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Phillips SM, Starikovsky J, Solk P, Desai R, Reading JM, Hasanaj K, Wang SD, Cullather E, Lee J, Song J, Spring B, Gradishar W. Feasibility and preliminary effects of the Fit2ThriveMB pilot physical activity promotion intervention on physical activity and patient reported outcomes in individuals with metastatic breast cancer. Breast Cancer Res Treat 2024:10.1007/s10549-024-07432-5. [PMID: 39014267 DOI: 10.1007/s10549-024-07432-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 07/05/2024] [Indexed: 07/18/2024]
Abstract
PURPOSE Physical activity research among patients with metastatic breast cancer (MBC) is limited. This study examined the feasibility and potential benefits of Fit2ThriveMB, a tailored mHealth intervention. METHODS Insufficiently active individuals with MBC (n = 49) were randomized 1:1 to Fit2ThriveMB (Fit2ThriveMB app, Fitbit, and weekly coaching calls) or Healthy Lifestyle attention control (Cancer.Net app and weekly calls) for 12 weeks. Fit2ThriveMB aimed to increase daily steps via an algorithm tailored to daily symptom rating and step goal attainment. The primary outcome was feasibility defined as ≥ 80% completion rate. Secondary feasibility metrics included meeting daily step goal and wearing the Fitbit ≥ 70% of study days, fidelity, adherence to intervention features and safety. Secondary outcomes included physical activity, sedentary time, patient reported outcomes (PROs), health-related quality of life (QOL) and social cognitive theory constructs. A subsample (n = 25) completed functional performance tests via video conferencing. RESULTS The completion rate was 98% (n = 1 died). No related adverse events were reported. Fit2ThriveMB participants (n = 24) wore the Fitbit 92.7%, met their step goal 53.1%, set a step goal 84.6% and used the app 94.1% of 84 study days. Intent-to-treat analyses indicated trends toward improvements in activity, QOL, and some PROs, social cognitive theory constructs, and functional performance tests favoring the Fit2ThriveMB group. Significant effects favoring Fit2ThriveMB were observed for self-efficacy and goal-setting. However, some PROs and functional performance improvements favored the control group (p-values > 0.05). CONCLUSIONS Fit2ThriveMB is feasible and safe for patients with MBC and warrants further evaluation in randomized controlled trials with larger sample sizes. Registration Clinicaltrials.gov NCT04129346, https://clinicaltrials.gov/ct2/show/NCT04129346.
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Affiliation(s)
- Siobhan M Phillips
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N Lake Shore Drive, Suite 1400, Chicago, IL, 60611, USA.
| | - Julia Starikovsky
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N Lake Shore Drive, Suite 1400, Chicago, IL, 60611, USA
| | - Payton Solk
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N Lake Shore Drive, Suite 1400, Chicago, IL, 60611, USA
| | - Ria Desai
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N Lake Shore Drive, Suite 1400, Chicago, IL, 60611, USA
| | - Jean M Reading
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N Lake Shore Drive, Suite 1400, Chicago, IL, 60611, USA
| | - Kristina Hasanaj
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N Lake Shore Drive, Suite 1400, Chicago, IL, 60611, USA
| | - Shirlene D Wang
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N Lake Shore Drive, Suite 1400, Chicago, IL, 60611, USA
| | - Erin Cullather
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N Lake Shore Drive, Suite 1400, Chicago, IL, 60611, USA
| | - Jungwha Lee
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N Lake Shore Drive, Suite 1400, Chicago, IL, 60611, USA
| | - Jing Song
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N Lake Shore Drive, Suite 1400, Chicago, IL, 60611, USA
| | - Bonnie Spring
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N Lake Shore Drive, Suite 1400, Chicago, IL, 60611, USA
| | - William Gradishar
- Department of Medicine, Hematology and Oncology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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Yang L, Courneya KS, Friedenreich CM. The Physical Activity and Cancer Control (PACC) framework: update on the evidence, guidelines, and future research priorities. Br J Cancer 2024:10.1038/s41416-024-02748-x. [PMID: 38926526 DOI: 10.1038/s41416-024-02748-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 05/22/2024] [Accepted: 06/03/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND We proposed the Physical Activity and Cancer Control (PACC) framework in 2007 to help organise, focus, and stimulate research on physical activity in eight cancer control categories: prevention, detection, treatment preparation/coping, treatment coping/effectiveness, recovery/rehabilitation, disease prevention/health promotion, palliation, and survival. METHODS This perspective paper provides a high-level overview of the scientific advances in physical activity research across cancer control categories, summarises current guidelines, updates the PACC framework, identifies remaining and emerging knowledge gaps, and provides future research directions. RESULTS Many scientific advances have been made that are reflected in updated physical activity guidelines for six of the cancer control categories apart from detection and palliation. Nevertheless, the minimal and optimal type, dose, and timing of physical activity across cancer control categories remain unknown, especially for the understudied population subgroups defined by cancer type, age, race/ethnicity, and resource level of regions/countries. CONCLUSION To achieve the full benefit of physical activity in cancer control, future research should use innovative study designs that include diverse at-risk populations and understudied cancer sites. Additionally, effective behaviour change strategies are needed to increase physical activity levels across populations that use implementation science to accelerate the translation from evidence generation into practical, real-world interventions.
