1
|
Lin PJ, Altman BJ, Gilmore NJ, Loh KP, Dunne RF, Bautista J, Fung C, Janelsins MC, Peppone LJ, Melnik MK, Gococo KO, Messino MJ, Mustian KM. Effect of Yoga and Mediational Influence of Fatigue on Walking, Physical Activity, and Quality of Life Among Cancer Survivors. J Natl Compr Canc Netw 2023; 21:153-162.e2. [PMID: 36791754 PMCID: PMC9990873 DOI: 10.6004/jnccn.2022.7080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 09/27/2022] [Indexed: 02/17/2023]
Abstract
BACKGROUND Cancer-related fatigue (CRF) negatively affects survivors' walking, engagement in physical activity (PA), and quality of life (QoL). Yoga is an effective therapy for treating CRF; however, evidence from large clinical trials regarding how reducing CRF through yoga influences CRF's interference with survivors' walking, engagement in PA, and QoL is not available. We examined the effects of yoga and the mediational influence of CRF on CRF's interference with walking, PA, and QoL among cancer survivors in a multicenter phase III randomized controlled trial. PATIENTS AND METHODS Cancer survivors (n=410) with insomnia 2 to 24 months posttreatment were randomized to a 4-week yoga intervention-Yoga for Cancer Survivors (YOCAS)-or standard care. A symptom inventory was used to assess how much CRF interfered with survivors' walking, PA, and QoL. The Multidimensional Fatigue Symptom Inventory-Short Form was used to assess CRF. Two-tailed t tests and analyses of covariance were used to examine within-group and between-group differences. Path analysis was used to evaluate mediational relationships between CRF and changes in CRF's interference with walking, PA, and QoL among survivors. RESULTS Compared with standard care controls, YOCAS participants reported significant improvements in CRF's interference with walking, PA, and QoL at postintervention (all effect size = -0.33; all P≤.05). Improvements in CRF resulting from yoga accounted for significant proportions of the improvements in walking (44%), PA (53%), and QoL (45%; all P≤.05). CONCLUSIONS A significant proportion (44%-53%) of the YOCAS effect on CRF's interference with walking, PA, and QoL was due to improvements in CRF among cancer survivors. Yoga should be introduced and included as a treatment option for survivors experiencing fatigue. By reducing fatigue, survivors further improve their walking, engagement in PA, and QoL.
Collapse
Affiliation(s)
- Po-Ju Lin
- Department of Surgery, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York
| | - Brian J Altman
- Department of Biomedical Genetics, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York
| | - Nikesha J Gilmore
- Department of Surgery, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York
| | - Kah Poh Loh
- Department of Medicine, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York
| | - Richard F Dunne
- Department of Medicine, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York
| | - Javier Bautista
- Department of Mathematics, University of Rochester, Rochester, New York
| | - Chunkit Fung
- Department of Medicine, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York
| | - Michelle C Janelsins
- Department of Surgery, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York
| | - Luke J Peppone
- Department of Surgery, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York
| | - Marianne K Melnik
- Cancer Research Consortium of West Michigan NCORP, Grand Rapids, Michigan
| | - Kim O Gococo
- NCORP of the Carolinas (Greenville Health System), Greenville, South Carolina
| | - Michael J Messino
- Southeast Clinical Oncology Research Consortium NCORP, Winston Salem, North Carolina
| | - Karen M Mustian
- Department of Surgery, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York
| |
Collapse
|
2
|
Animaw L, Woldegiorgis Abate T, Endeshaw D, Tsegaye D. Fatigue and associated factors among adult cancer patients receiving cancer treatment at oncology unit in Amhara region, Ethiopia. PLoS One 2023; 18:e0279628. [PMID: 36607977 PMCID: PMC9821493 DOI: 10.1371/journal.pone.0279628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 12/12/2022] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION Fatigue is one of the most commonly and frequently reported symptoms by cancer patients. The cause of fatigue is multifactorial in origin, and its impact varies in range from affecting patients' daily social life, and physical, mental, economic, and social well-being to becoming a threat to their quality of life. Therefore every cancer patient needs to be screened for fatigue and considered as one of the vital signs. OBJECTIVE To assess the prevalence of fatigue and associated factors among adult cancer patients, receiving cancer treatment at the oncology unit in Amhara region, Ethiopia, 2022. METHOD Institutional-based, cross-sectional study was conducted among adult cancer patients receiving cancer treatment from May 9th-June 8th, 2022. A stratified random sampling technique was used to select study participants. Data were entered into Epi data version 4.6 and then exported to the SPSS statistical package version 23 for further analysis. Both bivariable and multivariable logistic regression analyses were carried out. P-values <0.05 in multivariable logistic regression were considered statistically significant. RESULTS The prevalence of cancer-related fatigue was 77.3% at 95% CI (73.1-81.1) with nonresponse rate of 1.97% (9). Poor social support (AOR = 3.62; 95% CI: 1.53-8.60), anxiety (AOR = 3.13; 95% CI: 1.54-6.36), physical inactivity (AOR = 3.67; 95% CI: 1.74-7.54), underweight (AOR = 2.03; 95% CI: 1.05-3.90), anemia (AOR = 2.01; 95% CI: 1.04-3.90), surgery as a treatment modality (AOR = 0.21; 95% CI: 0.06-0.78), combination therapy (AOR = 3.56; 95% CI: 1.68-7.54), treatment less than 3 cycle (AOR = 4.43; 95% CI: 1.53-12.80), and treatment 3-5 cycle (AOR = 3.55; 95% CI: 1.38-9.09) were significantly associated factors with cancer related fatigue. CONCLUSION Psychosocial assessment and intervention, nutritional support, early intervention of anemia, and promoting exercise are the key elements to minimizing fatigue among cancer patients.
Collapse
Affiliation(s)
- Lingerew Animaw
- Adult Health Nursing at Feres Bet primary hospital, Amhara, Ethiopia
| | - Teshager Woldegiorgis Abate
- Department of Adult Health Nursing, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Destaw Endeshaw
- Department of Adult Health Nursing, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Dejen Tsegaye
- Department of Nursing, Debre Markos University, College of Health Sciences, Debre Markos, Ethiopia
| |
Collapse
|
3
|
Rau KM, Shun SC, Hung SH, Chou HL, Ho CL, Chao TC, Liu CY, Lien CT, Hong MY, Wu CJ, Tsai LY, Jane SW, Hsieh RK. Management of cancer-related fatigue in Taiwan: an evidence-based consensus for screening, assessment and treatment. Jpn J Clin Oncol 2022; 53:46-56. [PMID: 36354095 PMCID: PMC9825724 DOI: 10.1093/jjco/hyac164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 10/08/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Cancer-related fatigue is one of the most common and persistent issues experienced by cancer patients. Cancer-related fatigue is a distinct form of fatigue that is subjective, long-lasting and unalleviated by rest or sleep. Studies have shown that almost all cancer patients experience severe fatigue that disrupts the quality of life and physical function, but cancer-related fatigue remains under-addressed in clinical care, and only about half of all patients receive treatment. METHODS To increase the awareness of cancer-related fatigue and improve current management, the Taiwan Society of Cancer Palliative Medicine and the Taiwan Oncology Nursing Society convened a consensus committee to develop recommendations for the screening, assessment and treatment of cancer-related fatigue. RESULTS Thirteen consensus recommendations were subsequently developed based on the best available evidence and the clinical experience of committee members. CONCLUSIONS These recommendations are expected to facilitate the standardization of cancer-related fatigue management across Taiwan and may also serve as a reference for other clinicians.
Collapse
Affiliation(s)
| | | | - Shih-Hsin Hung
- Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hsiu-Ling Chou
- Department of Nursing, Asia Eastern University of Science and Technology, New Taipei City, Taiwan,Department of Nursing, Far Eastern Memorial Hospital, New Taipei City, Taiwan,School of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ching-Liang Ho
- Division of Hematology and Oncology, Tri-Service General Hospital, Taipei, Taiwan,Division of Oncology, National Defense Medical Center, Taipei, Taiwan
| | - Ta-Chung Chao
- Department of Oncology and Comprehensive Breast Health Center, Taipei Veterans General Hospital, Taipei, Taiwan,Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chun-Yu Liu
- Division of Transfusion Medicine, Department of Medicine and Comprehensive Breast Health Center, Taipei Veterans General Hospital, Taipei, Taiwan,Division of Medical Oncology, Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan,School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ching-Ting Lien
- Department of Nursing, MacKay Memorial Hospital, Taipei, Taiwan
| | - Ming-Ying Hong
- Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan
| | - Ching-Jung Wu
- Department of Radiation Oncology, Cathay General Hospital, Taipei, Taiwan,Department of Radiation Oncology, National Defense Medical Center, Taipei, Taiwan,Department of Biomedical Engineering, I-Shou University, Kaohsiung, Taiwan
| | - Li-Yun Tsai
- College of Nursing, Central Taiwan University of Science and Technology, Taichung, Taiwan
| | - Sui-Whi Jane
- Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan,Graduate Institute of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Ruey-Kuen Hsieh
- For reprints and all correspondence: Ruey-Kuen Hsieh, Department of Hematology and Oncology, MacKay Memorial Hospital, Taipei, Taiwan. No. 92, Sec. 2, Zhongshan N. Rd., Taipei City 10449, Taiwan. E-mail:
| |
Collapse
|
4
|
Abstract
This study was conducted to evaluate the effect of yoga on pain levels in female students with primary dysmenorrhea. This study is a randomized experimental study with control group and pretest post-test practice. This study included 60 volunteer female students (30 experimental and 30 control groups). The patients in the experimental group took part in the yoga program a total of 12 sessions, once per week for 12 weeks. "Personal Information Form", "Visual Analog Skala (VAS)" and "Dysmenorrhea Monitoring Form (DMF)" were used in data collection process. To measure dysmenorrhea pain, the students were requested to mark a number between 1 and 10 on the VAS scale according to the severity of their pain on the menstruation starting date. The yoga applications were used for three menstrual cycles. The mean age of the students in the experimental group was 20.30 ± 0.46, while the mean age of the students in the control group was 20.46 ± 0.50. The difference between the pain levels of the students in the experimental group in the first, second, third and fourth measurements was found to be statistically significant (p < 0.001). It was determined that the difference between the pain levels of the students in the control group in the first, second, third and fourth measurements was not statistically significant (p > 0.05). Yoga can be used as an effective intervention in reducing menstrual pain in women with primary dysmenorrhea.
