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Manhas A, Tripathi D, Thomas D, Sayed N. Cardiovascular Toxicity in Cancer Therapy: Protecting the Heart while Combating Cancer. Curr Cardiol Rep 2024; 26:953-971. [PMID: 39042344 DOI: 10.1007/s11886-024-02099-2] [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] [Accepted: 07/09/2024] [Indexed: 07/24/2024]
Abstract
PURPOSE OF REVIEW This review explores the cardiovascular toxicity associated with cancer therapies, emphasizing the significance of the growing field of cardio-oncology. It aims to elucidate the mechanisms of cardiotoxicity due to radiotherapy, chemotherapy, and targeted therapies, and to discuss the advancements in human induced pluripotent stem cell technology (hiPSC) for predictive disease modeling. RECENT FINDINGS Recent studies have identified several chemotherapeutic agents, including anthracyclines and kinase inhibitors, that significantly increase cardiovascular risks. Advances in hiPSC technology have enabled the differentiation of these cells into cardiovascular lineages, facilitating more accurate modeling of drug-induced cardiotoxicity. Moreover, integrating hiPSCs into clinical trials holds promise for personalized cardiotoxicity assessments, potentially enhancing patient-specific therapeutic strategies. Cardio-oncology bridges oncology and cardiology to mitigate the cardiovascular side-effects of cancer treatments. Despite advancements in predictive models using hiPSCs, challenges persist in accurately replicating adult heart tissue and ensuring reproducibility. Ongoing research is essential for developing personalized therapies that balance effective cancer treatment with minimal cardiovascular harm.
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Affiliation(s)
- Amit Manhas
- Stanford Cardiovascular Institute, Stanford, CA, 94305, USA
- Baszucki Family Vascular Surgery Biobank, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Dipti Tripathi
- Stanford Cardiovascular Institute, Stanford, CA, 94305, USA
- Division of Vascular Surgery, Department of Surgery, Stanford, CA, 94305, USA
- Baszucki Family Vascular Surgery Biobank, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Dilip Thomas
- Stanford Cardiovascular Institute, Stanford, CA, 94305, USA
| | - Nazish Sayed
- Stanford Cardiovascular Institute, Stanford, CA, 94305, USA.
- Division of Vascular Surgery, Department of Surgery, Stanford, CA, 94305, USA.
- Baszucki Family Vascular Surgery Biobank, Stanford University School of Medicine, Stanford, CA, 94305, USA.
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Narasimhan P, Levy AR, Rogers SN, Schache AG, Patterson JM, Williams NH, Brooker RC, Midgley AW. A protocol for the longitudinal investigation of cancer related fatigue in head and neck cancer with an emphasis on the role of physical activity. PLoS One 2024; 19:e0308400. [PMID: 39141642 PMCID: PMC11324130 DOI: 10.1371/journal.pone.0308400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 07/24/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND AND AIM Cancer related fatigue significantly impairs the ability to undertake sustained physical activity across the domains of daily living, work and recreation. The purpose of this study is to monitor cancer related fatigue and the factors affected or caused by it for 12 months in head and neck cancer patients following their diagnosis. Their perceptions of how fatigue might affect their activity levels in addition to identifying avenues to improve engagement with physical activity will be also explored. METHODS A single centre longitudinal mixed-methods study will be conducted. Forty head and neck cancer patients will be recruited over 6 months following the confirmation of their treatment plan, after which fatigue and physical activity will be assessed at four time points over 12 months. Additionally, other factors which influence fatigue such as body composition, blood counts, systemic inflammation levels, haemoglobin concentration, thyroid function, sleep quality, cardiorespiratory fitness and upper and lower extremity strength will be measured to understand how the multifactorial problem of fatigue may evolve over time and influence physical activity levels. Semi-structured interviews will be conducted after treatment completion and at end of twelve months which will analyse the participants fatigue experiences, understand how their perceived fatigue may have impacted physical activity and report the factors which may improve engagement with physical activity during cancer. Quantitative data will be analysed and reported using standard descriptive statistics and post-hoc pairwise comparisons. The changes in outcome measures across time will be analysed using the MIXED procedure in SPSS software. Statistical significance will be accepted at p<0.05. Qualitative data will be analysed using the Interpretative Phenomenological Approach using the NVivo software. DISCUSSION The results from this study may help inform the planning and delivery of appropriately timed interventions for the management of cancer related fatigue.
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Affiliation(s)
- Prahalad Narasimhan
- Department of Sport and Physical Activity, Edge Hill University, Ormskirk, United Kingdom
| | - Andrew R. Levy
- Health Research Institute, Edge Hill University, Ormskirk, United Kingdom
- Department of Psychology, Edge Hill University, Ormskirk, United Kingdom
| | - Simon N. Rogers
- Wirral University Teaching Hospital, Wirral, United Kingdom
- Faculty of Health and Social Care, Edge Hill University, Ormskirk, United Kingdom
| | - Andrew G. Schache
- Liverpool Head and Neck Centre, Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom
| | - Joanne M. Patterson
- Liverpool Head and Neck Centre, Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom
| | - Nefyn H. Williams
- Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
| | - Rachel C. Brooker
- Liverpool Head and Neck Centre, Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom
- The Clatterbridge Cancer Centre NHS Foundation Trust, Wirral, United Kingdom
| | - Adrian W. Midgley
- Department of Sport and Physical Activity, Edge Hill University, Ormskirk, United Kingdom
- Health Research Institute, Edge Hill University, Ormskirk, United Kingdom
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Kim J, Park SH, Kim DY, Ryu HW, Jun HS. Molecular Mechanisms of Anticarcinogenic Potential of Hydrocotyle umbellata and Its Major Components. Nutr Cancer 2024:1-13. [PMID: 38994559 DOI: 10.1080/01635581.2024.2377344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 07/02/2024] [Indexed: 07/13/2024]
Abstract
Despite the development of several anticancer treatments, there remains a need for new drugs that can overcome resistance and reduce side effects. While the medicinal herb Hydrocotyle umbellata (H. umbellata) has been used to relieve pain and inflammation, its antitumor properties have not yet been explored. In this study, we investigated the anticarcinogenic potential of H. umbellata extract (HUE) and its major components, as well as the underlying molecular mechanisms. Our results showed that HUE inhibited the growth of various tumor cell lines, including B16F10, without affecting non-cancer cells. Furthermore, HUE was effective in treating and preventing tumor growth in mice. Our mechanistic studies revealed that HUE inhibited cellular respiration, thereby reducing tumor cell proliferation. When combined with 2-deoxy-D-glucose, HUE demonstrated an enhanced anticancer effect by increasing the rate apoptosis. Analysis of the ethyl acetate and n-butanol fractions of HUE identified 1,3,4-trihydroxy-2-butanyl-α-d-glucopyranoside and caffeoylquinic acid derivatives as the major components responsible for the observed anticancer effects. In conclusion, our findings suggest that HUE and its two major components have the potential to be developed as effective therapeutic agents for a wide range of tumors by targeting cancer cell metabolism.
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Affiliation(s)
- Jaeyong Kim
- Department of Biotechnology and Bioinformatics, College of Science and Technology, Korea University, Sejong, Republic of Korea
| | - Sang Hyuk Park
- Department of Biotechnology and Bioinformatics, College of Science and Technology, Korea University, Sejong, Republic of Korea
| | - Doo-Young Kim
- Natural Medicine Research Center, Korea Research Institute of Bioscience and Biotechnology, Cheong-ju si, Chungcheongbuk-do, Republic of Korea
| | - Hyung Won Ryu
- Natural Medicine Research Center, Korea Research Institute of Bioscience and Biotechnology, Cheong-ju si, Chungcheongbuk-do, Republic of Korea
| | - Hyun Sik Jun
- Department of Biotechnology and Bioinformatics, College of Science and Technology, Korea University, Sejong, Republic of Korea
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Huynh TTM, Falk RS, Hellebust TP, Dale E, Astrup GL, Hjermstad MJ, Malinen E, Bjordal K, Kiserud CE, Herlofson BB, Nome R, Amdal CD. Chronic fatigue in long-term survivors of head and neck cancer treated with radiotherapy. Radiother Oncol 2024; 195:110231. [PMID: 38518958 DOI: 10.1016/j.radonc.2024.110231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 03/13/2024] [Accepted: 03/14/2024] [Indexed: 03/24/2024]
Abstract
BACKGROUND There is lack of evidence on chronic fatigue (CF) following radiotherapy (RT) in survivors of head and neck cancer (HNC). We aimed to compare CF in HNC survivors > 5 years post-RT with a reference population and investigate factors associated with CF and the possible impact of CF on health-related quality of life (HRQoL). MATERIAL AND METHODS In this cross-sectional study we included HNC survivors treated in 2007-2013. Participants filled in patient-reported outcome measures and attended a one-day examination. CF was measured with the Fatigue Questionnaire and compared with a matched reference population using t-tests and Cohen's effect size. Associations between CF, clinical and RT-related factors were investigated using logistic regression. HRQoL was measured with the EORTC Quality of Life core questionnaire. RESULTS The median age of the 227 HNC survivors was 65 years and median time to follow-up was 8.5 years post-RT. CF was twice more prevalent in HNC survivors compared to a reference population. In multivariable analyses, female sex (OR 3.39, 95 % CI 1.82-6.31), comorbidity (OR 2.17, 95 % CI 1.20-3.94) and treatment with intensity-modulated RT (OR 2.13, 95 % CI 1.16-3.91) were associated with CF, while RT dose parameters were not. Survivors with CF compared to those without, had significantly worse HRQoL. CONCLUSIONS CF in HNC survivors is particularly important for female patients, while specific factors associated with RT appear not to play a role. The high CF prevalence in long-term HNC survivors associated with impaired HRQoL is important information beneficial for clinicians and patients to improve patient follow-up.
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Affiliation(s)
- Thuy-Tien Maria Huynh
- Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Oncology, Oslo University Hospital, Oslo, Norway.
| | | | - Taran Paulsen Hellebust
- Department of Physics, University of Oslo, Oslo, Norway; Department of Medical Physics, Oslo University Hospital, Oslo, Norway
| | - Einar Dale
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| | | | | | - Eirik Malinen
- Department of Physics, University of Oslo, Oslo, Norway; Department of Radiation Biology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway
| | - Kristin Bjordal
- Faculty of Medicine, University of Oslo, Oslo, Norway; Research Support Services, Oslo University Hospital, Oslo, Norway
| | | | - Bente Brokstad Herlofson
- Faculty of Dentistry, University of Oslo, Oslo, Norway; Department of Otorhinolaryngology, Head and Neck Surgery, Oslo University Hospital, Oslo, Norway
| | - Ragnhild Nome
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
| | - Cecilie Delphin Amdal
- Department of Oncology, Oslo University Hospital, Oslo, Norway; Research Support Services, Oslo University Hospital, Oslo, Norway
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Lopez-Olivo MA, James J, James J, Krause KJ, Roth M, Palos GR, Ma H, Rodriguez A, Gilmore K, Cinciripini P, Suarez-Almazor ME. A systematic review and meta-analysis of e-cigarette use among cancer survivors. J Cancer Surviv 2024; 18:1059-1074. [PMID: 36952212 DOI: 10.1007/s11764-023-01357-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 03/01/2023] [Indexed: 03/24/2023]
Abstract
PURPOSE We conducted a systematic review and meta-analysis to determine the use of e-cigarettes among cancer survivors, factors associated with their use, and prevalence of e-cigarette use as a quit attempt. METHODS We searched five electronic databases until June 2022. Two authors independently selected studies, appraised their quality, and collected data. RESULTS Twenty-three publications from eight data sources (national surveys) met our eligibility criteria. The pooled rate of lifetime e-cigarette use among cancer survivors was 15% (95% CI 6-27%); current use was 3% (95% CI 0-8%). Among survivors who currently used traditional cigarettes, 63% (95% CI 57-69%) also used e-cigarettes. The reported rates of weighted lifetime e-cigarette use differed between age groups (18-44 years, up to 46.7%; 45-64, up to 27.2%; ≥65, up to 24.8%). Nine publications reported factors associated with lifetime e-cigarette use (i.e., active use of traditional cigarettes; heavy drinking; poor mental health; younger age; being male, non-Hispanic White, or single; having less than high school education or income ≤$25,000 USD; and living in the South regions of the US or urban areas). E-cigarettes were used as a quit resource by 75% of survivors reporting dual use of electronic and traditional cigarettes (95% CI 63%, 85%). CONCLUSION More than two-thirds of survivors currently using traditional cigarettes also use e-cigarettes. Higher use rates of e-cigarettes were reported among young cancer survivors compared to older survivors. Future studies are needed to assess the impact of e-cigarettes on long-term health and improve screening of smoking behaviors. IMPLICATIONS FOR CANCER SURVIVORS Our study provides an overview of the prevalence of e-cigarette use and sociodemographic risk factors associated with e-cigarette use among cancer survivors. The findings can assist providers in supporting attempts to quit among cancer survivors.
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Affiliation(s)
- Maria A Lopez-Olivo
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, USA.
- The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1444, Houston, TX, 77030, USA.
| | - Justin James
- City University of New York School of Medicine, New York, NY, USA
| | - Joel James
- City University of New York School of Medicine, New York, NY, USA
| | - Kate J Krause
- Research Medical Library, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Michael Roth
- Department of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Guadalupe R Palos
- Office of Cancer Survivorship, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Hilary Ma
- Department of General Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Alma Rodriguez
- Department of Lymphoma-Myeloma, The University of Texas MD Anderson Cancer Center, Lymphoma-Myeloma, Houston, USA
| | - Katherine Gilmore
- Office of Cancer Survivorship, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Paul Cinciripini
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Maria E Suarez-Almazor
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, USA
- Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, USA
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Tokala M, Weber J, Gilbert R, Dreyer Gillette ML, August KJ, Befort CA, Bates CR. Caregiver perceptions of child heath behaviors and weight during treatment for acute lymphoblastic leukemia. Pediatr Blood Cancer 2024; 71:e30984. [PMID: 38584336 DOI: 10.1002/pbc.30984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 03/07/2024] [Accepted: 03/18/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND Changes in health behaviors and weight are common during the early phases of pediatric acute lymphoblastic leukemia treatment, and may negatively impact treatment tolerability. Given that ALL is most prevalent in children, caregivers play an essential role in shaping health behaviors during treatment. This study presents a qualitative analysis of semi-structured interviews with caregivers of youth in the early phases of ALL treatment. PROCEDURE Caregivers (N = 17, 95% female) of a child (M age = 6.76 years) diagnosed with ALL and on treatment for less than 1 year (M = 8.7 months since diagnosis) completed a semi-structured interview about perceptions of their child's nutrition, physical activity, sedentary time, and weight during ALL treatment. Thematic analysis followed Braun and Clark's six-step framework (2006). Two coders established reliability (alpha = .88) and used a multi-pass coding system to extract themes. RESULTS Caregivers' concerns around their child's weight during ALL treatment primarily centered around avoiding malnutrition. Weight gain during treatment was less of a concern and often viewed as protective. Caregivers reported encouraging their child to eat palatable, calorie-dense foods to mitigate risk for weight loss. Caregivers also expressed concern that children were less active and more sedentary due to treatment-related pain. Caregivers discussed health behaviors during treatment as being child-directed, rather than parent- or provider-directed. CONCLUSION Future interventions may consider strategies to engage in joint parent-child decisions and caregiver education around risks of excessive weight gain during treatment. Interventions should include anticipatory guidance and aim to support parents in developing skills to support their child's health behaviors during treatment.
