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Sharman R, Harris Z, Ernst B, Mussallem D, Larsen A, Gowin K. Lifestyle Factors and Cancer: A Narrative Review. Mayo Clin Proc Innov Qual Outcomes 2024; 8:166-183. [PMID: 38468817 PMCID: PMC10925935 DOI: 10.1016/j.mayocpiqo.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2024] Open
Abstract
Lifestyle factors and their impact on cancer prevention, prognosis, and survivorship are increasingly recognized in the medical literature. Lifestyle factors are primarily defined here as diet and physical activity. We conducted a narrative review of the primary published data, including randomized controlled trials and prospective studies, on the impact of primary lifestyle factors on oncogenesis and clinical outcomes in the preventative and survivorship setting. First, we discuss the oncogenic mechanisms behind primary lifestyle factors (diet, physical activity and, within these 2, obesity). Then, we discuss the impact of adherence to lifestyle guidelines and dietary patterns on cancer incidence based on primary data. Owing to the plethora of published literature, to summarize the data in a more efficient manner, we describe the role of physical activity on cancer incidence using summative systematic reviews. We end by synthesizing the primary data on lifestyle factors in the survivorship setting and conclude with potential future directions. In brief, the various large-scale studies investigating the role diet and physical activity have reported a beneficial effect on cancer prevention and survivorship. Although the impact of single lifestyle factors on cancer incidence risk reduction is generally supported, holistic approaches to address the potential synergistic impact of multiple lifestyle factors together in concert is limited. Future research to identify the potentially synergistic effects of lifestyle modifications on oncogenesis and clinical outcomes is needed, particularly in cancer subtypes beyond colorectal and breast cancers.
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Affiliation(s)
- Reya Sharman
- Division of Hematology Oncology, Department of Medicine, University of Arizona, Tucson, AZ
| | - Zoey Harris
- Division of Hematology and Medical Oncology, Department of Medicine, Mayo Clinic, Phoenix, AZ
| | - Brenda Ernst
- Division of Hematology and Medical Oncology, Department of Medicine, Mayo Clinic, Phoenix, AZ
| | - Dawn Mussallem
- Division of Hematology and Medical Oncology, Department of Medicine, Mayo Clinic, Jacksonville, FL
| | - Ashley Larsen
- Division of Hematology Oncology, Department of Medicine, University of Arizona, Tucson, AZ
| | - Krisstina Gowin
- Division of Hematology Oncology, Department of Medicine, University of Arizona, Tucson, AZ
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Hendricks LAJ, Verbeek KCJ, Schuurs-Hoeijmakers JHM, Mensenkamp AR, Brems H, de Putter R, Anastasiadou VC, Villy MC, Jahn A, Steinke-Lange V, Baldassarri M, Irmejs A, de Jong MM, Links TP, Leter EM, Bosch DGM, Høberg-Vetti H, Tveit Haavind M, Jørgensen K, Mæhle L, Blatnik A, Brunet J, Darder E, Tham E, Hoogerbrugge N, Vos JR. Lifestyle Factors and Breast Cancer in Females with PTEN Hamartoma Tumor Syndrome (PHTS). Cancers (Basel) 2024; 16:953. [PMID: 38473316 DOI: 10.3390/cancers16050953] [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: 01/08/2024] [Revised: 02/15/2024] [Accepted: 02/17/2024] [Indexed: 03/14/2024] Open
Abstract
Females with PTEN Hamartoma Tumor Syndrome (PHTS) have breast cancer risks up to 76%. This study assessed associations between breast cancer and lifestyle in European female adult PHTS patients. Data were collected via patient questionnaires (July 2020-March 2023) and genetic diagnoses from medical files. Associations between lifestyle and breast cancer were calculated using logistic regression corrected for age. Index patients with breast cancer before PHTS diagnosis (breast cancer index) were excluded for ascertainment bias correction. In total, 125 patients were included who completed the questionnaire at a mean age of 44 years (SD = 13). This included 21 breast cancer indexes (17%) and 39 females who developed breast cancer at 43 years (SD = 9). Breast cancer patients performed about 1.1 times less often 0-1 times/week physical activity than ≥2 times (ORtotal-adj = 0.9 (95%CI 0.3-2.6); consumed daily about 1.2-1.8 times more often ≥1 than 0-1 glasses of alcohol (ORtotal-adj = 1.2 (95%CI 0.4-4.0); ORnon-breastcancer-index-adj = 1.8 (95%CI 0.4-6.9); were about 1.04-1.3 times more often smokers than non-smokers (ORtotal-adj = 1.04 (95%CI 0.4-2.8); ORnon-breastcancer-index-adj = 1.3 (95%CI 0.4-4.2)); and overweight or obesity (72%) was about 1.02-1.3 times less common (ORtotal-adj = 0.98 (95%CI 0.4-2.6); ORnon-breastcancer-index-adj = 0.8 (95%CI 0.3-2.7)). Similar associations between lifestyle and breast cancer are suggested for PHTS and the general population. Despite not being statistically significant, results are clinically relevant and suggest that awareness of the effects of lifestyle on patients' breast cancer risk is important.
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Affiliation(s)
- Linda A J Hendricks
- Department of Human Genetics, Radboudumc Expert Center for PHTS, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
- Radboud Institute for Medical Innovation, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
| | - Katja C J Verbeek
- Department of Human Genetics, Radboudumc Expert Center for PHTS, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
- Radboud Institute for Medical Innovation, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
| | - Janneke H M Schuurs-Hoeijmakers
- Department of Human Genetics, Radboudumc Expert Center for PHTS, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
| | - Arjen R Mensenkamp
- Department of Human Genetics, Radboudumc Expert Center for PHTS, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
- Radboud Institute for Medical Innovation, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
| | - Hilde Brems
- Department of Human Genetics, University of Leuven, 3000 Leuven, Belgium
| | - Robin de Putter
- Center for Medical Genetics, Ghent University Hospital, 9000 Ghent, Belgium
| | - Violetta C Anastasiadou
- Karaiskakio Foundation, Nicosia Cyprus and Archbishop Makarios III Children's Hospital, Nicosia 2012, Cyprus
| | | | - Arne Jahn
- Institute for Clinical Genetics, Faculty of Medicine Carl Gustav Carus, Technische Universitat Dresden, 01062 Dresden, Germany
- Hereditary Cancer Syndrome Center Dresden, 01307 Dresden, Germany
- German Cancer Consortium (DKTK), 69120 Dresden, Germany
| | - Verena Steinke-Lange
- Medical Genetics Center, 80335 Munich, Germany
- Arbeitsgruppe Erbliche Gastrointestinale Tumore, Medizinische Klinik und Poliklinik IV-Campus Innenstadt, Klinikum der Universität München, 81377 Munich, Germany
| | - Margherita Baldassarri
- Medical Genetics, University of Siena, 53100 Siena, Italy
- Med Biotech Hub and Competence Center, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
- Genetica Medica, Azienda Ospedaliero-Universitaria Senese, 53100 Siena, Italy
| | - Arvids Irmejs
- Institute of Oncology, Riga Stradins University, 1007 Riga, Latvia
- Breast Unit, Pauls Stradins Clinical University Hospital, 1002 Riga, Latvia
| | - Mirjam M de Jong
- Department of Genetics, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands
| | - Thera P Links
- Department of Endocrinology, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands
| | - Edward M Leter
- Department of Clinical Genetics, Maastricht University Medical Center, 6229 ER Maastricht, The Netherlands
| | - Daniëlle G M Bosch
- Department of Clinical Genetics, Erasmus MC Rotterdam, 3015 GD Rotterdam, The Netherlands
| | - Hildegunn Høberg-Vetti
- Western Norway Familial Cancer Center, Department of Medical Genetics, Haukeland University Hospital, 5021 Bergen, Norway
| | - Marianne Tveit Haavind
- Western Norway Familial Cancer Center, Department of Medical Genetics, Haukeland University Hospital, 5021 Bergen, Norway
| | - Kjersti Jørgensen
- Department of Medical Genetics, Oslo University Hospital, 0450 Oslo, Norway
| | - Lovise Mæhle
- Department of Medical Genetics, Oslo University Hospital, 0450 Oslo, Norway
| | - Ana Blatnik
- Department of Clinical Cancer Genetics, Institute of Oncology Ljubljana, 1000 Ljubljana, Slovenia
| | - Joan Brunet
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL-IDIBGI, 08916 Barcelona, Spain
| | - Esther Darder
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL-IDIBGI, 08916 Barcelona, Spain
| | - Emma Tham
- Department of Clinical Genetics, Karolinska University Hospital, 14186 Stockholm, Sweden
- Department of Molecular Medicine and Surgery, Karolinska Institute, 17177 Stockholm, Sweden
| | - Nicoline Hoogerbrugge
- Department of Human Genetics, Radboudumc Expert Center for PHTS, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
- Radboud Institute for Medical Innovation, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
| | - Janet R Vos
- Department of Human Genetics, Radboudumc Expert Center for PHTS, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
- Radboud Institute for Medical Innovation, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
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3
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Allahyari P, Ahmadzadeh M, Vahid F, Gholamalizadeh M, Shafaei H, Shekari S, Ardekanizadeh NH, Shafiee F, Majidi N, Akbari ME, Doaei S, Goodarzi MO. The association of dietary antioxidant index (DAI) with breast cancer among Iranian women. INT J VITAM NUTR RES 2023; 93:483-489. [PMID: 35240869 DOI: 10.1024/0300-9831/a000750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Recent studies have reported that dietary antioxidants can influence the risk of breast cancer (BC). Therefore, this study aimed to investigate the association of dietary antioxidant index (DAI) with BC among Iranian women. This case-control study was conducted on 180 women with breast cancer and 360 healthy women who were referred to the cancer clinic of Shohadaye Tajrish Hospital in Tehran, Iran. A 168-item validated food frequency questionnaire (FFQ) was used to assess dietary intake. The DAI score was calculated based on the intake of antioxidant vitamins and minerals derived from the FFQ. The control group had a significantly higher intake of vitamin D (1.79±1.56 vs. 1.05±0.84 μg/d; P=0.01) and lower intake of calorie (2315±1066 vs. 2737±925 kcal/d; P=0.01), carbohydrate (311±170 vs. 402±124 g/d; P=0.01), iron (15.4±12.1 vs. 19.7±6.4 mg/d; P=0.01), thiamine (1.5±0.7 vs. 2.3±0.9 mg/d; P=0.01), niacin (18.2±9.2 vs. 24.3±7.9 mg/d; P=0.01), folic acid (465±308.7 vs. 673±205.2 μg/d; P=0.01), and selenium (82.6±41.7 vs. 98.7±40.8 μg/d; P=0.01) compared to the case group. No significant association was found between DAI with breast cancer after adjustments for age. DAI had a negative association with breast cancer after additional adjustments for BMI, the number of pregnancies, duration of breastfeeding, menopause age, and total energy intake (OR: 0.91, 95% CI: 0.90-.93, and all P<0.001). The present study identified a negative association between DAI and the risk of BC, indicating the importance of antioxidants in preventing BC. Longitudinal studies should be conducted to confirm this association.
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Affiliation(s)
- Pooneh Allahyari
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, Islamic Azad University, Central Tehran Branch, Tehran, Iran
| | - Mina Ahmadzadeh
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farhad Vahid
- Population Health Department, Nutrition and Health Research Group, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Maryam Gholamalizadeh
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hanieh Shafaei
- Student Research Committee, Guilan University of Medical Sciences, Rasht, Iran
| | - Soheila Shekari
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Naeemeh Hasanpour Ardekanizadeh
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Shafiee
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nazanin Majidi
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | | | - Saeid Doaei
- Research Center of Health and Environment, School of Health, Guilan University of Medical Sciences, Rasht, Iran
| | - Mark O Goodarzi
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, USA
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Cho SJ, Tian Y. Celebrity Identification and Reasoned Action: An Integrative Model of the Relationship Between Media Use and Breast Cancer Screening Intention. HEALTH COMMUNICATION 2023:1-10. [PMID: 37733416 DOI: 10.1080/10410236.2023.2258308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
This study investigates the relationship between media use and breast cancer screening intentions by integrating the celebrity identification model and the theory of reasoned action. It tests an integrative model with survey data from 315 U.S. adult women. The study found that media use for breast cancer information was positively associated with parasocial interaction (PSI) and identification with celebrities who have or have had breast cancer; PSI was positively associated with attitudes, descriptive and injunctive norms in breast cancer screening, while identification with celebrities was positively associated with descriptive norms; attitudes, injunctive norms and descriptive norms were positively associated with breast cancer screening intentions. The study supports the mediating effect of PSI, identification, attitudes, and descriptive and injunctive norms on the association between media use and breast cancer prevention intentions.
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Affiliation(s)
- Suahn Jang Cho
- Department of Communication & Media, University of Missouri-St. Louis
| | - Yan Tian
- Department of Communication & Media, University of Missouri-St. Louis
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Uhelski ACR, Blackford AL, Sheng JY, Snyder C, Lehman J, Visvanathan K, Lim D, Stearns V, Smith KL. Factors associated with weight gain in pre- and post-menopausal women receiving adjuvant endocrine therapy for breast cancer. J Cancer Surviv 2023:10.1007/s11764-023-01408-y. [PMID: 37261654 DOI: 10.1007/s11764-023-01408-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 05/22/2023] [Indexed: 06/02/2023]
Abstract
PURPOSE Weight gain after breast cancer poses health risks. We aimed to identify factors associated with weight gain during adjuvant endocrine therapy (AET). METHODS Women initiating AET enrolled in a prospective cohort. Participants completed FACT-ES plus PROMIS pain interference, depression, anxiety, fatigue, sleep disturbance and physical function measures at baseline, 3, 6, 12, 24, 36, 48 and 60 months. Treatment-emergent symptoms were defined as changes in scores in the direction indicative of worsening symptoms that exceeded the minimal important difference at 3 and/or 6 months compared to baseline. We used logistic regression to evaluate associations of clinicodemographic features and treatment-emergent symptoms with clinically significant weight gain over 60 months (defined as ≥ 5% compared to baseline) in pre- and post-menopausal participants. RESULTS Of 309 participants, 99 (32%) were pre-menopausal. The 60 months cumulative incidence of clinically significant weight gain was greater in pre- than post-menopausal participants (67% vs 43%, p < 0.001). Among pre-menopausal participants, treatment-emergent pain interference (OR 2.49), aromatase inhibitor receipt (OR 2.8), mastectomy, (OR 2.06) and White race (OR 7.13) were associated with weight gain. Among post-menopausal participants, treatment-emergent endocrine symptoms (OR 2.86), higher stage (OR 2.25) and White race (OR 2.29) were associated with weight gain while treatment-emergent physical function decline (OR 0.30) was associated with lower likelihood of weight gain. CONCLUSIONS Weight gain during AET is common, especially for pre-menopausal women. Clinicodemographic features and early treatment-emergent symptoms may identify at risk individuals. IMPLICATIONS FOR CANCER SURVIVORS Patients at risk for weight gain can be identified early during AET. CLINICAL TRIALS GOV IDENTIFIER NCT01937052, registered September 3, 2013.
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Affiliation(s)
- Anna-Carson Rimer Uhelski
- Johns Hopkins Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Hematology/Oncology Fellowship Program, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Amanda L Blackford
- Division of Biostatistics and Bioinformatics, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, USA
| | - Jennifer Y Sheng
- Johns Hopkins Women's Malignancies Disease Group, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Claire Snyder
- Johns Hopkins Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jennifer Lehman
- Johns Hopkins Women's Malignancies Disease Group, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kala Visvanathan
- Johns Hopkins Women's Malignancies Disease Group, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Division of Cancer Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - David Lim
- Division of Biostatistics and Bioinformatics, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, USA
- Division of Statistics, Collaborative Inc., WCG, Washington, DC, USA
| | - Vered Stearns
- Johns Hopkins Women's Malignancies Disease Group, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins School of Medicine, Under Armour Breast Health Innovation Center, The Skip Viragh Outpatient Cancer, Building 201 North Broadway Viragh 10th floor, Room 10291, Baltimore, MD, 21287, USA.
| | - Karen Lisa Smith
- Johns Hopkins Women's Malignancies Disease Group, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- AstraZeneca, Gaithersburg, MD, USA
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6
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Christensen EW, Waid M, Scott J, Patel BK, Bello JA, Rula EY. Relationship between Race and Access to Newer Mammographic Technology in Women with Medicare Insurance. Radiology 2023; 306:e221153. [PMID: 36219114 DOI: 10.1148/radiol.221153] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Background Racial disparities in breast cancer mortality have been reported. Mammographic technology has undergone two major technology transitions since 2000: first, the transition from screen-film mammography (SFM) to full-field digital mammography (FFDM) and second, the transition to digital breast tomosynthesis (DBT). Purpose To examine the relationship between use of newer mammographic technology and race in women receiving mammography services. Materials and Methods This was a multiyear (January 2005 to December 2020) retrospective study of women aged 40-89 years with Medicare fee-for-service insurance who underwent mammography. Data were obtained using a 5% research identifiable sample of all Medicare fee-for-service beneficiaries. Within-institution and comparable-institution use of mammographic technology between Black women or women of other races and White women were assessed with multivariable logistic and linear regression, respectively, adjusted for age, race, Charlson comorbidity index, per capita income, urbanicity, and institutional capability. Results Between 2005 and 2020, there were 4 028 696 institutional mammography claims for women (mean age, 72 years ± 8 [SD]). Within an institution, the odds ratio (OR) of Black women receiving digital mammography rather than SFM in 2005 was 0.80 (95% CI: 0.70, 0.91; P < .001) when compared with White women; these differences remained until 2009. Compared with White women, the use of DBT within an institution was less likely for Black women from 2015 to 2020 (OR, 0.84; 95% CI: 0.81, 0.87; P < .001). Across institutions, there were racial differences in digital mammography use, which followed a U-shaped pattern, and the differences peaked at 3.8 percentage points less for Black compared with White women (95% CI: -6.1, -1.6; P = .001) in 2011 and then decreased to 1.2 percentage points less (95% CI: -2.2, -0.2; P = .02) in 2016. Conclusion In the Medicare population, Black women had less access to new mammographic imaging technology compared with White women for both the transition from screen-film mammography to digital mammography and then for the transition to digital breast tomosynthesis. © RSNA, 2022 Online supplemental material is available for this article. See also the editorial by Lee and Lawson in this issue.
