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Jack S, Andritsch E, Joaquim A, Kreissl M, Locati L, Netea-Maier R, Reverter J, Elisei R. Current landscape and support for practical initiation of oncological prehabilitation translatable to thyroid cancer: A position paper. Heliyon 2024; 10:e30723. [PMID: 38813200 PMCID: PMC11133508 DOI: 10.1016/j.heliyon.2024.e30723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 05/02/2024] [Accepted: 05/02/2024] [Indexed: 05/31/2024] Open
Abstract
Despite a growing body of evidence for the effectiveness of prehabilitation, the uptake of prehabilitation in Europe remains low. Contributing factors range from limited awareness and understanding of prehabilitation to a lack of supporting infrastructure and reimbursement challenges. In this position paper, the authors propose a new comprehensive definition of prehabilitation and identify differentiated thyroid cancer as a type of cancer particularly well-suited for prehabilitation. To support clinicians with the implementation of prehabilitation programs in their clinics, the authors discuss the following practical solutions: a) find the most appropriate prehabilitation program for each patient; b) raise awareness among peers; c) develop evidence to demonstrate the effectiveness of prehabilitation; d) expand the interdisciplinary team; e) expand your network and make use of existing assets; f) utilize learnings from the COVID-19 pandemic.
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Affiliation(s)
- S. Jack
- Clinical Experimental Sciences, Faculty of Medicine, University of Southampton, University Road, Southampton, SO17 1BJ, UK
| | - E. Andritsch
- Clinical Department of Oncology, University Medical Centre of Internal Medicine, Medical University of Graz, Auenbruggerpl. 2, 8036, Graz, Austria
| | - A. Joaquim
- ONCOMOVE®, Associação de Investigação de Cuidados de Suporte em Oncologia (AICSO), 4410-406, Vila Nova de Gaia, Portugal
| | - M.C. Kreissl
- Division of Nuclear Medicine, Department of Radiology and Nuclear Medicine, University Hospital Magdeburg, Otto von Guericke University, Universitatsplätz 2, 39106, Magdeburg, Germany
| | - L. Locati
- Department of Internal Medicine and Therapeutics, University of Pavia, S. da Nuova, 65, 27100, Pavia, PV, Italy
- Medical Oncology Unit, IRCCS ICS, Maugeri, Via Salvatore Maugeri, 10, 27100 Pavia PV, Italy
| | - R.T. Netea-Maier
- Division of Endocrinology, Department of Internal Medicine, Radboud University Medical Centre, Radboud Institute for Molecular Life Sciences, Geert Grooteplein Zuid 28, 6525, GA, Nijmegen, the Netherlands
| | - J.L. Reverter
- Endocrinology and Nutrition Department, Germans Trias i Pujol University Hospital, Universidad Autónoma de Barcelona, Placa Civica, 08193, Bellaterra, Barcelona, Spain
| | - R. Elisei
- Endocrine Unit, Department of Clinical and Experimental Medicine, University of Pisa, Lungarno Antonio Pacinotti, 43, 56126, Pisa, PI, Italy
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Fedorchenko Y, Mahmudov K, Abenov Z, Zimba O, Yessirkepov M. Rehabilitation of patients with inflammatory rheumatic diseases and comorbidities: unmet needs. Rheumatol Int 2024; 44:583-591. [PMID: 38296848 DOI: 10.1007/s00296-023-05529-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 12/25/2023] [Indexed: 02/02/2024]
Abstract
Comorbidities may contribute to inadequate response to therapy and accelerate disability in various rheumatic diseases such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and psoriatic arthritis (PsA). Cardiovascular, oncological, and infectious comorbidities are common in rheumatic patients. The rehabilitation of patients with inflammatory rheumatic diseases (IRDs) with comorbidities requires a multidisciplinary approach to improving patients' functional mobility, slowing down the disease progression and minimizing the risks of complications. The evidence suggests that cardiac rehabilitation can be implemented in daily practice in patients with IRDs to reduce mortality for those with established risk factors. Physical exercises reduce the severity, improve the clinical course, and reduce hospitalization rates in patients with rheumatic diseases. A rehabilitation program with focused physical therapy can lead to functional improvements and reduction of disease activity in patients with lowered quality of life (QoL). Health professionals should provide evidence-based recommendations for patients with rheumatic diseases and comorbidities to initiate the self-management of their diseases and prevent complications.
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Affiliation(s)
- Yuliya Fedorchenko
- Department of Pathophysiology, Ivano-Frankivsk National Medical University, Halytska Str. 2, Ivano-Frankivsk, 76018, Ukraine.
| | - Khaiyom Mahmudov
- Department of Propaedeutics of Internal Diseases, Avicenna Tajik State Medical University, Dushanbe, Tajikistan
| | - Zhumabek Abenov
- Student Polyclinic, Shymkent, Kazakhstan
- South Kazakhstan Medical Academy, Shymkent, Kazakhstan
| | - Olena Zimba
- Department of Clinical Rheumatology and Immunology, University Hospital in Krakow, Krakow, Poland
- National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
- Department of Internal Medicine N2, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
| | - Marlen Yessirkepov
- Department of Biology and Biochemistry, South Kazakhstan Medical Academy, Shymkent, Kazakhstan
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Ahmedzai HH, Oldervoll LM, Sweetmore AMH, Hauken MA. Community-Based Multidimensional Cancer Rehabilitation in Norway: A Feasibility Study. Cancer Nurs 2024; 47:E123-E133. [PMID: 36066332 DOI: 10.1097/ncc.0000000000001161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Cancer survival is often accompanied by late effects that can be mitigated by tailored rehabilitation. In Norway, this has traditionally been offered as residential programs, whereas community-based cancer rehabilitation programs are lacking. OBJECTIVE This study aimed to assess the feasibility and acceptability of a newly developed community-based multidimensional cancer rehabilitation program in Norway. METHODS A feasibility study with a mixed methods explanatory sequential design was implemented. The intervention was a 12-week group-based rehabilitation program comprising 5 components: goal setting, physical exercise, psychoeducation, individual follow-up consultations, and peer support. Feasibility was assessed through recruitment, retention, and intervention delivery. Acceptability was assessed through intervention adherence and participant evaluation. Qualitative data were generated from focus group interviews. Statistical analyses were descriptive, and qualitative data were transcribed and analyzed using framework analyses. RESULTS Sixty participants started, and 55 completed the 12-week rehabilitation program. The majority were female (80%), and the mean age was 56 years. The largest diagnostic group was breast cancer (42%). Retention was high (92%), as were adherence rates for all intervention components. The exercise component was rated the most beneficial, followed by individual consultations and peer support. Qualitative findings contributed to explaining the high adherence and positive evaluation. CONCLUSION High retention, strong adherence, and positive evaluation imply that the community-based program was feasible and acceptable to cancer survivors. IMPLICATION FOR PRACTICE The results will aid intervention refinement and contribute to a future randomized controlled trial to examine its effectiveness. If successful, the rehabilitation program could be implemented in the Norwegian Cancer Pathway "Home."
