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Santos LDS, Rehder MHHDS, Negrao MV, Goes-Santos BR, Toshi Dias E, Paixão CJ, Urias U, Giannetti NS, Hajjar LA, Filho RK, Negrão CE. Aerobic exercise training combined with local strength exercise restores muscle blood flow and maximal aerobic capacity in long-term Hodgkin lymphoma survivors. Am J Physiol Heart Circ Physiol 2024; 326:H1462-H1468. [PMID: 38639741 DOI: 10.1152/ajpheart.00132.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 04/05/2024] [Accepted: 04/10/2024] [Indexed: 04/20/2024]
Abstract
It is unclear whether muscle blood flow (MBF) is altered in long-term Hodgkin lymphoma (HL) survivors. We tested the hypothesis that 1) MBF response during mental stress (MS) is impaired in long-term HL survivors and 2) aerobic exercise training combined with local strength exercise (ET) restores MBF responses during MS in these survivors. Eighteen 5-year HL survivors and 10 aged-paired healthy subjects (HC) were studied. Twenty HL survivors were randomly divided into two groups: exercise-trained (HLT, n = 10) and untrained (HLUT, n = 10). Maximal aerobic capacity was evaluated by a cardiopulmonary exercise test and forearm blood flow (FBF) by venous occlusion plethysmography. MS was elicited by Stroop color and word test. ET was conducted for 4 mo, 3/wk for 60 min each session. The aerobic exercise intensity corresponded to anaerobic threshold up to 10% below the respiratory compensation point. The strength exercises consisted of two to three sets of chest press, pulley and squat exercises, 12-15 repetitions each exercise at 30-50% of the maximal voluntary contraction. Baseline was similar in HL survivors and HC, except peak oxygen consumption (peak V̇o2, P = 0.013) and FBF (P = 0.006) that were lower in the HL survivors. FBF responses during MS were lower in HL survivors (P < 0.001). ET increased peak V̇o2 (11.59 ± 3.07%, P = 0.002) and FBF at rest (33.74 ± 5.13%, P < 0.001) and during MS (24 ± 5.31%, P = 0.001). Further analysis showed correlation between the changes in peak V̇o2 and the changes in FBF during MS (r = 0.711, P = 0.001). In conclusion, long-term HL survivors have impaired MBF responses during MS. ET restores MBF responses during MS.NEW & NOTEWORTHY Long-term Hodgkin lymphoma (HL) survivors have impaired muscle blood flow responses during mental stress and decreased maximal aerobic capacity. Supervised aerobic exercise training combined with local strength exercises restores muscle blood flow responses during mental stress and maximal aerobic capacity in these survivors. These findings provide evidence of safety and effectiveness of exercise training in HL survivors. Moreover, they highlight the importance of exercise training in the treatment of this set of patients.
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Affiliation(s)
- Luciana De Souza Santos
- Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Marília Harumi Higuchi Dos Santos Rehder
- Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
- Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Marcelo Vailati Negrao
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States
| | | | | | - Camila Jordão Paixão
- Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Ursula Urias
- Escola de Educação Física e Esporte, Universidade de São Paulo, São Paulo, Brazil
| | - Natali Schiavo Giannetti
- Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Ludhmila A Hajjar
- Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
- Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Roberto Kalil Filho
- Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Carlos E Negrão
- Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
- Escola de Educação Física e Esporte, Universidade de São Paulo, São Paulo, Brazil
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Bøhn S, Oldervoll LM, Reinertsen KV, Seland M, Fosså A, Kiserud C, Skaali T, Nilsen TS, Blomhoff R, Henriksen HB, Lie HC, Berge T, Fjerstad E, Wisløff T, Slott M, Zajmovic I, Thorsen L. The feasibility of a multidimensional intervention in lymphoma survivors with chronic fatigue. Support Care Cancer 2023; 32:22. [PMID: 38095797 PMCID: PMC10721709 DOI: 10.1007/s00520-023-08204-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 11/21/2023] [Indexed: 12/17/2023]
Abstract
PURPOSE Chronic fatigue (CF) affects 25-30% of lymphoma survivors, but interventions designed to reduce fatigue are lacking. The main aim of this study was to test the feasibility of a multidimensional intervention study in lymphoma survivors with CF. Secondary aims were to describe individual changes in fatigue, quality of life (QoL) and physical performance from pre (T0) to post (T1) intervention. METHODS This feasibility study was as a one-armed intervention study performed in 2021. Hodgkin or aggressive non-Hodgkin lymphoma survivors received mailed study information and Chalder Fatigue Questionnaire and were asked to respond if they suffered from fatigue. The 12-week intervention included patient education, physical exercise, a cognitive behavioural therapy (CBT)-based group program and nutritional counselling. Feasibility data included patient recruitment, completion of assessments, adherence to the intervention and patient-reported experience measures. Participants responded to questionnaires and underwent physical tests at T0 and T1. RESULTS Seven lymphoma survivors with CF were included. Of all assessments, 91% and 83% were completed at T0 and T1, respectively. Adherence to the interventional components varied from 69% to 91%. At T1, all participants rated exercise as useful, of whom five rated the CBT-based program and five rated individual nutritional counselling as useful. Five participants reported improved fatigue, QoL and physical performance. CONCLUSION Lymphoma survivors with CF participating in a multidimensional intervention designed to reduce the level of fatigue showed high assessment completion rate and intervention adherence rate. Most of the participants evaluated the program as useful and improved their level of fatigue, QoL and physical performance after the intervention. TRIAL REGISTRATION ClinicalTrials.gov, identifier: NCT04931407. Registered 16. April 2021-Retrospectively registered. https://www. CLINICALTRIALS gov/ct2/show/NCT04931407.
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Affiliation(s)
- Skh Bøhn
- National Advisory Unit for Late Effects After Cancer Treatment, Department of Oncology, Oslo University Hospital, Radiumhospitalet, Oslo, Norway.
| | - L M Oldervoll
- Centre for Crisis Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - K V Reinertsen
- National Advisory Unit for Late Effects After Cancer Treatment, Department of Oncology, Oslo University Hospital, Radiumhospitalet, Oslo, Norway
| | - M Seland
- Department of Clinical Service, The Cancer Rehabilitation Center, Aker, Oslo University Hospital, Oslo, Norway
| | - A Fosså
- National Advisory Unit for Late Effects After Cancer Treatment, Department of Oncology, Oslo University Hospital, Radiumhospitalet, Oslo, Norway
| | - C Kiserud
- National Advisory Unit for Late Effects After Cancer Treatment, Department of Oncology, Oslo University Hospital, Radiumhospitalet, Oslo, Norway
| | - T Skaali
- Department of Clinical Service, The Cancer Rehabilitation Center, Aker, Oslo University Hospital, Oslo, Norway
| | - T S Nilsen
- Institute of Physical Performance, Norwegian School of Sports Sciences, Oslo, Norway
| | - R Blomhoff
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Department of Clinical Service, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
| | - H B Henriksen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - H C Lie
- Department of Behavioural Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - T Berge
- Diakonhjemmet Hospital, Oslo, Norway
| | | | - T Wisløff
- Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
| | - M Slott
- Department of Clinical Service, The Cancer Rehabilitation Center, Aker, Oslo University Hospital, Oslo, Norway
| | - I Zajmovic
- Department of Clinical Service, The Cancer Rehabilitation Center, Aker, Oslo University Hospital, Oslo, Norway
| | - L Thorsen
- National Advisory Unit for Late Effects After Cancer Treatment, Department of Oncology, Oslo University Hospital, Radiumhospitalet, Oslo, Norway
- Department of Clinical Service, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
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Mian H, Ringash J, Meyer R, Hay AE, Shepherd L, Djurfeldt M, Winter JN, Sussman J, Pater J, Chen BE, Prica A. Health-related quality of life in early-stage Hodgkin lymphoma: a longitudinal analysis of the ABVD arm in the randomized controlled trial HD.6. Support Care Cancer 2023; 31:256. [PMID: 37043087 DOI: 10.1007/s00520-023-07717-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 03/29/2023] [Indexed: 04/13/2023]
Abstract
Early-stage Hodgkin lymphoma has become one of the most curable hematologic malignancies. Depending upon the disease location, possible toxicities, and patient preference, chemotherapy alone with ABVD remains an accepted treatment modality for this disease. There remains a paucity of data regarding the longitudinal trajectory of health-related quality of life (HRQoL) in patients treated for HL. The impact of disease and treatment on HRQoL is increasingly important to understand as the number of long-term survivors increases. We report the longitudinal HRQoL using data prospectively collected from diagnosis up to 10 years post-treatment in the ABVD arm of the HD.6 randomized controlled trial for early-stage HL patients (N=169). We analyzed HRQoL using the EORTC QLQ-C30 collected at baseline, 3 months, 6 months, and 12 months after completion of chemotherapy and yearly up to year 10. Clinically and statistically significant improvements were noted for specific domains including emotional (3 months post-treatment), social (12 months post-treatment) and financial functioning (2 years post-treatment), and the specific symptom of fatigue (6 months post-treatment) during the follow-up period. To our knowledge, this is the first prospective, longitudinal analysis of HRQoL specifically among patients with early-stage HL treated with ABVD therapy alone. Although improvements were noted, sustained clinically and statistically significant improvements were noted only in select symptoms emphasizing the need to better understand and optimize HRQoL among this patient group.
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Affiliation(s)
- Hira Mian
- Department of Oncology, McMaster University, 699 Concession St, Hamilton, ON, L8V 5C2, Canada.
| | - Jolie Ringash
- Cancer Clinical Research Unit (CCRU), Princess Margaret Cancer Centre/UHN, University of Toronto, Toronto, Canada
- Department of Radiation Oncology, University of Toronto, Toronto, Canada
| | - Ralph Meyer
- Department of Oncology, McMaster University, 699 Concession St, Hamilton, ON, L8V 5C2, Canada
| | - Annette E Hay
- Canadian Cancer Trials Group, Department of Medicine, Queen's University, Kingston, Canada
| | - Lois Shepherd
- Canadian Cancer Trials Group, Department of Pathology & Molecular Medicine, Queen's University, Kingston, Canada
| | - Marina Djurfeldt
- Canadian Cancer Trials Group, Queen's University, Kingston, Canada
| | - Jane N Winter
- Northwestern University, Feinberg School of Medicine, Illinois, USA
| | - Jonathan Sussman
- Department of Oncology, McMaster University, 699 Concession St, Hamilton, ON, L8V 5C2, Canada
| | - Joseph Pater
- Canadian Cancer Trials Group, Queen's University, Kingston, Canada
| | - Bingshu E Chen
- Canadian Cancer Trials Group, Department of Public Health Sciences and Department of Mathematics and Statistics, Queen's University, Kingston, Canada
| | - Anca Prica
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada
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Rapti C, Dinas PC, Chryssanthopoulos C, Mila A, Philippou A. Effects of Exercise and Physical Activity Levels on Childhood Cancer: An Umbrella Review. Healthcare (Basel) 2023; 11:healthcare11060820. [PMID: 36981477 PMCID: PMC10048410 DOI: 10.3390/healthcare11060820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 02/21/2023] [Accepted: 02/27/2023] [Indexed: 03/14/2023] Open
Abstract
Patients and survivors of childhood cancer experience adverse effects related to the disease and its treatment. These adverse effects are associated with both physiological and psychological health. Exercise helps manage the side effects and improve the health outcomes. The objective of this umbrella review is to search the current literature in the context of exercise and physical activity as complementary interventions on pediatric cancer and to provide comprehensive information about the derived health outcomes. A literature search was conducted on the Cochrane, PubMed, and Embase databases for systematic reviews published up to January 2023. Moreover, a hand search of reference lists was performed. We included participants under 19 years of age at diagnosis of any type of childhood cancer, without restriction on the type or phase of treatment, who participated in exercise interventions. The results showed a beneficial impact on fatigue, muscle strength, aerobic capacity, activity and participation levels, psychosocial health, cardiovascular/cardiorespiratory fitness, physical function, bone mineral density, and brain volume and structure, with limited and not serious adverse effects. These findings documented that exercise interventions had a positive effect on many physiological and psychological health outcomes in pediatric cancer patients and survivors.
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Affiliation(s)
- Christina Rapti
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Petros C. Dinas
- FAME Laboratory, Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece
| | - Costas Chryssanthopoulos
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Alexandra Mila
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Anastassios Philippou
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Correspondence:
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Flack KD, Stults-Kolehmainen MA, Creasy SA, Khullar S, Boullosa D, Catenacci VA, King N. Altered motivation states for physical activity and 'appetite' for movement as compensatory mechanisms limiting the efficacy of exercise training for weight loss. Front Psychol 2023; 14:1098394. [PMID: 37187558 PMCID: PMC10176969 DOI: 10.3389/fpsyg.2023.1098394] [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: 11/14/2022] [Accepted: 03/23/2023] [Indexed: 05/17/2023] Open
Abstract
Weight loss is a major motive for engaging in exercise, despite substantial evidence that exercise training results in compensatory responses that inhibit significant weight loss. According to the Laws of Thermodynamics and the CICO (Calories in, Calories out) model, increased exercise-induced energy expenditure (EE), in the absence of any compensatory increase in energy intake, should result in an energy deficit leading to reductions of body mass. However, the expected negative energy balance is met with both volitional and non-volitional (metabolic and behavioral) compensatory responses. A commonly reported compensatory response to exercise is increased food intake (i.e., Calories in) due to increased hunger, increased desire for certain foods, and/or changes in health beliefs. On the other side of the CICO model, exercise training can instigate compensatory reductions in EE that resist the maintenance of an energy deficit. This may be due to decreases in non-exercise activity thermogenesis (NEAT), increases in sedentary behavior, or alterations in sleep. Related to this EE compensation, the motivational states associated with the desire to be active tend to be overlooked when considering compensatory changes in non-exercise activity. For example, exercise-induced alterations in the wanting of physical activity could be a mechanism promoting compensatory reductions in EE. Thus, one's desires, urges or cravings for movement-also known as "motivation states" or "appetence for activity"-are thought to be proximal instigators of movement. Motivation states for activity may be influenced by genetic, metabolic, and psychological drives for activity (and inactivity), and such states are susceptible to fatigue-or reward-induced responses, which may account for reductions in NEAT in response to exercise training. Further, although the current data are limited, recent investigations have demonstrated that motivation states for physical activity are dampened by exercise and increase after periods of sedentarism. Collectively, this evidence points to additional compensatory mechanisms, associated with motivational states, by which impositions in exercise-induced changes in energy balance may be met with resistance, thus resulting in attenuated weight loss.
