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Pinto BM, Dunsiger SI, Kindred M, Mitchell S, DeScenza V. Effects of a peer-led physical activity program on psychosocial outcomes among breast cancer survivors. Psychooncology 2024; 33:e6292. [PMID: 38282225 PMCID: PMC10829062 DOI: 10.1002/pon.6292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 12/11/2023] [Accepted: 12/28/2023] [Indexed: 01/30/2024]
Abstract
OBJECTIVE To examine the effects of three programs aimed at maintaining moderate-to-vigorous physical activity (MVPA) on breast cancer survivors' quality of life, physical functioning, fatigue and mood. METHODS 161 survivors participated in a 12-month randomized controlled study and were assigned to one of three groups: Reach Plus, Reach Plus Message, or Reach Plus Phone. All participants received the same intervention for the first 3 months (weekly calls from peer coach) for MVPA adoption. In Months 4-9, Reach Plus monitored MVPA and received feedback reports. Reach Plus Message monitored MVPA and received weekly text/email messages and feedback reports. Reach Plus Phone participants monitored MVPA and received monthly calls from coaches and feedback reports. Intervention delivery ended at 9 months. Assessments were obtained at baseline, 3, 6, 9, and 12-months. Analyses used a series of longitudinal mixed effects models with subject-specific intercepts. RESULTS All groups improved significantly across time on psychosocial measures. At 9 months, Reach Plus Message and Reach Plus Phone reported better physical functioning compared to Reach Plus (b = 8.27, 95% CI: [2.27, 14.27]; b = 4.89, 95% CI: [0.01, 10.53]) respectively). At 12 months, Reach Plus Message reported better physical functioning than Reach Plus (b = 4.52, 95% CI: [0.01, 9.75]. Participants who met national PA guidelines reported significantly lower fatigue and higher physical functioning (at 9 and 12 months), and improved mood (at 12 months). CONCLUSIONS MVPA maintenance via weekly messages or monthly coach calls improved physical functioning. Maintaining MVPA at or above national recommendations was associated with improved physical functioning, mood and less fatigue.
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Affiliation(s)
| | - Shira I Dunsiger
- Brown University School of Public Health, Providence, Rhode Island, USA
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2
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Natalucci V, Ferri Marini C, Lucertini F, Annibalini G, Sisti D, Vallorani L, Saltarelli R, Panico AR, Imperio M, Flori M, Busacca P, Villarini A, Donati Zeppa S, Agostini D, Monaldi S, Barocci S, Catalano V, Rocchi MBL, Benelli P, Stocchi V, Barbieri E, Emili R. Effect of a lifestyle intervention program's on breast cancer survivors' cardiometabolic health: Two-year follow-up. Heliyon 2023; 9:e21761. [PMID: 38027927 PMCID: PMC10651516 DOI: 10.1016/j.heliyon.2023.e21761] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 10/26/2023] [Accepted: 10/27/2023] [Indexed: 12/01/2023] Open
Abstract
The purpose of this study is to assess the cardiometabolic responses of a lifestyle intervention (LI) conducted at home among breast cancer (BC) survivors during the two years of COVID-19 pandemic. A 3-month LI focused on diet and exercise was performed on thirty BC survivors (women; stages 0-II; non-metastatic; aged 53.6 ± 7.6 years; non-physically active) with a risk factor related to metabolic/endocrine diseases. Anthropometrics, cardiorespiratory fitness (V ˙ O2max), physical activity level (PAL), adherence to the Mediterranean diet (MeDiet modified questionnaire), and several biomarkers (i.e., glycemia, insulin, insulin resistance [HOMA-IR] index, triglycerides, high- [HDL] and low- [LDL] density lipoproteins, total cholesterol, progesterone, testosterone, and hs-troponin) were evaluated before and 3-, 6-, 12-, and 24-month after the LI. Beneficial effects of the LI were observed on several variables (i.e., body mass index, waist circumference, MeDiet, PAL, V ˙ O2max, glycemia, insulin, HOMA-IR index, LDL, total cholesterol, triglycerides, testosterone) after 3-month. The significant effect on Mediterranean diet adherence and V ˙ O2max persisted up to the 24-month follow-up. Decreases in HOMA-IR index and triglycerides were observed up to 12-month, however did not persist afterward. This study provides evidence on the positive association between LI and cardiometabolic health in BC survivors.
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Affiliation(s)
- Valentina Natalucci
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Carlo Ferri Marini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Francesco Lucertini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Giosuè Annibalini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Davide Sisti
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Luciana Vallorani
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Roberta Saltarelli
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Andrea Rocco Panico
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Marta Imperio
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Marco Flori
- U.O.C. Cardiologia/UTIC, AST, Ospedale Santa Maria della Misericordia, 61029, Urbino, Italy
| | - Paolo Busacca
- U.O.C. Cardiologia/UTIC, AST, Ospedale Santa Maria della Misericordia, 61029, Urbino, Italy
| | - Anna Villarini
- Department of Medicine and Surgery, University of Perugia, Piazzale Settimio Gambuli, 06132, Perugia, Italy
| | - Sabrina Donati Zeppa
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Deborah Agostini
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Silvia Monaldi
- U.O.C. Oncologia Medica, AST, Ospedale Santa Maria della Misericordia, 61029, Urbino, Italy
| | - Simone Barocci
- U.O.C. Patologia Clinica, AST, Ospedale Santa Maria della Misericordia, 61029, Urbino, Italy
| | - Vincenzo Catalano
- U.O.C. Oncologia Medica, AST, Ospedale Santa Maria della Misericordia, 61029, Urbino, Italy
| | | | - Piero Benelli
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Vilberto Stocchi
- Department of Human Sciences for the Promotion of Quality of Life, University San Raffaele, 20132, Roma, Italy
| | - Elena Barbieri
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Rita Emili
- U.O.C. Oncologia Medica, AST, Ospedale Santa Maria della Misericordia, 61029, Urbino, Italy
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3
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Liang Z, Zhang M, Shi F, Wang C, Wang J, Yuan Y. Comparative efficacy of four exercise types on obesity-related outcomes in breast cancer survivors: A Bayesian network meta-analysis. Eur J Oncol Nurs 2023; 66:102423. [PMID: 37742423 DOI: 10.1016/j.ejon.2023.102423] [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: 07/18/2023] [Revised: 09/12/2023] [Accepted: 09/16/2023] [Indexed: 09/26/2023]
Abstract
PURPOSE Exercise training is associated with improving the prognosis of breast cancer survivors, but no studies have evaluated the optimal exercise intervention. We aimed to investigate the most effective exercise intervention to improve obesity-related outcomes in breast cancer survivors. METHODS A comprehensive search strategy was conducted in Medline, Embase, Web of Science, Cochrane Library, and Chinese biomedical literature databases from the time of library construction to April 2, 2023. We included randomized controlled trials reporting the effects of four types of exercise interventions (aerobic exercise; aerobic combined with resitance exercise, resitstance exercise and mind-body exercise ) on obesity-related outcomes in breast cancer survivors. A Bayesian network meta-analysis was used to analyze and rank the effectiveness of four exercise types. RESULTS A total of 76 randomized controlled trials that contained 5610 breast cancer survivors were included. The treatment effect of combined aerobic and resistance exercise (mean difference = -0.59; 95% credible interval: 1.15, -0.08) was significantly better than that of the control groups in terms of body mass index. For percentage of body fat, combined aerobic and resistance exercise (mean difference = -1.74; 95% credible interval: 0.87, -0.90) and aerobic exercise (mean difference = -1.16; 95% credible interval: 2.15, -0.16) were significantly better than controls. Subgroup analysis suggested that combined aerobic and resistance exercise significantly affected body mass index at an intervention duration >12 weeks or weekly time on exercise >150 min. CONCLUSION Our network meta-analysis found combined aerobic and resistance exercise may be the most effective intervention to improve obesity-related outcomes in breast cancer survivors. In addition, intervention duration and participant adherence are important factors that influence the effectiveness of exercise interventions.
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Affiliation(s)
- Zhide Liang
- Cancer Institute of the Affiliated Hospital of Qingdao University and Qingdao Cancer Institute, Qingdao, 266071, China.
| | - Meng Zhang
- Xi'an Physical Education University, Xi'an, 710068, China.
| | - Fang Shi
- School of Education and Physical Education, Yangtze University, Jingzhou, 434023, China.
| | - Chuanzhi Wang
- Department of Physical Education, College of Physical Education, Qingdao University, Qingdao, 266071, China.
| | - Jingtai Wang
- Department of Physical Education, College of Physical Education, Qingdao University, Qingdao, 266071, China.
| | - Yang Yuan
- Cancer Institute of the Affiliated Hospital of Qingdao University and Qingdao Cancer Institute, Qingdao, 266071, China.
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4
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Yang H, Liu L, Zhang X. Exercise interventions on body composition and quality of life of overweight/obese breast cancer survivors: a meta-analysis. BMC Womens Health 2023; 23:484. [PMID: 37700300 PMCID: PMC10498647 DOI: 10.1186/s12905-023-02627-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 08/29/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND This meta-analysis aimed to assess the effects of exercise interventions on body composition and quality of life in overweight/obese breast cancer survivors. METHODS Eligible randomized controlled trials (RCTs) were searched from the Cochrane Library, PubMed, and Embase databases and assessed using the Cochrane Collaboration's assessing risk tool. The effect size was pooled as weighted mean difference (WMD) for body composition variables (i.e., body mass index [BMI], body fat, body weight, fat mass, lean mass, bone mineral density) and quality of life (i.e., physical health and mental health), and the confidence interval (CI) was set as 95%. Since heterogeneity existed, subgroup analysis was conducted to detect the source of heterogeneity. RESULTS Eight articles from six RCTs containing 548 overweight/obese breast cancer survivors (BMI ≥ 25 kg/m2) were included and analyzed. Compared to routine care, exercise intervention significantly decreased the body mass index [WMD (95% CI) = -1.37 (-2.50, -0.23) kg/m2] and body fat [WMD (95% CI) = -3.80 (-6.59, -1.01) %] of overweight/obese breast cancer survivors. Exercise intervention showed a tendency to increase physical health [WMD (95% CI) = 2.65 (-10.19, 15.48)] and mental health [WMD (95%CI) = 1.38 (-4.18, 6.95)], but no statistical significance was observed. A subgroup analysis showed the duration of intervention was a source of heterogeneity on body composition. In the 16-week subgroup, exercise intervention decreased fat mass and BMI while increased lean mass and bone mineral density. The 52-week exercise intervention was effective in increasing lean mass. A significant exercise intervention effect on reducing body fat was only detected in the 12-week subgroup. CONCLUSION Exercise intervention significantly decreased the body mass index and body fat of overweight/obese breast cancer survivors. The benefits of exercise interventions for overweight/obese breast cancer survivors need more evidence from high-quality RCTs with large sample sizes.
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Affiliation(s)
- Hongchang Yang
- Physical Education Department, Hohai University, Nanjing, Jiangsu, China
| | - Li Liu
- Department of Rehabilitation, Brain Hospital Affiliated to Nanjing Medical University, No.264, Guangzhou Road, Gulou District, Nanjing, Jiangsu, China.
| | - Xiaoxia Zhang
- Department of Kinesiology, Centenary College of Louisiana, 2911 Centenary Blvd, Shreveport, LA, USA.
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Solk P, Song J, Welch WA, Spring B, Cella D, Penedo F, Ackermann R, Courneya KS, Siddique J, Freeman H, Starikovsky J, Mishory A, Alexander J, Wolter M, Carden L, Phillips SM. Effect of the Fit2Thrive Intervention on Patient-reported Outcomes in Breast Cancer Survivors: A Randomized Full Factorial Trial. Ann Behav Med 2023; 57:765-776. [PMID: 37203237 PMCID: PMC10441864 DOI: 10.1093/abm/kaad024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Abstract
BACKGROUND Moderate to vigorous physical activity (MVPA) interventions improve patient-reported outcomes (PROs) of physical and psychological health among breast cancer survivors (BCS); however, the effects of specific intervention components on PROs are unknown. PURPOSE To use the Multiphase Optimization Strategy (MOST) to examine overall effects of the Fit2Thrive MVPA promotion intervention on PROs in BCS and explore whether there are intervention component-specific effects on PROs. METHODS Physically inactive BCS [n = 269; Mage = 52.5 (SD = 9.9)] received a core intervention (Fitbit + Fit2Thrive smartphone app) and were randomly assigned to one of 32 conditions in a full factorial experiment of five components ("on" vs. "off"): (i) support calls, (ii) deluxe app, (iii) text messages, (iv) online gym, and (v) buddy. Patient-Reported Outcomes Measurement Information System (PROMIS) questionnaires assessed anxiety, depression, fatigue, physical functioning, sleep disturbance and sleep-related impairment at baseline, post-intervention (12-week), and 24-week follow-up. Main effects for all components at each time point were examined using an intention to treat mixed-effects model. RESULTS All PROMIS measures except sleep disturbance significantly improved (p's < .008 for all) from baseline to 12-weeks. Effects were maintained at 24-weeks. The "on" level of each component did not result in significantly greater improvements on any PROMIS measure compared to the "off" level. CONCLUSIONS Participation in Fit2Thrive was associated with improved PROs in BCS, but improvements did not differ for "on" vs. "off" levels for any component tested. The low-resource Fit2Thrive core intervention is a potential strategy to improve PROs among BCS. Future studies should test the core in an RCT and examine various intervention component effects in BCS with clinically elevated PROs.
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Affiliation(s)
- Payton Solk
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jing Song
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Whitney A Welch
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Bonnie Spring
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - David Cella
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Frank Penedo
- University of Miami Sylvester Comprehensive Cancer Center, Miami, FL, USA
| | - Ron Ackermann
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Kerry S Courneya
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Juned Siddique
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Hannah Freeman
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Julia Starikovsky
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Abby Mishory
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Melanie Wolter
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Lillian Carden
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Bucciarelli V, Bianco F, Di Blasio A, Morano T, Tuosto D, Mucedola F, Di Santo S, Cimini A, Napolitano G, Bucci I, Di Baldassarre A, Cianchetti E, Gallina S. Cardiometabolic Profile, Physical Activity, and Quality of Life in Breast Cancer Survivors after Different Physical Exercise Protocols: A 34-Month Follow-Up Study. J Clin Med 2023; 12:4795. [PMID: 37510910 PMCID: PMC10381308 DOI: 10.3390/jcm12144795] [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: 06/10/2023] [Revised: 07/15/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Breast cancer (BC) and cardiovascular (CV) disease share many risk factors associated with worse outcomes, in terms of cancer relapse, CV events, and quality of life (QoL), that could be counteracted by physical exercise (PE). We aimed to assess the impact of a 12-week differential PE protocol on cardiometabolic profile, QoL, CV- and BC-related long-term outcomes, and physical activity (PA) in a cohort of BC survivors (BCS) not treated with chemotherapy. METHODS 57 BCS participated in a 12-week PE protocol [aerobic exercise training (AET) or resistance exercise training (RET)]. Anthropometric and CV evaluation, health-related (HR)-QoL, daily PA, cortisol, and dehydroepiandrosterone sulfate (DHEA-S) levels were assessed before (T0) and after (T1) PE. We assessed BC and CV outcomes, HR-QoL, CV-QoL, and PA at the follow-up. RESULTS RET improved waist circumference, DHEA-S, cortisol/DHEA-S, systolic and mean blood pressure, and ventricular/arterial coupling; AET ameliorated sagittal abdomen diameter and pulse wave velocity. Regarding HR-QoL, physical function improved only in AET group. At a mean 34 ± 3.6-month follow-up, we documented no significant differences in CV-QoL, HR-QoL, and PA or CV and BC outcomes. CONCLUSIONS AET and RET determine specific, positive adaptations on many parameters strongly related to CV risk, CV and BC outcomes, and QoL, and should be included in any cardio-oncology rehabilitation program.
