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Derry-Vick H. Writing tips for psychoneuroimmunology trainees: Lessons learned from Dr. Kiecolt-Glaser. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2024; 20:100258. [PMID: 39219689 PMCID: PMC11363997 DOI: 10.1016/j.cpnec.2024.100258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Revised: 07/31/2024] [Accepted: 08/02/2024] [Indexed: 09/04/2024] Open
Abstract
Psychoneuroimmunology (PNI) researchers can advance their careers and increase their scientific impact by prioritizing their writing skills. In addition to Dr. Kiecolt-Glaser's landmark research that inspired this special issue, her legacy is reflected in her prolific writing. Dr. Kiecolt-Glaser has the unique ability to convey her innovative research clearly and to diverse audiences. She also made writing mentorship a critical part of the training experience in her lab. In these ways, Dr. Kiecolt-Glaser's writing skills and mentorship have shaped both the PNI field and her trainees' careers. In this paper, I distill lessons learned about writing from Dr. Kiecolt-Glaser during my time as a graduate student in her Stress and Health Lab in the 2010s. I reflect on Dr. Kiecolt-Glaser's influence on her trainees' writing habits, summarize "writing pearls" inspired by her feedback/revisions, and provide observations on her writing mentorship habits. These tips are intended to help PNI trainees to clearly communicate their work and to help mentors reflect on ways they can prioritize and advance their trainees' writing skills. Finally, I reflect on how Dr. Kiecolt-Glaser's mentorship and scientific accomplishments had a tremendous impact on my own career development.
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Affiliation(s)
- Heather Derry-Vick
- Cancer Prevention Precision Control Institute, Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ, USA
- Hackensack Meridian School of Medicine, Nutley, NJ, USA
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Malarkey WB. Psychoneuroimmunology and the research of Janice Kiecolt-Glaser: It informs self-care and the practice of medicine. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2024; 20:100260. [PMID: 39258160 PMCID: PMC11386094 DOI: 10.1016/j.cpnec.2024.100260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 08/06/2024] [Accepted: 08/16/2024] [Indexed: 09/12/2024] Open
Abstract
Dr. Janice Kiecolt-Glaser as an undergraduate obtained a major in psychology and a minor in biological sciences which was an early indication of her budding interest in how the brain talks to a variety of physiologic systems. Early in her research career Jan began to build a research team that eventually consisted of scientists with expertise in a variety of disciplines including virology, immunology, endocrinology, nutrition science, biostatistics, genetics, and the microbiome. Additionally, Jan enlisted the aid of a group of bright energetic pre- and post-doctoral graduate students, obtained numerous NIH grants, and utilized an excellent Clinical Research Center. Over many years Jan directed these teams to help with understanding some of the biologic consequences of common life stressors such as loneliness, academic examinations, marital discord, breast cancer survivorship, and dementia caregiving. In this survey of her accomplishments, I will present some of the highlights of her prolific contributions which have encouraged many to enter the field of psychoneuroimmunology.
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Christian LM. Turning stress into success: A festschrift in honor of Janice Kiecolt-Glaser. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2024; 19:100251. [PMID: 39170082 PMCID: PMC11338126 DOI: 10.1016/j.cpnec.2024.100251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 07/12/2024] [Accepted: 07/17/2024] [Indexed: 08/23/2024] Open
Affiliation(s)
- Lisa M. Christian
- Department of Psychiatry & Behavioral Health and the Institute for Behavioral Medicine Research and The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH, USA
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Blockhuys S, Wittung-Stafshede P. Yoga as a Complementary Therapy for Cancer Patients: From Clinical Observations to Biochemical Mechanisms. Complement Med Res 2024:1-13. [PMID: 38991506 DOI: 10.1159/000540213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 07/03/2024] [Indexed: 07/13/2024]
Abstract
BACKGROUND Integrative oncology combines conventional and complementary, or integrative, therapies for a holistic treatment of cancer patients. Yoga is increasingly used as a complementary therapy for cancer patients, but there is no direct evidence for its effect on cancer pathophysiology like tumor response, or patient outcome like overall survival. SUMMARY In this narrative review, we present in detail published studies from randomized clinical trials on complementary yoga therapy for cancer patients, including details about the biochemical mechanisms involved. Medicinal hatha yoga with breathing, postures, meditation, and relaxation enhances the quality of life of cancer patients by providing both psychological and physiological health benefits, highlighting the interconnectedness of mind and body. Yoga therapy reduces stress levels improving heart rate variability, leading to changes in hormonal regulation (e.g., cortisol), reduced oxidative stress, and improved immune function with reduced inflammation. Still, the biochemical effects of yoga on the cancer disease itself are unrevealed. KEY MESSAGES More clinical and basic research is needed for further establishment of yoga as complementary therapy in oncology.
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Affiliation(s)
- Stéphanie Blockhuys
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Dong Y, Huang H, Wang A. Effects of different exercise interventions on chemotherapy-related cognitive impairment in patients with breast cancer: a study protocol for systematic review and network meta-analysis. BMJ Open 2024; 14:e078934. [PMID: 38631832 PMCID: PMC11029385 DOI: 10.1136/bmjopen-2023-078934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 04/10/2024] [Indexed: 04/19/2024] Open
Abstract
INTRODUCTION Breast cancer stands as the most prevalent type of cancer affecting women globally, and chemotherapy plays a pivotal role in its treatment by diminishing tumour recurrence and enhancing the survival rates of patients. However, chemotherapy-related cognitive impairment (CRCI) often occurs in patients undergoing treatment. Although multiple clinical trials have indicated that exercise therapy can improve CRCI in patients with breast cancer, there are variations in the types of exercise interventions and their effectiveness. We aim to perform a pioneering network meta-analysis (NMA) to assess and prioritise the effectiveness of various exercise interventions in enhancing cognitive function in patients with breast cancer undergoing chemotherapy. METHODS AND ANALYSIS We will search multiple databases, including PubMed, Web of Science, Cochrane, Embase, China National Knowledge Infrastructure, VIP Database for Chinese Technical Periodicals, Wanfang and Sinomed databases, from their inception to May 2023. The main outcome is the cognitive function changes in patients with breast cancer, including subjective and objective results. We will specifically include randomised controlled trials reported in English and Chinese languages, whose primary outcome consists of an assessment of the cognitive function of patients with breast cancer using standardised and validated assessment tools, encompassing both subjective and objective outcomes. The quality of all the trials included will be evaluated based on 'Version 2 of the Cochrane tool for assessing the risk of bias in randomized controlled trials (RoB2)'. We will conduct a Bayesian NMA to thoroughly evaluate and compare the effectiveness of different exercise interventions. We will use cumulative ranking probability plots to estimate the ranking of the best interventions for various exercises. Network plots and funnel plots will be employed to display the study sizes and participants of each exercise intervention, as well as potential publication biases. ETHICS AND DISSEMINATION The study findings will be shared via peer-reviewed journals to ensure the highest quality and credibility of the research. As the reporting will not include any private patient data, there are no ethical considerations associated with this protocol. PROSPERO REGISTRATION NUMBER CRD42023406597.
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Affiliation(s)
- Yu Dong
- The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Hao Huang
- The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Aiping Wang
- The First Hospital of China Medical University, Shenyang, Liaoning, China
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Giridharan S, Kumar NV. Bibliometric Analysis of Randomized Controlled Trials on Yoga Interventions for Cancer Patients: A Decade in Review. Cureus 2024; 16:e58993. [PMID: 38800314 PMCID: PMC11127709 DOI: 10.7759/cureus.58993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2024] [Indexed: 05/29/2024] Open
Abstract
This literature review presents a bibliometric analysis of the randomized controlled trials conducted between 2014 and 2023 on the potential benefits of yoga as a complementary therapy for cancer patients. To conduct this analysis, we searched medical and scientific databases, such as Scopus, Cochrane, and PubMed, using relevant keywords. Our search yielded 58 clinical trials involving 4,762 patients, which indicates a growing trend in this field of research. The studies we reviewed mainly focused on breast cancer patients and demonstrated the adaptability and versatility of yoga, offering a ray of hope and optimism. Among the various styles of yoga, Hatha yoga was the most frequently practiced style in these clinical trials. The analysis we conducted reveals that yoga interventions have a promising role in cancer care and can be a valuable complementary therapy for cancer patients. However, significant gaps and limitations still need to be addressed in this area of research. For instance, more rigorous and diverse investigations are needed to further establish the potential benefits of yoga interventions for cancer patients. Additionally, the standardization of yoga interventions is crucial to optimize therapeutic benefits. By addressing these gaps and limitations, we can further enhance the potential of yoga as a complementary therapy for cancer patients.
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García-Muñoz C, Villar-Alises O, Rodríguez-Sánchez-Laulhé P, Matias-Soto J, Martinez-Calderon J. No effects were found in favor of Hatha or Iyengar yoga exercises for improving cancer-related fatigue, depression symptoms, or quality of life: a systematic review with meta-analysis and metaregression. Support Care Cancer 2023; 32:3. [PMID: 38049680 DOI: 10.1007/s00520-023-08174-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 11/07/2023] [Indexed: 12/06/2023]
Abstract
OBJECTIVE To summarize the evidence on the effectiveness of Hatha or Iyengar yoga exercises on cancer-related fatigue, depression symptoms, and the overall quality of life in adults with cancer. METHODS A systematic review with meta-analysis was conducted. The CINAHL (via EBSCOhost), Embase, PubMed, and SPORTDiscus (via EBSCOhost) databases were searched from inception to 7th November 2022. Clinical trials evaluating cancer-related fatigue, depression symptoms, and the overall quality of life were included. The risk of bias was assessed using the Cochrane Risk of Bias tool 2. The Template for Intervention Description and Replication (TIDieR) checklist was used to check if the interventions reviewed were described in detail to be implemented in the clinical setting. The Grading of Recommendations, Assessment, Development, and Evaluations approach was used to rate the certainty of evidence. Meta-regressions, sensitivity analyses, and subgroup meta-analyses were conducted to explore sources of heterogeneity. RESULTS Eleven studies were included (N = 777 participants). Overall, Hatha, Iyengar, and the combination of both yoga styles did not improve any of the outcomes of interest. In addition, five studies had a high risk of bias, and six studies had some concerns about biases. Weaknesses in reporting modifications during the development of the study were observed (TIDieR item 10). The certainty of evidence ranged from low to very low across the outcomes. CONCLUSIONS We could not make sound clinical recommendations with the current quality of the findings.
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Affiliation(s)
- Cristina García-Muñoz
- Universidad Loyola de Andalucía, Sevilla, Spain
- CTS 1110: Uncertainty, Mindfulness, Self, and Spirituality (UMSS) Research Group, Andalusia, Spain
| | - Olga Villar-Alises
- CTS 1110: Uncertainty, Mindfulness, Self, and Spirituality (UMSS) Research Group, Andalusia, Spain
| | - Pablo Rodríguez-Sánchez-Laulhé
- CTS 1110: Uncertainty, Mindfulness, Self, and Spirituality (UMSS) Research Group, Andalusia, Spain.
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, 41009, Sevilla, Spain.
| | - Javier Matias-Soto
- CTS 1110: Uncertainty, Mindfulness, Self, and Spirituality (UMSS) Research Group, Andalusia, Spain
- Department of Physical Therapy, Universidad de Malaga, Faculty of Health Sciences, Malaga, Spain
| | - Javier Martinez-Calderon
- CTS 1110: Uncertainty, Mindfulness, Self, and Spirituality (UMSS) Research Group, Andalusia, Spain
- Departamento de Fisioterapia, Instituto de Biomedicina de Sevilla, IBiS, Universidad de Sevilla, Sevilla, Spain
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Duivon M, Lange M, Binarelli G, Lefel J, Hardy-Léger I, Kiasuwa-Mbengi R, Méric JB, Charles C, Joly F. Improve the management of cancer-related cognitive impairment in clinical settings: a European Delphi study. J Cancer Surviv 2023:10.1007/s11764-023-01436-8. [PMID: 37934312 DOI: 10.1007/s11764-023-01436-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 07/21/2023] [Indexed: 11/08/2023]
Abstract
PURPOSE Cancer-related cognitive impairment (CRCI) is under-addressed by healthcare professionals owing to a lack of clinical management guidelines. This European Delphi study proposes recommendations to healthcare professionals for the management of CRCI in patients with non-central nervous system (non-CNS) cancers. METHODS Twenty-two recommendations were developed based on a literature review and authors' clinical experience, split into three categories: screening, cognitive assessment, intervention. The survey included European professionals, experts in CRCI. The Delphi method was used: experts rated the clinical relevancy of recommendations on a 9-point Likert scale in three rounds. A recommendation was accepted if all votes were between 7 and 9. Recommendations not accepted in round 1 and round 2 were deleted, or modified and rated in round 3. RESULTS Eighteen professionals (psychologists, physicians, researchers) voted and accepted 15 recommendations. Experts recommended the systematic screening of CRCI, followed by a short objective cognitive assessment, if complaints screened. A comprehensive evaluation is recommended if CRCI persists 6 months post-treatment. Cognitive rehabilitation, physical activity, meditative-movement therapy, and multimodal intervention should be offered. Recommendations about frequency and duration of interventions, the professional to administer cognitive rehabilitation and the use of meditation and cognitive training without psychoeducation were not accepted. CONCLUSIONS This survey provides 15 recommendations to assist healthcare professionals in detecting, assessing and offering interventions for CRCI. IMPLICATIONS FOR CANCER SURVIVORS These recommendations should be included in supportive care to help healthcare professionals to detect CRCI and propose the best available intervention for patients with cognitive complaints. Developing CRCI management in clinical settings would improve patients' quality of life.
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Affiliation(s)
- Mylène Duivon
- Normandie Univ, UNICAEN, INSERM, ANTICIPE, 14000, Caen, France
| | - Marie Lange
- Normandie Univ, UNICAEN, INSERM, ANTICIPE, 14000, Caen, France
- Clinical Research Department, Centre François Baclesse, 14000, Caen, France
- Cancer & Cognition Platform, Ligue Contre le Cancer, 14000, Caen, France
| | - Giulia Binarelli
- Normandie Univ, UNICAEN, INSERM, ANTICIPE, 14000, Caen, France
- Clinical Research Department, Centre François Baclesse, 14000, Caen, France
| | - Johan Lefel
- Care Support Department, Centre Henri Becquerel, 76000, Rouen, France
| | | | - Régine Kiasuwa-Mbengi
- Department of Public Health and Epidemiology, Belgian Cancer Centre, Sciensano, Brussels, Belgium
| | - Jean-Baptiste Méric
- Public Health Division, National Cancer Institute, 52 Avenue André Morizet, 92100, Boulogne-Billancourt, France
| | - Cécile Charles
- Bordeaux Population Health Research Center, University of Bordeaux, Bordeaux, France
| | - Florence Joly
- Normandie Univ, UNICAEN, INSERM, ANTICIPE, 14000, Caen, France.
- Clinical Research Department, Centre François Baclesse, 14000, Caen, France.
- Cancer & Cognition Platform, Ligue Contre le Cancer, 14000, Caen, France.
- Medical Oncology Department, CHU de Caen, 14000, Caen, France.
