1
|
Metcalfe JW, Orange ST, Madden LA, Marshall P, Vince RV. Effects of resistance training on quality of life, fatigue, physical function, and muscular strength during chemotherapy treatment: a systematic review and meta-analysis. Support Care Cancer 2024; 32:593. [PMID: 39153023 PMCID: PMC11330399 DOI: 10.1007/s00520-024-08766-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 07/26/2024] [Indexed: 08/19/2024]
Abstract
PURPOSE To systematically review and meta-analyse the efficacy of resistance training on quality of life (QOL), fatigue, physical function, and muscular strength in people diagnosed with cancer undergoing chemotherapy. METHODS Electronic databases PubMed, Cochrane Central, CINAHL, SCOPUS and Web of Science were systematically searched for randomised controlled trials (RCTs) that compared the effects of resistance training to control on QOL, fatigue, physical function, and lower-body and upper-body muscular strength in adults undergoing chemotherapy. Standardised mean differences (SMDs) were pooled using a random effects model. Risk of bias was assess using the risk of bias tool for randomised trials (RoB 2). RESULTS Seven RCTs encompassing 561 participants were included. The pooled results of seven RCTs showed that resistance training during chemotherapy significantly improved lower-body strength (n = 555, SMD 0.33, 95% CI 0.12 to 0.53, moderate-quality evidence, I2 = 23%) compared to control. There was no evidence for an effect of resistance training on QOL (n = 373, SMD 0.13, 95% CI -0.15 to 0.42, low-quality evidence, I2 = 0%), fatigue (n = 373, SMD -0.08, 95% CI -0.37 to 0.22, low-quality evidence, I2 = 20%), physical function (n = 198, SMD 0.61, 95% CI -0.73 to 1.95, very low-quality evidence, I2 = 83%), or upper-body strength (n = 413, SMD 0.37, 95% CI -0.07 to 0.80, very low-quality evidence, I2 = 69%). CONCLUSIONS Resistance training may improve lower-body strength in patients undergoing chemotherapy treatment compared to control.
Collapse
Affiliation(s)
- James W Metcalfe
- School of Sport, Exercise & Rehabilitation Sciences, Faculty of Health Sciences, University of Hull, Hull, UK.
| | - Samuel T Orange
- School of Biomedical, Nutritional and Sport Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
- Newcastle University Centre for Cancer, Newcastle University, Newcastle Upon Tyne, UK
| | - Leigh A Madden
- Centre for Biomedicine, Hull York Medical School, University of Hull, Hull, UK
| | - Phil Marshall
- School of Sport, Exercise & Rehabilitation Sciences, Faculty of Health Sciences, University of Hull, Hull, UK
| | - Rebecca V Vince
- School of Sport, Exercise & Rehabilitation Sciences, Faculty of Health Sciences, University of Hull, Hull, UK
| |
Collapse
|
2
|
Corso-Amado C, Muñoz-Rodríguez D, Hormiga-Sánchez C. [Self-sense and experiences of physical activity in breast cancer survivors: Qualitative evidence synthesis]. Rehabilitacion (Madr) 2024; 58:100851. [PMID: 38703489 DOI: 10.1016/j.rh.2024.100851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 04/04/2024] [Accepted: 04/07/2024] [Indexed: 05/06/2024]
Abstract
Breast cancer has a high incidence rate and a negative impact on women's lives. The practice of physical activity (PA) has shown strong evidence in controlling the side effects associated with the disease and its treatment. However, having an active lifestyle is influenced by socio-health inequities. The objective was to analyze the categories related to the meanings and perceived experiences with PA in breast cancer survivors (BCS). Protocol https://osf.io/7fwbs/. Articles describing the meanings of PA in BCS published after 2010 were included. Fourteen articles were analyzed using line-by-line coding. The emerging categories were: 1)PA as a strategy to re-signify and empower the body. 2)Cancer means a change in PA trajectories. 3)PA is a tool for a healthy and functional body in everyday life.
Collapse
Affiliation(s)
- C Corso-Amado
- Facultad de Medicina, Universidad Autónoma de Bucaramanga, Bucaramanga, Santander, Colombia.