Collapse
Affiliation(s)
- Nurcan Kirca
- Faculty of Nursing, Department of Obstetrics & Gynecological Nursing, Akdeniz University, Antalya, Turkey
| | - AslıSis Celik
- Faculty of Nursing, Department of Obstetrics & Gynecological Nursing, Ataturk University, Erzurum, Turkey
| |
Collapse
|
5
|
Soones T, Ombres R, Escalante C. An update on cancer-related fatigue in older adults: A narrative review. J Geriatr Oncol 2021; 13:125-131. [PMID: 34353750 DOI: 10.1016/j.jgo.2021.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 07/17/2021] [Accepted: 07/26/2021] [Indexed: 12/17/2022]
Abstract
Up to 70% of older adults report fatigue after a cancer diagnosis. For many of these patients, cancer-related fatigue (CRF) persists for years after cancer treatment and is associated with significant disability. Despite this, little has been written on the diagnosis and management of CRF in older adults. To address this gap, we performed a narrative review of the literature on CRF in older adults and used literature from the general population when evidence was lacking to provide guidance to clinical providers on how to tailor care to this population. We recommend evidence-based options for evaluating CRF and address their limitations in the assessment of older adults. We also provide guidance and a treatment algorithm on evaluating CRF using the Comprehensive Geriatrics Assessment. Lastly, we present evidence for the use of non-pharmacologic and pharmacologic therapies in the management of CRF in older adults.
Collapse
Affiliation(s)
- Tacara Soones
- Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1465, Houston, TX 77030, USA.
| | - Rachel Ombres
- Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1465, Houston, TX 77030, USA.
| | - Carmen Escalante
- Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1465, Houston, TX 77030, USA.
| |
Collapse
|
6
|
Wilke E, Reindl W, Thomann PA, Ebert MP, Wuestenberg T, Thomann AK. Effects of yoga in inflammatory bowel diseases and on frequent IBD-associated extraintestinal symptoms like fatigue and depression. Complement Ther Clin Pract 2021; 45:101465. [PMID: 34388560 DOI: 10.1016/j.ctcp.2021.101465] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 06/24/2021] [Accepted: 07/28/2021] [Indexed: 12/22/2022]
Abstract
Quality of life (QoL) of persons with inflammatory bowel diseases (IBD) is often impaired by symptoms that do not primarily relate to intestinal inflammation. Among the most challenging extraintestinal symptoms are depression and fatigue, which are also frequent in other chronic diseases like multiple sclerosis, rheumatoid arthritis and cancer. Yoga as an ancient Indian tradition containing postures, breathing exercises and meditation may positively influence those symptoms. This review evaluates the current literature with regard to the effect of yoga-based interventions in persons with IBD and with regard to QoL, depression and fatigue in other somatic disorders. A systematic literature search yielded three trials examining the effects of yoga in patients with IBD and 37 trials addressing depressive syndromes or fatigue in somatic disorders. In summary, both in-person and video-based yoga classes are feasible, acceptable and safe as complementary treatment in patients with IBD and significantly improve anxiety and impaired quality of life. Current literature does not provide information on the effect of yoga on depression and fatigue in patients with IBD, but research from other somatic disorders or patients with depressive disorders implies the potential of yoga in this regard for persons with IBD. This should be specifically addressed in interventional trials with standardized yoga modules including patients with IBD suffering from fatigue, depression and/or impaired QoL.
Collapse
Affiliation(s)
- E Wilke
- Department of Medicine II, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany.
| | - W Reindl
- Department of Medicine II, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany
| | - P A Thomann
- Center for Mental Health, Odenwald District Healthcare Center, Erbach, Germany
| | - M P Ebert
- Department of Medicine II, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany
| | - T Wuestenberg
- Department of Medicine II, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany
| | - A K Thomann
- Department of Medicine II, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany
| |
Collapse
|
7
|
Uslu A, Canbolat O. Relationship Between Frailty and Fatigue in Older Cancer Patients. Semin Oncol Nurs 2021; 37:151179. [PMID: 34275706 DOI: 10.1016/j.soncn.2021.151179] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 06/11/2021] [Accepted: 06/16/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Older patients with cancer present many symptoms during treatment. One of those symptoms is fatigue, which may be caused by factors unrelated to cancer. One of those factors is frailty increased with age. Frailty and fatigue affect older patients with cancer physically, psychosocially, emotionally, and spiritually. This study investigated the relationship between frailty and fatigue in older patients with cancer. DATA SOURCES This descriptive study was conducted between July 15, 2019, and February 15, 2020, in the medical oncology polyclinic and the medical oncology outpatient treatment unit of a university hospital. The sample consisted of voluntary 288 patients who met inclusion criteria. Data were collected using a demographic questionnaire and the Edmonton Frail Scale (EFS), and the Cancer Fatigue Scale (CFS). CONCLUSION The mean age of participants was 71.71 ± 5.29 years. Participants had a mean EFS score of 6 ± 3.21. Of participants, 36.1% were not frail, while 20.1% were vulnerable, 19.1% moderately frail, 17.7% mildly frail, and 6.9% severely frail. Participants had a mean CFS score of 21.41 ± 12.25. There was a positive correlation between EFS and CFS scores (P = .000, r = 0.734). Of participants, 63.8% were frail with physical and cognitive fatigue. The higher the frailty, the higher the fatigue. IMPLICATIONS FOR NURSING PRACTICE Elderly patients with cancer appear to be fragile, with frailty causing fatigue and many other conditions. It is important to determine the frailty and fatigue of elderly patients with cancer. It is essential understand the relationship between the frailty and fatigue for effective and correct management of nursing care.
Collapse
Affiliation(s)
- Arzu Uslu
- Faculty of Nursing, Department of Internal Medicine Nursing, Necmettin Erbakan University, Konya, Turkey.
| | - Ozlem Canbolat
- Faculty of Health Science, Department of Internal Medicine Nursing, Gazi University, Ankara, Turkey
| |
Collapse
|
8
|
Okolo ON, Gowin K. Emerging Role of Integrative Medicine in Hematologic Malignancies: a Literature Review and Update on Current Trends in Complementary Medical Practices in Hematologic Cancers. Curr Hematol Malig Rep 2019; 14:328-36. [PMID: 31209644 DOI: 10.1007/s11899-019-00526-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE OF REVIEW This review discusses the emerging role of integrative hematology. It reinforces the growing interest of CAM among patients, and the importance of provider knowledge and participation in discussions with patients about the subject. The main question asked in this review, "Is there evidence for the use of integrative medicine practices in the field of malignant hematology?" is answered by examining current research and providing relevant summaries. RECENT FINDINGS Data suggests that practices such as meditative movement, exercise, nutrition and supplements and touch therapy can be used for symptom alleviation, preventive measures, and novel treatment development. Integrative hematology is a needed part of complete patient care, and it is the role of providers to be knowledgeable and open to ensure patients are engaging in practices that are evidence-informed and safe. More studies are needed in the field in order to make concrete and robust recommendations.
Collapse
|
9
|
Yashkin AP, Greenup RA, Gorbunova G, Akushevich I, Oeffinger KC, Hwang ES. Outcomes and Costs for Women After Breast Cancer: Preparing for Improved Survivorship of Medicare Beneficiaries. JCO Oncol Pract 2020; 17:e469-e478. [PMID: 32692618 DOI: 10.1200/op.20.00155] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Increasing health care costs, longer life expectancy, improved breast cancer (BC) survival, and higher levels of complex comorbidities have important implications for future Medicare expenditures. METHODS Data from the SEER program linked to Medicare claims records were used. Women with BC (cases) were categorized into 3 groups on the basis of their year of diagnosis (1998, 2003, or 2008) and were propensity score matched to women without a BC diagnosis (controls). All stage and stage-specific longitudinal changes in survival, morbidity levels using the Elixhauser index, and Medicare expenditures in 2018 dollars were calculated and compared. RESULTS More than 15% of BC cases were diagnosed in patients over the age of 85 years. The prevalence of most comorbidities increased over time. Costs among cases increased between 1998 and 2008. Spending directly correlated with the stage of disease at diagnosis, with the lowest per-patient costs in the ductal carcinoma in situ (DCIS) subgroup ($14,792 in 1998 and $19,652 in 2008) and the highest in those with distant cancer ($37,667 in 1998 and $43,675 in 2008). Assuming no significant changes in the distribution of BC stage or age at diagnosis, the total annual costs of caring for patients with BC in women 65 years of age or older at diagnosis increased by at least $1.1 billion between 1998 and 2008. CONCLUSION Improvements in BC survivorship are associated with intensive use of health care resources and substantially higher downstream costs among Medicare beneficiaries. Appropriate planning, in both the fiscal and the oncology care infrastructure, is required to prepare the health system for these emerging health care trends.
