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Martín-Rodríguez A, Belinchón-deMiguel P, Rubio-Zarapuz A, Tornero-Aguilera JF, Martínez-Guardado I, Villanueva-Tobaldo CV, Clemente-Suárez VJ. Advances in Understanding the Interplay between Dietary Practices, Body Composition, and Sports Performance in Athletes. Nutrients 2024; 16:571. [PMID: 38398895 PMCID: PMC10892519 DOI: 10.3390/nu16040571] [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: 01/19/2024] [Revised: 02/15/2024] [Accepted: 02/16/2024] [Indexed: 02/25/2024] Open
Abstract
The dietary practices of athletes play a crucial role in shaping their body composition, influencing sports performance, training adaptations, and overall health. However, despite the widely acknowledged significance of dietary intake in athletic success, there exists a gap in our understanding of the intricate relationships between nutrition, body composition, and performance. Furthermore, emerging evidence suggests that many athletes fail to adopt optimal nutritional practices, which can impede their potential achievements. In response, this Special Issue seeks to gather research papers that delve into athletes' dietary practices and their potential impacts on body composition and sports performance. Additionally, studies focusing on interventions aimed at optimizing dietary habits are encouraged. This paper outlines the key aspects and points that will be developed in the ensuing articles of this Special Issue.
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Affiliation(s)
- Alexandra Martín-Rodríguez
- Faculty of Sports Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain; (A.M.-R.); (A.R.-Z.); (V.J.C.-S.)
| | - Pedro Belinchón-deMiguel
- Faculty of Biomedical and Health Sciences, Department of Nursing and Nutrition, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain;
| | - Alejandro Rubio-Zarapuz
- Faculty of Sports Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain; (A.M.-R.); (A.R.-Z.); (V.J.C.-S.)
| | - Jose Francisco Tornero-Aguilera
- Faculty of Sports Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain; (A.M.-R.); (A.R.-Z.); (V.J.C.-S.)
| | - Ismael Martínez-Guardado
- Faculty of Health Sciences, Camilo José Cela University, C. Castillo de Alarcón, 49, Villafranca del Castillo, 28692 Madrid, Spain;
| | | | - Vicente Javier Clemente-Suárez
- Faculty of Sports Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain; (A.M.-R.); (A.R.-Z.); (V.J.C.-S.)
- Grupo de Investigación en Cultura, Educación y Sociedad, Universidad de la Costa, Barranquilla 080002, Colombia
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Trauchburg A, Schwingshackl L, Hoffmann G. Association between Dietary Indices and Dietary Patterns and Mortality and Cancer Recurrence among Cancer Survivors: An Updated Systematic Review and Meta-Analysis of Cohort Studies. Nutrients 2023; 15:3151. [PMID: 37513568 PMCID: PMC10385219 DOI: 10.3390/nu15143151] [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: 06/15/2023] [Revised: 07/10/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
The number of cancer survivors is growing rapidly; however, specific lifestyle recommendations for these patients are still sparse, including dietary approaches. Thus, the aim of the present systematic review and meta-analysis was to examine the associations between adherence to diet-quality indices and dietary patterns on overall mortality, cancer-specific mortality, and cancer recurrence among cancer survivors. The literature search was conducted in PubMed and Web of Science between 18 May 2016 and 22 May 2022 with no language restrictions. Thirty-nine studies were included for quantitative analysis, providing data from 77,412 participants. Adherence to both diet-quality indices and a healthy/prudent dietary pattern was inversely associated with overall mortality (RR, 0.81; 95% CI, 0.77-0.86; RR, 0.80; 95% CI, 0.70-0.92, respectively) and with cancer-specific mortality (RR, 0.86; 95% CI, 0.79-0.94; RR, 0.79; 95% CI, 0.64-0.97, respectively). These associations could be observed following assessment of dietary patterns either pre- and/or postdiagnosis. For unhealthy/western dietary patterns, high adherence was associated with overall mortality (RR, 1.26; 95% CI, 1.08-1.47). Although the certainty of evidence was rated as low, we conclude that there are no reservations against high adherence to healthy dietary patterns or indices in cancer survivors.
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Affiliation(s)
- Angela Trauchburg
- Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Josef-Holaubek-Platz 2, UZA II, 1090 Vienna, Austria
| | - Lukas Schwingshackl
- Institute for Evidence in Medicine, Medical Center, Faculty of Medicine, University of Freiburg, Breisacher Straße 153, 79110 Freiburg, Germany
| | - Georg Hoffmann
- Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Josef-Holaubek-Platz 2, UZA II, 1090 Vienna, Austria
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Rau KM, Shun SC, Hung SH, Chou HL, Ho CL, Chao TC, Liu CY, Lien CT, Hong MY, Wu CJ, Tsai LY, Jane SW, Hsieh RK. Management of cancer-related fatigue in Taiwan: an evidence-based consensus for screening, assessment and treatment. Jpn J Clin Oncol 2022; 53:46-56. [PMID: 36354095 PMCID: PMC9825724 DOI: 10.1093/jjco/hyac164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 10/08/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Cancer-related fatigue is one of the most common and persistent issues experienced by cancer patients. Cancer-related fatigue is a distinct form of fatigue that is subjective, long-lasting and unalleviated by rest or sleep. Studies have shown that almost all cancer patients experience severe fatigue that disrupts the quality of life and physical function, but cancer-related fatigue remains under-addressed in clinical care, and only about half of all patients receive treatment. METHODS To increase the awareness of cancer-related fatigue and improve current management, the Taiwan Society of Cancer Palliative Medicine and the Taiwan Oncology Nursing Society convened a consensus committee to develop recommendations for the screening, assessment and treatment of cancer-related fatigue. RESULTS Thirteen consensus recommendations were subsequently developed based on the best available evidence and the clinical experience of committee members. CONCLUSIONS These recommendations are expected to facilitate the standardization of cancer-related fatigue management across Taiwan and may also serve as a reference for other clinicians.
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Affiliation(s)
| | | | - Shih-Hsin Hung
- Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hsiu-Ling Chou
- Department of Nursing, Asia Eastern University of Science and Technology, New Taipei City, Taiwan,Department of Nursing, Far Eastern Memorial Hospital, New Taipei City, Taiwan,School of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ching-Liang Ho
- Division of Hematology and Oncology, Tri-Service General Hospital, Taipei, Taiwan,Division of Oncology, National Defense Medical Center, Taipei, Taiwan
| | - Ta-Chung Chao
- Department of Oncology and Comprehensive Breast Health Center, Taipei Veterans General Hospital, Taipei, Taiwan,Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chun-Yu Liu
- Division of Transfusion Medicine, Department of Medicine and Comprehensive Breast Health Center, Taipei Veterans General Hospital, Taipei, Taiwan,Division of Medical Oncology, Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan,School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ching-Ting Lien
- Department of Nursing, MacKay Memorial Hospital, Taipei, Taiwan
| | - Ming-Ying Hong
- Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan
| | - Ching-Jung Wu
- Department of Radiation Oncology, Cathay General Hospital, Taipei, Taiwan,Department of Radiation Oncology, National Defense Medical Center, Taipei, Taiwan,Department of Biomedical Engineering, I-Shou University, Kaohsiung, Taiwan
| | - Li-Yun Tsai
- College of Nursing, Central Taiwan University of Science and Technology, Taichung, Taiwan
| | - Sui-Whi Jane
- Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan,Graduate Institute of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Ruey-Kuen Hsieh
- For reprints and all correspondence: Ruey-Kuen Hsieh, Department of Hematology and Oncology, MacKay Memorial Hospital, Taipei, Taiwan. No. 92, Sec. 2, Zhongshan N. Rd., Taipei City 10449, Taiwan. E-mail:
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McGovern KA, Durham WJ, Wright TJ, Dillon EL, Randolph KM, Danesi CP, Urban RJ, Sheffield-Moore M. Impact of Adjunct Testosterone on Cancer-Related Fatigue: An Ancillary Analysis from a Controlled Randomized Trial. Curr Oncol 2022; 29:8340-8356. [PMID: 36354718 PMCID: PMC9689748 DOI: 10.3390/curroncol29110658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 10/29/2022] [Accepted: 10/31/2022] [Indexed: 11/06/2022] Open
Abstract
Many cancer patients undergoing treatment experience cancer-related fatigue (CRF). Inflammatory markers are correlated with CRF but are not routinely targeted for treatment. We previously demonstrated in an NIH-funded placebo-controlled, double-blind, randomized clinical trial (NCT00878995, closed to follow-up) that seven weekly injections of 100 mg adjunct testosterone preserved lean body mass in cancer patients undergoing standard-of-care treatment in a hospital setting. Because testosterone therapy can reduce circulating proinflammatory cytokines, we conducted an ancillary analysis to determine if this testosterone treatment reduced inflammatory burden and improved CRF symptoms and health-related quality of life. Randomization was computer-generated and managed by the pharmacy, which dispensed testosterone and placebo in opaque syringes to the administering study personnel. A total of 24 patients were randomized (14 placebo, 10 testosterone), and 21 were included in the primary analysis (11 placebo, 10 testosterone). Testosterone therapy did not ameliorate CRF symptoms (placebo to testosterone difference in predicted mean multidimensional fatigue symptom inventory scores: -5.6, 95% CI: -24.6 to 13.3), improve inflammatory markers, or preserve health-related quality of life and functional measures of performance in late-stage cancer patients.
