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Gnagnarella P, Dragà D, Raja S, Baggi F, Simoncini MC, Sabbatini A, Mazzocco K, Masiero M, Bassi FD, Peradze N, Zorzino L, Latella M, Pravettoni G, Maisonneuve P. Physical activity and/or dietary intervention in overweight or obese breast cancer survivors: results of the InForma randomized trial. J Cancer Surviv 2024; 18:1732-1746. [PMID: 37418169 DOI: 10.1007/s11764-023-01415-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 06/05/2023] [Indexed: 07/08/2023]
Abstract
PURPOSE This study aimed to test the efficacy of a 6-month intervention on weight loss in a group of overweight or obese breast cancer (BC) survivors. We promoted adherence to a healthy diet or/and to increase physical activity, making use of a step counter device. Here we present results regarding the change in anthropometric measures and blood parameters. METHODS 266 women treated for BC with a BMI ≥ 25 kg/m2 were randomized to a 6-month intervention into four arms: Dietary Intervention (DI); Physical Activity Intervention (PAI); Physical Activity and Dietary Intervention (PADI); Minimal Intervention (MI). Women were offered individualized counseling by a dietitian, a physiotherapist and a psychologist. Participants were followed up for an additional 18 months. RESULTS 231 women completed the 6-month intervention and 167 completed the additional 18-month follow-up. Respectively, 37.5% and 36.7% of women included in the DI and PADI arm reached the objective of the trial (weight reduction > 5%). Significant weight and circumferences decrease was observed at 6-month in the four arms. Weight decrease was more pronounced in the DI (-4.7% ± 5.0%) and PADI (-3.9% ± 4.5%) arms, persisted over time (at 12 and 24 months), where counseling was mainly focused on the dietic component. The intervention had an effect on the glucose level with a significant reduction in whole population (-0.9 ± 11.7 p-value 0.02) and most pronounced in the PADI arm (-2.4 ± 7.8 p-value 0.03). CONCLUSIONS Lifestyle intervention mainly focused on the dietetic component and making use of a step counter improved body weight, circumferences and glucose levels. IMPLICATIONS FOR CANCER SURVIVORS A personalized approach yields a potential clinical benefit for BC survivors.
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Affiliation(s)
- Patrizia Gnagnarella
- Division of Epidemiology and Biostatistics, IEO European Institute of Oncology IRCSS, Via Ripamonti 435, 20141, Milan, Italy.
| | - Daniele Dragà
- Division of Epidemiology and Biostatistics, IEO European Institute of Oncology IRCSS, Via Ripamonti 435, 20141, Milan, Italy
| | - Silvia Raja
- Division of Epidemiology and Biostatistics, IEO European Institute of Oncology IRCSS, Via Ripamonti 435, 20141, Milan, Italy
| | - Federica Baggi
- Physiotherapy Unit, IEO European Institute of Oncology IRCSS, Via Ripamonti 435, 20141, Milan, Italy
| | - Maria Claudia Simoncini
- Physiotherapy Unit, IEO European Institute of Oncology IRCSS, Via Ripamonti 435, 20141, Milan, Italy
| | - Annarita Sabbatini
- Dietetic and Clinical Nutrition Unit, IEO European Institute of Oncology IRCSS, Via Ripamonti 435, 20141, Milan, Italy
| | - Ketti Mazzocco
- Department of Oncology and Hemato-Oncology, University of Milan, Via Festa del Perdono 7, 20122, Milan, Italy
- Applied Research Division for Cognitive and Psychological Sciences, IEO European Institute of Oncology IRCSS, Via Ripamonti 435, 20141, Milan, Italy
| | - Marianna Masiero
- Department of Oncology and Hemato-Oncology, University of Milan, Via Festa del Perdono 7, 20122, Milan, Italy
- Applied Research Division for Cognitive and Psychological Sciences, IEO European Institute of Oncology IRCSS, Via Ripamonti 435, 20141, Milan, Italy
| | - Fabio Domenico Bassi
- Division of Breast Surgery, IEO European Institute of Oncology IRCSS, Via Ripamonti 435, 20141, Milan, Italy
| | - Nickolas Peradze
- Division of Breast Surgery, IEO European Institute of Oncology IRCSS, Via Ripamonti 435, 20141, Milan, Italy
| | - Laura Zorzino
- Division of Laboratory Medicine, IEO European Institute of Oncology IRCSS, Via Ripamonti 435, 20141, Milan, Italy
| | - Marialetizia Latella
- Division of Epidemiology and Biostatistics, IEO European Institute of Oncology IRCSS, Via Ripamonti 435, 20141, Milan, Italy
| | - Gabriella Pravettoni
- Department of Oncology and Hemato-Oncology, University of Milan, Via Festa del Perdono 7, 20122, Milan, Italy
- Applied Research Division for Cognitive and Psychological Sciences, IEO European Institute of Oncology IRCSS, Via Ripamonti 435, 20141, Milan, Italy
| | - Patrick Maisonneuve
- Division of Epidemiology and Biostatistics, IEO European Institute of Oncology IRCSS, Via Ripamonti 435, 20141, Milan, Italy
