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Binyam D, Naaktgeboren WR, Groen WG, Aaronson NK, Hiensch AE, van Harten WH, Stuiver MM, May AM. Eight-year follow-up of patient-reported outcomes in patients with breast cancer participating in exercise studies during chemotherapy. J Cancer Surviv 2024:10.1007/s11764-024-01640-0. [PMID: 39103710 DOI: 10.1007/s11764-024-01640-0] [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: 03/11/2024] [Accepted: 07/01/2024] [Indexed: 08/07/2024]
Abstract
PURPOSE Numerous randomized controlled trials (RCTs) have shown beneficial exercise effects on fatigue, anxiety and depression and health-related quality of life (HRQoL) in breast cancer (BC) patients during and shortly after treatment. Here, we investigated the long-term effects of exercise during chemotherapy for BC on these outcomes. METHODS We invited participants of two highly comparable RCTs that investigated the effects of exercise (EX) (versus usual care (UC)) during chemotherapy in patients with non-metastatic BC (N = 357) to participate in an 8-year follow-up. In both trials, fatigue, anxiety and depression and HRQoL were assessed using the same questionnaires, at multiple timepoints. Linear mixed-effect models were used to compare study arms over time. RESULTS In total, 156 participants (EX = 82; UC = 74) completed the follow-up questionnaires. EX reported comparable general (between-group difference 0.73, 95% confidence interval (- 0.35; 1.80), ES = 0.18) and physical fatigue (0.55 (- 0.55; 1.65), ES = 0.13), small but statistically significantly higher levels of anxiety (1.24 (0.47 to 2.00), ES = 0.39) and depression (1.10 (0.34; 1.85), ES = 0.38), significantly lower global HRQoL (- 5.99 (- 10.65; - 1.32), ES = 0.34) and comparable summary HRQoL (- 1.90 (- 4.70; 0.89), ES = 0.16) compared to UC. CONCLUSION No long-term beneficial effects of exercise during chemotherapy on BC patients' fatigue, anxiety, depression or HRQoL were observed. The less favourable outcomes for mood and HRQoL that were observed 8 years after participation in an exercise intervention may be explained by selective loss-to-follow-up. IMPLICATIONS FOR CANCER SURVIVORS The results highlight the need to incorporate strategies that promote physical activity maintenance after participation in an exercise programme to also counteract long-term detrimental side effects of cancer treatment.
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Affiliation(s)
- David Binyam
- Julius Center, University Medical Center Utrecht, Universiteitsweg 100, 3584CG, Utrecht, The Netherlands
| | - Willeke R Naaktgeboren
- Julius Center, University Medical Center Utrecht, Universiteitsweg 100, 3584CG, Utrecht, The Netherlands
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Wim G Groen
- Department of Medicine for Older People, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Aging & Later Life, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Ageing & Vitality, Rehabilitation & Development, Amsterdam, The Netherlands
| | - Neil K Aaronson
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Anouk E Hiensch
- Julius Center, University Medical Center Utrecht, Universiteitsweg 100, 3584CG, Utrecht, The Netherlands
| | - Wim H van Harten
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Department of Health Services and Technology Research, University of Twente, Enschede, The Netherlands
- Rijnstate Hospital, Arnhem, The Netherlands
| | - Martijn M Stuiver
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | - Anne M May
- Julius Center, University Medical Center Utrecht, Universiteitsweg 100, 3584CG, Utrecht, The Netherlands.
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Finch A, Benham A. Patient attitudes and experiences towards exercise during oncological treatment. A qualitative systematic review. Support Care Cancer 2024; 32:509. [PMID: 38992238 PMCID: PMC11239782 DOI: 10.1007/s00520-024-08649-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 06/10/2024] [Indexed: 07/13/2024]
Abstract
PURPOSE Exercise and physical activity (PA) during oncological treatment have many benefits. However, PA levels and adherence are often low. This systematic review of qualitative literature aims to explore the experience and the perceived barriers and facilitators to exercise and physical activity during treatment. METHODS A systematic search of the published literature was carried out in the Embase and Medline databases; full details for the protocol can be found in the Prospero database (CRD42022371206). Studies eligible for inclusion were qualitative and included participants that were either currently undergoing oncological treatment or had finished treatment within the last 6 months. The findings from each study were tabulated and synthesised into analytical themes. RESULTS Eighteen full texts from 309 studies met inclusion criteria with a total of 420 participants including both curative and palliative treatment intents. Four overarching themes were generated: (1) Facilitators; (2) Barriers; (3) Experience of PA/exercise and (4) Transforming attitudes. Sub-themes that showed perceptions of PA or exercise during treatment were positive, and seeing personal positive change was highly motivating, especially in a group class setting. Barriers included lack of support or guidance from healthcare professionals (HCPs), environmental challenges and disease burden/fear or worsening symptoms. CONCLUSIONS Despite having positive perceptions of exercise and PA during oncological treatment, there are significant barriers impacting participation. Lack of support from HCPs and fear of worsening symptoms were significant barriers. Future research should focus on impacting these barriers to ultimately improve PA and exercise levels in those undergoing oncological treatment.
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Affiliation(s)
- Alice Finch
- Oncology Therapies Department, St Bartholomew's Hospital, Barts Health NHS Trust, London, EC1A 7BE, UK
| | - Alex Benham
- School of Allied Health Professions, Keele University, Keele, ST5 5BG, UK.
