Monday, March 12, 2018

New Research : Biopsychosocial Distress Associated with Breast and Gynecologic Cancer

Last week I read this tweet.
After tweeting questions about the study to  Dr Bergerot, she kindly shared with me the complete article.

Here are some details from the study.

This study was a retrospective quantitative study part of a larger study which took place at City of Hope. It used the City of Hope electronic screening device called You , Your Family and City of Hope are a Team that measures distress.The screening tool involved over 30 core questions and also asked participants their preferred method of assistance/support ( None, Written Info, Talk, Talk + Written Info).

There were 2111 breast cancer patients and 641 gynecologic cancer patients who took part in the study . Most gyn patients were late stage and older (M 57.17 yrs) than the breast cancer patients. There was no significant difference in their body mass.

The study found that gyn cancer patients reported higher problem-related distress compared to breast cancer patients in the following areas:
  • fatigue
  • pain
  • walking or climbing stairs
  • bowel movement/ constipation
  • questions and fear of end of life
  • feeling angry and irritable 
  • needing practical help at home

Gyn cancer patients requested to Talk with a team member about the following issues at a higher level than breast cancer patients:
  • understanding treatment options
  • solving problems
  • fear of medical procedures

Gyn patients also requested Written Information and Talk for at a higher level than breast cancer patients:
  • side effects of treatments
  • finances
  • pain
  • fatigue
  • feeling anxious or fearful

The researchers found that having a gyn cancer and being diagnosed at a younger age were significant predictors of total distress.

In conclusion researchers found that gyn cancer patients had higher problem-related distress. They found no significant difference between cervical and ovarian cancers on the sum of  biopsychosocial problems, which shows they are both at high risk for distress.

It was also found that gyn cancer patients requested to talk to a member of their team more often than breast cancer patients. The authors stated that preexisting support for breast cancer patients may be the reason for lower requests from breast cancer patients.

While the study hypothesized that gyn cancer patients would represent a high-risk group for high levels of distress they did not expect that gyn cancer patients would required higher levels of assistance.  The article stated, "the computerized touch screen system may have facilitated the expression of needs and concerns despite cancer stigma: In research involving sensitive or embarrassing information, electronic questionnaires have been more accepted by patients and more sensi- tive than paper questionnaires." Age , race, education and annual income could also contribute to problem-related distress.

Bergerot CD, Clark KL, Obenchain R, Philip EJ, Loscalzo M. Breast and gynecological cancer patients' risk factors associated with biopsychosocial problemrelated distress. PsychoOncology. 2018;27:10131020.
In my 13 years as an ovarian cancer survivor I have seen some improvement in support of gyn cancer patients. There are more in-person gynecologic cancer support and networking groups, gynecologic cancer awareness organizations providing platforms online for peer support and more attention being given to gyn cancers symptoms during Gyn Cancer Awareness Month ( September).

But this study verifies that we need to understand that the needs of gyn cancer patients may be different and require different support than other women's cancers. 

Every Day is a Blessing! 

Wednesday, March 7, 2018

Ovarian Cancer Screening in Asymptomatic Women - USPSTF

In 2012, I wrote a blog post titled I Agree with the USPSTF  regarding the latest recommendation on screening asymptomatic women for ovarian cancer.

On February 13, 2018 the USPSTK released an updated recommendation.

The USPSTF recommends against screening for ovarian cancer in asymptomatic women.
This recommendation applies to asymptomatic women who are not known to have a high-risk hereditary cancer syndrome.
Grade: D 
(The USPSTF recommends against the service. There is moderate to high certainty the service has no net benefits or the harms outweigh the benefits.)

You can read the full recommendation here.

In the February 25th issue of the ASCO Post. Michael J. Barry, MD said "“Evidence shows that current screening methods do not prevent women from dying of ovarian cancer and that screening can lead to unnecessary surgery in women without cancer.”

Remember if you have a history of breast or ovarian cancer in your family these recommendations do NOT apply to you.

It is sad that in the past six years there is still no effective screening test for ovarian cancer that is both specific and sensitive to the disease. We still have a lot of work to do to help find a test that will find ovarian cancer at an early stage.

