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Keane KF, Wickstrom J, Livinski AA, Blumhorst C, Wang TF, Saligan LN. The definitions, assessment, and dimensions of cancer-related fatigue: A scoping review. Support Care Cancer 2024; 32:457. [PMID: 38916815 PMCID: PMC11199267 DOI: 10.1007/s00520-024-08615-y] [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: 01/19/2024] [Accepted: 05/29/2024] [Indexed: 06/26/2024]
Abstract
PURPOSE Cancer-related fatigue (CRF) is challenging to diagnose and manage due to a lack of consensus on its definition and assessment. The objective of this scoping review is to summarize how CRF has been defined and assessed in adult patients with cancer worldwide. METHODS Four databases (PubMed, Embase, CINAHL Plus, PsycNet) were searched to identify eligible original research articles published in English over a 10-year span (2010-2020); CRF was required to be a primary outcome and described as a dimensional construct. Each review phase was piloted: title and abstract screening, full-text screening, and data extraction. Then, two independent reviewers participated in each review phase, and discrepancies were resolved by a third party. RESULTS 2923 articles were screened, and 150 were included. Only 68% of articles provided a definition for CRF, of which 90% described CRF as a multidimensional construct, and 41% were identical to the National Comprehensive Cancer Network definition. Studies were primarily conducted in the United States (19%) and the majority employed longitudinal (67%), quantitative (93%), and observational (57%) study designs with sample sizes ≥ 100 people (57%). Participant age and race were often not reported (31% and 82%, respectively). The most common cancer diagnosis and treatment were breast cancer (79%) and chemotherapy (80%; n = 86), respectively. CRF measures were predominantly multidimensional (97%, n = 139), with the Multidimensional Fatigue Inventory (MFI-20) (26%) as the most common CRF measure and "Physical" (76%) as the most common CRF dimension. CONCLUSION This review confirms the need for a universally agreed-upon definition and standardized assessment battery for CRF.
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Affiliation(s)
- Kayla F Keane
- National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, USA
| | - Jordan Wickstrom
- Sinai Rehabilitation Center, Sinai Hospital of Baltimore, Baltimore, MD, USA
- Rehabilitation Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Alicia A Livinski
- Office of Research Services, Office of the Director, National Institutes of Health Library, National Institutes of Health, Bethesda, MD, USA
| | - Catherine Blumhorst
- National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, USA
| | - Tzu-Fang Wang
- National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, USA
| | - Leorey N Saligan
- National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, USA.
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Guo W, Liu S, Xia H, Luo J, Chen H, Hu L, Zheng X, Xiao Z, Lin L. Shenqi Fuzheng injection facilitates skeletal muscle mitophagy mediated by the ubiquitination of HIF-1α to ameliorate cancer-associated fatigue. J Cell Mol Med 2024; 28:e18455. [PMID: 38898772 PMCID: PMC11187406 DOI: 10.1111/jcmm.18455] [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: 01/19/2024] [Revised: 04/07/2024] [Accepted: 05/16/2024] [Indexed: 06/21/2024] Open
Abstract
Cancer-related fatigue (CRF) significantly impacts the quality of life of cancer patients. This study investigates the therapeutic potential of Shenqi Fuzheng injection (SFI) in managing CRF, focusing on its mechanistic action in skeletal muscle. We utilized a CRF mouse model to examine the effects of SFI on physical endurance, monitoring activity levels, swimming times and rest periods. Proteomic analysis of the gastrocnemius muscle was performed using isobaric tags and liquid chromatography-tandem mass spectrometry to map the muscle proteome changes post-SFI treatment. Mitochondrial function in skeletal muscle was assessed via ATP bioluminescence assay. Furthermore, the regulatory role of the hypoxia inducible factor 1 subunit alpha (HIF-1α) signalling pathway in mediating SFI's effects was explored through western blotting. In CRF-induced C2C12 myoblasts, we evaluated cell viability (CCK-8 assay), apoptosis (flow cytometry) and mitophagy (electron microscopy). The study also employed pulldown, luciferase and chromatin immunoprecipitation assays to elucidate the molecular mechanisms underlying SFI's action, particularly focusing on the transcriptional regulation of PINK1 through HIF-1α binding at the PINK1 promoter region. Our findings reveal that SFI enhances physical mobility, reduces fatigue symptoms and exerts protective effects on skeletal muscles by mitigating mitochondrial damage and augmenting antioxidative responses. SFI promotes cell viability and induces mitophagy while decreasing apoptosis, primarily through the modulation of HIF-1α, PINK1 and p62 proteins. These results underscore SFI's efficacy in enhancing mitochondrial autophagy, thereby offering a promising approach for ameliorating CRF. The study not only provides insight into SFI's potential therapeutic mechanisms but also establishes a foundation for further exploration of SFI interventions in CRF management.
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Affiliation(s)
- Wei Guo
- Department of OncologyThe First Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouGuangdongChina
| | - Shan Liu
- Department of OncologyThe First Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouGuangdongChina
- Lingnan Medical Research CenterGuangzhou University of Chinese MedicineGuangzhouGuangdongChina
- Science and Technology Innovation CenterGuangzhou university of Chinese MedicineGuangzhouChina
| | - Huan Xia
- Geriatrics Research InstituteSichuan Provincial People's HospitalChengduSichuanChina
| | - Jiamin Luo
- Department of OncologyThe First Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouGuangdongChina
- Lingnan Medical Research CenterGuangzhou University of Chinese MedicineGuangzhouGuangdongChina
| | - Hanrui Chen
- Department of OncologyThe First Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouGuangdongChina
| | - Leihao Hu
- Department of OncologyThe First Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouGuangdongChina
| | - Xinting Zheng
- Department of OncologyThe First Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouGuangdongChina
| | - Zhiwei Xiao
- Department of OncologyThe First Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouGuangdongChina
| | - Lizhu Lin
- Department of OncologyThe First Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouGuangdongChina
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Brady B, Brown A, Barrett M, Maraj V, Lawler F, Murphy R, Walsh D. Cardiac dysfunction in solid tumours: scoping review. BMJ Support Palliat Care 2023:spcare-2023-004440. [PMID: 38050023 DOI: 10.1136/spcare-2023-004440] [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: 06/17/2023] [Accepted: 11/07/2023] [Indexed: 12/06/2023]
Abstract
Cardio-oncology is a dynamic field. Research has suggested that cancer itself can damage the heart, independent of cancer treatment-related cardiac dysfunction (CTRCD). The aim of this study was to establish the nature of cardiovascular abnormalities reported in cancer, excluding CTRCD. Scoping review search included cardiovascular abnormalities in adults with solid tumour malignancies, and excluded CTRCD and thrombotic events. Three databases (CINAHL, Embase, Medline) were searched, supplemented by a handsearch. All screening and data extraction was done by two researchers with consensus reached for any conflicts. Given the heterogeneous nature of the studies identified, data synthesis was narrative. The search identified 42 366 studies. Following deduplication and title/abstract screening, 195 studies were assessed for full-text eligibility. Forty-four studies are included in the final analysis. There are 19 prospective observational studies, 13 retrospective studies, 9 case reports and 3 cross-sectional studies. Types of abnormality identified include cardiomyopathy (16, including Takotsubo (9)), autonomic nervous system (ANS) dysfunction (10), biomarker disturbances (9), reduced myocardial strain (6) and others (3). Due to variable study design, the prevalence was not determined. Cardiovascular abnormalities were associated with morbidity (chest pain, dyspnoea, fatigue) and shortened prognosis. In conclusion: (1) There is evidence for cardiovascular dysfunction in patients with solid tumour malignancies, distinct from CTRCD. People with solid tumours have higher rates of cardiac disease, even when newly diagnosed and treatment naïve. (2) Abnormalities manifest mainly as cardiomyopathies, ANS dysfunction and raised biomarker levels and are associated with significant symptoms. (3) Treatment plans need to take account of these risks, and widen criteria for screening.
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Affiliation(s)
- Bernadette Brady
- Academic Department of Palliative Medicine, Our Lady's Hospice & Care Services, Dublin, Ireland
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Alexandra Brown
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Michelle Barrett
- Academic Department of Palliative Medicine, Our Lady's Hospice & Care Services, Dublin, Ireland
| | | | - Fiona Lawler
- Education & Research Department, Our Lady's Hospice & Care Services, Dublin, Ireland
| | - Ross Murphy
- Institute of Cardiovascular Science, St James's Hospital, Dublin, Ireland
| | - Declan Walsh
- Academic Department of Palliative Medicine, Our Lady's Hospice & Care Services, Dublin, Ireland
- Supportive Oncology, Levine Cancer Institute, Charlotte, North Carolina, USA
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4
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Bøhn S, Oldervoll LM, Reinertsen KV, Seland M, Fosså A, Kiserud C, Skaali T, Nilsen TS, Blomhoff R, Henriksen HB, Lie HC, Berge T, Fjerstad E, Wisløff T, Slott M, Zajmovic I, Thorsen L. The feasibility of a multidimensional intervention in lymphoma survivors with chronic fatigue. Support Care Cancer 2023; 32:22. [PMID: 38095797 PMCID: PMC10721709 DOI: 10.1007/s00520-023-08204-5] [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: 10/20/2023] [Accepted: 11/21/2023] [Indexed: 12/17/2023]
Abstract
PURPOSE Chronic fatigue (CF) affects 25-30% of lymphoma survivors, but interventions designed to reduce fatigue are lacking. The main aim of this study was to test the feasibility of a multidimensional intervention study in lymphoma survivors with CF. Secondary aims were to describe individual changes in fatigue, quality of life (QoL) and physical performance from pre (T0) to post (T1) intervention. METHODS This feasibility study was as a one-armed intervention study performed in 2021. Hodgkin or aggressive non-Hodgkin lymphoma survivors received mailed study information and Chalder Fatigue Questionnaire and were asked to respond if they suffered from fatigue. The 12-week intervention included patient education, physical exercise, a cognitive behavioural therapy (CBT)-based group program and nutritional counselling. Feasibility data included patient recruitment, completion of assessments, adherence to the intervention and patient-reported experience measures. Participants responded to questionnaires and underwent physical tests at T0 and T1. RESULTS Seven lymphoma survivors with CF were included. Of all assessments, 91% and 83% were completed at T0 and T1, respectively. Adherence to the interventional components varied from 69% to 91%. At T1, all participants rated exercise as useful, of whom five rated the CBT-based program and five rated individual nutritional counselling as useful. Five participants reported improved fatigue, QoL and physical performance. CONCLUSION Lymphoma survivors with CF participating in a multidimensional intervention designed to reduce the level of fatigue showed high assessment completion rate and intervention adherence rate. Most of the participants evaluated the program as useful and improved their level of fatigue, QoL and physical performance after the intervention. TRIAL REGISTRATION ClinicalTrials.gov, identifier: NCT04931407. Registered 16. April 2021-Retrospectively registered. https://www. CLINICALTRIALS gov/ct2/show/NCT04931407.
