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Adamsen L, Stage M, Laursen J, Rørth M, Quist M. Exercise and relaxation intervention for patients with advanced lung cancer: a qualitative feasibility study. Scand J Med Sci Sports 2011; 22:804-15. [PMID: 21599754 DOI: 10.1111/j.1600-0838.2011.01323.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Lung cancer patients experience loss of physical capacity, dyspnea, pain, reduced energy and psychological distress. The aim of this study was to explore feasibility, health benefits and barriers of exercise in former sedentary patients with advanced stage lung cancer, non-small cell lung cancer (NSCLC) (III-IV) and small cell lung cancer (SCLC) (ED), undergoing chemotherapy. The intervention consisted of a hospital-based, supervised, group exercise and relaxation program comprising resistance-, cardiovascular- and relaxation training 4 h weekly, 6 weeks, and a concurrent unsupervised home-based exercise program. An explorative study using individual semi-structured interviews (n=15) and one focus group interview (n=8) was conducted among the participants. Throughout the intervention the patients experienced increased muscle strength, improvement in wellbeing, breathlessness and energy. The group exercise and relaxation intervention showed an adherence rate of 76%, whereas the patients failed to comply with the home-based exercise. The hospital-based intervention initiated at time of diagnosis encouraged former sedentary lung cancer patients to participation and was undertaken safely by cancer patients with advanced stages of disease, during treatment. The patients experienced physical, functional and emotional benefits. This study confirmed that supervised training in peer-groups was beneficial, even in a cancer population with full-blown symptom burden and poor prognosis.
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Affiliation(s)
- L Adamsen
- Department 7331, The University Hospitals' Centre for Nursing and Care Research, Copenhagen University Hospital Copenhagen, Denmark.
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52
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Mustian KM, Sprod LK, Palesh OG, Peppone LJ, Janelsins MC, Mohile SG, Carroll J. Exercise for the management of side effects and quality of life among cancer survivors. Curr Sports Med Rep 2010; 8:325-30. [PMID: 19904073 DOI: 10.1249/jsr.0b013e3181c22324] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Physical activity may play an important role in the rehabilitation of cancer survivors during and after treatment. Current research suggests that numerous beneficial outcomes are experienced in cancer survivors undergoing exercise interventions during or after cancer treatment. Exercise not only plays a role in managing side effects but also improves functional capacity and quality of life. The purpose of this article is to provide an overview of the oncology literature supporting the use of exercise as an effective intervention for improving cancer-related fatigue, other side effects, functional capacity, and quality of life among cancer survivors.
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Affiliation(s)
- Karen M Mustian
- University of Rochester School of Medicine and Dentistry, James P. Wilmot Cancer Center, Department of Radiation Oncology, Rochester, NY, USA.
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53
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Abstract
Physical exercise has attracted increased interest in rehabilitation of oncological patients. The purpose of this paper is to review the literature and summarize the evidence of physical exercise in preventing cancer, its ability in attenuating the effect of cancer and its treatments and to provide guidelines for exercise prescription Review of recent literature by electronic search of MEDline (Pub Med), Cancer lit, Cochrane libraries, CINAHL were done using Keywords and the variables were identified and systematically evaluated. There is strong evidence for reduced risk of colorectal and breast cancer with possible association for prostate, endometrial and lung cancer with increasing physical activity. Exercise helps cancer survivors cope with and recover from treatment; exercise may improve the health of long term cancer survivors and extend survival. Physical exercise will benefit throughout the spectrum of cancer. However, an understanding of the amount, type and intensity of exercise needed has not been fully elucidated. There is sufficient evidence to promote exercise in cancer survivors following careful assessment and tailoring on exercise prescription.
