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Aumaitre A, Gagnayre R, Foucaut AM. Determinants and factors of physical activity and sedentary behaviors among post-treatment breast, colorectal, lung, and prostate cancer survivors living in France: Results from the DEFACTO study first phase. PATIENT EDUCATION AND COUNSELING 2024; 124:108273. [PMID: 38598865 DOI: 10.1016/j.pec.2024.108273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 03/18/2024] [Accepted: 03/21/2024] [Indexed: 04/12/2024]
Abstract
OBJECTIVE This study aimed to investigate the facilitators and barriers to adopting an active lifestyle among post-treatment cancer survivors in France. METHODS Breast, colorectal, lung, and prostate cancer survivors were recruited. Participants completed a questionnaire covering sociodemographic and clinical factors, physical activity (PA) experiences, variables from the Transtheoretical model, types of motivation, knowledge of PA benefits, barriers to PA, and quality of life. We categorized participants into 4 profiles combining PA level and sedentary behaviors. RESULTS One hundred and seventy-five participants were included. Ordinal logistic regression revealed that the active lifestyle of cancer survivors is influenced by their professional situation (OR, 3.99; 95%CI, 1.76-9.10 and OR, 3.14; 95%CI, 1.45-6.77), the use of self-liberation (OR, 0.41; 95%CI, 0.20-0.82), helping relationships processes of change (OR, 2.45; 95%CI, 1.20-5.00), and quality of life (OR, 1.11; 95%CI, 1.04-1.18). CONCLUSIONS Identifying the factors associated with PA and sedentary behavior among cancer survivors in France will facilitate the adaptation of programs according to a whole-person approach. Semi-structured interviews will further enhance insights in this mixed-methods study. PRACTICE IMPLICATIONS Interventions aimed at promoting an active lifestyle among cancer survivors should be customized based on professional situation, the utilization of experiential behavior change processes, and perceived quality of life.
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Affiliation(s)
- Albane Aumaitre
- Sorbonne Paris North University, Health Educations and Promotion Laboratory, LEPS, UR 3412, F-93430 Villetaneuse, France.
| | - Rémi Gagnayre
- Sorbonne Paris North University, Health Educations and Promotion Laboratory, LEPS, UR 3412, F-93430 Villetaneuse, France
| | - Aude-Marie Foucaut
- Sorbonne Paris North University, Health Educations and Promotion Laboratory, LEPS, UR 3412, F-93430 Villetaneuse, France; Sports Science department, Sorbonne Paris North University, Bobigny, France
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Noriega Esquives BS, St George SM, Moreno PI, Lee TK, Munoz E, Lad T, Pollack A, Hollowell CMP, Ramirez AG, Penedo FJ. A latent class analysis of health behavior changes after cancer diagnosis among Hispanic/Latino cancer survivors. J Cancer Surviv 2024; 18:739-749. [PMID: 36459380 PMCID: PMC10441686 DOI: 10.1007/s11764-022-01300-1] [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: 09/14/2022] [Accepted: 11/10/2022] [Indexed: 12/03/2022]
Abstract
PURPOSE We aimed to identify subgroups of Hispanic/Latino (H/L) cancer survivors with distinct health behavior patterns and their associated sociodemographic, medical, and psychosocial characteristics. METHODS Baseline data were used from a randomized clinical trial evaluating the efficacy of an enhanced patient navigation intervention in H/L cancer survivors. Participants (n = 278) completed the Lifestyle Behavior Scale and validated questionnaires on health-related quality of life (HRQOL), supportive care needs, distress, and satisfaction with cancer care. Latent class analysis was used to determine the latent classes and associated characteristics. RESULTS Three latent classes emerged: class 1 (survivors who increased health behaviors [e.g., exercising and eating healthy] since diagnosis); class 2 (no changes in health behaviors since diagnosis); and class 3 (a "mixed class," with a higher or lower engagement across various health behaviors since diagnosis). Participants in class 1 were significantly more educated and less likely to be foreign born. Participants in class 2 were significantly older and more likely to have prostate cancer. H/L cancer survivors in class 3 had a significantly lower income, were less educated, and reported greater unmet supportive care needs, more distress, and poorer HRQOL. CONCLUSIONS Survivors who report engaging in health behaviors less frequently since diagnosis may be experiencing psychosocial challenges and health disparities. IMPLICATIONS FOR CANCER SURVIVORS Hispanic/Latino cancer survivors may benefit from screening for social determinants of health and mental health needs, prompt referral to supportive care services, community resources, and public services, and participating in culturally informed psychosocial interventions to address their unique needs.
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Affiliation(s)
| | - Sara M St George
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, USA
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, USA
| | - Patricia I Moreno
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, USA
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, USA
| | - Tae Kyoung Lee
- Department of Child Psychology and Education, Sungkyunkwan University, Seoul, South Korea
| | - Edgar Munoz
- Institute for Health Promotion Research, UT Health San Antonio, San Antonio, USA
| | - Thomas Lad
- Department of Oncology, Cook County Health and Hospital Systems, Chicago, USA
| | - Alan Pollack
- Department of Radiation Oncology, University of Miami Miller School of Medicine, Miami, USA
| | | | - Amelie G Ramirez
- Institute for Health Promotion Research, UT Health San Antonio, San Antonio, USA
| | - Frank J Penedo
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, USA.
- Department of Psychology, University of Miami, Coral Gables, USA.
- Department of Medicine, University of Miami Miller School of Medicine, Miami, USA.
- University of Miami Don Soffer Clinical Research Center, 1120 NW 14Th Street, 15th Floor, Miami, FL, 33136, USA.
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Calderon C, Gustems M, Obispo B, García-García T, Hernández R, Fernández-Montes A, Jiménez-Fonseca P. The Mediating Role of Exercise in Depression and Fatigue in Patients with Advanced Cancer. Curr Oncol 2024; 31:3006-3016. [PMID: 38920713 PMCID: PMC11203259 DOI: 10.3390/curroncol31060229] [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: 04/09/2024] [Revised: 05/14/2024] [Accepted: 05/23/2024] [Indexed: 06/27/2024] Open
Abstract
This study explored the interconnections between sociodemographic elements, depression, fatigue, and exercise in patients suffering from incurable neoplasm, particularly emphasizing the mediating influence of exercise on the relationship between depression and fatigue This was a prospective, multicenter, observational study involving 15 hospitals across Spain. After three months of systemic cancer treatment, participants completed the Brief Symptom Inventory (BSI), the Godin-Shephard Leisure-Time Physical Activity Questionnaire (GSLTPAQ) and the Fatigue Assessment Scale (FAS) to measure levels of depression, fatigue, and exercise, respectively. A total of 616 subjects participated in this study. Activity levels differed markedly according to educational attainment, marital, and work status. There was a negative correlation between physical activity and depression, and a positive correlation between depression and fatigue (β = -0.18, and β = 0.46, respectively). Additionally, physical activity inversely influenced fatigue levels (β = 0.21). Physical activity served as a partial intermediary in the link between depression and fatigue among patients with advanced, unresectable cancer. Healthcare providers are urged to consider both the physical and emotional dimensions of cancer treatment, implementing physical activity programs to enhance overall patient quality of life and mental health.
