Post-Hurricane Cancer Care: Patient Needs after Hurricane Maria

摘要 飓风玛丽亚于2017年9月20日在波多黎各（PR）登陆，成为5级风暴， 造成至少64人死亡，估计损失达900亿美元。癌症患者 特别容易受到玛丽亚造成的破坏;据估计，90%的患者 他们的护理受到了干扰。目前的研究将描述未满足的医疗和 心理需求以及障碍和促进因素，以照顾癌症患者在公关。 此外，玛丽亚提供了一个独特的机会，研究压力和癌症的交叉点， 特别是极端的身体和精神压力对下丘脑-垂体-肾上腺的影响 (HPA)轴功能，这是已知的影响癌症生物学。研究目的：1） 描述PR中癌症患者随时间推移未满足的医疗和心理需求 2）确定获得护理的多层次障碍和促进因素， 和3）探索患者和匹配样本中应激的假定生理标志物， 受飓风玛丽亚影响的非癌症对照组。目前的研究利用了一个长期的 庞塞健康科学大学（PHSU）和莫菲特癌症之间的U 54资助的伙伴关系 中心资源包括社区外展核心和波多黎各生物库以及 作为研究团队成员之间合作的历史。

ABSTRACT Hurricane Maria made landfall in Puerto Rico (PR) on September 20, 2017 as Category 5 storm, killing at least 64 people and causing an estimated $90 billion in damage. Cancer patients are particularly vulnerable to the devastation caused by Maria; it is estimated that 90% of patients have experienced interruptions in their care. The current study will describe unmet medical and psychological needs as well as barriers and facilitators to care in cancer patients in PR. In addition, Maria presents a unique opportunity to study the intersection of stress and cancer, specifically the impact of extreme physical and mental stress on hypothalamic-pituitary-adrenal (HPA) axis functioning which is known to affect cancer biology. Study aims are to: 1) to describe unmet medical and psychological needs over time among cancer patients in PR affected by Hurricane Maria, 2) to identify multilevel barriers and facilitators to access to care, and 3) to explore putative physiological markers of stress in patients and a matched sample of non-cancer controls affected by Hurricane Maria. The current study leverages a longstanding U54-funded partnership between Ponce Health Sciences University (PHSU) and Moffitt Cancer Center. Resources include an Community Outreach Core and the Puerto Rico Biobank as well as a history of collaboration among members of the research team.