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Millar MM, Edwards SL, Codden RR, Ofori-Atta BS, Herget KA, Carter ME, Kirchhoff AC, Coletta AM, Sweeney C. Physical Activity Among Utah Cancer Survivors: Analysis From a Population-Based Statewide Survey. J Phys Act Health 2024; 21:807-816. [PMID: 38866381 PMCID: PMC11290589 DOI: 10.1123/jpah.2023-0683] [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: 11/16/2023] [Revised: 04/17/2024] [Accepted: 04/18/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND Regular physical activity improves cancer survivors' health-related quality of life and physical function. We estimated the proportion of Utah cancer survivors meeting U.S. Department of Health and Human Services guidelines for weekly physical activity (aerobic plus strength exercise) and identify sociodemographic, cancer, and health-related factors associated with meeting guidelines. METHODS Survivors randomly sampled from Utah Cancer Registry records were surveyed from 2018 to 2022 to ascertain physical activity. We calculated the percent of survivors meeting guidelines and conducted logistic regression to assess predictors of meeting guidelines. Analyses were weighted to account for complex survey sample design and nonresponse and age adjusted. RESULTS Among Utah cancer survivors, 20.7% (95% CI, 18.5%-23.2%) met guidelines for both aerobic activity and strength exercise. 22.4% reported no aerobic exercise in a typical week, and 59.4% reported no strength exercise. Survivors 75 or older were less likely to meet physical activity guidelines than those under 55 (adjusted odds ratio: 0.40; 95% CI, 0.25-0.65). Survivors with a bachelor's degree or higher were more likely to meet physical activity guidelines than those without a college degree. Individuals with poorer overall health were less likely to report sufficient physical activity. Individuals treated with both chemotherapy and radiation had decreased odds of meeting guidelines compared to no treatment (adjusted odds ratio: 0.54; 95% CI, 0.29-0.99). CONCLUSIONS Most Utah cancer survivors, and particularly those who received multiple modes of adjuvant treatment, are not participating in sufficient physical activity to improve longevity and quality of life after cancer.
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Affiliation(s)
- Morgan M Millar
- Utah Cancer Registry, University of Utah School of Medicine, Salt Lake City, UT, USA
- Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Sandra L Edwards
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Rachel R Codden
- Utah Cancer Registry, University of Utah School of Medicine, Salt Lake City, UT, USA
- Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Blessing S Ofori-Atta
- Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Kimberly A Herget
- Utah Cancer Registry, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Marjorie E Carter
- Utah Cancer Registry, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Anne C Kirchhoff
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, USA
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Adriana M Coletta
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, USA
- Department of Health and Kinesiology, University of Utah College of Health, Salt Lake City, UT, USA
| | - Carol Sweeney
- Utah Cancer Registry, University of Utah School of Medicine, Salt Lake City, UT, USA
- Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, USA
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Osaki K, Fukushima T, Suzuki K, Kamimura A, Yanai S, Morishita S. Current status of research on sarcopenia in post-treatment cancer survivors in Japan:A narrative review. Fukushima J Med Sci 2024; 70:119-131. [PMID: 38925958 PMCID: PMC11330266 DOI: 10.5387/fms.23-00019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 03/13/2024] [Indexed: 06/28/2024] Open
Abstract
Sarcopenia is prevalent among 11-25% of adult cancer survivors, depending on the cancer type, although the available data on post-treatment survivors in Japan are limited. If cancer patients develop cachexia, they may experience sustained weight loss as a result, ultimately leading to sarcopenia. Conversely, some patients experience post-treatment weight gain, resulting in sarcopenic obesity. Both sarcopenia and obesity elevate the risk of cardiovascular diseases and mortality; therefore, the importance of sarcopenia prevention and management is undeniable. The Guidelines for Exercise for Cancer Survivors recommend continued physical activity. Recent studies have reported the effectiveness of multimodal interventions, combining pharmacological, nutritional, and exercise approaches, necessitating multidisciplinary care for post-treatment sarcopenia. Innovative health interventions using mobile devices have also gained attention. However, studies on sarcopenia in post-treatment cancer survivors, especially those regarding exercise interventions, remain scarce in Japan, primarily due to limited insurance coverage for such post-treatment interventions and workforce challenges. It is clear that some cancer survivors have sarcopenia, which can lead to worse survival and secondary illness. While the benefits of exercise are clear, a comprehensive approach to sarcopenia is a further challenge for the future.
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Affiliation(s)
- Keiichi Osaki
- Department of Rehabilitation, Panasonic Health Insurance Organization, Matsushita Memorial Hospital
| | | | | | - Akiho Kamimura
- Department of Rehabilitation, Panasonic Health Insurance Organization, Matsushita Memorial Hospital
| | - Saki Yanai
- Department of Rehabilitation, Panasonic Health Insurance Organization, Matsushita Memorial Hospital
| | - Shinichiro Morishita
- Department of Physical Therapy, School of Health Science, Fukushima Medical University
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Broadbent S, Buhmann R, Kriel Y, Coetzee S, Jones C, Morris M, Wright HH. Study protocol - assessing parkrun for walking rehabilitation for people living with, and beyond, cancer: acceptability, adherence, social support and physical function. BMC Sports Sci Med Rehabil 2024; 16:88. [PMID: 38641624 PMCID: PMC11027354 DOI: 10.1186/s13102-024-00882-w] [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: 10/20/2023] [Accepted: 04/15/2024] [Indexed: 04/21/2024]
Abstract
INTRODUCTION Due to a variety of barriers, the majority of cancer survivors do not do enough physical activity to meet current recommendations. This study will assess the feasibility of participation in parkrun walk-run events as a novel mode of community rehabilitation exercise. METHODS This protocol describes a single-arm intervention study with participants acting as their own controls. The study accepts adults diagnosed with any type of cancer, undergoing treatment or in remission. Participants must be able to walk and have medical clearance to exercise. A sample of 100 participants will be recruited across the Sunshine Coast over two years. Data will be collected over 9-months at 4 time points: Baseline (T1); after 4-weeks of usual daily activities and cancer management prior to parkrun participation(T2); after a 6-month parkrun intervention (T3); at 2-month follow-up (T4). The primary objectives are to assess the acceptability of, and adherence to, parkrun as rehabilitation exercise. Secondary outcomes include wellness, health-related quality of life, anxiety, depression, mood, physical function, parkrun metrics, dietary intake, and diet and exercise behaviour. CONCLUSION This study will be the first to examine the long-term effects of parkrun as a cancer rehabilitation modality with regard to physical function, psychosocial outcomes and dietary intake. TRIAL REGISTRATION Australian and New Zealand Clinical Trials Registry ACTRN12623000473662 registered 09/05/2023.Approved by UniSC Human Research Ethics Committee (A221828) and the UK parkrun Research Board. Original protocol. Authors SB, RB, HHW, MM, YK.
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Affiliation(s)
- Suzanne Broadbent
- School of Health, University of the Sunshine Coast, 4556, Sippy Downs, QLD, Australia.
