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.
The primary objective of this study is to assess the rate of appropriate referral of newly diagnosed breast cancer patients at increased risk for HBOC to genetic counseling in the community oncology setting among patients at clusters receiving the active intervention compared with patients at clusters receiving the passive intervention. Participating centers without in-house genetic counseling services will be randomized to receive either an active or passive provider education/information intervention regarding identification and referral of breast cancer patients at risk for hereditary breast and ovarian cancer (HBOC) to genetic counseling services. Practice patterns and patient outcomes will be compared between the two intervention groups. No data from specific sites will be released; only group comparisons (i.e., between the two intervention groups) will be made. Registered patients will receive Patient Questionnaire approximately 12 months after registration.
This study is for females, ages 25-55, who have tested positive for atypia (early cell changes that are thought to be a marker of breast cancer risk) in the breast, and are considered high risk for the development of breast cancer in the future.
The purpose of this research study is to test whether metformin, a drug commonly used to treat diabetes, is able to get rid of atypia (marker of breast cancer risk) in women at increased risk for breast cancer. This study will test for the presence of atypia in the breast after metformin is given to see if it can get rid of atypia. The study sponsor would like to compare the effects, good and/or bad, of metformin or placebo on atypia to find out which is better. In this study, patients will get either metformin or a placebo (an inactive product) for the first twelve months. After the first twelve months, women who received placebo during the first twelve months can choose to receive metformin for the second year.
Note: The standard drug used for the "breast cancer prevention" is tamoxifen. If you are eligible to take tamoxifen, you must be offered tamoxifen prevention as part of your clinical care and you must have refused tamoxifen treatment to be on this study. Metformin and tamoxifen are not similar and function differently. This study is not investigating the use of tamoxifen.
While on this research study patients will have the Random Periareolar Fine Needle Aspiration (RPFNA) of their breasts to test for atypia (marker of breast cancer risk), before the study starts, and also at 12 and 24 months (24 month optional for placebo-only group for patients who remain on placebo arm and will not receive metformin) after the study starts. If the pathologist does not identify atypia in the samples you will not be able to participate. You will also provide blood during this study to determine if changes in your blood are related to changes in your breasts. You will need to provide a little less than 4 tablespoons of blood for this research study.
Study participation will last for 48 months (2 years).
This study is a cancer care delivery trial where study sites will be randomized into one of two ARMs: Usual Care or Navigation Intervention. 200 African American patients with recently diagnosed/probable/proven, early stage NSCLC will be enrolled on this trial at eligible sites. Each participant will be followed for 13 months post enrollment. The intervention consists of a series of telephone surveys conducted by trained Medical University of South Carolina staff member at baseline(initial telephone survey), at 3, 6, 9, and 12 month post enrollment.