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Background: Few studies have examined risk for severe symptoms during early cancer survivorship. By using baseline data from the American Cancer Society's Study of Cancer Survivors-I, the authors examined cancer survivors with high symptom burden, identified risk factors associated with high symptom burden, and evaluated the impact of high symptom burden on health-related quality of life (HRQoL) 1 year postdiagnosis.Methods: Participants were enrolled from 11 state cancer registries approximately 1 year after diagnosis and were surveyed by telephone or mail. The outcomes measures used were the Modified Rotterdam Symptom Checklist and the Profile of Mood States-37 (to assess symptom burden) and the Satisfaction with Life Domains Scale-Cancer (to assess HRQoL).Results: Of 4903 survivors, 4512 (92%) reported symptoms related to their cancer and/or its treatment. Two-step clustering yielded 2 subgroups, 1 with low symptom burden (n = 3113) and 1 with high symptom burden (n = 1399). Variables that were associated with high symptom burden included lung cancer (odds ratio [OR], 2.27), metastatic cancer (OR, 2.05), the number of comorbid conditions (OR, 1.76), remaining on active chemotherapy (OR, 1.93), younger age (OR, 2.31), lacking insurance/being underinsured (OR, 1.57), having lower income (OR, 1.61), being unemployed (OR, 1.27), and being less educated (OR, 1.29). Depression, fatigue, and pain had the greatest impact on HRQoL in survivors with high symptom burden, who also had lower HRQoL (P < .0001).Conclusions: More than 1 in 4 cancer survivors had high symptom burden 1 year postdiagnosis, even after treatment termination. These results indicate a need for continued symptom monitoring and management in early post-treatment survivorship, especially for the underserved. [ABSTRACT FROM AUTHOR]

Lupine has been increasingly used in food applications due to its high nutritional value and excellent functional properties. However, lupine provokes allergic reactions in susceptible individuals. The presence of undeclared lupine residues in foods can pose a serious health risk to lupine-allergic individuals. Therefore, the objective of this research was to develop a sandwich-type ELISA for the detection of lupine residues in foods. Lupine flour derived from Lupinus albus was used to immunize 3 rabbits and a sheep. Pooled lupine-specific antibodies were partially purified from the sera by ammonium sulfate precipitation. A sandwich lupine ELISA with a limit of quantification (LOQ) of 1 ppm was developed by utilizing the rabbit antisera as the capture reagent and the sheep antiserum as the detector reagent. The binding of the antigen-antibody complex was visualized by the addition of commercial rabbit antisheep IgG antibody labeled with alkaline phosphatase with subsequent addition of p-nitrophenyl phosphate substrate to produce a colored product for quantification. Minor cross-reactivity was observed with soy ( Glycine max) and black bean ( Castanospermum australe). The performance of the lupine ELISA was evaluated in reference food standards (beef frankfurter and apple cinnamon muffin) and laboratory-prepared cooked frankfurters and corn muffins. The mean percent recovery for lupine spiked-frankfurters and corn muffins were 108.4%± 8.8% and 103.1%± 11.5%, respectively. The sandwich-type lupine ELISA developed in this study provides food manufacturers and regulatory agencies with an effective analytical tool to detect and quantify lupine residues in processed foods. [ABSTRACT FROM AUTHOR]