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Affiliation(s)
- Lin Yang
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada
- Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Kerry S Courneya
- Faculty of Kinesiology, Sport and Recreation, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
| | - Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada.
- Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
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Herrero López B, Cardeña-Gutiérrez A, Godoy Ortiz A, Gonzaga López A, Grueso López AM, Nuño Alves A, Ramírez Daffós P, Rodríguez Sánchez CA, Rodríguez Pérez ÁR, Sacristán Santos V, Saura Grau S, Sebio García R, Seguí Palmer MÁ. Exercise in cancer patients: assistance levels and referral pathways-a position statement from the Spanish Society of Medical Oncology. Clin Transl Oncol 2024:10.1007/s12094-024-03546-w. [PMID: 38909323 DOI: 10.1007/s12094-024-03546-w] [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: 05/29/2024] [Accepted: 06/03/2024] [Indexed: 06/24/2024]
Abstract
There is growing evidence about how physical activity can improve cancer care. Unfortunately, exercise is still not widely prescribed to oncology patients, despite the benefit it brings. For this to occur, it is necessary for a multidisciplinary approach involving different types of healthcare professionals, given that each treatment be tailored for each single case. Besides incorporating appropriate infrastructures and referral pathways, we need to integrate exercise into healthcare practice, which ameliorates patients' quality of life and treatment side effects. From the Spanish Society of Medical Oncology (SEOM), and through the Exercise and Cancer Working Group, we indicate considerations, analyze patient care scenarios, and propose a referral pathway algorithm for exercise prescription, taking in account the patient's needs. In later sections of this paper, we describe how this algorithm could be implemented, and how the exercise programs should be built, including the physical activity contents, the settings, and the delivery mode. We conclude that professionals, infrastructures, and organizations should be available at every assistance level to create programs providing adequate exercise training for cancer patients.
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Affiliation(s)
- Blanca Herrero López
- Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón. Madrid (España), Madrid, Spain.
| | - Ana Cardeña-Gutiérrez
- Hospital Universitario Nuestra Señora de Candelaria. Santa Cruz de Tenerife (España), Santa Cruz de Tenerife, Spain
| | - Ana Godoy Ortiz
- UGCI Oncología Médica Hospitales Universitarios Regional y Virgen de La Victoria, Málaga, Málaga, Spain
| | | | | | | | | | | | | | | | - Salvador Saura Grau
- Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | | | - Miguel Ángel Seguí Palmer
- Parc Taulí Consorci Corporació Sanitaria. Sabadell. Servicio de Oncologia. Institut d'Investigació I Innovació Parc Taulí, Universitat Autònoma de Barcelona, Barcelona, Spain
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4
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Agnew M, Cadmus-Bertram L, Kwekkeboom K, Gorzelitz J, Ruzicka M, Gangnon R, Andersen SW. "There is no expiration date": a qualitative analysis using the Social Cognitive Theory to identify factors influencing physical activity among adults living with advanced cancer. Support Care Cancer 2024; 32:242. [PMID: 38514490 DOI: 10.1007/s00520-024-08440-3] [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: 10/16/2023] [Accepted: 03/15/2024] [Indexed: 03/23/2024]
Abstract
PURPOSE To identify cognitive, behavioral, environmental, and other factors that influence physical activity in adults with advanced cancer using qualitative, semi-structured interviews. METHODS Eighteen semi-structured interviews were conducted with adults living with stage IV breast, prostate, or colorectal cancer; or multiple myeloma recruited from the University of Wisconsin Carbone Cancer Center. We used the Social Cognitive Theory to design the interview guide and a reflexive thematic approach for analysis. RESULTS Participants were 62 years old on average and currently receiving treatment. Despite reporting numerous barriers to physical activity, most participants discussed engaging in some physical activity. Participants reported difficulties coping with changes in physical functioning especially due to fatigue, weakness, neuropathy, and pain. While cold weather was seen as a deterrent for activity, access to sidewalks was a commonly reported feature of neighborhood conduciveness for physical activity. Regardless of current activity levels, adults with advanced cancer were interested in engaging in activities to meet their goals of gaining strength and maintaining independence. Having a conversation with a provider from their cancer care team about physical activity was seen as encouraging for pursuing some activity. CONCLUSIONS Adults living with advanced cancer are interested in pursuing activity to gain strength and maintain independence despite reported barriers to physical activity. To ensure patients are encouraged to be active, accessible resources, targeted referrals, and interventions designed to address their goals are critical next steps. RELEVANCE Integrating conversations about physical activity into oncology care for adults living with advanced cancer is an important next step to encourage patients to remain active and help them improve strength and maintain quality of life and independence.
