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Lahousse A, Reynebeau I, Nijs J, Beckwée D, van Wilgen P, Fernández-de-Las-Peñas C, Mostaqim K, Roose E, Leysen L. The effect of psychologically informed practice with behavioural graded activity in cancer survivors: systematic review and meta-analysis. J Cancer Surviv 2024; 18:854-899. [PMID: 36701101 PMCID: PMC9878499 DOI: 10.1007/s11764-022-01270-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 10/01/2022] [Indexed: 01/27/2023]
Abstract
PURPOSE This systematic review and meta-analysis aimed to determine the effectiveness of psychologically informed practice (PIP) with behavioural graded activity (BGA) compared to (1) waitlist controls (WLC), (2) other interventions (OI), (3) PIP alone or (4) BGA alone in cancer patients and survivors (CPaS). METHODS PubMed, Web of Science and Embase were screened for randomised controlled trials encompassing BGA + PIP in CPaS. Effect sizes were inventoried for outcomes regarding physical activity (PA), quality of life (QoL) and debilitating symptoms (DS), which were assessed at four time points: post-intervention (PI), follow-up F1 (1 to 3 months), F2 (4 to 6 months) and F3 (> 6 months). The quality of the evidence was classified by the GRADE approach. RESULTS Thirty-three studies were found eligible, comprising 4330 participants. Significant effects with low heterogeneity of PIP + BGA comparing to WLC were found for anxiety (SMD - 1.29 [-1.71; - 0.86]), depression (SMD - 0.79 [- 1.10; - 0.48]), functional impairment (SMD - 0.72 [- 0.95; - 0.50]), PA (self-reported: (SMD - 0.58 [- 0.84; - 0.32]) and objectively measured: (SMD - 0.51 [- 0.90; - 0.13])) and social impairment (SMD - 0.33 [- 0.58; - 0.08]). When comparing PIP + BGA to OI, fatigue (SMD - 0.35 [- 0.51; - 0.20]) and PA (SMD - 0.26 [- 0.41; - 0.11]) at PI, and fatigue (SMD - 0.34 [- 0.58; - 0.10]) at F1 were found significant with low heterogeneity. No significant effects were observed in the meta-analyses of studies comparing PIP + BGA to BGA or PIP alone. CONCLUSIONS PIP with BGA has a favourable effect on DS, PA and QoL in CPaS when compared to non-behavioural interventions such as WLC, usual care and education. However, further research is needed on 'how' and 'when' PIP + BGA should be provided in cancer rehabilitation. IMPLICATIONS FOR CANCER SURVIVORS PIP + BGA has the potential to facilitate CPaS to reach the recommended amount of PA and reduce DS.
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Affiliation(s)
- Astrid Lahousse
- Research Foundation - Flanders (FWO), Brussels, Belgium.
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.
- Rehabilitation Research (RERE) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.
| | - Iris Reynebeau
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Jo Nijs
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium
- Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - David Beckwée
- Rehabilitation Research (RERE) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | - Paul van Wilgen
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Transcare Transdisciplinary Pain Management Centre, Groningen, the Netherlands
| | - César Fernández-de-Las-Peñas
- Department of Physical Therapy Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Alcorcon, Madrid, Spain
| | - Kenza Mostaqim
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Eva Roose
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Rehabilitation Research (RERE) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Laurence Leysen
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Rehabilitation Research (RERE) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
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Yang U, Harikrishna A, Preda V, Chen J. Efficacy of multidisciplinary interventions in preventing metabolic syndrome and improving body composition in prostate cancer patients treated with androgen deprivation therapy: A systematic review and meta-analysis. Clin Nutr ESPEN 2023; 58:27-49. [PMID: 38057016 DOI: 10.1016/j.clnesp.2023.09.001] [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: 08/28/2023] [Accepted: 09/01/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND Exercise is known to reduce adverse side effects of androgen-deprivation therapy (ADT) on quality of life, bone health and fatigue for prostate cancer (PCa) patients. We conducted a systematic review with meta-analysis to evaluate the effect of multidisciplinary interventions on body composition and metabolic syndrome (MetS) in ADT-treated PCa patients. METHODS A systematic review and meta-analysis were conducted based on searches of EMBASE, MEDLINE, CENTRAL and Scopus databases from inception to March 2023. Participants included ADT-treated PCa patients who received multidisciplinary interventions including exercise, diet, nutrition, pharmacotherapy, bariatric surgery, or psychological/behavioural therapy. Primary outcomes were changes in body composition and MetS, with prostate-specific antigen (PSA) as a secondary outcome. After meta-analysis, results were reported in mean difference, 95% confidence interval and p-value, with forest plots. Additionally, we conducted subgroup analyses to compare the effect of different interventions. RESULTS Thirty-three articles met the eligibility criteria out of 1443 articles and 28 studies were included in meta-analysis. Of 33 studies, 17 included exercise-only interventions and 10 included exercise + diet/nutrition interventions, but no studies included diet/nutrition-only interventions. All studies employed multidisciplinary approaches in developing or delivering the interventions. Most studies (85%) had low-moderate risk of bias, thus providing good evidence to this review. Overall, interventions had a positive effect on body composition measures; lean mass (LM):0.82 kg (95% CI:0.47,1.17;p < 0.00001), body fat mass (BFM):-0.68 kg (95% CI:-1.12,-0.24;p = 0.002), fat-free mass:0.75 kg (95% CI:0.14,1.37;p = 0.02) and body fat percentage (BFP):-0.99% (95% CI:-1.29,-0.68;p < 0.00001), as well as on MetS; waist circumference:-1.95 cm (95% CI:-3.10,-0.79;p = 0.0009), systolic blood pressure:-3.43 mmHg (95% CI:-6.36,-0.50;p = 0.02) and diastolic blood pressure:-2.48 mmHg (95% CI:-4.19,-0.76;p = 0.005). Subgroup-analyses showed that a combined approach including exercise + diet/nutrition was most effective in improving BFP, WC, SBP and DBP whereas exercise was more effective in improving LM and BFM. CONCLUSIONS In ADT-treated PCa patients, multidisciplinary interventions, especially those combining exercise and diet/nutrition, can improve body composition and metabolic health.
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Affiliation(s)
- Uhjin Yang
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia.
| | - Athulya Harikrishna
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Veronica Preda
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Juliana Chen
- Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia; Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
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Saab MM, McCarthy M, Murphy M, Medved K, O'Malley M, Bambury RM, Gleeson JP, Noonan B. Supportive care interventions for men with urological cancers: a scoping review. Support Care Cancer 2023; 31:530. [PMID: 37603072 PMCID: PMC10442278 DOI: 10.1007/s00520-023-07984-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 08/02/2023] [Indexed: 08/22/2023]
Abstract
PURPOSE To identify supportive care interventions for men with urological cancers. METHODS Experimental studies conducted among men with any urological cancer were eligible for inclusion. Academic Search Complete, CINAHL Plus with Full Text, MEDLINE, APA PsycArticles, APA PsycInfo, Social Sciences Full Text (H.W. Wilson), SocINDEX with Full Text, ERIC, Google Scholar and ClinicalTrials.gov were searched on 6 December 2022. No database limits were applied. The included studies were methodologically appraised. A narrative synthesis of the results was conducted. RESULTS Thirty studies were included with 10 categories of interventions identified. Over 300 outcomes were measured, and more than 100 instruments were used. Multicomponent interventions generally led to positive changes in physiological outcomes like body mass index, as well as exercise tolerance and quality of life. This change, however, was not sustained in the long term. Cognitive-behavioural interventions significantly improved psychological symptoms but seldom physical symptoms. Telephone and web-based interventions showed great promise in improving outcomes like depression, positive affect, negative affect, perceived stress, spiritual wellbeing and fatigue. Findings from physical activity/exercise-based interventions were promising for both, physical and psychological outcomes. Rehabilitative interventions were associated with significant improvements in quality of life, urinary symptoms and psychological symptoms, albeit in the short term. Mixed results were reported for nurse-led interventions, family-based interventions and nutritional interventions. CONCLUSION All but one study focused exclusively on prostate cancer. The included studies were significantly heterogeneous. Multicomponent, cognitive-behavioural, telephone and web-based, physical activity/exercise-based and rehabilitative interventions showed great promise in improving various outcomes. This improvement, however, was often short-lived.
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Affiliation(s)
- Mohamad M Saab
- Catherine McAuley School of Nursing and Midwifery, College of Medicine and Health, University College Cork, Cork, Ireland.
| | - Megan McCarthy
- Catherine McAuley School of Nursing and Midwifery, College of Medicine and Health, University College Cork, Cork, Ireland
| | - Mike Murphy
- School of Applied Psychology, College of Arts, Celtic Studies & Social Sciences, University College Cork, Cork, Ireland
| | - Katarina Medved
- Cancer Research @UCC, College of Medicine and Health, University College Cork, Cork, Ireland
| | - Maria O'Malley
- Catherine McAuley School of Nursing and Midwifery, College of Medicine and Health, University College Cork, Cork, Ireland
| | - Richard M Bambury
- Cancer Research @UCC, College of Medicine and Health, University College Cork, Cork, Ireland
- Medical Oncology Department, Cork University Hospital, Cork, Ireland
| | - Jack P Gleeson
- Cancer Research @UCC, College of Medicine and Health, University College Cork, Cork, Ireland
- Medical Oncology Department, Cork University Hospital, Cork, Ireland
| | - Brendan Noonan
- Catherine McAuley School of Nursing and Midwifery, College of Medicine and Health, University College Cork, Cork, Ireland
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Lapointe J, Comtois AS, Romain AJ, Bernard P. The Transtheoretical model's processes of change in the heart of a physical activity intervention: A series of n-of-1. PSYCHOLOGY OF SPORT AND EXERCISE 2023; 67:102430. [PMID: 37665883 DOI: 10.1016/j.psychsport.2023.102430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 03/21/2023] [Accepted: 03/21/2023] [Indexed: 09/06/2023]
Abstract
The objectives were a) to test whether a Processes of Change (POC)-personalized Transtheoretical model (TTM)-based intervention could increase physical activity (PA) among inactive adults, and b) to examine whether the intervention increased the level of TTM theoretical constructs. The following hypotheses were formulated: 1) PA levels will be significantly higher during and after the intervention in comparison to baseline measures; 2) the level of targeted POCs will increase during the intervention; 3) non targeted POCs will stay stable, and 4) self-efficacy and decisional balance levels will increase during the intervention. A series of N-of-1 with A (1 to 2-week)-B(10-week)-A'(2-week) design were conducted with 12 inactive adults. Behavioral counselors used behavior change techniques to target TTM constructs and supervise PA. Interventions were individualized based on the 5 POCs with the lowest pre-intervention level. Device-based and subjective PA along with TTM measures were collected weekly online. PA data were analyzed with piecewise linear models. A visual analysis was run to examine the TTM constructs. Device, self-reported and TTM data were available for five, seven and five participants, respectively. A significant self-reported PA increase for six participants was found during the phase B and A2. A significant device-measured PA increase was observed in two participants during the study. A substantial increase of targeted POC from baseline for all participants with available data was observed. This study provides the first evidence of behavioral and psychological effects of a POC-personalized TTM-based intervention in inactive adults.
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Affiliation(s)
- Josyanne Lapointe
- Physical Activity Sciences Department, Université Du Québec à Montréal, Montréal, QC, Canada; Research Centre, University Institute of Mental Health in Montreal, Montreal, QC, Canada
| | - Alain-Steve Comtois
- Physical Activity Sciences Department, Université Du Québec à Montréal, Montréal, QC, Canada
| | - Ahmed-Jérôme Romain
- Research Centre, University Institute of Mental Health in Montreal, Montreal, QC, Canada; School of Kinesiology and Physical Activity Sciences, University of Montreal, Montreal, QC, Canada
| | - Paquito Bernard
- Physical Activity Sciences Department, Université Du Québec à Montréal, Montréal, QC, Canada; Research Centre, University Institute of Mental Health in Montreal, Montreal, QC, Canada.
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Dovey Z, Horowitz A, Waingankar N. The influence of lifestyle changes (diet, exercise and stress reduction) on prostate cancer tumour biology and patient outcomes: A systematic review. BJUI COMPASS 2023; 4:385-416. [PMID: 37334023 PMCID: PMC10268595 DOI: 10.1002/bco2.237] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 03/05/2023] [Indexed: 06/20/2023] Open
Abstract
Background The mostly indolent natural history of prostate cancer (PCa) provides an opportunity for men to explore the benefits of lifestyle interventions. Current evidence suggests appropriate changes in lifestyle including diet, physical activity (PA) and stress reduction with or without dietary supplements may improve both disease outcomes and patient's mental health. Objective This article aims to review the current evidence on the benefits of all lifestyle programmes for PCa patients including those aimed at reducing obesity and stress, explore their affect on tumour biology and highlight any biomarkers that have clinical utility. Evidence acquisition Evidence was obtained from PubMed and Web of Science using keywords for each section on the affects of lifestyle interventions on (a) mental health, (b) disease outcomes and (c) biomarkers in PCa patients. PRISMA guidelines were used to gather the evidence for these three sections (15, 44 and 16 publications, respectively). Evidence synthesis For lifestyle studies focused on mental health, 10/15 demonstrated a positive influence, although for those programmes focused on PA it was 7/8. Similarly for oncological outcomes, 26/44 studies demonstrated a positive influence, although when PA was included or the primary focus, it was 11/13. Complete blood count (CBC)-derived inflammatory biomarkers show promise, as do inflammatory cytokines; however, a deeper understanding of their molecular biology in relation to PCa oncogenesis is required (16 studies reviewed). Conclusions Making PCa-specific recommendations on lifestyle interventions is difficult on the current evidence. Nevertheless, notwithstanding the heterogeneity of patient populations and interventions, the evidence that dietary changes and PA may improve both mental health and oncological outcomes is compelling, especially for moderate to vigorous PA. The results for dietary supplements are inconsistent, and although some biomarkers show promise, significantly more research is required before they have clinical utility.
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Affiliation(s)
- Zach Dovey
- Mount Sinai Health System, Department of UrologyIcahn Medical SchoolNew YorkNew YorkUSA
| | - Amir Horowitz
- Icahn School of MedicineThe Mount Sinai HospitalNew YorkNew YorkUSA
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Martín-Núñez J, Raya-Benítez J, López-López L, Calvache-Mateo A, Heredia-Ciuró A, Navas-Otero A, Valenza MC. Efficacy in urinary symptom burden, psychological distress, and self-efficacy of education-enhanced interventions in prostate cancer patients: a systematic review and meta-analyses. Support Care Cancer 2023; 31:340. [PMID: 37191890 DOI: 10.1007/s00520-023-07803-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 05/09/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND Worldwide, prostate cancer is both the second-most diagnosed cancer and most common solid tumor in men. Prostate cancer patients present with a symptom burden that is compounded by the impact of medical oncology treatment, affecting different domains of their perceived health status. Education active techniques are a key role in chronic disease to increase participation in their recovery. PURPOSE The purpose of the current review was to examine the efficacy of education-enhanced in urinary symptom burden, psychological distress, and self-efficacy in patients diagnosed with prostate cancer. METHODS A wide search of the literature was conducted for articles from their inception to June 2022. Only randomized controlled trials were included. Data extraction and methodologic quality assessment of the studies were carried out by two reviewers. We previously registered the protocol of this systematic review on PROSPERO (CRD42022331954). RESULTS A total of six studies were included in the study. After education-enhanced intervention showed significant improvements in any of perceived urinary symptom burden, one in psychological distress, and one in self-efficacy in the experimental group. The meta-analysis showed that education-enhanced interventions have a significant effect on depression. CONCLUSION Education-enhanced could have positive effects on urinary symptom burden, psychological distress, and self-efficacy in prostate cancer survivors. Our review was unable to demonstrate the best timing to apply education-enhanced strategies.
