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McLaughlin E, Arshad N, Ellis K, Chen A, Fougere K, Culos-Reed SN, Wurz A. Experiences of young adults affected by cancer within an 8-week yoga intervention delivered by videoconference: a qualitative interview study. Ann Med 2024; 56:2309275. [PMID: 38289977 PMCID: PMC10829813 DOI: 10.1080/07853890.2024.2309275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 01/18/2024] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND Yoga may reduce negative cancer- and treatment-related effects and help improve a range of outcomes, including flexibility, mindfulness, and quality of life among adults affected by cancer. Yet there is little evidence for the role of yoga among young adults (18-39 years) affected by cancer. PURPOSE The purpose of this study was to explore the experiences of young adults affected by cancer in an 8-week yoga intervention delivered by videoconference. METHODS Young adults who were diagnosed with cancer between the ages of 18 and 39 years, at any stage of the cancer trajectory, who were living in Canada, and who completed an 8-week yoga intervention were approached to complete a semi-structured interview. A social constructivist paradigm was adopted. Interviews were transcribed verbatim and analyzed using reflexive thematic analysis. RESULTS Twenty-eight young adults (Mean age = 34.67 ± 5.11 years; n = 25 female) with varied cancer diagnoses participated. Participants' perspectives were represented across 6 themes: (1) I was juggling a number of challenges and changes throughout the yoga intervention; (2) I noticed some improvements in my mental and physical health; (3) I made time to discover new strategies to take care of myself; (4) I was able to see what my body is capable of; (5) I was held accountable and I appreciated that, and; (6) I was able to be around similar others in a safe (virtual) space. CONCLUSIONS Findings suggest that an 8-week yoga intervention may offer some benefits for young adults affected by cancer. Self-care, self-compassion, mindfulness, feelings of physical competence, establishing a routine, and being around similar others were viewed as important components of the intervention and may have contributed to the benefits experienced. Findings underscore the potential utility of yoga as a supportive care intervention for young adults affected by cancer.
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Affiliation(s)
- Emma McLaughlin
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Nafeel Arshad
- School of Kinesiology, University of the Fraser Valley, Chilliwack, Canada
| | - Kelsey Ellis
- Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Amy Chen
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Kate Fougere
- Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - S. Nicole Culos-Reed
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Department of Psychosocial Resources, Tom Baker Cancer Centre, Cancer Care, Alberta Health Services, Calgary, Canada
| | - Amanda Wurz
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
- School of Kinesiology, University of the Fraser Valley, Chilliwack, Canada
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Sun F, Li L, Wen X, Xue Y, Yin J. The effect of Tai Chi/Qigong on depression and anxiety symptoms in adults with Cancer: A systematic review and meta-regression. Complement Ther Clin Pract 2024; 56:101850. [PMID: 38626582 DOI: 10.1016/j.ctcp.2024.101850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 02/18/2024] [Accepted: 04/03/2024] [Indexed: 04/18/2024]
Abstract
OBJECTIVE We expand on prior systematic reviews of Tai chi/Qigong (TCQ) practice on depression or anxiety symptoms in adults with cancer to estimate the mean effect of TCQ on depression and anxiety in randomized controlled trials. Additionally, we perform moderator analysis to examine whether effects vary based on patient features, TCQ stimuli properties, or characteristics of research design. METHODS Guided by PRISMA guidelines, we located articles published before August 31, 2023 using a combination of electronic database search and a complementary manual search through reference lists of articles and published reviews. Two separate multilevel meta-analyses with random-effects model were employed to estimate the overall effect of TCQ on depression and anxiety respectively. Further, multilevel meta-regression analysis was utilized to examine moderating effects based on moderators derived from patient features, TCQ stimuli properties, or characteristics associated with research design. Meta-analyses were performed in R4.0.0 and certainty of evidence with GRADEpro software. RESULTS The TCQ intervention yielded a standardized mean effect size of 0.29 (95% CI, 0.18 to 0.40) for anxiety, indicating homogeneity among the included studies. Conversely, for depression, the standardized mean effect size was 0.35 (95% CI, 0.14 to 0.55), signifying heterogeneity: reductions were larger when the trial primary outcome, predominantly function-related outcomes, changed significantly between the TCQ and control group. CONCLUSIONS TCQ practice exhibits small-to-moderate efficacy in alleviating depression and anxiety symptoms among cancer patients and survivors. Moreover, patients with depressive symptoms for whom TCQ intervention coupled with improvements in function-related outcomes manifested greater antidepressant effect.
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Affiliation(s)
- Fengqin Sun
- Anji County Experimental Junior Middle School, Huzhou City, Zhejiang Province, China
| | - Li Li
- Institue for Sport and Health, Harbin Sport University, Harbin, Heilongjiang Province, China
| | - Xiaodong Wen
- School of Sport and Physical Education, Shanghai Normal University, Shanghai, Shanghai, China
| | - Yuan Xue
- School of Sport and Physical Education, Shanghai Normal University, Shanghai, Shanghai, China
| | - Jianchun Yin
- School of Sport and Physical Education, Shanghai Normal University, Shanghai, Shanghai, China.
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Boopalan D, Vijayakumar V, Ravi P, Shanmugam P, Kuppusamy M, Masilamani E, Karuppasamy G. Effect of yoga as a complementary therapy in prostate cancer survivors: a systematic review. Support Care Cancer 2024; 32:553. [PMID: 39066831 DOI: 10.1007/s00520-024-08754-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 07/21/2024] [Indexed: 07/30/2024]
Abstract
PURPOSE Currently, available evidence suggests a positive impact of yoga on physical and psychological well-being in patients across different types of cancer, especially breast cancer survivors. However, there are no available systematic reviews on the effects of yoga on male prostate cancer survivors. The objective of the current systematic review is to specifically examine the quality of life, feasibility, and other effects of yoga on prostate cancer survivors. METHODS Bibliographic databases such as PubMed/Medline, CINAHL, EMBASE, Cochrane Library, and Google Scholar were searched for studies that were conducted till December 2022 to assess the effect of yoga on prostate cancer survivors. Studies that met predefined eligibility criteria were included. The quality of the included studies was assessed by the Cochrane risk of bias tool, and for single-arm studies, the Newcastle-Ottawa Scale was used. RESULTS A comprehensive literature search yielded a total of 137 studies. After careful consideration, this review included five studies involving 129 prostate cancer survivors. The included studies were published between 2012 and 2022. This systematic review observed that yoga has the potential to enhance erectile function, reduce fatigue and urinary symptoms, alleviate psychological stress, boost immune function, and improve the overall quality of life in prostate cancer survivors. Furthermore, it demonstrates the feasibility of incorporating yoga into their regular routine. CONCLUSIONS Yoga could be an effective complementary therapy in the management of physical and psychological symptoms experienced by prostate cancer survivors. However, until more comprehensive evidence becomes available, it would be premature to draw definitive conclusions about the effectiveness of yoga in the context of prostate cancer (PCa).
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Affiliation(s)
- Deenadayalan Boopalan
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Venugopal Vijayakumar
- Department of Yoga, Government Yoga and Naturopathy Medical College and Hospital, The Tamil Nadu Dr. MGR Medical University, Chennai, India
| | - Poornima Ravi
- Department of Clinical Research, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - Poonguzhali Shanmugam
- Department of Community Medicine, Government Yoga and Naturopathy Medical College and Hospital, The Tamil Nadu Dr. MGR Medical University, Chennai, India
| | - Maheshkumar Kuppusamy
- Department of Physiology, Government Yoga and Naturopathy Medical College and Hospital, The Tamil Nadu Dr. MGR Medical University, Chennai, 600106, India.
| | - Elayaraja Masilamani
- Department of Physical Education and Sports, Pondicherry University, Puducherry, India
| | - Govindasamy Karuppasamy
- Department of Physical Education and Sports Sciences, Faculty of Science and Humanities, SRM Institute of Science and Technology, Kattankulathur, India
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Đorđević D, Garnier J, van Mackelenbergh T, Seitz S, Mundhenke C. The impact of online yoga on sleep and quality of life in women with breast cancer: a randomized trial. Arch Gynecol Obstet 2024; 310:571-575. [PMID: 38814454 DOI: 10.1007/s00404-024-07563-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 05/17/2024] [Indexed: 05/31/2024]
Abstract
INTRODUCTION There is growing evidence of the benefit of physical activity and mindfulness in breast cancer patients (HC et al. in BMC Complement Altern Med, 2017). Yoga offers a combination of both. The aim of this study was to establish an online yoga program for breast cancer patients and survivors. As the project was launched during the (COVID) pandemic restrictions, we intended to prove effective online yoga as a way to access supportive therapy independently of sanitary issues and geographic locations in rural regions. METHODS The two main outcomes were quality of life and sleep quality, and both were evaluated by standardized questionnaires (EORTC-QLQ 30 BR 23 and PSQI). Participants (n = 173) had breast cancer or a history of breast cancer and were randomized to either 6 weeks online yoga, twice a week for 45 min or a waiting control group. RESULTS Our results show improved sleep quality in the PSQI score and improved subitems (dyspnea and physical activity) in the EORTC quality of life score. DISCUSSION Online yoga seems to be a valid option in supportive therapy for breast cancer patients, as it improves physical fitness, dyspnea and overall sleep quality. It is also safe and cost effective as a remote intervention. TRIAL REGISTRATION Trial registration number and date of registration for prospectively registered trials: DRKS00029548, 07.07.2022.WHO International clinical trials registry platform number: DRKS00029548. The registration number of the ethical committee CAU in Kiel: D 589/20.
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Affiliation(s)
- D Đorđević
- Clinic of Gynecology and Obstetrics, Caritas St. Josef Krankenhaus UKR, Regensburg, Germany.
| | - J Garnier
- Clinic of Gynecology and Obstetrics, Klinikum Amberg, Amberg, Germany.
| | - T van Mackelenbergh
- Clinic of Gynecology and Obstetrics, Universitätsklinik Schleswig-Holstein Kiel, Kiel, Germany
| | - S Seitz
- Clinic of Gynecology and Obstetrics, Caritas St. Josef Krankenhaus UKR, Regensburg, Germany
| | - C Mundhenke
- OB/GYN Breast Unit, Medizincampus Oberfranken/ Klinikum Bayreuth, Bayreuth, Germany
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Yu K, Portes P, Morris GS, Huang L, Felix ER, Farkas GJ, Molinares D, Tiozzo E. The role of exercise in aromatase inhibitor-induced arthralgia. PM R 2024. [PMID: 38780410 DOI: 10.1002/pmrj.13193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 03/04/2024] [Accepted: 03/25/2024] [Indexed: 05/25/2024]
Abstract
Aromatase inhibitors are prescribed in breast cancer due to their associated lower rate of cancer recurrence compared to tamoxifen. However, aromatase inhibitor-induced arthralgia (AIIA) is one of the leading causes of treatment nonadherence, increasing the risk of cancer recurrence. The pathophysiology of AIIA is poorly understood, and although current recommendations for AIIA include lifestyle changes and analgesics depending on the severity of symptoms, there is no established effective treatment. The aim of this study is to explore the presentation and mechanism of AIIA and investigate the feasibility and efficacy of different exercise interventions (aerobic, resistance, aerobic and resistance combined, and yoga or tai chi) in patients with AIIA to guide the development of formal exercise prescription guidelines. Findings indicate that a mixed-modality regimen of aerobic and resistance exercises is feasible and safe and may serve the most benefit in improving joint pain, functionality, and quality of life. More specifically, the weekly regimen should consist of 150 min of aerobic exercise with two sessions of at least six resistance exercises, 8 to 12 repetitions, three sets each. Supplementary yoga and tai chi may be recommended twice a week depending on a patient's target symptoms. Yoga was associated with improved physical functionality, whereas tai chi was related to improvements in mental health. However, the feasibility and impact of combined aerobic and resistance exercise protocols with yoga or tai chi in our target population were not investigated in this review. The use of large, randomized controlled trials is recommended for future studies.
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Affiliation(s)
- Kerstin Yu
- University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Pauline Portes
- University of Miami Miller School of Medicine, Miami, Florida, USA
| | - G Stephen Morris
- Department of Physical Therapy, Wingate University, Wingate, North Carolina, USA
| | - Laura Huang
- Department of Physical Medicine & Rehabilitation, University of Miami Miller School of Medicine, Miami, Florida, USA
- Mount Vernon Rehabilitation Medicine Associates, Alexandria, Virginia, USA
| | - Elizabeth R Felix
- Department of Physical Medicine & Rehabilitation, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Gary J Farkas
- Department of Physical Medicine & Rehabilitation, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Diana Molinares
- Department of Physical Medicine & Rehabilitation, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Eduard Tiozzo
- Department of Physical Medicine & Rehabilitation, University of Miami Miller School of Medicine, Miami, Florida, USA
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Hush JM, Steffens D, Solomon MJ. A patient-designed integrative oncology intervention for stage IV locally recurrent rectal cancer: A case report. Explore (NY) 2024; 20:103004. [PMID: 38777724 DOI: 10.1016/j.explore.2024.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 04/25/2024] [Accepted: 05/03/2024] [Indexed: 05/25/2024]
Abstract
INTRODUCTION Stage IV colorectal cancer is a highly challenging condition to treat, with 5-year survival rates of 13% in Australia, improving to 40% for those patients with locally recurrent rectal cancer who are suitable for total neoadjuvant therapy and pelvic exenterative surgery. This study reports a unique case of a patient with Stage IV locally recurrent rectal cancer (LRRC), who designed and implemented a holistic integrative oncology intervention. CASE PRESENTATION The patient was 59-years-old when diagnosed with Stage IV locally recurrent rectal cancer, and referred to a highly specialised centre for colorectal cancer care at a tertiary teaching hospital in Sydney, Australia. Treatment included chemo/radiotherapy, liver resection and posterior pelvic exenteration surgery. The patient's background as a health researcher and clinician optimised her ability to design and implement an integrative oncology model of care, including yoga, mindfulness, Buddhist meditation and study, social connection, exercise, psychotherapeutic and nutritional support. This paper describes these mind-body practices and lifestyle modifications and outlines her experiences and outcomes at each stage of her extensive and radical treatment. CONCLUSION This case provides a unique perspective into how the integration of mind-body practices and lifestyle modifications with conventional treatment can support those living with colorectal cancer.
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Affiliation(s)
- Julia M Hush
- Faculty of Medicine and Health Sciences, Macquarie University, NSW 2109, Australia.
| | - Daniel Steffens
- Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Camperdown 2050, New South Wales, Australia; Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Camperdown, NSW 2006, Australia
| | - Michael J Solomon
- Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Camperdown, NSW 2006, Australia; Institute of Academic Surgery (IAS), Royal Prince Alfred Hospital, The University of Sydney, Camperdown 2050, New South Wales, Australia
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7
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Fabi A, Rossi A, Mocini E, Cardinali L, Bonavolontà V, Cenci C, Magno S, Barberi V, Moretti A, Besharat ZM, Iolascon G, Baldari C, Ferretti E, Botticelli A, Paris I, Scambia G, Migliaccio S. An Integrated Care Approach to Improve Well-Being in Breast Cancer Patients. Curr Oncol Rep 2024; 26:346-358. [PMID: 38400984 PMCID: PMC11021235 DOI: 10.1007/s11912-024-01500-1] [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] [Accepted: 01/24/2024] [Indexed: 02/26/2024]
Abstract
BACKGROUND Breast cancer (BC) treatment has recently been revolutionized by the introduction of newer targeted agents, that helped tailoring therapies around the single patient. Along with increased survival rates, a careful evaluation of diet, lifestyle habits, physical activity, emotional and psychological experiences linked to the treatment journey, is now mandatory. However, a true proposal for an omnicomprehensive and "integrative" approach is still lacking in literature. METHODS A scientific board of internationally recognized specialists throughout different disciplines designed a shared proposal of holistic approach for BC patients. RESULTS A narrative review, containing information on BC treatment, endocrinological and diet aspects, physical activity, rehabilitation, integrative medicine, and digital narrative medicine, was developed. CONCLUSIONS In the context of a patient-centered care, BC treatment cannot be separated from a patient's long-term follow-up and care, and an organized interdisciplinary collaboration is the future in this disease's cure, to make sure that our patients will live longer and better. TRIAL REGISTRATION NCT05893368: New Model for Integrating Person-based Care (PbC) in the Treatment of Advanced HER2-negative Breast Cancer (PERGIQUAL). Registration date: 29th May 2023.