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Weitz MV, Bloch JR, Birati Y, Rundio A, Fisher K, Byrne S, Guerra L. The Relationship Between Yoga Practice Dosage and Perceived Stress, Anxiety, and Self-reported Health Among Breast Cancer Survivors Who Practice Yoga. Holist Nurs Pract 2023; 37:347-355. [PMID: 37851351 DOI: 10.1097/hnp.0000000000000610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
The aim of this anonymous online study was to explore the yoga practice of breast cancer survivors to determine if yoga dosage (frequency and duration of practice) was related to stress, anxiety, and self-reported health in female survivors. Participants were recruited from online breast cancer support groups during a 3-month period (June-September 2019). Demographic information, stage and treatment of breast cancer, and frequency of yoga participation, including a home yoga practice were reported. Measures include the Perceived Stress Scale, State-Trait Anxiety Inventory, and self-reported health. Cumulative yoga dosage was calculated. Thirty-five women participated (mean age = 55 years) and were divided into low and high yoga dosage groups based on the sample distribution. Low dosage of yoga was operationally defined as a cumulative dosage that fell within the lowest quartile (≤25%). Findings indicated no difference between the low-dosage group compared with the high-dosage group for perceived stress and self-reported health; but the high dosage yoga group had lower state anxiety scores (P < .05). All participants reported good self-reported health. These findings contribute to our knowledge of the psychosocial aspects of breast cancer survivorship and raise questions for further research quantifying the therapeutic dosing of yoga practice.
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Affiliation(s)
- M Velma Weitz
- M Velma Weitz Wellness Practice, Philadelphia, Pennsylvania (Dr Weitz); Graduate Nursing Department, College of Nursing and Health Professions, Drexel University (Drs Bloch, Rundio, and Fisher); Department of Population Health, Azrieli Faculty of Medicine, Bar Ilan University Safed, Isreal (Dr Birati); and Department of Nursing & Public Health, School of Nursing and Health Science, The College of New Jersey (Dr Byrne). Dr Guerra, is in private practice at Bala Cynwyd, Pennsylvania
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Xia R, Wan M, Lin H, Ye Y, Chen S, Zheng G. Effects of mind-body exercise Baduanjin on cognition in community-dwelling older people with mild cognitive impairment: A randomized controlled trial. Neuropsychol Rehabil 2023; 33:1368-1383. [PMID: 35838817 DOI: 10.1080/09602011.2022.2099909] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 07/05/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVE To determine the effect of a 6-month traditional Chinese mind-body Baduanjin exercise intervention on cognitive ability in older people with Mild cognitive impairment (MCI). METHODS A total of 135 community-dwelling seniors with MCI were randomized into either the Baduanjin group (BDJ), the brisk walking group (BWK) or the usual physical activity control group (UPA). Cognitive ability was assessed at baseline, 2, 4 and 6 months post-intervention, and 3 months after the intervention ended. RESULTS After 6 months of intervention, the MoCA score of the BDJ group was significantly higher than that of the UPA group (P < 0.05), The Go/No-go correct numbers of the BDJ group and BWK group were significantly higher than those of the UPA group (P < 0.05). There was no statistical difference in other outcomes, or there were only a tiny effect size. Three months after the intervention, there was no significant difference between the primary and secondary outcomes(P > 0.05). CONCLUSION The 6-month period of Baduanjin training has positive benefits on global cognitive function and attention function in community-dwelling elderly individuals with MCI. The effect seems to have been transient and needs to be confirmed by additional studies.
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Affiliation(s)
- Rui Xia
- The Second Affiliated Hospital of Shenzhen University, Shenzhen, People's Republic of China
| | - Mingyue Wan
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, People's Republic of China
| | - Huiying Lin
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, People's Republic of China
| | - Yu Ye
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, People's Republic of China
| | - Shangjie Chen
- The Second Affiliated Hospital of Shenzhen University, Shenzhen, People's Republic of China
| | - Guohua Zheng
- College of Nursing and Health Management, Shanghai University of Medicine & Health Sciences, Shanghai, People's Republic of China
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Liu Y, Liu JE, Chen S, Zhao F, Chen L, Li R. Effectiveness of Nonpharmacologic Interventions for Chemotherapy-Related Cognitive Impairment in Breast Cancer Patients: A Systematic Review and Network Meta-analysis. Cancer Nurs 2023; 46:E305-E319. [PMID: 37607381 DOI: 10.1097/ncc.0000000000001152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Neurotoxicity is a major adverse effect of chemotherapy in breast cancer (BC) patients. A number of nonpharmacologic interventions are used to alleviate chemotherapy-related cognitive impairment (CRCI), but no studies have compared their effectiveness. OBJECTIVES The aim of this study was to identify and compare the effectiveness of different nonpharmacologic interventions for CRCI in BC patients. METHODS A systematic review and network meta-analysis was conducted following the Cochrane guidelines. All randomized controlled trials were searched in the Cochrane Library, PubMed, MEDLINE (via OVID), Web of Science, EMBASE, and CINAHL databases from inception to September 2021. Studies using nonpharmacologic interventions to manage CRCI symptoms were included. A network meta-analysis and a comparative effects ranking were completed by STATA v14.0. RESULTS Twelve studies with 8 nonpharmacologic interventions were included. For subjective outcomes on CRCI, there was no significant difference between nonpharmacologic interventions. For objective outcomes, qigong and exercise were more effective than the psychotherapy. Qigong and exercise were also more effective than music therapy. The top 3 interventions were psychotherapy (83.4%), music therapy (60.8%), and electroacupuncture (52.5%) for subjective outcomes and qigong (87.7%), exercise (82.1%), and electroacupuncture (70.3%) for objective outcomes. CONCLUSION In the subjective evaluation, it was difficult to judge which interventions are best, but psychotherapy had the greatest probability. For objective evaluation, qigong and exercise may be the best nonpharmacologic interventions. IMPLICATIONS FOR PRACTICE This study provides evidence for the effectiveness of nonpharmacologic interventions for CRCI in BC patients and facilitates support for future clinical trials and work.
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Affiliation(s)
- Yu Liu
- Author Affiliation: School of Nursing, Capital Medical University, People's Republic of China
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Brunet J, Sharma S. A scoping review of studies exploring physical activity and cognition among persons with cancer. J Cancer Surviv 2023:10.1007/s11764-023-01441-x. [PMID: 37561316 DOI: 10.1007/s11764-023-01441-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 07/27/2023] [Indexed: 08/11/2023]
Abstract
PURPOSE This scoping review aimed to identify and synthesize published studies on physical activity (PA) and cognition among persons with cancer and elucidate knowledge gaps. METHODS Articles were identified through electronic and manual searches (02/21 and 03/22) using the following inclusion criteria: (1) empirical, peer-reviewed publication in English, (2) sample comprised persons with cancer, and (3) reported at least one statistical association between PA and cognition. Multiple reviewers independently performed study selection and data extraction, and results were mapped in tabular and narrative form. RESULTS Ninety-seven articles were eligible; these were largely published from 2017 to 2022 (54.6%), conducted in high-income countries (96.9%), and presented (quasi-)experimental studies (73.2%). Samples predominantly comprised women with breast cancer (48.5%), and recruitment often occurred post-treatment (63.9%). PA interventions included: aerobic (32.3%), resistance (4.8%), combined aerobic/resistance (38.7%), mind-body (19.4%), or other PA (4.8%). Most (66%) articles reported inconclusive findings; 32% were positive (in support of PA promoting cognition or vice versa), and 2.1% were negative. Diverse samples and studies with long-term follow-up were scarce. CONCLUSIONS The state of knowledge is insufficient and more rigorous, large-scale studies are required to provide definitive conclusions about the cognitive benefits of PA among persons with cancer. IMPLICATIONS FOR CANCER SURVIVORS Cancer-related cognitive impairment (CRCI) thwarts quality of life. This review summarizes what is known about the association between PA and cognition among persons with cancer and concludes that the evidence is currently equivocal. Hence, it remains uncertain if PA interventions can reduce CRCI, and large-scale PA intervention trials explicitly designed to promote cognition are greatly needed.
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Affiliation(s)
- Jennifer Brunet
- School of Human Kinetics, University of Ottawa, 125 University (MNT 339), Ottawa, ON, K1N 6N5, Canada.
- Institut du savoir Montfort, l'Hôpital Montfort, Ottawa, ON, Canada.
- Cancer Therapeutic Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.
| | - Sitara Sharma
- School of Human Kinetics, University of Ottawa, 125 University (MNT 339), Ottawa, ON, K1N 6N5, Canada
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Kaligal C, Kanthi A, Vidyashree M, Krishna D, Raghuram N, Hongasandra Ramarao N, Deepeshwar S. Prefrontal oxygenation and working memory in patients with type 2 diabetes mellitus following integrated yoga: a randomized controlled trial. Acta Diabetol 2023; 60:951-961. [PMID: 37014456 DOI: 10.1007/s00592-023-02085-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 03/24/2023] [Indexed: 04/05/2023]
Abstract
AIMS Type 2 diabetes mellitus (T2DM) alters brain functional and structural connectivity leading to cognitive dysfunction. This study examined the effect of a 12-week yoga intervention on prefrontal cortex (PFC) oxygenation and working memory in patients with T2DM. METHODS Fifty participants were randomized into yoga and waitlist control groups. The yoga protocol specific to T2DM was followed. The pre- (day 1), mid- (6 weeks) and post-intervention (12 weeks) assessments included measurement of PFC oxygenation while performing working memory tasks (n-back) using functional near-infrared spectroscopy. RESULTS Following a 12-week intervention, the yoga group showed improved performance in working memory [accuracy (geometric mean difference of 3.15%, 95% CI [2.33,3.96], p = 0.001) and reaction time (mean difference of 100.8 milliseconds,95% CI [- 166.6, - 35.1], p = 0.002] in the high task load (2-back) associated with higher oxygenation in dorsolateral PFC (β coefficient mean difference of 95.6, 95% CI [0.23,191], p = 0.049) and ventrolateral PFC (β coefficient mean difference of 53.4, 95% CI [7.8,98.9], p = 0.018) regions. Higher oxygenation in dorsolateral PFC during 2-back task was positively correlated with accuracy (r(23) = 0.65, p < 0.001) and negatively correlated with reaction time (r(23) = - 0.47,p = 0.017). CONCLUSION Integrated yoga practice may improve working memory performance associated with higher PFC oxygenation in patients with T2DM. As 12 weeks of yoga intervention improved working memory performance, the regular practice of yoga may have the potential to prevent decline of cognitive functions in clinical conditions.
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Affiliation(s)
- Chidananda Kaligal
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana, Samsthana (S-VYASA), #19 Eknath Bhavan, Gavipuram Circle, K.G. Nagar, Bangalore, 560019, India
| | - Amit Kanthi
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana, Samsthana (S-VYASA), #19 Eknath Bhavan, Gavipuram Circle, K.G. Nagar, Bangalore, 560019, India
| | - M Vidyashree
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana, Samsthana (S-VYASA), #19 Eknath Bhavan, Gavipuram Circle, K.G. Nagar, Bangalore, 560019, India
| | - Dwivedi Krishna
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana, Samsthana (S-VYASA), #19 Eknath Bhavan, Gavipuram Circle, K.G. Nagar, Bangalore, 560019, India
| | - Nagarathna Raghuram
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana, Samsthana (S-VYASA), #19 Eknath Bhavan, Gavipuram Circle, K.G. Nagar, Bangalore, 560019, India
| | - Nagendra Hongasandra Ramarao
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana, Samsthana (S-VYASA), #19 Eknath Bhavan, Gavipuram Circle, K.G. Nagar, Bangalore, 560019, India
| | - Singh Deepeshwar
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana, Samsthana (S-VYASA), #19 Eknath Bhavan, Gavipuram Circle, K.G. Nagar, Bangalore, 560019, India.
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Li S, Gao Y, Lin Y, Wu W, Fang Q, Ni X, Zhou Y, Hong M, Zhang R, Lou Y. Development and preliminary testing of the cancer-related fatigue comprehensive assessment scale in cancer survivors. J Clin Nurs 2023; 32:1186-1217. [PMID: 35285109 DOI: 10.1111/jocn.16272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 01/19/2022] [Accepted: 02/04/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Tailored management of cancer-related fatigue (CRF) is important for effective coping; however, it has been hindered by the lack of a comprehensive tool that assesses both symptoms and treatable influencing factors. AIMS AND OBJECTIVES The aim was to develop a cancer-related fatigue comprehensive assessment scale (CRF-CAS) and assess its psychometric properties. DESIGN This was a mixed-method study. METHODS The study included two phases which were conducted in Zhejiang Province, China. In phase one, a literature search, brainstorming sessions, Delphi studies, cognitive interviews and a pilot study were conducted to construct and revise CRF-CAS indicators. In phase two, a questionnaire-based survey was conducted among cancer survivors. Item analysis was used to select and optimize indicators. Cronbach's α was calculated for reliability analysis. Validity analysis included concurrent validity and structural validity. RESULTS A 93-item tool was initially constructed. Phase one ended with revision and optimization. The preliminary scale included five dimensions (CRF symptoms, physical activity, cognitive-emotional status, sleep status, nutritional status) and 30 items. The mean item-content validity index (I-CVI) and scale-level CVI universal agreement (S-CVI/UA) were .98, and the adjusted mean values of Kappa for indicators ranged from .91-1, as evaluated by the expert group. The Pearson correlation coefficient between the CRF-CAS and criterion scales ranged from .337-.862. Cronbach's α coefficient ranged from .624-.728. Respondents agreed that the scale was acceptable for administration and that it contributed to decision-making in fatigue management. Confirmatory factor analysis (CFA) indicated that the CRF-CAS fit well. CONCLUSIONS The construction process of the CRF-CAS, involving panel discussion and expert and participant evaluations, was shown to be scientific and feasible. The CRF-CAS had relatively good validity and reliability in version 5 of its preliminary scale, which requires further improvement in future studies.
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Affiliation(s)
- Shuaini Li
- Hangzhou Normal University, Hangzhou, Zhejiang Province, China.,The Children's Hospital Zhejiang University School of Medicine (National Clinical Research Center for Child Health), Hangzhou, Zhejiang Province, China
| | - Yating Gao
- Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Ying Lin
- Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Wanying Wu
- Zhejiang Cancer Hospital (Cancer Hospital of the University of Chinese Academy of Sciences), Hangzhou, Zhejiang Province, China
| | - Qunying Fang
- Zhejiang Cancer Hospital (Cancer Hospital of the University of Chinese Academy of Sciences), Hangzhou, Zhejiang Province, China
| | - Xiaosha Ni
- Hangzhou Ninth People's Hospital, Hangzhou, Zheijiang province, China
| | - Yao Zhou
- Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Meirong Hong
- Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Ruolin Zhang
- Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Yan Lou
- Hangzhou Normal University, Hangzhou, Zhejiang Province, China
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15
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Park JH, Jung SJ, Lee LJ, Rhu J, Bae SH. Impact of non-pharmacological interventions on cognitive impairment in women with breast cancer: A systematic review and meta-analysis. Asia Pac J Oncol Nurs 2023; 10:100212. [PMID: 37095894 PMCID: PMC10121786 DOI: 10.1016/j.apjon.2023.100212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 02/16/2023] [Indexed: 03/06/2023] Open
Abstract
Objective This study aimed to examine the characteristics of research conducted on nonpharmacological interventions for cognitive impairment in patients with breast cancer and identify the primary effects of nonpharmacological interventions through a systematic review and meta-analysis. Methods Five electronic databases were searched to identify all randomized controlled trial studies until September 30, 2022, using the key terms "breast cancer," "cognitive disorders," and their possible variations. The Cochrane Risk of Bias tool was used to assess risk of bias. The effect sizes were calculated in Hedges' g. Potential moderators influencing the intervention effects were explored. Results Twenty-three studies were included in the systematic review, and 17 studies were included in the meta-analysis. Among the nonpharmacological interventions for patients with breast cancer, cognitive rehabilitation and physical activity were the most common, followed by cognitive behavioral therapy. The meta-analysis indicated that nonpharmacological interventions had a significant effect on attention (g = 0.83; 95% CI: 0.14 to 1.52; I 2 = 76%), immediate recall (g = 0.33; 95% CI: 0.18 to 0.49; I 2 = 0%), executive function (g = 0.25; 95% CI: 0.13 to 0.37; I 2 = 0%), and processing speed (g = 0.44; 95% CI: 0.14 to 0.73; I 2 = 51%) among objective cognitive functions, as well as subjective cognitive function (g = 0.68; 95% CI: 0.40 to 0.96; I 2 = 78%). Intervention type and mode of delivery were potential moderators for the effects of nonpharmacological interventions on cognitive functions. Conclusions Nonpharmacological interventions can improve subjective and objective cognitive functioning among patients with breast cancer undergoing cancer treatment. Therefore, it is necessary to provide nonpharmacological interventions by screening patients at high risk of cancer-related cognitive impairment. Systematic review registration CRD42021251709.