| | - D Muñoz-Rodríguez
- Facultad de Fisioterapia, Universidad CES, Medellín, Antioquia, Colombia
| | - C Hormiga-Sánchez
- Facultad de Medicina, Universidad Autónoma de Bucaramanga, Bucaramanga, Santander, Colombia
| |
Collapse
|
3
|
Fhlannagáin NN, Greaney C, Byrne C, Keaver L. A qualitative analysis of nutritional needs and dietary changes during cancer treatment in Ireland. Ir J Med Sci 2024; 193:1171-1182. [PMID: 38010446 DOI: 10.1007/s11845-023-03572-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 11/10/2023] [Indexed: 11/29/2023]
Abstract
INTRODUCTION Cancer and its associated side effects can cause changes in dietary intakes of people with cancer due to a variety of nutrition impact symptoms. These symptoms can lead to suboptimal dietary intakes which negatively affect muscle mass and therefore survivorship. The aim of this qualitative study was to assess the nutrition needs and dietary changes made by cancer patients in Ireland. METHODS Online focus groups were completed with cancer patients and caregivers, and demographic information was collected via an online questionnaire. An inductive thematic analysis approach was utilised to derive themes and subthemes from the data. RESULTS Four online focus groups were held with cancer patients and caregivers (n = 15) which reflected 18 total cancer experiences. Novel themes identified from this research included that symptoms were varied and transient-coming and going rapidly-and that patients were not satisfied with dietetic and broader nutrition services provided by hospitals. Themes that aligned with previous research were the severity and variety of nutrition impact symptoms and the variety of both evidence-based and non-evidence-based nutrition strategies used by patients to overcome nutrition impact symptoms, as general coping strategies, and potentially due to the belief that nutrition can be curative. CONCLUSION Treatment of nutrition impact symptoms must be rapid and responsive. The development of responsive self-management resources such as booklets and apps for patients is likely to be valuable to ensure that patients can access support for their nutrition impact symptoms as-and when-they occur. Nutrition support must be integrated across the multi-disciplinary team to optimise trust in nutrition strategies.
Collapse
Affiliation(s)
| | - Cian Greaney
- School of Allied Health, University of Limerick, Limerick, V94 T9PX, Ireland
| | - Clare Byrne
- Atlantic Technological University, Galway, Ireland
| | - Laura Keaver
- Department of Health and Nutritional Science, Atlantic Technological University, Sligo, Ireland
| |
Collapse
|
4
|
Fukushima T, Suzuki K, Tanaka T, Okayama T, Inoue J, Morishita S, Nakano J. Global quality of life and mortality risk in patients with cancer: a systematic review and meta-analysis. Qual Life Res 2024:10.1007/s11136-024-03691-3. [PMID: 38811448 DOI: 10.1007/s11136-024-03691-3] [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] [Accepted: 05/20/2024] [Indexed: 05/31/2024]
Abstract
PURPOSE This systematic review and meta-analysis aimed to examine the impact of global quality of life (QOL) on mortality risk in patients with cancer, considering cancer type and timepoint of QOL assessment. METHODS A systematic search was conducted using Cumulated Index to Nursing and Allied Health Literature, PubMed/MEDLINE, and Scopus databases from inception to December 2022. Observational studies that assessed QOL and examined mortality risk in patients with cancer were extracted. Subgroup analyses were performed for cancer types and timepoints of QOL assessment. RESULTS Overall, global QOL was significantly associated with mortality risk (hazard ratio: 1.06, 95% confidence interval: 1.05-1.07; p < 0.00001). A subgroup analysis based on cancer type demonstrated that lung, head and neck, breast, esophagus, colon, prostate, hematologic, liver, gynecologic, stomach, brain, bladder, bone and soft tissue, and mixed type cancers were significantly associated with mortality risk; however, melanoma and pancreatic cancer were not significantly associated with mortality risk. Additionally, global QOL was associated with mortality risk at all timepoints (pretreatment, posttreatment, and palliative phase); pretreatment QOL had the largest impact, followed by posttreatment QOL. CONCLUSION These findings provide evidence that QOL is associated with mortality risk in patients with cancer at any timepoint. These results indicate the importance of evaluating the QOL and supportive interventions to improve QOL in any phase.
Collapse
Affiliation(s)
- Takuya Fukushima
- Faculty of Rehabilitation, Kansai Medical University, Osaka, Japan.
