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Liu YX, Wang J. Impact of comorbid subthreshold depressive symptoms on cancer-related fatigue and complications in adults with leukemia. World J Psychiatry 2024; 14:1009-1016. [DOI: 10.5498/wjp.v14.i7.1009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 05/13/2024] [Accepted: 06/18/2024] [Indexed: 07/12/2024] Open
Abstract
BACKGROUND Patients not only experience symptoms caused by cancer but also suffer from the accompanying psychological pain. Therefore, these patients do not have high quality of life. According to the World Health Organization, the incidence of leukemia in China in 2020 was 5.1/100000, the mortality rate was 3.3/100000, and the prevalence rate was 16.7/100000. Therefore, it is important to examine the influence of comorbid subthreshold depressive symptoms on leukemia patients.
AIM To determine the impact of comorbid subthreshold depressive symptoms on cancer-related fatigue and complications in leukemia patients, thereby providing a basis for early diagnosis and treatment in clinical practice.
METHODS A questionnaire survey was conducted among leukemia patients admitted to a tertiary hospital in Xi'an, Shaanxi Province, China, from August 2022 to December 2023. Patients with a score > 16 on the Chinese Classification of Mental Disorders (CCMD-3) and a Hamilton Depression Rating Scale score of 8-17 were classified as the subthreshold depressive group (n = 95), while 100 leukemia patients admitted during the same period were classified as the control group. Data were collected using Epidata 3.1 software, and comparisons were made between the two groups regarding general clinical data, the Piper Fatigue Scale (PFS), the Pittsburgh Sleep Quality Index (PSQI), the Numeric Rating Scale for pain assessment, laboratory indicators, and the occurrence of complications.
RESULTS In this survey, 120 leukemia patients with depression were preliminarily screened, 95 patients with subthreshold depression were ultimately selected as the subthreshold depression group, and 100 leukemia patients admitted during the same period were enrolled as the normal group. Comparison of basic clinical data between the two groups revealed no significant differences in age, sex, body mass index, cognitive function, or comorbidity with other chronic diseases. However, there were statistically significant differences in the use of radiotherapy and regular exercise between the two groups (P < 0.05). Comparisons of scales and laboratory indicators revealed no significant differences in albumin or PSQI scores between the two groups, but there were statistically significant differences in pain scores, PSQI scores, PFS scores, hemoglobin levels, and C-reactive protein levels (P < 0.05). Spearman’s correlation analysis indicated that cancer-related fatigue was correlated with age, hemoglobin levels, C-reactive protein levels, pain, and regular exercise among leukemia patients with subthreshold depression. Multivariate regression analysis revealed that advanced age, combined radiotherapy, pain, and low hemoglobin levels were risk factors for cancer-related fatigue in leukemia patients with comorbid subthreshold depression, while regular exercise was a protective factor against cancer-related fatigue. Follow-up comparisons revealed a significantly lower overall incidence of complications in the control group (4%) than in the depressive group (24.21%; P < 0.001).
CONCLUSION Leukemia patients with comorbid subthreshold depressive symptoms experience more severe cancer-related fatigue and a higher incidence of complications. These findings may be related to advanced age, combined radiotherapy, pain, and low hemoglobin levels, while regular exercise may effectively alleviate symptoms.
