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Li S, Xiang Y, Li H, Yang C, He W, Wu J, Knobf MT, Ye Z. Body image, self-efficacy, and sleep quality among patients with breast cancer: A latent profile and mediation analysis. Eur J Oncol Nurs 2024; 71:102652. [PMID: 38968669 DOI: 10.1016/j.ejon.2024.102652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Revised: 06/05/2024] [Accepted: 06/27/2024] [Indexed: 07/07/2024]
Abstract
PURPOSE As a sign of femininity, impaired breast after surgery causes particularly confusion for patients with breast cancer resulting in increased body image distress, which has negative impacts on sleep quality. And self-efficacy enables patients to use positive and effective coping strategies to maintain a favorable night's sleep. Therefore, our study is to explore the heterogeneity in body image experienced by patients with breast cancer and to examine the mediation effects of self-efficacy between body image and sleep quality. METHOD Between July 2023 and October 2023, 251 patients with breast cancer were recruited for the Be Resilient to Breast Cancer program. They responded to the General Perceived Self-Efficacy Scale, Body Image Scale, and Pittsburgh Sleep Quality Index Scale. Data were analyzed using a latent profile analysis (LPA) and mediation analysis. RESULTS Results of the LPA indicated that body image could be classified into three subgroups as follows: low (43.0%), moderate (45.5%), and high (11.5%). Furthermore, the mediation analysis demonstrated two partially mediated effects upon comparing the low and moderate (standard error, SE = 0.548, 95% confidence interval, CI = 0.009, 0.366) and the high and low (SE = 0.848, 95% CI = 0.570, 3.909) body image groups. CONCLUSION Heterogeneity exists in body image, and self-efficacy mediates the relationship between body image and sleep quality. Hence, promoting self-efficacy can buffer the negative impacts of body image on sleep quality in patients with breast cancer, and self-efficacy-orientated interventions should also receive more attention in clinic.
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Affiliation(s)
- Shuhan Li
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Yuxuan Xiang
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Hongman Li
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Chunmin Yang
- Department of Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Wenting He
- Department of Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Jiahua Wu
- Department of Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong Province, China.
| | - M Tish Knobf
- School of Nursing, Yale University, Orange, CT, United States.
| | - Zengjie Ye
- School of Nursing, Guangzhou Medical University, Guangzhou, Guangdong Province, China.
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Freeman JR, Saint-Maurice PF, Watts EL, Moore SC, Shams-White MM, Wolff-Hughes DL, Russ DE, Almeida JS, Caporaso NE, Hong HG, Loftfield E, Matthews CE. Actigraphy-derived measures of sleep and risk of prostate cancer in the UK Biobank. J Natl Cancer Inst 2024; 116:434-444. [PMID: 38013591 PMCID: PMC10919343 DOI: 10.1093/jnci/djad210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 08/02/2023] [Accepted: 10/08/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Studies of sleep and prostate cancer are almost entirely based on self-report, with limited research using actigraphy. Our goal was to evaluate actigraphy-measured sleep and prostate cancer and to expand on findings from prior studies of self-reported sleep. METHODS We prospectively examined 34 260 men without a history of prostate cancer in the UK Biobank. Sleep characteristics were measured over 7 days using actigraphy. We calculated sleep duration, onset, midpoint, wake-up time, social jetlag (difference in weekend-weekday sleep midpoints), sleep efficiency (percentage of time spent asleep between onset and wake-up time), and wakefulness after sleep onset. Cox proportional hazards models were used to estimate covariate-adjusted hazards ratios (HRs) and 95% confidence intervals (CIs). RESULTS Over 7.6 years, 1152 men were diagnosed with prostate cancer. Sleep duration was not associated with prostate cancer risk. Sleep midpoint earlier than 4:00 am was not associated with prostate cancer risk, though sleep midpoint of 5:00 am or later was suggestively associated with lower prostate cancer risk but had limited precision (earlier than 4:00 am vs 4:00-4:59 am HR = 1.00, 95% CI = 0.87 to 1.16; 5:00 am or later vs 4:00-4:59 am HR = 0.79, 95% CI = 0.57 to 1.10). Social jetlag was not associated with greater prostate cancer risk (1 to <2 hours vs <1 hour HR = 1.06, 95% CI = 0.89 to 1.25; ≥2 hours vs <1 hour HR = 0.90, 95% CI = 0.65 to 1.26). Compared with men who averaged less than 30 minutes of wakefulness after sleep onset per day, men with 60 minutes or more had a higher risk of prostate cancer (HR = 1.20, 95% CI = 1.00 to 1.43). CONCLUSIONS Of the sleep characteristics studied, higher wakefulness after sleep onset-a measure of poor sleep quality-was associated with greater prostate cancer risk. Replication of our findings between wakefulness after sleep onset and prostate cancer are warranted.