Every Day is a Blessing!

Wednesday, February 7, 2018

Monday, January 29, 2018

Taking a Look at the Big Picture

Over the past few days I have been thinking about the role my advocacy work takes in relationship to my family and life outside of cancer. Every January for the past few years, I've reviewed my advocacy work and decided what I want to continue with in the next year.  This year though I  know the my family will require more time ( which I am happy to do), so I felt I needed to look at my advocacy work in a different way.

I have been blessed to be involved in different aspects of advocacy with a number of organizations and non-profits. Some organizations raise awareness, some raise funds for research and others reach out to Congress. There are ovarian cancer organizations, gynecologic cancer organizations, support organizations, peep to peer support groups, cancer patient empowerment groups, and industry groups.

Yesterday, I made a list of all the organizations I was involved with 2017 and my responsibilities.  The list contained eighteen organizations. Some volunteer positions had sub-items. Some of these organizations required me to travel or required me to attend an event or multiple events in person. Some required me to spend a great deal of time preparing information to disseminate to others. Some responsibilities were once a quarter, once a month or twice a month.  A few advocacy responsibilities required daily input or responding to multiple e-mails.  Some volunteer work was only "as needed". Some groups offer compensation but most do not. Some I could choose to do when I had time, like this blog. I like those best!

So my next step was to look at each advocacy opportunity and asked myself:
  • how effective am I at doing that work?
  • am I the only one doing that work?
  • if I am the only one can another advocate/person do it?
  • how much does the work benefit other survivors/patients? 
  • how many people are effected by the work I do?
  • do I ever regret having agreed to do the work and feel that way when I am doing it?
  • does the work ever prevent me from doing other things - like hang out with my husband, grand-kids or dog?
  • does that work bring me joy?
By asking those questions I came to the realization that I can and should make a change in what I concentrate my advocacy efforts on. So that is what I am starting to do. After all my priority has always been family first.

Some of these activities will be harder to step back from than others (I really love the people I interact with in these organizations) but I need to look at the Big Picture and make some changes. 

Don't worry though I will still be writing this blog and co-moderating the #gyncsm chat. For many others, well, over time I will need to let them know I will not be participating at the level I have in the past.
I just read a post by Susannah Fox ( Letter to Shareholders) in which she reviewed her work life in 2017 and detailed her wins and losses.  Have any of my fellow advocates gone through a similar process to determine where they were and how they want to spend their time going forward ?  I'd love to hear how made your decisions.

Every Day is a Blessing!

Thursday, January 11, 2018

Time to Look Forward

I've been feeling pretty under the weather lately so I regret taking so long to do this post.

Every year in January I write a post on my aspirations for the year ahead. I'm not keen on resolutions but aspirations well those are just things I will keep trying for.

Just now, when I looked back at my aspirations from January 2017, I'm glad I can keep trying because I wasn't totally successful.

Here is aspirations will remain from last year:
  • I aspire to continue to support other women who are diagnosed with ovarian cancer, to share my story as an ovarian cancer survivor and to promote ovarian cancer research. ( There are some activities that I will have to cut back on so I can achieve some of my other aspirations on this list.  I am adding that I aspire to  help more women become advocates. I see the same awesome advocates at events. We need more new and fresh voices.)
  • I aspire to travel with my husband and visit at least 2 states I have not visited before. Maine is one of the two.  ( This has been on my list since 2016. But I'll try again this year.)
  • I aspire to learn a new arts and craft technique. ( I did some glass blowing in 2017 which was loads of fun. ) 
  •  I aspire to find a way to give back in my community or church. ( I wasn't as successful at this one as I had hoped to be so on the list it will stay.)
  • I aspire to spend more time with my daughter and her family and my son and his wife.  (Trying to fill the time over the next few months while my daughter and her family are stateside and only 3 hours away.There are a few built in get-togethers too that I am excited about. ) 
  •  I aspire to build an even better bond with my dog Amber so we can compete at the masters level in agility. (She did get her excellent std title last year,  so we really will be competing in masters in both JWW and STD.)
Now for new aspirations:
  • Update this blog's layout. (Look! It's done! That was easy.) 
  • I aspire to complete an online course in Genomics. (Yeah I'm a science geek. )
  • I aspire to go kayaking.
  • I aspire to make my FitBit celebrate each day as I hit my step count, sleep better, increase my fiber intake and drink more water. 

