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De La Torre SA, Pickering T, Spruijt-Metz D, Farias AJ. The frequency of using wearable activity trackers is associated with minutes of moderate to vigorous physical activity among cancer survivors: Analysis of HINTS data. Cancer Epidemiol 2024; 88:102491. [PMID: 38042129 DOI: 10.1016/j.canep.2023.102491] [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: 06/05/2023] [Revised: 11/03/2023] [Accepted: 11/10/2023] [Indexed: 12/04/2023]
Abstract
BACKGROUND Despite the health benefits, cancer survivors tend to exercise less after diagnosis and treatment. Wearable activity trackers (WATs) can provide avenues for self-monitoring and may enhance exercise motivation and enjoyment. However, less is known about the relationship between how often survivors use wearables and their amount of moderate to vigorous physical activity (MVPA). METHODS Data was utilized from the National Cancer Institute's Health Information National Trend Survey 5 Cycles 3-4 (January 2019 - June 2020). To account for overdispersion and excessive zeros in the outcome variable (weekly minutes of MVPA), a zero inflated negative binomial regression model was used. RESULTS The majority of the sample (n = 1369) were female (n = 735, 53.7 %), non-Hispanic White (n = 961, 70.2 %) and 34.3 % (n = 664) were between the ages of 65-74 years. Non-melanoma skin cancer was the most frequently reported cancer type (n = 334, 24.4 %) and 48.5 % (n = 664) reported that it had been 11 + years since their diagnosis. Survivors who reported daily WAT use were estimated to have 3.53 times higher number of MVPA minutes per week compared to survivors who reported non-daily WAT usage (RR: 3.53, 2.76-4.53, p = <0.001). Based on the model, daily WAT users had an expected mean MVPA of 202 min per week (95 % CI: 191.15-226.59) compared to non-daily users (132 min, 95 % CI: 119.81-140.22) and non-WAT users (88 min, 95 % CI: 84.46-92.50). CONCLUSION According to this model, survivors who reported daily WAT use were estimated on average to have weekly MVPA minutes that meet or exceed MVPA recommendations (>= 150 min of MVPA per week) compared to survivors who reported infrequent or no WAT use. Wearables may provide an opportunity for survivors to engage in self-monitoring and can potentially support exercise tracking and engagement.
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Affiliation(s)
- Steven A De La Torre
- The Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, United States.
| | - Trevor Pickering
- Department of Population and Public Health Sciences, Keck School of Medicine, Los Angeles, CA, United States
| | - Donna Spruijt-Metz
- Dornsife Center for Economic and Social Research, Department of Psychology, University of Southern California, Los Angeles, CA, United States
| | - Albert J Farias
- Department of Population and Public Health Sciences, Keck School of Medicine, Los Angeles, CA, United States; Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
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2
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Dovey Z, Horowitz A, Waingankar N. The influence of lifestyle changes (diet, exercise and stress reduction) on prostate cancer tumour biology and patient outcomes: A systematic review. BJUI COMPASS 2023; 4:385-416. [PMID: 37334023 PMCID: PMC10268595 DOI: 10.1002/bco2.237] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 03/05/2023] [Indexed: 06/20/2023] Open
Abstract
Background The mostly indolent natural history of prostate cancer (PCa) provides an opportunity for men to explore the benefits of lifestyle interventions. Current evidence suggests appropriate changes in lifestyle including diet, physical activity (PA) and stress reduction with or without dietary supplements may improve both disease outcomes and patient's mental health. Objective This article aims to review the current evidence on the benefits of all lifestyle programmes for PCa patients including those aimed at reducing obesity and stress, explore their affect on tumour biology and highlight any biomarkers that have clinical utility. Evidence acquisition Evidence was obtained from PubMed and Web of Science using keywords for each section on the affects of lifestyle interventions on (a) mental health, (b) disease outcomes and (c) biomarkers in PCa patients. PRISMA guidelines were used to gather the evidence for these three sections (15, 44 and 16 publications, respectively). Evidence synthesis For lifestyle studies focused on mental health, 10/15 demonstrated a positive influence, although for those programmes focused on PA it was 7/8. Similarly for oncological outcomes, 26/44 studies demonstrated a positive influence, although when PA was included or the primary focus, it was 11/13. Complete blood count (CBC)-derived inflammatory biomarkers show promise, as do inflammatory cytokines; however, a deeper understanding of their molecular biology in relation to PCa oncogenesis is required (16 studies reviewed). Conclusions Making PCa-specific recommendations on lifestyle interventions is difficult on the current evidence. Nevertheless, notwithstanding the heterogeneity of patient populations and interventions, the evidence that dietary changes and PA may improve both mental health and oncological outcomes is compelling, especially for moderate to vigorous PA. The results for dietary supplements are inconsistent, and although some biomarkers show promise, significantly more research is required before they have clinical utility.