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Affiliation(s)
- Joshua R Freeman
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Pedro F Saint-Maurice
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Eleanor L Watts
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Steven C Moore
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Marissa M Shams-White
- Risk Factor Assessment Branch, Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Dana L Wolff-Hughes
- Risk Factor Assessment Branch, Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Daniel E Russ
- Trans-Divisional Research Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Jonas S Almeida
- Trans-Divisional Research Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Neil E Caporaso
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Hyokyoung G Hong
- Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Erikka Loftfield
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Charles E Matthews
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
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Kaakour D, Fortin B, Masri S, Rezazadeh A. Circadian Clock Dysregulation and Prostate Cancer: A Molecular and Clinical Overview. Clin Med Insights Oncol 2023; 17:11795549231211521. [PMID: 38033743 PMCID: PMC10683379 DOI: 10.1177/11795549231211521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 10/15/2023] [Indexed: 12/02/2023] Open
Abstract
Circadian clock dysregulation has been implicated in various types of cancer and represents an area of growing research. However, the role of the circadian clock in prostate cancer has been relatively unexplored. This literature review will highlight the potential role of circadian clock dysregulation in prostate cancer by examining molecular, epidemiologic, and clinical data. The influence of melatonin, light, night shift work, chronotherapy, and androgen independence are discussed as they relate to the existing literature on their role in prostate cancer.
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Affiliation(s)
- Dalia Kaakour
- Division of Hematology/Oncology, Department of Medicine, University of California, Irvine, Orange, CA, USA
| | - Bridget Fortin
- Department of Biological Chemistry, University of California, Irvine, Irvine, CA, USA
| | - Selma Masri
- Department of Biological Chemistry, University of California, Irvine, Irvine, CA, USA
| | - Arash Rezazadeh
- Division of Hematology/Oncology, Department of Medicine, University of California, Irvine, Orange, CA, USA
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Mangar S, Abbadasari M, Carollo A, Esposito G, Ahmed H, Shah T, Dimitriou D. Understanding Sleep Disturbances in Prostate Cancer-A Scientometric Analysis of Sleep Assessment, Aetiology, and Its Impact on Quality of Life. Cancers (Basel) 2023; 15:3485. [PMID: 37444596 DOI: 10.3390/cancers15133485] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 06/12/2023] [Accepted: 06/23/2023] [Indexed: 07/15/2023] Open
Abstract
Prostate cancer is the most commonly diagnosed cancer in the United Kingdom. While androgen-deprivation therapy is the most common treatment for prostate cancer, patients undergoing this treatment typically experience side effects in terms of sleep disturbances. However, the relation between prostate cancer and sleep and the way in which sleep interventions may benefit oncological patients is underinvestigated in the literature. The current study aims to review in a data-driven approach the existing literature on the field of prostate cancer and sleep to identify impactful documents and major thematic domains. To do so, a sample of 1547 documents was downloaded from Scopus, and a document co-citation analysis was conducted on CiteSpace software. In the literature, 12 main research domains were identified as well as 26 impactful documents. Research domains were examined regarding the link between prostate cancer and sleep, by taking into account variations in hormonal levels. A major gap in the literature was identified in the lack of use of objective assessment of sleep quality in patients with prostate cancer.
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Affiliation(s)
- Stephen Mangar
- Department of Clinical Oncology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London W6 8RF, UK
- Sleep Education and Research Laboratory, UCL Institute of Education, London WC1H 0AA, UK
| | - Monica Abbadasari
- Sleep Education and Research Laboratory, UCL Institute of Education, London WC1H 0AA, UK
| | - Alessandro Carollo
- Department of Psychology and Cognitive Science, University of Trento, 38068 Rovereto, Italy
| | - Gianluca Esposito
- Department of Psychology and Cognitive Science, University of Trento, 38068 Rovereto, Italy
| | - Hashim Ahmed
- Department of Surgery and Cancer, Imperial College London, London W6 8RF, UK
- Imperial Urology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London W2 1NY, UK
| | - Taimur Shah
- Department of Surgery and Cancer, Imperial College London, London W6 8RF, UK
- Imperial Urology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London W2 1NY, UK
| | - Dagmara Dimitriou
- Sleep Education and Research Laboratory, UCL Institute of Education, London WC1H 0AA, UK
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Park MJ, Han KD, Cho JH, Choi JH. Testicular Cancer Incidence among Obstructive Sleep Apnea (OSA) Patients: South Korean National Health Insurance Data. Cancers (Basel) 2023; 15:3273. [PMID: 37444382 DOI: 10.3390/cancers15133273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 06/16/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023] Open
Abstract
Obstructive sleep apnea (OSA) has been linked to an increased risk of acquiring many types of cancer. No data on the prevalence of testicular cancer in OSA patients have been reported in the literature. The goal of the present investigation is to find out the impact of OSA on the incidence of testicular cancer based on the Korea National Health Insurance Service (KNHIS) dataset. A cohort of adult male patients newly registered with OSA in the KNHIS data from 2007 to 2014 who had no history of any previous cancer diagnosis was included. The main outcome measure was newly diagnosed testicular cancer in the National Medical Expenses Support Program. The control group was set at five times larger than the OSA group, and it was matched with age and sex. The cumulative incidence and hazard ratio (HR) for the development of testicular cancer were compared between the OSA and control groups. Further subgroup analysis was conducted in the three different age groups. In the study period, a total of 152,801 male adult patients newly diagnosed with OSA were included, whereas 764,005 individuals were recruited as the control group. The HR of OSA for developing testicular cancer was 1.58 (95% confidence interval [CI]: 0.92-2.60), showing no significant HR regardless of confounding adjustment. However, the subgroup analysis revealed a significantly increased HR to develop testicular cancer of 3.39 (95% CI: 1.08-10.06) in groups aged more than 65, whereas the age ranges of 20-40 and 40-64 showed no significance (1.19 (0.44-2.75) and 1.27 (0.50-2.80), respectively). OSA may not influence the incidence of testicular cancer in the general adult population. However, compared to younger males, males over 65 may be more susceptible to OSA when it comes to developing testicular cancer.