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Anandavadivelan P, Mijwel S, Wiklander M, Kjoe PLM, Luijendijk M, Bergh J, Rundqvist H, Wengstrom Y. Five-year follow-up of the OptiTrain trial on concurrent resistance and high-intensity interval training during chemotherapy for patients with breast cancer. Sci Rep 2024; 14:15333. [PMID: 38961182 PMCID: PMC11222517 DOI: 10.1038/s41598-024-65436-z] [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: 03/20/2024] [Accepted: 06/20/2024] [Indexed: 07/05/2024] Open
Abstract
The protocol predefined aim of this study is to assess sustained effects of the OptiTrain trial on several health outcomes, 5 years after the baseline assessment. The OptiTrain study was a prospective, randomised controlled trial with 240 patients with breast cancer undergoing adjuvant chemotherapy that compared the effects of 16 weeks of two exercise programs, RT-HIIT and AT-HIIT, with usual care (UC). After a 5-year follow-up, eligible participants were evaluated for the primary outcome of cancer-related fatigue (CRF) and secondary outcomes including quality of life, symptoms, muscle strength, cardiorespiratory fitness, body mass, physical activity, and sedentary behavior. Statistical analysis was conducted using linear mixed models adjusted for baseline values. Tumour profile and menopausal status were additionally adjusted for CRF. Mean differences (MD), 95% confidence intervals (CIs), and standardized effect sizes (ES) were reported. At the 5-year follow-up, there were no statistically significant differences in total CRF between the intervention groups and the UC group. RT-HIIT reported significantly reduced pain sensitivity at the gluteus MD = 79.00 (95% CI 10.17, 147.83, ES = 0.55) compared to UC. Clinically meaningful differences for an increase in cognitive CRF and cardiorespiratory fitness were observed for the AT-HIIT versus UC group, and for lower limb strength for the RT-HIIT versus UC group, albeit without statistical significance. Engaging in targeted exercise during adjuvant chemotherapy for breast cancer provides short-term benefits in reducing fatigue and maintaining physical function. However, our 5-year follow-up indicates that these effects are limited in the long term. This underscores the need to support breast cancer survivors maintain their PA levels throughout their survivorship journey.
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Affiliation(s)
- Poorna Anandavadivelan
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institute, Stockholm, Sweden.
| | - Sara Mijwel
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institute, Stockholm, Sweden
- Department of Physical Performance, The Norwegian School of Sport Sciences, Oslo, Norway
| | - Maria Wiklander
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institute, Stockholm, Sweden
| | - Philippe Lee Meeuw Kjoe
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute-Antoni Van Leeuwenhoek, Amsterdam, The Netherlands
| | - Maryse Luijendijk
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute-Antoni Van Leeuwenhoek, Amsterdam, The Netherlands
| | - Jonas Bergh
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
- Breast Center, Karolinska University Hospital, Karolinska Comprehensive Cancer Center, Stockholm, Sweden
| | - Helene Rundqvist
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
- Unit of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden
| | - Yvonne Wengstrom
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institute, Stockholm, Sweden
- Breast Center, Karolinska University Hospital, Karolinska Comprehensive Cancer Center, Stockholm, Sweden
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Rashid FA, Anwar W, Kandakurti PK, Hazari A. Physical rehabilitation program for cardiorespiratory health and quality of life among breast cancer survivors in UAE: protocol for a randomized control trial. Trials 2024; 25:354. [PMID: 38835046 PMCID: PMC11149173 DOI: 10.1186/s13063-024-08192-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 05/22/2024] [Indexed: 06/06/2024] Open
Abstract
BACKGROUND Cancer is a medical condition where some cells of the body reproduce uncontrollably and metastasize to other parts of the body. The burden of the disease is significantly high both at the global and national levels. In UAE, cancer was found to be the third leading cause of death. Breast cancer has been ranked first due to its prevalence, incidence, and mortality in UAE. Breast cancer survivors have significantly poor cardiovascular tolerance which affects their quality of life (QoL), even after the carcinoma has been treated or removed. Thus, the protocol aims to analyze the changes in cardiovascular endurance and QoL domains for breast cancer survivors in the United Arab Emirates using a long-term 2-month physical rehabilitation. METHODS A total of 60 breast cancer survivors would be included in the study using a randomized controlled allocation of a 2-month physical rehabilitation intervention program with 3 months of follow-up. The intervention would target the cardiovascular endurance component of the participants to improve their physical well-being and quality of life ultimately. DISCUSSION The findings of the study would have high clinical significance among breast cancer survivors in the UAE. The proposed physical rehabilitation program could be beneficial in improving cardiovascular endurance and thereby reduce the risk of mortality among breast cancer survivors. In addition, the physiological benefits of the exercise program could improve their quality-of-life domains including physical, mental, and social well-being. On a larger view, it could also help to reduce the economic burden on the health system due to associated complications. TRIAL REGISTRATION ClinicalTrials.gov NCT06013527. Registered on 28 August 2023.
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Affiliation(s)
- Fatima Abdul Rashid
- College of Health Sciences, Gulf Medical University, Ajman, United Arab Emirates
| | - Wajiha Anwar
- College of Health Sciences, Gulf Medical University, Ajman, United Arab Emirates
| | | | - Animesh Hazari
- College of Health Sciences, Gulf Medical University, Ajman, United Arab Emirates.
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5
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Tan GA, Peiris CL, Dennett AM. Cancer survivors maintain health benefits 6 to 12 months after exercise-based rehabilitation: a systematic review and meta-analysis. J Cancer Surviv 2024; 18:651-672. [PMID: 36547801 DOI: 10.1007/s11764-022-01322-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE To determine if the effects of exercise-based cancer rehabilitation on physical functioning, activity (including physical activity) and participation (including quality of life) are maintained at 6 to 12 months. METHODS Electronic databases CINAHL, Embase, MEDLINE, PsycINFO and PubMed were searched from the earliest available time to August 2021. Randomised controlled trials examining the long-term effects (≥ 6 months post-intervention) of exercise-based rehabilitation were eligible for inclusion. Outcome data (e.g. fitness, physical activity, walking capacity, fatigue, depression, quality of life) were extracted and the methodological quality assessed using PEDro. Meta-analyses using standardised mean differences were used to synthesise data and Grades of Recommendation, Assessment, Development and Evaluation criteria were applied. RESULTS Nineteen randomised controlled trials including 2974 participants were included. Participants who underwent exercise-based rehabilitation had improved physical activity (SMD 0.30, 95% CI 0.09 to 0.51, I2 = 0%), cardiorespiratory fitness (SMD 2.00 ml/kg/min, 95% CI 0.56 to 3.45, I2 = 0%), walking capacity (SMD 0.62, 95% CI 0.33 to 0.92, I2 = 0%), depression (SMD 0.71, 95% 0.05 to 1.37, I2 = 90%), quality of life (physical functioning component SMD 0.56, 95% CI 0.11 to 1.01, I2 = 62%) and sleep (MD 0.69 points, 95% 0.46 to 0.92, I2 = 0%) at 6 to 12 months follow-up. There was no data available on cancer-related mortality or recurrence. CONCLUSION Health outcomes of cancer survivors after exercise-based rehabilitation can be maintained after rehabilitation completion. IMPLICATIONS FOR CANCER SURVIVORS Cancer survivors can maintain health benefits achieved through exercise-based rehabilitation.
