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Martínez Aguirre-Betolaza A, Dobaran Amezua A, Yagin FH, Cacicedo J, Olasagasti-Ibargoien J, Castañeda-Babarro A. Do Oncologists Recommend the "Pill" of Physical Activity in Their Practice? Answers from the Oncologist and Patients' Perspectives. Cancers (Basel) 2024; 16:1720. [PMID: 38730668 PMCID: PMC11083921 DOI: 10.3390/cancers16091720] [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: 04/10/2024] [Revised: 04/23/2024] [Accepted: 04/26/2024] [Indexed: 05/13/2024] Open
Abstract
OBJECTIVES The purposes of this current questionnaire-based study were to analyse whether oncologists prescribed PA to their patients in Spain, as well as the type of exercise recommended, the variables that influence whether or not to recommend it and to compare these recommendations with the values reported by their patients. METHODS Two online questionnaires were designed for this study. The first one, filled in by the oncologists (n = 93), contained aspects such as the attitude or barriers to promoting PA. The second was designed for patients with cancer (n = 149), which assessed PA levels and counselling received from oncologists, among other facets. RESULTS The majority of oncologists (97%) recommend PA during their consultations. Instead, only 62% of patients reported participating in exercise within the last 7 days. Walking was the most common form of exercise, reported by 50% of participants. Patients who received exercise recommendations from their oncologist walked for more days (p = 0.004; ES = 0.442) and more minutes per day (p = 0.022; ES = 0.410). The barriers most highlighted by patients were lack of time and not knowing how to perform PA. CONCLUSION Oncologists and patients seem to be interested and able to participate in PA counselling and programmes. However, there was a discrepancy between what was reported by oncologists and expressed by patients in terms of recommendations for PA and the modality itself.
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Affiliation(s)
- Aitor Martínez Aguirre-Betolaza
- Department of Physical Activity and Sport Science, Faculty of Education and Sport, University of Deusto, 48007 Bilbao, Spain; (A.M.A.-B.); (A.D.A.); (J.O.-I.)
| | - Ander Dobaran Amezua
- Department of Physical Activity and Sport Science, Faculty of Education and Sport, University of Deusto, 48007 Bilbao, Spain; (A.M.A.-B.); (A.D.A.); (J.O.-I.)
| | - Fatma Hilal Yagin
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Inonu University, Malatya 44280, Turkey;
| | - Jon Cacicedo
- Department of Radiation Oncology, Cruces University Hospital, BioCruces Health Research Institute, Osakidetza, 48903 Barakaldo, Spain;
| | - Jurgi Olasagasti-Ibargoien
- Department of Physical Activity and Sport Science, Faculty of Education and Sport, University of Deusto, 48007 Bilbao, Spain; (A.M.A.-B.); (A.D.A.); (J.O.-I.)
| | - Arkaitz Castañeda-Babarro
- Department of Physical Activity and Sport Science, Faculty of Education and Sport, University of Deusto, 48007 Bilbao, Spain; (A.M.A.-B.); (A.D.A.); (J.O.-I.)
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Kearney N, Connolly D, Begic S, Mockler D, Guinan E. Feasibility metrics of exercise interventions during chemotherapy: A systematic review. Crit Rev Oncol Hematol 2024; 195:104272. [PMID: 38272152 DOI: 10.1016/j.critrevonc.2024.104272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 01/19/2024] [Accepted: 01/21/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Exercise has been shown to play an important role in managing chemotherapy-related side effects, preserving skeletal muscle mass, and attenuating decline in cardiorespiratory fitness associated with chemotherapy treatment, however, the feasibility of how these exercise programs are being delivered has yet to be synthesized. The objective of this review was to measure the rates of recruitment, adherence, and retention to exercise programs delivered for cancer patients during chemotherapy. METHODS Relevant studies were identified through a search of MEDLINE, Cochrane, EMBASE and CINAHL databases from January 2002 to July 2022 using keywords relating to exercise interventions during chemotherapy. Title and abstract screening, full text review, data extraction, and quality assessment were all performed independently by two reviewers. RESULTS A total of 36 studies were included in the review. The mean recruitment rate for the included studies was 62.39% (SD = 19.40; range 25.7-95%). Travel was the most common reason for declining recruitment in these trials. Adherence rates ranged from 17-109%, however the definition of adherence varied greatly between studies. Mean retention rates for the exercise groups was 84.1% (SD = 12.7; range 50-100%), with chemotherapy side effects being the most common reason why participants dropped out of these trials. CONCLUSION Multiple challenges exist for cancer patients during chemotherapy and careful consideration needs to be given when designing an exercise program for this population. Future research should include public and patient involvement to ensure exercise programs are pragmatic and patient centred.
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Affiliation(s)
- Neil Kearney
- Department of Surgery, School of Medicine, Trinity College Dublin, Dublin, Ireland; Trinity St James's Cancer Institute, St James's Hospital, Dublin, Ireland.
| | - Deirdre Connolly
- Trinity St James's Cancer Institute, St James's Hospital, Dublin, Ireland; Discipline of Occupational Therapy, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Sanela Begic
- Trinity St James's Cancer Institute, St James's Hospital, Dublin, Ireland; Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - David Mockler
- John Stearne Medical Library, Trinity College Library, Trinity Centre for Health Sciences, Dublin, Ireland
| | - Emer Guinan
- Trinity St James's Cancer Institute, St James's Hospital, Dublin, Ireland; Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, Dublin, Ireland
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Fatemi N, Karimpour M, Bahrami H, Zali MR, Chaleshi V, Riccio A, Nazemalhosseini-Mojarad E, Totonchi M. Current trends and future prospects of drug repositioning in gastrointestinal oncology. Front Pharmacol 2024; 14:1329244. [PMID: 38239190 PMCID: PMC10794567 DOI: 10.3389/fphar.2023.1329244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 12/11/2023] [Indexed: 01/22/2024] Open
Abstract
Gastrointestinal (GI) cancers comprise a significant number of cancer cases worldwide and contribute to a high percentage of cancer-related deaths. To improve survival rates of GI cancer patients, it is important to find and implement more effective therapeutic strategies with better prognoses and fewer side effects. The development of new drugs can be a lengthy and expensive process, often involving clinical trials that may fail in the early stages. One strategy to address these challenges is drug repurposing (DR). Drug repurposing is a developmental strategy that involves using existing drugs approved for other diseases and leveraging their safety and pharmacological data to explore their potential use in treating different diseases. In this paper, we outline the existing therapeutic strategies and challenges associated with GI cancers and explore DR as a promising alternative approach. We have presented an extensive review of different DR methodologies, research efforts and examples of repurposed drugs within various GI cancer types, such as colorectal, pancreatic and liver cancers. Our aim is to provide a comprehensive overview of employing the DR approach in GI cancers to inform future research endeavors and clinical trials in this field.
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Affiliation(s)
- Nayeralsadat Fatemi
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mina Karimpour
- Department of Molecular Genetics, Faculty of Biological Sciences, Tarbiat Modares University, Tehran, Iran
| | - Hoda Bahrami
- Department of Molecular Genetics, Faculty of Biological Sciences, Tarbiat Modares University, Tehran, Iran
| | - Mohammad Reza Zali
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Vahid Chaleshi
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Andrea Riccio
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies (DiSTABiF), Università degli Studi della Campania “Luigi Vanvitelli”, Caserta, Italy
- Institute of Genetics and Biophysics (IGB) “Adriano Buzzati-Traverso”, Consiglio Nazionale delle Ricerche (CNR), Naples, Italy
| | - Ehsan Nazemalhosseini-Mojarad
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Totonchi
- Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies (DiSTABiF), Università degli Studi della Campania “Luigi Vanvitelli”, Caserta, Italy
- Department of Genetics, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
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Gautam P, Shankar A. Management of cancer cachexia towards optimizing care delivery and patient outcomes. Asia Pac J Oncol Nurs 2023; 10:100322. [PMID: 38197039 PMCID: PMC10772213 DOI: 10.1016/j.apjon.2023.100322] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 10/17/2023] [Indexed: 01/11/2024] Open
Abstract
Cancer cachexia is a complex syndrome characterized by progressive weight loss, muscle mass depletion, and systemic inflammation, profoundly affecting the well-being and treatment outcomes of cancer patients. Effective management of cancer cachexia demands a coordinated, multifaceted approach involving various healthcare disciplines and operational strategies. Streamlining care processes is crucial to ensure timely interventions and support, reducing delays in diagnosis and treatment initiation. Multidisciplinary collaboration is pivotal in creating integrated care plans that address the multifactorial nature of cancer cachexia comprehensively. Data-driven decision-making empowers healthcare teams to identify trends, monitor treatment responses, and tailor care plans to individual needs, ultimately leading to improved patient outcomes. Standardized assessment and monitoring play a vital role in maintaining consistent, high-quality care, facilitating early interventions and treatment adjustments. Implementing patient-centered care fosters trust, enhances treatment adherence, and encourages patients to actively engage in their care journey, thereby improving their overall quality of life. This paper underscores the significance of applying operations management principles to optimize care delivery and enhance patient outcomes in the management of cancer cachexia. It provides valuable insights for healthcare institutions and professionals striving to provide comprehensive and effective care for individuals affected by this challenging condition.
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Affiliation(s)
- Prerna Gautam
- Department of Management Sciences, Indian Institute of Technology, Kanpur, Uttar Pradesh, India
| | - Abhishek Shankar
- Department of Radiation Oncology, Dr. B R Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Delhi, India
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Toohey K, Chapman M, Rushby AM, Urban K, Ingham G, Singh B. The effects of physical exercise in the palliative care phase for people with advanced cancer: a systematic review with meta-analysis. J Cancer Surviv 2023; 17:399-415. [PMID: 35040076 DOI: 10.1007/s11764-021-01153-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 12/02/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE The purpose of this systematic review with meta-analysis was to evaluate the safety, feasibility and effectiveness of exercise in the palliative care phase for people with advanced cancer. METHODS Electronic databases were searched for exercise randomised controlled trials involving individuals with incurable cancer that were published prior to April 14, 2021. Meta-analyses were performed to evaluate the effects of exercise on health outcomes. Subgroup effects for exercise mode, supervision, intervention duration and cancer diagnosis were assessed. RESULTS Twenty-two trials involving interventions ranging between 2 weeks and 6 months were included. Interventions comprised of aerobic (n = 3), resistance (n = 4), mixed-mode (n = 14) and other exercise (n = 1) modalities. Cancer types consisted of lung (n = 6), breast (n = 3), prostate (n = 2), multiple myeloma (n = 1) and mixed cancer types (n = 10). Meta-analysis of 20 RCTs involving 1840 participants showed no difference in the risk of a grade 2-4 adverse event between exercise and usual care (n = 110 adverse events (exercise: n = 66 events; usual care: n = 44 events), RD = - 0.01 (91% CI = - 0.01, 0.02); p = 0.24). Overall median recruitment, retention and adherence rates were 56%, 80% and 69%, respectively. Meta-analysis of health outcomes showed effects in favour of exercise for quality of life, fatigue, aerobic fitness and lower-body strength (SMD range = 0.27-0.48, all p < 0.05). CONCLUSIONS Participants who engaged in exercise experienced an increase in quality of life, fitness and strength and a decrease in fatigue. IMPLICATIONS FOR CANCER SURVIVORS Physical activity programs were found to be safe and feasible for people with advanced cancer in the palliative care phase.
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Affiliation(s)
- Kellie Toohey
- Faculty of HealthCanberra Specialist Medical CentreACT, University of Canberra, Level C Office 3, Bruce, 2617, Australia.
- Exercise and Survivorship (PACES) Research Group, University of Canberra, ActivityBruce ACT, Cancer, Australia.
| | - Michael Chapman
- Palliative Care, Canberra Hospital, ACT Health Services, Canberra ACT, Australia
- ANU Medical School, Australian National University, Canberra, Australia
| | - Anne-Marie Rushby
- Faculty of HealthCanberra Specialist Medical CentreACT, University of Canberra, Level C Office 3, Bruce, 2617, Australia
- University of South Australia, Adelaide, SA, Australia
- Australian Institute of Health and Welfare, Canberra, Australia
| | - Kat Urban
- Palliative Care, Lismore Base Hospital, Lismore, NSW, Australia
| | - Gemma Ingham
- Palliative Care, Prince of Wales Hospital, Randwick, NSW, Australia
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Divella R, Marino G, Infusino S, Lanotte L, Gadaleta-Caldarola G, Gadaleta-Caldarola G. The Mediterranean Lifestyle to Contrast Low-Grade Inflammation Behavior in Cancer. Nutrients 2023; 15:1667. [PMID: 37049508 PMCID: PMC10096668 DOI: 10.3390/nu15071667] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/21/2023] [Accepted: 03/25/2023] [Indexed: 04/01/2023] Open
Abstract
A healthy diet and an active lifestyle are both effective ways to prevent, manage, and treat many diseases, including cancer. A healthy, well-balanced diet not only ensures that the body gets the right amount of nutrients to meet its needs, but it also lets the body get substances that protect against and/or prevent certain diseases. It is now clear that obesity is linked to long-term diseases such as heart disease, diabetes, and cancer. The main reasons for people being overweight or obese are having bad eating habits and not moving around enough. Maintaining weight in the normal range may be one of the best things to avoid cancer. It has been scientifically proven that those who perform regular physical activity are less likely to develop cancer than those who lead a sedentary lifestyle. Moving regularly not only helps to maintain a normal body weight, avoiding the effects that favor tumor growth in overweight subjects, but also makes the immune system more resistant by counteracting the growth of tumor cells. Physical activity also helps prevent cardiovascular and metabolic diseases. In this review, it is highlighted that the association between the Mediterranean diet and physical activity triggers biological mechanisms capable of counteracting the low-grade chronic inflammation found in patients with cancer. This assumes that healthy lifestyles associated with cancer therapies can improve the expectations and quality of life of cancer patients.
