1
|
Dent S, Tumlinson R, Guha A, Moore H. Breast cancer risk reduction: Beyond pharmacologic intervention. Cancer 2024. [PMID: 39031558 DOI: 10.1002/cncr.35442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2024]
Abstract
Breast cancer and cardiovascular disease share common risk factors, and are responsible for significant morbidity and mortality in women in North America. Nonpharmacologic approaches such as lifestyle modifications can decrease this risk but may be constrained by social determinants of health.
Collapse
Affiliation(s)
- Susan Dent
- Department of Medicine, Duke Cancer Institute, Duke University, Durham, North Carolina, USA
| | - Robin Tumlinson
- Department of Pharmacy, Duke Cancer Institute, Duke University Hospital, Durham, North Carolina, USA
| | - Avirup Guha
- Cardio-Oncology Program, Division of Cardiology, Department of Medicine, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
- Division of Cardiology, Department of Medicine, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
| | - Heather Moore
- Department of Pharmacy, Duke Cancer Institute, Duke University Hospital, Durham, North Carolina, USA
| |
Collapse
|
2
|
Benitez TJ, Artigas E, Larsen B, Joseph RP, Pekmezi D, Marquez B, Whitworth JW, Marcus BH. Barriers and Facilitators to Muscle-Strengthening Activity Among Latinas in the U.S.: Results From Formative Research Assessments. Int J Behav Med 2024; 31:292-304. [PMID: 37231222 DOI: 10.1007/s12529-023-10183-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2023] [Indexed: 05/27/2023]
Abstract
BACKGROUND Latinas are disproportionately affected by low physical activity (PA) levels and related health conditions (e.g., diabetes, obesity). Few Latinas in the U.S. (17%) meet the National PA Guidelines for both aerobic PA and muscle-strengthening activity (MSA), yet, research to date in this population has focused almost exclusively on aerobic PA. Performing regular MSA is linked with numerous health improvements and reduced mortality; thus, may be key to addressing health disparities in this community. This study examined perspectives on engaging in MSA among Latinas enrolled in two aerobic PA RCTs. METHODS Brief quantitative surveys were conducted to assess interest in MSA among Latinas (N = 81), along with 19 follow-up in-depth semi-structured interviews on knowledge, barriers, and facilitators for engaging in regular MSA. Interview transcripts were analyzed by two independent bilingual researchers using a directed content analysis approach. RESULTS Eighty-one Latinas (18-65 years) completed the survey. Most (91%) expressed interest in learning more about MSA and 60% reported not knowing how to do MSA as a substantial MSA barrier. Interview results indicated Latinas were aware of health benefits of MSA and motivated to engage in MSA but reported barriers (e.g., perception that MSA is for men, a taboo topic, and lack of knowledge on how to do MSA). CONCLUSION This study contributes to a critical gap in PA research among Latinas. Findings will inform future culturally appropriate MSA interventions in this at-risk population. Addressing MSA and aerobic PA together in future interventions will provide a more comprehensive approach to reducing PA-related health disparities in Latinas than aerobic PA alone.
Collapse
Affiliation(s)
- Tanya J Benitez
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island, USA.
| | - Eileen Artigas
- Center for Health Communication, University of Texas at Austin, Austin, TX, USA
| | - Britta Larsen
- Herbert Wertheim School of Public Health, University of California, San Diego, California, USA
| | - Rodney P Joseph
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Dori Pekmezi
- Department of Health Behavior, School of Public Health at, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Becky Marquez
- Herbert Wertheim School of Public Health, University of California, San Diego, California, USA
| | - James W Whitworth
- National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Bess H Marcus
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island, USA
| |
Collapse
|
3
|
Dibble KE, Deng Z, Jin M, Connor AE. Associations between race/ethnicity and SEER-CAHPS patient care experiences among female Medicare beneficiaries with breast cancer. J Geriatr Oncol 2023; 14:101633. [PMID: 37741036 PMCID: PMC10843501 DOI: 10.1016/j.jgo.2023.101633] [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: 06/26/2023] [Revised: 08/31/2023] [Accepted: 09/13/2023] [Indexed: 09/25/2023]
Abstract
INTRODUCTION We aimed to determine if racial/ethnic disparities exist in survivorship care patient experiences among older breast cancer survivors. MATERIALS AND METHODS Nineteen thousand seventeen female breast cancer survivors aged ≥65 at post-diagnosis survey contributed data via the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) and Centers for Medicare and Medicaid Services Consumer Assessment of Healthcare Providers & Systems (CAHPS) data linkage (2000-2019). Multivariable linear regression models were used to estimate adjusted beta (β) coefficients and standard error (SE) estimates for associations between race/ethnicity and survivorship care patient experiences. RESULTS Most women were non-Hispanic (NH)-White (78.1%; NH-Black [8.1%], NH-Asian [6.5%], Hispanic [6.2%]). On average, women reported 76.3 years (standard deviation [SD] = 7.14) at CAHPS survey and 6.10 years since primary diagnosis (SD = 3.51). Compared with NH-White survivors, NH-Black survivors reported lower mean scores for Getting Care Quickly (β = -5.17, SE = 0.69, p ≤0.001), Getting Needed Care (β = -1.72, SE = 0.63, p = 0.006), and Overall Care Ratings (β = -2.72, SE = 0.48, p ≤0.001), mirroring the results for NH-Asian survivors (Getting Care Quickly [β = -7.06, SE = 0.77, p ≤0.001], Getting Needed Care [β = -4.43, SE = 0.70, p ≤0.001], Physician Communication [β = -1.15, SE = 0.54, p = 0.03], Overall Care Rating [β = -2.32, SE = 0.53, p ≤0.001]). Findings among Hispanic survivors varied, where mean scores were lower for Getting Care Quickly (β = -2.83, SE = 0.79, p ≤0.001), Getting Needed Care (β = -2.43, SE = 0.70, p = 0.001), and Getting Needed Prescription Drug(s) (β = -1.47, SE = 0.64, p = 0.02), but were higher for Health Plan Rating (β = 2.66, SE = 0.55, p ≤0.001). Education, Medicare plan, and multimorbidity significantly modified various associations among NH-Black survivors, and education was a significant modifier among NH-Asian and Hispanic survivors. DISCUSSION We observed racial/ethnic disparities in the associations with survivorship care patient experience among NH-Black, Hispanic, and NH-Asian breast cancer survivors. Future research should examine the impact of education, Medicare plans, and multimorbidity on these associations.
