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Timm E, Ko YM, Hundhammer T, Berlowitz I, Wolf U. Online eurythmy therapy for cancer-related fatigue: a prospective repeated-measures observational study exploring fatigue, stress, and mindfulness. Front Integr Neurosci 2024; 18:1472562. [PMID: 39364432 PMCID: PMC11447702 DOI: 10.3389/fnint.2024.1472562] [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: 07/29/2024] [Accepted: 09/05/2024] [Indexed: 10/05/2024] Open
Abstract
Introduction Cancer is a debilitating disease with an often chronic course. One of the most taxing and prevalent sequelae in this context is cancer-related fatigue (CRF) resulting from the disease and/or associated treatments. Over the last years mindfulness-based interventions such as eurythmy therapy (ERYT), a mindful-movement therapy from anthroposophic medicine, have emerged as promising adjunct therapies in oncology. This prospective study investigated an online implementation of ERYT for CRF using a single arm repeated-measures design based on two consecutive studies. Method Study 1 consisted of an initial assessment before, during, after, and at follow up of a 6-week online ERYT-based program in a mixed sample of N = 165 adults with or without cancer diagnosis. Study 2 involved a similar design with an adapted 8-week online ERYT-based program in a sample of N = 125 adults who had been diagnosed with cancer. Outcomes were assessed using the Functional Assessment of Chronic Illness Therapy-Fatigue, Perceived Stress Scale, Mindful Attention Awareness Scale, and Insomnia Severity Index (for Study 1 all, for Study 2 only the former three). We additionally performed an exploratory analysis regarding practice frequency and duration. Data were analyzed using Linear Mixed-Effect Models per outcome; ANOVA was used for practice times. Results For Study 1, mixed-effects model estimates showed no significant effect on fatigue, but pointed to significantly improved emotional and physical well-being, reduced stress, as well as increased mindfulness (mixed subjects). Functional and social well-being or sleep quality did not change significantly. Study 2 model estimates on the other hand showed significantly improved CRF in conjunction with the ERYT-based online intervention, as well as improved stress and mindfulness scores (cancer-diagnosed subjects). Conclusion Taken together, while our results should be interpreted with caution given the single-arm design and relatively high dropout, they suggest online ERYT may be associated with a reduction in fatigue for individuals diagnosed with cancer, an increase in mindfulness, and benefits for stress and certain well-being indicators. The online group format is advantageous in view of affordability and accessibility, the latter being particularly relevant for individuals who due to high symptom severity cannot leave their homes. Randomized-controlled studies will be needed to confirm these findings.
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Affiliation(s)
- Eliane Timm
- Institute of Complementary and Integrative Medicine, Faculty of Medicine, University of Bern, Bern, Switzerland
| | - Yobina Melanie Ko
- Institute of Complementary and Integrative Medicine, Faculty of Medicine, University of Bern, Bern, Switzerland
| | | | - Ilana Berlowitz
- Institute of Complementary and Integrative Medicine, Faculty of Medicine, University of Bern, Bern, Switzerland
| | - Ursula Wolf
- Institute of Complementary and Integrative Medicine, Faculty of Medicine, University of Bern, Bern, Switzerland
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Oei SL, Thronicke A, Grieb G, Schad F, Groß J. Evaluation of quality of life in breast cancer patients who underwent breast-conserving surgery or mastectomy using real-world data. Breast Cancer 2023; 30:1008-1017. [PMID: 37587322 DOI: 10.1007/s12282-023-01494-x] [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: 03/15/2023] [Accepted: 08/09/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND Due to advances in the fight against breast cancer, aesthetic aspects and the prevention of breast deformities are playing an important role in surgical procedures. Currently the main form of breast cancer surgery is breast-conserving surgery (BCS), and even if mastectomy (MAS) is required, oncoplastic surgery and reconstruction options can improve outcomes, including health-related quality of life (QoL) of cancer patients. The purpose of this study was to assess whether surgery options induce different outcomes in self-reported QoL in guide-line treated breast cancer patients of the Network Oncology (NO). METHODS This prospective Real-World-Data (RWD) study was conducted using data from the NO-clinical registry. QoL was assessed by evaluation of the European Organization of Research and Treatment Health-Related Quality of Life Core Questionnaire scale (EORTC QLQ-C30). Association factors between type of surgery options, without or with immediate breast reconstructions the EORTC QLQ-C30-scales at baseline after surgery, 6, 12, and 24 months later were analyzed with adjusted multivariate regression analysis, considering age, cancer stage, and treatment regimens, using software R. RESULTS A total of 623 primary breast cancer patients (all tumor stages, median age 58 (ICR: 50-68) diagnosed and guide-line treated between 2013 and 2021), 524 BCS and 99 MAS, 24 of whom received immediate breast reconstruction (MBR), were eligible for analyses. Compared with BCS patients, MBR patients self-reported considerably lower global health, physical and social functioning, and higher burden of pain and financial difficulties at baseline. In later follow-up surveys, functional scales increased and symptoms decreased in all patients, and the differences between MAS and BCS equalized. Longitudinal analyses after 24 months were obtained from 258 patients and revealed that compared to 224 BCS, the 34 MAS patients reported increased social functioning (p = 0.04). CONCLUSIONS At 24 months after MAS, breast cancer patients' QoL improved compared with BCS, although impairments in QoL were reported immediately after MAS. A growing expertise in surgical procedures as well as supportive care is critical to optimizing patients' well-being. These findings may be considered when counseling breast cancer patients pre- and post-surgery. TRIAL REGISTRATION NUMBER DRKS00013335 on 27/11/2017 retrospectively registered.