| | - Robert Buhmann
- School of Health, University of the Sunshine Coast, 4556, Sippy Downs, QLD, Australia
| | - Yuri Kriel
- School of Health, University of the Sunshine Coast, 4556, Sippy Downs, QLD, Australia
| | - Sonja Coetzee
- School of Health, University of the Sunshine Coast, 4556, Sippy Downs, QLD, Australia
| | - Christian Jones
- School of Law and Society, University of the Sunshine Coast, 4556, Sippy Downs, QLD, Australia
| | - Michelle Morris
- Sunshine Coast University Private Hospital, 4575, Birtinya, QLD, Australia
| | - Hattie H Wright
- School of Health, University of the Sunshine Coast, 4556, Sippy Downs, QLD, Australia
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Huizinga F, Kieboom EAM, de Greef MHG, Walenkamp AME, Berendsen AJ, Berger MY, Brandenbarg D. Cancer survivors' experiences of a physical activity program in primary care: a qualitative study. J Cancer Surviv 2024:10.1007/s11764-024-01571-w. [PMID: 38517578 DOI: 10.1007/s11764-024-01571-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 03/15/2024] [Indexed: 03/24/2024]
Abstract
PURPOSE This study aimed to gain insight into the experiences of, and reasons for, cancer survivors participating in a primary care PA program. METHODS We interviewed 17 patients from 11 Dutch GP practices. Patients were selected by purposive sampling based on their general practice, gender, educational level, motivation for PA, and change in PA. Interviews were audio recorded, transcribed verbatim, and pseudonymized for inductive thematic analysis. RESULTS Three domains were identified with five themes: institutional domain: GP practice; program-specific domain: content sessions and PA, and activity tracker and goal setting; individual domain: experienced benefits, and personalized care needs. Participants valued the PA program because it was offered close to home, without additional costs, and by a trusted practice nurse familiar with the patients' medical background. Activity tracker use and goal setting motivated many participants but also led to demotivation and feelings of failure in others. Reported benefits included behavior change and favorable health outcomes. Many patients expressed the need to personalize psychological support and the program's timing. CONCLUSIONS Access to a PA program in a primary care setting is valued for its accessibility and experienced health benefits, but also seems to meet an unmet need for support in picking up life during cancer recovery. IMPLICATIONS FOR CANCER SURVIVORS Primary care is important for continued care of cancer survivors. An accessible PA program in this setting may fulfil a need for not only lifestyle support but also continuing life after cancer treatment.
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Affiliation(s)
- Famke Huizinga
- Department of Primary and Long-Term Care, University Medical Centre Groningen, University of Groningen, PO Box 196, FA 21, 9700 AD, Groningen, The Netherlands.
| | - Eleonora A M Kieboom
- Department of Human Movement Sciences, University Medical Centre Groningen, University of Groningen, PO Box 196, FA 23, 9700 AD, Groningen, The Netherlands
| | - Mathieu H G de Greef
- Department of Human Movement Sciences, University Medical Centre Groningen, University of Groningen, PO Box 196, FA 23, 9700 AD, Groningen, The Netherlands
| | - Annemiek M E Walenkamp
- Department of Medical Oncology, University Medical Centre Groningen, University of Groningen, DA 11, PO Box 30.001, 9700 RB, Groningen, The Netherlands
| | - Annette J Berendsen
- Department of Primary and Long-Term Care, University Medical Centre Groningen, University of Groningen, PO Box 196, FA 21, 9700 AD, Groningen, The Netherlands
| | - Marjolein Y Berger
- Department of Primary and Long-Term Care, University Medical Centre Groningen, University of Groningen, PO Box 196, FA 21, 9700 AD, Groningen, The Netherlands
| | - Daan Brandenbarg
- Department of Primary and Long-Term Care, University Medical Centre Groningen, University of Groningen, PO Box 196, FA 21, 9700 AD, Groningen, The Netherlands
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Rodrigues B, Encantado J, Franco S, Silva MN, Carraça EV. Psychosocial correlates of physical activity in cancer survivors: a systematic review and meta-analysis. J Cancer Surviv 2024:10.1007/s11764-024-01559-6. [PMID: 38448768 DOI: 10.1007/s11764-024-01559-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 02/28/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND Physical activity (PA) is a non-pharmacological approach to optimize health benefits in cancer survivors and is recommended as part of care. However, most cancer survivors fail to meet PA recommendations. The current systematic review and meta-analysis aimed to identify psychosocial correlates of free-living PA in cancer survivors. METHODS Three electronic databases were searched (PubMed, PsycINFO, and SportDiscus). Meta-analyses were conducted for psychosocial correlates tested ≥ 3 times. RESULTS Sixty-four articles were included. Eighty-eight different free-living PA correlates were identified. Meta-analyses (n = 32 studies) tested 23 PA correlates, of which 16 were significant (p < 0.05). Larger effect sizes (0.30 < ES > 0.45) were found for exercise self-efficacy, perceived behavioral control, intention, lower perceived barriers for exercise, enjoyment, perceived PA benefits, and attitudes. Small-to-moderate effects (0.18 < ES < 0.22) were found for subjective norms, physical functioning, quality of life, depression, and mental health. These findings were generally in line with narrative results. CONCLUSIONS This systematic review highlights important psychosocial correlates of free-living PA that can be targeted in future PA promotion interventions for cancer survivors. Constructs mainly from SCT and TPB were the most studied and appear to be associated with free-living PA in this population. However, we cannot currently assert which frameworks might be more effective. Further studies of better methodological quality, per correlate and theory, exploring longer-term associations and across different types of cancer, are needed. IMPLICATIONS FOR CANCER SURVIVORS Having higher exercise self-efficacy, perceived behavioral control, intention, enjoyment and perceived PA benefits, more positive attitudes towards PA, and lower perceived barriers for exercise, can help increase PA in cancer survivors.
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Affiliation(s)
- Bruno Rodrigues
- Faculty of Sport, University of Porto (Research Centre in Physical Activity, Health and Leisure), R. Dr. Plácido da Costa 91, 4200-450, Porto, Portugal.
| | - Jorge Encantado
- Faculdade de Motricidade Humana, CIPER, Universidade de Lisboa, Cruz Quebrada, Portugal
| | - Sofia Franco
- CIDEFES, Universidade Lusófona, Lisboa & CIFI2D, Universidade do Porto, Porto, Universidade Lusófona and Universidade do Porto, Lisbon and Porto, Portugal
| | - Marlene N Silva
- CIDEFES, Universidade Lusófona, Lisboa & CIFI2D, Universidade do Porto, Porto, Universidade Lusófona and Universidade do Porto, Lisbon and Porto, Portugal
| | - Eliana V Carraça
- CIDEFES, Universidade Lusófona, Lisboa & CIFI2D, Universidade do Porto, Porto, Universidade Lusófona and Universidade do Porto, Lisbon and Porto, Portugal
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Morano T, Lancia F, Di Marco A, Viscioni G, Bucci I, Grossi S, Pellegrino R, Cugusi L, Grassadonia A, Manca A, Bullo V, Di Giminiani R, Izzicupo P, Di Baldassarre A, Fusco A, Cortis C, Napolitano G, Di Blasio A. Flexibility and Strength Effects of Adapted Nordic Walking and Myofascial Exercises Practice in Breast Cancer Survivors and Analysis of Differences. Healthcare (Basel) 2024; 12:222. [PMID: 38255109 PMCID: PMC10815343 DOI: 10.3390/healthcare12020222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 01/07/2024] [Accepted: 01/13/2024] [Indexed: 01/24/2024] Open
Abstract
Breast cancer treatments can elicit negative kinesiological side effects concerning both the posture and functional status of breast cancer survivors. As our body is functionally organized in myofascial meridians, physical exercise practice should favor a whole-body approach rather than a local one. The aim of the study was to investigate and compare the effects of two whole-body disciplines, i.e., adapted Nordic Walking and myofascial exercise, on the flexibility and strength performances in BCS. One hundred and sixty breast cancer survivors were trained three times per week for 12 weeks through adapted Nordic Walking or myofascial exercise. Handgrip, sit and reach, back scratch, and single leg back bridge tests and body composition were assessed at the beginning and completion of the training period. Linear mixed models showed no significant changes in body composition, whereas flexibility (p < 0.001), strength (p < 0.001), and muscle quality index (p = 0.003) changed independently from the treatment. When data modification has been analyzed according to sub-sample membership, no significant differences have been observed. Age, radiation therapy, and chemotherapy seem to have independent effects on several investigated variables. Twelve weeks of adapted myofascial exercise and Nordic Walking led to significant changes in flexibility, strength, and muscle quality in breast cancer survivors, with no apparent superiority of one approach over the other.