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Affiliation(s)
- Kristen A. McGovern
- Department of Internal Medicine, The University of Texas Medical Branch (UTMB), 301 University Blvd., Galveston, TX 77555, USA
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Xu N, An Q. Correlation between dietary score and depression in cancer patients: Data from the 2005–2018 National Health and Nutrition Examination Surveys. Front Psychol 2022; 13:978913. [PMID: 36186370 PMCID: PMC9523136 DOI: 10.3389/fpsyg.2022.978913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 08/23/2022] [Indexed: 11/13/2022] Open
Abstract
AimTo investigate the correlation between dietary score and depression in patients with cancer.MethodsIn this cross-sectional study, data were collected from the National Health and Nutrition Examination Survey (NHANES) 2005–2018, a cross-sectional and nationally representative database, to compare 322 patients with depression to 2,868 with no depression. Mediterranean (MEDS) diet, Dietary Approaches to Stop Hypertension (DASH) diet, and the Healthy Eating Index 2015 (HEI-2015) score were calculated. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9). Weighted logistic regression models were used to explore the relationship between dietary scores and depression in patients with cancer. Subgroup analysis was performed by sleep disorders, sex, cancer type, number of tumors, and pain relief prescription treatment.ResultsThe final study sample included 3,190 adults, with 56.94% of them being women, representing 2,177 (86.51%) non-Hispanic white adults. After multivariable adjustment, the MEDS score was correlated with a reduced risk of depression in patients with cancer [odds ratio (OR): 0.90, 95% confidence interval (CI): 0.82–0.97, p = 0.010]. Moreover, the MEDS score was correlated with depression in cancer patients with sleep disorders (OR: 0.84, 95% CI: 0.76–0.93, p = 0.001), in female patients with cancer (OR: 0.83, 95% CI: 0.74–0.92, p < 0.001), particularly in female cancer reproductive system patients (OR: 0.69, 95% CI: 0.57–0.82, p < 0.001). MEDS score also showed a decreased risk of depression in patients with 1 cancer (OR: 0.90, 95% CI: 0.82–0.98, p = 0.019). MEDS score (OR: 0.86, 95% CI: 0.86–0.98, p = 0.024) and DASH (OR: 0.91, 95% CI: 0.84–0.98, p = 0.015) score were related to a decreased risk of depression in patients with cancer using pain relief prescription.ConclusionGood diet quality is significantly correlated with decreased risk of depression in patients with cancer. Aligning with the Dietary Guidelines, such as the MEDS diet, may be beneficial to the reduced risk of depression in patients with cancer.
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Affiliation(s)
- Nan Xu
- Department of Traditional Chinese Medicine, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
- Nanjing University of Chinese Medicine, Nanjing, China
| | - Qing An
- Department of Traditional Chinese Medicine, Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
- *Correspondence: Qing An
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Lei YY, Ho SC, Kwok C, Cheng A, Cheung KL, Lee R, Mo FKF, Yeo W. Association of high adherence to vegetables and fruits dietary pattern with quality of life among Chinese women with early-stage breast cancer. Qual Life Res 2022; 31:1371-1384. [PMID: 34532834 PMCID: PMC9023405 DOI: 10.1007/s11136-021-02985-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE Dietary intake and patients' quality of life (QoL) are important supportive care issues in breast cancer survivorship. This study aimed to identify dietary pattern before and after breast cancer diagnosis. In addition, the association between dietary patterns and QoL were cross-sectionally and longitudinally investigated. METHODS A breast cancer cohort which included 1462 Chinese women were longitudinally interviewed at four time-points, namely baseline, 18-, 36-, and 60 months after diagnosis. At each follow-up, validated food frequency questionnaires (FFQ) were used to assess patients' dietary intake, and factor analysis was used to derive dietary patterns. European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) were used to measure QoL at each follow-up. This study included 1368, 1226, 1079 and 1095 patients with invasive disease who completed assessment at baseline, 18-, 36- and 60-month follow-up and had detailed data of dietary intake and QoL. RESULTS Based on data obtained at 18-month follow-up, two major dietary patterns were identified: "grain and animal food pattern" and "vegetables and fruits pattern". Similar dietary patterns were obtained at baseline, 36- and 60- month follow-up. Generalized Estimating Equations (GEE) were used to analyze the longitudinal associations between dietary patterns and QoL over the four follow-ups. High intake of grain and animal food was inversely associated with scores for role functioning (B = - 0.744; 95%CI - 0.147 to - 0.017), dyspnea (B = - 0.092; 95%CI - 0.092 to - 0.092) and constipation (B = - 1.355; 95%CI - 2.174 to - 0.536). Vegetables and fruits intake were positively associated with scores for global health status/QoL (B = 1.282; 95%CI 0.545-2.019), physical functioning (B = 0.545; 95%CI: 0.037-1.053), emotional functioning (B = 1.426; 95%CI 0.653-2.200) and cognitive functioning (B = 0.822; 95%CI 0.007-1.637), while inversely associated with scores for nausea and vomiting (B = - 0.382; 95%CI - 0.694 to - 0.071), dyspnea (B = - 0.570; 95%CI - 0.570 to - 0.570), insomnia (B = - 1.412; 95%CI - 2.647 to - 0.177), loss of appetite (B = - 0.722; 95%CI - 1.311 to - 0.132), constipation (B = - 2.028; 95%CI - 2.775 to - 1.281) and diarrhea (B = - 0.929; 95%CI - 1.481 to - 0.377). CONCLUSION This study suggested that high adherence to "grain and animal food pattern" or "vegetables and fruits pattern" was significantly associated with several aspects of QoL. For instance, vegetables and fruits pattern appears to have beneficial effect on global health status/QoL among Chinese breast cancer patients. Prospective follow-up data could further confirm whether a specific dietary pattern has impact on cancer outcomes.
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Affiliation(s)
- Yuan-Yuan Lei
- Department of Clinical Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
| | - Suzanne C Ho
- Division of Epidemiology, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China
| | - Carol Kwok
- Department of Clinical Oncology, Princess Margaret Hospital, New Territories, Hong Kong SAR, China
| | - Ashley Cheng
- Department of Clinical Oncology, Princess Margaret Hospital, New Territories, Hong Kong SAR, China
| | - Ka Li Cheung
- Department of Clinical Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
| | - Roselle Lee
- Department of Clinical Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
| | - Frankie K F Mo
- Department of Clinical Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
- State Key Laboratory in Oncology in South China, Faculty of Medicine, Hong Kong Cancer Institute, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China
| | - Winnie Yeo
- Department of Clinical Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China.
- State Key Laboratory in Oncology in South China, Faculty of Medicine, Hong Kong Cancer Institute, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China.
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Sleight AG, Crowder SL, Skarbinski J, Coen P, Parker NH, Hoogland AI, Gonzalez BD, Playdon MC, Cole S, Ose J, Murayama Y, Siegel EM, Figueiredo JC, Jim HSL. A New Approach to Understanding Cancer-Related Fatigue: Leveraging the 3P Model to Facilitate Risk Prediction and Clinical Care. Cancers (Basel) 2022; 14:cancers14081982. [PMID: 35454890 PMCID: PMC9027717 DOI: 10.3390/cancers14081982] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/12/2022] [Accepted: 04/12/2022] [Indexed: 01/02/2023] Open
Abstract
Simple Summary For the growing number of cancer survivors worldwide, fatigue presents a major hurdle to function and quality of life. Treatment options for cancer-related fatigue are still emerging, and our current understanding of its etiology is limited. In this paper, we describe a new application of a comprehensive model for cancer-related fatigue: the predisposing, precipitating, and perpetuating (3P) factors model. We propose that the 3P model may be leveraged—particularly using metabolomics, the microbiome, and inflammation in conjunction with behavioral science—to better understand the pathophysiology of cancer-related fatigue. Abstract A major gap impeding development of new treatments for cancer-related fatigue is an inadequate understanding of the complex biological, clinical, demographic, and lifestyle mechanisms underlying fatigue. In this paper, we describe a new application of a comprehensive model for cancer-related fatigue: the predisposing, precipitating, and perpetuating (3P) factors model. This model framework outlined herein, which incorporates the emerging field of metabolomics, may help to frame a more in-depth analysis of the etiology of cancer-related fatigue as well as a broader and more personalized set of approaches to the clinical treatment of fatigue in oncology care. Included within this review paper is an in-depth description of the proposed biological mechanisms of cancer-related fatigue, as well as a presentation of the 3P model’s application to this phenomenon. We conclude that a clinical focus on organization risk stratification and treatment around the 3P model may be warranted, and future research may benefit from expanding the 3P model to understand fatigue not only in oncology, but also across a variety of chronic conditions.
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Affiliation(s)
- Alix G. Sleight
- Department of Physical Medicine & Rehabilitation, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA;
- Center for Integrated Research in Cancer and Lifestyle, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Sylvia L. Crowder
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33601, USA; (S.L.C.); (N.H.P.); (A.I.H.); (B.D.G.)
| | - Jacek Skarbinski
- Division of Research, Kaiser Permanente Northern California, Oakland, CA 94501, USA;
- Department of Infectious Diseases, Oakland Medical Center, Kaiser Permanente Northern California, Oakland, CA 94501, USA
- Physician Researcher Program, Kaiser Permanente Northern California, Oakland, CA 94501, USA
- The Permanente Medical Group, Kaiser Permanente Northern California, Oakland, CA 94501, USA
| | - Paul Coen
- AdventHealth Orlando, Translational Research Institute, Orlando, FL 32804, USA;
| | - Nathan H. Parker
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33601, USA; (S.L.C.); (N.H.P.); (A.I.H.); (B.D.G.)
| | - Aasha I. Hoogland
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33601, USA; (S.L.C.); (N.H.P.); (A.I.H.); (B.D.G.)
| | - Brian D. Gonzalez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33601, USA; (S.L.C.); (N.H.P.); (A.I.H.); (B.D.G.)
| | - Mary C. Playdon
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT 84044, USA;
- Department of Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84044, USA
| | - Steven Cole
- Department of Psychiatry & Biobehavioral Sciences and Medicine, University of California, Los Angeles, CA 90001, USA;
| | - Jennifer Ose
- Department of Population Sciences, University of Utah, Salt Lake City, UT 84044, USA;
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84044, USA
| | - Yuichi Murayama
- Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA; (Y.M.); (J.C.F.)
| | - Erin M. Siegel
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL 33601, USA;
| | - Jane C. Figueiredo
- Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA; (Y.M.); (J.C.F.)
| | - Heather S. L. Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33601, USA; (S.L.C.); (N.H.P.); (A.I.H.); (B.D.G.)
