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Song J, Yang X, Wu J, Wu Z, Niu S, Zhuo L, Lyu W, Ye J, Fang Y, Zhan Z, Zhang H, Li X, Hong J, Su L. The association analysis between fatigue and body composition loss in patients with nasopharyngeal carcinoma during radiotherapy: An observational longitudinal study. Radiother Oncol 2024; 197:110340. [PMID: 38797492 DOI: 10.1016/j.radonc.2024.110340] [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: 10/06/2023] [Revised: 05/02/2024] [Accepted: 05/12/2024] [Indexed: 05/29/2024]
Abstract
PURPOSE This study aimed to reveal the association of fatigue with weekly changes in the body composition in patients with nasopharyngeal carcinoma (NPC) and identified the independent strength. METHODS Four body composition indexes and fatigue were assessed before treatment (T0, baseline) and once a week throughout radiotherapy (T1-T7). Generalized additive mixed models (GAMMs) were used to explore the trajectories and longitudinal relationships of fatigue and weekly changes in body composition. The marginal structural model (MSM) was used to control the effect of depression and anxiety. RESULTS The trajectories of fatigue in 105 participants reached a peak in the fifth week, and changes in body composition started appearing from the second week. Four body composition indexes, weight, body mass index (BMI), body fat rate, and lean body weight loss weekly were positively associated with fatigue. High magnitude of effects was revealed when anxiety and depression were controlled as time-dependent confounders. The positive associations with fatigue were manifested in patients aged >53 years, those with senior high and above education, no drinking, >5000 Y/month of family inflow, ≥ stage III, or those receiving a dose of ≥70 Gy, ≥3 cycles of induced chemotherapy, and ≤1 cycle of concurrent chemotherapy. CONCLUSIONS Loss of weight, BMI, body fat rate, and lean body weight could be used to independently evaluate the development of fatigue in patients with NPC during radiotherapy. Positive associations between fatigue and weekly body composition loss were found in patients with certain characteristics.
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Affiliation(s)
- Jihong Song
- School of Nursing, Fujian Medical University, Fuzhou, China; School of Nursing, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Xinru Yang
- School of Nursing, Fujian Medical University, Fuzhou, China
| | - Jieling Wu
- School of Nursing, Fujian Medical University, Fuzhou, China
| | - Zilan Wu
- School of Nursing, Fujian Medical University, Fuzhou, China
| | - Sitian Niu
- School of Nursing, Fujian Medical University, Fuzhou, China
| | - Litao Zhuo
- School of Nursing, Fujian Medical University, Fuzhou, China
| | - Wenlong Lyu
- Department of Radiotherapy, Cancer Center, The First Affiliated Hospital of Fujian Medical University, China; Department of Radiotherapy, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, China; Key Laboratory of Radiation Biology of Fujian Higher Education Institutions, the First Affiliated Hospital, Fujian Medical University, China
| | - Jinru Ye
- Department of Radiotherapy, Cancer Center, The First Affiliated Hospital of Fujian Medical University, China; Department of Radiotherapy, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, China; Key Laboratory of Radiation Biology of Fujian Higher Education Institutions, the First Affiliated Hospital, Fujian Medical University, China
| | - Yan Fang
- Nursing Department, The First Affiliated Hospital of Fujian Medical University, China
| | - Zhiying Zhan
- Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, China
| | - Hairong Zhang
- Fujian Center for Disease Control and Prevention, China
| | - Xiaomei Li
- School of Nursing, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Jinsheng Hong
- Department of Radiotherapy, Cancer Center, The First Affiliated Hospital of Fujian Medical University, China; Department of Radiotherapy, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, China; Key Laboratory of Radiation Biology of Fujian Higher Education Institutions, the First Affiliated Hospital, Fujian Medical University, China.
| | - Li Su
- Department of Radiotherapy, Cancer Center, The First Affiliated Hospital of Fujian Medical University, China; Department of Radiotherapy, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, China; Key Laboratory of Radiation Biology of Fujian Higher Education Institutions, the First Affiliated Hospital, Fujian Medical University, China.
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Li Q, Kong ZD, Wang H, Gu HH, Chen Z, Li SG, Chen YQ, Cai Y, Yang ZJ. Jianpi Decoction Combined with Medroxyprogesterone Acetate Alleviates Cancer Cachexia and Prevents Muscle Atrophy by Directly Inhibiting E3 Ubiquitin Ligase. Chin J Integr Med 2024; 30:499-506. [PMID: 37612478 DOI: 10.1007/s11655-023-3702-4] [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] [Accepted: 03/01/2023] [Indexed: 08/25/2023]
Abstract
OBJECTIVE To provide comprehensive evidence for the anti-cancer cachexia effect of Jianpi Decoction (JP) and to explore its mechanism of anti-cancer cachexia. METHODS A mouse model of colon cancer (CT26)-induced cancer cachexia (CC) was used to investigate the anti-CC effect of JP combined with medroxyprogesterone acetate (MPA). Thirty-six mice were equally divided into 6 groups: normal control, CC, MPA (100 mg•kg-1•d-1), MPA + low-dose (20 mg•kg-1•d-1) JP (L-JP), MPA + medium-dose (30 mg•kg-1•d-1) JP (M-JP), and MPA + high-dose (40 mg•kg-1•d-1) JP (H-JP) groups. After successful modeling, the mice were administered by gavage for 11 d. The body weight and tumor volume were measured and recorded every 2 d starting on the 8th day after implantation. The liver, heart, spleen, lung, kidney, tumor and gastrocnemius muscle of mice were collected and weighed. The pathological changes of the tumor was observed, and the cross-sectional area of the gastrocnemius muscle was calculated. The protein expressions of STAT3 and E3 ubiquitinase in the gastrocnemius muscle were measured by Western blot. In addition, an in vitro C2C12 myotube formation model was established to investigate the role of JP in hindering dexamethasone-induced muscle atrophy. In vitro experiments were divided into control, model, and JP serum groups. After 2-d administration, microscopic photographs were taken and myotube diameters were calculated. Western blot was performed to measure the protein expressions of STAT3 and E3 ubiquitinase. RESULTS JP combined with MPA restored tumor-induced weight loss (P<0.05, vs. CC) and muscle fiber size (P<0.01, vs. CC). Mechanistically, JP reduced the expression of atrophy-related proteins MuRF1 and MAFbx in tumor-induced muscle atrophy in vivo (P<0.05, vs. CC). In addition, JP reduced the expression of atrophy-related proteins MuRF1 and MAFbx and p-STAT3 phosphorylation (P<0.05 or P<0.01 vs. model group) in C2C12 myotubes treated with dexamethasone in vitro. CONCLUSIONS Administration of JP combined with MPA restores tumor-induced cachexia conditions. In addition, the profound effect of JP combined with MPA on tumor-induced cachexia may be due to its inhibition of muscle proteolysis (E3 ubiquitinase system).
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Affiliation(s)
- Qi Li
- Department of Oncology and Hematology, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, Guangdong Province, 518033, China
| | - Zhao-di Kong
- College of Pharmacy/International Cooperative Laboratory of Traditional Chinese Medicine Modernization and Innovative Drug Development of Ministry of Education (MOE) of China, Jinan University, Guangzhou, 510632, China
| | - Huan Wang
- College of Pharmacy/International Cooperative Laboratory of Traditional Chinese Medicine Modernization and Innovative Drug Development of Ministry of Education (MOE) of China, Jinan University, Guangzhou, 510632, China
| | - Hong-Hui Gu
- Department of Oncology and Hematology, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, Guangdong Province, 518033, China
| | - Zhong Chen
- Department of Oncology and Hematology, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, Guangdong Province, 518033, China
| | - Shi-Guang Li
- Department of Oncology and Hematology, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, Guangdong Province, 518033, China
| | - Yi-Qi Chen
- Department of Oncology and Hematology, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, Guangdong Province, 518033, China
| | - Yu Cai
- College of Pharmacy/International Cooperative Laboratory of Traditional Chinese Medicine Modernization and Innovative Drug Development of Ministry of Education (MOE) of China, Jinan University, Guangzhou, 510632, China
- Guangdong Key Lab of Traditional Chinese Medicine Information Technology, Jinan University, Guangzhou, 510632, China
| | - Zhen-Jiang Yang
- Department of Oncology and Hematology, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, Guangdong Province, 518033, China.
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Coletta AM, Simon LH, Maslana K, Taylor S, Larson K, Hansen PA, Thomas VM, Ulrich CM, Kohli M, Chipman J, Swami U, Gupta S, Maughan BL, Agarwal N. Creatine supplementation and resistance training to preserve muscle mass and attenuate cancer progression (CREATINE-52): a protocol for a double-blind randomized controlled trial. BMC Cancer 2024; 24:493. [PMID: 38637770 PMCID: PMC11025211 DOI: 10.1186/s12885-024-12260-3] [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: 03/14/2024] [Accepted: 04/15/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Muscle mass is important for metastatic prostate cancer survival and quality of life (QoL). The backbone of treatment for men with metastatic castration sensitive prostate cancer (mCSPC) is androgen deprivation therapy (ADT) with an androgen signaling inhibitor. ADT is an effective cancer treatment, but it facilitates significant declines in muscle mass and adverse health outcomes important to mCSPC survivors, such as fatigue, and reductions in physical function, independence, insulin sensitivity, and QoL. In non-metastatic CSPC survivors, resistance training (RT) preserves muscle mass and improves these related health outcomes, but the biggest barrier to RT in CSPC survivors of all stages is fatigue. Creatine monohydrate supplementation coupled with RT (Cr + RT) may address this barrier since creatine plays a critical role in energy metabolism. Cr + RT in cancer-free older adults and other clinical populations improves muscle mass and related health outcomes. Evidence also suggests that creatine supplementation can complement cancer treatment. Thus, Cr + RT is a strategy that addresses gaps in survivorship needs of people with mCSPC. The purpose of this parallel, double-blind randomized controlled trial is to test the effects of 52-weeks of Cr + RT compared with placebo (PLA) and RT (PLA + RT) on muscle mass, other related health outcomes, and markers of cancer progression. METHODS We will carry out this trial with our team's established, effective, home-based, telehealth RT program in 200 mCSPC survivors receiving ADT, and evaluate outcomes at baseline, 24-, and 52-weeks. RT will occur twice weekly with elastic resistance bands, and an established creatine supplementation protocol will be used for supplementation delivery. Our approach addresses a major facilitator to RT in mCSPC survivors, a home-based RT program, while utilizing a supervised model for safety. DISCUSSION Findings will improve delivery of comprehensive survivorship care by providing a multicomponent, patient-centered lifestyle strategy to preserve muscle mass, improve health outcomes, and complement cancer treatment (NCT06112990).
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Affiliation(s)
- Adriana M Coletta
- Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, USA.
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.
| | - Lea Haverbeck Simon
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Kelsey Maslana
- Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, USA
| | - Sarah Taylor
- The Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Kish Larson
- The Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Pamela A Hansen
- The Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
- Division of Physical Medicine and Rehabilitation, Salt Lake City, UT, USA
| | - Vinay Mathew Thomas
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
- Division of Medical Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Cornelia M Ulrich
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Manish Kohli
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
- Division of Medical Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Jonathan Chipman
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Umang Swami
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
- Division of Medical Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Sumati Gupta
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
- Division of Medical Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
- George E Whalen Department of Veterans Affairs Medical Center, Salt Lake City, UT, USA
| | - Benjamin L Maughan
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
- Division of Medical Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Neeraj Agarwal
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
- Division of Medical Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
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Bécam J, Ropars G, Dwiri FA, Brunaud C, Toutain J, Chazalviel L, Naveau M, Valable S, Bernaudin M, Touzani O, Pérès EA. Physical Activity Attenuates Brain Irradiation-Associated Skeletal Muscle Damage in the Rat. Int J Radiat Oncol Biol Phys 2024; 118:1081-1093. [PMID: 37866760 DOI: 10.1016/j.ijrobp.2023.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 09/09/2023] [Accepted: 10/08/2023] [Indexed: 10/24/2023]
Abstract
PURPOSE Radiation therapy for brain tumors increases patient survival. Nonetheless, side effects are increasingly reported such as cognitive deficits and fatigue. The etiology of fatigue remains poorly described. Our hypothesis is that the abscopal effects of radiation therapy on skeletal muscle may be involved in fatigue. The present study aims to assess the effect of brain irradiation on skeletal muscles and its relationship with fatigue and to analyze whether physical activity could counteract brain radiation-induced side effects. METHODS AND MATERIALS Adult Wistar rats were randomly distributed between 4 groups: control (CTL), irradiated (IR), nonirradiated with physical activity (PA), and irradiated with physical activity (IR+PA). IR rats were exposed to a whole-brain irradiation (WBI) of 30 Gy (3 × 10 Gy). Rats subjected to PA underwent sessions of running on a treadmill, 3 times/week for 6 months. The effects of WBI on muscles were evaluated by complementary approaches: behavioral tests (fatigue, locomotion activity), magnetic resonance imaging, and histologic analyses. RESULTS IR rats displayed a significant fatigue and a reduced locomotor activity at short term compared with the CTL group, which were attenuated with PA at 6 months after WBI. The IR rat's gastrocnemius mass decreased compared with CTL rats, which was reversed by physical activity at 14 days after WBI. Multiparametric magnetic resonance imaging of the skeletal muscle highlighted an alteration of the fiber organization in IR rats as demonstrated by a significant decrease of the mean diffusivity in the gastrocnemius at short term. Alteration of fibers was confirmed by histologic analyses: the number of type I fibers was decreased, whereas that of type IIa fibers was increased in IR animals but not in the IR+PA group. CONCLUSIONS The data show that WBI induces skeletal muscle damage, which is attenuated by PA. This muscle damage may explain, at least in part, the fatigue of patients treated with radiation therapy.
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Affiliation(s)
- Julie Bécam
- Université de Caen Normandie, CNRS, Normandie Université, ISTCT, UMR6030, GIP Cyceron, F-14000 Caen, France
| | - Gwenn Ropars
- Université de Caen Normandie, CNRS, Normandie Université, ISTCT, UMR6030, GIP Cyceron, F-14000 Caen, France
| | - Fatima-Azzahra Dwiri
- Université de Caen Normandie, CNRS, Normandie Université, ISTCT, UMR6030, GIP Cyceron, F-14000 Caen, France
| | - Carole Brunaud
- Université de Caen Normandie, CNRS, Normandie Université, ISTCT, UMR6030, GIP Cyceron, F-14000 Caen, France
| | - Jérôme Toutain
- Université de Caen Normandie, CNRS, Normandie Université, ISTCT, UMR6030, GIP Cyceron, F-14000 Caen, France
| | - Laurent Chazalviel
- Université de Caen Normandie, CNRS, Normandie Université, ISTCT, UMR6030, GIP Cyceron, F-14000 Caen, France
| | - Mikaël Naveau
- Université de Caen Normandie, CNRS, INSERM, CEA, Normandie Université, UAR3408/US50, Cyceron, GIP Cyceron, F-14000 Caen, France
| | - Samuel Valable
- Université de Caen Normandie, CNRS, Normandie Université, ISTCT, UMR6030, GIP Cyceron, F-14000 Caen, France
| | - Myriam Bernaudin
- Université de Caen Normandie, CNRS, Normandie Université, ISTCT, UMR6030, GIP Cyceron, F-14000 Caen, France
| | - Omar Touzani
- Université de Caen Normandie, CNRS, Normandie Université, ISTCT, UMR6030, GIP Cyceron, F-14000 Caen, France
| | - Elodie Anne Pérès
- Université de Caen Normandie, CNRS, Normandie Université, ISTCT, UMR6030, GIP Cyceron, F-14000 Caen, France.
