Greater Financial Toxicity Relates to Greater Distress and Worse Quality of Life Among Breast and Gynecologic Cancer Survivors.

2021 ◽  
Author(s):  
Catherine Benedict ◽  
Sophie Fisher ◽  
Lidia Schapira ◽  
Sabrina Chao ◽  
Sarah Sackeyfio ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cancer Survivors ◽  
Gynecologic Cancer ◽  
Financial Toxicity ◽  
Breast And Gynecologic Cancer

Financial toxicity in gynecologic cancer survivors and its impact on quality of life.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 53-53
Author(s):  
Akhil Mehta ◽  
Jukes P. Namm ◽  
Ellen D'Errico ◽  
Eric Lau ◽  
Linda Hong ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Cancer Survivors ◽  
Cancer Care ◽  
Uterine Cancer ◽  
Gynecologic Cancer ◽  
Financial Toxicity ◽  
Patient Reported ◽  
The Continuum

53 Background: Financial toxicity (FT) is a critical concern for cancer survivors. There is limited data about the relationship between FT throughout the continuum of cancer care, demographics, disease factors, and quality of life (QoL) indicators in gynecologic cancer survivors. Methods: Gynecologic cancer survivors who received treatment from 2015 to 2019 at Loma Linda University Cancer Center were invited to complete an anonymous online survey. A modified version of the comprehensive score for financial toxicity (COST) survey was used to assess FT at baseline and after treatment. The patient-reported outcomes measurement information system (PROMIS) survey was used to assess QoL. Demographic data were summarized using descriptive statistics. Associations between disease factors and FT measured at baseline and after treatment were analyzed using univariable linear regression. Lower COST score coefficients indicate greater FT. Correlations between FT and QoL were evaluated using the Pearson correlation. Results: A total of 252 surveys were sent to gynecologic cancer survivors who met study criteria, of whom 28% responded. Amongst 70 patients included in this analysis, the median age was 64 (IQR 56, 70), 47% were white (n = 33), 20% were unemployed, 22% had a high school or lower level of education, and 50% had an annual income < $60,000. With respect to cancer subtype, 63% had uterine cancer (n = 44), 20% had cervical cancer (n = 14), and 17% had ovarian cancer (n = 12). The mean COST score at baseline and after treatment was 21.2 ± 9.2 and 12.9 ± 7.8, respectively. The following characteristics were associated with significantly greater FT at baseline: Hispanic ethnicity (-5.5; 95% CI: -1 to -10), Black race (-14.4; 95% CI: -3.4 to -25.4), household number > 4 (-6.9; 95% CI: -2.6 to -16.4), Medicare insurance (-6.5; 95% CI: -1.7 to -11.2), and Medicaid insurance (-11.2; 95% CI: -4.3 to -17.9) (p < 0.05). Patients who received combined modality surgery, chemotherapy, and radiation had significantly higher FT (-5.6; 95% CI: -1.3 to -9.8, p < 0.05) compared to those who received single-modality treatment. Likewise, patients with 5 or more treatment-related side effects had significantly higher FT (-6.3; 95% CI -1.13 to -11.4, p < 0.05) compared to those who reported no side effects. During treatment, 24% of patients turned down or skipped treatment, 38% quit their job, and 28% reported family members quit their job. Finally, COST scores measured after treatment correlated positively with physical and mental health (Pearson coefficient 0.57 and 0.56 respectively, p < 0.001). Conclusions: These findings support the need for assessing FT at baseline and throughout the continuum of cancer care to provide individualized assistance to patients facing financial strain. FT affects compliance to treatment which can adversely affect cancer-related outcomes and QoL. Additional policies are needed to address the increasing cost of cancer care.

Feasibility of a telemedicine lifestyle-based rehabilitation program (HEAL) for gynecologic cancer patients.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e24033-e24033
Author(s):  
Nathalie Dauphin McKenzie ◽  
Nnamdi Ifekandu Gwacham ◽  
Julie W. Pepe ◽  
Sarfraz Ahmad ◽  
James Erasmus Kendrick ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Cancer Survivors ◽  
Social Integration ◽  
Stress Management ◽  
Cancer Patients ◽  
Gynecologic Cancer ◽  
Lifestyle Medicine ◽  
Rehabilitation Team

e24033 Background: General health related factors such as obesity, unhealthy diets disproportionate with sugary and highly processed foods, inactivity, and smoking have repeatedly been shown to negatively impact survival and quality of life outcomes in cancer survivors. The Healthy Eating Active Lifestyle (HEAL) – GYN “rehabilitation” cancer program was developed to provide intensive group lifestyle training on exercise, nutrition, sleep, social integration, and stress management via a telemedicine platform. The aim of this study was to determine the feasibility of such an intervention and its tolerability, in addition to its impact on short-term quality of life for gynecologic cancer patients. Methods: HEAL – GYN consists of 8 weekly group sessions offering experiential instruction and personalized goal setting for patients with diagnosis of gynecologic cancer. Components are drawn from the tenets of lifestyle medicine. An oncologist certified in lifestyle medicine along with a multidisciplinary rehabilitation team addressed diet, physical activity, strategies for sleep and stress management, smoking cessation, and alcohol intake. The intervention included training to address unmet psychologic, emotional, physical, sexual, social, and spiritual needs common to cancer survivors. American College of Lifestyle Medicine questionnaires were administered, utilizing Likert scales (1-5) in a pre- and post- fashion to assess improvements in physical activity levels, dietary habits, sleep hygiene, and quality of life. Medical records were reviewed including anthropometric data. Results: 26 patients have enrolled thus far, and we report outcomes on the first 20 participants. The mean age was 58.8 years; 22 were Caucasian, and 7 were on maintenance therapies for gynecologic cancers. Average total severity of reported symptoms (scale = 100 points) on a general medical symptom questionnaire (MSQ) decreased by 22% (61 vs 48). Eight patients reported increased perceived levels of health and 6 had stable perception of health. There were also notable improvements from baseline in item assessments of eating behavior (34%), perceived stress (20%), and resilience (21%). Patients also reported a notable trend towards improvement in anxiety (35%) and depression (34%), as well as social integration and connectedness (30%). 100% of participants would “highly recommend the program” and none complained of stress or altered mood associated with online instruction. Conclusions: The telemedicine HEAL – GYN peri-habilitation program is feasible and well tolerated. In addition, the program may improve quality of life and may prevent further decline for those on treatment or maintenance therapy. These preliminary findings support continued investigation of a telemedicine healthy lifestyle peri-habilitative program.

Patient-reported financial toxicity, quality of life, and health behaviors in insured US cancer survivors

2020 ◽  
Vol 29 (1) ◽  
pp. 349-358 ◽  
Author(s):  
Elizabeth S. Ver Hoeve ◽  
Leila Ali-Akbarian ◽  
Sarah N. Price ◽  
Nurhyikmah M. Lothfi ◽  
Heidi A. Hamann
Keyword(s):  
Quality Of Life ◽  
Health Behaviors ◽  
Cancer Survivors ◽  
Financial Toxicity ◽  
Patient Reported

scholarly journals The associations between physical activity, neuropathy symptoms and health-related quality of life among gynecologic cancer survivors

2020 ◽  
Vol 158 (2) ◽  
pp. 361-365
Author(s):  
Lauren Thomaier ◽  
Patricia Jewett ◽  
Katherine Brown ◽  
Rachael Gotlieb ◽  
Deanna Teoh ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Cancer Survivors ◽  
Gynecologic Cancer ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related
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