Kathleen Lynch

Memorial Sloan Kettering Cancer Center | MSKCC · Memorial Hospital Research

PURPOSE Mastectomy without reconstruction is recommended for most Nigerian women with non-metastatic breast cancer (BC), but only 43% receive surgery, partly due to psychosocial factors. Patient-reported outcome measures (PROMs) are valuable tools for improving patient-centered care. BREAST-Q is a validated PROM for evaluating satisfaction and heal...

PURPOSE The Nigerian Federal Ministry of Health (FMOH) endorses National Comprehensive Cancer Network (NCCN) Harmonized Guidelines for sub-Saharan Africa (SSA) for breast cancer (BC), which were developed with the African Cancer Coalition and resource adapted for SSA. The FMOH advocates for multi-disciplinary tumor boards. This research aimed to be...

Objective To explore the gaps in the safe handling, administration, preparation and disposal of chemotherapy agents in low and middle-income countries. Design Two surveys comprising a needs assessment survey and an American Cancer Society (ACS) ChemoSafe Facility Assessment. Setting 2019 African Research Group for Oncology Symposium in South-West...

e13782 Background: Breast cancer [BC] is the leading cause of cancer incidence and mortality in Nigerian women, with five-year survival of 44% vs. 90% in the US. The World Health Organization [WHO], through the Global Breast Cancer Initiative [GBCI], endorses a 3-pillar program that promotes early-stage detection, timely diagnosis, and expeditious...

Background The majority of non-metastatic breast cancer patients in sub-Saharan Africa are recommended to have mastectomy. The impact of mastectomy on a predominantly young African patient population requires evaluation. The BREAST-Q is a validated patient-reported outcome measure of quality-of-life following breast surgery that has been translated...

Purpose: There is an urgent need to address the growing global cancer burden in the context of complex disaster events, which both disrupt access to oncology care and facilitate carcinogenic exposures. Older adults (65 years and older) are a growing population with multifaceted care needs, making them especially vulnerable to disasters. The object...

Introduction Patient-reported outcome measures that were initially designed for research studies including heterosexual, partnered, educated cisgender women may have limited applicability for clinical use among Sexual and Gender Minority (SGM) patients and patients without a partner. Objective We aimed to conduct cognitive interviews with both SGM...

Background: Patient-reported outcome measures for sexual health were often designed for research studies that included only heterosexual, partnered, and cisgender participants; as such, they may have limited applicability for clinical use among sexual and gender minority (SGM) individuals or those without a partner. Aim: We aimed to conduct cogn...

Purpose To determine whether treatment of anal high-grade squamous intraepithelial lesions (HSIL), vs active monitoring, is effective in reducing incidence of anal cancer in persons living with HIV, the US National Cancer Institute funded the Phase III ANal Cancer/HSIL Outcomes Research (ANCHOR) clinical trial. As no established patient-reported ou...

Purpose. To evaluate patient perceptions of a Web-based decision aid for the treatment of localized prostate cancer. Methods. We assessed patient perceptions of a multicomponent, Web-based decision aid with a preference elicitation/values clarification exercise using adaptive conjoint analysis, the generation of a summary report, and provision of i...

Background: The importance of deriving benefit and meaning has been identified among cancer caregivers, but this has yet to be examined in the context of rare cancers. We sought to characterize unmet needs and experiences of caregivers of patients with Erdheim-Chester disease (ECD) and other histiocytic neoplasms (HN) and to identify factors associ...

Objectives: The Anal Cancer High-grade squamous intraepithelial lesions (HSIL) Outcomes Research (ANCHOR) Health-Related Symptom Index (A-HRSI) is a 25-item measure that assesses physical symptoms and impacts, and psychological symptoms. To promote generalizability and equity in the capture of these concepts in Spanish-speaking participants, we li...

Community-based organizations (CBOs) play a key role in assisting local communities, especially those in under-resourced areas, through their deep knowledge of the community’s needs and available resources. We examined perceptions of COVID-19’s impact on health-related services in CBOs located in Upper Manhattan, New York City (serving East Harlem,...

Background There is widespread agreement that the integration of cessation services in lung cancer screening (LCS) is essential for achieving the full benefits of LCS with low-dose computed tomography (LDCT). There is a formidable knowledge gap about how to best design feasible, effective, and scalable cessation services in LCS facilities. A collec...