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Affiliation(s)
- P. Rajarajeswaran
- College of Physiotherapy, Mother Theresa Post Graduate and Research Institute of Health Sciences, Puducherry – 6, India
| | - R. Vishnupriya
- College of Physiotherapy, Mother Theresa Post Graduate and Research Institute of Health Sciences, Puducherry – 6, India
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54
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Self-reported physical activity behaviour; exercise motivation and information among Danish adult cancer patients undergoing chemotherapy. Eur J Oncol Nurs 2009; 13:116-21. [DOI: 10.1016/j.ejon.2009.01.006] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2008] [Revised: 01/11/2009] [Accepted: 01/15/2009] [Indexed: 11/19/2022]
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55
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Stoma surgery for colorectal cancer: a population-based study of patient concerns. J Wound Ostomy Continence Nurs 2008; 35:424-8. [PMID: 18635994 DOI: 10.1097/01.won.0000326664.78131.1c] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The difficulties and concerns of colorectal cancer patients with an ostomy are not well documented. This study describes the difficulties experienced by colorectal cancer patients with a temporary or permanent ostomy over the 2-year period following their diagnosis. Patients' satisfaction with the information provided to them by their healthcare providers was also assessed. METHODS Colorectal cancer patients with an ostomy (N 5332) recruited through a cancer registry completed telephone interviews at approximately 5, 12, and 24 months following diagnosis. RESULTS Painful or irritated peristomal skin and odor and noise from the appliance were the most commonly reported stoma-related difficulties. The proportion of participants reporting these difficulties decreased over time. Provision of preoperative information was comprehensive, and satisfaction with preoperative information was high. However, 34% of patients said they were not seen by an ostomy nurse prior to surgery. CONCLUSIONS The ostomy nurse may be ideally placed to initiate, develop, and implement survivorship care plans for colorectal cancer patients.
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56
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What advice are oncologists and surgeons in the United Kingdom giving to breast cancer patients about physical activity? Int J Behav Nutr Phys Act 2008; 5:46. [PMID: 18803812 PMCID: PMC2553795 DOI: 10.1186/1479-5868-5-46] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2008] [Accepted: 09/19/2008] [Indexed: 11/10/2022] Open
Abstract
Evidence has shown that physical activity may attenuate the negative physical, psychological and functional effects of treatment in women diagnosed with breast cancer. Physical activity levels also decline substantially during and after completion of treatment for cancer, highlighting the importance of strategies to promote participation in regular physical activity in this population. Oncologists and surgeons may serve as an influential source of motivation to be physically activity in cancer patients, by conveying the importance of a healthy lifestyle. The primary purpose of the present study was to investigate whether oncologists and surgeons routinely discuss physical activity with their breast cancer patients and to investigate the nature of any information/advice provided during consultations. A secondary aim was to examine whether physically active oncologists and surgeons were more likely to provide advice about physical activity to patients, than inactive oncologists and surgeons. A brief postal questionnaire was sent to 710 consultant breast cancer oncologists and surgeons throughout the UK and 102 responded (response rate = 14.4%). Of responders, most (55.9%) did not routinely discuss physical activity with their patients. Amongst oncologists/surgeons (clinicians) who did offer advice, most focussed on discussing the benefits of physical activity for physical and functional health gains and for facilitating weight control and maintenance. A number of clinicians indicated they advised patients that physical activity may decrease risk of recurrence and improve survival, despite the lack of evidence from RCTs to support this suggestion. There was no significant association between the physical activity status of oncologists/surgeons and the likelihood that they discussed physical activity with patients. Educational strategies aimed at encouraging clinicians to promote physical activity in consultations need to be targeted widely amongst the cancer clinician community.
