Caroline Susan Dorfman

• PhD
• Professor (Assistant) at Duke University Medical Center

Adolescent and young adult (AYA) cancer survivors often search online for information about cancer-related sexual and reproductive health concerns. A review of the websites of National Cancer Institute-designated cancer centers (n = 9) and comprehensive cancer centers (n = 58) was conducted to identify the presence of AYA-specific sexual and reprod...

This study aimed to characterize unmet reproductive health needs of female young adult survivors of childhood cancer (YASCC), as understood by oncology providers (N = 10) caring for this patient population. Providers completed brief online questionnaires and a one-time semi-structured interview. Descriptive statistics characterized quantitative dat...

Background Young adult (YA) cancer survivors are a growing, yet underserved population who often face significant and long-lasting cancer-related physical (e.g., pain, fatigue) and emotional (e.g., psychological distress) symptoms. Post-treatment symptoms can persist, disrupting YA’s abilities to complete goals consistent with their developmental s...

Female survivors of young adult (YA) cancers are at risk of fertility impacts following cancer treatment. For these women, fertility-related distress is both prevalent and persistent. Yet there is little research regarding survivors' perspectives on alternative family-building options, particularly adoption. This exploratory secondary data analysis...

Purpose: To examine the impact of financial costs on fertility preservation decisions among female young adults (YAs) with cancer. Methods: Female YAs (N = 18; aged 21-36) with a history of cancer and oncology providers (N = 12) were recruited from an National Cancer Institute-designated comprehensive cancer center in a state without insurance cove...

Purpose Overweight and obesity are common for breast cancer survivors and associated with high symptom burden (i.e., pain, fatigue, depressive symptoms). Physical activity may protect breast cancer survivors with higher body mass indexes (BMI) from increased symptoms. However, the role of physical activity in buffering the relationship between high...

Purpose: Adolescents and young adult (AYA) cancer survivors (15-39 years at diagnosis) are at risk for treatment-related late effects but face barriers in accessing survivorship care. We examined the prevalence of five health care access (HCA) barriers: affordability, accessibility, availability, accommodation, and acceptability. Methods: We identi...

Background: Colorectal cancer (CRC) patients in early to mid-adulthood (≤50 years) are challenged by high symptom burden (i.e., pain, fatigue, distress) and age-related stressors (e.g., managing family, work). Cognitive behavioral theory (CBT)-based coping skills training interventions reduce symptoms and improve quality of life in cancer patients...

Objective Research on burnout among physical therapists and occupational therapists in the context of the coronavirus disease 2019 (COVID-19) pandemic is limited. Resilience may be important for reducing burnout and promoting well-being among rehabilitation specialists, especially during periods of elevated occupational demand and stress. The purpo...

Purpose: Improved symptom management is a critical although unmet post-treatment need for young adult (YA) cancer survivors (aged 18-39 at diagnosis). This study aimed to develop and refine a behavioral symptom management intervention for YA survivors. Methods: Phase I: YA survivors (N = 21) and oncology providers (N = 11) completed individual inte...

Background: Weight gain is common for breast cancer survivors and associated with disease progression, recurrence, and mortality. Traditional behavioral programs fail to address symptoms (i.e., pain, fatigue, distress) experienced by breast cancer survivors that may interfere with weight loss and fail to capitalize on the concordance in weight-rel...

Purpose: Effective communication between young adult (YA; aged 18-39 years) cancer survivors and their health care providers is critical for managing post-treatment symptoms. Yet, little is known about YAs' and providers' preferences for and barriers to symptom communication, variables important for developing interventions to improve and optimize...

Background: Obesity is associated with poor outcomes for patients with rheumatoid arthritis (RA). Effective weight management is imperative. Although traditional lifestyle behavioral weight loss programs have demonstrated efficacy for reducing weight, these interventions do not meet the pain-related weight loss challenges of RA patients with obesi...

Background: Infertility is a common late effect for cancer survivors. Whereas assisted reproductive technology has made it possible for survivors to take steps to preserve fertility before starting treatment, only a minority of patients proceed with preservation. Patient-, provider-, health system-, and societal-level barriers to fertility preserv...

A small but significant portion of breast cancer survivors will meet diagnostic criteria for anxiety and depressive disorders. Oncology providers’ awareness of patients’ symptoms is critical for ensuring appropriate follow-up. Routine symptom assessment with well-validated measures is recommended. Patients with symptoms in the moderate to severe ra...