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Affiliation(s)
- Marn Joon Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Inha University Hospital, School of Medicine, Inha University, 27 Inhang-ro, Jung-gu, Incheon 22332, Republic of Korea
| | - Kyung-Do Han
- Department of Statistics and Actuarial Science, Soongsil University, 369 Sangdo-ro, Dongjak-gu, Seoul 06978, Republic of Korea
| | - Jae Hoon Cho
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Konkuk University, 120-1 Neungdong-ro, Gwangjin-gu, Seoul 05030, Republic of Korea
| | - Ji Ho Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Bucheon Hospital, Soonchunhyang University, 170 Jomaru-ro, Bucheon 14584, Republic of Korea
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Palm A, Theorell-Haglöw J, Isakson J, Ljunggren M, Sundh J, Ekström MP, Grote L. Association between obstructive sleep apnoea and cancer: a cross-sectional, population-based study of the DISCOVERY cohort. BMJ Open 2023; 13:e064501. [PMID: 36868588 PMCID: PMC9990651 DOI: 10.1136/bmjopen-2022-064501] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/05/2023] Open
Abstract
OBJECTIVES Nocturnal hypoxia in obstructive sleep apnoea (OSA) is a potential risk factor for cancer. We aimed to investigate the association between OSA measures and cancer prevalence in a large national patient cohort. DESIGN Cross-sectional study. SETTINGS 44 sleep centres in Sweden. PARTICIPANTS 62 811 patients from the Swedish registry for positive airway pressure (PAP) treatment in OSA, linked to the national cancer registry and national socioeconomic data (the course of DIsease in patients reported to Swedish CPAP, Oxygen and VEntilator RegistrY cohort). OUTCOME MEASURES After propensity score matching for relevant confounders (anthropometric data, comorbidities, socioeconomic status, smoking prevalence), sleep apnoea severity, measured as Apnoea-Hypopnoea Index (AHI) or Oxygen Desaturation Index (ODI), were compared between those with and without cancer diagnosis up to 5 years prior to PAP initiation. Subgroup analysis for cancer subtype was performed. RESULTS OSA patients with cancer (n=2093) (29.8% females, age 65.3 (SD 10.1) years, body mass index 30 (IQR 27-34) kg/m2) had higher median AHI (n/hour) (32 (IQR 20-50) vs 30 (IQR 19-45), n/hour, p=0.002) and median ODI (n/hour) (28 (IQR 17-46) vs 26 (IQR 16-41), p<0.001) when compared with matched OSA patients without cancer. In subgroup analysis, ODI was significantly higher in OSA patients with lung cancer (N=57; 38 (21-61) vs 27 (16-43), p=0.012)), prostate cancer (N=617; 28 (17-46) vs 24, (16-39)p=0.005) and malignant melanoma (N=170; 32 (17-46) vs 25 (14-41),p=0.015). CONCLUSIONS OSA mediated intermittent hypoxia was independently associated with cancer prevalence in this large, national cohort. Future longitudinal studies are warranted to study the potential protective influence of OSA treatment on cancer incidence.