Collapse
Affiliation(s)
- Kate E Dibble
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD 21205, USA.
| | - Zhengyi Deng
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD 21205, USA
| | - Mu Jin
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD 21205, USA
| | - Avonne E Connor
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD 21205, USA; Department of Oncology, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD 21205, USA
| |
Collapse
|
4
|
Middha P, Thummalapalli R, Betti MJ, Yao L, Quandt Z, Balaratnam K, Bejan CA, Cardenas E, Falcon CJ, Faleck DM, Gubens MA, Huntsman S, Johnson DB, Kachuri L, Khan K, Li M, Lovly CM, Murray MH, Patel D, Werking K, Xu Y, Zhan LJ, Balko JM, Liu G, Aldrich MC, Schoenfeld AJ, Ziv E. Polygenic risk score for ulcerative colitis predicts immune checkpoint inhibitor-mediated colitis. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.05.15.23289680. [PMID: 37292751 PMCID: PMC10246037 DOI: 10.1101/2023.05.15.23289680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Immune checkpoint inhibitors (ICIs) are a remarkable advancement in cancer therapeutics; however, a substantial proportion of patients develop severe immune-related adverse events (irAEs). Understanding and predicting irAEs is a key to advancing precision immuno-oncology. Immune checkpoint inhibitor-mediated colitis (IMC) is a significant complication from ICI and can have life-threatening consequences. Based on clinical presentation, IMC mimics inflammatory bowel disease, however the link is poorly understood. We hypothesized that genetic susceptibility to Crohn's disease (CD) and ulcerative colitis (UC) may predispose to IMC. We developed and validated polygenic risk scores for CD (PRSCD) and UC (PRSUC) in cancer-free individuals and assessed the role of each of these PRSs on IMC in a cohort of 1,316 patients with non-small cell lung cancer who received ICIs. Prevalence of all-grade IMC in our cohort was 4% (55 cases), and for severe IMC, 2.5% (32 cases). The PRSUC predicted the development of all-grade IMC (HR=1.34 per standard deviation [SD], 95% CI=1.02-1.76, P=0.04) and severe IMC (HR=1.62 per SD, 95% CI=1.12-2.35, P=0.01). PRSCD was not associated with IMC or severe IMC. The association between PRSUC and IMC (all-grade and severe) was consistent in an independent pan-cancer cohort of patients treated with ICIs. Furthermore, PRSUC predicted severe IMC among patients treated with combination ICIs (OR = 2.20 per SD, 95% CI = 1.07-4.53, P=0.03). This is the first study to demonstrate the potential clinical utility of a PRS for ulcerative colitis in identifying patients receiving ICI at high risk of developing IMC, where risk reduction and close monitoring strategies could help improve overall patient outcomes.
Collapse
Affiliation(s)
- Pooja Middha
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Rohit Thummalapalli
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Michael J Betti
- Department of Medicine, Division of Genetic Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Lydia Yao
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Zoe Quandt
- Division of Endocrinology and Metabolism, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
- Diabetes Center, University of California San Francisco, San Francisco, CA, USA
| | | | - Cosmin A Bejan
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Eduardo Cardenas
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Christina J Falcon
- Fiona and Stanley Druckenmiller Center for Lung Cancer Research, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - David M Faleck
- Gastroenterology, Hepatology & Nutrition Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Matthew A Gubens
- Medical Oncology, University of California San Francisco, San Francisco, CA, USA
- Department of Medicine, Weill Cornell Medical Center, New York, NY, USA
| | - Scott Huntsman
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Douglas B Johnson
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Linda Kachuri
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA
- Stanford Cancer Institute, Stanford University of Medicine, Stanford, CA, USA
| | - Khaleeq Khan
- Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Min Li
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Christine M Lovly
- Department of Medicine, Division of Hematology and Oncology, Vanderbilt University Medical Center and Vanderbilt Ingram Cancer Center, Nashville, TN, USA
| | - Megan H Murray
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Kristin Werking
- Department of Thoracic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Yaomin Xu
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Luna Jia Zhan
- Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Justin M Balko
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Geoffrey Liu
- Princess Margaret Cancer Centre, Temerty School of Medicine, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Melinda C Aldrich
- Department of Medicine, Division of Genetic Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Adam J Schoenfeld
- Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Elad Ziv
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
- Helen Diller Family Comprehensive Cancer Center, Center for Genes, Environment and Health and Institute for Human Genetics, University of California San Francisco, San Francisco, California
| |
Collapse
|
5
|
Anderson T, Herrera D, Mireku F, Barner K, Kokkinakis A, Dao H, Webber A, Merida AD, Gallo T, Pierobon M. Geographical Variation in Social Determinants of Female Breast Cancer Mortality Across US Counties. JAMA Netw Open 2023; 6:e2333618. [PMID: 37707814 PMCID: PMC10502521 DOI: 10.1001/jamanetworkopen.2023.33618] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 08/04/2023] [Indexed: 09/15/2023] Open
Abstract
Importance Breast cancer mortality is complex and traditional approaches that seek to identify determinants of mortality assume that their effects on mortality are stationary across geographic space and scales. Objective To identify geographic variation in the associations of population demographics, environmental, lifestyle, and health care access with breast cancer mortality at the US county-level. Design, Setting, and Participants This geospatial cross-sectional study used data from the Surveillance, Epidemiology, and End Results (SEER) database on adult female patients with breast cancer. Statistical and spatial analysis was completed using adjusted mortality rates from 2015 to 2019 for 2176 counties in the US. Data were analyzed July 2022. Exposures County-level population demographics, environmental, lifestyle, and health care access variables were obtained from open data sources. Main Outcomes and Measures Model coefficients describing the association between 18 variables and age-adjusted breast cancer mortality rate. Compared with a multivariable linear regression (OLS), multiscale geographically weighted regression (MGWR) relaxed the assumption of spatial stationarity and allowed for the magnitude, direction, and significance of coefficients to change across geographic space. Results Both OLS and MGWR models agreed that county-level age-adjusted breast cancer mortality rates were significantly positively associated with obesity (OLS: β, 1.21; 95% CI, 0.88 to 1.54; mean [SD] MGWR: β, 0.72 [0.02]) and negatively associated with proportion of adults screened via mammograms (OLS: β, -1.27; 95% CI, -1.70 to -0.84; mean [SD] MGWR: β, -1.07 [0.16]). Furthermore, the MGWR model revealed that these 2 determinants were associated with a stationary effect on mortality across the US. However, the MGWR model provided important insights on other county-level factors differentially associated with breast cancer mortality across the US. Both models agreed that smoking (OLS: β, -0.65; 95% CI, -0.98 to -0.32; mean [SD] MGWR: β, -0.75 [0.92]), food environment index (OLS: β, -1.35; 95% CI, -1.72 to -0.98; mean [SD] MGWR: β, -1.69 [0.70]), exercise opportunities (OLS: β, -0.56; 95% CI, -0.91 to -0.21; mean [SD] MGWR: β, -0.59 [0.81]), racial segregation (OLS: β, -0.60; 95% CI, -0.89 to -0.31; mean [SD] MGWR: β, -0.47 [0.41]), mental health care physician ratio (OLS: β, -0.93; 95% CI, -1.44 to -0.42; mean [SD] MGWR: β, -0.48 [0.92]), and primary care physician ratio (OLS: β, -1.46; 95% CI, -2.13 to -0.79; mean [SD] MGWR: β, -1.06 [0.57]) were negatively associated with breast cancer mortality, and that light pollution was positively associated (OLS: β, 0.48; 95% CI, 0.24 to 0.72; mean [SD] MGWR: β, 0.27 [0.04]). But in the MGWR model, the magnitude of effect sizes and significance varied across geographical regions. Inversely, the OLS model found that disability was not a significant variable for breast cancer mortality, yet the MGWR model found that it was significantly positively associated in some geographical locations. Conclusions and Relevance This cross-sectional study found that not all social determinants associated with breast cancer mortality are spatially stationary and provides spatially explicit insights for public health practitioners to guide geographically targeted interventions.
