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Background: Integrative therapies are shown to support cancer patients’ treatment plans, help with side effect management, and improve patients’ quality of life ([1-9]). In 2017, the American Society of Clinical Oncology endorsed the Association of Integrative Oncology’s Clinical Practice Guidelines highlighting their importance in breast cancer care. Recent studies suggest that more evidence is needed to bring attention to the role of integrative therapies in advanced breast cancer care [4, 7, 8, 10]. This analysis explores participants’ experiences with a wellness program implemented by Unite for HER (UFH), a non-profit organization that delivers integrative therapies and support services such as whole food nutrition services, medical acupuncture, oncology massage therapy, counseling, reiki, meditation, yoga, and fitness classes to patients with breast, metastatic breast, and ovarian cancer. As of April 2022, there were over 1,700 women diagnosed with metastatic breast cancer (MBC) participating in UFH locally and nationally. Methods: UFH members completed a survey about the impact of the UFH Wellness Program on the overall quality of life, including measures on side-effect management, OTC/prescription drug utilization rate, stress reduction, changes to wellness habits, and the social and emotional challenges associated with living with MBC. In total, 119 unique UFH members with MBC answered online surveys distributed by email in 2020 and 2021. Survey questions were designed to evaluate the impact of the UFH Wellness Program. Descriptive analyses of survey questions and open-ended comments were conducted to assess program impact. Results: All respondents were MBC patients/survivors. No other demographic information was collected. While 2020 respondents received mostly in-person services for part of their program, all 2021 respondents received primarily virtual services due to the Covid-19 restrictions. Despite the inaccessibility of in-person services, the satisfaction levels with the wellness program did not drop significantly in 2021. More than two-thirds of respondents (80% in 2020, 67% in 2021) indicated that the therapies offered through UFH Wellness Program significantly improved the side effects of their treatment for MBC. Notably, more than a quarter of respondents (28% in 2020, 26% in 2021) specified that due to UFH integrative therapies they were able to reduce or eliminate one or more OTC/prescription drugs to manage side effects. At the same time, the majority reported experiencing reduced levels of stress after utilizing integrative therapies offered by UFH (93% in 2020, 81% in 2021), as well as improvements in their emotional wellbeing (95% in 2020, 83% in 2021), and quality of life during or after treatment for MBC (97% in 2020, 96% in 2021). Also, 86% of respondents in both years indicated that UFH services, such as nutrition counseling, cooking classes, and exercise classes, helped them adopt and maintain healthier habits in their life. Furthermore, a qualitative analysis of open-ended comments found that 1) respondents expressed deep gratitude and appreciation for UFH integrative therapies, 2) noted that they would otherwise not be able to access such therapies due to financial barriers, and 3) helped them feel better prepared to cope with the psychosocial aspects of their MBC experience. Discussion: These results suggest that integrative therapies such as those offered by UFH can play a significant role in improving patients’ outcomes by reducing stress and drug utilization to manage side effects and improving patients’ well-being and quality of life during metastatic breast cancer treatment. These findings highlight the importance of choosing integrative oncology programs to support MBC patients’ needs in managing the psychosocial and physical side effects of the disease. This project was supported by a grant from individual donors in 2020 and 2021. References Citation Format: Elif Andac-Jones, Maria B. Gonzalo, Gail Kelly, Susan Weldon. Impact of Integrative Therapies on Patients with Metastatic Breast Cancer [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P5-07-15.

e24102 Background: Sleep disturbance and fatigue are prevalent among ovarian cancer patients and are associated with poor mental health and Health-related quality of life (HRQoL) outcomes; while this has been well-documented, we know less about the factors that may contribute, what cancer patients perceive as contributing to their issues, and how they describe and manage these issues across their treatment trajectory. Methods: In this qualitative study, data were collected via semi-structured interviews with 20 stage III/IV ovarian cancer patients diagnosed within three years with varied treatment trajectory, race/ethnicity, and location. A screener included PROMIS Sleep Disturbance and Fatigue measures, sociodemographics, and cancer history. Transcripts were analyzed using deductive codes of sleep and fatigue and inductive codes based on emergent themes. We identify two novel concepts of patients’ sleep and fatigue experiences: relative and functioning. Relative fatigue and sleep issues capture how patients self-report relative to different points in their treatment. Functioning concept shows how patients reinterpret and self-censor the severity and impact of their sleep and fatigue by emphasizing their ability to overcome exhaustion or insomnia. Results: All twenty patients reported persistent, debilitating fatigue, difficulty falling and staying asleep through the course of their disease, which negatively impacted their HRQoL and activities of daily living. The majority of patients struggled to complete daily chores (17/20), keep up with paid work (9/10), and maintain relationships(16/20). Although patients experience fatigue across their trajectories, the majority of patients described their fatigue as more intense during chemotherapy than maintenance therapy. Patients struggled to evaluate their current fatigue and sleep without reflecting on previous treatment experiences (relative), and continuously reinterpreted their levels of fatigue and sleep based on how much of their daily functions they could complete (functioning). Patients self-censor in reporting to meet their perceived expectations of their care provider/data collector . Although fatigue and sleep disturbance significantly impaired their HRQoL, patients framed their experiences positively and minimized their struggles. Conclusions: We conclude that PROMIS measures are important in evaluating baseline sleep disturbance and fatigue in patients with ovarian cancer. However, patients’ reporting is informed by their previous treatment experiences, subject to continued reinterpretation. Therefore 1) more nuanced and repeated measures including patients’ narratives are needed to understand the complexity of patients’ experiences; and 2) Patients’ self-censorship and filtering need to be considered. Future research will test these new concepts with a 200 patient survey.