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57
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Physical activity, activity change, and their correlates in a population-based sample of colorectal cancer survivors. Ann Behav Med 2008; 34:135-43. [PMID: 17927552 DOI: 10.1007/bf02872668] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
BACKGROUND Physical activity can provide benefits to cancer survivors, including reduced symptoms and treatment side effects, improved overall quality of life, and decreased risk of other chronic diseases. PURPOSE The aim of the study was to describe physical activity before and after diagnosis of colorectal cancer and to examine the associations with sociodemographic and disease-related variables. METHODS Telephone interviews were conducted with 1,996 colorectal cancer survivors recruited through a cancer registry. RESULTS In comparison to prediagnosis activity levels, there were 21% fewer participants meeting the physical activity and health guideline (150 min of moderate-intensity physical activity per week) postdiagnosis. Meeting the guideline postdiagnosis was associated with being male, living outside of the state capital city, having a higher education, having a healthy body mass index, not smoking, having had surgery only, and no reported fatigue. Attributes associated with a decrease in physical activity following diagnosis were being female, living within the state capital city, having a lower level of education, having a stoma, having adjuvant therapy, and experiencing fatigue. CONCLUSIONS There is considerable scope for targeted interventions to increase the physical activity of colorectal cancer survivors, particularly for those groups that we have identified as being less active and/or have reduced their activity.
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58
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Milne HM, Guilfoyle A, Gordon S, Wallman KE, Courneya KS. Personal accounts of exercise and quality of life from the perspective of breast cancer survivors. Qual Life Res 2007; 16:1473-81. [PMID: 17717726 DOI: 10.1007/s11136-007-9251-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2007] [Accepted: 08/01/2007] [Indexed: 10/22/2022]
Abstract
OBJECTIVES The purpose of the study was to examine breast cancer survivors' perceptions of exercise and their quality of life (QoL). METHODS About 289 breast cancer survivors completed a survey addressing exercise attitudes, behaviour and perceived QoL. In addition, the breast cancer survivors completed two open-ended questions designed to explore perceptions of exercise and QoL throughout their cancer experience. Inductive and deductive content analyses were used to analyse responses. RESULTS About 19 first-order themes were identified, which were clustered into five second-order themes that included; Exercise behaviour, Lifestyle, Limitations and barriers, Growth and priorities, and Personal beliefs and values. The findings identified a framework of multifaceted views held by breast cancer survivors in relation to their QoL and outlook on their disease. CONCLUSIONS Given that cancer survivors are faced with a number of treatment related morbidities 2 years post-diagnosis, there is a need for health professionals to carefully address a cancer survivor's exercise needs in an attempt to help improve their future QoL.
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Affiliation(s)
- Helen M Milne
- The School of Human Movement and Exercise Science, The University of Western Australia, 35 Stirling Highway, Crawley, WA 6008, Australia.
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59
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Rooney M, Wald A. Interventions for the Management of Weight and Body Composition Changes in Women With Breast Cancer. Clin J Oncol Nurs 2007; 11:41-52. [PMID: 17441396 DOI: 10.1188/07.cjon.41-52] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Weight gain and body composition changes are common during the first year after breast cancer diagnosis. Women who are overweight or obese at the time of diagnosis or who gain weight following diagnosis are at higher risk for adverse clinical outcomes. Unhealthy weight conditions, compounded or caused by weight gain after diagnosis, are a considerable challenge for women with breast cancer during and after treatment. Despite the prevalence of weight gain in women with breast cancer as well as its adverse effects, little research has examined preventive and therapeutic interventions targeting reduction of weight and/or body fat. The purpose of this article is to update the state of knowledge on weight gain and body composition changes in women with breast cancer. Current evidence from weight intervention studies, including diet, exercise, and combined approaches for weight loss-or for prevention of weight gain-are reviewed. Along with published practice guidelines, the currently available information provides guidance for oncology nurses on the methods that can impact unhealthy weight conditions associated with breast cancer.
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Affiliation(s)
- Michelle Rooney
- Diablo Valley Oncology and Hematology Medical Group, Inc., Walnut Creek, CA, USA.