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Affiliation(s)
- Skh Bøhn
- National Advisory Unit for Late Effects After Cancer Treatment, Department of Oncology, Oslo University Hospital, Radiumhospitalet, Oslo, Norway.
| | - L M Oldervoll
- Centre for Crisis Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - K V Reinertsen
- National Advisory Unit for Late Effects After Cancer Treatment, Department of Oncology, Oslo University Hospital, Radiumhospitalet, Oslo, Norway
| | - M Seland
- Department of Clinical Service, The Cancer Rehabilitation Center, Aker, Oslo University Hospital, Oslo, Norway
| | - A Fosså
- National Advisory Unit for Late Effects After Cancer Treatment, Department of Oncology, Oslo University Hospital, Radiumhospitalet, Oslo, Norway
| | - C Kiserud
- National Advisory Unit for Late Effects After Cancer Treatment, Department of Oncology, Oslo University Hospital, Radiumhospitalet, Oslo, Norway
| | - T Skaali
- Department of Clinical Service, The Cancer Rehabilitation Center, Aker, Oslo University Hospital, Oslo, Norway
| | - T S Nilsen
- Institute of Physical Performance, Norwegian School of Sports Sciences, Oslo, Norway
| | - R Blomhoff
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Department of Clinical Service, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
| | - H B Henriksen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - H C Lie
- Department of Behavioural Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - T Berge
- Diakonhjemmet Hospital, Oslo, Norway
| | | | - T Wisløff
- Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
| | - M Slott
- Department of Clinical Service, The Cancer Rehabilitation Center, Aker, Oslo University Hospital, Oslo, Norway
| | - I Zajmovic
- Department of Clinical Service, The Cancer Rehabilitation Center, Aker, Oslo University Hospital, Oslo, Norway
| | - L Thorsen
- National Advisory Unit for Late Effects After Cancer Treatment, Department of Oncology, Oslo University Hospital, Radiumhospitalet, Oslo, Norway
- Department of Clinical Service, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
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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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Chen P, Zhang L, Sun J, Xing Q, Shi D. Pre- and post-operative comprehensive nursing care versus conventional nursing care: An evaluation of quality of life, postoperative pain, adverse effects, and treatment satisfaction of patients who underwent surgeries and interventional therapies for liver cancer. Medicine (Baltimore) 2023; 102:e34643. [PMID: 37653829 PMCID: PMC10470759 DOI: 10.1097/md.0000000000034643] [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: 05/22/2023] [Revised: 06/22/2023] [Accepted: 07/17/2023] [Indexed: 09/02/2023] Open
Abstract
Interventional therapies including chemotherapies and radiotherapies are the most preferred treatment for liver cancer. However, these therapies have adverse effects. Therefore, careful care is required to relieve these adverse effects. The objectives of this study were to evaluate the quality of life, pain, anxiety, depression, adverse effects, and satisfaction of patients with liver cancer who received pre- and post-operative comprehensive nursing care against those of patients who received conventional nursing care. Patients with liver cancer who underwent surgeries and interventional therapies for liver cancer received pre- and post-operative comprehensive nursing care (CMN cohort, n = 105) or conventional nursing care (CNN cohort, n = 135), or did not receive any kind of nursing care (NNC cohort, n = 175). Before the non-treatment intervention(s) (BL), none of the patients had absent post-operative pain, all patients had mild or moderate anxiety and depression, and patients had ≤70 overall quality of life score. In the NNC cohort, a few of the patients reported being completely dissatisfied with overall personal satisfaction, and anxiety, depression, and overall the quality of life of patients were clinically worse during the follow-up period generally after completion of all doses of chemo radiotherapies (EL) as compared to BL. Hospital stays due to surgery, visual analog scale (VAS) score, Zung Self-rating Anxiety Scale score, the Self-rating Depression Scale score, and rehospitalization due to any reason(s) in follow-up were fewer and overall quality of life score and overall personal satisfaction score were higher for patients of the CMN cohort than those of patients at BL and those of patients of the CNN and the NNC cohorts at EL (P < .05 for all). Fever, bleeding, urinary retention, gastrointestinal disturbance, and hepatic and renal impairments reported in patients of the NNC cohort. Fever, bleeding, and urinary retention reported in patients of the CNN cohort (P < .05 for all). Nursing non-treatment intervention(s) is necessary for liver cancer patients after surgery, in the follow-up, and between 2 doses of chemoradiotherapies. Pre- and post-operative comprehensive nursing care relieves postoperative pain, psychological burden and improves quality of life in the follow-up period in patients who underwent surgeries and interventional therapies for liver cancer (Level of Evidence: IV; Technical Efficacy: Stage 5).
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Affiliation(s)
- PeiPei Chen
- Department of Hepatopancreatobiliary & Thyroid Breast, the first affiliated Hospital of Suchow University, Suzhou, Jiangsu, China
| | - LiQun Zhang
- Department of Hepatopancreatobiliary & Thyroid Breast, the first affiliated Hospital of Suchow University, Suzhou, Jiangsu, China
| | - JinFeng Sun
- Department of Hepatopancreatobiliary & Thyroid Breast, the first affiliated Hospital of Suchow University, Suzhou, Jiangsu, China
| | - QiaoYing Xing
- Department of Hepatopancreatobiliary & Thyroid Breast, the first affiliated Hospital of Suchow University, Suzhou, Jiangsu, China
| | - Dan Shi
- Department of Hepatopancreatobiliary & Thyroid Breast, the first affiliated Hospital of Suchow University, Suzhou, Jiangsu, China
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Sharbafchi MR, Malekian A, Ahmadzadeh Z, Torkian S, Baharizadeh A, Zarean E. Evaluate the Effectiveness of a Group Psychoeducational Intervention in Reducing the Level of Cancer-Related Fatigue in Women Receiving Chemotherapy for Breast Cancer: A Randomized Controlled Trial. Adv Biomed Res 2023; 12:151. [PMID: 37564460 PMCID: PMC10410410 DOI: 10.4103/abr.abr_137_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 02/10/2023] [Accepted: 02/13/2023] [Indexed: 08/12/2023] Open
Abstract
Background One of the most debilitating symptoms in breast cancer survivors is cancer-related fatigue (CRF). CRF weakens patients' physical, cognitive, and occupational functions. It is associated with poorer quality of life and may reduce recurrence-free and overall survival. This study aimed to evaluate the efficacy of a group psychoeducational intervention in improving CRF in breast cancer patients. Materials and Methods Fifty breast cancer patients who suffered from CRF were randomly assigned to receive a group psychoeducational intervention or control group. This study was designed as an eight weeks clinical trial. The psychoeducational intervention mainly consisted of concentrative movement therapy and energy conservation strategies. Primary outcome measures were the changes in the Fatigue Visual Analogue scale, Cancer Fatigue scale, and Piper Fatigue scale at the study endpoint. Measure assessments were made on four occasions: at baseline, after the intervention, one week, and four weeks post intervention. Statistical analysis was performed using SPSS26. Results The intervention improved CRF significantly (P < 0.001). All subscales of the Cancer Fatigue scale and the sensory, affective, and cognitive subscales of the Piper Fatigue scale showed statistically significant effects (P < 0.001) at all time points. However, the behavioral subscale of the Piper Fatigue scale was different only at the end of the study (P < 0.001). Conclusions The group psychoeducational intervention improved CRF significantly. All the sensory, behavioral, physical, affective, and cognitive subscales improved. Accessible and confirmatory treatment can help patients to cope with fatigue in communities.
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Affiliation(s)
- Mohammad Reza Sharbafchi
- Department of Psychiatry, School of Medicine, Isfahan University of Medical Sciences and Iranian Cancer Control Center (MACSA), Isfahan, Iran
| | - Azadeh Malekian
- Clinical Research Development Center (CRDC), Islamic Azad University, Najafabad Independent Branch, Najafabad, Iran
| | - Zahra Ahmadzadeh
- Cancer Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Samaneh Torkian
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Alireza Baharizadeh
- College of Skill and Entrepreneurship, Shahrekord Branch, Islamic Azad University, Shahrekord, Iran
| | - Elham Zarean
- Cancer Research Center and Department of Psychiatry, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
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8
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Bootsma TI, Schellekens MPJ, van Woezik RAM, van der Lee ML, Slatman J. Navigating severe chronic cancer-related fatigue: an interpretative phenomenological analysis. Psychol Health 2023; 38:494-517. [PMID: 34474619 DOI: 10.1080/08870446.2021.1973468] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE This article presents a phenomenological study on the embodied experiences of patients with Chronic Cancer-Related Fatigue (CCRF), aiming to better understand this complex phenomenon. DESIGN Data collection consisted of individual interviews with 25 participants who suffered from severe CCRF for at least three months after cancer treatment was finished. MAIN OUTCOME MEASURES Against the theoretical background of philosophical phenomenology, we explored embodied experiences, incorporated temporal and spatial aspects of living with CCRF. We applied interpretative phenomenological analysis (IPA) to analyze the transcripts of the interviews. RESULTS Using IPA, we identified four themes on how chronic fatigue is experienced post-cancer: (1) Worn out; (2) Diminishment of one's 'I can'; (3) Invisibility; and (4) Regaining one's 'I can'. CONCLUSION For clinical practice, these results imply that professionals could focus more on the role of the body and limitations of one's 'I can' when treating CCRF. By studying these embodied CCRF experiences in individual patients, future research could help personalize and optimize treatment.
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Affiliation(s)
- Tom I Bootsma
- Center for Psycho-Oncology, Scientific Research Department, Helen Dowling Institute, Bilthoven, The Netherlands.,School of Humanities and Digital Sciences, Department of Culture Studies, Tilburg University, Tilburg, The Netherlands
| | - Melanie P J Schellekens
- Center for Psycho-Oncology, Scientific Research Department, Helen Dowling Institute, Bilthoven, The Netherlands.,School of Social and Behavioral Sciences, Department of Medical and Clinical Psychology and Center of Research on Psychological disorders and Somatic diseases (CoRPS), Tilburg University, Tilburg, The Netherlands
| | - Rosalie A M van Woezik
- Center for Psycho-Oncology, Scientific Research Department, Helen Dowling Institute, Bilthoven, The Netherlands
| | - Marije L van der Lee
- Center for Psycho-Oncology, Scientific Research Department, Helen Dowling Institute, Bilthoven, The Netherlands.,School of Social and Behavioral Sciences, Department of Medical and Clinical Psychology and Center of Research on Psychological disorders and Somatic diseases (CoRPS), Tilburg University, Tilburg, The Netherlands
| | - Jenny Slatman
- School of Humanities and Digital Sciences, Department of Culture Studies, Tilburg University, Tilburg, The Netherlands
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Psychosocial Interventions for the Treatment of Cancer-Related Fatigue: An Umbrella Review. Curr Oncol 2023; 30:2954-2977. [PMID: 36975439 PMCID: PMC10047125 DOI: 10.3390/curroncol30030226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/04/2023] [Accepted: 02/15/2023] [Indexed: 03/06/2023] Open
Abstract
Cancer-related fatigue is one of the most common symptoms of cancer and one of those referred by patients as the most disabling. However, we still do not have enough evidence to allow us to recommend effective and personalized approaches. Goal: To provide evidence on the efficacy of ASCO-recommended psychosocial interventions for reducing cancer-related fatigue. Methodology: A general quantitative systematic review for nonprimary clinical interventions that allows the collection, synthesis and analysis of already published reviews. Systematic reviews of RTCs were selected as these make up the body of knowledge that provides the most evidence in an umbrella format. The results do not provide clear or comparable evidence regarding the different interventions, with moderate evidence standing out for cognitive interventions and mindfulness. Conclusions: Research gaps, study biases and the need for further research to ask more precise questions and to make reliable recommendations to mitigate the impact of cancer-related fatigue are evident.
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Maulidawati D, Rochmawati E, Granel N. Non-pharmacological management for chemotherapy-induced nausea and vomiting in patients with cancer: a scoping review †. FRONTIERS OF NURSING 2023. [DOI: 10.2478/fon-2023-0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
Abstract
Abstract
Objective
This review aimed to map and summarize published studies that tested non-pharmacological management for chemotherapy-induced nausea and vomiting (CINV).
Methods
We searched for eligible studies in 5 electronic databases and screened the retrieved studies using the inclusion and exclusion criteria. Data were then collated according to the types of interventions, measurement tool, and outcomes.
Results
The search yielded 2343 records, of which 11 were included. Four categories of non-pharmacological CINV management were made; manipulative and body-based therapy (n = 5 studies); mind–body therapy (n = 3 studies); biologically based practice (n = 1 study), and energy therapy (n = 2 studies). Seven different scales were used to measure CINV. Nine studies reported improvement in CINV.
Conclusions
This scoping review demonstrates the breadth of non-pharmacological management to address CINV. Various types of CINV scales were used to measure CINV severity. The management and scale can be utilized to improve nursing care, particularly in cancer care.