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Affiliation(s)
- Valentina Bucciarelli
- Cardiovascular Sciences Department-Azienda Ospedaliero-Universitaria delle Marche, 60126 Ancona, Italy
- Department of Neurosciences, Imaging and Clinical Sciences, "G. d'Annunzio" University, 66100 Chieti, Italy
| | - Francesco Bianco
- Cardiovascular Sciences Department-Azienda Ospedaliero-Universitaria delle Marche, 60126 Ancona, Italy
- Department of Neurosciences, Imaging and Clinical Sciences, "G. d'Annunzio" University, 66100 Chieti, Italy
| | - Andrea Di Blasio
- Department of Medicine and Aging Sciences, "G. d'Annunzio" University, 66100 Chieti, Italy
| | - Teresa Morano
- Department of Medicine and Aging Sciences, "G. d'Annunzio" University, 66100 Chieti, Italy
| | - Desiree Tuosto
- Department of Neurosciences, Imaging and Clinical Sciences, "G. d'Annunzio" University, 66100 Chieti, Italy
| | - Francesco Mucedola
- Department of Neurosciences, Imaging and Clinical Sciences, "G. d'Annunzio" University, 66100 Chieti, Italy
| | - Serena Di Santo
- Department of Medicine and Aging Sciences, "G. d'Annunzio" University, 66100 Chieti, Italy
| | - Alessandra Cimini
- Eusoma Breast Centre, "G. Bernabeo" Hospital, ASL02 Lanciano-Vasto-Chieti, 66026 Ortona, Italy
| | - Giorgio Napolitano
- Department of Medicine and Aging Sciences, "G. d'Annunzio" University, 66100 Chieti, Italy
| | - Ines Bucci
- Center for Advanced Studies and Technology (CAST), "G. d'Annunzio" University of Chieti-Pescara, 66100 Chieti, Italy
| | - Angela Di Baldassarre
- Department of Medicine and Aging Sciences, "G. d'Annunzio" University, 66100 Chieti, Italy
| | - Ettore Cianchetti
- Eusoma Breast Centre, "G. Bernabeo" Hospital, ASL02 Lanciano-Vasto-Chieti, 66026 Ortona, Italy
| | - Sabina Gallina
- Department of Neurosciences, Imaging and Clinical Sciences, "G. d'Annunzio" University, 66100 Chieti, Italy
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7
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Cartmel B, Li F, Zhou Y, Gottlieb L, Lu L, Mszar R, Harrigan M, Ligibel JA, Gogoi R, Schwartz PE, Risch HA, Irwin ML. Randomized trial of exercise on cancer-related blood biomarkers and survival in women with ovarian cancer. Cancer Med 2023; 12:15492-15503. [PMID: 37269192 PMCID: PMC10417064 DOI: 10.1002/cam4.6187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 04/13/2023] [Accepted: 05/21/2023] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND In randomized trials in women with breast cancer, exercise has been shown to have beneficial effects on cancer-related circulating biomarkers that may impact survival. Such studies are lacking for ovarian cancer. METHODS This secondary analysis of a published randomized controlled trial examined the impact of a 6-month exercise intervention versus attention-control on change in prespecified circulating biomarkers (cancer antigen 125 (CA-125), C-reactive protein (CRP), insulin-like growth factor-1(IGF-1), insulin and leptin) in a subset of participants who provided a fasting blood draw (N = 104/144) at enrollment and at 6 months. Change in biomarkers between study arms was compared using a linear mixed effects model analysis. An exploratory analysis of the exercise intervention versus attention-control on all-cause mortality included all (N = 144) participants. All statistical tests were two-sided. RESULTS Participants included in the biomarker analysis were 57.0 ± 8.8 (mean ± SD) years old and 1.6 ± 0.9 years post-diagnosis. Adherence to the exercise intervention was 176.4 ± 63.5 min/week. Post intervention IGF-1 (group difference in change: -14.2 (-26.1 to -2.3) ng/mL (least squared means (95% CI))) and leptin (-8.9 (-16.5 to -1.4) ng/mL) were significantly reduced in the exercise group (N = 53) compared to those in attention-control (N = 51). No group difference in change was seen for CA-125 (p = 0.54), CRP (p = 0.95), or insulin (p = 0.37). With median follow-up of 70 months [range 6.6-105.4 months], 50/144 (34.7%) (exercise group; 24/74 (32.4%) versus attention-control group; 26/70 (37.1%)) participants died with no between group difference in overall survival (p = 0.99). CONCLUSIONS Further studies are needed to determine the clinical significance of exercise-induced changes in cancer-related circulating biomarkers in women with ovarian cancer.
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Affiliation(s)
- Brenda Cartmel
- Department of Chronic Disease EpidemiologyYale School of Public HealthNew HavenConnecticutUSA
- Yale Cancer CenterNew HavenConnecticutUSA
| | - Fang‐yong Li
- Department of BiostatisticsYale School of Public HealthNew HavenConnecticutUSA
| | - Yang Zhou
- Department of Chronic Disease EpidemiologyYale School of Public HealthNew HavenConnecticutUSA
- Yale Cancer CenterNew HavenConnecticutUSA
| | - Linda Gottlieb
- Department of Chronic Disease EpidemiologyYale School of Public HealthNew HavenConnecticutUSA
| | - Lingeng Lu
- Department of Chronic Disease EpidemiologyYale School of Public HealthNew HavenConnecticutUSA
- Yale Cancer CenterNew HavenConnecticutUSA
| | - Reed Mszar
- Department of Chronic Disease EpidemiologyYale School of Public HealthNew HavenConnecticutUSA
| | - Maura Harrigan
- Department of Chronic Disease EpidemiologyYale School of Public HealthNew HavenConnecticutUSA
| | - Jennifer A. Ligibel
- Department of Medical OncologyDana‐Farber Cancer InstituteBostonMassachusettsUSA
| | - Radhika Gogoi
- Gynecologic Oncology, Women and Children's InstituteGeisinger Health SystemDanvillePennsylvaniaUSA
- Present address:
Department of Obstetrics & GynecologyWayne State UniversityDetroitMichiganUSA
| | - Peter E. Schwartz
- Yale Cancer CenterNew HavenConnecticutUSA
- Section of Medical Oncology, Department of Internal MedicineYale School of MedicineNew HavenConnecticutUSA
| | - Harvey A. Risch
- Department of Chronic Disease EpidemiologyYale School of Public HealthNew HavenConnecticutUSA
- Yale Cancer CenterNew HavenConnecticutUSA
| | - Melinda L. Irwin
- Department of Chronic Disease EpidemiologyYale School of Public HealthNew HavenConnecticutUSA
- Yale Cancer CenterNew HavenConnecticutUSA
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Petrigna L, Zanghì M, Maugeri G, D'Agata V, Musumeci G. Methodological consideration for a physical activity intervention in breast cancer population: An umbrella review. Heliyon 2023; 9:e17470. [PMID: 37455988 PMCID: PMC10338308 DOI: 10.1016/j.heliyon.2023.e17470] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 06/16/2023] [Accepted: 06/19/2023] [Indexed: 07/18/2023] Open
Abstract
Objective Breast cancer patients and survivors are increasing in the last years such as their mean age. A feasible and useful complementary intervention to improve physical and psychological health, and decrease some disease symptoms seems to be physical activity. Consequently, this umbrella review wanted to analyze the protocols of different physical activity interventions and to eventually propose a standard operating procedure for possible exercise training in breast cancer patients.Design, Data sources, Eligibility criteria. The electronic databases PubMed, Scopus, and Web of Science were searched till 25 March 2022 to detect all systematic review and meta-analysis of randomized controlled trials on this topic. The studies were analyzed narratively and evaluated with a scale to assess their quality. Results The studies presented heterogeneity in their population included in terms of disease stage and treatments, intervention protocols and outcomes evaluated. This made difficult to synthesize the findings. Conclusion It was not possible to propose a standard operating procedure but some indications were proposed to provide feedback for future studies. Ideally, an intervention should be composed of combined training (aerobic and resistance training) with a component of a mindfulness intervention, with an intensity from moderate to high, and 3 times a week. The intervention should be supervised in the first period and then it could be home-based. Exercise training should be personalized to the patients treated.
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Affiliation(s)
- Luca Petrigna
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology and Movement Science, School of Medicine, University of Catania, Via S. Sofia n°97, 95123, Catania, Italy
| | - Marta Zanghì
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology and Movement Science, School of Medicine, University of Catania, Via S. Sofia n°97, 95123, Catania, Italy
| | - Grazia Maugeri
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology and Movement Science, School of Medicine, University of Catania, Via S. Sofia n°97, 95123, Catania, Italy
| | - Velia D'Agata
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology and Movement Science, School of Medicine, University of Catania, Via S. Sofia n°97, 95123, Catania, Italy
| | - Giuseppe Musumeci
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology and Movement Science, School of Medicine, University of Catania, Via S. Sofia n°97, 95123, Catania, Italy
- Research Center on Motor Activities (CRAM), University of Catania, Via S. Sofia n°97, 95123, Catania, Italy
- Department of Biology, College of Science and Technology, Sbarro Health Research Organization, Temple University, Philadelphia, PA, 19122, USA
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9
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Garcia-Unciti M, Palacios Samper N, Méndez-Sandoval S, Idoate F, Ibáñez-Santos J. Effect of Combining Impact-Aerobic and Strength Exercise, and Dietary Habits on Body Composition in Breast Cancer Survivors Treated with Aromatase Inhibitors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4872. [PMID: 36981785 PMCID: PMC10049091 DOI: 10.3390/ijerph20064872] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/06/2023] [Accepted: 03/08/2023] [Indexed: 06/18/2023]
Abstract
This study examines both the effect of a twice-weekly combined exercise-1 h session of strength and 1 h session of impact-aerobic-on body composition and dietary habits after one year of treatment with aromatase inhibitors (AI) in breast cancer survivors. Overall, forty-three postmenopausal women with a BMI ≤ 35 kg/m2, breast cancer survivors treated with AI, were randomized into two groups: a control group (CG) (n = 22) and a training group (IG) (n = 21). Body composition, i.e., abdominal, visceral, and subcutaneous adipose tissue) was measured by magnetic resonance. In addition, some questionnaires were used to gather dietary data and to measure adherence to the Mediterranean diet. After one year, women in the IG showed a significant improvement in body composition, indicated by decreases in subcutaneous and visceral adipose tissue, and total fat tissue. Furthermore, the dietary habits were compatible with moderate adherence to the Mediterranean diet pattern and a low dietary intake of Ca, Zn, Folic Ac, and vitamins D, A, and E. A twice-weekly training program combining impact aerobic exercise and resistance exercise may be effective in improving the body composition for postmenopausal women who have breast cancer treated with AI, and the results suggest the need for nutritional counselling for this population.
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Affiliation(s)
- Marisol Garcia-Unciti
- Department of Nutrition, Food Sciences and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, Campus Universitario, 31008 Pamplona, Spain
- Center for Nutrition Research, University of Navarra, c/Irunlarrea 1, 31008 Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain
| | - Natalia Palacios Samper
- Centro de Estudios, Investigación y Medicina del Deporte (CEIMD), Gobierno de Navarra, 31005 Pamplona, Spain
- Department of Gerontology and Public Health, Faculty of Health Science, University of Jyväskylä, Seminaarinkatu 15, Jyväskylän Yliopisto, 40014 Jyväskylä, Finland
- Department of Physiology, Faculty of Health Science, Public University of Navarre, Av. Cataluña, s/n, 31006 Pamplona, Spain
| | - Sofía Méndez-Sandoval
- Department of Nutrition, Food Sciences and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, Campus Universitario, 31008 Pamplona, Spain
| | - Fernando Idoate
- Servicio de Radiología de la Mutua Navarra, 31012 Pamplona, Spain;
| | - Javier Ibáñez-Santos
- Centro de Estudios, Investigación y Medicina del Deporte (CEIMD), Gobierno de Navarra, 31005 Pamplona, Spain
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10
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Ryu J, Lee EY, Min J, Yeon S, Lee JW, Chu SH, Lee H, Kim SI, Kim JY, Park S, Jeon JY. Effect of a 1-year tailored exercise program according to cancer trajectories in patients with breast cancer: study protocol for a randomized controlled trial. BMC Cancer 2023; 23:200. [PMID: 36864418 PMCID: PMC9983270 DOI: 10.1186/s12885-023-10664-1] [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: 12/01/2022] [Accepted: 02/20/2023] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND Patients with breast cancer undergo various treatments according to their tumor subtype and cancer stages within 1 year after being diagnosed. Each treatment may cause treatment-related symptoms that have negative impacts on patients' health and quality of life (QoL) The symptoms can be mitigated when exercise interventions are appropriately applied to patients' physical and mental conditions. Although many exercise programs were developed and implemented during this period, the effects of tailored exercise programs according to symptoms and cancer trajectories on patients' long-term health outcomes have not yet been fully elucidated. Therefore, this randomized controlled trial (RCT) aims to investigate the effect of tailored home-based exercise programs on short-term and long-term physiological outcomes in patients with breast cancer. METHODS This 12-month RCT includes 96 patients with (stages 1-3) breast cancer randomly assigned to the exercise or control groups. Participants in the exercise group will receive an exercise program tailored to their phase of treatment, type of surgery, and physical function. During post-operative recovery, exercise interventions will be emphasized to improve shoulder range of motion (ROM) and strength. During chemoradiation therapy, exercise intervention will focus on improving physical function and preventing loss of muscle mass. Once chemoradiation therapy is completed, exercise intervention will focus on improving cardiopulmonary fitness and insulin resistance. All interventions will be home-based exercise programs supplemented with once-monthly exercise education and counseling sessions. The main outcome of the study is fasting insulin level at baseline, 6 months, and 1 year post-intervention. Our secondary outcomes include shoulder ROM and strength at 1 month and 3 months, body composition, inflammatory markers, microbiome, QoL, and physical activity levels at 1 month, 6 months, and 1 year post-intervention. CONCLUSION This trial is the first tailored home-based exercise oncology trial to better understand the comprehensive phase-dependent short- and long-term effects of exercise on shoulder function, body composition, fasting insulin, biomarkers, and microbiome. The results of this study will inform the development of effective exercise programs tailored to the needs of patients with breast cancer post-operatively. TRIAL REGISTRATION The protocol for this study is registered with the Korean Clinical Trials Registry (KCT0007853).
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Affiliation(s)
- Jiin Ryu
- grid.15444.300000 0004 0470 5454Department of Sport Industry Studies, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722 Republic of Korea
| | - Eun-Young Lee
- grid.410356.50000 0004 1936 8331School of Kinesiology & Health Studies, Queen’s University, Kingston, ON Canada
| | - Jihee Min
- grid.410914.90000 0004 0628 9810National Cancer Survivorship Center, National Cancer Center, Goyang, Republic of Korea
| | - Sujin Yeon
- grid.15444.300000 0004 0470 5454Department of Sport Industry Studies, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722 Republic of Korea
| | - Ji-Won Lee
- grid.15444.300000 0004 0470 5454Department of Family Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Sang Hui Chu
- grid.15444.300000 0004 0470 5454Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, Korea
| | - Hyangkyu Lee
- grid.15444.300000 0004 0470 5454Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, Korea
| | - Seung Il Kim
- grid.15444.300000 0004 0470 5454Division of Breast Surgery, Department of Surgery, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea
| | - Jee Ye Kim
- grid.15444.300000 0004 0470 5454Division of Breast Surgery, Department of Surgery, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea
| | - Seho Park
- Division of Breast Surgery, Department of Surgery, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea.
| | - Justin Y. Jeon
- grid.15444.300000 0004 0470 5454Department of Sport Industry Studies, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722 Republic of Korea ,grid.15444.300000 0004 0470 5454Exercise Medicine Center for Diabetes and Cancer Patients, ICONS, Yonsei University, Seoul, Republic of Korea ,grid.15444.300000 0004 0470 5454Cancer Prevention Center, Shinchon Severance Hospital, Yonsei Cancer Center, Yonsei University College of Medicine, Yonsei University, Seoul, Republic of Korea
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11
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Kaya C, Chan F, Iwanaga K, Wu JR, Bezyak J. A Psychometric Validation of the Impact on Participation and Autonomy Questionnaire in a Sample of Turkish Cancer Survivors. REHABILITATION COUNSELING BULLETIN 2023. [DOI: 10.1177/00343552221146160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Community participation and autonomy are two of the vital treatments and rehabilitation outcomes for people with chronic health conditions and disabilities, including people with cancer. The purpose of this study is to investigate psychometric properties of the Impact on Participation and Autonomy Scale (IPA) in a sample of Turkish cancer survivors. An exploratory factor analysis was used to analyze data collected from 186 cancer survivors who completed the IPA, Health Care Climate Questionnaire, Satisfaction with Life Scale, and the Role Functioning subscale of the EORTC Core Quality of Life Questionnaire. In contrast to the original five-factor solution, the results provided a better fit for a three-factor correlated model ( Activities of Daily Living [ADL]/ Instrumental ADL, social relations, and employment and education). The IPA factors were significantly associated with supportive healthcare climate, role functioning, and life satisfaction in the theoretically expected directions, providing support for the nomological construct validity of the Turkish version of the IPA. Overall, the Turkish version of the IPA is a psychometrically sound measure of participation and autonomy that can be used to assess cancer survivors’ levels of community participation for treatment planning and selection of evidence-based healthcare and psychosocial interventions for cancer survivors.