| | - Katsuyoshi Suzuki
- Division of Rehabilitation Medicine, Shizuoka Cancer Center, Shizuoka, Japan
| | - Takashi Tanaka
- Department of Rehabilitation, Hyogo Medical University Hospital, Nishinomiya, Japan
| | - Taro Okayama
- Division of Rehabilitation Medicine, Shizuoka Cancer Center, Shizuoka, Japan
| | - Junichiro Inoue
- Division of Rehabilitation Medicine, Kobe University Hospital International Clinical Cancer Research Center, Kobe, Japan
| | - Shinichiro Morishita
- Department of Physical Therapy, School of Health Science, Fukushima Medical University, Fukushima, Japan
| | - Jiro Nakano
- Faculty of Rehabilitation, Kansai Medical University, Osaka, Japan
| |
Collapse
|
5
|
Nyrop KA, Page A, Deal AM, Wagoner C, Kelly EA, Kimmick GG, Copeland A, Speca J, Wood WA, Muss HB. Association of self-directed walking with toxicity moderation during chemotherapy for the treatment of early breast cancer. Support Care Cancer 2023; 32:68. [PMID: 38153568 DOI: 10.1007/s00520-023-08275-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 12/18/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND In the field of exercise oncology, there is a need to quantify the potential benefits of moderate, self-directed physical activity during active treatment. In a pooled analysis of three identical single-arm intervention studies, we investigate the association of activity tracker steps with patient-reported toxicities during chemotherapy. METHODS Women with early breast cancer who were enrolled in the intervention studies reported their symptom severity every 2-3 weeks throughout chemotherapy, and daily steps were documented through a Fitbit activity tracker. Relative risks (RR) and 95% confidence intervals (CI) were calculated using Poisson regression models with robust variance. For outcomes significant in unadjusted models, adjusted RRs were calculated controlling for race, age, and education level. Tracker step cut point (high step, low step) was determined by the means. Cumulative incidence functions of moderate, severe, and very severe (MSVS) symptoms were estimated using the Kaplan-Meier method and compared using a Cox proportional hazard model. RESULTS In a sample of 283 women, mean age was 56 years and 76% were White. Mean tracker-documented steps/week were 29,625, with 55% walking below the mean (low step) and 45% above (high step). In multivariable analysis, high step patients had lower risk for fatigue [RR 0.83 (0.70, 0.99)] (p = 0.04), anxiety [RR 0.59 (0.42, 0.84)] (p = 0.003), nausea [RR 0.66 (0.46, 0.96)] (p = 0.03), depression [RR 0.59 (0.37, 0.03)] (p = 0.02), and ≥ 6 MSVS symptoms [RR 0.73 (0.54, 1.00)] (p = 0.05) and had 36% lower risk for dose reductions [RR 0.64 (95% CI 0.43, 0.97)] (p = 0.03). CONCLUSION Self-directed walking at a rate of at least 30,000 steps/week may moderate the severity of treatment side effects during chemotherapy for early breast cancer. TRIAL NUMBERS NCT02167932, NCT02328313, NCT03761706.
Collapse
Affiliation(s)
- K A Nyrop
- Division of Oncology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, USA.
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, USA.
| | - A Page
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - A M Deal
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - C Wagoner
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - E A Kelly
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | | | | | - JoEllen Speca
- UNC Rex Cancer Care, UNC Rex Healthcare, Raleigh, USA
| | - William A Wood
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, USA
- Division of Hematology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - H B Muss
- Division of Oncology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, USA
| |
Collapse
|
6
|
Andersen C, Adamsen L, Damhus CS, Piil K, Missel M, Jarden M, Larsen A, Larsen HB, Møller T. Qualitative exploration of the perceptions of exercise in patients with cancer initiated during chemotherapy: a meta-synthesis. BMJ Open 2023; 13:e074266. [PMID: 38086582 PMCID: PMC10729187 DOI: 10.1136/bmjopen-2023-074266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 11/20/2023] [Indexed: 12/18/2023] Open
Abstract
OBJECTIVE To synthesise qualitative literature on (1) the perceptions of patients with cancer of participating in an exercise intervention while undergoing chemotherapy and (2) to inform and guide professionals in oncology and haematology practice. DESIGN A qualitative meta-synthesis based on Noblit and Hare's seven-step meta-ethnography. DATA SOURCES Six electronic databases: Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, EMBASE, PubMed, SCI-Expanded-SSCI and Scopus (final search June 2022) were used to identify qualitative literature containing individual or focus group interviews. The transparency of reporting for each study was assessed using the Consolidated criteria for Reporting Qualitative research checklist. RESULTS The search identified 5002 articles, 107 of which were selected for full-text review. Seventeen articles from five countries with patients undergoing chemotherapy during exercise interventions were included. Eleven articles were included in the meta-synthesis, which comprised 193 patients with various cancer diagnoses, disease stages, sexes and ages. Four main themes were identified: chemotherapy overpowers the body; exercise in battle with side effects; a break from gloomy thoughts; and a question of survivorship. CONCLUSIONS AND IMPLICATIONS The meta-synthesis emphasised that patients with cancer undergoing chemotherapy and simultaneously participating in exercise interventions may experience momentary relief from overwhelming side effects, even though full bodily recovery may be perceived as a distant prospect. The synthesis offers a sparse empirical basis for gaining insight into what patients experience existentially following exercise interventions. It is up to patients to independently apply the transfer value of exercise to their own existential circumstances.
