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Bower JE, Lacchetti C, Alici Y, Barton DL, Bruner D, Canin BE, Escalante CP, Ganz PA, Garland SN, Gupta S, Jim H, Ligibel JA, Loh KP, Peppone L, Tripathy D, Yennu S, Zick S, Mustian K. Management of Fatigue in Adult Survivors of Cancer: ASCO-Society for Integrative Oncology Guideline Update. J Clin Oncol 2024; 42:2456-2487. [PMID: 38754041 DOI: 10.1200/jco.24.00541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 03/27/2024] [Indexed: 05/18/2024] Open
Abstract
PURPOSE To update the ASCO guideline on the management of cancer-related fatigue (CRF) in adult survivors of cancer. METHODS A multidisciplinary panel of medical oncology, geriatric oncology, internal medicine, psychology, psychiatry, exercise oncology, integrative medicine, behavioral oncology, nursing, and advocacy experts was convened. Guideline development involved a systematic literature review of randomized controlled trials (RCTs) published in 2013-2023. RESULTS The evidence base consisted of 113 RCTs. Exercise, cognitive behavioral therapy (CBT), and mindfulness-based programs led to improvements in CRF both during and after the completion of cancer treatment. Tai chi, qigong, and American ginseng showed benefits during treatment, whereas yoga, acupressure, and moxibustion helped to manage CRF after completion of treatment. Use of other dietary supplements did not improve CRF during or after cancer treatment. In patients at the end of life, CBT and corticosteroids showed benefits. Certainty and quality of evidence were low to moderate for CRF management interventions. RECOMMENDATIONS Clinicians should recommend exercise, CBT, mindfulness-based programs, and tai chi or qigong to reduce the severity of fatigue during cancer treatment. Psychoeducation and American ginseng may be recommended in adults undergoing cancer treatment. For survivors after completion of treatment, clinicians should recommend exercise, CBT, and mindfulness-based programs; in particular, CBT and mindfulness-based programs have shown efficacy for managing moderate to severe fatigue after treatment. Yoga, acupressure, and moxibustion may also be recommended. Patients at the end of life may be offered CBT and corticosteroids. Clinicians should not recommend L-carnitine, antidepressants, wakefulness agents, or routinely recommend psychostimulants to manage symptoms of CRF. There is insufficient evidence to make recommendations for or against other psychosocial, integrative, or pharmacological interventions for the management of fatigue.Additional information is available at www.asco.org/survivorship-guidelines.
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Affiliation(s)
| | | | - Yesne Alici
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - Debra L Barton
- University of Tennessee, College of Nursing, Knoxville, TN
| | | | | | | | | | | | | | | | | | - Kah Poh Loh
- University of Rochester Medical Center, Rochester, NY
| | - Luke Peppone
- Wilmot Cancer Institute, University of Rochester, Rochester, NY
| | | | | | | | - Karen Mustian
- University of Rochester Medical Center, Rochester, NY
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Gururaj R, Samuel SR, Kumar KV, Nagaraja R, Keogh JW. Effect of exercise based interventions on sleep and circadian rhythm in cancer survivors-a systematic review and meta-analysis. PeerJ 2024; 12:e17053. [PMID: 38468641 PMCID: PMC10926908 DOI: 10.7717/peerj.17053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 02/13/2024] [Indexed: 03/13/2024] Open
Abstract
Background Disrupted circadian rhythm commonly reported in cancer survivors is closely associated with cancer related fatigue, sleep disturbances and compromised quality of life. As more cancer survivors request non-pharmacological treatment strategies for the management of their chronic sleep-related symptoms, there is a need for meta-analyses of various interventions such as exercise on sleep and circadian rhythm disturbances. Methods A search for RCT's was conducted in April 2020 and updated in July 2023 using relevant keywords for cancer, sleep, circadian rhythm and exercise interventions on PubMed, Scopus, Web of Science, PEDro and CINAHL. Results Thirty-six studies were included for qualitative analysis and 26, for meta-analysis. Thirty-five studies analyzed sleep outcomes, while five analyzed circadian rhythm. RCT's studying the effect of aerobic exercise, resistance exercise, combined aerobic and resistance exercise, physical activity, yoga, or tai chi were included. Meta-analysis results showed significant exercise-related improvements on sleep quality assessed by Pittsburgh Sleep Quality index (PSQI) (SMD = -0.50 [-0.87, -0.13], p = 0.008), wake after sleep onset (WASO) (SMD = -0.29 [-0.53, -0.05], p = 0.02) and circadian rhythm, assessed by salivary cortisol levels (MD = -0.09 (95% CI [-0.13 to -0.06]) mg/dL, p < 0.001). Results of the meta-analysis indicated that exercise had no significant effect on sleep efficiency, sleep onset latency, total sleep time and circadian rhythm assessed by accelerometry values. Conclusion While some sleep and circadian rhythm outcomes (PSQI, WASO and salivary cortisol) exhibited significant improvements, it is still somewhat unclear what exercise prescriptions would optimize different sleep and circadian rhythm outcomes across a variety of groups of cancer survivors. Implication As exercise does not exacerbate cancer-related circadian rhythm and sleep disturbances, and may actually produce some significant benefits, this meta-analysis provides further evidence for cancer survivors to perform regular exercise.
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Affiliation(s)
- Rachita Gururaj
- Ramaiah College of Physiotherapy, Ramaiah University of Applied Sciences, Bengaluru, Karnataka, India
| | - Stephen Rajan Samuel
- Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
- Cancer Control Division, Department of Surgery University of Rochester Medical Center, University of Rochester, Rochester, NY, United States of America
| | - K Vijaya Kumar
- Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Ravishankar Nagaraja
- Department of Biostatistics, Vallabhbhai Patel Chest Institute, University of Delhi, New Delhi, New Delhi, India
| | - Justin W.L. Keogh
- Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia, Australia
- Human Potential Centre, AUT University, Auckland, New Zealand
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Ding X, Li Q, Tang YY. The thalamic clustering coefficient moderates the vigor-sleep quality relationship. Sleep Biol Rhythms 2023; 21:369-375. [PMID: 38476314 PMCID: PMC10899908 DOI: 10.1007/s41105-023-00456-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 03/06/2023] [Indexed: 03/28/2023]
Abstract
Sleep disorders affect more than one-quarter of the world's population, resulting in reduced daytime productivity, impaired immune function, and an increased risk of cardiovascular disease. It is important to identify the physiological and psychological factors related to sleep for the prevention and treatment of sleep disorders. In this study, we correlated measurements of emotional state, sleep quality, and some brain neural activity parameters to better understand the brain and psychological factors related to sleep. Resting-state functional magnetic resonance imaging (rs-fMRI) of 116 healthy undergraduates were analyzed using graph theory to assess regional topological characteristics. Among these, the left thalamic cluster coefficient proved to be the ablest to reflect the characteristics of the sleep neural graph index. The Profile of Mood States (POMS) was used to measure vigor, and the Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality. The results showed that the left thalamic clustering coefficient was negatively correlated with sleep quality and vigor. Further, the left thalamic clustering coefficient moderated the relationship between vigor and sleep quality. When the left thalamic clustering coefficient was very low, there was a significant positive correlation between vigor and sleep quality. However, when the left thalamic clustering coefficient was high, the correlation between vigor and sleep quality became insignificant. The relationship between vigor and sleep quality is heterogeneous. Analyzing the function of the left thalamic neural network could help understand the variation in the relationship between vigor and sleep quality in different populations. Such observations may help in the development of personalized interventions for sleep disorders.
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Affiliation(s)
- Xiaoqian Ding
- College of Psychology, Liaoning Normal University, Dalian, 116029 China
| | - Qingmin Li
- College of Psychology, Liaoning Normal University, Dalian, 116029 China
| | - Yi-Yuan Tang
- College of Health Solutions, Arizona State University, Tempe, AZ 85281 USA
- College of Health Solutions, Arizona State University, Phoenix, AZ 85004 USA
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Sleight A, Gerber LH, Marshall TF, Livinski A, Alfano CM, Harrington S, Flores AM, Virani A, Hu X, Mitchell SA, Varedi M, Eden M, Hayek S, Reigle B, Kerkman A, Neves R, Jablonoski K, Hacker ED, Sun V, Newman R, McDonnell KK, L'Hotta A, Schoenhals A, Dpt NLS. Systematic Review of Functional Outcomes in Cancer Rehabilitation. Arch Phys Med Rehabil 2022; 103:1807-1826. [PMID: 35104445 PMCID: PMC9339032 DOI: 10.1016/j.apmr.2022.01.142] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 01/10/2022] [Accepted: 01/11/2022] [Indexed: 11/02/2022]
Abstract
OBJECTIVE To systematically review the evidence regarding rehabilitation interventions targeting optimal physical or cognitive function in adults with a history of cancer and describe the breadth of evidence as well as strengths and limitations across a range of functional domains. DATA SOURCES PubMed, Cumulative Index to Nursing and Allied Health Plus, Scopus, Web of Science, and Embase. The time scope was January 2008 to April 2019. STUDY SELECTION Prospective, controlled trials including single- and multiarm cohorts investigating rehabilitative interventions for cancer survivors at any point in the continuum of care were included, if studies included a primary functional outcome measure. Secondary data analyses and pilot/feasibility studies were excluded. Full-text review identified 362 studies for inclusion. DATA EXTRACTION Extraction was performed by coauthor teams and quality and bias assessed using the American Academy of Neurology (AAN) Classification of Evidence Scheme (class I-IV). DATA SYNTHESIS Studies for which the functional primary endpoint achieved significance were categorized into 9 functional areas foundational to cancer rehabilitation: (1) quality of life (109 studies), (2) activities of daily living (61 studies), (3) fatigue (59 studies), (4) functional mobility (55 studies), (5) exercise behavior (37 studies), (6) cognition (20 studies), (7) communication (10 studies), (8) sexual function (6 studies), and (9) return to work (5 studies). Most studies were categorized as class III in quality/bias. Averaging results found within each of the functional domains, 71% of studies reported statistically significant results after cancer rehabilitation intervention(s) for at least 1 functional outcome. CONCLUSIONS These findings provide evidence supporting the efficacy of rehabilitative interventions for individuals with a cancer history. The findings should be balanced with the understanding that many studies had moderate risk of bias and/or limitations in study quality by AAN criteria. These results may provide a foundation for future work to establish clinical practice guidelines for rehabilitative interventions across cancer disease types.
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Affiliation(s)
- Alix Sleight
- Department of Physical Medicine and Rehabilitation, Cedars-Sinai Medical Center, Los Angeles, California, United States; Center for Integrated Research in Cancer and Lifestyle (CIRCL), Cedars-Sinai Medical Center, Los Angeles, California, United States; Cedars Sinai Cancer, Los Angeles, California, United States; Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland, United States.