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Affiliation(s)
- Javier Martín-Núñez
- Faculty of Health Sciences, Department of Physiotherapy, University of Granada, Av. De La Ilustración, 60, 18016, Granada, Spain
| | - Julia Raya-Benítez
- Faculty of Health Sciences, Department of Physiotherapy, University of Granada, Av. De La Ilustración, 60, 18016, Granada, Spain
| | - Laura López-López
- Faculty of Health Sciences, Department of Physiotherapy, University of Granada, Av. De La Ilustración, 60, 18016, Granada, Spain
| | - Andrés Calvache-Mateo
- Faculty of Health Sciences, Department of Physiotherapy, University of Granada, Av. De La Ilustración, 60, 18016, Granada, Spain
| | - Alejandro Heredia-Ciuró
- Faculty of Health Sciences, Department of Physiotherapy, University of Granada, Av. De La Ilustración, 60, 18016, Granada, Spain
| | - Alba Navas-Otero
- Faculty of Health Sciences, Department of Physiotherapy, University of Granada, Av. De La Ilustración, 60, 18016, Granada, Spain
| | - Marie Carmen Valenza
- Faculty of Health Sciences, Department of Physiotherapy, University of Granada, Av. De La Ilustración, 60, 18016, Granada, Spain.
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Martín-Núñez J, Heredia-Ciuró A, Valenza-Peña G, Granados-Santiago M, Hernández-Hernández S, Ortiz-Rubio A, Valenza MC. Systematic review of self-management programs for prostate cancer patients, a quality of life and self-efficacy meta-analysis. PATIENT EDUCATION AND COUNSELING 2023; 107:107583. [PMID: 36459830 DOI: 10.1016/j.pec.2022.107583] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 11/25/2022] [Accepted: 11/26/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVE To investigate the efficacy of self-management interventions on quality of life and/or self-efficacy in patients diagnosed with prostate cancer through a systematic review with meta-analysis. METHODS A search was conducted from database inception to March 2022 across three databases. Randomized controlled trials were included. Two reviewers performed independent data extraction and methodologic quality assessment of the studies. RESULTS A total of fifteen studies were included in the study. Self-management interventions were identified by the Practical Reviews in Self-Management Support. The meta-analysis showed that self-management interventions have a significant effect on self-efficacy CONCLUSION: Self-management programs could have positive effects on quality of life and improve self-efficacy in prostate cancer patients. PRACTICE IMPLICATIONS Self-management components may be heterogeneous but show positive results in improving self-efficacy in prostate cancer survivors. Including self-management components in the rehabilitation of prostate survivors can improve their quality of life.
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Affiliation(s)
- Javier Martín-Núñez
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Spain.
| | | | | | | | | | - Araceli Ortiz-Rubio
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Spain.
| | - Marie Carmen Valenza
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Spain.
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8
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Lopez P, Newton RU, Taaffe DR, Singh F, Lyons-Wall P, Buffart LM, Tang C, Hayne D, Galvão DA. Interventions for Improving Body Composition in Men with Prostate Cancer: A Systematic Review and Network Meta-analysis. Med Sci Sports Exerc 2022; 54:728-740. [PMID: 34935706 DOI: 10.1249/mss.0000000000002843] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE To perform a systematic review and network meta-analysis to investigate the most effective intervention for improving body composition outcomes in prostate cancer patients during or after treatment. METHODS A systematic search was undertaken in multiple databases from inception to December 2020. Randomized clinical trials examining the effects of exercise/physical activity and/or nutrition interventions on body composition and body weight measures in prostate cancer patients were included. The primary endpoints were both whole-body and regional fat mass and lean mass measures, with body weight and BMI as secondary outcomes. A frequentist random-effects network meta-analysis was undertaken to examine the clustering effect of intervention modalities or control groups on the outcomes of interest. The study protocol is publicly available on PROSPERO (CRD42020202339). RESULTS Fifty articles describing 47 trials (n = 3207) were included. Resistance training and combined resistance and aerobic exercise were the most effective interventions to reduce body fat percentage (-0.9%; 95% confidence interval [CI], -1.4% to -0.3%) and fat mass (-0.5 kg; 95% CI, -0.9 to -0.1 kg), respectively. For whole-body and regional lean mass, combined resistance and aerobic exercise + healthy diet (0.6 kg; 95% CI, 0.1 to 1.0 kg) and resistance training alone (0.7 kg, 95% CI: 0.4 to 1.0 kg) were the best intervention, respectively. A low-fat diet was the most effective for reducing body weight immediately after or at follow-up, while no intervention promoted significant reductions in BMI. CONCLUSIONS These results indicate that a resistance-based exercise program alone or combined with a general healthy diet are the most effective interventions for improving overall body composition in men with prostate cancer.
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9
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Forster RB, Engeland A, Kvåle R, Hjellvik V, Bjørge T. Association between medical androgen deprivation therapy and long-term cardiovascular disease and all-cause mortality in non-metastatic prostate cancer. Int J Cancer 2022; 151:1109-1119. [PMID: 35489025 PMCID: PMC9544783 DOI: 10.1002/ijc.34058] [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: 01/19/2022] [Revised: 04/08/2022] [Accepted: 04/19/2022] [Indexed: 11/10/2022]
Abstract
Studies have suggested that prostate cancer (PCa) patients receiving androgen deprivation therapy (ADT) are at increased risk of developing or exacerbating cardiovascular disease (CVD). We aimed to explore the association between ADT for PCa and subsequent CVD and all‐cause mortality in this nationwide, longitudinal study. We also evaluated the role of cardiovascular risk and ADT duration to determine effect modification. Norwegian registry data were used to identify patients with PCa from 2008‐18 and who received primary ADT in the first year after diagnosis. The associations between ADT and composite cardiovascular events, and the individual components of myocardial infarction, stroke and heart failure, in addition to atrial fibrillation and all‐cause mortality, were explored using time‐varying Cox regression models. We included 30 923 PCa patients, of whom 8449 (27%) received primary ADT. Mean follow‐up was 2.9 and 3.8 years for CVD events and mortality, respectively. We found an association between ADT and composite CVD (adjusted HR 1.13: 95% CI 1.05‐1.21), myocardial infarction (1.18: 1.05‐1.32), stroke (1.21: 1.06‐1.38), heart failure (1.23: 1.13‐1.35) and all‐cause mortality (1.49: 1.39‐1.61). These associations persisted in those with low and moderate CVD risk and ADT longer than 7 months. A relationship between ADT and composite CVD and all‐cause mortality was observed, especially in those with moderate CVD risk and longer treatment duration. Future studies with more detailed cancer data are needed to verify the clinical relevance of these results, especially when considering all‐cause mortality within the context of treatment guidelines and benefits of ADT.
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Affiliation(s)
- R B Forster
- Department of Health Registry Research and Development, Norwegian Institute of Public Health, Bergen, Norway
| | - A Engeland
- Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway.,Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - R Kvåle
- Department of Health Registry Research and Development, Norwegian Institute of Public Health, Bergen, Norway.,Department of Oncology and Medical Physics, Haukeland University Hospital, Bergen, Norway
| | - V Hjellvik
- Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway
| | - T Bjørge
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Cancer Registry of Norway, Oslo, Norway
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Plausible conditions and mechanisms for increasing physical activity behavior in men with prostate cancer using patient education interventions: sequential explanatory mixed studies synthesis. Support Care Cancer 2022; 30:4617-4633. [PMID: 35064329 DOI: 10.1007/s00520-021-06693-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 11/10/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE This mixed studies synthesis sought to evaluate structured patient education interventions (PEIs) to elucidate relevant conditions and mechanisms for increasing physical activity behavior in men with prostate cancer (PCa). METHODS Studies that randomized men diagnosed with PCa, assessed PEIs, and reported (1) between-group changes in the outcome measures of exercise self-efficacy, PA level, or patient-centered outcomes (cancer-related fatigue, aerobic fitness, and quality of life) at baseline and post-intervention, and/or (2) men's perceptions of structured PEIs were synthesized. Results from five RCTs reporting data on 895 men and qualitative reports from four studies were respectively and sequentially analyzed with narrative and thematic syntheses. Findings from both syntheses were further integrated using the context-mechanism-outcome configuration (CMO) to elucidate potential "contextual factors" or "conditions" that may support plausible PEI mechanisms. RESULTS Structured PEIs were associated with a beneficial increase in task self-efficacy, vigorous-intensity PA, minutes/week of resistance exercise, the proportion of men meeting ≥ 150 minutes/week of moderate-vigorous intensity aerobic exercise, and overall PA. No effects were found on patient-centered outcomes. Drawing upon the CMO configuration, the inclusion of a referral process, access to "credible influence" (e.g., involving former patients as program facilitators), and adopting hybrid service delivery are likely critical conditions that may explain the success of PEIs in men with PCa. CONCLUSION PEIs can increase PA behavior in men with PCa. The likelihood of success is higher for multicomponent interventions that prioritized credible influence and exercise referral as critical components besides offering access to interventions within hospital settings, with home-based sessions in addition.
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Meyer-Schwickerath C, Morawietz C, Baumann FT, Huber G, Wiskemann J. Efficacy of face-to-face behavior change counseling interventions on physical activity behavior in cancer survivors - a systematic review and meta-analysis. Disabil Rehabil 2021; 44:5386-5401. [PMID: 34261403 DOI: 10.1080/09638288.2021.1938247] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE This systematic review and meta-analysis of randomized controlled trials determines the efficacy of face-to-face behavior change counseling (BCC) interventions on physical activity (PA) behavior in adult cancer survivors at least pre-and immediately post-intervention compared to usual care. Additionally, this review aims to answer the question which behavior change techniques (BCTs) are most effective. MATERIALS AND METHODS A structured search of the databases Medline, OTseeker, PEDro, the Cochrane Library, and article reference lists was conducted. All trials were critically appraised for methodological quality using the PEDro scale. The BCC interventions were coded using the BCT Taxonomy (v1). Random effect meta-analysis explored between group differences in PA behavior post intervention. Standardized mean differences (SMD) describe effect sizes. RESULTS Fourteen studies were included, 12 effect sizes within 11 trials were pooled in meta-analysis. The SMD between groups favored the intervention group with a small effect (SMD 0.22; 95% CI 0.11, 0.33; p < 0.0001). The BCTs "graded tasks", "self-monitoring of behavior", "action planning" and "habit reversal" were more frequently coded in more efficacious interventions. CONCLUSION BCC interventions are effective in increasing PA behavior in cancer survivors. Further research is needed providing details of fidelity assessment and structuring the intervention description by using a BCT taxonomy. Health care professionals should consider our results while awaiting further trial evaluation.Implications for RehabilitationFace-to-face behavior change counseling interventions can significantly increase physical activity behavior in cancer survivors.Although small differences are evident, included trials presented with a broad variety of study components, and characteristics, which limits the interpretation of effective components.The behavior change techniques "Graded tasks", "Action planning", "Habit reversal", and "Credible Source" were used in the trials with a positive effect, but not in the ineffective ones.
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Affiliation(s)
- Corinna Meyer-Schwickerath
- Institute of Sports and Sports Sciences, University of Heidelberg, Heidelberg, Germany.,Department of Medical Oncology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, Heidelberg, Germany
| | - Christina Morawietz
- Institute of Sports and Sports Sciences, University of Duisburg-Essen, Essen, Germany
| | - Freerk T Baumann
- Department of Internal Medicine, Center for Integrated Oncology Cologne Bonn, University Hospital of Cologne, Cologne, Germany
| | - Gerhard Huber
- Institute of Sports and Sports Sciences, University of Heidelberg, Heidelberg, Germany
| | - Joachim Wiskemann
- Department of Medical Oncology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, Heidelberg, Germany
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LeVasseur N, Cheng W, Mazzarello S, Clemons M, Vandermeer L, Jones L, Joy AA, Barbeau P, Wolfe D, Ahmadzai N, Hersi M, Stober C, Shorr R, Hilton J, Hutton B. Optimising weight-loss interventions in cancer patients-A systematic review and network meta-analysis. PLoS One 2021; 16:e0245794. [PMID: 33539414 PMCID: PMC7861370 DOI: 10.1371/journal.pone.0245794] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 01/07/2021] [Indexed: 12/15/2022] Open
Abstract
Background Excess weight has been associated with increased morbidity and a worse prognosis in adult patients with early-stage cancer. The optimal lifestyle interventions to optimize anthropometric measures amongst cancer patients and survivors remain inconsistent. Objective To conduct a systematic review and network meta-analysis (NMA) of randomized controlled trials (RCTs) comparing the effects of exercise and dietary interventions alone or in combination on anthropometric measures of adult cancer patients and survivors. Methods A systematic search of Medline, Embase and the Cochrane Trials Registry was performed. Outcomes of interest included changes in weight, body mass index (BMI), and waist circumference. Screening and data collection were performed by two reviewers. Bayesian NMAs were performed. Results Overall, 98 RCTs were included; 75 were incorporated in NMAs (n = 12,199). Groups of intervention strategies included: 3 exercise interventions, 8 dietary interventions, 7 combination interventions of diet and exercise and standard care. Median intervention duration was 26 weeks. NMA suggested that diet alone (mean difference [MD] -2.25kg, 95% CrI -3.43 to -0.91kg) and combination strategies (MD -2.52kg, 95% CrI -3.54 to -1.62kg) were associated with more weight loss compared to standard care. All dietary interventions achieved a similar magnitude of weight loss (MD range from -2.03kg to -2.52kg). Both diet alone and combination strategies demonstrated greater BMI reductions versus standard care, and each of diet alone, exercise alone and combination strategies demonstrated greater reductions in waist circumference than standard care. Conclusion Diet and exercise alone or in combination are effective lifestyle interventions to improve anthropometric measures in cancer patients and survivors. All reputable diets appear to be similarly effective to achieve weight loss.