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Coping Strategies in Elderly Colorectal Cancer Patients. Cancers (Basel) 2022; 14:cancers14030608. [PMID: 35158876 PMCID: PMC8833470 DOI: 10.3390/cancers14030608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 01/16/2022] [Accepted: 01/21/2022] [Indexed: 01/27/2023] Open
Abstract
Simple Summary Coping strategies help to mitigate the impact of a situation on an individual’s life. Elderly patients that undergo the stressful situation of going through colorectal cancer are no exception. This systematic review describes the improvement of the quality of life of patients who applied coping strategies to their situation. The results expose that coping strategies helped these patients to adapt and overcome the disease’s stressful scenarios. Abstract In Spain, 34,331 new cases of colorectal cancer were diagnosed in 2018 and 15,923 individuals died from this disease in the same year. The highest incidence of colorectal cancer is among individuals aged 65–75 years and the physiological consequences of aging, alongside the effects of the disease and its treatment, can exacerbate their physical deterioration and cognitive impairment and reduce their social relationships. The learning of coping strategies may help to improve the quality of life of patients after cancer diagnosis. To test the hypothesis that the utilization of coping strategies can improve the quality of life of elderly patients with colorectal cancer, PubMed and EBSCO databases were searched, up to 2021, using the following terms: “coping strategies and colorectal cancer” with “anxiety”, “quality of life”, “depression”, “unmet needs”, “optimism”, “intimacy”, “distress”, “self-efficacy” and “self-esteem” with Boolean operators “AND”, “OR”. The literature search retrieved 641 titles/abstracts written in English. After an exhaustive analysis, only 7 studies met the inclusion criteria. Randomized evidence was scant and was reported only in 3/7 of the studies analyzed. Data from available randomized evidence support that patients improved on their depression and quality of life and felt more prepared to deal with their cancer. Coping strategies in patients with colorectal cancer were effective in improving patient adaptation to their new situation. Healthcare professionals working with these patients should receive training in this complementary treatment, to be able to conduct comprehensive care in order to improve the quality of life of these patients.
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Guillamó E, Travier N, Oviedo GR, Fonseca-Nunes A, Alamo JM, Cos F, Roca A, Niño O, Agudo A, Javierre C. Physical Test to Estimate Suitable Workloads for an Exercise Program in Breast Cancer Survivors. J Strength Cond Res 2021; 34:3593-3599. [PMID: 29579014 DOI: 10.1519/jsc.0000000000002337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Guillamó, E, Travier, N, Oviedo, GR, Fonseca-Nunes, A, Alamo, JM, Cos, F, Roca, A, Niño, O, Agudo, A, and Javierre, C. Physical test to estimate suitable workloads for an exercise program in breast cancer survivors. J Strength Cond Res 34(12): 3593-3599, 2020-Epidemiologic studies suggest that patients with breast cancer who gain weight after diagnosis have a higher risk of recurrence and death. Regular physical exercise can help minimize postdiagnosis weight gain. The objective of the study was to assess the effectiveness of a physical test for individualizing the workloads used during a fitness program. To continuously individualize the intensity of the training, a test was designed and integrated into the sessions. The test consisted in monitoring heart rate and workload during 2 bouts of cycling at moderate intensity. The workload parameters recorded during the tests were later used as reference values to plan the intensity of the next in-person training sessions. The 5 tests conducted during the 12 weeks of the intervention showed significant differences in intensity (F = 3.034, p = 0.047). Compared with the first evaluation, the intensities measured during the third, fourth, and fifth tests presented increases of 9.9% (p = 0.02), 13.2% (p = 0.019), and 17.5% (p = 0.002), respectively. A significant increase in workload with respect to body weight was observed in the physical assessment performed after the program (t = 13.2, p = 0.0001). The peak oxygen consumption with respect to body weight (peak V[Combining Dot Above]O2) achieved by the subjects during the assessment at the end of the program had also increased (t = 9.72, p = 0.0001). The intensity test, introduced in the training sessions along with the physical exercise program, was an easy-to-use, practical tool for monitoring intensity. It allows an adjustment of the workload over the program period that respects the individual progression of each patient.
