Cancer

The field of cancer survivorship is characterized by a complex and rapidly evolving landscape. This supplement presents a series of data-driven articles selected to highlight the breadth of new knowledge in this area of the cancer control continuum that were presented at the Fourth Biennial Cancer Survivorship Research Conference in Atlanta, Georgia, June 2008. Included in the volume is research on the biobehavioral impact of cancer; studies on quality-of-life and economic outcomes; and work focused on caregivers, understudied populations, and healthcare providers.

This follow-up study is novel in that it combines data on psychosocial measures from detailed in-person interviews collected shortly after diagnosis with extensive biomedical information to study the role of cancer-specific beliefs on survival over a 15-year follow-up period. This population-based cohort oversampled African Americans to address racial differences in cancer outcomes; thus, this article contributes to the almost nonexistent literature on psychosocial predictors of survival among colorectal cancer patients involving minority patients.

By examining quality of life in a prospective cohort of elderly women with and without cancer, cancer-related effects on quality of life could be distinguished from influences of aging, comorbidity, current treatment, or second primary cancers. As a result, the authors found lower scores for the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) General Health scale and comparable SF-36 Mental Health scores among survivors relative to cancer-free women. Quality of life decrements were observed across most SF-36 scales for survivors of specific cancers, those with advanced stage, and those who had survived the longest.

Psychospiritual well being and adaptation were explored in a study of middle-aged and older patients with advanced cancer (N = 142) who survived into their second year after diagnosis and were assessed in interviews across 4 time points. Three distinct group trajectories of psychospiritual well being were identified: low-worsening, moderate-improving, and high-stable. Age and education were correlated with group membership.

Protective buffering (hiding cancer-related thoughts and concerns from one's spouse or partner) predicted negative outcomes for those who engaged in this behavior, decreased relationship satisfaction and poorer mental health. In addition, buffering with a strong prosocial orientation (a greater desire to protect one's partner vs oneself) predicted positive outcomes among patients but negative outcomes among partners.

Partner-assisted emotional disclosure is a brief intervention focused on facilitating the cancer patient's emotional disclosure to his or her partner. Results from this study suggested that this intervention led to increases in relationship quality and intimacy for couples in which the patient initially held back from disclosing cancer-related concerns.

A prospective study demonstrated that the classification of families at diagnosis into 1 of 3 psychosocial risk levels based on the Psychosocial Assessment Tool, a brief parent-report screener, was relatively stable across the first 4 months of treatment. Furthermore, families classified at higher levels of psychosocial risk at diagnosis had more distress and poorer family functioning 4 months into treatment and required more psychosocial care than families at lower levels of risk.

Married men's earnings are lower after cancer than they otherwise would have been, but their wives' earnings are also affected, most likely because of the care burden placed on them. Married women's cancer illness affects only their own earnings, and matters less than their male partners' malignancy for the couples' total income.

Data from a national survey of caregivers of cancer survivors were used to estimate the time costs associated with informal caregiving in the 2 years after patient diagnosis with 10 of the most prevalent cancers. Valued at the median wage in 2006, time costs associated with informal caregiving were substantial and ranged from $72,702 (95% confidence interval [95% CI], $56,814-$88,590) for lung cancer patients to $38,334 (95% CI, $31,442-$45,226) for breast cancer patients.

Pediatric cancer survivors are at higher risk for developing skin cancer due to exposure to radiation; however, the utilization of sun protection behaviors is not known. Cancer survivors in the current study reported similar sunscreen use, but less sunbathing and artificial tanning practices than their siblings.

This article describes the design and recruitment strategies of a study designed to gather information on the health behaviors (diet, physical activity, smoking) and body mass index, and associated mediators in African-American, Hispanic and white childhood cancer survivors and noncancer controls.

A population-based survey of 252 male and 277 female colorectal cancer survivors identified significant sex differences in the prevalence and psychological correlates of use of complementary and alternative methods.

Little is known regarding the attitudes, needs, and practice patterns of primary care physicians (PCPs) regarding long-term cancer survivors. Results have suggested that PCPs need and want more preparation, training, and practical guidelines to care for their long-term cancer survivors.

Unmet psychosocial needs figure prominently among the concerns identified by survivors of adult-onset cancers after completion of their primary treatment. This article focuses on the role that development of clinical practice guidelines could play in improving the quality of psychosocial care provided in the post-treatment period.