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60
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Nikander R, Sievänen H, Ojala K, Oivanen T, Kellokumpu-Lehtinen PL, Saarto T. Effect of a vigorous aerobic regimen on physical performance in breast cancer patients - a randomized controlled pilot trial. Acta Oncol 2007; 46:181-6. [PMID: 17453366 DOI: 10.1080/02841860600833145] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This randomized, controlled pilot trial was carried out to assess the feasibility and efficacy of an aerobic exercise in enhancing physical performance of breast cancer patients after adjuvant treatments. The potential of the training regimen to prevent accompanying bone loss was also assessed. Thirty patients, 41-65 years of age, were randomly assigned into training or control groups shortly after adjuvant chemo- or radiotherapy. The 12-week training included a guided aerobic exercise session once a week (the effective part being either step aerobic- or circuit-training in alternate weeks) and similar home exercise sessions twice a week. Adherence to the guided sessions was 78%, while home training was performed an average 2.1 times per week. Agility assessed with figure-8 running test and peak jumping power showed significant between-group treatment-effects (approximately 5% and approximately 10%, respectively). Judged from the accelerometer data, reaction forces up to six times body weight occurred during the training, which implies that the training could also have potential to affect bone mass. The present exercise regimen turned out to be feasible and effective among breast cancer patients in terms of physical performance. Large controlled trials are necessary to confirm these findings.
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Affiliation(s)
- Riku Nikander
- Bone Research Group, UKK Institute for Health Promotion Research, Tampere, Finland.
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61
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Jones LW, Guill B, Keir ST, Carter K, Friedman HS, Bigner DD, Reardon DA. Exercise interest and preferences among patients diagnosed with primary brain cancer. Support Care Cancer 2006; 15:47-55. [PMID: 16819629 DOI: 10.1007/s00520-006-0096-8] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2006] [Accepted: 05/18/2006] [Indexed: 10/24/2022]
Abstract
GOALS OF THE WORK The purpose of the present investigation was to examine the interest and exercise preferences of an institution-based sample of brain tumor patients. Secondary aims were to examine potential differences in participant's interest and preferences by exercise behavior and select demographic/medical variables. MATERIALS AND METHODS Using a cross-sectional design, 106 brain tumor patients (age range, 32 to 83 years) who received treatment at the Preston Robert Tisch Brain Tumor Center (BTC) at Duke completed a questionnaire that assessed self-reported exercise behavior, exercise interest and preferences during active and off-treatment periods. MAIN RESULTS For exercise program preferences, participants were significantly more interested and felt more capable of participating in an exercise program following compared to during adjuvant therapy. Approximately equal proportions of brain tumor patients preferred to exercise at home with their spouse or other family members. These preferences were consistent across both cancer treatment-related time periods. For exercise information preferences, a higher proportion of respondents preferred receiving information via technologically based approaches (i.e., Internet, CD-ROM, and mailed correspondence) compared with more traditional methods (i.e., mail or face-to-face counseling). Chi-square analyses revealed that a small number of exercise program and information preferences were modified by exercise, medical, and demographic variables. CONCLUSIONS Brain tumor patients may have unique and varied preferences compared with other cancer populations. Incorporating patient's preferences into rehabilitation programs and clinical exercise investigations may optimize the potential benefits of this modality for patients with neurologic malignancies.
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Affiliation(s)
- Lee W Jones
- Duke University Medical Center, Durham, NC 27710, USA.
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62
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Vallance JKH, Courneya KS, Jones LW, Reiman T. Exercise preferences among a population-based sample of non-Hodgkin's lymphoma survivors. Eur J Cancer Care (Engl) 2006; 15:34-43. [PMID: 16441675 DOI: 10.1111/j.1365-2354.2005.00617.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
In the present study, we examined the exercise preferences of a population-based sample of non-Hodgkin's lymphoma (NHL) survivors. A secondary purpose was to explore the association between various demographic, medical, and exercise behaviour variables and elicited exercise preferences. Using a retrospective survey design, 431 NHL survivors residing in Alberta, Canada completed a mailed questionnaire designed to assess exercise preferences, past exercise behaviour, and various demographic variables. Overall, 77% of participants preferred or maybe preferred to receive exercise counselling at some point after their NHL diagnosis. An overwhelming majority indicated that they would possibly be interested (81%) and able (85%) to participate in an exercise programme designed for NHL survivors. The majority of participants (55%) listed walking as their preferred choice of exercise. Logistic regression analyses indicated that NHL survivors' exercise preferences were influenced by body mass index (BMI), exercise behaviour, and gender. Eliciting exercise preferences from the population in question yields important information for cancer care professionals designing exercise programmes for NHL survivors. Furthermore, tailoring exercise programmes to the preferences of NHL survivors may be one method to potentially enhance exercise adherence in this population both inside and outside of clinical trials.
