Cost of care discussions rarely documented for patients with advanced cancer

 A recently completed population study by researchers at the American Cancer Society and the National Cancer Institute shows "cost discussions were infrequently documented in medical records" of patients with advanced non-small cell lung cancer and melanoma.  According to lead study author Dr. Robin Yabroff, scientific vice president of health services research at the American Cancer Society, cost discussions were noted in only 20.3% of non-small cell lung cancer and 24% of melanoma patients.  

To read more about this study, click here. 

Study mentioned: Yabroff KR, Mittu K, Halpern MT. Cost-of-care discussions for individuals with advanced non-small cell lung cancer and melanoma: Findings from a large, population-based pilot study. Cancer. 2024 Jun 13. doi: 10.1002/cncr.35380. Epub ahead of print. PMID: 38869706.

Webinar: compassion in oncology: a powerful antidote to a patient’s negative emotions

 The National Coalition for Cancer Survivorship (NCCS) has produced a new webinar discussing empathy and compassion in cancer care. In their presentation, Dr. Michael Crain and Claudio Pannunzio discuss three key aspects of compassionate care: "improving patient outcomes and satisfaction, decreasing health care costs, [and] reducing workplace burnout." 

To learn more and view the webinar, click here. 

 

Patient-reported symptom burden and supportive care needs of patients with stage II-III colorectal cancer during and after adjuvant systemic treatment

 A retrospective population-based cohort study conducted on newly diagnosed stage II-III colorectal cancer patients in Calgary, Alberta, Canada was recently published in JCO Oncology Practice.  The study, conducted on 303 patients over a period of 3 years (January 2016 - January 2019), indicated that while symptom severity was low and most systems either remained stable and/or or improved following adjuvant systemic treatment, "ongoing assessments and interventions to address physical and psychologic symptoms and supportive care needs in patients [with colorectal cancer] during and after treatment are needed." 

Study mentioned: Cuthbert CA, O'Sullivan DE, Boyne DJ, Brenner DR, Cheung WY. Patient-Reported Symptom Burden and Supportive Care Needs of Patients With Stage II-III Colorectal Cancer During and After Adjuvant Systemic Treatment: A Real-World Evidence Study. JCO Oncol Pract. 2023 Jan 6:OP2200462. doi: 10.1200/OP.22.00462. Epub ahead of print. PMID: 36608313.

Alternate approach to World Health Organization (WHO) analgesic ladder for cancer pain management

Results of a recent randomized parallel group study conducted at the Edinburgh Cancer Research Institute in the UK unveiled a new 2-step option for cancer main management which is more cost-effective than the standard 3-step analgesic ladder approach created decades ago by the World Health Organization (WHO).  The authors of this study, led by Professor Marie T. Fallon state that study findings will be of particular interest "in low- and middle-income countries where weak opioids are expensive and switching complicated."  Further, the study, the first of its kind to access the WHO analgesic ladder from a cost-effectiveness perspective, brought forth several findings, including that the 3-step approach (direct to strong opioid) did not results in fast pain relief that the 2-step (weak opioid approach).  

To read more about this study, click here. 

Sources mentioned: 

Fallon M, Dierberger K, Leng M, et al. An international, open-label, randomised trial comparing a two-step approach versus the standard three-step approach of the WHO analgesic ladder in patients with cancer. Annals of Oncology 2022;33(12):1296-1303.

Bramati PS, Bruera E. The end of the second step of the World Health Organization analgesic ladder? Annals of Oncology 2022;33(12):1212-1213.

Geriatric assessment intervention reduces patient-reported symptom toxicities in older patients with advanced cancer

 Findings from GAP70+, the first study to "systematically describe baseline symptom burden as measured by the Patient-Reported Outcomes Common Terminology Criteria for Adverse Events (PRO-CTCAE) in older adults with advanced cancer" was recently published in the Journal of Clinical Oncology. 

According to the GAO70+ study, more than 25% of new cancer diagnoses occur in older patients, however this demographic is often now well-represented in clinical trials, which limits understanding of the various treatment options available.  