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Affiliation(s)
- Germaine A Tan
- Allied Health Clinical Research Office, Eastern Health, Melbourne, VIC, Australia.
- School of Allied Health, La Trobe University, Melbourne, VIC, Australia.
| | - Casey L Peiris
- Allied Health Clinical Research Office, Eastern Health, Melbourne, VIC, Australia
- School of Allied Health, La Trobe University, Melbourne, VIC, Australia
| | - Amy M Dennett
- Allied Health Clinical Research Office, Eastern Health, Melbourne, VIC, Australia
- School of Allied Health, La Trobe University, Melbourne, VIC, Australia
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Sebri V, Durosini I, Pravettoni G. An integrated intervention on well-being: A qualitative study on relationships and emotions. Acta Psychol (Amst) 2024; 246:104276. [PMID: 38640577 DOI: 10.1016/j.actpsy.2024.104276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 02/29/2024] [Accepted: 04/15/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND Oncological treatments lead to physical and emotional difficulties with notable consequences in everyday life. Thus, integrated interventions that can promote quality of life are needed. Since current studies suggest that integrated programs of both physical exercises and psychological sessions can promote positive emotions, this pilot study aims to explore the impact of a one-week intervention that combines sailing activities and psychological support. METHODS Twenty-nine breast cancer survivors took part in this study. Before and after the intervention, participants were invited to answer three open questions to evaluate their perceptions of personal evaluations about their relationships and emotions. A Qualitative Thematic Analysis was used to evaluate participants' answers and to compare the sub-themes that emerged in the two times. RESULTS Findings highlighted three main themes: a) caregivers and emotional closeness - family members are generally a crucial point of reference for participants. Friends, colleagues, and healthcare professionals were also cited as relevant figures during the cancer journey and after the psychological intervention; b) emotions towards others - positive and negative emotions towards these figures emerged, and some women felt alone, and c) emotions towards oneself - exploring emotions related to themselves highlighted positive and negative feelings and the desire for change to promote love and care towards themselves. Interestingly, the number of negative emotions towards themselves decreased after the intervention. CONCLUSIONS The integrated intervention could promote the reflection on personal relationships and emotions.
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Affiliation(s)
- Valeria Sebri
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy.
| | - Ilaria Durosini
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Gabriella Pravettoni
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
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7
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Okayama T, Suzuki K, Morishita S, Inoue J, Tanaka T, Nakano J, Fukushima T. Pretreatment quality of life and survival in patients with lung cancer: a systematic review and meta-analysis. BMC Cancer 2024; 24:495. [PMID: 38637726 PMCID: PMC11027547 DOI: 10.1186/s12885-024-12267-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 04/16/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Although many studies have explored the correlation between quality of life and survival, none have reported this relationship for specific cancers assessed at distinct time points. This meta-analysis aimed to investigate the impact of pretreatment Global Quality of Life (QOL) and functioning QOL, including physical, social, role, emotional, and cognitive QOLs, on mortality risk in patients with lung cancer. METHODS A literature search was conducted across the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, and PubMed databases for articles published between their inception and December 2022. Subsequently, 11 studies were selected based on predefined eligibility criteria to investigate the relationship between pretreatment QOLs and mortality risk in patients with lung cancer. RESULTS Pretreatment global, physical, social, role, and emotional QOLs were significantly associated with mortality risk as follows: Global QOL (hazard ratio [HR] = 1.08 95% confidence interval [CI] = 1.03-1.13); Physical QOL (HR = 1.04 95% CI = 1.02-1.05); Social QOL (HR = 1.02 95% CI = 1.01-1.03; Role QOL (HR = 1.01 95% CI = 1.01-1.02); Emotional QOL (HR = 1.01 95% CI = 1.00-1.03). CONCLUSIONS These findings underscore the importance of early QOL assessment after diagnosis as well as early provision of physical, social, and psychological support accommodating each patient's demands. TRIAL REGISTRATION The International Prospective Register of Systematic Reviews registration number CRD42023398206, Registered on February 20, 2023.
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Affiliation(s)
- Taro Okayama
- Division of Rehabilitation Medicine, Shizuoka Cancer Center, Shizuoka, Japan
| | - Katsuyoshi Suzuki
- Division of Rehabilitation Medicine, Shizuoka Cancer Center, Shizuoka, Japan
| | - Shinichiro Morishita
- Department of Physical Therapy, School of Health Science, Fukushima Medical University, Fukushima, Japan
| | - Junichiro Inoue
- Division of Rehabilitation Medicine, Kobe University Hospital International Clinical Cancer Research Center, Kobe, Japan
| | - Takashi Tanaka
- Department of Rehabilitation, Hyogo Medical University Hospital, Nishinomiya, Japan
| | - Jiro Nakano
- Faculty of Rehabilitation, Kansai Medical University, Osaka, Japan
| | - Takuya Fukushima
- Faculty of Rehabilitation, Kansai Medical University, Osaka, Japan.
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Brunet J, Price J, Baillot A, Dann E, Vani MF. Feasibility and acceptability of study methods and psychosocial interventions for body image among women diagnosed with breast cancer: A systematic review and narrative synthesis. Psychooncology 2024; 33:e6278. [PMID: 38282235 DOI: 10.1002/pon.6278] [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: 08/16/2023] [Revised: 11/02/2023] [Accepted: 12/13/2023] [Indexed: 01/30/2024]
Abstract
OBJECTIVE This systematic review aimed to summarize evidence for the feasibility and acceptability of psychosocial interventions for body image among women diagnosed with breast cancer and the study methods used to evaluate the interventions in question. METHODS Articles were identified via MEDLINE, CINAHL, CENTRAL, PsychINFO, and EMBASE. Inclusion criteria were: (1) peer-reviewed publication in English from 2000 onward with accessible full-text, (2) reported data on the feasibility and/or acceptability of psychosocial interventions and/or study methods, (3) included at least one measure of body image or reported a body-related theme, and (4) sample comprised women diagnosed with breast cancer. All study designs were eligible. Two reviewers independently performed study selection, data extraction, and quality assessment. RESULTS Sixty-two articles were included. Participants and comparator groups varied as did interventions. Feasibility and acceptability of the interventions and study methods were inconsistently operationalized and reported across studies. Evidence of feasibility and acceptability was heterogeneous within and across studies, though mostly positive. CONCLUSION Published psychosocial interventions for body image and study methods are generally feasible and acceptable. Findings should be used to advance the development, implementation, and evaluation of interventions designed to improve outcomes (body image or otherwise) for women diagnosed with breast cancer. SYSTEMATIC REVIEW REGISTRATION This review was registered with the International Prospective Register of Systematic Reviews (PROSPERO; ID: CRD42021269062, 11 September 2021).
