1
|
Chong MY, Frenken KG, Eussen SJPM, Koster A, Pot GK, Breukink SO, Janssen-Heijnen M, Keulen ETP, Bijnens W, Buffart LM, Meijer K, Scheer FAJL, Steindorf K, de Vos-Geelen J, Weijenberg MP, van Roekel EH, Bours MJL. Longitudinal associations of diurnal rest-activity rhythms with fatigue, insomnia, and health-related quality of life in survivors of colorectal cancer up to 5 years post-treatment. Int J Behav Nutr Phys Act 2024; 21:51. [PMID: 38698447 PMCID: PMC11067118 DOI: 10.1186/s12966-024-01601-x] [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: 01/24/2024] [Accepted: 04/24/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND There is a growing population of survivors of colorectal cancer (CRC). Fatigue and insomnia are common symptoms after CRC, negatively influencing health-related quality of life (HRQoL). Besides increasing physical activity and decreasing sedentary behavior, the timing and patterns of physical activity and rest over the 24-h day (i.e. diurnal rest-activity rhythms) could also play a role in alleviating these symptoms and improving HRQoL. We investigated longitudinal associations of the diurnal rest-activity rhythm (RAR) with fatigue, insomnia, and HRQoL in survivors of CRC. METHODS In a prospective cohort study among survivors of stage I-III CRC, 5 repeated measurements were performed from 6 weeks up to 5 years post-treatment. Parameters of RAR, including mesor, amplitude, acrophase, circadian quotient, dichotomy index, and 24-h autocorrelation coefficient, were assessed by a custom MATLAB program using data from tri-axial accelerometers worn on the upper thigh for 7 consecutive days. Fatigue, insomnia, and HRQoL were measured by validated questionnaires. Confounder-adjusted linear mixed models were applied to analyze longitudinal associations of RAR with fatigue, insomnia, and HRQoL from 6 weeks until 5 years post-treatment. Additionally, intra-individual and inter-individual associations over time were separated. RESULTS Data were available from 289 survivors of CRC. All RAR parameters except for 24-h autocorrelation increased from 6 weeks to 6 months post-treatment, after which they remained relatively stable. A higher mesor, amplitude, circadian quotient, dichotomy index, and 24-h autocorrelation were statistically significantly associated with less fatigue and better HRQoL over time. A higher amplitude and circadian quotient were associated with lower insomnia. Most of these associations appeared driven by both within-person changes over time and between-person differences in RAR parameters. No significant associations were observed for acrophase. CONCLUSIONS In the first five years after CRC treatment, adhering to a generally more active (mesor) and consistent (24-h autocorrelation) RAR, with a pronounced peak activity (amplitude) and a marked difference between daytime and nighttime activity (dichotomy index) was found to be associated with lower fatigue, lower insomnia, and a better HRQoL. Future intervention studies are needed to investigate if restoring RAR among survivors of CRC could help to alleviate symptoms of fatigue and insomnia while enhancing their HRQoL. TRIAL REGISTRATION EnCoRe study NL6904 ( https://www.onderzoekmetmensen.nl/ ).
Collapse
Affiliation(s)
- Marvin Y Chong
- Department of Epidemiology, GROW Research Institute for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands.
- Department of Epidemiology, CARIM Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands.
- Department of Epidemiology, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.
| | - Koen G Frenken
- Department of Epidemiology, GROW Research Institute for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
| | - Simone J P M Eussen
- Department of Epidemiology, CARIM Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands
- Department of Epidemiology, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Annemarie Koster
- Department of Social Medicine, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Gerda K Pot
- Nutrition and Healthcare Alliance, Hospital Gelderse Vallei, Ede, The Netherlands
| | - Stéphanie O Breukink
- Department of Surgery, GROW Research Institute for Oncology and Reproduction, NUTRIM Research Institute of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Maryska Janssen-Heijnen
- Department of Epidemiology, GROW Research Institute for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
- Department of Clinical Epidemiology, VieCuri Medical Centre, Venlo, The Netherlands
| | - Eric T P Keulen
- Department of Internal Medicine and Gastroenterology, Zuyderland Medical Centre Sittard-Geleen, Geleen, The Netherlands
| | - Wouter Bijnens
- Research Engineering (IDEE), Maastricht University, Maastricht, The Netherlands
| | - Laurien M Buffart
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Kenneth Meijer
- Department of Nutrition and Movement Sciences, NUTRIM Research Institute of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Frank A J L Scheer
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
- Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, USA
| | - Karen Steindorf
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Judith de Vos-Geelen
- Department of Internal Medicine, Division of Medical Oncology, GROW Research Institute for Oncology and Reproduction, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Matty P Weijenberg
- Department of Epidemiology, GROW Research Institute for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
| | - Eline H van Roekel
- Department of Epidemiology, GROW Research Institute for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
| | - Martijn J L Bours
- Department of Epidemiology, GROW Research Institute for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
| |
Collapse
|
2
|
Chen J, Liu L, Wang Y, Qin H, Liu C. Effects of psychotherapy interventions on anxiety and depression in patients with gastrointestinal cancer: A systematic review and network meta-analysis. J Psychosom Res 2024; 179:111609. [PMID: 38394712 DOI: 10.1016/j.jpsychores.2024.111609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 02/05/2024] [Accepted: 02/10/2024] [Indexed: 02/25/2024]
Abstract
OBJECTIVE Various psychological interventions have been demonstrated to be effective at preventing anxiety and depression symptoms in patients with gastrointestinal (GI) cancer. However, it remains unclear which intervention is the best option. This study aimed to evaluate the impact of various psychological interventions on anxiety and depression in symptomatic patients with GI cancer. METHODS The PubMed, Cochrane Library, Embase, CNKI, WanFang Data, and VIP databases were systematically searched from inception to June 2023 to identify randomized controlled trials (RCTs). The primary outcomes were anxiety and depression levels. Two reviewers independently selected the studies, extracted the data based on prespecified criteria, and evaluated the risk of bias using the Cochrane Collaboration risk of bias tool. Stata 14.0 was used to conduct network meta-analysis. RESULTS Thirty-two RCTs (2453 patients) involving 9 psychological interventions were included. The results of the network meta-analysis showed that cognitive-behavioral therapy (CBT; mean difference [MD] = -4.98, 95% CI (-7.04, -2.93), relaxation therapy (MD = -4.39, 95% CI (-7.90, -0.88), reminiscence therapy (MD = -5.01, 95% CI (-8.20, -1.81)), and narrative nursing (MD = -4.89, 95% CI (-8.54, -1.23)) significantly reduced anxiety levels, and CBT (MD = -2.15, 95% CI (-4.28, -0.02), reminiscence therapy (MD = -7.20, 95% CI (-10.48, -3.91), and narrative nursing (MD = -7.20, 95% CI (-10.48, -3.91)) significantly reduced depression levels in patients with GI cancer compared with conventional nursing care. CONCLUSION The findings of this network meta-analysis revealed that CBT, reminiscence therapy and narrative nursing can be actively considered as part of sequential therapy to reduce anxiety and depression levels in patients with GI cancer.
Collapse
Affiliation(s)
- Jianwen Chen
- Department of Nursing, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Dongfengdong Road, 510060 Guangzhou, Guangdong Province, China.
| | - Li Liu
- Department of Nursing, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Dongfengdong Road, 510060 Guangzhou, Guangdong Province, China
| | - Yalan Wang
- Department of Nursing, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Dongfengdong Road, 510060 Guangzhou, Guangdong Province, China
| | - Huiying Qin
- Department of Nursing, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Dongfengdong Road, 510060 Guangzhou, Guangdong Province, China.
| | - Chengjiang Liu
- Department of General Medicine, Affiliated Anqing First People's Hospital of Anhui Medical University, 246000 Anqing, Anhui Province, China.
| |
Collapse
|
3
|
Naeimabadi Z, Bana Derakhshan H, Rassouli M, Ebadi A. Health-related quality of life and related factors in patients with colorectal cancer in Iran: a systematic review. Ann Med Surg (Lond) 2024; 86:2088-2097. [PMID: 38576919 PMCID: PMC10990301 DOI: 10.1097/ms9.0000000000001058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 07/02/2023] [Indexed: 04/06/2024] Open
Abstract
Introduction This systematic review aims to examine the health-related quality of life (QOL) in Iranian patients with colorectal cancer (CRC) and its related factors. Methods A thorough, systematic search was conducted in different international electronic databases, including Scopus, PubMed, Web of Science, and Persian electronic databases such as Iranmedex, and Scientific Information Database using keywords such as "Colorectal neoplasm", "Colorectal tumors", "Colorectal cancer", "Quality of life", and "Life quality" from the earliest to 17 October 2022. The quality of the studies included in this systematic review was evaluated using the appraisal tool for cross-sectional studies (AXIS tool). Results There were 820 CRC patients in the five cross-sectional studies that made up this systematic review. The mean score of QOL in patients with CRC was 61.99 (SD=15.87) out of 100 based on EORTC-QLQ-C30, which indicates a moderate to good level of QOL. Factors such as age, gender, living conditions, level of education, occupation, monthly income, health insurance, physical activity, performance status, and comorbidities had a significant relationship with QOL in patients with CRC. Conclusion In sum, the findings of the five studies that were a part of this systematic review revealed that Iranian patients with CRC had a moderate to good QOL. Therefore, managers and health policymakers can create psychological counseling programs with an emphasis on the factors affecting the QOL of patients in light of how crucial it is to raise patients' understanding of the long-term impacts of CRC and how they affect their QOL.
Collapse
Affiliation(s)
- Zahra Naeimabadi
- Student Research Committee, Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Science
| | - Homayoon Bana Derakhshan
- Assistant Professor of Medical Education, Head of Anesthesia & Operating Room Department, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences
| | - Maryam Rassouli
- Professor, Cancer Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abbas Ebadi
- Behavioral Sciences Research Center, Life style institute, Nursing Faculty, Baqiyatallah University of Medical Sciences
| |
Collapse
|
4
|
Feizpour CA, Turk A, Mohanty S. Quality of Life Outcomes in Stage IV Colorectal Cancer. Clin Colon Rectal Surg 2024; 37:102-107. [PMID: 38322606 PMCID: PMC10843882 DOI: 10.1055/s-0043-1761476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
With improvements across the colorectal cancer care continuum, from screening and earlier detection to better systemic options, patients are living longer with the disease. Given these improvements over the last several decades, quality of life outcomes have become important components when evaluating treatment efficacy and adverse effects. This article reviews quality of life measurement generally, discusses tools currently being used in colorectal cancer patients, and reviews outcomes following both surgical and nonsurgical management from clinical trials, observational studies, and meta-analyses.
Collapse
Affiliation(s)
- Cyrus Ali Feizpour
- Division of General Surgery, Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana
| | - Anita Turk
- Division of Hematology/Oncology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Sanjay Mohanty
- Division of General Surgery, Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana
| |
Collapse
|
5
|
Su CC, Guo SE, Kuo YW. Effects of internet-based digital health interventions on the physical activity and quality of life of colorectal cancer survivors: a systematic review and meta-analysis. Support Care Cancer 2024; 32:168. [PMID: 38374448 DOI: 10.1007/s00520-024-08369-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 02/11/2024] [Indexed: 02/21/2024]
Abstract
PURPOSE The recent trend of Internet-based digital health interventions has driven researchers to implement them to promote physical activity (PA) and improve patients' health outcomes. This systematic review and meta-analysis aim to evaluate the effects of Internet-based digital health interventions on PA and quality of life (QoL) in colorectal cancer (CRC) survivors. METHODS We searched for relevant studies investigating the effects of internet-based digital health interventions published until Dec. 2022 in electronic databases (PubMed, CINAHL, EMBASE, Cochrane Central Register of Controlled Trials, and CEPS) according to PRISMA guidelines. The Joanna Briggs Institute critical appraisal checklist was used to examine the quality of the included studies. We performed the fixed and random effects model for meta-analysis. RESULTS Among 746 identified studies, eight published between 2018 and 2022 were included. These covered 991 internet-based digital health interventions and 875 controls. After 6 months of internet-based digital health interventions, CRC survivors' performance in PA (standardized mean difference (SMD) = 0.23, 95% confidence interval [CI] = 0.09-0.38) and QoL (SMD = 0.11, 95% CI = 0.01-0.22) indicators improved significantly. CONCLUSIONS Internet-based digital health improved the PA behaviour and QoL of patients with CRC. Because of differences in intervention outcomes, additional randomized controlled trials are warranted to provide suggestions for clinical practice. Internet-based digital health interventions are promising for promoting PA in CRC survivors.
Collapse
Affiliation(s)
- Ching-Ching Su
- Department of Nursing and Graduate Institute of Nursing, College of Nursing, Chang Gung University of Science and Technology (CGUST), No. 2, Sec. W., Jiapu Rd., Puzi City, Chiayi County, 61363, Taiwan
- Department of Hematology and Oncology, Chiayi Chang Gung Memorial Hospital, No. 6, West Sec., Jiapu Road, Puzi City, Chiayi County, 61363, Taiwan
| | - Su-Er Guo
- Department of Nursing and Graduate Institute of Nursing, College of Nursing, Chang Gung University of Science and Technology (CGUST), No. 2, Sec. W., Jiapu Rd., Puzi City, Chiayi County, 61363, Taiwan.
- Chronic Diseases and Health Promotion Research Center, Chang Gung University of Science and Technology (CGUST), No. 2, Sec. W., Jiapu Rd., Puzi City, Chiayi County, 61363, Taiwan.
- Division of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, No. 6, West Sec., Jiapu Road, Puzi City, Chiayi County, 61363, Taiwan.
- Department of Safety Health and Environmental Engineering, Ming Chi University of Technology, No. 84 Gungjuan Rd., Taishan Dist., New Taipei City, 24301, Taiwan.
| | - Ya-Wen Kuo
- Department of Nursing and Graduate Institute of Nursing, College of Nursing, Chang Gung University of Science and Technology (CGUST), No. 2, Sec. W., Jiapu Rd., Puzi City, Chiayi County, 61363, Taiwan.
- Department of Neurology, Chang Gung Memorial Hospital, No. 6, West Sec., Jiapu Road, Puzi City, Chiayi County, 61363, Taiwan.
| |
Collapse
|
6
|
Abdul Razak N, Azhar AR, Baharuddin IH, Ismail Z, Azman ZAM, Abdul Manap SA, Ramli N. Does Exercise Improve Health-Related Quality of Life of Colorectal Cancer Survivors? A Systematic Review and Meta-Analysis. Asian Pac J Cancer Prev 2024; 25:379-391. [PMID: 38415522 PMCID: PMC11077098 DOI: 10.31557/apjcp.2024.25.2.379] [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: 08/04/2023] [Accepted: 02/16/2024] [Indexed: 02/29/2024] Open
Abstract
INTRODUCTION Early diagnostic and treatment advances have resulted in prolonged cancer survivorship. Therefore, exercise intervention in survivorship management is essential for enhancing cancer survivors' health-related quality of life (HRQoL). OBJECTIVE The systematic review and meta-analysis in this study aimed to explore the effect of exercise intervention on health-related quality of life of colorectal cancer survivors. METHODS The current study followed guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 (PRISMA 2020) to identify relevant literature. Comprehensive searches were conducted using EBSCOhost, Web of Science (WOS), Scopus, Science Direct, and PubMed. The inclusion criteria included are randomised control trials studies written in English, with no restrictions for the time of publication that reported the effects of exercise intervention on health-related quality of live among colorectal cancer survivors. Meta-analysis was conducted by pooling the mean and standard deviation of post-intervention scores across randomised control trial studies using a random effects model. RESULT A total of 467 articles were identified but only seven articles were randomised control trials (RCT) (n = 7) with PEDro scores ranging from 6 to 9 showing good internal validity were included in the review. The results of the meta-analysis of pooled data from six RCTs studies on HRQoL showed no significant effect of exercise intervention on HRQoL in the intervention group compared to control group [SMD = 0.25; 95% CI; -0.0, 0.51; Z = 1.88; p = 0.06; I2 = 30.8%]. CONCLUSION This meta-analysis provides key insights into the effect of exercise on the health-related quality of life (HRQoL) of colorectal cancer (CRC) survivors. Therefore, more experimental studies should be carried out with rigorous methodology to evaluate the effectiveness of exercise interventions before it is recommended as a routine activity in post-treatment management for CRC survivors.
