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From page 81... ... Common health conditions such as overweight/obesity, cardiovascular disease, and osteopenia/osteoporosis may develop as a primary effect of specific cancer treatments or as a secondary effect of cancer on functional status, and dietary interventions offer the potential to reduce such cancer-related morbidity and promote overall health in vulnerable patients. Dietary interventions targeting patients with cancer have been evaluated in 11 prospective controlled trials that focused on either weight reduction (de Waard et al., 1993; Loprinzi et al., 1996; Djuric et al., 2002) Read the entire page →
From page 82... ... . Of these studies, 34 involved randomized or controlled clinical trials that employed various exercise modalities, including cardiovascular (Winningham and MacVicar, 1988; MacVicar et al., 1989; Winningham et al., 1989; Dimeo et al., 1997a, 1998, 2003; Mock et al., 1997, 2001; Na et al., 2000; Schwartz, 1999, 2000; Schwartz et al., 2001; Segal et al., 2001; Courneya et al., 2003a) Read the entire page →
From page 83... ... Some of these services also have been perceived as "human services" rather than "health services" because they are not directly curative or biomedical in intent or origin, and are frequently provided through voluntary human services agencies as opposed to health care providers under PREPUBLICATION COPY: UNCORRECTED PROOFS Read the entire page →
From page 86... ... . The generalizability of these findings to interventions targeting cancer patients is unclear; a meta-analysis of a variety of caregiver support interventions found that caregivers of patients with dementia benefited less from such intervention than did others (Sorensen et al., 2002) Read the entire page →
From page 87... ... . READY AVAILABILITY OF KEY SERVICES As described in Chapter 1, patients vary in the extent to which they need the psychosocial health services described in this chapter. Read the entire page →
From page 88... ... Table 3-2 highlights information services and Table 3-3 other key psychosocial health services available nationwide at no cost to patients. Information such as this may be helpful to oncologists as they seek to provide their patients with information on sources of psychosocial health services. Read the entire page →
From page 89... ... Information www.aicr.org Nutrition, diet, and exercise to combat American Institute cancer of Cancer Research 1–800–843–8114 (toll free) Its online Nutrition Hotline allows survivors to e-mail a personal nutrition and diet question to a registered dietician http://www.apiahf.com/devsearch/re Information on where to obtain Asian and Pacific port.asp psychosocial services, and languages Islander National spoken by sources of the services Cancer Survivors Network www.acor.org Types of cancer, treatment options, Association of clinical trials, and locating support Cancer Online groups. Read the entire page →
From page 90... ... www.colorectal-cancer.net Colorectal cancer, treatment options, Colorectal Cancer clinical trials, and finding treatment Network centers and support. www.curesearch.org Information on childhood cancers, CureSearch treatments, side effects, hospitals, and 1-800-458-6223 (toll free) Read the entire page →
From page 91... ... www.myeloma.org Myeloma, treatment options, managing International side effects of treatment and myeloma Myeloma Telephone Hotline: Toll free at 1 symptoms, finding clinical trials, Foundation (800) Read the entire page →
From page 92... ... America www.lymphoma.org Different types of lymphoma, treatment Lymphoma options, clinical trials, and finding peer Research Helplines: Survivors hotline:1-800 support Foundation 500-9976 (toll free) helpline@lymphoma.org www.lungcanceralliance.org Lung cancer, treatment options, clinical Lung Cancer trials, finding support groups, other Alliance Hotline: 1-800-298-2436 (toll free) Read the entire page →
From page 93... ... National Ovarian Cancer Coalition 1-888-OVARIAN (toll free) Finding NOCC state chapters for (NOCC) Read the entire page →
From page 94... ... 1-800-757-2873 (toll free) info@prostatecancerfoundation.org www.curesarcoma.org Types of sarcomas, symptoms, Sarcoma Foundation diagnosis; treatment options; links to of America other sarcoma organizations; information on clinical trials. Read the entire page →