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Affiliation(s)
- Cahit Kaya
- University of Texas Rio Grande Valley, Edinburg, TX, USA
- Harran University, Sanliurfa, Turkey
| | - Fong Chan
- University of Wisconsin-Madison, USA
| | | | - Jia Rung Wu
- Northern Illinois University, DeKalb, IL, USA
| | - Jill Bezyak
- University of Northern Colorado, Greeley, USA
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12
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Han J, Jang MK, Lee H, Kim SY, Kim SH, Hee Ko Y, Song Y, Kang MJ, Jeon JY, Cho YU, Yi G, Kim S. Long Term Effects of a Social Capital-Based Exercise Adherence Intervention for Breast Cancer Survivors With Moderate Fatigue: A Randomized Controlled Trial. Integr Cancer Ther 2023; 22:15347354231209440. [PMID: 37965797 PMCID: PMC10652802 DOI: 10.1177/15347354231209440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 08/28/2023] [Accepted: 10/07/2023] [Indexed: 11/16/2023] Open
Abstract
OBJECTIVES This study reports on the long-term effects of the Better Life After Cancer: Energy, Strength, and Support (BLESS) program, a 12-week social capital-based exercise adherence program for breast cancer survivors (BCS), implemented using a randomized controlled trial design. The study investigated outcomes related to cancer-related fatigue (CRF), quality of life (QOL), physical activity, depression, anxiety, sleep quality, and social capital. METHODS Participants who had moderate or greater CRF were randomly assigned to the intervention (n = 24), consisting of supervised and home-based exercise, or the control (n = 26), who received exercise leaflets. Generalized estimating equations models were fitted for the outcome variables. The assessment points were baseline (M1), immediately after completing the intervention at 12 weeks (M2), 1 month (M3), and 6 months post-intervention (M4). RESULTS A significant reduction in the total CRF score was found for both groups. We observed a significant time by group effect at M2, indicating a reduction of behavioral/severity CRF scores and a higher increase of physical activity. Also, there was an increase in the QOL score of both groups at M2, M3, and M4, compared to M1. Both groups had reduced anxiety at M3 and M4 compared to M1. The time by group effect for depression, sleep quality and social capital was not statistically significant. CONCLUSION This 12-week exercise adherence program improved behavioral/severity CRF and physical activity post-intervention. Both the experimental group and control group showed significant improvements in CRF, QOL, and anxiety domains compared to the baseline, which extended to 6 months post-intervention. TRIAL REGISTRATION Korean Clinical Research Information Service (KCT0005763).
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Affiliation(s)
| | | | | | - Soo Yeon Kim
- Korea Armed Forces Nursing Academy, Daejeon, Korea
| | | | | | | | | | - Justin Y. Jeon
- Yonsei University, Seoul, Korea
- Severance Hospital, Seoul, Korea
| | | | | | - Sue Kim
- Yonsei University, Seoul, Korea
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13
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Liu YC, Hung TT, Konara Mudiyanselage SP, Wang CJ, Lin MF. Beneficial Exercises for Cancer-Related Fatigue among Women with Breast Cancer: A Systematic Review and Network Meta-Analysis. Cancers (Basel) 2022; 15:cancers15010151. [PMID: 36612147 PMCID: PMC9817866 DOI: 10.3390/cancers15010151] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/15/2022] [Accepted: 12/17/2022] [Indexed: 12/29/2022] Open
Abstract
CONTEXT Cancer-related fatigue (CRF) is the most common cause of physical powerlessness in women with breast cancer (BC). The practice of continuous effective exercise is beneficial with respect to reducing CRF. OBJECTIVE To explore exercise efficacy and respective ranks with respect to reducing CRF in women with BC within the inter-treatment and post-treatment periods. METHODS Throughout this systematic review and network meta-analysis, articles published from 2000 to March 2022 were included. Article searches were conducted on the MEDLINE, Embase, CINAHL, and CENTRAL databases. Adult women with BC and different exercise programs were compared with those involved in regular care as a control during or after treatment. In addition, randomized controlled trials (RCT) were also included. A risk-of-bias assessment, with the revised Cochrane risk-of-bias tool regarding RCT and probability-based ranking, was established based on the surface under the cumulative rank (SUCRA) method via network meta-analysis. RESULTS a total of 5747 women with BC followed seven exercise interventions. Yoga (SMD = -0.54, 95% CI [-0.86, -0.22]) was ranked first (94.5%), with significant effects in respect of mitigating CRF, followed by resistance exercise (66.2%), and aerobic resistance (63.3%), while Qigong ranked last (22.2%) among the 36 RCT in inter-treatment. Aerobic resistance exercise (SMD = -0.52, 95% CI [-0.98, -0.07]) induced significant effects in respect of mitigating CRF in the 38 RCTs in the post-treatment period. Yoga, aerobic yoga, and aerobic resistance exercise ranked as the top three (75.5%, 75.0%, and 72.4%, respectively), whereas relaxation ranked last (38.8%) in the post-treatment period. CONCLUSION Yoga, aerobic resistance, and aerobic yoga are recommended for the purposes of inter- and post-treatment exercise to reduce CRF in women with BC by enhancing their physical resilience and long-term quality of life.
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Affiliation(s)
- Yu-Chen Liu
- School of Nursing, College of Medicine, National Taiwan University, Taipei 100, Taiwan
| | - Tsai-Tzu Hung
- Nursing Department, National Cheng Kung University Hospital, Tainan 70101, Taiwan
| | | | - Chi-Jane Wang
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
| | - Mei-Feng Lin
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
- Correspondence: ; Tel.: +886-6-2353535 (ext. 5035); Fax: +886-6-237-7550
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14
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Zhou HJ, Wang T, Xu YZ, Chen YN, Deng LJ, Wang C, Chen JX, Tan JYB. Effects of exercise interventions on cancer-related fatigue in breast cancer patients: an overview of systematic reviews. Support Care Cancer 2022; 30:10421-10440. [PMID: 36326908 PMCID: PMC9715478 DOI: 10.1007/s00520-022-07389-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 10/02/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This overview of systematic reviews aims to critically appraise and consolidate evidence from current systematic reviews (SRs)/meta-analyses on the effects of exercise interventions on cancer-related fatigue (CRF) in breast cancer patients. METHODS SRs/meta-analyses that explored the effects of exercise interventions on CRF in breast cancer patients compared with the routine methods of treatment and care were retrieved from nine databases. The methodological quality of the included SRs was appraised using A MeaSurement Tool to Assess systematic Reviews II (AMSTAR II). The Grading of Recommendations Assessment, Development and Evaluation (GRADE) was used to calculate the grading of outcomes in the included SRs. The exercise type, frequency, duration, and inclusion/absence of supervision were further evaluated with subgroup analyses. The Stata 16.0 software was utilized for data analysis. RESULTS Twenty-nine reviews were included. The overall methodological quality and level of evidence of the included reviews were unsatisfactory, with only three reviews rated as high methodological quality and no review identified as high-quality evidence. Moderate certainty evidence indicated that exercise could improve fatigue in breast cancer patients (SMD = - 0.40 [95%CI - 0.58, - 0.22]; P = 0.0001). Subgroup analysis based on the types of exercise showed that yoga (SMD = - 0.30 [95%CI - 0.56, - 0.05]; I2 = 28.7%) and aerobic exercise (SMD = - 0.29 [95%CI - 0.56, - 0.02]; I2 = 16%) had a significantly better effect on CRF in breast cancer patients; exercising for over 6 months (SMD = - 0.88 [95%CI - 1.59, - 0.17]; I2 = 42.7%; P = 0.0001), three times per week (SMD = - 0.77 [95%CI - 1.04, - 0.05]; I2 = 0%; P = 0.0001), and for 30 to 60 min per session (SMD = - 0.81 [95%CI - 1.15, - 0.47]; I2 = 42.3%; P = 0.0001) can contribute to a moderate improvement of CRF. Supervised exercise (SMD = - 0.48 [95%CI - 0.77, - 0.18]; I2 = 87%; P = 0.001) was shown to relieve CRF. CONCLUSION Exercise played a favorable role in alleviating CRF in breast cancer. Yoga was recommended as a promising exercise modality for CRF management in the majority of the included studies. Exercising for at least three times per week with 30 to 60 min per session could be recommended as a suitable dosage for achieving improvement in CRF. Supervised exercise was found to be more effective in alleviating CRF than unsupervised exercise. More rigorously designed clinical studies are needed to specify the exact exercise type, duration, frequency, and intensity to have an optimal effect on CRF in breast cancer patients. TRIAL REGISTRATION ClinicalTrials.gov Identifier: CRD42020219866.
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Affiliation(s)
- Hong-Juan Zhou
- School of Nursing, Putian University, 1133 Xueyuan Middle Road, Putian, Fujian, China
| | - Tao Wang
- College of Nursing and Midwifery, Charles Darwin University, Brisbane Centre, 410 Ann Street, Brisbane, QLD, Australia
| | - Yong-Zhi Xu
- Department of Traditional Chinese Medicine, Putian Hospital of Traditional Chinese Medicine, 99 Xueyuan North Road, Putian, Fujian, China
| | - Yan-Nan Chen
- School of Nursing, Fujian University of Traditional Chinese Medicine, 1 Qiu Yang Road, Fuzhou, Fujian, China
| | - Li-Jing Deng
- School of Nursing, Fujian University of Traditional Chinese Medicine, 1 Qiu Yang Road, Fuzhou, Fujian, China
| | - Chang Wang
- School of Nursing, Fujian University of Traditional Chinese Medicine, 1 Qiu Yang Road, Fuzhou, Fujian, China
| | - Jin-Xiu Chen
- School of Nursing, Fujian University of Traditional Chinese Medicine, 1 Qiu Yang Road, Fuzhou, Fujian, China.
| | - Jing-Yu Benjamin Tan
- College of Nursing and Midwifery, Charles Darwin University, Ellengowan Dr, Casuarina, NT, Australia.
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15
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Baguley BJ, Dalla Via J, Fraser SF, Daly RM, Kiss N. Effectiveness of combined nutrition and exercise interventions on body weight, lean mass, and fat mass in adults diagnosed with cancer: a systematic review and meta-analysis. Nutr Rev 2022; 81:625-646. [PMID: 36206176 DOI: 10.1093/nutrit/nuac079] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
CONTEXT Changes in body weight and composition (fat and lean mass) are prominent side effects of cancer treatment. Nutrition and exercise interventions are both key strategies to protect against these adverse effects, yet their impact when combined has not been comprehensively reviewed in adults with cancer. OBJECTIVE This systematic review and meta-analysis aims to assess the effects of combined nutrition and exercise interventions on body weight and composition in adults with cancer. DATA SOURCES Four databases were searched until January 2021. Combined nutrition and exercise randomized controlled trials that detailed the nutrition and exercise prescription and reported body weight and composition outcomes were eligible. DATA EXTRACTION Risk of bias was assessed through the Cochrane Collaboration tool. The number of participants, mean values, and standard deviations of the outcome variables were extracted. Mean differences (MDs) were pooled using random-effects models. Predetermined subgroup analyses included cancer type, intervention intent, exercise modality, and use of behavior change strategies. DATA ANALYSIS Twenty-three RCTs were included. Nutrition plus exercise interventions significantly reduced body weight (MD - 2.13 kg; 95%CI, - 3.07 to - 1.19), fat mass (MD - 2.06 kg; 95%CI, - 3.02 to - 1.09), and lean mass (MD - 0.43; 95%CI, - 0.82 to - 0.04). Subgroup analyses in women with breast cancer showed that weight loss interventions and interventions incorporating behavior change strategies significantly reduced body weight and fat mass but also reduced lean mass. Interventions aiming to maintain body weight showed no changes in body weight, as intended. CONCLUSION Combined nutrition and exercise interventions successfully reduce body weight and fat mass in adults with cancer but also reduce lean mass. In contrast, weight loss-focused interventions are associated mostly with reduced lean mass. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration number CRD42020161805.
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Affiliation(s)
- Brenton J Baguley
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
| | - Jack Dalla Via
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia.,Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - Steve F Fraser
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
| | - Robin M Daly
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
| | - Nicole Kiss
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia.,Allied Health Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
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16
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Miller N, Conway R, Pini S, Buck C, Gil N, Lally P, Beeken RJ, Fisher A. Exploring the perceived impact of social support on the health behaviours of people living with and beyond cancer during the COVID-19 pandemic: a qualitative study. Support Care Cancer 2022; 30:8357-8366. [PMID: 35879472 PMCID: PMC9311339 DOI: 10.1007/s00520-022-07291-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 07/18/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE Social support facilitated healthy behaviours in people living with and beyond cancer (LWBC) before the COVID-19 pandemic. Little is known about how social support impacted their health behaviours during the pandemic when social restrictions were imposed. The aim of this study was to qualitatively explore how social support was perceived to impact the health behaviours of people LWBC during the COVID-19 pandemic. METHODS Semi-structured interviews were conducted via telephone with 24 adults living with and beyond breast, prostate and colorectal cancer. Inductive and deductive framework analysis was used to analyse the data. RESULTS Five themes developed. These were (1) Companionship and accountability as motivators for physical activity, (2) Social influences on alcohol consumption, (3) Instrumental support in food practices, (4) Informational support as important for behaviour change and (5) Validation of health behaviours from immediate social networks. CONCLUSION This study described how companionship, social influence, instrumental support, informational support and validation were perceived to impact the health behaviours of people LWBC during the COVID-19 pandemic. Interventions for people LWBC could recommend co-participation in exercise with friends and family; promote the formation of collaborative implementation intentions with family to reduce alcohol consumption; and encourage supportive communication between partners about health behaviours. These interventions would be useful during pandemics and at other times. Government policies to help support clinically extremely vulnerable groups of people LWBC during pandemics should focus on providing access to healthier foods.