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Affiliation(s)
- Meghan Tokala
- University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Jacee Weber
- Kansas City University College of Osteopathic Medicine, Kansas City, Missouri, USA
| | - Renee Gilbert
- University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Meredith L Dreyer Gillette
- Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri, USA
- University of Missouri Kansas City School of Medicine, Kansas City, Missouri, USA
- Center for Children's Healthy Lifestyles & Nutrition, Kansas City, Missouri, USA
| | - Keith J August
- Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri, USA
- University of Missouri Kansas City School of Medicine, Kansas City, Missouri, USA
| | - Christie A Befort
- University of Kansas Medical Center, Kansas City, Kansas, USA
- Center for Children's Healthy Lifestyles & Nutrition, Kansas City, Missouri, USA
- University of Kansas Cancer Center, Westwood, Kansas, USA
| | - Carolyn R Bates
- University of Kansas Medical Center, Kansas City, Kansas, USA
- Center for Children's Healthy Lifestyles & Nutrition, Kansas City, Missouri, USA
- University of Kansas Cancer Center, Westwood, Kansas, USA
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Hussey C, Hanbridge M, Dowling M, Gupta A. Cancer survivorship: understanding the patients' journey and perspectives on post-treatment needs. BMC Sports Sci Med Rehabil 2024; 16:82. [PMID: 38605386 PMCID: PMC11010277 DOI: 10.1186/s13102-024-00864-y] [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: 10/29/2023] [Accepted: 03/15/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Cancer treatments have many adverse effects on patient's health leading to poor cardiorespiratory capacity, muscular- degeneration, fatigue, loss of strength and physical function, altered body-composition, compromised immune-function, peripheral neuropathy, and reduced quality of life (QOL). Exercise programs can significantly increase functional capacity when tailored to individual needs, thus improving health. Exercise interventions in cancer rehabilitation, when supported by appropriate nutrition can be effective in attaining a healthy weight and body-composition. The successful rehabilitation program should also include psycho-social education aimed to reduce anxiety and improve motivation. METHODS The current study aimed to collect information on the post-treatment needs of cancer patients including barriers and expectations facing them, their caregivers and their families through consultation in focus group interviews. Cancer survivors living in the Republic of Ireland were recruited from the University Hospital Galway, community-based cancer centres, cancer support groups and social media platforms to participate in the study and attend a focus group interview. The focus group discussions were designed to obtain information on the collective views of cancer survivors on relevant topics selected. The topics were developed in consultation with a patient and public involvement (PPI) group supporting the study. The topics list was circulated to all participants prior to the focus group. The interviews were audio recorded and transcribed verbatim. Focus group transcripts were analysed subjected to a thematic framework analysis using NVivo. RESULTS Thirty-six participants took part in 9 focus groups. Our analysis uncovered two main themes. The first theme 'cast adrift with no direction' was grouped into three sub-themes: everything revolves around treatment; panic and fear; and what exercise should I be doing? The second theme 'everybody is different' was clustered into two sub-themes: side effects get in the way; and personalised exercise program. CONCLUSION The study highlighted the lack of information and support needed by patients living with and beyond cancer. The study also highlighted the need for a personalised exercise programme designed to target the individual patient symptoms that would be ideal for the mitigation of long term symptoms and in improving QOL.
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Affiliation(s)
- Conor Hussey
- School of Medicine, University of Galway, Galway, Ireland
| | - Moira Hanbridge
- IPPOSI - Patient Education Programme in Health Innovation, Dublin, Ireland
| | - Maura Dowling
- School of Nursing and Health Sciences, University of Galway, Galway, Ireland
| | - Ananya Gupta
- School of Medicine, University of Galway, Galway, Ireland.
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Adamovich T, Watson R, Murdoch S, Giovino L, Kulkarni S, Luchak M, Smith-Turchyn J. Barriers and facilitators to physical activity participation for child, adolescent, and young adult cancer survivors: a systematic review. J Cancer Surviv 2024; 18:245-262. [PMID: 35665472 DOI: 10.1007/s11764-022-01217-9] [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: 03/24/2022] [Accepted: 05/18/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE The aim of this systematic review is to explore and describe the barriers and facilitators to physical activity (PA) participation for child, adolescent, and young adult cancer survivors. METHODS MEDLINE, Embase, AMED, CINAHL, Cochrane, and Web of Science were searched for manuscripts published between January 2000 and February 2021. To be included in this review, studies had to report qualitative or quantitative data on barriers and facilitators to PA participation in child (4 to < 10 years), adolescent (10 to 19 years), and young adult (> 19 to < 40 years) cancer survivors. Six independent reviewers assessed methodological quality using the Mixed Methods Appraisal Tool (MMAT-version 18) in duplicate. RESULTS Fifteen studies were included in this systematic review. Fatigue and psychological factors were the most prevalent barriers shared between children, adolescents, and young adults. Support from others was a shared facilitator between age groups. CONCLUSION Psychological barriers and social support are important to address in younger cancer survivors. Clinicians can use these findings to create exercise interventions to facilitate and overcome barriers to PA participation. IMPLICATIONS FOR CANCER SURVIVORS While PA is beneficial for cancer survivors of all ages, different barriers and facilitators to PA participation exist depending on a survivors age and life stage. Survivors should discuss PA with their healthcare team at all timepoints in the cancer treatment trajectory in order to gain the associated benefits during and after treatment.
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Affiliation(s)
- Tatsiana Adamovich
- School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
| | - Rebecca Watson
- School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
| | - Sydney Murdoch
- School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
| | - Liana Giovino
- School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
| | - Sunket Kulkarni
- School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
| | - Michael Luchak
- School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
| | - Jenna Smith-Turchyn
- School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada.
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Cheung DST, Ho MH, Chau PH, Yu DSF, Chan WL, Soong SI, Woo J, Lin CC. Screening for Frailty Using the FRAIL Scale in Older Cancer Survivors: A Cross-sectional Comparison With the Fried Phenotype. Semin Oncol Nurs 2024:151617. [PMID: 38423822 DOI: 10.1016/j.soncn.2024.151617] [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: 06/08/2023] [Revised: 02/01/2024] [Accepted: 02/07/2024] [Indexed: 03/02/2024]
Abstract
OBJECTIVES To examine the diagnostic performance of the FRAIL Scale for frailty screening with reference to the Fried phenotype and investigate its association with health outcomes in older cancer survivors. DATA SOURCE In this cross-sectional quantitative study, participants were post-treatment cancer survivors aged 65 or above. Measurements included the FRAIL Scale, Fried phenotype, Geriatric Depression Scale-15 item, Modified Barthel Inventory, and EORTC Core Quality of Life Questionnaire. Receiver operating characteristic curve analysis was performed to evaluate the diagnostic performance of the FRAIL Scale with reference to the Fried phenotype. Health outcomes associated with being frail as estimated by the FRAIL Scale and Fried phenotype were also examined using regressions. RESULTS Based on 293 older cancer survivors, the area under curve (AUC) of the FRAIL Scale was 0.79, and the optimal cut-off of 1 yielded a sensitivity of 92% and specificity of 41%. According to regression results, the FRAIL Scale was modified by adding an item on time since cancer treatment completion (AUC = 0.81), and using a cut-off of 2 for older cancer survivors, which yielded a sensitivity of 74% and specificity of 67%. The modified FRAIL Scale was associated with depressive symptoms, functional independence, fatigue, dyspnea, physical functioning, and role functioning. CONCLUSIONS The modified FRAIL Scale is proposed for use in older cancer survivors, and a cut-off of 2 should be used. IMPLICATIONS FOR NURSING PRACTICE The modified FRAIL Scale can serve as a brief screening tool for identifying frailty among older cancer survivors in practice.
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Affiliation(s)
| | - Mu-Hsing Ho
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Pui Hing Chau
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Doris Sau Fung Yu
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Wing Lok Chan
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Sung Inda Soong
- Department of Clinical Oncology, Pamela Youde Nethersole Hospital, Hong Kong
| | - Jean Woo
- Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Chia Chin Lin
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong; Alice Ho Miu Ling Nethersole Charity Foundation Professorship in Nursing, Hong Kong
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Andersen C, Adamsen L, Damhus CS, Piil K, Missel M, Jarden M, Larsen A, Larsen HB, Møller T. Qualitative exploration of the perceptions of exercise in patients with cancer initiated during chemotherapy: a meta-synthesis. BMJ Open 2023; 13:e074266. [PMID: 38086582 PMCID: PMC10729187 DOI: 10.1136/bmjopen-2023-074266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 11/20/2023] [Indexed: 12/18/2023] Open
Abstract
OBJECTIVE To synthesise qualitative literature on (1) the perceptions of patients with cancer of participating in an exercise intervention while undergoing chemotherapy and (2) to inform and guide professionals in oncology and haematology practice. DESIGN A qualitative meta-synthesis based on Noblit and Hare's seven-step meta-ethnography. DATA SOURCES Six electronic databases: Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, EMBASE, PubMed, SCI-Expanded-SSCI and Scopus (final search June 2022) were used to identify qualitative literature containing individual or focus group interviews. The transparency of reporting for each study was assessed using the Consolidated criteria for Reporting Qualitative research checklist. RESULTS The search identified 5002 articles, 107 of which were selected for full-text review. Seventeen articles from five countries with patients undergoing chemotherapy during exercise interventions were included. Eleven articles were included in the meta-synthesis, which comprised 193 patients with various cancer diagnoses, disease stages, sexes and ages. Four main themes were identified: chemotherapy overpowers the body; exercise in battle with side effects; a break from gloomy thoughts; and a question of survivorship. CONCLUSIONS AND IMPLICATIONS The meta-synthesis emphasised that patients with cancer undergoing chemotherapy and simultaneously participating in exercise interventions may experience momentary relief from overwhelming side effects, even though full bodily recovery may be perceived as a distant prospect. The synthesis offers a sparse empirical basis for gaining insight into what patients experience existentially following exercise interventions. It is up to patients to independently apply the transfer value of exercise to their own existential circumstances.
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Affiliation(s)
- Christina Andersen
- Center for Health Research (UCSF), Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Lis Adamsen
- Center for Health Research (UCSF), Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Christina Sadolin Damhus
- Department of Public Health, University of Copenhagen Faculty of Health and Medical Sciences, Copenhagen, Denmark
| | - Karin Piil
- Department of Oncology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Malene Missel
- Department of Cardiothoracic Surgery, Copenhagen University Hospital, Copenhagen, Denmark
| | - Mary Jarden
- Department of Public Health, University of Copenhagen Faculty of Health and Medical Sciences, Copenhagen, Denmark
- Department of Heamatology, Centre for Cancer and Organ Diseases, University of Copenhagen, Copenhagen, Denmark
| | - Anders Larsen
- Center for Health Research (UCSF), Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Hanne Baekgaard Larsen
- Department of Public Health, University of Copenhagen Faculty of Health and Medical Sciences, Copenhagen, Denmark
- Department of Peadiatrics and Adolescent Medicine, Copenhagen University Hospital, Copenhagen, Denmark
| | - Tom Møller
- Center for Health Research (UCSF), Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen Faculty of Health and Medical Sciences, Copenhagen, Denmark
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Ayala-Garcia A, Benavides FG, Serra L. Labour market participation after sickness absence due to cancer: a dynamic cohort study in Catalonia (Spain). BMC Public Health 2023; 23:2477. [PMID: 38082284 PMCID: PMC10714569 DOI: 10.1186/s12889-023-17321-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND The consequences of cancer on working until retirement age remain unclear. This study aimed to analyse working life considering all possible labour market states in a sample of workers after sickness absence (SA) due to cancer and to compare their working life paths to those of a sample of workers without SA and with an SA due to other diseases. METHODS This was a retrospective dynamic cohort study among social security affiliates in Catalonia from 2012-2018. Cases consisted of workers with an SA due to cancer between 2012-2015 (N = 516) and were individually age- and sex-matched with those of affiliates with an SA due to other diagnoses and workers without an SA. All workers (N = 1,548, 56% women) were followed up from entry into the cohort until the end of 2018 to characterise nine possible weekly labour states. Sequence analysis, optimal matching, and multinomial logistic regression were used to identify and assess the probability of future labour market participation patterns (LMPPs). All analyses were stratified by sex. RESULTS Compared with workers with an SA due to cancer, male workers with no SA and SA due to other causes showed a lower probability of being in the LMPP of death (aRRR 0.02, 95% CI: 0.00‒0.16; aRRR 0.17, 95% CI: 0.06‒0.46, respectively) and, among women, a lower probability of permanent disability and death (aRRR 0.24, 95% CI: 0.10‒0.57; aRRR 0.39, 95% CI: 0.19‒0.83, respectively). Compared to workers with SA due to cancer, the risk of early retirement was lower among workers with no SA (women, aRRR 0.60, 95% CI: 0.22‒1.65; men, aRRR 0.64, 95% CI: 0.27‒1.52), although these results were not statistically significant. CONCLUSIONS Workplaces, many of which have policies common to all diagnoses, should be modified to the needs of cancer survivors to prevent an increasing frequency of early retirement and permanent disability when possible. Future studies should assess the impact of cancer on premature exit from the labour market among survivors, depending on cancer localisation and type of treatment.
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Affiliation(s)
- Amaya Ayala-Garcia
- Center for Research in Occupational Health (CiSAL), Universitat Pompeu Fabra, PRBB Building, Dr. Aiguader, 88, 08003, Barcelona, Spain.