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Gonzalez M, Grant S, de Manincor M, Lacey J, Sarris J. Cancer survivors’ experiences, barriers and preferences with yoga: A cross-sectional survey to inform a yoga intervention. Explore (NY) 2022; 19:389-395. [PMID: 36283942 DOI: 10.1016/j.explore.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 10/05/2022] [Accepted: 10/10/2022] [Indexed: 11/04/2022]
Abstract
PURPOSE Evidence suggests that yoga may help improve cancer-related symptoms though knowledge of the experiences, barriers and preferences of people diagnosed with cancer is limited. This study sought to examine the use of yoga in an Australian sample and identify the experiences and preferences associated with undertaking yoga practice as formative research to help inform a future yoga intervention. METHODS Adults diagnosed with any type of cancer completed a cross-sectional survey including questions regarding their demographics, experiences and preferences for yoga practice. RESULTS Sixty-eight people who had been diagnosed with cancer completed the survey. Most of the participants (70.8%) had practiced yoga since their diagnosis. A variety of reasons for practice were endorsed, and benefits experienced included physical and psychological factors. The most common barrier to practice was related to the physical ability to undertake yoga. Participants indicated a preference for group classes (44.1%), with a frequency of practice of 2-3 times per week (60.3%), 60 min in length (75%). The preferred time of practice was 9am-12pm (51.5%) and travel distance 5-10 km (44.1%). Online yoga delivery was endorsed, with participants preferring pre-recorded sessions. CONCLUSIONS Results from this study provide insights into the experiences, barriers and preferences for yoga practice in people with cancer which will assist in developing yoga programs in this cohort to investigate the effects on cancer and treatment-related symptoms.
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17
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Oppegaard KR, Armstrong TS, Anguera JA, Kober KM, Debr LK, Laister RC, Saligan LN, Ayala AP, Kuruvilla J, Alm MW, Byker WH, Miaskowski C, Mayo SJ. Blood-Based Biomarkers of Cancer-Related Cognitive Impairment in Non-Central Nervous System Cancer: A Scoping Review. Crit Rev Oncol Hematol 2022; 180:103822. [PMID: 36152911 DOI: 10.1016/j.critrevonc.2022.103822] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 09/17/2022] [Accepted: 09/19/2022] [Indexed: 11/24/2022] Open
Abstract
This scoping review was designed to synthesize the extant literature on associations between subjective and/or objective measures of cancer-related cognitive impairment (CRCI) and blood-based biomarkers in adults with non-central nervous system cancers. The literature search was done for studies published from the start of each database searched (i.e., MEDLINE, Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials, grey literature) through to October 20, 2021. A total of 95 studies are included in this review. Of note, a wide variety of biomarkers were evaluated. Most studies evaluated patients with breast cancer. A variety of cognitive assessment measures were used. The most consistent significant findings were with various subjective and objective measures of CRCI and levels of interleukin-6 and tumor necrosis factor. Overall, biomarker research is in an exploratory phase. However, this review synthesizes findings and proposes directions for future research.
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Affiliation(s)
- Kate R Oppegaard
- University of California San Francisco, School of Nursing, Department of Physiological Nursing, USA
| | - Terri S Armstrong
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, USA
| | - Joaquin A Anguera
- University of California San Francisco, Department of Neurology and Psychiatry, USA
| | - Kord M Kober
- University of California San Francisco, School of Nursing, Department of Physiological Nursing, USA
| | - Lynch Kelly Debr
- University of Florida, College of Nursing, USA; University of Florida Health Cancer Center, USA
| | - Rob C Laister
- Princess Margaret Health Center, University Health Network, Canada
| | - Leorey N Saligan
- Symptoms Biology Unit, Division of Intramural Research, National Institutes of Health, USA
| | | | - John Kuruvilla
- Princess Margaret Health Center, University Health Network, Canada
| | - Mark W Alm
- Toronto General Hospital, University Health Network, Canada
| | | | - Christine Miaskowski
- University of California San Francisco, School of Medicine, Department of Anesthesia and Perioperative Care, USA
| | - Samantha J Mayo
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Canada.
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18
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Inbaraj G, Sathyaprabha TN, Udupa K, Ram A, Patil S, Rajeswaran J, Nandakumar KK, Belur S, Singh AD, Prathyusha PV, Bayari SK, Raghavendra RM. Impact of integrated yoga therapy on cognitive impairment and cardiac dysfunction in relation to quality of life in breast cancer patients undergoing chemotherapy: Study protocol for a two-arm randomized controlled trial. Front Oncol 2022; 12:955184. [PMID: 36185291 PMCID: PMC9524232 DOI: 10.3389/fonc.2022.955184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 08/15/2022] [Indexed: 12/24/2022] Open
Abstract
BackgroundChemotherapy-related cognitive impairment (CRCI) and cardiac dysfunction (CRCD) are common adverse effects seen in breast cancer patients undergoing chemotherapy. Even though these effects significantly influence daily functioning and overall quality of life, effective strategies to avoid and/or mitigate these adverse effects remain elusive. Yoga as a Mind-body intervention has been used increasingly by cancer patients and has undergone empirical investigations as a potential intervention for patients with cancer. Furthermore, yoga is associated with improved cognition and cardiac functioning in healthy older adults and subjects with cognitive and cardiac impairments. Accordingly, in the current study, yoga holds promise as an intervention to prevent/manage CRCI and CRCD with improved overall QOL in women receiving chemotherapy for breast cancer.MethodsThe study is a two-arm, randomized controlled trial. Women diagnosed with stage I-III breast cancer and awaiting neo-adjuvant or adjuvant chemotherapy will be recruited from a tertiary care center in Bangalore, India. Following recruitment, subjects are randomized to the intervention group (integrated yoga therapy intervention during chemotherapy) or the control group (standard care during chemotherapy). The study’s primary outcome is to measure the quality of life (cognitive domain) using European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). The other primary objectives will include cognitive functioning using neuropsychological test battery and cardiac autonomic function testing using heart rate variability. Secondary outcomes are Brain-derived neurotrophic factor (BDNF), brain function (functional MRI), Echocardiography, serum cortisol, Functional assessment of cancer therapy-cognition (FACT-Cog V3), perceived stress scale and Ryff Scales of Psychological Well-Being. Assessments take place before, during and after chemotherapy; 16-weeks post chemotherapy and 1-year post-baseline.DiscussionYoga is a promising intervention for preventing and/or managing chemotherapy-related adverse effects (CRAE) and enhancing the quality of life among breast cancer patients. The findings from this study may also help understand the inner mechanisms involved in the protective and restorative effects of yoga on CRAE and support the use of yoga prophylactically for breast cancer patients. In addition, the results of this study could help chemotherapy-exposed individuals with other solid cancer types who have cognitive and cardiac issues.Ethics and DisseminationThe study is approved by the ethics committee of the HealthCare Global Enterprises Ltd. Hospital (EC/434/19/01) and National Institute of Mental Health and Neurosciences (NIMH/DO/ETHICS SUB-COMMITTEE (BS&NS) 9th MEETING/2018).Clinical Trial Registrationhttp://ctri.nic.in/Clinicaltrials/advancesearchmain.php, identifier CTRI/2020/10/028446.
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Affiliation(s)
- Ganagarajan Inbaraj
- Department of Neurophysiology, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Talakad N. Sathyaprabha
- Department of Neurophysiology, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Kaviraja Udupa
- Department of Neurophysiology, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Amritanshu Ram
- Department of Complementary and Alternative Medicine, HealthCare Global, Bangalore, Karnataka, India
| | - Shekar Patil
- Department of Clinical Oncology, HealthCare Global, Bangalore, Karnataka, India
| | - Jamuna Rajeswaran
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Krishna K. Nandakumar
- Department of Complementary and Alternative Medicine, HealthCare Global, Bangalore, Karnataka, India
| | - Spoorthi Belur
- Department of Complementary and Alternative Medicine, HealthCare Global, Bangalore, Karnataka, India
| | - Arman Deep Singh
- Centre for Ayurveda Biology and Holistic Nutrition, The University of Trans-Disciplinary Health Sciences and Technologies (TDU), Bengaluru, Karnataka, India
| | | | - Sapna K. Bayari
- Department of Complementary and Alternative Medicine, HealthCare Global, Bangalore, Karnataka, India
| | - Rao M. Raghavendra
- Department of Complementary and Alternative Medicine, HealthCare Global, Bangalore, Karnataka, India
- Central Council for Research in Yoga and Naturopathy, New Delhi, India
- *Correspondence: Rao M. Raghavendra,
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Sleight A, Gerber LH, Marshall TF, Livinski A, Alfano CM, Harrington S, Flores AM, Virani A, Hu X, Mitchell SA, Varedi M, Eden M, Hayek S, Reigle B, Kerkman A, Neves R, Jablonoski K, Hacker ED, Sun V, Newman R, McDonnell KK, L'Hotta A, Schoenhals A, Dpt NLS. Systematic Review of Functional Outcomes in Cancer Rehabilitation. Arch Phys Med Rehabil 2022; 103:1807-1826. [PMID: 35104445 PMCID: PMC9339032 DOI: 10.1016/j.apmr.2022.01.142] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 01/10/2022] [Accepted: 01/11/2022] [Indexed: 11/02/2022]
Abstract
OBJECTIVE To systematically review the evidence regarding rehabilitation interventions targeting optimal physical or cognitive function in adults with a history of cancer and describe the breadth of evidence as well as strengths and limitations across a range of functional domains. DATA SOURCES PubMed, Cumulative Index to Nursing and Allied Health Plus, Scopus, Web of Science, and Embase. The time scope was January 2008 to April 2019. STUDY SELECTION Prospective, controlled trials including single- and multiarm cohorts investigating rehabilitative interventions for cancer survivors at any point in the continuum of care were included, if studies included a primary functional outcome measure. Secondary data analyses and pilot/feasibility studies were excluded. Full-text review identified 362 studies for inclusion. DATA EXTRACTION Extraction was performed by coauthor teams and quality and bias assessed using the American Academy of Neurology (AAN) Classification of Evidence Scheme (class I-IV). DATA SYNTHESIS Studies for which the functional primary endpoint achieved significance were categorized into 9 functional areas foundational to cancer rehabilitation: (1) quality of life (109 studies), (2) activities of daily living (61 studies), (3) fatigue (59 studies), (4) functional mobility (55 studies), (5) exercise behavior (37 studies), (6) cognition (20 studies), (7) communication (10 studies), (8) sexual function (6 studies), and (9) return to work (5 studies). Most studies were categorized as class III in quality/bias. Averaging results found within each of the functional domains, 71% of studies reported statistically significant results after cancer rehabilitation intervention(s) for at least 1 functional outcome. CONCLUSIONS These findings provide evidence supporting the efficacy of rehabilitative interventions for individuals with a cancer history. The findings should be balanced with the understanding that many studies had moderate risk of bias and/or limitations in study quality by AAN criteria. These results may provide a foundation for future work to establish clinical practice guidelines for rehabilitative interventions across cancer disease types.
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Affiliation(s)
- Alix Sleight
- Department of Physical Medicine and Rehabilitation, Cedars-Sinai Medical Center, Los Angeles, California, United States; Center for Integrated Research in Cancer and Lifestyle (CIRCL), Cedars-Sinai Medical Center, Los Angeles, California, United States; Cedars Sinai Cancer, Los Angeles, California, United States; Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland, United States.
| | - Lynn H Gerber
- College of Health and Human Services, George Mason University, Fairfax County, Virginia, United States; Inova Health System, Inova Medicine Services, Falls Church, Virginia, United States
| | | | - Alicia Livinski
- National Institutes of Health Library, Office of Research Services, National Institutes of Health, Bethesda, Maryland, United States
| | - Catherine M Alfano
- Northwell Health Cancer Institute, New Hyde Park, New York, United States; Center for Personalized Health, Feinstein Institutes for Medical Research, Manhasset, New York, United States; Department of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York, United States
| | - Shana Harrington
- Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States
| | - Ann Marie Flores
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States; Robert H. Lurie Comprehensive Cancer Center, Cancer Survivorship Institute, Chicago, Illinois, United States
| | - Aneesha Virani
- Rehabilitation Department, Northside Hospital, Atlanta, Georgia, United States
| | - Xiaorong Hu
- Rehabilitation Medicine Department, Clinical Center, National Institutes of Health, Boston, Massachusetts, United States; Rehabilitation Medicine School, Nanjing Medical University, Nanjing, China
| | - Sandra A Mitchell
- Outcomes Research Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland, United States
| | - Mitra Varedi
- Epidemiology and Cancer Control Department, St Jude Children's Research Hospital, Memphis, Tennessee, United States
| | - Melissa Eden
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Scottsdale, Arizona, United States
| | - Samah Hayek
- Clalit Health Services, Clalit Research Institute, Ramat-Gan, Israel
| | - Beverly Reigle
- College of Nursing, University of Cincinnati, Cincinnati, Ohio, United States
| | - Anya Kerkman
- Lincoln Cancer Rehabilitation, Lincoln, Nebraska, United States; CHI Health St Elizabeth, Lincoln, Nebraska, United States
| | - Raquel Neves
- Czech Rehabilitation Hospital, Al Ain, United Arab Emirates
| | - Kathleen Jablonoski
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC, United States; Department of Biostatistics, Milken Institute School of Public Health, George Washington University, Washington, DC, United States
| | - Eileen Danaher Hacker
- Department of Science of Nursing Care, Indiana University School of Nursing, Indianapolis, Indiana, United States
| | - Virginia Sun
- Department of Population Sciences, City of Hope, Duarte, California, United States; Department of Surgery, City of Hope, Duarte, California, United States
| | - Robin Newman
- Department of Occupational Therapy, Boston University College of Health and Rehabilitation Sciences: Sargent College, Boston, Massachusetts, United States
| | - Karen Kane McDonnell
- College of Nursing, University of South Carolina, Columbia, South Carolina, United States
| | - Allison L'Hotta
- Department of Occupational Therapy, Washington University in St Louis, St Louis, Missouri, United States
| | - Alana Schoenhals
- Mrs T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, United States
| | - Nicole L Stout Dpt
- West Virginia University Cancer Institute, West Virginia University School of Public Health, Morgantown, West Virginia, United States; Rehabilitation Medicine Department, Clinical Center, National Institutes of Health, Bethesda, Maryland, United States
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20
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Effects of Baduanjin exercise on cognitive function and cancer-related symptoms in women with breast cancer receiving chemotherapy: a randomized controlled trial. Support Care Cancer 2022; 30:6079-6091. [PMID: 35416502 DOI: 10.1007/s00520-022-07015-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 03/25/2022] [Indexed: 12/17/2022]
Abstract
PURPOSE Cognitive decline is one of the main side effects of breast cancer patients after relevant treatment, but there is a lack of clear measures for prevention and management without definite mechanism. Moreover, postoperative patients also have a need for limb rehabilitation. Whether the cognitive benefits of Baduanjin exercise can improve the overall well-being of breast cancer patients remains unknown. METHODS This randomized controlled trial was conducted on 70 patients with breast cancer receiving chemotherapy who were randomly assigned and allocated to (1:1) a supervised Baduanjin intervention group (5 times/week, 30 min each time) or a control group for 3 months. The effects of Baduanjin exercise intervention were evaluated by outcome measures including subjective cognitive function, symptoms (fatigue, depression, and anxiety), and health-related quality of life at pre-intervention (T0), 4 weeks (T1), 8 weeks (T2), and 12 weeks (T3). The collected data were analyzed by using an intention-to-treat principle and linear mixed-effects modeling. RESULTS Participants in the Baduanjin intervention group had a significantly greater improvement in terms of FACT-Cog (F = 14.511; p < 0.001), PCI (F = 15.789; p < 0.001), PCA (F = 6.261; p = 0.015), and FACT-B scores (F = 8.900; p = 0.004) compared with the control group over the time. The exercise-cognition relationship was significantly mediated through the reduction of fatigue (indirect effect: β = 0.132; 95% CI 0.046 to 0.237) and the improvement of anxiety (indirect effect: β = - 0.075; 95% CI - 0.165 to -0.004). CONCLUSIONS This pilot study revealed the benefits of Baduanjin exercise for subjective cognition and health-related quality of life of Chinese breast cancer patients receiving chemotherapy and outlined the underlying mediating mechanism of exercise-cognition. The findings provided insights into the development of public health initiatives to promote brain health and improve quality of life among breast cancer patients. TRIAL REGISTRATION NUMBER ChiCTR 2,000,033,152.