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Affiliation(s)
- Shiao Li Oei
- Research Institut Havelhöhe gGmbH at, Hospital Gemeinschaftskrankenhaus Havelhöhe, Kladower Damm 221, 14089, Berlin, Germany.
| | - Anja Thronicke
- Research Institut Havelhöhe gGmbH at, Hospital Gemeinschaftskrankenhaus Havelhöhe, Kladower Damm 221, 14089, Berlin, Germany
| | - Gerrit Grieb
- Department of Plastic Surgery and Hand Surgery, Hospital Gemeinschaftskrankenhaus Havelhöhe, Kladower Damm 221, 14089, Berlin, Germany
| | - Friedemann Schad
- Research Institut Havelhöhe gGmbH at, Hospital Gemeinschaftskrankenhaus Havelhöhe, Kladower Damm 221, 14089, Berlin, Germany
- Interdisciplinary Oncology and Supportive Cancer Medicine, Hospital Gemeinschaftskrankenhaus Havelhöhe, Kladower Damm 221, 14089, Berlin, Germany
| | - Jessica Groß
- Breast Cancer Centre, Hospital Gemeinschaftskrankenhaus Havelhöhe, Kladower Damm 221, 14089, Berlin, Germany
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Rahman R, Mamat P, Wang H, Nurtai M, Mahsut M, Ahmat Z, Siyit M, Shang H, Zhang X. Effect of personalized care based on OPT model on perceived control and quality of life among patients with breast cancer. Front Public Health 2023; 11:1149558. [PMID: 37139376 PMCID: PMC10149826 DOI: 10.3389/fpubh.2023.1149558] [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: 01/22/2023] [Accepted: 03/31/2023] [Indexed: 05/05/2023] Open
Abstract
Introduction Patients with breast cancer (BC) after surgery are prone to negative physiological and psychosocial discomforts which cause the poor quality of life (QoL) among the patients. Therefore, how to improve the disease management ability of BC patients and to alleviate these cancer-related negative experience are particularly important. This study purpose to explore the potential effects of personalized care based on OPT model on the perceived control and the QoL among patients with BC, and to provide effective clinical nursing intervention for BC patients. Methods In this study, nonsynchronous controlled experiments were carried out on patients with BC, and the patients were randomly allocated to the control (n = 40) and intervention (n = 40) groups. The patients in the control group were given routine care; while the patients in the intervention group were given personalized care based on OPT model. The perceived control ability and QoL of the two groups were measured before and after the intervention. Results There were no significant differences in the total score of cancer experience and control efficacy of BC patients between the control group (61.15 ± 5.659, 41.80 ± 4.702) and the intervention group (60.58 ± 7.136, 42.15 ± 5.550) before intervention (p > 0.05). After the intervention, the total score of cancer experience in the intervention group (54.80 ± 8.519) was significantly lower than that in the control group (59.575 ± 7.331), with significant differences (p < 0.05). The total score of control efficacy in the intervention group (49.78 ± 6.466) was significantly higher than that in the control group (43.32 ± 6.219), with significant differences (p < 0.05). Compared with the control group, patients in intervention groups showed significant improvement in QoL after the intervention (p < 0.05). Conclusion Personalized care based on OPT model plays a significant role in improving the level of perceived control and the QoL among patients with BC.Clinical Trial Registration:www.chictr.org.cn, ChiCTR2300069476.