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Affiliation(s)
- Elisabet Guillamó
- Department of Physiological Sciences II, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Noemie Travier
- Breast Cancer Screening Unit, Cancer Prevention and Control Program, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
| | - Guillermo R Oviedo
- Department of Physical Activity and Sports Sciences. Faculty of Psychology, Education and Sport Sciences Blanquerna, University Ramon Llull, Barcelona, Spain
| | - Ana Fonseca-Nunes
- Unit of Nutrition, Environment and Cancer, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain; and
| | - Juan-Mariano Alamo
- Department of Physiological Sciences II, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Francesc Cos
- Health and Applied Sciences Department, National Institute for Physical Education of Catalonia, Barcelona, Spain
| | - Ariadna Roca
- Department of Physiological Sciences II, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Oscar Niño
- Department of Physiological Sciences II, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Antonio Agudo
- Unit of Nutrition, Environment and Cancer, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain; and
| | - Casimiro Javierre
- Department of Physiological Sciences II, School of Medicine, University of Barcelona, Barcelona, Spain
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Pisegna J, Xu M, Spees C, Krok-Schoen JL. Mental health-related quality of life is associated with diet quality among survivors of breast cancer. Support Care Cancer 2021; 29:2021-2028. [PMID: 32844314 DOI: 10.1007/s00520-020-05698-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 08/19/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE This study sought to understand the association of mental health-related quality of life (MHRQoL) and nutritional status (food security status and malnutrition risk), with diet quality among female survivors of breast cancer. METHOD This pilot cross-sectional study utilized self-report survey data from the RAND-36, the USDA 2-item food insecurity screen, the Malnutrition Screening Tool (MST), and the Diet History Questionnaire II (DHQII)/Health Eating Index 2015 (HEI). Participants self-selected participation after being identified through an academic medical center cancer registry and contact through mailed recruitment letters and flyers posted in oncology clinics. Emotional well-being and social functioning composite scores of the RAND-36 were used to characterize MHRQoL. Correlational and regression analyses were performed to assess the association of diet quality, nutritional status, and MHRQoL. RESULTS The majority of participants (n = 90) were non-Hispanic white (90%), average age of 71.3 ± 8.1 years, and an average body mass index (BMI) of 28.2 ± 6.6. Four of the 90 participants (4.4%) scored at risk for food insecurity. Linear regression indicated that social functioning composite scores were positively associated with HEI scores (β = 0.11, SE = 0.53, p = 0.03). Controlling for demographic characteristics, education level (β = 5.25, SE = 2.25, p = 0.02) was positively associated with HEI scores. CONCLUSION Diet quality and MHRQoL were associated among breast cancer survivors, with education level also being associated with diet quality. These results can be used to aid targeted nutrition counseling and mental health interventions to address the nutritional vulnerabilities among female breast cancer survivors, particularly among older cancer survivors.
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Affiliation(s)
- Janell Pisegna
- Division of Medical Dietetics and Health Sciences, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, 306 Atwell Hall 453 W. 10th Ave., Columbus, OH, 43210, USA
| | - Menglin Xu
- Comprehensive Cancer Center, The Ohio State University, 460 W. 10th Avenue, Columbus, OH, 43210, USA
| | - Colleen Spees
- Division of Medical Dietetics and Health Sciences, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, 306 Atwell Hall 453 W. 10th Ave., Columbus, OH, 43210, USA
- Comprehensive Cancer Center, The Ohio State University, 460 W. 10th Avenue, Columbus, OH, 43210, USA
| | - Jessica L Krok-Schoen
- Division of Medical Dietetics and Health Sciences, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, 306 Atwell Hall 453 W. 10th Ave., Columbus, OH, 43210, USA.
- Comprehensive Cancer Center, The Ohio State University, 460 W. 10th Avenue, Columbus, OH, 43210, USA.
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dos Santos ATC, da Silva RP, de Almeida LM, Bosi MLM, de Menezes MDFB, Skaba MMVF, Nigenda G, Arruda CAM, Pinheiro CPO, González-Robledo MC, Knaul FM. Cancer survivorship needs in Brazil: Patient and family perspective. PLoS One 2020; 15:e0239811. [PMID: 33031426 PMCID: PMC7544129 DOI: 10.1371/journal.pone.0239811] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 09/14/2020] [Indexed: 11/18/2022] Open
Abstract
Introduction Cancer Survivorship is a growing public health challenge. Effective responses from health care and social services depend on appropriate identification of survivors and their families´ specific needs. There are few studies on survivorship in low and middle-income countries, therefore, more evidence-based studies are necessary to develop a comprehensive approach to cancer survivorship. Objectives Identify the needs of cancer survivors and their relatives, specifically those of individuals with breast, cervical or prostate cancer, and with acute lymphocytic leukemia (ALL). Methods A qualitative, exploratory study conducted in two referral institutions in Brazil, located in Rio de Janeiro (Southeast region) and Fortaleza (Northeast region). The study included 47 patients of public and private health services and 12 family members. We used script-based semi-structured interviews. The discursive material obtained was categorized and analyzed using the Thematic Analysis approach. Results The analysis identified three central themes: 1) consequences of cancer treatment; 2) Changes in daily life associated with cancer survivorship; and 3) Unmet structural needs in cancer survivorship. Conclusion Social and cancer control policies in Brazil should provide resources, specific care standards and clinical, psychological and social support. Cancer survivors should also receive rehabilitation and work reintegration guidelines. This matter requires broader access to qualified cancer information, development of an integrated patient-centered care and care model, and more research resources for the country's post-treatment cancer period.