| | - Lynn H Gerber
- College of Health and Human Services, George Mason University, Fairfax County, Virginia, United States; Inova Health System, Inova Medicine Services, Falls Church, Virginia, United States
| | | | - Alicia Livinski
- National Institutes of Health Library, Office of Research Services, National Institutes of Health, Bethesda, Maryland, United States
| | - Catherine M Alfano
- Northwell Health Cancer Institute, New Hyde Park, New York, United States; Center for Personalized Health, Feinstein Institutes for Medical Research, Manhasset, New York, United States; Department of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York, United States
| | - Shana Harrington
- Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States
| | - Ann Marie Flores
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States; Robert H. Lurie Comprehensive Cancer Center, Cancer Survivorship Institute, Chicago, Illinois, United States
| | - Aneesha Virani
- Rehabilitation Department, Northside Hospital, Atlanta, Georgia, United States
| | - Xiaorong Hu
- Rehabilitation Medicine Department, Clinical Center, National Institutes of Health, Boston, Massachusetts, United States; Rehabilitation Medicine School, Nanjing Medical University, Nanjing, China
| | - Sandra A Mitchell
- Outcomes Research Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland, United States
| | - Mitra Varedi
- Epidemiology and Cancer Control Department, St Jude Children's Research Hospital, Memphis, Tennessee, United States
| | - Melissa Eden
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Scottsdale, Arizona, United States
| | - Samah Hayek
- Clalit Health Services, Clalit Research Institute, Ramat-Gan, Israel
| | - Beverly Reigle
- College of Nursing, University of Cincinnati, Cincinnati, Ohio, United States
| | - Anya Kerkman
- Lincoln Cancer Rehabilitation, Lincoln, Nebraska, United States; CHI Health St Elizabeth, Lincoln, Nebraska, United States
| | - Raquel Neves
- Czech Rehabilitation Hospital, Al Ain, United Arab Emirates
| | - Kathleen Jablonoski
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC, United States; Department of Biostatistics, Milken Institute School of Public Health, George Washington University, Washington, DC, United States
| | - Eileen Danaher Hacker
- Department of Science of Nursing Care, Indiana University School of Nursing, Indianapolis, Indiana, United States
| | - Virginia Sun
- Department of Population Sciences, City of Hope, Duarte, California, United States; Department of Surgery, City of Hope, Duarte, California, United States
| | - Robin Newman
- Department of Occupational Therapy, Boston University College of Health and Rehabilitation Sciences: Sargent College, Boston, Massachusetts, United States
| | - Karen Kane McDonnell
- College of Nursing, University of South Carolina, Columbia, South Carolina, United States
| | - Allison L'Hotta
- Department of Occupational Therapy, Washington University in St Louis, St Louis, Missouri, United States
| | - Alana Schoenhals
- Mrs T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, United States
| | - Nicole L Stout Dpt
- West Virginia University Cancer Institute, West Virginia University School of Public Health, Morgantown, West Virginia, United States; Rehabilitation Medicine Department, Clinical Center, National Institutes of Health, Bethesda, Maryland, United States
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5
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Comparative efficacy of exercise regimens on sleep quality in older adults: A systematic review and network meta-analysis. Sleep Med Rev 2022; 65:101673. [DOI: 10.1016/j.smrv.2022.101673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 06/19/2022] [Accepted: 07/18/2022] [Indexed: 11/22/2022]
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Grogg KA, Giacobbi PR, Blair EK, Haggerty TS, Lilly CL, Winters CS, Kelley GA. Physical Activity Assessment and Promotion in Clinical Settings in the United States: A Scoping Review. Am J Health Promot 2022; 36:714-737. [PMID: 35224998 DOI: 10.1177/08901171211051840] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The purpose of this scoping review was to systematically examine interventions that focused on physical activity assessment and promotion in clinical settings in the United States. DATA SOURCES A literature search was performed in 6 major databases to extract published peer-reviewed studies from 2008 to 2019. INCLUSION AND EXCLUSION CRITERIA Interventions with practicing health professionals in the United States who performed physical activity assessment and promotion with adult patients 18 years of age and older. Studies were excluded if they were published in non-English, observational or case study designs, or gray literature. DATA EXTRACTION Studies were screened and coded based on the population, intervention, comparison, outcomes and study setting for scoping reviews (PRISMA-ScR) framework. Of 654 studies that were identified and screened for eligibility, 78 met eligibility criteria and were independently coded by two coders. DATA SYNTHESIS Data were synthesized using qualitative and descriptive methods. RESULTS Forty-three of the included studies were randomized controlled trials with a majority being delivered by physicians and nurses in primary care settings. Fifty-six studies reported statistically significant findings in outcome measures such as anthropometrics and chronic disease risk factors, with 17 demonstrating improvements in physical activity levels as a result of the interventions. CONCLUSION The assessment and promotion of physical activity in clinical settings appears to be effective but warrants continued research.
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Affiliation(s)
- Kristin A Grogg
- West Virginia Clinical and Translational Science Institute, 5631West Virginia University School of Medicine and Honors College, Morgantown, WV, USA
| | - Peter R Giacobbi
- Department of Sport Sciences, Joint Appointment in Department of Social & Behavioral Sciences, 5631West Virginia University College of Physical Activity & Sport Sciences, School of Public Health, Morgantown, WV, USA
| | - Emma K Blair
- Department of Exercise Physiology, 5631West Virginia University, School of Medicine, Morgantown, WV, USA
| | - Treah S Haggerty
- Department of Family Medicine, 5631West Virginia University, School of Medicine, Morgantown, WV, USA
| | - Christa L Lilly
- Department of Biostatistics, 5631West Virginia University, School of Public Health, Morgantown, WV, USA
| | - Carena S Winters
- Department of Kinesiology, 4121Jacksonville University, Brooks Rehabilitation College of Healthcare Sciences, Jacksonville, FL, USA
| | - George A Kelley
- Department of Biostatistics, 5631West Virginia University, School of Public Health, Morgantown, WV, USA
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Brett Whalen L, Zachary Wright W, Kundur P, Angadi S, Modesitt SC. Beneficial effects of exercise on chemotherapy-induced peripheral neuropathy and sleep disturbance: A review of literature and proposed mechanisms. Gynecol Oncol Rep 2022; 39:100927. [PMID: 35071723 PMCID: PMC8761687 DOI: 10.1016/j.gore.2022.100927] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 12/16/2021] [Accepted: 01/03/2022] [Indexed: 12/17/2022] Open
Abstract
Exercise counters chemotherapy-induced peripheral neuropathy and sleep disturbances. Exercise reduces inflammation, promotes neuroplasticity, modulates pain signaling. Exercise improves sleep disturbances by entraining circadian rhythmicity. Oncologists should learn how to prescribe exercise regimens for their patients.
The goal of this narrative review is to evaluate the literature regarding exercise training as a therapy to prevent or mitigate deleterious side effects of chemotherapy, specifically peripheral neuropathy and sleep disturbances and to make concrete recommendations for implementation for the practicing oncologist. A literature search was conducted for studies that included an exercise intervention to be implemented for patients undergoing or previously treated with chemotherapy along with an analysis of its effect on either chemotherapy-induced peripheral neuropathy (CIPN) or chemotherapy-induced sleep disturbances. Studies were subsequently analyzed and summarized in order to determine the overall promise of exercise as a therapy in this setting. Five studies met inclusion criteria to be assessed with regard to the effect of exercise on CIPN and eight were included for sleep disturbances. Exercise was found to be a significantly beneficial therapy in preventing, mitigating, or improving the symptoms of CIPN and sleep disturbances in cancer patients in the majority of studies evaluated. Exercise is an effective intervention and should be specifically prescribed concurrently with chemotherapy to maximize potential of avoiding these debilitating side effects, which significantly and negatively impact quality of life in cancer survivors.
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Affiliation(s)
- L. Brett Whalen
- University of Virginia School of Medicine, Charlottesville, VA, United States
- Corresponding author at: University of Virginia School of Medicine, 1215 Lee St, CVC 5144, Charlottesville, VA 22903, United States.
| | - W. Zachary Wright
- University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Priyanka Kundur
- University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Siddhartha Angadi
- Department of Kinesiology, School of Education and Human Development, University of Virginia, Charlottesville, VA, United States
| | - Susan C. Modesitt
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, School of Medicine, University of Virginia, Charlottesville, VA, United States
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Ha Y, Lee SH, Lee DH, Kang YH, Choi W, An J. Effectiveness of a Mobile Wellness Program for Nurses with Rotating Shifts during COVID-19 Pandemic: A Pilot Cluster-Randomized Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1014. [PMID: 35055833 PMCID: PMC8776111 DOI: 10.3390/ijerph19021014] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/11/2022] [Accepted: 01/13/2022] [Indexed: 01/15/2023]
Abstract
Nurses with rotating shifts, including night shifts, have suffered from low physical activity during the COVID-19 pandemic and lower sleep quality due to the disruption of their circadian rhythm. This study aimed to develop and examine the effectiveness of a mobile wellness program on daily steps, sleep quality, exercise self-efficacy, intrinsic motivation for exercise, self-rated fatigue, and wellness. A cluster randomized controlled trial design was used to examine the effectiveness of the mobile wellness program for nurses with rotating shifts. Sixty nurses from one university hospital participated and were allocated to an intervention group and a control group. The intervention group received a 12-week mobile wellness program to improve their physical activity and sleep quality, and the control group was only given a Fitbit to self-monitor their health behaviors. There were significant differences between the two groups in daily steps (p = 0.000), three components (subjective sleep quality, sleep disturbance, daytime dysfunction) of the PSQI, exercise self-efficacy, intrinsic motivation for exercise, and wellness. In conclusion, this study provides meaningful information that the mobile wellness program using Fitbit, online exercise using Zoom, online health coaching on a Korean mobile platform, and motivational text messages effectively promoted physical activity and sleep quality for nurses with rotating shifts during the COVID-19 pandemic.
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Affiliation(s)
- Yeongmi Ha
- School of Nursing, Institute of Health Sciences, Gyeongsang National University, Jinju 52727, Korea;
| | - Sang-Ho Lee
- Convergence Research Advanced Centre for Olfaction, DGIST, Daegu 42988, Korea;
- Division of Intelligent Robot, DGIST, Daegu 42988, Korea;
| | - Dong-Ha Lee
- Division of Intelligent Robot, DGIST, Daegu 42988, Korea;
| | | | - Woonjoo Choi
- Department of Nursing, Gyeongsang National University Hospital, Jinju 52727, Korea;
| | - Jinung An
- Division of Intelligent Robot, DGIST, Daegu 42988, Korea;
- Department of Interdisciplinary Engineering, DGIST, Daegu 42988, Korea
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Era DP, Sitorus R, Afiyanti Y. Empowerment In The Treatment Of Fatigue In Breast Cancer Patients. RUSSIAN OPEN MEDICAL JOURNAL 2021. [DOI: 10.15275/rusomj.2021.0411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
This review aimed at providing a summary of a collection of literature that covers breast cancer and related phenomena, namely fatigue and the disruption of self-esteem and body image that can occur when a cancer diagnosis is given. As the most common symptom reported by survivors, fatigue is a unique personal symptom that burdened survivors, a consequence as well as an antecedent. Fatigue in cancer is caused by disease processes as well as treatment side effects and becomes a serious problem compared to pain and nausea due to limited physical function, and psychological and social welfare. Facing the problem of fatigue, and poor self-esteem and body image in nursing science contributes to the empowerment of survivors; this is achieved through nursing processes and is a standard that can be used to solve fatigue problems.
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Effects of Walking on Fatigue in Cancer Patients: A Systematic Review and Meta-analysis. Cancer Nurs 2021; 45:E270-E278. [PMID: 34870943 DOI: 10.1097/ncc.0000000000000914] [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 Walking is a simple form of exercise that is easily accepted by patients. Exercise is one of the main ways to control cancer-related fatigue (CRF). However, there are conflicting data on the association between walking and severity of CRF. OBJECTIVE The aim of this study was to assess the overall effect of walking on CRF among adult cancer patients. METHODS Databases including PubMed, CINAHL, EMBASE, and Cochrane Library were systematically reviewed to identify suitable randomized controlled trials from inception to February 29, 2020. Two reviewers independently evaluated the risk of bias and extracted correlated data with Cochrane Handbook of Systematic Reviews on Interventions. The data analysis was performed by Review Manager 5.3. RESULTS A total of 12 studies with 1064 patients were identified. Integrated result analysis of walking yielded a statistically significant effect on CRF (standard mean difference [SMD], -0.66; 95% confidence interval [CI], -1.06 to -0.26). Subgroup analysis demonstrated that intervention time longer than 6 weeks (SMD, -0.89; 95% CI, -1.22 to -0.57) had a better effect on fatigue compared with that of less than 6 weeks (SMD, 0.03; 95% CI, -0.39 to 0.45). The study showed walking was statistically more effective than the control intervention in patients undergoing cancer treatment (SMD, -0.79; 95% CI, -1.16 to -0.42). Descriptive analysis also showed that walking was effective for cancer patients who completed treatment. CONCLUSIONS Walking is effective for CRF during and after cancer therapy. IMPLICATIONS FOR PRACTICE The results provide evidence for a general exercise form to relieve fatigue in cancer patients and facilitate support for future clinical trials and work.