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Affiliation(s)
- Teresa Morano
- Department of Medicine and Aging Sciences, “G. d’Annunzio” University of Chieti-Pescara, Via Polacchi L. 11, 66100 Chieti, Italy; (T.M.); (F.L.); (A.D.M.); (I.B.); (P.I.); (A.D.B.); (G.N.)
| | - Federica Lancia
- Department of Medicine and Aging Sciences, “G. d’Annunzio” University of Chieti-Pescara, Via Polacchi L. 11, 66100 Chieti, Italy; (T.M.); (F.L.); (A.D.M.); (I.B.); (P.I.); (A.D.B.); (G.N.)
| | - Alessandra Di Marco
- Department of Medicine and Aging Sciences, “G. d’Annunzio” University of Chieti-Pescara, Via Polacchi L. 11, 66100 Chieti, Italy; (T.M.); (F.L.); (A.D.M.); (I.B.); (P.I.); (A.D.B.); (G.N.)
| | - Gianluca Viscioni
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Piazzale Scuro L.A. 10, 37124 Verona, Italy;
| | - Ines Bucci
- Department of Medicine and Aging Sciences, “G. d’Annunzio” University of Chieti-Pescara, Via Polacchi L. 11, 66100 Chieti, Italy; (T.M.); (F.L.); (A.D.M.); (I.B.); (P.I.); (A.D.B.); (G.N.)
| | - Simona Grossi
- Eusoma Breast Center, “G. Bernabeo” Hospital, ASL02 Lanciano-Vasto-Chieti, c.da S. Liberata, 66026 Ortona, Italy;
| | - Raffaello Pellegrino
- Department of Scientific Research, Campus Ludes, Off-Campus Semmelweis University, 6912 Lugano, Switzerland;
| | - Lucia Cugusi
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43/B, 07100 Sassari, Italy; (L.C.); (A.M.)
| | - Antonino Grassadonia
- Department of Innovative Technologies in Medicine and Dentistry, “G. d’Annunzio” University of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy;
| | - Andrea Manca
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43/B, 07100 Sassari, Italy; (L.C.); (A.M.)
| | - Valentina Bullo
- Department of Medicine, University of Padova, Via Giustiniani 2, 35128 Padova, Italy;
| | - Riccardo Di Giminiani
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, Via Vetoio, 67100 L’Aquila, Italy;
| | - Pascal Izzicupo
- Department of Medicine and Aging Sciences, “G. d’Annunzio” University of Chieti-Pescara, Via Polacchi L. 11, 66100 Chieti, Italy; (T.M.); (F.L.); (A.D.M.); (I.B.); (P.I.); (A.D.B.); (G.N.)
| | - Angela Di Baldassarre
- Department of Medicine and Aging Sciences, “G. d’Annunzio” University of Chieti-Pescara, Via Polacchi L. 11, 66100 Chieti, Italy; (T.M.); (F.L.); (A.D.M.); (I.B.); (P.I.); (A.D.B.); (G.N.)
| | - Andrea Fusco
- Department of Human Sciences, Society and Health, University of Cassino and Lazio Meridionale, Via S. Angelo, 03043 Cassino, Italy; (A.F.); (C.C.)
| | - Cristina Cortis
- Department of Human Sciences, Society and Health, University of Cassino and Lazio Meridionale, Via S. Angelo, 03043 Cassino, Italy; (A.F.); (C.C.)
| | - Giorgio Napolitano
- Department of Medicine and Aging Sciences, “G. d’Annunzio” University of Chieti-Pescara, Via Polacchi L. 11, 66100 Chieti, Italy; (T.M.); (F.L.); (A.D.M.); (I.B.); (P.I.); (A.D.B.); (G.N.)
| | - Andrea Di Blasio
- Department of Medicine and Aging Sciences, “G. d’Annunzio” University of Chieti-Pescara, Via Polacchi L. 11, 66100 Chieti, Italy; (T.M.); (F.L.); (A.D.M.); (I.B.); (P.I.); (A.D.B.); (G.N.)
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Walsh S, Wang K, Lam A, Du S, Hu Y, Sun YT, Tcharkhedian E, Nikas E, Webb G, Moylan E, Della-Fiorentina S, Fahey P, Shelley Wang X, Chen M, Zhu X. Baduanjin Mind-Body Exercise for Cancer-Related Fatigue: Protocol for a Remotely Delivered Randomized Wait-List Controlled Feasibility Study. Integr Cancer Ther 2024; 23:15347354231226127. [PMID: 38317410 PMCID: PMC10845985 DOI: 10.1177/15347354231226127] [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: 08/30/2023] [Revised: 11/15/2023] [Accepted: 12/27/2023] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND People living with a cancer diagnosis often experience cancer-related fatigue (CRF). Between 9% and 45% of people report CRF as moderate to severe, negatively impacting their quality-of-life (QOL). The evidence-base for managing CRF recommends exercise-related therapies over pharmaceutical interventions. One such exercise-like therapy is Baduanjin mind-body exercise (MBE), which has additional benefits. A remotely delivered program may further benefit people with CRF. The primary objective of this pilot will test study feasibility of a remotely delivered Baduanjin MBE exercise program for people living with CRF. METHODS This is a randomized wait-list controlled pilot study and will take place in Sydney, Australia. Subject to informed consent, 40 adults with moderate CRF levels and receiving or previously received adjuvant chemotherapy, will undertake a home-based 8-week Baduanjin MBE program supported by online resources and instructors. The primary feasibility outcomes are recruitment, enrollment, retention, and adherence rates; and safety as measured by tolerance and adverse-event frequency. Clinical outcomes (eg, changes in CRF, QOL, and participant perceptions) are assessed at pre-intervention, week 1, week 4, week 8, and post-intervention. Analyses follows the Intent-to-Treat (all participants as per randomization) and per-protocol (participants adhering to the protocol). Missing data will be imputed from previous data entries and regression models may be tested to predict missing outcomes. DISCUSSION To our knowledge, this is the first study evaluating the feasibility and effects of Baduanjin MBE on CRF using a remote delivery method. These feasibility data will inform a fully powered future trial investigating evidence of effect on CRF and QOL.Trial registration: Australian and New Zealand Clinical Trials Registry (ANZCTR 12623000177651).Ringgold ID: 651498 Chinese Medicine Centre.
