moderate level of agreement (i.e., Kappa) of 0.77. Five major themes were identified: defining QoL (what QoL means to them), behavioral changes (e.g., altering behaviors due to cancer), phases of cancer (e.g., breast cancer diagnosis), QoL experiences and factors affecting QoL, and impactful statements from cancer survivors (other meaningful information shared by the participants). The survivors reported multiple QoL concerns and body image issues. The study findings warrant cancer education interventions or programs to address the relevant survivorship issues of Black BCS. [ABSTRACT FROM AUTHOR]

This article, titled "Smoking habit change after cancer diagnosis: effect on cardiovascular risk," explores the patterns and cardiovascular consequences of post-diagnosis smoking habit change among cancer survivors. The study, conducted in Korea, analyzed data from a nationwide database of adults newly diagnosed with cancer. The findings highlight the need for strategies to address cardiovascular disease, the leading cause of death among cancer survivors, particularly in relation to smoking cessation. The study cohort consisted of 309,095 participants, and the research complied with ethical guidelines. [Extracted from the article]

Background: Treatment exposures for childhood cancer reduce ovarian reserve. However, the success of assisted reproductive technology (ART) among female survivors is not well established. Methods: Five‐year survivors of childhood cancer in the Childhood Cancer Survivor Study were linked to the Society for Assisted Reproductive Technology Clinic Outcome Reporting System, which captures national ART outcomes. The authors assessed the live birth rate, the relative risk (RR) with 95% confidence intervals (95% CIs), and associations with treatment exposure using generalized estimating equations to account for multiple ovarian stimulations per individual. Siblings from a random sample of survivors were recruited to serve as a comparison group. Results: Among 9885 female survivors, 137 (1.4%; median age at diagnosis, 10 years [range, 0–20 years]; median years of follow‐up after age 18 years, 11 years [range, 2–11 years]) underwent 224 ovarian stimulations using autologous or donor eggs and/or gestational carriers (157 autologous ovarian stimulation cycles, 67 donor ovarian stimulation cycles). In siblings, 33 (1.4%) underwent 51 autologous or donor ovarian stimulations. Of those who used embryos from autologous eggs without using gestational carriers, 97 survivors underwent 155 stimulations, resulting in 49 live births, for a 31.6% chance of live birth per ovarian stimulation (vs. 38.3% for siblings; p =.39) and a 43.9% chance of live birth per transfer (vs. 50.0%; p =.33). Prior treatment with cranial radiation therapy (RR, 0.44; 95% CI, 0.20–0.97) and pelvic radiation therapy (RR, 0.33; 95% CI, 0.15–0.73) resulted in a reduced chance of live birth compared with siblings. The likelihood of live birth after ART treatment in survivors was not affected by alkylator exposure (cyclophosphamide‐equivalent dose, ≥8000 mg/m2 vs. none; RR, 1.04; 95% CI, 0.52–2.05). Conclusions: Childhood cancer survivors are as likely to undergo treatment using ART as sibling controls. The success of ART treatment was not reduced after alkylator exposure. The results from the current study provide needed guidance on the use of ART in this population. Linking the Childhood Cancer Survivor Study database to the Society for Assisted Reproductive Technology Clinic Outcome Reporting System revealed that childhood cancer survivors are as likely to undergo treatment with assisted reproductive technology as their siblings. The success of assisted reproductive technology was not reduced after alkylator exposure. [ABSTRACT FROM AUTHOR]

Objective: As social support has been shown to have beneficial effects on coping with cancer, our study aims to close the research gap on perceived social support in adolescent and young adult (AYA) cancer survivors. Methods: AYAs evaluated their perceived positive social support (PS) and detrimental interactions (DI) by completing the Illness‐Specific Social Support Scale (ISSS‐8) upon completion of acute treatment (t1) as well as 1 year (t2) and 7 years (t6) later. Temporal changes of social support were examined. Sociodemographic, psychological and medical factors were investigated as predictors for PS and DI by using mixed effects models. Results: We analyzed data from 319 cancer survivors (74.9% women). At baseline, survivors reported an average score of 13.73 (SD = 2.52) for PS and 3.92 (SD = 2.85) for DI. Average perceived PS changed over time, while DI remained stable. Males, AYAs without a partner and AYAs with clinically meaningful anxiety or depression levels reported fewer PS. Higher effort to cope with the disease and clinically significant anxiety and depression levels were associated with more perceived DI. Conclusions: Existing social networks and perceived social support should be evaluated regularly in AYA‐cancer survivorship. The identification and discussion of mental health of AYAs should also be a standard component in survivor consultations both during treatment and follow‐up care, as elevated depression and anxiety levels were associated with fewer PS and more perceived DI. [ABSTRACT FROM AUTHOR]