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Affiliation(s)
- Alessandra Fabi
- Precision Medicine Unit in Senology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy.
| | - Alessandro Rossi
- Precision Medicine Unit in Senology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy
- Department of Movement, Human and Health Sciences, University Foro Italico of Rome, Rome, Italy
| | - Edoardo Mocini
- Department of Experimental Medicine, University Sapienza of Rome, Rome, Italy
| | - Ludovica Cardinali
- Department of Experimental Medicine, University Sapienza of Rome, Rome, Italy
- Bone Metabolic Diseases Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Valerio Bonavolontà
- Department of Biotechnological and Applied Clinical Science, University of L'Aquila, L'Aquila, Italy
| | | | - Stefano Magno
- Center for Integrative Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Vittoria Barberi
- Medical Oncology 1, Regina Elena National Cancer Institute IRCCS, Rome, Italy
| | - Antimo Moretti
- Multidisciplinary Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | | | - Giovanni Iolascon
- Multidisciplinary Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Carlo Baldari
- Department of Theoretical and Applied Sciences, eCampus University, Rome, Italy
| | - Elisabetta Ferretti
- Department of Experimental Medicine, University Sapienza of Rome, Rome, Italy
| | - Andrea Botticelli
- Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Ida Paris
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giovanni Scambia
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Silvia Migliaccio
- Department of Movement, Human and Health Sciences, University Foro Italico of Rome, Rome, Italy
- Department of Experimental Medicine, University Sapienza of Rome, Rome, Italy
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Giridharan S, Kumar NV. Bibliometric Analysis of Randomized Controlled Trials on Yoga Interventions for Cancer Patients: A Decade in Review. Cureus 2024; 16:e58993. [PMID: 38800314 PMCID: PMC11127709 DOI: 10.7759/cureus.58993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2024] [Indexed: 05/29/2024] Open
Abstract
This literature review presents a bibliometric analysis of the randomized controlled trials conducted between 2014 and 2023 on the potential benefits of yoga as a complementary therapy for cancer patients. To conduct this analysis, we searched medical and scientific databases, such as Scopus, Cochrane, and PubMed, using relevant keywords. Our search yielded 58 clinical trials involving 4,762 patients, which indicates a growing trend in this field of research. The studies we reviewed mainly focused on breast cancer patients and demonstrated the adaptability and versatility of yoga, offering a ray of hope and optimism. Among the various styles of yoga, Hatha yoga was the most frequently practiced style in these clinical trials. The analysis we conducted reveals that yoga interventions have a promising role in cancer care and can be a valuable complementary therapy for cancer patients. However, significant gaps and limitations still need to be addressed in this area of research. For instance, more rigorous and diverse investigations are needed to further establish the potential benefits of yoga interventions for cancer patients. Additionally, the standardization of yoga interventions is crucial to optimize therapeutic benefits. By addressing these gaps and limitations, we can further enhance the potential of yoga as a complementary therapy for cancer patients.
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Hollenbach L, Rogahn J, le Coutre P, Schulze S, Muegge LO, Geissler J, Gruen J, Junghanss C, Felser S. Physical exercise recommendations for patients with chronic myeloid leukemia based on individual preferences identified in a large international patient survey study of the East German Study Group for Hematology and Oncology (OSHO #97). Front Oncol 2024; 14:1345050. [PMID: 38450192 PMCID: PMC10915004 DOI: 10.3389/fonc.2024.1345050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 02/06/2024] [Indexed: 03/08/2024] Open
Abstract
Background Tyrosine kinase inhibitors (TKIs) have significantly lowered mortality of chronic myeloid leukemia (CML) patients adjusting life expectancy to that of the standard population. However, CML and its treatment with TKIs causes a high disease burden. Physical exercise (PE) could be a non-pharmacological approach to reducing these and improving quality of life. Purpose The aim of this study was to determine the individual disease burden as well as PE preferences of CML patients and to deduce thereof specific PE recommendations. Methods This multicenter survey was conducted in cooperation with the LeukaNET/Leukemia-patient network including CML patients aged ≥18 years (German Registry of Clinical Trials, DRKS00023698). The severity of selected symptoms was assessed using the adapted Myeloproliferative Neoplasms Symptom Assessment Form: 0 (absent), 1-30 (mild), 31-70 (moderate), or 71-100 (severe). Information about patients' PE needs and preferences depending on their motivation was recorded. Results A total of 212 questionnaires were analyzed (52% female, median age 54 years). The prevalence of moderate-to-severe symptoms was 49% for fatigue, 40% for musculoskeletal pain, and 37% for concentration problems. Other commonly reported symptoms included skin reactions (42%) and weight gain (24%). The proportion of overweight/obese patients was 52%. Half of all respondents requested more information regarding PE. Patients with CML preferred individual training (82%), located outdoors (71%), at home (47%), or in an indoor swimming pool (31%). Regarding the training frequency, sports-inactive patients preferred a frequency of 1-2 training sessions per week, whereas sports-active patients preferred 3-4 sessions per week (p <0.001). Sports-inactive patients preferred a training time of 15-45 minutes, while sports-active patients preferred 30-60 minutes (p = 0.002). Subsequently, PE recommendations were developed for patients with CML. Combined resistance and endurance training (moderate intensity twice per week for 30 minutes) was recommended for beginners. Obese patients should prioritize joint-relieving sports. To reduce the risk of skin reactions, direct sunlight and possibly water sports should be avoided, and UV protection should be used. Conclusion Counseling and motivation of CML patients to be physically active should be part of the standard of care as well as support for implementation.
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Affiliation(s)
- Lina Hollenbach
- Department of Internal Medicine, Clinic III – Hematology, Oncology and Palliative Care, Rostock University Medical Center, Rostock, Germany
| | - Julia Rogahn
- Department of Internal Medicine, Clinic III – Hematology, Oncology and Palliative Care, Rostock University Medical Center, Rostock, Germany
| | - Philipp le Coutre
- Department of Hematology, Oncology, and Cancer Immunology, Campus Virchow‐Klinikum, Charité ‐ Universitätsmedizin Berlin, Berlin, Germany
| | - Susann Schulze
- Krukenberg Cancer Center Halle, University Hospital Halle, Halle (Saale), Germany
- Department of Medicine, Medical Clinic II, Carl-von-Basedow-Klinikum, Merseburg, Germany
| | - Lars-Olof Muegge
- Department of Internal Medicine III, Heinrich Braun Klinikum Zwickau, Zwickau, Germany
| | - Jan Geissler
- LeukaNET/Leukemia-Online e. V., Riemering, Germany
| | - Julia Gruen
- Department of Internal Medicine, Clinic III – Hematology, Oncology and Palliative Care, Rostock University Medical Center, Rostock, Germany
| | - Christian Junghanss
- Department of Internal Medicine, Clinic III – Hematology, Oncology and Palliative Care, Rostock University Medical Center, Rostock, Germany
| | - Sabine Felser
- Department of Internal Medicine, Clinic III – Hematology, Oncology and Palliative Care, Rostock University Medical Center, Rostock, Germany
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Brunet J, Hussien J, Pitman A, Wurz A, Conte E, Polskaia N, Seely D. Yoga Therapy as an Intervention to Improve Patient-Reported Outcomes Among Adults After Treatment for Cancer: Preliminary Findings From a Trial Using Single-Subject Experimental Design. Integr Cancer Ther 2024; 23:15347354241233517. [PMID: 38385326 PMCID: PMC10893844 DOI: 10.1177/15347354241233517] [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: 08/10/2023] [Revised: 01/23/2024] [Accepted: 02/02/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND Cancer is a chronic condition associated with a substantial symptom burden, which can impair recovery after treatment. Investigating interventions with potential to improve self-reported disease and/or treatment effects-known as patient-reported outcomes (PROs)-is paramount to inform cancer care. The objective of this study was to evaluate the effects of a yoga therapy (YT) intervention on key PROs (ie, cancer-related fatigue, anxiety, cognitive function, depression, stress, quality of life [QoL]) among adults after treatment for cancer. METHODS Data from 20 adults (Mage = 55.74 years, 85% female; Mtime since diagnosis = 2.83 years) who had completed treatment for cancer were analyzed for this study. In this single-subject exploratory experimental study, the YT intervention comprised a 1:1 YT session (ie, 1 participant with 1 yoga therapist) followed by 6 weekly small (ie, 2-3 participants) group YT sessions. Group sessions were facilitated by the same yoga therapist who delivered participants' 1:1 session to ensure an in-depth personalized approach. PROs were assessed before (ie, pre-intervention) and after the 1:1 YT session (ie, during the intervention), as well as after the last group YT session (ie, post-intervention). Hierarchical linear modeling was used to analyze the data. RESULTS Participants showed improvements in cancer-related fatigue, state anxiety, trait anxiety, perceived cognitive impairments, impacts of perceived cognitive impairments on QoL, and 1 dimension of QoL (ie, functional wellbeing) over time. Notably, cancer-related fatigue and state anxiety increased immediately after the 1:1 session, but showed greater improvements over time afterward (ie, during the intervention phase). No changes were observed for the remaining PROs. CONCLUSION Although results require confirmation in future trials, this study highlights the importance of continuing to investigate YT as an intervention to enhance important PROs (ie, cancer-related fatigue and state anxiety) after treatment for cancer. More research is needed to identify additional beneficial effects and factors that influence participants' responses to 1:1 and group YT (ie, moderators and mediators). REGISTRATION NUMBER ISRCTN64763228. DATE OF REGISTRATION December 12, 2021. This trial was registered retrospectively. URL OF TRIAL REGISTRY RECORD https://www.isrctn.com/ISRCTN64763228. PUBLISHED PROTOCOL Brunet, J., Wurz, A., Hussien, J., Pitman, A., Conte, E., Ennis, J. K., . . . & Seely, D. (2022). Exploring the Effects of Yoga Therapy on Heart Rate Variability and Patient-Reported Outcomes After Cancer Treatment: A Study Protocol. Integrative Cancer Therapies, 21, 15347354221075576.
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Affiliation(s)
- Jennifer Brunet
- University of Ottawa, Ottawa, ON, Canada
- Ottawa Hospital Research Institute, Ottawa, ON, Canada
- Hôpital Montfort, Ottawa, ON, Canada
| | | | - Anne Pitman
- Centre for Health Innovation, Ottawa, ON, Canada
| | - Amanda Wurz
- University of the Fraser Valley, Chilliwack, BC, Canada
| | - Ellen Conte
- Centre for Health Innovation, Ottawa, ON, Canada
- Canadian College of Naturopathic Medicine, Toronto, ON, Canada
| | | | - Dugald Seely
- University of Ottawa, Ottawa, ON, Canada
- Centre for Health Innovation, Ottawa, ON, Canada
- Canadian College of Naturopathic Medicine, Toronto, ON, Canada
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11
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Ma X, Li SN, Chan DNS. Effects of Yoga on Cancer-Related Fatigue, Psychological Distress, and Quality of Life Among Patients With Cancer Undergoing Chemotherapy and/or Radiotherapy: A Systematic Review and Meta-analysis. Cancer Nurs 2023:00002820-990000000-00196. [PMID: 38011074 DOI: 10.1097/ncc.0000000000001293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
BACKGROUND Yoga can be considered supportive therapy for patients with cancer to alleviate cancer-related symptoms. However, there has been no meta-analysis examining yoga's effects among patients with cancer undergoing chemotherapy and/or radiotherapy. OBJECTIVE To synthesize the evidence regarding the effects of yoga on improving cancer-related fatigue, psychological distress, and quality of life among patients with cancer undergoing chemotherapy and/or radiotherapy. METHODS Ten English databases and 2 Chinese databases were searched from inception to December 2022. Two independent reviewers screened studies and extracted the data. Randomized controlled trials examining the effects of yoga on cancer-related fatigue, psychological distress, and quality of life were included. Meta-analysis was conducted, and narrative synthesis was performed when meta-analysis was not applicable. RESULTS Fourteen studies from 16 articles were included. The results showed that yoga reduced cancer-related fatigue (standardized mean difference [SMD], -0.75; 95% confidence interval [CI], -1.12 to -0.38; P < .001), anxiety (SMD, -0.91; 95% CI, -1.68 to -0.14; P = .02), but not depression (SMD, -0.82; 95% CI, -1.67 to 0.04; P = .06). The effects of yoga on distress and quality of life were inconclusive. CONCLUSIONS Yoga significantly helped reduce cancer-related fatigue and anxiety but did not reduce depression among patients with cancer undergoing chemotherapy and/or radiotherapy. Further rigorous studies are needed to identify the optimal characteristics of yoga for these patients. IMPLICATIONS FOR PRACTICE It is possible to recommend yoga to patients with cancer undergoing chemotherapy and/or radiotherapy for managing cancer-related fatigue and anxiety after duly considering patients' physical conditions and ensuring appropriate instructions are given.
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Affiliation(s)
- Xing Ma
- Author Affiliation: The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
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12
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Fraterman I, Wollersheim BM, Tibollo V, Glaser SLC, Medlock S, Cornet R, Gabetta M, Gisko V, Barkan E, di Flora N, Glasspool D, Kogan A, Lanzola G, Leizer R, Mallo H, Ottaviano M, Peleg M, van de Poll-Franse LV, Veggiotti N, Śniatała K, Wilk S, Parimbelli E, Quaglini S, Rizzo M, Locati LD, Boekhout A, Sacchi L, Wilgenhof S. An eHealth App (CAPABLE) Providing Symptom Monitoring, Well-Being Interventions, and Educational Material for Patients With Melanoma Treated With Immune Checkpoint Inhibitors: Protocol for an Exploratory Intervention Trial. JMIR Res Protoc 2023; 12:e49252. [PMID: 37819691 PMCID: PMC10600650 DOI: 10.2196/49252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 07/12/2023] [Accepted: 08/03/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Since treatment with immune checkpoint inhibitors (ICIs) is becoming standard therapy for patients with high-risk and advanced melanoma, an increasing number of patients experience treatment-related adverse events such as fatigue. Until now, studies have demonstrated the benefits of using eHealth tools to provide either symptom monitoring or interventions to reduce treatment-related symptoms such as fatigue. However, an eHealth tool that facilitates the combination of both symptom monitoring and symptom management in patients with melanoma treated with ICIs is still needed. OBJECTIVE In this pilot study, we will explore the use of the CAPABLE (Cancer Patients Better Life Experience) app in providing symptom monitoring, education, and well-being interventions on health-related quality of life (HRQoL) outcomes such as fatigue and physical functioning, as well as patients' acceptance and usability of using CAPABLE. METHODS This prospective, exploratory pilot study will examine changes in fatigue over time in 36 patients with stage III or IV melanoma during treatment with ICI using CAPABLE (a smartphone app and multisensory smartwatch). This cohort will be compared to a prospectively collected cohort of patients with melanoma treated with standard ICI therapy. CAPABLE will be used for a minimum of 3 and a maximum of 6 months. The primary endpoint in this study is the change in fatigue between baseline and 3 and 6 months after the start of treatment. Secondary end points include HRQoL outcomes, usability, and feasibility parameters. RESULTS Study inclusion started in April 2023 and is currently ongoing. CONCLUSIONS This pilot study will explore the effect, usability, and feasibility of CAPABLE in patients with melanoma during treatment with ICI. Adding the CAPABLE system to active treatment is hypothesized to decrease fatigue in patients with high-risk and advanced melanoma during treatment with ICIs compared to a control group receiving standard care. The Medical Ethics Committee NedMec (Amsterdam, The Netherlands) granted ethical approval for this study (reference number 22-981/NL81970.000.22). TRIAL REGISTRATION ClinicalTrials.gov NCT05827289; https://clinicaltrials.gov/study/NCT05827289. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/49252.