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Kawka L, Sarmiento-Monroy JC, Mertz P, Pijnenburg L, Rinagel M, Ugarte-Gil MF, Geneton S, Blaess J, Piga M, Arnaud L. Assessment and personalised advice for fatigue in systemic lupus erythematosus using an innovative digital tool: the Lupus Expert system for the Assessment of Fatigue (LEAF) study. RMD Open 2023; 9:e003476. [PMID: 38056917 PMCID: PMC10711918 DOI: 10.1136/rmdopen-2023-003476] [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: 07/07/2023] [Accepted: 10/31/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND Fatigue is reported as the most prevalent symptom by patients with systemic lupus erythematosus (SLE). Fatigue management is complex due to its multifactorial nature. The aim of the study was to assess the usefulness of an innovative digital tool to manage fatigue in SLE, in a completely automated manner. METHODS The «Lupus Expert System for Assessment of Fatigue» (LEAF) is free digital tool which measures the intensity and characteristics of fatigue and assesses disease activity, pain, insomnia, anxiety, depression, stress, fibromyalgia and physical activity using validated patient-reported instruments. Then, LEAF automatically provides personalised feedback and recommendations to cope with fatigue. RESULTS Between May and November 2022, 1250 participants with SLE were included (95.2% women, median age 43yo (IQR: 34-51)). Significant fatigue (Functional Assessment of Chronic Illness Therapy-Fatigue <34) was reported by 78.9% of patients. In univariate analysis, SLE participants with fatigue were more likely to be women (p=0.01), perceived their disease as more active (p<0.0001), had higher levels of pain (p<0.0001), anxiety (p<0.0001), depression (p<0.0001), insomnia (p<0.0001), stress (p<0.0001) and were more likely to screen for fibromyalgia (p<0.0001), compared with patients without significant fatigue. In multivariable analysis, parameters independently associated with fatigue were insomnia (p=0.0003), pain (p=0.002), fibromyalgia (p=0.008), self-reported active SLE (p=0.02) and stress (p=0.045). 93.2% of the participants found LEAF helpful and 92.3% would recommend it to another patient with SLE. CONCLUSION Fatigue is commonly severe in SLE, and associated with insomnia, pain, fibromyalgia and active disease according to patients' perspective. Our study shows the usefulness of an automated digital tool to manage fatigue in SLE.
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Affiliation(s)
- Lou Kawka
- Department of Rheumatology, National Reference Center for Autoimmune Disease (RESO), Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | | | - Philippe Mertz
- Department of Rheumatology, National Reference Center for Autoimmune Disease (RESO), Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Luc Pijnenburg
- Department of Rheumatology, National Reference Center for Autoimmune Disease (RESO), Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Marina Rinagel
- Department of Rheumatology, National Reference Center for Autoimmune Disease (RESO), Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Manuel Francisco Ugarte-Gil
- Grupo Peruano de Estudio de Enfermedades Autoinmunes Sistémicas, Universidad Cientifica del Sur, Lima, Peru
- Rheumatology Department, Hospital Guillermo Almenara Irigoyen, EsSalud, Lima, Peru
| | - Sophie Geneton
- Department of Rheumatology, National Reference Center for Autoimmune Disease (RESO), Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Julien Blaess
- Department of Rheumatology, National Reference Center for Autoimmune Disease (RESO), Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Matteo Piga
- Department of Medical Sciences and Public health, University of Cagliari, Cagliari, Italy
| | - Laurent Arnaud
- Department of Rheumatology, National Reference Center for Autoimmune Disease (RESO), Hôpitaux Universitaires de Strasbourg, Strasbourg, France
- INSERM UMR-S 1109, Immuno-rhumatologie moléculaire, Strasbourg, France
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Miola TM, Bitencourt AGV, Souza JDO, Kowalski LP, Gonçalves Filho J. Analysis of muscle mass by computed tomography in patients with head and neck cancer: a prospective study. Radiol Bras 2023; 56:269-274. [PMID: 38204897 PMCID: PMC10775814 DOI: 10.1590/0100-3984.2023.0037] [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: 04/17/2023] [Revised: 05/16/2023] [Accepted: 06/09/2023] [Indexed: 01/12/2024] Open
Abstract
Objective To evaluate the preoperative muscle mass of patients with head and neck cancer (HNC) with computed tomography (CT), comparing the results obtained through analysis of cross-sectional areas at the level of the third lumbar vertebra (L3) with those obtained through analysis of cross-sectional areas at the levels of the third cervical and fourth thoracic vertebrae (C3 and T4, respectively). Materials and Methods A total of 63 patients with HNC were evaluated preoperatively. Using CT, we assessed muscle mass at L3, as well as at C3 and T4. Results Most (73.0%) of the patients had low muscle mass at L3, whereas 50.8% had a normal body mass index. The cross-sectional area at L3 correlated strongly with those at C3 and T4 (r = 0.831 and r = 0.763, respectively; p < 0.001 for both). In addition, the muscle mass index at L3 correlated strongly with those at C3 and T4 (r = 0.781 and r = 0.715, respectively; p < 0.001 for both). Conclusion Low muscle mass appears to be highly prevalent in patients with HNC. Measurements at C3 and T4 could represent alternative means of assessing muscle mass in such patients.
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Datta Gupta A, Wilson D, Tucker G, Albanese D, Berrigan S, Nath S. Effects of an outpatient exercise programme for Australians with cancer-related fatigue: an unmet need. Intern Med J 2023; 53:1400-1408. [PMID: 36043994 DOI: 10.1111/imj.15909] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 08/05/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Cancer-related fatigue (CRF) is a common debilitating condition. International evidence supports an exercise prescription for CRF. The majority of Australians with cancer do not meet recommended exercise targets. AIMS To analyse the effects of a guideline-based supervised exercise programme on CRF among a representative private hospital cancer patient sample (n = 268). METHODS We collected data from 268 patients recruited from haematology and oncology over a 5-year period. Participants underwent a 3-month CRF exercise programme based on internationally recognised exercise guidelines. The programme, conducted by a multidisciplinary team, operated twice weekly sessions of 2 h duration comprising aerobic, resistance and balance exercises; hydrotherapy and condition counselling; fatigue management; and dietetic, speech pathology and swallowing education (head and neck cancers). The effect of the programme was measured in relation to the following outcomes: Functional Assessment of Chronic Illness Therapy, Fatigue (self-reported fatigue); Functional Assessment of Cancer Therapy, general quality of life (health-related quality of life in cancer); six-minute walk test; and Lawton's Instrumental Activities of Daily Living Scale. RESULTS Multivariate outcomes showed statistically significant improvements in all four major outcome measures, plus a programme effect of greater than 0.7 for each outcome variable. The programme treatment outcomes were consistent over the 5 years of the programme. CONCLUSIONS The outcomes of this programme contribute to exercise guidelines in Australia. Currently only position statements exist on the subject, but there are no programme guidelines. An exercise prescription is critical to cancer outcomes. This programme is likely to benefit cancer survivors experiencing CRF across private and public hospitals in Australia.
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Affiliation(s)
- Anupam Datta Gupta
- Department of Rehabilitation Medicine, The Queen Elizabeth Hospital (University of Adelaide), Adelaide, South Australia, Australia
| | - David Wilson
- National Health and Medical Research Council Centre of Research Excellence in Frailty and Healthy Aging, Basil Hetzel Institute, Adelaide, South Australia, Australia
| | - Graeme Tucker
- National Health and Medical Research Council Centre of Research Excellence in Frailty and Healthy Aging, Basil Hetzel Institute, Adelaide, South Australia, Australia
| | | | - Sonia Berrigan
- Memorial Hospital, North Adelaide, South Australia, Australia
| | - Shriram Nath
- Adelaide Haematology, Adelaide, South Australia, Australia
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Kenkhuis MF, Klingestijn M, Fanshawe AM, Breukink SO, Janssen-Heijnen MLG, Keulen ETP, Rinaldi S, Vineis P, Gunter MJ, Leitzmann MF, Scalbert A, Weijenberg MP, Bours MJL, van Roekel EH. Longitudinal associations of sedentary behavior and physical activity with body composition in colorectal cancer survivors up to 2 years post treatment. J Cancer Res Clin Oncol 2023; 149:4063-4075. [PMID: 36040665 PMCID: PMC10314855 DOI: 10.1007/s00432-022-04267-9] [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: 06/27/2022] [Accepted: 08/03/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE We investigated longitudinal associations of sedentary behavior, light-intensity physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) with body composition in colorectal cancer (CRC) survivors, between 6 weeks and 24 months post treatment. In addition, we explored whether body composition mediated associations of sedentary behavior and MVPA with fatigue. METHODS A prospective cohort study was conducted in 459 stage I-III CRC patients recruited at diagnosis. Measurements were performed of accelerometer-assessed sedentary time (hours/day), self-reported LPA and MVPA (hours/week), anthropometric assessment of body mass index (BMI), waist circumference and fat percentage (measures of adiposity), and muscle circumference and handgrip strength (measures of muscle mass/function) repeated at 6 weeks, and 6, 12 and 24 months post treatment. Longitudinal associations of sedentary time and physical activity with body composition were analyzed using confounder-adjusted linear mixed models. Mediation analyses were performed to explore the role of body mass index (BMI) and handgrip strength as mediators in associations of sedentary time and MVPA with fatigue. RESULTS Less sedentary time and LPA were, independent of MVPA, longitudinally associated with increased handgrip strength, but not with measures of adiposity. More MVPA was associated with increased adiposity and increased handgrip strength. Higher BMI partly mediated associations between higher sedentary time and more fatigue. CONCLUSION Within the first two years after CRC treatment, changes in sedentary behavior, physical activity and body composition are interrelated and associated with fatigue. Intervention studies are warranted to investigate causality. TRIAL REGISTRATION The EnCoRe study is registered at trialregister.nl as NL6904 (former ID: NTR7099).
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Affiliation(s)
- Marlou-Floor Kenkhuis
- Department of Epidemiology, GROW School for Oncology and Reproduction, Maastricht University, P.O. BOX 616, 6200 MD, Maastricht, The Netherlands.
| | - Mo Klingestijn
- Department of Epidemiology, GROW School for Oncology and Reproduction, Maastricht University as Part of an Internship, Maastricht University, Maastricht, The Netherlands
| | - Anne-Marie Fanshawe
- Department of Epidemiology, GROW School for Oncology and Reproduction, Maastricht University as Part of an Internship, Maastricht University, Maastricht, The Netherlands
| | - Stéphanie O Breukink
- Department of Surgery, GROW School for Oncology and Reproduction, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Maryska L G Janssen-Heijnen
- Department of Epidemiology, GROW School for Oncology and Reproduction, Maastricht University, P.O. BOX 616, 6200 MD, Maastricht, The Netherlands
- Department of Clinical Epidemiology, Viecuri Medical Center, Venlo, The Netherlands
| | - Eric T P Keulen
- Department of Internal Medicine and Gastroenterology, Zuyderland Medical Centre, Sittard-Geleen, The Netherlands
| | - Sabina Rinaldi
- Nutrition and Metabolism Branch, International Agency for Research On Cancer (IARC-WHO), Lyon, France
| | - Paolo Vineis
- MRC Centre for Environment and Health, School of Public Health, Imperial College, London, UK
- Italian Institute of Technology, Genoa, Italy
| | - Marc J Gunter
- Nutrition and Metabolism Branch, International Agency for Research On Cancer (IARC-WHO), Lyon, France
| | - Michael F Leitzmann
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Augustin Scalbert
- Nutrition and Metabolism Branch, International Agency for Research On Cancer (IARC-WHO), Lyon, France
| | - Matty P Weijenberg
- Department of Epidemiology, GROW School for Oncology and Reproduction, Maastricht University, P.O. BOX 616, 6200 MD, Maastricht, The Netherlands
| | - Martijn J L Bours
- Department of Epidemiology, GROW School for Oncology and Reproduction, Maastricht University, P.O. BOX 616, 6200 MD, Maastricht, The Netherlands
| | - Eline H van Roekel
- Department of Epidemiology, GROW School for Oncology and Reproduction, Maastricht University, P.O. BOX 616, 6200 MD, Maastricht, The Netherlands
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9
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Fernandez-Rodriguez EJ, Sanchez-Gomez C, Mendez-Sanchez R, Recio-Rodriguez JI, Puente-Gonzalez AS, Gonzalez-Sanchez J, Cruz-Hernandez JJ, Rihuete-Galve MI. Multimodal Physical Exercise and Functional Rehabilitation Program in Oncological Patients with Cancer-Related Fatigue-A Randomized Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4938. [PMID: 36981846 PMCID: PMC10049732 DOI: 10.3390/ijerph20064938] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/03/2023] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
UNLABELLED The increase in life expectancy and survival time implies an increase in the possible side-effects of pharmacological treatments in patients. Cancer-related fatigue is one of these side-effects. The main objective of this study was to evaluate the effects of a multimodal program of physical exercise and functional rehabilitation on asthenia, pain, functional capacity, and quality of life in cancer patients with cancer-related fatigue. METHODS This was a randomized, parallel-controlled clinical trial, with two arms (experimental and control group), and it was conducted over the course of a year in the Oncology Hospitalization Unit at the University Hospital of Salamanca, Spain. Participants (n = 48) were assessed at three points during the study. The first assessment was prior to hospital discharge, the second assessment was after 15 days, and the final assessment was at one month post-hospital follow-up. The intervention lasted one month. The main variables studied were the dependency levels (Barthel), cancer-related fatigue (FACT-An), health-related quality of life (EuroQoL-5D), functional capacity (SPPB), and kinesiophobia (TSK-F). RESULTS Sample size (n = 44). Mean age 63.46 ± 12.36 years. Significant differences between control and experimental group participants in Barthel, FACT-An, TSK-F, and SPPB scores at follow-up and final assessment. CONCLUSIONS There are beneficial effects of a multimodal physical exercise and functional rehabilitation program in improving the autonomy of cancer-related fatigue patients.
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Affiliation(s)
- Eduardo J. Fernandez-Rodriguez
- Department of Nursing and Physiotherapy, University of Salamanca, 37007 Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), 37007 Salamanca, Spain; (C.S.-G.)
| | - Celia Sanchez-Gomez
- Instituto de Investigación Biomédica de Salamanca (IBSAL), 37007 Salamanca, Spain; (C.S.-G.)
- Department of Developmental and Educational Psychology, University of Salamanca, 37005 Salamanca, Spain
| | - Roberto Mendez-Sanchez
- Department of Nursing and Physiotherapy, University of Salamanca, 37007 Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), 37007 Salamanca, Spain; (C.S.-G.)
| | - Jose I. Recio-Rodriguez
- Department of Nursing and Physiotherapy, University of Salamanca, 37007 Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), 37007 Salamanca, Spain; (C.S.-G.)
| | - A. Silvia Puente-Gonzalez
- Department of Nursing and Physiotherapy, University of Salamanca, 37007 Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), 37007 Salamanca, Spain; (C.S.-G.)
| | - Jesus Gonzalez-Sanchez
- Department of Nursing and Physiotherapy, University of Salamanca, 37007 Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), 37007 Salamanca, Spain; (C.S.-G.)
| | - Juan J. Cruz-Hernandez
- Instituto de Investigación Biomédica de Salamanca (IBSAL), 37007 Salamanca, Spain; (C.S.-G.)
- Department of Medicine, University of Salamanca, 37007 Salamanca, Spain
- Medical Oncology Unit, University Hospital of Salamanca, 37007 Salamanca, Spain
| | - Maria I. Rihuete-Galve
- Department of Nursing and Physiotherapy, University of Salamanca, 37007 Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), 37007 Salamanca, Spain; (C.S.-G.)
- Medical Oncology Unit, University Hospital of Salamanca, 37007 Salamanca, Spain
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10
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Vangelov B, Bauer J, Moses D, Smee R. Comparison of Skeletal Muscle Changes at Three Vertebral Levels Following Radiotherapy in Patients With Oropharyngeal Carcinoma. Nutr Cancer 2023; 75:572-581. [PMID: 36308327 DOI: 10.1080/01635581.2022.2138468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Evaluation of skeletal muscle (SM) depletion, or sarcopenia, utilizes the cross-sectional area (CSA) of computed tomography (CT) scans at the lumbar level L3. However, alternate vertebral landmarks are used in patients with head and neck cancer due to scan unavailability. Muscle changes following radiotherapy at cervical (C3) and thoracic (T2) levels were compared to L3 in patients with oropharyngeal carcinoma. Muscle density data were derived retrospectively from diagnostic PET-CT scans at C3, T2 and L3 pretreatment, and up to six months post. CSA changes were compared to L3 in scans of 33 patients (88% male, mean age 61 (SD 8.5) years). On matched pair analysis; mean L3-CSA change -12.1 cm2 (SD 9.7, 95%CI -15.5 to -8.6, and p < 0.001), T2-CSA -30.5 cm2 (SD 34.8, 95%CI -42.8 to -18.1, and p < 0.001) and C3-CSA +2.1 cm2 (SD 4.1, 95%CI 0.63 to 3.5, and p < 0.00). No difference was found in the percentage change of T2-CSA with L3-CSA (mean -2.2%, SD 10.6, 95%CI -6.0 to 1.6, and p = 0.240), however, was significantly different to C3-CSA (mean 13.2%, SD 11.6, 95%CI 9.1 to 17.3, and p < 0.001). Results suggest SM at C3 does not change proportionately and may not be a reliable representation of whole-body SM change over time.
