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Sarcopenia in lung cancer
S238 living in an island community [OR 1.32; CI 1.09e1.59] predicted timely treatment (treatment within 62 days of GP referral). Increased travelling time to treatment centre >30 minutes on the mainland was associated with reduced survival to one year (30e59 minutes [OR 0.70; 95%CI 0.59e0.86], >60 minutes [OR 0.80; 95%CI 0.67e0.96]). Living in an island community did not have an association with survival. Conclusion: Living in an island community or having travelling time on the mainland of greater than 60 minutes to a cancer treatment centre is associated with timely treatment. However, survival at one year is less likely in those on the mainland with a travelling time greater than 30 minutes. http://dx.doi.org/10.1016/j.ejso.2016.07.084
229. Sarcopenia in lung cancer Iain Phillips1, John Tenny1, Lucinda Gunn1, Kofi Nimako2, Adele Hug1, Lindsey Allan1, Veni Ezhil1 1 Royal Surrey County Hospital, UK 2 East Surrey Hospital, UK Background: Cancer cachexia (loss of muscle mass) is an adverse effect of many common cancers. The presence of refractory (irreversible) cachexia is associated with a very poor overall survival. Sarcopenia (muscle loss) is a feature of cachexia and can be assessed on CT imaging. Cross sectional measurement of the psoas muscle is an accurate, quick and inexpensive assessment of sarcopenia. Sarcopenia is associated with a poor prognosis in Small Cell Lung Cancer. This has not been previously shown in Non Small Cell Lung Cancer (NSCLC). We show the relationship between sarcopenia and overall survival in NSCLC. Method: Data was collected from an MDT between July 2012 and December 2013. Anterior-posterior and lateral measurements of greatest diameter of psoas muscle was made at level of L3 through the transverse processes from the diagnostic CT. Left and right psoas muscle measurements were taken and standardised for height. Psoas area (in mm)/height (m). Sarcopenia defined as <385mm/m2 in females and <585mm/m2 in males. Results: 90 patients were identified retrospectively with appropriate imaging. Cohort was 54% male and 46% female. Mean age 67 years (range 46e85). Of 56 patients with radically treatable cancer (stage IeIIIa + T4N2M0), 24 patients (43%) had sarcopenia at diagnosis. Of 31 patients with incurable lung cancer (stage IIIb + IV excludingT4N2M0), 15 had sarcopenia at diagnosis. Median survival of non-sarcopenic patients was 14 months. Median survival of sarcopenic patients was 12 months (p ¼ 0.2218). Conclusion: Sarcopenia is common in patients with NSCLC. Sarcopenia assessment using cross sectional measurements of psoas muscle is quick and easy. The presence of radiological sarcopenia may correlate with a poorer overall survival in NSCLC, but did not reach statistical significance. Sarcopenia requires further investigation and will be investigated in a prospective clinical trial, the NAIL trial (Nutrition Assessment and Intervention in Lung Cancer). http://dx.doi.org/10.1016/j.ejso.2016.07.085
255. Cancer stigma among ethnic minority women Laura Marlow, Charlotte Vrinten, Jo Waller University College of London, UK Background: Qualitative research with ethnic minority groups often finds that participants feel cancer is stigmatised or ‘taboo’. Cancer stigma has also been shown to influence engagement with cancer prevention/early detection behaviours particularly in some ethnic minority groups. To date there have been few studies attempting to quantify perceptions of stigma in ethnic minority populations. We aimed to explore differences in cancer
ABSTRACTS stigma in a sample of ethnic minority women and the association between cancer stigma and attendance at cervical screening. Method: Women aged 30e60 years were recruited from Indian, Pakistani, Bangladeshi, Caribbean, African and white British backgrounds (n ¼ 720, response rate ¼ 65%). Participants completed face-to-face interviews with a multi-lingual interviewer. We assessed socio-demographics, self-reported cervical screening attendance, and four dimensions of cancer stigma: personal responsibility, awkwardness, avoidance and communitylevel stigma. Results: There were significant differences by ethnic group for each of the four stigma dimensions (p < .001 for each), with White British women scoring lowest on each. Differences on individual items were striking, for example <5% of Bangladeshi and Pakistani women believed cancer was talked about openly in their community compared to 97% of White British women. Across all ethnic groups, personal responsibility, awkwardness and avoidance scores were significantly lower among those born in the UK, but there were no differences in