Browsing by Subject "Survivorship"

Now showing 1 - 3 of 3
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    Comparison of quality of life and health behaviors between melanoma survivors and controls
    (2016-01) Vogel, Rachel
    Unlike most cancer types, melanoma incidence has been increasing over the past 30 years in the United States. The unique characteristics of melanoma argue for research that captures the specific issues faced by melanoma survivors. Studies of long-term melanoma survivors are lacking, and the survivorship research to date has been limited by the inability to make comparisons with a population control group. The goal of this dissertation was to document the long-term effects of a melanoma diagnosis and treatment on survivors and compare their quality of life and health behaviors with population controls. First, a series of focus groups were conducted to describe the breadth of experiences among melanoma survivors, focusing on the experience at diagnosis, ongoing physical, emotional and social concerns, and behavioral changes since diagnosis (Manuscript 1). Based on these data, a comprehensive questionnaire to address the quality of life issues faced by melanoma survivors was designed and tested. Finally a cross-sectional study of melanoma survivors and population controls was conducted. The goal was to collect data to evaluate the impact of melanoma on long-term survivorship focusing on quality of life (Manuscript 2) and sun exposure and protection behaviors (Manuscript 3). A total of 592 melanoma survivors and 518 controls completed the survey. Results indicate that long-term survivors of melanoma reported similar general physical and emotional quality of life as controls. In addition, while they generally reported greater use of sun protection behaviors than controls, a significant subgroup experienced sunburn in the past year, putting them at elevated risk for future melanomas. The data presented in this dissertation suggest that long-term melanoma survivors reported similar quality of life as controls, though opportunities exist to improve their sun exposure and protection behaviors.
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    Growth Hormone Deficiency in Childhood Germ Cell Tumor Survivors
    (2021-06) Lone, Diana
    Background: Intracranial germ cell tumor (iGCT) survivors have multiple risk factors for growth hormone (GH) deficiency, a commonly reported late effect in childhood cancer survivors. The objective of this study is to examine the prevalence of GH deficiency among childhood iGCT survivors. Methods: Participants were previously enrolled in the Germ Cell Tumor Epidemiology Study (GaMETES), a case-parent triad study by the Children’s Oncology Group registries. A subset of these participants consented to this late effects follow-up study. Questionnaire responses or medical records were available for 129 participants. Results: Forty-five percent had GH deficiency. Eighteen percent had GH deficiency predating the iGCT and 27% developed it within a median of 19 months. Younger age, suprasellar location, and higher radiation doses were associated with GH deficiency as a late effect. Conclusions: GH deficiency is highly prevalent as an early clinical sign for an iGCT and frequently arises as an early late effect.
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    Physical activity in childhood cancer survivors
    (2014-08) Slater, Megan Elizabeth
    Background: Childhood cancer survivors (CCS) are at high risk of developing treatment-related late effects, including cardiovascular disease and diabetes, which can be exacerbated by inadequate physical activity (PA). Relationships between PA, physical fitness, and cardiometabolic risk factors in CCS have not been well described. Furthermore, active transportation, a specific domain of PA, has not been previously studied in CCS. The primary aims of this dissertation were to examine associations between PA/fitness and cardiometabolic risk factors and to identify active transportation behaviors and barriers in CCS.Methods: In Project 1, associations between PA and cardiometabolic risk factors were examined in 319 CCS and 208 sibling controls aged 9-18 years. In Project 2, associations between PA/fitness and cardiometabolic risk factors were examined in 119 adult CCS with a history of hematopoietic cell transplantation and 66 adult sibling controls. In Project 3, we recruited 158 adult CCS and 153 controls matched on age, sex, and location to complete a survey regarding active transportation behaviors and perceptions. Linear and logistic regression models accounting for correlation among siblings or matched participants were used to address research questions.Results: Higher levels of PA in CCS aged 9-18 (Project 1) and higher levels of endurance in adult CCS (Project 2) were associated with a favorable cardiometabolic profile. In Project 3, adult CCS engaged in similar levels of active transportation as controls despite perceiving greater health-related barriers. Marital/relationship status, planning/psychosocial barriers, and perceived neighborhood walkability were the strongest correlates of active transportation among CCS, while objective neighborhood walkability was the strongest correlate among controls.Conclusions: Findings suggest that efforts to increase PA and endurance in CCS may reduce the risk of future cardiovascular disease. Interventions might consider promoting active transportation as a moderate intensity PA option, since it appears to be as well accepted in CCS as in healthy adults. Such interventions will not be successful, however, without existing or improved pedestrian and bicycle infrastructure, safety, and access to local amenities. Additional research is needed to confirm results and explore the feasibility and efficacy of active transportation interventions in this population.