Lucas, Pauline

Breast cancer is the most common cancer in women. The life expectancy after a breast cancer diagnosis is improving steadily, leaving many more persons with the long-term consequences of treatment. Sexual problems are a common concern for breast cancer survivors yet remain overlooked in both the clinical setting and the research literature. Factors that contribute to sexual health concerns in breast cancer survivors are biopsychosocial, as are the barriers to addressing and treating these health concerns. Sexual health needs and treatment may vary by anatomy and gender. Multidisciplinary management may comprise lifestyle modifications, medications, sexual health aids such as vibrators, counseling, and referrals to pelvic health physical therapy and specialty care. In this article, we review the contributing factors, screening, and management of sexual difficulties in cisgender female breast cancer survivors. More information is needed to better address the sexual health of breast cancer survivors whose sexual/gender identity differs from that of cisgender women.

Purpose: High-value care is becoming increasingly important as the United States shifts toward a more sustainable health care system. Lifestyle medicine (LM) may be the highest-value model of care. Surprisingly, however, it is taught in a minority of medical schools. In this article, we describe a pilot project of introducing a brief LM course taught within the Mayo Clinic Alix School of Medicine in Arizona. The main purpose of the course was to introduce the students to LM as a specialty practice and to provide students with foundational knowledge of the pillars of LM. Results: Students reported improved personal health habits and increased confidence in LM competencies.

AbstractBackgroundThe American Academy of Neurology Practice Guidelines recommends physical exercise to help maintain cognition in people with Mild Cognitive Impairment (pwMCI). We previously demonstrated yoga’s benefit in maintenance of memory related activities of daily living at one year follow‐up in pwMCI (Chandler et al., 2019), and yoga may be beneficial in offsetting a sense of burden in care partners at 12 months (Amofa et al., submitted). In this analysis, we sought to examine the impact of yoga training on physical performance in pwMCI and their care partners.MethodIn this multisite, randomized clinical trial, we enrolled 272 patients meeting National Institute on Aging–Alzheimer’s Association criteria for MCI and a care partner. The intervention program was modeled on the 10 day Mayo Clinic HABIT Healthy Action to Benefit Independence and Thinking® program. Of 5 possible interventions (memory compensation training, computerized cognitive training, yoga, patient and partner support groups, and wellness education), 1 of 5 interventions was randomly selected to be withheld for each intervention group, thus allowing us to examine comparative effectiveness. Participants and their partners had 1‐day booster sessions at 6 and 12 months after intervention. The Short Physical Performance Battery (SPPB), a measure of balance, gait speed, and repeated chair stands was used to assess physical function outcomes.ResultThere was a general pattern of physical decline on the SPPB over the year in pwMCI, regardless of yoga training (d=‐0.04, p=0.78) (Figure 1, Panel A). Among care partners, those randomized to the no yoga group had a worse decline in physical function compared to those receiving yoga (d=‐0.31, p=0.034) (Figure 1, Panel B). While not reaching statistical significance in subgroup comparisons, yoga training tended to have a greater effect on SPPB than computerized cognitive training (d = 0.35, p = .06) or wellness education (d = 0.32, p =.09) (Table 1).ConclusionParticipation in yoga had a positive impact on physical performance outcomes at one year for care partners, but did not counteract general physical decline in pwMCI.