- Correspondence:
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Crowder SL, Playdon MC, Gudenkauf LM, Ose J, Gigic B, Greathouse L, Peoples AR, Sleight AG, Jim HSL, Figueiredo JC. A Molecular Approach to Understanding the Role of Diet in Cancer-Related Fatigue: Challenges and Future Opportunities. Nutrients 2022; 14:nu14071496. [PMID: 35406105 PMCID: PMC9003400 DOI: 10.3390/nu14071496] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 03/27/2022] [Accepted: 03/31/2022] [Indexed: 02/04/2023] Open
Abstract
Cancer-related fatigue (CRF) is considered one of the most frequent and distressing symptoms for cancer survivors. Despite its high prevalence, factors that predispose, precipitate, and perpetuate CRF are poorly understood. Emerging research focuses on cancer and treatment-related nutritional complications, changes in body composition, and nutritional deficiencies that can compound CRF. Nutritional metabolomics, the novel study of diet-related metabolites in cells, tissues, and biofluids, offers a promising tool to further address these research gaps. In this position paper, we examine CRF risk factors, summarize metabolomics studies of CRF, outline dietary recommendations for the prevention and management of CRF in cancer survivorship, and identify knowledge gaps and challenges in applying nutritional metabolomics to understand dietary contributions to CRF over the cancer survivorship trajectory.
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Affiliation(s)
- Sylvia L. Crowder
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33617, USA; (S.L.C.); (L.M.G.); (H.S.L.J.)
| | - Mary C. Playdon
- Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA;
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT 84112, USA
| | - Lisa M. Gudenkauf
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33617, USA; (S.L.C.); (L.M.G.); (H.S.L.J.)
| | - Jennifer Ose
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT 84112, USA; (J.O.); (A.R.P.)
- Huntsman Cancer Institute, Salt Lake City, UT 84112, USA
| | - Biljana Gigic
- Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, 69047 Heidelberg, Germany;
| | - Leigh Greathouse
- Human Science and Design, Robbins College of Health and Human Sciences, Baylor University, Waco, TX 76798, USA;
| | - Anita R. Peoples
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT 84112, USA; (J.O.); (A.R.P.)
- Huntsman Cancer Institute, Salt Lake City, UT 84112, USA
| | - Alix G. Sleight
- Department of Physical Medicine and Rehabilitation, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA;
- Center for Integrated Research in Cancer and Lifestyle, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Heather S. L. Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33617, USA; (S.L.C.); (L.M.G.); (H.S.L.J.)
| | - Jane C. Figueiredo
- Center for Integrated Research in Cancer and Lifestyle, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Correspondence:
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Kleckner AS, van Wijngaarden E, Jusko TA, Kleckner IR, Lin PJ, Mustian KM, Peppone LJ. Serum carotenoids and cancer-related fatigue: An analysis of the 2005-2006 National Health and Nutrition Examination Survey. CANCER RESEARCH COMMUNICATIONS 2022; 2:202-210. [PMID: 36134125 PMCID: PMC9489051 DOI: 10.1158/2767-9764.crc-21-0172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/17/2023]
Abstract
Cancer-related fatigue is a prevalent, debilitating condition, and preliminary evidence suggests a relationship between higher diet quality and lower fatigue. Serum-based carotenoids, Vitamin A, and Vitamin E are biomarkers of fruit and vegetable intake and therefore diet quality. To further elucidate the link between diet quality and cancer-related fatigue, associations were assessed between these serum-based nutrients and fatigue among American adults with special attention to cancer history. Data were analyzed from the United States 2005-2006 National Health and Nutrition Examination Survey (NHANES) dataset. Ten carotenoids, vitamin A, vitamin E, and γ-tocopherol were measured from fasting blood samples and fatigue was patient-reported. Associations between carotenoid concentration and fatigue were estimated using ordinal logistic regression models. Adjusted models included a diagnosis of cancer (with the exception on non-melanoma skin cancer, yes/no), age, body mass index, race/ethnicity, education, and exercise habits as covariates, and additional models included a cancer×nutrient interaction. Of 4091 participants, 272 (8.0%) reported a history of cancer. Greater fatigue was associated with lower serum trans-lycopene, retinyl palmitate, and retinyl stearate (all p<0.05) in separate models adjusting for potential confounders. For these nutrients, a one-standard deviation increase in nutrient was associated with a 6.8-9.9% lower risk of greater fatigue. Among cancer survivors only (n=272), statistically significant associations were not observed between any of the nutrients and fatigue. In conclusion, greater serum concentrations of carotenoid biomarkers were associated with less fatigue. These results support further exploration into relationships between carotenoid intake, diet quality, and persistent fatigue.
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Affiliation(s)
- Amber S. Kleckner
- Department of Pain and Translational Symptom Science, University of Maryland School of Nursing, Baltimore, Maryland
- Corresponding Author: Amber Kleckner, Department of Pain and Translational Symptom Science, University of Maryland School of Nursing, 655 W. Lombard Street, 7th floor, Baltimore, MD 21201. Phone: 410-706-5961; E-mail:
| | - Edwin van Wijngaarden
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, New York
| | - Todd A. Jusko
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, New York
| | - Ian R. Kleckner
- Department of Pain and Translational Symptom Science, University of Maryland School of Nursing, Baltimore, Maryland
| | - Po-Ju Lin
- Division of Supportive Care in Cancer, Department of Surgery, University of Rochester Medical Center, Rochester, New York
| | - Karen M. Mustian
- Division of Supportive Care in Cancer, Department of Surgery, University of Rochester Medical Center, Rochester, New York
| | - Luke J. Peppone
- Division of Supportive Care in Cancer, Department of Surgery, University of Rochester Medical Center, Rochester, New York
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10
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Wang Y, Liu Y, Zhang Y, Huo Z, Wang G, He Y, Man S, Gao W. Effects of the polysaccharides extracted from Chinese yam ( Dioscorea opposita Thunb.) on cancer-related fatigue in mice. Food Funct 2021; 12:10602-10614. [PMID: 34585194 DOI: 10.1039/d1fo00375e] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The aim of this study was to investigate the anti-fatigue activity of Chinese Yam polysaccharides (CYPs). The structural characterization of CYPs was conducted using Fourier transform-infrared spectroscopy, nuclear magnetic resonance spectroscopy, gel permeation chromatography-light scattering-refractive index, and ion chromatography. The weight-loaded swimming capability, behavior performance, tumor growth, content of adenosine triphosphate (ATP), and biochemical markers of CYP in a cancer-related fatigue mouse model were tested. The results showed that CYP is a mixture with an average Mw of 75.57 kDa and is mainly composed of rhamnose, glucuronic acid, glucose, galactose, and arabinose with a molar ratio of 0.01 : 0.06 : 1.00 : 0.17 : 0.01. CYP increased the exhausting swimming time, which was decreased in the cisplatin (DDP) control group and the model group. CYP also increased the content of ATP in musculus gastrocnemius, which was down-regulated by DDP; the DDP had significantly enhanced the contents of interleukin-1β (IL-lβ), malondialdehyde (MDA), blood urea nitrogen (BUN) and lactic dehydrogenase (LDH) and inhibited the activity of superoxide dismutase (SOD) in the muscle. Administration of CYP decreased the levels of IL-lβ, MDA, BUN and LDH, and up-regulated the SOD activity. The DDP + CYP group presented a decreased tumor volume and a lower tumor weight as compared with the model group. Moreover, the mice in the CYP or DDP + CYP groups had heavier body weights than the mice in the model group and DDP group. These results suggest that CYP should improve cancer-related fatigue via the regulation of inflammatory responses, oxidative stress and increase in energy supplementation.
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Affiliation(s)
- Yu Wang
- Tianjin Key Laboratory for Modern Drug Delivery & High-Efficiency, School of Pharmaceutical Science and Technology, Tianjin University, Tianjin 300072, China. .,Tasly Academy, Tasly Holding Group Co., Ltd., No. 2 Pujihe East Road, Tasly TCM Garden, Beichen District, Tianjin 300410, China.,State Key Laboratory of Core Technology in Innovative Chinese Medicine, Tasly Holding Group Co., Ltd., No. 2 Pujihe East Road, Tasly TCM Garden, Beichen District, Tianjin 300410, China
| | - Yuanxue Liu
- Tasly Academy, Tasly Holding Group Co., Ltd., No. 2 Pujihe East Road, Tasly TCM Garden, Beichen District, Tianjin 300410, China.,State Key Laboratory of Core Technology in Innovative Chinese Medicine, Tasly Holding Group Co., Ltd., No. 2 Pujihe East Road, Tasly TCM Garden, Beichen District, Tianjin 300410, China
| | - Yiqian Zhang
- Tasly Academy, Tasly Holding Group Co., Ltd., No. 2 Pujihe East Road, Tasly TCM Garden, Beichen District, Tianjin 300410, China.,State Key Laboratory of Core Technology in Innovative Chinese Medicine, Tasly Holding Group Co., Ltd., No. 2 Pujihe East Road, Tasly TCM Garden, Beichen District, Tianjin 300410, China
| | - Zhipeng Huo
- Tasly Academy, Tasly Holding Group Co., Ltd., No. 2 Pujihe East Road, Tasly TCM Garden, Beichen District, Tianjin 300410, China.,State Key Laboratory of Core Technology in Innovative Chinese Medicine, Tasly Holding Group Co., Ltd., No. 2 Pujihe East Road, Tasly TCM Garden, Beichen District, Tianjin 300410, China
| | - Genbei Wang
- Tianjin Key Laboratory for Modern Drug Delivery & High-Efficiency, School of Pharmaceutical Science and Technology, Tianjin University, Tianjin 300072, China. .,Tasly Academy, Tasly Holding Group Co., Ltd., No. 2 Pujihe East Road, Tasly TCM Garden, Beichen District, Tianjin 300410, China.,State Key Laboratory of Core Technology in Innovative Chinese Medicine, Tasly Holding Group Co., Ltd., No. 2 Pujihe East Road, Tasly TCM Garden, Beichen District, Tianjin 300410, China
| | - Yi He
- Tianjin Key Laboratory for Modern Drug Delivery & High-Efficiency, School of Pharmaceutical Science and Technology, Tianjin University, Tianjin 300072, China. .,Tasly Academy, Tasly Holding Group Co., Ltd., No. 2 Pujihe East Road, Tasly TCM Garden, Beichen District, Tianjin 300410, China.,State Key Laboratory of Core Technology in Innovative Chinese Medicine, Tasly Holding Group Co., Ltd., No. 2 Pujihe East Road, Tasly TCM Garden, Beichen District, Tianjin 300410, China
| | - Shuli Man
- State Key Laboratory of Food Nutrition and Safety, Key Laboratory of Industrial Microbiology, Ministry of Education, College of Biotechnology, Tianjin University of Science & Technology, Tianjin, 300457, China.