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Affiliation(s)
- Zach Dovey
- Mount Sinai Health System, Department of UrologyIcahn Medical SchoolNew YorkNew YorkUSA
| | - Amir Horowitz
- Icahn School of MedicineThe Mount Sinai HospitalNew YorkNew YorkUSA
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Eyl-Armbruster RE, Thong MSY, Carr PR, Jansen L, Chang-Claude J, Hoffmeister M, Brenner H, Arndt V. Change Toward Healthier Lifestyles Is Associated With Better Health-Related Quality of Life in Long-Term Colorectal Cancer Survivors. J Natl Compr Canc Netw 2022; 20:1233-1243.e10. [PMID: 36351340 DOI: 10.6004/jnccn.2022.7049] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 06/28/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Little is known about how changes in a constellation of lifestyle factors affect health-related quality of life (HRQoL) in colorectal cancer (CRC) survivors. Our study aimed to investigate the association between changes in healthy lifestyle and HRQoL over time in survivors of stage I-IV CRC. METHODS We included 2,283 long-term (≥5 years postdiagnosis) survivors. A healthy lifestyle score (HLS) comprising smoking, alcohol consumption, diet, physical activity, and body fatness was derived at diagnosis and 5-year follow-up (5YFU) and categorized as low, moderate, or high. We assessed HRQoL with the EORTC Quality of Life Questionnaire-Core 30 at 5YFU and 10-year follow-up. We used multivariable linear regression and linear mixed models to explore associations between changes in HLS and HRQoL over follow-up. RESULTS A low baseline HLS was associated with poorer functioning and global health/QoL and a higher symptom burden at 5YFU compared with a high baseline HLS. An improved HLS from baseline to 5YFU was associated with better functioning, higher global health/QoL, and fewer symptoms at 5YFU than a maintained-high HLS. In longitudinal analyses, improved HLS was associated with better functioning at follow-up. Survivors with a maintained-high or an improved HLS reported generally less fatigue, pain, and dyspnea at follow-ups compared with survivors with a maintained-low or decreased HLS. CONCLUSIONS Change toward a healthier lifestyle since diagnosis was associated with better HRQoL in long-term CRC survivors. Our results support the importance of maintaining and/or promoting a healthier lifestyle among CRC survivors postdiagnosis.
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Affiliation(s)
- Ruth Elisa Eyl-Armbruster
- 1Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
- 2Stuttgart Cancer Center-Tumorzentrum Eva Mayr-Stihl, Klinikum Stuttgart, Stuttgart, Germany
| | - Melissa S Y Thong
- 3Unit of Cancer Survivorship, Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
| | - Prudence R Carr
- 1Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
- 4Division of Chronic Disease and Aging, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Lina Jansen
- 1Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
| | - Jenny Chang-Claude
- 5Unit of Genetic Epidemiology, Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
- 6Cancer Epidemiology Group, University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michael Hoffmeister
- 1Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
| | - Hermann Brenner
- 1Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
- 7Division of Preventive Oncology, German Cancer Research Center and National Center for Tumor Diseases, Heidelberg, Germany; and
- 8German Cancer Consortium, German Cancer Research Center, Heidelberg, Germany
| | - Volker Arndt
- 3Unit of Cancer Survivorship, Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
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Robles LA, Shingler E, McGeagh L, Rowe E, Koupparis A, Bahl A, Shiridzinomwa C, Persad R, Martin RM, Lane JA. Attitudes and adherence to changes in nutrition and physical activity following surgery for prostate cancer: a qualitative study. BMJ Open 2022; 12:e055566. [PMID: 35768108 PMCID: PMC9244678 DOI: 10.1136/bmjopen-2021-055566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Interventions designed to improve men's diet and physical activity (PA) have been recommended as methods of cancer prevention. However, little is known about specific factors that support men's adherence to these health behaviour changes, which could inform theory-led diet and PA interventions. We aimed to explore these factors in men following prostatectomy for prostate cancer (PCa). DESIGN, SETTING AND PARTICIPANTS A qualitative study using semistructured interviews with men, who made changes to their diet and/or PA as part of a factorial randomised controlled trial conducted at a single hospital in South West England. Participants were 17 men aged 66 years, diagnosed with localised PCa and underwent prostatectomy. Interview transcripts underwent thematic analysis. RESULTS Men were ambivalent about the relationship of nutrition and PA with PCa risk. They believed their diet and level of PA were reasonable before being randomised to their interventions. Men identified several barriers and facilitators to performing these new behaviours. Barriers included tolerance to dietary changes, PA limitations and external obstacles. Facilitators included partner involvement in diet, habit formation and brisk walking as an individual activity. Men discussed positive effects associated with brisk walking, such as feeling healthier, but not with nutrition interventions. CONCLUSIONS The facilitators to behaviour change suggest that adherence to trial interventions can be supported using well-established behaviour change models. Future studies may benefit from theory-based interventions to support adherence to diet and PA behaviour changes in men diagnosed with PCa.
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Affiliation(s)
- Luke A Robles
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Ellie Shingler
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Lucy McGeagh
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
- Supportive Cancer Care Research Group, Faculty of Health and Life Sciences, Oxford Institute of Nursing, Midwifery and Allied Health Research, Oxford Brookes University, Oxford, UK
| | - Edward Rowe
- Bristol Urology Institute, Department of Urology, North Bristol NHS Trust, Bristol, UK
| | - Anthony Koupparis
- Bristol Urology Institute, Department of Urology, North Bristol NHS Trust, Bristol, UK
| | - Amit Bahl
- Bristol Haematology and Oncology Centre, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | | | - Raj Persad
- Bristol Urology Institute, Department of Urology, North Bristol NHS Trust, Bristol, UK
| | - Richard M Martin
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
- Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
| | - J Athene Lane
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
- Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
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Bahar-Ozdemir Y, Kaya S, Babacan NA, Al T, Albayrak E, Coskun N, Akyuz G. Can assessment of disease burden and quality of life based on mobility level in patients with end-stage cancer provide an insight into unmet needs? An exploratory cross-sectional study. Physiother Theory Pract 2022; 39:1141-1151. [PMID: 35100940 DOI: 10.1080/09593985.2022.2035029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE The purpose of this study was to: 1) investigate the differences in the needs of end-stage cancer who can move independently, using mobility aids (MA), or are bedridden; and 2) determine the effects of these different mobility levels on the patients' current quality of life (QoL), fatigue, and mental conditions. METHODS The study employed an exploratory prospective cross-sectional study design, which was carried out in two hospitals. The study included 99 end-stage cancer. The mobility levels of the patients were evaluated in three groups: Group 1: bedridden; Group 2: mobile with MA; and Group 3: ambulatory (under supervision or fully independent). A core cancer-specific questionnaire-integrating system for assessing health-related QOL (EORTC-QLQ-C15-PAL), the Piper Fatigue Scale (PFS), and the Hospital Anxiety-Depression scale were utilized. The median age was 60years (31-83). Cancer types were as follows: gastrointestinal (45.5%), lung (38.4%), breast (4%), genitourinary system (4%), and others (8%). Forty-two percent of the patients were completely bedridden, 42.2% used MA, and 15.2% were independently ambulatory. The EORTC QLQ-C15-PAL physical (=.000) and emotional function values (=.029) differed among mobilization statuses. There was a significant difference among mobilization groups, in terms of behavioral values, in the PFS (=.006). The depression rate in the independent ambulatory group was lower than in the bedridden and MA groups (=0.011; =0.004). p p p p1 p2 . CONCLUSION Health-related QoL, fatigue level, and emotional state vary in end-stage cancer who undergo evaluations according to their mobility levels. These patients should be assessed comprehensively, and treatment plans should be organized carefully, with a multidisciplinary approach.