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Mackenzie L, Marshall K. Effective non-pharmacological interventions for cancer related cognitive impairment in adults (excluding central nervous system or head and neck cancer): systematic review and meta-analysis. Eur J Phys Rehabil Med 2022; 58:258-270. [PMID: 34498828 PMCID: PMC9980504 DOI: 10.23736/s1973-9087.21.06898-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Cancer-related cognitive impairment (CRCI) is prevalent in cancer survivors, and impairments affect daily living tasks and overall wellbeing. This review aimed to identify and evaluate published randomized controlled trials (RCTs) of interventions to manage CRCI in adult populations, to analyze their effectiveness and to investigate the quality of the studies. EVIDENCE ACQUISITION Seven databases were searched (Medline, Scopus, CINAHL, AMED, PsychINFO, OTseeker, and the Cochrane Database of Systematic Reviews), including years 2005-2020, for randomized controlled trials (RCTs) investigating interventions to address cognition for adults with cancer. The final search was conducted in February 2021. The quality of studies was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for RCTs. Meta-analysis used comprehensive meta-analysis software. The study protocol was registered with PROSPERO (registration N. CRD42017076868). EVIDENCE SYNTHESIS A total of 45 studies involving 4727 participants examined interventions for CRCI and met selection criteria. Categories of interventions included cognitive training-based intervention (N.=15), cognitive behavior therapy (CBT) (N.=4), physical activity (N.=16) and other supportive therapies (N.=10). Meta-analysis indicated beneficial overall effects for all categories of interventions: cognitive training (standardized mean difference [SMD]=0.41, 95% CI: 0.28-0.53, I2=88.87%); CBT (SMD=0.30, 95% CI: 0.14-0.46, I2=44.86%); physical activity (SMD=0.27, 95% CI: 0.20-0.35, I2=37.67%); and supportive therapies (SMD=0.27, 95% CI: 0.16-0.39, I2=64.94%). Studies used self-report cognitive outcome measures and neurocognitive testing, or a mixture. CONCLUSIONS Findings suggest that effective intervention for CRCI exist, and cognitive training is consistently supported as an effective intervention; however, a high level of heterogeneity was found. CRCI research is currently dominated by breast cancer survivors, and quality research is also needed to address the broader population of cancer survivors who experience CRCI.
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Affiliation(s)
- Lynette Mackenzie
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia -
| | - Kelsey Marshall
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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22
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Farahani MA, Soleimanpour S, Mayo SJ, Myers JS, Panesar P, Ameri F. Revue systématique : Effet des exercices corpsesprit sur la fonction cognitive des survivants du cancer. Can Oncol Nurs J 2022; 32:49-60. [PMID: 35280069 PMCID: PMC8849166 DOI: 10.5737/236880763214960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objectif Plusieurs survivants du cancer souffrant de troubles cognitifs liés à la maladie se tournent vers des approches non pharmacologiques pour soulager leurs symptômes. La présente revue systématique avait pour objectif d’évaluer l’effet des « exercices corps-esprit » sur les fonctions cognitives des survivants du cancer. Devis de l’étude Les bases de données PubMed, Embase, Scopus et Web of Science ont été interrogées afin de trouver des études pertinentes sur le sujet. L’échelle du Joanna Briggs Institute et l’échelle de Jadad ont servi à évaluer la qualité des études sélectionnées. Résultats Onze études comptant 1 032 participants et publiées entre 2006 et 2019 ont été choisies pour la revue à partir de certains critères d’inclusion. Nos résultats indiquent que les activités comme le yoga, le tai-chi et le qi gong peuvent améliorer de manière objective et subjective la fonction cognitive des survivants du cancer. Conclusion Les survivants du cancer qui présentent des symptômes cognitifs peuvent bénéficier d’exercices agissant sur le corps et l’esprit. Il faudra cependant mener des essais contrôlés randomisés ayant la puissance statistique nécessaire pour établir les effets à court et à long terme de ce type d’exercices sur les facultés cognitives.
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Affiliation(s)
- Mansoureh Ashghali Farahani
- Centre de recherche en soins infirmiers, École de sciences infirmières et de pratique sagefemme, Université des sciences médicales d'Iran, Téhéran, Iran
| | - Samira Soleimanpour
- étudiante au doctorat, Département de bibliothéconomie médicale et des sciences de l'information, École de gestion en santé et de sciences de l'information, Université des sciences médicales d'Iran, Téhéran, Iran
| | - Samantha J Mayo
- Faculté des sciences infirmières Lawrence S. Bloomberg, Université de Toronto, Toronto, Ontario; Centre de cancérologie Princess Margaret, Réseau universitaire de santé, Toronto, Ontario
| | - Jamie S Myers
- École de sciences infirmières, Université du Kansas, Kansas City, Kansas, États-Unis
| | - Prabdeep Panesar
- Faculté des sciences infirmières Lawrence S. Bloomberg, Université de Toronto, Toronto, Ontario
| | - Farzaneh Ameri
- en soins infirmiers médico-chirurgicaux, École de sciences infirmières et de pratique sage-femme, Université des sciences médicales d'Iran, Téhéran, Iran
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23
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Farahani MA, Soleimanpour S, Mayo SJ, Myers JS, Panesar P, Ameri F. The effect of mind-body exercise on cognitive function in cancer survivors: A systematic review. Can Oncol Nurs J 2022; 32:38-48. [PMID: 35280065 PMCID: PMC8849176 DOI: 10.5737/236880763213848] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objective Cancer-related cognitive impairments experienced by cancer survivors cause many to seek non-pharmacological intereventions to manage these symptoms. The aim of this systematic review was to evaluate the effects of one such intervention, mindbody exercise (MBE), on cognitive function in cancer survivors. Design Searches for relevant studies were conducted in four electronic databases, including PubMed, Embase, Scopus, and Web of Science. The Joanna Briggs Institute and Jadad scales were utilized to evaluate the quality of the selected studies. Results Eleven studies including 1,032 participants, published between 2006 and 2019, were selected for review based on specific inclusion criteria. Our results indicated that interventions including, yoga, tai chi, and qigong may improve objective and subjective cognitive function in cancer survivors. Conclusion Cancer survivors experiencing cognitive symptoms may benefit from participation in MBE. Adequately powered randomized controlled trials are required to establish the short- and long-term effects of MBE on cognitive functioning.
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Affiliation(s)
- Mansoureh Ashghali Farahani
- Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Samira Soleimanpour
- Department of Medical Library and Information Science, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Samantha J Mayo
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada; Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Jamie S Myers
- University of Kansas School of Nursing, Kansas City, KS, USA
| | - Prabdeep Panesar
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Farzaneh Ameri
- School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
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24
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Deng G, Bao T, Ryan EL, Benusis L, Hogan P, Li QS, Dries A, Konner J, Ahles TA, Mao JJ. Effects of Vigorous Versus Restorative Yoga Practice on Objective Cognition Functions in Sedentary Breast and Ovarian Cancer Survivors: A Randomized Controlled Pilot Trial. Integr Cancer Ther 2022; 21:15347354221089221. [PMID: 35861215 PMCID: PMC9403449 DOI: 10.1177/15347354221089221] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 02/07/2022] [Accepted: 02/28/2022] [Indexed: 11/15/2022] Open
Abstract
PURPOSE Many cancer survivors experience cancer-related cognitive impairment (CRCI). We conducted a randomized controlled pilot trial of 2 types of yoga practice and evaluated their effects on participants' objective cognitive function. METHODS Sedentary breast or ovarian cancer survivors were randomized to practice either restorative yoga (with more meditative practice and minimal physical exertion) or vigorous yoga (with considerable physical exertion and minimal meditative practice) in 60-minute supervised sessions 3 times a week for 12 weeks, followed by 12 weeks of home practice. We used the NIH Toolbox Cognition Domain to evaluate participants at baseline, week 12, and week 24. RESULTS We enrolled 35 participants. For women in the restorative yoga group, overall cognitive function was statistically significantly improved at weeks 12 and 24 compared to baseline (P = .03 and 0.004; Cohen's D = 0.3 and 0.5). Fluid cognitive function also significantly improved at weeks 12 and 24 (P = .02 and 0.0007; Cohen's D = 0.3 and 0.6), whereas improvements in crystallized cognition were not significant. For women in the vigorous yoga group, significant improvement was only seen in tasks of crystallized cognition at week 24 (P = .03; Cohen's D = 0.5). Between-group comparisons showed that at week 24, women in the restorative yoga group had significantly higher scores on fluid cognition tasks. CONCLUSIONS Patients who participated in yoga practice demonstrated improvement in objective cognitive function over time. Restorative yoga may be more effective in improving fluid cognitive function at week 24 when compared to vigorous yoga. These promising findings should be confirmed in definitive studies. TRIAL REGISTRATION Clinicaltrials.gov; NCT02305498 (Date Registered: December 2, 2014).
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Affiliation(s)
- Gary Deng
- Memorial Sloan Kettering Cancer Center,
New York, NY, USA
| | - Ting Bao
- Memorial Sloan Kettering Cancer Center,
New York, NY, USA
| | | | | | - Pasha Hogan
- Memorial Sloan Kettering Cancer Center,
New York, NY, USA
| | - Qing S. Li
- Memorial Sloan Kettering Cancer Center,
New York, NY, USA
| | - Annika Dries
- Stanford University School of Medicine,
Stanford, CA, USA
| | - Jason Konner
- Memorial Sloan Kettering Cancer Center,
New York, NY, USA
| | - Tim A. Ahles
- Memorial Sloan Kettering Cancer Center,
New York, NY, USA
| | - Jun J. Mao
- Memorial Sloan Kettering Cancer Center,
New York, NY, USA
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25
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Brunet J, Wurz A, Hussien J, Pitman A, Conte E, Ennis JK, Herry CL, Seely AJE, Seely D. Exploring the Effects of Yoga Therapy on Heart Rate Variability and Patient-Reported Outcomes After Cancer Treatment: A Study Protocol. Integr Cancer Ther 2022; 21:15347354221075576. [PMID: 35393867 PMCID: PMC9016564 DOI: 10.1177/15347354221075576] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Following cancer treatment, adults commonly report worsened patient-reported outcomes (PROs) such as anxiety, stress, depression, persistent and upsetting cognitive complaints, unrelenting fatigue, and reduced quality of life. Poorer PROs are associated with disrupted autonomic nervous system functioning as measured by heart rate variability (HRV), both of which have been associated with greater morbidity and mortality. Interventions to improve HRV and PROs among adults following cancer treatment are needed. Yoga therapy holds promise as an intervention to improve HRV and PROs. Therefore, we conducted a single-subject exploratory experimental study to investigate the effects of yoga therapy on HRV and specific PROs (ie, cancer-related fatigue, anxiety, cognitive function, depression, stress, quality of life) in adults treated for cancer. To reduce publication bias, improve reproducibility, and serve as a reference for forthcoming reporting of study results, we present the study protocol for this study herein. METHODS Participants were adults who completed cancer treatment that were recruited from the Ottawa Integrative Cancer Centre. Consenting and eligible participants received one 1:1 yoga therapy session (ie, 1 participant, 1 Yoga Therapist) and 6 weekly group-based yoga therapy sessions (ie, 2-3 participants, 1 Yoga Therapist). Participants completed assessments 7 times: 3 times prior to the program (ie, -6 weeks, -3 weeks, immediately prior to the 1:1 yoga therapy session), immediately following the 1:1 yoga therapy session, prior to the first group-based yoga therapy session, after the last group-based yoga therapy session, and at a 6-week follow-up. Hierarchical linear modeling will be used to test the average effects of the yoga therapy program across participants. DISCUSSION This study will explore several novel hypotheses, including whether yoga therapy can improve HRV and/or specific PROs among adults treated for cancer acutely (ie, during a 1:1 yoga therapy session) and/or through repeated exposure (ie, after completing 6 weeks of group-based yoga therapy). Although the findings will require confirmation or refutation in future trials, they may provide initial evidence that YT may benefit adults treated for cancer. TRIAL REGISTRATION ISRCTN registry, ISRCTN64763228. Registered on December 12, 2021. This trial was registered retrospectively. URL of trial registry record: https://www.isrctn.com/ISRCTN64763228.