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Affiliation(s)
- Rosa Divella
- Unità Operativa Complessa di Oncologia, Ospedale “Mons. A. R. Dimiccoli”, Asl BT, Viale Ippocrate 15, 76121 Barletta, Italy
| | - Graziella Marino
- Department of Breast Unit—Centro d Riferimento Oncologico della Basilicata, IRCCS-CROB, Via Padre Pio 1, 85028 Rionero in Vulture, Italy
| | - Stefania Infusino
- Unità Operativa Complessa di Oncologia, Ospedale “SS Annunziata”, Via Felice Migliori 1, 87100 Cosenza, Italy
| | - Laura Lanotte
- Unità Operativa Complessa di Oncologia, Ospedale “Mons. A. R. Dimiccoli”, Asl BT, Viale Ippocrate 15, 76121 Barletta, Italy
| | - Gaia Gadaleta-Caldarola
- Scienze e Tecnologie Alimentari, Università di Parma, Via Delle Scienze 59/A, 43124 Parma, Italy
| | - Gennaro Gadaleta-Caldarola
- Unità Operativa Complessa di Oncologia, Ospedale “Mons. A. R. Dimiccoli”, Asl BT, Viale Ippocrate 15, 76121 Barletta, Italy
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Keats MR, Yu X, Sweeney Magee M, Forbes CC, Grandy SA, Sweeney E, Dummer TJB. Use of Wearable Activity-Monitoring Technologies to Promote Physical Activity in Cancer Survivors: Challenges and Opportunities for Improved Cancer Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4784. [PMID: 36981693 PMCID: PMC10048707 DOI: 10.3390/ijerph20064784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/02/2023] [Accepted: 03/06/2023] [Indexed: 06/18/2023]
Abstract
The aim of this review was to explore the acceptability, opportunities, and challenges associated with wearable activity-monitoring technology to increase physical activity (PA) behavior in cancer survivors. A search of Medline, Embase, CINAHL, and SportDiscus was conducted from 1 January 2011 through 3 October 2022. The search was limited to English language, and peer-reviewed original research. Studies were included if they reported the use of an activity monitor in adults (+18 years) with a history of cancer with the intent to motivate PA behavior. Our search identified 1832 published articles, of which 28 met inclusion/exclusion criteria. Eighteen of these studies included post-treatment cancer survivors, eight were on active cancer treatment, and two were long-term cancer survivor studies. ActiGraph accelerometers were the primary technology used to monitor PA behaviors, with Fitbit as the most commonly utilized self-monitoring wearable technology. Overall, wearable activity monitors were found to be an acceptable and useful tool in improving self-awareness, motivating behavioral change, and increasing PA levels. Self-monitoring wearable activity devices have a positive impact on short-term PA behaviors in cancer survivors, but the increase in PA gradually attenuated through the maintenance phase. Further study is needed to evaluate and increase the sustainability of the use of wearable technologies to support PA in cancer survivors.
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Affiliation(s)
- Melanie R. Keats
- School of Health and Human Performance, Dalhousie University, Halifax, NS B3H 4R2, Canada
- Division of Medical Oncology, Department of Medicine, Dalhousie University & Nova Scotia Health, Halifax, NS B3H 4R2, Canada
- Beatrice Hunter Cancer Research Institute, Halifax, NS B3H 4R2, Canada
| | - Xing Yu
- School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Molly Sweeney Magee
- School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Cynthia C. Forbes
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull HU6 7RX, UK
| | - Scott A. Grandy
- School of Health and Human Performance, Dalhousie University, Halifax, NS B3H 4R2, Canada
- Division of Medical Oncology, Department of Medicine, Dalhousie University & Nova Scotia Health, Halifax, NS B3H 4R2, Canada
- Beatrice Hunter Cancer Research Institute, Halifax, NS B3H 4R2, Canada
- Faculty of Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Ellen Sweeney
- Beatrice Hunter Cancer Research Institute, Halifax, NS B3H 4R2, Canada
- Faculty of Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Trevor J. B. Dummer
- School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
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An Evaluation of Participant Perspectives and Wear-Time Compliance for a Wrist-Worn Versus Thigh-Worn Accelerometer in Cancer Survivors. J Phys Act Health 2023; 20:129-133. [PMID: 36535268 DOI: 10.1123/jpah.2022-0346] [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: 06/28/2022] [Revised: 10/31/2022] [Accepted: 11/05/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Accelerometers are frequently used to measure free-living physical activity and sleep in cancer survivors. To obtain valid data, participants must adhere to wear-time guidelines; therefore, understanding survivor's preference may be critical when selecting an accelerometer. This study compared cancer survivors' reported discomfort and interference, and wear-time compliance between a wrist-worn accelerometer and a thigh-worn accelerometer. METHODS This was a secondary data analysis. Cancer survivors (N = 52, mean age = 51.8 [13.0], 82.3% female) wore the Actiwatch-2 (wrist) and the activPAL (thigh) for 7 days, 24 hours per day. On day 7, participants completed a questionnaire to evaluate each accelerometer using a 1 to 5 Likert scale and open-ended questions. The Kolmogorov-Smirnov test evaluated differences in discomfort and interference. Paired samples t test evaluated differences in wear-time compliance. Open-ended responses were analyzed using thematic analysis methods. RESULTS No differences were observed in discomfort, interference, or wear-time compliance (P = .08). Qualitative analysis resulted in 2 themes: discomfort and ease of use and interference and adverse reaction. Interferences were primarily reported with the Actiwatch-2, whereas discomfort and ease were primarily reported with the activPAL. CONCLUSION No significant differences were observed regarding discomfort, interference, and compliance. Results of this study can prepare researchers for common issues regarding accelerometer compliance, allowing researchers to offer resources to alleviate discomforts or interferences that may affect wear-time compliance.
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Handford J, Chen M, Rai R, Moss CL, Enting D, Peat N, Karagiannis SN, Van Hemelrijck M, Russell B. Is There a Role for Exercise When Treating Patients with Cancer with Immune Checkpoint Inhibitors? A Scoping Review. Cancers (Basel) 2022; 14:cancers14205039. [PMID: 36291823 PMCID: PMC9599872 DOI: 10.3390/cancers14205039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/07/2022] [Accepted: 10/11/2022] [Indexed: 11/26/2022] Open
Abstract
The impact of using exercise as a non-pharmacological intervention in patients with cancer receiving immune checkpoint inhibitors (ICIs) is not well known. Our objective was to determine the extent of, and identify gaps within, available literature addressing the effect of exercise on (a) oncological outcomes and (b) quality of life (QoL) in patients with cancer receiving ICIs, and (c) the underlying biological mechanisms for such effects. We conducted searches across EMBASE, APA PsycInfo and Ovid MEDLINE(R). Studies were eligible if they addressed at least one aspect of the objective and were available in the English language. Results were synthesised using a narrative approach and subsequently discussed with multidisciplinary stakeholders. As of the final search on 5 April 2022, 11 eligible studies were identified, of which 8 were preclinical and 3 were clinical. Clinical studies only focused on QoL-related outcomes. When studies were grouped by whether they addressed oncological outcomes (n = 7), QoL (n = 5) or biological mechanisms (n = 7), they were found to be heterogeneous in methodology and findings. Additional evidence, particularly in the clinical setting, is required before robust recommendations about whether, and how, to include exercise alongside ICI treatment can be made.
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Affiliation(s)
- Jasmine Handford
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK
- Correspondence:
| | - Miaoqi Chen
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK
| | - Ridesh Rai
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK
| | - Charlotte L. Moss
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK
| | - Deborah Enting
- Guy’s and St Thomas’ NHS Foundation Trust, London SE1 9RT, UK
| | - Nicola Peat
- Guy’s and St Thomas’ NHS Foundation Trust, London SE1 9RT, UK
| | - Sophia N. Karagiannis
- St John’s Institute of Dermatology, School of Basic & Medical Biosciences, King’s College London, London SE1 9RT, UK
- Breast Cancer Now Research Unit, School of Cancer & Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK
| | - Mieke Van Hemelrijck
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK
| | - Beth Russell
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London SE1 9RT, UK
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Colomba E, Alves Costa Silva C, Le Teuff G, Elmawieh J, Afonso D, Benchimol-Zouari A, Guida A, Derosa L, Flippot R, Raynard B, Escudier B, Bidault F, Albiges L. Weight and skeletal muscle loss with cabozantinib in metastatic renal cell carcinoma. J Cachexia Sarcopenia Muscle 2022; 13:2405-2416. [PMID: 35903892 PMCID: PMC9530538 DOI: 10.1002/jcsm.13021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 03/10/2022] [Accepted: 05/09/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Cabozantinib, a standard of care metastatic renal cell carcinoma (mRCC), may be associated with weight and muscle loss. These effects of new generation VEGFR tyrosine kinase inhibitor on muscle mass loss are poorly described. METHODS All cabozantinib-treated mRCC patients from January 2014 to February 2019 in our institution were included. Clinical data including weight were collected during therapy. Computed tomography images were centrally reviewed for response assessment, and axial sections at the third lumbar vertebrae were used to measure the total muscle area. Toxicities and cabozantinib outcomes were evaluated. Co-primary endpoints included skeletal muscle loss and weight loss (WL), longitudinally evaluated during treatment. WL has been classified according to CTCAEv5.0: Grade 1 (loss of 5 to <10% of baseline body weight), Grade 2 (loss of 10% to <20% of baseline body weight), and Grades 3-4 (loss >20% of baseline body weight). RESULTS Patients were mostly men (70.3%), median age was 59.2 (range: 22.0-78.0) years, and median baseline body mass index was 25.0 (range: 16.4-49.3) kg/cm2 . Prognosis according to International Metastatic RCC Database Consortium score was good, intermediate, and poor for 13 (13.0%), 63 (63.0%), and 24 (24.0%) patients, respectively. Out of a total of 120 patients, 101 patients with a median follow-up of 22.3 months (range: 4.5-62.2) were eligible for analysis; 85 experienced muscle loss and muscle loss >10% increased during cabozantinib exposition, especially after 6 months of treatment. At cabozantinib baseline, 71 patients (70.3%) had sarcopenia, and 16/30 (53.3%) non-sarcopenic patients developed sarcopenia during treatment. Baseline sarcopenia was associated with lower response rates (P = 0.031) and higher grades 3-4 toxicities (P = 0.001). Out of 92 patients included in the WL analysis, 44 (47.8%) and 12 (13.0%) experienced grades 2 and 3 WL, respectively. CONCLUSIONS We report a high incidence of grades 3-4 WL, fourth times higher than reported in prior pivotal trials, and half of the patients developed sarcopenia while on cabozantinib treatment. Weight and muscle mass loss with cabozantinib are underreported and may require further investigations and early management.
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Affiliation(s)
- Emeline Colomba
- Cancer Medicine Department, Gustave Roussy, Paris-Saclay University, Villejuif, France
| | - Carolina Alves Costa Silva
- Cancer Medicine Department, Gustave Roussy, Paris-Saclay University, Villejuif, France.,Institut National de la Santé Et de la Recherche Médicale (INSERM) U1015, Equipe Labellisée-Ligue Nationale contre le Cancer, Villejuif, France
| | - Gwénaël Le Teuff
- Biostatistics and Epidemiology Department, Gustave Roussy, Villejuif, France.,Oncostat U1018, Inserm, Labeled Ligue Contre le Cancer, University Paris-Saclay, Villejuif, France
| | - Jamie Elmawieh
- Department of Anaesthesia, Surgery and Interventional, Gustave Roussy, Paris-Saclay University, Villejuif, France
| | - Daniel Afonso
- Imaging Department, Gustave Roussy, Paris-Saclay University, Villejuif, France
| | | | - Annalisa Guida
- Medical and Translational Oncology Unit, Department of Oncology, Azienda Ospedaliera Santa Maria, Terni, Italy
| | - Lisa Derosa
- Cancer Medicine Department, Gustave Roussy, Paris-Saclay University, Villejuif, France.,Institut National de la Santé Et de la Recherche Médicale (INSERM) U1015, Equipe Labellisée-Ligue Nationale contre le Cancer, Villejuif, France
| | - Ronan Flippot
- Cancer Medicine Department, Gustave Roussy, Paris-Saclay University, Villejuif, France
| | - Bruno Raynard
- Dietetics and Nutrition Unit, Gustave Roussy, Paris-Saclay University, Villejuif, France
| | - Bernard Escudier
- Cancer Medicine Department, Gustave Roussy, Paris-Saclay University, Villejuif, France
| | - François Bidault
- Imaging Department, Gustave Roussy, Paris-Saclay University, Villejuif, France
| | - Laurence Albiges
- Cancer Medicine Department, Gustave Roussy, Paris-Saclay University, Villejuif, France
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11
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Kraemer MB, Silva KC, Kraemer CCF, Pereira JS, dos Reis IGM, Priolli DG, Messias LHD. Validity of the peak velocity to detect physical training improvements in athymic mice. Front Physiol 2022; 13:943498. [PMID: 36091383 PMCID: PMC9451039 DOI: 10.3389/fphys.2022.943498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 07/22/2022] [Indexed: 11/18/2022] Open
Abstract
This study comprises two complementary experiments with athymic Balb/c (Nu/Nu) mice. In experiment 1, the aim was to verify the reproducibility of the peak velocity (VPeak) determined from the incremental test. The second experiment aimed to assess the VPeak sensitivity to prescribe and detect modulations of the physical training in athymic nude mice. Sixteen mice were submitted to two incremental treadmill tests separated by 48-h (Experiment 1). The test consisted of an initial warm-up of 5 minutes. Subsequently, animals initiated the tests at 8 m min−1 with increments of 2 m min−1 every 3 minutes. The VPeak was determined as the highest velocity attained during the protocol. In experiment 2, these animals were randomly allocated to an exercise group (EG) or a control group (CG). The training protocol consisted of 30-min of treadmill running at 70% of the VPeak five times a week for 4 weeks. High indexes of reproducibility were obtained for VPeak (Test = 19.7 ± 3.6 m min−1; Retest = 19.2 ± 3.4 m min−1; p = 0.171; effect size = 0.142; r = 0.90). Animals from the EG had a significant increase of VPeak (Before = 18.4 ± 2.7 m min−1; After = 24.2 ± 6.0 m min−1; p = 0.023). Conversely, a significant decrease was observed for the CG (Before = 21.1 ± 3.9 m min−1; After = 15.9 ± 2.7 m min−1; p = 0.038). The VPeak is a valid parameter for exercise prescription in studies involving athymic nude mice.