Young adults (ages 18–39) living with cancer often encounter developmental disruptions placing them at risk for anxiety, depression, social isolation, and a lost sense of meaning. To support their sense of belonging, meaning, and illness adaption, the authors developed Through the Lens: Living Beyond Young Adult Cancer, a virtual 8-week synchronous, meaning-centered photovoice group intervention. The study aimed to investigate the feasibility and acceptability of intervention among young adult survivors. Data collection centered on recruitment, group attendance, retention, and exit interview data evaluating barriers and facilitators to participation, and ease and comfort with photovoice group methods. Data analysis included descriptive statistics and thematic analysis of participants' exit interviews. Findings present descriptive results and quotes of the survivors' (n = 11) experiences who participated in two 8-week series of the intervention. Group members found the intervention feasible and acceptable and shared practical strategies to enhance the intervention. [ABSTRACT FROM AUTHOR]

This article discusses the association between physical activity (PA) and cardiovascular disease (CVD) among cancer survivors. The study utilized a database of Korean cancer survivors and found that increasing PA after a cancer diagnosis was associated with a reduced risk of CVD, while decreasing PA was associated with a higher risk of CVD. The findings suggest that promoting a healthy lifestyle, including regular physical activity, is important for cancer survivors to reduce their risk of CVD. However, the study has limitations, such as the inability to establish causality and the use of self-reported questionnaires for PA assessment. [Extracted from the article]

Background: Education plays a pivotal role in the care of oncological patients, reducing health costs, hospital readmission, and disease relapses. Education can be supportive in achieving multiple outcomes, improving symptom control and quality of life. A new approach is emerging in patient education: gamification. Gamification was defined as the "use of game elements in non-game contexts", including the application of games in serious contexts. The aim of this review is to explore the use of gamification in the oncology setting. Methods: A systematic scoping review was conducted in the MEDLINE, CINAHL, PsychINFO, Embase, Scopus, and Cochrane Library databases using the JBI guidelines. Results: The 13 included reports were critically appraised by two reviewers independently. It seems that gamification could be effective both in prevention and cancer treatments. Gamification also seems to improve chemotherapy-induced nausea and vomiting management, quality of life, and reduced anxiety levels in different cancer groups. Moreover, gamification seems effective in improving self-care in cancer patients, regardless of gender, age, and ethnicity. Conclusions: Gamification improves patient engagement and biopsychosocial outcomes and could represent a valid approach to cancer patient education; however, it is not a substitute for healthcare professionals, who remain the leaders in the education process. [ABSTRACT FROM AUTHOR]

Background: Evaluating the effects of cancer diagnosis and treatment on a patient's overall well-being is crucial and health-related quality of life (HRQoL) is a reliable metric for assessing this impact. Little is known about HRQoL among cancer survivors across various stages and treatments. The study examined individual and clinical factors influencing HRQoL among cancer survivors. Methods: A cross-sectional study was conducted in two specialised cancer care hospitals in Dhaka, Bangladesh. Cancer-diagnosed adults receiving treatment at selected hospitals from January to May 2022 were enrolled. The 5-level EuroQol-5 Dimensions version (EQ-5D-5L) instrument was used to collect HRQoL data. HRQoL scores were derived using UK value sets. The investigation used a multivariable Tobit regression model to determine the association between independent variables and HRQoL scores. Results: A total of 607 adult patients were enrolled, with 55% being females and 66% aged 36 to 64 years. Reported health problems in five EQ-5D domains include mobility (11%), self-care (11%), usual daily activities (19%), pain/discomfort (21%), and anxiety/depression (46%). Patients with throat, brain, lung, blood, and liver cancer had lower utility scores. Advanced-stage cancer survivors had lower utility scores (β = -49 units, 95% codfidence interval [CI]: -0.75 to -0.22) compared to early-stage survivors. Physically inactive survivors had lower utility scores by 0.41 units (95% CI: -0.51 to -0.30) compared to their counterparts. Private hospital patients had higher utility scores, whereas patients belonged to poor socioeconomic groups scored worse than wealthier ones. Conclusions: This study highlights the impact of clinical and individual characteristics on HRQoL among cancer survivors. These findings advocate for an enhanced Bangladeshi cancer patient care model through timely interventions or programs, early detection or diagnosis, tailored treatments, and the promotion of physical activity to bolster HRQoL outcomes. [ABSTRACT FROM AUTHOR]

