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Sharma A. Palliative Care and Care Partner Support in Neuro-oncology. Continuum (Minneap Minn) 2023; 29:1872-1895. [PMID: 38085902 DOI: 10.1212/con.0000000000001353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
ABSTRACT The journey for a patient with a brain tumor and their loved ones can be extremely challenging due to the high burden of physical symptoms and the emotional distress caused by the diagnosis. Optimizing quality of life by addressing symptoms and reducing this emotional distress can improve treatment tolerance and outcomes and alleviate care partner distress and burden. Symptoms in patients with central nervous system (CNS) tumors can vary in onset and intensity, ranging from headaches, seizures, and focal weakness to emotional distress and cognitive dysfunction. Additionally, care partners may demonstrate distress due to the high burden of care and need appropriate support structures and access to resources to alleviate this stress. Evidence-based recommendations are unfortunately limited given the lack of high-quality research in this area, but patients living with CNS tumors and their loved ones can benefit from early and routine symptom identification and management, compassionate and transparent communication, and practical guidance for the future. These principles are part of palliative care, a field of medicine focused on alleviating suffering in patients with serious, chronic illness. Clinicians involved in the care of patients with CNS tumors must be educated in these important primary palliative care principles. This article focuses on key symptom management, strategies for high-quality communication, a discussion of advance care planning, and an overview of end-of-life care.
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Parkinson JF, Ospina PA, Round J, McNeely ML, Jones CA. Generic Health Utility Measures in Exercise Oncology: A Scoping Review and Future Directions. Curr Oncol 2023; 30:8888-8901. [PMID: 37887542 PMCID: PMC10605555 DOI: 10.3390/curroncol30100642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 09/11/2023] [Accepted: 09/23/2023] [Indexed: 10/28/2023] Open
Abstract
Despite the evidence that exercise is effective at mitigating common side effects in adults with cancer, it is rarely part of usual cancer care. One reason for this is the lack of economic evidence supporting the benefit of exercise. Economic evaluations often rely on the use of generic utility measures to assess cost effectiveness. This review identifies and synthesizes the literature on the use of generic utility measures used to evaluate exercise interventions for adults with cancer. A systematic search of the literature from January 2000 to February 2023 was conducted using four databases (Medline, EMBASE, CINAHL, Academic Search Complete). Exercise studies involving adults with any type of cancer that used a generic utility measure were eligible for inclusion. Of the 2780 citations retrieved, 10 articles were included in this review. Seven articles included economic evaluations, with varying results. Four studies reported on cost-effectiveness; however, detailed effectiveness data derived from the generic utility measure were often not reported. Generic utility measures help to compare baseline values of and changes in health utility weights across studies and to general population norms; however, to date, they are underutilized in exercise oncology studies. Consideration should be given to the identified research evidence, population, and methodological gaps.
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Affiliation(s)
- Joanna F. Parkinson
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2G4, Canada; (J.F.P.); (P.A.O.); (C.A.J.)
| | - Paula A. Ospina
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2G4, Canada; (J.F.P.); (P.A.O.); (C.A.J.)
| | - Jeff Round
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 1C9, Canada;
- Institute of Health Economics, Edmonton, AB T5J 3N4, Canada
| | - Margaret L. McNeely
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2G4, Canada; (J.F.P.); (P.A.O.); (C.A.J.)
- Department of Oncology, Cancer Care Alberta, Edmonton, AB T6G 1Z2, Canada
| | - C. Allyson Jones
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2G4, Canada; (J.F.P.); (P.A.O.); (C.A.J.)
- School of Public Health, University of Alberta, Edmonton, AB T6G 1C9, Canada
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Gu Z, Yang C, Tang L, Wu H. Interaction of anxiety and hypertension on quality of life among patients with gynecological cancer: a cross-sectional study. BMC Psychiatry 2023; 23:26. [PMID: 36631792 PMCID: PMC9832796 DOI: 10.1186/s12888-023-04521-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 01/04/2023] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Patients with gynecological cancer are prone to anxiety, and many of them are accompanied by hypertension, which seriously affects the quality of life (QOL). The study was to explore the interaction of anxiety and hypertension on QOL, and the moderating effect of perceived social support (PSS) in the impact of anxiety and hypertension on QOL of patients with gynecological cancer. METHODS A cross-sectional study was conducted in 2020, and 566 patients have been collected from the Affiliated Hospital of China Medical University. The Self-Rating Anxiety Scale (SAS), the Functional Assessment of Cancer Therapy Genera tool (FACT-G), and the Multidimensional Scale of Perceived Social Support Scale (MSPSS) were used. The interaction was analyzed by additive model, and the moderating effect was conducted by regression analysis and the simple slope analysis. RESULTS We found that 68.8% of patients had poor QOL due to the interaction between anxiety and hypertension. The relative excess risk ratio (RERI) was 22.238 (95%CI:44.119-88.596); the attribution ratio (AP) was 0.688 (95%CI:0.234-1.142); The interaction index (S) was 3.466 (95%CI: 0.823-14.435). The interaction items of PSS and anxiety were negatively correlated with QOL (β = -0.219, P < 0.01) and explained an additional 4.0% variance (F = 68.649, Adjusted R2 = 0.399, ΔR2 = 0.040, P < 0.01); PSS and blood pressure interaction item was not associated with QOL (β = 0.013, F = 55.138, Adjusted R2 = 0.365, ΔR2 = 0.001, P = 0.730). CONCLUSIONS When anxiety and hypertension coexist, the QOL was affected. PSS played a moderating role in the impact of anxiety on QOL. Healthcare providers should take intervention measures to improve patients' social support to reduce the impact of anxiety on QOL.
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Affiliation(s)
- ZhiHui Gu
- grid.412449.e0000 0000 9678 1884Department of Social Medicine, School of Health Management, China Medical University, Shenyang North New District, No. 77 Puhe Road, Shenyang, Liaoning 110122 People’s Republic of China
| | - ChenXin Yang
- grid.412449.e0000 0000 9678 1884Department of Social Medicine, School of Health Management, China Medical University, Shenyang North New District, No. 77 Puhe Road, Shenyang, Liaoning 110122 People’s Republic of China
| | - Lin Tang
- grid.412449.e0000 0000 9678 1884Department of Social Medicine, School of Health Management, China Medical University, Shenyang North New District, No. 77 Puhe Road, Shenyang, Liaoning 110122 People’s Republic of China
| | - Hui Wu
- Department of Social Medicine, School of Health Management, China Medical University, Shenyang North New District, No. 77 Puhe Road, Shenyang, Liaoning, 110122, People's Republic of China.
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4
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de Wiel HJV, Groen WG, Kampshoff CS, Buffart LM, van Mechelen W, Schep G, Sonke GS, Huijsmans R, van Harten WH, Aaronson NK, Stuiver MM. Construct Validity of the Steep Ramp Test for Assessing Cardiorespiratory Fitness in Patients With Breast Cancer and the Effect of Chemotherapy-Related Symptom Burden. Arch Phys Med Rehabil 2022; 103:2362-2367. [PMID: 35732249 DOI: 10.1016/j.apmr.2022.05.014] [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: 01/07/2022] [Revised: 04/20/2022] [Accepted: 05/10/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To investigate the construct validity of the Steep Ramp Test (SRT) by longitudinally comparing the correlation between maximum short exercise capacity of the SRT and direct measurements of peak oxygen consumption (Vo2peak) during or shortly after treatment in patients with breast cancer and the potential effect of chemotherapy-induced symptom burden. DESIGN Cross-sectional. SETTING Multicenter. PARTICIPANTS We used data from 2 studies that included women with breast cancer treated with chemotherapy, resulting in 274 observations. A total of 161 patients (N=161) performed the cardiopulmonary exercise test and the SRT in 2 test sessions on different time points around chemotherapy treatment. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Fatigue was assessed with the Multidimensional Fatigue Inventory, and nausea and vomiting and pain by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30. The longitudinal correlation between the maximum short exercise capacity and Vo2peak was investigated using a linear mixed model. Interaction terms were added to the model to investigate whether the correlation varied by symptom burden. RESULTS We found a statistically significant moderate correlation between Vo2peak and maximum short exercise capacity (0.61; 95% confidence interval, 0.51-0.70; P<.01) over time. This correlation was slightly attenuated (-0.07; 95% confidence interval, -0.13 to 0.00; P=.04) in patients with chemotherapy-related nausea and vomiting, indicating smaller correlations of Vo2peak with the maximum short exercise capacity with increasing symptom burden. Pain and fatigue did not significantly modify the correlation. CONCLUSIONS The SRT can only be used as a proxy for changes in aerobic capacity with great caution and with attention for the level of nausea and vomiting.
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Affiliation(s)
- Hester J Van de Wiel
- Division of Psychosocial Research and Epidemiology, the Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Wim G Groen
- Division of Psychosocial Research and Epidemiology, the Netherlands Cancer Institute, Amsterdam, the Netherlands
| | | | - Laurien M Buffart
- Department of Physiology, Radboudumc, Radboud Institute for Health Sciences, Nijmegen, the Netherlands; Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia
| | - Willem van Mechelen
- Department of Public and Occupational Health and Amsterdam Public Health Research Insitute, Amsterdam University Medical Centres, location VUmc, Amsterdam, the Netherlands; School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia; Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; School of Public Health, Physiotherapy and Population Sciences, University College Dublin, Dublin, Ireland
| | - Goof Schep
- Department of Sports Medicine, Máxima Medical Center, Veldhoven, The Netherlands
| | - Gabe S Sonke
- Department of Medical Oncology, the Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Rosalie Huijsmans
- Department of Rehabilitation Medicine, Amsterdam University Medical Centre, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Wim H van Harten
- Division of Psychosocial Research and Epidemiology, the Netherlands Cancer Institute, Amsterdam, the Netherlands; Rijnstate Hospital, Arnhem, the Netherlands; Department of Health Technology and Services Research, University of Twente, Enschede, the Netherlands
| | - Neil K Aaronson
- Division of Psychosocial Research and Epidemiology, the Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Martijn M Stuiver
- Division of Psychosocial Research and Epidemiology, the Netherlands Cancer Institute, Amsterdam, the Netherlands; Center for Quality of Life, the Netherlands Cancer Institute, Amsterdam, the Netherlands; Center of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands.
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Handford J, Chen M, Rai R, Moss CL, Enting D, Peat N, Karagiannis SN, Van Hemelrijck M, Russell B. Is There a Role for Exercise When Treating Patients with Cancer with Immune Checkpoint Inhibitors? A Scoping Review. Cancers (Basel) 2022; 14:cancers14205039. [PMID: 36291823 PMCID: PMC9599872 DOI: 10.3390/cancers14205039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/07/2022] [Accepted: 10/11/2022] [Indexed: 11/26/2022] Open
Abstract
The impact of using exercise as a non-pharmacological intervention in patients with cancer receiving immune checkpoint inhibitors (ICIs) is not well known. Our objective was to determine the extent of, and identify gaps within, available literature addressing the effect of exercise on (a) oncological outcomes and (b) quality of life (QoL) in patients with cancer receiving ICIs, and (c) the underlying biological mechanisms for such effects. We conducted searches across EMBASE, APA PsycInfo and Ovid MEDLINE(R). Studies were eligible if they addressed at least one aspect of the objective and were available in the English language. Results were synthesised using a narrative approach and subsequently discussed with multidisciplinary stakeholders. As of the final search on 5 April 2022, 11 eligible studies were identified, of which 8 were preclinical and 3 were clinical. Clinical studies only focused on QoL-related outcomes. When studies were grouped by whether they addressed oncological outcomes (n = 7), QoL (n = 5) or biological mechanisms (n = 7), they were found to be heterogeneous in methodology and findings. Additional evidence, particularly in the clinical setting, is required before robust recommendations about whether, and how, to include exercise alongside ICI treatment can be made.