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Affiliation(s)
- Dewi Maulidawati
- a Department of Medical Surgical Nursing, Nursing Program , Universitas Muhammadiyah Yogyakarta, Jl Brawijaya , Tamantirto, Kasihan, Bantul , Indonesia
| | - Erna Rochmawati
- a Department of Medical Surgical Nursing, Nursing Program , Universitas Muhammadiyah Yogyakarta, Jl Brawijaya , Tamantirto, Kasihan, Bantul , Indonesia
| | - Nina Granel
- b Department of Nursing , Universitat Autònoma de Barcelona , Cerdanyola del Valles , Spain
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Stone P, Candelmi DE, Kandola K, Montero L, Smetham D, Suleman S, Fernando A, Rojí R. Management of Fatigue in Patients with Advanced Cancer. Curr Treat Options Oncol 2023; 24:93-107. [PMID: 36656503 PMCID: PMC9883329 DOI: 10.1007/s11864-022-01045-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2022] [Indexed: 01/20/2023]
Abstract
OPINION STATEMENT Fatigue is a common and distressing symptom experienced by patients with cancer. It is most common in patients with locally advanced or metastatic incurable disease. It can have profound effects on quality-of-life and physical functioning. In addition to general supportive measures (directed at tackling contributory conditions and comorbidities), a variety of specific interventions have been developed which can be broadly categorised as physical therapies, psychological therapies or medication. There is some evidence that each of these approaches can have benefits in patients with earlier stage disease, those undergoing active treatment and in cancer survivors. The best evidence is for aerobic exercise, yoga, cognitive-behavioural therapy (CBT) and psycho-educational interventions. Less strong evidence supports the use of medications such as methylphenidate or ginseng. In patients with advanced disease, it is likely that the mechanisms of fatigue or the factors contributing to fatigue maintenance may be different. Relatively fewer studies have been undertaken in this group and the evidence is correspondingly weaker. The authors recommend the cautious use of aerobic exercise (e.g. walking) in those who are still mobile. The authors advise considering the use of psycho-educational approaches or CBT in those patients who are able to engage in such forms of therapy. In patients near the end-of-life, the authors advise use of dexamethasone (short-term use) and other pharmacological treatments only on the basis of a clinical trial.
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Affiliation(s)
- Patrick Stone
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London (UCL), 6th Floor, Maple House, 149 Tottenham Court Road, W1T 7NF, London, UK
| | | | - Kerran Kandola
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London (UCL), 6th Floor, Maple House, 149 Tottenham Court Road, W1T 7NF, London, UK
| | - Ligia Montero
- departametno de Oncología de la Clinica Universidad de Navarra, Pamplona, Spain
| | - Dom Smetham
- Cancer Psychological Support Team, St George’s University Hospitals NHS Foundation Trust, London, UK
| | - Sahil Suleman
- Cancer Psychological Support Team, St George’s University Hospitals NHS Foundation Trust, London, UK
| | - Asanga Fernando
- Cancer Psychological Support Team, Department of Medical Oncology and Department of Liaison Psychiatry, St George’s University Hospitals NHS Foundation Trust, London, UK
| | - Rocío Rojí
- Paliative Medicine Department, Clinica Universidad de Navarra, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Navarra, Spain
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12
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Physical rehabilitation for the management of cancer-related fatigue during cytotoxic treatment: a systematic review with meta-analysis. Support Care Cancer 2023; 31:129. [PMID: 36683104 DOI: 10.1007/s00520-022-07549-7] [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: 08/29/2022] [Accepted: 12/16/2022] [Indexed: 01/24/2023]
Abstract
OBJECTIVE To assess the effect of physical therapy on cancer-related fatigue (CRF) during cytotoxic anticancer treatment. METHODS Systematic review with meta-analysis of randomized clinical trials published from 2010 to 2021 (EMBASE, MEDLINE, PEDro; SciELO, and LILACS). Studies assessing the effect of supervised physical therapy (IG) for the management of CRF on adults undergoing anticancer treatment compared with a control group (CG) covering usual care or any uncontrolled practice, such as recommendations about exercise and health education, were included in this review. RESULTS A total of 22 studies were included in the SR and 21 in the meta-analysis, resulting in 1.992 individuals (CG = 973 and IG = 1.019). There was a reduction in general fatigue [SMD = - 0.69; 95%CI (- 1.15, - 0.22) p < 0.01; I2 = 87%; NNT = 3], with greater weight attributed to combined exercise (44%). Physical fatigue also reduced [SMD = - 0.76; 95%CI (- 1.13, - 0.39) p < 0.01; I2 = 90%; NNT = 2], with greater weight for resistance exercise (50%) and greater effect with combined exercise [SMD = - 1.90; 95%CI (- 3.04, - 0.76) p < 0.01; I 2 = 96%]. There was reduction in general fatigue with moderate intensity (74%) [SMD = - 0.89; 95%CI (- 1.61, - 0.17) p < 0.02; I2 = 90%] and physical fatigue [SMD = - 1.00; 95%CI (- 1.54, - 0.46) p < 0.01; I2 = 92%], while high intensity reduced only general fatigue [SMD = - 0.35; 95%CI (- 0.51, - 0.20) p < 0.01; I2 = 0%]. The number of overall and weekly sessions has been shown to contribute to the reduction of CRF. CONCLUSION Physical rehabilitation with moderate intensity promoted greater relief of general and physical fatigue. Even after controlling for high heterogeneity, the quality of evidence, summarized in GRADE, was considered moderate for general fatigue and low for physical fatigue.
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13
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Beenhakker L, Witteveen A, Wijlens KAE, Siemerink EJM, van der Lee ML, Bode C, Siesling S, Vollenbroek‐Hutten MMR. Patient preference attributes in eHealth interventions for cancer-related fatigue: A scoping review. Eur J Cancer Care (Engl) 2022; 31:e13754. [PMID: 36385440 PMCID: PMC9786794 DOI: 10.1111/ecc.13754] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 10/05/2022] [Accepted: 10/09/2022] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Cancer-related fatigue (CRF) is one of the most reported long-term effects breast cancer patients experience after diagnosis. Many interventions for CRF are effective, however, not for every individual. Therefore, intervention advice should be adjusted to patients' preferences and characteristics. Our aim was to develop an overview of eHealth interventions and their (preference sensitive) attributes. METHODS eHealth interventions were identified using a scoping review approach. Eligible studies included breast cancer patients and assessed CRF as outcome. Interventions were categorised as physical activity, mind-body, psychological, 'other' or 'combination'. Information was extracted on various (preference sensitive) attributes, like duration, intensity, peer support and costs. RESULTS Thirty-five interventions were included and divided over the intervention categories. (Preference sensitive) attributes varied both within and between these categories. Duration varied from 4 weeks to 6 months, intensity from daily to own pace. Peer support was present in seven interventions and costs were known for six. CONCLUSION eHealth interventions exist in various categories, additionally, there is much variation in (preference sensitive) attributes. This provides opportunities to implement our overview for personalised treatment recommendations for breast cancer patients struggling with CRF. Taking into account patients' preferences and characteristics suits the complexity of CRF and heterogeneity of patients.
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Affiliation(s)
- Lian Beenhakker
- Department of Biomedical Signals and SystemsUniversity of TwenteEnschedeThe Netherlands
| | - Annemieke Witteveen
- Department of Biomedical Signals and SystemsUniversity of TwenteEnschedeThe Netherlands
| | - Kim A. E. Wijlens
- Department of Biomedical Signals and SystemsUniversity of TwenteEnschedeThe Netherlands
| | | | - Marije L. van der Lee
- Scientific Research DepartmentHelen Dowling InstituteBilthovenThe Netherlands,Department of Medical and Clinical Psychology, Center of Research on Psychology in Somatic diseasesTilburg UniversityTilburgThe Netherlands
| | - Christina Bode
- Department of Psychology, Health and TechnologyUniversity of TwenteEnschedeThe Netherlands
| | - Sabine Siesling
- Department of Health Technology and Services Research, Technical Medical CentreUniversity of TwenteEnschedeThe Netherlands,Department of Research and DevelopmentNetherlands Comprehensive Cancer Organisation (IKNL)UtrechtThe Netherlands
| | - Miriam M. R. Vollenbroek‐Hutten
- Department of Biomedical Signals and SystemsUniversity of TwenteEnschedeThe Netherlands,Board of DirectorsMedisch Spectrum TwenteEnschedeThe Netherlands
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Effect of Comprehensive Nursing Approach in Perioperative Stage of Patients with Hepatocellular Carcinoma Interventional Therapy. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:6862463. [PMID: 35966746 PMCID: PMC9374545 DOI: 10.1155/2022/6862463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/03/2022] [Accepted: 07/05/2022] [Indexed: 11/17/2022]
Abstract
Objective. To examine the efficacy of a complete nursing strategy during the perioperative phase for patients undergoing interventional treatment for hepatocellular cancer. Methods. Sixty patients who were diagnosed with liver cancer and underwent interventional therapy in our hospital between February 2019 and December 2021 were recruited in this trial. All study subjects were numbered according to the time when the patients first came to our hospital, and were equally divided into a comprehensive group and a conventional group based on the odd and even number of the last number, with 30 cases in each group. Those in the conventional group received conventional nursing care, whereas patients in the comprehensive group received comprehensive nursing care. Before and after the nursing intervention, the quality of life, pain, and patient satisfaction in both groups were compared. Results. The quality of survival scores, including physical, emotional, role, social, and cognitive function scores of patients in the comprehensive group, were significantly higher than those in the conventional group (
); there was no statistically significant difference in numeric rating scales (NRS) scores between the two groups compared before treatment (
). After treatment, the NRS scores of patients in the study group were significantly lower than those of patients in the control group (
); before the intervention, the difference between the emotional state scores of patients in the two groups was not significant and not statistically significant (
), while the emotional state of patients in both groups improved after the intervention, and the Self-Rating Anxiety Scale (SAS) and the Self-Rating Depression Scale (SDS) scores of patients in the comprehensive group were lower than those in the conventional group (
); the total incidence of adverse reactions in the comprehensive group (10.00%) was significantly lower than that in the conventional group (46.67%) (
); and the total satisfaction of patients in the comprehensive group (93.33%) was significantly higher than that of patients in the conventional group (73.33%) (
). Conclusion. The intervention of a comprehensive nursing approach in the perioperative period for patients with liver cancer is remarkable as it can relieve patients' psychological burden and pain, ensure a smooth operation, improve patients' postoperative quality of life, and also help to reduce the risk of postoperative adverse reactions, effectively enhancing patients’ satisfaction, and thus deserves to be promoted in clinical practice.
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Health-related quality of life in long-term Caribbean prostate cancer survivors: comparisons with prostate cancer-free men. Qual Life Res 2022; 31:3391-3401. [PMID: 35900615 DOI: 10.1007/s11136-022-03202-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2022] [Indexed: 11/12/2022]
Abstract
PURPOSE Prostate cancer (PCa) and its treatment can impact health-related quality of life (HRQoL). There are few studies of HRQoL in long-term PCa survivors of African ancestry from low- and middle-income countries. We examined the effect of PCa treatment on HRQoL of Jamaican PCa survivors compared with cancer-free controls and explored the effect of demographic and clinical factors on these outcomes. METHODS PCa survivors (n = 64) treated with and without ADT along with PCa-free controls (n = 88) from a case-control study of 10 years post enrolment. HRQoL was measured using the European Organisation for Research and Treatment of Cancer Quality of Life (EORTC-QLQ-C30). Effects of demographic and clinical variables on HRQoL on PCa and type of therapy were evaluated in multivariable linear regression models. RESULTS HRQoL of PCa survivors (overall and by treatment group) indicated a high quality of life, comparable to PCa-free men. However, ADT-treated survivors had lower physical functioning that was of small clinical relevance compared with those not on ADT. Symptom burden scores of PCa survivors and controls were similar excluding fatigue and dyspnoea which were highest in men on ADT and controls. In multivariable models, PCa was not an important determinant of overall HRQoL, functioning or symptom burdens. Underlying medical conditions and marital status were the main contributors to HRQoL in PCa survivors. CONCLUSION PCa cancer status was not an independent determinant of long-term HRQoL in Jamaican men. Interventions addressing social factors and comorbid illnesses could improve HRQOL in long-term PCa survivors.