Purpose: Pain post-treatment is a debilitating symptom in the growing population of cancer survivors. While physical activity is an integral part of pain management, low levels of physical activity are often observed in this population. The aim of this systematic review is to gain insight into the barriers and facilitators to physical activity in cancer survivors afflicted with pain. Methods: In December 2021, a systematic search was conducted using PubMed and Web of Science. All studies exploring barriers and/or facilitators to physical activity in cancer survivors with pain were included. The methodological quality of the evidence was appraised with the Mixed Methods Appraisal Tool (version 2018). Results: Six articles were included. Current literature was limited and mostly focused on female breast cancer survivors. The identified barriers and facilitators could be categorized into six different domains: the logistical, symptoms, cognitive, clinical, social, and knowledge domain. The barrier of pain was reported as a barrier on its own that is closely linked to other barriers in this specific population. Conclusion: Barriers and facilitators to physical activity were categorized in six different domains. The barrier of pain distinguishes itself and brings along additional obstacles such as anxiety, fear, and avoidance behavior. Current evidence is limited and focuses mostly on female breast cancer survivors. Further research in larger cohorts representing various subsets of cancer survivors with pain is warranted, as well as studies that implement these insights in physical activity interventions. [ABSTRACT FROM AUTHOR]

Objective To explore the safety of radiofrequency catheter ablation in patients with atrial fibrillation (AF) and a history of tumor. Methods We collected the clinical data of 269 AF patients who had undergone radiofrequency ablation. Among the enrolled patients, those non-valvular AF patients with a history of tumor were labeled as the tumor group (16 cases) while those without a history of tumor were divided into the non-tumor group (253 cases). The clinical characteristics and incidences of peripheral complications were compared between the two groups. Results The top three previous tumors are separately gastrointestinal tract tumor (37. 50%), gynecology tumor (25. 00%), and lung tumor (18. 75%). There is no significant difference in the incidence of peripheral complications between the two groups. During 12-month follow-up, the recurrence rate of AF between the two groups also does not vary significantly. Conclusion In AF patients with a history of tumor, the incidence of complications during perioperative period of catheter ablation is similar to that of AF patients without tumor history, so is the postoperative recurrence rate of AF. Radiofrequency ablation could be used as one of the treatment options for such patients. [ABSTRACT FROM AUTHOR]

Younger onset colorectal cancer (CRC) rates continue to rise. Survivors younger than the requisite age of population-based screening guidelines experience adverse symptoms, longer appraisal delays, and more advanced-stage diagnoses. This secondary analysis of interviews with n=252 recently diagnosed CRC survivors was completed to compare younger and older survivors' symptoms, attributed causes, and healthcare seeking assets. The original transcripts and quantitative data were divided into two survivor classifications, younger (age <50 years) (N=64) and older (N=188). Bivariate analyses assessed differences between younger and older survivors for symptoms, attributed causes, and seeking healthcare assets. Multiple logistic regression models adjusting for race, sex, income, education, and stage of diagnosis were conducted for significant bivariate findings. An α level.05 was used to detect significance. Bleeding (훘2=3.8, p =0.05) and loss of appetite/weight differed between survivors (훘2=5.3, p=0.02) but not after controlling for sex and race respectively. Younger survivors were more likely to report being too young/healthy to have cancer (훘2=7.8, p<0.01) and social support encouragement to seek healthcare (훘2=6.4, p=0.01). Having a regular healthcare provider was more common among older survivors (훘2=6.4, p=0.01). Logistic regression models also detected age as a significant predictor for all healthcare seeking assets. Clinical and public health practice can benefit from understanding that CRC symptoms may present similarly but assets that facilitate seeking healthcare appraisal differ based upon age. Expanding knowledge of CRC risk factors and symptoms across healthcare professionals and the general public could promote earlier appraisal regardless of age and improve outcomes for younger survivors. [ABSTRACT FROM AUTHOR]

