Procedures. The study protocol was submitted to the Institutional Review Board of the Ponce School of Medicine and Health Sciences, and found to be exempt from the requirement for full approval. The research was conducted in accordance with the Declaration of Helsinki. The selection process was conducted through the availability of compara­tive sample. The groups were recruited with the intention of matching for age, education level, and socioeconomic fac­tors. Each participant agreed to participate through verbal consent or submission of the online survey. Potential sub­jects were recruited by the researchers, volunteers, and medi­cal personnel. Those who meet the inclusion criteria for the study were offered the opportunity to participate. Following informed consent, participants completed the questionnaire in either a pen and paper format or an online survey. Testing took place at hospitals, cancer walks, charity events, and sup­port groups; all of the information from each participant was collected in a single session and transferred to the Neuropsy­chological Laboratory in the Clinical Psychology building for long-term storage.

Statistical analysis. All data were collected using stan­dard data forms and entered or downloaded into a Microsoft Excel (2010) spreadsheet for analysis using the Statisti­cal Package for the Social Sciences software (version 20). Survey information (except for demographics) takes the form of yes/no questions. Descriptive statistics was used to calculate demographic variables. Survey responses for each item were reported as a percentage or an average response. Nonparametric methods (Wilcoxon matched-pair signed-rank test or paired t-test) were used to examine different characteristics of cancer interventions, frequency of alcohol consumption, and memory loss following chemotherapy. Chi-square tests of association were used as appropriate to analyze sample characteristics (eg, race/ethnicity, drinking levels, coping styles, memory loss, and other response fac­tors) to establish the strength of association.36 Odd ratios (ORs) were then performed to find the effect size for the associations that were significant in order to summarize a focused comparison.36


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RESULTS

Demographic characteristics of cancer survivors. Table 1 summarizes the sample consisting of 79 female par­ticipants (46 PR and 33 US) of various socioeconomic statuses and an education level equivalent to high school or greater. Pearson’s chi-square tests were conducted to assess the rela­tion between demographic characteristics among PR and US cancer survivors. Most of the PR survivors were unemployed at the time of the study (52.2%) in contrast to US survivors who were unemployed (36.4%), which explains the discrepancy between groups with respect to income (Table 1, P , 0.001).

Characteristics of cancer diagnosis. Breast cancer was the most common diagnosis among the survivors (PR 89.1% and US 63.0%) followed by ovarian cancer (PR 4.3% and US 18.2%). Survivors were most commonly diagnosed more than three years before this study was conducted (Table 2). More than half of the participants had metastatic cancer (PR 50% and US 51.5%), and stage II diagnoses were the most common (PR 30.4% and 39.4%) (Table 2).

Treatment medications. Adjuvant chemotherapy was the most common reported type of treatment among PR and US cancer survivors. Paclitaxel (Taxol) was the most common chemotherapy medication administered to female cancer patients in US, and doxorubicin (Adriamycin and Rubex) was the most common in PR (Table 3). Overall, a wide range of medications was given to treat female cancers (Table 3). A greater number of PR survivors (27.3%) did not remember which medications they took during chemotherapy treatment compared to the US survivors (Table 3).

Treatment conditions. Most participants did not pres­ent a cancer recurrence at the time of completion of the survey (Table 4). The most common duration of chemotherapy and other cancer interventions is six months to one year among US survivors and three years among PR survivors (Table 4). It is interesting to highlight that 30.4% of survivors from the PR sample had a hysterectomy as a consequence of chemotherapy compared to only 12.1% in the US sample (Table 4).