Collapse
Affiliation(s)
- Arseniy P Yashkin
- Biodemography of Aging Research Unit, Duke Population Research Center, Duke University, Durham, NC
| | - Rachel A Greenup
- Department of Surgery, Duke University, Durham, NC.,Duke Cancer Institute, Duke University, Durham, NC.,Department of Population Health Sciences, Duke University, Durham, NC
| | - Galina Gorbunova
- Biodemography of Aging Research Unit, Duke Population Research Center, Duke University, Durham, NC
| | - Igor Akushevich
- Biodemography of Aging Research Unit, Duke Population Research Center, Duke University, Durham, NC
| | - Kevin C Oeffinger
- Duke Cancer Institute, Duke University, Durham, NC.,Department of Population Health Sciences, Duke University, Durham, NC.,Department of Medicine, Duke University, Durham, NC
| | - E Shelley Hwang
- Department of Surgery, Duke University, Durham, NC.,Duke Cancer Institute, Duke University, Durham, NC
| |
Collapse
|
10
|
Fabi A, Bhargava R, Fatigoni S, Guglielmo M, Horneber M, Roila F, Weis J, Jordan K, Ripamonti CI. Cancer-related fatigue: ESMO Clinical Practice Guidelines for diagnosis and treatment. Ann Oncol 2020; 31:713-723. [PMID: 32173483 DOI: 10.1016/j.annonc.2020.02.016] [Citation(s) in RCA: 185] [Impact Index Per Article: 46.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 02/27/2020] [Indexed: 12/18/2022] Open
Affiliation(s)
- A Fabi
- Division of Medical Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - R Bhargava
- William Osler Health System, Corporate Department of Research, Department of Oncology and Division of Palliative Care, Brampton, Canada
| | - S Fatigoni
- Division of Medical Oncology, Ospedale Santa Maria della Misericordia, Perugia, Italy
| | - M Guglielmo
- Oncology-Supportive Care Unit, Department Onco-Haematology, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - M Horneber
- Department of Internal Medicine, Division of Oncology and Hematology & Division of Pneumology, Paracelsus Medical University, Klinikum, Nuremberg, Germany
| | - F Roila
- Division of Medical Oncology, Ospedale Santa Maria della Misericordia, Perugia, Italy
| | - J Weis
- Department of Self Help Research in Oncology, Comprehensive Cancer Center, University Medical Center, Freiburg, Germany
| | - K Jordan
- Department of Medicine V, Hematology, Oncology and Rheumatology, University Hospital Heidelberg, Heidelberg, Germany
| | - C I Ripamonti
- Oncology-Supportive Care Unit, Department Onco-Haematology, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| |
Collapse
|
11
|
McGettigan M, Cardwell CR, Cantwell MM, Tully MA. Physical activity interventions for disease-related physical and mental health during and following treatment in people with non-advanced colorectal cancer. Cochrane Database Syst Rev 2020; 5:CD012864. [PMID: 32361988 PMCID: PMC7196359 DOI: 10.1002/14651858.cd012864.pub2] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Colorectal cancer is the third most commonly diagnosed cancer worldwide. A diagnosis of colorectal cancer and subsequent treatment can adversely affect an individuals physical and mental health. Benefits of physical activity interventions in alleviating treatment side effects have been demonstrated in other cancer populations. Given that regular physical activity can decrease the risk of colorectal cancer, and cardiovascular fitness is a strong predictor of all-cause and cancer mortality risk, physical activity interventions may have a role to play in the colorectal cancer control continuum. Evidence of the efficacy of physical activity interventions in this population remains unclear. OBJECTIVES To assess the effectiveness and safety of physical activity interventions on the disease-related physical and mental health of individuals diagnosed with non-advanced colorectal cancer, staged as T1-4 N0-2 M0, treated surgically or with neoadjuvant or adjuvant therapy (i.e. chemotherapy, radiotherapy or chemoradiotherapy), or both. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2019, Issue 6), along with OVID MEDLINE, six other databases and four trial registries with no language or date restrictions. We screened reference lists of relevant publications and handsearched meeting abstracts and conference proceedings of relevant organisations for additional relevant studies. All searches were completed between 6 June and 14 June 2019. SELECTION CRITERIA We included randomised control trials (RCTs) and cluster-RCTs comparing physical activity interventions, to usual care or no physical activity intervention in adults with non-advanced colorectal cancer. DATA COLLECTION AND ANALYSIS Two review authors independently selected studies, performed the data extraction, assessed the risk of bias and rated the quality of the studies using GRADE criteria. We pooled data for meta-analyses by length of follow-up, reported as mean differences (MDs) or standardised mean differences (SMDs) using random-effects wherever possible, or the fixed-effect model, where appropriate. If a meta-analysis was not possible, we synthesised studies narratively. MAIN RESULTS We identified 16 RCTs, involving 992 participants; 524 were allocated to a physical activity intervention group and 468 to a usual care control group. The mean age of participants ranged between 51 and 69 years. Ten studies included participants who had finished active treatment, two studies included participants who were receiving active treatment, two studies included both those receiving and finished active treatment. It was unclear whether participants were receiving or finished treatment in two studies. Type, setting and duration of physical activity intervention varied between trials. Three studies opted for supervised interventions, five for home-based self-directed interventions and seven studies opted for a combination of supervised and self-directed programmes. One study did not report the intervention setting. The most common intervention duration was 12 weeks (7 studies). Type of physical activity included walking, cycling, resistance exercise, yoga and core stabilisation exercise. Most of the uncertainty in judging study bias came from a lack of clarity around allocation concealment and blinding of outcome assessors. Blinding of participants and personnel was not possible. The quality of the evidence ranged from very low to moderate overall. We did not pool physical function results at immediate-term follow-up due to considerable variation in results and inconsistency of direction of effect. We are uncertain whether physical activity interventions improve physical function compared with usual care. We found no evidence of effect of physical activity interventions compared to usual care on disease-related mental health (anxiety: SMD -0.11, 95% confidence interval (CI) -0.40 to 0.18; 4 studies, 198 participants; I2 = 0%; and depression: SMD -0.21, 95% CI -0.50 to 0.08; 4 studies, 198 participants; I2 = 0%; moderate-quality evidence) at short- or medium-term follow-up. Seven studies reported on adverse events. We did not pool adverse events due to inconsistency in reporting and measurement. We found no evidence of serious adverse events in the intervention or usual care groups. Minor adverse events, such as neck, back and muscle pain were most commonly reported. No studies reported on overall survival or recurrence-free survival and no studies assessed outcomes at long-term follow-up We found evidence of positive effects of physical activity interventions on the aerobic fitness component of physical fitness (SMD 0.82, 95% CI 0.34 to 1.29; 7 studies, 295; I2 = 68%; low-quality evidence), cancer-related fatigue (MD 2.16, 95% CI 0.18 to 4.15; 6 studies, 230 participants; I2 = 18%; low-quality evidence) and health-related quality of life (SMD 0.36, 95% CI 0.10 to 0.62; 6 studies, 230 participants; I2 = 0%; moderate-quality evidence) at immediate-term follow-up. These positive effects were also observed at short-term follow-up but not medium-term follow-up. Only three studies reported medium-term follow-up for cancer-related fatigue and health-related quality of life. AUTHORS' CONCLUSIONS The findings of this review should be interpreted with caution due to the low number of studies included and the quality of the evidence. We are uncertain whether physical activity interventions improve physical function. Physical activity interventions may have no effect on disease-related mental health. Physical activity interventions may be beneficial for aerobic fitness, cancer-related fatigue and health-related quality of life up to six months follow-up. Where reported, adverse events were generally minor. Adequately powered RCTs of high methodological quality with longer-term follow-up are required to assess the effect of physical activity interventions on the disease-related physical and mental health and on survival of people with non-advanced colorectal cancer. Adverse events should be adequately reported.