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
- IMIM - Parc Salut Mar, Barcelona, Spain.
| | - Fernando G Benavides
- Center for Research in Occupational Health (CiSAL), Universitat Pompeu Fabra, PRBB Building, Dr. Aiguader, 88, 08003, Barcelona, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- IMIM - Parc Salut Mar, Barcelona, Spain
| | - Laura Serra
- Center for Research in Occupational Health (CiSAL), Universitat Pompeu Fabra, PRBB Building, Dr. Aiguader, 88, 08003, Barcelona, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- IMIM - Parc Salut Mar, Barcelona, Spain
- Research Group On Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain
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12
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Nadolny S, Schildmann E, Gaßmann ES, Schildmann J. What is an "early palliative care" intervention? A scoping review of controlled studies in oncology. Cancer Med 2023; 12:21335-21353. [PMID: 37902232 PMCID: PMC10726823 DOI: 10.1002/cam4.6490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 07/21/2023] [Accepted: 08/21/2023] [Indexed: 10/31/2023] Open
Abstract
INTRODUCTION Early palliative care (EPC) has been advocated to improve cancer patients' health. However, EPC differs with regard to its elements and target groups. It is not known which parts of EPC contribute to effectiveness for which patient group. This scoping review provides a structured analysis of EPC interventions and outcome measures. DESIGN We searched EMBASE, MEDLINE, CINAHL, and CENTRAL up to February 2022. We included randomized controlled trials (RCT), nonrandomized trials, cohort studies (CS), and controlled before-after studies of EPC in adult patients in English, Dutch, and German language. Interventions had to be self-labeled as EPC. Screening and data extraction were performed by two raters. A structured analysis incorporating the TIDieR checklist was performed to describe the elements of the interventions. RESULTS We screened 2651 articles, resulting in 40 articles being included: 34 studies were RCT and six studies were CS with a mean sample size of 208 patients. Patients with pancreatic (n = 10) and lung cancer (n = 9) were most often included. Studies reported different reference points for the onset of EPC such as time after diagnosis of incurable cancer (n = 18) or prognosis (n = 9). Thirteen studies provided information about elements of EPC and eight studies about the control intervention. Most frequent elements of EPC were symptom management (n = 28), case management (n = 16), and advance care planning (ACP; n = 15). Most frequently reported outcome measures were health-related quality of life (n = 26), symptom intensity (n = 6), resource use, and the patient's mood (n = 4 each). CONCLUSION The elicited heterogeneity of ECP in combination with deficits of reporting are considerable barriers that should be addressed to further develop effective EPC interventions for different groups of cancer patients.
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Affiliation(s)
- Stephan Nadolny
- Institute for History and Ethics of Medicine, Interdisciplinary Center for Health SciencesMartin Luther University Halle‐WittenbergHalleGermany
- Institute for Educational and Health‐Care Research in the Health SectorHochschule Bielefeld—University of Applied Sciences and ArtsBielefeldGermany
| | - Eva Schildmann
- Department of Palliative MedicineMedical Faculty, University of AugsburgAugsburgGermany
- Department of Palliative MedicineLMU University Hospital, LMU MunichMunichGermany
| | - Elena S. Gaßmann
- Institute for History and Ethics of Medicine, Interdisciplinary Center for Health SciencesMartin Luther University Halle‐WittenbergHalleGermany
| | - Jan Schildmann
- Institute for History and Ethics of Medicine, Interdisciplinary Center for Health SciencesMartin Luther University Halle‐WittenbergHalleGermany
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13
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Wickersham KE, Morrill KE, Lopez-Pentecost M, Heiney SP, King JJ, Madhivanan P, Hirschey R. Losing a part of life: experiences of cancer survivors accessing treatment and sheltering in place during the COVID-19 pandemic. Cancer Causes Control 2023; 34:149-157. [PMID: 37378866 DOI: 10.1007/s10552-023-01742-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 06/21/2023] [Indexed: 06/29/2023]
Abstract
PURPOSE To explore experiences of sheltering in place and accessing treatment during the initial stages of the COVID-19 pandemic among survivors with cancer receiving tyrosine kinase inhibitor (TKI) therapy. METHODS Participants from two pilot studies evaluating TKI therapy use in the Southeastern United States during the start of the COVID-19 pandemic (March 2020) were interviewed. Identical interview guides were used across both studies to assess participants' experiences accessing cancer treatment, sheltering in place, and coping during the COVID-19 pandemic. Digitally recorded sessions were transcribed professionally and checked for accuracy. Descriptive statistics were used to summarize participant sociodemographics, and a six-step thematic approach was used to analyze interview data and identify salient themes. Dedoose qualitative research software was used to manage and organize qualitative codes, themes, and memos. RESULTS Participants (n = 15) ranged from 43 to 84 years of age, and were mostly female (53.3%), married (60%), and survivors with hematologic malignancies (86.7%). The research team identified five salient themes: Participants followed pandemic guidelines, Variable impact on well-being, Common feelings of fear, anxiety and anger, No barriers to accessing therapy and medical care, and Faith and God as powerful forces for coping. CONCLUSIONS The conclusions of the study provide several implications for survivorship programs or clinics for supporting survivors who are taking chronic TKI therapy during COVID-19, including enhancement of current psychosocial support efforts for cancer survivors or development of new programs tailored to the unique needs of a survivor during a pandemic, such as focused coping strategies, modified physical activity programs, family/professional role changes, and access to safe public spaces.
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Affiliation(s)
- K E Wickersham
- College of Nursing, University of South Carolina, Columbia, SC, USA.
| | - K E Morrill
- Community & System Health Sciences Division, College of Nursing, University of Arizona, Tucson, AZ, USA
| | - M Lopez-Pentecost
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - S P Heiney
- College of Nursing, University of South Carolina, Columbia, SC, USA
| | - J J King
- University of Arizona Cancer Center, University of Arizona, Tucson, AZ, USA
| | - P Madhivanan
- Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - R Hirschey
- School of Nursing, UNC Chapel Hill, and Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
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14
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Alolayan WR, Rieger JM, Yoon MN. Head and neck cancer treatment outcome priorities: A multi-perspective concept mapping study. PLoS One 2023; 18:e0294712. [PMID: 38033014 PMCID: PMC10688684 DOI: 10.1371/journal.pone.0294712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 11/08/2023] [Indexed: 12/02/2023] Open
Abstract
With the increasing focus on patient-centred care, this study sought to understand priorities considered by patients and healthcare providers from their experience with head and neck cancer treatment, and to compare how patients' priorities compare to healthcare providers' priorities. Group concept mapping was used to actively identify priorities from participants (patients and healthcare providers) in two phases. In phase one, participants brainstormed statements reflecting considerations related to their experience with head and neck cancer treatment. In phase two, statements were sorted based on their similarity in theme and rated in terms of their priority. Multidimensional scaling and cluster analysis were performed to produce multidimensional maps to visualize the findings. Two-hundred fifty statements were generated by participants in the brainstorming phase, finalized to 94 statements that were included in phase two. From the sorting activity, a two-dimensional map with stress value of 0.2213 was generated, and eight clusters were created to encompass all statements. Timely care, education, and person-centred care were the highest rated priorities for patients and healthcare providers. Overall, there was a strong correlation between patient and healthcare providers' ratings (r = 0.80). Our findings support the complexity of the treatment planning process in head and neck cancer, evident by the complex maps and highly interconnected statements related to the experience of treatment. Implications for improving the quality of care delivered and care experience of head and cancer are discussed.
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Affiliation(s)
- Waad R. Alolayan
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Jana M. Rieger
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
- Institute for Reconstructive Sciences in Medicine (iRSM), Misericordia Community Hospital, Edmonton, Alberta, Canada
| | - Minn N. Yoon
- Faculty of Medicine and Dentistry, School of Dentistry, University of Alberta, Edmonton, Alberta, Canada
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15
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Navntoft S, Andreasen J, Petersen KS, Rossau HK, Jørgensen L. Barriers and facilitators to cancer rehabilitation for patients with head and neck or lung cancer-a scoping review mapping structural and healthcare professionals' perspectives. Disabil Rehabil 2023:1-13. [PMID: 37961874 DOI: 10.1080/09638288.2023.2280073] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 11/01/2023] [Indexed: 11/15/2023]
Abstract
PURPOSE Rehabilitation can positively affect quality of life, functional status, and physiological status for patients with head and neck or lung cancer. However, barriers and facilitators regarding access, referral, and participation in rehabilitation have not been outlined in the literature either from a healthcare professional or from a structural perspective. Therefore, the objective of this paper was to identify and map barriers and facilitators from structural and healthcare professionals' perspectives in relation to access, referral, and participation in rehabilitation for patients with head and neck or lung cancer. MATERIALS AND METHODS Two systematic searches were conducted in five databases mapping peer-reviewed research literature. RESULTS In total, 17 studies of 3918 potential sources were included. Seven themes were identified. Four themes concerned access: Understanding Patients' Resources; Collaboration Determining Access; Education, Knowledge, and Evidence Impact Access to Rehabilitation; and Resources Affecting Availability to Rehabilitation Services. Two themes concerned referral: Referral Criteria; and Elements Affecting Referral Pathway. One theme concerned participation: Factors Influencing Participation. CONCLUSION From structural and healthcare professionals' perspectives, barriers and facilitators impact access, referral and participation in rehabilitation. However, the findings on facilitators were limited; only one theme addressed participation and two findings concerned patients with low socioeconomic status.IMPLICATIONS FOR REHABILITATIONHealthcare professionals should be mindful that a diverse array of barriers and facilitators may impact the rehabilitation pathway for patients with head, neck, and lung cancer.Engagement by healthcare professionals and structural initiatives are needed to ensure comprehensive access to information concerning rehabilitation options.Local guidelines should be developed to prescribe methods for informing and guiding patients towards suitable rehabilitation options.It is important that healthcare professionals take the individual patient's resources into account when navigating aspects of access, referral, and participation in rehabilitation.
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Affiliation(s)
- Sophie Navntoft
- Public Health and Epidemiology Group, Department of Health Science and Technology, The Faculty of Medicine, Aalborg University, Gistrup, Denmark
| | - Jane Andreasen
- Public Health and Epidemiology Group, Department of Health Science and Technology, The Faculty of Medicine, Aalborg University, Gistrup, Denmark
- Aalborg Centre of Health and Rehabilitation, Aalborg Municipality, Aalborg, Denmark
| | - Kirsten Schultz Petersen
- Public Health and Epidemiology Group, Department of Health Science and Technology, The Faculty of Medicine, Aalborg University, Gistrup, Denmark
| | - Henriette Knold Rossau
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Nyborg, Denmark
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Lone Jørgensen
- Clinic for Surgery and Cancer Treatment & Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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16
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Edward H, Smith-Turchyn J. Clinician's Commentary on Nicoll et al. 1. Physiother Can 2023; 75:348-349. [PMID: 38037574 PMCID: PMC10686308 DOI: 10.3138/ptc-2021-0084-cc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Affiliation(s)
- Holly Edward
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada;
| | - Jenna Smith-Turchyn
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada;
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17
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de Vries-Ten Have J, Winkels RM, Kampman E, Winkens LHH. Behaviour change techniques used in lifestyle interventions that aim to reduce cancer-related fatigue in cancer survivors: a systematic review. Int J Behav Nutr Phys Act 2023; 20:126. [PMID: 37833784 PMCID: PMC10576285 DOI: 10.1186/s12966-023-01524-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 09/29/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Lifestyle interventions that target dietary and/or physical activity behaviours may impact cancer-related fatigue in cancer survivors. Changing lifestyle may be especially difficult for cancer survivors suffering from cancer-related fatigue. To increase effectiveness of lifestyle interventions, behaviour change techniques (BCTs) can be applied. The aim of this review is to systematically describe which BCTs are applied in lifestyle interventions targeting cancer-related fatigue among cancer survivors who finished primary treatment. METHODS PubMed, Scopus, PsycINFO, Cochrane Library and Web of Science were searched to identify randomised controlled trials (RCTs) of dietary and/or physical activity interventions targeting cancer-related fatigue in cancer survivors. The BCT taxonomy was used to code the BCTs that were applied in those interventions. BCTs that were reported in at least 25% of effective interventions were indicated as 'promising BCT', but only retained this classification when these BCTs were present in less than 25% of ineffective interventions. RESULTS Twenty-nine RCTs were identified, of which 17 were effective in reducing cancer-related fatigue. The most frequently applied BCTs were Goal setting (behaviour), Instruction on how to perform the behaviour, Demonstration of the behaviour, Behavioural practice/rehearsal, and Credible Source. The BCT 'Generalisation of the target behaviour' was identified as promising. These results should be interpreted with caution as only three studies screened their participants on level of cancer-related fatigue and most studies focused only on physical activity. Furthermore, many studies did not include a measure for actual behaviour change and had no follow-up period after the intervention ended. CONCLUSIONS There is a need for studies that screen their participants on level of cancer-related fatigue and a need for studies that focus more on dietary behaviours as a possible intervention to reduce fatigue. Also, studies should include follow-up timepoints after the interventions ends to examine long-term behaviour change. Future lifestyle interventions should describe interventions in detail to allow for easier coding of BCTs, and report on actual behaviour change following the intervention. Interventions may apply the BCT 'Generalisation of the target behaviour' to incorporate lifestyle behaviours in daily life. This may increase the chance that interventions will effectively reduce cancer-related fatigue.
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Affiliation(s)
- Judith de Vries-Ten Have
- Division of Human Nutrition and Health, Nutrition and Disease Chair Group, Wageningen University and Research, Stippeneng 4, 6708 WE, Wageningen, The Netherlands.
- Consumption and Healthy Lifestyles Chair Group, Wageningen University and Research, Hollandseweg 1, 6706 KN, Wageningen, The Netherlands.
| | - Renate M Winkels
- Division of Human Nutrition and Health, Nutrition and Disease Chair Group, Wageningen University and Research, Stippeneng 4, 6708 WE, Wageningen, The Netherlands
| | - Ellen Kampman
- Division of Human Nutrition and Health, Nutrition and Disease Chair Group, Wageningen University and Research, Stippeneng 4, 6708 WE, Wageningen, The Netherlands
| | - Laura H H Winkens
- Consumption and Healthy Lifestyles Chair Group, Wageningen University and Research, Hollandseweg 1, 6706 KN, Wageningen, The Netherlands
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18
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Buntval K, Dobrovolny HM. Modeling of oncolytic viruses in a heterogeneous cell population to predict spread into non-cancerous cells. Comput Biol Med 2023; 165:107362. [PMID: 37633084 DOI: 10.1016/j.compbiomed.2023.107362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 08/06/2023] [Accepted: 08/12/2023] [Indexed: 08/28/2023]
Abstract
New cancer treatment modalities that limit patient discomfort need to be developed. One possible new therapy is the use of oncolytic (cancer-killing) viruses. It is only recently that our ability to manipulate viral genomes has allowed us to consider deliberately infecting cancer patients with viruses. One key consideration is to ensure that the virus exclusively targets cancer cells and does not harm nearby non-cancerous cells. Here, we use a mathematical model of viral infection to determine the characteristics a virus would need to have in order to eradicate a tumor, but leave non-cancerous cells untouched. We conclude that the virus must differ in its ability to infect the two different cell types, with the infection rate of non-cancerous cells needing to be less than one hundredth of the infection rate of cancer cells. Differences in viral production rate or infectious cell death rate alone are not sufficient to protect non-cancerous cells.
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Affiliation(s)
- Karan Buntval
- SUNY Upstate Medical University, Syracuse, NY, United States of America; Department of Physics and Astronomy, Texas Christian University, Fort Worth, TX, United States of America
| | - Hana M Dobrovolny
- Department of Physics and Astronomy, Texas Christian University, Fort Worth, TX, United States of America.