The objective of this Research-Practice Partnership was to disseminate and implement strategies to assist Community Health Centers in improving the care of rural cancer survivors in Montana. Funded by the National Cancer Institute's Community Outreach and Engagement mechanism, this project utilized the MAP-IT (Mobilize, Assess, Plan, Implement, Track) program planning framework from Healthy People 2020. Partners included Montana's Department of Public Health and Human Services' Cancer Control Program, Montana Primary Care Association, One Health Community Health Center, and Huntsman Cancer Institute at the University of Utah. Project activities focused on (1) Planning, creating, implementing, and evaluating provider/care team education sessions through the Project ECHO tele-mentoring platform and through short webinars and (2) Building processes for identifying, documenting, and connecting with survivors using electronic health records (EHRs) and other resources. Lessons learned from this project include the value of aligning partner goals from the outset to foster sustained commitment, the importance of adapting implementation plans to address challenges and leverage opportunities, and the need for accurate EHR data and formal processes for identifying and engaging with cancer survivors. [ABSTRACT FROM AUTHOR]

For many cancer survivors, toxic side effects of treatment, lingering effects of the aftermath of disease and cancer recurrence adversely affect quality of life (QoL) and reduce healthspan. Data−driven approaches for quantifying and improving wellness in healthy individuals hold great promise for improving the lives of cancer survivors. The data-driven strategy will also guide personalized nutrition and exercise recommendations that may help prevent cancer recurrence and secondary malignancies in survivors.

Abstract Background Personal history of cancer is an independent risk factor for lung cancer but is omitted from existing lung cancer screening eligibility criteria. In this study, we assess the lung cancer risk among cancer survivors and discuss potential implications for screening. Methods This was a retrospective, secondary analysis of data from the Surveillance, Epidemiology and End Results (SEER) registry and the MD Anderson Cancer Center (MDACC). We estimated the standardized incidence ratios (SIRs) for lung cancer by site of first primary cancer using data from SEER. We assessed the lung cancer risk among head and neck cancer survivors from MDACC using cumulative incidence and compared the risk ratios (RR) by individuals' screening eligibility status. Results Other than first primary lung cancer (SIR: 5.10, 95% CI: 5.01–5.18), cancer survivors in SEER with personal history of head and neck cancer (SIR: 3.71, 95% CI: 3.63–3.80) had the highest risk of developing second primary lung cancer, followed by bladder (SIR: 1.86, 95% CI: 1.81–1.90) and esophageal cancers (SIR: 1.78, 95% CI: 1.61–1.96). Head and neck cancer survivors had higher risk to develop lung cancer compared to the National Lung Screening Trial's subjects, (781 vs. 572 per 100,000 person‐years, respectively). Head and neck cancer survivors ineligible for lung cancer screening seen at MDACC had significantly higher lung cancer risk than head and neck cancer survivors from SEER (RR: 1.9, p

Advances in medicine have made long-term survival of cancer patients possible. Hence, it is now necessary to consider how to approach common symptoms, such as cancer-related pain, in these patients. In this study, we describe a lung cancer patient in whom relief of intractable thoracic pain caused by pleural metastasis was achieved through thoracic radiofrequency thermocoagulation (RF), improving his quality of life (QOL). The patient was a man in his 70s with right upper lobe lung cancer, left 9th ?11th rib metastasis, and left thoracic pain associated with parietal pleural metastasis. The patient experienced insomnia and weight loss due to poor appetite caused by opioid analgesics and inadequate pain control. Therefore, RF was performed as interventional treatment, resulting in a decrease in the numerical rating scale score from 10/10 to 2/10, and an improvement in QOL. In cases wherein long-term survival is expected, a long-term treatment plan for chronic cancer-related pain, which has a tendency to become persistent, becomes necessary. RF for the nerve roots might be a viable option for pain caused by pleural metastasis in cancer survivors.