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Affiliation(s)
- Nathalie LeVasseur
- Division of Medical Oncology, British Columbia Cancer Agency, Vancouver, Canada
| | - Wei Cheng
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Sasha Mazzarello
- Division of Medical Oncology, British Columbia Cancer Agency, Vancouver, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Mark Clemons
- Division of Medical Oncology, British Columbia Cancer Agency, Vancouver, Canada
- Ottawa Hospital Research Institute, Ottawa, Canada
| | - Lisa Vandermeer
- Division of Medical Oncology, British Columbia Cancer Agency, Vancouver, Canada
| | - Lee Jones
- Memorial Sloan Kettering Cancer Center, New York, New York, United States of America
- Weill Cornell Medical Center, New York, New York, United States of America
| | - Anil Abraham Joy
- Division of Medical Oncology, Department of Oncology, University of Alberta, Cross Cancer Institute, Edmonton, Canada
| | | | - Dianna Wolfe
- Ottawa Hospital Research Institute, Ottawa, Canada
| | | | - Mona Hersi
- Ottawa Hospital Research Institute, Ottawa, Canada
| | - Carol Stober
- Division of Medical Oncology, British Columbia Cancer Agency, Vancouver, Canada
| | | | - John Hilton
- Division of Medical Oncology, British Columbia Cancer Agency, Vancouver, Canada
- Ottawa Hospital Research Institute, Ottawa, Canada
| | - Brian Hutton
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
- University of Ottawa School of Epidemiology and Public Health, Ottawa, Canada
- * E-mail:
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Bouchard LC, Yanez B, Dahn JR, Flury SC, Perry KT, Mohr DC, Penedo FJ. Brief report of a tablet-delivered psychosocial intervention for men with advanced prostate cancer: Acceptability and efficacy by race. Transl Behav Med 2020; 9:629-637. [PMID: 30285186 DOI: 10.1093/tbm/iby089] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Relative to non-Hispanic whites (NHW), black men are disproportionately affected by prostate cancer (PC) incidence, have poorer PC outcomes, and report greater compromises in health-related quality of life. Despite these challenges, black men are underrepresented in psychosocial cancer research, possibly due to limited access to supportive oncology programs. The purpose of this article is to examine the acceptability and efficacy for reducing disease-specific distress of a tablet-delivered psychosocial intervention for older men with advanced PC (APC) and explore differences by race. Men with APC (N = 192, 37.5% black, age M = 68.84 years) were randomized to 10-week Cognitive Behavioral Stress Management (CBSM) or attention-control Health Promotion (HP), both delivered via tablets. Assessments occurred at baseline in person, weekly during the 10-week program via tablets, and at 6 and 12 months in person. Weekly session evaluations and postprogram exit surveys assessed acceptability. Efficacy was assessed with a measure of PC-anxiety validated with racially diverse PC patients using linear mixed effects modeling. Study retention and group attendance did not differ by race. CBSM and HP were both acceptable among older APC patients. Black men rated both conditions more favorably than NHW men. Men in CBSM (vs. HP) reported greater reductions in PC-anxiety at 6 months (not sustained at 12 months). Black men in CBSM reported greater decreases in PC-anxiety over time compared with all other groups. Tablet-delivered CBSM and HP were acceptable for black and NHW APC patients, although black men rated both conditions more favorably. Black men reported a unique intervention benefit related to reduced disease-specific distress.
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Affiliation(s)
- Laura C Bouchard
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Betina Yanez
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jason R Dahn
- Mental Health and Behavioral Sciences Service, Miami Veterans Affairs Healthcare System, Miami, FL, USA
| | - Sarah C Flury
- Department of Urology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Kent T Perry
- Department of Urology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - David C Mohr
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Frank J Penedo
- Departments of Psychology and Medicine, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA
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Kenk M, Grégoire JC, Coté MA, Connelly KA, Davis MK, Dresser G, Ghosh N, Goodman S, Johnson C, Fleshner N. Optimizing screening and management of cardiovascular health in prostate cancer: A review. Can Urol Assoc J 2020; 14:E458-E464. [PMID: 32569573 DOI: 10.5489/cuaj.6685] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
In clinical practice, cancer management does not consistently encompass screening and identification of cardiovascular (CV) risk. The use of androgen deprivation therapy (ADT) in prostate cancer has been associated with increased CV risk and development of metabolic syndrome, necessitating identification of patients at risk in this population (e.g., those with pre-existing CV disease). A multidisciplinary team of Canadian physicians was assembled to develop a series of recommendations intended to identify patients who may benefit from optimal management of their CV disease and/or modification of cardiac risk factors. A key goal was the development of a simple screening tool for identification of patients with pre-existing CV disease. This simple and inclusive set of recommendations are intended for use within urology clinics to facilitate holistic approaches and simplify the management of patients.
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Affiliation(s)
- Miran Kenk
- Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | | | - Marc-Andre Coté
- Centre hospitalier universitaire de Quebec, Québec City, QC, Canada
| | - Kim A Connelly
- St. Michael's Hospital Li Ka Shing Knowledge Institute, Toronto, ON, Canada
| | - Margot K Davis
- University of British Columbia Diamond Health Care Center, Vancouver, BC, Canada
| | - George Dresser
- Division of Clinical Pharmacology, Department of Medicine, Western University, London, ON, Canada
| | - Nina Ghosh
- Queensway Carleton Hospital, University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Shaun Goodman
- Division of Cardiology, St. Michael's Hospital, Toronto, ON, Canada
| | | | - Neil Fleshner
- Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
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15
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The effectiveness of lifestyle interventions to reduce side effects of androgen deprivation therapy for men with prostate cancer: a systematic review. Qual Life Res 2019; 29:843-865. [PMID: 31832978 PMCID: PMC7142057 DOI: 10.1007/s11136-019-02361-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2019] [Indexed: 12/18/2022]
Abstract
Purpose The aim of this review is to systematically review randomized controlled trials on lifestyle interventions on PCa patients undergoing androgen deprivation therapy. Methods A literature search was conducted using the electronic databases Medline and PubMed. To be eligible, studies had to be randomized controlled trials (RCTs) that focused on side effects of ADT and lifestyle interventions to reduce side effects for men undergoing ADT with PCa. Lifestyle interventions were defined as interventions that included any dietary or behavioral components. Results Twenty-nine trials were included. Most of them focused on exercise interventions, while some investigated the effect of dietary or behavioral interventions. The effect of different lifestyle influencing modalities aimed to improve on the adverse effects of ADT varied greatly. Conclusions It is not possible to draw one conclusion on the effect of exercise-based interventions, but noted on several adverse effects of ADT improvement. Further studies are necessary to develop personalized lifestyle interventions in order to mitigate the adverse effects.
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Fox L, Wiseman T, Cahill D, Beyer K, Peat N, Rammant E, Van Hemelrijck M. Barriers and facilitators to physical activity in men with prostate cancer: A qualitative and quantitative systematic review. Psychooncology 2019; 28:2270-2285. [DOI: 10.1002/pon.5240] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 09/13/2019] [Accepted: 09/15/2019] [Indexed: 12/19/2022]
Affiliation(s)
- Louis Fox
- Translational Oncology and Urology ResearchKing's College London London UK
| | - Theresa Wiseman
- Applied Health ResearchThe Royal Marsden NHS Foundation Trust London UK
- Health SciencesUniversity of Southampton Southampton UK
| | - Declan Cahill
- Urology SurgeryThe Royal Marsden NHS Foundation Trust London UK
| | - Katharina Beyer
- Translational Oncology and Urology ResearchKing's College London London UK
| | - Nicola Peat
- Cancer Exercise PhysiotherapyGuy's and St Thomas' NHS Foundation Trust London UK
| | - Elke Rammant
- Department of Radiation Oncology and Experimental Cancer ResearchUniversity Hospital Ghent Ghent Belgium
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Focht BC, Lucas AR, Grainger E, Simpson C, Fairman CM, Thomas-Ahner JM, Buell J, Monk JP, Mortazavi A, Clinton SK. Effects of a Group-Mediated Exercise and Dietary Intervention in the Treatment of Prostate Cancer Patients Undergoing Androgen Deprivation Therapy: Results From the IDEA-P Trial. Ann Behav Med 2019; 52:412-428. [PMID: 29684136 DOI: 10.1093/abm/kax002] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Background Although androgen-deprivation therapy (ADT) is the foundation of treatment for prostate cancer, the physiological impacts of ADT result in functional decline and enhanced risk of chronic disease and metabolic syndrome. Purpose The Individualized Diet and Exercise Adherence Pilot Trial (IDEA-P) is a single-blind, randomized, pilot trial comparing the effects of a group-mediated, cognitive-behavioral (GMCB) exercise and dietary intervention (EX+D) with those of a standard-of-care (SC) control during the treatment of prostate cancer patients undergoing ADT. Methods A total of 32 prostate cancer patients (M age = 66.28, SD = 7.79) undergoing ADT were randomly assigned to the 12-week EX+D intervention (n = 16) or control (n = 16). The primary outcome in IDEA-P was change in mobility performance with secondary outcomes including body composition and muscular strength. Blinded assessment of outcomes were obtained at baseline and at 2- and 3-month follow-ups. Results Favorable adherence and retention rates were observed, and no serious intervention-related adverse events were documented. Intent-to-treat ANCOVA controlling for baseline value and ADT duration demonstrated that EX+D resulted in significantly greater improvements in mobility performance (p < .02), muscular strength (p < .01), body fat percentage (p < .05), and fat mass (p < .03) at 3-month follow-up, relative to control. Conclusion Findings from the IDEA-P trial suggest that a GMCB-based EX+D intervention resulted in significant, clinically meaningful improvements in mobility performance, muscular strength, and body composition, relative to controls. Collectively, these results suggest that the EX+D was a safe and well-tolerated intervention for prostate cancer patients on ADT. The utility of implementing this approach in the treatment of prostate cancer patients on ADT should be evaluated in future large-scale efficacy trials. Clinical Trial information NCT02050906.
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Affiliation(s)
- Brian C Focht
- Exercise and Behavioral Medicine Laboratory, Kinesiology, The Ohio State University, Columbus, OH, USA
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
| | - Alexander R Lucas
- Exercise and Behavioral Medicine Laboratory, Kinesiology, The Ohio State University, Columbus, OH, USA
| | - Elizabeth Grainger
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
- Department of Internal Medicine, Division of Medical Oncology, The Ohio State University, Columbus, OH, USA
| | - Christina Simpson
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
- Department of Internal Medicine, Division of Medical Oncology, The Ohio State University, Columbus, OH, USA
| | - Ciaran M Fairman
- Exercise and Behavioral Medicine Laboratory, Kinesiology, The Ohio State University, Columbus, OH, USA
| | - Jennifer M Thomas-Ahner
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
- Department of Internal Medicine, Division of Medical Oncology, The Ohio State University, Columbus, OH, USA
| | - Jackie Buell
- Medical Dietetics, The Ohio State University, Columbus, OH, USA
| | - J Paul Monk
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
- Department of Internal Medicine, Division of Medical Oncology, The Ohio State University, Columbus, OH, USA
| | - Amir Mortazavi
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
- Department of Internal Medicine, Division of Medical Oncology, The Ohio State University, Columbus, OH, USA
| | - Steven K Clinton
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
- Department of Internal Medicine, Division of Medical Oncology, The Ohio State University, Columbus, OH, USA
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Stevens EM, Wetter DW, Vidrine DJ, Hoover DS, Frank-Pearce SG, Nguyen N, Li Y, Waters AJ, Meade CD, Wagener TL, Vidrine JI. Enhancing Smoking Risk Communications: The Influence of Need for Cognition. Am J Health Behav 2019; 43:950-962. [PMID: 31439101 PMCID: PMC7045173 DOI: 10.5993/ajhb.43.5.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objectives: One way to enhance the impact of smoking health risk messages may be to tailor their content to individual difference factors such as need for cognition (NFC). In this study, we examined how NFC influenced responses to different smoking risk messages. Outcomes included knowledge, risk perceptions, and behavioral expectations related to quitting smoking. Methods: We randomized 402 participants to one of 4 different risk message sets that were manipulated in terms of emotionality and framing in a 2x2 design: (1) factual gain-framed, (2) factual loss-framed, (3) emotional gain-framed, and (4) emotional loss-framed. Results: Statistically significant main effects emerged for NFC and emotionality. For certain risk perceptions, those with lower NFC reported greater perceived risk in response to emotional messages and lower risk in response to factual messages; those with higher NFC showed an opposite pattern. Similarly, those with lower NFC reported greater risk in response to gain-framed messages and lower risk in response to loss-framed messages; the opposite pattern emerged for those lower in NFC. Conclusions: Findings highlight the importance of an individual difference variable in influencing the impact of different types of smoking risk messages.
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Affiliation(s)
- Elise M Stevens
- Postdoctoral Research Fellow, Oklahoma Tobacco Research Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK; and ,
| | - David W Wetter
- Jon M. and Karen Huntsman Presidential Professor, and Director of the Center for Health Outcomes and Population Equity (HOPE), University of Utah and the Huntsman Cancer Institute, Salt Lake City, UT
| | - Damon J Vidrine
- Professor and Program Co-leader, Cancer Prevention and Control Program, Stephenson Cancer Center and the Director of Intervention Research for the Oklahoma Tobacco Research Center
| | - Diana Stewart Hoover
- Assistant Professor, Department of Health Disparities Research, MD Anderson Cancer Center, University of Texas, Houston, TX
| | - Summer G Frank-Pearce
- Assistant Professor of Research in Biostatistics, Department of Biostatistics and Epidemiology, College of Public Health, Oklahoma Tobacco Research Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Nga Nguyen
- Biostatistician, MD Anderson Cancer Center, The University of Texas, Houston, TX
| | - Yisheng Li
- Associate Professor, MD Anderson Cancer Center, The University of Texas, Houston, TX
| | - Andrew J Waters
- Professor, Medical and Clinical Psychology, Uniformed Services University, Bethesda, MD
| | - Cathy D Meade
- Professor, Moffitt Cancer Center, University of South Florida, Tampa, FL
| | - Theodore L Wagener
- Associate Professor and Director of Tobacco Regulatory Science Research, Oklahoma Tobacco Research Center at the Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Jennifer I Vidrine
- Professor and Associate Director for Cancer Prevention and Control and Director of the Oklahoma Tobacco Research Center, Stephenson Cancer Center, Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK
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Grimmett C, Corbett T, Brunet J, Shepherd J, Pinto BM, May CR, Foster C. Systematic review and meta-analysis of maintenance of physical activity behaviour change in cancer survivors. Int J Behav Nutr Phys Act 2019; 16:37. [PMID: 31029140 PMCID: PMC6486962 DOI: 10.1186/s12966-019-0787-4] [Citation(s) in RCA: 102] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 03/04/2019] [Indexed: 01/05/2023] Open
Abstract
Background Physical activity can improve health and wellbeing after cancer and may reduce cancer recurrence and mortality. To achieve such long-term benefits cancer survivors must be habitually active. This review evaluates the effectiveness of interventions in supporting maintenance of physical activity behaviour change among adults diagnosed with cancer and explores which intervention components and contextual features are associated with effectiveness. Methods Relevant randomised controlled trials (RCTs) were identified by a search of Ovid Medline, Ovid Embase and PsychINFO. Trials including adults diagnosed with cancer, assessed an intervention targeting physical activity and reported physical activity behaviour at baseline and ≥ 3 months post-intervention were included. The behaviour change technique (BCT) taxonomy was used to identify intervention components and the Template for Intervention Description and Replication to capture contextual features. Random effect meta-analysis explored between and within group differences in physical activity behaviour. Standardised mean differences (SMD) describe effect size. Results Twenty seven RCTs were included, 19 were pooled in meta-analyses. Interventions were effective at changing long-term behaviour; SMD in moderate to vigorous physical activity (MVPA) between groups 0.25; 95% CI = 0.16–0.35. Within-group pre-post intervention analysis yielded a mean increase of 27.48 (95% CI = 11.48-43.49) mins/wk. of MVPA in control groups and 65.30 (95% CI = 45.59–85.01) mins/wk. of MVPA in intervention groups. Ineffective interventions tended to include older populations with existing physical limitations, had fewer contacts with participants, were less likely to include a supervised element or the BCTs of ‘action planning’, ‘graded tasks’ and ‘social support (unspecified)’. Included studies were biased towards inclusion of younger, female, well-educated and white populations who were already engaging in some physical activity. Conclusions Existing interventions are effective in achieving modest increases in physical activity at least 3 months post-intervention completion. Small improvements were also evident in control groups suggesting low-intensity interventions may be sufficient in promoting small changes in behaviour that last beyond intervention completion. However, study samples are not representative of typical cancer populations. Interventions should consider a stepped-care approach, providing more intensive support for older people with physical limitations and others less likely to engage in these interventions. Electronic supplementary material The online version of this article (10.1186/s12966-019-0787-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Chloe Grimmett
- School of Health Sciences, University of Southampton, Southampton, UK.