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Affiliation(s)
- Megan Agnew
- Department of Population Health Sciences, University of Wisconsin Madison, 610 Walnut St #707, Madison, WI, 53726, USA.
| | - Lisa Cadmus-Bertram
- Department of Kinesiology, University of Wisconsin Madison, 1300 University Ave, Madison, WI, 53706, USA
- University of Wisconsin Carbone Cancer Center, 600 Highland Ave, Madison, WI, 53705, USA
| | - Kristine Kwekkeboom
- University of Wisconsin Carbone Cancer Center, 600 Highland Ave, Madison, WI, 53705, USA
- School of Nursing, University of Wisconsin Madison, 701 Highland Ave, Madison, WI, 53705, USA
| | - Jessica Gorzelitz
- Department of Health and Human Physiology, University of Iowa, 225 E Market St, Iowa City, IA, 52242, USA
- Holden Comprehensive Cancer Center, University of Iowa, 200 Hawkins Dr, Iowa City, IA, 52242, USA
| | - Marla Ruzicka
- Department of Kinesiology, University of Wisconsin Madison, 1300 University Ave, Madison, WI, 53706, USA
| | - Ronald Gangnon
- Department of Population Health Sciences, University of Wisconsin Madison, 610 Walnut St #707, Madison, WI, 53726, USA
- University of Wisconsin Carbone Cancer Center, 600 Highland Ave, Madison, WI, 53705, USA
- Department of Biostatistics and Medical Informatics, University of Wisconsin Madison, 600 Highland Ave, Madison, WI, 53792, USA
| | - Shaneda Warren Andersen
- Department of Population Health Sciences, University of Wisconsin Madison, 610 Walnut St #707, Madison, WI, 53726, USA
- University of Wisconsin Carbone Cancer Center, 600 Highland Ave, Madison, WI, 53705, USA
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Lally P, Kennedy F, Smith S, Beeken RJ, Buck C, Thomas C, Counsell N, Wyld L, Martin C, Williams S, Roberts A, Greenfield DM, Gath J, Potts HWW, Latimer N, Smith L, Fisher A. The feasibility and acceptability of an app-based intervention with brief behavioural support (APPROACH) to promote brisk walking in people diagnosed with breast, prostate and colorectal cancer in the UK. Cancer Med 2024; 13:e7124. [PMID: 38529687 DOI: 10.1002/cam4.7124] [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: 10/10/2023] [Revised: 03/05/2024] [Accepted: 03/08/2024] [Indexed: 03/27/2024] Open
Abstract
INTRODUCTION Increased moderate to vigorous physical activity (MVPA) can improve clinical and psychosocial outcomes for people living with and beyond cancer (LWBC). This study aimed to assess the feasibility and acceptability of trial procedures in a pilot randomised controlled trial (RCT) of a theory-driven app-based intervention with behavioural support focused on promoting brisk walking (a form of MVPA) in people LWBC (APPROACH). METHODS Participants diagnosed with breast, prostate or colorectal cancer were recruited from a single UK hospital site. Assessments at baseline and 3 months included online questionnaires, device-measured brisk walking (activPAL accelerometer) and self-reported weight and height. Participants were randomised to intervention or control (care as usual). The intervention comprised a non-cancer-specific app to promote brisk walking (National Health Service 'Active 10') augmented with print information about habit formation, a walking planner and two behavioural support telephone calls. Feasibility and acceptability of trial procedures were explored. Initial estimates for physical activity informed a power calculation for a phase III RCT. A preliminary health economics analysis was conducted. RESULTS Of those medically eligible, 369/577 (64%) were willing to answer further eligibility questions and 90/148 (61%) of those eligible were enrolled. Feasibility outcomes, including retention (97%), assessment completion rates (>86%) and app download rates in the intervention group (96%), suggest that the trial procedures are acceptable and that the intervention is feasible. The phase III RCT will require 472 participants to be randomised. As expected, the preliminary health economic analyses indicate a high level of uncertainty around the cost-effectiveness of the intervention. CONCLUSIONS This pilot study demonstrates that a large trial of the brisk walking intervention with behavioural support is both feasible and acceptable to people LWBC. The results support progression onto a confirmatory phase III trial to determine the efficacy and cost-effectiveness of the intervention.
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Affiliation(s)
- Phillippa Lally
- Department of Psychological Sciences, University of Surrey, Guildford, Surrey, UK
| | - Fiona Kennedy
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Susan Smith
- Department of Behavioural Science and Health, University College London, London, UK
| | - Rebecca J Beeken
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Caroline Buck
- Department of Behavioural Science and Health, University College London, London, UK
| | - Chloe Thomas
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Nicholas Counsell
- Cancer Research UK & Cancer Trials Centre, Cancer Institute, University College London, London, UK
| | - Lynda Wyld
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - Charlene Martin
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - Sarah Williams
- Department of Behavioural Science and Health, University College London, London, UK
| | - Anna Roberts
- Department of Behavioural Science and Health, University College London, London, UK
| | - Diana M Greenfield
- Sheffield Teaching Hospitals NHS FT, Weston Park Hospital, Sheffield, UK
| | - Jacqui Gath
- Independent Cancer Patients' Voice (ICPV), London, UK
| | - Henry W W Potts
- Institute of Health Informatics, University College London, London, UK
| | - Nicholas Latimer
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Lee Smith
- The Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Abi Fisher
- Department of Behavioural Science and Health, University College London, London, UK
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6
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Smith-Turchyn J, Mukherjee SD, Tomasone JR, Fong AJ, Nayiga BK, Ball E, Stouth DW, Sabiston CM. Evaluating Wall-Mounted Prompts to Facilitate Physical Activity-Related Discussion between Individuals with Cancer and Oncology Health Care Providers: A Pre-post Survey Study. Physiother Can 2024; 76:34-45. [PMID: 38465300 PMCID: PMC10919365 DOI: 10.3138/ptc-2023-0046] [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: 06/28/2023] [Revised: 09/12/2023] [Accepted: 09/12/2023] [Indexed: 03/12/2024]
Abstract
Purpose To evaluate the use of wall-mounted prompts in facilitating physical activity (PA)-related discussions between individuals with cancer and oncology care providers. Methods Individuals with cancer were approached to participate in a survey-based pre-post study. Half of participants (n = 100) completed a survey prior to installation of wall-mounted prompts in clinic while the other half (n = 100) completed a survey following installation of the prompts. Survey questions included content of PA-related discussion, satisfaction with PA education across treatment, and current PA level. The post-prompt survey also asked questions related to the prompt. Survey responses were analyzed using descriptive statistics. Chi-squared tests were performed to determine significance between timepoints. Results One hundred participants completed the survey at each timepoint. A significant difference was found pre and post-prompt in the number of PA discussions occurring overall during care (p = 0.03). Some participants (53%) were satisfied with the PA education received during treatment. There was no significant difference in occurrence of PA discussion (p = 0.36) pre and post-prompt and no difference in PA behaviour was observed (p = 0.130). Conclusions Wall-mounted prompts may be effective in increasing the frequency of PA-related discussions between individuals with cancer and their oncology team across treatment. Additional strategies, such as easy referral to rehabilitation professionals, are also needed to facilitate safe and effective PA behaviour during and after cancer treatments.