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Affiliation(s)
- Maurício Beitia Kraemer
- Research Group on Technology Applied to Exercise Physiology (GTAFE), Laboratory of Multidisciplinary Research, São Francisco University, Bragança Paulista, Brazil
| | - Karen Christine Silva
- Research Group on Technology Applied to Exercise Physiology (GTAFE), Laboratory of Multidisciplinary Research, São Francisco University, Bragança Paulista, Brazil
| | - Camila Cunha França Kraemer
- Research Group on Technology Applied to Exercise Physiology (GTAFE), Laboratory of Multidisciplinary Research, São Francisco University, Bragança Paulista, Brazil
| | - Juliana Silva Pereira
- Research Group on Technology Applied to Exercise Physiology (GTAFE), Laboratory of Multidisciplinary Research, São Francisco University, Bragança Paulista, Brazil
| | - Ivan Gustavo Masseli dos Reis
- Research Group on Technology Applied to Exercise Physiology (GTAFE), Laboratory of Multidisciplinary Research, São Francisco University, Bragança Paulista, Brazil
| | - Denise Gonçalves Priolli
- Coloproctology Service of the Federal University of São Paulo, São Paulo and Faculty of Health Sciences Pitágoras de Codó, São Paulo, Brazil
| | - Leonardo Henrique Dalcheco Messias
- Research Group on Technology Applied to Exercise Physiology (GTAFE), Laboratory of Multidisciplinary Research, São Francisco University, Bragança Paulista, Brazil
- *Correspondence: Leonardo Henrique Dalcheco Messias,
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12
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Silva da Costa N, Alves da Silva AS, de Melo-Neto JS. Effects of dance therapy in women with breast cancer: A systematic review protocol. PLoS One 2022; 17:e0257948. [PMID: 35749369 PMCID: PMC9231811 DOI: 10.1371/journal.pone.0257948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 09/14/2021] [Indexed: 11/18/2022] Open
Abstract
Background
Cancer is an important public health problem with an increasing global incidence in the recent decades. Breast cancer has become the leading cause of death in women worldwide. Women suffering from breast cancer, as well as survivors, may experience some adverse effects of treatment–including cancer-related fatigue, sleep disorders, and pain–which may manifest alone or in combination with other symptoms. Non-pharmacological interventions, such as physical activity, have been associated with improvements in these adverse effects. This study aims to evaluate the effects of dance therapy in women with breast cancer.
Methods
We will perform a systematic review according to the Cochrane methodology. An overall search strategy will be developed and adapted for PubMed, Virtual Health Library, PEDro, SciELO, SciVerse Scopus, Cochrane Library, and Web of Science using the descriptors “Dance therapy” or “Dancing” and “Breast neoplasms” or “Breast cancer.” The size of the intervention effect (Z) will be calculated for each outcome included in this review. Outcomes will be pain, cancer-related fatigue, sleep disturbance, body image and depression in women with breast cancer. Quality assessment will be performed using the Cochrane instrument. Metanalysis, if plausible, will be performed using Review Manager 5.3.
Discussion
Studies have reported positive results of dance therapy as a non-pharmacological intervention in women with breast cancer. Thus, it is expected that robust and conclusive evidence of the effects of dance therapy during or after treatment (radiotherapy, chemotherapy, hormone therapy, and/or surgery) can be obtained.
Trial registration
Systematic review registration: CRD42020152876. (S1 File).
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13
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Toscano JJDO, Barros KMDS, Alves Júnior CAS, Silva DAS. Efeito de um Programa de Exercício Físico na Pressão Arterial Aguda e Crônica em Sobreviventes de Câncer de Mama. REVISTA BRASILEIRA DE CANCEROLOGIA 2022. [DOI: 10.32635/2176-9745.rbc.2022v68n2.2188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Introdução: Poucos estudos exploraram o desfecho de componentes hemodinâmicos em sobreviventes de câncer em um programa de exercícios físicos. Objetivo: Verificar alterações agudas e crônicas na pressão arterial sistólica (PAS) e diastólica (PAD) durante um programa de exercícios em sobreviventes de câncer de mama. Método: Um hospital de referência, 24 mulheres sobreviventes participaram de um programa de exercícios físicos. A PA foi monitorada com monitor digital de pulso, antes e após a realização das sessões. Para comparação pré e pós-exercício em cada sessão, foi empregado o teste t para amostras pareadas. Para analises dos efeitos crônicos, utilizou-se a analise de variância (Anova), com medidas repetidas para identificar possíveis diferenças nas variáveis PAS e PAD pré-exercício ao longo das 15 sessões de treinamento. Considerou-se o nível de significância de 5%. Resultados: Observou-se que, com exceção da quarta e sexta sessões, os níveis de PAS diminuíram em todas as sessões após o exercício (p≤0,05). Para a PAD, somente houve diminuição significativa após o exercício nas três primeiras sessões. Nos efeitos crônicos, ocorreu redução media nos valores de PAS em repouso ao longo das sessões, com efeito hipotensor acima de 70% a partir da sétima sessão (p≤0,05). Na PAD, diferenças nos valores em repouso se acentuaram a partir da decima sessão; ao comparar com os valores de PAD em repouso, verificou-se efeito hipotensor acima de 94%. Conclusão: Sobreviventes que aderiram ao programa de exercício físico apresentaram redução aguda e crônica da PAS e da PAD.
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14
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Weyhe D, Obonyo D, Uslar V, Tabriz N. Effects of intensive physiotherapy on Quality of Life (QoL) after pancreatic cancer resection: a randomized controlled trial. BMC Cancer 2022; 22:520. [PMID: 35534822 PMCID: PMC9082826 DOI: 10.1186/s12885-022-09586-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 04/18/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Patients have significantly lower QoL scores after pancreatic resection due to cancer in the physical and psychological domains compared to healthy controls or other cancer patients. Intensified physiotherapy or physical training can increase QoL by reducing fatigue levels and improving physical functioning. However, data on the long-term effects of intensive or supervised physiotherapy is lacking. The aim of this exploratory study is the assessment of QoL in the intervention group, using various QoL questionnaires in their validated German translations and gather data on its feasibility in the context of chemotherapy with a follow-up of 12 months (and develop concepts to improve QoL after pancreatic cancer resection). METHODS Fifty-six patients (mean age: 66.4 ± 9.9 years) were randomized in this study to intervention (cohort A, n = 28) or control group (cohort B, n = 28). Intervention of intensified physiotherapy program consisted of endurance and muscle force exercises using cycle ergometer. In the control group physiotherapy was limited to the duration of the hospital stay and was scheduled for 20 min on 5 days per week. The clinical visits took place 2 days preoperatively, 1 week, 3 months, 6 months and 12 months postoperatively. Both groups attended the follow-up program. QoL was evaluated using the Short Physical Performance Battery (SPPB), Short Form-8 Health Survey (SF-8) and the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and pancreatic cancer-specific module QLQ-PAN26 questionnaires. The course of QoL was evaluated using a repeated measures ANOVA and a per protocol design. RESULTS Of the initial 56 randomized patients, 34 finished the 12 months follow-up period. There were no adverse events due to the intervention and 80% of patients in the intervention group where adherent. There was no significant influence on physical performance as measured by SPPB and SF-8 questionnaire. However, after 6 months patients in the intervention group regained their prior physical condition, whereas the control group did not. Intensive physiotherapy significantly influenced various factors of QoL measured with the C30 questionnaire positively, such as physical functioning (p = 0.018), role functioning (p = 0.036), and appetite loss (p = 0.037), even after 6 months. No negative effects in patients undergoing chemotherapy compared to those without chemotherapy was observed. CONCLUSION This first randomized controlled study with a 12-month follow-up shows that supervised physiotherapy or prescribed home-based exercise after pancreatic cancer resection is safe and feasible and should be proposed and started as soon as possible to improve certain aspects of QoL. TRIAL REGISTRATION German Clinical Trials Register (No: DRKS00006786 ); Date of registration: 01/10/2014.
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Affiliation(s)
- Dirk Weyhe
- Carl von Ossietzky University Oldenburg, University Hospital for Visceral Surgery, Pius-Hospital Oldenburg, Georgstr. 12, 26121, Oldenburg, Germany
| | - Dennis Obonyo
- Carl von Ossietzky University Oldenburg, University Hospital for Visceral Surgery, Pius-Hospital Oldenburg, Georgstr. 12, 26121, Oldenburg, Germany
| | - Verena Uslar
- Carl von Ossietzky University Oldenburg, University Hospital for Visceral Surgery, Pius-Hospital Oldenburg, Georgstr. 12, 26121, Oldenburg, Germany.
| | - Navid Tabriz
- Carl von Ossietzky University Oldenburg, University Hospital for Visceral Surgery, Pius-Hospital Oldenburg, Georgstr. 12, 26121, Oldenburg, Germany
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15
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Gil-Herrero L, Pollán M, Martín M, López-Tarruella S, Castellanos M, Casla-Barrio S. The importance of physical exercise in cardiovascular fitness in breast cancer survivors. A cross-sectional study: women in Motion 2.0. Support Care Cancer 2022; 30:6745-6754. [PMID: 35524144 DOI: 10.1007/s00520-022-06993-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 03/15/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE To compare the cardiovascular fitness of breast cancer (BC) survivors with an active lifestyle to those with a sedentary lifestyle. METHODS A cross-sectional study was conducted. Participants were classified into four groups: two groups of active women who performed more than 150 min/week of physical exercise, active with BC (Act-BCW) and active without BC (Act-HW); and two groups of sedentary women who performed less than 90 min/week of physical exercise, sedentary with BC (Sed-BCW) and sedentary without BC (Sed-HW). VO2max was estimated by the 6-min walking test (6MWT); speed, isometric strength, lower body maximum strength, explosive strength, balance, and body composition were also measured. ANOVA was used to analyze group differences and post hoc comparisons were developed with the Bonferroni test. RESULTS A total of 92 women were recruited. Significant differences were found in VO2max between the Act-BCW and Sed-BCW groups (MeanDif = 5.86, p < 0.001). No differences in VO2max were observed between the active groups (MeanDif = 0.42, p = 0.753). Related body composition and fat mass levels were significantly lower in the Act-BCW group than in the sedentary groups (Sed-BCW MeanDif = - 6.78; p = 0.012; and Sed-HW MeanDif = - 12.07; p < 0.001). CONCLUSIONS Women who are Act-BCW can achieve similar values in physical condition as women who are Act-HW and have better values than women who are sedentary. Furthermore, our results suggest than physical activity level may have a greater impact in body composition than a previous history of BC.
