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Stub T, Mathisen M, Thorsen L, Kiserud CE, Lie HC. Experiences Using Nonpharmacological Interventions for Chronic Fatigue: A Focus Group Study of Long-Term Survivors of Young Adult Cancers With Fatigue. Cancer Rep (Hoboken) 2024; 7:e2139. [PMID: 39233646 PMCID: PMC11375328 DOI: 10.1002/cnr2.2139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 06/18/2024] [Accepted: 06/30/2024] [Indexed: 09/06/2024] Open
Abstract
BACKGROUND Cancer-related fatigue is a common and distressing late effect of cancer that can persist for decades after treatment completion. Although negatively affecting survivors' quality of life, few, if any, efficacious interventions for persistent, or chronic, fatigue exist. AIMS To inform future interventions, we explored how long-term, young adult cancer survivors (YACSs) with chronic fatigue live with, and manage their fatigue over time, including their experiences with nonpharmacological interventions (NPIs) for chronic fatigue. METHODS AND RESULTS We conducted a qualitative focus group study with 15 YACSs (13 women) with chronic fatigue, on average 7.3 years post-diagnosis. The YACS were identified and recruited through a nationwide health survey of cancer survivors (the NOR-CAYACS study). Systematic content analysis was used to identify recurrent themes. Analysis revealed five themes: (1) manifestation of fatigue, detailing chronic fatigue experiences; (2) impact on daily life, highlighting the necessity to balance rest and activity, affecting relationships; (3) NPIs, where walks in nature were notably beneficial; (4) barriers to fatigue management, including energy deficits, treatment-related bodily changes, and self-care prioritization challenges; (5) facilitators to fatigue management, emphasizing the need for regular breaks, self-care practices, and the importance of fatigue management education. CONCLUSION This study offers novel insights into the lived experiences of YACSs with chronic fatigue, a subject scarcely examined in prior research. Our findings highlight the significant impact of chronic fatigue and the individualized strategies YACSs use to cope. The research emphasizes the need for personalized interventions to support chronic fatigue management, marking a critical step forward in addressing this often-overlooked issue in survivorship care. Future research should focus on tailored approaches to improve YACSs' quality of life.
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Affiliation(s)
- Trine Stub
- NAFKAM-Norway's National Research Center in Complementary and Alternative Medicine, Faculty of Health Science, Department of Community Medicine, UiT, The Arctic University of Norway, Tromsø, Norway
| | - Marleen Mathisen
- Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences in Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Lene Thorsen
- Department of Oncology, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
| | - Cecilie E Kiserud
- Department of Oncology, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
| | - Hanne C Lie
- Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences in Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
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Ee C, Kay S, Reynolds A, Lovato N, Lacey J, Koczwara B. Lifestyle and integrative oncology interventions for cancer-related fatigue and sleep disturbances. Maturitas 2024; 187:108056. [PMID: 38981156 DOI: 10.1016/j.maturitas.2024.108056] [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: 12/18/2023] [Revised: 03/19/2024] [Accepted: 06/14/2024] [Indexed: 07/11/2024]
Abstract
Fatigue, insomnia and sleep disturbances are common after cancer diagnosis, and have a negative impact on quality of life and function. This narrative review synthesised evidence on lifestyle and integrative oncology interventions for cancer-related fatigue, insomnia and sleep disturbances in cancer survivors. There is strong evidence in support of aerobic and strength exercise for the relief of cancer-related fatigue. Yoga, massage therapy, acupuncture, Tai Chi and qigong can also be recommended for cancer-related fatigue. The evidence on yoga, acupuncture and massage therapy for sleep disturbances in cancer is mixed, while exercise appears to have a modest favourable effect. There is insufficient evidence on nutrient supplements or dietary interventions for cancer-related fatigue or insomnia and other sleep disturbances after cancer. Beyond alleviating cancer-related fatigue and insomnia-related symptoms, integrative oncology and lifestyle interventions have potential to effect multiple other benefits, such as improvement in symptoms such as pain and menopausal symptoms. There is a need for well-designed randomised controlled trials of interventions, particularly in the areas of diet and nutrient supplements, and for implementation studies of interventions already supported by evidence.
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Affiliation(s)
- Carolyn Ee
- NICM Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia; Supportive Care and Integrative Oncology Department, Chris O'Brien Lifehouse, PO Box M33, Missenden Road, Camperdown, NSW 2050, Australia; Caring Futures Institute, Flinders University, GPO Box 2100, Adelaide 5001, South Australia, Australia; Translational Health Institute, Western Sydney University, Locked Bag 1797, Penrith 2751, NSW, Australia.
| | - Shelley Kay
- Supportive Care and Integrative Oncology Department, Chris O'Brien Lifehouse, PO Box M33, Missenden Road, Camperdown, NSW 2050, Australia.
| | - Amy Reynolds
- Flinders Health and Medical Research Institute (Sleep Health), Flinders University, GPO Box 2100, Adelaide 5001, South Australia, Australia; Adelaide Institute for Sleep Health, Flinders University, GPO Box 2100, Adelaide 5001, South Australia, Australia.
| | - Nicole Lovato
- Flinders Health and Medical Research Institute (Sleep Health), Flinders University, GPO Box 2100, Adelaide 5001, South Australia, Australia; Adelaide Institute for Sleep Health, Flinders University, GPO Box 2100, Adelaide 5001, South Australia, Australia.
| | - Judith Lacey
- NICM Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia; Supportive Care and Integrative Oncology Department, Chris O'Brien Lifehouse, PO Box M33, Missenden Road, Camperdown, NSW 2050, Australia; School of Medicine, University of Sydney, NSW 2006, Australia.
| | - Bogda Koczwara
- Flinders Health and Medical Research Institute (Sleep Health), Flinders University, GPO Box 2100, Adelaide 5001, South Australia, Australia; Department of Medical Oncology, Flinders Medical Centre, Flinders Drive, Bedford Park 5042, South Australia, Australia.
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Zdun – Ryżewska A, Gawlik-Jakubczak T, Trawicka A, Trawicki P. Fatigue and related variables in bladder cancer treatment - Longitudinal pilot study. Heliyon 2024; 10:e35995. [PMID: 39224322 PMCID: PMC11366915 DOI: 10.1016/j.heliyon.2024.e35995] [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: 11/24/2023] [Revised: 08/05/2024] [Accepted: 08/07/2024] [Indexed: 09/04/2024] Open
Abstract
Fatigue is a significant problem in patients with bladder cancer treated by radical cystectomy. This pilot study evaluated fatigue and related variables during a treatment period. Four measurements were made, the first 1 month after the cystectomy, and the next three at an interval of about 3 months each (at 4 months, 7 months, and 10 months after the surgery). In addition to the author's questionnaire (sociodemographic variables and a question about the impact of the disease on the patient's life), the FACIT-F Fatigue (to measure fatigue), NCCN/FACT FBISI-18, version 2 (symptoms, general condition of the patient), HADS (depression, anxiety, and irritability) measures were used. In this study, 21 patients participated in all four measurement periods. The fatigue intensity increased significantly between the first and second measurements and gradually decreased between the third and fourth measurements. As the severity of fatigue increases, can be observed an increase in the sense of the impact of the disease on the patient's life in all except the first measurement. The study revealed statistically significant correlations between fatigue and experiencing symptoms of cancer and treatment at each stage of the study, with the strongest correlations in the second and fourth measurements regarding symptoms of cancer and a stronger correlation in the second compared to the first measurement regarding side effects. At each stage of measurement, the experience of dizziness, lack of appetite, feeling of being sick, and feeling of annoyance from treatment side effects were statistically significantly correlated with fatigue. The intensity of fatigue correlated with the feeling of experiencing difficulties in meeting the needs of the family due to the physical condition in the first measurement (Rho = 0.76), a sense of weakness (Rho = 0.92) and sleepiness (Rho = 0.72) in the second measurement, pain in the third (Rho = 0.77). The greatest number of correlates of fatigue were described in the fourth measurement (all symptoms of cancer and side effects except losing weight). Stress, anxiety, depression and irritability were correlated with fatigue at each of the stages of research except the first one (without differences between the correlation coefficients in the second, third and fourth measurements). Significantly lower levels of fatigue characterised patients who survived over 6 months after the end of the study compared to the first three measurements.
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Affiliation(s)
- Agata Zdun – Ryżewska
- Division of Quality of Life Research, Department of Psychology, Faculty of Health Sciences, Medical University of Gdansk, Poland
| | | | - Agnieszka Trawicka
- Department of Developmental Support Psychology, Faculty of Psychology, University of Social Sciences and Humanities, Sopot, Poland
| | - Paweł Trawicki
- Division of Contemporary History and Political Thought, Faculty of Social Sciences, Institute of Political Sciences, University of Gdańsk, Poland
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Zhang L, Luo Y, Mao D, Zhu B, Yang Z, Miao J, Zhang L. Nonpharmacological Interventions for the Fatigue-Pain-Sleep Disturbance Symptom Cluster in Lung Cancer Patients: Best Evidence Summary. Semin Oncol Nurs 2024:151727. [PMID: 39191622 DOI: 10.1016/j.soncn.2024.151727] [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: 03/21/2024] [Revised: 07/31/2024] [Accepted: 08/01/2024] [Indexed: 08/29/2024]
Abstract
OBJECTIVES This study aimed to summarize the most effective evidence on nonpharmacological interventions for the fatigue-pain-sleep disturbance symptom cluster in lung cancer patients and to provide evidence-based management methods for clinical team and lung cancer patients. METHODS Guided by the "6S" pyramid model, we retrieved evidence on fatigue, pain, and sleep disturbance management from relevant websites and databases, and unpublished gray literature was also searched. The time frame of the search ranged from database establishment to September 30, 2023. Two researchers independently evaluated the literature quality using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) for guidelines, and the Assessment of Multiple Systematic Reviews II (AMSTAR II) for systematic reviews. Two people independently extracted and summarized the evidence according to the first principle of high-quality evidence and newly published evidence. The included evidence was graded by the JBI Evidence Pre-Grading System. RESULTS A total of 52,238 articles were retrieved, of which 60 articles, including 18 guidelines, 18 JBI best practice recommendations, one Up To Date clinical practice, and 23 systematic reviews, were included. Overall, 49 pieces of evidence from six dimensions-screening, assessment, management, education, referral, and follow-up-were summarized. Forty-three pieces of evidence were level 1, three pieces of evidence were level 4, and three pieces of evidence were level 5. CONCLUSIONS The best 49 pieces of evidence on nonpharmacological interventions for the fatigue-pain-sleep disturbance symptom cluster in lung cancer patients were summarized in this study, and these nonpharmacological interventions are scientific and comprehensive. IMPLICATIONS FOR NURSING PRACTICE This study can provide guidance for clinical team to improve the fatigue-pain-sleep disturbance symptom cluster management. These evidence items can be implemented by clinical team to reduce the symptom burden and improve the self-management ability of symptoms in lung cancer patients.
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Affiliation(s)
- Le Zhang
- School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Yuanyuan Luo
- School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Dongmei Mao
- School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Benxiang Zhu
- School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Zhihui Yang
- School of Nursing, Southern Medical University, Guangzhou, Guangdong, China
| | - Jingxia Miao
- Department of Medical Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Lili Zhang
- School of Nursing, Southern Medical University, Guangzhou, Guangdong, China.
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Borsati A, Giannarelli D, Belluomini L, Ciurnelli C, Colonna A, D’Amico I, Daniele A, Del Bianco N, Toniolo L, Trestini I, Tregnago D, Insolda J, Sposito M, Lanza M, Milella M, Schena F, Pilotto S, Avancini A. Exploring the Association between Health-Related Physical Fitness and Quality of Life in Patients with Cancer: A Cross-Sectional Study. Healthcare (Basel) 2024; 12:1643. [PMID: 39201201 PMCID: PMC11353676 DOI: 10.3390/healthcare12161643] [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: 07/22/2024] [Revised: 08/13/2024] [Accepted: 08/15/2024] [Indexed: 09/02/2024] Open
Abstract
Whereas an exercise intervention effectively improves patients' quality of life, little information is available about the contribution of each physical fitness component. This study aims to explore the association between physical fitness components and the quality-of-life domain in patients with cancer. Between September 2021 and August 2023, 160 patients with mixed cancer types visiting the Oncology Unit were selected on a consecutive basis according to selection criteria. They underwent a comprehensive baseline assessment including the six-minute walking test, the handgrip strength test, the isometric leg press test, the back scratch, sit and reach tests, their waist-hip ratio, and their body mass index. The European Organization for Research and Treatment of Cancer Quality of Life and Core Questionnaire was used to measure the quality of life. The sample size was based on the use of regression models to study associations between clinical characteristics and fitness outcomes. All of the analyses were performed using the SPSS v.25 statistical package. Patients had a mean age of 58 years, 68% were female, 42% were affected by breast cancer, and all were receiving anticancer treatments. Higher functional capacity was associated with better global health status (p < 0.0001) and physical (p < 0.0001), role (p < 0.0001), emotional (p = 0.026), and social function (p = 0.016) and inversely linked with fatigue (p = 0.001). Lower-limb flexibility was significantly associated with all of the domains except for role and social functions. The waist-hip ratio was inversely associated with physical function (p < 0.0001) and positively related to fatigue (p = 0.037). Exercise programs aiming to improve the quality of life in cancer should be addressed to optimize these fitness components.
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Affiliation(s)
- Anita Borsati
- Department of Medicine, University of Verona, 37129 Verona, Italy;
| | - Diana Giannarelli
- A. Gemelli University Hospital Foundation, IRCCS-Epidemiology&Biostatistic, 00168 Rome, Italy;
| | - Lorenzo Belluomini
- Section of Innovation Biomedicine—Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona and University and Hospital Trust (AOUI) of Verona, 37126 Verona, Italy; (L.B.); (D.T.); (J.I.); (M.S.); (M.M.); (S.P.)
| | - Christian Ciurnelli
- Department of Neuroscience, Biomedicine, and Movement Sciences, University of Verona, 37129 Verona, Italy (A.C.); (I.D.); (A.D.); (N.D.B.); (L.T.); (M.L.); (F.S.)
| | - Alessio Colonna
- Department of Neuroscience, Biomedicine, and Movement Sciences, University of Verona, 37129 Verona, Italy (A.C.); (I.D.); (A.D.); (N.D.B.); (L.T.); (M.L.); (F.S.)
| | - Irene D’Amico
- Department of Neuroscience, Biomedicine, and Movement Sciences, University of Verona, 37129 Verona, Italy (A.C.); (I.D.); (A.D.); (N.D.B.); (L.T.); (M.L.); (F.S.)
| | - Arianna Daniele
- Department of Neuroscience, Biomedicine, and Movement Sciences, University of Verona, 37129 Verona, Italy (A.C.); (I.D.); (A.D.); (N.D.B.); (L.T.); (M.L.); (F.S.)
| | - Nicole Del Bianco
- Department of Neuroscience, Biomedicine, and Movement Sciences, University of Verona, 37129 Verona, Italy (A.C.); (I.D.); (A.D.); (N.D.B.); (L.T.); (M.L.); (F.S.)
| | - Linda Toniolo
- Department of Neuroscience, Biomedicine, and Movement Sciences, University of Verona, 37129 Verona, Italy (A.C.); (I.D.); (A.D.); (N.D.B.); (L.T.); (M.L.); (F.S.)
| | - Ilaria Trestini
- Dietetics Service, Medical Direction, University Hospital of Verona, 37126 Verona, Italy;
| | - Daniela Tregnago
- Section of Innovation Biomedicine—Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona and University and Hospital Trust (AOUI) of Verona, 37126 Verona, Italy; (L.B.); (D.T.); (J.I.); (M.S.); (M.M.); (S.P.)
| | - Jessica Insolda
- Section of Innovation Biomedicine—Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona and University and Hospital Trust (AOUI) of Verona, 37126 Verona, Italy; (L.B.); (D.T.); (J.I.); (M.S.); (M.M.); (S.P.)
| | - Marco Sposito
- Section of Innovation Biomedicine—Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona and University and Hospital Trust (AOUI) of Verona, 37126 Verona, Italy; (L.B.); (D.T.); (J.I.); (M.S.); (M.M.); (S.P.)
| | - Massimo Lanza
- Department of Neuroscience, Biomedicine, and Movement Sciences, University of Verona, 37129 Verona, Italy (A.C.); (I.D.); (A.D.); (N.D.B.); (L.T.); (M.L.); (F.S.)
| | - Michele Milella
- Section of Innovation Biomedicine—Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona and University and Hospital Trust (AOUI) of Verona, 37126 Verona, Italy; (L.B.); (D.T.); (J.I.); (M.S.); (M.M.); (S.P.)
| | - Federico Schena
- Department of Neuroscience, Biomedicine, and Movement Sciences, University of Verona, 37129 Verona, Italy (A.C.); (I.D.); (A.D.); (N.D.B.); (L.T.); (M.L.); (F.S.)
| | - Sara Pilotto
- Section of Innovation Biomedicine—Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona and University and Hospital Trust (AOUI) of Verona, 37126 Verona, Italy; (L.B.); (D.T.); (J.I.); (M.S.); (M.M.); (S.P.)
| | - Alice Avancini
- Section of Innovation Biomedicine—Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona and University and Hospital Trust (AOUI) of Verona, 37126 Verona, Italy; (L.B.); (D.T.); (J.I.); (M.S.); (M.M.); (S.P.)