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Montagut-Martínez P, Pérez-Cruzado D, Gutiérrez-Sánchez D. Cancer-related fatigue measures in palliative care: A psychometric systematic review. Eur J Cancer Care (Engl) 2022; 31:e13642. [PMID: 35822246 DOI: 10.1111/ecc.13642] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 04/26/2022] [Accepted: 06/06/2022] [Indexed: 01/21/2023]
Abstract
INTRODUCTION In palliative care, the prevention and relief of fatigue are regarded as crucial goals in patients with cancer. METHODS A systematic review was carried out according to the COnsensus-based Standards for the selection of health status Measurement INstruments methodology. Searches were conducted in Medline (through PubMed), Web of Science, Open Gray, Scielo, Cochrane, CINAHL and EMBASE. All instruments found in each study were assessed using the COnsensus-based Standards for the selection of health status Measurement INstruments checklist and Grading of Recommendations, Assessment, Development and Evaluation approach. RESULTS A total of 5598 articles were identified in the different databases. In total, 57 studies describing 19 instruments were included in this study. The main properties evaluated were internal consistency, cross-cultural validity, hypotheses testing and responsiveness. All studies were evaluated with the Strobe scale with a score greater than 6 points. CONCLUSIONS According to the quality methodological results, Edmonton Symptom Assessment System, Problems and Needs in Palliative Care Questionnaire, European Organisation for Research and Treatment of Cancer Quality of Life 15-item Questionnaire for Palliative Care and Palliative Care Quality of Life Instrument are the recommended instruments used for assessing cancer-related fatigue in palliative care. PROPESRO registration number: CRD42020206783.
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Affiliation(s)
| | - David Pérez-Cruzado
- Department of Occupational Therapy, Universidad Catolica de Murcia UCAM, Murcia, Spain.,Biomedical Research Institute of Málaga (IBIMA), Málaga, Spain
| | - Daniel Gutiérrez-Sánchez
- Biomedical Research Institute of Málaga (IBIMA), Málaga, Spain.,Department of Nursing and Podiatry, University of Málaga, Málaga, Spain
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Delgado-Bustamante RI, Rodríguez-Santillán E. Evidencia del ejercicio en el tratamiento de la fatiga relacionada al cáncer infantil. Revisión temática. Rev Salud Publica (Bogota) 2022. [DOI: 10.15446/rsap.v24n3.99217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objetivo Recopilar la evidencia más reciente que soporte el uso del ejercicio y la actividad física para disminuir la fatiga relacionada al cáncer infantil.
Métodos Se llevó a cabo una búsqueda electrónica de literatura no mayor a cinco años. Posteriormente, los artículos se agruparon en categorías por tipo de estudio y se analizaron sus resultados de acuerdo con el objetivo planteado.
Resultados Fueron incluidos 16 artículos de diferentes diseños, incluyendo estudios clínicos y revisiones sistemáticas. De manera general, se muestran diferencias significativas en favor del ejercicio para disminuir la fatiga; también se reportan efectos positivos en otros aspectos como la movilidad funcional y la calidad de vida.
Conclusión Se respalda la idea de continuar generando evidencias para conocer de manera más puntual la dosificación del ejercicio dependiendo de todas las variables que se pueden presentar en el pediátrico oncológico.
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18
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Zhang H, Duan Y, Zhou F. Explore the Application Value of Prospective Monitoring Model in the Nursing Management of Breast Cancer Patients During Perioperative Period. Front Surg 2022; 9:850662. [PMID: 35284475 PMCID: PMC8906514 DOI: 10.3389/fsurg.2022.850662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 01/31/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose To explore the application value of prospective monitoring model in the nursing management of breast cancer patients during perioperative period. Methods 300 perioperative breast cancer patients admitted to our hospital from January to August 2021 were randomly divided into the control group (n = 150) and the model group (n = 150). Both groups used routine nursing management, and the model group added nursing management based on a prospective monitoring model. The quality of surgical nursing, circumference of the upper limbs, and the scores of disability of arm-shoulder-hand (DASH), exerciseofself-care agencyscale (ESCA), social self-esteem scale (SSES), multidimensional fatigue symptom inventory-short form (MFSI-SF) and functional assessment of cancer therapy-breast cancer (FACT-B) were compared of the two groups. Results Postoperatively, the quality of surgical nursing was better in the model group than in the control group (P < 0.05). At 3 months postoperatively, the number of cases of upper limb lymphedema was higher in both groups than before (P < 0.05), but there was no statistical difference between the two groups in the preoperative and 3 months postoperative comparisons (P > 0.05). At 3 months postoperatively, the total DASH score was higher than preoperatively in both groups, but lower in the model group than in the control group (P < 0.05). After nursing, the ESCA and SSES scores of each dimension were higher in both groups than before, and the model group was higher than the control group (P < 0.05). At 3 months postoperatively, the total MFSI-SF score was lower than preoperatively in both groups, and lower in the model group than in the control group (P < 0.05). At 3 months postoperatively, the FACT-B scores of each dimensions were higher in the model group than in the control group (P < 0.05). Conclusion The implementation of nursing management based on a prospective monitoring model for breast cancer patients during the perioperative period has important clinical value in improving the quality of surgical nursing and improving postoperative upper limb lymphedema, upper limb function, self-care ability, social self-esteem, cancer-related fatigue symptoms, quality of life, etc.
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Fatigue in Persons With Heart Failure: A Systematic Literature Review and Meta-Synthesis Using the Biopsychosocial Model of Health. J Card Fail 2022; 28:283-315. [PMID: 34329719 PMCID: PMC8795245 DOI: 10.1016/j.cardfail.2021.07.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 06/27/2021] [Accepted: 07/08/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Fatigue is a common and distressing symptom of heart failure (HF) and has important implications for patient-reported and clinical outcomes. Despite being a common and bothersome symptom, fatigue has been understudied in HF. We sought to synthesize existing literature on fatigue in HF through a systematic literature review guided by the biopsychosocial model of health. METHODS AND RESULTS A systematic search of the literature was performed on March 18, 2020, using Pubmed, Embase, and CINAHL. Full-text, primary research articles, written in English, in which fatigue was a primary symptom of interest in adults with a diagnosis of HF, were included. The search yielded 1138 articles; 33 articles that met inclusion criteria were selected for extraction and synthesis. Biological and psychological factors associated with fatigue were New York Heart Association functional class, hemoglobin level, history of stroke, and depression. However, there are limited HF-specific factors linked to fatigue. Social factors related to fatigue included social roles, relationship strain, and loneliness and isolation. Few nonpharmacologic interventions have been tested by show some promise for alleviating fatigue in HF. Studies show conflicting evidence related to the prognostic implications of fatigue. CONCLUSIONS Important biological correlates of fatigue were identified; however, psychological and social variables were limited to qualitative description. There is need for expanded models to better understand the complex physiologic nature of fatigue in HF. Additionally, more research is needed to (1) define the relationships between fatigue and both psychological and social factors, (2) better describe the prognostic implications of fatigue, and (3) develop more therapeutic approaches to alleviate fatigue with the goal of improving overall quality of life.
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20
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Spahrkäs SS, Looijmans A, Sanderman R, Hagedoorn M. How does the Untire App alleviate Cancer‐Related Fatigue?A Longitudinal Mediation Analysis. Psychooncology 2022; 31:970-977. [PMID: 35060222 PMCID: PMC9303515 DOI: 10.1002/pon.5886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 12/13/2021] [Accepted: 01/07/2022] [Indexed: 11/08/2022]
Affiliation(s)
- Simon S. Spahrkäs
- Department of Health Psychology University Medical Center Groningen University of Groningen The Netherlands
| | - Anne Looijmans
- Department of Health Psychology University Medical Center Groningen University of Groningen The Netherlands
| | - Robbert Sanderman
- Department of Health Psychology University Medical Center Groningen University of Groningen, The Netherlands and Department of Psychology Health & Technology University of Twente The Netherlands
| | - Mariët Hagedoorn
- Department of Health Psychology University Medical Center Groningen University of Groningen The Netherlands
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21
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Profiling patient-reported symptom recovery from oesophagectomy for patients with oesophageal squamous cell carcinoma: a real-world longitudinal study. Support Care Cancer 2021; 30:2661-2670. [PMID: 34817693 DOI: 10.1007/s00520-021-06711-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 11/18/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE Oesophageal squamous cell carcinoma (ESCC) patients have severe symptom burden after oesophagectomy; however, longitudinal studies of symptom recovery after surgery are scarce. This study used longitudinal patient-reported outcome (PRO)-based symptoms to identify severe symptoms and profile symptom recovery from surgery in patients undergoing oesophagectomy. METHODS Oesophageal cancer patients (N = 327) underwent oesophagectomy were consecutively included between April 2019 and March 2020. Data were extracted from the Sichuan Cancer Hospital's Esophageal Cancer Case Management Registration Database. Symptom assessment time points were pre-surgery and 1, 3, 5, 7, 14, 21, 30, and 90 days post-surgery using the Chinese version of the MD Anderson Symptom Inventory. And each symptom was rated on an 11-point scale, with 0 being 'not present' and 10 being 'as bad as you can imagine'. The symptom recovery trajectories were profiled using mixed effect models and Kaplan-Meier analysis. RESULTS The most-severe symptoms on day 1 after oesophagectomy were pain, fatigue, dry mouth, disturbed sleep, and distress. The severity of symptoms peaked on day 1 after surgery. The top two symptoms were fatigue (mean: 5.44 [SD 1.88]) and pain (mean: 5.23 [SD 1.29]). Fatigue was more severe 90 days after surgery than at baseline (mean: 1.77 [SD 1.47] vs 0.65 [SD 1.05]; P < .0001). Disturbed sleep and distress persisted from pre-surgery to 90 days post-surgery; average sleep recovery time was up to 20 days, and 50.58% of patients had sleep disturbances 90 days post-surgery. CONCLUSIONS Early post-operative pain management after oesophagectomy should be considered. Characteristics and intervention strategies of post-operative fatigue, distress, and disturbed sleep in oesophageal cancer patients warrant further studies.
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Yang W, Xi J, Guo L, Cao Z. Nurse-led exercise and cognitive-behavioral care against nurse-led usual care between and after chemotherapy cycles in Han Chinese women of ovarian cancer with moderate to severe levels of cancer-related fatigue: A retrospective analysis of the effectiveness. Medicine (Baltimore) 2021; 100:e27317. [PMID: 34871205 PMCID: PMC8568398 DOI: 10.1097/md.0000000000027317] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 09/07/2021] [Indexed: 01/05/2023] Open
Abstract
Women with ovarian cancer are reported to fatigue over time. Moderate to severe levels of cancer-related fatigue is fluent in Han Chinese patients with cancer. Comprehensive Cancer Network guidelines are recommending exercise and cognitive behavioral therapy to reduce cancer-related fatigue. Exercise is an easy, cost-effective, and non-pharmacological approach. The objective of the study was to evaluate the effectiveness of nurse-led exercise and cognitive-behavioral care against nurse-led usual care in Han Chinese women of ovarian cancer regarding cancer-related fatigue, depressive symptoms, and sleep quality.Han Chinese women with moderate to severe levels of cancer-related fatigue have received 30 minutes, 5 times/week nurse-led exercise and 60 min/week cognitive-behavioral care (EC cohort, n = 118) or nurse-led usual care regarding educations and recommendations only (UC cohort, n = 126) or have not received nurse-led exercise, cognitive-behavioral care, educations, and recommendations (NC cohort, n = 145) between and after chemotherapy cycles. The Piper Fatigue Scale, the Zung Self-rating Depression Scale, and Pittsburgh Sleep Quality Index questionnaires were evaluated at the start and the end of non-pharmacological treatment.At the end of treatment as compared to the start of treatment, only women of EC cohort had decrease Piper Fatigue Scale (5.40 ± 1.49/woman vs 6.06 ± 1.49/woman, P < .0001, q = 4.973) and Zung Self-rating Depression Scale score (48.67 ± 4.24/woman vs 49.93 ± 4.29/woman, P = .001, q = 3.449). Also, at the end of treatment, as compared to the start of treatment, only women of EC cohort have increased Pittsburgh Sleep Quality Index score (14.76 ± 2.18/woman vs 13.94 ± 2.90/woman, P = .045, q = 3.523). Only exercise and cognitive-behavioral care were successful in a decrease in the numbers of women with depression (the Mandarin Chinese version of the Zung Self-rating Depression Scale score >53, 32 vs 16, P = .015).Nurse-led exercise and cognitive-behavioral care can help Han Chinese women with ovarian cancer to decrease cancer-related fatigue and depression. Also, it can improve the quality of sleep.Evidence Level: 4.Technical Efficacy: Stage 5.
