A5105231053- BRCA gene mutations in cancer
- Nutrition, Genetics, and Disease
- Ethics in Clinical Research
- Childhood Cancer Survivors' Quality of Life
- Family Support in Illness
- Cancer Risks and Factors
- Health, Environment, Cognitive Aging
- Cancer survivorship and care
- Complementary and Alternative Medicine Studies
- Science, Research, and Medicine
- Mental Health Research Topics
- Berberine and alkaloids research
- Chronic Myeloid Leukemia Treatments
- Behavioral Health and Interventions
- Platelet Disorders and Treatments
- Therapeutic Uses of Natural Elements
- Optimism, Hope, and Well-being
- Estrogen and related hormone effects
- Endometrial and Cervical Cancer Treatments
- Mobile Health and mHealth Applications
- Cardiovascular Health and Risk Factors
- Phytochemistry Medicinal Plant Applications
- Menopause: Health Impacts and Treatments
- Pancreatic and Hepatic Oncology Research
- Pharmacogenetics and Drug Metabolism
Independent Sector
2018-2020
University of Pennsylvania
2016-2018
Behavioral Tech
2018
University of Chicago Medical Center
2014-2018
University of Chicago
2016-2018
Temple University Health System
2016
Fox Chase Cancer Center
2016
Abramson Cancer Center
2016
Cancer Genetics (United States)
2016
Duke University Hospital
2013
Videoconferencing has been used to expand medical services low-access populations and could increase access genetic at community sites where in-person visits with providers are not available.To evaluate the feasibility of, patient feedback cognitive affective responses remote two-way videoconferencing (RVC) telegenetic multiple sociodemographically diverse practices without providers.Patients 3 in 2 US states outside host center completed RVC pretest (visit 1, V1) post-test 2, V2) counseling...
To test hypotheses about the relationship between negative affect and symptom reports, reports of 4 groups elderly participants (N = 76; mean age 73.5 years) were compared: those high on measures both depression anxiety, one measure low other, measures. Symptom obtained before after 3 simultaneously given active inoculations (influenza; tetanus toxoid; keyhole limpet hemocyanin, a neoantigen) similarly placebo injections. Cross-sectional analyses replicated associations elevated systemic...
Abstract Objective : To examine the experience, comprehension and perceptions of learning a parent's BRCA mutation during adolescence early adulthood, explore impact on offspring's physical psychosocial well‐being. Methods Semi‐structured interviews were completed with 22 adult offspring who learned their prior to age 25 years. Data summarized using qualitative methods response proportions. Results Offspring reports content shared varied; discussion cancer risks genetic testing described...
Patients with cancer increasingly use complementary and alternative medicine (CAM) in conjunction conventional oncology treatments. This study looks at the prevalence correlates of individual CAM modalities initiated after diagnosis.
The objective of this study was to provider attitudes and perceived barriers the clinical use pharmacogenomics before during participation in an implementation program.From 2012 2017, providers were recruited. After completing semistructured interviews (SSIs) about pharmacogenomics, received training on access a decision support tool housing patient-specific pharmacogenomic results. Thematic analysis SSI conducted (inter-rater reliability κ≥0.75). Providers also completed surveys...
To evaluate the impact of breast cancer family history and maternal BRCA1/2 mutation on psychosocial adjustment perceived risk in girls age 11 to 19 years old.Girls old with one or more relatives a familial (breast [BCFH] positive, n = 208; 69 BRCA1/2-positive mother), peers (BCFH negative, 112), their mothers completed assessments adjustment, cancer-specific distress, cancer.General did not differ significantly between BCFH-positive BCFH-negative girls, either by self-report mother report,...
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Objective Tamoxifen therapy preserves BMD of the lumbar spine and increases levels SHBG. We assessed whether trait anxiety, a factor linked with reactive endocrine system, is associated differential changes in SHBG response to tamoxifen therapy. Methods Postmenopausal women (N = 140) axillary-node-negative breast cancer participated 2-year randomized, double-blind, placebo-controlled trial (10 mg twice day). Levels were at baseline 3, 6, 12, 18, 24 months. Results Trait anxiety predicted...
6024 Background: Psychosocial distress in ambulatory oncology patients (AOP) is common, and deleterious to treatment decisions, symptoms, adherence outcomes, but easily treated. Recent NCCN guidelines recommend all AOP be screened at initial patient visit (IPV) "appropriate intervals" determine level, nature cause of inform intervention. The brevity the Memorial Sloan-Kettering Distress Thermometer (DT), a one item self-report measure, warrants NCCN's endorsement, however, operating...
4183 Background: Chemotherapy treatment of metastatic pancreatic cancer remains quite limited. Platelet-Derived Growth Factor and its tyrosine kinase receptor (PDGFr) are overexpressed in tumor cells. Imatinib (Gleevec) is a inhibitor that inhibits PDGFr, bcr-Abl, c-kit. It well tolerated oral agent with clinical activity CML GIST tumors.Thus, given the evidence increased PDGFr few options for patients cancer, we conducted phase II trial cancer. Methods: Previously treated or untreated...
Abstract #1098 Disclosure of BRCA1/2 test results has historically been conducted in person by a certified genetic counselor (GC) and/or other health care professional. Due to increasing demand for and access testing, there interest providing counseling services, including disclosure results, telephone internet. The practice among counselors not described. We semi-structured interviews with GCs determine current prevalence of, future in, (TD) results. Surveys were self-administered completed...