What do you aspire to do in 2018?

Every Day is a Blessing!

Monday, January 8, 2018

Impact of Digital Info & Patient Support Networks 2017

Healthline recently release the 2017 Cancer State of Cancer Report: Impact of Digital Info & Patient Support Networks. The Report provided the results of a survey of cancer patients, survivors and caregivers regarding their use of online resources for information and support. They surveyed 1500 people over the age of 18 who were diagnosed with cancer or a caregiver of someone with cancer.

The key findings are listed below.
  • 89 percent of cancer patients and caregivers go online for information related to cancer.
  • 49 percent of millennials go online for information the same day they receive a cancer diagnosis.
  • 73 percent of millennials join an online cancer community after diagnosis — three times more than baby boomers do (23 percent).
  • Emotional support is the no. 1 benefit of joining an online or in-person cancer support group, but millennials also report they’re valuable for helping them make treatment decisions.
  • Millennials place a higher degree of trust in online resources than older generations.
  • Half of millennials also feel the information they encounter online causes more anxiety and fear.
  • 78 percent agree that the internet empowers cancer patients and caregivers to make more informed decisions and cope with fear and anxiety (71 percent).
  • Boomers value their clinical care team more than Generation X or millennials do, but millennials are the most likely generation to prefer to defer to their clinical team to make treatment decisions (48 percent). 62 percent of boomers and Gen Xers prefer shared decision-making.
  • About half of cancer survivors or their caregivers stay engaged in online support groups to track long-term side effects (64 percent), because they fear recurrence (49 percent), and for emotional support (47 percent).
  • There’s a stark difference in the behavior of survivors by generation, with 59 percent of millennials, 51 percent of Gen Xers, and 37 percent of boomers staying engaged in groups.
The Report is divided into 13 sections such as Cancer Support Groups, Health Privacy, Social Media, Trusting Internet Info, etc. You can read the sections you are interested in or the entire report, like I did, at .

I found the report reflected the use of the internet by age group that I have observed from my time as co-founder/ co-moderator of the #gyncsm Twitter Community. My only comment would be regarding the report's use of the term community versus group. They separate online communities ( Inspire and Smart Patients) from Communities found on Twitter - which they call groups. Yes there is a difference in terms of privacy but I believe if you use the definition of community - "a body of persons of common ideas scattered through a larger society" then the groups on Twitter are in fact communities. 

Enjoy your read.

Every Day is a Blessing!

Monday, January 1, 2018

Hello 2018! Changes and Challenges

On New Year's Day, it has become a bit of a tradition that I write a post about my aspirations for the year ahead.  It just so happens that today I am still thinking through my priorities and learning to use my FitBit, which I am sure will work into those aspirations, so I am going to save that post for later this week.

Instead, I am going to share with you some points made in a book I am reading. My friend, a Disney fan like I am, shared the book with me and I am enjoying reading it.  My Pride - Mastering Life's Daily Performance  is written by Alton Fitzgerald White. Alton White played Mufasa for over 4000 performances of Broadway's Lion King.

In the book, he tells the story of his life growing up and dealing with failure and success. He asks readers to challenge yourself to  :
  1. Keep Sight of Your Dreams
  2. Trust Your Instincts
  3. Be Responsible for your Actions  and Choices
  4. Develop Discipline and Define a Work Ethic
  5. Take Care of Yourself
  6. Foster a Sense of Spirituality
  7. Commit Yourself to Service
  8. Learn to Live with Rejection
  9. Understand Success
  10. Be In Business ( I would change this to Advocacy.) 
I think most folks, even if we aren't in show business, can benefit to think about these 10 items and how we can work them into our lives in the year ahead.

As we begin this New Year you will notice that I made a few design changes to this blog. I hope you like them.

Wishing you all a very Happy New Year!

Every Day is a Blessing!