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Affiliation(s)
- Hilde Hjelmeland Ahmedzai
- Author Affiliations: Centre for Crisis Psychology, University of Bergen (Dr Ahmedzai, Profs Hauken and Oldervoll), Norway; and The Healthy Life Centre, Askøy District Council (Ms Sweetmore), Norway
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Aagesen M, la Cour K, Hauken MA, Pilegaard MS. The 'Young Adult Taking Action' programme for young adult cancer survivors: A study protocol for a feasibility study. Scand J Occup Ther 2023; 30:1472-1488. [PMID: 37557906 DOI: 10.1080/11038128.2023.2244563] [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: 11/14/2022] [Revised: 07/25/2023] [Accepted: 08/01/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND Young adult cancer survivors (YACS) aged 18-39 report age-specific multifactorial challenges with self-care, leisure, work and education requiring multicomponent rehabilitation intervention. Therefore, the 'Young Adult Taking Action' (YATAC) programme was developed. AIMS/OBJECTIVES To present a protocol for a feasibility study evaluating the acceptability of the YATAC programme and exploring implementation, mechanisms of impact and outcomes. MATERIAL AND METHODS A mixed-method feasibility study with a convergent research design will be conducted. The programme is an age-specific, multicomponent, goal-oriented, and peer-based rehabilitation programme delivered by an interdisciplinary staff consisting of nine components: 1) Goal setting, 2) Everyday life, 3) Physical activity, 4) Psychological issues, 5) Work and study, 6) Sexuality and relationship, 7) Rights and finance, 8) Peer-to-peer support and 9) Individual consultation. Quantitative and qualitative data about acceptability, implementation, mechanisms of impact and outcomes will be collected. RESULTS The results will provide essential knowledge about the programme's acceptability, implementation, mechanisms of impact and outcomes. CONCLUSION AND SIGNIFICANCE The study will inform adjustment of the programme and will provide knowledge of whether and how to deliver age-specific rehabilitation to YACS.
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Affiliation(s)
- Maria Aagesen
- Occupational Science, User Perspectives and Community-based Interventions, Department of Public Health, University of Southern Denmark, Odense, Denmark
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Nyborg, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Karen la Cour
- Occupational Science, User Perspectives and Community-based Interventions, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - May Aasebø Hauken
- Centre for Crisis Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Marc Sampedro Pilegaard
- Occupational Science, User Perspectives and Community-based Interventions, Department of Public Health, University of Southern Denmark, Odense, Denmark
- DEFACTUM, Central Region Denmark, Aarhus, Denmark
- Department of Clinical Social Medicine and Rehabilitation, Regional Hospital Gødstrup, Herning, Denmark
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Aagesen M, la Cour K, Møller JJK, Stapelfeldt CM, Hauken MA, Pilegaard MS. Rehabilitation interventions for young adult cancer survivors: A scoping review. Clin Rehabil 2023; 37:1347-1374. [PMID: 37083478 DOI: 10.1177/02692155231168720] [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] [Indexed: 04/22/2023]
Abstract
OBJECTIVE To map existing research concerning rehabilitation interventions for young adult cancer survivors (YACS) that address at least one factor from the biopsychosocial health model. DESIGN Scoping review. DATA SOURCES Searches were performed in EMBASE, MEDLINE, PsycINFO, CINAHL and Cochrane in January 2022 and updated in March 2023, and grey literature between February and April 2022. METHODS The review followed Joanna Briggs Institute's methodology for scoping reviews. Quantitative, qualitative and mixed methods studies evaluating interventions for YACS of any cancer who had completed primary treatment and were between 18 and 39 years old at diagnosis were included. Two authors independently screened studies for eligibility, and standardised forms were used for data extraction. Descriptive statistics, narrative summaries and thematic analysis were used to analyse the data. RESULTS The search revealed 5706 records, of which 70 were full-text screened. The 20 included studies represented a heterogeneous group of 444 young adults with different cancer types, mean age above 25, and an overrepresentation of females. Most studies were feasibility and pilot studies. The 20 studies consisted of 14 unique interventions focusing primarily on one dimension of the biopsychosocial health model like biological or psychological factors. In the 14 interventions, the most frequent intervention element was peer-to-peer support (n = 12). The interventions were often delivered online (n = 9), lasting 3-12 months (n = 8). A wide variety of theories, providers and outcome measures were used. CONCLUSION The results show that current research on multicomponent, biopsychosocial and age-specific rehabilitation for YACS remains at an early stage.
