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Park JE, Yeob KE, Kim SY, Kim CW, Han HS, Park JH. U-shaped association between body mass index and health-related quality of life impairment in Korean cancer survivors: a nationwide representative cross-sectional survey. J Cancer Surviv 2023; 17:1522-1532. [PMID: 35089523 DOI: 10.1007/s11764-022-01174-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 01/17/2022] [Indexed: 10/19/2022]
Abstract
PURPOSE Although obesity is an important risk factor for cancer incidence, the effect of body mass index (BMI) on health-related quality of life (HRQoL) after cancer treatment remains unknown. This population-based cross-sectional study assessed different levels of BMI as an important factor associated with impaired HRQoL in long-term cancer survivors. METHODS The study enrolled 1104 cancer survivors from the fourth to seventh Korea National Health and Nutrition Examination Surveys (KNHANES 2007-2018) who were alive at least 5 years after their cancer diagnoses. The BMI was classified into four categories: < 20 (underweight), 20-22.9 (healthy weight), 23-24.9 (overweight), and ≥ 25 kg/m2 (obese). Impaired HRQoL was defined as the lowest quartile of European Quality of Life 5-Dimensions (EQ-5D) questionnaire scores. RESULTS Cancer survivors who were underweight or obese were more likely to report health problems on each dimension of the EQ-5D compared to the other BMI groups. In multivariate logistic regression analysis, the two extreme BMI categories were significantly associated with impaired HRQoL (BMI < 20 kg/m2: odds ratio [OR] = 1.73, 95% confidence interval [CI] = 1.08-2.86; BMI ≥ 25 kg/m2: OR = 2.14, 95% CI = 1.41-3.25; P trend = 0.049), especially in the gastrointestinal cancer group (P heterogeneity = 0.007). Moreover, the association between underweight/obese and impaired HRQoL showed a significant sex difference (P heterogeneity = 0.019). CONCLUSIONS The results of this study suggest that deviations from normal BMI, such as being underweight or obese, are negatively associated with HRQoL in long-term cancer survivors; to some extent, this may depend on cancer type and sex. IMPLICATIONS FOR CANCER SURVIVORS Reaching or maintaining a healthy weight should be emphasized for cancer survivors as a long-term goal even after cancer treatment.
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Affiliation(s)
- Jong Eun Park
- Institute of Health & Science Convergence, Chungbuk National University, Cheongju, Republic of Korea
| | - Kyoung Eun Yeob
- Institute of Health & Science Convergence, Chungbuk National University, Cheongju, Republic of Korea
| | - So Young Kim
- Department of Public Health and Preventive Medicine, Chungbuk National University Hospital, Cheongju, Republic of Korea
- College of Medicine, Chungbuk National University, Cheongju, Republic of Korea
| | - Chul-Woung Kim
- Department of Preventive Medicine, College of Medicine, Chungnam National University, Daejeon, Republic of Korea
| | - Hye Sook Han
- College of Medicine, Chungbuk National University, Cheongju, Republic of Korea
- Department of Internal Medicine, College of Medicine, Chungbuk National University Hospital, Cheongju, Republic of Korea
| | - Jong Hyock Park
- Institute of Health & Science Convergence, Chungbuk National University, Cheongju, Republic of Korea.
- College of Medicine, Chungbuk National University, Cheongju, Republic of Korea.
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Clark LA, Klinedinst NJ, Zhu S, Seong H, Reed R, Renn C, Corazzini KN. Factors Related to Fatigue and Physical Function in COPD: A Secondary Analysis Using National Survey Data. West J Nurs Res 2023; 45:653-664. [PMID: 37114849 DOI: 10.1177/01939459231170710] [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] [Indexed: 04/29/2023]
Abstract
Fatigue in chronic obstructive pulmonary disease (COPD) is debilitating and associated with considerable morbidity. The aim of this study is to present a model based on the Theory of Unpleasant Symptoms of physiologic, psychologic, and situational factors with COPD-related fatigue and the relationship with physical functioning. This study used data collected from Wave 2 (2010-2011) of the National Social, Health, and Aging Project (NSHAP). A total of 518 adults with self-reported COPD were included in this study. Path analysis was used for hypothesis testing. Depression was the only psychologic factor found to have a direct relation to both fatigue (β = 0.158, p < .001) and physical function (β = -0.131, p = .001). Factors related to physical function included fatigue, depression, sleep, loneliness, and pain. Additionally, fatigue was indirectly associated with physical function via depression (β = -0.064, p = .012). These findings suggest avenues for future research on predictors of COPD-related fatigue in relation to physical functioning.