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Affiliation(s)
- Jenna Smith-Turchyn
- From the:
School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Som D. Mukherjee
- Department of Oncology, McMaster University, Hamilton, Ontario, Canada
| | - Jennifer R. Tomasone
- School of Kinesiology and Health Studies, Queens University, Kingston, Ontario, Canada
| | - Angela J. Fong
- Section of Behavioral Sciences, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - Brenda Kibuka Nayiga
- From the:
School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Elizabeth Ball
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Derek W. Stouth
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Catherine M. Sabiston
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
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Olszyna-Serementa M, Zaborowska-Szmit M, Szmit S, Jaśkiewicz P, Zajda K, Krzakowski M, Kowalski DM. Performance-Status Deterioration during Sequential Chemo-Radiotherapy as a Predictive Factor in Locally Advanced Non-Small Cell Lung Cancer. Curr Oncol 2023; 30:2049-2060. [PMID: 36826120 PMCID: PMC9955383 DOI: 10.3390/curroncol30020159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/29/2023] [Accepted: 02/04/2023] [Indexed: 02/11/2023] Open
Abstract
The role of sequential chemoradiotherapy in non-small cell lung cancer (NSCLC) patients who are not eligible for concurrent therapy has not been clearly defined. The aim of this study was to determine the usefulness of Karnofsky performance status (KPS) monitoring and to define the factors determining clinical deterioration during sequential chemoradiotherapy in patients treated from July 2009 to October 2014. The study included 196 patients. The clinical stage was defined as III A in 94 patients (48%) and III B in 102 patients (52%). Reduced KPS was found in 129 patients (65.8%). Baseline KPS had no significant prognostic significance. Deterioration of KPS during chemoradiotherapy was observed in 53 patients (27%) and had a negative predictive value for both worse-progression free survival (HR = 1.44; 95% CI: 1.03-1.99; p = 0.03) and overall survival (HR = 1.42; 95% CI: 1.02-1, 99; p = 0.04). The deterioration of KPS correlated with the disease control rate 6 weeks after the end of chemoradiotherapy (p = 0.0085). The risk of KPS worsening increased with each subsequent day between the end of chemotherapy and the start of radiotherapy (OR = 1.03; 95%CI: 1.01-1.05; p = 0.001), but decreased with each year of older age of patients (OR = 0.94, 95% CI: 0.9-0.98, p = 0.009). The time between the end of chemotherapy and the start of radiotherapy determined the prognosis of NSCLC after chemoradiotherapy. It should be adjusted to the age of patients.
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Affiliation(s)
- Marta Olszyna-Serementa
- Department of Lung Cancer and Thoracic Tumors, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
| | - Magdalena Zaborowska-Szmit
- Department of Lung Cancer and Thoracic Tumors, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
| | - Sebastian Szmit
- Department of Cardio-Oncology, Centre of Postgraduate Medical Education, Institute of Hematology and Transfusion Medicine, 02-776 Warsaw, Poland
- Clinic of Oncological Diagnostics and Cardio-Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
- Correspondence:
| | - Piotr Jaśkiewicz
- Department of Lung Cancer and Thoracic Tumors, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
| | - Katarzyna Zajda
- Department of Lung Cancer and Thoracic Tumors, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
| | - Maciej Krzakowski
- Department of Lung Cancer and Thoracic Tumors, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
| | - Dariusz M. Kowalski
- Department of Lung Cancer and Thoracic Tumors, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
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Belcher BR, Kang DW, Yunker AG, Dieli-Conwright CM. Interventions to Reduce Sedentary Behavior in Cancer Patients and Survivors: a Systematic Review. Curr Oncol Rep 2022; 24:1593-1605. [PMID: 35829982 DOI: 10.1007/s11912-022-01313-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2022] [Indexed: 01/27/2023]
Abstract
PURPOSE OF REVIEW Sedentary behaviors (SB) after cancer diagnosis are associated with poor prognosis for certain cancers, and cancer patients and survivors report high levels of SB. Reducing SB may be a feasible and effective intervention strategy to improve outcomes. This systematic review aims to identify and evaluate the literature on interventions to reduce SB in cancer patients and survivors. RECENT FINDINGS Studies were identified via database searches in December 2020. Two authors evaluated study eligibility. Data were extracted and checked, and risk of bias was assessed by the study team. Of 1401 records identified, nine studies involving 394 cancer patients or survivors were included in this review. Six were randomized trials, three were non-randomized intervention studies, and almost all (n = 8) focused on feasibility with small sample sizes. All studies were conducted within the previous 5 years in Canada, Australia, USA, and South Korea. Cancer types studied were breast (n = 3), prostate (n = 2), colorectal or peritoneal (n = 1), and mixed types (n = 3). Intervention duration of 12 weeks was most common (n = 7). Five studies had multiple intervention components, and six studies included wearable devices to measure and/or prompt behavior change. There was an overall trend where intervention groups reduced SB vs. control groups, often coupled with an increase in moderate-to-vigorous physical activity. This review suggests that there is some promise for intervention strategies to reduce SB in cancer patients and survivors. There is a need for more high-quality randomized controlled trials to understand how to best decrease SB in cancer patients and survivors.