Collapse
Affiliation(s)
- Taylor Anderson
- Department of Geography and Geoinformation Science, George Mason University, Fairfax, Virginia
| | - Dan Herrera
- Department of Environmental Science and Technology, University of Maryland, College Park
- Department of Environmental Science and Policy, George Mason University, Fairfax, Virginia
| | - Franchesca Mireku
- Department of Geography and Geoinformation Science, George Mason University, Fairfax, Virginia
| | - Kai Barner
- Department of Geography and Geoinformation Science, George Mason University, Fairfax, Virginia
| | - Abigail Kokkinakis
- Department of Environmental Science and Policy, George Mason University, Fairfax, Virginia
| | - Ha Dao
- Department of Statistics, George Mason University, Fairfax, Virginia
| | - Amanda Webber
- Department of Geography and Geoinformation Science, George Mason University, Fairfax, Virginia
| | - Alexandra Diaz Merida
- Department of Global and Community Health, George Mason University, Fairfax, Virginia
| | - Travis Gallo
- Department of Environmental Science and Technology, University of Maryland, College Park
- Department of Environmental Science and Policy, George Mason University, Fairfax, Virginia
| | - Mariaelena Pierobon
- School of Systems Biology, Center for Applied Proteomics and Molecular Medicine, George Mason University, Manassas, Virginia
| |
Collapse
|
6
|
Seven M, Reid A, Abban S, Madziar C, Faro JM. Motivational interviewing interventions aiming to improve health behaviors among cancer survivors: a systematic scoping review. J Cancer Surviv 2023; 17:795-804. [PMID: 36100801 PMCID: PMC10652272 DOI: 10.1007/s11764-022-01253-5] [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: 06/25/2022] [Accepted: 08/29/2022] [Indexed: 10/14/2022]
Abstract
PURPOSE The scoping review aimed to map out the literature on the utilization of motivational interviewing (MI) to improve health behaviors (i.e., physical activity, nutrition) in adult cancer survivors. METHODS This scoping review was conducted following the methods and protocol outlined by the Joanna Briggs Institute Methods Manual. Five databases, including PubMed, CINAHL, Web of Science, and SPORTDiscus, were searched in February 2022 to identify MI interventions to improve health behaviors among cancer survivors. RESULTS The review included 22 interventions mostly designed to optimize exercise/physical activity (50%). The number of sessions ranged from 2 to 19, and most MI sessions were offered via telephone calls combined with face-to-face sessions (31.8%). Of the interventions, 81.8% improved at least one outcome measurement. Most studies used principles of MI such as empathy expression, developing discrepancy, roll with resistance, and supporting self-efficacy. CONCLUSION The use of MI appears to have the potential to improve health behaviors in various settings for individuals on different cancer care trajectories. IMPLICATIONS FOR CANCER SURVIVORS Healthcare providers can use MI to support physical activity and a healthy diet. Future research should focus on providing evidence on the utilization of MI with minimum standards and longitudinal outcome assessment for developing and maintaining sustainable healthy behaviors.
Collapse
Affiliation(s)
- Memnun Seven
- Elaine Marieb College of Nursing, University of Massachusetts Amherst, 230 Skinner Hall, 651 North Pleasant Street, Amherst, MA, 01003, USA.
| | - Allecia Reid
- Department of Psychological and Brain Sciences, College of Natural Sciences, University of Massachusetts Amherst, Tobin 628, Amherst, MA, 01003, USA
| | - Sabriye Abban
- Elaine Marieb College of Nursing, University of Massachusetts Amherst, 230 Skinner Hall, 651 North Pleasant Street, Amherst, MA, 01003, USA
| | - Camilla Madziar
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, 368 Plantation Street, Worcester, MA, 01605, USA
| | - Jamie M Faro
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, 368 Plantation Street, Worcester, MA, 01605, USA
| |
Collapse
|
7
|
Fong AJ, Llanos AAM, Ashrafi A, Zeinomar N, Chokshi S, Bandera EV, Devine KA, Hudson SV, Qin B, O’Malley D, Paddock LE, Stroup AM, Evens AM, Manne SL. Sociodemographic and Health Correlates of Multiple Health Behavior Adherence among Cancer Survivors: A Latent Class Analysis. Nutrients 2023; 15:2354. [PMID: 37242237 PMCID: PMC10223681 DOI: 10.3390/nu15102354] [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: 03/20/2023] [Revised: 04/24/2023] [Accepted: 05/13/2023] [Indexed: 05/28/2023] Open
Abstract
The study aimed to (a) assess current levels of adherence to the National Comprehensive Cancer Network's multiple health behavior guidelines and (b) identify characteristics of cancer survivors associated with different adherence levels. Cancer survivors (N = 661) were identified through the state registry and completed questionnaires. Latent class analysis (LCA) was used to identify patterns of adherence. Associations between predictors with the latent classes were reported as risk ratios. LCA identified three classes: lower- (39.6%), moderate- (52.0%), and high-risk lifestyle (8.3%). Participants in the lower-risk lifestyle class had the highest probability of meeting most of the multiple health behavior guidelines compared to participants in the high-risk lifestyle class. Characteristics associated with membership in the moderate-risk lifestyle class included self-identifying as a race other than Asian/Asian American, being never married, having some college education, and having been diagnosed with later stage colorectal or lung cancer. Those in the high-risk lifestyle class were more likely to be male, never married, have a high school diploma or less, diagnosed with colorectal or lung cancer, and diagnosed with pulmonary comorbidities. Study findings can be used to inform development of future interventions to promote multiple health behavior adherence among higher risk cancer survivors.