Sexual and reproductive health are important and valued aspects of a woman’s health and well-being and can be profoundly impacted by breast cancer diagnosis and treatments. For breast cancer survivors, sexual and reproductive health changes are associated with significant emotional distress and often negatively impact women’s emotional well-being,...

Objective Provide an overview of sexual dysfunction in female urologic cancer patients, approaches for assessing sexual problems, and interventions to treat sexual dysfunction in this patient population. Methods A review of the literature in urologic oncology was conducted. Research on other female pelvic cancers with similar treatments was also r...

Objective There is a need for oncology mental health providers to receive training to use empirically supported psychological treatments (ESTs) with their patients. The purpose of this editorial is to describe “lessons learned” from disseminating–conducting EST trainings–and supporting providers' capacity and confidence to use the EST. Method Proc...

Cognitive and behavioral interventions are effective in treating mood and anxiety disorders in patients with cancer. Screening for disorders is more common, but referral (and uptake) of psychosocial services remains low relative to patient need. Efficacious, cognitive behavioral treatments (CBTs) are first-line treatments for adults with major depr...

Breast cancer survivors with type 2 diabetes are at high risk for cancer recurrence, serious health complications, more severe symptoms, psychological distress, and premature death relative to breast cancer survivors without diabetes. Maintaining glycemic control is critical for decreasing symptoms and preventing serious health problems. Many breas...

Objective Behavioral cancer pain interventions are efficacious for improving important pain outcomes; yet, traditional in‐person delivery limits patient access. This study compared videoconference‐delivered Pain Coping Skills Training (mPCST) to in‐person Pain Coping Skills Training (PCST‐traditional). Methods This study was a randomized, noninfer...

Objective: Past studies indicate that >90% of breast cancer survivors taking adjuvant endocrine therapy (AET) experience menopausal symptoms including sexual problems (eg, vaginal dryness, dyspareunia); however, research examining the impact of these problems on quality-of-life is limited. This cross-sectional study examined (1) the impact of sexu...

First-degree relatives of women with breast cancer may experience increased worry or perceived risk when faced with reminders of their own cancer risk. Worry and risk reminders may include physical symptoms (e.g., persistent breast pain) and caregiving experiences. Women who engage in pain catastrophizing may be particularly likely to experience in...

The purpose of this study was to refine and test a mobile-health behavioral cancer pain coping skills training protocol for women with breast cancer and pain from medically underserved areas. Three focus groups (Phase 1) were used to refine the initial protocol. A single-arm pilot trial (Phase 2) was conducted to assess feasibility, acceptability,...

Adjuvant endocrine therapy (AET) is used to prevent recurrence and reduce mortality for women with hormone receptor positive breast cancer. Poor adherence to AET is a significant problem and contributes to increased medical costs and mortality. A variety of problematic symptoms associated with AET are related to non-adherence and early discontinuat...

Purpose: Pain is common for hematopoietic stem cell transplant (HSCT) patients and may be experienced pre-transplant, acutely post-transplant, and for months or years following transplant. HSCT patients with persistent pain may be at risk for poor quality of life following transplant; however, the impact of pre-transplant pain on quality of life p...

Background: Pain is a challenge for patients following hematopoietic stem cell transplantation (HCT). Objective: This study aimed to develop and test the feasibility, acceptability, and initial efficacy of a Web-based mobile pain coping skills training (mPCST) protocol designed to address the needs of HCT patients. Methods: Participants had un...

Purpose: Evidence suggests open communication about breast cancer concerns promotes psychological adjustment, while holding back can lead to negative outcomes. Little is known about the relationship between communication and distress following breast biopsy. Design/ Sample: Women (N = 128) were assessed at the time of breast biopsy and again one we...

Background/aims: Pain is common in cancer patients and results in lower quality of life, depression, poor physical functioning, financial difficulty, and decreased survival time. Behavioral pain interventions are effective and nonpharmacologic. Traditional randomized controlled trials (RCT) test interventions of fixed time and dose, which poorly r...

Cognitive problems are a significant, persistent concern for patients undergoing hematopoietic stem cell transplant (HSCT). Sleep is important for many cognitive tasks; however, the relationship between sleep and cognitive problems for HSCT patients is unknown. This study examined the relationship between sleep and cognitive problems for HSCT patie...