Collapse
Affiliation(s)
- Najibah Abdul Razak
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Jalan Hospital, 47000 Sungai Buloh, Selangor, Malaysia.
| | - Abdul Razak Azhar
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Jalan Hospital, 47000 Sungai Buloh, Selangor, Malaysia.
| | - Izyan Hazwani Baharuddin
- Faculty of Dentistry, Universiti Teknologi MARA, Sungai Buloh Campus, Jalan Hospital, 47000 Sungai Buloh, Selangor, Malaysia.
| | - Zaliha Ismail
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Jalan Hospital, 47000 Sungai Buloh, Selangor, Malaysia.
| | | | - Shaiful Amir Abdul Manap
- Department of Surgery Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Selangor, Malaysia.
| | - Nurhidayu Ramli
- Physiotherapy Unit, Department of Medical Rehabilitation Services, Hospital Canselor Tuanku Muhriz, Cheras, Kuala Lumpur, Malaysia.
| |
Collapse
|
7
|
De La Torre SA, Pickering T, Spruijt-Metz D, Farias AJ. The frequency of using wearable activity trackers is associated with minutes of moderate to vigorous physical activity among cancer survivors: Analysis of HINTS data. Cancer Epidemiol 2024; 88:102491. [PMID: 38042129 DOI: 10.1016/j.canep.2023.102491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 11/03/2023] [Accepted: 11/10/2023] [Indexed: 12/04/2023]
Abstract
BACKGROUND Despite the health benefits, cancer survivors tend to exercise less after diagnosis and treatment. Wearable activity trackers (WATs) can provide avenues for self-monitoring and may enhance exercise motivation and enjoyment. However, less is known about the relationship between how often survivors use wearables and their amount of moderate to vigorous physical activity (MVPA). METHODS Data was utilized from the National Cancer Institute's Health Information National Trend Survey 5 Cycles 3-4 (January 2019 - June 2020). To account for overdispersion and excessive zeros in the outcome variable (weekly minutes of MVPA), a zero inflated negative binomial regression model was used. RESULTS The majority of the sample (n = 1369) were female (n = 735, 53.7 %), non-Hispanic White (n = 961, 70.2 %) and 34.3 % (n = 664) were between the ages of 65-74 years. Non-melanoma skin cancer was the most frequently reported cancer type (n = 334, 24.4 %) and 48.5 % (n = 664) reported that it had been 11 + years since their diagnosis. Survivors who reported daily WAT use were estimated to have 3.53 times higher number of MVPA minutes per week compared to survivors who reported non-daily WAT usage (RR: 3.53, 2.76-4.53, p = <0.001). Based on the model, daily WAT users had an expected mean MVPA of 202 min per week (95 % CI: 191.15-226.59) compared to non-daily users (132 min, 95 % CI: 119.81-140.22) and non-WAT users (88 min, 95 % CI: 84.46-92.50). CONCLUSION According to this model, survivors who reported daily WAT use were estimated on average to have weekly MVPA minutes that meet or exceed MVPA recommendations (>= 150 min of MVPA per week) compared to survivors who reported infrequent or no WAT use. Wearables may provide an opportunity for survivors to engage in self-monitoring and can potentially support exercise tracking and engagement.
Collapse
Affiliation(s)
- Steven A De La Torre
- The Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, United States.
| | - Trevor Pickering
- Department of Population and Public Health Sciences, Keck School of Medicine, Los Angeles, CA, United States
| | - Donna Spruijt-Metz
- Dornsife Center for Economic and Social Research, Department of Psychology, University of Southern California, Los Angeles, CA, United States
| | - Albert J Farias
- Department of Population and Public Health Sciences, Keck School of Medicine, Los Angeles, CA, United States; Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| |
Collapse
|
8
|
Hu Y, Wang L, Su G, Chen B, Ruan Z, Yang J, Shen Q. The relationship between physical activity, self-efficacy and quality of life in colorectal cancer survivors: a multicenter cross-sectional study. Discov Oncol 2024; 15:4. [PMID: 38177612 PMCID: PMC10766897 DOI: 10.1007/s12672-023-00854-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 12/19/2023] [Indexed: 01/06/2024] Open
Abstract
PURPOSE This study aimed to investigate the current situation and factors influencing physical activity, self-efficacy, and quality of life in Chinese colorectal cancer survivors. Additionally, this study explored the associations between physical activity, self-efficacy, and quality of life. METHODS A multicenter, cross-sectional study was conducted, involving 173 colorectal cancer survivors with a mean age of 59 years. Self-reported data on basic demographic characteristics, physical activity, self-efficacy, and quality of life were collected. RESULTS Among 173 colorectal cancer survivors, 90 (52.0%) were engaged in manual work. The self-efficacy score was found to be 25.99 ± 7.10, while the global health status score was 54.96 ± 21.56. Global health status was associated with sex, residence, chemoradiotherapy, and monthly income (p < 0.01). The self-efficacy score exhibited a significant positive correlation with quality of life, while demonstrating a negative correlation with symptom scores (p < 0.01). Recreational PA scores were positively associated with global health status (P < 0.05). Self-efficacy, recreational physical activity during winter, and whether the participants underwent chemoradiotherapy explained 29.3% of the variance in quality of life among colorectal cancer survivors. CONCLUSIONS Colorectal cancer survivors exhibited low levels of physical activity, self-efficacy, and quality of life. Their health is influenced by self-efficacy, recreational physical activity, and chemoradiotherapy. When developing intervention plans for colorectal cancer survivorship, it is crucial to consider survivors' self-efficacy and the type of physical activity in which they engage.
Collapse
Affiliation(s)
- Yuru Hu
- School of Medicine, Xiamen University, Xiangshan Street, Xiang'an District, Xiamen, 361102, Fujian, China
| | - Lijun Wang
- School of Medicine, Xiamen University, Xiangshan Street, Xiang'an District, Xiamen, 361102, Fujian, China
| | - Guoqiang Su
- Department of Colorectal Surgery, The First Affiliated Hospital of Xiamen University, 55 Zhenhai Road, Xiamen, 361003, Fujian, China
| | - Bo Chen
- Department of Colorectal Surgery, The First Affiliated Hospital of Xiamen University, 55 Zhenhai Road, Xiamen, 361003, Fujian, China
| | - Zheng Ruan
- Department of Colorectal Surgery, The First Affiliated Hospital of Xiamen University, 55 Zhenhai Road, Xiamen, 361003, Fujian, China
| | - Jinqiu Yang
- Department of Nursing, School of Medicine, Xiamen University, Xiangshan Street, Xiang'an District, Xiamen, 361102, Fujian, China.
| | - Qu Shen
- Department of Nursing, School of Medicine, Xiamen University, Xiangshan Street, Xiang'an District, Xiamen, 361102, Fujian, China.
| |
Collapse
|
9
|
Li YC, Hsu HH, Yang SP, Hu GC, Wang HM, Huang WC, Wang TJ. Healthy Lifestyle and Quality of Life in Post-Operative Colorectal Cancer Patients: A Five-Month Observational Study. Nutrients 2023; 16:68. [PMID: 38201897 PMCID: PMC10781141 DOI: 10.3390/nu16010068] [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: 10/25/2023] [Revised: 12/15/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024] Open
Abstract
Health-related quality of life (HRQOL) is an important indicator of treatment effectiveness. An unhealthy lifestyle can have a negative impact on quality of life. This study aimed to investigate changes in health-related lifestyle over time after surgery for colorectal cancer and their impact on HRQOL. Healthy lifestyle habits examined in this study included physical activity, smoking, alcohol consumption, fruit and vegetable intake, sleep, and obesity levels. An observational study design was used. A total of 75 post-operative colorectal cancer patients were recruited from two medical centers in Taiwan. Data were collected through structured questionnaires. Mean HRQOL scores at 1, 3, and 5 months after discharge were 102.5 (SD = 18.8), 102.9 (SD = 20.1), and 103.0 (SD = 18.9), respectively. A generalized estimating equation analysis showed that alcohol consumption (p = 0.009), fruit and vegetable intake (p = 0.020), physical activity (p = 0.023), sleep quality (p < 0.001), and obesity (p = 0.035) were important predictors of post-operative quality of life in patients with colorectal cancer. The impact of smoking on HRQOL did not reach statistical significance. Colorectal cancer patients tend to have better HRQOL after surgery if they stay physically active, eat enough fruits and vegetables, and sleep well.
Collapse
Affiliation(s)
- Yi-Chiu Li
- Division of Colorectal, Department of Surgery, MacKay Memorial Hospital, Taipei City 10449, Taiwan; (Y.-C.L.); (H.-H.H.)
| | - Hsi-Hsien Hsu
- Division of Colorectal, Department of Surgery, MacKay Memorial Hospital, Taipei City 10449, Taiwan; (Y.-C.L.); (H.-H.H.)
- MacKay Junior College of Medicine Nursing and Management, Taipei City 11260, Taiwan
| | - Shu-Ping Yang
- Department of Nursing, Cathay General Hospital, Taipei City 10630, Taiwan; (S.-P.Y.); (H.-M.W.)
| | - Gwo-Chi Hu
- Department of Rehabilitation, MacKay Memorial Hospital, Taipei City 10449, Taiwan;
- Department of Medicine, MacKay Medical College, New Taipei City 25245, Taiwan
| | - Hui-Mei Wang
- Department of Nursing, Cathay General Hospital, Taipei City 10630, Taiwan; (S.-P.Y.); (H.-M.W.)
| | - Wen-Chien Huang
- Department of Medicine, MacKay Medical College, New Taipei City 25245, Taiwan
- Department of Thoracic Surgery, MacKay Memorial Hospital, Taipei City 10449, Taiwan
| | - Tsae-Jyy Wang
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei City 11219, Taiwan
| |
Collapse
|
10
|
Gresham G, Raines C, Asher A, Freedland SJ, Shirazipour CH, Sleight AG. Can high-intensity interval training impact tumor suppression and inflammatory response in prostate cancer survivors? Prostate Cancer Prostatic Dis 2023; 26:643-645. [PMID: 37002380 DOI: 10.1038/s41391-023-00661-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/15/2023] [Accepted: 03/10/2023] [Indexed: 04/07/2023]
Affiliation(s)
- Gillian Gresham
- Cedars-Sinai Cancer, Cedars-Sinai Health System, Los Angeles, CA, USA.
| | - Carolina Raines
- Cedars-Sinai Cancer, Cedars-Sinai Health System, Los Angeles, CA, USA
| | - Arash Asher
- Cedars-Sinai Cancer, Cedars-Sinai Health System, Los Angeles, CA, USA
| | | | | | - Alix G Sleight
- Cedars-Sinai Cancer, Cedars-Sinai Health System, Los Angeles, CA, USA
| |
Collapse
|
11
|
Ramezanzade Tabriz E, Ramezani M, Heydari A, Aledavood SA. Health-Promoting Lifestyle among the Survivors of Colorectal Cancer: An Integrative Review. J Caring Sci 2023; 12:201-210. [PMID: 38020738 PMCID: PMC10663441 DOI: 10.34172/jcs.2023.31768] [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: 07/13/2022] [Accepted: 09/03/2022] [Indexed: 12/01/2023] Open
Abstract
Introduction Health-promoting lifestyle (HPL) among the survivors of colorectal cancer (CRC) is essential to reduce CRC complications, prevent its recurrence, and improve survival. Nonetheless, there is no comprehensive definition for the concept of HPL in CRC survivors. This study aimed to define the concept of HPL among CRC survivors based on the existing literature. Methods This integrative review was conducted in 2021 using Whittemore and Knafl's method. The national and international databases of SID, Magiran, ProQuest, Medline, ScienceDirect, Web of Science, and Scopus were searched. Quality appraisal was performed using the Mixed Methods Appraisal Tool (MMAT) and the data were analyzed using the four-step approach proposed by Whittemore and Knafl. Results After data evaluation, 167 documents were included in final analysis. In total, 1863 codes were generated and categorized into eighteen main categories and the three main themes of antecedents, attributes, and consequences. Accordingly, HPL among CRC survivors was defined as "a set of behaviors in the areas of health responsibility, physical activity, nutrition, spiritual growth, psychological management, and interpersonal relations which are affected by socio-demographic characteristics, clinical characteristics, psychological status, physical conditions, time and place limitations, and patient education, and lead to better disease prognosis, better general health status, better bio-psycho-social status, and better quality of life". Conclusion The definition of HPL among CRC survivors provided in the present study can be used in counseling, educational, supportive, and care programs for CRC survivors in order to improve their quality of life and survival.
Collapse
Affiliation(s)
- Elahe Ramezanzade Tabriz
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Monir Ramezani
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Pediatric Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Abbas Heydari
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | |
Collapse
|
12
|
Gildea GC, Spence RR, Jones TL, Turner JC, Macdonald ER, Hayes SC, Sandler CX. Barriers, facilitators, perceptions and preferences influencing physical activity participation, and the similarities and differences between cancer types and treatment stages - A systematic rapid review. Prev Med Rep 2023; 34:102255. [PMID: 37273528 PMCID: PMC10236469 DOI: 10.1016/j.pmedr.2023.102255] [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: 02/18/2023] [Revised: 04/25/2023] [Accepted: 05/19/2023] [Indexed: 06/06/2023] Open
Abstract
The aim of this systematic rapid review was to explore barriers, facilitators, perceptions and preferences of physical activity for people diagnosed with cancer, by cancer type and treatment stage. The search strategy, implemented through four databases, included terms relating to cancer, physical activity, barriers, facilitators, perceptions and preferences, and relevant study designs. Studies reporting the outcomes of interests for adults diagnosed with cancer and living in Western countries were included and grouped according to the Social-Ecological Model and the Health Belief Model, and pragmatically. A total of 118 studies, involving 15 cancers were included. Outcomes were most commonly explored within samples involving mixed cancers (32 studies) and breast cancer (31 studies), and at the post-treatment phase (52 studies). Across all cancers and during- and post-treatment, treatment- and disease-related side-effects were the most commonly identified barrier, social support and guidance was the most commonly identified facilitator, and promoting health and recovery was the most commonly identified perception of benefit of physical activity. Notable differences were identified in barriers, facilitators and perceptions across cancer types and treatment stages, with specific examples including: comorbidities were inconsistently reported as a barrier across cancers; time pressure was more commonly reported as a barrier post-treatment; and women with breast cancer reported inaccessibility of appropriate services more commonly during-treatment than post-treatment. Preference findings varied widely across cancer types and treatment phases. These findings can be used to aid efforts to improve physical activity levels post-cancer by providing healthcare professionals with information to facilitate individualised advice and services.
