Self-reported memory problems in adult-onset cancer survivors: effects of cardiovascular disease and insomnia.

Background: Cancer and its treatments can deleteriously affect memory. Cardiac function and insomnia can exacerbate memory problems.

Objective: To examine the relationships among cardiovascular disease, insomnia, and self-reported memory problems (SRMP) in adult-onset cancer survivors.

Neuropsychological care and rehabilitation of cancer patients with chemobrain: strategies for evaluation and intervention development.

Malignant tumors and their various treatments such as chemotherapy, radiotherapy and hormonal therapy can deleteriously affect a large number of cancer patients and survivors on multiple dimensions of psychosocial and neurocognitive functioning. Oncology researchers and clinicians are increasingly cognizant of the negative effects of cancer and its treatments on the brain and its mental processes and cognitive outcomes. Nevertheless, effective interventions to treat cancer and treatment-related neurocognitive dysfunction (CRND), also known as chemobrain, are still lacking.

The role of behavioral and psychosocial science in reducing cancer morbidity and mortality.

Behavioral and psychosocial science has the potential to contribute much to the overall effort to reduce cancer morbidity and mortality and to improve the quality of life for cancer patients and their families. However, for a variety of reasons, including a lack of sustained funding for research and training and a lack of confidence by some in the potential payoff for investments in the area, this potential has not only not been realized but also not been adequately explored. A special subcommittee of "The March" Research Task Force studied research in this area and issued a report making several recommendations for future funding for psychosocial and behavioral research in cancer.

Progress in reducing anticipatory nausea and vomiting: a study of community practice.

Chemotherapy-related nausea and vomiting (NV) in 300 consecutive patients treated in community practices prior to the availability of 5-HT3 antiemetics (9/87 to 1/91) were compared with NV in a second sample of 300 patients treated after their commercial introduction (9/93 to 2/95). Eighty-six percent of the later patients received 5-HT3 antiemetics, and significantly fewer (43.3%) reported one or more episodes of posttreatment vomiting during their first four cycles of chemotherapy compared with those in the previous sample (55.

Energy level and sleep quality following bone marrow transplantation.

While problems with sleep and energy level (ie fatigue) are commonly reported during recovery from bone marrow transplantation (BMT), little in-depth information regarding these two problem areas in BMT patients is available. Using both questionnaire and telephone interview methods, information regarding current sleep and energy level problems was obtained from 172 adult BMT survivors drawn from five different BMT treatment centers. Respondents were a mean of 43.

Frequency and clinical implications of delayed nausea and delayed emesis.

Studies of the adverse effects of cancer chemotherapy often do not distinguish between delayed and persistent nausea and emesis. Although persistent nausea is simply acute nausea that continues beyond the treatment day, postchemotherapy delayed nausea and delayed vomiting first develop after an initial 24 h free of these symptoms. To access its occurrence in clinical practice, we conducted a structured examination of chemotherapy-induced delayed nausea and emesis in consecutive chemotherapy patients unselected for diagnosis, chemotherapy, or antiemetic usage.

Quality of life following bone marrow transplantation: findings from a multicentre study.

Questionnaires assessing a range of quality of life (QOL) outcomes were completed by 200 adult bone marrow transplant (BMT) recipients from five BMT treatment centres. Respondents had undergone allogeneic (46%) or autologous BMT (54%) for a haematological malignancy and were disease free and at least 12 months post BMT (mean 43 months). Variability in post-BMT QOL was reported with deficits in physical, sexual and occupational functioning particularly likely.

'Returning to normal' following bone marrow transplantation: outcomes, expectations and informed consent.

The psychosocial impact of bone marrow transplantation (BMT) was investigated in 172 disease-free adult BMT survivors drawn from five different BMT treatment centers. Respondents were a mean of 43.5 months after BMT.

Behavioral aspects of clinical trials. An integrated framework from behavior theory.

A less-than-optimal proportion of patients with cancer are entered into National Cancer Institute-sponsored clinical trials. This article reviews the literature on accrual in oncology clinical trials to characterize the extent of the problem, identify reasons for low accrual, and suggest ways to promote accrual. Four well known theories of health behavior (the Health Belief Model, Subjective Expected Utility Theory, Protection Motivation Theory, and the Theory of Reasoned Action) point to central concepts involved in understanding patient health-related behavior: (1) the probability that an unwelcomed health event will happen to a patient, (2) the severity of that event if it does occur, (3) the effectiveness of a particular behavior (such as taking part in a clinical trial) to modify the severity, and (4) the cost of adopting that behavior.

Symptom control in psychosocial oncology.

A major thrust in psychosocial oncology has been to use psychosocial and behavioral techniques to prevent and manage the adverse symptoms associated with cancer and its treatment. This article defines the field of symptom management in psychosocial oncology and reviews its early and recent history. Recent progress in the field is reviewed, with a focus on several thematic advances in theory and practice.