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Affiliation(s)
- Itske Fraterman
- Department of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Barbara M Wollersheim
- Department of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Valentina Tibollo
- Laboratory of Informatics and Systems Engineering for Clinical Research, Istituti Clinici Scientifici Maugeri SpA SB IRCCS, Pavia, Italy
| | - Savannah Lucia Catherina Glaser
- Medical Informatics, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
- Methodology, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Stephanie Medlock
- Medical Informatics, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
- Methodology, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
- Aging and Later Life, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Ronald Cornet
- Medical Informatics, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
- Methodology, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Matteo Gabetta
- BIOMERIS SRL, Pavia, Italy
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
| | | | - Ella Barkan
- Department of Artificial Intelligence for Accelerated Healthcare and Life Sciences Discovery, IBM Research, IBM R&D Laboratories, Haifa, Israel
| | | | | | - Alexandra Kogan
- Department of Information Systems, University of Haifa, Haifa, Israel
| | - Giordano Lanzola
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
| | - Roy Leizer
- Department of Information Systems, University of Haifa, Haifa, Israel
| | - Henk Mallo
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, Netherlands
| | - Manuel Ottaviano
- Life Supporting Technologies, Universidad Politécnica de Madrid, Madrid, Spain
| | - Mor Peleg
- Department of Information Systems, University of Haifa, Haifa, Israel
| | - Lonneke V van de Poll-Franse
- Department of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, Netherlands
- Department of Research and Development, Netherlands Comprehensive Cancer Organization, Utrecht, Netherlands
- Department of Medical and Clinical Psychology, Center of Research on Psychological and Somatic Disorders (CoRPS), Tilburg University, Tilburg, Netherlands
| | - Nicole Veggiotti
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
| | - Konrad Śniatała
- Institute of Computing Science, Poznan University of Technology, Poznan, Poland
| | - Szymon Wilk
- Institute of Computing Science, Poznan University of Technology, Poznan, Poland
| | - Enea Parimbelli
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
| | - Silvana Quaglini
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
| | - Mimma Rizzo
- Division of Medical Oncology, Azienda Ospedaliero Universitaria Consorziale Policlinico di Bari, Bari, Italy
| | - Laura Deborah Locati
- Department of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy
- Medical Oncology Unit, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Annelies Boekhout
- Department of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Lucia Sacchi
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
| | - Sofie Wilgenhof
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, Netherlands
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13
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Wong SSS, Liu TW, Ng SSM. Health status of aged women with or without the experience of practicing yoga. BMC Womens Health 2023; 23:524. [PMID: 37794374 PMCID: PMC10552255 DOI: 10.1186/s12905-023-02586-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 08/02/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Yoga is a popular training practice that enhances women's physical activity level and modifies the major risk factors contributing to noncommunicable diseases. This study aimed to compare general health and cardiovascular health, musculoskeletal health, psychological health, and health-related quality of life between aged women with and without long-term yoga practice. METHODS Thirty-two female yoga practitioners (mean age 56 years) with ≥ 2 years experience in regular yoga practice and 32 age-matched women without yoga experience participated in the study. Between-group comparisons was performed to explore the differences in various health outcomes, including body build indices, exercise endurance, blood pressure, and heart rate variability; hamstring flexibility, upper-limb muscle strength, shoulder range of motion, and upper-limb function; and the symptoms of anxiety and depression, sleep quality, and fatigue. RESULTS Our findings revealed that yoga practitioners demonstrated greater hamstring flexibility, shoulder ROM on the non-dominant side, and hand-grip strength; a higher heart rate variability parameter value (RMSSD); and shorter sleep latency than those who did not practice yoga. CONCLUSIONS In view of the encouraging results of the long-term benefits of yoga practice, it warrants being promoted among aged women to enhance their physical and mental well-being.
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Affiliation(s)
- Sarah Suet Shan Wong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong (SAR), China.
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Ho Man Tin, Hong Kong (SAR), China.
| | - Tai Wa Liu
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Ho Man Tin, Hong Kong (SAR), China
| | - Shamay Sheung Mei Ng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong (SAR), China.
- Research Centre for Chinese Medicine Innovation, The Hong Kong Polytechnic University, Hong Kong (SAR), Hung Hom, Hong Kong (SAR), China.
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14
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Sohl SJ, Strahley AE, Tooze JA, Levine B, Kelly MG, Wheeler A, Evans S, Danhauer SC. Qualitative results from a randomized pilot study of eHealth Mindful Movement and Breathing to improve gynecologic cancer surgery outcomes. J Psychosoc Oncol 2023; 42:223-241. [PMID: 37462260 PMCID: PMC10794552 DOI: 10.1080/07347332.2023.2236083] [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] [Indexed: 01/19/2024]
Abstract
PURPOSE Improved management of pain and co-morbid symptoms (sleep disturbances, psychological distress) among women undergoing surgery for suspected gynecologic malignancies may reach a population vulnerable to chronic pain. PARTICIPANTS Women undergoing surgery for a suspected gynecologic malignancy. METHOD We conducted a pilot randomized controlled trial of eHealth Mindful Movement and Breathing (eMMB) compared to an empathic attention control (AC). Semi-structured interviews were conducted by telephone (n = 23), recorded, transcribed, coded, and analyzed using thematic analysis. FINDINGS Participants reported overall high acceptability such that all would recommend the study to others. Positive impacts of practicing eMMB included that it relieved tension, facilitated falling asleep, and decreased pain. Participants also reported high adherence to self-directed eMMB and AC writing practices and described facilitators and barriers to practicing. CONCLUSIONS This qualitative feedback will inform future research to assess the efficacy of eMMB for reducing pain and use of remotely-delivered interventions more broadly. CLINICAL TRIAL REGISTRATION NUMBER NCT03681405.
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Affiliation(s)
- Stephanie J. Sohl
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Medical Center Boulevard, Winston Salem, NC, 27157, USA
| | - Ashley E. Strahley
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Medical Center Boulevard, Winston Salem, NC, 27157, USA
| | - Janet A. Tooze
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA
| | - Beverly Levine
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Medical Center Boulevard, Winston Salem, NC, 27157, USA
| | - Michael G. Kelly
- Department of Obstetrics and Gynecology, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA
| | - Amy Wheeler
- Kinesiology Department, California State University, San Bernardino, 5500 University Pkwy, San Bernardino, CA 92407
| | - Sue Evans
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Medical Center Boulevard, Winston Salem, NC, 27157, USA
| | - Suzanne C. Danhauer
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Medical Center Boulevard, Winston Salem, NC, 27157, USA
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15
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Nishigami T, Manfuku M, Lahousse A. Central Sensitization in Cancer Survivors and Its Clinical Implications: State of the Art. J Clin Med 2023; 12:4606. [PMID: 37510721 PMCID: PMC10380903 DOI: 10.3390/jcm12144606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/04/2023] [Accepted: 07/06/2023] [Indexed: 07/30/2023] Open
Abstract
Although the prevalence of cancer pain is 47% after treatment, cancer pain is often underestimated, and many patients are undertreated. The complexity of cancer pain contributes to the lack of its management. Recently, as the mechanism of cancer pain, it has become clear that central sensitization (CS) influences chronic pain conditions and the transition from acute to chronic pain. In this state-of-the-art review, we summarized the association of CS or central sensitivity syndrome with pain and the treatment for pain targeting CS in cancer survivors. The management of patients with CS should not only focus on tissue damage in either the affected body regions or within the central nervous system; rather, it should aim to target the underlying factors that sustain the CS process. Pain neuroscience education (PNE) is gaining popularity for managing chronic musculoskeletal pain and could be effective for pain and CS in breast cancer survivors. However, there is a study that did not demonstrate significant improvements after PNE, so further research is needed. Precision medicine involves the classification of patients into subgroups based on a multifaceted evaluation of disease and the implementation of treatment tailored to the characteristics of each patient, which may play a central role in the treatment of CS.
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Affiliation(s)
- Tomohiko Nishigami
- Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, Hiroshima 723-0053, Japan
| | - Masahiro Manfuku
- Graduate School of Comprehensive Scientific Research, Prefectural University of Hiroshima, Hiroshima 723-0053, Japan
- Department of Rehabilitation, Breast Care Sensyu Clinic, Osaka 596-0076, Japan
| | - Astrid Lahousse
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy (KIMA), Vrije Universiteit Brussel, 1090 Brussels, Belgium
- Chronic Pain Rehabilitation, Department of Physical Medicine and Physiotherapy, University Hospital Brussels, 1090 Brussels, Belgium
- Research Foundation Flanders (FWO), 1000 Brussels, Belgium
- Rehabilitation Research (RERE) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy (KIMA), Vrije Universiteit Brussel, 1090 Brussels, Belgium
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16
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Wang TC, Chen PL, Liao WC, Tsai IC. Differential Impact of Exercises on Quality-of-Life Improvement in Breast Cancer Survivors: A Network Meta-Analysis of Randomized Controlled Trials. Cancers (Basel) 2023; 15:3380. [PMID: 37444490 DOI: 10.3390/cancers15133380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 05/22/2023] [Accepted: 06/21/2023] [Indexed: 07/15/2023] Open
Abstract
This study aimed to assess the effectiveness of various exercise interventions in enhancing the quality of life for breast cancer survivors. To achieve this, randomized controlled trials were identified from major electronic databases, focusing on the relationship between exercise and quality of life in breast cancer survivors. The primary outcome was the impact of exercise on quality of life 12 weeks after the intervention, with a secondary outcome comparing dropout rates between intervention groups and a regular care control group. The study protocol was registered with INPLASY (INPLASY202340007). A network meta-analysis of nine randomized controlled trials involving 725 participants was conducted, examining aerobic and strength training, aerobic activity, yoga, and strength exercise. Results showed that aerobic and strength training was the most effective intervention, significantly improving the quality of life of breast cancer survivors (1.31; 95% confidence interval: 0.49 to 2.12). Aerobic activity had a borderline effect (0.83; 0.03 to 1.63), while no exercise interventions were associated with an increased dropout risk compared to the control group (regular care). The study concluded that concurrent aerobic and strength training can improve breast cancer survivors' quality of life after 12 weeks of intervention without increasing dropout risk compared to regular care.
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Affiliation(s)
- Tzu-Chieh Wang
- Doctoral Program, Department of Nursing, College of Nursing, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan
- Department of Nursing, Taichung Veterans General Hospital, Taichung 407219, Taiwan
| | | | | | - I-Chen Tsai
- InnovaRad, Taichung 407217, Taiwan
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan
- Congenital Heart Disease Study Group, Asian Society of Cardiovascular Imaging, Seoul 13572, Republic of Korea
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17
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Nguyen T, Tracy K, Ullah A, Karim NA. Effect of Exercise Training on Quality of Life, Symptoms, and Functional Status in Advanced-Stage Lung Cancer Patients: A Systematic Review. Clin Pract 2023; 13:715-730. [PMID: 37366934 DOI: 10.3390/clinpract13030065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 06/07/2023] [Accepted: 06/09/2023] [Indexed: 06/28/2023] Open
Abstract
Advanced-stage lung cancer (LC) causes significant morbidity and impacts patients' quality of life (QoL). Exercise has been proven to be safe, feasible, and beneficial for symptom reduction and QoL improvement in many types of cancers, but research is limited in advanced-stage LC patients. This systematic review evaluates the effect of exercise interventions on the symptoms and QoL in patients with advanced-stage LC. Twelve prospective studies (744 participants) were included, evaluating different combinations of exercises and training such as aerobics, tai chi, strength, inspiratory muscle training, and relaxation. Studies found outcomes including but not limited to improved QoL, symptom burden, psychosocial health, functional status, and physical function. The results of this review support that exercise is safe and feasible with evidence supporting improved QoL and symptom mitigation. Integration of exercise should be considered in the individualized management of advanced-stage LC patients under the guidance of their healthcare providers.
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Affiliation(s)
- Tena Nguyen
- Medical College of Georgia, Augusta University, Augusta, GA 30904, USA
| | - Katharine Tracy
- Medical College of Georgia, Augusta University, Augusta, GA 30904, USA
| | - Asad Ullah
- Department of Pathology, Immunology and Microbiology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Nagla Abdel Karim
- Inova Schar Cancer Institute, Department of Medicine, University of Virginia, Fairfax, VA 22031, USA
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18
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Lee NG, Kim BK. Effects of Brain Wave Vibration Training on the Pain and Fatigue Disturbance Symptom Cluster in Persons with Cancer: A Randomized Controlled Trial. Healthcare (Basel) 2023; 11:healthcare11070956. [PMID: 37046883 PMCID: PMC10094369 DOI: 10.3390/healthcare11070956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 03/24/2023] [Accepted: 03/25/2023] [Indexed: 03/29/2023] Open
Abstract
Pain and fatigue disturbance constitute the most common symptom cluster in persons with cancer, causing physical and psychological problems associated with a decreased quality of life. This study investigated the effects of brain wave vibration (BWV) training on the pain and fatigue disturbance symptom cluster in persons with cancer. A total of 43 participants were voluntarily recruited and randomly assigned to the experimental group (BWV with therapeutic massage, n = 25) or the control group (conventional physical therapy with spontaneous physical activity, n = 18) (Randomized controlled trial registration number: KCT0005843). BWV with therapeutic massage was performed for a total of 24 sessions (70 min/day, 2 days/week for 12 weeks). The Breakthrough Pain Assessment Tool and Brief Fatigue Inventory were used to evaluate cancer-related pain (CRP) and cancer-related fatigue (CRF), respectively. Regarding CRP variables, the experimental group demonstrated significant improvements in the worst and typical episodes of breakthrough pain, pain distress, and interference with living a normal life compared to the control group. In CRF, there was no significant difference between the groups, although BWV training with therapeutic massage resulted in a significant difference between before and after the intervention. Therefore, our study suggests that BWV training with therapeutic massage is beneficial for improving CRP and CRF in cancer survivors.