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11
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Johannsen M, Stoll C, Raida M, van Oorschot B, Flörcken A. Supportive therapy and complementary medicine in renal cell carcinoma. World J Urol 2021; 40:2359-2371. [PMID: 34821959 DOI: 10.1007/s00345-021-03885-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 11/08/2021] [Indexed: 11/29/2022] Open
Abstract
PURPOSE As part of the German interdisciplinary S3-guideline "Diagnosis, Treatment and Followup of Renal Cell Carcinoma", this article aimes to provide guidance regarding the use of supportive therapy and complementary medicine in patients with advanced or metastatic renal cell carcinoma. METHODS The German interdisciplinary S3-guidelines are national clinical practice guidelines that implement the highest methodological quality of evidence-based medicine. Recommendations and evidence-based statements are provided according to available evidence. RESULTS Supportive and palliative care are important areas of tumor treatment and require knowledge on the management of a variety of issues. This article outlines the management of tumor-related symptoms such as pain, undesired treatment-related effects, palliative care and end-of-life care in patients with renal cell carcinoma. CONCLUSION Patients with advanced or metastatic renal cell carcinoma should have access to supportive and palliative care according to their individual needs. There is very limited evidence regarding the impact of complementary medicine for the treatment of patients with renal cell carcinoma.
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Affiliation(s)
- M Johannsen
- Urology Practice Johannsen & Laux, Berlin and d-uo (Deutsche Uro-Onkologen), Berlin, Germany
| | - C Stoll
- Department of Oncology, Clinic Herzoghoehe, Bayreuth, Germany
| | - M Raida
- VAMED Rehabilitation Clinic Bergisch-Land, Wuppertal, Germany
| | - B van Oorschot
- Interdisciplinary Center for Palliative Medicine, Department of Radiation Oncology, University Hospital Würzburg, Würzburg, Germany
| | - A Flörcken
- Department of Hematology, Oncology, and Tumor Immunology, Charité-Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany
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12
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Attention to principles of exercise training: an updated systematic review of randomized controlled trials in cancers other than breast and prostate. BMC Cancer 2021; 21:1179. [PMID: 34740332 PMCID: PMC8569988 DOI: 10.1186/s12885-021-08701-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 08/16/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The primary objective of this systematic review was to update our previous review on randomized controlled trials (RCTs) of exercise in cancers other than breast or prostate, evaluating: 1) the application of principles of exercise training within the exercise prescription; 2) reporting of the exercise prescription components (i.e., frequency, intensity, time, and type (FITT)); and 3) reporting of participant adherence to FITT. A secondary objective was to examine whether reporting of these interventions had improved over time. METHODS MEDLINE, EMBASE, CINAHL and SPORTDiscus databases were searched from 2012 to 2020. Eligible studies were RCTs of at least 4 weeks of aerobic and/or resistance exercise that reported on physiological outcomes relating to exercise (e.g., aerobic capacity, muscular strength) in people with cancer other than breast or prostate. RESULTS Eighty-six new studies were identified in the updated search, for a total of 107 studies included in this review. The principle of specificity was applied by 91%, progression by 32%, overload by 46%, initial values by 72%, reversibility by 7% and diminishing returns by 5%. A significant increase in the percentage of studies that appropriately reported initial values (46 to 80%, p < 0.001) and progression (15 to 37%, p = 0.039) was found for studies published after 2011 compared to older studies. All four FITT prescription components were fully reported in the methods in 58% of all studies, which was higher than the proportion that fully reported adherence to the FITT prescription components in the results (7% of studies). Reporting of the FITT exercise prescription components and FITT adherence did not improve in studies published after 2011 compared to older studies. CONCLUSION Full reporting of exercise prescription and adherence still needs improvement within exercise oncology RCTs. Some aspects of exercise intervention reporting have improved since 2011, including the reporting of the principles of progression and initial values. Enhancing the reporting of exercise prescriptions, particularly FITT adherence, may provide better context for interpreting study results and improve research to practice translation.
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13
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D'Ascenzi F, Anselmi F, Fiorentini C, Mannucci R, Bonifazi M, Mondillo S. The benefits of exercise in cancer patients and the criteria for exercise prescription in cardio-oncology. Eur J Prev Cardiol 2021; 28:725-735. [PMID: 31587570 DOI: 10.1177/2047487319874900] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 08/19/2019] [Indexed: 12/24/2022]
Abstract
Cancer and cardiovascular diseases are the leading causes of death in high-income countries. Cardiovascular complications can be found in cancer patients, being the result of so-called 'cardio-toxicity'. Therefore, it becomes essential to thoroughly investigate the origin of cardiac damage and the strategy to prevent it or to reverse the negative remodelling associated with cardiotoxicity. In this review the beneficial effects of physical exercise in cancer patients were analysed, particularly to prevent cardio-toxicity before its clinical manifestation. According to the relevance of exercise, we suggest strategies for exercise prescription with a tailored approach in these patients. In conclusion, physical exercise seems to be a promising and effective treatment for cancer patients during and after therapy and seems to counteract the negative effects induced by drugs on the cardiovascular system. Exercise prescription should be tailored according to patient's individual characteristics, to the drugs administered, to the personal history, and to his/her response to exercise, taking into account that different types of training can be prescribed according also to the patient's choice. A cardiological evaluation including exercise testing is essential for an appropriate prescription of exercise in these patients.
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Affiliation(s)
- Flavio D'Ascenzi
- Department of Medical Biotechnologies, University of Siena, Italy
- Department of Medicine, University of Pittsburgh, USA
| | | | | | - Roberta Mannucci
- Institute for Health, University of Pittsburgh Medical Center, C. Terme (Siena), Italy
| | - Marco Bonifazi
- Department of Medicine, Science, and Neurosciences, University of Siena, Italy
| | - Sergio Mondillo
- Department of Medical Biotechnologies, University of Siena, Italy
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14
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Ng SM, Fung MHY, Chan JSM, Chan CHY, Chan CLW. Physical activity, confidence and quality of life among cancer patient-carer dyads. SPORTS MEDICINE-OPEN 2021; 7:46. [PMID: 34196850 PMCID: PMC8249531 DOI: 10.1186/s40798-021-00333-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 06/01/2021] [Indexed: 01/09/2023]
Abstract
Background Physical activity (PA) has been positively associated with health-related quality of life (HRQoL) among cancer patients and family caregivers. However, there has been no relevant research for patient-caregiver dyads. Methods Path analysis, based on the actor–partner interdependence model (APIM), was used to examine the relationship between physical activity and health-related quality of life and explore the mediating role of emotional distress in 233 dyads. Results In both patients and caregivers, physical activity had a direct positive effect on physical quality of life (QoL) but not on mental. There was a significant indirect effect of physical activity on health-related quality of life via emotional distress for both dyad members. Patients’ and caregivers’ confidence in fighting cancer was negatively associated with their own emotional distress. Caregivers’ confidence in fighting cancer was positively associated with their physical activity and also negatively associated with patients’ emotional distress. Conclusions Physical activity may be considered as a possible behavioral and rehabilitation strategy for improving health-related quality of life in patient-caregiver dyads and reducing negative symptoms. Future research and intervention may consider cancer patient-family caregiver dyad as a unit of care.
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Affiliation(s)
- Siu-Man Ng
- Department of Social Work and Social Administration, The University of Hong Kong, 5/F, Jockey Club Tower, The Centennial Campus, Pokfulam, Hong Kong, China. .,Centre on Behavioral Health, The University of Hong Kong, Pokfulam, Hong Kong, China.
| | - Melody H Y Fung
- Department of Social Work and Social Administration, The University of Hong Kong, 5/F, Jockey Club Tower, The Centennial Campus, Pokfulam, Hong Kong, China.
| | - Jessie S M Chan
- School of Chinese Medicine, Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China.
| | - Celia H Y Chan
- Department of Social Work and Social Administration, The University of Hong Kong, 5/F, Jockey Club Tower, The Centennial Campus, Pokfulam, Hong Kong, China
| | - Cecilia L W Chan
- Department of Social Work and Social Administration, The University of Hong Kong, 5/F, Jockey Club Tower, The Centennial Campus, Pokfulam, Hong Kong, China.,Centre on Behavioral Health, The University of Hong Kong, Pokfulam, Hong Kong, China
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15
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Moraitis AM, Seven M, Walker RK. Physical Activity in Young Adult Cancer Survivors: A Scoping Review. Oncol Nurs Forum 2021; 48:184-194. [PMID: 33600391 DOI: 10.1188/21.onf.184-194] [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] [Indexed: 11/17/2022]
Abstract
PROBLEM IDENTIFICATION Physical activity, a precision health strategy, positively affects biopsychosocial health in adult cancer survivors. However, understanding its effects among young adult (YA) cancer survivors is limited. The purpose of this scoping review was to explore existing research on physical activity in YA cancer survivors. LITERATURE SEARCH CINAHL®, PubMed®, PsycINFO®, SPORTDiscus, Web of Science, and Cochrane Library were searched, producing 63 articles and 28 grey materials. DATA EVALUATION Data extraction, guided by the revised symptom management model, included research aims, sample, design, primary outcome measures, and effects of physical activity. SYNTHESIS Findings of 35 review articles were reported under three main categories. IMPLICATIONS FOR RESEARCH Lack of clinical guidelines and limited research specific to YA cancer survivors hinders physical activity's use as a symptom management strategy. Research is needed that addresses the development and clinical implementation of physical activity guidelines.
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16
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Moore J, Richards S, Popp C, Hollimon L, Reid M, Jean-Louis G, Seixas AA. The Moderating Effect of Physical Activity on the Relationship between Sleep and Emotional Distress and the Difference between Blacks and Whites: A Secondary Data Analysis Using the National Health Interview Survey from 2005-2015. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1718. [PMID: 33578959 PMCID: PMC7916647 DOI: 10.3390/ijerph18041718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 01/22/2021] [Accepted: 01/28/2021] [Indexed: 12/27/2022]
Abstract
(1) Background: Unhealthy sleep durations (short and long sleep) are associated with emotional distress (ED). Minority populations, specifically Blacks, are more burdened with unhealthy sleep durations and ED. The ameliorative effect of physical activity (PA) on ED and sleep duration may provide insight into how to reduce the burden among Blacks and other minorities. However, it is unclear whether PA attenuates the relationship between sleep and ED, and whether this relationship differs by race. (2) Methods: We analyzed data from the nationally representative 2005-2015 National Health Interview Survey (NHIS) dataset. ED, physical activity, and sleep duration were collected through self-reports. Regression analyses investigated the moderating effect of PA on the relationship between sleep and ED (adjusting for age, sex, BMI, and employment status) and stratified by race. (3) Results: We found that sleep duration was independently associated with ED. Physical activity moderated the relationship between sleep and ED, the full population, and Whites, but not Blacks. (4) Conclusion: PA moderated the relationship between short, average, or long sleep and ED, but in stratified analyses, this was only evident for Whites, suggesting Blacks received differing protective effects from physical activity. Further research should be performed to understand the connection of physical activity to sleep and mental health.
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Affiliation(s)
- Jesse Moore
- Department of Population Health, New York University Langone Health, New York, NY 10016, USA; (S.R.); (C.P.); (L.H.); (G.J.-L.)
| | - Shannique Richards
- Department of Population Health, New York University Langone Health, New York, NY 10016, USA; (S.R.); (C.P.); (L.H.); (G.J.-L.)
| | - Collin Popp
- Department of Population Health, New York University Langone Health, New York, NY 10016, USA; (S.R.); (C.P.); (L.H.); (G.J.-L.)
| | - Laronda Hollimon
- Department of Population Health, New York University Langone Health, New York, NY 10016, USA; (S.R.); (C.P.); (L.H.); (G.J.-L.)
| | - Marvin Reid
- Department of Community Medicine & Psychiatry, University of the West Indies, Kingston JMCJS2, Jamaica;
| | - Girardin Jean-Louis
- Department of Population Health, New York University Langone Health, New York, NY 10016, USA; (S.R.); (C.P.); (L.H.); (G.J.-L.)
| | - Azizi A. Seixas
- Department of Population Health, New York University Langone Health, New York, NY 10016, USA; (S.R.); (C.P.); (L.H.); (G.J.-L.)