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Affiliation(s)
- Jennifer Brunet
- University of Ottawa, Ottawa, ON, Canada.,Ottawa Hospital Research Institute, Ottawa, ON, Canada.,Institut du savoir de l'Hôpital Montfort, Ottawa, ON, Canada
| | - Amanda Wurz
- University of the Fraser Valley, Chilliwack, BC, Canada
| | | | - Anne Pitman
- The Centre for Health Innovation, Ottawa, ON, Canada
| | - Ellen Conte
- The Centre for Health Innovation, Ottawa, ON, Canada.,Canadian College of Naturopathic Medicine, Toronto, ON, Canada
| | - Julie K Ennis
- The Centre for Health Innovation, Ottawa, ON, Canada
| | | | - Andrew J E Seely
- University of Ottawa, Ottawa, ON, Canada.,The Ottawa Hospital, Ottawa, ON, Canada
| | - Dugald Seely
- University of Ottawa, Ottawa, ON, Canada.,The Centre for Health Innovation, Ottawa, ON, Canada.,Canadian College of Naturopathic Medicine, Toronto, ON, Canada
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26
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Binarelli G, Joly F, Tron L, Lefevre Arbogast S, Lange M. Management of Cancer-Related Cognitive Impairment: A Systematic Review of Computerized Cognitive Stimulation and Computerized Physical Activity. Cancers (Basel) 2021; 13:5161. [PMID: 34680310 PMCID: PMC8534081 DOI: 10.3390/cancers13205161] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/05/2021] [Accepted: 10/11/2021] [Indexed: 01/27/2023] Open
Abstract
Cancer-related cognitive impairment (CRCI) occurs frequently in patients living with cancer, with consequences on quality of life. Recently, research on the management of these difficulties has focused on computerized cognitive stimulation and computerized physical activity programs. This systematic review presents the state of knowledge about interventions based on computerized-cognitive stimulation and/or physical activity to reduce CRCI. The review followed the PRISMA guidelines. A search was conducted in PUBMED and Web of Science databases. Risk of bias analysis was conducted using the Rob2 tool and the quality of evidence was conducted following the GRADE approach. A total of 3776 articles were initially identified and 20 of them met the inclusion criteria. Among them, sixteen investigated computerized-cognitive stimulation and four computerized-physical activity. Most of the studies were randomized controlled trials and assessed the efficacy of a home-based intervention on objective cognition in adults with cancer. Overall, cognitive improvement was found in 11/16 computerized-cognitive stimulation studies and 2/4 computerized-physical activity studies. Cognitive stimulation or physical activity improved especially cognitive complaints, memory, and attention. These results suggest the efficacy of both computerized-cognitive stimulation and physical activity. However, we report a high risk of bias for the majority of studies and a low level of quality of evidence. Therefore, further investigations are needed to confirm the efficacy of these interventions and to investigate the possible added benefit on cognition of a combined computerized-cognitive/physical intervention.
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Affiliation(s)
- Giulia Binarelli
- Clinical Research Department, Centre François Baclesse, 14000 Caen, France; (G.B.); (F.J.)
- ANTICIPE, INSERM, UNICAEN, Normandie University, 14000 Caen, France; (L.T.); (S.L.A.)
| | - Florence Joly
- Clinical Research Department, Centre François Baclesse, 14000 Caen, France; (G.B.); (F.J.)
- ANTICIPE, INSERM, UNICAEN, Normandie University, 14000 Caen, France; (L.T.); (S.L.A.)
- Cancer and Cognition Platform, Ligue Nationale Contre le Cancer, 14000 Caen, France
| | - Laure Tron
- ANTICIPE, INSERM, UNICAEN, Normandie University, 14000 Caen, France; (L.T.); (S.L.A.)
- Cancer and Cognition Platform, Ligue Nationale Contre le Cancer, 14000 Caen, France
| | - Sophie Lefevre Arbogast
- ANTICIPE, INSERM, UNICAEN, Normandie University, 14000 Caen, France; (L.T.); (S.L.A.)
- Cancer and Cognition Platform, Ligue Nationale Contre le Cancer, 14000 Caen, France
| | - Marie Lange
- Clinical Research Department, Centre François Baclesse, 14000 Caen, France; (G.B.); (F.J.)
- ANTICIPE, INSERM, UNICAEN, Normandie University, 14000 Caen, France; (L.T.); (S.L.A.)
- Cancer and Cognition Platform, Ligue Nationale Contre le Cancer, 14000 Caen, France
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27
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Bail JR, Ivankova N, Heaton K, Vance DE, Triebel K, Meneses K. Cancer-Related Symptoms and Cognitive Intervention Adherence Among Breast Cancer Survivors: A Mixed-Methods Study. Cancer Nurs 2021; 43:354-365. [PMID: 30950929 DOI: 10.1097/ncc.0000000000000700] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Breast cancer survivors (BCSs) experience long-term symptoms of cancer and treatment, which may exacerbate cognitive function and ability to adhere to interventions aimed at improving cognition. OBJECTIVE The intent of this study was to explore the relationship between selected cancer-related symptoms and adherence to the Speed of Processing in Middle Aged and Older BreAst Cancer SuRvivors (SOAR) cognitive training (CT) intervention among BCSs residing in Alabama. METHODS A sequential quantitative to qualitative (Quan→Qual) mixed-methods design was used. First, the relationship between selected cancer-related symptoms and adherence to SOAR among BCSs (n = 30) was examined using self-reported questionnaire data. Follow-up semistructured interviews with 15 purposefully selected participants (adherent and nonadherent) were conducted to explore how symptoms contributed to/explained differences in adherence to SOAR. Data were analyzed using RStudio and NVivo software. RESULTS Spearman's ρ correlation suggested relationships between adherence and perceived cognitive impairment, depressive symptoms, and sleep quality. Inductive thematic analysis yielded 4 themes: (1) experiences of cancer-related symptoms, (2) influences of CT, (3) adherence to CT, and (4) environment for CT. Integration of quantitative and qualitative results revealed that experiences of and responses to CT and cancer-related symptoms differently shape adherence to CT among BCSs. CONCLUSIONS To aid in cognitive intervention adherence among BCSs, future studies may consider applying a comprehensive approach aimed at addressing concurrent cancer-related symptoms. IMPLICATIONS FOR PRACTICE Clinicians can routinely assess cognition and provide education and resources for management of cancer-related symptoms.
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Affiliation(s)
- Jennifer R Bail
- Authors Affiliations: Department of Nutrition Sciences (Dr Bail), School of Health Professions (Dr Ivankova), School of Nursing (Drs Ivankova, Heaton, Vance, and Meneses), and Department of Neurology (Dr Triebel), University of Alabama at Birmingham
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28
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Drijver AJ, Reijneveld JC, Wesselman LMP, Klein M. A Web-Based Lifestyle Intervention Aimed at Improving Cognition in Patients With Cancer Returning to Work in an Outpatient Setting: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2021; 10:e22670. [PMID: 33900201 PMCID: PMC8111506 DOI: 10.2196/22670] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 01/20/2021] [Accepted: 02/16/2021] [Indexed: 01/19/2023] Open
Abstract
Background A high percentage of patients with cancer experience cognitive impairment after cancer treatment, resulting in a decreased health-related quality of life and difficulty returning to work. Consequently, there is a need for effective treatment options to improve cognitive functioning in these patients. In a healthy aging population, multidomain web-based lifestyle interventions have been found to be effective in preventing cognitive decline and improving cognitive functioning. Objective This study aims to investigate the feasibility and effectiveness of the web-based lifestyle intervention Mijn Fitte Brein (My Fit Brain [MFB]) on cognitive functioning in patients with cancer returning to work. Methods The study consists of a feasibility study (N=10), followed by a randomized controlled trial (RCT; N=220). Patients will be recruited by their occupational physicians after their return to work following cancer treatment. Mijn Fitte Brein is organized into 4-week cycles in which patients set a lifestyle goal using the Goal Attainment Scale, receive weekly tips and support, and finally evaluate whether they succeeded in achieving this goal. Lifestyle goals are based on 6 domains: physical exercise, diet, sleep, stress, alcohol use, and smoking. In the feasibility study, data on user experience (structured interview) and usability, assessed with the Post-Study System Usability Scale, will be collected and used to optimize Mijn Fitte Brein. In the RCT, patients will be randomized 1:1 between an intervention group and a control group. Patients will be assessed at baseline, 3 months, and 6 months. The primary outcome measure is subjective cognitive functioning, assessed with the Functional Assessment of Cancer Therapy–Cognitive Function (FACT-Cog). Secondary outcome measures are lifestyle, objective cognitive functioning, and work and psychosocial factors. Results Recruitment for the feasibility study has started in February 2020. As of July 2020, however, no patients have been enrolled (due to COVID-19 restrictions). The findings of the feasibility study will be used to optimize the Mijn Fitte Brein intervention. Enrollment for the RCT will continue when possible. The feasibility study will take 6 months (including making adjustments to the intervention), and the RCT will take 2 years. The final results are expected in 2024. The results of the feasibility study and the RCT will be published in peer-reviewed journals. Conclusions This is the first time the feasibility and efficacy of a multidomain web-based lifestyle intervention will be studied in patients with cancer. If Mijn Fitte Brein is found to be effective in decreasing cognitive complaints in these patients returning to work, it will be a promising treatment option because of being both affordable and accessible. Trial Registration Netherlands Trial Register NL8407; https://www.trialregister.nl/trial/8407 International Registered Report Identifier (IRRID) DERR1-10.2196/22670
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Affiliation(s)
- A Josephine Drijver
- Department of Neurology, Amsterdam UMC, Amsterdam, Netherlands.,Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Jaap C Reijneveld
- Department of Neurology, Amsterdam UMC, Amsterdam, Netherlands.,Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, Netherlands
| | - Linda M P Wesselman
- Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Alzheimer Center Amsterdam, Department of Neurology, Amsterdam UMC, Amsterdam, Netherlands.,Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Martin Klein
- Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Department of Medical Psychology, Amsterdam UMC, Amsterdam, Netherlands
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29
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Gonzalez M, Pascoe MC, Yang G, de Manincor M, Grant S, Lacey J, Firth J, Sarris J. Yoga for depression and anxiety symptoms in people with cancer: A systematic review and meta-analysis. Psychooncology 2021; 30:1196-1208. [PMID: 33763925 DOI: 10.1002/pon.5671] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 02/20/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Cancer and its treatment can lead to a variety of physical and emotional concerns impacting on those affected, including subclinical or clinical depression and anxiety, which in turn have a significant impact on wellbeing, quality of life and survival. The aim of this review was to evaluate the effect of yoga-based interventions on self-reported depression and anxiety symptoms in people with cancer in randomized controlled trials. METHOD Six databases were searched to identify relevant studies. Systematic review procedures were followed including a quality assessment. Meta-analysis of suitable studies was conducted. RESULTS 26 studies from our search criteria were eligible for inclusion for depressive and 16 for anxiety symptoms. Meta-analyses revealed evidence for significant medium effects of yoga on depression symptoms (N = 1,486, g = -0.419, 95% confidence interval [CI] = -0.558 to -0.281, p < 0.001) and anxiety (N = 977, g = -0.347, 95% CI = -0.473 to -0.221, p < 0.001) compared to controls. Subgroup analyses for depressive symptoms revealed significant effects for all analyses performed (type of cancer, type of control, treatment status, duration of intervention or frequency of yoga sessions), with effect sizes being comparable between subgroups. Similar findings were found for anxiety symptoms except for treatment status, where the only significant effect was found when yoga was delivered during active treatment. CONCLUSIONS This review provides evidence that in people with cancer, yoga-based interventions are associated with amelioration of depression and anxiety symptoms and therefore a promising therapeutic modality for their management. However, the potential for risk of bias together with control group design challenges means the results should be interpreted with caution.
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Affiliation(s)
- Maria Gonzalez
- NICM Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
| | - Michaela C Pascoe
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
| | - Guoyan Yang
- NICM Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
| | - Michael de Manincor
- NICM Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
| | - Suzanne Grant
- NICM Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia.,Chris O'Brien Lifehouse Comprehensive Cancer Centre, Camperdown, New South Wales, Australia
| | - Judith Lacey
- NICM Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia.,Chris O'Brien Lifehouse Comprehensive Cancer Centre, Camperdown, New South Wales, Australia.,School of Medicine, Sydney University, Australia
| | - Joseph Firth
- NICM Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia.,Division of Psychology and Mental Health, University of Manchester, Manchester, UK
| | - Jerome Sarris
- NICM Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia.,Department of Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia
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30
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Hsueh EJ, Loh EW, Lin JJA, Tam KW. Effects of yoga on improving quality of life in patients with breast cancer: a meta-analysis of randomized controlled trials. Breast Cancer 2021; 28:264-276. [PMID: 33452652 DOI: 10.1007/s12282-020-01209-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 08/06/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Complications of breast cancer treatment can cause physical and psychosocial distress in patients. Yoga demonstrates substantial potential as a supportive therapy for patients with breast cancer. Our aim is to conduct a meta-analysis of randomized controlled trials to evaluate the effectiveness of yoga in enhancing the quality of life (QoL) of patients with breast cancer. METHODS We searched for studies published before March 2020 in the PubMed, Embase, and Cochrane Library databases. Individual effect sizes were standardized, and the pooled effect size was calculated using a random effect model. Measured outcomes included QoL, anxiety and depression, stress, fatigue, pain severity, and sleep quality. RESULTS In total, 26 trials involving 2069 patients were reviewed. Significant enhancement in QoL was observed immediately after the yoga intervention. The pooled mean differences in social (weighted mean difference [WMD]: 1.36, 95% confidence interval [CI] 0.12-2.61), emotional (WMD: 1.46, 95% CI 0.26-2.66), and functional well-being (WMD: 2.04, 95% CI 0.21-3.87) were significantly higher in the yoga group than in the control group. Patients practicing yoga exhibited significant improvements in physical well-being, mental well-being, and sleep quality as well as reductions in anxiety, depression, stress, fatigue, and pain severity after the intervention. CONCLUSIONS Yoga may enhance QoL in patients with breast cancer experiencing post-treatment complications. Therefore, we recommend yoga as a supportive therapy for patients with breast cancer to relieve post-treatment distress.
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Affiliation(s)
- Er-Jung Hsueh
- Cancer Center, Yuan's General Hospital, Kaohsiung, Taiwan
| | - El-Wui Loh
- Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan.,Center for Evidence-Based Health Care, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Joyce Jui-An Lin
- School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
| | - Ka-Wai Tam
- Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan. .,Center for Evidence-Based Health Care, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan. .,Division of General Surgery, Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. .,Division of General Surgery, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, No. 291, Zhongzheng Road, Zhonghe District, New Taipei City, 23561, Taiwan.
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31
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Ortega MA, Fraile-Martínez O, García-Montero C, Pekarek L, Guijarro LG, Castellanos AJ, Sanchez-Trujillo L, García-Honduvilla N, Álvarez-Mon M, Buján J, Zapico Á, Lahera G, Álvarez-Mon MA. Physical Activity as an Imperative Support in Breast Cancer Management. Cancers (Basel) 2020; 13:E55. [PMID: 33379177 PMCID: PMC7796347 DOI: 10.3390/cancers13010055] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 12/21/2020] [Accepted: 12/24/2020] [Indexed: 02/06/2023] Open
Abstract
Breast cancer (BC) is the most common malignancy and the second cause of cancer-related death among women. It is estimated that 9 in 10 cases of BC are due to non-genetic factors, and approximately 25% to 30% of total breast cancer cases should be preventable only by lifestyle interventions. In this context, physical activity represents an excellent and accessible approach not only for the prevention, but also for being a potential support in the management of breast cancer. The present review will collect the current knowledge of physical activity in the background of breast cancer, exploring its systemic and molecular effects, considering important variables in the training of these women and the evidence regarding the benefits of exercise on breast cancer survival and prognosis. We will also summarize the various effects of physical activity as a co-adjuvant therapy in women receiving different treatments to deal with its adverse effects. Finally, we will reveal the impact of physical activity in the enhancement of quality of life of these patients, to conclude the central role that exercise must occupy in breast cancer management, in an adequate context of a healthy lifestyle.