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Affiliation(s)
- Caterina Calderon
- Faculty of Psychology, University of Barcelona, 08007 Barcelona, Spain
| | - Marina Gustems
- Faculty of Psychology, University of Barcelona, 08007 Barcelona, Spain
| | - Berta Obispo
- Department of Medical Oncology, Hospital Infanta Leonor, 28031 Madrid, Spain
| | - Teresa García-García
- Department of Medical Oncology, Hospital General Universitario Santa Lucia, 30202 Cartagena, Spain
| | - Raquel Hernández
- Department of Medical Oncology, Hospital Universitario de Canarias, 38320 Tenerife, Spain
| | - Ana Fernández-Montes
- Department of Medical Oncology, Complejo Hospitalario Universitario de Ourense, 32005 Ourense, Spain
| | - Paula Jiménez-Fonseca
- Department of Medical Oncology, Hospital Universitario Central de Asturias, Instituto de Investigación del Principado de Asturias, ISPA, 33011 Oviedo, Spain
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Land SR, Baker L, Twesten J, Reyes-Guzman CM, Kaufman AR. Smoking Cessation and Tobacco-related Risk Perceptions among People with and without a Diagnosis of Cancer. Cancer Epidemiol Biomarkers Prev 2023; 32:266-273. [PMID: 36480285 PMCID: PMC9905258 DOI: 10.1158/1055-9965.epi-22-0651] [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: 06/03/2022] [Revised: 08/31/2022] [Accepted: 12/01/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Little is known about how cancer diagnosis and tobacco-related risk perceptions are associated with smoking behavior. METHODS We used data from Waves (W) 1-3 (2013-2016) of the Population Assessment of Tobacco and Health Study to analyze longitudinal smoking behavior among adults who were current smokers and not previously diagnosed with cancer at baseline (W1; N = 7,829). The outcome was smoking cessation as of follow-up (W3). Explanatory variables were sociodemographics, other tobacco product use, adult at first cigarette, tobacco dependence, cancer diagnosis after baseline, and tobacco-related risk perceptions [cigarette harm perception, worry that tobacco products will damage one's health ("worry"), belief that smoking causes cancer ("belief"), and nondaily smoking harm perception]. RESULTS Cessation was significantly associated with baseline worry (OR = 1.26; 95% confidence interval, 1.13-1.40), follow-up cigarette harm perception [OR = 2.01 (1.77-2.29)], and follow-up belief [OR = 1.40 (1.20-1.63)]. Cessation was inversely associated with follow-up (W3) worry, and this association was stronger among those without a cancer diagnosis (OR = 0.37 without cancer; OR = 0.76 among individuals diagnosed with cancer; interaction P = 0.001). CONCLUSIONS Cessation is associated with tobacco-related risk perceptions, with different perceptions contributing in unique ways. Cessation is predicted by baseline worry but is inversely associated with worry at follow-up, suggesting that perhaps cessation has alleviated worry. The latter finding was stronger among respondents not diagnosed with cancer. IMPACT Associations between cancer diagnosis, tobacco-related risk perceptions, and smoking behavior may inform the development of evidence-based smoking cessation interventions.
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Affiliation(s)
| | - Laura Baker
- The Bizzell Group, LLC, New Carrollton, Maryland
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Suzuki K, Naito T, Okayama T, Yonenaga Y, Kitagawa M, Sato R, Suzuki K, Ishii T, Mitsuhashi N, Uehara R, Shimizu A, Nishizawa T, Fuseya H. Perception of the prognostic impact of physical activity among cancer survivors: a narrative review. SPORT SCIENCES FOR HEALTH 2023. [DOI: 10.1007/s11332-022-01033-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Abstract
Purpose
Little is known about cancer survivors’ perceptions of the prognostic impact of physical activity (PA) and the association between perceptions and PA. Therefore, the present narrative review aimed to identify cancer survivors' perceptions of the prognostic impact of PA, perception barriers, and association with PA.
Methods
A literature search was performed via PubMed and Scopus with search terms including “physical activity”, “cancer survivor”, and “perception” in November 2022. Inclusion criteria were studies that investigated cancer survivors’ perceptions of the prognostic impact of PA written in English. Studies were excluded for patients undergoing cancer treatment or advanced cancer patients only.
Results
Our search identified a total of 13,080 articles, and 14 studies met the inclusion criteria. The study sample size ranged from 8 to 1003 participants. Most studies showed that cancer survivors poorly understood the prognostic impact of PA. Perception barriers were cited as a lack of advice from health care professionals (HCPs). Several studies reported a positive association between the perception of the prognostic impact of PA and actual PA.
Conclusions
This narrative review revealed that most reports showed that cancer survivors have a poor perception of the prognostic impact of PA. In addition, the lack of advice from HCPs may also be contributing to the lack of perception among cancer survivors. Therefore, to increase the amount of PA among cancer survivors, it is necessary to improve the perception of the prognostic impact of PA in both cancer survivors and HCPs.
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Land SR, Baker L, Bachand J, Twesten J, Kaufman AR, Reyes-Guzman CM. Associations of Daily Versus Nondaily Smoking, Tobacco-Related Risk Perception, and Cancer Diagnosis Among Adults in the Population Assessment of Tobacco and Health (PATH) Study. Nicotine Tob Res 2022; 24:1540-1547. [PMID: 35245943 PMCID: PMC9575975 DOI: 10.1093/ntr/ntac059] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 02/02/2022] [Accepted: 03/01/2022] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Nondaily smoking has become increasingly common among cigarette smokers. Our objective was to determine whether current daily versus nondaily smoking differed by tobacco-related risk perceptions (TRRPs), demographic factors, and cancer history. METHODS Participants were all adults in Waves 1-3 of the longitudinal cohort Population Assessment of Tobacco and Health Study who were current smokers at Wave 3 (N = 8307). The primary analysis was weighted logistic regression of daily versus nondaily smoking at Wave 3. TRRP measures were cigarette harm perception, worry that tobacco products will damage one's health, belief that smoking cigarettes causes [lung/bladder/mouth/liver] cancer, and nondaily cigarette harm perception (Likert-type scale). Other measures included demographic factors, other tobacco product use, minor at time of first cigarette, and cancer survivor status (yes/no). RESULTS Among current smokers, daily versus nondaily smoking was significantly associated with being a minor at time of first cigarette (OR = 1.54, p < .001), TRRPs (OR = 0.83, p < .001; OR = 1.40, p < .001; and OR = 1.17, p = .009 [harm perception, worry, and nondaily cigarette harm perception, respectively]), and interaction between cancer survivor status and belief that smoking causes cancer (p < .001). TRRPs among current smokers did not differ significantly between cancer survivors and respondents without a cancer history. CONCLUSIONS Respondents with lower harm perception, higher worry, and higher nondaily cigarette harm perception were more likely to be daily versus nondaily smokers. Respondents with higher belief that smoking causes cancer or who were cancer survivors were less likely to be daily (versus nondaily) smokers compared to respondents with low belief and no cancer history. IMPLICATIONS This study is unique in that it examined associations of smoking cigarettes daily versus nondaily with tobacco-related risk perceptions and cancer survivorship-comparing cancer survivors to those without a cancer history. Given the increasing prevalence of nondaily smoking as compared with daily smoking in the general population, and the prognostic significance of smoking after cancer diagnosis, these findings fill a clinically important gap in the literature and provide a foundation for further research.
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Affiliation(s)
- Stephanie R Land
- Tobacco Control Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Laura Baker
- The Bizzell Group, LLC, New Carrollton, MD, USA
| | - Jacqueline Bachand
- U.S. Department of Housing and Urban Development, Office of Policy Development and Research, Washington, DC, USA
| | | | - Annette R Kaufman
- Tobacco Control Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Carolyn M Reyes-Guzman
- Tobacco Control Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
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Knowles R, Kemp E, Miller M, Davison K, Koczwara B. Physical activity interventions in older people with cancer: A review of systematic reviews. Eur J Cancer Care (Engl) 2022; 31:e13637. [PMID: 35730689 DOI: 10.1111/ecc.13637] [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: 11/30/2021] [Revised: 03/30/2022] [Accepted: 06/06/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Whilst there has been a wealth of research on benefits of physical activity (PA) in people with cancer, with three published reviews of reviews, no review of reviews has focused on older adults (65 years or older) who may have unique biological characteristics and barriers. We summarised PA effectiveness from reviews where majority of study participants were 65 years or older. METHODS Six databases were searched for systematic reviews of randomised controlled studies (RCTs)/quasi-RCTs examining any type of PA in reviews where majority of study participants were aged 65 years or older. Two reviewers conducted the search and analysis according to PRISMA and JBI guidelines. RESULTS Fifteen reviews involving 76 different primary studies (5404 participants) were included. The majority (3827; 71%) had prostate cancer. PA was associated with benefits across multiple physical outcomes (muscle mass, functional performance, strength), improved fatigue and health service outcomes. In contrast to younger adults, there was no improvement in anxiety and mixed findings for quality of life and depression. CONCLUSION PA is associated with multiple benefits in older adults with cancer, with some differences compared to younger individuals which may reflect biological or behavioural determinants. Future research should focus on mechanisms underlying PA effectiveness and underrepresented populations.
