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Yang J, Guo G, Yang F, Li C, Wang H, Yang W, Yang Z, Liu Q, Li Q, Sun C. A sex-oriented analysis concerning skeletal muscle quantity and quality and associations to quality of life in hospitalized patients with cirrhosis. Health Qual Life Outcomes 2024; 22:78. [PMID: 39267044 PMCID: PMC11395965 DOI: 10.1186/s12955-024-02295-2] [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: 02/09/2024] [Accepted: 08/29/2024] [Indexed: 09/14/2024] Open
Abstract
BACKGROUND There is a paucity of data regarding sex-oriented analyses of connection between muscle quantity and quality and health-related quality of life (HRQoL), taking into account the pathophysiological differences of sarcopenia/myosteatosis in males versus females. We sought to investigate the associations between skeletal muscle index (SMI)-defined sarcopenia and intramuscular adipose tissue content (IMAC)-defined myosteatosis and EuroQol-5D (EQ-5D)-defined HRQoL in patients with decompensated cirrhosis concerning sex disparities. METHODS Totally, 382 patients were enrolled. The relationship between SMI/IMAC and HRQoL was evaluated with restricted cubic spline and Pearson correlation analyses. Furthermore, association between SMI or sarcopenia and EQ-5D utility index was determined by multiple linear regression, adjusted for age, BMI and concurrent disease severity. RESULTS The study population comprised evenly distributed male and female patients (190: 192), mean age 61.9 years. The prevalence of sarcopenia (40.5 versus 9.9%, P < 0.001) and SMI (48.8 versus 42.2 cm2/m2, P < 0.001) were significantly higher in males relative to females, with comparable myosteatosis prevalence (15.3 versus 16.7%, P = 0.708). Self-care, usual activities and pain within EQ-5D scale were more prevalent in the sarcopenia compared with non-sarcopenia groups across entire population and stratified by sex. The SMI values exhibited a significantly linear correlation with EQ-5D utility index in male but not female patients (P for non-linearity = 0.281). In multiple analysis, SMI or the presence of sarcopenia was both significantly associated with EQ-5D utility index. Subgroup analyses unveiled no discernible interactions between sarcopenia and EQ-5D utility index. CONCLUSIONS Muscle quantity measured by SMI was associated with declined HRQoL in males rather than females, whereas no associations were found regarding muscle quality measured by IMAC in both sexes. It is tempting to manage sarcopenia by increasing SMI levels as high as possible in hopes of achieving better health consequence. Our findings represent the importance of connecting CT-demarcated body composition abnormalities to meaningful patient-centered outcomes. Future targeted studies with sizable multi-center populations are warranted to clarify this causality, and in consequence develop optimized intervention against sarcopenia/myosteatosis or key determinants concerning impaired HRQoL.
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Affiliation(s)
- Jie Yang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Anshan Road 154, Heping District, Tianjin, 300052, China
- Department of Gastroenterology, Tianjin Medical University General Hospital Airport Hospital, East Street 6, Tianjin Airport Economic Area, Tianjin, 300308, China
| | - Gaoyue Guo
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Anshan Road 154, Heping District, Tianjin, 300052, China
| | - Fang Yang
- Department of Digestive System, Baodi Clinical College of Tianjin Medical University, No.8, Guangchuan Road, Baodi District, Tianjin, 301800, China
| | - Chaoqun Li
- Department of Geriatrics, Tianjin Hexi Hospital, Tianjin, 300202, China
| | - Han Wang
- Department of Health Management, Tianjin Hospital, No. 406 Jiefang South Road, Hexi District, Tianjin, 300211, China
| | - Wanting Yang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Anshan Road 154, Heping District, Tianjin, 300052, China
| | - Ziyi Yang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Anshan Road 154, Heping District, Tianjin, 300052, China
| | - Qing Liu
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Anshan Road 154, Heping District, Tianjin, 300052, China
- Department of Gastroenterology, Tianjin Medical University General Hospital Airport Hospital, East Street 6, Tianjin Airport Economic Area, Tianjin, 300308, China
| | - Qian Li
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Anshan Road 154, Heping District, Tianjin, 300052, China
- Department of Gastroenterology, Tianjin Medical University General Hospital Airport Hospital, East Street 6, Tianjin Airport Economic Area, Tianjin, 300308, China
| | - Chao Sun
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Anshan Road 154, Heping District, Tianjin, 300052, China.
- Department of Gastroenterology, Tianjin Medical University General Hospital Airport Hospital, East Street 6, Tianjin Airport Economic Area, Tianjin, 300308, China.
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Tarca B, Jesudason S, Bennett PN, Wycherley TP, Ferrar KE. Characteristics and Frequency of Physical Activity and Exercise-Related Side Effects in People Receiving Peritoneal Dialysis. J Ren Nutr 2024; 34:359-367. [PMID: 38128852 DOI: 10.1053/j.jrn.2023.12.003] [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: 05/24/2023] [Revised: 10/21/2023] [Accepted: 12/03/2023] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVE People receiving peritoneal dialysis may receive health benefits from physical activity or exercise. However, on-going uncertainty and fear regarding safety may result in this population missing out on the health benefits of participation. The aim of this study was to explore the characteristics and frequency of physical activity and/or exercise-related side effects (e.g., symptoms such as pain or shortness of breath) and negative health events (e.g., stroke or hyper/hypoglycemia) experienced by people receiving peritoneal dialysis. METHODS An international online survey involving adults receiving peritoneal dialysis was conducted with questions related to nature, occurrence, and impact of side effects and/or negative health events experienced during or soon after participation in physical activity or exercise. RESULTS Fifty-two people completed the survey reporting 151 side effects that were related to physical activity and exercise and 67 that were possibly related. Fatigue (58% of respondents), muscle/joint soreness or pain (54%), and dizziness (43%) were the most frequently reported side-effect types. The majority occurred occasionally (58% of all side effects), if not rarely (24%) and participation in on-going physical activity or exercise was typically prevented only occasionally (39%) or not at all (31%). Side effects were mainly self-managed (54% of all side effects) or did not require treatment (19%) and had low (38%) or no effect (30%) on ability to do daily activities. CONCLUSIONS People receiving peritoneal dialysis generally experience side effects that can be considered a normal response to physical activity or exercise engagement. Furthermore, the risk of serious or peritoneal dialysis-specific side effects as a result of physical activity or exercise appears to be low. The results add to the emerging evidence suggesting physical activity and exercise appear to be safe for people receiving peritoneal dialysis.
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Affiliation(s)
- Brett Tarca
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, Australia.
| | - Shilpanjali Jesudason
- Central Northern Adelaide Renal and Transplantation Service Clinical Research Group, Royal Adelaide Hospital, Adelaide, Australia; Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - Paul N Bennett
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, Australia; Medical & Clinical Affairs, Satellite Healthcare, San Jose, California
| | - Thomas P Wycherley
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Katia E Ferrar
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, Australia; Wardliparingga Aboriginal Health Equity, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
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Iheanacho CO, Odili VU, Enakirerhi GE, Isiwele EM, Essiet A. Pattern, Clinical Characteristics, and Impact of Family History on Prostate-Specific Antigen in Prostate Cancer: A Multicenter Study. Am J Mens Health 2024; 18:15579883241264949. [PMID: 39054776 PMCID: PMC11282506 DOI: 10.1177/15579883241264949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Revised: 06/06/2024] [Accepted: 06/10/2024] [Indexed: 07/27/2024] Open
Abstract
Prostate cancer (PCa) is a major cause of illness and death in men of Sub-Sahara African origin. The study assessed the pattern of PCa, the effect of family history on PSA at diagnosis, and clinical characteristics of PCa in Nigeria. A cross-sectional survey of 200 participants was performed within a 12-month period in Nigeria. Data were collected through patients' interview and hospital records and analyzed using SPSS version 25. Descriptive and inferential statistics were performed. P values <.05 were significant. Mean age of 68.5 years was observed among the 200 study participants. Only 64 (32.0%) had a positive immediate family history of PCa, and 61 (30.5%) were not aware of their family cancer history. Most patients 140 (70.0%) had lower urinary tract symptom (LUTS)/lower back pain/leg pain, and the average Gleason score was 7.55 (±0.876). Symptoms of LUTS/lower back pain mostly occurred in patients between 58 and 79 years, while LUTS/leg pain was more common in persons between 60 and 84. Average PSA differed among participants; persons with no family cancer history (M = 143.989; 95% confidence interval [CI] = 114.849-173.129), family history of PCa (M = 165.463; 95% CI = 131.435), family history of cervical cancer (M = 133.456; 95% CI = 49.335-217.576), and persons with no knowledge of their family cancer history (M = 121.546; 95% CI = 89.234-153.857). Univariate one-way (F-Tests) showed that family history of cancer had no significant impact on patients' PSA (R2 = 0.017; adjusted R2 = 0.002; df = 3; F = 1.154; p = .329) at diagnosis. PCa mostly occurred in men within 60 to 70 years of age, and family history of cancer did not predict PSA at diagnosis. Patients presented to health facilities at advanced or metastatic stages. These findings highlight the need for policies and strategies that encourage early PCa screening.
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Affiliation(s)
- Chinonyerem O. Iheanacho
- Department of Clinical Pharmacy and Public Health, Faculty of Pharmacy, University of Calabar, Calabar, Nigeria
| | - Valentine U. Odili
- Department of Pharmacy and Pharmacy Practice, Faculty of Pharmacy, University of Benin, Benin City, Nigeria
| | - Glen E. Enakirerhi
- Department of Urology, University of Calabar Teaching Hospital, Calabar, Nigeria
| | - Edoise M. Isiwele
- Department of Urology, University of Calabar Teaching Hospital, Calabar, Nigeria
| | - Akanimo Essiet
- Department of Urology, University of Calabar Teaching Hospital, Calabar, Nigeria
- Urology Department, Faculty of Clinical Sciences, College of Medical Sciences, University of Calabar, Calabar, Nigeria
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Wright HH, Walker MA, Broadbent S, Linton C, Keech JJ, Rune KT, Davis CL, Morris M, Zhang A, Newton RU, Marshall S. The effect of dietary interventions or patterns on the cardiometabolic health of individuals treated with androgen deprivation therapy for prostate cancer: A systematic review. Maturitas 2024; 184:107940. [PMID: 38430616 DOI: 10.1016/j.maturitas.2024.107940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/30/2024] [Accepted: 02/09/2024] [Indexed: 03/05/2024]
Abstract
Prostate cancer survivors treated with androgen deprivation therapy may be at increased risk of cardiovascular disease. Dietary recommendations for the prevention and/or management of cardiovascular disease for these individuals are lacking. This review synthesizes the evidence on the effect of dietary interventions on cardiometabolic biomarkers and cardiovascular disease risk in prostate cancer survivors receiving androgen deprivation therapy. A systematic review was conducted across PubMed, CINAHL, Embase, and Cochrane CENTRAL. Intervention or observational cohort studies evaluating diets, nutrients, or nutraceuticals with or without concurrent exercise interventions on cardiovascular disease, cardiovascular events, or cardiovascular disease biomarkers in those treated with androgen deprivation therapy were included. Confidence in the body of evidence was appraised using Grading of Recommendations, Assessment, Development and Evaluations. Twelve studies reported across fifteen papers were included. Interventions were heterogenous, with most studies including an exercise co-intervention (n = 8). Few significant findings for the effects of diet on cardiometabolic markers were likely due to weak methodology and sample sizes. Strongest evidence was for the effect of a healthy Western dietary pattern with exercise on improved blood pressure (Confidence: moderate). The healthy Western dietary pattern with exercise may improve high-density lipoprotein cholesterol (Confidence: Low) and flow-mediated dilation. Soy may improve total cholesterol (Confidence: Very low). A low-carbohydrate diet with physical activity may improve high-density lipoprotein cholesterol, incidence of metabolic syndrome, and Framingham cardiovascular disease risk score. Evidence of the effect of dietary interventions on cardiometabolic biomarkers and cardiovascular disease risk of prostate cancer survivors receiving androgen deprivation therapy is insufficient to inform practice. Well-designed dietary interventions aimed at improving cardiometabolic outcomes of this population are warranted to inform future dietary recommendations.
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Affiliation(s)
- Hattie Hester Wright
- Nutrition and Dietetics, School of Health, University of the Sunshine Coast, 90 Sippy Downs Drive, Sippy Downs 4556, QLD, Australia; Sunshine Coast Health Institute, 60 Doherty Street, Birtinya 4575, QLD, Australia.
| | - Meegan Anne Walker
- Exercise Science, School of Health, University of the Sunshine Coast, 90 Sippy Downs Drive, Sippy Downs 4556, QLD, Australia.
| | - Suzanne Broadbent
- Exercise Science, School of Health, University of the Sunshine Coast, 90 Sippy Downs Drive, Sippy Downs 4556, QLD, Australia.
| | - Corey Linton
- Nutrition and Dietetics, School of Health, University of the Sunshine Coast, 90 Sippy Downs Drive, Sippy Downs 4556, QLD, Australia.
| | - Jacob Joseph Keech
- School of Applied Psychology, Griffith University, Mt Gravatt Campus, 4122, QLD, Australia.
| | - Karina Tirsvad Rune
- Psychology, School of Health, University of the Sunshine Coast, 90 Sippy Downs Drive, Sippy Downs 4556, QLD, Australia.
| | - Cindy Lynne Davis
- School of Law and Social Sciences, University of the Sunshine Coast, 90 Sippy Downs Drive, Sippy Downs 4556, QLD, Australia.
| | - Michelle Morris
- Sunshine Coast University Private Hospital, 3 Doherty Street, Birtinya 4556, QLD, Australia.
| | - Anao Zhang
- School of Social work, University of Michigan, 1080 S. University Ave, Ann Arbor, MI 48105, United States of America.
| | - Robert Usher Newton
- Exercise Medicine Research Institute, Edith Cowan University, 270 Joondalup Drive, Joondalup 6027, Western Australia, Australia; School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane 4072, Queensland, Australia.
| | - Skye Marshall
- Research Institute for Future Health, PO Box 5033, Q Super Centre, Mermaid Waters, QLD 4218, Australia; The Centre for Health Services Research, The University of Queensland, Brisbane 4072, QLD, Australia; Nutrition and Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, 14 University Drive, Robina 4226, QLD, Australia.
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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.
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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
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Kouroukli O, Bravou V, Giannitsas K, Tzelepi V. Tissue-Based Diagnostic Biomarkers of Aggressive Variant Prostate Cancer: A Narrative Review. Cancers (Basel) 2024; 16:805. [PMID: 38398199 PMCID: PMC10887410 DOI: 10.3390/cancers16040805] [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: 01/12/2024] [Revised: 02/10/2024] [Accepted: 02/12/2024] [Indexed: 02/25/2024] Open
Abstract
Prostate cancer (PC) is a common malignancy among elderly men, characterized by great heterogeneity in its clinical course, ranging from an indolent to a highly aggressive disease. The aggressive variant of prostate cancer (AVPC) clinically shows an atypical pattern of disease progression, similar to that of small cell PC (SCPC), and also shares the chemo-responsiveness of SCPC. The term AVPC does not describe a specific histologic subtype of PC but rather the group of tumors that, irrespective of morphology, show an aggressive clinical course, dictated by androgen receptor (AR) indifference. AR indifference represents an adaptive response to androgen deprivation therapy (ADT), driven by epithelial plasticity, an inherent ability of tumor cells to adapt to their environment by changing their phenotypic characteristics in a bi-directional way. The molecular profile of AVPC entails combined alterations in the tumor suppressor genes retinoblastoma protein 1 (RB1), tumor protein 53 (TP53), and phosphatase and tensin homolog (PTEN). The understanding of the biologic heterogeneity of castration-resistant PC (CRPC) and the need to identify the subset of patients that would potentially benefit from specific therapies necessitate the development of prognostic and predictive biomarkers. This review aims to discuss the possible pathophysiologic mechanisms of AVPC development and the potential use of emerging tissue-based biomarkers in clinical practice.