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Affiliation(s)
- Yue-Xian Liu
- Department of Hematology, Central Hospital Affiliated to Shandong First Medical University, Jinan 250013, Shandong Province, China
| | - Juan Wang
- Department of Hematology, Central Hospital Affiliated to Shandong First Medical University, Jinan 250013, Shandong Province, China
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Ikeda T, Toyama S, Harada T, Noma K, Hamada M, Kitagawa T. Effectiveness of prehabilitation during neoadjuvant therapy for patients with esophageal or gastroesophageal junction cancer: a systematic review. Esophagus 2024; 21:283-297. [PMID: 38411724 PMCID: PMC11199248 DOI: 10.1007/s10388-024-01049-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 02/05/2024] [Indexed: 02/28/2024]
Abstract
Progression of the physical weakness during neoadjuvant therapy (NAT) in patients with esophageal or gastroesophageal junction cancer is a serious problem; however, prehabilitation during NAT has the potential to overcome the unmet need. Nevertheless, systematic reviews on this topic have not been summarized. Therefore, this systematic review aimed to determine prehabilitation's effectiveness, acceptability, and safety during NAT for patients with esophageal or gastroesophageal junction cancer. An electronic search was performed in the MEDLINE, Web of Science, CENTRAL, CINAHL, and PEDro databases. A meta-analysis was conducted to assess the effectiveness of prehabilitation during NAT, along with a descriptive analysis of acceptance and safety. This study analyzed data from three randomized controlled trials (RCTs) and nine non-RCTs involving 664 patients. The meta-analysis of two RCTs demonstrated that prehabilitation during NAT may be more effective than usual care in enhancing tolerance to NAT and grip strength; moreover, one RCT and three non-RCTs revealed that prehabilitation may reduce the risk of postoperative complications. The adherence rates for exercise programs in two RCTs and seven non-RCTs were 55-76%. Additionally, two studies reported a 76% adherence rate for multimodal prehabilitation programs, including exercise, dietary, and psychological care. Six studies reported no serious prehabilitation-related adverse events during NAT. Prehabilitation during NAT may be a safe and beneficial intervention strategy for patients with esophageal or gastroesophageal junction cancer. However, the investigation of strategies to enhance adherence is essential. Furthermore, additional high-quality RCTs are needed to examine the effect of prehabilitation during NAT.
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Affiliation(s)
- Tomohiro Ikeda
- Department of Rehabilitation Medicine, Okayama University Hospital, 2-5-1 Shikatacho, Kita-ku, Okayama, 700-8558, Japan.
| | - Shusuke Toyama
- Department of Rehabilitation, Tagami Hospital, 2-14-15 tagami, Nagasaki, Japan
| | - Tsuyoshi Harada
- Department of Rehabilitation Medicine, National Cancer Center Hospital East, 6-5-1 Kashiwa, Chiba, Japan
- Department of Rehabilitation Medicine, Keio University Graduate School, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Kazuhiro Noma
- Department of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikatacho, Kita-ku, Okayama, Japan
| | - Masanori Hamada
- Department of Rehabilitation Medicine, Okayama University Hospital, 2-5-1 Shikatacho, Kita-ku, Okayama, 700-8558, Japan
| | - Takashi Kitagawa
- Department of Physical Therapy, School of Health Sciences, Shinshu University, 3‑1‑1 Asahi, Matsumoto, Nagano, Japan
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Yang L, Courneya KS, Friedenreich CM. The Physical Activity and Cancer Control (PACC) framework: update on the evidence, guidelines, and future research priorities. Br J Cancer 2024:10.1038/s41416-024-02748-x. [PMID: 38926526 DOI: 10.1038/s41416-024-02748-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 05/22/2024] [Accepted: 06/03/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND We proposed the Physical Activity and Cancer Control (PACC) framework in 2007 to help organise, focus, and stimulate research on physical activity in eight cancer control categories: prevention, detection, treatment preparation/coping, treatment coping/effectiveness, recovery/rehabilitation, disease prevention/health promotion, palliation, and survival. METHODS This perspective paper provides a high-level overview of the scientific advances in physical activity research across cancer control categories, summarises current guidelines, updates the PACC framework, identifies remaining and emerging knowledge gaps, and provides future research directions. RESULTS Many scientific advances have been made that are reflected in updated physical activity guidelines for six of the cancer control categories apart from detection and palliation. Nevertheless, the minimal and optimal type, dose, and timing of physical activity across cancer control categories remain unknown, especially for the understudied population subgroups defined by cancer type, age, race/ethnicity, and resource level of regions/countries. CONCLUSION To achieve the full benefit of physical activity in cancer control, future research should use innovative study designs that include diverse at-risk populations and understudied cancer sites. Additionally, effective behaviour change strategies are needed to increase physical activity levels across populations that use implementation science to accelerate the translation from evidence generation into practical, real-world interventions.