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Affiliation(s)
- Kyle D. Flack
- Department of Dietetics and Human Nutrition, University of Kentucky, Lexington, KY, United States
| | - Matthew A. Stults-Kolehmainen
- Division of Digestive Health, Yale New Haven Hospital, New Haven, CT, United States
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, United States
- *Correspondence: Matthew A. Stults-Kolehmainen,
| | - Seth A. Creasy
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
- Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Saumya Khullar
- School of Applied Sciences, Edinburgh Napier University, Edinburgh, United Kingdom
| | - Daniel Boullosa
- Faculty of Physical Activity and Sports Sciences, Universidad de León, León, Spain
- College of Healthcare Sciences, James Cook University, Townsville, QLD, Australia
- Graduate Program in Movement Sciences, Integrated Institute of Health, Federal University of Mato Grosso do Sul, Campo Grande, Brazil
| | - Victoria A. Catenacci
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
- Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Neil King
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
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Campanini I, Ligabue MB, Bò MC, Bassi MC, Lusuardi M, Merlo A. Self-managed physical activity in cancer survivors for the management of cancer-related fatigue: A scoping review. PLoS One 2022; 17:e0279375. [PMID: 36542639 PMCID: PMC9770433 DOI: 10.1371/journal.pone.0279375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 12/06/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE Cancer-related fatigue (CRF) is a disabling chronic condition that cancer survivors could experience during and after recovery and that might benefit from self-managed physical activity (PA) programs. This scoping review aimed to map self-managed PA interventions found in literature for the management of CRF. METHODS Given the heterogeneity of the topic, scoping review methodological frameworks were used. Pubmed, Cinahl and Cochrane databases were searched for primary literature. Inclusion criteria: self-managed PA meant as any exercise program prescribed by a professional either with or without initial supervision and training which then continued independently for a given time frame; patient-reported fatigue assessment included in the outcome measures. Articles dealing with entirely supervised interventions, dietary or psychological-only therapies, and with palliative care were excluded. RESULTS Of the 543 experimental or observational studies screened, 63 were included. Of these forty-three studies were randomized controlled trials. Data were summarized in tables describing self-managed interventions according to: type of self-managed activity, frequency and duration, strategies to promote adherence, professionals supervising the treatment, outcome measures, and efficacy. A narrative synthesis was also added to further explain findings. CONCLUSIONS We collected the available evidence on PA when this was self-managed by patients after prescription by a healthcare provider. Clinicians and researchers should consider incorporating self-care programs in CRF patients' recovery journey gradually, identifying the best strategies to integrate them into daily life. Researchers should specify the characteristics of PA programs when designing new studies. This review highlighted the areas to be investigated for future studies pertaining to self-managed PA.
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Affiliation(s)
- Isabella Campanini
- LAM - Motion Analysis Laboratory, Neuromotor and Rehabilitation Department, San Sebastiano Hospital, Azienda USL-IRCCS di Reggio Emilia, Correggio, Reggio Emilia, Italy
| | - Maria Bernadette Ligabue
- Motor Rehabilitation Unit, Neuromotor and Rehabilitation Department, San Sebastiano Hospital, Azienda USL-IRCCS di Reggio Emilia, Correggio, Reggio Emilia, Italy
| | | | - Maria Chiara Bassi
- Medical Library, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Mirco Lusuardi
- Neuromotor and Rehabilitation Department, Azienda USL-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Andrea Merlo
- LAM - Motion Analysis Laboratory, Neuromotor and Rehabilitation Department, San Sebastiano Hospital, Azienda USL-IRCCS di Reggio Emilia, Correggio, Reggio Emilia, Italy
- Merlo Bioengineering, Parma, Italy
- * E-mail:
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Liu D, Han S, Zhou C. The Influence of Physical Exercise Frequency and Intensity on Individual Entrepreneurial Behavior: Evidence from China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12383. [PMID: 36231684 PMCID: PMC9564728 DOI: 10.3390/ijerph191912383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 09/21/2022] [Accepted: 09/24/2022] [Indexed: 06/16/2023]
Abstract
Physical exercise can benefit individuals' physical and mental health and also influence individuals' long-term behavioral choices. Doing exercise is particularly important given that physical exercise can impact individuals' cognitive abilities and positive emotional states, which may further impact entrepreneurial behavior. Therefore, understanding the relationship between exercise and entrepreneurial behavior is essential, because it can provide policy suggestions for popularizing athletic activities and boosting entrepreneurship. Consequently, the present study examined whether physical exercise could predict entrepreneurial behavior and the possible psychological mechanisms within this relationship. Based on the 2017 Chinese General Social Survey (CGSS2017), this study tested the hypotheses using the Probit and Tobit models. The results showed that individuals' physical exercise intensity and frequency positively affected their entrepreneurial behavior. In addition, five variables moderated the relationships between physical exercise and individual entrepreneurial behavior: urban-rural differences, education level, marital status, the existence of minor children, and age. Moreover, positive emotions and physical/mental health mediated the influence of physical exercise (exercise frequency and exercise intensity) on individual entrepreneurial behavior. Endogeneity explanations were ruled out by including instrumental variable, copula terms and adopting coarsened exact matching.
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Affiliation(s)
- Dewen Liu
- School of Management, Nanjing University of Posts and Telecommunications, Nanjing 210003, China
| | - Shenghao Han
- College of Business, Shanghai University of Finance and Economics, Shanghai 200433, China
| | - Chunyang Zhou
- College of Business, Shanghai University of Finance and Economics, Shanghai 200433, China
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Abstract
PURPOSE OF REVIEW With an increasing number of long-term lymphoma survivors, there has been emphasis on optimizing quality of life and identifying survivorship challenges. This review summarizes the latest advancements pertaining to health-related quality of life and survivorship in lymphoma. RECENT FINDINGS Quality of life can vary from diagnosis through survivorship though some physical, social, and emotional effects may be persistent. Incorporation of patient reported outcomes enables recognition of factors that significantly impact quality of life. A greater understanding of quality of life and survivorship issues has generated momentum for practice change, improving education, and designing behavior related interventions. Patients with lymphoma face many challenges as they navigate their cancer experience. There is a tremendous opportunity to build upon this work through well-designed prospective longitudinal studies aimed at identifying vulnerable patient groups and impactful points of intervention during survivorship.
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Franceschetti S, Annunziata MA, Agostinelli G, Gerardi C, Allocati E, Minoia C, Guarini A. Late Neurological and Cognitive Sequelae and Long-Term Monitoring of Classical Hodgkin Lymphoma and Diffuse Large B-Cell Lymphoma Survivors: A Systematic Review by the Fondazione Italiana Linfomi. Cancers (Basel) 2021; 13:cancers13143401. [PMID: 34298616 PMCID: PMC8307605 DOI: 10.3390/cancers13143401] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/21/2021] [Accepted: 06/29/2021] [Indexed: 01/07/2023] Open
Abstract
Simple Summary The last 25 years have seen a significant increase in the number of lymphoma survivors. This review was carried out to examine the data currently available on the incidence of some of the consequences most reported by this population: peripheral neuropathy, cognitive impairment, fatigue, and anxiety and depression. This review also investigated any follow-up strategies or monitoring implemented. The 35 articles included in the final analysis provided an idea of what the incidence of these sequelae may be in long-term survivors of classical Hodgkin lymphoma and diffuse large B-cell lymphoma. Despite methodological limitations encountered in the literature search, the Authors attempted to summarize the available evidence and provide support to clinical practice. This systematic review represents the basis for designing future studies with a longitudinal trial design and examining more homogeneous populations to assess and monitor these dimensions over time in clinical practice and to respond promptly to the needs of lymphoma survivors. Abstract Background: The continuously improving treatment outcome for classical Hodgkin lymphoma (cHL) and diffuse large B-cell lymphoma (DLBCL) over the last 25 years has led to a high number of long-term survivors. The impact of treatment, however, can sometimes be dramatic and long-lasting. Focusing on peripheral neuropathy (PN), cognitive impairment, fatigue, anxiety, and depression, researchers of the Fondazione Italiana Linfomi conducted a systematic review of the literature to collect the available data on sequelae incidence as well as evidence of follow-up strategies for long-term cHL and DLBCL survivors. Methods: The review was carried out under the methodological supervision of the Istituto di Ricerche Farmacologiche “Mario Negri”, Milan, Italy. The literature search was conducted on three databases (MEDLINE, Embase, and the Cochrane Library) updated to November 2019. The selection process and data extraction were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: A total of 2236 abstracts were screened, 247 full texts were analyzed, and 35 papers were included in the final analysis. Fatigue was the most extensively studied among neuropsychological sequelae, with a mean prevalence among cHL survivors of 10–43%. Although many of the papers showed an increased incidence of PN, cognitive impairment, and anxiety and depression in long-term cHL and DLBCL survivors, no definite conclusions can be drawn because of the methodological limitations of the analyzed studies. No data on monitoring and follow-up strategies of PN and other neuropsychological sequelae were highlighted. Conclusions: Based on our findings, future studies in this setting should include well-defined study populations and have a longitudinal trial design to assess the outcomes of interest over time, thus as to structure follow-up programs that can be translated into daily practice.
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Affiliation(s)
- Silvia Franceschetti
- Haematology Unit, Ospedale Civile di Legnano, ASST Ovest Milanese, 20025 Legnano, Italy
- Correspondence:
| | - Maria Antonietta Annunziata
- Oncological Psychology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy; (M.A.A.); (G.A.)
| | - Giulia Agostinelli
- Oncological Psychology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy; (M.A.A.); (G.A.)
| | - Chiara Gerardi
- Istituto di Ricerche Farmacologiche “Mario Negri” IRCCS, 20156 Milano, Italy; (C.G.); (E.A.)
| | - Eleonora Allocati
- Istituto di Ricerche Farmacologiche “Mario Negri” IRCCS, 20156 Milano, Italy; (C.G.); (E.A.)
| | - Carla Minoia
- Hematology Unit, IRCCS Istituto Tumori “Giovanni Paolo II”, 70124 Bari, Italy; (C.M.); (A.G.)
| | - Attilio Guarini
- Hematology Unit, IRCCS Istituto Tumori “Giovanni Paolo II”, 70124 Bari, Italy; (C.M.); (A.G.)
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Minoia C, Gerardi C, Allocati E, Daniele A, De Sanctis V, Bari A, Guarini A. The Impact of Healthy Lifestyles on Late Sequelae in Classical Hodgkin Lymphoma and Diffuse Large B-Cell Lymphoma Survivors. A Systematic Review by the Fondazione Italiana Linfomi. Cancers (Basel) 2021; 13:cancers13133135. [PMID: 34201563 PMCID: PMC8268176 DOI: 10.3390/cancers13133135] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 06/09/2021] [Accepted: 06/20/2021] [Indexed: 01/08/2023] Open
Abstract
Simple Summary With the presented study, Fondazione Italiana Linfomi (FIL) researchers want to fill a gap in the literature regarding long-lived lymphoma patients (beyond 5 years after diagnosis). These patients can develop a series of late sequelae that affect their quality of life and overall survival, especially cardiotoxicity and secondary malignancies. In this context, although part of the risk is closely related to the chemotherapy and radiotherapy, some risk factors can be modified through tertiary prevention. There are currently no specific indications for tertiary prevention in the subset of long-term lymphoma survivors. This systematic review conducted by the FIL researchers is aimed at understanding whether there is evidence that correcting unhealthy lifestyles can reduce the onset of late sequelae. Abstract Background: In recent years, the scientific community has been paying ever more attention to the promotion of lifestyles aimed at the prevention of late toxicities related to anti-cancer treatments. Methods: Fondazione Italiana Linfomi (FIL) researchers conducted a systematic review in order to evaluate the evidence in favor of the promotion of lifestyles aimed at the prevention of the main sequelae of long-term classical Hodgkin lymphoma (cHL) and diffuse large B-cell lymphoma (DLBCL) in survivors treated at adulthood with first-line or second-line therapy, including autologous stem cell transplants (ASCTs). Pubmed, Embase and Cochrane Library were searched up to December 2020. Results: Seven studies were ultimately included in this systematic review; some of them were eligible for multiple PICOS. The majority of the studies emerged from data extraction regarding cHL; less evidence resulted for DLBCL survivors. Five studies in favor of physical activity provided consistent data for a reduction of the cardiovascular risk in cHL and also in survivors who underwent ASCT. A beneficial effect of physical activity in reducing chronic fatigue was found. Being overweight was associated with a higher risk of coronary heart disease in cHL survivors in one of the two eligible studies. Studies aiming to evaluate the impact of the Mediterranean diet on late toxicities and secondary cancers were lacking. Tailored survivorship care plans (SCP) seemed to represent an optimal tool to guide the follow-up and promote healthier lifestyles in the one eligible study. Thus, promotion of healthy lifestyles and empowering of lymphoma survivors should be implemented through structured models. The study also brought to light numerous areas of future clinical research.