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Affiliation(s)
- Belinda Vangelov
- Department of Radiation Oncology, Nelune Comprehensive Cancer Centre, Prince of Wales Hospital and Community Health Services, Randwick, New South Wales, Australia.,Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Randwick, New South Wales, Australia
| | - Judith Bauer
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Monash University, Clayton, Victoria, Australia
| | - Daniel Moses
- Graduate School of Biomedical Engineering, University of New South Wales, Randwick, New South Wales, Australia.,Department of Radiology, Prince of Wales Hospital and Community Health Services, Randwick, New South Wales, Australia
| | - Robert Smee
- Department of Radiation Oncology, Nelune Comprehensive Cancer Centre, Prince of Wales Hospital and Community Health Services, Randwick, New South Wales, Australia.,Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Randwick, New South Wales, Australia.,Department of Radiation Oncology, Tamworth Base Hospital, Tamworth, New South Wales, Australia
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11
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Clinical Impacts of Interventions for Physical Activity and Sedentary Behavior on Patients with Chronic Obstructive Pulmonary Disease. J Clin Med 2023; 12:jcm12041631. [PMID: 36836165 PMCID: PMC9963889 DOI: 10.3390/jcm12041631] [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: 12/23/2022] [Revised: 02/15/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Abstract
Recently, physical activity has increasingly become the focus in patients with chronic obstructive airway disease (COPD) because it is a strong predictor of COPD-related mortality. In addition, sedentary behavior, which is included as a category of physical inactivity including such behaviors as sitting or lying down, has an independent clinical impact on COPD patients. The present review examines clinical data related to physical activity, focusing on the definition, associated factors, beneficial effects, and biological mechanisms in patients with COPD and with respect to human health regardless of COPD. The data related to how sedentary behavior is associated with human health and COPD outcomes are also examined. Lastly, possible interventions to improve physical activity or sedentary behavior, such as bronchodilators and pulmonary rehabilitation with behavior modification, to ameliorate the pathophysiology of COPD patients are described. A better understanding of the clinical impact of physical activity or sedentary behavior may lead to the planning of a future intervention study to establish high-level evidence.
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12
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Van den Broeck J, Sealy MJ, Brussaard C, Kooijman J, Jager-Wittenaar H, Scafoglieri A. The correlation of muscle quantity and quality between all vertebra levels and level L3, measured with CT: An exploratory study. Front Nutr 2023; 10:1148809. [PMID: 36908909 PMCID: PMC9996002 DOI: 10.3389/fnut.2023.1148809] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 02/10/2023] [Indexed: 02/25/2023] Open
Abstract
Introduction In patients with cancer, low muscle mass has been associated with a higher risk of fatigue, poorer treatment outcomes, and mortality. To determine body composition with computed tomography (CT), measuring the muscle quantity at the level of lumbar 3 (L3) is suggested. However, in patients with cancer, CT imaging of the L3 level is not always available. Thus far, little is known about the extent to which other vertebra levels could be useful for measuring muscle status. In this study, we aimed to assess the correlation of the muscle quantity and quality between any vertebra level and L3 level in patients with various tumor localizations. Methods Two hundred-twenty Positron Emission Tomography (PET)-CT images of patients with four different tumor localizations were included: 1. head and neck (n = 34), 2. esophagus (n = 45), 3. lung (n = 54), and 4. melanoma (n = 87). From the whole body scan, 24 slices were used, i.e., one for each vertebra level. Two examiners contoured the muscles independently. After contouring, muscle quantity was estimated by calculating skeletal muscle area (SMA) and skeletal muscle index (SMI). Muscle quality was assessed by calculating muscle radiation attenuation (MRA). Pearson correlation coefficient was used to determine whether the other vertebra levels correlate with L3 level. Results For SMA, strong correlations were found between C1-C3 and L3, and C7-L5 and L3 (r = 0.72-0.95). For SMI, strong correlations were found between the levels C1-C2, C7-T5, T7-L5, and L3 (r = 0.70-0.93), respectively. For MRA, strong correlations were found between T1-L5 and L3 (r = 0.71-0.95). Discussion For muscle quantity, the correlations between the cervical, thoracic, and lumbar levels are good, except for the cervical levels in patients with esophageal cancer. For muscle quality, the correlations between the other levels and L3 are good, except for the cervical levels in patients with melanoma. If visualization of L3 on the CT scan is absent, the other thoracic and lumbar vertebra levels could serve as a proxy to measure muscle quantity and quality in patients with head and neck, esophageal, lung cancer, and melanoma, whereas the cervical levels may be less reliable as a proxy in some patient groups.
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Affiliation(s)
- Jona Van den Broeck
- Experimental Anatomy Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Martine J Sealy
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, Netherlands
| | - Carola Brussaard
- Department of Radiology, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Jasmijn Kooijman
- Department of Medical Imaging and Radiation Therapy, Hanze University of Applied Sciences, Groningen, Netherlands
| | - Harriët Jager-Wittenaar
- Experimental Anatomy Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.,Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, Netherlands.,Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Aldo Scafoglieri
- Experimental Anatomy Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
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13
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The Beneficial Effect of a Healthy Dietary Pattern on Androgen Deprivation Therapy-Related Metabolic Abnormalities in Patients with Prostate Cancer: A Meta-Analysis Based on Randomized Controlled Trials and Systematic Review. Metabolites 2022; 12:metabo12100969. [PMID: 36295871 PMCID: PMC9611951 DOI: 10.3390/metabo12100969] [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] [Received: 09/23/2022] [Revised: 10/10/2022] [Accepted: 10/10/2022] [Indexed: 12/24/2022] Open
Abstract
Metabolic abnormalities as side effects of androgen-deprivation therapy (ADT) can accelerate progression of prostate cancer (PCa) and increase risks of cardiovascular diseases. A healthy dietary pattern (DP) plays an important role in regulating glycolipid metabolism, while evidence about DP on ADT-related metabolic abnormalities is still controversial. To explore the effect of DP on metabolic outcomes in PCa patients with ADT, PubMed, Embase, Cochrane, and CINAHL were searched from inception to 10 September 2022. Risk of biases was evaluated through Cochrane Collaboration’s Tool. If heterogeneity was low, the fixed-effects model was carried out; otherwise, the random-effects model was used. Data were determined by calculating mean difference (MD) or standardized MD (SMD) with 95% confidence intervals (CIs). Nine studies involving 421 patients were included. The results showed that healthy DP significantly improved glycated hemoglobin (MD: −0.13; 95% CI: −0.24, −0.02; p = 0.020), body mass index (MD: −1.02; 95% CI: −1.29, −0.75; p < 0.001), body fat mass (MD: −1.78; 95% CI: −2.58, −0.97; p < 0.001), triglyceride (MD: −0.28; 95% CI: −0.51, −0.04; p = 0.020), systolic blood pressure (MD: −6.30; 95% CI: −11.15, −1.44; p = 0.010), and diastolic blood pressure (MD: −2.94; 95% CI: −5.63, −0.25; p = 0.030), although its beneficial effects on other glycolipid metabolic indicators were not found. Additionally, a healthy DP also lowered the level of PSA (MD: −1.79; 95% CI: −2.25, −1.33; p < 0.001). The meta-analysis demonstrated that a healthy DP could improve ADT-related metabolic abnormalities and be worthy of being recommended for PCa patients with ADT.
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14
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Changes in skeletal muscle and adipose tissue during cytotoxic chemotherapy for testicular germ cell carcinoma and associations with adverse events. Urol Oncol 2022; 40:456.e19-456.e30. [DOI: 10.1016/j.urolonc.2022.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 05/26/2022] [Accepted: 07/25/2022] [Indexed: 11/18/2022]
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15
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Yifei sanjie Pills Alleviate Chemotherapy-Related Fatigue by Reducing Skeletal Muscle Injury and Inhibiting Tumor Growth in Lung Cancer Mice. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:2357616. [PMID: 36045663 PMCID: PMC9423986 DOI: 10.1155/2022/2357616] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 08/02/2022] [Indexed: 11/18/2022]
Abstract
Chemotherapy-related fatigue (CRF), one of the most severe adverse effects observed in cancer patients, has been theoretically related to oxidative stress, and antioxidant treatment might be one of the most valuable therapeutic approaches. However, there are still few effective pharmacological therapies. Yifei Sanjie pills (YFSJ), a classical formula used to treat lung cancer as complementary and alternative medicine, have been proved to alleviate CRF of lung cancer patients in clinical practices. However, the underlying mechanisms have not been clarified. In this study, our data showed that YFSJ alleviated CRF presented as reversing the decline of swimming time and locomotor activity induced by cisplatin (DDP). Moreover, YFSJ significantly reduces the accidence of mitophagy and mitochondrial damage and reduces apoptosis in skeletal muscle tissues caused by DDP. It probably works by decreasing the oxidative stress, inhibiting the activation of the AMPK/mTOR pathway, decreasing protein expression levels of Beclin1 and other autophagy-related proteins, and attenuating the activation of Cytochrome c (cyto. C), Cleaved Caspase-9 (c-Casp 9), and other apoptosis-related proteins. Furthermore, YFSJ enhanced DDP sensitivity by specifically promoting oxidative stress and activating apoptosis and autophagy in the tumor tissues of mice. It was also found that YFSJ reduced the loss of body weight caused by DDP, reversed the ascent of serum concentrations of alanine aminotransferase (ALT), aminotransferase (AST), and creatinine (CREA), increased the spleen index, and prolonged the survival time of mice. Taken together, these results revealed that YFSJ could alleviate CRF by reducing mitophagy and apoptosis induced by oxidative stress in skeletal muscle; these results also displayed the effects of YFSJ on enhancing chemotherapy sensitivity, improving quality of life, and prolonging survival time in lung cancer mice received DDP chemotherapy.
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16
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Barnes O, Wilson RL, Gonzalo-Encabo P, Kang DW, Christopher CN, Bentley T, Dieli-Conwright CM. The Effect of Exercise and Nutritional Interventions on Body Composition in Patients with Advanced or Metastatic Cancer: A Systematic Review. Nutrients 2022; 14:nu14102110. [PMID: 35631251 PMCID: PMC9145470 DOI: 10.3390/nu14102110] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 05/11/2022] [Accepted: 05/16/2022] [Indexed: 02/07/2023] Open
Abstract
Advanced and metastatic cancers significantly alter body composition, leading to decreased lean mass and variable effects on fat mass. These effects on body composition are associated with significant physical dysfunction and poor prognosis in patients with cancer. Whilst exercise and nutritional interventions are likely to be of benefit in counteracting these effects, relatively little is known about using such interventions in patients with advanced or metastatic cancer. Therefore, in this systematic review we examine the effect of exercise and combined exercise and nutritional interventions on lean mass and fat mass among patients diagnosed with advanced or metastatic cancer. Following PRISMA guidelines, we identified 20 articles from PubMed, EMBASE, CINAHL, Cochrane CENTRAL, PEDro, SPORTDiscus, and REHABDATA. Overall, advanced or metastatic cancer populations comprising of mixed cancer types were most commonly examined (n = 8) with exercise or combined exercise and nutritional interventions being well-tolerated with few adverse effects. Both intervention approaches may preserve lean mass, while only combined interventions may lead to alterations in fat mass. However, further exercise and nutritional studies are needed to definitively understand their effects on body composition. As exercise and nutrition-related research continues in this understudied population, the knowledge gained will help guide supportive clinical treatments.
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Affiliation(s)
- Oscar Barnes
- Green Templeton College, University of Oxford, Oxford OX2 6HG, UK; (O.B.); (T.B.)
| | - Rebekah L. Wilson
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, 375 Longwood Avenue, Boston, MA 02215, USA; (R.L.W.); (P.G.-E.); (D.-W.K.); (C.N.C.)
- Department of Medicine, Harvard Medical School, Boston, MA 02215, USA
| | - Paola Gonzalo-Encabo
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, 375 Longwood Avenue, Boston, MA 02215, USA; (R.L.W.); (P.G.-E.); (D.-W.K.); (C.N.C.)
- Department of Medicine, Harvard Medical School, Boston, MA 02215, USA
| | - Dong-Woo Kang
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, 375 Longwood Avenue, Boston, MA 02215, USA; (R.L.W.); (P.G.-E.); (D.-W.K.); (C.N.C.)
- Department of Medicine, Harvard Medical School, Boston, MA 02215, USA
| | - Cami N. Christopher
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, 375 Longwood Avenue, Boston, MA 02215, USA; (R.L.W.); (P.G.-E.); (D.-W.K.); (C.N.C.)
- Department of Epidemiology, Boston University, Boston, MA 02118, USA
| | - Thomas Bentley
- Green Templeton College, University of Oxford, Oxford OX2 6HG, UK; (O.B.); (T.B.)
| | - Christina M. Dieli-Conwright
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, 375 Longwood Avenue, Boston, MA 02215, USA; (R.L.W.); (P.G.-E.); (D.-W.K.); (C.N.C.)
- Department of Medicine, Harvard Medical School, Boston, MA 02215, USA
- Correspondence:
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17
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Sleight AG, Crowder SL, Skarbinski J, Coen P, Parker NH, Hoogland AI, Gonzalez BD, Playdon MC, Cole S, Ose J, Murayama Y, Siegel EM, Figueiredo JC, Jim HSL. A New Approach to Understanding Cancer-Related Fatigue: Leveraging the 3P Model to Facilitate Risk Prediction and Clinical Care. Cancers (Basel) 2022; 14:cancers14081982. [PMID: 35454890 PMCID: PMC9027717 DOI: 10.3390/cancers14081982] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/12/2022] [Accepted: 04/12/2022] [Indexed: 01/02/2023] Open
Abstract
Simple Summary For the growing number of cancer survivors worldwide, fatigue presents a major hurdle to function and quality of life. Treatment options for cancer-related fatigue are still emerging, and our current understanding of its etiology is limited. In this paper, we describe a new application of a comprehensive model for cancer-related fatigue: the predisposing, precipitating, and perpetuating (3P) factors model. We propose that the 3P model may be leveraged—particularly using metabolomics, the microbiome, and inflammation in conjunction with behavioral science—to better understand the pathophysiology of cancer-related fatigue. Abstract A major gap impeding development of new treatments for cancer-related fatigue is an inadequate understanding of the complex biological, clinical, demographic, and lifestyle mechanisms underlying fatigue. In this paper, we describe a new application of a comprehensive model for cancer-related fatigue: the predisposing, precipitating, and perpetuating (3P) factors model. This model framework outlined herein, which incorporates the emerging field of metabolomics, may help to frame a more in-depth analysis of the etiology of cancer-related fatigue as well as a broader and more personalized set of approaches to the clinical treatment of fatigue in oncology care. Included within this review paper is an in-depth description of the proposed biological mechanisms of cancer-related fatigue, as well as a presentation of the 3P model’s application to this phenomenon. We conclude that a clinical focus on organization risk stratification and treatment around the 3P model may be warranted, and future research may benefit from expanding the 3P model to understand fatigue not only in oncology, but also across a variety of chronic conditions.
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Affiliation(s)
- Alix G. Sleight
- Department of Physical Medicine & Rehabilitation, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA;
- Center for Integrated Research in Cancer and Lifestyle, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Sylvia L. Crowder
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33601, USA; (S.L.C.); (N.H.P.); (A.I.H.); (B.D.G.)
| | - Jacek Skarbinski
- Division of Research, Kaiser Permanente Northern California, Oakland, CA 94501, USA;
- Department of Infectious Diseases, Oakland Medical Center, Kaiser Permanente Northern California, Oakland, CA 94501, USA
- Physician Researcher Program, Kaiser Permanente Northern California, Oakland, CA 94501, USA
- The Permanente Medical Group, Kaiser Permanente Northern California, Oakland, CA 94501, USA
| | - Paul Coen
- AdventHealth Orlando, Translational Research Institute, Orlando, FL 32804, USA;
| | - Nathan H. Parker
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33601, USA; (S.L.C.); (N.H.P.); (A.I.H.); (B.D.G.)
| | - Aasha I. Hoogland
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33601, USA; (S.L.C.); (N.H.P.); (A.I.H.); (B.D.G.)
| | - Brian D. Gonzalez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33601, USA; (S.L.C.); (N.H.P.); (A.I.H.); (B.D.G.)
| | - Mary C. Playdon
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT 84044, USA;
- Department of Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84044, USA
| | - Steven Cole
- Department of Psychiatry & Biobehavioral Sciences and Medicine, University of California, Los Angeles, CA 90001, USA;
| | - Jennifer Ose
- Department of Population Sciences, University of Utah, Salt Lake City, UT 84044, USA;
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84044, USA
| | - Yuichi Murayama
- Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA; (Y.M.); (J.C.F.)
| | - Erin M. Siegel
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL 33601, USA;
| | - Jane C. Figueiredo
- Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA; (Y.M.); (J.C.F.)
| | - Heather S. L. Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33601, USA; (S.L.C.); (N.H.P.); (A.I.H.); (B.D.G.)
