Skip to main content

Advertisement

SpringerLink
Log in

Randomized controlled trial of a clinic-based survivorship intervention following adjuvant therapy in breast cancer survivors

  • Clinical trial
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

In 2006, the IOM released a report citing the importance of “survivorship plans” to improve quality of life and care coordination for cancer survivors, but little has been done to evaluate their efficacy. Women with early-stage breast cancer were randomized within 6 weeks of completing adjuvant therapy to a survivorship intervention group (SI) or control group (CG). All subjects were given the NCI publication, “Facing Forward: Life after Cancer Treatment.” The SI also met with a nurse/nutritionist to receive a treatment summary, surveillance, and lifestyle recommendations. Both groups completed questionnaires on the impact of cancer (IOC), patient satisfaction (FACIT-TS-PS), and assessment of survivor concerns (ASC) at baseline, 3 and 6 months. Within and between group t tests and linear regression analyses were performed. Among 126 women (60 CG, 66 SI), mean age was 54 years, 48 % were Hispanic, and the groups were well-balanced by baseline characteristics. No significant differences between the CG and SI on the FACIT-TS-PS or IOC at 3 and 6 months were seen. The ASC health worry subscale was lower (less worry) in the SI compared to CG (p = 0.02). At all time-points, Hispanic women had higher (worse) health worry (p = 0.0008), social-life interference (p = 0.009), and meaning of cancer scales (p = 0.0004), and more trust in medical professionals (p = 0.03) compared to non-Hispanic women. While the SI did not lead to significant improvements in most patient-reported outcomes, it was associated with decreased health worry. Future interventions should determine the most efficient and effective method for delivering survivorship care plans.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Green BL, Rowland JH, Krupnick JL, Epstein SA, Stockton P, Stern NM, Spertus IL, Steakley C (1998) Prevalence of posttraumatic stress disorder in women with breast cancer. Psychosomatics 39(2):102–111

    Article  PubMed  CAS  Google Scholar 

  2. Beisecker A, Cook M, Ashworth J, Hayes J, Bresheisen M, Helmig L (1997) Side effects of adjuvant chemotherapy: perceptions of node-negative breast cancer patients. Psychooncology 6:85–93

    Article  PubMed  CAS  Google Scholar 

  3. Ward SE, Viergutz G, Tormey D (1992) deMuth J, Paulen A: Patients’ reactions to completion of adjuvant breast cancer therapy. Nurs Res 41(6):362–366

    Article  PubMed  CAS  Google Scholar 

  4. Hewitt MEGS, Stovall E (2006) From cancer patient to cancer survivor: lost in transition. National Academies Press, Washington DC

    Google Scholar 

  5. New Commission on Cancer Accreditation Standards (2012) http://www.facs.org/cancerprogram/home.html

  6. Stanton AL, Ganz PA, Kwan L, Meyerowitz BE, Bower JE, Krupnick JL, Rowland JH, Leedham B, Belin TR (2005) Outcomes from the moving beyond cancer psychoeducational, randomized, controlled trial with breast cancer patients. J Clin Oncol 23(25):6009–6018

    Article  PubMed  Google Scholar 

  7. Grunfeld E, Julian JA, Pond G, Maunsell E, Coyle D, Folkes A, Joy AA, Provencher L, Rayson D, Rheaume DE et al (2011) Evaluating survivorship care plans: results of a randomized, clinical trial of patients with breast cancer. J Clin Oncol 29(36):4755–4762

    Article  PubMed  Google Scholar 

  8. Facing Forward: Life After Cancer Treatment National Cancer Institute July 2010. https://pubs.cancer.gov/ncipl/detail.aspx?prodid=p119

  9. Functional Assessment of Chronic Illness Therapy (2012) http://www.facit.org/qview/qlist.aspx

  10. Zebrack BJ, Ganz PA, Bernaards CA, Petersen L, Abraham L (2006) Assessing the impact of cancer: development of a new instrument for long-term survivors. Psychooncology 15(5):407–421

    Article  PubMed  Google Scholar 

  11. Gotay CC, Pagano IS (2007) Assessment of Survivor Concerns (ASC): a newly proposed brief questionnaire. Health Qual Life Outcomes 5:15

    Article  PubMed  Google Scholar 

  12. Cella DF, Tulsky DS, Gray G, Sarafian B, Linn E, Bonomi A, Silberman M, Yellen SB, Winicour P, Brannon J et al (1993) The Functional Assessment of Cancer Therapy scale: development and validation of the general measure. J Clin Oncol 11(3):570–579

