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Purpose: National mandates require cancer centers provide comprehensive survivorship care. We created an 8-session, group intervention, the Survivorship Wellness Group Program (SWGP), that covered 8 topics: nutrition, physical activity, stress, sleep/fatigue, sexuality/body image, emotional wellbeing/fear of cancer recurrence, spirituality/meaning, and health promotion/goal setting. This study examined the acceptability and preliminary outcomes of SWGP., Methods: We evaluated SWGP using questionnaire data collected at program entry and 15-week follow-up. Questionnaires assessed acceptability and impact on anxiety, depression, quality of life, and perceived knowledge of topics. Enrollees who consented to participate in research and completed the baseline and 15-week follow-up were included in the analysis (N = 53). We assessed acceptability and preliminary outcomes using paired-samples t-tests. Due to the COVID-19 pandemic, SWGP transitioned to telehealth partway through data collection. Post-hoc analyses compared outcomes by intervention delivery., Results: Participants completed an average of 7.44/8 classes. Participants reported a mean response of 3.42/4 regarding overall program satisfaction and 90.6% reported being "very likely" to recommend SWGP. SWGP was associated with decreases in anxiety and depression; increases in physical, emotional, functional, and overall quality of life; and increases in knowledge of all health behavior domains. No outcomes differed significantly between delivery in person versus telehealth., Conclusions: SWGP offers an acceptable and replicable model for cancer centers to meet national survivorship care guidelines., Implication for Cancer Survivors: SWGP provides a comprehensive service for cancer survivors post-treatment, and was associated with better quality of life, fewer mental health symptoms, and increased knowledge in multiple domains of wellness., (© 2023. The Author(s).)

Background: Women diagnosed with colorectal cancer (CRC) or anal squamous cell carcinoma (ASCC) are at high risk of sexual dysfunction after treatment, yet little is known about recovery and risk factors for chronic dysfunction., Aim: We aimed to describe sexual function and sexual activity among women who underwent definitive treatment for CRC or ASCC, examine relationships between time since treatment completion and sexual function, and explore factors associated with desire and changes in sexual desire over time., Methods: As part of a prospective cohort study of patients with gastrointestinal cancer at the University of California San Francisco, female-identifying participants who finished definitive treatment for CRC or ASCC completed the Female Sexual Function Index (FSFI) at 6- to 12-month intervals. We used multivariable linear mixed models to explore factors associated with the FSFI desire subscale., Outcomes: Outcomes were rates of sexual activity, proportion at risk for sexual dysfunction (FSFI score <26.55), total FSFI score, and FSFI desire subscale., Results: Among the 97 cancer survivors who completed at least 1 FSFI, the median age was 59 years, the median time since treatment end was 14 months, and 87% were menopausal. Fifty-five women (57%) had a history of colon cancer; 21 (22%), rectal cancer; and 21 (22%), ASCC. An additional 13 (13%) had a current ostomy. Approximately half the women were sexually active (n = 48, 49%). Among these 48 sexually active women, 34 (71%) had FSFI scores indicating risk for sexual dysfunction. Among the 10 sexually active women who completed a FSFI ≥2 years since end of treatment, the median total score was 22.6 (IQR, 15.6-27.3). None of the evaluated characteristics were associated with desire (age, tumor site, treatment, menopause status, or ostomy status)., Clinical Implications: Consistent with prior studies, we found low desire scores after treatment for CRC or ASCC, with little recovery over time, suggesting that patients should not expect an eventual rebound of sexual function., Strengths and Limitations: Strengths of our study include longitudinal data and use of the validated FSFI. Women with ASCC composed 22% of our cohort, allowing for insight into this rare disease group. Limitations of this study include the small sample size, particularly for longitudinal analyses, and the enrollment of patients at variable times since treatment end., Conclusion: We observed a high prevalence of sexual health concerns, including low desire, after the treatment of CRC and ASCC that persisted for years after treatment was completed., (© The Author(s) 2023. Published by Oxford University Press on behalf of The International Society of Sexual Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: In contrast to the large literature on patients' coping with an initial diagnosis of cancer, there have been few quantitative or qualitative studies of patients coping with recurrence. A qualitative study was undertaken to aid in the development of a tailored intervention for these patients., Methods: Individuals (N=35) receiving follow-up care for recurrent breast or gynecologic cancer at a university-affiliated cancer center participated in an individual or a group interview. Transcripts of interviews were analyzed using a coding format with two areas of emphasis. First, we focused on patients' emotions, as there is specificity between emotions and the corresponding ways in which individuals choose to manage them. Secondly, we considered the patients' social environments and relationships, as they too appear key in the adjustment to, and survival from, cancer., Results: Patients identified notable differences in their responses to an initial diagnosis of cancer and their current ones to recurrence, including the following: (i) depressive symptoms being problematic; (ii) with the passing years and the women's own aging, there is shrinkage in the size of social networks; and (iii) additional losses come from social support erosion, arising from a) intentional distancing by social contacts, b) friends and family not understanding that cancer recurrence is a chronic illness, and/or c) patients stemming their support requests across time., Conclusion: The contribution of these findings to the selection of intervention strategies is discussed., (Copyright © 2013 John Wiley & Sons, Ltd.)