- Department of Neuroscience, Biomedicine, and Movement Sciences, University of Verona, 37129 Verona, Italy (A.C.); (I.D.); (A.D.); (N.D.B.); (L.T.); (M.L.); (F.S.)
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Narasimhan P, Levy AR, Rogers SN, Schache AG, Patterson JM, Williams NH, Brooker RC, Midgley AW. A protocol for the longitudinal investigation of cancer related fatigue in head and neck cancer with an emphasis on the role of physical activity. PLoS One 2024; 19:e0308400. [PMID: 39141642 PMCID: PMC11324130 DOI: 10.1371/journal.pone.0308400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 07/24/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND AND AIM Cancer related fatigue significantly impairs the ability to undertake sustained physical activity across the domains of daily living, work and recreation. The purpose of this study is to monitor cancer related fatigue and the factors affected or caused by it for 12 months in head and neck cancer patients following their diagnosis. Their perceptions of how fatigue might affect their activity levels in addition to identifying avenues to improve engagement with physical activity will be also explored. METHODS A single centre longitudinal mixed-methods study will be conducted. Forty head and neck cancer patients will be recruited over 6 months following the confirmation of their treatment plan, after which fatigue and physical activity will be assessed at four time points over 12 months. Additionally, other factors which influence fatigue such as body composition, blood counts, systemic inflammation levels, haemoglobin concentration, thyroid function, sleep quality, cardiorespiratory fitness and upper and lower extremity strength will be measured to understand how the multifactorial problem of fatigue may evolve over time and influence physical activity levels. Semi-structured interviews will be conducted after treatment completion and at end of twelve months which will analyse the participants fatigue experiences, understand how their perceived fatigue may have impacted physical activity and report the factors which may improve engagement with physical activity during cancer. Quantitative data will be analysed and reported using standard descriptive statistics and post-hoc pairwise comparisons. The changes in outcome measures across time will be analysed using the MIXED procedure in SPSS software. Statistical significance will be accepted at p<0.05. Qualitative data will be analysed using the Interpretative Phenomenological Approach using the NVivo software. DISCUSSION The results from this study may help inform the planning and delivery of appropriately timed interventions for the management of cancer related fatigue.
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Affiliation(s)
- Prahalad Narasimhan
- Department of Sport and Physical Activity, Edge Hill University, Ormskirk, United Kingdom
| | - Andrew R. Levy
- Health Research Institute, Edge Hill University, Ormskirk, United Kingdom
- Department of Psychology, Edge Hill University, Ormskirk, United Kingdom
| | - Simon N. Rogers
- Wirral University Teaching Hospital, Wirral, United Kingdom
- Faculty of Health and Social Care, Edge Hill University, Ormskirk, United Kingdom
| | - Andrew G. Schache
- Liverpool Head and Neck Centre, Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom
| | - Joanne M. Patterson
- Liverpool Head and Neck Centre, Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom
| | - Nefyn H. Williams
- Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
| | - Rachel C. Brooker
- Liverpool Head and Neck Centre, Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom
- The Clatterbridge Cancer Centre NHS Foundation Trust, Wirral, United Kingdom
| | - Adrian W. Midgley
- Department of Sport and Physical Activity, Edge Hill University, Ormskirk, United Kingdom
- Health Research Institute, Edge Hill University, Ormskirk, United Kingdom
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Di Meglio A, Havas J, Pagliuca M, Franzoi MA, Soldato D, Chiodi CK, Gillanders E, Dubuisson F, Camara-Clayette V, Pistilli B, Ribeiro J, Joly F, Cottu PH, Tredan O, Bertaut A, Ganz PA, Bower J, Partridge AH, Martin AL, Everhard S, Boyault S, Brutin S, André F, Michiels S, Pradon C, Vaz-Luis I. A bio-behavioral model of systemic inflammation at breast cancer diagnosis and fatigue of clinical importance two years later. Ann Oncol 2024:S0923-7534(24)01517-5. [PMID: 39098454 DOI: 10.1016/j.annonc.2024.07.728] [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: 12/03/2023] [Revised: 07/25/2024] [Accepted: 07/29/2024] [Indexed: 08/06/2024] Open
Abstract
BACKGROUND We aimed to generate a model of cancer-related fatigue (CRF) of clinical importance two years after diagnosis of breast cancer building on clinical and behavioral factors and integrating pre-treatment markers of systemic inflammation. METHODS Women with stage I-III HR+/HER2- breast cancer were included from the multimodal, prospective CANTO cohort (NCT01993498). The primary outcome was global CRF of clinical importance (EORTC QLQ-C30≥40/100) two years after diagnosis (year-2). Secondary outcomes included physical, emotional, and cognitive CRF (EORTC QLQ-FA12). All pre-treatment candidate variables were assessed at diagnosis, including inflammatory markers (interleukin [IL]-1a, IL-1b, IL-2, IL-4, IL-6, IL-8, IL-10, interferon gamma, IL-1 receptor antagonist, TNF-α, and C-reactive protein), and were tested in multivariable logistic regression models implementing multiple imputation and validation by 100-fold bootstrap resampling. RESULTS Among 1208 patients, 415 (34.4%) reported global CRF of clinical importance at year-2. High pre-treatment levels of IL-6 (Quartile 4 vs.1) were associated with global CRF at year-2 (adjusted Odds Ratio [aOR]: 2.06 [95% Confidence Interval 1.40-3.03]; p=0.0002; AUC=0.74). Patients with high pre-treatment IL-6 had unhealthier behaviors, including being frequently either overweight or obese (62.4%; mean BMI 28.0 [SD 6.3] Kg/m2) and physically inactive (53.5% did not meet WHO recommendations). Clinical and behavioral associations with CRF at year-2 included pre-treatment CRF (aOR vs no: 3.99 [2.81-5.66]), younger age (per 1-year decrement: 1.02 [1.01-1.03]), current smoking (vs never: 1.81 [1.26-2.58]), and worse insomnia or pain (per 10-unit increment: 1.08 [1.04-1.13], and 1.12 [1.04-1.21], respectively). Secondary analyses indicated additional associations of IL-2 (aOR per log-unit increment:1.32 [CI 1.03-1.70]) and IL-10 (0.73 [0.57-0.93]) with global CRF and of C-reactive protein (1.42 [1.13-1.78]) with cognitive CRF at year-2. Emotional distress was consistently associated with physical, emotional, and cognitive CRF. CONCLUSIONS This study proposes a bio-behavioral framework linking pre-treatment systemic inflammation with CRF of clinical importance two years later among a large prospective sample of survivors of breast cancer.
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Affiliation(s)
- A Di Meglio
- Cancer Survivorship Program, INSERM U981, Gustave Roussy, Villejuif, France.
| | - J Havas
- Cancer Survivorship Program, INSERM U981, Gustave Roussy, Villejuif, France
| | - M Pagliuca
- Cancer Survivorship Program, INSERM U981, Gustave Roussy, Villejuif, France; Division of Breast Medical Oncology, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", Naples, Italy
| | - M A Franzoi
- Cancer Survivorship Program, INSERM U981, Gustave Roussy, Villejuif, France
| | - D Soldato
- Cancer Survivorship Program, INSERM U981, Gustave Roussy, Villejuif, France
| | - C K Chiodi
- Cancer Survivorship Program, INSERM U981, Gustave Roussy, Villejuif, France
| | - E Gillanders
- Cancer Survivorship Program, INSERM U981, Gustave Roussy, Villejuif, France
| | - F Dubuisson
- Department of Medical Biology and Pathology, Gustave Roussy, Villejuif, France
| | - V Camara-Clayette
- Biological Resource Center, AMMICa, INSERM US23/CNRS UMS3655, Gustave Roussy, Villejuif, France
| | - B Pistilli
- Medical Oncology Department, INSERM U981, Gustave Roussy, Villejuif, France
| | - J Ribeiro
- Medical Oncology Department, INSERM U981, Gustave Roussy, Villejuif, France
| | - F Joly
- Centre Francois Baclesse, University UniCaen, Anticipe U1086 Inserm, Caen, France
| | | | - O Tredan
- Centre Léon Bérard, Lyon, France
| | - A Bertaut
- Centre Georges François Leclerc, Dijon, France
| | - P A Ganz
- University of California, Los Angeles, CA, United States
| | - J Bower
- University of California, Los Angeles, CA, United States
| | - A H Partridge
- Dana-Farber Cancer Institute, Boston, MA, United States
| | | | | | - S Boyault
- Centre Georges François Leclerc, Dijon, France
| | - S Brutin
- Biological Resource Center, AMMICa, INSERM US23/CNRS UMS3655, Gustave Roussy, Villejuif, France
| | - F André
- Cancer Survivorship Program, INSERM U981, Gustave Roussy, Villejuif, France
| | - S Michiels
- Service de Biostatistique et d'Epidémiologie, Gustave Roussy, Villejuif, France; Oncostat U1018, Inserm, University Paris-Saclay, labeled « Ligue Contre le Cancer », France
| | - C Pradon
- Department of Medical Biology and Pathology, Gustave Roussy, Villejuif, France; Biological Resource Center, AMMICa, INSERM US23/CNRS UMS3655, Gustave Roussy, Villejuif, France
| | - I Vaz-Luis
- Cancer Survivorship Program, INSERM U981, Gustave Roussy, Villejuif, France; Interdisciplinary Department for the Organization of Patient Pathways (DIOPP), Gustave Roussy, Villejuif, France
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Rossi F, Botti S, Morri M, Asaftei S, Bertin D, Breggiè S, Casalaz R, Cervo M, Ciullini P, Coppo M, Cornelli A, Esposito M, Ferrarese M, Ghetti M, Longo L, Naretto G, Orsini N, Panzeri D, Pellegrini C, Peranzoni M, Perna A, Petit N, Picone F, Pittorru G, Raffa D, Recchiuti V, Rizzato L, Sarzana M, Sensi R, Fagioli F, Ricci F. The Italian Consensus Conference on the role of rehabilitation for children and adolescents with leukemia, central nervous system tumors, and bone cancer, part 2: general principles for the rehabilitation treatment of motor function impairments. Pediatr Hematol Oncol 2024; 41:346-366. [PMID: 38984654 DOI: 10.1080/08880018.2024.2353360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 03/29/2023] [Accepted: 03/31/2023] [Indexed: 07/11/2024]
Abstract
In Italy, 1400 children and 800 adolescents are diagnosed with cancer every year. About 80% of them can be cured but are at high risk of experiencing severe side effects, many of which respond to rehabilitation treatment. Due to the paucity of literature on this topic, the Italian Association of Pediatric Hematology and Oncology organized a Consensus Conference on the role of rehabilitation of motor impairments in children/adolescents affected by leukemia, central nervous system tumors, and bone cancer to state recommendations to improve clinical practice. This paper includes the consensus on the rehabilitation of children and adolescents with these cancers.
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Affiliation(s)
- Francesca Rossi
- Rehabilitation Service, Public Health and Pediatric Sciences Department, A.O.U. Città della Salute e della Scienza - Regina Margherita Children's Hospital, Turin, Italy
| | - Stefano Botti
- Haematology Unit, Oncology and Advanced Technology Department, Azienda USL-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Mattia Morri
- Nursing, Technical and Rehabilitation Assistance Service, IRCCS Rizzoli Orthopedic Institute, Bologna, Italy
| | - Sebastian Asaftei
- Pediatric Oncohematology, Stem Cell Transplantation and Cell Therapy Division, A.O.U. Città della Salute e della Scienza - Regina Margherita Children's Hospital, Turin, Italy
| | - Daniele Bertin
- Pediatric Oncohematology, Stem Cell Transplantation and Cell Therapy Division, A.O.U. Città della Salute e della Scienza - Regina Margherita Children's Hospital, Turin, Italy
| | - Simona Breggiè
- Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Roberto Casalaz
- Paediatric Oncohematology, Unit Institute for Maternal and Child Health - IRCCS Burlo Garofolo, Trieste, Italy
| | - Marta Cervo
- Functional Rehabilitation Unit, A.O.U. Meyer, Florence, Italy
| | - Paola Ciullini
- Functional Rehabilitation Unit, A.O.U. Meyer, Florence, Italy
| | - Monica Coppo
- Health Professions of Rehabilitation Sciences Masters Degree, Clinical and Biological Sciences Department, University of Turin, Turin, Italy
| | - Annalisa Cornelli
- Pediatric Oncology Department, ASST Papa Giovanni XXIII, Bergamo, Italy
| | | | - Miriana Ferrarese
- Health Professions of Rehabilitation Sciences Masters Degree, Clinical and Biological Sciences Department, University of Turin, Turin, Italy
| | - Marina Ghetti
- Pediatric Hematology Department, A.O.U. Policlinico Umberto I-Rome, Rome, Italy
| | - Lucia Longo
- Health Professions of Rehabilitation Sciences Masters Degree, Clinical and Biological Sciences Department, University of Turin, Turin, Italy
| | - Gabriella Naretto
- Rehabilitation, Department of Pediatric Orthopedics Unit A.O.U. Città della Salute e della Scienza, Regina Margherita Children's Hospital, Turin, Italy
| | - Nicoletta Orsini
- Physical Therapy and Rehabilitation Department, Children's Hospital Giannina Gaslini, Genoa, Italy
| | - Daniele Panzeri
- Neuro-oncological Rehabilitation Unit, Scientific Institute, IRCCS E. Medea, Lecco, Italy
| | - Chiara Pellegrini
- Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Michela Peranzoni
- Department of Physiotherapy, Hospital of Bolzano, Health Trust, Bolzano, Italy
| | - Antonella Perna
- Medical Department of Continuity of Care and Disability, Physical Medicine and Rehabilitation, University Hospital St. Orsola-Malpighi, Bologna, Italy
| | - Nadine Petit
- Pediatric Hematology Department, A.O.U. Policlinico Umberto I-Rome, Rome, Italy
| | - Fabiola Picone
- Functional Rehabilitation Unit, A.O.U. Meyer, Florence, Italy
| | - Gianna Pittorru
- Medical Department of Continuity of Care and Disability, Physical Medicine and Rehabilitation, University Hospital St. Orsola-Malpighi, Bologna, Italy
| | - Debora Raffa
- Nursing, Technical and Rehabilitation Assistance Service, IRCCS Rizzoli Orthopedic Institute, Bologna, Italy
| | - Veronica Recchiuti
- Physical Therapy Neuroscience Department and Functional Rehabilitation, Children's Hospital Bambino Gesù, Rome, Italy
| | - Lucia Rizzato
- Complex Operative Unit of Orthopaedic Rehabilitation, AO of Padua, Padua, Italy
| | - Marina Sarzana
- Pediatric Immunohematology Unit and Stem Cell Program, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Raffaella Sensi
- Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Franca Fagioli
- Pediatric Oncohematology, Stem Cell Transplantation and Cell Therapy Division, A.O.U. Città della Salute e della Scienza - Regina Margherita Children's Hospital, Turin, Italy
| | - Federica Ricci
- Division of Child Neurology and Psychiatry A.O.U. Città della Salute e della Scienza, Regina Margherita Children's Hospital, Turin, Italy
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Rutkowski NA, Jones G, Brunet J, Lebel S. An Ideal Intervention for Cancer-Related Fatigue: Qualitative Findings from Patients, Community Partners, and Healthcare Providers. Curr Oncol 2024; 31:4357-4368. [PMID: 39195308 DOI: 10.3390/curroncol31080325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2024] [Revised: 07/17/2024] [Accepted: 07/26/2024] [Indexed: 08/29/2024] Open
Abstract
Patients consistently rate cancer-related fatigue (CrF) as the most prevalent and debilitating symptom. CrF is an important but often neglected patient concern, partly due to barriers to implementing evidence-based interventions. This study explored what an ideal intervention for CrF would look like from the perspectives of different stakeholders and the barriers to its implementation. Three participant populations were recruited: healthcare providers (HCPs; n = 32), community support providers (CSPs; n = 14), and cancer patients (n = 16). Data were collected via nine focus groups and four semi-structured interviews. Data were coded into themes using content analysis. Two main themes emerged around addressing CrF: "It takes a village" and "This will not be easy". Participants discussed an intervention for CrF could be anywhere, offered by anyone and everyone, and provided early and frequently throughout the cancer experience and could include peer support, psychoeducation, physical activity, mind-body interventions, and interdisciplinary care. Patients, HCPs, and CSPs described several potential barriers to implementation, including patient barriers (i.e., patient variability, accessibility, online literacy, and overload of information) and systems barriers (i.e., costs, lack of HCP knowledge, system insufficiency, and time). As CrF is a common post-treatment symptom, it is imperative to offer patients adequate support to manage CrF. This study lays the groundwork for the implementation of a patient-centered intervention for CrF in Canada and possibly elsewhere.