Collapse
Affiliation(s)
| | - Chris R Cardwell
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Marie M Cantwell
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Mark A Tully
- Institute of Mental Health Sciences, School of Health Sciences, Ulster University, Newtownabbey, UK
| |
Collapse
|
12
|
Forbes CC, Swan F, Greenley SL, Lind M, Johnson MJ. Physical activity and nutrition interventions for older adults with cancer: a systematic review. J Cancer Surviv 2020; 14:689-711. [PMID: 32328828 PMCID: PMC7473955 DOI: 10.1007/s11764-020-00883-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 04/02/2020] [Indexed: 12/17/2022]
Abstract
Purpose The aim of this review was to summarize the current literature for the effectiveness of activity and nutritional based interventions on health-related quality of life (HRQoL) in older adults living with and beyond cancer (LWBC). Methods We conducted systematic structured searches of CINAHL, Embase, Medline, Cochrane CENTRAL databases, and bibliographic review. Two independent researchers selected against inclusion criteria: (1) lifestyle nutrition and/or activity intervention for people with any cancer diagnosis, (2) measured HRQoL, (3) all participants over 60 years of age and (4) randomized controlled trials. Results Searches identified 5179 titles; 114 articles had full text review, with 14 studies (participant n = 1660) included. Three had nutrition and activity components, one, nutrition only and ten, activity only. Duration ranged from 7 days to 1 year. Interventions varied from intensive daily prehabilitation to home-based gardening interventions. Studies investigated various HRQoL outcomes including fatigue, general and cancer-specific quality of life (QoL), distress, depression, global side-effect burden and physical functioning. Eight studies reported significant intervention improvements in one or more QoL measure. Seven studies reported using a psychosocial/theoretical framework. There is a gap in tailored nutrition advice. Conclusions Among the few studies that targeted older adults with cancer, most were activity-based programmes with half reporting improvements in QoL. Future research should focus on or include tailored nutrition components and consider appropriate behaviour change techniques to maximize potential QoL improvement. Implications for Cancer Survivors More research is needed to address the research gap regarding older adults as current recommendations are derived from younger populations. Electronic supplementary material The online version of this article (10.1007/s11764-020-00883-x) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Cynthia C Forbes
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Kingston-Upon-Hull, UK. .,University of Hull, Allam Medical Building 3rd Floor, Cottingham Road, Kingston-Upon-Hull, East Yorkshire, HU6 7RX, UK.
| | - Flavia Swan
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Kingston-Upon-Hull, UK
| | - Sarah L Greenley
- Academy of Primary Care, Hull York Medical School, University of Hull, Kingston-Upon-Hull, UK
| | - Michael Lind
- Cancer Research Group, Hull York Medical School, University of Hull, Kingston-Upon-Hull, UK
| | - Miriam J Johnson
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Kingston-Upon-Hull, UK
| |
Collapse
|
13
|
Armer JS, Lutgendorf SK. The Impact of Yoga on Fatigue in Cancer Survivorship: A Meta-Analysis. JNCI Cancer Spectr 2020; 4:pkz098. [PMID: 32368719 PMCID: PMC7190209 DOI: 10.1093/jncics/pkz098] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 11/20/2019] [Accepted: 11/26/2019] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Mind-body approaches, particularly yoga, are used by cancer survivors to cope with treatment-related symptoms. Consistency of yoga-related effects on treatment-related symptoms are not known. This meta-analysis was designed to examine effects of yoga on pre- to postintervention improvements in fatigue among cancer patients. METHODS PubMed and PsycINFO were searched for peer-reviewed articles of yoga randomized controlled trials including cancer survivors and reporting at least one fatigue measure. Twenty-nine studies met inclusion criteria (n = 1828 patients). Effect sizes (Hedge's g) were calculated for fatigue, depression, and quality of life. Patient-related and intervention-related characteristics were tested as moderators of outcomes. All statistical tests were two-sided. RESULTS Yoga practice was associated with a small, statistically significant decrease in fatigue (g = 0.45, P = .013). Yoga type was a statistically significant moderator of this relationship (P = .02). Yoga was associated with a moderate decrease in depression (g = 0.72, P = .007) but was not associated with statistically significant changes in quality of life (P = .48). Session length was a statistically significant moderator of the relationship between yoga and depression (P = .004). Neither timing of treatment (during treatment vs posttreatment) nor clinical characteristics were statistically significant moderators of the effects of yoga on outcomes. The effect of yoga on fatigue and depression was larger when the comparator was a "waitlist" or "usual care" than when the control group was another active treatment (P = .036). CONCLUSIONS Results suggest yoga may be beneficial as a component of treatment for both fatigue and depression in cancer survivors.
Collapse
Affiliation(s)
- Jessica S Armer
- Department of Psychological & Brain Sciences
- Gynecologic Oncology, Obstetrics & Gynecology
| | - Susan K Lutgendorf
- Department of Psychological & Brain Sciences
- Gynecologic Oncology, Obstetrics & Gynecology
- Holden Comprehensive Cancer Center
- Department of Urology (SKL), University of Iowa, Iowa City, IA
| |
Collapse
|
14
|
Trabulsy P. COMPLEMENTARY AND ALTERNATIVE MEDICINE. Cancer 2019. [DOI: 10.1002/9781119645214.ch27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
|
15
|
Kinney AY, Blair CK, Guest DD, Ani JK, Harding EM, Amorim F, Boyce T, Rodman J, Ford CG, Schwartz M, Rosenberg L, Foran O, Gardner J, Lin Y, Arap W, Irwin MR. Biobehavioral effects of Tai Chi Qigong in men with prostate cancer: Study design of a three-arm randomized clinical trial. Contemp Clin Trials Commun 2019; 16:100431. [PMID: 31650067 PMCID: PMC6804681 DOI: 10.1016/j.conctc.2019.100431] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 08/02/2019] [Accepted: 08/19/2019] [Indexed: 12/18/2022] Open
Abstract
Fatigue is often one of the most commonly reported symptoms in prostate cancer survivors, but it is also one of the least understood cancer-related symptoms. Fatigue is associated with psychological distress, disruptions in sleep quality, and impairments in health-related quality of life. Moreover, inflammatory processes and changes related to the hypothalamic-pituitary-adrenal (HPA) axis and/or autonomic nervous system may also play a role in cancer-related fatigue. Thus, effective treatments for fatigue in prostate cancer survivors represent a current unmet need. Prior research has shown that Tai Chi Qigong, a mind-body exercise intervention, can improve physical and emotional health. Herein, we describe the protocol of the ongoing 3-arm randomized controlled Health Empowerment & Recovery Outcomes (HERO) clincal trial. One hundred sixty-six prostate cancer survivors with fatigue are randomized to a modified Tai Chi Qigong intervention (TCQ), intensity-matched body training intervention (BT), or usual care (UC) condition. Guided by biopsychosocial and psychoneuroimmunology models, we propose that TCQ, as compared to BT or UC will: i) reduce fatigue (primary outcome) in prostate cancer survivors; ii) reduce inflammation; and iii) regulate the expression of genes from two major functional clusters: a) inflammation, vasodilation and metabolite sensing and b) energy and adrenergic activation. Assessments are conducted at baseline, the 6-week midpoint of the intervention, and 1 week, 3 months, and 12 months post-intervention. If our findings show that TCQ promotes recovery from prostate cancer and its treatment, this type of intervention can be integrated into survivorship care plans as the standard of care. The study's findings will also provide novel information about underlying biobehavioral mechanisms of cancer-related fatigue. Trial registration number NCT03326713; clinicaltrials.gov.
Collapse
Affiliation(s)
- Anita Y Kinney
- Department of Biostatistics and Epidemiology, School of Public Health, Rutgers University, Piscataway, NJ, USA.,Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Cindy K Blair
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA.,University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA
| | - Dolores D Guest
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA
| | - Julianne K Ani
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | | | - Fabiano Amorim
- Department of Health, Exercise and Sports Sciences, University of New Mexico, Albuquerque, NM, USA
| | - Tawny Boyce
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA
| | - Joseph Rodman
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA
| | - C Graham Ford
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA.,Department of Psychology, University of New Mexico, Albuquerque, NM, USA
| | - Matthew Schwartz
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA.,University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA
| | | | - Olivia Foran
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Jerry Gardner
- Department of Theatre, University of Utah, Salt Lake City, UT, USA
| | - Yong Lin
- Department of Biostatistics and Epidemiology, School of Public Health, Rutgers University, Piscataway, NJ, USA.,Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Wadih Arap
- Division of Hematology/Oncology, Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA.,Rutgers Cancer Institute of New Jersey, Newark, NJ, USA
| | - Michael R Irwin
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neurosciences, University of California Los Angeles, California, USA.,Department of Psychiatry, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| |
Collapse
|
16
|
Danhauer SC, Addington EL, Cohen L, Sohl SJ, Van Puymbroeck M, Albinati NK, Culos-Reed SN. Yoga for symptom management in oncology: A review of the evidence base and future directions for research. Cancer 2019; 125:1979-1989. [PMID: 30933317 PMCID: PMC6541520 DOI: 10.1002/cncr.31979] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 08/14/2018] [Accepted: 10/30/2018] [Indexed: 01/23/2023]
Abstract
Because yoga is increasingly recognized as a complementary approach to cancer symptom management, patients/survivors and providers need to understand its potential benefits and limitations both during and after treatment. The authors reviewed randomized controlled trials (RCTs) of yoga conducted at these points in the cancer continuum (N = 29; n = 13 during treatment, n = 12 post-treatment, and n = 4 with mixed samples). Findings both during and after treatment demonstrated the efficacy of yoga to improve overall quality of life (QOL), with improvement in subdomains of QOL varying across studies. Fatigue was the most commonly measured outcome, and most RCTs conducted during or after cancer treatment reported improvements in fatigue. Results also suggested that yoga can improve stress/distress during treatment and post-treatment disturbances in sleep and cognition. Several RCTs provided evidence that yoga may improve biomarkers of stress, inflammation, and immune function. Outcomes with limited or mixed findings (eg, anxiety, depression, pain, cancer-specific symptoms, such as lymphedema) and positive psychological outcomes (such as benefit-finding and life satisfaction) warrant further study. Important future directions for yoga research in oncology include: enrolling participants with cancer types other than breast, standardizing self-report assessments, increasing the use of active control groups and objective measures, and addressing the heterogeneity of yoga interventions, which vary in type, key components (movement, meditation, breathing), dose, and delivery mode.