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Affiliation(s)
- Andreas Palm
- Department of Medical Sciences, Lung, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
- Centre for Research and Development, Region of Gävleborg Gävle Hospital, Gävle, Sweden
| | - J Theorell-Haglöw
- Department of Medical Sciences, Lung, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Johan Isakson
- Centre for Research and Development, Region of Gävleborg, Gävle Hospital, Gävle, Sweden
| | - Mirjam Ljunggren
- Department of Medical Sciences, Lung, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Josefin Sundh
- Department of Respiratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Magnus Per Ekström
- Department of Clinical Sciences, Respiratory Medicine and Allergology, Lund University, Lund, Sweden, Lund, Sweden
| | - Ludger Grote
- Sahlgrenska Academy, Gothenburg University, Centre for Sleep and Wake Disorders, Goteborg, Sweden
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Sleep and breast and prostate cancer risk in the MCC-Spain study. Sci Rep 2022; 12:21807. [PMID: 36526666 PMCID: PMC9758125 DOI: 10.1038/s41598-022-25789-9] [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: 04/09/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022] Open
Abstract
Breast and prostate cancers have been associated with circadian disruption. Some previous studies examined associations of sleep duration and breast or prostate cancer risk though findings remain inconsistent. This study examines associations of a range of detailed sleep characteristics and breast and prostate cancer risk in a large-scale population-based case-control study, MCC-Spain. A total of 1738 incident breast cancer cases, 1112 prostate cancer cases and frequency matched controls (n = 1910, and 1493 respectively) were recruited. Detailed data on habitual sleep duration, quality, timing, and daytime napping ("siesta") were collected at recruitment. Additional data on sleep habits during both the previous year and at age 40 years were also subsequently captured. Adjusted odds ratios (ORs) and 95% confidence intervals (CI) were estimated. There were no associations of habitual sleep duration (h), timing of sleep, or any or specific sleep problems, and either breast and prostate cancer risk. There was a significant positive association of ever taking habitual siestas at recruitment and breast cancer risk (OR = 1.22, 95% CI 1.06-1.42), which strengthened with increased frequency or duration. There were also significant positive associations observed for both breast and prostate cancer, among those reporting recent sleep problems, but not sleep problems at age 40 years, in a subsequent circadian questionnaire. Adverse associations with siesta and disturbed sleep during the previous year likely reflect symptoms of developing/diagnosed cancer and comorbidities. Overall, there was no clear association between various sleep characteristics and breast or prostate cancer risk observed.
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Abstract
BACKGROUND It is unclear which psychological factors (stressors, emotional correlates, and psychophysiological markers) induce cancer risk. This currently limits the potential for prevention strategies. PURPOSE The aim of this review is to bring forth evidence of stress as a determinant of cancer risk from a public health perspective, written for a broad public of practitioners and scientists. METHODS Based on a semisystematic literature search, the impact of different aspects/types of stress and the potential physiological and behavioral pathways are summarized, while highlighting further research, public health and clinical implications. RESULTS Between 2007 and 2020, 65 case-control or cohort studies have been identified. Apart from overall cancer ( N = 24), 12 cancer types have been associated with psychological stress with most for breast ( N = 21), colorectal ( N = 11) and lung/prostate/pancreas cancer ( N = 8 each). Although the evidence regarding the mechanisms is still scarce, cancer development in relation to stress might be due to interacting and combined effects of different stress(or) types, but such interaction has not really been tested yet. The path from stress towards cancer incidence consists of a biological pathway with endocrinology and immunology as well as stress-induced behavioral pathways, including smoking, alcoholism, sleep disruption, an unhealthy diet, and low physical activity together with the related phenomenon of obesity. CONCLUSION Not only the stress but also the stress-induced lifestyle should be targeted for cancer prevention and treatment. Future research should include a more diverse spectrum of cancer types (not only hormonal related like breast cancer) and of stress measures while also considering behavioral covariates.
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Affiliation(s)
- Ananyaa Mohan
- Friedman School of Nutrition Science and Policy, Boston, Massachusetts, USA
| | - Inge Huybrechts
- International Agency for Research on Cancer, Nutrition and Metabolism Section, Lyon, France and Departments of
| | - Nathalie Michels
- Public Health and Primary Care
- Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
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Lv X, Li Y, Li R, Guan X, Li L, Li J, Si S, Ji X, Cao Y, Xue F. Relationships of sleep traits with prostate cancer risk: A prospective study of 213,999 UK Biobank participants. Prostate 2022; 82:984-992. [PMID: 35403721 DOI: 10.1002/pros.24345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 02/24/2022] [Accepted: 03/14/2022] [Indexed: 11/12/2022]
Abstract
BACKGROUND The effect of sleep on the occurrence of prostate cancer (PCa) remains unclear. This study explored the influence of sleep traits on the incidence of PCa using a UK Biobank cohort study. METHODS In this prospective cohort study, 213,999 individuals free of PCa at recruitment from UK Biobank were included. Missing data were imputed using multiple imputation by chained equations. Cox proportional hazards models were used to calculate the adjusted hazard ratios and 95% confidence intervals for PCa (6747 incident cases) across seven sleep traits (sleep duration, chronotype, insomnia, snoring, nap, difficulty to get up in the morning, and daytime sleepiness). In addition, we newly created a healthy sleep quality score according to sleep traits to assess the impact of the overall status of night and daytime sleep on PCa development. E values were used to assess unmeasured confounding. RESULTS We identified 6747 incident cases, of which 344 died from PCa. Participants who usually suffered from insomnia had a higher risk of PCa (hazard ratio [HR]: 1.11; 95% confidence interval [CI]: 1.04-1.19, E value: 1.46). Finding it fairly easy to get up in the morning was also positively associated with PCa (HR: 1.09; 95% CI: 1.04-1.15, E value: 1.40). Usually having a nap was associated with a lower risk of PCa (HR: 0.91; 95% CI: 0.83-0.99, E value: 1.42). CONCLUSIONS Fairly easy to get up in the morning and usually experiencing insomnia were associated with an increased incidence of PCa. Moreover, usually having a nap was associated with a lower risk of PCa. Therefore, sleep behaviors are modifiable risk factors that may have a potential impact on PCa risk.