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Affiliation(s)
- Nicole Anna Rutkowski
- Faculty of Social Sciences, School of Psychology, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Georden Jones
- Mary A. Rackham Institute, University of Michigan, Ann Arbor, MI 48104, USA
| | - Jennifer Brunet
- Faculty of Social Sciences, School of Psychology, University of Ottawa, Ottawa, ON K1N 6N5, Canada
- School of Human Kinetics, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Sophie Lebel
- Faculty of Social Sciences, School of Psychology, University of Ottawa, Ottawa, ON K1N 6N5, Canada
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Alræk T, Skjerve H, Sørensen A, Lie SA, Presterud Ødegård H, Lu W, Mao J, Deng G, Lee MS, Birch S, Lamu AN, Kim TH, MacPherson H. Acupuncture for fatigue in breast cancer survivors: a study protocol for a pragmatic, mixed method, randomised controlled trial. BMJ Open 2024; 14:e077514. [PMID: 39079925 PMCID: PMC11293412 DOI: 10.1136/bmjopen-2023-077514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 07/09/2024] [Indexed: 08/03/2024] Open
Abstract
INTRODUCTION Fatigue is a common symptom observed in post-cancer treatment, yet its underlying mechanisms remain poorly understood. Acupuncture has been employed to alleviate cancer-related fatigue (CRF); however, its effectiveness in addressing associated comorbidities that may influence fatigue is also poorly understood. This study represents the first investigation to use acupuncture as an intervention for fatigue in breast cancer survivors within a Norwegian cohort. The study will employ questionnaires to evaluate various facets of fatigue. As a pragmatic trial, it statistically assesses its clinical relevance, documents adverse events and evaluates the cost-effectiveness of the acupuncture treatment. METHODS AND ANALYSIS This assessor-blinded, pragmatic, randomised, mixed method, controlled trial with two parallel arms aims to evaluate the effectiveness, safety and cost-effectiveness of acupuncture. It will recruit 250 participants presented with CRF for 6 months or longer. Patients will be randomly allocated either to acupuncture and usual care (n=125) or to usual care alone (n=125). Acupuncture treatments (12 in total) are to be given within 12 weeks. The statistician who will analyse the data will be blinded to group allocation. The primary outcome will be changes in CRF measured by the Chalder fatigue scale. Measurements will be taken 12 weeks and 6 months after randomisation. The secondary outcomes include patient-reported outcomes of pain, anxiety, depression, hot flashes, insomnia and sleepiness. Health-related quality of life and economic evaluation will also be conducted 12 weeks and 6 months after randomisation. Nested within this randomised controlled trial are two qualitative studies and one sub-study measuring biomarkers (C-reactive protein, interleukin (IL)-1, IL-6, tumour necrosis factor alpha (TNF-α) and aPL in addition to the current genotype genes TNF-308 and IL-6-174) from blood samples (n=80). Such biomarkers can potentially address changes in CRF. ETHICS AND DISSEMINATION Ethical approval of this study has been granted by the Regional Committees for Medical and Health Research Ethics (REC southeast ID number: 112285). Written informed consent will be obtained from all participants. The outcomes of the trial will be disseminated through peer-reviewed publications. TRIAL REGISTRATION NUMBER NCT04418115.
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Affiliation(s)
- Terje Alræk
- Department of Community Medicine, The Artic University of Norway Department of Clinical Medicine, Tromso, Norway
- Department of Health and Excercise, Kristiania University College, Oslo, Norway
| | - Hilde Skjerve
- Department of Health and Excercise, Kristiania University College, Oslo, Norway
| | - Anette Sørensen
- Department of Health and Excercise, Kristiania University College, Oslo, Norway
| | - S A Lie
- Department of Dentistry, University of Bergen Faculty of Medicine and Dentistry, Bergen, Norway
| | | | - Weidong Lu
- Department of Medical Oncology, Harvard Medical School, Boston, Massachusetts, USA
| | - Jun Mao
- Integrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York City, New York, USA
| | - G Deng
- Integrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York City, New York, USA
| | - Myeong Soo Lee
- Korea Institute of Oriental Medicine, Daejeon, Korea (the Republic of)
| | - Stephen Birch
- Department of Health and Excercise, Kristiania University College, Oslo, Norway
| | | | - Tae-hun Kim
- Korean Medicine Clinical Trial Center, Kyung Hee University, Seoul, Korea (the Republic of)
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11
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Fabi A, Gavioli EM, Wakade R, Spera MC, Miracle S, Valveny N, Butler E, DePizzol M, Ruffini PA, Allegretti M. Fatigue in patients with metastatic breast cancer undergoing single-agent taxane-based chemotherapy: a real-world data global network. Ther Adv Med Oncol 2024; 16:17588359241240972. [PMID: 39072243 PMCID: PMC11282541 DOI: 10.1177/17588359241240972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 03/04/2024] [Indexed: 07/30/2024] Open
Abstract
Background Cancer-related fatigue (CRF) occurs in nearly all patients with metastatic breast cancer (MBC). Objectives This real-world analysis aimed to describe the prevalence and importance of fatigue in patients with MBC within 3 months of treatment with single-agent taxane-based chemotherapy during the timeframe of 2020-2022 in the United States and Europe. It was also conducted to assess whether there was a difference in relapsed patients compared to patients diagnosed de novo. Design Electronic health records were analyzed from approximately 150 million patients to identify patients with MBC who underwent taxane treatment. Results In 2021, 50,490 patients had MBC, of whom 16,170 were diagnosed de novo and 34,330 experienced relapse. The proportion of patients undergoing taxane-based chemotherapy was 7.5% (n = 1220) and 13.4% (n = 4590), respectively, and the prevalence of any fatigue and CRF was similar between the groups (24.6% versus 25.7% and 6.6% versus 5.4%, respectively). Conclusion At least one in four patients with MBC undergoing taxane-based treatment will experience fatigue. This highlights the importance of validating screening tools to identify CRF, which is necessary to advance clinical trials aimed at investigating treatment strategies to improve patient-centered outcomes for fatigue.
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Affiliation(s)
- Alessandra Fabi
- Precision Medicine Unit in Senology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, P.le A. Gemelli n. 8, Rome 00168, Italy
| | | | | | | | | | - Neus Valveny
- Regulatory & Start-up, TFS HealthScience, Solna, Sweden
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Bayülgen MY. The Effect of Reiki on Fatigue Symptoms of Cancer Patients: A Systematic Review. Holist Nurs Pract 2024:00004650-990000000-00029. [PMID: 39042722 DOI: 10.1097/hnp.0000000000000664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2024]
Abstract
Fatigue is one of the most common symptoms experienced by cancer patients. This systematic review aimed to investigate the effect of reiki on fatigue symptoms of cancer patients. The databases "PubMed," "ScienceDirect," "Scopus," "Web of Science," and "Cochrane Library" were screened between July 12, 2023, and July 25, 2023, using the keywords "Reiki," "Fatigue," and "Cancer" without any restriction to the publication year. The selected studies were evaluated using the Jadad scale, a quality assessment checklist for randomized controlled trials. Among 794 studies initially found, 5 studies meeting the inclusion criteria were included in the present systematic review. Of these studies, 2 were randomized controlled trials, 2 were quasi-experimental studies, and 1 was a cross-over study. It was found that reiki applied to cancer patients in the studies included in the systematic review reduced fatigue while being effective in pain and stress alleviation and improvement of quality of life.
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Affiliation(s)
- Melek Yeşil Bayülgen
- Author Affiliations: Mersin University, Vocational School of Health Services, Elderly Care, Yenişehir Campus, Mersin, Turkey
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Blockhuys S, Wittung-Stafshede P. Yoga as a Complementary Therapy for Cancer Patients: From Clinical Observations to Biochemical Mechanisms. Complement Med Res 2024:1-13. [PMID: 38991506 DOI: 10.1159/000540213] [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: 02/14/2024] [Accepted: 07/03/2024] [Indexed: 07/13/2024]
Abstract
BACKGROUND Integrative oncology combines conventional and complementary, or integrative, therapies for a holistic treatment of cancer patients. Yoga is increasingly used as a complementary therapy for cancer patients, but there is no direct evidence for its effect on cancer pathophysiology like tumor response, or patient outcome like overall survival. SUMMARY In this narrative review, we present in detail published studies from randomized clinical trials on complementary yoga therapy for cancer patients, including details about the biochemical mechanisms involved. Medicinal hatha yoga with breathing, postures, meditation, and relaxation enhances the quality of life of cancer patients by providing both psychological and physiological health benefits, highlighting the interconnectedness of mind and body. Yoga therapy reduces stress levels improving heart rate variability, leading to changes in hormonal regulation (e.g., cortisol), reduced oxidative stress, and improved immune function with reduced inflammation. Still, the biochemical effects of yoga on the cancer disease itself are unrevealed. KEY MESSAGES More clinical and basic research is needed for further establishment of yoga as complementary therapy in oncology.
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Affiliation(s)
- Stéphanie Blockhuys
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Schmocker M, Engst R, Wirz M, Bana M. Factors influencing physical activity in individuals with head and neck cancer: a scoping review. BMJ Open 2024; 14:e083852. [PMID: 39019637 PMCID: PMC11331979 DOI: 10.1136/bmjopen-2023-083852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 06/07/2024] [Indexed: 07/19/2024] Open
Abstract
OBJECTIVES Higher physical activity (PA) levels are associated with better quality of life in people with head and neck cancer (HNC). Despite this positive association, most individuals with these cancer types have a sedentary or low-activity lifestyle. Limited knowledge exists regarding the factors that influence PA in this group. Therefore, we reviewed and mapped the available literature on factors that may influence PA in people with HNC. DESIGN We conducted a scoping review based on the framework of Arksey and O'Malley and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline extension for scoping reviews. DATA SOURCES CINHAL, the Cochrane Library, EMBASE, PsycINFO, MEDLINE and Scopus were searched from inception to July 2023. ELIGIBILITY CRITERIA We included qualitative and quantitative studies that stated factors such as barriers, facilitators, beliefs, perceptions and views influencing PA in individuals with HNC. Furthermore, views and recommendations of healthcare professionals involved in the care of people affected by HNC and researchers in this domain were eligible for data extraction. DATA EXTRACTION AND SYNTHESIS Data were extracted and synthesised by one reviewer according to the predefined items including characteristics, barriers, facilitators, beliefs, perceptions and views of people being affected and views and recommendations of experts. Quantitative data were charted descriptively, and qualitative data were analysed and summarised using a basic content analysis approach. RESULTS Of the 1351 publications, we included 19 in our review. Publications mainly focused on barriers to PA, with some studies reporting facilitators and collecting data on patients' and healthcare professionals' views on PA. Most research teams made recommendations for promoting PA in people with HNC.Characteristics associated with activity levels included age, cancer type and stage, morbidity level and attitude towards being active. Prevalent barriers consisted of health-related factors, including fatigue, pain and nutritional issues, alongside personal and environmental impediments such as time constraints, lack of interest or motivation. Facilitating factors for PA included perceived or experienced mental and health-related benefits. Consensus among patients, healthcare professionals and researchers highlighted the necessity for enhanced information and education, emphasising individualised approaches to promote PA throughout the cancer continuum. CONCLUSIONS Numerous factors affect PA in individuals with HNC. Future research should concentrate on screening and addressing risk factors for sedentary behaviour and activity barriers and on optimal design and delivery of interventions to incorporate PA promotion into the care pathway.
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Affiliation(s)
- Martina Schmocker
- Institute for Therapies and Rehabilitation, Cantonal Hospital Winterthur, Winterthur, Switzerland
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Ramona Engst
- Institute of Nursing Sciences, Eastern Switzerland University of Applied Sciences, St. Gallen, Switzerland
| | - Markus Wirz
- Institute of Physiotherapy, School of Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Marika Bana
- School of Health Sciences, University of Applied Sciences and Arts Western Switzerland, Fribourg, Switzerland
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Lu X, Wei S, Liang B, Huang C, Meng W, Zhang X, Chen X. Impact of rehabilitation unit-based physical activity therapy versus symptomatic supportive treatment on older patients with advanced cancer: a non-randomized controlled study. Support Care Cancer 2024; 32:514. [PMID: 39007999 PMCID: PMC11249417 DOI: 10.1007/s00520-024-08701-1] [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: 01/24/2024] [Accepted: 07/01/2024] [Indexed: 07/16/2024]
Abstract
OBJECTIVES Relatively few studies have investigated the effects of rehabilitation-based physical activity therapy as a treatment for older patients with advanced cancer. This study evaluated the effects of individualized precise and structured exercise interventions, prescribed by a rehabilitation physician, on fatigue, quality of life (QOL), and physical activity in older patients with advanced cancer. METHODS After admission to the rehabilitation department, older cancer patients were divided into groups receiving conventional symptomatic supportive therapy (SST) or physical activity therapy plus conventional symptomatic supportive therapy (PAT). The SST group was given symptomatic supportive treatment, exercised on their own, and were observed at home after their symptoms improved. The PAT group was required to implement physical exercise along with SST, involving 30 min of moderate-intensity exercise per day and 5 days per week, and were discharged after 4 weeks and instructed to continue to exercise outside the hospital. Cancer-related fatigue (CRF) at 4 and 8 weeks was the primary endpoint of the study, while the secondary endpoints included patients' QOL, physical activity, and exercise adherence rate. RESULTS Sixty-five patients were included; 37 (56.92%) chose to enter the PAT group, and 28 (43.08%) chose to enter the SST group. After 4 and 8 weeks of treatment, CRF relief and QOL improvement were significantly better in the PAT group than in the SST group (p < 0.05), whereas global health status did not differ between the two treatment groups (T1: p = 0.84; T2: p = 0.92). Mild physical activity significantly increased for the PAT group at T1 and T2 (T1: p = 0.03; T2: p = 0.005). At the T2 time point, the PAT group exhibited a higher level of participation in moderate-intensity physical activities as well as a higher total leisure activity score (p < 0.05). Thirty-three patients (94.29%) completed the PAT exercise program during hospitalization. Only four (12.12%) patients achieved moderate-intensity exercise, while the other 29 (87.88%) patients were able to continue exercising after their exercise intensity was decreased. CONCLUSIONS Implementation of precise and individualized exercise interventions, prescribed by the rehabilitation team, can lead to the reduction of CRF and improvement of QOL, and change in behavior related to physical activity.
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Affiliation(s)
- Xiaoqiong Lu
- Department of Pain Rehabilitation, Jiangbin Hospital of Guangxi Zhuang Autonomous Region, 85 Hedi Road, Nanning, 530000, Guangxi Province, China
| | - Shubao Wei
- Department of Pain Rehabilitation, Jiangbin Hospital of Guangxi Zhuang Autonomous Region, 85 Hedi Road, Nanning, 530000, Guangxi Province, China
| | - Benzi Liang
- Department of Pain Rehabilitation, Jiangbin Hospital of Guangxi Zhuang Autonomous Region, 85 Hedi Road, Nanning, 530000, Guangxi Province, China
| | - Cheng Huang
- Department of Pain Rehabilitation, Jiangbin Hospital of Guangxi Zhuang Autonomous Region, 85 Hedi Road, Nanning, 530000, Guangxi Province, China
| | - Weiwei Meng
- Department of Pain Rehabilitation, Jiangbin Hospital of Guangxi Zhuang Autonomous Region, 85 Hedi Road, Nanning, 530000, Guangxi Province, China
| | - Xiaojing Zhang
- Department of Pain Rehabilitation, Jiangbin Hospital of Guangxi Zhuang Autonomous Region, 85 Hedi Road, Nanning, 530000, Guangxi Province, China
| | - Xiuqiong Chen
- Department of Pain Rehabilitation, Jiangbin Hospital of Guangxi Zhuang Autonomous Region, 85 Hedi Road, Nanning, 530000, Guangxi Province, China.
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Alves I, Moreira AP, Sousa T, Teles P, Fernandes CS, Goncalves F, Magalhães B. Exergame-based rehabilitation for cancer patients undergoing abdominal surgery: Effects on pain, anxiety, depression, and fatigue - A pilot study. Eur J Oncol Nurs 2024; 72:102665. [PMID: 39018959 DOI: 10.1016/j.ejon.2024.102665] [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: 09/22/2023] [Revised: 06/25/2024] [Accepted: 07/10/2024] [Indexed: 07/19/2024]
Abstract
PURPOSE This study aimed to determine the efficacy of an exergame rehabilitation program on pain, anxiety or depression, and fatigue in oncology patients undergoing abdominal surgery. METHODS The randomized controlled trial evaluated the efficacy of exergame rehabilitation on Pain, Anxiety, Depression, and Fatigue in oncology patients undergoing abdominal surgery. Patients were recruited from October 2022-March 2023 and were randomly assigned to the intervention group (postoperative traditional rehabilitation plus an exergame rehabilitation program) or control group (postoperative traditional rehabilitation). Data were collected at three different times: on admission, in the first 48 h, and on the 7th day after surgery. Primary outcomes were evaluated and monitored with different validated instruments: numeric rating scale (NRS) for pain, Hospital Anxiety and Depression Scale (HADS) to assess the level of anxiety and depression, and the Fatigue Assessment Scale (FAS) to assess physical and psychological fatigue. The length of stay and program completion were secondary outcomes. RESULTS A total of 128 postoperative patients were recruited. Of these, 58 patients were excluded from the study due to clinical complications related to the surgical procedure (n = 53) or healthcare staff-related reasons (n = 5). Both the control and intervention groups were the same size (n = 35). Lower pain scores were observed on the 7th postoperative day in the group subject to the "exergame rehabilitation program" (p = 0.006). No statistically significant differences were observed for anxiety and depression between the 2 groups. Regarding fatigue, statistically significant differences were observed on admission (p = 0.03), which disappeared 48 h after surgery (p = 0.143). Differences between the groups were observed again on the 7th day after surgery (p = 0.005). CONCLUSIONS The intervention using exergames was effective in reducing the postoperative pain of the patient undergoing major abdominal surgery and in restoring the levels of fatigue before surgical intervention. However, no differences were observed for anxiety or depression. Future studies with larger samples should be carried out.