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Affiliation(s)
- Maria Aagesen
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Nyborg, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- The Research Unit for User Perspectives and Community-Based Interventions, The Research Group for Occupational Science, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Karen la Cour
- The Research Unit for User Perspectives and Community-Based Interventions, The Research Group for Occupational Science, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Jens-Jakob Kjer Møller
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Nyborg, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Christina M Stapelfeldt
- The Danish Clinical Quality Program - National Clinical Registries (RKKP), Aarhus N, Denmark
- Department of Public Health, Aarhus University, Aarhus C, Denmark
| | - May Aasebø Hauken
- Faculty of Psychology, Centre for Crisis Psychology, University of Bergen, Bergen, Norway
| | - Marc Sampedro Pilegaard
- Central Region Denmark, DEFACTUM, Aarhus, Denmark
- Department of Social Medicine and Rehabilitation, Regional Hospital Gødstrup, Herning, Denmark
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Lippi L, Turco A, Moalli S, Gallo M, Curci C, Maconi A, de Sire A, Invernizzi M. Role of Prehabilitation and Rehabilitation on Functional Recovery and Quality of Life in Thyroid Cancer Patients: A Comprehensive Review. Cancers (Basel) 2023; 15:4502. [PMID: 37760472 PMCID: PMC10526253 DOI: 10.3390/cancers15184502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 09/07/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND This narrative review aims to provide a comprehensive overview of the current prehabilitation and rehabilitation strategies for thyroid cancer survivors to optimize functional outcomes and enhance their quality of life. METHODS The review follows the SANRA quality criteria and includes an extensive literature search conducted in PubMed/Medline, Web of Science, and Scopus. RESULTS The review emphasizes the role of a comprehensive rehabilitation approach in targeting the different domains that generate disability in thyroid cancer patients. In this context, physical activity, range of motion exercises, myofascial release, joint mobilization, and postural exercises are crucial for improving functional outcomes and reducing treatment-related discomfort and disability. Moreover, tailored rehabilitative management addressing dysphonia and dysphagia might have a positive impact on the quality of life of these patients. Despite these considerations, several barriers still affect the implementation of a multimodal rehabilitative approach in common clinical practice. Thus, sustainable and effective strategies like digital innovation and patient-centered approaches are strongly needed in order to implement the rehabilitative treatment framework of these subjects. CONCLUSIONS This narrative review provides valuable insights into the current prehabilitation and rehabilitation strategies to treat thyroid cancer survivors, addressing physical, psychological, and vocational needs to optimize functional outcomes and enhance their quality of life.
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Affiliation(s)
- Lorenzo Lippi
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (A.T.); (S.M.)
- Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Translational Medicine, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy;
| | - Alessio Turco
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (A.T.); (S.M.)
| | - Stefano Moalli
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (A.T.); (S.M.)
| | - Marco Gallo
- Endocrinology and Metabolic Diseases Unit, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy;
| | - Claudio Curci
- Physical Medicine and Rehabilitation Unit, Department of Neurosciences, ASST Carlo Poma, 46100 Mantova, Italy;
| | - Antonio Maconi
- Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Translational Medicine, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy;
| | - Alessandro de Sire
- Physical and Rehabilitative Medicine Unit, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, Viale Europa, 88100 Catanzaro, Italy;
- Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy
| | - Marco Invernizzi
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (A.T.); (S.M.)
- Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Translational Medicine, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy;
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Song J, Li R, Hu X, Ding G, Chen M, Jin C. Current status of and future perspectives on care for cancer survivors in China. Glob Health Med 2023; 5:208-215. [PMID: 37655186 PMCID: PMC10461331 DOI: 10.35772/ghm.2023.01014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/01/2023] [Accepted: 05/09/2023] [Indexed: 09/02/2023]
Abstract
Cancer is currently a major public health issue faced by countries around the world. With the progress of medical science and technology, the survival rate of cancer patients has increased significantly and the survival time has been effectively prolonged. How to provide quality and efficient care for the increasingly large group of cancer survivors with limited medical resources will be a key concern in the field of global public health in the future. Compared to developed countries, China's theoretical research and practical experience in care for cancer survivors are relatively limited and cannot meet the multi-faceted and diverse care needs of cancer patients. Based on the existing models of care worldwide, the current work reviews care for cancer survivors in China, it proposes considerations and suggestions for the creation of models of cancer care with Chinese characteristics in terms of optimizing top-level system design, enhancing institutional mechanisms, accelerating human resource development, and enhancing self-management and social support for patients.
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Affiliation(s)
- Jie Song
- Shanghai Health Development Research Center, Shanghai Medical Information Center, Shanghai, China
| | - Ruijia Li
- Shanghai Health Development Research Center, Shanghai Medical Information Center, Shanghai, China
| | - Xiaojing Hu
- Shanghai Health Development Research Center, Shanghai Medical Information Center, Shanghai, China
| | - Gang Ding
- Oncology Department, Shanghai International Medical Center, Shanghai, China
| | - Minxing Chen
- Shanghai Health Development Research Center, Shanghai Medical Information Center, Shanghai, China
| | - Chunlin Jin
- Shanghai Health Development Research Center, Shanghai Medical Information Center, Shanghai, China
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Gjerset GM, Skaali T, Seland M, Thorsen L. Health-Related Quality of Life, Fatigue, Level of Physical Activity, and Physical Capacity Before and After an Outpatient Rehabilitation Program for Women Within Working Age Treated for Breast Cancer. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2023; 38:948-956. [PMID: 35974293 PMCID: PMC10234893 DOI: 10.1007/s13187-022-02211-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/01/2022] [Indexed: 06/02/2023]
Abstract
The aims were to examine changes in patient-reported outcome measures (PROMs), level of physical activity (LPA), and physical capacity from before to after an outpatient rehabilitation program (ORP) for women with breast cancer (BC). Further aims were to explore the proportions of patients with clinically relevant improvements defined as ≥ 10% beneficial change in the scores of PROMs and variables associated with such improvements.A total of 270 women within working age (< 67 years) who recently (< 1.5 years) had completed primary therapy for BC with curative intent were included. The ORP consisted of seven weekly group sessions with patient education, group conversations, and PA. The patients completed questionnaires measuring health-related quality of life (HRQoL), fatigue and LPA before (T0), immediately after (T1), and 6 months after (T2) the program, and were physically tested at T0 and T1. The mean age of the patients was 50.4 years (SD 7.3) and the mean time since diagnosis was 10.6 months (SD 2.6). All patients had undergone surgery and 94% radiotherapy, and 96% had received chemotherapy and/or hormonal therapy.Physical-, role-, emotional-, cognitive-, and social function, global health, and fatigue significantly improved from T0 to T1. Physical-, role-, and cognitive function, and fatigue significantly improved from T1 to T2. LPA and physical capacity significantly improved from T0 to T1. More than 40% of the patients had a clinically relevant improvement in role-, social function, and fatigue symptoms, from T0 to T1. Low level of education was associated with an improvement in emotional function, and living alone was associated with an improvement in mental fatigue.HRQoL, fatigue, LPA, and physical capacity improved in women within working age recently treated for BC who participated in an ORP.