Collapse
Affiliation(s)
- Christina Andersen
- Center for Health Research (UCSF), Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Lis Adamsen
- Center for Health Research (UCSF), Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Christina Sadolin Damhus
- Department of Public Health, University of Copenhagen Faculty of Health and Medical Sciences, Copenhagen, Denmark
| | - Karin Piil
- Department of Oncology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Malene Missel
- Department of Cardiothoracic Surgery, Copenhagen University Hospital, Copenhagen, Denmark
| | - Mary Jarden
- Department of Public Health, University of Copenhagen Faculty of Health and Medical Sciences, Copenhagen, Denmark
- Department of Heamatology, Centre for Cancer and Organ Diseases, University of Copenhagen, Copenhagen, Denmark
| | - Anders Larsen
- Center for Health Research (UCSF), Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Hanne Baekgaard Larsen
- Department of Public Health, University of Copenhagen Faculty of Health and Medical Sciences, Copenhagen, Denmark
- Department of Peadiatrics and Adolescent Medicine, Copenhagen University Hospital, Copenhagen, Denmark
| | - Tom Møller
- Center for Health Research (UCSF), Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen Faculty of Health and Medical Sciences, Copenhagen, Denmark
| |
Collapse
|
7
|
Parkinson JF, Ospina PA, Round J, McNeely ML, Jones CA. Generic Health Utility Measures in Exercise Oncology: A Scoping Review and Future Directions. Curr Oncol 2023; 30:8888-8901. [PMID: 37887542 PMCID: PMC10605555 DOI: 10.3390/curroncol30100642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 09/11/2023] [Accepted: 09/23/2023] [Indexed: 10/28/2023] Open
Abstract
Despite the evidence that exercise is effective at mitigating common side effects in adults with cancer, it is rarely part of usual cancer care. One reason for this is the lack of economic evidence supporting the benefit of exercise. Economic evaluations often rely on the use of generic utility measures to assess cost effectiveness. This review identifies and synthesizes the literature on the use of generic utility measures used to evaluate exercise interventions for adults with cancer. A systematic search of the literature from January 2000 to February 2023 was conducted using four databases (Medline, EMBASE, CINAHL, Academic Search Complete). Exercise studies involving adults with any type of cancer that used a generic utility measure were eligible for inclusion. Of the 2780 citations retrieved, 10 articles were included in this review. Seven articles included economic evaluations, with varying results. Four studies reported on cost-effectiveness; however, detailed effectiveness data derived from the generic utility measure were often not reported. Generic utility measures help to compare baseline values of and changes in health utility weights across studies and to general population norms; however, to date, they are underutilized in exercise oncology studies. Consideration should be given to the identified research evidence, population, and methodological gaps.
Collapse
Affiliation(s)
- Joanna F. Parkinson
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2G4, Canada; (J.F.P.); (P.A.O.); (C.A.J.)
| | - Paula A. Ospina
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2G4, Canada; (J.F.P.); (P.A.O.); (C.A.J.)
| | - Jeff Round
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 1C9, Canada;
- Institute of Health Economics, Edmonton, AB T5J 3N4, Canada
| | - Margaret L. McNeely
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2G4, Canada; (J.F.P.); (P.A.O.); (C.A.J.)
- Department of Oncology, Cancer Care Alberta, Edmonton, AB T6G 1Z2, Canada
| | - C. Allyson Jones
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2G4, Canada; (J.F.P.); (P.A.O.); (C.A.J.)
- School of Public Health, University of Alberta, Edmonton, AB T6G 1C9, Canada
| |
Collapse
|
8
|
van Eckert S, Seidel N, Stölzel F, Wolff M, Glausch M, Spallek J. [Living Actively with Cancer - Recommendations for a Healthy Life Style: Needs Assessment and Design of Multimedia Patient Information]. DAS GESUNDHEITSWESEN 2023; 85:227-233. [PMID: 35073593 PMCID: PMC11248723 DOI: 10.1055/a-1709-0939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The positive effects of a healthy lifestyle on the holistic physical condition and quality of life of cancer survivors is scientifically proven. The National Comprehensive Cancer Network (NCCN) Guidelines for Survivorship specifically highlight the need for support in these areas. The lack of specialised offers for cancer patients in predominantly rural areas, however, represents a high level of assistance needed in terms of the development and implementation of a healthy lifestyle. Following a needs assessment, our aim was to conceptualise and design an easily accessible multi-media patient information system on the basis of a social-cognitive process model on health behaviour (Health Action Process Approach - HAPA). A higher level of health literacy represents, inter alia, the basis for informed choice and, as such, forms an important resource for the aftercare of cancer patients. Further studies are recommended on the acceptance, use and effects of patient information with regard to intended longer-term changes of health behaviour.
Collapse
Affiliation(s)
- Sandra van Eckert
- Gesundheitswissenschaften, Brandenburgische Technische Universität Cottbus-Senftenberg Fakultät 4 Soziale Arbeit Gesundheit und Musik, Senftenberg, Germany
| | - Nadja Seidel
- Nationales Centrum für Tumorerkrankungen Dresden (NCT/UCC), Präventionszentrum, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - Friederike Stölzel
- Nationales Centrum für Tumorerkrankungen Dresden (NCT/UCC), Präventionszentrum, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - Michaela Wolff
- Nationales Centrum für Tumorerkrankungen Dresden (NCT/UCC), Präventionszentrum, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - Melanie Glausch
- Nationales Centrum für Tumorerkrankungen Dresden (NCT/UCC), Präventionszentrum, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - Jacob Spallek
- Gesundheitswissenschaften, Brandenburgische Technische Universität Cottbus-Senftenberg Fakultät 4 Soziale Arbeit Gesundheit und Musik, Senftenberg, Germany
| |
Collapse
|
9
|
Morishita S, Suzuki K, Okayama T, Inoue J, Tanaka T, Nakano J, Fukushima T. Recent Findings in Physical Exercise for Cancer Survivors. Phys Ther Res 2023; 26:10-16. [PMID: 37181484 PMCID: PMC10169310 DOI: 10.1298/ptr.r0023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 02/10/2023] [Indexed: 05/16/2023]
Abstract
In recent years, the number of cancer survivors has been increasing each year due to advances in the early diagnosis and treatment of cancer. Cancer survivors present a variety of physical and psychological complications due to cancer and its treatment. Physical exercise is an effective nonpharmacological treatment for complications in cancer survivors. Furthermore, recent evidence has shown that physical exercise improves the prognosis of cancer survivors. The benefits of physical exercise have been widely reported, and guidelines for physical exercise for cancer survivors have been published. These guidelines recommend that cancer survivors engage in moderate- or vigorous-intensity aerobic exercises and/or resistance training. However, many cancer survivors have a poor commitment to physical exercise. In the future, it is necessary to promote physical exercise among cancer survivors through outpatient rehabilitation and community support.