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Affiliation(s)
- Reegan Knowles
- Survivorship and Psycho-Oncology, Flinders Cancer Research, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Emma Kemp
- Survivorship and Psycho-Oncology, Flinders Cancer Research, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Michelle Miller
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Kade Davison
- Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Bogda Koczwara
- Survivorship and Psycho-Oncology, Flinders Cancer Research, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
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Canadian Resources, Programs, and Models of Care to Support Cancer Survivors' Transition beyond Treatment: A Scoping Review. ACTA ACUST UNITED AC 2021; 28:2134-2145. [PMID: 34207635 PMCID: PMC8293069 DOI: 10.3390/curroncol28030198] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 05/27/2021] [Accepted: 06/03/2021] [Indexed: 12/01/2022]
Abstract
(1) Background: One in two Canadians will be diagnosed with cancer in their lifetime, but as a result of the progress in diagnosis and treatment, more individuals are surviving cancer than ever before. However, the impact of cancer does not end with treatment. The objectives of this review are to (1) provide a broad overview of the supportive care interventions and models of care that have been researched to support Canadian post-treatment cancer survivors; and (2) analyze how these supportive care interventions and/or care models align with the practice recommendations put forth by Cancer Care Ontario (CCO) and the Canadian Association of Psychosocial Oncology/Canadian Partnership Against Cancer (CAPO/CPAC). (2) Methods: An electronic search was completed in MEDLINE, Embase, PsycINFO, and CINAHL in January 2021. Included studies described supportive care interventions or models of care utilized by adult Canadian cancer survivors. (3) Results: Forty-two articles were included. Survivors utilized a multitude of supportive care interventions, with peer support and physical activity programs being most frequently cited. Four models of follow-up care were identified: primary care, oncology care, shared-care, and transition clinics. The supportive care interventions and models of care variably aligned with the recommendations set by CCO and CAPO/CPAC. The most commonly followed recommendation was the promotion of self-management and quality resources for patients. (4) Conclusions: Results indicate an inconsistency in access to supportive care interventions and the delivery of survivorship care for cancer survivors across Canada. Current efforts are being made to implement the recommendations by CCO and CAPO/CPAC; however, provision of these guidelines remains varied.
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Cheung DST, Takemura N, Chau PH, Ng AYM, Xu X, Lin CC. Exercise levels and preferences on exercise counselling and programming among older cancer survivors: A mixed-methods study. J Geriatr Oncol 2021; 12:1173-1180. [PMID: 33985930 DOI: 10.1016/j.jgo.2021.05.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 04/14/2021] [Accepted: 05/04/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To assess exercise levels and exercise counselling /programming preferences among older cancer survivors. MATERIALS AND METHODS A mixed-methods study design was employed. Quantitative instruments on exercise levels, exercise counselling and programming preferences, frailty status, and cancer-related symptoms were administered to 290 post-treatment older cancer survivors aged ≥65. Twelve participants with different exercise levels and different views on exercise counselling and programming were purposively selected to participate in semi-structured interviews. RESULTS Overall, 58.3% of participants did not meet the recommended exercise guidelines, and 44.1% were not engaging in any vigorous or moderate exercise. Frail survivors were less likely to meet the guidelines (aOR = 0.194, 95%CI = 0.053, 0.712) compared to their robust counterparts. However, 66.9% and 62.8% of participants expressed a definite or possible interest in receiving exercise counselling and participating in an exercise program, respectively. Particularly, survivors who are male, did not receive chemotherapy, are less educated, and have higher symptom burden were less likely to show interest. Most preferred low-intensity exercise (59.8%) and wanted to start the exercise program after treatment (68.2%), which differs from the literature on general adult survivors. The major trigger to initiate and maintain exercise behaviors was the benefits of exercise and a common barrier to exercising was lack of time. CONCLUSION Most older cancer survivors did not meet the recommended exercise guidelines, but they were open to exercise counselling and programming. Reviewing education on the benefits of exercise is especially important after treatment completion to promote healthy lifestyles.
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Affiliation(s)
| | - Naomi Takemura
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Pui Hing Chau
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Alina Yee Man Ng
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Xinyi Xu
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Chia Chin Lin
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong; School of Nursing, College of Nursing, Taipei Medical University, Taiwan; Alice Ho Miu Ling Nethersole Charity Foundation, Hong Kong
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Ibeggazene S, Turner R, Rosario D, Bourke L. Remote interventions to improve exercise behaviour in sedentary people living with and beyond cancer: a systematic review and meta-analysis. BMC Cancer 2021; 21:308. [PMID: 33761906 PMCID: PMC7987748 DOI: 10.1186/s12885-021-07989-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 03/01/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has forced many cancer services to consider a transition to a remote format of delivery that is largely untested. Accordingly, we sought to perform a systematic review of the effects of remotely delivered interventions to improve exercise behaviour in sedentary adults living with and beyond cancer. METHODS Eligible studies were randomised controlled trials comparing a remotely delivered exercise intervention to a usual care comparison in sedentary people over 18 years old with a primary cancer diagnosis. Nine electronic databases were searched from inception to November 2020. RESULTS The review included three trials, totalling 186 participants. Two of the included trials incorporated prescriptions that meet current aerobic exercise recommendations, one of which also meets the guidelines for resistance exercise. No trials reported an intervention adherence of 75% or more for a set prescription that meets current exercise guidelines. CONCLUSION There is little evidence suggesting that remote exercise interventions promote exercise behaviours or improve physical function in sedentary adults living with and beyond cancer. The development and evaluation of novel remote exercise interventions is needed to establish their usefulness for clinical practice. Given the social response to the COVID-19 pandemic, further research in this area is urgently needed.
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Affiliation(s)
- Saïd Ibeggazene
- College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Sheffield, UK.
| | - Rebecca Turner
- College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Sheffield, UK
| | - Derek Rosario
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - Liam Bourke
- College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Sheffield, UK
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Robinson A, Husband AK, Slight RD, Slight SP. Digital technology to support lifestyle and health behaviour changes in surgical patients: systematic review. BJS Open 2020; 5:6054048. [PMID: 33688953 PMCID: PMC7944850 DOI: 10.1093/bjsopen/zraa009] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 06/10/2020] [Accepted: 08/23/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Digital technologies (such as smartphone applications, activity trackers, and e-learning platforms) have supported patients with long-term conditions to change their lifestyle health behaviours. The aim of this study was to examine the effectiveness of digital technologies in supporting patients undergoing elective surgery to change their health behaviours. METHODS A systematic review was conducted of articles reporting a digital intervention supporting behaviour change in adult patients who underwent elective bariatric, oncological or orthopaedic surgery. MEDLINE, Embase, CINAHL, PsycINFO, Web of Science, and Scopus were searched from inception to March 2019 for quantitative intervention studies with a specific focus on physical activity, dietary intake, and weight loss in patients before and after surgery (PROSPERO: CRD42019127972). The Joanna Briggs Institute critical appraisal checklist was used to assess study quality. RESULTS Of 3021 citations screened, 17 studies were included comprising 4923 surgical patients; these included experimental (pre-post design, feasibility studies, and RCTs) and observational studies. Three factors were identified as effective for supporting health behaviour change in elective surgical populations: digital technology delivery, implementation, and theoretical underpinning. Six of eight studies that referred to behaviour change theories observed significant improvements in health behaviour relating to reduced weight regain, and improved lifestyle choices for physical activity and diet. Meta-analysis was not possible because of heterogeneous outcome measures. CONCLUSION Digital technologies may effectively support behavioural change in patients undergoing elective surgery.
