Table Of ContentTanya R. Fitzpatrick Editor
Treating Vulnerable
Populations of
Cancer Survivors:
A Biopsychosocial
Approach
Treating Vulnerable Populations of Cancer
Survivors: A Biopsychosocial Approach
Tanya R. Fitzpatrick
Editor
Treating Vulnerable
Populations of Cancer
Survivors: A Biopsychosocial
Approach
123
Editor
Tanya R.Fitzpatrick
Department ofOncology
McGill University
Montreal
Canada
and
Department ofSocial Work
Arizona State University
Westmount
Canada
ISBN978-3-319-32362-6 ISBN978-3-319-32364-0 (eBook)
DOI 10.1007/978-3-319-32364-0
LibraryofCongressControlNumber:2016938396
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Contents
1 Theoretical and Conceptual Models of Age and Ethnicity . . . . . . . 1
Tanya R. Fitzpatrick
2 Providing Psychosocial Distress Screening, Coping Resources,
and Self-care to Newly Diagnosed Cancer Survivors
in a Canadian Small Town Setting . . . . . . . . . . . . . . . . . . . . . . . . 7
Linda J. Edgar
3 Latino Cancer Survivors: The Old and the Young . . . . . . . . . . . . 23
Tanya R. Fitzpatrick
4 An Exploration of Latvian Immigrants’ Cancer Experience
and Implications for Supportive Interventions. . . . . . . . . . . . . . . . 37
Mara L. Leimanis
5 Survivorship Issues Among Muslim Women with Cancer . . . . . . . 55
Suzanne Y. Bushfield
6 Exploring the Artist’s Book: How Art Therapy Can Benefit
the Quality of Life of Young Adult Breast Cancer Survivors. . . . . 67
Katherine Laux
7 Physical Activity, Locus of Control, and Fear of Recurrence
Among Cancer Survivors from a Community-Based Cancer
Support Program. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93
Roxana Mititelu, Achuthan Aruljothy and Tanya R. Fitzpatrick
8 Oral Health Issues and Quality of Life Among Pediatric
Cancer Survivors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111
Crystal Noronha and Mary Ellen Macdonald
9 Quality of Life Among Esophageal Cancer Survivors:
Medical and Psychosocial Support . . . . . . . . . . . . . . . . . . . . . . . . 127
Adriano Petrangelo, Mara L. Leimanis, Lorenzo Ferri
and Tanya R. Fitzpatrick
v
vi Contents
10 The Family Caregiver as Cancer Survivor: Supporting
and Promoting Positive Bereavement Outcomes . . . . . . . . . . . . . . 143
Lorraine Holtslander
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 155
Editor and Contributors
About the Editor
TanyaR.Fitzpatrick,Ph.D.,MSW,RN obtainedherPh.D.fromBostonCollege
Graduate School of Social Work and is Professor Emeritus from Arizona State
UniversityinPhoenix,Arizona(DepartmentofSocialWork)withabackgroundin
nursing, oncology, and gerontology. She was the Director of Research and
Consultant at Hope & Cope in the Jewish General Hospital (2009–2013). More
recently, she was a research consultant assisting on a project in the Department of
Nursing at McGill University, Montreal. She is also mentoring first- and
second-year McGill medical students in research projects focusing on cancer sur-
vivors and other health-related outcomes. Besides editing a book on ethnic elders,
she has published more than 50 articles, book chapters in scientific journals, and
received numerous grants.
Contributors
Achuthan Aruljothy, B.Sc. completed his undergraduate degree in Anatomy and
Cell Biology from McGill University and continued to pursue his medical school
training at McGill, where he is completing his final year. Working in numerous
clinical settings throughout his medical education and having been involved in
psychosocial research under the mentorship of Dr. Fitzpatrick has reinforced his
goalsanddesirestopracticeprimarycarethrougharesidencyininternalmedicine.
He is a strong advocate of preventive care, patient education, and community
outreach, which are fundamental to the art and science of medicine.
Suzanne Y. Bushfield, Ph.D., MSW (retired) after completing her Ph.D. she
served as a Faculty Member and Researcher at Arizona State University, New
Mexico State University, Lewis Clark State College, and the University of North
Dakota. She ended her career as Accreditation Director for the Council of Social
Work Education and as Chief Accreditation Operations Officer for the Association
vii
viii EditorandContributors
for the Accreditation of Human Research Protection Programs. Her research has
focused on issues that have an impact on women’s lives throughout the lifespan,
including breast cancer and end-of-life caregiving.
Linda Edgar obtained her Ph.D. from McGill University, Montreal, Canada. Her
research career focuses on psychosocial interventions for cancer patients and their
families. She was instrumental in advocating for the use of the distress ther-
mometer.ShehaspublishedmanyreferredarticlesandobtainedgrantsfromCIHR.
Shehasheldnursingpositionsasteacher,researcher,consultant,andclinician,and
continues to stress the importance of good coping in all those roles.
Lorenzo Ferri, MD, Ph.D. FRCSC is Associate Professor of Surgery and
OncologyatMcGillUniversityandChiefofThoracicandEsophagealSurgery.As
athoracicsurgeon,hehasconductedandpublishednumerousstudiesontheclinical
outcomesofpatientssufferingfromesophagealandlungcancer.Inadditionheruns
the MUHC program in Upper GI Cancer, the largest and most comprehensive in
Canada.
Lorraine Holtslander, RN, Ph.D., CHPCN(c) Honorary Associate Professor,
UniversityoftheWitwatersrand,Johannesburg,SouthAfricaisAssociateProfessor
in the College of Nursing in Saskatoon, Canada with the University of
Saskatchewan and a certified hospice palliative care nurse. Her clinical area is in
Palliative Home Care, which supports the focus of her research in palliative care,
specifically grief and loss, family caregiving and supporting family caregivers
during bereavement.