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Affiliation(s)
- Olga Kouroukli
- Department of Pathology, Evaggelismos General Hospital, 10676 Athens, Greece
| | - Vasiliki Bravou
- Department of Anatomy-Histology-Embryology, School of Medicine, University of Patras, 26504 Patras, Greece;
| | | | - Vasiliki Tzelepi
- Department of Pathology, School of Medicine, University of Patras, 26504 Patras, Greece
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Willbanks A, Seals M, Karmali R, Roy I. Harnessing the Systemic Biology of Functional Decline and Cachexia to Inform more Holistic Therapies for Incurable Cancers. Cancers (Basel) 2024; 16:360. [PMID: 38254849 PMCID: PMC10814065 DOI: 10.3390/cancers16020360] [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: 12/13/2023] [Revised: 01/10/2024] [Accepted: 01/11/2024] [Indexed: 01/24/2024] Open
Abstract
Options for treatment of incurable cancer remain scarce and are largely focused on limited therapeutic mechanisms. A new approach specific to advanced cancers is needed to identify new and effective treatments. Morbidity in advanced cancer is driven by functional decline and a number of systemic conditions, including cachexia and fatigue. This review will focus on these clinical concepts, describe our current understanding of their underlying biology, and then propose how future therapeutic strategies, including pharmaceuticals, exercise, and rehabilitation, could target these mechanisms as an alternative route to addressing incurable cancer.
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Affiliation(s)
| | - Mina Seals
- Shirley Ryan AbilityLab, Chicago, IL 60611, USA
| | - Reem Karmali
- Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL 60611, USA
| | - Ishan Roy
- Shirley Ryan AbilityLab, Chicago, IL 60611, USA
- Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL 60611, USA
- Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, IL 60611, USA
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Marker RJ, Wechsler S, Leach HJ. Cancer-related fatigue is associated with objective measures of physical function before and after a clinical exercise program: A retrospective analysis. REHABILITATION ONCOLOGY 2024; 42:31-38. [PMID: 38774708 PMCID: PMC11104554 DOI: 10.1097/01.reo.0000000000000354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2024]
Abstract
Background:
Cancer-related fatigue (CRF) is a common symptom reported by survivors of cancer. CRF is associated with reduced self-reported physical function, but associations with objective measures of physical function are less robust. Exercise programs have been shown to improve both CRF and objective physical function, but the interaction of exercise, CRF, and function has not been explored.
Methods:
Retrospective data were collected from baseline (n = 420) and final assessments (n = 234) of survivors who participated in a 3-month clinical exercise program. Assessments included measures of CRF (Functional Assessment of Chronic Illness Therapy–Fatigue) and physical function (6-minute walk test, usual and fast gait speed, 30-second sit-to-stand test, and the Timed Up and Go test). Multiple regression analyses investigated associations between CRF and physical function before and after the program. CRF and functional changes following the program were calculated and associations investigated with multiple regressions.
Results:
All measures of CRF and physical function significantly improved following the program (P < .01). CRF was associated with all functional measures at baseline (standardized β = −0.18 to 0.29, P < .01) and final assessments (r = −0.27 to 0.26, P < .01). Changes in CRF were associated with changes in function (standardized β = −0.12 to 0.23, P < .05), except usual gait speed (P = .17).
Conclusion:
This investigation demonstrated associations between CRF and objective physical function before and after participation in an exercise program. The 3-way interaction between CRF, physical function, and exercise can be used clinically to personalize rehabilitation strategies. Future studies should investigate changes in CRF and function during an exercise program.
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Affiliation(s)
- Ryan J Marker
- Assistant Professor, Department of Physical Medicine and
Rehabilitation, University of Colorado Anschutz Medical Campus
| | - Stephen Wechsler
- Post-Doctoral Research Fellow, Department of Occupational
Therapy, MGH Institute of Health Professions
| | - Heather J Leach
- Associate Professor, Department of Health and Exercise
Science, Colorado State University
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Steenstrup B, Cartier M, Cornu JN. What more comprehensive physiotherapy techniques than pelvic floor muscles training should be investigated in the context of post-prostatectomy? A narrative review. Prog Urol 2023; 33:1092-1100. [PMID: 37798160 DOI: 10.1016/j.purol.2023.09.017] [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: 09/04/2023] [Accepted: 09/14/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND In a previous article, we have underlined the emerging level of evidence for the effectiveness of a more comprehensive functional physical therapy than solely pelvic floor muscles training (PFMT) for men after radical prostatectomy (RP). More and more authors suggest that physiotherapy programs should not focus only on the side effect of continence, but more generally on the interaction of continence disorders with all other side effects related to patient's physical and emotional functioning. RESEARCH QUESTION The aims of this narrative review are to highlight rehabilitation approaches unrelated to analytical PFMT that would seem relevant to consider in the future for post-RP men. METHOD Our narrative review sought to map the body of literature relevant to the primary objective (non-PFMT), supplementing the data from our previous review with additional recent articles that were not eligible due to not meeting the inclusion criteria for a systematic review. RESULTS After full text screening, 13 interventional studies have been selected. Intervention strategies were based on five major type of exercises: flexibility, synergism & co-activation, coordination & movement control, strength & endurance, aerobic & games therapy. Most of the studies of this narrative review focused on synergies, co-activations and movement control techniques that emphasized the deep abdominal muscles and PFMs reflexive activation. The wide variety of countries represented in the 13 studies with consistent results point to the potential effectiveness and replicability across various socio-cultural, ethnical, or religious contexts. CONCLUSION We found 13 studies from 9 different countries that provide a more complete rehabilitation approach than PFMT alone in men post-RP. Intervention strategies were built around five main types of exercises, with the majority of them emphasizing synergies, co-activations, and movement control techniques. In light of these data, we hope that future research will enable us to offer the most relevant and patient-centered physiotherapy treatment.
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Affiliation(s)
- B Steenstrup
- Rouen University Hospital, Department of Urology, Rouen, France; La Musse Physiotherapy Training Institute, Saint-Sébastien-de-Morsent, France.
| | - M Cartier
- La Musse Physiotherapy Training Institute, Saint-Sébastien-de-Morsent, France
| | - J N Cornu
- Rouen University Hospital, Department of Urology, Rouen, France
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Topcu A, Yurtsever I, Isleyen ZS, Besiroglu M, Yasin AI, Topcu ZA, Shbair AT, Toluk O, Simsek M, Seker M, Turk HM. The correlation between skeletal muscle index and anxiety in patients with lung cancer on the first day of chemotherapy. Future Oncol 2023. [PMID: 37367530 DOI: 10.2217/fon-2022-1200] [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: 06/28/2023] Open
Abstract
Aim: To evaluate the relationship between anxiety and skeletal muscle index (SMI) levels in lung cancer patients on the first day of chemotherapy. Materials & methods: This cross-sectional study included 108 patients. We analyzed patient characteristics, SMI levels, pain status and predicted anxiety factors. Results: Anxiety was detected in 61% of patients. SMI levels were significantly lower in the high anxiety group than the low anxiety group (p < 0.001). A significant correlation was observed between anxiety and SMI levels (r = -0.292; p = 0.002). Anxiety levels were significantly correlated with trait anxiety (r = 0.618; p < 0.001) and visual analog scale-pain (r = 0.364; p < 0.001). SMI (odds ratio: 0.94), trait anxiety (odds ratio: 1.12) and visual analog scale pain (odds ratio: 1.28) were independent risk factors for anxiety after adjusting for sex, stage and Eastern Cooperative Oncology Group performance status. Conclusion: Our study highlighted that higher anxiety scores were significantly correlated with lower SMI levels. We found that SMI, pain and trait anxiety were independent risk factors for anxiety.
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Affiliation(s)
- Atakan Topcu
- Department of Medical Oncology, Bezmialem Vakif University, Istanbul, 34093, Turkey
| | - Ismail Yurtsever
- Department of Radiology, Bezmialem Vakif University, Istanbul, 34093, Turkey
| | | | - Mehmet Besiroglu
- Department of Medical Oncology, Bezmialem Vakif University, Istanbul, 34093, Turkey
| | - Ayse Irem Yasin
- Department of Medical Oncology, Bezmialem Vakif University, Istanbul, 34093, Turkey
| | - Zeynep Alaca Topcu
- Department of Medical Oncology, Istanbul Medeniyet University, Istanbul, 34722, Turkey
| | - Abdallah Tm Shbair
- Department of Medical Oncology, Bezmialem Vakif University, Istanbul, 34093, Turkey
| | - Ozlem Toluk
- Department of Biostatistics, Bezmialem Vakif University, Istanbul, 34093, Turkey
| | - Melih Simsek
- Department of Medical Oncology, Bezmialem Vakif University, Istanbul, 34093, Turkey
| | - Mesut Seker
- Department of Medical Oncology, Bezmialem Vakif University, Istanbul, 34093, Turkey
| | - Haci Mehmet Turk
- Department of Medical Oncology, Bezmialem Vakif University, Istanbul, 34093, Turkey
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Trommer M, Marnitz S, Skoetz N, Rupp R, Niels T, Morgenthaler J, Theurich S, von Bergwelt-Baildon M, Baues C, Baumann FT. Exercise interventions for adults with cancer receiving radiation therapy alone. Cochrane Database Syst Rev 2023; 3:CD013448. [PMID: 36912791 PMCID: PMC10010758 DOI: 10.1002/14651858.cd013448.pub2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
BACKGROUND Radiation therapy (RT) is given to about half of all people with cancer. RT alone is used to treat various cancers at different stages. Although it is a local treatment, systemic symptoms may occur. Cancer- or treatment-related side effects can lead to a reduction in physical activity, physical performance, and quality of life (QoL). The literature suggests that physical exercise can reduce the risk of various side effects of cancer and cancer treatments, cancer-specific mortality, recurrence of cancer, and all-cause mortality. OBJECTIVES To evaluate the benefits and harms of exercise plus standard care compared with standard care alone in adults with cancer receiving RT alone. SEARCH METHODS We searched CENTRAL, MEDLINE (Ovid), Embase (Ovid), CINAHL, conference proceedings and trial registries up to 26 October 2022. SELECTION CRITERIA We included randomised controlled trials (RCTs) that enrolled people who were receiving RT without adjuvant systemic treatment for any type or stage of cancer. We considered any type of exercise intervention, defined as a planned, structured, repetitive, objective-oriented physical activity programme in addition to standard care. We excluded exercise interventions that involved physiotherapy alone, relaxation programmes, and multimodal approaches that combined exercise with other non-standard interventions such as nutritional restriction. DATA COLLECTION AND ANALYSIS We used standard Cochrane methodology and the GRADE approach for assessing the certainty of the evidence. Our primary outcome was fatigue and the secondary outcomes were QoL, physical performance, psychosocial effects, overall survival, return to work, anthropometric measurements, and adverse events. MAIN RESULTS Database searching identified 5875 records, of which 430 were duplicates. We excluded 5324 records and the remaining 121 references were assessed for eligibility. We included three two-arm RCTs with 130 participants. Cancer types were breast and prostate cancer. Both treatment groups received the same standard care, but the exercise groups also participated in supervised exercise programmes several times per week while undergoing RT. Exercise interventions included warm-up, treadmill walking (in addition to cycling and stretching and strengthening exercises in one study), and cool-down. In some analysed endpoints (fatigue, physical performance, QoL), there were baseline differences between exercise and control groups. We were unable to pool the results of the different studies owing to substantial clinical heterogeneity. All three studies measured fatigue. Our analyses, presented below, showed that exercise may reduce fatigue (positive SMD values signify less fatigue; low certainty). • Standardised mean difference (SMD) 0.96, 95% confidence interval (CI) 0.27 to 1.64; 37 participants (fatigue measured with Brief Fatigue Inventory (BFI)) • SMD 2.42, 95% CI 1.71 to 3.13; 54 participants (fatigue measured with BFI) • SMD 1.44, 95% CI 0.46 to 2.42; 21 participants (fatigue measured with revised Piper Fatigue Scale) All three studies measured QoL, although one provided insufficient data for analysis. Our analyses, presented below, showed that exercise may have little or no effect on QoL (positive SMD values signify better QoL; low certainty). • SMD 0.40, 95% CI -0.26 to 1.05; 37 participants (QoL measured with Functional Assessment of Cancer Therapy-Prostate) • SMD 0.47, 95% CI -0.40 to 1.34; 21 participants (QoL measured with World Health Organization QoL questionnaire (WHOQOL-BREF)) All three studies measured physical performance. Our analyses of two studies, presented below, showed that exercise may improve physical performance, but we are very unsure about the results (positive SMD values signify better physical performance; very low certainty) • SMD 1.25, 95% CI 0.54 to 1.97; 37 participants (shoulder mobility and pain measured on a visual analogue scale) • SMD 3.13 (95% CI 2.32 to 3.95; 54 participants (physical performance measured with the six-minute walk test) Our analyses of data from the third study showed that exercise may have little or no effect on physical performance measured with the stand-and-sit test, but we are very unsure about the results (SMD 0.00, 95% CI -0.86 to 0.86, positive SMD values signify better physical performance; 21 participants; very low certainty). Two studies measured psychosocial effects. Our analyses (presented below) showed that exercise may have little or no effect on psychosocial effects, but we are very unsure about the results (positive SMD values signify better psychosocial well-being; very low certainty). • SMD 0.48, 95% CI -0.18 to 1.13; 37 participants (psychosocial effects measured on the WHOQOL-BREF social subscale) • SMD 0.29, 95% CI -0.57 to 1.15; 21 participants (psychosocial effects measured with the Beck Depression Inventory) Two studies recorded adverse events related to the exercise programmes and reported no events. We estimated the certainty of the evidence as very low. No studies reported adverse events unrelated to exercise. No studies reported the other outcomes we intended to analyse (overall survival, anthropometric measurements, return to work). AUTHORS' CONCLUSIONS There is little evidence on the effects of exercise interventions in people with cancer who are receiving RT alone. While all included studies reported benefits for the exercise intervention groups in all assessed outcomes, our analyses did not consistently support this evidence. There was low-certainty evidence that exercise improved fatigue in all three studies. Regarding physical performance, our analysis showed very low-certainty evidence of a difference favouring exercise in two studies, and very low-certainty evidence of no difference in one study. We found very low-certainty evidence of little or no difference between the effects of exercise and no exercise on quality of life or psychosocial effects. We downgraded the certainty of the evidence for possible outcome reporting bias, imprecision due to small sample sizes in a small number of studies, and indirectness of outcomes. In summary, exercise may have some beneficial outcomes in people with cancer who are receiving RT alone, but the evidence supporting this statement is of low certainty. There is a need for high-quality research on this topic.