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Affiliation(s)
- Antonio Tadeu Cheriff dos Santos
- Population Research Division, Nucleus of Research and Qualitative Studies, National Cancer Institute, Rio de Janeiro, Brazil
- * E-mail:
| | - Rildo Pereira da Silva
- Population Research Division, Nucleus of Research and Qualitative Studies, National Cancer Institute, Rio de Janeiro, Brazil
| | - Liz Maria de Almeida
- Division of Population Research, National Cancer Institute, Rio de Janeiro, Brazil
| | - Maria Lúcia Magalhães Bosi
- Laboratory of Qualitative Research and Evaluation in Health, Federal University of Ceara, Fortaleza, Ceará, Brazil
| | | | | | - Gustavo Nigenda
- National School of Nursing and Obstetrics, National Autonomous University of México, México City, México
| | - Carlos André Moura Arruda
- Laboratory of Qualitative Research and Evaluation in Health, Federal University of Ceara, Fortaleza, Ceará, Brazil
| | | | | | - Felícia Marie Knaul
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Coral Gables, Florida, United States of America
- Institute for Advanced Study of the Americas, University of Miami, Coral Gables, Florida, United States of America
- Programa Universalidad y Competitividad en Salud, Fundación Mexicana para la Salud, Mexico City, Mexico
- Tómatelo a Pecho, Mexico City, Mexico
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Kim S, Han J, Lee MY, Jang MK. The experience of cancer-related fatigue, exercise and exercise adherence among women breast cancer survivors: Insights from focus group interviews. J Clin Nurs 2019; 29:758-769. [PMID: 31769562 DOI: 10.1111/jocn.15114] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 09/21/2019] [Accepted: 11/19/2019] [Indexed: 12/11/2022]
Abstract
AIMS AND OBJECTIVES To identify the experience of breast cancer survivors regarding cancer-related fatigue, exercise and exercise adherence. BACKGROUND Cancer-related fatigue is a common symptom among cancer survivors that limits quality of life. Despite exercise being recommended as a viable solution to manage cancer-related fatigue, relatively few research studies on the experience of cancer-related fatigue and exercise adherence have been conducted. DESIGN This was a qualitative study to identify breast cancer survivors' experience of cancer-related fatigue, exercise and exercise adherence. This paper adhered to the COREQ checklist in reporting. METHODS Four focus group interviews were conducted with 16 breast cancer survivors who had fatigue score of 4 out of 10 (moderate fatigue) or greater. Ethical approval was obtained and participants met for focus group interview discussion. The interview guide included questions on cancer-related fatigue, barriers and facilitators of exercising, strategies for exercise adherence and suggestions for a supportive programme. RESULTS Four themes were identified through thematic analysis: (a) The insidious and overpowering nature of cancer-related fatigue; (b) exercising when experiencing fatigue surrounded by prevailing myths; (c) multiple barriers to exercise; and (d) facilitative factors to continue exercising despite fatigue. CONCLUSIONS Participants' experience of moderate or greater cancer-related fatigue prevented them from exercising, despite knowing its importance, and limited them to passive activities. Misconceptions that exercise is associated with lymphedema and risk of recurrence, poor psychosocial self-image and lack of clear knowledge and exercise programmes for cancer survivors further limited adherence to exercise. In contrast, finding comfort and strength through exercising and interacting with other breast cancer survivors were facilitative factors. RELEVANCE TO CLINICAL PRACTICE The insights shared by breast cancer survivors experiencing cancer-related fatigue can contribute to developing an exercise adherence programme as a way to manage and alleviate fatigue and establish healthy survivorship care.
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Affiliation(s)
- Sue Kim
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Republic of Korea
| | - Jeehee Han
- Yonsei University College of Nursing, Seoul, Republic of Korea
| | - Min Young Lee
- Yonsei University College of Nursing, Seoul, Republic of Korea
| | - Min Kyeong Jang
- University of Illinois Cancer Center, Chicago, IL, USA.,College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
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Lozano-Lozano M, Martín-Martín L, Galiano-Castillo N, Fernández-Lao C, Cantarero-Villanueva I, López-Barajas IB, Arroyo-Morales M. Mobile health and supervised rehabilitation versus mobile health alone in breast cancer survivors: Randomized controlled trial. Ann Phys Rehabil Med 2019; 63:316-324. [PMID: 31454561 DOI: 10.1016/j.rehab.2019.07.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 07/29/2019] [Accepted: 07/29/2019] [Indexed: 01/04/2023]
Abstract
BACKGROUND Survival rates in cancer are increasing exponentially, with a corresponding increase/influence in disability-adjusted life-years. Efforts should be made to explore the optimal balance between unsupervised/distance-based and supervised/onsite approaches to cancer care. OBJECTIVE This study aimed to compare the clinical efficacy of the BENECA mobile Health (mHealth) lifestyle application combined with a supervised rehabilitation program (BENECA and supervised rehabilitation) versus the BENECA mHealth lifestyle application alone on quality of life (QoL) and functional outcomes of breast cancer survivors. METHODS This randomized controlled trial included 80 survivors of breast cancer diagnosed at stage I-IIIA, who completed adjuvant therapy and were overweight or obese at diagnosis. Participants were randomly allocated (ratio 1:1, 3 waves) to BENECA mHealth and rehabilitation for 2months (n=40) or BENECA mHealth and usual care (BENECA mHealth alone; n=40). Participants completed a questionnaire at baseline (T1), 8-weeks post-intervention (T2) and 6-month follow-up (T3). The primary outcome was QoL assessed with the EORT QLQ-C30. Secondary outcomes included upper-limb functionality and body composition. Statistical (between-group analyses of covariance) and clinical effects were analyzed by intention to treat. RESULTS Both groups showed improved outcomes, but global QoL was significantly better with BENECA mHealth and rehabilitation than BENECA mHealth alone (mean difference, 12.76; 95% confidence interval 4.85; 20.67; P=0.004), with a moderate-to-large effect size (d=72). The proportion of participants reporting reliable clinical improvement on global QoL at T2 was higher with BENECA mHealth and rehabilitation than BENECA mHealth alone (57.5% vs 26.3%, P=0.008). Improvement in subjective and objective upper-limb functionality was also higher with BENECA mHealth and rehabilitation. CONCLUSIONS The BENECA mHealth lifestyle application with a supervised rehabilitation program had a statistically and clinically significant effect on QoL and upper-limb functionality in breast cancer survivors and is a unique and important promising new approach.