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Affiliation(s)
- Eric W Christensen
- From the Neiman Health Policy Institute, 1891 Preston White Dr, Reston, VA 20191 (E.W.C., M.W., E.Y.R.); Health Services Management, University of Minnesota, St Paul, Minn (E.W.C.); Department of Radiology, SUNY Downstate Health Sciences University, Brooklyn, NY (J.S.); Department of Radiology, Mayo Clinic Arizona, Phoenix, Ariz (B.K.P.); and Department of Radiology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY (J.A.B.)
| | - Mikki Waid
- From the Neiman Health Policy Institute, 1891 Preston White Dr, Reston, VA 20191 (E.W.C., M.W., E.Y.R.); Health Services Management, University of Minnesota, St Paul, Minn (E.W.C.); Department of Radiology, SUNY Downstate Health Sciences University, Brooklyn, NY (J.S.); Department of Radiology, Mayo Clinic Arizona, Phoenix, Ariz (B.K.P.); and Department of Radiology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY (J.A.B.)
| | - Jinel Scott
- From the Neiman Health Policy Institute, 1891 Preston White Dr, Reston, VA 20191 (E.W.C., M.W., E.Y.R.); Health Services Management, University of Minnesota, St Paul, Minn (E.W.C.); Department of Radiology, SUNY Downstate Health Sciences University, Brooklyn, NY (J.S.); Department of Radiology, Mayo Clinic Arizona, Phoenix, Ariz (B.K.P.); and Department of Radiology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY (J.A.B.)
| | - Bhavika K Patel
- From the Neiman Health Policy Institute, 1891 Preston White Dr, Reston, VA 20191 (E.W.C., M.W., E.Y.R.); Health Services Management, University of Minnesota, St Paul, Minn (E.W.C.); Department of Radiology, SUNY Downstate Health Sciences University, Brooklyn, NY (J.S.); Department of Radiology, Mayo Clinic Arizona, Phoenix, Ariz (B.K.P.); and Department of Radiology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY (J.A.B.)
| | - Jacqueline A Bello
- From the Neiman Health Policy Institute, 1891 Preston White Dr, Reston, VA 20191 (E.W.C., M.W., E.Y.R.); Health Services Management, University of Minnesota, St Paul, Minn (E.W.C.); Department of Radiology, SUNY Downstate Health Sciences University, Brooklyn, NY (J.S.); Department of Radiology, Mayo Clinic Arizona, Phoenix, Ariz (B.K.P.); and Department of Radiology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY (J.A.B.)
| | - Elizabeth Y Rula
- From the Neiman Health Policy Institute, 1891 Preston White Dr, Reston, VA 20191 (E.W.C., M.W., E.Y.R.); Health Services Management, University of Minnesota, St Paul, Minn (E.W.C.); Department of Radiology, SUNY Downstate Health Sciences University, Brooklyn, NY (J.S.); Department of Radiology, Mayo Clinic Arizona, Phoenix, Ariz (B.K.P.); and Department of Radiology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY (J.A.B.)
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Elshami M, Usrof FD, Alser M, Al-Slaibi I, Okshiya HM, Ghithan RJ, Shurrab NRS, Ismail IO, Mahfouz II, Fannon AA, Qawasmi MAM, Hawa MRM, Giacaman N, Ahmaro M, Zaatreh RK, AbuKhalil WA, Melhim NK, Madbouh RJ, Abu Hziema HJ, Lahlooh RAA, Ubaiat SN, Jaffal NA, Alawna RK, Abed SN, Abuzahra BNA, Abu Kwaik AJ, Dodin MH, Taha RO, Alashqar DM, Mobarak RAAF, Smerat T, Abu-El-Noor N, Bottcher B. Awareness of Palestinian Women About Breast Cancer Risk Factors: A National Cross-Sectional Study. JCO Glob Oncol 2022; 8:e2200087. [PMID: 36508704 PMCID: PMC10166356 DOI: 10.1200/go.22.00087] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
PURPOSE This study aimed to assess awareness of Palestinian women about breast cancer (BC) age-related and lifetime risks and its risk factors and to identify factors associated with good awareness. MATERIALS AND METHODS Adult women were recruited from government hospitals, primary health care centers, and public spaces in 11 governorates in Palestine. Recognition of 14 BC risk factors was assessed using a translated-into-Arabic version of the validated BC awareness measure. The level of BC risk factor awareness was determined on the basis of the number of risk factors recognized: poor (0-4), fair (5-9), and good (10-14). RESULTS Of 6,269 potential participants approached, 5,434 agreed and completed the questionnaire (response rate = 86.7%). A total of 5,257 questionnaires were included: 2,706 from the West Bank and Jerusalem and 2,551 from the Gaza Strip. Only 173 participants (3.3%) recognized the age-related risk of BC. More than one quarter (n = 1,465; 27.9%) recognized the lifetime risk of BC. The most recognized modifiable risk factor was not breastfeeding (n = 4,937; 93.9%), whereas the least recognized was having children later on in life or not at all (n = 1,755; 33.4%). The most recognized nonmodifiable risk factor was radiation exposure (n = 4,579; 87.1%), whereas the least recognized was starting the periods at an early age (n = 1,030; 19.6%). In total, 2,024 participants (38.4%) demonstrated good BC risk factor awareness. Participants from the Gaza Strip had a higher likelihood than participants from the West Bank and Jerusalem to have good awareness (42.0% v 35.2%). Age ≥ 40 years, postsecondary education, and visiting hospitals and primary health care centers were all associated with an increase in the likelihood of having good BC risk factor awareness. CONCLUSION The awareness of BC risk factors was suboptimal. These findings highlight the need for implementing health education programs combined with consistent use of ad hoc opportunities to raise awareness by health care providers.
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Affiliation(s)
- Mohamedraed Elshami
- Division of Surgical Oncology, Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH.,Ministry of Health, Gaza, Palestine
| | - Faten Darwish Usrof
- Department of Medical Laboratory Sciences, Faculty of Health Sciences, Islamic University of Gaza, Gaza City, Palestine
| | | | | | | | | | | | | | | | | | | | | | | | - Manar Ahmaro
- Faculty of Medicine, Al-Quds University, Palestine
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Tasneem Smerat
- Faculty of Medicine and Health Sciences, Palestine Polytechnic University, Hebron, Palestine
| | | | - Bettina Bottcher
- Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine
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8
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Socha M, Sobiech KA. Eating Habits, Risk of Breast Cancer, and Diet-Dependent Quality of Life in Postmenopausal Women after Mastectomy. J Clin Med 2022; 11:jcm11154287. [PMID: 35893378 PMCID: PMC9331180 DOI: 10.3390/jcm11154287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 07/15/2022] [Accepted: 07/21/2022] [Indexed: 11/16/2022] Open
Abstract
The present study examined dietary risk factors for breast cancer, their association with quality of life, and changes in eating habits in postmenopausal women after mastectomy. The study included 210 women with histologically confirmed invasive breast cancer and 225 women without a cancer diagnosis. Questionnaire data on frequency of intake of 40 different foods, the Block Food Frequency Questionnaire, and SF-36 for evaluation of quality of life were used. All questionnaire data in the patient group were collected after diagnosis. Questions about eating habits covered two time points—before breast cancer diagnosis and after completion of treatment. Logistic regression was applied to calculate the odds ratios of breast cancer risk and 95% confidence intervals. A significant positive association was found between the risk of breast cancer and more frequent intake of red meat, smoked products, offal, animal fat, white bread, potatoes, and sweets, high intake of total fat, and low consumption of dietary fibre. Foods that were inversely associated with the risk of breast cancer included fish, vegetables, fruit, wholemeal bread, and groats. The relationship between quality of life and dietary habits according to the Block Eating Frequency Questionnaire was analysed using multiple regression. It was shown that high intake of total fat reduces the quality of life in its mental components. We observed a positive change in eating habits after cancer diagnosis, albeit not always to the level in the control group. As an important lifestyle component, the diet is of great significance for primary prevention of breast cancer as well as for improving the quality of life of breast cancer patients.
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9
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Long-term dietary intervention influence on physical activity in the Women's Health Initiative Dietary Modification randomized trial. Breast Cancer Res Treat 2022; 195:43-54. [PMID: 35821536 DOI: 10.1007/s10549-022-06655-8] [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: 11/08/2021] [Accepted: 06/08/2022] [Indexed: 11/02/2022]
Abstract
PURPOSE In the Women's Health Initiative (WHI) Dietary Modification (DM) randomized trial, dietary intervention significantly reduced breast cancer mortality (P = 0.02). In observational studies, physical activity is associated with lower breast cancer incidence. Currently, dietary intervention influence on other health-related behaviors is unknown. Therefore, we evaluated whether the WHI dietary intervention influenced self-directed physical activity. METHODS Of 48,835 postmenopausal women, 19,541 were randomized to dietary intervention (18 nutritionist-led group sessions first year, then quarterly sessions throughout 8.5 years [median] intervention) and 29,294 to a usual diet comparison (written health-related materials only). Neither randomization group received specific or ongoing instructions to increase physical activity. Episodes per week of moderate or vigorous recreational physical activity (MVPA) were serially reported. Marginal longitudinal logistic regression models were used to assess physically inactive (MVPA = 0) or physically active (MVPA > 0) participants by randomization group. Marginal Poisson regression models estimated mean weekly MVPA. RESULTS At entry, 45.6% of all participants reported physical inactivity (MVPA = 0). In 43,760 women with MVPA information, throughout 15.9 years (median) cumulative follow-up, dietary intervention group participation was associated with 7% lower physical inactivity rate (odds ratio [OR] 0.93, 95% confidence interval [CI] 0.91, 0.95, P < 0.001) and a 4% higher mean MVPA (ratio of means [RM] 1.04 95% CI 1.02, 1.06, P < 0.001), relative to the comparison group. CONCLUSION In a randomized trial setting, a low-fat dietary pattern intervention was associated with a long-term, favorable influence on self-directed recreational physical activity. TRIAL REGISTRATION NCT00000611.
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10
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Adherence to dietary patterns among cancer survivors in the United States. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-021-01579-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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11
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Accumulation of Arachidonic Acid, Precursor of Pro-Inflammatory Eicosanoids, in Adipose Tissue of Obese Women: Association with Breast Cancer Aggressiveness Indicators. Biomedicines 2022; 10:biomedicines10050995. [PMID: 35625732 PMCID: PMC9138452 DOI: 10.3390/biomedicines10050995] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/14/2022] [Accepted: 04/18/2022] [Indexed: 01/27/2023] Open
Abstract
While obesity is linked to cancer risk, no studies have explored the consequences of body mass index (BMI) on fatty acid profiles in breast adipose tissue and on breast tumor aggressiveness indicators. Because of this, 261 breast adipose tissue samples of women with invasive breast carcinoma were analyzed. Fatty acid profile was established by gas chromatography. For normal-weight women, major changes in fatty acid profile occurs after menopause, with the enrichment of long-chain polyunsaturated fatty acids (LC-PUFAs) of both n-6 and n-3 series enrichment, but a stable LC-PUFAs n-6/n-3 ratio across age. BMI impact was analyzed by age subgroups to overcome the age effect. BMI increase is associated with LC-PUFAs n-6 accumulation, including arachidonic acid. Positive correlations between BMI and several LC-PUFAs n-6 were observed, as well as a strong imbalance in the LC-PUFAs n-6/n-3 ratio. Regarding cancer, axillary lymph nodes (p = 0.02) and inflammatory breast cancer (p = 0.08) are more frequently involved in obese women. Increased BMI induces an LC-PUFAs n-6 accumulation, including arachidonic acid, in adipose tissue. This may participate in the development of low-grade inflammation in obese women and breast tumor progression. These results suggest the value of lifestyle and LC-PUFAs n-3 potential, in the context of obesity and breast cancer secondary/tertiary prevention.
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12
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Morey BN, Gee GC, Wang MC, von Ehrenstein OS, Shariff-Marco S, Canchola AJ, Yang J, Lee SSJ, Bautista R, Tseng W, Chang P, Gomez SL. Neighborhood Contexts and Breast Cancer Among Asian American Women. J Immigr Minor Health 2022; 24:445-454. [PMID: 33846877 PMCID: PMC8553603 DOI: 10.1007/s10903-021-01196-6] [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] [Accepted: 04/02/2021] [Indexed: 01/07/2023]
Abstract
BACKGROUND This study examines how neighborhood socioeconomic status (nSES) and ethnic composition are associated with breast cancer risk for Asian American women. METHODS We linked individual level data from a population-based case-control study of breast cancer among Asian American women with neighborhood level data in the Greater San Francisco Bay Area (cases: n = 118, controls: n = 390). Multivariable logistic regression models examined the association between nSES, ethnic composition, and odds of having breast cancer. RESULTS Asian American women living in neighborhoods with high nSES and high ethnic composition had the highest odds of breast cancer, compared to those living in neighborhoods with high nSES and low ethnic composition (OR = 0.34, 95% CI [0.16-0.75]) or in neighborhoods with low nSES and high ethnic composition (OR = 0.37, 95% CI [0.17-0.83]). DISCUSSION Neighborhood socioeconomic and ethnic contexts are associated with breast cancer for Asian American women. We discuss explanations and avenues for future research.
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Affiliation(s)
- Brittany N Morey
- Program of Public Health, Department of Health, Society, & Behavior, University of California Irvine, 653 E. Peltason Dr., Anteater Instruction and Research Building 2022, Irvine, CA, 92697-3957, USA.