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Affiliation(s)
- Carla Minoia
- Hematology Unit, IRCCS Istituto Tumori “Giovanni Paolo II”, 70124 Bari, Italy;
- Correspondence:
| | - Chiara Gerardi
- Istituto di Ricerche Farmacologiche “Mario Negri” IRCCS, 20156 Milano, Italy; (C.G.); (E.A.)
| | - Eleonora Allocati
- Istituto di Ricerche Farmacologiche “Mario Negri” IRCCS, 20156 Milano, Italy; (C.G.); (E.A.)
| | - Antonella Daniele
- Experimental Oncology and Biobank Management Unit, IRCCS Istituto Tumori “Giovanni Paolo II”, 70124 Bari, Italy;
| | - Vitaliana De Sanctis
- Department of Medicine and Surgery and Translational Medicine, “Sapienza” University of Rome, Radio-Therapy Oncology, Sant′ Andrea Hospital, 00189 Rome, Italy;
| | - Alessia Bari
- Dipartimento di Scienze Mediche e Chirurgiche Materno-Infantili e dell’Adulto, Università di Modena e Reggio Emilia, 41124 Modena, Italy;
| | - Attilio Guarini
- Hematology Unit, IRCCS Istituto Tumori “Giovanni Paolo II”, 70124 Bari, Italy;
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Sica A, Sagnelli C, Papa A, Ciccozzi M, Sagnelli E, Calogero A, Martinelli E, Casale B. An Anecdotal Case Report of Chronic Lymphatic Leukemia with del(11q) Treated with Ibrutinib: Artificial Nourishment and Physical Activity Program. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E1929. [PMID: 32188040 PMCID: PMC7142487 DOI: 10.3390/ijerph17061929] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 03/12/2020] [Accepted: 03/13/2020] [Indexed: 12/14/2022]
Abstract
Chronic lymphatic leukemia (CLL) is the most frequent type of leukemia in western countries and when association with del(11q) is correlated with a worse prognosis. We reported the clinical case of an 80-year-old patient with CLL related to del(11q) and a BMI of 16.4 kg/m2, who presented a voluminous mass in abdominal cavity (23 × 14 × 4 cm) which occupied the whole of the mesentery and the retroperitoneal space, treated with ibrutinib, adequate nutrition, and a program of physical activity. He showed a great improvement under ibrutinib therapy and took to artificial nourishment and adequate muscle rehabilitation until he recovered his autonomy. In August 2018, a 5-days-a-week training program was started: Physical activity for at least 20 min consisting of a fast walk in the open air three times a week and a moderate physical activity in the remaining two days of at least 20 consecutive minutes (cycling at a regular pace, carrying light weights). The exercise program included also aerobic, upper and lower limb resistance training, chore stability and stretches. The physical condition further improved and remained excellent throughout the follow-up period. In December 2018, his clinical condition was quite normal; a CT showed a great decrease of all lymphoadenomegaly, and FISH test did not show del(11q). He continued to cultivate his land, while still being treated with ibrutinib. The combination of the right therapy, adequate nutrition, and muscle rehabilitation is the best solution to improve the clinical condition of old cachectic CLL del(11q) patient.
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Affiliation(s)
- Antonello Sica
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, 80131 Naples, Italy;
| | - Caterina Sagnelli
- Department of Mental Health and Public Medicine, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (C.S.); (E.S.)
| | - Alfonso Papa
- Pain Department, AORN Dei Colli V. Monaldi, 80131 Naples, Italy;
| | - Massimo Ciccozzi
- Medical Statistics and Molecular Epidemiology, Campus Bio-Medico University, 00100 Rome, Italy;
| | - Evangelista Sagnelli
- Department of Mental Health and Public Medicine, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (C.S.); (E.S.)
| | - Armando Calogero
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy;
| | - Erika Martinelli
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, 80131 Naples, Italy;
| | - Beniamino Casale
- Department of Pneumology and Tisiology, AORN Dei Colli - V. Monaldi, 80131 Naples, Italy;
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Alvarez-Pitti J, Casajús Mallén JA, Leis Trabazo R, Lucía A, López de Lara D, Moreno Aznar LA, Rodríguez Martínez G. [Exercise as medicine in chronic diseases during childhood and adolescence]. An Pediatr (Barc) 2020; 92:173.e1-173.e8. [PMID: 32061527 DOI: 10.1016/j.anpedi.2020.01.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 01/14/2020] [Accepted: 01/15/2020] [Indexed: 12/30/2022] Open
Abstract
Physical activity (PA) and exercise improve the overall quality of life, as well as prevent the onset of diseases in healthy children and adolescents, and as an aid to treat prevalent chronic diseases in childhood. PA and exercise are like medicine, but sedentary lifestyle and inactivity cause disease. In this article, the existing scientific evidence in this field is reviewed and recommendations for professionals involved in child health are updated. A good knowledge of how to prescribe exercise and PA in paediatrics in different diseases is necessary. Interventions to avoid inactivity of children and adolescents must be supported by the appropriate increase in the level of PA, through integration and training programs, which achieve both an overall improvement of the neuromuscular physical condition and also physical, cognitive, and psychosocial performance. The Health Promotion Committee of Spanish Paediatric Association proposes strategies that help to obtain this objective, aiming to improve the health of our patients through the practice of exercise and the increase in PA.
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Affiliation(s)
- Julio Alvarez-Pitti
- Unidad contra la Obesidad y el Riesgo Cardiovascular, Servicio de Pediatría, Consorcio Hospital General Universitario de Valencia, Valencia, España; Comité de Promoción de la Salud, Asociación Española de Pediatría, Madrid, España; CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, España.
| | - José A Casajús Mallén
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, España; Grupo GENUD (Growth, Exercise, Nutrition and Development), Universidad de Zaragoza, Zaragoza, España; Departamento de Fisiatría y Enfermería, Área de Educación Física y Deportiva, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, España
| | - Rosaura Leis Trabazo
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, España; Unidad de Gastroenterología, Hepatología y Nutrición Pediátrica, Departamento de Pediatría, Hospital Clínico Universitario de Santiago, Universidad de Santiago de Compostela, Santiago de Compostela, España; Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, A Coruña, España
| | - Alejandro Lucía
- Laboratorio de Fisiología del Ejercicio, Universidad Europea de Madrid. Facultad de Ciencias de la Salud
| | | | - Luis A Moreno Aznar
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, España; Grupo GENUD (Growth, Exercise, Nutrition and Development), Universidad de Zaragoza, Zaragoza, España; Instituto Agroalimentario de Aragón (IA2), Zaragoza, España; Instituto de Investigación Sanitaria Aragón (IIS Aragón, Zaragoza), Zaragoza, España
| | - Gerardo Rodríguez Martínez
- Comité de Promoción de la Salud, Asociación Española de Pediatría, Madrid, España; Grupo GENUD (Growth, Exercise, Nutrition and Development), Universidad de Zaragoza, Zaragoza, España; Instituto de Investigación Sanitaria Aragón (IIS Aragón, Zaragoza), Zaragoza, España; Red Salud Materno Infantil y del Desarrollo (SAMID, RETICS ISCIII, España), Baracaldo, Vizcaya, España
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Sica A, Vitiello P, Ronchi A, Casale B, Calogero A, Sagnelli E, Costa Nachtigal G, Troiani T, Franco R, Argenziano G, Moscarella E, Sagnelli C. Primary Cutaneous Anaplastic Large Cell Lymphoma (pcALCL) in the Elderly and the Importance of Sport Activity Training. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17030839. [PMID: 32013101 PMCID: PMC7037068 DOI: 10.3390/ijerph17030839] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Revised: 01/16/2020] [Accepted: 01/22/2020] [Indexed: 12/22/2022]
Abstract
Primary cutaneous anaplastic large cell lymphoma (pcALCL) is part of a spectrum of cutaneous CD30+ lymphoproliferative disease that also includes lymphomatoid papulosis. It often occurs in elderly patients, presenting at a median age of 60 years, although it may occur at any age. It is a CD30+ T-cell neoplasm composed of large cells with anaplastic, pleomorphic, or immunoblastic morphology, with exclusively cutaneous onset and localization. The clinical course of pcALCL is predominantly indolent. Most elderly patients with lymphoma tend to have a sedentary lifestyle, which has a negative effect on their quality of life (QoL) and survival. Several studies indicate that exercise has a positive impact on QoL because it reduces peak oxygen consumption, improves physical capacity, increases self-esteem, reduces accumulated stress, and promotes relaxation. Therefore, particularly in indolent lymphomas, it is necessary to indicate a program of physical activity to be practiced systematically. Complete surgical excision and local radiotherapy are the first line gold standard in pcALCL with a solitary lesion.
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Affiliation(s)
- Antonello Sica
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, 80131 Naples, Italy;
- Correspondence: ; Tel.: +39-333-225-3315; +39-0811-957-3375
| | - Paola Vitiello
- Dermatology Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (P.V.); (G.A.); (E.M.)
| | - Andrea Ronchi
- Department of Mental Health and Preventive, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (A.R.); (E.S.); (R.F.); (C.S.)
| | - Beniamino Casale
- Department of Pneumology and Tisiology, AO Dei Colli—V. Monaldi, 80130 Naples, Italy;
| | - Armando Calogero
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy;
| | - Evangelista Sagnelli
- Department of Mental Health and Preventive, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (A.R.); (E.S.); (R.F.); (C.S.)
| | - Gilca Costa Nachtigal
- Department of Clinical Medicine, Faculty of Medicine at UFPel—Federal University of Pelotas, 1160 Centro, Pelotas, Brazil;
| | - Teresa Troiani
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, 80131 Naples, Italy;
| | - Renato Franco
- Department of Mental Health and Preventive, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (A.R.); (E.S.); (R.F.); (C.S.)
| | - Giuseppe Argenziano
- Dermatology Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (P.V.); (G.A.); (E.M.)
| | - Elvira Moscarella
- Dermatology Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (P.V.); (G.A.); (E.M.)
| | - Caterina Sagnelli
- Department of Mental Health and Preventive, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (A.R.); (E.S.); (R.F.); (C.S.)
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Fischetti F, Greco G, Cataldi S, Minoia C, Loseto G, Guarini A. Effects of Physical Exercise Intervention on Psychological and Physical Fitness in Lymphoma Patients. MEDICINA (KAUNAS, LITHUANIA) 2019; 55:medicina55070379. [PMID: 31315290 PMCID: PMC6681308 DOI: 10.3390/medicina55070379] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 07/12/2019] [Accepted: 07/12/2019] [Indexed: 02/05/2023]
Abstract
Background and objectives: Lymphoma patients experience a psychological and physiological decline that could be reversed by exercise. However, little is known about the effects of the exercise on psychological and physical fitness variables. Therefore, the purpose of this longitudinal study was to assess self-efficacy, fatigue and physical fitness before and after an eight-week exercise intervention. Materials and Methods: Thirty-six participants (54.4 ± 19.1 years) performed a supervised exercise program (~60 min, 2d·wk-1). Each session included a combined progressive training of cardiorespiratory, resistance, flexibility and postural education exercises. Self-efficacy and fatigue were measured with the Regulatory Emotional Self-Efficacy scale and 0-10 rating scale, respectively. Physical fitness was assessed with the body mass index, lower back flexibility, static balance, muscle strength and functional mobility. Results: Adherence to exercise was high (91.2% ± 4.8%) and no major health problems were noted in the patients over the intervention period. At baseline, significant differences were found between Hodgkin's lymphoma and non-Hodgkin's lymphoma patients by age and all dependent measures (p < 0.05). Fatigue significantly decreased and the perceived capability to regulate negative affect and to express positive emotions improved after exercise (p < 0.001). Significant improvements were found for body mass index, trunk lateral flexibility, monopodalic balance, isometric handgrip force and functional mobility (p < 0.001). Fatigue was significantly correlated with handgrip force (r = -0.56, p < 0.001) and functional mobility (r = -0.69, p < 0.001). Conclusions: The supervised exercise program improved psychological and physical fitness without causing adverse effects and health problems. Therefore, exercise to improve fitness levels and reduce perceived fatigue should be considered in the management of lymphoma patients.
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Affiliation(s)
- Francesco Fischetti
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, School of Medicine, University of Study of Bari, 70124 Bari, Italy.
| | - Gianpiero Greco
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, School of Medicine, University of Study of Bari, 70124 Bari, Italy
| | - Stefania Cataldi
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, School of Medicine, University of Study of Bari, 70124 Bari, Italy
| | - Carla Minoia
- Haematology Unit, IRCCS Cancer Institute "Giovanni Paolo II", 70124 Bari, Italy
| | - Giacomo Loseto
- Haematology Unit, IRCCS Cancer Institute "Giovanni Paolo II", 70124 Bari, Italy
| | - Attilio Guarini
- Haematology Unit, IRCCS Cancer Institute "Giovanni Paolo II", 70124 Bari, Italy
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16
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Liu L, He X, Feng L. Exercise on quality of life and cancer-related fatigue for lymphoma survivors: a systematic review and meta-analysis. Support Care Cancer 2019; 27:4069-4082. [PMID: 31300873 DOI: 10.1007/s00520-019-04983-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 07/04/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND People treated for lymphoma can experience several significant long-term and late effects, including fatigue and decreased quality of life. This study aimed to systematically review the evidence from randomized controlled trials (RCTs) and to conduct a meta-analysis of the effect of exercise on quality of life and other health outcomes for adults suffering from lymphoma. METHODS We searched the following databases and sources: PubMed, Cochrane Library, Embase, Web of Science, and MEDLINE. Such studies would be included if they were RCT designs which focus on observing the evaluated health outcomes of exercise intervention for lymphoma patients or survivors, comparing with non-exercise or wait-list control groups. Two review authors independently screened search results, extracted data, and assessed the quality of trials. We used standardized mean differences for quality of life (QoL), fatigue, sleep quality, and depression. RESULTS Six publications have met the inclusion criteria and the exercise interventions are short term. Slight improvement can be seen on QoL, fatigue, sleep quality, and depression due to exercise for lymphoma patients. Subgroup analysis was carried out according to the classification of mind-body exercise and aerobic exercise, and significant progress can be seen after mind-body exercise intervention in the area of fatigue and sleep. CONCLUSIONS Short-term exercises do not appear to convey benefits to quality of life and other psychosocial outcomes. Subgroup analysis showed that physical activity together with mental exercise may be more beneficial to lymphoma patients, but it needs more research to verify this finding. The interpretation of this result should be cautious due to the baseline difference, completion efficiency of intervention process, and high heterogeneity.