- Correspondence:
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18
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Barreto CS, Borges TC, Valentino NP, Gomes TLN, Soares JDP, Siqueira JM, Pichard C, Laviano A, Pimentel GD. Absence of risk of sarcopenia protects cancer patients from fatigue. Eur J Clin Nutr 2022; 76:206-211. [PMID: 33986491 DOI: 10.1038/s41430-021-00931-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 04/12/2021] [Accepted: 04/19/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Cancer and its treatments often lead to sarcopenia and fatigue. However, whether these factors are associated remains unproven. OBJECTIVE To evaluate whether the risk of sarcopenia predicts the presence of fatigue. METHODS A cross-sectional study was completed and included 198 cancer patients of both sexes, undergoing in- and outpatient treatment. The Strength, Assistance for walking, Rise from a chair, Climb stairs, and Falls (SARC-F) and the Functional Assessment of Cancer Therapy Fatigue (FACT-F) were used to assess the risk of sarcopenia and the presence of fatigue, respectively. The cut-off values used to identify the risk of sarcopenia and the severity of fatigue scale were SARC-F ≥ 4 and Fatigue <34, respectively. Logistic regression analysis was performed to evaluate the association between SARC-F and the FACT-F. RESULTS Out of 198 patients, 35% were at risk of sarcopenia and of these 87% had fatigue. Patients at risk of sarcopenia had lower scores in the FACT-F subscales, lower handgrip strength, lower performance status, were mostly hospitalized and were sedentary. Logistic regression analysis revealed that patients with SARC-F < 4 had a lower risk of fatigue in both models, crude (OR: 0.83; CI 95% [0.79-0.88], p < 0.0001) as well as adjusted for age, gender, BMI, physical activity, current use of alcoholic beverages, smoking, performance status, cancer type, clinical setting and use of supplements (OR: 0.87; CI 95% [0.81-0.92], p < 0.0001). CONCLUSION In patients with cancer, 35% presented risk of sarcopenia and of these 87% had fatigue. In addition, the absence of sarcopenia was considered protective against fatigue.
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Affiliation(s)
- Cleidiana S Barreto
- Laboratory of Research in Clinical Nutrition and Sports (Labince), Faculty of Nutrition, Federal University of Goiás, Goiânia, Brazil
| | - Thaís C Borges
- Laboratory of Research in Clinical Nutrition and Sports (Labince), Faculty of Nutrition, Federal University of Goiás, Goiânia, Brazil
| | - Nathalia P Valentino
- Laboratory of Research in Clinical Nutrition and Sports (Labince), Faculty of Nutrition, Federal University of Goiás, Goiânia, Brazil
| | - Tatyanne L N Gomes
- Laboratory of Research in Clinical Nutrition and Sports (Labince), Faculty of Nutrition, Federal University of Goiás, Goiânia, Brazil
| | - Jéssika D P Soares
- Laboratory of Research in Clinical Nutrition and Sports (Labince), Faculty of Nutrition, Federal University of Goiás, Goiânia, Brazil
| | - Jéssika M Siqueira
- Laboratory of Research in Clinical Nutrition and Sports (Labince), Faculty of Nutrition, Federal University of Goiás, Goiânia, Brazil
| | - Claude Pichard
- Clinical Nutrition, Geneva University Hospital, Geneva, Switzerland
| | - Alessandro Laviano
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Gustavo D Pimentel
- Laboratory of Research in Clinical Nutrition and Sports (Labince), Faculty of Nutrition, Federal University of Goiás, Goiânia, Brazil.
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19
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Ikeno Y, Inomata M, Tsukimura Y, Suzuki Y, Takeuchi H, Harada Y, Kon R, Ikarashi N, Chiba Y, Yamada T, Kamei J, Sakai H. Eicosapentaenoic acid suppresses cisplatin-induced muscle atrophy by attenuating the up-regulated gene expression of ubiquitin. J Nutr Biochem 2022; 103:108953. [PMID: 35121023 DOI: 10.1016/j.jnutbio.2022.108953] [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: 03/01/2021] [Revised: 07/15/2021] [Accepted: 01/04/2022] [Indexed: 10/19/2022]
Abstract
Previously it was shown that cisplatin causes muscle atrophy. Under this condition, cisplatin increased the expression of atorogenes, such as muscle ring finger 1 and atrogin-1 (also known as muscle atrophy F-box protein), in mouse skeletal muscle. It was reported recently that ubiquitin (Ub) and ubiquitinated protein levels in skeletal muscle were also up-regulated in cisplatin-induced muscle atrophy, and cisplatin-induced ubiquitinated proteins were degraded by the 26S proteasome pathway. Eicosapentaenoic acid (EPA) is effective against skeletal muscle atrophy in mice. However, it is unclear how EPA suppresses the Ub-proteasome pathway. In this study, the effect of EPA on cisplatin-induced muscle atrophy in mice was examined. Mice were intraperitoneally injected with cisplatin or vehicle control once daily for 4 days. EPA or its vehicle was orally administered 30 min before cisplatin administration. Cisplatin systemic administration induced decrease in muscle mass, myofiber diameter, and increase in Ub genes and ubiquitinated proteins in mouse skeletal muscle were recovered by co-treatment with EPA. However, weight loss and up-regulated atrogenes induced by cisplatin were not changed by co-treatment with EPA in skeletal muscle. In this study, EPA attenuated cisplatin-induced muscle atrophy via down-regulation of up-regulated Ub gene expression. Although further clinical studies are needed, EPA administration can be effective in the development of muscle atrophy in cisplatin-treated patients.
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Affiliation(s)
- Yohei Ikeno
- Department of Biomolecular Pharmacology, School of Pharmacy, Hoshi University, 2-4-41 Ebara, Shinagawa-ku, Tokyo 1428501, Japan
| | - Maya Inomata
- Department of Biomolecular Pharmacology, School of Pharmacy, Hoshi University, 2-4-41 Ebara, Shinagawa-ku, Tokyo 1428501, Japan
| | - Yuka Tsukimura
- Department of Biomolecular Pharmacology, School of Pharmacy, Hoshi University, 2-4-41 Ebara, Shinagawa-ku, Tokyo 1428501, Japan
| | - Yuta Suzuki
- Department of Biomolecular Pharmacology, School of Pharmacy, Hoshi University, 2-4-41 Ebara, Shinagawa-ku, Tokyo 1428501, Japan
| | - Hiroto Takeuchi
- Department of Biomolecular Pharmacology, School of Pharmacy, Hoshi University, 2-4-41 Ebara, Shinagawa-ku, Tokyo 1428501, Japan
| | - Yui Harada
- Department of Biomolecular Pharmacology, School of Pharmacy, Hoshi University, 2-4-41 Ebara, Shinagawa-ku, Tokyo 1428501, Japan
| | - Risako Kon
- Department of Biomolecular Pharmacology, School of Pharmacy, Hoshi University, 2-4-41 Ebara, Shinagawa-ku, Tokyo 1428501, Japan
| | - Nobutomo Ikarashi
- Department of Biomolecular Pharmacology, School of Pharmacy, Hoshi University, 2-4-41 Ebara, Shinagawa-ku, Tokyo 1428501, Japan
| | - Yoshihiko Chiba
- Laboratory of Molecular Biology and Physiology, School of Pharmacy, Hoshi University, 2-4-41 Ebara, Shinagawa-ku, Tokyo 1428501, Japan
| | - Takeshi Yamada
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, Tokyo, Japan
| | - Junzo Kamei
- Department of Biomolecular Pharmacology, School of Pharmacy, Hoshi University, 2-4-41 Ebara, Shinagawa-ku, Tokyo 1428501, Japan
| | - Hiroyasu Sakai
- Department of Biomolecular Pharmacology, School of Pharmacy, Hoshi University, 2-4-41 Ebara, Shinagawa-ku, Tokyo 1428501, Japan.
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20
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Nikitina AJ, Levin OS. [Chronic fatigue syndrome against the background of the COVID-19 pandemic]. Zh Nevrol Psikhiatr Im S S Korsakova 2021; 121:92-98. [PMID: 34870921 DOI: 10.17116/jnevro202112110292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The more we learn about the new coronavirus infection, the more we understand that we will feel the echoes of the pandemic for many years, and those who have successfully endured the acute phase of COVID-19 may face the consequences of the infection. One of the most frequent manifestations will be the development of chronic fatigue syndrome (CFS) after COVID-19. This article discusses the possible causes of the development of CFS, as well as possible ways of its treatment and prevention.
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Affiliation(s)
- A J Nikitina
- Russian Medical Academy of continuous Professional Education, Moscow, Russia
| | - O S Levin
- Russian Medical Academy of continuous Professional Education, Moscow, Russia
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21
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The Intricate Web of Fatigue in Women. WOMEN 2021. [DOI: 10.3390/women1040023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The modern woman has taken her rightful place in society as a worker, a caregiver, a mother, and a world citizen. However, along with the privileges of these roles comes the great cost of stress and resultant exhaustion and fatigue. Psychosocial, physical, cultural, and disease-related realms of stress act as strands of a web that serve to bind and hinder women with chronic stress. New areas of research, such as exercise intervention, improved social programs (e.g., childcare), and supplementation are constantly evaluated for effectiveness alongside traditional remedies such as exercise. This review will highlight some of the key issues regarding stress in women and explore reports of new treatment modalities in light of the specific requirements of the modern woman.
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22
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Fernández-Rodríguez EJ, González-Sánchez J, Puente-González AS, Recio-Rodríguez JI, Sánchez-Gómez C, Méndez-Sánchez R, Cruz-Hernández JJ, Rihuete-Galve MI. Multimodal physical exercise and functional rehabilitation program in oncological patients with asthenia. study protocol. BMC Nurs 2021; 20:207. [PMID: 34686180 PMCID: PMC8540070 DOI: 10.1186/s12912-021-00734-9] [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] [Received: 08/07/2021] [Accepted: 10/12/2021] [Indexed: 12/09/2022] Open
Abstract
Background The increase in the survival of oncology patients include multiple side effects as cancer-related asthenia and dyspnea, which represents a serious health problem. An implementation of the conventional clinical practice, developed through multimodal physical exercise and functional rehabilitation program intervention, may be useful in controlling dyspnoea. This study aims to evaluate the effects of a multimodal exercise and functional rehabilitation program on fatigue, pain, functional capacity, and quality of life in cancer patients with cancer-related asthenia. Methods This is a protocol for an experimental, prospective, randomised study using a parallel, fixed assignment scheme, with an experimental group and a control group in patients from the oncology hospitalisation unit at the Salamanca University Hospital Complex in Spain, using consecutive sampling to select 50 participants with oncological asthenia who are hospitalised at the time of inclusion. After the baseline evaluation, the participants will be randomised into two groups. Both groups will receive standard clinical practice care and the normal health education program at discharge, but in addition, the participants assigned to the experimental group will also complete a multimodal exercise and functional rehabilitation program lasting one month. The primary outcomes will be basic activities of daily living (Barthel Index) and degree of asthenia (FACT-An scale). Additionally, physical performance will be evaluated with the Short Physical Performance Battery (SPPB), as will the attention and executive functions (Trail-Making Test), fear/avoidance of movement (TAMPA scale), pain (VAS scale), and body composition (waist, hip, brachial, thigh, wrist, and ankle circumferences). Discussion The results of this study may be translated to clinical practice, incorporating a specific autonomy recovery programme into comprehensive rehabilitation programmes of care for cancer patients with asthenia. The current study addresses to improve the conventional clinical practice by proposing a multimodal physical exercise and functional rehabilitation program intervention, which will be implemented by an interdisciplinary team, to try to improve the autonomy of cancer patients with cancer-related asthenia. Trial registration ClinicalTrials.gov; ID: NCT04761289. (February 18, 2021). https://clinicaltrials.gov/ct2/show/ NCT04761289.
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Affiliation(s)
- Eduardo José Fernández-Rodríguez
- Department of Nursing and Physiotherapy, University of Salamanca, Salamanca, Spain.,Medical Oncology Service, University Hospital Complex of Salamanca, Salamanca, Spain.,Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
| | - Jesús González-Sánchez
- Department of Nursing and Physiotherapy, University of Salamanca, Salamanca, Spain. .,Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain.
| | - Ana Silvia Puente-González
- Department of Nursing and Physiotherapy, University of Salamanca, Salamanca, Spain.,Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
| | - José Ignacio Recio-Rodríguez
- Department of Nursing and Physiotherapy, University of Salamanca, Salamanca, Spain.,Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
| | - Celia Sánchez-Gómez
- Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain.,Department of Developmental and Educational Psychology, University of Salamanca, Salamanca, Spain
| | - Roberto Méndez-Sánchez
- Department of Nursing and Physiotherapy, University of Salamanca, Salamanca, Spain.,Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
| | - Juan Jesús Cruz-Hernández
- Medical Oncology Service, University Hospital Complex of Salamanca, Salamanca, Spain.,Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain.,Department of Medicine, University of Salamanca, Salamanca, Spain
| | - María Isabel Rihuete-Galve
- Department of Nursing and Physiotherapy, University of Salamanca, Salamanca, Spain.,Medical Oncology Service, University Hospital Complex of Salamanca, Salamanca, Spain.,Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
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23
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Abulizi A, Hu L, Ma A, Shao FY, Zhu HZ, Lin SM, Shao GY, Xu Y, Ran JH, Li J, Zhou H, Lin DM, Wang LF, Li M, Yang BX. Ganoderic acid alleviates chemotherapy-induced fatigue in mice bearing colon tumor. Acta Pharmacol Sin 2021; 42:1703-1713. [PMID: 33927358 PMCID: PMC8463583 DOI: 10.1038/s41401-021-00669-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 03/23/2021] [Indexed: 02/02/2023] Open
Abstract
Chemotherapy-related fatigue (CRF) is increasingly being recognized as one of the severe symptoms in patients undergoing chemotherapy, which not only largely reduces the quality of life in patients, but also diminishes their physical and social function. At present, there is no effective drug for preventing and treating CRF. Ganoderic acid (GA), isolated from traditional Chinese medicine Ganoderma lucidum, has shown a variety of pharmacological activities such as anti-tumor, anti-inflammation, immunoregulation, etc. In this study, we investigated whether GA possessed anti-fatigue activity against CRF. CT26 tumor-bearing mice were treated with 5-fluorouracil (5-FU, 30 mg/kg) and GA (50 mg/kg) alone or in combination for 18 days. Peripheral and central fatigue-related behaviors, energy metabolism and inflammatory factors were assessed. We demonstrated that co-administration of GA ameliorated 5-FU-induced peripheral muscle fatigue-like behavior via improving muscle quality and mitochondria function, increasing glycogen content and ATP production, reducing lactic acid content and LDH activity, and inhibiting p-AMPK, IL-6 and TNF-α expression in skeletal muscle. Co-administration of GA also retarded the 5-FU-induced central fatigue-like behavior accompanied by down-regulating the expression of IL-6, iNOS and COX2 in the hippocampus through inhibiting TLR4/Myd88/NF-κB pathway. These results suggest that GA could attenuate 5-FU-induced peripheral and central fatigue in tumor-bearing mice, which provides evidence for GA as a potential drug for treatment of CRF in clinic.