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Affiliation(s)
- Lin Yang
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada
- Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Kerry S Courneya
- Faculty of Kinesiology, Sport and Recreation, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
| | - Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada.
- Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
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Albini A, La Vecchia C, Magnoni F, Garrone O, Morelli D, Janssens JP, Maskens A, Rennert G, Galimberti V, Corso G. Physical activity and exercise health benefits: cancer prevention, interception, and survival. Eur J Cancer Prev 2024:00008469-990000000-00152. [PMID: 38920329 DOI: 10.1097/cej.0000000000000898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
Physical activity (PA) has an established role in the promotion of health and fitness and the prevention of disease. Expected overall benefits include reduction of all-cause morbidity and death, weight control, improved quality of life, improved bone health and decreased falls of elderly subjects, , deeper cognition, and reduced risk of depression, anxiety, and sleeplessness. Currently, PA is a mainstay in the management of cardiovascular diseases, metabolic syndrome, diabetes, and bone health. Recently, the perception of its role in primary and secondary prevention, interception, and treatment of cancer, however, is also gaining importance. Regular walking, the simplest type of PA, is associated with reduced all-cause and cardiovascular disease mortality, and a role in cancer prevention is of increasing interest. Furthermore, PA improves the quality of life of cancer patients, attenuating side effects of chemotherapy, decreasing sarcopenia, increasing fitness, and inhibiting the recurrence and progression of some cancer types. It promotes emotional and psychological benefits in patients, inducing positive changes. While mechanisms, effective levels and useful amount of PA practice are well established in cardiology, they are yet to be fully determined in oncology. Nevertheless, PA is recommended to reduce cancer risk in the general population, and it has been introduced in programs for the prevention of second cancers. In perspective, it will help as integrative therapy in cancer patients and for cancer survivors. The number of beneficial effects in the cancer continuum is highlighted in this review.
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Affiliation(s)
- Adriana Albini
- European Institute of Oncology (IEO), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS)
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan
| | - Francesca Magnoni
- Division of Breast Surgery, European Institute of Oncology (IEO), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS)
| | - Ornella Garrone
- Department of Medical Oncology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico
| | - Danilo Morelli
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) MultiMedica
| | | | - Alain Maskens
- European Cancer Prevention Organization (ECP), Milan, Italy
| | - Gad Rennert
- Carmel Medical Center and Technion Faculty of Medicine, Haifa, Israel
| | - Viviana Galimberti
- Division of Breast Surgery, European Institute of Oncology (IEO), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS)
| | - Giovanni Corso
- Division of Breast Surgery, European Institute of Oncology (IEO), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS)
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
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Nemkov T, Cendali F, Dzieciatkowska M, Stephenson D, Hansen KC, Jankowski CM, D’Alessandro A, Marker RJ. A Multiomics Assessment of Preoperative Exercise in Pancreatic Cancer Survivors Receiving Neoadjuvant Therapy: A Case Series. PATHOPHYSIOLOGY 2024; 31:166-182. [PMID: 38535623 PMCID: PMC10975467 DOI: 10.3390/pathophysiology31010013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 03/11/2024] [Accepted: 03/13/2024] [Indexed: 04/01/2024] Open
Abstract
To molecularly characterize the impact of exercise on mitigating neoadjuvant treatment (NAT)-induced physical decline in pancreatic ductal adenocarcinoma (PDAC) patients, a multi-omics approach was employed for the analysis of plasma samples before and after a personalized exercise intervention. Consisting of personalized aerobic and resistance exercises, this intervention was associated with significant molecular changes that correlated with improvements in lean mass, appendicular skeletal muscle index (ASMI), and performance in the 400-m walk test (MWT) and sit-to-stand test. These alterations indicated exercise-induced modulation of inflammation and mitochondrial function markers. This case study provides proof-of-principal application for multiomics-based assessments of supervised exercise, thereby supporting this intervention as a feasible and beneficial intervention for PDAC patients to potentially enhance treatment response and patient quality of life. The molecular changes observed here underscore the importance of physical activity in cancer treatment protocols, advocating for the development of accessible multiomics-guided exercise programs for cancer patients.