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Affiliation(s)
- J K H Vallance
- Faculty of Physical Education, University of Alberta, Edmonton, AB, Canada
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63
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Jones LW, Courneya KS, Peddle C, Mackey JR. Oncologists' opinions towards recommending exercise to patients with cancer: a Canadian national survey. Support Care Cancer 2005; 13:929-37. [PMID: 15809835 DOI: 10.1007/s00520-005-0805-8] [Citation(s) in RCA: 86] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2004] [Accepted: 03/01/2005] [Indexed: 12/25/2022]
Abstract
RATIONALE The goal of this study was to examine oncologists' attitudes towards recommending exercise to patients with cancer during treatment. PATIENTS AND METHODS Using a national survey, all 659 practicing medical and radiation oncologists in Canada were sent a brief questionnaire. RESULTS The response rate was 46% (281/610). The majority of oncologists agreed that exercise was beneficial (62.0%), important (55.8%) and safe (63.1%) for patients with cancer during treatment. Forty-three percent of oncologists reported that they tried to recommend exercise to their patients when appropriate. Moreover, oncologists actually reported recommending exercise to 28% of their patients during the past month. Analyses also indicated significant differences between oncologists, with younger, female, and medical oncologists generally having more favorable attitudes towards exercise for patients with cancer than their older, male, and radiation oncology counterparts. CONCLUSIONS Oncologists have a favorable attitude toward recommending exercise to patients with cancer although several important barriers may prevent oncologists from providing exercise advice to their patients. Further research is required evaluating the effectiveness of interventions and strategies designed to improve oncologists' confidence and ability to advise their patients on exercise during oncology consultations.
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Affiliation(s)
- Lee W Jones
- Department of Medicine, Duke University Medical Center, Durham, NC, USA.
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64
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Jones LW, Courneya KS, Fairey AS, Mackey JR. Does the theory of planned behavior mediate the effects of an oncologist's recommendation to exercise in newly diagnosed breast cancer survivors? Results from a randomized controlled trial. Health Psychol 2005; 24:189-97. [PMID: 15755233 DOI: 10.1037/0278-6133.24.2.189] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This randomized trial examined the effects of 2 oncologist-based exercise interventions--recommendation only (RO) and recommendation plus referral (RR)--versus usual care (UC) on social-cognitive constructs from the theory of planned behavior (TPB). The authors also examined whether the TPB mediated the significant effect of the RO intervention on exercise and explained the null effect of the RR intervention. Independent t tests revealed that both interventions had significant effects on TPB constructs; however, only the RO intervention impacted perceived behavioral control (PBC). Path analyses indicated that PBC was the only construct with a direct effect on exercise and that it mediated the effect of the RO intervention on exercise and explained the null effect of the RR intervention.
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Affiliation(s)
- Lee W Jones
- Faculty of Physical Education, University of Alberta, Edmonton, Alberta, Canada.
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65
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Jones LW, Courneya KS, Vallance JKH, Ladha AB, Mant MJ, Belch AR, Stewart DA, Reiman T. Association between exercise and quality of life in multiple myeloma cancer survivors. Support Care Cancer 2005; 12:780-8. [PMID: 15322968 DOI: 10.1007/s00520-004-0668-4] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
GOALS OF THE WORK The goal of this study was to examine the association between exercise and quality of life (QOL) in multiple myeloma cancer survivors. PATIENTS AND METHODS Using a retrospective design, 156 multiple myeloma cancer survivors were mailed a questionnaire that assessed self-reported exercise behavior over three periods (prediagnosis, active treatment, and off-treatment) and QOL. MAIN RESULTS The response rate was 56% (88/ 156). Descriptive analyses indicated that 6.8% and 20.4% of survivors met national exercise guidelines during active and off-treatment periods, respectively. Exercise during active treatment and off-treatment were positively associated with overall QOL and all subdomains of QOL (all P<0.05) except physical wellbeing. CONCLUSIONS A low percentage of multiple myeloma cancer survivors are exercising regularly either during active or off-treatment periods. Survivors who report more exercise during these periods also report higher QOL. These findings suggest that a randomized controlled trial is warranted.