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Affiliation(s)
- Yeliz Bahar-Ozdemir
- Department of Physical Medicine and Rehabilitation, Health Sciences University Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - Sefik Kaya
- Department of Physical Medicine and Rehabilitation, Arnavutkoy State Hospital, Istanbul, Turkey
| | - Nalan Akgul- Babacan
- Department of Clinical Oncology, Marmara University School of Medicine, Istanbul, Turkey
| | - Tugce Al
- Emergency Medicine Clinic, Mardin State Hospital, Mardin, Turkey
| | - Ece Albayrak
- Department of Internal Medicine, Ammerland Klinik GmbH, Westerstede, Germany
| | - Nilufer Coskun
- Department of Anesthesiology and Reanimation, Sancaktepe Sehit Prof Dr Ilhan Varank Training and Research Hospital, Istanbul, Turkey
| | - Gulseren Akyuz
- Department of Physical Medicine and Rehabilitation and Division of Pain Medicine, Marmara University School of Medicine, Istanbul, Turkey
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Cho D, Milbury K, Liao Y, Pettaway CA, Gregg JR, Li Y, McNeill LH. Study protocol: One plus one can be greater than two-Ecological momentary assessment for Black prostate cancer survivors and partners. PLoS One 2021; 16:e0255614. [PMID: 34370761 PMCID: PMC8351991 DOI: 10.1371/journal.pone.0255614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 07/20/2021] [Indexed: 11/18/2022] Open
Abstract
Given that romantic partners play a pivotal role in patients' survivorship period, integrating partners into survivorship care and broadening the focus of behavioral interventions from the individual (survivor) to the survivor-partner dyad may make healthy lifestyle behaviors more easily adopted and potentially maintained. Understanding the role of dyadic processes in Black survivors is particularly important because their lifestyle behaviors are poor and they have higher cancer-specific and all-cause mortality. To develop an effective dyadic lifestyle behavior intervention for Black survivors, micro-level investigations of interactions between Black survivors and their partners are necessary to pinpoint how survivors and partners facilitate or hinder each other's lifestyle behaviors in their natural, everyday lives. Accordingly, the objective of the present study is to fill these gaps using ecological momentary assessment to eventually develop more effective lifestyle interventions for Black prostate cancer (PCa) survivors and partners. A total of 120 dyads (i.e., 240 individuals) who are Black adult survivors diagnosed with non-metastatic PCa and their romantic partners will be asked to complete four assessments per day for 14 consecutive days on a smartphone after an initial retrospective survey. Over the 14 days, participants will be asked to complete a brief survey regarding their lifestyle behaviors (physical activity, sedentariness and eating behaviors), contexts of lifestyle behaviors, stress, and coping. Physical activity and sedentary behavior will be assessed via accelerometer; eating behaviors will be assessed with the Automated Self-Administered 24-hour Dietary Assessment Tool. After completing the 14-day assessment, participants will be asked to complete a final retrospective survey. Results of the proposed study will inform the rigorous development of a theory-based dyadic lifestyle intervention in this vulnerable survivorship population with the ultimate goal to improve overall survival and reduce morbidities (for survivors) and reduce cancer incidence (for partners).
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Affiliation(s)
- Dalnim Cho
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
| | - Kathrin Milbury
- Department of Behavioral Sciences, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
| | - Yue Liao
- Department of Kinesiology, The University of Texas at Arlington, Dallas, Texas, United States of America
| | - Curtis A. Pettaway
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
| | - Justin R. Gregg
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
| | - Yisheng Li
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
| | - Lorna H. McNeill
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
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Canadian Resources, Programs, and Models of Care to Support Cancer Survivors' Transition beyond Treatment: A Scoping Review. ACTA ACUST UNITED AC 2021; 28:2134-2145. [PMID: 34207635 PMCID: PMC8293069 DOI: 10.3390/curroncol28030198] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 05/27/2021] [Accepted: 06/03/2021] [Indexed: 12/01/2022]
Abstract
(1) Background: One in two Canadians will be diagnosed with cancer in their lifetime, but as a result of the progress in diagnosis and treatment, more individuals are surviving cancer than ever before. However, the impact of cancer does not end with treatment. The objectives of this review are to (1) provide a broad overview of the supportive care interventions and models of care that have been researched to support Canadian post-treatment cancer survivors; and (2) analyze how these supportive care interventions and/or care models align with the practice recommendations put forth by Cancer Care Ontario (CCO) and the Canadian Association of Psychosocial Oncology/Canadian Partnership Against Cancer (CAPO/CPAC). (2) Methods: An electronic search was completed in MEDLINE, Embase, PsycINFO, and CINAHL in January 2021. Included studies described supportive care interventions or models of care utilized by adult Canadian cancer survivors. (3) Results: Forty-two articles were included. Survivors utilized a multitude of supportive care interventions, with peer support and physical activity programs being most frequently cited. Four models of follow-up care were identified: primary care, oncology care, shared-care, and transition clinics. The supportive care interventions and models of care variably aligned with the recommendations set by CCO and CAPO/CPAC. The most commonly followed recommendation was the promotion of self-management and quality resources for patients. (4) Conclusions: Results indicate an inconsistency in access to supportive care interventions and the delivery of survivorship care for cancer survivors across Canada. Current efforts are being made to implement the recommendations by CCO and CAPO/CPAC; however, provision of these guidelines remains varied.