| | - Wenyuan Gao
- Tianjin Key Laboratory for Modern Drug Delivery & High-Efficiency, School of Pharmaceutical Science and Technology, Tianjin University, Tianjin 300072, China.
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11
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Wang S, Yang T, Qiang W, Shen A, Zhao Z, Liu X. Benefits of Dietary Management in Breast Cancer Patients: A Systematic Review and Meta-Analysis. Nutr Cancer 2021; 74:1580-1592. [PMID: 34319187 DOI: 10.1080/01635581.2021.1957129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The World Cancer Research Fund/American Institute of Cancer Research recommendations include guidance on diet, nutrition, and weight management for people with cancer. However, for women diagnosed with breast cancer there is a lack of comprehensive analyses on the effects of dietary interventions. The purpose of this study was to investigate the impact of changes in dietary behavior and body composition on breast cancer development. A comprehensive and systematic literature search of 12 electronic databases was undertaken on January 27, 2021 to identify randomized controlled trials (RCTs) of dietary interventions for breast cancer. The Cochrane risk bias assessment tool was used to evaluate the quality of the trials identified with the data analyzed by Review Manager 5.3 software. The results showed that dietary interventions probably did not modify servings of fruit (P = 0.08), fat intake (P = 0.10), total cholesterol level (P = 0.82), body weight (P = 0.08), waist circumference (P = 0.15), or waist-to-hip ratio (P = 0.32). However, a significant reduction in body mass index (P = 0.03), and hip circumference (P = 0.03), and improvement in energy intake (P = 0.02), vegetable servings (P < 0.0001), and fiber intake (P < 0.00001) were observed. Future studies should investigate the benefits of exercise in combination with dietary interventions in breast cancer patients.Supplemental data for this article is available online at https://doi.org/10.1080/01635581.2021.1957129.
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Affiliation(s)
- Shurui Wang
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Ting Yang
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Wanmin Qiang
- Nursing Department, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China
| | - Aomei Shen
- Nursing Department, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China
| | - Zihan Zhao
- Nursing Department, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China
| | - Xiaofeng Liu
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
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12
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Gonzalez-Mercado VJ, Marrero S, Pérez-Santiago J, Tirado-Gómez M, Marrero-Falcón MA, Pedro E, Saligan LN. Association of Radiotherapy-Related Intestinal Injury and Cancer-related Fatigue: A Brief Review and Commentary. PUERTO RICO HEALTH SCIENCES JOURNAL 2021; 40:6-11. [PMID: 33876912 PMCID: PMC9109698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Radiotherapy treatment-induced intestinal injury and gut microbial perturbation/dysbiosis have been implicated in the pathobiology of cancer-related fatigue. The objective of this brief review was to explore the available evidence of the relationship between intestinal injury and self-reported fatigue, especially among cancer patients. The scientific evidence-including our own-linking gut mucosal barrier dysfunction and gut microbial perturbation/dysbiosis induced by cancer treatment with worsening of cancer related fatigue (perhaps through the gut-brain axis) is limited but promising. Emerging data suggest that lifestyle interventions and the administration of specific probiotics may favorably modulate the gut microbiota and potentially mediate beneficial effects leading to improvements in fatigue.
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Affiliation(s)
| | - Sara Marrero
- College of Arts and Sciences, University of South Florida, Tampa, FL, United States
| | - Josué Pérez-Santiago
- Assistant Professor of Computational Biology and Bioinformatics Director, Puerto Rico Omics Center Comprehensive Cancer Center, University of Puerto Rico San Juan, PR
| | - Maribel Tirado-Gómez
- Assistant Professor of Medicine, Department of Hematology and Oncology, Medical Sciences Campus, University of Puerto Rico, San Juan, PR
| | | | - Elsa Pedro
- Assistant Professor, School of Pharmacy, Medical Sciences Campus, University of Puerto Rico, San Juan, PR
| | - Leorey N Saligan
- Tenure-Track Investigator and Chief of Symptom Biology Unit NINR/NIH, Bethesda, MD, United States
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13
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Marchello NJ, Gibbs HD, Sullivan DK, Taylor MK, Hamilton-Reeves JM, Beltramo AF, Befort CA. Rural breast cancer survivors are able to maintain diet quality improvements during a weight loss maintenance intervention. J Cancer Surviv 2020; 15:576-584. [DOI: 10.1007/s11764-020-00951-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 09/28/2020] [Indexed: 12/11/2022]
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14
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do Nascimento Santos Lima E, Ferreira IB, Lajolo PP, Paiva CE, de Paiva Maia YC, das Graças Pena G. Health-related quality of life became worse in short-term during treatment in head and neck cancer patients: a prospective study. Health Qual Life Outcomes 2020; 18:307. [PMID: 32938480 PMCID: PMC7493852 DOI: 10.1186/s12955-020-01543-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 08/26/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Quality of life (QoL) is influenced in head and neck cancer (HNC) patients by a set of factors related to diagnosis, treatment and tumor impacts. The aim of this study was to evaluate the Quality of Life (QoL) changes in Head and Neck cancer (HNC) patients during treatment (radiotherapy and/or chemoradiotherapy). METHODS QoL was evaluated prospectively in 63 HNC patients during radiotherapy and/or chemoradiotherapy at three moments: before or at beginning (T0), in the middle (T1 ~ four weeks) and immediately at the end (T2 ~ eight weeks) of treatment. The differences between the scores at different time points was verified using Friedman's non-parametric test. Negative changes between time points were evaluated, with differences (delta) of ±10 points being considered to be clinically significant. RESULTS The total mean age was 59.1 ± 9.5y, and 82.5% were male. The oral cavity and larynx were more frequent tumors. The functional score for 'role' was decreased at time points T1 and T2 as compared to T0, while an improvement in scores was observed for cognitive function. Several physical symptoms also worsened over time, such as: fatigue, nausea and vomiting, dry mouth and sticky saliva, swallowing and skin symptoms, senses and teeth problems. A high frequency of altered and clinically meaningful values were observed for most of domains, ranging from 6 to 74%. CONCLUSIONS The QoL became worse at approximately one month after treatment beginning in HNC patients, and this remained until the end of therapy. Protocols directing to early nutritional counseling and management of symptoms of nutritional impact are important to improve clinical outcomes. This is part of preventive actions aiming to make the exhausting treatment process less traumatic and easier to complete.
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Affiliation(s)
- Emanuelle do Nascimento Santos Lima
- Graduate Program in Health Sciences, Federal University of Uberlandia, Pará Av, 1720 / 2U, Campus Umuarama, Uberlandia, Minas Gerais 38400-902 Brazil
| | - Isabela Borges Ferreira
- Graduate Program in Health Sciences, Federal University of Uberlandia, Pará Av, 1720 / 2U, Campus Umuarama, Uberlandia, Minas Gerais 38400-902 Brazil
| | - Paula Philbert Lajolo
- Department of Clinical Oncology, Clinical Hospital, Federal University of Uberlandia, Pará Av, 1720 / sala 9, Campus Umuarama, Uberlandia, Minas Gerais 38.405-320 Brazil
| | - Carlos Eduardo Paiva
- Department of Clinical Oncology and Research Group on Palliative Care and Health-Related Quality of Life (GPQual), Barretos Cancer Hospital, Barretos, Antenor Duarte Viléla St, 1331, Dr. Paulo Prata, Barretos, SP 14784-400 Brazil
| | - Yara Cristina de Paiva Maia
- School of Medicine; Nutrition Course, Federal University of Uberlandia, Pará Av, 1720 / 2U, Campus Umuarama, Uberlandia, Minas Gerais 38400-902 Brazil
| | - Geórgia das Graças Pena
- School of Medicine; Nutrition Course, Federal University of Uberlandia, Pará Av, 1720 / 2U, Campus Umuarama, Uberlandia, Minas Gerais 38400-902 Brazil
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15
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Cooking for Vitality: Pilot Study of an Innovative Culinary Nutrition Intervention for Cancer-Related Fatigue in Cancer Survivors. Nutrients 2020; 12:nu12092760. [PMID: 32927752 PMCID: PMC7551599 DOI: 10.3390/nu12092760] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 09/04/2020] [Accepted: 09/07/2020] [Indexed: 12/21/2022] Open
Abstract
(1) Background: Cancer-related fatigue (CRF) is one of the most prevalent and distressing side effects experienced by patients with cancer during and after treatment, and this negatively impacts all aspects of quality of life. An increasing body of evidence supports the role of poor nutritional status in the etiology of CRF and of specific diets in mitigating CRF. We designed a group-based two session culinary nutrition intervention for CRF, Cooking for Vitality (C4V), aimed at increasing understanding of how food choices can impact energy levels and establishing basic food preparation and cooking skills as well as the application of culinary techniques that minimize the effort/energy required to prepare meals. The purpose of this pilot mixed-method study was to evaluate: Feasibility of the experimental methods and intervention; acceptability and perceived helpfulness of intervention; and to obtain a preliminary estimate of the effectiveness of the intervention on fatigue (primary outcome), energy, overall disability, and confidence to manage fatigue (secondary outcomes). (2) Methods: Prospective, single arm, embedded mixed-methods feasibility study of cancer survivors with cancer-related fatigue was conducted. Participants completed measures at baseline (T0), immediately following the intervention (T1), and three months after the last session (T2). Qualitative interviews were conducted at T2. (3) Results: Recruitment (70%) and retention (72%) rates along with qualitative findings support the feasibility of the C4V intervention for cancer survivors living with CRF (program length and frequency, ease of implementation, and program flexibility). Acceptability was also high and participants provided useful feedback for program improvements. Fatigue (FACT-F) scores significantly improved from T0–T1 and T0–T2 (p < 0.001). There was also a significant decrease in disability scores (WHO-DAS 2.0) from T0–T2 (p = 0.006) and an increase in POMS-Vigor (Profile of Mood States) from T0–T1 (p = 0.018) and T0–T2 (p = 0.013). Confidence in managing fatigue improved significantly from T0–T1 and T0–T2 (p < 0.001). (4) Conclusions: The results suggest that the C4V program was acceptable and helpful to patients and may be effective in improving fatigue levels and self-management skills. A randomized controlled trial is required to confirm these findings.