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Affiliation(s)
- Isabel Alves
- Portuguese Institute of Oncology, Porto, Portugal
| | | | - Teresa Sousa
- Portuguese Institute of Oncology, Porto, Portugal
| | - Paulo Teles
- Faculty of Economics of the University of Porto, Portugal
| | - Carla Sílvia Fernandes
- Porto Higher School of Nursing, Porto, Portugal; Rise-Health, Portugal and ADITGames Association, Portugal
| | - Filipe Goncalves
- University of A Coruña, Faculty of Health Sciences, Coruña, Spain; PO Porto Research Center (CI-IPOP), Portuguese Oncology Institute of Porto (IPO Porto) / Porto Comprehensive Cancer Centre (Porto.CCC) & RISE@CI-IPOP (Health Research Network), Porto, Portugal; APELA -Portuguese Amyotrophic Lateral Sclerosis Association, Portugal
| | - Bruno Magalhães
- School of Health, University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal; RISE-Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal; Clinical Academic Centre of Trás-os-Montes and Alto Douro (CACTMAD), Vila Real, Portugal.
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Chin-Yee N, Yennurajalingam S, Zimmermann C. Putting Methylphenidate for Cancer-Related Fatigue to Rest? J Clin Oncol 2024; 42:2363-2366. [PMID: 38771985 DOI: 10.1200/jco.24.00707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 04/10/2024] [Indexed: 05/23/2024] Open
Affiliation(s)
- Nicolas Chin-Yee
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
- Division of Palliative Medicine, Department of Medicine, University of Toronto, Toronto, Canada
| | | | - Camilla Zimmermann
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
- Division of Palliative Medicine, Department of Medicine, University of Toronto, Toronto, Canada
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Stone PC, Minton O, Richardson A, Buckle P, Enayat ZE, Marston L, Freemantle N. Methylphenidate Versus Placebo for Treating Fatigue in Patients With Advanced Cancer: Randomized, Double-Blind, Multicenter, Placebo-Controlled Trial. J Clin Oncol 2024; 42:2382-2392. [PMID: 38757263 PMCID: PMC11227299 DOI: 10.1200/jco.23.02639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 01/24/2024] [Accepted: 02/28/2024] [Indexed: 05/18/2024] Open
Abstract
PURPOSE To compare effects and side effects of 6 weeks of individually dose-titrated methylphenidate or placebo on fatigue in palliative care patients with advanced cancer. METHODS This is a randomized, double-blind, placebo-controlled, multicenter trial. Eligible patients had advanced incurable cancer and fatigue >3/10. Principal exclusions were hypertension; psychiatric, cardiovascular, cerebrovascular, renal, liver, or blood disorders; substance dependency; and epilepsy. Patients were randomly assigned 1:1 methylphenidate or placebo starting at 5 mg twice daily. Dose of methylphenidate/placebo was titrated once per week, over 6 weeks, up to a maximum of 20 mg three times daily. Trial ended at 10 weeks. Primary outcome was the difference in Functional Assessment of Chronic Illness Therapy Fatigue (FACIT-F) scores between groups at 6 ± 2 weeks. Secondary outcomes included adverse effects, quality of life, and mood. RESULTS One hundred sixty-two patients (73 men; mean, 65.8; standard deviation [SD], 10.3 years) were randomly assigned, and three were excluded from analysis. Seventy-seven were allocated placebo (baseline FACIT-F = 22 [SD, 10]); 82 were allocated methylphenidate (FACIT-F = 20 [SD, 9]). After 6 ± 2 weeks, FACIT-F scores were 1.97 points (95% CI, -0.95 to 4.90; P = .186) higher (better) on methylphenidate than placebo. Across 10 weeks of the study, FACIT-F was nominally higher in the methylphenidate group versus placebo (Diff, 2.20 [95% CI, 0.39 to 4.01]), but this did not reach the minimally clinically important difference (5-points). At 6 weeks, there were no differences between groups in quality-of-life or symptom domains except for depression scores (nominally reduced in the methylphenidate group: Diff, -1.35 [95% CI, -2.41 to -0.30]). There were no differences in mortality or serious adverse events. CONCLUSION After 6 ± 2 weeks of treatment, methylphenidate was not superior to placebo for treating fatigue in advanced cancer. Methylphenidate was safe and well-tolerated.
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Affiliation(s)
- Patrick Charles Stone
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London (UCL), London, United Kingdom
| | - Ollie Minton
- University Hospitals Sussex NHS Foundation Trust, Worthing Hospital, Lyndhurst Road, Worthing, West Sussex, United Kingdom
| | - Alison Richardson
- University of Southampton & University Hospital Southampton NHS Foundation Trust, Southampton General Hospital, Southampton, United Kingdom
| | - Peter Buckle
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London (UCL), London, United Kingdom
| | - Zinat E. Enayat
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London (UCL), London, United Kingdom
| | - Louise Marston
- Department of Primary Care & Population Health, Institute of Epidemiology & Health Care, Faculty of Population Health Sciences, University College London (UCL), London, United Kingdom
| | - Nick Freemantle
- Comprehensive Clinical Trials Unit, University College London (UCL), London, United Kingdom
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Aumaitre A, Gagnayre R, Foucaut AM. Determinants and factors of physical activity and sedentary behaviors among post-treatment breast, colorectal, lung, and prostate cancer survivors living in France: Results from the DEFACTO study first phase. PATIENT EDUCATION AND COUNSELING 2024; 124:108273. [PMID: 38598865 DOI: 10.1016/j.pec.2024.108273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 03/18/2024] [Accepted: 03/21/2024] [Indexed: 04/12/2024]
Abstract
OBJECTIVE This study aimed to investigate the facilitators and barriers to adopting an active lifestyle among post-treatment cancer survivors in France. METHODS Breast, colorectal, lung, and prostate cancer survivors were recruited. Participants completed a questionnaire covering sociodemographic and clinical factors, physical activity (PA) experiences, variables from the Transtheoretical model, types of motivation, knowledge of PA benefits, barriers to PA, and quality of life. We categorized participants into 4 profiles combining PA level and sedentary behaviors. RESULTS One hundred and seventy-five participants were included. Ordinal logistic regression revealed that the active lifestyle of cancer survivors is influenced by their professional situation (OR, 3.99; 95%CI, 1.76-9.10 and OR, 3.14; 95%CI, 1.45-6.77), the use of self-liberation (OR, 0.41; 95%CI, 0.20-0.82), helping relationships processes of change (OR, 2.45; 95%CI, 1.20-5.00), and quality of life (OR, 1.11; 95%CI, 1.04-1.18). CONCLUSIONS Identifying the factors associated with PA and sedentary behavior among cancer survivors in France will facilitate the adaptation of programs according to a whole-person approach. Semi-structured interviews will further enhance insights in this mixed-methods study. PRACTICE IMPLICATIONS Interventions aimed at promoting an active lifestyle among cancer survivors should be customized based on professional situation, the utilization of experiential behavior change processes, and perceived quality of life.
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Affiliation(s)
- Albane Aumaitre
- Sorbonne Paris North University, Health Educations and Promotion Laboratory, LEPS, UR 3412, F-93430 Villetaneuse, France.
| | - Rémi Gagnayre
- Sorbonne Paris North University, Health Educations and Promotion Laboratory, LEPS, UR 3412, F-93430 Villetaneuse, France
| | - Aude-Marie Foucaut
- Sorbonne Paris North University, Health Educations and Promotion Laboratory, LEPS, UR 3412, F-93430 Villetaneuse, France; Sports Science department, Sorbonne Paris North University, Bobigny, France
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20
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Keane KF, Wickstrom J, Livinski AA, Blumhorst C, Wang TF, Saligan LN. The definitions, assessment, and dimensions of cancer-related fatigue: A scoping review. Support Care Cancer 2024; 32:457. [PMID: 38916815 PMCID: PMC11199267 DOI: 10.1007/s00520-024-08615-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 05/29/2024] [Indexed: 06/26/2024]
Abstract
PURPOSE Cancer-related fatigue (CRF) is challenging to diagnose and manage due to a lack of consensus on its definition and assessment. The objective of this scoping review is to summarize how CRF has been defined and assessed in adult patients with cancer worldwide. METHODS Four databases (PubMed, Embase, CINAHL Plus, PsycNet) were searched to identify eligible original research articles published in English over a 10-year span (2010-2020); CRF was required to be a primary outcome and described as a dimensional construct. Each review phase was piloted: title and abstract screening, full-text screening, and data extraction. Then, two independent reviewers participated in each review phase, and discrepancies were resolved by a third party. RESULTS 2923 articles were screened, and 150 were included. Only 68% of articles provided a definition for CRF, of which 90% described CRF as a multidimensional construct, and 41% were identical to the National Comprehensive Cancer Network definition. Studies were primarily conducted in the United States (19%) and the majority employed longitudinal (67%), quantitative (93%), and observational (57%) study designs with sample sizes ≥ 100 people (57%). Participant age and race were often not reported (31% and 82%, respectively). The most common cancer diagnosis and treatment were breast cancer (79%) and chemotherapy (80%; n = 86), respectively. CRF measures were predominantly multidimensional (97%, n = 139), with the Multidimensional Fatigue Inventory (MFI-20) (26%) as the most common CRF measure and "Physical" (76%) as the most common CRF dimension. CONCLUSION This review confirms the need for a universally agreed-upon definition and standardized assessment battery for CRF.
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Affiliation(s)
- Kayla F Keane
- National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, USA
| | - Jordan Wickstrom
- Sinai Rehabilitation Center, Sinai Hospital of Baltimore, Baltimore, MD, USA
- Rehabilitation Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Alicia A Livinski
- Office of Research Services, Office of the Director, National Institutes of Health Library, National Institutes of Health, Bethesda, MD, USA
| | - Catherine Blumhorst
- National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, USA
| | - Tzu-Fang Wang
- National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, USA
| | - Leorey N Saligan
- National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, USA.
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21
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Kalloger SE, Watson A, Sajkowski S, Warwick L. Cancer-related Fatigue and the Additive Effect of Treatment in the Context of Lymphoma: An Analysis of the Lymphoma Coalition's 2022 Global Patient Survey. CANCER RESEARCH COMMUNICATIONS 2024; 4:1561-1565. [PMID: 38837892 PMCID: PMC11195524 DOI: 10.1158/2767-9764.crc-24-0048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 04/21/2024] [Accepted: 05/29/2024] [Indexed: 06/07/2024]
Abstract
Cancer-related fatigue (CRF) continues to be a challenging phenomenon that is often under-reported and poorly understood. With etiologies in both disease and treatment manifesting as a symptom and a side effect respectively, CRF is highly incident and presents a significant clinical problem that impacts survivorship. We conducted a survey to ascertain the patient reported incidence of symptoms and side effects for people with lymphoma or chronic lymphocytic leukemia. We found that CRF was enhanced in those who received more intense therapies that coincided with more aggressive lymphoma subtypes. These data illuminate an unmet need among patients with lymphoma and provides an opportunity to further refine treatment regimens to reduce the burden of CRF in this vulnerable population. SIGNIFICANCE CRF is a highly incident phenomenon in lymphoma that can be ascribed to a combination of causes. We have demonstrated substantial variability across various subtypes of lymphoma and have estimated that nearly half of the reported fatigue comes from treatment. Increased screening for and monitoring of fatigue will yield favorable health-related quality of life that will benefit health technology assessment activities and yield improved outcomes for patients.
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Affiliation(s)
- Steve E. Kalloger
- Lymphoma Coalition, Mississauga, Ontario, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
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22
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Zachariae R, Christiansen P, Amidi A, Wu L, Ventzel L, Tauber N, Von Heymann A, Skjødt Rafn B, Fassov J, Juul T, Christensen P, Johansen C. The time has come for national clinical practice guidelines for managing late effects after cancer and cancer treatment. Acta Oncol 2024; 63:491-493. [PMID: 38910334 PMCID: PMC11332514 DOI: 10.2340/1651-226x.2024.40787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Accepted: 05/23/2024] [Indexed: 06/25/2024]
Affiliation(s)
- Robert Zachariae
- Unit for Psychooncology and Health Psychology, Department of Oncology, Aarhus University Hospital, Aarhus, Denmark; Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark; Danish Breast Cancer Group Center for Late Effects (DCCL), Aarhus University Hospital, Aarhus, Denmark.
| | - Peer Christiansen
- Danish Breast Cancer Group Center for Late Effects (DCCL), Aarhus University Hospital, Aarhus, Denmark; Department of Plastic and Breast Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Ali Amidi
- Unit for Psychooncology and Health Psychology, Department of Oncology, Aarhus University Hospital, Aarhus, Denmark; Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Lisa Wu
- Unit for Psychooncology and Health Psychology, Department of Oncology, Aarhus University Hospital, Aarhus, Denmark; Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Lise Ventzel
- Department of Oncology, Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, Denmark
| | - Nina Tauber
- Unit for Psychooncology and Health Psychology, Department of Oncology, Aarhus University Hospital, Aarhus, Denmark; Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Annika Von Heymann
- Center for Cancer Late Effects (CASTLE), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Bolette Skjødt Rafn
- Center for Cancer Late Effects (CASTLE), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Janne Fassov
- Danish Cancer Society Centre for Research on Survivorship and Late Adverse Effects After Cancer in the Pelvic Organs, Department of Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Therese Juul
- Danish Cancer Society Centre for Research on Survivorship and Late Adverse Effects After Cancer in the Pelvic Organs, Department of Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Peter Christensen
- Danish Cancer Society Centre for Research on Survivorship and Late Adverse Effects After Cancer in the Pelvic Organs, Department of Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Christoffer Johansen
- Danish Cancer Society Centre for Research on Survivorship and Late Adverse Effects After Cancer in the Pelvic Organs, Department of Surgery, Aarhus University Hospital, Aarhus, Denmark
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23
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Xia W, Ding J, Yan Y, Chen F, Yan M, Xu X. Effectiveness of Virtual Reality Technology in Symptom Management of Patients at the end of life: A Systematic Review and Meta-Analysis. J Am Med Dir Assoc 2024:105086. [PMID: 38880120 DOI: 10.1016/j.jamda.2024.105086] [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: 01/23/2024] [Revised: 05/07/2024] [Accepted: 05/07/2024] [Indexed: 06/18/2024]
Abstract
OBJECTIVES The objective of this review was to explore the effectiveness of virtual reality (VR) technology in symptom management of patients at the end of life. DESIGN This is a systematic review and meta-analysis, which has been registered on PROSPERO (CRD42022344679). SETTING AND PARTICIPANTS Patients at the end of life. METHODS PubMed, Embase, Web of Science, the Cochrane Library, JBI, EBSCO, CNKI, Wanfang, and SinoMed were searched from inception to July 31, 2023. Search terms included "virtual reality" and "end-of-life." Articles were screened according to the inclusion and exclusion criteria. The random effects model was used to calculate the standardized mean difference (SMD), and the fixed effects model was used to calculate the mean difference (MD). The Cochrane Risk of Bias Tool 2.0 and JBI Evaluation tool were used to assess the risk of bias. The I2 statistic was used to measure heterogeneity between studies. Forest plots were used for analysis. RESULTS A total of 234 patients at the end of life from 3 randomized controlled trials and 6 quasi-experimental studies were included. Compared with pre-VR intervention, the pain [standardized mean difference (SMD) -0.89, 95% CI -1.29 to -0.48, P < .05], shortness of breath [mean difference (MD) -0.98, 95% CI -0.98-0.51, P < .05], depression (MD -0.62, 95% CI -0.85 to -0.40, P < .05), and anxiety (SMD -0.93, 95% CI -1.50 to 0.36, P < .05) of patients at the end of life was significantly improved after VR intervention. However, there were no significant differences observed in tiredness, drowsiness, nausea, and lack of appetite. CONCLUSIONS AND IMPLICATIONS VR technology can be effective in improving pain, shortness of breath, depression, and anxiety in patients at the end of life. For tiredness, drowsiness, nausea, and lack of appetite, further research is required.
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Affiliation(s)
- Wanting Xia
- The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, Hunan, China; Xiangya School of Nursing, Central South University, Changsha, Hunan, China; Xiangya Subcenter of JBI Evidence-Based Center, China
| | - JinFeng Ding
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China; Xiangya Subcenter of JBI Evidence-Based Center, China
| | - Yixia Yan
- The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, Hunan, China
| | - Furong Chen
- The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, Hunan, China
| | - Mengyao Yan
- The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, Hunan, China; Xiangya School of Nursing, Central South University, Changsha, Hunan, China; Xiangya Subcenter of JBI Evidence-Based Center, China
| | - Xianghua Xu
- The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, Hunan, China.