The Alzheimer’s Prevention Initiative Generation Study is enrolling APOE e4 homozygotes age 60-75 YO and includes standardized disclosure of disease risk by genotype. Given the potential psychosocial risks complexity genetic information communication probabilistic risk, testing for predisposition has traditionally included in-person counseling. However, some participating sites do not have providers to provide counseling test study participants. Building off an established program providing...
The Alzheimer's Prevention Initiative (API) is a collaborative funded by the NIH, philanthropy, and industry to conduct preclinical disease (AD) trials in people who, based on age genetics, are at elevated risk of developing AD symptoms. API's Generation Study enrolling apolipoprotein E (APOE) e4 homozygotes 60-75. To support this future trials, API established an interdisciplinary APOE Genetic Testing Disclosure Committee whose aims include establishing genetic testing program enrich...
6506 Background: Providing remote genetic services by phone or videoconference for patients at community practices without access to providers could increase testing. How uptake of testing compares usual care options has not been reported. Methods: To date, 106 6 were randomized counseling (35 phone; 31 videoconferencing) and 40 (recruitment end 3/2018). Primary outcomes months. Secondary include knowledge, state general anxiety, depression, cancer-specific distress in versus...
Background: Women diagnosed as having a high risk for breast cancer (HR-BC) often seek different health behaviors (HBs) such complementary and alternative medicine (CAM), diet, exercise to improve their outcome. Methods: already enrolled in multimodality screening study patients at HR-BC (gene mutation carrier or >20% cumulative lifetime risk) were given questionnaire evaluate use of CAM therapies, before after diagnosis HR-BC. Patients also asked complete the Short-Form 36, State-Trait...
Abstract Background:The risks, benefits and utilities of multiplex panels for breast cancer susceptibility are unknown new counseling informed consent models needed. We sought to obtain patient reported outcomes testing in BRCA1/2 negative patients utilizing a novel, previously piloted tiered-binned model testing. Methods:BRCA1/2 participants completed pre(V1) post-test counseling(V2) surveys evaluating cognitive, affective behavioral responses 25-gene panel. used linear regressions with...
1502 Background: Genetic testing for cancer predisposition traditionally includes in-person pre- and post-test genetic counseling. Outcomes of telephone delivery a range test results, including multi-gene panel testing, are unknown. Methods: 984 patients at 5 centers undergoing (after pre-test counseling) enrolled. 819 were randomly assigned to (IPD; n=418) or disclosure (TD; n=401) results. 17% (n=165) declined randomization given preference IPD. Primary outcomes knowledge, state anxiety...
9527 Background: Most girls in families at high risk (HR; familial or genetic) for breast cancer learn of that a young age. Additionally, new guidelines support disclosure incidental findings predisposition genes regardless The association this information with psychosocial well-being and health behaviors is unknown. Methods: 238 HR control (11-19 YO) mothers (48 BRCA1/2+) completed surveys to evaluate adjustment behaviors. We used linear logistic regressions variable selection. Results:...
Abstract Background: Professional societies recommend against the genetic testing of minors for hereditary cancer syndromes that present in adulthood. Yet, many adolescent specialists indicate they would consider BRCA1/2 minor children. We conducted interviews with parents who have had testing, to evaluate their opinions regarding BRCA1/2. Methods: 244 parents, including 67 mutation carriers (MCs), 140 uninformative negative results (UN), 14 true (TN) & 23 a variant uncertain...
e12037 Background: Evidence suggests that early events may influence or modify adult breast cancer (BC) risk. Little is known about how adolescents from hereditary BC families understand, respond to and incorporate Methods: Seventeen 11-17 YO girls (13 high risk, HR; 4 population PR) completed semi-structured interviews evaluating knowledge perceptions of risk health behaviors (anticipated enrollment: 35). Descriptive responses were coded response proportions utilized summarize findings....
1511 Background: ASCO recommends against the genetic testing of minors for hereditary cancer syndromes that present in adulthood. To better understand opinions those most affected by these issues, we interviewed parents who had undergone BRCA1/2 and children <25 years old at time BRCA testing. Methods: 153 completed semi-structured interviews (52 mutation carriers (MC), 77 with uninformative negative results (UN), 6 true (TN) 18 a variant uncertain significance (VUS). Multiple logistic...
1504 Background: Alternative delivery models are needed in the era of Precision Medicine given a shortage genetic providers and increasing utilization testing. Telephone disclosure (TD) test results, including multi-gene panel testing, is non-inferior to usual care in-person (IPD) for short-term distress but failed non-inferiority knowledge. Longitudinal data health behaviors needed. Methods: 970 patients undergoing clinical testing at 5 centers were randomly assigned IPD (n = 497) or TD...
1534 Background: Telephone disclosure (TD) of genetic testing is non-inferior to in-person (IPD) for most outcomes but did not meet non-inferiority knowledge change. We sought understand which concepts patients don’t and factors associated with lower knowledge. Methods: Patients were recruited a multi-center, randomized trial (NCT01736345) comparing TD IPD test results. 819 (IPD = 418; 401); 165 declined randomization requested IPD. Knowledge was assessed after pre-test counseling (V1) (V2)....