Collapse
Affiliation(s)
- Suzanne C. Danhauer
- Department of Social Sciences & Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Elizabeth L. Addington
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Lorenzo Cohen
- Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Stephanie J. Sohl
- Department of Social Sciences & Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Marieke Van Puymbroeck
- School of Health Research, College of Behavioral, Social, and Health Sciences, Department of Parks, Recreation, & Tourism Management, Clemson University, Clemson, SC, USA
| | | | | |
Collapse
|
17
|
Kaushik M, Mahendru S, Chaudhary S, Kumar M, Kukreti S. Prerequisite of a Holistic Blend of Traditional and Modern Approaches of Cancer Management. CCTR 2019. [DOI: 10.2174/1573394714666180417160750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
With the advent of changes in lifestyle of people all around the world,
cancer cases have been showing an exponential rise. Researchers from varied fields have been trying
to solve this tricky issue.
Methods:
We undertook a systematic search of bibliographic databases of peer-reviewed research
literature to evaluate the holistic blend of modern and traditional approaches, especially the
Ayurvedic perspective of treatment of cancer along with the effect of our diet and lifestyle on the
management (both prevention and cure) of cancer.
Results:
On the basis of extensive literature survey, it was found that Ayurveda as one of the ancient
medicinal systems had been very well documented for utilizing its best practices for the
treatment of various diseases including cancer, by utilization of several herbal plants and dietary
interventions as therapeutics. Active components present in various herbs, which interfere with
certain molecular targets to inhibit carcinogenesis are also summarized. Further, beneficial effects
of yoga and exercise on psychological distress, cancer-related fatigue and global side-effects as
well as their mechanism of action are also discussed. In addition, we recapitulate an upcoming
field of Ayurgenomics to understand the possible correlation of Prakriti with genetics as well as
epigenetics.
Conclusion:
Both genetic as well as environmental factors have shown their linkage with cancer.
Substantial advancements in the field of targeted therapies have opened new horizons for the cancer
patients. To fight with this grave situation, a combination of ancient and modern medicinal
systems seems to be the need of the hour.
Collapse
Affiliation(s)
- Mahima Kaushik
- Department of Chemistry, University of Delhi, Delhi, India
| | - Swati Mahendru
- Department of Chemistry, University of Delhi, Delhi, India
| | | | - Mohan Kumar
- Department of Chemistry, University of Delhi, Delhi, India
| | | |
Collapse
|
18
|
Abstract
PURPOSE/OBJECTIVES To evaluate mind-body movement exercise (MBME) classes (yoga, tai chi, and Qigong) for cancer survivors.
. DESIGN A single-group, repeated-measures design.
. SETTING The Ohio State University Wexner Medical Center-Arthur G. James Cancer Hospital in Columbus.
. SAMPLE 33 adult cancer survivors, with any cancer diagnosis, participating in MBME classes.
. METHODS The researchers sought to examine feasibility of multiple data collection time points and data collection measures; acceptability; and changes to physical, emotional, and biometric measures over time, as a result of participation in MBME classes.
. MAIN RESEARCH VARIABLES Quality of life, sleep, depressive symptomatology, fatigue, stress, upper body strength, gait and balance, body mass index, heart rate, and blood pressure.
. FINDINGS The current study was feasible because survivors were willing to participate and completed most of the questionnaires. Participants found these classes to be beneficial not only for exercise, but also for social support and social connectedness. Poor sleep quality was consistently reported by participants. MBME classes should be recommended to survivors and are beneficial for oncology practices to offer.
. CONCLUSIONS Conducting MBME research with cancer survivors is feasible, and participants find the MBME acceptable and a way of addressing health and managing cancer-related symptoms.
. IMPLICATIONS FOR NURSING Nurses should help patients and caregivers identify locations and times when MBME class participation is possible, assess MBME class participation during each clinic visit to promote continued involvement and to understand if positive effects are occurring, and continue to provide support for MBME classes throughout the survivorship experience.
Collapse
|
19
|
Carli F, Ferreira V. Prehabilitation: a new area of integration between geriatricians, anesthesiologists, and exercise therapists. Aging Clin Exp Res 2018; 30:241-244. [PMID: 29302796 DOI: 10.1007/s40520-017-0875-8] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 11/29/2017] [Indexed: 11/29/2022]
Abstract
Surgery in combination with risk factors such as poor physical and nutritional status have detrimental effects on short- and long-term aspects of recovery and quality of life, especially in elderly patients whose functional reserve is limited. Strategies to minimize these effects and accelerate return to baseline levels have focused on the intra- and post-operative period; however, this may not be the most opportune time to intervene. Instead, the preoperative period may be a more emotionally salient and physically enabling time to initiate an intervention aimed at attenuating surgical stress and enhancing recovery after surgery. The process of increasing patients' functional reserve in anticipation for surgery is referred to as prehabilitation. Elements of surgical prehabilitation programs include a structured exercise program consisting of both resistance and aerobic training, supplemented by flexibility exercises and nutritional optimization through counselling and supplementation. In general, individuals who are the least fit and the most sedentary have shown the most improvement when they initiate an exercise program. Since their physiologic reserve is limited, even small amounts of physical training can yield significant improvements. The interaction of physical activity and nutrition promotes anabolism, thereby preparing patients to better withstand the stress of surgery and subsequently mitigating the impact on postoperative outcome.
Collapse
Affiliation(s)
- Francesco Carli
- Department of Anesthesia, McGill University Health Centre, Montreal, QC, Canada
| | - Vanessa Ferreira
- Department of Anesthesia, McGill University Health Centre, Montreal, QC, Canada.
| |
Collapse
|
20
|
Armstrong K, Lanni T, Anderson MM, Patricolo GE. Integrative medicine and the oncology patient: options and benefits. Support Care Cancer 2018; 26:2267-2273. [DOI: 10.1007/s00520-017-4007-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 12/05/2017] [Indexed: 01/27/2023]
|
21
|
Lin PJ, Peppone LJ, Janelsins MC, Mohile SG, Kamen CS, Kleckner IR, Fung C, Asare M, Cole CL, Culakova E, Mustian KM. Yoga for the Management of Cancer Treatment-Related Toxicities. Curr Oncol Rep 2018; 20:5. [PMID: 29388071 PMCID: PMC5901971 DOI: 10.1007/s11912-018-0657-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW To (1) explain what yoga is, (2) summarize published literature on the efficacy of yoga for managing cancer treatment-related toxicities, (3) provide clinical recommendations on the use of yoga for oncology professionals, and (4) suggest promising areas for future research. RECENT FINDINGS Based on a total of 24 phase II and one phase III clinical trials, low-intensity forms of yoga, specifically gentle hatha and restorative, are feasible, safe, and effective for treating sleep disruption, cancer-related fatigue, cognitive impairment, psychosocial distress, and musculoskeletal symptoms in cancer patients receiving chemotherapy and radiation and cancer survivors. Clinicians should consider prescribing yoga for their patients suffering with these toxicities by referring them to qualified yoga professionals. More definitive phase III clinical trials are needed to confirm these findings and to investigate other types, doses, and delivery modes of yoga for treating cancer-related toxicities in patients and survivors.