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Affiliation(s)
- Abudumijiti Abulizi
- State Key Laboratory of Natural and Biomimetic Drugs, Department of Pharmacology, School of Basic Medical Sciences, Peking University, Beijing, 100191, China
| | - Ling Hu
- Department of Anatomy and Laboratory of Neuroscience and Tissue Engineering, Basic Medical College, Chongqing Medical University, Chongqing, 400016, China
| | - Ang Ma
- State Key Laboratory of Natural and Biomimetic Drugs, Department of Pharmacology, School of Basic Medical Sciences, Peking University, Beijing, 100191, China
| | - Fang-Yu Shao
- State Key Laboratory of Natural and Biomimetic Drugs, Department of Pharmacology, School of Basic Medical Sciences, Peking University, Beijing, 100191, China
| | - Hui-Ze Zhu
- State Key Laboratory of Natural and Biomimetic Drugs, Department of Pharmacology, School of Basic Medical Sciences, Peking University, Beijing, 100191, China
| | - Si-Mei Lin
- State Key Laboratory of Natural and Biomimetic Drugs, Department of Pharmacology, School of Basic Medical Sciences, Peking University, Beijing, 100191, China
| | - Guang-Ying Shao
- State Key Laboratory of Natural and Biomimetic Drugs, Department of Pharmacology, School of Basic Medical Sciences, Peking University, Beijing, 100191, China
| | - Yue Xu
- State Key Laboratory of Natural and Biomimetic Drugs, Department of Pharmacology, School of Basic Medical Sciences, Peking University, Beijing, 100191, China
| | - Jian-Hua Ran
- Stem Cell and Tissue Engineering, Department of Histology and Embryology, Chongqing Medical University, Chongqing, 400016, China
| | - Jing Li
- Stem Cell and Tissue Engineering, Department of Histology and Embryology, Chongqing Medical University, Chongqing, 400016, China
| | - Hong Zhou
- State Key Laboratory of Natural and Biomimetic Drugs, Department of Pharmacology, School of Basic Medical Sciences, Peking University, Beijing, 100191, China
| | - Dong-Mei Lin
- JUNCAO Technology Research Institute, Fujian Agriculture and Forestry University, Fuzhou, 350002, China
| | - Lian-Fu Wang
- JUNCAO Technology Research Institute, Fujian Agriculture and Forestry University, Fuzhou, 350002, China
| | - Min Li
- State Key Laboratory of Natural and Biomimetic Drugs, Department of Pharmacology, School of Basic Medical Sciences, Peking University, Beijing, 100191, China.
| | - Bao-Xue Yang
- State Key Laboratory of Natural and Biomimetic Drugs, Department of Pharmacology, School of Basic Medical Sciences, Peking University, Beijing, 100191, China.
- Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing, 100191, China.
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24
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Li CC, Chou YJ, Shun SC. The Relationship Between Muscle Strength and Body Composition Measures and Cancer-Related Fatigue: A Systematic Review and Meta-Analysis. Oncol Nurs Forum 2021; 48:558-576. [PMID: 34411084 DOI: 10.1188/21.onf.558-576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PROBLEM IDENTIFICATION Cancer-related fatigue (CRF) substantially affects daily living and quality of life, but objective CRF measures remain limited. This review aimed to identify the correlation between muscle strength and body composition measures and CRF, as well as potential objective indicators for assessing CRF. LITERATURE SEARCH PubMed®, MEDLINE®, CINAHL®/PsycINFO®, and Embase® were searched for studies published from January 2000 to January 2021. DATA EVALUATION Study selection and quality assessment were conducted using the Critical Appraisals Skills Programme checklist and the Strengthening the Reporting of Observational Studies in Epidemiology statement. Comprehensive Meta-Analysis software was used to perform meta-analysis. SYNTHESIS 25 studies were selected, and 19 measures were analyzed. CRF negatively correlated with hand grip strength, knee extensor strength, and the sit-to-stand test. No significant correlation was found between body composition measures and CRF. IMPLICATIONS FOR NURSING The evidence suggests that muscle strength measures may be potential indicators for CRF assessment. Combining objective and subjective CRF assessments could assist clinicians in evaluating the effectiveness of CRF interventions more accurately.
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25
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van Heusden HC, Swartz JE, Chargi N, de Jong PA, van Baal MCPM, Wegner I, de Bree R. Feasibility of assessment of skeletal muscle mass on a single cross-sectional image at the level of the fourth thoracic vertebra. Eur J Radiol 2021; 142:109879. [PMID: 34343845 DOI: 10.1016/j.ejrad.2021.109879] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 06/18/2021] [Accepted: 07/22/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Skeletal muscle mass (SMM) determined on computed tomography (CT) is emerging as a novel imaging biomarker. Cross-sectional area (CSA) of SMM at the level of the third lumbar vertebra (L3) on abdominal imaging is considered the clinical reference standard for measuring SMM. In certain patient groups, such as those with oncological or non-oncological lung disease like COVID-19, a chest CT may be available while an abdominal CT is not. The purpose of this study was to investigate whether determining SMM on a chest CT is a feasible alternative to abdominal CT. RESEARCH QUESTION What is the correlation between SMM measurements at the level of L3 and the level of the fourth thoracic vertebra (Th4)? STUDY DESIGN AND METHODS In this study we retrospectively analyzed abdominal and thoracic series of whole-body CT-scans of trauma patients (N = 47) and head and neck cancer patients (N = 194). All abdominal muscles were delineated on a single axial slice at the level of L3. The erector spinae, levator scapulae, rhomboideus minor and major and pectoralis minor and major muscles were delineated on a single axial slice at the level of Th4. CSA of the muscles at Th4 and the L3 level were compared using linear regression, and a multivariate linear regression model was established. RESULTS Muscle CSA at level Th4 strongly correlates with L3 muscle CSA (r = 0.791, p < 0.05). A multivariate model incorporating the patient characteristics arm positioning, age, sex, and weight achieved a stronger correlation (r = 0.856, p < 0.05). INTERPRETATION Skeletal muscle CSA measured at the level of Th4 is a feasible alternative to measurements at L3. This allows diagnosing low SMM using clinically available thoracic CT-scans. SMM measurements at the level of Th4 may become a prognostic or triage tool when faced with mechanical ventilator shortage.
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Affiliation(s)
- Hugo C van Heusden
- Department of Head and Neck Surgical Oncology, UMC Utrecht Cancer Center, University Medical Center Utrecht and Utrecht University, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands
| | - Justin E Swartz
- Department of Head and Neck Surgical Oncology, UMC Utrecht Cancer Center, University Medical Center Utrecht and Utrecht University, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands.
| | - Najiba Chargi
- Department of Head and Neck Surgical Oncology, UMC Utrecht Cancer Center, University Medical Center Utrecht and Utrecht University, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands
| | - Pim A de Jong
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht and Utrecht University, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands
| | - Mark C P M van Baal
- Department of Surgery, University Medical Center Utrecht and Utrecht University, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands
| | - Inge Wegner
- Department of Otorhinolaryngology and Head and Neck Surgery, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, the Netherlands
| | - Remco de Bree
- Department of Head and Neck Surgical Oncology, UMC Utrecht Cancer Center, University Medical Center Utrecht and Utrecht University, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands
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26
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Intermuscular fat density as a novel prognostic factor in breast cancer patients treated with adjuvant chemotherapy. Breast Cancer Res Treat 2021; 189:759-768. [PMID: 34283341 DOI: 10.1007/s10549-021-06322-4] [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: 04/25/2021] [Accepted: 06/27/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Body composition, including sarcopenia and fat parameters, has received much attention as a prognostic factor in breast cancer. METHODS A total of 479 breast cancer patients who underwent surgery and received adjuvant chemotherapy were enrolled in this study. Body composition, including the index and density of skeletal muscle, visceral fat, subcutaneous fat, and intermuscular fat calculated by CT scan, was used as a prognostic factor. The endpoints were breast cancer-specific survival (BCSS) and overall survival (OS). RESULTS The number of patients with stages I, II, and III was 146 (30.5%), 237 (49.5%), and 96 (20%), respectively. Sarcopenia and muscle density were not significant prognostic factors for BCSS and OS. A high visceral fat index (VFI) was an independent prognostic factor for BCSS (HR, 2.55; 95% CI 1.10-5.95, p = 0.03) and OS (HR 2.55, 95% CI 1.26-5.16, p = 0.01). In addition, high intermuscular fat density (IMFD) was also a significant prognostic factor for BCSS (HR, 2.95; 95% CI 1.34-6.46, p = 0.007) and OS (HR 2.28, 95% CI 1.22-4.26, p = 0.01) in multivariate analysis. CONCLUSION VFI and IMFD were significant prognostic factors for BCSS and OS in breast cancer patients treated with adjuvant chemotherapy.
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27
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Increases in adipose tissue and muscle function are longitudinally associated with better quality of life in colorectal cancer survivors. Sci Rep 2021; 11:12440. [PMID: 34127719 PMCID: PMC8203762 DOI: 10.1038/s41598-021-91709-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 05/24/2021] [Indexed: 12/26/2022] Open
Abstract
Colorectal cancer (CRC) survivors need evidence-based guidelines pertaining to post-treatment body composition, which could benefit health-related quality of life (HRQoL). We aimed to describe the course of several body composition measures, and to assess longitudinal associations of these measures with HRQoL, fatigue and chemotherapy-induced peripheral neuropathy (CIPN). In a prospective cohort among stage I–III CRC survivors (n = 459), five repeated home visits from diagnosis up to 24 months post-treatment were executed. Body mass index (BMI), waist circumference and fat percentage were assessed as measures of adiposity, and muscle arm circumference and handgrip strength as measures of muscle mass and function. We applied linear mixed-models to describe changes in body composition over time and to analyze overall longitudinal associations. Of included participants, 44% was overweight and 31% was obese at diagnosis. All body composition measures followed similar trends, decreasing from diagnosis to 6 weeks and then increasing up to 24 months post-treatment. In confounder-adjusted mixed models, increases in adipose tissue and muscle function were longitudinally associated with better HRQoL and less fatigue, regardless of pre-treatment body composition. With regards to improving HRQoL, decreasing fatigue and CIPN, clinical practice should also focus on restoring body tissues after CRC treatment. Trial registration: NTR7099.
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28
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Associations of the dietary World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) recommendations with patient-reported outcomes in colorectal cancer survivors 2-10 years post-diagnosis: a cross-sectional analysis. Br J Nutr 2021; 125:1188-1200. [PMID: 33087189 DOI: 10.1017/s0007114520003487] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The World Cancer Research Fund and American Institute for Cancer Research (WCRF/AICR) advise cancer survivors to follow their lifestyle recommendations for cancer prevention. Adhering to these recommendations may have beneficial effects on patient-reported outcomes after a cancer diagnosis, but evidence is scarce. We aimed to assess associations of the individual dietary WCRF/AICR recommendations regarding fruit and vegetables, fibre, fast foods, red and processed meat, sugar-sweetened drinks and alcohol consumption with patient-reported outcomes in colorectal cancer (CRC) survivors. Cross-sectional data of 150 stage I-III CRC survivors, 2-10 years post-diagnosis, were used. Dietary intake was measured by 7-d dietary records. Validated questionnaires were used to measure health-related quality of life (HRQoL), fatigue and neuropathy. Confounder-adjusted linear regression models were used to analyse associations of each WCRF/AICR dietary recommendation with patient-reported outcomes. Higher vegetable intake (per 50 g) was associated with better global QoL (β 2·6; 95 % CI 0·6, 4·7), better physical functioning (3·3; 1·2, 5·5) and lower levels of fatigue (-4·5; -7·6, -1·4). Higher fruit and vegetables intake (per 100 g) was associated with better physical functioning (3·2; 0·8, 5·5) and higher intake of energy-dense food (per 100 kJ/100 g) with worse physical functioning (-4·2; -7·1, -1·2). No associations of dietary recommendations with neuropathy were found. These findings suggest that adhering to specific dietary WCRF/AICR recommendations is associated with better HRQoL and less fatigue in CRC survivors. Although the recommendations regarding healthy dietary habits may be beneficial for the well-being of CRC survivors, longitudinal research is warranted to gain insight into the direction of associations.
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The use of alternate vertebral levels to L3 in computed tomography scans for skeletal muscle mass evaluation and sarcopenia assessment in patients with cancer: a systematic review. Br J Nutr 2021; 127:722-735. [PMID: 33910664 DOI: 10.1017/s0007114521001446] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Body composition measurement using diagnostic computed tomography (CT) scans has emerged as a method to assess sarcopenia (low muscle mass) in oncology patients. Assessment of skeletal muscle mass (SMM) using the cross-sectional area of a single vertebral slice (at lumbar L3) in a CT scan is correlated with whole-body skeletal muscle volume. This method is used to assess CT-defined sarcopenia in patients with cancer, with low SMM effecting outcomes. However, as diagnostic scans are based on tumour location, not all include L3. We evaluated the evidence for the use of alternate vertebral CT slices for SMM evaluation when L3 is not available. Five electronic databases were searched from January 1996 to April 2020 for studies using CT scan vertebral slices above L3 for SM measurement in adults with cancer (solid tumours). Validation with whole-body SMM, rationale for the chosen slice and sarcopenia cut-off values were investigated. Thirty-two studies were included, all retrospective and cross-sectional in design. Cervical, thoracic and lumbar slices were used (from C3 to L1), with no validation of whole-body SMM using CT scans. Alternate slices were used in lung, and head and neck cancer patients. Sarcopenia cut-off values were reported in 75 % of studies, with differing methods, with or without sex-specific values, and a lack of consensus. Current evidence is inadequate to provide definitive recommendations for alternate vertebral slice use for SMM evaluation in cancer patients. Variation in sarcopenia cut-offs warrants more robust investigation, in order for risk stratification to be applied to all patients with cancer.
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Su Y, Asamoto M, Yuki M, Saito M, Hasebe N, Hirayama K, Otsuki M, Iino C. Predictors and short-term outcomes of post-stroke fatigue in initial phase of transition from hospital to home: A prospective observational study. J Adv Nurs 2020; 77:1825-1838. [PMID: 33368578 PMCID: PMC8048815 DOI: 10.1111/jan.14731] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 11/03/2020] [Accepted: 11/24/2020] [Indexed: 12/17/2022]
Abstract
AIM To analyse the interactions of associated factors with post stroke fatigue (PSF) after discharge home and determine the predictors of PSF and their impact on stroke survivors. DESIGN A prospective observational study. METHODS A total of 94 patients with acute stroke were recruited between May 2019 -July 2020. The main outcomes were fatigue, depression, insomnia, sarcopenia, and health-related quality of life (HRQOL) and were assessed at admission and 1 month after discharge. Fatigue was measured using the Fatigue Assessment Scale. Depression and Insomnia were assessed using the Hospital Anxiety and Depression Scale-Depression and Insomnia Severity Index, respectively. Sarcopenia was measured using the SARC-F questionnaire, and HRQOL was assessed using the Short Form-8. RESULTS Acute phase PSF was an independent predictor of PSF after discharge home. Moreover the path analysis revealed that this effect is mediated through both the direct effect of acute-phase PSF on PSF after discharge home and through the indirect effect of interaction with pre-stroke SARC-F, acute phase depression, and acute phase insomnia, which remains a separate predictor of acute-phase PSF. In total, 17% of the survivors had persistent PSF. Persistent PSF was significantly associated with depression, insomnia, sarcopenia, and a lower quality of life scores. CONCLUSIONS Post-stroke fatigue may occur in the acute phase and persists after discharge, it will not only affect later depression, insomnia, and quality of life, but also sarcopenia. IMPACT Acute phase PSF was found to be an independent predictor of PSF after discharge home. In addition, the interaction with pre-stroke SARC-F, acute phase depression and insomnia had an indirect connection with PSF after discharge home, which remains a separate predictor of acute-phase PSF. Thus, early assessment and management of mental status, sleep problems, and sarcopenia during hospitalization might be an important step in post-stroke rehabilitation and home transition.
