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Bilc M, Pollmann N, Buchholz A, Lauche R, Cramer H. Yoga and meditation for menopausal symptoms in breast cancer survivors: a qualitative study exploring participants' experiences. Support Care Cancer 2024; 32:413. [PMID: 38842686 PMCID: PMC11156729 DOI: 10.1007/s00520-024-08603-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 05/24/2024] [Indexed: 06/07/2024]
Abstract
PURPOSE Breast cancer survivors commonly experience menopausal symptoms, specifically when undergoing antihormonal therapy. Unfortunately, they often have a restricted range of treatment options available to alleviate menopausal symptoms. The objective of this qualitative study was to explore breast cancer survivors' experiences and effects of a yoga and meditation intervention supplementing previously reported RCT outcomes. METHODS The qualitative data included in this study were part of a larger randomized controlled trial which evaluated the efficacy and safety of a 12-week yoga and meditation intervention on menopausal symptoms in breast cancer survivors. All participants who underwent the yoga intervention (n = 19) were invited to take part in semi-structured interviews after all quantitative data collection had been completed. Interviews (n = 9) were recorded, transcribed, and then coded into superordinate themes using thematic analysis. RESULTS Nine female participants were interviewed, and the following themes emerged: (1) representations and expectations from the yoga intervention; (2) course structure and implementation; (3) perceptions and effects of the intervention (at emotional, physical, behavioral, and spiritual level); (4) differences between the study yoga intervention and other physical activities. CONCLUSIONS In accordance with the accounts of participants, yoga might offer a promising intervention for breast cancer survivors. All those interviewed either currently attended a yoga class or expressed a desire to continue practicing yoga. Additionally, our findings inform future studies regarding aspects such as the importance of extending outcome measures beyond specific cancer-related complains, the advantages of addressing homogenous groups (i.e., breast cancer specific), or considering that different intervention components might need different assistance to encourage long-term use.
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Affiliation(s)
- Mirela Bilc
- Institute of General Practice and Interprofessional Care, University Hospital Tübingen, Osianderstr. 5, 72076, Tübingen, Germany
- Robert Bosch Center for Integrative Medicine and Health, Bosch Health Campus, Stuttgart, Germany
| | - Nina Pollmann
- Institute of General Practice and Interprofessional Care, University Hospital Tübingen, Osianderstr. 5, 72076, Tübingen, Germany
- Robert Bosch Center for Integrative Medicine and Health, Bosch Health Campus, Stuttgart, Germany
| | - Analena Buchholz
- Institute of General Practice and Interprofessional Care, University Hospital Tübingen, Osianderstr. 5, 72076, Tübingen, Germany
- Robert Bosch Center for Integrative Medicine and Health, Bosch Health Campus, Stuttgart, Germany
| | - Romy Lauche
- National Centre for Naturopathic Medicine, Southern Cross University, Lismore, NSW, Australia
| | - Holger Cramer
- Institute of General Practice and Interprofessional Care, University Hospital Tübingen, Osianderstr. 5, 72076, Tübingen, Germany.
- Robert Bosch Center for Integrative Medicine and Health, Bosch Health Campus, Stuttgart, Germany.
- National Centre for Naturopathic Medicine, Southern Cross University, Lismore, NSW, Australia.
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Martini RS, Brown T, Singh V, Woodbury A. Integrative Approaches for Cancer Pain Management. Curr Oncol Rep 2024; 26:691-705. [PMID: 38683254 DOI: 10.1007/s11912-024-01536-3] [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] [Accepted: 04/09/2024] [Indexed: 05/01/2024]
Abstract
PURPOSE OF REVIEW The goal of this review is to summarize updates to the broad array of complementary therapies available for cancer pain. This paper will serve as a reference for clinicians managing pain in cancer patients. RECENT FINDINGS Patients are embracing integrative therapies in growing numbers; clinicians must be prepared to incorporate these therapies into patients' existing treatment regimens. This requires knowledge regarding risks, benefits, and potential interactions with existing cancer therapies. Integrative cancer pain management strategies have shown promise, with several proven effective for the management of cancer pain. Energy therapies, including acupuncture, and biologicals and nutraceuticals including overall diet and vitamin D, have the highest level of evidence for efficacy. The remaining therapies discussed in this chapter may be beneficial for patients on a case-by-case basis; risks and benefits of each individual therapy as described in the text must be further assessed in future rigorous trials to further clarify the role of these complementary therapies in cancer pain management.
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Affiliation(s)
- Reema Sabeeha Martini
- Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA, USA.
- Emory University Laney Graduate School, Atlanta, GA, USA.
| | | | - Vinita Singh
- Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA, USA
| | - Anna Woodbury
- Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA, USA
- Atlanta Veterans Affairs Healthcare System, Atlanta, GA, USA
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Giridharan S, Ansari J, Shanbhag NM, Balaraj K. Yoga as a Therapeutic Intervention in Cancer Care: An Umbrella Review of Systematic Reviews and Meta-Analyses. Cureus 2024; 16:e62668. [PMID: 39036256 PMCID: PMC11259513 DOI: 10.7759/cureus.62668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Accepted: 06/19/2024] [Indexed: 07/23/2024] Open
Abstract
The therapeutic efficacy of yoga in cancer care has increasingly attracted attention due to the imperative to address the physical and psychosocial obstacles encountered by cancer patients. Despite previous research presenting conflicting findings on the effectiveness of yoga, there is a need for a comprehensive review to consolidate existing evidence and identify commonalities across studies. An umbrella review was undertaken to aggregate and analyse findings from multiple systematic reviews and meta-analyses on the role of yoga in cancer care. Relevant literature was identified through searches on the Web of Science, Cochrane Library, PubMed, and Scopus databases, using a combination of MeSH (Medical Subject Headings) terms and free-text terms with Boolean operators. The quality of the included reviews was evaluated using the AMSTAR-2 tool to ensure the reliability and validity of the discussed findings. The outcomes revealed a predominance of favourable results associated with yoga interventions, particularly in enhancing psychosocial well-being and the quality of life among cancer patients. Consistent reports indicated significant reductions in symptoms such as anxiety, depression, and stress, as well as enhancements in physical outcomes such as fatigue and sleep quality. However, variations in the efficacy of yoga were observed and were dependent on the type of intervention, patient adherence, and comparative analyses with other forms of exercise. While the benefits were substantial in the short term, they did not uniformly surpass those of other therapeutic exercises in the medium term. Despite yoga demonstrating significant immediate benefits in managing both the physical and psychological symptoms associated with cancer, the variability in its long-term and comparative effectiveness suggests the necessity for personalised approaches. The findings emphasise the importance of considering individual patient needs and treatment contexts when integrating yoga into cancer care protocols. Future research should focus on identifying the optimal conditions under which yoga is most beneficial to tailor interventions for enhanced therapeutic efficacy.