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Affiliation(s)
- Jasmine Handford
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK
- Correspondence:
| | - Miaoqi Chen
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK
| | - Ridesh Rai
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK
| | - Charlotte L. Moss
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK
| | - Deborah Enting
- Guy’s and St Thomas’ NHS Foundation Trust, London SE1 9RT, UK
| | - Nicola Peat
- Guy’s and St Thomas’ NHS Foundation Trust, London SE1 9RT, UK
| | - Sophia N. Karagiannis
- St John’s Institute of Dermatology, School of Basic & Medical Biosciences, King’s College London, London SE1 9RT, UK
- Breast Cancer Now Research Unit, School of Cancer & Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK
| | - Mieke Van Hemelrijck
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK
| | - Beth Russell
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK
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Anandavadivelan P, Malberg K, Vikstrom K, Nielsen S, Holdar U, Johar A, Lagergren P. Home-based physical activity after treatment for esophageal cancer-A randomized controlled trial. Cancer Med 2022; 12:3477-3487. [PMID: 36812121 PMCID: PMC9939163 DOI: 10.1002/cam4.5131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 06/13/2022] [Accepted: 06/30/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The treatment of most esophageal cancer patients includes chemo(radio)therapy and extensive surgery, causing physical decline with loss of muscles. This trial aimed to test the hypothesis that a tailored home-based physical activity (PA) intervention improves muscle strength and mass in patients having undergone curative treatment for esophageal cancer. METHODS Patients operated for esophageal cancer 1 year earlier were included in a nationwide randomized controlled trial in Sweden in 2016-2020. The intervention group was randomized to a 12-week home-based exercise program, while the control group was encouraged to maintain routine daily PA. The primary outcomes were changes in maximal/average hand grip strength measured with hand grip dynamometer and lower extremity strength measured using 30-second chair stand test and muscle mass measured using a portable bio-impedance analysis monitor. Intention-to-treat analysis was used, and results were presented as mean differences (MDs) with 95% confidence intervals (CIs). RESULTS Among 161 randomized patients, 134 completed the study, 64 in the intervention group and 70 in the control group. Compared with the control group (MD 2.73; 95% CI 1.75-3.71), patients in the intervention group (MD 4.48; 95% CI 3.18-5.80) had statistically significantly (p = 0.03) improved lower extremity strength. No differences were seen for hand grip strength or muscle mass. CONCLUSION A home-based PA intervention 1 year after surgery for esophageal cancer improves lower extremity muscle strength.
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Affiliation(s)
- Poorna Anandavadivelan
- Surgical Care Science, Department of Molecular Medicine and SurgeryKarolinska InstitutetStockholmSweden
| | - Kalle Malberg
- Surgical Care Science, Department of Molecular Medicine and SurgeryKarolinska InstitutetStockholmSweden
| | - Karin Vikstrom
- Surgical Care Science, Department of Molecular Medicine and SurgeryKarolinska InstitutetStockholmSweden
| | - Sandra Nielsen
- Surgical Care Science, Department of Molecular Medicine and SurgeryKarolinska InstitutetStockholmSweden
| | - Ulrika Holdar
- Medical Unit Occupational Therapy and PhysiotherapyFunction Allied Health Professionals, Karolinska University HospitalStockholmSweden
| | - Asif Johar
- Surgical Care Science, Department of Molecular Medicine and SurgeryKarolinska InstitutetStockholmSweden
| | - Pernilla Lagergren
- Surgical Care Science, Department of Molecular Medicine and SurgeryKarolinska InstitutetStockholmSweden,Department of Surgery and CancerImperial College LondonLondonUK
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Omorou AY, Peiffert D, Rotonda C, Van Hoye A, Allado E, Hily O, Temperelli M, Chenuel B, Hornus-Dragne D, Poussel M. Adapted Fencing for Patients With Invasive Breast Cancer: The RIPOSTE Pilot Randomized Controlled Trial. Front Sports Act Living 2022; 4:786852. [PMID: 35425895 PMCID: PMC9002110 DOI: 10.3389/fspor.2022.786852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 03/08/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionEven if indications for mastectomy have been progressively reduced in loco-regional breast cancer (BC) treatment, the harmful effects of surgery are still numerous and can impact physical and psychological wellbeing of women. The RIPOSTE (Reconstruction, self-Image, Posture, Oncology, “Santé”-Health, Therapy, “Escrime”-Fencing) program aimed to propose adapted fencing to patients with BC. This study aims to investigate the effect and conditions of effectiveness of the RIPOSTE program.Methods and analysisThis is a prospective randomized controlled trial including 24 patients with invasive BC who have just undergone surgery. The study will be proposed to the patient and if interested, the patient will be referred to a sports physician for a medico-sportive evaluation. At the end the evaluation, if the patient meets the inclusion criteria, she will be randomly assigned to one of the 2 groups based on a 1:1 principle: Early RIPOSTE group (receive one fencing session per week for 3 months immediately after their inclusion), Delayed RIPOSTE group (receive one fencing session per week for 3 months but within the 3 months following their inclusion). Patients will be included for 6 months with 3 follow-up times (0, 3, and 6 months) by a sport physician. The primary outcome is the evolution of quality of life score. Secondary outcomes are disability score, fatigue, anxiety-depression, cost-effectiveness and process evaluation.Ethics and disseminationThe study protocol has been approved by a French ethics committee (CPP Sud Méditerranée IV, N°ID-RCB: 2020-A01916-33). Results will be submitted for publication, at scientific conferences and through press releases.Trial RegistrationNCT04627714.
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Affiliation(s)
- Abdou Y. Omorou
- Université de Lorraine, CHRU-Nancy, Inserm CIC-1433 Clinical Epidemiology, Nancy, France
- Université de Lorraine, Apemac, Nancy, France
- The French National Platform Quality of Life and Cancer, Nancy, France
| | - Didier Peiffert
- Université de Lorraine, Apemac, Nancy, France
- Lorraine Institute of Oncology, Department of Radiation Oncology, Vandoeuvre-Lès-Nancy, France
| | - Christine Rotonda
- Université de Lorraine, Apemac, Nancy, France
- Université de Lorraine, Centre Pierre Janet, Metz, France
| | | | - Edem Allado
- Université de Lorraine, CHRU-Nancy, University Centre of Sports Medicine and Adapted Physical Activity, Nancy, France
- Université de Lorraine, DevAH, Department of Physiology, Nancy, France
| | - Oriane Hily
- Université de Lorraine, CHRU-Nancy, University Centre of Sports Medicine and Adapted Physical Activity, Nancy, France
| | - Margaux Temperelli
- Université de Lorraine, CHRU-Nancy, University Centre of Sports Medicine and Adapted Physical Activity, Nancy, France
| | - Bruno Chenuel
- Université de Lorraine, CHRU-Nancy, University Centre of Sports Medicine and Adapted Physical Activity, Nancy, France
- Université de Lorraine, DevAH, Department of Physiology, Nancy, France
| | | | - Mathias Poussel
- Université de Lorraine, CHRU-Nancy, University Centre of Sports Medicine and Adapted Physical Activity, Nancy, France
- Université de Lorraine, DevAH, Department of Physiology, Nancy, France
- *Correspondence: Mathias Poussel
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Brickler M, Raskin A, Ryan TD. Current State of Pediatric Cardio-Oncology: A Review. CHILDREN 2022; 9:children9020127. [PMID: 35204848 PMCID: PMC8870613 DOI: 10.3390/children9020127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 11/23/2021] [Accepted: 11/30/2021] [Indexed: 01/03/2023]
Abstract
The landscape of pediatric oncology has dramatically changed over the course of the past several decades with five-year survival rates surpassing 80%. Anthracycline therapy has been the cornerstone of many chemotherapy regimens for pediatric patients since its introduction in the 1960s, and recent improved survival has been in large part due to advancements in chemotherapy, refinement of supportive care treatments, and development of novel therapeutics such as small molecule inhibitors, chimeric antigen receptor T-cell therapy, and immune checkpoint inhibitors. Unfortunately, many cancer-targeted therapies can lead to acute and chronic cardiovascular pathologies. The range of cardiotoxicity can vary but includes symptomatic or asymptotic heart failure, arrhythmias, coronary artery disease, valvar disease, pericardial disease, hypertension, and peripheral vascular disease. There is lack of data guiding primary prevention and treatment strategies in the pediatric population, which leads to substantial practice variability. Several important future research directions have been identified, including as they relate to cardiac disease, prevention strategies, management of cardiovascular risk factors, risk prediction, early detection, and the role of genetic susceptibility in development of cardiotoxicity. Continued collaborative research will be key in advancing the field. The ideal model for pediatric cardio-oncology is a proactive partnership between pediatric cardiologists and oncologists in order to better understand, treat, and ideally prevent cardiac disease in pediatric oncology patients.
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Affiliation(s)
| | | | - Thomas D. Ryan
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA;
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The Visual Attention and Psychological Responses from Older Customers to Wellness Service Pictures of Hotels. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031084. [PMID: 35162108 PMCID: PMC8834234 DOI: 10.3390/ijerph19031084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 01/02/2022] [Accepted: 01/10/2022] [Indexed: 12/04/2022]
Abstract
Understanding the visual attention and psychological responses of consumers to marketing pictures allows hotel managers to design more attractive advertisements. Therefore, the purposes of the present study were to use an eye-tracking analysis to explore whether there were different effects from tourist hotels’ wellness service pictures based on whether they had natural or built clues. The psychological responses with regard to perceived well-being and willingness to pay were also examined. Eighty-five older consumers were recruited. Their eye movement performance while observing marketing pictures with different visual clues and their subsequent psychological responses were measured. It was found that wellness service pictures with natural clues captured more visual attention and induced higher willingness-to-pay perceptions than those with built clues in these older consumers. The present results suggest that marketing pictures with natural clues may create positive visual responses in older customers and further enhance their purchase intention.
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10
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Tweed TTT, Sier MAT, Van Bodegraven AA, Van Nie NC, Sipers WMWH, Boerma EJG, Stoot JHMB. Feasibility and Efficiency of the BEFORE (Better Exercise and Food, Better Recovery) Prehabilitation Program. Nutrients 2021; 13:nu13103493. [PMID: 34684494 PMCID: PMC8538645 DOI: 10.3390/nu13103493] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 09/26/2021] [Accepted: 09/29/2021] [Indexed: 12/11/2022] Open
Abstract
Prehabilitation has been postulated as an effective preventive intervention to reduce postoperative complications, particularly for elderly patients with a relatively high risk of complications. To date, it remains to be determined whether prehabilitation increases physical capacity and reduces postoperative complications. The aim of this study was to assess the feasibility of a 4-week multimodal prehabilitation program consisting of a personalized, supervised training program and nutritional intervention with daily fresh protein-rich food for colorectal cancer patients aged over 64 years prior to surgery. The primary outcome was the feasibility of this prehabilitation program defined as ≥80% compliance with the exercise training program and nutritional intervention. The secondary outcomes were the organizational feasibility and acceptability of the prehabilitation program. A compliance rate of ≥80% to both the exercise and nutritional intervention was accomplished by 6 patients (66.7%). Attendance of ≥80% at all 12 training sessions was achieved by 7 patients (77.8%); all patients (100%) attended ≥80% of the available training sessions. Overall, compliance with the training was 91.7%. Six patients (66.7%) accomplished compliance of ≥80% with the nutritional program. The median protein intake was 1.2 (g/kg/d). No adverse events occurred. This multimodal prehabilitation program was feasible for the majority of patients.
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Affiliation(s)
- Thaís T. T. Tweed
- Department of Surgery, Zuyderland Medical Center, Dr. H van der Hoffplein 1, 6162BG Sittard-Geleen, The Netherlands; (M.A.T.S.); (N.C.V.N.); (E.-J.G.B.); (J.H.M.B.S.)
- Correspondence: ; Tel.: +31-6-47596097
| | - Misha A. T. Sier
- Department of Surgery, Zuyderland Medical Center, Dr. H van der Hoffplein 1, 6162BG Sittard-Geleen, The Netherlands; (M.A.T.S.); (N.C.V.N.); (E.-J.G.B.); (J.H.M.B.S.)
| | - Ad A. Van Bodegraven
- Department of Gastroenterology, Zuyderland Medical Center, Dr. H van der Hoffplein 1, 6162BG Sittard-Geleen, The Netherlands;
| | - Noémi C. Van Nie
- Department of Surgery, Zuyderland Medical Center, Dr. H van der Hoffplein 1, 6162BG Sittard-Geleen, The Netherlands; (M.A.T.S.); (N.C.V.N.); (E.-J.G.B.); (J.H.M.B.S.)
| | - Walther M. W. H. Sipers
- Department of Geriatric Medicine, Zuyderland Medical Center, Dr. H van der Hoffplein 1, 6162BG Sittard-Geleen, The Netherlands;
| | - Evert-Jan G. Boerma
- Department of Surgery, Zuyderland Medical Center, Dr. H van der Hoffplein 1, 6162BG Sittard-Geleen, The Netherlands; (M.A.T.S.); (N.C.V.N.); (E.-J.G.B.); (J.H.M.B.S.)
| | - Jan H. M. B. Stoot
- Department of Surgery, Zuyderland Medical Center, Dr. H van der Hoffplein 1, 6162BG Sittard-Geleen, The Netherlands; (M.A.T.S.); (N.C.V.N.); (E.-J.G.B.); (J.H.M.B.S.)