Collapse
Affiliation(s)
- Gabrielle C. Gildea
- Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
- School of Health Science and Social Work, Griffith University, Brisbane, Queensland, Australia
| | - Rosalind R. Spence
- Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
- School of Health Science and Social Work, Griffith University, Brisbane, Queensland, Australia
| | - Tamara L. Jones
- Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
- Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Victoria, Australia
| | - Jemma C. Turner
- Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
| | - Eliza R. Macdonald
- Department of Exercise Physiology, School of Health Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Sandra C. Hayes
- Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
- School of Health Science and Social Work, Griffith University, Brisbane, Queensland, Australia
| | - Carolina X. Sandler
- Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
- Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
- School of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia
| |
Collapse
|
13
|
Pelosi AC, Rostirola GC, Pereira JS, Silva KC, Fontanari MER, Oliveira MSP, dos Reis IGM, Messias LHD. Remote and Unsupervised Exercise Strategies for Improving the Physical Activity of Colorectal Cancer Patients: A Meta-Analysis. Healthcare (Basel) 2023; 11:723. [PMID: 36900728 PMCID: PMC10000866 DOI: 10.3390/healthcare11050723] [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: 02/02/2023] [Revised: 02/22/2023] [Accepted: 02/24/2023] [Indexed: 03/06/2023] Open
Abstract
Colorectal cancer (CRC) burden across the world is expected to increase by ~2.2 million new cases and ~1.1 million deaths by 2030. Regular physical exercise is recommended to prevent CRC, but the myriad of protocols preclude further discussion on how to manage its variables for this population. Home-based exercise guided by remote monitoring provides an alternative to surpass the barriers of supervised exercise. However, no meta-analysis was conducted to verify the effectiveness of this intervention for improving physical activity (PA). We performed a systematic review of remote and unsupervised strategies imposed on CRC patients for improving PA and compared, via a meta-analysis, their effectiveness against CRC patients submitted to usual care or no intervention. The databases PubMed, Scopus, and Web of Science were searched on 20 September 2022. Eleven studies attained the criteria for eligibility in the qualitative approach, and seven were included in the meta-analysis. No significant effect (p = 0.06) of remote and unsupervised exercise intervention was observed. However, a sensitivity analysis including three studies that only considered CRC patients was performed, demonstrating a significant effect in favor of exercise (p = 0.008). Based on our sensitivity analysis, remote and unsupervised exercise strategies were effective to improve the PA of CRC patients.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Leonardo Henrique Dalcheco Messias
- Research Group on Technology Applied to Exercise Physiology (GTAFE), Laboratory of Multidisciplinary Research, São Francisco University, Bragança Paulista 12916-900, Brazil
| |
Collapse
|
14
|
The Impact of Bevacizumab and Chemotherapy on Quality of Life in Metastatic Colorectal Cancer Patients. Healthcare (Basel) 2023; 11:healthcare11040591. [PMID: 36833125 PMCID: PMC9956224 DOI: 10.3390/healthcare11040591] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/13/2023] [Accepted: 02/15/2023] [Indexed: 02/18/2023] Open
Abstract
Health-related quality is of life of great importance in cancer care. This prospective study aimed to evaluate the impact of chemotherapy and bevacizumab on the activities of daily living, cancer symptoms, and general well-being in 59 metastatic colorectal cancer patients. We gathered information using the EORTC QLQ-C30 and QLQ-CR29 questionnaires. The paired sample t-test, MANOVA test, and Pearson's correlation test were used to analyze the presence of significant differences in mean scores before and after 6 months of treatment. The results revealed significant differences in the functioning and symptoms that influence patients' quality of life after 6 months of treatment: increased pain (p = 0.003), nausea and vomiting (p = 0.003), diarrhea (p = 0.021) and decreased appetite (p = 0.003). At the same time, there were several aspects that improved the quality of life. Increases in emotional function (p = 0.009), cognitive function (p = 0.033), and perception of body image (p = 0.026) were observed after 6 months of treatment. Elderly patients reported a higher frequency of stools (p = 0.028), and young patients had increased concerns about body perception (p = 0.047). Assessing the quality of life of metastatic colorectal cancer patients is an important way to identify and treat symptoms related to both cancer and therapy by establishing a holistic care plan and implementing measures to increase the quality of life.
Collapse
|
15
|
Nelson D, McGonagle I, Jackson C, Tsuro T, Scott E, Gussy M, Kane R. Health-Promoting Behaviours following Primary Treatment for Cancer: A Rural-Urban Comparison from a Cross-Sectional Study. Curr Oncol 2023; 30:1585-1597. [PMID: 36826083 PMCID: PMC9955107 DOI: 10.3390/curroncol30020122] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/22/2023] [Accepted: 01/24/2023] [Indexed: 01/27/2023] Open
Abstract
AIM To compare health-promoting behaviours among rural and urban residents following primary treatment for cancer. METHODS A cross-sectional survey collecting demographic variables and data pertaining to health-promoting behaviours, documented using the 52-item Health Promotion Lifestyle Profile II (HPLP-II) measure, which is categorised into six subscales: (1) health responsibility, (2) spiritual growth, (3) physical activity, (4) interpersonal relations, (5) nutrition, and (6) stress management. Residence was defined using the U.K. Office for National Statistics RUC 2011 Rural Urban Classifications. The Index of Multiple Deprivation (IMD) Decile was used to measure deprivation. Quantitative data were analysed using independent samples t-test and multiple linear regression. Qualitative data from open-ended questions were analysed thematically. RESULTS In total, 227 participants with a range of cancer types completed the questionnaire. Fifty-three percent were residents in urban areas and forty-five percent in rural areas. Rural participants scored significantly higher on health responsibility (p = 0.001), nutrition (p = 0.001), spiritual growth (p = 0.004), and interpersonal relationships (p = 0.001), as well as on the overall HPLP-II (p = 0.001). When controlling for deprivation, age, marital status, and education, rural-urban residence was a significant predictor of exhibiting health-promoting behaviours. A central theme from the qualitative data was the concept of "moving on" from cancer following treatment, by making adjustments to physical, social, psychological, spiritual, and emotional wellbeing. CONCLUSIONS This research revealed, for the first time, differences in health-promoting behaviours among rural and urban U.K. populations who have completed primary cancer treatment. Rural residence can provide a positive environment for engaging with health-promoting behaviours following a cancer diagnosis and treatment.
Collapse
Affiliation(s)
- David Nelson
- Lincoln International Institute for Rural Health, College of Social Science, University of Lincoln, Lincoln LN6 7TS, UK
- Macmillan Cancer Support, London SE1 7UQ, UK
- Correspondence: ; Tel.: +44-(0)1522-837343
| | - Ian McGonagle
- School of Health and Social Care, College of Social Science, University of Lincoln, Lincoln LN6 7TS, UK
| | - Christine Jackson
- School of Health and Social Care, College of Social Science, University of Lincoln, Lincoln LN6 7TS, UK
| | - Trish Tsuro
- United Lincolnshire Hospitals NHS Trust, Research and Innovation Department, Pilgrim Hospital, Boston PE21 9QS, UK
| | - Emily Scott
- Lincolnshire Partnership NHS Foundation Trust, Peter Hodgkinson Centre, Lincoln County Hospital, Lincoln LN2 5UA, UK
| | - Mark Gussy
- Lincoln International Institute for Rural Health, College of Social Science, University of Lincoln, Lincoln LN6 7TS, UK
- La Trobe Rural Health School, College of Science, Health and Engineering, La Trobe University, Bendigo P.O. Box 199, Australia
| | - Ros Kane
- School of Health and Social Care, College of Social Science, University of Lincoln, Lincoln LN6 7TS, UK
| |
Collapse
|
16
|
Kim J, Kang S, Kim D, Kang H. Associations of Physical Activity and Handgrip Strength with Health-Related Quality of Life in Older Korean Cancer Survivors. Cancers (Basel) 2022; 14:cancers14246067. [PMID: 36551553 PMCID: PMC9776490 DOI: 10.3390/cancers14246067] [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: 10/28/2022] [Revised: 12/01/2022] [Accepted: 12/08/2022] [Indexed: 12/14/2022] Open
Abstract
Background: Uncertainty exists regarding the associations between physical activity (PA), relative handgrip strength (RHGS), and health-related quality of life (HRQoL) among elderly Korean cancer survivors. This study investigated the moderating effect of RHGS on the relationship between PA and HRQoL in 308 cancer survivors aged ≥65 years using the data from the Korean National Health and Nutrition Examination Survey in 2014−2019. Methods: HRQoL was evaluated with the EuroQol-5-dimension instrument. PA and handgrip strength were assessed with the Global Physical Activity Questionnaire and a hand dynamometer, respectively. Age, sex, body mass index, income, marital status, educational background, heavy alcohol consumption, smoking status, multimorbidity, and hemoglobin were included as covariates. Results: Bivariate logistic regression showed that insufficient PA and no PA were associated with higher odds of a low HRQoL (odds ratio, OR = 2.6, 95% confidence interval, CI = 1.3~5.1, p = 0.005; OR = 2.4, 95% CI = 1.1~5.0, p = 0.024, respectively), compared with sufficient PA (OR = 1). Weak RHGS was associated with high odds of a low HRQoL (OR = 2.6, 95%= 1.530~4.6, p < 0.001) compared with normal RHGS (OR = 1). Particularly, RHGS (β = −0.0573, 95% CI = −0.1033~−0.0112) had a significant moderating effect on the relationship between PA and HRQoL even after adjustments for all the covariates. The negative influence of physical inactivity on HRQoL was observed in cancer survivors with weak RHGS but not in cancer survivors with normal RHGS. Conclusions: The current findings suggest that maintaining or promoting muscular strength through regular exercise is critical for the HRQoL of elderly Korean cancer survivors.
Collapse
Affiliation(s)
- Jeonghyeon Kim
- College of Sport Science, Sungkyunkwan University, Suwon 16419, Republic of Korea
| | - Seamon Kang
- College of Sport Science, Sungkyunkwan University, Suwon 16419, Republic of Korea
| | - Donghyun Kim
- Department of Sports and Health Science, Hanbat National University, Daejeon 34158, Republic of Korea
| | - Hyunsik Kang
- College of Sport Science, Sungkyunkwan University, Suwon 16419, Republic of Korea
- Correspondence: ; Tel.: +82-31-299-6911
| |
Collapse
|
17
|
Westrick AC, Langa KM, Kobayashi LC. The association of health behaviors prior to cancer diagnosis and functional aging trajectories after diagnosis: Longitudinal cohort study of middle-aged and older US cancer survivors. Prev Med Rep 2022; 31:102083. [PMID: 36505272 PMCID: PMC9732401 DOI: 10.1016/j.pmedr.2022.102083] [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: 08/01/2022] [Revised: 11/29/2022] [Accepted: 11/30/2022] [Indexed: 12/03/2022] Open
Abstract
We aimed to determine the influence of modifiable health behaviors prior to a cancer diagnosis on functional aging trajectories after diagnosis among middle-aged and older cancer survivors in the United States. Data were from biennial interviews with 2,717 survivors of a first incident cancer diagnosis after age 50 in the population-based US Health and Retirement Study from 1998 to 2016. Smoking status, alcohol use, and vigorous physical activity frequency were assessed at the interview prior to cancer diagnosis. Confounder-adjusted multinomial logistic regression was used to determine the associations between each pre-diagnosis health behavior and post-diagnosis trajectories of memory function and limitations to activities of daily living (ADLs), which were identified using group-based trajectory modeling. Overall, 20.7 % of cancer survivors were current smokers, 30.6 % drank alcohol, and 27.1 % engaged in vigorous physical activity >=once a week prior to their diagnosis. In the years following diagnosis, those who had engaged in vigorous physical activity > once a week were less likely to have a medium-high (OR: 0.5; 95 % CI: 0.2-0.9) or medium-low memory loss trajectories (OR: 0.6; 95 % CI: 0.3-1.0) versus very low memory loss trajectory, and were less likely to have a high, increasing ADL limitation trajectory (OR: 0.3; 95 % CI: 0.2, 0.6) versus no ADL limitation trajectory. Vigorous physical activity, but not smoking or alcohol use, was associated with better post-diagnosis functional aging trajectories after a first incident cancer diagnosis in mid-to-later life in this population-based study. Identification of modifiable risk factors can inform targeted interventions to promote healthy aging among cancer survivors.
Collapse
Affiliation(s)
- Ashly C. Westrick
- Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, United States,Corresponding author at: Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, United States.
| | - Kenneth M. Langa
- Division of General Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor Veterans Affairs Center for Clinical Management Research, Ann Arbor, MI, United States,Institute for Social Research, University of Michigan, Ann Arbor, United States,Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, United States
| | - Lindsay C. Kobayashi
- Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, United States
| |
Collapse
|
18
|
Eyl-Armbruster RE, Thong MSY, Carr PR, Jansen L, Chang-Claude J, Hoffmeister M, Brenner H, Arndt V. Change Toward Healthier Lifestyles Is Associated With Better Health-Related Quality of Life in Long-Term Colorectal Cancer Survivors. J Natl Compr Canc Netw 2022; 20:1233-1243.e10. [PMID: 36351340 DOI: 10.6004/jnccn.2022.7049] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 06/28/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Little is known about how changes in a constellation of lifestyle factors affect health-related quality of life (HRQoL) in colorectal cancer (CRC) survivors. Our study aimed to investigate the association between changes in healthy lifestyle and HRQoL over time in survivors of stage I-IV CRC. METHODS We included 2,283 long-term (≥5 years postdiagnosis) survivors. A healthy lifestyle score (HLS) comprising smoking, alcohol consumption, diet, physical activity, and body fatness was derived at diagnosis and 5-year follow-up (5YFU) and categorized as low, moderate, or high. We assessed HRQoL with the EORTC Quality of Life Questionnaire-Core 30 at 5YFU and 10-year follow-up. We used multivariable linear regression and linear mixed models to explore associations between changes in HLS and HRQoL over follow-up. RESULTS A low baseline HLS was associated with poorer functioning and global health/QoL and a higher symptom burden at 5YFU compared with a high baseline HLS. An improved HLS from baseline to 5YFU was associated with better functioning, higher global health/QoL, and fewer symptoms at 5YFU than a maintained-high HLS. In longitudinal analyses, improved HLS was associated with better functioning at follow-up. Survivors with a maintained-high or an improved HLS reported generally less fatigue, pain, and dyspnea at follow-ups compared with survivors with a maintained-low or decreased HLS. CONCLUSIONS Change toward a healthier lifestyle since diagnosis was associated with better HRQoL in long-term CRC survivors. Our results support the importance of maintaining and/or promoting a healthier lifestyle among CRC survivors postdiagnosis.
Collapse
Affiliation(s)
- Ruth Elisa Eyl-Armbruster
- 1Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
- 2Stuttgart Cancer Center-Tumorzentrum Eva Mayr-Stihl, Klinikum Stuttgart, Stuttgart, Germany
| | - Melissa S Y Thong
- 3Unit of Cancer Survivorship, Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
| | - Prudence R Carr
- 1Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
- 4Division of Chronic Disease and Aging, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Lina Jansen
- 1Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
| | - Jenny Chang-Claude
- 5Unit of Genetic Epidemiology, Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
- 6Cancer Epidemiology Group, University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michael Hoffmeister
- 1Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
| | - Hermann Brenner
- 1Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
- 7Division of Preventive Oncology, German Cancer Research Center and National Center for Tumor Diseases, Heidelberg, Germany; and
- 8German Cancer Consortium, German Cancer Research Center, Heidelberg, Germany
| | - Volker Arndt
- 3Unit of Cancer Survivorship, Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
| |
Collapse
|
19
|
Fodor LA, Todea D, Podina IR. Core Fear of Cancer recurrence symptoms in Cancer Survivors: a network approach. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03500-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
20
|
Xie F, Guan C, Gu Y, You Y, Yao F. Effects of the Prolong Life With Nine Turn Method (Yan Nian Jiu Zhuan) Qigong on Brain Functional Changes in Patients With Chronic Fatigue Syndrome in Terms of Fatigue and Quality of Life. Front Neurol 2022; 13:866424. [PMID: 35911899 PMCID: PMC9326262 DOI: 10.3389/fneur.2022.866424] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 06/22/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundChronic fatigue syndrome (CFS) is characterized by persistent fatigue, which often leads to physical and psychological damage. The Prolong Life with Nine Turn method (PLWNT) Qigong is considered as one of the complementary treatments for improving symptoms in patients with CFS. In this study, we used functional magnetic resonance imaging (fMRI) to explore the effects of PLWNT intervention on the subjects with CFS.MethodsThirty four CFS patients were randomly divided into PLWNT group and cognitive behavioral therapy (CBT) group. Both groups were taught by a highly qualified professor at the Shanghai University of Traditional Chinese Medicine once a week and were supervised online during the remaining 6 days at home, over 12 consecutive weeks. We calculated the regional rs-fMRI index amplitude of low-frequency fluctuations (ALFF) for all subjects. To study the changes of the brain network, we used the brain regions with significant differences in ALFF as the regions of interest for whole-brain functional connectivity (FC) analysis. The Multi-dimensional Fatigue Inventory 20 (MFI-20) and Short Form 36-item Health Survey (SF-36) were used for clinical symptom assessment to explore the possible correlation between the rs-fMRI indicators and clinical variations.ResultsThe ALFF values of the right superior frontal gyrus (SFG), and left median cingulate gyrus (DCG) were increased, whereas those of the left middle occipital gyrus (OG), right middle OG and left middle temporal gyrus (MTG) were decreased in PLWNT group. The FC values between the DCG and middle temporal gyrus (MTG), and those between the left OG and the right OG were enhanced. In addition, the SF-36 were positively with the left OG (r = 0.524), SFG (r = 0.517), and DCG (r = 0.533), MFI-20 were negatively with the SFG (r = −0.542) and DCG (r = −0.578). These results were all corrected by FWE (voxel level p < 0.001, cluster level p < 0.05).ConclusionCFS patients have abnormal regional spontaneous neuronal activity and abnormal functional connections between regions after PLWNT intervention. PLWNT can relieve the fatigue symptoms of CFS patients and improve their quality of life. The study was registered in the American Clinical Trial Registry (12/04/2018). Registration Number is NCT03496961.