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Affiliation(s)
| | | | - Nandan M Shanbhag
- Oncology/Radiation Oncology/Palliative Care, Tawam Hospital, Al Ain, ARE
- Medicine and Health Sciences, United Arab Emirates University, Al Ain, ARE
| | - Khalid Balaraj
- Oncology/Radiation Oncology, Tawam Hospital, Al Ain, ARE
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Ott KU, Keinki C, Kaesmann L, Huebner J. Education of complementary and alternative medicine in adult education centers in Germany: a web-based survey. Wien Med Wochenschr 2024; 174:181-188. [PMID: 35948702 PMCID: PMC11130027 DOI: 10.1007/s10354-022-00951-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 03/07/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Adult education centers are an important part of health education worldwide. Our aim was to evaluate the courses offered by German adult education centers with regard to complementary medicine and nutrition. METHODS A systematic web-based search was done for the websites of German adult education centers and courses were analyzed considering topics, scientific soundness, and qualification of instructors. RESULTS Our search revealed 502 courses, 360 (71.7%) related to complementary and alternative medicine (CAM) and 176 courses on nutrition (35.1%). CAM courses most often presented methods with a focus on traditional Eastern medicine with yoga and similar mind-body practices (41.9%), traditional Chinese medicine (TCM; 13.3%), and ayurvedic medicine (11.4%). Content concerning nutrition mainly included controversial fasting methods like alkaline fasting, detox diets, and therapeutic fasting (43.8%), as well as Eastern traditional diets from TCM and ayurveda (21.7%). Most of the courses were given by non-medical practitioners (NMPs; 36.4%), while only very few physicians were engaged. CONCLUSION There are substantial doubts on the scientific background of many courses offered for lay adult health education. Besides direct misinformation, many courses reinforce alternative and non-evidence-based notions in society. Adult education centers should reconsider the topics of their courses as well as the professional qualifications of the instructors.
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Affiliation(s)
- Kai-Uwe Ott
- Department of Cardiology, Kerckhoff-Klinik, Benekestr. 2-8, 61231, Bad Nauheim, Germany.
- Practice for general medicine Dres.Ott&Schoening, Karlstr. 3, 63579, Freigericht, Germany.
- Department of Hematology and Oncology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany.
| | - Christian Keinki
- Department of Hematology and Oncology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany
| | - Lukas Kaesmann
- Department of Radiation Oncology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
- German Cancer Consortium (DKTK), partner site Munich, Munich, Germany
| | - Jutta Huebner
- Department of Hematology and Oncology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany
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Brunet J, Hussien J, Pitman A, Wurz A, Conte E, Polskaia N, Seely D. Yoga Therapy as an Intervention to Improve Patient-Reported Outcomes Among Adults After Treatment for Cancer: Preliminary Findings From a Trial Using Single-Subject Experimental Design. Integr Cancer Ther 2024; 23:15347354241233517. [PMID: 38385326 PMCID: PMC10893844 DOI: 10.1177/15347354241233517] [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: 08/10/2023] [Revised: 01/23/2024] [Accepted: 02/02/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND Cancer is a chronic condition associated with a substantial symptom burden, which can impair recovery after treatment. Investigating interventions with potential to improve self-reported disease and/or treatment effects-known as patient-reported outcomes (PROs)-is paramount to inform cancer care. The objective of this study was to evaluate the effects of a yoga therapy (YT) intervention on key PROs (ie, cancer-related fatigue, anxiety, cognitive function, depression, stress, quality of life [QoL]) among adults after treatment for cancer. METHODS Data from 20 adults (Mage = 55.74 years, 85% female; Mtime since diagnosis = 2.83 years) who had completed treatment for cancer were analyzed for this study. In this single-subject exploratory experimental study, the YT intervention comprised a 1:1 YT session (ie, 1 participant with 1 yoga therapist) followed by 6 weekly small (ie, 2-3 participants) group YT sessions. Group sessions were facilitated by the same yoga therapist who delivered participants' 1:1 session to ensure an in-depth personalized approach. PROs were assessed before (ie, pre-intervention) and after the 1:1 YT session (ie, during the intervention), as well as after the last group YT session (ie, post-intervention). Hierarchical linear modeling was used to analyze the data. RESULTS Participants showed improvements in cancer-related fatigue, state anxiety, trait anxiety, perceived cognitive impairments, impacts of perceived cognitive impairments on QoL, and 1 dimension of QoL (ie, functional wellbeing) over time. Notably, cancer-related fatigue and state anxiety increased immediately after the 1:1 session, but showed greater improvements over time afterward (ie, during the intervention phase). No changes were observed for the remaining PROs. CONCLUSION Although results require confirmation in future trials, this study highlights the importance of continuing to investigate YT as an intervention to enhance important PROs (ie, cancer-related fatigue and state anxiety) after treatment for cancer. More research is needed to identify additional beneficial effects and factors that influence participants' responses to 1:1 and group YT (ie, moderators and mediators). REGISTRATION NUMBER ISRCTN64763228. DATE OF REGISTRATION December 12, 2021. This trial was registered retrospectively. URL OF TRIAL REGISTRY RECORD https://www.isrctn.com/ISRCTN64763228. PUBLISHED PROTOCOL Brunet, J., Wurz, A., Hussien, J., Pitman, A., Conte, E., Ennis, J. K., . . . & Seely, D. (2022). Exploring the Effects of Yoga Therapy on Heart Rate Variability and Patient-Reported Outcomes After Cancer Treatment: A Study Protocol. Integrative Cancer Therapies, 21, 15347354221075576.
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Affiliation(s)
- Jennifer Brunet
- University of Ottawa, Ottawa, ON, Canada
- Ottawa Hospital Research Institute, Ottawa, ON, Canada
- Hôpital Montfort, Ottawa, ON, Canada
| | | | - Anne Pitman
- Centre for Health Innovation, Ottawa, ON, Canada
| | - Amanda Wurz
- University of the Fraser Valley, Chilliwack, BC, Canada
| | - Ellen Conte
- Centre for Health Innovation, Ottawa, ON, Canada
- Canadian College of Naturopathic Medicine, Toronto, ON, Canada
| | | | - Dugald Seely
- University of Ottawa, Ottawa, ON, Canada
- Centre for Health Innovation, Ottawa, ON, Canada
- Canadian College of Naturopathic Medicine, Toronto, ON, Canada
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Nair J, Mishra A, Sharan AM. Assessment of the Impact of Yoga on the Quality of Life of Breast Cancer Patients: A Systematic Literature Review. Indian J Palliat Care 2023; 29:348-358. [PMID: 38058475 PMCID: PMC10696314 DOI: 10.25259/ijpc_306_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 10/04/2023] [Indexed: 12/08/2023] Open
Abstract
Patients with breast cancer (BC) typically undergo multimodal treatment over an extended period and deal with a wide range of symptoms that severely impair their overall quality of life (QoL) and prognosis. Concern about the health-related QoL of persons diagnosed with cancer as well as the calibre of care they receive is increasing every day. This study aims to assess the impact of yoga on the QoL of patients with BC. PRISMA guidelines served as the foundation for the methodologies used to identify the studies. A total of 480 records were found using PubMed/Medline and Google Scholar databases. A final set of 22 studies was assessed for the work based on the exclusion and inclusion criteria and study eligibility. Yoga has a moderate effect on BC patients. Pranayama has been shown to have a positive effect on improving the QoL. The study observed that yoga was more useful during actual treatment for cancer than after completion. The various randomised controlled trials (RCT) and meta-analysis included in this study believe that yoga has a positive effect. However, the outcomes of various studies do not support this point completely. According to the safety information that is currently available, yoga is not associated with severe adverse outcomes. There is no concrete evidence that establishes the role of yoga as one of the alternative medicines in treating BC patients after chemotherapy. More clinical trials are needed to investigate the advantages of yoga in the overall improvement of QoL in BC patients.