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Affiliation(s)
- Gunhild M Gjerset
- Unit for Psychosocial Oncology, Coping and Rehabilitation, Department of Clinical Service, Division of Cancer Medicine, Oslo University Hospital, P.O. Box 4953 Nydalen, 0424, Oslo, Norway.
- National Advisory Unit On Late Effects After Cancer Treatment, Department of Oncology, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway.
| | - Tone Skaali
- Unit for Psychosocial Oncology, Coping and Rehabilitation, Department of Clinical Service, Division of Cancer Medicine, Oslo University Hospital, P.O. Box 4953 Nydalen, 0424, Oslo, Norway
| | - Mette Seland
- Unit for Psychosocial Oncology, Coping and Rehabilitation, Department of Clinical Service, Division of Cancer Medicine, Oslo University Hospital, P.O. Box 4953 Nydalen, 0424, Oslo, Norway
| | - Lene Thorsen
- National Advisory Unit On Late Effects After Cancer Treatment, Department of Oncology, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
- Department of Clinical Service, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
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Khalil MT, Rathore FA. Does Prehabilitation in Colorectal Cancer Surgery Improve Functional Capacity, Quality of Life, and Reduce Postoperative Complications?: A Cochrane Review Summary With Commentary. Am J Phys Med Rehabil 2023; 102:548-549. [PMID: 36821479 DOI: 10.1097/phm.0000000000002219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
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Effect of Postoperative Adjuvant Radiotherapy on Quality of Life, Anxiety, and Depression in Adult Female Breast Cancer Patients. Cureus 2023; 15:e36635. [PMID: 36968677 PMCID: PMC10038179 DOI: 10.7759/cureus.36635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2023] [Indexed: 03/26/2023] Open
Abstract
Aim: This study aims to identify anxiety and depression caused by adjuvant radiotherapy in breast cancer cases to determine the deterioration in the quality of life and investigate the effect of early treatment. Materials and Methods: In this study, the Beck Depression Inventory, Beck Anxiety Inventory, and European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-30 (EORTC QLQ-C30) Turkish 3.0 forms were evaluated in 63 breast cancer patients before the start of radiotherapy treatment (T1) and at six weeks after the end of radiotherapy treatment (T2). Results: A high level of anxiety was detected in 77.8% of patients, and depression was found in 25.4% of patients in T1. When depressive cases were evaluated with EORTC QLQ-C30 scores, the general health status (p = 0.043), role function (p = 0.027), emotional (p < 0.002), cognitive (p < 0.001), and social (p < 0.0001) scales were statistically lower in T1, whereas pain (p = 0.045) and insomnia (p < 0.0001) symptoms were higher in T1. Anxiety and EORTC QLQ-C30 scores in terms of emotional function (p = 0.015), social function (p < 0.003), and symptoms of insomnia (p = 0.027) were found to be statistically higher in T1 anxious cases. However, anxiety was detected in only 3% of T2 cases, and no depression was found in any of the cases. Anxiety and EORTC QLQ-C30 scores and symptom scales were evaluated in terms of role function (p < 0.0001), emotional (p = 0.041) and social scales (p = 0.014), fatigue (p = 0.028), pain (p = 0.033), insomnia (p = 0.011), and constipation (p < 0.0001); these were found to be statistically significant in T2. Conclusion: This study revealed that early diagnosis and treatment of anxiety before initiating adjuvant radiotherapy reduces the development of long-term anxiety-related depression in the future. Therefore, it is recommended that patients be evaluated for anxiety and depression before starting adjuvant radiotherapy.
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Giallauria F, Testa C, Cuomo G, Di Lorenzo A, Venturini E, Lauretani F, Maggio MG, Iannuzzo G, Vigorito C. Exercise Training in Elderly Cancer Patients: A Systematic Review. Cancers (Basel) 2023; 15:cancers15061671. [PMID: 36980559 PMCID: PMC10046194 DOI: 10.3390/cancers15061671] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 03/02/2023] [Accepted: 03/03/2023] [Indexed: 03/11/2023] Open
Abstract
Due to the aging of the population, in 70% of cases, a new cancer diagnosis equals a cancer diagnosis in a geriatric patient. In this population, beyond the concept of mortality and morbidity, functional capacity, disability, and quality of life remain crucial. In fact, when the functional status is preserved, the pathogenetic curve towards disability will stop or even regress. The present systematic review investigated the effectiveness of physical exercise, as part of a holistic assessment of the patient, for preventing disability and improving the patient’s quality of life, and partially reducing all-cause mortality. This evidence must point towards decentralization of care by implementing the development of rehabilitation programs for elderly cancer patients either before or after anti-cancer therapy.
