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Lavoie HA, Scotti KB, Christou DD, Jake-Schoffman DE. A look into the cancer continuum for the development of a physical activity intervention: qualitative investigation of the physical activity experiences and preferences of female cancer survivors. Support Care Cancer 2024; 32:759. [PMID: 39477901 DOI: 10.1007/s00520-024-08955-9] [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: 05/31/2024] [Accepted: 10/21/2024] [Indexed: 11/14/2024]
Abstract
PURPOSE Clinical guidelines recommend cancer survivors (i.e., people with a cancer diagnosis) engage in regular physical activity (PA) during and post treatment, yet most do not. Additionally, PA promotion for cancer survivors has primarily focused on post treatment, calling for an understanding of PA promotion during treatment. This study explores the PA experiences and preferences of both in-treatment and post-treatment breast and gynecologic cancer survivors (BGCS) to inform the design of a PA intervention. METHODS Semi-structured interviews were conducted with postmenopausal women aged ≥ 50 years, diagnosed with breast or gynecological cancer (stages 1-3), who were undergoing, or recently completed (12 to 24 months) chemotherapy and/or primary treatment. Interviews were audio-recorded and transcribed verbatim. Thematic analysis was used to explore themes. RESULTS Participants (N = 26; Mage: 63.9 years) had a breast (92.3%) and gynecologic (7.7%) cancer diagnosis and 46.2% (n = 12) were in treatment whereas 53.8% (n = 14) were post treatment. BGCS experienced several side effects of cancer treatment and both groups felt PA was an important goal. In-treatment BGCS focused on managing side effects (e.g., fatigue) and recognized energy fluctuated around treatments, making those periods less ideal for PA. In-treatment BGCS strongly endorsed a flexible, at-home intervention. Post-treatment BGCS emphasized recovery and relapse prevention, also favoring at-home, flexible interventions but showing greater interest towards support groups to aid with their recovery journey. Preferred activities included walking, dancing, and muscle-strengthening. CONCLUSION Findings highlight the unique challenges postmenopausal BGCS face in participating in PA, especially in-treatment, emphasizing the importance of a tailored PA intervention.
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Affiliation(s)
- Hannah A Lavoie
- Department of Health Education and Behavior, University of Florida, Gainesville, FL, USA
| | - Kellie B Scotti
- Department of Health Education and Behavior, University of Florida, Gainesville, FL, USA
| | - Demetra D Christou
- Department of Applied Physiology & Kinesiology, University of Florida, Gainesville, FL, USA
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Seke Etet PF, Vecchio L, Nwabo Kamdje AH, Mimche PN, Njamnshi AK, Adem A. Physiological and environmental factors affecting cancer risk and prognosis in obesity. Semin Cancer Biol 2023; 94:50-61. [PMID: 37301450 DOI: 10.1016/j.semcancer.2023.06.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 05/12/2023] [Accepted: 06/07/2023] [Indexed: 06/12/2023]
Abstract
Obesity results from a chronic excessive accumulation of adipose tissue due to a long-term imbalance between energy intake and expenditure. Available epidemiological and clinical data strongly support the links between obesity and certain cancers. Emerging clinical and experimental findings have improved our understanding of the roles of key players in obesity-associated carcinogenesis such as age, sex (menopause), genetic and epigenetic factors, gut microbiota and metabolic factors, body shape trajectory over life, dietary habits, and general lifestyle. It is now widely accepted that the cancer-obesity relationship depends on the site of cancer, the systemic inflammatory status, and micro environmental parameters such as levels of inflammation and oxidative stress in transforming tissues. We hereby review recent advances in our understanding of cancer risk and prognosis in obesity with respect to these players. We highlight how the lack of their consideration contributed to the controversy over the link between obesity and cancer in early epidemiological studies. Finally, the lessons and challenges of interventions for weight loss and better cancer prognosis, and the mechanisms of weight gain in survivors are also discussed.
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Affiliation(s)
- Paul F Seke Etet
- Department of Physiological Sciences and Biochemistry, Faculty of Medicine and Biomedical Sciences, University of Garoua, Cameroon; Basic and Translational Research Unit, Center for Sustainable Health and Development, Garoua, Cameroon; Brain Research Africa Initiative (BRAIN) &Neuroscience Laboratory, Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaoundé, Cameroon.
| | - Lorella Vecchio
- Basic and Translational Research Unit, Center for Sustainable Health and Development, Garoua, Cameroon; Brain Research Africa Initiative (BRAIN) &Neuroscience Laboratory, Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaoundé, Cameroon
| | - Armel H Nwabo Kamdje
- Department of Physiological Sciences and Biochemistry, Faculty of Medicine and Biomedical Sciences, University of Garoua, Cameroon
| | - Patrice N Mimche
- Division of Microbiology and Immunology, Department of Pathology, University of Utah School of Medicine, Salt Lake City, UT 84112, United States
| | - Alfred K Njamnshi
- Brain Research Africa Initiative (BRAIN) &Neuroscience Laboratory, Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaoundé, Cameroon
| | - Abdu Adem
- Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates.