Abstract Background The current guidelines for survivorship in adolescents and young adults (AYA) cancer are based on studies conducted in the United States and European AYA survivors. However, previous studies have shown that the health-related quality of life in cancer survivors can vary depending on race, yet the long-term health differences among AYA survivors by race/ethnicity have not been fully explored. Therefore, our aim is to compare the psychosocial and physical health of AYA survivors and their matched controls across different racial and ethnic groups. Methods We conducted a cross-sectional study using US National Health and Nutrition Examination Survey (NHANES) and the Korea NHANES from 2007 to 2018. We included AYA cancer survivors who were diagnosed with any type of cancer aged between 15 and 39 years, and who were adult with aged over 18 years old at survey year. We then stratified the study population by race/ethnicity with Non-Hispanic White (NHW, n = 310), African American (AA, n = 42), Hispanic (n = 81) from NHANES, and Asian (n = 389) from the Korea NHANES. We also selected 5 times age-, sex-, race-, and survey year-matched general population among participants who had never been diagnosed with cancer (N = 4110). Variables were defined using questionnaire data, physical exams, and laboratory tests. Results Compared to NHW, Hispanics (aOR 1.15, 95% CI 1.00–1.32) had poor or fair general health, lower education (aOR 1.23, 95% CI 1.07–1.40), and lower household income (aOR 1.16, 95% CI 1.01–1.33). AA survivors were more likely to be non-coupled (aOR 1.35, 95% 1.15–1.60) and have hypertension (aOR 1.18, 95% CI 1.03–1.36). Asians were more former/current drinkers (aOR 1.21, 95% CI 1.05–1.40). NHW are more likely to experience psychological limitation. Compared to matched general, NHW and Asian survivors had poor general health and psychological health. Conclusions This study provides evidence for future studies concerning long-term health after AYA cancer survivorship that may vary according to race.

Abstract Background The present study sought to investigate how comorbidity burden influences cancer survivors' quality of life (QoL) and the challenges/adaptations during the coronavirus disease 2019 (COVID) pandemic, and to examine how appraisal processes are related to this impact. Methods This cross‐sectional study, administered in spring/summer 2020, compared cancer survivors to a general‐population comparison sample. QoL was assessed with standardized tools. COVID‐specific questions included selected items compiled by the US National Institutes of Health, and cognitive appraisal processes were assessed using the QoL Appraisal Profilev2 Short‐Form. Principal components analysis reduced the number of comparisons. Multivariate analysis of covariance investigated group differences in QoL, COVID‐specific variables, and cognitive‐appraisal processes. Linear regression investigated group differences in COVID‐specific variables as a function of cognitive‐appraisal processes, QoL, demographic covariates, and their interactions. Results Cancer survivors fared substantially better than non‐cancer participants in QoL and cognitive functioning when they had no other comorbidities, but substantially worse on QoL when they had three or more comorbidities. Cancer survivors with no comorbidities were less likely to feel worried about COVID, less likely to engage in self‐protection, and prioritized engaging in problem‐focused and prosocial actions compared to non‐cancer participants. Conversely, cancer survivors confronted with multiple comorbidities exhibited more proactive self‐protection and experienced more anxiety about the pandemic. Conclusion The impact of having multiple comorbidities in the context of cancer is associated with notable differences in social determinants of health, QoL outcomes, COVID‐specific challenges/adaptations, and appraisal of QoL. These findings provide an empirical basis for implementing appraisal‐based coping interventions.

Objectives: To investigate the health-related quality of life (HRQL) of long-term survivors of inoperable esophageal squamous cell carcinoma (ESCC) treated with definitive radiation therapy, the real-world trends in the use of advanced radiation techniques, and their impact on the survival outcomes of ESCC patients. Methods: In this multicenter retrospective observational study, the medical records related to demographics and treatment of ESCC patients who were treated with definitive radiation therapy at 14 provincial hospitals in China from 1 January 2015 to 31 December 2016 were analyzed. A HRQL questionnaire was completed by survivors and collected by doctors at the final follow-up. The difference in quality of life between patients with or without recurrence was compared using the Wilcoxon–Mann–Whitney test. Overall survival (OS) was estimated using the Kaplan–Meier method and the group differences were assessed by unstratified log-rank test. The Cox proportional hazards model with Efron's method of tie handling was used to calculate the risk factors for OS. Results: The data of a total of 3,308 patients were collected for this study, 248 were excluded because of missing data, and a final of 3,060 patients were included in the analysis. Most patients (2,901; 94.8%) received intensity-modulated radiotherapy (IMRT)/volumetric-modulated arc therapy (VMAT)/tomotherapy (TOMO). The 5-year OS rate was 30%. Patients who received either two-dimensional radiotherapy (2DRT; HR, 2.43 [95% CI, 1.70–3.47]; P 80% patients did not experience weight loss. Nearly 80% patients found life very enjoyable or were fairly enjoying life. Conclusions: This large, multicenter retrospective study on ESCC patients who received definitive radiation therapy found that most ESCC survivors are satisfied with their quality of life. Most patients received advanced radiation technology. Patients who received either 2DRT or 3DRT had a significantly increased risk of death compared to those who received advanced radiation technology.