From page 95... ... Thyroid cancer, treatment, nutrition and www.thyca.org Thyroid Cancer diet, finding a specialist and support Survivors' 1-877-588-7904 (toll free) groups. Read the entire page →
From page 96... ... Organization, Inc. 24 hour toll free, national hotline staffed by trained survivors: 1-800-221-2141 (English) Read the entire page →
From page 97... ... 42,680 individuals from all 50 states Counseling www.cancercare.org CancerCare received counseling, education, support Counseling -- Face-to-face, group, referral or financial assistance 1-800-813-HOPE (toll free) online, telephone. Read the entire page →
From page 98... ... www.cancer.org/docroot/ESN/co Education ACS' I Can Cope ntent/ESN_3_1X_I_Can_Cope.a Program sp Education -- community or online classes on cancer 1-800-ACS-2345 (toll free) management, treatment, financial concerns, community resources, nutrition, emotional matters, and communication skills. Read the entire page →
From page 99... ... 42,680 individuals from all 50 states Education CancerCare received counseling, education, support Education -- cancer types, 1-800-813-HOPE (toll free) group, referral or financial assistance treatment options, quality in FY2005 (unduplicated count) Read the entire page →
From page 100... ... Education www.lbbc.org Conferences / Living Beyond Breast workshops Cancer Support services. 1-888-753-5222 (toll free) Read the entire page →
From page 101... ... survivors and loved ones have received Foundation (Lymphoma) education 1-800-500-9976 (toll free) Read the entire page →
From page 102... ... Education Approximately 170 attendees at each www.pancan.org In 2006 held Pancreatic Cancer Action Network (Pancreatic 2006 symposium symposia in 1-877-272-6226 (toll free) Chicago, New Cancer) Read the entire page →
From page 103... ... 1-800-221-2141 (toll free) various regions (Breast Cancer) Read the entire page →
From page 104... ... 31 people matched in 2006 Emotional www.tbts.org Brain Tumor Society support COPE Program is a matching program that To participate in the COPE provides emotional support Program, call toll free at 1-800 by email or telephone. Read the entire page →
From page 105... ... www.facingourrisk.org Emotional Facing Our Risk for support Cancer Empowerment 1-866-824-7475 (toll free) (Breast Cancer) Read the entire page →
From page 106... ... 1-888-753-5222 (toll free) Emotional support -- one on-one via telephone. Read the entire page →
From page 107... ... In 2006, provided emotional support to www.pancan.org Emotional Pancreatic Cancer Action 6,655 people via e-mail or telephone support Network 1-877-272-6226 (toll free) (Pancreatic Cancer) Read the entire page →
From page 108... ... Sponsors 8 Emotional www.ulmanfund.org Ulman Cancer Fund for support groups support Young Adults nationally in 6 1-888-393-FUND (toll free) Emotional support -- e-mail different cities. Read the entire page →
From page 109... ... 16 Y-ME local Emotional www.y-me.org Y-ME National Breast affiliates in support Cancer Organization, Inc. various regions 1-800-221-2141 (toll free) Read the entire page →
From page 110... ... Financial Brain Tumor Society assistance CARES Financial 1-800-770-8287 (toll free) Assistance Program provides grants up to $2,000 per family, per year for specific non-medical costs related to a primary brain tumor diagnosis such as transportation, home health assistance related to brain tumor diagnosis, home adaptation related to brain tumor diagnosis, and child care. Read the entire page →
From page 111... ... Also offers financial assistance for insurance co-payments. In all 50 states Approximately 81 grants awarded www.lymphoma.org Financial Lymphoma Research yearly assistance Foundation 1-800-500-9976 (toll free) Read the entire page →
From page 112... ... In 2005, made 24-36 referrals Lymphoma Foundation of assistance America 1-800-385-1060 (toll free) (Lymphoma) Read the entire page →
From page 113... ... sitearea=COM cancer patients from home to treatment center. 1-800-ACS-2345 (toll free) Read the entire page →
From page 114... ... various regions 1-800-221-2141 (toll free) (Breast Cancer) Read the entire page →
From page 115... ... European Journal of Cancer Care 30A(12) Read the entire page →
From page 116... ... 2003c. Randomized controlled trial of exercise training in postmenopausal breast cancer survivors: Cardiopulmonary and quality of life outcomes. Read the entire page →