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11
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Preliminary Evidence on the Effects of Exercise on Tumor Biology: a Potential Guide for Prescribing Exercise. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2021. [DOI: 10.1007/s40141-021-00316-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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12
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Ellawindi MI, Shoman TH, Taher E, Gohar S, Shehata S. Effectiveness of Psychosocial Supportive Care Trial on Quality of Life among Breast Cancer Patients: An Interventional Study at the National Cancer Institute, Egypt. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Breast cancer (BC) patients suffer from many psychosocial problems due to their health condition and treatment side effects so they are in great need for psychosocial supportive care.
AIM: The aim of the study was to provide a comprehensive psych-social supportive health-care model for BC patients a step toward improving their quality of life (QOL).
PATIENTS AND METHODS: Random assignment was done for 185 patients with primary operated BC to a control or an intervention group. The researcher offered five daily successive psychosocial supportive care sessions for the patients in the intervention group. All patients were followed up for coping ability, mood and QOL 8 weeks after the intervention.
RESULTS: The intervention had statistically significant effects on psychological distress, depression, problem focused, and active emotional coping domain, while had not any statistically significant effects on avoidant emotional coping domain.
CONCLUSION: Psychosocial supportive developed health-care model decreased psychological distress, depression, and improved QOL among patients with primary BC.
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Kennedy MA, Bayes S, Newton RU, Zissiadis Y, Spry NA, Taaffe DR, Hart NH, Davis M, Eiszele A, Galvão DA. We have the program, what now? Development of an implementation plan to bridge the research-practice gap prevalent in exercise oncology. Int J Behav Nutr Phys Act 2020; 17:128. [PMID: 33036627 PMCID: PMC7545878 DOI: 10.1186/s12966-020-01032-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Accepted: 09/30/2020] [Indexed: 12/31/2022] Open
Abstract
Background Exercise has emerged as a promising therapy for people with cancer. Novel programs have been developed to translate research into practice; however, implementation barriers have limited their success in part because successful translation of exercise oncology research into practice requires context-specific implementation plans. The aim of this study was to employ the implementation mapping protocol to develop an implementation plan to support programming of a co-located exercise clinic and cancer treatment center. Methods The Implementation Mapping protocol, which consists of five specific iterative tasks, was used. A stakeholder advisory group advised throughout the process. Results A comprehensive needs assessment was used to identify the organization’s general manager as the program adopter; oncologists, center leaders, and various administrative staff as program implementers; and the operations manager as the program maintainer. Twenty performance objectives were identified. The theoretical domains framework was used to identify likely determinants of change, which informed the selection of eight individual implementation strategies across the individual and organizational levels. Finally, an evaluation plan was developed which will be used to measure the success of the implementation plan in the project’s next phase. Conclusion The Implementation Mapping protocol provided a roadmap to guide development of a comprehensive implementation plan that considered all ecological domains, was informed by theory, and demonstrated an extensive understanding of the implementation context. Strong research-practitioner partnerships and effective stakeholder engagement were critical to development of the plan.
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Affiliation(s)
- Mary A Kennedy
- Exercise Medicine Research Institute, Edith Cowan University, 270 Joondalup Drive, JOONDALUP, Perth, WA, 6027, Australia. .,School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia.
| | - Sara Bayes
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Fitzroy, VIC, Australia.,School of Nursing and Midwifery, Edith Cowan University, Perth, WA, Australia
| | - Robert U Newton
- Exercise Medicine Research Institute, Edith Cowan University, 270 Joondalup Drive, JOONDALUP, Perth, WA, 6027, Australia.,School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia.,School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, QLD, Australia
| | - Yvonne Zissiadis
- Exercise Medicine Research Institute, Edith Cowan University, 270 Joondalup Drive, JOONDALUP, Perth, WA, 6027, Australia.,GenesisCare, Perth, WA, Australia.,Faculty of Medicine, University of Western Australia, Perth, WA, Australia
| | - Nigel A Spry
- Exercise Medicine Research Institute, Edith Cowan University, 270 Joondalup Drive, JOONDALUP, Perth, WA, 6027, Australia.,School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia.,GenesisCare, Perth, WA, Australia.,Faculty of Medicine, University of Western Australia, Perth, WA, Australia
| | - Dennis R Taaffe
- Exercise Medicine Research Institute, Edith Cowan University, 270 Joondalup Drive, JOONDALUP, Perth, WA, 6027, Australia.,School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia.,School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, QLD, Australia
| | - Nicolas H Hart
- Exercise Medicine Research Institute, Edith Cowan University, 270 Joondalup Drive, JOONDALUP, Perth, WA, 6027, Australia.,School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia.,Institute for Health Research, University of Notre Dame Australia, Fremantle, WA, Australia.,Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, Brisbane, QLD, Australia
| | | | | | - Daniel A Galvão
- Exercise Medicine Research Institute, Edith Cowan University, 270 Joondalup Drive, JOONDALUP, Perth, WA, 6027, Australia.,School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
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Montaño-Rojas LS, Romero-Pérez EM, Medina-Pérez C, Reguera-García MM, de Paz JA. Resistance Training in Breast Cancer Survivors: A Systematic Review of Exercise Programs. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186511. [PMID: 32906761 PMCID: PMC7558202 DOI: 10.3390/ijerph17186511] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 08/29/2020] [Accepted: 09/02/2020] [Indexed: 11/16/2022]
Abstract
The aim of this study was to identify the characteristics of resistance training (RT) programs for breast cancer survivors (BCS). A systematic review of the literature was performed using PubMed, Medline, Science Direct, the Cochrane Breast Cancer Specialised Register of the Cochrane Library, the Physiotherapy Evidence Database (PEDro), and Scopus, with the aim of identifying all published studies on RT and BCS from 1 January 1990 to 6 December 2019, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The risk of bias in the studies was assessed using the revised Cochrane Risk of Bias tool (RoB 2.0). Sixteen trials were included for qualitative analysis. More than half of the trials do not adequately report the characteristics that make up the exercise program. The maximal strength was the most frequently monitored manifestation of strength, evaluated mainly as one-repetition maximum (1RM). Resistance training was performed on strength-training machines, twice a week, using a load between 50% and 80% of 1RM. The trials reported significant improvement in muscle strength, fatigue, pain, quality of life, and minor changes in aerobic capacity.
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Affiliation(s)
- Leidy Sofía Montaño-Rojas
- Escuela Normal Superior of Pitalito, 417037 Pitalito, Colombia
- Correspondence: (L.S.M.-R.); (E.M.R.-P.)
| | - Ena Monserrat Romero-Pérez
- Department of Sports Science and Physical Activity, University of Sonora, 83000 Hermosillo, Mexico
- Correspondence: (L.S.M.-R.); (E.M.R.-P.)
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Exercise Levels and Preferences in Cancer Patients: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17155351. [PMID: 32722265 PMCID: PMC7432474 DOI: 10.3390/ijerph17155351] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 07/20/2020] [Accepted: 07/22/2020] [Indexed: 12/22/2022]
Abstract
Background: Despite the benefits related to physical exercise, large numbers of cancer patients are not sufficiently active. Methods: To investigate exercise levels and preferences in cancer patients, a cross-sectional study was conducted on a random sample of 392 cancer outpatients who anonymously completed a questionnaire investigating general and medical characteristics, and expressed willingness to participate in exercise programs. Current exercise levels were estimated with the Leisure Score Index (LSI). Results: Most patients (93%) were insufficiently active but 80% declared an interest in exercise programs. Patients preferred oncologist-instructed programs and specified particular exercise needs. Multivariate logistic regression showed that willingness to exercise was associated with education (OR: 1.87; 95% CI: 1.15–3.04 beyond age 14 years vs. up to 14 years) and current physical activity (OR: 1.92; 95% CI: 1.92–3.63 for sweat-inducing activity >2 times/week vs. <1 time/week). Patients given chemotherapy were less inclined to exercise (OR: 0.45; 95% CI: 0.23–0.86) than those who did not. LSI was lower if cancer stage was advanced (β: -0.36; 95% CI: −0.75 to −0.02) than if it was in remission. High LSI was also associated with longer education, lower BMI, and longer time after diagnosis. Conclusion: Cancer patients are insufficiently active but are willing to participate in personalized exercise programs. Information from this survey may help in designing personalized interventions so these patients will achieve sufficient exercise.
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Schorn L, Lommen J, Sproll C, Krüskemper G, Handschel J, Nitschke J, Prokein B, Gellrich NC, Holtmann H. Evaluation of patient specific care needs during treatment for head and neck cancer. Oral Oncol 2020; 110:104898. [PMID: 32674039 DOI: 10.1016/j.oraloncology.2020.104898] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 06/19/2020] [Accepted: 07/04/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Tumorous diseases of the head and neck region annually occur in more than 550.000 cases worldwide. Little is known about patient specific care needs and potential relationships between non-fulfillment of those following therapeutic and especially surgical treatment of head and neck cancer (HNC). OBJECTIVES This study aimed to evaluate potential correlations between patient specific care needs, regarding physiological rehabilitation, family/social support, economic needs, and their impact on health-related quality of life (HRQoL). METHODS A total of 1359 patients were included in this retrospective analysis. Data derived from the exploratory international multicenter rehabilitation study of the German-Austrian-Swiss Cooperative Group on Tumors of the Maxillofacial Region (DÖSAK), including 43 oral and maxillofacial departments in Germany, Austria, and Switzerland using the Bochum patient questionnaire on rehabilitation and a questionnaire on tumor and treatment related data. RESULTS Results showed a significant correlation of a patient's social bonds and depression, coping with depression, and anxiety. Patients' needs for speech therapy, physiotherapy or respiratory training were hardly ever met and patients had to compensate for financial losses during hospitalization for acute treatment. CONCLUSION In conclusion, this study describes social, physical, and socio-economic care needs. A multidisciplinary approach managing cancer and treatment related side effects is necessary, as well as enhanced awareness of care needs of practitioners during early recovery after surgery.