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Affiliation(s)
- Jennifer Brunet
- School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
- Cancer Therapeutic Program, Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, Ontario, Canada
- Institut du Savoir Montfort, Hôpital Montfort, Ottawa, Ontario, Canada
| | - Jenson Price
- School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Aurélie Baillot
- Institut du Savoir Montfort, Hôpital Montfort, Ottawa, Ontario, Canada
- Département des Sciences Infirmières, Université du Québec en Outaouais, Gatineau, Québec, Canada
- Centre de Recherche en Médecine Psychosociale, Gatineau, Québec, Canada
| | - Erica Dann
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Madison F Vani
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
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Gutiérrez-Santamaría B, Martinez Aguirre-Betolaza A, García-Álvarez A, Arietaleanizbeaskoa MS, Mendizabal-Gallastegui N, Grandes G, Coca A, Castañeda-Babarro A. Association between Phase Angle and Subjective Perceptions of Health Variables in Cancer Patients. Healthcare (Basel) 2023; 11:1852. [PMID: 37444686 DOI: 10.3390/healthcare11131852] [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: 05/13/2023] [Revised: 06/20/2023] [Accepted: 06/25/2023] [Indexed: 07/15/2023] Open
Abstract
The phase angle, an increasingly studied healthcare tool, was studied to explore its relationship with psychological factors in cancer patients. The aim of this study was to investigate the relationship between the phase angle (PhA), obtained by the bioimpedance analysis of body composition, and psychological factors measured by questionnaire in cancer patients. The study included 311 patients who underwent bioimpedance testing to determine their PhA value; their psychological profiles were assessed using SF-36, FACIT, QLQ-C30, and GHQ-12 questionnaires. Mixed linear regression models were used to analyze the relationship between PhA and the psychological tests. The results showed a statistical correlation between PhA and the GHQ-12, FACIT, and SF-36 questionnaires, with higher PhA values associated with better results on the questionnaires. In the QLQ-C30 questionnaire, a correlation was observed between PhA and the functioning scales (p < 0.001), except for emotional and cognitive functioning (p = 0.148 and p = 0.544, respectively), but not in most of the symptom scales. The PhA is a useful tool for assessing the subjective health perception of cancer patients, especially with regard to psychological factors. While there is a statistically significant correlation, further research is required before confidently applying it in clinical practice. The current predictive value of this predictor for certain psychological aspects is limited, underscoring the need for additional research.
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Affiliation(s)
- Borja Gutiérrez-Santamaría
- Department of Physical Activity and Sport Sciences, Faculty of Education and Sport, University of Deusto, 48007 Bilbo, Bizkaia, Spain
| | - Aitor Martinez Aguirre-Betolaza
- Department of Physical Activity and Sport Sciences, Faculty of Education and Sport, University of Deusto, 48007 Bilbo, Bizkaia, Spain
| | - Arturo García-Álvarez
- Primary Care Research Unit of Bizkaia, Biocruces Bizkaia Health Research Institute, Plaza de Cruces 12, 48903 Barakaldo, Biscay, Spain
| | - María Soledad Arietaleanizbeaskoa
- Primary Care Research Unit of Bizkaia, Biocruces Bizkaia Health Research Institute, Plaza de Cruces 12, 48903 Barakaldo, Biscay, Spain
| | - Nere Mendizabal-Gallastegui
- Primary Care Research Unit of Bizkaia, Biocruces Bizkaia Health Research Institute, Plaza de Cruces 12, 48903 Barakaldo, Biscay, Spain
| | - Gonzalo Grandes
- Primary Care Research Unit of Bizkaia, Biocruces Bizkaia Health Research Institute, Plaza de Cruces 12, 48903 Barakaldo, Biscay, Spain
| | - Aitor Coca
- Department of Physical Activity and Sports Sciences, Faculty of Health Sciences, Euneiz University, Vitoria-Gasteiz, Alava, La Biosfera Ibilbidea, 6, 01013 Gasteiz, Araba, Spain
| | - Arkaitz Castañeda-Babarro
- Department of Physical Activity and Sport Sciences, Faculty of Education and Sport, University of Deusto, 48007 Bilbo, Bizkaia, Spain
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10
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Salisbury CE, Hyde MK, Cooper ET, Stennett RC, Gomersall SR, Skinner TL. Physical activity behaviour change in people living with and beyond cancer following an exercise intervention: a systematic review. J Cancer Surviv 2023; 17:569-594. [PMID: 37074621 PMCID: PMC10209249 DOI: 10.1007/s11764-023-01377-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 03/31/2023] [Indexed: 04/20/2023]
Abstract
PURPOSE Exercise interventions can increase physical activity and wellbeing of people living with/beyond cancer. However, little is known about maintenance of physical activity in this population ≥ 6 months post-exercise intervention, when theoretical evidence suggests behaviour maintenance occurs. Study aims are to (i) systematically review maintenance of physical activity ≥ 6-month post-exercise intervention, and (ii) investigate the influence of behaviour change techniques (BCTs) on physical activity maintenance in people living with/beyond cancer. METHODS CINAHL, CENTRAL, EMBASE and PubMed databases were searched for randomised controlled trials up to August 2021. Trials including adults diagnosed with cancer that assessed physical activity ≥ 6 months post-exercise intervention were included. RESULTS Of 142 articles assessed, 21 reporting on 18 trials involving 3538 participants were eligible. Five (21%) reported significantly higher physical activity ≥ 6 months post-exercise intervention versus a control/comparison group. Total number of BCTs (M = 8, range 2-13) did not influence intervention effectiveness. The BCTs Social support, Goal setting (behaviour), and Action planning, alongside supervised exercise, were important, but not sufficient, components for long-term physical activity maintenance. CONCLUSIONS Evidence for long-term physical activity maintenance post-exercise intervention for people living with/beyond cancer is limited and inconclusive. Further research is required to ensure the physical activity and health benefits of exercise interventions do not quickly become obsolete. IMPLICATIONS FOR CANCER SURVIVORS Implementation of the BCTs Social support, Goal setting (behaviour), and Action planning, alongside supervised exercise, may enhance physical activity maintenance and subsequent health outcomes in people living with/beyond cancer.