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17
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Takemura N, Cheung DST, Smith R, Deng W, Ho KY, Lin J, Kwok JYY, Lam TC, Lin CC. Effectiveness of aerobic exercise and mind-body exercise in cancer patients with poor sleep quality: A systematic review and meta-analysis of randomized controlled trials. Sleep Med Rev 2020; 53:101334. [PMID: 32505970 DOI: 10.1016/j.smrv.2020.101334] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 03/17/2020] [Accepted: 03/18/2020] [Indexed: 02/02/2023]
Abstract
Exercise has promising effects on sleep disturbances and quality of life among cancer patients. Aerobic exercises (AE) and mind-body exercises (MBE) have different mechanisms for improving sleep, but whether they are effective remains unclear. This systematic review and meta-analysis is the first to examine the effectiveness of AE and MBE on sleep outcomes, specifically among cancer patients with sleep disturbances. A systematic search of several databases, from inception to January 2018, was conducted. The pooled effect sizes suggested that both AE (standardized mean difference (SMD) = 0.33, 95% confidence intervals (CI): 0.11, 0.54) and MBE (SMD = 0.18, 95% CI: 0.06, 0.30), improved sleep outcomes in cancer patients with poor sleep quality post-intervention. The effects remained significant after 3-6 months for AE, but not MBE. Due to the heterogeneity in AE, future studies should establish the optimal AE prescription. For MBE, future research should study essential components that make the intervention effect sustainable.
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Affiliation(s)
- Naomi Takemura
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Denise Shuk Ting Cheung
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Robert Smith
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Wen Deng
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Ka Yan Ho
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Jingxia Lin
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Jojo Yan Yan Kwok
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Tai-Chung Lam
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Chia-Chin Lin
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong; Alice Ho Miu Ling Nethersole Charity Foundation Professor in Nursing, Hong Kong; School of Nursing, College of Nursing, Taipei Medical University, Taiwan.
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18
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Wang F, Boros S. Effects of a pedometer-based walking intervention on young adults’ sleep quality, stress and life satisfaction: Randomized controlled trial. J Bodyw Mov Ther 2020; 24:286-292. [DOI: 10.1016/j.jbmt.2020.07.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Revised: 06/22/2020] [Accepted: 07/19/2020] [Indexed: 01/07/2023]
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19
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Ehlers DK, DuBois K, Salerno EA. The effects of exercise on cancer-related fatigue in breast cancer patients during primary treatment: a meta-analysis and systematic review. Expert Rev Anticancer Ther 2020; 20:865-877. [PMID: 32842816 DOI: 10.1080/14737140.2020.1813028] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Cancer-related fatigue is one of the most prevalent symptoms reported by breast cancer survivors. Despite a corpus of literature dedicated to understanding and identifying evidence-based treatments for cancer-related fatigue, gaps in the literature remain, particularly for breast cancer survivors during their primary treatment. Exercise training may represent an efficacious behavioral modality for mitigating fatigue symptoms in cancer survivors; yet, the effects of exercise during adjuvant therapy is an understudied area. AREAS COVERED In this review, we synthesize the most recent evidence of exercise's effects on cancer-related fatigue during active treatment for breast cancer. We summarize the overall effects of exercise, moderators of these effects, and areas requiring further research. EXPERT OPINION Strong evidence supports at least modest effects of exercise on cancer-related fatigue during breast cancer treatment. However, several knowledge gaps persist, including the need to: risk stratify patients to tailor exercise promotion strategies; implement higher-quality studies and translate this evidence to clinical practice; adopt biobehavioral models to better understand exercise's effects on cancer-related fatigue; evaluate the effects of exercise modes besides aerobic and combined training; and integrate technology to better understand and promote fatigue-reducing behaviors, such as exercise, across cancer care.
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Affiliation(s)
- Diane K Ehlers
- Department of Neurological Sciences, University of Nebraska Medical Center , Omaha, NE, USA
| | - Kelli DuBois
- Department of Health Promotion, Education, & Behavior, University of South Carolina Arnold School of Public Health , Columbia, SC, USA
| | - Elizabeth A Salerno
- Division of Cancer Epidemiology & Genetics, Metabolic Epidemiology Branch, National Cancer Institute , Rockville, MD, USA
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20
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Piringer G, Vormittag L, Öhler L, Grünberger B, Meran J, Moshammer M, Andel J, Eisterer W, Trommet V, Thaler J. REGO-ACT: assessment of physical activity during treatment with regorafenib for metastatic colorectal cancer. Wien Klin Wochenschr 2020; 132:423-430. [PMID: 32643016 DOI: 10.1007/s00508-020-01703-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 06/06/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND A frequent side effect of the multikinase inhibitor regorafenib is fatigue. Physical activity has shown potential in reducing cancer-related fatigue. METHODS This non-interventional pilot study assessed physical activity levels of metastatic colorectal cancer (mCRC) patients treated with regorafenib based on median daily step counts measured at 1‑week intervals using a pedometer. The study further evaluated relations between physical activity levels and fatigue, quality of life (QoL) and progression-free survival. RESULTS Pedometer data were available for 22 out of 25 enrolled patients. The numbers of days with available pedometer data ranged from 6 to 100 days. The overall median daily step count was 2357 (range 10-14,931), with substantial interindividual and intraindividual variations. Interindividual median weekly step counts were in the range of 5000-7000 in some, 2000-3000 in others, and several hundreds or less in a few patients. Intraindividual daily step counts also varied by several thousands of steps. Step counts in weeks in which patients reported fatigue were well within the range of or even higher than step counts in adjacent weeks, indicating a lack of correlation. The risk of disease progression was also independent of median weekly step counts; however, significant correlations were seen between QoL and step counts. CONCLUSION Despite the severity of their disease patients showed remarkable levels of walking activity. In view of the highly individual activity levels, exercise prescriptions for seriously ill patient populations should be personalized to the specific needs and preferences of each individual patient.
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Affiliation(s)
- Gudrun Piringer
- Department of Internal Medicine IV, Klinikum Wels-Grieskirchen, Grieskirchnerstraße 42, 4600, Wels, Austria. .,Johannes Kepler University Linz, Linz, Austria.
| | - Laurenz Vormittag
- Department of Internal Medicine I, St. Josef Hospital Vienna, Vienna, Austria
| | - Leopold Öhler
- Department of Internal Medicine I, St. Josef Hospital Vienna, Vienna, Austria
| | - Birgit Grünberger
- Department of Internal Medicine, Hospital of The Merciful Brothers, Vienna, Austria.,Department of Internal Medicine, Landesklinikum Wiener Neustadt, Wiener Neustadt, Austria
| | - Johannes Meran
- Department of Internal Medicine, Hospital of The Merciful Brothers, Vienna, Austria
| | | | - Johannes Andel
- Department of Internal Medicine II, Landeskrankenhaus Steyr, Steyr, Austria
| | - Wolfgang Eisterer
- Department of Internal Medicine V, Innsbruck Medical University, Innsbruck, Austria.,Department of Internal Medicine, Klinikum Klagenfurt, Klagenfurt, Austria
| | - Vera Trommet
- Department of Internal Medicine IV, Klinikum Wels-Grieskirchen, Grieskirchnerstraße 42, 4600, Wels, Austria
| | - Josef Thaler
- Department of Internal Medicine IV, Klinikum Wels-Grieskirchen, Grieskirchnerstraße 42, 4600, Wels, Austria.,Johannes Kepler University Linz, Linz, Austria
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21
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Lopez C, McGarragle K, Pritlove C, Jones JM, Alibhai SMH, Lenton E, Santa Mina D. Variability and limitations in home-based exercise program descriptions in oncology: a scoping review. Support Care Cancer 2020; 28:4005-4017. [PMID: 32296982 DOI: 10.1007/s00520-020-05453-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 04/01/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND The literature reflects considerable heterogeneity in what constitutes home-based exercise interventions. The variability for where and what "home-based" exercise can represent challenges interpretation of findings and appropriate advocacy, referral, or development of these models of care. Therefore, the objective of this review was to provide a comprehensive summary of how home-based exercise is defined and reported in the literature and summarize the range of supportive elements utilized in home-based exercise trials. METHODS We followed methodology for scoping reviews. Relevant research databases were searched from inception to March 2019. Two reviewers independently screened articles to determine eligibility and extracted terminology used to describe home-based exercise and intervention details for intervention delivery. RESULTS Of the 9432 records identified, 229 articles met inclusion criteria. Across the literature, exercise interventions were described as home-based if they were completed at-home, outdoors in the neighbourhood, and in community facilities; or in self-selected environments; or if they were unsupervised. Supportive elements for home-based models ranged with respect to the amount of supervision and resources utilized, including the provision of print materials, exercise equipment, telephone support, home visits, and technology. CONCLUSIONS This review provides a comprehensive summary of strategies previously utilized to deliver home-based exercise interventions in oncology, along with the various definitions of the home-based environment for exercise reported by researchers. Specific recommendations to improve the prescription and reporting of home-based exercise interventions are provided in order to facilitate the delivery, evaluation, and translation of findings into clinical practice.
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Affiliation(s)
- Christian Lopez
- Faculty of Kinesiology and Physical Education, The University of Toronto, 55 Harbord St., Toronto, Ontario, M5S 2W6, Canada
- Cancer Rehabilitation and Survivorship, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Kaitlin McGarragle
- Cancer Rehabilitation and Survivorship, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Cheryl Pritlove
- Applied Health Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
| | - Jennifer M Jones
- Cancer Rehabilitation and Survivorship, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Shabbir M H Alibhai
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Medicine, University Health Network, Toronto, Ontario, Canada
| | - Erica Lenton
- Gerstein Science Information Centre, University of Toronto, Toronto, Ontario, Canada
| | - Daniel Santa Mina
- Faculty of Kinesiology and Physical Education, The University of Toronto, 55 Harbord St., Toronto, Ontario, M5S 2W6, Canada.
- Cancer Rehabilitation and Survivorship, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
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22
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Tang MF, Chiu HY, Xu X, Kwok JY, Cheung DST, Chen CY, Lin CC. Walking is more effective than yoga at reducing sleep disturbance in cancer patients: A systematic review and meta-analysis of randomized controlled trials. Sleep Med Rev 2019; 47:1-8. [DOI: 10.1016/j.smrv.2019.05.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 05/09/2019] [Accepted: 05/16/2019] [Indexed: 11/16/2022]
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23
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Fang Y, Hung C, Chan J, Huang S, Lee Y. Meta‐analysis: Exercise intervention for sleep problems in cancer patients. Eur J Cancer Care (Engl) 2019; 28:e13131. [DOI: 10.1111/ecc.13131] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 10/26/2018] [Accepted: 05/14/2019] [Indexed: 12/19/2022]
Affiliation(s)
- Yuan‐Yuan Fang
- School of Nursing, College of Medicine National Taiwan University Taipei Taiwan
| | - Chia‐Tai Hung
- Department of Nursing Mackay Medical College New Taipei City Taiwan
| | - Jui‐Chun Chan
- Department of Nursing Mackay Medical College New Taipei City Taiwan
| | | | - Yun‐Hsiang Lee
- School of Nursing, College of Medicine National Taiwan University Taipei Taiwan
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24
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Ciambella CC, Taneja C, Dizon DS, Wiggins DL, Emmick CM, Leonard KL, Lopresti ML, Witherby S, Cabral D, Snow S, Graves TA. Distress: Characterizing What Causes the Thermometer to Shift in Patients with Newly Diagnosed Breast Cancer Attending a Multidisciplinary Clinic. Ann Surg Oncol 2019; 26:3204-3209. [PMID: 31342366 DOI: 10.1245/s10434-019-07544-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND A diagnosis of breast cancer (BC) can result in multifactorial stress. If not addressed, distress can have a negative impact on outcomes. The experience of patients with newly diagnosed BC has not been sufficiently investigated. This study characterizes distress among new patients in a multidisciplinary care (MDC) clinic. The study aimed to determine the degree of distress at presentation, to characterize the sources, and to evaluate the impact of an MDC visit. METHODS A retrospective review was performed from January 2015 to November 2017. Charts were accessed for demographics, tumor characteristics, and treatment data. Distress scores (DS) and problems as captured using the National Comprehensive Cancer Network (NCCN) Distress Thermometer were completed before evaluation and in a subgroup after an MDC visit. Predictors of severe distress (DS ≥4) were investigated using multivariable logistic regression. The paired t test was used to determine the impact of an MDC visit. RESULTS The mean initial DS (n = 474) was 4.98. The top four sources of distress were worry, anxiety, fears, and sadness. Age younger than 65 years was significantly associated with a higher DS at presentation (p < 0.003). Among the patients queried before and after MDC (n = 137), a significant reduction in distress was identified (5.58-2.94; p < 0.0005). CONCLUSIONS Severe distress was found in 66 % of the patients with a recent diagnosis of BC, with younger age related to higher distress scores at presentation. Emotional stressors were the predominant factors accounting for distress. A same-day MDC visit was associated with a significant reduction in DS. These data indicate the importance and feasibility of proactively screening patients. Our research lends support to the value of multidisciplinary evaluation in this setting.