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Affiliation(s)
- Francesco Giallauria
- Department of Translational Medical Sciences, University of Naples Federico II, via S. Pansini 5, 80131 Naples, Italy
- Faculty of Sciences and Technology, University of New England, Armidale, NSW 2351, Australia
- Correspondence:
| | - Crescenzo Testa
- Geriatric Clinic Unit, Geriatric-Rehabilitation Department, University Hospital, 43126 Parma, Italy
| | - Gianluigi Cuomo
- Department of Translational Medical Sciences, University of Naples Federico II, via S. Pansini 5, 80131 Naples, Italy
| | - Anna Di Lorenzo
- Department of Translational Medical Sciences, University of Naples Federico II, via S. Pansini 5, 80131 Naples, Italy
| | - Elio Venturini
- Cardiac Rehabilitation Unit and Department of Cardiology, Azienda USL Toscana Nord-Ovest, “Cecina Civil Hospital”, 57023 Cecina, Italy
| | - Fulvio Lauretani
- Geriatric Clinic Unit, Geriatric-Rehabilitation Department, University Hospital, 43126 Parma, Italy
- Cognitive and Motor Center, Medicine and Geriatric-Rehabilitation Department of Parma, University Hospital of Parma, 43126 Parma, Italy
| | - Marcello Giuseppe Maggio
- Geriatric Clinic Unit, Geriatric-Rehabilitation Department, University Hospital, 43126 Parma, Italy
- Cognitive and Motor Center, Medicine and Geriatric-Rehabilitation Department of Parma, University Hospital of Parma, 43126 Parma, Italy
| | - Gabriella Iannuzzo
- Department of Clinical Medicine and Surgery, University of Naples Federico II, via S. Pansini 5, 80131 Naples, Italy
| | - Carlo Vigorito
- Department of Translational Medical Sciences, University of Naples Federico II, via S. Pansini 5, 80131 Naples, Italy
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Hao J, Li Y, Swanson R, Chen Z, Siu KC. Effects of virtual reality on physical, cognitive, and psychological outcomes in cancer rehabilitation: a systematic review and meta-analysis. Support Care Cancer 2023; 31:112. [PMID: 36633695 DOI: 10.1007/s00520-022-07568-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 12/28/2022] [Indexed: 01/13/2023]
Abstract
PURPOSE To systematically examine and summarize the current evidence regarding the effects of virtual reality (VR) on physical, cognitive, and psychological outcomes in cancer rehabilitation. METHODS Six bioscience and engineering databases were searched. Two independent reviewers screened the titles and abstracts of 2397 records and retrieved 25 full-text articles. Inclusion criteria included patients with a current or previous diagnosis of cancer; VR was used as an intervention for physical, cognitive, or psychological impairments and functional limitations; and clinical trials with at least two arms and with both pre- and post-intervention assessments. Reviewers assessed methodological quality using the Physiotherapy Evidence Database scale. RESULTS Seventeen studies including 799 patients with cancer were identified. Within-group pooled analysis indicated that patients demonstrated significant improvement in pain (P < 0.001), fatigue (P < 0.001), anxiety (P < 0.001), upper extremity function (P < 0.001), and quality of life (P = 0.008) after VR intervention. Between-group pooled analysis indicated significant improvements with VR in pain (P = 0.004), anxiety (P < 0.001), and upper extremity function (P < 0.001) compared with the control. Three studies reported the positive effects of VR on cognition. CONCLUSIONS VR demonstrates promising effects in physical, cognitive, and psychological aspects of patients with cancer. VR can be incorporated into a comprehensive cancer rehabilitation program to alleviate impairments and functional limitations.
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Affiliation(s)
- Jie Hao
- Division of Physical Therapy Education, Department of Health & Rehabilitation Sciences, College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE, 68198-4420, USA
| | - Yanfei Li
- Division of Physical Therapy Education, Department of Health & Rehabilitation Sciences, College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE, 68198-4420, USA
| | - Rebecca Swanson
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, College of Medicine, University of Nebraska Medical Center, Omaha, NE, 68198-6878, USA
| | - Zhen Chen
- Department of Neurorehabilitation, The First Rehabilitation Hospital of Shanghai, Shanghai, China
| | - Ka-Chun Siu
- Division of Physical Therapy Education, Department of Health & Rehabilitation Sciences, College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE, 68198-4420, USA.
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Tam S, Kumar R, Lopez P, Mattsson J, Alibhai S, Atenafu EG, Bernstein LJ, Chang E, Clarke S, Langelier D, Lipton J, Mayo S, Papadakos T, Jones JM. A longitudinal multidimensional rehabilitation program for patients undergoing allogeneic blood and marrow transplantation (CaRE-4-alloBMT): Protocol for a phase II feasibility pilot randomized controlled trial. PLoS One 2023; 18:e0285420. [PMID: 37192195 DOI: 10.1371/journal.pone.0285420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 04/19/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND Allogeneic blood and marrow transplantation (alloBMT) is a curative treatment for blood cancers associated with various treatment-related adverse events and morbidities. Current rehabilitation programs are limited for patients undergoing alloBMT and research is urgently needed to test the acceptability and effectiveness of these programs. In response, we developed a 6-month multidimensional longitudinal rehabilitation program that spans from pre transplant to 3 months post transplant discharge (CaRE-4-alloBMT). METHODS This study is a phase II randomized controlled trial (RCT) conducted at the Princess Margaret Cancer Centre in patients undergoing alloBMT. A total of 80 patients stratified by frailty score will be randomized to receive usual care (n = 40) or CaRE-4-alloBMT plus usual care (n = 40). The CaRE-4-alloBMT program includes individualized exercise prescriptions, access to online education through a dedicated self-management platform, wearable technology for remote monitoring, and remote tailored clinical support. Feasibility will be assessed by examining the recruitment and retention rates and adherence to the intervention. Safety events will be monitored. Acceptability of the intervention will be assessed through qualitative interviews. Secondary clinical outcomes will be collected through questionnaires and physiological assessments at baseline (T0, 2-6 weeks pre-transplant), transplant hospital admission (T1), hospital discharge (T2), and 3 months post-discharge (T3). CONCLUSION This pilot RCT study will determine the feasibility and acceptability of the intervention and study design and will inform full-scale RCT planning.
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Affiliation(s)
- Samantha Tam
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Rajat Kumar
- Hans Messner Allogeneic Transplant Program, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Paty Lopez
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Jonas Mattsson
- Hans Messner Allogeneic Transplant Program, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Shabbir Alibhai
- General Internal Medicine, University Health Network, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Eshetu G Atenafu
- Department of Biostatistics, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Lori J Bernstein
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Eugene Chang
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Susan Clarke
- Hans Messner Allogeneic Transplant Program, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - David Langelier
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Jeffrey Lipton
- Hans Messner Allogeneic Transplant Program, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Samantha Mayo
- Faculty of Nursing, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Tina Papadakos
- Cancer Education, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
- Patient Education, Ontario Health, Cancer Care Ontario, Toronto, Ontario, Canada
| | - Jennifer Michelle Jones
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
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14
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Maino Vieytes CA, Zhu R, Gany F, Burton-Obanla A, Arthur AE. Empirical Dietary Patterns Associated with Food Insecurity in U.S. Cancer Survivors: NHANES 1999-2018. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14062. [PMID: 36360938 PMCID: PMC9656362 DOI: 10.3390/ijerph192114062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/19/2022] [Accepted: 10/25/2022] [Indexed: 06/16/2023]
Abstract
(1) Background: Food insecurity (FI) is a public health and sociodemographic phenomenon that besets many cancer survivors in the United States. FI in cancer survivors may arise as a consequence of financial toxicity stemming from treatment costs, physical impairment, labor force egress, or a combination of those factors. To our knowledge, an understanding of the dietary intake practices of this population has not been delineated but is imperative for addressing the needs of this vulnerable population; (2) Methods: Using data from NHANES, 1999-2018, we characterized major dietary patterns in the food insecure cancer survivor population using: i. penalized logistic regression (logit) and ii. principal components analysis (PCA). We validated these patterns by examining the association of those patterns with food insecurity in the cancer population; (3) Results: Four dietary patterns were extracted with penalized logit and two with PCA. In the pattern validation phase, we found several patterns exhibited strong associations with FI. The FI, SNAP, and Household Size patterns (all extracted with penalized logit) harbored the strongest associations and there was evidence of stronger associations in those moderately removed from a cancer diagnosis (≥2 and <6 years since diagnosis); (4) Conclusions: FI may play an influential role on the dietary intake patterns of cancer survivors in the U.S. The results highlight the relevance of FI screening and monitoring for cancer survivors.