Collapse
Affiliation(s)
- Angela J. Fong
- Section of Behavioral Sciences, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08901, USA
- Division of Medical Oncology, Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USA
| | - Adana A. M. Llanos
- Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY 10032, USA
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Adiba Ashrafi
- Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY 10032, USA
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Nur Zeinomar
- Division of Medical Oncology, Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USA
- Section of Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08901, USA
| | - Sagar Chokshi
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Rutgers Robert Wood Johnson University Hospital, New Brunswick, NJ 08901, USA
| | - Elisa V. Bandera
- Division of Medical Oncology, Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USA
- Section of Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08901, USA
| | - Katie A. Devine
- Department of Pediatrics, Section of Pediatric Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08901, USA
| | - Shawna V. Hudson
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USA
| | - Bo Qin
- Division of Medical Oncology, Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USA
- Section of Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08901, USA
| | - Denalee O’Malley
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USA
| | - Lisa E. Paddock
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08901, USA
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ 08854, USA
| | - Antoinette M. Stroup
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08901, USA
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ 08854, USA
| | - Andrew M. Evens
- Department of Medicine, Division of Blood Disorders, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USA
| | - Sharon L. Manne
- Section of Behavioral Sciences, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08901, USA
- Division of Medical Oncology, Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USA
| |
Collapse
|
8
|
Clemente-Suárez VJ, Martín-Rodríguez A, Redondo-Flórez L, Ruisoto P, Navarro-Jiménez E, Ramos-Campo DJ, Tornero-Aguilera JF. Metabolic Health, Mitochondrial Fitness, Physical Activity, and Cancer. Cancers (Basel) 2023; 15:cancers15030814. [PMID: 36765772 PMCID: PMC9913323 DOI: 10.3390/cancers15030814] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 01/26/2023] [Accepted: 01/27/2023] [Indexed: 01/31/2023] Open
Abstract
Cancer continues to be a significant global health issue. Traditional genetic-based approaches to understanding and treating cancer have had limited success. Researchers are increasingly exploring the impact of the environment, specifically inflammation and metabolism, on cancer development. Examining the role of mitochondria in this context is crucial for understanding the connections between metabolic health, physical activity, and cancer. This study aimed to review the literature on this topic through a comprehensive narrative review of various databases including MedLine (PubMed), Cochrane (Wiley), Embase, PsychINFO, and CinAhl. The review highlighted the importance of mitochondrial function in overall health and in regulating key events in cancer development, such as apoptosis. The concept of "mitochondrial fitness" emphasizes the crucial role of mitochondria in cell metabolism, particularly their oxidative functions, and how proper function can prevent replication errors and regulate apoptosis. Engaging in high-energy-demanding movement, such as exercise, is a powerful intervention for improving mitochondrial function and increasing resistance to environmental stressors. These findings support the significance of considering the role of the environment, specifically inflammation and metabolism, in cancer development and treatment. Further research is required to fully understand the mechanisms by which physical activity improves mitochondrial function and potentially reduces the risk of cancer.
Collapse
Affiliation(s)
| | | | - Laura Redondo-Flórez
- Department of Health Sciences, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, C/Tajo s/n Villaviciosa de Odón, 28670 Madrid, Spain
| | - Pablo Ruisoto
- Department of Health Sciences, Public University of Navarre, 31006 Navarre, Spain
| | | | - Domingo Jesús Ramos-Campo
- Departamento de Salud y Rendimiento, Universidad Politécnica de Madrid, 28040 Madrid, Spain
- Correspondence:
| | | |
Collapse
|
9
|
Wilkerson AD, Obi M, Ortega C, Sebikali-Potts A, Wei W, Pederson HJ, Al-Hilli Z. Young Black Women May be More Likely to Have First Mammogram Cancers: A New Perspective in Breast Cancer Disparities. Ann Surg Oncol 2023; 30:2856-2869. [PMID: 36602665 DOI: 10.1245/s10434-022-12995-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 12/10/2022] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Black women are diagnosed with breast cancer at earlier ages and are 42% more likely to die from the disease than White women. Recommendations for commencement of screening mammography remain discordant. This study sought to determine the frequency of first mammogram cancers among Black women versus other self-reported racial groups. METHODS In this retrospective cohort study, clinical and mammographic data were obtained from 738 women aged 40-45 years who underwent treatment for breast cancer between 2010 and 2019 within a single hospital system. First mammogram cancers were defined as those with tissue diagnoses within 3 months of baseline mammogram. Multivariate logistic regression was applied to assess variables associated with first mammogram cancer detection. RESULTS Black women were significantly more likely to have first mammogram cancer diagnoses (39/82, 47.6%) compared with White women (162/610, 26.6%) and other groups (16/46, 34.8%) [p < 0.001]. Black women were also more likely to have a body mass index > 30 (p < 0.001), higher clinical T categories (p = 0.02), and present with more advanced clinical stages (p = 0.03). Every month delay in mammographic screening beyond age 40 years (odds ratio [OR] 1.06, 95% confidence interval [CI] 1.05-1.07; p < 0.0001), Black race (OR 2.24, 95% CI 1.10-4.53; p = 0.03), and lack of private insurance (OR 2.41, 95% CI 1.22-4.73; p = 0.01) were associated with an increased likelihood of cancer detection on first mammogram. CONCLUSION Our findings suggests that Black women aged 40-45 years may be more likely to have cancer detected on their first mammogram and would benefit from starting screening mammography no later than age 40 years, and for those with elevated lifetime risk, even sooner.
