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Latham S, Leach MJ, White VM, Webber K, Jefford M, Lisy K, Davis N, Millar JL, Evans S, Emery JD, IJzerman M, Ristevski E. Health-related quality of life in rural cancer survivors compared with their urban counterparts: a systematic review. Support Care Cancer 2024; 32:424. [PMID: 38864894 PMCID: PMC11168981 DOI: 10.1007/s00520-024-08618-9] [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: 03/04/2024] [Accepted: 05/29/2024] [Indexed: 06/13/2024]
Abstract
PURPOSE We conducted a systematic review to describe health-related quality of life (HRQOL) in rural cancer survivors (RCS), and compare HRQOL between RCS and urban cancer survivors (UCS). METHOD We searched Medline, Embase, CINAHL Plus, and PsycINFO for studies with HRQOL in adult cancer survivors living in rural, regional, remote, and urban areas, who had completed definitive primary cancer treatment, without evidence of residual disease. Where available, we used normative and clinically important values to ascribe meaning to HRQOL data. FINDINGS Fifteen studies (16 papers) were included. Most were from the US (n = 8) and reported on breast cancer survivors (n = 9). Six HRQOL instruments, collecting data across 16 domains, were used. Three instruments were specific to the survivorship phase. Normative and clinical data were available for 12 studies. Compared with normative populations, RCS had clinically worse physical HRQOL (6/12 studies), better social/family (5/7), and functional (3/6) HRQOL, and there were no differences in emotional or/mental HRQOL (9/12). In six studies with rural-urban comparator groups and normative and clinically important data, RCS and UCS had clinically worse physical (3/6 and 2/6, respectively) and better social/family (3/4 and 2/4 studies, respectively) HRQOL than normative populations. Functional HRQOL was better in RCS (2/4 studies) than UCS and normative populations. In 3/6 studies, there were no clinical differences in emotional or/mental HRQOL between RCS, UCS, and normative populations. CONCLUSION Overall, HRQOL is not clearly better or worse in RCS than UCS. Future research should include different tumor types, rural residents, and survivorship-specific HRQOL instruments.
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Affiliation(s)
- S Latham
- Department of Oncology, Monash Health, Clayton, Victoria, Australia
- Department of Oncology, Eastern Health, Box Hill, Victoria, Australia
- Medical Oncology, Alfred Health, Melbourne, Victoria, Australia
| | - M J Leach
- School of Rural Health, Monash University, Bendigo, VIC, Australia
| | - V M White
- School of Psychology, Deakin University, Melbourne, Victoria, Australia
| | - K Webber
- Department of Oncology, Monash Health, Clayton, Victoria, Australia
- School of Clinical Sciences, Monash University, Clayton, Victoria, Australia
| | - M Jefford
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, , Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
| | - K Lisy
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, , Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
| | - N Davis
- Cancer Survivor, Melbourne, Australia
| | - J L Millar
- Central Clinical School, Monash University, Melbourne, Victoria, Australia
- Radiation Oncology, Alfred Health, Melbourne, Victoria, Australia
| | - S Evans
- Victorian Cancer Registry, Cancer Council Victoria, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - J D Emery
- Department of General Practice and Primary Care, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia
- Centre for Cancer Research, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia
| | - M IJzerman
- Centre for Health Policy, Cancer Health Services Research, Melbourne School of Population and Global/Total Health, The University of Melbourne, Carlton, Victoria, Australia
| | - E Ristevski
- School of Rural Health, Monash University, 15 Sargeant Street, Warragul, VIC, 3820, Australia.
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Tagai EK, Mantia‐Smaldone GM, Belfiglio A, Chu CS, Lapitan E, Santos H, Hernandez E, Sarwer DB, Miller SM. Perceived importance of weight loss and exercise among endometrial cancer survivors with overweight or obesity: Implications for lifestyle modification interventions. Obes Sci Pract 2023; 9:661-669. [PMID: 38090692 PMCID: PMC10712408 DOI: 10.1002/osp4.701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/23/2023] [Accepted: 07/17/2023] [Indexed: 02/01/2024] Open
Abstract
Objective Type 1 endometrial cancer (EC) survivors who are overweight or obese are at increased risk of comorbidities and reduced quality of life. Lifestyle modification interventions (e.g., healthy eating, exercise) may help these women reduce excess weight and improve their quality of life. However, existing interventions have shown limited success. Guided by Self-Determination Theory, the proposed study sought to identify factors associated with perceived importance of weight loss and exercise as well as interest in lifestyle modification interventions (components of extrinsic and intrinsic motivation) among EC survivors with overweight or obesity to inform future intervention development. Methods One hundred type 1 EC survivors [body mass index (BMI) ≥ 25 kg/m2] completed a cross-sectional survey assessing sociodemographics, medical factors, exercise, risk perceptions and provider communication, quality of life, barriers to dieting and exercise, perceived importance of healthy lifestyles, and desired intervention content. Results EC survivors who were aware obesity is a risk factor for EC were significantly more likely to perceive weight loss as important and were interested in weight loss programs and receiving information about exercise (ps < 0.05). Additionally, EC survivors who reported their provider discussed the importance of a healthy weight after their diagnosis were significantly more likely to perceive exercise as important and were interested in receiving dieting information. Conclusions EC survivors expressed interest in lifestyle modification interventions. Increasing awareness about the risk of obesity and provider discussions about healthy weight during routine appointments may motivate EC survivors to engage in lifestyle modification interventions.