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Affiliation(s)
- A Robinson
- School of Pharmacy, Newcastle University, Newcastle upon Tyne, UK
| | - A K Husband
- School of Pharmacy, Newcastle University, Newcastle upon Tyne, UK
| | - R D Slight
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - S P Slight
- School of Pharmacy, Newcastle University, Newcastle upon Tyne, UK.,Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
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12
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Suderman K, Dolgoy N, Yurick J, Sellar C, Nishimura K, Culos-Reed SN, Joy AA, McNeely ML. A Practical Approach to Using Integrated Knowledge Translation to Inform a Community-Based Exercise Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17113911. [PMID: 32492824 PMCID: PMC7312668 DOI: 10.3390/ijerph17113911] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 05/19/2020] [Accepted: 05/28/2020] [Indexed: 12/17/2022]
Abstract
Background: Our aim was to understand cancer survivor needs prior to, and following the Alberta Cancer Exercise (ACE) pilot randomized trial as a means to inform implementation of a province-wide cancer-specific, community-based exercise program. Methods: Questionnaires and semi-structured stakeholder engagement sessions were conducted with cancer survivors to explore preferences, barriers and facilitators/benefits at two timepoints: (1) pre-ACE: prior to initiation of the ACE pilot trial (n = 13 survivors and n = 5 caregivers); and (2) post-ACE: following participation in the ACE pilot trial (n = 20 survivors). Descriptive statistics were used to summarize quantitative data from questionnaires. Stakeholder engagement data were analyzed using a framework analysis approach. Emergent themes were then mapped to actionable outcomes. Results: Pre-ACE, survivors indicated a preference for exercise programs that were (1) supervised by exercise specialists knowledgeable about cancer, (2) included support from other health care providers, (3) were held in community locations that were easily accessible. Post-ACE, participants identified (1) a lack of exercise counseling from health care providers, (2) the need for earlier introduction of exercise in the care pathway, and (3) supported referral to exercise programming. Conclusions: An integrated knowledge translation approach identified actionable outcomes to address survivor needs related to exercise in clinical cancer and community-based contexts.
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Affiliation(s)
- Kirsten Suderman
- Department of Physical Therapy, University of Alberta, 2-50 Corbett Hall, Edmonton, AB T6G 2G4, Canada; (K.S.); (N.D.); (C.S.); (K.N.)
| | - Naomi Dolgoy
- Department of Physical Therapy, University of Alberta, 2-50 Corbett Hall, Edmonton, AB T6G 2G4, Canada; (K.S.); (N.D.); (C.S.); (K.N.)
| | - Janice Yurick
- Cross Cancer Institute, Alberta Health Services, 11560 University Avenue, Edmonton, AB T6G 1Z2, Canada; (J.Y.); (A.A.J.)
| | - Christopher Sellar
- Department of Physical Therapy, University of Alberta, 2-50 Corbett Hall, Edmonton, AB T6G 2G4, Canada; (K.S.); (N.D.); (C.S.); (K.N.)
| | - Kathryn Nishimura
- Department of Physical Therapy, University of Alberta, 2-50 Corbett Hall, Edmonton, AB T6G 2G4, Canada; (K.S.); (N.D.); (C.S.); (K.N.)
- Faculty of Kinesiology, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada;
| | - S. Nicole Culos-Reed
- Faculty of Kinesiology, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada;
| | - Anil A. Joy
- Cross Cancer Institute, Alberta Health Services, 11560 University Avenue, Edmonton, AB T6G 1Z2, Canada; (J.Y.); (A.A.J.)
| | - Margaret L. McNeely
- Department of Physical Therapy, University of Alberta, 2-50 Corbett Hall, Edmonton, AB T6G 2G4, Canada; (K.S.); (N.D.); (C.S.); (K.N.)
- Cross Cancer Institute, Alberta Health Services, 11560 University Avenue, Edmonton, AB T6G 1Z2, Canada; (J.Y.); (A.A.J.)
- Correspondence: ; Tel.: +1-780-248-1531
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Cortés-Ibáñez FO, Jaramillo-Calle DA, Vinke PC, Byambasukh O, Corpeleijn E, Sijtsma A, Eulenburg C, Vonk JM, de Bock GH. Comparison of health behaviours between cancer survivors and the general population: a cross-sectional analysis of the Lifelines cohort. J Cancer Surviv 2020; 14:377-385. [PMID: 31933151 PMCID: PMC7256022 DOI: 10.1007/s11764-020-00854-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 01/03/2020] [Indexed: 01/16/2023]
Abstract
PURPOSE To compare the differences in lifestyle behaviours between cancer survivors (CSs) and cancer-free participants in a large and representative population-based cohort. METHODS We included 115,257 adults from the Lifelines cohort. Cancer status was self-reported, and health behaviours were measured (e.g. body mass index [BMI]) or assessed by questionnaire (e.g. physical activity, smoking, alcohol consumption, sedentary behaviour and diet). The data were then categorised for logistic regression analysis, stratified and adjusted by sex and age (< 55 vs ≥ 55 years). RESULTS CSs (5473; 4.7%) were diagnosed 9 ± 8.5 years before data collection, were older (mean age 55.4 vs 44.4 years) and more often female (66.6% vs 33.4%) than the cancer-free participants. They were also more likely to be physically active and to have a better diet, and also less likely to be alcohol drinkers; but, were more likely to have a higher BMI, be former smokers and to be sedentary. After adjustment for sex and age, however, BMI was more likely to be normal, physical activity was more likely to be higher and smoking to be prevalent in CSs. Current smoking was also significantly higher among females and those aged < 55 years who were CSs than for those with no history of cancer. CONCLUSIONS In this population-based cohort, CSs have health behaviour comparable to those without a cancer diagnosis. IMPLICATIONS FOR CANCER SURVIVORS Smoking cessation strategies should target all CSs, but efforts could yield greatest benefit if they target females and those younger than 55 years.
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Affiliation(s)
- Francisco O Cortés-Ibáñez
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1 (9713 GZ), Groningen, The Netherlands.
- National Autonomous University of Mexico (UNAM), Mexico City, Mexico.
| | - Daniel A Jaramillo-Calle
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1 (9713 GZ), Groningen, The Netherlands
- IPS Universitaria, University of Antioquia, Medellin, Colombia
| | - Petra C Vinke
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1 (9713 GZ), Groningen, The Netherlands
| | - Oyuntugs Byambasukh
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1 (9713 GZ), Groningen, The Netherlands
| | - Eva Corpeleijn
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1 (9713 GZ), Groningen, The Netherlands
| | - Anna Sijtsma
- The Lifelines Cohort, University Medical Center in Groningen, Groningen, The Netherlands
| | - Christine Eulenburg
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1 (9713 GZ), Groningen, The Netherlands
| | - Judith M Vonk
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1 (9713 GZ), Groningen, The Netherlands
| | - Geertruida H de Bock
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1 (9713 GZ), Groningen, The Netherlands
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14
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Sremanakova J, Jones D, Cooke R, Burden S. Exploring Views of Healthcare Professionals, Researchers, and People Living with and beyond Colorectal Cancer on a Healthy-Eating and Active Lifestyle Resource. Nutrients 2019; 11:E2482. [PMID: 31623177 PMCID: PMC6835229 DOI: 10.3390/nu11102482] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 10/03/2019] [Accepted: 10/09/2019] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND People after bowel cancer are at high risk of cancer recurrences and co-morbidities, and therefore strategies are needed to reduce these risks. One promising strategy targets modifiable lifestyle factors including diet and physical activity. However, effective, evidence-based resources in adopting new lifestyle habits are currently lacking. METHODS The Healthy-Eating and Active Lifestyle After Bowel Cancer (HEAL ABC) resource was developed incorporating behavior change theory and World Cancer Research Fund and American Institute of Cancer Research guidelines. Focus groups and telephone interviews were conducted with professionals and survivors (age ≥18 years) to obtain feedback on the resource layout, structure, and content. Recorded data were transcribed verbatim and analyzed using framework analysis. RESULTS Thirty participants evaluated the resource-19 cancer survivors and 11 professionals. Survivors' mean age was 62 years (SD 11.5), 11 (58%) were females and 8 (42%) were male. Professionals were all females and mean age was 40 years (SD 6.06). Both survivors and professionals evaluated the resource as useful and provided suggestions for improvements. CONCLUSIONS HEAL ABC is an evidence-based resource designed to aid cancer survivors in translating their motivation into action. It was valued positively by both survivors and healthcare professionals and viewed as filling a gap in post-treatment advice.