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Affiliation(s)
- Natalie Miller
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, 1-19 Torrington Place, Gower Street, London, UK.
| | - Rana Conway
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, 1-19 Torrington Place, Gower Street, London, UK
| | - Simon Pini
- Leeds Institute of Health Sciences, University of Leeds, Leeds, LS2 9JT, UK
| | - Caroline Buck
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, 1-19 Torrington Place, Gower Street, London, UK
| | - Natalie Gil
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, 1-19 Torrington Place, Gower Street, London, UK
| | - Phillippa Lally
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, 1-19 Torrington Place, Gower Street, London, UK
| | - Rebecca J Beeken
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, 1-19 Torrington Place, Gower Street, London, UK
- Leeds Institute of Health Sciences, University of Leeds, Leeds, LS2 9JT, UK
| | - Abigail Fisher
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, 1-19 Torrington Place, Gower Street, London, UK
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Bringel MDO, Reis AD, Aguiar LC, Garcia JBS. Ansiedade, Depressão, Dor e Fadiga em Pacientes com Câncer de Mama que Realizaram Treinamento Combinado. REVISTA BRASILEIRA DE CANCEROLOGIA 2022. [DOI: 10.32635/2176-9745.rbc.2022v68n3.2611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
Introdução: Apesar do aumento na sobrevida de pacientes com neoplasias de mama, muitas persistem com ansiedade, depressão, fadiga e dor mesmo após o tratamento anticancerígeno, fatores associados a uma pior qualidade de vida. Objetivo: Avaliar a influencia do treinamento combinado na ansiedade, depressão, dor e fadiga em pacientes com câncer de mama. Método: Ensaio controlado randomizado com 26 pacientes em quimioterapia, radioterapia ou acompanhamento clinico em um centro de referência em tratamento de câncer, com idade 30 a 59 anos, não praticantes de treinamento físico nos últimos três meses. O grupo experimental (GE) (n=13) foi submetido a três sessões por semana de treinamento aeróbico e resistido em 12 semanas, com duração de 60 minutos, e duas sessões de treinamento de flexibilidade por semana com duração de 20 segundos em três series. O grupo controle (GC) (n=13) realizou somente o tratamento hospitalar convencional. Todas as avaliações foram realizadas no tempo basal e após 12 semanas. Resultados: As pacientes do GE apresentaram redução significativa da ansiedade (p=0,0242), intensidade da dor (p=0,0290) e dimensão comportamental da fadiga (0,0033). Não foram observadas diferenças na depressão (p=0,0803), interferência da dor nas atividades habituais (p=0,0933) e dimensões afetiva (p=0,0583) e sensorial/cognitiva/emocional (p=0,5525) da fadiga. O GC permaneceu inalterado em todas as variáveis. Conclusão: O treinamento combinado, envolvendo exercícios aeróbios, de resistência e de flexibilidade durante 12 semanas, apresenta efeitos benéficos na ansiedade, fadiga e dor em pacientes com câncer de mama.
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18
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Charati FG, Shojaee L, Haghighat S, Esmaeili R, Madani Z, Charati JY, Hosseini SH, Shafipour V. Motor exercises effect on improving shoulders functioning, functional ability, quality of life, depression and anxiety for women with breast cancer. Clin Breast Cancer 2022; 22:666-673. [DOI: 10.1016/j.clbc.2022.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 07/17/2022] [Accepted: 07/19/2022] [Indexed: 11/03/2022]
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Rubio MA, Mosquera D, Blanco M, Montes F, Finck C, Duval M, Trillos C, Jaramillo AM, Rosas LG, King AC, Sarmiento OL. Cross-sector co-creation of a community-based physical activity program for breast cancer survivors in Colombia. Health Promot Int 2022; 37:6646635. [PMID: 35853152 DOI: 10.1093/heapro/daac073] [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: 11/13/2022] Open
Abstract
Benefits of physical activity (PA) in breast cancer survivors (BCS) are well established. However, programs to promote PA among BCS tailored to real-world contexts within low- to middle-income countries are limited. Cross-sector co-creation can be key to effective and scalable programs for BCS in these countries. This study aimed to evaluate the networking process to engage multisector stakeholders in the co-creation of a PA program for Colombian BCS called My Body. We employed a mixed-methods design including semistructured interviews, workshops and a social network analysis of centrality measures to assess stakeholders' engagement, resources and skills enabling the collaborative work, challenges, outcomes and lessons learned. The descriptive analysis and the centrality measures of the network revealed that 19 cross-sector stakeholders engaged in the My Body collaborative network. Through ongoing communication and cooperation, My Body built relationships between the academic lead institutions (local and international), and local and national public, private and academic institutions working in public health, sports and recreation, social sciences and engineering fields. The outcomes included the co-creation of the community-based PA program for BCS, its implementation through cross-sector synergies, increased relationships and communications among stakeholders, and successful dissemination of evidence and project results to the collaboration partners and other relevant stakeholders and community members. The mixed-methods assessment enabled understanding of ways to advance cross-sector co-creation of health promotion programs. The findings can help to enable continued development of sustainable cross-sector co-creation processes aimed at advancing PA promotion.
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Affiliation(s)
- María Alejandra Rubio
- Department of Public Health, School of Medicine, Universidad de los Andes, Carrera 1 #18ª-12, Bogotá, Colombia
| | - Daniela Mosquera
- Department of Public Health, School of Medicine, Universidad de los Andes, Carrera 1 #18ª-12, Bogotá, Colombia
| | - Martha Blanco
- Department of Industrial Engineering, School of Engineering, Universidad de los Andes, Carrera 1 #18ª-12, Bogotá, Colombia
| | - Felipe Montes
- Department of Industrial Engineering, School of Engineering, Universidad de los Andes, Carrera 1 #18ª-12, Bogotá, Colombia
| | - Carolyn Finck
- Department of Psychology, Universidad de los Andes, Carrera 1 #18ª-12, Bogotá, Colombia
| | - Martin Duval
- Department of Public Health, School of Medicine, Universidad de los Andes, Carrera 1 #18ª-12, Bogotá, Colombia
| | - Catalina Trillos
- Department of Public Health, School of Medicine, Universidad de los Andes, Carrera 1 #18ª-12, Bogotá, Colombia
| | - Ana María Jaramillo
- Department of Industrial Engineering, School of Engineering, Universidad de los Andes, Carrera 1 #18ª-12, Bogotá, Colombia
| | - Lisa G Rosas
- Department of Epidemiology and Population Health, Stanford University School Medicine, Stanford, CA 94305, USA.,Division of Primary Care and Population Health, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Abby C King
- Department of Epidemiology and Population Health, Stanford University School Medicine, Stanford, CA 94305, USA.,Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Olga L Sarmiento
- Department of Public Health, School of Medicine, Universidad de los Andes, Carrera 1 #18ª-12, Bogotá, Colombia
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20
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Ficarra S, Thomas E, Bianco A, Gentile A, Thaller P, Grassadonio F, Papakonstantinou S, Schulz T, Olson N, Martin A, Wagner C, Nordström A, Hofmann H. Impact of exercise interventions on physical fitness in breast cancer patients and survivors: a systematic review. Breast Cancer 2022; 29:402-418. [PMID: 35278203 PMCID: PMC9021138 DOI: 10.1007/s12282-022-01347-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 02/16/2022] [Indexed: 01/25/2023]
Abstract
Background This systematic review aims to identify the effects of exercise interventions in patients with breast cancer (BCP) and survivors (BCS) on selected variables of physical fitness. Methods A comprehensive literature search was conducted using Medline and Scopus. Randomized controlled trials with isolated exercise interventions in BCP and BCS women (< 5 years from therapy completion) were included. The risk of bias (RoB) assessment was conducted using the Cochrane RoB-2-tool. Variables regarding cardiorespiratory fitness (CRF), strength (ST), fatigue (F) and health-related quality of life (HRQoL) were discussed. Results Of the 336 studies initially identified, 22 met all the inclusion criteria and were deemed eligible. RoB assessment indicated that the studies had predominantly “some concerns” or had “low RoB”, with only 3 studies presenting a “high RoB”. The mean duration and frequency of exercise interventions were 19 weeks and 3 sessions/week, performed at moderate intensity (65% VO2max and 66% 1RM, for aerobic and resistance-training interventions, respectively). Conclusions Exercise interventions seem to be a valuable strategy in BCP to avoid the decline of CRF, ST, F and HRQoL. Conversely, improved physical function among BCS is observed for the same variables. Resistance training and combined interventions seem to provide the most encouraging variations of the selected outcomes. PROSPERO registration ID CRD42021237917. Supplementary Information The online version contains supplementary material available at 10.1007/s12282-022-01347-z.
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Affiliation(s)
- Salvatore Ficarra
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Via Giovanni Pascoli 6, 90144, Palermo, Italy.
| | - Ewan Thomas
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Via Giovanni Pascoli 6, 90144, Palermo, Italy
| | - Antonino Bianco
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Via Giovanni Pascoli 6, 90144, Palermo, Italy
| | - Ambra Gentile
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Via Giovanni Pascoli 6, 90144, Palermo, Italy
| | - Petra Thaller
- OAC-Outdoor Against Cancer, Europe-Wide Outdoor Sport and Exercise Network for Cancer Prevention, Prinzregentenstrasse 97, 81677, Munich, Germany
| | - Fulvio Grassadonio
- International Centre for the Promotion of Education and Development (CEIPES), Via Francesco Maria Alias 20, 90145, Palermo, Italy
| | - Sofia Papakonstantinou
- Creative Thinking Development (CreThiDev), Solonos 8 & Empedokleus, 19009, Ntrafi Rafinas, Attiki, Greece
| | - Thorsten Schulz
- Department of Sport and Health Sciences, Institute of Preventive Pediatrics, Technical University of Munich, Georg-Brauchle-Ring 60/62, D-80992, Munich, Germany
| | - Nils Olson
- Department of Sport and Health Sciences, Institute of Preventive Pediatrics, Technical University of Munich, Georg-Brauchle-Ring 60/62, D-80992, Munich, Germany
| | - Alexandra Martin
- Department of Sport and Health Sciences, Technical University of Munich, Uptown Munich-Campus D Georg-Brauchle-Ring 60/62, D-80992, Munich, Germany
| | - Christian Wagner
- Naturfreunde, Bundesorganisation, Viktoriagasse 6, 1150, Vienna, Austria
| | - Anna Nordström
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden
- Umeå School of Sport Sciences, Umeå University, Umeå, Sweden
| | - Hande Hofmann
- Department of Sport and Health Sciences, Institute of Preventive Pediatrics, Technical University of Munich, Georg-Brauchle-Ring 60/62, D-80992, Munich, Germany
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21
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Hirko KA, Dorn JM, Dearing JW, Alfano CM, Wigton A, Schmitz KH. Implementation of Physical Activity Programs for Rural Cancer Survivors: Challenges and Opportunities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182412909. [PMID: 34948517 PMCID: PMC8702182 DOI: 10.3390/ijerph182412909] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 11/26/2021] [Accepted: 12/01/2021] [Indexed: 12/03/2022]
Abstract
Physical activity after cancer diagnosis has been consistently associated with improvements in quality of life and prognosis. However, few cancer survivors meet physical activity recommendations, and adherence is even lower among those living in rural settings. The purpose of this quasi-experimental study was to evaluate the implementation of a clinic-based physical activity program for cancer survivors at a rural community oncology setting. We also examined changes in quality-of-life measures among 24 cancer survivors participating in the physical activity program and described challenges and opportunities to optimize future implementation efforts in rural settings. Significant pre- to post-program improvements in fatigue (5.5 to 6.8; p = 0.03), constipation (7.7 to 9.0; p = 0.02), pain (6.7 to 8.0; p = 0.007), and sleep quality (p = 0.008) were observed. Participants also reported improved nausea, stamina, depression, stress, and overall physical health after participation in the physical activity program, although the differences were not statistically significant (all p-values > 0.13). However, the reach of the physical activity program was limited, with only 0.59% of cancer survivors participating. Fidelity to the physical activity program was relatively high, with 72.7% of survivors participating in at least five classes. Our findings suggest that physical activity programs in oncological settings may need tailoring to effectively reach rural cancer survivors.
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Affiliation(s)
- Kelly A. Hirko
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI 48824, USA
- Correspondence:
| | - Joan M. Dorn
- Department of Exercise and Nutrition Sciences, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY 14214, USA;
| | - James W. Dearing
- Department of Communications, Michigan State University, East Lansing, MI 48824, USA;
| | | | | | - Kathryn H. Schmitz
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA 17033, USA;
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22
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de Jesus Leite MAF, Mariano IM, Dechichi JGC, Giolo JS, Gonçalves ÁDC, Puga GM. Exercise training and detraining effects on body composition, muscle strength and lipid, inflammatory and oxidative markers in breast cancer survivors under tamoxifen treatment. Life Sci 2021; 284:119924. [PMID: 34480935 DOI: 10.1016/j.lfs.2021.119924] [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: 07/12/2021] [Revised: 08/16/2021] [Accepted: 08/24/2021] [Indexed: 12/14/2022]
Abstract
AIMS The present study aimed to verify the effects of resistance training (RT) and successive detraining on body composition, muscle strength and lipid profile as primary outcome, and the oxidative stress and inflammatory markers as second outcome of postmenopausal Breast Cancer (BC) survivors undergoing tamoxifen (TA). MAIN METHODS Fourteen postmenopausal BC survivors underwent 12 weeks of resistance exercise training and subsequently 12 weeks of detraining. Anthropometric parameters, lipid profile, muscle strength, inflammatory cytokines and the oxidative stress markers, were assessed before, after the training period and after detraining period. KEY FINDINGS One-way ANOVA showed that fat mass decrease (39.4 ± 6.9 to 37.7 ± 6.8%) and free-fat mass increase (39.3 ± 4.9 to 40.3 ± 5.6%) after RT. Muscle strength increased in response to training but decreased after the detraining period. Triglycerides (156 ± 45 to 123 ± 43 mg/dL) and total cholesterol (202 ± 13 to 186 ± 16 mg/dL) decreased after the RT and HDL-cholesterol (47 ± 9 to 56 ± 9 mg/dL) increased after RT and remained higher (53 ± 10 mg/dL) than after detraining. IL-6 increases (24.65 ± 10.85 to 41.42 ± 22.88 pg/mL) and IL-17 (2.42 ± 0.32 to 1.69 ± 0.19 pg/mL), TBARS (1.91 ± 0.19 to 1.03 ± 0.1 μmol/L), SOD (24.65 ± 10.85 to 41.42 ± 22.88 U/gHb) and Catalase activity (445.9 ± 113.0 to 345.8 ± 81.7 k/gHb·s) reduced after RT and remained lower after detraining. SIGNIFICANCE Resistance exercise training improves health markers of BC survivors undergoing TA and detraining are not sufficient to reverse the positive effects in oxidative stress markers.
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Affiliation(s)
- Marco Aurélio Ferreira de Jesus Leite
- Laboratory of Cardiorespiratory and Metabolic Physiology, Faculty of Physical Education, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Igor Moraes Mariano
- Laboratory of Cardiorespiratory and Metabolic Physiology, Faculty of Physical Education, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Juliene Gonçalves Costa Dechichi
- Laboratory of Cardiorespiratory and Metabolic Physiology, Faculty of Physical Education, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Jéssica Sanjulião Giolo
- Laboratory of Cardiorespiratory and Metabolic Physiology, Faculty of Physical Education, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | | | - Guilherme Morais Puga
- Laboratory of Cardiorespiratory and Metabolic Physiology, Faculty of Physical Education, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil.
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23
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Lim J, Kim KW, Ko Y, Jang IY, Lee YS, Chung YH, Lee HC, Lim YS, Kim KM, Shim JH, Choi J, Lee D. The role of muscle depletion and visceral adiposity in HCC patients aged 65 and over undergoing TACE. BMC Cancer 2021; 21:1164. [PMID: 34715813 PMCID: PMC8557070 DOI: 10.1186/s12885-021-08905-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 10/19/2021] [Indexed: 11/29/2022] Open
Abstract
Background The incidence of hepatocellular carcinoma (HCC) has been increasing among the elderly populations. Trans-arterial chemoembolization (TACE), a widely used first-line non-curative therapy for HCCs is an issue in geriatrics. We investigated the prognosis of elderly HCC patients treated with TACE and determined the factors that affect the overall survival. Methods We included 266 patients who were older than 65 years and had received TACE as initial treatment for HCC. We analyzed the skeletal muscle index (SMI) and visceral-to-subcutaneous fat ratio (VSR) around the third lumbar vertebrae using computed tomography scans. Muscle depletion with visceral adiposity (MDVA) was defined by falling below the median SMI and above the median VSR value sex-specifically. We evaluated the overall survival in association with MDVA and other clinical factors. Results The mean age was 69.9 ± 4.5 years, and 70.3% of the patients were men. According to the Barcelona Clinic Liver Cancer (BCLC) staging system, 29, 136, and 101 patients were classified as BCLC 0, A, and B stages, respectively, and 79 (29.7%) had MDVA. During the median follow-up of 4.1 years, patients with MDVA had a shorter life expectancy than those without MDVA (P = 0.007) even though MDVA group had a higher objective response rate after the first TACE (82.3% vs. 75.9%, P = 0.035). Multivariate analysis revealed that MDVA (Hazard ratio [HR] 1.515) age (HR 1.057), liver function (HR 1.078), tumor size (HR 1.083), serum albumin level (HR 0.523), platelet count (HR 0.996), tumor stage (stage A, HR 1.711; stage B, HR 2.003), and treatment response after the first TACE treatment (HR 0.680) were associated with overall survival. Conclusions MDVA is a critical prognostic factor for predicting survival in the elderly patients with HCC who have undergone TACE. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-021-08905-2.
