Elizabeth Henry

Self-reported memory problems in adult-onset cancer survivors: effects of cardiovascular disease and insomnia

BACKGROUND Cancer and its treatments can deleteriously affect memory. Cardiac function and insomnia can exacerbate memory problems. OBJECTIVE To examine the relationships among cardiovascular disease, insomnia, and self-reported memory problems (SRMP) in adult-onset cancer survivors. METHODS We included data from participants (41-64 year-old) of the 2007-2008 National Health and Nutrition Examination Survey, a nationally representative probability sample of the civilian, non-institutionalized population of the US. We excluded participants with brain cancer/stroke history since these conditions are expected to cause cognitive problems. Using binary logistic regression, we determined the prevalence of SRMP relative to cardiac problems and insomnia by weighting our results proportionally. We adjusted for predictors of memory problems: age, sex, race, education and general health. RESULTS The sample included 2289 adults (49% females), 9% with a cancer history. The results pertain only to cancer survivors. Those with insomnia were 16 times as likely to have SRMP. Only insomnia symptoms (OR, 15.74; 95% CI, 1.73-143.30; p < 0.01) significantly predicted SRMP, uniquely explaining 12% of the variance. Insomnia accounted for 18.8% of the association between cardiac issues and SRMP, demonstrating mediation (Sobel p < 0.05). The large CI is a consequence of analyzing a sub-group of a subpopulation. Among participants without a cancer history, cardiovascular disease and insomnia were not associated with SRMP (p > 0.05). LIMITATIONS We could not determine severity and time-related changes in SRMP. CONCLUSION Likelihood of SRMP was higher in cancer survivors with a history of cardiovascular disease and insomnia symptoms. Future studies are needed to delineate the cardiac-insomnia-memory interrelationships.

Experience with IL-2 in metastatic renal cell carcinoma after treatment with one or more targeted therapies.

622 Background: Over half of patients (pts) diagnosed with Renal Cell Carcinoma require systemic therapy for metastatic disease (mRCC). Approved first line treatment includes immunotherapy and targeted therapy (TT). TT is commonly used given its efficacy, favorable side effect profile, and convenience of oral administration. High dose IL-2 (HD-IL2) can induce durable long term remissions in a subset of pts. There is limited data on the efficacy of HD-IL2 after disease progression on TT. Methods: All pts treated with HD-IL2 for mRCC from 2008-2014 were reviewed. A focused analysis was performed on pts who received HD-IL2 after first-line TT. Three pts were excluded from analysis. Data regarding pt demographics, health status, disease related characteristics, prognostic factors, treatment history and toxicity were captured. Response to HD-IL2 was also classified using RECIST definition. Utilizing descriptive statistics, we examined response rates, toxicities, and outcomes in this subset of pts. Results: Eig...

Prevalence of atypical urine cytology in patients treated with gemcitabine-cisplatin (GC) for urothelial carcinoma (UC).

363 Background: The prevalence of atypical urothelial cells (AUC) in the general population is estimated to range between 2-23% with known variability between individual pathologists’ use of this diagnosis. At our institution, the AUC rate for all urinary tract cytology (UTC) is 6.1%. Increased rates of urothelial atypia have been described in pts receiving certain systemic and intravesical therapies for UC. This may confound the use of UTC for post-therapy surveillance. Our objective is to describe the prevalence of urothelial atypia in pts treated with GC, as it is currently unknown. Methods: Patients who received at least one cycle of GC for UC at a single institution from 1/1/2007-9/30/2014 were identified. Demographics, clinical characteristics, treatment setting, number of cycles, and specimen type were recorded. Urine cytology reports were reviewed and tabulated. Results: Seventy-four pts treated with GC were identified. Median age at treatment was 65 (range 42-80); 58 (78%) were male. Median numbe...

Abstract B20: Self-reported memory problems in adult-onset cancer survivors in the United States: Effects of cardiac complications, short sleep duration, and general health

Background: Memory impairments are debilitating adverse effects of malignant tumors and their various treatments. Factors such as cardiac complications and sleep loss/impairment can exacerbate memory problems for cancer patients and survivors. We examined the relationships among history of cardiac complications, short sleep duration, and self-reported memory problems (SRMP) in adult-onset cancer survivors. Methods: We included data from middle-aged (41 to 64 years) participants who completed the 2007-2008 National Health and Nutrition Examination Survey (NHANES), a nationally representative, stratified, multistage probability sample of the civilian, non-institutionalized population of the United States. We excluded participants with a history of brain cancer or stroke since these conditions are expected to cause cognitive problems because of direct insults to the brain. Using binary a logistic regression, we determined the prevalence of SRMP in cancer survivors relative to cardiac complications and short sleep duration ( Results: The sample included 2,289 adults (49% female). There were 46% Whites, 20% Blacks, 29% Hispanics, and 4% Asian/other. A total of 9% of the sample were cancer survivors. Cardiac complications (Odds ratio (OR), 6.97, p 0.05). Conclusion: The likelihood of SRMP is higher in cancer survivors with a history of cardiac complications or short sleep duration. Future studies are needed to systematically delineate the cardiac-sleep-memory relationships, which could inform the development of reliable assessment and intervention to mitigate memory impairments and sleep problems for cancer survivors. Citation Format: Pascal Jean-Pierre, Michael Grandner, Elizabeth Henry. Self-reported memory problems in adult-onset cancer survivors in the United States: Effects of cardiac complications, short sleep duration, and general health. [abstract]. In: Proceedings of the Twelfth Annual AACR International Conference on Frontiers in Cancer Prevention Research; 2013 Oct 27-30; National Harbor, MD. Philadelphia (PA): AACR; Can Prev Res 2013;6(11 Suppl): Abstract nr B20.