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Affiliation(s)
- Mario Lozano-Lozano
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Avda. de la Ilustración, 60, 18016 Granada, Spain; Sport and Health Joint University Institute (iMUDS), Granada, Spain; Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain; "Cuídate" Support Unit for Oncology Patients (UAPO-Cuídate), Granada, Spain
| | - Lydia Martín-Martín
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Avda. de la Ilustración, 60, 18016 Granada, Spain; Sport and Health Joint University Institute (iMUDS), Granada, Spain; Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain; "Cuídate" Support Unit for Oncology Patients (UAPO-Cuídate), Granada, Spain
| | - Noelia Galiano-Castillo
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Avda. de la Ilustración, 60, 18016 Granada, Spain; Sport and Health Joint University Institute (iMUDS), Granada, Spain; Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain; "Cuídate" Support Unit for Oncology Patients (UAPO-Cuídate), Granada, Spain.
| | - Carolina Fernández-Lao
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Avda. de la Ilustración, 60, 18016 Granada, Spain; Sport and Health Joint University Institute (iMUDS), Granada, Spain; Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain; "Cuídate" Support Unit for Oncology Patients (UAPO-Cuídate), Granada, Spain
| | - Irene Cantarero-Villanueva
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Avda. de la Ilustración, 60, 18016 Granada, Spain; Sport and Health Joint University Institute (iMUDS), Granada, Spain; Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain; "Cuídate" Support Unit for Oncology Patients (UAPO-Cuídate), Granada, Spain
| | | | - Manuel Arroyo-Morales
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Avda. de la Ilustración, 60, 18016 Granada, Spain; Sport and Health Joint University Institute (iMUDS), Granada, Spain; Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain; "Cuídate" Support Unit for Oncology Patients (UAPO-Cuídate), Granada, Spain
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Lozano-Lozano M, Galiano-Castillo N, Martín-Martín L, Pace-Bedetti N, Fernández-Lao C, Arroyo-Morales M, Cantarero-Villanueva I. Monitoring Energy Balance in Breast Cancer Survivors Using a Mobile App: Reliability Study. JMIR Mhealth Uhealth 2018; 6:e67. [PMID: 29588273 PMCID: PMC5893887 DOI: 10.2196/mhealth.9669] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Revised: 01/25/2018] [Accepted: 01/26/2018] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The majority of breast cancer survivors do not meet recommendations in terms of diet and physical activity. To address this problem, we developed a mobile health (mHealth) app for assessing and monitoring healthy lifestyles in breast cancer survivors, called the Energy Balance on Cancer (BENECA) mHealth system. The BENECA mHealth system is a novel and interactive mHealth app, which allows breast cancer survivors to engage themselves in their energy balance monitoring. BENECA was designed to facilitate adherence to healthy lifestyles in an easy and intuitive way. OBJECTIVE The objective of the study was to assess the concurrent validity and test-retest reliability between the BENECA mHealth system and the gold standard assessment methods for diet and physical activity. METHODS A reliability study was conducted with 20 breast cancer survivors. In the study, tri-axial accelerometers (ActiGraphGT3X+) were used as gold standard for 8 consecutive days, in addition to 2, 24-hour dietary recalls, 4 dietary records, and sociodemographic questionnaires. Two-way random effect intraclass correlation coefficients, a linear regression-analysis, and a Passing-Bablok regression were calculated. RESULTS The reliability estimates were very high for all variables (alpha≥.90). The lowest reliability was found in fruit and vegetable intakes (alpha=.94). The reliability between the accelerometer and the dietary assessment instruments against the BENECA system was very high (intraclass correlation coefficient=.90). We found a mean match rate of 93.51% between instruments and a mean phantom rate of 3.35%. The Passing-Bablok regression analysis did not show considerable bias in fat percentage, portions of fruits and vegetables, or minutes of moderate to vigorous physical activity. CONCLUSIONS The BENECA mHealth app could be a new tool to measure energy balance in breast cancer survivors in a reliable and simple way. Our results support the use of this technology to not only to encourage changes in breast cancer survivors' lifestyles, but also to remotely monitor energy balance. TRIAL REGISTRATION ClinicalTrials.gov NCT02817724; https://clinicaltrials.gov/ct2/show/NCT02817724 (Archived by WebCite at http://www.webcitation.org/6xVY1buCc).