Collapse
Affiliation(s)
- Avia D Wilkerson
- Department of General Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Megan Obi
- Department of General Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Camila Ortega
- Department of General Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA
| | | | - Wei Wei
- Department of Quantitative Health Sciences, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Holly J Pederson
- Department of Breast Services, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Zahraa Al-Hilli
- Department of General Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA. .,Department of Breast Services, Cleveland Clinic Foundation, Cleveland, OH, USA.
| |
Collapse
|
10
|
Ochs-Balcom HM, Johnson C, Guertin KA, Qin B, Beeghly-Fadiel A, Camacho F, Bethea TN, Dempsey LF, Rosenow W, Joslin CE, Myers E, Moorman PG, Harris HR, Peres LC, Wendy Setiawan V, Wu AH, Rosenberg L, Schildkraut JM, Bandera EV. Racial differences in the association of body mass index and ovarian cancer risk in the OCWAA Consortium. Br J Cancer 2022; 127:1983-1990. [PMID: 36138071 PMCID: PMC9681872 DOI: 10.1038/s41416-022-01981-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 08/30/2022] [Accepted: 09/01/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Obesity disproportionately affects African American (AA) women and has been shown to increase ovarian cancer risk, with some suggestions that the association may differ by race. METHODS We evaluated body mass index (BMI) and invasive epithelial ovarian cancer (EOC) risk in a pooled study of case-control and nested case-control studies including AA and White women. We evaluated both young adult and recent BMI (within the last 5 years). Associations were estimated using multi-level and multinomial logistic regression models. RESULTS The sample included 1078 AA cases, 2582 AA controls, 3240 White cases and 9851 White controls. We observed a higher risk for the non-high-grade serous (NHGS) histotypes for AA women with obesity (ORBMI 30+= 1.62, 95% CI: 1.16, 2.26) and White women with obesity (ORBMI 30+= 1.20, 95% CI: 1.02, 2.42) compared to non-obese. Obesity was associated with higher NHGS risk in White women who never used HT (ORBMI 30+= 1.40, 95% CI: 1.08, 1.82). Higher NHGS ovarian cancer risk was observed for AA women who ever used HT (ORBMI 30+= 2.66, 95% CI: 1.15, 6.13), while in White women, there was an inverse association between recent BMI and risk of EOC and HGS in ever-HT users (EOC ORBMI 30+= 0.81, 95% CI: 0.69, 0.95, HGS ORBMI 30+= 0.73, 95% CI: 0.61, 0.88). CONCLUSION Obesity contributes to NHGS EOC risk in AA and White women, but risk across racial groups studied differs by HT use and histotype.
Collapse
Affiliation(s)
- Heather M Ochs-Balcom
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA.
| | - Courtney Johnson
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Kristin A Guertin
- Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Bo Qin
- Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Alicia Beeghly-Fadiel
- Department of Medicine, Division of Epidemiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Fabian Camacho
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Traci N Bethea
- Office of Minority Health and Health Disparities Research, Georgetown Lombardi Comprehensive Cancer Center, Georgetown University Medical Campus, Washington DC, USA
| | - Lauren F Dempsey
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Will Rosenow
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Charlotte E Joslin
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago School of Medicine and Division of Epidemiology and Biostatistics, School of Public Health, Chicago, IL, USA
| | - Evan Myers
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA
| | - Patricia G Moorman
- Department of Family Medicine and Community Health, Duke University Medical Center, Durham, NC, USA
| | - Holly R Harris
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Lauren C Peres
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - V Wendy Setiawan
- University of Southern California Norris Comprehensive Cancer Center, and Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Anna H Wu
- University of Southern California Norris Comprehensive Cancer Center, and Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Lynn Rosenberg
- Slone Epidemiology Center at Boston University, Boston, MA, USA
| | - Joellen M Schildkraut
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Elisa V Bandera
- Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| |
Collapse
|
11
|
Seven M, Marie Moraitis A. Community-based interventions designed to optimize health behaviors among cancer survivors: an integrative systematic review. Support Care Cancer 2022; 30:8405-8415. [PMID: 35524870 DOI: 10.1007/s00520-022-07097-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 04/27/2022] [Indexed: 01/01/2023]
Abstract
PURPOSE The purpose of this review was to synthesize the evidence on community-based health behavior optimization interventions (physical activity, nutrition, weight management) with a focus on cancer survivors at risk for poor health outcomes. METHODS This integrative review followed the methods and protocol outlined by the Joanna Briggs Institute Methods Manual for systematic reviews and was reported using PRISMA-Scr. Four databases, namely, PubMed, CINAHL, Web of Science, SportDiscus, were searched in March 2021 to identify articles addressing health behaviors among cancer survivors. RESULTS The review included 43 articles describing unique interventions developed through community-based participatory research (CBPR). The majority of community-based interventions were designed to optimize exercise/physical activity (76.7%) exclusively or in combination with nutrition. Non-Hispanic White persons constituted most participants. Most interventions took place as a part of an established community program and recruited from existing community programs to evaluate intervention effects on specific health outcomes. Of the interventions, 88.3% improved at least one outcome measurement. CONCLUSION The current studies have built on the strengths and resources of the community using existing programs. There was a lack of diversity in socioeconomic status and racial/ethnic background among participants of most interventions and inputs from partners such as cancer survivors, community, and healthcare organizations. Multiple health behavior interventions with longitudinal studies are needed for racial/ethnic minoritized cancer survivors. Future research should focus on achieving mutual benefits through iterative processes to develop sustainable community/research partnerships, ensuring long-term commitment, and disseminating knowledge gained from CBPR to and by all involved partners to improve health behaviors.