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8
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Cho D, Basen-Engquist K, Acquati C, Pettaway C, Ma H, Markofski M, Li Y, Canfield SE, Gregg J, McNeill LH. Cultural Adaptation of Evidence-Based Lifestyle Interventions for African American Men With Prostate Cancer: A Dyadic Approach. Am J Mens Health 2020; 14:1557988320945449. [PMID: 33148111 PMCID: PMC7653295 DOI: 10.1177/1557988320945449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 06/16/2020] [Accepted: 07/06/2020] [Indexed: 11/16/2022] Open
Abstract
Although a number of lifestyle interventions have been developed for cancer survivors, the extent to which they are effective for African American men with cancer is unclear. Given that African American men have the highest prostate cancer burden and the lack of proven interventions, this study developed a culturally-tailored lifestyle intervention for African American men with prostate cancer and their partners that aimed to improve healthy lifestyle behaviors (physical activity and healthy eating) and quality of life. The aim of the present study is to provide a detailed overview of the model-based process of intervention adaptation. Based on the IM Adapt approach (Highfield et al., 2015) and Typology of Adaptation (Davidson et al., 2013), the present study adapted existing, evidence-based interventions to address African American prostate cancer survivors' and their partners' potential unmet needs including anxiety/uncertainty about cancer progression, communication between partners, cultural sensitivity, and concordance/discordance of motivation and behaviors between partners. The intervention adaptation was a comprehensive and fluid process. To the best knowledge of the author, this is the first couple-based lifestyle intervention specifically developed for African American men with prostate cancer. The present study will be highly informative to future investigators by providing flexible and detailed information regarding lifestyle intervention adaptation for racial/ethnic minority men with prostate cancer and their partners.
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Affiliation(s)
- Dalnim Cho
- University of Texas MD Anderson
Cancer Center, Houston, TX, USA
| | | | | | - Curtis Pettaway
- University of Texas MD Anderson
Cancer Center, Houston, TX, USA
| | - Hilary Ma
- University of Texas MD Anderson
Cancer Center, Houston, TX, USA
| | | | - Yisheng Li
- University of Texas MD Anderson
Cancer Center, Houston, TX, USA
| | | | - Justin Gregg
- University of Texas MD Anderson
Cancer Center, Houston, TX, USA
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Bergengren O, Enblad AP, Garmo H, Bratt O, Holmberg L, Johansson E, Bill-Axelson A. Changes in lifestyle among prostate cancer survivors: A nationwide population-based study. Psychooncology 2020; 29:1713-1719. [PMID: 32779258 PMCID: PMC7589218 DOI: 10.1002/pon.5513] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 07/16/2020] [Accepted: 08/03/2020] [Indexed: 12/20/2022]
Abstract
Objective Long‐term information on lifestyle changes among prostate survivors is lacking. In this nationwide, population‐based study we investigated the prevalence of lifestyle changes, factors associated with lifestyle changes and associations between lifestyle changes and general quality of life. Methods All men registered in the National Prostate Cancer Register of Sweden diagnosed in 2008 with low‐risk prostate cancer at age 70 years or younger were sent a questionnaire. Logistic regression was used to calculate odds ratios (ORs) with 95% confidence intervals for factors potentially associated with lifestyle change. Results Out of 1288, 1720 men (75%) were responded. A total of 279 (22%) reported a positive lifestyle change regarding diet or exercise. Poor functional outcomes after treatment was associated with exercising less (OR 1.6, 95% CI 1.2‐2.1) and less interest in social activities and relationships (OR 1.8, 95% CI 1.5‐2.1). Men who exercised more (OR 7.9, 95% CI 4.4‐14) and men who had an increased interest in relationships and social activities (OR 5.2, 95% CI 2.1‐13) reported higher general quality of life. Conclusions A considerable proportion of men reported making positive lifestyle changes after the prostate cancer diagnosis. The time after diagnosis may be a teachable moment that facilitates lifestyle interventions. Poor functional outcomes after treatment may reduce the willingness to engage in positive lifestyle change, which need be considered when supporting men after treatment. Men who made a positive lifestyle change, regardless of whether it was exercise or regarding relationships and social activities more often reported a high level of general quality of life.
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Affiliation(s)
- Oskar Bergengren
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Anna Pia Enblad
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Hans Garmo
- Regional Cancer Center Uppsala Örebro, Uppsala University, Uppsala, Sweden.,Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Ola Bratt
- Department of Urology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Urology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Lars Holmberg
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.,Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - Eva Johansson
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Anna Bill-Axelson
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
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Tristão Parra M, Esmeaeli N, Kohn J, Henry BL, Klagholz S, Jain S, Pruitt C, Vicario D, Jonas W, Mills PJ. Greater Well-Being in More Physically Active Cancer Patients Who Are Enrolled in Supportive Care Services. Integr Cancer Ther 2020; 19:1534735420921439. [PMID: 32456467 PMCID: PMC7265567 DOI: 10.1177/1534735420921439] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background: Cancers are one of the leading causes of mortality
worldwide. Cancer patients are increasingly seeking integrative care clinics to
promote their health and well-being during and after treatment.
Aim: To examine relationships between physical activity (PA)
and quality of life (QoL) in a sample of cancer patients enrolling in
integrative care in a supportive care clinic. Also, to explore circulating
inflammatory biomarkers and heart rate variability (HRV) in relationship to PA
and QoL. Methods: A cross-sectional design of adult patients who
sought care in the InspireHealth clinic, Vancouver, British Columbia, Canada.
