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The field of radionuclide therapy (RNT) for prostate cancer (PC) is growing rapidly, with recent Food and Drug Administration approval of the first 177Lu-PSMA ligand. We aimed to develop the first patient-reported outcome (PRO) measure for PC patients receiving RNT. Methods: We identified relevant symptoms and toxicities by reviewing published trials and interviews with PC patients receiving RNT (n = 29), caregivers (n = 14), and clinicians (n = 11). Second, we selected items for measure inclusion. Third, we refined the item list with input from experts in RNTs and PROs. Fourth, we finalized the Functional Assessment of Cancer Therapy-Radionuclide Therapy (FACT-RNT) with patient input. Results: This multistep process yielded a brief 15-item measure deemed by key stakeholders to be relevant and useful in the context of RNT for PC. Conclusion: The FACT-RNT is a new standardized tool to monitor relevant symptoms and toxicities among PC patients in RNT trials and real-world settings.

Cognitive-Behavioral Therapy for Insomnia (CBT-I) is the gold-standard treatment for insomnia, which is common among breast cancer survivors (BCS). This pilot randomized controlled trial tested the first CBT-I intervention for Spanish-speaking BCS delivered using eHealth. Participants (N = 30) were Spanish-speaking BCS with insomnia symptoms recruited in Puerto Rico and randomized to a 6-week eHealth CBT-I group intervention or a waitlist control. Primary outcomes were acceptability (recruitment, treatment satisfaction) and feasibility (retention, attendance). Secondary outcomes were group differences in sleep outcomes post-treatment (i.e., insomnia symptoms, sleep disturbance, sleep efficiency). Recruitment (95%) and retention (97%) were excellent. All CBT-I participants (100%) attended [greater than or equal to] 3 of 6 sessions. Satisfaction with CBT-I was acceptable. Post-intervention, there were medium to large group differences for average insomnia symptoms (d = 1.02), sleep disturbance (d = 1.25), and sleep efficiency (d = 0.77) favoring CBT-I. There were small/medium to medium/large group differences for the proportion of participants with clinically significant insomnia symptoms (d = 0.52), sleep disturbance (d = 0.67), and low sleep efficiency (d = 0.33) favoring CBT-I. Spanish-language eHealth CBT-I for BCS was acceptable and feasible and showed preliminary efficacy. ClinicalTrials.gov TRN: NCT04101526 (Posted September 24, 2019)., Author(s): Laura B. Oswald [sup.1] , Jennifer Morales-Cruz [sup.2] , Sarah L. Eisel [sup.1] , Jocelyn Del Rio [sup.1] , Aasha I. Hoogland [sup.1] , Vanessa Ortiz-Rosado [sup.2] , Grace [...]

Background: Social isolation and social connectedness are health determinants and aspects of social well‐being with strong associations with psychological distress. This study evaluated relationships among social isolation, social connectedness, and psychological distress (i.e., depression, anxiety) over 1 year in young adult (YA) cancer survivors 18–39 years old. Methods: Participants were YAs in a large cohort study that completed questionnaires every 2 months for 1 year. Social isolation, aspects of social connectedness (i.e., companionship, emotional support, instrumental support, and informational support), depression, and anxiety were assessed with Patient‐Reported Outcomes Measurement Information System short form measures. Mixed‐effect models were used to evaluate changes over time. Confirmatory factor analysis and multilevel structural equation modeling were used to define social connectedness as a latent construct and determine whether relationships between social isolation and psychological distress were mediated by social connectedness. Results: Participants (N = 304) were mean (M) = 33.5 years old (SD = 4.7) and M = 4.5 years (SD = 3.5) post‐initial cancer diagnosis. Most participants were female (67.4%) and non‐Hispanic White (68.4%). Average scores for social well‐being and psychological distress were within normative ranges and did not change (p values >.05). However, large proportions of participants reported at least mild social isolation (27%–30%), depressive symptoms (36%–37%), and symptoms of anxiety (49%–51%) at each time point. Across participants, more social isolation was related to less social connectedness (p values <.001), more depressive symptoms (p <.001), and more symptoms of anxiety (p <.001). Social connectedness mediated the relationship between social isolation and depression (p =.004), but not anxiety (p >.05). Conclusions: Social isolation and connectedness could be intervention targets for reducing depression among YA cancer survivors. Among young adult cancer survivors, social connectedness mediated the relationship between social isolation and depression, but not anxiety. Social isolation and connectedness could be intervention targets for reducing depression among young adult cancer survivors. [ABSTRACT FROM AUTHOR]