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Affiliation(s)
- Sean Walsh
- Chinese Medicine Centre (an international collaboration between Western Sydney University and Beijing University of Chinese Medicine), Western Sydney University, NSW, Australia
- School of Health Sciences, Western Sydney University, NSW, Australia
| | - Kang Wang
- Chinese Medicine Centre (an international collaboration between Western Sydney University and Beijing University of Chinese Medicine), Western Sydney University, NSW, Australia
- Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
| | - Anderson Lam
- Chinese Medicine Centre (an international collaboration between Western Sydney University and Beijing University of Chinese Medicine), Western Sydney University, NSW, Australia
| | - Shihao Du
- Chinese Medicine Centre (an international collaboration between Western Sydney University and Beijing University of Chinese Medicine), Western Sydney University, NSW, Australia
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, People’s Republic of China
| | - Yanbin Hu
- Chinese Medicine Centre (an international collaboration between Western Sydney University and Beijing University of Chinese Medicine), Western Sydney University, NSW, Australia
- Beijing University of Chinese Medicine, Beijing, People’s Republic of China
| | - Yu-Ting Sun
- Chinese Medicine Centre (an international collaboration between Western Sydney University and Beijing University of Chinese Medicine), Western Sydney University, NSW, Australia
- School of Health Sciences, Western Sydney University, NSW, Australia
| | - Elise Tcharkhedian
- South Western Sydney Local Health District, Liverpool Hospital, NSW, Australia
| | - Evangeline Nikas
- South Western Sydney Local Health District, Liverpool Hospital, NSW, Australia
| | - Gregory Webb
- South Western Sydney Local Health District, Liverpool Hospital, NSW, Australia
- South Western Sydney Local Health District, Campbelltown Hospital, NSW, Australia
| | - Eugene Moylan
- South Western Sydney Local Health District, Liverpool Hospital, NSW, Australia
| | - Stephen Della-Fiorentina
- South Western Sydney Local Health District, Liverpool Hospital, NSW, Australia
- South Western Sydney Local Health District, Campbelltown Hospital, NSW, Australia
| | - Paul Fahey
- School of Health Sciences, Western Sydney University, NSW, Australia
| | - Xin Shelley Wang
- University of Texas, MD Anderson Cancer Centre, Houston, TX, USA
| | - Ming Chen
- Chinese Medicine Centre (an international collaboration between Western Sydney University and Beijing University of Chinese Medicine), Western Sydney University, NSW, Australia
- Guizhou University of Traditional Chinese Medicine, Guiyang, People’s Republic of China
| | - Xiaoshu Zhu
- Chinese Medicine Centre (an international collaboration between Western Sydney University and Beijing University of Chinese Medicine), Western Sydney University, NSW, Australia
- School of Health Sciences, Western Sydney University, NSW, Australia
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Cao C, Patel AV, Liu R, Cao Y, Friedenreich CM, Yang L. Trends and cancer-specific patterns of physical activity, sleep duration, and daily sitting time among US cancer survivors, 1997-2018. J Natl Cancer Inst 2023; 115:1563-1575. [PMID: 37527029 PMCID: PMC10699842 DOI: 10.1093/jnci/djad146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/21/2023] [Accepted: 07/28/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND Physical activity, sufficient sleep, and limiting sedentary time may improve cancer survivorship. METHODS Utilizing US nationally representative samples from the National Health Interview Survey 1997-2018 and the National Health and Nutrition Examination Survey 2007-2018, this study investigated the trends of meeting physical activity guidelines, insufficient sleep duration, and sitting time in US cancer survivors (n = 58 527) and noncancer adults (n = 640 109). RESULTS From 1997 to 2018, the prevalence of meeting physical activity guidelines was consistently lower in cancer survivors than in noncancer adults. Among cancer survivors, the prevalence of meeting physical activity guidelines increased from 34.9% (95% confidence interval [CI] = 33.1% to 36.8%) to 46.5% (95% CI = 45.0% to 48.1%) for aerobic (≥150 minutes per week at moderate intensity or 75 minutes per week at vigorous intensity), from 13.9% (95% CI = 12.8% to 15.1%) to 23.1% (95% CI = 21.8% to 24.4%) for muscle strengthening (≥2 days per week) activities, and from 9.5% (95% CI = 8.4% to 10.7%) to 17.9% (95% CI = 16.7% to 19.1%) for both combined (all Ptrend < .001). From 2004 to 2018, the prevalence of insufficient sleep duration (<7 hours per day) increased from 28.4% (95% CI = 26.3% to 30.5%) to 30.8% (95% CI = 29.3% to 32.2%) (Ptrend = .004). Daily sitting time increased from 6.09 hours per day (95% CI = 5.71 to 6.46 hours per day) in 2007-2008 to 7.36 hours per day (95% CI = 7.05 to 7.68 hours per day) in 2013-2014 and attenuated to 6.20 hours per day (95% CI = 5.74 to 6.65 hours per day) in 2017-2018. The pattern of physical activity, sleep, and sitting time varied by sex, race and ethnicity, body mass index, cancer type, and time since cancer diagnosis. CONCLUSIONS More than half of US cancer survivors did not meet physical activity guidelines, and a large proportion had insufficient sleep duration and prolonged sitting time.
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Affiliation(s)
- Chao Cao
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Alpa V Patel
- Department of Population Sciences, American Cancer Society, Atlanta, GA, USA
| | - Raymond Liu
- San Francisco Medical Center, Kaiser Permanente Northern California, San Francisco, CA, USA
| | - Yin Cao
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis, MO, USA
- Alvin J. Siteman Cancer Center, Washington University School of Medicine, St Louis, MO, USA
- Division of Gastroenterology, Department of Medicine, Washington University School of Medicine, St Louis, MO, USA
| | - Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, Cancer Research & Analytics, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada
- Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Lin Yang
- Department of Cancer Epidemiology and Prevention Research, Cancer Research & Analytics, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada
- Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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9
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Bettariga F, Bishop C, Taaffe DR, Galvão DA, Maestroni L, Newton RU. Time to consider the potential role of alternative resistance training methods in cancer management? JOURNAL OF SPORT AND HEALTH SCIENCE 2023; 12:715-725. [PMID: 37399886 PMCID: PMC10658316 DOI: 10.1016/j.jshs.2023.06.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/09/2023] [Accepted: 06/08/2023] [Indexed: 07/05/2023]
Abstract
Exercise has emerged as fundamental therapeutic medicine in the management of cancer. Exercise improves health-related outcomes, including quality of life, neuromuscular strength, physical function, and body composition, and it is associated with a lower risk of disease recurrence and increased survival. Moreover, exercise during or post cancer treatments is safe, can ameliorate treatment-related side effects, and may enhance the effectiveness of chemotherapy and radiation therapy. To date, traditional resistance training (RT) is the most used RT modality in exercise oncology. However, alternative training modes, such as eccentric, cluster set, and blood flow restriction are gaining increased attention. These training modalities have been extensively investigated in both athletic and clinical populations (e.g., age-related frailty, cardiovascular disease, type 2 diabetes), showing considerable benefits in terms of neuromuscular strength, hypertrophy, body composition, and physical function. However, these training modes have only been partially or not at all investigated in cancer populations. Thus, this study outlines the benefits of these alternative RT methods in patients with cancer. Where evidence in cancer populations is sparse, we provide a robust rationale for the possible implementation of certain RT methods that have shown positive results in other clinical populations. Finally, we provide clinical insights for research that may guide future RT investigations in patients with cancer and suggest clear practical applications for targeted cancer populations and related benefits.
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Affiliation(s)
- Francesco Bettariga
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA 6027, Australia; School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia
| | - Chris Bishop
- London Sport Institute, School of Science and Technology, Middlesex University, London, NW4 4BT, UK
| | - Dennis R Taaffe
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA 6027, Australia; School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia
| | - Daniel A Galvão
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA 6027, Australia; School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia
| | - Luca Maestroni
- London Sport Institute, School of Science and Technology, Middlesex University, London, NW4 4BT, UK
| | - Robert U Newton
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA 6027, Australia; School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia; School of Human Movement and Nutrition Sciences, University of Queensland, St. Lucia, QLD 4067, Australia.
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10
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Caperchione CM, English M, Sharp P, Agar MR, Phillips JL, Liauw W, Harris CA, McCullough S, Lilian R. Exploring the practicality and acceptability a brief exercise communication and clinician referral pathway in cancer care: a feasibility study. BMC Health Serv Res 2023; 23:1023. [PMID: 37740170 PMCID: PMC10517509 DOI: 10.1186/s12913-023-10003-x] [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: 03/27/2023] [Accepted: 09/04/2023] [Indexed: 09/24/2023] Open
Abstract
BACKGROUND The majority of cancer patients and cancer care clinicians-CCCs (e.g., oncologists) believe that exercise is an important adjunct therapy that should be embedded in standard practice. Yet, CCCs do not routinely discuss exercise with their patients, nor do they regularly refer them to exercise professionals (e.g., exercise physiologists-EPs). This study evaluated the feasibility and acceptability of an evidence-based approach to improving exercise communication between CCCs and their patients, including an exercise referral pathway. METHODS Implementation and testing of the Exercise Communication and Referral Pathway (ECRP) occurred in Sydney, Australia. The ECRP included a brief oncology-initiated communication exchange with patients, CCC exercise referral to an EP, followed by EP-initiated telephone consultation with patients concerning tailored exercise advice. Participant perceptions concerning the feasibility and applicability of the ECPR were evaluated. Semi-structured interviews were conducted with CCCs (n = 3), cancer patients (n = 21), and an EP (n = 1). Inductive thematic analysis was undertaken. RESULTS Analysis generated three themes: (1) Navigating the role of CCCs in the ECRP, suggesting that oncology-initiated communication is a cue to action, however there was a lack of role clarity regarding exercise referral; (2) Implementing Patient-Orientated Care within a Standardised Pathway, highlighting the need for tailored information and advice for patients that reflects individual disease, socio-cultural, and environmental factors, and; (3) Taking Steps Towards Action, revealing the need for structural (e.g., EP initiated contact with patients) and policy changes (i.e., changes to Medicare, direct oncologist referral) to engage patients and better integrate exercise as part of standard care. CONCLUSIONS Findings provide important insights into improving oncology-patient exercise communication and developing an exercise referral pathway to increase engagement and patient reach. However, individual (e.g., experience, knowledge) and contextual factors (e.g., time, resources) need consideration when implementing an ECRP. TRIAL REGISTRATION This trial was prospectively registered with the Australian New Zealand Clinical (#ACTRN12620000358943) on March 13, 2020.