Patients with complete PA data (n = 118) answered psychosocial questionnaires,
provided blood samples, and received HRV recordings before enrollment. Patients
were stratified into “less” versus “more” active groups according to PA
guidelines (150 minutes of moderate or 75 minutes of vigorous PA or an
equivalent combination). Results: Breast (33.1%) and prostate
(10.2%) cancers were the most prevalent primary diagnoses. Patients engaging in
more PA reported better physical (U = 1265.5,
P = .013), functional (U = 1306.5,
P = .024), and general QoL (U = 1341,
P = .039), less fatigue (U = 1268,
P = .014), fewer physical cancer-related symptoms
(U = 2.338, P = .021), and less general
distress (U = 2.061, P = .021). Between PA
groups, type of primary cancer diagnosis differed (χ2 = 41.79,
P = .014), while stages of cancer did not (χ2 =
3.95, P = .412). Fewer patients reported depressed mood within
the more active group (χ2 = 6.131, P = .047). More
active patients were also less likely to have ever used tobacco (χ2 =
7.41, P = .025) and used fewer nutritional supplements
(χ2 = 39.74, P ≤ .001). An inflammatory
biomarker index was negatively correlated with vigorous PA
(rs = −0.215, P = .022).
Multivariable linear regression (R2 = 0.71) revealed
that age (β = 0.22; P = .001), fatigue (β = −0.43;
P ≤ .001), anxiety (β = −0.14; P = .048),
and social support (β = 0.38; P = .001) were significant
correlates of QoL.
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Affiliation(s)
| | - Naghmeh Esmeaeli
- Samueli Integrative Health Programs, H&S Ventures, Alexandria, VA, USA
| | - Jordan Kohn
- University of California San Diego, La Jolla, CA, USA
| | - Brook L Henry
- University of California San Diego, La Jolla, CA, USA
| | | | - Shamini Jain
- University of California San Diego, La Jolla, CA, USA
| | | | | | - Wayne Jonas
- Samueli Integrative Health Programs, H&S Ventures, Alexandria, VA, USA
| | - Paul J Mills
- University of California San Diego, La Jolla, CA, USA
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Papadopoulos E, Alibhai SMH, Doré I, Matthew AG, Tomlinson GA, Nesbitt M, Finelli A, Trachtenberg J, Santa Mina D. Associations between self-reported physical activity, quality of life, and emotional well-being in men with prostate cancer on active surveillance. Psychooncology 2020; 29:1044-1050. [PMID: 32154965 DOI: 10.1002/pon.5375] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 02/29/2020] [Accepted: 03/03/2020] [Indexed: 01/21/2023]
Abstract
OBJECTIVE The relationship between physical activity (PA) and quality of life (QOL) relative to active treatment for prostate cancer (PCa) has been well-studied; however, little is known about this relationship during active surveillance (AS). Moreover, whether PA is associated with better emotional well-being (EWB) in men with low-risk PCa requires further investigation. Accordingly, we examined the association between self-reported PA and the average change in QOL and EWB over time during AS. METHODS A total of 630 men on AS were included in this retrospective, longitudinal study from AS initiation until AS discontinuation. Generalized estimated equations were used to determine the association between self-reported PA (independent variable) and QOL and EWB (dependent variables) over time, adjusting for participants' age. RESULTS QOL was higher over time in active ( β ^ (95%CI) = 1.14 (0.11, 2.16), P = .029) and highly active participants ( β ^ (95%CI) = 1.62 (0.58, 2.67), P = .002) compared to their inactive counterparts. Highly active participants had 55% greater odds of experiencing high EWB relative to inactive participants (OR (95%CI) = 1.55 (1.11, 2.16), P = .010). In men with low EWB at baseline (median = 3 months after diagnosis), the highest levels of PA (>1000 metabolic equivalent-minutes per week) were associated with high EWB over time (OR (95%CI) = 2.17 (1.06, 4.46), P = .034). CONCLUSIONS These data further support the importance of PA as a supportive care strategy for men on AS. Our findings suggest that engaging in higher volumes of PA post-diagnosis may be beneficial particularly for men exhibiting low emotional well-being early on during AS.
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Affiliation(s)
- Efthymios Papadopoulos
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada.,Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Shabbir M H Alibhai
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.,Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Medicine, University Health Network, Toronto, Ontario, Canada.,Institute for Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Isabelle Doré
- School of Kinesiology and Physical Activity Sciences, Université de Montréal, Montréal, Québec, Canada.,Centre Hospitalier de l'Université de Montréal Research Centre, Montréal, Québec, Canada
| | - Andrew G Matthew
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Medicine, University Health Network, Toronto, Ontario, Canada
| | - George A Tomlinson
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Medicine, University Health Network, Toronto, Ontario, Canada.,Institute for Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Michael Nesbitt
- Division of Urology, Department of Surgical Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Antonio Finelli
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Division of Urology, Department of Surgical Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - John Trachtenberg
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Division of Urology, Department of Surgical Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Daniel Santa Mina
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada.,Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.,Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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12
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Lucas AR, Bitting RL, Fanning J, Isom S, Rejeski WJ, Klepin HD, Kritchevsky SB. Trajectories in muscular strength and physical function among men with and without prostate cancer in the health aging and body composition study. PLoS One 2020; 15:e0228773. [PMID: 32053654 PMCID: PMC7017990 DOI: 10.1371/journal.pone.0228773] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 01/22/2020] [Indexed: 12/31/2022] Open
Abstract
Objectives To examine and compare changes in strength and physical function from pre- to post-diagnosis among men with prostate cancer (PC, [cases]) and matched non-cancer controls identified from the Health, Aging and Body Composition (Health ABC) study. Materials and methods We conducted a longitudinal analysis of 2 strength and 3 physical function-based measures among both cases and controls, identified from a large cohort of community living older adults enrolled in the Health ABC study. We plotted trajectories for each measure and compared cases vs. controls from the point of diagnosis onwards using mixed-effects regression models. For cases only, we examined predictors of poor strength or physical function. Results We identified 117 PC cases and 453 matched non-cancer controls (50% African Americans). At baseline, there were no differences between cases and controls in demographic factors, comorbidities or self-reported physical function; however, cases had slightly better grip strength (44.6 kg vs. 41.0 kg, p<0.01), quadriceps strength (360.5 Nm vs. 338.7 Nm, p = 0.02) and Health ABC physical performance battery scores (2.4 vs. 2.3, p = 0.01). All men experienced similar declines in strength and physical function over an equivalent amount of time. The loss of quad strength was most notable, with losses of nearly two-thirds of baseline strength over approximately 7 years of follow up. Conclusions Among both cases and controls, strength and physical function decline with increasing age. The largest declines were seen in lower body strength. Regular assessments should guide lifestyle interventions that can offset age- and treatment-related declines among men with PC.