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Affiliation(s)
- Mario Lozano-Lozano
- Department of Physical Therapy, University of Granada, Granada, Spain.,Centro de Investigación Deporte y Salud, University of Granada, Granada, Spain
| | - Noelia Galiano-Castillo
- Department of Physical Therapy, University of Granada, Granada, Spain.,Centro de Investigación Deporte y Salud, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria ibs-Granada, Complejo Hospitalario Universitario de Granada, University of Granada, Granada, Spain
| | - Lydia Martín-Martín
- Department of Physical Therapy, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria ibs-Granada, Complejo Hospitalario Universitario de Granada, University of Granada, Granada, Spain
| | | | - Carolina Fernández-Lao
- Department of Physical Therapy, University of Granada, Granada, Spain.,Centro de Investigación Deporte y Salud, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria ibs-Granada, Complejo Hospitalario Universitario de Granada, University of Granada, Granada, Spain
| | - Manuel Arroyo-Morales
- Department of Physical Therapy, University of Granada, Granada, Spain.,Centro de Investigación Deporte y Salud, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria ibs-Granada, Complejo Hospitalario Universitario de Granada, University of Granada, Granada, Spain
| | - Irene Cantarero-Villanueva
- Department of Physical Therapy, University of Granada, Granada, Spain.,Centro de Investigación Deporte y Salud, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria ibs-Granada, Complejo Hospitalario Universitario de Granada, University of Granada, Granada, Spain
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9
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Weight changes in postmenopausal breast cancer survivors over 2 years of endocrine therapy: a retrospective chart review. Breast Cancer Res Treat 2017; 162:375-388. [DOI: 10.1007/s10549-017-4106-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 01/06/2017] [Indexed: 10/20/2022]
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Lindsey S, Astroth K, Kumar P. Improving Awareness, Identification, and Management of Sarcopenic Obesity in Cancer Survivors: An Evidence-Based Toolbox. Clin J Oncol Nurs 2016; 20:E132-8. [PMID: 27668384 DOI: 10.1188/16.cjon.e132-e138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Sarcopenic obesity, the dual condition of decreased muscle mass with increased fat mass, can affect morbidity, mortality, and quality of life in adult cancer survivors. OBJECTIVES The purpose of this project was to determine the effects of the use of an educational toolbox on advanced practice nurses' (APNs') confidence in identifying and managing adult cancer survivors at risk for sarcopenic obesity. METHODS APNs in an outpatient practice who care for adult cancer survivors received an educational toolbox with strategies to identify and manage adult cancer survivors at risk for sarcopenic obesity. FINDINGS APNs reported being more confident in their ability to identify adult patients with cancer at risk for sarcopenic obesity and in their ability to manage these patients compared to prior to the intervention. Educational resources provided an effective tool for identifying and managing patients at risk for sarcopenic obesity.
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Stoutenberg M, Sogor A, Arheart K, Cutrono SE, Kornfeld J. A Wellness Program for Cancer Survivors and Caregivers: Developing an Integrative Pilot Program with Exercise, Nutrition, and Complementary Medicine. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2016; 31:47-54. [PMID: 25663357 DOI: 10.1007/s13187-014-0785-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The Integrative Wellness Program (IWP) at the University of Miami Sylvester Comprehensive Cancer Center (SCCC) sought to provide integrative wellness education to cancer patients, survivors, and caregivers by offering instruction in exercise, nutrition, and complementary and alternative medicine. The objective of this study was to assess the impact of the IWP on the overall wellness of the individuals participating in the program. Three different 10-week versions of the IWP were conducted over a 1-year period. Each session focused on a different wellness topic presented through interactive lectures and applied activities. A series of self-report questionnaires were administered at baseline and again at the completion of the program to assess improvements in physical activity levels, dietary habits, sleep hygiene, and quality of life. Participants were generally older, Caucasian, female, had higher levels of education, and still currently receiving treatment. Significant changes were observed in two measures: Starting the Conversation (-2.0 ± 2.40, p = .037) and the Sticking To It subscale of the Self-Efficacy and Eating Habits Survey (1.7 ± 1.22, p = .0013). A trend for improvement in the Reducing Fat subscale of the Self-Efficacy Eating Habits (0.44 ± 0.60, p = .056) was also observed. Participant satisfaction surveys indicated high levels of satisfaction and applicability of the material presented. The significant improvements detected related to dietary habits, combined with the responses from the participant satisfaction surveys, suggest that the IWP was well received and can positively impact the overall wellness of cancer patients, survivors, and their caregivers.