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Affiliation(s)
- Ya Su
- Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Mitsuko Asamoto
- Nursing Department, Sapporo Azabu Neurosurgical Hospital, Sapporo, Japan
| | - Michiko Yuki
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Masaru Saito
- Nursing Department, Sapporo Azabu Neurosurgical Hospital, Sapporo, Japan
| | - Naoko Hasebe
- Nursing Department, Sapporo Azabu Neurosurgical Hospital, Sapporo, Japan
| | - Kengo Hirayama
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Mika Otsuki
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Chieko Iino
- Nursing Department, Sapporo Azabu Neurosurgical Hospital, Sapporo, Japan
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Development and Internal Validation of a Nomogram to Predict Post-Stroke Fatigue After Discharge. J Stroke Cerebrovasc Dis 2020; 30:105484. [PMID: 33253982 DOI: 10.1016/j.jstrokecerebrovasdis.2020.105484] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 11/10/2020] [Accepted: 11/16/2020] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES We aimed to develop and validate a nomogram for the individualized prediction of the risk of post-stroke fatigue (PSF) after discharge. MATERIALS AND METHODS Fatigue was measured using the Fatigue Assessment Scale. Multivariable logistic regression analysis was applied to build a prediction model incorporating the feature selected in the least absolute shrinkage and selection operator regression model. Discrimination, calibration, and clinical usefulness of the predictive model were assessed using the C-index, calibration plot, and decision curve analysis. Internal validation was conducted using bootstrapping validation. Finally, a web application was developed to facilitate the use of the nomogram. RESULTS We developed a nomogram based on 95 stroke patients. The predictors included in the nomogram were sex, pre-stroke sarcopenia, acute phase fatigue, dysphagia, and depression. The model displayed good discrimination, with a C-index of 0.801 (95% confidence interval: 0.700-0.902) and good calibration. A high C-index value of 0.762 could still be reached in the interval validation. Decision curve analysis showed that the risk of PSF after discharge was clinically useful when the intervention was decided at the PSF risk possibility threshold of 10% to 90%. CONCLUSION This nomogram could be conveniently used to provide an individual, visual, and precise prediction of the risk probability of PSF after being discharged home. Thus, as an aid in decision-making, physicians and other healthcare professionals can use this predictive method to provide early intervention or a discharge plan for stroke patients during the hospitalization period.
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Storck LJ, Ruehlin M, Gaeumann S, Gisi D, Schmocker M, Meffert PJ, Imoberdorf R, Pless M, Ballmer PE. Effect of a leucine-rich supplement in combination with nutrition and physical exercise in advanced cancer patients: A randomized controlled intervention trial. Clin Nutr 2020; 39:3637-3644. [DOI: 10.1016/j.clnu.2020.04.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 03/28/2020] [Accepted: 04/04/2020] [Indexed: 01/05/2023]
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Impact of musculoskeletal degradation on cancer outcomes and strategies for management in clinical practice. Proc Nutr Soc 2020; 80:73-91. [PMID: 32981540 DOI: 10.1017/s0029665120007855] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The prevalence of malnutrition in patients with cancer is one of the highest of all patient groups. Weight loss (WL) is a frequent manifestation of malnutrition in cancer and several large-scale studies have reported that involuntary WL affects 50-80% of patients with cancer, with the degree of WL dependent on tumour site, type and stage of disease. The study of body composition in oncology using computed tomography has unearthed the importance of both low muscle mass (sarcopenia) and low muscle attenuation as important prognostic indications of unfavourable outcomes including poorer tolerance to chemotherapy; significant deterioration in performance status and quality of life (QoL), poorer post-operative outcomes and shortened survival. While often hidden by excess fat and high BMI, muscle abnormalities are highly prevalent in patients with cancer (ranging from 10 to 90%). Early screening to identify individuals with sarcopenia and decreased muscle quality would allow for earlier multimodal interventions to attenuate adverse body compositional changes. Multimodal therapies (combining nutritional counselling, exercise and anti-inflammatory drugs) are currently the focus of randomised trials to examine if this approach can provide a sufficient stimulus to prevent or slow the cascade of tissue wasting and if this then impacts on outcomes in a positive manner. This review will focus on the aetiology of musculoskeletal degradation in cancer; the impact of sarcopenia on chemotherapy tolerance, post-operative complications, QoL and survival; and outline current strategies for attenuation of muscle loss in clinical practice.
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Body composition and its association with fatigue in the first 2 years after colorectal cancer diagnosis. J Cancer Surviv 2020; 15:597-606. [PMID: 33067775 PMCID: PMC8272706 DOI: 10.1007/s11764-020-00953-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 10/06/2020] [Indexed: 01/07/2023]
Abstract
Purpose Persistent fatigue among colorectal cancer (CRC) patients might be associated with unfavorable body composition, but data are sparse and inconsistent. We studied how skeletal muscle index (SMI), skeletal muscle radiodensity (SMR), visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT) at diagnosis are associated with fatigue up to 24 months post-diagnosis in stage I–III CRC patients. Methods SMI, SMR, VAT, and SAT were assessed among 646 CRC patients using pre-treatment computed tomography images. Fatigue at diagnosis, at 6, and 24 months post-diagnosis was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire. The association of SMI, SMR, VAT, and SAT with fatigue (yes/no) was assessed using confounder-adjusted restricted cubic spline analyses. Results Prevalence of fatigue at diagnosis was 18%, at 6 months 25%, and at 24 months 12%. At diagnosis, a significant (p = 0.01) non-linear association of higher levels of SAT with higher prevalence of fatigue was observed. Lower levels of SMR were linearly associated with higher prevalence of fatigue at 6 months post-diagnosis (overall association p = 0.02). None of the body composition parameters were significantly associated with fatigue at 24 months. Conclusion Having more SAT was associated with more fatigue at diagnosis, while low levels of SMR were associated with more fatigue at 6 months post-diagnosis. Implications for Cancer Survivors Our results suggest that it may be interesting to investigate whether interventions that aim to increase SMR around the time of diagnosis may help to lower fatigue. However, more knowledge is needed to understand the mechanisms behind the association of SMR with fatigue. Electronic supplementary material The online version of this article (10.1007/s11764-020-00953-0) contains supplementary material, which is available to authorized users.
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Fu X, Tian Z, Wen S, Sun H, Thapa S, Xiong H, Liu H, Li L, Yu S. A new index based on serum creatinine and cystatin C is useful for assessing sarcopenia in patients with advanced cancer. Nutrition 2020; 82:111032. [PMID: 33172686 DOI: 10.1016/j.nut.2020.111032] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 08/28/2020] [Accepted: 09/29/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Sarcopenia is a well-known risk factor for inferior cancer outcomes, but the identification of patients at risk remains challenging. A new sarcopenia index (SI), defined as serum creatinine (Cr) × cystatin C (CysC)-based glomerular filtration rate (eGFRCysC), has been reported to be an objective surrogate marker for sarcopenia. The aim of this study was to assess whether the SI is associated with sarcopenia and cancer-related fatigue (CRF) in patients with advanced cancer. METHODS This cross-sectional study included 182 patients with different types of cancer (cancer stages III/IV; mean age 55.1 ± 11.1 y). Sarcopenia was defined as the presence of both low muscle mass and low muscle strength. The cross-sectional area of skeletal muscle mass (SMA) at the third lumbar spine was estimated by computed tomography (CT). Low muscle mass was defined as a skeletal muscle index (SMA/height2) <34.9 cm2/m2 for women and 40.8 cm2/m2 for men. Low muscle strength was determined by handgrip strength (HGS) according to the cutoffs of the Asian Working Group for Sarcopenia (<18 kg for women and <26 kg for men). CRF was measured by the Brief Fatigue Inventory (BFI). The associations between SI with both sarcopenia and CRF were investigated. RESULTS The prevalence of sarcopenia was 27.5%. The SI was significantly lower in both the sarcopenia and severe fatigue groups. The associations between SI and SMA (r = 0.365; P < 0.001), skeletal muscle index (SMI) (r = 0.340; P < 0.001), and HGS (r = 0.414; P <0 .001) were stronger than the associations between the serum creatinine/cystatin C (Cr/CysC) ratio and SMA (r = 0.299; P < 0.001), SMI (r = 0.269; P <0 .001), and HGS (r = 0.364; P <0 .001). Additionally, a decrease in the SI was associated with a higher likelihood of sarcopenia (odds ratio per 10-unit, 1.09; 95% confidence interval, 1.02-1.16) after adjusting for potential confounding factors. However, there was only a weak correlation between the SI and BFI score (r = -0.161, P = 0.045). CONCLUSION The SI might be a useful objective tool for assessing sarcopenia in patients with advanced cancer. Further studies are warranted to extend the present findings.
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Affiliation(s)
- Xiaofen Fu
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, People's Republic of China
| | - Zhen Tian
- Department of Minimally Invasive Interventional Oncology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, People's Republic of China
| | - Su Wen
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, People's Republic of China
| | - Huihui Sun
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, People's Republic of China
| | - Sudip Thapa
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, People's Republic of China
| | - Huihua Xiong
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, People's Republic of China
| | - Huiquan Liu
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, People's Republic of China
| | - Lu Li
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, People's Republic of China
| | - Shiying Yu
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, People's Republic of China.
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Mallard J, Hucteau E, Schott R, Petit T, Demarchi M, Belletier C, Ben Abdelghani M, Carinato H, Chiappa P, Fischbach C, Kalish-Weindling M, Bousinière A, Dufour S, Favret F, Pivot X, Hureau TJ, Pagano AF. Evolution of Physical Status From Diagnosis to the End of First-Line Treatment in Breast, Lung, and Colorectal Cancer Patients: The PROTECT-01 Cohort Study Protocol. Front Oncol 2020; 10:1304. [PMID: 32903594 PMCID: PMC7438727 DOI: 10.3389/fonc.2020.01304] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 06/23/2020] [Indexed: 01/06/2023] Open
Abstract
Background: Cancer cachexia and exacerbated fatigue represent two hallmarks in cancer patients, negatively impacting their exercise tolerance and ultimately their quality of life. However, the characterization of patients' physical status and exercise tolerance and, most importantly, their evolution throughout cancer treatment may represent the first step in efficiently counteracting their development with prescribed and tailored exercise training. In this context, the aim of the PROTECT-01 study will be to investigate the evolution of physical status, from diagnosis to the end of first-line treatment, of patients with one of the three most common cancers (i.e., lung, breast, and colorectal). Methods: The PROTECT-01 cohort study will include 300 patients equally divided between lung, breast and colorectal cancer. Patients will perform a series of assessments at three visits throughout the treatment: (1) between the date of diagnosis and the start of treatment, (2) 8 weeks after the start of treatment, and (3) after the completion of first-line treatment or at the 6-months mark, whichever occurs first. For each of the three visits, subjective and objective fatigue, maximal voluntary force, body composition, cachexia, physical activity level, quality of life, respiratory function, overall physical performance, and exercise tolerance will be assessed. Discussion: The present study is aimed at identifying the nature and severity of maladaptation related to exercise intolerance in the three most common cancers. Therefore, our results should contribute to the delineation of the needs of each group of patients and to the determination of the most valuable exercise interventions in order to counteract these maladaptations. This descriptive and comprehensive approach is a prerequisite in order to elaborate, through future interventional research projects, tailored exercise strategies to counteract specific symptoms that are potentially cancer type-dependent and, in fine, to improve the health and quality of life of cancer patients. Moreover, our concomitant focus on fatigue and cachexia will provide insightful information about two factors that may have substantial interaction but require further investigation. Trial registration: This prospective study has been registered at ClinicalTrials.gov (NCT03956641), May, 2019.
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Affiliation(s)
- Joris Mallard
- Institut de Cancérologie Strasbourg Europe (ICANS), Strasbourg, France.,EA 3072: Mitochondria, Oxidative Stress and Muscular Protection Laboratory, Faculty of Medicine, Faculty of Sports Sciences, University of Strasbourg, Strasbourg, France
| | - Elyse Hucteau
- Institut de Cancérologie Strasbourg Europe (ICANS), Strasbourg, France.,EA 3072: Mitochondria, Oxidative Stress and Muscular Protection Laboratory, Faculty of Medicine, Faculty of Sports Sciences, University of Strasbourg, Strasbourg, France
| | - Roland Schott
- Institut de Cancérologie Strasbourg Europe (ICANS), Strasbourg, France
| | - Thierry Petit
- Institut de Cancérologie Strasbourg Europe (ICANS), Strasbourg, France
| | - Martin Demarchi
- Institut de Cancérologie Strasbourg Europe (ICANS), Strasbourg, France
| | | | | | - Hélène Carinato
- Institut de Cancérologie Strasbourg Europe (ICANS), Strasbourg, France
| | - Pascale Chiappa
- Institut de Cancérologie Strasbourg Europe (ICANS), Strasbourg, France
| | - Cathie Fischbach
- Institut de Cancérologie Strasbourg Europe (ICANS), Strasbourg, France
| | | | - Audren Bousinière
- Institut de Cancérologie Strasbourg Europe (ICANS), Strasbourg, France
| | - Stéphane Dufour
- EA 3072: Mitochondria, Oxidative Stress and Muscular Protection Laboratory, Faculty of Medicine, Faculty of Sports Sciences, University of Strasbourg, Strasbourg, France
| | - Fabrice Favret
- EA 3072: Mitochondria, Oxidative Stress and Muscular Protection Laboratory, Faculty of Medicine, Faculty of Sports Sciences, University of Strasbourg, Strasbourg, France
| | - Xavier Pivot
- Institut de Cancérologie Strasbourg Europe (ICANS), Strasbourg, France
| | - Thomas J Hureau
- EA 3072: Mitochondria, Oxidative Stress and Muscular Protection Laboratory, Faculty of Medicine, Faculty of Sports Sciences, University of Strasbourg, Strasbourg, France
| | - Allan F Pagano
- EA 3072: Mitochondria, Oxidative Stress and Muscular Protection Laboratory, Faculty of Medicine, Faculty of Sports Sciences, University of Strasbourg, Strasbourg, France
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Buffart LM, Sweegers MG, de Ruijter CJ, Konings IR, Verheul HMW, van Zweeden AA, Grootscholten C, Chinapaw MJ, Altenburg TM. Muscle contractile properties of cancer patients receiving chemotherapy: Assessment of feasibility and exercise effects. Scand J Med Sci Sports 2020; 30:1918-1929. [PMID: 32599670 PMCID: PMC7540386 DOI: 10.1111/sms.13758] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 06/18/2020] [Accepted: 06/22/2020] [Indexed: 12/20/2022]
Abstract
Background This pilot trial explores the feasibility of measuring muscle contractile properties in patients with cancer, effects of exercise during chemotherapy on muscle contractile properties and the association between changes in contractile muscle properties and perceived fatigue. Method Patients who received (neo)adjuvant chemotherapy for breast or colon cancer were randomized to a 9‐12 week exercise intervention or a waitlist‐control group. At baseline and follow‐up, we measured knee extensor strength using maximal voluntary contraction (MVC), contractile muscle properties of the quadriceps muscle using electrical stimulation, and perceived fatigue using the Multidimensional Fatigue Inventory. Feasibility was assessed by the proportion of patients who successfully completed measurements of contractile muscle properties. Exercise effects on muscle contractile properties were explored using linear regression analyses. Between‐group differences >10% were considered potentially relevant. Pearson correlation (rp) of changes in contractile muscle properties and changes in perceived fatigue was calculated. Results Twenty two of 30 patients completed baseline and follow‐up assessments. Measurements of contractile properties were feasible except for muscle fatigability. We found a potentially relevant between‐group difference in the rate of force development favoring the intervention group (1192 N/s, 95% CI = −335; 2739). Change in rate of force development was negatively correlated with change in perceived general (rp = −0.54, P = .04) and physical (rp = −0.59, P = .02) fatigue. Conclusion Chemotherapy induces a decrease in the rate of force development, which may reflect a larger loss in type II muscle fibers. This may be attenuated with (resistance) exercise. The increase in the rate of force development was related to a decrease in perceived fatigue.