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Affiliation(s)
- Alexander R. Lucas
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, Virginia, United States of America
- Division of Cardiology, Department of Internal Medicine, VCU Pauley Heart Center, Richmond, Virginia, United States of America
- * E-mail:
| | - Rhonda L. Bitting
- Department of Internal Medicine, Hematology and Oncology, Wake Forest Baptist Health, Winston-Salem, North Carolina, United States of America
| | - Jason Fanning
- Department of Health & Exercise Science, Wake Forest University, Winston-Salem, North Carolina, United States of America
| | - Scott Isom
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America
| | - W. Jack Rejeski
- Department of Health & Exercise Science, Wake Forest University, Winston-Salem, North Carolina, United States of America
| | - Heidi D. Klepin
- Department of Internal Medicine, Hematology and Oncology, Wake Forest Baptist Health, Winston-Salem, North Carolina, United States of America
| | - Stephen B. Kritchevsky
- Department of Internal Medicine, Sticht Center for Healthy Aging and Alzheimer’s Prevention, Wake Forest Baptist Health, Winston-Salem, North Carolina, United States of America
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13
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Rees-Punia E, Patel AV, Nocera JR, Chantaprasopsuk S, Demark-Wahnefried W, Leach CR, Smith TG, Cella D, Gapstur SM. Self-reported physical activity, sitting time, and mental and physical health among older cancer survivors compared with adults without a history of cancer. Cancer 2020; 127:115-123. [PMID: 33079415 PMCID: PMC9105766 DOI: 10.1002/cncr.33257] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/28/2020] [Accepted: 09/20/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND To the authors' knowledge, few studies to date have examined associations between moderate to vigorous physical activity (MVPA) and sitting time with quality of life in cancer survivors compared with a cancer-free group. The current study examined differences in global mental health (GMH) and global physical health (GPH) across levels of MVPA and sitting among cancer survivors and cancer-free participants. METHODS Cancer Prevention Study II participants (59.9% of whom were female with an age of 77.8 ± 5.8 years) were grouped as: 1) survivors who were 1 to 5 years after diagnosis (3718 participants); 2) survivors who were 6 to 10 years after diagnosis (4248 participants); and 3) cancer-free participants (ie, no history of cancer; 69,860 participants). In 2009, participants completed MVPA, sitting, and Patient-Reported Outcomes Measurement Information System GMH/GPH surveys. Mean differences in GMH and GPH T scores across MVPA (none, 0 to <7.5, 7.5 to <15, 15 to <22.5, and ≥22.5 metabolic equivalent [MET]-hours/week) and sitting (0 to <3, 3 to <6, and ≥6 hours/day) were assessed using multivariate generalized linear models. RESULTS The mean GMH and GPH scores were statistically significantly higher in cancer-free participants compared with cancer survivor groups, although the differences were not clinically meaningful (mean difference of 0.52 for GMH and 0.88 for GPH). More MVPA was associated with higher GMH and GPH scores for all 3 groups (P for trend <.001), and differences between the least and most active participants were found to be clinically meaningful (mean differences of ≥4.34 for GMH and ≥6.39 for GPH). Similarly, a lower duration of sitting was associated with higher GMH and GPH scores for all groups (P for trend <.001), with clinically meaningful differences observed between the least and most sedentary participants (mean differences of ≥2.74 for GMH and ≥3.75 for GPH). CONCLUSIONS The findings of the current study provide evidence of the importance of increased MVPA and decreased sitting for improved health in older adults with or without a prior cancer diagnosis.
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Affiliation(s)
- Erika Rees-Punia
- Department of Population Science, American Cancer Society, Atlanta, Georgia
| | - Alpa V. Patel
- Department of Population Science, American Cancer Society, Atlanta, Georgia
| | - Joseph R. Nocera
- Department of Neurology, Emory University, Atlanta, Georgia,Department of Rehabilitation Medicine, Emory University, Atlanta, Georgia,Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Medical Center, Atlanta, Georgia,Cancer Prevention and Control Program, Winship Cancer Institute, Atlanta, Georgia
| | | | - Wendy Demark-Wahnefried
- O’Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama
| | - Corinne R. Leach
- Department of Population Science, American Cancer Society, Atlanta, Georgia
| | - Tenbroeck G. Smith
- Department of Population Science, American Cancer Society, Atlanta, Georgia
| | - David Cella
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Susan M. Gapstur
- Department of Population Science, American Cancer Society, Atlanta, Georgia
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14
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Ozdemir K, Keser I, Sen I, Ozgur Tan M. Investigating the relationships between quality of life, fatigue and leisure time physical activity in prostate cancer patients. J Back Musculoskelet Rehabil 2019; 32:497-503. [PMID: 30584117 DOI: 10.3233/bmr-181220] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES The aim of this study was to investigate the relationship between the parameters of fatigue, quality of life and leisure time physical activity in prostate cancer (PCa) patients. This is the first study in the literature to report interaction between these parameters from the perspective of physiotherapy and rehabilitation. MATERIALS AND METHODS Fifty-eight out-patients were enrolled in this study. In an oncologic rehabilitation unit, Functional Assessment of Chronic Illness Therapy-Fatigue Questionnaire (FACIT-F), Functional Assessment of Cancer Therapy-Prostate Questionnaire (FACT-P) and Godin Leisure Time Exercise Questionnaire (GLTEQ) were utilized to evaluate fatigue, quality of life and physical activity, respectively. Frequencies and the relationships between the results of the parameters were analyzed. RESULTS The average age of patients was 67.68 ± 7.54 years. Mean scores of FACIT-F [42.94 ± 8.25] and FACT-P [118.81 ± 13.39] were determined. The median score of GLTEQ was 14 (0-70). There were positive correlations between FACIT-F and FACT-P (r= 0.633, p< 0.001); GLTEQ and FACT-P (r= 0.275, p< 0.05) and; FACIT-F and GLTEQ (r= 0.297, p< 0.05). CONCLUSION Increased fatigue and decreased leisure time physical activity level may affect quality of life negatively. Moreover, it was observed that decreasing leisure time physical activity level affects fatigue negatively. Accordingly, physiotherapists with PCa patients may focus on developing physical activity levels in various ways to address the multidimensional problems of fatigue and quality of life.