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16
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Psychoneurological symptom cluster in breast cancer: the role of inflammation and diet. Breast Cancer Res Treat 2020; 184:1-9. [DOI: 10.1007/s10549-020-05808-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 07/15/2020] [Indexed: 12/20/2022]
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17
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Ruiz-Casado A, Álvarez-Bustos A, de Pedro CG, Méndez-Otero M, Romero-Elías M. Cancer-related Fatigue in Breast Cancer Survivors: A Review. Clin Breast Cancer 2020; 21:10-25. [PMID: 32819836 DOI: 10.1016/j.clbc.2020.07.011] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 07/12/2020] [Accepted: 07/21/2020] [Indexed: 02/06/2023]
Abstract
Fatigue has been the most distressing and frequent symptom in breast cancer (BC) survivors after treatment. Although fatigue can occur in other cancer survivors, women with a history of BC might share some distinctive features. The present study aimed to recapitulate the knowledge about risk factors and correlates of cancer-related fatigue (CRF) in BC survivors after oncologic therapy. An electronic data search was conducted in PubMed using the terms "fatigue," "breast," "cancer," and "survivors." Records were included if they were original articles, available in English, had used a quantitative scale, had > 100 participants, and had excluded women with BC relapse. BC survivors were required to have finished their treatments ≥ 2 months before, except for hormonal therapy. The physiopathology and other interventions were considered beyond the scope of our review. The correlates were subsequently classified into 7 main categories: (1) sociodemographic data, (2) physical variables, (3) tumor- and treatment-related variables, (4) comorbidities, (5) other symptoms, (6) psychological issues, and (7) lifestyle factors. Fatigue was consistently greater in younger, obese, and diabetic women. Women reporting fatigue often communicated symptoms such as pain, depression, insomnia, and cognitive dysfunction. Coping strategies such as catastrophizing could play an important role in the persistence of fatigue. However, tumor characteristics, previous treatments received, and physical activity were not consistently reported. CRF was a strong predictor of the quality of life of BC survivors after treatment. In conclusion, we found CRF was a frequent and serious symptom that severely affects the quality of life of BC survivors after treatment. Health practitioners require more awareness and information about CRF.
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Affiliation(s)
- Ana Ruiz-Casado
- Department of Medical Oncology, University Hospital Puerta de Hierro-Majadahonda, Madrid, Spain.
| | | | - Cristina G de Pedro
- Department of Medical Oncology, University Hospital Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Marta Méndez-Otero
- Department of Medical Oncology, University Hospital Puerta de Hierro-Majadahonda, Madrid, Spain
| | - María Romero-Elías
- Department of Sport Sciences, Sport Research Centre, Miguel Hernandez University of Elche, Alicante, Spain
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18
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Shin KNL, Mun CY, Shariff ZM. Nutrition Indicators, Physical Function, and Health-Related Quality of Life in Breast Cancer Patients. Asian Pac J Cancer Prev 2020; 21:1939-1950. [PMID: 32711419 PMCID: PMC7573431 DOI: 10.31557/apjcp.2020.21.7.1939] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 07/15/2020] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE This study aimed to investigate how nutrition indicators and physical function may influence Health-related Quality of Life (HRQoL) of breast cancer patients undergoing treatment. METHODS This was a cross sectional study among a total of 163 breast cancer patients. Series of measurements including anthropometry, biochemical, and dietary were employed to assess patients' nutritional status while physical function was assessed by handgrip strength. HRQoL of patients was determined using European Organization for Research and Treatment of Cancer quality of life questionnaire Core 30 (EORTC-QLQ-C30) version 3.0. Multiple linear regression was used to identify factors associated with HRQoL. RESULTS Breast cancer patients perceived moderately their overall quality of life (QoL), with the mean global health status (GHS) score of 69.12. Emotional functioning was the poorest functional scale while fatigue was the most distressing symptom presented by the patients. Approximately 20% of patients had low corrected arm muscle area while more than half had low hemoglobin level. More than 90% of patients did not meet the overall dietary recommendation and had poor handgrip strength. Mid-upper arm circumference (MUAC) was associated with GHS (β: 0.906; 95% CI: 0.22, 1.56) and cognitive functioning (β: -1.543; 95% CI: -3.07, -0.01). Handgrip strength was positively associated with most of HRQoL outcomes. CONCLUSIONS Breast cancer patients reported overall good nutritional status and moderate QoL during treatment. Being well-nourished improved HRQoL and handgrip strength could be a potential proxy for functional outcomes as well as overall QoL.
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Affiliation(s)
- Krystal Ng Lu Shin
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Malaysia.
- Department of Health Education, Literacy, Promotion and Policy, National Cancer Society of Malaysia, Malaysia.
| | - Chan Yoke Mun
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Malaysia.
- Research Centre of Excellence Nutrition and Non-communicable Diseases, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Malaysia.
| | - Zalilah Mohd Shariff
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Malaysia.
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19
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Anti-Inflammatory Diets and Fatigue. Nutrients 2019; 11:nu11102315. [PMID: 31574939 PMCID: PMC6835556 DOI: 10.3390/nu11102315] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 09/12/2019] [Accepted: 09/25/2019] [Indexed: 12/12/2022] Open
Abstract
Accumulating data indicates a link between a pro-inflammatory status and occurrence of chronic disease-related fatigue. The questions are whether the observed inflammatory profile can be (a) improved by anti-inflammatory diets, and (b) if this improvement can in turn be translated into a significant fatigue reduction. The aim of this narrative review was to investigate the effect of anti-inflammatory nutrients, foods, and diets on inflammatory markers and fatigue in various patient populations. Next to observational and epidemiological studies, a total of 21 human trials have been evaluated in this work. Current available research is indicative, rather than evident, regarding the effectiveness of individuals’ use of single nutrients with anti-inflammatory and fatigue-reducing effects. In contrast, clinical studies demonstrate that a balanced diet with whole grains high in fibers, polyphenol-rich vegetables, and omega-3 fatty acid-rich foods might be able to improve disease-related fatigue symptoms. Nonetheless, further research is needed to clarify conflicting results in the literature and substantiate the promising results from human trials on fatigue.
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20
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The relationship between diet and cognitive function in adult cancer survivors: a systematic review. J Cancer Surviv 2019; 13:773-791. [PMID: 31399855 DOI: 10.1007/s11764-019-00796-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 08/01/2019] [Indexed: 12/17/2022]
Abstract
PURPOSE To perform a systematic review identifying how dietary factors are related to cognitive function in cancer survivors who are not currently undergoing primary treatment. METHODS Using the PRISMA framework, a search was conducted for studies published before February 2019 across multiple databases, identifying 2304 unique articles. Twelve met final inclusion criteria and were evaluated through narrative synthesis. This review was registered with the International Prospective Register Of Systematic Reviews (CRD42018111941). RESULTS Included studies were heterogeneous in methodology and in dietary and cognitive variables investigated making direct comparisons difficult. Evidence of a relationship between diet and cognition was mixed; the most consistent evidence was identified in relation to a positive relationship between fruit and vegetable intake and cognitive function (both self-reported and objectively tested) in five out of six studies, but was not concordant across all studies. CONCLUSION Preliminary evidence exists that a greater fruit and vegetable intake is associated with better cognitive functioning in cancer survivors, as has been reported in healthy populations; however, these data are correlational and include relatively small samples. Most evidence related to breast cancer survivors, with individual studies extending to colorectal and stomach cancer survivors. Experimental trials are needed to identify causal attribution of dietary factors on cognitive function in cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS At this time, there is not sufficient evidence to make dietary or nutritional recommendations specifically for improving cognitive function in cancer survivors. This should be considered in light of the general paucity of research on this subject, necessitating further investigations.