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Affiliation(s)
- Cristina M Caperchione
- School of Sport, Exercise and Rehabilitation, University of Technology Sydney, Sydney, NSW, Australia.
| | - Madeleine English
- School of Sport, Exercise and Rehabilitation, University of Technology Sydney, Sydney, NSW, Australia
| | - Paul Sharp
- School of Sport, Exercise and Rehabilitation, University of Technology Sydney, Sydney, NSW, Australia
| | - Meera R Agar
- IMPACCT, University of Technology Sydney, Sydney, NSW, Australia
| | - Jane L Phillips
- IMPACCT, University of Technology Sydney, Sydney, NSW, Australia
- School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Winston Liauw
- Cancer Care Centre, St George Hospital, Sydney, NSW, Australia
- St George and Sutherland Clinical School, University of New South Wales, Sydney, NSW, Australia
- Translational Cancer Research Network, Sydney, NSW, Australia
| | - Carole A Harris
- Cancer Care Centre, St George Hospital, Sydney, NSW, Australia
- St George and Sutherland Clinical School, University of New South Wales, Sydney, NSW, Australia
- Translational Cancer Research Network, Sydney, NSW, Australia
| | | | - Ruth Lilian
- Translational Cancer Research Network, Sydney, NSW, Australia
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11
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Wang K, Consagra W, Jensen-Battaglia M, Kleckner A, Kleckner IR, Loh KP. Chemotherapy-related symptoms and exercise adherence in older patients with myeloid neoplasms. Support Care Cancer 2023; 31:572. [PMID: 37698745 PMCID: PMC10883479 DOI: 10.1007/s00520-023-08039-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 09/04/2023] [Indexed: 09/13/2023]
Abstract
PURPOSE Exercise may ameliorate treatment-related symptoms, but older adults have lower exercise adherence compared to their younger counterparts due to treatment-related symptoms. METHODS We recruited older patients with myeloid neoplasms receiving chemotherapy to a pilot study of a mobile health exercise intervention. Participants entered their steps and resistance data into the app daily, and symptom data twice a week, over an 8-12 week period. In this proof-of-concept analysis, we used a linear mixed-effects model to assess the association of symptoms from the previous week with exercise adherence in the current week among older adults with myeloid neoplasms. RESULTS Mean age was 74.3 (SD = 5.0) years (N = 7). At baseline, patients on average walked 2564 daily steps (SD = 1816), which increased to 2967 (SD = 3448) post-intervention. Patients on average performed 3.5 (SD = 2.6) days of resistance training weekly, with mean duration of 21.5 min (SD = 11.6) and rated perceived exertion of 3.68 (SD = 1.78) on a 0-10 scale. Lower average steps in the current week was associated with greater interference with daily activities from pain (β = - 203.13, p = 0.05), memory (β = - 492.29, p = 0.09), numbness (β = - 353.57, p = 0.07), and sadness (β = - 403.03, p = 0.09) in the previous week. Similarly, lower average resistance minutes in the current week were associated with greater pain, sadness, and anxiety in the previous week. CONCLUSIONS We found that greater pain, sadness, and anxiety were associated with lower exercise adherence. Symptom monitoring and management in older adults with myeloid neoplasms receiving chemotherapy can promote exercise adherence and in turn improve symptoms. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04035499. Registered 7/29/2019.
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Affiliation(s)
- Katarina Wang
- School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA
| | - William Consagra
- Department of Biostatistics and Computational Biology, University of Rochester, Rochester, NY, USA
| | | | - Amber Kleckner
- Department of Pain and Translational Symptom Science, University of Maryland School of Nursing, Baltimore, MD, USA
| | - Ian R Kleckner
- Department of Pain and Translational Symptom Science, University of Maryland School of Nursing, Baltimore, MD, USA
| | - Kah Poh Loh
- Division of Hematology/Oncology, Department of Medicine, James P Wilmot Cancer Institute, University of Rochester Medical Center, 601 Elmwood Avenue, Box 704, Rochester, NY, 14642, USA.
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12
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Maurer GS, Clayton ZS. Anthracycline chemotherapy, vascular dysfunction and cognitive impairment: burgeoning topics and future directions. Future Cardiol 2023; 19:547-566. [PMID: 36354315 PMCID: PMC10599408 DOI: 10.2217/fca-2022-0086] [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: 09/09/2022] [Accepted: 10/17/2022] [Indexed: 11/12/2022] Open
Abstract
Anthracyclines, chemotherapeutic agents used to treat common forms of cancer, increase cardiovascular (CV) complications, thereby necessitating research regarding interventions to improve the health of cancer survivors. Vascular dysfunction, which is induced by anthracycline chemotherapy, is an established antecedent to overt CV diseases. Potential treatment options for ameliorating vascular dysfunction have largely been understudied. Furthermore, patients treated with anthracyclines have impaired cognitive function and vascular dysfunction is an independent risk factor for the development of mild cognitive impairment. Here, we will focus on: anthracycline chemotherapy associated CV diseases risk; how targeting mechanisms underlying vascular dysfunction may be a means to improve both CV and cognitive health; and research gaps and potential future directions for the field of cardio-oncology.
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Affiliation(s)
- Grace S Maurer
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO 80309, USA
| | - Zachary S Clayton
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO 80309, USA
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13
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Marell PS, Vierkant RA, Olson JE, Herrmann J, Larson NL, Lebrasseur NK, D’Andre SD, Ehlers DK, Stan DL, Cheville AL, Barksdale T, Loprinzi CL, Couch FJ, Ruddy KJ. Changes in amount and intensity of physical activity over time in breast cancer survivors. JNCI Cancer Spectr 2023; 7:pkad056. [PMID: 37561108 PMCID: PMC10471529 DOI: 10.1093/jncics/pkad056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 07/28/2023] [Accepted: 08/01/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Physical activity is associated with decreased breast cancer recurrence and mortality, as well as fewer treatment-related symptoms. Nevertheless, most breast cancer survivors do not meet physical activity guidelines. The purpose of this manuscript is to characterize physical activity trends over time in breast cancer survivors. METHODS Mayo Clinic Breast Disease Registry participants received surveys at baseline and at 1 and 4 years after diagnosis; breast cancer recurrence and/or metastatic disease were exclusion criteria. Participants were considered to be meeting guidelines if they self-reported at least 150 minutes of moderate-intensity (eg, fast walking) and/or strenuous (eg, jogging) physical activity per week. Statistical analyses include analysis of covariance methods, paired t tests, conditional logistic regression models, and McNemar tests of homogeneity. RESULTS A total of 171 participants were included in the analysis. The amount of total physical activity decreased over time (P = .07). Mild-intensity physical activity (eg, easy walking) decreased most over time (P = .05). Among participants aged 18-49 years, mild-intensity (P = .05) and moderate-intensity (P = .02) physical activity decreased over time. Strenuous-intensity physical activity levels decreased over time among participants with a normal body mass index (P = .002) and with obesity (P = .01). CONCLUSIONS We found a trend-level decrease in total physical activity over time, driven mostly by a decrease in mild-intensity physical activity. Young breast cancer survivors are especially likely to reduce their physical activity over time. Further research on implementing physical activity guidelines in clinical practice is warranted.