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19
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Bernardo BM, Pennell ML, Naughton MJ, Brodin NP, Neuhouser ML, Chlebowski RT, Paskett ED. Self-reported symptoms among cancer survivors in the Women's Health Initiative (WHI) Life and Longevity after Cancer (LILAC) cohort. J Cancer Surviv 2023; 17:1427-1434. [PMID: 35314957 PMCID: PMC10725662 DOI: 10.1007/s11764-022-01200-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 03/10/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE Due to cancer survivors living longer and morbidity associated with cancer treatments, it is necessary to understand symptoms experienced by cancer survivors. This study will analyze the symptom burden among a large cohort of survivors across multiple cancer sites. METHODS Data from the Women's Health Initiative (WHI) Life and Longevity After Cancer (LILAC) study were used to examine the symptom burden of older cancer survivors. Poisson regression with robust standard errors was utilized to determine differences in symptoms by cancer site, treatment, and other covariates. RESULTS The most frequently reported symptoms among cancer survivors were fatigue (15.8%) and feeling sad or depressed (14.1%). Multivariable analyses indicated that more symptoms were reported among survivors who were younger (p = 0.002), divorced or separated (p = 0.03), and had a combination of public and private insurance (p = 0.01). Survivors who received chemotherapy (p < 0.001), radiation (p = 0.01), or hormone therapy (p = 0.02) reported more symptoms than survivors who did not receive these treatments. Survivors diagnosed with cancer < 5 years ago reported fewer symptoms than longer-term survivors, particularly those diagnosed > 10 years ago (p = 0.02). CONCLUSIONS Results indicate that common physical and psychological symptoms are reported across cancer types. Cancer survivors diagnosed with cancer 10 or more years ago reported more symptoms than those recently diagnosed. This suggests that symptoms may remain a problem for some survivors decades after their diagnosis. IMPLICATIONS FOR CANCER SURVIVORS Future research should focus on implementing active surveillance of cancer survivors. Healthcare providers and those who care for cancer survivors should understand that the symptom burden associated with cancer may persist even decades following diagnosis.
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Affiliation(s)
- Brittany M Bernardo
- Division of Population Sciences, The Ohio State University James Comprehensive Cancer Center, Columbus, OH, USA.
- Denison University, Department of Global Health, Granville, OH, USA.
| | - Michael L Pennell
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Michelle J Naughton
- Division of Cancer Prevention and Control, The Ohio State University, Columbus, OH, USA
| | - Nils Patrik Brodin
- Department of Radiation Oncology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Marian L Neuhouser
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | | | - Electra D Paskett
- Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
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20
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Silva CR, Pereira ST, Silva DFT, De Pretto LR, Freitas AZ, Zeituni CA, Rostelato MECM, Ribeiro MS. Noninvasive Red Laser Intervention before Radiotherapy of Triple-negative Breast Cancer in a Murine Model. Radiat Res 2023; 200:366-373. [PMID: 37772737 DOI: 10.1667/rade-23-00050.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 07/31/2023] [Indexed: 09/30/2023]
Abstract
Radiotherapy is a well-established cancer treatment; it is estimated that approximately 52% of oncology patients will require this treatment modality at least once. However, some tumors, such as triple-negative breast cancer (TNBC), may present as radioresistant and thus require high doses of ionizing radiation and a prolonged period of treatment, which may result in more severe side effects. Moreover, such tumors show a high incidence of metastases and decreased survival expectancy of the patient. Thus, new strategies for radiosensitizing TNBC are urgently needed. Red light therapy, photobiomodulation, has been used in clinical practice to mitigate the adverse side effects usually associated with radiotherapy. However, no studies have explored its use as a radiosensitizer of TNBC. Here, we used TNBC-bearing mice as a radioresistant cancer model. Red light treatment was applied in three different protocols before a high dose of radiation (60 Gy split in 4 fractions) was administered. We evaluated tumor growth, mouse clinical signs, total blood cell counts, lung metastasis, survival, and levels of glutathione in the blood. Our data showed that the highest laser dose in combination with radiation arrested tumor progression, likely due to inhibition of GSH synthesis. In addition, red light treatment before each fraction of radiation, regardless of the light dose, improved the health status of the animals, prevented anemia, reduced metastases, and improved survival. Collectively, these results indicate that red light treatment in combination with radiation could prove useful in the treatment of TNBC.
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Affiliation(s)
- Camila R Silva
- Center for Lasers and Applications, São Paulo, SP, Brazil
| | | | | | | | | | - Carlos A Zeituni
- Radiation Technology Center, Nuclear and Energy Research Institute (IPEN-CNEN), São Paulo, SP, Brazil
| | - Maria E C M Rostelato
- Radiation Technology Center, Nuclear and Energy Research Institute (IPEN-CNEN), São Paulo, SP, Brazil
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21
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Jain A, Casanova D, Padilla AV, Paniagua Bojorges A, Kotla S, Ko KA, Samanthapudi VSK, Chau K, Nguyen MTH, Wen J, Hernandez Gonzalez SL, Rodgers SP, Olmsted-Davis EA, Hamilton DJ, Reyes-Gibby C, Yeung SCJ, Cooke JP, Herrmann J, Chini EN, Xu X, Yusuf SW, Yoshimoto M, Lorenzi PL, Hobbs B, Krishnan S, Koutroumpakis E, Palaskas NL, Wang G, Deswal A, Lin SH, Abe JI, Le NT. Premature senescence and cardiovascular disease following cancer treatments: mechanistic insights. Front Cardiovasc Med 2023; 10:1212174. [PMID: 37781317 PMCID: PMC10540075 DOI: 10.3389/fcvm.2023.1212174] [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: 04/25/2023] [Accepted: 08/03/2023] [Indexed: 10/03/2023] Open
Abstract
Cardiovascular disease (CVD) is a leading cause of morbidity and mortality, especially among the aging population. The "response-to-injury" model proposed by Dr. Russell Ross in 1999 emphasizes inflammation as a critical factor in atherosclerosis development, with atherosclerotic plaques forming due to endothelial cell (EC) injury, followed by myeloid cell adhesion and invasion into the blood vessel walls. Recent evidence indicates that cancer and its treatments can lead to long-term complications, including CVD. Cellular senescence, a hallmark of aging, is implicated in CVD pathogenesis, particularly in cancer survivors. However, the precise mechanisms linking premature senescence to CVD in cancer survivors remain poorly understood. This article aims to provide mechanistic insights into this association and propose future directions to better comprehend this complex interplay.
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Affiliation(s)
- Ashita Jain
- Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Diego Casanova
- Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | | | | | - Sivareddy Kotla
- Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Kyung Ae Ko
- Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | | | - Khanh Chau
- Department of Cardiovascular Sciences, Houston Methodist Research Institute, Houston, TX, United States
| | - Minh T. H. Nguyen
- Department of Cardiovascular Sciences, Houston Methodist Research Institute, Houston, TX, United States
| | - Jake Wen
- Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | | | - Shaefali P. Rodgers
- Department of Cardiovascular Sciences, Houston Methodist Research Institute, Houston, TX, United States
| | | | - Dale J. Hamilton
- Department of Medicine, Center for Bioenergetics, Houston Methodist Research Institute, Houston, TX, United States
| | - Cielito Reyes-Gibby
- Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Sai-Ching J. Yeung
- Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - John P. Cooke
- Department of Cardiovascular Sciences, Houston Methodist Research Institute, Houston, TX, United States
| | - Joerg Herrmann
- Cardio Oncology Clinic, Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States
| | - Eduardo N. Chini
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, FL, United States
| | - Xiaolei Xu
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States
| | - Syed Wamique Yusuf
- Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Momoko Yoshimoto
- Center for Stem Cell & Regenerative Medicine, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Philip L. Lorenzi
- Department of Bioinformatics and Computational Biology, Division of VP Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Brain Hobbs
- Department of Population Health, The University of Texas at Austin, Austin, TX, United States
| | - Sunil Krishnan
- Department of Neurosurgery, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Efstratios Koutroumpakis
- Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Nicolas L. Palaskas
- Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Guangyu Wang
- Department of Cardiovascular Sciences, Houston Methodist Research Institute, Houston, TX, United States
| | - Anita Deswal
- Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Steven H. Lin
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Jun-ichi Abe
- Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Nhat-Tu Le
- Department of Cardiovascular Sciences, Houston Methodist Research Institute, Houston, TX, United States
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22
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Guo E, Dobrovolny HM. Mathematical Modeling of Oncolytic Virus Therapy Reveals Role of the Immune Response. Viruses 2023; 15:1812. [PMID: 37766219 PMCID: PMC10536413 DOI: 10.3390/v15091812] [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: 07/10/2023] [Revised: 08/23/2023] [Accepted: 08/24/2023] [Indexed: 09/29/2023] Open
Abstract
Oncolytic adenoviruses (OAds) present a promising path for cancer treatment due to their selectivity in infecting and lysing tumor cells and their ability to stimulate the immune response. In this study, we use an ordinary differential equation (ODE) model of tumor growth inhibited by oncolytic virus activity to parameterize previous research on the effect of genetically re-engineered OAds in A549 lung cancer tumors in murine models. We find that the data are best fit by a model that accounts for an immune response, and that the immune response provides a mechanism for elimination of the tumor. We also find that parameter estimates for the most effective OAds share characteristics, most notably a high infection rate and low viral clearance rate, that might be potential reasons for these viruses' efficacy in delaying tumor growth. Further studies observing E1A and P19 recombined viruses in different tumor environments may further illuminate the extent of the effects of these genetic modifications.
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Affiliation(s)
| | - Hana M. Dobrovolny
- Department of Physics & Astronomy, Texas Christian University, Fort Worth, TX 76109, USA
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23
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Pimentel-Parra GA, Soto-Ruiz MN, San Martín-Rodríguez L, Escalada-Hernández P, García-Vivar C. Effectiveness of Digital Health on the Quality of Life of Long-Term Breast Cancer Survivors: A Systematic Review. Semin Oncol Nurs 2023; 39:151418. [PMID: 37045645 DOI: 10.1016/j.soncn.2023.151418] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 03/02/2023] [Accepted: 03/08/2023] [Indexed: 04/14/2023]
Abstract
OBJECTIVES To identify, critically appraise, and synthesize the available evidence on the effectiveness of digital health interventions to improve the quality of life or any of its four dimensions (physical, psychological, social, and spiritual) in women survivors of breast cancer who are in the extended or permanent survival stage. DATA SOURCES Systematic review-Four databases were searched: PubMed, CINAHL, PsycINFO, and Web of Science. CONCLUSION The clinical evidence shows a positive relationship or association between eHealth use and improved quality of life in breast cancer survivors at extended or permanent survival stage. However, the findings point to a deficit in the assessment of the social and spiritual domains that play a fundamental role in the quality of life of survivors. IMPLICATION FOR NURSING PRACTICE The findings found reflect implications of great value for nursing practice because these professionals are the main users of digital health tools to provide them to patients. Using these digital tools contributes to improving evidence-based practice and providing greater efficiency and effectiveness in the care of long-term cancer survivors.
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Affiliation(s)
| | - M Nelia Soto-Ruiz
- Department of Health Sciences, Public University of Navarre, and IdiSNA, Navarra Institute for Health Research, Irunlarrea, Pamplona, Navarra, Spain.
| | - Leticia San Martín-Rodríguez
- Department of Health Sciences, Public University of Navarre, and IdiSNA, Navarra Institute for Health Research, Irunlarrea, Pamplona, Navarra, Spain
| | - Paula Escalada-Hernández
- Department of Health Sciences, Public University of Navarre, and IdiSNA, Navarra Institute for Health Research, Irunlarrea, Pamplona, Navarra, Spain
| | - Cristina García-Vivar
- Department of Health Sciences, Public University of Navarre, and IdiSNA, Navarra Institute for Health Research, Irunlarrea, Pamplona, Navarra, Spain
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24
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Wiwaranukool P, Chan RJ, Yates P. The Effects of an Educational Intervention on Exercise Advice Behaviors of Thai Oncology Nurses. Semin Oncol Nurs 2023; 39:151453. [PMID: 37336680 DOI: 10.1016/j.soncn.2023.151453] [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: 02/18/2023] [Revised: 05/01/2023] [Accepted: 05/17/2023] [Indexed: 06/21/2023]
Abstract
OBJECTIVE To evaluate an educational intervention based on the Theory of Planned Behavior to increase oncology nurses' exercise advice behaviors. METHODS A single-group, quasi-experimental repeated measures design study was used with 124 oncology nurses in a Thai cancer institute. The educational intervention included preeducation self-directed activities for 1 hour, a 2-hour group education session, and posteducation outreach contact 1 week later. The outcome measures, including the Theory of Planned Behavior constructs, exercise knowledge, and self-reported exercise prescription behaviors, were collected at three time points: Time 1 (2 weeks preintervention), Time 2 (immediately preintervention), and Time 3 (2 weeks after the intervention). CONCLUSION Results indicated a statistically significant increase in scores after the intervention for all outcomes, including the Theory of Planned Behavior constructs (overall P value <.001), exercise knowledge (β = 2.99, P < .001), and exercise prescription behaviors: asking (odds ratio [OR] = 12.98, P < .001), assessing (OR = 6.20, P < .001), referring (OR = 4.10, P < .001), and writing exercise advice (OR = 11.52, P < .001). Additionally, verbal counseling behavior was performed by all participants, and therefore, the odds for verbal counseling were not reported. Structural equation modeling analysis demonstrated that attitudes and perceived behavioral control explained 41% of the variance in exercise advice intention. Perceived behavioral control and intention also explained 20% of the variance in self-reported exercise advice behaviors. IMPLICATIONS FOR NURSING PRACTICE Attitudinal and perceived behavioral control constructs should be a focus of attention to improve health care professionals' exercise advice behaviors. More focused research is required to examine whether patients engage in and follow the exercise advice provided by oncology nurses.
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Affiliation(s)
- Porawan Wiwaranukool
- Ramathibodi School of Nursing, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
| | - Raymond J Chan
- Caring Futures Institute, Flinders University, Bedford Park, South Australia, Australia;; Cancer and Palliative Care Outcomes Centre, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Patsy Yates
- Cancer and Palliative Care Outcomes Centre, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
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25
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Huq MR, He X, Woodard N, Chen C, Knott CL. The role of community health advisors' cancer history in implementation and efficacy of a cancer control intervention. HEALTH EDUCATION RESEARCH 2023; 38:350-361. [PMID: 36892605 PMCID: PMC10558036 DOI: 10.1093/her/cyad011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 01/24/2023] [Accepted: 02/13/2023] [Indexed: 06/18/2023]
Abstract
Community health advisors (CHAs) play a key role in promoting health in medically underserved communities, including in addressing cancer disparities. There is a need to expand the research on what characteristics make for an effective CHA. We examined the relationship between CHA personal and family history of cancer, and implementation and efficacy outcomes in a cancer control intervention trial. Twenty-eight trained CHAs implemented a series of three cancer educational group workshops for N = 375 workshop participants across 14 churches. Implementation was operationalized as participant attendance at the educational workshops, and efficacy as workshop participants' cancer knowledge scores at the 12-month follow-up, controlling for baseline scores. CHA personal history of cancer was not significantly associated with implementation, nor knowledge outcomes. However, CHAs with family history of cancer had significantly greater participant attendance at the workshops than CHAs without family history of cancer (P = 0.03) and a significant, positive association with male workshop participants' prostate cancer knowledge scores at 12 months (estimated beta coefficient = 0.49, P < 0.01) after adjusting for confounders. Findings suggest that CHAs with family history of cancer may be particularly suitable for cancer peer education, although further research is needed to confirm this and identify other factors conducive to CHA success.
