Perspectives from patients with chronic lung disease on a telehealth-facilitated integrated palliative care model: a qualitative content analysis study.

Background: Chronic lung disease affects nearly 37 million Americans and often results in significant quality of life impairment and healthcare burden. Despite guidelines calling for palliative care (PC) integration into pulmonary care as a vital part of chronic lung disease management, existing PC models have limited access and lack scalability. Use of telehealth to provide PC offers a potential solution to these barriers.

Survivorship Care Challenges: Navigating Changing Concerns.

Advanced practitioners are often in charge of planning and implementing care for cancer survivors, as noted by Carrie Tompkins Stricker, PhD, RN, ANP-BC, during JADPRO Live Virtual 2021. During a session at the conference, Dr. Stricker reviewed quality measures, best practices, and exciting innovations to draw on to improve survivorship care delivery.

Shared Decision-Making in Managing Breakthrough Cancer Pain in Patients With Advanced Cancer.

Background: Pain is a significant problem in patients with cancer. Breakthrough cancer pain contributes to the pain experience, but it is often underassessed and underrecognized. Shared decision-making (SDM), where patient preferences, goals, and concerns are discussed and integrated into a shared decision, can potentially foster earlier identification of pain, including breakthrough cancer pain, and improve pain management.

Integrating Touchscreen-Based Geriatric Assessment and Frailty Screening for Adults With Multiple Myeloma to Drive Personalized Treatment Decisions.

Purpose: Geriatric assessment (GA) results predict toxicity/survival in older adults, yet GA is not routinely used in care for patients with multiple myeloma (MM). We tested a tablet-based modified GA (mGA) providing real-time results to clinicians.

Methods: One hundred sixty-five patients with MM aged ≥ 65 years facing a treatment decision from 4 sites completed a tablet-based mGA with Katz Activities of Daily Living (ADL), Lawton Instrumental ADL, Charlson Comorbidity Index, and variables from the Cancer and Aging Research Group's Chemotherapy Toxicity Calculator.

Evaluating the Impact of Treatment Care Planning on Quality Measures.

Purpose: The Center for Medicare & Medicaid Innovation Oncology Care Model (OCM) requires documentation of a 13-point Institute of Medicine care management plan for Medicare patients. In addition, OCM includes evaluation of quality using key performance measures that align with the ASCO Quality Oncology Practice Initiative (QOPI). Both efforts are designed to improve patient-centered care and foster patients' engagement in their care plan.

The use of a patient-reported outcome questionnaire to assess cancer survivorship concerns and psychosocial outcomes among recent survivors.

Purpose: Survivor distress is well represented in the literature, but less is known about survivors' concerns and how these relate to adaptation. Using a newly designed Survivorship Concern Scale, we examined concerns and their relationship to psychosocial adaptation among recent breast cancer (BC) survivors.

Methods: One hundred forty-three stage 0-III BC survivors completed an online assessment including the Survivorship Concern Scale (0-3 scale; alpha = 0.

Teams and teamwork during a cancer diagnosis: interdependency within and between teams.

This article discusses the care process among three groups (primary care, radiology, and surgery) aiding a 57-year-old woman during her screening mammography and diagnosis of breast cancer. This is the first in a series of articles exploring principles and topics relevant to teams guiding clinicians involved in cancer care. The challenges demonstrated in this case illustrate how clinicians work within and between groups to deliver this first phase of cancer care.

Outcomes and satisfaction after delivery of a breast cancer survivorship care plan: results of a multicenter trial.

Purpose: Survivorship care plans (SCPs) have been suggested to reduce fragmentation of care experienced by cancer survivors. Acceptance of SCPs is high, but trials in the United States are few. This pilot study used a quasiexperimental design to examine the outcomes achieved by breast cancer survivors receiving a standardized SCP visit at one of seven comprehensive cancer centers.

Implementing the commission on cancer standards for survivorship care plans.

The number of adult cancer survivors in the United States has exceeded 13 million and continues to rise, yet care for these survivors continues to be poorly coordinated and their needs remain inadequately addressed. As one solution to this growing problem, the Institute of Medicine in 2006 recommended the delivery of a survivorship care plan (SCP) to each patient completing active treatment. The American College of Surgeons Commission on Cancer subsequently published its Program Standard 3.

Navigating the seasons of survivorship in community oncology.

Nurses have an important role in the development, implementation, and evaluation of cancer survivorship programs. Growing numbers of cancer survivors challenge community oncology practices to incorporate survivorship care according to new standards and guidelines. In response, one community-based oncology clinic created an advanced practice nurse (APN)-led survivorship program using the concept of Seasons of Survival as a guide.

Metrics to evaluate treatment summaries and survivorship care plans: a scorecard.

Purpose: The Institute of Medicine (IOM) and Commission on Cancer have called for provision of treatment summaries (TSs) and survivorship care plans (SCPs) at the end of primary cancer therapy and endorsed guidelines for content. Institutions are providing TS/SCPs but with little guidance concerning concordance with IOM recommended content. This manuscript presents a recently developed tool to allow rating of breast cancer-specific TS/SCPs as a model for assessing concordance with IOM recommendations and facilitating research and clinical fidelity.

A randomised trial of electro-acupuncture for arthralgia related to aromatase inhibitor use.

Background: Arthralgia is a common and debilitating side-effect experienced by breast cancer patients receiving aromatase inhibitors (AIs) and often results in premature drug discontinuation.