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Affiliation(s)
- Laurien M Buffart
- Department of Physiology, Radboudumc, Radboud Institute for Health Sciences, Nijmegen, The Netherlands.,Department of Epidemiology and Biostatistics and Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, The Netherlands
| | - Maike G Sweegers
- Department of Epidemiology and Biostatistics and Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Cornelis J de Ruijter
- Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Inge R Konings
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, The Netherlands
| | - Henk M W Verheul
- Department of Medical Oncology, Radboudumc, Nijmegen, The Netherlands
| | - Annette A van Zweeden
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, The Netherlands.,Department of Internal Medicine, Amstelland Hospital, Amstelveen, The Netherlands
| | - Cecile Grootscholten
- Department of Gastrointestinal Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Mai J Chinapaw
- Department of Public and Occupational Health and Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Teatske M Altenburg
- Department of Public and Occupational Health and Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Derksen JWG, Kurk SA, Peeters PHM, Dorresteijn B, Jourdan M, van der Velden AMT, Nieboer P, de Jong RS, Honkoop AH, Punt CJA, Koopman M, May AM. The association between changes in muscle mass and quality of life in patients with metastatic colorectal cancer. J Cachexia Sarcopenia Muscle 2020; 11:919-928. [PMID: 32107889 PMCID: PMC7432557 DOI: 10.1002/jcsm.12562] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 12/16/2019] [Accepted: 02/09/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Skeletal muscle mass (SMM) loss is common in metastatic colorectal cancer (mCRC) patients and associated with poor clinical outcomes, including increased treatment-related toxicities and reduced survival. Muscle loss may contribute to reduced health-related quality of life (HRQoL), including fatigue. Our aim was to study associations between changes in SMM and concomitant changes in patient-reported HRQoL. METHODS This was a secondary analysis of mCRC patients in the CAIRO3 randomized clinical trial who were-after initial treatment-randomized between maintenance treatment with capecitabine plus bevacizumab (CAP-B) and observation until first disease progression (PD1). Included patients had computed tomography images for SMM quantification, together with HRQoL assessments available at randomization and PD1. Changes in SMM (categorized as >2% loss, stable, and >2% gain) and HRQoL were computed between randomization and PD1. Changes in HRQoL score >10 points were considered clinically relevant. Associations between SMM and HRQoL changes were studied by multiple linear regression models. We also investigated whether associations differed by treatment arm for global health and the 13 other HRQoL subscales. RESULTS Of 221 patients included (mean age 63.5 ± 8.4 years), 24% lost, 27% remained stable, and 49% gained SMM. At randomization, mean global health status was 73.5 ± 15.9 in the CAP-B arm and 75.1 ± 17.5 in the observation arm (P = 0.48). A stable or gain in SMM was significantly associated with a clinically relevant improvement in global health status (9.9 and 14.7 points, respectively), compared with patients who lost SMM. From the subscales that did not show significant differences between the two treatment arms, we found significant and clinically relevant associations for stable or gain in SMM with improved role functioning (12.0 and 17.9, respectively) and with less fatigue (-10.0 and -15.0, respectively) and pain (-16.3 for SMM gain). From the subscales that did show significantly different associations with SMM between the two treatment arms, we only found significant results in the observation arm. Here, associations were found for stable or gain in SMM with clinically relevant improved physical (12.4 for SMM gain), cognitive (10.7 and 9.7, respectively), and social functioning (15.5 and 15.6, respectively) as well as reduced appetite loss (-28.5 and -30.7, respectively). CONCLUSIONS In mCRC, SMM preservation during CAP-B and observation treatment is associated with significant and clinically relevant improvements in global health status and multiple functional and symptom scales. Studies are warranted to investigate whether interventions targeting SMM lead to improved HRQoL, fewer symptoms, and better functioning.
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Affiliation(s)
- Jeroen W G Derksen
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, GA, Utrecht, The Netherlands
| | - Sophie A Kurk
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, GA, Utrecht, The Netherlands
| | - Petra H M Peeters
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, GA, Utrecht, The Netherlands
| | - Bram Dorresteijn
- Danone Nutricia Research, Nutricia Advanced Medical Nutrition, Utrecht, The Netherlands
| | - Marion Jourdan
- Danone Nutricia Research, Nutricia Advanced Medical Nutrition, Utrecht, The Netherlands
| | | | - Peter Nieboer
- Department of Medical Oncology, Wilhemina Hospital, Assen, The Netherlands
| | - Robert S de Jong
- Department of Medical Oncology, Martini Hospital, Groningen, The Netherlands
| | - Aafke H Honkoop
- Department of Medical Oncology, Isala Hospital, Zwolle, The Netherlands
| | - Cornelis J A Punt
- Department of Medical Oncology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Miriam Koopman
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Anne M May
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, GA, Utrecht, The Netherlands
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Zhou YT, Li SS, Ai M, Chen H, Liu YX, Li BY, Zhao Y, Cai WW, Hou B, Ni LL, Xu F, Qiu LY. 1,25(OH)2D3 mitigate cancer-related fatigue in tumor-bearing mice: Integrating network pharmacological analysis. Biomed Pharmacother 2020; 128:110256. [DOI: 10.1016/j.biopha.2020.110256] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 05/06/2020] [Accepted: 05/10/2020] [Indexed: 12/19/2022] Open
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Smith SGVS, Power GA, Bent LR. Foot sole cutaneous stimulation mitigates neuromuscular fatigue during a sustained plantar flexor isometric task. J Appl Physiol (1985) 2020; 129:325-334. [PMID: 32584665 DOI: 10.1152/japplphysiol.00157.2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Neuromuscular fatigue impairs motor coordination, movement stability, and proprioception, which further decreases performance. A neuromechanical coupling exists between foot sole cutaneous mechanoreceptors and motoneurons of the lower limb, however, the contribution of skin sensory input on muscle fatigue remains unclear. The purpose of this study was to determine if the presence of cutaneous stimulation could mitigate the effect of fatigue of the plantar flexor muscles during a sustained isometric task at 30% maximal voluntary contraction (MVC). Participants (N = 16, age 24.1 ± 2.6 yr) underwent a 30% isometric plantar flexor fatiguing task in a seated position with hip, knee, and ankle angle at 80°, 100°, and 90°, respectively, with intermittent MVCs until task failure. Failure was defined as when the participant could no longer maintain 30% MVC for a minimum of two seconds. Throughout the protocol, electrical stimulation was applied to either the right heel, right metatarsals, or no stimulation. A subset of participants (N = 6) underwent an additional condition with electrical stimulation applied to the left arm. MVCs were also conducted intermittently throughout recovery for 30 min. Foot sole cutaneous stimulation mitigated fatigue, as demonstrated by an ~15% increased time to task failure (TTF) compared with the control condition. When normalized to TTF, MVC torque amplitude was not different at each time epoch, which indicated that each %MVC was maintained longer into the fatigue task during the heel and metatarsal stimulation conditions However, there was no significant effect of cutaneous stimulation on recovery. The results indicate that cutaneous stimulation may serve as a feasible means to mitigate fatigue.NEW & NOTEWORTHY Cutaneous coupling with lower limb motor neurons has long been known. We set out to establish whether this pathway could serve a purpose other than muscular modulation during standing and walking. We found that during a submaximal contraction of the plantar flexor muscles, the addition of intermittent cutaneous stimulation to the skin of the foot sole resulted in an increase in time to task failure by 15%, which was over a minute longer in duration. We conclude that skin stimulation may serve as a mechanism to mitigate fatigue.
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Affiliation(s)
- Simone G V S Smith
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Geoffrey A Power
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Leah R Bent
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
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Balderas-Peña LMA, González-Barba F, Martínez-Herrera BE, Palomares-Chacón UR, Durán-Anguiano O, Salazar-Páramo M, Gómez-Sánchez E, Dávalos-Cobián C, Nava-Zavala AH, Hernández-Chávez GA, Sat-Muñoz D. Body Composition and Biochemical Parameters of Nutritional Status: Correlation with Health-Related Quality of Life in Patients with Colorectal Cancer. Nutrients 2020; 12:nu12072110. [PMID: 32708665 PMCID: PMC7400949 DOI: 10.3390/nu12072110] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 06/29/2020] [Accepted: 07/14/2020] [Indexed: 11/17/2022] Open
Abstract
Up to 60% of colorectal cancer (CRC) patients develop malnutrition, affecting treatment effectiveness, increasing toxicity, postoperative complications, hospital stay, and worsening health-related quality of life (HRQOL). This cross-sectional study analyzed data from 48 women and 65 men with CRC. We correlated scores of the scales from the questionnaires EORTC (European Organisation for Research and Treatment of Cancer) Quality of Life Questionnaire Core 30 (QLQ)-C30 and Colorectal Cancer module Colorectal 29 (QLQ-CR29) with patients’ body composition and clinical and biochemical indicators of nutritional status. Results: Scores on quality of life were negatively associated with the lymphocyte count (rP = −0.386) and the fat trunk percentage (rP = −0.349) in the women’s group. Scores on the physical and role functioning were inversely associated with the adiposity percentage (rP = −0.486 and rP = −0.411, respectively). In men, total skeletal muscle mass (SMM) was positively associated with emotional functioning (rP = 0.450); the trunk SMM was negatively related to fatigue (rP = −0.586), nausea and vomiting (rP = −0.469), pain (rP = −0.506), and financial difficulties (rP = −0.475); additionally, serum albumin was positively related to physical, emotional, and social functioning scales (rPs = 0.395, 0.453, and 0.363, respectively) and negatively to fatigue (rP = −0.362), nausea and vomiting (rP = −0.387), and appetite loss (rP = −0.347). Among the men, the reduced SMM and biochemical, nutritional parameters were related to low scores on the EORTC QLQ-C30 and QLQ-CR29 functioning scales. In conclusion, in patients with CRC, malnourishment could have a profound effect on the patients’ functionality and QoL (quality of life).
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Affiliation(s)
- Luz-Ma-Adriana Balderas-Peña
- Unidad de Investigación Biomédica 02, UMAE Hospital de Especialidades (HE), Centro Médico Nacional de Occidente (CMNO), Instituto Mexicano del Seguro Social (IMSS), 1000 Belisario Domínguez, Colonia Independencia, Guadalajara, Jalisco 44340, Mexico; (L.-M.-A.B.-P.); (F.G.-B.); (B.-E.M.-H.); (A.-H.N.-Z.)
- Departamento de Morfología, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdG), Cuerpo Académico UDG CA-874 “Ciencias morfológicas en el diagnóstico y tratamiento de la enfermedad”, 950 Sierra Mojada, Gate 7, Building C, 1st level, Colonia Independencia, Guadalajara, Jalisco 44340, Mexico
| | - Faviola González-Barba
- Unidad de Investigación Biomédica 02, UMAE Hospital de Especialidades (HE), Centro Médico Nacional de Occidente (CMNO), Instituto Mexicano del Seguro Social (IMSS), 1000 Belisario Domínguez, Colonia Independencia, Guadalajara, Jalisco 44340, Mexico; (L.-M.-A.B.-P.); (F.G.-B.); (B.-E.M.-H.); (A.-H.N.-Z.)
| | - Brenda-Eugenia Martínez-Herrera
- Unidad de Investigación Biomédica 02, UMAE Hospital de Especialidades (HE), Centro Médico Nacional de Occidente (CMNO), Instituto Mexicano del Seguro Social (IMSS), 1000 Belisario Domínguez, Colonia Independencia, Guadalajara, Jalisco 44340, Mexico; (L.-M.-A.B.-P.); (F.G.-B.); (B.-E.M.-H.); (A.-H.N.-Z.)
- Hospital General de Zona (HGZ) #02 c/MF “Dr. Francisco Padrón Puyou”, Delegación Estatal San Luis Potosí, IMSS, Benigno Arriaga street and Melchor Ocampo S/N, Colonia Tequisquiapan, San Luis Potosí, San Luis Potosí 78250, Mexico
| | - Ulises-Rodrigo Palomares-Chacón
- Servicio de Coloproctología, Unidad Médica de Alta Especialidad (UMAE), Hospital de Especialidades (HE), Centro Médico Nacional de Occidente (CMNO), Instituto Mexicano del Seguro Social (IMSS), 1000 Belisario Domínguez, Colonia Independencia, Guadalajara, Jalisco 44340, Mexico; (U.-R.P.-C.); (O.D.-A.)
| | - Oscar Durán-Anguiano
- Servicio de Coloproctología, Unidad Médica de Alta Especialidad (UMAE), Hospital de Especialidades (HE), Centro Médico Nacional de Occidente (CMNO), Instituto Mexicano del Seguro Social (IMSS), 1000 Belisario Domínguez, Colonia Independencia, Guadalajara, Jalisco 44340, Mexico; (U.-R.P.-C.); (O.D.-A.)
| | - Mario Salazar-Páramo
- Academia de Inmunología, Departamento de Fisiología, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdG), 950 Sierra Mojada, Gate 7, Building O, 1st level, Colonia Independencia, Guadalajara, Jalisco 44340, Mexico;
| | - Eduardo Gómez-Sánchez
- División de Disciplinas Básicas para Salud, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdG), Sierra Mojada 950, Edificio N, Puerta 1, Planta Baja, Colonia Independencia, Guadalajara, Jalisco 44340, Mexico;
| | - Carlos Dávalos-Cobián
- Departamento Clínico de Gastroenterología Endoscópica, Unidad Médica de Alta Especialidad (UMAE), Hospital de Especialidades (HE), Centro Médico Nacional de Occidente (CMNO,) Instituto Mexicano del Seguro Social (IMSS), 1000 Belisario Domínguez, Colonia Independencia, Guadalajara, Jalisco 44340, Mexico;
| | - Arnulfo-Hernán Nava-Zavala
- Unidad de Investigación Biomédica 02, UMAE Hospital de Especialidades (HE), Centro Médico Nacional de Occidente (CMNO), Instituto Mexicano del Seguro Social (IMSS), 1000 Belisario Domínguez, Colonia Independencia, Guadalajara, Jalisco 44340, Mexico; (L.-M.-A.B.-P.); (F.G.-B.); (B.-E.M.-H.); (A.-H.N.-Z.)
- Programa Internacional Facultad de Medicina, Universidad Autónoma de Guadalajara, Av. Patria 1201, Lomas del Valle, Zapopan 45129, Mexico
- Servicio de Inmunología y Reumatología, División de Medicina Interna, Hospital General de Occidente, Secretaria de Salud Jalisco, Av. Zoquipan 1050, Zoquipan, Zapopan, Jalisco 45170, Mexico
| | - Guillermo-Allan Hernández-Chávez
- División de Oncología Hematología, UMAE, Hospital de Especialidades, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, 1000 Belisario Domínguez, Colonia Independencia, Guadalajara, Jalisco 44340, Mexico;
| | - Daniel Sat-Muñoz
- Departamento de Morfología, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdG), Cuerpo Académico UDG CA-874 “Ciencias morfológicas en el diagnóstico y tratamiento de la enfermedad”, 950 Sierra Mojada, Gate 7, Building C, 1st level, Colonia Independencia, Guadalajara, Jalisco 44340, Mexico
- Departamento Clínico de Oncología Quirúrgica, División de Oncología Hematología, UMAE, Hospital de Especialidades, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, 1000 Belisario Domínguez, Colonia Independencia, Guadalajara, Jalisco 44340, Mexico
- Correspondence: ; Tel.: +52-33-3668-3000 (ext. 31611)
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Wilson HE, Stanton DA, Montgomery C, Infante AM, Taylor M, Hazard-Jenkins H, Pugacheva EN, Pistilli EE. Skeletal muscle reprogramming by breast cancer regardless of treatment history or tumor molecular subtype. NPJ Breast Cancer 2020; 6:18. [PMID: 32550263 PMCID: PMC7272425 DOI: 10.1038/s41523-020-0162-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 05/08/2020] [Indexed: 12/24/2022] Open
Abstract
Increased susceptibility to fatigue is a negative predictor of survival commonly experienced by women with breast cancer (BC). Here, we sought to identify molecular changes induced in human skeletal muscle by BC regardless of treatment history or tumor molecular subtype using RNA-sequencing (RNA-seq) and proteomic analyses. Mitochondrial dysfunction was apparent across all molecular subtypes, with the greatest degree of transcriptomic changes occurring in women with HER2/neu-overexpressing tumors, though muscle from patients of all subtypes exhibited similar pathway-level dysregulation. Interestingly, we found no relationship between anticancer treatments and muscle gene expression, suggesting that fatigue is a product of BC per se rather than clinical history. In vitro and in vivo experimentation confirmed the ability of BC cells to alter mitochondrial function and ATP content in muscle. These data suggest that interventions supporting muscle in the presence of BC-induced mitochondrial dysfunction may alleviate fatigue and improve the lives of women with BC.
