Physical Activity: Impact on Survival in Gynecologic Cancer

Increasing physical activity among older adults with gynecologic cancers: a qualitative study

PURPOSE

The purpose of this study was to gain an understanding of older gynecologic cancer patients' preferences and opinions related to physical activity during chemotherapy, including interventions to promote physical activity.

METHODS

Gynecologic cancer patients 60 years or older receiving chemotherapy at a single institution within the last 12 months completed questionnaires and a semi-structured interview asking about their preferences for physical activity interventions aimed at promoting physical activity while receiving treatment.

RESULTS

Among the 30 gynecologic cancer patients surveyed and interviewed, a majority agreed with the potential usefulness of a physical activity intervention during chemotherapy (67%) and most reported they would be willing to use an activity tracker during chemotherapy (73%). They expressed a preference for an aerobic activity intervention such as walking, indicated a desire for education from their clinical team on the effects physical activity can have on treatment symptoms, and stated a need for an intervention that could be accessed from anywhere and anytime. Additionally, they emphasized a need for an intervention that considered their treatment symptoms as these were a significant barrier to physical activity while on chemotherapy.

CONCLUSION

In this study of older gynecologic cancer patients receiving chemotherapy, most were open to participating in a virtually accessible and symptom-tailored physical activity intervention to promote physical activity during chemotherapy.

The relationship of exercise and cancer-related fatigue in patients with advanced liver cancer: a cross-sectional study

There is increasing interest in understanding exercise as a potential treatment for cancer-related fatigue (CRF); however, rarely research has been conducted on more aggressive cancers with short survival, such as liver cancer. The purpose of this study was to provide educational ideas for insufficient exercise and provide clues for the design of effective and safe exercise intervention programs with high compliance in patients of advanced liver cancer in the future. Participants were recruited from a tertiary cancer hospital using convenience sampling. All participants were asked to complete self-report questionnaires that assessed their medical and demographic variables, exercise habits and CRF during their hospitalization in the interventional department. Spearman's correlation analysis and Nonparametric test was used to explore correlations between exercise subgroups and CRF. The Baron and Kenny's Approach was used to investigate the mediating effect of exercise index between P-EX and CRF. 207 out of 255 participants were enrolled in this study, with an average age of 55.4 years. The CRF score was 33 (28, 36), and 93.2% had insufficient exercise. Exercise frequency (≥ 3 Times/week) (Z = 4.34, p = 0.037) and maintaining exercise trend (Z = 15.85, p = 0.001) had a positive effect on CRF. P-EX had a great impact on exercise index and affecting CRF directly. Participants in the study showed serious fatigue and insufficient exercise. Exercise education can be initiated earlier, particularly those without regular exercise experience. Sustained light exercise, compliant with exercise habits and interests, three times a week may be a practical way to reduce the risk of CRF in advanced liver cancer.

Pain nursing for gynecologic cancer patients

Gynecological malignancy remains a prevalent cause of mortality among women. Chronic cancer pain, as a severe complication of malignancy and its therapies, accounts for a substantial burden of physical and psychological distress in affected patients. Accordingly, early identification, assessment, and standardized management of such pain are crucial in the prevention or delay of its progression. In the present review, we provide a comprehensive overview of the pathological factors that contribute to pain in patients with gynecological malignancy while highlighting the underlying mechanisms of pain in this population. In addition, we summarize several treatment modalities targeting pain management in gynecologic cancer patients, including surgery, radiotherapy, and chemotherapy. These interventions are crucial for tumor elimination and patient survival. Chronic cancer pain exerts a significant impact on wellbeing and quality of life for patients with gynecologic cancer. Therefore, our review emphasizes the importance of addressing this pain and its psychological sequelae and advocates for a multidisciplinary approach that encompasses nursing and psychological support. In summary, this review offers valuable insights into the pathological factors underlying pain, reviews pain management modalities, and stresses the critical role of early intervention and comprehensive care in enhancing the quality of life of these patients.

Preventive behaviors and behavioral risk factors among gynecologic cancer survivors: Results from the 2020 Behavioral Risk Factor Surveillance System Survey

BACKGROUND

Maintaining a healthy lifestyle is an important factor in promoting positive outcomes for gynecologic cancer survivors.

METHODS

We examined preventive behaviors among gynecologic cancer survivors (n = 1824) and persons without a history of cancer in a cross-sectional analysis, using data from the 2020 Behavioral Risk Factor Surveillance System survey (BRFSS). BRFSS is a cross-sectional telephone-based survey of U.S. residents 18 years of age and older, which collects information about health-related factors and use of preventive services.

RESULTS

The prevalence rates of colorectal cancer screening were respectively 7.9 (95% CI: 4.0-11.9) and 15.0 (95% CI: 4.0-11.9) %-points higher among gynecologic and other cancer survivors compared to that of 65.2% among those without any history of cancer. However, no differences were observed in breast cancer screening between gynecologic cancer survivors (78.5%) and respondents without any history of cancer (78.7%). Coverage of influenza vaccination among gynecologic cancer survivors were 4.0 (95% CI: 0.3-7.6) %-points higher than that of the no cancer group, but 11.6 (95% CI: 7.6-15.6) %-points lower than that of the other cancer group. Pneumonia vaccination rate among gynecologic cancer survivors, however, was not statistically different than that of other cancer survivors and respondents with no history of cancer. When examining modifiable risk behaviors, the prevalence of smoking among gynecologic cancer survivors was 12.8 (95% CI: 9.5-16.0) and 14.2 (95% CI: 10.8-17.7) %-points higher than smoking prevalence among other cancer survivors and respondents without any history of cancer. The rate differentials were even higher in rural areas, 17.4 (95% CI: 7.2-27.6) and 18.4 (95% CI: 7.4-29.4) %-points respectively. There were no differences in the prevalence of heavy drinking across the groups. Lastly, gynecologic and other cancer survivors were less likely to be physically active (Δ = -12.3, 95% CI: -15.8 to -8.8 and Δ = -6.9, 95% CI: -8.5 to -5.3, respectively) than those without any history of cancer.