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Affiliation(s)
- Miguel A. Ortega
- Unit of Histology and Pathology, Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (O.F.-M.); (C.G.-M.); (L.P.); (A.J.C.); (L.S.-T.); (N.G.-H.); (M.Á.-M.); (J.B.); (G.L.); (M.A.Á.-M.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
- Cancer Registry and Pathology Department, Hospital Universitario Principe de Asturias, 28806 Alcalá de Henares, Spain
- University Center for the Defense of Madrid (CUD-ACD), 28047 Madrid, Spain
| | - Oscar Fraile-Martínez
- Unit of Histology and Pathology, Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (O.F.-M.); (C.G.-M.); (L.P.); (A.J.C.); (L.S.-T.); (N.G.-H.); (M.Á.-M.); (J.B.); (G.L.); (M.A.Á.-M.)
| | - Cielo García-Montero
- Unit of Histology and Pathology, Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (O.F.-M.); (C.G.-M.); (L.P.); (A.J.C.); (L.S.-T.); (N.G.-H.); (M.Á.-M.); (J.B.); (G.L.); (M.A.Á.-M.)
| | - Leonel Pekarek
- Unit of Histology and Pathology, Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (O.F.-M.); (C.G.-M.); (L.P.); (A.J.C.); (L.S.-T.); (N.G.-H.); (M.Á.-M.); (J.B.); (G.L.); (M.A.Á.-M.)
| | - Luis G. Guijarro
- Unit of Biochemistry and Molecular Biology (CIBEREHD), Department of System Biology, University of Alcalá, 28801 Alcalá de Henares, Spain;
| | - Alejandro J. Castellanos
- Unit of Histology and Pathology, Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (O.F.-M.); (C.G.-M.); (L.P.); (A.J.C.); (L.S.-T.); (N.G.-H.); (M.Á.-M.); (J.B.); (G.L.); (M.A.Á.-M.)
| | - Lara Sanchez-Trujillo
- Unit of Histology and Pathology, Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (O.F.-M.); (C.G.-M.); (L.P.); (A.J.C.); (L.S.-T.); (N.G.-H.); (M.Á.-M.); (J.B.); (G.L.); (M.A.Á.-M.)
| | - Natalio García-Honduvilla
- Unit of Histology and Pathology, Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (O.F.-M.); (C.G.-M.); (L.P.); (A.J.C.); (L.S.-T.); (N.G.-H.); (M.Á.-M.); (J.B.); (G.L.); (M.A.Á.-M.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
- University Center for the Defense of Madrid (CUD-ACD), 28047 Madrid, Spain
| | - Melchor Álvarez-Mon
- Unit of Histology and Pathology, Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (O.F.-M.); (C.G.-M.); (L.P.); (A.J.C.); (L.S.-T.); (N.G.-H.); (M.Á.-M.); (J.B.); (G.L.); (M.A.Á.-M.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
- University Center for the Defense of Madrid (CUD-ACD), 28047 Madrid, Spain
- Immune System Diseases-Rheumatology, Oncology Service an Internal Medicine, University Hospital Príncipe de Asturias, (CIBEREHD), 28806 Alcalá de Henares, Spain
| | - Julia Buján
- Unit of Histology and Pathology, Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (O.F.-M.); (C.G.-M.); (L.P.); (A.J.C.); (L.S.-T.); (N.G.-H.); (M.Á.-M.); (J.B.); (G.L.); (M.A.Á.-M.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
- Cancer Registry and Pathology Department, Hospital Universitario Principe de Asturias, 28806 Alcalá de Henares, Spain
| | - Álvaro Zapico
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcala de Henares, Spain;
- Obstetrics and Gynecology Service, Center for Biomedical Research in the Mental Health Network, University Hospital Príncipe de Asturias, 28806 Alcalá de Henares, Spain
| | - Guillermo Lahera
- Unit of Histology and Pathology, Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (O.F.-M.); (C.G.-M.); (L.P.); (A.J.C.); (L.S.-T.); (N.G.-H.); (M.Á.-M.); (J.B.); (G.L.); (M.A.Á.-M.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
- Psychiatry Service, Center for Biomedical Research in the Mental Health Network, University Hospital Príncipe de Asturias, 28806 Alcalá de Henares, Spain
| | - Miguel A. Álvarez-Mon
- Unit of Histology and Pathology, Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (O.F.-M.); (C.G.-M.); (L.P.); (A.J.C.); (L.S.-T.); (N.G.-H.); (M.Á.-M.); (J.B.); (G.L.); (M.A.Á.-M.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
- Department of Psychiatry and Medical Psychology, Hospital Universitario Infanta Leonor, 28031 Madrid, Spain
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Dhruva A, Wu C, Miaskowski C, Hartogensis W, Rugo HS, Adler SR, Kaptchuk TJ, Kelkar R, Agarawal S, Vadodaria A, Garris E, Hecht FM. A 4-Month Whole-Systems Ayurvedic Medicine Nutrition and Lifestyle Intervention Is Feasible and Acceptable for Breast Cancer Survivors: Results of a Single-Arm Pilot Clinical Trial. Glob Adv Health Med 2020; 9:2164956120964712. [PMID: 33312762 PMCID: PMC7716077 DOI: 10.1177/2164956120964712] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 09/14/2020] [Accepted: 09/15/2020] [Indexed: 01/22/2023] Open
Abstract
PURPOSE Ongoing symptoms and impairments in quality of life (QOL) among breast cancer survivors remain a significant problem. We tested the feasibility and acceptability of a manualized Ayurvedic nutrition and lifestyle intervention for breast cancer survivors. METHODS Eligible participants had Stage I-III breast cancer, underwent treatment within the past year that included chemotherapy, and were without active disease. The 4-month individualized Ayurvedic intervention included counseling on nutrition, lifestyle, yoga, and marma (like acupressure) during 8 one-on-one visits with an Ayurvedic practitioner. Feasibility and acceptability were the primary outcomes. QOL (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire [EORTC QLQ C30]) and symptoms-sleep disturbance (General Sleep Disturbance Scale [GSDS]), fatigue (Lee Fatigue Scale [LFS]), depressive symptoms (Center for Epidemiological Studies-Depression Scale [CES-D]), anxiety (Spielberger State-Trait Anxiety Inventory [STAI-S, STAI-T]), and stress (Perceived Stress Scale [PSS])-were measured prior to, at midpoint, and at the end of the 4-month intervention. Effect sizes (Cohen's d) were calculated along with paired t tests comparing baseline to end of month 4 time points. Mixed effects models were used for repeated measures analyses. RESULTS Participants (n = 32) had a mean age of 48 years (SD = 10). Retention at the end of the intervention was 84%. Among those who completed the intervention (n = 27), adherence was high (99.5% of visits with practitioners attended). Large improvements were seen in QLQ-C30 emotional functioning (d = 0.84, P < 0.001), QLQ-C30 cognitive functioning (d = 0.86, P < 0.001), GSDS (d = -1.23, P < 0.001), and CES-D (d = -1.21, P < 0.001). Moderate improvements were seen in QLQ-C30 global health (d = 0.65, p = 0.003), LFS (d = -0.68, P = 0.002), and PSS (d = -0.75, P < 0.001). No adverse events were observed due to the intervention. CONCLUSION This 4-month Ayurvedic whole-systems multimodal nutrition and lifestyle intervention was feasible and acceptable for breast cancer survivors. Promise of clinical benefit was seen in terms of improvements in symptoms and QOL that warrants further investigation.
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Affiliation(s)
- Anand Dhruva
- Osher Center for Integrative Medicine, University of California San Francisco, San Francisco, California
- Department of Medicine, Division of Hematology and Oncology, University of California San Francisco, San Francisco, California
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, California
| | - Cairn Wu
- Osher Center for Integrative Medicine, University of California San Francisco, San Francisco, California
| | - Christine Miaskowski
- School of Nursing, Department of Physiologic Nursing, University of California San Francisco, San Francisco, California
- Department of Anesthesiology, University of California San Francisco, San Francisco, California
| | - Wendy Hartogensis
- Osher Center for Integrative Medicine, University of California San Francisco, San Francisco, California
| | - Hope S Rugo
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, California
| | - Shelley R Adler
- Osher Center for Integrative Medicine, University of California San Francisco, San Francisco, California
- Department of Anesthesiology, University of California San Francisco, San Francisco, California
| | - Ted J Kaptchuk
- Department of Family and Community Medicine, University of California San Francisco, San Francisco, California
| | - Rucha Kelkar
- Osher Center for Integrative Medicine, University of California San Francisco, San Francisco, California
| | - Sangeeta Agarawal
- Osher Center for Integrative Medicine, University of California San Francisco, San Francisco, California
| | - Amisha Vadodaria
- Osher Center for Integrative Medicine, University of California San Francisco, San Francisco, California
| | - Ellen Garris
- Osher Center for Integrative Medicine, University of California San Francisco, San Francisco, California
| | - Frederick M Hecht
- Osher Center for Integrative Medicine, University of California San Francisco, San Francisco, California
- Beth Israel Hospital, Harvard Medical School, Boston, Massachusetts
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Yoga effectively reduces fatigue and symptoms of depression in patients with different types of cancer. Support Care Cancer 2020; 29:2973-2982. [PMID: 33026490 PMCID: PMC8062403 DOI: 10.1007/s00520-020-05794-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 09/18/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE Examine the effects of an 8-week yoga therapy on fatigue in patients with different types of cancer. METHODS A total of 173 cancer patients suffering from mild to severe fatigue were randomly allocated to yoga intervention (n = 84) (IG) versus waitlist control group (CG) (n = 88). Yoga therapy consisted of eight weekly sessions with 60 min each. The primary outcome was self-reported fatigue symptoms. Secondary outcomes were symptoms of depression and quality of life (QoL). Data were assessed using questionnaires before (T0) and after yoga therapy for IG versus waiting period for CG (T1). RESULTS A stronger reduction of general fatigue (P = .033), physical fatigue (P = .048), and depression (P < .001) as well as a stronger increase in QoL (P = .002) was found for patients who attended 7 or 8 sessions compared with controls. Within the yoga group, both higher attendance rate and lower T0-fatigue were significant predictors of lower T1-fatigue (P ≤ .001). Exploratory results revealed that women with breast cancer report a higher reduction of fatigue than women with other types of cancer (P = .016) after yoga therapy. CONCLUSION The findings support the assumption that yoga therapy is useful to reduce cancer-related fatigue, especially for the physical aspects of fatigue. Women with breast cancer seem to benefit most, and higher attendance rate results in greater reduction of fatigue. TRIAL REGISTRATION German Clinical Trials Register DRKS00016034.
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Effects of Yoga-Based Interventions on Cancer-Associated Cognitive Decline: a Systematic Review. Curr Oncol Rep 2020; 22:100. [DOI: 10.1007/s11912-020-00960-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Emerging Role of Integrative Medicine in Hematologic Malignancies: a Literature Review and Update on Current Trends in Complementary Medical Practices in Hematologic Cancers. Curr Hematol Malig Rep 2020; 14:328-336. [PMID: 31209644 DOI: 10.1007/s11899-019-00526-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE OF REVIEW This review discusses the emerging role of integrative hematology. It reinforces the growing interest of CAM among patients, and the importance of provider knowledge and participation in discussions with patients about the subject. The main question asked in this review, "Is there evidence for the use of integrative medicine practices in the field of malignant hematology?" is answered by examining current research and providing relevant summaries. RECENT FINDINGS Data suggests that practices such as meditative movement, exercise, nutrition and supplements and touch therapy can be used for symptom alleviation, preventive measures, and novel treatment development. Integrative hematology is a needed part of complete patient care, and it is the role of providers to be knowledgeable and open to ensure patients are engaging in practices that are evidence-informed and safe. More studies are needed in the field in order to make concrete and robust recommendations.
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Liou KT, Root JC, Garland SN, Green J, Li Y, Li QS, Kantoff PW, Ahles TA, Mao JJ. Effects of acupuncture versus cognitive behavioral therapy on cognitive function in cancer survivors with insomnia: A secondary analysis of a randomized clinical trial. Cancer 2020; 126:3042-3052. [PMID: 32320061 DOI: 10.1002/cncr.32847] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 01/29/2020] [Accepted: 02/20/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Cancer-related cognitive impairment is a prevalent, disruptive condition potentially exacerbated by sleep disturbances. The current study was performed to evaluate the effects of acupuncture versus cognitive behavioral therapy for insomnia (CBT-I) on objective and subjective cognitive function in cancer survivors with insomnia. METHODS Using data from a randomized clinical trial (160 survivors) that compared acupuncture versus CBT-I for insomnia occurring in cancer survivors, the authors analyzed cognitive outcomes and their relationship to insomnia symptoms. Analysis was limited to 99 patients who reported baseline cognitive difficulties. Interventions were delivered over 8 weeks. Objective attention, learning, and memory were evaluated using the Buschke Selective Reminding Test. Subjective cognitive function was assessed using the Brown Attention-Deficit Disorder Scales. Insomnia symptoms were assessed using the Insomnia Severity Index. All outcomes were collected at baseline, week 8, and week 20. RESULTS From baseline to week 8, acupuncture produced statistically significant within-group improvements in objective attention (Cohen D, 0.29), learning (Cohen D, 0.31), and memory (Cohen D, 0.33) that persisted to week 20 (all P < .05), whereas CBT-I produced a statistically significant within-group improvement in objective attention from baseline to week 20 (Cohen D, 0.50; P < .05); between-group differences were not statistically significant. Both interventions produced statistically significant within-group improvements in subjective cognitive function at weeks 8 and 20 compared with baseline (all P < .001); between-group differences were not statistically significant. In the acupuncture group, patients with clinically meaningful responses with regard to insomnia symptoms demonstrated a significantly greater improvement in subjective cognitive function compared with those without clinically meaningful insomnia responses (P = .006). CONCLUSIONS Among cancer survivors with insomnia, both acupuncture and CBT-I produced significant improvements in objective and subjective cognitive function. However, the effect sizes varied and only survivors in the acupuncture group demonstrated a significant relationship between cognitive and sleep outcomes. These preliminary findings warrant further investigation to guide the personalized management of patients with cancer-related cognitive impairment.
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Affiliation(s)
- Kevin T Liou
- Integrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - James C Root
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Sheila N Garland
- Department of Psychology, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | - Jamie Green
- Integrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Yuelin Li
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York.,Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Q Susan Li
- Integrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Philip W Kantoff
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Tim A Ahles
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jun J Mao
- Integrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
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Pathogenesis, Assessments, and Management of Chemotherapy-Related Cognitive Impairment (CRCI): An Updated Literature Review. JOURNAL OF ONCOLOGY 2020; 2020:3942439. [PMID: 32684930 PMCID: PMC7333028 DOI: 10.1155/2020/3942439] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 05/10/2020] [Accepted: 06/08/2020] [Indexed: 02/06/2023]
Abstract
There are various cancer treatments at present, and chemotherapy is one of the main methods. Chemotherapy-related cognitive impairment (CRCI), as one of the side effects of chemotherapy, has gradually attracted the attention of more and more researchers. CRCI has been verified by subjective reports and objective neuropsychological tests so far. But oncologists' understanding of it and its treatments are still incomplete. In this review, we mainly give a comprehensive overview of the mechanism of CRCI, then describe a variety of evaluation methods, and finally summarize the treatment approaches under current medical conditions and compare it with an excellent article published in 2015 with the aim of providing directions for future research and better understanding of CRCI for clinicians.