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Affiliation(s)
- Hannah E. Wilson
- MD/PhD Medical Scientist Program, West Virginia University School of Medicine, Morgantown, WV 26506 USA
- Cancer Institute, West Virginia University School of Medicine, Morgantown, WV 26506 USA
| | - David A. Stanton
- Division of Exercise Physiology, Department of Human Performance, West Virginia University School of Medicine, Morgantown, WV 26506 USA
| | - Cortney Montgomery
- Cancer Institute, West Virginia University School of Medicine, Morgantown, WV 26506 USA
| | - Aniello M. Infante
- Genomics Core Facility, West Virginia University, Morgantown, WV 26506 USA
| | - Matthew Taylor
- West Virginia School of Osteopathic Medicine, Lewisburg, WV 24901 USA
| | - Hannah Hazard-Jenkins
- Department of Surgery, West Virginia University School of Medicine, Morgantown, WV 26506 USA
| | - Elena N. Pugacheva
- Cancer Institute, West Virginia University School of Medicine, Morgantown, WV 26506 USA
- Department of Biochemistry, West Virginia University School of Medicine, Morgantown, WV 26506 USA
| | - Emidio E. Pistilli
- Cancer Institute, West Virginia University School of Medicine, Morgantown, WV 26506 USA
- Division of Exercise Physiology, Department of Human Performance, West Virginia University School of Medicine, Morgantown, WV 26506 USA
- Department of Microbiology, Immunology, and Cell Biology, West Virginia University School of Medicine, Morgantown, WV 26506 USA
- West Virginia Clinical and Translational Sciences Institute, West Virginia University School of Medicine, Morgantown, WV 26506 USA
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Baguley BJ, Skinner TL, Jenkins DG, Wright ORL. Mediterranean-style dietary pattern improves cancer-related fatigue and quality of life in men with prostate cancer treated with androgen deprivation therapy: A pilot randomised control trial. Clin Nutr 2020; 40:245-254. [PMID: 32534948 DOI: 10.1016/j.clnu.2020.05.016] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 05/14/2020] [Accepted: 05/14/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND & AIMS Cancer-related fatigue (CRF) is a prevalent and persistent symptom from androgen deprivation therapy (ADT) in prostate cancer. The Mediterranean-style dietary pattern (MED-diet) offers a plausible mechanism to mitigate CRF through reducing inflammation and improving body composition. This study aimed to evaluate the effects of a 12-week MED-diet, compared to usual care, on CRF and quality of life in men with prostate cancer treated with ADT. METHODS Twenty-three men (65.9 ± 7.8 years; body mass index: 29.6 ± 2.7 kg/m2; ADT duration: 33.8 ± 35.6 months) receiving ADT for ≥3 months were randomly assigned (1:1) to 12-weeks of usual care or the MED-diet involving six individualised nutrition consults. Primary outcomes included CRF [Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue scale (FACIT-F) and quality of life [FACIT-General (FACIT-G)], secondary outcomes included body mass/composition and interleukin (IL)-6 and IL-8 concentrations measured at baseline, 8-weeks and 12 weeks. Intervention feasibility was measured by intervention safety, study completion rate, consult attendance, and adherence to the MED-diet through the Mediterranean-diet adherence screener (MEDAS). Intention to treat linear mixed models were used to determine changes in outcomes between the MED-diet and usual care at baseline, 8-weeks and 12-weeks. RESULTS The MED-diet improved CRF (FACIT-F) at 8-weeks [+4.8 (0.0, 9.8); P = 0.05] and 12-weeks [+7.2 (2.2, 12.0); P = 0.005], quality of life (FACIT-G) at 12-weeks [+9.2 (2.7, 15.8); P = 0.006], reduced total body mass at 8-weeks [-2.51 kg (-4.25, -0.78); P = 0.005] and 12-weeks [-2.97 kg (-4.71, -1.25); P = 0.001], lean mass at 8-weeks [-1.50 kg (-2.91, -0.10); P = 0.036], and IL-8 at 8-weeks [-0.18 ng/ml (-0.34, -0.02); P = 0.029] compared to usual care. The MED-diet demonstrated zero adverse events, 91% study completion, 100% attendance, and 81% adherence to the MEDAS. CONCLUSION The MED-diet is safe and feasible, and has the potential to improve CRF and quality of life in overweight men treated with ADT compared to usual care. Further exploration of the MED-diet is warranted in a larger powered sample size to consolidate these findings.
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Affiliation(s)
- Brenton J Baguley
- Institute of Physical Activity and Nutrition, Deakin University, Geelong, Australia; School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia.
| | - Tina L Skinner
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - David G Jenkins
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia; School of Health and Sport Sciences, University of the Sunshine Coast, Sippy Downs, QLD, Australia
| | - Olivia R L Wright
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia; Mater Research Institute, The University of Queensland, Brisbane, QLD, Australia
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Chen L, Xu W, Yang Q, Zhang H, Wan L, Xin B, Zhang J, Guo C. Imperatorin alleviates cancer cachexia and prevents muscle wasting via directly inhibiting STAT3. Pharmacol Res 2020; 158:104871. [PMID: 32413482 DOI: 10.1016/j.phrs.2020.104871] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 04/09/2020] [Accepted: 04/24/2020] [Indexed: 01/08/2023]
Abstract
Skeletal muscle wasting is the most remarkable phenotypic feature of cancer cachexia that increases the risk of morbidity and mortality. Imperatorin (IMP), a main bioactive component of Angelica dahurica Radix, has been reported to possess several pharmacological effects including potential anti-colitis, anti-arthritis and anti-tumor activities. In this work, we demonstrated that IMP is a promising agent for the treatment of muscle wasting in cancer cachexia. IMP (5-20 μM) dose-dependently attenuated TCM-induced C2C12 myotube atrophy and prevented the induction of E3 ubiquitin ligases muscle RING-finger containing protein-1 (MuRF1) and muscle atrophy Fbox protein (Atrogin-1/MAFbx). Moreove, IMP administration significantly improved chief features of cancer cachexia in vivo, with significant prevention of the loss of body weight and deleterious wasting of multiple tissues, including skeletal muscle, fat and kidney and decreased expression of MuRF1 and Atrogin-1 in cachectic muscles. Cellular signaling pathway analysis showed that IMP selectively inhibited the phosphorylation of signal transducer and activator of transcription 3 (STAT3) in vitro and in vivo, and surface plasmon resonance (SPR) affinity experiments further demonstrated IMP bound to STAT3 in a concentration-dependent resonance manner. Molecular docking results revealed that IMP binds to the SH2 domain of STAT3, forming a hydrogen bond interaction with Arg-609, and a Sigma-Pi interaction with Lys-591. Mechanism analysis demonstrated that STAT3 overexpression markedly weakens the improvements of IMP on myotube atrophy and muscle wasting of cancer cachexia, indicating that STAT3 mediated the therapeutic effect of IMP. All these favorable results indicated that IMP is a new potential therapeutic candidate for cancer cachexia.
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Affiliation(s)
- Linlin Chen
- Department of Pharmacy, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, PR China; School of Medicine, Shanghai Jiao Tong University, Shanghai 200240, PR China.
| | - Weiheng Xu
- School of Pharmacy, Second Military Medical University, Shanghai 200433, PR China.
| | - Quanjun Yang
- Department of Pharmacy, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, PR China.
| | - Hong Zhang
- Department of Pharmacy, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, PR China; School of Medicine, Shanghai Jiao Tong University, Shanghai 200240, PR China.
| | - Lili Wan
- Department of Pharmacy, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, PR China.
| | - Bo Xin
- Department of Pharmacy, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, PR China.
| | - Junping Zhang
- School of Pharmacy, Second Military Medical University, Shanghai 200433, PR China; College of Pharmacy, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, PR China.
| | - Cheng Guo
- Department of Pharmacy, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, PR China; School of Medicine, Shanghai Jiao Tong University, Shanghai 200240, PR China.
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Daly LE, Dolan RD, Power DG, Ní Bhuachalla É, Sim W, Cushen SJ, Fallon M, Simmons C, McMillan DC, Laird BJ, Ryan AM. Determinants of quality of life in patients with incurable cancer. Cancer 2020; 126:2872-2882. [DOI: 10.1002/cncr.32824] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 09/19/2019] [Accepted: 01/24/2020] [Indexed: 12/25/2022]
Affiliation(s)
- Louise E. Daly
- School of Food and Nutritional Sciences College of Science, Engineering and Food Science University College Cork Cork Ireland
| | - Ross D. Dolan
- Academic Unit of Surgery University of Glasgow Glasgow United Kingdom
| | - Derek G. Power
- Department of Medical Oncology Mercy and Cork University Hospital Cork Ireland
| | - Éadaoin Ní Bhuachalla
- School of Food and Nutritional Sciences College of Science, Engineering and Food Science University College Cork Cork Ireland
| | - Wei Sim
- Academic Unit of Surgery University of Glasgow Glasgow United Kingdom
| | - Samantha J. Cushen
- School of Food and Nutritional Sciences College of Science, Engineering and Food Science University College Cork Cork Ireland
| | - Marie Fallon
- Edinburgh Cancer Research Centre Institute of Genetics and Molecular Medicine University of Edinburgh Edinburgh United Kingdom
| | - Claribel Simmons
- Edinburgh Cancer Research Centre Institute of Genetics and Molecular Medicine University of Edinburgh Edinburgh United Kingdom
| | | | - Barry J. Laird
- Edinburgh Cancer Research Centre Institute of Genetics and Molecular Medicine University of Edinburgh Edinburgh United Kingdom
| | - Aoife M. Ryan
- School of Food and Nutritional Sciences College of Science, Engineering and Food Science University College Cork Cork Ireland
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Hua X, Deng JP, Long ZQ, Zhang WW, Huang X, Wen W, Guo L, He ZY, Lin HX. Prognostic significance of the skeletal muscle index and an inflammation biomarker in patients with breast cancer who underwent postoperative adjuvant radiotherapy. Curr Probl Cancer 2020; 44:100513. [DOI: 10.1016/j.currproblcancer.2019.100513] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 09/30/2019] [Indexed: 12/13/2022]
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Computed Tomography–based Body Composition Analysis and Its Role in Lung Cancer Care. J Thorac Imaging 2020; 35:91-100. [DOI: 10.1097/rti.0000000000000428] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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48
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Does Physical Activity Regulate Prostate Carcinogenesis and Prostate Cancer Outcomes? A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041441. [PMID: 32102283 PMCID: PMC7068391 DOI: 10.3390/ijerph17041441] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 02/20/2020] [Accepted: 02/20/2020] [Indexed: 12/12/2022]
Abstract
Background: Prostate cancer (PCa) represents a common disease in men aged >65 years. The role of physical activity (PA) in patients at risk or diagnosed with PCa represents an evolving issue. We aimed to summarize available evidences about the impact of PA on the pathophysiology and clinical outcomes of PCa. Methods: We performed a narrative review. Evidences about the role of PA in elderly patients in terms of PCa biology, epidemiology, oncological and functional outcomes, as well as in terms of impact on the outcomes of androgen deprivation therapy (ADT) were summarized. Results: Potential pathophysiological pathways hypothesized to explain the benefits of PA in terms of prostate carcinogenesis include circulating levels of Insulin-like growth factor-1 (IGF-1), oxidative stress, systemic inflammation, sex hormones, and myokines. Clinically, emerging evidences support the hypothesis that PA is associated with decreased PCa risk, improved PCa-related survival, improved functional outcomes, and reduced ADT-related adverse events.
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Suzuki T, Von Haehling S, Springer J. Promising models for cancer-induced cachexia drug discovery. Expert Opin Drug Discov 2020; 15:627-637. [PMID: 32050816 DOI: 10.1080/17460441.2020.1724954] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Introduction: Cachexia is a frequent, multifactorial syndrome associated with cancer afflicting patients' quality of life, their ability to tolerate anti-neoplastic therapies and the therapies efficacy, as well as survival. Currently, there are no approved cancer cachexia treatments other than those for the treatment of the underlying cancer. Cancer cachexia (CC) is poorly understood and hence makes clinical trial design difficult at best. This underlines the importance of well-characterized animal models to further elucidate the pathophysiology of CC and drug discovery/development.Areas covered: This review gives an overview of the available animal models and their value and limitations in translational studies.Expert opinion: Using more than one CC model to test research questions or novel compounds/treatment strategies is strongly advisable. The main reason is that models have unique signaling modalities driving cachexia that may only relate to subgroups of cancer patients. Human xenograph CC models require the use of mice with a compromised immune system, limiting their value for translational experiments. It may prove beneficial to include standard care chemotherapy in the experimental design, as many chemotherapeutic agents can induce cachexia themselves and alter the metabolic and signaling derangements of CC and thus the response to new therapeutic strategies.
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Affiliation(s)
- Tsuyoshi Suzuki
- Department of Cardiology and Pneumology, University Medical Center Göttingen (UMG), Germany and German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
| | - Stephan Von Haehling
- Department of Cardiology and Pneumology, University Medical Center Göttingen (UMG), Germany and German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
| | - Jochen Springer
- Berlin Institute of Health Center for Regenerative Therapies (BCRT), Charité Universitätsmedizin Berlin, Berlin, Germany
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50
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Anker MS, Hadzibegovic S, Lena A, Belenkov Y, Bergler‐Klein J, de Boer RA, Farmakis D, von Haehling S, Iakobishvili Z, Maack C, Pudil R, Skouri H, Cohen‐Solal A, Tocchetti CG, Coats AJ, Seferović PM, Lyon AR. Recent advances in cardio-oncology: a report from the 'Heart Failure Association 2019 and World Congress on Acute Heart Failure 2019'. ESC Heart Fail 2019; 6:1140-1148. [PMID: 31884717 PMCID: PMC6989292 DOI: 10.1002/ehf2.12551] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Indexed: 02/06/2023] Open
Abstract
While anti-cancer therapies, including chemotherapy, immunotherapy, radiotherapy, and targeted therapy, are constantly advancing, cardiovascular toxicity has become a major challenge for cardiologists and oncologists. This has led to an increasing demand of cardio-oncology units in Europe and a growing interest of clinicians and researchers. The Heart Failure 2019 meeting of the Heart Failure Association of the European Society of Cardiology in Athens has therefore created a scientific programme that included four dedicated sessions on the topic along with several additional lectures. The major points that were discussed at the congress included the implementation and delivery of a cardio-oncology service, the collaboration among cardio-oncology experts, and the risk stratification, prevention, and early recognition of cardiotoxicity. Furthermore, sessions addressed the numerous different anti-cancer therapies associated with cardiotoxic effects and provided guidance on how to treat cancer patients who develop cardiovascular disease before, during, and after treatment.
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Affiliation(s)
- Markus S. Anker
- Division of Cardiology and Metabolism, Department of CardiologyCharité and Berlin Institute of Health Center for Regenerative Therapies (BCRT) and DZHK (German Centre for Cardiovascular Research)partner site Berlin and Department of Cardiology, Charité Campus Benjamin FranklinBerlinGermany
| | - Sara Hadzibegovic
- Division of Cardiology and Metabolism, Department of CardiologyCharité and Berlin Institute of Health Center for Regenerative Therapies (BCRT) and DZHK (German Centre for Cardiovascular Research)partner site Berlin and Department of Cardiology, Charité Campus Benjamin FranklinBerlinGermany
| | - Alessia Lena
- Division of Cardiology and Metabolism, Department of CardiologyCharité and Berlin Institute of Health Center for Regenerative Therapies (BCRT) and DZHK (German Centre for Cardiovascular Research)partner site Berlin and Department of Cardiology, Charité Campus Benjamin FranklinBerlinGermany
| | | | | | - Rudolf A. de Boer
- Department of CardiologyUniversity of GroningenUniversity Medical Center Groningen, GroningenThe Netherlands
| | - Dimitrios Farmakis
- University of Cyprus Medical SchoolNicosiaCyprus
- Department of Cardiology, Cardio‐Oncology Clinic, Heart Failure UnitAthens University Hospital ‘Attikon’, National and Kapodistrian University of AthensAthensGreece
| | - Stephan von Haehling
- Department of Cardiology and Pneumology, Heart Center Göttingen, German Center for Cardiovascular Medicine (DZHK)University of Göttingen Medical Center, Georg‐August‐UniversityGöttingenGermany
| | - Zaza Iakobishvili
- Department of Community Cardiology, Clalit Health Fund, and Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael
| | - Christoph Maack
- Comprehensive Heart Failure Center (CHFC)University Clinic WürzburgWürzburgGermany
| | - Radek Pudil
- 1st Department of Medicine–Cardioangiology, Faculty of MedicineUniversity HospitalHradec KrálovéCzech Republic
| | - Hadi Skouri
- Department of Internal MedicineAmerican University of Beirut Medical CenterBeirutLebanon
| | - Alain Cohen‐Solal
- Department of Cardiology, Lariboisière Hospital and U942 INSERM, BIOCANVAS (Biomarqueurs Cardiovasculaires)Paris UniversityParisFrance
| | - Carlo G. Tocchetti
- Department of Translational Medical Sciences and Interdepartmental Center for Clinical and Translational Sciences (CIRCET)Federico II UniversityNaplesItaly
| | | | - Petar M. Seferović
- Faculty of Medicine and Heart Failure CenterBelgrade University Medical Center, University of BelgradeBelgradeSerbia
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