Carol N. D'Onofrio

Bio: Carol N. D'Onofrio is an academic researcher from Cancer Prevention Institute of California. The author has contributed to research in topics: Breast cancer & Vietnamese. The author has an hindex of 6, co-authored 6 publications receiving 1078 citations.

Body image and sexual problems in young women with breast cancer

Abstract: Purpose: The purpose of this study was to determine the frequency of body image and sexual problems in the first months after treatment among women diagnosed with breast cancer at age 50 or younger. Background: Breast cancer treatment may have severe effects on the bodies of younger women. Surgical treatment may be disfiguring, chemotherapy may cause abrupt menopause, and hormone replacement is not recommended. Methods: A multi-ethnic population-based sample of 549 women aged 22–50 who were married or in a stable unmarried relationship were interviewed within seven months of diagnosis with in situ, local, or regional breast cancer. Results: Body image and sexual problems were experienced by a substantial proportion of women in the early months after diagnosis. Half of the 546 women experienced two or more body image problems some of the time (33%), or at least one problem much of the time (17%). Among sexually active women, greater body image problems were associated with mastectomy and possible reconstruction, hair loss from chemotherapy, concern with weight gain or loss, poorer mental health, lower self-esteem, and partner's difficulty understanding one's feelings. Among the 360 sexually active women, half (52%) reported having a little problem in two or more areas of sexual functioning (24%), or a definite or serious problem in at least one area (28%). Greater sexual problems were associated with vaginal dryness, poorer mental health, being married, partner's difficulty understanding one's feelings, and more body image problems, and there were significant ethnic differences in reported severity. Conclusions: Difficulties related to sexuality and sexual functioning were common and occurred soon after surgical and adjuvant treatment. Addressing these problems is essential to improve the quality of life of young women with breast cancer. Copyright © 2005 John Wiley & Sons, Ltd.

Pathways to Early Cancer Detection in the Multiethnic Population of the San Francisco Bay Area

Abstract: The Pathways project studied the relationship of race/ethnicity, socioeconomic status, and culture to breast and cervical cancer screening. A multidisciplinary, multicultural team of investigators ...

Quality of data in multiethnic health surveys.

Abstract: Objective.There has been insufficient research on the influence of ethno-cultural and language differences in public health surveys. Using data from three independent studies, the authors examine methods to assess data quality and to identify causes of problematic survey questions.Methods.Qualitative and quantitative methods were used in this exploratory study, including secondary analyses of data from three baseline surveys (conducted in English, Spanish, Cantonese, Mandarin, and Vietnamese). Collection of additional data included interviews with investigators and interviewers; observations of item development; focus groups; think-aloud interviews; a test-retest assessment survey; and a pilot test of alternatively worded questions.Results.The authors identify underlying causes for the 12 most problematic variables in three multiethnic surveys and describe them in terms of ethnic differences in reliability, validity, and cognitive processes (interpretation, memory retrieval, judgment formation, and respon...

Addressing the needs of young breast cancer survivors at the 5 year milestone: can a short-term, low intensity intervention produce change?

Abstract: Background Today, the 5-year relative survival rate for cancer is 65% and there are 10.5 million survivors. The largest group of survivors are those of breast cancer. Reductions in mortality are occurring at a greater rate for women under age 50 at diagnosis than among older women.

Problems and Progress in Translation of Health Survey Questions: The Pathways Experience

Abstract: Pathways to Early Cancer Detection in Four Ethnic Groups is a program project funded by the National Cancer Institute aimed at increasing the use of breast and cervical cancer screening among underserved African American, Chinese, Hispanic, and Vietnamese women. The program project core is dedicated to cross-cultural studies including development of survey questions that are comparable in four languages. This article describes the Pathways surveys, summarizes the challenges encountered in question translation, and presents an adapted approach to translation. Concurrent, multilingual, decentered translation was the process through which an English version of each question was selected only when it could be directly and meaningfully translated into Mandarin, Cantonese, Spanish, and Vietnamese. Examples of challenges and how these were addressed in the Pathways surveys are presented, along with lessons learned throughout this process.

Clinical practice guidelines in oncology

Abstract: Ductal carcinoma in situ (DCIS) of the breast represents a heterogeneous group of neoplastic lesions in the breast ducts. The goal for management of DCIS is to prevent the development of invasive breast cancer. This manuscript focuses on the NCCN Guidelines Panel recommendations for the workup, primary treatment, risk reduction strategies, and surveillance specific to DCIS.

Effects of Aerobic and Resistance Exercise in Breast Cancer Patients Receiving Adjuvant Chemotherapy: A Multicenter Randomized Controlled Trial

Abstract: Purpose Breast cancer chemotherapy may cause unfavorable changes in physical functioning, body composition, psychosocial functioning, and quality of life (QOL). We evaluated the relative merits of aerobic and resistance exercise in blunting these effects. Patients and Methods We conducted a multicenter randomized controlled trial in Canada between 2003 and 2005 that randomly assigned 242 breast cancer patients initiating adjuvant chemotherapy to usual care (n = 82), supervised resistance exercise (n = 82), or supervised aerobic exercise (n = 78) for the duration of their chemotherapy (median, 17 weeks; 95% CI, 9 to 24 weeks). Our primary end point was cancer-specific QOL assessed by the Functional Assessment of Cancer Therapy–Anemia scale. Secondary end points were fatigue, psychosocial functioning, physical fitness, body composition, chemotherapy completion rate, and lymphedema. Results The follow-up assessment rate for our primary end point was 92.1%, and adherence to the supervised exercise was 70.2%. ...