Abstract Introduction Initial cancer survivorship care planning efforts focused on information sharing demonstrated limited impact on patient health outcomes. We designed the Shared Healthcare Actions & Reflections Electronic Systems in survivorship (SHARE‐S) program to enhance survivorship guideline implementation by transitioning some effort from clinicians to technology and patients through supporting health self‐management (e.g., healthy lifestyles). Methods We conducted a single‐group hybrid implementation‐effectiveness pilot study. SHARE‐S incorporated three strategies: (1) e‐referral from the clinical team for patient engagement, (2) three health self‐management coach calls, and (3) text messages to enhance coaching. Our primary implementation measure was the proportion of patients e‐referred who enrolled (target >30%). Secondary implementation measures assessed patient engagement. We also measured effectiveness by describing changes in patient health outcomes. Results Of the 118 cancer survivor patients e‐referred, 40 engaged in SHARE‐S (proportion enrolled = 34%). Participants had a mean age of 57.4 years (SD = 15.7), 73% were female, 23% were Black/African American, and 5 (12.5%) were from a rural location. Patient‐level adherence to coach calls was >90%. Changes from baseline to follow‐up showed at least a small effect (Cohen's d = 0.2) for improvements in: mindful attention, alcohol use, physical activity, fruit and vegetable intake, days of mindfulness practice, depressive symptoms, ability to participate in social roles and activities, cancer‐specific quality of life, benefits of having cancer, and positive feelings. Conclusion The SHARE‐S program successfully engaged cancer survivor patients. Once enrolled, patients showed promising improvements in health outcomes. Supporting patient self‐management is an important component of optimizing delivery of cancer survivorship care.

People living with facial eye disfigurements (LwFED) are often shunned by a society that makes spontaneous judgements based on appearance. This article is a case study of the lived experience of Toni, a 27-year-old woman LwFED, the result of her treatment for ocular cancer. Semi-structured interviews facilitated the exploration of her experiences. We present the findings chronologically but interwoven with themes such as: being strong for others; responding to her partner's abuse; dealing with strangers; and reinventing her sense of identity and supporting others. We identified institutional perspectives of work, hospital, and family within the prevailing UK that impacted Toni's experiences of LwFED and argue that institutional perspectives need to be educated about the ordinary person's daily grind of LwFED to address unrecognised bias and assumption. Only when identified and addressed can the reframing of social, institutional, organisational, and medical understandings and responses facilitate and support the lives of those LwFED. [ABSTRACT FROM AUTHOR]

This study aims to examine the feasibility of DNA methylation age as a biomarker for symptoms and resilience in cancer survivors with multiple chronic conditions (MCCs). We included ten participants from our parent study, an ongoing randomized control trial study. Participants' symptoms and resilience were assessed, and peripheral blood was collected. DNA methylation age calculation was performed using DNAge® analysis. Data were analyzed using Spearman's correlation analysis and the Mann–Whitney U test. Participants in the intervention group tended to have a decrease in DNA methylation age and age acceleration after completing an exercise program (mean difference = −0.83 ± 1.26). The change in DNA methylation age was significantly correlated with the change in resilience score (r = −0.897, p = 0.015). The preliminary results suggest that DNA methylation age can be a potential biomarker for improving resilience in cancer survivors with multiple chronic conditions. This finding is limited by the small sample size, and a larger study is needed. [ABSTRACT FROM AUTHOR]