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24
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Shore ND, Broder MS, Barata PC, Crispino T, Fay AP, Lloyd J, Mellado B, Matsubara N, Pfanzelter N, Schlack K, Sieber P, Soares A, Dalglish H, Niyazov A, Shaman S, Zielinski MA, Chang J, Agarwal N. Expert Consensus Recommendations on the Management of Treatment-emergent Adverse Events Among Men with Prostate Cancer Taking Poly-ADP Ribose Polymerase Inhibitor + Novel Hormonal Therapy Combination Therapy. Eur Urol Oncol 2024:S2588-9311(24)00140-8. [PMID: 38866640 DOI: 10.1016/j.euo.2024.05.009] [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: 03/20/2024] [Revised: 04/30/2024] [Accepted: 05/29/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND AND OBJECTIVE Recent clinical trials have shown improvement in progression-free survival in men with metastatic prostate cancer (mPC) treated with combination poly-ADP ribose polymerase (PARP) inhibitors (PARPi) and novel hormonal therapy (NHT). Regulatory bodies in the USA, Canada, Europe, and Japan have recently approved this combination therapy for mPC. Common adverse events (AEs) include fatigue, nausea and vomiting, and anemia. Nuanced AE management guidance for these combinations is lacking. The panel objective was to develop expert consensus on AE management in patients with mPC treated with the combination PARPi + NHT. METHODS The RAND/University of California Los Angeles modified Delphi Panel method was used. AEs were defined using the Common Terminology Criteria for Adverse Events. Twelve experts (seven medical oncologists, one advanced practice registered nurse, three urologists, and one patient advocate) reviewed the relevant literature; independently rated initial AE management options for the agent suspected of causing the AE for 419 patient scenarios on a 1-9 scale; discussed areas of agreement (AoAs) and disagreement (AoDs) at a March 2023 meeting; and repeated these ratings following the meeting. Second-round ratings formed the basis of guidelines. KEY FINDINGS AND LIMITATIONS AoDs decreased from 41% to 21% between the first and second round ratings, with agreement on at least one management strategy for every AE. AoAs included the following: (1) continue therapy with symptomatic treatment for patients with mild AEs; (2) for moderate fatigue, recommend nonpharmacologic treatment, hold treatment temporarily, and restart at a reduced dose when symptoms resolve; (3) for severe nausea or any degree of vomiting where symptomatic treatment fails, hold treatment temporarily and restart at a reduced dose when symptoms resolve; and (4) for hemoglobin 7.1-8.0 g/dl and symptoms of anemia, hold treatment temporarily and restart at a reduced dose after red blood cell transfusion. CONCLUSIONS AND CLINICAL IMPLICATIONS This expert guidance can support management of AEs in patients with mPC receiving combination PARPi + NHT therapy. PATIENT SUMMARY A panel of experts developed guidelines for adverse event (AE) management in patients with metastatic prostate cancer treated with a combination of poly-ADP ribose polymerase inhibitors and novel hormonal therapy. For mild AEs, continuation of cancer therapy along with symptomatic treatment is recommended. For moderate or severe AEs, cancer therapy should be stopped temporarily and restarted at the same or a reduced dose when AE resolves.
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Affiliation(s)
- Neal D Shore
- Carolina Urologic Research Center/GenesisCare, Myrtle Beach, SC, USA.
| | - Michael S Broder
- PHAR (Partnership for Health Analytic Research), Beverly Hills, CA, USA
| | - Pedro C Barata
- University Hospitals Seidman Cancer Center, Cleveland, OH, USA
| | - Tony Crispino
- Southwestern Oncology Group Cancer Research Network, UsTOO Prostate Cancer Support and Education, Las Vegas Chapter, NV, USA
| | - André P Fay
- PUCRS School of Medicine, Porto Alegre, Brazil
| | - Jennifer Lloyd
- Huntsman Cancer Institute (NCI-CCC), University of Utah, Salt Lake City, UT, USA
| | | | | | | | - Katrin Schlack
- Department of Urology, Prostate Center, University of Muenster Medical Center, Muenster, Germany
| | - Paul Sieber
- Keystone Urology Specialists, Lancaster, PA, USA
| | - Andrey Soares
- Hospital Israelita Albert Einstein, Sao Paulo, Brazil; Centro Paulista de Oncologia/Oncoclínicas, Sao Paulo, Brazil
| | - Hannah Dalglish
- PHAR (Partnership for Health Analytic Research), Beverly Hills, CA, USA
| | | | | | | | | | - Neeraj Agarwal
- Huntsman Cancer Institute (NCI-CCC), University of Utah, Salt Lake City, UT, USA
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25
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Xu F, Zhang J, Xie S, Li Q. Effects of Mindfulness-Based Cancer Recovery training on anxiety, depression, post-traumatic stress disorder, and cancer-related fatigue in breast neoplasm patients undergoing chemotherapy. Medicine (Baltimore) 2024; 103:e38460. [PMID: 38847730 PMCID: PMC11155580 DOI: 10.1097/md.0000000000038460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 04/03/2024] [Indexed: 06/10/2024] Open
Abstract
RATIONALE Mindfulness-Based Cancer Recovery (MBCR) program is a group course training for cancer patients that combines cancer knowledge and psychological knowledge, emphasizing focusing on the psychosomatic symptoms of cancer patients. Currently, the application value of Mindfulness-Based Cancer Recovery in improving psychosomatic health of cancer patients has been confirmed, however, its intervention effect on breast neoplasm patients has not yet been widely studied in China. PATIENT CONCERNS AND DIAGNOSES This study introduced the Mindfulness-Based Cancer Recovery protocol into the rehabilitation process of breast cancer patients, aiming to elucidate the effects of Mindfulness-Based Cancer Recovery on anxiety, depression, post-traumatic stress disorder, and cancer-related fatigue in breast neoplasm patients, to provide a practical basis for improving the physical and mental health of breast cancer patients. INTERVENTION In this study, 80 patients with chemotherapy-stage breast neoplasm attending the oncology department of a tertiary-level hospital from January 2022 to December 2022 were selected, 40 patients attending from January 2022 to June 2022 were included in the study group, and 40 patients attending from July 2022 to December 2022 were included in the control group. The control group was administered conventional care, and the study group was administered Mindfulness-Based Cancer Recovery based on conventional care in the control group for 8 weeks. After the intervention, hospital anxiety and depression scale, impact of event scale-revised, and cancer fatigue scale were used for evaluation. OUTCOMES After the intervention, hospital anxiety and depression scale scores decreased in both groups compared with pre-intervention, with the study group scoring lower than the control group (P < .05). After the intervention, the impact of event scale-revised scores of the 2 groups decreased from the preintervention period, with the study group scoring lower than the control group (P < .05). After the intervention, cancer fatigue scale scores decreased in the 2 groups compared with the preintervention period, with the study group scoring lower than the control group (P < .05). LESSONS Mindfulness-Based Cancer Recovery can effectively reduce the levels of anxiety, depression and post-traumatic stress disorder in breast neoplasm patients undergoing chemotherapy, reduce the levels of cancer-related fatigue, and promote the physical and mental health of patients.
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Affiliation(s)
- Fan Xu
- Oncology Department, Deyang People’s Hospital, Deyang, China
| | - Jiquan Zhang
- Nephrology Department, Deyang People’s Hospital, Deyang, China
| | - Shaoju Xie
- Oncology Department, Deyang People’s Hospital, Deyang, China
| | - Qiao Li
- Oncology Department, Deyang People’s Hospital, Deyang, China
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26
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Gray L, Sindall P, Pearson SJ. Does resistance training ameliorate cancer-related fatigue in cancer survivors? A systematic review with meta-analysis. Disabil Rehabil 2024; 46:2213-2222. [PMID: 37345506 DOI: 10.1080/09638288.2023.2226408] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 06/12/2023] [Indexed: 06/23/2023]
Abstract
PURPOSE Cancer-related fatigue (CRF) is unrelenting. As neither rest nor sleep ameliorates cognitive, emotional, and physical symptoms, quality of life is diminished. This study examines resistance training (RT) effectiveness on CRF in cancer survivors. The secondary aims were to identify the dose-response relationship of RT frequency, intensity, and volume on CRF in different cancer survivor populations. MATERIALS AND METHODS Systematic searches via numerous databases for RCTs were performed in June 2022. Patient-reported outcome measures (PROM), were analysed, pre-to-post intervention, using a random-effects model. The Physiotherapy Evidence Database (PEDro) scale informed methodological quality assessment. RESULTS Eight studies were included (cancer survivors: breast (BCS) = 5; endometrial (ECS) = 1; prostate (PCS) = 2). Overall, RT interventions ≥ 6 weeks elicited large significant reductions in CRF for FACIT-F (SMD = 0.932, p = <0.001) and moderate significant reductions in CRF for PFS-R (SMD = -0.622, p = 0.004). CONCLUSION Main findings indicate that RT ameliorates CRF, especially in BCS; however, individualised approaches should be advocated. Supervised training elicited the greatest positive outcomes, thus should be a pivotal part of the cancer rehabilitation pathway. Future studies should be adequately powered, undertake discrete analyses of different cancer types, and investigate chronic RT effects.
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Affiliation(s)
- Luke Gray
- Department of Health and Social Care, University of Salford, Salford, UK
| | - Paul Sindall
- Department of Health and Social Care, University of Salford, Salford, UK
| | - Stephen J Pearson
- Department of Health and Social Care, University of Salford, Salford, UK
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27
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Huynh TTM, Falk RS, Hellebust TP, Dale E, Astrup GL, Hjermstad MJ, Malinen E, Bjordal K, Kiserud CE, Herlofson BB, Nome R, Amdal CD. Chronic fatigue in long-term survivors of head and neck cancer treated with radiotherapy. Radiother Oncol 2024; 195:110231. [PMID: 38518958 DOI: 10.1016/j.radonc.2024.110231] [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: 11/17/2023] [Revised: 03/13/2024] [Accepted: 03/14/2024] [Indexed: 03/24/2024]
Abstract
BACKGROUND There is lack of evidence on chronic fatigue (CF) following radiotherapy (RT) in survivors of head and neck cancer (HNC). We aimed to compare CF in HNC survivors > 5 years post-RT with a reference population and investigate factors associated with CF and the possible impact of CF on health-related quality of life (HRQoL). MATERIAL AND METHODS In this cross-sectional study we included HNC survivors treated in 2007-2013. Participants filled in patient-reported outcome measures and attended a one-day examination. CF was measured with the Fatigue Questionnaire and compared with a matched reference population using t-tests and Cohen's effect size. Associations between CF, clinical and RT-related factors were investigated using logistic regression. HRQoL was measured with the EORTC Quality of Life core questionnaire. RESULTS The median age of the 227 HNC survivors was 65 years and median time to follow-up was 8.5 years post-RT. CF was twice more prevalent in HNC survivors compared to a reference population. In multivariable analyses, female sex (OR 3.39, 95 % CI 1.82-6.31), comorbidity (OR 2.17, 95 % CI 1.20-3.94) and treatment with intensity-modulated RT (OR 2.13, 95 % CI 1.16-3.91) were associated with CF, while RT dose parameters were not. Survivors with CF compared to those without, had significantly worse HRQoL. CONCLUSIONS CF in HNC survivors is particularly important for female patients, while specific factors associated with RT appear not to play a role. The high CF prevalence in long-term HNC survivors associated with impaired HRQoL is important information beneficial for clinicians and patients to improve patient follow-up.
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Affiliation(s)
- Thuy-Tien Maria Huynh
- Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Oncology, Oslo University Hospital, Oslo, Norway.
| | | | - Taran Paulsen Hellebust
- Department of Physics, University of Oslo, Oslo, Norway; Department of Medical Physics, Oslo University Hospital, Oslo, Norway
| | - Einar Dale
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| | | | | | - Eirik Malinen
- Department of Physics, University of Oslo, Oslo, Norway; Department of Radiation Biology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway
| | - Kristin Bjordal
- Faculty of Medicine, University of Oslo, Oslo, Norway; Research Support Services, Oslo University Hospital, Oslo, Norway
| | | | - Bente Brokstad Herlofson
- Faculty of Dentistry, University of Oslo, Oslo, Norway; Department of Otorhinolaryngology, Head and Neck Surgery, Oslo University Hospital, Oslo, Norway
| | - Ragnhild Nome
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
| | - Cecilie Delphin Amdal
- Department of Oncology, Oslo University Hospital, Oslo, Norway; Research Support Services, Oslo University Hospital, Oslo, Norway
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Agbejule OA, Hart NH, Ekberg S, Chan RJ. Development of a self-management support practice framework for addressing cancer-related fatigue: a modified Delphi study. J Cancer Surviv 2024; 18:972-982. [PMID: 36826459 PMCID: PMC11082027 DOI: 10.1007/s11764-023-01348-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 02/08/2023] [Indexed: 02/25/2023]
Abstract
PURPOSE Managing cancer-related fatigue requires individuals to adopt a range of self-management behaviours. However, clinicians report the lack of clear guidance on self-management support practices hinders their provision of supportive care. To develop consensus on a framework of core practices required by health professionals to deliver effective self-management support to cancer patients and survivors experiencing cancer-related fatigue. METHODS A preliminary framework of 47 practice items (14 Key Practices, 33 Practice Components) was derived from a systematic review, and a self-management support capability outline for primary care professionals. This preliminary framework was presented for consensus rating and comment in a two-round modified Delphi study conducted with a panel of health professionals, research academics, and cancer consumers. RESULTS Fifty-two panel participants comprising consumers (n = 25), health professionals (n = 19), and researchers (n = 16) were included in Round 1 of the modified Delphi study. Feedback from the panel produced consensus on retaining 27 of 47 original practice items without change. Seventeen items (including 12 modified, and 5 newly created practice items) were sent to the panel for rating in Round 2. Thirty-six experts produced consensus on retaining all 17 practice items in Round 2. The final framework comprised 44 items (13 Key Practices, 31 Practice Components). CONCLUSIONS The practice framework offers an evidence- and consensus-based model of best practice for health professionals providing self-management support for cancer-related fatigue. IMPLICATIONS FOR CANCER SURVIVORS This framework is the first to focus on quality provision of self-management support in managing cancer-related fatigue, one of the most prevalent symptoms experienced by cancer patients and survivors.
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Affiliation(s)
- Oluwaseyifunmi Andi Agbejule
- Caring Futures Institute, College of Nursing and Allied Health, Flinders University, Bedford Park, South Australia, 5042, Australia.
| | - Nicolas H Hart
- Caring Futures Institute, College of Nursing and Allied Health, Flinders University, Bedford Park, South Australia, 5042, Australia
- Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, Kelvin Grove, Queensland, 4059, Australia
- Centre for IMPACCT, Faculty of Health, University of Technology, NSW, Sydney, 2007, Australia
| | - Stuart Ekberg
- Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, Kelvin Grove, Queensland, 4059, Australia
- School of Psychology & Counselling, Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland, 4059, Australia
| | - Raymond Javan Chan
- Caring Futures Institute, College of Nursing and Allied Health, Flinders University, Bedford Park, South Australia, 5042, Australia
- Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, Kelvin Grove, Queensland, 4059, Australia
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Trudel G, Lebel S, Stephens RL, Leclair CS, Leach CR, Westmaas JL. Afraid and tired: A longitudinal study of the relationship between cancer-related fatigue and fear of cancer recurrence in long-term cancer survivors. Cancer Med 2024; 13:e7313. [PMID: 38845458 PMCID: PMC11157147 DOI: 10.1002/cam4.7313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 05/03/2024] [Accepted: 05/08/2024] [Indexed: 06/10/2024] Open
Abstract
OBJECTIVE Cancer-related fatigue (CRF) and fear of cancer recurrence (FCR) are two common concerns experienced by cancer survivors. However, the relationship between these two concerns is poorly understood, and whether CRF and FCR influence each other over time is unclear. METHODS Data were from a national, prospective, longitudinal study, the American Cancer Society's Study of Cancer Survivors-I (SCS-I). Surveys were completed by 1395 survivors of 10 different cancer types at three time-points, including assessment 1.3 years (T1), 2.2 years (T2) and 8.8 years (T3) following their cancer diagnosis. CRF was assessed using the fatigue-inertia subscale of the Profile of Mood States, and FCR by the FCR subscale of the Cancer Problems in Living Scale. Multiple group random intercepts cross-lagged panel models investigated prospective associations between CRF and FCR. RESULTS For younger participants (at or below median age of 55 years, n = 697), CRF at T1 and T2 marginally and significantly predicted FCR at T2 and T3, respectively, but no lagged effects of FCR on subsequent CRF were observed. Cross-lagged effects were not observed for survivors over 55 years of age. CONCLUSION Both CRF and FCR are debilitating side effects of cancer and its treatments. Given that CRF may be predictive of FCR, it possible that early detection and intervention for CRF could contribute to lowering FCR severity.
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Affiliation(s)
| | - Sophie Lebel
- School of PsychologyUniversity of OttawaOttawaOntarioCanada
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Iyizoba-Ebozue Z, Nicklin E, Price J, Prestwich R, Brown S, Hall E, Lilley J, Lowe M, Thomson DJ, Slevin F, Murray L, Boele F. "Why am I still suffering?": Experience of long-term fatigue and neurocognitive changes in oropharyngeal cancer survivors following (chemo)radiotherapy. Tech Innov Patient Support Radiat Oncol 2024; 30:100241. [PMID: 38510557 PMCID: PMC10951087 DOI: 10.1016/j.tipsro.2024.100241] [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: 11/23/2023] [Revised: 02/02/2024] [Accepted: 02/29/2024] [Indexed: 03/22/2024] Open
Abstract
Background Late effects of cancer treatment, such as neurocognitive deficits and fatigue, can be debilitating. Other than head and neck-specific functional deficits such as impairments in swallowing and speech, little is known about survivorship after oropharyngeal cancer. This study examines the lived experience of fatigue and neurocognitive deficits in survivors of oropharyngeal squamous cell cancer and impact on their daily lives. Methods This work is part of the multicentre mixed method ROC-oN study (Radiotherapy for Oropharyngeal Cancer and impact on Neurocognition), evaluating fatigue and neurocognitive function in patients following radiotherapy +/- chemotherapy for oropharyngeal cancer and impact on quality of life. Semi-structured interviews were conducted in adults treated with radiotherapy (+/-chemotherapy) for oropharyngeal squamous cell carcinoma >/=24 months from completing treatment. Reflexive thematic analysis performed. Results 21 interviews (11 men and 10 women; median age 58 years and median time post-treatment 5 years) were conducted and analysed, yielding six themes: (1) unexpected burden of fatigue, (2) noticing changes in neurocognitive function, (3) the new normal, (4) navigating changes, (5)insufficient awareness and (6)required support. Participants described fatigue that persisted beyond the acute post-treatment period and changes in neurocognitive abilities across several domains. Paid and unpaid work, emotions and mood were impacted. Participants described navigating the new normal by adopting self-management strategies and accepting external support. They reported lack of recognition of these late effects, being poorly informed and being unprepared. Follow-up services were thought to be inadequate. Conclusions Fatigue and neurocognitive impairment were frequently experienced by survivors of oropharyngeal cancer, at least two years after treatment. Patients felt ill-prepared for these late sequelae, highlighting opportunities for improvement of patient information and support services.