Caregivers of patients with glioblastoma multiforme (GBM) are at significant risk for existential distress. Such distress negatively impacts caregivers’ quality of life and capacity to serve in their role as healthcare proxies, and ultimately, contributes to poor bereavement outcomes. Our team developed Meaning-Centered Psychotherapy for Cancer Car...

New York City was a “global COVID-19 hotspot” in spring 2020. Many health teams rapidly transitioned to telehealth platforms. Little is known about the experiences of inpatient palliative care services who delivered telehealth services during the pandemic. This study was aimed to explore the experiences of an interdisciplinary palliative care team...

Introduction: We aimed to assess contouring-related practices among US radiation oncologists and explore how access to and use of resources and quality improvement strategies vary based on individual- and organization-level factors. Methods: We conducted a mixed methods study with a sequential explanatory design. Surveys were emailed to a random...

Aim: To elicit oncology nurse leaders' perceptions and experiences of accessing, using, and interpreting report data at the unit level, and their suggestions for future reports. Background: Nurse leaders are expected to use data reports for decisions about unit-level operations, yet data may be inaccessible, unavailable, and lack relevance for i...

Background: The COVID-19 pandemic has led to the rapid expansion of telehealth service delivery. We explored the experiences of a multidisciplinary palliative care team delivering telepalliative care for oncology inpatients during a 10-weeks COVID-19 surge in New York City. Methods/participants: We conducted semi-structured qualitative interview...

Background: Technology acceptability and usage surveys (TAUS) are brief questionnaires that measure technology comfort, typical daily use, and access in a population. However, current measures are not adapted to low- and middle-income country (LMIC) contexts. Objective: The objective of this pilot study was to develop a TAUS that could be used t...

Background Advance care planning, the process through which patient values and goals are explored and documented, is a core quality indicator in cancer care. However, patient values are predominantly elicited at the end of life; patient values earlier in serious illness are not clearly delineated. The objective of this analysis is to assess the con...

Objective To characterize lung cancer patients' reactions to cancer care providers' (CCPs) assessment of smoking behavior and to develop recommendations to reduce stigma and improve patient-clinician communication about smoking in the context of lung cancer care. Methods Semi-structured interviews with 56 lung cancer patients (Study 1) and focus g...

Introduction Hispanics are the largest minority group in the United States, constituting 18 % of the population. Mexicans are the largest Hispanic subgroup and are at disproportionate risk for overweight/obesity. Lifestyle interventions targeting dietary change and physical activity have resulted in significant weight loss in several large randomiz...

Adolescents and young adults (AYAs) require a multidisciplinary approach to cancer care due to their complex biopsychosocial situations and varied developmental maturity. Currently, age and diagnosis determine referral to pediatric or adult oncology, with differing treatment paradigms and service utilization patterns, contributing to suboptimal imp...

Objective: Caregivers of patients with cancer are at significant risk for existential distress. Such distress negatively impacts caregivers' quality of life and capacity to serve in their role as healthcare proxies, and ultimately, contributes to poor bereavement outcomes. Our team developed Meaning-Centered Psychotherapy for Cancer Caregivers (MC...

Background: High levels of moral distress in nursing professionals, of which oncology nurses are particularly prone, can negatively impact patient care, job satisfaction, and retention. Aim: "Positive Attitudes Striving to Rejuvenate You: PASTRY" was developed at a tertiary cancer center to reduce the burden of moral distress among oncology nurs...

Objective Among patients living with advanced, life-limiting illness, reconciling the prospect of disease progression with future goals and expectations is a key psychological task, integral to treatment decision-making and emotional well-being. To-date, this psychological process remains poorly understood with no available measurement tools. The p...

PURPOSE The COVID-19 pandemic surge in New York City in Spring 2020 resulted in an unprecedented constraint on health care resources. This study aimed to explore the experiences of doctors providing care to oncology patients during this time. METHODS Hospitalists and medical oncologists from two large inpatient services at a dedicated cancer cente...

Background There is widespread agreement that integration of cessation services in lung cancer screening (LCS) is essential for achieving the full benefits of LCS with low-dose computed tomography (LDCT). There is a formidable knowledge gap about how to best design feasible, effective and scalable cessation services in LCS facilities. A collective...

Aim: To describe patient communication challenges encountered by oncology clinicians, which represent a fundamental barrier to implementing precision oncology. Materials & methods: We conducted three focus groups including breast, melanoma and thoracic oncology clinicians regarding their precision oncology communication experiences. Transcripts wer...