Collapse
Affiliation(s)
- Memnun Seven
- University of Massachusetts Amherst, Elaine Marieb College of Nursing, Amherst, MA, USA.
| | | |
Collapse
|
12
|
Dibble KE, Connor AE. Evaluation of disparities in maintaining healthy lifestyle behaviors among female cancer survivors by race/ethnicity and US nativity. Cancer Epidemiol 2022; 80:102235. [PMID: 35952462 DOI: 10.1016/j.canep.2022.102235] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 07/25/2022] [Accepted: 07/30/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND There are well-known racial/ethnic disparities in maintaining healthy lifestyle behaviors throughout cancer survivorship among US-born women. Less is known about these associations among women born outside the US, as these women may experience disparities in survivorship care due to the lack of access to culturally appropriate health services. We evaluated disparities in the associations between race/ethnicity and US nativity and the likelihood of meeting recommendations for maintaining a healthy lifestyle during cancer survivorship. METHODS 2044 female cancer survivors contributed data from the National Health and Nutrition Examination Survey (NHANES) (1999-2018). Adjusted odds ratios (aORs) and 95 % confidence intervals (CIs) were calculated with multivariable logistic regression models to measure the association between independent variables (race/ethnicity, US nativity, length of time in the US) and outcomes (obesity, meeting weekly physical activity (PA) recommendations, smoking history, alcoholic drinks/day) overall and by comorbidity. RESULTS Most survivors were breast cancer survivors (27.6 %), non-Hispanic white (64.2 %), and US native (84.5 %). Compared to US native survivors, foreign-born survivors were less likely (aOR, 0.30, 95 % CI, 0.10-0.87) to not meet PA recommendations, while foreign-born survivors living in the US ≥ 15 years were 2.30 times more likely (95 % CI, 1.12-4.73) to not meet PA recommendations. Having at least one comorbidity modified (p-interaction< 0.05) the relationships between US nativity and length of time in the US. CONCLUSION Our findings provide new evidence for disparities in maintaining healthy lifestyle behaviors among female cancer survivors and can help inform lifestyle interventions for female cancer survivors from different racial/ethnic backgrounds.
Collapse
Affiliation(s)
- Kate E Dibble
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615N. Wolfe Street, Baltimore, MD 21205, USA.
| | - Avonne E Connor
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615N. Wolfe Street, Baltimore, MD 21205, USA; Department of Oncology, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD 21205, USA
| |
Collapse
|
13
|
Grimm M, Radcliff L, Giles M, Nash R, Holley E, Panda S, Brophy L, Williams N, Cherian M, Stover D, Gatti-Mays ME, Wesolowski R, Sardesai S, Sudheendra P, Reinbolt R, Ramaswamy B, Pariser A. Living with Advanced Breast Cancer: A Descriptive Analysis of Survivorship Strategies. J Clin Med 2022; 11:jcm11143992. [PMID: 35887755 PMCID: PMC9319697 DOI: 10.3390/jcm11143992] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 06/27/2022] [Accepted: 07/05/2022] [Indexed: 02/04/2023] Open
Abstract
Survivors of advanced breast cancer (ABC), also known as metavivors, are often left with fewer treatment options in the landscape of a cure culture. Metavivors have unique psychosocial and physical needs distinct from patients with early-stage breast cancer. This analysis delves into side effects commonly experienced by patients with ABC, such as fatigue, anxiety, and cardiotoxicity; how these side effects impact caregiver support, financial toxicity, emotional strain, and spiritual and emotional distress; as well as current strategies for mitigation, including nutrition, exercise, and participation in clinical research. Overall, this analysis is a mandate for additional research to explore novel treatments and implement strategies to maintain and improve patients’ quality of life.
Collapse
Affiliation(s)
- Michael Grimm
- Division of Medical Oncology, Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH 43210, USA; (M.G.); (L.R.); (S.P.); (L.B.); (N.W.); (M.C.); (D.S.); (M.E.G.-M.); (R.W.); (S.S.); (P.S.); (B.R.)
| | - Lindsey Radcliff
- Division of Medical Oncology, Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH 43210, USA; (M.G.); (L.R.); (S.P.); (L.B.); (N.W.); (M.C.); (D.S.); (M.E.G.-M.); (R.W.); (S.S.); (P.S.); (B.R.)
| | - Mariann Giles
- Family Medicine, The Ohio State University, Columbus, OH 43210, USA;
| | - Ryan Nash
- Center for Bioethics and Medical Humanities, The Ohio State University, Columbus, OH 43210, USA;
| | - Erin Holley
- Nutrition and Dietetics, The Ohio State University, Columbus, OH 43210, USA;
| | - Shannon Panda
- Division of Medical Oncology, Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH 43210, USA; (M.G.); (L.R.); (S.P.); (L.B.); (N.W.); (M.C.); (D.S.); (M.E.G.-M.); (R.W.); (S.S.); (P.S.); (B.R.)
| | - Lynne Brophy
- Division of Medical Oncology, Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH 43210, USA; (M.G.); (L.R.); (S.P.); (L.B.); (N.W.); (M.C.); (D.S.); (M.E.G.-M.); (R.W.); (S.S.); (P.S.); (B.R.)
| | - Nicole Williams
- Division of Medical Oncology, Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH 43210, USA; (M.G.); (L.R.); (S.P.); (L.B.); (N.W.); (M.C.); (D.S.); (M.E.G.-M.); (R.W.); (S.S.); (P.S.); (B.R.)
| | - Mathew Cherian
- Division of Medical Oncology, Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH 43210, USA; (M.G.); (L.R.); (S.P.); (L.B.); (N.W.); (M.C.); (D.S.); (M.E.G.-M.); (R.W.); (S.S.); (P.S.); (B.R.)
| | - Daniel Stover
- Division of Medical Oncology, Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH 43210, USA; (M.G.); (L.R.); (S.P.); (L.B.); (N.W.); (M.C.); (D.S.); (M.E.G.-M.); (R.W.); (S.S.); (P.S.); (B.R.)
| | - Margaret E. Gatti-Mays
- Division of Medical Oncology, Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH 43210, USA; (M.G.); (L.R.); (S.P.); (L.B.); (N.W.); (M.C.); (D.S.); (M.E.G.-M.); (R.W.); (S.S.); (P.S.); (B.R.)
| | - Robert Wesolowski
- Division of Medical Oncology, Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH 43210, USA; (M.G.); (L.R.); (S.P.); (L.B.); (N.W.); (M.C.); (D.S.); (M.E.G.-M.); (R.W.); (S.S.); (P.S.); (B.R.)
| | - Sagar Sardesai
- Division of Medical Oncology, Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH 43210, USA; (M.G.); (L.R.); (S.P.); (L.B.); (N.W.); (M.C.); (D.S.); (M.E.G.-M.); (R.W.); (S.S.); (P.S.); (B.R.)