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Affiliation(s)
- Maike Trommer
- Department of Radiation Oncology, Cyberknife and Radiotherapy, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Simone Marnitz
- Department of Radiation Oncology, Cyberknife and Radiotherapy, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Nicole Skoetz
- Cochrane Cancer, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ronja Rupp
- Internal Medicine I, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Timo Niels
- Internal Medicine I, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Janis Morgenthaler
- Department of Radiation Oncology, Cyberknife and Radiotherapy, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Sebastian Theurich
- Internal Medicine III - Hematology/Oncology, University Hospital Munich, Munich, Germany
| | | | - Christian Baues
- Department of Radiation Oncology, Cyberknife and Radiotherapy, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Freerk T Baumann
- Internal Medicine I, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
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12
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Nguyen JM, Rotonda C, Gendarme S, Martin-Krumm C, Omorou A, Van Hoye A. Oncology health professionals' perspectives of determinants of exercise by cancer patients: A socio-ecological approach. Eur J Oncol Nurs 2022; 61:102234. [DOI: 10.1016/j.ejon.2022.102234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 10/13/2022] [Accepted: 10/30/2022] [Indexed: 11/06/2022]
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13
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Moon C, Gallegos AM, Sheikh B, Kumar P, Liss M, Patel DI. Pilot Study on the Impact of a Home-Based Exercise Program on Inflammatory Cytokines and Quality of Life in Men with Prostate Cancer Under Active Surveillance. Cancer Control 2022; 29:10732748221130964. [PMID: 36200522 PMCID: PMC9549098 DOI: 10.1177/10732748221130964] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES This study aimed to demonstrate potential translation of pre-clinical studies to a home-based exercise intervention in mediating inflammatory cytokine markers and tumor progression in men under active surveillance for prostate cancer. METHODS A 2-arm randomized control parallel group design was used. The exercise intervention consisted of 24 weeks of an aerobic and resistance home-based exercise program and results were compared to a waitlist control group. Data were collected at baseline and end of study for eotaxin, interferon-γ (INF-γ), interleukin-12 (IL-12), interleukin-1α (IL-1α), interleukin-5 (IL-5), interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), and vascular endothelial growth factor (VEGF), distanced walked during a 6-minute walk test (6MWT), body mass index, and health-related quality of life. RESULTS Non-significant decreases were observed in all biomarkers, especially VEGF (pre: 125.16 ± 198.66, post: 80.29 ± 124.30, P = .06) and INF-γ (pre: 152.88 ± 312.71, post: 118.93 ± 158.79, P = .08), in the intervention group; only IL- α (pre: 332.15 ± 656.77, post: 255.12 ± 502.09, P = .20) decreased in the control group while all other biomarkers increased from baseline to end of study. A non-significant increase in 6MWT distance was observed in the intervention group, while a decrease was seen in the control group. Significant decreases in physical function, emotional wellbeing, and total composite scale on the FACIT-F were observed in the intervention group, possibly due to the isolation restrictions of COVID-19. Physical function on the SF-36 significantly increased in the control group. CONCLUSIONS Future studies with powered samples are needed to confirm the trends observed for inflammatory biomarkers and functional fitness.
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Affiliation(s)
- Crisann Moon
- Biobehavioral Laboratory, School of
Nursing, UT Health San Antonio, San Antonio, TX, USA
| | - Amber M. Gallegos
- Biobehavioral Laboratory, School of
Nursing, UT Health San Antonio, San Antonio, TX, USA
| | - Bilal Sheikh
- Biobehavioral Laboratory, School of
Nursing, UT Health San Antonio, San Antonio, TX, USA
| | - Pratap Kumar
- School of Medicine, UT Health San Antonio, San Antonio, TX, USA,Mays Cancer Center, UT Health San Antonio, San Antonio, TX, USA
| | - Michael Liss
- School of Medicine, UT Health San Antonio, San Antonio, TX, USA,Mays Cancer Center, UT Health San Antonio, San Antonio, TX, USA
| | - Darpan I. Patel
- Biobehavioral Laboratory, School of
Nursing, UT Health San Antonio, San Antonio, TX, USA,Mays Cancer Center, UT Health San Antonio, San Antonio, TX, USA,Barshop Institute for Longevity and
Aging Studies, UT Health San Antonio, San Antonio, TX, USA,Darpan I. Patel, The University of Texas
Health Science Center at San Antonio, 7703 Floyd Curl Dr, San Antonio, TX 78229,
USA.
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14
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Gnagnarella P, Marvaso G, Jereczek-Fossa BA, de Cobelli O, Simoncini MC, Nevola Teixeira LF, Sabbatini A, Pravettoni G, Johansson H, Nezi L, Muto P, Borzillo V, Celentano E, Crispo A, Pinto M, Cavalcanti E, Gandini S. Life style and interaction with microbiota in prostate cancer patients undergoing radiotherapy: study protocol for a randomized controlled trial. BMC Cancer 2022; 22:794. [PMID: 35854230 PMCID: PMC9295396 DOI: 10.1186/s12885-022-09521-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 04/08/2022] [Indexed: 11/11/2022] Open
Abstract
Background Prostate cancer (PCa) is the second most common cancer in men worldwide. The standard non-surgical approach for localized PCa is radiotherapy (RT), but one of the limitations of high-dose RT is the potential increase in gastrointestinal and genitourinary toxicities. We present the protocol of the Microstyle study, a multicentre randomized two-arm crossover clinical trial. The primary outcome will be assessed at the end of 6-month intervention, by measuring the change in adherence to a healthy lifestyle score. The hypothesis is that modifying lifestyle we change microbiome and improve quality of life and decrease side effects of RT. Methods Study participants will be recruited among men undergoing RT in two Italian centers (Milan and Naples). We foresee to randomize 300 patients in two intervention arms: Intervention Group (IG) and Control Group (CG). Participants allocated to the IG will meet a dietitian and a physiotherapist before RT to receive personalized diet and exercise recommendations, according to their health status, to improve overall lifestyle and reduce side effects (bowel and/or urinary problems). Dietitian and physiotherapist will work together to set individualized goals to reduce or eliminate side effects and pain according to their health status. All participants (IG) will be given a pedometer device (steps counter) in order to monitor and to spur participants to increase physical activity and reduce sedentary behavior. Participants included in the CG will receive baseline general advice and materials available for patients undergoing RT. According to the cross-over design, the CG will cross to the intervention approach after 6-month, to actively enhance compliance towards suggested lifestyle recommendations for all patients. Discussion This trial is innovative in its design because we propose a lifestyle intervention during RT, that includes both dietary and physical activity counselling, as well as monitoring changes in microbiome and serum biomarkers. The promotion of healthy behaviour will be initiated before initiation of standard care, to achieve long lasting effects, controlling side effects, coping with feelings of anxiety and depression and improve efficacy of RT. Trial registration ClincalTrial.gov registration number: NCT05155618. Retrospectively registered on December 13, 2021. The first patient was enrolled on October 22, 2021. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-022-09521-4.
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Affiliation(s)
- Patrizia Gnagnarella
- Division of Epidemiology and Biostatistics, European Institute of Oncology IRCSS, Milan, Italy.
| | - Giulia Marvaso
- Department of Radiation Oncology, European Institute of Oncology IRCSS, Milan, Italy.,Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | - Barbara Alicja Jereczek-Fossa
- Department of Radiation Oncology, European Institute of Oncology IRCSS, Milan, Italy.,Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | - Ottavio de Cobelli
- Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy.,Division of Urology, European Institute of Oncology IRCSS, Milan, Italy
| | | | | | - Annarita Sabbatini
- Dietetic and Clinical Nutrition Unit, European Institute of Oncology IRCSS, Milan, Italy
| | - Gabriella Pravettoni
- Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy.,Applied Research Division for Cognitive and Psychological Sciences, European Institute of Oncology IRCSS, Milan, Italy
| | - Harriet Johansson
- Division of Cancer Prevention and Genetics, European Institute of Oncology IRCSS, Milan, Italy
| | - Luigi Nezi
- Department of Experimental Oncology, European Institute of Oncology IRCSS, Milan, Italy
| | - Paolo Muto
- Department of Radiation Oncology, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Naples, Italy
| | - Valentina Borzillo
- Department of Radiation Oncology, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Naples, Italy
| | - Egidio Celentano
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Naples, Italy
| | - Anna Crispo
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Naples, Italy
| | - Monica Pinto
- Rehabilitation Medicine Unit, Strategic Health Services Department, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Naples, Italy
| | - Ernesta Cavalcanti
- Laboratory Medicine Unit, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Naples, Italy
| | - Sara Gandini
- Department of Experimental Oncology, European Institute of Oncology IRCSS, Milan, Italy
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15
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Knowles R, Kemp E, Miller M, Davison K, Koczwara B. Physical activity interventions in older people with cancer: A review of systematic reviews. Eur J Cancer Care (Engl) 2022; 31:e13637. [PMID: 35730689 DOI: 10.1111/ecc.13637] [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: 11/30/2021] [Revised: 03/30/2022] [Accepted: 06/06/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Whilst there has been a wealth of research on benefits of physical activity (PA) in people with cancer, with three published reviews of reviews, no review of reviews has focused on older adults (65 years or older) who may have unique biological characteristics and barriers. We summarised PA effectiveness from reviews where majority of study participants were 65 years or older. METHODS Six databases were searched for systematic reviews of randomised controlled studies (RCTs)/quasi-RCTs examining any type of PA in reviews where majority of study participants were aged 65 years or older. Two reviewers conducted the search and analysis according to PRISMA and JBI guidelines. RESULTS Fifteen reviews involving 76 different primary studies (5404 participants) were included. The majority (3827; 71%) had prostate cancer. PA was associated with benefits across multiple physical outcomes (muscle mass, functional performance, strength), improved fatigue and health service outcomes. In contrast to younger adults, there was no improvement in anxiety and mixed findings for quality of life and depression. CONCLUSION PA is associated with multiple benefits in older adults with cancer, with some differences compared to younger individuals which may reflect biological or behavioural determinants. Future research should focus on mechanisms underlying PA effectiveness and underrepresented populations.
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Affiliation(s)
- Reegan Knowles
- Survivorship and Psycho-Oncology, Flinders Cancer Research, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Emma Kemp
- Survivorship and Psycho-Oncology, Flinders Cancer Research, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Michelle Miller
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Kade Davison
- Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Bogda Koczwara
- Survivorship and Psycho-Oncology, Flinders Cancer Research, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
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16
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Toohey K, Paterson C, Moore M, Hunter M. Towards best practice in the delivery of prescribed exercise via telehealth for individuals diagnosed with cancer: A randomised controlled trial protocol. Contemp Clin Trials 2022; 119:106833. [PMID: 35718307 PMCID: PMC9380644 DOI: 10.1016/j.cct.2022.106833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 06/07/2022] [Accepted: 06/11/2022] [Indexed: 11/26/2022]
Abstract
Introduction There is a plethora of evidence supporting the therapeutic effects of regular exercise for individuals diagnosed with cancer, particularly during active treatment. The COVID-19 pandemic has complicated delivery of face-to-face exercise programs for individuals with cancer, particularly as this cohort is at much higher risk of morbidity and mortality. The proposed randomised controlled trial explores best practice and assesses the feasibility of exercise programs delivered via Telehealth for individuals diagnosed with cancer. Methods Participants (n = 160) must have a current cancer diagnosis, must be undergoing active treatment, receive medical clearance, and have access to a smart device to participate in supervised exercise. Participants will be randomly assigned (two arms; 1:1) to supervised exercise delivered via Telehealth (Coviu) or usual care (receiving physical activity guidelines). Telehealth arm participants will receive an individualised program according to their health status, comorbidities, and exercise history, delivered weekly for eight weeks by an Accredited Exercise Physiologist in a group setting. Outcome measures will assess feasibility, psychological wellbeing, quality of life, symptom management, physical activity and fitness levels. A Telehealth arm participant sub-sample will have the opportunity to share their experience and feedback via an online interview at the intervention completion. Ethics and dissemination Outcomes from this study will create evidence to inform best practice for the safe delivery of exercise via Telehealth for individuals diagnosed with cancer. Evidence will be published in peer-reviewed journals and may be presented at national and international conferences. Ethics approval was obtained at the University of Canberra (Project ID: 4604. Version 2: 1st March 2022). Trial registration number: ANZCTR: ACTRN12620001054909. Universal Trial Number: U1111–1256-4083.
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Affiliation(s)
- Kellie Toohey
- Faculty of Health, University of Canberra, Bruce 2617, ACT, Australia; Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce 2617, Australia.
| | - Catherine Paterson
- Faculty of Health, University of Canberra, Bruce 2617, ACT, Australia; Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce 2617, Australia; Robert Gordon University, Aberdeen AB10 7QB, Scotland, UK
| | - Melanie Moore
- Faculty of Health, University of Canberra, Bruce 2617, ACT, Australia; Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce 2617, Australia
| | - Maddison Hunter
- Faculty of Health, University of Canberra, Bruce 2617, ACT, Australia; Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce 2617, Australia
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17
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Visser D, Wattel EM, Gerrits KHL, van der Wouden JC, Meiland FJM, de Groot AJ, Jansma EP, Hertogh CMPM, Smit EB. Effectiveness and characteristics of physical fitness training on aerobic fitness in vulnerable older adults: an umbrella review of systematic reviews. BMJ Open 2022; 12:e058056. [PMID: 35641014 PMCID: PMC9157351 DOI: 10.1136/bmjopen-2021-058056] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES To present an overview of effectiveness and training characteristics of physical training on aerobic fitness, compared with alternative or no training, in adults aged over 65 years with various health statuses, providing a basis for guidelines for aerobic training of vulnerable older adults that can be used in geriatric rehabilitation. DESIGN An umbrella review of systematic reviews that included both randomised controlled trials and other types of trials. DATA SOURCES MEDLINE, Embase, CINAHL and the Cochrane Library were searched on 9 September 2019. ELIGIBILITY CRITERIA FOR SELECTING STUDIES We included systematic reviews reporting on physical training interventions that are expected to improve aerobic fitness, presenting results for adults aged 65 years and older, describing at least one of the FITT-characteristics: Frequency, Intensity, Time or Type of exercise, and measuring aerobic fitness at least before and after the intervention. DATA EXTRACTION AND SYNTHESIS Two independent reviewers extracted the data and assessed the risk of bias. A narrative synthesis was performed. RESULTS We included 51 papers on 49 reviews. Positive effect of training on aerobic fitness was reported by 33 reviews, 11 reviews remained inconclusive and 5 reviews reported no effect. Training characteristics varied largely. Frequency: 1-35 sessions/week, Intensity: light-vigorous, Time: <10-120 min/session and Types of exercise: many. The methodological quality was most often low. Subgroup analyses revealed positive effects for all health conditions except for trauma patients. Exercise characteristics from current existing guidelines are widely applicable. For vulnerable older adults, lower intensities and lower frequencies were beneficial. Some health conditions require specific adjustments. Information on adverse events was often lacking, but their occurrence seemed rare. CONCLUSION Physical fitness training can be effective for vulnerable older adults. Exercise characteristics from current existing guidelines are widely applicable, although lower frequencies and intensities are also beneficial. For some conditions, adjustments are advised. PROSPERO REGISTRATION NUMBER CRD42020140575.