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Affiliation(s)
- Chloe E Salisbury
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia.
| | - Melissa K Hyde
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
| | - Ella T Cooper
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Rebecca C Stennett
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Sjaan R Gomersall
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Tina L Skinner
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
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11
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Álvarez-Salvago F, Jiménez-García JD, Martínez-Amat A, Pujol-Fuentes C, Atienzar-Aroca S, Molina-García C, Aibar-Almazán A. Does participation in therapeutic exercise programs after finishing oncology treatment still ensure an adequate health status for long-term breast cancer survivors? A ≥ 5 years follow-up study. Support Care Cancer 2023; 31:343. [PMID: 37199790 DOI: 10.1007/s00520-023-07801-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 05/04/2023] [Indexed: 05/19/2023]
Abstract
PURPOSE The aims of this study were to evaluate whether the effects of two therapeutic exercise programs are sustained over time (≥ 5 years) in long-term breast cancer survivors (LTBCS). Second, to determine the influence of the current level of physical activity (PA) performed on cancer-related fatigue (CRF) that these patients may present ≥5 years later. METHODS A prospective observational study was conducted with a cohort of 80 LTBCS in Granada during 2018. Firstly, considering their participation in one of the programs, they were allocated into two groups: usual care and therapeutic exercise program, to assess CRF, pain and pressure pain sensitivity, muscle strength, functional capacity, and quality of life. Secondly, they were also classified into 3 groups according to current level of weekly PA performed: ≤ 3, 3.1-7.4, and ≥ 7.5 (MET-hour/week) respectively, to assess its impact over CRF. RESULTS Although the positive effects of the programs are not sustained over time, a trend toward significance can be observed for a greater reduction in overall CRF levels, lower intensity of pain in the affected arm and cervical region, and greater functional capacity and quality of life in the group that underwent therapeutic exercise. Additionally, 66.25% of LTBCS are inactive ≥ 5 years after completion of the program and furthermore, such inactivity is accompanied by higher CRF levels (P .013 to .046). CONCLUSION The positive effects of therapeutic exercise programs are not maintained over time for LTBCS. Additionally, more than half of these women (66.25%) are inactive ≥ 5 years after completion of the program, this inactivity being accompanied by higher levels of CRF.
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Affiliation(s)
- Francisco Álvarez-Salvago
- Department of Physiotherapy, Faculty of Health Sciences, European University of Valencia, Valencia, Spain
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, Jaén, Spain
| | - José Daniel Jiménez-García
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, Jaén, Spain.
- Department of Physiotherapy, Faculty of Health Sciences, University of Jaén, Jaén, Spain, Campus Las Lagunillas s/n, 23071, Jaén, Spain.
| | - Antonio Martínez-Amat
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, Jaén, Spain
| | - Clara Pujol-Fuentes
- Department of Physiotherapy, Faculty of Health Sciences, European University of Valencia, Valencia, Spain
| | - Sandra Atienzar-Aroca
- Department of Dentistry, Faculty of Health Sciences, European University of Valencia, Valencia, Spain
| | | | - Agustín Aibar-Almazán
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, Jaén, Spain
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12
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Effect of Postoperative Adjuvant Radiotherapy on Quality of Life, Anxiety, and Depression in Adult Female Breast Cancer Patients. Cureus 2023; 15:e36635. [PMID: 36968677 PMCID: PMC10038179 DOI: 10.7759/cureus.36635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2023] [Indexed: 03/26/2023] Open
Abstract
Aim: This study aims to identify anxiety and depression caused by adjuvant radiotherapy in breast cancer cases to determine the deterioration in the quality of life and investigate the effect of early treatment. Materials and Methods: In this study, the Beck Depression Inventory, Beck Anxiety Inventory, and European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-30 (EORTC QLQ-C30) Turkish 3.0 forms were evaluated in 63 breast cancer patients before the start of radiotherapy treatment (T1) and at six weeks after the end of radiotherapy treatment (T2). Results: A high level of anxiety was detected in 77.8% of patients, and depression was found in 25.4% of patients in T1. When depressive cases were evaluated with EORTC QLQ-C30 scores, the general health status (p = 0.043), role function (p = 0.027), emotional (p < 0.002), cognitive (p < 0.001), and social (p < 0.0001) scales were statistically lower in T1, whereas pain (p = 0.045) and insomnia (p < 0.0001) symptoms were higher in T1. Anxiety and EORTC QLQ-C30 scores in terms of emotional function (p = 0.015), social function (p < 0.003), and symptoms of insomnia (p = 0.027) were found to be statistically higher in T1 anxious cases. However, anxiety was detected in only 3% of T2 cases, and no depression was found in any of the cases. Anxiety and EORTC QLQ-C30 scores and symptom scales were evaluated in terms of role function (p < 0.0001), emotional (p = 0.041) and social scales (p = 0.014), fatigue (p = 0.028), pain (p = 0.033), insomnia (p = 0.011), and constipation (p < 0.0001); these were found to be statistically significant in T2. Conclusion: This study revealed that early diagnosis and treatment of anxiety before initiating adjuvant radiotherapy reduces the development of long-term anxiety-related depression in the future. Therefore, it is recommended that patients be evaluated for anxiety and depression before starting adjuvant radiotherapy.