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Affiliation(s)
- Maisha R Huq
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, 4200 Valley Drive, College Park, MD 20742, USA
| | - Xin He
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, 4200 Valley Drive, College Park, MD 20742, USA
| | - Nathaniel Woodard
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, 4200 Valley Drive, College Park, MD 20742, USA
| | - Chang Chen
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, 4200 Valley Drive, College Park, MD 20742, USA
| | - Cheryl L Knott
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, 4200 Valley Drive, College Park, MD 20742, USA
- Community Outreach and Engagement, University of Maryland Greenebaum Comprehensive Cancer Center, 22 S Greene St, Baltimore, MD 21201, USA
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26
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Gjerset GM, Kiserud CE, Wisløff T, McCarthy JB, Thorsen L. Perceived burden and need for support among caregivers of cancer patients. Acta Oncol 2023; 62:794-802. [PMID: 37540581 DOI: 10.1080/0284186x.2023.2240008] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 07/07/2023] [Indexed: 08/06/2023]
Abstract
BACKGROUND The aims of this study were to examine (1) the perceived burden among caregivers and identify those in risk of high burden and (2) the need for support among caregivers and identify associated factors. MATERIALS AND METHODS Cancer patients who participated in an educational program at the Montebello Center (MBC) in Norway between May 2021 and February 2022 were asked to invite a caregiver to answer a questionnaire. The caregiving burden was assessed with the Caregivers Reaction Assessment (CRA) that consists of 24 questions scored from 1 (strongly disagree) to 5 (strongly agree), covering five domains. A mean sum score was calculated for each domain. Higher subscale scores indicate higher levels of burden, except for caregiver esteem where a high score indicates a low burden. Need for support was assessed with 13 questions. RESULTS Of 464 invitations, 185 caregivers responded (response 40%), median age was 58.0 years and 58% were male. Caregiver burden mean scores were: 2.6 (SD 1.03) for Impact on schedule, 2.1 (SD 0.79) for Lack of family support, 2.1 (SD 0.76) for Impact on health, 2.0 (SD 0.86) for Impact on finances, and 4.2 (SD 0.47) for Caregiver esteem. Female caregivers, younger, higher education, having comorbidities, caring for patients having recurrence of cancer, and shorter time since diagnosis were associated with higher burden measured on individual subscales of the CRA. Most reported needs were information about: cancer, late effects and rehabilitation services and support from peers and professionals to cope with the new situation. Younger, caregiver comorbidity and recurrence of cancer of the patient were associated with more needs. CONCLUSIONS The results indicate that caregivers of cancer patients participating at the MBC report moderate caregiver burden, however, numerous caregivers reported need for support within several areas. Our findings need to be confirmed in a larger unselected group.
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Affiliation(s)
- Gunhild M Gjerset
- Department of Oncology, National Advisory Unit on Late Effects after Cancer Treatment, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
- Montebello Center, The Norwegian Resource Center for Coping with Cancer, Mesnali, Norway
- Department of Clinical Service, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
| | - Cecilie E Kiserud
- Department of Oncology, National Advisory Unit on Late Effects after Cancer Treatment, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
| | - Torbjørn Wisløff
- Health Service Research Unit, Akershus University Hospital, Lørenskog, Norway
| | - Jane B McCarthy
- Montebello Center, The Norwegian Resource Center for Coping with Cancer, Mesnali, Norway
| | - Lene Thorsen
- Department of Oncology, National Advisory Unit on Late Effects after Cancer Treatment, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
- Department of Clinical Service, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
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27
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Parvini S, Majidpoor J, Mortezaee K. The impact of PD-L1 as a biomarker of cancer responses to combo anti-PD-1/CTLA-4. Pathol Res Pract 2023; 247:154583. [PMID: 37267723 DOI: 10.1016/j.prp.2023.154583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 05/28/2023] [Indexed: 06/04/2023]
Abstract
Combination therapy of solid tumors with immune checkpoint inhibitors (ICIs) is a promising and rapidly evolving area of clinical research. Combo nivolumab-ipilimumab therapy has demonstrated potent efficacy in recent years, and PD-L1 expression profile has shown to play a key role in determining the most optimal immunotherapeutic regimen in advanced cancer patients. Here, the focus is over the impact of PD-L1 on combo nivolumab-ipilimumab in advanced solid cancer patients. Interpretations of this review indicate that patient responses to combo nivolumab-ipilimumab can be affected from different levels of PD-L1 expression states. A point required attention is the variations in responses among diverse cancer types or between different doses of the immunotherapy drugs. In general, higher rates of responses are seen with higher PD-L1 expression levels in many cancer types. This, however, is not coincided with survival of patients. Taken all into consideration, it could be asserted that considering PD-L1 as a solo biomarker may not be reliable for predicting clinical efficacy of combo nivolumab-ipilimumab. Thus, a search for other biomarkers or combination of PD-L1 with other factors may be considered for predicting patient responses.
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Affiliation(s)
- Sasan Parvini
- Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.
| | - Jamal Majidpoor
- Department of Anatomy, School of Medicine, Infectious Diseases Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Keywan Mortezaee
- Department of Anatomy, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.
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28
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Phothikul J, Seven M. Knowledge, Perception, and Skills, and Practices of Oncology Nurses in Cancer Survivorship Care: a Scoping Review. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2023:10.1007/s13187-023-02311-x. [PMID: 37227591 DOI: 10.1007/s13187-023-02311-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Accepted: 05/12/2023] [Indexed: 05/26/2023]
Abstract
Survivorship care focuses on the well-being and quality of life of people affected by cancer. Oncology nurses play an essential role in survivorship care and must be equipped with the knowledge, skills, and competencies to provide survivorship care. This scoping review explored the existing literature on nurses' knowledge, perception, skills, or practices in delivering cancer survivorship care for adult cancer survivors. A scoping review was conducted through databases including PubMed, CINAHL, Scopus, Web of Science, and PsycInfo in February 2022, following the Joanna Briggs Institute methodology. Fourteen original research studies were included. Most of the studies were conducted in the USA and targeted oncology registered nurses. The studies primarily focused on the knowledge (n = 2, 14.3%), perception of responsibility (n = 8, 57.1%), and practice (n = 9, 64.3%) regarding survivorship care among oncology nurses, reporting widely varied results. Nine studies reported perceived skills, practice, and perceived barriers as the most used outcome measurements, while two assessed nurses' cancer survivorship care knowledge. The main gaps were discrepancies between oncology nurses' perceptions of responsibility and practices in delivering survivorship care. Lack of time, knowledge, and skills were reported as significant factors impeding survivorship care provision among oncology nurses. Limited research shows a gap in integrating knowledge into survivorship care practices among oncology nurses. Further studies are needed to develop educational programs on survivorship care to support the integration of survivorship care into oncology nurses' practice.
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Affiliation(s)
- Jittrarath Phothikul
- Elaine Marieb College of Nursing, University of Massachusetts Amherst, Amherst, USA.
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
| | - Memnun Seven
- Elaine Marieb College of Nursing, University of Massachusetts Amherst, Amherst, USA
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29
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Erickson N, Sullivan ES, Kalliostra M, Laviano A, Wesseling J. Nutrition care is an integral part of patient-centred medical care: a European consensus. Med Oncol 2023; 40:112. [PMID: 36881207 PMCID: PMC9992033 DOI: 10.1007/s12032-023-01955-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 01/18/2023] [Indexed: 03/08/2023]
Abstract
While healthcare is becoming more patient-centred, evidence-based nutrition interventions are still not accessible to all patients with cancer. As nutrition interventions directly improve clinical and socioeconomic outcomes, patient-centred care is not complete without nutrition care. While awareness of the negative impact of malnutrition on clinical outcomes, quality of life, and functional and emotional wellbeing in cancer is growing, there is relatively poor awareness amongst patients, clinicians, policymakers, and payers that nutrition interventions -particularly those begun in the early stages of the disease course- are an effective method for improving such outcomes. The European Beating Cancer Plan recognises the need for a holistic approach to cancer but lacks actionable recommendations to implement integrated nutrition cancer care at member state level. When considering nutrition care as a human right, the impact on quality of life and functional status must be prioritized, as these may be equally as important to patients, especially in advanced cancer where improvements in clinical outcomes such as survival or tumour burden may not be attainable. We formulate actions needed at the regional and the European level to ensure integrated nutrition care for all patients with cancer. The 4 main Take Home Messages are as follows: 1. The goals of Europe's Beating Cancer Plan cannot be achieved without integrating nutrition across the cancer care continuum. 2. Malnutrition negatively impacts clinical outcomes and has socioeconomic consequences for patients and healthcare systems. 3. Championing integrating nutrition care into cancer care is therefore the duty and ethical responsibility of clinicians (Hippocratic Oath-primum non nocere) and 4. Nutrition care is a cost effective, evidence-based therapy.
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Affiliation(s)
- Nicole Erickson
- Comprehensive Cancer Center Munich, Ludwig Maximilian University of Munich Hospital, Munich, Germany.
- Writing Group, The European Union Thematic Network on Integrated Nutrition in Cancer Care (INC2), Croydon, UK.
- European Federation of the Associations of Dietitians (EFAD), Naarden, The Netherlands.
| | - Erin Stella Sullivan
- Writing Group, The European Union Thematic Network on Integrated Nutrition in Cancer Care (INC2), Croydon, UK
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Marianna Kalliostra
- Writing Group, The European Union Thematic Network on Integrated Nutrition in Cancer Care (INC2), Croydon, UK
- European Federation of the Associations of Dietitians (EFAD), Naarden, The Netherlands
- The European Nutrition for Health Alliance, London, UK
| | - Alessandro Laviano
- Writing Group, The European Union Thematic Network on Integrated Nutrition in Cancer Care (INC2), Croydon, UK
- The European Nutrition for Health Alliance, London, UK
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Joost Wesseling
- Writing Group, The European Union Thematic Network on Integrated Nutrition in Cancer Care (INC2), Croydon, UK
- The European Nutrition for Health Alliance, London, UK
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30
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Natalucci V, Ferri Marini C, De Santi M, Annibalini G, Lucertini F, Vallorani L, Panico AR, Sisti D, Saltarelli R, Donati Zeppa S, Agostini D, Gervasi M, Baldelli G, Grassi E, Nart A, Rossato M, Biancalana V, Piccoli G, Benelli P, Villarini A, Somaini M, Catalano V, Guarino S, Pietrelli A, Monaldi S, Sarti D, Barocci S, Flori M, Rocchi MBL, Brandi G, Stocchi V, Emili R, Barbieri E. Movement and health beyond care, MoviS: study protocol for a randomized clinical trial on nutrition and exercise educational programs for breast cancer survivors. Trials 2023; 24:134. [PMID: 36814313 PMCID: PMC9946288 DOI: 10.1186/s13063-023-07153-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 02/08/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Breast cancer (BC) is the most common invasive cancer in women, and exercise can significantly improve the outcomes of BC survivors. MoviS (Movement and Health Beyond Care) is a randomized controlled trial aimed to evaluate the potential health benefits of exercise and proper nutritional habits. This study aims to assess the efficacy of aerobic exercise training in improving quality of life (QoL) and health-related factors in high-risk BC. METHODS One hundred seventy-two BC survivor women, aged 30-70 years, non-metastatic, stage 0-III, non-physically active, 6-12 months post-surgery, and post chemo- or radiotherapy, will be recruited in this study. Women will be randomly allocated to the intervention arm (lifestyle recommendations and MoviS Training) or control arm (lifestyle recommendations). The MoviS training consists of 12 weeks of aerobic exercise training (2 days/week of supervised and 1 day/week of unsupervised exercise) with a progressive increase in exercise intensity (40-70% of heart rate reserve) and duration (20-60 min). Both arms will receive counseling on healthy lifestyle habits (nutrition and exercise) based on the World Cancer Research Fund International (WCRF) 2018 guidelines. The primary outcome is the improvement of the QoL. The secondary outcomes are improvement of health-related parameters such as Mediterranean diet adherence, physical activity level, flexibility, muscular fitness, fatigue, cardiorespiratory fitness (estimated maximal oxygen uptake), echocardiographic parameters, heart rate variability (average of the standard deviations of all 5 min normal to normal intervals (ASDNN/5 min) and 24 h very low and low frequency), and metabolic, endocrine, and inflammatory serum biomarkers (glycemia, insulin resistance, progesterone, testosterone, and high-sensitivity C-reactive protein). DISCUSSION This trial aims to evaluate if supervised exercise may improve QoL and health-related factors of BC survivors with a high risk of recurrence. Findings from this project could provide knowledge improvement in the field of exercise oncology through the participation of a multidisciplinary team that will provide a coordinated program of cancer care to improve healthcare quality, improve prognosis, increase survival times and QoL, and reduce the risk of BC recurrence. TRIAL REGISTRATION ClinicalTrials.gov NCT04818359 . Retrospectively registered on March 26, 2021.