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Affiliation(s)
- Wei Yang
- Department of Obstetrics and Gynecology, Shanghai Fourth People's Hospital, No. 1279 Sanmen Road, Hongkou District, Shanghai, China
| | - Jia Xi
- Department of Nursing, Shanghai Fourth People's Hospital, No. 1279 Sanmen Road, Hongkou District, Shanghai, China
| | - Lingxin Guo
- Department of Gynecology, The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, No. 910 Hengshan Road, Xuhui District, Shanghai, China
| | - Zhefei Cao
- Department of Nursing, Shanghai Fourth People's Hospital, No. 1279 Sanmen Road, Hongkou District, Shanghai, China
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Liu Y, Xu P, Song C, Jiang T, Liu JE, Shi T. The effectiveness of non-pharmacological interventions on cancer related fatigue in breast cancer patients: A protocol for systematic review and network meta-analysis. Nurs Open 2021; 9:851-855. [PMID: 34725949 PMCID: PMC8685844 DOI: 10.1002/nop2.1118] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 09/14/2021] [Accepted: 10/14/2021] [Indexed: 12/22/2022] Open
Abstract
AIM To assess the effect of different non-pharmacological interventions on cancer-related fatigue (CRF) in breast cancer (BC) patients and identify the most effective method for improving CRF. DESIGN A systematic review and network meta-analysis. METHODS Literature will be searched in the ongoing trail in the Clinical Trials.gov, World Health Organization, the International Clinical Trials Registry Platform, Cochrane Library, PubMed, EMBASE, Web of Science and CINAHL, from the inception until December 31, 2020. Two independent researchers will rigorously screen the literature according to the inclusion and exclusion criteria and assess the risk of bias based on the Cochrane Collaboration's Tool of RCTs. Stata 13.0 and Aggregate Data Drug Information System will be used for data analysis. RESULTS This protocol has been registered on the PROSPERO website (registration number is CRD42020222093). This study will provide the reliable evidence of the most effective non-pharmacological intervention to improving CRF.
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Affiliation(s)
- Yu Liu
- Department of Nursing, The First Affiliated Hospital of Dalian Medical University, Dalian, China.,School of Nursing, Capital Medical University, Beijing, China
| | - Pengzhu Xu
- Department of Nursing, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Chunli Song
- Department of Nursing, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Tongtong Jiang
- Department of Nursing, The First Affiliated Hospital of Dalian Medical University, Dalian, China.,Nursing College, Chiba University, Chiba, Japan
| | - Jun-E Liu
- School of Nursing, Capital Medical University, Beijing, China
| | - Tieying Shi
- Department of Nursing, The First Affiliated Hospital of Dalian Medical University, Dalian, China
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Adam S, Thong MSY, Martin-Diener E, Camey B, Egger Hayoz C, Konzelmann I, Mousavi SM, Herrmann C, Rohrmann S, Wanner M, Staehelin K, Strebel RT, Randazzo M, John H, Schmid HP, Feller A, Arndt V. Identifying classes of the pain, fatigue, and depression symptom cluster in long-term prostate cancer survivors-results from the multi-regional Prostate Cancer Survivorship Study in Switzerland (PROCAS). Support Care Cancer 2021; 29:6259-6269. [PMID: 33847829 PMCID: PMC8464556 DOI: 10.1007/s00520-021-06132-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 03/04/2021] [Indexed: 12/25/2022]
Abstract
PURPOSE Aside from urological and sexual problems, long-term (≥5 years after initial diagnosis) prostate cancer (PC) survivors might suffer from pain, fatigue, and depression. These concurrent symptoms can form a cluster. In this study, we aimed to investigate classes of this symptom cluster in long-term PC survivors, to classify PC survivors accordingly, and to explore associations between classes of this cluster and health-related quality of life (HRQoL). METHODS Six hundred fifty-three stage T1-T3N0M0 survivors were identified from the Prostate Cancer Survivorship in Switzerland (PROCAS) study. Fatigue was assessed with the EORTC QLQ-FA12, depressive symptoms with the MHI-5, and pain with the EORTC QLQ-C30 questionnaire. Latent class analysis was used to derive cluster classes. Factors associated with the derived classes were determined using multinomial logistic regression analysis. RESULTS Three classes were identified: class 1 (61.4%) - "low pain, low physical and emotional fatigue, moderate depressive symptoms"; class 2 (15.1%) - "low physical fatigue and pain, moderate emotional fatigue, high depressive symptoms"; class 3 (23.5%) - high scores for all symptoms. Survivors in classes 2 and 3 were more likely to be physically inactive, report a history of depression or some other specific comorbidity, be treated with radiation therapy, and have worse HRQoL outcomes compared to class 1. CONCLUSION Three distinct classes of the pain, fatigue, and depression cluster were identified, which are associated with treatment, comorbidities, lifestyle factors, and HRQoL outcomes. Improving classification of PC survivors according to severity of multiple symptoms could assist in developing interventions tailored to survivors' needs.
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Affiliation(s)
- Salome Adam
- National Institute for Cancer Epidemiology and Registration (NICER), c/o University of Zurich, Zurich, Switzerland
- Division of Chronic Disease Epidemiology, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Melissa S Y Thong
- Unit of Cancer Survivorship, German Cancer Research Center (DKFZ), Heidelberg, Germany.
| | - Eva Martin-Diener
- Division of Chronic Disease Epidemiology, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | | | | | | | - Seyed Mohsen Mousavi
- Cancer Registry East Switzerland, St. Gallen, Switzerland
- Cancer Registry Graubünden and Glarus, Chur, Switzerland
| | - Christian Herrmann
- Cancer Registry East Switzerland, St. Gallen, Switzerland
- Cancer Registry Graubünden and Glarus, Chur, Switzerland
| | - Sabine Rohrmann
- Division of Chronic Disease Epidemiology, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
- Cancer Registry Zurich, Zug, Schaffhausen and Schwyz, University Hospital Zurich, Zurich, Switzerland
| | - Miriam Wanner
- Division of Chronic Disease Epidemiology, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
- Cancer Registry Zurich, Zug, Schaffhausen and Schwyz, University Hospital Zurich, Zurich, Switzerland
| | | | - Räto T Strebel
- Department of Urology, Graubünden Cantonal Hospital, Chur, Switzerland
| | - Marco Randazzo
- Department of Urology, GZO Spital Wetzikon AG, Wetzikon, Switzerland
- Department of Urology, Winterthur Cantonal Hospital, Winterthur, Switzerland
| | - Hubert John
- Department of Urology, Winterthur Cantonal Hospital, Winterthur, Switzerland
| | - Hans-Peter Schmid
- Department of Urology, School of Medicine (Med-HSG), St. Gallen, Switzerland
| | - Anita Feller
- National Institute for Cancer Epidemiology and Registration (NICER), c/o University of Zurich, Zurich, Switzerland
| | - Volker Arndt
- National Institute for Cancer Epidemiology and Registration (NICER), c/o University of Zurich, Zurich, Switzerland
- Unit of Cancer Survivorship, German Cancer Research Center (DKFZ), Heidelberg, Germany
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Wyatt G, Lehto R, Guha-Niyogi P, Brewer S, Victorson D, Pace T, Badger T, Sikorskii A. Reflexology and meditative practices for symptom management among people with cancer: Results from a sequential multiple assignment randomized trial. Res Nurs Health 2021; 44:796-810. [PMID: 34515341 PMCID: PMC8438223 DOI: 10.1002/nur.22169] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 06/03/2021] [Accepted: 07/03/2021] [Indexed: 12/12/2022]
Abstract
Optimal sequencing of complementary therapies can help improve symptom management through nonpharmacological approaches. A 12-week sequential multiple assignment randomized trial comparing home-based reflexology and meditative practices on severity of fatigue and other symptoms was conducted among patients with cancer and their informal caregivers. Dyads were initially randomized to reflexology (N = 150), meditative practices (N = 150), or control (N = 47). If patient's fatigue did not improve (nonresponse) after 4 weeks of reflexology or meditative practices, the dyad was rerandomized to either add the other therapy or continue with the original therapy for weeks 5-8. Four decision rules (DRs) were compared: (1) Initiating reflexology, and if nonresponse on fatigue after 4 weeks, continue with reflexology for another 4 weeks, thus providing a higher dose; (2) Initiating reflexology, and if nonresponse on fatigue after 4 weeks, add meditative practices for the next 4 weeks; (3) Initiating meditative practices, and if nonresponse on fatigue after 4 weeks, continue meditative practices for another 4 weeks, thus providing a higher dose; and (4) Initiating meditative practices, and if nonresponse on fatigue after 4 weeks, add reflexology for the next 4 weeks. Symptoms were evaluated weekly using the M.D. Anderson Symptom Inventory (MDASI). Clinically, nurses can recommend either therapy since no differences were found among the 4 DRs, with the exception of lower severity for summed MDASI symptoms at week 8 for the use of reflexology only (DR-1) versus DR-2 (sequencing reflexology to meditative practices). Adding the other therapy for nonresponders after 4 weeks may not be warranted.
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Affiliation(s)
- Gwen Wyatt
- College of Nursing, Michigan State University, East Lansing, Michigan, USA
| | - Rebecca Lehto
- College of Nursing, Michigan State University, East Lansing, Michigan, USA
| | - Pratim Guha-Niyogi
- Department of Statistics and Probability, Michigan State University, East Lansing, Michigan, USA
| | - Sarah Brewer
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, Michigan, USA
| | - David Victorson
- Feinberg School of Medicine, Northwestern University, Evanston, Illinois, USA
| | - Thaddeus Pace
- University of Arizona College of Nursing, Tucson, Arizona, USA
| | - Terry Badger
- University of Arizona College of Nursing, Tucson, Arizona, USA
| | - Alla Sikorskii
- Department of Psychiatry, Michigan State University, East Lansing, Michigan, USA
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Sun X, Chen Y, Cheung WK, Wu IX, Xiao F, Chung VC. Pharmacological Interventions for the Management of Cancer-Related Fatigue Among Cancer Survivors: Systematic Review and Meta-Analysis. Integr Cancer Ther 2021; 20:15347354211038008. [PMID: 34369188 PMCID: PMC8358505 DOI: 10.1177/15347354211038008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Current guidelines have different recommendations on applying pharmacological interventions for managing cancer-related fatigue (CRF) among cancer survivors. This systematic review aims to synthesize clinical evidence on pharmacological interventions for managing CRF. METHODS Five databases were searched for potential randomized controlled trials (RCTs) from their inception until October 2020. RCTs assessing the effect of pharmacological treatments for CRF among cancer survivors were considered eligible. Clinical significance was determined by comparing the estimated effect with that of minimal important difference (MID). The risk of bias of each included RCT was appraised using the Cochrane risk of bias tool for randomized trials 2. Data were synthesized using random-effect pairwise meta-analyses. RESULTS A total of 15 RCTs (1238 participants) were included. The majority presented some concerns of bias arising from the randomization process and selection of the reported results. Meta-analysis showed that psychostimulant and wakefulness agents had statistically significant while clinically insignificant effects on the treatment of CRF (pooled weighted mean difference [WMD]: 2.8, 95% confidence interval [CI]: 0.2-5.4, I2: 0%, 3 RCTs, MID: 3.0-6.0). Three natural products, including Renshen Yangrong Tang (mean difference [MD]: -16.1, 95% CI: -8.9 to -23.3, MID: -17.3 to -11.4), Tualang honey (MD: 11.2, 95% CI: 7.1-15.3, MID: 3.0-6.0), and Shenmai injection plus Peptisorb (MD: -1.6, 95% CI: -2.1 to -1.1, MID: -1.1 to -0.8) demonstrated statistically and clinically significant effect in reducing CRF. CONCLUSIONS Existing evidence showed promising effects of 3 natural products in reducing CRF among cancer survivors. The results from this study need to be further confirmed with well-designed and adequately powered RCTs that use validated instruments for the measurement of CRF.
