Biomedical subjects

Nancy Stark

Publications and source records attributed to Nancy Stark.

6 recordsLinked to original sources

PubMed2005

Economic outcomes of breast cancer survivorship: CALGB study 79804.

BACKGROUND: Over 80% of women diagnosed with breast cancer will be survivors. We sought to determine the economic consequences of surviving breast cancer. METHODS: Disease-free survivors who had received adjuvant chemotherapy for stage II breast cancer on CALGB study 8541 participated in a study of long-term outcomes. Survey responses were used to determine the types and frequency of medical resources used in follow-up, annual direct medical costs, and survivor perceptions of the personal economic impact of breast cancer. RESULTS: 245 of 314 (78%) invited breast cancer survivors (median follow-up 12.2 years, range 9.3-16.4) completed the surveys. Eighty-seven percent reported having cancer specialist follow-up in the past year. The following percentages of survivors reported having had, for breast cancer follow-up, at least once in the past year: breast examination 92%, mammogram 88%, bone scan 18%, chest radiograph 59%, tumor marker studies 37%. When follow-up care included a medical oncologist, resources were more likely to be used at least according to published follow-up guidelines, or over-used. Median annual cost of follow-up per survivor was US 630 dollars (range US 0-10,817 dollars) with higher costs associated with medical oncology follow-up, lower income, and younger age. Few women reported a negative impact of breast cancer on employment, but 16% reported being denied life insurance. CONCLUSIONS: Among long-term breast cancer survivors, patient self-report data suggest that over-use of medical resources for follow-up appears common. When follow-up care included a medical oncologist, resources were more likely to be used appropriately, or over-used. Costs of follow-up are higher with medical oncology follow-up, lower income and among younger survivors. The annual cost of follow-up varies widely and may be driven by over-use of follow-up tests.

Adult↗

PubMed2005

Cancer screening among Native Americans in eastern North Carolina.

The purpose of the study is to explore cancer screening predictors and practices among Lumbee Indians in eastern North Carolina. Interviewers from the community conducted phone interviews with 333 men and 456 women aged 40 and older randomly selected from the Lumbee Tribal roll as part of the Lumbee Diabetes and Health Survey. The survey has sections on demographic information and health conditions, family history of chronic conditions, and health behaviors. This paper reports on cancer screening behaviors. Rates of ever being screened for breast, cervical, prostate and colon cancer were relatively high compared with overall national rates. Predictors included younger age, better health, more education, and lifestyle factors such as engaging in regular physical activity and not smoking. Future research should focus on developing culturally appropriate campaigns to increase the frequency of cancer screening to conform to guidelines, and educational programs and interventions to reach Lumbee Indians most at risk for not being screened.

Adult↗

PubMed2002

Increasing participation of minorities in cancer clinical trials: summary of the "Moving Beyond the Barriers" Conference in North Carolina.

A day-long seminar was held at Wake Forest University School of Medicine to address barriers among ethnic minorities in cancer clinical trials and explore ways that individuals who design and conduct clinical trials could increase minority representation. Speakers addressed implications of under-representation of minorities and identified barriers to minority participation. State-wide focus group results were presented and revealed suspicion of medical research among minorities and the need for bridging to minority communities to improve participation in cancer clinical trials. Working groups assembled and identified barriers specific to trial design, providers, and participants. Attendees were encouraged to devise strategies within their institutions to overcome barriers to minority participation.

Clinical Trials as Topic↗

PubMed2002

Understanding biological safety.

A biocompatible device is one that can coexist with living tissue without causing harm. A lack of biocompatibility is usually caused by a chemical interaction between a reactive molecule in or on the device and the tissue with which it comes in contact (although tissue injury may also be caused by mechanical interaction). This article explains the causes and the effects of bioincompatibility.

Biocompatible Materials↗

PubMed2000

Lymphedema: Knowledge, Treatment, and Impact Among Breast Cancer Survivors.

Lymphedema is an understudied consequence of surgery for breast cancer. It is estimated that as many as 60% of breast cancer survivors report symptoms of lymphedema. Few studies have examined the impact of lymphedema on the lives of women with breast cancer. The goal of this pilot study was to identify knowledge about, treatment received for, and the effect of lymphedema among a group of breast cancer survivors and physicians. Forty women with lymphedema and 10 physicians who treat breast cancer patients participated. Overall, women knew little to nothing about lymphedema before they developed it. After diagnosis, the primary source of information about lymphedema was a doctor or physical therapist. The majority of women received compressive garment therapy (75%), 46.9% received mechanical compressive therapy, 26% received bandaging, and 22% received physical therapy. More than half (55%) reported that clothing and appearance were affected by their condition and 48% reported that routine daily activities were impaired. Hot weather (58%) and regular arm use (40%) were reported to exacerbate the swelling. Most physicians reported that they did not routinely counsel women or provide written information on lymphedema prevention to their patients, and the extent to which women's daily living was affected by the condition was not always recognized. These findings have implications for interventions aimed at educating women and providers about lymphedema.

Journal Article↗

PubMedDate not supplied

Clinical trial enrollment of rural patients with cancer.

PURPOSE: The goal of this study was to examine the effect of a rural community clinical oncology program-based cancer-care intervention program that was launched to increase the number of rural patients with cancer enrolled in clinical trials. DESCRIPTION OF STUDY: Five rural counties in eastern North Carolina served as intervention communities, and five rural counties in South Carolina served as the comparison region. The intervention counties used a rapid tumor-reporting system, a nurse facilitator who identified and prompted oncologists to enter patients into clinical trials, a quarterly newsletter to primary-care physicians about cancer treatment and clinical trials, and a health educator who focused on community-wide education regarding cancer prevention, treatment, and clinical trial information. Outcomes included changes in knowledge and attitudes about clinical trials among the primary-care providers who were surveyed and enrollment in clinical treatment trials for breast and colorectal cancer, as analyzed by comparing practice pattern data from before and after the intervention. RESULTS: The results indicate that the intervention was not effective. The proportion of primary-care physicians who were aware of clinical trials for their patients with cancer rose slightly in comparison counties (26% to 34%) but remained constant (41% to 43%) in intervention counties. Perceived patient and actual physician barriers toward clinical trial participation were reported by the physicians. A minority of potentially eligible patients with breast or colon cancer in both North Carolina and South Carolina were enrolled in clinical trials. CLINICAL IMPLICATIONS: These data suggest that different types of interventions may be needed to improve accrual to cancer treatment trials in rural communities. In addition, the role that primary-care providers play in encouraging patients with cancer to participate in clinical treatment trials needs further exploration.

Breast Neoplasms↗