Purpose: To characterize dietary patterns and examine associations with cross-sectional and longitudinal changes in quality of life (QOL) over approximately one year after colorectal cancer (CRC) diagnosis. Methods: The ColoCare Study is an international, multi-center, prospective cohort study of newly diagnosed CRC survivors of any stage. A subset of participants with CRC in the United States completed patient-reported outcome measures at 6- and 12-months post-enrollment, including the Food Frequency Questionnaire (FFQ) and European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). Dietary patterns at 6 months (around the time of treatment completion) were identified using Principal Component Analysis (PCA) with varimax rotation. Adherence scores were calculated for participants within each dietary pattern, with higher scores indicating higher adherence. Mixed models were used to examine the effect of each dietary pattern on changes in QOL at 6- and 12-month follow-ups, controlling for cancer stage, biological sex, body mass index (BMI), smoking status, and age. Results: Participants (N = 174) were, on average, 56 ± 14 years old and were mostly female (51.5%), stage III or IV (51.7%), never smokers (60.2%), non-Hispanic (97.1%), and White (83.3%) with a BMI of 27.9 ± 6.1 kg/m2. PCA revealed two emerging dietary patterns: "Western diet", characterized by processed meats, refined grains, and sugars, and "Prudent diet" characterized by lean proteins, fruits, and vegetables. Higher adherence to a Western diet was associated with worse social functioning at 6-month follow-up (FE = −12.6, p = 0.010). Loss of appetite from 6 to 12 months was associated with higher adherence to both the Western and Prudent dietary patterns (FE = 1.5, p = 0.044; FE = 1.3, p = 0.046, respectively). Neither dietary pattern was associated with global QOL score at 6- or 12-month follow-up (p's > 0.05). Conclusions: Among CRC survivors in the United States, the Western diet was concurrently associated with worse social functioning. Loss of appetite was reported by CRC survivors following both dietary patterns, suggesting that loss of appetite may be a global experience for CRC survivors during this timeframe. Further research is needed to understand specific social challenges experienced by CRC survivors and develop supportive care interventions to address appetite and nutritional concerns. [ABSTRACT FROM AUTHOR]

Simple Summary: About half of young adults (YAs) who have had cancer experience changes in their ability to think, concentrate, and remember; however, these cognitive changes are subtle, difficult to measure, and often dismissed as attributable to anxiety or depression. We suspect that cognitive and mental health changes during and after cancer treatment may be linked by underlying physical and psychological changes. We interviewed 20 YA cancer survivors about their experiences with cognitive and mental health changes during and after cancer treatment. Participants described feeling depression after diagnosis; feeling anxious during treatment, interfering with their ability to think; experiencing cognitive and mental health challenges that exacerbated one another; and feeling frustrated and self-critical about having continued difficulties with cognitive function after treatment. Because YA cancer survivors describe cognitive and mental health as being closely linked, there is potential for psychological interventions to improve both symptoms. Background/Objectives: Cancer-related cognitive impairment (CRCI) is common and distressing for young adult (YA) cancer survivors; however, subjective CRCI is often attributed to psychological distress rather than true cognitive change. Thus, we aimed to generate hypotheses regarding potential common biobehavioral mechanisms of CRCI and psychological distress. Methods: We conducted semi-structured interviews with YA cancer survivors in peak years for frontal neurocognitive development (ages 18–30), and we asked them to describe their experiences with cognitive and mental health changes during and after treatment for their cancer. An applied thematic analysis was used to identify themes. Results: The participants were 20 YA cancer survivors who were, on average, 23 years old at diagnosis and 26 years old when interviewed. Five themes emerged regarding the connection between cognitive and mental health: depressed mood after diagnosis that decreased mental engagement, cancer-related anxiety consumed cognitive resources during treatment, a bidirectional "downward spiral" during treatment, frustration with forgetfulness, and self-criticism about long-term cognitive limitations. Additionally, participants described receiving minimal information about evidence-based strategies for managing CRCI. Conclusions: Future research is needed to examine common neurological mechanisms among symptoms of depression, anxiety, and CRCI and to address gaps in survivorship care for YA survivors with CRCI. Cognitive–behavioral interventions may address both cognitive and mental health. [ABSTRACT FROM AUTHOR]

Breast cancer is the most common cancer among Latina women, and Latina women are at higher risk for breast cancer mortality than white women. Lifestyle factors, such as consuming a nutritious diet and engaging in regular physical activity, promote health and are protective against heart disease, type 2 diabetes, and breast cancer recurrence. Previous studies have developed and tested interventions for Latina breast cancer survivors to improve diet and increase physical activity, however, no studies to date have developed a smartphone delivered intervention. The purpose of the current study was to compare two Smartphone delivered interventions, My Health, which focused on diet and physical activity, and My Guide, which focused on psychosocial functioning, on dietary and physical activity outcomes, post-intervention, and at a 2-week follow-up assessment. Overall, participants receiving the My Health intervention reported a greater reduction in daily fat sources than the My Guide group over time. However, daily sources of fat did not differ between conditions. Walking, measured by estimated weekly metabolic equivalents, increased across time points in both groups. These preliminary findings suggest that eHealth interventions aimed at improving lifestyle factors may favorably impact nutritional intake and physical activity. Future research should utilize more comprehensive and objective measures of diet and physical activity, and incorporate more behavioral lifestyle components into the intervention in larger samples with a longer follow-up period., Author(s): Joanna Buscemi [sup.1] [sup.2] , Laura B. Oswald [sup.3] [sup.4] , Sharon H. Baik [sup.3] , Diana Buitrago [sup.3] , Francisco Iacobelli [sup.5] , Siobhan M. Phillips [sup.6] , [...]