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Milbury K, Weathers SP, Durrani S, Li Y, Whisenant M, Li J, Lim B, Weinberg JS, Kesler SR, Cohen L, Bruera E. Online Couple-Based Meditation Intervention for Patients With Primary or Metastatic Brain Tumors and Their Partners: Results of a Pilot Randomized Controlled Trial. J Pain Symptom Manage 2020; 59:1260-1267. [PMID: 32061834 DOI: 10.1016/j.jpainsymman.2020.02.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 02/03/2020] [Accepted: 02/05/2020] [Indexed: 02/03/2023]
Abstract
OBJECTIVES Although patients with primary and metastatic brain tumors and their partners are at risk of experiencing high symptom burden, they are often excluded from psychosocial intervention studies. Thus, we sought to examine the feasibility and preliminary efficacy of a couple-based meditation (CBM) program targeting symptom and well-being outcomes. METHODS Couples completed baseline measures assessing symptom and well-being outcomes and were randomized to the CBM or a usual care control group. Couples in the CBM groups attended four weekly (60 minutes each) therapist-led sessions that were delivered via FaceTime (Apple Inc, Cupertino, CA). The CBM program focused on cultivating mindfulness, compassion, gratitude and purpose, and integrated emotional disclosure exercises. Both groups were reassessed six and 12 weeks after baseline. RESULTS We approached 60 eligible dyads, of which 37 (62%) consented, 35 (95%) were randomized, and 22 (63%) completed all assessments. Couples in the CBM group attended a mean of 3.33 sessions (SD 1.09). For patients, significant group differences in favor of the CBM group were found for cognitive (d = 1.05) and general disease symptoms (d = 0.93), and relationship well-being (d = 0.68) and compassion (d = 0.96). No significant group differences were revealed for partners. CONCLUSION It seems to be feasible, acceptable, and possibly efficacious to deliver a dyadic intervention via FaceTime to brain tumor couples. Although both patients and partners in the CBM group rated the intervention as beneficial, significant group differences with medium-to-large effect sizes were only found for patients.
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Affiliation(s)
- Kathrin Milbury
- Department of Behavioral Science, The University of Texas, MD Anderson Cancer Center, Houston, Texas, USA.
| | - Shiao-Pei Weathers
- Department of Neuro-Oncology, The University of Texas, MD Anderson Cancer Center, Houston, Texas, USA
| | - Sania Durrani
- Department of Behavioral Science, The University of Texas, MD Anderson Cancer Center, Houston, Texas, USA
| | - Yisheng Li
- Department of Biostatistics, The University of Texas, MD Anderson Cancer Center, Houston, Texas, USA
| | - Meagan Whisenant
- Department of Symptom Research, The University of Texas, MD Anderson Cancer Center, Houston, Texas, USA
| | - Jing Li
- Department of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, Texas, USA
| | - Bora Lim
- Department of Breast Medical Oncology, The University of Texas, MD Anderson Cancer Center, Houston, Texas, USA
| | - Jeffrey S Weinberg
- Department of Neurosurgery, The University of Texas, MD Anderson Cancer Center, Houston, Texas, USA
| | - Shelli R Kesler
- Department of Oncology, Dell Medical School, University of Texas at Austin, Austin, Texas, USA
| | - Lorenzo Cohen
- Department of Palliative, Rehabilitation & Integrative Medicine, The University of Texas, MD Anderson Cancer Center, Houston, Texas, USA
| | - Eduardo Bruera
- Department of Palliative, Rehabilitation & Integrative Medicine, The University of Texas, MD Anderson Cancer Center, Houston, Texas, USA
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Wagner MA, Erickson KI, Bender CM, Conley YP. The Influence of Physical Activity and Epigenomics On Cognitive Function and Brain Health in Breast Cancer. Front Aging Neurosci 2020; 12:123. [PMID: 32457596 PMCID: PMC7225270 DOI: 10.3389/fnagi.2020.00123] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 04/14/2020] [Indexed: 12/17/2022] Open
Abstract
The risk of breast cancer increases with age, with the majority of women diagnosed with breast cancer being postmenopausal. It has been estimated that 25-75% of women with breast cancer experience changes in cognitive function (CF) related to disease and treatment, which compromises psychological well-being, decision making, ability to perform daily activities, and adherence to cancer therapy. Unfortunately, the mechanisms that underlie neurocognitive changes in women with breast cancer remain poorly understood, which in turn limits the development of effective treatments and prevention strategies. Exercise has great potential as a non-pharmaceutical intervention to mitigate the decline in CF in women with breast cancer. Evidence suggests that DNA methylation, an epigenetic mechanism for gene regulation, impacts CF and brain health (BH), that exercise influences DNA methylation, and that exercise impacts CF and BH. Although investigating DNA methylation has the potential to uncover the biologic foundations for understanding neurocognitive changes within the context of breast cancer and its treatment as well as the ability to understand how exercise mitigates these changes, there is a dearth of research on this topic. The purpose of this review article is to compile the research in these areas and to recommend potential areas of opportunity for investigation.
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Affiliation(s)
- Monica A. Wagner
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, United States
| | - Kirk I. Erickson
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
- Discipline of Exercise Science, College of Science, Health, Engineering and Education, Murdoch University, Perth Campus, Murdoch, WA, Australia
| | | | - Yvette P. Conley
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, United States
- Department of Human Genetics, University of Pittsburgh, Pittsburgh, PA, United States
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Zhang Q, Gao X, Liu S, Yu L, Zhu J, Qiu S. Therapies for cognitive impairment in breast cancer survivors treated with chemotherapy: A protocol for systematic review. Medicine (Baltimore) 2020; 99:e20092. [PMID: 32384481 PMCID: PMC7440308 DOI: 10.1097/md.0000000000020092] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE The aim of this systematic review was to evaluate the effect of therapies for cognitive impairment on patients' perceived cognitive function in breast cancer survivors with chemotherapy-related cognitive impairment. METHOD A literature search of PubMed, Embase, and the Cochrane Library was conducted up to April 2019. Search terms included breast cancer, chemotherapy, and cognitive impairment. RESULT Six randomized controlled trials with a total of 305 patients were included in this review. A total of 6 randomized controlled trials using various treatments (Tibetan sound meditation, donepezil, memory and attention adaptation training, aerobic exercise, acupuncture, Qigong) for chemotherapy-related cognitive impairment met the eligibility criteria and were included. This review showed that meditative interventions (Tibetan sound meditation, Qigong) and cognitive therapy (memory and attention adaptation training) may partially improve some aspects of patients' perceived (self-reported) cognitive functioning, particularly patients' perceived cognitive impairment and ability. CONCLUSION In this systematic review, the results showed that meditative interventions (Tibetan sound meditation, Qigong) and cognitive therapy (memory and attention adaptation training) may be optional therapies. We hope to have more randomized controlled trials to support this result in the future.
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Affiliation(s)
- Qiuhua Zhang
- First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang
| | - Xiufei Gao
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), China
| | - Shan Liu
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), China
| | - Linghong Yu
- First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang
| | - Jiayan Zhu
- First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang
| | - Shengliang Qiu
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), China
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Lewis JK. Yoga for Cancer-Related Symptoms #391. J Palliat Med 2020; 23:719-720. [DOI: 10.1089/jpm.2020.0179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Gaynor AM, Pergolizzi D, Alici Y, Ryan E, McNeal K, Ahles TA, Root JC. Impact of transcranial direct current stimulation on sustained attention in breast cancer survivors: Evidence for feasibility, tolerability, and initial efficacy. Brain Stimul 2020; 13:1108-1116. [PMID: 32353419 DOI: 10.1016/j.brs.2020.04.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Revised: 02/26/2020] [Accepted: 04/19/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND A significant subset of breast cancer survivors experience cognitive difficulties in attention and memory, which persist for years following treatment. Transcranial direct current stimulation (tDCS) has been shown to be effective in improving working memory, attention, processing speed, and other cognitive functions in both healthy and clinical populations. To date, no studies have examined tDCS for rehabilitation of cancer-related cognitive dysfunction. OBJECTIVE/HYPOTHESIS We aimed to provide preliminary evidence for feasibility, tolerability, acceptability, and efficacy of tDCS in improving performance on a measure of sustained attention. METHODS In a within-subjects design, 16 breast cancer survivors underwent 2 consecutive days of active tDCS over the prefrontal cortex, and 2 days of sham tDCS, counterbalanced for order of stimulation condition, while performing a continuous performance test. RESULTS Stimulation was feasible and tolerable, with 89% of participants completing all sessions, and none reporting more than mild to moderate discomfort. Analyses of efficacy showed that during active stimulation, participants had significantly lower standard errors of reaction times overall, indicating better sustained attention ability, as compared to sham stimulation (p < 0.05). Furthermore, the effect of stimulation on standard errors of reaction times differed by inter-stimulus interval (ISI): for 1 and 2 s ISIs, there was no significant difference in performance between sham and active tDCS conditions, but for 4 s ISIs, stimulation improved variability in response times relative to sham (p < 0.05). CONCLUSIONS Results suggest that tDCS is feasible, tolerable, and may be an effective intervention to improve sustained attention difficulties in survivors with cancer-related cognitive dysfunction.
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Affiliation(s)
- Alexandra M Gaynor
- Memorial Sloan Kettering Cancer Center, Department of Psychiatry and Behavioral Sciences, New York, NY, USA.
| | - Denise Pergolizzi
- Universitat Internacional de Catalunya, School of Medicine and Health Sciences, Barcelona, Spain
| | - Yesne Alici
- Memorial Sloan Kettering Cancer Center, Department of Psychiatry and Behavioral Sciences, New York, NY, USA
| | - Elizabeth Ryan
- Memorial Sloan Kettering Cancer Center, Department of Psychiatry and Behavioral Sciences, New York, NY, USA
| | - Katrazyna McNeal
- Memorial Sloan Kettering Cancer Center, Department of Psychiatry and Behavioral Sciences, New York, NY, USA
| | - Tim A Ahles
- Memorial Sloan Kettering Cancer Center, Department of Psychiatry and Behavioral Sciences, New York, NY, USA
| | - James C Root
- Memorial Sloan Kettering Cancer Center, Department of Psychiatry and Behavioral Sciences, New York, NY, USA
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Pergolotti M, Battisti NML, Padgett L, Sleight AG, Abdallah M, Newman R, Van Dyk K, Covington KR, Williams GR, van den Bos F, Pollock Y, Salerno EA, Magnuson A, Gattás-Vernaglia IF, Ahles TA. Embracing the complexity: Older adults with cancer-related cognitive decline-A Young International Society of Geriatric Oncology position paper. J Geriatr Oncol 2020; 11:237-243. [PMID: 31619372 PMCID: PMC7054166 DOI: 10.1016/j.jgo.2019.09.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 08/01/2019] [Accepted: 09/04/2019] [Indexed: 01/16/2023]
Abstract
Cancer-related cognitive decline (CRCD) may have particularly significant consequences for older adults, impacting their functional and physical abilities, level of independence, ability to make decisions, treatment adherence, overall quality of life, and ultimately survival. In honor of Dr. Hurria's work we explore and examine multiple types of screening, assessment and non-pharmacologic treatments for CRCD. We then suggest future research and clinical practice questions to holistically appreciate the complexity of older adults with cancer's experiences and fully integrate the team-based approach to best serve this population.
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Affiliation(s)
- Mackenzi Pergolotti
- ReVital Cancer Rehabilitation, Select Medical, 4174 Gettysburg Rd, Mechanicsburg, PA 17055, USA; Department of Occupational Therapy - College of Health and Human Sciences, Colorado State University, 200 Occupational Therapy Building, Fort Collins, CO 80523-1573, USA.
| | - Nicolò Matteo Luca Battisti
- Department of Medicine - Breast Unit, The Royal Marsden NHS Foundation Trust, Downs Road, Sutton Surrey SM2 5PT, United Kingdom.
| | - Lynne Padgett
- Veterans Affairs Medical Center, Washington, DC, USA
| | - Alix G Sleight
- Outcomes Research Branch, Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, USA.
| | - Maya Abdallah
- Department of Internal Medicine, University of Massachusetts Medical School - Baystate Medical Center, 759 Chestnut St., Springfield, MA, 01199, USA.
| | - Robin Newman
- Department of Occupational Therapy, Boston University Sargent College of Health and Rehabilitation Sciences, 635 Commonwealth Avenue, Boston, MA 02215, USA.
| | - Kathleen Van Dyk
- Jonsson Comprehensive Cancer Center, Cancer Prevention and Control Research, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA 90095, USA.
| | - Kelley R Covington
- ReVital Cancer Rehabilitation, Select Medical, 4174 Gettysburg Rd, Mechanicsburg, PA 17055, USA; Department of Occupational Therapy - College of Health and Human Sciences, Colorado State University, 200 Occupational Therapy Building, Fort Collins, CO 80523-1573, USA.
| | - Grant R Williams
- Divisions of Hematology/Oncology & Gerontology, Geriatrics, and Palliative Care, Institute for Cancer Outcomes and Survivorship, The University of Alabama at Birmingham, 1670 University Blvd, Birmingham, AL 35233, USA.
| | - Frederiek van den Bos
- Departement of Geriatric Medicine, University Medical Centre Utrecht, Heidelberglaan 100, 3584, CX, Utrecht, Netherlands.
| | - YaoYao Pollock
- Geriatric Oncology Fellowship Program, University of California, San Francisco, 1600 Divisadero St, San Francisco, CA 94115, USA.
| | - Elizabeth A Salerno
- Division of Cancer Epidemiology & Genetics, Metabolic Epidemiology Branch, National Cancer Institute, 9609 Medical Center Dr, Rockville, MD 20850, USA.
| | - Allison Magnuson
- Department of Medicine, Hematology/Oncology, University of Rochester Medical Center, 601 Elmwood Ave, Box 704, Rochester, NY 14642, USA.
| | - Isabella F Gattás-Vernaglia
- Division of Geriatrics, Department of Internal Medicine, University of São Paulo Medical School, Hospital Sírio-Libanês- Geriatric Oncology Team, Av. Dr. Enéas de Carvalho Aguiar, 155, 8° Andar, Bloco 3, São Paulo, SP CEP 05403-900, Brazil
| | - Tim A Ahles
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 641 Lexington Ave, New York, NY 10022, USA.
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Campbell KL, Zadravec K, Bland KA, Chesley E, Wolf F, Janelsins MC. The Effect of Exercise on Cancer-Related Cognitive Impairment and Applications for Physical Therapy: Systematic Review of Randomized Controlled Trials. Phys Ther 2020; 100:523-542. [PMID: 32065236 PMCID: PMC8559683 DOI: 10.1093/ptj/pzz090] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Revised: 04/11/2019] [Accepted: 07/02/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Cancer-related cognitive impairment (CRCI), often called "chemo-brain" or "chemo-fog," is a common side effect among adults with cancer, which can persist well after treatment completion. Accumulating evidence demonstrates exercise can improve cognitive function in healthy older adults and adults with cognitive impairments, suggesting exercise may play a role in managing CRCI. PURPOSE The purpose was to perform a systematic review of randomized controlled trials (RCTs) to understand the effect of exercise on CRCI. DATA SOURCES Relevant literature was retrieved from CINAHL, Medline (Ovid), and EMBASE. STUDY SELECTION Eligible articles were RCTs that prescribed aerobic, resistance, combined aerobic/resistance, or mind-body (eg, yoga or Qigong) exercise during or following cancer treatment and included cognitive function outcome measures. DATA EXTRACTION Descriptive information and Cohen d effect sizes were directly extracted or calculated for included trials. DATA SYNTHESIS Twenty-nine trials were included in the final analysis. A statistically significant effect of exercise on self-reported cognitive function, both during and postadjuvant treatment, was reported in 12 trials (41%) (Cohen d range: 0.24-1.14), most commonly using the EORTC QLQ-C30. Ten trials (34%) performed neuropsychological testing to evaluate cognitive function; however, only 3 trials in women with breast cancer reported a significant effect of exercise (Cohen d range: 0.41-1.47). LIMITATIONS Few RCTs to date have evaluated the effect of exercise on CRCI as a primary outcome. Twenty-six trials (90%) in this review evaluated CRCI as secondary analyses. CONCLUSIONS Evidence supporting exercise as a strategy to address CRCI is limited. Future research evaluating CRCI as a primary outcome, including self-reported and objective measures, is needed to confirm the possible role of exercise in preventing and managing cognitive impairments in adults with cancer.