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Affiliation(s)
- Lixing Liu
- Department of Chinese Medicine, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Xiran He
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Li Feng
- Department of Chinese Medicine, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
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17
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Busson R, van der Kaaij M, Mounier N, Aleman BMP, Thiéblemont C, Stamatoullas A, Ribrag V, Tilly H, Haioun C, Casasnovas RO, Kluin-Nelemans HC, Henry-Amar M. Fatigue level changes with time in long-term Hodgkin and non-Hodgkin lymphoma survivors: a joint EORTC-LYSA cross-sectional study. Health Qual Life Outcomes 2019; 17:115. [PMID: 31266501 PMCID: PMC6604328 DOI: 10.1186/s12955-019-1186-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 06/23/2019] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Long-term lymphoma survivors often complain of persistent fatigue that remains unexplained. While largely reported in Hodgkin lymphoma (HL), long-term fatigue is poorly documented in non-Hodgkin lymphomas (NHL). Data collected in two cohort studies were used to illustrate the fatigue level changes with time in the two populations. METHODS Two cross-sectional studies were conducted in 2009-2010 (HL) and in 2015 (NHL) in survivors enrolled in European Organisation for Research and Treatment of Cancer (EORTC) Lymphoma Group and Lymphoma Study Association (LYSA) trials. The same protocol and questionnaires were used in both studies including the Multidimensional Fatigue Inventory (MFI) tool to assess fatigue and a checklist of health disorders. Multivariate linear regression models were used in the two populations separately to assess the influence of time since diagnosis and primary treatment, age, gender, education level, cohabitation status, obesity and health disorders on fatigue level changes. Fatigue level changes were compared to general population data. RESULTS Overall, data of 2023 HL and 1619 NHL survivors with fatigue assessment available (99 and 97% of cases, respectively) were analyzed. Crude levels of fatigue were similar in the two populations. Individuals who reported health disorders (61% of HL and 64% of NHL) displayed higher levels of fatigue than those who did not (P < 0.001). HL survivors showed increasing fatigue level with age while in NHL survivors mean fatigue level remained constant until age 70 and increased beyond. HL survivors showed fatigue changes with age higher than those of the general population with health disorders while NHL survivors were in between those of the general population with and without health disorders. CONCLUSIONS Among lymphoma survivors progressive increase of fatigue level with time since treatment completion is a distinctive feature of HL. Our data suggest that changes in fatigue level are unlikely to only depend on treatment complications and health disorders. Investigations should be undertaken to identify which factors including biologic mechanisms could explain why a substantial proportion of survivors develop high level of fatigue.
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Affiliation(s)
- Raphaël Busson
- École Doctorale MIIS, University of Caen-Normandie, 14032, Caen, France
- Centre de Traitement des Données du Cancéropôle Nord-Ouest, Plateforme de Recherche Clinique Ligue Contre le Cancer, Centre François Baclesse, 3 Avenue Général Harris, 14076, Caen, Cedex 5, France
| | - Marleen van der Kaaij
- Department of Internal Medicine, Leiden University Medical Centre, Albinusdreef 2, 2333, ZA, Leiden, the Netherlands
| | - Nicolas Mounier
- Service d'Onco-hématologie, Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Hôpital l'Archet 2, 151 Route Saint-Antoine de Ginestière, BP 3079, 06202, Nice, Cedex 3, France
| | - Berthe M P Aleman
- Department of Radiotherapy, The Netherlands Cancer Institute, Plesmanlaan 121, 1066, CX, Amsterdam, the Netherlands
| | - Catherine Thiéblemont
- Service d'Hématologie, AP-HP CHU Saint-Louis, 1 Avenue Claude Vellefaux, 75010, Paris, France
| | - Aspasia Stamatoullas
- Service d'Hématologie, Centre Henri Becquerel, Rue d'Amiens, 76000, Rouen, France
| | - Vincent Ribrag
- Service d'Hématologie, Gustave Roussy Cancer Campus, 114 Rue Edouard Vaillant, 94805, Villejuif, Cedex, France
| | - Hervé Tilly
- Service d'Hématologie, Centre Henri Becquerel, Rue d'Amiens, 76000, Rouen, France
| | - Corinne Haioun
- Service d'Hématologie, AP-HP CHU Henri Mondor, 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France
| | - René-Olivier Casasnovas
- Service d'Hématologie, CHRU de Dijon Bourgogne, Hôpital Le Bocage, 2 Boulevard Maréchal de Lattre of Tassigny, 21000, Dijon, France
| | - Hanneke C Kluin-Nelemans
- Department of Haematology, University Medical Centre Groningen, University of Groningen, PO Box 30.001, 9700, RB, Groningen, the Netherlands
| | - Michel Henry-Amar
- Centre de Traitement des Données du Cancéropôle Nord-Ouest, Plateforme de Recherche Clinique Ligue Contre le Cancer, Centre François Baclesse, 3 Avenue Général Harris, 14076, Caen, Cedex 5, France.
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18
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Mizrahi D, Fardell JE, Wakefield CE, Simar D, Maguire AM, Hubbard G, Cohn RJ. How physically active do Australian and New Zealander childhood cancer survivors perceive themselves? A report from the ANZCHOG survivorship study. Complement Ther Med 2019; 44:196-203. [PMID: 31126556 DOI: 10.1016/j.ctim.2019.04.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 04/24/2019] [Accepted: 04/24/2019] [Indexed: 10/26/2022] Open
Abstract
PURPOSE Childhood cancer survivors are at risk of treatment late-effects. Physical activity represents a necessary complementary therapy and modifiable risk-factor across all ages for many cardio-metabolic late-effects. This study assessed perceived physical activity in Australian and New Zealander childhood cancer survivors. METHODS We recruited parents of survivors aged <16 years, and adult survivors of childhood cancer aged ≥16 years, ≥5 years since diagnosis, with age-matched controls for comparison. We compared perceived moderate-vigorous physical activity between survivors and controls, using regression to identify associations with physical activity. RESULTS We recruited 914 participants (570 childhood cancer survivors and 344 age-matched controls). Parents of survivors perceived more moderate-vigorous physical activity than child controls (248 ± 218, 95% Confidence Interval (CI) = 218-280 vs 185 ± 214 min/week, 95% CI = 144-225, p = 0.036), with no perceived difference between adult survivors and controls (125 ± 152, 95% CI = 108-140 vs 160 ± 201 min/week, 95% CI = 132-187, p = 0.477). Twenty-seven percent of child survivors (vs. 14.5% controls) and 30% of adult survivors (vs. 39.4% controls) met recommendations. Adult survivors who received radiotherapy (OR = 0.585, 95% CI = 0.343-0.995, p = 0.048) or not completed university (OR = 1.808, 95% CI = 1.071-3.053, p = 0.027) were less likely to meet recommendations. CONCLUSIONS Over two-thirds of Australian and New Zealander childhood cancer survivors across all ages are perceived to not meet physical activity recommendations. Adult survivors who had radiotherapy or did not complete university appeared at-risk for low physical activity. PRACTICAL IMPLICATIONS Physical activity is important for everyone, but critical among childhood cancer survivors due to increased late cardio-metabolic risks. Monitoring survivors' perceived but also objectively measured physical activity as complementary to routine care is warranted, to provide education and motivate survivors to take control of their health.
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Affiliation(s)
- David Mizrahi
- School of Medical Sciences, UNSW Medicine, UNSW Sydney, Australia; Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia.
| | - Joanna E Fardell
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia; School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Australia
| | - Claire E Wakefield
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia; School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Australia
| | - David Simar
- School of Medical Sciences, UNSW Medicine, UNSW Sydney, Australia
| | - Ann M Maguire
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, Australia; Discipline of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Gill Hubbard
- Department of Nursing, Centre for Health Sciences, University of the Highlands and Islands, Inverness, United Kingdom
| | - Richard J Cohn
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia; School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Australia
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Schink K, Reljic D, Herrmann HJ, Meyer J, Mackensen A, Neurath MF, Zopf Y. Whole-Body Electromyostimulation Combined With Individualized Nutritional Support Improves Body Composition in Patients With Hematological Malignancies - A Pilot Study. Front Physiol 2018; 9:1808. [PMID: 30618820 PMCID: PMC6305403 DOI: 10.3389/fphys.2018.01808] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 11/30/2018] [Indexed: 12/22/2022] Open
Abstract
Patients undergoing the complex treatment for hematological malignancies are exposed to a high physiological and psychological distress inducing fatigue and physical inactivity. In line with cancer-related metabolic changes patients are predisposed for skeletal muscle mass loss that leads to a functional decline, affects therapeutic success, and quality of life. Benefits of physical exercise and nutritional interventions on muscle maintenance are observed in solid cancer patients, but marginally investigated in patients with hematological cancer. We here studied the effects of a combined supportive exercise and nutrition intervention using whole-body electromyostimulation (WB-EMS) training and individualized nutritional support in patients actively treated for hematological malignancy. In a controlled pilot trial, 31 patients (67.7% male; 58.0 ± 16.7 years) with various hematological cancers were allocated to a control group (n = 9) receiving nutritional support of usual care regarding a high protein intake (>1.0 g/kg/d) or to a physical exercise group (n = 22) additionally performing WB-EMS training twice weekly for 12 weeks. Bodyweight and body composition assessed by bioelectrical impedance analysis were measured every 4 weeks. Physical function, blood parameters, quality of life and fatigue were assessed at baseline and after 12 weeks. No WB-EMS-related adverse effects occurred. Patients attending the exercise program presented a higher skeletal muscle mass than controls after 12-weeks (1.51 kg [0.41, 2.60]; p = 0.008). In contrast, patients of the control group showed a higher fat mass percentage than patients of the WB-EMS group (-4.46% [-7.15, -1.77]; p = 0.001) that was accompanied by an increase in serum triglycerides in contrast to a decrease in the WB-EMS group (change ± SD, control 36.3 ± 50.6 mg/dl; WB-EMS -31.8 ± 68.7 mg/dl; p = 0.064). No significant group differences for lower limb strength, quality of life, and fatigue were detected. However, compared to controls the WB-EMS group significantly improved in physical functioning indicated by a higher increase in the 6-min-walking distance (p = 0.046). A combined therapeutic intervention of WB-EMS and protein-rich nutritional support seems to be safe and effective in improving skeletal muscle mass and body composition in hematological cancer patients during active oncological treatment. Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT02293239.
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Affiliation(s)
- Kristin Schink
- Hector-Center for Nutrition, Exercise and Sports, Department of Medicine 1, University Hospital Erlangen, Friedrich–Alexander University Erlangen–Nürnberg, Erlangen, Germany
| | - Dejan Reljic
- Hector-Center for Nutrition, Exercise and Sports, Department of Medicine 1, University Hospital Erlangen, Friedrich–Alexander University Erlangen–Nürnberg, Erlangen, Germany
| | - Hans J. Herrmann
- Hector-Center for Nutrition, Exercise and Sports, Department of Medicine 1, University Hospital Erlangen, Friedrich–Alexander University Erlangen–Nürnberg, Erlangen, Germany
| | - Julia Meyer
- Hector-Center for Nutrition, Exercise and Sports, Department of Medicine 1, University Hospital Erlangen, Friedrich–Alexander University Erlangen–Nürnberg, Erlangen, Germany
| | - Andreas Mackensen
- Department of Medicine 5 – Haematology and Oncology, University Hospital Erlangen, Friedrich–Alexander University Erlangen–Nürnberg, Erlangen, Germany
| | - Markus F. Neurath
- Department of Medicine 1 – Gastroenterology, Pneumology and Endocrinology, University Hospital Erlangen, Friedrich–Alexander University Erlangen–Nürnberg, Erlangen, Germany
| | - Yurdagül Zopf
- Hector-Center for Nutrition, Exercise and Sports, Department of Medicine 1, University Hospital Erlangen, Friedrich–Alexander University Erlangen–Nürnberg, Erlangen, Germany
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20
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Yilmaz ÖF, Özdal M. Acute, chronic, and combined pulmonary responses to swimming in competitive swimmers. Respir Physiol Neurobiol 2018; 259:129-135. [PMID: 30217724 DOI: 10.1016/j.resp.2018.09.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Revised: 08/10/2018] [Accepted: 09/10/2018] [Indexed: 11/30/2022]
Abstract
The combined effects of swimming on the inspiratory muscles and pulmonary functions are not well known. The aim of the present study was to determine the acute, chronic, and combined effects of swimming on the pulmonary functions and respiratory muscles of competitive swimmers. Thirty males (15 in the experimental group [EG] and 15 in the control group [CG]) participated in this study. The EG subjects participated in an 8-week swim training program and performed 1 day before and after an 8-week 100-m swimming event. Pulmonary functions and respiratory muscle strength were measured immediately before and after the swimming event in the EG and before and after an 8-week period in the CG. The obtained data were analyzed using repeated measures one-way analysis of variance, least significant difference, and independent- and paired-sample t-tests. Swimming exerted negative acute effects (p < 0.05) and positive chronic effects (p < 0.05) on respiratory muscle strength and pulmonary functions. Further, the negative acute effects decreased the combined effects of the chronic and acute effects of swimming on respiratory muscle strength and pulmonary functions (p < 0.05). The results indicated that swimming exerts negative acute, positive chronic, and combined effects on respiratory muscle strength and pulmonary functions.
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Affiliation(s)
- Ömer Faruk Yilmaz
- Department of Physical Education and Sport, Institution of Gaziantep University, Lab of Gaziantep University Performance Laboratory, Turkey.
| | - Mustafa Özdal
- Department of Physical Education and Sport, Institution of Gaziantep University, Lab of Gaziantep University Performance Laboratory, Turkey.
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21
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Brunet J, Wurz A, Shallwani SM. A scoping review of studies exploring physical activity among adolescents and young adults diagnosed with cancer. Psychooncology 2018; 27:1875-1888. [PMID: 29719077 DOI: 10.1002/pon.4743] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 04/05/2018] [Accepted: 04/09/2018] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Physical activity can improve health, functional capacity, and quality of life among children and adults diagnosed with cancer. Physical activity may also offer important benefits to adolescents and young adults diagnosed with cancer (AYAs). We conducted a scoping review to: determine the extent, range, and nature of published studies on physical activity among AYAs; identify knowledge gaps; and provide directions for future research. METHODS We searched 4 electronic databases for published studies. Two authors independently scanned the titles, abstracts, and full-texts against inclusion criteria: original research with humans, published in an English-language peer-reviewed journal, ≥50% of participants were diagnosed with cancer between the ages of 15 and 39 years, and included at least 1 measure of physical activity behavior. Data were extracted from studies meeting these criteria and subsequently summarized narratively. RESULTS Our search yielded 4729 articles; 32 met inclusion criteria. These included 18 cross-sectional and 4 longitudinal studies that explored descriptive (ie, sociodemographic or medical), physical, personal/psychological, social, other health behaviors, and/or other factors as antecedents or correlates of physical activity. The remaining 10 were intervention studies that focused on changing physical activity behavior or on testing the effects of physical activity. CONCLUSIONS We can conclude that physical activity is not well researched among AYAs. More high-quality research adopting longitudinal or intervention study designs that incorporate a range of descriptive, physical, personal/psychological, social, and environmental measures are warranted to better inform the development of behavior change interventions as well as to establish the benefits of physical activity for AYAs.