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van Cappellen-van Maldegem SJ, Hoedjes M, de Boer MR, Nijman IL, van Valenberg HM, Seidell JC, van de Poll-Franse LV, Buffart LM, Mols F, de Rooij BH. Course of objectively measured physical activity and sleep in postmenopausal breast cancer survivors during the COVID-19 pandemic: A 1-year follow-up. Breast Dis 2023; 42:415-427. [PMID: 38143333 PMCID: PMC10836571 DOI: 10.3233/bd-230049] [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] [Indexed: 12/26/2023]
Abstract
BACKGROUND As physical inactivity and poor sleep quality may impose additional risk for cancer recurrence and overall mortality in postmenopausal breast cancer (PMBC) survivors, it is important to gain insight into the effect of the COVID-19 pandemic on their physical activity (PA) and sleep level. OBJECTIVE This study aimed to assess the course of their physical activity (PA) and sleep throughout governmental measures against COVID-19 during 12 months of the COVID-19 pandemic. METHODS PMBC survivors (n = 96) wore an ActiGraph wGT3X-BT for seven consecutive days at 12 and 18 months after diagnosis and additional measurements were taken after onset of the second (partial) COVID-19 lockdown. Longitudinal data was categorized into four timepoints: before onset of COVID-19 (T1), during the initial lockdown (T2), in between initial and second lockdown (T3), and during the second lockdown (T4). General linear mixed effects models assessed differences in moderate-to-vigorous physical activity (MVPA) per day, total minutes of PA per day, average acceleration, intensity gradient, sleep efficiency, and sleep duration over time. RESULTS Levels of MVPA per day before COVID-19 were low (Median = 20.9 min/day (IQR = 10.8;36.2)), and time spent physically active was most often in light intensity, which remained stable throughout the pandemic. Sleep duration (Median = 442.8 min/night (IQR = 418.3;478.0)) and efficiency (85.9% (IQR = 79.6;88.4)) was sufficient before COVID-19 and showed stability over time. CONCLUSIONS Low levels of PA with mostly light intensity, and adequate sleep efficiency and duration were observed before COVID in PMBC survivors. This was not further affected by COVID-19 governmental measures.
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Affiliation(s)
- Sandra J.M. van Cappellen-van Maldegem
- Department of Medical and Clinical Psychology, Center of Research on Psychological Disorders and Somatic Diseases, Tilburg University, Tilburg, The Netherlands
| | - Meeke Hoedjes
- Department of Medical and Clinical Psychology, Center of Research on Psychological Disorders and Somatic Diseases, Tilburg University, Tilburg, The Netherlands
| | - Michiel R. de Boer
- Department of Health Sciences and the Amsterdam Public Health Research Institute, VU University Amsterdam, Amsterdam, The Netherlands
- Department of General Practice and Elderly Care Medicine, UMCG, Groningen, The Netherlands
| | - Inge L. Nijman
- Department of Developmental Psychology, Tilburg University, Tilburg, The Netherlands
| | - Henrike M.W. van Valenberg
- Department of Medical and Clinical Psychology, Center of Research on Psychological Disorders and Somatic Diseases, Tilburg University, Tilburg, The Netherlands
- Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Eindhoven, The Netherlands
| | - Jacob C. Seidell
- Department of Health Sciences and the Amsterdam Public Health Research Institute, VU University Amsterdam, Amsterdam, The Netherlands
| | - Lonneke V. van de Poll-Franse
- Department of Medical and Clinical Psychology, Center of Research on Psychological Disorders and Somatic Diseases, Tilburg University, Tilburg, The Netherlands
- Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Eindhoven, The Netherlands
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Laurien M. Buffart
- Department of Physiology, Radboud Institute for Health Sciences, Radboudumc, Nijmegen, The Netherlands
| | - Floortje Mols
- Department of Medical and Clinical Psychology, Center of Research on Psychological Disorders and Somatic Diseases, Tilburg University, Tilburg, The Netherlands
- Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Eindhoven, The Netherlands
| | - Belle H. de Rooij
- Department of Medical and Clinical Psychology, Center of Research on Psychological Disorders and Somatic Diseases, Tilburg University, Tilburg, The Netherlands
- Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Eindhoven, The Netherlands