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Affiliation(s)
- Lindsey A Clark
- University of Maryland School of Nursing, Baltimore, MD, USA
| | | | - Shijun Zhu
- University of Maryland School of Nursing, Baltimore, MD, USA
| | - Hohyun Seong
- University of Maryland School of Nursing, Baltimore, MD, USA
| | - Robert Reed
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - Cynthia Renn
- University of Maryland School of Nursing, Baltimore, MD, USA
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Berkman AM, Andersen CR, Tang K, Gilchrist SC, Roth ME. Disparities in physical activity in adolescent and young adult cancer survivors. J Cancer Surviv 2022; 17:848-858. [DOI: 10.1007/s11764-022-01264-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 09/24/2022] [Indexed: 11/11/2022]
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Gorzelitz JS, Stoller S, Costanzo E, Gangnon R, Koltyn K, Dietz AT, Spencer RJ, Rash J, Cadmus-Bertram L. Improvements in strength and agility measures of functional fitness following a telehealth-delivered home-based exercise intervention in endometrial cancer survivors. Support Care Cancer 2022; 30:447-455. [PMID: 34304292 PMCID: PMC9362897 DOI: 10.1007/s00520-021-06415-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 07/04/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Endometrial cancer is strongly linked to obesity and inactivity; however, increased physical activity has important benefits even in the absence of weight loss. Resistance (strength) training can deliver these benefits; yet few women participate in resistance exercise. The purpose of this study was to describe both physiological and functional changes following a home-based strength training intervention. METHODS Forty post-treatment endometrial cancer survivors within 5 years of diagnosis were enrolled in a pilot randomized trial, comparing twice-weekly home-based strength exercise to wait list control. Participants conducted the exercises twice per week for 10 supervised weeks with 5 weeks of follow-up. Measures included DXA-measured lean mass, functional fitness assessments, blood biomarkers, and quality of life outcomes. RESULTS On average, participants were 60.9 years old (SD = 8.7) with BMI of 39.9 kg/m2 (SD = 15.2). At baseline, participants had 51.2% (SD = 6.0) body fat, which was not different between groups. Improvements were seen in the 30-s chair sit to stand (d = .99), the 30-s arm curl (d = .91), and the 8-ft up-and-go test (d = .63). No changes were measured for HbA1c or C-reactive protein. No changes were observed for flexibility (chair sit and reach, back scratch tests), 6-min walk test, maximum handgrip test, anxiety, depression, fatigue, or self-efficacy for exercise. CONCLUSIONS Home-based muscle-strengthening exercise led to favorable and clinically relevant improvements in 3 of 7 physical function assessments. Physical function, body composition, blood biomarkers, and patient-reported outcomes were feasible to measure. These fitness improvements were observed over a relatively short time frame of 10 weeks.
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Affiliation(s)
- Jessica S Gorzelitz
- Department of Kinesiology, University of Wisconsin-Madison, 1300 University Ave, Bardeen 253A, Madison, WI, 53706, USA
| | - Stefanie Stoller
- Department of Orthopaedic Surgery, Doctor of Physical Therapy Division, Duke University, Durham, NC, USA
| | - Erin Costanzo
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, USA
| | - Ronald Gangnon
- Departments of Biostatistics & Medical Informatics, and Statistics, University of Wisconsin-Madison, Madison, WI, USA
- Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI, USA
| | - Kelli Koltyn
- Department of Kinesiology, University of Wisconsin-Madison, 1300 University Ave, Bardeen 253A, Madison, WI, 53706, USA
| | - Amy Trentham Dietz
- Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI, USA
| | - Ryan J Spencer
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of Wisconsin-Madison, Madison, WI, USA
| | - Joanne Rash
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of Wisconsin-Madison, Madison, WI, USA
| | - Lisa Cadmus-Bertram
- Department of Kinesiology, University of Wisconsin-Madison, 1300 University Ave, Bardeen 253A, Madison, WI, 53706, USA.