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Affiliation(s)
- Jayajith Nair
- School of Management, G D Goenka University, Sohna, Haryana, India
| | - Anju Mishra
- School of Management, G D Goenka University, Sohna, Haryana, India
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Price J, Sharma S, Brunet J. Women's experiences with yoga after a cancer diagnosis: a qualitative meta-synthesis-part I. Syst Rev 2023; 12:176. [PMID: 37752520 PMCID: PMC10521480 DOI: 10.1186/s13643-023-02350-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 09/10/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Qualitative research on women's experiences participating in yoga after a cancer diagnosis is growing; systematic synthesis and integration of results are necessary to facilitate the transfer and implementation of knowledge among researchers and end-users. Thus, the purpose of this meta-synthesis was to: (1) integrate findings from qualitative studies, (2) compare and contrast findings to elucidate patterns or contradictions in conclusions, and (3) develop an overarching interpretation of women's experiences participating in yoga after a cancer diagnosis. METHODS Using meta-study methodology, six electronic databases were searched using a sensitive search strategy in November 2020, a supplemental scan of reference lists was conducted in August 2021, and the database search was replicated in October 2021. Two reviewers independently screened titles/abstracts and full-texts to determine eligibility. RESULTS The searches yielded 6804 citations after de-duplication. Data from 24 articles meeting the eligibility criteria were extracted, and the results, methods, and theoretical approach(es) were analyzed. The analysis revealed that there was a predominant focus on two focal points in the primary articles: (1) women's well-being and quality of life (QoL; part I) and (2) intervention preferences (part II). Five overarching categories emerged related to well-being and QoL: (1) yoga can support improvements in multiple dimensions of QoL in women diagnosed with cancer, (2) women diagnosed with cancer experience an interaction between QoL dimensions, (3) elements of yoga that support improvements in QoL dimensions, (4) breathwork and meditation are integral elements of yoga, and (5) yoga practice may support lifestyle behavior change. The articles reviewed had notable limitations related to: (1) reporting about instructor(s), content of the intervention, and environmental characteristics of the setting, (2) identifying and incorporating optimal features in the intervention design, (3) incorporating theory and real-world considerations into the study procedures, and (4) including positive and negative conceptualizations of QoL as an interconnected and multidimensional concept. CONCLUSION Moving forward, it remains critical to identify the ideal structure and content of yoga programs for promoting well-being and QoL among women diagnosed with cancer, as well as to explore barriers and facilitators to sustainable program implementation. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42021229253.
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Affiliation(s)
- Jenson Price
- School of Human Kinetics, University of Ottawa, 125 University Private, Montpetit Hall, Room 339, Ottawa, ON, K1N 6N5, Canada
| | - Sitara Sharma
- School of Human Kinetics, University of Ottawa, 125 University Private, Montpetit Hall, Room 339, Ottawa, ON, K1N 6N5, Canada
| | - Jennifer Brunet
- School of Human Kinetics, University of Ottawa, 125 University Private, Montpetit Hall, Room 339, Ottawa, ON, K1N 6N5, Canada.
- Cancer Therapeutic Program, Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON, Canada.
- Institut du Savoir Montfort, Hôpital Montfort, Ottawa, ON, Canada.
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Chen X, Li J, Chen C, Zhang Y, Zhang S, Zhang Y, Zhou L, Hu X. Effects of exercise interventions on cancer-related fatigue and quality of life among cancer patients: a meta-analysis. BMC Nurs 2023; 22:200. [PMID: 37312185 DOI: 10.1186/s12912-023-01363-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 05/31/2023] [Indexed: 06/15/2023] Open
Abstract
PURPOSE In this study, exercise interventions were evaluated for their effects on cancer-related fatigue (CRF) and quality of life (QoL) among cancer patients. DESIGN A meta-analysis was performed. METHODS We systematically searched the PubMed/Medline, Web of Science, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), PsycINFO, and CINAHL databases, and gray literature sources including the Virginia Henderson International Nursing Library and Google Scholar. This study only included randomized controlled trials (RCTs) examining how exercise interventions affect CRF and QoL among cancer patients. Based on the Cochrane Risk-of-Bias Assessment Tool, version 2 (RoB 2) and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, the methodological quality of the included studies was evaluated. In addition, standardized mean differences (SMDs) and 95% confidence intervals (CIs) were applied to assess the intervention effect with respect to CRF and QoL. Data analysis was performed using Review Manager (version 5.4). RESULTS There were a total of 1573 participants in the 28 included articles. According to the meta-analysis, CRF (SMD = -0.35, 95% CI: -0.63 to -0.07, p = 0.01) and QoL (SMD = 0.36, 95% CI: 0.20 to 0.53, p < 0.01) were positively affected by exercise interventions. Subgroup analyses revealed considerable improvements in CRF (SMD = -0.54, 95% CI: -1.00 to -0.09, p = 0.02) and QoL (SMD = 0.38, 95% CI: 0.16 to 0.59, p < 0.01) from aerobic exercise. An intervention duration less than 12 weeks had a better effect on CRF (SMD = -0.80, 95% CI: -1.43 to -0.17, p = 0.01) and QoL (SMD = 0.53, 95% CI: 0.21 to 0.85, p < 0.01), and three times per week was the most effective frequency in improving QoL (SMD = 0.69, 95% CI: 0.28 to 1.11, p < 0.01). Exercise intervention was more successful in improving CRF (SMD = -0.66, 95% CI: -1.10 to -0.21, p < 0.01) and QoL (SMD=-0.50, 95% CI: 0.23 to 0.78, p < 0.01) in female cancer patients. Sensitivity analyses showed that the pooled outcomes were reliable and stable. CONCLUSION Exercise interventions are a workable approach to improve CRF and QoL among cancer patients. An aerobic exercise intervention of less than 12 weeks might be most effective in improving CRF and QoL, and three times per week might be the most appropriate frequency. Exercise might have a more positive effect on improving CRF and QoL in female cancer patients. Additionally, a larger number of high-quality RCTs should be conducted to further confirm the efficacy of exercise interventions on CRF and QoL among cancer patients. REGISTRATION NUMBER CRD42022351137.
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Affiliation(s)
- Xiaoli Chen
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, PR China
| | - Juejin Li
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, PR China
| | - Chongcheng Chen
- Department of Nephrology, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, PR China
| | - Yalin Zhang
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, PR China
| | - Shu Zhang
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, PR China
| | - Yun Zhang
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, PR China
| | - Lin Zhou
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, PR China
| | - Xiaolin Hu
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, PR China.
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Zhang YB, Zhong XM, Han N, Tang H, Wang SY, Lin WX. Effectiveness of exercise interventions in the management of cancer-related fatigue: a systematic review of systematic reviews. Support Care Cancer 2023; 31:153. [PMID: 36746815 DOI: 10.1007/s00520-023-07619-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 01/29/2023] [Indexed: 02/08/2023]
Abstract
BACKGROUND Cancer-related fatigue is a widely prevalent global public health concern with serious consequences. Increasing evidence suggests the effectiveness of exercise intervention in treating cancer-related fatigue, but there is a lack of a summary of relevant literature on the same to help reach a clear consensus. OBJECTIVE To summarize evidence regarding the efficacy of exercise interventions to reduce cancer fatigue, as determined in systematic reviews (SRs) and/or meta-analyses (MAs). METHOD From inception to September 2022, PubMed (1948-2022), Embase (1974-2022), Cochrane Library (1993-2022), CINAHL (1937-2022), Web of Science (1997-2022), China Knowledge Resource Integrated Database (1999-2022), Wanfang Database (1993-2022), and Chinese Biomedical Database (1994-2022) were searched for inclusion to the study. Two reviewers independently extracted the data from the included articles. AMSTAR II was to evaluate the methodological quality of the reviews. RESULTS A total of 46 systematic reviews were assessed for data on exercise intervention in reducing cancer-related fatigue among cancer patients. In addition, some studies have reported adverse events during the exercise intervention period. The quality of the included systematic review was found to be low or critically low. CONCLUSIONS The present systematic review of systematic reviews supports exercise intervention for reducing cancer-related fatigue. Further higher-quality studies are warranted to improve the level of evidence for exercise interventions for application in the treatment of cancer-related fatigue.