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19
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Effect of Postoperative Adjuvant Radiotherapy on Quality of Life, Anxiety, and Depression in Adult Female Breast Cancer Patients. Cureus 2023; 15:e36635. [PMID: 36968677 PMCID: PMC10038179 DOI: 10.7759/cureus.36635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2023] [Indexed: 03/26/2023] Open
Abstract
Aim: This study aims to identify anxiety and depression caused by adjuvant radiotherapy in breast cancer cases to determine the deterioration in the quality of life and investigate the effect of early treatment. Materials and Methods: In this study, the Beck Depression Inventory, Beck Anxiety Inventory, and European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-30 (EORTC QLQ-C30) Turkish 3.0 forms were evaluated in 63 breast cancer patients before the start of radiotherapy treatment (T1) and at six weeks after the end of radiotherapy treatment (T2). Results: A high level of anxiety was detected in 77.8% of patients, and depression was found in 25.4% of patients in T1. When depressive cases were evaluated with EORTC QLQ-C30 scores, the general health status (p = 0.043), role function (p = 0.027), emotional (p < 0.002), cognitive (p < 0.001), and social (p < 0.0001) scales were statistically lower in T1, whereas pain (p = 0.045) and insomnia (p < 0.0001) symptoms were higher in T1. Anxiety and EORTC QLQ-C30 scores in terms of emotional function (p = 0.015), social function (p < 0.003), and symptoms of insomnia (p = 0.027) were found to be statistically higher in T1 anxious cases. However, anxiety was detected in only 3% of T2 cases, and no depression was found in any of the cases. Anxiety and EORTC QLQ-C30 scores and symptom scales were evaluated in terms of role function (p < 0.0001), emotional (p = 0.041) and social scales (p = 0.014), fatigue (p = 0.028), pain (p = 0.033), insomnia (p = 0.011), and constipation (p < 0.0001); these were found to be statistically significant in T2. Conclusion: This study revealed that early diagnosis and treatment of anxiety before initiating adjuvant radiotherapy reduces the development of long-term anxiety-related depression in the future. Therefore, it is recommended that patients be evaluated for anxiety and depression before starting adjuvant radiotherapy.
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Addington EL, Schlundt D, Bonnet K, Birdee G, Avis NE, Wagner LI, Rothman RL, Ridner S, Tooze JA, Wheeler A, Schnur JB, Sohl SJ. Qualitative similarities and distinctions between participants' experiences with a yoga intervention and an attention control. Support Care Cancer 2023; 31:172. [PMID: 36795229 PMCID: PMC10211359 DOI: 10.1007/s00520-023-07639-0] [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: 09/12/2022] [Accepted: 02/10/2023] [Indexed: 02/17/2023]
Abstract
PURPOSE This manuscript aims to compare and contrast acceptability and perceived benefits of yoga-skills training (YST) and an empathic listening attention control (AC) in the Pro-You study, a randomized pilot trial of YST vs. AC for adults receiving chemotherapy infusions for gastrointestinal cancer. METHODS Participants were invited for a one-on-one interview at week 14 follow-up, after completing all intervention procedures and quantitative assessments. Staff used a semi-structured guide to elicit participants' views on study processes, the intervention they received, and its effects. Qualitative data analysis followed an inductive/deductive approach, inductively identifying themes and deductively guided by social cognitive theory. RESULTS Some barriers (e.g., competing demands, symptoms), facilitators (e.g., interventionist support, the convenience of clinic-based delivery), and benefits (e.g., decreased distress and rumination) were common across groups. YST participants uniquely described the importance of privacy, social support, and self-efficacy for increasing engagement in yoga. Benefits specific to YST included positive emotions and greater improvement in fatigue and other physical symptoms. Both groups described some self-regulatory processes, but through different mechanisms: self-monitoring in AC and the mind-body connection in YST. CONCLUSIONS This qualitative analysis demonstrates that participant experiences in a yoga-based intervention or an AC condition reflect social cognitive and mind-body frameworks of self-regulation. Findings can be used to develop yoga interventions that maximize acceptability and effectiveness and to design future research that elucidates the mechanisms by which yoga is efficacious.
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Affiliation(s)
- Elizabeth L Addington
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
| | - David Schlundt
- Vanderbilt University School of Nursing, Nashville, TN, USA
| | | | - Gurjeet Birdee
- Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Nancy E Avis
- Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Lynne I Wagner
- Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | | | - Sheila Ridner
- Vanderbilt University School of Nursing, Nashville, TN, USA
| | - Janet A Tooze
- Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Amy Wheeler
- California State University, San Bernardino, CA, USA
| | - Julie B Schnur
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Stephanie J Sohl
- Wake Forest University School of Medicine, Winston-Salem, NC, USA
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Abstract
This article provides an overview of the fields of psychosocial and integrative oncology, highlighting common psychological reactions to being diagnosed with and treated for cancer, including distress, anxiety, depression, fear of cancer recurrence and caregiver burden, as well as symptoms of fatigue, pain, and sleep disturbance. Patterns of symptomatology across the disease continuum are also discussed. Interventions targeted at treating these symptoms are reviewed, including acceptance-based and mindfulness therapies, mind-body therapies, and meaning-based approaches designed for people with advanced stages of disease, including psychedelic therapy. Common methodological issues and shortcomings of the evidence base are summarized with design recommendations, and a discussion of trends in future research including pragmatic research design, digital health interventions, and implementation science completes the article.
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Affiliation(s)
- Linda E Carlson
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada;
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Jain M, Mishra A, Yadav V, Shyam H, Kumar S, Mishra SK, Ramakant P. Long-term yogic intervention decreases serum interleukins IL-10 and IL-1β and improves cancer-related fatigue and functional scale during radiotherapy/chemotherapy in breast cancer patients: a randomized control study. Support Care Cancer 2022; 31:6. [PMID: 36512140 DOI: 10.1007/s00520-022-07487-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 11/09/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE Yoga improved fatigue and immunological profile in cancer survivors and has been a promising alternative therapy. Breast cancer treatments are rapidly improving, along with their side effects. This article investigated the effect of the yogic intervention at a different time interval during radiotherapy/chemotherapy on the pro- and anti-inflammatory interleukins along with the cancer-related fatigue and functional scale among patients with stage II/III breast cancer. METHODS A total of 96 stage II/III breast cancer patients were enrolled in this study and randomly divided into two different groups. Group I (non-Yoga) received chemotherapy and/or radiotherapy and group II (Yoga) received an additional yogic intervention. Both groups were followed up for a period of 48 weeks and blood was collected at the time of enrollment, 16, 32, and 48 weeks, and serum was isolated to measure the pro- and anti-inflammatory interleukins, fatigue, and functional scale questionnaire obtained at each time point. RESULTS Breast cancer patients in group II showed a significant improvement (p < 0.05) in the functional scale and fatigue from baseline to 48 weeks compared to group I. The yogic intervention significantly decreased (p < 0.05) the level of pro-inflammatory interleukin IL-1β and pleiotropic interleukin IL-10 in group II compared to group I. CONCLUSION These finding suggested that improved fatigue and functional scale is associated with a lower level of IL-1β and IL-10. Yoga may be an important additional therapy along with the cancer treatment to help the patients with cancer-related fatigue and improve their overall immunological profile.
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Affiliation(s)
- Mayank Jain
- Department of Thoracic Surgery, King George's Medical University, Lucknow, 226003, UP, India
| | - Archana Mishra
- Department of Thoracic Surgery, King George's Medical University, Lucknow, 226003, UP, India
| | - Vishnu Yadav
- Department of Physical Education, University of Lucknow, Lucknow, UP, India
| | - Hari Shyam
- Department of Center for Advance Research, King George's Medical University, Lucknow, UP, India
| | - Shailendra Kumar
- Department of Thoracic Surgery, King George's Medical University, Lucknow, 226003, UP, India.
| | - Satyendra Kumar Mishra
- Department of Human Consciousness and Yogic Sciences, University of Lucknow, Lucknow, UP, India
| | - Pooja Ramakant
- Department of Endocrine Surgery, King George's Medical University, Lucknow, UP, India
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Mallaiah S, Narayanan S, Wagner R, Cohen C, Christie AJ, Bruera E, Lopez G, Cohen L. Yoga Therapy in Cancer Care via Telehealth During the COVID-19 Pandemic. Integr Cancer Ther 2022; 21:15347354221141094. [PMID: 36510480 PMCID: PMC9749058 DOI: 10.1177/15347354221141094] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Yoga is an evidence-based mind-body practice known to improve physical and mental health in cancer patients. We report on the processes and patient-reported outcomes of one-on-one yoga therapy (YT) consultations delivered via telehealth. METHODS For patients completing a YT consultation between March 2020 and October 2021, we examined demographics, reasons for referral, and self-reported symptom burden before and after one YT session using the Edmonton Symptom Assessment Scale (ESAS). Changes in ESAS symptom and subscale scores [physical distress (PHS), psychological distress (PSS), and global distress (GDS)] were evaluated by Wilcoxon signed-rank test. Descriptive statistics summarized the data. RESULTS Ninety-seven initial YT consults were completed, with data evaluated for 95 patient encounters. The majority were women (83.2%) and white (75.8%), The mean age for females was 54.0 and for males was 53.4; the most common diagnosis was breast cancer (48%), 32.6% had metastatic disease, and nearly half (48.4%) were employed full-time. Mental health (43.0%) was the most common reason for referral, followed by fatigue (13.2%) and sleep disturbances (11.7%). The highest symptoms at baseline were sleep disturbance (4.3), followed by anxiety (3.7) and fatigue (3.5). YT lead to clinically and statistically significant reductions in PHS (mean change = -3.1, P < .001) and GDS (mean change = -5.1, P < .001) and significant reductions in PSS (mean change = -1.6, P < .001). Examination of specific symptom scores revealed clinically and statistically significant reductions in anxiety (mean change score -1.34, P < .001) and fatigue (mean change score -1.22, P < .001). Exploratory analyses of patients scoring ≥1 for specific symptoms pre-YT revealed clinically and statistically significant improvements in almost all symptoms and those scoring ≥4 pre-YT. CONCLUSIONS As part of an integrative oncology outpatient consultation service, a single YT intervention delivered via telehealth contributed to a significant improvement in global, physical, and psychosocial distress. Additional research is warranted to explore the long-term sustainability of the improvement in symptoms.
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Affiliation(s)
- Smitha Mallaiah
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Santhosshi Narayanan
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA,S. Narayanan, Department of Palliative, Rehabilitation, and Integrative Medicine, Unit 1414, The University of Texas MD Anderson Cancer, 1515 Holcombe Blvd, Houston, TX 77030, USA.
| | - Richard Wagner
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Chiara Cohen
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Eduardo Bruera
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Gabriel Lopez
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lorenzo Cohen
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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24
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Di Nardo P, Lisanti C, Garutti M, Buriolla S, Alberti M, Mazzeo R, Puglisi F. Chemotherapy in patients with early breast cancer: clinical overview and management of long-term side effects. Expert Opin Drug Saf 2022; 21:1341-1355. [DOI: 10.1080/14740338.2022.2151584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Paola Di Nardo
- Department of Medical Oncology, CRO Aviano, National Cancer Institute, IRCCS, Aviano, Italy
| | - Camilla Lisanti
- Department of Medical Oncology, CRO Aviano, National Cancer Institute, IRCCS, Aviano, Italy
| | - Mattia Garutti
- Department of Medical Oncology, CRO Aviano, National Cancer Institute, IRCCS, Aviano, Italy
| | - Silvia Buriolla
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Martina Alberti
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Roberta Mazzeo
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Fabio Puglisi
- Department of Medical Oncology, CRO Aviano, National Cancer Institute, IRCCS, Aviano, Italy
- Department of Medicine (DAME), University of Udine, Udine, Italy
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25
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Ohlsson Nevo E, Arvidsson-Lindvall M, Hellerstedt Börjeson S, Hagberg L, Hultgren Hörnqvist E, Valachis A, Wickberg Å, Duberg A. Digitally distributed Yoga Intervention in Breast Cancer Rehabilitation (DigiYoga CaRe): protocol for a randomised controlled trial. BMJ Open 2022; 12:e065939. [PMID: 36319059 PMCID: PMC10098266 DOI: 10.1136/bmjopen-2022-065939] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
INTRODUCTION Breast cancer is the most prevalent cancer among women. The treatment is extensive; in addition to surgery, various combinations of radiation therapy, chemotherapy and antibody and endocrine treatment can be applied. Cancer-related fatigue (CRF) is high in patients with breast cancer, peaking during chemotherapy, but may persist for several years. Physical activity has proven to be effective in reducing CRF in breast cancer rehabilitation, but many patients tend to be less active after the diagnosis. Yoga has a previously demonstrated effect on energy levels and digitally distributed yoga intervention can potentially increase accessibility in pandemic times and facilitate participation for patients susceptible to infection and those living far from organised rehabilitation opportunities. The purpose of this study, Digital Yoga Intervention in Cancer Rehabilitation (DigiYoga CaRe) is to investigate whether a 12-week digitally distributed yoga intervention can reduce CRF and stress, improve health-related quality of life (HRQL) and affect pro-inflammatory and metabolic markers in patients with breast cancer. METHODS AND ANALYSIS This multicentre study will adopt a randomised controlled design including 240 persons after their breast cancer surgery. They will be randomised to a 12-week digitally distributed yoga intervention or to a control group. The intervention group practice yoga two times a week, one yoga class live-streamed to the patient's computer or mobile device and one prerecorded video class for self-training. The controls receive standardised care, gift cards for flowers and access to yoga video links after the data collection has ended. The primary analysis will be performed following the principle of intention to treat. Data will be collected by questionnaires, blood samples, accelerometers and interviews. ETHICS AND DISSEMINATION The DigiYoga CaRe study was approved by the Regional Ethical Review Board in Lund. The final results of this study will be disseminated to conference, patient and public involvements and peer-reviewed publications. TRIAL REGISTRATION NUMBER NCT04812652.
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Affiliation(s)
- Emma Ohlsson Nevo
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Orebro, Sweden
| | - MiaLinn Arvidsson-Lindvall
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Orebro, Sweden
| | - Susanne Hellerstedt Börjeson
- Department of Public Health and Caring Sciences, Center for Clinical Research, Uppsala University, Uppsala, Sweden
| | - Lars Hagberg
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Orebro, Sweden
| | | | - Antonios Valachis
- Department of Oncology, Faculty of Medicin and Health,Örebro University, Örebro, Sweden
| | - Åsa Wickberg
- Department of Surgery, Faculty of Medicine and Health, Örebro University, Orebro, Sweden
| | - Anna Duberg
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Orebro, Sweden
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26
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Gonzalez M, Grant S, de Manincor M, Lacey J, Sarris J. Cancer survivors’ experiences, barriers and preferences with yoga: A cross-sectional survey to inform a yoga intervention. Explore (NY) 2022; 19:389-395. [PMID: 36283942 DOI: 10.1016/j.explore.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 10/05/2022] [Accepted: 10/10/2022] [Indexed: 11/04/2022]
Abstract
PURPOSE Evidence suggests that yoga may help improve cancer-related symptoms though knowledge of the experiences, barriers and preferences of people diagnosed with cancer is limited. This study sought to examine the use of yoga in an Australian sample and identify the experiences and preferences associated with undertaking yoga practice as formative research to help inform a future yoga intervention. METHODS Adults diagnosed with any type of cancer completed a cross-sectional survey including questions regarding their demographics, experiences and preferences for yoga practice. RESULTS Sixty-eight people who had been diagnosed with cancer completed the survey. Most of the participants (70.8%) had practiced yoga since their diagnosis. A variety of reasons for practice were endorsed, and benefits experienced included physical and psychological factors. The most common barrier to practice was related to the physical ability to undertake yoga. Participants indicated a preference for group classes (44.1%), with a frequency of practice of 2-3 times per week (60.3%), 60 min in length (75%). The preferred time of practice was 9am-12pm (51.5%) and travel distance 5-10 km (44.1%). Online yoga delivery was endorsed, with participants preferring pre-recorded sessions. CONCLUSIONS Results from this study provide insights into the experiences, barriers and preferences for yoga practice in people with cancer which will assist in developing yoga programs in this cohort to investigate the effects on cancer and treatment-related symptoms.