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Affiliation(s)
- Chelsey C Ciambella
- Department of Surgery, Brown University Warren Alpert Medical School, Providence, RI, USA. .,Rhode Island Hospital, Providence, RI, USA.
| | - Charu Taneja
- Rhode Island Hospital, Providence, RI, USA.,Lifespan Health System, Providence, RI, USA
| | - Don S Dizon
- Rhode Island Hospital, Providence, RI, USA.,Lifespan Health System, Providence, RI, USA
| | - Doreen L Wiggins
- Rhode Island Hospital, Providence, RI, USA.,Lifespan Health System, Providence, RI, USA
| | - Christine M Emmick
- Rhode Island Hospital, Providence, RI, USA.,Lifespan Health System, Providence, RI, USA
| | - Kara L Leonard
- Rhode Island Hospital, Providence, RI, USA.,Lifespan Health System, Providence, RI, USA
| | - Mary L Lopresti
- Rhode Island Hospital, Providence, RI, USA.,Lifespan Health System, Providence, RI, USA
| | - Sabrina Witherby
- Rhode Island Hospital, Providence, RI, USA.,Lifespan Health System, Providence, RI, USA
| | - Diana Cabral
- Rhode Island Hospital, Providence, RI, USA.,Lifespan Health System, Providence, RI, USA
| | - Serena Snow
- Rhode Island Hospital, Providence, RI, USA.,Lifespan Health System, Providence, RI, USA
| | - Theresa A Graves
- Rhode Island Hospital, Providence, RI, USA.,Lifespan Health System, Providence, RI, USA
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Gheyasi F, Baraz S, Malehi A, Ahmadzadeh A, Salehi R, Vaismoradi M. Effect of the Walking Exercise Program on Cancer-Related Fatigue in Patients with Acute Myeloid Leukemia Undergoing Chemotherapy. Asian Pac J Cancer Prev 2019; 20:1661-1666. [PMID: 31244285 PMCID: PMC7021614 DOI: 10.31557/apjcp.2019.20.6.1661] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Indexed: 01/24/2023] Open
Abstract
Background: Cancer-related Fatigue (CRF) is one of the most common complications of acute myeloid leukemia (AML) and its related therapies. It can influence all physical and psychological aspects of the patient’s life. Also, it is believed that exercise can improve CRF in patients with cancer. Objective: This study aimed to investigate the effect of the walking exercise program on CRF in patients with AML undergoing chemotherapy. Methods: In this quasi-experimental study with a pre- and post-test design, 50 patients with AML undergoing chemotherapy were selected using a convenience sampling method at a teaching hospital in an urban area of Iran. The intervention included daily 30 minutes of planned walking for ten days. Data was collected using a demographic data form and the Brief Fatigue Inventory, which were filled out before the intervention, and on the fifth and tenth days of the intervention. Findings: Statistically significant differences were reported in the reduction of CRF on the fifth day and tenth day of the intervention (p <0.001). Conclusions: The planned walking intervention can be used as an easy and low-cost method for reducing CRF in patients with leukemia.
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Affiliation(s)
- Fatemeh Gheyasi
- Nursing Care Research Center in Chronic Diseases, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Shahram Baraz
- Nursing Care Research Center in Chronic Diseases, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Amal Malehi
- Thalassemia and Hemoglobinopathy Research Center, Research Institute of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ahmad Ahmadzadeh
- Thalassemia and Hemoglobinopathy Research Center, Research Institute of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Reza Salehi
- School of Rehabilitation, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Rafie C, Ning Y, Wang A, Gao X, Houlihan R. Impact of physical activity and sleep quality on quality of life of rural residents with and without a history of cancer: findings of the Day and Night Study. Cancer Manag Res 2018; 10:5525-5535. [PMID: 30519100 PMCID: PMC6234991 DOI: 10.2147/cmar.s160481] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Lifestyle behaviors may impact quality of life (QoL). The relative impact of physical activity and sleep quality on QoL of individuals with and without a history of cancer living in underserved rural communities requires further study to inform health care and public health initiatives. METHODS Individuals with and without a history of cancer were recruited from rural Virginia. We collected information on physical activity level (PAL), sleep quality (Pittsburgh Sleep Quality Index), and QoL (Short Form-36). Additional dimensions of physical activity and sleep were measured including ambient light exposure and sleep duration via Actiwatch2, and serum vitamin D and urine melatonin, which are markers of outdoor activity and sleep. RESULTS A total of 124 cancer survivors and 48 cancer-free individuals were enrolled in the study. Mean age was 59 years, with the majority being women (89%) and Caucasian (76%). Breast cancer was the most common cancer (72%), and mean time from diagnosis to the survey was 8.1 years. Survivors were significantly less active, more likely to be inactive, and had significantly worse sleep quality and physical and mental health relative to cancer-free individuals (P<0.05). Quality of sleep and average sleep time were associated with physical (r=-0.371, P<0.001; r=-0.327, P<0.000) and mental health (r=-0.442, P=<0.001; r=-0.265, P<0.004), as was PAL (r=0.181, P=0.019; r=0.288, P=0.003). Self-reported outdoor activity was associated with mental health (r=0.233, P=0.003) and vitamin D3 (r=0.193, P=0.015). No association was found between melatonin, sleep quality, and QoL. Sleep quality, cancer status, body mass index, and sleep time were predictive of physical health, while sleep quality, sleep time, and outdoor activity were predictive of mental health. CONCLUSION Quality of sleep is a significant predictor of mental and physical health, and important for cancer survivors who experience poorer QoL. Outdoor activity should be encouraged to improve mental health and vitamin D status, and interventions to improve sleep for those with poor sleep quality should be considered in cancer survivorship planning.
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Affiliation(s)
- Carlin Rafie
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA,
| | - Yi Ning
- GlaxoSmithKline Institute of Infectious Disease and Public Health, Beijing, China
| | | | - Xiang Gao
- Department of Nutritional Sciences, Pennsylvania State University, University Park, PA, USA
| | - Robert Houlihan
- Department of Nutritional Sciences, Pennsylvania State University, University Park, PA, USA
- UF Health Cancer Center, University of Florida, Gainesville, FL, USA
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Nguyen LT, Alexander K, Yates P. Psychoeducational Intervention for Symptom Management of Fatigue, Pain, and Sleep Disturbance Cluster Among Cancer Patients: A Pilot Quasi-Experimental Study. J Pain Symptom Manage 2018; 55:1459-1472. [PMID: 29505795 DOI: 10.1016/j.jpainsymman.2018.02.019] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 02/22/2018] [Accepted: 02/23/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVES To assess the feasibility of conducting a trial of a psychoeducational intervention involving the provision of tailored information and coaching to improve management of a cancer-related symptom cluster (fatigue, pain, and sleep disturbance) and reduce symptom cluster impacts on patient health outcomes in the Vietnamese context and to undertake a preliminary evaluation of the intervention. METHODS A parallel-group single-blind pilot quasi-experimental trial was conducted with 102 cancer patients in one Vietnamese hospital. The intervention group received one face-to-face session and two phone sessions delivered by a nurse one week apart, and the comparison group received usual care. Patient outcomes were measured at baseline before the chemotherapy cycle and immediately preceding the next chemotherapy cycle. Separate linear mixed models were used to evaluate the impact of the intervention on total symptom cluster severity, symptom scores, functional status, depressive symptoms, and health-related quality of life. RESULTS The study design was feasible with a recruitment rate of 22.6% and attrition rate of 9.8%. Compared to the control group, the intervention group showed a significant reduction in symptom cluster severity, fatigue severity, fatigue interference, sleep disturbance, depression, and anxiety. Significant differences were not observed for pain severity, pain interference, functional status, and health-related quality of life. The intervention was acceptable to the study population, with a high attendance rate of 78% and adherence rate of 95.7%. CONCLUSION On the basis of the present study findings, future randomized controlled trials are needed to test the effectiveness of a symptom cluster psychoeducational intervention in Vietnam.
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Affiliation(s)
- Ly Thuy Nguyen
- School of Nursing, Queensland University of Technology, Brisbane, Australia; Faculty of Nursing and Midwifery, Hanoi Medical University, Hanoi, Vietnam.
| | - Kimberly Alexander
- School of Nursing, Queensland University of Technology, Brisbane, Australia
| | - Patsy Yates
- School of Nursing, Queensland University of Technology, Brisbane, Australia
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Tsiouris A, Ungar N, Haussmann A, Sieverding M, Steindorf K, Wiskemann J. Health Care Professionals' Perception of Contraindications for Physical Activity During Cancer Treatment. Front Oncol 2018; 8:98. [PMID: 29670858 PMCID: PMC5894008 DOI: 10.3389/fonc.2018.00098] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 03/21/2018] [Indexed: 01/15/2023] Open
Abstract
Introduction Suggested medical contraindications for physical activity (PA) during cancer therapy might have an influence on PA recommendation behavior of Health Care Professionals (HCP). The purpose of the present study was to examine perceptions of physicians and oncology nurses (ON) toward specific medical conditions as contraindications for PA during cancer treatment. Materials and methods A total of 539 physicians and 386 ON were enrolled in this cross-sectional survey. HCP judged 13 medical conditions as to whether they are contraindications for PA during cancer treatment. Answering format was "no contraindication"/"potentially a contraindication"/"yes, a contraindication." Results χ2 analyses revealed significant differences between general practitioners, specialized physicians, and ON in their perception of 10 medical conditions. Approximately half of the medical conditions were answered cautiously, showing high numbers on the response option potentially (36-72%). Moreover, physicians' ratings differed significantly depending on their practical experience with particular medical conditions. Those being familiar with a specific medical condition was more permissive to PA during treatment, with effect sizes (Cramer's V) ranging from 0.13 to 0.27. Conclusion Results indicate high cautiousness among HCP in judging medical conditions and their impact on PA during cancer treatment. However, group comparisons show that familiarity and clinical experience with potential contraindications facilitate a confident handling of safety issues, which at best leads to higher levels of PA recommendations during cancer treatment.
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Affiliation(s)
- Angeliki Tsiouris
- Exercise Oncology, Department of Medical Oncology, National Center for Tumor Diseases (NCT) and Heidelberg University Hospital, Heidelberg, Germany
| | - Nadine Ungar
- Gender Studies and Health Psychology, Institute of Psychology, Heidelberg University, Heidelberg, Germany
| | - Alexander Haussmann
- Division of Physical Activity, Prevention and Cancer, National Center for Tumor Diseases (NCT), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Monika Sieverding
- Gender Studies and Health Psychology, Institute of Psychology, Heidelberg University, Heidelberg, Germany
| | - Karen Steindorf
- Division of Physical Activity, Prevention and Cancer, National Center for Tumor Diseases (NCT), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Joachim Wiskemann
- Exercise Oncology, Department of Medical Oncology, National Center for Tumor Diseases (NCT) and Heidelberg University Hospital, Heidelberg, Germany
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Freedman RA, Partridge AH. Emerging Data and Current Challenges for Young, Old, Obese, or Male Patients with Breast Cancer. Clin Cancer Res 2018; 23:2647-2654. [PMID: 28572259 DOI: 10.1158/1078-0432.ccr-16-2552] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 02/20/2017] [Accepted: 04/04/2017] [Indexed: 11/16/2022]
Abstract
There are distinct subgroups of patients who have historically been underrepresented in most prospective clinical trials in breast cancer, including the youngest and oldest patients, male patients, and those struggling with obesity. Herein, we review current and future directions in research for each of these special populations with breast cancer, highlighting significant knowledge gaps and priorities in tumor biology and heterogeneity, therapeutic decision making promotion of adherence, supportive care, and psychosocial and functional well-being. In younger women, future study should focus on the biological underpinnings of aggressive disease and optimizing adherence and treatment decision making while addressing their unique survivorship needs. The latter includes generating a scientific basis for interruption of therapy for pregnancy. Among older patients, interventions should focus on increasing clinical trial accrual, predicting and mitigating toxicity so that functional status can be optimized, tailoring needs for dose modification, and anticipating life expectancy in the context of competing causes of death. For men with breast cancer, we need worldwide collaboration to answer even basic questions on optimal treatment, supportive care, and survivorship strategies. Finally, for those struggling with obesity, we need to better understand the biological associations with cancer incidence, prognosis and outcome, and how we can best intervene to assure weight loss at the "right time." It is only through highly collaborative, far-reaching, prospective, multidisciplinary, patient-centered, and patient-engaged efforts that we can optimize the physical and psychologic outcomes for all patients with breast cancer. Clin Cancer Res; 23(11); 2647-54. ©2017 AACRSee all articles in this CCR Focus section, "Breast Cancer Research: From Base Pairs to Populations."