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Affiliation(s)
- Lee W Jones
- Faculty of Physical Education, University of Alberta, E-424 Van Vliet Centre, Edmonton, Alberta, Canada.
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66
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Irwin ML, McTiernan A, Baumgartner RN, Baumgartner KB, Bernstein L, Gilliland FD, Ballard-Barbash R. Changes in body fat and weight after a breast cancer diagnosis: influence of demographic, prognostic, and lifestyle factors. J Clin Oncol 2005; 23:774-82. [PMID: 15681521 PMCID: PMC3000612 DOI: 10.1200/jco.2005.04.036] [Citation(s) in RCA: 236] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
PURPOSE Obese women and women who gain weight after a breast cancer diagnosis are at a greater risk for breast cancer recurrence and death compared with lean women and women who do not gain weight after diagnosis. In this population-based study, we assessed weight and body fat changes from during the first year of diagnosis to during the third year after diagnosis, and whether any changes in weight and body fat varied by demographic, prognostic, and lifestyle factors in 514 women with incident Stage 0-IIIA breast cancer. METHODS Patients were participants in the Health, Eating, Activity, and Lifestyle (HEAL) study. Weight and body fat (via dual-energy x-ray absorptiometry scans) were measured during the baseline visit and 2 years later at a follow-up visit. Analysis of covariance methods were used to obtain mean weight and body fat changes adjusted for potential cofounders. RESULTS Women increased their weight and percent body fat by 1.7 +/- 4.7 kg and 2.1% +/- 3.9%, respectively, from during their first year of diagnosis to during their third year of diagnosis. A total of 68% and 74% of patients gained weight and body fat, respectively. Greater increases in weight were observed among women diagnosed with a higher disease stage, younger age, being postmenopausal, and women who decreased their physical activity from diagnosis to up to 3 years after diagnosis (P for trend < .05). CONCLUSION Weight and body fat increased in the postdiagnosis period. Future research should focus on the effect of physical activity on weight and fat loss and breast cancer prognosis.
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Affiliation(s)
- Melinda L Irwin
- Department of Epidemiology and Public Health, Yale School of Medicine, PO Box 208034, New Haven, CT 06520-8034, USA.
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67
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Stevinson C, Fox KR. Role of exercise for cancer rehabilitation in UK hospitals: a survey of oncology nurses. Eur J Cancer Care (Engl) 2005; 14:63-9. [PMID: 15698387 DOI: 10.1111/j.1365-2354.2005.00514.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
A growing body of evidence indicates the potential benefits of exercise for cancer patients but little is known about exercise promotion within cancer services. A postal survey of oncology nurses in UK hospitals was conducted to ascertain the extent to which exercise has a role in cancer care. The survey design was based on the Total Design Method leading to a completed sample of 221 (62% response rate). Nineteen hospitals (9%) offered some kind of exercise programme or class for patients. In a further 17 (8%), there were other opportunities for exercise available (e.g. an exercise bicycle for inpatients). Sixty-five per cent of nurses were in favour of the notion of providing a specific exercise rehabilitation service for patients. Scarce resources and lack of awareness and expertise were identified as common barriers to establishing such a service. Fifty-eight per cent of nurses were unaware of, or unfamiliar with the published research on exercise for cancer rehabilitation and 33% reported receiving no training relating to exercise and health. The survey results indicate that some hospitals include exercise in the services offered to patients and that the majority of nurses favour adopting exercise as a rehabilitation intervention. However in general, the use of exercise within cancer care in the UK is currently rare.
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Affiliation(s)
- C Stevinson
- Department of Exercise and Health Sciences, University of Bristol, Centre for Sport, Exercise & Health, Tyndall Avenue, Bristol, BS8 1TP, UK.