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Affiliation(s)
- Jana Sremanakova
- School of Health Sciences, University of Manchester, Oxford Road, Manchester M13 9PL, UK.
| | - Debra Jones
- School of Health Sciences, University of Manchester, Oxford Road, Manchester M13 9PL, UK.
| | - Richard Cooke
- Department of Psychology, University of Liverpool, Bedford Street South, Liverpool L69 7ZA, UK.
| | - Sorrel Burden
- School of Health Sciences, University of Manchester, Oxford Road, Manchester M13 9PL, UK.
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15
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Siembida EJ, Kent EE, Bellizzi KM, Smith AW. Healthcare providers' discussions of physical activity with older survivors of cancer: Potential missed opportunities for health promotion. J Geriatr Oncol 2019; 11:437-443. [PMID: 31122873 DOI: 10.1016/j.jgo.2019.05.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 04/22/2019] [Accepted: 05/09/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Physical activity (PA) promotes physical functioning and health-related quality of life in older survivors of cancer. Using a population-based sample of Medicare Advantage beneficiaries, we aimed to characterize the survivors who reported discussing PA with their healthcare provider. MATERIALS AND METHODS Data from the Surveillance, Epidemiology, and End Results (SEER) cancer registries was linked with the 2008-2014 Medicare Health Outcomes Survey (MHOS). Older survivors diagnosed with localized- or regional-stage female breast, prostate, or colorectal cancer ≥24 months prior to survey and had visited a healthcare provider in the previous year were included in the multiple logistic regression model. Best-fitting models were identified using the Hosmer and Lemeshow Goodness-of-Fit test. RESULTS The final sample (N = 5630) included 3006 survivors who reported discussing PA and 2624 survivors who did not report discussing PA. Older survivors of cancer were significantly more likely to report discussing PA if they had a history of cardiovascular disease (p < .001), diabetes (p < .001), or musculoskeletal disease (p < .001); had a history of fall(s) in the previous twelve months (p = .003); or were obese (p < .001). DISCUSSION PA is an important aspect of the management of cancer, other comorbid conditions, and maintenance of physical functioning in older adulthood. The results suggest that PA discussions are not occurring consistently across survivors, and key opportunities for health promotion are being missed. Future work should identify ways to encourage these conversations in all cancer follow-up appointments.
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Affiliation(s)
- Elizabeth J Siembida
- Outcomes Research Branch, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20850, USA.
| | - Erin E Kent
- Outcomes Research Branch, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20850, USA
| | - Keith M Bellizzi
- Department of Human Development and Family Studies, University of Connecticut, 348 Mansfield Road, U-1058, Storrs, CT 06269, USA
| | - Ashley Wilder Smith
- Outcomes Research Branch, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20850, USA
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16
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Liu SY, Lu L, Pringle D, Mahler M, Niu C, Charow R, Tiessen K, Lam C, Halytskyy O, Naik H, Hon H, Irwin M, Pat V, Gonos C, Chan CWT, Villeneuve J, Shani RM, Chaudhry M, Brown MC, Selby P, Howell D, Xu W, Alibhai SMH, Jones JM, Liu G, Eng L. Impact of immigration status on health behaviors and perceptions in cancer survivors. Cancer Med 2019; 8:2623-2635. [PMID: 30897287 PMCID: PMC6537043 DOI: 10.1002/cam4.2079] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 01/29/2019] [Accepted: 02/13/2019] [Indexed: 11/20/2022] Open
Abstract
Background Health behaviors including smoking cessation, physical activity (PA), and alcohol moderation are key aspects of cancer survivorship. Immigrants may have unique survivorship needs. We evaluated whether immigrant cancer survivors had health behaviors and perceptions that were distinct from native‐born cancer survivors. Methods Adult cancer patients from Princess Margaret Cancer Centre were surveyed on their smoking, PA, and alcohol habits and perceptions of the effects of these behaviors on quality of life (QoL), 5‐year survival, and fatigue. Multivariable models evaluated the association of immigration status and region‐of‐origin on behaviors and perceptions. Results Of the 784 patients, 39% self‐identified as immigrants. Median time of survey was 24 months after histological diagnosis. At baseline, immigrants had trends toward not meeting Canadian PA guidelines or being ever‐drinkers; patients from non‐Western countries were less likely to smoke (aORcurrent = 0.46, aORex‐smoker = 0.47, P = 0.02), drink alcohol (aORcurrent = 0.22, aORex‐drinker = 0.52, P < 0.001), or meet PA guidelines (aOR = 0.44, P = 0.006). Among immigrants, remote immigrants (migrated ≥40 years ago) were more likely to be consuming alcohol at diagnosis (aOR = 5.70, P < 0.001) compared to recent immigrants. Compared to nonimmigrants, immigrants were less likely to perceive smoking as harmful on QoL (aOR = 0.58, P = 0.008) and survival (aOR = 0.56, P = 0.002), and less likely to perceive that PA improved fatigue (aOR = 0.62, P = 0.04) and survival (aOR = 0.64, P = 0.08). Conclusions Immigrants had different patterns of health behaviors than nonimmigrants. Immigrants were less likely to perceive continued smoking as harmful and were less likely to be aware of PA benefits. Culturally tailored counselling may be required for immigrants who smoke or are physically sedentary at diagnosis.