community stigma. Cancer stigma was significantly associated with increased odds of non-attendance for cervical screening. This was the case for community stigma (OR ¼ 1.09), personal responsibility (OR ¼ 1.12), awkwardness (OR ¼ 1.12) and avoidance (OR ¼ 1.15). Odds ratios were small but highly significant (p < .001). Conclusion: While low in the general population, cancer stigma is prevalent in ethnic minority groups, even among the younger generation, and is associated with cervical screening status. Interventions to tackle stigma in ethnic minority populations could be a first step to addressing ethnic inequalities in cancer awareness and preventive behaviours. http://dx.doi.org/10.1016/j.ejso.2016.07.086
264. The meaning of the term ‘breast cancer survivor’ for young women living with a history of breast cancer in the UK Sophie Rees University of Warwick, UK Background: Despite its usage, ‘cancer survivor’ remains a contested term as not only is there is a lack of consensus over the exact definition and meaning, but there have been strong critiques of ‘survivorship’ by scholars and activists. A recent turn to researching how individuals who have or have had cancer perceive the term ‘cancer survivor’ has had mixed findings. Some people embrace the term, but there are many who do not feel it fits with their own experience, and who resist it. Most existing research has been conducted outside of the UK. Method: Twenty women diagnosed with breast cancer under the age of 45 took part in semi-structured interviews, and, among other topics, their perceptions of the term ‘breast cancer survivor’ were explored. Social constructionist grounded theory methods were used in order to develop an understanding grounded in the worldviews of the participants. Results: Only 3 of the twenty women interviewed said they would use ‘survivor’ to describe themselves and many held negative views about the identity in relation to themselves. Reasons for rejecting it included not feeling close enough to death, the fear of recurrence, and the obfuscating of cancer’s ongoing presence in their lives. At the end of curative breast cancer treatment, most young women found themselves in a ‘liminal’ state e neither patients nor survivors e and, therefore, found that the term did not resonate with their experiences. Conclusion: The term ‘cancer survivor’ may not be appropriate for many young women living with a history of breast cancer for a number of reasons, including that it obscures the long-term and uncertain impact on their lives. Being labelled a ‘survivor’ can be a disempowering experience. Further research is needed but this small study troubles the use of the term in everyday usage to refer to this population. http://dx.doi.org/10.1016/j.ejso.2016.07.087
229. Sarcopenia in lung cancer Iain Phillips1, John Tenny1, Lucinda Gunn1, Kofi Nimako2, Adele Hug1, Lindsey Allan1, Veni Ezhil1 1 Royal Surrey County Hospital, UK 2 East Surrey Hospital, UK Background: Cancer cachexia (loss of muscle mass) is an adverse effect of many common cancers. The presence of refractory (irreversible) cachexia is associated with a very poor overall survival. Sarcopenia (muscle loss) is a feature of cachexia and can be assessed on CT imaging. Cross sectional measurement of the psoas muscle is an accurate, quick and inexpensive assessment of sarcopenia. Sarcopenia is associated with a poor prognosis in Small Cell Lung Cancer. This has not been previously shown in Non Small Cell Lung Cancer (NSCLC). We show the relationship between sarcopenia and overall survival in NSCLC. Method: Data was collected from an MDT between July 2012 and December 2013. Anterior-posterior and lateral measurements of greatest diameter of psoas muscle was made at level of L3 through the transverse processes from the diagnostic CT. Left and right psoas muscle measurements were taken and standardised for height. Psoas area (in mm)/height (m). Sarcopenia defined as <385mm/m2 in females and <585mm/m2 in males. Results: 90 patients were identified retrospectively with appropriate imaging. Cohort was 54% male and 46% female. Mean age 67 years (range 46e85). Of 56 patients with radically treatable cancer (stage IeIIIa + T4N2M0), 24 patients (43%) had sarcopenia at diagnosis. Of 31 patients with incurable lung cancer (stage IIIb + IV excludingT4N2M0), 15 had sarcopenia at diagnosis. Median survival of non-sarcopenic patients was 14 months. Median survival of sarcopenic patients was 12 months (p ¼ 0.2218). Conclusion: Sarcopenia is common in patients with NSCLC. Sarcopenia assessment using cross sectional measurements of psoas muscle is quick and easy. The presence of radiological sarcopenia may correlate with a poorer overall survival in NSCLC, but did not reach statistical significance. Sarcopenia requires further investigation and will be investigated in a prospective clinical trial, the NAIL trial (Nutrition Assessment and Intervention in Lung Cancer). http://dx.doi.org/10.1016/j.ejso.2016.07.085