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Affiliation(s)
- Jihye Lim
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 44-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Kyung Won Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Yousun Ko
- Biomedical Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea
| | - Il-Young Jang
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Yung Sang Lee
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 44-gil, Songpa-gu, Seoul, 05505, Republic of Korea.,Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Young-Hwa Chung
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 44-gil, Songpa-gu, Seoul, 05505, Republic of Korea.,Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Han Chu Lee
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 44-gil, Songpa-gu, Seoul, 05505, Republic of Korea.,Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Young-Suk Lim
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 44-gil, Songpa-gu, Seoul, 05505, Republic of Korea.,Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Kang Mo Kim
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 44-gil, Songpa-gu, Seoul, 05505, Republic of Korea.,Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Ju Hyun Shim
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 44-gil, Songpa-gu, Seoul, 05505, Republic of Korea.,Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jonggi Choi
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 44-gil, Songpa-gu, Seoul, 05505, Republic of Korea.,Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Danbi Lee
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 44-gil, Songpa-gu, Seoul, 05505, Republic of Korea. .,Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
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24
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Brunet J, Price J, Harris C. Women's Preferences for Body Image Programming: A Qualitative Study to Inform Future Programs Targeting Women Diagnosed With Breast Cancer. Front Psychol 2021; 12:720178. [PMID: 34721173 PMCID: PMC8548366 DOI: 10.3389/fpsyg.2021.720178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 09/16/2021] [Indexed: 12/25/2022] Open
Abstract
Purpose: This paper describes women's opinions of the attributes of the ideal body image program to inform the design, development, and implementation of future programs for those diagnosed with breast cancer. Methods: Deductive-inductive content analysis of semi-structured interviews with 26 women diagnosed with breast cancer (mean age = 55.96 years; mean time since diagnosis = 2.79 years) was performed. Findings: Participants' opinions regarding the ideal body image program are summarized into five themes, mapping the where (community-based, hospital-based, or online), when (across the cancer continuum or at specific points), how (peer-led programs, professional help, events, presentations/workshops, resources, support groups), what (self-care, counseling and education for one self, education for others, support for addressing sexuality/sexual health concerns, and concealing treatment-related changes), and who (team approach or delivered by women, health professionals, make-up artists). Conclusion: This study provides useful data on what women believe are the attributes of the ideal body image program, which can contribute to efforts aimed at developing and delivering body image programs for women diagnosed with breast cancer that prioritize their needs and preferences.
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Affiliation(s)
- Jennifer Brunet
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
- Cancer Therapeutics Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- Institut du Savoir Montfort, Hôpital Montfort, Ottawa, ON, Canada
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Jenson Price
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
| | - Cheryl Harris
- Cancer Therapeutics Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
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25
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Leite B, de Bem Fretta T, Boing L, Coutinho de Azevedo Guimarães A. Can belly dance and mat Pilates be effective for range of motion, self-esteem, and depressive symptoms of breast cancer women? Complement Ther Clin Pract 2021; 45:101483. [PMID: 34517217 DOI: 10.1016/j.ctcp.2021.101483] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 08/23/2021] [Accepted: 09/06/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE This study aims to analyse the effect of an intervention with belly dance or mat Pilates on range of motion, self-esteem and depressive symptoms in women with breast cancer receiving hormone therapy. METHOD A randomized clinical trial of 52 participants, diagnosed with breast cancer and undergoing adjuvant hormone therapy that were randomized and divided into three groups (1): Belly dance group, which received 16 weeks of Belly Dance classes 2) Mat Pilates group, that performed 16 weeks of Pilates intervention and (3) Control group, that received educational activities in the form of lectures and was invited to maintain its routine activities. The participants answered a questionnaire in which they contained the clinical and personal characteristics; quantification of the range of motion of the upper limbs using the Absolute Axis 360° digital goniometer; self-esteem by the Self-Esteem Scale (EAR) and depressive symptoms by the Beck Depression Inventory (BDI). All data was collected at two moments in the study, in the pre-intervention period (baseline) and at the end of the 16 weeks of intervention. RESULTS Only the variable range of motion variable showed significant results in all study groups (p = 0.025), with the Mat Pilates group having the best scores. Although not significant, the other study variables also improved after the intervention period. CONCLUSION Belly dance and the Mat Pilates can bring positive results in the range of movement of women undergoing adjuvant treatment of breast cancer, with the Pilates method being the one that most contributed to improvements in this variable.
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Affiliation(s)
- Bruna Leite
- Physiotherapy, Science Center of Health Sciences and Sports, Santa Catarina State University, Brazil.
| | - Tatiana de Bem Fretta
- Functional Performance Physiotherapist, Ribeirão Preto Medical School- University of São Paulo, Brazil
| | - Leonessa Boing
- Human Movement, Science Center of Health Sciences and Sports, Santa Catarina State University, Scholarship of the Coordination of Improvement of Higher Level (CAPES), Brazil
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26
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De Lazzari N, Niels T, Tewes M, Götte M. A Systematic Review of the Safety, Feasibility and Benefits of Exercise for Patients with Advanced Cancer. Cancers (Basel) 2021; 13:cancers13174478. [PMID: 34503288 PMCID: PMC8430671 DOI: 10.3390/cancers13174478] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 08/27/2021] [Accepted: 09/01/2021] [Indexed: 12/15/2022] Open
Abstract
Simple Summary Most advanced cancer patients suffer from severe symptoms due to cancer and medical treatment. Common symptoms are physical weakness, mental problems, and tiredness. Research has shown that exercise positively influences cancer-related side effects during and after treatment and longevity in cancer survivorship. However, exercise as a supportive therapy in advanced cancer patients is still not recommended in oncological guidelines. Therefore, the aim of this systematic review was to assess the safety, feasibility, and benefits of exercise for patients with advanced cancer. Based on the results of 14 included exercise intervention studies, we conclude that exercise is safe and feasible, seems to improve physical performance, and may lower symptoms like chronic tiredness. Early integration of exercise for advanced cancer patients should be considered as usual care as a supportive strategy. Abstract Exercise therapy is a common supportive strategy in curative cancer treatment with strong evidence regarding its positive effects on, for example, cancer-related fatigue, health- related quality of life, and physical function. In the field of advanced cancer patients, knowledge about exercise as a useful supportive strategy is missing. The aim of this systematic review was to evaluate the feasibility and safety of exercise interventions as well as its effects on lowering the symptom burden. We included randomized controlled trials and nonrandomized controlled trials with advanced cancer patients receiving any type of exercise intervention. After an extensive literature search (in accordance to PRIMSA guidelines) in PubMed, Cochrane Library, and SPORTDiscus, 14 studies including 940 participants with different cancer entities were eligible. The results indicated the safety of exercise. In total, 493 participants received exercise interventions, with nine adverse events and no severe adverse events. The median recruitment rate was 68.33%, and adherence to exercise intervention was 86%. Further research with a high-quality and larger sample size is needed to clarify the potential of exercise with advanced cancer patients. Different advanced cancer entities have distinguished symptoms, and future research should construct entities-specific trial populations to figure out the best supportive exercise interventions.
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Affiliation(s)
- Nico De Lazzari
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, 45147 Essen, Germany;
- Correspondence:
| | - Timo Niels
- Department I of Internal Medicine, Center of Integrated Oncology Aachen Bonn Cologne Düsseldorf, University Hospital of Cologne, 50937 Cologne, Germany;
| | - Mitra Tewes
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, 45147 Essen, Germany;
| | - Miriam Götte
- Department of Pediatric Hematology/Oncology, Clinic for Pediatrics 3, Center for Child and Adolescent Medicine, West German Cancer Center, University Hospital Essen, 45147 Essen, Germany;
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27
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Utilization of Forearm Crutches to Avoid Lymphedema After Breast Cancer Lymph Node Surgery. JOURNAL OF ACUTE CARE PHYSICAL THERAPY 2021. [DOI: 10.1097/jat.0000000000000180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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28
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Lin HP, Kuo YH, Tai WY, Liu HE. Exercise effects on fatigue in breast cancer survivors after treatments: A systematic review and meta-analysis. Int J Nurs Pract 2021; 28:e12989. [PMID: 34258817 DOI: 10.1111/ijn.12989] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 03/15/2021] [Accepted: 06/12/2021] [Indexed: 01/15/2023]
Abstract
AIM The aim of this study is to explore the effects of exercise interventions by type, duration and intensity of exercise for fatigue in breast cancer survivors who had completed their treatment. BACKGROUND Most studies found that exercise has valuable outcomes for cancer survivors. This meta-analysis comprehensively summarizes the benefits of exercise intervention for fatigue in breast cancer patients who had completed their adjuvant treatments. METHODS We conducted a meta-analysis on randomized control trials published during 1 January 2000 through 31 December 2019, from PubMed, Cochrane Library databases, EMBASE, Medline (ProQuest), CINAHL, PsycINFO, Chinese Electronic Periodical Service and Wan Fan Data with prespecified searching criteria. Breast cancer patients earlier than stage IIIc and completing adjuvant treatments were included, and the effects of exercise on fatigue were investigated. RESULTS Nine randomized controlled trials (RCTs) were included (N = 581). Patients receiving exercise interventions showed reduced fatigue comparing with those without exercise. Exercise with low-moderate intensity, 20 min/day, three times per week and lasting up to 12 weeks had a significant effect on reducing fatigue for breast cancer survivors. CONCLUSION Our study suggested that exercise interventions can reduce fatigue for this group of cancer survivors. The duration and intensity of exercise intervention could be prescribed for this specific group of cancer patients as a basic requirement to handle their reported fatigue.
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Affiliation(s)
- Hui-Ping Lin
- Department of Nursing, Tao Yuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan.,Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yi-Hsuan Kuo
- Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Wen-Yuan Tai
- Graduate Institute of Sport Promotion, National Taiwan Sport University, Taoyuan, Taiwan
| | - Hsueh-Erh Liu
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan, R. O. C.,Department of Rheumatology, Chang Gung Memorial Hospital, Lin Kou & Taoyuan, Taiwan, R. O. C.,Department of Nursing, College of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan, R. O. C
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Szuhany KL, Malgaroli M, Riley G, Miron CD, Suzuki R, Park JH, Rosenthal J, Chachoua A, Meyers M, Simon NM. Barriers and engagement in breast cancer survivorship wellness activities. Breast Cancer Res Treat 2021; 188:317-325. [PMID: 34095986 PMCID: PMC8482782 DOI: 10.1007/s10549-021-06279-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 05/28/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Breast cancer survivors may be at risk for increased rates of emotional distress and poorer quality of life. Survivorship care plans (SCPs) promoting wellness activities may support well-being; however, survivors may not receive or engage in their SCPs. This study aimed to assess receipt and participation in SCP activities as well as barriers to engagement amongst breast cancer survivors. METHODS Breast cancer survivors (n = 187; 99% female, Mean age = 57.7) consented and completed self-reported assessments of SCP recommendations, engagement and interest in wellness activities, and potential barriers to engagement. RESULTS A minority of participants recalled receiving an SCP (21%). The most physician recommended (62%) and completed (53%) activity was exercise. Interest in adding other wellness activities to the SCP was high, with reported interest levels of approximately 50% for several activities (e.g., mind body, nutrition, psychotherapy interventions). Fully half reported that having a physician-designed plan would influence participation in activities. The most common reported barriers to SCP activity engagement were lack of time (82%), work/school (65%), and lack of information (65%). CONCLUSION Few survivors recalled receiving a formal SCP, and lack of information about wellness activities was a commonly reported barrier to participation. Interest in wellness activities was generally high and may indicate the need for more formal prescription or motivation enhancement techniques to promote SCP engagement. There may be a clinical need to emphasize SCP recommendations to enhance recall and increase engagement in wellness activities that may reduce psychological distress and improve quality of life.
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Affiliation(s)
- Kristin L Szuhany
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NY, USA.
| | - Matteo Malgaroli
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NY, USA
| | - Gabriella Riley
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NY, USA
| | - Carly D Miron
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NY, USA
| | | | | | - Jane Rosenthal
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NY, USA
- Perlmutter Cancer Center, NYU Grossman School of Medicine, New York, NY, USA
| | - Abraham Chachoua
- Department of Medicine, NYU Grossman School of Medicine, New York, NY, USA
- Perlmutter Cancer Center, NYU Grossman School of Medicine, New York, NY, USA
| | - Marleen Meyers
- Department of Medicine, NYU Grossman School of Medicine, New York, NY, USA
- Perlmutter Cancer Center, NYU Grossman School of Medicine, New York, NY, USA
| | - Naomi M Simon
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NY, USA
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Han JK, Kim G. Role of physical exercise in modulating the insulin-like growth factor system for improving breast cancer outcomes: A meta-analysis. Exp Gerontol 2021; 152:111435. [PMID: 34098007 DOI: 10.1016/j.exger.2021.111435] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 04/30/2021] [Accepted: 05/29/2021] [Indexed: 02/09/2023]
Abstract
BACKGROUND Physical activity prevents cancer and improves cancer outcomes. Insulin-like growth factor (IGF) signaling plays a significant role in cancer development and progression. However, there are heterogeneous results regarding physical activity and its effect on the IGF system. This study meta-analyzed the results of randomized clinical trials which evaluated the effects of physical exercise on the changes of physiologic markers to identify the role of physical exercise in modulating the IGF system in women with breast cancer. METHODS PubMed, Embase, CENTRAL, and SPORTDiscus were systematically searched until October 2020. Eligibility criteria included randomized controlled trials that evaluated the effects of physical exercise on the insulin-like growth factor system among women with breast cancer. RESULTS Twelve randomized controlled studies involving 736 participants were analyzed. Physical exercise significantly reduced levels of serum insulin (MD -1.24 μIU/mL, 95% CI -2.12 to -0.36, p = 0.006), IGF-II (MD -54.21 ng/mL, 95% CI -61.41 to -47.00, p < 0.00001), IGFBP-1 (MD -2.90 ng/mL, 95% CI -3.91 to -1.90, p < 0.00001), and HOMA score (MD -0.47, 95% CI -0.87 to -0.06, p = 0.02). In addition, serum glucose (MD -0.71 mg/dL, 95% CI -2.57 to 1.15; p = 0.45) and IGF-I levels (MD -5.23 ng/mL, 95% CI -13.00 to 2.53; p = 0.19) were decreased after physical exercise although they did not show a statistical significance. CONCLUSION Physical exercise had a positive effect on the IGF system in women with breast cancer.
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Affiliation(s)
- Joung-Kyue Han
- College of Sport Science, Chung-Ang University, Republic of Korea
| | - Gangmi Kim
- Department of Surgery, Dongguk University Gyeongju Hospital, Dongguk University College of Medicine, Republic of Korea.
