Survivors of advanced breast cancer (ABC), also known as metavivors, are often left with fewer treatment options in the landscape of a cure culture. Metavivors have unique psychosocial and physical needs distinct from patients with early-stage breast cancer. This analysis delves into side effects commonly experienced by patients with ABC, such as fatigue, anxiety, and cardiotoxicity; how these side effects impact caregiver support, financial toxicity, emotional strain, and spiritual and emotional distress; as well as current strategies for mitigation, including nutrition, exercise, and participation in clinical research. Overall, this analysis is a mandate for additional research to explore novel treatments and implement strategies to maintain and improve patients’ quality of life.

Background: Older cancer survivors in general are at greater risk for cancer-related cognitive impairment (CRCI), yet few studies have explored its association with health outcomes. This study examined the association between subjective and objective measures of cognitive function and physical function, frailty, and quality of life (QoL) among older breast cancer survivors. Materials and Methods: Older breast cancer survivors who reported cognitive concerns completed surveys on patient-reported cognitive function, physical function, frailty, and QoL as well as objective tests of visuospatial working memory and sustained attention. Data were analyzed using descriptive statistics and separate linear regression models. Results: A total of 219 female breast cancer survivors completed the study. Perceived cognitive abilities were associated with better physical function, frailty, and QoL (p ≤ 0.001) while cognitive concerns were negatively related with these metrics (p ≤ 0.001). Poorer visuospatial working memory and sustained attention were linked to increased frailty (p ≤ 0.001–0.01), whereas poorer sustained attention was associated with poorer physical function (p < 0.01). Conclusions: Older breast cancer survivors with perceived cognitive impairment and poorer cognitive performance reported poorer physical functioning, increased frailty, and poorer QoL. These findings underscore the importance of assessing cognitive concerns and their associated outcomes in older breast cancer survivors.

Our pilot study aimed to evaluate the needs of community oncology providers with regard to cancer survivorship education, develop a survivorship curriculum based on the needs assessment, and evaluate the acceptability of the Project ECHO® (Extension for Community Healthcare Outcomes) model for delivery of the survivorship curriculum. A needs assessment was delivered to participants in suburban community cancer practices, and a curriculum was developed based on the results. Participants were enrolled in an ECHO curriculum consisting of 6 sessions from October to December 2019. Participants included registered nurses (RN), registered dietitians (RD), clinical social workers (LCSW), advanced practice providers (APP), radiation oncologists, and medical oncologists (MD). Participants were invited to participate in exit interviews designed to better evaluate the participant experience. Ninety percent of needs assessment participants (n = 37) expressed an interest in cancer survivorship education. Eight participants from 3 community practices in suburban Connecticut enrolled in the ECHO curriculum. Four participants (50%) agreed to participate in exit interviews. Five themes emerged from the exit interviews: interest in survivorship, time, positive experience, empowerment, and community. Our Survivorship ECHO pilot demonstrated the acceptability of the Project ECHO® model for delivering cancer survivorship education to oncology providers. Further research confirming the feasibility of this model in additional oncology provider settings is needed.

Purpose: This pilot study evaluated a 12-week Cancer Survivorship curriculum delivered utilizing the Project Echo® model on provider self-efficacy (SE), knowledge (KN), and professional improvement (PI). Methods: Providers affiliated with the Mercy Health System were enrolled in two cohorts. Six one-hour sessions were developed from a needs assessment and delivered over 12 weeks. Participants completed pre and post session surveys evaluating 3 domains: SE, KN and PI. The average score for survey items overall and within each domain was compared pre- and postsurvey results. Results: Twenty-six participants completed the baseline survey and 22 completed the poststudy survey. For cohort 1, the overall score (0.94 (0.45,1.42) (P=0.0023), SE (1.1 (0.5,1.7) p = 0.003), and KN domain (1.03 (0.45,1.62) p= 0.0036) scores significantly increased. For cohort 2, the overall score (0.617 (0.042,1.193) p=0.0378), the SE (0.728(0.048,1.407), p = 0.0379), and KN domains (0.665 (0.041,1.289), p= 0.0387) increased significantly. The PI did not change for either cohort. Conclusions: This Cancer Survivorship ECHO pilot resulted in a statistically significant increase in provider self-efficacy and knowledge. All 22 participants rated the Cancer Survivorship ECHO pilot experience as a positive (greater than neutral) on their training. Implications for Cancer Survivors: The Cancer Survivorship ECHO model may serve as a scalable strategy for building cancer survivorship care capacity in community-based oncology practices through equipping multidisciplinary teams to meet the needs of cancer survivors within their community. Further research is needed to assess implementation of this model into novel settings and evaluate its impact on patient outcomes.