255. Cancer stigma among ethnic minority women Laura Marlow, Charlotte Vrinten, Jo Waller University College of London, UK Background: Qualitative research with ethnic minority groups often finds that participants feel cancer is stigmatised or ‘taboo’. Cancer stigma has also been shown to influence engagement with cancer prevention/early detection behaviours particularly in some ethnic minority groups. To date there have been few studies attempting to quantify perceptions of stigma in ethnic minority populations. We aimed to explore differences in cancer
ABSTRACTS stigma in a sample of ethnic minority women and the association between cancer stigma and attendance at cervical screening. Method: Women aged 30e60 years were recruited from Indian, Pakistani, Bangladeshi, Caribbean, African and white British backgrounds (n ¼ 720, response rate ¼ 65%). Participants completed face-to-face interviews with a multi-lingual interviewer. We assessed socio-demographics, self-reported cervical screening attendance, and four dimensions of cancer stigma: personal responsibility, awkwardness, avoidance and communitylevel stigma. Results: There were significant differences by ethnic group for each of the four stigma dimensions (p < .001 for each), with White British women scoring lowest on each. Differences on individual items were striking, for example <5% of Bangladeshi and Pakistani women believed cancer was talked about openly in their community compared to 97% of White British women. Across all ethnic groups, personal responsibility, awkwardness and avoidance scores were significantly lower among those born in the UK, but there were no differences in community stigma. Cancer stigma was significantly associated with increased odds of non-attendance for cervical screening. This was the case for community stigma (OR ¼ 1.09), personal responsibility (OR ¼ 1.12), awkwardness (OR ¼ 1.12) and avoidance (OR ¼ 1.15). Odds ratios were small but highly significant (p < .001). Conclusion: While low in the general population, cancer stigma is prevalent in ethnic minority groups, even among the younger generation, and is associated with cervical screening status. Interventions to tackle stigma in ethnic minority populations could be a first step to addressing ethnic inequalities in cancer awareness and preventive behaviours. http://dx.doi.org/10.1016/j.ejso.2016.07.086
264. The meaning of the term ‘breast cancer survivor’ for young women living with a history of breast cancer in the UK Sophie Rees University of Warwick, UK Background: Despite its usage, ‘cancer survivor’ remains a contested term as not only is there is a lack of consensus over the exact definition and meaning, but there have been strong critiques of ‘survivorship’ by scholars and activists. A recent turn to researching how individuals who have or have had cancer perceive the term ‘cancer survivor’ has had mixed findings. Some people embrace the term, but there are many who do not feel it fits with their own experience, and who resist it. Most existing research has been conducted outside of the UK. Method: Twenty women diagnosed with breast cancer under the age of 45 took part in semi-structured interviews, and, among other topics, their perceptions of the term ‘breast cancer survivor’ were explored. Social constructionist grounded theory methods were used in order to develop an understanding grounded in the worldviews of the participants. Results: Only 3 of the twenty women interviewed said they would use ‘survivor’ to describe themselves and many held negative views about the identity in relation to themselves. Reasons for rejecting it included not feeling close enough to death, the fear of recurrence, and the obfuscating of cancer’s ongoing presence in their lives. At the end of curative breast cancer treatment, most young women found themselves in a ‘liminal’ state e neither patients nor survivors e and, therefore, found that the term did not resonate with their experiences. Conclusion: The term ‘cancer survivor’ may not be appropriate for many young women living with a history of breast cancer for a number of reasons, including that it obscures the long-term and uncertain impact on their lives. Being labelled a ‘survivor’ can be a disempowering experience. Further research is needed but this small study troubles the use of the term in everyday usage to refer to this population. http://dx.doi.org/10.1016/j.ejso.2016.07.087