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Affiliation(s)
- Rabigul Rahman
- School of Nursing, Xinjiang Medical University, Urumqi, Xinjiang, China
- *Correspondence: Rabigul Rahman,
| | - Parida Mamat
- School of Nursing, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Haiyan Wang
- Breast Surgical Department, Oncology Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
- Haiyan Wang,
| | - Mili Nurtai
- School of Public Health, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Maynur Mahsut
- Nursing Supervision Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Zulhumar Ahmat
- Intensive Care Unit (ICU), The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Mukadas Siyit
- School of Nursing, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Hongmei Shang
- Breast Surgical Department, Oncology Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Xiaoyan Zhang
- Breast Surgical Department, Oncology Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
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Hajj A, Chamoun R, Salameh P, Khoury R, Hachem R, Sacre H, Chahine G, Kattan J, Rabbaa Khabbaz L. Fatigue in breast cancer patients on chemotherapy: a cross-sectional study exploring clinical, biological, and genetic factors. BMC Cancer 2022; 22:16. [PMID: 34979978 PMCID: PMC8722263 DOI: 10.1186/s12885-021-09072-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 11/25/2021] [Indexed: 11/10/2022] Open
Abstract
Background Cancer-related fatigue (CRF) is one of the most common and distressing complaints reported by cancer patients during chemotherapy considerably impacting all aspects of a patient’s life (physical, psychosocial, professional, and socioeconomic). The aim of this study was to assess the severity of cancer-related fatigue in a group of breast cancer patients undergoing chemotherapy and explore the association between fatigue scores and sociodemographic, clinical, biological, psychiatric, and genetic factors. Methods A cross-sectional pilot study carried out at the oncology outpatient unit of Hôtel-Dieu de France University Hospital recruited 67 breast cancer patients undergoing chemotherapy between November 2017 and June 2019 to evaluate fatigue using the EORTC QLQ-C30 scale (European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire). Genotyping for seven gene polymorphisms (COMT, DRD2, OPRM1, CLOCK, PER2, CRY2, ABCB1) was performed using the Lightcycler® (Roche). Results The prevalence of fatigue was 46.3%. Multivariable analysis taking the fatigue score as the dependent variable showed that a higher number of cycles and a lower hemoglobin level were significantly associated with higher odds of exhibiting fatigue. Moreover, having at least one C allele for DRD2 SNP (vs. TT) was significantly associated with a 4.09 higher odds of expressing fatigue compared to TT patients. Finally, patients with at least one C allele for CLOCK SNP tended to display higher fatigue levels than TT patients. Conclusions Our study showed that anemic breast cancer patients with a high number of chemotherapy cycles and those carrying at least one C allele for DRD2 and CLOCK SNPs are at greater risk of exhibiting fatigue. Since no previous research has reported such genetic results, future studies are necessary to confirm our findings.
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Affiliation(s)
- Aline Hajj
- Faculty of Pharmacy, Saint-Joseph University of Beirut, Beirut, Lebanon. .,Laboratoire de Pharmacologie, Pharmacie Clinique et Contrôle de Qualité des Médicaments, Faculty of Pharmacy, Saint-Joseph University of Beirut, Beirut, Lebanon.