From page 117... ... : Intervening to improve function among older breast and prostate cancer survivors. Controlled Clinical Trials 24(2) Read the entire page →
From page 118... ... 2003. Effects of exercise training on fasting insulin, insulin resistance, insulin-like growth factors, and insulin-like growth factor binding proteins in postmenopausal breast cancer survivors: A randomized controlled trial. Read the entire page →
From page 119... ... 2004. Effects of an oncologist's recommendation to exercise on self-reported exercise behavior in newly diagnosed breast cancer survivors: A single-blind, randomized controlled trial. Read the entire page →
From page 120... ... . Supportive-expressive group therapy for women with metastatic breast cancer: Survival and psychosocial outcome from a randomized controlled trial. Read the entire page →
From page 121... ... 1998. Telephone counseling of breast cancer patients after treatment: A description of a randomized controlled trial. Read the entire page →
From page 122... ... 2001. Effective methods of giving information in cancer: A systematic literature review of randomized controlled trials. Read the entire page →
From page 123... ... 2005. Home-based physical activity intervention for breast cancer patients. Read the entire page →
From page 124... ... 2001. Structured exercise improves physical functioning in women with stages I and II breast cancer: Results of a randomized controlled trial. Read the entire page →
From page 125... ... 1994. A smoking cessation intervention with hospitalized surgical cancer patients: A pilot study. Read the entire page →
From page 127... ... follow up on care delivery to monitor the effectiveness of services and determine whether any changes are needed. In addition, practice guidelines produced through systematic reviews of evidence that identify approaches for the effective delivery of psychosocial health services are also included in Table 4.1 along with the consensusbased guidelines for Distress Management developed by the National Comprehensive Cancer Network (NCCN) Read the entire page →
From page 129... ... standardized care providers and assessment (Anonymous, instruments consulting 2004, 2006) psychiatrists PREPUBLICATION COPY: UNCORRECTED PROOFS Read the entire page →
From page 131... ... is needed to deliver appropriate psychosocial health care effectively to individuals with complex health conditions. This conclusion also is supported by the findings of several systematic reviews of psychosocial care. Read the entire page →
From page 132... ... CANCER CARE FOR THE WHOLE PATIENT: MEETING PSYCHOSOCIAL HEALTH NEEDS 132 FIGURE 4-1 Model for the delivery of psychosocial health services. Effective Patient–Provider Communication Patient–Provider Provider Team Patient/Family Partnership Identification of Psychosocial Needs Development and Implementation of a Plan That: Supports patients by: • Providing personalized Links information patient/family with Coordinates • Identifying strategies to needed psychosocial and address needs psychosocial biomedical care • Providing emotional services support • Helping patients manage their illness and health Follow-up and Re-evaluation PREPUBLICATION COPY: UNCORRECTED PROOFS Read the entire page →
From page 133... ... report, PatientCentered Communication in Cancer Care include: 1) fostering healing relationships; 2) Read the entire page →
From page 134... ... . Moreover, a systematic review of randomized controlled trials and uncontrolled studies of interventions designed to improve the provision of information and encourage participation in decision making by patients with advanced cancer found that although almost all patients expressed a desire for full information, only about two-thirds wished to participate actively in decision making about their care (Gaston and Mitchell, 2005) Read the entire page →
From page 135... ... . Similar benefits are found specifically in cancer care (Arora, 2003) Read the entire page →
From page 136... ... can inform clinical practice, as well as research. This report finds that most skill-building interventions targeting clinicians consist of formal training as part of medical education or continuing education programs; e.g., a three day course on communication skills) Read the entire page →
From page 137... ... can also impede the detection of problems. In contrast, several screening tools and in-depth needs assessment instruments have been found to be effective in reliably identifying individuals with psychosocial health needs. Read the entire page →