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Affiliation(s)
- Britni R Belcher
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Dong-Woo Kang
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, 375 Longwood Avenue, MB, Boston, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Alexandra G Yunker
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, 375 Longwood Avenue, MB, Boston, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Christina M Dieli-Conwright
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, 375 Longwood Avenue, MB, Boston, USA.
- Department of Medicine, Harvard Medical School, Boston, MA, USA.
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Siiss LA, Guarda A, Graeff DB, Cecagno-Zanini SC. Benefícios e Segurança dos Exercícios Físicos em Pacientes com Metástases Ósseas: Revisão Sistemática da Literatura e Metanálise. REVISTA BRASILEIRA DE CANCEROLOGIA 2022. [DOI: 10.32635/2176-9745.rbc.2022v68n4.2520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Introdução: A expectativa de vida de pessoas com câncer metastático está aumentando, mas esse grupo de pacientes corre um risco considerável de apresentar problemas psicológicos e de saúde física. Nesse sentido, o exercício físico tem sido um aliado no tratamento de pacientes com metástases ósseas. Objetivo: Realizar uma revisão sistemática e metanálise sobre a segurança e os benefícios do exercício físico em pacientes com metástases ósseas. Método: Metanálise com pesquisa bibliográfica realizada nas bases eletrônicas: PubMed, LILACS, PEDro e Embase. Resultados: Dos 396 estudos, somente dez foram incluídos, com um total de 531 indivíduos. Não foi observado nenhum efeito adverso musculoesquelético durante a intervenção, sendo significativamente seguro o exercício em indivíduos com metástases ósseas. Não houve melhora considerável na capacidade aeróbica, progressão da doença, qualidade de vida, massa magra e gordura corporal. Três dos estudos incluídos avaliaram a dor durante e após a intervenção, demonstrando melhora no escore de dor, assim como a diminuição do uso do analgésico no grupo intervenção. Conclusão: A terapia com exercícios aeróbicos e isométricos e segura para pacientes com metástases ósseas, além de apresentar melhora da dor, mas sem evolução relevante na capacidade aeróbica, na progressão da doença, na massa corporal e na qualidade de vida.
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10
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Gil Herrero L, McNeely ML, Courneya KS, Castellanos Montealegre M, González Marquez AI, Pollan Santamaría M, Casla Barrio S. Safety, feasibility, and effectiveness of implementing supervised exercise into the clinical care of individuals with advanced cancer. Clin Rehabil 2022; 36:1666-1678. [PMID: 35850600 DOI: 10.1177/02692155221114556] [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] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To evaluate the safety, feasibility, and preliminary effectiveness of implementing supervised exercise programming into the clinical care of individuals with advanced cancer. DESIGN Single group implementation feasibility study using a pre-posttest design. SETTING Exercise Oncology Unit of the Spanish Cancer Association (a cancer-specific community facility outside the hospital setting). PARTICIPANTS Adult individuals with advanced cancer profile involving advanced local cancer or distant metastases. INTERVENTION A 12-week, twice-weekly, supervised, clinic-based multi-component exercise program. MAIN MEASURE Paired t-tests were used to assess pre-post changes and analyses of covariance were used to compare effects based on selected participant characteristics. RESULTS Eighty-four individuals with advanced cancer completed the baseline assessment, with six participants withdrawing prior to the start of the program. Of the 78 participants, 17 dropped out, thus, a total of 61 completed the final assessment. Mean adherence was 82.5%. No serious adverse events occurred. Exercise significantly improved VO2max by 5.2 mL·kg·min (p < 0.001), chest strength (p < 0.001), leg strength (p < 0.001), lean body mass (p = 0.003), skeletal muscle mass (p < 0.002), % body fat (p = 0.02), quality of life by 5.3 points (p = 0.009), fatigue by 3.2 points (p = 0.012), and physical activity by 1680 METs/week (p < 0.001). CONCLUSIONS Our clinically supervised and tailored exercise program involving moderate to vigorous intensity exercise was found to be feasible, safe, and effective for individuals with advanced cancer. IMPLICATIONS FOR CANCER SURVIVORS With proper screening and supervision, individuals with advanced cancer can benefit from tailored exercise oncology support as part of an overall therapeutic care plan.