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Affiliation(s)
- Mark Stoutenberg
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 1008, Miami, FL, 33136, USA.
| | - Alyssa Sogor
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 1008, Miami, FL, 33136, USA
| | - Kris Arheart
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 1008, Miami, FL, 33136, USA
| | - Stacy E Cutrono
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Julie Kornfeld
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 1008, Miami, FL, 33136, USA
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Karvinen K, Bruner B, Truant T. Lifestyle Counseling Practices of Oncology Nurses in the United States and Canada. Clin J Oncol Nurs 2015; 19:690-6. [DOI: 10.1188/15.cjon.690-696] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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13
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Finocchiaro C, Ossola M, Monge T, Fadda M, Brossa L, Caudera V, De Francesco A. Effect of specific educational program on dietary change and weight loss in breast-cancer survivors. Clin Nutr 2015. [PMID: 26199085 DOI: 10.1016/j.clnu.2015.05.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
AIMS Consumption of Western foods with high dietary glycemic load is associated with breast cancer development, whereas adherence to Mediterranean diet has been linked to a reduced risk. Changing lifestyle can decrease risk of recurrences and mortality. Thus decreasing the weight, improving the diet and promoting lifestyle are among of the most important issues of public health. We evaluated the effects of a specific educational intervention conducted by dietitians, nutritionists physicians, oncologist and sport physician to promote lifestyle in breast cancer survivors. METHODS We recruited 100 pts in breast cancer follow up. The intervention program consisted of four meetings once a week including lectures, training sessions and workshops lasting overall a month. Dietary recommendations were provided on the basis of WCRF/AICR guidelines and were modelled on Mediterranean diet. Sport physician recommended adapted physical activity, based on clinical experiences and scientific evidences. RESULTS Significantly decrease of BMI and waist circumference was observed after 2 and 6 months. Adherence to Mediterranean diet was significantly improved, both in heightening typical Mediterranean foods, both in decreasing consumption of non typical foods. At baseline 63% of women was inactive, 37% was mild active and 0% active, while at the end inactive patients felt by half (30%) and mild active women almost doubled (67%). CONCLUSIONS We found this dietary intervention effective in reducing BMI and waist circumference, and enhancing healthy lifestyle in BC survivors. It has surely contributed to achieve these results besides the change in diet quality, mostly a marked reduction in sedentary habits.
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Affiliation(s)
- Concetta Finocchiaro
- Department of Clinical Nutrition, Hospital Città della Salute e della Scienza, Turin, Italy.
| | - Marta Ossola
- Department of Clinical Nutrition, Hospital Città della Salute e della Scienza, Turin, Italy
| | - Taira Monge
- Department of Clinical Nutrition, Hospital Città della Salute e della Scienza, Turin, Italy
| | - Maurizio Fadda
- Department of Clinical Nutrition, Hospital Città della Salute e della Scienza, Turin, Italy
| | - Laura Brossa
- Department of Clinical Nutrition, Hospital Città della Salute e della Scienza, Turin, Italy
| | - Vilma Caudera
- Department of Clinical Nutrition, Hospital Città della Salute e della Scienza, Turin, Italy
| | - Antonella De Francesco
- Department of Clinical Nutrition, Hospital Città della Salute e della Scienza, Turin, Italy
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Bluethmann SM, Vernon SW, Gabriel KP, Murphy CC, Bartholomew LK. Taking the next step: a systematic review and meta-analysis of physical activity and behavior change interventions in recent post-treatment breast cancer survivors. Breast Cancer Res Treat 2015; 149:331-42. [PMID: 25555831 DOI: 10.1007/s10549-014-3255-5] [Citation(s) in RCA: 114] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Accepted: 12/20/2014] [Indexed: 12/18/2022]
Abstract
Research has shown that recent post-treatment breast cancer survivors face significant challenges around physical activity as they transition to recovery. This review examined randomized controlled trials targeting physical activity behavior change in breast cancer survivors <5 years post-treatment and described (1) characteristics of interventions for breast cancer survivors as well as (2) effect size estimates for these studies. A systematic search was conducted following PRISMA guidelines with Medline, PubMed, PsycINFO, CINAHL, and Scopus databases. Data were abstracted for primary intervention strategies and other details (e.g., setting, duration, theory use). A subgroup analysis was conducted to assess intensity of exercise supervision/monitoring and intervention effectiveness. The search produced 14 unique behavior intervention trials from the US and abroad published 2005-2013. The mean sample size was 153 participants per study. All interventions included moderate-intensity activities plus various behavioral change strategies. Most interventions were partially or entirely home based. The overall standardized mean difference was 0.47 (0.23, 0.67) with p < 0.001. Most interventions were effective in producing short-term behavior changes in physical activity, but varied greatly relative to intervention strategies and intensity of supervision/monitoring. Highly structured interventions tended to produce larger behavior change effects overall, but many larger effect sizes came from interventions supported by phone counseling or e-mail. We observed that 'more' may not be better in terms of direct supervision/monitoring in physical activity behavior interventions. This may be important in exploring less resource-intensive options for effective behavior change strategies for recent post-treatment survivors.