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Ferioli M, Zauli G, Martelli AM, Vitale M, McCubrey JA, Ultimo S, Capitani S, Neri LM. Impact of physical exercise in cancer survivors during and after antineoplastic treatments. Oncotarget 2018; 9:14005-14034. [PMID: 29568412 PMCID: PMC5862633 DOI: 10.18632/oncotarget.24456] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Accepted: 01/23/2018] [Indexed: 12/12/2022] Open
Abstract
Cancer patients experience symptoms and adverse effects of treatments that may last even after the end of treatments. Exercise is a safe, non-pharmacological and cost-effective therapy that can provide several health benefits in cancer patient and survivors, reducing cancer symptoms and cancer treatment side effects. The purpose of this review is to describe how the physical exercise is capable to reduce cancer symptoms and cancer treatment side effects. We realized a pragmatic classification of symptoms, dividing them into physical, psychological and psycho-physical aspects. For each symptom we discuss causes, therapies, we analyse the effects of physical exercise and we summarize the most effective type of exercise to reduce the symptoms. This review also points out what are the difficulties that patients and survivors face during the practice of physical activity and provides some solutions to overcome these barriers. Related to each specific cancer, it emerges that type, frequency and intensity of physical exercise could be prescribed and supervised as a therapeutic program, like it occurs for the type, dose and duration of a drug treatment.
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Affiliation(s)
- Martina Ferioli
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Giorgio Zauli
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Alberto M Martelli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Marco Vitale
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- CoreLab, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - James A McCubrey
- Department of Microbiology and Immunology, Brody School of Medicine, East Carolina University, Greenville, NC, USA
| | - Simona Ultimo
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Silvano Capitani
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Luca M Neri
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
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Matthews E, Carter P, Page M, Dean G, Berger A. Sleep-Wake Disturbance: A Systematic Review of Evidence-Based Interventions for Management in Patients With Cancer. Clin J Oncol Nurs 2018; 22:37-52. [DOI: 10.1188/18.cjon.37-52] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Mercier J, Savard J, Bernard P. Exercise interventions to improve sleep in cancer patients: A systematic review and meta-analysis. Sleep Med Rev 2017; 36:43-56. [DOI: 10.1016/j.smrv.2016.11.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 10/28/2016] [Accepted: 11/01/2016] [Indexed: 12/26/2022]
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Abbott L, Hooke MC. Energy Through Motion©: An Activity Intervention for Cancer-Related Fatigue in an Ambulatory Infusion Center. Clin J Oncol Nurs 2017; 21:618-626. [DOI: 10.1188/17.cjon.618-626] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Edbrooke L, Aranda S, Granger CL, McDonald CF, Krishnasamy M, Mileshkin L, Irving L, Braat S, Clark RA, Gordon I, Denehy L. Benefits of home-based multidisciplinary exercise and supportive care in inoperable non-small cell lung cancer - protocol for a phase II randomised controlled trial. BMC Cancer 2017; 17:663. [PMID: 28962608 PMCID: PMC5622453 DOI: 10.1186/s12885-017-3651-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 09/22/2017] [Indexed: 12/31/2022] Open
Abstract
Background Lung cancer is one of the most commonly diagnosed cancers, and is a leading cause of cancer mortality world-wide. Due to lack of early specific symptoms, the majority of patients present with advanced, inoperable disease and five-year relative survival across all stages of non-small cell lung cancer (NSCLC) is 14%. People with lung cancer also report higher levels of symptom distress than those with other forms of cancer. Several benefits for survival and patient reported outcomes are reported from physical activity and exercise in other tumour groups. We report the protocol for a study investigating the benefits of exercise, behaviour change and symptom self-management for patients with recently diagnosed, inoperable, NSCLC. Methods This multi-site, parallel-group, assessor-blinded randomised controlled trial, powered for superiority, aims to assess functional and patient-reported outcomes of a multi-disciplinary, home-based exercise and supportive care program for people commencing treatment. Ninety-two participants are being recruited from three tertiary-care hospitals in Melbourne, Australia. Following baseline testing, participants are randomised using concealed allocation, to receive either: a) 8 weeks of home-based exercise (comprising an individualised endurance and resistance exercise program and behaviour change coaching) and nurse-delivered symptom self-management intervention or b) usual care. The primary outcome is the between-group difference in the change in functional exercise capacity (six-minute walk distance) from baseline to post-program assessment. Secondary outcomes include: objective and self-reported physical activity levels, physical activity self-efficacy, behavioural regulation of motivation to exercise and resilience, muscle strength (quadriceps and grip), health-related quality of life, anxiety and depression and symptom interference. Discussion There is a lack of evidence regarding the benefit of exercise intervention for people with NSCLC, particularly in those with inoperable disease receiving treatment. This trial will contribute to evidence currently being generated in national and international trials by implementing and evaluating a home-based program including three components not yet combined in previous research, for people with inoperable NSCLC receiving active treatment and involving longer-term follow-up of outcomes. This trial is ongoing and currently recruiting. Trial registration This trial was prospectively registered on the Australian New Zealand Clinical Trials Registry (ACTRN12614001268639: (4/12/14). Electronic supplementary material The online version of this article (10.1186/s12885-017-3651-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lara Edbrooke
- Department of Physiotherapy, The University of Melbourne, Level 7, 161 Barry St, Parkville, VIC, 3010, Australia.
| | - Sanchia Aranda
- Cancer Council Australia, Sydney, NSW, Australia.,Department of Nursing, The University of Melbourne, Parkville, VIC, Australia
| | - Catherine L Granger
- Department of Physiotherapy, The University of Melbourne, Level 7, 161 Barry St, Parkville, VIC, 3010, Australia.,Institute for Breathing and Sleep, Heidelberg, VIC, Australia.,Department of Physiotherapy, Melbourne Health, Parkville, VIC, Australia
| | - Christine F McDonald
- Institute for Breathing and Sleep, Heidelberg, VIC, Australia.,Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, VIC, Australia
| | - Mei Krishnasamy
- Department of Nursing, The University of Melbourne, Parkville, VIC, Australia.,The University of Melbourne Centre for Cancer Research, Parkville, VIC, Australia
| | - Linda Mileshkin
- The Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Louis Irving
- Department of Respiratory and Sleep Medicine, Melbourne Health, Parkville, VIC, Australia
| | - Sabine Braat
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
| | - Ross A Clark
- University of the Sunshine Coast, Sunshine Coast, QLD, Australia
| | - Ian Gordon
- Statistical Consulting Centre, The University of Melbourne, Parkville, VIC, Australia
| | - Linda Denehy
- Department of Physiotherapy, The University of Melbourne, Level 7, 161 Barry St, Parkville, VIC, 3010, Australia.,Institute for Breathing and Sleep, Heidelberg, VIC, Australia
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Huether K, Abbott L, Cullen L, Cullen L, Gaarde A. Energy Through Motion©: An Evidence-Based Exercise Program to Reduce Cancer-Related Fatigue and Improve Quality of Life. Clin J Oncol Nurs 2017; 20:E60-70. [PMID: 27206306 DOI: 10.1188/16.cjon.e60-e70] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Evidence supports addressing cancer-related fatigue (CRF) with activity. Activity promotion is feasible during and following cancer treatment and improves patient outcomes. OBJECTIVES This project provided an evidence-based activity program for adult cancer survivors after treatment to reduce CRF and improve quality of life. METHODS The Iowa Model of Evidence-Based Practice to Promote Quality Care guided development of the activity promotion evidence-based practice project. This included evidence review, creation of an evidence-based activity intervention, and evaluation of the practice change. Two groups participated in the project; one group, the usual care group, provided baseline data and received "usual" instructions for activity, fatigue, and sleep, whereas the Energy Through Motion© (ETM) activity group received a three-month activity intervention with prepackaged ETM kits and follow-up phone calls. FINDINGS Patients in the ETM activity group had increased activity levels, whereas those in the usual care group had decreased activity levels. Fatigue levels in the ETM activity group decreased, and quality of life improved. This project supports nurse-led activity promotion as useful in addressing CRF and feasible for use in a busy clinical setting.
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Affiliation(s)
| | | | | | - Liz Cullen
- University of Iowa Hospitals and Clinics
| | - Ami Gaarde
- University of Iowa Hospitals and Clinics
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Medysky ME, Temesi J, Culos-Reed SN, Millet GY. Exercise, sleep and cancer-related fatigue: Are they related? Neurophysiol Clin 2017; 47:111-122. [PMID: 28392007 DOI: 10.1016/j.neucli.2017.03.001] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Cancer-related fatigue (CRF) is a commonly reported and debilitating side effect of cancer and/or cancer treatment. Sleep disorders are also highly reported in the cancer population; however it is unknown if sleep is associated with fatigue. In the general population, exercise has been shown to improve sleep, however in the cancer population this idea is under investigation. The primary purposes of this review were to: (i) review the prevalence and causes of sleep disorders in cancer patients and survivors, (ii) examine the relationship between sleep and CRF and (iii) review the impact of exercise interventions on sleep in cancer patients and survivors. A scoping review of the literature was conducted regarding exercise interventions in cancer patients and survivors with sleep as at least one outcome measure. A search of the literature revealed limited studies (n=21) assessing the effect of exercise on sleep disorders in the cancer population. Methodological issues are evident because assessing sleep is often not the main outcome of interest. The reviewed studies revealed that exercise positively impacts sleep quality and quantity. There seems to be possible relationship between sleep disorders, exercise and CRF. Further investigation of this relationship is necessary, specifically using objective measurement tools, in large, controlled studies, focusing on sleep as the primary outcome.
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Affiliation(s)
- Mary E Medysky
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - John Temesi
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Susan Nicole Culos-Reed
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Canada; Department of Oncology, Cumming School of Medicine, Calgary, Canada; Department of Psychosocial Resources, Tom Baker Cancer Centre, Calgary, Canada
| | - Guillaume Y Millet
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Canada.
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Armstrong TS, Shade MY, Breton G, Gilbert MR, Mahajan A, Scheurer ME, Vera E, Berger AM. Sleep-wake disturbance in patients with brain tumors. Neuro Oncol 2017; 19:323-335. [PMID: 27286798 PMCID: PMC5464298 DOI: 10.1093/neuonc/now119] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 05/04/2016] [Indexed: 02/07/2023] Open
Abstract
Sleep-wake disturbances are defined as perceived or actual alterations in sleep that result in impaired daytime functioning. Unlike other cancers, there is limited information about sleep-wake disturbances in adults with primary brain tumors throughout the illness trajectory. Sleep-wake disturbance is among the most severe and common symptoms reported by primary brain-tumor patients, particularly those undergoing radiation therapy. As with other cancers and neurologic illness, sleep-wake disturbance may also be clustered or related to other symptoms such as fatigue, depression, and cognitive impairment. There is increasing evidence for a genetic basis of normal sleep and sleep regulation in healthy adults. Specific mutations and single nucleotide variants have been reported to be associated with both fatigue and sleep-wake disorders, and both inflammation and alterations in circadian rhythms have been postulated to have a potential role. Guidelines for assessment and interventions have been developed, with cognitive behavioral therapy, exercise, and sleep hygiene demonstrating benefit in patients with other solid tumors. Further research is needed to identify risk and appropriate treatment in the brain-tumor patient population.