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Affiliation(s)
| | | | - Miguel Martín
- Hospital General Universitario Gregorio Marañon, Madrid, Spain
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16
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Keats MR, Grandy SA, Blanchard C, Fowles JR, Neyedli HF, Weeks AC, MacNeil MV. The Impact of Resistance Exercise on Muscle Mass in Glioblastoma in Survivors (RESIST): Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2022; 11:e37709. [PMID: 35507403 PMCID: PMC9118089 DOI: 10.2196/37709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 03/17/2022] [Accepted: 03/23/2022] [Indexed: 11/25/2022] Open
Abstract
Background Glioblastoma is the most common primary brain malignancy in adults, accounting for approximately 48% of all brain tumors. Standard treatment includes radiation and temozolomide chemotherapy. Glioblastomas are highly vascular and can cause vasogenic brain edema and mass effect, which can worsen the neurologic symptoms associated with the disease. The steroid dexamethasone (DEX) is the treatment of choice to reduce vasogenic edema and intracranial pressure associated with glioblastoma. However high-dose DEX or long-term use can result in muscle myopathy in 10%-60% of glioblastoma patients, significantly reducing functional fitness and quality of life (QOL). There is a wealth of evidence to support the use of exercise as an adjuvant therapy to improve functional ability as well as help manage treatment-related symptoms. Specifically, resistance training has been shown to increase muscle mass, strength, and functional fitness in aging adults and several cancer populations. Although studies are limited, research has shown that exercise is safe and feasible in glioblastoma populations. However, it is not clear whether resistance training can be successfully used in glioblastoma to prevent or mitigate steroid-induced muscle myopathy and associated loss of function. Objective The primary purpose of this study is to establish whether an individualized circuit-based program will reduce steroid-induced muscle myopathy, as indicated by maintained or improved functional fitness for patients on active treatment and receiving steroids. Methods This is a 2-armed, randomized controlled trial with repeated measures. We will recruit 38 adult (≥18 years) patients diagnosed with either primary or secondary glioblastoma who are scheduled to receive standard radiation and concurrent and adjuvant temozolomide chemotherapy postsurgical debulking and received any dose of DEX through the neurooncology clinic and the Nova Scotia Health Cancer Center. Patients will be randomly allocated to a standard of care waitlist control group or standard of care + circuit-based resistance training exercise group. The exercise group will receive a 12-week individualized, group and home-based exercise program. The control group will be advised to maintain an active lifestyle. The primary outcome, muscle myopathy (functional fitness), will be assessed using the Short Physical Performance Battery and hand grip strength. Secondary outcome measures will include body composition, cardiorespiratory fitness, physical activity, QOL, fatigue, and cognitive function. All measures will be assessed pre- and postintervention. Participant accrual, exercise adherence, and safety will be assessed throughout the study. Results This study has been funded by the Canadian Cancer Society Atlantic Cancer Research Grant and the J.D. Irving Limited–Excellence in Cancer Research Fund (grant number 707182). The protocol was approved by the Nova Scotia Health and Acadia University’s Research Ethics Boards. Enrollment is anticipated to begin in March 2022. Conclusions This study will inform how individualized circuit-based resistance training may improve functional independence and overall QOL of glioblastoma patients. Trial Registration ClinicalTrails.gov NCT05116137; https://www.clinicaltrials.gov/ct2/show/NCT05116137 International Registered Report Identifier (IRRID) DERR1-10.2196/37709
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Affiliation(s)
- Melanie R Keats
- Division of Kinesiology, School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada.,Division of Medical Oncology, Department of Medicine, Dalhousie University, Halifax, NS, Canada.,Beatrice Hunter Cancer Research Institute, Halifax, NS, Canada
| | - Scott A Grandy
- Division of Kinesiology, School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada.,Division of Medical Oncology, Department of Medicine, Dalhousie University, Halifax, NS, Canada.,Beatrice Hunter Cancer Research Institute, Halifax, NS, Canada
| | - Christopher Blanchard
- Department of Medicine, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | | | - Heather F Neyedli
- Division of Kinesiology, School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada.,Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Adrienne C Weeks
- Division of Neurosurgery, Department of Surgery, Dalhousie University, Halifax, NS, Canada
| | - Mary V MacNeil
- Division of Medical Oncology, Department of Medicine, Dalhousie University, Halifax, NS, Canada
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17
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Roscoe CMP, Pringle A, Chandler C, Faghy MA, Barratt B. The Role of Physical Activity in Cancer Recovery: An Exercise Practitioner's Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063600. [PMID: 35329286 DOI: 10.3390/ijerph19063600] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/08/2022] [Accepted: 03/16/2022] [Indexed: 11/16/2022]
Abstract
Less than 20% of cancer patients meet the recommended physical activity (PA) guidelines, partially due to poor knowledge and enforcement/encouragement amongst health-care professionals (HCPs). The primary aim of this study was to explore the perceptions of exercise practitioners on the role of PA and the physiological and psychological benefits to recovering cancer patients; the secondary aim was to understand the barriers and facilitators of promoting PA to cancer survivors. The third aim was to, seek the perspectives on the effectiveness of referral systems between the hospitals and PA structures. A purposive sample of five exercise practitioners' (four male and one female) with experience with cancer patients participated in a semi-structured interview (45-60 min). Interviews addressed five key topics: intervention procedures, patient well-being, patient education on PA, effectiveness of referrals from hospitals, and post-intervention PA. Interviews were transcribed verbatim and analysed via thematic analysis. The participants believed that recovering cancer patients possess a knowledge of the physiological benefits of PA, yet psychological understanding remains unknown. Social environments are key to participation in PA and most HCPs lacked knowledge/awareness of the benefits of engaging in PA. There is a need to improve HCPs knowledge of the benefits of PA, whilst providing standardised training on how PA can improve cancer patients' outcomes.
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Affiliation(s)
- Clare M P Roscoe
- Human Sciences Research Centre, University of Derby, Derby DE22 1GB, UK
| | - Andy Pringle
- Human Sciences Research Centre, University of Derby, Derby DE22 1GB, UK
| | | | - Mark A Faghy
- Human Sciences Research Centre, University of Derby, Derby DE22 1GB, UK
| | - Ben Barratt
- Human Sciences Research Centre, University of Derby, Derby DE22 1GB, UK
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18
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Lopez-Garzon M, Cantarero-Villanueva I, Postigo-Martin P, González-Santos Á, Lozano-Lozano M, Galiano-Castillo N. Can physical exercise prevent chemotherapy-induced peripheral neuropathy in patients with cancer? A systematic review and meta-analysis. Arch Phys Med Rehabil 2022; 103:2197-2208. [PMID: 35271844 DOI: 10.1016/j.apmr.2022.02.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 02/04/2022] [Indexed: 11/02/2022]
Abstract
OBJECTIVE This systematic review analyzed the effects of physical exercise programs in patients with cancer undergoing chemotherapy on Chemotherapy-induced Peripheral Neuropathy (CIPN) prevention. DATA SOURCES PubMed, Web of Science, Scopus, and Cochrane Library were searched for relevant studies published before December 2020. Additional references were identified by manual screening of the reference lists. STUDY SELECTION Based on the PICOS strategy, randomized controlled trials in which physical exercise was applied before or during chemotherapy to prevent or ameliorate CIPN were included. DATA EXTRACTION Two reviewers blinded and independent screened the articles, scored methodologic quality, and extracted data for analysis. The review was conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA). Sensitivity and precision analysis databases was included. Risk of bias assessment and meta-analysis were conducted using the Cochrane tools. DATA SYNTHESIS Of 229 potentially relevant studies, eight randomized controlled trials were included and scored. They comprise a total of 618 patients with cancer. Medline and Scopus databases recorded the highest sensitivity. None of the studies achieved a "low" overall risk of bias. Four studies were included in meta-analysis for quality of life, and a significance standardized mean difference was found between groups from baseline of 14.62, 95% CI 6.03, 23.20, with a large effect size g= .83, 95% CI .48, 1.18) in favor to physical exercise program compared with usual care. CONCLUSIONS Physical exercise at the onset of chemotherapy has shown promising effects on the prevention of CIPN, specially improving quality of life.
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Affiliation(s)
- Maria Lopez-Garzon
- 'Cuídate' Support Unit for Oncology Patients (UAPO-Cuídate), University of Granada, Granada, Spain; Department of Physical Therapy, Faculty of Health Sciences, University of Granada. Avenida de la Ilustración 60, 18016, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Av. de Madrid, 15, 18012 Granada, Spain
| | - Irene Cantarero-Villanueva
- 'Cuídate' Support Unit for Oncology Patients (UAPO-Cuídate), University of Granada, Granada, Spain; Department of Physical Therapy, Faculty of Health Sciences, University of Granada. Avenida de la Ilustración 60, 18016, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Av. de Madrid, 15, 18012 Granada, Spain; Sport and Health Joint University Institute (iMUDS). University of Granada Av. del Conocimiento, s/n, 18007 Granada, Spain; Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain
| | - Paula Postigo-Martin
- 'Cuídate' Support Unit for Oncology Patients (UAPO-Cuídate), University of Granada, Granada, Spain; Department of Physical Therapy, Faculty of Health Sciences, University of Granada. Avenida de la Ilustración 60, 18016, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Av. de Madrid, 15, 18012 Granada, Spain; Sport and Health Joint University Institute (iMUDS). University of Granada Av. del Conocimiento, s/n, 18007 Granada, Spain
| | - Ángela González-Santos
- 'Cuídate' Support Unit for Oncology Patients (UAPO-Cuídate), University of Granada, Granada, Spain; Department of Physical Therapy, Faculty of Health Sciences, University of Granada. Avenida de la Ilustración 60, 18016, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Av. de Madrid, 15, 18012 Granada, Spain.
| | - Mario Lozano-Lozano
- 'Cuídate' Support Unit for Oncology Patients (UAPO-Cuídate), University of Granada, Granada, Spain; Department of Physical Therapy, Faculty of Health Sciences, University of Granada. Avenida de la Ilustración 60, 18016, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Av. de Madrid, 15, 18012 Granada, Spain; Sport and Health Joint University Institute (iMUDS). University of Granada Av. del Conocimiento, s/n, 18007 Granada, Spain; Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain
| | - Noelia Galiano-Castillo
- 'Cuídate' Support Unit for Oncology Patients (UAPO-Cuídate), University of Granada, Granada, Spain; Department of Physical Therapy, Faculty of Health Sciences, University of Granada. Avenida de la Ilustración 60, 18016, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Av. de Madrid, 15, 18012 Granada, Spain; Sport and Health Joint University Institute (iMUDS). University of Granada Av. del Conocimiento, s/n, 18007 Granada, Spain; Unit of Excellence on Exercise and Health (UCEES), University of Granada, Granada, Spain
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19
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Botta RM, Palermi S, Tarantino D. High-intensity interval training for chronic pain conditions: a narrative review. J Exerc Rehabil 2022; 18:10-19. [PMID: 35356137 PMCID: PMC8934613 DOI: 10.12965/jer.2142718.359] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 01/10/2022] [Indexed: 11/22/2022] Open
Abstract
Chronic pain is defined as pain that persists past the normal healing time. Physical activity and exercise programs are increasingly being promoted and used for a variety of chronic pain conditions. Evidence suggests that physical exercise is an intervention with few adverse events that may improve pain severity and physical function, thus improving the quality of life. High-intensity interval training (HIIT) has been shown to improve physical outcome measures and to decrease disorder-related disability in people with chronic disorders. Since an overview of the benefits of HIIT on chronic pain conditions has not been published yet, this review aims to report the effects of HIIT alone or in combination with other forms of training on different kind of chronic pain conditions. A search in the main scientific electronic databases was performed. The results of the studies included in this review showed that HIIT is beneficial for several chronic pain conditions, improving pain and physical function. Since HIIT could represent a valid help to conventional drug therapies, it could improve the quality of life of these subjects. The actual quality of evidence remains very low, and further high evidence studies are needed to confirm the promising outcomes reported in this review.
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Affiliation(s)
- Riccardo Maria Botta
- Anesthesia and Intensive Care, Department of Medical and Surgical Science, Magna Graecia University, Catanzaro,
Italy
| | - Stefano Palermi
- Department of Public Health, University of Naples Federico II, Naples,
Italy
| | - Domiziano Tarantino
- Department of Public Health, University of Naples Federico II, Naples,
Italy
- Corresponding author: Domiziano Tarantino, Department of Public Health, University of Naples Federico II, Via Sergio Pansini nr. 5, 80131 Naples, Italy,
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20
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Caperchione CM, Stolp S, Phillips JL, Agar M, Sharp P, Liauw W, Harris CA, McCullough S, Lilian R. Cancer survivors' exercise beliefs, knowledge, and behaviors: An Australian National Survey. Asia Pac J Clin Oncol 2022; 18:625-633. [PMID: 35098655 DOI: 10.1111/ajco.13729] [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: 07/29/2021] [Accepted: 11/03/2021] [Indexed: 11/02/2022]
Abstract
AIMS This study aimed to (1) explore the perceptions of people living with cancer about exercise in general and exercise as an adjunct form of cancer care, (2) explore their perceptions regarding exercise counselling needs and preferences, and (3) investigate how these perceptions of exercise as an adjunct form of cancer care shape survivors exercise levels postcancer diagnosis. METHODS A cross-sectional design and online survey were used to recruit cancer survivors via cancer-related networks throughout Australia. Two factor analyses were conducted to examine the structure and reduce the number of variables pertaining to exercise during and after the cancer treatment. Extracted components were used in one-way analysis of variance to compare differences in physical activity levels postcancer diagnosis. RESULTS Participants (N = 288) had very positive perceptions of exercise, yet only 50% of participants would prefer to receive exercise counselling. Those who were more active postcancer diagnosis had higher exercise beliefs than those who were similarly active (p = 0.04, r = 0.27) and less active (p = 0.03, r = 0.24) postdiagnosis. Those who were less active also had lower exercise knowledge than those who were similarly active (p = 0.01, r = 0.31) and more active (p = 0.03, r = 0.26). Safety beliefs did not significantly differ between cancer survivors' activity levels (p = 0.16) CONCLUSION: This survey highlights the potential benefits of a concentrated effort in connecting survivors to relevant services and resources, and utilizing cancer clinicians to communicate with survivors about the role of exercise in cancer care.
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Affiliation(s)
- Cristina M Caperchione
- School of Sport, Exercise and Rehabilitation, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Sean Stolp
- School of Sport, Exercise and Rehabilitation, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Jane L Phillips
- School of Nursing, Queensland University of Technology, Brisbane, QLD.,IMPACCT, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Meera Agar
- IMPACCT, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Paul Sharp
- School of Sport, Exercise and Rehabilitation, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Winston Liauw
- Cancer Care Centre, St George Hospital, Sydney, New South Wales, Australia.,St. George and Sutherland Clinical School, University of New South Wales, Sydney, New South Wales, Australia.,Translational Cancer Research Network Sydney, Sydney, New South Wales, Australia
| | - Carole A Harris
- Cancer Care Centre, St George Hospital, Sydney, New South Wales, Australia.,St. George and Sutherland Clinical School, University of New South Wales, Sydney, New South Wales, Australia.,Translational Cancer Research Network Sydney, Sydney, New South Wales, Australia
| | - Susan McCullough
- Translational Cancer Research Network Sydney, Sydney, New South Wales, Australia
| | - Ruth Lilian
- Translational Cancer Research Network Sydney, Sydney, New South Wales, Australia
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21
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Agrawal A, Bhattacharya S. Cutting-edge Nanotechnological Approaches for Lung Cancer Therapy. Curr Drug Res Rev 2022; 14:171-187. [PMID: 35440332 DOI: 10.2174/2589977514666220418085658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 01/17/2022] [Accepted: 02/22/2022] [Indexed: 06/14/2023]
Abstract
Lung cancer is the second leading cancer with a high rate of mortality. It can be treated using different intervention techniques such as chemotherapy, radiation therapy, surgical removal, and photodynamic therapy. All of these interventions lack specificity, implying that it harms the normal cells adjacent to the infected ones. Nanotechnology provides a promising solution that increases the bioavailability of anticancer drugs at the tumor site with reduced toxicity and improved therapeutic efficacy. Nanotechnology also improves the way lung cancer is diagnosed and treated. Various nanocarriers like liposomes, polymeric nanoparticles, magnetic nanoparticles, and different theranostic approaches are already approved for medical use, while various are under clinical and preclinical stages. This review article covers the details about lung cancer, types of overexpressed receptors, and cutting-edge nanocarriers used for treating lung cancer at its specific target.