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Affiliation(s)
- Kristin L Campbell
- Department of Physical Therapy, University of British Columbia 212-2177
Wesbrook Mall, Vancouver, British Columbia, Canada V7J 3K6,Address all correspondence to Dr Campbell at:
| | | | - Kelcey A Bland
- Mary MacKillop Institute for Health Research, Australian Catholic
University, Melbourne, Victoria, Australia
| | | | - Florian Wolf
- Institute for Cardiovascular Research and Sports Medicine, German Sport
University, Cologne, Germany
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Zeng Y, Dong J, Huang M, Zhang JE, Zhang X, Xie M, Wefel JS. Nonpharmacological interventions for cancer-related cognitive impairment in adult cancer patients: A network meta-analysis. Int J Nurs Stud 2020; 104:103514. [PMID: 32004776 DOI: 10.1016/j.ijnurstu.2019.103514] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 12/25/2019] [Accepted: 12/27/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND Conventional meta-analyses can only provide direct comparison evidence, and the best options of nonpharmacological interventions for cancer-related cognitive impairment remain largely unknown. OBJECTIVES To evaluate the comparative effects of all known nonpharmacological interventions for cancer-related cognitive impairment, and to rank the best intervention options for adult non- central nervous system cancer patients with cancer-related cognitive impairment. DESIGN Systematic review with a new analytic approach of network meta-analysis. DATA SOURCES Six electronic databases were searched for randomized controlled trials from January 2010 to July 2019. REVIEW METHODS Literature screening, data extraction and quality appraisal was undertaken systematically by two independent reviewers. Quantitative network meta-analysis performed to analyze key study outcomes. The primary outcome was the effectiveness of interventions on subjective cognitive function, and the secondary outcome was the safety of nonpharmacological interventions for cancer-related cognitive impairment. RESULTS There were 29 eligible randomized controlled trials searched, and a total of 10 interventions identified. All 29 randomized controlled trials that were included had no reported significant adverse events, therefore, these 10 nonpharmacological interventions are safe for cancer-related cognitive impairment management. In terms of effectiveness, the pooled overall effects were in favor of these 10 nonpharmacological interventions. The most effective interventions included meditation, cognitive training, cognitive rehabilitation, and exercise interventions, with a mean difference of effective size plus 95% confidence interval 10.26 (1.53, 19.00), 5.02 (1.41, 8.63), 4.88 (0.65, 9.11), and 3.82 (0.52, 7.13), respectively. Other treatment effects did not show statistically significant differences. CONCLUSIONS This network meta-analysis found that meditation interventions, cognitive training, cognitive rehabilitation, and exercise were the most effective interventions for adult non-central nervous system cancer patients to manage cancer-related cognitive impairment. Results of this network meta-analysis contribute evidence-based data to inform medical decision-making.
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Affiliation(s)
- Yingchun Zeng
- Department of Nursing, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Juntao Dong
- Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Meiling Huang
- Department of Nursing, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
| | - Jun-E Zhang
- School of Nursing, Sun Yat-sen University, Guangzhou, China.
| | - Xiaoming Zhang
- The Affiliated Baoan Hospital of Southern Medical University, The People's Hospital of Baoan Shenzhen, Shenzhen, China
| | - Man Xie
- Jieyang People's Hospital, Jieyang, Guangdong Province, China
| | - Jeffrey S Wefel
- Departments of Neuro-Oncology and Radiation Oncology, The University of Texas MD Anderson Cancer Center, TX, US
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Precautions for yoga practice are necessary in cancer patients. Support Care Cancer 2019; 28:3981-3982. [PMID: 31828487 DOI: 10.1007/s00520-019-05154-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 10/29/2019] [Indexed: 01/11/2023]
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Loo LWM, Nishibun K, Welsh L, Makolo T, Chong CD, Pagano I, Yu H, Bantum EO. Using a cultural dance program to increase sustainable physical activity for breast cancer survivors-A pilot study. Complement Ther Med 2019; 47:102197. [PMID: 31780003 PMCID: PMC6905195 DOI: 10.1016/j.ctim.2019.102197] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 07/27/2019] [Accepted: 09/18/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Studies have shown that physical activity can reduce the risk of mortality for female breast cancer patients and improve quality of life, reduce weight, and alter circulating biomarker levels. We conducted a pilot trial to determine the feasibility of increasing physical activity through a cultural dance intervention to achieve similar benefits. METHODS Conducted a pilot trial implementing a cultural dance intervention to increase and sustain physical activity for breast cancer survivors, which consisted of a six-month group-based intervention of Hula Dance. Anthropometric measures, fasting blood draws, and self-reported questionnaires to assess physical activity, mood, and quality of life, were completed at baseline, at the end of the 6-month intervention (time point month-6), and at two additional post-intervention time points (month-12 and month-24) to assess sustainability. RESULTS A total of 11 women with a median age of 63 years were enrolled in the intervention trial. Eight of the 11 (73%) completed the trial to month-12 and demonstrated an overall significant increase in weekly moderate exercise. There were no significant changes in intra-individual body mass index (BMI). However, there was a sustained post-intervention reduction in waist circumference and significant changes in circulating biomarker levels. For the self-reported measures, there was a significant increase in vigor/activity (p < 0.001; Profile of Mood States-Short Form). CONCLUSION Our intervention pilot trial demonstrated that a cultural dance program could achieve a sustainable increase in physical activity for breast cancer survivors, with potential to improve quality of life, increase vigor, and decrease levels of circulating cytokines associated with obesity and inflammation.
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Affiliation(s)
- Lenora W M Loo
- University of Hawaii Cancer Center, Population Sciences in the Pacific Program, 701 Ilalo Street, Honolulu, HI, 96813, United States.
| | - Kryslin Nishibun
- University of Hawaii Cancer Center, Population Sciences in the Pacific Program, 701 Ilalo Street, Honolulu, HI, 96813, United States
| | - Leslie Welsh
- University of Hawaii Cancer Center, Population Sciences in the Pacific Program, 701 Ilalo Street, Honolulu, HI, 96813, United States
| | - TeMoana Makolo
- University of Hawaii Cancer Center, Population Sciences in the Pacific Program, 701 Ilalo Street, Honolulu, HI, 96813, United States
| | - Clayton D Chong
- The Queen's Medical Center, Queen's Cancer Center, 1301 Punchbowl Street, Honolulu, HI, 96813, United States
| | - Ian Pagano
- University of Hawaii Cancer Center, Population Sciences in the Pacific Program, 701 Ilalo Street, Honolulu, HI, 96813, United States
| | - Herbert Yu
- University of Hawaii Cancer Center, Population Sciences in the Pacific Program, 701 Ilalo Street, Honolulu, HI, 96813, United States
| | - Erin O Bantum
- University of Hawaii Cancer Center, Population Sciences in the Pacific Program, 701 Ilalo Street, Honolulu, HI, 96813, United States
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Joly F, Lange M, Dos Santos M, Vaz-Luis I, Di Meglio A. Long-Term Fatigue and Cognitive Disorders in Breast Cancer Survivors. Cancers (Basel) 2019; 11:E1896. [PMID: 31795208 PMCID: PMC6966680 DOI: 10.3390/cancers11121896] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 11/25/2019] [Accepted: 11/26/2019] [Indexed: 01/20/2023] Open
Abstract
Survivors of early-stage breast cancer may report treatment-related side effects that persist for several years after the end of primary treatment. Among these, fatigue and cognitive disorders are frequent complaints and can negatively impact quality of life. Cancer-related fatigue is a very prevalent and distressing long-term side effect among breast cancer survivors that typically improves after completion of treatment, although many patients report severe fatigue several years post-treatment. Cognitive disorders are also common among survivors of breast cancer, especially if treated with chemotherapy. These symptoms are usually mild-to-moderate and often transient. Cognitive recovery is frequently observed within months or a few years after completion of chemotherapy or endocrine therapy. However, some breast cancer survivors may have persistent cognitive difficulties. Several types of interventions have proved to be beneficial in reducing cancer-related fatigue and cognitive difficulties. Most of these interventions for cancer-related fatigue are thought to be effective by reducing inflammation or disrupting pro-inflammatory circuits. Further studies are needed on cognitive management that has showed promising results. This narrative review summarizes the state of the art regarding long-term fatigue and cognitive disorders in patients with early breast cancer, describing prevalence, impact, pathophysiology, and risk factors, and focusing on available interventions.
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Affiliation(s)
- Florence Joly
- Clinical Research Department, Centre François Baclesse, 14000 Caen, France; (M.L.); (M.D.S.)
- INSERM U1086, ANTICIPE, Normandie Univ, UNICAEN, 14000 Caen, France
- Cancer and Cognition Platform, Ligue Nationale Contre le Cancer, 14000 Caen, France
- University Hospital of Caen, 14000 Caen, France
| | - Marie Lange
- Clinical Research Department, Centre François Baclesse, 14000 Caen, France; (M.L.); (M.D.S.)
- INSERM U1086, ANTICIPE, Normandie Univ, UNICAEN, 14000 Caen, France
- Cancer and Cognition Platform, Ligue Nationale Contre le Cancer, 14000 Caen, France
| | - Melanie Dos Santos
- Clinical Research Department, Centre François Baclesse, 14000 Caen, France; (M.L.); (M.D.S.)
- INSERM U1086, ANTICIPE, Normandie Univ, UNICAEN, 14000 Caen, France
- Cancer and Cognition Platform, Ligue Nationale Contre le Cancer, 14000 Caen, France
- University Hospital of Caen, 14000 Caen, France
- INSERM Unit 981, Gustave Roussy, 94800 Villejuif, France; (I.V.-L.); (A.D.M.)
| | - Ines Vaz-Luis
- INSERM Unit 981, Gustave Roussy, 94800 Villejuif, France; (I.V.-L.); (A.D.M.)
| | - Antonio Di Meglio
- INSERM Unit 981, Gustave Roussy, 94800 Villejuif, France; (I.V.-L.); (A.D.M.)
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Miladi N, Dossa R, Dogba MJ, Cléophat-Jolicoeur MIF, Gagnon B. Psychostimulants for cancer-related cognitive impairment in adult cancer survivors: a systematic review and meta-analysis. Support Care Cancer 2019; 27:3717-3727. [PMID: 31250183 DOI: 10.1007/s00520-019-04907-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 05/31/2019] [Indexed: 01/10/2023]
Abstract
BACKGROUND Cognitive impairment is recognized as a common symptom experienced by cancer survivors which impacts on quality of life (QoL) and day-to-day activities. One of the treatment options is the use of psychostimulants but the evidence supporting its use remains unclear. OBJECTIVES To identify the level of evidence of psychostimulants' effect on the management of cognitive impairment in adult cancer survivors. METHODS Electronic databases (MEDLINE, EMBASE, CENTRAL, CINAHL) and reference lists of relevant reviews were searched from inception to December 2017, with no language restrictions applied. Randomized controlled trials (RCTs), evaluating the effect of psychostimulants on cognitive impairment among cancer patients with no primary or secondary brain tumor or brain radiation, were included. The primary outcome was cognitive function changes, whereas secondary outcomes were adverse events (AEs) and QoL. RESULTS Six RCTs were included: three studies investigating methylphenidate and three modafinil, with a total of 244 and 146 patients, respectively. Due to important differences in methodologies between studies, a meta-analysis was assumed inappropriate for the primary outcome. A narrative synthesis was performed. One study using methylphenidate and two using modafinil demonstrated improvements in some cognitive functions as measured by objective cognitive assessment tests. Psychostimulants did not improve QoL and were not associated with more AEs. CONCLUSION To date, limited evidence is available to estimate the usefulness (or lack) of psychostimulants on cognitive function in this population.
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Affiliation(s)
- Nadia Miladi
- Oncology Division, CHU de Québec-Laval University Research Center, Quebec City, QC, Canada
| | - Richi Dossa
- Oncology Division, CHU de Québec-Laval University Research Center, Quebec City, QC, Canada
| | - Maman Joyce Dogba
- Oncology Division, CHU de Québec-Laval University Research Center, Quebec City, QC, Canada
| | | | - Bruno Gagnon
- Oncology Division, CHU de Québec-Laval University Research Center, Quebec City, QC, Canada.
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Voiss P, Höxtermann MD, Dobos G, Cramer H. Cancer, sleep problems, and mind-body medicine use: Results of the 2017 National Health Interview Survey. Cancer 2019; 125:4490-4497. [PMID: 31524958 DOI: 10.1002/cncr.32469] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 06/07/2019] [Accepted: 07/18/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Sleep problems affect physical and emotional well-being as well as immune system function. Evidence has demonstrated an improvement in sleep problems in patients with cancer through the use of mind-body medicine (MBM). In the current study, the authors sought to elucidate the prevalence of sleep problems and the use of MBM in adult cancer survivors. METHODS The authors analyzed data from the 2017 US National Health Interview Survey (NHIS) to estimate the prevalence of sleep problems and use of MBM in adult cancer survivors using means, standard deviations, weighted frequencies, and distributions. Backward stepwise multiple logistic regression analyses were used to identify independent predictors of MBM use within the past 12 months: age, sex, ethnicity, region, educational level, employment, and time since cancer diagnosis. RESULTS A weighted total of 13,750,028 cancer survivors (59.2%) reported sleep problems. For the most part, survivors with sleep problems were aged ≥40 years, female, and non-Hispanic white. More survivors with (weighted N = 3,794,493; 27.6%) compared with without (weighted N = 1,695,435; 17.9%) sleep problems used MBM. Among cancer survivors with sleep problems, the most commonly used mind-body practice was spiritual meditation (weighted N = 1,972,578; 14.3%), followed by yoga (weighted N = 1,695,553; 17.9%). The use of MBM was independently predicted by being female, living in the western United States, having a higher educational level, and being employed. CONCLUSIONS The high prevalence of sleep problems in cancer survivors is a major health issue that needs to be addressed. A considerable number of cancer survivors with sleep problems use MBM. This finding warrants the investigation of MBM concepts as treatment options for cancer survivors experiencing sleep problems.
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Affiliation(s)
- Petra Voiss
- Department of Internal and Integrative Medicine, Essen-Mitte Clinic, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Melanie Désirée Höxtermann
- Department of Internal and Integrative Medicine, Essen-Mitte Clinic, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Gustav Dobos
- Department of Internal and Integrative Medicine, Essen-Mitte Clinic, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Holger Cramer
- Department of Internal and Integrative Medicine, Essen-Mitte Clinic, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
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