Collapse
Affiliation(s)
- Po-Ju Lin
- Department of Surgery, James P. Wilmot Cancer Institute, University of Rochester Medical Center, 265 Crittenden Blvd., Box CU 420658, Rochester, NY, 14642, USA
| | - Luke J Peppone
- Department of Surgery, James P. Wilmot Cancer Institute, University of Rochester Medical Center, 265 Crittenden Blvd., Box CU 420658, Rochester, NY, 14642, USA
| | - Michelle C Janelsins
- Department of Surgery, James P. Wilmot Cancer Institute, University of Rochester Medical Center, 265 Crittenden Blvd., Box CU 420658, Rochester, NY, 14642, USA
| | - Supriya G Mohile
- Department of Medicine, University of Rochester Medical Center, 601 Elmwood Ave., Box 704, Rochester, NY, 14642, USA
| | - Charles S Kamen
- Department of Surgery, James P. Wilmot Cancer Institute, University of Rochester Medical Center, 265 Crittenden Blvd., Box CU 420658, Rochester, NY, 14642, USA
| | - Ian R Kleckner
- Department of Surgery, James P. Wilmot Cancer Institute, University of Rochester Medical Center, 265 Crittenden Blvd., Box CU 420658, Rochester, NY, 14642, USA
| | - Chunkit Fung
- Department of Medicine, University of Rochester Medical Center, 601 Elmwood Ave., Box 704, Rochester, NY, 14642, USA
| | - Matthew Asare
- Department of Surgery, James P. Wilmot Cancer Institute, University of Rochester Medical Center, 265 Crittenden Blvd., Box CU 420658, Rochester, NY, 14642, USA
| | - Calvin L Cole
- Department of Orthopaedics, University of Rochester Medical Center, 601 Elmwood Ave., Box 658, Rochester, NY, 14642, USA
| | - Eva Culakova
- Department of Surgery, James P. Wilmot Cancer Institute, University of Rochester Medical Center, 265 Crittenden Blvd., Box CU 420658, Rochester, NY, 14642, USA
| | - Karen M Mustian
- Department of Surgery, James P. Wilmot Cancer Institute, University of Rochester Medical Center, 265 Crittenden Blvd., Box CU 420658, Rochester, NY, 14642, USA.
| |
Collapse
|
22
|
Abstract
PURPOSE OF REVIEW A growing body of research supports the use of mind-body therapies (MBTs) as minimally invasive and effective approaches for the management of late-life mood and cognitive disorders. RECENT FINDINGS Recent randomized controlled trials and meta-analyses indicate that MBTs are effective for enhancing well-being, mood, sleep, and cognition in older adults. Evidence suggests that mindful movement (e.g., yoga, tai chi, walking meditation) may even outperform conventional physical exercise with regard to effects on quality of life, mood, and cognitive functioning. Practitioners may recommend MBTs as holistic, effective approaches for the management of common late-life mood and cognitive disorders. Continued research on MBTs will inform the development of even more effective/targeted interventions and contribute to greater acceptance and integration of these therapies into geriatric medicine and psychiatry.
Collapse
Affiliation(s)
- Kelsey T Laird
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA
| | - Pattharee Paholpak
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA
- Department of Psychiatry, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Michael Roman
- David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Berna Rahi
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA
| | - Helen Lavretsky
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA.
- Late-life Mood, Stress, and Wellness Research Program, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine at UCLA, 760 Westwood Plaza, Los Angeles, CA, 90095, USA.
| |
Collapse
|
23
|
Abstract
To cope with cancer and its treatment-related side effects and toxicities, people are increasingly using complementary and alternative medicine (CAM). Consequently, integrative oncology, which combines conventional therapies and evidence-based CAM practices, is an emerging discipline in cancer care. The use of yoga as a CAM is proving to be beneficial and increasingly gaining popularity. An electronic database search (PubMed), through December 15, 2016, revealed 138 relevant clinical trials (single-armed, nonrandomized, and randomized controlled trials) on the use of yoga in cancer patients. A total of 10,660 cancer patients from 20 countries were recruited in these studies. Regardless of some methodological deficiencies, most of the studies reported that yoga improved the physical and psychological symptoms, quality of life, and markers of immunity of the patients, providing a strong support for yoga's integration into conventional cancer care. This review article presents the published clinical research on the prevalence of yoga's use in cancer patients so that oncologists, researchers, and the patients are aware of the evidence supporting the use of this relatively safe modality in cancer care.
Collapse
Affiliation(s)
- Ram P Agarwal
- Department of Medicine, Division of Oncology, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Adi Maroko-Afek
- Department of Medicine, Division of Oncology, Miller School of Medicine, University of Miami, Miami, Florida, USA
| |
Collapse
|
24
|
Cramer H, Peng W, Lauche R. Yoga for menopausal symptoms-A systematic review and meta-analysis. Maturitas 2018; 109:13-25. [PMID: 29452777 DOI: 10.1016/j.maturitas.2017.12.005] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 11/23/2017] [Accepted: 12/05/2017] [Indexed: 02/05/2023]
Abstract
OBJECTIVES To systematically review and meta-analyze the effectiveness of yoga for menopausal symptoms. METHODS Medline (via PubMed), the Cochrane Central Register of Controlled Trials, and Scopus were screened through to February 21, 2017 for randomized controlled trials (RCTs) comparing the effects of yoga on menopausal symptoms to those of no treatment or active comparators. Standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated. Two authors independently assessed risk of bias using the Cochrane risk of bias tool. RESULTS Thirteen RCTs with 1306 participants were included. Compared with no treatment, yoga reduced total menopausal symptoms (SMD=-1.05; 95% CI -1.57 to -0.53), psychological (SMD=-0.75; 95% CI -1.17 to -0.34), somatic (SMD=-0.65; 95% CI -1.05 to -0.25), vasomotor (SMD=-0.76; 95% CI -1.27 to -0.25), and urogenital symptoms (SMD=-0.53; 95% CI -0.81 to -0.25). Compared with exercise controls, only an effect on vasomotor symptoms was found (SMD=-0.45; 95% CI -0.87 to -0.04). Effects were robust against selection bias, but not against detection and attrition bias. No serious adverse events were reported. CONCLUSION Yoga seems to be effective and safe for reducing menopausal symptoms. Effects are comparable to those of other exercise interventions.
Collapse
|
25
|
Abstract
Cancer-related fatigue (CRF) significantly interferes with usual functioning because of the distressing sense of physical, emotional, and cognitive exhaustion. Assessment of CRF is important and should be performed during the initial cancer diagnosis, throughout cancer treatment, and after treatment using a fatigue scoring scale (mild-severe). The general approach to CRF management applies to cancer survivors at all fatigue levels and includes education, counseling, and other strategies. Nonpharmacologic interventions include psychosocial interventions, exercise, yoga, physically based therapy, dietary management, and sleep therapy. Pharmacologic interventions include psychostimulants. Antidepressants may also benefit when CRF is accompanied by depression.
Collapse
Affiliation(s)
- Chidinma C Ebede
- Department of General Internal Medicine, The University of Texas M.D. Anderson Cancer Center, 1400 Pressler Street, Unit 1465, Houston, TX 77030-4008, USA
| | - Yongchang Jang
- Department of General Internal Medicine, The University of Texas M.D. Anderson Cancer Center, 1400 Pressler Street, Unit 1465, Houston, TX 77030-4008, USA
| | - Carmen P Escalante
- Department of General Internal Medicine, The University of Texas M.D. Anderson Cancer Center, 1400 Pressler Street, Unit 1465, Houston, TX 77030-4008, USA.
| |
Collapse
|
26
|
Palesh O, Scheiber C, Kesler S, Mustian K, Koopman C, Schapira L. Management of side effects during and post-treatment in breast cancer survivors. Breast J 2017; 24:167-175. [DOI: 10.1111/tbj.12862] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 06/06/2017] [Accepted: 06/07/2017] [Indexed: 01/06/2023]
Affiliation(s)
- Oxana Palesh
- Department of Psychiatry and Behavioral Sciences; Stanford University; Stanford CA USA
| | - Caroline Scheiber
- Department of Psychiatry and Behavioral Sciences; Stanford University; Stanford CA USA
| | | | - Karen Mustian
- Department of Surgery; University of Rochester; Rochester NY USA
| | - Cheryl Koopman
- Department of Psychiatry and Behavioral Sciences; Stanford University; Stanford CA USA
| | | |
Collapse
|
27
|
|
28
|
Abstract
The number of survivors of cancer in the United States, already 14.5 million, is growing with improved cancer treatment and aging of the population. Two-thirds of cancer survivors will be older than age 65 and are likely to enter cancer treatment already deconditioned and with multiple comorbidities. Survivors of cancer face numerous adverse consequences of cancer treatment that add to or exacerbate the effects of existing comorbidities and increase risk of functional decline. Many of these problems are amenable to rehabilitation interventions, but referral to cancer rehabilitation professionals is not a standard part of care. We present an expanded prospective model of surveillance, cancer rehabilitation assessment, and referral efforts using a multidisciplinary team approach. In this model, cancer rehabilitation begins at the time of cancer diagnosis and continues through and beyond cancer treatment. Physical impairments and psychosocial symptoms are assessed and treated, and lifestyle and exercise interventions are provided to optimize functioning, health, and quality of life. We present a stepped-care framework to guide decisions on when, how, and where to refer survivors to cancer rehabilitation specialists depending on safety requirements and needs. This model has the potential to result in early identification of symptoms and impairments, appropriate referral and timely treatment, and, in turn, will better address and minimize both acute and long-term cancer morbidity.