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Affiliation(s)
- Amaiyya Agrawal
- Department of Pharmaceutics, School of Pharmacy & Technology Management, SVKM\'S NMIMS Deemed-to-be University, Shirpur 425405, Maharashtra, India
| | - Sankha Bhattacharya
- Department of Pharmaceutics, School of Pharmacy & Technology Management, SVKM\'S NMIMS Deemed-to-be University, Shirpur 425405, Maharashtra, India
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22
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Watson G, Coyne Z, Houlihan E, Leonard G. Exercise oncology: an emerging discipline in the cancer care continuum. Postgrad Med 2021; 134:26-36. [PMID: 34854802 DOI: 10.1080/00325481.2021.2009683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Exercise is an essential component of healthy living and well-being. While there is a global acceptance of the benefits of exercise for the general population, there exists hesitancy and confusion among health-care professionals, particularly oncologists, as to whether these benefits translate to cancer patients. Patient referrals to accessible, structured exercise programs in this setting are often overlooked by physicians when formulating a cancer management plan. There is however increasing awareness and acceptance of cancer survivorship as a part of the cancer care continuum, identifying multiple factors that contribute to well-being beyond just cancer outcomes. Efforts to optimize cancer survivorship have stimulated further academic interest in the benefits of healthy living and particularly exercise oncology. There is now compelling evidence that exercise, which includes daily activities such as walking, as well as structured programs, improves multiple-cancer outcomes such as fatigue, quality of life and likely survival, and warrants consideration in the multidisciplinary care of cancer patients. International guidelines have been established that recommend counseling cancer patients with regard to healthy lifestyle changes including exercise. However, there still remains a reluctance from oncology physicians to prescribe exercise for these patients, largely due to uncertainty with regard to their patients' ability to tolerate such an intervention, coupled with insufficient understanding of the potential benefits of these programs. There also exist patient barriers and attitudes that must be overcome. Exercise strategies and bespoke programs that are tailored to the unique abilities and goals of the patients will enhance participation. To move the field forward and integrate exercise oncology into standard practice, it is imperative to raise awareness of the benefits of exercise to cancer patients and their health-care providers. This will facilitate the prescription of exercise as part of the multimodal treatment plan with the ultimate aim of promoting an active lifestyle to optimize patient care and well-being.
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Affiliation(s)
- Ga Watson
- Department of Medical Oncology, University Hospital Galway, Galway, Ireland
| | - Zl Coyne
- Department of Medical Oncology, University Hospital Galway, Galway, Ireland
| | - E Houlihan
- Department of Physiotherapy, Cancer Care West, Galway, Ireland
| | - Gd Leonard
- Department of Medical Oncology, University Hospital Galway, Galway, Ireland
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23
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Park C, Park SK, Upshaw JN, Schonberg MA. In-hospital mortality, length of stay and hospital costs for hospitalized breast cancer patients with comorbid heart failure in the USA. Curr Med Res Opin 2021; 37:2043-2047. [PMID: 34525896 PMCID: PMC9627537 DOI: 10.1080/03007995.2021.1980775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 08/29/2021] [Accepted: 09/11/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Breast cancer and heart failure (HF) are frequently interconnected due to shared risk factors and the cardiotoxicity of breast cancer treatment. However, the association between HF and hospital outcomes among breast cancer patients has not been studied. This study examined the association between HF and hospital outcomes among hospitalized patients with breast cancer. METHODS This cross-sectional study using the 2015-2018 Healthcare Cost and Utilization Project-National Inpatient Sample data included hospitalized women who were aged 18 years or older and had a primary diagnosis code for breast cancer. Logistic regression, negative binomial regression, and generalized linear models with log-link and gamma distribution were used to assess the associations of HF with in-hospital mortality, length of stay (LOS) and hospital costs. RESULTS Among 17,335 hospitalized patients with breast cancer, 4.2% (n = 1021) had HF. Compared to breast cancer patients without HF, those with HF were more likely to die during hospitalization (odds ratio = 1.65, 95% CI = 1.27-2.16, p < .001), stay in the hospital longer (incidence rate ratio = 1.22, 95% CI = 1.15-1.30, p < .001) and have higher hospital costs (cost ratio = 1.09, 95% CI = 1.03-1.14, p = .003) during hospitalization, controlling for covariates. CONCLUSION HF has a substantial negative impact on health outcomes among hospitalized breast cancer patients. Breast cancer and HF are often considered separate medical conditions, but promoting effective management of comorbid HF in breast cancer patients may help to improve hospital outcomes in this population.
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Affiliation(s)
- Chanhyun Park
- Health Outcomes Division, College of Pharmacy, The University of Texas at Austin, Austin, TX, United States of America
| | - Sun-Kyeong Park
- School of Pharmacy, The Catholic University of Korea, Bucheon, South Korea
| | - Jenica N. Upshaw
- Division of Cardiology, Tufts Medical Center, Boston, MA, United States of America
| | - Mara A. Schonberg
- Division of General Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States of America
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24
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Beghean R, Coffey L. "You either sink or you swim, and you're better off swimming": A qualitative study exploring the self-management experiences of soft tissue sarcoma survivors. Eur J Oncol Nurs 2021; 55:102062. [PMID: 34775165 DOI: 10.1016/j.ejon.2021.102062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 11/02/2021] [Accepted: 11/03/2021] [Indexed: 12/29/2022]
Abstract
PURPOSE To qualitatively explore the consequences of soft tissue sarcoma and its treatment experienced by survivors, the self-management strategies they use to deal with these consequences, and any factors that may act as barriers or facilitators to their self-management. METHODS Semi-structured interviews were conducted with seven soft tissue sarcoma survivors who had completed their primary treatment. Interviews were audio-recorded, transcribed and thematically analysed. RESULTS Physical, psychological and social consequences of soft tissue sarcoma and its treatment were identified, with side-effects, physical restrictions, body image issues, fear of recurrence, feeling depressed, familial relationships and sexual activity being the most frequently reported. Nine different types of self-management strategy encompassing eighteen specific strategies were identified, including cognitive strategies, lifestyle changes and utilisation of resources. Personal, social and environmental facilitators of self-management were identified; being in a relationship, being at an appropriate life stage, and having support from family, friends and medical staff were most commonly reported. Finally, personal and environmental barriers to self-management included the adaptation period, ongoing complications, rareness of sarcoma and poor patient-healthcare provider communication. CONCLUSIONS The findings of this study suggest that soft tissue sarcoma survivors, especially those who are younger and experience physical limitations, may find the immediate post-treatment period particularly challenging and may benefit from nurse-led self-management support.
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Affiliation(s)
- Rahela Beghean
- Department of Psychology, Maynooth University, Maynooth, Co. Kildare, Ireland
| | - Laura Coffey
- Department of Psychology, Maynooth University, Maynooth, Co. Kildare, Ireland.
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25
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David A, Hausner D, Frenkel M. Cancer-Related Fatigue-Is There a Role for Complementary and Integrative Medicine? Curr Oncol Rep 2021; 23:145. [PMID: 34743258 DOI: 10.1007/s11912-021-01135-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE OF REVIEW This review aims to assess recent data on possible effective and safe complementary and integrative medicine (CIM) modalities that can be of help to patients affected by cancer that suffer from cancer-related fatigue (CRF). RECENT FINDINGS Cancer-related fatigue (CRF) is one of the most common, persistent, and challenging symptoms among cancer patients and survivors. Many world-leading cancer centers incorporate CIM into routine cancer care including integrating multiple approaches to address CRF. Approaches that are supported by clinical evidence on the use of CIM during and following conventional oncology treatments are being discussed in this review. The review suggests that some CIM modalities might have a potential role in alleviating cancer-related fatigue. These modalities include acupuncture, touch therapies, nutrition, nutritional supplements, stress reduction, homeopathy, and circadian rhythm management. Additional research is still needed to better support the process of integrating CIM into a routine approach to cancer-related fatigue.
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Affiliation(s)
- Adi David
- Tal Center for Integrative Medicine, Institute of Oncology, Chaim Sheba Medical Center, Ramat Gan, Israel
| | - David Hausner
- Tal Center for Integrative Medicine, Institute of Oncology, Chaim Sheba Medical Center, Ramat Gan, Israel.,Palliative Care Service, Chaim Sheba Medical Center, Ramat Gan, Israel
| | - Moshe Frenkel
- Department of Family Medicine, University of Texas Medical Branch, Galveston, TX, USA. .,Complementary and Integrative Medicine Service, Oncology Division, Rambam Health Care Campus, Hashoftim 1 B, Zichron Yaacov, 30900, Haifa, Israel.
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26
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Forner JK, Doughty A, Dalstrom M, Messer BL, Lizer SK. Quality of Life: A Nurse-Led Physical Activity Coaching Program to Improve the Quality of Life of Patients With Cancer During the COVID-19 Pandemic. Clin J Oncol Nurs 2021; 25:571-577. [PMID: 34533516 DOI: 10.1188/21.cjon.571-577] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Physical activity has been shown to mitigate many of the effects of cancer treatment, yet it often is not embraced by the patient or made part of the nursing standard of care. OBJECTIVES This pilot study evaluates the impact of the Oncology Nursing Society's Get Up, Get Moving program, a personalized, home-based, nurse-led physical activity coaching program. METHODS Patients with cancer in the intervention and control groups completed the SF-36® and the Godin Leisure-Time Exercise Questionnaire at weeks 1 and 12. All patients were initially counseled on exercise. A nurse called each member of the intervention group weekly to encourage physical activity and asked about fatigue, nausea, and step count. The control group was contacted at 6 weeks and 12 weeks only. FINDINGS The program, coupled with nurse telephone calls, increased steps, decreased fatigue, and maintained health-related quality of life among patients in the intervention group. The control group had a decrease in steps, a decline in their SF-36 general health score, and an increase in fatigue. Nurse coaching positively affects physical activity, which may help to decrease cancer treatment side effects.
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27
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Murnane A, Kiss N, Fraser SF, Lewin J. Health-related quality of life, fatigue and health behaviours in Australian adolescent and young adult cancer survivors. Pediatr Blood Cancer 2021; 68:e29243. [PMID: 34309171 DOI: 10.1002/pbc.29243] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 06/29/2021] [Accepted: 06/30/2021] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Current knowledge of the long-term health behaviours and well-being of adolescent and yong adult (AYA) cancer survivors is limited. The aim of this study was to evaluate the health behaviours of AYA cancer survivors compared to Australian normative data and describe their health-related quality of life (HR-QoL) and levels of fatigue. METHOD A cross-sectional online survey of participants aged 15-25 years at diagnosis and 2-7 years post treatment completion was conducted at a comprehensive cancer centre. Validated questionnaires assessed health behaviours and functioning including current physical activity (PA) levels, diet quality, fatigue (FACIT-F) and HR-QoL (AQoL-6D, Short Form 36v2 [SF-36v2]) were compared to Australian normative data. RESULTS Ninety individuals completed the survey (26% response rate) with a mean age of 25.4 years and median time post treatment of 61 months (24-85 months). Compared to normative data, a higher proportion of AYA cancer survivors was consuming the recommended daily serves of fruit and vegetables (16.7% vs. 3.9%, p < .0001), had a lower presence of overweight or obesity (46.7% vs. 57.7%, p = .04) and lower percentage of current smokers (2.2% vs. 16.7%, p < .0001). However, AYA cancer survivors reported increased fatigue (t[df = 596] = -4.1, p < .0001) and reduced HR-QoL compared to normative data (t[df = 533] = 9.2, p < .0001) along with a higher proportion suffering from one or more chronic health conditions (65% vs. 40%, p < .0001). CONCLUSION AYA cancer survivors from a single Australian institution, who were on average 5 years post treatment, exhibited better health behaviours compared to Australian normative data, but still below recommended guidelines. However, they continue to experience issues with fatigue and reduced HR-QoL, especially in those not meeting the PA guidelines.
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Affiliation(s)
- Andrew Murnane
- ONTrac at Peter Mac Victorian Adolescent and Young Adult Cancer Service, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Victoria, Australia
| | - Nicole Kiss
- Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Victoria, Australia.,Allied Health Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Steve F Fraser
- Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Victoria, Australia
| | - Jeremy Lewin
- ONTrac at Peter Mac Victorian Adolescent and Young Adult Cancer Service, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
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28
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Effects of Exercise in the Treatment of Alzheimer's Disease: An Umbrella Review of Systematic Reviews and Meta-Analyses. J Aging Phys Act 2021; 30:535-551. [PMID: 34489364 DOI: 10.1123/japa.2021-0033] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 06/11/2021] [Accepted: 06/26/2021] [Indexed: 11/18/2022]
Abstract
The authors aimed to provide an overview of the evidence on the effects of exercise in people with Alzheimer's disease through a comprehensive review of the existing systematic reviews and meta-analyses. A literature search was performed in CINAHL, Cochrane Library, EMBASE, PubMed, SPORTDiscus, Scopus, and Web of Science databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The AMSTAR-2-Tool was used for the quality assessment. Twenty-three reviews fulfilled the criteria. Most of the reviews investigated the effects of aerobic exercise on Alzheimer's disease symptoms. The largest effects of exercise were seen in terms of improved cognition by multiple exercises. The majority of the reviews were rated as being of moderate quality and none were classified as having high quality. Exercise is an effective way to treat Alzheimer's disease symptoms and has a low incidence of related adverse events. As most reviews were evaluated as low-moderate quality, caution is needed in the interpretation of the results.
