1
|
Nicolson GL, Ferreira de Mattos G. Membrane Lipid Replacement for reconstituting mitochondrial function and moderating cancer-related fatigue, pain and other symptoms while counteracting the adverse effects of cancer cytotoxic therapy. Clin Exp Metastasis 2024; 41:199-217. [PMID: 38879842 DOI: 10.1007/s10585-024-10290-6] [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: 10/07/2023] [Accepted: 04/25/2024] [Indexed: 06/30/2024]
Abstract
Cancer-related fatigue, pain, gastrointestinal and other symptoms are among the most familiar complaints in practically every type and stage of cancer, especially metastatic cancers. Such symptoms are also related to cancer oxidative stress and the damage instigated by cancer cytotoxic therapies to cellular membranes, especially mitochondrial membranes. Cancer cytotoxic therapies (chemotherapy and radiotherapy) often cause adverse symptoms and induce patients to terminate their anti-neoplastic regimens. Cancer-related fatigue, pain and other symptoms and the adverse effects of cancer cytotoxic therapies can be safely moderated with oral Membrane Lipid Replacement (MLR) glycerolphospholipids and mitochondrial cofactors, such as coenzyme Q10. MLR provides essential membrane lipids and precursors to maintain mitochondrial and other cellular membrane functions and reduces fatigue, pain, gastrointestinal, inflammation and other symptoms. In addition, patients with a variety of chronic symptoms benefit from MLR supplements, and MLR also has the ability to enhance the bioavailability of nutrients and slowly remove toxic, hydrophobic molecules from cells and tissues.
Collapse
Affiliation(s)
- Garth L Nicolson
- Department of Molecular Pathology, The Institute for Molecular Medicine, Huntington Beach, CA, 92647, USA.
- Department of Molecular Pathology, The Institute for Molecular Medicine, P.O. Box 9355, S. Laguna Beach, CA, 92652, USA.
| | - Gonzalo Ferreira de Mattos
- Laboratory of Ion Channels, Biological Membranes and Cell Signaling, Department of Biophysics, Facultad de Medicina, Universidad de La República, Montevideo, Uruguay
| |
Collapse
|
2
|
Grant SJ, Kay S, Lacey J, Kumar S, Kerin-Ayres K, Stehn J, Gonzalez M, Templeton S, Heller G, Cockburn J, Wahlroos S, Malalasekera A, Mak C, Graham S. Feasibility study of a multimodal prehabilitation programme in women receiving neoadjuvant therapy for breast cancer in a major cancer hospital: a protocol. BMJ Open 2024; 14:e080239. [PMID: 38508617 PMCID: PMC10961545 DOI: 10.1136/bmjopen-2023-080239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 02/27/2024] [Indexed: 03/22/2024] Open
Abstract
INTRODUCTION Neoadjuvant therapy has become a standard treatment for patients with stage II/III HER2 positive and triple negative breast cancer, and in well-selected patients with locally advanced and borderline resectable high risk, luminal B breast cancer. Side effects of neoadjuvant therapy, such as fatigue, cardiotoxicity, neurotoxicity, anxiety, insomnia, vasomotor symptoms, gastrointestinal disturbance as well as a raft of immune-related adverse events, may impact treatment tolerance, long-term outcomes, and quality of life. Providing early supportive care prior to surgery (typically termed 'prehabilitation') may mitigate these side effects and improve quality of life.During our codesign of the intervention, consumers and healthcare professionals expressed desire for a programme that 'packaged' care, was easy to access, and was embedded in their care pathway. We hypothesise that a multimodal supportive care programme including exercise and complementary therapies, underpinned by behavioural change theory will improve self-efficacy, quality of life, readiness for surgery and any additional treatment for women with breast cancer. We seek to explore cardiometabolic, residual cancer burden and surgical outcomes, along with chemotherapy completion (relative dose intensity). This article describes the protocol for a feasibility study of a multimodal prehabilitation programme. METHODS AND ANALYSIS This is a prospective, mixed-method, feasibility study of a multi-modal programme in a hospital setting for 20-30 women with breast cancer receiving neoadjuvant therapy. Primary outcomes are recruitment rate, retention rate, adherence and acceptability. Secondary outcomes include patient reported outcome measures (PROMs), surgical outcomes, length of stay, satisfaction with surgery, chemotherapy completion rates, changes in metabolic markers and adverse events. Interviews and focus groups to understand the experience with prehabilitation and different factors that may affect feasibility of the intervention . The output of this study will be a codesigned, evidence-informed intervention assessed for feasibility and acceptability by women with breast cancer and the healthcare professionals that care for them. ETHICS AND DISSEMINATION The study received ethics approval from the St Vincents Hospital HREC (HREC/2021/ETH12198). Trial results will be communicated to participants, healthcare professionals, and the public via publication and conferences. TRIAL REGISTRATION NUMBER ACTRN12622000584730.
Collapse
Affiliation(s)
- Suzanne J Grant
- Supportive Care and Integrative Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
- NICM Health Research Institute, Western Sydney University, Westmead, New South Wales, Australia
| | - Shelley Kay
- Supportive Care and Integrative Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
| | - Judith Lacey
- Supportive Care and Integrative Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
- NICM Health Research Institute, Western Sydney University, Westmead, New South Wales, Australia
| | - Sanjeev Kumar
- Medical Oncology Department, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
| | - Kim Kerin-Ayres
- Supportive Care and Integrative Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
| | - Justine Stehn
- Supportive Care and Integrative Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
| | - Maria Gonzalez
- Supportive Care and Integrative Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
- NICM Health Research Institute, Western Sydney University, Westmead, New South Wales, Australia
| | - Sandra Templeton
- Supportive Care and Integrative Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
| | - Gillian Heller
- NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Jane Cockburn
- Patient Advocate, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
| | - Sara Wahlroos
- Medical Oncology Department, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
| | - Ashanya Malalasekera
- Supportive Care and Integrative Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
- School of Medicine, University of Sydney SDN, Sydney, New South Wales, Australia
| | - Cindy Mak
- Surgical Oncology Department, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
| | - Susannah Graham
- Surgical Oncology Department, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
| |
Collapse
|
3
|
Lee H, Park EY, Sung JH. Validation of the Korean Version of the Cancer Fatigue Scale in Patients with Cancer. Healthcare (Basel) 2023; 11:1796. [PMID: 37372914 DOI: 10.3390/healthcare11121796] [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: 05/25/2023] [Revised: 06/15/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023] Open
Abstract
Cancer-related fatigue is a highly prevalent and distressing symptom that negatively affects the quality of life of patients in all stages of cancer, including survivors. The Cancer Fatigue Scale (CFS) is a 15-item multidimensional instrument with the potential to enhance comprehension of fatigue. This study aimed to translate the original English version of the CFS into Korean and establish the validity and reliability of the translated version. A cross-sectional descriptive design was used to translate and validate the CFS in Korean. Factor analyses were performed to understand and establish construct and convergent validity with the Brief Fatigue Inventory (BFI), Functional Assessment of Chronic Illness Therapy-Fatigue (FACT-F), and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 (EORTC QLQ-C30). The CFS demonstrated good internal consistency (Cronbach's alpha coefficient for all 15 items = 0.806); the Kaiser-Meyer-Olkin Measure of Sampling Adequacy was found to be 0.897, and Bartlett's test of sphericity was significant (p < 0.001). Moderate correlations were found between BFI, FACT-F, and EROTC QLQ-C30, indicating moderate validity. However, there were differences in factorial validity between the original scale and the Korean version, demonstrating a need for further testing in a homogenous population of cancer patients. The findings of this validation and reliability study showed that the Korean version of the CFS is a concise, reliable, feasible, and practical tool for evaluating the multidimensional aspects of cancer-related fatigue in patients with cancer.
Collapse
Affiliation(s)
- Haneul Lee
- Department of Physical Therapy, College of Health Science, Gachon University, Incheon 21936, Republic of Korea
| | - Eun Young Park
- College of Nursing, Gachon University, Incheon 21936, Republic of Korea
| | - Ji Hyun Sung
- College of Nursing, Kosin University, 262 Gamcheon-ro, Seo-gu, Busan 49267, Republic of Korea
| |
Collapse
|
4
|
Four-year follow-up on fatigue and sleep quality of a three-armed partly randomized controlled study in breast cancer survivors with cancer-related fatigue. Sci Rep 2023; 13:2705. [PMID: 36792620 PMCID: PMC9931714 DOI: 10.1038/s41598-022-25322-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 11/28/2022] [Indexed: 02/17/2023] Open
Abstract
Cancer-related fatigue (CRF) is a frequent long-term symptom in non-metastasized breast cancer patients (BC). This 4-year follow-up intended to compare the long-term effects of a 10-week multimodal therapy (MT: sleep education, psychoeducation, eurythmy- and painting therapy) and combination therapy [CT: MT plus aerobic training (AT)] to AT-control. BC-patients were randomized or allocated by preference to three arms in a comprehensive cohort study. Primary outcome was a composite score including Pittsburgh Sleep Quality Index (PSQI) and Cancer Fatigue Scale (CFS-D), captured at baseline, after 10 weeks of intervention (T1), 6 months later (T2), and after 4 years (T3). We exploratively tested for superiority of MT and CT versus AT after 4 years (T3) based on the statistical model of the main analysis. Of 126 (65 randomized) BC-patients included, 105 started treatments and 79 were re-assessed for long-term effects (T3). MT and CT were superior over AT after 4 years regarding PSQI/CFS-D and PSQI sum-score, respectively (all p < 0.05), but not for CFS-D. The multimodal and combination treatment for breast cancer patients with CRF indicates sustainable long-term superiority over aerobic training for the outcomes sleep quality and combined sleep quality/fatigue. A confirmative randomized controlled trial is warranted.
Collapse
|
5
|
Accogli MA, Denti M, Costi S, Fugazzaro S. Therapeutic education and physical activity are feasible and safe in hematologic cancer patients referred to chemotherapy: results of a randomized controlled trial. Support Care Cancer 2023; 31:61. [PMID: 36534365 PMCID: PMC9763142 DOI: 10.1007/s00520-022-07530-4] [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: 03/21/2022] [Accepted: 11/12/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE Although over 60% of patients with hematologic cancer report distressing fatigue, they often do not receive recommendations on fatigue management strategies. The aim of this pilot study was to estimate the feasibility of therapeutic education and physical activity (TEPA) by measuring the patients' adherence to this multidimensional intervention. The secondary aim was to estimate the impact of TEPA on clinical outcomes. METHODS Patients with hematologic cancer participated in this single-center, open-label, randomized controlled trial. The control group (CG) received two educational group sessions on fatigue and physical activity. The experimental group (EG) received the two educational sessions plus six weekly individual sessions aimed at implementing a personalized physical exercise program. Follow-ups were at 1, 3, and 7 months. RESULTS Forty-six patients referred to chemotherapy were included, corresponding to 54% of recruitment rate. Adherence reached 90% in the EG and 68% in the CG. Most patients (65% in EG and 64% in CG) attended a minimum of 80% of the planned sessions. Overall retention rate was 87% (85% in EG and 91% in CG). No adverse events were registered. No between-group differences were detected in fatigue (FACIT-F), psychological distress (NCCN Distress Thermometer), QoL (EORTC QLQ-C30), or functional exercise capacity (TUG test and 6MWT). Adherence to an active lifestyle, measured by a semi-structured interview, increased from 56.5 to 84% in the EG at 7 months (p = 0.02), whereas it decreased slightly in the CG (from 47.8 to 42.9%). CONCLUSION Multidimensional rehabilitation interventions are feasible and safe in this population, and larger trials should focus on the efficacy of such approaches on clinically relevant outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03403075.