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Saxton JM, Pickering K, Wane S, Humphreys H, Crank H, Anderson AS, Cain H, Cohen J, Copeland RJ, Gray J, Hargreaves J, McNally RJQ, Wilson C. Co-designed weight management intervention for women recovering from oestrogen-receptor positive breast cancer. BMC Cancer 2022; 22:1202. [PMID: 36418985 PMCID: PMC9682743 DOI: 10.1186/s12885-022-10287-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 10/06/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Weight gain is commonly observed during and after breast cancer treatment and is associated with poorer survival outcomes, particularly in women with oestrogen receptor-positive (ER +) disease. The aim of this study was to co-design (with patients) a programme of tailored, personalised support (intervention), including high-quality support materials, to help female breast cancer patients (BCPs) with ER + disease to develop the skills and confidence needed for sustainable weight loss. METHODS: ER + BCPs were recruited from two UK National Health Service (NHS) Trusts. The selection criteria included (i) recent experience of breast cancer treatment (within 36 months of completing primary treatment); (ii) participation in a recent focus group study investigating weight management perceptions and experiences; (iii) willingness to share experiences and contribute to discussions on the support structures needed for sustainable dietary and physical activity behaviour change. Co-design workshops included presentations and interactive activities and were facilitated by an experienced co-design researcher (HH), assisted by other members of the research team (KP, SW and JS). RESULTS Two groups of BCPs from the North of England (N = 4) and South Yorkshire (N = 5) participated in a two-stage co-design process. The stage 1 and stage 2 co-design workshops were held two weeks apart and took place between Jan-March 2019, with each workshop being approximately 2 h in duration. Guided by the Behaviour Change Wheel, a theoretically-informed weight management intervention was developed on the basis of co-designed strategies to overcome physical and emotional barriers to dietary and physical activity behaviour change. BCPs were instrumental in designing all key features of the intervention, in terms of Capability (e.g., evidence-based information, peer-support and shared experiences), Opportunity (e.g., flexible approach to weight management based on core principles) and Motivation (e.g., appropriate use of goal-setting and high-quality resources, including motivational factsheets) for behaviour change. CONCLUSION This co-design approach enabled the development of a theoretically-informed intervention with a content, structure and delivery model that has the potential to address the weight management challenges faced by BCPs diagnosed with ER + disease. Future research is required to evaluate the effectiveness of the intervention for eliciting clinically-important and sustainable weight loss in this population.
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Affiliation(s)
- J M Saxton
- School of Sport, Exercise & Rehabilitation Sciences, Faculty of Health Sciences, University of Hull, Cottingham Road, Hull, HU6 7RX, UK.
| | - K Pickering
- Advanced Wellbeing Research Centre, Sheffield Hallam University, Olympic Legacy Park 2 Old Hall Rd, Sheffield, S9 3TU, UK
| | - S Wane
- Department of Sport, Exercise and Rehabilitation, Northumbria University, City Campus, Newcastle-Upon-Tyne, NE1 8ST, UK
| | - H Humphreys
- Academy of Sport and Physical Activity, Sheffield Hallam University, Sheffield, S10 2BP, UK
| | - H Crank
- Academy of Sport and Physical Activity, Sheffield Hallam University, Sheffield, S10 2BP, UK
| | - A S Anderson
- Division of Population Health and Genomics, Centre for Research Into Cancer Prevention and Screening, Ninewells Hospital and Medical School, University of Dundee, Dundee, DD1 9SY, UK
| | - H Cain
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Queen Victoria Road, Newcastle Upon Tyne, NE1 4LP, UK
| | - J Cohen
- York Medical School, Hull Heath Trials Unit, University of Hull, Cottingham Road, HullHull, HU6 7RX, UK
| | - R J Copeland
- Advanced Wellbeing Research Centre, Sheffield Hallam University, Olympic Legacy Park 2 Old Hall Rd, Sheffield, S9 3TU, UK
| | - J Gray
- Department of Nursing, Midwifery Are Health, Northumbria University, Coach Lane Campus, Newcastle Upon Tyne, NE7 7XA, UK
| | - J Hargreaves
- Carnegie School of Sport, Leeds Beckett University, 9 Fairfax Hall, Headingley Campus, Leeds, LS6 3QS, UK
| | - R J Q McNally
- Population Health Sciences Institute, Newcastle University GB, Newcastle Upon Tyne, NE1 7RU, UK
| | - C Wilson
- Department of Oncology and Metabolism, The Medical School, University of Sheffield, Beech Hill Road, Sheffield, S10 2RX, UK
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