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29
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Bhuiyan N, Linden-Carmichael AN, Lanza ST, Schmitz KH, Mama SK. Age-varying associations between physical activity and psychological outcomes among rural cancer survivors. J Behav Med 2021; 44:484-491. [PMID: 33047213 PMCID: PMC8039059 DOI: 10.1007/s10865-020-00187-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 09/25/2020] [Indexed: 12/12/2022]
Abstract
We examined the prevalence of psychological outcomes (i.e., symptoms of depression and anxiety) by age and age-varying associations between physical activity and psychological outcomes among rural cancer survivors. Participants (N = 219; ages 22-93) completed sociodemographic, psychological, and physical activity questionnaires. Time-varying effect models estimated the prevalence of psychological outcomes and assessed associations between physical activity and psychological outcomes as a flexible function of age. Depression and anxiety symptoms decreased with age among cancer survivors aged 22-40 years and were relatively stable across age among those > 40 years. Positive associations between vigorous physical activity and psychological outcomes in those aged 22-40 years were identified. In those > 70-80 years, there were negative associations between vigorous physical activity and psychological outcomes. Results suggest there is variation across age in the associations between physical activity and psychological outcomes among rural survivors. Future research should further explore these age-varying relationships to identify important intervention targets.
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Affiliation(s)
- Nishat Bhuiyan
- Department of Kinesiology, The Pennsylvania State University, 23B Recreation Building, University Park, PA, 16802, USA.
| | - Ashley N Linden-Carmichael
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, PA, USA
| | - Stephanie T Lanza
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, USA
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, PA, USA
| | - Kathryn H Schmitz
- Department of Public Health Sciences, College of Medicine, The Pennsylvania State University, Hershey, PA, USA
| | - Scherezade K Mama
- Department of Kinesiology, The Pennsylvania State University, 23B Recreation Building, University Park, PA, 16802, USA
- Penn State Cancer Institute, Hershey, PA, USA
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30
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Tay MRJ, Wong CJ. Cancer Rehabilitation-Improving Cancer Survivorship in Singapore. Asia Pac J Oncol Nurs 2021; 8:346-348. [PMID: 34159225 PMCID: PMC8186382 DOI: 10.4103/apjon.apjon-2115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 03/30/2021] [Indexed: 11/07/2022] Open
Affiliation(s)
- Matthew Rong Jie Tay
- Department of Rehabilitation Medicine, Tan Tock Seng Hospital, Singapore.,Singapore Cancer Society Rehabilitation Centre, Singapore Cancer Society, Singapore
| | - Chin Jung Wong
- Department of Rehabilitation Medicine, Tan Tock Seng Hospital, Singapore.,Singapore Cancer Society Rehabilitation Centre, Singapore Cancer Society, Singapore
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31
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Clinical Effects of Baduanjin Qigong Exercise on Cancer Patients: A Systematic Review and Meta-Analysis on Randomized Controlled Trials. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:6651238. [PMID: 33880125 PMCID: PMC8049783 DOI: 10.1155/2021/6651238] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 03/06/2021] [Accepted: 03/20/2021] [Indexed: 11/17/2022]
Abstract
Objective Baduanjin is a traditional Chinese Qigong exercise for health improvement. However, a few studies were examining the association between Baduanjin Qigong exercise and cancer patients. This study is conducted to explore the clinical effects of the Baduanjin Qigong exercise among cancer patients. Methods We conducted a systematic review and meta-analysis using randomized controlled trials to assess the effects of the Baduanjin Qigong exercise on cancer patients. We searched Cochrane Library, PubMed, Embase, and Airiti Library for all relevant studies from inception through December 31, 2020, without language limitations. Two authors independently screened selected studies, assessed the quality of included studies, and extracted information. Any disagreement was discussed with a third senior author. Summary estimates were obtained using meta-analysis with the random effects model. Results Among the fourteen articles involved in the systematic review, ten studies were included in the meta-analysis. Cancer patients with moderate-severe cancer-related fatigue were significantly less in the Baduanjin group compared with the control group (odds ratio = 0.27; 95% confidence interval (CI) [0.17, 0.42]). Three studies used the questionnaire of Functional Assessment of Cancer Therapy-Breast Cancer (FACT-B) in the assessment of quality of life, and two used the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). For FACT-B, the Baduanjin group scored significantly higher than the control group (mean difference = 11.04, 95% CI [9.56, 12.53]). For EORTC QLQ-C30, the Baduanjin group scored significantly higher than the control group (mean difference = 10.57, 95% CI [7.82, 13.32]). The Pittsburgh Sleep Quality Index (PSQI) score for sleep quality of the Baduanjin group is significantly lower than the control group (mean difference = −2.89, 95% CI [−3.48, −2.30]). Conclusion In conclusion, we found the Baduanjin exercise had positive clinical effects on cancer patients. This meta-analysis not only supported that the Baduanjin exercise can alleviate the degree of cancer-related fatigue in patients but also improved their quality of life and sleep quality. Further long-term follow-up randomized controlled trials are warranted.
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32
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Smoak P, Flores V, Harman N, Lisano J, Hayward R, Stewart LK. Structured Exercise in Cancer Survivors: Is it Enough for Neural, Mental Health and Well-being? INTERNATIONAL JOURNAL OF EXERCISE SCIENCE 2021; 14:162-176. [PMID: 34055157 PMCID: PMC8136549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The purpose of this cross-sectional study was to explore physical activity, depression, fatigue, and quality of life (QOL), and their relationship to brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) in cancer survivors enrolled in a structured exercise program. Participants were recruited into two groups: in-treatment (IT), currently receiving chemotherapy and/or radiotherapy, and out of treatment (OT), not undergoing therapy. Participants wore accelerometers for 7 days and completed cardiorespiratory fitness, muscular strength, and depression, fatigue, and QOL assessments. Circulating BDNF and NGF concentrations were obtained using enzyme-linked immunosorbent assays. Thirty-two participants (IT: n = 13, OT: n = 19) with an average age of 63 years and BMI of 27.5, spent 78% of their waking hours engaged in sedentary behavior outside of exercise training. Significant correlations were observed between light physical activity (LPA) outside of exercise training and QOL in IT (r = 0.626, p = 0.030), and fatigue in OT (r = 0.553, p = 0.021). Moderate to vigorous physical activity (MVPA) outside of exercise training significantly correlated with leg press strength (r = 0.700, p = 0.008) in IT, and cardiorespiratory fitness (r = 0.440, p = 0.013) when groups were combined. Concentrations of NGF did not differ between groups, and in IT, BDNF was positively related to LPA outside of training and was significantly lower (87 ± 28.5 pg/mL) than in OT (137 ± 54 pg/mL; p=0.010). While structured exercise programs should focus on improving cardiorespiratory fitness and muscular strength during exercise training, these programs should consider physical activity outside of training, if well-tolerated, to potentially further lower fatigue and improve QOL in cancer survivors.
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Affiliation(s)
- Peter Smoak
- School of Sport and Exercise Science, University of Northern Colorado, Greeley, CO, USA
| | - Victoria Flores
- School of Sport and Exercise Science, University of Northern Colorado, Greeley, CO, USA
| | - Nicholas Harman
- University of Northern Colorado Cancer Rehabilitation Institute, Greeley, CO, USA
| | - Jonathon Lisano
- School of Sport and Exercise Science, University of Northern Colorado, Greeley, CO, USA
| | - Reid Hayward
- University of Northern Colorado Cancer Rehabilitation Institute, Greeley, CO, USA
| | - Laura K Stewart
- School of Sport and Exercise Science, University of Northern Colorado, Greeley, CO, USA
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Arana Echarri A, Beresford M, Campbell JP, Jones RH, Butler R, Gollob KJ, Brum PC, Thompson D, Turner JE. A Phenomic Perspective on Factors Influencing Breast Cancer Treatment: Integrating Aging and Lifestyle in Blood and Tissue Biomarker Profiling. Front Immunol 2021; 11:616188. [PMID: 33597950 PMCID: PMC7882710 DOI: 10.3389/fimmu.2020.616188] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 12/11/2020] [Indexed: 01/10/2023] Open
Abstract
Breast cancer is the most common malignancy among women worldwide. Over the last four decades, diagnostic and therapeutic procedures have improved substantially, giving patients with localized disease a better chance of cure, and those with more advanced cancer, longer periods of disease control and survival. However, understanding and managing heterogeneity in the clinical response exhibited by patients remains a challenge. For some treatments, biomarkers are available to inform therapeutic options, assess pathological response and predict clinical outcomes. Nevertheless, some measurements are not employed universally and lack sensitivity and specificity, which might be influenced by tissue-specific alterations associated with aging and lifestyle. The first part of this article summarizes available and emerging biomarkers for clinical use, such as measurements that can be made in tumor biopsies or blood samples, including so-called liquid biopsies. The second part of this article outlines underappreciated factors that could influence the interpretation of these clinical measurements and affect treatment outcomes. For example, it has been shown that both adiposity and physical activity can modify the characteristics of tumors and surrounding tissues. In addition, evidence shows that inflammaging and immunosenescence interact with treatment and clinical outcomes and could be considered prognostic and predictive factors independently. In summary, changes to blood and tissues that reflect aging and patient characteristics, including lifestyle, are not commonly considered clinically or in research, either for practical reasons or because the supporting evidence base is developing. Thus, an aim of this article is to encourage an integrative phenomic approach in oncology research and clinical management.
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Affiliation(s)
| | - Mark Beresford
- Department of Oncology and Haematology, Royal United Hospitals Bath NHS Trust, Bath, United Kingdom
| | | | - Robert H. Jones
- Department of Medical Oncology, Velindre Cancer Centre, Cardiff, United Kingdom
- Department of Cancer and Genetics, Cardiff University, Cardiff, United Kingdom
| | - Rachel Butler
- South West Genomics Laboratory Hub, North Bristol NHS Trust, Bristol, United Kingdom
| | - Kenneth J. Gollob
- International Center for Research, A.C.Camargo Cancer Center, São Paulo, Brazil
| | - Patricia C. Brum
- School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Dylan Thompson
- Department for Health, University of Bath, Bath, United Kingdom
| | - James E. Turner
- Department for Health, University of Bath, Bath, United Kingdom
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Wang HL, Donovan KA, Rajasekhara S, Padhya T, Buck HG, Szalacha L, Chang JM, Brown JD, Smith B. The pre-efficacy phase testing for PAfitME™-A behavioral physical activity intervention to manage moderate and severe symptoms among advanced stage cancer patients. Res Nurs Health 2020; 44:238-249. [PMID: 33373078 DOI: 10.1002/nur.22099] [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: 06/03/2020] [Revised: 11/19/2020] [Accepted: 12/05/2020] [Indexed: 11/08/2022]
Abstract
Fatigue and pain are the most frequently reported symptoms among advanced-stage cancer patients. Although physical activity (PA) is known to improve the aforementioned symptoms, few patients demonstrate the physically active behavior that adheres to the clinical guidelines regarding PA. The current article presents an exemplar that used the National Institute of Health's Obesity-Related Behavioral Intervention Trial (ORBIT) model and developed a behavioral intervention known as the personalized Physical Activity intervention with fitness graded Motion Exergames (PAfitME™). There were two phases of testing in the ORBIT model presented in the current paper. In Phase I testing, a standardized exergame prescription was evaluated by an advisory board and a single-case study was used to evaluate the personalized exergame prescription with personalization of the fitness levels. In Phase IIa, a within-group pre- and posttest design was used to evaluate the personalized exergame prescriptions with personalization of the fitness levels, self-efficacy, and variation in fatigue/pain. Subsequently, a complete intervention package was developed in accordance with a logic model, driven from the result of the Phase IIa testing with clinically significant findings. Currently, PAfitME™ is under Phase IIb testing in a randomized clinical trial with a control group. PAfitME™ employs a personalized approach to initiate and promote physically active behavior, to facilitate the management of fatigue and pain in cancer patients. Positive results from an efficacy trial would support the use of PAfitME™ in the management of fatigue and pain in advanced-stage cancer patients.