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Affiliation(s)
- Shirley M Bluethmann
- Center for Health Promotion and Prevention Research, University of Texas School of Public Health, 7000 Fannin, Suite 2560, Houston, TX, 77030, USA,
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Philip EJ, Torghabeh MH, Strain GW. Bariatric surgery in cancer survivorship: does a history of cancer affect weight loss outcomes? Surg Obes Relat Dis 2015; 11:1105-8. [PMID: 26048524 DOI: 10.1016/j.soard.2014.12.028] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Revised: 12/04/2014] [Accepted: 12/24/2014] [Indexed: 12/16/2022]
Abstract
BACKGROUND Weight loss is recommended for obese cancer survivors who are at increased risk of recurrence and non-cancer-related mortality. It remains unknown if this vulnerable population benefits from bariatric surgery to the same extent as those without a history of cancer. METHODS A retrospective chart review of 1013 patients identified 29 bariatric surgery patients with a history of cancer who were then matched to patients without a history of cancer. RESULTS At 1-year postsurgical follow-up, individuals with a history of cancer had lost less weight than those without a history of cancer (14.2 versus 14.8); however, this difference was not significant (P = .76). CONCLUSION Cancer survivors appear to draw similar benefit from bariatric surgery as those without a history of cancer, although a larger study with greater statistical power to detect differences is needed to confirm these results. These preliminary results are encouraging in light of the increasing focus on weight loss among this population.
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Affiliation(s)
- Errol J Philip
- Memorial Sloan Kettering Cancer Center, New York, New York.
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Shaitelman SF, Cromwell KD, Rasmussen JC, Stout NL, Armer JM, Lasinski BB, Cormier JN. Recent progress in the treatment and prevention of cancer-related lymphedema. CA Cancer J Clin 2015; 65:55-81. [PMID: 25410402 PMCID: PMC4808814 DOI: 10.3322/caac.21253] [Citation(s) in RCA: 160] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
This article provides an overview of the recent developments in the diagnosis, treatment, and prevention of cancer-related lymphedema. Lymphedema incidence by tumor site is evaluated. Measurement techniques and trends in patient education and treatment are also summarized to include current trends in therapeutic and surgical treatment options as well as longer-term management. Finally, an overview of the policies related to insurance coverage and reimbursement will give the clinician an overview of important trends in the diagnosis, treatment, and management of cancer-related lymphedema.
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Differences in health behaviour between recipients of allogeneic haematopoietic SCT and the general population: a matched control study. Bone Marrow Transplant 2014; 49:1223-30. [PMID: 25046214 DOI: 10.1038/bmt.2014.142] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Revised: 05/12/2014] [Accepted: 05/23/2014] [Indexed: 12/30/2022]
Abstract
Little is known of health-relevant behaviour among long-term survivors of haematological disorders treated with haematopoietic SCT. This comparative cross-sectional multicentre study aimed (1) to explore the prevalence of selected behaviours in this group and (2) to compare them with those of the general population. Self-reported data of 376 survivors (mean age: 50.4 (s.d. = 12.8); median 7 years postallogeneic SCT (interquartile range (IQR) = 8.9; range 1-33) were compared with controls derived from the Swiss Health Survey 2007 by propensity score matching. Survivors were more physically inactive (26.8% vs 12.5%; P ⩽ 0.001) and consumed fewer portions of vegetables (⩾ 3 pieces: 10% vs 21.6%; P < 0.001), fruits (⩾ 3 pieces: 6.5% vs 10.6%; P < 0.001) and fish (31.2% vs 60.9% weekly fish dish; P < 0.001). More survivors consumed dairy products daily (92.5% vs 62.9%; P < 0.001), used sun protection regularly (94.5% vs 85.3%, P < 0.001) and had received influenza vaccinations in the past year (58.4% vs 21.5%; P < 0.001); fewer survivors smoked (13.4% vs 35.4%; P < 0.001). Survivors' weekly alcohol consumption was lower (median 1.5 servings (IQR 4) vs median 4.5 (IQR 10.3); P < 0.001). Of those taking immunosuppressants, 65.7% were non-adherent. Similar to the general population, survivors experience problems executing several health-enhancing behaviours, warranting corrective interventions.
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Abstract
Overweight and obesity have reached pandemic levels on a worldwide basis and are associated with increased risk and worse prognosis for many but not all malignancies. Pathophysiologic processes that affect this association are reviewed, with a focus on the relationship between type 2 diabetes mellitus and cancer, lessons learned from the use of murine models to study the association, the impact of obesity on pancreatic cancer, the effects of dietary fats and cholesterol on cancer promotion, and the mechanisms by which the intestinal microbiome affects obesity and cancer.
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Affiliation(s)
- Nathan A Berger
- Departments of Medicine, Biochemistry, and Genetics, Center for Science, Health and Society, Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, Ohio
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