At this year’s Annual Meeting, the Rehabilitation, Survivorship, and Quality of Life Study Group honored three young investigators with awards for outstanding research.
Best Abstract Awards 2018 for a Junior Faculty Member
Jacqui Frowen, PhD — Dysphagia and Oral Complications in Cancer Patients1
Swallowing problems and complications within the oral cavity are common after treatment for head and neck cancer, but less is known about these problems in patients with other types of cancer. Jacqui Frowen and her colleagues at the Peter MacCallum Cancer Centre and the University of Melbourne (Australia) conducted this study to determine the prevalence of patient-reported dysphagia and oral complications in all cancer patients across all treatment settings and to examine the relationships between cancer types, oral complications, and dysphagia. Their cross-sectional study at a specialist cancer center in Australia involved 239 participants (either admitted patients or outpatients currently receiving treatment) who completed the Vanderbilt Head and Neck Symptom Survey (version 2.0) to report on dysphagia and oral complications experienced. These patients represented 14 different types of cancer. More than 46% of patients reported dysphagia for solids, while about 20% reported dysphagia for liquids. Nearly half of the patients reported weight loss and more than half reported dry mouth. Other reported symptoms included mouth or throat pain (19.7%), thick phlegm (33.5%), changes in taste (61.8%), and changes in voice (36.8%). Symptoms did not vary by cancer type, but significant associations were found between dysphagia and dry mouth, mouth or throat pain, thick phlegm, taste changes, and voice changes. This is the first known set of comprehensive data on dysphagia and oral complications across all cancer patients. The results indicate that symptoms of dysphagia, which have significant implications for quality of life, are common in patients receiving cancer treatment and are associated with other common oral symptoms of cancer treatment. These findings have implications for monitoring, assessment, and management, which could improve quality of life in cancer patients.
Micah D. J. Peters, PhD — Cancer Care Experiences and Unmet Needs of Lesbian, Gay, and Bisexual People with Cancer2
People who identify as sexually and/or gender diverse may face additional challenges in receiving equitable and appropriate cancer care. This can lead to worse outcomes and avoidable harm. Micah D. J. Peters, PhD, with colleagues at the Peter MacCallum Cancer Centre in Melbourne, Australia, the University of South Australia (Adelaide), Swinburne University (Melbourne), and the University of Melbourne conducted a research study to explore qualitative evidence regarding the cancer care experiences and unmet needs of this diverse and often overlooked population to identify areas for improvement. The research team conducted a qualitative systematic review and meta-synthesis of English language studies. Following a literature search, study selection, and methodological review, relevant qualitative data were extracted verbatim and synthesized using thematic analysis. Fifteen articles including lesbian, gay, and bisexual (LGB) people were included, all of them dating from 2002 or later, since no relevant studies published before 2002 were identified. Most participants were women with breast cancer or men with prostate cancer. No studies involving participants who identified as transgender were identified. A synthesis of 106 findings produced six core themes: sexual orientation disclosure, experiences and fear of homophobia, positive and negative healthcare professional behaviors, heterocentric systems and care, inadequacy of available support groups, and unmet needs for patient-centered care and LGB-specific information. The findings suggest that LGB people receiving cancer care experience anxiety, invisibility, isolation, and may receive inadequate, and sometimes inappropriate, care. While positive experiences with care were also revealed, many unmet needs were identified. The research team concluded that training and education of healthcare professionals should address these challenges and practice gaps. Culturally appropriate care includes the use of inclusive language, the provision of tailored information, involving partners in care, and avoiding assumptions of heterosexuality.
Best Abstract Award 2018 for a Trainee
Xiaotao Zhang, MD, PhD, MS — Malnutrition and Overall Survival in Older Patients with Cancer3
It is well known that malnutrition is common among older adults with cancer. Xiaotao Zhang, MD, along with colleagues at the University of Texas MD Anderson Cancer Center and the Central Texas Veterans Administration undertook a study to assess the prevalence of malnutrition among cancer patients and its association with overall cancer survival. This single-site, retrospective cohort study involved 456 cancer care patients aged 65 and older who had undergone comprehensive geriatric assessments. The assessment included cognitive, functional, nutritional, physical, and comorbidity measurement. Malnutrition status was assessed with the Mini Nutritional Assessment (MNA®) and clinical interviews. Patients received recommendations for nutritional supplementation and/or appetite stimulants and were followed for 3 years. The patients in the current analysis had a mean age of 77.7 and represented hematologic, gastrointestinal, urologic, breast, lung, and gynecologic cancers. Forty-one percent were found to have malnutrition and 33% died during the 3-year follow-up. Malnutrition was found, via Cox regression analysis, to be associated with all-cause mortality in for all cancer types. Multivariate Cox regression analysis showed an association between malnutrition and all-cause mortality in patients with solid tumors, but not in those with hematologic malignancies. Despite nutritional recommendations for increased dietary intake, malnutrition at the time of initial visit remained a risk factor for mortality in older cancer patients, and it was an independent risk factor for mortality in patients with solid tumors. The research team recommends prospective intervention studies to minimize malnutrition and its negative consequences for older cancer patients.
________________________________________
1Frowen J, Hughes R, Perera R, Sao J, Skeat J. Prevalence of Patient-Reported Dysphagia and Oral Complications in Cancer Patients: An Australian Study.
2Lisy K, Peters M, Schofield P, Jefford M. Cancer Care Experiences and Unmet Needs of Lesbian, Gay, and Bisexual People with Cancer: A Systematic Review of Qualitative Evidence. Psychooncology. 2018 Jun;27(6):1480-1489. (Epub Mar 15, 2018)
3Zhang X, Sun M, Geng Y, Dinney C, Popat U, Chamlin R, Valero V, Tripathy D, Hedberg AM, Stroehlein J, Edwards B. Malnutrition and Overall Survival in Older Patients with Cancer.