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Affiliation(s)
- Jennifer Brunet
- School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada.,Institut du savoir Montfort, Hôpital Montfort, Ottawa, Ontario, Canada.,Cancer Therapeutic Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Amanda Wurz
- School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Shirin M Shallwani
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
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22
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Howden EJ, La Gerche A, Arthur JF, McMullen JR, Jennings GL, Dunstan DW, Owen N, Avery S, Kingwell BA. Standing up to the cardiometabolic consequences of hematological cancers. Blood Rev 2018; 32:349-360. [PMID: 29496356 DOI: 10.1016/j.blre.2018.02.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 12/06/2017] [Accepted: 02/20/2018] [Indexed: 12/18/2022]
Abstract
Hematological cancer survivors are highly vulnerable to cardiometabolic complications impacting long-term health status, quality of life and survival. Elevated risk of diabetes and cardiovascular disease arises not only from the effects of the cancers themselves, but also from the toxic effects of cancer therapies, and deconditioning arising from reduced physical activity levels. Regular physical activity can circumvent or reverse adverse effects on the heart, skeletal muscle, vasculature and blood cells, through a combination of systemic and molecular mechanisms. We review the link between hematological cancers and cardiometabolic risk with a focus on adult survivors, including the contributing mechanisms and discuss the potential for physical activity interventions, which may act to oppose the negative effects of both physical deconditioning and therapies (conventional and targeted) on metabolic and growth signaling (kinase) pathways in the heart and beyond. In this context, we focus particularly on strategies targeting reducing and breaking up sedentary time and provide recommendations for future research.
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Affiliation(s)
- Erin J Howden
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, Australia.
| | - André La Gerche
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, Australia.
| | - Jane F Arthur
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, Australia
| | - Julie R McMullen
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, Australia.
| | - Garry L Jennings
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, Australia; Sydney Medical School, University of Sydney, NSW, Australia.
| | - David W Dunstan
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, Australia.
| | - Neville Owen
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, Australia.
| | - Sharon Avery
- Malignant Hematology and Stem Cell Transplantation Service, The Alfred Hospital, 55 Commercial Road, Melbourne, VIC, Australia.
| | - Bronwyn A Kingwell
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, Australia.
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23
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de Lima FD, Bottaro M, de Oliveira Valeriano R, Cruz L, Battaglini CL, Vieira CA, de Oliveira RJ. Cancer-Related Fatigue and Muscle Quality in Hodgkin's Lymphoma Survivors. Integr Cancer Ther 2017; 17:299-305. [PMID: 28617061 PMCID: PMC6041909 DOI: 10.1177/1534735417712009] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
The purpose of this study was to compare fatigue, strength, body composition, muscle thickness, and muscle quality between Hodgkin's lymphoma survivors (HLS) and apparently healthy subjects matched by age, gender, and physical activity levels (CON). Twelve HLS (32.16 ± 8.06) and 36 CON (32.42 ± 7.64) were enrolled in the study. Fatigue was assessed using the 20-item Multidimensional Fatigue Inventory, muscle strength using an isokinetic dynamometer, body composition using dual-energy X-ray absorptiometry, and thickness and muscle quality using B-mode ultrasound. Differences between HLS and CON were analyzed using independent samples t tests. No significant differences were observed between groups for any demographic characteristics: age ( P = .922), weight ( P = .943), height ( P = .511), body mass index ( P = .796), fat mass ( P = .688), fat-free mass ( P = .520), and percent body fat ( P = .446). No significant differences were observed for strength (peak torque; P = .552), relative peak torque ( P = .200), muscle thickness ( P > .05) and muscle quality ( P > .05). However, self-perceived fatigue was significantly higher in HLS than in CON ( P = .009). It appears that when HLS are matched by age and physical activity levels to CON, no significant difference in body composition, muscle thickness, muscle quality, or strength is observed. Self-perceived fatigue, as predicted, is higher in HLS, which may have implications and should be considered when prescribing exercise training to this cancer population.
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24
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Swartz MC, Lewis ZH, Lyons EJ, Jennings K, Middleton A, Deer RR, Arnold D, Dresser K, Ottenbacher KJ, Goodwin JS. Effect of Home- and Community-Based Physical Activity Interventions on Physical Function Among Cancer Survivors: A Systematic Review and Meta-Analysis. Arch Phys Med Rehabil 2017; 98:1652-1665. [PMID: 28427925 DOI: 10.1016/j.apmr.2017.03.017] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Revised: 01/11/2017] [Accepted: 03/18/2017] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To examine the effect of home- and community-based physical activity interventions on physical functioning among cancer survivors based on the most prevalent physical function measures, randomized trials were reviewed. DATA SOURCES Five electronic databases-Medline Ovid, PubMed, CINAHL, Web of Science, and PsycINFO-were searched from inception to March 2016 for relevant articles. STUDY SELECTION Search terms included community-based interventions, physical functioning, and cancer survivors. A reference librarian trained in systematic reviews conducted the final search. DATA EXTRACTION Four reviewers evaluated eligibility and 2 reviewers evaluated methodological quality. Data were abstracted from studies that used the most prevalent physical function measurement tools-Medical Outcomes Study 36-Item Short-Form Health Survey, Late-Life Function and Disability Instrument, European Organisation for the Research and Treatment of Cancer Quality-of-Life Questionnaire, and 6-minute walk test. Random- or fixed-effects models were conducted to obtain overall effect size per physical function measure. DATA SYNTHESIS Fourteen studies met inclusion criteria and were used to compute standardized mean differences using the inverse variance statistical method. The median sample size was 83 participants. Most of the studies (n=7) were conducted among breast cancer survivors. The interventions produced short-term positive effects on physical functioning, with overall effect sizes ranging from small (.17; 95% confidence interval [CI], .07-.27) to medium (.45; 95% CI, .23-.67). Community-based interventions that met in groups and used behavioral change strategies produced the largest effect sizes. CONCLUSIONS Home and community-based physical activity interventions may be a potential tool to combat functional deterioration among aging cancer survivors. More studies are needed among other cancer types using clinically relevant objective functional measures (eg, gait speed) to accelerate translation into the community and clinical practice.
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Affiliation(s)
- Maria C Swartz
- Division of Rehabilitation Sciences, The University of Texas Medical Branch, Galveston, TX.
| | - Zakkoyya H Lewis
- Division of Rehabilitation Sciences, The University of Texas Medical Branch, Galveston, TX; Fitness & Nutrition Results, Beachbody, Santa Monica, CA
| | - Elizabeth J Lyons
- Department of Nutrition and Metabolism, The University of Texas Medical Branch, Galveston, TX
| | - Kristofer Jennings
- Department of Preventive Medicine and Community Health, The University of Texas Medical Branch, Galveston, TX
| | - Addie Middleton
- Division of Rehabilitation Sciences, The University of Texas Medical Branch, Galveston, TX
| | - Rachel R Deer
- Sealy Center on Aging, The University of Texas Medical Branch, Galveston, TX
| | - Demi Arnold
- Department of Nutrition and Metabolism, The University of Texas Medical Branch, Galveston, TX
| | - Kaitlin Dresser
- Department of Nutrition and Metabolism, The University of Texas Medical Branch, Galveston, TX
| | - Kenneth J Ottenbacher
- Division of Rehabilitation Sciences, The University of Texas Medical Branch, Galveston, TX
| | - James S Goodwin
- Division of Geriatric Medicine, The University of Texas Medical Branch, Galveston, TX
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25
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Le A, Mitchell HR, Zheng DJ, Rotatori J, Fahey JT, Ness KK, Kadan-Lottick NS. A home-based physical activity intervention using activity trackers in survivors of childhood cancer: A pilot study. Pediatr Blood Cancer 2017; 64:387-394. [PMID: 27615711 DOI: 10.1002/pbc.26235] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 07/29/2016] [Accepted: 08/02/2016] [Indexed: 11/08/2022]
Abstract
BACKGROUND Over 70% of childhood cancer survivors develop late complications from therapy, many of which can be mitigated by physical activity. Survivors engage in exercise at similar or lower rates than their sedentary healthy peers. We piloted a novel home-based exercise intervention with a motivational activity tracker. We evaluated (i) feasibility, (ii) impact on activity levels and physical fitness, and (iii) barriers, preferences, and beliefs regarding physical activity. METHODS Childhood cancer survivors currently 15 years or older and not meeting the Centers for Disease Control and Prevention physical activity guidelines were enrolled and instructed to wear the Fitbit One, a 4.8 cm × 1.8 cm motivational activity tracker, daily for 6 months. Baseline and follow-up evaluations included self-report surveys, an Actigraph accelerometer for 7 days, and a VO2 maximum test by cardiac stress test. RESULTS Nineteen participants were enrolled (13.4% participation rate) with a mean age of 24.3 ± 5.8 years (range 15-35). Four participants withdrew with a 79% retention rate. Participants wore the Fitbit an average of 19.0 ± 4.7 days per month during months 1-3 and 15.0 ± 7.9 days per month during months 4-6. Total weekly moderate to vigorous physical activity increased from 265.6 ± 117.0 to 301.4 ± 135.4 min and VO2 maximum increased from 25.7 ± 7.7 to 27.2 ± 7.4 ml/kg/min. These changes were not statistically significant (P = 0.47 and 0.30, respectively). Survey responses indicated no change in barriers, preferences, and beliefs regarding physical activity. CONCLUSIONS This pilot study of a motivational activity tracker demonstrated feasibility as measured by participant retention, receptivity, and belief of utility. Future studies with a large sample size are needed to demonstrate the efficacy and sustainability of this intervention.
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Affiliation(s)
- Alyssa Le
- Department of Pediatric Hematology/Oncology, Yale School of Medicine, New Haven, Connecticut
| | - Hannah-Rose Mitchell
- Department of Pediatric Hematology/Oncology, Yale School of Medicine, New Haven, Connecticut
| | - Daniel J Zheng
- Department of Pediatric Hematology/Oncology, Yale School of Medicine, New Haven, Connecticut
| | - Jaime Rotatori
- Department of Pediatric Hematology/Oncology, Yale School of Medicine, New Haven, Connecticut
| | - John T Fahey
- Department of Pediatric Cardiology, Yale School of Medicine, New Haven, Connecticut
| | - Kirsten K Ness
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Nina S Kadan-Lottick
- Department of Pediatric Hematology/Oncology, Yale School of Medicine, New Haven, Connecticut.,Yale Cancer Center, New Haven, Connecticut
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26
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Behringer K, Goergen H, Müller H, Thielen I, Brillant C, Kreissl S, Halbsguth TV, Meissner J, Greil R, Moosmann P, Shonukan O, Rueffer JU, Flechtner HH, Fuchs M, Diehl V, Engert A, Borchmann P. Cancer-Related Fatigue in Patients With and Survivors of Hodgkin Lymphoma: The Impact on Treatment Outcome and Social Reintegration. J Clin Oncol 2016; 34:4329-4337. [DOI: 10.1200/jco.2016.67.7450] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose Cancer-related fatigue occurs frequently in patients with Hodgkin lymphoma (HL) and has a major impact on their quality of life. We hypothesized that severe fatigue (sFA) might have an impact on patients’ treatment outcome and social reintegration. Methods Of 5,306 patients enrolled in the German Hodgkin Study Group’s fifth generation of clinical trials in HL (HD13, HD14, and HD15; nonqualified and older [> 60 years] patients excluded), 4,529 provided data on health-related quality of life. We describe sFA (defined as a score ≥ 50 on the 0 to 100 scale from the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30) before and up to 9 years after therapy and analyze its impact on treatment outcome and social reintegration. Results The proportion of patients reporting sFA was 37% at baseline and ranged from 20% to 24% during follow-up. Baseline sFA was associated with significantly impaired progression-free survival and a trend to impaired overall survival, which can be overcome in patients receiving highly effective HL therapies as applied in our fifth-generation trials. Our analysis revealed a significant negative association of sFA and employment in survivors: 5 years after therapy, 51% and 63% of female and male survivors, respectively, with sFA were working or in professional education, compared with 78% and 90% without sFA, respectively ( P < .001 adjusted for age, sex, stage, baseline employment status, and treatment outcome). sFA was also associated with financial problems and the number of visits to a general practitioner and medical specialists. Conclusion sFA is an important factor preventing survivors from social reintegration during follow-up. This observation underscores the need to address fatigue as a significant diagnosis when treating patients with and survivors of cancer.