Collapse
Affiliation(s)
- Monia Allisen Accogli
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale-IRCCS Di Reggio Emilia, Viale Risorgimento N°80, 42123 Reggio Emilia, Italy
| | - Monica Denti
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale-IRCCS Di Reggio Emilia, Viale Risorgimento N°80, 42123 Reggio Emilia, Italy
| | - Stefania Costi
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale-IRCCS Di Reggio Emilia, Viale Risorgimento N°80, 42123 Reggio Emilia, Italy ,grid.7548.e0000000121697570Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Via del Pozzo N°74, 41100 Modena, Italy
| | - Stefania Fugazzaro
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale-IRCCS Di Reggio Emilia, Viale Risorgimento N°80, 42123 Reggio Emilia, Italy
| |
Collapse
|
6
|
Janjua S, Brown M, Parker R, Prue G, Closier P, Cramp F. Physical activity for the management of cancer-related fatigue in adults. Hippokratia 2022. [DOI: 10.1002/14651858.cd015348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Affiliation(s)
- Sadia Janjua
- Pain, Palliative and Supportive Care Review Group; Cochrane; Oxford UK
| | - Malcolm Brown
- School of Nursing and Midwifery; Queen's University Belfast; Belfast UK
| | - Roses Parker
- Cochrane MOSS Network; c/o Cochrane Pain Palliative and Supportive Care Group; Oxford UK
| | - Gillian Prue
- School of Nursing and Midwifery; Queen's University Belfast; Belfast UK
| | - Philippa Closier
- University Hospitals Bristol and Weston NHS Foundation Trust; Bristol UK
| | - Fiona Cramp
- Faculty of Health & Applied Sciences; University of the West of England; Bristol UK
| |
Collapse
|
7
|
Kirvin-Quamme A, Rumble ME, Cadmus-Bertram L, Juckett MB, Rathouz PJ, Schell G, Callander NS, Hematti P, Costanzo ES. A biobehavioral intervention to enhance recovery following hematopoietic cell transplantation: Protocol for a feasibility and acceptability randomized control trial. Contemp Clin Trials Commun 2022; 28:100938. [PMID: 35664502 PMCID: PMC9160488 DOI: 10.1016/j.conctc.2022.100938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 04/14/2022] [Accepted: 05/25/2022] [Indexed: 11/18/2022] Open
Abstract
Background Insomnia, fatigue, and depression are among the most persistent and distressing concerns for hematologic cancer patients recovering from hematopoietic cell transplantation (HCT). This study will evaluate a novel behavioral intervention, Restoring Sleep and Energy after Transplant (ReSET), designed to alleviate insomnia, fatigue, and depression by improving rest-activity patterns. Evidence-based behavioral strategies to improve nighttime sleep and increase non-sedentary daytime activity will be combined to optimize 24-h rest-activity patterns. Methods The protocol herein evaluates the feasibility and acceptability of ReSET by conducting a pilot randomized controlled trial to compare the intervention with usual care. Adults undergoing HCT will be randomly assigned to ReSET or usual care. The ReSET arm will receive 3 face-to-face sessions and telephone coaching delivered in an individual format tailored to each patient. Patient-reported insomnia, fatigue, and depression will be the primary outcome measures. Actigraphy will be used to objectively quantify rest-activity patterns. Semi-structured interviews will evaluate participant satisfaction with ReSET. The goals are to determine: (1) participant satisfaction with and acceptability of the behavioral techniques; (2) facilitator fidelity and participant uptake of key intervention components; (3) ability to recruit, retain, and collect complete data from participants; (4) participant willingness to be randomized and acceptability of the control condition; and (5) validity and acceptability of the assessment strategy. Conclusion The overarching goal is to optimize recovery following HCT with a brief, non-invasive intervention that can be implemented as a part of routine clinical care. First intervention for cancer patients to optimize 24-h rest-activity rhythms. Non-invasive intervention designed for implementation in routine clinical care. Restoration of normal circadian rhythm targets insomnia, fatigue, and depression. Addresses the high need for efficacious, brief interventions for cancer patients. Innovative behavioral intervention approach applicable to a wide variety of cancers.
Collapse
Affiliation(s)
- Andrew Kirvin-Quamme
- Department of Psychiatry, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
- Paul P. Carbone Cancer Center, Madison, WI, United States
| | - Meredith E. Rumble
- Department of Psychiatry, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
- Center for Sleep Medicine & Research, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Lisa Cadmus-Bertram
- Paul P. Carbone Cancer Center, Madison, WI, United States
- Department of Kinesiology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Mark B. Juckett
- Division of Hematology, Oncology, Transplantation, Department of Medicine, University of Minnesota, Minneapolis, MN, United States
| | - Paul J. Rathouz
- Department of Population Heath, Dell Medical School, University of Texas at Austin, Austin, TX, United States
| | - Gwynneth Schell
- Department of Psychiatry, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Natalie S. Callander
- Paul P. Carbone Cancer Center, Madison, WI, United States
- Division of Hematology and Oncology, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Peiman Hematti
- Paul P. Carbone Cancer Center, Madison, WI, United States
- Division of Hematology and Oncology, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Erin S. Costanzo
- Department of Psychiatry, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
- Paul P. Carbone Cancer Center, Madison, WI, United States
- Corresponding author. Department of Psychiatry, University of Wisconsin- Madison, 6001 Research Park Blvd, Madison, WI, 53719, United States.
| |
Collapse
|
8
|
D’Silva F, Javeth A, Singh P. Cancer-Related Fatigue – Clinical Evaluation Scales and Interventions: A Systematic Review. Indian J Palliat Care 2022; 28:88-98. [PMID: 35673374 PMCID: PMC9165454 DOI: 10.25259/ijpc_455_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 12/13/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Cancer-related fatigue (CRF) is one of the most frequent and prevalent symptoms expressed by cancer patients and cancer survivors. It is a multifactorial phenomenon that causes a direct detrimental impact on quality of life. Objectives: This systematic review aims to identify different clinical evaluation scales and interventions available for fatigue associated with cancer. Materials and Methods: A methodology of the systematic literature review was carried out. Two separate databases PubMed and Google Scholar searches were performed using different MeSH terms. Results: A total of 2611 research articles were screened and identified 10 unidimensional scales (four with one item scales and six with numerous item scales) and 13 multidimensional scales which are available for the screening and clinical evaluation of fatigue. Reviews have also revealed non-pharmacological interventions such as exercise, complementary therapies, nutritional and psychoeducational interventions, sleep therapy, energy therapy, bright white light, restorative therapies upcoming anthroposophical medicine, and various pharmacological agents effective in managing CRF. Conclusion: Clinical evaluation of fatigue and its management is crucial for improving the quality of life. Yet, more rigorous research studies with higher statistical power need to be conducted on these interventions to generate adequate evidences for managing the CRF.
Collapse
Affiliation(s)
- Fatima D’Silva
- Department of Medical Surgical Nursing, Nitte Usha Institute of Nursing Sciences, NITTE (Deemed to Be University), Mangalore, Karnataka, India,
| | - Athar Javeth
- Department of Medical Surgical Nursing, College of Nursing, Patna, Bihar, India,
| | - Pritanjali Singh
- Department of Radiation Oncology, All India Institute of Medical Science, Patna, Bihar, India,
| |
Collapse
|
9
|
Hsueh HY, Pita-Grisanti V, Gumpper-Fedus K, Lahooti A, Chavez-Tomar M, Schadler K, Cruz-Monserrate Z. A review of physical activity in pancreatic ductal adenocarcinoma: Epidemiology, intervention, animal models, and clinical trials. Pancreatology 2022; 22:98-111. [PMID: 34750076 PMCID: PMC8748405 DOI: 10.1016/j.pan.2021.10.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 10/18/2021] [Accepted: 10/20/2021] [Indexed: 01/03/2023]
Abstract
Pancreatic ductal adenocarcinoma (PDAC) is one of the deadliest types of cancer, and the increasing incidence of PDAC may be related to the prevalence of obesity. Physical activity (PA), a method known to mitigate obesity by increasing total energy expenditure, also modifies multiple cellular pathways associated with cancer hallmarks. Epidemiologic evidence has shown that PA can lower the risk of developing a variety of cancers, reduce some of the detrimental side effects of treatments, and improve patient's quality of life during cancer treatment. However, little is known about the pathways underlying the correlations observed between PA interventions and PDAC. Moreover, there is no standard dose of PA intervention that is ideal for PDAC prevention or as an adjuvant of cancer treatments. In this review, we summarize relevant literature showing how PDAC patients can benefit from PA, the potential of PA as an adjuvant treatment for PDAC, the studies using preclinical models of PDAC to study PA, and the clinical trials to date assessing the effects of PA in PDAC.
Collapse
Affiliation(s)
- Hsiang-Yin Hsueh
- Division of Gastroenterology, Hepatology, and Nutrition, Division of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA; The Comprehensive Cancer Center-Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The Ohio State University, Columbus, OH, USA
| | - Valentina Pita-Grisanti
- Division of Gastroenterology, Hepatology, and Nutrition, Division of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA; The Comprehensive Cancer Center-Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The Ohio State University, Columbus, OH, USA
| | - Kristyn Gumpper-Fedus
- Division of Gastroenterology, Hepatology, and Nutrition, Division of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA; The Comprehensive Cancer Center-Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The Ohio State University, Columbus, OH, USA
| | - Ali Lahooti
- Division of Gastroenterology, Hepatology, and Nutrition, Division of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA; The Comprehensive Cancer Center-Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The Ohio State University, Columbus, OH, USA
| | - Myrriah Chavez-Tomar
- Division of Gastroenterology, Hepatology, and Nutrition, Division of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA; The Comprehensive Cancer Center-Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The Ohio State University, Columbus, OH, USA
| | - Keri Schadler
- Department of Pediatrics Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Zobeida Cruz-Monserrate
- Division of Gastroenterology, Hepatology, and Nutrition, Division of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA; The Comprehensive Cancer Center-Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The Ohio State University, Columbus, OH, USA.
| |
Collapse
|
10
|
Shapiro YN, Peppercorn JM, Yee AJ, Branagan AR, Raje NS, Donnell EKO. Lifestyle considerations in multiple myeloma. Blood Cancer J 2021; 11:172. [PMID: 34702799 PMCID: PMC8548591 DOI: 10.1038/s41408-021-00560-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 09/08/2021] [Accepted: 10/01/2021] [Indexed: 12/12/2022] Open
Abstract
As the prognosis for multiple myeloma (MM) has significantly improved and patients remain on therapy longer, there is a need for supportive care interventions to optimize patient quality of life (QOL) and functional status over the course of cancer treatment. MM is characterized by a significant symptom burden and a relatively lower QOL compared to other cancers. This review evaluates the role of healthy lifestyle behaviors in improving both the physical functioning and psychological well-being of the MM population. We (1) describe the current literature on physical activity, weight management, diet, sleep, and substance use in the context of MM, (2) present important considerations for incorporating lifestyle factors into clinical practice, and (3) identify directions for future research. Developing MM-specific guidelines for modifiable lifestyle changes that take into account both the length of treatment and the unique disease features (i.e. osteolytic lesions and anemia) may provide a promising path for improved patient QOL and functioning.