| | - Preeti Sudheendra
- Division of Medical Oncology, Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH 43210, USA; (M.G.); (L.R.); (S.P.); (L.B.); (N.W.); (M.C.); (D.S.); (M.E.G.-M.); (R.W.); (S.S.); (P.S.); (B.R.)
| | - Raquel Reinbolt
- Internal Medicine, The Ohio State University, Columbus, OH 43210, USA;
| | - Bhuvaneswari Ramaswamy
- Division of Medical Oncology, Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH 43210, USA; (M.G.); (L.R.); (S.P.); (L.B.); (N.W.); (M.C.); (D.S.); (M.E.G.-M.); (R.W.); (S.S.); (P.S.); (B.R.)
| | - Ashley Pariser
- Division of Medical Oncology, Stefanie Spielman Comprehensive Breast Cancer, The Ohio State University, Columbus, OH 43210, USA; (M.G.); (L.R.); (S.P.); (L.B.); (N.W.); (M.C.); (D.S.); (M.E.G.-M.); (R.W.); (S.S.); (P.S.); (B.R.)
- Correspondence: ; Tel.: +1-614-293-6401
| |
Collapse
|
14
|
Gonzalo-Encabo P, Wilson RL, Kang DW, Norris MK, Uno H, Christopher CN, Chow C, Sami N, Fox FS, Ligibel JA, Dieli-Conwright CM. Reducing Metabolic Dysregulation in Obese Latina and/or Hispanic Breast Cancer Survivors Using Physical Activity (ROSA) Trial: A Study Protocol. Front Oncol 2022; 12:864844. [PMID: 35619910 PMCID: PMC9128380 DOI: 10.3389/fonc.2022.864844] [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: 01/28/2022] [Accepted: 03/28/2022] [Indexed: 11/13/2022] Open
Abstract
Background Latina and Hispanic breast cancer survivors (LHBCS) are at increased risk for long-term complications and poorer metabolic health, including metabolic dysregulation (MetD) before and following breast cancer diagnosis. MetD can increase risk of cancer recurrence, death, and comorbid conditions by increasing inflammation and cancer cell proliferation. While exercise improves physical fitness and metabolic outcomes in breast cancer survivors, there is a lack of studies including underrepresented and disadvantaged minority groups such as LHBCS. Methods Our 12-month randomized (exercise or attention control) controlled trial (the ROSA trial) aims to utilize a progressive combined aerobic and resistance exercise program to improve MetD, insulin resistance, and visceral adiposity among obese LHBCS. We aim to recruit 160 women with Stage I-III breast cancer who are sedentary, centrally obese, and have completed treatment (e.g., surgery, radiation, chemotherapy) prior to enrollment. Participants randomized to the exercise group receive 16-weeks of virtually supervised aerobic and resistance training, followed by 16-weeks of unsupervised home-based aerobic and resistance exercise, and 16-weeks of follow-up. The attention control group receive a 12-month home-based stretching program. Primary and secondary outcomes are measured every 4-weeks during study visits. Discussion The ROSA trial is the first exercise oncology trial targeting high-risk sedentary, obese LHBCS to improve MetD-related outcomes. Results of this trial will help illuminate how exercise impacts health-related outcomes, survivorship, and recurrence, and inform future exercise oncology guidelines to reduce health disparities among minority cancer survivors.
Collapse
Affiliation(s)
- Paola Gonzalo-Encabo
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States.,Department of Medicine, Harvard Medical School, Boston, MA, United States
| | - Rebekah L Wilson
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States.,Department of Medicine, Harvard Medical School, Boston, MA, United States
| | - Dong-Woo Kang
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States.,Department of Medicine, Harvard Medical School, Boston, MA, United States
| | - Mary K Norris
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
| | - Hajime Uno
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States.,Department of Medicine, Harvard Medical School, Boston, MA, United States
| | - Cami N Christopher
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
| | - Christina Chow
- UCSF School of Dentistry, University of California, San Francisco, San Francisco, CA, United States
| | - Nathalie Sami
- Department of Internal Medicine, Los Angeles County-University of Southern California (LAC+USC) Medical Center, Keck School of Medicine, Los Angeles, CA, United States
| | - Frank S Fox
- Gerson Lehrman Group, New York, NY, United States
| | - Jennifer A Ligibel
- Department of Medicine, Harvard Medical School, Boston, MA, United States.,Division of Breast Oncology, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
| | - Christina M Dieli-Conwright
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States.,Department of Medicine, Harvard Medical School, Boston, MA, United States
| |
Collapse
|
15
|
Jia T, Liu Y, Fan Y, Wang L, Jiang E. Association of Healthy Diet and Physical Activity With Breast Cancer: Lifestyle Interventions and Oncology Education. Front Public Health 2022; 10:797794. [PMID: 35400043 PMCID: PMC8984028 DOI: 10.3389/fpubh.2022.797794] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 02/22/2022] [Indexed: 11/13/2022] Open
Abstract
Global cancer statistics suggest that breast cancer (BC) is the most diagnosed cancer in women, with an estimated 2. 3 million new cases reported in 2020. Observational evidence shows a clear link between prevention and development of invasive BC and lifestyle-based interventions such as a healthy diet and physical activity. The recent findings reveal that even minimal amounts of daily exercise and a healthy diet reduced the risk of BC, mitigated the side effects of cancer treatment, and stopped the recurrence of cancer in the survivors. Despite the myriad benefits, the implementation of these lifestyle interventions in at-risk and survivor populations has been limited to date. Given the need to disseminate information about the role of physical activity and nutrition in BC reduction, the review aimed to present the recent scientific outreach and update on associations between the lifestyle interventions and BC outcomes to narrow the gap and strengthen the understanding more clearly. This review covers more direct, detailed, and updated scientific literature to respond to frequently asked questions related to the daily lifestyle-based interventions and their impact on BC risk and survivors. This review also highlights the importance of the oncology provider's job and how oncology education can reduce the BC burden.