Cognitive distraction and relaxation training for the control of side effects due to cancer chemotherapy.

Sixty cancer chemotherapy patients were randomly assigned to one of six conditions formed by a 3(cognitive distraction, relaxation training, no intervention) x 2(high anxiety, low anxiety) factorial design. All patients were followed for five consecutive chemotherapy sessions. Outcome measures included patient reports, nurse observations, and physiological indices.

Psychological techniques for controlling the adverse side effects of cancer chemotherapy: findings from a decade of research.

Cancer patients receiving chemotherapeutic treatments often experience unpleasant side effects that compromise the quality of their life and may be so severe that they lead to suboptimal drug dosages, missed treatments, or even discontinuation of treatment. In recent years it has been discovered that some of these side effects result from maladaptive learning. This article reviews over 10 years of research conducted at Vanderbilt University on the prevention and treatment of these psychological side effects.

Effectiveness of biofeedback and relaxation training in reducing the side effects of cancer chemotherapy.

Assessed the effectiveness of electromyographic (EMG) and skin-temperature (ST) biofeedback and relaxation training (RT) in reducing the aversiveness of cancer chemotherapy. Eighty-one cancer patients, equated on several individual-difference variables, were randomized to one of six groups formed by a 3 (EMG Biofeedback, ST Biofeedback, No Biofeedback) x 2 (RT, No RT) factorial design. Outcome was assessed with physiological, patient-reported, and nurse-reported indices taken over five consecutive chemotherapy treatments.

Preparing patients for cancer chemotherapy: effect of coping preparation and relaxation interventions.

Sixty cancer chemotherapy patients were randomly assigned to one of four treatments: (a) relaxation training with guided relaxation imagery (RT), (b) general coping preparation package (PREP), (c) both RT and PREP, or (d) routine clinic treatment only. All patients were assessed on self-report, nurse observation, family observation, and physiological measures and were followed for five sequential chemotherapy treatments. Results indicate that the PREP intervention increased patients' knowledge of the disease and its treatment, reduced anticipatory side effects, reduced negative affect, and improved general coping.

Behavioral and psychosocial cancer research. Building on the past, preparing for the future.

This report identifies five general conclusions that emerged from the Second Workshop on Methodology in Behavioral and Psychosocial Cancer Research. These conclusions address diverse topics, including a focus on areas other than methodology; an emphasis on the transfer of technology and knowledge to applied settings; a recognition of the role of basic behavioral research in answering clinical questions; the need to recognize and strengthen ties between the field of behavioral and psychosocial oncology and the basic behavioral and social science fields from which it emerged; and the importance of additional research on minorities and other special populations. It is suggested that meeting the challenges posed in each of these five areas is critical to continued progress in the field.

Progress in psychosocial and behavioral cancer research. The need for enabling strategies.

A major component of the Second Workshop on Methodology in Behavioral and Psychosocial Cancer Research was a discussion of enabling strategies, that is, strategies by which future goals and needs in the area of psychosocial and behavioral oncology might be accomplished. This report describes and comments on the discussion that took place at a special plenary session at which representatives from four funding agencies, the American Cancer Society, National Cancer Institute, National Institute of Mental Health, and National Science Foundation, presented their views and their agencies' programs for promoting research in psychosocial and behavioral oncology. It is concluded that much progress has been made in the field and that strategies are in place for ensuring continued progress.

Physiologic and psychobehavioral research in oncology.

A major thrust in research in psychosocial oncology is the study of the interaction of psychologic and physiologic variables. This discussion reviews the current status and future directions of such research. Areas addressed include pain, nausea and vomiting with chemotherapy, sexuality, effects of cancer on psychologic and neuropsychologic function, impact of psychologic factors on cancer and its treatment, and psychoneuroimmunology.

Cognitive dysfunction in adult survivors of allogeneic marrow transplantation: relationship to dose of total body irradiation.

Bone marrow transplant (BMT) patients are exposed to several potential sources of neurologic damage including the neurotoxicity of pre-BMT preparative regimens. The latter generally include a combination of total body irradiation (TBI) and high-dose chemotherapy. Cognitive functioning in 30 adult allogeneic BMT patients (mean of 47 months post-BMT) treated for either acute or chronic leukemia was assessed by two standardized self-report questionnaires.

Psychogenic factors in predicting survival of breast cancer patients.

Considerable controversy and contradictory data exist about the notion that psychosocial factors can predict longevity in cancer patients. This study further addresses that issue by eliminating some of the methodological weaknesses of prior studies and focusing on a more tightly defined patient population. Forty-nine female metastatic breast cancer patients were given a variety of psychological tests.