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Affiliation(s)
- Xiaoyan Lv
- Department of Nursing, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P. R. China
- Nursing Theory & Practice Innovation Research Center, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P. R. China
| | - Yuxin Li
- Nursing Theory & Practice Innovation Research Center, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P. R. China
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P. R. China
| | - Rong Li
- Department of Nursing, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P. R. China
- Nursing Theory & Practice Innovation Research Center, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P. R. China
| | - Xiangyun Guan
- Department of Nursing, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P. R. China
- Nursing Theory & Practice Innovation Research Center, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P. R. China
| | - Li Li
- Department of Nursing, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P. R. China
- Nursing Theory & Practice Innovation Research Center, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P. R. China
| | - Junli Li
- Department of Nursing, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P. R. China
- Nursing Theory & Practice Innovation Research Center, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P. R. China
| | - Shucheng Si
- Institute for Medical Dataology, Shandong University, Jinan, Shandong, P. R. China
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P. R. China
| | - Xiaokang Ji
- Institute for Medical Dataology, Shandong University, Jinan, Shandong, P. R. China
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P. R. China
| | - Yingjuan Cao
- Department of Nursing, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P. R. China
- Nursing Theory & Practice Innovation Research Center, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P. R. China
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P. R. China
| | - Fuzhong Xue
- Institute for Medical Dataology, Shandong University, Jinan, Shandong, P. R. China
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P. R. China
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Maguire BJ, Hughes LM, McAdams DC, Gilbert M, Nordness R. Health Conditions Among Navy Submariners at the End of Active Duty; A Retrospective Cohort Study. Mil Med 2022; 188:usac063. [PMID: 35284923 DOI: 10.1093/milmed/usac063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 02/03/2022] [Accepted: 03/01/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Maintaining healthy, well-trained, and highly qualified armed forces is critical for ensuring military readiness. The purpose of this article is to contribute to the body of research focused on the health of U.S. Navy submariners and to identify the health conditions of U.S. Navy submariners during their final year of active duty service. MATERIALS AND METHODS In this retrospective cohort study, we examined medical records and personnel files of separating U.S. Navy sailors who were: (1) active duty between 2009 and 2018; (2) separated before 2019; and (3) were assigned to a submarine for at least 30 days. Both officers and enlisted service members were included. We linked, described, and analyzed data from the Defense Health Agency, Military Health System Data Repository (MDR), and the Bureau of Naval Personnel (BUPERS). International Classification of Diseases (ICD) diagnoses codes were obtained from MDR. Data collected from BUPERS include age, sex, and rank. We determined the number of individuals who had at least one diagnosed condition (identified as a three-digit ICD code). We report the number of diagnoses and calculate prevalence rates and confidence intervals per condition, as well as prevalence rates per year, using standard formulas. The study was approved by the Naval Submarine Medical Research Laboratory Institutional Review Board. RESULTS During the study period, 26,014 submariners separated from the Navy. The average number of separations per year was 2,601. About a third of the separating submariners were in the 25 to 29 age group and over 50% were under 30 years of age. Of the three-digit individual ICD codes, some of the highest operationally relevant rates over the 10-year study period (2009-2018) were for joint disorders (prevalence rate [PR] = 180 per 1,000 submariners), back disorders (PR = 128), and sleep disorders (PR = 134). Three mental-health-related conditions were also among the 20 conditions with the highest rates. CONCLUSIONS High rates of specific diagnoses such as joint disorders indicate the need for additional study to examine causal relationships, to determine which conditions may contribute to lost work time, early separations, or low rates of reenlistment and which conditions might be a result of specific military occupations or duties. Study strengths are the large number of subjects and the long period of observations. A study weakness was the inability to identify submariners who separated because of health conditions. The overall impact of the study is that it identifies urgent health risks and establishes a way to prioritize future research. Future research should include a focus on medically separated personnel; compare rates for submariners to other military groups including all-Navy and all-Department of Defense; and determine specific and relative risks as a necessary precursor to developing, implementing, and testing risk reduction and health improvement interventions.
