Grant: Team Grant: CCS/CIHR Cancer Survivorship Team Grants

Women aged 40 and under with breast cancer experience poorer outcomes, havea wide spectrum of supportive needs and face unique survivorship issues compared to their older counterparts. Comprising approximately 5.4% of all women diagnosed with breast cancer, research and supports are lacking for this population. To address this, we created RUBY (Reducing the bUrden of Breast cancer in Young women), one of the world's largest prospective cohorts of women with young-onset breast cancer. To date, we have enrolled over 1000 women from 32 sites across Canada at the time of cancer diagnosis following them through treatment and into the survivorship period. Through RUBY, we have identified a number of unique survivorship gaps, including high levels of anxiety at diagnosis and beyond especially given extended hormonal therapies, marital and motherhood challenges, and social isolation. Specific, accessible interventions are required, but are currently lacking. ICAN Survive, is a promising self-management, on-line intervention for patients with cancer designed to address global survivorship issues at diagnosis and beyond. Key areas of need include regaining balance/dealing with diagnosis, coping with treatment and side-effects, management of anxiety and depression, fatigue management, sexuality and relationships. The ICAN intervention aims to build self management skills through guided training and education, however does not focus on the specific needs of young women. Thus, we propose to modify the ICAN intervention in collaboration with young onset survivors and evaluate the modified tool (ICAN-RUBY) for effectiveness. We are uniquely positioned to develop this young women specific intervention given the direct knowledge of gaps identified to date from existing RUBY cohort. We will leverage established RUBY study infrastructure with a proven track record of recruitment, to evaluate the effectiveness of the ICAN-RUBY tool in an embedded randomized trial.