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27
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Danhauer SC, Miller ME, Divers J, Anderson A, Hargis G, Brenes GA. Long-Term Effects of Cognitive-Behavioral Therapy and Yoga for Worried Older Adults. Am J Geriatr Psychiatry 2022; 30:979-990. [PMID: 35260292 DOI: 10.1016/j.jagp.2022.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 01/31/2022] [Accepted: 02/01/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Cognitive-behavioral therapy (CBT) and yoga decrease worry and anxiety. There are no long-term data comparing CBT and yoga for worry, anxiety, and sleep in older adults. The impact of preference and selection on these outcomes is unknown. In this secondary data analysis, we compared long-term effects of CBT by telephone and yoga on worry, anxiety, sleep, depressive symptoms, fatigue, physical function, social participation, and pain; and examined preference and selection effects. DESIGN In this randomized preference trial, participants (N = 500) were randomized to a: 1) randomized controlled trial (RCT) of CBT or yoga (n = 250); or 2) preference trial (selected CBT or yoga; n = 250). Outcomes were measured at baseline and Week 37. SETTING Community. PARTICIPANTS Community-dwelling older adults (age 60+ years). INTERVENTIONS CBT (by telephone) and yoga (in-person group classes). MEASUREMENTS Penn State Worry Questionnaire - Abbreviated (worry);1,2 Insomnia Severity Index (sleep);3 PROMIS Anxiety Short Form v1.0 (anxiety);4,5 Generalized Anxiety Disorder Screener (generalized anxiety);6,7 and PROMIS-29 (depression, fatigue, physical function, social participation, pain).8,9 RESULTS: Six months after intervention completion, CBT and yoga RCT participants reported sustained improvements from baseline in worry, anxiety, sleep, depressive symptoms, fatigue, and social participation (no significant between-group differences). Using data combined from the randomized and preference trials, there were no significant preference or selection effects. Long-term intervention effects were observed at clinically meaningful levels for most of the study outcomes. CONCLUSIONS CBT and yoga both demonstrated maintained improvements from baseline on multiple outcomes six months after intervention completion in a large sample of older adults. TRIAL REGISTRATION www. CLINICALTRIALS gov Identifier NCT02968238.
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Affiliation(s)
- Suzanne C Danhauer
- Department of Social Sciences and Health Policy (SCD), Wake Forest School of Medicine, Winston Salem, NC.
| | - Michael E Miller
- Department of Biostatistics and Data Science (MEM), Wake Forest School of Medicine, Winston Salem, NC
| | - Jasmin Divers
- Division of Health Services Research (JD), NYU Long Island School of Medicine, New York, NY
| | - Andrea Anderson
- Department of Biostatistics and Data Science (AA), Wake Forest School of Medicine, Winston Salem, NC
| | - Gena Hargis
- Department of Internal Medicine (GH), Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston Salem, NC
| | - Gretchen A Brenes
- Department of Internal Medicine (GAB), Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston Salem, NC
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Sohl S, Tooze JA, Levine BJ, Zeidan F, Wheeler A, Kelly M, Shalowitz D, Danhauer S. A randomized pilot of eHealth mindful movement and breathing to improve gynecologic surgery outcomes. J Psychosoc Oncol 2022; 41:251-266. [PMID: 35900116 PMCID: PMC9883595 DOI: 10.1080/07347332.2022.2101908] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVE To conduct a pilot randomized controlled trial of eHealth Mindful Movement and Breathing (eMMB) compared to an empathic attention control (AC). PARTICIPANTS Women undergoing surgery for a suspected gynecologic malignancy. METHODS eMMB is a brief yoga intervention delivered remotely during the perioperative timeframe. We assessed feasibility and participants completed assessments (baseline, weeks 2 and 4 postoperatively). We summarized feasibility, participant characteristics, and outcomes by intervention group and time. FINDINGS Forty-three percent of eligible patients approached participated (n = 31). Adherence to the interventions was 77%. Percent of participants to complete outcomes was 81% at Week 2 and 84% at Week 4 (>70%; retention was the primary feasibility indicator). Average reductions in the primary outcome of pain intensity were larger in the eMMB group than AC group (Week 2 d = -0.38; Week 4 d = -0.46). IMPLICATIONS This pilot study of eMMB supported feasibility and improvements in pain intensity that warrant a future efficacy study.
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Affiliation(s)
- Stephanie Sohl
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine
| | - Janet A. Tooze
- Department of Biostatistical & Data Sciences, Wake Forest School of Medicine
| | - Beverly J. Levine
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine
| | - Fadel Zeidan
- Department of Anesthesiology, University of California, San Diego
| | - Amy Wheeler
- Kinesiology Department, California State University, San Bernardino
| | - Michael Kelly
- Department of Obstetrics and Gynecology, Wake Forest School of Medicine
| | - David Shalowitz
- Department of Obstetrics and Gynecology, Wake Forest School of Medicine
| | - Suzanne Danhauer
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine
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Boaventura P, Jaconiano S, Ribeiro F. Yoga and Qigong for Health: Two Sides of the Same Coin? Behav Sci (Basel) 2022; 12:bs12070222. [PMID: 35877292 PMCID: PMC9312231 DOI: 10.3390/bs12070222] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/28/2022] [Accepted: 06/30/2022] [Indexed: 02/04/2023] Open
Abstract
Yoga and qigong are ancient mind–body practices used in the East for thousands of years to promote inner peace and mental clarity. Both share breathing techniques and slow movements and are being used as alternative/complementary approaches to the management of disease, especially chronic problems with no effective conventional treatments. However, information comparing the health benefits of both approaches is scarce, and the choice between yoga or qigong practice may only depend on patients’ preferences or practice availability. The aim of the present paper was to overview yoga and qigong use for health benefits under different pathological conditions. Yoga and qigong seem to have similar effects, which might be expected, since both are similar mind–body approaches with the same concept of vital life-force energy and the practice of meditative movements. Problematic research issues within the literature on yoga and qigong are the small sample sizes, use of different styles, significant variance in practice duration and frequency, short duration of intervention effects, and the usage of a non-active control group, thus emphasizing the need for further high-quality randomized trials. Studies comparing yoga and qigong are warranted in order to assess differences/similarities between the two approaches for health benefits.
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Affiliation(s)
- Paula Boaventura
- IPATIMUP—Institute of Molecular Pathology and Immunology of the University of Porto, 4200-135 Porto, Portugal;
- i3S—Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen 208, 4200-135 Porto, Portugal
- FMUP—Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
- Correspondence:
| | - Sónia Jaconiano
- EAAD—School of Architecture Art and Design, University of Minho, 4800-058 Guimarães, Portugal;
| | - Filipa Ribeiro
- IPATIMUP—Institute of Molecular Pathology and Immunology of the University of Porto, 4200-135 Porto, Portugal;
- i3S—Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen 208, 4200-135 Porto, Portugal
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Methodological issues in conducting yoga- and meditation-based research: A narrative review and research implications. J Ayurveda Integr Med 2022; 13:100620. [PMID: 36087391 PMCID: PMC9451492 DOI: 10.1016/j.jaim.2022.100620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 05/08/2022] [Accepted: 06/22/2022] [Indexed: 11/24/2022] Open
Abstract
Yoga and meditation-based interventions have been extensively utilized in the field of contemporary complementary and alternative medicine for various physical and mental health conditions. Ongoing COVID-19 pandemic has rekindled the interest of researchers in yoga and meditation for its preventive and therapeutic utilities. However, the available literature in this area has several methodological concerns, limiting formers’ clinical utility. A comprehensive literature on this topic would stimulate researchers and guide them to conduct research on this topic with robust methodologies. The current review highlights the methodological issues with the yoga and meditation-based Research (henceforth, MBR), discusses some of the contentious issues, and provides future directions. The PubMed, Medline, and google scholar databases were searched to screen records dealing with the methodological issues on MBR. The search yielded 299 records, upon screening, only 24 articles were found suitable for the current study. Common methodological issues with MBR: lack of the consensus definitions of the yoga and meditations, interventions lacking theoretical framework of meditation; inadequate description of the study design; difficulty with participants recruitment, setting up the control groups, and blinding; difficulty in assessing the baseline characteristics of the participants, and validity issues with the outcome measures. A few research, however, have also highlighted the potential measures to overcome these methodological challenges. Yoga and meditation-based interventions are promising for several health conditions. However, literature suffers from considerable methodological issues, thus, limiting its utility in modern clinical practice. The study findings can stimulate and guide future research on this topic.
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Cancer Survivors' Perspectives of Virtual Yoga for Chronic Chemotherapy-Induced Peripheral Neuropathy Pain During the COVID-19 Pandemic. Comput Inform Nurs 2022; 40:641-647. [PMID: 35930413 PMCID: PMC9469911 DOI: 10.1097/cin.0000000000000937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
With the rise in telehealth due to the COVID-19 pandemic, further research is needed to determine how to optimize virtual delivery of existing integrative oncology interventions for cancer treatment-related symptoms. The purpose of this qualitative analysis was to explore cancer survivors' perspectives of the acceptability and satisfaction of an 8-week, virtual yoga intervention for cancer survivors with chronic chemotherapy-induced peripheral neuropathy pain. Fourteen participants with chronic chemotherapy-induced peripheral neuropathy pain who completed the virtual yoga intervention were interviewed using a semistructured interview guide. Themes were derived from the data using inductive content analysis methods. Main findings from the interviews included the following: (1) participants were willing to try new nonpharmacological treatments for chemotherapy-induced peripheral neuropathy due to the high symptom burden and prior lack of success with medications; (2) participants highly rated the flexibility offered by the virtual format, but desired the social support potentially offered by practicing in-person yoga; and (3) the impact of virtual yoga on chemotherapy-induced peripheral neuropathy severity was unclear. There were several barriers to participants' use of virtual yoga for chronic chemotherapy-induced peripheral neuropathy pain (eg, technology, lack of space/equipment). The results may be used to improve the design and delivery of future trials testing virtual yoga for chronic chemotherapy-induced peripheral neuropathy pain.
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Ruano A, García-Torres F, Gálvez-Lara M, Moriana JA. Psychological and Non-Pharmacologic Treatments for Pain in Cancer Patients: A Systematic Review and Meta-Analysis. J Pain Symptom Manage 2022; 63:e505-e520. [PMID: 34952171 DOI: 10.1016/j.jpainsymman.2021.12.021] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 12/07/2021] [Accepted: 12/11/2021] [Indexed: 12/21/2022]
Abstract
CONTEXT Pain is the most fearful symptom in cancer. Although there is a relationship between psychosocial variables and oncologic pain, psychological and non-pharmacological treatments for pain management in cancer patients are not very widespread. OBJECTIVES To analyze the efficacy of psychological and non-pharmacological treatments for reducing pain in cancer patients. METHODS We performed a systematic review following the PRISMA protocol. In January 2021, data were extracted from PubMed, Web of Science and Scopus, including randomised controlled trials (RCT) published in the last five years (from 28 January, 2015 to December 15, 2020), in the English language and whose sample was patients with cancer pain. The database search used the following keywords: cancer, cancer-related pain, psychological intervention, non-pharmacologic intervention. The Cochrane risk of bias assess ment for randomised trials (RoB 2) was used for quality appraisal. RESULTS After the inclusion and exclusion criteria were applied, ten papers were fully screened. The evidence suggested that the most effective interventions to reduce cancer pain were mindfulness-based cognitive therapy, guided imagery and progressive muscle relaxation and emotional and symptom focused engagement (EASE). Music therapy and brief cognitive behavioral strategies (CBS) require more research, while coping skills training and yoga did not show positive effects. Overall, we obtained a moderate size effect (d = 0.642, 95% CI: 0.125-1.158) favourable to psychological and non-pharmacologic treatments at post-treatment, which increased at follow-up (k = 5, d = 0.826, 95% CI: 0.141-1.511). CONCLUSION This study provides insight into psychological interventions which might be applied and contribute to cancer-related pain reduction in adults. Although the results are not completely consistent, they may shed light on psychology applications in the oncology environment.
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Affiliation(s)
- Alejandra Ruano
- Department of Psychology, University of Cordoba (A.R., F.G.-T., M.G.-L., J.A.M.), Cordoba, Spain
| | - Francisco García-Torres
- Department of Psychology, University of Cordoba (A.R., F.G.-T., M.G.-L., J.A.M.), Cordoba, Spain; Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC) (F.G.-T., M.G.-L., J.A.M.), Cordoba, Spain; Reina Sofia University Hospital (F.G.-T., M.G.-L., J.A.M.), Cordoba, Spain.
| | - Mario Gálvez-Lara
- Department of Psychology, University of Cordoba (A.R., F.G.-T., M.G.-L., J.A.M.), Cordoba, Spain; Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC) (F.G.-T., M.G.-L., J.A.M.), Cordoba, Spain; Reina Sofia University Hospital (F.G.-T., M.G.-L., J.A.M.), Cordoba, Spain
| | - Juan A Moriana
- Department of Psychology, University of Cordoba (A.R., F.G.-T., M.G.-L., J.A.M.), Cordoba, Spain; Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC) (F.G.-T., M.G.-L., J.A.M.), Cordoba, Spain; Reina Sofia University Hospital (F.G.-T., M.G.-L., J.A.M.), Cordoba, Spain
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Di Nitto M, Sollazzo F, Biagioli V, Torino F, Alvaro R, Vellone E, Durante A. Self-care behaviours in older adults treated with oral anticancer agents: A qualitative descriptive study. Eur J Oncol Nurs 2022; 58:102139. [DOI: 10.1016/j.ejon.2022.102139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 02/22/2022] [Accepted: 04/03/2022] [Indexed: 11/04/2022]
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34
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Pugh TM, Squarize F, Kiser AL. A Comprehensive Strategy to Pain Management for Cancer Patients in an Inpatient Rehabilitation Facility. FRONTIERS IN PAIN RESEARCH 2022; 2:688511. [PMID: 35295412 PMCID: PMC8915682 DOI: 10.3389/fpain.2021.688511] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 08/24/2021] [Indexed: 11/13/2022] Open
Abstract
Cancer pain has been shown to have a significant negative impact on health-related quality of life (HRQoL) for people experiencing it. This is also true for patients admitted to inpatient rehabilitation facilities (IRFs). An interdisciplinary approach is often needed to fully address a person's pain to help them attain maximum functional independence and to ensure a safe discharge home. Improving a patient's performance status in an IRF may also be a crucial determinant in their ability to continue receiving treatment for their cancer. However, if a person is determined to no longer be a candidate for aggressive, disease modulating treatment, IRFs can also be utilized to help patients and family's transition to comfort directed care with palliative or hospice services. This article will discuss the interventions of the multidisciplinary inpatient rehabilitation team to address a person's pain.