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Affiliation(s)
- Kadirhan Ozdemir
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Ilke Keser
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Ilker Sen
- Department of Urology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Mustafa Ozgur Tan
- Department of Urology, Faculty of Medicine, Gazi University, Ankara, Turkey
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15
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Quality of Life and Health among People Living in an Industrial Area of Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16071221. [PMID: 30959768 PMCID: PMC6480140 DOI: 10.3390/ijerph16071221] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 04/02/2019] [Accepted: 04/03/2019] [Indexed: 12/28/2022]
Abstract
Background: The quality of life and health status of the population significantly depends on socio-economic factors, including working and employment conditions. Methods: This epidemiological cross-sectional study was carried out among young inhabitants aged 25–44 years living in the Silesian voivodeship in Poland. The quality of life was evaluated using the short version of the WHOQOL-BREF questionnaire. Results: A total of 905 respondents were examined. It was shown that the poor quality of life in all assessed domains was associated with a low job satisfaction level, low physical activity, and higher self-assessed health status. Furthermore, the worse self-assessed health status in the study group was mainly related to such factors as earlier diagnosed chronic disease, lower job satisfaction, and low physical activity. Additionally, diagnosed chronic disease among occupationally active respondents was correlated with health deterioration due to excessive stress, living in the vicinity of heavy road traffic, and was declared by women more frequently. Conclusions: The results of the presented study confirmed that the quality of life and health status in young inhabitants of the Silesian voivodeship significantly depends on the work characteristics, employment conditions and lifestyle factors.
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16
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Neil-Sztramko SE, Medysky ME, Campbell KL, Bland KA, Winters-Stone KM. Attention to the principles of exercise training in exercise studies on prostate cancer survivors: a systematic review. BMC Cancer 2019; 19:321. [PMID: 30953460 PMCID: PMC6451299 DOI: 10.1186/s12885-019-5520-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 03/25/2019] [Indexed: 12/16/2022] Open
Abstract
Background The purpose of this review is to update previously published reviews on exercise programming in exercise trials in prostate cancer survivors. We evaluated: 1) the application of the principles of exercise training in prescribed programs; 2) the reporting of the components of the exercise prescription; and 3) the reporting of adherence of participants to the prescribed programs. Methods Building upon a previous review, a systematic review was conducted searching OVID Medline, Embase, CINAHL, and SPORTDiscus databases from 2012-2017. Randomized controlled trials of at least four weeks of aerobic and/or resistance exercise in men diagnosed with prostate cancer that reported physical fitness outcomes, including body composition were eligible for inclusion. Results Specificity was appropriately applied by 93%, progression by 55%, overload by 48%, initial values by 55%, and diminishing returns by 28% of eligible studies. No study adequately applied the principle of reversibility. Most (79%) studies reported all components of the exercise prescription in the study methods, but no study reported all components of adherence to the prescribed intervention in the study results. Conclusions Application of standard exercise training principles is inadequate in exercise trials in men with prostate cancer and could possibly lead to an inadequate exercise stimulus. While many studies report the basic components of the exercise prescription in their study methods, full reporting of actual exercise completed is needed to advance our understanding of the optimal exercise dose for men with prostate cancer and promote translation of controlled trials to practice.
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Affiliation(s)
- Sarah E Neil-Sztramko
- School of Nursing, McMaster University, 175 Longwood Road S, Suite 210a, Hamilton, ON, L8P 0A1, Canada.