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Cole A, Andrilla CHA, Patterson D, Davidson S, Mendoza J. Measuring the Impact of the COVID-19 Pandemic on Health Behaviors and Health Care Utilization in Rural and Urban Patients with Cancer and Cancer Survivors. CANCER RESEARCH COMMUNICATIONS 2023; 3:215-222. [PMID: 36817949 PMCID: PMC9934461 DOI: 10.1158/2767-9764.crc-22-0386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 12/06/2022] [Accepted: 01/23/2023] [Indexed: 01/28/2023]
Abstract
Healthcare access and health behaviors differ between those living in urban and rural communities and contribute to inequitable cancer health outcomes. The COVID-19 pandemic led to significant disruptions in daily life and healthcare delivery. This cross-sectional survey aimed to measure the impact of the COVID-19 pandemic on the health behaviors of cancer patients and survivors, comparing outcomes for urban and rural respondents. Survey was administered from January 2021-June 2021 to cancer patients or survivors (treated within the last 5 years) at one of six cancer centers in Washington and Idaho. Respondent ZIP code was used to assess rurality using Rural-Urban Commuting Area designation. 515 rural (43.5% of those contacted) and 146 urban (40% of those contacted) cancer patients and survivors participated. Few differences between urban and rural cancer patients and cancer survivors were noted. Rural residents were older (69.2 years vs. 66.9 years). Rural respondents had higher mean alcohol consumption than urban respondents (4.4 drinks per week vs. 2.7 drinks per week). 12.2% of those who reported drinking in the last 30 days also reported increased alcohol consumption since the start of the pandemic, with no difference in reported increased alcohol consumption in rural vs. urban respondents. 38.5% reported decreased physical activity. 20.5% reported cancelling or delaying cancer care due to the COVID-19 pandemic. Delays in cancer healthcare services and worsening health behaviors due to the COVID-19 pandemic may contribute to poorer health outcomes, with few differences between rural and urban cancer patients and cancer survivors.
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Affiliation(s)
- Allison Cole
- Department of Family Medicine, University of Washington, Seattle, Washington
| | | | - Davis Patterson
- Department of Family Medicine, University of Washington, Seattle, Washington
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14
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Gu J, Hu M, Chen Y, Yu J, Ji Y, Wei G, Huo J. Bibliometric analysis of global research on physical activity and sedentary behavior in the context of cancer. Front Oncol 2023; 13:1095852. [PMID: 36776335 PMCID: PMC9909561 DOI: 10.3389/fonc.2023.1095852] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 01/13/2023] [Indexed: 01/27/2023] Open
Abstract
Objective Numerous studies focusing on sedentary behavior (SB) and physical activity (PA) in the context of cancer have been reported in recent years. We analyzed and visualized studies on SB and PA in patients with cancer over the last 20 years using scientometric methods, to provide insights on gaps and deficiencies in the literature, and to inform future research guidelines. Methods All relevant studies in the field from 2001 to October 2022 were reviewed using bibliometric tools, including VOSviewer, Bibliometric online analysis platform, and biblioshiny, to determine the most influential countries, institutions, journals, and authors. We explored current research hotpots and potential research trends, based on keyword clustering and dynamic changes. Our research focuses on PA, SB, and cancer across the entire cancer continuum, from primary prevention to treatment to cancer survivorship. Results Scientometric analysis identified 4,382 relevant manuscripts on SB and PA in the context of cancer, with a 10-fold increase in articles over the past 20 years. The United States, Canada, and Australia were the most influential countries. The journal, Supportive Care in Cancer, had the highest number of publications, while Clinical Oncology had the highest H-index. K.S. Courneya was the most influential author in this field, with the highest number of publications, total citations, and H-index. Keyword analysis revealed that current research is focused on PA and SB in patients with breast cancer, quality of life, and aerobic exercise. Future frontiers include cancer prehabilitation programs and cardiorespiratory fitness, and remote intervention and social support. Conclusion By using bibliometrics, we conducted a comprehensive review of SB and PA in cancer-related studies. The current research focused on exercise and sedentariness in breast cancer patients and the role of PA in improving quality of life in survivorship. Emerging research foci were generally around cancer prehabilitation programs and remote intervention issues for PA. In addition, some publication deficits are noted: studies of PA and SB in less common cancers; the recommended doses and intensities of exercise for cancer; the timing of interventions for prehabilitation and the establishment of individualized exercise protocols. These deficiencies align with the needs for future research topics.
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Affiliation(s)
- Jialin Gu
- Department of Oncology, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China,The Third Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Miao Hu
- Department of Oncology, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China,The Third Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Yonglin Chen
- Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Jialin Yu
- Department of Oncology, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China,Department of Oncology, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, Jiangsu, China
| | - Yi Ji
- Department of Oncology, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China,Department of Oncology, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, Jiangsu, China
| | - Guoli Wei
- Department of Oncology, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China,Department of Oncology, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, Jiangsu, China,*Correspondence: Guoli Wei, ; Jiege Huo,
| | - Jiege Huo
- Department of Oncology, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China,Department of Oncology, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, Jiangsu, China,*Correspondence: Guoli Wei, ; Jiege Huo,
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15
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Gutiérrez-Santamaría B, Castañeda-Babarro A, Arietaleanizbeaskoa MS, Mendizabal-Gallastegui N, Grandes G, Coca A. Physiological and mental health changes in cancer patients during the COVID-19 state of emergency. SPORT SCIENCES FOR HEALTH 2023; 19:123-130. [PMID: 36211532 PMCID: PMC9525225 DOI: 10.1007/s11332-022-01008-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 09/15/2022] [Indexed: 11/24/2022]
Abstract
Backgrounds Due to the COVID-19 pandemic that we are currently facing, many governments across the world have declared a state of emergency and even confinements. This stressful situation, in addition to prolonged stays at home, may imply a radical change in lifestyle behavior and physical activity (PA). The aim of this study is to evaluate the physiological and psychological effects in cancer patients who changed their PA habits during the COVID-19 state of emergency in Spain. Methods Thirty-three participants were evaluated pre- and post-state of emergency. A series of questionnaires was used to assess cancer-specific quality of life. Results The most relevant results revealed significantly lower walking time (p < 0.001) and sitting time (p = 0.014). Upper and lower body strength also decreased significantly (p = 0.009 and 0.012, respectively) and oxygen consumption (VO2 peak) (p = 0.023). None of the parameters analysed showed significant differences for psychological aspects (QLQ-C-30 and SF-36) and body composition. Conclusion Lower physical activity leads to negative physiological adaptation, particularly affecting cardiovascular and strength levels. While it is important to maintain the general population's amount and intensity of exercise, this particularly vulnerable group's physical capacity is vital to their health and well-being.