Background and Objectives: It can be clinically challenging to differentiate dementia with Lewy bodies (DLB) and Alzheimer disease (AD). As potential therapies emerge with the goal of slowing or halting misfolded protein aggregation, it is imperative to be able to identify individuals before the disease becomes disabling. Differentiating between DLB and AD in the preclinical or prodromal phase of DLB and AD becomes more important. Studies are needed to validate the proposed criteria for prodromal DLB., Methods: Longitudinal data were obtained from the Uniform Data Set of the National Alzheimer's Coordinating Center. Included participants had a baseline diagnosis of normal or mild cognitive impairment and a consecutive 2-year follow-up diagnosis of DLB or AD. We examined whether core DLB clinical features, supportive neuropsychiatric features, and neuropsychological data in the 2 years preceding the dementia diagnosis distinguished DLB from AD., Results: We identified 143 participants with DLB and 429 age-matched/sex-matched participants with AD. The presence of 2 or more core DLB features in the year before dementia diagnosis yielded the greatest AUC (0.793; 95% CI 0.748-0.839) in distinguishing prodromal DLB from prodromal AD. Sleep disturbances, hallucinations, and a cognitive profile of worse processing speed, attention, and visuoconstruction performance were evident at least 2 years before the dementia diagnosis in DLB compared with AD., Discussion: Data from this multisite, longitudinal, well-characterized research North American cohort support the validity of the recently published criteria for prodromal DLB. In the prodromal stage, patients who subsequently develop DLB are more likely to have core DLB clinical features and worse attention, processing speed, and visuospatial performance than those who go on to develop AD. Differentiation of DLB and AD before dementia emerges provides an opportunity for early, disease-specific intervention and overall management., Competing Interests: K.A. Wyman-Chick receives research support from the NIH (R21AG074368). T.J. Ferman receives support from the National Institutes of Health and from Mangurian Foundation Lewy Body Dementia Program at Mayo Clinic. M.J. Armstrong receives research support from the NIH (R01AG068128, P30AG066506, R01NS121099, and R44AG062072), the Florida Department of Health (grants 20A08, 24A14, and 24A15), and as the local PI of a Lewy Body Dementia Association Research Center of Excellence. She serves on the DSMBs for the Alzheimer's Therapeutic Research Institute/Alzheimer's Clinical Trial Consortium and the Alzheimer's Disease Cooperative Study. She has provided educational content for Medscape, Vindico CME, and Prime Inc. E. Bayram receives research support from the NIH (K99AG073453) and the Lewy Body Dementia Association. B.F. Boeve has served as an investigator for clinical trials sponsored by Alector, Biogen, and Transposon. He serves on the Scientific Advisory Board of the Tau Consortium, which is funded by the Rainwater Charitable Foundation. He receives support from NIH, the Mayo Clinic Dorothy, Harry T. Mangurian Jr. Lewy Body Dementia Program, the Little Family Foundation, and the Ted Turner and Family Foundation. D. Weintraub has received research funding or support from MJFF, Alzheimer's Therapeutic Research Initiative, Alzheimer's Disease Cooperative Study, the International Parkinson and Movement Disorder Society, and National Institute on Aging (NIA); honoraria for consultancy from Acadia, Aptinyx, Biogen, CHDI Foundation, Clintrex LLC, Eisai, Enterin, F. Hoffmann-La Roche Ltd, Ferring, Janssen, Otsuka, Promentis, Sage, Signant Health, Sunovion, and Takeda; and license fee payments from the University of Pennsylvania for the QUIP and QUIP-RS. M.J. Barrett receives research support from the NIH (R21AG077469). Full disclosure form information provided by the authors is available with the full text of this article at Neurology.org/cp., (© 2024 American Academy of Neurology.)

Objective: Studies of health-related quality of life (HRQOL) among Black and White cancer survivors have been based on small convenience samples and yielded inconsistent results. We examined Black-White disparities in survivors' HRQOL with a population-based sample, and tested the hypothesis that area-level segregation accounts for those disparities., Design: A sample of survivors of 10 types of cancer was drawn from 11 U.S. state cancer registries and surveyed 12-15 months after diagnosis. The current sample consisted of 5195 survivors (415 Black, 4780 White) who resided in 584 counties., Main Outcome Measures: SF-36 General Health subscale scores were used as the measure of HRQOL., Results: Bivariate results revealed that Black survivors had significantly poorer HRQOL than did White survivors. Multilevel regression including individual-level (gender, age, marital status, education, cancer type, stage at diagnosis, cancer progression, comorbidities, race/ethnicity) and area-level (county segregation and poverty) variables found that HRQOL was poorer among survivors who resided in high-Black-segregated counties, whereas race/ethnicity was no longer significant., Conclusion: These findings indicate that Black-White disparities in HRQOL among cancer survivors might be a function, not of race/ethnicity, but of area-level variables associated with race/ethnicity. The strong role of segregation highlights the need for interventions to target Black-segregated areas.

We examined associations between spiritual well-being and CAM use among 4,139 cancer survivors. We also explored the classification of religious/spiritual practices (R/S) as CAMs and alternative subscale structures of the Functional Assessment of Chronic Illness Therapy--Spiritual Well-being (FACIT-Sp). We evaluated three aspects of spirituality, Faith, Peace, and Meaning, and use of 19 CAMs in 5 domains. Mind-body methods were subdivided into R/S and non-R/S. All FACIT-Sp factors were associated with CAM use, but in different directions: Meaning and Faith were positively associated; Peace was negatively associated. Peace was negatively associated with R/S CAMs, but not non-R/S CAMs. The prevalence of CAM use dropped from 79.3 to 64.8% when R/S items were excluded. These findings confirm an association between spiritual well-being and CAM use, including some non-R/S CAMs, and provide evidence of the benefits of using the three-factor FACIT-Sp solution and treating R/S CAMs as a separate category.

Background: Acupuncture is underutilized as an adjunct cancer therapy. The main study objectives were to determine the feasibility of administering acupuncture as palliative therapy to patients with advanced ovarian or breast cancer and to assess the effect on symptoms and quality of life (QOL)., Methods: This study was a pilot, single-armed prospective clinical trial for patients with advanced cancer to receive 12 acupuncture sessions over 8 weeks with follow-up at weeks 9 and 12. Ambulatory patients with advanced ovarian or breast cancer were enrolled to receive treatments at an outpatient academic oncology center. Symptom severity was measured before and after each acupuncture session.A composite QOL assessment tool, consisting of validated instruments, was completed at 5 time points., Results: Forty patients enrolled in the study. Twenty-eight patients (70%; 95% confidence interval [CI] = 53%-83%) completed 4 weeks of treatment, and 26 patients (65%; 95% CI = 48%-79%) completed 8 weeks. Eight patients (20%) withdrew before receiving acupuncture, and 6 patients (15%) discontinued treatment early because of disease progression or scheduling demands. Among all 32 assessed patients, there was self-reported improvement immediately post-treatment in anxiety,fatigue, pain, and depression and significant improvement over time for patients with anxiety (P = .001) and depression(P = .02). Among patients experiencing baseline symptoms, there was improvement in anxiety (P = .001), fatigue (P = .0002),pain (P = .0002), and depression (P = .003). QOL measures of pain severity and interference, physical and psychological distress, life satisfaction, and mood states showed improved scores during treatment, with sustained benefit at 12 weeks., Conclusions: This pilot study demonstrates that an 8-week outpatient acupuncture course is feasible for advanced cancer patients and produces a measurable benefit that should be evaluated in controlled trials.