BACKGROUND Technology acceptability and usage surveys (TAUS) are brief questionnaires that measure technology comfort, typical daily use, and access in a population. However, current measures are not adapted to low- and middle-income country (LMIC) contexts. OBJECTIVE The objective of this pilot study was to develop a TAUS that could be used to in...

249 Background: The objective of this study was to assess contouring-related quality improvement practices employed by radiation oncologists in the United States (US) and to identify individual and organizational factors associated with use. Methods: We conducted a mixed methods study with a sequential explanatory design. A survey was developed wit...

Background Patient-reported outcome instruments to assess sexual functioning typically assume that patients are heterosexual and have a single sexual partner, thus they may have limited applicability for sexual and gender minority (SGM) populations as well as for nonpartnered individuals or those with multiple partners. Aim To explore the percepti...

Background Engagement in physical activity (PA) post-treatment can improve health outcomes and quality of life among cancer survivors. The purpose of this study is to explore United States (US) older adult cancer survivors’ (OACS) reasons for engaging in group-based PA classes, to identify themes supporting exercise motivations in the context of ca...

Context: Depressive symptoms are prevalent and associated with greater healthcare utilization among hospitalized adults with cancer. Music therapy and massage therapy are available at many National Cancer Institute (NCI)-Designated Cancer Centers and recommended by the American Society of Clinical Oncology for depressive symptoms, but a paucity of...

Purpose/Objective(s): We aimed to develop and study the implementation of a remote system for toxicity assessment and management of acute breast radiation side effects using electronic patient-reported outcomes (ePROs). Materials/Methods: A response-adapted PRO-CTCAE-based assessment for breast radiation toxicity was administered weekly during and...

1585 Background: Despite growing evidence of mind-body therapies for physical and psychological health among patients with cancer, their access remains limited. The COVID-19 pandemic has further disrupted the delivery of necessary cancer and supportive care; thus, the need to support patients with cancer is unprecedented. To expand the reach and ac...

Social scientists have advocated for the use of participatory research methods for Global Health project design and planning. However, community-engaged approaches can be time and resource-intensive. This article proposes a feasible framework for conducting a participatory needs assessment in time-limited settings using multiple, triangulated quali...

Detention and removal of unauthorised immigrants by United States (U.S.) Immigration and Customs Enforcement (ICE) has steadily increased despite declining rates of unauthorised migration. ICE detainees are held in overcrowded detention centres, often without due process and deprived of adequate food, sanitation, and medical care. Conditions of ICE...

Survivors of head and neck cancer (HNC) can have multiple health concerns. To facilitate their care, we developed and pilot-tested a clinical informatics intervention, HN-STAR. HN-STAR elicits concerns online from HNC survivors prior to a routine oncology clinic visit. HN-STAR then presents tailored evidence-based clinical recommendations as a clin...

Objective Herbs and natural products are increasingly used by cancer patients for pain management, but few studies have examined their integration within conventional cancer care. This study describes the characteristics, experiences, and perspectives of cancer patients who were prescribed a herbal topical analgesic for pain management. Design and...

Purpose: In March-April 2020, New York City was overwhelmed by COVID-19 infections, leading to substantial disruptions in nearly all aspects of care and operations at most local hospitals. This qualitative study of a quaternary, urban oncology hospital investigated the effects of these disruptions upon a professionally diverse cohort of its employe...

Background Accurate self-reported symptomatic toxicity documentation via the Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) is essential throughout cancer treatment to ensure safety and understand therapeutic efficacy. However, the capture of accurate toxicities from patients undergoing radiation...

BACKGROUND Accurate self-reported symptomatic toxicity documentation via the Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) is essential throughout cancer treatment to ensure safety and understand therapeutic efficacy. However, the capture of accurate toxicities from patients undergoing radiation...

Purpose: High-quality cancer care must incorporate patients' personal values in decision making throughout illness. Unfortunately, patient values are neither consistently elicited nor easily accessible in the electronic health record (EHR). Memorial Sloan Kettering Cancer Center is deploying a major EHR innovation, called the Patient Values Tab, w...

BACKGROUND Patients with cancer are particularly vulnerable to stress and anxiety during the COVID-19 pandemic. Social distancing is critical for patients with cancer, yet this can also reduce access to psychosocial coping resources. OBJECTIVE This study aimed to identify how virtual mind-body programs impact patients’ psychosocial well-being duri...