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Affiliation(s)
- Dennis Visser
- Department of Medicine for Older People, Amsterdam UMC, location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Noord-Holland, The Netherlands
- Aging & Later Life, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Elizabeth M Wattel
- Department of Medicine for Older People, Amsterdam UMC, location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Noord-Holland, The Netherlands
- Aging & Later Life, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Karin H L Gerrits
- Department of Human Movement Sciences, VU University Amsterdam, Amsterdam, The Netherlands
- Stichting Merem Medische Revalidatie, Hilversum, Noord-Holland, The Netherlands
| | - Johannes C van der Wouden
- Department of Medicine for Older People, Amsterdam UMC, location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Noord-Holland, The Netherlands
- Aging & Later Life, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Franka J M Meiland
- Department of Medicine for Older People, Amsterdam UMC, location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Noord-Holland, The Netherlands
- Aging & Later Life, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Aafke J de Groot
- Department of Medicine for Older People, Amsterdam UMC, location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Noord-Holland, The Netherlands
- Aging & Later Life, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Elise P Jansma
- Aging & Later Life, Amsterdam Public Health, Amsterdam, The Netherlands
- Department of Epidemiology and Biostatistics, Amsterdam UMC, location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, The Netherlands
| | - Cees M P M Hertogh
- Department of Medicine for Older People, Amsterdam UMC, location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Noord-Holland, The Netherlands
- Aging & Later Life, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Ewout B Smit
- Department of Medicine for Older People, Amsterdam UMC, location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Noord-Holland, The Netherlands
- Aging & Later Life, Amsterdam Public Health, Amsterdam, The Netherlands
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18
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Trinh L, Sabiston CM, Alibhai SMH, Jones JM, Arbour-Nicitopoulos KP, Mina DS, Campbell K, Faulkner GE. A distance-based, randomized controlled trial for reducing sedentary behavior among prostate cancer survivors: a study protocol. BMC Public Health 2022; 22:855. [PMID: 35484523 PMCID: PMC9047476 DOI: 10.1186/s12889-022-13218-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 04/11/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Prostate cancer survivors (PCS) experience long-term side effects beyond treatment such as fatigue, depression and anxiety. Quality and engaging supportive care programs are needed to reduce these chronic and debilitating effects. Independent of physical activity (PA), high volumes of sedentary behavior (SB) are associated with chronic disease-related risk factors and poorer cancer-specific quality of life (QoL). Simultaneously increasing PA and decreasing SB may be an effective health promotion strategy. Given that PCS may face several barriers to engaging in supervised programs, there is a need to develop and assess the efficacy of interventions that employ distance-based approaches for behavior change. The primary aim of this study is to determine the effects of a 12-week intervention (Fitbit + behavioral counselling) vs. Fitbit-only control group in reducing SB among PCS. Secondary outcomes include light-intensity PA, QoL, motivational outcomes, and patient satisfaction. METHODS This two-armed, randomized controlled trial will recruit inactive PCS (stage I-IV) across Canada who self-report engaging in >8 hours/day of SB. Participants will be randomized to the intervention (n=60; Fitbit and behavioral support) or active control group (n=60; Fitbit-only). The intervention consists of the use of a Fitbit and a series of six behavioral support sessions (two group, four individual) to aid PCS in gradually replacing SB with light-intensity PA by increasing their daily step counts to 3,000 steps above their baseline values. The Fitbit-only control condition will receive a Fitbit and public health PA resources. The primary outcome is change in SB measured objectively using activPAL inclinometers. All secondary outcomes will be measured via self-report, except for PA which will be measuring using Fitbits. Data will be collected at baseline, post-intervention, and at 6-month post-intervention. DISCUSSION Reducing SB and increasing light-intensity PA plays an important, yet often undervalued role in the health and well-being of PCS. This study will create a unique distance-based platform that can be used by clinical and community-based organizations as a low-cost, supportive care tool to improve health outcomes for PCS. TRIAL REGISTRATION ClinicalTrials.gov Identifier NCT05214937 . Registered January 28, 2022 Protocol version: v.1.
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Affiliation(s)
- Linda Trinh
- Faculty of Kinesiology and Physical Education, University of Toronto, 55 Harbord Street, Toronto, Ontario, M5S 2W6, Canada.
| | - Catherine M Sabiston
- Faculty of Kinesiology and Physical Education, University of Toronto, 55 Harbord Street, Toronto, Ontario, M5S 2W6, Canada
| | - Shabbir M H Alibhai
- Faculty of Medicine, University of Toronto, 1 King's College Circle, Medical Sciences Building, Toronto, ON, M5S 1A8, Canada
- Toronto General Research Institute, Toronto General Hospital, 200 Elizabeth St, Toronto, ON, M5G 2C4, Canada
| | - Jennifer M Jones
- Department of Supportive Care, Princess Margaret Cancer Centre, 610 University Ave, Toronto, ON, M5G 2C1, Canada
| | - Kelly P Arbour-Nicitopoulos
- Faculty of Kinesiology and Physical Education, University of Toronto, 55 Harbord Street, Toronto, Ontario, M5S 2W6, Canada
| | - Daniel Santa Mina
- Faculty of Kinesiology and Physical Education, University of Toronto, 55 Harbord Street, Toronto, Ontario, M5S 2W6, Canada
| | - Kristin Campbell
- Department of Physical Therapy, University of British Columbia, 2177 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Guy E Faulkner
- School of Kinesiology, University of British Columbia, 210-6081 University Boulevard, Vancouver, BC, V6T 1Z1, Canada
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19
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Johannsen M, Stoll C, Raida M, van Oorschot B, Flörcken A. Supportive therapy and complementary medicine in renal cell carcinoma. World J Urol 2021; 40:2359-2371. [PMID: 34821959 DOI: 10.1007/s00345-021-03885-1] [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: 04/02/2021] [Accepted: 11/08/2021] [Indexed: 11/29/2022] Open
Abstract
PURPOSE As part of the German interdisciplinary S3-guideline "Diagnosis, Treatment and Followup of Renal Cell Carcinoma", this article aimes to provide guidance regarding the use of supportive therapy and complementary medicine in patients with advanced or metastatic renal cell carcinoma. METHODS The German interdisciplinary S3-guidelines are national clinical practice guidelines that implement the highest methodological quality of evidence-based medicine. Recommendations and evidence-based statements are provided according to available evidence. RESULTS Supportive and palliative care are important areas of tumor treatment and require knowledge on the management of a variety of issues. This article outlines the management of tumor-related symptoms such as pain, undesired treatment-related effects, palliative care and end-of-life care in patients with renal cell carcinoma. CONCLUSION Patients with advanced or metastatic renal cell carcinoma should have access to supportive and palliative care according to their individual needs. There is very limited evidence regarding the impact of complementary medicine for the treatment of patients with renal cell carcinoma.
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Affiliation(s)
- M Johannsen
- Urology Practice Johannsen & Laux, Berlin and d-uo (Deutsche Uro-Onkologen), Berlin, Germany
| | - C Stoll
- Department of Oncology, Clinic Herzoghoehe, Bayreuth, Germany
| | - M Raida
- VAMED Rehabilitation Clinic Bergisch-Land, Wuppertal, Germany
| | - B van Oorschot
- Interdisciplinary Center for Palliative Medicine, Department of Radiation Oncology, University Hospital Würzburg, Würzburg, Germany
| | - A Flörcken
- Department of Hematology, Oncology, and Tumor Immunology, Charité-Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany
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20
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Keine Zeit zum Heben? Planung von zeiteffizienten Trainingsprogrammen für Kraft und Hypertrophie: eine narrative Literaturübersicht. PHYSIOSCIENCE 2021. [DOI: 10.1055/a-1541-6897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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21
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Rhynehart A, Dunlevy C, Hayes K, O'Connell J, O'Shea D, O'Malley E. The Association of Physical Function Measures With Frailty, Falls History, and Metabolic Syndrome in a Population With Complex Obesity. FRONTIERS IN REHABILITATION SCIENCES 2021; 2:716392. [PMID: 36188769 PMCID: PMC9397832 DOI: 10.3389/fresc.2021.716392] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 07/16/2021] [Indexed: 11/19/2022]
Abstract
Background: Frailty, falls and metabolic syndrome are known to be associated with poorer physical function. This study builds on available research by further investigating the relationship between physical function measures, including those comprising frailty, with metabolic syndrome (MetS) and falls, in the context of complex obesity. Methods: Participants were recruited from the national Level 3 weight management service in Ireland. A retrospective audit of data gathered at initial assessment was performed. Data included past medical history, blood tests, blood pressure measurement, anthropometrics, falls history, self-reported physical activity levels (PALs) and physical function measures, including hand grip strength (HGS), “timed up and go” (TUG), functional reach (FR), sit to stand (STS) and gait speed. A modified version of the Fried Frailty Index was employed. Results: Of the 713 participants, 65.1% (n = 464) were female and 34.9% (n = 249) were male with a mean age of 44.2 (±11.7) years and body mass index (BMI) of 50.6 kg/m2 (±8.2). Frailty was identified in 3.4% (n = 24), falls in 28.8% (n = 205) and MetS in 55.1% (n = 393). Frailty was associated with older age (53.8 ± 14.3 vs. 43.9 ± 11.5 years), poorer PALs (27.29 ± 46.3 vs. 101.1 ± 147.4 min/wk), reduced grip strength (17.7 ± 4.6 vs. 34.2 ± 11.0 Kg) longer STS (21.7 ± 6.6 vs. 13.7 ± 5.7 s), shorter functional reach (29.7 ± 7.9 vs. 37.9 ± 8.2 cm) and slower gait speed (0.6 ± 0.2 vs. 1.1 ± 0.5 m/s). Those reporting a falls history had a reduced FR (35.8 ± 8.9 vs. 38.3 ± 7.8 cm) and slower STS (15.4 ± 8.0 vs. 13.3 ± 4.7 s). Participants with MetS had lower PALs (83.2 ± 128.2 vs. 119.2 ± 157.6) and gait speed (1.1 ± 0.3 vs. 1.2 ± 0.7 m/s). There was no difference in BMI between fallers and non-fallers (51.34 ± 8.44 vs. 50.33 ± 8.13 Kg/m2, p = 0.138), nor between those with or without MetS. Significant associations were found between BMI and all physical function measures except the TUAG. Conclusion: The associations between frailty, falls and MetS and their combined impact on physical function in people living with obesity demonstrates the need for appropriate screening. Utilising grip strength and gait speed to identify frailty in those with obesity and metabolic syndrome could help target therapies aimed at improving strength, physical function and ultimately quality of life.
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Affiliation(s)
- Amanda Rhynehart
- Weight Management Service, St Columcille's Hospital, Dublin, Ireland
- *Correspondence: Amanda Rhynehart ;
| | - Colin Dunlevy
- Weight Management Service, St Columcille's Hospital, Dublin, Ireland
| | - Katie Hayes
- Weight Management Service, St Columcille's Hospital, Dublin, Ireland
| | - Jean O'Connell
- Weight Management Service, St Columcille's Hospital, Dublin, Ireland
- Obesity Research Group, St Vincent's University Hospital, Dublin, Ireland
| | - Donal O'Shea
- Weight Management Service, St Columcille's Hospital, Dublin, Ireland
- Obesity Research Group, St Vincent's University Hospital, Dublin, Ireland
| | - Emer O'Malley
- Weight Management Service, St Columcille's Hospital, Dublin, Ireland
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22
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Marshall CH, Tunacao J, Danda V, Tsai HL, Barber J, Gawande R, Weiss CR, Denmeade SR, Joshu C. Reversing the effects of androgen-deprivation therapy in men with metastatic castration-resistant prostate cancer. BJU Int 2021; 128:366-373. [PMID: 33765326 PMCID: PMC9844547 DOI: 10.1111/bju.15408] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To investigate whether bipolar androgen therapy (BAT), involving rapid cyclic administration of high-dose testosterone, as a novel treatment for metastatic castration-resistant prostate cancer (mCRPC) promotes improvements in body composition and associated improvements in lipid profiles and quality of life. PATIENTS AND METHODS Men from two completed trials with computed tomography imaging at baseline and after three cycles of BAT were included. Cross-sectional areas of psoas muscle, visceral and subcutaneous fat were measured at the L3 vertebral level. Functional Assessment of Chronic Illness Therapy - Fatigue questionnaire and 36-item short-form health survey were used to assess quality of life. RESULTS The 60 included patients lost a mean (sd) of 7.8 (8.2)% of subcutaneous fat, 9.8 (18.2)% of visceral fat, and gained 12.2 (6.7)% muscle mass. Changes in subcutaneous and visceral fat were positively correlated with each other (Spearman's correlation coefficient 0.58, 95% confidence interval 0.35-0.71) independent of the effects of age, body mass index, and duration of androgen-deprivation therapy. Energy, physical function, and measures of limitations due to physical health were all significantly improved at 3 months. The improvements in body composition were not correlated with decreases in lipid levels or observed improvements in quality of life. CONCLUSIONS In the present study, BAT was associated with significant improvements in body composition, lipid parameters, and quality of life. This has promising implications for the long-term health of men with mCRPC.
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Affiliation(s)
| | - Jessa Tunacao
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Varun Danda
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA
| | - Hua-Ling Tsai
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - John Barber
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Rakhee Gawande
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Clifford R. Weiss
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Samuel R. Denmeade
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Corinne Joshu
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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23
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McGing JJ, Radford SJ, Francis ST, Serres S, Greenhaff PL, Moran GW. Review article: The aetiology of fatigue in inflammatory bowel disease and potential therapeutic management strategies. Aliment Pharmacol Ther 2021; 54:368-387. [PMID: 34228817 DOI: 10.1111/apt.16465] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 09/30/2020] [Accepted: 05/20/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Fatigue is the inability to achieve or maintain an expected work output resulting from central or peripheral mechanisms. The prevalence of inflammatory bowel disease (IBD) fatigue can reach 86% in active disease, persisting in 50%-52% of patients with mild to inactive disease. Fatigue is the commonest reason for work absence in IBD, and patients often report fatigue burden to be greater than that of primary disease symptoms. Relatively few evidence-based treatment options exist, and the aetiology is poorly understood. AIM To review the available data and suggest a possible aetiology of IBD fatigue and to consider the efficacy of existing management strategies and highlight potential future interventions. METHODS We reviewed fatigue-related literature in IBD using PubMed database. RESULTS Disease related factors such as inflammation and pharmacological treatments negatively impact skeletal muscle and brain physiology, likely contributing to fatigue symptoms. Secondary factors such as malnutrition, anaemia, sleep disturbance and psychological comorbidity are potential determinants. Immune profile, faecal microbiota composition and physical fitness differ significantly between fatigued and non-fatigued patients, suggesting these may be aetiological factors. Solution-focused therapy, high-dosage thiamine supplementation and biological therapy may reduce fatigue perception in IBD. The effect of physical activity interventions is inconclusive. CONCLUSIONS A multimodal approach is likely required to treat IBD fatigue. Established reversible factors like anaemia, micronutrient deficiencies and active disease should initially be resolved. Psychosocial intervention shows potential efficacy in reducing fatigue perception in quiescent disease. Restoring physical deconditioning by exercise training intervention may further improve fatigue burden.
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Affiliation(s)
- Jordan J McGing
- School of Medicine, University of Nottingham, Nottingham, UK.,Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, UK
| | - Shellie Jean Radford
- School of Medicine, University of Nottingham, Nottingham, UK.,National Institute of Health Research Nottingham Biomedical Research Centre (NIHR), Nottingham University Hospitals and University of Nottingham, Nottingham, UK
| | - Susan T Francis
- Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, UK.,National Institute of Health Research Nottingham Biomedical Research Centre (NIHR), Nottingham University Hospitals and University of Nottingham, Nottingham, UK
| | - Sébastien Serres
- School of Life Sciences, University of Nottingham, Nottingham, UK
| | - Paul L Greenhaff
- National Institute of Health Research Nottingham Biomedical Research Centre (NIHR), Nottingham University Hospitals and University of Nottingham, Nottingham, UK.,MRC Versus Arthritis Centre for Musculoskeletal Ageing Research, National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre, School of Life Sciences, University of Nottingham, Nottingham, UK
| | - Gordon W Moran
- School of Medicine, University of Nottingham, Nottingham, UK.,National Institute of Health Research Nottingham Biomedical Research Centre (NIHR), Nottingham University Hospitals and University of Nottingham, Nottingham, UK
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24
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Figueiredo VC, McCarthy JJ. Targeting cancer via ribosome biogenesis: the cachexia perspective. Cell Mol Life Sci 2021; 78:5775-5787. [PMID: 34196731 PMCID: PMC11072391 DOI: 10.1007/s00018-021-03888-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/03/2021] [Accepted: 06/18/2021] [Indexed: 12/14/2022]
Abstract
Cancer cachexia afflicts many advanced cancer patients with many progressing to death. While there have been many advancements in understanding the molecular mechanisms that contribute to the development of cancer cachexia, substantial gaps still exist. Chemotherapy drugs often target ribosome biogenesis to slow or blunt tumor cell growth and proliferation. Some of the most frequent side-effects of chemotherapy are loss of skeletal muscle mass, muscular strength and an increase in fatigue. Given that ribosome biogenesis has emerged as a main mechanism regulating muscle hypertrophy, and more recently, also implicated in muscle atrophy, we propose that some chemotherapy drugs can cause further muscle wasting via its effect on skeletal muscle cells. Many chemotherapy drugs, including the most prescribed drugs such as doxorubicin and cisplatin, affect ribosomal DNA transcription, or other pathways related to ribosome biogenesis. Furthermore, middle-aged and older individuals are the most affected population with cancer, and advanced cancer patients often show reduced levels of physical inactivity. Thus, aging and inactivity can themselves affect muscle ribosome biogenesis, which can further worsen the effect of chemotherapy on skeletal muscle ribosome biogenesis and, ultimately, muscle mass and function. We propose that chemotherapy can accelerate the onset or worsen cancer cachexia via its inhibitory effects on skeletal muscle ribosome biogenesis. We end our review by providing recommendations that could be used to ameliorate the negative effects of chemotherapy on skeletal muscle ribosome biogenesis.