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Affiliation(s)
- Terrence M Pugh
- Inpatient Oncology Rehabilitation, Atrium Health Carolinas Rehabilitation, Charlotte, NC, United States.,Cancer Rehabilitation, Levine Cancer Institute, Charlotte, NC, United States.,Atrium Health, Charlotte, NC, United States
| | - Fabiana Squarize
- Oncology Clinical Specialist, Atrium Health Carolinas Rehabilitation, Charlotte, NC, United States
| | - Allison L Kiser
- Oncology Occupational Therapist, Atrium Health Carolinas Rehabilitation, Charlotte, NC, United States
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Cancer-related accelerated ageing and biobehavioural modifiers: a framework for research and clinical care. Nat Rev Clin Oncol 2022; 19:173-187. [PMID: 34873313 PMCID: PMC9974153 DOI: 10.1038/s41571-021-00580-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2021] [Indexed: 12/15/2022]
Abstract
A growing body of evidence indicates that patients with cancer who receive cytotoxic treatments (such as chemotherapy or radiotherapy) have an increased risk of accelerated physical and cognitive ageing. Furthermore, accelerated biological ageing is a suspected driving force behind many of these observed effects. In this Review, we describe the mechanisms of biological ageing and how they apply to patients with cancer. We highlight the important role of specific behavioural factors, namely stress, sleep and lifestyle-related factors such as physical activity, weight management, diet and substance use, in the accelerated ageing of patients with cancer and cancer survivors. We also present a framework of how modifiable behaviours could operate to either increase the risk of accelerated ageing, provide protection, or promote resilience at both the biological level and in terms of patient-reported outcomes.
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Winters-Stone KM, Torgrimson-Ojerio B, Dieckmann N, Stoyles S, Mitri Z, Luoh SW. A randomized-controlled trial comparing supervised aerobic training to resistance training followed by unsupervised exercise on physical functioning in older breast cancer survivors. J Geriatr Oncol 2022; 13:152-160. [PMID: 34426142 PMCID: PMC9003120 DOI: 10.1016/j.jgo.2021.08.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 08/03/2021] [Accepted: 08/04/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION This study compared the relative efficacy of aerobic training to resistance training on physical functioning in older breast cancer survivors and determined whether benefits could be maintained by transitioning to unsupervised home-based training. MATERIALS AND METHODS Early-stage, post-treatment, older (≥65 years) breast cancer survivors (n = 114; mean age 72 years) were randomized to 12 months of supervised aerobic (n = 37), resistance (n = 39) or stretching (active control; n = 38) training followed by 6 months of unsupervised home-based training. Outcomes included aerobic capacity by 6-min walk distance (6MWD; m), maximal upper and lower body strength (1-repetition maximum; kg); physical function by short physical performance battery (SPPB), SF-36 and Late Life Function and Disability Instruments. RESULTS Over 12-months of supervised exercise, all groups improved in muscle strength and SPPB scores, but resistance trained women also improved 6MWD. Improvements in upper and lower body strength in the resistance group were significantly greater than those in the stretching control (+2.5 kg vs. +1.8 kg; p = 0.05) and aerobic groups (+8.3 kg vs +2.7 kg; p = 0.047), respectively, with trends for greater improvements in 6MWD (+57.9 m vs. +22.5 m; p = 0.057) and self-report physical function (+4.8 vs. -4.4; 0.066) in resistance trained women versus controls. Compared to values at 12 months, there were no changes during unsupervised training in any measure within or between groups, except for self-reported advanced lower extremity function which improved in the resistance group and fell in the aerobic group (+1.3 vs. -3.1; p = 0.043). DISCUSSION Supervised exercise can improve strength and physical functioning among older breast cancer survivors. Resistance training may lead to better improvements compared to aerobic or flexibility training, whether in a supervised or unsupervised setting. Clinicaltrials.govNCT00662103.
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Affiliation(s)
- Kerri M. Winters-Stone
- School of Nursing, Oregon Health & Science University, Portland, OR,Knight Cancer Institute, Oregon Health & Science University, Portland, OR,Corresponding author at: Oregon Health & Science University Mailcode: KCRB-CPC 3455 SW US Veteran’s Hospital Rd Portland, OR 97239,
| | | | - Nathan Dieckmann
- School of Nursing, Oregon Health & Science University, Portland, OR
| | - Sydnee Stoyles
- School of Nursing, Oregon Health & Science University, Portland, OR
| | - Zahi Mitri
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR
| | - Shiuh-Wen Luoh
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR,Portland Veterans Affairs Health Care System, Portland, OR
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Sleep moderates the effects of Tibetan yoga for women with breast cancer undergoing chemotherapy. Support Care Cancer 2022; 30:4477-4484. [PMID: 35107599 DOI: 10.1007/s00520-022-06861-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 01/21/2022] [Indexed: 10/19/2022]
Abstract
This study examined self-reported and actigraphy-assessed sleep and depression as moderators of the effect of a Tibetan yoga intervention on sleep and depression among women undergoing chemotherapy for breast cancer. This is a secondary analysis of an RCT examining a 4-session Tibetan yoga program (TYP; n = 74) versus stretching program (STP; n = 68) or usual care (UC; n = 85) on self-reported sleep (Pittsburgh Sleep Quality Index (PSQI), actigraphy-assessed sleep efficiency (SE)) and depression (Centers for Epidemiological Studies Depression Scale; CES-D) for women undergoing chemotherapy for breast cancer. Data were collected at baseline and 1-week and 3-month post-intervention. Baseline PSQI, actigraphy-SE, and CES-D were examined as moderators of the effect of group on PSQI, actigraphy-SE, and CES-D 1 week and 3 months after treatment. There was a significant baseline actigraphy-SE × group effect on PSQI at 1 week (p < .001) and 3 months (p = .002) and on CES-D at 3 months (p = .049). Specifically, the negative association of baseline actigraphy-SE with subsequent PSQI and CES-D was buffered for women in the TYP and, to a lesser extent in STP, compared to those in the UC. Baseline PSQI and CES-D were not significant moderators of the effect of group on any outcome. Behaviorally assessed sleep may be a more robust indicator of which patients are most appropriate for a yoga intervention than self-reported sleep quality. Women with poor sleep efficiency may derive the greatest benefit in terms of sleep quality and mood from a yoga intervention.
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Lefebvre T, Tack L, Meersman M, Vanneste H, Cool L, Van Eygen K, Stellamans K, Derijcke S, Vergauwe P, De Backer J, Chandler R, Lane P, Boterberg T, R. Debruyne P. Developing and evaluating a participatory arts programme for cancer patients and their caregivers. Acta Clin Belg 2022; 77:18-24. [PMID: 32515661 DOI: 10.1080/17843286.2020.1773653] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVES Cancer patients, survivors and caregivers often encounter severe distress, having significant consequences to wellbeing, functionality and physical health. This study developed and evaluated a participatory arts programme to determine if such could help to improve the wellbeing of cancer patients and their caregivers. METHODS To inform the development of a participatory arts programme, cancer patients and their caregivers at an Organisation of European Cancer Institute (OECI)-designated cancer centre were asked which activities they would wish to engage in (anonymous survey one). A programme was then developed and trialled for 1 year. Following participation, we explored the satisfaction and any benefits of taking part (anonymous survey two). RESULTS Survey one had a participation rate of 70%. In this survey, participants indicated they preferred group-based activities (61%) over an individual approachto take place on a monthly basis (46%). The developed programme ran from December 2018 to December 2019, with 435 patients and caregivers taking part. Two hundred and eighteen completed survey two and revealed a positive response to both the structure and content of the programme and its impact on the wellbeing of patients and caregivers. The majority indicated they felt (much) betterfrom participating in the participatory arts programme. CONCLUSION This study points out the interest and potential value of a participatory arts programme to the perceived wellbeing. This suggests such programmes could be incorporated into cancer care provision, to serve as psychosocial support. The latter is particularly relevant for improving the lives, wellbeing and health of cancer patients and those supporting them.
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Affiliation(s)
- Tessa Lefebvre
- Department of Medical Oncology, General Hospital Groeninge, Kortrijk, Belgium
- Department of Radiotherapy and Experimental Cancer Research, Ghent University, Ghent, Belgium
| | - Laura Tack
- Department of Medical Oncology, General Hospital Groeninge, Kortrijk, Belgium
- Department of Radiotherapy and Experimental Cancer Research, Ghent University, Ghent, Belgium
| | - Marlies Meersman
- Department of Medical Oncology, General Hospital Groeninge, Kortrijk, Belgium
| | - Hilde Vanneste
- Department of Medical Oncology, General Hospital Groeninge, Kortrijk, Belgium
| | - Lieselot Cool
- Department of Medical Oncology, General Hospital Groeninge, Kortrijk, Belgium
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Koen Van Eygen
- Department of Haematology, General Hospital Groeninge, Kortrijk, Belgium
| | - Karin Stellamans
- Department of Radiation Oncology, General Hospital Groeninge, Kortrijk, Belgium
| | - Sofie Derijcke
- Department of Respiratory Medicine, General Hospital Groeninge, Kortrijk, Belgium
| | - Philippe Vergauwe
- Department of Gastro-enterology, General Hospital Groeninge, Kortrijk, Belgium
| | - Jos De Backer
- Department of Music, LUCA School of Arts, Association KULeuven, Leuven, Belgium
| | - Rebecca Chandler
- Positive Ageing Research Institute (PARI), Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Chelmsford, UK
| | - Pauline Lane
- Positive Ageing Research Institute (PARI), Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Chelmsford, UK
| | - Tom Boterberg
- Department of Radiotherapy and Experimental Cancer Research, Ghent University, Ghent, Belgium
| | - Philip R. Debruyne
- Department of Medical Oncology, General Hospital Groeninge, Kortrijk, Belgium
- Positive Ageing Research Institute (PARI), Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Chelmsford, UK
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Bhargav H, Holla B, Ramakrishna KK, Shivakumar V, Gokulakrishnan K, Varambally S, Gangadhar BN. Yoga and Integrative Healthcare: Lessons from the National Institute of Mental Health and Neurosciences (NIMHANS) in India. Int J Yoga 2022; 15:150-157. [PMID: 36329771 PMCID: PMC9623895 DOI: 10.4103/ijoy.ijoy_56_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/19/2022] [Accepted: 05/23/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND There is growing evidence and increasing interest for systemic integration of medicine (synergistic and evidence-based combination of different systems along with conventional biomedicine). The National Institute of Mental Health and Neurosciences (NIMHANS), an Institute of National Importance and a tertiary mental and neurological healthcare hospital situated in Bengaluru, India, has established one such integrative model. The present manuscript traces the history and describes the important steps followed in this integrative approach. METHODOLOGY The NIMHANS model followed a stage-wise two-step approach: (1) First stage - Starting with Integration of Yoga: The process began more than a decade ago, with integrating yoga into a clinical department (rather than an exclusive research-based approach) of the institute which had relatively high clinical service load (For example, Department of Psychiatry in NIMHANS). Yoga was gradually formalized into academic and clinical activities (outpatient and inpatient services) by appointing a Yoga faculty with a medical background with an MD/PhD in Yoga. The research was primarily directed by the clinical observations of patients receiving yoga therapy. (2) Second stage: Adding an appropriate and compatible discipline from Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy (AYUSH) system (Ayurveda in this case): The center for yoga gradually evolved into the Department of Integrative Medicine with the appointment of faculty from the Ayurveda stream. In this model, specialists from each discipline provide clinical inputs after simultaneous consultation with the patient through systemic integration in clinical, academic, and research domains rather than mere co-location of AYUSH services with mainstream medicine. CONCLUSION The NIMHANS model of integration suggests the application of yoga into mainstream clinical service as the first step toward integration. Yoga should be added as a formalized clinical discipline with systemic integration. Gradually, other feasible systems of traditional medicine from AYUSH can be integrated at a later stage in a step-by-step manner based on clinical practice and evidence.
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Affiliation(s)
- Hemant Bhargav
- Department of Integrative Medicine, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Bharath Holla
- Department of Integrative Medicine, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Kishore Kumar Ramakrishna
- Department of Integrative Medicine, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Venkataram Shivakumar
- Department of Integrative Medicine, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - K. Gokulakrishnan
- Department of Neurochemistry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Shivarama Varambally
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India,Address for correspondence: Dr. Shivarama Varambally, Department of Integrative Medicine, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India. E-mail:
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Muñoz-Vergara D, Grabowska W, Yeh GY, Khalsa SB, Schreiber KL, Huang CA, Zavacki AM, Wayne PM. A systematic review of in vivo stretching regimens on inflammation and its relevance to translational yoga research. PLoS One 2022; 17:e0269300. [PMID: 35648793 PMCID: PMC9159623 DOI: 10.1371/journal.pone.0269300] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 05/18/2022] [Indexed: 12/09/2022] Open
Abstract
OBJECTIVE To conduct a systematic review evaluating the impact of stretching on inflammation and its resolution using in vivo rodent models. Findings are evaluated for their potential to inform the design of clinical yoga studies to assess the impact of yogic stretching on inflammation and health. METHODS Studies were identified using four databases. Eligible publications included English original peer-reviewed articles between 1900-May 2020. Studies included those investigating the effect of different stretching techniques administered to a whole rodent model and evaluating at least one inflammatory outcome. Studies stretching the musculoskeletal and integumentary systems were considered. Two reviewers removed duplicates, screened abstracts, conducted full-text reviews, and assessed methodological quality. RESULTS Of 766 studies identified, 25 were included for synthesis. Seven (28%) studies had a high risk of bias in 3 out of 10 criteria. Experimental stretching protocols resulted in a continuum of inflammatory responses with therapeutic and injurious effects, which varied with a combination of three stretching parameters--duration, frequency, and intensity. Relative to injurious stretching, therapeutic stretching featured longer-term stretching protocols. Evidence of pro- and mixed-inflammatory effects of stretching was found in 16 muscle studies. Evidence of pro-, anti-, and mixed-inflammatory effects was found in nine longer-term stretching studies of the integumentary system. CONCLUSION Despite the overall high quality of these summarized studies, evaluation of stretching protocols paralleling yogic stretching is limited. Both injurious and therapeutic stretching induce aspects of inflammatory responses that varied among the different stretching protocols. Inflammatory markers, such as cytokines, are potential outcomes to consider in clinical yoga studies. Future translational research evaluating therapeutic benefits should consider in vitro studies, active vs. passive stretching, shorter-term vs. longer-term interventions, systemic vs. local effects of stretching, animal models resembling human anatomy, control and estimation of non-specific stresses, development of in vivo self-stretching paradigms targeting myofascial tissues, and in vivo models accounting for gross musculoskeletal posture.