Collapse
Affiliation(s)
- Shinichiro Morishita
- Department of Physical Therapy, School of Health Sciences, Fukushima Medical University, Japan
| | | | - Taro Okayama
- Division of Rehabilitation Medicine, Shizuoka Cancer Center, Japan
| | - Junichiro Inoue
- Division of Rehabilitation Medicine, Kobe University Hospital International Clinical Cancer Research Center, Japan
| | - Takashi Tanaka
- Department of Rehabilitation, Hyogo Medical University Hospital, Japan
| | - Jiro Nakano
- Faculty of Rehabilitation, Kansai Medical University, Japan
| | | |
Collapse
|
10
|
Description of supportive care and feasibility of physical exercise program to improve quality of life in advanced melanoma patients. Melanoma Res 2023; 33:230-238. [PMID: 36928055 DOI: 10.1097/cmr.0000000000000889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
Physical activity is the first-line treatment of cancer-related fatigue. It has shown benefits on patient's quality of life (QoL) when practiced during and after treatment. New treatments have drastically changed the prognosis of melanoma. Still, few data are available about research program of supportive care in advanced melanoma. The primary outcome was to assess the feasibility of setting up a prospective study evaluating the benefits of Adapted Physical Activity (APA) on the QoL of patients with advanced melanoma. Feasibility was defined with a combination of five criteria including completion of questionnaire, recruitment, participant retention, patient adhesion to supportive care, and absence of adverse event. Between September 2019 and March 2021, 271 melanoma patients were questioned. Around 60% of stage IV melanoma patients were interested in support care. Patient retention at 3 months was sufficient. Only one patient could not be evaluated after 3 months of enrolment because of deterioration of the general state. Adhesion to exercise and sessions was good. Supervised APA program appeared to be safe and well tolerated as no adverse events or discontinuations were reported. Setting up a prospective research program evaluating the benefits of physical activity in advanced melanoma patients seems feasible. With melanoma becoming a chronic disease, supportive care may reduce fatigue, improve QoL and help maintain a healthy lifestyle. Data supporting its benefits on this survivor population are needed.
Collapse
|
11
|
Clemente-Suárez VJ, Martín-Rodríguez A, Redondo-Flórez L, Ruisoto P, Navarro-Jiménez E, Ramos-Campo DJ, Tornero-Aguilera JF. Metabolic Health, Mitochondrial Fitness, Physical Activity, and Cancer. Cancers (Basel) 2023; 15:814. [PMID: 36765772 PMCID: PMC9913323 DOI: 10.3390/cancers15030814] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 01/26/2023] [Accepted: 01/27/2023] [Indexed: 01/31/2023] Open
Abstract
Cancer continues to be a significant global health issue. Traditional genetic-based approaches to understanding and treating cancer have had limited success. Researchers are increasingly exploring the impact of the environment, specifically inflammation and metabolism, on cancer development. Examining the role of mitochondria in this context is crucial for understanding the connections between metabolic health, physical activity, and cancer. This study aimed to review the literature on this topic through a comprehensive narrative review of various databases including MedLine (PubMed), Cochrane (Wiley), Embase, PsychINFO, and CinAhl. The review highlighted the importance of mitochondrial function in overall health and in regulating key events in cancer development, such as apoptosis. The concept of "mitochondrial fitness" emphasizes the crucial role of mitochondria in cell metabolism, particularly their oxidative functions, and how proper function can prevent replication errors and regulate apoptosis. Engaging in high-energy-demanding movement, such as exercise, is a powerful intervention for improving mitochondrial function and increasing resistance to environmental stressors. These findings support the significance of considering the role of the environment, specifically inflammation and metabolism, in cancer development and treatment. Further research is required to fully understand the mechanisms by which physical activity improves mitochondrial function and potentially reduces the risk of cancer.