Collapse
Affiliation(s)
| | - Jeffrey M Peppercorn
- Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Andrew J Yee
- Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Andrew R Branagan
- Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Noopur S Raje
- Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Elizabeth K O' Donnell
- Massachusetts General Hospital, Boston, MA, USA. .,Harvard Medical School, Boston, MA, USA.
| |
Collapse
|
11
|
Tolotti A, Bonetti L, Pedrazzani C, Bianchi M, Moser L, Pagnucci N, Sari D, Valcarenghi D. Nursing management of fatigue in cancer patients and suggestions for clinical practice: a mixed methods study. BMC Nurs 2021; 20:182. [PMID: 34583693 PMCID: PMC8477483 DOI: 10.1186/s12912-021-00699-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 08/19/2021] [Indexed: 01/29/2023] Open
Abstract
Background Fatigue is a complex and frequent symptom in cancer patients, influencing their quality of life, but it is still underestimated and undertreated in clinical practice. The aims of this study were to detect the presence of fatigue in cancer patients, describe how patients and nurses perceived it and how nurses managed fatigue. Methods This is a mixed methods study. Data were collected in two oncological wards using the Brief Fatigue Inventory (BFI), an ad hoc questionnaire, patient interviews, focus groups with nurses and the review of nursing records. Interviews and focus groups were analysed through thematic analysis. We used SPSS 22.0 for quantitative data and Nvivo 10 for qualitative data analysis. Results A total of 71 questionnaires were analysed (39 males, mean age 65.7 years). Fatigue was reported 5 times (7%) in nursing records, while in 17 cases (23.9%) problems associated to it were reported. Twelve patients were interviewed. Five themes were identified: feeling powerless and aggressive, my strategies or what helps me, feeling reassured by the presence of family members, feeling reassured by nurses’ gestures, and being informed. Three themes were identified through the focus groups: objectivity and subjectivity in the assessment of fatigue, nurses’ contribution to the multidisciplinary management of fatigue, and difficulty in evaluating outcomes. Conclusions The approach to the management of fatigue was unstructured. Patients were satisfied with the care they received but needed more information and specific interventions. Useful aspects were identified that could be used to change health professionals’ approach towards the management of fatigue. Supplementary Information The online version contains supplementary material available at 10.1186/s12912-021-00699-9.
Collapse
Affiliation(s)
- Angela Tolotti
- Nursing Research and Development Unit, Oncology Institute of Southern Switzerland (IOSI), Via Gallino, 12, 6500, Bellinzona, Switzerland
| | - Loris Bonetti
- Nursing Research and Development Unit, Oncology Institute of Southern Switzerland (IOSI), Via Gallino, 12, 6500, Bellinzona, Switzerland. .,Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland (SUPSI), Manno, Switzerland.
| | - Carla Pedrazzani
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland (SUPSI), Manno, Switzerland
| | - Monica Bianchi
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland (SUPSI), Manno, Switzerland
| | - Laura Moser
- Clinical Trial Unit, Oncology Institute of Southern Switzerland (IOSI), Via Gallino, 12, 6500, Bellinzona, Switzerland
| | - Nicola Pagnucci
- Department of Surgical, Medical and Molecular Pathology and Critical Care, University of Pisa, Pisa, Italy
| | - Davide Sari
- Department of Nursing, Oncology Institute of Southern Switzerland (IOSI), Via Gallino, 12, 6500, Bellinzona, Switzerland
| | - Dario Valcarenghi
- Nursing Research and Development Unit, Oncology Institute of Southern Switzerland (IOSI), Via Gallino, 12, 6500, Bellinzona, Switzerland
| |
Collapse
|
12
|
Takahashi S. Fatigue and its management in cancer patients undergoing VEGFR-TKI therapy. Expert Opin Drug Saf 2021; 21:397-406. [PMID: 34461788 DOI: 10.1080/14740338.2021.1969360] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Fatigue is the most common side effect of cancer and cancer treatment and is often called cancer fatigue or cancer-related fatigue. For cancer patients, cancer-related fatigue has a negative impact on participation in work and social activities, mood, and daily activities, significantly impairing quality of life. Vascular endothelial growth factor receptor tyrosine kinase inhibitors (VEGFR-TKIs) sometimes cause fatigue, and early detection and appropriate management of fatigue in cancer patients treated with a VEGFR-TKI prevent fatigue from becoming more severe, thus maximizing the benefits of the treatment. AREAS COVERED This paper focuses on fatigue and discusses its frequency, assessment, risk factors, and management methods. EXPERT OPINION The drugs currently available for treating cancer-related fatigue are not effective enough, and their mechanisms of action are not fully understood. Some agents have demonstrated efficacy as treatments for fatigue due to pharmacotherapy, and further elucidation of their mechanisms is expected, together with the development of new drugs. Since fatigue has a range of causes, its treatment requires not only medication, but also exercise, nutrition, and other therapeutic approaches. The successful treatment of fatigue will therefore need multidisciplinary therapy involving the establishment of systems of cooperation across various specialties.
Collapse
Affiliation(s)
- Shunji Takahashi
- Department of Medical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| |
Collapse
|
13
|
Jaya P, Thakur A. Effect of Progressive Muscle Relaxation Therapy on Fatigue and Psychological Distress of Cancer Patients during Radiotherapy: A Randomized Controlled Trial. Indian J Palliat Care 2021; 26:428-432. [PMID: 33623302 PMCID: PMC7888427 DOI: 10.4103/ijpc.ijpc_236_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 05/14/2020] [Indexed: 12/04/2022] Open
Abstract
Background: Patients with cancer receiving radiotherapy experiences fatigue and psychological distress. Now a days there has been growing interest towards managing these symptoms with non-pharmacological treatments, But researches related to effect of progressive muscle relaxation therapy on fatigue and psychological distresses related to admitted patients are limited hence the aim of the study to evaluate the effect of progressive muscle relaxation therapy on fatigue and psychological distress in Cancer patients during Radiotherapy. Aims and Objectives: Aim of the study to evaluate the effect of progressive muscle relaxation therapy on fatigue and psychological distress in Cancer patients during Radiotherapy. Materials and Methods: The study design was single blinded randomized control trial. Total of 50 patients, for both intervention and control group 25 patients were included. The intervention group patients received P.M.R. therapy of 20 min. given for 3 times/week of total period of 3 weeks, whereas the control group received conventional treatment with no added intervention. Fatigue symptom inventory and hospital anxiety and depression scale used as an outcome measures. Results: Paired t-test used for FSI to compare among intervention and control group and results were showing statistical significant difference (P < 0.05), similarly pre and post improvement was observed in both the groups for HADS. Between group comparison showed no superior improvement one over the other. Conclusion: Based on the above findings, P.M.R. and conventional treatment were similarly efficacious in decreasing fatigue and psychological distress related to cancer patients who were hospitalized undergoing radiotherapy.
Collapse
Affiliation(s)
- P Jaya
- Department of Physiotherapy, Father Muller Medical College, Mangalore, Karnataka, India
| | - Ajay Thakur
- Department of Physiotherapy, Vikas College of Physiotherapy, Mangalore, Karnataka, India
| |
Collapse
|
14
|
Music interventions can alleviate cancer-related fatigue: a metaanalysis. Support Care Cancer 2021; 29:3461-3470. [DOI: 10.1007/s00520-021-05986-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 01/04/2021] [Indexed: 10/22/2022]
|
15
|
Effect of Tai Chi and Resistance Training on Cancer-Related Fatigue and Quality of Life in Middle-Aged and Elderly Cancer Patients. Chin J Integr Med 2021; 27:265-272. [PMID: 33420583 DOI: 10.1007/s11655-021-3278-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To study the effect of Tai Chi (TC) and resistance training (RT) with different intensity on the cancer-related fatigue (CRF) and quality of life (QoL) of middle-aged and elderly cancer patients. METHODS Totally 120 cancer patients were enrolled and randomly assigned to 4 groups by a random number table, including TC group, high-intensity 60% one repetition maximum (1-RM) RT group (HIRT), low-intensity (30% 1-RM) RT group (LIRT) and control group, 30 patients in each group. Participants in the TC group received 24-form simplified Yang-style TC training at a frequency of 40 min per day, 3 days per week for 12 weeks. Patients in the two RT groups received 10 sessions, 6 designated movements per day, 3 days per week for 12 weeks. The 1-RM of 6 muscle groups, fat mass (FM), lean body mass (LBM), along with the scores of Brief Fatigue Inventory (BFI), QoL questionnaire for Chinese cancer patients receiving chemobiotherapy (QLQ-CCC), Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9) and Pittsburgh Sleep Quality Index (PSQI) were measured before and after training. The adverse effect was also observed. RESULTS After 12-week intervention, patients in both TC and RT groups showed significant improvements in CRF and QLQ-CCC compared to pre-treatment (P<0.05). Compared with the LIRT and TC groups, patients in the HIRT group improved more significantly in increasing muscle strength and LBM, and reducing in FM (P<0.05). Patients in the TC group significantly increased in lower limb muscle strength compared with the LIRT group (P<0.05). In addition, patients in the TC group showed more significant improvements in scores of GAD-7, PHQ-9 and PSQI than 2 RT groups (P<0.05). CONCLUSIONS TC and RT, both low- and high-intensity training, can significantly increase muscle strength, reduce CRF and improve QoL in the middle-aged and elderly cancer patients. TC has a better effect than RT in terms of sleep quality and mental health. The long-term application is needed to substantiate the effect of TC as an alternative exercise in cancer patients.
Collapse
|
16
|
Jang MK, Park C, Lee KS, Lee K, Hwang EK, Joh HJ, Lim KH, Ko YH, Kim DM, Han J, Kim S. Does the Association Between Fatigue and Fatigue Self-management Preference Vary by Breast Cancer Stage? Cancer Nurs 2020; 45:43-51. [PMID: 33259375 DOI: 10.1097/ncc.0000000000000910] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Cancer-related fatigue (CRF) is a major issue facing breast cancer survivors (BCS) that can negatively impact their symptoms and quality of life. OBJECTIVES The aims of this study were to examine levels of fatigue, identify preferred types of fatigue self-management, and explore the relationship between fatigue levels and management choices by cancer stage. METHODS This cross-sectional descriptive study included 229 BCS recruited from 5 hospitals in Korea. The study inclusion criteria were limited to BCS between 20 and 69 years old in stages 1, 2, or 3 who were undergoing or had completed active therapy. The Revised Piper Fatigue Scale and a questionnaire developed for fatigue management were used for data collection. RESULTS The stage 2 group experienced more fatigue (mean, 5.31) than the other cancer stage groups, and significant differences in fatigue were found between stages 1 and 2 (P < .001). Fatigue self-management choices showed different correlations with fatigue levels in each stage. Physical activity control was most frequently used in stage 1, whereas exercise was most frequently used in stages 2 and 3. Multivariate regression analysis showed that exercise consistently and effectively decreased all fatigue dimensions. CONCLUSION Stage 2 BCS experienced the greatest level of CRF, and fatigue levels and management choices differed in BCS by cancer stage. IMPLICATIONS FOR PRACTICE Recognizing how CRF and patients' preferences for fatigue self-management may differ by cancer stage can alert clinicians in assessing CRF and tailoring effective fatigue management for BCS.