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Affiliation(s)
- Vandré Casagrande Figueiredo
- College of Health Sciences, University of Kentucky, Lexington, KY, USA.
- Center for Muscle Biology, University of Kentucky, Lexington, KY, USA.
| | - John J McCarthy
- Department of Physiology, College of Medicine, University of Kentucky, Lexington, KY, USA
- Center for Muscle Biology, University of Kentucky, Lexington, KY, USA
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25
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Zimmerman A, Planek MIC, Chu C, Oyenusi O, Paner A, Reding K, Skeete J, Clark B, Okwuosa TM. Exercise, cancer and cardiovascular disease: what should clinicians advise? Cardiovasc Endocrinol Metab 2021; 10:62-71. [PMID: 34113793 PMCID: PMC8186519 DOI: 10.1097/xce.0000000000000228] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 07/05/2020] [Indexed: 12/18/2022]
Abstract
Cardiovascular disease is one of the leading causes of morbidity and mortality in persons with cancer. The elevated risk is thought to derive from the combination of cardiovascular risk factors and direct cardiotoxicity from cancer therapies. Exercise may be a potential strategy to counteract these toxicities and maintain cardiovascular reserve. In this article, we review the evidence for the potential cardioprotective effects of exercise training in cancer patients before, during, and following treatment. We also propose a patient-tailored approach for the development of targeted prescriptions based on individual exercise capacity and cardiovascular reserve.
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Affiliation(s)
| | | | - Catherine Chu
- Rush Medical College, Rush University Medical Center
| | | | - Agne Paner
- Division of Hematology/Oncology, Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois
| | - Kerryn Reding
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Jamario Skeete
- Division of Cardiology, Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Brian Clark
- Division of Cardiology, Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Tochi M. Okwuosa
- Division of Cardiology, Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
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26
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Coping strategies in active and inactive men with prostate cancer: a qualitative study. J Cancer Surviv 2021; 16:421-431. [PMID: 33835392 PMCID: PMC8964636 DOI: 10.1007/s11764-021-01037-3] [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: 01/21/2021] [Accepted: 03/26/2021] [Indexed: 10/24/2022]
Abstract
PURPOSE Prostate cancer can result in a shift in the way men perceive their masculinity. Despite the interest in exercise as a treatment strategy to address masculinity concerns, there is insufficient information about how perceptions may differ in active and inactive men. The aim of this study was to explore how exercise might influence self-perceptions of masculinity in men across the exercise continuum (from active to inactive) and in men receiving different forms of treatment for their prostate cancer, including androgen deprivation therapy. METHODS Individual, semi-structured interviews were conducted with 15 men. Ten men met aerobic and/or resistance guidelines and were considered active, while five men, considered inactive, reached neither guideline. This study used a grounded theory approach to data analysis, examining masculinity issues in active men and compared them to inactive men. RESULTS Redefining masculinity emerged as an overarching theme. Subthemes were the various coping strategies men used to redefining masculinity and directly related to their exercise habits. Coping subthemes included re-establishing control, tapping into competition, remaining socially connected, rationalization, and acceptance. CONCLUSIONS In the active men, dominant coping strategies achieved from exercise included control through active participation, acceptance, competition, and leadership. In inactive men, control was observed with knowledge-seeking behaviors, rationalization, and acceptance. IMPLICATIONS FOR CANCER SURVIVORS A tailored approach to exercise counseling based upon specific masculine traits and motivations could lead to improved exercise engagement.
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27
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Turner RR, Arden MA, Reale S, Sutton E, Taylor SJC, Bourke L, Greenfield DM, Morrissey D, Brown J, Doherty P, Rosario DJ, Steed L. The development of a theory and evidence-based intervention to aid implementation of exercise into the prostate cancer care pathway with a focus on healthcare professional behaviour, the STAMINA trial. BMC Health Serv Res 2021; 21:273. [PMID: 33766001 PMCID: PMC7992804 DOI: 10.1186/s12913-021-06266-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 03/08/2021] [Indexed: 12/24/2022] Open
Abstract
Background Twice-weekly supervised aerobic and resistance exercise for 12 weeks reduces fatigue and improves quality of life in men on Androgen Deprivation Therapy for prostate cancer. Despite the National Institute for Health and Care Excellence (NICE) proposing this as standard of care, it does not routinely take place in practice. Healthcare professionals are in a prime position to deliver and integrate these recommendations. A change in the behaviour of clinical teams is therefore required. In this paper, we describe the development of a training package for healthcare professionals using theory and evidence to promote delivery of such recommendations as standard care. Methods The intervention development process was guided by the Medical Research Council guidance for complex interventions and the Behaviour Change Wheel. Target behaviours were identified from the literature and thirty-five prostate cancer care healthcare professionals (including oncologists, consultant urologists, clinical nurse specialists, physiotherapists, general practitioners and commissioners) were interviewed to understand influences on these behaviours. The Theoretical Domains Framework was used to identify theoretical constructs for change. Behaviour change techniques were selected based on theory and evidence and were translated into intervention content. The intervention was refined with the input of stakeholders including healthcare professionals, patients, and exercise professionals in the form of rehearsal deliveries, focus groups and a workshop. Results Seven modifiable healthcare professional target behaviours were identified to support the delivery of the NICE recommendations including identifying eligible patients suitable for exercise, recommending exercise, providing information, exercise referral, providing support and interpret and feedback on progress. Ten domains from the Theoretical Domain’s Framework were identified as necessary for change, including improving knowledge and skills, addressing beliefs about consequences, and targeting social influences. These were targeted through twenty-two behaviour change techniques delivered in a half-day, interactive training package. Based on initial feedback from stakeholders, the intervention was refined in preparation for evaluation. Conclusions We designed an intervention based on theory, evidence, and stakeholder feedback to promote and support the delivery of NICE recommendations. Future work will aim to test this training package in a multi-centre randomised trial. If proven effective, the development and training package will provide a template for replication in other clinical populations, where exercise has proven efficacy but is insufficiently implemented. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06266-x.
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Affiliation(s)
- Rebecca R Turner
- Allied Health Professionals, Radiotherapy and Oncology, Sheffield Hallam University, Sheffield, UK
| | - Madelynne A Arden
- Centre for Behavioural Science and Applied Psychology (CeBSAP), Sheffield Hallam University, Sheffield, UK
| | - Sophie Reale
- Allied Health Professionals, Radiotherapy and Oncology, Sheffield Hallam University, Sheffield, UK
| | - Eileen Sutton
- Population Health Sciences, University of Bristol, Bristol, UK
| | - Stephanie J C Taylor
- Institute for Population Health Sciences, Queen Mary, University of London, London, UK
| | - Liam Bourke
- Allied Health Professionals, Radiotherapy and Oncology, Sheffield Hallam University, Sheffield, UK
| | - Diana M Greenfield
- Specialised Cancer Services, Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, UK.,Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - Dylan Morrissey
- Sports and Exercise Medicine, William Harvey Research Institute, School of Medicine and Dentistry, Queen Mary, University of London, London, UK.,Physiotherapy Department, Barts Health NHS Trust, London, UK
| | - Janet Brown
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | | | - Derek J Rosario
- Allied Health Professionals, Radiotherapy and Oncology, Sheffield Hallam University, Sheffield, UK.,Department of Urology, Sheffield Teaching Hospitals, Sheffield, UK
| | - Liz Steed
- Institute for Population Health Sciences, Queen Mary, University of London, London, UK.
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28
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van Seventer E, Marquardt JP, Troschel AS, Best TD, Horick N, Azoba C, Newcomb R, Roeland EJ, Rosenthal M, Bridge CP, Greer JA, El-Jawahri A, Temel J, Fintelmann FJ, Nipp RD. Associations of Skeletal Muscle With Symptom Burden and Clinical Outcomes in Hospitalized Patients With Advanced Cancer. J Natl Compr Canc Netw 2021; 19:319-327. [PMID: 33513564 DOI: 10.6004/jnccn.2020.7618] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 07/08/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Low muscle mass (quantity) is common in patients with advanced cancer, but little is known about muscle radiodensity (quality). We sought to describe the associations of muscle mass and radiodensity with symptom burden, healthcare use, and survival in hospitalized patients with advanced cancer. METHODS We prospectively enrolled hospitalized patients with advanced cancer from September 2014 through May 2016. Upon admission, patients reported their physical (Edmonton Symptom Assessment System [ESAS]) and psychological (Patient Health Questionnaire-4 [PHQ-4]) symptoms. We used CT scans performed per routine care within 45 days before enrollment to evaluate muscle mass and radiodensity. We used regression models to examine associations of muscle mass and radiodensity with patients' symptom burden, healthcare use (hospital length of stay and readmissions), and survival. RESULTS Of 1,121 patients enrolled, 677 had evaluable muscle data on CT (mean age, 62.86 ± 12.95 years; 51.1% female). Older age and female sex were associated with lower muscle mass (age: B, -0.16; P<.001; female: B, -6.89; P<.001) and radiodensity (age: B, -0.33; P<.001; female: B, -1.66; P=.014), and higher BMI was associated with higher muscle mass (B, 0.58; P<.001) and lower radiodensity (B, -0.61; P<.001). Higher muscle mass was significantly associated with improved survival (hazard ratio, 0.97; P<.001). Notably, higher muscle radiodensity was significantly associated with lower ESAS-Physical (B, -0.17; P=.016), ESAS-Total (B, -0.29; P=.002), PHQ-4-Depression (B, -0.03; P=.006), and PHQ-4-Anxiety (B, -0.03; P=.008) symptoms, as well as decreased hospital length of stay (B, -0.07; P=.005), risk of readmission or death in 90 days (odds ratio, 0.97; P<.001), and improved survival (hazard ratio, 0.97; P<.001). CONCLUSIONS Although muscle mass (quantity) only correlated with survival, we found that muscle radiodensity (quality) was associated with patients' symptoms, healthcare use, and survival. These findings underscore the added importance of assessing muscle quality when seeking to address adverse muscle changes in oncology.
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Affiliation(s)
- Emily van Seventer
- 1Department of Medicine, Division of Hematology and Oncology, Massachusetts General Hospital Cancer Center and Harvard Medical School, and
| | - J Peter Marquardt
- 2Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Amelie S Troschel
- 2Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Till D Best
- 2Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.,3Department of Radiology, Charité-Universitätsmedizin Berlin, Berlin, Germany; and
| | - Nora Horick
- 4Department of Statistics, Massachusetts General Hospital and Harvard Medical School
| | - Chinenye Azoba
- 1Department of Medicine, Division of Hematology and Oncology, Massachusetts General Hospital Cancer Center and Harvard Medical School, and
| | - Richard Newcomb
- 1Department of Medicine, Division of Hematology and Oncology, Massachusetts General Hospital Cancer Center and Harvard Medical School, and
| | - Eric J Roeland
- 1Department of Medicine, Division of Hematology and Oncology, Massachusetts General Hospital Cancer Center and Harvard Medical School, and
| | - Michael Rosenthal
- 5Dana-Farber Cancer Institute.,6Department of Radiology, Brigham and Women's Hospital
| | - Christopher P Bridge
- 7Massachusetts General Hospital and Brigham and Women's Hospital Center for Clinical Data Science, and
| | - Joseph A Greer
- 8Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Areej El-Jawahri
- 1Department of Medicine, Division of Hematology and Oncology, Massachusetts General Hospital Cancer Center and Harvard Medical School, and
| | - Jennifer Temel
- 1Department of Medicine, Division of Hematology and Oncology, Massachusetts General Hospital Cancer Center and Harvard Medical School, and
| | - Florian J Fintelmann
- 2Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Ryan D Nipp
- 1Department of Medicine, Division of Hematology and Oncology, Massachusetts General Hospital Cancer Center and Harvard Medical School, and
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29
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Rammant E, Bultijnck R, Caperchione CM, Trinh L. The Use of Theory to Develop Physical Activity Interventions in Urological Cancer Survivors: A Narrative Review. Semin Oncol Nurs 2021; 37:151109. [PMID: 33516584 DOI: 10.1016/j.soncn.2020.151109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To summarize the current available evidence on the use of behavior change theories to explain and change physical activity behavior in urological cancer survivors. DATA SOURCES Five electronic databases including Medline, Web of Science, Embase, Cochrane, and Psych INFO and reference lists of key studies were searched between database inception and November 2020. Peer-reviewed articles on the use of behavior change theories to understand or change physical activity in urological cancer survivors were included. CONCLUSION The theory of planned behavior and the social cognitive theory were the most used theories to explain and change physical activity behavior in urological cancers, respectively. However, the use of behavior change theories in physical activity interventions for urological cancers is still low across all urological tumor groups. Planning frameworks such as the intervention mapping approach should be used to enhance the systematic use of behavior change theories during every phase of intervention development. In addition, more research is needed to identity which behavior change techniques are most effective to change physical activity behavior in urological cancer survivors. IMPLICATIONS FOR NURSING PRACTICE Nurses play a key role in the urological cancer patients' clinical pathway and should be able to motivate patients to engage in sufficient physical activity levels. Therefore, it is important that nurses understand the underlying reasons why patients (do not) engage in physical activity and which behavior change techniques are most effective in changing a patients' behavior.
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Affiliation(s)
- Elke Rammant
- Ghent University, Human Structure and Repair, Ghent, Belgium.
| | - Renée Bultijnck
- Ghent University, Human Structure and Repair, Ghent, Belgium; Research Foundation, Flanders (FWO), Brussels, Belgium
| | - Cristina M Caperchione
- Faculty of Health, Human Performance Research Centre, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Linda Trinh
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada
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Effect of a Single Bout of Aerobic Exercise on Kynurenine Pathway Metabolites and Inflammatory Markers in Prostate Cancer Patients-A Pilot Randomized Controlled Trial. Metabolites 2020; 11:metabo11010004. [PMID: 33374836 PMCID: PMC7823964 DOI: 10.3390/metabo11010004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 12/20/2020] [Accepted: 12/21/2020] [Indexed: 02/08/2023] Open
Abstract
The kynurenine (KYN) pathway gains growing research interest concerning the genesis, progression and therapy of solid tumors. Previous studies showed exercise-induced effects on metabolite levels along the KYN pathway. Modulations of the KYN pathway might be involved in the positive impact of exercise on prostate cancer progression and mortality. The objective of this trial was to investigate whether a single-physical exercise alters tryptophan (TRP) metabolism and related inflammatory markers in this population. We conducted a randomized controlled trial with 24 patients suffering from prostate cancer. While the control group remained inactive, the intervention group performed a 30-min aerobic exercise on a bicycle ergometer at 75% of individual VO2peak. Before (t0) and directly after the exercise intervention (t1) KYN, TRP, kynurenic acid, quinolinic acid as well as various inflammation markers (IL6, TNF-α, TGF-β) were measured in blood serum. At baseline, the present sample showed robust correlations between TRP, KYN, quinolinic acid and inflammatory markers. Regarding the exercise intervention, interaction effects for TRP, the KYN/TRP ratio and TGF-β were observed. The results show for the first time that acute physical exercise impacts TRP metabolism in prostate cancer patients. Moreover, baseline associations underline the relationship between inflammation and the KYN pathway in prostate cancer.