| | - Mary E Medysky
- School of Nursing, Oregon Health and Science University, Portland, Oregon, USA
| | - Kristin L Campbell
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kelcey A Bland
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Kerri M Winters-Stone
- School of Nursing, Oregon Health and Science University, Portland, Oregon, USA.,Knight Cancer Institute, Oregon Health and Science University, Portland, Oregon, USA
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17
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Smith L, Lee JA, Mun J, Pakpahan R, Imm KR, Izadi S, Kibel AS, Colditz GA, Grubb RL, Wolin KY, Sutcliffe S, Yang L. Levels and patterns of self-reported and objectively-measured free-living physical activity among prostate cancer survivors: A prospective cohort study. Cancer 2018; 125:798-806. [PMID: 30516839 PMCID: PMC6378115 DOI: 10.1002/cncr.31857] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 09/29/2018] [Accepted: 10/09/2018] [Indexed: 12/11/2022]
Abstract
Background No prior study has measured or compared self‐reported and objectively measured physical activity trajectories in prostate cancer survivors before and after treatment. Methods Clinically localized prostate cancer patients treated with radical prostatectomy were recruited between 2011 and 2014. Of the 350 participants enrolled at the main site, 310 provided self‐reported physical activity at baseline before radical prostatectomy, and 5 weeks, 6 months, and 12 months after radical prostatectomy. A subset of participants (n = 81) provided objectively measured physical activity at all study time points by wearing an accelerometer for 7 days each. Changes in activity over time were compared using Friedman’s test. Agreement between self‐reported and objective measures was evaluated using Spearman’s rank correlation coefficient. Results Self‐reported moderate‐to‐vigorous physical activity was high at baseline (median, 32.1 min/day), followed by a decline at 5 weeks (median, 15.0 min/day) and a recovery at 6 and 12 months (median, 32.1‐47.1 min/day). In contrast, objectively measured moderate‐to‐vigorous physical activity was low at all 4 time points (median, 0.0‐5.2 min/day), with no overall change across study assessments (global P = .29). Self‐reported moderate‐to‐vigorous physical activity tended to be more closely related to objectively measured light‐intensity physical activity (ρ = 0.29‐0.42) than to objectively measured moderate‐to‐vigorous physical activity (ρ = 0.07‐0.27, P = .009‐.32). Conclusions In our population of prostate cancer survivors with critically low moderate‐to‐vigorous physical activity levels, self‐reported measures greatly overestimated moderate‐to‐vigorous physical activity and may have been more reflective of light‐intensity physical activity. Because cancer survivor guidelines are derived from self‐reported data, our findings may imply that intensities of physical activity below moderate, such as light intensity, still have health benefits. In a population of 81 prostate cancer survivors with critically low moderate‐to‐vigorous physical activity levels, self‐reported measure greatly overestimates moderate‐to‐vigorous physical activity and may be more reflective of light‐intensity physical activity. Because prostate cancer guidelines are derived from self‐reported moderate‐to‐vigorous physical activity, the findings imply that lower intensities of physical activity, such as light‐intensity physical activity, may still have health benefits.
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Affiliation(s)
- Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - Jung Ae Lee
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri.,Agricultural Statistics Laboratory, Division of Agriculture, University of Arkansas, Fayetteville, Arkansas
| | - Junbae Mun
- Department of Physical Education, Korea Military Academy, Seoul, Republic of Korea
| | - Ratna Pakpahan
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Kellie R Imm
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri.,Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Sonya Izadi
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Adam S Kibel
- Division of Urology, Department of Surgery, Brigham & Women's Hospital, Boston, Massachusetts
| | - Graham A Colditz
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Robert L Grubb
- Division of Urological Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri.,College of Medicine, Medical University of South Carolina, Charleston, South Carolina
| | | | - Siobhan Sutcliffe
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Lin Yang
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri.,Department of Epidemiology, Medical University of Vienna, Vienna, Austria
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18
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Lin KY, Edbrooke L, Granger CL, Denehy L, Frawley HC. The impact of gynaecological cancer treatment on physical activity levels: a systematic review of observational studies. Braz J Phys Ther 2018; 23:79-92. [PMID: 30473435 DOI: 10.1016/j.bjpt.2018.11.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 10/28/2018] [Accepted: 11/06/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The natural history of physical activity levels during and following gynaecological cancer treatment is not well understood. This is required in order to establish the time at which physical activity levels are lowest in order to target cancer rehabilitation or exercise interventions in gynaecological cancer population accordingly. OBJECTIVES To conduct a systematic review to evaluate the impact of gynaecological cancer treatments on physical activity levels and to summarise the pattern of changes in physical activity levels over time among patients with gynaecological cancer. METHODS A comprehensive literature search was performed via MEDLINE (1946-2018), CINAHL (1982-2018), EMBASE (1947-2018), Ovid Emcare (1947-2018), PsycINFO (1806-2018) and the Cochrane Library (1991-2018). Studies were eligible for inclusion if they had assessed changes in physical activity levels during and after gynaecological cancer treatment. The methodological quality of the eligible studies was assessed by two independent reviewers using the Joanna Briggs Institute Critical Appraisal Tools. RESULTS In total, six studies (three cohort studies and three cross-sectional studies) with 1607 participants were included. All studies used patient-reported physical activity measures. Two of the three cohort studies measured patient-recalled physical activity levels before diagnosis (baseline), and length of follow-up varied across all studies. The majority of participants were treated surgically±adjuvant therapy. Physical activity levels decreased at 6 months following surgery when compared with pre-treatment levels. Approximately 91% of participants did not meet physical activity guidelines 2 years following diagnosis, and 58% reported being less physically active 3 years after diagnosis, compared with the pre-diagnosis levels. CONCLUSIONS Despite the paucity of evidence and limitations in the current body of literature, this review demonstrated that compared to pre-diagnosis, levels of physical activity remain low in gynaecological cancer survivors up to 3 years after diagnosis. More research is warranted to better characterise the pattern of change of physical activity levels across the disease trajectory and identify changes in physical activity patterns by cancer treatments and gynaecological tumour streams in order to target interventions accordingly.
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Affiliation(s)
- Kuan-Yin Lin
- Department of Physiotherapy, School of Primary and Allied Health Care, Monash University, Frankston, Victoria, Australia; Centre for Allied Health Research and Education, Cabrini Institute, Malvern, Victoria, Australia
| | - Lara Edbrooke
- Department of Physiotherapy, The University of Melbourne, Carlton, Victoria, Australia; Cancer Allied Health Service, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Catherine L Granger
- Department of Physiotherapy, The University of Melbourne, Carlton, Victoria, Australia; Department of Physiotherapy, The Royal Melbourne Hospital, Victoria, Australia
| | - Linda Denehy
- Department of Physiotherapy, The University of Melbourne, Carlton, Victoria, Australia; Cancer Allied Health Service, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Helena C Frawley
- Department of Physiotherapy, School of Primary and Allied Health Care, Monash University, Frankston, Victoria, Australia; Centre for Allied Health Research and Education, Cabrini Institute, Malvern, Victoria, Australia.
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