To read more about this study, click here. 

Source mentioned: Culakova E, Mohile SG, Peppone L, et al. Effects of a Geriatric Assessment Intervention on Patient-Reported Symptomatic Toxicity in Older Adults With Advanced Cancer. JCO; Published online 10 November. DOI: 10.1200/JCO.22.00738

Food, housing, transportation insecurity associated with disparities in cancer care and patient outcomes

 A series of three papers discussing housing, transportation, and food insecurity among cancer patients were recently published in the Journal of the National Cancer Institute (JNCI).  Researchers "summarized existing evidence related to disparities in cancer care and patient outcomes, as well as identifying promising interventions and research opportunities to inform policy and improve health equity."  

To read more about these studies and the programs that have been developed to combat inequities regarding access to cancer care, click here. 

Sources mentioned:  

Sanchez JI, Adjei BA, Randhawa G, Medel J, Doose M, Oh A, Jacobsen PB. National Cancer Institute-funded Social Risk Research in Cancer Care Delivery: Opportunities for Future Research. J Natl Cancer Inst. 2022 Sep 8:djac171. doi: 10.1093/jnci/djac171. Epub ahead of print. PMID: 36073952.

Graboyes EM, Chaiyachati KH, Sisto Gall J, Johnson W, Krishnan JA, McManus SS, Thompson L, Shulman LN, Yabroff KR. Addressing Transportation Insecurity Among Patients With Cancer. J Natl Cancer Inst. 2022 Sep 21:djac134. doi: 10.1093/jnci/djac134. Epub ahead of print. PMID: 36130286.

Fan Q, Keene DE, Banegas MP, Gehlert S, Gottlieb LM, Yabroff KR, Pollack CE. Housing Insecurity Among Patients With Cancer. J Natl Cancer Inst. 2022 Sep 21:djac136. doi: 10.1093/jnci/djac136. Epub ahead of print. PMID: 36130291.

Electronic symptom monitoring with PROs improves patient-reported physical function, symptom control and HRQOL

 Results from the PRO-TECT randomized controlled trial, conducted in 52 community oncology practices was recently published in JAMA.  The purpose of PRO-TECT was to "determine whether electronic monitoring of symptoms by patients undergoing treatment for metastatic cancer improves survival, quality of life outcomes and other outcomes compared with usual care."  Following enrollment of 1191 adult metastatic cancer patients, patients in the PRO group "had significantly greater odds of experiencing clinical meaningful benefits versus usual care for physical function", with an improvement of at least 5 points in 7.7% of patients studied. 

To read more about the PRO-TECT trial, click here. 

Source mentioned: Basch E, Schrag D, Henson S, et al. Effect of Electronic Symptom Monitoring on Patient-Reported Outcomes Among Patients With Metastatic Cancer A Randomized Clinical Trial. JAMA 2022;327(24):2413-2422.

Webinar: survivorship needs for people living with advanced and metastatic Cancers

 A recent webinar by Dr. Michelle Mollica, Senior Advisor at the National Cancer Institute's (NCI) Office of Cancer Survivorship, discusses efforts by the NCI on "understanding and addressing the survivorship needs for the growing population of survivors who are living with advanced and metastatic cancers." Dr. Mollica's presentation includes discussions on managing symptoms, psychosocial support, health care delivery and behaviours. 

Fore more information and to view the webinar, click here. 

First study examining mental illness and self-harm events across 26 cancer types

 Recently published findings in Nature Medicine studied risk of unnatural death following self-harm amongst 459,542 cancer patients diagnosed with 26 different types of cancer.  Due to psychological distress and depression experienced by cancer patients, the study authors concluded that the self-harm "prevalence ratio is higher among younger individuals, as they are more likely to be referred for specialized psychosocial cancer care."  In particular, the study further revealed the patients with co-occurring were mostly likely to cause self-harm to themselves during the first 12 months of a cancer diagnosis. 

To read more about this study, click here.  