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Use of rehabilitation pathways in women with breast cancer in the first 12 months of the disease: a retrospective study. BMC Cancer 2021; 21:311. [PMID: 33761916 PMCID: PMC7993006 DOI: 10.1186/s12885-021-07927-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 02/17/2021] [Indexed: 01/12/2023] Open
Abstract
Background Breast cancer (BC) presents important physical and psychological challenges that should be appropriately addressed through continuous, integrated and individualized rehabilitation programs after treatment. In this study, we aimed to collect more information on the rehabilitation patterns and utilization of healthcare services by women with BC. Methods We retrospectively analyzed data from two archives of the Lazio Regional Health System Database to assess rehabilitation patterns in women diagnosed with BC in the Lazio region (Italy) in 2008. Results A total of 5538 women diagnosed with BC were considered in the present study. Most patients (81.7%) received outpatient rehabilitative care, consisting mainly of pathology-related interventions and, more rarely, disability-related interventions (mainly motor rehabilitation and rarely cognitive or psychological therapy). Few patients followed an inpatient (1.3%) or an intensive outpatient rehabilitation program (1.0%). Conclusion Most patients do not receive adequate rehabilitation care during the first year after diagnosis. More information and better rehabilitation services should be provided to help patients with BC access rehabilitation programs. The study also suggests the importance of psychosocial and cognitive interventions, which is a major unmet need in women with BC.
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Effects of a personal trainer-led exercise intervention on physical activity, physical function, and quality of life of breast cancer survivors. Breast Cancer 2021; 28:737-745. [PMID: 33689150 DOI: 10.1007/s12282-020-01211-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 12/24/2020] [Indexed: 12/22/2022]
Abstract
PURPOSE Exercise is important to address physical and emotional effects of breast cancer treatment. This study examines effects of a personal trainer led exercise intervention on physical activity levels, physical function and quality of life (QoL) in breast cancer survivors. METHODS Women post active breast cancer treatment were recruited from 2015 to 2017, randomized to immediate exercise or wait-list control, and received three personal training sessions for up to 30 weeks. Physical activity and function were assessed by pedometer, and tests of endurance, strength, and flexibility. Self-reported physical activity, physical activity self-efficacy, and QoL were also assessed. RESULTS 60 women were randomized to immediate intervention (n = 31) or wait-list control (n = 29). Subjects were aged (mean ± SD) 56 ± 10 years. On the endurance test, the exercise group significantly improved (increase of 18 ± 20 steps vs control 9 ± 12 steps) (p = 0.036). On the strength test, the exercise group significantly improved (increase of 4 ± 3 curls vs control 1 ± 3 curls) (p = 0.002). After intervention, change (mean ∆ ± SD) in the FACT-ES physical well-being subscale score was 1 ± 2 in the exercise group and - 1 ± 2 in the control group (p = 0.023). Improvement in Self-efficacy and Physical Activity (SEPA) score was significant with a change (mean ∆ ± SD) of 2 ± 5 for exercise vs 0 ± 5 for control (p = 0.047). The number of steps/day, back scratch test, weight, and self-reported physical activity did not significantly improve with intervention. CONCLUSIONS The intervention yielded significant improvements in endurance and strength but not physical activity or quality of life. IMPLICATIONS FOR CANCER SURVIVORS Future efforts to explore feasible ways to support patient's physical activity efforts need to be undertaken.
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Quality of Life in Women Diagnosed with Breast Cancer after a 12-Month Treatment of Lifestyle Modifications. Nutrients 2020; 13:nu13010136. [PMID: 33396551 PMCID: PMC7824271 DOI: 10.3390/nu13010136] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 12/28/2020] [Accepted: 12/30/2020] [Indexed: 12/11/2022] Open
Abstract
Healthy lifestyles are associated with better health-related quality of life (HRQoL), favorable prognosis and lower mortality in breast cancer (BC) survivors. We investigated changes in HRQoL after a 12-month lifestyle modification program in 227 BC survivors participating in DEDiCa trial (Mediterranean diet, exercise, vitamin D). HRQoL was evaluated through validated questionnaires: EQ-5D-3L, EORTC-QLQ-C30 and EORTC QLQ-BR23. Baseline changes were tested using analysis of variance. Multiple regression analyses were performed to assess treatment effects on HRQoL. Increases were observed in global health status (p < 0.001), physical (p = 0.003), role (p = 0.002) and social functioning (p < 0.001), body image (p < 0.001), future perspective (p < 0.001), well-being (p = 0.001), and reductions in fatigue (p < 0.001), nausea and vomiting (p = 0.015), dyspnea (p = 0.001), constipation (p = 0.049), financial problems (p = 0.012), sexual functioning (p = 0.025), systematic therapy side effects (p < 0.001) and breast symptoms (p = 0.004). Multiple regression analyses found inverse associations between changes in BMI and global health status (p = 0.048) and between serum 25(OH)D levels and breast symptoms (p = 0.002). A healthy lifestyle treatment of traditional Mediterranean diet and exercise may impact positively on HRQoL in BC survivors possibly through reductions in body weight while vitamin D sufficiency may improve BC-related symptoms. These findings are relevant to BC survivors whose lower HRQoL negatively affects treatment compliance and disease outcomes.
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Ortega MA, Fraile-Martínez O, García-Montero C, Pekarek L, Guijarro LG, Castellanos AJ, Sanchez-Trujillo L, García-Honduvilla N, Álvarez-Mon M, Buján J, Zapico Á, Lahera G, Álvarez-Mon MA. Physical Activity as an Imperative Support in Breast Cancer Management. Cancers (Basel) 2020; 13:E55. [PMID: 33379177 PMCID: PMC7796347 DOI: 10.3390/cancers13010055] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 12/21/2020] [Accepted: 12/24/2020] [Indexed: 02/06/2023] Open
Abstract
Breast cancer (BC) is the most common malignancy and the second cause of cancer-related death among women. It is estimated that 9 in 10 cases of BC are due to non-genetic factors, and approximately 25% to 30% of total breast cancer cases should be preventable only by lifestyle interventions. In this context, physical activity represents an excellent and accessible approach not only for the prevention, but also for being a potential support in the management of breast cancer. The present review will collect the current knowledge of physical activity in the background of breast cancer, exploring its systemic and molecular effects, considering important variables in the training of these women and the evidence regarding the benefits of exercise on breast cancer survival and prognosis. We will also summarize the various effects of physical activity as a co-adjuvant therapy in women receiving different treatments to deal with its adverse effects. Finally, we will reveal the impact of physical activity in the enhancement of quality of life of these patients, to conclude the central role that exercise must occupy in breast cancer management, in an adequate context of a healthy lifestyle.
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Affiliation(s)
- Miguel A. Ortega
- Unit of Histology and Pathology, Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (O.F.-M.); (C.G.-M.); (L.P.); (A.J.C.); (L.S.-T.); (N.G.-H.); (M.Á.-M.); (J.B.); (G.L.); (M.A.Á.-M.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
- Cancer Registry and Pathology Department, Hospital Universitario Principe de Asturias, 28806 Alcalá de Henares, Spain
- University Center for the Defense of Madrid (CUD-ACD), 28047 Madrid, Spain
| | - Oscar Fraile-Martínez
- Unit of Histology and Pathology, Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (O.F.-M.); (C.G.-M.); (L.P.); (A.J.C.); (L.S.-T.); (N.G.-H.); (M.Á.-M.); (J.B.); (G.L.); (M.A.Á.-M.)
| | - Cielo García-Montero
- Unit of Histology and Pathology, Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (O.F.-M.); (C.G.-M.); (L.P.); (A.J.C.); (L.S.-T.); (N.G.-H.); (M.Á.-M.); (J.B.); (G.L.); (M.A.Á.-M.)
| | - Leonel Pekarek
- Unit of Histology and Pathology, Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (O.F.-M.); (C.G.-M.); (L.P.); (A.J.C.); (L.S.-T.); (N.G.-H.); (M.Á.-M.); (J.B.); (G.L.); (M.A.Á.-M.)
| | - Luis G. Guijarro
- Unit of Biochemistry and Molecular Biology (CIBEREHD), Department of System Biology, University of Alcalá, 28801 Alcalá de Henares, Spain;
| | - Alejandro J. Castellanos
- Unit of Histology and Pathology, Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (O.F.-M.); (C.G.-M.); (L.P.); (A.J.C.); (L.S.-T.); (N.G.-H.); (M.Á.-M.); (J.B.); (G.L.); (M.A.Á.-M.)
| | - Lara Sanchez-Trujillo
- Unit of Histology and Pathology, Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (O.F.-M.); (C.G.-M.); (L.P.); (A.J.C.); (L.S.-T.); (N.G.-H.); (M.Á.-M.); (J.B.); (G.L.); (M.A.Á.-M.)
| | - Natalio García-Honduvilla
- Unit of Histology and Pathology, Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (O.F.-M.); (C.G.-M.); (L.P.); (A.J.C.); (L.S.-T.); (N.G.-H.); (M.Á.-M.); (J.B.); (G.L.); (M.A.Á.-M.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
- University Center for the Defense of Madrid (CUD-ACD), 28047 Madrid, Spain
| | - Melchor Álvarez-Mon
- Unit of Histology and Pathology, Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (O.F.-M.); (C.G.-M.); (L.P.); (A.J.C.); (L.S.-T.); (N.G.-H.); (M.Á.-M.); (J.B.); (G.L.); (M.A.Á.-M.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
- University Center for the Defense of Madrid (CUD-ACD), 28047 Madrid, Spain
- Immune System Diseases-Rheumatology, Oncology Service an Internal Medicine, University Hospital Príncipe de Asturias, (CIBEREHD), 28806 Alcalá de Henares, Spain
| | - Julia Buján
- Unit of Histology and Pathology, Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (O.F.-M.); (C.G.-M.); (L.P.); (A.J.C.); (L.S.-T.); (N.G.-H.); (M.Á.-M.); (J.B.); (G.L.); (M.A.Á.-M.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
- Cancer Registry and Pathology Department, Hospital Universitario Principe de Asturias, 28806 Alcalá de Henares, Spain
| | - Álvaro Zapico
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcala de Henares, Spain;
- Obstetrics and Gynecology Service, Center for Biomedical Research in the Mental Health Network, University Hospital Príncipe de Asturias, 28806 Alcalá de Henares, Spain
| | - Guillermo Lahera
- Unit of Histology and Pathology, Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (O.F.-M.); (C.G.-M.); (L.P.); (A.J.C.); (L.S.-T.); (N.G.-H.); (M.Á.-M.); (J.B.); (G.L.); (M.A.Á.-M.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
- Psychiatry Service, Center for Biomedical Research in the Mental Health Network, University Hospital Príncipe de Asturias, 28806 Alcalá de Henares, Spain
| | - Miguel A. Álvarez-Mon
- Unit of Histology and Pathology, Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (O.F.-M.); (C.G.-M.); (L.P.); (A.J.C.); (L.S.-T.); (N.G.-H.); (M.Á.-M.); (J.B.); (G.L.); (M.A.Á.-M.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
- Department of Psychiatry and Medical Psychology, Hospital Universitario Infanta Leonor, 28031 Madrid, Spain
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Geng Z, Wang J, Zhang Y, Wu F, Yuan C. Physical activity in the context of advanced breast cancer: An integrative review. J Adv Nurs 2020; 77:2119-2143. [PMID: 33314310 DOI: 10.1111/jan.14709] [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: 05/22/2020] [Revised: 11/17/2020] [Accepted: 11/19/2020] [Indexed: 12/31/2022]
Abstract
AIMS To describe and synthesize diverse empirical evidence regarding physical activity (PA) in the context of advanced breast cancer (ABC). DESIGN Integrative review guided by the work of Whittemore and Knafl (2005). DATA SOURCES Six electronic databases were systematically searched to identify relevant literature published between January 2007-June 2019. REVIEW METHODS Abstracts of papers that met the inclusion criteria were reviewed by two researchers and full texts of eligible papers were assessed. Data were extracted by two independent researchers and inter-rater reliability of data extraction established. Quality of papers was evaluated using the Mixed Methods Appraisal Tool. Data were organized according to comprehensive thematic analysis and the biobehavioural model for the study of exercise interventions. RESULTS Of the 532 abstracts, 18 studies met the inclusion criteria which included six randomized controlled trials, one quantitative non-randomized study, seven quantitative descriptive studies, three mixed method studies and one qualitative study. Results from studies enrolled fell into four domains: PA performance and its influence on survival; barriers and preferences for PA; interventions to enhance PA; perceived benefits of PA from qualitative feedback. CONCLUSION Evidence suggests that ABC patients are physically inactive. Main barriers of PA are less aerobic fitness and heavy symptom burden. Simple, tailored and specialist-supervised PA is preferred by ABC patients. Form of joint self-instructed and group accompanying is advocated as well. PA intervention programmes identified in this review vary on type, intensity, duration and frequency, while generally, are found to be feasible, safe and beneficial to patients' physical and psychosocial well-being. IMPACT The results propose tailored, supervised, group-based PA programmes are in urgent need for ABC patients. Clinical professionals should manage more feasible and safer PA interventions to help improve patients' overall health. More research with rigorous methodology design is warranted to explore PA's effect on long-term health outcomes.
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Affiliation(s)
- Zhaohui Geng
- School of Nursing, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jingting Wang
- School of Nursing, Second Military Medical University, Shanghai, China
| | - Yingting Zhang
- School of Nursing, Second Military Medical University, Shanghai, China
| | - Fulei Wu
- School of Nursing, Fudan University, Shanghai, China
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Grote S, Ricci JM, Dehom S, Modeste N, Sealy DA, Tarleton HP. Heart Rate Variability and Cardiovascular Adaptations Among Cancer-Survivors Following a 26-Week Exercise Intervention. Integr Cancer Ther 2020; 19:1534735420969816. [PMID: 33118412 PMCID: PMC7605052 DOI: 10.1177/1534735420969816] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Cardiotoxicity as a result of cancer treatment contributes to autonomic dysfunction and decreased cardiorespiratory fitness among cancer survivors. These deleterious cardiovascular outcomes reduce the survival prognosis for cancer patients and contribute to poor quality of life among survivors. Exercise interventions have been shown as effective in mitigating treatment-related side effects. However, previously published interventions have not explored the potential for improvement in autonomic dysfunction (heart rate variability, HRV). This study examined cardiovascular adaptations in cancer survivors (n = 76) who participated in a 26-week intervention consisting of combined aerobic and resistance training (CART). The most noteworthy improvements occurred during the first 13 weeks of training and were maintained throughout the end of the 26-week period. HRrest improved from baseline (PRE) to the midpoint (MID) (P = .036) and from PRE to POST timepoints (P = .029). HRV and VO2max did not initially appear to change in response to CART. However, after stratification on time since treatment, participants who were 5 or more years from their last treatment experienced improvements (ie increase) in the HRV characteristic of HF power (P = .050) and also in VO2max (P =.043), when compared to those experiencing less than 5 years of time since their last treatment. These findings highlight a need for more attention to address the cardiorespiratory deficits experienced by those who have recently completed cancer treatment. In conclusion, the CART intervention is effective in improving cardiorespiratory fitness and autonomic dysfunction. The structure of the intervention is feasible for cancer survivors to continue with at home, using minimal resources, and without supervision. This at-home model may be even more acceptable to recent survivors that may be homebound immediately following treatment.
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Affiliation(s)
| | | | | | | | - Diadrey-Ann Sealy
- University of the Southern Caribbean, Port of Spain, Saint Joseph, Trinidad and Tobago
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Hirschey R, Nyrop KA, Mayer DK. Healthy Behaviors: Prevalence of Uptake Among Cancer Survivors. Clin J Oncol Nurs 2020; 24:19-29. [PMID: 32945809 DOI: 10.1188/20.cjon.s2.19-29] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Although most cancer survivors adhere to recommendations to refrain from tobacco and minimize alcohol use, survivors of certain cancers are not meeting these recommendations. In addition, most cancer survivors do not achieve optimal recommendations for diet and physical activity, further decreasing survivor health and quality of life. Sun protective and sleep behaviors also tend to be suboptimal among survivors. Uptake of age-appropriate vaccinations is variable among survivors. OBJECTIVES The purpose of this article is to review the prevalence of healthy behavior uptake among cancer survivors and provide nurses with an overview of effective interventions, strategies, and resources to help patients improve these behaviors. METHODS An expert panel was convened to conduct an integrative review and synthesis on the state of the science of healthy behavior uptake among cancer survivors. FINDINGS Not meeting recommendations for healthy lifestyle behaviors increases the risk of second cancers and mortality and decreases overall health and quality of life. Healthy lifestyle behaviors can contribute to improved function, quality of life, and overall survival for cancer survivors. Nurses can help survivors to understand and improve their behaviors.