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21
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Okubo R, Matsuoka YJ, Sawada N, Mimura M, Kurotani K, Nozaki S, Shikimoto R, Tsugane S. Diet quality and depression risk in a Japanese population: the Japan Public Health Center (JPHC)-based Prospective Study. Sci Rep 2019; 9:7150. [PMID: 31073185 PMCID: PMC6509323 DOI: 10.1038/s41598-019-43085-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 04/16/2019] [Indexed: 12/11/2022] Open
Abstract
The association of overall diet quality based on the Japanese Food Guide Spinning Top with risk of depression is not known. This prospective cohort study aimed to determine whether higher adherence to the Japanese food guide reduced the risk of depression. Of 12,219 residents enrolled at baseline, we extracted 1,112 participants who completed a 5-year follow-up (1995) and participated in a mental health screening (2014–2015). Diet quality was scored based on adherence to the Japanese food guide and the ratio of white to red meat according to the Alternative Healthy Index and ranged from 0 (worst) to 80 (best). We calculated odds ratios and 95% confidence intervals for current psychiatrist-diagnosed depression per quartile of total score and of eight component scores with the lowest quartile as reference. Mean age of the participants was 73 years and 59% were women. Total diet quality score was not significantly associated with risk of depression 20 years after the baseline assessment. Among the eight components on the diet quality score, there was a significantly reduced risk for the highest quartile of the white to red meat ratio score. In conclusion, our results do not indicate that higher adherence to the Japanese food guide prevents depression.
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Affiliation(s)
- Ryo Okubo
- Division of Health Care Research, Center for Public Health Sciences, National Cancer Center Japan, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Yutaka J Matsuoka
- Division of Health Care Research, Center for Public Health Sciences, National Cancer Center Japan, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
| | - Norie Sawada
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center Japan, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Kayo Kurotani
- Department of Nutritional Education, National Institute of Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8636, Japan
| | - Shoko Nozaki
- Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Ryo Shikimoto
- Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Shoichiro Tsugane
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center Japan, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
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22
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Springfield S, Odoms-Young A, Tussing-Humphreys LM, Freels S, Stolley MR. A Step toward Understanding Diet Quality in Urban African-American Breast Cancer Survivors: A Cross-sectional Analysis of Baseline Data from the Moving Forward Study. Nutr Cancer 2019; 71:61-76. [PMID: 30775929 PMCID: PMC6527422 DOI: 10.1080/01635581.2018.1557217] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 10/27/2018] [Accepted: 11/06/2018] [Indexed: 01/09/2023]
Abstract
PURPOSE Little is known about the dietary behaviors of African-American breast cancer survivors (AABCS). We sought to describe dietary intake and quality in AABCS and examine associations with demographic, social, lifestyle, and body composition factors to potentially inform the development of effective dietary interventions. METHODS Baseline data from a prospective weight loss trial of 210 AABCS were assessed. A food frequency questionnaire was used to evaluate dietary intake and diet quality via the Healthy Eating Index 2010 (HEI-2010) and Alternative Healthy Eating Index 2010 (AHEI-2010). Linear regression analysis was conducted to determine the most influential variables on diet quality. RESULTS Mean HEI- and AHEI-2010 total scores were 65.11 and 56.83 indicating that diet quality needs improvement. Women were the least adherent to recommendations for intake of whole grains, dairy, sodium, empty calories, sugary beverages, red/processed meats, and trans-fat. Increased self-efficacy for healthy eating behaviors, more years of education (AHEI only), negative smoking status, smaller waist circumference, and increased physical activity (HEI only) were significantly associated with higher diet quality scores. CONCLUSION Our findings suggest the diet quality of AABCS needs improvement. Intervention programs may achieve higher diet quality in AABCS by focusing on increasing self-efficacy for healthy eating behaviors.
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Affiliation(s)
- Sparkle Springfield
- Stanford Prevention Research Center, School of Medicine, 3300 Hillview Ave (MC 5411), Palo Alto, CA 94304, US
| | - Angela Odoms-Young
- Department of Kinesiology and Nutrition, 646 Applied Health Sciences Building, 1919 West Taylor Street (MC 517), Chicago, IL 60612, US
- University of Illinois Cancer Center, 486 Westside Research Office Bldg., 1747 West Roosevelt Road (MC 275), Chicago, IL 60608, US
- School of Public Health, Division of Epidemiology and Biostatistics, 953 SPHP1, 1603 W Taylor St (MC 923), Chicago, IL 60612, US
| | - Lisa M. Tussing-Humphreys
- University of Illinois Cancer Center, 486 Westside Research Office Bldg., 1747 West Roosevelt Road (MC 275), Chicago, IL 60608, US
- School of Public Health, Division of Epidemiology and Biostatistics, 953 SPHP1, 1603 W Taylor St (MC 923), Chicago, IL 60612, US
| | - Sally Freels
- School of Public Health, Division of Epidemiology and Biostatistics, 953 SPHP1, 1603 W Taylor St (MC 923), Chicago, IL 60612, US
| | - Melinda R. Stolley
- Medical College of Wisconsin, Department of Medicine, 8701 Watertown Plank Road, Milwaukee, WI 53226, US
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23
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Kim NH, Song S, Jung SY, Lee E, Kim Z, Moon HG, Noh DY, Lee JE. Dietary pattern and health-related quality of life among breast cancer survivors. BMC WOMENS HEALTH 2018; 18:65. [PMID: 29747623 PMCID: PMC5946513 DOI: 10.1186/s12905-018-0555-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/16/2017] [Accepted: 04/26/2018] [Indexed: 11/12/2022]
Abstract
Background There is limited evidence for the association between dietary pattern and quality of life among breast cancer survivors. We examined the association between dietary patterns and health-related quality of life (HRQoL) among Korean breast cancer survivors. Methods Our study included a total of 232 women, aged 21 to 79 years, who had been diagnosed with stage I to III breast cancer and who underwent breast cancer surgery at least 6 months prior to our baseline evaluation. We assessed HRQoL using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) and the Quality of Life Questionnaire Breast Cancer Module 23 (QLQ-BR23). We conducted a factor analysis to identify the major dietary patterns and used a generalized linear model to obtain the least squares mean (LS mean) and 95% confidence interval (CI) for HRQoL according to the dietary pattern scores. Results We identified 2 major dietary patterns: the Healthy dietary pattern and the Western dietary pattern. We found that breast cancer survivors who had higher Healthy dietary pattern scores tended to have lower dyspnea scores but higher insomnia scores, compared to breast cancer survivors with lower Healthy dietary pattern scores. For dyspnea, the LS mean (95% CI) was 8.86 (5.05-15.52) in the bottom quartile and 2.87 (1.62-5.08) in the top quartile (p for trend = 0.005). This association was limited to survivors with stage I for dyspnea or survivors with stage II or III for insomnia. Conclusions Healthy dietary patterns were associated with better scores for dyspnea but worse scores for insomnia among breast cancer survivors. Other components of EORTC QLQ did not vary by dietary patterns overall, but they warrant further investigation for subgroups of breast cancer survivors. Electronic supplementary material The online version of this article (10.1186/s12905-018-0555-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Na-Hui Kim
- Department of Food and Nutrition, Sookmyung Women's University, Cheongpa-ro 47-gil 100, Yongsan-gu, Seoul, 04310, Korea
| | - Sihan Song
- Department of Food and Nutrition, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, Korea
| | - So-Youn Jung
- Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10408, Korea
| | - Eunsook Lee
- Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10408, Korea
| | - Zisun Kim
- Department of Surgery, Soonchunhyang University College of Medicine, 1174 Joong-dong, Wonmi-gu, Bucheon, Gyeonggi-do, 14584, Korea
| | - Hyeong-Gon Moon
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, 101 Daehakro, Jongno-gu, Seoul, 03080, Korea.,Breast Care Center, Seoul National University Hospital, 101 Daehakro, Jongno-gu, Seoul, 03080, Korea
| | - Dong-Young Noh
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, 101 Daehakro, Jongno-gu, Seoul, 03080, Korea.,Breast Care Center, Seoul National University Hospital, 101 Daehakro, Jongno-gu, Seoul, 03080, Korea
| | - Jung Eun Lee
- Department of Food and Nutrition, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, Korea.
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24
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The Effect of Nutrition Therapy and Exercise on Cancer-Related Fatigue and Quality of Life in Men with Prostate Cancer: A Systematic Review. Nutrients 2017; 9:nu9091003. [PMID: 28895922 PMCID: PMC5622763 DOI: 10.3390/nu9091003] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 08/15/2017] [Accepted: 09/07/2017] [Indexed: 12/16/2022] Open
Abstract
Background: Improvements in diet and/or exercise are often advocated during prostate cancer treatment, yet the efficacy of, and optimal nutrition and exercise prescription for managing cancer-related fatigue and quality of life remains elusive. The aim of this study is to systematically review the effects of nutrition and/or exercise on cancer-related fatigue and/or quality of life. Methods: A literature search was conducted in six electronic databases. The Delphi quality assessment list was used to evaluate the methodological quality of the literature. The study characteristics and results were summarized in accordance with the review’s Population, Intervention, Control, Outcome (PICO) criteria. Results: A total of 20 articles (one diet only, two combined diet and exercise, and seventeen exercise only studies) were included in the review. Soy supplementation improved quality of life, but resulted in several adverse effects. Prescribing healthy eating guidelines with combined resistance training and aerobic exercise improved cancer-related fatigue, yet its effect on quality of life was inconclusive. Combined resistance training with aerobic exercise showed improvements in cancer-related fatigue and quality of life. In isolation, resistance training appears to be more effective in improving cancer-related fatigue and quality of life than aerobic exercise. Studies that utilised an exercise professional to supervise the exercise sessions were more likely to report improvements in both cancer-related fatigue and quality of life than those prescribing unsupervised or partially supervised sessions. Neither exercise frequency nor duration appeared to influence cancer-related fatigue or quality of life, with further research required to explore the potential dose-response effect of exercise intensity. Conclusion: Supervised moderate-hard resistance training with or without moderate-vigorous aerobic exercise appears to improve cancer-related fatigue and quality of life. Targeted physiological pathways suggest dietary intervention may alleviate cancer-related fatigue and improve quality of life, however the efficacy of nutrition management with or without exercise prescription requires further exploration.