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Affiliation(s)
- Lara Schorn
- Department of Oral-, Maxillo- and Plastic Facial Surgery, University Clinic Düsseldorf, Moorenstr. 5, 40225 Duesseldorf, Germany
| | - Julian Lommen
- Department of Oral-, Maxillo- and Plastic Facial Surgery, University Clinic Düsseldorf, Moorenstr. 5, 40225 Duesseldorf, Germany.
| | - Christoph Sproll
- Department of Oral-, Maxillo- and Plastic Facial Surgery, University Clinic Düsseldorf, Moorenstr. 5, 40225 Duesseldorf, Germany
| | - Gertrud Krüskemper
- Department of Medical Psychology, Ruhr University of Bochum, Universitätsstr. 150, Building MA 0/145, 44780 Bochum, Germany
| | - Jörg Handschel
- Department of Oral-, Maxillo- and Plastic Facial Surgery, Kaiserteich Medical Center, Reichstr. 59, 40217 Duesseldorf, Germany; Medical School, Heinrich-Heine-University, Universitätsstr. 1, 40225 Düsseldorf, Germany
| | - Julia Nitschke
- Department of Neurosurgery, University Clinic Düsseldorf, Moorenstr. 5, 40225 Duesseldorf, Germany
| | - Benjamin Prokein
- Department of Oral-, Maxillo- and Plastic Facial Surgery, University Medicine Rostock, Schillingallee 35, 18057 Rostock, Germany
| | - Nils-Claudius Gellrich
- Department for Oral-, Maxillo- and Plastic Facial Surgery, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Henrik Holtmann
- Department of Oral-, Maxillo- and Plastic Facial Surgery, Malteser Clinic St. Johannes, Johannisstraße 21, 47198 Duisburg, Germany
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Lu G, Zheng J, Zhang L. The effect of exercise on aromatase inhibitor-induced musculoskeletal symptoms in breast cancer survivors :a systematic review and meta-analysis. Support Care Cancer 2020; 28:1587-1596. [PMID: 31853701 PMCID: PMC7036069 DOI: 10.1007/s00520-019-05186-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 11/07/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Evidence is mixed regarding the effect of exercise programs on improving musculoskeletal symptoms and quality of life. Previous meta-analyses have not focused specifically on the musculoskeletal symptoms. Therefore, this meta-analysis aimed to evaluate the effect of exercise on these outcomes in breast cancer survivors taking aromatase inhibitors. METHODS PubMed, CINAHL, EMBASE, Web of Science, Wan Fang, CNKI, VIP, and CBM were searched for randomized control trials or quasi-experimental studies from the establishment of the database to May 2019. Studies comparing exercise programs with usual care among breast cancer survivors taking aromatase inhibitors were included. The primary outcome was the degree of musculoskeletal symptoms, as assessed by scores of pain, stiffness, and grip strength. The secondary outcome was the total quality of life score. RESULTS A total of 9 studies involving 743 participants were included. Exercise programs were more effective than usual care in improving musculoskeletal symptoms among breast cancer patients taking AIs. The subgroup scores of pain (SMD = -0.46, 95% CI -0.79 to -0.13, P = 0.006), stiffness (SMD = -0.40, 95% CI -0.71 to -0.08, P = 0.01), and grip strength (SMD = 0.43, 95% CI 0.16 to 0.71, P = 0.002) benefited from exercise interventions. Similar effects were found for the quality of life scores (SMD = 2.24, 95% CI 0.28 to 4.21, P = 0.03). CONCLUSIONS Results indicate that exercise relieves musculoskeletal symptoms and improves quality of life, which can be used to motivate patients to exercise actively under professional guidance. Due to a small sample size, further research is required to ensure the effectiveness of exercise on musculoskeletal symptoms and quality of life.
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Affiliation(s)
- Geling Lu
- Department of Urology, The First Hospital of China Medical University, Liaoning, China
| | - Jin Zheng
- Department of Urology, The First Hospital of China Medical University, Liaoning, China.
| | - Lei Zhang
- Department of Breast, The First Hospital of China Medical University, Liaoning, China
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Chen YJ, Li XX, Ma HK, Zhang X, Wang BW, Guo TT, Xiao Y, Bing ZT, Ge L, Yang KH, Han XM. Exercise Training for Improving Patient-Reported Outcomes in Patients With Advanced-Stage Cancer: A Systematic Review and Meta-Analysis. J Pain Symptom Manage 2020; 59:734-749.e10. [PMID: 31546002 DOI: 10.1016/j.jpainsymman.2019.09.010] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 09/12/2019] [Accepted: 09/12/2019] [Indexed: 12/16/2022]
Abstract
CONTEXT Patients with advanced-stage cancer often suffer many physical and psychological symptoms. Exercise has been shown to improve quality of life (QoL), decrease cancer-related symptoms, and maintain or improve functional status in cancer survivors or patients with early stage cancer. However, the effect of exercise on these outcomes in patients with advanced-stage cancer is unclear. OBJECTIVES This meta-analysis aimed to assess the effectiveness of exercise interventions for patients with advanced-stage cancer in improving cancer-related symptoms and functional status outcomes. METHODS We conducted a comprehensive literature search in PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and Web of Science from their inception to February 3, 2019, to include randomized controlled trials (RCTs) comparing exercise and usual care for improving outcomes in patients with advanced-stage cancer. Two reviewers independently screened the studies, extracted data of interest, and assessed the risk of bias of individual RCTs using the Cochrane Handbook, Version 5.1.0. RESULTS About 15 RCTs enrolling 1208 patients were included. Compared with usual care, exercise showed a significant improvement in QoL (standardized mean difference [SMD] 0.22; 95% CI 0.06-0.38; P = 0.009), fatigue (SMD -0.25; 95% CI -0.45 to -0.04; P = 0.02), insomnia (SMD -0.36; 95% CI -0.56 to -0.17; P = 0.0002), physical function (SMD 0.22; 95% CI 0.05-0.38; P = 0.009), social function (SMD 0.18; 95% CI 0.02-0.34; P = 0.03), and dyspnea reduction (SMD -0.18; 95% CI -0.34 to -0.01; P = 0.03). CONCLUSION Exercise serves as an effective intervention to improve QoL and alleviate fatigue, insomnia, dyspnea, and physical and social functions for patients with advanced-stage cancer.
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Affiliation(s)
- Ya-Jing Chen
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, Gansu, China; Evidence-Based Social Science Center, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Xiu-Xia Li
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, Gansu, China; Evidence-Based Social Science Center, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Hai-Kun Ma
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Xu Zhang
- General Department 2, Second Hospital, Lanzhou University, Lanzhou, Gansu, China
| | - Bang-Wei Wang
- The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, China
| | - Tao-Tao Guo
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Ya Xiao
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Zhi-Tong Bing
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China; Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, Gansu, China
| | - Long Ge
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, Gansu, China; Evidence-Based Social Science Center, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Ke-Hu Yang
- Evidence-Based Social Science Center, School of Public Health, Lanzhou University, Lanzhou, Gansu, China; Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China; Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, Gansu, China
| | - Xue-Mei Han
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, Gansu, China; Evidence-Based Social Science Center, School of Public Health, Lanzhou University, Lanzhou, Gansu, China.
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Gu ZH, Qiu T, Yang SH, Tian FQ, Wu H. A Study on the Psychological Factors Affecting the Quality of Life Among Ovarian Cancer Patients in China. Cancer Manag Res 2020; 12:905-912. [PMID: 32104072 PMCID: PMC7012214 DOI: 10.2147/cmar.s239975] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 01/22/2020] [Indexed: 01/07/2023] Open
Abstract
PURPOSE We aim to test whether resilience mediates the association of fear of progression (FoP) with quality of life (QoL) among ovarian cancer patients in China. METHODS We collected 230 questionnaires from the First Affiliated Hospital of China Medical University in Liaoning Province, and 209 completed the questionnaire survey. The survey instrument consisted of four questionnaires: a sociodemographic and clinical characteristics questionnaire, the Functional Assessment of Cancer Therapy general instrument, the Fear of Progression Questionnaire-Short Form and the Connor-Davidson Resilience Scale. Hierarchical regression analysis was used to examine the relationship among FoP, resilience, and QoL, including physical well-being, social well-being, emotional well-being, and functional well-being. We used asymptotic and resampling strategies to examine the indirect effect of resilience. RESULTS FoP was negatively associated with resilience (r=-0.543, P<0.01) and QoL (physical well-being: r=-0.537, P<0.01; social well-being: r=-0.426, P<0.01; emotional well-being: r=-0.487, P<0.01; functional well-being: r=-0.529, P<0.01). Resilience was positively related with QoL (physical well-being: r=0.449, P<0.01; social well-being: r=0.548, P<0.01; emotional well-being: r=0.430, P<0.01; functional well-being: r=0.655, P<0.01). Resilience partly mediated the association between FoP and physical well-being (a×b=-0.05, BCa 95% CI: -0.09, -0.02), social well-being (a×b=-0.21, BCa 95% CI: -0.29, -0.14), emotional well-being (a×b=-0.05, BCa 95% CI: -0.08, -0.02), and functional well-being (a×b=-0.24, BCa 95% CI: -0.32, -0.17). The proportion of the mediating effect accounted for by resilience were 22.57%, 57.22%, 26.02%, 53.42% for physical well-being, social well-being, emotional well-being and functional well-being, respectively. CONCLUSION The study showed that resilience could mediate the association between fear of progression and quality of life. It suggests that resilience might provide a potential target for intervention in quality of life with ovarian cancer.
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Affiliation(s)
- Zhi-Hui Gu
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, People’s Republic of China
| | - Tian Qiu
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, People’s Republic of China
| | - Shi-Han Yang
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, People’s Republic of China
| | - Fang-Qiong Tian
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, People’s Republic of China
| | - Hui Wu
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, People’s Republic of China
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Missel M, Borregaard B, Schoenau MN, Sommer MS. A sense of understanding and belonging when life is at stake—Operable lung cancer patients' lived experiences of participation in exercise. Eur J Cancer Care (Engl) 2019; 28:e13126. [DOI: 10.1111/ecc.13126] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 04/28/2019] [Accepted: 06/07/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Malene Missel
- Department of Cardiothoracic Surgery Copenhagen University Hospital Copenhagen Denmark
| | - Britt Borregaard
- Department of Cardiothoracic and Vascular Surgery Odense University Hospital Odense C Denmark
| | - Mai Nanna Schoenau
- Department of Cardiothoracic Surgery Copenhagen University Hospital Copenhagen Denmark
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Yen CJ, Hung CH, Kao CL, Tsai WM, Chan SH, Cheng HC, Jheng WT, Lu YJ, Tsai KL. Multimodal exercise ameliorates exercise responses and body composition in head and neck cancer patients receiving chemotherapy. Support Care Cancer 2019; 27:4687-4695. [DOI: 10.1007/s00520-019-04786-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 03/27/2019] [Indexed: 01/21/2023]
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23
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New insights into early recovery after robotic surgery for endometrial cancer. Gynecol Oncol 2019; 153:271-276. [PMID: 30808516 DOI: 10.1016/j.ygyno.2019.02.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 02/04/2019] [Accepted: 02/05/2019] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To assess early recovery of physical health after robotic minimally invasive surgery (RMIS) for early-stage endometrial cancer using the European Organisation of Research and Treatment of Cancer Computer Adaptive Test Core questionnaire (EORTC CAT Core). The EORTC CAT Core provides individualised measurements while maintaining comparability. A hypothesis of individual complete recovery to baseline within three post-surgical weeks was evaluated. METHODS Ninety-four women who underwent RMIS for early-stage endometrial cancer were included consecutively. The EORTC CAT Core was distributed before surgery and prospectively every week during the first post-operative month. Repeated measures models were fitted for each of the four domains (physical functioning, role function, fatigue, and pain) and tested for impact of age, ASA score, minor/major surgery, and the individual baseline scores (poorest, intermediate, best). RESULTS Women with the lowest physical functioning, lowest role function, highest fatigue level, and highest pain level at baseline all recovered within three weeks. Women with the highest physical functioning, highest role function, lowest level of fatigue, and lowest level of pain at baseline did not reach their individual baselines within the first post-operative month but had the most favourable domain-scores three weeks post-operatively. CONCLUSION The individual woman's physical health baseline score is predictive for her postoperative recovery following RMIS for early-stage endometrial cancer. Women with the best physical health had the best postoperative functions and lowest level of symptoms; however their recovery to baseline was prolonged. Computer adaptive testing may be a valuable tool for individualised pre-operative information and supportive care during surveillance.
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Moderate Exercise Improves Experimental Cancer Cachexia by Modulating the Redox Homeostasis. Cancers (Basel) 2019; 11:cancers11030285. [PMID: 30823492 PMCID: PMC6468783 DOI: 10.3390/cancers11030285] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Revised: 02/20/2019] [Accepted: 02/23/2019] [Indexed: 12/19/2022] Open
Abstract
Cachexia is a debilitating syndrome that complicates the management of cancer patients. Muscle wasting, one of the main features of cachexia, is associated with hyper-activation of protein degradative pathways and altered mitochondrial function that could both result from impaired redox homeostasis. This study aimed to investigate the contribution of oxidative stress to cancer-induced cachexia in the presence or in the absence of moderate exercise training. Mice bearing the colon C26 carcinoma, either sedentary or exercised, were used. The former showed muscle wasting and redox imbalance, with the activation of an antioxidant response and with upregulation of markers of proteasome-dependent protein degradation and autophagy. Moderate exercise was able to relieve muscle wasting and prevented the loss of muscle strength; such a pattern was associated with reduced levels of Reactive Oxygen Species (ROS), carbonylated proteins and markers of autophagy and with improved antioxidant capacity. The muscle of sedentary tumor hosts also showed increased levels of molecular markers of mitophagy and reduced mitochondrial mass. Conversely, exercise in the C26 hosts led to increased mitochondrial mass. In conclusion, moderate exercise could be an effective non-pharmacological approach to prevent muscle wasting in cancer patients, decreasing muscle protein catabolism and oxidative stress and preserving mitochondria.