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Affiliation(s)
| | - Margaret L McNeely
- Department of Physical Therapy/Department of Oncology, 3158University of Alberta, Edmonton, Canada
| | - Kerry S Courneya
- Faculty of Kinesiology, Sport, and Recreation, 3158University of Alberta, Edmonton, Canada
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11
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Wagoner CW, Capozzi LC, Culos-Reed SN. Tailoring the Evidence for Exercise Oncology within Breast Cancer Care. Curr Oncol 2022; 29:4827-4841. [PMID: 35877243 PMCID: PMC9322354 DOI: 10.3390/curroncol29070383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 07/02/2022] [Accepted: 07/06/2022] [Indexed: 11/24/2022] Open
Abstract
Exercise is safe and effective for those living with and beyond breast cancer, with evidence supporting exercise guidelines, and position statements from international organizations. Despite the clearly recognized benefits of exercise for these individuals, many do not participate or maintain recommended exercise levels throughout the breast cancer continuum, highlighting the lack of translation from research into practice. In addition, discerning how exercise can be tailored to address breast cancer-related impairments, so that individuals are able to participate safely and effectively, has also not been studied extensively. Thus, we propose that implementing exercise screening, triage, and referral pathways across the breast cancer continuum may allow for increased accessibility and adoption among those living with and beyond breast cancer. This paper provides an overview of exercise prescription tailoring for common breast cancer and treatment-related impairments, proposes a simplified screening tool for identifying physical activity and movement-related impairments, and considers how best to channel evidence into practice via proposed implementation pathways that may better connect individuals living with and beyond breast cancer with exercise oncology resources through screening, triage, and referral.
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Affiliation(s)
- Chad W. Wagoner
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada; (C.W.W.); (L.C.C.)
| | - Lauren C. Capozzi
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada; (C.W.W.); (L.C.C.)
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - S. Nicole Culos-Reed
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada; (C.W.W.); (L.C.C.)
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Department of Psychosocial Resources, Tom Baker Cancer Centre, Cancer Care, Alberta Health Services, Calgary, AB T2N 4N2, Canada
- Correspondence:
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12
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Brown JC, Brighton E, Campbell N, McCleary NJ, Abrams TA, Cleary JM, Enzinger PC, Ng K, Rubinson D, Wolpin BM, Yurgelun MB, Meyerhardt JA. Physical activity in older adults with metastatic gastrointestinal cancer: a pilot and feasibility study. BMJ Open Sport Exerc Med 2022; 8:e001353. [PMID: 35722047 PMCID: PMC9152931 DOI: 10.1136/bmjsem-2022-001353] [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] [Accepted: 05/16/2022] [Indexed: 11/04/2022] Open
Abstract
Objectives This study determined the feasibility of delivering a 12-week structured physical activity programme during chemotherapy to older adults recently diagnosed with metastatic gastrointestinal (GI) cancer. Methods This study used a single-cohort design. Older adults (aged ≥65 years) diagnosed with metastatic oesophageal, gastric, pancreatic or colorectal cancer who planned to initiate chemotherapy were enrolled. The physical activity programme included a combination of aerobic, flexibility, strength and balance modalities delivered by a certified cancer exercise trainer during chemotherapy infusion appointments, then translated and sustained at home by participants. The co-primary endpoints included: (1) accrual of 20 participants in 12 months and (2) physical activity adherence of ≥50%. Results Between March and October 2018, 29 participants were screened, and 20 were enrolled within 12 months (recruitment rate: 69% (90% CI: 55% to 83%); p<0.001), meeting the first co-primary endpoint. The median age of participants was 73.3 years (IQR: 69.3-77.2). At week 12, 67% (90% CI: 48% to 85%) of participants adhered to ≥50% of the prescribed physical activity (p=0.079 (statistically significant)), meeting the second co-primary endpoint. From baseline to week 12, accelerometer-measured light-intensity and moderate-intensity to vigorous-intensity physical activity increased by 307.4 (95% CI: 152.6 to 462.2; p<0.001) and 25.0 min per week (95% CI: 9.9 to 40.1; p=0.001), respectively. There were no serious or unexpected adverse events. The median overall survival was 16.2 months (8.4-22.4). Conclusion These results establish the feasibility of a larger scale randomised controlled trial that enrols older adults with metastatic GI cancer and delivers a structured physical activity programme during chemotherapy. Trial registration number NCT03331406.
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Affiliation(s)
- Justin C Brown
- Cancer Metabolism Program, Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA.,Department of Genetics, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - Elizabeth Brighton
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Nancy Campbell
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Nadine J McCleary
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Thomas A Abrams
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - James M Cleary
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Peter C Enzinger
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Kimmie Ng
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Douglas Rubinson
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Brian M Wolpin
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Matthew B Yurgelun
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Jeffrey A Meyerhardt
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
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Avancini A, Sperduti I, Borsati A, Ferri T, Belluomini L, Insolda J, Trestini I, Tregnago D, Schena F, Bria E, Milella M, Pilotto S. Effect of exercise on functional capacity in patients with advanced cancer: A meta-analysis of randomized controlled trials. Crit Rev Oncol Hematol 2022; 175:103726. [PMID: 35659975 DOI: 10.1016/j.critrevonc.2022.103726] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 05/19/2022] [Accepted: 05/19/2022] [Indexed: 01/18/2023] Open
Abstract
PURPOSE To determine the impact of exercise on functional capacity, measured through the "Six minutes walking test" (6MWT) in patients with advanced cancer stage. METHODS Systematic research on PubMed, Cochrane Library, and SportDiscus was conducted. Randomized controlled trials were eligible if they examined the effect of exercise on 6MWT. RESULTS Overall, a total of ten trials were included in the primary analysis. Compared to the controls, the exercise intervention was associated with an increase in functional capacity (+20.86 m; CI: -5.90 to 47.72, p = 0.12) although not reaching the statistical significance. Sensitivity analysis revealed an improvement for studies proposing a supervised exercise intervention towards the statistical significance. Few adverse events were associated with exercise training, and the median withdrawals rate was 17%. CONCLUSIONS Exercise may have a beneficial role on functional capacity in patients with advanced cancer, especially if supervised.