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Affiliation(s)
- Brian J Maguire
- Leidos/Naval Submarine Medical Research Laboratory (NSMRL), Naval Submarine Base, Groton, CT 06349, USA
| | - Linda M Hughes
- Naval Submarine Medical Research Laboratory (NSMRL), Naval Submarine Base, Groton, CT 06349, USA
| | - Douglas C McAdams
- Naval Submarine Medical Research Laboratory (NSMRL), Naval Submarine Base, Groton, CT 06349, USA
| | - Michael Gilbert
- Leidos/Naval Submarine Medical Research Laboratory (NSMRL), Naval Submarine Base, Groton, CT 06349, USA
| | - Robert Nordness
- Leidos/Naval Submarine Medical Research Laboratory (NSMRL), Naval Submarine Base, Groton, CT 06349, USA
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11
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Porcacchia AS, Câmara DAD, Andersen ML, Tufik S. Sleep disorders and prostate cancer prognosis: biology, epidemiology, and association with cancer development risk. Eur J Cancer Prev 2022; 31:178-189. [PMID: 33990093 DOI: 10.1097/cej.0000000000000685] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Sleep is crucial for the maintenance of health and well-being. Sleep disorders can result in physiological consequences and are associated with several health issues, including cancer. Cancer is one of the most significant health problems in the world. In Western countries, prostate cancer is the most prevalent noncutaneous cancer among men. Epidemiological studies showed that one in nine men will have this disease during their life. Many factors influence prostate cancer and the tumor niche, including endogenous hormones, family history, diet, and gene mutations. Disruption of the circadian cycle by sleep disorders or other factors has been suggested as a novel and important risk factor for prostate cancer and its tumorigenesis. This review presents information regarding the epidemiological and biological aspects of prostate cancer, and discusses the impact of sleep physiology and sleep disorders on this type of cancer, highlighting possible associations with risk of cancer development.
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Affiliation(s)
| | | | - Monica Levy Andersen
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP)
- Instituto do Sono, São Paulo, SP, Brazil
| | - Sergio Tufik
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP)
- Instituto do Sono, São Paulo, SP, Brazil
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12
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Sillah A, Watson NF, Peters U, Biggs ML, Nieto FJ, Li CI, Gozal D, Thornton T, Barrie S, Phipps AI. Sleep problems and risk of cancer incidence and mortality in an older cohort: The Cardiovascular Health Study (CHS). Cancer Epidemiol 2022; 76:102057. [PMID: 34798387 PMCID: PMC8792277 DOI: 10.1016/j.canep.2021.102057] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 10/17/2021] [Accepted: 10/31/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Sleep problems (SP) can indicate underlying sleep disorders, such as obstructive sleep apnea, which may adversely impact cancer risk and mortality. METHODS We assessed the association of baseline and longitudinal sleep apnea and insomnia symptoms with incident cancer (N = 3930) and cancer mortality (N = 4580) in the Cardiovascular Health Study. We used Cox proportional hazards regression to calculate adjusted hazard ratios (HR) and 95% confidence intervals (CI) to evaluate the associations. RESULTS Overall, 885 incident cancers and 804 cancer deaths were identified over a median follow-up of 12 and 14 years, respectively. Compared to participants who reported no sleep apnea symptoms, the risk of incident cancer was inversely associated [(HR (95%CI)] with snoring [0.84 (0.71, 0.99)]. We noted an elevated prostate cancer incidence for apnea [2.34 (1.32, 4.15)] and snoring [1.69 (1.11, 2.57)]. We also noted an elevated HR for lymphatic or hematopoietic cancers [daytime sleepiness: 1.81 (1.06, 3.08)]. We found an inverse relationship for cancer mortality with respect to snoring [0.73 (0.62, 0.8)] and apnea [(0.69 (0.51, 0.94))]. We noted a significant inverse relationship between difficulty falling asleep and colorectal cancer death [0.32 (0.15, 0.69)] and snoring with lung cancer death [0.56 (0.35, 0.89)]. CONCLUSIONS The relationship between SP and cancer risk and mortality was heterogeneous. Larger prospective studies addressing more cancer sites, molecular type-specific associations, and better longitudinal SP assessments are needed for improved delineation of SP-cancer risk dyad.