| | - Teresa Corbett
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Jennifer Brunet
- Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Jonathan Shepherd
- Southampton Health Technology Assessments Centre, University of Southampton, Southampton, UK
| | | | - Carl R May
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Claire Foster
- School of Health Sciences, University of Southampton, Southampton, UK
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20
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Alibhai SMH, Santa Mina D, Ritvo P, Tomlinson G, Sabiston C, Krahn M, Durbano S, Matthew A, Warde P, O’Neill M, Timilshina N, Segal R, Culos-Reed N. A phase II randomized controlled trial of three exercise delivery methods in men with prostate cancer on androgen deprivation therapy. BMC Cancer 2019; 19:2. [PMID: 30606137 PMCID: PMC6318980 DOI: 10.1186/s12885-018-5189-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Accepted: 12/05/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Existing evidence demonstrates that 1:1 personal training (PT) improves many adverse effects of androgen deprivation therapy (ADT). Whether less resource-intensive exercise delivery models are as effective remains to be established. We determined the feasibility of conducting a multi-center non-inferiority randomized controlled trial comparing PT with supervised group (GROUP) and home-based (HOME) exercise programs, and obtained preliminary efficacy estimates for GROUP and HOME compared to PT on quality of life (QOL) and physical fitness. METHODS Men with prostate cancer on ADT were recruited from one of two experienced Canadian centres and randomized 1:1:1 to PT, GROUP, or HOME. Randomization was stratified by length of ADT use and site. Participants completed moderate intensity aerobic and resistance exercises 4-5 days per week for 6 months with a target 150 min per week of exercise. Exercise prescriptions were individualized and progressed throughout the trial. Feasibility endpoints included recruitment, retention, adherence, and participant satisfaction. The efficacy endpoints QOL, fatigue, and fitness (VO2 peak, grip strength, and timed chair stands) in GROUP and HOME were compared for non-inferiority to PT. Descriptive analyses were used for feasibility endpoints. Between-group differences for efficacy endpoints were examined using Bayesian linear mixed effects models. RESULTS Fifty-nine participants (mean age 69.9 years) were enrolled. The recruitment rate was 25.4% and recruitment was slower than projected. Retention was 71.2%. Exercise adherence as measured through attendance was high for supervised sessions but under 50% by self-report and accelerometry. Satisfaction was high and there was no difference in this measure between all three groups. Between-group differences (comparing both GROUP and HOME to PT) were smaller than the minimum clinically important difference on most measures of QOL, fatigue, and fitness. However, two of six outcomes for GROUP and four of six outcomes for HOME had a > 20% probability of being inferior for GROUP. CONCLUSIONS Feasibility endpoints were generally met. Both GROUP and HOME interventions in men with PC on ADT appeared to be similar to PT for multiple efficacy outcomes, although conclusions are limited by a small sample size and cost considerations have not been incorporated. Efforts need to be targeted to improving recruitment and adherence. A larger trial is warranted. TRIAL REGISTRATION ClinicalTrials.gov: NCT02046837 . Date of registration: January 20, 2014.
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Affiliation(s)
- Shabbir M. H. Alibhai
- University Health Network, University of Toronto, Toronto, ON M5G 2C4 Canada
- Toronto General Hospital, 200 Elizabeth St Room EN14-214, Toronto, Ontario M5G 2C4 Canada
| | - Daniel Santa Mina
- University Health Network, University of Toronto, Toronto, ON M5G 2C4 Canada
- Cancer Care Ontario, York University, Toronto, ON M3J 1P3 Canada
| | - Paul Ritvo
- Cancer Care Ontario, York University, Toronto, ON M3J 1P3 Canada
| | - George Tomlinson
- University Health Network, University of Toronto, Toronto, ON M5G 2C4 Canada
- Cancer Care Ontario, York University, Toronto, ON M3J 1P3 Canada
| | | | - Murray Krahn
- University Health Network, University of Toronto, Toronto, ON M5G 2C4 Canada
- Cancer Care Ontario, York University, Toronto, ON M3J 1P3 Canada
| | - Sara Durbano
- University Health Network, University of Toronto, Toronto, ON M5G 2C4 Canada
| | - Andrew Matthew
- University Health Network, University of Toronto, Toronto, ON M5G 2C4 Canada
| | - Padraig Warde
- University Health Network, University of Toronto, Toronto, ON M5G 2C4 Canada
- Cancer Care Ontario, York University, Toronto, ON M3J 1P3 Canada
- University of Toronto, Toronto, ON M5S 2J7 Canada
| | - Meagan O’Neill
- University Health Network, University of Toronto, Toronto, ON M5G 2C4 Canada
| | - Narhari Timilshina
- University Health Network, University of Toronto, Toronto, ON M5G 2C4 Canada
| | - Roanne Segal
- The Ottawa Hospital Cancer Centre, University of Ottawa, Ottawa, ON K1N 6N5 Canada
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Myrhaug HT, Mbalilaki JA, Lie NEK, Hansen T, Nordvik JE. The effects of multidisciplinary psychosocial interventions on adult cancer patients: a systematic review and meta-analysis. Disabil Rehabil 2018; 42:1062-1070. [DOI: 10.1080/09638288.2018.1515265] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
| | - Julia Aneth Mbalilaki
- Regional Knowledge Translation Center, Southern-Eastern Norway Regional Health Authority, Sunnaas Rehabilitation Hospital, Oslo, Norway
| | | | - Tone Hansen
- The Norwegian Leukemia Association, Oslo, Norway
| | - Jan Egil Nordvik
- Regional Knowledge Translation Center, Southern-Eastern Norway Regional Health Authority, Sunnaas Rehabilitation Hospital, Oslo, Norway
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Finne E, Glausch M, Exner AK, Sauzet O, Stölzel F, Seidel N. Behavior change techniques for increasing physical activity in cancer survivors: a systematic review and meta-analysis of randomized controlled trials. Cancer Manag Res 2018; 10:5125-5143. [PMID: 30464612 PMCID: PMC6215922 DOI: 10.2147/cmar.s170064] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Purpose The purpose of this systematic review and meta-analysis is to investigate how physical activity (PA) can be effectively promoted in cancer survivors. The effect of PA-promoting interventions in general, behavior change techniques (BCTs), and further variables as moderators in particular are evaluated. Methods This study included randomized controlled trials of lifestyle interventions aiming at an increase in PA that can be carried out independently at home, published by December 2016, for adults diagnosed with cancer after completion of the main treatment. Primary outcomes were subjective and objective measures of PA prior to and immediately after the intervention. Meta-analysis and meta-regression were used to estimate effect sizes (ES) in terms of standardized mean differences, variation between ES in terms of heterogeneity indices (I2), and moderator effects in terms of regression coefficients. Results This study included 30 studies containing 45 ES with an overall significant small positive effect size of 0.28 (95% confidence interval=0.18–0.37) on PA, and I2=54.29%. The BCTs Prompts, Reduce prompts, Graded tasks, Non-specific reward, and Social reward were significantly related to larger effects, while Information about health consequences and Information about emotional consequences, as well as Social comparison were related to smaller ES. The number of BCTs per intervention did not predict PA effects. Interventions based on the Theory of Planned Behavior were associated with smaller ES, and interventions with a home-based setting component were associated with larger ES. Neither the duration of the intervention nor the methodological quality explained differences in ES. Conclusion Certain BCTs were associated with an increase of PA in cancer survivors. Interventions relying on BCTs congruent with (social) learning theory such as using prompts and rewards could be especially successful in this target group. However, large parts of between-study heterogeneity in ES remained unexplained. Further primary studies should directly compare specific BCTs and their combinations.
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Affiliation(s)
- Emily Finne
- School of Public Health, Bielefeld University, Bielefeld, Germany,
| | - Melanie Glausch
- University Cancer Center, University Hospital Carl Gustav Carus, Dresden University of Technology, Dresden, Germany
| | | | - Odile Sauzet
- School of Public Health, Bielefeld University, Bielefeld, Germany, .,Center for Statistics (ZeSt), Bielefeld University, Bielefeld, Germany
| | - Friederike Stölzel
- University Cancer Center, University Hospital Carl Gustav Carus, Dresden University of Technology, Dresden, Germany
| | - Nadja Seidel
- University Cancer Center, University Hospital Carl Gustav Carus, Dresden University of Technology, Dresden, Germany
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Alibhai SMH, Ritvo P, Santa Mina D, Sabiston C, Krahn M, Tomlinson G, Matthew A, Lukka H, Warde P, Durbano S, O’Neill M, Culos-Reed SN. Protocol for a phase III RCT and economic analysis of two exercise delivery methods in men with PC on ADT. BMC Cancer 2018; 18:1031. [PMID: 30352568 PMCID: PMC6199786 DOI: 10.1186/s12885-018-4937-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 10/10/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Androgen deprivation therapy (ADT) is commonly used to treat prostate cancer. However, side effects of ADT often lead to reduced quality of life and physical function. Existing evidence demonstrates that exercise can ameliorate multiple treatment-related side effects for men on ADT, yet adherence rates are often low. The method of exercise delivery (e.g., supervised group in-centre vs. individual home-based) may be important from clinical and economic perspectives; however, few studies have compared different delivery models. Additionally, long-term exercise adherence and an understanding of predictors of adherence are critical to achieving sustained benefits, but such data are lacking. The primary aim of this multi-centre phase III non-inferiority randomized controlled trial is to determine whether a home-based delivery model is non-inferior to a group-based delivery model in terms of benefits in fatigue and fitness in this population. Two other key aims include examining cost-effectiveness and long-term adherence. METHODS Men diagnosed with prostate cancer of any stage, starting or continuing on ADT for at least 6 months, fluent in English, and living close to a study centre are eligible. Participants complete five assessments over 12 months (baseline and every 3 months during the 6-month intervention and 6-month follow-up phases), including a fitness assessment and self-report questionnaires. Biological outcomes are collected at baseline, 6, and 12 months. A total of 200 participants will be randomized in a 1:1 fashion to supervised group training or home-based training supported by smartphones, health coaches, and Fitbit technology. Participants are asked to complete 4 to 5 exercise sessions per week, incorporating aerobic, resistance and flexibility training. Outcomes include fatigue, quality of life, fitness measures, body composition, biological outcomes, and program adherence. Cost information will be obtained using patient diary-based self-report and utilities via the EQ-5D. DISCUSSION To disseminate publicly funded exercise programs widely, clinical efficacy and cost-effectiveness have to be demonstrated. The goals of this trial are to provide these data along with an increased understanding of adherence to exercise among men with prostate cancer receiving ADT. TRIAL REGISTRATION The trial has been registered at clinicaltrials.gov (Registration # NCT02834416 ). Registration date was June 2, 2016.
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Affiliation(s)
- Shabbir M. H. Alibhai
- University Health Network, Toronto, ON M5G 2C4 Canada
- University of Toronto, Toronto, ON M5S 2J7 Canada
- Toronto General Hospital, 200 Elizabeth St Room EN14-214, Toronto, ON M5G 2C4 Canada
| | - Paul Ritvo
- Cancer Care Ontario, Toronto, ON M5G 2L3 Canada
| | - Daniel Santa Mina
- University Health Network, Toronto, ON M5G 2C4 Canada
- University of Toronto, Toronto, ON M5S 2J7 Canada
| | | | - Murray Krahn
- University Health Network, Toronto, ON M5G 2C4 Canada
- University of Toronto, Toronto, ON M5S 2J7 Canada
| | - George Tomlinson
- University Health Network, Toronto, ON M5G 2C4 Canada
- University of Toronto, Toronto, ON M5S 2J7 Canada
| | | | - Himu Lukka
- The Juravinski Cancer Centre, Hamilton, ON L8V 5C2 Canada
| | - Padraig Warde
- University Health Network, Toronto, ON M5G 2C4 Canada
- University of Toronto, Toronto, ON M5S 2J7 Canada
- Cancer Care Ontario, Toronto, ON M5G 2L3 Canada
| | - Sara Durbano
- University Health Network, Toronto, ON M5G 2C4 Canada
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Turner RR, Steed L, Quirk H, Greasley RU, Saxton JM, Taylor SJC, Rosario DJ, Thaha MA, Bourke L. Interventions for promoting habitual exercise in people living with and beyond cancer. Cochrane Database Syst Rev 2018; 9:CD010192. [PMID: 30229557 PMCID: PMC6513653 DOI: 10.1002/14651858.cd010192.pub3] [Citation(s) in RCA: 102] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND This is an updated version of the original Cochrane Review published in the Cochrane Library 2013, Issue 9. Despite good evidence for the health benefits of regular exercise for people living with or beyond cancer, understanding how to promote sustainable exercise behaviour change in sedentary cancer survivors, particularly over the long term, is not as well understood. A large majority of people living with or recovering from cancer do not meet current exercise recommendations. Hence, reviewing the evidence on how to promote and sustain exercise behaviour is important for understanding the most effective strategies to ensure benefit in the patient population and identify research gaps. OBJECTIVES To assess the effects of interventions designed to promote exercise behaviour in sedentary people living with and beyond cancer and to address the following secondary questions: Which interventions are most effective in improving aerobic fitness and skeletal muscle strength and endurance? Which interventions are most effective in improving exercise behaviour amongst patients with different cancers? Which interventions are most likely to promote long-term (12 months or longer) exercise behaviour? What frequency of contact with exercise professionals and/or healthcare professionals is associated with increased exercise behaviour? What theoretical basis is most often associated with better behavioural outcomes? What behaviour change techniques (BCTs) are most often associated with increased exercise behaviour? What adverse effects are attributed to different exercise interventions? SEARCH METHODS We used standard methodological procedures expected by Cochrane. We updated our 2013 Cochrane systematic review by updating the searches of the following electronic databases: Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE, Embase, AMED, CINAHL, PsycLIT/PsycINFO, SportDiscus and PEDro up to May 2018. We also searched the grey literature, trial registries, wrote to leading experts in the field and searched reference lists of included studies and other related recent systematic reviews. SELECTION CRITERIA We included only randomised controlled trials (RCTs) that compared an exercise intervention with usual care or 'waiting list' control in sedentary people over the age of 18 with a homogenous primary cancer diagnosis. DATA COLLECTION AND ANALYSIS In the update, review authors independently screened all titles and abstracts to identify studies that might meet the inclusion criteria, or that could not be safely excluded without assessment of the full text (e.g. when no abstract is available). We extracted data from all eligible papers with at least two members of the author team working independently (RT, LS and RG). We coded BCTs according to the CALO-RE taxonomy. Risk of bias was assessed using the Cochrane's tool for assessing risk of bias. When possible, and if appropriate, we performed a fixed-effect meta-analysis of study outcomes. If statistical heterogeneity was noted, a meta-analysis was performed using a random-effects model. For continuous outcomes (e.g. cardiorespiratory fitness), we extracted the final value, the standard deviation (SD) of the outcome of interest and the number of participants assessed at follow-up in each treatment arm, to estimate the standardised mean difference (SMD) between treatment arms. SMD was used, as investigators used heterogeneous methods to assess individual outcomes. If a meta-analysis was not possible or was not appropriate, we narratively synthesised studies. The quality of the evidence was assessed using the GRADE approach with the GRADE profiler. MAIN RESULTS We included 23 studies in this review, involving a total of 1372 participants (an addition of 10 studies, 724 participants from the original review); 227 full texts were screened in the update and 377 full texts were screened in the original review leaving 35 publications from a total of 23 unique studies included in the review. We planned to include all cancers, but only studies involving breast, prostate, colorectal and lung cancer met the inclusion criteria. Thirteen studies incorporated a target level of exercise that could meet current recommendations for moderate-intensity aerobic exercise (i.e.150 minutes per week); or resistance exercise (i.e. strength training exercises at least two days per week).Adherence to exercise interventions, which is crucial for understanding treatment dose, is still reported inconsistently. Eight studies reported intervention adherence of 75% or greater to an exercise prescription that met current guidelines. These studies all included a component of supervision: in our analysis of BCTs we designated these studies as 'Tier 1 trials'. Six studies reported intervention adherence of 75% or greater to an aerobic exercise goal that was less than the current guideline recommendations: in our analysis of BCTs we designated these studies as 'Tier 2 trials.' A hierarchy of BCTs was developed for Tier 1 and Tier 2 trials, with programme goal setting, setting of graded tasks and instruction of how to perform behaviour being amongst the most frequent BCTs. Despite the uncertainty surrounding adherence in some of the included studies, interventions resulted in improvements in aerobic exercise tolerance at eight to 12 weeks (SMD 0.54, 95% CI 0.37 to 0.70; 604 participants, 10 studies; low-quality evidence) versus usual care. At six months, aerobic exercise tolerance was also improved (SMD 0.56, 95% CI 0.39 to 0.72; 591 participants; 7 studies; low-quality evidence). AUTHORS' CONCLUSIONS Since the last version of this review, none of the new relevant studies have provided additional information to change the conclusions. We have found some improved understanding of how to encourage previously inactive cancer survivors to achieve international physical activity guidelines. Goal setting, setting of graded tasks and instruction of how to perform behaviour, feature in interventions that meet recommendations targets and report adherence of 75% or more. However, long-term follow-up data are still limited, and the majority of studies are in white women with breast cancer. There are still a considerable number of published studies with numerous and varied issues related to high risk of bias and poor reporting standards. Additionally, the meta-analyses were often graded as consisting of low- to very low-certainty evidence. A very small number of serious adverse effects were reported amongst the studies, providing reassurance exercise is safe for this population.