Background: The medical and demographic correlates of complementary and alternative medicine (CAM) use among cancer survivors have been well documented. However, the role of psychological functioning in cancer survivors' CAM use and the degree to which such factors apply to survivors of colorectal cancer require additional study. In addition, sex differences in CAM use and its correlates among colorectal cancer survivors are not well understood., Methods: By using data from a large-scale national population-based study of quality of life and health behaviors among cancer survivors, the authors examined the prevalence and psychological correlates of CAM use among 252 male and 277 female colorectal cancer survivors., Results: Use of CAM was more common among women, those with more education, and recipients of chemotherapy and radiation therapy. Several psychological factors predicted increased use of CAM among female colorectal cancer survivors, including anxiety, fear of cancer recurrence, fatigue, vigor, anger, mental confusion, and overall emotional distress. Depression was associated with decreased CAM use among female survivors, both for overall CAM use and across several standard CAM domains. In contrast, psychological functioning had little impact on male colorectal cancer survivors' CAM use. The only nonmedical/demographic variable associated with men's use of CAM was fatigue, which predicted use only of biologically based practices, such as diet and nutritional supplements., Conclusions: Psychological functioning has a significant impact on CAM use among female colorectal cancer survivors. Decreased use of CAM among women with depressive symptoms was unexpected and warrants additional investigation., (Copyright (c) 2009 American Cancer Society.)

Background: The use of complementary methods (CMs) is widespread and increasing in the United States. Most literature on CM use among cancer survivors focuses on the treatment period, whereas only a few studies address use further along the cancer continuum., Methods: This study analyzed the prevalence and the medical and demographic associations of CM use among cancer survivors surveyed 10 to 24 months after diagnosis. The study's sample-4139 survivors of 1 of 10 adult cancers-was selected from stratified random samples provided by statewide cancer registries and surveyed by mail and telephone. Three logistic regression models examined associations between medical and demographic factors and CM use among survivors of sex-specific and non-sex-specific cancers., Results: Of the 19 CMs included in the survey, the CMs most frequently reported were prayer/spiritual practice (61.4%), relaxation (44.3%), faith/spiritual healing (42.4%), nutritional supplements/vitamins (40.1%), meditation (15%), religious counseling (11.3%), massage (11.2%), and support groups (9.7%). Among these 19 CMs, the least prevalent were hypnosis (0.4%), biofeedback therapy (1.0%), and acupuncture/acupressure (1.2%). Survivors more likely to use CMs were female, younger, white, higher income, and more educated., Conclusions: This study provides information regarding prevalence and medical-demographic determinants of CM use reported by a large, population-based sample of survivors of 10 cancers surveyed 10 to 24 months after diagnosis. These findings may be used by clinicians and researchers to inform their decisions regarding which CMs to address in practice and research., ((c) 2008 American Cancer Society.)

The American Cancer Society (ACS) defines cancer survivorship as beginning at diagnosis with cancer and continuing for the balance of life and views quality of life (QOL) as a key outcome. In this article, the authors describe the rationale, methodology, and sample characteristics of the 2 ACS Studies of Cancer Survivors (SCS): 1) a longitudinal study identifying and surveying survivors approximately 1 year postdiagnosis that includes plans to resurvey the panel at 2 years, 7 years, and 12 years postdiagnosis to identify predictors of QOL; and 2) a cross-sectional study of QOL among 3 separate cohorts of survivors who were approximately 3 years, 6 years, and 11 years postdiagnosis at the time of data collection. Survivors of prostate, breast, lung, colorectal, bladder, skin, kidney, ovarian, and uterine cancers and of non-Hodgkin lymphoma were sampled from 25 different central cancer registries, with African-American and Hispanic survivors over sampled. Survivors completed either mail or telephone surveys that described their physical, psychological, social, and spiritual functioning. The overall recruitment rate was 34.0%; 15411 participants completed surveys, of whom 40.1% had a high school education or less and 19.4% were racial/ethnic minorities. The SCS surveys provide a large diagnostically, geographically, and demographically diverse database on cancer survivorship that was designed to overcome some of the limitations of past research. Future reports will compare QOL of survivors at different well-defined times postdiagnosis, investigate the issues of understudied populations and diagnostic groups, and describe survivor QOL at state levels. Insights valuable to those considering registry-based studies are offered on issues of ascertainment, sampling, and recruitment., ((c) 2006 American Cancer Society.)