Cancer Health_Fall_2018

Your Cancer Treatment
It is estimated that more than one in three people in the United States will be diagnosed with cancer during their lifetime. At a time when cancer therapy is evolving rapidly, Cancer Health wants to know about your experiences with treatment.
1) If you have been diagnosed with cancer,  what type was it?
2) Where are you in the treatment process?

I have not yet started treatment. I am currently receiving treatment. I have finished treatment and have no evidence of cancer. I finished treatment, but the cancer is still present or has come back. I will not receive further treatment beyond palliative care.
3) What types of treatment have you received? (Check all that apply.)

Surgery Radiation therapy Targeted therapy CAR-T therapy Traditional chemotherapy Hormone or endocrine therapy Immune checkpoint inhibitors
4) What treatment side effects have you experienced? (Check all that apply.)

Anemia Cognitive changes Constipation Diarrhea Fatigue Fever Hair loss Immune reactions Infections Loss of appetite Nausea/vomiting Neuropathy Pain Skin problems Sleep problems
5) What were your side effects like?

Mild Moderate Severe
6) Have you had to stop treatment because of side effects?

Yes No
7) What steps have you taken to reduce or relieve side effects? (Check all that apply.)

Acupuncture Anti-nausea or anti-diarrhea medication Exercise or physical therapy Mental health counseling Medical cannabis Pain medication Scalp cooling to reduce hair loss Treatment for anemia or neutropenia
8) What year were you born?
9) What is your gender?

Male Female Transgender
10) What is your level of education?

Some high school High school graduate Some college Bachelor’s degree Graduate or professional degree
11) What is your household income?

Less than $25,000 $25,000–$49,999 $50,000–$99,999 $100,000–$149,999 $150,000–$199,999 $200,000 or more
12) What is your ethnicity? (Check all that apply.)

American Indian or Alaska Native Arab or Middle Eastern Asian Black or African American Hispanic or Latino Native Hawaiian or other Pacific Islander White
13) What is your zip code?
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Your Cancer Treatment