| | - Gilbert C Gee
- Fielding School of Public Health, Department of Community Health Sciences, University of California Los Angeles, 650 Charles E. Young Dr. South, Los Angeles, CA, 90095, USA
| | - May C Wang
- Fielding School of Public Health, Department of Community Health Sciences, University of California Los Angeles, 650 Charles E. Young Dr. South, Los Angeles, CA, 90095, USA
| | - Ondine S von Ehrenstein
- Fielding School of Public Health, Department of Community Health Sciences, University of California Los Angeles, 650 Charles E. Young Dr. South, Los Angeles, CA, 90095, USA
- Fielding School of Public Health, Department of Epidemiology, University of California Los Angeles, 650 Charles E. Young Dr. South, Los Angeles, CA, 90095, USA
| | - Salma Shariff-Marco
- Helen Diller Family Comprehensive Cancer Center and Department of Epidemiology and Biostatistics, University of California San Francisco, 550 16th Street, San Francisco, CA, 94158, USA
| | - Alison J Canchola
- Helen Diller Family Comprehensive Cancer Center and Department of Epidemiology and Biostatistics, University of California San Francisco, 550 16th Street, San Francisco, CA, 94158, USA
| | - Juan Yang
- Helen Diller Family Comprehensive Cancer Center and Department of Epidemiology and Biostatistics, University of California San Francisco, 550 16th Street, San Francisco, CA, 94158, USA
| | - Sandra S-J Lee
- Division of Ethics, Department of Medical Humanities and Ethics, Columbia University, 630 West 168th Street, PH 1525, New York, NY, 10032, USA
| | | | - Winston Tseng
- School of Public Health Division of Community Health Sciences, University of California Berkeley, 2121 Berkeley Way, Berkeley, CA, 94720, USA
| | - Pancho Chang
- Council for the International Exchange of Scholars (CIES), Washington, DC, 20005, USA
| | - Scarlett Lin Gomez
- Helen Diller Family Comprehensive Cancer Center and Department of Epidemiology and Biostatistics, University of California San Francisco, 550 16th Street, San Francisco, CA, 94158, USA
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13
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Liu XY, Zhang X, Zhang Q, Xie HL, Ruan GT, Liu T, Song MM, Ge YZ, Xu HX, Song CH, Shi HP. The value of the controlling nutritional status score in predicting the prognosis of patients with lung cancer: A multicenter, retrospective study. JPEN J Parenter Enteral Nutr 2021; 46:1343-1352. [PMID: 34961947 DOI: 10.1002/jpen.2321] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND The body's immune-nutritional status affects prognosis in patients with lung cancer. The Controlling Nutritional Status (CONUT) score is an immune-nutrition-related index associated with prognosis in other tumors. We aimed to assess the value of CONUT in predicting prognosis in patients with lung cancer. METHODS In this retrospective multicenter study, 1,339 patients with lung cancer were divided into low- and high-CONUT score groups. The relationship between CONUT scores and overall survival (OS) was assessed by survival curves and Cox's proportional hazards regression modelling. A nomogram including CONUT and other clinical variables was established. RESULTS There were 659 (49.2%; mean age 59.91 years) low- and 680 (50.8%; mean age 62.23 years) high-CONUT score patients. OS was significantly worse in patients with high than in those with low CONUT scores (P < 0.001), even after stratification by pathological types (non-small-cell lung cancer and small-cell lung cancer) and Tumor-Node-Metastasis (TNM) stages. A high CONUT score independently predicted risk in patients with lung cancer (adjusted hazard ratio: 1.48, 95% confidence interval: 1.26-1.73; P < 0.001). The CONUT-based nomogram could predict prognosis well (C-index: 0.701), with better resolution and accuracy than TNM staging for predicting OS at 1, 2, and 3 years (Area under the ROC curve: 0.735 vs. 0.678; 0.742 vs. 0.696; and 0.768 vs. 0.743). CONCLUSION The CONUT score can predict prognosis in patients with lung cancer. A CONUT-based nomogram can improve the accuracy of survival prediction in such patients. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Xiao-Yue Liu
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
| | - Xi Zhang
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China.,Department of Radiotherapy, Affiliated Hospital of Hebei University, Baoding, 071000, China
| | - Qi Zhang
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
| | - Hai-Lun Xie
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
| | - Guo-Tian Ruan
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
| | - Tong Liu
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
| | - Meng-Meng Song
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
| | - Yi-Zhong Ge
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
| | - Hong-Xia Xu
- Department of Clinical Nutrition, Daping Hospital, Army Medical University, Chongqing, 400042, China
| | - Chun-Hua Song
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, China
| | - Han-Ping Shi
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China.,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China.,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China
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14
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Lynch KA, Merdjanoff A, Wilson D, Chiarello L, Hay J, Mao JJ. "Moving Forward": Older Adult Motivations for Group-Based Physical Activity After Cancer Treatment. Int J Behav Med 2021; 29:286-298. [PMID: 34585330 PMCID: PMC8478005 DOI: 10.1007/s12529-021-10018-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2021] [Indexed: 11/04/2022]
Abstract
Background Engagement in physical activity (PA) post-treatment can improve health outcomes and quality of life among cancer survivors. The purpose of this study is to explore United States (US) older adult cancer survivors’ (OACS) reasons for engaging in group-based PA classes, to identify themes supporting exercise motivations in the context of cancer recovery. Methods OACS participating in a fitness program at a large US comprehensive cancer center completed semi-structured interviews. Transcripts were analyzed using modified grounded theory, and demographic data were analyzed descriptively. Results Modified grounded theory analysis (n = 25; age M = 70.92, SD = 10.82; 9 cancer types) identified individual rationales for exercise grounded in collective experience. Participants’ internal motivations for PA are shaped by the desire for control over an uncertain future and post-treatment body, obtained by literally “moving forward” post-cancer; this is supported by external motivations for social connections that present a positive model of survivorship, within a setting that instills confidence and safety. Conclusions Exercise can be a way for older adults to tap into internal and external motivations that support cancer survivorship. Interventions that make explicit connections between exercise and cancer recovery, facilitate interpersonal interaction, and promote a sense of safety may be the most effective. The concepts identified in this study can inform the development of future interventions to improve long-term behavior change among OACS and evaluate existing PA programs.
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Affiliation(s)
- Kathleen A Lynch
- Department of Psychiatry and Behavioral Science, Memorial Sloan Kettering Cancer Center, 641 Lexington Avenue, 7th Floor, New York, NY, 10022, USA. .,Department of Social and Behavioral Sciences, School of Global Public Health, New York University, 715 Broadway, New York, NY, 10003, USA.
| | - Alexis Merdjanoff
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, 715 Broadway, New York, NY, 10003, USA
| | - Donna Wilson
- Department of Integrative Medicine, Memorial Sloan Kettering Cancer Center, 1429 1st Avenue, New York, NY, 10021, USA
| | - Lauren Chiarello
- Department of Integrative Medicine, Memorial Sloan Kettering Cancer Center, 1429 1st Avenue, New York, NY, 10021, USA
| | - Jennifer Hay
- Department of Psychiatry and Behavioral Science, Memorial Sloan Kettering Cancer Center, 641 Lexington Avenue, 7th Floor, New York, NY, 10022, USA
| | - Jun J Mao
- Department of Integrative Medicine, Memorial Sloan Kettering Cancer Center, 1429 1st Avenue, New York, NY, 10021, USA
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15
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Xu L, Zhou C, Ling Y, Ding H, Wang Q, Wu Y, Qian Y, He B, Ni T. Effects of Short-Term Unsupervised Exercise, Based on Smart Bracelet Monitoring, on Body Composition in Patients Recovering from Breast Cancer. Integr Cancer Ther 2021; 20:15347354211040780. [PMID: 34467791 PMCID: PMC8414611 DOI: 10.1177/15347354211040780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE We aimed to investigate the effects of exercise, monitored and managed using smart bracelets, on body composition, and quality of life in breast cancer survivors. METHODS A before-and-after study was conducted in 109 patients who were in the recovery phase of breast cancer and attended the Breast Surgery Department of the Cancer Hospital of Fudan University up to December 2017. Patients were advised to adhere to at least 150 minutes of moderate-intensity exercise per week, and a smart bracelet was issued to each participant to record their daily exercise data for 3 months. Bioelectrical impedance analysis was used to observe the effects of short-term unsupervised exercise intervention on body composition in patients recovering from breast cancer. Patients completed the Functional Assessment of Cancer Therapy-Breast to assess health-related quality of life. RESULTS Weight, body mass index (BMI), body fat mass (BFM), fat mass index (FMI), percent body fat (PBF), arm circumference (AC), arm muscle circumference (AMC), and visceral fat area (VFA) were lower than baseline after exercising for 3 months based on data from the wearable devices (P < .05). The only significant improvement was found in the "additional concerns about breast cancer" category among the quality-of-life assessments (P < .05). The average walking time was negatively associated with BFM, PBF, and FMI, while the average calorie consumption due to running was positively associated with fat free mass (FFM). CONCLUSION In this study, we demonstrated that short-term exercise may be beneficial for postoperative breast cancer survivors. A wearable device could help patients track physical data easily and promote a healthier and more positive life.
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Affiliation(s)
- Liuqing Xu
- Department of Nutrition, Fudan University Shanghai Cancer Center, People's Republic of China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Changming Zhou
- Department of Cancer Prevention, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Yiqun Ling
- Department of Nutrition, Fudan University Shanghai Cancer Center, People's Republic of China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Huiping Ding
- Department of Nutrition, Fudan University Shanghai Cancer Center, People's Republic of China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Qiong Wang
- Department of Nutrition, Fudan University Shanghai Cancer Center, People's Republic of China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Yan Wu
- Department of Nutrition, Fudan University Shanghai Cancer Center, People's Republic of China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Yong Qian
- Department of Nutrition, Fudan University Shanghai Cancer Center, People's Republic of China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Bingqing He
- Department of Nutrition, Fudan University Shanghai Cancer Center, People's Republic of China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Tianhao Ni
- Department of Nutrition, Fudan University Shanghai Cancer Center, People's Republic of China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
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Schmidt DR, Patel R, Kirsch DG, Lewis CA, Vander Heiden MG, Locasale JW. Metabolomics in cancer research and emerging applications in clinical oncology. CA Cancer J Clin 2021; 71:333-358. [PMID: 33982817 PMCID: PMC8298088 DOI: 10.3322/caac.21670] [Citation(s) in RCA: 275] [Impact Index Per Article: 91.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 03/07/2021] [Accepted: 03/09/2021] [Indexed: 12/12/2022] Open
Abstract
Cancer has myriad effects on metabolism that include both rewiring of intracellular metabolism to enable cancer cells to proliferate inappropriately and adapt to the tumor microenvironment, and changes in normal tissue metabolism. With the recognition that fluorodeoxyglucose-positron emission tomography imaging is an important tool for the management of many cancers, other metabolites in biological samples have been in the spotlight for cancer diagnosis, monitoring, and therapy. Metabolomics is the global analysis of small molecule metabolites that like other -omics technologies can provide critical information about the cancer state that are otherwise not apparent. Here, the authors review how cancer and cancer therapies interact with metabolism at the cellular and systemic levels. An overview of metabolomics is provided with a focus on currently available technologies and how they have been applied in the clinical and translational research setting. The authors also discuss how metabolomics could be further leveraged in the future to improve the management of patients with cancer.
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Affiliation(s)
- Daniel R. Schmidt
- Koch Institute, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
- Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
- Corresponding author:-
| | - Rutulkumar Patel
- Department of Radiation Oncology, Duke University School of Medicine, Durham, NC 27708 USA
| | - David G. Kirsch
- Department of Radiation Oncology, Duke University School of Medicine, Durham, NC 27708 USA
- Department of Pharmacology and Cancer Biology, Duke University, Durham, NC 27708 USA
| | - Caroline A. Lewis
- Whitehead Institute for Biomedical Research, Cambridge, MA 02142, USA
| | - Matthew G. Vander Heiden
- Koch Institute, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - Jason W. Locasale
- Department of Pharmacology and Cancer Biology, Duke University, Durham, NC 27708 USA
- Corresponding author:-
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17
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Osei-Afriyie S, Addae AK, Oppong S, Amu H, Ampofo E, Osei E. Breast cancer awareness, risk factors and screening practices among future health professionals in Ghana: A cross-sectional study. PLoS One 2021; 16:e0253373. [PMID: 34166407 PMCID: PMC8224936 DOI: 10.1371/journal.pone.0253373] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Accepted: 06/04/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Like many other women in the developing world, the practice of breast cancer screening among Ghanaian women is unsatisfactory. As a result, many cases are diagnosed at advanced stages leading to poor outcomes including mortalities. An understanding of the awareness and predictors of breast examination is an important first step that may guide the design of interventions aimed at raising awareness across the general population. This study aimed to explore the awareness, risk factors, and self-reported screening practices of breast cancer among female undergraduate students at the University of Health and Allied Sciences. METHODS This cross-sectional study was conducted among 385 female undergraduate students using a pre-tested questionnaire. Data were analysed using Stata Version 13.1 and presented using descriptive and inferential statistics comprising frequency, percentage, chi-square, and binary logistic regression. Odds ratios and 95% confidence intervals were computed to quantify the association between regular Breast-Self Examination (BSE) and socio-demographic characteristics of respondents. RESULTS Seventy-three per cent of the students were aware of breast cancer, with social media being the most important source of information (64.4%). The prevalence of breast cancer risk factors varied from 1% of having a personal history of breast cancer to 14.3% for positive family history of breast cancer. Current use of oral pills/injectable contraceptives was confirmed by 13.2% of participants; 20% were current alcohol users and10.1% were physically inactive. Regarding breast examination, 42.6% performed BSE; 10.1% had Clinical Breast Examination (CBE), while 2.3% had undergone mammography in the three years preceding the study. Women who did not believe to be susceptible to breast cancer (AOR: 0.04; 95%CI: 0.02-0.09) and those who did not know their risk status (AOR: 0.02; 95%CI: 0.005-0.57) were less likely to perform regular BSE compared to those who displayed pessimism. Further, women with no religious affiliation had 0.11 (95%CI: 0.02-0.55) odds of examining their breast regularly compared to Christians. CONCLUSION This study demonstrated moderate awareness of the modalities of breast cancer screening and the risk factors of breast cancer among the students. However, there exists a gap between awareness and practice of breast cancer screening, which was influenced by optimism in breast cancer risk perception and religion. Awareness campaigns and education should be intensified in the University to bridge this gap.
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Affiliation(s)
- Sandra Osei-Afriyie
- Department of Physician Assistantship, School of Medicine, University of Health and Allied Sciences, Ho, Ghana
| | - Albert Kwesi Addae
- Department of Psychological Medicine and Mental Health, School of Medicine, University of Health and Allied Sciences, Ho, Ghana
| | - Samuel Oppong
- Department of Epidemiology and Biostatistics, School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| | - Hubert Amu
- Department of Population and Behavioural Sciences, School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| | - Emmanuel Ampofo
- Directorate of Human Resource, University of Cape Coast, Cape Coast, Ghana
| | - Eric Osei
- Department of Population and Behavioural Sciences, School of Public Health, University of Health and Allied Sciences, Ho, Ghana
- Department of Public Health Graduate School, Yonsei University, Seoul, Republic of Korea
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18
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Total long-chain polyunsaturated n-3 fatty acids level is an independent predictive factor of breast cancer multifocality in women with positive hormone-receptors tumors. Surg Oncol 2021; 38:101597. [PMID: 34051659 DOI: 10.1016/j.suronc.2021.101597] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 04/25/2021] [Accepted: 04/26/2021] [Indexed: 01/16/2023]
Abstract
In a previous pilot study, we showed that polyunsaturated n-3 fatty acids of breast adipose tissues were associated with breast cancer multifocality. In the present study, we investigated biochemical, clinical and histological factors associated with breast cancer focality in a large cohort of women with positive hormone-receptors tumors. One hundred sixty-one consecutive women presenting with positive hormone-receptors breast cancer underwent breast-imaging procedures including a Magnetic Resonance Imaging prior to treatment. Breast adipose tissue specimens were collected during surgery of tumors. A biochemical profile of breast adipose tissue fatty acids was established by gas chromatography. Clinicopathologic characteristics were correlated with multifocality. We assessed whether these factors were predictive of breast cancer focality. We found that tumor size (OR = 1.06 95%CI [1.02-1.09], p < 0.001) and decreased levels in breast adipose tissue of long-chain polyunsaturated n-3 fatty acids (OR = 0.11 95%CI [0.01-0.98], p = 0.03), were independent predictive factors of multifocality. Low levels of long chain polyunsaturated n-3 fatty acids in breast adipose tissue appear to contribute to breast cancer multifocality. The present results reinforce the link between dietary habits and breast cancer clinical presentation.
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Choi IY, Chun S, Shin DW, Han K, Jeon KH, Yu J, Chae BJ, Suh M, Park YM. Changes in Metabolic Syndrome Status and Breast Cancer Risk: A Nationwide Cohort Study. Cancers (Basel) 2021; 13:cancers13051177. [PMID: 33803268 PMCID: PMC7967214 DOI: 10.3390/cancers13051177] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 02/11/2021] [Accepted: 03/08/2021] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE To our knowledge, no studies have yet looked at how the risk of developing breast cancer (BC) varies with changes in metabolic syndrome (MetS) status. This study aimed to investigate the association between changes in MetS and subsequent BC occurrence. RESEARCH DESIGN AND METHODS We enrolled 930,055 postmenopausal women aged 40-74 years who participated in a biennial National Health Screening Program in 2009-2010 and 2011-2012. Participants were categorized into four groups according to change in MetS status during the two-year interval screening: sustained non-MetS, transition to MetS, transition to non-MetS, and sustained MetS. We calculated multivariable-adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for BC incidence using the Cox proportional hazards models. RESULTS At baseline, MetS was associated with a significantly increased risk of BC (aHR 1.11, 95% CI 1.06-1.17) and so were all of its components. The risk of BC increased as the number of the components increased (aHR 1.46, 95% CI 1.26-1.61 for women with all five components). Compared to the sustained non-MetS group, the aHR (95% CI) for BC was 1.11 (1.04-1.19) in the transition to MetS group, 1.05 (0.96-1.14) in the transition to non-MetS group, and 1.18 (1.12-1.25) in the sustained MetS group. CONCLUSIONS Significantly increased BC risk was observed in the sustained MetS and transition to MetS groups. These findings are clinically meaningful in that efforts to recover from MetS may lead to reduced risk of BC.
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Affiliation(s)
- In Young Choi
- Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 04514, Korea;
| | - Sohyun Chun
- Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea;
- International Healthcare Center, Samsung Medical Center, Seoul 06351, Korea
- Correspondence: (S.C.); (D.W.S.); Tel.: +82-2-3410-0449 (S.C.); +82-2-3410-5252 (D.W.S.); Fax: +82-2-3410-0231 (S.C.); +82-2-3410-0388 (D.W.S.)
| | - Dong Wook Shin
- Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea;
- Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Science & Technology (SAIHST), Sungkyunkwan University, Seoul 06355, Korea
- Department of Digital Health, Samsung Advanced Institute for Health Science & Technology (SAIHST), Sungkyunkwan University, Seoul 06355, Korea
- Correspondence: (S.C.); (D.W.S.); Tel.: +82-2-3410-0449 (S.C.); +82-2-3410-5252 (D.W.S.); Fax: +82-2-3410-0231 (S.C.); +82-2-3410-0388 (D.W.S.)
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul 06978, Korea;
| | - Keun Hye Jeon
- Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea;
| | - Jonghan Yu
- Division of Breast and Endocrine Surgery, Department of General Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea;
| | - Byung Joo Chae
- National Cancer Control Institute, National Cancer Center, Goyang 10408, Korea; (B.J.C.); (M.S.)
| | - Mina Suh
- National Cancer Control Institute, National Cancer Center, Goyang 10408, Korea; (B.J.C.); (M.S.)