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Affiliation(s)
| | - Ruoqing Zhu
- Department of Statistics, The University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Francesca Gany
- Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Amirah Burton-Obanla
- Division of Nutritional Sciences, The University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Anna E. Arthur
- Department of Dietetics and Nutrition, The University of Kansas Medical Center, Kansas City, KS 66160, USA
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15
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Invernizzi M, Lippi L, Folli A, Turco A, Zattoni L, Maconi A, de Sire A, Fusco N. Integrating molecular biomarkers in breast cancer rehabilitation. What is the current evidence? A systematic review of randomized controlled trials. Front Mol Biosci 2022; 9:930361. [PMID: 36158576 PMCID: PMC9493088 DOI: 10.3389/fmolb.2022.930361] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 07/13/2022] [Indexed: 01/18/2023] Open
Abstract
Background: Quality of life issues is a crucial burden in breast cancer (BC) survivors with relevant implications in terms of survivorship and health-care costs. The increasing long-term survival of these patients provides new challenges, with translational research now focusing on innovative and tailored approaches to improve their complex management. In this scenario, several emerging biomarkers have the potential to improve the clinical rehabilitative management of patients with BC. However, to date, guidelines supporting biomarker implementation in this area are still lacking. Therefore, the aim of this systematic review was to summarize the currently available biomarkers that might be potentially integrated into rehabilitation practice to promote a precision medicine approach to BC survivorship issues. Methods: On 9th March 2022, PubMed, Scopus, Web of Science, Cochrane, and PEDro were systematically searched for randomized controlled trials (RCTs) assessing rehabilitation interventions in BC patients. Molecular biomarker modifications induced by physical exercise have been assessed through the review of the study protocols and published results. The Jadad scale was used to assess the quality of the studies included. Results: Out of 2,224 records, 22 studies were included in the present systematic review. Exercise therapy showed significant results in 15 RCTs, in terms of metabolic biomarkers, including glycemic and insulin profile, and lipid profile (p ≤ 0.05). Similarly, 12 studies underlined significant effects in inflammation and immune response biomarkers, including TNF-α, IL-6, IL-10, C-reactive protein, leptin, and adiponectin (p ≤ 0.05). On the other hand, cardiac biomarkers were assessed in three studies without reporting significant differences after exercise therapy (p = NS). The quality assessment identified 19 RCTs as high-quality studies and three RCTs of low quality. Conclusion: Our findings reveal significant biochemical perturbations in key molecules induced by physical exercise in patients with BC, suggesting room for the implementation of actionable biomarkers. Future research might clarify the role of biomarkers on treatment effectiveness monitoring, to optimize rehabilitative strategies tailored to patient’s needs.
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Affiliation(s)
- Marco Invernizzi
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, Novara, Italy
- Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Translational Medicine, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
- *Correspondence: Marco Invernizzi,
| | - Lorenzo Lippi
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, Novara, Italy
- Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Translational Medicine, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Arianna Folli
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, Novara, Italy
| | - Alessio Turco
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, Novara, Italy
| | - Lorenzo Zattoni
- Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Antonio Maconi
- Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Translational Medicine, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Alessandro de Sire
- Physical and Rehabilitative Medicine Unit, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, Catanzaro, Italy
| | - Nicola Fusco
- Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
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16
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Zhou X, Wang DY, Ding CY, Liu H, Sun ZQ. Psychosocial adaptation and influencing factors among patients with chemotherapy-induced peripheral neuropathy. World J Clin Cases 2022; 10:4843-4855. [PMID: 35801039 PMCID: PMC9198882 DOI: 10.12998/wjcc.v10.i15.4843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 02/03/2022] [Accepted: 03/26/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Chemotherapy-induced peripheral neuropathy (CIPN) is a severe and long-lasting side effect caused by various anticancer agents that damage sensory, motor and autonomic nerves. It can cause maladaptive behaviors, including disease severity, anxiety, depression, sleep disorders, falls, and social impairment. These disorders have physical, psychological and social effects on patients and can seriously influence their quality of life.
AIM To investigate the current situation of psychosocial adaptation to the disease and its influencing factor in patients with CIPN.
METHODS A convenience sampling method was used to select 233 patients with CIPN in our hospital from February to August 2021. In addition, a cross-sectional survey was conducted using a sociodemographic questionnaire, the Self-Report Psychosocial Adjustment to Illness Scale, and the European Organisation for the Research and Treatment of Cancer Quality of Life CIPN20 (QLQ-CIPN20). Factors influencing psychosocial adaptation in patients with CIPN were analyzed by t-test or one-way analysis of variance, correlation analysis, multiple stepwise regression analysis, and structural equation models.
RESULTS The psychosocial adaptation score of patients with CIPN was 52.51 ± 13.18. Multivariate analysis showed that autonomic nerves, tumor stage, motor nerves, education level, availability of caregivers, semi-retirement status, CIPN grade were independent risk factors for patients with CIPN (P < 0.05). Structural equation models showed that QLQ-CIPN20 mediated the relationship between CIPN grade, tumor stage, and psychosocial adaptation.
CONCLUSION Patients with CIPN have poor psychosocial adaptation and are affected by a variety of physiological, psychological, and social factors. Patients’ adaptive responses should be assessed, and targeted interventions implemented.