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Affiliation(s)
- Karolin Behringer
- Karolin Behringer, Helen Goergen, Horst Müller, Indra Thielen, Corinne Brillant, Stefanie Kreissl, Michael Fuchs, Volker Diehl, Andreas Engert, and Peter Borchmann, University Hospital of Cologne; Jens Ulrich Rueffer, German Fatigue Society, Cologne; Teresa Veronika Halbsguth, University Hospital of Frankfurt, Frankfurt; Julia Meissner, University of Heidelberg, Heidelberg; Hans-Henning Flechtner, Otto von Guericke University, Magdeburg, Germany; Richard Greil, Paracelsus Medical University, Salzburg,
| | - Helen Goergen
- Karolin Behringer, Helen Goergen, Horst Müller, Indra Thielen, Corinne Brillant, Stefanie Kreissl, Michael Fuchs, Volker Diehl, Andreas Engert, and Peter Borchmann, University Hospital of Cologne; Jens Ulrich Rueffer, German Fatigue Society, Cologne; Teresa Veronika Halbsguth, University Hospital of Frankfurt, Frankfurt; Julia Meissner, University of Heidelberg, Heidelberg; Hans-Henning Flechtner, Otto von Guericke University, Magdeburg, Germany; Richard Greil, Paracelsus Medical University, Salzburg,
| | - Horst Müller
- Karolin Behringer, Helen Goergen, Horst Müller, Indra Thielen, Corinne Brillant, Stefanie Kreissl, Michael Fuchs, Volker Diehl, Andreas Engert, and Peter Borchmann, University Hospital of Cologne; Jens Ulrich Rueffer, German Fatigue Society, Cologne; Teresa Veronika Halbsguth, University Hospital of Frankfurt, Frankfurt; Julia Meissner, University of Heidelberg, Heidelberg; Hans-Henning Flechtner, Otto von Guericke University, Magdeburg, Germany; Richard Greil, Paracelsus Medical University, Salzburg,
| | - Indra Thielen
- Karolin Behringer, Helen Goergen, Horst Müller, Indra Thielen, Corinne Brillant, Stefanie Kreissl, Michael Fuchs, Volker Diehl, Andreas Engert, and Peter Borchmann, University Hospital of Cologne; Jens Ulrich Rueffer, German Fatigue Society, Cologne; Teresa Veronika Halbsguth, University Hospital of Frankfurt, Frankfurt; Julia Meissner, University of Heidelberg, Heidelberg; Hans-Henning Flechtner, Otto von Guericke University, Magdeburg, Germany; Richard Greil, Paracelsus Medical University, Salzburg,
| | - Corinne Brillant
- Karolin Behringer, Helen Goergen, Horst Müller, Indra Thielen, Corinne Brillant, Stefanie Kreissl, Michael Fuchs, Volker Diehl, Andreas Engert, and Peter Borchmann, University Hospital of Cologne; Jens Ulrich Rueffer, German Fatigue Society, Cologne; Teresa Veronika Halbsguth, University Hospital of Frankfurt, Frankfurt; Julia Meissner, University of Heidelberg, Heidelberg; Hans-Henning Flechtner, Otto von Guericke University, Magdeburg, Germany; Richard Greil, Paracelsus Medical University, Salzburg,
| | - Stefanie Kreissl
- Karolin Behringer, Helen Goergen, Horst Müller, Indra Thielen, Corinne Brillant, Stefanie Kreissl, Michael Fuchs, Volker Diehl, Andreas Engert, and Peter Borchmann, University Hospital of Cologne; Jens Ulrich Rueffer, German Fatigue Society, Cologne; Teresa Veronika Halbsguth, University Hospital of Frankfurt, Frankfurt; Julia Meissner, University of Heidelberg, Heidelberg; Hans-Henning Flechtner, Otto von Guericke University, Magdeburg, Germany; Richard Greil, Paracelsus Medical University, Salzburg,
| | - Teresa Veronika Halbsguth
- Karolin Behringer, Helen Goergen, Horst Müller, Indra Thielen, Corinne Brillant, Stefanie Kreissl, Michael Fuchs, Volker Diehl, Andreas Engert, and Peter Borchmann, University Hospital of Cologne; Jens Ulrich Rueffer, German Fatigue Society, Cologne; Teresa Veronika Halbsguth, University Hospital of Frankfurt, Frankfurt; Julia Meissner, University of Heidelberg, Heidelberg; Hans-Henning Flechtner, Otto von Guericke University, Magdeburg, Germany; Richard Greil, Paracelsus Medical University, Salzburg,
| | - Julia Meissner
- Karolin Behringer, Helen Goergen, Horst Müller, Indra Thielen, Corinne Brillant, Stefanie Kreissl, Michael Fuchs, Volker Diehl, Andreas Engert, and Peter Borchmann, University Hospital of Cologne; Jens Ulrich Rueffer, German Fatigue Society, Cologne; Teresa Veronika Halbsguth, University Hospital of Frankfurt, Frankfurt; Julia Meissner, University of Heidelberg, Heidelberg; Hans-Henning Flechtner, Otto von Guericke University, Magdeburg, Germany; Richard Greil, Paracelsus Medical University, Salzburg,
| | - Richard Greil
- Karolin Behringer, Helen Goergen, Horst Müller, Indra Thielen, Corinne Brillant, Stefanie Kreissl, Michael Fuchs, Volker Diehl, Andreas Engert, and Peter Borchmann, University Hospital of Cologne; Jens Ulrich Rueffer, German Fatigue Society, Cologne; Teresa Veronika Halbsguth, University Hospital of Frankfurt, Frankfurt; Julia Meissner, University of Heidelberg, Heidelberg; Hans-Henning Flechtner, Otto von Guericke University, Magdeburg, Germany; Richard Greil, Paracelsus Medical University, Salzburg,
| | - Peter Moosmann
- Karolin Behringer, Helen Goergen, Horst Müller, Indra Thielen, Corinne Brillant, Stefanie Kreissl, Michael Fuchs, Volker Diehl, Andreas Engert, and Peter Borchmann, University Hospital of Cologne; Jens Ulrich Rueffer, German Fatigue Society, Cologne; Teresa Veronika Halbsguth, University Hospital of Frankfurt, Frankfurt; Julia Meissner, University of Heidelberg, Heidelberg; Hans-Henning Flechtner, Otto von Guericke University, Magdeburg, Germany; Richard Greil, Paracelsus Medical University, Salzburg,
| | - Oluwatoyin Shonukan
- Karolin Behringer, Helen Goergen, Horst Müller, Indra Thielen, Corinne Brillant, Stefanie Kreissl, Michael Fuchs, Volker Diehl, Andreas Engert, and Peter Borchmann, University Hospital of Cologne; Jens Ulrich Rueffer, German Fatigue Society, Cologne; Teresa Veronika Halbsguth, University Hospital of Frankfurt, Frankfurt; Julia Meissner, University of Heidelberg, Heidelberg; Hans-Henning Flechtner, Otto von Guericke University, Magdeburg, Germany; Richard Greil, Paracelsus Medical University, Salzburg,
| | - Jens Ulrich Rueffer
- Karolin Behringer, Helen Goergen, Horst Müller, Indra Thielen, Corinne Brillant, Stefanie Kreissl, Michael Fuchs, Volker Diehl, Andreas Engert, and Peter Borchmann, University Hospital of Cologne; Jens Ulrich Rueffer, German Fatigue Society, Cologne; Teresa Veronika Halbsguth, University Hospital of Frankfurt, Frankfurt; Julia Meissner, University of Heidelberg, Heidelberg; Hans-Henning Flechtner, Otto von Guericke University, Magdeburg, Germany; Richard Greil, Paracelsus Medical University, Salzburg,
| | - Hans-Henning Flechtner
- Karolin Behringer, Helen Goergen, Horst Müller, Indra Thielen, Corinne Brillant, Stefanie Kreissl, Michael Fuchs, Volker Diehl, Andreas Engert, and Peter Borchmann, University Hospital of Cologne; Jens Ulrich Rueffer, German Fatigue Society, Cologne; Teresa Veronika Halbsguth, University Hospital of Frankfurt, Frankfurt; Julia Meissner, University of Heidelberg, Heidelberg; Hans-Henning Flechtner, Otto von Guericke University, Magdeburg, Germany; Richard Greil, Paracelsus Medical University, Salzburg,
| | - Michael Fuchs
- Karolin Behringer, Helen Goergen, Horst Müller, Indra Thielen, Corinne Brillant, Stefanie Kreissl, Michael Fuchs, Volker Diehl, Andreas Engert, and Peter Borchmann, University Hospital of Cologne; Jens Ulrich Rueffer, German Fatigue Society, Cologne; Teresa Veronika Halbsguth, University Hospital of Frankfurt, Frankfurt; Julia Meissner, University of Heidelberg, Heidelberg; Hans-Henning Flechtner, Otto von Guericke University, Magdeburg, Germany; Richard Greil, Paracelsus Medical University, Salzburg,
| | - Volker Diehl
- Karolin Behringer, Helen Goergen, Horst Müller, Indra Thielen, Corinne Brillant, Stefanie Kreissl, Michael Fuchs, Volker Diehl, Andreas Engert, and Peter Borchmann, University Hospital of Cologne; Jens Ulrich Rueffer, German Fatigue Society, Cologne; Teresa Veronika Halbsguth, University Hospital of Frankfurt, Frankfurt; Julia Meissner, University of Heidelberg, Heidelberg; Hans-Henning Flechtner, Otto von Guericke University, Magdeburg, Germany; Richard Greil, Paracelsus Medical University, Salzburg,
| | - Andreas Engert
- Karolin Behringer, Helen Goergen, Horst Müller, Indra Thielen, Corinne Brillant, Stefanie Kreissl, Michael Fuchs, Volker Diehl, Andreas Engert, and Peter Borchmann, University Hospital of Cologne; Jens Ulrich Rueffer, German Fatigue Society, Cologne; Teresa Veronika Halbsguth, University Hospital of Frankfurt, Frankfurt; Julia Meissner, University of Heidelberg, Heidelberg; Hans-Henning Flechtner, Otto von Guericke University, Magdeburg, Germany; Richard Greil, Paracelsus Medical University, Salzburg,
| | - Peter Borchmann
- Karolin Behringer, Helen Goergen, Horst Müller, Indra Thielen, Corinne Brillant, Stefanie Kreissl, Michael Fuchs, Volker Diehl, Andreas Engert, and Peter Borchmann, University Hospital of Cologne; Jens Ulrich Rueffer, German Fatigue Society, Cologne; Teresa Veronika Halbsguth, University Hospital of Frankfurt, Frankfurt; Julia Meissner, University of Heidelberg, Heidelberg; Hans-Henning Flechtner, Otto von Guericke University, Magdeburg, Germany; Richard Greil, Paracelsus Medical University, Salzburg,
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Rach AM, Crabtree VM, Brinkman TM, Zeltzer L, Marchak JG, Srivastava D, Tynes B, Lai JS, Robison LL, Armstrong GT, Krull KR. Predictors of fatigue and poor sleep in adult survivors of childhood Hodgkin's lymphoma: a report from the Childhood Cancer Survivor Study. J Cancer Surviv 2016; 11:256-263. [PMID: 27837445 DOI: 10.1007/s11764-016-0583-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 11/02/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE Survivors of pediatric Hodgkin's lymphoma (HL) are at risk for a number of debilitating late effects. Excessive fatigue and poor sleep quality are primary complaints of HL survivors. Understanding the emotional and physical factors that influence fatigue and sleep quality may provide opportunities for intervention to improve health-related quality of life for HL survivors. METHODS Data from 751 adult survivors of childhood HL who participated in the Childhood Cancer Survivor Study (CCSS) from 2000-2002 were analyzed. Multivariable logistic regression analyses investigated the demographic, psychological, and physical variables that predicted clinically significant levels of poor sleep quality, fatigue, and excessive daytime sleepiness. RESULTS Survivors' self-reported level of emotional distress, pain, and physical functioning limitations did not differ from population norms. Clinically elevated levels of emotional distress (OR 8.38, 95% CI 4.28-16.42) and pain (OR 3.73, 95% CI 2.09-6.67) increased the risk for endorsing elevated levels of fatigue. Survivors with elevated levels of emotional distress (OR 6.83, 95% CI 2.71-15.90) and pain (OR 5.27, 95% CI 1.78-15.61) were more likely to report poor sleep quality. Pain (OR 2.11, 95% CI 1.39-3.34) was related to excessive daytime sleepiness. CONCLUSIONS Emotional and physical factors are associated with elevated levels of fatigue, excessive daytime sleepiness, and poor sleep quality in survivors of pediatric HL. This is consistent with findings from research conducted with non-cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS These results suggest that interventions designed to target sleep and fatigue difficulties in the general population may be well suited for pediatric HL survivors as well.
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Affiliation(s)
- Amanda M Rach
- UVA Neurocognitive Assessment Lab, The University of Virginia Health System, Charlottesville, VA, 22908, USA
| | - Valerie McLaughlin Crabtree
- Department of Psychology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Mail Stop 101, Memphis, TN, 38105, USA
| | - Tara M Brinkman
- Epidemiology and Cancer Control, St. Jude Children's Research Hospital, MS 735, Room S6047, 262 Danny Thomas Place, Memphis, TN, 38105, USA
| | - Lonnie Zeltzer
- Division of Pediatric Hematology-Oncology, David Geffen School of Medicine at UCLA, 22-464 MDCC, 10833 LeConte Ave, Los Angeles, CA, 90095, USA
| | | | - Deokumar Srivastava
- Biostatistics, St. Jude Children's Research Hospital, MS 768, Room 6010, 262 Danny Thomas Place, Memphis, TN, 38105, USA
| | - Brooklee Tynes
- Department of Psychology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Mail Stop 101, Memphis, TN, 38105, USA
| | - Jin-Shei Lai
- Department of Medical Social Sciences, Northwestern University, 633 N St. Clair 19th Floor, Chicago, IL, 60611, USA
| | - Leslie L Robison
- Epidemiology and Cancer Control, St. Jude Children's Research Hospital, MS 735, Room S6010, 262 Danny Thomas Place, Memphis, TN, 38105, USA
| | - Gregory T Armstrong
- Epidemiology and Cancer Control, St. Jude Children's Research Hospital, MS 735, 262 Danny Thomas Place, Memphis, TN, 38105, USA
| | - Kevin R Krull
- Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Ms 735, Room S6037, 262 Danny Thomas Place, Memphis, TN, 38105, USA.
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Henry-Amar M, Busson R. Does persistent fatigue in survivors relate to cancer? Lancet Oncol 2016; 17:1351-1352. [PMID: 27612584 DOI: 10.1016/s1470-2045(16)30156-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 05/09/2016] [Indexed: 11/18/2022]
Affiliation(s)
- Michel Henry-Amar
- Centre de Traitement des Données du Cancéropôle Nord-Ouest, Centre François Baclesse, 14076 Caen cedex 05, France.
| | - Raphaël Busson
- Centre de Traitement des Données du Cancéropôle Nord-Ouest, Centre François Baclesse, 14076 Caen cedex 05, France
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29
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Matheson L, Boulton M, Lavender V, Collins G, Mitchell-Floyd T, Watson E. The Experiences of Young Adults With Hodgkin Lymphoma Transitioning to Survivorship: A Grounded Theory Study. Oncol Nurs Forum 2016; 43:E195-E2014. [DOI: 10.1188/16.onf.e195-e2014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Linendoll N, Saunders T, Burns R, Nyce JD, Wendell KB, Evens AM, Parsons SK. Health-related quality of life in Hodgkin lymphoma: a systematic review. Health Qual Life Outcomes 2016; 14:114. [PMID: 27473596 PMCID: PMC4966803 DOI: 10.1186/s12955-016-0515-6] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2016] [Accepted: 07/25/2016] [Indexed: 01/28/2023] Open
Abstract
Purpose Hodgkin Lymphoma (HL) is highly curable with well-established treatment regimens; however, the impact on patient’s health-related quality of life (HRQL) from diagnosis through survivorship is unclear. This systematic review aimed to describe the available literature on HRQL in HL, assess the quality of these studies, identify gaps in the literature and recommend further areas of research. Methods Following PRISMA guidelines, we performed a systematic review to include studies assessing the HRQL in HL patients. Articles identified through database searches were screened and data extracted. Quality was evaluated using a 6-point scale, adapted from published HRQL systematic reviews. Results Sixty five articles published between 1986 and 2015 met inclusion criteria. These included 53 (82 %) cross-sectional studies; 12 (18 %) longitudinal studies, including three embedded in randomized trials; and three additional longitudinal studies that began assessment at diagnosis. Study sample sizes of HL patients varied considerably with only five (42 %) longitudinal studies including more than 50 patients. Multidimensional HRQL was assessed in 45 studies, single HRQL domains in 22 studies, and symptoms, including fatigue, in 28 studies. Conclusions The majority of studies employed a cross-sectional design, enrolling HL survivors at least 10 years after the completion of therapy. Emphasis on HRQL following therapy may inform initial treatment decisions and long-term survivorship goals. We recommend that future research include prospective, longitudinal randomized designs across both treatment and time.