Collapse
Affiliation(s)
| | | | - Laura Redondo-Flórez
- Department of Health Sciences, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, C/Tajo s/n Villaviciosa de Odón, 28670 Madrid, Spain
| | - Pablo Ruisoto
- Department of Health Sciences, Public University of Navarre, 31006 Navarre, Spain
| | | | | | | |
Collapse
|
12
|
Artese AL, Sitlinger A, MacDonald G, Deal MA, Hanson ED, Pieper CF, Weinberg JB, Brander DM, Bartlett DB. Effects of high-intensity interval training on health-related quality of life in chronic lymphocytic leukemia: A pilot study. J Geriatr Oncol 2023; 14:101373. [PMID: 36096873 DOI: 10.1016/j.jgo.2022.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 08/24/2022] [Accepted: 09/02/2022] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Chronic lymphocytic leukemia (CLL) is the most common incurable leukemia/lymphoma in the United States. Individuals with CLL are at risk for disability, frailty, and cancer-specific complications that negatively affect health-related quality of life (HRQOL). High-intensity interval training (HIIT) and resistance training (RT) are safe and feasible for individuals with chronic diseases and when combined, they may be beneficial for reducing cancer-related fatigue, symptom burden, and global quality of life. However, no studies have examined the impact of HIIT or RT on HRQOL in CLL. The purpose of this study was to investigate the effects of a 12-week HIIT and RT (HIIT+RT) intervention on HRQOL in adults with treatment naïve CLL. MATERIALS AND METHODS Changes in HRQOL was a secondary outcome in this pilot study. Individuals with CLL (63.9 ± 8.5 yrs) were non-randomly assigned to 12 weeks of HIIT+RT or a control group. The HIIT+RT protocol consisted of three 30-min sessions/week of HIIT and two sessions/week of RT. The control group maintained usual daily activities. We assessed pre and post HRQOL using the Functional Assessment of Cancer Therapy-Lymphoma (FACT-Lym) questionnaire with domains of physical (PWB), social (SWB), emotional (EWB), functional (FWB), and general (FACT-G) well-being as well as a lymphoma-specific subscale (LymS). We used a two-way mixed analysis of variance to assess changes in HRQOL. We calculated effect size (ES) using Cohen's d. RESULTS Fifteen participants (HIIT+RT: n = 9; Control: n = 6) completed the study and questionnaire. Scores for FWB improved following HIIT+RT (21.7 ± 3.4 to 23.9 ± 3.2; ES = 1.38) compared to controls (25.7 ± 2.2 to 25.7 ± 2.3). The HIIT+RT group experienced clinically meaningful improvements in total FACT-Lym, FWB, FACT-G, and LymS. The control group had clinically meaningful changes only in LymS. DISCUSSION The large effect sizes and clinically meaningful improvements associated with 12 weeks of HIIT+RT support the potential benefits of this type of exercise program for FWB, lymphoma-specific symptoms, and general well-being in CLL. A future randomized trial with an adequately powered sample size is needed to evaluate these findings. TRIAL REGISTRATION NCT04950452.
Collapse
Affiliation(s)
- Ashley L Artese
- Duke University Aging Center, Duke University School of Medicine, Durham, NC, USA; Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | - Andrea Sitlinger
- Hematologic Malignancies and Cellular Therapies, Duke University School of Medicine, Durham, NC, USA.
| | - Grace MacDonald
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA; Division of Medical Oncology, Duke University School of Medicine, Durham, NC, USA
| | - Michael A Deal
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA; Division of Medical Oncology, Duke University School of Medicine, Durham, NC, USA
| | - Erik D Hanson
- Department of Exercise & Sport Science, University of North Carolina, Chapel Hill, NC, USA
| | - Carl F Pieper
- Duke University Aging Center, Duke University School of Medicine, Durham, NC, USA
| | - J Brice Weinberg
- Division of Hematology, Duke University School of Medicine and VA Medical Center, Durham, NC, USA
| | - Danielle M Brander
- Hematologic Malignancies and Cellular Therapies, Duke University School of Medicine, Durham, NC, USA
| | - David B Bartlett
- Duke University Aging Center, Duke University School of Medicine, Durham, NC, USA; Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA; Division of Medical Oncology, Duke University School of Medicine, Durham, NC, USA; School of Bioscience and Medicine, University of Surrey, Guildford, UK.