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Affiliation(s)
- Sophia Y Liu
- Division of Medical Oncology and Hematology, Department of Medicine, Princess Margaret Hospital/University Health Network and University of Toronto, Toronto, ON, Canada
| | - Lin Lu
- Department of Biostatistics, Princess Margaret Cancer Centre/University Health Network and University of Toronto, Toronto, ON, Canada
| | - Dan Pringle
- Ontario Cancer Institute, Toronto, ON, Canada
| | - Mary Mahler
- Ontario Cancer Institute, Toronto, ON, Canada
| | - Chongya Niu
- Ontario Cancer Institute, Toronto, ON, Canada
| | | | | | | | | | - Hiten Naik
- Ontario Cancer Institute, Toronto, ON, Canada
| | | | | | - Vivien Pat
- Ontario Cancer Institute, Toronto, ON, Canada
| | | | | | | | | | - Maha Chaudhry
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | | | - Peter Selby
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada.,Departments of Family and Community Medicine and Psychiatry, University of Toronto, Toronto, ON, Canada
| | | | - Wei Xu
- Department of Biostatistics, Princess Margaret Cancer Centre/University Health Network and University of Toronto, Toronto, ON, Canada.,Ontario Cancer Institute, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Shabbir M H Alibhai
- Department of Medicine, University Health Network and University of Toronto, Toronto, ON, Canada
| | - Jennifer M Jones
- Ontario Cancer Institute, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Cancer Rehabilitation and Survivorship Program, Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Geoffrey Liu
- Division of Medical Oncology and Hematology, Department of Medicine, Princess Margaret Hospital/University Health Network and University of Toronto, Toronto, ON, Canada.,Department of Biostatistics, Princess Margaret Cancer Centre/University Health Network and University of Toronto, Toronto, ON, Canada.,Ontario Cancer Institute, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Lawson Eng
- Division of Medical Oncology and Hematology, Department of Medicine, Princess Margaret Hospital/University Health Network and University of Toronto, Toronto, ON, Canada.,Ontario Cancer Institute, Toronto, ON, Canada.,Department of Medicine, University Health Network and University of Toronto, Toronto, ON, Canada
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17
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Alton D, Eng L, Lu L, Song Y, Su J, Farzanfar D, Mohan R, Krys O, Mattina K, Harper C, Liu S, Yoannidis T, Milne R, Brown MC, Vennettilli A, Hope AJ, Howell D, Jones JM, Selby P, Xu W, Goldstein DP, Liu G, Giuliani ME. Perceptions of Continued Smoking and Smoking Cessation Among Patients With Cancer. J Oncol Pract 2018; 14:e269-e279. [PMID: 29676948 DOI: 10.1200/jop.17.00029] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Continued smoking after a cancer diagnosis leads to poorer treatment outcomes, survival, and quality of life. We evaluated the perceptions of the effects of continued smoking on quality of life, survival, and fatigue among patients with cancer after a cancer diagnosis and the effects of these perceptions on smoking cessation. PATIENTS AND METHODS Patients with cancer from all disease subsites from Princess Margaret Cancer Centre (Toronto, Ontario) were surveyed between April 2014 and May 2016 for sociodemographic variables, smoking history, and perceptions of continued smoking on quality of life, survival, and fatigue. Multivariable regression models evaluated the association between patients' perceptions and smoking cessation and the factors influencing patients' perceptions of smoking. RESULTS Among 1,121 patients, 277 (23%) were smoking cigarettes up to 1 year before diagnosis, and 54% subsequently quit; 23% had lung cancer, and 27% had head and neck cancers. The majority felt that continued smoking after a cancer diagnosis negatively affected quality of life (83%), survival (86%), and fatigue (82%). Current smokers during the peridiagnosis period were less likely to perceive that continued smoking was harmful when compared with ex-smokers and never-smokers ( P < .01). Among current smokers, perceiving that smoking negatively affected quality of life (adjusted odds ratio [aOR], 2.68 [95% CI, 1.26 to 5.72]; P = .011), survival (aOR, 5.00 [95% CI, 2.19 to 11.43]; P < .001), and fatigue (aOR, 3.57 [95% CI, 1.69 to 7.54]; P < .001) were each strongly associated with smoking cessation. Among all patients, those with a greater smoking history were less likely to believe that smoking was harmful in terms of quality of life (aOR, 0.98 [95% CI, 0.98 to 0.99]; P < .001), survival (aOR, 0.98 [95% CI, 0.98 to 0.99]; P < .001), and fatigue (aOR, 0.99 [95% CI, 0.98 to 0.99]; P < .001). CONCLUSION The perceptions of continued smoking after a cancer diagnosis among patients with cancer are strongly associated with smoking cessation. Counseling about the harms of continued smoking in patients with cancer, and in particular among those who have lower risk perceptions, should be considered when developing a smoking cessation program.
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Affiliation(s)
- Devon Alton
- University of Toronto; Ontario Cancer Institute; and Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
| | - Lawson Eng
- University of Toronto; Ontario Cancer Institute; and Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
| | - Lin Lu
- University of Toronto; Ontario Cancer Institute; and Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
| | - Yuyao Song
- University of Toronto; Ontario Cancer Institute; and Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
| | - Jie Su
- University of Toronto; Ontario Cancer Institute; and Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
| | - Delaram Farzanfar
- University of Toronto; Ontario Cancer Institute; and Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
| | - Rahul Mohan
- University of Toronto; Ontario Cancer Institute; and Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
| | - Olivia Krys
- University of Toronto; Ontario Cancer Institute; and Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
| | - Katie Mattina
- University of Toronto; Ontario Cancer Institute; and Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
| | - Christopher Harper
- University of Toronto; Ontario Cancer Institute; and Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
| | - Sophia Liu
- University of Toronto; Ontario Cancer Institute; and Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
| | - Tom Yoannidis
- University of Toronto; Ontario Cancer Institute; and Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
| | - Robin Milne
- University of Toronto; Ontario Cancer Institute; and Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
| | - M Catherine Brown
- University of Toronto; Ontario Cancer Institute; and Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
| | - Ashlee Vennettilli
- University of Toronto; Ontario Cancer Institute; and Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
| | - Andrew J Hope
- University of Toronto; Ontario Cancer Institute; and Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
| | - Doris Howell
- University of Toronto; Ontario Cancer Institute; and Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
| | - Jennifer M Jones
- University of Toronto; Ontario Cancer Institute; and Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
| | - Peter Selby
- University of Toronto; Ontario Cancer Institute; and Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
| | - Wei Xu
- University of Toronto; Ontario Cancer Institute; and Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
| | - David P Goldstein
- University of Toronto; Ontario Cancer Institute; and Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
| | - Geoffrey Liu
- University of Toronto; Ontario Cancer Institute; and Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
| | - Meredith E Giuliani
- University of Toronto; Ontario Cancer Institute; and Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
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18
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Demark-Wahnefried W, Schmitz KH, Alfano CM, Bail JR, Goodwin PJ, Thomson CA, Bradley DW, Courneya KS, Befort CA, Denlinger CS, Ligibel JA, Dietz WH, Stolley MR, Irwin ML, Bamman MM, Apovian CM, Pinto BM, Wolin KY, Ballard RM, Dannenberg AJ, Eakin EG, Longjohn MM, Raffa SD, Adams-Campbell LL, Buzaglo JS, Nass SJ, Massetti GM, Balogh EP, Kraft ES, Parekh AK, Sanghavi DM, Morris GS, Basen-Engquist K. Weight management and physical activity throughout the cancer care continuum. CA Cancer J Clin 2018; 68:64-89. [PMID: 29165798 PMCID: PMC5766382 DOI: 10.3322/caac.21441] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 10/10/2017] [Accepted: 10/11/2017] [Indexed: 12/20/2022] Open
Abstract
Mounting evidence suggests that weight management and physical activity (PA) improve overall health and well being, and reduce the risk of morbidity and mortality among cancer survivors. Although many opportunities exist to include weight management and PA in routine cancer care, several barriers remain. This review summarizes key topics addressed in a recent National Academies of Science, Engineering, and Medicine workshop entitled, "Incorporating Weight Management and Physical Activity Throughout the Cancer Care Continuum." Discussions related to body weight and PA among cancer survivors included: 1) current knowledge and gaps related to health outcomes; 2) effective intervention approaches; 3) addressing the needs of diverse populations of cancer survivors; 4) opportunities and challenges of workforce, care coordination, and technologies for program implementation; 5) models of care; and 6) program coverage. While more discoveries are still needed for the provision of optimal weight-management and PA programs for cancer survivors, obesity and inactivity currently jeopardize their overall health and quality of life. Actionable future directions are presented for research; practice and policy changes required to assure the availability of effective, affordable, and feasible weight management; and PA services for all cancer survivors as a part of their routine cancer care. CA Cancer J Clin 2018;68:64-89. © 2017 American Cancer Society.