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Affiliation(s)
- Ya-Bin Zhang
- The First Affiliated Hospital of Zhengzhou University, No. 1, Jianshe East Road, Zhengzhou, Henan, People's Republic of China
| | - Xue-Mei Zhong
- Guangdong Women and Children Hospital, 521 Xingnan Avenue, Panyu District, Guangzhou, 511400, Guangdong, People's Republic of China
| | - Ni Han
- Guangdong Women and Children Hospital, 521 Xingnan Avenue, Panyu District, Guangzhou, 511400, Guangdong, People's Republic of China
| | - Huang Tang
- Guangdong Women and Children Hospital, 521 Xingnan Avenue, Panyu District, Guangzhou, 511400, Guangdong, People's Republic of China
| | - Shui-Yu Wang
- The First Affiliated Hospital of Zhengzhou University, No. 1, Jianshe East Road, Zhengzhou, Henan, People's Republic of China.
| | - Wen-Xuan Lin
- Guangdong Women and Children Hospital, 521 Xingnan Avenue, Panyu District, Guangzhou, 511400, Guangdong, People's Republic of China.
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Abstract
This article provides an overview of the fields of psychosocial and integrative oncology, highlighting common psychological reactions to being diagnosed with and treated for cancer, including distress, anxiety, depression, fear of cancer recurrence and caregiver burden, as well as symptoms of fatigue, pain, and sleep disturbance. Patterns of symptomatology across the disease continuum are also discussed. Interventions targeted at treating these symptoms are reviewed, including acceptance-based and mindfulness therapies, mind-body therapies, and meaning-based approaches designed for people with advanced stages of disease, including psychedelic therapy. Common methodological issues and shortcomings of the evidence base are summarized with design recommendations, and a discussion of trends in future research including pragmatic research design, digital health interventions, and implementation science completes the article.
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Affiliation(s)
- Linda E Carlson
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada;
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Muacevic A, Adler JR, Yadav V, Shyam H, Kumar S, Mishra SK, Ramakant P. Long-Term Yogic Intervention Improves Symptomatic Scale and Quality of Life by Reducing Inflammatory Cytokines and Oxidative Stress in Breast Cancer Patients Undergoing Chemotherapy and/or Radiotherapy: A Randomized Control Study. Cureus 2023; 15:e33427. [PMID: 36751235 PMCID: PMC9899326 DOI: 10.7759/cureus.33427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2023] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION Inflammation has been associated with tumor proliferation and metastasis in breast cancer. Yoga is an ancient therapy that helps in reducing inflammation and improves the patient's quality of life (QoL) and fatigue. In the current study, we investigated the effects of long-term yogic intervention at different time points on the level of inflammatory cytokines and oxidative stress, along with the symptomatic scale and QoL in stage II/III breast cancer patients. METHODS Ninety-six stage II/III breast cancer patients receiving chemotherapy and/or radiotherapy were enrolled and divided into two groups, non-yoga (Group I) and yoga (Group II). Participants in Group II practiced yoga five days per week for 48 weeks. The European Organisation for Research and Treatment of Cancer quality of life questionnaire (EORTC-QLQ30) was used to measure the QoL and symptomatic scale. Serum levels of pro-inflammatory cytokines, tumor necrosis factor-alpha (TNF-α), interferon-γ (IFN-γ) and granulocyte macrophage colony-stimulating factor (GM-CSF), and oxidative stress markers, superoxide dismutase (SOD), catalase (CAT), malondialdehyde (MDA), and nitric oxide (NO) were measured at baseline, 16, 32, and 48 weeks in both groups. RESULTS Yoga significantly (p<0.05) reduced the level of IFN-γ, TNF-α, and MDA and improved QoL (p<0.001) and symptomatic scale (p<0.05) in Group II patients compared to Group I. NO was upregulated in Group I whereas in Group II, it was neither decreased nor increased. CONCLUSION These findings suggest that yoga may reduce levels of inflammatory cytokines and improve QoL and symptomatic scale in breast cancer patients receiving chemotherapy and/or radiotherapy. Yoga can be an important additional therapy during cancer treatments to cope with treatment side effects including fatigue, depression, and immunological profile, which directly affects the patient's quality of life.
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Li P, Wang Q, Liu L, Zhang Q, Zhou R, Wang Y, Liu T, Feng L. The Role of Complementary and Alternative Medicine on Cancer-Related Fatigue in Adults: An Overview of Systematic Reviews. Integr Cancer Ther 2023; 22:15347354231188947. [PMID: 37515495 PMCID: PMC10387784 DOI: 10.1177/15347354231188947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 05/15/2023] [Accepted: 07/04/2023] [Indexed: 07/31/2023] Open
Abstract
BACKGROUND Cancer-related fatigue (CRF) has an enormous adverse impact on quality of life and subsequent therapy of cancer patients. Complementary and alternative medicine (CAM) is reported to improve CRF in many systematic reviews (SRs), but the effects are controversial because of variations in the quality and outcomes. METHODS Thirteen databases were searched from inception to September 2022. Only SRs of randomized controlled trials (RCTs) were included. We assessed the quality of included SRs with the AMSTAR-2 tool, the strength of evidence with the GRADE system, the risk of bias with the ROBIS tool, and the integrity of SRs with the PRISMA checklist. RESULTS We included 30 eligible SRs (27 meta-analyses). Based on the AMSTAR-2 tool, 29 SRs were rated as "critically low" quality, and only one was rated as "low" quality. With the ROBIS tool, 19 SRs demonstrated a low risk of bias. According to the PRISMA checklist, no SRs reported all the items, and 10 SRs sufficiently reported over 70%. Based on the GRADE system, 7 outcomes were assessed as high-quality evidence. CONCLUSION This overview demonstrates promising evidence for the effectiveness of CAM interventions in the treatment of CRF in adults. The roles of qigong, music, auricular point therapy, and dietary supplements in CRF need further evaluation. Although findings are mixed, it is recommend to select appropriate CAM to manage cancer-related fatigue under the guidance of physicians. More studies with rigorous methodological designs and sufficient sample sizes are needed.