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Affiliation(s)
- Valentina Natalucci
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Carlo Ferri Marini
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Mauro De Santi
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029, Urbino, Italy.
| | - Giosuè Annibalini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029, Urbino, Italy.
| | - Francesco Lucertini
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Luciana Vallorani
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Andrea Rocco Panico
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Davide Sisti
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Roberta Saltarelli
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Sabrina Donati Zeppa
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Deborah Agostini
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Marco Gervasi
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Giulia Baldelli
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Eugenio Grassi
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Alessandra Nart
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Massimo Rossato
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Vincenzo Biancalana
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Giovanni Piccoli
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Piero Benelli
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Anna Villarini
- grid.9027.c0000 0004 1757 3630Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy
| | - Matteo Somaini
- grid.4708.b0000 0004 1757 2822School of Specialization in Nutrition Science, University of Milano, Milan, Italy
| | - Vincenzo Catalano
- Medical Oncology, Hospital Santa Maria della Misericordia di Urbino, 61029 Urbino, Italy
| | - Stefania Guarino
- Medical Oncology, Hospital Santa Maria della Misericordia di Urbino, 61029 Urbino, Italy
| | - Alice Pietrelli
- Medical Oncology, Hospital Santa Maria della Misericordia di Urbino, 61029 Urbino, Italy
| | - Silvia Monaldi
- Medical Oncology, Hospital Santa Maria della Misericordia di Urbino, 61029 Urbino, Italy
| | - Donatella Sarti
- Medical Oncology, Hospital Santa Maria della Misericordia di Urbino, 61029 Urbino, Italy
| | - Simone Barocci
- Clinical Pathology, Hospital Santa Maria della Misericordia di Urbino, 61029 Urbino, Italy
| | - Marco Flori
- Cardiology, Hospital Santa Maria della Misericordia di Urbino, 61029 Urbino, Italy
| | - Marco Bruno Luigi Rocchi
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Giorgio Brandi
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Vilberto Stocchi
- Department of Human Sciences for the Promotion of Quality of Life, University San Raffaele, 20132 Rome, Italy
| | - Rita Emili
- Medical Oncology, Hospital Santa Maria della Misericordia di Urbino, 61029 Urbino, Italy
| | - Elena Barbieri
- grid.12711.340000 0001 2369 7670Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
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Breast Cancer: How Hippotherapy Bridges the Gap between Healing and Recovery-A Randomized Controlled Clinical Trial. Cancers (Basel) 2023; 15:cancers15041317. [PMID: 36831658 PMCID: PMC9953804 DOI: 10.3390/cancers15041317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/16/2023] [Accepted: 02/17/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND Breast cancer is the most diagnosed women's cancer, and has a high survival rate. Despite great progress in detection and treatment, life reconstruction requires comprehensive cross-sectoral approaches between different disciplines and deeper consideration of the patient's challenges. Hippotherapy is an emerging specialized rehabilitation approach, performed by accredited health professionals and equine specialists, on specially trained horses via their movement, activating major paths for physical, mental, psychic and social reinforcement, and is synergistic to rehabilitative and supportive care. METHODS We conducted a randomized open, prospective, two-armed, controlled trial on the effectiveness of hippotherapy versus conventional supportive care on adult women with a diagnosis of breast cancer, after the period of primary treatment (surgery, chemotherapy, radiotherapy). The 6-month program included, in the treated group, an initial 1-week daily hippotherapy session, followed by three short 2-day sessions with an interval of 2 months between each, where the patients received conventional supportive care. The control group received 6 months of conventional supportive care. The primary end point was quality of life. Cognitive performances, fatigue, anxiety, depression, and body image were the secondary end points. Measurements were done through self-reported questionnaires. RESULTS We observed statistical differences in the evolution of the measured parameters over time between the two groups. The hippotherapy group showed a much faster, favorable and continuous improvement until the end of the program for each function assessed. The most striking improvements were observed in global quality of life, and fatigue, while breast cancer-specific quality of life, cognitive performance, anxiety and depression and body image showed a less marked but still statistically significant difference at the final post-treatment evaluation. CONCLUSIONS We demonstrate the therapeutic relevance of hippotherapy, a one-health approach, as a key initial stage after cancer diagnosis and treatment to foster recovery. Furthermore, hippotherapy has a strong impact on cancer treatments' efficiency and reconstruction of patient's life and ecosystem. This work reveals a layer of complexity that needs to be broadly considered. TRIAL REGISTRATION ClincalTrials.gov NCT04350398 accessed on 1 January 2022. Registered 17 April 2020, retrospectively registered; French Clinical Trials in Cancer Register RECF3818. Registered 18 March 2019, retrospectively registered.
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Ulrich GR, Callan S, Ranby KW. Beliefs and interests in physical activity programs of cancer survivors and their romantic partners. J Cancer Surviv 2023; 17:160-173. [PMID: 33595753 PMCID: PMC7886842 DOI: 10.1007/s11764-021-00996-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 01/18/2021] [Indexed: 12/14/2022]
Abstract
PURPOSE Physical activity is associated with improved health outcomes for cancer survivors and their romantic partners, yet it is unclear if joint exercise programs for survivor-partner dyads are acceptable. This study examined demographic, relationship, exercise, and cancer history correlates of survivors' and their romantic partners' couples-based exercise beliefs and their preferences for program designs. METHODS All participants (survivors n=209, partners n=155, couples n=143) completed an online survey. Correlations and linear regression analyses were used to examine correlates of participants' importance of and interest in couples-based exercise and their likelihood of joining a couples-based exercise program. Intraclass correlations estimated shared variance at the couple level. RESULTS Most participants believed that couples-based exercise was highly important (51.8%) and were interested in a couples-based exercise program (61.5%), but fewer survivors believed their partner would be interested or would likely join a couples-based program. Across all outcomes, partner support for exercise was most strongly associated with participants' couples-based exercise beliefs (r = 0.19-0.54, p<.05), and couples were significantly aligned in their beliefs (ρ=0.20-0.31, p<.01). Participants were interested in exercise programs involving exercising together (67.3%) as well as exercising separately while sharing activity data on an app or website (48.0%). CONCLUSIONS This novel understanding of couples-based exercise beliefs provides a strong foundation upon which future exercise programs may be designed for survivors and their romantic partners. IMPACT FOR CANCER SURVIVORS Survivors' adoption and maintenance of exercise may be enhanced by the inclusion of romantic partners in exercise programs, and partners' inclusion is appealing to couples.
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Affiliation(s)
- G R Ulrich
- Department of Psychology, University of Colorado Denver, Denver, CO, USA.
| | - S Callan
- Department of Psychology, University of Colorado Denver, Denver, CO, USA
| | - K W Ranby
- Department of Psychology, University of Colorado Denver, Denver, CO, USA
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Oldacres L, Hegarty J, O'Regan P, Murphy-Coakley NM, Saab MM. Interventions promoting cognitive function in patients experiencing cancer related cognitive impairment: A systematic review. Psychooncology 2023; 32:214-228. [PMID: 36443527 PMCID: PMC10107470 DOI: 10.1002/pon.6073] [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: 04/21/2022] [Revised: 11/17/2022] [Accepted: 11/22/2022] [Indexed: 12/03/2022]
Abstract
OBJECTIVE To examine the effect of interventions used to enhance cognitive function in patients experiencing cancer-related cognitive impairment. METHODS Studies including adults with a non-metastatic cancer who have received chemotherapy as part of their treatment and who have undergone interventions targeting cancer-related cognitive impairment were included. Studies involving patients with metastatic cancer and pre-existing cognitive deficits were excluded. Academic Search Complete, CINAHL Plus with full text, MEDLINE, Education Full Text, PsycARTICLES, PsycINFO, and ERIC were searched for studies published between January 2011 and September 2022. Data extraction and quality appraisal were conducted by two authors and cross-checked by the review team. Quality appraisal was conducted using 12 items from the Mixed Methods Appraisal Tool. Findings were presented narratively without meta-analysis. RESULTS Thirty-one studies were included. Interventions were categorised as integrative/complementary, cognitive behavioural therapy and compensatory strategies, exercise, psychoeducational/psychosocial, brain-training, and pharmacological. Over 100 instruments were identified, including the Functional Assessment of Cancer Therapy-Cognitive, Trail Making Tests-A and B, and instruments measuring secondary outcomes, including depression. Instruments often measured attention and concentration, language, memory, executive function, and/or patient-reported outcomes. Improvements were reported, with most studies measuring some or various aspects of cognitive functioning and very few studies measuring all domains of cognitive functioning, making it difficult to draw definitive conclusions about effectiveness. CONCLUSIONS Various interventions are available to treat cancer-related cognitive impairment. Outcome measurement was inconsistent and future research should prioritise using standardised measures. Current evidence, whilst not being definitive, suggests that certain interventions show greater promise than others, including cognitive behavioural therapy and brain training.
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Affiliation(s)
- Laura Oldacres
- School of Nursing & Midwifery, University College Cork, Cork, Ireland.,Bon Secours Hospital, Cork, Ireland
| | - Josephine Hegarty
- School of Nursing & Midwifery, University College Cork, Cork, Ireland
| | - Patricia O'Regan
- School of Nursing & Midwifery, University College Cork, Cork, Ireland
| | | | - Mohamad M Saab
- School of Nursing & Midwifery, University College Cork, Cork, Ireland
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Loibl S, Loirat D, Tolaney SM, Punie K, Oliveira M, Rugo HS, Bardia A, Hurvitz SA, Brufsky AM, Kalinsky K, Cortés J, O'Shaughnessy JA, Dieras V, Carey LA, Gianni L, Gharaibeh M, Preger L, Phan S, Chang L, Shi L, Piccart MJ. Health-related quality of life in the phase III ASCENT trial of sacituzumab govitecan versus standard chemotherapy in metastatic triple-negative breast cancer. Eur J Cancer 2023; 178:23-33. [PMID: 36379186 PMCID: PMC11195534 DOI: 10.1016/j.ejca.2022.10.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 10/10/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND The antibody-drug conjugate sacituzumab govitecan (SG) prolongs progression-free survival and overall survival in patients with refractory/relapsed metastatic triple-negative breast cancer (mTNBC). Here, we investigated its effect on health-related quality of life (HRQoL). METHODS This analysis was based on the open-label phase III ASCENT trial (NCT02574455). Adults with refractory/relapsed mTNBC who had received ≥2 prior systemic therapies (≥1 in the metastatic setting) were randomised 1:1 to SG or treatment of physician's choice (TPC; capecitabine, eribulin, vinorelbine, or gemcitabine). HRQoL was assessed on day 1 of each treatment cycle using the EORTC QLQ-C30. Score changes from baseline were analysed using linear mixed-effect models for repeated measures. Stratified Cox regressions evaluated time to first clinically meaningful change of HRQoL. RESULTS The analysis population comprised 236 patients randomised to SG and 183 to TPC. For global health status (GHS)/QoL, physical functioning, fatigue, and pain, changes from baseline were superior for SG versus TPC. Compared with TPC, SG was inferior regarding changes from baseline for nausea/vomiting and diarrhoea but non-inferior for other QLQ-C30 domains. Median time to first clinically meaningful worsening was longer for SG than for TPC for physical functioning (22.1 versus 12.1 weeks, P < 0.001), role functioning (11.4 versus 7.1 weeks, P < 0.001), fatigue (7.7 versus 6.0 weeks, P < 0.05), and pain (21.6 versus 9.9 weeks, P < 0.001). CONCLUSIONS SG was generally associated with greater improvements and delayed worsening of HRQoL scores compared with TPC. This supports the favourable profile of SG as an mTNBC treatment.
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Affiliation(s)
- Sibylle Loibl
- Hämatologisch-Onkologische Gemeinschaftspraxis Am Bethanien-Krankenhaus, Frankfurt, Germany.
| | - Delphine Loirat
- Medical Oncology Department and D3i, Institut Curie, Paris, France
| | - Sara M Tolaney
- Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Kevin Punie
- Department of General Medical Oncology and Multidisciplinary Breast Centre, Leuven Cancer Institute, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium
| | - Mafalda Oliveira
- Medical Oncology Department and Breast Cancer Group, Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Hope S Rugo
- Department of Medicine, University of California San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
| | - Aditya Bardia
- Department of Hematology and Oncology, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Sara A Hurvitz
- Department of Medicine, Division of Hematology/Medical Oncology, David Geffen School of Medicine, University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Adam M Brufsky
- Division of Hematology/Oncology, Magee-Womens Hospital and the Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Kevin Kalinsky
- Department of Medicine, Columbia University Irving Medical Center, New York, USA; Department of Hematology and Medical Oncology, Winship Cancer Institute at Emory University, Atlanta, GA, USA
| | - Javier Cortés
- Oncology Department, International Breast Cancer Center (BCC), Pangaea Oncology, Quirónsalud, Barcelona, Spain; Department of Medicine, Faculty of Biomedical and Health Sciences, European University of Madrid, Madrid, Spain
| | - Joyce A O'Shaughnessy
- Medical Oncology, Texas Oncology - Baylor Charles A. Sammons Cancer Center, Dallas, TX, USA
| | - Véronique Dieras
- Department of Medical Oncology, Centre Eugène Marquis, Rennes, France
| | - Lisa A Carey
- Medicine - Hematology/Oncology Division, University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
| | - Luca Gianni
- Medical Oncology, Gianni Bonadonna Foundation, Milano, Italy
| | - Mahdi Gharaibeh
- Department of Global Value and Access, Gilead Sciences, Inc., Foster City, CA, USA
| | - Luciana Preger
- Department of Medical Affairs, Gilead Sciences, Inc., Foster City, CA, USA
| | - See Phan
- Department of Clinical Development, Gilead Sciences, Inc., Foster City, CA, USA
| | - Lawrence Chang
- Department of Global Value and Access, Gilead Sciences, Inc., Foster City, CA, USA
| | - Ling Shi
- Evidence Synthesis, Modeling & Communication (EMC), Evidera PPD, Waltham, MA, USA
| | - Martine J Piccart
- Medical Oncology Department, Institut Jules Bordet and l'Université Libre de Bruxelles, Brussels, Belgium
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Sharifkazemi M, Elahi M, Sayad M. Case report: Early acute myocarditis after radiation therapy for breast cancer: A case presentation and review of literature. Front Cardiovasc Med 2023; 10:1020082. [PMID: 37153473 PMCID: PMC10154576 DOI: 10.3389/fcvm.2023.1020082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 03/24/2023] [Indexed: 05/09/2023] Open
Abstract
Breast cancer is the most commonly diagnosed cancer in women worldwide, and with the increased survival of patients by novel treatments, the frequency of complications of cancer treatments rises. Radiotherapy, especially on the chest wall, can damage different cardiac structures. Radiotherapy-induced cardiomyopathy mainly occurs over 10 years after breast cancer treatment; however, there is a gap in the literature on acute myocarditis following radiotherapy. Here, we present a 54-year-old woman who developed acute myocarditis shortly after 25 sessions of radiotherapy with 50 Gy of radiation, successfully diagnosed with the use of speckle tracking echocardiography (STE) and cardiac magnetic resonance (CMR), and responded to the medical treatment with relative clinical improvement until the final follow-up. This case suggests the necessity of detailed examination of patients after radiotherapy, not only for chronic occurrence of cardiomyopathy but also for acute myocarditis. Although STE and CMR resulted in accurate diagnosis, in this case, further studies are required to determine the diagnostic accuracy of these two imaging methods compared with other imaging modalities in such patients and investigate the best diagnostic tool and therapeutic approach for these patients.
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Affiliation(s)
- Mohammadbagher Sharifkazemi
- Department of Cardiology, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
- Correspondence: Mohammadbagher Sharifkazemi
| | - Mahsa Elahi
- Radiation Oncology Department, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masoud Sayad
- Cardio-Oncology Department, Rajaie Heart Hospital, Iran University of Medical Sciences, Tehran, Iran
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Pain prevalence and characteristics in survivors of solid cancers: a systematic review and meta-analysis. Support Care Cancer 2022; 31:85. [PMID: 36574040 DOI: 10.1007/s00520-022-07491-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 11/07/2022] [Indexed: 12/28/2022]
Abstract
PURPOSE The latest systematic review on the prevalence of pain in cancer survivors was published 5 years ago. The current review aims to provide an extended overview on the prevalence of pain, pain mechanisms, pain characteristics, and assessment methods in cancer survivors. METHODS A systematic research was conducted on 17th of April 2020 using MEDLINE, Embase, Scopus, Web of Science, and Cochrane looking at studies from 2014 to 2020. Studies had to report pain prevalence rates in cancer survivors with a solid tumor who finished curative treatment at least 3 months ago. Methodological quality was assessed by two independent reviewers using the Joanna Briggs Institute quality appraisal tool. Characteristics of the included studies, participants and reported pain prevalence rates were extracted. The reported prevalence rates of the individual studies were pooled within a meta-analysis. Meta-regressions were performed to identify possible determinants of the pooled pain prevalence. RESULTS After deduplication, 7300 articles were screened, after which 38 were included in the meta-analysis. Risk of bias was rated low in 26 articles and moderate in 12 articles. The pooled pain prevalence was 47% (95%CI 39-55), with a heterogeneity of 98.99%. CONCLUSION This meta-analysis suggests that nearly half of cancer survivors report pain after completing curative treatment at least 3 months ago. However, substantial unexplained heterogeneity warrants cautious interpretation of these results. Meta-regression using cancer type, treatment location, pain measurement, and follow-up time as a covariate could not explain influencing factors explaining the high heterogeneity.