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Affiliation(s)
- Hsiao-Lan Wang
- College of Nursing, University of South Florida, Tampa, Florida, USA
| | | | | | - Tapan Padhya
- College of Medicine, University of South Florida, Tampa, Florida, USA
| | - Harleah G Buck
- College of Nursing, University of South Florida, Tampa, Florida, USA
| | - Laura Szalacha
- College of Nursing, University of South Florida, Tampa, Florida, USA
| | - J Morris Chang
- College of Engineering, University of South Florida, Tampa, Florida, USA
| | - Jaelyn D Brown
- College of Nursing, University of South Florida, Tampa, Florida, USA
| | - Barbara Smith
- College of Nursing, University of South Florida, Tampa, Florida, USA
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Shaw S, Atkinson K, Jones LM. Cancer survivors' experiences of an exercise program during treatment and while employed: A qualitative pilot study. Health Promot J Austr 2020; 32 Suppl 2:378-383. [PMID: 33305519 DOI: 10.1002/hpja.447] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 12/07/2020] [Indexed: 11/07/2022] Open
Abstract
ISSUE ADDRESSED This study examined breast cancer survivors' (BCS) views on the role of exercise therapy while they were working in employment during cancer treatment. METHODS Research was undertaken with five participants who undertook an exercise programme as adjuvant care during treatment for breast cancer. Four female and one male client, the only clients who met the criteria for study in the clinic, were interviewed twice each during a two-month period. Participants wrote diaries to supplement the interview data and provide prompts for the second interview. An interpretive paradigm was used to identify themes for analysis. A multiple coding approach was used to interpret the data. The study was conducted at a small breast cancer recovery clinic, situated at a university in the South Island of New Zealand. RESULTS Participants reported that exercise was essential to their ability to work through the active treatment phase and provided positive effects on social, mental and emotional well-being. CONCLUSIONS Exercise therapy is an important element of enabling to work during treatment, for physical, mental and social well-being. SO WHAT?: Future research is required on support for employers to enable exercise therapy for employees; the needs of self-employed patients; tailoring exercise therapy for patients for whom social support is not a primary motivation; and the place of a clinic as a 'middle-ground' between social and emotional support and an exercise clinic.
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Affiliation(s)
- Sally Shaw
- School of Physical Education, Sport & Exercise Sciences, University of Otago, Dunedin, New Zealand
| | - Katy Atkinson
- School of Physical Education, Sport & Exercise Sciences, University of Otago, Dunedin, New Zealand
| | - Lynnette M Jones
- School of Physical Education, Sport & Exercise Sciences, University of Otago, Dunedin, New Zealand
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Exercise Reduces the Resumption of Tumor Growth and Proteolytic Pathways in the Skeletal Muscle of Mice Following Chemotherapy. Cancers (Basel) 2020; 12:cancers12113466. [PMID: 33233839 PMCID: PMC7699885 DOI: 10.3390/cancers12113466] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 11/09/2020] [Accepted: 11/12/2020] [Indexed: 12/14/2022] Open
Abstract
Simple Summary Doxorubicin is a chemotherapeutic agent that contributes to muscle wasting. Based on the evidence that many cancer variants are associated with cachexia and that cancer patients are usually treated with chemotherapeutic agents, it is important to determine strategies to mitigate muscle atrophy. Muscle loss is a poor prognosis during cancer treatment, and exercise has emerged as a potential strategy utilized in this context. Once an ongoing regimen of chemotherapeutic treatment is not always possible, our results demonstrated that continuity of endurance exercise is a potential strategy that can be adopted when chemotherapy needs to be interrupted, minimizing the resumption of tumor growth and avoiding muscle loss. Abstract The pathogenesis of muscle atrophy plays a central role in cancer cachexia, and chemotherapy contributes to this condition. Therefore, the present study aimed to evaluate the effects of endurance exercise on time-dependent muscle atrophy caused by doxorubicin. For this, C57 BL/6 mice were subcutaneously inoculated with Lewis lung carcinoma cells (LLC group). One week after the tumor establishment, a group of these animals initiated the doxorubicin chemotherapy alone (LLC + DOX group) or combined with endurance exercise (LLC + DOX + EXER group). One group of animals was euthanized after the chemotherapy cycle, whereas the remaining animals were euthanized one week after the last administration of doxorubicin. The practice of exercise combined with chemotherapy showed beneficial effects such as a decrease in tumor growth rate after chemotherapy interruption and amelioration of premature death due to doxorubicin toxicity. Moreover, the protein degradation levels in mice undergoing exercise returned to basal levels after chemotherapy; in contrast, the mice treated with doxorubicin alone experienced an increase in the mRNA expression levels of the proteolytic pathways in gastrocnemius muscle (Trim63, Fbxo32, Myostatin, FoxO). Collectively, our results suggest that endurance exercise could be utilized during and after chemotherapy for mitigating muscle atrophy promoted by doxorubicin and avoid the resumption of tumor growth.
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Cairo J, Williams L, Bray L, Goetzke K, Perez AC. Evaluation of a Mobile Health Intervention to Improve Wellness Outcomes for Breast Cancer Survivors. J Patient Cent Res Rev 2020; 7:313-322. [PMID: 33163551 DOI: 10.17294/2330-0698.1733] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Purpose Breast cancer survivors are at increased risk of cancer recurrence, second malignancies, and other comorbid conditions. This study examined if use of a convenient, commercially available, $65 per month app that gives breast cancer survivors access to a health and wellness coach is more effective than a self-guided toolkit and one-time health education session at achieving the following goals: 1) improving adherence to a plant-based diet, 2) increasing physical activity, 3) assisting with weight loss and reduction in body mass index, 4) reducing elevated depression and fatigue scores, and 5) leading to sustained adherence to lifestyle and wellness plan at and beyond 6 months. Methods A nonrandomized 2-group control study design with pre-post repeated measures (N=127 subjects) was utilized. Women 18 years of age or older, with curative-intent breast cancer, were included in the study. App users received a survivorship care plan and enrolled in a 6-month subscription to the health app. A control group received the same information but, instead of access to the app, were given a self-guided toolkit. Results At 6 months, more patients in the app group experienced weight loss and had a significantly greater reduction in overall body mass index (P<0.01). The app group also demonstrated statistically significant improvements in "strenuous" physical activity (P=0.04) and had significant improvement in their dietary patterns (P<0.001), as compared to the self-guided group. The app group had greater reduction in fatigue and improvement in depression, but these changes were not statistically significant. At 12 months, none of the app users were still using the app, but many were still following their wellness plan and had maintained their weight loss. Outliers in both groups and low rate of response made evaluation of results difficult. Conclusions The results of this advanced practice provider-led study demonstrated that a live health coaching app that provides wellness coaching can offer motivated breast cancer survivors and cancer programs a modality that offers convenient, effective support at a reasonable cost.
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Affiliation(s)
- Jamie Cairo
- Aurora Cancer Care, Advocate Aurora Health, Milwaukee, WI
| | | | - Lisa Bray
- Aurora Cancer Care, Advocate Aurora Health, Milwaukee, WI
| | | | - Ana Cristina Perez
- Advocate Aurora Research Institute, Advocate Aurora Health, Milwaukee, WI
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Patel DI, Gallegos AM, Sheikh B, Vardeman S, Liss MA. A randomized controlled trial of a home-based exercise program on prognostic biomarkers in men with prostate cancer: A study protocol. Contemp Clin Trials Commun 2020; 20:100659. [PMID: 33083630 PMCID: PMC7554354 DOI: 10.1016/j.conctc.2020.100659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 09/04/2020] [Accepted: 09/29/2020] [Indexed: 11/28/2022] Open
Abstract
Background Herein, we propose a novel RCT study to collect preliminary data on the impact of a 24-week home-based exercise program that can improve prognosis, physical function, and quality of life (QoL) in men with prostate cancer (PCa). This study will provide data on the feasibility of conducting a home-based exercise study and pilot data on the impact of exercise on circulating concentrations of biomarkers reported in the literature to be beneficial for the prognostication of PCa. Methods/design Thirty male patients, clinically-diagnosed with prostate cancer under active surveillance, will be recruited to participate in a 2-arm, 24-week home-based program. Random allocation to each arm - intervention, and control – will be performed in a 1:1 ratio. Participants assigned to the intervention group will perform 30 min of light-to-moderate intensity walking five days a week (40–60% heart rate reserve) and three sets of 15 repetitions of light callisthenic exercises (bodyweight squats, incline push-ups, and hip thrusts) 3 days a week. Participants randomized to the control group will maintain normal activity throughout the 24 weeks. Four visits occurring at baseline, 12-, 18-, and 24-weeks will be used to assess QoL, body composition, prognostic biomarker concentrations, and overall physical function. Primary endpoints include significant changes in prognostic biomarkers. Secondary endpoints include changes in quality of life, physical function and body composition. Discussion This study should demonstrate preliminary evidence that a home-based exercise intervention can impact biomarkers of progression while improving quality of life, physical function and body composition. Results from this study have the potential to promote health and wellness while minimizing cancer progression in men with PCa.
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Affiliation(s)
- Darpan I Patel
- School of Nursing, University of Texas Health at San Antonio, San Antonio, TX, 78229, USA.,Mays Cancer Center at UT Health San Antonio, University of Texas Health at San Antonio, San Antonio, TX, 78229, USA.,Barshop Institute for Longevity and Aging Studies, The University of Texas Health at San Antonio, San Antonio, TX, 78229, USA.,South Texas Veterans Health Care System, San Antonio, TX, 78229, USA
| | - Amber M Gallegos
- School of Nursing, University of Texas Health at San Antonio, San Antonio, TX, 78229, USA
| | - Bilal Sheikh
- School of Nursing, University of Texas Health at San Antonio, San Antonio, TX, 78229, USA
| | - Sarah Vardeman
- School of Nursing, University of Texas Health at San Antonio, San Antonio, TX, 78229, USA
| | - Michael A Liss
- Department of Urology, School of Medicine, University of Texas Health at San Antonio, San Antonio, TX, 78229, USA.,South Texas Veterans Health Care System, San Antonio, TX, 78229, USA
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Ethnic and biological differences in the association between physical activity and survival after breast cancer. NPJ Breast Cancer 2020; 6:51. [PMID: 33083530 PMCID: PMC7547070 DOI: 10.1038/s41523-020-00194-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 09/08/2020] [Indexed: 12/25/2022] Open
Abstract
Physical activity is recommended for most cancer patients as a nonpharmacological therapy to improve prognosis. Few studies have investigated the association between physical activity and breast cancer prognosis by ethnicity, biological, and modifiable risk factors for mortality. We investigated the association between physical activity and long-term survival among breast cancer survivors. A total of 397 survivors (96 Hispanic and 301 non-Hispanic White (NHW)) from the New Mexico HEAL study contributed baseline and biological data approximately 6 months after diagnosis. Study outcomes included all-cause, breast cancer-specific, and non-breast cancer mortality. The exposure was self-reported physical activity within the past month. Multivariable hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox Proportional Hazards regression. A total of 133 deaths (53 breast cancer-specific deaths) were observed after a median follow-up time of 13 years. Engaging in >6.9 metabolic equivalent hours/week (MET-h/week) of moderate to vigorous physical activity (active) was inversely associated with all-cause mortality among all women (HR 0.66, 95% CI 0.43-0.99) and NHWs (HR 0.58, 95% CI 0.36-0.94). Active NHW women also had a reduced risk of non-breast cancer mortality (HR 0.56, 95% CI 0.31-0.99), compared to inactive women (0 MET-h/week). In subgroups, we observed the inverse associations with all-cause mortality among women >58 years old (p-interaction= 0.03) and with localized stage (p-interaction = 0.046). Our results confirm the protective association between physical activity and mortality after breast cancer diagnosis, and demonstrate that this association significantly differs by age and cancer stage. Larger studies are warranted to substantiate our findings.
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Rastogi S, Tevaarwerk AJ, Sesto M, Van Remortel B, Date P, Gangnon R, Thraen-Borowski K, Cadmus-Bertram L. Effect of a technology-supported physical activity intervention on health-related quality of life, sleep, and processes of behavior change in cancer survivors: A randomized controlled trial. Psychooncology 2020; 29:1917-1926. [PMID: 32808383 DOI: 10.1002/pon.5524] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 07/10/2020] [Accepted: 07/28/2020] [Indexed: 01/22/2023]
Abstract
OBJECTIVES This pilot trial tested the effect of adding a multi-level, technology-based physical activity intervention module to a standard survivorship care plan for breast and colorectal cancer survivors. The objective of this analysis was to determine whether the physical activity module improved health-related quality of life, sleep, and factors key to lasting behavior change (eg, social support, self-efficacy). METHODS Breast and colorectal cancer survivors (n = 50) were enrolled alongside a support partner. Survivors were assigned to receive a standard survivorship care plan either alone or augmented by a 12-week multi-component physical activity module. The module included a Fitbit tracker (with the physical activity data integrated into the electronic health record for clinician review) and customized email feedback. Physical activity was measured using the ActiGraph GT3X+. Psychosocial outcomes included the SF-36, FACT, ISEL, PROMIS sleep measures, and physical activity beliefs. Data were analyzed using linear mixed modeling. RESULTS Cancer survivors were aged 54.4 ± 11.2 years and were 2.0 ± 1.5 years from diagnosis. Relative to comparison, the intervention was associated with moderate-to-large improvements in physical health (effect size: d = 0.39, 95% CI = 0.0, 0.78), mental health (d = 0.59, 95% CI = 0.19, 0.99), sleep impairment (d = 0.62, 95% CI = -1.02, -0.22), and exercise self-efficacy (d = 0.60, 95% CI = 0.20, 1.0). CONCLUSIONS The intervention delivered meaningful improvements in survivors' quality of life, social support, and sleep impairment. If replicated in a larger sample, adding a technology-supported physical activity module to survivorship care plans may be a practical strategy for supporting healthy survivorship. TRIAL REGISTRATION ClinicalTrials.gov#: NCT02677389.