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Affiliation(s)
- Alice Avancini
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy; Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
| | - Isabella Sperduti
- Biostatistical Unit - Clinical Trials Center IRCCS Istituto Nazionale Tumori Regina Elena, U.O. di Biostatistica e Bioinformatica, Rome, Italy.
| | - Anita Borsati
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
| | - Thomas Ferri
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
| | - Lorenzo Belluomini
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Jessica Insolda
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Ilaria Trestini
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Daniela Tregnago
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Federico Schena
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
| | - Emilio Bria
- Department of Medical Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
| | - Michele Milella
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
| | - Sara Pilotto
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.
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Baseline Electrocardiographic and Echocardiographic Assessment May Help Predict Survival in Lung Cancer Patients-A Prospective Cardio-Oncology Study. Cancers (Basel) 2022; 14:cancers14082010. [PMID: 35454916 PMCID: PMC9032028 DOI: 10.3390/cancers14082010] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 03/28/2022] [Accepted: 04/12/2022] [Indexed: 12/24/2022] Open
Abstract
Cardiovascular disease and cancer coexist and lead to exertional dyspnea. The aim of the study was to determine the prognostic significance of cardiac comorbidities, ECG and baseline echocardiography in lung cancer patients with varying degrees of reduced performance status. This prospective study included 104 patients with histopathologically confirmed lung cancer, pre-qualified for systemic treatment due to metastatic or locally advanced malignancy but not eligible for thoracic surgery. The patients underwent a comprehensive cardio-oncological evaluation. Overall survival negative predictors included low ECOG 2 (Eastern Cooperative Oncology Group) performance status, stage IV (bone or liver/adrenal metastases in particular), pleural effusion, the use of analgesics and among cardiac factors, two ECG parameters: atrial fibrillation (HR = 2.39) and heart rate >90/min (HR = 1.67). Among echocardiographic parameters, RVSP > 39 mmHg was a negative predictor (HR = 2.01), while RVSP < 21 mmHg and RV free wall strain < −30% were positive predictors (HR = 0.36 and HR = 0.56, respectively), whereas RV GLS < −25.5% had a borderline significance (HR = 0.59; p = 0.05). Logistical regression analysis showed ECOG = 2 significantly correlated with the following echocardiographic parameters: increasing RVSP, RV GLS, RV free wall strain and decreasing ACT, FAC (p < 0.05). Selected echocardiographic parameters may be helpful in predicting poor performance in lung cancer patients and, supplemented with ECG evaluation, broaden the possibilities of prognostic evaluation.
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Gouez M, Pérol O, Pérol M, Caux C, Ménétrier-Caux C, Villard M, Walzer T, Delrieu L, Saintigny P, Marijnen P, Pialoux V, Fervers B. Effect of acute aerobic exercise before immunotherapy and chemotherapy infusion in patients with metastatic non-small-cell lung cancer: protocol for the ERICA feasibility trial. BMJ Open 2022; 12:e056819. [PMID: 35393316 PMCID: PMC8990709 DOI: 10.1136/bmjopen-2021-056819] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION Patients with metastatic non-small cell lung cancer (mNSCLC) suffer from numerous symptoms linked to disease and treatment which may further impair the patient's overall condition. In addition to its benefits on quality of life and fatigue, physical exercise may improve treatment response, notably due to its known effects on the immune system. The ERICA study is designed to assess the feasibility of a supervised acute physical exercise therapy realised immediately prior immune-chemotherapy infusion in patients with mNSCLC. Secondary objectives will examine the effects of acute exercise combined with an unsupervised home-walking programme on clinical, physical, psychosocial and biological parameters. METHODS AND ANALYSIS ERICA is a prospective, monocentric, randomised controlled, open-label feasibility study conducted at the Centre Léon Bérard Comprehensive Cancer Center (France). Thirty patients newly diagnosed with mNSCLC will be randomised (2:1 ratio) to the 'exercise' or the 'control' group. At baseline and during the last treatment cycle, participants in both groups will receive Physical Activity recommendations, and two nutritional assessments. In the exercise group, participants will receive a 3-month programme consisting of a supervised acute physical exercise session prior to immune-chemotherapy infusion, and an unsupervised home-based walking programme with an activity tracker. The acute exercise consists of 35 min interval training at submaximal intensity scheduled to terminate 15 min prior to infusion. Clinical, physical, biological and psychosocial parameters will be assessed at baseline, 3 and 6 months after inclusion. Biological measures will include immune, inflammatory, metabolic, oxidative stress biomarkers and molecular profiling. ETHICS AND DISSEMINATION The study protocol was approved by the French ethics committee (Comité de protection des personnes Ile de France II, N°ID-RCB 20.09.04.65226, 8 December 2020). The study is registered on ClinicalTrials.gov (NCT number:NCT04676009) and is at the pre-results stage. All participants will sign an informed consent form. The findings will be disseminated in peer-reviewed journals and academic conferences.