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Affiliation(s)
- Rebecca R Turner
- Sheffield Hallam UniversityCentre for Sport and Exercise ScienceA124 Collegiate Hall, Collegiate CrescentSheffieldSouth YorkshireUKS10 2BP
| | - Liz Steed
- Barts and The London School of Medicine and Dentistry, Queen Mary University of LondonCentre for Primary Care and Public HealthBlizard Institute, Yvonne Carter Building58 Turner StreetLondonUKE1 2AT
| | - Helen Quirk
- Sheffield Hallam UniversityCentre for Sport and Exercise ScienceA124 Collegiate Hall, Collegiate CrescentSheffieldSouth YorkshireUKS10 2BP
| | - Rosa U Greasley
- Sheffield Hallam UniversityCentre for Sport and Exercise ScienceA124 Collegiate Hall, Collegiate CrescentSheffieldSouth YorkshireUKS10 2BP
| | - John M Saxton
- Northumbria UniversityDepartment of Sport, Exercise, and RehabilitationNewcastle‐upon‐TyneUKNE1 8ST
| | - Stephanie JC Taylor
- Barts and The London School of Medicine and Dentistry, Queen Mary University of LondonCentre for Primary Care and Public Health and Asthma UK Centre for Applied ResearchYvonne Carter Building58 Turner StreetLondonUKE1 2AB
| | - Derek J Rosario
- University of SheffieldDepartment of OncologyBeech Hill RoadRoyal Hallamshire HospitalSheffieldUKS010 2RX
| | - Mohamed A Thaha
- Barts & The London School of Medicine & Dentistry, Queen Mary University LondonAcademic Surgical Unit, National Centre for Bowel Research & Surgical Innovation, Centre for Digestive Diseases, Blizard Institute1st Floor, Abernethy Building, 2 Newark StreetThe Royal London Hospital, WhitechapelLondonEnglandUKE1 2AT
| | - Liam Bourke
- Sheffield Hallam UniversityHealth and Wellbeing Research InstituteSheffieldUKS10 2BP
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Finlay A, Wittert G, Short CE. A systematic review of physical activity-based behaviour change interventions reaching men with prostate cancer. J Cancer Surviv 2018; 12:571-591. [PMID: 29770953 DOI: 10.1007/s11764-018-0694-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 05/07/2018] [Indexed: 01/07/2023]
Abstract
PURPOSE Men who are survivors of prostate cancer report a variety of psychological and physical factors contributing to a lower quality of life, and physical activity can assist to mitigate these issues. This review aims to provide a summary of physical activity behaviour change trials targeting prostate cancer survivors, assess the feasibility of these interventions and, if possible, identify intervention and study characteristics associated with significant intervention effects. METHOD Four databases (PubMed, CINAHL, PsycINFO and EMBASE) were systematically searched for randomised controlled trials containing at least one behavioural outcome relating to physical activity published up until July 2016. Forward and backwards, hand, key author citation searching and known research were also considered. RESULTS From a total of 13, 828 titles, the search resulted in 12 studies (6 prostate cancer only and 6 mixed cancer interventions), eight of which found positive results most often related immediately to post-intervention aerobic activity. Factors relating to efficacy were not conclusive due to the heterogeneity of studies and lack of cancer-specific data in mixed cancer trials. Future research focusing on intervention reach, maintenance of intervention effects and resistance training outcomes is needed. CONCLUSION There is preliminary evidence to suggest that a variety of physical activity behaviour change interventions targeting men with a history of prostate cancer can be efficacious, at least in the short term. Experimental studies are required to identify key intervention features. IMPLICATIONS FOR CANCER SURVIVORS Physical activity interventions can assist prostate cancer survivors in relation to short-term lifestyle change, though more evidence is required to improve the clarity of factors related to efficacy.
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Affiliation(s)
- A Finlay
- The Freemasons Foundation Centre for Men's Health, School of Medicine, Level 7, South Australian Health and Medical Research Institute, University of Adelaide, Post Box 11060, Adelaide, 5001, SA, Australia.
| | - G Wittert
- The Freemasons Foundation Centre for Men's Health, School of Medicine, Level 7, South Australian Health and Medical Research Institute, University of Adelaide, Post Box 11060, Adelaide, 5001, SA, Australia
| | - C E Short
- The Freemasons Foundation Centre for Men's Health, School of Medicine, Level 7, South Australian Health and Medical Research Institute, University of Adelaide, Post Box 11060, Adelaide, 5001, SA, Australia
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26
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Hallward L, Patel N, Duncan LR. Behaviour change techniques in physical activity interventions for men with prostate cancer: A systematic review. J Health Psychol 2018; 25:105-122. [PMID: 29446325 DOI: 10.1177/1359105318756501] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Physical activity interventions can improve prostate cancer survivors' health. Determining the behaviour change techniques used in physical activity interventions can help elucidate the mechanisms by which an intervention successfully changes behaviour. The purpose of this systematic review was to identify and evaluate behaviour change techniques in physical activity interventions for prostate cancer survivors. A total of 7 databases were searched and 15 studies were retained. The studies included a mean 6.87 behaviour change techniques (range = 3-10), and similar behaviour change techniques were implemented in all studies. Consideration of how behaviour change techniques are implemented may help identify how behaviour change techniques enhance physical activity interventions for prostate cancer survivors.
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27
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Yan AF, Wang Y, Ng AV. Physical activity and annual medical outlay in U.S. colorectal, breast and prostate cancer survivors. Prev Med Rep 2018. [PMID: 29527464 PMCID: PMC5840848 DOI: 10.1016/j.pmedr.2018.01.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Multiple chronic conditions in cancer survivors are highly prevalent and may increase health care costs for both patients and the health care system. Studies of cancer survivors reveal positive effects of physical activity (PA) on reducing risk of cancer recurrence, other chronic conditions, and secondary cancer. Few nationally representative studies have examined how physical activity levels have affected survivors' annual economic burden in the United States. Leisure-time physical activity data from the National Health Interview Survey was linked to health care expenditure data from the Medical Expenditure Panel Survey data (2008–2012). We calculated per-person annual total medical expenditures for identified colorectal, breast, and prostate cancer survivors. We conducted multivariable analyses controlled for survival years and other sociodemographic variables. Generalized linear models were performed to measure correlation between medical expenditure and PA level using STATA 14. All analyses considered the complex survey design and were conducted in 2017. Of 1015 cancer survivors sampled, 30% (n = 305) adhered to physical activity recommendation, while the other 70% (n = 710) did not. Multivariable-adjusted expenditure in adherence group was $9108.8 (95% CI 7410.9–10,806.7) versus 12,899.1 (95% CI 11,450.2–14,348) in non-adherence group. Stratified analyses revealed cancer survivors who adhered to their PA recommendation saved $4686.1 (1–5 years' survival time) and $2874.5 (11 or more years' survival time) on average for total health care expenditure, respectively. Analyses of the national representative sample revealed that the economic burden of survivors from the three most prevalent cancers is substantial. Increasing survivor's PA to guidelines may reduce U.S. health care expenditure. Multiple chronic conditions are common among cancer survivors. The economic burden of survivors from the three prevalent cancers is substantial. Increasing survivor's PA to guidelines may reduce U.S. health care expenditure.
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Affiliation(s)
- Alice F Yan
- Community and Behavioral Health Promotion, Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, 53205, USA
| | - Yang Wang
- Public Health Policy and Administration, Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, 53205, USA
| | - Alexander V Ng
- Exercise Science Program, College of Health Sciences, Marquette University, Milwaukee, WI 53233, USA
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28
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Rosario DJ, Greasley R, Bourke L. Castration-resistant Prostate Cancer: Preservation of Quality of Life and Well-being. Eur Urol Focus 2017; 2:472-475. [PMID: 28723509 DOI: 10.1016/j.euf.2016.08.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 08/30/2016] [Indexed: 12/21/2022]
Abstract
Managing optimal health in castrate-resistant prostate cancer is a complex clinical challenge. Quality of life should be assessed with disease-specific validated tools and can be used in clinical practice to assist in considering management options.
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Affiliation(s)
- Derek J Rosario
- Department of Oncology, University of Sheffield, Sheffield, UK
| | - Rosa Greasley
- Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield, UK
| | - Liam Bourke
- Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield, UK.
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29
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Chambers SK, Hyde MK, Smith DP, Hughes S, Yuill S, Egger S, O'Connell DL, Stein K, Frydenberg M, Wittert G, Dunn J. New Challenges in Psycho-Oncology Research III: A systematic review of psychological interventions for prostate cancer survivors and their partners: clinical and research implications. Psychooncology 2017; 26:873-913. [PMID: 28691760 PMCID: PMC5535006 DOI: 10.1002/pon.4431] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 03/19/2017] [Accepted: 03/20/2017] [Indexed: 01/07/2023]
Affiliation(s)
- Suzanne K Chambers
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.,Cancer Research Centre, Cancer Council Queensland, Brisbane, Queensland, Australia.,Prostate Cancer Foundation of Australia, Sydney, New South Wales, Australia.,Health & Wellness Institute, Edith Cowan University, Perth, Australia.,Institute for Resilient Regions, University of Southern Queensland, Toowoomba, Queensland, Australia.,Australian and New Zealand Urogenital and Prostate Cancer Trials Group, Sydney, New South Wales, Australia
| | - Melissa K Hyde
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.,Cancer Research Centre, Cancer Council Queensland, Brisbane, Queensland, Australia
| | - David P Smith
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.,Australian and New Zealand Urogenital and Prostate Cancer Trials Group, Sydney, New South Wales, Australia.,Cancer Research Division, Cancer Council NSW, Sydney, New South Wales, Australia.,Sydney Medical School-Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Suzanne Hughes
- Cancer Research Division, Cancer Council NSW, Sydney, New South Wales, Australia
| | - Susan Yuill
- Cancer Research Division, Cancer Council NSW, Sydney, New South Wales, Australia
| | - Sam Egger
- Cancer Research Division, Cancer Council NSW, Sydney, New South Wales, Australia
| | - Dianne L O'Connell
- Cancer Research Division, Cancer Council NSW, Sydney, New South Wales, Australia.,Sydney Medical School-Public Health, University of Sydney, Sydney, New South Wales, Australia.,School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - Kevin Stein
- Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Mark Frydenberg
- Australian and New Zealand Urogenital and Prostate Cancer Trials Group, Sydney, New South Wales, Australia.,Department of Urology, Monash Health, Melbourne, Victoria, Australia.,Department of Surgery, Faculty of Medicine, Monash University, Melbourne, Victoria, Australia
| | - Gary Wittert
- Freemasons Foundation Centre for Men's Health, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
| | - Jeff Dunn
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.,Cancer Research Centre, Cancer Council Queensland, Brisbane, Queensland, Australia.,Institute for Resilient Regions, University of Southern Queensland, Toowoomba, Queensland, Australia
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30
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Williams F, Imm KR, Colditz GA, Housten AJ, Yang L, Gilbert KL, Drake BF. Physician role in physical activity for African-American males undergoing radical prostatectomy for prostate cancer. Support Care Cancer 2016; 25:1151-1158. [PMID: 27999951 PMCID: PMC5321695 DOI: 10.1007/s00520-016-3505-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 11/21/2016] [Indexed: 12/31/2022]
Abstract
Purpose Physical activity is recognized as a complementary therapy to improve physical and physiological functions among prostate cancer survivors. Little is known about communication between health providers and African-American prostate cancer patients, a high risk population, regarding the health benefits of regular physical activity on their prognosis and recovery. This study explores African-American prostate cancer survivors’ experiences with physical activity prescription from their physicians. Methods Three focus group interviews were conducted with 12 African-American prostate cancer survivors in May 2014 in St. Louis, MO. Participants’ ages ranged from 49 to 79 years, had completed radical prostatectomy, and their time out of surgery varied from 7 to 31 months. Results Emerged themes included physician role on prescribing physical activity, patients’ perceived barriers to engaging in physical activity, perception of normalcy following surgery, and specific resources survivors’ sought during treatment. Of the 12 men who participated, 8 men (67%) expressed that their physicians did not recommend physical activity for them. Although some participants revealed they were aware of the importance of sustained physical activity on their prognosis and recovery, some expressed concerns that urinary dysfunction, incontinence, and family commitments prevented them from engaging in active lifestyles. Conclusions Transitioning from post radical prostatectomy treatment to normal life was an important concern to survivors. These findings highlight the importance of physical activity communication and prescription for prostate cancer patients. Electronic supplementary material The online version of this article (doi:10.1007/s00520-016-3505-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Faustine Williams
- Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, P O Box 70264, Johnson City, TN, 37614, USA.
| | - Kellie R Imm
- Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis School of Medicine, 660 South Euclid Avenue, Campus Box 8100, St. Louis, MO, 63110, USA
| | - Graham A Colditz
- Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis School of Medicine, 660 South Euclid Avenue, Campus Box 8100, St. Louis, MO, 63110, USA
- Alvin J. Siteman Cancer Center, St. Louis, MO, USA
| | - Ashley J Housten
- Division of Cancer Prevention and Population Sciences, Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lin Yang
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1st Floor, 1090, Vienna, Austria
| | - Keon L Gilbert
- Department of Behavioral Science and Health Education, Saint Louis University, St. Louis, MO, USA
| | - Bettina F Drake
- Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis School of Medicine, 660 South Euclid Avenue, Campus Box 8100, St. Louis, MO, 63110, USA
- Alvin J. Siteman Cancer Center, St. Louis, MO, USA
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31
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Menichetti J, Villa S, Magnani T, Avuzzi B, Bosetti D, Marenghi C, Morlino S, Rancati T, Van Poppel H, Salvioni R, Valdagni R, Bellardita L. Lifestyle interventions to improve the quality of life of men with prostate cancer: A systematic review of randomized controlled trials. Crit Rev Oncol Hematol 2016; 108:13-22. [PMID: 27931831 DOI: 10.1016/j.critrevonc.2016.10.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 09/05/2016] [Accepted: 10/18/2016] [Indexed: 11/24/2022] Open
Abstract
Improving quality of life is a key issue for patients with prostate cancer (PCa). Lifestyle interventions could positively impact the quality of life of patients. However, there is no clear-cut understanding of the role of diet, exercise and risky behaviour reduction in improving the quality of life of men with PCa. The aim of this review was to systematically summarize randomized controlled trials on lifestyle in PCa patients with quality of life as main outcome. 17 trials were included. Most of them referred to exercise interventions (71%) and involved men undergoing androgen deprivation therapy (47%). Exercise studies yielded the greater amount of positive results on quality of life outcomes (67%), followed by dietary interventions (50%) and combined lifestyle interventions (33%). In particular, supervised exercise programs with resistance training sessions were the ones producing greater convincing evidence for benefits on quality of life. Further studies with high methodological quality providing adequate information to develop evidence-based, personalized lifestyle interventions that can effectively ameliorate PCa-related quality of life are needed.