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Affiliation(s)
| | - Emma Nicklin
- Leeds Institute of Medical Research, University of Leeds, Leeds, UK
| | - James Price
- Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK
| | - Robin Prestwich
- Department of Clinical Oncology, Leeds Cancer Centre, Leeds, UK
| | - Sarah Brown
- Leeds Cancer Research UK Clinical Trials Unit, Leeds Institute of Clinical Trials Research
| | - Emma Hall
- The Institute of Cancer Research, London, UK
| | - John Lilley
- Department of Radiotherapy Physics, Leeds Cancer Centre, Leeds, UK
| | - Matthew Lowe
- Christie Medical Physics and Engineering, The Christie NHS Foundation Trust, Manchester, UK
- Manchester Academic Health Sciences Centre, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - David J Thomson
- Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK
- Manchester Academic Health Sciences Centre, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Finbar Slevin
- Department of Clinical Oncology, Leeds Cancer Centre, Leeds, UK
- Leeds Institute of Medical Research, University of Leeds, Leeds, UK
| | - Louise Murray
- Department of Clinical Oncology, Leeds Cancer Centre, Leeds, UK
- Leeds Institute of Medical Research, University of Leeds, Leeds, UK
| | - Florien Boele
- Leeds Institute of Medical Research, University of Leeds, Leeds, UK
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Tometich DB, Geiss C, Maconi ML, Chavez M, Hoogland AI, Li X, Nieves-Lopez A, Rodriguez Y, Bryant C, Brohl AS, Eroglu Z, Markowitz J, Tarhini AA, Hwu P, Khushalani NI, Jim HSL. Patient reported outcomes and patient experiences of immune checkpoint modulators for advanced or recurrent melanoma: a mixed methods study. Support Care Cancer 2024; 32:330. [PMID: 38709312 PMCID: PMC11249036 DOI: 10.1007/s00520-024-08538-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 04/30/2024] [Indexed: 05/07/2024]
Abstract
PURPOSE Little is known about late and long-term patient-reported outcomes (PROs) of immune checkpoint modulators (ICMs) outside clinical trials. We conducted a cross-sectional, mixed-methods study to describe long-term PROs among advanced melanoma patients who began standard of care treatment with ICMs at least 1 year previously. METHODS All participants completed the Functional Assessment of Cancer Therapy-Immune Checkpoint Modulator (FACT-ICM), assessing 46 immune-related side effects on a 5-point Likert scale, and a subset completed individual interviews. Descriptive statistics were computed for quantitative data and applied thematic analysis was used to examine qualitative data. RESULTS Participants (N = 80) had a mean age of 67 years, and the majority were male (66%), non-Hispanic White (96%), and college graduates (61%). Single-agent nivolumab was the most common first (47%) and current/recent ICM (64%). On the FACT-ICM, 98% of participants reported at least one side effect, and 78% reported moderate or severe side effects. The most common moderate or severe side effects were aching joints (43%) and fatigue (38%). In interviews (n = 20), we identified five themes regarding patients' longer-term experiences after ICMs: lasting fatigue or decline in functioning, minimal side effects, manageable thyroid and pituitary dysfunction, skin conditions can be difficult to manage, and treating the cancer is worth the side effects. CONCLUSIONS Nearly all patients reported side effects of ICMs at least 1 year after starting treatment. Our findings suggest that ICM side effect screening and management-especially for aching joints and fatigue-are indicated during long-term care of people living with advanced melanoma.
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Affiliation(s)
- Danielle B Tometich
- Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL, 33612, USA.
- University of South Florida, 12901 Bruce B Downs Blvd, Tampa, FL, 33612, USA.
| | - Carley Geiss
- Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL, 33612, USA
| | - Melinda L Maconi
- Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL, 33612, USA
| | - Melody Chavez
- Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL, 33612, USA
| | - Aasha I Hoogland
- Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL, 33612, USA
| | - Xiaoyin Li
- Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL, 33612, USA
| | | | - Yvelise Rodriguez
- Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL, 33612, USA
| | - Crystal Bryant
- Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL, 33612, USA
| | - Andrew S Brohl
- Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL, 33612, USA
| | - Zeynep Eroglu
- Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL, 33612, USA
| | - Joseph Markowitz
- Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL, 33612, USA
| | - Ahmad A Tarhini
- Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL, 33612, USA
| | - Patrick Hwu
- Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL, 33612, USA
| | | | - Heather S L Jim
- Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL, 33612, USA
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Leclercq A, Chatrenet A, Bourgeois H, Cojocarasu O, Mathie C, Martin T, Rahmani A, Morel B. Multidisciplinary analysis of cancer-related fatigue at the time of diagnosis: preliminary results of the BIOCARE FActory cohort. Support Care Cancer 2024; 32:319. [PMID: 38689167 DOI: 10.1007/s00520-024-08520-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 04/22/2024] [Indexed: 05/02/2024]
Abstract
PURPOSE Cancer-related fatigue (CRF) is a common side effect of cancer and cancer treatment that significantly impairs the quality of life and can persist for years after treatment completion. Although fatigue is often associated with cancer treatment, it is also a result of the disease itself, even before intervention. CRF at the time of diagnosis may affect treatment timing or completion and is a consistent predictor of post-treatment fatigue at any time. The mechanisms underlying CRF are multidimensional and not well understood, particularly at the time of diagnosis. METHODS Sixty-five breast cancer patients at the time of diagnosis were included. The participants completed self-assessment questionnaires about CRF, sleep disturbances, and emotional symptoms and wore an accelerometer to assess levels of spontaneous physical activity and sleep quality. During the experimental session, the participants underwent cognitive, neuromuscular, and exercise metabolism evaluations. RESULTS Using augmented backward elimination regression, this study found that emotional symptoms and perceived sleep disturbances were the strongest predictors of CRF (adjusted r2 = 0.51). Neuromuscular fatigability and sleep disturbance were also associated with physical dimensions, whereas cognitive performance was associated with cognitive dimensions. CONCLUSION At the time of diagnosis, emotional and cognitive dimensions are over-represented compared to the general population, and specific subdimensions have specific predictors that support the idea of distinct mechanisms. Evaluating CRF subdimensions and their potential mechanisms at the time of diagnosis would be particularly relevant for identifying high-risk patients and offering them appropriate interventions. TRIAL REGISTRATION This study was registered at ClinicalTrials.gov (NCT04391543) in May, 2020.
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Affiliation(s)
- A Leclercq
- Laboratoire Movement, Interactions, Performance, MIP-UR 4334, Le Mans Université Avenue Olivier Messiaen, 72085, Le Mans Cedex 9, France.
| | - A Chatrenet
- Laboratoire Movement, Interactions, Performance, MIP-UR 4334, Le Mans Université Avenue Olivier Messiaen, 72085, Le Mans Cedex 9, France
- APCoSS-Institute of Physical Education and Sports Sciences (IFEPSA), UCO, Angers, France
| | - H Bourgeois
- Elsan-Clinique Victor Hugo, Centre Jean Bernard, Le Mans, France
| | - O Cojocarasu
- Centre Hospitalier Le Mans (CHM), Le Mans, France
| | - C Mathie
- Centre Hospitalier Le Mans (CHM), Le Mans, France
| | - T Martin
- Laboratoire Movement, Interactions, Performance, MIP-UR 4334, Le Mans Université Avenue Olivier Messiaen, 72085, Le Mans Cedex 9, France
| | - A Rahmani
- Laboratoire Movement, Interactions, Performance, MIP-UR 4334, Le Mans Université Avenue Olivier Messiaen, 72085, Le Mans Cedex 9, France
| | - B Morel
- Laboratoire Interuniversitaire de Biologie de La Motricité, Université Savoie Mont Blanc, EA 7424, F-73000, Chambéry, France
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Urbano Chamorro I, de la Torre-Montero JC. Cancer-related fatigue and activities of daily living: lessons learned from the COVID-19 pandemic. BMC Palliat Care 2024; 23:110. [PMID: 38678234 PMCID: PMC11055275 DOI: 10.1186/s12904-024-01437-z] [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: 12/15/2023] [Accepted: 04/19/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Cancer-related fatigue is a prevalent condition in all stages of oncologic disease that is poorly diagnosed, with a negative impact on physical function to perform activities of daily living. Fatigue is also one of the main manifestations in post-COVID-19 syndrome, and few studies have explored the functionality of cancer patients after infection by the new coronavirus. This study was designed to assess cancer-related fatigue symptoms and their implications on physical function and quality of life during the pandemic. METHODOLOGY An observational study with a cross-sectional survey in cancer patients ≥ 18 years of age was conducted. The Functional Assessment of Chronic Illness Therapy - Fatigue Scale (FACIT-F), the perception of asthenia and performance status were evaluated, and the differences between groups according to the history of COVID-19 were calculated. RESULTS A total of 60 cancer patients had an average age of 33.5 ± 10.11 years, 73.3% were female, and 98.3% had an Eastern Cooperative Oncology Group-Performance Status level < 2. Severe fatigue was found in 43.3% of patients, and the average FACIT-F score was 33.5 ± 10.11. The proportion of coronavirus infection was 13,3%, and the performance of this group was worse on the scale compared to the group without infection (25 ± 10,40 vs. 34,81 ± 9,50 [p = 0,009]). There was a significant correlation between visual analog scale values and FACIT-F scale scores (Pearson's r = -0.76). CONCLUSION SARS-CoV-2 infection could increase cancer-related fatigue symptoms, limiting activities of daily living and impairing quality of life.
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Affiliation(s)
- Iveth Urbano Chamorro
- Universidad Pontificia Comillas, Health Sciences Department, Madrid, Spain.
- Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Madrid, Spain.
| | - Julio C de la Torre-Montero
- Universidad Pontificia Comillas, Health Sciences Department, Madrid, Spain
- Fundación San Juan de Dios, Madrid, Spain
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Brower B, McCoy A, Ahmad H, Eitman C, Bowman IA, Rembisz J, Milowsky MI. Managing potential adverse events during treatment with enfortumab vedotin + pembrolizumab in patients with advanced urothelial cancer. Front Oncol 2024; 14:1326715. [PMID: 38711854 PMCID: PMC11071165 DOI: 10.3389/fonc.2024.1326715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 03/25/2024] [Indexed: 05/08/2024] Open
Abstract
Cisplatin-based chemotherapy has been the standard of care for patients with locally advanced or metastatic urothelial cancer (la/mUC). Enfortumab vedotin, an antibody-drug conjugate directed to Nectin-4, and pembrolizumab, an immune checkpoint inhibitor, are two therapies that have individually provided a survival benefit in patients with la/mUC. The combination regimen of enfortumab vedotin plus pembrolizumab was evaluated in EV-302 (KEYNOTE-A39; NCT0422385), a phase 3 study that showed statistically significant and clinically meaningful improvement in overall survival, progression-free survival, and a key secondary endpoint of overall response rate versus chemotherapy. Based on these results and those from the EV-103 (KEYNOTE-869; NCT03288545) Dose Escalation cohort, Cohort A, and Cohort K, enfortumab vedotin plus pembrolizumab was granted approval from the US Food and Drug Administration for the treatment of adults with la/mUC. While guidelines and recommendations for the management of adverse events (AEs) have been developed for immune checkpoint inhibitor monotherapy and enfortumab vedotin monotherapy, additional guidance is needed for managing AEs that occur with enfortumab vedotin plus pembrolizumab. As monotherapies, enfortumab vedotin and pembrolizumab are both associated with some of the AEs observed with the combination, such as skin reactions, pneumonitis, and diarrhea, which may confound the attribution of the AE to a specific agent and thereby complicate clinical management. In this manuscript, we aim to provide recommendations for best practice for patient care and the management of AEs of clinical interest for patients with la/mUC receiving enfortumab vedotin plus pembrolizumab, including skin reactions, peripheral neuropathy, hyperglycemia, and pneumonitis. These recommendations were developed based on published guidelines, expert opinions, and the clinical experience of the authors, which include oncologist, advanced practice provider, nursing, and pharmacy perspectives. In addition, guidance on patient education and communication is provided. With vigilant monitoring, early detection, and prompt intervention of treatment-emergent AEs based on recommended approaches described herein, it is the authors' experience that most AEs can be managed with supportive therapy and dose modification/interruptions, allowing patients to continue treatment.
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Affiliation(s)
- Blaine Brower
- Division of Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Asia McCoy
- Genitourinary Medical Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Hiba Ahmad
- Anschutz Cancer Center – GU Oncology Department, University of Colorado, Aurora, CO, United States
| | - Cheryl Eitman
- University Hospitals Seidman Cancer Center, Case Western Reserve University, Cleveland, OH, United States
| | - I. Alex Bowman
- Genitourinary Oncology, Banner MD Anderson Cancer Center, Gilbert, AZ, United States
| | - Jennifer Rembisz
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL, United States
| | - Matthew I. Milowsky
- Division of Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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Pérez C, Ochoa D, Sánchez N, Ballesteros AI, Santidrián S, López I, Mondéjar R, Carnaval T, Villoria J, Colomer R. Pain in Long-Term Cancer Survivors: Prevalence and Impact in a Cohort Composed Mostly of Breast Cancer Survivors. Cancers (Basel) 2024; 16:1581. [PMID: 38672663 PMCID: PMC11049399 DOI: 10.3390/cancers16081581] [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: 03/26/2024] [Revised: 04/16/2024] [Accepted: 04/17/2024] [Indexed: 04/28/2024] Open
Abstract
Cancer survival is becoming more common which means that there is now a growing population of cancer survivors, in whom pain may be common. However, its prevalence has hardly been addressed systematically. We aimed to assess the prevalence and explore the pathophysiology and impact of pain on health outcomes in cancer survivors. We conducted a retrospective-prospective cohort study in cancer-free patients diagnosed with cancer at least five years before the study start date. We used multivariable regression to establish the association of patients' cancer characteristics with pain, and then the association of patients' pain features with health outcomes and related symptoms. Between March and July 2021, 278 long-term cancer survivors were evaluated. Almost half of them (130/278, 46.8%) had pain, of whom 58.9% had a probable neuropathic component, but only 18 (13.8%) were taking specific drugs for neuropathic pain. A history of surgery-related pain syndrome in breast cancer patients was more than twice as frequent in the pain cohort. Post-chemotherapy and post-radiotherapy pain syndromes were uncommon. Pain was associated with lower QoL, emotional functioning, professional performance, and disability scores. Pain is a frequent health determinant in cancer survivors. Referral to specialised pain services may be a reasonable move in some cases.
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Affiliation(s)
- Concepción Pérez
- Pain Clinic, Hospital de La Princesa, 28006 Madrid, Spain; (D.O.); (N.S.); (S.S.); (I.L.)
| | - Dolores Ochoa
- Pain Clinic, Hospital de La Princesa, 28006 Madrid, Spain; (D.O.); (N.S.); (S.S.); (I.L.)
| | - Noelia Sánchez
- Pain Clinic, Hospital de La Princesa, 28006 Madrid, Spain; (D.O.); (N.S.); (S.S.); (I.L.)
| | - Ana Isabel Ballesteros
- Department of Clinical Oncology, Hospital de la Princesa, 28006 Madrid, Spain; (A.I.B.); (R.M.); (R.C.)
| | - Sheila Santidrián
- Pain Clinic, Hospital de La Princesa, 28006 Madrid, Spain; (D.O.); (N.S.); (S.S.); (I.L.)
| | - Isabel López
- Pain Clinic, Hospital de La Princesa, 28006 Madrid, Spain; (D.O.); (N.S.); (S.S.); (I.L.)
| | - Rebeca Mondéjar
- Department of Clinical Oncology, Hospital de la Princesa, 28006 Madrid, Spain; (A.I.B.); (R.M.); (R.C.)
| | - Thiago Carnaval
- Department of Design and Biometrics, Medicxact, S.L., 28430 Alpedrete, Spain; (T.C.); (J.V.)
| | - Jesús Villoria
- Department of Design and Biometrics, Medicxact, S.L., 28430 Alpedrete, Spain; (T.C.); (J.V.)
| | - Ramón Colomer
- Department of Clinical Oncology, Hospital de la Princesa, 28006 Madrid, Spain; (A.I.B.); (R.M.); (R.C.)