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Affiliation(s)
- Arthur Sillah
- University of Washington School of Public Health, United States; Fred Hutchinson Research Cancer Research Center, United States.
| | - Nathaniel F Watson
- Department of Neurology, University of Washington School of Medicine, United States
| | - Ulrike Peters
- University of Washington School of Public Health, United States; Fred Hutchinson Research Cancer Research Center, United States
| | - Mary L Biggs
- University of Washington School of Public Health, United States
| | - F Javier Nieto
- Oregon State University College of Public Health and Human Sciences, Corvallis, OR, United States
| | - Christopher I Li
- University of Washington School of Public Health, United States; Fred Hutchinson Research Cancer Research Center, United States
| | - David Gozal
- Department of Child Health, University of Missouri School of Medicine, United States
| | | | - Sonnah Barrie
- Burrell College of Osteopathic Medicine, University Park, NM, United States
| | - Amanda I Phipps
- University of Washington School of Public Health, United States; Fred Hutchinson Research Cancer Research Center, United States
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13
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Wiggins EK, Oyekunle T, Howard LE, Markt SC, Mucci LA, Bliwise D, Moreira DM, Andriole GL, Hopp ML, Freedland SJ, Allott EH. Sleep quality and prostate cancer aggressiveness: Results from the REDUCE trial. Prostate 2020; 80:1304-1313. [PMID: 32833249 PMCID: PMC7780858 DOI: 10.1002/pros.24052] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 07/17/2020] [Indexed: 11/06/2022]
Abstract
BACKGROUND Disrupted sleep has been associated with increased risk of certain cancers. Little data exist in prostate cancer. We tested the association between sleep quality and prostate cancer diagnosis overall and by tumor grade in the Reduction by Dutasteride of Prostate Cancer Events chemoprevention trial. We hypothesized that worse sleep quality would be associated with increased tumor aggressiveness. METHODS At baseline, 5614 men completed a validated six-item questionnaire on sleep quality. We generated a composite score categorized into tertiles to measure overall sleep quality and assessed each sleep quality question individually. Logistic regression was used to test associations between baseline sleep quality and overall, low-grade and high-grade prostate cancer diagnosis at 2-year study-mandated biopsy. Models were stratified by nocturia. RESULTS Overall sleep quality was unrelated to overall or low-grade prostate cancer. Worse overall sleep quality was associated with elevated odds of high-grade prostate cancer (odds ratio [OR]T3vsT1 1.15; 95% confidence interval [CI]: 0.83-1.60 and ORT2vsT1 1.39; 95% CI: 1.01-1.92). Men reporting trouble falling asleep at night sometimes vs never had elevated odds of high-grade prostate cancer (OR: 1.51; 95% CI: 1.08-2.09) while trouble staying awake during the day was associated with decreased odds of low-grade prostate cancer (OR: 0.65; 95% CI: 0.49-0.86). Results were similar within strata of nocturia severity. CONCLUSIONS Overall, associations between sleep quality and prostate cancer were inconsistent. However, there was some evidence for a positive association between insomnia and high-grade prostate cancer, and an inverse relationship between daytime sleepiness and low-grade prostate cancer; findings that should be validated by future studies.
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Affiliation(s)
- Emily K. Wiggins
- Division of Urology, Veterans Affairs Medical Center, Durham, NC
| | - Taofik Oyekunle
- Duke Cancer Institute, Duke University School of Medicine, Durham, NC
| | - Lauren E. Howard
- Duke Cancer Institute, Duke University School of Medicine, Durham, NC
| | - Sarah C. Markt
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH
| | - Lorelei A. Mucci
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Donald Bliwise
- Department of Neurology, Emory University School of Medicine, Atlanta, GA
| | - Daniel M. Moreira
- Department of Urology, University of Illinois at Chicago, Chicago, IL
| | - Gerald L. Andriole
- Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO
| | | | - Stephen J. Freedland
- Division of Urology, Veterans Affairs Medical Center, Durham, NC
- Cedars-Sinai Medical Center, Los Angeles, CA
| | - Emma H. Allott
- Patrick G. Johnston Centre for Cancer Research, Queen’s University Belfast, Belfast, United Kingdom
- Department of Histopathology and Morbid Anatomy, Trinity Translational Medicine Institute, Trinity College Dublin, Ireland
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14
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Kucera R, Pecen L, Topolcan O, Dahal AR, Costigliola V, Giordano FA, Golubnitschaja O. Prostate cancer management: long-term beliefs, epidemic developments in the early twenty-first century and 3PM dimensional solutions. EPMA J 2020; 11:399-418. [PMID: 32843909 PMCID: PMC7429585 DOI: 10.1007/s13167-020-00214-1] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 06/05/2020] [Indexed: 12/20/2022]
Abstract