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68
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Jones LW, Courneya KS, Fairey AS, Mackey JR. Effects of an oncologist's recommendation to exercise on self-reported exercise behavior in newly diagnosed breast cancer survivors: a single-blind, randomized controlled trial. Ann Behav Med 2004; 28:105-13. [PMID: 15454357 DOI: 10.1207/s15324796abm2802_5] [Citation(s) in RCA: 247] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND Increased attention has focused on exercise as a quality of life intervention for breast cancer survivors during and after adjuvant therapy. PURPOSE Our objective was to examine the effects of an oncologist's recommendation to exercise on self-reported exercise behavior in newly diagnosed breast cancer survivors attending their first adjuvant therapy consultation. METHODS Using a single-blinded, 3-armed, randomized controlled trial, 450 breast cancer survivors were randomly assigned to receive an oncologist exercise recommendation only, an oncologist exercise recommendation plus referral to an exercise specialist, or usual care. The primary outcome was self-reported total exercise (in metabolic equivalent [MET] hours per week) at 5 weeks postconsultation. RESULTS The follow-up assessment rate was 73% (329 of 450). Intention-to-treat analysis based on participants with follow-up data indicated a significant difference in total exercise in favor of the recommendation-only group over the usual care group (mean difference, 3.4 MET hr per week; 95% confidence interval [CI], 0.7-6.1 MET hr per week; p = .011). There was no significant difference between the recommendation-plus-referral group and the usual care group (mean difference, 1.5 MET hr per week; 95% CI, -1.0 to 4.0 MET hr per week; p = .244). Ancillary "on-treatment" analyzes showed that participants who recalled an exercise recommendation reported significantly more total exercise than participants who did not recall an exercise recommendation (mean difference, 4.1 MET hr per week: 95% CI, 1.9-6.4 MET hr per week; p < .001). CONCLUSIONS Our findings suggest that an oncologist recommendation may increase exercise behavior in newly diagnosed breast cancer survivors, particularly if it is recalled 1 week after the recommendation.
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Affiliation(s)
- Lee W Jones
- Faculty of Physical Education, University of Alberta, Edmonton, Alberta TG6 2H9, Canada.
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69
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Stevinson C, Lawlor DA, Fox KR. Exercise interventions for cancer patients: systematic review of controlled trials. Cancer Causes Control 2004; 15:1035-56. [PMID: 15801488 DOI: 10.1007/s10552-004-1325-4] [Citation(s) in RCA: 139] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To systematically review controlled trials investigating the effects of exercise interventions in cancer patients. METHODS Studies were located through searching seven electronic databases (Medline, Embase, Cochrane Library, CancerLit, PsycInfo, Cinahl, SportDiscus), scanning reference lists of relevant articles, contacting experts (n = 20), and checking the contents lists of journals available through ZETOC (Electronic Table of Contents). To be included, trials had to be prospective, controlled, involve participants diagnosed with cancer and test an exercise intervention. Types of outcome were not restricted. Two reviewers independently applied the selection criteria. RESULTS Thirty-three controlled trials (including 25 randomized trials) were included in the review. There was some evidence that physical function was increased among those who exercised. Furthermore, symptoms of fatigue did not appear to be increased and there were few adverse effects reported. There was insufficient evidence to determine effects on other outcomes, such as quality of life, with results hampered by the heterogeneity between studies as well as poor methodological quality. Data were also lacking on the long term effects of exercise relating to cancer recurrence or survival. CONCLUSIONS There is preliminary evidence that exercise interventions for cancer patients can lead to moderate increases in physical function and are not associated with increased symptoms of fatigue. However, it is impossible from current evidence to determine whether exercise has long term beneficial effects on survival or quality of life.
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Affiliation(s)
- Clare Stevinson
- Department of Exercise and Health Sciences, University of Bristol, Centre for Sport, Exercise and Health, Tyndall Avenue, Bristol BS8 1TP, UK.
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