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Affiliation(s)
- Paulina S Marell
- Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, Rochester, MN, USA
| | | | - Janet E Olson
- Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Joerg Herrmann
- Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Nicole L Larson
- Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | | | | | - Diane K Ehlers
- Quantitative Health Sciences, Mayo Clinic, Phoenix, AZ, USA
| | - Daniela L Stan
- General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Andrea L Cheville
- Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, USA
| | - Toure Barksdale
- Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, USA
| | | | - Fergus J Couch
- Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
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14
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Jones JM, Howell D, Longo C, Olson K, Bedard P, Amir E, Zheng S, Chow B, Avery L. The association of cancer-related fatigue on the social, vocational and healthcare-related dimensions of cancer survivorship. J Cancer Surviv 2023:10.1007/s11764-023-01451-9. [PMID: 37644355 DOI: 10.1007/s11764-023-01451-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 08/14/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Cancer-related fatigue (CRF) is well documented in cancer survivors, but little is known about the personal and societal impact of CRF. This study aimed to examine the impact of CRF in relation to social and vocational functioning and health care utilization in a large sample of post-treatment cancer survivors. METHODS We conducted a cross-sectional descriptive study of early stage breast and colorectal cancer survivors (n = 454) who were within 5 years from treatment completion. Social difficulties (SDI-21), work status, absenteeism and presenteeism (WHO-HPQ) and healthcare utilization (HSUQ) were compared in those with (CFR +) and without (CRF -) clinically significant fatigue (FACT-F ≤ 34). RESULTS A total of 32% met the cut-off criteria for CRF (≤ 34). Participants with CRF + had significantly higher scores on the SDI-21 across all domains and 55% of CRF + vs. 11% in CRF - was above the SDI cut-off (> 10) for significant social difficulties. Participants with CRF + were 2.74 times more likely to be unemployed or on leave (95% CI 1.62, 4.61, p < 0.001). In the subgroup of participants who were currently working (n = 249), those with CRF + reported working on average 27.4 fewer hours in the previous 4 weeks compared to CRF - (p = 0.05), and absolute presenteeism was on average 13% lower in the CRF + group (95% CI 8.0, 18.2, p < 0.001). Finally, individuals with CRF + reported significantly more physician (p < 0.001), other health care professional (p = 0.03) and psychosocial visits (p = 0.002) in the past month. CONCLUSIONS AND IMPLICATIONS FOR CANCER SURVIVORS CRF is associated with substantial disruption in social and work role functioning in the early transitional phase of cancer survivorship. Better management of persistent CRF and funding for the implementation of existing guidelines and recommended evidence-based interventions are urgently needed.
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Affiliation(s)
- Jennifer M Jones
- Cancer Rehabilitation and Survivorship Program, Princess Margaret Cancer Centre and Department of Psychiatry, University of Toronto, 200 Elizabeth Street, B-PMB-045, Toronto, ON, M5G 2C4, Canada.
| | - Doris Howell
- Department of Supportive Care, Princess Margaret Cancer Centre and Lawrence Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| | - Christopher Longo
- Health Policy and Management, DeGroote School of Business, McMaster University, Hamilton, Canada
| | - Karin Olson
- Faculty of Nursing, University of Alberta, and Edmonton Clinic Health Academy, Edmonton, Canada
| | - Philippe Bedard
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre and Department of Medicine, University of Toronto, Toronto, Canada
| | - Eitan Amir
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre and Department of Medicine, University of Toronto, Toronto, Canada
| | - Shiyu Zheng
- MD Program, University of Toronto, Toronto, Canada
| | - Brittany Chow
- Department of Family and Community Medicine, University of Toronto, Toronto, Canada
| | - Lisa Avery
- Department of Biostatistics, Princess Margaret Cancer Centre, and Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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15
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Liu X, Xu X, Cheung DST, Chau PH, Ho MH, Takemura N, Lin CC. The effects of exercise with or without dietary advice on muscle mass, muscle strength, and physical functioning among older cancer survivors: a meta-analysis of randomized controlled trials. J Cancer Surviv 2023:10.1007/s11764-023-01396-z. [PMID: 37266818 DOI: 10.1007/s11764-023-01396-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 04/28/2023] [Indexed: 06/03/2023]
Abstract
PURPOSE To evaluate the effect of exercise with or without dietary advice on muscle mass, muscle strength and physical functioning (including perceived physical functioning and physical performance) in old cancer survivors. METHODS A systematic literature search was undertaken in May 2022 by searching multiple databases. Randomized controlled trials (RCTs) that compared exercise with or without dietary advice to control group among old cancer survivors were screened. Meta-analyses were conducted to evaluate the effects of exercise with or without dietary advice on muscle mass, muscle strength, and physical functioning. RESULTS Data from 21 trials were included in this study, including 16 exercise trials and 5 exercise + dietary advice studies. Regarding exercise, evidence supported its significant benefits on muscle strength among old cancer survivors, while no effect was seen on physical functioning and muscle mass. Concerning exercise combined with dietary advice, meta-analysis showed overall benefits on physical functioning, while limited study examined muscle mass and strength. As for safety and feasibility of interventions, low recruitment rate, moderate compliance, and few adverse events were reported. CONCLUSIONS Exercise combined with dietary advice is a more effective approach for old cancer survivors in improving physical functioning compared with exercise alone. Future study is needed to explore the effects of exercise combined with dietary advice on combating sarcopenia. As recruitment and compliance among old cancer survivors were challenging, strategies to stimulate their motivation and promote habitual healthy behaviour are warranted. IMPLICATIONS FOR CANCER SURVIVORS It is necessary for old cancer survivors to receive exercise and dietary support to improve physical functioning.
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Affiliation(s)
- Xiaohang Liu
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Xinyi Xu
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Denise Shuk Ting Cheung
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Pui Hing Chau
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Mu-Hsing Ho
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Naomi Takemura
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Chia-Chin Lin
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China.
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16
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Raber M, Rechis R, LaRue DM, Ho-Pham TT, Oestman K, Walsh MT, Kizub D, Ma H, Galvan E, Zhao H, Gonzalez J, Lei X, Hu J, Basen-Engquist K. Enhancing the utilization of healthy living interventions among cancer survivors in historically underserved populations and communities. Cancer Causes Control 2023:10.1007/s10552-023-01701-2. [PMID: 37160832 DOI: 10.1007/s10552-023-01701-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 04/10/2023] [Indexed: 05/11/2023]
Abstract
PURPOSE This study aimed to describe the clinical characteristics and wellness programming preferences of cancer survivors from Acres Homes, a historically Black neighborhood in Houston, Texas, with areas of persistent poverty. The goal of this study was to identify opportunities to increase cancer survivor utilization of healthy eating and active living interventions aligned to cancer center community outreach and engagement efforts. METHODS This multiple methods study included a retrospective review of electronic health record data (n = 413) and qualitative interviews with cancer survivors (n = 31) immediately preceding initiation of healthy eating, active living programming in Acres Homes. RESULTS This study found Acres Homes survivors have high rates of co-occurrent cardiometabolic disease including obesity (45.0%), diabetes (30.8%), and other related risk factors as well as treatment-related symptoms. Four major concepts emerged from interviews: (1) Factors that influence survivors' ability to eat well and exercise, (2) Current usage of community resources, (3) Interest in relevant programming, and (4) Specific programming preferences. Opportunities for current and future health promotion programming for cancer survivors were explored. CONCLUSION Strategically tailoring community resources for cancer survivors can provide a more robust network of support to promote healthy eating and active living in this population. This work informed community implementation of evidence-based health interventions in Acres Homes and may support future projects aiming to enhance community-led cancer prevention efforts in historically underserved communities.