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Miladinia M, Jahangiri M, White SJ, Karimpourian H, Inno A, Chan SWC, Ganji R, Maniati M, Zarea K, Ghalamkari M, Farahat A, Fagerström C. 5-EPIFAT trial protocol: a multi-center, randomized, placebo-controlled trial of the efficacy of pharmacotherapy for fatigue using methylphenidate, bupropion, ginseng, and amantadine in advanced cancer patients on active treatment. Trials 2024; 25:230. [PMID: 38570861 PMCID: PMC10988831 DOI: 10.1186/s13063-024-08078-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 03/27/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Cancer-related fatigue (CRF) is still undertreated in most patients, as evidence for pharmacological treatments is limited and conflicting. Also, the efficacy of the pharmacological agents relative to each other is still unclear. Therefore, medications that may potentially contribute to improving CRF will be investigated in this head-to-head trial. Our main objective is to compare the efficacy of methylphenidate vs. bupropion vs. ginseng vs. amantadine vs. placebo in patients with advanced cancer. METHODS The 5-EPIFAT study is a 5-arm, randomized, multi-blind, placebo-controlled, multicenter trial that will use a parallel-group design with an equal allocation ratio comparing the efficacy and safety of four medications (Methylphenidate vs. Bupropion vs. Ginseng vs. Amantadine) versus placebo for management of CRF. We will recruit 255 adult patients with advanced cancer who experience fatigue intensity ≥ 4 based on a 0-10 scale. The study period includes a 4-week intervention and a 4-week follow-up with repeated measurements over time. The primary outcome is the cancer-related fatigue level over time, which will be measured by the functional assessment of chronic illness therapy-fatigue (FACIT-F) scale. To evaluate safety, the secondary outcome is the symptomatic adverse events, which will be assessed using the Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events in cancer clinical trials (PRO-CTCAE). Also, a subgroup analysis based on a decision tree-based machine learning algorithm will be employed for the clinical prediction of different agents in homogeneous subgroups. DISCUSSION The findings of the 5-EPIFAT trial could be helpful to guide clinical decision-making, personalization treatment approach, design of future trials, as well as the development of CRF management guidelines. TRIAL REGISTRATION IRCT.ir IRCT20150302021307N6. Registered on 13 May 2023.
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Affiliation(s)
- Mojtaba Miladinia
- Nursing Care Research Center in Chronic Diseases, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Mina Jahangiri
- Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | | | - Hossein Karimpourian
- Department of Medical Oncology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Alessandro Inno
- Medical Oncology Unit, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella (VR), Italy
| | | | - Reza Ganji
- Department of Clinical Pharmacy, School of Pharmacy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mahmood Maniati
- School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Kourosh Zarea
- Nursing Care Research Center in Chronic Diseases, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- School of Nursing and Midwifery, Deakin University, Burwood, VIC, Australia
| | - Marziyeh Ghalamkari
- Department of Internal Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Farahat
- Department of Hematology and Oncology, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Cecilia Fagerström
- Department of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus University, Kalmar/Växjö, Kalmar, Sweden
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Karakuş Z, Özer Z. The effect of a fatigue self-management program based on individual and family self-management theory in cancer patients: A single-blinded randomized controlled trial. Eur J Oncol Nurs 2024; 69:102483. [PMID: 38417400 DOI: 10.1016/j.ejon.2023.102483] [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: 01/06/2023] [Revised: 11/20/2023] [Accepted: 11/23/2023] [Indexed: 03/01/2024]
Abstract
PURPOSE This study was conducted to investigate the effect of the Fatigue Self-Management Program based on the Individual and Family Self-Management Theory on fatigue, daily living activities, and well-being in cancer patients. METHODS This randomized controlled single-blind experimental study was carried out between November 2020 and April 2022. A total of 94 patients with advanced cancer, 47 in each group, were included in the study, and 57 participants completed the study. Data were collected using the Brief Fatigue Inventory, Katz Index of Independence in Activities of Daily Living, and Well-Being Questionnaire-22. The Fatigue Self-Management Program based on Individual and Family Self-Management Theory was delivered to the intervention group with two face-to-face and two tele-monitoring sessions. No intervention was applied to the control group, who received only routine care. RESULTS The mean score of fatigue in the intervention group compared to the control group decreased, and the difference was statistically significant (p < .05); daily living activities mean scores were higher than the control group, but there was no statistically significant difference (p > .05). The mean scores of depression and anxiety in the intervention group were lower than those in the control group; energy, positive well-being, and general well-being mean scores were found to be higher than those in the control group, and the difference was statistically significant (p < .05). CONCLUSIONS The Fatigue Self-Management Program effectively reduces the fatigue experienced by cancer patients and increases their well-being but it does not increase their independence in daily living activities. CLINICAL TRIAL REGISTRY NCT04822220.
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Affiliation(s)
- Zeynep Karakuş
- Department of Internal Medicine Nursing, Faculty of Nursing, Akdeniz University, Antalya, Turkey.
| | - Zeynep Özer
- Department of Internal Medicine Nursing, Faculty of Nursing, Akdeniz University, Antalya, Turkey
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Antunes P, Joaquim A, Sampaio F, Nunes C, Ascensão A, Vilela E, Teixeira M, Oliveira J, Capela A, Amarelo A, Leão I, Marques C, Viamonte S, Alves A, Esteves D. Exercise Training Benefits Health-Related Quality of Life and Functional Capacity during Breast Cancer Chemotherapy: A Randomized Controlled Trial. Med Sci Sports Exerc 2024; 56:600-611. [PMID: 38051110 DOI: 10.1249/mss.0000000000003341] [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: 12/07/2023]
Abstract
PURPOSE To examine the effectiveness of a supervised exercise training program (SETP) on health-related quality of life (HRQoL) and functional capacity in women with breast cancer (BC) undergoing chemotherapy. METHODS Ninety-three women with early-stage BC were randomly allocated to a SETP plus usual care (exercise, n = 47) or usual care alone (UC, n = 46). The SETP included three sessions per week, combining aerobic and resistance training, conducted concurrently over the chemotherapy. The EORTC Cancer Quality-of-Life-Questionnaire-Core-30 (QLQ-C30) and the BC-specific module (QLQ-BR23) were used to assess HRQoL. Functional capacity was analyzed by maximum voluntary handgrip strength (MVHS) and by the 30-s chair sit-to-stand test (30-s CST). These endpoints were assessed at baseline (t0); middle (t1; after 8 or 12 wk of t0); and at the end of chemotherapy (t2; after 20 wk of t0). Mean changes from baseline were assessed by an intention-to-treat approach. RESULTS Mixed linear model analyses showed that Exercise group experienced less deterioration in several domains of QLQ-C30 at t2, including in global health status/QoL (Δ = 9.39 units; P = 0.034), QLQ-C30 summary score (Δ = 8.08 units; P < 0.001), physical (Δ = 15.14 units; P < 0.001), role ( Δ = 21.81 units; P < 0.001), cognitive (Δ = 9.16 units; P = 0.032) and social functioning (Δ = 11.67 units; P = 0.038), compared with the UC group. Similarly, Exercise group exhibited significant lower levels of fatigue (Δ = -20.19 units; P < 0.001) and appetite loss (Δ = -13.69 units; P = 0.034), compared with the UC group. Significant between-group differences were observed on MVHS of the tumor/surgery upper limb side (Δ = 2.64 kg; P < 0.001) and contralateral limb (Δ = 2.22 kg; P < 0.001), and on the 30-s CST score (Δ = 3.56repetitions; P < 0.001), favoring the Exercise group. No differences were observed on QLQ-BR23 domains. CONCLUSIONS Exercise training was an effective complementary therapy to prevent the deterioration of HRQoL and functional capacity during chemotherapy in women with early-stage BC.
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Affiliation(s)
| | | | | | - Célia Nunes
- Department of Mathematics and Center of Mathematics and Applications, University of Beira Interior, Covilhã, PORTUGAL
| | - António Ascensão
- Laboratory of Metabolism and Exercise (LaMetEx), Research Centre in Physical Activity, Health and Leisure (CIAFEL), Laboratory for Integrative and Translational Research in Population Health (ITR), Faculty of Sports, University of Porto, Porto, PORTUGAL
| | - Eduardo Vilela
- Department of Cardiology, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, PORTUGAL
| | - Madalena Teixeira
- Department of Cardiology, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, PORTUGAL
| | - Jorge Oliveira
- Department of Cardiology, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, PORTUGAL
| | | | | | | | - Cristiana Marques
- Department of Medical Oncology, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, PORTUGAL
| | | | | | - Dulce Esteves
- Research Center in Sport Sciences, Health and Human Development (CIDESD), Sport Sciences Department, University of Beira Interior, PORTUGAL
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Onyedibe MCC, Blickle P, Schmidt ME, Steindorf K. Posttraumatic growth and health-related quality of life in cancer survivors: Does fatigue moderate the link? Stress Health 2024; 40:e3299. [PMID: 37547957 DOI: 10.1002/smi.3299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 06/26/2023] [Accepted: 07/26/2023] [Indexed: 08/08/2023]
Abstract
Interest in post-traumatic growth (PTG) as a predictor of health-related quality of life (HRQoL) is currently gaining attention. However, current evidence is still inconclusive on the nature of this relationship. The first objective of this study was to investigate the relationship between PTG and global HRQoL among cancer survivors. We further investigated the moderating role of fatigue in the association between PTG and global HRQoL. In the FiX study (Fatigue in Germany - Examination of prevalence, severity, and state of screening and treatment) cancer-related fatigue (EORTC QLQ-FA12), PTG inventory and global HRQoL (EORTC QLQ-C30) were assessed four years after cancer diagnosis in 1316 cancer-free survivors (mean age = 67.28, SD = 11.05, 51.4% female). Multiple linear regression analysis and moderation analysis were performed. The results showed that PTG had a convex quadratic relationship with global HRQoL (p < 0.001). Contrary to our hypothesis, fatigue did not moderate the relationship between PTG (linear and quadratic terms) and global HRQoL, neither when considering the overall PTG score nor for any PTG subdimension. In conclusion, PTG has a convex quadratic relationship with long-term global HRQoL that was not modified by persisting fatigue. Future statistical models investigating PTG and global HRQoL should take this non-linear relationship into account. Aiming to increase PTG might contribute to, but is likely not sufficient for high levels of global HRQoL in cancer survivors in the long run.
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Affiliation(s)
- Maria-Chidi C Onyedibe
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
- Department of Psychology, University of Nigeria, Nsukka, Nigeria
| | - Patricia Blickle
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
- Medical Faculty, University of Heidelberg, Heidelberg, Germany
| | - Martina E Schmidt
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Karen Steindorf
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
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Wang Y, Yang L, Lin G, Huang B, Sheng X, Wang L, Chen L, Qiu X, Wu X, Lin R. The efficacy of progressive muscle relaxation training on cancer-related fatigue and quality of life in patients with cancer: A systematic review and meta-analysis of randomized controlled studies. Int J Nurs Stud 2024; 152:104694. [PMID: 38281450 DOI: 10.1016/j.ijnurstu.2024.104694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 01/08/2024] [Accepted: 01/08/2024] [Indexed: 01/30/2024]
Abstract
BACKGROUND Cancer-related fatigue is one of the most common symptoms in cancer patients, usually accompanied by anxiety, depression and insomnia, which seriously affect patients' quality of life. Progressive muscle relaxation training is widely used for cancer-related fatigue, but the overall effect is unclear. OBJECTIVES The aim of this study was to summarize the evidence on the effects of progressive muscle relaxation training on cancer-related fatigue and quality of life in cancer patients. DESIGN Systematic review and meta-analysis. METHODS Nine electronic databases (PubMed, Excerpta Medica Database (Embase), The Cochrane Library (Cochrane Central Register of Controlled Trials, CENTRAL), Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Chinese Biomedical Literature Database (CBM), Chinese National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP) and Wanfang Database) were explored for randomized controlled trials (RCTs) published before February 2023. This study was reported based on the PRISMA 2020 statement. The Cochrane Collaboration's risk of bias assessment tool was used for methodological assessment, and the GRADE pro online assessment tool was used for evidence evaluation. The data were analyzed with the Review Manager 5.4 software. RESULTS Twelve studies involving 1047 patients were included. Meta-analysis showed that progressive muscle relaxation training plus routine nursing produced more positive effects than routine nursing in improving cancer-related fatigue [SMD = -1.06, 95 % CI -1.49, -0.62, P < 0.00001], anxiety [SMD = -1.09, 95 % CI -1.40, -0.77, P < 0.00001], depression [SMD = -1.43, 95 % CI -1.76, -1.10, P < 0.00001], and quality of sleep [MD = -1.41, 95 % CI -1.74, -1.08, P < 0.00001]. However, there was no significant difference in improving quality of life [SMD = 0.27, 95 % CI -0.62, 1.15, P = 0.55]. Progressive resistance exercise plus routine nursing improved cancer-related fatigue more than progressive muscle relaxation training plus routine nursing [SMD = 1.11, 95 % CI 0.43, 1.78, P = 0.001]. There was low certainty of evidence that progressive muscle relaxation training improved cancer-related fatigue and quality of sleep, and the evidence that improved quality of life, anxiety and depression was very low. CONCLUSION Current evidence suggested that progressive muscle relaxation training has the potential to improve cancer-related fatigue, anxiety, depression and quality of sleep in patients with cancer and is a low-load, simple exercise worthy of recommendation for cancer patients in fatigue state. Future research should focus on improving the methodological quality of randomized controlled trials to enhance the persuasive evidence of progressive muscle relaxation training efficacy.
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Affiliation(s)
- Yajiao Wang
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Liu Yang
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China.
| | - Guijiao Lin
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Bichun Huang
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Xia Sheng
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Ligang Wang
- Xiamen University Xiamen Cardiovascular Hospital, Xiamen, Fujian, China
| | - Liuyin Chen
- The Second Hospital of Longyan, Fujian, China
| | - Xiahua Qiu
- Longyan Medical Treatment Security Data Monitoring Center, Longyan, Fujian, China
| | - Xinlei Wu
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Rujia Lin
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
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Masel EK, Baer J, Wenzel C. Integrating Palliative Care Into the Management of Genitourinary Malignancies. Am Soc Clin Oncol Educ Book 2024; 44:e438644. [PMID: 38662976 DOI: 10.1200/edbk_438644] [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: 05/29/2024]
Abstract
Palliative care (PC) plays a critical role in managing the difficulties associated with genitourinary malignancies. Its primary aim is to improve the overall health of patients, provide support to both patients and their caregivers, and help individuals to navigate the complex decisions about treatment and end-of-life care. PC takes a holistic approach to patient care, recognizing that genitourinary malignancies affect multiple aspects of a person's life. By addressing physical, emotional, social, and spiritual needs, PC aims to provide comprehensive support that is consistent with the patient's values and preferences. The goal is to optimize comfort, minimize distress, and enhance the patient's quality of life throughout the course of the illness. PC is not a one-off intervention, but an ongoing source of support. This article aims to provide a thorough overview of the critical elements involved in addressing the challenges posed by genitourinary cancers, emphasizing the importance of palliative interventions. We will highlight the multifaceted aspects of care and explore strategies to optimize the overall well-being of patients throughout the course of treatment for genitourinary malignancies.
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Affiliation(s)
- Eva K Masel
- Division of Palliative Medicine, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Joachim Baer
- Division of Palliative Medicine, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Claudia Wenzel
- Division of Palliative Medicine, Department of Medicine I, Medical University of Vienna, Vienna, Austria
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Rondanina G, Siri G, Marra D, DeCensi A. Effect of sex on psychological distress and fatigue over time in a prospective cohort of cancer survivors. J Cancer Surviv 2024; 18:586-595. [PMID: 36344904 DOI: 10.1007/s11764-022-01291-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 11/01/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Studies indicate a higher level of distress in women than men with cancer, but whether this difference is retained over time is unknown. We studied the frequency and level of distress and fatigue during time according to gender in a cohort of cancer survivors. PATIENTS AND METHODS In this prospective study, cancer survivors were invited to undergo a psychological session immediately before the medical visit. Distress was assessed by the distress thermometer, and fatigue was assessed by the ESAS-r scale. Patients underwent follow-up visits to assess changes over time. RESULTS A total of 305 patients and 568 visits were performed with a median follow-up of 15.8 months. At baseline, females, young age, and breast cancer patients had significantly higher distress. However, there was an increase in distress of 0.29 points every 6 months in males (95% CI, 0.09-0.50) versus no change in females (0.03 points, 95% CI, - 0.09-0.15; p-interaction = 0.01). The different behavior of cancer distress during time according to gender was more evident in subjects aged 68 or older due to increasing physical problems in men (p-interaction = 0.005). There was no change in fatigue with time according to sex. CONCLUSIONS Women, younger age, and breast cancer patients had increased cancer distress at the initial visit. However, women tend to stabilize during follow-up, whereas men tend to worsen their distress, especially because of physical and emotional problems, suggesting different coping capabilities. TRIAL REGISTRATION The study is registered at ClinicalTrials.gov NCT05122052. IMPLICATIONS FOR CANCER SURVIVORS Interventions aimed at improving recognition of emotions related to disease experience in male cancer survivors appear necessary.
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Affiliation(s)
- Gabriella Rondanina
- E.O. Ospedali Galliera, 16128, Genoa, Italy.