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Affiliation(s)
| | - Marcia Y Shade
- University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Ghislain Breton
- Department of Integrative Biology, UTHealth McGovern Medical School, Houston, Texas, USA
| | - Mark R Gilbert
- Neuro-Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, USA
| | - Anita Mahajan
- Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas, USA
| | | | - Elizabeth Vera
- University of Texas Health Science Center, Houston, Texas, USA
| | - Ann M Berger
- University of Nebraska Medical Center, Omaha, Nebraska, USA
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Steindorf K, Wiskemann J, Ulrich CM, Schmidt ME. Effects of exercise on sleep problems in breast cancer patients receiving radiotherapy: a randomized clinical trial. Breast Cancer Res Treat 2017; 162:489-499. [DOI: 10.1007/s10549-017-4141-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Accepted: 02/02/2017] [Indexed: 01/12/2023]
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Sharma N, Purkayastha A. Impact of Radiotherapy on Psychological, Financial, and Sexual Aspects in Postmastectomy Carcinoma Breast Patients: A Prospective Study and Management. Asia Pac J Oncol Nurs 2017; 4:69-76. [PMID: 28217733 PMCID: PMC5297236 DOI: 10.4103/2347-5625.199075] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2016] [Accepted: 10/11/2016] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE The aim of this study was to assess the impact of radiotherapy (RT) on psychological, financial, and sexual aspects in postmastectomy carcinoma breast patients affecting their quality of life (QOL) before, during, and after RT with a strong emphasis on their management and rehabilitation aspects. METHODS A cross-sectional study carried out in a specialized institution, comprising sixty women. Two standardized questionnaires European Organization for Research and Treatment of Cancer (EORTC) 30-item Quality of Life Questionnaire and Quality of Life Questionnaire breast cancer-23 (QLQ-BR23) for health-related quality, translated and validated for the Hindi language were used. The scores' manual of the EORTC was used to calculate the domain scores of the questionnaires. RESULTS According to the first questionnaire, the emotional function was most affected even at onset of RT treatment and it was worst at the completion of RT treatment with a mean score of 63.75. The global QOL score was also worst at the end of radiation treatment with a mean score of 32.36, while the score 3 months after completion of treatment was 68.16. The symptoms with the highest scores were insomnia with a worst scoring at completion of treatment (29.99), fatigue (26.57), and pain (23.05). According to the QLQ-BR23, the mean score for side effects such as sexual functioning was minimum 0.55 at the completion of RT, which improved to 11.66 on the first follow-up after 3 months. Mean future perspective score which was 57.22 before the start of RT which was reduced to 50.55 at completion, which means that many women experience side effects of RT and impaired sexual satisfaction. CONCLUSIONS Women with breast cancer showed changes in the following domains: financial, emotional, sexual satisfaction, and future prospects. The most frequently mentioned symptoms were fatigue, insomnia, and pain.
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Affiliation(s)
- Neelam Sharma
- Department of Radiation Oncology, Army Hospital Research and Referral, New Delhi, India
| | - Abhishek Purkayastha
- Department of Radiation Oncology, Army Hospital Research and Referral, New Delhi, India
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Abstract
BACKGROUND A huge clinical research database on adjuvant cancer treatment has verified improvements in breast cancer outcomes such as recurrence and mortality rates. On the other hand, adjuvant and neoadjuvant therapy with chemotherapy and radiotherapy impacts on quality of life due to substantial short- and long-term side effects. A number of studies have evaluated the effect of exercise interventions on those side effects. This is an updated version of the original Cochrane review published in 2006. The original review identified some benefits of physical activity on physical fitness and the resulting capacity for performing activities of daily life. It also identified a lack of evidence for other outcomes, providing clear justification for an updated review. OBJECTIVES To assess the effect of aerobic or resistance exercise interventions during adjuvant treatment for breast cancer on treatment-related side effects such as physical deterioration, fatigue, diminished quality of life, depression, and cognitive dysfunction. SEARCH METHODS We carried out an updated search in the Cochrane Breast Cancer Group Specialised Register (30 March 2015), the Cochrane Central Register of Controlled Trials (CENTRAL) (Issue 2, 2015), MEDLINE (1966 to 30 March 2015), and EMBASE (1966 to 30 March 2015). We did not update the original searches in CINAHL (1982 to 2004), SPORTDiscus (1975 to 2004), PsycINFO (1872 to 2003), SIGLE (1880 to 2004), and ProQuest Digital Dissertations (1861 to 2004). We searched the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) and ClinicalTrials.gov for ongoing trials on 30 March 2015. We screened references in relevant reviews and published clinical trials. SELECTION CRITERIA We included randomised controlled trials that examined aerobic or resistance exercise or both in women undergoing adjuvant treatment for breast cancer. Published and unpublished trials were eligible. DATA COLLECTION AND ANALYSIS Two review authors independently performed data extraction, assessed trials, and graded the methodological quality using Cochrane's 'Risk of bias' tool. Any disagreements were resolved through discussion or by consulting the third review author. We entered data into Review Manager for analysis. For outcomes assessed with a variety of instruments, we used the standardised mean difference (SMD) as a summary statistic for meta-analysis; for those assessed with the same instrument, we used the mean difference (MD). MAIN RESULTS For this 2015 update we included a total of 32 studies with 2626 randomised women, 8 studies from the original search and 24 studies from the updated search. We found evidence that physical exercise during adjuvant treatment for breast cancer probably improves physical fitness (SMD 0.42, 95% confidence interval (CI) 0.25 to 0.59; 15 studies; 1310 women; moderate-quality evidence) and slightly reduces fatigue (SMD -0.28, 95% CI -0.41 to -0.16; 19 studies; 1698 women; moderate-quality evidence). Exercise may lead to little or no improvement in health-related quality of life (MD 1.10, 95% CI -5.28 to 7.48; 1 study; 68 women; low-quality evidence), a slight improvement in cancer site-specific quality of life (MD 4.24, 95% CI -1.81 to 10.29; 4 studies; 262 women; low-quality evidence), and an improvement in cognitive function (MD -11.55, 95% CI -22.06 to -1.05; 2 studies; 213 women; low-quality evidence). Exercise probably leads to little or no difference in cancer-specific quality of life (SMD 0.12, 95% CI 0.00 to 0.25; 12 studies; 1012 women; moderate-quality evidence) and little or no difference in depression (SMD -0.15, 95% CI -0.30 to 0.01; 5 studies; 674 women; moderate-quality evidence). Evidence for other outcomes ranged from low to moderate quality. Seven trials reported a very small number of adverse events. AUTHORS' CONCLUSIONS Exercise during adjuvant treatment for breast cancer can be regarded as a supportive self care intervention that probably results in less fatigue, improved physical fitness, and little or no difference in cancer-specific quality of life and depression. Exercise may also slightly improve cancer site-specific quality of life and cognitive function, while it may result in little or no difference in health-related quality of life. This review is based on trials with a considerable degree of clinical heterogeneity regarding adjuvant cancer treatments and exercise interventions. Due to the difficulty of blinding exercise trials, all included trials were at high risk for performance bias. Furthermore, the majority of trials were at high risk for detection bias, largely due to most outcomes being self reported.The findings of the updated review have enabled us to make a more precise conclusion that both aerobic and resistance exercise can be regarded as beneficial for individuals with adjuvant therapy-related side effects. Further research is required to determine the optimal type, intensity, and timing of an exercise intervention. Furthermore, long-term evaluation is required due to possible long-term side effects of adjuvant treatment.
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Affiliation(s)
- Anna C Furmaniak
- Technische Universität MünchenDepartment of Psychosomatic Medicine and Psychotherapy, Klinikum Rechts der IsarMunichGermany
- University of BonnDepartment of Psychosomatic Medicine and PsychotherapyBonnGermany
| | - Matthias Menig
- Health and Accident Insurance DirectorateFederal Office of Public Health FOPHBernSwitzerland
| | - Martina H Markes
- Institute for Quality and Efficiency in Health Care (IQWiG)Department Non‐Drug InterventionsIm Mediapark 8KölnGermany50670
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Dennett AM, Peiris CL, Shields N, Prendergast LA, Taylor NF. Moderate-intensity exercise reduces fatigue and improves mobility in cancer survivors: a systematic review and meta-regression. J Physiother 2016; 62:68-82. [PMID: 26996098 DOI: 10.1016/j.jphys.2016.02.012] [Citation(s) in RCA: 105] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 02/05/2016] [Accepted: 02/25/2016] [Indexed: 12/15/2022] Open
Abstract
QUESTION Is there a dose-response effect of exercise on inflammation, fatigue and activity in cancer survivors? DESIGN Systematic review with meta-regression analysis of randomised trials. PARTICIPANTS Adults diagnosed with cancer, regardless of specific diagnosis or treatment. INTERVENTION Exercise interventions including aerobic and/or resistance as a key component. OUTCOME MEASURES The primary outcome measures were markers of inflammation (including C-reactive protein and interleukins) and various measures of fatigue. The secondary outcomes were: measures of activity, as defined by the World Health Organization's International Classification of Functioning, Disability and Health, including activities of daily living and measures of functional mobility (eg, 6-minute walk test, timed sit-to-stand and stair-climb tests). Risk of bias was evaluated using the PEDro scale, and overall quality of evidence was assessed using the Grades of Research, Assessment, Development and Evaluation (GRADE) approach. RESULTS Forty-two trials involving 3816 participants were included. There was very low-quality to moderate-quality evidence that exercise results in significant reductions in fatigue (SMD 0.32, 95% CI 0.13 to 0.52) and increased walking endurance (SMD 0.77, 95% CI 0.26 to 1.28). A significant negative association was found between aerobic exercise intensity and fatigue reduction. A peak effect was found for moderate-intensity aerobic exercise for improving walking endurance. No dose-response relationship was found between exercise and markers of inflammation or exercise duration and outcomes. Rates of adherence were typically high and few adverse events were reported. CONCLUSIONS Exercise is safe, reduces fatigue and increases endurance in cancer survivors. The results support the recommendation of prescribing moderate-intensity aerobic exercise to reduce fatigue and improve activity in people with cancer. REVIEW REGISTRATION PROSPERO CRD42015019164.
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Affiliation(s)
- Amy M Dennett
- School of Allied Health, La Trobe University and Allied Health Clinical Research Office, Eastern Health
| | - Casey L Peiris
- School of Allied Health, La Trobe University and Northern Health
| | - Nora Shields
- School of Allied Health, La Trobe University and Northern Health
| | - Luke A Prendergast
- Department of Mathematics and Statistics, La Trobe University, Melbourne, Australia
| | - Nicholas F Taylor
- School of Allied Health, La Trobe University and Allied Health Clinical Research Office, Eastern Health
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Zheng L, Feng Y, Wen DT, Wang H, Wu XS. Fatiguing exercise initiated later in life reduces incidence of fibrillation and improves sleep quality in Drosophila. AGE (DORDRECHT, NETHERLANDS) 2015; 37:9816. [PMID: 26206392 PMCID: PMC4512962 DOI: 10.1007/s11357-015-9816-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2015] [Accepted: 07/07/2015] [Indexed: 05/27/2023]
Abstract
As the human body ages, the risk of heart disease and stroke greatly increases. While there is evidence that lifelong exercise is beneficial to the heart's health, the effects of beginning exercise later in life remain unclear. This study aimed to investigate whether exercise training started later in life is beneficial to cardiac aging in Drosophila. We examined 4-week-old wild-type virgin female flies that were exposed to exercise periods of either 1.5, 2.0, or 2.5 h per day, 5 days a week for 2 weeks. Using M-mode traces to analyze cardiac function by looking at parameters including heart rate, rhythmicity, systolic and diastolic diameter, and interval and fractional shortening, we found that cardiac function declined with age, shown by an increase in the number of fibrillation events and a decrease in fractional shortening. About 2.0 and 2.5 h of exercise per day displayed a reduced incidence of fibrillation events, and only physical exercise lasting 2.5-h period increased fractional shortening and total sleep time in Drosophila. These data suggested that training exercise needs to be performed for longer duration to exert physiological benefits for the aging heart. Additionally, climbing ability to assess the exercise-induced muscle fatigue was also measured. We found that 2.0 and 2.5 h of exercise caused exercise-induced fatigue, and fatiguing exercise is beneficial for cardiac and healthy aging overall. This study provides a basis for further study in humans on the impact of beginning an exercise regimen later in life on cardiac health.