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van Rooijen S, Carli F, Dalton S, Thomas G, Bojesen R, Le Guen M, Barizien N, Awasthi R, Minnella E, Beijer S, Martínez-Palli G, van Lieshout R, Gögenur I, Feo C, Johansen C, Scheede-Bergdahl C, Roumen R, Schep G, Slooter G. Multimodal prehabilitation in colorectal cancer patients to improve functional capacity and reduce postoperative complications: the first international randomized controlled trial for multimodal prehabilitation. BMC Cancer 2019; 19:98. [PMID: 30670009 PMCID: PMC6341758 DOI: 10.1186/s12885-018-5232-6] [Citation(s) in RCA: 161] [Impact Index Per Article: 32.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 12/19/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Colorectal cancer (CRC) is the second most prevalent type of cancer in the world. Surgery is the only curative option. However, postoperative complications occur in up to 50% of patients and are associated with higher morbidity and mortality rates, lower health related quality of life (HRQoL) and increased expenditure in health care. The number and severity of complications are closely related to preoperative functional capacity, nutritional state, psychological state, and smoking behavior. Traditional approaches have targeted the postoperative period for rehabilitation and lifestyle changes. However, recent evidence shows that the preoperative period might be the optimal moment for intervention. This study will determine the impact of multimodal prehabilitation on patients' functional capacity and postoperative complications. METHODS/DESIGN This international multicenter, prospective, randomized controlled trial will include 714 patients undergoing colorectal surgery for cancer. Patients will be allocated to the intervention group, which will receive 4 weeks of prehabilitation (group 1, prehab), or the control group, which will receive no prehabilitation (group 2, no prehab). Both groups will receive perioperative care in accordance with the enhanced recovery after surgery (ERAS) guidelines. The primary outcomes for measurement will be functional capacity (as assessed using the six-minute walk test (6MWT)) and postoperative status determined with the Comprehensive Complication Index (CCI). Secondary outcomes will include HRQoL, length of hospital stay (LOS) and a cost-effectiveness analysis. DISCUSSION Multimodal prehabilitation is expected to enhance patients' functional capacity and to reduce postoperative complications. It may therefore result in increased survival and improved HRQoL. This is the first international multicenter study investigating multimodal prehabilitation for patients undergoing colorectal surgery for cancer. TRIAL REGISTRATION Trial Registry: NTR5947 - date of registration: 1 August 2016.
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Affiliation(s)
- Stefanus van Rooijen
- Department of Surgical Oncology, Máxima Medical Center, Veldhoven, the Netherlands
| | - Francesco Carli
- Department of Anesthesiology, the Montréal General Hospital, McGill University, Montréal, Canada
| | - Susanne Dalton
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Gwendolyn Thomas
- Department of Surgical Oncology, Máxima Medical Center, Veldhoven, the Netherlands
| | - Rasmus Bojesen
- Department of Surgery, Center for Surgical Science, Zealand University Hospital, Køge, Denmark
| | - Morgan Le Guen
- Department of Anesthesiology, Foch Hôpital, Paris, France
| | | | - Rashami Awasthi
- Department of Anesthesiology, the Montréal General Hospital, McGill University, Montréal, Canada
| | - Enrico Minnella
- Department of Anesthesiology, the Montréal General Hospital, McGill University, Montréal, Canada
| | - Sandra Beijer
- Netherlands Comprehensive Cancer Organisation, Utrecht, the Netherlands
| | - Graciela Martínez-Palli
- Department of Anesthesiology, Hospital Clinic de Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
| | | | - Ismayil Gögenur
- Department of Surgery, Center for Surgical Science, Zealand University Hospital, Køge, Denmark
| | - Carlo Feo
- Department of Surgery, S. Anna University Hospital, Ferrara, Italy
| | - Christoffer Johansen
- Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Oncology, Finsen Center, Rigshospitalet, Copenhagen, Denmark
| | - Celena Scheede-Bergdahl
- Department of Surgery, Center for Surgical Science, Zealand University Hospital, Køge, Denmark
- Department of Kinesiology and Physical Education, McGill University, Montréal, Canada
| | - Rudi Roumen
- Department of Surgical Oncology, Máxima Medical Center, Veldhoven, the Netherlands
| | - Goof Schep
- Department of Sports Medicine, Máxima Medical Center, Veldhoven, the Netherlands
| | - Gerrit Slooter
- Department of Surgical Oncology, Máxima Medical Center, Veldhoven, the Netherlands
- Department of Surgery, Máxima Medical Center, P.O. Box 7777, Veldhoven, the Netherlands
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Levett DZH, Grimmett C. Psychological factors, prehabilitation and surgical outcomes: evidence and future directions. Anaesthesia 2019; 74 Suppl 1:36-42. [DOI: 10.1111/anae.14507] [Citation(s) in RCA: 89] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2018] [Indexed: 12/23/2022]
Affiliation(s)
- D. Z. H. Levett
- Anaesthesia and Critical Care Research Area; Southampton NIHR Biomedical Research Centre; University Hospital Southampton NHS Foundation Trust; Southampton UK
- Clinical and Experimental Sciences; Faculty of Medicine; University of Southampton; Southampton UK
| | - C. Grimmett
- School of Health Sciences; University of Southampton; Southampton UK
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Rafie C, Ning Y, Wang A, Gao X, Houlihan R. Impact of physical activity and sleep quality on quality of life of rural residents with and without a history of cancer: findings of the Day and Night Study. Cancer Manag Res 2018; 10:5525-5535. [PMID: 30519100 PMCID: PMC6234991 DOI: 10.2147/cmar.s160481] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Lifestyle behaviors may impact quality of life (QoL). The relative impact of physical activity and sleep quality on QoL of individuals with and without a history of cancer living in underserved rural communities requires further study to inform health care and public health initiatives. METHODS Individuals with and without a history of cancer were recruited from rural Virginia. We collected information on physical activity level (PAL), sleep quality (Pittsburgh Sleep Quality Index), and QoL (Short Form-36). Additional dimensions of physical activity and sleep were measured including ambient light exposure and sleep duration via Actiwatch2, and serum vitamin D and urine melatonin, which are markers of outdoor activity and sleep. RESULTS A total of 124 cancer survivors and 48 cancer-free individuals were enrolled in the study. Mean age was 59 years, with the majority being women (89%) and Caucasian (76%). Breast cancer was the most common cancer (72%), and mean time from diagnosis to the survey was 8.1 years. Survivors were significantly less active, more likely to be inactive, and had significantly worse sleep quality and physical and mental health relative to cancer-free individuals (P<0.05). Quality of sleep and average sleep time were associated with physical (r=-0.371, P<0.001; r=-0.327, P<0.000) and mental health (r=-0.442, P=<0.001; r=-0.265, P<0.004), as was PAL (r=0.181, P=0.019; r=0.288, P=0.003). Self-reported outdoor activity was associated with mental health (r=0.233, P=0.003) and vitamin D3 (r=0.193, P=0.015). No association was found between melatonin, sleep quality, and QoL. Sleep quality, cancer status, body mass index, and sleep time were predictive of physical health, while sleep quality, sleep time, and outdoor activity were predictive of mental health. CONCLUSION Quality of sleep is a significant predictor of mental and physical health, and important for cancer survivors who experience poorer QoL. Outdoor activity should be encouraged to improve mental health and vitamin D status, and interventions to improve sleep for those with poor sleep quality should be considered in cancer survivorship planning.
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Affiliation(s)
- Carlin Rafie
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA,
| | - Yi Ning
- GlaxoSmithKline Institute of Infectious Disease and Public Health, Beijing, China
| | | | - Xiang Gao
- Department of Nutritional Sciences, Pennsylvania State University, University Park, PA, USA
| | - Robert Houlihan
- Department of Nutritional Sciences, Pennsylvania State University, University Park, PA, USA
- UF Health Cancer Center, University of Florida, Gainesville, FL, USA
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Mehta LS, Watson KE, Barac A, Beckie TM, Bittner V, Cruz-Flores S, Dent S, Kondapalli L, Ky B, Okwuosa T, Piña IL, Volgman AS. Cardiovascular Disease and Breast Cancer: Where These Entities Intersect: A Scientific Statement From the American Heart Association. Circulation 2018; 137:e30-e66. [PMID: 29437116 DOI: 10.1161/cir.0000000000000556] [Citation(s) in RCA: 437] [Impact Index Per Article: 72.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Cardiovascular disease (CVD) remains the leading cause of mortality in women, yet many people perceive breast cancer to be the number one threat to women's health. CVD and breast cancer have several overlapping risk factors, such as obesity and smoking. Additionally, current breast cancer treatments can have a negative impact on cardiovascular health (eg, left ventricular dysfunction, accelerated CVD), and for women with pre-existing CVD, this might influence cancer treatment decisions by both the patient and the provider. Improvements in early detection and treatment of breast cancer have led to an increasing number of breast cancer survivors who are at risk of long-term cardiac complications from cancer treatments. For older women, CVD poses a greater mortality threat than breast cancer itself. This is the first scientific statement from the American Heart Association on CVD and breast cancer. This document will provide a comprehensive overview of the prevalence of these diseases, shared risk factors, the cardiotoxic effects of therapy, and the prevention and treatment of CVD in breast cancer patients.
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Influence of physical activity on the immune system in breast cancer patients during chemotherapy. J Cancer Res Clin Oncol 2018; 144:579-586. [PMID: 29305709 DOI: 10.1007/s00432-017-2573-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 12/27/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE Physical activity can impact the immune system in different ways, e.g. by alteration of the humoral and cellular immune response. Physical activity at medium intensity enhances numbers of cytotoxic T cells, NK cells and macrophages in healthy people. The aim of this study was to compare the effects of endurance and resistance training on the immune system in breast cancer patients during adjuvant chemotherapy. METHODS In a prospective, controlled and randomized intervention exploratory trial, 12-week supervised endurance or resistance training were compared with usual care twice a week. Endpoints were the absolute numbers of the immune cells such as CD3+ T lymphocytes including CD4+- and CD8+, αβ T cells, γδT cells, CD3-/CD16+/56+ NK cells and CD19+ B cells, before and after 12 weeks of treatment. Cell numbers were analyzed using fluorescence-activated cell sorting. RESULTS Despite different physical interventions in all groups immune cell count decreased in CD3 T cells including TCR αβ and CD4 T cells, NK cells and CD19 B cells 12 weeks after initiation of chemotherapy and start of the physical intervention program, while the reduction of γδ T cells and CD8 T cells is less prominent in the RT and UC group. CONCLUSION Chemotherapy led to a decrease in nearly all measured immune cells. In this study, physical intervention with endurance or resistance training did not suppress cellular immunity any further. Larger multicenter trials are needed to evaluate the exact impact of sports intervention on immune cell subpopulations.
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Peña R, Suman OE, Rosenberg M, Andersen CR, Herndon DN, Meyer WJ. One-Year Comparison of a Community-Based Exercise Program Versus a Day Hospital-Based Exercise Program on Quality of Life and Mental Health in Severely Burned Children. Arch Phys Med Rehabil 2017; 101:S26-S35. [PMID: 29183752 DOI: 10.1016/j.apmr.2017.10.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 10/16/2017] [Accepted: 10/22/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To compare the effects of long-term psychosocial functioning and mental health of a "day hospital"-based exercise program (DAYEX) versus a community-based exercise program (COMBEX). DESIGN A prospective design that consisted of 2 groups (DAYEX and COMBEX). SETTING A children's hospital specialized in burn care. PARTICIPANTS Patients (N=18; DAYEX [n=9], COMBEX [n=9]) were assessed at intensive care unit discharge and up to 1 year postburn. INTERVENTIONS The Child Health Questionnaires (CHQ-Child Form [CHQ-CF87] and CHQ-Parent Form [CHQ-PF28]) were used to assess changes in quality of life from discharge to 1 year postburn. MAIN OUTCOME MEASURES CHQ-PF28 and CHQ-CF87. RESULTS Demographic characteristics and total body surface area burned were similar in both groups. Length of hospital stay was significant in the COMBEX group. CHQ-CF87 and CHQ-PF28 documented significant improvements in both groups between discharge and 1 year. Significance was evident in Physical Functioning, Bodily Pain, Self-Esteem, Change in Health, and Family Activities. CHQ-CF87 showed improvement in Family Cohesion in COMBEX more than DAYEX. CHQ-PF28 showed improvement in Role/Social Limitations-Emotional, Bodily Pain, and Family Activities in COMBEX more than DAYEX. CONCLUSIONS The proposed COMBEX program is feasible and beneficial physically, psychosocially, and mentally. The results show some improvements in the COMBEX group in optimizing function and health in severely burned children. The COMBEX group performed at least as well as the DAYEX group. Larger-scale studies are needed to validate current findings.