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Affiliation(s)
- Margaret Raber
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Ruth Rechis
- Cancer Prevention and Control Platform, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Denise M LaRue
- Population Health, Harris Health System, Bellaire, TX, USA
| | - Thy T Ho-Pham
- Population Health, Harris Health System, Bellaire, TX, USA
| | - Katherine Oestman
- Cancer Prevention and Control Platform, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Michael T Walsh
- Cancer Prevention and Control Platform, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Darya Kizub
- Department of General Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Hilary Ma
- Department of General Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Hui Zhao
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Xiudong Lei
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jingfan Hu
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Karen Basen-Engquist
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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17
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Soldato D, Arecco L, Agostinetto E, Franzoi MA, Mariamidze E, Begijanashvili S, Brunetti N, Spinaci S, Solinas C, Vaz-Luis I, Di Meglio A, Lambertini M. The Future of Breast Cancer Research in the Survivorship Field. Oncol Ther 2023:10.1007/s40487-023-00225-8. [PMID: 37005952 DOI: 10.1007/s40487-023-00225-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 03/03/2023] [Indexed: 04/04/2023] Open
Abstract
Prevalence of survivors of breast cancer has been steadily increasing in the last 20 years. Currently, more than 90% of women diagnosed with early-stage breast cancer are expected to be alive at 5 years from diagnosis thanks to early detection and breakthrough innovations in multimodal treatment strategies. Alongside this advancement in clinical outcomes, survivors of breast cancer might experience several specific challenges and present with unique needs. Survivorship trajectories after diagnosis and treatment of breast cancer can be significantly impacted by long-lasting and severe treatment-related side effects, including physical problems, psychological distress, fertility issues in young women, and impaired social and work reintegration, which add up to patients' individual risk of cancer recurrence and second primary malignancies. Alongside cancer-specific sequelae, survivors still present with general health needs, including management of chronic preexisting or ensuing conditions. Survivorship care should implement high-quality, evidence-based strategies to promptly screen, identify, and address survivors' needs in a comprehensive way and minimize the impact of severe treatment sequelae, preexisting comorbidities, unhealthy lifestyles, and risk of recurrence on quality of life. This narrative review focuses on core areas of survivorship care and discuss the state of the art and future research perspectives in key domains including selected long-term side effects, surveillance for recurrences and second cancers, well-being promotion, and specific survivors' needs.
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Affiliation(s)
- D Soldato
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genoa, Italy
- Department of Medical Oncology, U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132, Genoa, Italy
- Molecular Predictors and New Targets in Oncology, Institut National de la Sante et de la Recherche Medicale Unit 981, Gustave Roussy, Villejuif, France
- Breast Cancer Unit, Medical Oncology Department, Gustave Roussy, Villejuif, France
| | - L Arecco
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genoa, Italy
- Department of Medical Oncology, U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132, Genoa, Italy
| | - E Agostinetto
- Department of Medical Oncology, Institut Jules Bordet and Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
| | - M A Franzoi
- Molecular Predictors and New Targets in Oncology, Institut National de la Sante et de la Recherche Medicale Unit 981, Gustave Roussy, Villejuif, France
- Breast Cancer Unit, Medical Oncology Department, Gustave Roussy, Villejuif, France
| | - E Mariamidze
- Department of Oncology and Hematology, Todua Clinic, Tbilisi, Georgia
| | - S Begijanashvili
- Department of Clinical Oncology, American Hospital Tbilisi, Tbilisi, Georgia
| | - N Brunetti
- Department of Experimental Medicine (DIMES), University of Genoa, Genoa, Italy
| | - S Spinaci
- Division of Breast Surgery, Villa Scassi Hospital, Genoa, Italy
| | - C Solinas
- Medical Oncology, AOU Cagliari, Policlinico Duilio Casula, Monserrato, Italy
| | - I Vaz-Luis
- Molecular Predictors and New Targets in Oncology, Institut National de la Sante et de la Recherche Medicale Unit 981, Gustave Roussy, Villejuif, France
- Breast Cancer Unit, Medical Oncology Department, Gustave Roussy, Villejuif, France
| | - A Di Meglio
- Molecular Predictors and New Targets in Oncology, Institut National de la Sante et de la Recherche Medicale Unit 981, Gustave Roussy, Villejuif, France
- Breast Cancer Unit, Medical Oncology Department, Gustave Roussy, Villejuif, France
| | - M Lambertini
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genoa, Italy.
- Department of Medical Oncology, U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132, Genoa, Italy.
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Bluethmann SM, VanDyke E, Costigan H, O'Shea C, Van Scoy LJ. Exploring the acceptability of the 'smart cane' to support mobility in older cancer survivors and older adults: A mixed methods study. J Geriatr Oncol 2023; 14:101451. [PMID: 36871444 PMCID: PMC10106442 DOI: 10.1016/j.jgo.2023.101451] [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: 09/13/2022] [Revised: 01/19/2023] [Accepted: 02/14/2023] [Indexed: 03/07/2023]
Abstract
INTRODUCTION Approximately 25% of older cancer survivors (i.e., ≥ 65 years, with cancer history) use ≥1 mobility device, surpassing usage by other older adults. Few tools exist for older "survivors" to regain function or follow lifestyle recommendations. Our goal was to explore opportunities to leverage technology-enabled mobility devices, such as the "smart cane," to support mobility goals in these survivors. The research objective was to assess perceptions related to acceptability, usability and preferences of participants regarding technology-enabled mobility devices in everyday life. MATERIALS AND METHODS We used a convergent mixed-methods design, analyzing quantitative data followed by qualitative focus groups. A pre-survey derived from the Senior Technology Acceptance Model assessed the acceptability of technology-enabled devices among participants, who also participated in one of three focus groups delivered via Zoom. The Zoom sessions included facilitated 90-min discussions and video demonstration of the smart cane. Focus group sessions were recorded and transcribed verbatim and thematic content analysis was conducted. RESULTS We recruited 12 older US survivors. Participants were 58% female, aged 68-86, and 16% non-White. From a pre-survey of participants, 83% said that they liked the idea of technology-enhanced mobility device and 100% said they thought they could be skillful at using a technology-enabled device if training was provided. Though participants were enthusiastic about the smart cane overall and felt the smart cane supported independence for older adults, the themes revealed concerns about safety, accessibility and technology support, as well as the concern for negative impact on self-image due to use of a mobility device. There was a strong preference for working with clinical professionals as the most trusted sources for referrals, if a smart cane was suggested. DISCUSSION Older survivors in our sample found the smart cane very acceptable, and supportive of independence for older adults with cancer and other conditions. Participants also provided many insights that revealed additional research needed to support access, safety and usability for older adults, older survivors and caregivers, especially by partnering with clinical professionals.
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Affiliation(s)
- Shirley M Bluethmann
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, United States of America.
| | - Erika VanDyke
- Department of Medicine, The Pennsylvania State University College of Medicine, Hershey, PA, United States of America
| | - Heather Costigan
- Department of Medicine, The Pennsylvania State University College of Medicine, Hershey, PA, United States of America
| | - Charles O'Shea
- Stakeholders for Care in Oncology & Research for Our Elders Board (SCOREboard), Part of the Cancer and Aging Research Group, City of Hope, Duarte, CA, United States of America
| | - Lauren Jodi Van Scoy
- Department of Medicine, The Pennsylvania State University College of Medicine, Hershey, PA, United States of America; Department of Humanities and Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, PA, United States of America
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Ricke E, Dijkstra A, Bakker EW. Prognostic factors of adherence to home-based exercise therapy in patients with chronic diseases: A systematic review and meta-analysis. Front Sports Act Living 2023; 5:1035023. [PMID: 37033885 PMCID: PMC10080001 DOI: 10.3389/fspor.2023.1035023] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 03/06/2023] [Indexed: 04/11/2023] Open
Abstract
Background Patients with a chronic disease may have an increased risk of non-adherence to prescribed home-based exercise therapy. We performed a systematic review with the aim to identify variables associated with adherence to home-based exercise therapy in patients with chronic diseases and to grade the quality of evidence for the association between these prognostic factors and adherence. Methods Cohort studies, cross-sectional studies and the experimental arm of randomized trials were identified using a search strategy applied to PubMed, Embase, PsychINFO and CINAHL from inception until August 1, 2022. We included studies with participants ≥18 years with a chronic disease as an indication for home-based exercise therapy and providing data on prognostic factors of adherence to home-based exercise. To structure the data, we categorized the identified prognostic factors into the five WHO-domains; (1) Patient-related, (2) Social/economic, (3) Therapy-related, (4) Condition-related, and (5) Health system factors. Risk of bias was assessed using the Quality in Prognostic Studies (QUIPS) tool. Prognostic factors of adherence were identified and the quality of the evidence between the prognostic factors and adherence were graded using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework for predictor studies. We performed a meta-analysis of the obtained information. Results A total of 57 studies were included. Within patient-related factors moderate- and high-quality evidence suggested that more self-efficacy, exercise history, motivation and perceived behavioral control predicted higher adherence. Within social-economic factors moderate-quality evidence suggested more education and physical health to be predictive of higher adherence and within condition-related factors moderate- and low-quality evidence suggested that less comorbidities, depression and fatigue predicted higher adherence. For the domains therapy-related and health-system factors there was not enough information to determine the quality evidence of the prognostic factors. Conclusion These findings might aid the development of future home-based exercise programs as well as the identification of individuals who may require extra support to benefit from prescribed home-based exercise therapy. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=277003, identifier PROSPERO CRD42021277003.