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Affiliation(s)
- Borja Gutiérrez-Santamaría
- Department of Physical Activity and Sport Sciences, Faculty of Education and Sport, University of Deusto, 48007 Bizkaia, Spain
| | - Arkaitz Castañeda-Babarro
- Department of Physical Activity and Sport Sciences, Faculty of Education and Sport, University of Deusto, 48007 Bizkaia, Spain
| | - Maria Soledad Arietaleanizbeaskoa
- Primary Care Research Unit of Bizkaia, Biocruces Bizkaia Health Research Institute, Plaza de Cruces 12, 48903 Barakaldo, Biscay Spain
| | - Nere Mendizabal-Gallastegui
- Primary Care Research Unit of Bizkaia, Biocruces Bizkaia Health Research Institute, Plaza de Cruces 12, 48903 Barakaldo, Biscay Spain
| | - Gonzalo Grandes
- Primary Care Research Unit of Bizkaia, Biocruces Bizkaia Health Research Institute, Plaza de Cruces 12, 48903 Barakaldo, Biscay Spain
| | - Aitor Coca
- Department of Physical Activity and Sports Sciences, Faculty of Health Sciences, Euneiz University, La Biosfera Ibilbidea, 6, 01013 Vitoria-Gasteiz, Spain
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16
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Kang JJ, Lee H, Park BH, Song YK, Park SE, Kim R, Lee KA. Efficacy of a 4-Week Nurse-Led Exercise Rehabilitation Program in Improving the Quality of Life in Women Receiving a Post-Mastectomy Reconstruction Using the Motiva Ergonomix TM Round SilkSurface. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:16. [PMID: 36612340 PMCID: PMC9819378 DOI: 10.3390/ijerph20010016] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 12/13/2022] [Accepted: 12/16/2022] [Indexed: 06/17/2023]
Abstract
We assessed the efficacy of a 4-week nurse-led exercise rehabilitation (ER) program in improving the quality of life (QOL) of breast cancer survivors (BCS) receiving an implant-based breast reconstruction. The eligible patients were equally randomized to either of both groups: the intervention group (n = 30; a 4-week nurse-led ER program) and the control group (n = 30; a 4-week physical therapist-supervised one). Both after a 4-week ER program and at baseline, the patients were evaluated for the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) and Fatigue Severity Scale (FSS) scores. There was a significantly higher degree of increase in global health status/QOL scores, physical functioning scores, role functioning scores, and emotional functioning scores at 4 weeks from baseline in the intervention group as compared with the control group (p = 0.001). However, there was a significantly higher degree of decrease in fatigue scores, nausea/vomiting scores, pain scores, dyspnea scores, and FSS scores in the intervention group as compared with the control group (p = 0.001). In conclusion, our results indicate that a 4-week nurse-led ER program might be effective in the QOL in BCS receiving a post-mastectomy implant-based reconstruction using the Motiva ErgonomixTM Round SilkSurface.
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Affiliation(s)
- Jung Joong Kang
- Department of Physical Medicine and Rehabilitation, Booboo Medical Healthcare Hospital, Mokpo 58655, Republic of Korea
| | - Hyunho Lee
- Department of Anesthesiology and Pain Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan 44033, Republic of Korea
| | - Bom Hui Park
- Department of Medical Device Management and Research, SAIHST, Sungkyunkwan University, Seoul 06355, Republic of Korea
| | - Yu Kwan Song
- Department of Plastic and Reconstructive Surgery, Chung Ju Mirae Hospital, Chungju 27361, Republic of Korea
| | - Soon Eun Park
- Department of Anesthesiology and Pain Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan 44033, Republic of Korea
| | - Robert Kim
- Department of Medical and Pharmaceutical Affairs, Doctor CONSULT, Seoul 06296, Republic of Korea
| | - Kyung Ah Lee
- Department of Plastic and Reconstructive Surgery, Inje University Haeundae Paik Hospital, 875 Haeun-daero, Busan 48108, Republic of Korea
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17
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Briant A, Frandemiche C, Sevin E, Kaluzinski L, Levy C, André M, Rat F, Lucas V, Dadoun N, Segura C, Joly F, Delcambre C, Beauplet B, Lerosier B, Besnier A, Desvergée A, Leconte P, Morello R, Blaizot X. Supervised Physical Activity Quickly Improves Social Dimension of Quality of Life in Breast Cancer Patients. Med Sci Sports Exerc 2022; 54:2158-2166. [PMID: 35881932 DOI: 10.1249/mss.0000000000003005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE The objectives of the present study was to evaluate the implementation of the program in real life and the evolution of the quality of life (QoL) in breast cancer patients after 3 months of supervised PA in real life and to determine the factors associated with changes in various QoL dimensions. METHODS This prospective cohort study was carried out in female patients with breast cancer diagnosed within a maximum of 3 yr. QoL and physical exertion intensity during the supervised physical activity (PA) sessions were assessed by the Quality of Life Questionnaire for Cancer and Borg scale, respectively. Statistical analyses comparing QoL scores between the start and the end of supervised PA program were assessed using paired Student's t -tests. Multivariate analysis was performed by linear regression with only variables with a P value <0.15 in univariate model. RESULTS A total of 93 patients were included in the analyses. There was a significant improvement of social functioning at T3 (∆ = 11.5; P < 0.001). The improvement of social functioning was significantly and independently associated with the Borg improvement ( β = 2.66 ± 1.31, P = 0.046), chemotherapy ( β = 11.03 ± 5.45, P = 0.046), hormone therapy ( β = -13.91 ± 5.51, P = 0.013), social isolation ( β = -14.81 ± 6.55, P = 0.026), and comorbidities ( β = -15.32 ± 5.59, P = 0.007). CONCLUSIONS We observed a real enthusiasm and need among patients for practicing PA supervised by a sport trainer near their home. The increase in the intensity of exercise over time contributes to the improvement of the QoL, especially on the social functioning. These results, consistent with previous literature, reinforce the importance of exercise intensity on many dimensions of QoL. In addition, patients expressed great satisfaction with the supervised program, resulting in a strong desire to maintain long-term PA.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Bérengère Beauplet
- CHU de Caen et Normandie Univ, UniCaen, INSERM, U1086, ANTICIPE, Caen, FRANCE
| | | | | | - Antoine Desvergée
- CHU de Caen et Normandie Univ, UniCaen, INSERM, U1086, ANTICIPE, Caen, FRANCE
| | | | - Rémy Morello
- Unité de Biostatistique et de Recherche Clinique (UBRC), CHU de Caen Normandie, Caen, FRANCE
| | - Xavier Blaizot
- Réseau Régional de Cancérologie OncoNormandie, Caen, FRANCE
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18