| |
Collapse
|
13
|
Humphreys L, Frith G, Humphreys H, Crank H, Dixey J, Greenfield DM, Reece LJ. Evaluation of a city-wide physical activity pathway for people affected by cancer: the Active Everyday service. Support Care Cancer 2023; 31:101. [PMID: 36622460 PMCID: PMC9829638 DOI: 10.1007/s00520-022-07560-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 12/21/2022] [Indexed: 01/10/2023]
Abstract
PURPOSE The primary goal of this article is to present an evaluation of a UK-based city-wide physical activity pathway for patients with a cancer diagnosis, the Active Everyday service. Active Everyday was a co-produced physical activity service for people affected by cancer. The service was underpinned by a behaviour change care pathway model developed by Macmillan Cancer Support charity. METHODS This was a retrospective evaluation assessing physical activity levels and changes to outcome measures (fatigue, perceived health, and self-efficacy) over 6 months. Each participant self-reported their levels of physical activity for the previous 7 days at three-time points: baseline (T1), at 12-week exit from the scheme (T2), and at 6-month follow-up (T3). RESULTS The Active Everyday service received 395 referrals, of which 252 attended a baseline assessment. Participants' fatigue and self-efficacy improved between T1 and T2 and T1 and T3. Perceived health improved across all time points. Participant exercise levels showed significant differences between T1 and T2. CONCLUSION The service, provided over 3 years, resulted in positive health and wellbeing outcomes in people affected by cancer who engaged in the service. Future services must routinely include exercise referrals/prescriptions as a standard part of care to help engage inactive individuals. Services should focus on targeted promotion to people from ethnic minority groups, and a wide socioeconomic population.
Collapse
Affiliation(s)
- Liam Humphreys
- Academy of Sport and Physical Activity, Sheffield Hallam University, Collegiate Crescent Campus, Sheffield, S10 2BP, UK. .,Advanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield, UK.
| | - Gabriella Frith
- grid.5884.10000 0001 0303 540XAcademy of Sport and Physical Activity, Sheffield Hallam University, Collegiate Crescent Campus, Sheffield, S10 2BP UK ,grid.5884.10000 0001 0303 540XAdvanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield, UK
| | - Helen Humphreys
- grid.5884.10000 0001 0303 540XCentre for Behavioural Science and Applied Psychology, Sheffield Hallam University, Sheffield, UK
| | - Helen Crank
- grid.5884.10000 0001 0303 540XAcademy of Sport and Physical Activity, Sheffield Hallam University, Collegiate Crescent Campus, Sheffield, S10 2BP UK
| | - Joanne Dixey
- grid.31410.370000 0000 9422 8284Therapy Services, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Diana M Greenfield
- grid.31410.370000 0000 9422 8284Specialised Cancer Services, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK ,grid.11835.3e0000 0004 1936 9262Department of Oncology and Metabolism, University of Sheffield Medical School Beech Hill Road, Sheffield, UK
| | - Lindsey J Reece
- grid.5884.10000 0001 0303 540XAdvanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield, UK ,grid.1013.30000 0004 1936 834XSPRINTER Research Group, Prevention Research Collaboration, Charles Perkins centre, School of Public Health, University of Sydney, Sydney, Australia
| |
Collapse
|
14
|
Brito JS, Reis D, Silva G, Fonseca L, Ribeiro M, Chermut T, Oliveira L, Borges NA, Ribeiro-Alves M, Mafra D. Bicycle ergometer exercise during hemodialysis and its impact on quality of life, aerobic fitness and dialysis adequacy: A pilot study. Complement Ther Clin Pract 2022; 49:101669. [PMID: 36152526 DOI: 10.1016/j.ctcp.2022.101669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 09/01/2022] [Accepted: 09/13/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Chronic kidney disease patients on hemodialysis commonly have a worse quality of life (QoL) due to complications of the disease and dialysis procedure. Physical exercise has emerged as a strategy to improve this scenario. The objective of this study was to evaluate the effect of an intradialytic aerobic exercise program on QoL and aerobic fitness in hemodialysis patients. MATERIAL AND METHODS These are a secondary analysis of clinical trial data previously published in which hemodialysis patients were randomized into "bike group" (using an adapted exercise bicycle) or "control group" (usual care). The exercise sessions lasted 45 min (5 min of warm-up, 35 min of moderate-intensity and 5 min of cool-down) three times/week for three months. The QoL domains were assessed using the SF-36 QoL questionnaire. Aerobic fitness was evaluated using the 6-min walk test (6MWT). Circulating cytokines, biochemical parameters and Kt/V were also assessed. RESULTS Nine patients completed three months of exercise (5 men, 44 ± 11 years), and nine were in the control group (6 men, 44 ± 14 years). In the bike group, there was a trend to improve the physical role domain (p = 0.06) regarding QoL, an improvement in the 6MWT (p = 0.02), and in the Kt/V (p = 0.03) after three months. There was a positive correlation between the general health domain and Kt/V (r = 0.691; p = 0.003) and an inverse correlation between the physical functioning domain and plasma TNF-α levels (r = -0.514; p = 0.04). CONCLUSIONS 12 weeks of intradialytic aerobic exercise was enough to benefit hemodialysis patients' quality of life, aerobic fitness, and quality of dialysis. CLINICALTRIALS gov id: NCT04375553.