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Hallward L, Chemtob K, Lambert SD, Duncan LR. Prostate Cancer Survivors' and Caregivers' Experiences Using Behavior Change Techniques during a Web-Based Self-Management and Physical Activity Program: A Qualitative Study. J Clin Med 2020; 9:E3244. [PMID: 33050578 PMCID: PMC7601492 DOI: 10.3390/jcm9103244] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 10/06/2020] [Accepted: 10/07/2020] [Indexed: 01/23/2023] Open
Abstract
Both men with prostate cancer and their caregivers report experiencing a number of challenges and health consequences, and require programs to help support the cancer patient-caregiver dyad. A tailored, web-based, psychosocial and physical activity self-management program (TEMPO), which implements behavior change techniques to help facilitate behavior change for the dyads was created and its acceptability was tested in a qualitative study. The purpose of this secondary analysis was to explore the dyads' experiences using behavior change techniques to change behavior and address current needs and challenges while enrolled in TEMPO. Multiple semi-structured interviews were conducted with 19 prostate cancer-caregiver dyads over the course of the program, resulting in 46 transcripts that were analyzed using an inductive thematic analysis. Results revealed four main themes: (1) learning new behavior change techniques, (2) engaging with behavior change techniques learned in the past, (3) resisting full engagement with behavior change techniques, and (4) experiencing positive outcomes from using behavior change techniques. The dyads' discussions of encountering behavior change techniques provided unique insight into the process of learning and implementing behavior change techniques through a web-based self-management program, and the positive outcomes that resulted from behavior changes.
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Affiliation(s)
- Laura Hallward
- Department of Kinesiology and Physical Education, McGill University, Montreal, QC H2W 1S4, Canada; (L.H.); (K.C.)
| | - Keryn Chemtob
- Department of Kinesiology and Physical Education, McGill University, Montreal, QC H2W 1S4, Canada; (L.H.); (K.C.)
| | - Sylvie D. Lambert
- Ingram School of Nursing, McGill University, Montreal, QC H3A 2M7, Canada;
- St. Mary’s Research Centre, Montreal, QC H3T 1M5, Canada
| | - Lindsay R. Duncan
- Department of Kinesiology and Physical Education, McGill University, Montreal, QC H2W 1S4, Canada; (L.H.); (K.C.)
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Joly F, Lefeuvre-Plesse C, Garnier-Tixidre C, Helissey C, Menneveau N, Zannetti A, Salas S, Houede N, Abadie-Lacourtoisie S, Stefani L, Nenan S, Rieger I, Durand-Zaleski I, Descotes JM, Anota A. Feasibility and efficacy of a supervised home-based physical exercise program for metastatic cancer patients receiving oral targeted therapy: study protocol for the phase II/III - UNICANCER SdS 01 QUALIOR trial. BMC Cancer 2020; 20:975. [PMID: 33036567 PMCID: PMC7545839 DOI: 10.1186/s12885-020-07381-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 09/04/2020] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Currently, oral targeted therapies are known to be effective and are frequently used to treat metastatic cancer patients, but fatigue is a frequently reported early side effect of these treatments. This fatigue may impact the patient's treatment adherence and result in a negative impact on quality of life. Physical exercise significantly improved the general well-being and quality of life of advanced cancer patients. However, there is no specific physical activity program adapted for patients with advanced disease. METHODS QUALIOR is a two-part, randomized, open-label, and multicenter with two arms phase II/III trial. Patients (phase II: n = 120; phase III: n = 312) with metastatic cancer (breast cancer, kidney cancer, lung cancer, and other cancers [including but not limited to colon cancer, melanoma, sarcoma, or hepatocarcinoma]) treated with a first- or second-line oral targeted therapy without chemotherapy will be included. Patients will be randomized (2:1) to a 3-month supervised home-based standardized physical activity program or to a recommended adapted physical activity (via a booklet). The primary objective of the phase II is to evaluate the feasibility of the supervised program. The primary objective of the phase III is the evaluation of the benefit of the supervised home-based program compare to the recommended program in terms of fatigue and quality of life at 3 months. The secondary objectives aim to evaluate the impact of the supervised program on fatigue over time, pain, physical capacities, psychosocial and cognitive functions, general quality of life, frequency of dose reduction and patients' adherence to the targeted therapy, overall survival, and progression-free survival. This study will also evaluate the medico-economic impact of supervised program compared to the recommended adapted physical activity program. DISCUSSION The aim of this study is to evaluate home-based physical exercise program for metastatic cancer patients treated with oral targeted therapies to help patients to cope with fatigue and improve quality of life. TRIAL REGISTRATION This trial was registered in ClinicalTrials.gov since May 2017 ( NCT03169075 ).
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Affiliation(s)
- Florence Joly
- Centre François Baclesse et CHU Côte de Nacre, Caen, France.
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Logan L, Toohey K, Kavanagh PS, Paterson C, McKune AJ. The Effect of Exercise on Body Composition and Physical Performance in Prostate Cancer Patients Undergoing Androgen Deprivation Therapy (ADT): A Narrative Synthesis. Semin Oncol Nurs 2020; 36:151067. [PMID: 33010982 DOI: 10.1016/j.soncn.2020.151067] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This review sought to synthesize evidence examining the effect of exercise on prostate cancer patients undergoing androgen deprivation therapy (ADT). DATA SOURCES A systematic literature search was conducted in electronic databases (CINAHL, MEDLINE, APA PsychINFO, Scopus, SPORTDiscus, and Cochrane Library) from their inception to March 31, 2020. Inclusion criteria were randomized controlled trials (RCTs) testing the effect of exercise on body composition, muscle strength and physical performance. Fourteen RCTs were included. Participant numbers within the individual RCTs ranged from 19 to 163 with heterogeneity in prostate cancer stage (localized and locally advanced diagnoses) with age of participants ranging from 43 to 90 years. The length of the interventions ranged from 12 weeks to 12 months, with the number of sessions per week ranging from 2 to 5. Resistance training intensity ranged from 60% to 90% 1RM and the aerobic training ranged from 60% to 90% HRmax. CONCLUSIONS Resistance training and sport (football) in the form of small sided games (SSGs) played an important role in preserving bone mineral density and lean mass as well as improving muscle strength and physical performance outcomes in men affected by prostate cancer undergoing ADT. IMPLICATIONS FOR NURSING PRACTICE Multimodal exercise, including resistance exercise and activity that includes repeated sprints (SSGs), benefit the maintenance of bone mineral density and lean mass as well as increase strength and physical performance in men affected by prostate cancer undergoing ADT. Based on this evidence, nurses should coordinate timely referrals to qualified exercise physiologists or physiotherapist with expertise in cancer care.
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Affiliation(s)
- Lucas Logan
- Faculty of Health, University of Canberra, Canberra, Australia
| | - Kellie Toohey
- Faculty of Health, University of Canberra, Canberra, Australia; Prehabilitation, Activity, Cancer, Exercise, Survivorship (PACES) Research Group, University of Canberra, Canberra, Australia
| | - Phillip S Kavanagh
- Faculty of Health, University of Canberra, Canberra, Australia; Justice and Society, University of South Australia, Magill SA, Australia
| | - Catherine Paterson
- Faculty of Health, University of Canberra, Canberra, Australia; Prehabilitation, Activity, Cancer, Exercise, Survivorship (PACES) Research Group, University of Canberra, Canberra, Australia
| | - Andrew J McKune
- Faculty of Health, University of Canberra, Canberra, Australia; Prehabilitation, Activity, Cancer, Exercise, Survivorship (PACES) Research Group, University of Canberra, Canberra, Australia; Research Institute for Sport and Exercise (UCRISE), Faculty of Health, University of Canberra, Canberra ACT, Australia; Discipline of Biokinetics, Exercise and Leisure Sciences, School of Health Sciences, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa.
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A pilot feasibility randomized controlled trial adding behavioral counseling to supervised physical activity in prostate cancer survivors: behavior change in prostate cancer survivors trial (BOOST). J Behav Med 2020; 44:172-186. [DOI: 10.1007/s10865-020-00185-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 09/16/2020] [Indexed: 01/19/2023]
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35
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Edmunds K, Tuffaha H, Scuffham P, Galvão DA, Newton RU. The role of exercise in the management of adverse effects of androgen deprivation therapy for prostate cancer: a rapid review. Support Care Cancer 2020; 28:5661-5671. [PMID: 32699997 DOI: 10.1007/s00520-020-05637-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Accepted: 07/16/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE Prostate cancer (PCa) is the most commonly diagnosed cancer in Australia, accounting for one quarter of all new cancer diagnoses for males. Androgen deprivation therapy (ADT) is the standard first-line therapy for metastatic PCa but is also used across much of the spectrum of disease. Unfortunately, debilitating adverse effects are a significant and largely unavoidable feature of ADT. A recent systematic review of adverse effects of ADT identified 19 sub-groups classified according to the Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0. The potential for multiple simultaneous adverse effects, their associated management and the impact of adverse effects on cancer outcomes and quality of life are important considerations in the treatment and supportive care of men with PCa. Exercise is increasingly being recognized as an efficacious strategy in managing these adverse effects. METHODS A rapid review was undertaken to examine the role of exercise in the management of the most commonly reported ADT adverse effects classified according to the CTCAE sub-groups. A systematic search was conducted in Medline, PsycINFO, Google Scholar and Google for the years 2010 to September 2019 to identify the benefits of exercise in managing the adverse effects of ADT for PCa. RESULTS There is strong evidence for exercise as medicine in addressing several of the adverse effects of PCa such as loss of muscle mass and strength, fatigue and declining physical function. Moderate level evidence for PCa exists for exercise-induced improvements in depression and anxiety, bone loss, and sexual dysfunction. While evidence of the effectiveness of exercise is lacking for many adverse effects of ADT for PCa, evidence in the cancer population as a whole or other clinical populations is strong, and many clinical guidelines recommend exercise as a fundamental part of their clinical management. With the exception of gynaecomastia and breast pain, there is increasing evidence (PCa, cancer or other clinical populations) to suggest that exercise has the potential to reduce and even prevent many of the adverse effects of ADT, thus improving survivorship outcomes for men with PCa. CONCLUSION Exercise has the potential to reduce and even prevent many of the adverse effects of ADT, thus improving survivorship outcomes for men with PCa. The use of exercise for PCa management has the potential to translate into health and economic benefits in improved quality of life and fewer complications, resulting in savings to the health care system, enhanced productivity and reduced patient and carer burden. Exercise thus has the potential to improve quality of life for this population as well as generate significant cost savings.
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Affiliation(s)
- Kim Edmunds
- Centre for Applied Health Economics, Griffith University, Brisbane, Australia. .,Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.
| | - Haitham Tuffaha
- Centre for the Business and Economics of Health, University of Queensland, Brisbane, Australia
| | - Paul Scuffham
- Centre for Applied Health Economics, Griffith University, Brisbane, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
| | - Daniel A Galvão
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Australia
| | - Robert U Newton
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Australia.,School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia
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36
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Patterson MS, Gagnon LR, Nelon JL, Spadine MN. A pilot study using egocentric network analysis to assess holistic health benefits among a sample of university employees involved in a worksite fitness program. Work 2020; 66:63-72. [PMID: 32417814 DOI: 10.3233/wor-203151] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Working adults in the United States often do not engage in enough exercise to experience health benefits. With workplaces becoming increasingly sedentary, more emphasis is placed on providing exercise opportunities at work. Evidence suggests participating in exercise during the workday and socially connecting with others while exercising, can lead to positive health outcomes. OBJECTIVE The purpose of this study is to examine whether mental and social health factors were related to increased exercise among employees participating in a worksite group exercise program. METHODS An egocentric network analysis was conducted on a sample of university employees (n = 57). RESULTS Regression analyses (Adjusted R2 = 0.501, F = 4.686, p = 0.001) suggest that depression (β= -0.548, p = 0.041), stress (β= 0.530, p = 0.016), nominating alters who exercise similarly (β= 0.326, t = 2.111, p = 0.045), average exercise scores across egonetworks (β= -0.330, t = -2.135, p = 0.043), and nominating other group exercise members (β= 0.579, t = 3.721, p = 0.001) were related to physical activity scores. CONCLUSION These findings provide empirical support for using group exercise environments as a mechanism for increasing exercise among employees. Specifically, fostering social connections between employees involved in the program can lead to greater physical activity scores. Future research should confirm these results in larger samples, along with determining more causal relationships with longitudinal and experimental designs.
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Affiliation(s)
- Megan S Patterson
- Health and Kinesiology, Texas A&M University, College Station, TX, USA
| | - Leah R Gagnon
- Community Health Center of Southeast Kansas, Pittsburg, KS, USA
| | - Jordan L Nelon
- Health and Kinesiology, Texas A&M University, College Station, TX, USA
| | - Mandy N Spadine
- Health and Kinesiology, Texas A&M University, College Station, TX, USA
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37
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Cai Q, Chen Y, Zhang D, Pan J, Xie Z, Xu C, Li S, Zhang X, Gao Y, Hou J, Guo X, Zhou X, Zhang B, Ma F, Zhang W, Lin G, Xin Z, Niu Y, Wang Y. Estimates of over-time trends in incidence and mortality of prostate cancer from 1990 to 2030. Transl Androl Urol 2020; 9:196-209. [PMID: 32420125 PMCID: PMC7214983 DOI: 10.21037/tau.2020.02.21] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background This research aims to identify the current and future trends in the incidence and death rate of prostate cancer and to provide the necessary data support for making relevant health decisions. Methods This study used the collected data and methodologies to describe the incidence and mortality trends of prostate cancer from 1990 to 2016. Based on the data, this paper projected the future trends in prostate cancer incidence and death rate. Results In 2016, prostate cancer cases [1,435,742; 95% uncertainty interval (UI), 1,293,395–1,618,655] were nearly 2.5-fold the number in 1990 (579,457; 95% UI, 521,564–616,107). Deaths increased by 2.0-fold from 191,687 (95% UI, 168,885–209,254) in 1990 to 380,916 (95% UI, 320,808–412,868) in 2016. The global age-standardized incidence rate (ASIR) increased from 17.75 (95% UI, 18.91–15.95) in 1990 to 22.12 (95% UI, 19.92–24.91) in 2016, changing 24.62%. The global change of age-standardized death rate (ASDR) has declined slightly, but in some regions it shows a trend of growth. By sociodemographic index (SDI) sub-types, prostate cancer will frequently occur in high SDI countries from 1990 to 2030. Simultaneously, the highest mortality will present in low SDI countries. Conclusions Through projecting and analyzing incidence and mortality rate of prostate cancer, from 1990 to 2030, by different ages, regions and SDI sub-types, this result may reveal the relationship between prostate cancer and financial development. At the same time, the result also showed a sufficiently heavy burden of prostate cancer, but the burden varies greatly in each region. The burden is a challenge and will require attention for all levels of society. The current study is beneficial to formulate more specific and efficient policies.