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Affiliation(s)
- Julia Menichetti
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milan, Italy; Dept. of Psychology, Università Cattolica, Largo Gemelli 1, 20123 Milan, Italy.
| | - Silvia Villa
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milan, Italy
| | - Tiziana Magnani
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milan, Italy
| | - Barbara Avuzzi
- Dept. of Radiation Oncology 1, Fondazione IRCCS Istituto nazionale dei Tumori, Via Venezian 1, 20133 Milan, Italy
| | - Davide Bosetti
- Dept. of Radiation Oncology 1, Fondazione IRCCS Istituto nazionale dei Tumori, Via Venezian 1, 20133 Milan, Italy
| | - Cristina Marenghi
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milan, Italy
| | - Sara Morlino
- Dept. of Radiation Oncology 1, Fondazione IRCCS Istituto nazionale dei Tumori, Via Venezian 1, 20133 Milan, Italy
| | - Tiziana Rancati
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milan, Italy
| | - Hein Van Poppel
- University Hospitals Leuven, Department of Urology, Leuven, Belgium
| | - Roberto Salvioni
- Dept. of Radiation Oncology 1, Fondazione IRCCS Istituto nazionale dei Tumori, Via Venezian 1, 20133 Milan, Italy
| | - Riccardo Valdagni
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milan, Italy; Dept. of Radiation Oncology 1, Fondazione IRCCS Istituto nazionale dei Tumori, Via Venezian 1, 20133 Milan, Italy; Department of Oncology and Hemato-Oncology, Università di Milano, Via Festa del Perdono 7, 20122, Milan, Italy
| | - Lara Bellardita
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133 Milan, Italy
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Queen M, Karatzaferi C, Bloxham SR, Panwar U, Drew P, Barton AG, Edwards AM, Sakkas GK. How Can Physical Activity Referral Rates for Breast Cancer Patients be Increased? Front Oncol 2016; 6:198. [PMID: 27672620 PMCID: PMC5018693 DOI: 10.3389/fonc.2016.00198] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 08/22/2016] [Indexed: 11/13/2022] Open
Affiliation(s)
- Martyn Queen
- Faculty of Sport and Health Sciences, University of St Mark and St John , Plymouth , UK
| | - Christina Karatzaferi
- Faculty of Sport and Health Sciences, University of St Mark and St John , Plymouth , UK
| | - Saul R Bloxham
- Faculty of Sport and Health Sciences, University of St Mark and St John , Plymouth , UK
| | - Udaiveer Panwar
- Oncology Department, Plymouth Hospitals NHS Trust , Plymouth , UK
| | - Philip Drew
- Department of Breast Care, Royal Cornwall Hospitals NHS Trust , Truro, Cornwall , UK
| | - Andrew G Barton
- Research Design Service South West, Plymouth Hospitals NHS Trust , Plymouth , UK
| | - Andrew M Edwards
- Faculty of Sport and Health Sciences, University of St Mark and St John , Plymouth , UK
| | - Giorgos K Sakkas
- Faculty of Sport and Health Sciences, University of St Mark and St John , Plymouth , UK
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Huntley AL, King AJ, Moore TH, Paterson C, Persad R, Sharp D, Evans M. Methodological exemplar of integrating quantitative and qualitative evidence - supportive care for men with prostate cancer: what are the most important components? J Adv Nurs 2016; 73:5-20. [DOI: 10.1111/jan.13082] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Alyson L. Huntley
- Centre for Academic Primary Care; School of Social and Community Medicine; University of Bristol; UK
| | - Anna J.L. King
- Centre for Academic Primary Care; School of Social and Community Medicine; University of Bristol; UK
| | - Theresa H.M. Moore
- The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West) at University Hospitals Bristol NHS Foundation Trust; UK
- School of Social and Community Medicine; University of Bristol; UK
| | - Charlotte Paterson
- Centre for Academic Primary Care; School of Social and Community Medicine; University of Bristol; UK
| | - Raj Persad
- Bristol Urological Institute Southmead Hospital; Bristol UK
| | - Debbie Sharp
- Centre for Academic Primary Care; School of Social and Community Medicine; University of Bristol; UK
| | - Maggie Evans
- Centre for Academic Primary Care; School of Social and Community Medicine; University of Bristol; UK
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Schofield P, Gough K, Lotfi-Jam K, Bergin R, Ugalde A, Dudgeon P, Crellin W, Schubach K, Foroudi F, Tai KH, Duchesne G, Sanson-Fisher R, Aranda S. Nurse-led group consultation intervention reduces depressive symptoms in men with localised prostate cancer: a cluster randomised controlled trial. BMC Cancer 2016; 16:637. [PMID: 27530156 PMCID: PMC4986252 DOI: 10.1186/s12885-016-2687-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 08/08/2016] [Indexed: 02/02/2023] Open
Abstract
Background Radiotherapy for localised prostate cancer has many known and distressing side effects. The efficacy of group interventions for reducing psychological morbidity is lacking. This study investigated the relative benefits of a group nurse-led intervention on psychological morbidity, unmet needs, treatment-related concerns and prostate cancer-specific quality of life in men receiving curative intent radiotherapy for prostate cancer. Methods This phase III, two-arm cluster randomised controlled trial included 331 men (consent rate: 72 %; attrition: 5 %) randomised to the intervention (n = 166) or usual care (n = 165). The intervention comprised four group and one individual consultation all delivered by specialist uro-oncology nurses. Primary outcomes were anxious and depressive symptoms as assessed by the Hospital Anxiety and Depression Scale. Unmet needs were assessed with the Supportive Care Needs Survey-SF34 Revised, treatment-related concerns with the Cancer Treatment Scale and quality of life with the Expanded Prostate Cancer Index −26. Assessments occurred before, at the end of and 6 months post-radiotherapy. Primary outcome analysis was by intention-to-treat and performed by fitting a linear mixed model to each outcome separately using all observed data. Results Mixed models analysis indicated that group consultations had a significant beneficial effect on one of two primary endpoints, depressive symptoms (p = 0.009), and one of twelve secondary endpoints, procedural concerns related to cancer treatment (p = 0.049). Group consultations did not have a significant beneficial effect on generalised anxiety, unmet needs and prostate cancer-specific quality of life. Conclusions Compared with individual consultations offered as part of usual care, the intervention provides a means of delivering patient education and is associated with modest reductions in depressive symptoms and procedural concerns. Future work should seek to confirm the clinical feasibility and cost-effectiveness of group interventions. Trial registration Australian and New Zealand Clinical Trials Registry ANZCTRN012606000184572. 1 March 2006.
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Affiliation(s)
- Penelope Schofield
- Department of Psychology, Swinburne University of Technology, Hawthorn, Australia. .,Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, 2 St Andrews Place, East Melbourne, Australia. .,Sir Peter MacCallum Department of Oncology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia. .,School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia.
| | - Karla Gough
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, 2 St Andrews Place, East Melbourne, Australia.,School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia
| | - Kerryann Lotfi-Jam
- School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia
| | - Rebecca Bergin
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, 2 St Andrews Place, East Melbourne, Australia
| | - Anna Ugalde
- Deakin University, Faculty of Health, 221 Burwood Highway, Burwood, Australia.,Cancer Council Victoria, Cancer Information and Support Services, 615 St Kilda Rd, Melbourne, Australia
| | - Paul Dudgeon
- School of Behavioural Science, University of Melbourne, Parkville, Australia
| | - Wallace Crellin
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, 2 St Andrews Place, East Melbourne, Australia
| | - Kathryn Schubach
- Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, 2 St Andrews Place, East Melbourne, Australia
| | - Farshard Foroudi
- Sir Peter MacCallum Department of Oncology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia.,Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, 2 St Andrews Place, East Melbourne, Australia
| | - Keen Hun Tai
- Sir Peter MacCallum Department of Oncology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia.,Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, 2 St Andrews Place, East Melbourne, Australia
| | - Gillian Duchesne
- Sir Peter MacCallum Department of Oncology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia.,Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, 2 St Andrews Place, East Melbourne, Australia
| | - Rob Sanson-Fisher
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, Australia
| | - Sanchia Aranda
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, 2 St Andrews Place, East Melbourne, Australia.,Sir Peter MacCallum Department of Oncology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia.,Cancer Council Australia, Sydney, NSW, Australia
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Dennett AM, Peiris CL, Shields N, Prendergast LA, Taylor NF. Moderate-intensity exercise reduces fatigue and improves mobility in cancer survivors: a systematic review and meta-regression. J Physiother 2016; 62:68-82. [PMID: 26996098 DOI: 10.1016/j.jphys.2016.02.012] [Citation(s) in RCA: 105] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 02/05/2016] [Accepted: 02/25/2016] [Indexed: 12/15/2022] Open
Abstract
QUESTION Is there a dose-response effect of exercise on inflammation, fatigue and activity in cancer survivors? DESIGN Systematic review with meta-regression analysis of randomised trials. PARTICIPANTS Adults diagnosed with cancer, regardless of specific diagnosis or treatment. INTERVENTION Exercise interventions including aerobic and/or resistance as a key component. OUTCOME MEASURES The primary outcome measures were markers of inflammation (including C-reactive protein and interleukins) and various measures of fatigue. The secondary outcomes were: measures of activity, as defined by the World Health Organization's International Classification of Functioning, Disability and Health, including activities of daily living and measures of functional mobility (eg, 6-minute walk test, timed sit-to-stand and stair-climb tests). Risk of bias was evaluated using the PEDro scale, and overall quality of evidence was assessed using the Grades of Research, Assessment, Development and Evaluation (GRADE) approach. RESULTS Forty-two trials involving 3816 participants were included. There was very low-quality to moderate-quality evidence that exercise results in significant reductions in fatigue (SMD 0.32, 95% CI 0.13 to 0.52) and increased walking endurance (SMD 0.77, 95% CI 0.26 to 1.28). A significant negative association was found between aerobic exercise intensity and fatigue reduction. A peak effect was found for moderate-intensity aerobic exercise for improving walking endurance. No dose-response relationship was found between exercise and markers of inflammation or exercise duration and outcomes. Rates of adherence were typically high and few adverse events were reported. CONCLUSIONS Exercise is safe, reduces fatigue and increases endurance in cancer survivors. The results support the recommendation of prescribing moderate-intensity aerobic exercise to reduce fatigue and improve activity in people with cancer. REVIEW REGISTRATION PROSPERO CRD42015019164.
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Affiliation(s)
- Amy M Dennett
- School of Allied Health, La Trobe University and Allied Health Clinical Research Office, Eastern Health
| | - Casey L Peiris
- School of Allied Health, La Trobe University and Northern Health
| | - Nora Shields
- School of Allied Health, La Trobe University and Northern Health
| | - Luke A Prendergast
- Department of Mathematics and Statistics, La Trobe University, Melbourne, Australia
| | - Nicholas F Taylor
- School of Allied Health, La Trobe University and Allied Health Clinical Research Office, Eastern Health
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Martin E, Bulsara C, Battaglini C, Hands B, Naumann FL. Breast and Prostate Cancer Survivor Responses to Group Exercise and Supportive Group Psychotherapy. J Psychosoc Oncol 2016; 33:620-34. [PMID: 26315617 DOI: 10.1080/07347332.2015.1082166] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This study qualitatively examined an 8-week group exercise and counseling intervention for breast and prostate cancer survivors. Groups exercised 3 days per week, 50 minutes per session, performing moderate-intensity aerobic and resistance training. Groups also underwent 90-minute supportive group psychotherapy sessions once per week. Survivors discussed their experiences in focus groups post intervention. Transcripts were analyzed using interpretative phenomenological analysis. Survivors described how exercise facilitated counseling by creating mutual aid and trust, and counseling helped participants with self-identity, sexuality, and the return to normalcy. When possible, counselors and fitness professionals should create partnerships to optimally support cancer survivors.
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Affiliation(s)
- Eric Martin
- a Department of Kinesiology , California State University-Monterey Bay , Seaside , CA , USA.,b School of Health Sciences , University of Notre Dame Australia , Fremantle , Australia
| | - Caroline Bulsara
- c School of Nursing , University of Notre Dame Australia , Fremantle , Australia
| | - Claudio Battaglini
- d Department of Exercise and Sport Science , University of North Carolina at Chapel Hill , Chapel Hill , NC , USA.,e Lineberger Comprehensive Cancer Center , Chapel Hill , NC , USA
| | - Beth Hands
- f Institute for Health Research , University of Notre Dame Australia , Fremantle , Australia
| | - Fiona L Naumann
- g School of Exercise and Nutrition Sciences , Queensland University of Technology , Brisbane , Australia
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Abstract
Since prostate cancer becomes more common with age, at least one-third of men have sexual problems at diagnosis. All localized treatments for prostate cancer greatly increase the prevalence of sexual dysfunction, which include loss of desire, erectile dysfunction, and changes in orgasm. Even men on active surveillance have a higher rate of problems than matched peers without prostate cancer. However, men given androgen deprivation therapy (ADT) have the worst rates of sexual dysfunction. Even after 3 to 4 months of ADT, men's desire for sex is decreased and irreversible damage may occur to the erectile tissue in the penis. Erections do not recover in about one-half of men, even if ADT is discontinued. Although intermittent ADT allows some recovery of sexual function, serum testosterone requires 9 to 12 months off ADT to recover. Again, one-half of men have permanent erectile dysfunction. If ADT causes atrophy of the erectile tissue, blood leaks out of the venous system during erection. This syndrome is difficult to treat except with surgery to implant a penile prosthesis. Despite the high rate of sexual problems in men on ADT, a small group stays sexually active and is able to have reliable erections. To improve men's sexual satisfaction on ADT, it may be important to educate them about getting extra mental and physical sexual stimulation, as well as using penile rehabilitation during hormone therapy. Information on reaching orgasm and coping with problems such as dry orgasm, pain with orgasm, and urinary incontinence during sex also should be provided.