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Affiliation(s)
- Raquel Peña
- Department of Psychology, University of Texas Medical Branch/Shriners Hospitals for Children, Galveston, TX.
| | - Oscar E Suman
- Department of Surgery, University of Texas Medical Branch/Shriners Hospitals for Children, Galveston, TX
| | - Marta Rosenberg
- Department of Psychology, University of Texas Medical Branch/Shriners Hospitals for Children, Galveston, TX
| | - Clark R Andersen
- Department of Surgery, University of Texas Medical Branch/Shriners Hospitals for Children, Galveston, TX
| | - David N Herndon
- Department of Surgery, University of Texas Medical Branch/Shriners Hospitals for Children, Galveston, TX
| | - Walter J Meyer
- Department of Psychology, University of Texas Medical Branch/Shriners Hospitals for Children, Galveston, TX
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Adamsen L, Andersen C, Lillelund C, Bloomquist K, Møller T. Rethinking exercise identity: a qualitative study of physically inactive cancer patients' transforming process while undergoing chemotherapy. BMJ Open 2017; 7:e016689. [PMID: 28838897 PMCID: PMC5629696 DOI: 10.1136/bmjopen-2017-016689] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To explore physically inactive breast and colon cancer patients' prediagnosis exercise history and attitudes to physical activity (PA) and experiences in initiating PA while undergoing adjuvant chemotherapy. DESIGN An explorative qualitative study guided the interpretive analysis of semistructured, open-ended interviews conducted at initiation of chemotherapy and after 12 weeks. The study was embedded in a pilot randomised controlled trial. SETTING Participants were recruited from the Oncological Department at a hospital in Copenhagen, Denmark. PARTICIPANTS 33 patients with cancer, median age 49 years: 25 patients with breast cancer and 8 with colon cancer, 72% with a low cardiac respiratory fitness level and the majority with a high level of education. Patients received adjuvant chemotherapy, oncologist's PA recommendation and exercise, cancer nurse specialist's counselling prior to allocation to PA interventions or waitlist control group. RESULTS Prediagnosis exercise had been excluded from patients' daily lives due to perceptions of exercise as boring, lack of discipline and stressful work conditions for both genders. Recommendations from oncologists and nurses inspired the patients to reconsider their attitudes and behaviour by accepting recruitment and participation in PA interventions during chemotherapy. Despite extensive side effects, most patients adhered to their PA commitment due to their perception of the bodily, emotional and social benefits and support of healthcare professionals, peers and family. CONCLUSION The patients' attitude towards exercise transformed from having no priority in patients' daily lives prediagnosis to being highly prioritised. This study identified four important phases in the exercise transformation process during the patients' treatment trajectory of relevance to clinicians in identifying, motivating and supporting physically inactive patients with cancer at long-term risk. Clinicians should address young, highly educated patients with cancer at onset of adjuvant chemotherapy due to their specific risk of a sedentary lifestyle resulting from being in stressful, ambitious careers. TRIAL REGISTRATION NUMBER Current Controlled Trials (ISRCTN24901641), Stage: Qualitative results.
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Affiliation(s)
- Lis Adamsen
- The University Hospitals Centre for Health Research, UCSF Copenhagen University Hospital Rigshospitalet, Department 9701, Copenhagen, Denmark
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Christina Andersen
- The University Hospitals Centre for Health Research, UCSF Copenhagen University Hospital Rigshospitalet, Department 9701, Copenhagen, Denmark
| | - Christian Lillelund
- The University Hospitals Centre for Health Research, UCSF Copenhagen University Hospital Rigshospitalet, Department 9701, Copenhagen, Denmark
| | - Kira Bloomquist
- The University Hospitals Centre for Health Research, UCSF Copenhagen University Hospital Rigshospitalet, Department 9701, Copenhagen, Denmark
| | - Tom Møller
- The University Hospitals Centre for Health Research, UCSF Copenhagen University Hospital Rigshospitalet, Department 9701, Copenhagen, Denmark
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Hilfiker R, Meichtry A, Eicher M, Nilsson Balfe L, Knols RH, Verra ML, Taeymans J. Exercise and other non-pharmaceutical interventions for cancer-related fatigue in patients during or after cancer treatment: a systematic review incorporating an indirect-comparisons meta-analysis. Br J Sports Med 2017; 52:651-658. [PMID: 28501804 PMCID: PMC5931245 DOI: 10.1136/bjsports-2016-096422] [Citation(s) in RCA: 182] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2017] [Indexed: 12/19/2022]
Abstract
Aim To assess the relative effects of different types of exercise and other non-pharmaceutical interventions on cancer-related fatigue (CRF) in patients during and after cancer treatment. Design Systematic review and indirect-comparisons meta-analysis. Data sources Articles were searched in PubMed, Cochrane CENTRAL and published meta-analyses. Eligibility criteria for selecting studies Randomised studies published up to January 2017 evaluating different types of exercise or other non-pharmaceutical interventions to reduce CRF in any cancer type during or after treatment. Study appraisal and synthesis Risk of bias assessment with PEDro criteria and random effects Bayesian network meta-analysis. Results We included 245 studies. Comparing the treatments with usual care during cancer treatment, relaxation exercise was the highest ranked intervention with a standardisedmean difference (SMD) of −0.77 (95% Credible Interval (CrI) −1.22 to −0.31), while massage (−0.78; −1.55 to −0.01), cognitive–behavioural therapy combined with physical activity (combined CBT, −0.72; −1.34 to −0.09), combined aerobic and resistance training (−0.67; −1.01 to −0.34), resistance training (−0.53; −1.02 to −0.03), aerobic (−0.53; −0.80 to −0.26) and yoga (−0.51; −1.01 to 0.00) all had moderate-to-large SMDs. After cancer treatment, yoga showed the highest effect (−0.68; −0.93 to −0.43). Combined aerobic and resistance training (−0.50; −0.66 to −0.34), combined CBT (−0.45; −0.70 to −0.21), Tai-Chi (−0.45; −0.84 to −0.06), CBT (−0.42; −0.58 to −0.25), resistance training (−0.35; −0.62 to −0.08) and aerobic (−0.33; −0.51 to −0.16) showed all small-to-moderate SMDs. Conclusions Patients can choose among different effective types of exercise and non-pharmaceutical interventions to reduce CRF.
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Affiliation(s)
- Roger Hilfiker
- School of Health Sciences, HES-SO Valais-Wallis, University of Applied Sciences and Arts Western Switzerland Valais, Leukerbad, Switzerland
| | - Andre Meichtry
- Institute of Physiotherapy, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Manuela Eicher
- School of Health Sciences, University of Applied Sciences and Arts Western Switzerland, Fribourg, Switzerland.,Institute of Higher Education and Research in Healthcare, Faculty of Biology and Medicine, University of Lausanne and Lausanne University Hospital, Lausanne, Switzerland
| | - Lina Nilsson Balfe
- School of Health Sciences, HES-SO Valais-Wallis, University of Applied Sciences and Arts Western Switzerland Valais, Leukerbad, Switzerland
| | - Ruud H Knols
- Directory of Research and Education, Physiotherapy Occupational Therapy Research, Center University Hospital Zurich, Zurich, Switzerland
| | - Martin L Verra
- Department of Physiotherapy, Inselspital, Bern University Hospital, Berne, Switzerland
| | - Jan Taeymans
- Bern University of Applied Sciences Health, Berne, Switzerland.,Faculty of Sports Sciences and Exercise Rehabilitation, Vrije Universiteit Brussel, Brussels, Belgium
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Armstrong TS, Shade MY, Breton G, Gilbert MR, Mahajan A, Scheurer ME, Vera E, Berger AM. Sleep-wake disturbance in patients with brain tumors. Neuro Oncol 2017; 19:323-335. [PMID: 27286798 PMCID: PMC5464298 DOI: 10.1093/neuonc/now119] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 05/04/2016] [Indexed: 02/07/2023] Open
Abstract
Sleep-wake disturbances are defined as perceived or actual alterations in sleep that result in impaired daytime functioning. Unlike other cancers, there is limited information about sleep-wake disturbances in adults with primary brain tumors throughout the illness trajectory. Sleep-wake disturbance is among the most severe and common symptoms reported by primary brain-tumor patients, particularly those undergoing radiation therapy. As with other cancers and neurologic illness, sleep-wake disturbance may also be clustered or related to other symptoms such as fatigue, depression, and cognitive impairment. There is increasing evidence for a genetic basis of normal sleep and sleep regulation in healthy adults. Specific mutations and single nucleotide variants have been reported to be associated with both fatigue and sleep-wake disorders, and both inflammation and alterations in circadian rhythms have been postulated to have a potential role. Guidelines for assessment and interventions have been developed, with cognitive behavioral therapy, exercise, and sleep hygiene demonstrating benefit in patients with other solid tumors. Further research is needed to identify risk and appropriate treatment in the brain-tumor patient population.
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Affiliation(s)
| | - Marcia Y Shade
- University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Ghislain Breton
- Department of Integrative Biology, UTHealth McGovern Medical School, Houston, Texas, USA
| | - Mark R Gilbert
- Neuro-Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, USA
| | - Anita Mahajan
- Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas, USA
| | | | - Elizabeth Vera
- University of Texas Health Science Center, Houston, Texas, USA
| | - Ann M Berger
- University of Nebraska Medical Center, Omaha, Nebraska, USA
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Brunet J, Burke S, Grocott MPW, West MA, Jack S. The effects of exercise on pain, fatigue, insomnia, and health perceptions in patients with operable advanced stage rectal cancer prior to surgery: a pilot trial. BMC Cancer 2017; 17:153. [PMID: 28228123 PMCID: PMC5322650 DOI: 10.1186/s12885-017-3130-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 02/09/2017] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Promoting quality of life (QoL) is a key priority in cancer care. We investigated the hypothesis that, in comparison to usual care, exercise post-neoadjuvant chemoradiation therapy/prior to surgical resection will reduce pain, fatigue, and insomnia, and will improve physical and mental health perceptions in patients with locally advanced stage rectal cancer. METHODS In this non-randomized controlled pilot trial, patients in the supervised exercise group (EG; M age = 64 years; 64% male) and in the control group (CG; M age = 72 years; 69% male) completed the European Organization for Research and Treatment of Cancer core Quality of Life questionnaire and the RAND 36-Item Health Survey three times: pre-neoadjuvant chemoradiation therapy (Time 1; n EC = 24; n CG = 11), post-neoadjuvant chemoradiation therapy/pre-exercise intervention (Time 2; n EC = 23; n CG = 10), and post-exercise intervention (Time 3; n EC = 22; n CG = 10). The 6-week exercise intervention was delivered in hospital and comprised of interval aerobic training. Patients trained in pairs three times per week for 30 to 40 min. Data were analyzed by Mann-Whitney tests and by Wilcoxon matched-pairs signed-rank tests. RESULTS No significant between-group differences in changes were found for any of the outcomes. In both groups, fatigue levels decreased and physical health perceptions increased from pre- to post-exercise intervention. Pain levels also decreased from pre- to post-exercise intervention, albeit not significantly. CONCLUSIONS The findings from this study can be used to guide a more definitive trial as they provide preliminary evidence regarding the potential effects of pre-operative exercise on self-reported pain, fatigue, insomnia, and health perceptions in patients with locally advanced rectal cancer. TRIAL REGISTRATION This study has been registered with clinicaltrials.gov (NCT01325909; March 29, 2011).