Background: Patients with cancer are particularly vulnerable to stress and anxiety during the COVID-19 pandemic. Social distancing is critical for patients with cancer, yet this can also reduce access to psychosocial coping resources. Objective: This study aimed to explore patient experiences to generate a model of how virtual mind-body programs...

Objective To address the lack of validated patient-reported outcome (PRO) instruments that define and quantify patient expectations in thyroid cancer surgery, we developed and initially validated ThyroidEx, a novel disease-specific PRO instrument. Study Design Survey study. Setting Single-institution tertiary care cancer center. Methods An exper...

PURPOSE The incidence of breast cancer is rising in Nigeria, and one major barrier to care is the lack of affordable and appropriate breast cancer diagnosis by ultrasound (US)–guided biopsy. The prohibitive cost of US devices limits their availability in low- and middle-income countries. The emergence of mobile health (mHealth) imaging devices may...

Context Music therapy (MT) is a nonpharmacologic therapy where licensed therapists provide active (e.g., singing, playing songs) or passive (e.g., listening) music-based interventions. Both active and passive MT are effective techniques for treating cancer-related symptoms. However, the influence of active vs. passive MT techniques on patient-repor...

Objective: Home care for hematopoietic stem cell transplants (HSCTs), an alternative to traditional inpatient or outpatient recovery programs, is safe and feasible but may place greater demand on full-time caregivers. The goal of this study was to characterize the experiences of caregivers in a newly piloted homebound HSCT program as a means of id...

The relationship between patient satisfaction, care compliance, and treatment outcomes suggests patients who report dissatisfaction perceive receipt of suboptimal care. Patient satisfaction plays a role in defining quality of care, affecting institutional reimbursement and reputation capital. Using an explanatory sequential mixed methodology approa...

Purpose Telemedicine was rapidly implemented for initial consultations and radiation treatment planning in the wake of the coronavirus disease 2019 (COVID-19) pandemic. In this study, we explore utilization of and physician perspectives on this approach in an attempt to identify patient populations that may benefit most from virtual care. Methods...

PURPOSE Cancer-related fatigue is a prevalent, debilitating symptom that contributes to increased health care utilization among hospitalized patients. Music therapy is a nonpharmacological intervention that uses active (eg, singing, selecting songs) and passive (eg, listening) techniques. Preliminary evidence from small trials suggests a potential...

e24163 Background: A novel, patient-verified summary documenting nurse-led discussions assessing health-related values of newly-diagnosed cancer patients has been implemented in outpatient gastrointestinal (GI) oncology clinics, but the content of these discussions has not previously been analyzed. Methods: Three interdisciplinary coders met and re...

12118 Background: Adolescents and young adults (AYAs) require a multidisciplinary approach to cancer care due to complex biopsychosocial variables and varied developmental maturity. Currently, age and diagnosis determine referral to pediatric or adult oncology with differing care paradigms and service utilization. These issues, in conjunction with...

Research examining the experience of informal caregivers (ICs) for patients with rare cancers is limited. This was a mixed-methods pilot study of 14 ICs for patients with Erdheim–Chester disease (ECD), an ultra-rare neoplasm. Participants were predominantly female and over half provided at least 60% of their loved one’s care. Participants completed...

Context: Research Medical Donation (RMD), which entails collecting human tissue within hours after death, benefits cancer research but data are limited regarding barriers institutions face accruing patients to RMD programs. Objectives: The objective of this study was to generate stakeholder perspectives to best inform the complex RMD process, wh...

Background: Opioid use disorder is a critical public health concern and the negative effects of opioids on sleep may reinforce addiction. The objective of this pilot study was to incorporate objective and subjective measures to examine if implantable buprenorphine altered patient sleep and quality of life after crossover from daily-dosed sublingual...

27 Background: Issues pertinent to serious illness are more prevalent in the current medical landscape of increasing technologic sophistication. RMD, the process of human tissue extraction within hours after death benefits cancer research but data are limited regarding barriers institutions face in accruing to RMD programs. Such data are needed due...

Interactions between a robot and a child (robot-child interactions) provide a unique context to engage children in whole body movements through a reciprocal imitation game. The effects of a novel, 8-session, robot-child interaction protocol on the imitation and praxis skills of 15 typically developing children and one child with autism between 4 an...

Background: While social communication delays are the primary impairments of Autism Spectrum Disorders (ASDs), motor impairments are quite frequent. Motor impairments in ASDs include incoordination and dyspraxia, namely difficulties in performing complex actions like skilled gestures. Traditional autism interventions address social communication...