Collapse
Affiliation(s)
- Fangfang Xie
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Acupuncture and Massage, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Chong Guan
- School of Acupuncture and Massage, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yuanjia Gu
- School of Acupuncture and Massage, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yanli You
- Department of Traditional Chinese Medicine, ChangHai Hospital, Naval Medical University, Shanghai, China
- *Correspondence: Yanli You
| | - Fei Yao
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Acupuncture and Massage, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Fei Yao
| |
Collapse
|
21
|
Belaid I, Ben Moussa C, Melliti R, Limam M, Ben Ahmed T, Ezzaari F, Elghali MA, Bouazzi A, Ben Mabrouk M, Bourigua R, Ammar N, Hochlaf M, Fatma LB, Chabchoub I, Ben Ahmed S. Quality of life in Tunisian colorectal cancer patients: a cross-sectional study. J Cancer Res Clin Oncol 2022:10.1007/s00432-022-04154-3. [PMID: 35771260 DOI: 10.1007/s00432-022-04154-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 06/13/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE Quality of life (QOL) of colorectal cancer (CRC) patients has been little studied in Tunisia. The aim of this work was to evaluate the QOL of CRC patients and to identify factors that may influence it. METHODS A cross-sectional, study spread was made over a period of 6 months on patients with CRC treated in the department of Medical Oncology of Farhat Hached University Hospital of Sousse. The EORTC questionnaires translated and validated in Arabic (QLQ-C30 and QLQ-CR29) were used. RESULTS 142 patients diagnosed with colon or rectal cancer were enrolled. The overall QOL score was 58.5 ± 29.1. The emotional and sexual functional dimensions were the most affected, especially in women and patients under 50 years of age. QOL scores were higher in patients who were in complete remission (71.4 ± 24.7) and in good general condition (63.7 ± 26.6) physical activity may have a significant influence on all functional dimensions of QOL (p < 0.001). Fatigue was significantly (p < 0.001) more present when there was a sedentary lifestyleradiotherapy, palliative chemotherapy (1st and 2nd line) and targeted therapy. CONCLUSION Evaluating quality of life of patients with colorectal cancer in Tunisia is necessary especially those under 50 years old and in women. Laparoscopic surgery with restoration of intestinal continuity, less toxic palliative chemotherapy protocols, more accessibility to new radiotherapy technics will improve QOL of CRC patients. Physical activity and nutrition support are also essential in promoting QOL of these patients.
Collapse
Affiliation(s)
- Imtinene Belaid
- Faculté de Médecine de Sousse, Hôpital Farhat Hached, Department of MedicalOncology, Association de Recherhe et d'Information Sur Le Cancer du Centre Tunisien, Université de Sousse, 4000, Sousse, Tunisie.
| | - Chaimaa Ben Moussa
- Faculté de Médecine de Sousse, Department of Epidemiology, Université de Sousse, 4000, Sousse, Tunisie
| | - Rihab Melliti
- Faculté de Médecine de Sousse, Hôpital Farhat Hached, Department of MedicalOncology, Association de Recherhe et d'Information Sur Le Cancer du Centre Tunisien, Université de Sousse, 4000, Sousse, Tunisie
| | - Manel Limam
- Faculté de Médecine de Sousse, Department of Epidemiology, Université de Sousse, 4000, Sousse, Tunisie
| | - Tarek Ben Ahmed
- Faculté de Médecine de Sousse, Hôpital Farhat Hached, Department of MedicalOncology, Association de Recherhe et d'Information Sur Le Cancer du Centre Tunisien, Université de Sousse, 4000, Sousse, Tunisie
| | - Faten Ezzaari
- Faculté de Médecine de Sousse, Hôpital Farhat Hached, Department of MedicalOncology, Association de Recherhe et d'Information Sur Le Cancer du Centre Tunisien, Université de Sousse, 4000, Sousse, Tunisie
| | - Mohamed Amine Elghali
- Faculté de Médecine de Sousse, Hôpital Farhat Hached, Department of Surgery, Université de Sousse, 4000, Sousse, Tunisie
| | - Amal Bouazzi
- Faculté de Médecine de Sousse, Hôpital Sahloul, Department of Surgery, Université de Sousse, 4000, Sousse, Tunisie
| | - Mohamed Ben Mabrouk
- Faculté de Médecine de Sousse, Hôpital Sahloul, Department of Surgery, Université de Sousse, 4000, Sousse, Tunisie
| | - Rym Bourigua
- Faculté de Médecine de Sousse, Hôpital Farhat Hached, Department of MedicalOncology, Association de Recherhe et d'Information Sur Le Cancer du Centre Tunisien, Université de Sousse, 4000, Sousse, Tunisie
| | - Nouha Ammar
- Faculté de Médecine de Sousse, Hôpital Farhat Hached, Department of MedicalOncology, Association de Recherhe et d'Information Sur Le Cancer du Centre Tunisien, Université de Sousse, 4000, Sousse, Tunisie
| | - Makrem Hochlaf
- Faculté de Médecine de Sousse, Hôpital Farhat Hached, Department of MedicalOncology, Association de Recherhe et d'Information Sur Le Cancer du Centre Tunisien, Université de Sousse, 4000, Sousse, Tunisie
| | - Leila Ben Fatma
- Faculté de Médecine de Sousse, Hôpital Farhat Hached, Department of MedicalOncology, Association de Recherhe et d'Information Sur Le Cancer du Centre Tunisien, Université de Sousse, 4000, Sousse, Tunisie
| | - Imene Chabchoub
- Faculté de Médecine de Sousse, Hôpital Farhat Hached, Department of MedicalOncology, Association de Recherhe et d'Information Sur Le Cancer du Centre Tunisien, Université de Sousse, 4000, Sousse, Tunisie
| | - Slim Ben Ahmed
- Faculté de Médecine de Sousse, Hôpital Farhat Hached, Department of MedicalOncology, Association de Recherhe et d'Information Sur Le Cancer du Centre Tunisien, Université de Sousse, 4000, Sousse, Tunisie
| |
Collapse
|
22
|
Hidde MC, Lyden K, Henry K, Leach HJ. Reallocating time to physical activity and sleep: associations with quality of life in cancer survivors. Support Care Cancer 2022; 30:7527-7534. [PMID: 35666303 PMCID: PMC9169586 DOI: 10.1007/s00520-022-07187-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 05/30/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE Quality of life (QOL) is an important psychosocial outcome in cancer survivors (CS). Physical activity (PA), reducing sedentary time (ST), and sleep can help CS improve QOL; however, these behaviors are commonly studied in isolation, despite their interdependence during the 24-h day (i.e., time in one activity cannot increase without time decreasing in another activity). This study examined the effects of reallocating time between moderate to vigorous PA (MVPA), light PA, ST, and sleep on QOL in a mixed sample of CS. METHODS A cross-sectional sample of CS (N = 73) diagnosed with breast (29.7%), colorectal (33.8%), or other (36.5%) cancer. MVPA, light PA, and ST were measured using the activPAL™ accelerometer, and sleep duration using the Actiwatch™ accelerometer. Both were worn for 7 days, 24 h per day. QOL was self-reported using the Functional Assessment of Cancer Therapy-General (FACT-G) questionnaire. Isotemporal substitution models were used to reallocate 30 min between activities. Statistical significance was set at p < .05. RESULTS Participants accumulated, M = 24.0 ± 18.9 min/day of MVPA, 291.7 ± 100.4 min/day of light PA, 593.1 ± 108.3 min/day of ST, and 486.6 ± 57.6 min/night of sleep. Isotemporal substitution effects for reallocating time between MVPA, light PA, ST, and sleep were not significantly associated with QOL. CONCLUSIONS Findings from this study suggest that among CS who are achieving adequate levels of PA and sleep, changes in 30 min of these activities may not impact QOL. Future studies should aim to recruit a larger, more representative sample and explore the role of bouted activity time.
Collapse
Affiliation(s)
- Mary C Hidde
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - Kate Lyden
- KAL Research and Consulting, LLC, Denver, CO, USA
| | - Kim Henry
- Department of Psychology, Colorado State University, Fort Collins, CO, USA
| | - Heather J Leach
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, USA
| |
Collapse
|
23
|
Kopetz S, Grothey A, Van Cutsem E, Yaeger R, Wasan H, Yoshino T, Desai J, Ciardiello F, Loupakis F, Hong YS, Steeghs N, Guren TK, Arkenau HT, Garcia-Alfonso P, Belani A, Zhang X, Tabernero J. Quality of life with encorafenib plus cetuximab with or without binimetinib treatment in patients with BRAF V600E-mutant metastatic colorectal cancer: patient-reported outcomes from BEACON CRC. ESMO Open 2022; 7:100477. [PMID: 35653981 PMCID: PMC9271477 DOI: 10.1016/j.esmoop.2022.100477] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 03/15/2022] [Accepted: 03/16/2022] [Indexed: 12/12/2022] Open
Abstract
Background In the BEACON CRC study (NCT02928224), encorafenib plus cetuximab with binimetinib {9.3 versus 5.9 months; hazard ratio (HR) [95% confidence interval (CI)]: 0.60 [0.47-0.75]} or without binimetinib [9.3 versus 5.9 months; HR (95% CI): 0.61 (0.48-0.77)] significantly improved overall survival (OS) compared with the previous standard of care (control) in patients with BRAF V600E metastatic colorectal cancer (mCRC). Quality of life (QoL) was a secondary endpoint, assessed using validated instruments. Patients and methods BEACON CRC was a randomized, open-label, phase III study comparing encorafenib plus cetuximab with or without binimetinib and the investigator’s choice of irinotecan plus cetuximab or FOLFIRI plus cetuximab (chemotherapy control) in patients with previously treated BRAF V600E mCRC. Patient-reported QoL assessments included the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC) and Functional Assessment of Cancer Therapy—Colorectal (FACT-C). The primary outcome for these tools was time to definitive 10% deterioration. Results Encorafenib plus cetuximab, both with and without binimetinib, was associated with longer median times to definitive 10% deterioration versus the control group in the EORTC Global Health Status scale [HR (95% CI): 0.65 (0.52-0.80) versus 0.61 (0.49-0.75), respectively] and the FACT-C functional well-being subscale [HR (95% CI): 0.62 (0.50-0.76) versus 0.58 (0.47-0.72), respectively]. Consistent results were observed across all subscales of the EORTC and FACT-C instruments. QoL was generally maintained during treatment for the global EORTC and FACT-C scales. Conclusions In addition to improving OS, encorafenib plus cetuximab with or without binimetinib delays QoL decline in previously treated patients with BRAF V600E-mutant mCRC. BEACON CRC compares encorafenib + cetuximab ± binimetinib to chemotherapy in previously treated BRAF V600E mCRC. Encorafenib + cetuximab had longer time to 10% deterioration versus control in QoL and functional well-being scales. Encorafenib + cetuximab ± binimetinib delays QoL decline in previously treated patients with BRAF V600E mCRC.
Collapse
Affiliation(s)
- S Kopetz
- University of Texas MD Anderson Cancer Center, Houston, USA.
| | - A Grothey
- West Cancer Center and Research Institute, OneOncology, Germantown, USA
| | - E Van Cutsem
- University Hospitals Gasthuisberg Leuven and KU Leuven, Leuven, Belgium
| | - R Yaeger
- Memorial Sloan-Kettering Cancer Center, New York, USA
| | - H Wasan
- Hammersmith Hospital, Department of Cancer Medicine, London, UK
| | - T Yoshino
- National Cancer Center Hospital East, Kashiwa, Japan
| | - J Desai
- Royal Melbourne Hospital and Peter MacCallum Cancer Centre, Walter and Aliza Hall Institute, Parkville, Australia
| | | | - F Loupakis
- Istituto Oncologico del Veneto IRCCS, Padova, Italy
| | - Y S Hong
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - N Steeghs
- Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - T K Guren
- Oslo University Hospital, Department of Oncology, Oslo, Norway
| | - H-T Arkenau
- Sarah Cannon Research Institute, University College of London, London, UK
| | | | | | | | - J Tabernero
- Vall d'Hebron Hospital Campus, Vall d'Hebron Institute of Oncology (VHIO), IOB-Quiron, UVic-UCC, Barcelona, Spain
| |
Collapse
|
24
|
Lemoine A, Perrier M, Mazza C, Quinquenel A, Brasseur M, Delmer A, Vallerand H, Dewolf M, Bertin E, Barbe C, Botsen D, Bouché O. Feasibility and Impact of Adapted Physical Activity (APA) in Cancer Outpatients Beginning Medical Anti-Tumoral Treatment: The UMA-CHAPA Study. Cancers (Basel) 2022; 14:cancers14081993. [PMID: 35454896 PMCID: PMC9029046 DOI: 10.3390/cancers14081993] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 04/12/2022] [Accepted: 04/12/2022] [Indexed: 12/15/2022] Open
Abstract
Simple Summary Physical activity may reduce the risk of overall cancer incidence and improve survival in cancer patients. The beneficial effects of physical activity are also described in cancer survivors but remains poorly known during systemic cancer treatment. Therefore, we studied the feasibility of an adapted physical activity (APA) program in cancer outpatients beginning a medical anti-tumoral treatment for a digestive, lung, hematological, or dermatological cancer. We also studied the impact of APA on fatigue, anxiety, depression, and handgrip strength. Abstract Adapted physical activity (APA) improves quality of life and cancer outcomes. The aim of this study was to assess the feasibility of an APA program in outpatients beginning medical anticancer treatment. The secondary objective was to assess the impact of APA on fatigue, anxiety, depression, and handgrip strength (HGS). This prospective study was conducted between January and July 2017. Among 226 patients beginning treatment in the unit for a digestive, lung, hematological, or dermatological cancer, 163 were included. Adherence to the APA program was defined as more than or equal to one one-hour session per week for 3 months. The first evaluation was conducted at 3 months (M3), and the second evaluation at 6 months (M6). A total of 163 patients were included (mean age 62.5 ± 14.3); 139 (85.3%) agreed to follow the APA program. At M3, 106 of them were evaluated, of which 86 (81.1%) declared that they had followed the program. Improvement in anxiety was observed at M3 (−1.0 ± 3.2; p = 0.002) but there was no significant change in fatigue or depression. HGS decreased significantly (−1.2 ± 5.5; p = 0.04). The APA program was feasible in cancer outpatients beginning medical anticancer treatment. APA should be part of standard support care.
Collapse
Affiliation(s)
- Amélie Lemoine
- Department of Medical Oncology, Godinot Cancer Institute, 51100 Reims, France; (C.M.); (D.B.)
- Correspondence:
| | - Marine Perrier
- Department of Gastroenterology and Digestive Oncology, CHU Reims, University of Reims Champagne-Ardenne (URCA), 51100 Reims, France; (M.P.); (M.B.); (O.B.)
| | - Camille Mazza
- Department of Medical Oncology, Godinot Cancer Institute, 51100 Reims, France; (C.M.); (D.B.)
| | - Anne Quinquenel
- Department of Clinical Hematology, CHU Reims, 51100 Reims, France; (A.Q.); (A.D.)
| | - Mathilde Brasseur
- Department of Gastroenterology and Digestive Oncology, CHU Reims, University of Reims Champagne-Ardenne (URCA), 51100 Reims, France; (M.P.); (M.B.); (O.B.)
| | - Alain Delmer
- Department of Clinical Hematology, CHU Reims, 51100 Reims, France; (A.Q.); (A.D.)
| | - Hervé Vallerand
- Department of Pulmonary Medicine, CHU Reims, 51100 Reims, France; (H.V.); (M.D.)
| | - Maxime Dewolf
- Department of Pulmonary Medicine, CHU Reims, 51100 Reims, France; (H.V.); (M.D.)
| | - Eric Bertin
- Department of Nutrition, Endocrinology and Diabetology, CHU Reims, 51100 Reims, France;
| | - Coralie Barbe
- Research on Health University Department, University of Reims Champagne-Ardenne (URCA), 51100 Reims, France;
| | - Damien Botsen
- Department of Medical Oncology, Godinot Cancer Institute, 51100 Reims, France; (C.M.); (D.B.)