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25
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Zick SM, Colacino J, Cornellier M, Khabir T, Surnow K, Djuric Z. Fatigue reduction diet in breast cancer survivors: a pilot randomized clinical trial. Breast Cancer Res Treat 2016; 161:299-310. [PMID: 27913933 DOI: 10.1007/s10549-016-4070-y] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 11/28/2016] [Indexed: 01/25/2023]
Abstract
PURPOSE Fatigue is a prevalent and burdensome effect of breast cancer. Fatigue has been linked to chronic inflammation, and diets high in antioxidant nutrients have been associated with lesser prevalence and severity of fatigue. Studies are needed, however, to test if antioxidant-rich diets could improve fatigue. METHODS Pilot, randomized, trial conducted between January 2014 and April 2015, to investigate if a 3-month diet rich in fruit, vegetables, whole grains, and omega-3 fatty acid-rich foods, named the fatigue reduction diet (FRD), improved fatigue and sleep compared to an attention control, named the general health curriculum (GHC). 30 stage 0 to III breast cancer survivors, who had completed cancer treatments, were randomized: 15 receiving the FRD and 15 the GHC. Primary outcome was change in fatigue, as measured by the brief fatigue Inventory, from baseline to 3 months analyzed using linear mixed models. Secondary analyses were changes in sleep quality, serum carotenoids, and fatty acids. RESULTS From baseline to 3-month fatigue improved by 44 ± 39% in FRD compared to 8 ± 34% in GHC (p = 0.01); sleep quality improved by 2.5 ± 3.3 points in FRD, and diminished by 0.9 ± 2.3 in GHC (p = 0.03); serum total carotenoids (p < 0.01), β-cryptoxanthin (p = 0.02), lutein (p = 0.05), zeaxanthin (p = 0.01), lycopene (p = 0.05), omega-3 fatty acids (p < 0.01), and ratio of omega-3:omega-6 fatty acids (p = 0.02) were significantly increased, and percent saturated fatty acids were decreased (p = 0.04) in FRD; γ-tocopherol was significantly increased in GHC (p = 0.03), and there was a significant visit by group difference for α-carotene between the study groups (p = 0.05). CONCLUSIONS The FRD intervention improved fatigue and sleep in breast cancer survivors compared to the GHC. FRD diet could provide a non-toxic treatment strategy for persistent fatigue.
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Affiliation(s)
- Suzanna Maria Zick
- Department Family Medicine, University of Michigan Medical School, 24 Frank Lloyd Wright Drive, Ann Arbor, MI, 48105, USA. .,Department of Nutritional Sciences, University of Michigan School of Public Health, 1415 Washington Heights, 6651 SPH I, Ann Arbor, MI, 48109-2029, USA.
| | - Justin Colacino
- Department of Nutritional Sciences, University of Michigan School of Public Health, 1415 Washington Heights, 6651 SPH I, Ann Arbor, MI, 48109-2029, USA.,Environmental Health Sciences, University of Michigan School of Public Health, 1415 Washington Heights, 6651 SPH I, Ann Arbor, MI, 48109-2029, USA
| | - Maria Cornellier
- Department Family Medicine, University of Michigan Medical School, 24 Frank Lloyd Wright Drive, Ann Arbor, MI, 48105, USA
| | - Tohfa Khabir
- Department Family Medicine, University of Michigan Medical School, 24 Frank Lloyd Wright Drive, Ann Arbor, MI, 48105, USA
| | - Katie Surnow
- Department of Nutritional Sciences, University of Michigan School of Public Health, 1415 Washington Heights, 1700 SPH I, Ann Arbor, MI, 48109-2029, USA
| | - Zora Djuric
- Department Family Medicine, University of Michigan Medical School, 24 Frank Lloyd Wright Drive, Ann Arbor, MI, 48105, USA.,Department of Nutritional Sciences, University of Michigan School of Public Health, Cancer Center room 4306, Ann Arbor, MI, 48109-5936, USA
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26
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Shtaynberger J, Krebs P. Associations Between Decisional Balance and Health Behaviors Among Adult Cancer Survivors. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2016; 31:749-754. [PMID: 27524376 PMCID: PMC5073008 DOI: 10.1007/s13187-016-1097-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Interventions directed at health behavior change are increasingly being developed for cancer survivors. This study validates decisional balance measures for physical activity and fruit and vegetable (F/V) consumption among adult survivorship population. Participants were N = 86 patients who previously completed primary treatment for breast or prostate cancer for at least 5 years and were enrolled in an e-health intervention that aimed to improve physical activity and nutrition behaviors. Decisional balance, stage of change, F/V consumption, and physical activity were assessed at baseline and 3 months. Factor analysis was used to assess the structure of the decisional balance measures. The relationship between decisional balance, stage, and behavioral outcomes was assessed with mixed model analyses. The two factor structures of each measure were supported. Pros and cons differed across stages of change for both behaviors (p's < .0001). Total Metabolic Equivalent of Task units (METs) were related to decisional balance pros (p = .012) and cons (p = .003). F/V consumption was significantly associated with decisional balance pros (p = .0003), but not cons (p = .112). Overall, findings provide validation for these decisional balance measures as indicators of health behaviors and support the value of using these measures in further research to aid in understanding of behavior change in this population.
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Affiliation(s)
- Jonathan Shtaynberger
- Department of Population Health, New York University School of Medicine, 227 East 30th St. 7th Floor, New York, NY, 10016, USA
| | - Paul Krebs
- Department of Population Health, New York University School of Medicine, 227 East 30th St. 7th Floor, New York, NY, 10016, USA.
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27
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Zhang FF, Ojha RP, Krull KR, Gibson TM, Lu L, Lanctot J, Chemaitilly W, Robison LL, Hudson MM. Adult Survivors of Childhood Cancer Have Poor Adherence to Dietary Guidelines. J Nutr 2016; 146:2497-2505. [PMID: 27798341 PMCID: PMC5118766 DOI: 10.3945/jn.116.238261] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 08/05/2016] [Accepted: 09/21/2016] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Poor nutritional intake can exacerbate the chronic disease burden in childhood cancer survivors, whereas a healthful diet serves a protective function. Few studies have provided detailed evaluations of the diet of childhood cancer survivors. OBJECTIVES This study aimed to evaluate diet quality and dietary intakes of key food groups and nutrients in a large cohort of childhood cancer survivors and whether cancer and treatment characteristics have an impact on survivors' long-term intake. METHODS Diet was assessed in 2570 adult survivors of childhood cancer enrolled in the St. Jude Lifetime cohort (mean age = 32.3 y) by using the Block food-frequency questionnaire. The Healthy Eating Index-2010 (HEI-2010) was calculated to quantify diet quality. Cancer diagnosis and treatment exposure were abstracted from medical records. Differences in HEI-2010 by patient characteristics and treatment exposure were examined by using ANCOVA. RESULTS The mean ± SD HEI-2010 in childhood cancer survivors was 57.9 ± 12.4 of a maximum score of 100. Referenced to Dietary Reference Intakes, survivors consumed inadequate amounts of vitamin D, vitamin E, potassium, fiber, magnesium, and calcium (27%, 54%, 58%, 59%, 84%, and 90% of the recommended intakes) but excessive amounts of sodium and saturated fat (155% and 115% of the recommended intakes) from foods. Survivors diagnosed when <5 y of age had a lower diet quality than did those diagnosed when ≥5 y of age (mean HEI-2010 score: 56.9 compared with 58.2; P = 0.046). Survivors who received higher radiation doses to the abdomen had a lower diet quality than those who received lower doses (mean HEI-2010 scores = 58.9, 57.2, 56.7, and 56.1 for doses of 0, 1-19.9, 20-29.9, and ≥30 Gy, respectively; P = 0.02). CONCLUSIONS Long-term childhood cancer survivors have poor adherence to the 2010 Dietary Guidelines for Americans. Findings reinforce the need to incorporate nutrition into cancer care to improve diet quality and to reduce morbidities.
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Affiliation(s)
- Fang Fang Zhang
- Friedman School of Nutrition Science and Policy and
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA; and
| | | | | | | | - Lu Lu
- Departments of Epidemiology and Cancer Control
| | | | | | | | - Melissa M Hudson
- Departments of Epidemiology and Cancer Control
- Oncology, St. Jude Children's Research Hospital, Memphis, TN
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28
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Reeves MM, Terranova CO, Erickson JM, Job JR, Brookes DSK, McCarthy N, Hickman IJ, Lawler SP, Fjeldsoe BS, Healy GN, Winkler EAH, Janda M, Veerman JL, Ware RS, Prins JB, Vos T, Demark-Wahnefried W, Eakin EG. Living well after breast cancer randomized controlled trial protocol: evaluating a telephone-delivered weight loss intervention versus usual care in women following treatment for breast cancer. BMC Cancer 2016; 16:830. [PMID: 27793125 PMCID: PMC5086071 DOI: 10.1186/s12885-016-2858-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 10/19/2016] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Obesity, physical inactivity and poor diet quality have been associated with increased risk of breast cancer-specific and all-cause mortality as well as treatment-related side-effects in breast cancer survivors. Weight loss intervention trials in breast cancer survivors have shown that weight loss is safe and achievable; however, few studies have examined the benefits of such interventions on a broad range of outcomes and few have examined factors important to translation (e.g. feasible delivery method for scaling up, assessment of sustained changes, cost-effectiveness). The Living Well after Breast Cancer randomized controlled trial aims to evaluate a 12-month telephone-delivered weight loss intervention (versus usual care) on weight change and a range of secondary outcomes including cost-effectiveness. METHODS/DESIGN Women (18-75 years; body mass index 25-45 kg/m2) diagnosed with stage I-III breast cancer in the previous 2 years are recruited from public and private hospitals and through the state-based cancer registry (target n = 156). Following baseline assessment, participants are randomized 1:1 to either a 12-month telephone-delivered weight loss intervention (targeting diet and physical activity) or usual care. Data are collected at baseline, 6-months (mid-intervention), 12-months (end-of-intervention) and 18-months (maintenance). The primary outcome is change in weight at 12-months. Secondary outcomes are changes in body composition, bone mineral density, cardio-metabolic and cancer-related biomarkers, metabolic health and chronic disease risk, physical function, patient-reported outcomes (quality of life, fatigue, menopausal symptoms, body image, fear of cancer recurrence) and behaviors (dietary intake, physical activity, sitting time). Data collected at 18-months will be used to assess whether outcomes achieved at end-of-intervention are sustained six months after intervention completion. Cost-effectiveness will be assessed, as will mediators and moderators of intervention effects. DISCUSSION This trial will provide evidence needed to inform the wide-scale provision of weight loss, physical activity and dietary interventions as part of routine survivorship care for breast cancer survivors. TRIAL REGISTRATION Australian and New Zealand Clinical Trial Registry (ANZCTR) - ACTRN12612000997853 (Registered 18 September 2012).