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Affiliation(s)
- Manon Gouez
- Department of Cancer Prevention and Environment, Centre Léon Bérard, Lyon, Rhône-Alpes, France
- Inter-University Laboratory of Human Movement Biology, Universite Claude Bernard Lyon 1, Villeurbanne, Auvergne-Rhône-Alpes, France
| | - Olivia Pérol
- Department of Cancer Prevention and Environment, Centre Léon Bérard, Lyon, Rhône-Alpes, France
| | - Maurice Pérol
- Department of Medical Oncology, Centre Léon Bérard, Lyon, Rhône-Alpes, France
| | - Christophe Caux
- INSERM U1052, Lyon, Rhône-Alpes, France
- Laboratory of Cancer Immunotherapy of LYON, Centre Léon Bérard, Lyon, Rhône-Alpes, France
| | - Christine Ménétrier-Caux
- INSERM U1052, Lyon, Rhône-Alpes, France
- Laboratory of Cancer Immunotherapy of LYON, Centre Léon Bérard, Lyon, Rhône-Alpes, France
| | - Marine Villard
- Inserm, U1111, CNRS UMR5308, Centre International de Recherche en Infectiologie, Lyon, Rhône-Alpes, France
| | - Thierry Walzer
- Inserm, U1111, CNRS UMR5308, Centre International de Recherche en Infectiologie, Lyon, Rhône-Alpes, France
| | - Lidia Delrieu
- Department of Cancer Prevention and Environment, Centre Léon Bérard, Lyon, Rhône-Alpes, France
- Inter-University Laboratory of Human Movement Biology, Universite Claude Bernard Lyon 1, Villeurbanne, Auvergne-Rhône-Alpes, France
| | - Pierre Saintigny
- INSERM U1052, Lyon, Rhône-Alpes, France
- Department of Translational Medicine, Centre Léon Bérard, Lyon, Rhône-Alpes, France
| | - Philippe Marijnen
- Department of Cancer Prevention and Environment, Centre Léon Bérard, Lyon, Rhône-Alpes, France
| | - Vincent Pialoux
- Inter-University Laboratory of Human Movement Biology, Universite Claude Bernard Lyon 1, Villeurbanne, Auvergne-Rhône-Alpes, France
| | - Béatrice Fervers
- Department of Cancer Prevention and Environment, Centre Léon Bérard, Lyon, Rhône-Alpes, France
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Rehabilitation in Advanced Cancer Patients with Bone Metastases and Neural Compromise: Current Status and Future Directions. Curr Oncol Rep 2022; 24:1023-1033. [PMID: 35362828 DOI: 10.1007/s11912-022-01229-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE OF REVIEW This review aimed to increase the understanding of oncologists and physiatrists about the necessity, efficacy, and safety of rehabilitation in advanced cancer patients with bone metastases and neural compromise. RECENT FINDINGS Recently, there are growing evidence supporting the safety and efficacy of rehabilitation in patients with bone metastases and neural compromise. Despite the potential benefits of rehabilitation, however, rehabilitative services are considerably underutilized in clinical practice. Many oncologists are not familiar with functional issues and have limited understanding of the available rehabilitative services. Moreover, medical professionals, even physiatrists, have uncertainties and concerns about skeletal complications and often regard rehabilitation as a contraindication in this patient group. This review aimed to raise awareness on the role of rehabilitation in the continuum of cancer treatment, to improve its use in clinical practice. A multidisciplinary team approach involving physiatrist may facilitate integration of relevant clinicians.
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Abstract
PURPOSE OF REVIEW In this review, we provide an overview of what is currently known about the impacts of mechanical stimuli on metastatic tumor-induced bone disease (TIBD). Further, we focus on the role of the osteocyte, the skeleton's primary mechanosensory cell, which is central to the skeleton's mechanoresponse, sensing and integrating local mechanical stimuli, and then controlling the downstream remodeling balance as appropriate. RECENT FINDINGS Exercise and controlled mechanical loading have anabolic effects on bone tissue in models of bone metastasis. They also have anti-tumorigenic properties, in part due to offsetting the vicious cycle of osteolytic bone loss as well as regulating inflammatory signals. The impacts of metastatic cancer on the mechanosensory function of osteocytes remains unclear. Increased mechanical stimuli are a potential method for mitigating TIBD.
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Affiliation(s)
- Blayne A Sarazin
- Department of Mechanical Engineering, University of Colorado, 427 UCB, Boulder, CO, 80309, USA
| | - Claire L Ihle
- Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Philip Owens
- Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA
- Department of Veterans Affairs, Research Service, Eastern Colorado Health Care System, Aurora, CO, 80045, USA
| | - Maureen E Lynch
- Department of Mechanical Engineering, University of Colorado, 427 UCB, Boulder, CO, 80309, USA.
- Biofrontiers Institute, University of Colorado, Boulder, CO, 80309, USA.
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