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Sisodia RC, Dewdney SB, Fader AN, Wethington SL, Melamed A, Von Gruenigen VE, Zivanovic O, Carter J, Cohn DE, Huh W, Wenzel L, Doll K, Cella D, Dowdy SC. Patient reported outcomes measures in gynecologic oncology: A primer for clinical use, Part II. Gynecol Oncol 2020; 158:201-207. [DOI: 10.1016/j.ygyno.2020.03.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 03/16/2020] [Indexed: 11/28/2022]
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Wong ML, Paul SM, Mastick J, Ritchie C, Steinman MA, Walter LC, Miaskowski C. Characteristics Associated With Physical Function Trajectories in Older Adults With Cancer During Chemotherapy. J Pain Symptom Manage 2018; 56:678-688.e1. [PMID: 30144536 PMCID: PMC6195841 DOI: 10.1016/j.jpainsymman.2018.08.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 08/07/2018] [Accepted: 08/13/2018] [Indexed: 12/27/2022]
Abstract
CONTEXT Studies on physical function trajectories in older adults during chemotherapy remain limited. OBJECTIVES The objective of this study was to determine demographic, clinical, and symptom characteristics associated with initial levels as well as trajectories of physical function over two cycles of chemotherapy in adults aged ≥65 years with breast, gastrointestinal, gynecological, or lung cancer. METHODS Older adults with cancer (n = 363) who had received chemotherapy within the preceding four weeks were assessed six times over two cycles of chemotherapy using the Short Form-12 Physical Component Summary (PCS) score. Hierarchical linear modeling was used to evaluate for interindividual variability in initial levels and trajectories of PCS scores. RESULTS Mean age was 71.4 years (SD 5.5). Mean PCS score at enrollment was 40.5 (SD .45). On average, PCS scores decreased slightly (i.e., 0.21 points) at each subsequent assessment. Lower PCS scores at enrollment were associated with older age, greater comorbidity, being unemployed, lack of regular exercise, higher morning fatigue, lower evening energy, occurrence of pain, lower trait anxiety, and lower attentional function. Only higher morning fatigue and lower enrollment PCS scores were associated with decrements in physical function over time. CONCLUSION While several symptoms were associated with decrements in PCS scores at enrollment in older adults with cancer receiving chemotherapy, morning fatigue was the only symptom associated with decreases in physical function over time. Regular assessments of symptoms and implementation of evidence-based interventions should be considered to maintain physical function in older adults during chemotherapy.
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Affiliation(s)
- Melisa L Wong
- Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, California, USA.
| | - Steven M Paul
- Department of Physiological Nursing, School of Nursing, University of California, San Francisco, California, USA
| | - Judy Mastick
- Department of Physiological Nursing, School of Nursing, University of California, San Francisco, California, USA
| | - Christine Ritchie
- Division of Geriatrics, Department of Medicine, University of California, San Francisco and San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
| | - Michael A Steinman
- Division of Geriatrics, Department of Medicine, University of California, San Francisco and San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
| | - Louise C Walter
- Division of Geriatrics, Department of Medicine, University of California, San Francisco and San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
| | - Christine Miaskowski
- Department of Physiological Nursing, School of Nursing, University of California, San Francisco, California, USA
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Life after endometrial cancer: A systematic review of patient-reported outcomes. Gynecol Oncol 2018; 148:403-413. [DOI: 10.1016/j.ygyno.2017.11.007] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 11/03/2017] [Accepted: 11/04/2017] [Indexed: 12/15/2022]
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