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Affiliation(s)
- Nadine Linendoll
- Tufts Cancer Center, Tufts Medical Center, 800 Washington Street, #245, Boston, MA, 02111, USA. .,Tufts University School of Medicine, 145 Harrison Avenue, Boston, MA, 02111, USA.
| | - Tully Saunders
- Institute for Clinical Research and Health Policy, Tufts Medical Center, 800 Washington Street, #345, Boston, MA, 02111, USA
| | - Rebecca Burns
- Institute for Clinical Research and Health Policy, Tufts Medical Center, 800 Washington Street, #345, Boston, MA, 02111, USA
| | - Jonathan D Nyce
- Tufts University School of Medicine, 145 Harrison Avenue, Boston, MA, 02111, USA
| | - Kristen B Wendell
- Advocate Lutheran General Hospital, 1775 Dempster St, Park Ridge, IL, 60068, USA
| | - Andrew M Evens
- Tufts Cancer Center, Tufts Medical Center, 800 Washington Street, #245, Boston, MA, 02111, USA.,Tufts University School of Medicine, 145 Harrison Avenue, Boston, MA, 02111, USA
| | - Susan K Parsons
- Tufts Cancer Center, Tufts Medical Center, 800 Washington Street, #245, Boston, MA, 02111, USA.,Institute for Clinical Research and Health Policy, Tufts Medical Center, 800 Washington Street, #345, Boston, MA, 02111, USA.,Tufts University School of Medicine, 145 Harrison Avenue, Boston, MA, 02111, USA
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Eckert R, Huberty J, Gowin K, Mesa R, Marks L. Physical Activity as a Nonpharmacological Symptom Management Approach in Myeloproliferative Neoplasms: Recommendations for Future Research. Integr Cancer Ther 2016; 16:439-450. [PMID: 27458250 PMCID: PMC5739136 DOI: 10.1177/1534735416661417] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
PURPOSE Essential thrombocythemia, polycythemia vera, and myelofibrosis are rare chronic hematological malignancies known as myeloproliferative neoplasms (MPNs) and are characterized by deregulated myeloid lineage cell production, splenomegaly, and heterogeneous symptom profiles. MPN patients suffer from a significant symptom burden (eg, fatigue, depressive symptoms, early satiety) and an impaired overall quality of life (QoL). Current treatments typically include pharmacological approaches, which may come with additional side effects and may be limited by treatment-associated toxicities (ie, cytopenias). Nonpharmacological approaches such as physical activity may be beneficial for reducing symptom burden and improving QoL. To date, no studies have examined physical activity as a nonpharmacological approach in MPN patients despite preliminary evidence supporting its benefit in other hematological cancers. The purpose of this article is to (1) review the literature related to physical activity and specific hematological cancer subtypes and to (2) make suggestions for future research involving physical activity in MPN patients as a symptom management strategy. METHODS A brief review of studies examining physical activity in leukemias, lymphomas, and myelomas (excluding stem-cell transplant patients) was conducted. RESULTS There is preliminary evidence to suggest that physical activity may be an effective approach to improve patient-reported outcomes (fatigue, depression, anxiety, sleep), physical fitness (cardiovascular fitness, balance, body composition), and overall QoL in other hematological cancers. CONCLUSIONS Based on encouraging findings in other hematological cancers, future research should examine the feasibility and effectiveness of physical activity in MPN patients.
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Affiliation(s)
- Ryan Eckert
- 1 Arizona State University, Phoenix, AZ, USA
| | | | | | - Ruben Mesa
- 2 Mayo Clinic Cancer Center, Phoenix, AZ, USA
| | - Lisa Marks
- 2 Mayo Clinic Cancer Center, Phoenix, AZ, USA
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Ng AK, van Leeuwen FE. Hodgkin lymphoma: Late effects of treatment and guidelines for surveillance. Semin Hematol 2016; 53:209-15. [PMID: 27496313 DOI: 10.1053/j.seminhematol.2016.05.008] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Long-term survivors of Hodgkin lymphoma (HL) are at risk for a range of late effects, with second malignant neoplasm and cardiovascular diseases being the leading causes of death in these patients. The excess risks remain significantly elevated decades after treatment, and are clearly associated with extent of treatment exposures. Other late effects have also been identified, such as pulmonary dysfunction, endocrinopathies, muscle atrophy, and persistent fatigue. Systemic documentation of late effects and recognition of treatment- and patient-related risk factors are important, as they inform optimal surveillance and risk-reduction strategies, as well as guide therapeutic modifications in newly diagnosed patients to minimize treatment-related complications. As HL therapy evolves over time, with adoption of novel agents and contemporary treatment techniques, late effect risks and follow-up recommendations need to be continuously updated.
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Affiliation(s)
- Andrea K Ng
- Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Flora E van Leeuwen
- Department of Epidemiology, Division of Psychosocial Research & Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands.
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Adams MJ, Ng AK, Mauch P, Lipsitz SR, Winters P, Lipshultz SE. Peak oxygen consumption in Hodgkin's lymphoma survivors treated with mediastinal radiotherapy as a predictor of quality of life 5years later. PROGRESS IN PEDIATRIC CARDIOLOGY 2015. [DOI: 10.1016/j.ppedcard.2015.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Yu AF, Jones LW. Modulation of cardiovascular toxicity in Hodgkin lymphoma: potential role and mechanisms of aerobic training. Future Cardiol 2015; 11:441-52. [PMID: 26234325 DOI: 10.2217/fca.15.29] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Hodgkin lymphoma (HL) outcomes have improved due to advances in cancer treatment. However, HL survivors remain at increased risk for cardiovascular (CV) morbidity and mortality related to the long-term cardiotoxicity of HL treatment, particularly anthracycline chemotherapy and mediastinal radiotherapy. The role of aerobic training for the prevention of CV disease in the general population has been well established. However the safety and efficacy of aerobic training on CV outcomes has not been well studied in HL survivors. The purpose of this paper is to provide an up-to-date summary of the treatment-related adverse CV effects in HL survivors, review the CV benefits of exercise and review the limited evidence on the potential CV benefit of aerobic training in HL survivors.
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Affiliation(s)
- Anthony F Yu
- Department of Medicine, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - Lee W Jones
- Department of Medicine, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
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35
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Husson O, Oerlemans S, Mols F, Schep G, Van De Poll-Franse LV. High levels of physical activity are associated with lower levels of fatigue among lymphoma patients: Results from the longitudinal PROFILES registry. Acta Oncol 2015; 54:678-84. [PMID: 25752967 DOI: 10.3109/0284186x.2014.996664] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Studies show a cross-sectional association between physical activity (PA) and fatigue among lymphoma cancer patients. However, few longitudinal studies have examined whether PA has a sustained effect on fatigue over time. PURPOSE To examine the longitudinal relationship between PA and fatigue. METHODS All living individuals diagnosed with lymphoma between 1999 and 2010 as registered by the Dutch population-based Eindhoven Cancer Registry received a questionnaire on three time points. Generalized linear mixed models were used to estimate the independent effects of PA on fatigue. RESULTS PA and fatigue levels did not differ between patients short-term (< 1 year) and long-term after diagnosis (1-5 years or > 5 years). PA behavior was relatively constant over time with 84% of the patients meeting the Dutch PA guidelines at all assessment periods. Fatigue scores also remained fairly stable over time with 46% of the patients never being fatigued and 29% always being fatigued. Multivariate analyses showed that patients who met the PA guidelines scored 6.2 (95% CI 3.1-9.2) points lower on total fatigue over time (between subject effect; p < 0.01), compared to patients not meeting PA guidelines. CONCLUSION During a period of two years, PA and fatigue levels were rather stable within lymphoma patients. Patients who met the PA guidelines reported lower levels of fatigue compared to those not meeting the guidelines, which appeared to be a constant association over time. The observed association between PA and fatigue underlines the importance to focus upon physical training in the care of cancer patients.
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Affiliation(s)
- Olga Husson
- CoRPS - Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University , Tilburg , The Netherlands
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Allart-Vorelli P, Porro B, Baguet F, Michel A, Cousson-Gélie F. Haematological cancer and quality of life: a systematic literature review. Blood Cancer J 2015; 5:e305. [PMID: 25909835 PMCID: PMC4450328 DOI: 10.1038/bcj.2015.29] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 02/02/2015] [Indexed: 11/11/2022] Open
Abstract
The aim of this study is to examine the impact of haematological cancers on quality of life (QoL). A review of the international literature was conducted from the databases ‘PsycInfo' and 'Medline' using the keywords: 'haematological cancer', 'quality of life', 'physical', 'psychological', 'social', 'vocational', 'professional', 'economic', 'cognitive', and 'sexual'. Twenty-one reliable studies were analysed. Among these studies, 12 showed that haematological cancer altered overall QoL, 8 papers found a deterioration of physical dimension, 8 papers reported on functional and role dimensions, 11 papers reported on the psychological component and 9 on the social component. Moreover, one study and two manuscripts, respectively, reported deteriorated sexual and cognitive dimensions. Our review demonstrates that the different dimensions of QoL are deteriorated by haematological malignancies and, probably, by the side effects of treatment.
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Affiliation(s)
- P Allart-Vorelli
- Laboratory of Psychology 'Health and Quality of Life' EA 4139, University Bordeaux Segalen, Bordeaux, France
| | - B Porro
- Department of Psychology, Epsylon EA 4556 Laboratory 'Dynamics of Human Abilities and Health Behaviors', University Paul Valéry Montpellier 3, Montpellier, France
| | - F Baguet
- 1] Department of Psychology, Epsylon EA 4556 Laboratory 'Dynamics of Human Abilities and Health Behaviors', University Paul Valéry Montpellier 3, Montpellier, France [2] ICM, Institut Régional du Cancer de Montpellier, Epidaure Prevention Unit - Rue des Apothicaires, Montpellier Cedex 5, France
| | - A Michel
- 1] Department of Psychology, Epsylon EA 4556 Laboratory 'Dynamics of Human Abilities and Health Behaviors', University Paul Valéry Montpellier 3, Montpellier, France [2] MIS, Montpellier Institut du Sein - 25 rue de Clémentville, Montpellier, France
| | - F Cousson-Gélie
- 1] Department of Psychology, Epsylon EA 4556 Laboratory 'Dynamics of Human Abilities and Health Behaviors', University Paul Valéry Montpellier 3, Montpellier, France [2] ICM, Institut Régional du Cancer de Montpellier, Epidaure Prevention Unit - Rue des Apothicaires, Montpellier Cedex 5, France
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Buss T, Kruk A, Wiśniewski P, Modlinska A, Janiszewska J, Lichodziejewska-Niemierko M. Psychometric properties of the Polish version of the Multidimensional Fatigue Inventory-20 in cancer patients. J Pain Symptom Manage 2014; 48:730-7. [PMID: 24681111 DOI: 10.1016/j.jpainsymman.2013.11.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Revised: 11/19/2013] [Accepted: 12/12/2013] [Indexed: 11/26/2022]
Abstract
CONTEXT Multidimensional questionnaires estimating cancer-related fatigue (CRF) as a symptom cluster or a clinical syndrome primarily have been used and validated in English-speaking populations. However, cultural issues and language peculiarities can affect CRF assessment OBJECTIVES The main aims of this study were to evaluate the psychometric properties of the Polish version of the Multidimensional Fatigue Inventory-20 (MFI-20) and to deliver to clinicians a multidimensional tool for CRF assessment in Polish-speaking patients with cancer. METHODS After forward-backward translation procedures, the Polish version of MFI-20 was administered to 340 cancer patients. The Polish MFI-20 was appraised in terms of acceptability, reliability, and validity. Internal consistency was assessed by calculating Cronbach's alpha coefficients. Structural validity was evaluated with confirmatory factor analysis. RESULTS The translated MFI-20 was well accepted; 90% of subjects fully completed the questionnaire. The overall Cronbach's alpha coefficient was 0.9, ranging from 0.57 to 0.81. All correlation coefficients among Numeric Rating Scale-fatigue, fatigue-related items from the European Organization for Research and Treatment of Cancer Quality of Life Core-30 questionnaire, and the MFI--20 were statistically significant (P < 0.001). Confirmatory factor analysis demonstrated good structural validity and revealed only three dimensions in the Polish version of the MFI-20-physical and mental fatigue as well as reduced motivation. CONCLUSION The Polish version of the MFI-20 is well accepted by patients, reliable, and a valid instrument to assess CRF in Polish cancer patients.