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang 10408, Korea
| | - Yong-Moon Park
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA;
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Xu H, Jiang G, Zhang X, Wang D, Xu L, Wang A. Development of health behaviour questionnaire for breast cancer women in Mainland China. Nurs Open 2020; 8:1209-1219. [PMID: 33369265 PMCID: PMC8046107 DOI: 10.1002/nop2.737] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 10/21/2020] [Accepted: 11/13/2020] [Indexed: 12/27/2022] Open
Abstract
Aim To develop a questionnaire on the health behaviour of breast cancer women with adjuvant endocrine therapy and to test its reliability and validity. Design An instrument‐development study was applied that comprised three steps: conceptualization, item generation, content validity and field testing of the health behavior properties. Methods On the basis of literature review, the conceptual framework and initial items of each dimension of were designed. The questionnaire investigation was divided into two steps: pre‐experiment (group 1) and psychometrics evaluation (group 2). Correlation procedure and factor analysis were employed to rescreen the items. Reliability testing and validity testing were conducted to analyse the psychometric properties of questionnaire. Results Exploratory and confirmatory factor analyses yielded a five‐factor solution. Cronbach's α was 0.93, the sub‐semi‐reliability of the questionnaire was 0.79 and internal consistency coefficients was 0.70.
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Affiliation(s)
- Hui Xu
- Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Insititute, Shenyang, China.,The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Guichun Jiang
- Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Insititute, Shenyang, China
| | - Xiujie Zhang
- The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Daqiu Wang
- Liaoning University of Traditional Chinese Medicine, Shenyang, China
| | - Lei Xu
- The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Aiping Wang
- The First Affiliated Hospital of China Medical University, Shenyang, China
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21
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Rossen S, Kayser L, Vibe-Petersen J, Christensen JF, Ried-Larsen M. Cancer Survivors' Receptiveness to Digital Technology-Supported Physical Rehabilitation and the Implications for Design: Qualitative Study. J Med Internet Res 2020; 22:e15335. [PMID: 32755892 PMCID: PMC7439140 DOI: 10.2196/15335] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 03/06/2020] [Accepted: 06/03/2020] [Indexed: 01/19/2023] Open
Abstract
Background Physical activity is associated with a positive prognosis in cancer survivors and may decrease the risk of adverse effects of treatment. Accordingly, physical activity programs are recommended as a part of cancer rehabilitation services. Digital technology may support cancer survivors in increasing their level of physical activity and increase the reach or efficiency of cancer rehabilitation services, yet it also comes with a range of challenges. Objective The aim of this qualitative study was to explore cancer survivors’ receptiveness to using digital technology as a mode of support to increase their physical activity in a municipality-based cancer rehabilitation setting. Methods Semistructured interviews were conducted with 11 cancer survivors (3 males, 8 females, age range 32-82 years) who were referred for cancer rehabilitation and had participated in a questionnaire survey using the Readiness and Enablement Index for Health Technology (READHY) questionnaire. Data analysis was based on the content analysis method. Results Two themes were identified as important for the interviewees’ receptiveness to using digital technology services in connection with their physical activity during rehabilitation: their attitude toward physical activity and their attitude toward digital technology–assisted physical activity. Our results indicated that it is important to address the cancer survivors’ motivation for using technology for physical activity and their individual preferences in terms of the following: (1) incidental or structured (eg, cardiovascular and strength exercises or disease-specific rehabilitative exercises) physical activity; (2) social or individual context; and (3) instruction (know-how) or information (know-why). Conclusions The identified preferences provide new insight that complements the cancer survivors’ readiness level and can likely help designers, service providers, and caregivers provide solutions that increase patient receptiveness toward technology-assisted physical activity. Combining digital technology informed by cancer survivors’ needs, preferences, and readiness with the capacity building of the workforce can aid in tailoring digital solutions to suit not only individuals who are receptive to using such technologies but also those reluctant to do so.
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Affiliation(s)
- Sine Rossen
- Centre for Physical Activity Research, Rigshospitalet, Copenhagen, Denmark.,Copenhagen Centre for Cancer and Health, Municipality of Copenhagen, Copenhagen, Denmark
| | - Lars Kayser
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Jette Vibe-Petersen
- Copenhagen Centre for Cancer and Health, Municipality of Copenhagen, Copenhagen, Denmark
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22
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Rennert G, Rennert HS, Gronich N, Pinchev M, Gruber SB. Use of metformin and risk of breast and colorectal cancer. Diabetes Res Clin Pract 2020; 165:108232. [PMID: 32446797 DOI: 10.1016/j.diabres.2020.108232] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 04/15/2020] [Accepted: 05/18/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Diabetes has been associated with increased risk of cancer, including breast cancer and colorectal cancer. Metformin, an oral hypoglycemic drug, but not other anti-diabetic drugs, has been associated with reduced risk of breast and of colon cancers in some, but not in other, studies. METHODS Data from two large-scale, population-based, case-control studies of breast and colorectal cancers etiology, conducted in Northern Israel since 1998 were analyzed to evaluate the association between regular use (>3 times) of metformin prior to diagnosis and risk of developing cancer. The multivariate analyses for both cancer sites included age, family history of breast/colorectal cancer, history of diabetes, sports participation, fruits/vegetables consumption, aspirin and statins use, and for breast cancer, also included use of oral contraceptives and postmenopausal hormones and number of pregnancies. Use of metformin and diabetes status were determined based on valid electronic medical records of the participants. RESULTS Metformin use prior to diagnosis of cancer was associated with a decrease in risk of both breast cancer (OR = 0.821, 0.726-0.928, p = 0.002) and colorectal cancer (OR = 0.754, 0.623-0.912, p = 0.004). An inverse association was not identified with use of other anti-diabetic medications. Diabetes was found to be associated with risk of colorectal cancer (OR = 1.204, 1.014-1.431, p = 0.034) but not of breast cancer. No dose response by years of use of metformin was found. CONCLUSION These analyses of large population-based studies provide evidence of a strong inverse association of metformin with breast and, even more so, with colorectal cancer risk.
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Affiliation(s)
- Gad Rennert
- Department of Community Medicine and Epidemiology, Carmel Medical Center and B. Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel; Clalit Health Services National Cancer Control Center (NICCC), Haifa, Israel.
| | - Hedy S Rennert
- Department of Community Medicine and Epidemiology, Carmel Medical Center and B. Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Naomi Gronich
- Department of Community Medicine and Epidemiology, Carmel Medical Center and B. Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Mila Pinchev
- Department of Community Medicine and Epidemiology, Carmel Medical Center and B. Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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Effectiveness of a Global Multidisciplinary Supportive and Educational Intervention in Thermal Resort on Anthropometric and Biological Parameters, and the Disease-Free Survival after Breast Cancer Treatment Completion (PACThe). JOURNAL OF ONCOLOGY 2020; 2020:4181850. [PMID: 32454823 PMCID: PMC7222596 DOI: 10.1155/2020/4181850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 11/06/2019] [Accepted: 02/07/2020] [Indexed: 11/18/2022]
Abstract
A growing knowledge highlights the strong benefit of regular physical activity in the management of breast cancer patients, but few studies have considered biological parameters in their outcomes. In the prospective randomised trial after breast cancer treatment completion “PACThe,” we determined the effects of physical activity and nutritional intervention on the biological and anthropometric status of patients after one year of follow-up, and clarified the link between biomarkers at allocation and disease-free survival. 113 patients from the population of the “PACThe” study (n = 251) were analysed for biological parameters. Patients were randomized after chemotherapy in two arms: the intervention “SPA” receiving a 2-week session of physical training, dietary education, and physiotherapy (n = 57), and the control “CTR” (n = 56). Diet questionnaire, anthropometric measures, and blood parameters were determined at allocation and one year later. Survival and recurrence were checked over 7 years. Data were considered as a function of BMI, i.e., ≤25 for normal, 25–30 for overweight, and >30 for obese patients. At allocation, the large standard deviation for nutrient-intake values reflected an unbalanced diet for some patients in the three groups. At one-year follow-up, we noticed an increase in glucose (p < 10−6), insulin (p < 10−7), and adiponectin (p < 0.022) plasma levels for both intervention arms, which were more accentuated for the >30 groups. Using the Cox model, we demonstrated that the highest testosterone plasma values were linked to an increase of the recurrence risk (HR [CI–95%] = 5.06 [1.66–15.41]; p=0.004). One-year after a global multidisciplinary supportive and educational intervention, we found few anthropometric and biological changes, mainly related to the patient's initial BMI. We highlighted the importance of plasma testosterone in the evaluation of patient's recurrence risk. Future studies would help better understand the mechanisms by which such multidisciplinary interventions could interact with breast cancer recurrence and define the most effective modalities.
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24
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Zhou W, Chen X, Huang H, Liu S, Xie A, Lan L. Birth Weight and Incidence of Breast Cancer: Dose-Response Meta-analysis of Prospective Studies. Clin Breast Cancer 2020; 20:e555-e568. [PMID: 32665189 DOI: 10.1016/j.clbc.2020.04.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 04/13/2020] [Accepted: 04/23/2020] [Indexed: 01/22/2023]
Abstract
BACKGROUND Many studies have shown the association between birth weight and breast cancer (BC), but the evidence remains limited and inconsistent, especially in different menopause status. We sought to clarify the relationship and shape of the dose-response relation between birth weight and BC. METHODS The Web of Science, PubMed, and Embase databases were searched for prospective studies involving the relationship between birth weight and risk of BC published to November 2019. Random effects of generalized least squares regression models were used to estimate the quantitative dose-response association, and restricted cubic splines were used to model the association. RESULTS We included reports of 16 prospective studies describing 16,000 incident cases among 553,644 participants. We identified a modest-in-magnitude, but significant, association between birth weight and BC risk: risk increased by 2% (risk ratio, 1.02, 95% confidence interval, 1.01-1.03) and 9% (risk ratio, 1.09, 95% confidence interval, 1.04-1.15) with a per-500 g birth weight increment in all ages and premenopausal women, respectively. Our results showed a linear dose-response relationship between birth weight and BC risk (Pnonlinearity = .311) in premenopausal women, with statistical significance when birth weight was above about 3.5 kg. No significant association was found in postmenopausal women. CONCLUSION Higher birth weight has a relationship with increased risk of BC in premenopausal women, particularly when birth weight is above 3.5 kg.
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Affiliation(s)
- Wen Zhou
- Department of Health Management Center, Guangzhou Hospital of Integrated Traditional and West Medicine, Guangzhou, China
| | - Xu Chen
- Department of Health Services Section, The Eighth Affiliated Hospital Sun Yat-sen university, Shenzhen, China
| | - Hui Huang
- Department of Health Management Center, Guangzhou Hospital of Integrated Traditional and West Medicine, Guangzhou, China
| | - Shaoxia Liu
- Department of Health Management Center, Guangzhou Hospital of Integrated Traditional and West Medicine, Guangzhou, China
| | - Aixian Xie
- Department of Health Management Center, Guangzhou Hospital of Integrated Traditional and West Medicine, Guangzhou, China
| | - Liqin Lan
- Department of Health Management Center, Guangzhou Hospital of Integrated Traditional and West Medicine, Guangzhou, China.
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25
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Chlebowski RT, Aragaki AK, Anderson GL, Pan K, Neuhouser ML, Manson JE, Thomson CA, Mossavar-Rahmani Y, Lane DS, Johnson KC, Wactawski-Wende J, Snetselaar L, Rohan TE, Luo J, Barac A, Prentice RL. Dietary Modification and Breast Cancer Mortality: Long-Term Follow-Up of the Women's Health Initiative Randomized Trial. J Clin Oncol 2020; 38:1419-1428. [PMID: 32031879 PMCID: PMC7193750 DOI: 10.1200/jco.19.00435] [Citation(s) in RCA: 81] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2019] [Indexed: 01/13/2023] Open
Abstract
PURPOSE Observational studies of dietary fat intake and breast cancer have reported inconsistent findings. This topic was addressed in additional analyses of the Women's Health Initiative (WHI) Dietary Modification (DM) clinical trial that evaluated a low-fat dietary pattern influence on breast cancer incidence. METHODS In the WHI DM trial, 48,835 postmenopausal women, ages 50-79 years, with no prior breast cancer, and a dietary fat intake of ≥ 32% of energy were randomly assigned at 40 US centers to a usual diet comparison group (60%) or dietary intervention group (40%). The goals were to reduce fat intake to 20% of energy and increase vegetable, fruit, and grain intake. Breast cancers were confirmed after central medical record review and serial National Death Index linkages to enhance mortality findings. RESULTS During 8.5 years of dietary intervention, breast cancer incidence and deaths as a result of breast cancer were nonsignificantly lower in the intervention group, while deaths after breast cancer were statistically significantly lower both during intervention and through a 16.1-year (median) follow-up. Now, after a long-term, cumulative 19.6-year (median) follow-up, the significant reduction in deaths after breast cancer persists (359 [0.12%] v 652 [0.14%] deaths; hazard ratio [HR], 0.85; 95% CI, 0.74 to 0.96; P = .01), and a statistically significant reduction in deaths as a result of breast cancer (breast cancer followed by death attributed to the breast cancer) emerged (132 [0.037%, annualized risk] v 251 [0.047%] deaths, respectively; HR, 0.79; 95% CI, 0.64 to 0.97; P = .02). CONCLUSION Adoption of a low-fat dietary pattern associated with increased vegetable, fruit, and grain intake, demonstrably achievable by many, may reduce the risk of death as a result of breast cancer in postmenopausal women.
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Affiliation(s)
- Rowan T. Chlebowski
- Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA
| | - Aaron K. Aragaki
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Garnet L. Anderson
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Kathy Pan
- Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA
| | - Marian L. Neuhouser
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - JoAnn E. Manson
- Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | | | - Yasmin Mossavar-Rahmani
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Dorothy S. Lane
- Department of Family, Population and Preventive Medicine, Stony Brook University School of Medicine, Stony Brook, NY
| | - Karen C. Johnson
- Departments of Preventive Medicine and Medicine, University of Tennessee, Memphis, TN
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY
| | | | - Thomas E. Rohan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Juhua Luo
- Department of Epidemiology and Biostatistics, Indiana University, Bloomington, IN
| | - Ana Barac
- MedStar Heart and Vascular Institute, Georgetown University, Washington, DC
| | - Ross L. Prentice
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - on behalf of the Women’s Health Initiative
- Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
- Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
- Department of Family, Population and Preventive Medicine, Stony Brook University School of Medicine, Stony Brook, NY
- Departments of Preventive Medicine and Medicine, University of Tennessee, Memphis, TN
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY
- Department of Epidemiology and Biostatistics, Indiana University, Bloomington, IN
- College of Public Health, University of Iowa, Iowa City, IA
- MedStar Heart and Vascular Institute, Georgetown University, Washington, DC
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26
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Caparica R, Richard F, Brandão M, Awada A, Sotiriou C, de Azambuja E. Prognostic and Predictive Impact of Beta-2 Adrenergic Receptor Expression in HER2-Positive Breast Cancer. Clin Breast Cancer 2020; 20:262-273.e7. [PMID: 32229175 DOI: 10.1016/j.clbc.2020.01.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 01/07/2020] [Accepted: 01/16/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND Beta-2 adrenergic receptor (ADRB2) mediates proliferation and treatment resistance in preclinical models of human epidermal growth factor receptor 2 positive (HER2+) breast cancer. We evaluated ADRB2 gene expression as a prognostic and predictive biomarker in patients with HER2+ early breast cancer. METHODS ADRB2 expression was retrieved from HER2+ patients enrolled in the FinHer study (N = 202), and 2 public datasets containing data from patients with HER2+ early breast cancer: one including patients who did not receive systemic treatment (disease-free survival [DFS] dataset; n = 175) and another including patients who received neoadjuvant treatment (pathologic complete response [pCR] dataset; n = 207). Survival was estimated with Kaplan-Meier method and Cox regression was used for uni-multivariate analyses. ADRB2 expression was correlated with several gene signatures. RESULTS ADRB2 high expression was associated with improved DFS rates in HER2+ patients (hazard ratio [HR] 0.52; 95% confidence interval [CI] 0.32-0.84; P = .0068). No association between ADRB2 expression and pCR was observed (odds ratio 1.14; 95% CI, 0.63-2.10; P = .67). No association between ADRB2 and relapse-free survival (RFS) was observed in HER2+ patients enrolled in the FinHer study (HR 0.93; 95% CI, 0.69-1.25; P = .61). ADRB2 was associated with a low expression of angiogenesis-related (vascular endothelial growth factor -0.38, P < .001) and proliferation-related (aurora kinase A -0.36, P < .001; genomic grade index -0.028, P < .001; signal transducers and activators of transcription -0.17, P < .001) genes; and a high expression of immune-related genes (Perez +0.45, P < .001; STAT1 +0.28, P < .001; immune response gene expression module +0.29, P < .001). CONCLUSIONS Opposing our initial hypothesis, a high ADRB2 expression may be a favorable prognostic factor in patients with HER2+ early breast cancer. This association appears to be mediated by antiproliferative, antiangiogenic, and immunogenic effects of ADRB2.