Positive and negative mood are independent psychological responses to stressful events. Negative mood negatively impacts well-being and co-occurring positive mood leads to improved adjustment. Women undergoing core needle breast biopsies (CNB) experience distress during CNB and awaiting results; however, influences of mood are not well known. This...

Background: In psycho-oncology care, steps toward dissemination and implementation of evidence-based treatments (EBTs) have not been made. For this to change, factors associated with real-world dissemination and implementation must be identified. In the community, providers, their organizations, and patients are key stakeholders. Method: A focus...

Sickle cell disease (SCD) is an understudied chronic condition that produces elevated pain and distress. Despite known benefits of social support for chronic illness, there has been minimal research on how social support may affect adjustment among SCD patients. In a sample of 181 adults with SCD, an exploratory study was conducted to examine th...

Guidelines for screening for depression and anxiety issused by the American Society of Clinical Oncology, as well as the new patient-centered standards for accreditation of cancer clinics and hospitals put forth by the Commission on Cancer of the American College of Surgeons, provide the means and the incentive for identifying and providing treatme...

Objective: Psychological interventions can attenuate distress and enhance coping for those with an initial diagnosis of cancer, but there are few intervention options for individuals with cancer recurrence. To address this gap, we developed and tested a novel treatment combining Mindfulness, Hope Therapy, and biobehavioral components. Method: An...

Objective: Social support and hope are considered positive, important contributors to psychological well-being for women with breast cancer and their spouses. Few studies examine the role of age in relation to these variables. The current study compares the relationship between social support, hope and depression among different age groups of wome...

In contrast to the large literature on patients' coping with an initial diagnosis of cancer, there have been few quantitative or qualitative studies of patients coping with recurrence. A qualitative study was undertaken to aid in the development of a tailored intervention for these patients. Individuals (N=35) receiving follow-up care for recurrent...

Objective: Screening asymptomatic men for prostate cancer is controversial and informed decision making is recommended. Within two prostate cancer screening programs, we evaluated the impact of a print-based decision aid (DA) on decision-making outcomes. Methods: Men (N=543) were 54.9 (SD=8.1) years old and 61% were African-American. The 2(bookl...

Background The impact of lung cancer screening on smoking behavior is unclear. The aims of this ancillary study of the Prostate Lung Colorectal and Ovarian Cancer Screening Trial were to produce risk prediction models to identify individuals at risk of relapse or continued smoking and to evaluate whether cancer-screening variables affect long-term...

Spouses of cancer patients are at-risk for poor psychological and physical health as they cope with the complex nature of the disease and fears of losing their partner. Moreover, spouses often serve as patients' primary informal caregivers, a group that evidences poor outcomes across a variety of domains. The present study examines the relative con...

Shared decision making (SDM) for prostate cancer screening (PCS) is recommended for physicians and patients due to the uncertainty regarding the risks and benefits of screening. We assessed primary care physicians' attitudes and specific factors that may influence the SDM process, including level of training and practice setting. Participants inclu...

Appendix A. Outcomes of Randomized Controlled Trials of Prostate Cancer Screening Decision Aids

Supp File 3. Pilot Screening and Internet Usage Questionnaire-Feasibility Study 2 - June 2006

Supp File 2. Pilot Screening and Internet Usage Questionnaire-Feasibility Study 1 - January 2005

Supp File 5. Website Usability Testing Questionnaire

Supp File 4. Booklet Usability Testing Questionnaire

Whether early detection and treatment of prostate cancer (PCa) will reduce disease-related mortality remains uncertain. As a result, tools are needed to facilitate informed decision making. While there have been several decision aids (DAs) developed and tested, very few have included an exercise to help men clarify their values and preferences abou...

Screening asymptomatic men for prostate cancer (PCa) continues to be controversial: whether early diagnosis and treatment of PCa results in reduced disease-related mortality has not yet been demonstrated in a randomized trial. The primary question is whether PCa screening results in overdiagnosis, the detection and treatment of disease that would n...

Molecules that govern the formation, integrity, and function of the hippocampus remain an important area of investigation. Here we show that absence of the proneuropeptide processing enzyme, carboxypeptidase E (CPE) in CPE knock-out (KO) mice had a profound effect on memory, synaptic physiology, and the cytoarchitecture of the hippocampus in these...