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Affiliation(s)
- Ellen Ricke
- Department of Social Psychology, University of Groningen, Groningen, Netherlands
- Correspondence: Ellen Ricke
| | - Arie Dijkstra
- Department of Social Psychology, University of Groningen, Groningen, Netherlands
| | - Eric W. Bakker
- Department of Epidemiology and Data Science | Division EBM, Academic Medical Centre, Amsterdam, Netherlands
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Humphreys L, Frith G, Humphreys H, Crank H, Dixey J, Greenfield DM, Reece LJ. Evaluation of a city-wide physical activity pathway for people affected by cancer: the Active Everyday service. Support Care Cancer 2023; 31:101. [PMID: 36622460 PMCID: PMC9829638 DOI: 10.1007/s00520-022-07560-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 12/21/2022] [Indexed: 01/10/2023]
Abstract
PURPOSE The primary goal of this article is to present an evaluation of a UK-based city-wide physical activity pathway for patients with a cancer diagnosis, the Active Everyday service. Active Everyday was a co-produced physical activity service for people affected by cancer. The service was underpinned by a behaviour change care pathway model developed by Macmillan Cancer Support charity. METHODS This was a retrospective evaluation assessing physical activity levels and changes to outcome measures (fatigue, perceived health, and self-efficacy) over 6 months. Each participant self-reported their levels of physical activity for the previous 7 days at three-time points: baseline (T1), at 12-week exit from the scheme (T2), and at 6-month follow-up (T3). RESULTS The Active Everyday service received 395 referrals, of which 252 attended a baseline assessment. Participants' fatigue and self-efficacy improved between T1 and T2 and T1 and T3. Perceived health improved across all time points. Participant exercise levels showed significant differences between T1 and T2. CONCLUSION The service, provided over 3 years, resulted in positive health and wellbeing outcomes in people affected by cancer who engaged in the service. Future services must routinely include exercise referrals/prescriptions as a standard part of care to help engage inactive individuals. Services should focus on targeted promotion to people from ethnic minority groups, and a wide socioeconomic population.
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Affiliation(s)
- Liam Humphreys
- Academy of Sport and Physical Activity, Sheffield Hallam University, Collegiate Crescent Campus, Sheffield, S10 2BP, UK. .,Advanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield, UK.
| | - Gabriella Frith
- grid.5884.10000 0001 0303 540XAcademy of Sport and Physical Activity, Sheffield Hallam University, Collegiate Crescent Campus, Sheffield, S10 2BP UK ,grid.5884.10000 0001 0303 540XAdvanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield, UK
| | - Helen Humphreys
- grid.5884.10000 0001 0303 540XCentre for Behavioural Science and Applied Psychology, Sheffield Hallam University, Sheffield, UK
| | - Helen Crank
- grid.5884.10000 0001 0303 540XAcademy of Sport and Physical Activity, Sheffield Hallam University, Collegiate Crescent Campus, Sheffield, S10 2BP UK
| | - Joanne Dixey
- grid.31410.370000 0000 9422 8284Therapy Services, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Diana M Greenfield
- grid.31410.370000 0000 9422 8284Specialised Cancer Services, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK ,grid.11835.3e0000 0004 1936 9262Department of Oncology and Metabolism, University of Sheffield Medical School Beech Hill Road, Sheffield, UK
| | - Lindsey J Reece
- grid.5884.10000 0001 0303 540XAdvanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield, UK ,grid.1013.30000 0004 1936 834XSPRINTER Research Group, Prevention Research Collaboration, Charles Perkins centre, School of Public Health, University of Sydney, Sydney, Australia
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Ramírez-Parada K, Lopez-Garzon M, Sanchez-Rojel C, Petric-Guajardo M, Alfaro-Barra M, Fernández-Verdejo R, Reyes-Ponce A, Merino-Pereira G, Cantarero-Villanueva I. Effect of Supervised Resistance Training on Arm Volume, Quality of Life and Physical Perfomance Among Women at High Risk for Breast Cancer-Related Lymphedema: A Study Protocol for a Randomized Controlled Trial (STRONG-B). Front Oncol 2022; 12:850564. [PMID: 35299753 PMCID: PMC8921986 DOI: 10.3389/fonc.2022.850564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 02/01/2022] [Indexed: 01/31/2023] Open
Abstract
Objectives To determine the preventive effects of supervised resistance training on arms volume, quality of life, physical performance, and handgrip strength in Chilean women at high risk for breast cancer-related lymphedema (BCRL) undergoing chemotherapy. Design Randomized control trial. Participants One hundred and six women at high risk for breast cancer-related lymphedema aged 18 to 70 years. Interventions Participants will be randomized into two groups: [a] intervention, who will receive 12 weeks of supervised resistance training (STRONG-B) during adjuvant chemotherapy; and [b] control, who will receive education to promote lymphatic and venous return, maintain range of motion, and promote physical activity. Main Outcome Measures The primary outcome will be arms volume measured with an optoelectric device (perometer NT1000). Secondary outcomes will be quality of life, handgrip strength, and physical performance. Primary and secondary outcomes will be measured at baseline, just after the intervention, and 3 and 6 months after. Statistical analysis will be performed following intention-to-treat and per-protocol approaches. The treatment effect will be calculated using linear mixed models. Discussion The STRONG-B will be a tailored supervised resistance training that attempts to prevent or mitigate BCRL in a population that, due to both intrinsic and extrinsic factors, will commonly suffer from BCRL. Clinical Trial Registration [https://clinicaltrials.gov/ct2/show/NCT04821609], identifier NCT04821609.
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Affiliation(s)
- Karol Ramírez-Parada
- Carrera de Kinesiología, Departamento Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Maria Lopez-Garzon
- 'Cuídate' From Biomedical Group (BIO277), Instituto de Investigación Biosanitaria (ibs.GRANADA), Granada, Spain
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
- Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain
| | - Cesar Sanchez-Rojel
- Departamento de Hematología-Oncología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Militza Petric-Guajardo
- Department of Surgery Dr Sótero del Río Hospital, Santiago, Chile
- Department of Surgery Davila Clinic, Santiago, Chile
| | - Margarita Alfaro-Barra
- Centro de Cáncer, Red de Salud U- Christus, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Rodrigo Fernández-Verdejo
- Laboratorio de Fisiología del Ejercicio y Metabolismo (LABFEM), Escuela de Kinesiología, Facultad de Medicina, Universidad Finis Terrae, Santiago, Chile
| | - Alvaro Reyes-Ponce
- Escuela de Kinesiología, Facultad de Ciencias de la Rehabilitación, Universidad Andrés Bello, Viña del Mar, Chile
| | - Gina Merino-Pereira
- Departamento Manejo Integral del Cáncer y Otros Tumores, Subsecretaria de Salud Pública, Ministerio de Salud de Chile, Santiago, Chile
- Escuela de Medicina, Facultad de Ciencias, Universidad Mayor, Santiago, Chile
- Instituto de Investigación y Postgrado, Facultad de Ciencias de la Salud, Universidad Central de Chile, Santiago, Chile
| | - Irene Cantarero-Villanueva
- 'Cuídate' From Biomedical Group (BIO277), Instituto de Investigación Biosanitaria (ibs.GRANADA), Granada, Spain
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
- Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain
- Sport and Health Research Center (iMUDS), Granada, Spain
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