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Affiliation(s)
- Rafael Caparica
- Department of Medical Oncology, Institut Jules Bordet, Université Libre de Bruxelles (U.L.B.), Brussels, Belgium.
| | - François Richard
- Laboratory for Translational Breast Cancer Research, Department of Oncology, KU Leuven, Leuven, Belgium
| | - Mariana Brandão
- Department of Medical Oncology, Institut Jules Bordet, Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
| | - Ahmad Awada
- Department of Medical Oncology, Institut Jules Bordet, Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
| | - Christos Sotiriou
- Breast Cancer Translational Research Laboratory, Institut Jules Bordet, Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
| | - Evandro de Azambuja
- Department of Medical Oncology, Institut Jules Bordet, Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
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Oba T, Maeno K, Takekoshi D, Ono M, Ito T, Kanai T, Ito KI. Neoadjuvant chemotherapy-induced decrease of prognostic nutrition index predicts poor prognosis in patients with breast cancer. BMC Cancer 2020; 20:160. [PMID: 32106833 PMCID: PMC7045374 DOI: 10.1186/s12885-020-6647-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 02/17/2020] [Indexed: 01/04/2023] Open
Abstract
Background The prognostic nutritional index (PNI), which is an easily calculated nutritional index, is significantly associated with patient outcomes in various solid malignancies. This study aimed to evaluate the prognostic impact of PNI changes in patients with breast cancer undergoing neoadjuvant chemotherapy (NAC). Methods We reviewed patients with breast cancer who underwent NAC and a subsequent surgery for breast cancer between 2005 and 2016. PNI before and after NAC were calculated using the following formula: 10 × serum albumin (g/dl) + 0.005 × total lymphocyte count/mm3. The relationship between PNI and prognosis was retrospectively analyzed. Results In total, 191 patients were evaluated. There was no significant difference in disease-free survival (DFS) between the pre-NAC PNI high group and the pre-NAC PNI low group (cutoff: 53.1). However, PNI decreased in 181 patients (94.7%) after NAC and the mean PNI also significantly decreased after NAC from 52.6 ± 3.8 pre-NAC to 46.5 ± 4.4 post-NAC (p < 0.01). The mean ΔPNI, which was calculated as pre-NAC PNI minus post-NAC PNI, was 5.4. The high ΔPNI group showed significantly poorer DFS than the low ΔPNI group (cut off: 5.26) (p = 0.015). Moreover, high ΔPNI was an independent risk factor of DFS on multivariate analysis (p = 0.042). Conclusions High decrease of PNI during NAC predicts poor prognosis. Thus, maintaining the nutritional status during NAC may result in better treatment outcomes in patients with breast cancer.
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Affiliation(s)
- Takaaki Oba
- Division of Breast and Endocrine Surgery, Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, Japan
| | - Kazuma Maeno
- Division of Breast and Endocrine Surgery, Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, Japan.
| | - Daiya Takekoshi
- Division of Breast and Endocrine Surgery, Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, Japan
| | - Mayu Ono
- Division of Breast and Endocrine Surgery, Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, Japan
| | - Tokiko Ito
- Division of Breast and Endocrine Surgery, Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, Japan
| | - Toshiharu Kanai
- Division of Breast and Endocrine Surgery, Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, Japan
| | - Ken-Ichi Ito
- Division of Breast and Endocrine Surgery, Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, Japan
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Abstract
This statement has been produced by the European Region of the World Confederation for Physiotherapy (ER-WCPT) to promote the role of the physiotherapy profession within primary care, to describe the health and economic benefits to health systems and populations of having a skilled, appropriately resourced and utilised physiotherapy workforce in primary care services, and to illustrate how different models of physiotherapy service delivery are contributing to these health and cost benefits.
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Marinari G, Espitalier-Rivière C, Fédou C, Romain AJ, Raynaud de Mauverger E, Brun JF. Activité physique, obésité et cancer du sein : quelles conclusions pratiques ? Sci Sports 2019. [DOI: 10.1016/j.scispo.2019.04.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Lifestyle change experiences among breast cancer survivors participating in a pilot intervention: A narrative thematic analysis. Eur J Oncol Nurs 2019; 41:97-103. [PMID: 31358264 DOI: 10.1016/j.ejon.2019.06.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Revised: 05/31/2019] [Accepted: 06/02/2019] [Indexed: 12/31/2022]
Abstract
PURPOSE Healthy lifestyle adoption among breast cancer (BC) survivors remains a poorly understood process. This study aimed to qualitatively examine the unique change trajectories of BC survivors who partook in a pilot version of the Healthy Lifestyle Modification After Breast Cancer (HLM-ABC) intervention. METHODS A sample of four BC survivors were studied intensively through longitudinal interviews conducted at four time points with each participant: (1) pre-treatment, (2) mid-way treatment, (3) post-treatment, and (4) three-months following their participation in the HLM-ABC. A multiple-case study, narrative analysis was applied to 15 interviews, resulting in individual narratives as well as shared 'thematic intersections' elucidating cross-participant experiences. RESULTS The findings showed that participants offered unique styles of authorship, characterized by diverse struggles, victories, and motivational insights, organized around the following intersecting themes: (1)Weight management prescription as a motivator or deterrent, (2) 'Time for me' is time away from my family, and (3) Patterns of opposition to lifestyle change. These women's rich, storied accounts suggest experiences of personal growth and imply that existential concerns can be both motivating and deterring in relation to health behavior change. CONCLUSION This research provides a comprehensive and nuanced grasp of healthy lifestyle modification in the survivorship stage of BC.
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Kupsik M, Sulo S, Katz A, Memmel H. What do women really think? Patient understanding of breast cancer risk. Breast J 2019; 25:1320-1322. [DOI: 10.1111/tbj.13472] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Revised: 12/15/2018] [Accepted: 12/18/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Michalina Kupsik
- Metropolitan Group Hospitals, University of Illinois Chicago Illinois
| | - Suela Sulo
- Russell Institute for Research and Innovation Park Ridge Illinois
| | - Anna Katz
- Division of Breast Surgical Oncology Advocate Lutheran General Hospital Park Ridge Illinois
| | - Heidi Memmel
- Division of Breast Surgical Oncology Advocate Lutheran General Hospital Park Ridge Illinois
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Nutrition and Breast Cancer: A Literature Review on Prevention, Treatment and Recurrence. Nutrients 2019; 11:nu11071514. [PMID: 31277273 PMCID: PMC6682953 DOI: 10.3390/nu11071514] [Citation(s) in RCA: 162] [Impact Index Per Article: 32.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 06/28/2019] [Accepted: 07/01/2019] [Indexed: 12/13/2022] Open
Abstract
Breast cancer (BC) is the second most common cancer worldwide and the most commonly occurring malignancy in women. There is growing evidence that lifestyle factors, including diet, body weight and physical activity, may be associated with higher BC risk. However, the effect of dietary factors on BC recurrence and mortality is not clearly understood. Here, we provide an overview of the current evidence obtained from the PubMed databases in the last decade, assessing dietary patterns, as well as the consumption of specific food-stuffs/food-nutrients, in relation to BC incidence, recurrence and survival. Data from the published literature suggest that a healthy dietary pattern characterized by high intake of unrefined cereals, vegetables, fruit, nuts and olive oil, and a moderate/low consumption of saturated fatty acids and red meat, might improve overall survival after diagnosis of BC. BC patients undergoing chemotherapy and/or radiotherapy experience a variety of symptoms that worsen patient quality of life. Studies investigating nutritional interventions during BC treatment have shown that nutritional counselling and supplementation with some dietary constituents, such as EPA and/or DHA, might be useful in limiting drug-induced side effects, as well as in enhancing therapeutic efficacy. Therefore, nutritional intervention in BC patients may be considered an integral part of the multimodal therapeutic approach. However, further research utilizing dietary interventions in large clinical trials is required to definitively establish effective interventions in these patients, to improve long-term survival and quality of life.
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Chlebowski RT, Anderson GL, Manson JE, Prentice RL, Aragaki AK, Snetselaar L, Beresford SAA, Kuller LH, Johnson K, Lane D, Luo J, Rohan TE, Jiao L, Barac A, Womack C, Coday M, Datta M, Thomson CA. Low-Fat Dietary Pattern and Cancer Mortality in the Women's Health Initiative (WHI) Randomized Controlled Trial. JNCI Cancer Spectr 2019; 2:pky065. [PMID: 31360880 PMCID: PMC6649760 DOI: 10.1093/jncics/pky065] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 07/19/2018] [Accepted: 10/03/2018] [Indexed: 01/08/2023] Open
Abstract
Background In the Women’s Health Initiative Dietary Modification trial, a low-fat dietary pattern reduced deaths after breast cancer. Mortality from other cancer sites has not been reported. Methods A low-fat dietary pattern influence on deaths from and after site-specific cancers was examined during 8.5 years (median) of dietary intervention and cumulatively during 17.7 years (median) of follow-up. A total 48 835 postmenopausal women, ages 50–79 years, were randomly assigned from 1993 to 1998 at 40 US clinical centers to dietary intervention (40%, n = 19 541 or a usual diet comparison group (60%, n = 29 294). Dietary intervention influence on mortality from protocol-specified cancers (breast, colon and rectum, endometrium and ovary), individually and as a composite, represented the primary analyses. Results During the dietary intervention period, a reduction in deaths after breast cancer (HR = 0.65 95% CI = 0.45 to 0.94, P = .02) was the only statistically significant cancer mortality finding. During intervention, the HRs for deaths after the protocol-specified cancer composite were 0.90 (95% CI = 0.73 to 1.10) and 0.95 (95% CI = 0.85 to 1.06) for deaths after all cancers. During 17.7 years of follow-up with 3867 deaths after all cancers, reduction in deaths after breast cancer continued in the dietary intervention group (HR = 0.85, 95% CI = 0.74 to 0.99, P = .03). However, no dietary intervention influence on deaths from or after any other cancer or cancer composite was seen. Conclusions A low-fat dietary pattern reduced deaths after breast cancer. No reduction in mortality from or after any other cancer or cancer composite was seen.
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Affiliation(s)
| | - Garnet L Anderson
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - JoAnn E Manson
- Harvard Medical School, Brigham and Women's Hospital, Boston, MA
| | - Ross L Prentice
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Aaron K Aragaki
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
| | | | | | - Lewis H Kuller
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA
| | - Karen Johnson
- Department of Preventive Medicine, University of Tennessee, Memphis, TN
| | - Dorothy Lane
- Preventive Medicine, Stony Brook University, Stony Brook, NY
| | - Juhua Luo
- School of Public Health, University of Indiana, Bloomington, IN
| | - Thomas E Rohan
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Li Jiao
- Department of Medicine, Baylor College of Medicine, Houston, TX
| | - Ana Barac
- MedStar Health Research Institute and Georgetown/Howard Universities Center for Clinical and Translational Sciences, Washington, DC
| | | | - Mace Coday
- Department of Preventive Medicine, University of Tennessee, Memphis, TN
| | - Mridul Datta
- School of Public Health, University of Purdue, West Lafayette, IN
| | - Cynthia A Thomson
- Mel and Enid Zuckerman College of Public Health, University of Arizona Cancer Center, Tucson, AZ
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Molanouri Shamsi M, Chekachak S, Soudi S, Gharakhanlou R, Quinn LS, Ranjbar K, Rezaei S, Shirazi FJ, Allahmoradi B, Yazdi MH, Mahdavi M, Voltarelli FA. Effects of exercise training and supplementation with selenium nanoparticle on T-helper 1 and 2 and cytokine levels in tumor tissue of mice bearing the 4 T1 mammary carcinoma. Nutrition 2019; 57:141-147. [DOI: 10.1016/j.nut.2018.05.022] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 04/16/2018] [Accepted: 05/07/2018] [Indexed: 11/26/2022]
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Xiang Y, Zhou W, Duan X, Fan Z, Wang S, Liu S, Liu L, Wang F, Yu L, Zhou F, Huang S, Li L, Zhang Q, Fu Q, Ma Z, Gao D, Cui S, Geng C, Cao X, Yang Z, Wang X, Liang H, Jiang H, Wang H, Li G, Wang Q, Zhang J, Jin F, Tang J, Tian F, Ye C, Yu Z. Metabolic Syndrome, and Particularly the Hypertriglyceridemic-Waist Phenotype, Increases Breast Cancer Risk, and Adiponectin Is a Potential Mechanism: A Case-Control Study in Chinese Women. Front Endocrinol (Lausanne) 2019; 10:905. [PMID: 32038481 PMCID: PMC6990117 DOI: 10.3389/fendo.2019.00905] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Accepted: 12/11/2019] [Indexed: 12/14/2022] Open
Abstract
Objective: To investigate the association between metabolic syndrome and breast cancer and to elucidate the potential mechanism underlying this association. Patients and Methods: Based on baseline data drawn from 21 hospitals in 11 provinces of China, we performed a case-control study among 1,127 women (595 cases and 532 controls), divided into premenopausal, and postmenopausal subgroups. Student's t test, Pearson's χ2 test, and logistic regression analyses were performed to ascertain the association between breast cancer and metabolic syndrome, including all of its components. In addition, we attempted to clarify the potential role of adiponectin in this association. Results: Among the components of metabolic syndrome, abnormal waist circumference was the component that markedly increased breast cancer risk in premenopausal women (OR 1.447, 95% CI 1.043-2.006). Metabolic syndrome with clusters of special risk factors showed an association with breast cancer risk. Among all these components of metabolic syndrome, the hypertriglyceridemic-waist (HW) phenotype significantly increased breast cancer risk (OR 1.56, 95% CI 1.02-2.39), regardless of menopausal status, rendering it a strong predictor of breast cancer. Total adiponectin levels and high-molecular-weight adiponectin were reversely associated with metabolic syndrome. In addition, total adiponectin levels among breast cancer patients were much lower than among controls (6.67 ± 3.05 vs. 8.01 ± 4.18, p = 0.014) only in the HW phenotype subgroup. Furthermore, the HW phenotype was associated with increased risk of estrogen receptor/progesterone receptor-positive (ER+/PR+) and -negative (ER-/PR-) breast cancer, with a 51% (OR 1.51, 95% CI 1.03-2.21) and 69% (OR 1.69, 95% CI 1.05-2.72) increase, respectively. However, there was no significant association between the HW phenotype and the ER+/PR- subtype. These results suggested that low adiponectin levels may be a mechanism that explains the association between the HW phenotype and breast cancer risk. Conclusion: Metabolic syndrome with special cluster factors is related to breast cancer risk; in particular, the HW phenotype can be regarded as a strong predictor of breast cancer. As an important factor involved in fat metabolism, adiponectin may strongly predict metabolic syndrome, especially the HW phenotype and breast cancer. Further research into this mechanism and epidemiological studies are needed. This study provides new evidence for the role of a healthy lifestyle in preventing breast cancer.