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Affiliation(s)
- Travis Nemkov
- Department of Biochemistry and Molecular Genetics, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA; (F.C.); (M.D.); (D.S.); (A.D.)
| | - Francesca Cendali
- Department of Biochemistry and Molecular Genetics, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA; (F.C.); (M.D.); (D.S.); (A.D.)
| | - Monika Dzieciatkowska
- Department of Biochemistry and Molecular Genetics, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA; (F.C.); (M.D.); (D.S.); (A.D.)
| | - Daniel Stephenson
- Department of Biochemistry and Molecular Genetics, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA; (F.C.); (M.D.); (D.S.); (A.D.)
| | - Kirk C. Hansen
- Department of Biochemistry and Molecular Genetics, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA; (F.C.); (M.D.); (D.S.); (A.D.)
| | | | - Angelo D’Alessandro
- Department of Biochemistry and Molecular Genetics, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA; (F.C.); (M.D.); (D.S.); (A.D.)
| | - Ryan J. Marker
- Department of Medicine, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA
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Ramos PGF, Júdice PB, Nobre I, Carraça EV. Home-based exercise interventions' impact on breast cancer survivors' functional performance: a systematic review. J Cancer Surviv 2024:10.1007/s11764-024-01545-y. [PMID: 38356019 DOI: 10.1007/s11764-024-01545-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 01/27/2024] [Indexed: 02/16/2024]
Abstract
INTRODUCTION Home-based exercise (HBE) programs can be a feasible strategy to enhance functional performance and promote physical activity (PA) in breast cancer survivors. A deeper analysis of the effects of HBE interventions, structured by HBE program type and treatment phase, is needed. This systematic review aimed to synthesize the evidence on HBE interventions' impact on breast cancer survivors' functional performance, PA levels, and program adherence rates, according to HBE intervention type and treatment phase. METHODS A comprehensive search of peer-reviewed articles reporting HBE interventions' effects on the outcomes of interest was performed in Pubmed, Google Scholar, EBSCO, Web of Science, Science Direct, and B-ON until January 15th, 2024. Data were synthesized according to Denton's domains to classify HBE interventions (prescription: structured vs. unstructured; Delivery method: supervised vs. facilitated vs. unsupervised) and treatment phase. Methodological quality appraisal was performed using the Effective Public Health Practice Project tool. RESULTS Twenty-six studies were included. Most studies conducted structured/facilitated interventions and reported positive effects on functional performance (particularly aerobic capacity), increases in PA levels, and high adherence rates (> 70%) during and post-treatment. CONCLUSION HBE interventions may be feasible to improve functional performance and promote physical activity among breast cancer survivors. Further studies are needed to confirm which HBE intervention type is more appropriate for each treatment phase. More evidence applying HBE interventions with different designs is required to allow the drawing of more solid conclusions. Studies exploring the effects of HBE interventions on the pre-treatment phase are needed.
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Affiliation(s)
- Pedro G F Ramos
- Universidade Lusófona, Campo Grande 376, Lisboa, 1749-024, Portugal
| | - Pedro B Júdice
- Centro de Investigação em Educação Física, Exercício e Saúde (CIDEFES), Universidade Lusófona, Campo Grande 376, Desporto, Lisboa, 1749-024, Portugal
| | - Inês Nobre
- Centro Interdisciplinar de Performance Humana (CIPER), Faculdade de Motricidade Humana, Estrada Costa Cruz Quebrada, Cruz Quebrada-Dafundo, 1495-688, Portugal
| | - Eliana V Carraça
- Centro de Investigação em Educação Física, Exercício e Saúde (CIDEFES), Universidade Lusófona, Campo Grande 376, Desporto, Lisboa, 1749-024, Portugal.
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