- Department of Gastroenterology and Digestive Oncology, CHU Reims, University of Reims Champagne-Ardenne (URCA), 51100 Reims, France; (M.P.); (M.B.); (O.B.)
| | - Olivier Bouché
- Department of Gastroenterology and Digestive Oncology, CHU Reims, University of Reims Champagne-Ardenne (URCA), 51100 Reims, France; (M.P.); (M.B.); (O.B.)
| |
Collapse
|
25
|
Utley M, Adeyanju T, Bernardo B, Paskett ED, Krok-Schoen JL. The association between mental health, social support and physical health outcomes among older female cancer survivors. J Geriatr Oncol 2022; 13:834-838. [DOI: 10.1016/j.jgo.2022.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 03/21/2022] [Accepted: 04/05/2022] [Indexed: 11/25/2022]
|
26
|
Fujii H, Ueda Y, Hirose C, Ohata K, Sekiya K, Kitahora M, Sadaka S, Yamamoto S, Watanabe D, Kato-Hayashi H, Iihara H, Kobayashi R, Kaburaki M, Matsuhashi N, Takahashi T, Makiyama A, Yoshida K, Hayashi H, Suzuki A. Pharmaceutical intervention for adverse events improves quality of life in patients with cancer undergoing outpatient chemotherapy. J Pharm Health Care Sci 2022; 8:8. [PMID: 35236407 PMCID: PMC8889741 DOI: 10.1186/s40780-022-00239-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 02/08/2022] [Indexed: 11/30/2022] Open
Abstract
Background The effect of pharmaceutical intervention to treat adverse events on quality of life (QOL) in outpatients receiving cancer chemotherapy is unclear. We investigated whether pharmaceutical intervention provided by pharmacists in collaboration with physicians improves QOL with outpatient cancer chemotherapy. Methods We conducted a single-center retrospective descriptive study of pharmaceutical intervention for patients receiving outpatient cancer chemotherapy at Gifu University Hospital between September 2017 and July 2020. We assessed patient QOL using the Japanese version of the EuroQol 5 Dimension5 Level (EQ-5D-5L). Adverse events were graded using the Common Terminology Criteria for Adverse Events (CTCAE) version 4.0. We compared the EQ-5D-5L utility value and incidence of grade 2 or higher adverse events before and after pharmaceutical intervention. Results Our analysis included 151 patients who underwent 210 chemotherapy cycles. Pharmaceutical intervention significantly improved patients’ EQ-5D-5L utility values from 0.8197 to 0.8603 (P < 0.01). EQ-5D-5L utility values were significantly improved after pharmaceutical intervention for nausea and vomiting (pre-intervention 0.8145, post-intervention 0.8603, P = 0.016), peripheral neuropathy (pre-intervention 0.7798, post-intervention 0.7988, P = 0.032) and pain (pre-intervention 0.7625, post-intervention 0.8197, P = 0.035). Although not statistically significant, the incidence of grade 2 or higher adverse events, including nausea and vomiting, dermopathy, pain, oral mucositis, diarrhea and dysgeusia, tended to be lower post-intervention than pre-intervention. Conclusions Pharmaceutical intervention by pharmacists in collaboration with physicians may improve QOL in patients undergoing outpatient cancer chemotherapy.
Collapse
Affiliation(s)
- Hironori Fujii
- Department of Pharmacy, Gifu University Hospital, Yanagido 1-1, Gifu, 501-1194, Japan. .,Laboratory of Pharmacy Practice and Social Science, Gifu Pharmaceutical University, Gifu, Japan.
| | - Yukino Ueda
- Laboratory of Pharmacy Practice and Social Science, Gifu Pharmaceutical University, Gifu, Japan
| | - Chiemi Hirose
- Department of Pharmacy, Gifu University Hospital, Yanagido 1-1, Gifu, 501-1194, Japan
| | - Koichi Ohata
- Department of Pharmacy, Gifu University Hospital, Yanagido 1-1, Gifu, 501-1194, Japan
| | - Kumiko Sekiya
- Department of Pharmacy, Gifu University Hospital, Yanagido 1-1, Gifu, 501-1194, Japan
| | - Mika Kitahora
- Department of Pharmacy, Gifu University Hospital, Yanagido 1-1, Gifu, 501-1194, Japan
| | - Shiori Sadaka
- Department of Pharmacy, Gifu University Hospital, Yanagido 1-1, Gifu, 501-1194, Japan
| | - Senri Yamamoto
- Department of Pharmacy, Gifu University Hospital, Yanagido 1-1, Gifu, 501-1194, Japan
| | - Daichi Watanabe
- Department of Pharmacy, Gifu University Hospital, Yanagido 1-1, Gifu, 501-1194, Japan
| | - Hiroko Kato-Hayashi
- Department of Pharmacy, Gifu University Hospital, Yanagido 1-1, Gifu, 501-1194, Japan
| | - Hirotoshi Iihara
- Department of Pharmacy, Gifu University Hospital, Yanagido 1-1, Gifu, 501-1194, Japan.,Laboratory of Pharmacy Practice and Social Science, Gifu Pharmaceutical University, Gifu, Japan
| | - Ryo Kobayashi
- Department of Pharmacy, Gifu University Hospital, Yanagido 1-1, Gifu, 501-1194, Japan
| | - Miho Kaburaki
- Laboratory of Community Healthcare Pharmacy, Gifu Pharmaceutical University, Gifu, Japan
| | - Nobuhisa Matsuhashi
- Department of Surgical Oncology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Takao Takahashi
- Department of Surgical Oncology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Akitaka Makiyama
- Department of Surgical Oncology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Kazuhiro Yoshida
- Department of Surgical Oncology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Hideki Hayashi
- Laboratory of Pharmacy Practice and Social Science, Gifu Pharmaceutical University, Gifu, Japan.,Laboratory of Community Healthcare Pharmacy, Gifu Pharmaceutical University, Gifu, Japan
| | - Akio Suzuki
- Department of Pharmacy, Gifu University Hospital, Yanagido 1-1, Gifu, 501-1194, Japan.,Laboratory of Pharmacy Practice and Social Science, Gifu Pharmaceutical University, Gifu, Japan
| |
Collapse
|
27
|
Yu YQ, Ma L, Wang WJ, Zhao YQ, Xu HF, Cao J, Li L, Hao JQ, Gao JR, Gu XF, Liu YY, Huang JX, Fan YP, Du LB, Cao HL, Feng CY, Zhu Q, Wang XH, Du JC, Bangura MS, Zhang X, Zhang SK, Qiao YL. Health-related quality of life in advanced colorectal cancer patients in China: a nationwide hospital-based survey. ANNALS OF TRANSLATIONAL MEDICINE 2022; 10:328. [PMID: 35433947 PMCID: PMC9011208 DOI: 10.21037/atm-22-991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 03/18/2022] [Indexed: 11/06/2022]
Abstract
Background Colorectal cancer (CRC) is one of the most common cancers in China, and most CRC patients have already reached an advanced stage by the time of initial diagnosis. Due to the loss of health as a result of cancer, it has consequence on the treatment which may affect the psychophysical and social impairment of CRC patients. These indicators (psychophysical, function and social impairment) affect the health-related quality of life (HRQOL). There are limited studies that focus on advanced CRC patients in China. This study aimed to assess the HRQOL and its associated factors of advanced CRC patients in China. Methods This was a cross-sectional, nationwide, hospital-based, and multi-center survey. According to the traditional administrative district definition, we selected 19 hospitals in 7 regions by multi-stage stratified sampling in China. For each eligible CRC patient with stage III or IV in the selected hospitals, socio-demographics, clinical information, and HRQOL were collected based on patients’ self-reporting and/or medical records between March 2020 and March 2021. Patients completed the Functional Assessment of Cancer Therapy Colorectal (FACT-C) plus-traditional Chinese version of the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ)-9. Results A total of 4,589 CRC patients (mean age 60.1 years, including 2,730 males and 1,859 females) were included. The total score of HRQOL in population was 128.2±24.70. There were significant differences in the overall score of HRQOL in gender, education level, occupation, region, disease type, and disease stage (P<0.05). The score of HRQOL was better in males, undergraduates and above, unemployed/laid-off, and southwestern and central China. Multivariate analysis showed that education level, occupation, location, number of hospitals visited and treatment methods, and gender were associated with utilities of CRC patients. Conclusions The HRQOL is an important outcome measure for CRC patients. The HRQOL scores differed according to socio-demographic and clinical characteristics, and findings of these factors were associated with education level, occupation, region, number of visited and treatment methods, and gender.
Collapse
Affiliation(s)
- Yan-Qin Yu
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,The Clinical Epidemiology of Research Center, Department of Public Health and Preventive Medicine, Baotou Medical College, Baotou, China
| | - Li Ma
- Public Health School, Dalian Medical University, Dalian, China
| | - Wen-Jun Wang
- School of Nursing, Jining Medical University, Jining, China
| | - Yu-Qian Zhao
- Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Hui-Fang Xu
- Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, China
| | - Ji Cao
- Department of Cancer Prevention and Control Office, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Li Li
- Department of Clinical Research, The First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Jin-Qi Hao
- The Clinical Epidemiology of Research Center, Department of Public Health and Preventive Medicine, Baotou Medical College, Baotou, China
| | - Jing-Ru Gao
- The Clinical Epidemiology of Research Center, Department of Public Health and Preventive Medicine, Baotou Medical College, Baotou, China
| | - Xiao-Fen Gu
- Department of Student Affairs, Affiliated Tumor Hospital, Xinjiang Medical University, Ürümqi, China
| | - Yun-Yong Liu
- Liaoning Office for Cancer Control and Research, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, China
| | - Juan-Xiu Huang
- Department of Gastroenterology, Wuzhou Red Cross Hospital, Wuzhou, China
| | - Yan-Ping Fan
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Ling-Bin Du
- Department of Cancer Prevention, The Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, China
| | - He-Lu Cao
- Department of Preventive Health, Xinxiang Central Hospital, Xinxiang, China
| | - Chang-Yan Feng
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, China
| | - Qian Zhu
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Xiao-Hui Wang
- Department of Public Health, Gansu Provincial Cancer Hospital, Lanzhou, China
| | - Jing-Chang Du
- School of Public Health, Chengdu Medical College, Chengdu, China
| | | | - Xi Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing, China
| | - Shao-Kai Zhang
- Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, China
| | - You-Lin Qiao
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, China.,Center for Global Health, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | | |
Collapse
|
28
|
Goodman W, Downing A, Allsop M, Munro J, Taylor C, Hubbard G, Beeken RJ. Quality of life profiles and their association with clinical and demographic characteristics and physical activity in people with a stoma: a latent profile analysis. Qual Life Res 2022; 31:2435-2444. [PMID: 35217962 PMCID: PMC9250477 DOI: 10.1007/s11136-022-03102-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2022] [Indexed: 12/03/2022]
Abstract
Purpose Quality of life can be negatively impacted by the formation of a stoma and is influenced by a number of factors. Research to date treats people with a stoma as a homogenous group based on their quality of life. We attempted to identify subgroups based upon self-reported quality of life and explored variables associated with group membership. Methods The present study is a secondary analysis of a cross-sectional sample of 1419 people with a stoma. Participants completed validated questionnaires for quality of life, physical activity and clinical and demographic characteristics. Latent profile analysis was used to identify the optimal number of subgroups (profiles) and multinomial regression modelling was conducted to identify variables associated with profile membership. Results The analysis revealed 4 distinct profiles of people with a stoma: ‘consistently good quality of life’ [N = 891 (62.8%)], ‘some quality of life concerns’ [N = 184 (13.0%)], ‘low quality of life’ [N = 181 (12.8%)] and ‘financial concerns’ [N = 163 (11.5%)]. Modelling revealed that people with a recent stoma (formed < 2 years previously), who have a hernia and are less physically active were more likely to belong to the ‘low quality of life’ profile. Furthermore, those aged 16–55 were more likely to have financial concerns. Conclusion This study was the first to identify latent profiles within this population and assess whether certain variables are associated with membership. Future research should build upon this to identify additional variables associated with these profiles, which can help to provide the basis for targeting and tailoring future interventions to specific subgroups of people with a stoma. Supplementary Information The online version contains supplementary material available at 10.1007/s11136-022-03102-5.
Collapse
Affiliation(s)
- William Goodman
- School of Medicine, University of Leeds, Clarendon Way, Leeds, LS2 9JT, UK
| | - Amy Downing
- School of Medicine, University of Leeds, Clarendon Way, Leeds, LS2 9JT, UK
| | - Matthew Allsop
- School of Medicine, University of Leeds, Clarendon Way, Leeds, LS2 9JT, UK
| | - Julie Munro
- Department of Nursing, University of the Highlands and Islands, 12b Ness Walk, Inverness, IV3 5SQ, UK
| | - Claire Taylor
- London North West Healthcare NHS Trust, Watford Road, Harrow, HA1 3UJ, UK
| | - Gill Hubbard
- Department of Nursing, University of the Highlands and Islands, 12b Ness Walk, Inverness, IV3 5SQ, UK
| | - Rebecca J Beeken
- School of Medicine, University of Leeds, Clarendon Way, Leeds, LS2 9JT, UK.
- Research Department of Behavioural Science and Health, University College London, Gower Street, London, WC1E 6BT, UK.
| |
Collapse
|
29
|
Lin ZG, Li RD, Ai FL, Li S, Zhang XA. Effects of cognitive behavior therapy combined with Baduanjin in patients with colorectal cancer. World J Gastrointest Oncol 2022; 14:319-333. [PMID: 35116119 PMCID: PMC8790406 DOI: 10.4251/wjgo.v14.i1.319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 07/30/2021] [Accepted: 09/10/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Cancer-related fatigue (CRF) is the most common concomitant symptom in the treatment of colorectal cancer (CRC). Such patients often present with subjective fatigue state accompanied by cognitive dysfunction, which seriously affects the quality of life of patients.
AIM To explore the effects of cognitive behavior therapy (CBT) combined with Baduanjin exercise on CRF, cognitive impairment, and quality of life in patients with CRC after chemotherapy, and to provide a theoretical basis and practical reference for rehabilitation of CRC after chemotherapy.
METHODS Fifty-five patients with CRC after radical resection and chemotherapy were randomly divided into either an experimental or a control group. The experimental group received the intervention of CBT combined with exercise intervention for 6 mo, and indicators were observed and measured at baseline, 3 mo, and 6 mo to evaluate the intervention effect.
RESULTS Compared with the baseline values, in the experimental group 3 mo after intervention, cognitive function, quality of life score, and P300 amplitude and latency changes were significantly better (P < 0.01). Compared with the control group, at 3 mo, the experimental group had significant differences in CRF, P300 amplitude, and quality of life score (P < 0.05), as well as significant differences in P300 latency and cognitive function (P < 0.01). Compared with the control group, at 6 mo, CRF, P300 amplitude, P300 latency, cognitive function and quality of life score were further improved in the experimental group, with significant differences (P < 0.01). The total score of CRF and the scores of each dimension were negatively correlated with quality of life (P < 0.05), while the total score of cognitive impairment and the scores of each dimension were positively correlated with quality of life (P < 0.05).
CONCLUSION CBT combined with body-building Baduanjin exercise can improve CRF and cognitive impairment in CRC patients after chemotherapy, and improve their quality of life.