Objectives: Sexual morbidity is a distressing and undertreated problem in gynecological cancer survivorship known to occur early and persist well beyond the period of physical recovery. Although often studied as a separate domain, sexuality represents an integral component of psychological adjustment and quality of life (QoL) that is adversely affected by cancer treatments. The present study tests the association between sexual morbidity, and adverse psychological adjustment and QoL outcomes., Methods: A cross-sectional design was used. The participants were gynecological (cervical, endometrial, ovarian, and vulvar) cancer survivors who were partnered (N = 186), whose cancer was diagnosed 2 to 10 years previously, and who were at least 6 months post any cancer therapy. Most had been found to have early-stage disease (70%) and were treated with hysterectomy (77%), chemotherapy (43%), and/or radiotherapy (23%). Sexual morbidity was operationalized as a multidimensional construct including sexual behavior, sexual functioning, and subjective sexual satisfaction, assessed by patient self-report. Outcomes included self-reported depressive symptoms, traumatic stress symptoms, cancer-specific stress, stress about body changes, and QoL. Nurse-rated of performance status and disruptive signs/symptoms of treatment toxicity, as well as relevant sociodemographic and disease variables were collected as potential controls., Results: Hierarchical multiple regression analyses tested sexual morbidity as a predictor of poor outcomes. All statistical models were significant, accounting for 12% to 53% of the variance in psychological adjustment/QoL. Sexual morbidity covaried with worsened depressive symptoms, body change stress, and psychological QoL beyond the negative contributions of (older) age, (poorer) performance status, and (greater) fatigue. Notably, disease and treatment variables were not statistically significant correlates of psychological adjustment or QoL., Conclusions: These findings suggest that prevention or treatment of sexual morbidity might foster improved psychological adjustment/QoL. Given the high rates of sexual morbidity in this population and the connection between sexuality and broader psychological adjustment/QoL, there is a clear need for better integration of sexuality rehabilitation into routine clinical care.

Eighty-five patients were surgically treated for postmastectomy edema of the upper extremity. In 20 of them, phlebolysis of the subclavian vein was performed. It was established that the vein was most often compressed by a long stump of the small pectoral muscle. Surgery and subsequent radiation treatment create unfavorable conditions for the muscle leading to its morphologic restructuring. Classic mastectomy after Halsted-Meier is recommended.

Based on examinations and treatment of 210 patients with postmastectomy edema of the extremity (with operations made on 75 of them) the authors have developed a clinico-surgical classification of the postmastectomy edema with special reference to the character of morphologic alterations of soft tissues which determinates tactics of treatment and choice of surgical methods (LVA, phlebolysis of the subclavian vein, RRO or their combination in different succession). Phlebographic and tonometric examinations are shown to be necessary, their findings being compared for the establishment of indications for phlebolysis for stenosis of the vein resulting from X-ray therapy and long stump of the musculus pectoralis minor in radical mastectomy after Holsted.

Changes in lymphocyte and monocyte counts in peripheral blood of patients who had undergone combined treatment for malignant cutaneous melanoma of low extremities were evaluated. The posttreatment counts were compared with those for mononuclear cell infiltration of tumor stroma. Mononuclear cell levels in blood and in tumor stroma versus patients' survival time were analysed. A moderate correlation between lymphocyte and monocyte (macrophage) levels in tumor stroma, on the one hand, and survival time, on the other, was established.