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Affiliation(s)
- Xuemei Sun
- Central South University, Changsha, Hunan, China
| | - Yancong Chen
- Central South University, Changsha, Hunan, China
| | | | - Irene Xy Wu
- Central South University, Changsha, Hunan, China.,Hunan Provincial Key Laboratory of Clinical Epidemiology, Changsha, China
| | - Fang Xiao
- Central South University, Changsha, Hunan, China
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Martínez-Miranda P, Casuso-Holgado MJ, Jesús Jiménez-Rejano J. Effect of patient education on quality-of-life, pain and fatigue in breast cancer survivors: A systematic review and meta-analysis. Clin Rehabil 2021; 35:1722-1742. [PMID: 34266300 DOI: 10.1177/02692155211031081] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To synthesise the existing evidence about the effect of patient education, either used alone or as adjunctive therapy, on the improvement of quality of life, pain and fatigue in adult breast cancer survivors. DATA SOURCES We searched PubMed, Web of Science, CINAHL, SCOPUS, Cochrane Plus, PEDro, Dialnet and Clinicaltrials.gov databases. METHODS We conducted this systematic review in accordance with the PRISMA statement. Only randomised controlled trials with adult breast cancer survivors were included. We assessed the methodological quality of the studies using the PEDro scale and the Cochrane risk-of-bias tool. We synthesised evidence using the GRADE tool. RESULTS We included 14 studies (PEDro 4-8 points) comprising 1749 adult women who survived breast cancer, of which we included 12 in the quantitative analysis. There were statistically significant short-term benefits for improved global quality-of-life (standardised mean difference [SMD] = 0.43, P = 0.05, 95% CI [0.00, 0.85]; GRADE: low certainty; not important), emotional quality-of-life (SMD = 0.32, P = 0.04, 95% CI [0.02, 0.62]) and fatigue (SMD = 0.24, P = 0.0004, 95% CI [0.11, 0.37]; GRADE: low certainty; not important). However, there were not statistically significant for pain severity (SMD = -0.05, P = 0.67, 95% CI [-0.26, 0.17]; GRADE: low certainty; not important) and fear to recurrence (SMD = -0.05, P = 0.68, 95% CI [-0.31, 0.20]; GRADE: moderate certainty; not important). CONCLUSION Patient education have a significative effect in short-term global quality-of-life, emotional quality-of-life and fatigue, though all the results were classified as 'not important'.
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Affiliation(s)
- Patricia Martínez-Miranda
- Department of Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Universidad de Sevilla, Sevilla, Spain
| | - María Jesús Casuso-Holgado
- Department of Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Universidad de Sevilla, Sevilla, Spain
| | - José Jesús Jiménez-Rejano
- Department of Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Universidad de Sevilla, Sevilla, Spain
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Porter KJ, Moon KE, LeBaron VT, Zoellner JM. A Novel Behavioral Intervention for Rural Appalachian Cancer Survivors (weSurvive): Participatory Development and Proof-of-Concept Testing. JMIR Cancer 2021; 7:e26010. [PMID: 33843597 PMCID: PMC8076984 DOI: 10.2196/26010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 01/04/2021] [Accepted: 01/14/2021] [Indexed: 11/23/2022] Open
Abstract
Background Addressing the modifiable health behaviors of cancer survivors is important in rural communities that are disproportionately impacted by cancer (eg, those in Central Appalachia). However, such efforts are limited, and existing interventions may not meet the needs of rural communities. Objective This study describes the development and proof-of-concept testing of weSurvive, a behavioral intervention for rural Appalachian cancer survivors. Methods The Obesity-Related Behavioral Intervention Trials (ORBIT) model, a systematic model for designing behavioral interventions, informed the study design. An advisory team (n=10) of community stakeholders and researchers engaged in a participatory process to identify desirable features for interventions targeting rural cancer survivors. The resulting multimodal, 13-week weSurvive intervention was delivered to 12 participants across the two cohorts. Intervention components included in-person group classes and group and individualized telehealth calls. Indicators reflecting five feasibility domains (acceptability, demand, practicality, implementation, and limited efficacy) were measured using concurrent mixed methods. Pre-post changes and effect sizes were assessed for limited efficacy data. Descriptive statistics and content analysis were used to summarize data for other domains. Results Participants reported high program satisfaction (acceptability). Indicators of demand included enrollment of cancer survivors with various cancer types and attrition (1/12, 8%), recruitment (12/41, 30%), and attendance (median 62%) rates. Dietary (7/12, 59%) and physical activity (PA; 10/12, 83%) behaviors were the most frequently chosen behavioral targets. However, the findings indicate that participants did not fully engage in action planning activities, including setting specific goals. Implementation indicators showed 100% researcher fidelity to delivery and retention protocols, whereas practicality indicators highlighted participation barriers. Pre-post changes in limited efficacy outcomes regarding cancer-specific beliefs and knowledge and behavior-specific self-efficacy, intentions, and behaviors were in desired directions and demonstrated small and moderate effect sizes. Regarding dietary and PA behaviors, effect sizes for fruit and vegetable intake, snacks, dietary fat, and minutes of moderate-to-vigorous activity were small (Cohen d=0.00 to 0.32), whereas the effect sizes for change in PA were small to medium (Cohen d=0.22 to 0.45). Conclusions weSurvive has the potential to be a feasible intervention for rural Appalachian cancer survivors. It will be refined and further tested based on the study findings, which also provide recommendations for other behavioral interventions targeting rural cancer survivors. Recommendations included adding additional recruitment and engagement strategies to increase demand and practicality as well as increasing accountability and motivation for participant involvement in self-monitoring activities through the use of technology (eg, text messaging). Furthermore, this study highlights the importance of using a systematic model (eg, the ORBIT framework) and small-scale proof-of-concept studies when adapting or developing behavioral interventions, as doing so identifies the intervention’s potential for feasibility and areas that need improvement before time- and resource-intensive efficacy trials. This could support a more efficient translation into practice.
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Affiliation(s)
- Kathleen J Porter
- Department of Public Health Sciences, School of Medicine, University of Virginia, Christiansburg, VA, United States
| | - Katherine E Moon
- Department of Public Health Sciences, School of Medicine, University of Virginia, Christiansburg, VA, United States
| | - Virginia T LeBaron
- Department of Acute & Specialty Care, School of Nursing, University of Virginia, Charlottesville, VA, United States
| | - Jamie M Zoellner
- Department of Public Health Sciences, School of Medicine, University of Virginia, Christiansburg, VA, United States
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Vollbracht C, Kraft K. Feasibility of Vitamin C in the Treatment of Post Viral Fatigue with Focus on Long COVID, Based on a Systematic Review of IV Vitamin C on Fatigue. Nutrients 2021; 13:1154. [PMID: 33807280 PMCID: PMC8066596 DOI: 10.3390/nu13041154] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 03/25/2021] [Accepted: 03/27/2021] [Indexed: 12/13/2022] Open
Abstract
Fatigue is common not only in cancer patients but also after viral and other infections. Effective treatment options are still very rare. Therefore, the present knowledge on the pathophysiology of fatigue and the potential positive impact of treatment with vitamin C is illustrated. Additionally, the effectiveness of high-dose IV vitamin C in fatigue resulting from various diseases was assessed by a systematic literature review in order to assess the feasibility of vitamin C in post-viral, especially in long COVID, fatigue. Nine clinical studies with 720 participants were identified. Three of the four controlled trials observed a significant decrease in fatigue scores in the vitamin C group compared to the control group. Four of the five observational or before-and-after studies observed a significant reduction in pre-post levels of fatigue. Attendant symptoms of fatigue such as sleep disturbances, lack of concentration, depression, and pain were also frequently alleviated. Oxidative stress, inflammation, and circulatory disorders, which are important contributors to fatigue, are also discussed in long COVID fatigue. Thus, the antioxidant, anti-inflammatory, endothelial-restoring, and immunomodulatory effects of high-dose IV vitamin C might be a suitable treatment option.
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Affiliation(s)
- Claudia Vollbracht
- Medical Science Department, Pascoe Pharmazeutische Präparate GmbH, 35383 Giessen, Germany
- Department of Internal Medicine, University Medicine Rostock, 18057 Rostock, Germany;
| | - Karin Kraft
- Department of Internal Medicine, University Medicine Rostock, 18057 Rostock, Germany;
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Yeun EJ, Jeon M. Attitudes About Coping With Fatigue in Patients With Gastric Cancer: A Q-Methodology Study. Gastroenterol Nurs 2020; 43:97-105. [PMID: 31990878 DOI: 10.1097/sga.0000000000000390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Cancer-related fatigue is the most common symptom in patients with cancer. Coping methods for cancer-related fatigue differ from those of patients without cancer, as the situations faced by patients with cancer are unique. This study aimed to identify subjectivity concerning coping with fatigue in Korean patients with gastric cancer. Q-methodology was used to examine subjective perceptions regarding coping with fatigue among Korean patients with gastric cancer. A convenience sample of 33 participants, who had been hospitalized in 2 university hospitals in South Korea, was recruited to participate in the study and 37 selected Q-samples were classified into a normal forced distribution using a 9-point bipolar grid. The obtained data were analyzed by using PC-QUANL for Windows. Three factors representing distinct attitudes about coping with fatigue emerged among Korean patients with gastric cancer: an optimistic mind, dependency on medicine, and exercise preference. The 3 factors explained 39.4% of the total variance (23.7%, 7.9%, and 7.8%, respectively). Based on the study findings, it is important to develop customized nursing interventions that consider the characteristics of each patient group with gastric cancer. Health professionals should assess the attitudes of patients with gastric cancer about coping with fatigue, explore their situation, and consider their lifestyle.
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Affiliation(s)
- Eun Ja Yeun
- Eun Ja Yeun, PhD, RN, is Professor, Department of Nursing, Konkuk University, Chungju, Chungbuk, Republic of Korea. Misoon Jeon, PhD, RN, is Professor, Department of Nursing, Baekseok University, Cheonan, Chungnam, Republic of Korea
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ÖCALAN S, ÜZAR ÖZÇETİN YS. Kanser Deneyiminde Ruminasyon, Tükenmişlik ve Psikolojik Sağlamlık. PSIKIYATRIDE GUNCEL YAKLASIMLAR 2020. [DOI: 10.18863/pgy.664396] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Cooking for Vitality: Pilot Study of an Innovative Culinary Nutrition Intervention for Cancer-Related Fatigue in Cancer Survivors. Nutrients 2020; 12:nu12092760. [PMID: 32927752 PMCID: PMC7551599 DOI: 10.3390/nu12092760] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 09/04/2020] [Accepted: 09/07/2020] [Indexed: 12/21/2022] Open
Abstract
(1) Background: Cancer-related fatigue (CRF) is one of the most prevalent and distressing side effects experienced by patients with cancer during and after treatment, and this negatively impacts all aspects of quality of life. An increasing body of evidence supports the role of poor nutritional status in the etiology of CRF and of specific diets in mitigating CRF. We designed a group-based two session culinary nutrition intervention for CRF, Cooking for Vitality (C4V), aimed at increasing understanding of how food choices can impact energy levels and establishing basic food preparation and cooking skills as well as the application of culinary techniques that minimize the effort/energy required to prepare meals. The purpose of this pilot mixed-method study was to evaluate: Feasibility of the experimental methods and intervention; acceptability and perceived helpfulness of intervention; and to obtain a preliminary estimate of the effectiveness of the intervention on fatigue (primary outcome), energy, overall disability, and confidence to manage fatigue (secondary outcomes). (2) Methods: Prospective, single arm, embedded mixed-methods feasibility study of cancer survivors with cancer-related fatigue was conducted. Participants completed measures at baseline (T0), immediately following the intervention (T1), and three months after the last session (T2). Qualitative interviews were conducted at T2. (3) Results: Recruitment (70%) and retention (72%) rates along with qualitative findings support the feasibility of the C4V intervention for cancer survivors living with CRF (program length and frequency, ease of implementation, and program flexibility). Acceptability was also high and participants provided useful feedback for program improvements. Fatigue (FACT-F) scores significantly improved from T0–T1 and T0–T2 (p < 0.001). There was also a significant decrease in disability scores (WHO-DAS 2.0) from T0–T2 (p = 0.006) and an increase in POMS-Vigor (Profile of Mood States) from T0–T1 (p = 0.018) and T0–T2 (p = 0.013). Confidence in managing fatigue improved significantly from T0–T1 and T0–T2 (p < 0.001). (4) Conclusions: The results suggest that the C4V program was acceptable and helpful to patients and may be effective in improving fatigue levels and self-management skills. A randomized controlled trial is required to confirm these findings.