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Affiliation(s)
- Leslie R Schover
- From the Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX
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Bourke L, Smith D, Steed L, Hooper R, Catto J, Albertsen PC, Tombal B, Payne HA, Rosario DJ. Exercise interventions for men with prostate cancer. Cochrane Database Syst Rev 2015. [DOI: 10.1002/14651858.cd011251.pub2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Liam Bourke
- Sheffield Hallam University; Health and Wellbeing Research Institute; Sheffield UK S10 2BP
| | - Dianna Smith
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London; Centre for Primary Care and Public Health; 58 Turner Street London UK E1 2AB
| | - Liz Steed
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London; Centre for Primary Care and Public Health; 58 Turner Street London UK E1 2AB
| | - Richard Hooper
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London; Centre for Primary Care and Public Health; 58 Turner Street London UK E1 2AB
| | - James Catto
- University of Sheffield; Academic Urology Unit and Institute for Cancer Studies, The Medical School; Beech Hill Road Sheffield UK S10 2JF
| | - Peter C Albertsen
- University of Connecticut Health Center; Department of Surgery, Division of Urology; Farmington Connecticut USA
| | - Bertrand Tombal
- University Clinics Saint Luc/Catholic University of Louvain; Brussels Belgium
| | - Heather A Payne
- University College London Hospitals; Department of Oncology; 235 Euston Road London UK NW1 2BU
| | - Derek J Rosario
- University of Sheffield; Department of Oncology; Beech Hill Road Royal Hallamshire Hospital Sheffield UK S010 2RX
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Forbes CC, Blanchard CM, Mummery WK, Courneya KS. Feasibility and Preliminary Efficacy of an Online Intervention to Increase Physical Activity in Nova Scotian Cancer Survivors: A Randomized Controlled Trial. JMIR Cancer 2015; 1:e12. [PMID: 28410166 PMCID: PMC5367676 DOI: 10.2196/cancer.4586] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 08/10/2015] [Accepted: 08/15/2015] [Indexed: 12/11/2022] Open
Abstract
Background Physical activity (PA) behavior change interventions among cancer survivors have used face-to-face, telephone, email, and print-based methods. However, computer-tailored, Internet-delivered programs may be a more viable option to achieve PA behavior change. Objective The objective of this study is to test the feasibility and preliminary efficacy of a Web-based PA behavior change program among cancer survivors. Methods Nova Scotian cancer survivors (N=415) who previously expressed interest in a research study were approached. Interested participants were asked to complete an online assessment of PA and quality of life (QOL) before being randomized to either a theory-based PA behavior change program using the PA tracking website UWALK (UCAN; n=48) or usual care (UC; n=47). After the intervention (9 weeks), participants completed another online assessment of PA and QOL as well as measures to evaluate the program and website. Descriptive analyses from surveys and Web analytic software were used to assess feasibility and mean change scores were used to test efficacy. Results Of all contacted survivors, 95 (22.3%, 95/415) completed baseline measures and were randomized with 84 (88%, 84/95) completing the 9-week assessment. The behavior change program and website were rated highly on the satisfaction items. Average logins were 10.3 (1.1 per week) and 26.0% (111/432) of the weekly modules were completed. Most participants (71%, 29/41) indicated they were more aware of their daily PA levels and 68% (28/41) found the site easily navigable. Adjusted group differences in total exercise minutes favored the UCAN group by an increase of 42 minutes (95% CI -65 to 150; P=.44, d=0.17). Results were more pronounced, though still nonsignificant, among those not meeting guidelines at baseline where UCAN increased PA by 52 minutes compared to a decrease of 15 minutes in UC (adjusted between group difference=75, 95% CI -95 to 244; P=.38, d=0.27). Conclusions We found that Internet-delivery may be a feasible alternative to more costly methods to promote PA among Nova Scotian cancer survivors. Moreover, there was a trend toward increased PA among those in the UCAN group, especially among those who were not meeting PA guidelines at baseline. Future research should focus on recruiting inactive cancer survivors and engaging them in the website to determine the optimal potential of Web-based interventions for promoting PA in cancer survivors.
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Evaluation of a supervised multi-modal physical exercise program for prostate cancer survivors in the rehabilitation phase: Rationale and study protocol of the ProCaLife study. Contemp Clin Trials 2015; 45:311-319. [DOI: 10.1016/j.cct.2015.09.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 09/21/2015] [Accepted: 09/27/2015] [Indexed: 11/20/2022]
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Paterson C, Jones M, Rattray J, Lauder W, Nabi G. What is the mechanism effect that links social support to coping and psychological outcome within individuals affected by prostate cancer? Real time data collection using mobile technology. Eur J Oncol Nurs 2015; 21:126-33. [PMID: 26440544 DOI: 10.1016/j.ejon.2015.09.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2015] [Revised: 07/15/2015] [Accepted: 09/22/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE Unmet support needs are prevalent in men affected by prostate cancer. Moreover, little is known about the optimal type of social support, or its mechanism effect between coping and emotional outcome in men affected by this disease to identify areas for clinical intervention. This study aimed to empirically test the propositions of social support theory in "real time" within individual men living with and beyond prostate cancer. METHODS Purposeful sub-sample from a larger prospective longitudinal study of prostate cancer survivors, took part in real time data collection using mobile technology. Self-reports were collected for 31 days prompted by an audio alarm 3 times per day (a total of 93 data entries) for each of the 12 case studies. Electronic data were analysed using time series analysis. RESULTS Majority of response rates were >90%. Men reported a lack of satisfaction with their support over time. Testing the propositions of social support theory "within individuals" over time demonstrated different results for main effect, moderation and mediation pathways that linked coping and social support to emotional outcome. For two men, negative effects of social support were identified. For six men the propositions of social support theory did not hold considering their within-person data. CONCLUSION This innovative study is one of the first, to demonstrate the acceptability of e-health technology in an ageing population of men affected by prostate cancer. Collectively, the case series provided mixed support for the propositions of social support theory, and demonstrates that "one size does not fit all".
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Affiliation(s)
| | - Martyn Jones
- School of Nursing and Midwifery, University of Dundee, 11 Airlie Place, Dundee, DD1 4HJ, UK.
| | - Janice Rattray
- School of Nursing and Midwifery, University of Dundee, 11 Airlie Place, Dundee, DD1 4HJ, UK.
| | - William Lauder
- School of Nursing, Midwifery and Health, University of Stirling, Stirling, FK9 4LA, UK.
| | - Ghulam Nabi
- Division on Cancer, University of Dundee, UK.
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Galdas P, Darwin Z, Fell J, Kidd L, Bower P, Blickem C, McPherson K, Hunt K, Gilbody S, Richardson G. A systematic review and metaethnography to identify how effective, cost-effective, accessible and acceptable self-management support interventions are for men with long-term conditions (SELF-MAN). HEALTH SERVICES AND DELIVERY RESEARCH 2015. [DOI: 10.3310/hsdr03340] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BackgroundSelf-management support interventions can improve health outcomes, but their impact is limited by the numbers of patients able or willing to access them. Men’s attendance at, and engagement with, self-management support appears suboptimal despite their increased risk of developing serious and disabling long-term conditions (LTCs).ObjectivesTo assess the effectiveness, cost-effectiveness, accessibility and acceptability of self-management support interventions in men with LTCs.MethodsA quantitative systematic review with meta-analysis and a qualitative review using a metaethnography approach. The findings of the two reviews were integrated in parallel synthesis.Data sourcesIn the quantitative review, the Cochrane Database of Systematic Reviews was searched to identify published reviews of self-management support interventions. Relevant reviews were screened to identify randomised controlled trials (RCTs) of self-management support interventions conducted in men alone, or which analysed the effects of interventions by gender. In the qualitative review, the databases Cumulative Index to Nursing and Allied Health Literature, EMBASE, Medical Literature Analysis and Retrieval System Online, PsycINFO and Social Science Citation Index (July 2013) were searched from inception to July 2013.Review methodsIn the quantitative review, data on relevant outcomes, patient populations, intervention type and study quality were extracted. Quality appraisal was conducted independently by two reviewers using the Cochrane risk of bias tool. Meta-analysis was conducted to compare the effects of interventions in male, female and mixed-sex groups. In the metaethnography, study details, participant quotes (first-order constructs) and study authors’ themes/concepts (second-order constructs) were extracted. Quality appraisal was conducted independently by two reviewers using the Critical Appraisal Skills Programme tool. Data were synthesised according to a metaethnography approach. Third-order interpretations/constructs were derived from the extracted data and integrated to generate a ‘line-of-argument’ synthesis.ResultsForty RCTs of self-management support interventions in male-only samples, and 20 RCTs where an analysis by gender was reported, were included in the quantitative review. Meta-analysis suggested that interventions including physical activity, education and peer support have a positive impact on quality of life in men, and that men may derive more benefit than women from them, but there is currently insufficient evidence to draw definitive conclusions. Thirty-eight qualitative studies relevant to men’s experiences of, and perceptions of, self-management support were included in the qualitative review. The metaethnography identified four concepts: (1) need for purpose; (2) trusted environments; (3) value of peers; and (4) becoming an expert. Findings indicated that men may feel less comfortable engaging in support if it is perceived to be incongruous with valued aspects of masculine identities. Men may find support interventions more attractive when they have a clear purpose, are action-oriented and offer practical strategies that can be integrated into daily life. Support delivered in an environment that offers a sense of shared understanding can be particularly appealing to some men.ConclusionsHealth professionals and those involved in designing interventions may wish to consider whether or not certain components (e.g. physical activity, education, peer support) are particularly effective in men, although more research is needed to fully determine and explore this. Interventions are most likely to be accessible and acceptable to men when working with, not against, valued aspects of masculine identities.Study registrationThis study is registered as PROSPERO CRD42013005394.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
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Affiliation(s)
- Paul Galdas
- Department of Health Sciences, University of York, York, UK
| | - Zoe Darwin
- School of Healthcare, Faculty of Medicine, University of Leeds, Leeds, UK
| | - Jennifer Fell
- Department of Health Sciences, University of York, York, UK
| | - Lisa Kidd
- School of Health and Life Sciences/Institute for Applied Health Research, Glasgow Caledonian University, Glasgow, UK
| | - Peter Bower
- National Institute for Health Research School for Primary Care Research, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Christian Blickem
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (CLAHRC) Greater Manchester, Centre for Primary Care, Institute of Population Health, University of Manchester, Manchester, UK
| | - Kerri McPherson
- School of Health and Life Sciences/Institute for Applied Health Research, Glasgow Caledonian University, Glasgow, UK
| | - Kate Hunt
- Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Simon Gilbody
- Department of Health Sciences, University of York, York, UK
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The effects of resistance exercise on physical performance and health-related quality of life in prostate cancer patients: a systematic review. Support Care Cancer 2015; 23:2479-97. [PMID: 26003426 DOI: 10.1007/s00520-015-2782-x] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Accepted: 05/17/2015] [Indexed: 02/07/2023]
Abstract
PURPOSE Physical exercise has been shown to be an effective, safe, and quite inexpensive method to reduce cardiovascular and metabolic risk factors and is currently in the process of establishing its relevance for cancer specific morbidity and mortality. The aim of this systematic review was to focus on specific effects of resistance exercise (RE) in the adjuvant therapy and rehabilitation of prostate cancer patients (PCaPs) receiving or having received androgen deprivation therapy (ADT). METHODS A systematic literature search focusing on relevant and peer-reviewed studies published between 1966 and September 2014, using PubMed, EMBASE, MEDLINE, SCOPUS, and Cochrane Library databases, was conducted. RESULTS The majority of studies demonstrated RE as an effective and safe intervention to improve muscular strength and performance, fatigue and quality of life (QoL) in PCaPs, while there is inconclusive evidence concerning cardiovascular performance, body composition, blood lipids, bone mineral density (BMD), and immune response. CONCLUSION Existing evidence leads to the conclusion that RE seems to be a safe intervention in PCaPs with beneficial effects on physical performance capacity and QoL. Nevertheless, further research in this field is urgently needed to increase understanding of exercise interventions in PCaPs.
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Demark-Wahnefried W, Rogers LQ, Alfano CM, Thomson CA, Courneya KS, Meyerhardt JA, Stout NL, Kvale E, Ganzer H, Ligibel JA. Practical clinical interventions for diet, physical activity, and weight control in cancer survivors. CA Cancer J Clin 2015; 65:167-89. [PMID: 25683894 DOI: 10.3322/caac.21265] [Citation(s) in RCA: 151] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Answer questions and earn CME/CNE The importance of expanding cancer treatment to include the promotion of overall long-term health is emphasized in the Institute of Medicine report on delivering quality oncology care. Weight management, physical activity, and a healthy diet are key components of tertiary prevention but may be areas in which the oncologist and/or the oncology care team may be less familiar. This article reviews current diet and physical activity guidelines, the evidence supporting those recommendations, and provides an overview of practical interventions that have resulted in favorable improvements in lifestyle behavior change in cancer survivors. It also describes current lifestyle practices among cancer survivors and the role of the oncologist in helping cancer patients and survivors embark upon changes in lifestyle behaviors, and it calls for the development of partnerships between oncology providers, primary care providers, and experts in nutrition, exercise science, and behavior change to help positively orient cancer patients toward longer and healthier lives.