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Affiliation(s)
| | - Kathryn H Schmitz
- Professor of Public Health Sciences, Penn State College of Medicine, Hershey, PA
| | - Catherine M Alfano
- Vice President, Survivorship, American Cancer Society, Inc., Washington, DC
| | - Jennifer R Bail
- Post-Doctoral Fellow, Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL
| | - Pamela J Goodwin
- Professor of Medicine, Mount Sinai Hospital, Lunenfeld-Tanenbaum Research Institute at the University of Toronto, Toronto, Ontario, Canada
| | - Cynthia A Thomson
- Professor of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ
| | - Don W Bradley
- Associate Consulting Professor, Community and Family Medicine, Duke School of Medicine, Durham, NC
| | - Kerry S Courneya
- Professor of Physical Education and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Christie A Befort
- Associate Professor of Preventive Medicine, University of Kansas Medical Center, Kansas City, KS
| | - Crystal S Denlinger
- Associate Professor of Hematology/Oncology, Fox Chase Cancer Center, Philadelphia, PA
| | | | - William H Dietz
- Chair, Redstone Global Center for Prevention and Wellness, George Washington University, Washington, DC
| | | | - Melinda L Irwin
- Professor of Epidemiology, Yale School of Public Health, New Haven, CT
| | - Marcas M Bamman
- Professor of Cell Developmental and Integrative Biology, University of Alabama at Birmingham, Birmingham, AL
| | | | | | | | - Rachel M Ballard
- Director, Prevention Research Coordination, Office of Disease Prevention, Office of the Director, National Institutes of Health, Bethesda, MD
| | | | - Elizabeth G Eakin
- Professor and Director, Cancer Prevention Research Centre, School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Matt M Longjohn
- Vice President and National Health Officer, YMCA of the USA, Chicago, IL
| | - Susan D Raffa
- National Program Director for Weight Management, Veterans Health Administration, Durham, NC
| | | | - Joanne S Buzaglo
- Senior Vice President, Research and Training Institute, Cancer Support Community, Philadelphia, PA
| | - Sharyl J Nass
- Director, National Cancer Policy Forum and Board on Health Care Services, Health and Medicine Division, National Academies of Science, Engineering, and Medicine, Washington, DC
| | - Greta M Massetti
- Associate Director for Science, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA
| | - Erin P Balogh
- Senior Program Officer, National Cancer Policy Forum, Health and Medicine Division, National Academies of Science, Engineering, and Medicine, Washington, DC
| | | | - Anand K Parekh
- Chief Medical Advisor, Bipartisan Policy Center, Washington, DC
| | - Darshak M Sanghavi
- Chief Medical Officer, Senior Vice President, Translation, Optum Labs, Cambridge, MA
| | | | - Karen Basen-Engquist
- Professor of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX
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19
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Ganesh V, Zaki P, Chan S, Turner A, Bristow B, Di Prospero L, Gibson L, DeAngelis C, Chow E. Adverse Health Outcomes Associated with Postdiagnosis Smoking in Prostate Cancer Patients: A Literature Review. J Med Imaging Radiat Sci 2017; 48:103-110. [PMID: 31047202 DOI: 10.1016/j.jmir.2016.11.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2016] [Revised: 11/23/2016] [Accepted: 11/23/2016] [Indexed: 11/28/2022]
Abstract
This literature review presents what is currently known about the association between postdiagnosis smoking and adverse health outcomes in prostate cancer. A literature search was conducted using Ovid Embase and Ovid MEDLINE. Information from 36 studies was summarized. There is strong evidence across the included studies of higher overall mortality and biochemical recurrence in current smokers diagnosed with prostate cancer. In addition, enhanced adverse effects following surgery, radiation, and hormone therapy have also been identified in current smokers of this population.
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Affiliation(s)
- Vithusha Ganesh
- Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Pearl Zaki
- Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Stephanie Chan
- Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Angela Turner
- Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Bonnie Bristow
- Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Lisa Di Prospero
- Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Leslie Gibson
- Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Carlo DeAngelis
- Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Edward Chow
- Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada.
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20
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Kanera IM, Willems RA, Bolman CAW, Mesters I, Verboon P, Lechner L. Long-term effects of a web-based cancer aftercare intervention on moderate physical activity and vegetable consumption among early cancer survivors: a randomized controlled trial. Int J Behav Nutr Phys Act 2017; 14:19. [PMID: 28187725 PMCID: PMC5303303 DOI: 10.1186/s12966-017-0474-2] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2016] [Accepted: 01/31/2017] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND The number of cancer survivors is growing. Negative physical and psychosocial consequences of cancer treatment can occur during survivorship. Following healthy lifestyle recommendations is beneficial to increase quality of life and to reduce the risk of cancer recurrence and comorbidities. To meet individual needs, web-based interventions can supply a large population of cancer survivors with easily accessible and personalized information. Evidence concerning the long-term effects of web-based cancer aftercare interventions on lifestyle outcomes is limited. The present study evaluates the 12-month effects of a fully automated web-based cancer aftercare intervention. We investigated whether the previously determined 6-month effects on moderate physical activity and vegetable intake were maintained over 12 months. Possible moderator effects of using specific intervention modules, gender, age, and education were also explored. METHOD A two-armed randomized controlled trial was conducted using online self-report questionnaires among survivors of various types of cancer (N = 462). The intervention group had access to the online intervention for 6 months, and the control group received access after 12-months. Multilevel linear regression analyses (complete cases and intention-to-treat) were conducted to explore 12- month effects. RESULTS A significant intervention effect after 12 months was found for moderate physical activity (complete cases: B = 128.475, p = .010, d = .35; intention-to-treat: B = 129.473, p = .011). Age was the only significant moderator (p = .010), with the intervention being effective among participants aged younger than 57 years (B = 256.549, p = .000, d = .59). No significant intervention effect remained for vegetable consumption after 12 months (complete cases: B = 5.860, p = .121; intention-to-treat: B = 5.560, p = .132). CONCLUSION The online cancer after care intervention is effective in increasing and maintaining moderate physical activity in the long term among early cancer survivors younger than 57 years. Short-term increases in vegetable consumption were not sustained in the long term. These findings indicate the value and potential of eHealth interventions for cancer survivors. Based on the study results, web-based self-management interventions could be recommended for younger cancer survivors (<57 years of age) as a possible method to increase physical activity. TRIAL REGISTRATION Dutch Trial Register NTR3375 . Registered 29 March 2012.
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Affiliation(s)
- Iris M. Kanera
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, P. O. Box 2960, 6401 DL Heerlen, The Netherlands
| | - Roy A. Willems
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, P. O. Box 2960, 6401 DL Heerlen, The Netherlands
| | - Catherine A. W. Bolman
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, P. O. Box 2960, 6401 DL Heerlen, The Netherlands
| | - Ilse Mesters
- Department of Epidemiology, Optimizing Patient Care, Care and Public Health Research Institute, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Peter Verboon
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, P. O. Box 2960, 6401 DL Heerlen, The Netherlands
| | - Lilian Lechner
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, P. O. Box 2960, 6401 DL Heerlen, The Netherlands
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Kanera IM, Willems RA, Bolman CAW, Mesters I, Zambon V, Gijsen BC, Lechner L. Use and Appreciation of a Tailored Self-Management eHealth Intervention for Early Cancer Survivors: Process Evaluation of a Randomized Controlled Trial. J Med Internet Res 2016; 18:e229. [PMID: 27554525 PMCID: PMC5013245 DOI: 10.2196/jmir.5975] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 07/11/2016] [Accepted: 07/20/2016] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND A fully automated computer-tailored Web-based self-management intervention, Kanker Nazorg Wijzer (KNW [Cancer Aftercare Guide]), was developed to support early cancer survivors to adequately cope with psychosocial complaints and to promote a healthy lifestyle. The KNW self-management training modules target the following topics: return to work, fatigue, anxiety and depression, relationships, physical activity, diet, and smoking cessation. Participants were guided to relevant modules by personalized module referral advice that was based on participants’ current complaints and identified needs. OBJECTIVE The aim of this study was to evaluate the adherence to the module referral advice, examine the KNW module use and its predictors, and describe the appreciation of the KNW and its predictors. Additionally, we explored predictors of personal relevance. METHODS This process evaluation was conducted as part of a randomized controlled trial. Early cancer survivors with various types of cancer were recruited from 21 Dutch hospitals. Data from online self-report questionnaires and logging data were analyzed from participants allocated to the intervention condition. Chi-square tests were applied to assess the adherence to the module referral advice, negative binominal regression analysis was used to identify predictors of module use, multiple linear regression analysis was applied to identify predictors of the appreciation, and ordered logistic regression analysis was conducted to explore possible predictors of perceived personal relevance. RESULTS From the respondents (N=231; mean age 55.6, SD 11.5; 79.2% female [183/231]), 98.3% (227/231) were referred to one or more KNW modules (mean 2.9, SD 1.5), and 85.7% (198/231) of participants visited at least one module (mean 2.1, SD 1.6). Significant positive associations were found between the referral to specific modules (range 1-7) and the use of corresponding modules. The likelihoods of visiting modules were higher when respondents were referred to those modules by the module referral advice. Predictors of visiting a higher number of modules were a higher number of referrals by the module referral advice (β=.136, P=.009), and having a partner was significantly related with a lower number of modules used (β=-.256, P=.044). Overall appreciation was high (mean 7.5, SD 1.2; scale 1-10) and was significantly predicted by a higher perceived personal relevance (β=.623, P=.000). None of the demographic and cancer-related characteristics significantly predicted the perceived personal relevance. CONCLUSIONS The KNW in general and more specifically the KNW modules were well used and highly appreciated by early cancer survivors. Indications were found that the module referral advice might be a meaningful intervention component to guide the users in following a preferred selection of modules. These results indicate that the fully automated Web-based KNW provides personal relevant and valuable information and support for early cancer survivors. Therefore, this intervention can complement usual cancer aftercare and may serve as a first step in a stepped-care approach. TRIAL REGISTRATION Nederlands Trial Register: NTR3375; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=3375 (Archived by WebCite at http://www.webcitation.org/6jo4jO7kb).