CONCLUSION

Smoking prevalence among gynecologic cancer survivors is alarmingly high. Intervention studies are needed to identify effective ways to assist gynecologic cancer survivors to quit smoking and refrain from hazardous alcohol consumption. In addition, women with gynecologic malignancies should made aware of the importance of physical activity.

Association between Energy Balance-Related Factors and Clinical Outcomes in Patients with Ovarian Cancer: A Systematic Review and Meta-Analysis

Background: This systematic review and meta-analysis synthesized evidence in patients with ovarian cancer at diagnosis and/or during first-line treatment on; (i) the association of body weight, body composition, diet, exercise, sedentary behavior, or physical fitness with clinical outcomes; and (ii) the effect of exercise and/or dietary interventions. Methods: Risk of bias assessments and best-evidence syntheses were completed. Meta-analyses were performed when ≥3 papers presented point estimates and variability measures of associations or effects. Results: Body mass index (BMI) at diagnosis was not significantly associated with survival. Although the following trends were not supported by the best-evidence syntheses, the meta-analyses revealed that a higher BMI was associated with a higher risk of post-surgical complications (n = 5, HR: 1.63, 95% CI: 1.06−2.51, p = 0.030), a higher muscle mass was associated with a better progression-free survival (n = 3, HR: 1.41, 95% CI: 1.04−1.91, p = 0.030) and a higher muscle density was associated with a better overall survival (n = 3, HR: 2.12, 95% CI: 1.62−2.79, p < 0.001). Muscle measures were not significantly associated with surgical or chemotherapy-related outcomes. Conclusions: The prognostic value of baseline BMI for clinical outcomes is limited, but muscle mass and density may have more prognostic potential. High-quality studies with comprehensive reporting of results are required to improve our understanding of the prognostic value of body composition measures for clinical outcomes. Systematic review registration number: PROSPERO identifier CRD42020163058.

Metabolic dysfunction and obesity-related cancer: Beyond obesity and metabolic syndrome

OBJECTIVES

The metabolic dysfunction driven by obesity, including hyperglycemia and dyslipidemia, increases risk for developing at least 13 cancer types. The concept of "metabolic dysfunction" is often defined by meeting various combinations of criteria for metabolic syndrome. However, the lack of a unified definition of metabolic dysfunction makes it difficult to compare findings across studies. This review summarizes 129 studies that evaluated variable definitions of metabolic dysfunction in relation to obesity-related cancer risk and mortality after a cancer diagnosis. Strategies for metabolic dysfunction management are also discussed.

METHODS

A comprehensive search of relevant publications in MEDLINE (PubMed) and Google Scholar with review of references was conducted.

RESULTS

Metabolic dysfunction, defined as metabolic syndrome diagnosis or any number of metabolic syndrome criteria out of clinical range, inflammatory biomarkers, or markers of metabolic organ function, has been associated with risk for, and mortality from, colorectal, pancreatic, postmenopausal breast, and bladder cancers. Metabolic dysfunction associations with breast and colorectal cancer risk have been observed independently of BMI, with increased risk in individuals with metabolically unhealthy normal weight or overweight/obesity compared with metabolically healthy normal weight.

CONCLUSION

Metabolic dysfunction is a key risk factor for obesity-related cancer, regardless of obesity status. Nonetheless, a harmonized definition of metabolic dysfunction will further clarify the magnitude of the relationship across cancer types, enable better comparisons across studies, and further guide criteria for obesity-related cancer risk stratification.

Regular Physical Activities and Related Factors among Middle-Aged and Older Adults in Jinan, China: A Cross-Sectional Study

The objective of this study was to investigate the prevalence of regular physical activity (RPA) among middle-aged and older adults in urban communities in Jinan, China, and to identify the factors related to RPA. A cross-sectional survey was conducted among middle-aged and elderly urban residents. A total of 1406 participants were included in the final data analysis. The results of the four models consistently showed that the relevant factors of RPA were educational level, previously diagnosed hypertension (PDH) and depression. In terms of educational level, compared with illiteracy, from the first model to the fourth model, the odds ratios (ORs) and 95% confidence intervals (CIs) of senior middle school were 2.072 (1.418, 3.026), 2.072 (1.418, 3.026), 1.905 (1.289, 2.816) and 1.926 (1.302, 2.848), respectively, and the ORs and 95% CIs of college or above were 2.364 (1.462, 3.823), 2.364 (1.462, 3.823), 2.001 (1.208, 3.312) and 2.054 (1.239, 3.405). In terms of PDH, compared with those with PDH, from the first model to the fourth model, ORs and 95% CIs of non-PDH were 1.259 (1.003, 1.580), 1.259 (1.003, 1.580), 1.263 (1.006, 1.585) and 1.261 (1.004, 1.584), respectively. For depression, compared with those without depression, also from the first model to the fourth model, ORs and 95% CIs of depression were 0.702 (0.517, 0.951), 0.702 (0.517, 0.951), 0.722 (0.532, 0.981) and 0.719 (0.529, 0.977), respectively. In conclusion, the results of this study showed that participation in RPA among middle-aged and older adults in Jinan urban communities was significantly associated with education level, PDH and depression.