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Meier-Girard D, Ribi K, Gerstenberg G, Ruhstaller T, Wolf U. Eurythmy therapy versus slow movement fitness in the treatment of fatigue in metastatic breast cancer patients: study protocol for a randomized controlled trial. Trials 2020; 21:612. [PMID: 32631427 PMCID: PMC7336433 DOI: 10.1186/s13063-020-04542-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 06/21/2020] [Indexed: 02/06/2023] Open
Abstract
Background Cancer-related fatigue (CRF) is the most taxing symptom for many breast cancer patients during and after therapy. In patients with metastatic disease, the prevalence of CRF exceeds 75%. Currently, there is no gold standard for the treatment of CRF. Physical activity can reduce CRF and is recommended during and after cancer treatment, but may be too burdensome for patients with metastatic breast cancer. The aim of this study is to assess the effect on fatigue of eurythmy therapy (ERYT) compared to slow movement fitness (CoordiFit) in metastatic breast cancer patients. Methods The ERYT/CoordiFit study is a randomized controlled, open-label, two-arm, multi-center Swiss clinical trial. A sample of 196 patients presenting with CRF will be recruited by oncologists from the departments of clinical oncology at each local study site. All participants will be randomly allocated to the intervention or control group in a 1:1 ratio. The control group is an active control intervention (CoordiFit) in order to control for potential non-intended effects such as therapist-patient interaction and participation in a program. Both ERYT and CoordiFit exercises are easy to learn, and the training sessions will follow the same frequency and duration schedule, i.e., 13 standardized therapy sessions of 45 min (once a week for 6 weeks and then once every second week) during the total intervention period of 20 weeks. The primary endpoint of the study is the change from baseline over the whole intervention period (i.e., including measurements at baseline, weeks 8, 14, and 20) in the Functional Assessment of Chronic Illness Therapy – Fatigue (FACIT-F) subscale score. Discussion This study is the first-known randomized clinical trial assessing eurythmy therapy in the treatment of fatigue in metastatic breast cancer patients. Given the distress that fatigue causes patients, it is important to validate treatment options. If eurythmy therapy proves beneficial in CRF as part of this randomized controlled clinical trial, the study may be very impactful with implications not only for metastatic breast cancer patients but also for other cancer patients, health care personnel, scientists, and funding and regulatory bodies. Trial registration The ERYT/CoordiFit trial was registered at the US National Institutes of Health (ClinicalTrials.gov) on July 18, 2019, #NCT04024267, and in the portal for human research in Switzerland on December 3, 2019, #SNCTP000003525.
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Affiliation(s)
- Delphine Meier-Girard
- Institute of Complementary and Integrative Medicine, University of Bern, Fabrikstrasse 8, 3012, Bern, Switzerland.
| | - Karin Ribi
- International Breast Cancer Study Group, Coordinating Center, Bern, Switzerland
| | - Gisa Gerstenberg
- Institute of Complementary and Integrative Medicine, University of Bern, Fabrikstrasse 8, 3012, Bern, Switzerland
| | | | - Ursula Wolf
- Institute of Complementary and Integrative Medicine, University of Bern, Fabrikstrasse 8, 3012, Bern, Switzerland
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Corbett TK, Groarke A, Devane D, Carr E, Walsh JC, McGuire BE. The effectiveness of psychological interventions for fatigue in cancer survivors: systematic review of randomised controlled trials. Syst Rev 2019; 8:324. [PMID: 31836007 PMCID: PMC6911282 DOI: 10.1186/s13643-019-1230-2] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 11/12/2019] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Fatigue is a common symptom in cancer patients that can persist beyond the curative treatment phase. This systematic review evaluated the effectiveness of psychological interventions for cancer-related fatigue in post-treatment cancer survivors. METHODS We searched relevant online databases and sources of grey literature. Randomised controlled trials (RCTs) evaluating psychological interventions in adult cancer patients after the completion of treatment, with fatigue as an outcome measure, were included. Two review authors extracted data independently from the selected studies and assessed the methodological quality using the Cochrane Collaboration Risk of Bias Tool. RESULTS Thirty-three psychological interventions were identified. The sample size of the included studies varied between 28 and 409, with 4525 participants overall. Twenty-three of the included studies reported a significant effect of the interventions on reducing fatigue in cancer survivors. Most interventions focused on psychoeducation, mindfulness, cognitive or behaviour therapy-oriented strategies. However, studies differed widely in terms of measurement tools used to assess fatigue, mode, duration and frequency of the intervention delivery. CONCLUSIONS This review showed some tentative support for psychological interventions for fatigue after cancer treatment. However, as the RCTs were heterogeneous in nature and the number of high-quality studies was limited, definitive conclusions are not yet possible. With the growing need for stage-specific research in cancer, this review sought to inform current practice and to summarise the existing evidence base of randomised controlled trials in the area. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration number: CRD42014015219.
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Affiliation(s)
- T K Corbett
- NIHR ARC Wessex, School of Health Sciences, University of Southampton, Highfield, Southampton, SO17 1BJ, UK.
| | - A Groarke
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - D Devane
- School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland
| | - E Carr
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - J C Walsh
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - B E McGuire
- School of Psychology, National University of Ireland Galway, Galway, Ireland
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O'Regan P, McCarthy G, O'Reilly S, Power D, Bird BH, Murphy CG, Hegarty J. Cancer‐related fatigue and self‐care agency: A multicentre survey of patients receiving chemotherapy. J Clin Nurs 2019; 28:4424-4433. [DOI: 10.1111/jocn.15026] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 04/05/2019] [Accepted: 08/03/2019] [Indexed: 12/21/2022]
Affiliation(s)
- Patricia O'Regan
- School of Nursing and Midwifery University College Cork Cork Ireland
| | | | - Seamus O'Reilly
- Cork‐Mercy‐South Infirmary Victoria University Hospitals University College Cork Cork Ireland
| | - Derek Power
- The Mercy University Hospital/Cork University Hospital Cork Ireland
| | | | | | - Josephine Hegarty
- School of Nursing and Midwifery University College Cork Cork Ireland
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Bonhof CS, van de Poll-Franse LV, Vissers PAJ, Wasowicz DK, Wegdam JA, Révész D, Vreugdenhil G, Mols F. Anxiety and depression mediate the association between chemotherapy-induced peripheral neuropathy and fatigue: Results from the population-based PROFILES registry. Psychooncology 2019; 28:1926-1933. [PMID: 31293046 PMCID: PMC6771569 DOI: 10.1002/pon.5176] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 07/02/2019] [Accepted: 07/08/2019] [Indexed: 01/20/2023]
Abstract
OBJECTIVE Chemotherapy-induced sensory peripheral neuropathy (CIPN) is common among colorectal cancer (CRC) survivors. The aim of this study was to examine whether CIPN is associated with both psychological distress (ie, anxiety and depression) and fatigue and whether the relationship between CIPN and fatigue can (partly) be explained by psychological distress. METHODS All CRC survivors diagnosed between 2000 and 2009 as registered by the population-based Netherlands Cancer Registry (Eindhoven region) were eligible for participation. Chemotherapy-treated survivors completed questions on CIPN (EORTC QLQ-CIPN20), psychological distress (HADS), and fatigue (FAS) on average 5.6 years after diagnosis. Simple and multiple mediation analyses were performed to examine anxiety and depression as possible mediators in the association between CIPN and fatigue. RESULTS Survivors with high (ie, upper 30% of scores) CIPN (n = 172) reported more anxiety and depressive symptoms and more fatigue compared with those with low CIPN (n = 299). Furthermore, among survivors with high CIPN, those who were anxious, depressed, or both reported more fatigue compared with those without psychological distress. These differences were clinically relevant. Finally, mediation analyses showed that while CIPN was directly associated with fatigue, the relationship between CIPN and fatigue was also significantly mediated by both anxiety and depression. CONCLUSIONS CRC survivors with high CIPN report more fatigue, especially those who are also anxious and/or depressed. More research is needed on the direction of the relationship between CIPN, psychological distress, and fatigue. For now, the treatment of fatigue should also focus on addressing psychological distress, as treating fatigue alone might not be sufficient.
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Affiliation(s)
- Cynthia S Bonhof
- Center of Research on Psychology in Somatic Disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.,Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Lonneke V van de Poll-Franse
- Center of Research on Psychology in Somatic Disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.,Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.,Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Pauline A J Vissers
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Dareczka K Wasowicz
- Department of Surgery, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | | | - Dóra Révész
- Center of Research on Psychology in Somatic Disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Gerard Vreugdenhil
- Department of Internal Medicine, Máxima Medical Centre, Eindhoven, The Netherlands
| | - Floortje Mols
- Center of Research on Psychology in Somatic Disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.,Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
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Adam S, van de Poll-Franse LV, Mols F, Ezendam NPM, de Hingh IHJT, Arndt V, Thong MSY. The association of cancer-related fatigue with all-cause mortality of colorectal and endometrial cancer survivors: Results from the population-based PROFILES registry. Cancer Med 2019; 8:3227-3236. [PMID: 31012272 PMCID: PMC6558477 DOI: 10.1002/cam4.2166] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 04/03/2019] [Accepted: 04/03/2019] [Indexed: 11/10/2022] Open
Abstract
Purpose Cancer‐related fatigue (CRF) is one of the most prevalent symptoms experienced by cancer survivors. However, researchers are only beginning to elucidate the risk factors, underlying mechanism(s), and its association with other outcomes. Research on the association between CRF and mortality is limited. Methods The study sample comprised 2059 short‐term (<5 years postdiagnosis) cancer survivors from four PROFILES registry studies. Survivors diagnosed with stage I‐III colorectal cancer (CRC) or stage I‐III endometrial cancer (EC), with no evidence of disease, were identified and followed‐up by the Netherlands Cancer Registry. Fatigue was assessed with the Fatigue Assessment Scale. Cox proportional hazards models adjusted for demographic, clinical, and lifestyle characteristics were performed to assess the association of CRF with all‐cause mortality. Date of censoring was February 1, 2017. Results Prevalence of CRF varied between 35.8% (male CRC) and 43.6% (female CRC). After a median follow‐up period of 9.0 years, a total of 408 survivors (20%) had died. CRF was associated with increased all‐cause mortality in male CRC survivors (HRadj = 1.75, 95% CI [1.31‐2.33]). This association remained statistically significant after excluding survivors experiencing anhedonia. For female CRC (HRadj = 1.32, 95% CI [0.90‐1.97]) and EC (HRadj = 1.27, 95% CI [0.84‐1.90]) survivors, there was no significant association with all‐cause mortality for the fatigued group in multivariable analyses. Conclusion Our study found that CRF is significantly associated with all‐cause mortality in male CRC survivors, irrespective of potential confounders. This result suggests that clinicians should increase their attention towards the recognition and treatment of CRF.
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Affiliation(s)
- Salome Adam
- Netherlands Comprehensive Cancer Organisation, Utrecht, the Netherlands.,Division of Chronic Disease Epidemiology, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Switzerland
| | - Lonneke V van de Poll-Franse
- Netherlands Comprehensive Cancer Organisation, Utrecht, the Netherlands.,Department of Medical and Clinical Psychology, CoRPS-Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, the Netherlands.,Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Floortje Mols
- Department of Medical and Clinical Psychology, CoRPS-Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, the Netherlands
| | - Nicole P M Ezendam
- Netherlands Comprehensive Cancer Organisation, Utrecht, the Netherlands.,Department of Medical and Clinical Psychology, CoRPS-Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, the Netherlands
| | | | - Volker Arndt
- Unit of Cancer Survivorship, Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Melissa S Y Thong
- Unit of Cancer Survivorship, Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Medical Psychology, Amsterdam Public Health Research Institute, Location AMC, Amsterdam UMC, Amsterdam, the Netherlands
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Ashrafi F, Mousavi S, Karimi M. Potential Role of Bupropion Sustained Release for Cancer-Related Fatigue: a Double-Blind, Placebo-Controlled Study. Asian Pac J Cancer Prev 2018; 19:1547-1551. [PMID: 29936730 PMCID: PMC6103561 DOI: 10.22034/apjcp.2018.19.6.1547] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Background: Cancer-related fatigue (CRF) is very common and can be experienced at all stages of disease and in survivors. CRF causes patients more distress than pain or nausea and vomiting. Different pharmacologic interventions have been evaluated for the management of CRF. The purpose of this study was to determine the efficacy of bupropion sustained release (SR) as a treatment for fatigue in patients with cancer. Methods: In this randomized, double-blind, placebo-controlled trial, patients with fatigue due to cancer were randomly assigned to either 150mg daily of bupropion SR or matching placebo. The primary endpoint was the changes in average daily fatigue from baseline to week 4 using the Functional Assessment of Chronic Illness-therapy- Fatigue (FACIT-F) questionnaire. Results: 40 patients were randomly assigned to treatment with bupropion SR or placebo (20 in each group). Analysis of covariance (ANCOVA) showed a significant improvement in fatigue and quality of life in the bupropion group compared to baseline (P=0.000). Secondary outcome, including depression, severity of fatigue and performance status didn’t show significant difference between groups. Generally, bupropion SR was tolerated well. Conclusion: Four weeks of 150 mg bupropion SR improve fatigue significantly in cancer patients. Bupropion has potential as an effective and safe pharmaceutical agent for treating CRF.