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Affiliation(s)
- Peijin Li
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy for Medical Sciences and Peking Union Medical College, Beijing, China
- Beijing University of Chinese Medicine, Beijing, China
| | - Qian Wang
- Beijing University of Chinese Medicine, Beijing, China
| | - Lixing Liu
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy for Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qinglin Zhang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy for Medical Sciences and Peking Union Medical College, Beijing, China
- Beijing University of Chinese Medicine, Beijing, China
| | - Rui Zhou
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy for Medical Sciences and Peking Union Medical College, Beijing, China
- Beijing University of Chinese Medicine, Beijing, China
| | - Yue Wang
- Beijing Hospital of Traditional Chinese Medicine, Beijing, China
| | - Tingting Liu
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy for Medical Sciences and Peking Union Medical College, Beijing, China
- Beijing University of Chinese Medicine, Beijing, China
| | - Li Feng
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy for Medical Sciences and Peking Union Medical College, Beijing, China
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Silveira JD, Fausto DY, Saraiva PSDS, Boing L, Lyra VB, Bergmann A, Guimarães ACDA. How do Body Practices Affect the Psychological Aspects of Survivors Women Undergoing Treatment for Breast Cancer? Systematic Literature Review. REVISTA BRASILEIRA DE CANCEROLOGIA 2022. [DOI: 10.32635/2176-9745.rbc.2023v69n1.2981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Introduction: Body practices can bring physical, psychological benefits and social rehabilitation and may be an alternative treatment for breast cancer. Objective: To analyze the evidence of the results of body practices over the psychological aspects of survivors women undergoing treatment for breast cancer. Method: Systematic blind and independent review from September to December 2021 following the PRISMA guidelines, carried out in the databases: Embase Elsevier; PubMed Central; ScienceDirect; Scopus Elsevier and Web of Science – Core Collection. Results: Of 1,372 studies identified, 22 were included in this systematic review. Among the practices that stood out are meditation and Yoga, with anxiety being the most investigated variable by the studies. It is clear that body practices are options for non-pharmacological clinical treatments utilized in clinical practice by different health professionals in women who have survived breast cancer. Conclusion: Body practices proved to be beneficial in the treatment and psychological health of women who survived breast cancer. This evidence may help to implement body practices as a therapeutic resource to be used in the clinical practice of health professionals. However, more randomized clinical trials that follow study protocols more rigorously are suggested, so that the effectiveness of this approach can be evaluated in different clinical outcomes.
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Jain M, Mishra A, Yadav V, Shyam H, Kumar S, Mishra SK, Ramakant P. Long-term yogic intervention decreases serum interleukins IL-10 and IL-1β and improves cancer-related fatigue and functional scale during radiotherapy/chemotherapy in breast cancer patients: a randomized control study. Support Care Cancer 2022; 31:6. [PMID: 36512140 DOI: 10.1007/s00520-022-07487-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 11/09/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE Yoga improved fatigue and immunological profile in cancer survivors and has been a promising alternative therapy. Breast cancer treatments are rapidly improving, along with their side effects. This article investigated the effect of the yogic intervention at a different time interval during radiotherapy/chemotherapy on the pro- and anti-inflammatory interleukins along with the cancer-related fatigue and functional scale among patients with stage II/III breast cancer. METHODS A total of 96 stage II/III breast cancer patients were enrolled in this study and randomly divided into two different groups. Group I (non-Yoga) received chemotherapy and/or radiotherapy and group II (Yoga) received an additional yogic intervention. Both groups were followed up for a period of 48 weeks and blood was collected at the time of enrollment, 16, 32, and 48 weeks, and serum was isolated to measure the pro- and anti-inflammatory interleukins, fatigue, and functional scale questionnaire obtained at each time point. RESULTS Breast cancer patients in group II showed a significant improvement (p < 0.05) in the functional scale and fatigue from baseline to 48 weeks compared to group I. The yogic intervention significantly decreased (p < 0.05) the level of pro-inflammatory interleukin IL-1β and pleiotropic interleukin IL-10 in group II compared to group I. CONCLUSION These finding suggested that improved fatigue and functional scale is associated with a lower level of IL-1β and IL-10. Yoga may be an important additional therapy along with the cancer treatment to help the patients with cancer-related fatigue and improve their overall immunological profile.
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Affiliation(s)
- Mayank Jain
- Department of Thoracic Surgery, King George's Medical University, Lucknow, 226003, UP, India
| | - Archana Mishra
- Department of Thoracic Surgery, King George's Medical University, Lucknow, 226003, UP, India
| | - Vishnu Yadav
- Department of Physical Education, University of Lucknow, Lucknow, UP, India
| | - Hari Shyam
- Department of Center for Advance Research, King George's Medical University, Lucknow, UP, India
| | - Shailendra Kumar
- Department of Thoracic Surgery, King George's Medical University, Lucknow, 226003, UP, India.
| | - Satyendra Kumar Mishra
- Department of Human Consciousness and Yogic Sciences, University of Lucknow, Lucknow, UP, India
| | - Pooja Ramakant
- Department of Endocrine Surgery, King George's Medical University, Lucknow, UP, India
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Zhou HJ, Wang T, Xu YZ, Chen YN, Deng LJ, Wang C, Chen JX, Tan JYB. Effects of exercise interventions on cancer-related fatigue in breast cancer patients: an overview of systematic reviews. Support Care Cancer 2022; 30:10421-10440. [PMID: 36326908 PMCID: PMC9715478 DOI: 10.1007/s00520-022-07389-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 10/02/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This overview of systematic reviews aims to critically appraise and consolidate evidence from current systematic reviews (SRs)/meta-analyses on the effects of exercise interventions on cancer-related fatigue (CRF) in breast cancer patients. METHODS SRs/meta-analyses that explored the effects of exercise interventions on CRF in breast cancer patients compared with the routine methods of treatment and care were retrieved from nine databases. The methodological quality of the included SRs was appraised using A MeaSurement Tool to Assess systematic Reviews II (AMSTAR II). The Grading of Recommendations Assessment, Development and Evaluation (GRADE) was used to calculate the grading of outcomes in the included SRs. The exercise type, frequency, duration, and inclusion/absence of supervision were further evaluated with subgroup analyses. The Stata 16.0 software was utilized for data analysis. RESULTS Twenty-nine reviews were included. The overall methodological quality and level of evidence of the included reviews were unsatisfactory, with only three reviews rated as high methodological quality and no review identified as high-quality evidence. Moderate certainty evidence indicated that exercise could improve fatigue in breast cancer patients (SMD = - 0.40 [95%CI - 0.58, - 0.22]; P = 0.0001). Subgroup analysis based on the types of exercise showed that yoga (SMD = - 0.30 [95%CI - 0.56, - 0.05]; I2 = 28.7%) and aerobic exercise (SMD = - 0.29 [95%CI - 0.56, - 0.02]; I2 = 16%) had a significantly better effect on CRF in breast cancer patients; exercising for over 6 months (SMD = - 0.88 [95%CI - 1.59, - 0.17]; I2 = 42.7%; P = 0.0001), three times per week (SMD = - 0.77 [95%CI - 1.04, - 0.05]; I2 = 0%; P = 0.0001), and for 30 to 60 min per session (SMD = - 0.81 [95%CI - 1.15, - 0.47]; I2 = 42.3%; P = 0.0001) can contribute to a moderate improvement of CRF. Supervised exercise (SMD = - 0.48 [95%CI - 0.77, - 0.18]; I2 = 87%; P = 0.001) was shown to relieve CRF. CONCLUSION Exercise played a favorable role in alleviating CRF in breast cancer. Yoga was recommended as a promising exercise modality for CRF management in the majority of the included studies. Exercising for at least three times per week with 30 to 60 min per session could be recommended as a suitable dosage for achieving improvement in CRF. Supervised exercise was found to be more effective in alleviating CRF than unsupervised exercise. More rigorously designed clinical studies are needed to specify the exact exercise type, duration, frequency, and intensity to have an optimal effect on CRF in breast cancer patients. TRIAL REGISTRATION ClinicalTrials.gov Identifier: CRD42020219866.