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Affiliation(s)
- Xiao Zhou
- Changzhou School of Clinical Medicine, Nanjing Medical University, Changzhou 213000, Jiangsu Province, China
| | - Dong-Yang Wang
- Department of Nursing, School of Pharmacy, Changzhou University, Changzhou 213000, Jiangsu Province, China
- Faculty of Nursing, Mahidol University, Nakhon Pathom 73170, Thailand
| | - Cai-Yan Ding
- Department of Nursing, The Affiliated Changzhou Second People's Hospital of Nanjing Medical University, Changzhou 213000, Jiangsu Province, China
| | - Hui Liu
- School of Nursing, Bengbu Medical College, Bengbu 233000, Jiangsu Province, China
| | - Zhi-Qin Sun
- Department of Nursing, The Affiliated Changzhou Second People's Hospital of Nanjing Medical University, Changzhou 213000, Jiangsu Province, China
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17
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Jefford M, Howell D, Li Q, Lisy K, Maher J, Alfano CM, Rynderman M, Emery J. Improved models of care for cancer survivors. Lancet 2022; 399:1551-1560. [PMID: 35430022 PMCID: PMC9009839 DOI: 10.1016/s0140-6736(22)00306-3] [Citation(s) in RCA: 74] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 01/23/2022] [Accepted: 02/10/2022] [Indexed: 12/24/2022]
Abstract
The number of survivors of cancer is increasing substantially. Current models of care are unsustainable and fail to address the many unmet needs of survivors of cancer. Numerous trials have investigated alternate models of care, including models led by primary-care providers, care shared between oncology specialists and primary-care providers, and care led by oncology nurses. These alternate models appear to be at least as effective as specialist-led care and are applicable to many survivors of cancer. Choosing the most appropriate care model for each patient depends on patient-level factors (such as risk of longer-term effects, late effects, individual desire, and capacity to self-manage), local services, and health-care policy. Wider implementation of alternative models requires appropriate support for non-oncologist care providers and endorsement of these models by cancer teams with their patients. The COVID-19 pandemic has driven some changes in practice that are more patient-centred and should continue. Improved models should shift from a predominant focus on detection of cancer recurrence and seek to improve the quality of life, functional outcomes, experience, and survival of survivors of cancer, reduce the risk of recurrence and new cancers, improve the management of comorbidities, and reduce costs to patients and payers. This Series paper focuses primarily on high-income countries, where most data have been derived. However, future research should consider the applicability of these models in a wider range of health-care settings and for a wider range of cancers.
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Affiliation(s)
- Michael Jefford
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia.
| | - Doris Howell
- Princess Margaret Cancer Research Institute, Toronto, ON, Canada
| | - Qiuping Li
- Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Karolina Lisy
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia
| | | | - Catherine M Alfano
- Northwell Health Cancer Institute, Lake Success, NY, USA; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA; Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Meg Rynderman
- Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Jon Emery
- Centre for Cancer Research, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia
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18
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Weemaes ATR, Weijenberg MP, Lenssen AF, Beelen M. Exercise training as part of multidisciplinary rehabilitation in cancer survivors: an observational study on changes in physical performance and patient-reported outcomes. Support Care Cancer 2022; 30:9255-9266. [PMID: 36066627 PMCID: PMC9444699 DOI: 10.1007/s00520-022-07351-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 08/25/2022] [Indexed: 01/05/2023]
Abstract
PURPOSE To describe changes in physical performance and patient-reported outcomes in cancer survivors who participated in an exercise program as part of usual-care multidisciplinary rehabilitation and the influence of training adaptations during the coronavirus-19 (COVID-19) pandemic. METHODS In an observational cohort study, cancer survivors underwent usual-care multidisciplinary rehabilitation including a 10-week exercise program. During the COVID-19 pandemic, the exercise program was adapted with reduced training time and frequency. Mean changes and 95% confidence intervals in physical performance (peak oxygen uptake (VO2peak), peak work rate during a steep ramp test (SRT-WRpeak), 6-min walking distance, muscle strength) and patient-reported outcomes (health-related quality of life, fatigue, anxiety, and depression) were assessed between the start and the end of the exercise program. Linear regression analysis, adjusting for baseline levels of outcomes, was used to investigate differences in changes in outcomes between participants who underwent the original and the adapted program. RESULTS All outcomes statistically significantly improved over time, regardless of adaptations in the exercise program. VO2peak increased with 9.6% and 7.7% in the original and adapted program, respectively. Significant smaller improvements were observed in SRT-WRpeak (- 3.9%) and upper body muscle strength (- 10.8%) after participation in the adapted compared to the original program. No significant between-group differences were observed for other outcomes. CONCLUSION Physical performance and patient-reported outcomes statistically and clinically significantly improved in cancer survivors who participated in an exercise program as part of usual-care multidisciplinary rehabilitation. Improvements of performance outcomes were smaller since the training adaptations, though only significant for SRT-WRpeak and upper body strength.
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Affiliation(s)
- Anouk T. R. Weemaes
- grid.412966.e0000 0004 0480 1382Department of Physical Therapy, Maastricht University Medical Center+, Maastricht, the Netherlands ,grid.5012.60000 0001 0481 6099Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Matty P. Weijenberg
- grid.5012.60000 0001 0481 6099Department of Epidemiology, School for Oncology and Reproduction (GROW), Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Antoine F. Lenssen
- grid.412966.e0000 0004 0480 1382Department of Physical Therapy, Maastricht University Medical Center+, Maastricht, the Netherlands ,grid.5012.60000 0001 0481 6099Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Milou Beelen
- grid.5012.60000 0001 0481 6099Department of Human Biology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
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19
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Burton-Obanla AA, Sloane S, Koester B, Gundersen C, Fiese BH, Arthur AE. Oncology registered dietitian nutritionists' knowledge, attitudes and practices related to food insecurity among cancer patients: a qualitative study. J Acad Nutr Diet 2021; 122:2267-2287. [PMID: 34896629 DOI: 10.1016/j.jand.2021.12.004] [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: 04/14/2021] [Revised: 11/12/2021] [Accepted: 12/06/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Understanding the knowledge, attitudes and practices pertaining to food insecurity among oncology Registered Dietitian Nutritionists (RDNs) is critical to ensuring that cancer survivors have adequate nutrition-a fundamental component of successful treatment and recovery. OBJECTIVE To qualitatively assess Oncology RDN's knowledge, attitudes and practices regarding the food access needs of their patients using a qualitative semantic approach to thematic analysis. DESIGN The qualitative cross-sectional study was conducted from September 2018 to January 2019. PARTICIPANTS/SETTING Forty-one oncology RDNs working with cancer survivors in various clinical settings across the U.S participated. MAIN OUTCOME MEASURES Participants completed a semi-structured, in-depth interview via telephone, lasting an average of 49 minutes. STATISTICAL ANALYSES PERFORMED Two coders (primary and secondary) trained in qualitative thematic data analysis methods used a semantic approach to thematic analysis to analyze transcripts. A qualitative and mixed methods online coding program, Dedoose, was used to organize and analyze the data. RESULTS Participants defined FI as a lack of access to nutritious foods and a lack of resources to purchase nutritious foods. RDNs stated they believe FI is a serious problem in the U.S., has a greater impact on cancer survivors than healthy individuals and they have specific concerns about FI among their own patients. Despite their concerns, most expressed that they do not use a validated tool to identify FI, nor were they aware that any exists. Only a small proportion of the RDNs stated that they regularly ask patients about their food access needs. CONCLUSIONS While Oncology RDNs have heard of FI, they do not routinely assess patients' food security status with a validated tool, nor do they consistently ask patients directly about their food access needs. These findings suggest there is a need for developing education and training opportunities for oncology RDNs in order to enhance their ability to screen for and address FI with their patients.