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Affiliation(s)
- Jennifer Brunet
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, 125 University Private, Montpetit Hall Room 339, Ottawa, ON, K1N 6N5, Canada. .,Institut de Recherche de l'Hôpital Montfort (IRHM), Hôpital Montfort, Ottawa, ON, Canada. .,Cancer Therapeutic Program, Ottawa Hospital Research Institute (OHRI), Ottawa, ON, Canada.
| | - Shaunna Burke
- Centre for Sport and Exercise Sciences, School of Biomedical Sciences, University of Leeds, Leeds, UK
| | - Michael P W Grocott
- Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Malcolm A West
- Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,Academic Unit of Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,Critical Care Research Area, Southampton NIHR Respiratory Biomedical Research Unit, Southampton, UK.,Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Sandy Jack
- Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,Critical Care Research Area, Southampton NIHR Respiratory Biomedical Research Unit, Southampton, UK.,Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK
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Steindorf K, Wiskemann J, Ulrich CM, Schmidt ME. Effects of exercise on sleep problems in breast cancer patients receiving radiotherapy: a randomized clinical trial. Breast Cancer Res Treat 2017; 162:489-499. [DOI: 10.1007/s10549-017-4141-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Accepted: 02/02/2017] [Indexed: 01/12/2023]
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36
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A comparison of the effects of medical Qigong and standard exercise therapy on symptoms and quality of life in patients with advanced cancer. Support Care Cancer 2017; 25:1749-1758. [PMID: 28102437 DOI: 10.1007/s00520-017-3579-x] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 01/09/2017] [Indexed: 02/05/2023]
Abstract
PURPOSE Patients with advanced cancer frequently experience anxiety, depression and poor quality of life (QOL), as well as physical symptoms such as fatigue and weakness. Physical exercise has potential to help control these symptoms but the optimal training prescription is still not clear. We performed a study comparing medical Qigong (QG) and standard endurance and strength training (SET) in patients with advanced stage non-small cell lung (NSCLC) and gastrointestinal (GI) cancers. METHODS A randomized, cross-over study was performed in patients with advanced NSCLC and GI cancers receiving or eligible for chemotherapy. Patients received supervised QG or SET twice-weekly for 6 weeks. Psychological functioning, QOL, symptoms and physical functioning were assessed before and after each intervention period. RESULTS Nineteen patients completed both interventions. Comparing interventions revealed no difference between QG and SET on change in anxiety or depression scores or QOL. However, SET treatment was better at improving perceived strength (P = 0.05) and walking distance (P = 0.02). The order in which interventions were performed had a significant impact on the improvement in certain symptoms (sleep quality, breathlessness, P < 0.05), QOL (P = 0.01) and walking distance (P = 0.008). In all cases, the beneficial effects of the exercise interventions were markedly reduced during the second interval. CONCLUSIONS QG and SET are equivalent in their impact on many aspects of psychological function in cancer patients. However, SET leads to greater improvements in exercise capacity and helps reduce some symptoms. The reduction in beneficial effect of SET on exercise function when offered as the second intervention is a new finding that warrants further study.
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Food Habits, Lifestyle Factors, and Risk of Prostate Cancer in Central Argentina: A Case Control Study Involving Self-Motivated Health Behavior Modifications after Diagnosis. Nutrients 2016; 8:nu8070419. [PMID: 27409631 PMCID: PMC4963895 DOI: 10.3390/nu8070419] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 06/28/2016] [Accepted: 07/04/2016] [Indexed: 02/06/2023] Open
Abstract
Cancer is the second most important non-communicable disease worldwide and disproportionately impacts low- to middle-income countries. Diet in combination with other lifestyle habits seems to modify the risk for some cancers but little is known about South Americans. Food habits of Argentinean men pre- and post-diagnosis of prostate cancer (n = 326) were assessed along with other lifestyle factors. We studied whether any of the behaviors and risk factors for prostate cancer were found in men with other cancers (n = 394), compared with control subjects (n = 629). Before diagnosis, both cases reported a greater mean consumption of meats and fats and lower intakes of fruits, green vegetables, cruciferous vegetables, legumes, nuts, seeds, and whole grains than the controls (all p < 0.001). After diagnosis, cases significantly reduced the intake of meats and fats, and reported other dietary modifications with increased consumption of fish, fruits (including red fruits in prostate cancer), cruciferous vegetables, legumes, nuts, and black tea (all p < 0.001). Additional lifestyle aspects significantly predominant in cases included a reduced quality of sleep, emotional stress, low physical activity, tobacco smoking, alcohol consumption, living in rural areas, and being exposed to environmental contaminants. Argentinian men were predisposed to modify their unhealthy dietary habits and other lifestyle factors after cancer diagnosis.
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Ungar N, Wiskemann J, Sieverding M. Physical Activity Enjoyment and Self-Efficacy As Predictors of Cancer Patients' Physical Activity Level. Front Psychol 2016; 7:898. [PMID: 27445882 PMCID: PMC4914598 DOI: 10.3389/fpsyg.2016.00898] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 05/31/2016] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Physical activity (PA) can support cancer patients during medical treatment by reducing side-effects and increasing quality of life. However, PA levels mostly decline after diagnosis. Which factors can explain if patients are able to remain or even increase their PA level? Self-efficacy is an important cognitive factor that has been linked to cancer patients' PA across many studies. In contrast, affective factors such as PA enjoyment have rarely been examined. We compare the influence of self-efficacy and PA enjoyment on cancer patients' PA levels after completion of an exercise or stress-management intervention. METHODS Outpatient cancer patients [N = 72; 54% female; M = 56 years, SD = 12.34; most with breast or colon cancer (34%, 15%)] were enrolled in the MOTIVACTION study, a 4-week intervention (1 h counseling followed by weekly phone calls), with pre-test (T1), post-test (T2), and a 10-week follow-up (T3). Participants were randomized to either an exercise intervention (emphasizing self-regulatory strategies for behavior change) or to a stress management intervention (coping and relaxation techniques). Sixty-seven patients remained in the study and completed the SQUASH assessment of PA, a measure of maintenance self-efficacy (7 items, Cronbach's α = 0.88) and PA enjoyment (2 items, Cronbach's α = 0.89). Regression analyses were calculated with PA level (at T2 and T3) as dependent variable and relative weight analyses were conducted. The study was registered at clinicalTrials.gov (unique identifier:NCT01576107; URL: https://clinicaltrials.gov/ct2/show/NCT01576107?term=motivaction&rank=1). RESULTS Baseline self-efficacy and change in PA enjoyment significantly predicted cancer patients' PA level at T2 adjusting for baseline PA and type of intervention. Relative weight (RW) analysis revealed that PA enjoyment (baseline and change together) explained 34.3% of the dependent variable, self-efficacy (baseline and change) explained 38.4%. At follow-up, self-efficacy was still a significant predictor of PA (RW = 74.6%), whereas PA enjoyment was no longer a relevant factor (RW = 5.2%). CONCLUSION The affective factor PA enjoyment was equally important as self-efficacy for predicting cancer patient' PA level directly after completion of the intervention. Reasons for the reduced relevance at follow-up and a broader range of affective factors should be analyzed in future studies on cancer patients' PA level.
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Affiliation(s)
- Nadine Ungar
- Institute of Psychology, Heidelberg UniversityHeidelberg, Germany
| | - Joachim Wiskemann
- Division of Medical Oncology, National Center for Tumor Diseases Heidelberg and University Clinic HeidelbergHeidelberg, Germany
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Activité physique et cancer : mise au point et revue de la littérature. Rev Med Interne 2016; 37:399-405. [DOI: 10.1016/j.revmed.2015.12.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 11/04/2015] [Accepted: 12/24/2015] [Indexed: 12/29/2022]
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Van Moll CCA, Schep G, Vreugdenhil A, Savelberg HHCM, Husson O. The effect of training during treatment with chemotherapy on muscle strength and endurance capacity: A systematic review. Acta Oncol 2016; 55:539-46. [PMID: 26755191 DOI: 10.3109/0284186x.2015.1127414] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background Treatment of cancer with chemotherapy decreases endurance capacity and muscle strength. Training during chemotherapy might prevent this. There are no clear guidelines concerning which type of training and which training dose are effective. This review aims to gain insight into the different training modalities during chemotherapy and the effects of such training to improve endurance capacity and muscle strength in order to obtain the knowledge to compose a future training program which trains cancer patients in the most effective way. Material and methods A systematic search of PubMed was carried out. In total, 809 studies of randomized controlled trials studying the effects of training during chemotherapy on endurance capacity and muscle strength were considered. Only 14 studies met all the inclusion criteria. The studies were assessed on methodological quality by using Cochrane criteria for randomized controlled trials. Results The quality of the studies was generally poor and the study populations varied considerably as the training programs were very heterogeneous. Variables of endurance capacity reported beneficial effects in 10 groups (59%). Increases due to training ranged from 8% to 31%. Endurance capacity decreased in nine of 13 control groups (69%), which ranged from 1% to 32%. Muscle strength improved significantly in 17 of 18 intervention groups (94%), ranging from 2% to 38%. Muscle strength also improved in 11 of 14 control groups (79%), but this increase was only minimal, ranging from 1.3% to 6.5%. Conclusions This review indicates that training during chemotherapy may help in preventing the decrease in muscle strength and endurance capacity. It is important to know which training intensity and duration is the most effective in training cancer patients, to provide a training program suitable for every cancer patient. Training should be based on good research and should be implemented into international guidelines and daily practice. More research is needed.
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Affiliation(s)
| | - Goof Schep
- Department of Sports Medicine, SportMáx, Máxima Medical Centre, Eindhoven and Veldhoven, The Netherlands
| | - Art Vreugdenhil
- Department of Internal Medicine, Máxima Medical Centre, Eindhoven and Veldhoven, The Netherlands
- Department of Medical Oncology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | | | - Olga Husson
- Department of Medical Psychology, Radboud University Medical Centre, Nijmegen, The Netherlands
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Giallauria F, Vitelli A, Maresca L, Santucci De Magistris M, Chiodini P, Mattiello A, Gentile M, Mancini M, Grieco A, Russo A, Lucci R, Torella G, Berrino F, Panico S, Vigorito C. Exercise training improves cardiopulmonary and endothelial function in women with breast cancer: findings from the Diana-5 dietary intervention study. Intern Emerg Med 2016; 11:183-9. [PMID: 26016834 DOI: 10.1007/s11739-015-1259-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Accepted: 05/12/2015] [Indexed: 12/18/2022]
Abstract
To investigate whether exercise training (ET) improves cardiopulmonary and endothelial function in women with breast cancer (BC). Fifty-one female patients (aged between 39 and 72 years) with a history of primary invasive BC within the previous 5 years and enrolled in the Mediterranean diet-based DIANA (diet and androgens)-5 Trial were subdivided into 2 groups: an ET group (n = 25) followed a formal ET program of moderate intensity (3 session/week on a bicycle at 60-70 % VO2peak for 3 months, followed by one session/week until 1-year follow-up), while a control group (n = 26) did not perform any formal ET. At baseline and at 1-year follow-up, all patients underwent cardiopulmonary exercise stress test (CPET) and measurements of vascular endothelial function by peripheral artery tonometry (Reactive Hyperemia Index, RHI). There were no significant differences between the groups in baseline anthropometrical, BC characteristics, and metabolic profile. No differences in baseline CPET and RHI parameters were found. Peak oxygen consumption (VO2peak) significantly increased in ET group (from 12.4 ± 2.9 to 14.3 ± 3.3 mL/kg/min, p < 0.001) compared to the control group (from 12.8 ± 2.5 to 12.6 ± 2.8 mL/kg/min, p = 0.55; p < 0.001 between groups). Compared to the control group (from 2.0 ± 0.4 to 1.9 ± 0.4, p = 0.62), the ET group showed a significant improvement of RHI after 1 year (from 2.1 ± 0.7 to 2.5 ± 0.8, p < 0.001). Changes in VO2peak were correlated with changes in RHI (ΔVO2peak vs. ΔRHI: r = 0.47, p = 0.017). In BC survivors, ET program improves cardiopulmonary functional capacity and vascular endothelial function after 12 months. Whether these changes may favorably modulate some of the pathophysiological mechanisms implied in cancer evolution should be investigated.