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Affiliation(s)
- Marina M. Reeves
- School of Public Health, The University of Queensland, Brisbane, Australia
| | | | - Jane M. Erickson
- School of Public Health, The University of Queensland, Brisbane, Australia
| | - Jennifer R. Job
- School of Public Health, The University of Queensland, Brisbane, Australia
| | - Denise S. K. Brookes
- School of Public Health, The University of Queensland, Brisbane, Australia
- School of Medicine, Children’s Nutrition Research Centre, The University of Queensland, Brisbane, Australia
| | - Nicole McCarthy
- Icon Cancer Care, Wesley Medical Centre, Brisbane, Australia
| | - Ingrid J. Hickman
- Department of Nutrition & Dietetics, Princess Alexandra Hospital, Brisbane, Australia
- Mater Research Institute, University of Queensland, Brisbane, Australia
| | - Sheleigh P. Lawler
- School of Public Health, The University of Queensland, Brisbane, Australia
| | | | - Genevieve N. Healy
- School of Public Health, The University of Queensland, Brisbane, Australia
- Baker IDI Heart and Diabetes Institute, Melbourne, Australia
- School of Physiotherapy, Curtin University, Perth, Australia
| | | | - Monika Janda
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - J. Lennert Veerman
- School of Public Health, The University of Queensland, Brisbane, Australia
| | - Robert S. Ware
- School of Public Health, The University of Queensland, Brisbane, Australia
| | - Johannes B. Prins
- Mater Research Institute, University of Queensland, Brisbane, Australia
| | - Theo Vos
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA
| | | | - Elizabeth G. Eakin
- School of Public Health, The University of Queensland, Brisbane, Australia
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29
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Kenzik KM, Morey MC, Cohen HJ, Sloane R, Demark-Wahnefried W. Symptoms, weight loss, and physical function in a lifestyle intervention study of older cancer survivors. J Geriatr Oncol 2015; 6:424-32. [PMID: 26362355 PMCID: PMC4662250 DOI: 10.1016/j.jgo.2015.08.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Revised: 05/06/2015] [Accepted: 08/17/2015] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Many older cancer survivors are overweight or obese, with additional illness burden increasing functional decline, which may affect their ability to engage in lifestyle interventions. This study examined how overweight long-term survivors' symptom severity associated with comorbidity prior to a diet and exercise intervention was associated with post-intervention function and examined symptoms' effects on function through change in physical activity, diet quality, and weight status. MATERIALS AND METHODS This is a secondary data analysis of 514 breast, prostate, and colorectal cancer survivors who participated in the one-year home-based diet and exercise intervention Reach-Out to Enhance Wellness trial. Measures included symptoms, weight, physical activity, diet quality, overall physical function (PF), and basic and advanced lower extremity function (BLEF and ALEF). Simple and serial mediation analyses were conducted to examine direct effects of symptom severity on PF, BLEF, and ALEF and indirect effects of symptom severity through changes in diet quality, physical activity, and weight. RESULTS Symptom severity was directly associated with lower functioning scores for PF (b=-0.63 p<0.001), BLEF (b=-0.33, p<0.001), and ALEF (b=-0.22, p<0.001). Indirect effects of symptom severity through weight loss, physical activity, and diet were not significant. Weight loss and physical activity were associated with higher PF and ALEF and diet quality was associated with higher BLEF. CONCLUSION Symptom severity of older, overweight cancer survivors negatively affects physical function. However, greater weight loss and more physical activity were associated with higher functioning scores, regardless of symptom severity.
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Affiliation(s)
- Kelly M Kenzik
- University of Alabama at Birmingham, School of Medicine, Birmingham, AL, USA.
| | - Miriam C Morey
- Claude D. Pepper Older Americans Independence Center, Duke University Medical Center, Durham, NC, USA; Durham Veterans Affairs Medical Center, Geriatric Research, Education, and Clinical Center, Durham, NC, USA
| | - Harvey J Cohen
- Claude D. Pepper Older Americans Independence Center, Duke University Medical Center, Durham, NC, USA; Durham Veterans Affairs Medical Center, Geriatric Research, Education, and Clinical Center, Durham, NC, USA; Duke University School of Nursing, Durham, NC, USA
| | - Richard Sloane
- Durham Veterans Affairs Medical Center, Geriatric Research, Education, and Clinical Center, Durham, NC, USA; Duke University School of Nursing, Durham, NC, USA
| | - Wendy Demark-Wahnefried
- University of Alabama at Birmingham, School of Medicine, Birmingham, AL, USA; University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL, USA; University of Alabama at Birmingham Center for Aging, Birmingham, AL, USA
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30
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Coughlin SS, Yoo W, Whitehead MS, Smith SA. Advancing breast cancer survivorship among African-American women. Breast Cancer Res Treat 2015; 153:253-61. [PMID: 26303657 DOI: 10.1007/s10549-015-3548-3] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Accepted: 08/12/2015] [Indexed: 12/20/2022]
Abstract
Advances have occurred in breast cancer survivorship but, for many African-American women, challenges and gaps in relevant information remain. This article identifies opportunities to address disparities in breast cancer survival and quality of life, and thereby to increase breast cancer survivorship among African-American women. For breast cancer survivors, common side effects, lasting for long periods after cancer treatment, include fatigue, loss of strength, difficulty sleeping, and sexual dysfunction. For addressing physical and mental health concerns, a variety of interventions have been evaluated, including exercise and weight training, dietary interventions, yoga and mindfulness-based stress reduction, and support groups or group therapy. Obesity has been associated with breast cancer recurrence and poorer survival. Relative to white survivors, African-American breast cancer survivors are more likely to be obese and less likely to engage in physical activity, although exercise improves overall quality of life and cancer-related fatigue. Considerable information exists about the effectiveness of such interventions for alleviating distress and improving quality of life among breast cancer survivors, but few studies have focused specifically on African-American women with a breast cancer diagnosis. Studies have identified a number of personal factors that are associated with resilience, increased quality of life, and positive adaptation to a breast cancer diagnosis. There is a need for a better understanding of breast cancer survivorship among African-American women. Additional evaluations of interventions for improving the quality of life and survival of African-American breast cancer survivors are desirable.
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Affiliation(s)
- Steven S Coughlin
- Department of Community Health and Sustainability, Division of Public Health, University of Massachusetts, Lowell, MA, USA,
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31
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Wang XS, Woodruff JF. Cancer-related and treatment-related fatigue. Gynecol Oncol 2014; 136:446-52. [PMID: 25458588 DOI: 10.1016/j.ygyno.2014.10.013] [Citation(s) in RCA: 105] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Revised: 10/07/2014] [Accepted: 10/11/2014] [Indexed: 12/18/2022]
Abstract
Fatigue is a distressing and persistent symptom for patients with gynecological cancer and for survivors. Debilitating cancer-related fatigue (CRF) is produced by both the disease and its treatment. Although awareness and study of CRF have grown in recent years, consistent assessment has not been a priority in routine medical practice. The pathophysiological mechanisms that induce CRF remain unclear, and effective pharmacological interventions have yet to be established. Based on the literature and our own research results, this review focuses on recent progress toward understanding the nature and causes of CRF and on several promising treatment modalities. Given the prevalence and severity of CRF in the gynecological cancer patient population, establishing standardized fatigue measurement and management methods in routine clinical oncology care is of utmost importance. Whether CRF has an underlying inflammatory cause is still hypothetical, however, and no mechanism-driven symptom intervention is currently in clinical use, even though the development of such interventions would provide patients with greater symptom control. Advancing translational and clinical fatigue research will require anatomical pathway studies and well-designed clinical investigations that focus on the development of mechanism-driven interventions based on physiological-behavioral fatigue research, implementation of guidelines for experimental designs, and discovery of biomarkers identifying individuals at high risk for CRF. Validated patient-reported outcomes measures are an essential component of such clinical studies. Because numerous subscales, unidimensional measures, and multidimensional measures exist, clinicians and researchers should consider individual circumstances, good clinical practice, and research goals as guides for choosing the most appropriate fatigue measurement tool. Additionally, education about CRF should be made available to all patients and their caregivers, as accurate and age-appropriate information about conditions like CRF can alleviate much of the stress and anxiety brought on by poor communication about this distressing condition.
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Affiliation(s)
- Xin Shelley Wang
- Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Jeanie F Woodruff
- Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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