Collapse
Affiliation(s)
- Min Kyeong Jang
- Author Affiliations: Department of Biobehavioral Nursing Science, College of Nursing, University of Illinois at Chicago (Drs Jang and Park); University of Illinois Cancer Center (Dr Jang), Chicago; National Cancer Center (Mss K.S. Lee and D.M. Kim), Ilsan, Korea; Severance Hospital (Ms K. Lee), Seoul, Korea; Seoul National University Hospital (Ms Hwang), Korea; Catholic University Seoul St. Mary's Hospital (Ms Joh), Korea; College of Nursing, Keimyung University (Dr Lim), Daegu, Korea; and College of Nursing, Yonsei University (Ms Ko, and Drs Han and S. Kim), Seoul, Korea
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Gong J, Payne D, Caron J, Bay CP, McGregor BA, Hainer J, Partridge AH, Neilan TG, Di Carli M, Nohria A, Groarke JD. Reduced Cardiorespiratory Fitness and Increased Cardiovascular Mortality After Prolonged Androgen Deprivation Therapy for Prostate Cancer. JACC: CARDIOONCOLOGY 2020; 2:553-563. [PMID: 34396266 PMCID: PMC8352085 DOI: 10.1016/j.jaccao.2020.08.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 08/18/2020] [Accepted: 08/19/2020] [Indexed: 01/25/2023]
Abstract
Background Prolonged androgen deprivation therapy (ADT) is favored over short-term use in patients with localized high-risk prostate cancer (PC). Objectives This study sought to compare cardiorespiratory fitness (CRF) and cardiovascular (CV) mortality among patients with PC with and without ADT exposure and to explore how duration of ADT exposure influences CRF and CV mortality. Methods Retrospective cohort study of patients referred for exercise treadmill testing (ETT) after a PC diagnosis. PC risk classification was based on Gleason score (GS): high risk if GS ≥8; intermediate risk if GS = 7; and low risk if GS <7. CRF was categorized by metabolic equivalents (METs): METs >8 defined as good CRF and METs ≤8 as reduced CRF. ADT exposure was categorized as short term (≤6 months) versus prolonged (>6 months). Results A total of 616 patients underwent an ETT a median of 4.8 years (interquartile range: 2.0, 7.9 years) after PC diagnosis. Of those, 150 patients (24.3%) received ADT prior to the ETT; 99 with short-term and 51 with prolonged exposure. 504 patients (81.8%) had ≥2 CV risk factors. Prolonged ADT was associated with reduced CRF (odds ratio [OR]: 2.71; 95% confidence interval [CI]: 1.31 to 5.61; p = 0.007) and increased CV mortality (hazard ratio [HR]: 3.87; 95% CI: 1.16 to 12.96; p = 0.028) in adjusted analyses. Although the association between short-term ADT exposure and reduced CRF was of borderline significance (OR: 1.71; 95% CI: 1.00 to 2.94; p = 0.052), there was no association with CV mortality (HR: 1.60; 95% CI: 0.51 to 5.01; p = 0.420) in adjusted Cox regression models. Conclusions Among patients with PC and high baseline CV risk, prolonged ADT exposure was associated with reduced CRF and increased CV mortality.
Collapse
Key Words
- ADT, androgen deprivation therapy
- BMI, body mass index
- CI, confidence interval
- CRF, cardiorespiratory fitness
- CV, cardiovascular
- ETT, exercise treadmill test
- HR, hazard ratio
- IQR, interquartile range
- MET, metabolic equivalent
- OR, odds ratio
- PC, prostate cancer
- androgen deprivation therapy
- cardio-oncology
- cardiorespiratory fitness
- cardiovascular mortality
- cardiovascular risk
- prostate cancer
Collapse
Affiliation(s)
- Jingyi Gong
- Heart and Vascular Center, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - David Payne
- Heart and Vascular Center, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Jesse Caron
- Heart and Vascular Center, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Camden P Bay
- Center for Clinical Investigation, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Bradley A McGregor
- Lank Center for Genitourinary Oncology, Dana Farber Cancer Institute, Boston, Massachusetts, USA
| | - Jon Hainer
- Noninvasive Cardiovascular Imaging Program, Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Ann H Partridge
- Adult Survivorship Program, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Tomas G Neilan
- Cardio-Oncology Program, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Marcelo Di Carli
- Noninvasive Cardiovascular Imaging Program, Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Anju Nohria
- Heart and Vascular Center, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Adult Survivorship Program, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - John D Groarke
- Heart and Vascular Center, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Adult Survivorship Program, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| |
Collapse
|
18
|
Mindfulness Ased Stress Reduction Interventions for Cancer Related Fatigue: A Meta-Analysis and Systematic Review. J Natl Med Assoc 2020; 112:387-394. [DOI: 10.1016/j.jnma.2020.04.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 04/20/2020] [Accepted: 04/26/2020] [Indexed: 11/17/2022]
|
19
|
Penner C, Zimmerman C, Conboy L, Kaptchuk T, Kerr C. "Honorable Toward Your Whole Self": Experiences of the Body in Fatigued Breast Cancer Survivors. Front Psychol 2020; 11:1502. [PMID: 32719641 PMCID: PMC7350261 DOI: 10.3389/fpsyg.2020.01502] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 06/05/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction Cancer Related Fatigue (CRF) is one of the most common and detrimental side effects of cancer treatment. Despite its increasing prevalence and severity CRF remains dismissed by the majority of clinicians. One reason for the apparent gap between clinical need and clinical undertaking is the penchant toward reductionist accounts of the disorder: a tendency to discount the interface between the lived experience of sufferers and the multi-dimensional etiology of CRF as it manifests adversely on a day-to-day basis. Methods In order to better understand the interplay between social, bodily, and emotional components of the disorder we undertook semi-structured interviews with thirteen Breast Cancer survivors suffering from CRF, and then subsequently analyzed their responses using Team Based Qualitative Analysis. Results Our analysis revealed multiple dimensions of the social and bodily underpinnings of fatigue. Most relevantly we found a consistent change in the level and quality of attention to bodily signals. This shift in awareness appeared to be directly connected to the experience of CRF and a newfound, “respect,” for the needs of the body. Furthermore, we found that many of the practices that were described as helpful in alleviating fatigue were oriented around eliciting a sense of embodied awareness, examples being: dance, yoga, and shamanic ritual. This relationship with bodily sensations existed in conjunction with the anxiety and trauma that arose as a result of cancer treatment. Conclusion Our analysis suggests that the quality of awareness and relationship to bodily experience in CRF is a functionally relevant component of the disorder and should be considered as an experiential target moving forward.
Collapse
Affiliation(s)
- Cooper Penner
- Department of Neuroscience, Brown University, Providence, RI, United States.,Department of Neurosurgery, Cedars Sinai Medical Center, Los Angeles, CA, United States
| | - Chloe Zimmerman
- Department of Neuroscience, Brown University, Providence, RI, United States.,Warren Alpert Medical School, Brown University, Providence, RI, United States.,Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Lisa Conboy
- Warren Alpert Medical School, Brown University, Providence, RI, United States.,Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States.,New England School of Acupuncture, Newton, MA, United States
| | - Ted Kaptchuk
- Warren Alpert Medical School, Brown University, Providence, RI, United States.,Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Catherine Kerr
- Department of Contemplative Studies, Brown University, Providence, RI, United States
| |
Collapse
|
20
|
Fabi A, Bhargava R, Fatigoni S, Guglielmo M, Horneber M, Roila F, Weis J, Jordan K, Ripamonti CI. Cancer-related fatigue: ESMO Clinical Practice Guidelines for diagnosis and treatment. Ann Oncol 2020; 31:713-723. [PMID: 32173483 DOI: 10.1016/j.annonc.2020.02.016] [Citation(s) in RCA: 204] [Impact Index Per Article: 51.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 02/27/2020] [Indexed: 12/18/2022] Open
Affiliation(s)
- A Fabi
- Division of Medical Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - R Bhargava
- William Osler Health System, Corporate Department of Research, Department of Oncology and Division of Palliative Care, Brampton, Canada
| | - S Fatigoni
- Division of Medical Oncology, Ospedale Santa Maria della Misericordia, Perugia, Italy
| | - M Guglielmo
- Oncology-Supportive Care Unit, Department Onco-Haematology, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - M Horneber
- Department of Internal Medicine, Division of Oncology and Hematology & Division of Pneumology, Paracelsus Medical University, Klinikum, Nuremberg, Germany
| | - F Roila
- Division of Medical Oncology, Ospedale Santa Maria della Misericordia, Perugia, Italy
| | - J Weis
- Department of Self Help Research in Oncology, Comprehensive Cancer Center, University Medical Center, Freiburg, Germany
| | - K Jordan
- Department of Medicine V, Hematology, Oncology and Rheumatology, University Hospital Heidelberg, Heidelberg, Germany
| | - C I Ripamonti
- Oncology-Supportive Care Unit, Department Onco-Haematology, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| |
Collapse
|
21
|
Denti M, Accogli MA, Costi S, Fugazzaro S. Therapeutic Education and Physical Activity to Support Self-management of Cancer-related Fatigue in Hematologic Cancer Patients: Protocol of a Feasibility Randomized Controlled Trial. Integr Cancer Ther 2020; 19:1534735420969830. [PMID: 33243016 PMCID: PMC7705784 DOI: 10.1177/1534735420969830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 09/23/2020] [Accepted: 10/08/2020] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Hematologic malignancies account for nearly 8% of new cancer diagnosis in Italy. Cancer-related fatigue (CRF) is one of the most distressing symptoms reported by patients with cancer. As CRF has a multifactorial etiology, physical activity and therapeutic education may be beneficial for managing CRF, both during and after cancer treatment. However, there is a lack of evidence specific to hematologic malignancies. This paper describes the protocol of a feasibility study on Therapeutic Education and Physical Activity (TEPA) intervention to support self-management of CRF in patients with hematologic malignancies. METHODS TEPA was addressed to newly diagnosed adult individuals with hematologic malignancy able to take part in a rehabilitation programme at the AUSL-IRCCS of Reggio Emilia. The protocol was developed in 2 phases. Phase I was an observational cohort study involving a convenience sample of 10 participants with the aim to evaluate the feasibility of the assessment schedule and to register longitudinal clinical data regarding CRF (FACIT-F), psychologic distress (NCCN Distress Thermometer), QoL (EORTC QLQ-C30), physical performance (TUG and 6MWT) and habitual level of physical activity during first months after diagnosis. Phase II (underway) is a feasibility randomized controlled trial (TEPA) involving a convenience sample of 40 participants and comparing 2 parallel active interventions (Therapeutic Education versus Therapeutic Education and Physical Activity) on top of usual care. The primary aim is to estimate the feasibility of TEPA, measured by the adherence rate to the intervention. Secondary aims are: to estimate the effect size of TEPA in terms of changes in CRF, psychological distress, QoL, physical performance and habitual level of physical activity (measured as in Phase I); to collect patient satisfaction, perception of usefulness of the TEPA intervention and data on long-term adherence to an active lifestyle. Data are collected in both phases at the time of diagnosis and then at 1-, 3- (completion of intervention) and 7-month follow-up. DISCUSSION Data on feasibility and effect size of TEPA will be analyzed upon completion of Phase II, allowing us to design a large, adequately powered RCT to verify the effectiveness of this intervention on CRF management in patients with hematologic cancer. Trial registration: clinicaltrials.gov; Trial registration number: NCT03403075.
Collapse
Affiliation(s)
- Monica Denti
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Monia Allisen Accogli
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Stefania Costi
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
- University of Modena and Reggio Emilia, Modena, Italy
| | - Stefania Fugazzaro
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| |
Collapse
|
22
|
Arizona IKLT, Sukartini T, Efendi F, Estiadewi PS, Anggraeni NPDA. The Experiences of Cancer-Related Fatigue among Adult Cancer Patients: A Systematic Review. JURNAL NERS 2019. [DOI: 10.20473/jn.v14i3.16973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction: Cancer-related fatigue (CRF) is one of the symptoms commonly experienced and it is a subjective feeling felt by cancer patients. The aim of this systematic review was to summarize how fatigue has been described from the perspective of adult cancer patients, the impact of fatigue on their quality of life, what the patient reported as contributing factors and potential coping strategies to reduce fatigue.Methods: A systematic review is in line with PRISMA guidelines. Five databases were systematically searched (Scopus, PubMed, Springerlink, ProQuest and Science Direct) from January 2009 to February 2019 for qualitative studies describing the experience of adult cancer patients using a predefined search strategy and any relevant keywords.Results: In total, 13 out of 4692 studies were included. The ages of the included patient cancer ranged from 26 to 84 years. The majority of studies used in-depth interviews and semi-structured interviews to elicit the participant’s experiences of fatigue. Four themes were identified: the perception of cancer-related fatigue, the etiology of cancer fatigue, impact and coping strategies.Conclusion: Fatigue is impactful on quality of life from the perspective of cancer patients. Future research should focus on the prospective exploration of the impact of fatigue on woman's and men's health and identifying approaches to reduce fatigue.