Collapse
Affiliation(s)
- Catherine M Alfano
- From American Cancer Society, Washington, DC; Department of Physical Medicine and Rehabilitation, Program to Enhance Care Experiences Through Research, Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN; University of Rochester Medical Center, Wilmot Cancer Institute, Rochester, NY
| | - Andrea L Cheville
- From American Cancer Society, Washington, DC; Department of Physical Medicine and Rehabilitation, Program to Enhance Care Experiences Through Research, Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN; University of Rochester Medical Center, Wilmot Cancer Institute, Rochester, NY
| | - Karen Mustian
- From American Cancer Society, Washington, DC; Department of Physical Medicine and Rehabilitation, Program to Enhance Care Experiences Through Research, Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN; University of Rochester Medical Center, Wilmot Cancer Institute, Rochester, NY
| |
Collapse
|
29
|
Abstract
More than 50% of the elderly above 60 years of age suffer from chronic medical conditions, the prevalence of which increases with age. Though Yoga has been reported as an effective modality in improving various physical and psychological aspects of elderly populations, a comprehensive review of Yoga and its effects on various health related problems of elderly populations has not yet been reported. Hence, we performed PubMed/Medline search to review relevant articles, using keyword "yoga and elderly". Relevant articles published since inception till 6th October 2016 were included for the review. Based on the available scientific literature, this review suggests that the regular practice of Yoga can be considered as an effective intervention in improving physical (reduces heart rate, blood pressure, blood glucose, oxidative damage, fatigue, weakness, fear of fall, and improve heart rate variability, baroreflex sensitivity, insulin sensitivity, physical functions, mobility, flexibility, and urinary incontinence), mental (reduces depression, anxiety), emotional (reduces anger, stress, tension and improve self-efficacy), social (improve life satisfaction), and vital (improved vitality) planes of elderly individuals, offering a better quality of sleep and quality of life.
Collapse
Affiliation(s)
- A Mooventhan
- Department of Research and Development, S-VYASA University, #19, Eknath Bhavan, Kavipuram Circle, Kempegowda Nagar, Bengaluru, 560019, Karnataka, India.
| | - L Nivethitha
- Department of Research and Development, S-VYASA University, #19, Eknath Bhavan, Kavipuram Circle, Kempegowda Nagar, Bengaluru, 560019, Karnataka, India
| |
Collapse
|
30
|
|
31
|
Mustian KM, Cole CL, Lin PJ, Asare M, Fung C, Janelsins MC, Kamen CS, Peppone LJ, Magnuson A. Exercise Recommendations for the Management of Symptoms Clusters Resulting From Cancer and Cancer Treatments. Semin Oncol Nurs 2016; 32:383-393. [PMID: 27776835 DOI: 10.1016/j.soncn.2016.09.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To review existing exercise guidelines for cancer patients and survivors for the management of symptom clusters. DATA SOURCES Review of PubMed literature and published exercise guidelines. CONCLUSION Cancer and its treatments are responsible for a copious number of incapacitating symptoms that markedly impair quality of life. The exercise oncology literature provides consistent support for the safety and efficacy of exercise interventions in managing cancer- and treatment-related symptoms, as well as improving quality of life in cancer patients and survivors. IMPLICATIONS FOR NURSING PRACTICE Effective management of symptoms enhances recovery, resumption of normal life activities and quality of life for patients and survivors. Exercise is a safe, appropriate, and effective therapeutic option before, during, and after the completion of treatment for alleviating symptoms and symptom clusters.
Collapse
|
32
|
McQuade JL, Prinsloo S, Chang DZ, Spelman A, Wei Q, Basen-Engquist K, Harrison C, Zhang Z, Kuban D, Lee A, Cohen L. Qigong/tai chi for sleep and fatigue in prostate cancer patients undergoing radiotherapy: a randomized controlled trial. Psychooncology 2016; 26:1936-1943. [PMID: 27548839 DOI: 10.1002/pon.4256] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 07/26/2016] [Accepted: 08/14/2016] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Sleep disturbances and fatigue are common in prostate cancer patients undergoing radiotherapy. Prior research suggests mind-body techniques may improve these outcomes. We conducted a randomized controlled trial of qigong/tai chi (QGTC) in men with prostate cancer undergoing radiotherapy. METHODS Men with prostate cancer starting definitive radiation were randomized to 1 of 3 groups: (1) QGTC; (2) light exercise (LE); or (3) waiting list control. Sleep disturbances (Pittsburgh Sleep Quality Index) and fatigue (Brief Fatigue Inventory) were assessed at baseline, midway through radiotherapy (T2), during the last week of radiotherapy (T3), and at 1 (T4) and 3 months (T5) after the end of radiotherapy. Patients in the QGTC and LE groups attended three 40-minute classes per week throughout radiotherapy. RESULTS Ninety patients were randomized to the 3 groups (QGTC = 26; LE = 26; waiting list control = 24). The QGTC group reported longer sleep duration midway through radiotherapy (QGTC = 7.01 h; LE = 6.42; WL = 6.50; P = .05), but this difference did not persist over time. There were no group differences in other domains of sleep or fatigue. Exploratory analyses conducted to examine the effect of health-related quality of life (Expanded Prostate Cancer Index Composite and American Urological Association Symptom score) on sleep and fatigue showed significant correlations across multiple domains. CONCLUSIONS Qigong/tai chi during radiation for prostate cancer resulted in superior sleep duration midway through radiation, but this effect was not durable, and there were no differences in other domains of sleep or fatigue. Exploratory analysis demonstrated that both sleep and fatigue were highly correlated with prostate cancer-related physical symptoms. Future mind-body intervention studies should incorporate multimodal therapy focused on improving physical symptoms in this population.
Collapse
Affiliation(s)
- Jennifer L McQuade
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sarah Prinsloo
- Department of Palliative Care, Rehabilitation Medicine, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - David Z Chang
- Virginia Oncology Associates and Department of Medicine, Eastern Virginia Medical School, Newport News, VA, USA
| | - Amy Spelman
- Department of Palliative Care, Rehabilitation Medicine, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Qi Wei
- Department of Palliative Care, Rehabilitation Medicine, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Karen Basen-Engquist
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Carol Harrison
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Zonghao Zhang
- School of Physical Education and Sports, Soochow University, Suzhou, China
| | - Debra Kuban
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Andrew Lee
- Department of Radiation Oncology, Texas Oncology, Irving, TX, USA
| | - Lorenzo Cohen
- Department of Palliative Care, Rehabilitation Medicine, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| |
Collapse
|
33
|
Abstract
Evidence of the benefits of exercise for people with cancer from diagnosis through survivorship is growing. However, most cancers occur in older adults and little exercise advice is available for making specific recommendations for older adults with cancer. Individualized exercise prescriptions are safe, feasible, and beneficial for the geriatric oncology population. Oncology providers must be equipped to discuss the short- and long-term benefits of exercise and assist older patients in obtaining appropriate exercise prescriptions. This review provides detailed information about professionals and their roles as it relates to functional assessment, intervention, and evaluation of the geriatric oncology population. This review addresses the importance of functional status assessment and appropriate referrals to other oncology professionals.
Collapse
Affiliation(s)
| | - Ashley Leak Bryant
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Karen M Mustian
- Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA
| |
Collapse
|
34
|
Lauche R, Langhorst J, Lee MS, Dobos G, Cramer H. A systematic review and meta-analysis on the effects of yoga on weight-related outcomes. Prev Med 2016; 87:213-232. [PMID: 27058944 DOI: 10.1016/j.ypmed.2016.03.013] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Revised: 01/26/2016] [Accepted: 03/17/2016] [Indexed: 01/16/2023]
Abstract
INTRODUCTION Overweight and obesity are among the most important modifiable risk factors for chronic diseases and premature death. The aim of this review was to systematically assess and analyze the effects of yoga on weight-related outcomes. METHODS Medline/PubMed, Scopus, and the Cochrane Library were screened through March 2015 for randomized controlled trials on yoga for weight-related outcomes in the general population or overweight/obese individuals. Risk of bias was assessed using the Cochrane risk of bias tool on the following domains: selection bias, performance bias, detection bias, attrition bias, reporting bias, and other bias. RESULTS Out of 445 records identified during literature search, 30 trials with a total of 2173 participants were included. No effects on weight, body mass index, body fat percentage or waist circumference were found. In studies with healthy adult participants an effect of yoga compared to usual care was found regarding waist/hip ratio (SMD=--1.00; 95% CI=--1.44, -0.55; p<0.001). In studies with overweight/obese participants only, effects relative to usual care were found for body mass index (SMD=-0.99; 95% CI=-1.67, -0.31; p=0.004). Effects however were not robust against selection bias; and publication bias could not be ruled out. No intervention-related adverse events were reported. CONCLUSIONS Despite methodological drawbacks, yoga can be preliminarily considered a safe and effective intervention to reduce body mass index in overweight or obese individuals.
Collapse
Affiliation(s)
- Romy Lauche
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany; Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney, Australia
| | - Jost Langhorst
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Myeong Soo Lee
- Medical Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Gustav Dobos
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Holger Cramer
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany; Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney, Australia.
| |
Collapse
|
35
|
Kilari D, Soto-Perez-de-Celis E, Mohile SG, Alibhai SMH, Presley CJ, Wildes TM, Klepin HD, Demark-Wahnefried W, Jatoi A, Harrison R, Won E, Mustian KM. Designing exercise clinical trials for older adults with cancer: Recommendations from 2015 Cancer and Aging Research Group NCI U13 Meeting. J Geriatr Oncol 2016; 7:293-304. [PMID: 27197916 DOI: 10.1016/j.jgo.2016.04.007] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 02/10/2016] [Accepted: 04/18/2016] [Indexed: 12/17/2022]
Abstract
Cancer and its treatment can lead to a myriad of adverse events and negatively impact quality of life of older cancer patients and survivors. Unmet physical activity needs vary across the cancer continuum and remain an important yet understudied area of research in this population. Exercise interventions have been shown to be effective in treating both the physical and psychological declines associated with cancer and its treatment, with a potential to improve cancer-related outcomes. Despite the current evidence, exercise is clearly underutilized due to several barriers and knowledge gaps in existing trials that include appropriate population identification, design, and outcome measures selection. The benefits of regular exercise in both the primary and secondary prevention of chronic conditions are well established in the non-cancer population. In older cancer patients and survivors, further research is needed before exercise gains widespread acceptance. The Cancer and Aging Research Group convened experts in exercise, aging and cancer to evaluate current scientific evidence and knowledge gaps in geriatric exercise oncology. This report summarizes these findings and provides future research directions.