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Affiliation(s)
- Wendy Demark-Wahnefried
- Professor of Nutrition Sciences, Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, Alabama
| | - Laura Q Rogers
- Professor of Nutrition Sciences, Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, Alabama
| | - Catherine M Alfano
- Behavioral Research Program, National Cancer Institute, Bethesda, Maryland
| | - Cynthia A Thomson
- Professor of Health Promotion Sciences, Department of Health Promotion Sciences, University of Arizona, Tucson, Arizona
| | - Kerry S Courneya
- Professor, Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | | | - Nicole L Stout
- Department of Rehabilitation Medicine, National Institutes of Health, Bethesda, Maryland
| | - Elizabeth Kvale
- Associate Professor of Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | | | - Jennifer A Ligibel
- Assistant Professor, Dana-Farber Cancer Institute, Boston, Massachusetts
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O'Neill RF, Haseen F, Murray LJ, O'Sullivan JM, Cantwell MM. A randomised controlled trial to evaluate the efficacy of a 6-month dietary and physical activity intervention for patients receiving androgen deprivation therapy for prostate cancer. J Cancer Surviv 2015; 9:431-40. [PMID: 25916660 DOI: 10.1007/s11764-014-0417-8] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Accepted: 11/19/2014] [Indexed: 12/17/2022]
Abstract
PURPOSE Treatment of prostate cancer with androgen deprivation therapy (ADT) is associated with an increased fat mass, decreased lean mass, increased fatigue and a reduction in quality of life (QoL). The aim of this study was to evaluate the efficacy of a 6-month dietary and physical activity intervention for prostate cancer patients receiving ADT, to help minimise these side effects. METHODS Patients (n = 94) were recruited to this study if they were planned to receive ADT for prostate cancer for at least 6 months. Men randomised to the intervention arm received a dietary and exercise intervention, commensurate with UK healthy eating and physical activity recommendations. The primary outcome of interest was body composition; secondary outcomes included fatigue, QoL, functional capacity, stress and dietary change. RESULTS The intervention group had a significant (p < 0.001) reduction in weight, body mass index and percentage fat mass compared to the control group at 6 months; the between-group differences were -3.3 kg (95% confidence interval (95% CI) -4.5, -2.1), -1.1 kg/m(2) (95% CI -1.5, -0.7) and -2.1% (95% CI -2.8, -1.4), respectively, after adjustment for baseline values. The intervention resulted in improvements in functional capacity (p < 0.001) and dietary intakes but did not significantly impact fatigue, QoL or stress scores at endpoint. CONCLUSIONS A 6-month diet and physical activity intervention can minimise the adverse body composition changes associated with ADT. IMPLICATIONS FOR CANCER SURVIVORS This study shows that a pragmatic lifestyle intervention is feasible and can have a positive impact on health behaviours and other key outcomes in men with prostate cancer receiving ADT.
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Affiliation(s)
- Roisin F O'Neill
- Cancer Epidemiology and Health Services Research Group, Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland, UK,
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Moore THM, King AJL, Evans M, Sharp D, Persad R, Huntley AL. Supportive care for men with prostate cancer: why are the trials not working? A systematic review and recommendations for future trials. Cancer Med 2015; 4:1240-51. [PMID: 25828811 PMCID: PMC4559035 DOI: 10.1002/cam4.446] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 02/05/2015] [Accepted: 02/11/2015] [Indexed: 11/29/2022] Open
Abstract
Men with prostate cancer are likely to have a long illness and experience psychological distress for which supportive care may be helpful. This systematic review describes the evidence for effectiveness and cost-effectiveness of supportive care for men with prostate cancer, taking into account treatment pathway and components of interventions. MEDLINE, EMBASE, CINAHL, CENTRAL, and Psychinfo were searched from inception––July 2013 for randomized controlled trials and controlled trials. Two authors independently assessed risk of bias and extracted data. Twenty-six studies were included (2740 participants). Interventions were delivered pre and during (n = 12), short-term (n = 8), and longer term (18 months) (n = 5) after primary treatment. No interventions were delivered beyond this time. Few trials recruited ethnic minorities and none recruited men in same sex relationships. Intervention components included information, education, health professional discussion, homework, peer discussion, buddy support, cognitive behavioral therapy, cognitive restructuring, psychoeducation, Reiki and relaxation. Most interventions were delivered for 5–10 weeks. Risk of bias of trials was assessed as unclear for most domains due to lack of information. The majority of trials measuring quality of life and depression found no effect. Relatively few trials measured anxiety, coping skills and self-efficacy, and the majority found no effect. No cost data were available. Trials of supportive care for men with prostate cancer cover a range of interventions but are limited by population diversity, inconsistent measurement and reporting of outcomes, and inability to assess risk of bias. Recommendations on design and conduct of future trials are presented.
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Affiliation(s)
- Theresa Helen Mazzarello Moore
- Academic Unit of Primary Care, School of Social and Community Medicine, University of Bristol, Canynge Hall, Bristol, BS8 2PA, UK
| | - Anna Jyoti Louise King
- Academic Unit of Primary Care, School of Social and Community Medicine, University of Bristol, Canynge Hall, Bristol, BS8 2PA, UK
| | - Maggie Evans
- Academic Unit of Primary Care, School of Social and Community Medicine, University of Bristol, Canynge Hall, Bristol, BS8 2PA, UK
| | - Debbie Sharp
- Academic Unit of Primary Care, School of Social and Community Medicine, University of Bristol, Canynge Hall, Bristol, BS8 2PA, UK
| | - Raj Persad
- Academic Unit of Primary Care, School of Social and Community Medicine, University of Bristol, Canynge Hall, Bristol, BS8 2PA, UK
| | - Alyson Louise Huntley
- Academic Unit of Primary Care, School of Social and Community Medicine, University of Bristol, Canynge Hall, Bristol, BS8 2PA, UK
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Parahoo K, McDonough S, McCaughan E, Noyes J, Semple C, Halstead EJ, Neuberger MM, Dahm P. Psychosocial interventions for men with prostate cancer: a Cochrane systematic review. BJU Int 2015; 116:174-83. [PMID: 25429987 DOI: 10.1111/bju.12989] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
To evaluate the effectiveness of psychosocial interventions for men with prostate cancer in improving quality of life (QoL), self-efficacy and knowledge and in reducing distress, uncertainty and depression. We searched for trials using a range of electronic databases including the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE and PsycINFO to October 2013, together with hand searching of journals and reference lists. Randomised controlled trials were eligible if they included psychosocial interventions that explicitly used one or a combination of the following approaches: cognitive behavioural, psycho-educational, supportive and counselling. Interventions had to be delivered or facilitated by trained or lay personnel. Our outcomes were an improvement in QoL, self-efficacy and knowledge and a reduction in distress, uncertainty and depression. Pairs of review authors independently extracted data and assessed risk of bias. We analysed data using standardised mean differences (SMDs), random-effects models and 95% confidence intervals (CIs). In all, 19 studies with a total of 3 204 men, with a diagnosis of prostate cancer, comparing psychosocial interventions vs usual care were included in this review. Men in the psychosocial intervention group had a small, statistically significant improvement in the physical component of general health-related QoL (GHQoL) at end of intervention (SMD 0.12, 95% CI 0.01-0.22) based on low quality evidence. There was no clear evidence of benefit associated with psychosocial interventions for the mental component of GHQoL at end of intervention (SMD -0.04, 95% CI -0.15 to 0.06) based on moderate quality evidence. At end of intervention, cancer-related QoL showed a small improvement after psychosocial interventions (SMD 0.21, 95% CI 0.04-0.39). For prostate cancer-specific and symptom-related QoL, the differences between intervention and control groups were not significant. There was no clear evidence that psychosocial interventions were beneficial in improving self-efficacy at end of intervention (SMD 0.16, 95% CI -0.05 to 0.38) based on very low quality evidence. Men in the psychosocial intervention group had a moderate increase in prostate cancer knowledge at end of intervention (SMD 0.51, 95% CI 0.32-0.71) based on very low quality evidence. A small increase in knowledge with psychosocial interventions was noted at 3 months after intervention (SMD 0.31, 95% CI 0.04-0.58). The results for uncertainty (SMD -0.05, 95% CI -0.35 to 0.26) and distress (SMD 0.02, 95% CI -0.11 to 0.15) at end of intervention were compatible with both benefit and harm based on very low quality evidence. Finally, there was no clear evidence of benefit associated with psychosocial interventions for depression at end of intervention (SMD -0.18, 95% CI -0.51 to 0.15) based on very low quality evidence. The overall risk of bias in the included studies was unclear or high, primarily as the result of performance bias. No data about stage of disease or treatment with androgen-deprivation therapy were extractable for subgroup analysis. Only one study addressed adverse effects. Overall, this review shows that psychosocial interventions may have small, short-term beneficial effects on certain domains of wellbeing, as measured by the physical component of GHQoL and cancer-related QoL when compared with usual care. Prostate cancer knowledge was also increased. However, this review failed to show a statistically significant effect on other domains such as symptom-related QoL, self-efficacy, uncertainty, distress or depression. Moreover, when beneficial effects were seen, it remained uncertain whether the magnitude of effect was large enough to be considered clinically important. The quality of evidence for most outcomes was rated as very low according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system, reflecting study limitations, loss to follow-up, study heterogeneity and small sample sizes. We were unable to perform meaningful subgroup analyses based on disease stage or treatment method. Although some findings of this review are encouraging, they do not provide sufficiently strong evidence to permit meaningful conclusions about the effects of these interventions in men with prostate cancer. Additional well executed and transparently reported research studies are necessary to establish the role of psychosocial interventions in men with prostate cancer.
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Affiliation(s)
- Kader Parahoo
- Institute of Nursing and Health Research, University of Ulster, Coleraine, Co. Londonderry, UK
| | - Suzanne McDonough
- Institute of Nursing and Health Research, University of Ulster, Newtownabbey, Co. Antrim, UK
| | - Eilis McCaughan
- Institute of Nursing and Health Research, University of Ulster, Coleraine, Co. Londonderry, UK
| | - Jane Noyes
- Centre for Health-Related Research, Bangor University Fron Heulog, Bangor, Gwynedd, UK
| | - Cherith Semple
- Cancer Services, South Eastern Health & Social Care Trust, Belfast, UK
| | - Elizabeth J Halstead
- School of Healthcare Sciences, Bangor University Fron Heulog, Bangor, Gwynedd, UK
| | | | - Philipp Dahm
- Minneapolis VA Health Care System, Minneapolis, MN, USA.,Department of Urology, University of Minnesota, Minneapolis, MN, USA
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Newby TA, Graff JN, Ganzini LK, McDonagh MS. Interventions that may reduce depressive symptoms among prostate cancer patients: a systematic review and meta-analysis. Psychooncology 2015; 24:1686-93. [PMID: 25753507 DOI: 10.1002/pon.3781] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 01/01/2015] [Accepted: 01/29/2015] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Prostate cancer patients are at increased risk of depression yet there is no standard intervention to address this. The purpose of this meta-analysis is to examine the efficacy of interventions in reducing depressive symptoms in men with prostate cancer. METHODS Searches for studies were conducted in four databases and by hand. Randomized controlled trials of any intervention relative to control for depression in prostate cancer patients at any stage of their cancer treatment were included. RESULTS We identified 11 studies that randomized men with prostate cancer to either an intervention meant to improve some aspect of quality of life or control and reported depressive symptoms scores before and after the intervention or control condition. Two of these were not used in our meta-analysis either for concerns about quality or for lack of depression scores. The interventions identified in the remaining nine articles were exercise (four), information (three), psychotherapy or peer support (three), massage therapy (one), and medication (one). Several publications included more than one type of intervention. A meta-analysis of all studies showed that an intervention of some types significantly improved depressive symptom scores relative to the control condition (improvement in depression score by -0.86 unit (95% CI: -1.42, -0.31)). Isolating the peer support/psychotherapy studies also showed significant improvement (improvement in depression score by -1.09 unit (95% CI: -2.05, -0.13)). CONCLUSION Treatments to improve depressive symptoms in men with prostate cancer may be effective, with the best evidence supporting the use of peer support/psychotherapy.
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Affiliation(s)
- Timothy A Newby
- Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA
| | - Julie N Graff
- Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA.,Division of Hospital & Specialty Medicine, Veterans Affairs Medical Center, Portland, OR, USA
| | - Linda K Ganzini
- Mental Health and Clinical Neurosciences, Portland Veterans Affairs Medical Center, Portland, OR, USA.,Departments of Psychiatry and Medicine, Oregon Health and Science University - OHSU, Portland, OR, USA
| | - Marian S McDonagh
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, OR, USA
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Valle CG, Tate DF, Mayer DK, Allicock M, Cai J. Exploring Mediators of Physical Activity in Young Adult Cancer Survivors: Evidence from a Randomized Trial of a Facebook-Based Physical Activity Intervention. J Adolesc Young Adult Oncol 2015; 4:26-33. [PMID: 25852972 PMCID: PMC4365511 DOI: 10.1089/jayao.2014.0034] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE This study examined the effects of a physical activity (PA) intervention for young adult cancer survivors on changes in self-efficacy, social support, and self-monitoring and determined whether changes in these social cognitive theory constructs mediated the relationship between the intervention and changes in PA. METHODS A 12-week randomized trial compared a Facebook-based intervention (FITNET) aimed at increasing moderate-to-vigorous intensity PA to a Facebook-based self-help comparison group. Young adult cancer survivors (N=86, aged 21-39) were randomly assigned to one of the two groups. Self-report measures of PA and psychosocial variables were collected at baseline and after 12 weeks. RESULTS The FITNET group reported lower self-efficacy for sticking to exercise (mean change=-0.38; 95% CI: -0.62 to -0.12; p=0.025) and social support from friends on social networking websites (mean change=-0.47; 95% CI: -1.45 to 0.65; p=0.039) relative to the self-help comparison group over time. Changes in social support from friends on social networking websites partially mediated the intervention effects on moderate-to-vigorous PA (mean indirect effect=-22.4; 95% CI: -62.0 to -2.8) in the unexpected direction. Across both groups, social support from friends and self-monitoring were positively associated with changes in moderate-to-vigorous PA. CONCLUSION The proposed mediators did not explain the positive effects of the FITNET intervention on mild PA. The lack of significant improvements in psychosocial constructs among FITNET participants may partly explain why the intervention did not increase moderate-to-vigorous PA relative to the self-help comparison group. Future PA interventions with young adult cancer survivors should examine targeting social support from friends and self-monitoring.
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Affiliation(s)
- Carmina G. Valle
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Deborah F. Tate
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Department of Health Behavior, Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Deborah K. Mayer
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Marlyn Allicock
- Division of Health Promotion and Behavioral Sciences, University of Texas School of Public Health, Dallas, Texas
| | - Jianwen Cai
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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To J, Goldberg AS, Jones J, Zhang J, Lowe J, Ezzat S, Gilbert J, Zahedi A, Segal P, Sawka AM. A systematic review of randomized controlled trials for management of persistent post-treatment fatigue in thyroid cancer survivors. Thyroid 2015; 25:198-210. [PMID: 25382050 DOI: 10.1089/thy.2014.0418] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND Fatigue that persists post-treatment is commonly reported by thyroid cancer (TC) survivors. METHODS A systematic review of published English language randomized controlled trials (RCTs) on interventions for management of persistent post-treatment fatigue in TC was conducted. This review excluded studies on short-term interventions used in preparation for radioactive iodine diagnostic scans or treatment. An electronic search was executed in six databases and supplemented by a hand search. Two reviewers independently reviewed all citations from the electronic search and relevant full-text studies. Two abstractors independently critically appraised included studies and abstracted the data. The data were qualitatively summarized. RESULTS A total of 1086 unique citations and 25 full-text studies were reviewed. Four studies summarizing the results of three RCTs were included. The interventions included: combination triiodothyronine with levothyroxine (L-T4) therapy compared to L-T4 alone (one RCT), reduction in degree of thyrotropin (TSH) suppression using L-T4 compared to maintenance of TSH suppression (one RCT), and supervised exercise compared to inactivity (two RCTs examining different fatigue outcomes in same population). Trial duration ranged from 10 weeks to six months. All trials had limitations, and the number of TC survivors included in respective RCTs ranged from 15 to 36. Hormonal treatment RCTs had mixed fatigue outcome results within respective trials. However, multiple measures suggesting improvement in fatigue were reported following the exercise intervention. CONCLUSIONS There is paucity of RCTs to guide evidence-based management of persistent post-treatment fatigue in TC survivors. RCTs of interventions for prevention or treatment of fatigue in TC survivors are needed.
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Affiliation(s)
- Joshua To
- 1 Department of Psychology, University of Waterloo , Waterloo, Canada
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