Methods: We conducted a randomised controlled trial of electro-acupuncture (EA) as compared to waitlist control (WLC) and sham acupuncture (SA) in postmenopausal women with breast cancer who self-reported arthralgia attributable to AIs. Acupuncturists performed 10 EA/SA treatments over 8 weeks using a manualised protocol with 2 Hz electro-stimulation delivered by a TENS unit.

Joint pain severity predicts premature discontinuation of aromatase inhibitors in breast cancer survivors.

Background: Premature discontinuation of aromatase inhibitors (AIs) in breast cancer survivors compromises treatment outcomes. We aimed to evaluate whether patient-reported joint pain predicts premature discontinuation of AIs.

Methods: We conducted a retrospective cohort study of postmenopausal women with breast cancer on AIs who had completed a survey about their symptom experience on AIs with specific measurements of joint pain.

Integrating a prospective surveillance model for rehabilitation into breast cancer survivorship care.

At some point during or after treatment, breast cancer may be considered a chronic illness, presenting many choices for managing the disease, its adverse treatment-related effects, other medical comorbidities as well as the biobehavioral burden of having a life-threatening disease, even for individuals with potentially curable breast cancer. Health care models, such as the chronic care model, the medical home, and the shared care model, provide a context for building survivorship health care models. Goals and characteristics of recently proposed shared care models for cancer survivorship health care delivery closely align with the goals and concepts of the prospective surveillance model (PSM) proposed elsewhere in this supplement to the journal Cancer.

Survivorship care planning after the institute of medicine recommendations: how are we faring?

Introduction: This study evaluates the concordance of treatment summaries (TSs) and survivorship care plans (SCPs) delivered to breast cancer survivors within the LIVESTRONG™ Network of Survivorship Centers of Excellence with Institute of Medicine (IOM) recommendations and describes additional structure/process variables.

Method: Seven NCI-designated comprehensive cancer centers and six community-based centers participated. TS/SCPs for 65 patients were rated against IOM recommendations using a study-derived checklist, and surveys were administered to better understand the structure and process of delivering TSs/SCPs.

Impact of yoga on functional outcomes in breast cancer survivors with aromatase inhibitor-associated arthralgias.

Arthralgia affects postmenopausal breast cancer survivors (BCSs) receiving aromatase inhibitors (AIs). This study aims to establish the feasibility of studying the impact of yoga on objective functional outcomes, pain, and health-related quality of life (HR-QOL) for AI-associated arthralgia (AIAA). Postmenopausal women with stage I to III breast cancer who reported AIAA were enrolled in a single-arm pilot trial.

Diagnosis and management of opioid-induced bowel dysfunction in patients with advanced cancer.

Opioid-induced bowel dysfunction (OBD) is characterized by a constellation of symptoms, including constipation; dry, hard stools; straining; and incomplete evacuation. The use of a prophylactic bowel regimen that includes a stimulant laxative and stool softener generally is accepted and should be initiated at the start of opioid therapy. Effective prevention and treatment of OBD reduce the risk of associated physiologic complications and can improve pain management and quality of life for patients and their families.

Diagnosis and management of postpneumonectomy empyema with an Eloesser flap.

Postpneumonectomy empyema (PPE) is an uncommon and devastating complication of pneumonectomy, with substantial morbidity and mortality. The condition is characterized by pleural cavity infection and inflammation. This article focuses on the management of complicated and persistent PPE with a procedure called Eloesser flap placement, a type of open-window thoracostomy.

Delivery of survivorship care by primary care physicians: the perspective of breast cancer patients.

Purpose: Most of the 182,460 women diagnosed with breast cancer in the United States this year will become long-term survivors. Helping these women transition from active treatment to survivorship is a challenge that involves both oncologists and primary care physicians (PCPs). This study aims to describe postmenopausal breast cancer survivors' (BCS) perceptions of PCP-related survivorship care.

Physical late effects in adult cancer survivors.

There are nearly 12 million cancer survivors living in the US today, and these individuals are at risk for long-term physical complications of treatment. Although development of less toxic treatments such as targeted therapies is helping to decrease the risk of physical effects in individual survivors, the absolute burden of physical complications in cancer survivors is increasing owing to growing numbers of cancer survivors combined with demographic and health trends such as population aging. In cancer survivors, direct effects of cancer and treatment exposures converge with pre-existing risk factors such as age, comorbidities, heredity, and lifestyle factors to elevate the risk of physical complications.

Validation and psychometric assessment of a short clinical scale to measure chemotherapy-induced nausea and vomiting: the MASCC antiemesis tool.

There is a lack of clinical tools to facilitate communication between clinicians and patients about chemotherapy-induced nausea and vomiting (CINV). The Multinational Association of Supportive Care in Cancer (MASCC) has developed such a tool, which is an eight-item scale for the assessment of acute and delayed nausea and vomiting, and is completed once per cycle of chemotherapy. The aim of the current study was to assess its psychometric properties, specifically reliability and validity, cultural transferability and equivalence, and congruence with proxy assessments, as well as to determine if accuracy of recall of CINV events using the MASCC Antiemesis Tool (MAT) differed over time from chemotherapy.

The intersection of cancer and aging: establishing the need for breast cancer rehabilitation.

The increasing success of treatments for common cancers has resulted in growing awareness of the unique health care needs of cancer survivors. Cancer treatments can be toxic and have long-lasting effects on health, potentially accelerating the aging process and producing associated declines in physical function. In this synthesis of the literature, we critically examine the strength of existing evidence that breast cancer diagnosis and treatment are associated with a disproportionate decline in physical function compared with the effects of living without cancer for the same number of years.