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Affiliation(s)
- Dennis Muñoz-Vergara
- Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States of America
- Osher Center for Integrative Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States of America
- * E-mail:
| | - Weronika Grabowska
- Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States of America
| | - Gloria Y. Yeh
- Osher Center for Integrative Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States of America
- Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States of America
| | - Sat Bir Khalsa
- Osher Center for Integrative Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States of America
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States of America
| | - Kristin L. Schreiber
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States of America
| | - Christene A. Huang
- The Department of Surgery, School of Medicine, University of Colorado, Denver, CO, United States of America
| | - Ann Marie Zavacki
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States of America
| | - Peter M. Wayne
- Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States of America
- Osher Center for Integrative Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States of America
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Anisman H, Kusnecov AW. Cancer therapies: Caveats, concerns, and momentum. Cancer 2022. [DOI: 10.1016/b978-0-323-91904-3.00001-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Sohl SJ, Tooze JA, Johnson EN, Ridner SH, Rothman RL, Lima CR, Ansley KC, Wheeler A, Nicklas B, Avis NE, Wagner LI. A Randomized Controlled Pilot Study of Yoga Skills Training Versus an Attention Control Delivered During Chemotherapy Administration. J Pain Symptom Manage 2022; 63:23-32. [PMID: 34343620 PMCID: PMC8766874 DOI: 10.1016/j.jpainsymman.2021.07.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 07/23/2021] [Accepted: 07/24/2021] [Indexed: 01/03/2023]
Abstract
CONTEXT It is important to address fatigue and co-occurring symptoms during chemotherapy to preserve quality of life in patients with gastrointestinal (GI) cancer. OBJECTIVE To conduct a randomized controlled pilot study of a Yoga Skills Training (YST) intervention compared to an attention control (AC) among adults diagnosed with GI cancer. METHODS YST consisted of four 30-minute sessions delivered individually during chemotherapy plus home practice. AC provided empathic attention plus home diaries. Patient-reported (PROMIS T-score) assessments of fatigue, depressive symptoms, sleep disturbances, and psychological stress (Perceived Stress Scale) were collected at chemotherapy visits: baseline, Week 8, Week 10 and Week 14, and analyzed using a mixed effects model. Inflammatory cytokines were assessed at baseline and Week 10. RESULTS Forty-four of 77 adults approached agreed to participate (57%; YST n = 23; AC n = 21). Participants' mean age was 58 years and 48% were men. Participants randomized to YST reported a larger decline in fatigue (-2.4 difference, d = 0.30) and depressive symptoms (-2.5 difference, d = 0.30) than AC participants from baseline to Week 10 and sleep disturbances at Week 8 (-3.9 difference, d = 0.50). Differences in magnitude of change in symptoms were consistent with or exceeded a minimally important difference. Psychological stress decreased more in the AC at Week 10 (d = 0.30). Reductions in inflammatory cytokines (IL-6, sTNF R1) were larger in the YST group than AC. CONCLUSION YST showed promise for improving fatigue, depressive symptoms, sleep disturbances, and inflammation. YST is also feasible and reaches patients underrepresented in yoga research (i.e., GI cancer, men), thus warranting further examination.
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Affiliation(s)
- Stephanie J Sohl
- Wake Forest School of Medicine (S.J.S., J.A.T., E.N.J., C.R.L., K.C.A., B.N., N.E.A, L.I.W.), Winston-Salem, North Carolina, USA.
| | - Janet A Tooze
- Wake Forest School of Medicine (S.J.S., J.A.T., E.N.J., C.R.L., K.C.A., B.N., N.E.A, L.I.W.), Winston-Salem, North Carolina, USA
| | - Emily Nance Johnson
- Wake Forest School of Medicine (S.J.S., J.A.T., E.N.J., C.R.L., K.C.A., B.N., N.E.A, L.I.W.), Winston-Salem, North Carolina, USA
| | - Sheila H Ridner
- Vanderbilt University School of Nursing (S.H.R.), Nashville, Tennessee, USA
| | - Russell L Rothman
- Vanderbilt University School of Medicine (R.L.R.), Nashville, Tennessee, USA
| | - Caio Rocha Lima
- Wake Forest School of Medicine (S.J.S., J.A.T., E.N.J., C.R.L., K.C.A., B.N., N.E.A, L.I.W.), Winston-Salem, North Carolina, USA
| | - Katherine C Ansley
- Wake Forest School of Medicine (S.J.S., J.A.T., E.N.J., C.R.L., K.C.A., B.N., N.E.A, L.I.W.), Winston-Salem, North Carolina, USA
| | - Amy Wheeler
- California State University (A.W.), San Bernardino, California, USA
| | - Barbara Nicklas
- Wake Forest School of Medicine (S.J.S., J.A.T., E.N.J., C.R.L., K.C.A., B.N., N.E.A, L.I.W.), Winston-Salem, North Carolina, USA
| | - Nancy E Avis
- Wake Forest School of Medicine (S.J.S., J.A.T., E.N.J., C.R.L., K.C.A., B.N., N.E.A, L.I.W.), Winston-Salem, North Carolina, USA
| | - Lynne I Wagner
- Wake Forest School of Medicine (S.J.S., J.A.T., E.N.J., C.R.L., K.C.A., B.N., N.E.A, L.I.W.), Winston-Salem, North Carolina, USA
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Brunet J, Wurz A, Hussien J, Pitman A, Conte E, Ennis JK, Herry CL, Seely AJE, Seely D. Exploring the Effects of Yoga Therapy on Heart Rate Variability and Patient-Reported Outcomes After Cancer Treatment: A Study Protocol. Integr Cancer Ther 2022; 21:15347354221075576. [PMID: 35393867 PMCID: PMC9016564 DOI: 10.1177/15347354221075576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Following cancer treatment, adults commonly report worsened patient-reported outcomes (PROs) such as anxiety, stress, depression, persistent and upsetting cognitive complaints, unrelenting fatigue, and reduced quality of life. Poorer PROs are associated with disrupted autonomic nervous system functioning as measured by heart rate variability (HRV), both of which have been associated with greater morbidity and mortality. Interventions to improve HRV and PROs among adults following cancer treatment are needed. Yoga therapy holds promise as an intervention to improve HRV and PROs. Therefore, we conducted a single-subject exploratory experimental study to investigate the effects of yoga therapy on HRV and specific PROs (ie, cancer-related fatigue, anxiety, cognitive function, depression, stress, quality of life) in adults treated for cancer. To reduce publication bias, improve reproducibility, and serve as a reference for forthcoming reporting of study results, we present the study protocol for this study herein. METHODS Participants were adults who completed cancer treatment that were recruited from the Ottawa Integrative Cancer Centre. Consenting and eligible participants received one 1:1 yoga therapy session (ie, 1 participant, 1 Yoga Therapist) and 6 weekly group-based yoga therapy sessions (ie, 2-3 participants, 1 Yoga Therapist). Participants completed assessments 7 times: 3 times prior to the program (ie, -6 weeks, -3 weeks, immediately prior to the 1:1 yoga therapy session), immediately following the 1:1 yoga therapy session, prior to the first group-based yoga therapy session, after the last group-based yoga therapy session, and at a 6-week follow-up. Hierarchical linear modeling will be used to test the average effects of the yoga therapy program across participants. DISCUSSION This study will explore several novel hypotheses, including whether yoga therapy can improve HRV and/or specific PROs among adults treated for cancer acutely (ie, during a 1:1 yoga therapy session) and/or through repeated exposure (ie, after completing 6 weeks of group-based yoga therapy). Although the findings will require confirmation or refutation in future trials, they may provide initial evidence that YT may benefit adults treated for cancer. TRIAL REGISTRATION ISRCTN registry, ISRCTN64763228. Registered on December 12, 2021. This trial was registered retrospectively. URL of trial registry record: https://www.isrctn.com/ISRCTN64763228.
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Affiliation(s)
- Jennifer Brunet
- University of Ottawa, Ottawa, ON, Canada.,Ottawa Hospital Research Institute, Ottawa, ON, Canada.,Institut du savoir de l'Hôpital Montfort, Ottawa, ON, Canada
| | - Amanda Wurz
- University of the Fraser Valley, Chilliwack, BC, Canada
| | | | - Anne Pitman
- The Centre for Health Innovation, Ottawa, ON, Canada
| | - Ellen Conte
- The Centre for Health Innovation, Ottawa, ON, Canada.,Canadian College of Naturopathic Medicine, Toronto, ON, Canada
| | - Julie K Ennis
- The Centre for Health Innovation, Ottawa, ON, Canada
| | | | - Andrew J E Seely
- University of Ottawa, Ottawa, ON, Canada.,The Ottawa Hospital, Ottawa, ON, Canada
| | - Dugald Seely
- University of Ottawa, Ottawa, ON, Canada.,The Centre for Health Innovation, Ottawa, ON, Canada.,Canadian College of Naturopathic Medicine, Toronto, ON, Canada
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Lifestyle and Pain following Cancer: State-of-the-Art and Future Directions. J Clin Med 2021; 11:jcm11010195. [PMID: 35011937 PMCID: PMC8745758 DOI: 10.3390/jcm11010195] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/17/2021] [Accepted: 12/23/2021] [Indexed: 01/08/2023] Open
Abstract
This review discusses chronic pain, multiple modifiable lifestyle factors, such as stress, insomnia, diet, obesity, smoking, alcohol consumption and physical activity, and the relationship between these lifestyle factors and pain after cancer. Chronic pain is known to be a common consequence of cancer treatments, which considerably impacts cancer survivors' quality of life when it remains untreated. Improvements in lifestyle behaviour are known to reduce mortality, comorbid conditions (i.e., cardiovascular diseases, other cancer, and recurrence) and cancer-related side-effects (i.e., fatigue and psychological issues). An inadequate stress response plays an important role in dysregulating the body's autonomic, endocrine, and immune responses, creating a problematic back loop with pain. Next, given the high vulnerability of cancer survivors to insomnia, addressing and treating those sleep problems should be another target in pain management due to its capacity to increase hyperalgesia. Furthermore, adherence to a healthy diet holds great anti-inflammatory potential for relieving pain after cancer. Additionally, a healthy diet might go hand in hand with weight reduction in the case of obesity. Consuming alcohol and smoking have an acute analgesic effect in the short-term, with evidence lacking in the long-term. However, this acute effect is outweighed by other harms on cancer survivors' general health. Last, informing patients about the benefits of an active lifestyle and reducing a sedentary lifestyle after cancer treatment must be emphasised when considering the proven benefits of physical activity in this population. A multimodal approach addressing all relevant lifestyle factors together seems appropriate for managing comorbid conditions, side-effects, and chronic pain after cancer. Further research is needed to evaluate whether modifiable lifestyle factors have a beneficial influence on chronic pain among cancer survivors.
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Faravel K, Huteau ME, Jarlier M, de Forges H, Meignant L, Senesse P, Norton J, Jacot W, Stoebner A. Importance of Patient Education for At-home Yoga Practice in Women With Hormonal Therapy-induced Pain During Adjuvant Breast Cancer Treatment: A Feasibility Study. Integr Cancer Ther 2021; 20:15347354211063791. [PMID: 34939444 PMCID: PMC8725037 DOI: 10.1177/15347354211063791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Osteo-articular pain (OAP) is experienced by approximately 50% of women under
hormonal therapy (HT) for breast cancer (BC), which increases the risk for
therapy discontinuation. This study was aimed to assess benefits of yoga
practice combined with patient education (PE) for at-home practice by
evaluating feasibility among BC patients under HT and measuring OAP,
flexibility and satisfaction. Methods Feasibility was evaluated by patient adherence as accomplishment of at least
4 out of 6 supervised yoga-PE sessions along with 70% or more at-home yoga
sessions. Intervention (12 weeks) included two 6-weeks periods: P1
comprising one 90-minutes supervised yoga-PE session/week and 15-minutes
daily at-home yoga and P2, daily autonomous at-home yoga sessions.
Evaluations (at inclusion and by the end of each period) consisted in
assessment of OAP on Visual Analog Scale (VAS), forward flexibility (cm) and
patient satisfaction on Likert (0-10 points) scale. Results Between September 2018 and May 2019 we included 24 patients of median
53 years (range 36-72). Feasibility was validated by 83% successful
adherence rate. Pain was significantly reduced from median VAS of 6 [range
4-10] to 4 [range 0-7] at the end of both P1 and P2
(p < 0.01), albeit with no difference between P1 and P2.
Forward flexibility improved by a median gain of 8 cm (end of P2) and median
satisfaction score of 10/10 [range 8-10]. Conclusion Combined physiotherapy-yoga-PE intervention is a feasible strategy to
increase at-home yoga practice with potential benefit on pain, flexibility,
and satisfaction, thus prompting further evaluations in larger randomized
multicenter trials. ClinicalTrials.gov NCT04001751
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Affiliation(s)
- Kerstin Faravel
- Cancer Institute of Montpellier, University of Montpellier, Montpellier, France
| | - Marie-Eve Huteau
- Cancer Institute of Montpellier, University of Montpellier, Montpellier, France
| | - Marta Jarlier
- Cancer Institute of Montpellier, University of Montpellier, Montpellier, France
| | - Hélène de Forges
- Cancer Institute of Montpellier, University of Montpellier, Montpellier, France
| | - Laetitia Meignant
- Cancer Institute of Montpellier, University of Montpellier, Montpellier, France
| | - Pierre Senesse
- Cancer Institute of Montpellier, University of Montpellier, Montpellier, France.,University of Montpellier, INSERM UA11, U1194, U1298, Montpellier, France
| | - Joanna Norton
- University of Montpellier, INSERM UA11, U1194, U1298, Montpellier, France
| | - William Jacot
- Cancer Institute of Montpellier, University of Montpellier, Montpellier, France.,University of Montpellier, INSERM UA11, U1194, U1298, Montpellier, France
| | - Anne Stoebner
- Cancer Institute of Montpellier, University of Montpellier, Montpellier, France.,University of Montpellier, INSERM UA11, U1194, U1298, Montpellier, France
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Stritter W, Everding J, Luchte J, Eggert A, Seifert G. Yoga, Meditation and Mindfulness in pediatric oncology - A review of literature. Complement Ther Med 2021; 63:102791. [PMID: 34808385 DOI: 10.1016/j.ctim.2021.102791] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/12/2021] [Accepted: 11/15/2021] [Indexed: 10/19/2022] Open
Abstract
PURPOSE Children and adolescents undergoing treatment for cancer are exposed to a wide variety of stressors both physical and mental. Not only adults but also children and adolescents increasingly practice yoga in a health-promoting manner and to cope with stressful situations. METHODS A review of literature was conducted to present the current outcomes on yoga, meditation and mindfulness for children and adolescents who are affected by an oncological disease. RESULTS Eight studies were identified that examined yoga treatment for children and adolescents with oncological diseases. Three studies were found on mindfulness in pediatric oncology. The studies summarized here suggest that yoga and mindfulness could help to improve quality of life, reduce fatigue, improve activity and fitness levels, improve sleep quality, increase appetite and decrease anxiety in various stages of the disease and its treatment. The reviewed studies showed that yoga and mindfulness-based interventions for children and adolescents with oncological illnesses are feasible in different settings and are well received. CONCLUSIONS The results of the studies suggest that yoga and mindfulness may help to support children and adolescents during and after oncological treatment. Based on the current body of evidence it is not possible to draw conclusions about the efficacy of yoga and mindfulness-based interventions in pediatric oncology patients. Research must meet this challenge to develop suitable designs to further and better investigate the effects of yoga and mindfulness in children and adolescents with oncological diseases.