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Affiliation(s)
- Yujuan Xiang
- Department of Breast Surgery, The Second Hospital of Shandong University, Jinan, China
- Institute of Translational Medicine of Breast Disease Prevention and Treatment, Shandong University, Jinan, China
| | - Wenzhong Zhou
- Department of Breast Surgery, The Second Hospital of Shandong University, Jinan, China
- School of Medicine, Shandong University, Jinan, China
| | - Xuening Duan
- Breast Disease Center, Peking University First Hospital, Beijing, China
| | - Zhimin Fan
- Department of Breast Surgery, The First Hospital of Jilin University, Changchun, China
| | - Shu Wang
- Breast Disease Center, Peking University People's Hospital, Beijing, China
| | - Shuchen Liu
- Department of Breast Surgery, The Second Hospital of Shandong University, Jinan, China
- School of Medicine, Shandong University, Jinan, China
| | - Liyuan Liu
- Department of Breast Surgery, The Second Hospital of Shandong University, Jinan, China
- Institute of Translational Medicine of Breast Disease Prevention and Treatment, Shandong University, Jinan, China
| | - Fei Wang
- Department of Breast Surgery, The Second Hospital of Shandong University, Jinan, China
- Institute of Translational Medicine of Breast Disease Prevention and Treatment, Shandong University, Jinan, China
| | - Lixiang Yu
- Department of Breast Surgery, The Second Hospital of Shandong University, Jinan, China
- Institute of Translational Medicine of Breast Disease Prevention and Treatment, Shandong University, Jinan, China
| | - Fei Zhou
- Department of Breast Surgery, The Second Hospital of Shandong University, Jinan, China
- Institute of Translational Medicine of Breast Disease Prevention and Treatment, Shandong University, Jinan, China
| | - Shuya Huang
- Department of Breast Surgery, The Second Hospital of Shandong University, Jinan, China
- Institute of Translational Medicine of Breast Disease Prevention and Treatment, Shandong University, Jinan, China
| | - Liang Li
- Department of Breast Surgery, The Second Hospital of Shandong University, Jinan, China
- Institute of Translational Medicine of Breast Disease Prevention and Treatment, Shandong University, Jinan, China
| | - Qiang Zhang
- Department of Breast Surgery, The Second Hospital of Shandong University, Jinan, China
- Institute of Translational Medicine of Breast Disease Prevention and Treatment, Shandong University, Jinan, China
| | - Qinye Fu
- Department of Breast Surgery, The Second Hospital of Shandong University, Jinan, China
- Institute of Translational Medicine of Breast Disease Prevention and Treatment, Shandong University, Jinan, China
| | - Zhongbing Ma
- Department of Breast Surgery, The Second Hospital of Shandong University, Jinan, China
- Institute of Translational Medicine of Breast Disease Prevention and Treatment, Shandong University, Jinan, China
| | - Dezong Gao
- Department of Breast Surgery, The Second Hospital of Shandong University, Jinan, China
- Institute of Translational Medicine of Breast Disease Prevention and Treatment, Shandong University, Jinan, China
| | - Shude Cui
- Department of Breast Surgery, Affiliated Tumor Hospital of Zhengzhou University, Zhengzhou, China
| | - Cuizhi Geng
- Breast Center, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xuchen Cao
- Department of Breast Surgery, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Zhenlin Yang
- Department of Thyroid and Breast Surgery, The First Affiliated Hospital of Binzhou Medical University, Binzhou, China
| | - Xiang Wang
- Department of Breast Surgery, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Hong Liang
- Department of General Surgery, Linyi People's Hospital, Linyi, China
| | - Hongchuan Jiang
- Department of General Surgery, Beijing Chaoyang Hospital, Beijing, China
| | - Haibo Wang
- Breast Center, Qingdao University Affiliated Hospital, Qingdao, China
| | - Guolou Li
- Department of Breast and Thyroid Surgery, Weifang Traditional Chinese Hospital, Weifang, China
| | - Qitang Wang
- Department of Breast Surgery, The Second Affiliated Hospital of Qingdao Medical College, Qingdao Central Hospital, Qingdao, China
| | - Jianguo Zhang
- Department of General Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Feng Jin
- Department of Breast Surgery, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Jinhai Tang
- Department of General Surgery, Nanjing Medical University Affiliated Cancer Hospital Cancer Institute of Jiangsu Province, Nanjing, China
| | - Fuguo Tian
- Department of Breast Surgery, Shanxi Cancer Hospital, Taiyuan, China
| | - Chunmiao Ye
- Department of Breast Surgery, The Second Hospital of Shandong University, Jinan, China
- School of Medicine, Shandong University, Jinan, China
| | - Zhigang Yu
- Department of Breast Surgery, The Second Hospital of Shandong University, Jinan, China
- Suzhou Institute, Shandong University, Suzhou, China
- *Correspondence: Zhigang Yu
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Using Mouse and Drosophila Models to Investigate the Mechanistic Links between Diet, Obesity, Type II Diabetes, and Cancer. Int J Mol Sci 2018; 19:ijms19124110. [PMID: 30567377 PMCID: PMC6320797 DOI: 10.3390/ijms19124110] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 12/12/2018] [Accepted: 12/14/2018] [Indexed: 02/06/2023] Open
Abstract
Many of the links between diet and cancer are controversial and over simplified. To date, human epidemiological studies consistently reveal that patients who suffer diet-related obesity and/or type II diabetes have an increased risk of cancer, suffer more aggressive cancers, and respond poorly to current therapies. However, the underlying molecular mechanisms that increase cancer risk and decrease the response to cancer therapies in these patients remain largely unknown. Here, we review studies in mouse cancer models in which either dietary or genetic manipulation has been used to model obesity and/or type II diabetes. These studies demonstrate an emerging role for the conserved insulin and insulin-like growth factor signaling pathways as links between diet and cancer progression. However, these models are time consuming to develop and expensive to maintain. As the world faces an epidemic of obesity and type II diabetes we argue that the development of novel animal models is urgently required. We make the case for Drosophila as providing an unparalleled opportunity to combine dietary manipulation with models of human metabolic disease and cancer. Thus, combining diet and cancer models in Drosophila can rapidly and significantly advance our understanding of the conserved molecular mechanisms that link diet and diet-related metabolic disorders to poor cancer patient prognosis.
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Huneidi SA, Wright NC, Atkinson A, Bhatia S, Singh P. Factors associated with physical inactivity in adult breast cancer survivors-A population-based study. Cancer Med 2018; 7:6331-6339. [PMID: 30358141 PMCID: PMC6308073 DOI: 10.1002/cam4.1847] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 10/03/2018] [Accepted: 10/04/2018] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Physical activity has been shown to reduce the risk of breast cancer-specific mortality. Although factors associated with physical inactivity in breast cancer survivors have been studied, a detailed examination at the population level is still lacking. METHODS We addressed this gap in 1236 women with a diagnosis of breast cancer from the 2016 Behavioral Risk Factor Surveillance System Cancer Survivorship module. Physical inactivity was defined as self-reported absence of leisure time physical activity. Factors examined in the multivariable logistic regression model included sociodemographic, behavioral factors, access to health care, health history, current cancer treatment, and pain from cancer or treatment. RESULTS Overall, older age (≥65 years: OR = 2.63, 95% CI: 1.25-5.55) and being underweight (BMI <18.5: OR = 6.11, 95% CI: 1.35-27.66), were identified as significant factors associated with physical inactivity. In models adjusting for sociodemographics (Model 1), and the prior plus behavioral factors (Model 2), pain from cancer or treatment was significantly associated with physical inactivity (Model 2: OR = 2.23, 95% CI: 1.16-4.28); however, after fully adjusting for all variables (Model 3), there was no longer evidence of a significant association between pain from cancer and physical activity in female survivors with breast cancer. CONCLUSIONS We identified demographic (older age) and physical (low BMI and pain) factors to be significantly associated with physical inactivity among breast cancer survivors. Future interventions to promote physical activity in breast cancer survivors could benefit by taking into account these factors to develop tailored recommendations for increasing activity.
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Affiliation(s)
- Salam A. Huneidi
- Department of EpidemiologyUniversity of Alabama at BirminghamBirminghamAlabama
| | - Nicole C. Wright
- Department of EpidemiologyUniversity of Alabama at BirminghamBirminghamAlabama
| | - Arnisha Atkinson
- Department of EpidemiologyUniversity of Alabama at BirminghamBirminghamAlabama
| | - Smita Bhatia
- Institute for Cancer Outcomes and SurvivorshipUniversity of Alabama at BirminghamBirminghamAlabama
| | - Purnima Singh
- Institute for Cancer Outcomes and SurvivorshipUniversity of Alabama at BirminghamBirminghamAlabama
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Fararouei M, Iqbal A, Rezaian S, Gheibi Z, Dianatinasab A, Shakarami S, Dianatinasab M. Dietary Habits and Physical Activity are Associated With the Risk of Breast Cancer Among Young Iranian Women: A Case-control Study on 1010 Premenopausal Women. Clin Breast Cancer 2018; 19:e127-e134. [PMID: 30503310 DOI: 10.1016/j.clbc.2018.10.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 10/26/2018] [Accepted: 10/26/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Several studies conducted in developed countries introduced diet and physical inactivity as major risk factors for several types of cancers. However, the impact of diet and physical inactivity on the risk of breast cancer (BC) is understudied, and the limited findings are controversial. In addition, no or limited knowledge is available from the developing world. PATIENTS AND METHODS This case-control study was performed from November 2014 to March 2016 on 1010 young women aged 20 to 50 years who were newly diagnosed with BC. Data was obtained via a validated questionnaire and the global physical activity questionnaire (GPAQ2). Also, patients' medical and histopathology reports were reviewed. RESULTS The results of multiple logistic regression suggested that, except for the common risk factors for BC (older marital age, family history of BC, smoking, and being a passive smoker), eating red meat (adjusted odds ratio [aOR] >8 portions/week [p/w] vs. 0-2 p/w, 1.15; 95% confidence interval [CI], 1.04-1.28); eating fish (aOR >8 p/w vs. 0-2 p/w, 1.55; 95% CI, 1.12-2.76), fruit consumption (aOR 0-4 p/w vs. >8 p/w, 1.96; 95% CI, 1.07-3.82), pickle consumption (aOR >8 p/w vs. 7-8 p/w, 1.46; 95% CI, 1.31-1.70), and intensity of physical activity (aOR light vs. vigorous, 1.68; 95% CI, 1.47-1.98) were directly associated with a higher risk of BC in young women. CONCLUSION Our study supported the hypothesis that unhealthy dietary habits and physical inactivity are risk factors for BC. We found that a healthy diet containing low fat and high fruits and vegetables with regular exercise are effective ways to reduce the risk of BC among young women.
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Affiliation(s)
- Mohammad Fararouei
- Department of Epidemiology, Faculty of Public Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Aqsa Iqbal
- Physiology and Biophysics Department, University of Illinois at Chicago, Chicago, IL
| | - Shahab Rezaian
- Research Center for Environmental Determinants of Health (RCEDH), School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Zahra Gheibi
- Department of Epidemiology, Faculty of Public Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Aria Dianatinasab
- Department of Biochemistry, Student research committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Saba Shakarami
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Mostafa Dianatinasab
- Bahar Center for Education, Research and Treatment, Shahroud University of Medical Sciences, Shahroud, Iran.
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Chlebowski RT, Aragaki AK, Anderson GL, Simon MS, Manson JE, Neuhouser ML, Pan K, Stefanic ML, Rohan TE, Lane D, Qi L, Snetselaar L, Prentice RL. Association of Low-Fat Dietary Pattern With Breast Cancer Overall Survival: A Secondary Analysis of the Women's Health Initiative Randomized Clinical Trial. JAMA Oncol 2018; 4:e181212. [PMID: 29800122 PMCID: PMC6233778 DOI: 10.1001/jamaoncol.2018.1212] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Accepted: 02/26/2018] [Indexed: 01/03/2023]
Abstract
Importance In a randomized clinical trial, a low-fat eating pattern was associated with lower risk of death after breast cancer. However, the extent to which results were driven by dietary influence on survival after breast cancer diagnosis was unknown. Objective To determine the association of a low-fat dietary pattern with breast cancer overall survival (breast cancer followed by death from any cause measured from cancer diagnosis). Design, Setting, and Participants This is a secondary analysis of the Women's Health Initiative randomized clinical trial that was conducted at 40 US clinical centers enrolling participants from 1993 through 1998. Participants were 48 835 postmenopausal women with no previous breast cancer and dietary fat intake of greater than 32% by food frequency questionnaire. Interventions Participants were randomized to a dietary intervention group (40%; n = 19 541) with goals to reduce fat intake to 20% of energy and increase fruit, vegetable, and grain intake or a usual-diet comparison group (60%; n = 29 294). Dietary group participants with incident breast cancers continued to participate in subsequent dietary intervention activities. Main Outcomes and Measures Breast cancer overall survival for incident breast cancers diagnosed during the 8.5-year (median) dietary intervention, examined in post hoc analyses after 11.5 years (median) postdiagnosis follow-up. Results Of 1764 women diagnosed with breast cancer during the dietary intervention period, mean (SD) age at screening was 62.7 (6.7) years and age at diagnosis was 67.6 (6.9) years. With 516 total deaths, breast cancer overall survival was significantly greater for women in the dietary intervention group than in the usual-diet comparison group (10-year survival of 82% and 78%, respectively; hazard ratio [HR], 0.78; 95% CI, 0.65-0.94; P = .01). In the dietary group there were fewer deaths from breast cancer (68 vs 120; HR, 0.86; 95% CI, 0.64-1.17), other cancers (36 vs 65; HR, 0.76; 95% CI, 0.50-1.17), and cardiovascular disease (27 vs 64; HR, 0.62; 95% CI, 0.39-0.99). Conclusions and Relevance In women who received a diagnosis of breast cancer during the dietary intervention period, those in the dietary group had increased overall survival. The increase is due, in part, to better survival from several causes of death. Trial Registration ClinicalTrials.gov Identifier: NCT00000611.
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Affiliation(s)
- Rowan T. Chlebowski
- City of Hope National Medical Center, Department of Medical Oncology and Therapeutics Research, Duarte, California
| | - Aaron K. Aragaki
- Fred Hutchinson Cancer Research Center, Division of Public Health Sciences, Seattle, Washington
| | - Garnet L. Anderson
- Fred Hutchinson Cancer Research Center, Division of Public Health Sciences, Seattle, Washington
| | - Michael S. Simon
- Wayne State University, Karmanos Cancer Institute, Detroit, Michigan
| | - JoAnn E. Manson
- Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Marian L. Neuhouser
- Fred Hutchinson Cancer Research Center, Division of Public Health Sciences, Seattle, Washington
| | - Kathy Pan
- Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Department of Medicine, Torrance, California
| | - Marcia L. Stefanic
- Stanford Prevention Research Center, School of Medicine, Stanford University, Palo Alto, California
| | - Thomas E. Rohan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Dorothy Lane
- Stony Brook University, Preventive Medicine, Stony Brook, New York
| | - Lihong Qi
- Department of Public Health Sciences, University of California at Davis
| | - Linda Snetselaar
- College of Public Health, University of Iowa, Iowa City/Davenport
| | - Ross L. Prentice
- Fred Hutchinson Cancer Research Center, Division of Public Health Sciences, Seattle, Washington
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Diet and exercise in cancer: Epidemiologic perspectives on optimizing survivorship via lifestyle. J Cancer Policy 2018. [DOI: 10.1016/j.jcpo.2017.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Schmidt T, Rudolph I, Wozniak T, Ruetters D, Van Mackelenbergh MT, Huebner J. Effect of ballroom dancing on the well-being of cancer patients: Report of a pilot project. Mol Clin Oncol 2018; 9:342-346. [PMID: 30112180 DOI: 10.3892/mco.2018.1663] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 06/08/2018] [Indexed: 12/14/2022] Open
Abstract
The present study aimed to evaluate the feasibility of ballroom dancing for patients with cancer and their partners, and develop a simple method for assessing its effects on the patients' well-being. A total of 11 pairs (14 patients and 8 healthy partners) participated. Participation was open, and there were no restrictions in terms of the type of cancer, treatment or comorbidities. An anonymous standardized questionnaire allowing participants to rate their well-being on a visual analogue scale (VAS) from 1 to 10 was used. This rating was repeated at defined time points over 1 week. No adverse events occurred during the study, and the teaching methods appeared to be feasible for the patients. The well-being of all patients remained stable or increased during the class, and returned to the initial level within the following days. A total of 3 patients with a low well-being rating prior to class experienced a strong improvement during the class, which continued until the last day of observation for 2 patients. These results confirm the effectiveness of a VAS-based method for the evaluation of ballroom dancing in patients with different types of cancer undergoing different treatments, and its positive effect on the patients' well-being.
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Affiliation(s)
- Thorsten Schmidt
- Cancer Center North, Schleswig-Holstein University Hospital, D-24105 Kiel, Germany
| | - Ivonne Rudolph
- Hematology and Oncology Department, Jena University Hospital, D-04774 Jena, Germany
| | - Tobias Wozniak
- Hematology and Oncology Department, Jena University Hospital, D-04774 Jena, Germany
| | - Dana Ruetters
- Hematology and Oncology Department, Jena University Hospital, D-04774 Jena, Germany
| | | | - Jutta Huebner
- Hematology and Oncology Department, Jena University Hospital, D-04774 Jena, Germany
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Bodai BI, Nakata TE, Wong WT, Clark DR, Lawenda S, Tsou C, Liu R, Shiue L, Cooper N, Rehbein M, Ha BP, Mckeirnan A, Misquitta R, Vij P, Klonecke A, Mejia CS, Dionysian E, Hashmi S, Greger M, Stoll S, Campbell TM. Lifestyle Medicine: A Brief Review of Its Dramatic Impact on Health and Survival. Perm J 2018; 22:17-025. [PMID: 29035175 DOI: 10.7812/tpp/17-025] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
By ignoring the root causes of disease and neglecting to prioritize lifestyle measures for prevention, the medical community is placing people at harm. Advanced nations, influenced by a Western lifestyle, are in the midst of a health crisis, resulting largely from poor lifestyle choices. Epidemiologic, ecologic, and interventional studies have repeatedly indicated that most chronic illnesses, including cardiovascular disease, cancer, and type 2 diabetes, are the result of lifestyles fueled by poor nutrition and physical inactivity.In this article, we describe the practice of lifestyle medicine and its powerful effect on these modern instigators of premature disability and death. We address the economic benefits of prevention-based lifestyle medicine and its effect on our health care system: A system on the verge of bankruptcy. We recommend vital changes to a disastrous course. Many deaths and many causes of pain, suffering, and disability could be circumvented if the medical community could effectively implement and share the power of healthy lifestyle choices. We believe that lifestyle medicine should become the primary approach to the management of chronic conditions and, more importantly, their prevention. For future generations, for our own health, and for the Hippocratic Oath we swore to uphold ("First do no harm"), the medical community must take action. It is our hope that the information presented will inspire our colleagues to pursue lifestyle medicine research and incorporate such practices into their daily care of patients. The time to make this change is now.