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Raptopoulos Z, Constantinou C. The Effect of Exercise on the Alleviation of Side Effects Induced by Aromatase Inhibitors in Postmenopausal Breast Cancer Patients. Curr Oncol Rep 2020; 22:110. [PMID: 32803384 DOI: 10.1007/s11912-020-00971-2] [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: 12/30/2022]
Abstract
PURPOSE OF REVIEW Aromatase inhibitors (AIs) are effective in treating postmenopausal women suffering from estrogen receptor-positive breast cancer (BC). However, AIs are also commonly associated with a number of side effects which decrease the quality of life (QoL) of the patients. This review focuses on the effects of exercise interventions on reducing the side effects commonly experienced by BC patients on AI treatment. RECENT FINDINGS Recent studies in the literature support that exercise interventions are feasible and improve body composition, aromatase inhibitor-induced Arthralgia (AIIA), and the overall QoL of BC patients. Successful implementation of longitudinal exercise interventions is expected to improve the QoL of BC patients on AI treatment. Future studies should therefore be carried out with a larger number of postmenopausal BC patients on AI treatment to (a) investigate the effects of exercise interventions on depression, cognitive decline, and cardiotoxicity and (b) address the motivation that should be used to keep BC survivors engaged in exercise intervention programs.
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Affiliation(s)
- Zacharias Raptopoulos
- Department of Basic and Clinical Sciences, University of Nicosia Medical School, 21 Ilia Papakyriakou, 2414 Engomi, P.O. Box 24005, CY-1700, Nicosia, Cyprus
| | - Constantina Constantinou
- Department of Basic and Clinical Sciences, University of Nicosia Medical School, 21 Ilia Papakyriakou, 2414 Engomi, P.O. Box 24005, CY-1700, Nicosia, Cyprus.
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Brenin DR, Dietz JR, Baima J, Cheng G, Froman J, Laronga C, Ma A, Manahan MA, Mariano ER, Rojas K, Schroen AT, Tiouririne NAD, Wiechmann LS, Rao R. Pain Management in Breast Surgery: Recommendations of a Multidisciplinary Expert Panel-The American Society of Breast Surgeons. Ann Surg Oncol 2020; 27:4588-4602. [PMID: 32783121 DOI: 10.1245/s10434-020-08892-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 07/02/2020] [Indexed: 12/13/2022]
Abstract
Opioid overdose accounted for more than 47,000 deaths in the United States in 2018. The risk of new persistent opioid use following breast cancer surgery is significant, with up to 10% of patients continuing to fill opioid prescriptions one year after surgery. Over prescription of opioids is far too common. A recent study suggested that up to 80% of patients receiving a prescription for opioids post-operatively do not need them (either do not fill the prescription or do not use the medication). In order to address this important issue, The American Society of Breast Surgeons empaneled an inter-disciplinary committee to develop a consensus statement on pain control for patients undergoing breast surgery. Representatives were nominated by the American College of Surgeons, the Society of Surgical Oncology, The American Society of Plastic Surgeons, and The American Society of Anesthesiologists. A broad literature review followed by a more focused review was performed by the inter-disciplinary panel which was comprised of 14 experts in the fields of breast surgery, anesthesiology, plastic surgery, rehabilitation medicine, and addiction medicine. Through a process of multiple revisions, a consensus was developed, resulting in the outline for decreased opioid use in patients undergoing breast surgery presented in this manuscript. The final document was reviewed and approved by the Board of Directors of the American Society of Breast Surgeons.
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Affiliation(s)
- David R Brenin
- Department of Surgery, University of Virginia, Charlottesville, VA, USA.
| | - Jill R Dietz
- Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Jennifer Baima
- Department of Physical Medicine and Rehabilitation, UMass Memorial Medical Center, Worcester, MA, USA
| | - Gloria Cheng
- Department of Anesthesia, University of Texas Southwestern, Dallas, TX, USA
| | - Joshua Froman
- Department of Surgery, Mayo Clinic, Owatonna, MN, USA
| | | | - Ayemoethu Ma
- Surgery and Integrative Medicine, Scripps Health, La Jolla, CA, USA
| | - Michele A Manahan
- Department of Plastic Surgery, Johns Hopkins University, Baltimore, MD, USA
| | - Edward R Mariano
- Department of Anesthesia, Stanford University, Stanford, CA, USA
| | - Kristin Rojas
- Department of Surgery, Maimonides Medical Center, Brooklyn, NY, USA
| | - Anneke T Schroen
- Department of Surgery, University of Virginia, Charlottesville, VA, USA
| | | | - Lisa S Wiechmann
- New York Presbyterian Department of Surgery, Columbia University Irving Medical Center, New York, NY, USA
| | - Roshni Rao
- New York Presbyterian Department of Surgery, Columbia University Irving Medical Center, New York, NY, USA
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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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Boing L, Vieira MDCS, Moratelli J, Bergmann A, Guimarães ACDA. Effects of exercise on physical outcomes of breast cancer survivors receiving hormone therapy - A systematic review and meta-analysis. Maturitas 2020; 141:71-81. [PMID: 33036706 DOI: 10.1016/j.maturitas.2020.06.022] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 05/14/2020] [Accepted: 06/24/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Side-effects of hormone therapy can impair the physical health of breast cancer survivors. Exercise has been clearly shown to improve the quality of life of breast cancer survivors. Less is known about the effects of exercise on physical outcomes for breast cancer survivors receiving hormone therapy. OBJECTIVE To investigate the effects of exercise on physical outcomes of breast cancer survivors receiving hormone therapy. METHODS Five electronic databases were searched by two authors using the terms "Breast Neoplasms" [MeSH] and "Tamoxifen" [MeSH] and "Aromatase Inhibitors" [MeSH] and "Exercise" [MeSH]. Randomized and non-randomized clinical trials were included. Risk of bias was assessed by the Cochrane Collaboration tool and ROBINS-I, and the quality of evidence was evaluated using GRADE. Pooled effects were reported as standardized mean differences (SMDs) and 95 % confidence intervals (CIs) using a random effects model. RESULTS Eleven studies were included in the meta-analysis. Two hundred and fourteen breast cancer survivors receiving hormone therapy, tamoxifen, or aromatase inhibitors participated in interventions based on aerobic plus resistance exercise or walking activity. The physical outcomes reported in the articles were: cardiorespiratory fitness, pain, bone mineral density, grip strength, and body fat percentage. Exercise effects were found only for cardiorespiratory fitness (SMD = 0.37; 95 % CI: 0.11; 0.63; I2 = 93 %) and pain (SMD = -0.55; IC95 % -1.11; -0.00; I2 = 80 %), with low quality of evidence. No effects were observed for the other variables. CONCLUSIONS Aerobic plus resistance exercise had positive effects on cardiorespiratory fitness and pain in breast cancer survivors receiving hormone therapy. However, high-quality randomized clinical trials are required to confirm this finding.
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Affiliation(s)
- Leonessa Boing
- College of Health and Sport Science, Santa Catarina State University, Brazil.
| | | | - Jéssica Moratelli
- College of Health and Sport Science, Santa Catarina State University, Brazil
| | - Anke Bergmann
- Clinical Research Program, National Cancer Institute, Brazil
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Carvalho AF, Solmi M, Sanches M, Machado MO, Stubbs B, Ajnakina O, Sherman C, Sun YR, Liu CS, Brunoni AR, Pigato G, Fernandes BS, Bortolato B, Husain MI, Dragioti E, Firth J, Cosco TD, Maes M, Berk M, Lanctôt KL, Vieta E, Pizzagalli DA, Smith L, Fusar-Poli P, Kurdyak PA, Fornaro M, Rehm J, Herrmann N. Evidence-based umbrella review of 162 peripheral biomarkers for major mental disorders. Transl Psychiatry 2020; 10:152. [PMID: 32424116 PMCID: PMC7235270 DOI: 10.1038/s41398-020-0835-5] [Citation(s) in RCA: 92] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 04/03/2020] [Accepted: 05/01/2020] [Indexed: 01/03/2023] Open
Abstract
The literature on non-genetic peripheral biomarkers for major mental disorders is broad, with conflicting results. An umbrella review of meta-analyses of non-genetic peripheral biomarkers for Alzheimer's disease, autism spectrum disorder, bipolar disorder (BD), major depressive disorder, and schizophrenia, including first-episode psychosis. We included meta-analyses that compared alterations in peripheral biomarkers between participants with mental disorders to controls (i.e., between-group meta-analyses) and that assessed biomarkers after treatment (i.e., within-group meta-analyses). Evidence for association was hierarchically graded using a priori defined criteria against several biases. The Assessment of Multiple Systematic Reviews (AMSTAR) instrument was used to investigate study quality. 1161 references were screened. 110 met inclusion criteria, relating to 359 meta-analytic estimates and 733,316 measurements, on 162 different biomarkers. Only two estimates met a priori defined criteria for convincing evidence (elevated awakening cortisol levels in euthymic BD participants relative to controls and decreased pyridoxal levels in participants with schizophrenia relative to controls). Of 42 estimates which met criteria for highly suggestive evidence only five biomarker aberrations occurred in more than one disorder. Only 15 meta-analyses had a power >0.8 to detect a small effect size, and most (81.9%) meta-analyses had high heterogeneity. Although some associations met criteria for either convincing or highly suggestive evidence, overall the vast literature of peripheral biomarkers for major mental disorders is affected by bias and is underpowered. No convincing evidence supported the existence of a trans-diagnostic biomarker. Adequately powered and methodologically sound future large collaborative studies are warranted.
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Affiliation(s)
- André F. Carvalho
- grid.17063.330000 0001 2157 2938Department of Psychiatry, University of Toronto, Toronto, ON Canada ,grid.155956.b0000 0000 8793 5925Centre for Addiction & Mental Health (CAMH), Toronto, ON Canada
| | - Marco Solmi
- grid.5608.b0000 0004 1757 3470Neuroscience Department, University of Padova, Padova, Italy ,grid.5608.b0000 0004 1757 3470Neuroscience Center, University of Padova, Padova, Italy ,grid.13097.3c0000 0001 2322 6764Early Psychosis: Interventions and Clinical-detection (EPIC) lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Marcos Sanches
- grid.155956.b0000 0000 8793 5925Centre for Addiction & Mental Health (CAMH), Toronto, ON Canada ,Krembil Centre for NeuroInformatics, Toronto, ON Canada
| | - Myrela O. Machado
- grid.417199.30000 0004 0474 0188Division of Dermatology, Women’s College Hospital, Toronto, ON Canada
| | - Brendon Stubbs
- grid.37640.360000 0000 9439 0839Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK ,grid.13097.3c0000 0001 2322 6764Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, London, UK
| | - Olesya Ajnakina
- grid.13097.3c0000 0001 2322 6764Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Chelsea Sherman
- grid.17063.330000 0001 2157 2938Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON Canada
| | - Yue Ran Sun
- grid.17063.330000 0001 2157 2938Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON Canada
| | - Celina S. Liu
- grid.17063.330000 0001 2157 2938Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON Canada
| | - Andre R. Brunoni
- grid.11899.380000 0004 1937 0722Service of Interdisciplinary Neuromodulation, Laboratory of Neurosciences (LIM-27) and National Institute of Biomarkers in Psychiatry (INBioN), Department and Institute of Psychiatry, University of São Paulo, São Paulo, SP Brazil ,grid.11899.380000 0004 1937 0722Department of Internal Medicine, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Giorgio Pigato
- grid.5608.b0000 0004 1757 3470Neuroscience Department, University of Padova, Padova, Italy ,grid.5608.b0000 0004 1757 3470Neuroscience Center, University of Padova, Padova, Italy
| | - Brisa S. Fernandes
- grid.267308.80000 0000 9206 2401Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center, Houston, TX USA
| | | | - Muhammad I. Husain
- grid.17063.330000 0001 2157 2938Department of Psychiatry, University of Toronto, Toronto, ON Canada ,grid.155956.b0000 0000 8793 5925Centre for Addiction & Mental Health (CAMH), Toronto, ON Canada
| | - Elena Dragioti
- grid.5640.70000 0001 2162 9922Pain and Rehabilitation Centre, and Department of Medical and Health Sciences, Linköping University, SE-581 85 Linköping, Sweden
| | - Joseph Firth
- grid.1029.a0000 0000 9939 5719NICM Health Research Institute, Western Sydney University, Westmead, Australia ,grid.5379.80000000121662407Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Theodore D. Cosco
- grid.61971.380000 0004 1936 7494Gerontology Research Center, Simon Fraser University, Vancouver, Canada ,grid.4991.50000 0004 1936 8948Oxford Institute of Population Ageing, University of Oxford, Oxford, UK
| | - Michael Maes
- grid.7922.e0000 0001 0244 7875Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand ,grid.1021.20000 0001 0526 7079IMPACT Strategic Research Center, Deakin University, Geelong, Australia
| | - Michael Berk
- grid.1021.20000 0001 0526 7079IMPACT Strategic Research Center, Deakin University, Geelong, Australia ,grid.488501.0Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, VIC Australia ,grid.1008.90000 0001 2179 088XCentre for Youth Mental Health, University of Melbourne, Melbourne, VIC Australia ,grid.1008.90000 0001 2179 088XFlorey Institute for Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC Australia
| | - Krista L. Lanctôt
- grid.17063.330000 0001 2157 2938Department of Psychiatry, University of Toronto, Toronto, ON Canada ,grid.155956.b0000 0000 8793 5925Centre for Addiction & Mental Health (CAMH), Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Sunnybrook Research Institute, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON Canada
| | - Eduard Vieta
- grid.418264.d0000 0004 1762 4012Psychiatry and Psychology Department of the Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia Spain
| | - Diego A. Pizzagalli
- grid.38142.3c000000041936754XDepartment of Psychiatry & McLean Hospital, Harvard Medical School, Belmont, MA 02478 USA
| | - Lee Smith
- grid.5115.00000 0001 2299 5510The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - Paolo Fusar-Poli
- grid.13097.3c0000 0001 2322 6764Early Psychosis: Interventions and Clinical-detection (EPIC) lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK ,OASIS Service, South London and Maudsley National Health Service Foundation Trust, London, UK ,grid.8982.b0000 0004 1762 5736Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Paul A. Kurdyak
- grid.17063.330000 0001 2157 2938Department of Psychiatry, University of Toronto, Toronto, ON Canada ,grid.418647.80000 0000 8849 1617Canada Institute for Clinical Evaluative Sciences (ICES), Toronto, ON Canada ,grid.155956.b0000 0000 8793 5925Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
| | - Michele Fornaro
- grid.4691.a0000 0001 0790 385XDepartment of Neuroscience, Reproductive Science and Dentistry, Section of Psychiatr, University School of Medicine Federico II, Naples, Italy
| | - Jürgen Rehm
- grid.17063.330000 0001 2157 2938Department of Psychiatry, University of Toronto, Toronto, ON Canada ,grid.155956.b0000 0000 8793 5925Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Canada ,grid.155956.b0000 0000 8793 5925Campbell Family Mental Health Research Institute, CAMH, Toronto, Canada ,grid.17063.330000 0001 2157 2938Addiction Policy, Dalla Lana School of Public Health, University of Toronto, Toronto, ON Canada ,grid.4488.00000 0001 2111 7257Institute of Clinical Psychology and Psychotherapy & Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Dresden, Germany ,grid.17063.330000 0001 2157 2938Institute of Medical Science, University of Toronto, Toronto, Canada ,grid.448878.f0000 0001 2288 8774Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Nathan Herrmann
- grid.17063.330000 0001 2157 2938Department of Psychiatry, University of Toronto, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Sunnybrook Research Institute, Toronto, ON Canada
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Jiang M, Ma Y, Yun B, Wang Q, Huang C, Han L. Exercise for fatigue in breast cancer patients: An umbrella review of systematic reviews. Int J Nurs Sci 2020; 7:248-254. [PMID: 32685623 PMCID: PMC7355202 DOI: 10.1016/j.ijnss.2020.03.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 01/01/2020] [Accepted: 03/05/2020] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE To evaluate evidence from published systematic reviews about the effectiveness of exercise interventions on fatigue management in breast cancer patients. METHODS PubMed, Web of Science, the Cochrane Library, the Cumulative Index of Nursing and Allied Health (CINAHL), Embase databases, the China National Knowledge Infrastructure (CNKI), the Wanfang database, the China Biomedical Literature Database (CBM), and the VIP database were searched to identify relevant systematic reviews. The reviews which assessed exercise interventions on cancer-related fatigue (CRF) in breast cancer patients were included. Quality of evidence was evaluated by the Grade of Recommendation, Assessment, Development, and Evaluation (GRADE) tool. The Assessment of Multiple Systematic Reviews (AMSTAR) appraisal tool was used to evaluate the methodological quality of included systematic reviews. RESULTS Twenty-four systematic reviews met all the inclusion criteria. The overall mean score for AMSATR is 7.38 and ranged from 4 to 10 points. In addition, 21 reviews arrived at positive conclusions, which exercises could reduce CRF, and 3 obtained that exercise does not affect fatigue. As for GRADE, 8 of the reviews were graded as 'moderate', 2 of the studies were 'very low', and the others were 'low'. CONCLUSIONS Aerobic and resistance exercise can be regarded as beneficial to CRF in breast cancer patients, and limited evidence exists that yoga had an effect on reducing fatigue. The quality of the current systematic review is still far from satisfactory.