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Affiliation(s)
- Hong-Juan Zhou
- School of Nursing, Putian University, 1133 Xueyuan Middle Road, Putian, Fujian, China
| | - Tao Wang
- College of Nursing and Midwifery, Charles Darwin University, Brisbane Centre, 410 Ann Street, Brisbane, QLD, Australia
| | - Yong-Zhi Xu
- Department of Traditional Chinese Medicine, Putian Hospital of Traditional Chinese Medicine, 99 Xueyuan North Road, Putian, Fujian, China
| | - Yan-Nan Chen
- School of Nursing, Fujian University of Traditional Chinese Medicine, 1 Qiu Yang Road, Fuzhou, Fujian, China
| | - Li-Jing Deng
- School of Nursing, Fujian University of Traditional Chinese Medicine, 1 Qiu Yang Road, Fuzhou, Fujian, China
| | - Chang Wang
- School of Nursing, Fujian University of Traditional Chinese Medicine, 1 Qiu Yang Road, Fuzhou, Fujian, China
| | - Jin-Xiu Chen
- School of Nursing, Fujian University of Traditional Chinese Medicine, 1 Qiu Yang Road, Fuzhou, Fujian, China.
| | - Jing-Yu Benjamin Tan
- College of Nursing and Midwifery, Charles Darwin University, Ellengowan Dr, Casuarina, NT, Australia.
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Mind–body practices for cancer-related symptoms management: an overview of systematic reviews including one hundred twenty-nine meta-analyses. Support Care Cancer 2022; 30:10335-10357. [DOI: 10.1007/s00520-022-07426-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 10/20/2022] [Indexed: 12/04/2022]
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Martinez-Calderon J, de-la-Casa-Almeida M, Matias-Soto J. The Effects of Mind-Body Exercises on Chronic Spinal Pain Outcomes: A Synthesis Based on 72 Meta-Analyses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191912062. [PMID: 36231365 PMCID: PMC9564899 DOI: 10.3390/ijerph191912062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 09/17/2022] [Accepted: 09/20/2022] [Indexed: 05/12/2023]
Abstract
An umbrella review of systematic reviews with a meta-analysis was developed to summarize the evidence on the effectiveness of qigong, tai chi, and yoga in chronic spinal pain outcomes. The CINAHL, Cochrane Library, Embase, PsycINFO, PubMed and SPORTDiscus databases were searched. Pain, psychological factors, and quality of life (QOL) were the outcomes of interest. The methodological quality of the reviews was evaluated using the AMSTAR-2 tool. The overlap was calculated using the corrected covered area. A total of 72 meta-analyses drawn from 20 systematic reviews were included and often were rated at a critically low quality. The effects of qigong on chronic low back and neck pain (CLBP and CNP, respectively) were inconsistent, although it improved the physical component of QOL after 12 weeks for CNP. Tai chi was superior to the controls in reducing CLBP; no reviews of interest were found on CNP. Yoga was superior to multiple controls in reducing CLBP, but no relevant effects on depression or QOL were found. QOL, anxiety, depression, and general mood improved with yoga for CNP. Inconsistencies arose related to yoga and CNP. Our findings mainly supported the potential effects of yoga and tai chi on pain-related outcomes, psychological factors, and QOL in populations with CLBP and NP. Clinical and methodological considerations were discussed.
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Affiliation(s)
- Javier Martinez-Calderon
- Department of Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, Avicena s/n, 41009 Sevilla, Spain
- Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, University of Seville, 41004 Seville, Spain
| | - Maria de-la-Casa-Almeida
- Department of Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Sevilla, Avicena s/n, 41009 Sevilla, Spain
- Correspondence: ; Tel.: +34-954-486-520
| | - Javier Matias-Soto
- Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, University of Seville, 41004 Seville, Spain
- Department of Physical Therapy, Faculty of Health Sciences, University of Malaga, Arquitecto Francisco Peñalosa, 3, 29071 Malaga, Spain
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Price J, Brunet J. Exploring women's experiences participating in yoga after a cancer diagnosis: a protocol for a meta-synthesis. Syst Rev 2022; 11:166. [PMID: 35953865 PMCID: PMC9373540 DOI: 10.1186/s13643-022-02042-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 07/28/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The benefits of yoga for clinical and non-clinical populations have been summarized in published systematic reviews. The vast majority of systematic reviews on the topic are syntheses of quantitative research that evaluated the effects of yoga. As qualitative research related to women's experiences participating in yoga after a cancer diagnosis is growing in quantity, systematic synthesis and integration of qualitative research are necessary to facilitate the transfer of knowledge. This paper describes the protocol for a meta-synthesis of qualitative research exploring women's experiences participating in yoga after a cancer diagnosis. METHODS Using a meta-study methodology, six electronic databases were searched to identify relevant articles. Additionally, the reference lists of relevant articles retrieved during the electronic database search were scanned to identify other relevant articles. Two reviewers independently screened the titles and abstracts, retaining those that appeared to relate to the review objectives. Next, they reviewed the retained full-text articles to assess eligibility according to four inclusion criteria. They will extract data from eligible studies and assess the quality of included studies. Data analysis will involve three main analytical steps: meta-data analysis, meta-method analysis, and meta-theory analysis. Findings from the three analytical steps will be interpreted collectively to generate additional insights beyond the findings of the primary studies to facilitate a more comprehensive understanding of women's experiences participating in yoga after a cancer diagnosis. DISCUSSION By systematically collecting, analysing, and interpreting findings across multiple primary qualitative studies, we will develop an overarching narrative and interpretation of the role and value of yoga for women diagnosed with cancer. A synthesis of qualitative research is vital as it embraces the heterogeneity of the research so as to provide important context for understanding the experiences of various women participating in yoga. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42021229253.
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Affiliation(s)
- Jenson Price
- School of Human Kinetics, University of Ottawa, Ottawa, Ontario, K1N 6N5, Canada
| | - Jennifer Brunet
- School of Human Kinetics, University of Ottawa, Ottawa, Ontario, K1N 6N5, Canada. .,Cancer Therapeutic Program, Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, Ontario, Canada. .,Institut du savoir Montfort, Hôpital Montfort, Ottawa, Ontario, Canada.