- Villa Serena Hospital, GVM, 16145, Genoa, Italy.
| | | | | | - Andrea DeCensi
- E.O. Ospedali Galliera, 16128, Genoa, Italy
- Villa Serena Hospital, GVM, 16145, Genoa, Italy
- Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
- European Institute of Oncology, IRCCS, 20141, Milan, Italy
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Belloni S, Caruso R, Giacon C, Baroni I, Conte G, Magon A, Arrigoni C. Microbiome-Modifiers for Cancer-Related Fatigue Management: A Systematic Review. Semin Oncol Nurs 2024; 40:151619. [PMID: 38503656 DOI: 10.1016/j.soncn.2024.151619] [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: 09/11/2023] [Revised: 02/06/2024] [Accepted: 02/10/2024] [Indexed: 03/21/2024]
Abstract
OBJECTIVES This study systematically investigates the evidence regarding the use of probiotics in managing cancer-related fatigue (CRF). STUDY DESIGN We conducted a systematic review of randomized controlled trials. DATA SOURCES The systematic search encompassed six databases: PubMed, CINHAL, Cochrane Database of Systematic Reviews, Web of Science, Scopus, and EMBASE, covering the period from inception to December 2023. The assessment of risk of bias employed the Cochrane risk of bias tool (RoB 2). A narrative synthesis and an exploratory meta-analysis were conducted to summarize the evidence. RESULTS Among 460 records, three studies met the eligibility criteria and were included in the review. These studies involved a total of 284 participants with colorectal and breast cancer. One study demonstrated a marginal improvement in CRF postchemotherapy in colorectal cancer patients using probiotics. Another study, also using probiotics, reported a significant reduction in CRF among colorectal cancer patients undergoing chemotherapy. Additionally, a study employing synbiotics showed a substantial decrease in CRF severity in breast cancer patients receiving chemotherapy. CONCLUSION The study presents initial but varied evidence suggesting the potential of probiotics and synbiotics as adjunctive therapies in managing CRF alongside anticancer treatments. IMPLICATIONS FOR NURSING PRACTICE In nursing practice, large-scale clinical trials are urgently needed to evaluate the effectiveness of probiotics in treating cancer-related fatigue during cancer therapy. Insights from this review could guide nurses in selecting appropriate probiotic strains and integrating microbiome modifiers into comprehensive care plans, potentially enhancing the quality of life for cancer patients.
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Affiliation(s)
- Silvia Belloni
- Gastroenterology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Rosario Caruso
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy; Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.
| | - Chiara Giacon
- Department of Public Health, Experimental and Forensic Medicine, Section of Hygiene, University of Pavia, Pavia, Italy
| | - Irene Baroni
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Gianluca Conte
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Arianna Magon
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Cristina Arrigoni
- Department of Public Health, Experimental and Forensic Medicine, Section of Hygiene, University of Pavia, Pavia, Italy
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Liu L, Cai S, Wu X, Zhu H, Wang Y. Effects of Ward Noise Reduction Administration on Mental Health and Lung Function of Patients with Lung Cancer. Noise Health 2024; 26:235-241. [PMID: 38904829 DOI: 10.4103/nah.nah_98_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 02/28/2024] [Indexed: 06/22/2024] Open
Abstract
OBJECTIVE This study aimed to analyze the effects of ward noise reduction administration on the lung function and mental health of patients with lung cancer. METHODS A total of 195 patients who underwent lung cancer surgery in PLA Northern Theater Command Air Force Hospital from November 2020 to November 2022 were selected to be divided into a control group (routine nursing) and an observation group (routine nursing and ward noise reduction administration) in accordance with the medical record system. The general demographic data, noise level, lung function (forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and FEV1/FVC)), and complications of patients in the two groups were collected. Propensity score matching (PSM) was used to balance the baseline data of the two groups, and t-test and chi-square test were used to analyze the data. RESULTS After PSM was conducted, 50 patients were enrolled in each group. No statistical difference was found in the baseline data, preadministration noise levels, and FEV1, FVC, FEV1/FVC, state-anxiety inventory (S-AI), and trait anxiety inventory scale (T-AI) scores between the two groups (P > 0.05). After ward noise reduction was administered, the noise level in the observation group was lower than that in the control group (P < 0.05). The FEV1, FVC, and FEV1/FVC scores of the observation group were higher than those of the control group but were not statistically significant (P > 0.05). The S-AI and T-AI scores of the observation group were lower than those of the control group (P < 0.05). No differences were found in the complications between the two groups (P > 0.05). CONCLUSION Administering ward noise reduction in patients with lung cancer can alleviate their negative emotions, thus worthy of clinical adoption.
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Affiliation(s)
- Lina Liu
- Department of Radiation Oncology, Air Force Hospital of the PLA Northern Theater Command, Shenyang, 110042, China
| | - Shuo Cai
- Department of Nursing, PLA Northern Theater Command Air Force Hospital, Shenyang, 110042, China
| | - Xiaoyu Wu
- Department of Respiratory and Critical Care Medicine, PLA Northern Theater Command Air Force Hospital, Shenyang, 110042, China
| | - Huixin Zhu
- Department of Nursing, PLA Northern Theater Command Air Force Hospital, Shenyang, 110042, China
| | - Yu Wang
- Department of Pharmacy, PLA Northern Theater Command Air Force Hospital, Shenyang, 110042, China
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Devoogdt N, De Groef A. Physiotherapy management of breast cancer treatment-related sequelae. J Physiother 2024; 70:90-105. [PMID: 38519340 DOI: 10.1016/j.jphys.2024.02.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 02/29/2024] [Indexed: 03/24/2024] Open
Affiliation(s)
- Nele Devoogdt
- Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium; Department of Vascular Surgery, Center for Lymphedema, University Hospitals Leuven, Leuven, Belgium.
| | - An De Groef
- Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium; Department of Rehabilitation Sciences, MOVANT Research Group, Antwerp University, Antwerp, Belgium
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Cui C, Wang L, Wang X. Effects of physical and psychological symptoms on cancer-related fatigue among esophageal cancer patients. BMC Cancer 2024; 24:398. [PMID: 38553681 PMCID: PMC10981330 DOI: 10.1186/s12885-024-12138-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 03/18/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Cancer-related fatigue (CRF) is considered one of the most prevalent and distressing symptoms among cancer patients and may vary among patients with different cancer types. However, few studies have explored the influence of physical and psychological symptoms on CRF among esophageal cancer (EC) patients without esophagectomy. Therefore, this study aimed to examine the effects of physical and psychological symptoms on CRF among EC patients without esophagectomy. METHODS In the present study, a cross-sectional study was conducted from February 2021 to March 2022 in Liaoning Province, China. Among the 112 included participants, 97 completed our investigation. The questionnaires used consisted of the Brief Fatigue Inventory (BFI), the MD Anderson Symptom Inventory Gastrointestinal Cancer Module (MDASI-GI), the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder-7 (GAD-7), and demographic and clinical information. Multivariate linear regression was conducted to test the relationships between physical and psychological symptoms and CRF. RESULTS Of the 97 EC patients, 60.8% reported CRF (BFI ≥ 4). The mean age of the participants was 64.92 years (SD = 8.67). According to the regression model, all the variables explained 74.5% of the variance in CRF. Regression analysis indicated that physical symptoms, including constipation, diarrhoea, and difficulty swallowing, contributed to CRF. On the other hand, depressive symptoms increased the level of CRF among EC patients without esophagectomy. CONCLUSIONS Given the high prevalence of CRF among EC patients without esophagectomy, it is urgent to emphasize the importance of fatigue management interventions based on physical and psychological symptoms to alleviate CRF in EC patients.
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Affiliation(s)
- ChunYing Cui
- School of Humanities and Management, Wannan Medical College, 241002, Wuhu, Anhui, PR China
| | - Lie Wang
- School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, 110122, Shenyang, Liaoning, PR China
| | - XiaoXi Wang
- Medical Basic Experimental Teaching Center, China Medical University, No.77 Puhe Road, Shenyang North New Area, 110122, Shenyang, Liaoning, PR China.
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Li M, Zhang Y, Liu J, Zhang D. Complementary and alternative medicine: A narrative review of nutritional approaches for cancer-related fatigue. Medicine (Baltimore) 2024; 103:e37480. [PMID: 38489718 PMCID: PMC10939540 DOI: 10.1097/md.0000000000037480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 02/08/2024] [Accepted: 02/13/2024] [Indexed: 03/17/2024] Open
Abstract
Cancer-related fatigue (CRF) is a common symptom among patients with cancer, with a prevalence of >49%. CRF significantly affects the quality of life of patients and may also affect their overall survival. Pharmacological interventions serve as a last resort after carefully weighing the risks and benefits, with limited benefits for patients, many side effects, and adverse reactions. Compared to traditional medicine, nutritional approaches have fewer side effects, are highly accepted by patients, and do not affect the antitumor treatment of patients. Many studies have shown that nutritional approaches, as a form of complementary and alternative medicine, help improve the symptoms of CRF and the quality of life of patients. This study was designed to examine nutritional approaches to CRF and assess their effectiveness of nutritional approaches in improving CRF. We present an overview of clinical trials investigating nutritional approaches for CRF that have been published over the last 2 decades. A total of 33 records were obtained from 3 databases: Web of Science, MEDLINE, and PubMed. Some nutritional approaches, such as melatonin, PG2, and S-adenosyl-l-methionine, are potential options for CRF treatment. However, the trials included in the review varied widely in quality, most were weak in methodology, and there is currently insufficient evidence to conclude with certainty the effectiveness of nutritional approaches in reducing CRF. Therefore, the design and methods used in future complementary and alternative medicine trials should be more rigorous.
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Affiliation(s)
- Meng Li
- College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Yue Zhang
- Department of Integrated Chinese and Western Medicine, Jilin Cancer Hospital, Changchun, China
| | - Jimin Liu
- The Third Clinical Hospital of Changchun University of Traditional Chinese Medicine, Changchun, China
| | - Dong Zhang
- College of Basic Medicine, Changchun University of Chinese Medicine, Changchun, China
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Ingham G, Urban K, Phyo Y, Hunt J, Tuffin P, Seah D. Use of Dexamethasone for Severe Fatigue in the Advanced Cancer Population: A Brief Report. Palliat Med Rep 2024; 5:116-121. [PMID: 38560745 PMCID: PMC10979672 DOI: 10.1089/pmr.2023.0050] [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] [Accepted: 01/02/2024] [Indexed: 04/04/2024] Open
Abstract
Background Fatigue is a common and distressing symptom for palliative care patients. Although the current literature emphasizes nonpharmacological management, dexamethasone is reportedly used in clinical practice. This study helps to characterize its use, efficacy, and adverse effects in a real-world setting. Objective To improve the evidence base by exploring the use, efficacy, and side effect profile of dexamethasone for fatigue management. Methods This international multisite prospective observational case series assessed the benefit and adverse effects of dexamethasone at baseline (T0) and at five to seven days postbaseline (T1). Fatigue scores were assessed using the symptom assessment scale (SAS) and visual analogue fatigue scale (VAFS). Adverse events were graded using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE). The related samples Wilcoxon signed-rank test was used to compare before and after scores. Results All 18 patients (male-female, 11:7) had advanced metastatic cancer with most in the deteriorating palliative care phase (56%). The most common dose of dexamethasone was 4 mg daily orally. At T1 (n = 12), improvement was seen in all measures of fatigue; the median SAS scores decreased from 7 to 5.5 (p = 0.007), the median VAFS scores increased from 3 to 5 (p = 0.126), and the median NCI-CTCAE fatigue scores were reduced from 3 to 2.5 (p = 0.18). Dexamethasone was well tolerated; one participant experienced grade 3 delirium. Conclusion The small number of participants recruited for this study suggests that dexamethasone is not widely used specifically for fatigue. Our results suggest an improvement in fatigue scores from T0 to T1.
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Affiliation(s)
- Gemma Ingham
- Department of Palliative Care, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Kat Urban
- Department of Palliative Care, Lismore Base Hospital, Lismore, New South Wales, Australia
| | - Yinyin Phyo
- Centre for Improving Palliative, Aged, and Chronic Care Through Clinical Research and Translation (IMPACCT), University of Technology, Sydney, New South Wales, Australia
| | - Jane Hunt
- Centre for Improving Palliative, Aged, and Chronic Care Through Clinical Research and Translation (IMPACCT), University of Technology, Sydney, New South Wales, Australia
| | - Penelope Tuffin
- Palliative Care Program, Pharmacist WA Country Health Service, Western Australia
- Pharmacy and Palliative Care Departments, Fiona Stanley Hospital, Perth, Western Australia
- Palliative Care Unit, Bethesda Hospital, Perth, Western Australia
| | - Davinia Seah
- Centre for Improving Palliative, Aged, and Chronic Care Through Clinical Research and Translation (IMPACCT), University of Technology, Sydney, New South Wales, Australia
- Supportive and Palliative Care, Sacred Heart Health Service, Sydney, New South Wales, Australia
- St Vincent's Clinical School, University of New South Wales, Sydney, New South Wales, Australia
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Yackel HD, Halpenny B, Abrahm JL, Ligibel J, Enzinger A, Lobach DF, Cooley ME. A qualitative analysis of algorithm-based decision support usability testing for symptom management across the trajectory of cancer care: one size does not fit all. BMC Med Inform Decis Mak 2024; 24:63. [PMID: 38443870 PMCID: PMC10913367 DOI: 10.1186/s12911-024-02466-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 02/22/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Adults with cancer experience symptoms that change across the disease trajectory. Due to the distress and cost associated with uncontrolled symptoms, improving symptom management is an important component of quality cancer care. Clinical decision support (CDS) is a promising strategy to integrate clinical practice guideline (CPG)-based symptom management recommendations at the point of care. METHODS The objectives of this project were to develop and evaluate the usability of two symptom management algorithms (constipation and fatigue) across the trajectory of cancer care in patients with active disease treated in comprehensive or community cancer care settings to surveillance of cancer survivors in primary care practices. A modified ADAPTE process was used to develop algorithms based on national CPGs. Usability testing involved semi-structured interviews with clinicians from varied care settings, including comprehensive and community cancer centers, and primary care. The transcripts were analyzed with MAXQDA using Braun and Clarke's thematic analysis method. A cross tabs analysis was also performed to assess the prevalence of themes and subthemes by cancer care setting. RESULTS A total of 17 clinicians (physicians, nurse practitioners, and physician assistants) were interviewed for usability testing. Three main themes emerged: (1) Algorithms as useful, (2) Symptom management differences, and (3) Different target end-users. The cross-tabs analysis demonstrated differences among care trajectories and settings that originated in the Symptom management differences theme. The sub-themes of "Differences between diseases" and "Differences between care trajectories" originated from participants working in a comprehensive cancer center, which tends to be disease-specific locations for patients on active treatment. Meanwhile, participants from primary care identified the sub-theme of "Differences in settings," indicating that symptom management strategies are care setting specific. CONCLUSIONS While CDS can help promote evidence-based symptom management, systems providing care recommendations need to be specifically developed to fit patient characteristics and clinical context. Findings suggest that one set of algorithms will not be applicable throughout the entire cancer trajectory. Unique CDS for symptom management will be needed for patients who are cancer survivors being followed in primary care settings.
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Affiliation(s)
| | - Barbara Halpenny
- Dana-Farber Cancer Institute, 450 Brookline Ave, LW-508, 02215, Boston, MA, USA
| | - Janet L Abrahm
- Dana-Farber Cancer Institute, 450 Brookline Ave, LW-508, 02215, Boston, MA, USA
| | - Jennifer Ligibel
- Dana-Farber Cancer Institute, 450 Brookline Ave, LW-508, 02215, Boston, MA, USA
| | - Andrea Enzinger
- Dana-Farber Cancer Institute, 450 Brookline Ave, LW-508, 02215, Boston, MA, USA
| | - David F Lobach
- Elimu Informatics, 1709 Julian Court, 94530, El Cerrito, CA, USA
| | - Mary E Cooley
- Dana-Farber Cancer Institute, 450 Brookline Ave, LW-508, 02215, Boston, MA, USA.
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Hu S, Xiong X, Qiu S, Li J, Xu H, Zhou X, Wang S, Wei Q, Yang L. Comparing Efficacies of Different Exercises on Androgen Deprivation Therapy Adverse Effects in Prostate Cancer Patients: A Network Meta-Analysis. Urol Int 2024; 108:298-313. [PMID: 38432212 DOI: 10.1159/000538114] [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: 12/06/2023] [Accepted: 01/31/2024] [Indexed: 03/05/2024]
Abstract
INTRODUCTION Previous studies showed exercise have efficacies for androgen deprivation therapy (ADT) adverse effects. To compare the efficacies of different exercises on ADT adverse effects, we conducted the network meta-analysis (NMA). METHODS Literature retrieval was performed in PubMed, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL). Nineteen studies (1,184 participants) were included. All analyses were performed in R 4.1.2 or RevMan 5.4.1. RESULTS NMA results showed that compared with the control group, both aerobic + resistance training (ART) (MD = 5.92, 95% CI: 0.38; 11.46) and resistance exercise (RE) (MD = 5.62, 95% CI: 2.70; 8.55) improved quality of life (QoL). ART (P score: 0.72) may have superiority over RE (P score: 0.7). ART (MD = -10.89, 95% CI: -17.67; -4.11) significantly improved the performance of 400-m test. RE could significantly improve leg strength (MD = 118, 95% CI: 78.75; 157.25) and chest strength (MD = 13.30, 95% CI: 4.07; 22.53). RE ranked first for strength improvements of leg and chest. CONCLUSION ART showed better efficacy for the QoL and significantly improved the performance of 400-m test. RE might be superior for the strengths of leg and chest. ART may be appropriate for patients with less significant muscle strength decline but also other adverse effects of ADT, such as decreased cardiopulmonary function.
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Affiliation(s)
- Siping Hu
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, China,
- West China School of Clinical Medicine, West China Hospital, Sichuan University, Chengdu, China,
| | - Xingyu Xiong
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, China
- West China School of Clinical Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Shi Qiu
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, China
- Center of Biomedical Big Data, West China Hospital, Sichuan University, Chengdu, China
| | - Jiakun Li
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, China
- Institutes for Systems Genetics, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Hang Xu
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, China
- West China School of Clinical Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Xianghong Zhou
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, China
- West China School of Clinical Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Sheng Wang
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, China
- West China School of Clinical Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Qiang Wei
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, China
| | - Lu Yang
- Department of Urology, Institute of Urology and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, China
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