Source mentioned: Chang WH, Lai AG. Cumulative burden of psychiatric disorders and self-harm across 26 adult cancers. Nature Medicine; Published online 28 March 2022. DOI: https://doi.org/10.1038/s41591-022-01740-3

Children of patients with cancer more likely to experience medical financial hardship and emotional and educational challenges following parental diagnosis

 A new study conducted by researchers at the American Cancer Society indicates that children "living in families with a history of parental cancer were more likely to face financial, emotional, and educational challenges."  According to Dr. Zhiyuan Zheng, lead author of the study, 3.4% of children between 5-17 are living in families with a parental history of cancer.  As a result, these children may miss school and may be less likely to receive medical care due to lack of family financial resources.  Further, the study states that these children "were particularly vulnerable and began to experience psychosocial and behavioral challenges that often went unaddressed." 

To read more about this study, click here. 

Source mentioned: Zheng Z, Zhao J, Nogueira L, Han X, Fan Q, Yabroff KR. Associations of Parental Cancer With School Absenteeism, Medical Care Unaffordability, Health Care Use, and Mental Health Among Children. JAMA Pediatr. Published online April 11, 2022. doi:10.1001/jamapediatrics.2022.0494

 

Opioid use drops among cancer patients at end of life

 A new study recently published in the Journal of Clinical Oncology indicates that palliative care cancer patients are not receiving adequate opioid medication to control pain.  Conducted over a period of 10 years from 2007-2017 on 270,000 cancer patients, findings determined that the filling of opioid prescriptions during the last month of life dropped from 42% to 35%, correlated with a significant number of emergency departments visits due to pain increasing during this time period.  This translated into an overall 25% drop of daily medication dosage.  

To read more about this study, click here. 

Prefrail and frail young adult survivors of childhood cancers experience significant neurocognitive decline

 A recently published prospective study conducted in the Department of Epidemiology and Cancer Control at St. Jude's Children's Research Hospital in Memphis, Tennessee, indicates that frail young adult survivors of childhood cancers "experienced significantly larger declines than non frail survivors in memory, attention, processing speed, and executive function domains."  The study, conducted on childhood cancer survivors between 18-45 years old with at least 10 years from diagnosis supported background research findings where cancer-related neurocognitive impairment occurs in up to 35% of childhood cancer survivors.  However, study authors acknowledged that "further research is needed to understand the shared biologic pathways underlying frailty and neurocognitive function."  

To read more about this study, click here. 

Source mentioned: 

Williams ALM, Krull KR, Howell CR, et al. Physiologic Frailty and Neurocognitive Decline Among Young-Adult Childhood Cancer Survivors: A Prospective Study From the St Jude Lifetime Cohort. JCO; Published online 20 July 2021. DOI: 10.1200/JCO.21.00194

Assessment of patients' perspectives on consequences of COVID-19 on cancer care

A team of oncologists from the Netherlands recently published what is believed to be the first study focusing on perspectives of cancer patients during COVID-19.  Developed by the Dutch Federation of Cancer Patients Organizations, together with oncologists and patient advocacy groups from the Dutch Multidisciplinary Oncology Foundation, an online survey was distributed to cancer patients across the Netherlands via direct mail, website announcements, and social media.  "The survey consisted of 20 question on four topics: patients' characteristics, contact with the hospital, consequences of the COVID-19 pandemic, and concerns about COVID-19". Of the 5302 completed survey responses received 30% of patents stated a number of consequences pertaining to their cancer treatments or subsequent follow-up visits, many of which were altered from in-person visits to phone or video consultations.

To read more about this study, click here.

Source mentioned: de Joode K, Dumoukin DW, Engelen V, et al. Impact of the COVID-19 pandemic on cancer treatment the patients' perspective.  European Journal of Cancer; published online 4 July 2020. DOI: https://doi.org/10.1016/j.ecja.2020.06.019

New trial alert: NCI COVID-19 in cancer patients study

The National Cancer Institute (NCI) has launched a natural history study of COVID-19 in cancer patients.  Blood tests, medical history and imaging will be obtained from 2,000 cancer patients, who are more susceptible to serious illness if they contract COVID-19.  Anticipated outcomes of the trial include understanding genetic risk factors of COVID-19 diagnoses while patients are undergoing cancer treatment, as well as establish a repository of blood tests and imaging results for future research.