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Affiliation(s)
- Qiliang Cai
- Department of Urology, the Second Hospital of Tianjin Medical University, Tianjin Institute of Urology, Tianjin 300211, China.,School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Yegang Chen
- Department of Urology, the Second Hospital of Tianjin Medical University, Tianjin Institute of Urology, Tianjin 300211, China
| | - Dingrong Zhang
- Department of Urology, the Second Hospital of Tianjin Medical University, Tianjin Institute of Urology, Tianjin 300211, China
| | - Jiancheng Pan
- Department of Urology, the Second Hospital of Tianjin Medical University, Tianjin Institute of Urology, Tianjin 300211, China
| | - Zunke Xie
- Department of Urology, the Second Hospital of Tianjin Medical University, Tianjin Institute of Urology, Tianjin 300211, China
| | - Chenjie Xu
- School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Shu Li
- School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Xinyu Zhang
- School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Ying Gao
- Department of Health Management, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Jie Hou
- School of Basic Medical Sciences, Tianjin Medical University, Tianjin 300070, China
| | - Xuemei Guo
- Library of Tianjin Medical University, Tianjin Medical University, Tianjin 300070, China
| | - Xiaodong Zhou
- Department of Urology, the Second Hospital of Tianjin Medical University, Tianjin Institute of Urology, Tianjin 300211, China
| | - Baoshuai Zhang
- Scientific Research Department, the Second Hospital of Tianjin Medical University, Tianjin 300070, China
| | - Fei Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Wei Zhang
- Department of Urology, the Second Hospital of Tianjin Medical University, Tianjin Institute of Urology, Tianjin 300211, China
| | - Guiting Lin
- Knuppe Molecular Urology Laboratory, Department of Urology, School of Medicine, University of California, San Francisco, CA, USA
| | - Zhongcheng Xin
- Department of Urology, the Second Hospital of Tianjin Medical University, Tianjin Institute of Urology, Tianjin 300211, China.,Andrology Center, Peking University First Hospital, Peking University, Beijing 100034, China
| | - Yuanjie Niu
- Department of Urology, the Second Hospital of Tianjin Medical University, Tianjin Institute of Urology, Tianjin 300211, China
| | - Yaogang Wang
- School of Public Health, Tianjin Medical University, Tianjin 300070, China
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38
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Bluethmann SM, Wang M, Wasserman E, Chen C, Zaorsky NG, Hohl RJ, McDonald AC. Prostate cancer in Pennsylvania: The role of older age at diagnosis, aggressiveness, and environmental risk factors on treatment and mortality using data from the Pennsylvania Cancer Registry. Cancer Med 2020; 9:3623-3633. [PMID: 32212232 PMCID: PMC7221418 DOI: 10.1002/cam4.3003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Revised: 02/27/2020] [Accepted: 02/28/2020] [Indexed: 12/15/2022] Open
Abstract
Background To assess: (a) cancer treatment in prostate cancer survivors (PCS) by age at diagnosis (ADx) and prostate cancer (PC) aggressiveness; (b) potential impact on PC mortality; and (c) these results in the context of environmental/behavioral risk factors on PCS in Pennsylvania. Methods Prostate cancer survivors ages ≥40 years were identified from the 2004‐2014 Pennsylvania Cancer Registry (PCR). Demographic/clinical descriptors and PC treatment were extracted from PCR. Prostate cancer aggressiveness was defined by clinical/pathologic Gleason score and tumor stage. Logistic and Cox regression analyses tested associations between treatment received and PC‐specific mortality. County‐level data from the Pennsylvania BRFSS were used to estimate cancer‐related behavioral risk factors (eg, smoking, physical inactivity, fruit/vegetable consumption [FV], alcohol use) and used as covariates. Results There were 90 694 PCS ages 40‐105 years (mean age = 66.19 years, SD = 9.25) included. Most were non‐Hispanic white men (83%). Prostate cancer survivors ≥75 years were least likely to receive any treatment but men ages 65‐74 were more likely to receive combined therapies (OR = 1.47; 95% CI 1.28, 1.69) vs PCS ages 40‐54 years, controlling for covariates. Prostate cancer survivors 55‐75+ with aggressive PC who received any treatment vs no definitive treatment had significantly reduced mortality. Men from counties with high obesity and smoking rates were significantly less likely to receive any treatment than men living in counties with lower rates of these risk factors. Prostate cancer survivors who lived in counties with high rates of physical inactivity and had high rates of sufficient FV consumption were slightly more likely to receive cancer treatment vs no definitive treatment compared to men who lived in counties with high rates of physical activity and lower FV consumption. Conclusions We observed a general age‐related decline in receipt of treatment. Prostate cancer survivors ages ≥75 years were significantly less likely to get any cancer treatment compared to younger PCS. However, most men with more aggressive disease who received any treatment had greatly reduced PC mortality, regardless of age. Considering environmental/behavioral risk factors may attenuate PC risk and inform treatment options.
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Affiliation(s)
- Shirley M Bluethmann
- The Pennsylvania State University College of Medicine, Hershey, PA, USA.,Penn State Cancer Institute, Hershey, PA, USA
| | - Ming Wang
- The Pennsylvania State University College of Medicine, Hershey, PA, USA.,Penn State Cancer Institute, Hershey, PA, USA
| | - Emily Wasserman
- The Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Chixiang Chen
- The Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Nicholas G Zaorsky
- The Pennsylvania State University College of Medicine, Hershey, PA, USA.,Penn State Cancer Institute, Hershey, PA, USA
| | - Raymond J Hohl
- The Pennsylvania State University College of Medicine, Hershey, PA, USA.,Penn State Cancer Institute, Hershey, PA, USA
| | - Alicia C McDonald
- The Pennsylvania State University College of Medicine, Hershey, PA, USA.,Penn State Cancer Institute, Hershey, PA, USA
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39
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Cormie P, Zopf EM. Exercise medicine for the management of androgen deprivation therapy-related side effects in prostate cancer. Urol Oncol 2020; 38:62-70. [DOI: 10.1016/j.urolonc.2018.10.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 07/23/2018] [Accepted: 10/03/2018] [Indexed: 12/23/2022]
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40
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Hua X, Liao JF, Liu S, Zhang J, Huang HY, Wen W, Long ZQ, Zhang WW, Guo L, Lin HX. Low Skeletal Muscle Mass Impairs Quality of Life in Nasopharyngeal Carcinoma Patients Treated With Concurrent Chemoradiotherapy. Front Nutr 2020; 6:195. [PMID: 32010705 PMCID: PMC6974669 DOI: 10.3389/fnut.2019.00195] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Accepted: 12/20/2019] [Indexed: 12/13/2022] Open
Abstract
Background: Nasopharyngeal carcinoma (NPC) patients receiving concurrent chemoradiotherapy (CCRT) frequently develop low skeletal muscle mass (SMM), but, little is known about the impacts of low SMM on health-related quality of life (QOL). Methods: We retrospectively assessed 56 patients with locoregionally advanced NPC enrolled in a prospective trial. Low SMM was determined on routine computed tomography simulation (CT-sim) scans taken before radiotherapy, at the third cervical (C3) vertebral level with validated sex-specific cutoffs. QOL was assessed using the World Health Organization Quality of Life Questionnaire-100 at baseline and after 3 weeks. Pain was scored every 24 h using a numerical rating scale (NRS). Characteristics related to low SMM were identified by logistic regression. The chi-square test was used to examine the association of low SMM with QOL and pain. Results: Of the 56 participants (mean age 44.20 ± 10.93 years), over half (60.71%) developed low SMM. Patients with low SMM were more likely to be older (P = 0.035), male (P = 0.066), have a lower body-mass index (BMI; P = 0.091), and have a higher pain score (P = 0.001). Older age (hazard ratio [HR] = 1.788, P = 0.016), being male (HR = 3.145, P = 0.010), lower BMI (HR = 0.761, P = 0.033), and lower prognostic nutritional index (HR = 0.186, P = 0.034) were associated with higher risk of low SMM. Low SMM was associated with poorer baseline QOL scores (P = 0.072), especially in the physical domain (P = 0.002) and its three facets: pain (P = 0.003), energy (P = 0.021), and sleep (P = 0.007). Low SMM was also associated with significantly worse QOL scores (P = 0.006) at 3 weeks, especially in the physical (P = 0.002), psychological (P = 0.046), independence (P = 0.003), social domains (P = 0.023), and in general health condition (P = 0.043). For pain score, low SMM group had worse overall changes from baseline to week 3 (P = 0.011). Conclusions: The incidence of low SMM, as evaluated using routine CT-sim scans, is high in patients receiving CCRT for locoregionally advanced NPC. Low SMM results in poorer QOL and higher pain scores, which underscores the requirement for nutritional and functional interventions to address low SMM early in the treatment course.
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Affiliation(s)
- Xin Hua
- State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Jun-Fang Liao
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Shan Liu
- Department of Radiation Oncology, Sichuan Cancer Center, School of Medicine, Sichuan Cancer Hospital & Institute, University of Electronic Science and Technology of China, Chengdu, China
| | - Jun Zhang
- State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Radiotherapy, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Han-Ying Huang
- State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Radiotherapy, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Wen Wen
- State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Radiotherapy, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Zhi-Qing Long
- State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Radiotherapy, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Wen-Wen Zhang
- State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Radiotherapy, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Ling Guo
- State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Huan-Xin Lin
- State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Radiotherapy, Sun Yat-sen University Cancer Center, Guangzhou, China
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Effects of exercise interventions on social and cognitive functioning of men with prostate cancer: a meta-analysis. Support Care Cancer 2020; 28:2043-2057. [DOI: 10.1007/s00520-019-05278-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 12/23/2019] [Indexed: 12/24/2022]
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Lopes JSS, Silva Neto JFD, Gomes RL, Almeida ADC, Michelleti JK, Machado AF. Training with elastic and conventional devices on body composition: systematic review and meta-analysis. FISIOTERAPIA EM MOVIMENTO 2020. [DOI: 10.1590/1980-5918.033.ar02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction: Given the practicality and low cost of elastic devices, a comparison with conventional devices may be able to quantify gains from both tools for further conclusions. Objective: Compare the effect of resistance training with elastic (tubes and resistance band) and conventional (weight machines and dumbbells) devices on body composition. Method: This is a systematic review and meta-analysis. The PubMed/MEDLINE, Embase, PEDro and CENTRAL databases were searched from the earliest records to July 25, 2018. Data were described in standardized mean difference (SMD) with a 95% confidence interval (95% CI). Results: Four studies were included. The results of the meta-analysis did not show superiority among the analyzed methods for the variables investigated (SMD = -2.04, 95% CI -7.56, 3.48, p < 0.00001, lean mass: SMD = 0.28, 95% CI -0.29, 0.85, p = 0.97, body fat: SMD = 2.77, 95% CI -0.05, 5.59, p = 0.92, body mass: SMD = 1.22, 95% CI -0.29, 2.74, p = 0.11). Conclusion: The results of the meta-analysis showed superiority of outcome from training in conventional devices only for the variable fat mass. For the other variables, no statistically significant differences were found. Elastic resistance can promote similar outcomes to resistance in different population profiles and from various protocols on variables related to body composition.
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Perry CK, Ali W, Solanki E, Winters-Stone K. Attitudes and Beliefs of Older Female Breast Cancer Survivors and Providers About Exercise in Cancer Care. Oncol Nurs Forum 2020; 47:56-69. [PMID: 31845920 DOI: 10.1188/20.onf.56-69] [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] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To understand breast cancer survivors' and providers' attitudes and beliefs regarding exercise counseling and structured exercise programs within cancer care. SAMPLE & SETTING 61 female breast cancer survivors and 11 breast cancer providers from a university cancer center in the Pacific Northwest. METHODS & VARIABLES Survivors completed anonymous self-report surveys, and providers participated in semistructured interviews. Survey data were analyzed using descriptive statistics, and interview transcripts were analyzed using qualitative content analysis. RESULTS Breast cancer survivors and providers believed that including exercise counseling within cancer care was important. More than half of the survivors reported that they would attend structured exercise classes; a majority of providers thought cancer centers should offer exercise programs. IMPLICATIONS FOR NURSING Nurses could facilitate exercise counseling within cancer care and advocate for clinic-based exercise programs.
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Affiliation(s)
| | - Wafaa Ali
- King Saud bin Abdulaziz University for Health Sciences
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Relationship between body composition and hormone sensitivity for androgen deprivation therapy in patients with metastatic prostate cancer. Prostate Int 2019; 8:22-26. [PMID: 32257974 PMCID: PMC7125377 DOI: 10.1016/j.prnil.2019.11.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 11/05/2019] [Accepted: 11/14/2019] [Indexed: 11/20/2022] Open
Abstract
Background To evaluate the relationship between body composition and the oncological outcome of androgen deprivation therapy (ADT), we investigated whether body composition features including the psoas muscle may be predictive factors of ADT. Methods This study enrolled patients with hormone-naïve metastatic prostate cancer who were treated with primary ADT from April 1996 to November 2013 at Kyushu University Hospital and who underwent a computed tomography scan before primary ADT for calculating body fat percentage, psoas muscle ratio (psoas muscle, cm3/height, cm), and body mass index. Results Of the 178 patients enrolled, 60 patients died during follow-up. Median follow-up was 32 months, and progression-free survival and overall survival (OS) were 28 and 80 months, respectively. Multivariate analysis revealed that the psoas muscle ratio was correlated with OS (hazard ratio: 0.448; 95% confidence interval = 0.206–0.922; p = 0.028). Conclusions This study demonstrated that higher psoas muscle ratio predicts longer OS among patients with nonlocalized prostate cancer treated with primary ADT.
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45
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Craike MJ, Gaskin CJ, Mohebbi M, Courneya KS, Livingston PM. Mechanisms of Physical Activity Behavior Change for Prostate Cancer Survivors: A Cluster Randomized Controlled Trial. Ann Behav Med 2019; 52:798-808. [PMID: 30124758 PMCID: PMC6361272 DOI: 10.1093/abm/kax055] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Exercise is beneficial for prostate cancer survivors. Therefore, understanding the mechanisms of physical activity (PA) behavior change is imperative. Purpose The ENGAGE study was an exercise intervention for prostate cancer survivors, which improved vigorous physical activity (VPA) at postintervention and follow-up. The purpose of this study was to assess (a) whether the intervention improved social cognitive determinants of behavior and (b) the extent to which social cognitive determinants mediated the effect of the exercise intervention on VPA. Methods Overall, 147 men consented to be involved in the study (intervention = 54, usual care = 93). Data from baseline, postintervention (12 weeks) and follow-up (6 months) were used in this analysis. Social cognitive determinants were measured using appropriate measures. VPA was measured using an adapted version of the Leisure-Time Exercise Questionnaire. Results Compared with the control condition, men in the intervention condition had higher task self-efficacy postintervention (+16.23; 95% confidence interval [CI] +9.19 to +23.31; effect size [d] = 0.85, p < .001) and at follow-up (+12.58; 95% CI = +4.45 to +20.71, d = 0.50, p = .002). Task self-efficacy partially mediated the effect of the exercise intervention on VPA (indirect effect: B = 19.90; 95% CI 1.56 to 38.25, p = .033). Conclusion The intervention improved the belief among prostate cancer survivors that they could perform challenging exercises for longer periods of time, which partially explained the positive effect of the intervention on VPA. Australia and New Zealand Clinical Trials Registration ACTRN12610000609055.
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Affiliation(s)
- Melinda J Craike
- Institute of Sport, Exercise and Active Living (ISEAL), Victoria University, Footscray, Australia
| | - Cadeyrn J Gaskin
- Faculty of Health, Biostatistical Unit, Deakin University, Geelong, Australia
| | | | - Kerry S Courneya
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Canada
| | - Patricia M Livingston
- Faculty of Health, School of Nursing & Midwifery, Deakin University, Geelong, Australia
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Campbell KL, Winters-Stone K, Wiskemann J, May AM, Schwartz AL, Courneya KS, Zucker D, Matthews C, Ligibel J, Gerber L, Morris S, Patel A, Hue T, Perna F, Schmitz KH. Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable. Med Sci Sports Exerc 2019; 51:2375-2390. [PMID: 31626055 PMCID: PMC8576825 DOI: 10.1249/mss.0000000000002116] [Citation(s) in RCA: 1344] [Impact Index Per Article: 268.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE The number of cancer survivors worldwide is growing, with over 15.5 million cancer survivors in the United States alone-a figure expected to double in the coming decades. Cancer survivors face unique health challenges as a result of their cancer diagnosis and the impact of treatments on their physical and mental well-being. For example, cancer survivors often experience declines in physical functioning and quality of life while facing an increased risk of cancer recurrence and all-cause mortality compared with persons without cancer. The 2010 American College of Sports Medicine Roundtable was among the first reports to conclude that cancer survivors could safely engage in enough exercise training to improve physical fitness and restore physical functioning, enhance quality of life, and mitigate cancer-related fatigue. METHODS A second Roundtable was convened in 2018 to advance exercise recommendations beyond public health guidelines and toward prescriptive programs specific to cancer type, treatments, and/or outcomes. RESULTS Overall findings retained the conclusions that exercise training and testing were generally safe for cancer survivors and that every survivor should "avoid inactivity." Enough evidence was available to conclude that specific doses of aerobic, combined aerobic plus resistance training, and/or resistance training could improve common cancer-related health outcomes, including anxiety, depressive symptoms, fatigue, physical functioning, and health-related quality of life. Implications for other outcomes, such as peripheral neuropathy and cognitive functioning, remain uncertain. CONCLUSIONS The proposed recommendations should serve as a guide for the fitness and health care professional working with cancer survivors. More research is needed to fill remaining gaps in knowledge to better serve cancer survivors, as well as fitness and health care professionals, to improve clinical practice.