Objective: The authors investigated the functional status at ICU admission and at hospital discharge, and the impact of dysfunctions on survivors' lifespan. Method: Single-center retrospective cohort. The FSS (Functional Status Scale) was calculated at ICU admission and at hospital discharge. A new morbidity was defined as an increase in FSS = 3. Results: Among 1002 patients, there were 855 survivors. Of these, 194 (22.6%) had died by the end of the study; 45 (5.3%) had a new morbidity. Means in the motor domain at admission and discharge were 1.37 (SD: 0.82) and 1.53 (SD 0.95, p = 0.002). In the feeding domain, the means were 1.19 (SD 0.63) and 1.30 (SD 0.76), p = 0.002; global means were 6.93 (SD 2.45) and 7.2 (SD 2.94), p = 0.007. Acute respiratory failure requiring mechanical ventilation, the score PRISM IV, age < 5 years, and central nervous system tumors were independent predictors of new morbidity. New morbidity correlated with lower odds of survival after hospital discharge, considering all causes of death (p = 0.014), and was independently predictive of death (Cox hazard ratio = 1.98). In Weibull models, shortening in the life span of 14.2% (p = 0.014) was estimated as a new morbidity. Conclusions: New morbidities are related to age, disease severity at admission, and SNC tumors. New morbidities, in turn, correlate with lower probabilities of survival and shortening of the remaining life span. Physical rehabilitation interventions in this population of children may have the potential to provide an increase in lifespan. [ABSTRACT FROM AUTHOR]

Background: The use of electronic cigarettes (e‐cigarettes) is increasing rapidly in the United States, although the negative health outcomes associated with these products are still unknown. Emerging research has examined the use of e‐cigarettes in the cancer survivor population as a whole, yet none has focused on e‐cigarette use in the African American (AA) cancer survivor population. Methods: The authors used data from the Detroit Research on Cancer Survivors cohort study, comprised of AA adult cancer survivors. Logistic regression models were used to evaluate factors potentially associated with e‐cigarette ever use and current use. Results: Of 4443 cancer survivors who completed a baseline interview, 8.3% (n = 370) reported ever using e‐cigarettes, and 16.5% (n = 61) of those reporting ever use also reported current use of e‐cigarettes. Ever users and current users were on average younger than those who did not use e‐cigarettes (57.5 vs. 61.2 years; p <.001). Current cigarette smokers were >20 times more likely (odds ratio, 20.75; 95% confidence interval, 12.84–33.55) and former smokers were almost 10 times more likely (odds ratio, 9.50; 95% confidence interval, 6.03–14.97) to have ever used e‐cigarettes than never‐smokers. Preliminary data suggested that ever use of e‐cigarettes is associated with later stage at diagnosis for breast and colorectal cancers. Conclusions: As the use of e‐cigarettes increases in the general population, it is important to continue to monitor their use in cancer survivors and to gain more insight as it pertains to the AA cancer survivor population. Elucidation of the factors associated with e‐cigarette use in this population may help inform comprehensive cancer survivorship recommendations and interventions. The use of electronic cigarettes (e‐cigarettes) is becoming more prevalent in the general population, although data are sparse for cancer survivors, particularly African Americans. Here, the authors report estimates of e‐cigarette use in African American cancer survivors and note an association with younger age and use of combustible cigarettes. Additionally, for some cancer types, ever use of e‐cigarettes may be associated with advanced stage at diagnosis. [ABSTRACT FROM AUTHOR]

Recent advances in anticancer treatment have significantly improved the survival rate of young females; unfortunately, in about one third of cancer survivors the risk of ovarian insufficiency and infertility is still quite relevant. As the possibility of becoming a mother after recovery from a juvenile cancer is an important part of the quality of life, several procedures to preserve fertility have been developed: ovarian surgical transposition, induction of ovarian quiescence by gonadotropin-releasing hormone agonists (GnRH-a) treatment, and oocyte and/or ovarian cortical tissue cryopreservation. Ovarian tissue cryostorage and allografting is a valuable technique that applies even to prepubertal girls; however, some patients cannot benefit from it due to the high risk of reintroducing cancer cells during allograft in cases of ovary-metastasizing neoplasias, such as leukemias or NH lymphomas. Innovative techniques are now under investigation, as in the construction of an artificial ovary made of isolated follicles inserted into an artificial matrix scaffold, and the use of stem cells, including ovarian stem cells (OSCs), to obtain neo-folliculogenesis and the development of fertilizable oocytes from the exhausted ovarian tissue. This review synthesizes and discusses these innovative techniques, which potentially represent interesting strategies in oncofertility programs and a new hope for young female cancer survivors. [ABSTRACT FROM AUTHOR]