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Affiliation(s)
- Amirah A Burton-Obanla
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | - Stephanie Sloane
- Family Resiliency Center, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | - Brenda Koester
- Family Resiliency Center, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | - Craig Gundersen
- Department of Agricultural and Consumer Economics, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | - Barbara H Fiese
- Family Resiliency Center, University of Illinois at Urbana-Champaign, Urbana, Illinois; Department of Human Development and Family Studies, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | - Anna E Arthur
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, Illinois; Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, Illinois; Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, Kansas.
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20
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A Qualitative Study of Cancer Survivors' Experienced Outcomes of a Multidimensional Rehabilitation Program in Primary Healthcare. Cancer Nurs 2021; 45:E646-E654. [PMID: 34310389 DOI: 10.1097/ncc.0000000000000989] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Cancer survival rates are increasing, but survival is often followed by several late effects. Cancer survivors' need for complex rehabilitation is well documented, but this is mostly missing in primary healthcare. OBJECTIVE The aim of this study was to explore cancer survivors' experienced outcomes of a multidimensional rehabilitation program in primary healthcare. METHODS The study used a qualitative method with a descriptive research design. Fifty-six cancer survivors completed a 12-week rehabilitation program built upon the 5 elements of goal setting, physical exercise, psychoeducation, individual follow-up, and peer support. Data were collected at the end of the program via 8 focus group interviews, and systematic text condensation was used to analyze the data. RESULTS "Increased coping and participation" was identified as the overarching theme of the participants' experienced outcomes from the program, and this was elaborated by 3 main themes: (1) "increased energy and capacity," (2) "acceptance and understanding," and (3) "structure and hope." CONCLUSION The multidimensional rehabilitation program seemed to address cancer survivors' multiple challenges in survivorship. Proximity and accessibility to a local rehabilitation program and professionals' competence seemed to be essential factors for the participants' experienced outcomes of the program. IMPLICATION FOR PRACTICE A multidimensional rehabilitation program integrated in a Healthy Life Centre in primary healthcare may be beneficial for cancer survivors' coping and participation in everyday life. Cancer nurses play a crucial role in initiating and facilitating such programs.
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21
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Hernæs KH, Smeland KB, Fagerli UM, Kiserud CE. Post-treatment work patterns amongst survivors of lymphoma treated with high-dose chemotherapy with autologous stem-cell transplantation. BMC Cancer 2021; 21:143. [PMID: 33557789 PMCID: PMC7871541 DOI: 10.1186/s12885-021-07836-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 01/26/2021] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND This study describes post-treatment work patterns in lymphoma survivors treated with high-dose chemotherapy with autologous stem-cell transplantation (HDT-ASCT). It aims to identify determinants for labour force participation and exclusion after HDT-ASCT. METHODS All survivors treated with HDT-ASCT for lymphoma in Norway between 1995 and 2008, aged ≥18 years at HDT-ASCT and alive at survey in 2012-2013 were eligible. We divide survivors by current employment status (full-time, part-time and unemployed). Main outcomes are current employment status, work hours and work ability. Withdrawals are patients employed when diagnosed but not before HDT-ASCT. RESULTS Of the 274 who completed the survey, 82% (N = 225) were included in the final analyses. Mean age at survey was 52 years, 39% were female, 85% were employed when diagnosed, 77% before HDT-ASCT and 69% at survey. Employment before HDT-ASCT corresponds with a higher probability of employment at survey for a given symptom burden. In the most extensive statistical model, it increases with 37.3 percentage points. Work hours amongst withdrawals plummet after HDT-ASCT while work ability shows a rebound effect. The potential economic gain from their re-enter into the work force equals 70% of the average annual wage in Norway in 2012. CONCLUSIONS For a given symptom burden, staying employed throughout diagnosis and treatment is associated with a higher probability of future employment. These results favour policies for labour force inclusion past diagnosis and treatment increasing cancer survivors' probability of future employment. However, we need more research on withdrawal mechanisms, and on policy measures that promote inclusion.
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Affiliation(s)
- Kjersti Helene Hernæs
- Norwegian Institute of Public Health, PO Box 222, Skøyen, N-0213, Oslo, Norway. .,Previous affiliation: Research Support Services, Oslo University Hospital, Sogn Arena, Klaus Torgårds vei 3, 3. Floor, 0372, Oslo, Norway.
| | - Knut B Smeland
- National Advisory Unit for Late Effects after Cancer Treatment, Oslo University Hospital, Radiumhospitalet, PO 4953, Nydalen, N-0424, Oslo, Norway
| | - Unn-Merete Fagerli
- Department of Oncology, St. Olavs hospital HF, Postboks 3250 Torgarden, 7006, Trondheim, Norway.,Institute for Clinical and Molecular Medicine (IKOM), The Norwegian University of Science and Technology (NTNU), Olav kyrres gate 9, 7006, Trondheim, Norway
| | - Cecilie E Kiserud
- National Advisory Unit for Late Effects after Cancer Treatment, Oslo University Hospital, Radiumhospitalet, PO 4953, Nydalen, N-0424, Oslo, Norway
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