Katherine Laux is art therapist (MA, ATPQ) and arts-based researcher in
oncology at Cedars CanSupport, based at the McGill University Health Centre in
Montreal, Québec.Sheis also affiliated with theArt Hive movementand offers an
open art studio at La Ruche d’Art St-Henri for oncology patients and their loved
ones. In addition to individual and group work, Kate organizes and co-curates
public art exhibits of patient artwork. She also believes strongly in the healing
aspects of art-making, and in the ability of supportive art-making sessions and
group spaces to build connections and self-esteem, and to empower at any point
of the cancer trajectory, including end-of-life care.
Mara L. Leimanis, Ph.D. withabackgroundinbiochemistry,hastakenaspecial
interestintranslationresearch(“benchtobedside”),withover7yearsofexperiencein
clinicalresearch.Inthistime,sheworkedatthepostdoctorallevelabroadontheThai–
BurmeseborderwiththemigrantandrefugeepopulationswiththeMahidol-Oxford
ResearchUnitbasedinBangkok,Thailand.Forthepast5years,shehasfocusedher
research in medical and psychosocial oncology working in several hospitals in
Montreal,Canada.Dr.Leimanisisafirst-borngenerationCanadian-Latvian.Sheis
now living in Grand Rapids, Michigan and is Senior Research Specialist with the
HelenDeVosChildrens’Hospital.
EditorandContributors ix
Mary Ellen MacDonald, Ph.D. is Medical Anthropologist with postdoctoral
traininginPediatricPalliativeCare.ShehasanappointmentintheDivisionofOral
Health and Society and is affiliated with the Departments of Pediatrics and
Oncology, and the Ingram School of Nursing and Biomedical Ethics Unit. She is
alsoCoreFacultyintheMcGillCentreforMedicalEducation.ShechairstheMcGill
QualitativeHealthResearchgroup.Hermainresearchinterestsincludeoralhealthin
vulnerable populations, palliative care and bereavement, cultural aspects of health
and illness withindigenous communities, andhealth professionseducation.
Roxana Mititelu, B.Sc. originally from Romania, completed a bachelor’s of
science at McGill and is now in her final year of medical school, also at McGill
University. Roxana is passionate about complex medical care involving an inter-
disciplinaryapproach,soastobest providewhole-patient care. Shehaspreviously
performed pre-clinical vaccine research and has a strong interest in oncology. She
was a volunteer at the Hope & Cope Wellness Centre, at the Jewish General
Hospital and later was hired as Research Assistant (2013–2014) working with
Dr. Fitzpatrick on research projects focusing on cancer survivors.
Crystal Noronha, M.Sc. is Project Manager of the Views On Interdisciplinary
Childhood Ethics (VOICE) project. She completed a graduate degree in dental
sciences at McGill University, Montreal. She is currently working on scoping
reviewsonpediatric healthandethics andparticipatesinstudies addressingcancer
survivors.
AdrianoPetrangelo willobtainaBachelor’sdegreeinAnatomyandCellBiology
from McGill University (Spring, 2016). He worked as Research Assistant in
theDepartment ofThoracic Surgery attheMontrealGeneral Hospitalinthelabof
Dr. Lorenzo Ferri under the supervision of Dr. Mara Leimanis. His research has
focusedonesophagealcancerandmedicalandpsychosocialoutcomes.Heworked
on a project focusing on longitudinal HRQoL in esophageal cancer patients via
patient-reported surveys throughout treatment at the Montreal General Hospital.
HeisamemberoftheMcGillVarsityBaseballTeamandhopestopursueacareer
in medicine.
Introduction
The purpose of this book is to explore the relationships between a variety of ther-
apeutic interventions and strategies as they impact the social and health issues
among vulnerable populations of cancer survivors. Age and cultural behaviors are
also examined as they relate to cancer survivors seeking community and hospital
services.Whileresearchhasbeenconductedonageandrace,asitrelatestomental
and physical health outcomes among different ethnic groups, scant research has
been directed towards appropriate interventions among vulnerable populations of
cancer survivors.
The possibilityof surviving cancer for longer periods oftime isincreasing with
thelikelihoodofliving withachallengingandchronicdisease.Althoughcanceris
primarily a disease of older adults, young adults and children from minority and
ethnic groups experience different survival rates as compared to non-Hispanic
Whites (Chao et al. 2014). Yet many ethnic populations continue to underutilize
healthandsocialservicesinspiteoftheirhigherlevelofneed(Alemánetal.2000).
Ethnic minorities, especially the very young and elderly cancer survivors, are the
underserved population creating a complex burden for oncology professionals and
other health care workers—hence the need for this book. The necessity to under-
stand survivorship issues from the onset of diagnosis is critical.
This book will provide further understanding for oncology professional and
practitioners who must negotiate and provide optimum care for different ages and
ethnic groups of cancer survivors during illness and recovery. Health care practi-
tioners will need expertise in culturally competent practice to meet the needs and
barriers that face cancer survivors and their family members.
The chapters in this book attempt to demonstrate the various challenges facing
minority and different age groups with the goal of providing information on
culturally appropriate strategies and interventions. Initially, though not exhaustive,
theoretical and conceptual models are presented to help clarify the relationship
between the different approaches and interventions and the quality of life among
these populations.
Following this, Dr. Edgar begins by describing a pilot program that examines
psychosocialoutcomessuchasdistress,coping,andphysicallimitations,whichare
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