Collapse
|
23
|
Wang N, Yang Z, Miao J, Mi X, Liu S, Stern C, Porritt K, Zhang L. Clinical management of cancer-related fatigue in hospitalized adult patients: a best practice implementation project. ACTA ACUST UNITED AC 2019; 16:2038-2049. [PMID: 30335042 DOI: 10.11124/jbisrir-2017-003769] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVES This project aimed to identify and promote evidence-based practice in the management of cancer related fatigue (CRF) in the oncology unit of Nanfang Hospital, affiliated with the Southern Medical University in People's Republic of China. INTRODUCTION Cancer-related fatigue is one of the most common symptoms in patients with cancer and significantly affects their functioning and quality of life. However, it is often inadequately addressed and evidence-based practices are not always followed. METHODS The Joanna Briggs Institute (JBI) has a validated audit and feedback tool to assist with best practice implementation audits. The JBI Practical Application of Clinical Evidence System (PACES) was used in this project. A three-phase project was undertaken: i) a pre-implementation audit of current practice against evidence-based audit criteria, ii) identification of barriers and implementation of strategies to improve practice using the JBI Getting Research into Practice (GRiP) tool and iii) a post-implementation audit. RESULTS The baseline audit results identified non-compliance to best practice in all areas of CRF. Strategies to improve practice involved relevant education for nurses, establishment of a CRF management routine and related documentation systems and displaying and distributing educational materials for the patients. Improved compliance was shown across all audit criteria in post-evaluation. CONCLUSIONS The implementation of institution specific evidence-based resources demonstrated immediate improvement in CRF management and practice. Continuous effort is required to maintain changes and further improve practice. Future projects should focus on measuring the impact of changed practice on patient outcomes.
Collapse
Affiliation(s)
- Ning Wang
- PR China Southern Centre for Evidence Based Nursing and Midwifery Practice: a Joanna Briggs Institute Affiliated Group.,School of Nursing, Southern Medical University, Guangzhou City, PR China
| | - Zhihui Yang
- PR China Southern Centre for Evidence Based Nursing and Midwifery Practice: a Joanna Briggs Institute Affiliated Group.,School of Nursing, Southern Medical University, Guangzhou City, PR China
| | - Jingxia Miao
- Oncology Unit, Nanfang Hospital, Southern Medical University, Guangzhou City, PR China
| | - Xue Mi
- School of Nursing, Southern Medical University, Guangzhou City, PR China
| | - Suting Liu
- School of Nursing, Southern Medical University, Guangzhou City, PR China
| | - Cindy Stern
- Joanna Briggs Institute, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
| | - Kylie Porritt
- Joanna Briggs Institute, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
| | - Lili Zhang
- PR China Southern Centre for Evidence Based Nursing and Midwifery Practice: a Joanna Briggs Institute Affiliated Group.,School of Nursing, Southern Medical University, Guangzhou City, PR China
| |
Collapse
|
24
|
Carayol M, Ninot G, Senesse P, Bleuse JP, Gourgou S, Sancho-Garnier H, Sari C, Romieu I, Romieu G, Jacot W. Short- and long-term impact of adapted physical activity and diet counseling during adjuvant breast cancer therapy: the "APAD1" randomized controlled trial. BMC Cancer 2019; 19:737. [PMID: 31345179 PMCID: PMC6659309 DOI: 10.1186/s12885-019-5896-6] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 06/30/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Patients with breast cancer undergoing chemotherapy and radiotherapy experience fatigue and other treatment side effects. Integrative therapies combining physical activity and dietary counseling are recommended; however to date no large randomized controlled trial has been conducted during adjuvant therapy. The Adapted Physical Activity and Diet (APAD) intervention was evaluated for its ability to decrease fatigue (primary outcome), anxiety, depression, body mass index (BMI), and fat mass, and enhance muscular and cognitive performances, and quality-of-life (QoL). METHODS Women diagnosed with early breast cancer (N = 143, mean age = 52 ± 10 years) were randomized to APAD or usual care (UC). APAD included thrice-weekly moderate-intensity mixed aerobic and resistance exercise sessions and 9 dietetic consultations. Patient-reported outcomes (PROs) and anthropometric, muscular, and cognitive variables were measured at baseline, 18 weeks (end of chemotherapy), and 26 weeks (end of radiotherapy and intervention), and at 6- and 12-month post-intervention follow-ups. Multi-adjusted linear mixed-effects models were used to compare groups over time. RESULTS Significant beneficial effects of the APAD intervention were observed on all PROs (i.e., fatigue, QoL, anxiety, depression) at 18 and 26 weeks. The significant effect on fatigue and QoL persisted up to 12-month follow-up. Significant decreases in BMI, fat mass, and increased muscle endurance and cognitive flexibility were observed at 26 weeks, but did not persist afterward. Leisure physical activity was enhanced in the APAD group vs UC group at 18 and 26 weeks. No significant effect of the intervention was found on major macronutrients intake. CONCLUSIONS A combined diet and exercise intervention during chemotherapy and radiotherapy in patients with early breast cancer led to positive changes in a range of psychological, physiological and behavioral outcomes at the end of intervention. A beneficial effect persisted on fatigue and QoL at long term, i.e., 1 year post-intervention. Diet-exercise supportive care should be integrated into the management of early breast cancer patients. TRIAL REGISTRATION The APAD study was prospectively registered on ClinicalTrials.gov (NCT01495650; date of registration: December 20, 2011).
Collapse
Affiliation(s)
- Marion Carayol
- IAPS laboratory “Impact of Physical Activity on Health”, University of Toulon, Avenue de l’Université, 83957 La Garde, France
- Val d’Aurelle Montpellier Cancer Institute (ICM), 208, Avenue des Apothicaires, Parc Euromédecine, 34298 Montpellier Cedex 5, France; Montpellier University, 34000 Montpellier, France
- Section of Nutrition and Metabolism, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372 Lyon, Cedex 08 France
| | - Gregory Ninot
- Val d’Aurelle Montpellier Cancer Institute (ICM), 208, Avenue des Apothicaires, Parc Euromédecine, 34298 Montpellier Cedex 5, France; Montpellier University, 34000 Montpellier, France
- Laboratory Epsylon, EA 4556 Dynamics of Human Abilities & Health Behaviors, University of Montpellier, Rue du Pr. Henri Serre, 34000 Montpellier, France
| | - Pierre Senesse
- Val d’Aurelle Montpellier Cancer Institute (ICM), 208, Avenue des Apothicaires, Parc Euromédecine, 34298 Montpellier Cedex 5, France; Montpellier University, 34000 Montpellier, France
| | - Jean-Pierre Bleuse
- Val d’Aurelle Montpellier Cancer Institute (ICM), 208, Avenue des Apothicaires, Parc Euromédecine, 34298 Montpellier Cedex 5, France; Montpellier University, 34000 Montpellier, France
| | - Sophie Gourgou
- Val d’Aurelle Montpellier Cancer Institute (ICM), 208, Avenue des Apothicaires, Parc Euromédecine, 34298 Montpellier Cedex 5, France; Montpellier University, 34000 Montpellier, France
| | - Hélène Sancho-Garnier
- Val d’Aurelle Montpellier Cancer Institute (ICM), 208, Avenue des Apothicaires, Parc Euromédecine, 34298 Montpellier Cedex 5, France; Montpellier University, 34000 Montpellier, France
| | - Chakib Sari
- Val d’Aurelle Montpellier Cancer Institute (ICM), 208, Avenue des Apothicaires, Parc Euromédecine, 34298 Montpellier Cedex 5, France; Montpellier University, 34000 Montpellier, France
| | - Isabelle Romieu
- Center for Research on Population Health, National Institute of Public Health, Mexico City, Mexico
- Hubert Department of Global Health, Emory University, Atlanta, GA USA
| | - Gilles Romieu
- Val d’Aurelle Montpellier Cancer Institute (ICM), 208, Avenue des Apothicaires, Parc Euromédecine, 34298 Montpellier Cedex 5, France; Montpellier University, 34000 Montpellier, France
| | - William Jacot
- Val d’Aurelle Montpellier Cancer Institute (ICM), 208, Avenue des Apothicaires, Parc Euromédecine, 34298 Montpellier Cedex 5, France; Montpellier University, 34000 Montpellier, France
- Institut de Recherche en Cancérologie de Montpellier (IRCM), Inserm U1194, Université de Montpellier, Institut du Cancer Montpellier (ICM), Montpellier, France
| |
Collapse
|
25
|
Khanghah AG, Rizi MS, Nabi BN, Adib M, Leili EKN. Effects of Acupressure on Fatigue in Patients with Cancer Who Underwent Chemotherapy. J Acupunct Meridian Stud 2019; 12:103-110. [PMID: 31351998 DOI: 10.1016/j.jams.2019.07.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 06/14/2019] [Accepted: 07/09/2019] [Indexed: 11/26/2022] Open
Abstract
Fatigue is the commonest symptom in cancer patients; despite high levels of clinically significant persistent cancer-related fatigue, few treatments are currently available. The aim of this study was to evaluate the efficacy of acupressure on fatigue in patients with cancer who underwent chemotherapy. The study was designed as a randomized and controlled trial. Ninety samples were selected using the convenience sampling method, and random block sampling was used for allocation of groups (30 for each group). The three groups were similar by age and gender. The experimental group underwent acupressure at the Zusanli (ST-36), Hegu (LI-4), and Sanyingjiao (SP-6), whereas sham pressure was used in the placebo group and no intervention was applied in the control group; the level of fatigue of participants in three groups was calculated in three phases, before, during, and after chemotherapy. Data were analyzed using SPSS, version 22. The results showed that the mean of visual analog score of fatigue is significantly different in three groups at the end of chemotherapy (p = 0.021). The mean visual analog score of fatigue in the acupressure group was meaningfully lower than that in the control group after chemotherapy (p = 0.028). Results of this investigation showed that acupressure has short-term effectiveness on the cancer-related fatigue of patients undergoing chemotherapy.
Collapse
Affiliation(s)
- Atefeh Ghanbari Khanghah
- Social Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Moloud Sharifi Rizi
- Department of Nursing and Midwifery Ramsar, School of Medicine, Babol University of Medical Sciences, Ramsar, I.R Iran.
| | - Bahram Naderi Nabi
- Anesthesiology Department, Anesthesiology Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Masoumeh Adib
- School of Nursing and Midwifery, Social Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Ehsan Kazem Nejad Leili
- Social Determinants of Health Research Center (SDHRC), School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| |
Collapse
|
26
|
Cancer-related fatigue and biochemical parameters among cancer patients with different stages of sarcopenia. Support Care Cancer 2019; 28:581-588. [DOI: 10.1007/s00520-019-04717-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 02/25/2019] [Indexed: 02/07/2023]
|
27
|
Affiliation(s)
- Svetlana Savina
- Department of Out-Patient, Medical Center Hippocrates, Russian Federation
| | - Boris Zaydiner
- Regional Cancer Center, Rostov-on-Don, Russian Federation
| |
Collapse
|
28
|
Can levocarnitine supplementation improve fatigue caused by sunitinib as a treatment for renal cell carcinoma? A single-center prospective pilot study. Support Care Cancer 2018; 27:1491-1496. [PMID: 30374764 DOI: 10.1007/s00520-018-4521-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 09/26/2018] [Indexed: 01/17/2023]
Abstract
PURPOSE To evaluate the potential role of levocarnitine supplementation for cancer-related fatigue in patients treated with sunitinib. METHODS Patients treated with sunitinib for unresectable or metastatic renal cell carcinoma were enrolled prospectively. Assessment of fatigue in each patient was done using the Brief Fatigue Inventory (BFI) questionnaire. Evaluation of fatigue and the serum carnitine level was done at baseline, 2 weeks, and 4 weeks after sunitinib therapy was initiated. All patients were treated with sunitinib 37.5 mg or 50 mg/day orally, with a 4-week administration and 2-week discontinuation schedule. RESULTS Ten patients were finally enrolled in the study. Seven of them had worsened fatigue at the 2-week assessment and levocarnitine was administrated. All these seven patients whose serum carnitine level at 2 weeks was worse than at the baseline improved after 2-week-L-carnitine supplementation. For six of the seven (85.7%) patients who had L-carnitine supplementation, the BFI score at 4 weeks decreased compared to that at 2 weeks, which indicated improvement of fatigue. CONCLUSIONS Levocarnitine supplementation for cancer-related fatigue in patients treated with sunitinib appears to have a potential benefit. However, further study with a larger number of patients and longer follow-up is crucial to confirm this.