Collapse
Affiliation(s)
- Zheng-Gen Lin
- School of Social and Physical Education, Shenyang Sport University, Shenyang 110102, Liaoning Province, China
| | - Ren-Dong Li
- Physical Education Department, Shenyang University of Chemical Technology, Shenyang 110142, Liaoning Province, China
| | - Fu-Lu Ai
- Department of General Surgery (VIP Ward), Liaoning Tumor Hospital, Shenyang 110042, Liaoning Province, China
| | - Song Li
- Martial Arts and Dance Academy, Shenyang Sport University, Shenyang 110102, Liaoning Province, China
| | - Xin-An Zhang
- College of Kinesiology, Shenyang Sport University, Shenyang 110102, Liaoning Province, China
| |
Collapse
|
30
|
Fitz T, Sörgel C, Rutzner S, Hecht M, Fietkau R, Distel LV. Baseline Quality of Life of Physical Function Is Highly Relevant for Overall Survival in Advanced Rectal Cancer. Healthcare (Basel) 2022; 10:healthcare10010141. [PMID: 35052304 PMCID: PMC8775862 DOI: 10.3390/healthcare10010141] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 01/02/2022] [Accepted: 01/06/2022] [Indexed: 11/16/2022] Open
Abstract
In advanced rectal cancer, neoadjuvant radiochemotherapy and total mesorectal excision lead to long overall survival. The quality of life (QOL) of the patients is clearly related to the prognosis. Our question was whether the prognosis can be represented with only one question or one score from the QOL questionnaires. 360 consecutively recruited patients diagnosed with advanced rectal cancer were questioned during radiochemotherapy and a follow-up of 8 years. The questionnaires QLQ-C30 and QLQ-CR38 were used; 10 functional and 17 symptom scores were calculated. The functional score “physical function” and the symptom scores “fatigue”, “nausea and vomiting”, “pain” and “appetite loss” were highly prognostic (p < 0.001) for overall survival. “Physical function” was highly prognostic at all time points up to 1 year after starting therapy (p ≤ 0.001). The baseline “physical function” score divided the cohort into a favorable group with an 8-year overall survival rate of 70.4% versus an unfavorable group with 47.5%. In the multivariable analysis, baseline “physical function”, age and distant metastases were independent predictors of overall survival. The score “physical function” is a powerful unrelated risk factor for overall survival in patients with rectal cancer. Future analyses should study whether increased “physical function” after diagnosis could improve survival.
Collapse
Affiliation(s)
- Tim Fitz
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (C.S.); (S.R.); (M.H.); (R.F.)
- Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), 91054 Erlangen, Germany
- Correspondence: (T.F.); (L.V.D.)
| | - Christopher Sörgel
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (C.S.); (S.R.); (M.H.); (R.F.)
- Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), 91054 Erlangen, Germany
| | - Sandra Rutzner
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (C.S.); (S.R.); (M.H.); (R.F.)
- Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), 91054 Erlangen, Germany
| | - Markus Hecht
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (C.S.); (S.R.); (M.H.); (R.F.)
- Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), 91054 Erlangen, Germany
| | - Rainer Fietkau
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (C.S.); (S.R.); (M.H.); (R.F.)
- Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), 91054 Erlangen, Germany
| | - Luitpold V. Distel
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (C.S.); (S.R.); (M.H.); (R.F.)
- Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), 91054 Erlangen, Germany
- Correspondence: (T.F.); (L.V.D.)
| |
Collapse
|
31
|
Wang T, Zhang Y, Taaffe DR, Kim JS, Luo H, Yang L, Fairman CM, Qiao Y, Newton RU, Galvão DA. Protective effects of physical activity in colon cancer and underlying mechanisms: A review of epidemiological and biological evidence. Crit Rev Oncol Hematol 2022; 170:103578. [PMID: 35007701 DOI: 10.1016/j.critrevonc.2022.103578] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 11/07/2021] [Accepted: 01/05/2022] [Indexed: 12/24/2022] Open
Abstract
Numerous epidemiological studies indicate that physical activity has a protective effect against colon cancer development and progression. Further, the relevant biological mechanisms where physical activity or exercise may improve survival have also been initially examined. In this review, we provide an overview of the epidemiological evidence to date which comprises 16 cohort studies of the effects of physical activity on colon cancer outcomes including cancer recurrence, cancer-specific and overall survival. Moreover, we present four potential mechanisms involving shear pressure, systemic milieu alteration, extracellular vesicles, and immune function by which physical activity and exercise may favorably impact colon cancer. Research currently in progress will provide definitive evidence of survival benefits resulting from exercise and future work will help clarify the role of targeted exercise and the relevant mechanisms involved.
Collapse
Affiliation(s)
- Tianzhen Wang
- Department of Pathology, Harbin Medical University, Harbin, 150081, China; Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia; School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Ying Zhang
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia; School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia; Department of Physiology, Harbin Medical University, Harbin, 150081, China
| | - Dennis R Taaffe
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia; School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Jin-Soo Kim
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia; School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Hao Luo
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia; School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Lirui Yang
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Ciaran M Fairman
- Exercise Science Department, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Yuandong Qiao
- Laboratory of Medical Genetics, Harbin Medical University, Harbin, 150081, China
| | - Robert U Newton
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia; School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Daniel A Galvão
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia; School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.
| |
Collapse
|
32
|
Physical activity levels after low anterior resection for rectal cancer: one-year follow-up. BMC Public Health 2021; 21:2270. [PMID: 34903207 PMCID: PMC8667409 DOI: 10.1186/s12889-021-12311-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 11/17/2021] [Indexed: 12/22/2022] Open
Abstract
Background Overall survival rates after rectal cancer have increased. Therefore, functional outcomes rightly deserve more interest. The aims of this study were to assess progression in total, sports, occupational and household physical activity levels of rectal cancer survivors, from preoperatively to 12 months after surgery/stoma closure and to explore predictive factors. Methods Multi-center prospective study with 125 patients who underwent low anterior resection for rectal cancer. The Flemish Physical Activity Computerized Questionnaire was completed concerning all physical activity levels at baseline (past preoperative year) and at 1, 4, 6 and 12 months after surgery/stoma closure. At these timepoints, questionnaires (LARS−/ COREFO-questionnaire) regarding bowel symptoms were also filled out. Results were analyzed using linear mixed models for repeated measures. Results Total physical activity levels up to 12 months remained significantly lower than preoperative. Occupational and sports physical activity levels remained significantly lower until 6 and 4 months postoperative, respectively. Predictive factors for decreased physical activity levels at a specific timepoint were: younger age and no stoma (total physical activity, 1 month), low/mid rectal tumor, no stoma, non-employed status (total, 4 months), higher COREFO-scores (occupational, 4 months) and non-employed status (total, 12 months). At all timepoints, lower COREFO-scores were associated with higher total physical activity levels; male gender and lower educational levels with higher occupational levels; younger age, normal BMI, employed status and adjuvant therapy with higher sports levels; and female gender, lower educational level and unemployed status with higher household levels. Conclusions One year after rectal cancer treatment, total physical activity levels were still not recovered. Rectal cancer patients, especially those at risk for decreased physical activity levels and with major bowel complaints, should be identified and guided to increase their activities. Trial registration This trial has been registered at Netherlands Trial Register (NTR6383, 23/01/2017).
Collapse
|
33
|
Perrier F, Ghiasvand R, Lergenmuller S, Robsahm TE, Green AC, Borch KB, Sandanger TM, Weiderpass E, Rueegg CS, Veierød MB. Physical activity and cutaneous melanoma risk: A Norwegian population-based cohort study. Prev Med 2021; 153:106556. [PMID: 33862033 DOI: 10.1016/j.ypmed.2021.106556] [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: 11/06/2020] [Revised: 02/12/2021] [Accepted: 04/11/2021] [Indexed: 11/25/2022]
Abstract
Physical activity (PA) is an important factor in cancer prevention, but positive association between PA and risk of cutaneous melanoma found in recent studies may complicate this strategy. Ultraviolet radiation (UVR) exposure during outdoor PA is a plausible explanation for a positive association. We investigated the associations between PA, UVR and melanoma risk in the Norwegian Women and Cancer cohort. Overall PA was reported by 151,710 women, aged 30-75 at inclusion, using a validated 10-point-scale at enrolment and during follow-up, together with recent numbers of sunburns, indoor tanning sessions and weeks on sunbathing vacations. Seasonal outdoor walking and seasonal PAs were recorded in subsamples (n = 102,671 and n = 29,077, respectively). Logistic and Cox regression were used. Mean follow-up was 18.5 years, and 1565 invasive incident melanoma cases were diagnosed. Overall PA was inversely associated with sunburns, while positively associated with sunbathing vacations and indoor tanning. Overall PA was not associated with melanoma risk in all body sites combined (ptrend = 0.61), but reduced risk was found in upper limb melanomas (hazard ratio (HR) = 0.70, 95% confidence interval (CI) 0.51-0.96; high versus low PA). Non-significant reduced risks were found for seasonal outdoor walking >2 h/day versus 30-60 min/day (summer HR = 0.81, 95% CI 0.66-1.00; autumn HR = 0.74, 95%CI 0.55-1.01). Seasonal PAs were not associated with melanoma risk. In conclusion, we found positive associations between overall PA and sunbathing vacations and indoor tanning, and, unlike literature, inverse association between overall PA and sunburns. Our results do not support a positive association between PA and melanoma risk in Norwegian women.
Collapse
Affiliation(s)
- Flavie Perrier
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.
| | - Reza Ghiasvand
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway; Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
| | - Simon Lergenmuller
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Trude E Robsahm
- Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
| | - Adele C Green
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia; Cancer Research UK Manchester and Faculty of Biology, Medicine and Health, University of Manchester, United Kingdom
| | - Kristin B Borch
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Torkjel M Sandanger
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | | | - Corina S Rueegg
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Marit B Veierød
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| |
Collapse
|
34
|
Tabriz ER, Ramezani M, Heydari A, Aledavood SA. Health-Promoting Lifestyle in Colorectal Cancer Survivors: A Qualitative Study on the Experiences and Perspectives of Colorectal Cancer Survivors and Healthcare Providers. Asia Pac J Oncol Nurs 2021; 8:696-710. [PMID: 34790854 PMCID: PMC8522596 DOI: 10.4103/apjon.apjon-2132] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 07/28/2021] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE Understanding the experiences of survivors and healthcare providers about health-promoting lifestyle (HPL) in colorectal cancer (CRC) survivors is important in planning for coping with the disease, managing treatment side effects, increasing survival, and improving quality of life (QOL). This study was conducted to explore the experiences and perspectives of CRC survivors and healthcare providers about HPL in CRC survivors. METHODS This descriptive qualitative study was performed in 2020 at Omid and Imam Reza Hospitals in Mashhad, Iran. Participants were CRC survivors (n = 12) and healthcare providers (n = 33) who were selected by purposive sampling. Data were collected using in-depth semi-structured interview by face to face and then analyzed by Zhang and Wildemuth content analysis method. MaxQDA software was used to organize the data. RESULTS Following the treatment of cancer, CRC survivors seek to make changes in lifestyle and they choose a HPL that maintains or improves their health. HPL in CRC survivors includes nutrition, activity and rest, health responsibility, interpersonal relations, spiritual growth, and psychological management. The results showed that HPL can lead to motivation, the ability to self-care and improve daily performance, reduce treatment complications, and increase the QOL. CONCLUSIONS CRC survivors can help change their lifestyle patterns with healthy eating, treatment adherence, regular physical activity, and good sleep habits. Furthermore, effective personal and social relationships, spiritual growth, and management of psychological disorders develop health-promoting behaviors in them. CRC survivors also face challenges and limitations in their life after treatment; identifying the components of a HPL in CRC survivors can lead to desirable care, treatment, education, and counseling services.
Collapse
Affiliation(s)
- Elahe Ramezanzade Tabriz
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Monir Ramezani
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Abbas Heydari
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Amir Aledavood
- Cancer Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| |
Collapse
|
35
|
Physical Activity Interventions for Colorectal Cancer Survivors: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Cancer Nurs 2021; 44:E414-E428. [PMID: 34694086 PMCID: PMC8560161 DOI: 10.1097/ncc.0000000000000888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background Physical activity (PA) has been shown to improve total mortality and colorectal-specific mortality risk; however, colorectal cancer (CRC) survivors have lower rates of PA compared with survivors with other types of cancers. Objective To examine the effect of PA interventions on CRC survivors. Methods A systematic review and meta-analysis were conducted to identify randomized controlled trials that met the inclusion criteria, which included an intervention designed to increase PA and more than 1 outcome of interest. Random effects of the meta-analyses were performed using Review Manager 5.3. Results Eight publications representing 7 randomized controlled trials of 803 participants were identified. All studies used a combination of behavioral change methods. Physical activity interventions significantly improved disease-specific quality of life, PA level, and maximum amount of oxygen and did not show significant improvements for fatigue and body mass index among CRC survivors. Conclusions We provided evidence that PA interventions were effective in improving disease-specific quality of life, PA level, and maximum amount of oxygen; however, they did not improve fatigue and body mass index. Further randomized controlled trials are needed to determine the optimal mode of delivering PA intervention for CRC survivors. Implications for Practice As the survival rate of patients with CRC increases, survivors of CRC need to increase PA in a community setting after completing primary treatments. Effective and efficient modes of PA intervention delivery could improve health-related outcomes and address specific barriers for CRC survivors.
Collapse
|
36
|
SupPoRtive Exercise Programmes for Accelerating REcovery after major ABdominal Cancer surgery trial (PREPARE-ABC): Study protocol for a multicentre randomized controlled trial. Colorectal Dis 2021; 23:2750-2760. [PMID: 34245094 DOI: 10.1111/codi.15805] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 04/13/2021] [Accepted: 04/15/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Exercise programmes can increase cardiopulmonary reserve and functional capacity prior to surgery and can improve clinical, functional and survival outcomes after a colorectal cancer diagnosis. However, the impact of pre- and postoperative exercise on postoperative recovery outcomes and longer-term health-related quality of life are unknown; thus, there is a need for high-quality randomized controlled trials. METHOD SupPoRtive Exercise Programmes for Accelerating REcovery after major Abdominal Cancer surgery (PREPARE-ABC) is a three-arm multicentre randomized controlled trial with internal pilot. The primary objective is to assess the effects of pre- and postoperative exercise on surgical outcomes and longer-term health-related quality of life in cancer patients undergoing colorectal resection. The aim of PREPARE-ABC is to randomize 1146 patients at the individual level (1:1:1) to hospital-supervised exercise, home-supported exercise or treatment as usual. The primary outcomes are short-term (30-day) morbidity, assessed using the Clavien-Dindo classification, and longer-term health-related quality of life, assessed using the Medical Outcomes Study Health Questionnaire (36-item Short-Form Survey [SF-36]). Secondary outcomes include cardiopulmonary fitness, physical activity behaviour change, psychological health status and cost-effectiveness. A process evaluation of intervention delivery and usual care also will be undertaken. DISCUSSION This is the first UK-based definitive randomized controlled trial to investigate the effects of pre- and postoperative exercise on short-term postoperative health outcomes and longer-term health-related quality of life in colorectal cancer patients. The trial will yield robust clinical and cost-effectiveness data to underpin clinical guidance on how exercise programmes should be implemented in the routine management of patients undergoing major colorectal cancer surgery.
Collapse
|
37
|
Taking Advantage of the Teachable Moment at Initial Diagnosis of Prostate Cancer-Results of a Pilot Randomized Controlled Trial of Supervised Exercise Training. Cancer Nurs 2021; 45:E680-E688. [PMID: 34608048 DOI: 10.1097/ncc.0000000000001013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Increased physical activity (PA) levels are associated with improved prostate cancer (PCa) outcomes. Sustainable PA has been linked to improved health-related quality of life (QoL) in cancer patients. The time of diagnosis of PCa may offer a critical time point when patients might be more likely to consider lifestyle changes. This, in turn, may contribute to sustainable PA and its likely benefits. OBJECTIVE The aims of this study were to determine if a structured PA intervention introduced at the time of diagnosis can (1) lead to sustainable PA and (2) help improve psychosocial and QoL outcomes as compared with usual PA. INTERVENTIONS/METHODS This was a pilot randomized controlled trial enrolling patients with intermediate-risk PCa into either arm A (supervised 8- to 12-week physical exercise program; n = 10) or control arm B (usual PA; n = 10). Primary outcome was PA at 6 months. Secondary outcomes were QoL, psychological well-being, physical fitness, and functional outcomes postintervention. Change over time was compared using a nonparametric Wilcoxon test. RESULTS Demographic variables were the same between arms. Comparing parameters at the start and 6 months post-radical prostatectomy, PA significantly improved in arm A (self-reported Godin score 24.7 vs 42.8 units, P < .01, objective number of chair stands [14-19, P < .01]), but not in arm B. There were no significant differences between arms in QoL and psychosocial outcomes. CONCLUSIONS A preoperative supervised exercise training program increases long-term PA. IMPLICATIONS FOR PRACTICE Future trials should evaluate PA sustainability beyond 6 months and if this leads to improved psychosocial and QoL outcomes.