To learn more about this study, click here.

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COVID-19 Infection in Cancer Patients in Wuhan: Emphasis on Severe Events

A new retrospective study on COVID-19 among cancer patients, focusing on risk factors associated with admission to the intensive care unit (ICU) has been conducted by a team of clinicians from 3 hospitals in Wuhan, China, and recently published in the Annals of Oncology.  Clinical data gathered from 28 cancer patients with COVID-19 infection between January 13, 2020 - February 26, 2020 indicates that 17 patients (60%) were male, with an average age of 65 years.  Of the 28 cancer patients studied, 7 (25%) had lung cancer, followed by oesophageal cancer (4 patients), and breast cancer (3 patients).  10 patients had a stage IV cancer diagnosis and 8 patients developed COVID-19 from hospital-associated transmission.  Further, of the 6 patients who received anti-tumour treatment within 14 days of their COVID-19 diagnosis, 5 (83%) developed severe events.

To read more about this study, click here.

Study mentioned: Zhang L, Zhu F, Xie L, et al. Clinical characteristics of COVID-19-infected cancer patients: A retrospective case study in three hospitals within Wuhan, China. Annals of Oncology; Published online 23 March 2020. DOI: https://doi.org/10.1016/j.annonc.2020.03.296

Cancer treatment in the age of COVID-19

OncoLink, a prominent cancer blog created by the University of Pennsylvania recently posted 3 blogs entries on their forum pertaining to the COVID-19 pandemic.  The first, On the Front Lines with Cancer and COVID-19,  provides personal perspectives from a radiation therapist, while Cancer Treatment in the Age of COVID-19 contains key resources to address concerns cancer patients may have regarding coronavirus.   Finally, the OncoLink team focuses on the mental health perspective of COVID-19, providing suggestions on dealing with mandated self-isolation periods.  To read more, click here.

Communication between cancer patients and healthcare professionals through digital media

Researchers representing the European Organization for Treatment and Research of Cancer (EORTC) have recently completed a study on the use of social media by cancer patients as a means of discussing the cancer journey with fellow peers.  According to study authors Daniel P. Oran and Eric J. Topol, "social media may be taken a step further to provide a new tool for patient-caregiver interaction that allows oncologists to learn their patients' true concerns."


To read more about this study, click here


Source mentioned: Oran DP, Topol EJ. The rise of the virtualist. Lancet 2019 Jul 6; 394(10192).

Developing better methods for managing cancer pain

The increased prevalence of cancer pain and the impact of the opioid epidemic on cancer pain management—and on managing chronic pain in general—have sparked renewed interest in developing new, nonaddictive pain medications as well as nondrug approaches for managing chronic pain. Thanks in part to the development of animal models of some types of cancer pain, researchers are beginning to better understand its underlying biology. In particular, scientists are identifying molecules that generate pain signals and gaining insights into how the nervous system transmits these signals from the pain site to the brain, where pain is perceived.

To read more on this topic, click here.

A study tracked cancer patients using crowdfunding to pay for homeopathy

Health policy researchers from Simon Fraser University (SFU) and University of Alberta conducted a study to find out how often cancer patients or their supporters turned to crowdfunding platforms to raise money for complementary treatment. The analysis was published in The Lancet, identified 220 active fundraising campaigns in June 2018.

To read more about this study, click here.

Tailored psychotherapy eases depression in people with advanced cancer

A new clinical trial has found that just three to six sessions of a tailored psychotherapy approach known as Managing Cancer and Living Meaningfully, or CALM, helped to lessen symptoms of depression in people recently diagnosed with advanced cancer. Results from the trial also showed that the approach may help prevent the onset of depression in those with advanced disease.

To read more about this clinical trial, click here.