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Affiliation(s)
- Erin K. Tagai
- Cancer Prevention and ControlFox Chase Cancer Center/Temple University Health SystemPhiladelphiaPennsylvaniaUSA
| | - Gina M. Mantia‐Smaldone
- Division of Gynecologic OncologyFox Chase Cancer Center/Temple University Health SystemPhiladelphiaPennsylvaniaUSA
| | - Andrew Belfiglio
- Cancer Prevention and ControlFox Chase Cancer Center/Temple University Health SystemPhiladelphiaPennsylvaniaUSA
| | - Christina S. Chu
- Division of Gynecologic OncologyFox Chase Cancer Center/Temple University Health SystemPhiladelphiaPennsylvaniaUSA
| | - Emmanuel Lapitan
- Cancer Prevention and ControlFox Chase Cancer Center/Temple University Health SystemPhiladelphiaPennsylvaniaUSA
| | - Heather Santos
- Cancer Prevention and ControlFox Chase Cancer Center/Temple University Health SystemPhiladelphiaPennsylvaniaUSA
- Department of Epidemiology and BiostatisticsDornsife School of Public HealthDrexel UniversityPhiladelphiaPennsylvaniaUSA
| | - Enrique Hernandez
- Obstetrics, Gynecology, and Reproductive SciencesLewis Katz School of Medicine at Temple UniversityPhiladelphiaPennsylvaniaUSA
| | - David B. Sarwer
- College of Public HealthCenter for Obesity Research and EducationTemple UniversityPhiladelphiaPAUSA
| | - Suzanne M. Miller
- Cancer Prevention and ControlFox Chase Cancer Center/Temple University Health SystemPhiladelphiaPennsylvaniaUSA
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Edbrooke L, Khaw P, Freimund A, Carpenter D, McNally O, Joubert L, Loeliger J, Traill A, Gough K, Mileshkin L, Denehy L. ENhAncing Lifestyle Behaviors in EndometriaL CancEr (ENABLE): A Pilot Randomized Controlled Trial. Integr Cancer Ther 2022; 21:15347354211069885. [PMID: 35045735 PMCID: PMC8785429 DOI: 10.1177/15347354211069885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
PURPOSE Endometrial cancer is associated with the highest comorbid disease burden of any cancer. The aim of this trial was to assess the feasibility and safety of an allied health intervention during adjuvant treatment. METHODS A mixed-methods pilot randomized (2:1) controlled trial with concealed allocation and assessor-blinding. Eligibility criteria: adjuvant endometrial cancer treatment scheduled, disease stage I-IIIC1, ECOG 0-2 and able to perform unsupervised physical activity (PA). Participants received usual care and 8 sessions of weekly, individualized, lifestyle education (diet and PA) with behavior change and social support (intervention group), delivered predominantly by telehealth, or usual care alone. Feasibility outcomes: recruitment and consent rates, decline reasons, program acceptability, intervention adherence and retention. RESULTS 22/44 eligible patients (50%, 95%CI: 36%, 64%) were recruited over 10 months (14 intervention, 8 usual care). The recruitment rate was 2.2 patients/month (95%CI: 1.4, 3.3). Patients who declined had too much going on (7/22, 32%) or were not interested (6/22, 27%). Mean (SD) age and BMI were 63.2 years (6.8) and 31.9 kg/m2 (6.7). A majority were FIGO stage I (15/22, 68%) and received vaginal brachytherapy (14/22, 64%). Adherence was high, 11/14 (79%, 95%CI: 52%, 92%) participants attended >70% of scheduled sessions. Retention was 100% (95%CI: 85%, 100%) at 9 weeks, however completion of objective measures was impacted by COVID-19 restrictions. Telehealth and online questionnaires enabled participation. No serious adverse events occurred. CONCLUSION The intervention was acceptable to participants with high levels of adherence and retention. Trial findings will be used to design a future RCT. TRIAL REGISTRATION The trial was registered on www.anzctr.org.au (ACTRN12619000631101) 29/04/2019.
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Affiliation(s)
- Lara Edbrooke
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,The University of Melbourne, Parkville, VIC, Australia
| | - Pearly Khaw
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,The University of Melbourne, Parkville, VIC, Australia
| | - Alison Freimund
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,The University of Melbourne, Parkville, VIC, Australia
| | | | - Orla McNally
- The University of Melbourne, Parkville, VIC, Australia.,The Royal Women's Hospital, Parkville, VIC, Australia
| | - Lynette Joubert
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,The University of Melbourne, Parkville, VIC, Australia
| | | | - Anya Traill
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Karla Gough
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,The University of Melbourne, Parkville, VIC, Australia
| | - Linda Mileshkin
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,The University of Melbourne, Parkville, VIC, Australia
| | - Linda Denehy
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,The University of Melbourne, Parkville, VIC, Australia
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