Collapse
Affiliation(s)
- Jessyca S Brito
- Graduate Program in Medical Sciences, Fluminense Federal University (UFF), Niterói, RJ, Brazil.
| | - Drielly Reis
- Graduate Program in Medical Clinic, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Greicielle Silva
- Graduate Program in Nutrition Sciences, Fluminense Federal University (UFF), Niterói, RJ, Brazil
| | - Larissa Fonseca
- Graduate Program in Medical Sciences, Fluminense Federal University (UFF), Niterói, RJ, Brazil
| | - Marcia Ribeiro
- Graduate Program in Biological Sciences, Physiology, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Tuany Chermut
- Graduate Program in Nutrition Sciences, Fluminense Federal University (UFF), Niterói, RJ, Brazil
| | - Leonardo Oliveira
- Graduate Program in Cardiovascular Sciences, Fluminense Federal University (UFF), Niterói, RJ, Brazil
| | - Natália A Borges
- Graduate Program in Cardiovascular Sciences, Fluminense Federal University (UFF), Niterói, RJ, Brazil; Institute of Nutrition, State University of Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
| | - Marcelo Ribeiro-Alves
- HIV/AIDS Clinical Research Center, National Institute of Infectology Evandro Chagas (INI/Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Denise Mafra
- Graduate Program in Medical Sciences, Fluminense Federal University (UFF), Niterói, RJ, Brazil; Graduate Program in Nutrition Sciences, Fluminense Federal University (UFF), Niterói, RJ, Brazil; Graduate Program in Biological Sciences, Physiology, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| |
Collapse
|
15
|
Fukushima T, Tsuji T, Watanabe N, Sakurai T, Matsuoka A, Kojima K, Yahiro S, Oki M, Okita Y, Yokota S, Nakano J, Sugihara S, Sato H, Kawakami J, Kagaya H, Tanuma A, Sekine R, Mori K, Zenda S, Kawai A. Cancer Rehabilitation Provided by Designated Cancer Hospitals in Japan: The Current State of Outpatient Setting and Coordination after Discharge. Prog Rehabil Med 2022; 7:20220006. [PMID: 35274061 PMCID: PMC8850184 DOI: 10.2490/prm.20220006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 01/17/2022] [Indexed: 11/09/2022] Open
Abstract
Objectives: The aim of the present study was to clarify the current state of outpatient cancer
rehabilitation and coordination systems provided by designated cancer hospitals in
Japan. Methods: A questionnaire was sent to 427 designated cancer hospitals in Japan to investigate the
status of outpatient cancer rehabilitation and whether it was sufficiently conducted.
The status of regional coordination with post-discharge rehabilitation facilities was
surveyed. Results: Responses were received from 235/427 facilities (55.0%). Outpatient cancer
rehabilitation was implemented in 92 (39.1% of responding facilities), and of these
facilities, 83.7% answered that the provision of rehabilitation was insufficient. The
reasons were ineligibility for reimbursement of medical fees, a lack of human resources,
a lack of awareness of the need, and a lack of education. Regional coordination was
conducted by 39.1% of responding facilities, yet a regional alliance path had been
established in only 9.8% of centers. The absence of coordination was associated with
large facility size, the absence of physiatrists, and few rehabilitation professionals
who had completed the training program; an insufficient framework for regional
coordination was also given as a reason. Conclusions: To provide adequate outpatient cancer rehabilitation, sufficient human resources, the
reimbursement of medical fees in the outpatient setting, and education and a framework
to promote regional coordination are necessary.
Collapse
Affiliation(s)
- Takuya Fukushima
- Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital, Tokyo, Japan
| | - Tetsuya Tsuji
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Noriko Watanabe
- Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital, Tokyo, Japan
| | - Takuro Sakurai
- Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital, Tokyo, Japan
| | - Aiko Matsuoka
- Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital, Tokyo, Japan
| | - Kazuhiro Kojima
- Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital, Tokyo, Japan
| | - Sachiko Yahiro
- Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital, Tokyo, Japan
| | - Mami Oki
- Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital, Tokyo, Japan
| | - Yusuke Okita
- Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital, Tokyo, Japan
| | - Shota Yokota
- Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital, Tokyo, Japan
| | - Jiro Nakano
- Department of Physical Medicine and Rehabilitation, Kansai Medical University, Osaka, Japan
| | - Shinsuke Sugihara
- Department of Orthopedic Oncology and Rehabilitation, National Hospital Organization Shikoku Cancer Center, Ehime, Japan
| | - Hiroshi Sato
- Department of Gastroenterological Surgery, Saitama International Medical Center, Saitama Medical University, Saitama, Japan
| | - Juichi Kawakami
- Department of Rehabilitation Medicine, Shiga Prefectural Rehabilitation Center, Shiga, Japan
| | - Hitoshi Kagaya
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Aichi, Japan
| | - Akira Tanuma
- Department of Rehabilitation Medicine, Juntendo University Shizuoka Hospital, Shizuoka, Japan
| | - Ryuichi Sekine
- Department of Pain and Palliative Care, Kameda Medical Center, Chiba, Japan
| | - Keita Mori
- Department of Clinical Research Center, Shizuoka Cancer Center, Shizuoka, Japan
| | - Sadamoto Zenda
- Department of Radiation Oncology, National Cancer Center Hospital East, Chiba, Japan
| | - Akira Kawai
- Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital, Tokyo, Japan
| |
Collapse
|