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Affiliation(s)
- Iris Maria Kanera
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, Netherlands.
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Thong MSY, Kaptein AA, Vissers PAJ, Vreugdenhil G, van de Poll-Franse LV. Illness perceptions are associated with mortality among 1552 colorectal cancer survivors: a study from the population-based PROFILES registry. J Cancer Surviv 2016; 10:898-905. [PMID: 26995005 PMCID: PMC5018027 DOI: 10.1007/s11764-016-0536-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 03/08/2016] [Indexed: 01/13/2023]
Abstract
Purpose Cancer survivors construct perceptions of illness as a (mal)adaptive mechanism. These perceptions motivate/drive subsequent self-management behaviors toward symptoms and treatment that influence health outcomes. Negative illness perceptions have been associated with increased mortality in other chronically ill groups. However, this association is under-researched in cancer survivors. We aimed to explore the association between illness perceptions and mortality in stage I–III progression-free colorectal cancer (CRC) survivors. Methods We used data from the population-based Patient Reported Outcomes Following Initial treatment and Long Term Evaluation of Survivorship (PROFILES) registry of two CRC survivorship studies conducted in 2009 and 2010. We accessed clinical data from the Netherlands Cancer Registry, and mortality data from municipal personal records database. Follow-up was until 31 December 2014. Survivors (n = 1552) completed the Brief Illness Perception Questionnaire. Cox proportional hazard models estimated the association between illness perceptions and mortality. Results Negative illness perceptions on consequences (adjusted hazard ratio (HRadj) 1.60, 95 % confidence interval (CI) 1.14–2.25) and emotion (HRadj 1.65, 95 % CI 1.18–2.31) were associated with higher mortality, after adjusting for demographic, clinical, and lifestyle factors. Smoking and inadequate physical activity were independently associated with mortality for all Brief Illness Perception Questionnaire (BIPQ) dimensions. Conclusions Survivors’ perceptions of their illness are important as these perceptions may influence health outcomes during survivorship period. Clinical practice needs to identify and address maladaptive illness perceptions to support more adaptive self-management behaviors and enhance survivorship. Implications for cancer survivors Cancer survivors may benefit from interventions that address potentially maladaptive perceptions and encourage more adaptive self-management behaviors.
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Affiliation(s)
- Melissa S Y Thong
- Department of Medical Psychology, Academic Medical Center University of Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, Netherlands.
| | - Adrian A Kaptein
- Department of Medical Psychology, Leiden University Medical Center, Leiden, Netherlands
| | | | - Gerard Vreugdenhil
- Department of Internal Medicine, Máxima Medical Centre, Veldhoven, Netherlands
- Department of Medical Oncology, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Lonneke V van de Poll-Franse
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, Netherlands
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, Netherlands
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Abstract
OBJECTIVES This article summarizes the evolution of gero-oncology nursing and highlights key educational initiatives, clinical practice issues, and research areas to enhance care of older adults with cancer. DATA SOURCES Peer-reviewed literature, position statements, clinical practice guidelines, Web-based materials, and professional organizations' resources. CONCLUSION Globally, the older adult cancer population is rapidly growing. The care of older adults with cancer requires an understanding of their diverse needs and the intersection of cancer and aging. Despite efforts to enhance competence in gero-oncology and to develop a body of evidence, nurses and health care systems remain under-prepared to provide high-quality care for older adults with cancer. IMPLICATIONS FOR NURSING PRACTICE Nurses must take a leadership role in integrating gerontological principles into oncology settings. Working closely with interdisciplinary team members, nurses should utilize available resources and continue to build evidence through gero-oncology nursing research.
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Affiliation(s)
- Stewart M. Bond
- William F. Connell School of Nursing, 378C Maloney Hall, 140 Commonwealth Ave, Chestnut Hill, MA 02467
| | - Ashley Leak Bryant
- School of Nursing, The University of North Carolina at Chapel Hill, 401 Carrington Hall, Chapel Hill, NC 27599,
| | - Martine Puts
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Suite 130, Toronto, Ontario, Canada M5T1P8,
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Prospectively measured lifestyle factors and BMI explain differences in health-related quality of life between colorectal cancer patients with and without comorbid diabetes. Support Care Cancer 2015; 24:2591-601. [PMID: 26715295 PMCID: PMC4846693 DOI: 10.1007/s00520-015-3052-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 12/07/2015] [Indexed: 11/12/2022]
Abstract
PURPOSE This study aimed to assess the longitudinal association between lifestyle factors, body mass index (BMI), and health-related quality of life (HRQoL) among colorectal cancer patients with (CRCDM+) and without diabetes (CRCDM-). METHODS Data from a longitudinal study among CRC patients diagnosed between 2000 and 2009 were used. Clinical characteristics were retrieved from the Netherlands Cancer Registry and questionnaires were sent in 2010, 2011, and 2012 using the Patient Reported Outcomes Following Initial Treatment and Long term Evaluation of Survivorship (PROFILES) registry. Lifestyle (including moderate-to-vigorous physical activity (MVPA), smoking and alcohol use), BMI, diabetes status, and HRQoL were assessed in the questionnaire. RESULTS One thousand seven hundred thirty-nine (49 %) patients responded to ≥2 questionnaires, of whom 126 CRCDM+ and 789 CRCDM- patients were included. CRCDM+ patients had a higher BMI (29.1 ± 4.2 vs. 26.4 ± 3.7 kg/m(2)), whereas the number of alcohol users was lower (50 vs. 70 %, p value <0.0001) among CRCDM+ as compared to CRCDM- patients. Analyses adjusted for sociodemographic and cancer characteristics showed that CRCDM+ patients reported statistically significantly lower physical function (beta = -5.76; SE = 1.67), global QoL (beta = -4.31; SE = 1.48), and more symptoms of fatigue (beta = 5.38; SE = 1.95) than CRCDM- patients. However, these effects disappeared after adjustments for lifestyle factors and BMI which were all significant predictors of HRQoL. Additional adjustment for comorbidity further attenuated the main effect of DM on HRQoL. CONCLUSIONS Diabetes was not independently associated with HRQoL but deteriorated HRQoL among CRCDM+ patients seem to be explained by an unhealthier lifestyle and other comorbid conditions. Moreover, residual confounding cannot be ruled out.
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