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19
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Custódio IDD, Nunes FSM, Lima MTM, de Carvalho KP, Alves DS, Chiaretto JF, Canto PPL, Paiva CE, de Paiva Maia YC. Serum 25-hydroxyvitamin D and cancer-related fatigue: associations and effects on depression, anxiety, functional capacity and health-related quality of Life in breast cancer survivors during adjuvant endocrine therapy. BMC Cancer 2022; 22:860. [PMID: 35933326 PMCID: PMC9357315 DOI: 10.1186/s12885-022-09962-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 07/26/2022] [Indexed: 11/10/2022] Open
Abstract
Background The adjuvant treatment with Aromatase Inhibitor (AI) is considered standard of care for postmenopausal breast cancer (BC) women with hormone receptor-positive (HR +), however, it often causes adverse effects such as cancer-related fatigue (CRF). The high prevalence of vitamin D deficiency in postmenopausal women who start adjuvant AI supports the hypothesis that hypovitaminosis D would be one of the biological explanations for toxicity of AI. This study aimed to identify the relationship between 25-hydroxyvitamin D [25(OH)D] and CRF, and to analyze their associations and effects on depression, anxiety, functional disability, muscle/joint aches and HRQL. Methods This prospective study included 89 postmenopausal women diagnosed with HR + early BC in adjuvant endocrine therapy with AI. Anthropometric and body composition assessments were performed, as well as dietary assessments by application of 24-h dietary recall, at three time points, totaling 24 months of follow-up. The women completed the Cervantes Scale (CS), Hospital Anxiety and Depression Scale (HADS) and Health Assessment Questionnaire (HAQ). The CRF was determined from the Functional Assessment of Chronic Illness Therapy-fatigue (FACIT-F). The serum 25(OH)D was determined by electrochemiluminescence, with cut-off point above 75 nmol/L adopted as sufficiency. Generalized Linear Model (GLzM) and Generalized Mixed Model (GMM) analysis were used. Results At baseline, 36% (n = 32) of the women presented CRF and 39.3% (n = 35) had 25(OH)D below 75 nmol/L. None of the women reached the Estimated Average Requirements (EAR) of vitamin D. The causality between 25(OH)D and CRF was not significant. Longitudinally, lower levels of 25(OH)D had a negative effect on anxiety (p = 0.020), Menopause and Health (p = 0.033) and Vasomotor scores (p = 0.007). Also, the CRF had a negative effect on anxiety (p = 0.028); depression (p = 0.027); functional disability (p = 0.022); HRQL (p = 0.007); Menopause and Health (p = 0.042), Psychological (p = 0.008) and Couple Relations (p = 0.008) domains; and on Health (p = 0.019) and Aging (p = 0.036) subdomains. Vasomotor subdomain (β = -2.279, p = 0.045) and muscle/joint aches (β = -0.779, p = 0.013) were significant with CRF only at baseline. Conclusions This study found negative effect of body adiposity on CRF. Still, the clinical relevance of 25(OH)D and CRF is highlighted, especially that of CRF, considering the consistent impact on several adverse effects reported by BC survivors during adjuvant endocrine therapy. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-022-09962-x.
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Affiliation(s)
- Isis Danyelle Dias Custódio
- Molecular Biology and Nutrition Research Group, School of Medicine, Federal University of Uberlandia, Uberlandia, Minas Gerais, 38405-320, Brazil
| | - Fernanda Silva Mazzutti Nunes
- Molecular Biology and Nutrition Research Group, School of Medicine, Federal University of Uberlandia, Uberlandia, Minas Gerais, 38405-320, Brazil
| | - Mariana Tavares Miranda Lima
- Molecular Biology and Nutrition Research Group, School of Medicine, Federal University of Uberlandia, Uberlandia, Minas Gerais, 38405-320, Brazil
| | - Kamila Pires de Carvalho
- Molecular Biology and Nutrition Research Group, School of Medicine, Federal University of Uberlandia, Uberlandia, Minas Gerais, 38405-320, Brazil
| | - Débora Santana Alves
- Molecular Biology and Nutrition Research Group, School of Medicine, Federal University of Uberlandia, Uberlandia, Minas Gerais, 38405-320, Brazil
| | - Juliana Freitas Chiaretto
- Molecular Biology and Nutrition Research Group, School of Medicine, Federal University of Uberlandia, Uberlandia, Minas Gerais, 38405-320, Brazil
| | - Paula Philbert Lajolo Canto
- Department of Clinical Oncology, Clinic's Hospital, Federal University of Uberlandia, Uberlandia, Minas Gerais, 38405-320, Brazil
| | - Carlos Eduardo Paiva
- Department of Clinical Oncology, Barretos Cancer Hospital, Barretos, Sao Paulo, 14784-400, Brazil
| | - Yara Cristina de Paiva Maia
- Molecular Biology and Nutrition Research Group, School of Medicine, Federal University of Uberlandia, Uberlandia, Minas Gerais, 38405-320, Brazil. .,Nutrition Course, School of Medicine, Federal University of Uberlandia, Uberlandia, Minas Gerais, 38405-320, Brazil.
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20
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Pelzer F, Loef M, Martin DD, Baumgartner S. Cancer-related fatigue in patients treated with mistletoe extracts: a systematic review and meta-analysis. Support Care Cancer 2022; 30:6405-6418. [PMID: 35239008 PMCID: PMC9213316 DOI: 10.1007/s00520-022-06921-x] [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: 06/27/2021] [Accepted: 02/15/2022] [Indexed: 11/07/2022]
Abstract
PURPOSE Cancer-related fatigue remains one of the most prevalent and distressing symptoms experienced by cancer patients. Effective treatments for cancer-related fatigue are needed. The objective of this meta-analysis is to determine the impact of mistletoe extracts as a pharmacological treatment for the management of cancer-related fatigue. METHODS We included randomized clinical trials (RCTs) and non-randomized studies of interventions (NRSIs) in cancer patients. Inclusion criteria were cancer-related fatigue severity or prevalence as an outcome and testing of mistletoe extracts compared to control groups. We searched Medline (EuropePMC), Embase, the Cochrane Central Register of Controlled Trials, Clinicaltrials.gov, and opengrey.org through October 2020. We assessed the risk of bias using the Cochrane risk of bias tools for RCTs and NRSIs and conducted a meta-analysis. RESULTS We performed one meta-analysis with 12 RCTs, including 1494 participants, and one meta-analysis with seven retrospective NRSIs, including 2668 participants. Heterogeneity between the studies was high in both meta-analyses. Most studies had a high risk of bias. A random-effects model showed for RCTs a standardized mean difference of -0.48 (95% confidence interval -0.82 to -0.14; p = 0.006) and for NRSIs an odds ratio of 0.36 (95% confidence interval 0.20 to 0.66; p = 0.0008). CONCLUSION Treatment with mistletoe extracts shows a moderate effect on cancer-related fatigue of similar size to physical activity. These results need to be confirmed by more placebo-controlled trials. Future trials should investigate different treatment durations and their effect on cancer-related fatigue in post-treatment cancer survivors. TRIAL REGISTRATION This meta-analysis has been registered under the PROSPERO registration number CRD42020191967 on October 7, 2020.
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Affiliation(s)
- Florian Pelzer
- Institute of Integrative Medicine, Witten/Herdecke University, Witten, Germany.
- Society for Cancer Research, Arlesheim, Switzerland.
| | | | - David D Martin
- Institute of Integrative Medicine, Witten/Herdecke University, Witten, Germany
| | - Stephan Baumgartner
- Institute of Integrative Medicine, Witten/Herdecke University, Witten, Germany
- Society for Cancer Research, Arlesheim, Switzerland
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Haussmann A, Schmidt ME, Illmann ML, Schröter M, Hielscher T, Cramer H, Maatouk I, Horneber M, Steindorf K. Meta-Analysis of Randomized Controlled Trials on Yoga, Psychosocial, and Mindfulness-Based Interventions for Cancer-Related Fatigue: What Intervention Characteristics Are Related to Higher Efficacy? Cancers (Basel) 2022; 14:cancers14082016. [PMID: 35454922 PMCID: PMC9032769 DOI: 10.3390/cancers14082016] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/12/2022] [Accepted: 04/13/2022] [Indexed: 02/01/2023] Open
Abstract
Simple Summary Many individuals with cancer suffer from persistent exhaustion due to cancer therapy, known as cancer-related fatigue (CRF). Yoga, psychosocial, and mindfulness-based interventions are recommended to reduce CRF. However, it is not clear yet how interventions need to be designed to maximize their efficacy. This meta-analysis aimed to identify intervention characteristics associated with greater reductions in CRF. A total of 70 interventions with 6387 participants were included in the analysis. Our results found a positive effect of yoga, psychosocial, and mindfulness-based interventions, while all invention types revealed large differences in intervention effects. In psychosocial interventions, using a group setting and working on cognition was related to higher efficacy. Regarding yoga and mindfulness-based interventions, no specific intervention characteristics emerged as more favorable than others. Overall, this meta-analysis suggests opportunities to optimize psychosocial interventions for CRF, whereas the design of yoga and mindfulness-based interventions seems to allow for variation. Abstract Cancer-related fatigue (CRF) is a burdensome sequela of cancer treatments. Besides exercise, recommended therapies for CRF include yoga, psychosocial, and mindfulness-based interventions. However, interventions conducted vary widely, and not all show a significant effect. This meta-analysis aimed to explore intervention characteristics related to greater reductions in CRF. We included randomized controlled trials published before October 2021. Standardized mean differences were used to assess intervention efficacy for CRF and multimodel inference to explore intervention characteristics associated with higher efficacy. For the meta-analysis, we included 70 interventions (24 yoga interventions, 31 psychosocial interventions, and 15 mindfulness-based interventions) with 6387 participants. The results showed a significant effect of yoga, psychosocial, and mindfulness-based interventions on CRF but with high heterogeneity between studies. For yoga and mindfulness-based interventions, no particular intervention characteristic was identified to be advantageous for reducing CRF. Regarding psychosocial interventions, a group setting and work on cognition were related to higher intervention effects on CRF. The results of this meta-analysis suggest options to maximize the intervention effects of psychosocial interventions for CRF. The effects of yoga and mindfulness-based interventions for CRF appear to be independent of their design, although the limited number of studies points to the need for further research.