Adolescent and young adult cancer survivors experience barriers to occupational participation following cancer treatment. This article aims to identify the scope of occupational therapy evidence for adolescent and young adult cancer survivors. A scoping review of articles cited in CINAHL Complete, MEDLINE (EBSCO), Academic Search Complete, APA PsycINFO, and PubMed was performed. The initial search yielded 391 articles, with eight publications included in the final review. Results revealed a significant lack of age-specific occupational therapy-based resources for adolescent and young adult cancer survivors. Evidence supports the use of self-management, physical activity, therapeutic exercise, activities of daily living training and adaptation, and app-based coaching to improve client outcomes. Further research is required to determine the effectiveness of occupational therapy services, as well as to establish evidence-based guidelines for practice. [ABSTRACT FROM AUTHOR]

Purpose: Examine associations of social developmental factors (e.g., peer/parent social attachment, romantic relationships) and perceptions of social acceptance among emerging adult survivors of childhood cancer. Methods: A cross-sectional, within-group design was used. Questionnaires included the Multidimensional Body-Self Relations Questionnaire, Inventory of Parent and Peer Attachment, Adolescent Social Self-Efficacy Scale, Personal Evaluation Inventory, Self-Perception Profile for Adolescents, and demographics. Correlations were utilized to determine associations between general demographic, cancer-specific, and the psychosocial outcome variables. Peer and romantic relationship self-efficacy were assessed as potential mediators of social acceptance in three mediation models. Relationships between perceived physical attractiveness, peer attachment, parental attachment, and social acceptance were assessed. Results: Data were collected from N = 52 adult participants (Mage = 21.38 years, standard deviation = 3.11 years) diagnosed with cancer as a child. The first mediation model demonstrated a significant direct effect of perceived physical attraction on perceived social acceptance and retained significance after adjusting for indirect effects of the mediators. The second model demonstrated a significant direct effect of peer attachment on perceived social acceptance; however, significance was not retained after adjusting for peer self-efficacy, suggesting the relationship is partially mediated by peer relationship self-efficacy. The third model demonstrated a significant direct effect of parent attachment on perceived social acceptance; however, significance was not retained after adjusting for peer self-efficacy, suggesting the relationship is partially mediated by peer self-efficacy. Conclusion: Relationships between social developmental factors (e.g., parental and peer attachment) and perceived social acceptance are likely mediated by peer relationship self-efficacy in emerging adult survivors of childhood cancer. [ABSTRACT FROM AUTHOR]

Purpose: The majority of adolescent and young adult (AYA) cancer survivors do not receive recommended health care surveillance after therapy. We used cross-sectional survey data to evaluate the impact of income, education, marital status, and insurance on health care adherence among AYA survivors. Methods: Eligible survivors were 18–39 years at diagnosis with invasive malignancy, 1–5 years from therapy completion. Online surveys assessed sociodemographic factors and self-report of completion of recommended health care services. Diagnosis and treatment data were abstracted from medical records. Multivariable logistic regression calculated odds ratios (ORs) and 95% confidence intervals (CIs) for adherence in relation to socioeconomic status and support. Results: Of 344 participants, 36% were adherent to at least 80% of recommendations. Adherence varied by cancer type: 34% for breast cancer, 52% for leukemia/lymphoma, 23% for other tumors. Adherence rates were similar among White, Asian, and Hispanic/Latinx patients. Lower adherence was associated with lower education (OR: 0.43; 95% CI: 0.23–0.80 for <4-year college degree) and lower annual income (OR: 0.51; 95% CI: 0.28–0.95 for $41,000–$80,000; OR: 0.40; 95% CI: 0.19–0.86 for ≤$40,000). Adherence decreased with decreasing income levels among those who were 1 to less than 3 years after diagnosis (OR: 0.25; 95% CI: 0.07–0.93 for $81,000–$120,000; OR: 0.24; 95% CI: 0.07–0.84 for $41,000–$80,000; OR: 0.13; 95% CI: 0.03–0.60 for ≤$40,000). Conclusion: Risk of nonadherence to health care guidelines was associated with lower income and lower education among AYA cancer survivors. Identification of these risks and related barriers to adherence in AYA survivors will inform interventions designed to meet needs of these high-risk groups, particularly during the first years after diagnosis. Trial Registration: NCT02192333. [ABSTRACT FROM AUTHOR]