From page 138... ... , the research and implementation examples reviewed below and in Chapter 5 demonstrate that screening can be both an effective and a feasible mechanism for identifying individuals with psychosocial health needs. The variation among existing validated screening instruments can facilitate the inclusion of screening in routine clinical practice by accommodating the differing interests and resources of various clinical sites. Read the entire page →
From page 139... ... Such tools are available for screening patient populations and identifying individuals with some types of psychosocial health care needs. For example, a number of screening tools for detecting mental health problems, such as anxiety, depression, adjustment disorders, or post-traumatic stress syndrome or symptoms, have been tested with cancer survivors in different oncology settings and found to meet these criteria. Read the entire page →
From page 140... ... These instruments vary somewhat in their content and approach, which may reflect their different purposes and conceptual bases (as well as the absence of a shared understanding of health-related psychosocial stress and psychosocial health services - as discussed in Appendix B) Read the entire page →
From page 141... ... The Psychosocial Assessment Tool© (PAT) 2.0 was developed for use with families of children newly diagnosed with cancer to assess the patient's level of risk for psychosocial health problems during treatment. Read the entire page →
From page 142... ... However, a review of six studies of the use of checklists to identify psychosocial health needs in cancer care found that use of these screening tools positively influenced health care providers to pay attention to psychosocial health needs, talk with their patients about these needs, and make referrals to providers of psychosocial health services (Kruijver et al., 2006) Read the entire page →
From page 143... ... Despite these deficiencies and the need for further research (see Chapter 8) , results of the two systematic reviews that examined the use of needs assessment instruments when processes for follow-up on identified needs were implemented, and the reasonableness of needs assessment as a means of identifying individuals who need psychosocial health services, argue for the usefulness of the process as a prelude to the planning and provision of such services. Read the entire page →
From page 147... ... .20-.35. Patient prioritization completes of information needs PREPUBLICATION COPY: UNCORRECTED PROOFS Read the entire page →
From page 149... ... possible have purpose, clinician communication Caregiver Measure family 20 items; Five-point Interviews. Correlated R = .92 Time: 22 min; FAMCARE Overall α: satisfaction with 4 domains: Likert Family with n=23, Reading level: 0.93; advanced information "Satisfaction ranking of McCusker time < 23 hrs N/A; Domains: α cancer care giving, scale" items. Read the entire page →
From page 150... ... patients MD availability, MD competence, Interview; MD personality, patient may be MD able to communication, complete general satisfaction Preference for: home care, decision making PREPUBLICATION COPY: UNCORRECTED PROOFS Read the entire page →
From page 151... ... have primary "Need Met" "middle" relative with subscale class; breast cancer Acceptability: "several" Self-complete reported it didn't apply. NOTE: This table is from "Needs Assessment for Cancer Patients and Their Families." Kuang-Yi Wen and David H Gustafson Health and Quality of Life Outcomes 2004, © 2004 Wen and Gustafson; licensee BioMed Central Ltd.. Read the entire page →
From page 152... ... Interaction 11 4 2 4 • MD/Care 8 6 16 Availability MD Competence 4 4 Patient Care 8 8 4 PREPUBLICATION COPY: UNCORRECTED PROOFS Read the entire page →

From page 81...

... Common health conditions such as overweight/obesity, cardiovascular disease, and osteopenia/osteoporosis may develop as a primary effect of specific cancer treatments or as a secondary effect of cancer on functional status, and dietary interventions offer the potential to reduce such cancer-related morbidity and promote overall health in vulnerable patients. Dietary interventions targeting patients with cancer have been evaluated in 11 prospective controlled trials that focused on either weight reduction (de Waard et al., 1993; Loprinzi et al., 1996; Djuric et al., 2002)