Collapse
|
38
|
Flyum IR, Mahic S, Grov EK, Joranger P. Health-related quality of life in patients with colorectal cancer in the palliative phase: a systematic review and meta-analysis. BMC Palliat Care 2021; 20:144. [PMID: 34530833 PMCID: PMC8447559 DOI: 10.1186/s12904-021-00837-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 08/27/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The occurrence of colorectal cancer has doubled over the last 50 years and many people are living with the disease in the palliative phase. Therefore, it is important that healthcare personnel have knowledge about the patient's health-related quality of life (HRQoL). The aim of this review is to investigate how HRQoL is reported by means of different measures for patients in the palliative phase of colorectal cancer and examine which sociodemographic and clinical factors are associated with the mean scores reported for HRQoL. METHOD A systematic review and meta-analysis using forest plots in STATA were conducted. The databases MEDLINE, CINAHL, Embase, Amed, and SveMed+ were used for the systematic searches with combinations of terms for colorectal cancer, the palliative phase and HRQoL. The Cochrane handbook and the PRISMA checklist from 2009 were utilised. RESULTS In total, 710 articles were identified. Eleven quantitative studies met the inclusion criteria and six were included in the meta-analysis. Five of the 11 studies had a longitudinal design, while the other six had a cross-sectional design. The meta-analyzes shows that the average HRQoL in palliative phase was 62.9 (56.8-69.0) 15D was 0.76 (0.73-0.79), EQ-5D was 0.67 (0.62-0.73), and VAS was 64.1 (53.7-74.4). Multiple sociodemographic and clinical variables were associated with HRQoL and a higher prevalence of common cancer symptoms were reported than gastrointestinal symptoms. CONCLUSION This systematic review revealed that patients with colorectal cancer report low HRQoL. Furthermore, it shows that what affects HRQoL is complicated, including multiple clinical and sociodemographic variables. This underlines the need for further research. To ensure the best possible care, it is important that all healthcare professionals have easy access to knowledge about HRQoL in patients with colorectal cancer, and what impacts it in the last phase of life.
Collapse
Affiliation(s)
- Ida Røed Flyum
- Department of Nursing and Health Promotion. Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, P.O. Box 4, St. Olavs plass, NO-0130, Oslo, Norway. .,Department of Bachelor in Nursing, Lovisenberg Diaconal University College, Lovisenberggata 15B, NO-0456, Oslo, Norway.
| | - Seila Mahic
- Department of Nursing and Health Promotion. Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, P.O. Box 4, St. Olavs plass, NO-0130, Oslo, Norway. .,Centre of Diaconia and Professional Practice, VID Specialized University, P.O. Box 184 Vinderen, NO-0319, Oslo, Norway.
| | - Ellen Karine Grov
- Department of Nursing and Health Promotion. Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, P.O. Box 4, St. Olavs plass, NO-0130, Oslo, Norway
| | - Pål Joranger
- Department of Nursing and Health Promotion. Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, P.O. Box 4, St. Olavs plass, NO-0130, Oslo, Norway
| |
Collapse
|
39
|
Mulder FECM, van Roekel EH, Bours MJL, Weijenberg MP, Evers SMAA. The burden of colorectal cancer survivors in the Netherlands: costs, utilities, and associated patient characteristics. J Cancer Surviv 2021; 16:1055-1064. [PMID: 34510364 PMCID: PMC9489543 DOI: 10.1007/s11764-021-01096-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 08/09/2021] [Indexed: 11/24/2022]
Abstract
Purpose The aim of this study is to assess the societal burden of colorectal cancer (CRC) survivorship 2–10 years post-diagnosis in terms of (1) societal costs, and (2) quality of life/utilities, and to analyze associated patient characteristics. Methods This is a cross-sectional, bottom-up prevalence-based burden of disease study, conducted from a societal perspective in the Netherlands. In total, 155 CRC survivors were included. Utilities were measured by the EQ-5D-5L, using the Dutch tariffs. A cost questionnaire was developed to obtain cost information. Subgroup analyses were performed, based on patient characteristics and sensitivity analyses. Results Of all CRC survivors, 81(54%) reported no problems for mobility, 133(88%) for self-care, 98(65%) for daily activities, 59(39%) for pain/discomfort, and 112(74%) for anxiety/depression on the EQ-5D-5L. The average EQ-5D-5L utility score was 0.82 (SD = 0.2) on a scale from 0 (death) to 1 (perfect health). Significant differences in utility score were found for gender, tumor stage, number of comorbidities, and lifestyle score. The average societal costs per CRC survivor per 6 months were estimated at €971 (min = €0, max = €32,425). Significant differences in costs were found for the number of comorbidities. Conclusions This study shows a considerable burden of CRC survivors 2–10 years after diagnosis, in comparison with survivors sooner after diagnosis and with healthy individuals in the Netherlands. Implications for Cancer Survivors Long-term care of CRC survivors should focus on improving the societal burden by identifying modifiable factors, as summarized in the WCRF/AICR lifestyle score, including body composition, physical activity, and diet.
Collapse
Affiliation(s)
- Frederike E C M Mulder
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands. .,Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.
| | - Eline H van Roekel
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
| | - Martijn J L Bours
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
| | - Matty P Weijenberg
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
| | - Silvia M A A Evers
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| |
Collapse
|
40
|
Sun X, Chen Y, Cheung WK, Wu IX, Xiao F, Chung VC. Pharmacological Interventions for the Management of Cancer-Related Fatigue Among Cancer Survivors: Systematic Review and Meta-Analysis. Integr Cancer Ther 2021; 20:15347354211038008. [PMID: 34369188 PMCID: PMC8358505 DOI: 10.1177/15347354211038008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Current guidelines have different recommendations on applying pharmacological interventions for managing cancer-related fatigue (CRF) among cancer survivors. This systematic review aims to synthesize clinical evidence on pharmacological interventions for managing CRF. METHODS Five databases were searched for potential randomized controlled trials (RCTs) from their inception until October 2020. RCTs assessing the effect of pharmacological treatments for CRF among cancer survivors were considered eligible. Clinical significance was determined by comparing the estimated effect with that of minimal important difference (MID). The risk of bias of each included RCT was appraised using the Cochrane risk of bias tool for randomized trials 2. Data were synthesized using random-effect pairwise meta-analyses. RESULTS A total of 15 RCTs (1238 participants) were included. The majority presented some concerns of bias arising from the randomization process and selection of the reported results. Meta-analysis showed that psychostimulant and wakefulness agents had statistically significant while clinically insignificant effects on the treatment of CRF (pooled weighted mean difference [WMD]: 2.8, 95% confidence interval [CI]: 0.2-5.4, I2: 0%, 3 RCTs, MID: 3.0-6.0). Three natural products, including Renshen Yangrong Tang (mean difference [MD]: -16.1, 95% CI: -8.9 to -23.3, MID: -17.3 to -11.4), Tualang honey (MD: 11.2, 95% CI: 7.1-15.3, MID: 3.0-6.0), and Shenmai injection plus Peptisorb (MD: -1.6, 95% CI: -2.1 to -1.1, MID: -1.1 to -0.8) demonstrated statistically and clinically significant effect in reducing CRF. CONCLUSIONS Existing evidence showed promising effects of 3 natural products in reducing CRF among cancer survivors. The results from this study need to be further confirmed with well-designed and adequately powered RCTs that use validated instruments for the measurement of CRF.
Collapse
Affiliation(s)
- Xuemei Sun
- Central South University, Changsha, Hunan, China
| | - Yancong Chen
- Central South University, Changsha, Hunan, China
| | | | - Irene Xy Wu
- Central South University, Changsha, Hunan, China.,Hunan Provincial Key Laboratory of Clinical Epidemiology, Changsha, China
| | - Fang Xiao
- Central South University, Changsha, Hunan, China
| | | |
Collapse
|
41
|
Krogsgaard M, Andersen RM, Danielsen AK, Thomsen T, Klausen TW, Christensen BM, Gögenur I, Vinther A. Physical activity after colorectal cancer surgery-a cross sectional study of patients with a long-term stoma. Support Care Cancer 2021; 30:555-565. [PMID: 34342750 DOI: 10.1007/s00520-021-06374-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 06/19/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE Physical activity is recommended to cancer survivors by the World Health Organisation (WHO) and is associated with improved survival after colorectal cancer. It remains unclear whether having a stoma is a barrier for an active lifestyle. We examined the level of physical activity and explored factors impacting physical activity in survivors with a stoma. METHODS A total of 1265 (65%) patients in the Danish Stoma Database completed a multidimensional survey. Physical activity of moderate- and vigorous-intensity was assessed using two validated questions. Based on WHO guidelines, physical activity was categorised into 'Meeting' or 'Not Meeting' recommendations. Multivariate regression analysis, adjusting for potential confounders, provided odds ratio (OR) and 95% confidence intervals (CI) for factors' association with'Not Meeting' guideline recommendations. RESULTS In total, 571 patients with colorectal cancer reported on physical activity at a median of 4.3 years (interquartile range 3.1-5.8) after stoma surgery. Two hundred ninety-three patients (51%) were 'Meeting recommendations' and 63% of them were 'Highly active'. Two hundred seventy-eight were 'Not meeting' recommendations (49%). Of the factors analysed, patients without support garment were more likely (OR 1.72 [95% CI 1.16; 2.54] not to meet guideline recommendations. We found no association between stoma type, surgical procedure, parastomal bulging and 'problematic stoma' and level of physical activity, respectively. CONCLUSION In this large sample of survivors with a stoma half of patients met or exceeded guideline recommendations. Of patients not meeting recommendations some could potentially meet the recommendations by modest increases in either moderate or vigorous activity.
Collapse
Affiliation(s)
- Marianne Krogsgaard
- Department of Surgery and Transplantation, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark. .,Department of Gastroenterology, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark. .,Centre for Surgical Sciences, Department of Surgery, Zealand University Hospital, Lykkebækvej 1, 4600, Koege, Denmark.
| | - Rune Martens Andersen
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, 4200, Slagelse, Denmark.,Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Anne K Danielsen
- Department of Gastroenterology, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Thordis Thomsen
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Herlev Acute, Critical and Emergency Care Science Group, Department of Anaesthesiology, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
| | | | - Bo Marcel Christensen
- Department of Surgery and Transplantation, Clinic C, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Ismail Gögenur
- Centre for Surgical Sciences, Department of Surgery, Zealand University Hospital, Lykkebækvej 1, 4600, Koege, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Anders Vinther
- Department of Physiotherapy and Occupational Therapy and Hospital Secretariat and Communications, Research, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
| |
Collapse
|
42
|
Mollica MA, Mayer DK, Oeffinger KC, Kim Y, Buckenmaier SS, Sivaram S, Muha C, Taib NA, Andritsch E, Asuzu CC, Bochis OV, Diaz S, Trill MD, Garcia PJ, Grassi L, Uchitomi Y, Shaikh AJ, Jefford M, Lee HJ, Johansen C, Luyirika E, Maher EJ, Mallillin MMB, Maniragaba T, Mehnert-Theuerkauf A, Pramesh CS, Siesling S, Spira O, Sussman J, Tang L, Hai NV, Yalcin S, Jacobsen PB. Follow-Up Care for Breast and Colorectal Cancer Across the Globe: Survey Findings From 27 Countries. JCO Glob Oncol 2021; 6:1394-1411. [PMID: 32955943 PMCID: PMC7529533 DOI: 10.1200/go.20.00180] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
PURPOSE The purpose of this study was to describe follow-up care for breast and colorectal cancer survivors in countries with varying levels of resources and highlight challenges regarding posttreatment survivorship care. METHODS We surveyed one key stakeholder from each of 27 countries with expertise in survivorship care on questions including the components/structure of follow-up care, delivery of treatment summaries and survivorship care plans, and involvement of primary care in survivorship. Descriptive analyses were performed to characterize results across countries and variations between the WHO income categories (low, middle, high). We also performed a qualitative content analysis of narratives related to survivorship care challenges to identify major themes. RESULTS Seven low- or /lower-middle-income countries (LIC/LMIC), seven upper-middle-income countries (UMIC), and 13 high-income countries (HICs) were included in this study. Results indicate that 44.4% of countries with a National Cancer Control Plan currently address survivorship care. Additional findings indicate that HICs use guidelines more often than those in LICs/LMICs and UMICs. There was great variation among countries regardless of income level. Common challenges include issues with workforce, communication and care coordination, distance/transportation issues, psychosocial support, and lack of focus on follow-up care. CONCLUSION This information can guide researchers, providers, and policy makers in efforts to improve the quality of survivorship care on a national and global basis. As the number of cancer survivors increases globally, countries will need to prioritize their long-term needs. Future efforts should focus on efforts to bridge oncology and primary care, building international partnerships, and implementation of guidelines.
Collapse
Affiliation(s)
| | - Deborah K Mayer
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | | | | | | | | | | | - Nur Aishah Taib
- Graddip Genet Counsell, University of Malaya, Kuala Lumpur, Malaysia
| | | | | | - Ovidiu V Bochis
- Universitatea de Medicina si Farmacie Iuliu Hatieganu Facultatea de Medicina, Cluj-Napoca, Romania
| | - Sheila Diaz
- Universidad Autonoma de Santo Domingo Facultad Ciencias de la Salud, Santo Domingo, Dominican Republic
| | - Maria Die Trill
- Hospital General Universitario Gregorio Maranon, Madrid, Spain
| | | | | | | | | | - Michael Jefford
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | | | | | | | | | | | | | | | | | - Sabine Siesling
- Netherlands Comprehensive Cancer Organisation and University of Twente, Enschede, the Netherlands
| | - Orit Spira
- Israel Cancer Association, Givatayim, Israel
| | | | - Lili Tang
- Peking University Cancer Hospital, Beijing, People's Republic of China
| | - Nguyen V Hai
- Ho Chi Minh City University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | - Suayib Yalcin
- Hacettepe University Institute of Cancer, Ankara, Turkey
| | | |
Collapse
|
43
|
Azad AD, Yilmaz M, Bozkurt S, Brooks JD, Blayney DW, Hernandez-Boussard T. Diverse patient trajectories during cytotoxic chemotherapy: Capturing longitudinal patient-reported outcomes. Cancer Med 2021; 10:5783-5793. [PMID: 34254459 PMCID: PMC8419778 DOI: 10.1002/cam4.4124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 06/16/2021] [Accepted: 06/21/2021] [Indexed: 12/24/2022] Open
Abstract
Background High‐value cancer care balances effective treatment with preservation of quality of life. Chemotherapy is known to affect patients’ physical and psychological well‐being negatively. Patient‐reported outcomes (PROs) provide a means to monitor declines in a patients’ well‐being during treatment. Methods We identified 741 oncology patients undergoing chemotherapy in our electronic health record (EHR) system who completed Patient‐Reported Outcomes Measurement Information System (PROMIS) surveys during treatment at a comprehensive cancer center, 2013–2018. PROMIS surveys were collected before, during, and after chemotherapy treatment. Linear mixed‐effects models were performed to identify predictors of physical and mental health scores over time. A k‐mean cluster analysis was used to group patient PROMIS score trajectories. Results Mean global physical health (GPH) scores were 48.7 (SD 9.3), 47.7 (8.8), and 48.6 (8.9) and global mental health (GMH) scores were 50.4 (8.6), 49.5 (8.8), and 50.6 (9.1) before, during, and after chemotherapy, respectively. Asian race, Hispanic ethnicity, public insurance, anxiety/depression, stage III cancer, and palliative care were predictors of GPH and GMH decline. The treatment time period was also a predictor of both GPH and GMH decline relative to pre‐treatment. Trajectory clustering identified four distinct PRO clusters associated with chemotherapy treatment. Conclusions Patient‐reported outcomes are increasingly used to help monitor cancer treatment and are now a part of care reimbursement. This study leveraged routinely collected PROMIS surveys linked to EHRs to identify novel patient trajectories of physical and mental well‐being in oncology patients undergoing chemotherapy and potential predictors. Supportive care interventions in high‐risk populations identified by our study may optimize resource deployment. Novelty and impact This study leveraged routinely collected patient‐reported outcome (PROMIS) surveys linked to electronic health records to characterize oncology patients’ quality of life during chemotherapy. Important clinical and demographic predictors of declines in quality of life were identified and four novel trajectories to guide personalized interventions and support. This work highlights the utility of monitoring patient‐reported outcomes not only before and after, but during chemotherapy to help advert adverse patient outcomes and improve treatment adherence.
