Background

Patients with cancer may face a significant knowledge deficit as they battle their illness. We developed a first of its kind comprehensive patient symposia (Living with Cancer (LWC): A Mayo Clinic Symposia for Patients and Loved Ones) with 8 hours of general sessions (covering nutrition, exercise, cancer inheritance, financial and legal challenges, communication, survivorship, and cancer therapy) and a 4-hour disease specific breakout (myeloid diseases, myeloma, lymphoma, chronic lymphocytic leukemia, breast cancer, lung cancer, cutaneous malignancy, colorectal cancer, and prostate cancer). Through voluntary questionnaires, we studied the impact of this cancer symposium on quality of life, cancer specific knowledge, and symptom management among cancer patients.

Methods

LWC meeting attendees were provided surveys prior to and 3 months following the convention. Surveys included 1) EORTC-QLQ-C30; 2) new disease understanding tool developed specifically for this conference; 3) distress thermometer and problems checklist; 4) validated disease-specific questionnaires. Changes over time were assessed using McNemar’s tests and paired t-tests for categorical and continuous variables, respectively.

Results

Patients:158 attendees completed the pre-convention survey. The median age was 67.5 (range 30-86), 49% males, 76% over 1 year from diagnosis. Cancer type included 37% hematologic malignancies, 23% breast cancer, 23% prostate cancer, and 17% other. The hematologic malignancies were comprised of 34% leukemia, 31% CLL/lymphoma, 25% amyloid/multiple myeloma, and 9.3% myeloproliferative neoplasms.

Baseline Disease Understanding, Symptoms, QOL: Most attendees endorsed understanding their disease quite a bit (54%) or very much (29%). Most respondents reported at least “quite a bit” of understanding regarding treatment options (84%), screening modalities (83%), symptomatology (74%), and cancer-related side effects (71%). Attendees endorsed the least understanding of disease-related stress (49%), risk factors (49%), management of disease related fatigue (41%), and legal issues related to disease/treatment (27%)

Mean QLQ-C30 scores were 84.4 for physical functioning, 83 for role functioning, 80.7 for social functioning, and 72.7 for global health status.

The symptoms with highest mean scores were insomnia, fatigue, and pain.

Knowledge Improvement Durable at 3 Months: 115 (73%) patients completed the post-symposium survey.

There was improvement in 12 of 14 areas of self-reported knowledge (Table 1) especially in areas of nutrition, and management of disease related stress and fatigue (all p<0.001).

Table 1

Percentage of respondents completing both surveys (N=115) who reported understanding* of their disease Pre and Post-Convention

I understand…Pre-Convention (%)Post-Convention (%)P value
My disease 84 89 0.26 
Risk factors that can lead to my disease 48 58 0.11 
Screening tests for my disease 88 89 1.0 
Symptoms associated with my disease 75 75 1.0 
Treatment options for my disease 85 82 0.52 
Treatment side effects of my disease 70 75 0.42 
What to eat for my health 67 86 <0.001 
How to manage disease-related stress 48 65 <0.001 
How to manage disease related fatigue 44 64 <0.001 
Legal issues of my disease and treatment 29 36 0.16 
The process of making end of life decisions 61 69 0.23 
How to maintain my relationships 61 75 0.009 
How to navigate the health care system 55 60 0.39 
How to manage financial considerations 53 61 0.14 
I understand…Pre-Convention (%)Post-Convention (%)P value
My disease 84 89 0.26 
Risk factors that can lead to my disease 48 58 0.11 
Screening tests for my disease 88 89 1.0 
Symptoms associated with my disease 75 75 1.0 
Treatment options for my disease 85 82 0.52 
Treatment side effects of my disease 70 75 0.42 
What to eat for my health 67 86 <0.001 
How to manage disease-related stress 48 65 <0.001 
How to manage disease related fatigue 44 64 <0.001 
Legal issues of my disease and treatment 29 36 0.16 
The process of making end of life decisions 61 69 0.23 
How to maintain my relationships 61 75 0.009 
How to navigate the health care system 55 60 0.39 
How to manage financial considerations 53 61 0.14 
*

“Quite A Bit” or “Very Much” response on Cancer Knowledge Questionnaire

Symptomatic Changes at 3 Months: There was no significant change in QLQ-C30 physical/role/emotional functioning, fatigue, pain, or insomnia.

Conclusions

This first evaluation of a patient centered cancer symposium as an education intervention suggests patients selecting to participate in such an event seek to improve an already solid knowledge base regarding their malignant disease. Participating in the event improved disease specific knowledge in numerous areas. However, as a single intervention, function and symptoms tended not to improve with participation. Future efforts on 1) improving participation with disease knowledge “naïve” patients and 2) targeted efforts aimed at specific symptom management (i.e. insomnia, stress) are planned. This study serves as an avenue to empower patients and inform physicians to improve the experience of living with cancer.

Disclosures:

No relevant conflicts of interest to declare.

Author notes

*

Asterisk with author names denotes non-ASH members.

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