This study is for patients that have suffered a femur fracture due to metastatic cancer. The standard of care for this type of fracture is to stabilize the bone with an intramedullary nail. When preparing the femur for the nail, pressure can cause fat to enter the bloodstream and travel to the heart, causing heart and lung complications. The procedure being investigated in this study is called reduced pressure reaming. In this procedure the surgeon will use a device with suction when preparing the bone for the nail in order to decrease pressure and decrease the amount of fat that enters the bloodstream. Patients will be randomly assigned to either the standard preparation (standard reaming), or the reduced pressure preparation (reduced pressure reaming). After surgery, both treatment groups will followed according to standard practices at 2 weeks, 6 weeks, 3 months, and 6 months.
This research study is for patients who have completed all scheduled surgery, chemotherapy and/or radiation therapy for their cancer within the last 6-12 months and are currently having some type of sleep disturbance. While there is no standard treatment for sleep disturbance for cancer survivors, people who do not take part in this study may take over-the-counter or prescription medications, receive cognitive behavioral therapy, or exercise as a means of attempting to manage their sleep problems.
Sleep disturbance, particularly insomnia, is a common problem for cancer survivors. Insomnia can be described as excessive daytime napping, difficulty falling asleep, difficulty staying asleep, or waking up earlier than you would like. Insomnia can increase fatigue, impair physical function, impair immune function, cause circadian rhythms (known as your biological clock) to be disrupted and decrease quality of life.
Because there is no ideal standard of care for effectively treating sleep problems in cancer survivors, the purpose of this study is to compare the effectiveness of three different treatments for improving sleep problems and determine which is best. The three treatments are yoga, survivorship health education, and cognitive behavioral therapy (CBT-I).
Study participation will be approximately 8 months.