Collapse
|
29
|
Chen HL, Liu K, You QS. Self-efficacy, cancer-related fatigue, and quality of life in patients with resected lung cancer. Eur J Cancer Care (Engl) 2018; 27:e12934. [PMID: 30252973 DOI: 10.1111/ecc.12934] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 07/11/2018] [Accepted: 08/31/2018] [Indexed: 12/22/2022]
Affiliation(s)
- Hong-Lin Chen
- Nantong University; Nantong City, Jiangsu Province China
| | - Kun Liu
- Department of Cardiothoracic Surgery; Affiliated Hospital of Nantong University; Nantong City, Jiangsu Province China
| | - Qing-Sheng You
- Department of Cardiothoracic Surgery; Affiliated Hospital of Nantong University; Nantong City, Jiangsu Province China
| |
Collapse
|
30
|
Lin PJ, Peppone LJ, Janelsins MC, Mohile SG, Kamen CS, Kleckner IR, Fung C, Asare M, Cole CL, Culakova E, Mustian KM. Yoga for the Management of Cancer Treatment-Related Toxicities. Curr Oncol Rep 2018; 20:5. [PMID: 29388071 PMCID: PMC5901971 DOI: 10.1007/s11912-018-0657-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW To (1) explain what yoga is, (2) summarize published literature on the efficacy of yoga for managing cancer treatment-related toxicities, (3) provide clinical recommendations on the use of yoga for oncology professionals, and (4) suggest promising areas for future research. RECENT FINDINGS Based on a total of 24 phase II and one phase III clinical trials, low-intensity forms of yoga, specifically gentle hatha and restorative, are feasible, safe, and effective for treating sleep disruption, cancer-related fatigue, cognitive impairment, psychosocial distress, and musculoskeletal symptoms in cancer patients receiving chemotherapy and radiation and cancer survivors. Clinicians should consider prescribing yoga for their patients suffering with these toxicities by referring them to qualified yoga professionals. More definitive phase III clinical trials are needed to confirm these findings and to investigate other types, doses, and delivery modes of yoga for treating cancer-related toxicities in patients and survivors.
Collapse
Affiliation(s)
- Po-Ju Lin
- Department of Surgery, James P. Wilmot Cancer Institute, University of Rochester Medical Center, 265 Crittenden Blvd., Box CU 420658, Rochester, NY, 14642, USA
| | - Luke J Peppone
- Department of Surgery, James P. Wilmot Cancer Institute, University of Rochester Medical Center, 265 Crittenden Blvd., Box CU 420658, Rochester, NY, 14642, USA
| | - Michelle C Janelsins
- Department of Surgery, James P. Wilmot Cancer Institute, University of Rochester Medical Center, 265 Crittenden Blvd., Box CU 420658, Rochester, NY, 14642, USA
| | - Supriya G Mohile
- Department of Medicine, University of Rochester Medical Center, 601 Elmwood Ave., Box 704, Rochester, NY, 14642, USA
| | - Charles S Kamen
- Department of Surgery, James P. Wilmot Cancer Institute, University of Rochester Medical Center, 265 Crittenden Blvd., Box CU 420658, Rochester, NY, 14642, USA
| | - Ian R Kleckner
- Department of Surgery, James P. Wilmot Cancer Institute, University of Rochester Medical Center, 265 Crittenden Blvd., Box CU 420658, Rochester, NY, 14642, USA
| | - Chunkit Fung
- Department of Medicine, University of Rochester Medical Center, 601 Elmwood Ave., Box 704, Rochester, NY, 14642, USA
| | - Matthew Asare
- Department of Surgery, James P. Wilmot Cancer Institute, University of Rochester Medical Center, 265 Crittenden Blvd., Box CU 420658, Rochester, NY, 14642, USA
| | - Calvin L Cole
- Department of Orthopaedics, University of Rochester Medical Center, 601 Elmwood Ave., Box 658, Rochester, NY, 14642, USA
| | - Eva Culakova
- Department of Surgery, James P. Wilmot Cancer Institute, University of Rochester Medical Center, 265 Crittenden Blvd., Box CU 420658, Rochester, NY, 14642, USA
| | - Karen M Mustian
- Department of Surgery, James P. Wilmot Cancer Institute, University of Rochester Medical Center, 265 Crittenden Blvd., Box CU 420658, Rochester, NY, 14642, USA.
| |
Collapse
|
31
|
Abstract
Cancer-related fatigue (CRF) significantly interferes with usual functioning because of the distressing sense of physical, emotional, and cognitive exhaustion. Assessment of CRF is important and should be performed during the initial cancer diagnosis, throughout cancer treatment, and after treatment using a fatigue scoring scale (mild-severe). The general approach to CRF management applies to cancer survivors at all fatigue levels and includes education, counseling, and other strategies. Nonpharmacologic interventions include psychosocial interventions, exercise, yoga, physically based therapy, dietary management, and sleep therapy. Pharmacologic interventions include psychostimulants. Antidepressants may also benefit when CRF is accompanied by depression.
Collapse
Affiliation(s)
- Chidinma C Ebede
- Department of General Internal Medicine, The University of Texas M.D. Anderson Cancer Center, 1400 Pressler Street, Unit 1465, Houston, TX 77030-4008, USA
| | - Yongchang Jang
- Department of General Internal Medicine, The University of Texas M.D. Anderson Cancer Center, 1400 Pressler Street, Unit 1465, Houston, TX 77030-4008, USA
| | - Carmen P Escalante
- Department of General Internal Medicine, The University of Texas M.D. Anderson Cancer Center, 1400 Pressler Street, Unit 1465, Houston, TX 77030-4008, USA.
| |
Collapse
|
32
|
A 12-Week Exercise and Stress Management Pilot Program From Theory Through Implementation and Assessment. REHABILITATION ONCOLOGY 2017. [DOI: 10.1097/01.reo.0000000000000079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
33
|
Muz G, Taşcı S. Effect of aromatherapy via inhalation on the sleep quality and fatigue level in people undergoing hemodialysis. Appl Nurs Res 2017; 37:28-35. [DOI: 10.1016/j.apnr.2017.07.004] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 05/20/2017] [Accepted: 07/30/2017] [Indexed: 11/15/2022]
|
34
|
Palesh O, Scheiber C, Kesler S, Mustian K, Koopman C, Schapira L. Management of side effects during and post-treatment in breast cancer survivors. Breast J 2017; 24:167-175. [DOI: 10.1111/tbj.12862] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 06/06/2017] [Accepted: 06/07/2017] [Indexed: 01/06/2023]
Affiliation(s)
- Oxana Palesh
- Department of Psychiatry and Behavioral Sciences; Stanford University; Stanford CA USA
| | - Caroline Scheiber
- Department of Psychiatry and Behavioral Sciences; Stanford University; Stanford CA USA
| | | | - Karen Mustian
- Department of Surgery; University of Rochester; Rochester NY USA
| | - Cheryl Koopman
- Department of Psychiatry and Behavioral Sciences; Stanford University; Stanford CA USA
| | | |
Collapse
|
35
|
Bhardwaj T, Koffman J. Non-pharmacological interventions for management of fatigue among children with cancer: systematic review of existing practices and their effectiveness. BMJ Support Palliat Care 2017; 7:404-414. [PMID: 28760817 DOI: 10.1136/bmjspcare-2016-001132] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 04/06/2017] [Accepted: 06/26/2017] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Fatigue is common among children living with cancer, particularly in advance stages. Little is known about the effectiveness of non-pharmacological approaches to manage this complex and distressing symptom among children. Thus, the present paper aim to critically examine the effectiveness and setting for non-pharmacological interventions to manage fatigue among children with cancer. METHODS Six electronic databases were screened first in February 2013 and at second instance in March 2015. They include PsycINFO, Medline, EMBASE, CINAHL, Scopus and Cochrane library. All databases were systematically searched for literature on fatigue and cancer, limited to children (as age group) and English language. RESULTS 1498 articles were identified, of which six were reviewed. Three types of interventions for managing fatigue were identified including (1) complementary and alternative medicine (healing touch/massage therapy), (2) exercise-based interventions and (3) nursing-based interventions. Most interventions were delivered during active treatment and in hospital settings where parents were involved to optimise participation. Despite fatigue scores being lower among intervention groups, no study findings were observed as being statistically significant. CONCLUSION Fatigue is common among children treated for and living with cancer. The most appropriate setting to deliver non-pharmacological interventions to manage fatigue appears to be in hospital. However, in absence of any strong evidence, professionals need to be cautious about existing non-pharmacological interventions. Future research must adopt more rigorous research designs that are adequately powered using validated measures to identify potential benefits. In addition, researchers may wish to test psychosocial interventions shown to be of benefit in adults.
Collapse
Affiliation(s)
- Tushti Bhardwaj
- Department of Social Work, Dr B R Ambedkar College, University of Delhi, Yamuna Vihar, Delhi, India
| | - Jonathan Koffman
- Department of Palliative Care, Policy & Rehabilitation, King's College London, Cicely Saunders Institute, London, UK
| |
Collapse
|
36
|
McSorley ST, Dolan RD, Roxburgh CSD, McMillan DC, Horgan PG. How and why systemic inflammation worsens quality of life in patients with advanced cancer. ACTA ACUST UNITED AC 2017. [DOI: 10.1080/23809000.2017.1331705] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Stephen T. McSorley
- Academic Unit of Surgery, School of Medicine, University of Glasgow, Glasgow, UK
| | - Ross D. Dolan
- Academic Unit of Surgery, School of Medicine, University of Glasgow, Glasgow, UK
| | | | - Donald C. McMillan
- Academic Unit of Surgery, School of Medicine, University of Glasgow, Glasgow, UK
| | - Paul G. Horgan
- Academic Unit of Surgery, School of Medicine, University of Glasgow, Glasgow, UK
| |
Collapse
|
37
|
Abstract
Chronotherapeutics aim at treating illnesses according to the endogenous biologic rhythms, which moderate xenobiotic metabolism and cellular drug response. The molecular clocks present in individual cells involve approximately fifteen clock genes interconnected in regulatory feedback loops. They are coordinated by the suprachiasmatic nuclei, a hypothalamic pacemaker, which also adjusts the circadian rhythms to environmental cycles. As a result, many mechanisms of diseases and drug effects are controlled by the circadian timing system. Thus, the tolerability of nearly 500 medications varies by up to fivefold according to circadian scheduling, both in experimental models and/or patients. Moreover, treatment itself disrupted, maintained, or improved the circadian timing system as a function of drug timing. Improved patient outcomes on circadian-based treatments (chronotherapy) have been demonstrated in randomized clinical trials, especially for cancer and inflammatory diseases. However, recent technological advances have highlighted large interpatient differences in circadian functions resulting in significant variability in chronotherapy response. Such findings advocate for the advancement of personalized chronotherapeutics through interdisciplinary systems approaches. Thus, the combination of mathematical, statistical, technological, experimental, and clinical expertise is now shaping the development of dedicated devices and diagnostic and delivery algorithms enabling treatment individualization. In particular, multiscale systems chronopharmacology approaches currently combine mathematical modeling based on cellular and whole-body physiology to preclinical and clinical investigations toward the design of patient-tailored chronotherapies. We review recent systems research works aiming to the individualization of disease treatment, with emphasis on both cancer management and circadian timing system–resetting strategies for improving chronic disease control and patient outcomes.