In the early twenty-first century, societies around the world are facing the paradoxal epidemic development of PCa as a non-communicable disease. PCa is the most frequently diagnosed cancer for men in several countries such as the USA. Permanently improving diagnostics and treatments in the PCa management causes an impressive divergence between, on one hand, permanently increasing numbers of diagnosed PCa cases and, on the other hand, stable or even slightly decreasing mortality rates. Still, aspects listed below are waiting for innovate solutions in the context of predictive approaches, targeted prevention and personalisation of medical care (PPPM / 3PM).A.PCa belongs to the cancer types with the highest incidence worldwide. Corresponding economic burden is enormous. Moreover, the costs of treating PCa are currently increasing more quickly than those of any other cancer. Implementing individualised patient profiles and adapted treatment algorithms would make currently too heterogeneous landscape of PCa treatment costs more transparent providing clear "road map" for the cost saving.B.PCa is a systemic multi-factorial disease. Consequently, predictive diagnostics by liquid biopsy analysis is instrumental for the disease prediction, targeted prevention and curative treatments at early stages.C.The incidence of metastasising PCa is rapidly increasing particularly in younger populations. Exemplified by trends observed in the USA, prognosis is that the annual burden will increase by over 40% in 2025. To this end, one of the evident deficits is the reactive character of medical services currently provided to populations. Innovative screening programmes might be useful to identify persons in suboptimal health conditions before the clinical onset of metastasising PCa. Strong predisposition to systemic hypoxic conditions and ischemic lesions (e.g. characteristic for individuals with Flammer syndrome phenotype) and low-grade inflammation might be indicative for specific phenotyping and genotyping in metastasising PCa screening and disease management. Predictive liquid biopsy tests for CTC enumeration and their molecular characterisation are considered to be useful for secondary prevention of metastatic disease in PCa patients.D.Particular rapidly increasing PCa incidence rates are characteristic for adolescents and young adults aged 15-40 years. Patients with early onset prostate cancer pose unique challenges; multi-factorial risks for these trends are proposed. Consequently, multi-level diagnostics including phenotyping and multi-omics are considered to be the most appropriate tool for the risk assessment, prediction and prognosis. Accumulating evidence suggests that early onset prostate cancer is a distinct phenotype from both aetiological and clinical perspectives deserving particular attention from view point of 3P medical approaches.
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Affiliation(s)
- Radek Kucera
- Department of Immunochemistry Diagnostics, University Hospital and Faculty of Medicine, Pilsen, Czech Republic
| | - Ladislav Pecen
- Department of Immunochemistry Diagnostics, University Hospital and Faculty of Medicine, Pilsen, Czech Republic
| | - Ondrej Topolcan
- Department of Immunochemistry Diagnostics, University Hospital and Faculty of Medicine, Pilsen, Czech Republic
| | - Anshu Raj Dahal
- Center of Molecular Biotechnology, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
| | | | - Frank A. Giordano
- Department of Radiation Oncology, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
| | - Olga Golubnitschaja
- Predictive, Preventive and Personalised (3P) Medicine, Department of Radiation Oncology, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, Sigmund-Freud-Str. 25, 53105 Bonn, Germany
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15
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Cheng TC, Lee YH, Chang YP, Lee DC. Improved urinary melatonin level as the perspective indicator that leads to better sleeping quality in bladder cancer patients. Ther Adv Urol 2020; 12:1756287220940870. [PMID: 32782482 PMCID: PMC7385844 DOI: 10.1177/1756287220940870] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 06/17/2020] [Indexed: 12/24/2022] Open
Abstract
Background: Individuals with higher-than-average melatonin concentrations are less likely to develop cancer. In cancer patients, psychosomatic coping patterns and treatment side effects are important indicators of cancer prevention and immune system deterioration. This study focused on changes in the urinary melatonin concentration, life resilience, and sleep quality in bladder cancer patients before, and 3 months after, treatment. Methods: A controlled before-and-after study was performed. The subjects were patients who were previously diagnosed with bladder cancer and had received treatment (transurethral resection of bladder tumor + intravesical chemotherapy). Data from 23 subjects were analyzed. Results: The results showed a significant difference in the melatonin concentration before and after treatment (Wilcoxon signed-rank test, Z = −2.220, p = 0.026). The melatonin concentration in 16 patients (70%) increased after treatment. The mean Pittsburgh Sleep Quality Index (PSQI) score before treatment was 7.348 (SD = 4.030), which was associated with poor sleep quality. The mean PSQI score after treatment was 6.435 (SD = 3.300; Z = −2.071; p = 0.038). These results represent the improved sleep quality in patients post-treatment. Conclusions: After treatment, the urinary melatonin concentration and sleep quality (PSQI) improved, both of which were statistically significant in bladder cancer patients. Consequently, bladder cancer treatment should be initiated as soon as possible. There was no significant difference in overall life resilience before and after treatment, possibly because elderly individuals have strong personality traits and emotional stability and are not easily affected by life events or stress.
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Affiliation(s)
- Tse-Chou Cheng
- Department of Urology, Chi Mei Medical Center, Tainan City
| | - Yi-Hua Lee
- Department of Administration, National Health Research Institutes, Zhunan, Miaoli County
| | - Yuan-Ping Chang
- Nursing Department, Fooyin University, 151 Jinxue Rd, Daliao District, Kaohsiung City 83102 Taiwan
| | - De-Chih Lee
- Department of Information Management, Da-Yeh University, Dacun, Changhua
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