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Affiliation(s)
- Somya Rastogi
- Department of Kinesiology, University of Wisconsin, Madison, Wisconsin, USA
| | | | - Mary Sesto
- Department of Medicine, University of Wisconsin, Madison, USA
| | - Brittany Van Remortel
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Preshita Date
- Department of Anesthesiology, Montefiore Medical Center, The Bronx, New York, USA
| | - Ronald Gangnon
- Department of Population Health Sciences, University of Wisconsin, Madison, USA
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Clemens KS, Tull MT, Murray AB, Boardley D, Tipton J, Geers AL. Examination of the relationship between affect, values, and physical activity among cancer survivors. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2020. [DOI: 10.1016/j.jcbs.2020.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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IJsbrandy C, Ottevanger PB, Gerritsen WR, van Harten WH, Hermens RPMG. Determinants of adherence to physical cancer rehabilitation guidelines among cancer patients and cancer centers: a cross-sectional observational study. J Cancer Surviv 2020; 15:163-177. [PMID: 32986232 PMCID: PMC7822788 DOI: 10.1007/s11764-020-00921-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 07/25/2020] [Indexed: 12/14/2022]
Abstract
PURPOSE To tailor implementation strategies that maximize adherence to physical cancer rehabilitation (PCR) guidelines, greater knowledge concerning determinants of adherence to those guidelines is needed. To this end, we assessed the determinants of adherence to PCR guidelines in the patient and cancer center. METHODS We investigated adherence variation of PCR guideline-based indicators regarding [1] screening with the Distress Thermometer (DT), [2] information provision concerning physical activity (PA) and physical cancer rehabilitation programs (PCRPs), [3] advice to take part in PA and PCRPs, [4] referral to PCRPs, [5] participation in PCRPs, and [6] PA uptake (PAU) in nine cancer centers. Furthermore, we assessed patient and cancer center characteristics as possible determinants of adherence. Regression analyses were used to determine associations between guideline adherence and patient and cancer center characteristics. In these analyses, we assumed the patient (level 1) nested within the cancer center (level 2). RESULTS Nine hundred and ninety-nine patients diagnosed with cancer between January 2014 and June 2015 were included. Of the 999 patients included in the study, 468 (47%) received screening with the DT and 427 (44%) received information provision concerning PA and PCRPs. Subsequently, 550 (56%) patients were advised to take part in PA and PCRPs, which resulted in 174 (18%) official referrals. Ultimately, 280 (29%) patients participated in PCRPs, and 446 (45%) started PAU. Screening with the DT was significantly associated with information provision concerning PA and PCRPs (OR 1.99, 95% CI 1.47-2.71), advice to take part in PA and PCRPs (OR 1.79, 95% CI 1.31-2.45), referral to PCRPs (OR 1.81, 95% CI 1.18-2.78), participation in PCRPs (OR 2.04, 95% CI 1.43-2.91), and PAU (OR 1.69, 95% CI 1.25-2.29). Younger age, male gender, breast cancer as the tumor type, ≥2 cancer treatments, post-cancer treatment weight gain/loss, employment, and fatigue were determinants of guideline adherence. Less variation in scores of the indicators between the different cancer centers was found. This variation between centers was too low to detect any association between center characteristics with the indicators. CONCLUSIONS The implementation of PCR guidelines is in need of improvement. We found determinants at the patient level associated with guideline-based PCR care. IMPLICATIONS FOR CANCER SURVIVORS Implementation strategies that deal with the determinants of adherence to PCR guidelines might improve the implementation of PCR guidelines and the quality of life of cancer survivors.
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Affiliation(s)
- Charlotte IJsbrandy
- Scientific Institute for Quality of Healthcare (IQ Healthcare), Radboud Institute for Health Science (RIHS), Radboud University Medical Center Nijmegen, PO Box 9101, Nijmegen, 6500, HB, The Netherlands. .,Department of Medical Oncology, Radboud Institute for Health Science (RIHS), Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands. .,Department of Radiation Oncology, Radboud Institute for Health Science (RIHS), Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Petronella B Ottevanger
- Department of Medical Oncology, Radboud Institute for Health Science (RIHS), Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands
| | - Winald R Gerritsen
- Department of Medical Oncology, Radboud Institute for Health Science (RIHS), Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands
| | - Wim H van Harten
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands.,Department of Health Technology and Services Research, MB-HTSR, University of Twente, Enschede, The Netherlands
| | - Rosella P M G Hermens
- Scientific Institute for Quality of Healthcare (IQ Healthcare), Radboud Institute for Health Science (RIHS), Radboud University Medical Center Nijmegen, PO Box 9101, Nijmegen, 6500, HB, The Netherlands
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Vasbinder A, Reding KW, Wang D, Han CJ, Zaslavsky O, Langford D, Cespedes Feliciano EM, Barrington WE, Paskett ED. Postdiagnosis Physical Activity: Association With Long-Term Fatigue and Sleep Disturbance in Older Adult Breast Cancer Survivors. Clin J Oncol Nurs 2020; 24:381-391. [PMID: 32678375 DOI: 10.1188/20.cjon.381-391] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Physical activity is frequently proposed as an intervention to reduce fatigue and sleep disturbance in cancer survivors; however, the long-term effects of physical activity are often not reported, and older adults are typically excluded from these intervention studies. OBJECTIVES This article aimed to examine if postdiagnosis physical activity is associated with lower long-term fatigue and sleep disturbance in older adult breast cancer survivors. METHODS Data were analyzed of a prospective cohort of 440 breast cancer survivors aged 65 years or older from the Women's Health Initiative study. Multiple linear and logistic regression models were used to examine associations of physical activity with fatigue and sleep disturbance. FINDINGS Higher postdiagnosis physical activity was associated with lower long-term fatigue but was not associated with lower sleep disturbance after adjusting for demographics, cancer characteristics, and baseline measures.
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Codima A, das Neves Silva W, de Souza Borges AP, de Castro G. Exercise prescription for symptoms and quality of life improvements in lung cancer patients: a systematic review. Support Care Cancer 2020; 29:445-457. [PMID: 32388616 DOI: 10.1007/s00520-020-05499-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 04/24/2020] [Indexed: 12/25/2022]
Abstract
PURPOSE The purpose of this study was to conduct a systematic review to assess the effect of exercise on symptoms and quality of life in lung cancer patients. METHODS We conducted a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Medline, Embase, Scopus, Web of Science, and SciELO were searched for studies published from January 1998 to January 2019. The review included all randomized controlled trials that evaluated the effect of exercise on symptoms and quality of life of lung cancer patients. Two reviewers independently assessed the quality of all the included studies using the Physiotherapy Evidence Database scale. RESULTS In total, ten studies (835 participants) met all inclusion criteria. Three studies investigated the effect of exercise after lung resection, whereas four studies investigated it as a pre-surgery intervention. Two studies investigated the effect of exercise in patients under systemic treatment only, and one study included patients on diverse treatment plans. Exercise protocols consisted of different combinations of strength, aerobic, and inspiratory muscle training. Two trials, including 101 participants, found significant difference in quality of life between groups, favoring the intervention group; and five trials, including 549 participants, found significant inter-group differences in isolated symptoms, also favoring the intervention group. CONCLUSIONS Exercise can lead to improvements of symptoms and of quality of life in lung cancer survivors. Providing resistance training combined with high-intensity interval aerobic exercise after lung resection seems to be particularly effective. Further studies are warranted to investigate exercise for patients with poor performance status.
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Affiliation(s)
- Alberto Codima
- Faculdade de Medicina da Universidade de São Paulo (FMUSP), Av Dr. Arnaldo, 455, 4th floor, São Paulo, SP, 01246-903, Brazil
| | - Willian das Neves Silva
- Faculdade de Medicina da Universidade de São Paulo (FMUSP), Av Dr. Arnaldo, 455, 4th floor, São Paulo, SP, 01246-903, Brazil.,Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas da FMUSP, Av Dr. Arnaldo, 251, 5th floor, São Paulo, SP, 01246-000, Brazil
| | - Ana Paula de Souza Borges
- Faculdade de Medicina da Universidade de São Paulo (FMUSP), Av Dr. Arnaldo, 455, 4th floor, São Paulo, SP, 01246-903, Brazil.,Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas da FMUSP, Av Dr. Arnaldo, 251, 5th floor, São Paulo, SP, 01246-000, Brazil
| | - Gilberto de Castro
- Faculdade de Medicina da Universidade de São Paulo (FMUSP), Av Dr. Arnaldo, 455, 4th floor, São Paulo, SP, 01246-903, Brazil. .,Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas da FMUSP, Av Dr. Arnaldo, 251, 5th floor, São Paulo, SP, 01246-000, Brazil.
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Saif MW. Outstanding Outcome of Pancreatic Cancer: What Lessons Do We Learn. PANCREAS (FAIRFAX, VA.) 2020; 4:e012. [PMID: 32685869 PMCID: PMC7367552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Muhammad W. Saif
- Corresponding author: Muhammad W. Saif, MD, Professor, Deputy Physician-in-Chief, Northwell Health Cancer Institute and Donald and Barbara Zucker School of Medicine, Hofstra/Northwell, NY, USA; Tel. (516) 321-2238;
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Brown SA. Preventive Cardio-Oncology: The Time Has Come. Front Cardiovasc Med 2020; 6:187. [PMID: 31998754 PMCID: PMC6965025 DOI: 10.3389/fcvm.2019.00187] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 12/10/2019] [Indexed: 12/17/2022] Open
Affiliation(s)
- Sherry-Ann Brown
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, United States
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Exercise and Physical Activity in Patients with Osteosarcoma and Survivors. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1257:193-207. [PMID: 32483741 DOI: 10.1007/978-3-030-43032-0_16] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Exercise has the potential to positively affect patients with osteosarcoma by improvement of function, mitigation of disability, and maintenance of independence and quality of life. Exercise may also directly impact cancer treatment efficacy. This chapter examines the feasibility and use of exercise or physical activity as therapy in the treatment of osteosarcoma and its survivors. It additionally presents the benefits of physical activity as treatment and rehabilitation both preoperatively (prehabilitation) and postoperatively. This chapter will also discuss barriers to exercise and physical activity for patients with osteosarcoma and its survivors, emphasizing the need for a comprehensive and cohesive support system to promote its incorporation into patient treatment plans and ensure compliance.
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Ferioli M, Zauli G, Maiorano P, Milani D, Mirandola P, Neri LM. Role of physical exercise in the regulation of epigenetic mechanisms in inflammation, cancer, neurodegenerative diseases, and aging process. J Cell Physiol 2019; 234:14852-14864. [PMID: 30767204 DOI: 10.1002/jcp.28304] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 01/18/2019] [Accepted: 01/24/2019] [Indexed: 01/24/2023]
Abstract
The genetic heritage for decades has been considered to respond only to gene promoters or suppressors, with specific roles for oncogenes or tumor-suppressor genes. Epigenetics is progressively attracting increasing interest because it has demonstrated the capacity of these regulatory processes to regulate the gene expression without modifying gene sequence. Several factors may influence epigenetics, such as lifestyles including food selection. A role for physical exercise is emerging in the epigenetic regulation of gene expression. In this review, we resume physiological and pathological implications of epigenetic modification induced by the physical activity (PA). Inflammation and cancer mechanisms, immune system, central nervous system, and the aging process receive benefits due to PA through epigenetic mechanisms. Thus, the modulation of epigenetic processes by physical exercise positively influences prevention, development, and the course of inflammatory and cancer diseases, as well as neurodegenerative illnesses. This growing field of studies gives rise to a new role for PA as an option in prevention strategies and to integrate pharmacological therapeutic treatments.
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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
| | - Patrizia Maiorano
- Department of Medical Biotechnology, University of Siena, Siena, Italy
| | - Daniela Milani
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Prisco Mirandola
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Luca M Neri
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
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50
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Xin J, Wan Mahtar WNA, Siah PC, Miswan N, Khoo BY. Potential use of Pichia pastoris strain SMD1168H expressing DNA topoisomerase I in the screening of potential anti‑breast cancer agents. Mol Med Rep 2019; 19:5368-5376. [PMID: 31059050 PMCID: PMC6522884 DOI: 10.3892/mmr.2019.10201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Accepted: 02/28/2019] [Indexed: 11/05/2022] Open
Abstract
Cancer chemotherapy possesses high toxicity, particularly when a higher concentration of drugs is administered to patients. Therefore, searching for more effective compounds to reduce the toxicity of treatments, while still producing similar effects as current chemotherapy regimens, is required. Currently, the search for potential anticancer agents involves a random, inaccurate process with strategic deficits and a lack of specific targets. For this reason, the initial in vitro high‑throughput steps in the screening process should be reviewed for rapid identification of the compounds that may serve as anticancer agents. The present study aimed to investigate the potential use of the Pichia pastoris strain SMD1168H expressing DNA topoisomerase I (SMD1168H‑TOPOI) in a yeast‑based assay for screening potential anticancer agents. The cell density that indicated the growth of the recombinant yeast without treatment was first measured by spectrophotometry. Subsequently, the effects of glutamate (agonist) and camptothecin (antagonist) on the recombinant yeast cell density were investigated using the same approach, and finally, the effect of camptothecin on various cell lines was determined and compared with its effect on recombinant yeast. The current study demonstrated that growth was enhanced in SMD1168H‑TOPOI as compared with that in SMD1168H. Glutamate also enhanced the growth of the SMD1168H; however, the growth effect was not enhanced in SMD1168H‑TOPOI treated with glutamate. By contrast, camptothecin caused only lower cell density and growth throughout the treatment of SMD1168H‑TOPOI. The findings of the current study indicated that SMD1168H‑TOPOI has similar characteristics to MDA‑MB‑231 cells; therefore, it can be used in a yeast‑based assay to screen for more effective compounds that may inhibit the growth of highly metastatic breast cancer cells.
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Affiliation(s)
- Jian Xin
- Department of General Surgery, Taizhou First People's Hospital in Zhejiang Province, Taizhou, Zhejiang 318020, P.R. China
| | - Wan Nor Azlin Wan Mahtar
- Department of Microbiology, School of Biological Sciences, Universiti Sains Malaysia, 11800 Penang, Malaysia
| | - Poh Chiew Siah
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, 11800 Penang, Malaysia
| | - Noorizan Miswan
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, 11800 Penang, Malaysia
| | - Boon Yin Khoo
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, 11800 Penang, Malaysia
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