Body image and sexual problems in young women with breast cancer

Abstract: Purpose: The purpose of this study was to determine the frequency of body image and sexual problems in the first months after treatment among women diagnosed with breast cancer at age 50 or younger. Background: Breast cancer treatment may have severe effects on the bodies of younger women. Surgical treatment may be disfiguring, chemotherapy may cause abrupt menopause, and hormone replacement is not recommended. Methods: A multi-ethnic population-based sample of 549 women aged 22–50 who were married or in a stable unmarried relationship were interviewed within seven months of diagnosis with in situ, local, or regional breast cancer. Results: Body image and sexual problems were experienced by a substantial proportion of women in the early months after diagnosis. Half of the 546 women experienced two or more body image problems some of the time (33%), or at least one problem much of the time (17%). Among sexually active women, greater body image problems were associated with mastectomy and possible reconstruction, hair loss from chemotherapy, concern with weight gain or loss, poorer mental health, lower self-esteem, and partner's difficulty understanding one's feelings. Among the 360 sexually active women, half (52%) reported having a little problem in two or more areas of sexual functioning (24%), or a definite or serious problem in at least one area (28%). Greater sexual problems were associated with vaginal dryness, poorer mental health, being married, partner's difficulty understanding one's feelings, and more body image problems, and there were significant ethnic differences in reported severity. Conclusions: Difficulties related to sexuality and sexual functioning were common and occurred soon after surgical and adjuvant treatment. Addressing these problems is essential to improve the quality of life of young women with breast cancer. Copyright © 2005 John Wiley & Sons, Ltd.

Cognitive interviewing: verbal data in the design and pretesting of questionnaires.

Abstract: Purpose. The purpose of this paper is to discuss problems that occur in questionnaire responses and how cognitive interviewing can be used to identify problematic questions prior to using the questionnaire in the field. Background. Questionnaire design involves developing wording that is clear, unambiguous and permits respondents successfully to answer the question that is asked. However, a number of problems in relation to respondents' understanding and successfully completing questionnaires have been identified. Cognitive interviewing, an amalgamation of cognitive psychology and survey methodology, has been developed to identify problematic questions that may elicit response error. The overall aim is to use cognitive theory to understand how respondents perceive and interpret questions and to identify potential problems that may arise in prospective survey questionnaires. Methods. A literature review is used to examine the process of questionnaire design and how cognitive interviewing can be used to reduce sampling error and increase questionnaire response rates. Findings. Cognitive interviewing involves interviewers asking survey respondents to think out loud as they go through a survey questionnaire and tell them everything they are thinking. This allows understanding of the questionnaire from the respondents' perspective rather than that of the researchers. Cognitive interviews have been used in a number of areas in health care research to pretest and validate questionnaires and to ensure high response rates. Interviewing has been found to be highly effective in developing questionnaires for age specific groups (children and adolescents) and in ascertaining respondents' understanding in health surveys prior to distribution. However, cognitive interviews have been criticized for being overly subjective and artificial. Conclusion: Cognitive interviews are a positive addition to current methods of pretesting questionnaires prior to distribution to the sample. They are most valuable in pretesting questions that are complex, where questions are sensitive and intrusive and for specific groups for whom questionnaire completion may pose particular difficulties.

Exercise interventions on health related quality of life for cancer survivors

Abstract: There is a steady increase in the number of cancer survivors, that is people diagnosed with cancer (Aziz 2003), worldwide. This is due, in a large part, to the dramatic advances in cancer treatment and management (Aziz 2002; Aziz 2003), growing attention to multidisciplinary post-treatment care (Demark-Wahnefried 2000; Stull 2007), and healthier lifestyles (Demark-Wahnefried 2005; Stull 2007). These factors and trends especially when considered in light of an aging population (Aziz 2008; Stewart 2003), suggest that we can continue to expect increasing numbers of cancer survivors with greater expected length of survival. Ensuring the quality of that survival thus becomes a key priority. The objectives are as follows: To evaluate the effectiveness of exercise on overall HRQoL outcomes and specific HRQoL domains (e.g. physical, psychological, economic, social, and spiritual well-being, and key disease and/or treatment symptoms such as sexual functioning, neuropathy or cognitive changes, and chronic fatigue) among adult post-treatment cancer survivors (i.e. people with a history of cancer who are beyond active treatment, excluding those who are terminally ill and receiving hospice). We will focus on post-treatment cancer survivors so that we can evaluate the effectiveness of exercise on HRQoL without having to adjust for the adverse effects of cancer and/or its treatment on HRQoL. 1. A secondary objective is to examine the effectiveness of exercise on HRQoL outcomes among adult post-treatment cancer survivors stratified by the following: 2. Age at diagnosis (i.e. less than 65 years or greater than or equal to 65 years); 3. Age at trial enrolment (i.e. less than 65 years or greater than or equal to 65 years); 4. Sex; 5. Type of prescribed exercise (i.e. aerobic, anaerobic, combination); 6. Physical condition prior to cancer treatment (i.e. obesity, heart disease, smoking status, asthma); 7. Intensity of exercise (i.e. mild, moderate, vigorous); and Format of exercise (i.e. individual or group, professionally led or not, home or group facility).