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Affiliation(s)
- Kristin L. Campbell
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Kerri Winters-Stone
- School of Nursing, Oregon Health Sciences University and Knight Cancer Institute, Portland USA
| | - Joachim Wiskemann
- Division of Medical Oncology, National Center for Tumor Diseases (NCT) and Heidelberg University Clinic, Heidelberg, Germany
| | - Anne M. May
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Anna L. Schwartz
- School of Nursing, Northern Arizona University, Flagstaff, Arizona
| | - Kerry S. Courneya
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada
| | - David Zucker
- Medical Director & Program Leader, Cancer Rehabilitation Medicine Services, Swedish Cancer Institute, Swedish Health Services, Seattle, WA
| | - Charles Matthews
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD
| | | | - Lynn Gerber
- Department of Medicine, Inova Fairfax Medical Campus, Falls Church, VA
- Center for the Study of Chronic Illness and Disability, George Mason University, Fairfax, VA
| | | | - Alpa Patel
- Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, USA
| | - Trisha Hue
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA
| | - Frank Perna
- Division of Cancer Control and Population Sciences, Behavioral Research Program, Health Behaviors Research Branch, National Cancer Institute, Rockville, MD
| | - Kathryn H. Schmitz
- Public Health Science, Penn State Cancer Institute, Penn State College of Medicine, Hershey, PA
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Villumsen BR, Jorgensen MG, Frystyk J, Hørdam B, Borre M. Home-based 'exergaming' was safe and significantly improved 6-min walking distance in patients with prostate cancer: a single-blinded randomised controlled trial. BJU Int 2019; 124:600-608. [PMID: 31012238 DOI: 10.1111/bju.14782] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVES To explore the effects of 12 weeks of unsupervised home-based 'exergaming' (i.e., technology-driven exercise) compared to usual care on physical function, body composition, quality of life (QoL), and fatigue in patients with prostate cancer on androgen-deprivation therapy (ADT). PATIENTS AND METHODS In an assessor-blinded randomised controlled trial, 46 patients with prostate cancer (aged >65 years) with locally advanced or advanced stage disease undergoing ADT were randomised to 12 weeks of unsupervised home-based exergaming or usual care from two hospitals in Denmark. The primary outcome of the study was 6-min walking test (6MWT). Secondary outcomes were leg extensor power (LEP), body composition (lean- and fat-mass), self-reported physical functioning and global health status (European Organisation for Research and Treatment of Cancer quality of life questionnaire 30-item core [EORTC QLQ-C30]), QoL (Functional Assessment of Cancer Therapy - Prostate [FACT-P]) and fatigue (FACT - fatigue [FACT-F]). RESULTS There was significant improvement in the exergaming group compared to the usual care group in the primary outcome of 6MWT (mean difference: 21.5 m; 95% confidence interval ([CI]) 3.2-39.9; P = 0.023). There were no differences between the groups for LEP (P = 0.227), lean body mass (P = 0.100), fat body mass (P = 0.092), self-reported physical functioning (P = 0.084) and global health status (P = 0.113), QoL (P = 0.614), and fatigue (P = 0.147). CONCLUSION Unsupervised home-based exergaming for 12 weeks had an effect on the primary outcome of 6MWT in patients with prostate cancer receiving ADT. However, no significant effects were found in secondary outcomes. The exergaming intervention appeared safe and could be an alternative to traditional aerobic and resistance training in this patient group.
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Affiliation(s)
- Brigitta R Villumsen
- Department of Urology, Regional Hospital Holstebro, Holstebro, Denmark.,Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Martin G Jorgensen
- Center for PREdiction and prevention of FALLs (PREFALL), Department of Geriatrics, Aalborg University Hospital, Aalborg, Denmark
| | - Jan Frystyk
- Medical Research Laboratory, Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark.,Department of Endocrinology, Faculty of Health Sciences, Odense University Hospital & Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | | | - Michael Borre
- Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark.,Department of Urology, Aarhus University Hospital, Aarhus, Denmark
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48
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Bernard P, Savard J, Steindorf K, Sweegers MG, Courneya KS, Newton RU, Aaronson NK, Jacobsen PB, May AM, Galvao DA, Chinapaw MJ, Stuiver MM, Griffith KA, Mesters I, Knoop H, Goedendorp MM, Bohus M, Thorsen L, Schmidt ME, Ulrich CM, Sonke GS, van Harten W, Winters-Stone KM, Velthuis MJ, Taaffe DR, van Mechelen W, Kersten MJ, Nollet F, Wenzel J, Wiskemann J, Verdonck-de Leeuw IM, Brug J, Buffart LM. Effects and moderators of exercise on sleep in adults with cancer: Individual patient data and aggregated meta-analyses. J Psychosom Res 2019; 124:109746. [PMID: 31443811 DOI: 10.1016/j.jpsychores.2019.109746] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 06/14/2019] [Accepted: 06/16/2019] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To evaluate the effects of exercise interventions on sleep disturbances and sleep quality in patients with mixed cancer diagnoses, and identify demographic, clinical, and intervention-related moderators of these effects. METHODS Individual patient data (IPD) and aggregated meta-analyses of randomized controlled trials (RCTs). Using data from the Predicting OptimaL cAncer RehabIlitation and Supportive care project, IPD of 2173 adults (mean age = 54.8) with cancer from 17 RCTs were analyzed. A complementary systematic search was conducted (until November 2018) to study the overall effects and test the representativeness of analyzed IPD. Effect sizes of exercise effects on self-reported sleep outcomes were calculated for all included RCTs. Linear mixed-effect models were used to evaluate the effects of exercise on post-intervention outcome values, adjusting for baseline values. Moderator effects were studied by testing interactions for demographic, clinical and intervention-related characteristics. RESULTS For all 27 eligible RCTs from the updated search, exercise interventions significantly decreased sleep disturbances in adults with cancer (g = -0.09, 95% CI [-0.16; -0.02]). No significant effect was obtained for sleep quality. RCTs included in IPD analyses constituted a representative sample of the published literature. The intervention effects on sleep disturbances were not significantly moderated by any demographic, clinical, or intervention-related factor, nor by sleep disturbances. CONCLUSIONS This meta-analysis provides some evidence that, compared to control conditions, exercise interventions may improve sleep disturbances, but not sleep quality, in cancer patients, although this effect is of a small magnitude. Among the investigated variables, none was found to significantly moderate the effect of exercise interventions on sleep disturbances.
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Affiliation(s)
- P Bernard
- Université Laval Cancer Research Center, Québec, Québec, Canada; School of Psychology, Université Laval, Québec, Québec, Canada; CHU de Québec - Université Laval Research Center, Québec, Québec, Canada; Physical Activity Sciences Department, Université du Québec à Montréal, Montréal, Quebec, Canada; Research centre, University Institute of Mental Health at Montreal, Montréal, Quebec, Canada.
| | - J Savard
- Université Laval Cancer Research Center, Québec, Québec, Canada; School of Psychology, Université Laval, Québec, Québec, Canada; CHU de Québec - Université Laval Research Center, Québec, Québec, Canada
| | - K Steindorf
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany
| | - M G Sweegers
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - K S Courneya
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Canada
| | - R U Newton
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia
| | - N K Aaronson
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - P B Jacobsen
- Division of Population Science, Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - A M May
- Department of Clinical Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - D A Galvao
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia
| | - M J Chinapaw
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - M M Stuiver
- Department of Physiotherapy, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - K A Griffith
- School of Nursing, University of Maryland, Baltimore, USA
| | - I Mesters
- Department of Epidemiology, Maastricht University, The Netherlands
| | - H Knoop
- Amsterdam UMC, University of Amsterdam, Department of Medical Psychology, Amsterdam, The Netherlands
| | - M M Goedendorp
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands; Institute of Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health, Heidelberg t University, Mannheim, Germany
| | - M Bohus
- Institute of Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health, Heidelberg t University, Mannheim, Germany; Faculty of Health, University of Antwerp, Belgium
| | - L Thorsen
- National Advisory Unit on Late Effects after Cancer, Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - M E Schmidt
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany
| | - C M Ulrich
- Huntsman Cancer Institute and University of Utah, Department of Population Health Sciences, Salt Lake City, USA
| | - G S Sonke
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands; Division of Population Science, Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - W van Harten
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands; Huntsman Cancer Institute and University of Utah, Department of Population Health Sciences, Salt Lake City, USA
| | | | - M J Velthuis
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - D R Taaffe
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia
| | - W van Mechelen
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - M J Kersten
- Amsterdam UMC, University of Amsterdam, Department of Hematology, Amsterdam, The Netherlands
| | - F Nollet
- Amsterdam UMC, University of Amsterdam, Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - J Wenzel
- Johns Hopkins School of Nursing, Johns Hopkins School of Medicine, Sidney Kimmel Comprehensive Cancer Center, Baltimore, USA
| | - J Wiskemann
- Division of Medical Oncology, National Center for Tumor Diseases (NCT) and Heidelberg University Hospital, Heidelberg, Germany
| | - I M Verdonck-de Leeuw
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Otolaryngology-Head and Neck Surgery, The Netherlands; Department of Clinical Psychology, Vrije Universiteit Amsterdam, The Netherlands
| | - J Brug
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, Amsterdam, The Netherlands; National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - L M Buffart
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, Amsterdam, The Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam, The Netherlands
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Ozdemir K, Keser I, Sen I, Ozgur Tan M. Investigating the relationships between quality of life, fatigue and leisure time physical activity in prostate cancer patients. J Back Musculoskelet Rehabil 2019; 32:497-503. [PMID: 30584117 DOI: 10.3233/bmr-181220] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES The aim of this study was to investigate the relationship between the parameters of fatigue, quality of life and leisure time physical activity in prostate cancer (PCa) patients. This is the first study in the literature to report interaction between these parameters from the perspective of physiotherapy and rehabilitation. MATERIALS AND METHODS Fifty-eight out-patients were enrolled in this study. In an oncologic rehabilitation unit, Functional Assessment of Chronic Illness Therapy-Fatigue Questionnaire (FACIT-F), Functional Assessment of Cancer Therapy-Prostate Questionnaire (FACT-P) and Godin Leisure Time Exercise Questionnaire (GLTEQ) were utilized to evaluate fatigue, quality of life and physical activity, respectively. Frequencies and the relationships between the results of the parameters were analyzed. RESULTS The average age of patients was 67.68 ± 7.54 years. Mean scores of FACIT-F [42.94 ± 8.25] and FACT-P [118.81 ± 13.39] were determined. The median score of GLTEQ was 14 (0-70). There were positive correlations between FACIT-F and FACT-P (r= 0.633, p< 0.001); GLTEQ and FACT-P (r= 0.275, p< 0.05) and; FACIT-F and GLTEQ (r= 0.297, p< 0.05). CONCLUSION Increased fatigue and decreased leisure time physical activity level may affect quality of life negatively. Moreover, it was observed that decreasing leisure time physical activity level affects fatigue negatively. Accordingly, physiotherapists with PCa patients may focus on developing physical activity levels in various ways to address the multidimensional problems of fatigue and quality of life.
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Affiliation(s)
- Kadirhan Ozdemir
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Ilke Keser
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Ilker Sen
- Department of Urology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Mustafa Ozgur Tan
- Department of Urology, Faculty of Medicine, Gazi University, Ankara, Turkey
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50
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Chen Z, Zhang Y, Lu C, Zeng H, Schumann M, Cheng S. Supervised Physical Training Enhances Muscle Strength but Not Muscle Mass in Prostate Cancer Patients Undergoing Androgen Deprivation Therapy: A Systematic Review and Meta-Analysis. Front Physiol 2019; 10:843. [PMID: 31333495 PMCID: PMC6618665 DOI: 10.3389/fphys.2019.00843] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 06/19/2019] [Indexed: 02/05/2023] Open
Abstract
Introduction: Androgen deprivation therapy (ADT) is considered the basic treatment for advanced prostate cancer, but it is highly associated with detrimental changes in muscle mass and muscle strength. The aim of this meta-analysis was to investigate the effects of supervised physical training on lean mass and muscle strength in prostate cancer patients undergoing ADT. Methods: A systematic literature search was performed using MEDLINE, Embase, and ScienceDirect until October 2018. Only studies that examined both muscle mass and strength in prostate cancer patients undergoing ADT were included. Outcomes of interest were changes in lean body mass (surrogate for muscle mass) as well as upper and lower body muscle strength. The meta-analysis was performed with fixed-effects models to calculate mean differences between intervention and no-training control groups. Results: We identified 8,521 publications through the search of the following key words: prostate cancer, prostate tumor, prostate carcinoma, prostate neoplasm, exercise, and training. Out of these studies, seven randomized controlled trials met the inclusion criteria and where included in the analysis. No significant mean differences for changes in lean mass were observed between the intervention and control groups (0.49 kg, 95% CI: −0.76, 1.74; P = 0.44). In contrast, the mean difference for muscle strength was significant both in chest (3.15 kg, 95% CI: 2.46, 3.83; P < 0.001) and in leg press (27.46 kg, 95% CI: 15.05, 39.87; p < 0.001). Conclusion: This meta-analysis provides evidence that low- to moderate-intensity resistance and aerobic training is effective for increasing muscle strength but may not be sufficient to affect muscle mass in prostate cancer patients undergoing ADT. The underlying mechanisms for this maladaptation may in part be explained by an insufficient stimulus induced by the training regimens as well as a delayed initiation of training in relation to the start of ADT. When interpreting the present findings, one should bear in mind that the overall number of studies included in this review was rather low, emphasizing the need for further studies in this field.
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Affiliation(s)
- Ziyuan Chen
- Department of Physical Education, Exercise, Health and Technology Centre, Shanghai Jiao Tong University, Shanghai, China
| | - Yuan Zhang
- The Key Laboratory of Systems Biomedicine, Ministry of Education, and The Exercise Translational Medicine Centre, Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai, China
| | - Chunyan Lu
- Department of Endocrinology, West China Hospital, Sichuan University, Chengdu, China
| | - Hao Zeng
- Department of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Moritz Schumann
- Department of Physical Education, Exercise, Health and Technology Centre, Shanghai Jiao Tong University, Shanghai, China.,The Key Laboratory of Systems Biomedicine, Ministry of Education, and The Exercise Translational Medicine Centre, Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai, China.,Department of Molecular and Cellular Sport Medicine, Institute of Cardiovascular Research and Sport Medicine, German Sport University, Cologne, Germany
| | - Sulin Cheng
- Department of Physical Education, Exercise, Health and Technology Centre, Shanghai Jiao Tong University, Shanghai, China.,The Key Laboratory of Systems Biomedicine, Ministry of Education, and The Exercise Translational Medicine Centre, Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai, China.,Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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