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GilHerrero L, Courneya KS, McNeely ML, Castellanos M, González Marquez AI, Pollan M, Casla-Barrio S. Effects of a Clinical Exercise Program on Health-Related Fitness and Quality of Life in Spanish Cancer Patients Receiving Adjuvant Therapy. Integr Cancer Ther 2022; 21:15347354221141715. [PMID: 36565156 PMCID: PMC9793061 DOI: 10.1177/15347354221141715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE To report the feasibility and effectiveness of a newly developed clinical exercise program for improving maximal cardiorespiratory fitness in Spanish cancer patients receiving adjuvant chemotherapy or radiation. We also examined the effectiveness of the exercise program for improving maximal muscular strength, body composition, fatigue, and quality of life, and explored if the effectiveness varied based on selected patient characteristics. DESIGN The study was a single group implementation feasibility study using a pre-posttest design. METHODS Participants performed a 12-week, twice-weekly, supervised, multi-component exercise program during adjuvant therapy. Paired t-tests were used to assess pre-post changes, and analyses of covariance were used to compare effectiveness based on selected patient characteristics. RESULTS We had 100 cancer patients referred to the clinical exercise program of which 85 (85%) initiated the exercise program and 76 (89%) completed the post-intervention fitness assessment. Exercise significantly improved VO2max by 4.8 mL/kg/minutes (P < .001, d = 0.74). Exercise also significantly improved chest strength (P < .001, d = 0.82), leg strength (P < .001, d = 1.27), lean body mass (P < .001, d = 0.11), skeletal muscle mass (P < .001; d = 0.09), fat mass (P < .001; d = 0.10), % body fat (P < .001; d = 0.17), quality of life (P = .0017; d = 0.41), and fatigue (P = .007; d = 0.46). Treatment modality, cancer type, and age affected some exercise responses, especially related to body composition changes. CONCLUSIONS A 12-week, supervised, multi-component exercise program was effective for improving health-related fitness and quality of life in Spanish cancer patients receiving adjuvant therapy. Our results show the benefits of incorporating clinical exercise programming into the supportive care of cancer patients receiving treatments. REGISTRATION The study protocol is registered at ClinicalTrials.gov (NCT05078216).
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Affiliation(s)
| | | | | | | | | | | | - Soraya Casla-Barrio
- Universidad Pontificia de Comillas,
Madrid, Spain,Soraya Casla-Barrio, Universidad Pontificia
de Comillas, Nursing Department, Av. San Juan de Dios, 1, Madrid 28350, Spain.
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A review of mechanisms underlying the protective effects of natural compounds against arsenic-induced neurotoxicity. Biometals 2022:10.1007/s10534-022-00482-6. [PMID: 36564665 DOI: 10.1007/s10534-022-00482-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 12/17/2022] [Indexed: 12/25/2022]
Abstract
Arsenic (As) is a toxic metalloid that is widely distributed in the earth's crust. People are continuously exposed to this toxicant in their food and drinking water. Inorganic arsenic occurs in two oxidation states, arsenite 3+ (iAs3+) and arsenate 5+ (iAs5+). The most toxic form is its trivalent form which interferes with the electron transfer cycle and induces overproduction of reactive oxygen species, leading to depletion of the antioxidant defense system, as well as altering fatty acid levels and mitochondrial action. Since arsenic crosses the blood-brain barrier, it can damage cells in different regions of the brain, causing neurological disorders through the induction of oxidative stress, inflammation, DNA damage, and cell death. Hydroxytyrosol, taurine, alpha-lipoic acid, ellagic acid, and thymoquinone have been shown to effectively alleviate arsenic-induced neurotoxicity. The protective effects are the result of the anti-oxidative and anti-inflammatory properties of the phytochemicals and in particular their anti-apoptotic function via the Nrf2 and PI3/Akt/SIRT1 signaling pathways.
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Perfors IAA, Helsper CW, Noteboom EA, Visserman EA, van Dorst EBL, van Dalen T, Verhagen MAMT, Witkamp AJ, Koelemij R, Flinterman AE, Pruissen-Peeters KABM, Schramel FMNH, van Rens MTM, Ernst MF, Moons LMG, van der Wall E, de Wit NJ, May AM. Effects of structured involvement of the primary care team versus standard care after a cancer diagnosis on patient satisfaction and healthcare use: the GRIP randomised controlled trial. BMC PRIMARY CARE 2022; 23:145. [PMID: 35659264 PMCID: PMC9166421 DOI: 10.1186/s12875-022-01746-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 05/03/2022] [Indexed: 11/10/2022]
Abstract
Abstract
Background
The growing number of cancer survivors and treatment possibilities call for more personalised and integrated cancer care. Primary care seems well positioned to support this. We aimed to assess the effects of structured follow-up of a primary care team after a cancer diagnosis.
Methods
We performed a multicentre randomised controlled trial enrolling patients curatively treated for breast, lung, colorectal, gynaecologic cancer or melanoma. In addition to usual cancer care in the control group, patients randomized to intervention were offered a “Time Out consultation” (TOC) with the general practitioner (GP) after diagnosis, and subsequent follow-up during and after treatment by a home care oncology nurse (HON). Primary outcomes were patient satisfaction with care (questionnaire: EORTC-INPATSAT-32) and healthcare utilisation. Intention-to-treat linear mixed regression analyses were used for satisfaction with care and other continuous outcome variables. The difference in healthcare utilisation for categorical data was calculated with a Pearson Chi-Square or a Fisher exact test and count data (none versus any) with a log-binomial regression.
Results
We included 154 patients (control n = 77, intervention n = 77) who were mostly female (75%), mainly diagnosed with breast cancer (51%), and had a mean age of 61 (SD ± 11.9) years. 81% of the intervention patients had a TOC and 68% had HON contact. Satisfaction with care was high (8 out of 10) in both study groups. At 3 months after treatment, GP satisfaction was significantly lower in the intervention group on 3 of 6 subscales, i.e., quality (− 14.2 (95%CI -27.0;-1.3)), availability (− 15,9 (− 29.1;-2.6)) and information provision (− 15.2 (− 29.1;-1.4)). Patients in the intervention group visited the GP practice and the emergency department more often ((RR 1.3 (1.0;1.7) and 1.70 (1.0;2.8)), respectively).
Conclusions
In conclusion, the GRIP intervention, which was designed to involve the primary care team during and after cancer treatment, increased the number of primary healthcare contacts. However, it did not improve patient satisfaction with care and it increased emergency department visits. As the high uptake of the intervention suggests a need of patients, future research should focus on optimizing the design and implementation of the intervention.
Trial registration
GRIP is retrospectively (21/06/2016) registered in the ‘Netherlands Trial Register’ (NTR5909).
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Herranz‐Gómez A, Cuenca‐Martínez F, Suso‐Martí L, Varangot‐Reille C, Calatayud J, Blanco‐Díaz M, Casaña J. Effectiveness of HIIT in patients with cancer or cancer survivors: An umbrella and mapping review with meta-meta-analysis. Scand J Med Sci Sports 2022; 32:1522-1549. [PMID: 35925829 PMCID: PMC9804206 DOI: 10.1111/sms.14223] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 01/31/2022] [Accepted: 08/01/2022] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To assess the available evidence on the effectiveness of high-intensity interval training (HIIT) in addition to first-choice cancer treatment on cardiorespiratory fitness (CRF), quality of life (QoL), adherence, and adverse effects of HIIT in patients with cancer or cancer survivors. METHODS An umbrella review and meta-meta-analysis (MMA) was performed. A systematic search was conducted in MEDLINE, EMBASE, Cochrane Database, CINAHL, Scopus, SPORTDiscus, and Web of Science until August 2021. Article selection, quality assessment, and risk of bias assessment were performed by two independent reviewers. The MMA were performed with a random-effects model and the summary statistics were presented in the form of forest plot with a weighted compilation of all standardized mean differences (SMD) and corresponding 95% confidence interval (CI). RESULTS Seven systematic reviews were included. Regarding CRF, the addition of HIIT to cancer treatment showed statistically significant differences with a small clinical effect, compared with adding other treatments (SMD = 0.45; 95% CI 0.24 to 0.65). There was no significant difference when compared with adding moderate-intensity continuous training (MICT) (SMD = 0.23; 95% CI -0.04 to 0.50). QoL showed positive results although with some controversy. Adherence to HIIT intervention was high, ranging from 54% to 100%. Regarding adverse effects, most of the systematic reviews reported none, and in the cases in which they occurred, they were mild. CONCLUSION In conjunction with first-choice cancer treatment, HIIT has been shown to be an effective intervention in terms of CRF and QoL, as well as having optimal adherence rate. In addition, the implementation of HIIT in patients with cancer or cancer survivors is safe as it showed no or few adverse effects.
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Affiliation(s)
- Aida Herranz‐Gómez
- Exercise Intervention for Health Research Group (EXINH‐RG), Department of PhysiotherapyUniversity of ValenciaValenciaSpain,Department of Physiotherapy, Faculty of Health SciencesEuropean University of ValenciaValenciaSpain
| | - Ferran Cuenca‐Martínez
- Exercise Intervention for Health Research Group (EXINH‐RG), Department of PhysiotherapyUniversity of ValenciaValenciaSpain
| | - Luis Suso‐Martí
- Exercise Intervention for Health Research Group (EXINH‐RG), Department of PhysiotherapyUniversity of ValenciaValenciaSpain
| | - Clovis Varangot‐Reille
- Exercise Intervention for Health Research Group (EXINH‐RG), Department of PhysiotherapyUniversity of ValenciaValenciaSpain
| | - Joaquín Calatayud
- Exercise Intervention for Health Research Group (EXINH‐RG), Department of PhysiotherapyUniversity of ValenciaValenciaSpain
| | - María Blanco‐Díaz
- Surgery and Medical Surgical Specialities Department, Faculty of Medicine and Health SciencesUniversity of OviedoOviedoAsturiasSpain
| | - José Casaña
- Exercise Intervention for Health Research Group (EXINH‐RG), Department of PhysiotherapyUniversity of ValenciaValenciaSpain
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Andreu Y, Martínez P, Soto-Rubio A, Pérez-Marín M, Cervantes A, Arribas L. Quality of life in cancer survivorship: Sociodemographic and disease-related moderators. Eur J Cancer Care (Engl) 2022; 31:e13692. [PMID: 36069249 DOI: 10.1111/ecc.13692] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 06/23/2022] [Accepted: 08/02/2022] [Indexed: 01/06/2023]
Abstract
RATIONALE To identify high-risk survivors in order to provide appropriate care. PURPOSE To analyse the quality of life (QOL) of cancer survivors using an instrument designed specifically for this population and considering different sociodemographic and disease-related characteristics as possible modulating variables. METHODS The Quality of Life in Adult Cancer Survivors (QLACS) was filled out by a large and heterogeneous sample of disease-free post-treatment Spanish cancer survivors (N = 1862). RESULTS QLACS scores were comparable to those obtained in other studies and indicative of worse QOL as a function of shorter elapsed time since the end of primary treatment. The best QOL was shown by prostate, and the worst by hematologic cancer survivors. Both systemic treatments (chemotherapy and hormone therapy) and the combination of radiotherapy and chemotherapy were associated with worse QOL. Likewise, younger age, female sex, unemployment status and not having a stable partner were associated with worse QOL. CONCLUSION Greater understanding of the QOL experienced by the already large and continuously growing population of cancer survivors is relevant for guiding both clinical practice and health policy. In addition, knowing the risk factors associated with worse QOL facilitates the development of targeted prevention programmes for those survivors who need it the most.
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Affiliation(s)
- Yolanda Andreu
- Department of Personality, Assessment and Psychological Treatments, Universitat de València, Valencia, Spain
| | - Paula Martínez
- Faculty of Health Sciences, Valencian International University, Valencia, Spain
| | - Ana Soto-Rubio
- Department of Personality, Assessment and Psychological Treatments, Universitat de València, Valencia, Spain
| | - Marián Pérez-Marín
- Department of Personality, Assessment and Psychological Treatments, Universitat de València, Valencia, Spain
| | - Andrés Cervantes
- Medical Oncology Department, Instituto de Investigación Sanitaria INCLIVA, Valencia, Spain
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Guha A, Stabellini N, Montero AJ. Commentary: Longitudinal changes in circulating metabolites and lipoproteins after breast cancer treatment. Front Cardiovasc Med 2022; 9:962698. [PMID: 36017091 PMCID: PMC9395698 DOI: 10.3389/fcvm.2022.962698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 07/25/2022] [Indexed: 12/03/2022] Open
Affiliation(s)
- Avirup Guha
- Cardio-Oncology Program, Department of Cardiology, Medical College of Georgia at Augusta University, Augusta, GA, United States
- Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH, United States
| | - Nickolas Stabellini
- Graduate Education Office, Case Western Reserve University School of Medicine, Cleveland, OH, United States
- Department of Hematology-Oncology, University Hospitals Seidman Cancer Center, Cleveland, OH, United States
- Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, Brazil
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH, United States
| | - Alberto J. Montero
- Department of Hematology-Oncology, University Hospitals Seidman Cancer Center, Cleveland, OH, United States
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43
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Pérez-Bilbao T, Alonso M, San Juan AF, Bezares S, Gil L, Pollán M, González-Frutos P, Peinado AB, Casla-Barrio S. Case studies in physiology: Training adaptation in an elite athlete after breast cancer diagnosis. J Appl Physiol (1985) 2022; 133:443-448. [PMID: 35861518 DOI: 10.1152/japplphysiol.00504.2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to evaluate the capacity to return to competition of a 28-year-old female 400m hurdle elite athlete after a diagnosis of breast cancer. The study lasted 14 months after diagnosis. She was tested four times (T1-T4) to measure body mass (BM), body mass index (BMI), percentage of total fat mass (TFM%), total fat-free mass (TFFM%), bone mineral density (BMD), one-repetition maximum (1RM) and maximal power (MP) in bench-press and half-squat, maximum oxygen uptake, 400m dash and hurdles. T0 (baseline time) was established with values prior to diagnosis. BM and BMI increased from T0 to T1 (5.3% and 5.2%) and remained stable. BMD experienced no change. TFM% values decreased from T1 to T4 (3.5%). TFFM% values increased from T1 to T3 (0.9%). During T1-T2, the athlete presented a global decline from T0 in 1RMSquat, 1RMBench, MPSquat and MPBench (32.6%, 27.2%, 37.5%, 27.6%, respectively). Results during T3-T4 were also lower for these parameters from T0 (23.3%, 20.6%, 23.4%, 11%). During T1-T2, the VO2max declined, compared to T0 (1.8% and 6.4%), showing a small increase at T3 (+1%) and reaching the lowest level at T4 (9%). During T1-T2, the time record of 400 m dash (8.3%) and hurdles (7.4%) increased. However, a slight improvement was found at T3 (1.3% and 0.6%, respectively). that exercise training improved body composition, maintained BMD and TFFM, but could not completely reverse the worsening of the cardiorespiratory, muscle strength and power, and running performance levels.