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Affiliation(s)
- Tomasz Buss
- Department of Palliative Medicine, Medical University of Gdańsk, Poland.
| | - Agnieszka Kruk
- Department of Surgical Nursing, Medical University of Gdańsk, Poland
| | - Piotr Wiśniewski
- Department of Endocrinology and Internal Medicine, Medical University of Gdańsk, Gdańsk, Poland
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Roper K, Cooley ME, McDermott K, Fawcett J. Health-related quality of life after treatment of Hodgkin lymphoma in young adults. Oncol Nurs Forum 2014; 40:349-60. [PMID: 23803268 DOI: 10.1188/13.onf.349-360] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE/OBJECTIVES To describe changes in health-related quality of life (HRQOL) and to identify supportive care services used after treatment for Hodgkin lymphoma (HL) in young adults. DESIGN A longitudinal, repeated-measures study design was used to test the feasibility of data collection at the conclusion of treatment for HL and at one, three, and six months post-treatment. SETTING Participants were identified from two large comprehensive cancer centers in New England. SAMPLE 40 young adults with newly diagnosed HL were enrolled in the study prior to the completion of chemotherapy or radiation. METHODS Data were collected by interviews, standardized questionnaires, and medical record reviews. MAIN RESEARCH VARIABLES HRQOL variables defined as symptom distress, functional status, emotional distress, and intimate relationships; use of specific supportive care services; and baseline demographic and disease-related information. FINDINGS Results indicate that symptom distress improved at one month post-treatment and remained low at three and six months. Similarly, functional status improved at one month post-treatment. Only 13% of the sample had significant emotional distress at baseline, and this decreased to 8% over time. Patients placed high value on their intimate relationships (i.e., family and friends or sexual partners). A variety of supportive care services were used after treatment, the most common of which were related to economic issues. However, by six months post-treatment, services shifted toward enhancing nutrition and fitness. CONCLUSIONS The results from this study suggest that HRQOL in young adults with HL improved one-month post-treatment and that interest in using supportive care services was high. IMPLICATIONS FOR NURSING Facilitating the use of supportive care services at the end of cancer treatment appears to be an important part of helping young adults transition to survivorship. KNOWLEDGE TRANSLATION Supportive care services appear to be a vital component of the transition to survivorship and often change over time from an emphasis on economic issues to enhancing wellness through nutrition and fitness programs.
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Affiliation(s)
- Kristin Roper
- Phyllis F. Cantor Center, Dana-Farber Cancer Institute, Boston, USA.
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39
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Vermaete N, Wolter P, Verhoef G, Gosselink R. Physical activity and physical fitness in lymphoma patients before, during, and after chemotherapy: a prospective longitudinal study. Ann Hematol 2013; 93:411-24. [PMID: 23963412 DOI: 10.1007/s00277-013-1881-3] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Accepted: 08/06/2013] [Indexed: 11/24/2022]
Abstract
Fatigue is a common and distressing symptom in cancer patients, especially in lymphoma patients. One hypothesized mechanism in the etiology of fatigue is a vicious circle between fatigue, physical inactivity, and deconditioning. However, the natural evolution of physical activity and physical fitness over the course of treatment is unknown. Therefore, the aim of this longitudinal study was to assess fatigue, physical activity, and physical fitness in lymphoma patients before, during, and after treatment. Fatigue was measured with the EORTC-QLQ-C30, physical activity with an accelerometer, and physical fitness with a maximal incremental cycle ergometer test, 6-min walking distance test, and muscle strength measurements. Differences between the three measurement moments and baseline differences between Hodgkin lymphoma and non-Hodgkin lymphoma, early and advanced disease, were analyzed. Twenty-nine patients were included. Functional exercise capacity and quadriceps force were impaired before the start of treatment (86 ± 15 and 82 ± 16 % of predicted value, respectively). Over the course of treatment, significant declines were found in hemoglobin, quadriceps force, handgrip force, and maximal oxygen uptake, while patients reported more fatigue (p values < 0.016). Fatigue was significantly correlated with hemoglobin (r = -0.49), physical activity (r = 0.81), and physical functioning (r = -0.44). Large interindividual variations were found. The present study partially confirmed the hypothesized vicious circle between fatigue, physical inactivity, and deconditioning. Further research with larger samples and longer follow-up is needed to identify factors associated with individual variation in the evolution of fatigue, physical activity, and physical fitness.
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Affiliation(s)
- Nele Vermaete
- Department of Rehabilitation Sciences, Faculty of Rehabilitation Sciences, KU Leuven, 3001, Leuven, Belgium
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40
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Smith C, Hale L. The effects of non-pharmacological interventions on fatigue in four chronic illness conditions: a critical review. PHYSICAL THERAPY REVIEWS 2013. [DOI: 10.1179/108331907x223056] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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41
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Straus DJ. Long-term survivorship at a price: late-term, therapy-associated toxicities in the adult hodgkin lymphoma patient. Ther Adv Hematol 2013; 2:111-9. [PMID: 23556081 DOI: 10.1177/2040620711402414] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
There have been an increasing number of survivors of successful treatment of Hodgkin lymphoma (HL) over the past 30 years. Although these survivors may be cured of their HL, long-term morbidity and mortality are associated with late toxicities of treatment. Identification of these late complications will lead to strategies to manage them when they occur and hopefully to decrease the risk of their development. Second malignancies followed by cardiovascular disease are the leading causes of late morbidity and mortality. Musculoskeletal difficulties, endocrine abnormalities including sterility and thyroid disease, heart and lung damage, persistent fatigue and psychosocial distress have also been seen. The subjects of this review are the late complications of primary treatment of HL and autologous stem cell transplantation, usually for relapsed disease.
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Moonsammy SH, Guglietti CL, Santa Mina D, Ferguson S, Kuk JL, Urowitz S, Wiljer D, Ritvo P. A pilot study of an exercise & cognitive behavioral therapy intervention for epithelial ovarian cancer patients. J Ovarian Res 2013; 6:21. [PMID: 23557323 PMCID: PMC3623735 DOI: 10.1186/1757-2215-6-21] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Accepted: 03/24/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Ovarian cancer has the highest mortality rate of all gynaecologic cancers. Faced with poor prognoses, stressful treatment effects and a high likelihood of recurrence, survivors must confront significant physical and psychological morbidities that negatively impact health-related quality of life. Frequently reported side effects include cancer-related fatigue, peripheral neuropathy, and psychological distress. Exercise and cognitive behavioral therapy interventions have counteracted such adverse effects in other cancer populations. OBJECTIVE To investigate the feasibility and benefits of a 24-week home-based exercise intervention, coordinated with 12 weeks of cognitive behavioral therapy (two sessions per month), developed for two types of patients diagnosed with epithelial ovarian cancer: 1) those undergoing primary treatment with adjuvant chemotherapy after primary surgery; 2) those on surveillance after completing treatment within the last 2 years. METHODS Participants were recruited from the Gynaecologic Oncology Clinic. Eligible participants completed baseline assessments and were provided with home-based exercise equipment. Cognitive behavioral therapy was provided every other week for patients via telephone. Assessments were completed at baseline (T1), 3 months (T2) and 6 months (T3). RESULTS 19 of the 46 eligible patients approached were enrolled, with 7 patients in the treatment group and 12 in the surveillance group. There was a significant within group increase in peak VO2 from baseline to 6 months: F(2,16) = 5.531, p = 0.015, partial η2 = 0.409. CONCLUSION The combined 6-month exercise-cognitive behavioral therapy intervention was associated with significant increases in aerobic fitness in epithelial ovarian cancer patients assessed. These improvements were similar regardless of whether the patient was receiving chemotherapy or under surveillance.
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Affiliation(s)
- Shalini H Moonsammy
- School of Kinesiology and Health Science, York University, 4700 Keele Street, Toronto, Ontario, M3J 1P3, Canada.
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Björneklett HG, Rosenblad A, Lindemalm C, Ojutkangas ML, Letocha H, Strang P, Bergkvist L. Long-term follow-up of a randomized study of support group intervention in women with primary breast cancer. J Psychosom Res 2013; 74:346-53. [PMID: 23497838 DOI: 10.1016/j.jpsychores.2012.11.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2012] [Revised: 11/05/2012] [Accepted: 11/06/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND Despite a fairly good prognosis, many breast-cancer patients suffer from symptoms such as anxiety, depression and fatigue, which may affect health-related quality of life and may persist for several years. The aim of the present study was to perform a long-term follow-up of a randomized study of support group intervention in women after primary breast cancer treatment. MATERIALS AND METHODS Three hundred and eighty two women with primary breast cancer were randomized to support group intervention or control group, 181 in each group. Women in the intervention group participated in 1 week of intervention followed by 4 days of follow-up 2 months later. This is a long-term follow-up undertaken, in average, 6.5 years after randomization. Patients answered the questionnaires the European Organisation for Research and Treatment of Cancer, quality of life questionnaire (EORTC QLQ-C30) and the breast cancer module questionnaire (BR 23), the hospital anxiety and depression scale (HAD) and the Norwegian version of the fatigue scale (FQ). RESULTS After adjusting for treatment with chemotherapy, age, marriage, education and children at home, there was a significant improvement in physical, mental and total fatigue (FQ), cognitive function, body image and future perspective (EORTC QLQ C30 and BR23) in the intervention group compared with controls. The proportion of women affected by high anxiety and depression scores were not significantly different between the groups. CONCLUSION Support intervention significantly improved cognitive function, body image, future perspective and fatigue, compared with to the findings in the control group.
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Physical activity, physical fitness and the effect of exercise training interventions in lymphoma patients: a systematic review. Ann Hematol 2013; 92:1007-21. [DOI: 10.1007/s00277-013-1689-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2012] [Accepted: 01/24/2013] [Indexed: 11/24/2022]
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Abstract
BACKGROUND Cancer-related fatigue is recognised as an important symptom associated with cancer and its treatment. A number of studies have investigated the effects of physical activity in reducing cancer-related fatigue. This is an updated version of the original Cochrane review published in The Cochrane Library (2008, Issue 1). The original review identified some benefits of physical activity on fatigue in cancer both during and after adjuvant treatment. We identified a number of limitations in the evidence, providing clear justification for an updated review. OBJECTIVES To evaluate the effect of exercise on cancer-related fatigue both during and after cancer treatment. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (Issue 1, 2011), MEDLINE (1966 to March 2011), EMBASE (1980 to March 2011), CINAHL (1982 to March 2011), British Nursing Index (January 1984 to March 2011), AMED (1985 to March 2011), SIGLE (1980 to March 2011) and Dissertation Abstracts International (1861 to March 2011) using key words. We also searched reference lists off all studies identified for inclusion and relevant reviews. In addition, we handsearched relevant journals and contacted experts in the field of cancer-related fatigue. SELECTION CRITERIA We sought and included randomised controlled trials (RCTs) that investigated the effect of exercise on cancer-related fatigue in adults. DATA COLLECTION AND ANALYSIS Two review authors independently assessed the risk of bias of studies and extracted data based upon predefined criteria. Where data were available we performed meta-analyses for fatigue using a random-effects model. MAIN RESULTS For this update we identified a total of 56 studies (4068 participants) for inclusion (28 from the original search and 28 from the updated search), with the majority carried out in participants with breast cancer (28 studies). A meta-analysis of all fatigue data, incorporating 38 comparisons, provided data for 1461 participants who received an exercise intervention and 1187 control participants. At the end of the intervention period exercise was seen to be statistically more effective than the control intervention (standardised mean difference (SMD) -0.27, 95% confidence interval (CI) -0.37 to -0.17). Benefits of exercise on fatigue were observed for interventions delivered during or post-adjuvant cancer therapy. In relation to diagnosis, we identified benefits of exercise on fatigue for breast and prostate cancer but not for those with haematological malignancies. Finally, aerobic exercise significantly reduced fatigue but resistance training and alternative forms of exercise failed to reach significance. AUTHORS' CONCLUSIONS The findings of the updated review have enabled a more precise conclusion to be made in that aerobic exercise can be regarded as beneficial for individuals with cancer-related fatigue during and post-cancer therapy, specifically those with solid tumours. Further research is required to determine the optimal type, intensity and timing of an exercise intervention.
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Affiliation(s)
- Fiona Cramp
- Faculty of Health & Life Sciences, University of the West of England, Bristol, UK.
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Aapro M, Rüffer J, Fruehauf S. Haematological support, fatigue and elderly patients. J Geriatr Oncol 2012. [DOI: 10.1016/j.jgo.2012.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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A randomized controlled trial of a support group intervention on the quality of life and fatigue in women after primary treatment for early breast cancer. Support Care Cancer 2012; 20:3325-34. [DOI: 10.1007/s00520-012-1480-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2011] [Accepted: 04/22/2012] [Indexed: 11/12/2022]
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Davis ME, Stoiber AMM. Glioblastoma Multiforme: Enhancing Survival and Quality of Life. Clin J Oncol Nurs 2011; 15:291-7. [PMID: 21624864 DOI: 10.1188/11.cjon.291-297] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Mary Elizabeth Davis
- Department of Ambulatory Nursing, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
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Fatigue assessment and rehabilitation outcomes in patients with brain tumors. Support Care Cancer 2011; 20:805-12. [PMID: 21533813 DOI: 10.1007/s00520-011-1153-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2010] [Accepted: 03/28/2011] [Indexed: 10/18/2022]
Abstract
OBJECTIVES This study seeks to investigate the fatigue severity and the relationship among fatigue and other associated factors in patients with brain tumors, and to evaluate the rehabilitation outcome on fatigue. DESIGN We assessed 25 patients in whom brain tumors had been resected and transferred to the rehabilitation department of our hospital. Patients were evaluated for fatigue severity using the Piper Fatigue Scale (PFS) and the Brief Fatigue Inventory (BFI), for mood using the Beck Depression Inventory, for motor function using the Motricity Index (MI), for functional status using the Karnofsky Performance Status (KPS) scale and the Modified Barthel Index (MBI), and for quality-of-life using the European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire-Core 30 (EORTC QLQ-C30). We also measured the levels of serum hemoglobin, C-reactive protein, albumin, and creatine kinase; and anthropometric variables before and 4 weeks after rehabilitation. RESULTS Of the 25 patients, 21 (84.0%) reported fatigue during the previous week. The average PFS score was 4.6 ± 1.8 and the average BFI score 5.2 ± 2.2, indicating the moderate level of fatigue. Patients with recurrent tumors had significantly higher PFS scores than did those with initial tumors. Fatigue correlated significantly with the KPS, MBI, and EORTC QLQ-C30 physical functioning and insomnia scales. In addition, insomnia was a significant predictor of fatigue before rehabilitation, and the baseline fatigue scales, MBI, MI, and EORTC QLQ-C30 physical functioning scale were the important independent predictors of fatigue after rehabilitation. During rehabilitation, the KPS, MBI, and MI scores improved significantly, whereas total PFS and BFI scores did not change. CONCLUSIONS These findings suggest that patients with brain tumors commonly complain of moderate level of fatigue, which may reduce daily functioning and quality of life, with sleep disturbance being a significant predictor of fatigue. During rehabilitation, functional outcomes and motor power showed improvements in those patients, not aggravating fatigue.
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