Collapse
Affiliation(s)
- Amee D Azad
- Department of Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Melih Yilmaz
- Department of Medicine (Biomedical Informatics, Stanford University School of Medicine, Stanford, California, USA
| | - Selen Bozkurt
- Department of Medicine (Biomedical Informatics, Stanford University School of Medicine, Stanford, California, USA
| | - James D Brooks
- Department of Urology, Stanford University School of Medicine, Stanford, California, USA
| | - Douglas W Blayney
- Department of Medicine, Division of Medical Oncology, Stanford University School of Medicine, Stanford, California, USA
| | - Tina Hernandez-Boussard
- Department of Medicine (Biomedical Informatics, Stanford University School of Medicine, Stanford, California, USA.,Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, California, USA
| |
Collapse
|
44
|
Mercier LJ, Kowalski K, Fung TS, Joyce JM, Yeates KO, Debert CT. Characterizing Physical Activity and Sedentary Behavior in Adults With Persistent Postconcussive Symptoms After Mild Traumatic Brain Injury. Arch Phys Med Rehabil 2021; 102:1918-1925.e1. [PMID: 34044001 DOI: 10.1016/j.apmr.2021.05.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 04/20/2021] [Accepted: 05/10/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To evaluate physical activity (PA) and sedentary behavior and their associations with symptom and quality of life outcomes in adults with persistent postconcussive symptoms (PPCS) after mild traumatic brain injury (mTBI). DESIGN Cross-sectional cohort study. SETTING Outpatient brain injury clinic. PARTICIPANTS Consecutive sample of adults (N=180) with a diagnosis of mTBI and PPCS. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES PA and sedentary behavior were assessed using the Godin Leisure-Time Exercise Questionnaire and Rapid Assessment Disuse Index, respectively. Participants were dichotomized according to whether they completed 150 minutes of moderate-to-vigorous PA per week, based on Canadian guidelines. Postinjury moderate-to-vigorous PA was also analyzed as a continuous variable. RESULTS Prior to injury, 85% of participants reported meeting PA guidelines, compared with 28% postinjury. Individuals meeting PA guidelines postinjury reported higher quality of life (η2p=0.130; P<.001) and lower scores on measures of functional impact of headache (η2p=0.065; P=.009), fatigue (η2p=0.080; P=.004), depression (η2p=0.085; P=.001), and anxiety (η2p=0.046; P=.031), compared with those not meeting guidelines. Sedentary behavior postinjury was negatively correlated with quality of life (rs[127]=-0.252; P=.004) and positively correlated with symptom burden (rs[167]=0.227; P=.003), fatigue (rs[127]=0.288; P=.001), depression (rs[174]=0.319; P<.001), and anxiety (rs[127]=0.180; P=.042). CONCLUSIONS PA was significantly decreased in individuals with PPCS compared to preinjury levels. Meeting PA guidelines postinjury was associated with better clinical outcomes, suggesting that returning individuals to PA should be considered in the treatment of this patient population.
Collapse
Affiliation(s)
- Leah J Mercier
- Department of Clinical Neurosciences, Division of Physical Medicine and Rehabilitation, University of Calgary, Calgary.
| | | | - Tak S Fung
- Faculty of Nursing, University of Calgary, Calgary
| | - Julie M Joyce
- Department of Radiology, University of Calgary, Calgary
| | - Keith Owen Yeates
- Department of Psychology, University of Calgary, Calgary; Hotchkiss Brain Institute, University of Calgary, Calgary; Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
| | - Chantel T Debert
- Department of Clinical Neurosciences, Division of Physical Medicine and Rehabilitation, University of Calgary, Calgary; Hotchkiss Brain Institute, University of Calgary, Calgary; Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
| |
Collapse
|
45
|
Mbous YPV, Mohamed R, Kelley GA, Kelly KM. Interventions to improve physical activity in colorectal cancer survivors: protocol for a systematic review and meta-analysis of randomized controlled trials. J Adv Nurs 2021; 77:3921-3932. [PMID: 33969910 DOI: 10.1111/jan.14879] [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: 03/08/2021] [Accepted: 04/18/2021] [Indexed: 11/28/2022]
Abstract
AIM To examine the effectiveness of physical activity (PA) interventions on changes in PA among colorectal cancer survivors, including an examination of theoretical versus atheoretical-driven approaches, with a special focus on their effectiveness across ethnic and racial minorities. DESIGN Systematic review with aggregated data meta-analyses. DATA SOURCES Using six databases (Cochrane Central Register of Controlled Trials, PubMed, PsycINFO, CINAHL with full text, Scopus and Web of Science), we will screen for randomized controlled trials written in English from May 1, 1993 up to December 31, 2020. REVIEW METHODS Dual study-selection and data abstraction will be performed. The Behavior Change Technique Taxonomy (v1) will be used to examine behavior change techniques among selected studies, while the Theory Coding Scheme will be used to assess the extent of theory use. Risk of bias will be assessed using the revised Cochrane risk-of-bias tool for randomized trials, while the strength of the evidence will be assessed using the Grading of Recommendations Assessment, Development, and Evaluation instrument. In addition, intervention delivery will be appraised using the Template for Intervention Description and Replication. Changes in PA from each study will be calculated using the standardized mean difference effect size (Hedge's g). Results will be pooled using the inverse-variance heterogeneity model. Heterogeneity (Cochran's Q) and inconsistency (I2 ) will be examined, while small-study effects (publication bias) will be evaluated using the Doi plot and LFK Index. Meta-regression will also be conducted to examine for potential associations between changes in physical activity and selected covariates (theoretical versus atheoretical-driven approaches, race/ethnicity). DISCUSSION This systematic review will identify specific racial/ethnic minorities for whom interventions are most effective and summarize the evidence of the effectiveness of theoretical vs. theoretical based intervention. IMPACT This systematic review can direct policymakers and practitioners towards actions that are likely to bring about positive physical activity behaviour change.
Collapse
Affiliation(s)
- Yves Paul Vincent Mbous
- School of Pharmacy, Department of Pharmaceutical Systems and Policy, West Virginia University, Robert C. Byrd Health Sciences Center [North], Morgantown, WV, USA
| | - Rowida Mohamed
- School of Pharmacy, Department of Pharmaceutical Systems and Policy, West Virginia University, Robert C. Byrd Health Sciences Center [North], Morgantown, WV, USA
| | - George A Kelley
- School of Public Health, Department of Biostatistics, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, WV, USA
| | - Kimberly Michelle Kelly
- School of Pharmacy, Department of Pharmaceutical Systems and Policy, West Virginia University, Robert C. Byrd Health Sciences Center [North], Morgantown, WV, USA
| |
Collapse
|
46
|
The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Surveillance and Survivorship Care of Patients After Curative Treatment of Colon and Rectal Cancer. Dis Colon Rectum 2021; 64:517-533. [PMID: 33591043 DOI: 10.1097/dcr.0000000000001984] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
|
47
|
Theodosi A, Ouzounis S, Kostopoulos S, Glotsos D, Kalatzis I, Asvestas P, Tzelepi V, Ravazoula P, Cavouras D, Sakellaropoulos G. Employing machine learning and microscopy images of AIB1-stained biopsy material to assess the 5-year survival of patients with colorectal cancer. Microsc Res Tech 2021; 84:2421-2433. [PMID: 33929071 DOI: 10.1002/jemt.23797] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 02/04/2021] [Accepted: 04/10/2021] [Indexed: 01/07/2023]
Abstract
Our purpose was to employ microscopy images of amplified in breast cancer 1 (AIB1)-stained biopsy material of patients with colorectal cancer (CRC) to: (a) find statistically significant differences (SSDs) in the texture and color of the epithelial gland tissue, between 5-year survivors and non-survivors after the first diagnosis and (b) employ machine learning (ML) methods for predicting the CRC-patient 5-year survival. We collected biopsy material from 54 patients with diagnosed CRC from the archives of the University Hospital of Patras, Greece. Twenty-six of the patients had survived 5 years after the first diagnosis. We selected regions of interest containing the epithelial gland at different microscope lens magnifications. We computed 69 textural and color features. Furthermore, we identified features with SSDs between the two groups of patients and we designed a supervised ML system for predicting the CRC-patient 5-year survival. Additionally, we employed the VGG16 pretrained convolution neural network to extract deep learning (DL) features, the support vector machines classifier, and the bootstrap cross-validation method for boosting the accuracy of predicting 5-year survival. Fourteen features sustained SSDs between the two groups of patients. The supervised ML system achieved 87% accuracy in predicting 5-year survival. In comparison, the DL system, using images from all magnifications, gave 97% classification accuracy. Glandular texture in 5-year non-survivors appeared to be of lower contrast, coarseness, roughness, local pixel correlation, and lower AIB1 variation, all indicating loss of textural definition. The supervised ML system revealed useful information regarding features that discriminate between 5-year survivors and non-survivors while the DL system displayed superior accuracy by employing DL features.
Collapse
Affiliation(s)
- Angeliki Theodosi
- Department of Medical Physics, School of Health Sciences, Faculty of Medicine, University of Patras, Patras, Greece
| | - Sotiris Ouzounis
- Department of Biomedical Engineering, Medical Image and Signal Processing Laboratory, University of West Attica, Athens, Greece
| | - Spiros Kostopoulos
- Department of Biomedical Engineering, Medical Image and Signal Processing Laboratory, University of West Attica, Athens, Greece
| | - Dimitris Glotsos
- Department of Biomedical Engineering, Medical Image and Signal Processing Laboratory, University of West Attica, Athens, Greece
| | - Ioannis Kalatzis
- Department of Biomedical Engineering, Medical Image and Signal Processing Laboratory, University of West Attica, Athens, Greece
| | - Pantelis Asvestas
- Department of Biomedical Engineering, Medical Image and Signal Processing Laboratory, University of West Attica, Athens, Greece
| | - Vassiliki Tzelepi
- Department of Pathology, University Hospital of Patras, Patras, Greece
| | | | - Dionisis Cavouras
- Department of Biomedical Engineering, Medical Image and Signal Processing Laboratory, University of West Attica, Athens, Greece
| | - George Sakellaropoulos
- Department of Medical Physics, School of Health Sciences, Faculty of Medicine, University of Patras, Patras, Greece
| |
Collapse
|
48
|
Kim K, Yoon H. Health-Related Quality of Life among Cancer Survivors Depending on the Occupational Status. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073803. [PMID: 33917318 PMCID: PMC8038705 DOI: 10.3390/ijerph18073803] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 04/01/2021] [Accepted: 04/03/2021] [Indexed: 11/16/2022]
Abstract
The study aimed to identify and compare the factors affecting health-related quality of life (HRQoL) depending on the occupational status of cancer survivors. This study was a secondary data analysis from the Korea National Health and Nutrition Examination Survey (KNHANES) from 2014 to 2018. Hierarchical multivariate linear regression was used to investigate the factors affecting the HRQoL of each group. Non-working cancer survivors had significantly lower HRQoL than working cancer survivors (p < 0.001). A hierarchical multiple regression model showed that demographic, health-related, and psychological characteristics explained 62.0% of non-working cancer survivors' HRQoL (F = 4.29, p < 0.001). Among the input variables, health-related characteristics were the most influential factors (ΔR2 = 0.274, F = 9.84, p < 0.001). For working cancer survivors, health-related characteristics were the only variable that was statistically associated with HRQoL (F = 5.556, p < 0.001). It is important to enhance physical activities and manage the chronic disease to improve the HRQoL of working cancer survivors. Further, managing health-related characteristics, including depressive symptoms and suicidal ideation, is necessary for non-working cancer survivors. Regarding working survivors, psychological factors such as depressive symptoms and suicidal tendencies did not affect HRQoL. Therefore, an early and effective return to work program should be developed for the improvement of their HRQoL.
Collapse
|
49
|
Meng X, Wang X, Dong Z. Impact of non-pharmacological interventions on quality of life, anxiety, and depression scores in patients with colorectal cancer: a systematic review and meta-analysis of randomized controlled trials. Support Care Cancer 2021; 29:5635-5652. [PMID: 33786669 DOI: 10.1007/s00520-021-06185-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 03/24/2021] [Indexed: 02/08/2023]
Abstract
PURPOSE Different non-pharmacological interventions have been considered and applied to patients with colorectal cancer to improve their quality of life and distress symptoms; however, there is little evidence comparing the effectiveness of these strategies. This review aimed at assessing the effect of non-pharmacological interventions on quality of life, anxiety, and depression scores among patients with colorectal cancer. METHODS A systematic search for articles published until August 1, 2020, in the English language was performed in Medline, EMBASE, Web of Science, and the Cochrane Library; the reference lists of eligible articles were scanned for other potentially eligible publications. A meta-analysis was performed using random-effects models to estimate pooled effect sizes. RESULTS Twenty studies were included, representing a total of 3438 patients with colorectal cancer. Non-pharmacological interventions were associated with a significant reduction in anxiety (standardized mean difference [SMD] = - 0.157; 95% confidence interval [CI], - 0.312-[- 0.002]) and depression (SMD = - 0.207; 95% CI, - 0.390-[- 0.024]) scores during 5-8 months of follow-up. Subgroup analyses revealed that interventions delivered face-to-face improved patients' quality of life during 1-4 months of follow-up. Moreover, interventions delivered face-to-face but without a behavioral component were associated with improved anxiety scores, whereas interventions with a behavioral component improved the depression scores during 5-8 months of follow-up. CONCLUSIONS Non-pharmacological interventions were associated with reduced anxiety and depression scores, whereas interventions delivered face-to-face were associated with improved quality of life scores in patients with colorectal cancer. Given the few studies and patients included in this meta-analysis, these conclusions should be interpreted with caution.
Collapse
Affiliation(s)
- Xinyu Meng
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Xiaodong Wang
- Gastrointestinal Surgery Center of West China Hospital, Sichuan University, Chengdu, China
| | - Zaiquan Dong
- Mental Health Center of West China Hospital, Sichuan University, Chengdu, China.
| |
Collapse
|
50
|
Lim CYS, Laidsaar-Powell RC, Young JM, Kao SCH, Zhang Y, Butow P. Colorectal cancer survivorship: A systematic review and thematic synthesis of qualitative research. Eur J Cancer Care (Engl) 2021; 30:e13421. [PMID: 33733545 DOI: 10.1111/ecc.13421] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 12/06/2020] [Accepted: 01/15/2021] [Indexed: 12/24/2022]
Abstract
INTRODUCTION With rapid changes in treatments for colorectal cancer (CRC), qualitative research into CRC survivorship requires greater synthesis. This paper aims to fill this gap through a systematic review (PROSPERO CRD42019131576) and thematic synthesis of the qualitative literature on survivorship experiences across early-stage and advanced CRC survivors. METHODS CINAHL, Embase, MEDLINE, PsycINFO and PubMed were searched for qualitative CRC survivorship papers. Titles, abstracts and full texts were screened. Included articles (n = 81) underwent data extraction, CASP qualitative bias ratings and thematic synthesis. RESULTS Bowel dysfunction caused functional limitations and negative quality of life (QoL), while stomas posed threats to body image and confidence. Physical symptoms hindered return to work, increasing financial burdens. Survivors' unmet needs included information regarding symptom expectations and management, and ongoing support throughout recovery. Advanced and early-stage survivors shared similar experiences. Advanced survivors struggled with fear of cancer recurrence/progression and feelings of powerlessness. Functional limitations, financial impacts and sexuality in advanced survivors were underexplored areas. CONCLUSION CRC and its treatments impact survivors' QoL in all areas. A coordinated supportive care response is required to address survivors' unmet needs. Future qualitative studies should explore advanced CRC subpopulations, treatment-specific impacts on QoL and long-term (>5 years) impacts on CRC survivors.
Collapse
Affiliation(s)
- Chloe Yi Shing Lim
- Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
| | - Rebekah Clare Laidsaar-Powell
- Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
| | - Jane M Young
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.,RPA Institute of Academic Surgery (IAS) and Surgical Outcomes Research Centre (SOuRCe), Sydney Local Health District, Sydney, NSW, Australia
| | - Steven Chuan-Hao Kao
- Department of Medical Oncology, Chris O'Brien Lifehouse, Sydney, NSW, Australia.,Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Yuehan Zhang
- National Centre for Epidemiology and Population Health, Australian National University Research School of Population Health, Canberra, ACT, Australia
| | - Phyllis Butow
- Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
| |
Collapse
|