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Affiliation(s)
- Mengyao Jiang
- School of Nursing, Lanzhou University, Lanzhou, Gansu, China
| | - Yuxia Ma
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, Gansu, China
| | - Bei Yun
- School of Nursing, Lanzhou University, Lanzhou, Gansu, China
| | - Qing Wang
- School of Nursing, Lanzhou University, Lanzhou, Gansu, China
| | - Can Huang
- School of Nursing, Lanzhou University, Lanzhou, Gansu, China
| | - Lin Han
- Department of Nursing, Gansu Provincial Hospital, Lanzhou, Gansu, China
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Olsson Möller U, Olsson IM, Sjövall K, Beck I, Rydén L, Malmström M. Barriers and facilitators for individualized rehabilitation during breast cancer treatment - a focus group study exploring health care professionals' experiences. BMC Health Serv Res 2020; 20:252. [PMID: 32216786 PMCID: PMC7098158 DOI: 10.1186/s12913-020-05107-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 03/12/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Breast cancer (BC) and related treatment are associated with the risk of developing a wide range of persistent disabling impairments. Despite extensive research in the field and an enhanced focus on BC rehabilitation, up to 34-43% of these patients are at risk of developing chronic distress. In addition, it is known that these patients repeatedly report unmet needs, which are strongly associated with reduced quality of life. However, despite knowledge that patients' needs for support during BC rehabilitation varies greatly, individualized rehabilitation is often lacking. Therefore, this study aimed to explore health care professionals' (HCPs) experiences of current rehabilitation practice and describe current barriers and facilitators for individualized rehabilitation for patients following BC treatment. METHODS A total of 19 HCPs were included, representing various professions in BC care/rehabilitation within surgical, oncological and specialized cancer rehabilitation units at a university hospital in Sweden. Five semi structured focus group interviews were conducted and inductively analysed using conventional qualitative content analysis. RESULTS Three categories were captured: (1) varying attitudes towards rehabilitation; (2) incongruence in how to identify and meet rehabilitation needs and (3) suboptimal collaboration during cancer treatment. The results showed a lack of consensus in how to optimize individualized rehabilitation. It also illuminated facilitators for individualized rehabilitation in terms of extensive competence related to long-term experience of working with patients with BC care/rehabilitation. Further, the analysis exposed barriers such as a great complexity in promoting individualized rehabilitation in a medically and treatment-driven health care system, which lacked structure and knowledge, and overarching collaboration for rehabilitation. CONCLUSION This study suggests that the cancer trajectory is medically and treatment-driven and that rehabilitation plays a marginal role in today's BC trajectory. It also reveals that structures for systematic screening for needs, evidence-based guidelines for individualized rehabilitation interventions and structures for referring patients for advanced rehabilitation are lacking. To enable optimal and individualized recovery for BC patients', rehabilitation needs to be an integrated part of the cancer trajectory and run in parallel with diagnostics and treatment.
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Affiliation(s)
- Ulrika Olsson Möller
- Department of Nursing and Integrated Health Sciences, Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
| | - Ing-Marie Olsson
- Department of Health Sciences, Lund University, Box 157, 221 00, Lund, Sweden.,Skåne University Hospital, Lund, Sweden
| | - Katarina Sjövall
- Department of Clinical Sciences in Lund, Oncology and Pathology, Lund University, Lund, Sweden
| | - Ingela Beck
- Department of Nursing and Integrated Health Sciences, Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden.,Department of Clinical Sciences in Lund, Oncology and Pathology, Lund University, Lund, Sweden.,The Institute for Palliative Care, Lund University and Region Skåne, Lund, Sweden
| | - Lisa Rydén
- Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Surgery, Lund, Sweden
| | - Marlene Malmström
- Department of Health Sciences, Lund University, Box 157, 221 00, Lund, Sweden. .,Skåne University Hospital, Lund, Sweden. .,The Institute for Palliative Care, Lund University and Region Skåne, Lund, Sweden.
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The Effects of Diet and Dietary Interventions on the Quality of Life among Breast Cancer Survivors: A Cross-Sectional Analysis and a Systematic Review of Experimental Studies. Cancers (Basel) 2020; 12:cancers12020322. [PMID: 32019093 PMCID: PMC7072135 DOI: 10.3390/cancers12020322] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 01/24/2020] [Accepted: 01/26/2020] [Indexed: 12/14/2022] Open
Abstract
There is an ongoing need for solid evidence about the effects of healthy behaviors, and particularly diet, on the quality of life (QoL) among breast cancer survivors. We first conducted a cross-sectional study on 68 Italian stage I-III breast cancer survivors, to investigate the association of adherence to the Mediterranean diet (MD), physical activity and weight status with QoL. Adherence to MD and physical activity was assessed using structured questionnaires. QoL was assessed using the European Organization for the Research and Treatment of Cancer Quality-of-Life tools. We showed that low consumption of red meat and carbonated beverages, daily consumption of wine and high consumption of dishes seasoned with sofrito had beneficial effects on several QoL subscales. By contrast, using olive oil as the main culinary fat, low consumption of commercial sweets and high consumption of nuts were associated with negative effects. Overall, these findings resulted in a null effect of adherence to MD on QoL. Furthermore, we observed better QoL sub-scores among women who performed moderate physical activity (i.e., diarrhea) and those who were underweight/normal weight (i.e., physical functioning and dyspnea) if compared with their counterparts (p-values ≤ 0.003 after correction for multiple comparison). Next, we performed a systematic review of nine experimental studies to summarize whether dietary interventions might improve QoL among breast cancer patients. All the studies demonstrated significant improvements in overall QoL and/or its subscales after the interventions. However, differences in study design, interventions and tools used for QoL assessment did not allow us to provide an overall estimate. Moreover, only a single-arm trial evaluated the effect of an exclusive dietary-based intervention, while others combined dietary recommendations with physical activity and weight loss programs. For these reasons, our study encourages more efforts to improve the robustness of current evidence, through more homogenous tools, larger population-based studies and further randomized controlled trials.
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Abstract
OBJECTIVES To recognize cancer prehabilitation as a pretreatment regimen to increase functional status for patients requiring cancer treatment. This article presents current evidence addressing the efficacy and benefits of prehabilitation regimens in different cancer survivor populations. DATA SOURCES Studies and case reports in the PubMed database. CONCLUSION Cancer prehabilitation may improve outcomes. Prehabilitation may include targeted or whole-body exercise, nutrition, education, psychologic counseling, and smoking cessation. Opportunities exist to further improve access to and delivery of multimodal prehabilitation, and nurses play a critical role in connecting patients to these services. IMPLICATIONS FOR NURSING PRACTICE Oncology nurses who are knowledgeable of cancer treatment-related effects are poised to assess survivors for existing impairments, advocate for prehabilitation for existing and potential morbidities, and monitor functional status over time. As patient educators, they are key to informing cancer survivors about the role of prehabilitation.
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Boing L, do Bem Fretta T, de Carvalho Souza Vieira M, Pereira GS, Moratelli J, Sperandio FF, Bergmann A, Baptista F, Dias M, de Azevedo Guimarães AC. Pilates and dance to patients with breast cancer undergoing treatment: study protocol for a randomized clinical trial - MoveMama study. Trials 2020; 21:35. [PMID: 31910872 PMCID: PMC6947954 DOI: 10.1186/s13063-019-3874-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 11/02/2019] [Indexed: 12/31/2022] Open
Abstract
Background Breast cancer is a global public health issue. The side effects of the clinical treatment can decrease the quality of life of these women. Therefore, a healthy lifestyle is essential to minimize the physical and psychological side effects of treatment. Physical activity has several benefits for women with breast cancer, and Pilates solo and belly dancing can be an enjoyable type of physical activity for women with breast cancer undergoing clinical treatment. The purpose of this study is to provide a Pilates solo and a belly dance protocol (three times per week/16 weeks) for women undergoing breast cancer treatment and compare its effectiveness with that in the control group. Methods The participants will be allocated to either the intervention arm (Pilates solo or belly dance classes three times per week for 16 weeks) or a control group (receipt of a booklet on physical activity for patients with breast cancer and maintenance of habitual physical activity routine). The Pilates solo and belly dance classes will be divided into three stages: warmup and stretching, the main stage, and relaxation. Measurements of the study outcomes will take place at baseline; postintervention; and 6, 12, and 24 months after the end of the intervention (maintenance period). The data collection for both groups will occur with a paper questionnaire and tests covering general and clinical information. The primary outcome will be quality of life (EORT QLQ-C30 and EORT QLQ-BR23), and secondary outcomes will be physical aspects such as cardiorespiratory fitness (6-min walk test and cycle ergometer), lymphedema (sum of arm circumference), physical activity (IPAQ short version), disabilities of the arm (DASH), range of motion (goniometer test), muscular strength (dynamometer test) and flexibility (sit and reach test), and psychological aspects such as depressive symptoms (Beck Depression Inventory), body image (Body Image After Breast Cancer Questionnaire), self-esteem (Rosenberg), fatigue (FACT-F), pain (VAS), sexual function (FSFI), and sleep quality (Pittsburgh Sleep Quality Index). Discussion In view of the high prevalence of breast cancer among women, the implementation of a specific protocol of Pilates solo and belly dancing for patients with breast cancer is important, considering the necessity to improve their physical and psychological quality of life. Pilates solo and belly dancing are two types of physical activity that involve mental and physical concentration, music, upper limb movements, femininity, and social involvement. An intervention with these two physical activities could offer options of supportive care to women with breast cancer undergoing treatment, with the aim being to improve physical and psychological quality of life. Trial registration ClinicalTrials.gov, NCT03194997. Registration date 12 August 2017. Universal Trial Number (World Health Organization), U1111-1195-1623.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Mirella Dias
- Santa Catarina State University, Florianópolis, Brazil
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48
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Lee HS, Kim K. Social Network Analysis for Research of Cancer Patients' Health-Related Quality of Life. ASIAN ONCOLOGY NURSING 2020. [DOI: 10.5388/aon.2020.20.2.61] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Hyun Su Lee
- Graduate School of Nursing, Chung-Ang University, Seoul, Korea
| | - Kyunghee Kim
- Department of Nursing, Chung-Ang University, Seoul, Korea
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Wang Y, Jin B, Paxton RJ, Yang W, Wang X, Jiao Y, Yu C, Chen X. The effects of exercise on insulin, glucose, IGF-axis and CRP in cancer survivors: Meta-analysis and meta-regression of randomised controlled trials. Eur J Cancer Care (Engl) 2019; 29:e13186. [PMID: 31823458 DOI: 10.1111/ecc.13186] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 08/19/2019] [Accepted: 10/14/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND The purpose of this study was to investigate the relationship between physical activity and biological mediators of cancer recurrence and survival. METHODS We conducted a comprehensive literature search of PubMed, ScienceDirect and Web of Science for randomised controlled trials examining the association between physical activity and C-reactive protein (CRP), glucose, insulin, insulin resistance and insulin growth factor-one (IGF-1) up to December 2017. Standardised mean difference (SMD) scores were calculated, and meta-regression was performed. RESULTS The meta-analysis indicated that survivors randomised to physical activity conditions experienced greater improvements in Insulin (SMD = -0.59; 95% CI, -1.05 to -0.14), CRP (SMD = -0.52; 95% CI, -0.87 to -0.17), insulin resistance (SMD = -0.20; 95% CI, -0.41 to -0.003) and glucose (SMD = -0.19; 95% CI, -0.35 to -0.02) than survivors randomised to control conditions. The meta-regression showed that study duration was positively, albeit marginally related (p = .056) to change in CRP levels among survivors in the physical activity conditions. Furthermore, higher baseline insulin levels in the physical activity conditions were associated with improving insulin levels throughout the intervention (p = .007). CONCLUSIONS Promoting physical activity throughout the survivorship continuum is an effective intervention strategy for improving levels of insulin, glucose control, insulin resistance and CRP among cancer survivors.
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Affiliation(s)
- Yafeng Wang
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan, China
| | - Ben Jin
- Department of Urology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Raheem J Paxton
- Department of Community Medicine and Population Health, The University of Alabama, Tuscaloosa, AL, USA
| | - Weili Yang
- Department of Pediatric Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xirui Wang
- Department of Epidemiology and Biostatistics, Xi'an Jiaotong University, Xi'an, China
| | - Yurui Jiao
- Department of endocrinology, The Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan, China
| | - Xiong Chen
- Department of Endocrinology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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50
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Bekhet AH, Abdalla AR, Ismail HM, Genena DM, Osman NA, El Khatib A, Abbas RL. Benefits of Aerobic Exercise for Breast Cancer Survivors: A Systematic Review of Randomized Controlled Trials. Asian Pac J Cancer Prev 2019; 20:3197-3209. [PMID: 31759342 PMCID: PMC7063018 DOI: 10.31557/apjcp.2019.20.11.3197] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 09/10/2019] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Physical exercise may be beneficial to breast cancer (BC) survivors. Here, we systematically summarized the effects of aerobic exercise in BC survivors. We conducted a systematic review of randomized controlled trials (RCTs). METHODS We searched PubMed, Web of knowledge, Scopus, Cochrane Central, Virtual Health Library and PEDRO databases for relevant RCTs, comparing aerobic exercise with usual care among BC survivors. Data were extracted and evidence was synthesized narratively. RESULTS Twelve studies were included in this systematic review. Studies reported that aerobic exercise can significantly improve the quality of life in BC survivors. Moreover, aerobic exercise alleviated the symptoms of depression and anxiety. However, current evidence from the included studies showed that there was no significant benefit for aerobic exercise in terms of weight loss. CONCLUSION Our study suggests that aerobic exercise is beneficial to BC survivors. CLINICAL RELEVANCE Aerobic exercise should be recommended in the therapeutic and rehabilitative regimens of BC survivors. .
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Affiliation(s)
- Amira Hassan Bekhet
- Faculty of Physical Therapy, Cairo University,
- Medical Research Group of Egypt Cairo,
| | | | - Horeya M Ismail
- Medical Research Group of Egypt Cairo,
- Cancer Research Cluster,
| | - Doaa M Genena
- Medical Research Institute, Alexandria, University, Alexandria, Egypt,
| | - Nermin A Osman
- Medical Research Institute, Alexandria, University, Alexandria, Egypt,
| | - Ayman El Khatib
- Department of Physical Therapy, Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon.
| | - Rami Labib Abbas
- Department of Physical Therapy, Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon.
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