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Affiliation(s)
- Lan Zheng
- Key Laboratory of Physical Fitness and Exercise Rehabilitation of Hunan Province, Hunan Normal University, Changsha, China,
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43
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Bouillet T, Bigard X, Brami C, Chouahnia K, Copel L, Dauchy S, Delcambre C, Descotes J, Joly F, Lepeu G, Marre A, Scotte F, Spano J, Vanlemmens L, Zelek L. Role of physical activity and sport in oncology. Crit Rev Oncol Hematol 2015; 94:74-86. [DOI: 10.1016/j.critrevonc.2014.12.012] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2013] [Revised: 11/17/2014] [Accepted: 12/22/2014] [Indexed: 12/12/2022] Open
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Rogers LQ, Fogleman A, Trammell R, Hopkins-Price P, Spenner A, Vicari S, Rao K, Courneya KS, Hoelzer K, Robbs R, Verhulst S. Inflammation and psychosocial factors mediate exercise effects on sleep quality in breast cancer survivors: pilot randomized controlled trial. Psychooncology 2015; 24:302-10. [PMID: 24916951 PMCID: PMC4263679 DOI: 10.1002/pon.3594] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Revised: 05/12/2014] [Accepted: 05/16/2014] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To improve mechanistic understanding, this pilot randomized controlled trial examined mediators of an exercise intervention effects on sleep in breast cancer survivors (BCS). METHODS Forty-six postmenopausal BCS (≤Stage II, off primary treatment) were randomized to a 3-month exercise intervention or control group. Intervention included 160 min/week of moderate intensity aerobic walking, twice weekly resistance training (resistance bands), and six discussion groups (to improve adherence). Blinded assessments at baseline and post-intervention included sleep disturbance (PSQI and PROMIS®), objective sleep quality (accelerometer), serum cytokines, accelerometer physical activity, cardiorespiratory fitness, body composition, fatigue, and psychosocial factors. Mediation was tested using Freedman-Schatzkin difference-in-coefficients tests. RESULTS When compared with control, the intervention group demonstrated a significant increase in PSQI sleep duration (i.e., fewer hours of sleep/night) (d = 0.73, p = .03). Medium to large but non-significant standardized effect sizes were noted for PSQI daytime somnolence (d = -0.63, p = .05) and accelerometer latency (d = -0.49, p = .14). No statistically significant mediators were detected for PSQI sleep duration score or accelerometer latency. Daytime somnolence was mediated by tumor necrosis factor-alpha (mediated 23% of intervention effect, p < .05), interleukin (IL)-6:IL-10 (16%, p < .01), IL-8:IL-10 (26%, p < .01), and fatigue (38%, p < .05). Mediating or enhancing relationships for several of the sleep outcomes were noted for accelerometer physical activity, PROMIS® fatigue, exercise social support, and/or physical activity enjoyment. CONCLUSIONS Inflammation and psychosocial factors may mediate or enhance sleep response to our exercise intervention. Further study is warranted to confirm our results and translate our findings into more effective interventions aimed at improving sleep quality in BCS.
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Affiliation(s)
| | | | | | | | | | | | - Krishna Rao
- SIU School of Medicine, Springfield, IL, USA
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45
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Chiu HY, Huang HC, Chen PY, Hou WH, Tsai PS. Walking Improves Sleep in Individuals With Cancer: A Meta-Analysis of Randomized, Controlled Trials. Oncol Nurs Forum 2015; 42:E54-62. [DOI: 10.1188/15.onf.e54-e62] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Sancho A, Carrera S, Arietaleanizbeascoa M, Arce V, Gallastegui NM, Giné March A, Sanz-Guinea A, Eskisabel A, Rodriguez AL, Martín RA, Lopez-Vivanco G, Grandes G. Supervised physical exercise to improve the quality of life of cancer patients: the EFICANCER randomised controlled trial. BMC Cancer 2015; 15:40. [PMID: 25655792 PMCID: PMC4327975 DOI: 10.1186/s12885-015-1055-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Accepted: 01/29/2015] [Indexed: 01/29/2023] Open
Abstract
Background The optimal form of exercise for individuals with cancer has yet to be identified, but there is evidence that exercise improves their quality of life. The aim of this study is to assess the efficacy and efficiency of an innovative physical exercise programme, for individuals undergoing chemotherapy for breast, gastrointestinal or non-small cell lung tumours, for improving quality of life, reducing level of fatigue, and enhancing functional capacity over time. Design/Methods We will conduct a clinical trial in 66 patients with stage IV breast, gastrointestinal or non-small cell lung cancer, recruited by the Department of Oncology of the referral hospital from 4 primary care health centres of the Basque Health Service (Osakidetza). These patients will be randomised to one of two groups. The treatment common to both groups will be the usual care for cancer: optimized usual drug therapies and strengthening of self-care; in addition, patients in the intervention group will participate in a 2-month exercise programme, including both aerobic and strength exercises, supervised by nurses in their health centre. The principal outcome variable is health-related quality of life, measured blindly with the 30-item European Organization for the Research and Treatment of Cancer Core Quality of Life Questionnaire and Short Form-36 four times: at baseline, and 2, 6 and 12 months later. The secondary outcome variables are fatigue (Functional Assessment of Chronic Illness Therapy-Fatigue questionnaire), functional capacity (6-Minute Walk Test and cardiorespiratory test), muscle strength (hand-held dynamometry and sit-to-stand test), radiological response to treatment (Response Evaluation Criteria In Solid Tumors) and progression-free and overall survival. Age, sex, diagnosis, chemotherapy regimen, Eastern Cooperative Oncology Group performance status and smoking status will be considered as predictive variables. Data will be analysed on an intention-to-treat basis, comparing changes at each time point between groups, adjusting for baseline values by analysis of covariance. Discussion As well as achieving the objectives set, this study will provide us with information on patient perception of the care received and an opportunity to develop a project based on collaborative action between the primary care and oncology professionals. Trial registration ClinicalTrials.gov Identifier: NCT01786122 Registration date: 02/05/2013.
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Affiliation(s)
- Aintzane Sancho
- Department of Oncology, Cruces University Hospital, Basque Health Service (Osakidetza), Barakaldo, Bizkaia, Spain.
| | - Sergio Carrera
- Department of Oncology, Cruces University Hospital, Basque Health Service (Osakidetza), Barakaldo, Bizkaia, Spain.
| | | | - Veronica Arce
- Primary Care Research Unit of Bizkaia, Basque Health Service (Osakidetza), Bilbao, Bizkaia, Spain.
| | | | - Anna Giné March
- Primary Care Research Unit of Bizkaia, Basque Health Service (Osakidetza), Bilbao, Bizkaia, Spain.
| | - Aitor Sanz-Guinea
- Primary Care Research Unit of Bizkaia, Basque Health Service (Osakidetza), Bilbao, Bizkaia, Spain.
| | - Araceli Eskisabel
- Luxana-Barakaldo Health Centre, Basque Health Service (Osakidetza), Barakaldo, Bizkaia, Spain.
| | - Ana Lopez Rodriguez
- Basauri-Ariz. Health Centre, Basque Health Service (Osakidetza), Basauri, Bizkaia, Spain.
| | - Rosa A Martín
- Algorta-Bidezabal Health Centre, Basque Health Service (Osakidetza), Getxo, Bizkaia, Spain.
| | - Guillermo Lopez-Vivanco
- Department of Oncology, Cruces University Hospital, Basque Health Service (Osakidetza), Barakaldo, Bizkaia, Spain.
| | - Gonzalo Grandes
- Primary Care Research Unit of Bizkaia, Basque Health Service (Osakidetza), Bilbao, Bizkaia, Spain.
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Henoch I, Sawatzky R, Falk H, Fridh I, Jakobsson Ung E, Sarenmalm EK, Ozanne A, Öhlén J, Falk K. Symptom Distress Profiles in Hospitalized Patients in Sweden: A Cross-Sectional Study. Res Nurs Health 2014; 37:512-23. [DOI: 10.1002/nur.21624] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2014] [Indexed: 11/05/2022]
Affiliation(s)
- Ingela Henoch
- Associate Professor, Institute of Health and Care Sciences; Sahlgrenska Academy; University of Gothenburg; Box 457 SE-405 30 Göteborg Sweden
- Associate Professor, Centre for Person-Centred Care (GPCC); Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - Richard Sawatzky
- Associate Professor, Trinity Western University School of Nursing; Vancouver Canada
- Centre for Health Evaluation and Outcome Sciences; Providence Health Care; Vancouver Canada
| | - Hanna Falk
- Institute of Health and Care Sciences; Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
- Institute of Neuroscience and Physiology; Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - Isabell Fridh
- Institute of Health and Care Sciences; Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
- School of Health Sciences; University of Borås; Borås Sweden
| | - Eva Jakobsson Ung
- Associate Professor, Centre for Person-Centred Care (GPCC); Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
- Institute of Health and Care Sciences; Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - Elisabeth Kenne Sarenmalm
- Research and Development Centre; Skaraborg Hospital; Skövde Sweden
- Palliative Research Centre; Ersta Sköndal University College and Ersta Hospital; Stockholm Sweden
| | - Anneli Ozanne
- Institute of Neuroscience and Physiology; Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - Joakim Öhlén
- Associate Professor, Centre for Person-Centred Care (GPCC); Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
- Institute of Health and Care Sciences; Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
- Palliative Research Centre; Ersta Sköndal University College and Ersta Hospital; Stockholm Sweden
| | - Kristin Falk
- Associate Professor, Centre for Person-Centred Care (GPCC); Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
- Institute of Health and Care Sciences; Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
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Weymann KB, Wood LJ, Zhu X, Marks DL. A role for orexin in cytotoxic chemotherapy-induced fatigue. Brain Behav Immun 2014; 37:84-94. [PMID: 24216337 PMCID: PMC3951615 DOI: 10.1016/j.bbi.2013.11.003] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Revised: 10/16/2013] [Accepted: 11/01/2013] [Indexed: 02/08/2023] Open
Abstract
Fatigue is the most common symptom related to cytotoxic chemotherapeutic treatment of cancer. Peripheral inflammation associated with cytotoxic chemotherapy is likely a causal factor of fatigue. The neural mechanisms by which cytotoxic chemotherapy associated inflammation induces fatigue behavior are not known. This lack of knowledge hinders development of interventions to reduce or prevent this disabling symptom. Infection induced fatigue/lethargy in rodents is mediated by suppression of hypothalamic orexin activity. Orexin is critical for maintaining wakefulness and motivated behavior. Though there are differences between infection and cytotoxic chemotherapy in some symptoms, both induce peripheral inflammation and fatigue. Based on these similarities we hypothesized that cytotoxic chemotherapy induces fatigue by disrupting orexin neuron activity. We found that a single dose of a cytotoxic chemotherapy cocktail (cyclophosphamide, adriamycin, 5-fluorouracil - CAF) induced fatigue/lethargy in mice and rats as evidenced by a significant decline in voluntary locomotor activity measured by telemetry. CAF induced inflammatory gene expression - IL-1R1 (p<0.001), IL-6 (p<0.01), TNFα (p<0.01), and MCP-1 (p<0.05) - in the rodent hypothalamus 6-24h after treatment during maximum fatigue/lethargy. CAF decreased orexin neuron activity as reflected by decreased nuclear cFos localization in orexin neurons 24h after treatment (p<0.05) and by decreased orexin-A in cerebrospinal fluid 16 h after treatment (p<0.001). Most importantly, we found that central administration of 1 μg orexin-A restored activity in CAF-treated rats (p<0.05). These results demonstrate that cytotoxic chemotherapy induces hypothalamic inflammation and that suppression of hypothalamic orexin neuron activity has a causal role in cytotoxic chemotherapy-induced fatigue in rodents.
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Affiliation(s)
- K B Weymann
- Oregon Health & Science University, Portland, OR 97239, United States.
| | - L J Wood
- Oregon Health & Science University, Portland, OR 97239, United States; School of Nursing, MGH Institute of Health Professions, Boston, MA 02129, United States.
| | - X Zhu
- Oregon Health & Science University, Portland, OR 97239, United States.
| | - D L Marks
- Oregon Health & Science University, Portland, OR 97239, United States.
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