Simple Summary: Young adults (YAs) aged 18–39 living with advanced cancer face unique and complex challenges, but tailored behavioral interventions remain scarce. This commentary identifies unmet psychosocial needs and offers recommendations for targeted interventions to help improve overall quality of care for the often-marginalized group of YAs living with advanced cancer. The population of young adults (YAs) aged 18–39 living with advanced cancer is growing and faces a compounded set of challenges at the intersection of age and disease. Despite these substantial challenges, behavioral interventions tailored to YAs living with advanced cancer remain scarce. This commentary aims to (1) discuss the unmet psychological, social, and behavioral needs of YAs living with advanced cancer; (2) highlight the paucity of behavioral interventions tailored to this growing population; (3) offer recommendations for the development of behavioral interventions targeting the unique needs of YAs living with advanced cancer; and (4) describe potential far-reaching public health benefits of these targeted behavioral interventions. [ABSTRACT FROM AUTHOR]

BackgroundLatina breast cancer survivors experience poorer health-related quality of life (HRQoL), greater symptom burden, and more psychosocial needs compared to non-Latina breast cancer survivors. eHealth platforms such as smartphone apps are increasingly being used to deliver psychosocial interventions to cancer survivors. However, few psychosocial eHealth interventions have been developed specifically for Latina breast cancer survivors. Further, little is known about how Latinas, in general, engage with eHealth interventions and whether specific participant characteristics are associated with app use in this population. We evaluated the use of 2 culturally informed, evidence-based smartphone apps for Latina breast cancer survivors—one that was designed to improve HRQoL and reduce symptom burden (My Guide) and the other to promote healthy lifestyle behaviors (My Health). ObjectiveThe objectives of our study were to explore the patterns of use of the My Guide intervention app and My Health attention-control app among Latina breast cancer survivors. MethodsEighty Latina breast cancer survivors were randomized to use the My Guide or My Health app for 6 weeks. Assessments were collected at baseline (T1), immediately after the 6-week intervention (T2), and 2 weeks after T2 (T3). Specific study outcomes included subdomains of HRQoL, symptom burden, cancer-specific distress, cancer-relevant self-efficacy, and breast cancer knowledge. ResultsOn average, participants used their assigned app for more than 1 hour per week. Sociodemographic or psychological characteristics were not significantly associated with app use, except for employment status in the My Health group. Content related to common physical and emotional symptoms of breast cancer survivors as well as recommendations for nutrition and physical activity were most frequently accessed by My Guide and My Health participants, respectively. Lastly, clinically meaningful improvements were demonstrated in breast cancer well-being among low app users (ie,

Background Risk factors for cancer-related fatigue are understudied in colorectal cancer. Purpose This study aimed to address this critical gap in the literature by (a) describing changes in colorectal cancer-related fatigue and health behavior (physical activity, sleep problems) and (b) examining if physical activity and sleep problems predict fatigue trajectories from baseline (approximately at the time of diagnosis), to 6- and 12 months after enrollment. Methods Patients participating in the international ColoCare Study completed self-report measures at baseline (approximately time of diagnosis), 6-, and 12 months assessing physical activity using the International Physical Activity Questionnaire (IPAQ) and fatigue and sleep using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-C30). Mixed-effect models examined changes in physical activity, sleep problems, and fatigue. Cross-lagged panel models examined bidirectional relationships between physical activity or sleep and fatigue across time. Results Colorectal cancer patients (n = 649) had a mean age of 61 ± 13 years. Most were male (59%), non-Hispanic White (91%), diagnosed with Stages III–IV (56%) colon cancer (58%), and treated with surgery (98%). Within-person cross-lagged models indicated higher physical activity at Month 6 was associated with higher fatigue at Month 12 (β = 0.26, p =.016). When stratified by cancer stage (I–II vs. III–IV), the relationship between physical activity at Month 6 and fatigue at Month 12 existed only for patients with advanced cancer (Stages III and IV, β = 0.43, p =.035). Cross-lagged associations for sleep and fatigue from baseline to Month 6 were only observed in patients with Stages III or IV cancer, however, there was a clear cross-sectional association between sleep problems and fatigue at baseline and Month 6. Conclusions Within-person and cross-lagged association models suggest fatiguability may become increasingly problematic for patients with advanced colorectal cancer the first year after diagnosis. In addition, sleep problems were consistently associated with higher fatigue in the first year, regardless of cancer stage. Trial registration The international ColoCare Study was registered on clinicaltrials.gov, NCT02328677, in December 2014. [ABSTRACT FROM AUTHOR]