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Affiliation(s)
- Balazs I Bodai
- Director of The Breast Cancer Survivorship Institute in Sacramento, CA.
| | - Therese E Nakata
- Program Manager of The Breast Cancer Survivorship Institute in Sacramento, CA.
| | | | - Dawn R Clark
- Chief Facilitator of the Physician Wellness Program and an Obstetrician/Gynecologist at the San Dimas-Baldwin Park Medical Center in San Dimas, CA.
| | - Steven Lawenda
- Internist at the Antelope Valley Medical Center in Lancaster, CA.
| | | | - Raymond Liu
- Chief of Hematology-Oncology at the San Francisco Medical Center in CA.
| | - Linda Shiue
- Internist and the Director of Culinary Medicine at the San Francisco Medical Center in CA.
| | - Neil Cooper
- Radiologist at the Glenlake Medical Center in Atlanta, GA.
| | - Michael Rehbein
- Pediatrician and Assistant Physician-in-Charge for Outpatient Service at the Stockton Medical Office in CA.
| | - Benjamin P Ha
- Associate Area Medical Director for Family Medicine at the Bakersfield Medical Center in CA.
| | - Anne Mckeirnan
- Obstetrician/Gynecologist at the San Diego Medical Center in CA.
| | - Rajiv Misquitta
- Primary Care Physician at the South Sacramento Medical Center in CA. He is also an Elected Representative on The Permanente Medical Group Board of Directors.
| | - Pankaj Vij
- Medical Director of the Kaiser Permanente Weight Management Program in Pleasanton, CA.
| | - Andrew Klonecke
- Nuclear Medicine Specialist at the Sacramento Medical Center and at the Roseville Medical Center in CA.
| | | | - Emil Dionysian
- Orthopedic Surgeon at the Lakeview Medical Offices and at the Orange County Medical Center in Anaheim, CA.
| | - Sean Hashmi
- Internist at the Woodland Hills Medical Center in CA.
| | - Michael Greger
- Physician and Founder of NutritionFacts.org in Kensington, MD.
| | - Scott Stoll
- Co-Founder and Chairman of the Plantrician Project in Rieglesville, PA.
| | - Thomas M Campbell
- Instructor of Clinical Family Medicine at the University of Rochester School of Medicine and Dentistry and the Co-Founder and Clinical Director of the University of Rochester Program for Nutrition in Medicine in NY.
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de Kruif JTCM, Scholtens MB, van der Rijt J, de Boer MR, van den Berg MMGA, de Vries YC, Winkels RM, Visser M, Kampman E, Westerman MJ. Perceptions of Dutch health care professionals on weight gain during chemotherapy in women with breast cancer. Support Care Cancer 2018; 27:601-607. [PMID: 30022349 PMCID: PMC6325997 DOI: 10.1007/s00520-018-4347-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 07/06/2018] [Indexed: 11/29/2022]
Abstract
Purpose Dutch Health care professionals (HCPs) provide little information concerning health risks associated with weight gain during chemotherapy for breast cancer. Women with breast cancer have specified the need for more information on nutrition and physical activity to deal with weight gain. The aims of this study were to assess the perceptions of Dutch HCPs on weight gain during chemotherapy and in addition evaluate whether and what kind of information on dietary intake and physical activity HCPs provide to prevent/treat weight gain during (neo)adjuvant chemotherapy. Methods A qualitative study was conducted using semi-structured interviews with 34 HCPs involved in breast cancer care: general practitioners, oncologists, specialized nurses, and dieticians. Results To date, little information about nutrition, physical activity, and weight gain is given during chemotherapy because it is not part of most HCPs’ training, it is not included in the guidelines and it is not the best time to bring up information in the opinion of HCPs. Weight gain was perceived as just a matter of a few kilos and not an important health issue during treatment. All HCPs felt it is better that women themselves addressed their weight gain after chemotherapy. Conclusion More knowledge about health risks associated with chemotherapy-induced weight gain and how to combat these issues needs to be made readily available to the HCPs and should become part of their training. Existing patient guidelines should include information on how to prevent and/or reduce weight gain through self-management of nutrition intake and physical activity during and post chemotherapy.
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Affiliation(s)
- J Th C M de Kruif
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
| | - M B Scholtens
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - J van der Rijt
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - M R de Boer
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Y C de Vries
- Division of Human Nutrition, Wageningen University, Wageningen, the Netherlands
| | - R M Winkels
- Penn State Cancer Institute, Department of Public Health Sciences, Penn State University, Hershey, PA, USA
| | - M Visser
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - E Kampman
- Division of Human Nutrition, Wageningen University, Wageningen, the Netherlands
| | - M J Westerman
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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44
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The rationale for a role for diet and nutrition in the prevention and treatment of cancer. Eur J Cancer Prev 2018; 27:406-410. [DOI: 10.1097/cej.0000000000000427] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Rossi A, Friel C, Carter L, Garber CE. Effects of Theory-Based Behavioral Interventions on Physical Activity Among Overweight and Obese Female Cancer Survivors: A Systematic Review of Randomized Controlled Trials. Integr Cancer Ther 2018; 17:226-236. [PMID: 29076388 PMCID: PMC6041897 DOI: 10.1177/1534735417734911] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 08/23/2017] [Accepted: 09/07/2017] [Indexed: 11/17/2022] Open
Abstract
PURPOSE To determine whether theory-based physical activity (PA) interventions for overweight and obese female cancer survivors lead to increased PA and improved health. METHODS This systematic review examined randomized controlled trials analyzing the impact of theory-based PA interventions on overweight and obese female cancer survivors through December 2016. Searches of 5 electronic databases revealed 10 articles that included 1351 participants who met the inclusion criteria. RESULTS Participants were primarily non-Hispanic white (74%-100%) breast or endometrial cancer survivors. Intervention characteristics and PA assessment tools varied greatly. Adherence (68%-99%) and retention (79%-100%) were relatively high. Social cognitive theory was utilized as the theoretical construct in 9 of the 10 studies. Home-based interventions led to small improvements in PA (Cohen's d range = 0.25-0.31), whereas home-based plus center-based interventions led to moderate to large improvements (Cohen's d range = 0.45-1.02). Only three of the studies assessed psychosocial behavioral processes associated with PA, and the results were mixed. Health-related outcomes included improvements in aerobic fitness (Cohen's d = 0.32-1.1 in 5 studies), large absolute decreases in waist circumferences (>6 cm in 3 of 5 studies; Cohen's d = -0.31 to -1.02), and no change in inflammatory biomarkers (in 2 studies). Only one serious adverse event (pelvic stress fracture) was attributed to the interventions. CONCLUSIONS Theory-based PA interventions are safe and feasible for overweight and obese female cancer survivors. Interventions that include a center-based component showed moderate to large effect sizes for PA. Future studies should evaluate behavioral variables and more health-related clinical outcomes.
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Affiliation(s)
- Amerigo Rossi
- Long Island University Brooklyn, NY,
USA
- Columbia University, New York, NY,
USA
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46
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Weigl J, Hauner H, Hauner D. Can Nutrition Lower the Risk of Recurrence in Breast Cancer? Breast Care (Basel) 2018; 13:86-91. [PMID: 29887784 PMCID: PMC5981678 DOI: 10.1159/000488718] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND The impact of diet on breast cancer prognosis is poorly understood. Therefore, we conducted a literature search summarizing the current evidence on the effect of diet on breast cancer recurrence and mortality. METHODS The PubMed database was searched for original studies, reviews, and meta-analyses published between 2010 and 2017. Studies related to diet, dietary patterns, special diets or specific dietary factors, and breast cancer recurrence or mortality were included. RESULTS Adherence to high diet quality indices (relative risk (RR) 0.74, 95% confidence interval (CI) 0.60-0.90) and a prudent/healthy dietary pattern (RR 0.76, 95% CI 0.60-0.95) may have a beneficial effect on breast cancer prognosis, whereas a Western/unhealthy diet is associated with poorer overall mortality (RR 1.44, 95% CI 1.17-1.77). For low-fat diets, the findings are inconsistent. A positive effect of the Mediterranean Diet was found for all-cause mortality, but no beneficial effect from other diets such as low-carbohydrate, ketogenic or vegetarian/vegan diets was observed. Alcohol consumption was associated with an increased risk for breast cancer recurrence. No general recommendation for soy exists, but occasional intake seems to be acceptable, whereas the use of other supplements is not justified. CONCLUSION Adherence to high-quality diets and a prudent/healthy dietary pattern seem to be beneficial for breast cancer prognosis. No clear evidence for a benefit from special diets, soy products, or other supplements was found.
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Affiliation(s)
| | - Hans Hauner
- Institute for Nutritional Medicine, Else Kröner-Fresenius-Center for Nutritional Medicine, University Hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
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Höh JC, Schmidt T, Hübner J. Physical activity among cancer survivors-what is their perception and experience? Support Care Cancer 2017; 26:1471-1478. [PMID: 29168034 DOI: 10.1007/s00520-017-3977-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 11/13/2017] [Indexed: 02/02/2023]
Abstract
PURPOSE Physical activity (PA) plays an important role relating to cancer. The aim of this study was to investigate the attitude to and experience with the subject of PA in cancer in a large group of tumour patients. METHODS A standardised questionnaire was carried out and distributed to patients online and in printed form. RESULTS Nine hundred five patients answered the questionnaire. Most tumour patients (60%) received information about PA after their cancer therapy. The Internet was often rated to be inadequate as a source of information. One in two tumour patients were recommended PA by a therapist. During the acute phase, the majority (57% of the 776) did not receive a sport-therapeutic exercise programme. Two thirds (68%) of the 898 patients indicated regularly engaging in PA at least 3 or 5 days per week. In most cases (30% of the 787), 2 to 4 h per week were dedicated to PA. In addition to a desire to increase well-being, enjoyment played a large role. Weakness and lack of willpower are among the most common barriers. Most tumour patients confirmed that PA improved their body awareness (58%) or gave them the feeling that they could do something to better cope with the disease (61%) or feel better (68%). CONCLUSION On the one hand, the information requirements of tumour patients with respect to PA have not been adequately taken into account by practitioners. On the other hand, there are still subjective inhibitions on the part of the patients, which keep them from engaging in PA.
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Affiliation(s)
- Jan-Christoph Höh
- Department of Haematology and Medical Oncology, Clinic of Internal Medicine II of the University Hospital in Jena, Jena, Germany
| | - Thorsten Schmidt
- Comprehensive Cancer Center (CCC) North, University Medical Center Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, 24105, Kiel, Germany.
| | - Jutta Hübner
- Department of Haematology and Medical Oncology, Clinic of Internal Medicine II of the University Hospital in Jena, Jena, Germany
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Chlebowski RT, Aragaki AK, Anderson GL, Thomson CA, Manson JE, Simon MS, Howard BV, Rohan TE, Snetselar L, Lane D, Barrington W, Vitolins MZ, Womack C, Qi L, Hou L, Thomas F, Prentice RL. Low-Fat Dietary Pattern and Breast Cancer Mortality in the Women's Health Initiative Randomized Controlled Trial. J Clin Oncol 2017; 35:2919-2926. [PMID: 28654363 DOI: 10.1200/jco.2016.72.0326] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Purpose Earlier Women's Health Initiative Dietary Modification trial findings suggested that a low-fat eating pattern may reduce breast cancers with greater mortality. Therefore, as a primary outcome-related analysis from a randomized prevention trial, we examined the long-term influence of this intervention on deaths as a result of and after breast cancer during 8.5 years (median) of dietary intervention and cumulatively for all breast cancers diagnosed during 16.1 years (median) of follow-up. Patients and Methods The trial randomly assigned 48,835 postmenopausal women with normal mammograms and without prior breast cancer from 1993 to 1998 at 40 US clinical centers to a dietary intervention with goals of a reduction of fat intake to 20% of energy and an increased intake of fruits, vegetables, and grains (40%; n = 19,541) or to a usual diet comparison (60%; n = 29,294). Results In the dietary group, fat intake and body weight decreased (all P < .001). During the 8.5-year dietary intervention, with 1,764 incident breast cancers, fewer deaths occurred as a result of breast cancer in the dietary group, which was not statistically significant (27 deaths [0.016% per year] v 61 deaths [0.024% per year]; hazard ratio [HR], 0.67; 95% CI, 0.43 to 1.06; P = .08). During the same period, deaths after breast cancer (n = 134) were significantly reduced (40 deaths [0.025% per year] v 94 deaths [0.038% per year]; HR, 0.65; 95% CI, 0.45 to 0.94; P = .02) by the dietary intervention. During the 16.1-year follow-up, with 3,030 incident breast cancers, deaths after breast cancer also were significantly reduced (234 deaths [0.085% per year] v 443 deaths [0.11% per year]; HR, 0.82; 95% CI, 0.70 to 0.96; P = .01) in the dietary group. Conclusion Compared with a usual diet comparison group, a low-fat dietary pattern led to a lower incidence of deaths after breast cancer.