Collapse
Affiliation(s)
- Annabelle Ballesta
- Warwick Medical School (A.B., P.F.I., R.D., F.A.L.) and Warwick Mathematics Institute (A.B., D.A.R.), University of Warwick, Coventry, United Kingdom; Warwick Systems Biology and Infectious Disease Epidemiological Research Centre, Senate House, Coventry, United Kingdom (A.B., P.F.I., R.D., D.A.R., F.A.L.); INSERM-Warwick European Associated Laboratory "Personalising Cancer Chronotherapy through Systems Medicine" (C2SysMed), Unité mixte de Recherche Scientifique 935, Centre National de Recherche Scientifique Campus, Villejuif, France (A.B., P.F.I., R.D., D.A.R., F.A.L.); and Queen Elisabeth Hospital Birmingham, University Hospitals Birmingham National Health Service Foundation Trust, Cancer Unit, Edgbaston Birmingham, United Kingdom (P.F.I., F.A.L.)
| | - Pasquale F Innominato
- Warwick Medical School (A.B., P.F.I., R.D., F.A.L.) and Warwick Mathematics Institute (A.B., D.A.R.), University of Warwick, Coventry, United Kingdom; Warwick Systems Biology and Infectious Disease Epidemiological Research Centre, Senate House, Coventry, United Kingdom (A.B., P.F.I., R.D., D.A.R., F.A.L.); INSERM-Warwick European Associated Laboratory "Personalising Cancer Chronotherapy through Systems Medicine" (C2SysMed), Unité mixte de Recherche Scientifique 935, Centre National de Recherche Scientifique Campus, Villejuif, France (A.B., P.F.I., R.D., D.A.R., F.A.L.); and Queen Elisabeth Hospital Birmingham, University Hospitals Birmingham National Health Service Foundation Trust, Cancer Unit, Edgbaston Birmingham, United Kingdom (P.F.I., F.A.L.)
| | - Robert Dallmann
- Warwick Medical School (A.B., P.F.I., R.D., F.A.L.) and Warwick Mathematics Institute (A.B., D.A.R.), University of Warwick, Coventry, United Kingdom; Warwick Systems Biology and Infectious Disease Epidemiological Research Centre, Senate House, Coventry, United Kingdom (A.B., P.F.I., R.D., D.A.R., F.A.L.); INSERM-Warwick European Associated Laboratory "Personalising Cancer Chronotherapy through Systems Medicine" (C2SysMed), Unité mixte de Recherche Scientifique 935, Centre National de Recherche Scientifique Campus, Villejuif, France (A.B., P.F.I., R.D., D.A.R., F.A.L.); and Queen Elisabeth Hospital Birmingham, University Hospitals Birmingham National Health Service Foundation Trust, Cancer Unit, Edgbaston Birmingham, United Kingdom (P.F.I., F.A.L.)
| | - David A Rand
- Warwick Medical School (A.B., P.F.I., R.D., F.A.L.) and Warwick Mathematics Institute (A.B., D.A.R.), University of Warwick, Coventry, United Kingdom; Warwick Systems Biology and Infectious Disease Epidemiological Research Centre, Senate House, Coventry, United Kingdom (A.B., P.F.I., R.D., D.A.R., F.A.L.); INSERM-Warwick European Associated Laboratory "Personalising Cancer Chronotherapy through Systems Medicine" (C2SysMed), Unité mixte de Recherche Scientifique 935, Centre National de Recherche Scientifique Campus, Villejuif, France (A.B., P.F.I., R.D., D.A.R., F.A.L.); and Queen Elisabeth Hospital Birmingham, University Hospitals Birmingham National Health Service Foundation Trust, Cancer Unit, Edgbaston Birmingham, United Kingdom (P.F.I., F.A.L.)
| | - Francis A Lévi
- Warwick Medical School (A.B., P.F.I., R.D., F.A.L.) and Warwick Mathematics Institute (A.B., D.A.R.), University of Warwick, Coventry, United Kingdom; Warwick Systems Biology and Infectious Disease Epidemiological Research Centre, Senate House, Coventry, United Kingdom (A.B., P.F.I., R.D., D.A.R., F.A.L.); INSERM-Warwick European Associated Laboratory "Personalising Cancer Chronotherapy through Systems Medicine" (C2SysMed), Unité mixte de Recherche Scientifique 935, Centre National de Recherche Scientifique Campus, Villejuif, France (A.B., P.F.I., R.D., D.A.R., F.A.L.); and Queen Elisabeth Hospital Birmingham, University Hospitals Birmingham National Health Service Foundation Trust, Cancer Unit, Edgbaston Birmingham, United Kingdom (P.F.I., F.A.L.)
| |
Collapse
|
38
|
Ben-Josef AM, Chen J, Wileyto P, Doucette A, Bekelman J, Christodouleas J, Deville C, Vapiwala N. Effect of Eischens Yoga During Radiation Therapy on Prostate Cancer Patient Symptoms and Quality of Life: A Randomized Phase II Trial. Int J Radiat Oncol Biol Phys 2017; 98:1036-1044. [PMID: 28721886 DOI: 10.1016/j.ijrobp.2017.03.043] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 03/17/2017] [Accepted: 03/23/2017] [Indexed: 01/01/2023]
Abstract
PURPOSE A randomized phase II study was performed to measure the potential therapeutic effects of yoga on fatigue, erectile dysfunction, urinary incontinence, and overall quality of life (QOL) in prostate cancer (PCa) patients undergoing external beam radiation therapy (RT). METHODS AND MATERIALS The participants were randomized to yoga and no-yoga cohorts (1:1). Twice-weekly yoga interventions were offered throughout the 6- to 9-week courses of RT. Comparisons of standardized assessments were performed between the 2 cohorts for the primary endpoint of fatigue and the secondary endpoints of erectile dysfunction, urinary incontinence, and QOL before, during, and after RT. RESULTS From October 2014 to January 2016, 68 eligible PCa patients underwent informed consent and agreed to participate in the study. Of the 68 patients, 18 withdrew early, mostly because of treatment schedule-related time constraints, resulting in 22 and 28 patients in the yoga and no-yoga groups, respectively. Throughout treatment, those in the yoga arm reported less fatigue than those in the control arm, with global fatigue, effect of fatigue, and severity of fatigue subscales showing statistically significant interactions (P<.0001). The sexual health scores (International Index of Erectile Function Questionnaire) also displayed a statistically significant interaction (P=.0333). The International Prostate Symptom Score revealed a statistically significant effect of time (P<.0001) but no significant effect of treatment (P=.1022). The QOL measures had mixed results, with yoga having a significant time by treatment effect on the emotional, physical, and social scores but not on functional scores. CONCLUSIONS A structured yoga intervention of twice-weekly classes during a course of RT was associated with a significant reduction in pre-existing and RT-related fatigue and urinary and sexual dysfunction in PCa patients.
Collapse
Affiliation(s)
- Avital Mazar Ben-Josef
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jerry Chen
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Paul Wileyto
- Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Abigail Doucette
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Justin Bekelman
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - John Christodouleas
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Curtiland Deville
- Department of Radiation Oncology, Johns Hopkins University, Baltimore, Maryland
| | - Neha Vapiwala
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania.
| |
Collapse
|
39
|
Polo KM, Smith C. Taking Our Seat at the Table: Community Cancer Survivorship. Am J Occup Ther 2017; 71:7102100010p1-7102100010p5. [DOI: 10.5014/ajot.2017.020693] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Abstract
Cancer survivors are at risk for occupational performance issues related to activities of daily living, instrumental activities of daily living, work, and social and community participation. Occupational therapy practitioners can address these performance issues by offering services within existing community cancer survivorship programs that focus on adaptive and compensatory strategies to facilitate meaningful lifestyles and optimize health and well-being. Occupational therapy services do not currently exist at these community sites, nor are occupational therapy practitioners recognized as providers in existing community cancer survivorship programs. Recognition of practitioners’ distinct value in cancer survivorship, advocacy for occupational therapy services in the community, development of supporting documentation for occupational therapy’s role in community survivorship, and research on the efficacy of interventions in community cancer survivorship are needed to expand occupational therapy’s role with this growing population.
Collapse
Affiliation(s)
- Katie M. Polo
- Katie M. Polo, DHS, OTR/L, CLT-LANA, is Assistant Professor, College of Health Sciences, School of Occupational Therapy, University of Indianapolis, Indianapolis, IN. At the time of writing, she was Assistant Professor, Occupational Therapy Program, Midwestern University, Downers Grove, IL;
| | - Caitlin Smith
- Caitlin Smith, OTD, OTR/L, is Occupational Therapist, PhysioPartners, Chicago, IL
| |
Collapse
|
40
|
Cheville AL, Mustian K, Winters-Stone K, Zucker DS, Gamble GL, Alfano CM. Cancer Rehabilitation. Phys Med Rehabil Clin N Am 2017; 28:1-17. [DOI: 10.1016/j.pmr.2016.08.001] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
|
41
|
Clinical Implementation of Exercise Guidelines for Cancer Patients: Adaptation of ACSM’s Guidelines to the Italian Model. J Funct Morphol Kinesiol 2017. [DOI: 10.3390/jfmk2010004] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
|
42
|
Alfano CM, Cheville AL, Mustian K. Developing High-Quality Cancer Rehabilitation Programs: A Timely Need. Am Soc Clin Oncol Educ Book 2017; 35:241-9. [PMID: 27249704 DOI: 10.1200/edbk_156164] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The number of survivors of cancer in the United States, already 14.5 million, is growing with improved cancer treatment and aging of the population. Two-thirds of cancer survivors will be older than age 65 and are likely to enter cancer treatment already deconditioned and with multiple comorbidities. Survivors of cancer face numerous adverse consequences of cancer treatment that add to or exacerbate the effects of existing comorbidities and increase risk of functional decline. Many of these problems are amenable to rehabilitation interventions, but referral to cancer rehabilitation professionals is not a standard part of care. We present an expanded prospective model of surveillance, cancer rehabilitation assessment, and referral efforts using a multidisciplinary team approach. In this model, cancer rehabilitation begins at the time of cancer diagnosis and continues through and beyond cancer treatment. Physical impairments and psychosocial symptoms are assessed and treated, and lifestyle and exercise interventions are provided to optimize functioning, health, and quality of life. We present a stepped-care framework to guide decisions on when, how, and where to refer survivors to cancer rehabilitation specialists depending on safety requirements and needs. This model has the potential to result in early identification of symptoms and impairments, appropriate referral and timely treatment, and, in turn, will better address and minimize both acute and long-term cancer morbidity.