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Affiliation(s)
- Wiebke Stritter
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Pediatrics, Division of Oncology and Hematology, Charitéplatz 1, 10117 Berlin, Germany.
| | - Janina Everding
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Pediatrics, Division of Oncology and Hematology, Charitéplatz 1, 10117 Berlin, Germany
| | - Jacqueline Luchte
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Pediatrics, Division of Oncology and Hematology, Charitéplatz 1, 10117 Berlin, Germany
| | - Angelika Eggert
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Pediatrics, Division of Oncology and Hematology, Charitéplatz 1, 10117 Berlin, Germany
| | - Georg Seifert
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Pediatrics, Division of Oncology and Hematology, Charitéplatz 1, 10117 Berlin, Germany; University of São Paulo, Faculty of Medicine, Department of Pediatrics, São Paulo, Brazil
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Auguste EJ, Weiskittle RE, Sohl SJ, Danhauer SC, Doherty K, Naik AD, Moye J. Enhancing Access to Yoga for Older Male Veterans After Cancer: Examining Beliefs About Yoga. Fed Pract 2021; 38:450-458. [PMID: 34733065 DOI: 10.12788/fp.0180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background Yoga is an effective clinical intervention for cancer survivors. Most studies of the positive effects of yoga on cancer patients report on predominantly middle-aged women with breast cancer. Less is known about the use of yoga in older adults, veterans, and those from diverse racial or ethnic backgrounds. Methods We examined strategies to enhance access to yoga in older veterans after cancer, focusing on education (study 1) and intervention (study 2). Study 1 included 110 participants with a median (SD) age of 64.9 (9.4) years who were mostly male (99%) cancer survivors who were interviewed 12 months after their cancer diagnosis. Study 2 included 28 participants with a median (SD) age of 69.2 (10.9) years who were mostly male (96%) cancer survivors who participated in a yoga program within 3 years of their cancer diagnosis. Standardized interviews assessed interest in and barriers to yoga while self-reporting assessed health-related quality of life and beliefs about yoga. Results In study 1, interest in yoga increased from 5.5 to 31.8% (χ 2 = 22.25, P < .001) following education. In open-ended questions 4 themes related to negative beliefs or barriers emerged: lack of knowledge or skepticism, disinterest or dislike, physical health barriers, and logistical barriers. In study 2, beliefs were more positive following intervention for expected benefits (t = 4.44, P < .001), discomfort (t = 4.92, P < .001), and social norms (t = 4.38, P < .001) related to yoga. Physical function improved after participation in a yoga class, especially for those with higher beliefs in yoga prior to class. Age was not associated with beliefs about yoga in either sample. Conclusions A portion of older veterans who are cancer survivors were interested in yoga but faced access barriers. Implications for practice and research include increasing knowledge about yoga benefits and addressing physical health and logistical barriers to enhance access to yoga for older veterans.
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Affiliation(s)
- Elizabeth J Auguste
- is a Research Assistant; is an Advanced Fellow; is a Health Science Specialist; and is Associate Director for Education and Evaluation; all at US Department of Veterans Affairs (VA) New England Geriatric Research Education and Clinical Center, VA Boston Healthcare System in Massachusetts. is a Assistant Professor, and is a Professor and Director of Faculty Well-Being & Resilience, both at the Department of Social Sciences & Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine in Winston Salem, North Carolina. is Chief of Implementation Science at the VA Health Services Research and Development Center for Innovations in Quality, Effectiveness and Safety at the Michael E. DeBakey VA Medical Center and a Professor and Robert Luchi, MD Chair in Geriatric Medicine at the Baylor College of Medicine in Houston, Texas. Rachel Weiskittle is a Research Fellow and Jennifer Moye is a Professor, both at the Department of Psychiatry, Harvard Medical School
| | - Rachel E Weiskittle
- is a Research Assistant; is an Advanced Fellow; is a Health Science Specialist; and is Associate Director for Education and Evaluation; all at US Department of Veterans Affairs (VA) New England Geriatric Research Education and Clinical Center, VA Boston Healthcare System in Massachusetts. is a Assistant Professor, and is a Professor and Director of Faculty Well-Being & Resilience, both at the Department of Social Sciences & Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine in Winston Salem, North Carolina. is Chief of Implementation Science at the VA Health Services Research and Development Center for Innovations in Quality, Effectiveness and Safety at the Michael E. DeBakey VA Medical Center and a Professor and Robert Luchi, MD Chair in Geriatric Medicine at the Baylor College of Medicine in Houston, Texas. Rachel Weiskittle is a Research Fellow and Jennifer Moye is a Professor, both at the Department of Psychiatry, Harvard Medical School
| | - Stephanie J Sohl
- is a Research Assistant; is an Advanced Fellow; is a Health Science Specialist; and is Associate Director for Education and Evaluation; all at US Department of Veterans Affairs (VA) New England Geriatric Research Education and Clinical Center, VA Boston Healthcare System in Massachusetts. is a Assistant Professor, and is a Professor and Director of Faculty Well-Being & Resilience, both at the Department of Social Sciences & Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine in Winston Salem, North Carolina. is Chief of Implementation Science at the VA Health Services Research and Development Center for Innovations in Quality, Effectiveness and Safety at the Michael E. DeBakey VA Medical Center and a Professor and Robert Luchi, MD Chair in Geriatric Medicine at the Baylor College of Medicine in Houston, Texas. Rachel Weiskittle is a Research Fellow and Jennifer Moye is a Professor, both at the Department of Psychiatry, Harvard Medical School
| | - Suzanne C Danhauer
- is a Research Assistant; is an Advanced Fellow; is a Health Science Specialist; and is Associate Director for Education and Evaluation; all at US Department of Veterans Affairs (VA) New England Geriatric Research Education and Clinical Center, VA Boston Healthcare System in Massachusetts. is a Assistant Professor, and is a Professor and Director of Faculty Well-Being & Resilience, both at the Department of Social Sciences & Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine in Winston Salem, North Carolina. is Chief of Implementation Science at the VA Health Services Research and Development Center for Innovations in Quality, Effectiveness and Safety at the Michael E. DeBakey VA Medical Center and a Professor and Robert Luchi, MD Chair in Geriatric Medicine at the Baylor College of Medicine in Houston, Texas. Rachel Weiskittle is a Research Fellow and Jennifer Moye is a Professor, both at the Department of Psychiatry, Harvard Medical School
| | - Kelly Doherty
- is a Research Assistant; is an Advanced Fellow; is a Health Science Specialist; and is Associate Director for Education and Evaluation; all at US Department of Veterans Affairs (VA) New England Geriatric Research Education and Clinical Center, VA Boston Healthcare System in Massachusetts. is a Assistant Professor, and is a Professor and Director of Faculty Well-Being & Resilience, both at the Department of Social Sciences & Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine in Winston Salem, North Carolina. is Chief of Implementation Science at the VA Health Services Research and Development Center for Innovations in Quality, Effectiveness and Safety at the Michael E. DeBakey VA Medical Center and a Professor and Robert Luchi, MD Chair in Geriatric Medicine at the Baylor College of Medicine in Houston, Texas. Rachel Weiskittle is a Research Fellow and Jennifer Moye is a Professor, both at the Department of Psychiatry, Harvard Medical School
| | - Aanand D Naik
- is a Research Assistant; is an Advanced Fellow; is a Health Science Specialist; and is Associate Director for Education and Evaluation; all at US Department of Veterans Affairs (VA) New England Geriatric Research Education and Clinical Center, VA Boston Healthcare System in Massachusetts. is a Assistant Professor, and is a Professor and Director of Faculty Well-Being & Resilience, both at the Department of Social Sciences & Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine in Winston Salem, North Carolina. is Chief of Implementation Science at the VA Health Services Research and Development Center for Innovations in Quality, Effectiveness and Safety at the Michael E. DeBakey VA Medical Center and a Professor and Robert Luchi, MD Chair in Geriatric Medicine at the Baylor College of Medicine in Houston, Texas. Rachel Weiskittle is a Research Fellow and Jennifer Moye is a Professor, both at the Department of Psychiatry, Harvard Medical School
| | - Jennifer Moye
- is a Research Assistant; is an Advanced Fellow; is a Health Science Specialist; and is Associate Director for Education and Evaluation; all at US Department of Veterans Affairs (VA) New England Geriatric Research Education and Clinical Center, VA Boston Healthcare System in Massachusetts. is a Assistant Professor, and is a Professor and Director of Faculty Well-Being & Resilience, both at the Department of Social Sciences & Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine in Winston Salem, North Carolina. is Chief of Implementation Science at the VA Health Services Research and Development Center for Innovations in Quality, Effectiveness and Safety at the Michael E. DeBakey VA Medical Center and a Professor and Robert Luchi, MD Chair in Geriatric Medicine at the Baylor College of Medicine in Houston, Texas. Rachel Weiskittle is a Research Fellow and Jennifer Moye is a Professor, both at the Department of Psychiatry, Harvard Medical School
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48
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Massage Therapy for Fatigue Management in Breast Cancer Survivors: A Systematic Review and Descriptive Analysis of Randomized Controlled Trials. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:9967574. [PMID: 34603480 PMCID: PMC8483909 DOI: 10.1155/2021/9967574] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 09/01/2021] [Indexed: 11/18/2022]
Abstract
Background Fatigue is one of the most common symptoms among breast cancer survivors. Although massage therapy has been commonly used for fatigue management, relevant evidence on the effectiveness of massage therapy for the reduction of fatigue in breast cancer survivors is still unclear. Objective To identify the research evidence on the effectiveness and safety of massage therapy to manage fatigue in breast cancer survivors and summarize the characteristics of massage therapy protocols utilized for fatigue management in breast cancer survivors. Methods Randomized controlled trials (RCTs) using massage therapy to manage cancer-related fatigue were searched in PubMed, Medline, Web of Science, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), ScienceDirect, PsycINFO, Wan Fang Data, and China National Knowledge Infrastructure (CNKI) from the inception of each database to March 2021. The Cochrane Back Review Group Risk of Bias Assessment Criteria was used to assess the methodological quality of the included studies. Descriptive analysis was applied for a summary and synthesis of the findings. The primary outcome was fatigue measured by any patient-reported questionnaires, and the secondary outcomes were quality of life and massage-therapy-related adverse events. Results Ten RCTs were included. Massage therapy was found to have a positive effect on fatigue management compared with routine care/wait list control groups and sham massage. Despite these encouraging findings, the review concluded that most of the included studies exhibited an unsatisfactory experimental design, particularly, inadequate blinding and allocation concealment. The duration and frequency of the massage therapy interventions varied across the studies. Adverse events were reported in three included studies, with no study conducting causality analysis. Conclusion This systematic review provides the latest research evidence to support massage therapy as an encouraging complementary and alternative medicine approach to managing fatigue in breast cancer survivors. More rigorously designed, large-scale, sham-controlled RCTs are needed to further conclude the specific therapeutic effectiveness and safety issues of massage therapy for fatigue management.
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49
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Yang L, Winters-Stone K, Rana B, Cao C, Carlson LE, Courneya KS, Friedenreich CM, Schmitz KH. Tai Chi for cancer survivors: A systematic review toward consensus-based guidelines. Cancer Med 2021; 10:7447-7456. [PMID: 34533284 PMCID: PMC8559497 DOI: 10.1002/cam4.4273] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 08/27/2021] [Accepted: 08/30/2021] [Indexed: 12/21/2022] Open
Abstract
To manage acute, long‐term, and late effects of cancer, current guidelines recommend moderate‐to‐vigorous intensity aerobic and resistance exercise. Unfortunately, not all cancer survivors are able or willing to perform higher intensity exercise during difficult cancer treatments or because of other existing health conditions. Tai Chi is an equipment‐free, multicomponent mind–body exercise performed at light‐to‐moderate intensity that may provide a more feasible alternative to traditional exercise programs for some cancer survivors. This systematic review evaluated the therapeutic efficacy of Tai Chi across the cancer care continuum. We searched MEDLINE/PubMed, Embase, SCOPUS, and CINAHL databases for interventional studies from inception to 18 September 2020. Controlled trials of the effects of Tai Chi training on patient‐reported and objectively measured outcomes in cancer survivors were included. Study quality was determined by the RoB 2 tool, and effect estimates were evaluated using the Best Evidence Synthesis approach. Twenty‐six reports from 14 trials (one non‐randomized controlled trial) conducted during (n = 5) and after treatment (after surgery: n = 2; after other treatments: n = 7) were included. Low‐level evidence emerged to support the benefits of 40–60 min of thrice‐weekly supervised Tai Chi for 8–12 weeks to improve fatigue and sleep quality in cancer survivors. These findings need to be confirmed in larger trials and tested for scaling‐up potential. Insufficient evidence was available to evaluate the effects of Tai Chi on other cancer‐related outcomes. Future research should examine whether Tai Chi training can improve a broader range of cancer outcomes including during the pre‐treatment and end of life phases.
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Affiliation(s)
- Lin Yang
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, Canada.,Departments of Oncology, University of Calgary, Calgary, Canada.,Departments of Community Health Sciences, University of Calgary, Calgary, Canada
| | - Kerri Winters-Stone
- School of Nursing and Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon, USA
| | - Benny Rana
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, Canada
| | - Chao Cao
- Program in Physical Therapy, Washington University School of Medicine, St Louis, Missouri, USA
| | - Linda E Carlson
- Departments of Oncology, University of Calgary, Calgary, Canada.,Department of Psychosocial Oncology, Alberta Health Services, Calgary, Canada
| | - Kerry S Courneya
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada
| | - Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, Canada.,Departments of Oncology, University of Calgary, Calgary, Canada.,Departments of Community Health Sciences, University of Calgary, Calgary, Canada
| | - Kathryn H Schmitz
- Penn State Cancer Institute, Penn State College of Medicine, Hershey, Pennsylvania, USA
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50
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Yoga for chronic chemotherapy-induced peripheral neuropathy pain: a pilot, randomized controlled trial. J Cancer Surviv 2021; 16:882-891. [PMID: 34524631 PMCID: PMC8442518 DOI: 10.1007/s11764-021-01081-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 06/29/2021] [Indexed: 10/28/2022]
Abstract
PURPOSE To determine the feasibility of implementing a yoga intervention for cancer survivors with chronic CIPN pain, as well as the impact of the intervention on patient-reported outcomes. METHODS Cancer survivors with chronic CIPN pain were recruited from the breast, gastrointestinal, and gynecological oncology centers at Dana-Farber Cancer Institute. Participants were randomized (2:1) to receive an 8-week yoga intervention or usual care. After 21/50 of participants were enrolled, the COVID-19 pandemic required the yoga intervention to be delivered virtually (i.e., Zoom). Pre- and post-intervention, participants self-reported CIPN and co-occurring symptom severity. Adherence to the intervention was defined as practicing ≥ 12 yoga sessions over the 8-week intervention period. Changes in patient-reported outcomes between groups were compared using Wilcoxon's rank-sum tests. RESULTS Participants (n = 28 yoga, n = 16 control) were mainly female (96%) and diagnosed with stage III/IV disease (66%). Overall, 19/28 (67.8%) of yoga group participants were adherent to the yoga protocol. Yoga group participants experienced significant within-group improvements in all patient-reported outcomes, including worst CIPN pain (median change = - 1.7, p < 0.0001) and sensory CIPN (median change = - 14.8, p < 0.0001), but only improvements in fatigue (p = 0.05) and depression (p = 0.04) were significant compared to the control. There were no differences (p > 0.05) in changes in patient-reported outcomes between in-person (n = 6) or virtual (n = 15) yoga group participants. CONCLUSIONS Yoga is a feasible non-pharmacological modality for cancer survivors with CIPN, but more information is needed regarding its impact on CIPN and other symptoms. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03824860 IMPLICATIONS FOR CANCER SURVIVORS: Oncology clinicians may consider referring cancer survivors to yoga for chronic CIPN pain, but yoga cannot be currently recommended as an efficacious treatment.
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