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Affiliation(s)
- Farzaneh Ashrafi
- Department of Hematology and Oncology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
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Tomlinson D, Robinson P, Oberoi S, Cataudella D, Culos-Reed N, Davis H, Duong N, Gibson F, Götte M, Hinds P, Nijhof S, van der Torre P, Cabral S, Dupuis L, Sung L. Pharmacologic interventions for fatigue in cancer and transplantation: a meta-analysis. Curr Oncol 2018; 25:e152-e167. [PMID: 29719440 PMCID: PMC5927795 DOI: 10.3747/co.25.3883] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background Our objective was to determine whether, compared with control interventions, pharmacologic interventions reduce the severity of fatigue in patients with cancer or recipients of hematopoietic stem-cell transplantation (hsct). Methods For a systematic review, we searched medline, embase, the Cochrane Central Register of Controlled Trials, cinahl, and Psychinfo for randomized trials of systemic pharmacologic interventions for the management of fatigue in patients with cancer or recipients of hsct. Two authors independently identified studies and abstracted data. Methodologic quality was assessed using the Cochrane Risk of Bias tool. The primary outcome was fatigue severity measured using various fatigue scales. Data were synthesized using random-effects models. Results In the 117 included trials (19,819 patients), the pharmacologic agents used were erythropoietins (n = 31), stimulants (n = 19), l-carnitine (n = 6), corticosteroids (n = 5), antidepressants (n = 5), appetite stimulants (n = 3), and other agents (n = 48). Fatigue was significantly reduced with erythropoietin [standardized mean difference (smd): -0.52; 95% confidence interval (ci): -0.89 to -0.14] and with methylphenidate (smd: -0.36; 95% ci: -0.56 to -0.15); modafinil (or armodafinil) and corticosteroids were not effective. Conclusions Erythropoietin and methylphenidate significantly reduced fatigue severity in patients with cancer and in recipients of hsct. Concerns about the safety of those agents might limit their usefulness. Future research should identify effective interventions for fatigue that have minimal adverse effects.
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Affiliation(s)
- D. Tomlinson
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON
| | | | - S. Oberoi
- Pediatric Oncology Group of Ontario, Toronto, ON
| | - D. Cataudella
- Department of Pediatric Psychology, Children’s Hospital, London Health Sciences Centre, London, ON
| | - N. Culos-Reed
- Faculty of Kinesiology, University of Calgary, Calgary, AB
| | - H. Davis
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON
| | - N. Duong
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON
| | - F. Gibson
- Centre for Outcomes and Experiences Research in Children’s Health, Illness, and Disability, Great Ormond Street Hospital for Children NHS Foundation Trust, London, and School of Health Sciences, University of Surrey, Guildford, U.K
| | - M. Götte
- University Hospital Essen, Center for Child and Adolescent Medicine, Department of Pediatric Hematology/Oncology, Essen, Germany
| | - P. Hinds
- Department of Nursing Science, Professional Practice, and Quality, Children’s National Health System; and Department of Pediatrics, George Washington University, Washington, DC, U.S.A
| | - S.L. Nijhof
- Division of Pediatrics, Wilhelmina Children’s Hospital (part of UMC Utrecht), Utrecht, Netherlands
| | - P. van der Torre
- Division of Pediatrics, Wilhelmina Children’s Hospital (part of UMC Utrecht), Utrecht, Netherlands
| | - S. Cabral
- Pediatric Oncology Group of Ontario, Toronto, ON
| | - L.L. Dupuis
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON
- Department of Pharmacy, The Hospital for Sick Children; and Leslie Dan Faculty of Pharmacy, University of Toronto, The Hospital for Sick Children, Toronto, ON
| | - L. Sung
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, ON
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Quality of life among survivors of early-stage cervical cancer in Taiwan: an exploration of treatment modality differences. Qual Life Res 2017; 26:2773-2782. [PMID: 28608151 DOI: 10.1007/s11136-017-1619-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2017] [Indexed: 11/12/2022]
Abstract
PURPOSE Women with early-stage cervical cancer may experience changes in their quality of life (QoL) due to treatment or to the effects of the cancer. In this study, we examined differences in QoL by treatment modality between women who underwent surgery only and those treated with concurrent chemoradiation (CCRT). METHODS The sample of 290 women had been diagnosed with stage I-II cervical cancer. Data were collected on these women's demographic and disease characteristics, general QoL, and cancer-specific QoL using an author-designed demographic-disease survey, the European Organization for Research and Treatment of Cancer QoL questionnaire, and the Taiwanese-version Cervical Cancer Module 24 questionnaire, respectively. Data were analyzed by descriptive statistics and analysis of covariance. RESULTS Women with cervical cancer who underwent surgery only had significantly worse constipation and body image than those treated with CCRT. Women who underwent CCRT had worse physical and role functioning than those who underwent surgery only. Women who had CCRT also reported worse symptoms, such as fatigue, appetite loss, diarrhea, financial difficulties, sexual enjoyment, and sexual/vaginal functioning, than those who had only surgery. CONCLUSIONS Our results add knowledge about QoL in women with early-stage cervical cancer who receive different treatment modalities. When suggesting treatment modalities for women with cervical cancer, health professionals should also consider changes in women's QoL after cancer treatment. To improve women's QoL after treatment, professionals should also offer timely and individualized interventions based on women's cervical cancer treatment.
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Conte E, Camerino GM, Mele A, De Bellis M, Pierno S, Rana F, Fonzino A, Caloiero R, Rizzi L, Bresciani E, Ben Haj Salah K, Fehrentz J, Martinez J, Giustino A, Mariggiò MA, Coluccia M, Tricarico D, Lograno MD, De Luca A, Torsello A, Conte D, Liantonio A. Growth hormone secretagogues prevent dysregulation of skeletal muscle calcium homeostasis in a rat model of cisplatin-induced cachexia. J Cachexia Sarcopenia Muscle 2017; 8:386-404. [PMID: 28294567 PMCID: PMC5703021 DOI: 10.1002/jcsm.12185] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 12/21/2016] [Accepted: 12/28/2016] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Cachexia is a wasting condition associated with cancer types and, at the same time, is a serious and dose-limiting side effect of cancer chemotherapy. Skeletal muscle loss is one of the main characteristics of cachexia that significantly contributes to the functional muscle impairment. Calcium-dependent signaling pathways are believed to play an important role in skeletal muscle decline observed in cachexia, but whether intracellular calcium homeostasis is affected in this situation remains uncertain. Growth hormone secretagogues (GHS), a family of synthetic agonists of ghrelin receptor (GHS-R1a), are being developed as a therapeutic option for cancer cachexia syndrome; however, the exact mechanism by which GHS interfere with skeletal muscle is not fully understood. METHODS By a multidisciplinary approach ranging from cytofluorometry and electrophysiology to gene expression and histology, we characterized the calcium homeostasis in fast-twitch extensor digitorum longus (EDL) muscle of adult rats with cisplatin-induced cachexia and established the potential beneficial effects of two GHS (hexarelin and JMV2894) at this level. Additionally, in vivo measures of grip strength and of ultrasonography recordings allowed us to evaluate the functional impact of GHS therapeutic intervention. RESULTS Cisplatin-treated EDL muscle fibres were characterized by a ~18% significant reduction of the muscle weight and fibre diameter together with an up-regulation of atrogin1/Murf-1 genes and a down-regulation of Pgc1-a gene, all indexes of muscle atrophy, and by a two-fold increase in resting intracellular calcium, [Ca2+ ]i , compared with control rats. Moreover, the amplitude of the calcium transient induced by caffeine or depolarizing high potassium solution as well as the store-operated calcium entry were ~50% significantly reduced in cisplatin-treated rats. Calcium homeostasis dysregulation parallels with changes of functional ex vivo (excitability and resting macroscopic conductance) and in vivo (forelimb force and muscle volume) outcomes in cachectic animals. Administration of hexarelin or JMV2894 markedly reduced the cisplatin-induced alteration of calcium homeostasis by both common as well as drug-specific mechanisms of action. This effect correlated with muscle function preservation as well as amelioration of various atrophic indexes, thus supporting the functional impact of GHS activity on calcium homeostasis. CONCLUSIONS Our findings provide a direct evidence that a dysregulation of calcium homeostasis plays a key role in cisplatin-induced model of cachexia gaining insight into the etiopathogenesis of this form of muscle wasting. Furthermore, our demonstration that GHS administration efficaciously prevents cisplatin-induced calcium homeostasis alteration contributes to elucidate the mechanism of action through which GHS could potentially ameliorate chemotherapy-associated cachexia.
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Affiliation(s)
- Elena Conte
- Department of Pharmacy – Drug SciencesUniversity of BariVia Orabona 470125BariItaly
| | | | - Antonietta Mele
- Department of Pharmacy – Drug SciencesUniversity of BariVia Orabona 470125BariItaly
| | - Michela De Bellis
- Department of Pharmacy – Drug SciencesUniversity of BariVia Orabona 470125BariItaly
| | - Sabata Pierno
- Department of Pharmacy – Drug SciencesUniversity of BariVia Orabona 470125BariItaly
| | - Francesco Rana
- Department of Pharmacy – Drug SciencesUniversity of BariVia Orabona 470125BariItaly
| | - Adriano Fonzino
- Department of Pharmacy – Drug SciencesUniversity of BariVia Orabona 470125BariItaly
| | - Roberta Caloiero
- Department of Pharmacy – Drug SciencesUniversity of BariVia Orabona 470125BariItaly
| | - Laura Rizzi
- Department of Medicine and SurgeryUniversity of Milano‐BicoccaVia Cadore 4820900MonzaItaly
| | - Elena Bresciani
- Department of Medicine and SurgeryUniversity of Milano‐BicoccaVia Cadore 4820900MonzaItaly
| | - Khoubaib Ben Haj Salah
- Max Mousseron Institute of Biomolecules UMR5247, CNRSUniversity of Montpellier, ENSCMAvenue Charles Flahault BP 14491Montpellier Cedex 5France
| | - Jean‐Alain Fehrentz
- Max Mousseron Institute of Biomolecules UMR5247, CNRSUniversity of Montpellier, ENSCMAvenue Charles Flahault BP 14491Montpellier Cedex 5France
| | - Jean Martinez
- Max Mousseron Institute of Biomolecules UMR5247, CNRSUniversity of Montpellier, ENSCMAvenue Charles Flahault BP 14491Montpellier Cedex 5France
| | - Arcangela Giustino
- Department of Biomedical Sciences and Human OncologyUniversity of BariPiazza Giulio Cesare70125BariItaly
| | - Maria Addolorata Mariggiò
- Department of Biomedical Sciences and Human OncologyUniversity of BariPiazza Giulio Cesare70125BariItaly
| | - Mauro Coluccia
- Department of Pharmacy – Drug SciencesUniversity of BariVia Orabona 470125BariItaly
| | - Domenico Tricarico
- Department of Pharmacy – Drug SciencesUniversity of BariVia Orabona 470125BariItaly
| | | | - Annamaria De Luca
- Department of Pharmacy – Drug SciencesUniversity of BariVia Orabona 470125BariItaly
| | - Antonio Torsello
- Department of Medicine and SurgeryUniversity of Milano‐BicoccaVia Cadore 4820900MonzaItaly
| | - Diana Conte
- Department of Pharmacy – Drug SciencesUniversity of BariVia Orabona 470125BariItaly
| | - Antonella Liantonio
- Department of Pharmacy – Drug SciencesUniversity of BariVia Orabona 470125BariItaly
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Haas B, Hermanns M, Kimmel G. Incorporating Exercise Into the Cancer Treatment Paradigm. Clin J Oncol Nurs 2016; 20:S17-S24. [DOI: 10.1188/16.cjon.s2.17-24] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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