| | - Rami Chamoun
- Faculty of Pharmacy, Saint-Joseph University of Beirut, Beirut, Lebanon.,Laboratoire de Pharmacologie, Pharmacie Clinique et Contrôle de Qualité des Médicaments, Faculty of Pharmacy, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Pascale Salameh
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon.,Faculty of Pharmacy, Lebanese University, Beirut, Lebanon.,University of Nicosia Medical School, Nicosia, Cyprus
| | - Rita Khoury
- Faculty of Pharmacy, Saint-Joseph University of Beirut, Beirut, Lebanon.,Laboratoire de Pharmacologie, Pharmacie Clinique et Contrôle de Qualité des Médicaments, Faculty of Pharmacy, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Roula Hachem
- Faculty of Pharmacy, Saint-Joseph University of Beirut, Beirut, Lebanon.,Laboratoire de Pharmacologie, Pharmacie Clinique et Contrôle de Qualité des Médicaments, Faculty of Pharmacy, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Hala Sacre
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
| | - Georges Chahine
- Department of Hemato-Oncology, Hôtel-Dieu de France Hospital, Faculty of Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Joseph Kattan
- Department of Hemato-Oncology, Hôtel-Dieu de France Hospital, Faculty of Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Lydia Rabbaa Khabbaz
- Faculty of Pharmacy, Saint-Joseph University of Beirut, Beirut, Lebanon.,Laboratoire de Pharmacologie, Pharmacie Clinique et Contrôle de Qualité des Médicaments, Faculty of Pharmacy, Saint-Joseph University of Beirut, Beirut, Lebanon
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Oei SL, Rieser T, Becker S, Groß J, Matthes H, Schad F, Thronicke A. TANGO: effect of tango Argentino on cancer-associated fatigue in breast cancer patients-study protocol for a randomized controlled trial. Trials 2021; 22:866. [PMID: 34857031 PMCID: PMC8637025 DOI: 10.1186/s13063-021-05869-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 11/23/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The majority of breast cancer patients suffer from persistent impairments after completion of their primary oncological therapy. Cancer-related fatigue (CRF) in particular is a multidimensional syndrome having a profound negative impact on the quality of life. To counter CRF symptoms, physical activities are suggested as first-line interventions, mind-body therapies have been shown to be effective, and music therapy can also reduce anxiety and stress in breast cancer patients. Tango therapy that combines various elements can have an impact on physical, psychological, and cognitive abilities and could therefore have a beneficial effect on breast cancer patients. The purpose of this study is to investigate whether a 6-week tango module is suited as a therapeutic approach for people after primary breast cancer therapy to favorably influence their quality of life, especially CRF levels. METHODS Sixty patients with a diagnosis for stage I-III breast cancer 12-48 months before enrollment and with CRF (age > 18) will be recruited and randomized 1:1 to a tango or a waiting-list group. Movement concepts using elements of Argentine tango (self-awareness, musical and spatial perception, self-perception, playfulness, shared experience) will be examined with the participants during six consecutive weekly 1-h tango sessions. The primary outcome will be the improvement of CRF (German version of the Cancer Fatigue Scale), and the secondary outcomes will be the improvement in sleep quality (Pittsburgh Sleep Quality Index) and quality of life (EORTC-QLQ-C30). Patient-reported outcomes will be measured at baseline and 6 weeks later; follow-up will be performed 6, 12, and 24 months after baseline. An evaluation will be performed by means of descriptive data analyses. DISCUSSION Argentine tango, as a music-based movement therapy, can influence different skills and may improve several outcomes. The therapeutic use of Argentine tango in the care of breast cancer patients has not yet been reported. It is anticipated that participants receiving the tango module will have improved CRF, sleep, and quality of life scores compared to a waitlist control. TRIAL REGISTRATION German Clinical Trials Registry (DRKS) DRKS00021601 . Retrospectively registered on 21 August 2020.
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Affiliation(s)
- Shiao Li Oei
- Research Institute Havelhöhe at the Hospital Gemeinschaftskrankenhaus Havelhöhe, Berlin, Germany
| | - Thomas Rieser
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Sarah Becker
- Breast Cancer Centre, Hospital Gemeinschaftskrankenhaus Havelhöhe, Berlin, Germany
| | - Jessica Groß
- Breast Cancer Centre, Hospital Gemeinschaftskrankenhaus Havelhöhe, Berlin, Germany
| | - Harald Matthes
- Research Institute Havelhöhe at the Hospital Gemeinschaftskrankenhaus Havelhöhe, Berlin, Germany
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
- Medical Clinic for Gastroenterology, Infectiology and Rheumatology CBF Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Friedemann Schad
- Research Institute Havelhöhe at the Hospital Gemeinschaftskrankenhaus Havelhöhe, Berlin, Germany
- Institute for Gastroenterology, Hospital Gemeinschaftskrankenhaus Havelhöhe, Berlin, Germany
| | - Anja Thronicke
- Research Institute Havelhöhe at the Hospital Gemeinschaftskrankenhaus Havelhöhe, Berlin, Germany.
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany.
- Interdisciplinary Oncology and Palliative Care, Hospital Gemeinschaftskrankenhaus Havelhöhe, Berlin, Germany.
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