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Affiliation(s)
- Rowan T Chlebowski
- Rowan T. Chlebowski, Los Angeles Biomedical Research Institute, Torrance; Lihong Qi, University of California, Davis, Davis, CA; Aaron K. Aragaki, Garnet L. Anderson, Wendy Barrington, and Ross L. Prentice, Fred Hutchinson Cancer Research Center, Seattle, WA; Cynthia A. Thomson, University of Arizona Cancer Center, Tucson, AZ; JoAnn E. Manson, Brigham and Women's Hospital, Boston, MA; Michael S. Simon, Wayne State University, Detroit, MI; Barbara V. Howard, MedStar Health Research Institute; Barbara V. Howard, Georgetown-Howard Universities Center for Clinical and Translational Sciences, Washington, DC; Thomas E. Rohan, Albert Einstein College of Medicine, New York City; Dorothy Lane, Stony Brook University, Stony Brook, NY; Linda Snetselar, University of Iowa, Iowa City, IA; Catherine Womack, Methodist Healthcare; Fridtjof Thomas, University of Tennessee Health Science Center, Memphis, TN; Mara Z. Vitolins, Wake Forest School of Medicine, Winston-Salem, NC; and Lifang Hou, Northwestern University, Chicago, IL
| | - Aaron K Aragaki
- Rowan T. Chlebowski, Los Angeles Biomedical Research Institute, Torrance; Lihong Qi, University of California, Davis, Davis, CA; Aaron K. Aragaki, Garnet L. Anderson, Wendy Barrington, and Ross L. Prentice, Fred Hutchinson Cancer Research Center, Seattle, WA; Cynthia A. Thomson, University of Arizona Cancer Center, Tucson, AZ; JoAnn E. Manson, Brigham and Women's Hospital, Boston, MA; Michael S. Simon, Wayne State University, Detroit, MI; Barbara V. Howard, MedStar Health Research Institute; Barbara V. Howard, Georgetown-Howard Universities Center for Clinical and Translational Sciences, Washington, DC; Thomas E. Rohan, Albert Einstein College of Medicine, New York City; Dorothy Lane, Stony Brook University, Stony Brook, NY; Linda Snetselar, University of Iowa, Iowa City, IA; Catherine Womack, Methodist Healthcare; Fridtjof Thomas, University of Tennessee Health Science Center, Memphis, TN; Mara Z. Vitolins, Wake Forest School of Medicine, Winston-Salem, NC; and Lifang Hou, Northwestern University, Chicago, IL
| | - Garnet L Anderson
- Rowan T. Chlebowski, Los Angeles Biomedical Research Institute, Torrance; Lihong Qi, University of California, Davis, Davis, CA; Aaron K. Aragaki, Garnet L. Anderson, Wendy Barrington, and Ross L. Prentice, Fred Hutchinson Cancer Research Center, Seattle, WA; Cynthia A. Thomson, University of Arizona Cancer Center, Tucson, AZ; JoAnn E. Manson, Brigham and Women's Hospital, Boston, MA; Michael S. Simon, Wayne State University, Detroit, MI; Barbara V. Howard, MedStar Health Research Institute; Barbara V. Howard, Georgetown-Howard Universities Center for Clinical and Translational Sciences, Washington, DC; Thomas E. Rohan, Albert Einstein College of Medicine, New York City; Dorothy Lane, Stony Brook University, Stony Brook, NY; Linda Snetselar, University of Iowa, Iowa City, IA; Catherine Womack, Methodist Healthcare; Fridtjof Thomas, University of Tennessee Health Science Center, Memphis, TN; Mara Z. Vitolins, Wake Forest School of Medicine, Winston-Salem, NC; and Lifang Hou, Northwestern University, Chicago, IL
| | - Cynthia A Thomson
- Rowan T. Chlebowski, Los Angeles Biomedical Research Institute, Torrance; Lihong Qi, University of California, Davis, Davis, CA; Aaron K. Aragaki, Garnet L. Anderson, Wendy Barrington, and Ross L. Prentice, Fred Hutchinson Cancer Research Center, Seattle, WA; Cynthia A. Thomson, University of Arizona Cancer Center, Tucson, AZ; JoAnn E. Manson, Brigham and Women's Hospital, Boston, MA; Michael S. Simon, Wayne State University, Detroit, MI; Barbara V. Howard, MedStar Health Research Institute; Barbara V. Howard, Georgetown-Howard Universities Center for Clinical and Translational Sciences, Washington, DC; Thomas E. Rohan, Albert Einstein College of Medicine, New York City; Dorothy Lane, Stony Brook University, Stony Brook, NY; Linda Snetselar, University of Iowa, Iowa City, IA; Catherine Womack, Methodist Healthcare; Fridtjof Thomas, University of Tennessee Health Science Center, Memphis, TN; Mara Z. Vitolins, Wake Forest School of Medicine, Winston-Salem, NC; and Lifang Hou, Northwestern University, Chicago, IL
| | - JoAnn E Manson
- Rowan T. Chlebowski, Los Angeles Biomedical Research Institute, Torrance; Lihong Qi, University of California, Davis, Davis, CA; Aaron K. Aragaki, Garnet L. Anderson, Wendy Barrington, and Ross L. Prentice, Fred Hutchinson Cancer Research Center, Seattle, WA; Cynthia A. Thomson, University of Arizona Cancer Center, Tucson, AZ; JoAnn E. Manson, Brigham and Women's Hospital, Boston, MA; Michael S. Simon, Wayne State University, Detroit, MI; Barbara V. Howard, MedStar Health Research Institute; Barbara V. Howard, Georgetown-Howard Universities Center for Clinical and Translational Sciences, Washington, DC; Thomas E. Rohan, Albert Einstein College of Medicine, New York City; Dorothy Lane, Stony Brook University, Stony Brook, NY; Linda Snetselar, University of Iowa, Iowa City, IA; Catherine Womack, Methodist Healthcare; Fridtjof Thomas, University of Tennessee Health Science Center, Memphis, TN; Mara Z. Vitolins, Wake Forest School of Medicine, Winston-Salem, NC; and Lifang Hou, Northwestern University, Chicago, IL
| | - Michael S Simon
- Rowan T. Chlebowski, Los Angeles Biomedical Research Institute, Torrance; Lihong Qi, University of California, Davis, Davis, CA; Aaron K. Aragaki, Garnet L. Anderson, Wendy Barrington, and Ross L. Prentice, Fred Hutchinson Cancer Research Center, Seattle, WA; Cynthia A. Thomson, University of Arizona Cancer Center, Tucson, AZ; JoAnn E. Manson, Brigham and Women's Hospital, Boston, MA; Michael S. Simon, Wayne State University, Detroit, MI; Barbara V. Howard, MedStar Health Research Institute; Barbara V. Howard, Georgetown-Howard Universities Center for Clinical and Translational Sciences, Washington, DC; Thomas E. Rohan, Albert Einstein College of Medicine, New York City; Dorothy Lane, Stony Brook University, Stony Brook, NY; Linda Snetselar, University of Iowa, Iowa City, IA; Catherine Womack, Methodist Healthcare; Fridtjof Thomas, University of Tennessee Health Science Center, Memphis, TN; Mara Z. Vitolins, Wake Forest School of Medicine, Winston-Salem, NC; and Lifang Hou, Northwestern University, Chicago, IL
| | - Barbara V Howard
- Rowan T. Chlebowski, Los Angeles Biomedical Research Institute, Torrance; Lihong Qi, University of California, Davis, Davis, CA; Aaron K. Aragaki, Garnet L. Anderson, Wendy Barrington, and Ross L. Prentice, Fred Hutchinson Cancer Research Center, Seattle, WA; Cynthia A. Thomson, University of Arizona Cancer Center, Tucson, AZ; JoAnn E. Manson, Brigham and Women's Hospital, Boston, MA; Michael S. Simon, Wayne State University, Detroit, MI; Barbara V. Howard, MedStar Health Research Institute; Barbara V. Howard, Georgetown-Howard Universities Center for Clinical and Translational Sciences, Washington, DC; Thomas E. Rohan, Albert Einstein College of Medicine, New York City; Dorothy Lane, Stony Brook University, Stony Brook, NY; Linda Snetselar, University of Iowa, Iowa City, IA; Catherine Womack, Methodist Healthcare; Fridtjof Thomas, University of Tennessee Health Science Center, Memphis, TN; Mara Z. Vitolins, Wake Forest School of Medicine, Winston-Salem, NC; and Lifang Hou, Northwestern University, Chicago, IL
| | - Thomas E Rohan
- Rowan T. Chlebowski, Los Angeles Biomedical Research Institute, Torrance; Lihong Qi, University of California, Davis, Davis, CA; Aaron K. Aragaki, Garnet L. Anderson, Wendy Barrington, and Ross L. Prentice, Fred Hutchinson Cancer Research Center, Seattle, WA; Cynthia A. Thomson, University of Arizona Cancer Center, Tucson, AZ; JoAnn E. Manson, Brigham and Women's Hospital, Boston, MA; Michael S. Simon, Wayne State University, Detroit, MI; Barbara V. Howard, MedStar Health Research Institute; Barbara V. Howard, Georgetown-Howard Universities Center for Clinical and Translational Sciences, Washington, DC; Thomas E. Rohan, Albert Einstein College of Medicine, New York City; Dorothy Lane, Stony Brook University, Stony Brook, NY; Linda Snetselar, University of Iowa, Iowa City, IA; Catherine Womack, Methodist Healthcare; Fridtjof Thomas, University of Tennessee Health Science Center, Memphis, TN; Mara Z. Vitolins, Wake Forest School of Medicine, Winston-Salem, NC; and Lifang Hou, Northwestern University, Chicago, IL
| | - Linda Snetselar
- Rowan T. Chlebowski, Los Angeles Biomedical Research Institute, Torrance; Lihong Qi, University of California, Davis, Davis, CA; Aaron K. Aragaki, Garnet L. Anderson, Wendy Barrington, and Ross L. Prentice, Fred Hutchinson Cancer Research Center, Seattle, WA; Cynthia A. Thomson, University of Arizona Cancer Center, Tucson, AZ; JoAnn E. Manson, Brigham and Women's Hospital, Boston, MA; Michael S. Simon, Wayne State University, Detroit, MI; Barbara V. Howard, MedStar Health Research Institute; Barbara V. Howard, Georgetown-Howard Universities Center for Clinical and Translational Sciences, Washington, DC; Thomas E. Rohan, Albert Einstein College of Medicine, New York City; Dorothy Lane, Stony Brook University, Stony Brook, NY; Linda Snetselar, University of Iowa, Iowa City, IA; Catherine Womack, Methodist Healthcare; Fridtjof Thomas, University of Tennessee Health Science Center, Memphis, TN; Mara Z. Vitolins, Wake Forest School of Medicine, Winston-Salem, NC; and Lifang Hou, Northwestern University, Chicago, IL
| | - Dorothy Lane
- Rowan T. Chlebowski, Los Angeles Biomedical Research Institute, Torrance; Lihong Qi, University of California, Davis, Davis, CA; Aaron K. Aragaki, Garnet L. Anderson, Wendy Barrington, and Ross L. Prentice, Fred Hutchinson Cancer Research Center, Seattle, WA; Cynthia A. Thomson, University of Arizona Cancer Center, Tucson, AZ; JoAnn E. Manson, Brigham and Women's Hospital, Boston, MA; Michael S. Simon, Wayne State University, Detroit, MI; Barbara V. Howard, MedStar Health Research Institute; Barbara V. Howard, Georgetown-Howard Universities Center for Clinical and Translational Sciences, Washington, DC; Thomas E. Rohan, Albert Einstein College of Medicine, New York City; Dorothy Lane, Stony Brook University, Stony Brook, NY; Linda Snetselar, University of Iowa, Iowa City, IA; Catherine Womack, Methodist Healthcare; Fridtjof Thomas, University of Tennessee Health Science Center, Memphis, TN; Mara Z. Vitolins, Wake Forest School of Medicine, Winston-Salem, NC; and Lifang Hou, Northwestern University, Chicago, IL
| | - Wendy Barrington
- Rowan T. Chlebowski, Los Angeles Biomedical Research Institute, Torrance; Lihong Qi, University of California, Davis, Davis, CA; Aaron K. Aragaki, Garnet L. Anderson, Wendy Barrington, and Ross L. Prentice, Fred Hutchinson Cancer Research Center, Seattle, WA; Cynthia A. Thomson, University of Arizona Cancer Center, Tucson, AZ; JoAnn E. Manson, Brigham and Women's Hospital, Boston, MA; Michael S. Simon, Wayne State University, Detroit, MI; Barbara V. Howard, MedStar Health Research Institute; Barbara V. Howard, Georgetown-Howard Universities Center for Clinical and Translational Sciences, Washington, DC; Thomas E. Rohan, Albert Einstein College of Medicine, New York City; Dorothy Lane, Stony Brook University, Stony Brook, NY; Linda Snetselar, University of Iowa, Iowa City, IA; Catherine Womack, Methodist Healthcare; Fridtjof Thomas, University of Tennessee Health Science Center, Memphis, TN; Mara Z. Vitolins, Wake Forest School of Medicine, Winston-Salem, NC; and Lifang Hou, Northwestern University, Chicago, IL
| | - Mara Z Vitolins
- Rowan T. Chlebowski, Los Angeles Biomedical Research Institute, Torrance; Lihong Qi, University of California, Davis, Davis, CA; Aaron K. Aragaki, Garnet L. Anderson, Wendy Barrington, and Ross L. Prentice, Fred Hutchinson Cancer Research Center, Seattle, WA; Cynthia A. Thomson, University of Arizona Cancer Center, Tucson, AZ; JoAnn E. Manson, Brigham and Women's Hospital, Boston, MA; Michael S. Simon, Wayne State University, Detroit, MI; Barbara V. Howard, MedStar Health Research Institute; Barbara V. Howard, Georgetown-Howard Universities Center for Clinical and Translational Sciences, Washington, DC; Thomas E. Rohan, Albert Einstein College of Medicine, New York City; Dorothy Lane, Stony Brook University, Stony Brook, NY; Linda Snetselar, University of Iowa, Iowa City, IA; Catherine Womack, Methodist Healthcare; Fridtjof Thomas, University of Tennessee Health Science Center, Memphis, TN; Mara Z. Vitolins, Wake Forest School of Medicine, Winston-Salem, NC; and Lifang Hou, Northwestern University, Chicago, IL
| | - Catherine Womack
- Rowan T. Chlebowski, Los Angeles Biomedical Research Institute, Torrance; Lihong Qi, University of California, Davis, Davis, CA; Aaron K. Aragaki, Garnet L. Anderson, Wendy Barrington, and Ross L. Prentice, Fred Hutchinson Cancer Research Center, Seattle, WA; Cynthia A. Thomson, University of Arizona Cancer Center, Tucson, AZ; JoAnn E. Manson, Brigham and Women's Hospital, Boston, MA; Michael S. Simon, Wayne State University, Detroit, MI; Barbara V. Howard, MedStar Health Research Institute; Barbara V. Howard, Georgetown-Howard Universities Center for Clinical and Translational Sciences, Washington, DC; Thomas E. Rohan, Albert Einstein College of Medicine, New York City; Dorothy Lane, Stony Brook University, Stony Brook, NY; Linda Snetselar, University of Iowa, Iowa City, IA; Catherine Womack, Methodist Healthcare; Fridtjof Thomas, University of Tennessee Health Science Center, Memphis, TN; Mara Z. Vitolins, Wake Forest School of Medicine, Winston-Salem, NC; and Lifang Hou, Northwestern University, Chicago, IL
| | - Lihong Qi
- Rowan T. Chlebowski, Los Angeles Biomedical Research Institute, Torrance; Lihong Qi, University of California, Davis, Davis, CA; Aaron K. Aragaki, Garnet L. Anderson, Wendy Barrington, and Ross L. Prentice, Fred Hutchinson Cancer Research Center, Seattle, WA; Cynthia A. Thomson, University of Arizona Cancer Center, Tucson, AZ; JoAnn E. Manson, Brigham and Women's Hospital, Boston, MA; Michael S. Simon, Wayne State University, Detroit, MI; Barbara V. Howard, MedStar Health Research Institute; Barbara V. Howard, Georgetown-Howard Universities Center for Clinical and Translational Sciences, Washington, DC; Thomas E. Rohan, Albert Einstein College of Medicine, New York City; Dorothy Lane, Stony Brook University, Stony Brook, NY; Linda Snetselar, University of Iowa, Iowa City, IA; Catherine Womack, Methodist Healthcare; Fridtjof Thomas, University of Tennessee Health Science Center, Memphis, TN; Mara Z. Vitolins, Wake Forest School of Medicine, Winston-Salem, NC; and Lifang Hou, Northwestern University, Chicago, IL
| | - Lifang Hou
- Rowan T. Chlebowski, Los Angeles Biomedical Research Institute, Torrance; Lihong Qi, University of California, Davis, Davis, CA; Aaron K. Aragaki, Garnet L. Anderson, Wendy Barrington, and Ross L. Prentice, Fred Hutchinson Cancer Research Center, Seattle, WA; Cynthia A. Thomson, University of Arizona Cancer Center, Tucson, AZ; JoAnn E. Manson, Brigham and Women's Hospital, Boston, MA; Michael S. Simon, Wayne State University, Detroit, MI; Barbara V. Howard, MedStar Health Research Institute; Barbara V. Howard, Georgetown-Howard Universities Center for Clinical and Translational Sciences, Washington, DC; Thomas E. Rohan, Albert Einstein College of Medicine, New York City; Dorothy Lane, Stony Brook University, Stony Brook, NY; Linda Snetselar, University of Iowa, Iowa City, IA; Catherine Womack, Methodist Healthcare; Fridtjof Thomas, University of Tennessee Health Science Center, Memphis, TN; Mara Z. Vitolins, Wake Forest School of Medicine, Winston-Salem, NC; and Lifang Hou, Northwestern University, Chicago, IL
| | - Fridtjof Thomas
- Rowan T. Chlebowski, Los Angeles Biomedical Research Institute, Torrance; Lihong Qi, University of California, Davis, Davis, CA; Aaron K. Aragaki, Garnet L. Anderson, Wendy Barrington, and Ross L. Prentice, Fred Hutchinson Cancer Research Center, Seattle, WA; Cynthia A. Thomson, University of Arizona Cancer Center, Tucson, AZ; JoAnn E. Manson, Brigham and Women's Hospital, Boston, MA; Michael S. Simon, Wayne State University, Detroit, MI; Barbara V. Howard, MedStar Health Research Institute; Barbara V. Howard, Georgetown-Howard Universities Center for Clinical and Translational Sciences, Washington, DC; Thomas E. Rohan, Albert Einstein College of Medicine, New York City; Dorothy Lane, Stony Brook University, Stony Brook, NY; Linda Snetselar, University of Iowa, Iowa City, IA; Catherine Womack, Methodist Healthcare; Fridtjof Thomas, University of Tennessee Health Science Center, Memphis, TN; Mara Z. Vitolins, Wake Forest School of Medicine, Winston-Salem, NC; and Lifang Hou, Northwestern University, Chicago, IL
| | - Ross L Prentice
- Rowan T. Chlebowski, Los Angeles Biomedical Research Institute, Torrance; Lihong Qi, University of California, Davis, Davis, CA; Aaron K. Aragaki, Garnet L. Anderson, Wendy Barrington, and Ross L. Prentice, Fred Hutchinson Cancer Research Center, Seattle, WA; Cynthia A. Thomson, University of Arizona Cancer Center, Tucson, AZ; JoAnn E. Manson, Brigham and Women's Hospital, Boston, MA; Michael S. Simon, Wayne State University, Detroit, MI; Barbara V. Howard, MedStar Health Research Institute; Barbara V. Howard, Georgetown-Howard Universities Center for Clinical and Translational Sciences, Washington, DC; Thomas E. Rohan, Albert Einstein College of Medicine, New York City; Dorothy Lane, Stony Brook University, Stony Brook, NY; Linda Snetselar, University of Iowa, Iowa City, IA; Catherine Womack, Methodist Healthcare; Fridtjof Thomas, University of Tennessee Health Science Center, Memphis, TN; Mara Z. Vitolins, Wake Forest School of Medicine, Winston-Salem, NC; and Lifang Hou, Northwestern University, Chicago, IL
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Epidemiology and biology of physical activity and cancer recurrence. J Mol Med (Berl) 2017; 95:1029-1041. [PMID: 28620703 PMCID: PMC5613065 DOI: 10.1007/s00109-017-1558-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 05/24/2017] [Accepted: 06/02/2017] [Indexed: 12/12/2022]
Abstract
Physical activity is emerging from epidemiologic research as a lifestyle factor that may improve survival from colorectal, breast, and prostate cancers. However, there is considerably less evidence relating physical activity to cancer recurrence and the biologic mechanisms underlying this association remain unclear. Cancer patients are surviving longer than ever before, and fear of cancer recurrence is an important concern. Herein, we provide an overview of the current epidemiologic evidence relating physical activity to cancer recurrence. We review the biologic mechanisms most commonly researched in the context of physical activity and cancer outcomes, and, using the example of colorectal cancer, we explore hypothesized mechanisms through which physical activity might intervene in the colorectal recurrence pathway. Our review highlights the importance of considering pre-diagnosis and post-diagnosis activity, as well as cancer stage and timing of recurrence, in epidemiologic studies. In addition, more epidemiologic research is needed with cancer recurrence as a consistently defined outcome studied separately from survival. Future mechanistic research using randomized controlled trials, specifically those demonstrating the exercise responsiveness of hypothesized mechanisms in early stages of carcinogenesis, are needed to inform recommendations about when to exercise and to anticipate additive or synergistic effects with other preventive behaviors or treatments.
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Geyer C. When Diet and Exercise Aren't Enough: The Added Benefits of Connection, Community, and Psychosocial Support in Navigating Breast Cancer Treatment. Am J Lifestyle Med 2017; 11:436-439. [PMID: 30202367 DOI: 10.1177/1559827617713170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Breast cancer is the most common cancer diagnosis in women, and many lifestyle factors have been linked to an elevated risk for development of the disease. This case provides an example of how breast cancer can occur even in people who engage in healthy lifestyle behaviors, yet underscores the importance of exercise, healthy dietary patterns, and addressing psychological distress in supporting women through their treatment and beyond.
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