Collapse
Affiliation(s)
- Catherine M Alfano
- From American Cancer Society, Washington, DC; Department of Physical Medicine and Rehabilitation, Program to Enhance Care Experiences Through Research, Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN; University of Rochester Medical Center, Wilmot Cancer Institute, Rochester, NY
| | - Andrea L Cheville
- From American Cancer Society, Washington, DC; Department of Physical Medicine and Rehabilitation, Program to Enhance Care Experiences Through Research, Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN; University of Rochester Medical Center, Wilmot Cancer Institute, Rochester, NY
| | - Karen Mustian
- From American Cancer Society, Washington, DC; Department of Physical Medicine and Rehabilitation, Program to Enhance Care Experiences Through Research, Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN; University of Rochester Medical Center, Wilmot Cancer Institute, Rochester, NY
| |
Collapse
|
43
|
Amritanshu RR, Rao RM, Nagaratna R, Veldore VH, Usha Rani MU, Gopinath KS, Ajaikumar BS. Effect of Long-term Yoga Practice on Psychological outcomes in Breast Cancer Survivors. Indian J Palliat Care 2017; 23:231-236. [PMID: 28827924 PMCID: PMC5545946 DOI: 10.4103/ijpc.ijpc_93_17] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Aim: Breast cancer has become a pandemic with an ever-increasing incidence. Although better diagnostics and treatment modalities have reduced mortality, a large number of survivors face cancer and treatment-related long-term symptoms. Many survivors are taking up yoga for improving the quality of life (QoL). The present study attempts to evaluate predictors of psychological states in breast cancer survivors with long-term yoga experience. Materials and Methods: A case–control study recruited early breast cancer survivors, 30–65 years, completing treatment > 6 months before recruitment, and grouped them based on prior yoga experience (BCY, n = 27) or naïve (BCN, n = 25). Demography, cancer history, diet, exercise habits, and yoga schedule were collected and tools to assess stress, anxiety, depression, general health, and QoL were administered. Multivariate linear regression was done to identify predictors of psychological variables. Results: BCY had significantly lower stress, anxiety, depression, better general health, and QoL (P < 0.001). Global QoL and trait anxiety were significantly predicted by Yoga practice; depression was predicted by yoga practice, annual income, and sleep quality; state anxiety was predicted by Yoga practice and income; and stress was predicted by Yoga practice and sleep quality. Conclusion: Results indicate that breast cancer survivors, doing yoga, have better psychological profiles and are able to deal with demanding situations better. The psycho-oncogenic model of cancer etiology suggests that a better psychological state in survival has the potential to improve prognosis and survival outcomes and Yoga may be a suitable practice for staying cancer-free for a longer time.
Collapse
Affiliation(s)
- Ram R Amritanshu
- Department of Complementary and Alternative Medicine, Healthcare Global Enterprises Ltd., Bengaluru, Karnataka, India
| | - Raghavendra Mohan Rao
- Department of Complementary and Alternative Medicine, Healthcare Global Enterprises Ltd., Bengaluru, Karnataka, India
| | - Raghuram Nagaratna
- Department of Life Sciences SVYASA Yoga University, Bengaluru, Karnataka, India
| | - Vidya Harini Veldore
- Department of Complementary and Alternative Medicine, Healthcare Global Enterprises Ltd., Bengaluru, Karnataka, India
| | - Mr Usha Usha Rani
- Department of Complementary and Alternative Medicine, Healthcare Global Enterprises Ltd., Bengaluru, Karnataka, India
| | - Kodaganur S Gopinath
- Department of Surgical Oncology, HCG Bangalore Institute of Oncology Specialty Center, Bengaluru, Karnataka, India
| | - B S Ajaikumar
- Department of Radiation Oncology, HCG Bangalore Institute of Oncology Specialty Center, Bengaluru, Karnataka, India
| |
Collapse
|
44
|
Post-treatment cognitive dysfunction in women treated with thyroidectomy for papillary thyroid carcinoma. Support Care Cancer 2016; 25:915-923. [DOI: 10.1007/s00520-016-3481-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 11/01/2016] [Indexed: 01/17/2023]
|
45
|
Mustian KM, Cole CL, Lin PJ, Asare M, Fung C, Janelsins MC, Kamen CS, Peppone LJ, Magnuson A. Exercise Recommendations for the Management of Symptoms Clusters Resulting From Cancer and Cancer Treatments. Semin Oncol Nurs 2016; 32:383-393. [PMID: 27776835 DOI: 10.1016/j.soncn.2016.09.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To review existing exercise guidelines for cancer patients and survivors for the management of symptom clusters. DATA SOURCES Review of PubMed literature and published exercise guidelines. CONCLUSION Cancer and its treatments are responsible for a copious number of incapacitating symptoms that markedly impair quality of life. The exercise oncology literature provides consistent support for the safety and efficacy of exercise interventions in managing cancer- and treatment-related symptoms, as well as improving quality of life in cancer patients and survivors. IMPLICATIONS FOR NURSING PRACTICE Effective management of symptoms enhances recovery, resumption of normal life activities and quality of life for patients and survivors. Exercise is a safe, appropriate, and effective therapeutic option before, during, and after the completion of treatment for alleviating symptoms and symptom clusters.
Collapse
|
46
|
Ben-Josef AM, Wileyto EP, Chen J, Vapiwala N. Yoga Intervention for Patients With Prostate Cancer Undergoing External Beam Radiation Therapy: A Pilot Feasibility Study. Integr Cancer Ther 2016; 15:272-8. [PMID: 26590125 PMCID: PMC5739183 DOI: 10.1177/1534735415617022] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE Studies have demonstrated beneficial health effects from yoga interventions in cancer patients, but predominantly in breast cancer. Research on its role in alleviating prostate cancer (PC) patients' side effects has been lacking. Our primary goal was to determine the feasibility of recruiting PC patients on a clinical trial of yoga while they underwent external beam radiation therapy (RT). METHODS Twice-weekly yoga interventions were offered throughout the RT course (6-9 weeks). Baseline demographic information was collected. Feasibility was declared if 15 of the first 75 eligible PC patients approached (20%) were successfully accrued and completed the intervention. Additional end points included standardized assessments of fatigue, erectile dysfunction (ED), urinary incontinence (UI), and quality of life (QOL) at time points before, during, and after RT. RESULTS Between May 2013 and June 2014, 68 eligible PC patients were identified. 23 patients (34%) declined, and 45 (56%) consented to the study. 18 (40%) were voluntarily withdrawn due to treatment conflicts. Of the remaining 27, 12 (30%) participated in ≥50% of classes, and 15 (59%) were evaluable. Severity of fatigue scores demonstrated significant variability, with fatigue increasing by week 4, but then improving over the course of treatment (P = .008). ED, UI, and general QOL scores demonstrated reassuringly stable, albeit not significant trends. CONCLUSIONS A structured yoga intervention of twice-weekly classes is feasible for PC patients during a 6- to 9-week course of outpatient radiotherapy. Preliminary results are promising, showing stable measurements in fatigue, sexual health, UI, and general QOL.
Collapse
Affiliation(s)
| | | | - Jerry Chen
- University of Pennsylvania, Philadelphia, PA, USA
| | | |
Collapse
|
47
|
Abstract
Evidence of the benefits of exercise for people with cancer from diagnosis through survivorship is growing. However, most cancers occur in older adults and little exercise advice is available for making specific recommendations for older adults with cancer. Individualized exercise prescriptions are safe, feasible, and beneficial for the geriatric oncology population. Oncology providers must be equipped to discuss the short- and long-term benefits of exercise and assist older patients in obtaining appropriate exercise prescriptions. This review provides detailed information about professionals and their roles as it relates to functional assessment, intervention, and evaluation of the geriatric oncology population. This review addresses the importance of functional status assessment and appropriate referrals to other oncology professionals.
Collapse
Affiliation(s)
| | - Ashley Leak Bryant
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Karen M Mustian
- Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA
| |
Collapse
|
48
|
Hsiao CP, Daly B, Saligan LN. The Etiology and management of radiotherapy-induced fatigue. ACTA ACUST UNITED AC 2016; 1:323-328. [PMID: 29651466 DOI: 10.1080/23809000.2016.1191948] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Fatigue is one of the most common side-effects accompanying radiotherapy, but arguably the least understood. Radiotherapy-induced fatigue (RIF) is a clinical subtype of cancer treatment-related fatigue. It is described as a pervasive, subjective sense of tiredness persisting over time, interferes with activities of daily living, and is not relieved by adequate rest or sleep. RIF is one of the early side-effects and long-lasting for cancer patients treated with localized radiation. Although the underlying mechanisms of fatigue have been studied in several disease conditions, the etiology, mechanisms, and risk factors of RIF remain elusive, and this symptom remains poorly managed. The purpose of this paper is to review and discuss recent articles that defined, proposed biologic underpinnings and mechanisms to explain the pathobiology of RIF, as well as articles that proposed interventions to manage RIF. Understanding the mechanisms of RIF can describe promising pathways to identify at-risk individuals and identify potential therapeutic targets to alleviate and prevent RIF using a multimodal, multidisciplinary approach.
Collapse
Affiliation(s)
- Chao-Pin Hsiao
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Barbara Daly
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Leorey N Saligan
- Division of Intramural Research, National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, USA
| |
Collapse
|
49
|
Pearson EJM, Morris ME, di Stefano M, McKinstry CE. Interventions for cancer-related fatigue: a scoping review. Eur J Cancer Care (Engl) 2016; 27. [PMID: 27254272 DOI: 10.1111/ecc.12516] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2016] [Indexed: 01/09/2023]
Abstract
Cancer-related fatigue (CRF) is common and can be distressing for some survivors. There is increasing interest in measuring levels of CRF, highlighting its impact on quality of life. This review describes the nature and scope of evidence relating to interventions for CRF. Scoping review methodology was used to identify studies, extract data, collate and summarise results. Data were collated according to cancer tumour streams, stage of illness and the types of trial interventions. A total of 447 trials and 37 systematic reviews met the inclusion criteria. Nine papers reported longitudinal results. Populations studied were predominantly of mixed cancer diagnoses and breast cancer. The most frequent interventions were exercise, pharmacological, psycho-education and mind-body interventions. Fatigue was identified as a primary outcome measure (OM) in 58% of studies, with 58 different fatigue measures reported. Emerging evidence exists for the effectiveness of fatigue interventions for some cancer types. More research on interventions with participants with the same cancer type and illness phase is needed. Measurement of severity and impact of CRF using fewer, robust OMs will permit comparisons across studies.
Collapse
Affiliation(s)
- E J M Pearson
- La Trobe Rural Health School, College of Science, Health and Engineering, La Trobe University, Bendigo, Vic., Australia
| | - M E Morris
- La Trobe University Centre for Sport and Exercise Medicine Research, School Allied Health, College of Science, Health and Engineering, La Trobe University, Bundoora, Vic., Australia.,Healthscope Australia, Australia
| | - M di Stefano
- VicRoads, Melbourne, Vic., Australia.,La Trobe University, Bundoora, Vic., Australia
| | - C E McKinstry
- La Trobe Rural Health School, College of Science, Health and Engineering, La Trobe University, Bendigo, Vic., Australia
| |
Collapse
|
50
|
Berger AM, Mooney K, Alvarez-Perez A, Breitbart WS, Carpenter KM, Cella D, Cleeland C, Dotan E, Eisenberger MA, Escalante CP, Jacobsen PB, Jankowski C, LeBlanc T, Ligibel JA, Loggers ET, Mandrell B, Murphy BA, Palesh O, Pirl WF, Plaxe SC, Riba MB, Rugo HS, Salvador C, Wagner LI, Wagner-Johnston ND, Zachariah FJ, Bergman MA, Smith C. Cancer-Related Fatigue, Version 2.2015. J Natl Compr Canc Netw 2016; 13:1012-39. [PMID: 26285247 DOI: 10.6004/jnccn.2015.0122] [Citation(s) in RCA: 499] [Impact Index Per Article: 62.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Cancer-related fatigue is defined as a distressing, persistent, subjective sense of physical, emotional, and/or cognitive tiredness or exhaustion related to cancer or cancer treatment that is not proportional to recent activity and interferes with usual functioning. It is one of the most common side effects in patients with cancer. Fatigue has been shown to be a consequence of active treatment, but it may also persist into posttreatment periods. Furthermore, difficulties in end-of-life care can be compounded by fatigue. The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Cancer-Related Fatigue provide guidance on screening for fatigue and recommendations for interventions based on the stage of treatment. Interventions may include education and counseling, general strategies for the management of fatigue, and specific nonpharmacologic and pharmacologic interventions. Fatigue is a frequently underreported complication in patients with cancer and, when reported, is responsible for reduced quality of life. Therefore, routine screening to identify fatigue is an important component in improving the quality of life for patients living with cancer.
Collapse
|