Collapse
Affiliation(s)
- Tiantian Jia
- Institute of Nursing and Health, Henan University, Kaifeng, China
| | - Yufeng Liu
- Institute of Nursing and Health, Henan University, Kaifeng, China
| | - Yuanyuan Fan
- School of Life Sciences, Henan University, Kaifeng, China
| | - Lintao Wang
- Department of Neurology, The First Affiliated Hospital of Henan University, Kaifeng, China
| | - Enshe Jiang
- Institute of Nursing and Health, Henan University, Kaifeng, China
- *Correspondence: Enshe Jiang
| |
Collapse
|
16
|
Kang DW, Wilson RL, Christopher CN, Normann AJ, Barnes O, Lesansee JD, Choi G, Dieli-Conwright CM. Exercise Cardio-Oncology: Exercise as a Potential Therapeutic Modality in the Management of Anthracycline-Induced Cardiotoxicity. Front Cardiovasc Med 2022; 8:805735. [PMID: 35097024 PMCID: PMC8796963 DOI: 10.3389/fcvm.2021.805735] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 12/23/2021] [Indexed: 12/19/2022] Open
Abstract
Anthracyclines are one of the most effective chemotherapy agents and have revolutionized cancer therapy. However, anthracyclines can induce cardiac injuries through ‘multiple-hits', a series of cardiovascular insults coupled with lifestyle risk factors, which increase the risk of developing short- and long-term cardiac dysfunction and cardiovascular disease that potentially lead to premature mortality following cancer remission. Therefore, the management of anthracycline-induced cardiotoxicity is a serious unmet clinical need. Exercise therapy, as a non-pharmacological intervention, stimulates numerous biochemical and physiologic adaptations, including cardioprotective effects, through the cardiovascular system and cardiac muscles, where exercise has been proposed to be an effective clinical approach that can protect or reverse the cardiotoxicity from anthracyclines. Many preclinical and clinical trials demonstrate the potential impacts of exercise on cardiotoxicity; however, the underlying mechanisms as well as how to implement exercise in clinical settings to improve or protect against long-term cardiovascular disease outcomes are not clearly defined. In this review, we summarize the current evidence in the field of “exercise cardio-oncology” and emphasize the utilization of exercise to prevent and manage anthracycline-induced cardiotoxicities across high-risk and vulnerable populations diagnosed with cancer.
Collapse
Affiliation(s)
- Dong-Woo Kang
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
- Department of Medicine, Harvard Medical School, Boston, MA, United States
| | - Rebekah L. Wilson
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
- Department of Medicine, Harvard Medical School, Boston, MA, United States
| | - Cami N. Christopher
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
- Department of Epidemiology, School of Public Health, Boston University, Boston, MA, United States
| | - Amber J. Normann
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
- Department of Health Sciences, Boston University, Boston, MA, United States
| | - Oscar Barnes
- Green Templeton College, University of Oxford, Oxford, United Kingdom
| | - Jordan D. Lesansee
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, United States
| | | | - Christina M. Dieli-Conwright
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
- Department of Medicine, Harvard Medical School, Boston, MA, United States
- *Correspondence: Christina M. Dieli-Conwright
| |
Collapse
|
17
|
Anderson PM, Thomas SM, Sartoski S, Scott JG, Sobilo K, Bewley S, Salvador LK, Salazar-Abshire M. Strategies to Mitigate Chemotherapy and Radiation Toxicities That Affect Eating. Nutrients 2021; 13:nu13124397. [PMID: 34959948 PMCID: PMC8706251 DOI: 10.3390/nu13124397] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 12/06/2021] [Indexed: 01/02/2023] Open
Abstract
Background: Cancer and its therapy is commonly associated with a variety of side effects that impact eating behaviors that reduce nutritional intake. This review will outline potential causes of chemotherapy and radiation damage as well as approaches for the amelioration of the side effects of cancer during therapy. Methods: Information for clinicians, patients, and their caregivers about toxicity mitigation including nausea reduction, damage to epithelial structures such as skin and mucosa, organ toxicity, and education is reviewed. Results: How to anticipate, reduce, and prevent some toxicities encountered during chemotherapy and radiation is detailed with the goal to improve eating behaviors. Strategies for health care professionals, caregivers, and patients to consider include (a) the reduction in nausea and vomiting, (b) decreasing damage to the mucosa, (c) avoiding a catabolic state and muscle wasting (sarcopenia), and (d) developing therapeutic alliances with patients, caregivers, and oncologists. Conclusions: Although the reduction of side effects involves anticipatory guidance and proactive team effort (e.g., forward observation, electronic interactions, patient reported outcomes), toxicity reduction can be satisfying for not only the patient, but everyone involved in cancer care.
Collapse
Affiliation(s)
- Peter M. Anderson
- Pediatric Hematology/Oncology and Bone Marrow Transplant, Cleveland Clinic Children’s, Cleveland, OH 44195, USA; (S.M.T.); (S.S.); (K.S.); (S.B.)
- Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH 44195, USA;
- Correspondence: or ; Tel.: +216-445-7140 or +216-308-2706
| | - Stefanie M. Thomas
- Pediatric Hematology/Oncology and Bone Marrow Transplant, Cleveland Clinic Children’s, Cleveland, OH 44195, USA; (S.M.T.); (S.S.); (K.S.); (S.B.)
- Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH 44195, USA;
| | - Shauna Sartoski
- Pediatric Hematology/Oncology and Bone Marrow Transplant, Cleveland Clinic Children’s, Cleveland, OH 44195, USA; (S.M.T.); (S.S.); (K.S.); (S.B.)
- Department of Nursing, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Jacob G. Scott
- Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH 44195, USA;
- Department of Radiation Oncology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Kaitlin Sobilo
- Pediatric Hematology/Oncology and Bone Marrow Transplant, Cleveland Clinic Children’s, Cleveland, OH 44195, USA; (S.M.T.); (S.S.); (K.S.); (S.B.)
- Department of Nursing, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Sara Bewley
- Pediatric Hematology/Oncology and Bone Marrow Transplant, Cleveland Clinic Children’s, Cleveland, OH 44195, USA; (S.M.T.); (S.S.); (K.S.); (S.B.)
- Peds Nutritional Services, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Laura K. Salvador
- Department of Pediatrics, MD Anderson Cancer Center, Houston, TX 77030, USA; (L.K.S.); (M.S.-A.)
| | - Maritza Salazar-Abshire
- Department of Pediatrics, MD Anderson Cancer Center, Houston, TX 77030, USA; (L.K.S.); (M.S.-A.)
- Department of Nursing Education, MD Anderson Cancer Center, Houston, TX 77030, USA
| |
Collapse
|