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Affiliation(s)
- Alexander Haussmann
- Division of Physical Activity, Prevention, and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Im Neuenheimer Feld 581, 69120 Heidelberg, Germany; (A.H.); (M.E.S.); (M.L.I.)
| | - Martina E. Schmidt
- Division of Physical Activity, Prevention, and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Im Neuenheimer Feld 581, 69120 Heidelberg, Germany; (A.H.); (M.E.S.); (M.L.I.)
| | - Mona L. Illmann
- Division of Physical Activity, Prevention, and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Im Neuenheimer Feld 581, 69120 Heidelberg, Germany; (A.H.); (M.E.S.); (M.L.I.)
| | - Marleen Schröter
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte and Faculty of Medicine, University of Duisburg-Essen, Am Deimelsberg 34a, 45276 Essen, Germany; (M.S.); (H.C.)
| | - Thomas Hielscher
- Division of Biostatistics, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120 Heidelberg, Germany;
| | - Holger Cramer
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte and Faculty of Medicine, University of Duisburg-Essen, Am Deimelsberg 34a, 45276 Essen, Germany; (M.S.); (H.C.)
| | - Imad Maatouk
- Division of Medical Psychosomatics, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany;
| | - Markus Horneber
- Division of Pneumology, Klinikum Nürnberg, Paracelsus Medical University, Prof.-Ernst-Nathan-Str. 1, 90340 Nürnberg, Germany;
| | - Karen Steindorf
- Division of Physical Activity, Prevention, and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Im Neuenheimer Feld 581, 69120 Heidelberg, Germany; (A.H.); (M.E.S.); (M.L.I.)
- Correspondence: ; Tel.: +49-6221-422351
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22
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Vuong V, Rao V, Ee C. Mindfulness-based Interventions and Yoga for Managing Obesity/Overweight After Breast Cancer: A Scoping Review. Integr Cancer Ther 2022; 21:15347354221137321. [DOI: 10.1177/15347354221137321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Weight gain after breast cancer is common, and obesity after breast cancer increases breast cancer recurrence and mortality. Mindfulness-based interventions (MBIs) and yoga have been shown to be effective in managing obesity/overweight in people without breast cancer. There is a need to systematically map the extent and range of evidence on yoga and MBIs for managing obesity/overweight after breast cancer in order to aid planning and commissioning of future research. Methods We conducted a scoping review informed by methods described by Levac et al. Five electronic databases were searched for any peer-reviewed original research (including systematic reviews) that examined the role of yoga and/or MBIs for managing overweight/obesity after breast cancer. Data were extracted on study, population, intervention, comparator and outcome characteristics, and described narratively. Results: We found 18 publications representing 15 unique studies (11 clinical trials, 2 systematic reviews, and 2 observational studies). There were 10 studies on yoga, and 5 on MBIs. Of the clinical trials, only 4/11 examined a weight-related outcome as the primary outcome. The remaining trials examined lifestyle or metabolic outcomes (5/11) or unrelated outcomes such as psychological health (2/11). Gaps in the literature included small sample sizes, lack of cultural diversity amongst participants, inadequate reporting of the intervention, few lifestyle co-interventions offered, lack of active comparator groups, and inadequate safety reporting. Conclusions: There is a need for adequately-powered RCTs that adhere to reporting guidelines. The use of gold-standard methods for measuring outcomes, and active comparator groups, is also recommended.
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Affiliation(s)
- Vicki Vuong
- School of Medicine, Western Sydney University, NSW, Australia
| | - Vibhuti Rao
- WNICM Health Research Institute, Western Sydney University, NSW, Australia
| | - Carolyn Ee
- WNICM Health Research Institute, Western Sydney University, NSW, Australia
- Translational Health Research Institute, Western Sydney University, NSW, Australia
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23
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Effects of yoga in men with prostate cancer on quality of life and immune response: a pilot randomized controlled trial. Prostate Cancer Prostatic Dis 2021; 25:531-538. [PMID: 34815548 PMCID: PMC9124736 DOI: 10.1038/s41391-021-00470-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 10/30/2021] [Accepted: 11/02/2021] [Indexed: 11/30/2022]
Abstract
Background Diagnosis and treatment of prostate cancer is associated with anxiety, fear, and depression in up to one-third of men. Yoga improves health-related quality of life (QoL) in patients with several types of cancer, but evidence of its efficacy in enhancing QoL is lacking in prostate cancer. Methods In this randomized controlled study, 29 men newly diagnosed with localized prostate cancer were randomized to yoga for 6 weeks (n = 14) or standard-of-care (n = 15) before radical prostatectomy. The primary outcome was self-reported QoL, assessed by the Expanded Prostate Index Composite (EPIC), Functional Assessment of Cancer Therapy-Prostate (FACT-P), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT–F), Functional Assessment of Cancer Therapy-General (FACT-G) at baseline, preoperatively, and 6 weeks postoperatively. Secondary outcomes were changes in immune cell status and cytokine levels with yoga. Results The greatest benefit of yoga on QoL was seen in EPIC-sexual (mean difference, 8.5 points), FACIT-F (6.3 points), FACT-Functional wellbeing (8.6 points), FACT-physical wellbeing (5.5 points), and FACT-Social wellbeing (14.6 points). The yoga group showed increased numbers of circulating CD4+ and CD8+ T-cells, more production of interferon-gamma by natural killer cells, and increased Fc receptor III expression in natural killer cells. The yoga group also showed decreased numbers of regulatory T-cells, myeloid-derived suppressor cells, indicating antitumor activity, and reduction in inflammatory cytokine levels (granulocyte colony-stimulating factor [0.55 (0.05–1.05), p = 0.03], monocyte chemoattractant protein [0.22 (0.01–0.43), p = 0.04], and FMS-like tyrosine kinase-3 ligand [0.91 (−0.01, 1.82), p = 0.053]. Conclusions Perioperative yoga exercise improved QoL, promoted an immune response, and attenuated inflammation in men with prostate cancer. Yoga is feasible in this setting and has benefits that require further investigation. Trial registration clinicaltrials.org (NCT02620033).
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