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Affiliation(s)
- Txomin Pérez-Bilbao
- Health and Performance Department, Faculty of Physical Activity and Sports Sciences-INEF, Universidad Politécnica de Madrid, Madrid, Spain.,Department of Education, Investigation Methods and Evaluation, Faculty of Human and Social Sciences, Comillas Pontifical University, Madrid, Spain
| | - María Alonso
- Health and Performance Department, Faculty of Physical Activity and Sports Sciences-INEF, Universidad Politécnica de Madrid, Madrid, Spain.,GEICAM Spanish Breast Cancer Group, Madrid, Spain
| | - Alejandro F San Juan
- Health and Performance Department, Faculty of Physical Activity and Sports Sciences-INEF, Universidad Politécnica de Madrid, Madrid, Spain.,GEICAM Spanish Breast Cancer Group, Madrid, Spain
| | | | - Lucía Gil
- Asociación Española Contra el Cáncer, Spain
| | - Marina Pollán
- Cancer and Environmental Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | | | - Ana B Peinado
- Health and Performance Department, Faculty of Physical Activity and Sports Sciences-INEF, Universidad Politécnica de Madrid, Madrid, Spain.,LFE Research Group, Universidad Politécnica de Madrid, Madrid, Spain
| | - Soraya Casla-Barrio
- GEICAM Spanish Breast Cancer Group, Madrid, Spain.,Unidad de Ejercicio Oncológico en Tigers Running Club
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44
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Keaver L, O'Callaghan N, Douglas P. Nutrition Support & Intervention Preferences of Cancer Survivors. J Hum Nutr Diet 2022; 36:526-539. [PMID: 35778782 DOI: 10.1111/jhn.13058] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 06/03/2022] [Accepted: 06/23/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Ascertaining cancer survivors' specific needs and preferences regarding nutrition information delivery is important in developing and designing future health interventions in oncology. This study aimed to explore the nutrition information needs of cancer survivors and their preferences regarding intervention delivery. METHODS The present study is a mixed-methods study comprising a cross-sectional survey and focus groups. Participants were eligible for inclusion if they were 18+years, living in Ireland with a cancer diagnosis and had completed treatment at least six months previous. Cancer support centres promoted the online survey on social media. Focus groups were conducted with twenty individuals. RESULTS The cohort (n=56) were predominantly female (n=50, 89.3%), breast cancer survivors (n=42, 75%). Seven (12.5%) had received nutrition advice from a dietitian. Most are interested in receiving nutrition advice (n=52, 92.9%), with variability in delivery mode. There was interest in improving sleep quality (n=35, 62.5%), making positive lifestyle changes (n=28, 50%) and accessing cancer-specific physical activity classes (n=27, 48.2%). The best time to deliver information was throughout the cancer journey (n=31, 55.4%). Time and motivation (n=15, 26.8%) were the main barriers. Facilitators were keeping healthy (n=42, 75%), and weight maintenance (n=31, 55.4%). Four themes emerged from thematic analysis; lack of nutrition guidance, an abundance of misinformation, one size does not fit all and dietitians as the preferred source of advice. CONCLUSION There is a desire for evidence-based nutrition advice and for dietitians to be integrated into cancer clinics and cancer survivorship care. This research guides future interventional work on the efficacy of nutrition interventions to improve cancer survivorship outcomes. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Laura Keaver
- Department of Health and Nutritional Science, Atlantic Technological University, Sligo Campus, Ash Lane, Sligo, F91 YW50
| | - Niamh O'Callaghan
- Department of Health and Nutritional Science, Atlantic Technological University, Sligo Campus, Ash Lane, Sligo, F91 YW50
| | - Pauline Douglas
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, UK
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45
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Talwar A, Rege S, Aparasu RR. Pain management practices for outpatients with breast cancer. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2022; 6:100155. [PMID: 35865110 PMCID: PMC9294324 DOI: 10.1016/j.rcsop.2022.100155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 06/20/2022] [Accepted: 06/30/2022] [Indexed: 11/15/2022] Open
Abstract
Objectives Methods Results Conclusions One in four women office visits for breast cancer received pain medication prescriptions. Among the patients receiving pain medications, one in seven women received opioids. Both patient and provider characteristics contribute to variations in pain management in breast cancer patients.
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Affiliation(s)
| | | | - Rajender R. Aparasu
- Corresponding author at: Department of Pharmaceutical Health Outcomes and Policy, College of Pharmacy, University of Houston, Health and Biomedical Sciences Building 2 – Office 4052, 4849 Calhoun Road, Houston, TX 77204-5047, USA.
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46
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Toftdahl AKS, Hjoernholm LH, Simonsen M, Stapelfeldt CM, Thomsen JL, Kongsgaard M, Riis A. Perspectives on the treatment of sequelae after cancer: protocol of an interview study of primary care physiotherapists. BMJ Open 2022; 12:e052378. [PMID: 35428619 PMCID: PMC9014034 DOI: 10.1136/bmjopen-2021-052378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION An increasing number of patients are living with fatigue, pain and other sequelae after cancer. About 30% of these patients express a need for physical rehabilitation and patients prefer to be involved in medical decision-making. This includes being offered individualised treatment with patient-defined goals and education during all aspects of treatment by physiotherapists with empathic skills. However, physiotherapists are often unaware of the relationship between cancer and its presenting symptoms. This can lead to inappropriate care and unrealistic goalsetting for rehabilitation. This calls for greater attention towards physiotherapist's treatment and their current perspectives on how treatment can be improved in physiotherapy clinics. The aim of this study is to explore physiotherapists perspectives on barriers, facilitators and potential solutions to improve the care of sequelae after cancer in physiotherapy clinics. METHODS AND ANALYSIS This is a qualitative interview study using individual semistructured interviews with physiotherapists using a phenomenological approach to explore their lifeworld at work. We will recruit physiotherapists working in private clinics based on a variation in gender and years of working experience in private clinics. We will conduct between 10 and 16 interviews online via Microsoft Teams and thematically analyse data supported by NVivo software. Interviewing is scheduled to take place from April 2022. ETHICS AND DISSEMINATION This is a non-intervention and qualitative study, and the local Ethics Committee in the North Denmark Region has stated that their approval is not needed. Informants will provide a written informed consent. Study information will be sent to the informant at least 3 days prior to the interview session and information will be summarised by the interviewer before the interview.Aside from publication, results will be disseminated by two teaching institutions, a regional health care provider and DEFACTUM (a public Danish research institution focusing on increasing social equality in health).
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Affiliation(s)
| | | | - Mia Simonsen
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Christina M Stapelfeldt
- Public Health and Quality Improvement, Marselisborg Centret, Central Denmark Region, Aarhus, Denmark
- Department of Public Health/Section of Social Medicine and Rehabilitation, Aarhus University, Aarhus, Denmark
| | - Janus Laust Thomsen
- Aalborg University Hospital, Aalborg University, Aalborg, Denmark
- Research Unit for General Practice in the North Denmark Region, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Marianne Kongsgaard
- Quality Unit for General Practice in the North Denmark Region, Aalborg, Denmark
| | - Allan Riis
- Department of Physiotherapy, University College Northern Denmark, Aalborg, Denmark
- Research Unit for General Practice in the North Denmark Region, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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47
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Falanga A, Girvalaki C, Monreal M, Easaw JC, Young A. How well do European patients understand cancer-associated thrombosis? A patient survey. Cancer Treat Res Commun 2022; 31:100557. [PMID: 35462127 DOI: 10.1016/j.ctarc.2022.100557] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 03/27/2022] [Accepted: 04/04/2022] [Indexed: 06/14/2023]
Abstract
Ongoing concerns regarding the morbidity and mortality from cancer-associated thrombosis led the European Cancer Patient Coalition (ECPC), the voice of cancer patients across Europe, to create a pan-European cancer-associated awareness patient survey to assess cancer-associated thrombosis (CAT) knowledge among a large population of patients with cancer. The ECPC survey represents the largest of its kind among patients/caregivers with CAT. It identified significant gaps in patient awareness and knowledge of CAT as well as a need for educational CAT-related discussions and interventions between healthcare professionals and patients with cancer and their caregivers. The aim of this paper is to highlight these gaps and to provide awareness of what/when information should be shared with patients/caregivers. Notably, the importance of providing information on how to reduce their risk of CAT, the role of anticoagulant prophylaxis and treatment (short- and long-term) including possible side-effects, and finally how to identify CAT symptoms early. Here we outline what type of information should be provided, as well as when and how to best discuss CAT with our oncology patients and their caregivers along the cancer care continuum, to reduce the risk of CAT and associated complications with a goal of improving patient outcomes.
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Affiliation(s)
- Anna Falanga
- Full professor of Hematology at University of Milan Bicocca and Chief of the Department of Immunohematology and Transfusion Medicine and the Thrombosis and Hemostasis Center, at the Hospital Papa Giovanni XXIII, in Bergamo, Italy
| | - Charis Girvalaki
- EUA Affairs Manager, European Cancer Patient Coalition, Brussels, Belgium
| | - Manuel Monreal
- Professor Vascular Medicine at Faculty of Medicine, Universidad Autonoma de Barcelona, Head Internal Medicine Hospital Universitari Germans Trias, Barcelona, Spain
| | - Jacob C Easaw
- Professor, Department of Medical Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada.
| | - Annie Young
- Emerita Professor of Nursing, Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom
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48
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Tauseef A, Hisam F, Hussain T, Caruso A, Hussain K, Châtel A, Chénais B. Nanomicrobiology: Emerging Trends in Microbial Synthesis of Nanomaterials and Their Applications. J CLUST SCI 2022. [DOI: 10.1007/s10876-022-02256-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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49
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Ernst L, Schilling G. [Physical long-term consequences of cancer]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2022; 65:420-430. [PMID: 35312813 DOI: 10.1007/s00103-022-03504-3] [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: 10/03/2021] [Accepted: 01/31/2022] [Indexed: 11/02/2022]
Abstract
The number of long-term survivors of malignant diseases is steadily increasing, which is due to the further development and optimization of multimodal therapy strategies and the mechanisms of new substance classes. These can now be combined with classical treatment methods or used sequentially. At the same time the number of patients who suffer from physical and psychosocial long-term consequences of cancer therapies or have to live with chronic side effects under the long-term therapies increases. Every therapy, whether radiation, chemotherapy, targeted therapy, or operation, has undesirable long-term side effects that contribute to the decrease of one's quality of life. These affect all parts of the body. As a result, patients can be heavily burdened. In oncology and in other disciplines involved in aftercare, these consequences must therefore be increasingly addressed and clarified and treatment strategies further developed. Unfortunately, there is still a considerable need for research in this area; moreover, there is a lack of clinical studies examining the evidence of a wide variety of holistic therapy methods.
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Affiliation(s)
- Lisa Ernst
- Medizinische Fakultät: Asklepios Campus Hamburg, Semmelweis Universität Budapest, Lohmühlenstr. 5, Haus P, 20099, Hamburg, Deutschland.
| | - Georgia Schilling
- Internistisch-onkologische Rehabilitation, Asklepios Nordseeklinik Westerland/Sylt, Westerland/Sylt, Deutschland.,Asklepios Tumorzentrum Hamburg, Asklepios Klinik Altona, Hamburg, Deutschland
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50
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Sabik LM, Eom KY, Sun Z, Merlin JS, Bulls HW, Moyo P, Pruskowski JA, van Londen G, Rosenzweig M, Schenker Y. Patterns and Trends in Receipt of Opioids Among Patients Receiving Treatment for Cancer in a Large Health System. J Natl Compr Canc Netw 2022; 20:460-467.e1. [PMID: 35231900 PMCID: PMC10463265 DOI: 10.6004/jnccn.2021.7104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 10/18/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND Given limited evidence on opioid prescribing among patients receiving treatment for cancer during the ongoing opioid epidemic, our objective was to assess predictors of and trends in opioid receipt during cancer treatment, including how patterns differ by type of cancer. METHODS Using cancer registry data, we identified patients with a first lifetime primary diagnosis of breast, colorectal, or lung cancer from 2013 to 2017 who underwent treatment within a large cancer center network. Cancer registry data were linked to electronic health record information on opioid prescriptions. We examined predictors of and trends in receipt of any opioid prescription within 12 months of cancer diagnosis. RESULTS The percentage of patients receiving opioids varied by cancer type: breast cancer, 35% (1,996/5,649); colorectal, 37% (776/2,083); lung, 47% (1,259/2,654). In multivariable analysis, opioid use in the year before cancer diagnosis was the factor most strongly associated with receipt of opioids after cancer diagnosis, with 4.90 (95% CI, 4.10-5.86), 5.09 (95% CI, 3.88-6.69), and 3.31 (95% CI, 2.68-4.10) higher odds for breast, colorectal, and lung cancers, respectively. We did not observe a consistent decline in opioid prescribing over time, and trends differed by cancer type. CONCLUSIONS Our findings suggest that prescription of opioids to patients with cancer varies by cancer type and other factors. In particular, patients are more likely to receive opioids after cancer diagnosis if they were previously exposed before diagnosis, suggesting that pain among patients with cancer may commonly include non-cancer-related pain. Heterogeneity and complexity among patients with cancer must be accounted for in developing policies and guidelines aimed at addressing pain management while minimizing the risk of opioid misuse.
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Affiliation(s)
- Lindsay M. Sabik
- University of Pittsburgh Graduate School of Public Health, Department of Health Policy and Management
| | - Kirsten Y. Eom
- University of Pittsburgh Graduate School of Public Health, Department of Health Policy and Management
| | - Zhaojun Sun
- University of Pittsburgh Graduate School of Public Health, Department of Health Policy and Management
| | - Jessica S. Merlin
- University of Pittsburgh School of Medicine, Palliative Research Center (PaRC) and Section of Palliative Care and Medical Ethics, Division of General Internal Medicine
| | - Hailey W. Bulls
- University of Pittsburgh School of Medicine, Palliative Research Center (PaRC) and Section of Palliative Care and Medical Ethics, Division of General Internal Medicine
| | - Patience Moyo
- Brown University School of Public Health, Department of Health Services, Policy, and Practice
| | | | - G.J. van Londen
- University of Pittsburgh School of Medicine, Department of Medicine, Divisions of Hematology-Oncology and Geriatric Medicine
| | - Margaret Rosenzweig
- University of Pittsburgh School of Nursing, Department of Acute & Tertiary Care
| | - Yael Schenker
- University of Pittsburgh School of Medicine, Palliative Research Center (PaRC) and Section of Palliative Care and Medical Ethics, Division of General Internal Medicine
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