Reconstructive microsurgery carried out in 25 cases of postmastectomy edema of the upper extremity proved to be the most effective and safest in treatment of the said complication. The procedure should be supplemented with phlebolysis of the subclavicular vein (when occlusion of the latter exceeds 50%) or with resection of dermatofascial flap of the brachial area (fibrous stage of lymphostasis). Sequence of stages and the results of the surgical treatment are discussed.

In the paper, the data on the immediate and late results of skin tranplantation in the complex treatment of limb melanoblastomas are reported. The latter consisted in a one-moment massive regional chemotherapy by perfusion of the extremity (iliac, femoral, brachial) with antitumor drugs, against which background melanoblastoma was excised electrosurgically, and lymphadenectomy was performed. The defect of the limb tissues, which was located on the foot or leg in 61 cases, was replaced by a free skin graft. The results of the plastic repair were followed up within the terms from 1 to 10 years.

Results of the surgical treatment of 172 patients with tumors of the proximal part of the stomach and colon are analyzed. The patients were divided into 2 groups according to the method of forming the esophago-intestinal and colono-intestinal anastomoses. Suture incompetence and peritonitis were shown to appear much more rarely after using a microsurgical technique than after using surgical methods.

The analysis of the results of 74 experiments involving large bowel resection for intestinal obstruction in rabbits demonstrated advantages offered by microsurgical procedures intended to form large bowel anastomosis. The results were used in clinical practice. The immediate results of surgery, postoperative complications and lethality were evaluated in 133 cases of large bowel cancer (anastomosis formed by microtechnique-67; by standard procedures-66). In group I, heart-lung complications resulted in one death (lethality-1.5%); group II--in 18, 13 of them being caused by anastomotic leakage and peritonitis development (lethality-27.3%). It was clinically confirmed that precision formation of large bowel anastomosis by microsurgery prevents suture failure--the main factor of postoperative lethality.

The clinical picture and long-term results of the treatment of 123 patients with melanoblastoma of the limbs have been studied. 39 patients were subjected only to the surgical treatment, 84 patients with a developed tumor process were subjected to the combined treatment -- surgery with perfusional chemotherapy. 3 years survival has proved to be similar in both groups; (70.0% and 72.9%); 5 years survival has been 10% higher in the group subjected to the combined treatment (54.5% and 64.0%).

Femoral regional perfusions and continuous intraarterial infusions were used for the treatment of 84 patients. The 0,15-0,25% solution of H2O2 was used as the oxygenator. The methods used when combined with sympathectomy allowed to restrict the operation by a parcimonious amputation of the extremity and to retain the knee joint in most of the patients.

Under examination were 3--5--10 year results of ilioinguinal lymphadenectomy in 83 patients with skin melanoblastoma of the lower extremity. It is found that the status of inguinal and especially iliac lymphnodes is of primary importance for patients' survival. The latter were metastases involved in 24 cases (28.9%). Metastases may also develop in intact inguinal lymphnodes (in 4 cases). A 3-year survival, if one group of regional lymphnodes is involved (inguinal or iliac), is 20% lower than in the intact noes. With both groups of the nodes involved it is 4 times lower. A 5--10 year survival with involved inguinal nodes is 2 twice as low as with intact nodes. In iliac lymphnodes metastases there was no 5-year survival. Most poor results were noted in melanoblastoma located on the foot.

Patients with stage III and IV cancers of different sites revealed a 47-76% increase in serum total antitrypsinic activity. A mean 40% increase was observed in cases of inflammatory pathology. Both study groups demonstrated raised alpha 1-antitrypsin levels, while that of alpha 2-macroglobulin did not show any significant changes. The level of alpha 1-antitrypsin accounted for 89 and 83% of total antitrypsinic activity in cases of inflammation and controls, respectively, while in cancer patients this index was significantly lower (70%). The diagnostic value of total antitrypsinic activity appeared to be higher than that of alpha 1-antitrypsin level determination. It is inferred that, apart from alpha 1-antitrypsin, malignant growth is associated with raised levels of more specific endogenous proteinase inhibitors, except alpha 2-macroglobulin.