Collapse
Affiliation(s)
- Deepak Kilari
- Medical College of Wisconsin, Froedtert Clinical Cancer Center, Department of Medicine, Division of Medical Oncology, Milwaukee, WI, USA.
| | - Enrique Soto-Perez-de-Celis
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Cancer Care in the Elderly Clinic, Department of Geriatrics, Mexico City, Mexico
| | - Supriya Gupta Mohile
- University of Rochester Medical Center, Wilmot Cancer Institute, Department of Medicine, Division of Medical Oncology, Rochester, NY, USA
| | - Shabbir M H Alibhai
- University Health Network and University of Toronto, Department of Medicine, Toronto, Ontario, Canada
| | - Carolyn J Presley
- Yale School of Medicine, Yale Cancer Center, Department of Medicine, Division of Medical Oncology, New Haven, CT, USA
| | - Tanya M Wildes
- Washington University, Department of Medicine, Division of Medical Oncology, St. Louis, MO, USA
| | - Heidi D Klepin
- Wake Forrest School of Medicine, Department of Medicine, Section of Hematology and Oncology, Winston-Salem, NC, USA
| | - Wendy Demark-Wahnefried
- University of Alabama at Birmingham Comprehensive Cancer Center, Division of Cancer Control and Prevention, Birmingham, AL, USA
| | - Amina Jatoi
- Mayo Clinic, Department of Oncology, Division of Medical Oncology, Rochester, MN, USA
| | - Robert Harrison
- University of Rochester Medical Center, SCOREboard, Rochester, NY, USA
| | - Elizabeth Won
- Memorial Sloan-Kettering Cancer Center, Department of Medicine, Division of Medical Oncology, New York, NY, USA
| | - Karen M Mustian
- University of Rochester Medical Center, Wilmot Cancer Institute, Department of Surgery, Division of Cancer Control, Rochester, NY, USA
| |
Collapse
|
36
|
Berger AM, Mooney K, Alvarez-Perez A, Breitbart WS, Carpenter KM, Cella D, Cleeland C, Dotan E, Eisenberger MA, Escalante CP, Jacobsen PB, Jankowski C, LeBlanc T, Ligibel JA, Loggers ET, Mandrell B, Murphy BA, Palesh O, Pirl WF, Plaxe SC, Riba MB, Rugo HS, Salvador C, Wagner LI, Wagner-Johnston ND, Zachariah FJ, Bergman MA, Smith C. Cancer-Related Fatigue, Version 2.2015. J Natl Compr Canc Netw 2016; 13:1012-39. [PMID: 26285247 DOI: 10.6004/jnccn.2015.0122] [Citation(s) in RCA: 489] [Impact Index Per Article: 61.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Cancer-related fatigue is defined as a distressing, persistent, subjective sense of physical, emotional, and/or cognitive tiredness or exhaustion related to cancer or cancer treatment that is not proportional to recent activity and interferes with usual functioning. It is one of the most common side effects in patients with cancer. Fatigue has been shown to be a consequence of active treatment, but it may also persist into posttreatment periods. Furthermore, difficulties in end-of-life care can be compounded by fatigue. The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Cancer-Related Fatigue provide guidance on screening for fatigue and recommendations for interventions based on the stage of treatment. Interventions may include education and counseling, general strategies for the management of fatigue, and specific nonpharmacologic and pharmacologic interventions. Fatigue is a frequently underreported complication in patients with cancer and, when reported, is responsible for reduced quality of life. Therefore, routine screening to identify fatigue is an important component in improving the quality of life for patients living with cancer.
Collapse
|
37
|
Stepney R. Advances in caring for the older cancer patient: a report from the 2015 conference of the International Society of Geriatric Oncology. Cancer Biol Med 2016; 13. [PMCID: PMC4850124 DOI: 10.28092/j.issn.2095-3941.2016.0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022] Open
Abstract
A paradox in cancer research is that the majority of patients enrolled in clinical trials are relatively young and fit while typical patients in daily practice are elderly and have comorbidities and impaired organ function. Given these differences, many major studies provide an imperfect guide to optimizing the treatment of the majority of patients. Since cancer incidence is highly correlated with age, and since the world's population is rapidly ageing, this problem can only increase. For this reason, oncologists and geriatricians need to collaborate in developing tools to systematically assess the health status of elderly patients and their fitness to receive cancer therapies of various intensity. Tailoring anti-cancer treatments and supportive care to individual needs should be seen as part of the move towards personalized medicine. Achieving this goal is as much of a challenge to developing and middle-income countries as it is to western nations. The 2015 annual conference of the International Society of Geriatric Oncology (SIOG) held in Prague, Czech Republic, November 2015 and had a global focus on advancing the science of geriatric oncology and supportive care. Central to this approach is the systematic assessment of life expectancy, independent functioning, and the physical and psychological health of older cancer patients. The assumption behind comprehensive geriatric assessment is that elderly cancer patients have complex needs. The implication is that effective intervention will require a multidisciplinary team. Examples of effective geriatric assessment, multidisciplinary working and supportive care were presented at the SIOG conference.
Collapse
Affiliation(s)
- Rob Stepney
- Freelance Medical Writer. Charlbury, OX7 3HJ, UK
| |
Collapse
|
38
|
Janelsins MC, Peppone LJ, Heckler CE, Kesler SR, Sprod LK, Atkins J, Melnik M, Kamen C, Giguere J, Messino MJ, Mohile SG, Mustian KM. YOCAS©® Yoga Reduces Self-reported Memory Difficulty in Cancer Survivors in a Nationwide Randomized Clinical Trial: Investigating Relationships Between Memory and Sleep. Integr Cancer Ther 2015; 15:263-71. [PMID: 26621521 PMCID: PMC4884662 DOI: 10.1177/1534735415617021] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background. Interventions are needed to alleviate memory difficulty in cancer survivors. We previously showed in a phase III randomized clinical trial that YOCAS©® yoga—a program that consists of breathing exercises, postures, and meditation—significantly improved sleep quality in cancer survivors. This study assessed the effects of YOCAS©® on memory and identified relationships between memory and sleep. Study design and methods. Survivors were randomized to standard care (SC) or SC with YOCAS©® . 328 participants who provided data on the memory difficulty item of the MD Anderson Symptom Inventory are included. Sleep quality was measured using the Pittsburgh Sleep Quality Index. General linear modeling (GLM) determined the group effect of YOCAS©® on memory difficulty compared with SC. GLM also determined moderation of baseline memory difficulty on postintervention sleep and vice versa. Path modeling assessed the mediating effects of changes in memory difficulty on YOCAS©® changes in sleep and vice versa. Results. YOCAS©® significantly reduced memory difficulty at postintervention compared with SC (mean change: yoga=−0.60; SC=−0.16; P<.05). Baseline memory difficulty did not moderate the effects of postintervention sleep quality in YOCAS©® compared with SC. Baseline sleep quality did moderate the effects of postintervention memory difficulty in YOCAS©® compared with SC (P<.05). Changes in sleep quality was a significant mediator of reduced memory difficulty in YOCAS©® compared with SC (P<.05); however, changes in memory difficulty did not significantly mediate improved sleep quality in YOCAS©® compared with SC. Conclusions. In this large nationwide trial, YOCAS©® yoga significantly reduced patient-reported memory difficulty in cancer survivors.
Collapse
Affiliation(s)
- Michelle C Janelsins
- University of Rochester Medical Center, Rochester, NY, USA Wilmot Cancer Institute, Rochester, NY, USA
| | - Luke J Peppone
- University of Rochester Medical Center, Rochester, NY, USA Wilmot Cancer Institute, Rochester, NY, USA
| | - Charles E Heckler
- University of Rochester Medical Center, Rochester, NY, USA Wilmot Cancer Institute, Rochester, NY, USA
| | | | | | - James Atkins
- Southeast Clinical Oncology Research Consortium NCORP, Winston-Salem, NC, USA
| | - Marianne Melnik
- Cancer Research Consortium of West Michigan NCORP, Grand Rapids, MI, USA
| | - Charles Kamen
- University of Rochester Medical Center, Rochester, NY, USA Wilmot Cancer Institute, Rochester, NY, USA
| | | | - Michael J Messino
- Southeast Clinical Oncology Research Consortium NCORP, Winston-Salem, NC, USA
| | - Supriya G Mohile
- University of Rochester Medical Center, Rochester, NY, USA Wilmot Cancer Institute, Rochester, NY, USA
| | - Karen M Mustian
- University of Rochester Medical Center, Rochester, NY, USA Wilmot Cancer Institute, Rochester, NY, USA
| |
Collapse
|