    PubMed  CAS  Google Scholar 

  13. Weissman MM, Sholomskas D, Pottenger M, Prusoff BA, Locke BZ (1977) Assessing depressive symptoms in five psychiatric populations: a validation study. Am J Epidemiol 106(3):203–214

    PubMed  CAS  Google Scholar 

  14. Chew LD, Bradley KA, Boyko EJ (2004) Brief questions to identify patients with inadequate health literacy. Fam Med 36(8):588–594

    PubMed  Google Scholar 

  15. Portenoy RK, Thaler HT, Kornblith AB, Lepore JM, Friedlander-Klar H, Kiyasu E, Sobel K, Coyle N, Kemeny N, Norton L et al (1994) The Memorial Symptom Assessment Scale: an instrument for the evaluation of symptom prevalence, characteristics and distress. Eur J Cancer 30A(9):1326–1336

    Article  PubMed  CAS  Google Scholar 

  16. Ganz PA, Hahn EE (2008) Implementing a survivorship care plan for patients with breast cancer. J Clin Oncol 26(5):759–767

    Article  PubMed  Google Scholar 

  17. Rowland JH, Hewitt M, Ganz PA (2006) Cancer survivorship: a new challenge in delivering quality cancer care. J Clin Oncol 24(32):5101–5104

    Article  PubMed  Google Scholar 

  18. Salz T, Oeffinger KC, McCabe MS, Layne TM, Bach PB (2012) Survivorship care plans in research and practice. CA Cancer J Clin 62:101–117

    Google Scholar 

  19. Merport A, Lemon SC, Nyambose J, Prout MN (2012) The use of cancer treatment summaries and care plans among Massachusetts physicians. Support Care Cancer 20(7):1579–1583

    Article  PubMed  Google Scholar 

  20. Shalom MM, Hahn EE, Casillas J, Ganz PA (2011) Do survivorship care plans make a difference? A primary care provider perspective. J Oncol Pract 7(5):314–318

    Article  PubMed  Google Scholar 

  21. US Census Bureau (2000) Census 200 Restricting Data (PL 94-171), Summary File for States PL1, PL2, PL3, PL4

  22. Ashing-Giwa KT, Padilla G, Tejero J, Kraemer J, Wright K, Coscarelli A, Clayton S, Williams I, Hills D (2004) Understanding the breast cancer experience of women: a qualitative study of African American, Asian American, Latina and Caucasian cancer survivors. Psychooncology 13(6):408–428

    Article  PubMed  Google Scholar 

  23. Breslau J, Javaras KN, Blacker D, Murphy JM, Normand SL (2008) Differential item functioning between ethnic groups in the epidemiological assessment of depression. J Nerv Ment Dis 196(4):297–306

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

Supported by a grant from Susan G. Komen for The Cure (DISP0706868) (DLH). Additional funding provided from the Breast Cancer Research Foundation (DLH). Trial Registration: NCT00821288.

Conflict of interest

The authors declare that they have no conflict of interest of any kind.

Author information

Authors and Affiliations

  1. Department of Medicine, The Herbert Irving Comprehensive Cancer Center, College of Physicians and Surgeons, Columbia University, 161 Fort Washington Avenue, 10-1068, New York, NY, 10032, USA

    Dawn L. Hershman, Heather Greenlee, Danielle Awad, Kevin Kalinsky, Matthew Maurer, Grace Kranwinkel, Lois Brafman, Ramona Jayasena, Wei-Yann Tsai, Alfred I. Neugut & Katherine D. Crew

  2. Departments of Epidemiology and Biostatistics, Mailman School of Public Health, Columbia University, 161 Fort Washington Avenue, 10-1068, New York, NY, 10032, USA

    Dawn L. Hershman, Heather Greenlee, Wei-Yann Tsai, Alfred I. Neugut & Katherine D. Crew

Authors
  1. Dawn L. Hershman
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Heather Greenlee
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Danielle Awad
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kevin Kalinsky
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Matthew Maurer
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Grace Kranwinkel
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Lois Brafman
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Ramona Jayasena
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Wei-Yann Tsai
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Alfred I. Neugut
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Katherine D. Crew
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Dawn L. Hershman.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 49 kb)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hershman, D.L., Greenlee, H., Awad, D. et al. Randomized controlled trial of a clinic-based survivorship intervention following adjuvant therapy in breast cancer survivors. Breast Cancer Res Treat 138, 795–806 (2013). https://doi.org/10.1007/s10549-013-2486-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10549-013-2486-1

Keywords

Search

Navigation