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Affiliation(s)
- Francesco Giallauria
- Division of Internal Medicine and Cardiac Rehabilitation, Department of Translational Medical Sciences, University of Naples "Federico II", Via S. Pansini 5, 80131, Naples, NA, Italy.
| | - Alessandra Vitelli
- Division of Internal Medicine and Cardiac Rehabilitation, Department of Translational Medical Sciences, University of Naples "Federico II", Via S. Pansini 5, 80131, Naples, NA, Italy
| | - Luigi Maresca
- Division of Internal Medicine and Cardiac Rehabilitation, Department of Translational Medical Sciences, University of Naples "Federico II", Via S. Pansini 5, 80131, Naples, NA, Italy
| | | | - Paolo Chiodini
- Medical Statistics Unit, Second University of Naples, Naples, Italy
| | - Amalia Mattiello
- Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy
| | - Marco Gentile
- Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy
| | - Maria Mancini
- Division of Internal Medicine and Cardiac Rehabilitation, Department of Translational Medical Sciences, University of Naples "Federico II", Via S. Pansini 5, 80131, Naples, NA, Italy
| | - Alessandra Grieco
- Division of Internal Medicine and Cardiac Rehabilitation, Department of Translational Medical Sciences, University of Naples "Federico II", Via S. Pansini 5, 80131, Naples, NA, Italy
| | - Angelo Russo
- Division of Internal Medicine and Cardiac Rehabilitation, Department of Translational Medical Sciences, University of Naples "Federico II", Via S. Pansini 5, 80131, Naples, NA, Italy
| | - Rosa Lucci
- Division of Internal Medicine and Cardiac Rehabilitation, Department of Translational Medical Sciences, University of Naples "Federico II", Via S. Pansini 5, 80131, Naples, NA, Italy
| | - Giorgio Torella
- Division of Internal Medicine and Cardiac Rehabilitation, Department of Translational Medical Sciences, University of Naples "Federico II", Via S. Pansini 5, 80131, Naples, NA, Italy
| | - Franco Berrino
- Department of Preventive and Predictive Medicine, National Cancer Institute, Milan, Italy
| | - Salvatore Panico
- Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy
| | - Carlo Vigorito
- Division of Internal Medicine and Cardiac Rehabilitation, Department of Translational Medical Sciences, University of Naples "Federico II", Via S. Pansini 5, 80131, Naples, NA, Italy
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Abstract
Optimal multidisciplinary care of the lung cancer patient at all stages should encompass integration of the key relevant medical specialties, including not only medical, surgical, and radiation oncology, but also pulmonology, interventional and diagnostic radiology, pathology, palliative care, and supportive services such as physical therapy, case management, smoking cessation, and nutrition. Multidisciplinary management starts at staging and tissue diagnosis with pathologic and molecular phenotyping, extends through selection of a treatment modality or modalities, management of treatment and cancer-related symptoms, and to survivorship and end-of-life care. Well-integrated multidisciplinary care may reduce treatment delays, improve cancer-specific outcomes, and enhance quality of life. We address key topics and areas of ongoing investigation in multidisciplinary decision making at each stage of the lung cancer treatment course for early-stage, locally advanced, and metastatic lung cancer patients.
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Affiliation(s)
- Megan E Daly
- Department of Radiation Oncology, University of California Davis Comprehensive Cancer Center, 4501 X Street, Sacramento, CA, 95817, USA.
| | - Jonathan W Riess
- Department of Internal Medicine, Division of Hematology/Oncology, University of California Davis Comprehensive Cancer Center, 4501 X Street, Sacramento, CA, 95817, USA.
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Gallotta MC, Emerenziani GP, Monteiro MD, Iasevoli L, Iazzoni S, Baldari C, Guidetti L. PSYCHOPHYSICAL BENEFITS OF ROCK-CLIMBING ACTIVITY. Percept Mot Skills 2015; 121:675-89. [PMID: 26654990 DOI: 10.2466/30.pms.121c26x9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The aim of the study was to compare the psychophysical effects of rock climbing with a supervised fitness training in adults. Thirty-three healthy participants (M age=32 yr., SD=7) participated in rock climbing or in fitness training. The participants' functional fitness, anxiety, and mood states were tested before and after 3 mo. of training. There was significant improvement of physical fitness in both groups after the intervention period. Anxiety significantly decreased after each single training session at the end of both courses. Differential effects in the rock-climbing group, as compared to the fitness group, emerged only on Vigor. Specifically, the rock-climbing group showed a decreasing trend in Vigor while the fitness group showed an increasing trend of Vigor after the intervention.
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Affiliation(s)
- Maria Chiara Gallotta
- 1 Department of Movement, Human and Health Sciences, University of Rome "Foro Italico," Rome
| | - Gian Pietro Emerenziani
- 1 Department of Movement, Human and Health Sciences, University of Rome "Foro Italico," Rome
| | - Maria Dolores Monteiro
- 2 Departamento de Desporto Exercício e Saúde, Universidade de Trás os Montes e Alto Douro, Vila Real, Portugal
| | - Luigi Iasevoli
- 1 Department of Movement, Human and Health Sciences, University of Rome "Foro Italico," Rome
| | - Sara Iazzoni
- 1 Department of Movement, Human and Health Sciences, University of Rome "Foro Italico," Rome
| | - Carlo Baldari
- 1 Department of Movement, Human and Health Sciences, University of Rome "Foro Italico," Rome
| | - Laura Guidetti
- 1 Department of Movement, Human and Health Sciences, University of Rome "Foro Italico," Rome
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Developing and implementing a complex Complementary and Alternative (CAM) nursing intervention for breast and gynecologic cancer patients undergoing chemotherapy—report from the CONGO (complementary nursing in gynecologic oncology) study. Support Care Cancer 2015; 24:2341-2350. [DOI: 10.1007/s00520-015-3038-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 11/23/2015] [Indexed: 02/07/2023]
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Zhao SG, Alexander NB, Djuric Z, Zhou J, Tao Y, Schipper M, Feng FY, Eisbruch A, Worden FP, Strath SJ, Jolly S. Maintaining physical activity during head and neck cancer treatment: Results of a pilot controlled trial. Head Neck 2015; 38 Suppl 1:E1086-96. [PMID: 26445898 DOI: 10.1002/hed.24162] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2015] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Concurrent chemoradiotherapy (concurrent CRT) to treat head and neck cancer is associated with significant reductions of weight, mobility, and quality of life (QOL). An intervention focusing on functional exercise may attenuate these losses. METHODS We allocated patients to a 14-week functional resistance and walking program designed to maintain physical activity during cancer treatment (MPACT group; n = 11), or to usual care (control group; n = 9). Outcomes were assessed at baseline, and 7 and 14 weeks. RESULTS Compared to controls, the MPACT participants had attenuated decline or improvement in several strength, mobility, physical activity, diet, and QOL endpoints. These trends were statistically significant (p < .05) in knee strength, mental health, head and neck QOL, and barriers to exercise. CONCLUSION In this pilot study of patients with head and neck cancer undergoing concurrent CRT, MPACT training was feasible and maintained or improved function and QOL, thereby providing the basis for larger future interventions with longer follow-up. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1086-E1096, 2016.
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Affiliation(s)
- Shuang G Zhao
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan
| | - Neil B Alexander
- Division of Geriatric and Palliative Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan.,Geriatrics Research, Education and Clinical Center, University of Michigan, Ann Arbor, Michigan
| | - Zora Djuric
- Department of Family Medicine, University of Michigan, Ann Arbor, Michigan
| | - Jessica Zhou
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan
| | - Yebin Tao
- Department of Biostatistics, University of Michigan, Ann Arbor, Michigan
| | - Matthew Schipper
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan.,Department of Biostatistics, University of Michigan, Ann Arbor, Michigan
| | - Felix Y Feng
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan
| | - Avraham Eisbruch
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan
| | - Francis P Worden
- Division of Hematology/Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
| | - Scott J Strath
- Department of Kinesiology, Center for Aging and Translational Research, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin
| | - Shruti Jolly
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan.,Department of Radiation Oncology, Veterans Affairs Ann Arbor Health Care System, Ann Arbor, Michigan
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Longitudinal study on the impact of physical activity on the symptoms of lung cancer survivors. Support Care Cancer 2015; 23:3545-53. [PMID: 25855040 DOI: 10.1007/s00520-015-2724-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Accepted: 03/29/2015] [Indexed: 11/12/2022]
Abstract
PURPOSE To examine the effect of physical activity on the physical and psychosocial symptoms of lung cancer survivors. METHODS A longitudinal design was used in this study. Participants were recruited from the chest and surgical departments of medical centers in Taiwan. The instruments used were the Godin Leisure-Time Exercise Questionnaire and the Taiwanese version of the M.D. Anderson Symptom Inventory. RESULTS In total, 185 survivors were followed up for 6 months (response rate 66%). Disturbed sleep was the most prevalent symptom in the participants. A generalized estimating equation (GEE) method was employed to analyze the relationships among intensity of physical activity, symptom severity, and symptom interference in the daily life of the participants. Regarding symptom severity, significant differences were observed in fatigue, drowsiness, and disturbed sleep between the participants who engaged in moderate physical activity and those who did not engage in any physical activity. Regarding symptom interference, the participants who engaged in light physical activity experienced a significantly lower level of symptom interference than did those with a sedentary lifestyle. CONCLUSION This is the first study to explore the role of physical activity in alleviating symptoms in lung cancer survivors by using the GEE method. The results suggest that physical activity plays an essential role in alleviating the physical and psychological symptoms of lung cancer survivors.
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Chiu HY, Huang HC, Chen PY, Hou WH, Tsai PS. Walking Improves Sleep in Individuals With Cancer: A Meta-Analysis of Randomized, Controlled Trials. Oncol Nurs Forum 2015; 42:E54-62. [DOI: 10.1188/15.onf.e54-e62] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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48
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Villaron C, Marqueste T, Eisinger F, Cappiello MA, Therme P, Cury F. Activité physique et cancer du sein métastatique : qualité de vie, fatigue et estime de soi — étude pilote. ONCOLOGIE 2015. [DOI: 10.1007/s10269-014-2474-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Missel M, Pedersen JH, Hendriksen C, Tewes M, Adamsen L. Exercise intervention for patients diagnosed with operable non-small cell lung cancer: a qualitative longitudinal feasibility study. Support Care Cancer 2015; 23:2311-8. [PMID: 25577502 DOI: 10.1007/s00520-014-2579-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Accepted: 12/18/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE The purpose was to explore operable lung cancer patient experiences with an exercise intervention from a longitudinal perspective according to patient motivation and patient perceived benefits and barriers of exercise. METHODS Nineteen patients enrolled in an exercise intervention 2 weeks post-surgery participated in qualitative interviews at three time points. A criteria sampling strategy was applied. Ricoeur's phenomenological hermeneutical philosophy inspired the analysis. RESULTS Patients initiated exercising median 15 days postoperative. Eight patients included in the interview study dropped out of the intervention due to side effects of chemotherapy (n = 3) and external circumstances (n = 5). The mean attendance rate for the eleven participants who completed the intervention was 82 %. No patients experienced severe adverse events. Motivation for participation included patients' expectations of physical benefits and the security of having professionals present. Patients experienced physical and emotional benefits and affirmed their social identity. Barriers were primarily related to side effects of chemotherapy. CONCLUSION The exercise intervention was undertaken safely by operable lung cancer patients initiated 2 weeks after surgery. The intervention put the patients on track to a healthier lifestyle regarding physical activity and smoking. The study indicates that exercise initiated early in the treatment trajectory is beneficial for operable lung cancer patients and especially for those who were physically active and motivated pre-illness and who did not experience side effect of treatment.
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Affiliation(s)
- Malene Missel
- Department of Thoracic Surgery, the Heart Centre, University Hospital of Copenhagen Rigshospitalet, Denmark, Blegdamsvej 9, 2100, Copenhagen, Denmark,
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50
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Steindorf K, Schmidt M, Klassen O, Ulrich C, Oelmann J, Habermann N, Beckhove P, Owen R, Debus J, Wiskemann J, Potthoff K. Randomized, controlled trial of resistance training in breast cancer patients receiving adjuvant radiotherapy: results on cancer-related fatigue and quality of life. Ann Oncol 2014; 25:2237-2243. [DOI: 10.1093/annonc/mdu374] [Citation(s) in RCA: 111] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
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