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Associations between Physical Exercise, Quality of Life, Psychological Symptoms and Treatment Side Effects in Early Breast Cancer. Breast J 2022; 2022:9921575. [PMID: 36474966 PMCID: PMC9701120 DOI: 10.1155/2022/9921575] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 10/29/2022] [Accepted: 11/01/2022] [Indexed: 11/21/2022]
Abstract
Background Identifying and understanding modifiable factors for the well-being of cancer patients is critical in survivorship research. We studied variables associated with the exercise habits of breast cancer patients and investigated if the achievement of exercise recommendations was associated with enhanced quality of life and/or psychological well-being. Material and Methods. 311 women from Finland, Portugal, Israel, and Italy receiving adjuvant therapy for stage I-III breast cancer answered questions about sociodemographic factors and physical exercise. Quality of life was assessed by the EORTC C30 and BR23 questionnaires. Anxiety and depression were evaluated using the HADS scale. Results At the beginning of adjuvant therapy and after twelve months, 32% and 26% of participants were physically inactive, 27% and 30% exercised between 30 and 150 minutes per week, while 41% and 45% exercised the recommended 150 minutes or more per week. Relative to other countries, Finnish participants were more likely to be active at baseline and at twelve months (89% vs. 50%, p < 0.001 and 87% vs. 64%, p < 0.001). Participants with stage I cancer were more likely to be active at twelve months than those with a higher stage (80% vs. 70%,p < 0.05). The inactive participants reported more anxiety (p < 0.05) and depression (p < 0.001), lower global quality of life (p < 0.001), and more side effects (p < 0.05) than the others at twelve months. Accordingly, those who remained inactive or decreased their level of exercise from baseline to twelve months reported more anxiety (p < 0.01) and depression (p < 0.001), lower global quality of life (p < 0.001), and more side effects (p < 0.05) than those with the same or increased level of exercise. Conclusion For women with early breast cancer, exercise was associated with a better quality of life, less depression and anxiety, and fewer adverse events of adjuvant therapy. Trial registration number: NCT05095675. Paula Poikonen-Saksela on behalf of Bounce consortium (https://www.bounce-project.eu/).
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Lee K, Nathwani N, Shamunee J, Lindenfeld L, Wong FL, Krishnan A, Armenian S. Telehealth exercise to Improve Physical function and frailty in patients with multiple myeloma treated with autologous hematopoietic Stem cell transplantation (TIPS): protocol of a randomized controlled trial. Trials 2022; 23:921. [PMID: 36329525 PMCID: PMC9633031 DOI: 10.1186/s13063-022-06848-y] [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: 05/02/2022] [Accepted: 10/17/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Advances in autologous hematopoietic stem cell transplantation (HSCT) and supportive care have led to marked improvements in survival for patients with multiple myeloma. Despite these improvements, patients with multiple myeloma remain at high risk of physical dysfunction and frailty due to HSCT and its associated exposures. Although traditional supervised exercise programs can improve frailty in cancer patients and survivors, rehabilitation facilities are typically far from a patient's residence, are offered on fixed days/hours, contain uniform activities for everyone, and carry a higher risk of contact cross-infection due to immunosuppression, which can be barriers to exercise participation. Innovative personalized interventions are needed to overcome the limitations of traditional exercise interventions. The purpose of this study is to determine the efficacy and sustainability of a telehealth exercise intervention on physical function and frailty in patients with multiple myeloma treated with HSCT. METHODS This randomized controlled trial will assess the efficacy of an 8-week telehealth exercise intervention in 60 patients with multiple myeloma who underwent autologous HSCT (30-180 days post-transplant) and are pre-frail or frail. There will be 30 intervention participants and 30 delayed controls. We will administer remote baseline assessments (week 0), followed by an 8-week telehealth intervention (week 1-8), post assessment (week 9), and an additional follow-up assessment (week 17). Our primary endpoint will be improved physical function, as assessed by the Short Physical Performance Battery test. Our secondary endpoint will be a decrease in frailty characteristics such as gait speed, strength, and fatigue. We will also evaluate the sustainability of improved physical function and frailty at week 17. Participants randomized to the intervention group will perform at least 90 min of exercise per week throughout the 8 weeks. DISCUSSION This study will help optimize the delivery of safe, low-cost, and scalable telehealth exercise interventions to improve health outcomes in patients with multiple myeloma, an understudied population at high risk for physical dysfunction and frailty. Our study may provide the foundation for sustainable telehealth exercise interventions to improve physical function and frailty for other hematologic cancer patients (e.g., acute leukemia, lymphoma) as well as any other cancer population of interest. TRIAL REGISTRATION ClinicalTrials.gov NCT05142371 . This study was retrospectively registered on December 2nd, 2021, and is currently open to accrual.
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Affiliation(s)
- Kyuwan Lee
- Division of Outcomes Research, Department of Population Sciences, Beckman Research Institute, City of Hope Comprehensive Cancer Center, 1500 E. Duarte Rd., Bldg. 173, Duarte, CA, 91010, USA.
| | - Nitya Nathwani
- Division of Multiple Myeloma, Department of Hematology and Hematopoietic Cell Transplantation, City of Hope Comprehensive Cancer Center, Duarte, CA, 91010, USA
| | - Justin Shamunee
- Division of Outcomes Research, Department of Population Sciences, Beckman Research Institute, City of Hope Comprehensive Cancer Center, 1500 E. Duarte Rd., Bldg. 173, Duarte, CA, 91010, USA
| | - Lanie Lindenfeld
- Division of Outcomes Research, Department of Population Sciences, Beckman Research Institute, City of Hope Comprehensive Cancer Center, 1500 E. Duarte Rd., Bldg. 173, Duarte, CA, 91010, USA
| | - F Lennie Wong
- Division of Outcomes Research, Department of Population Sciences, Beckman Research Institute, City of Hope Comprehensive Cancer Center, 1500 E. Duarte Rd., Bldg. 173, Duarte, CA, 91010, USA
| | - Amrita Krishnan
- Division of Multiple Myeloma, Department of Hematology and Hematopoietic Cell Transplantation, City of Hope Comprehensive Cancer Center, Duarte, CA, 91010, USA
| | - Saro Armenian
- Division of Outcomes Research, Department of Population Sciences, Beckman Research Institute, City of Hope Comprehensive Cancer Center, 1500 E. Duarte Rd., Bldg. 173, Duarte, CA, 91010, USA
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Aune D, Markozannes G, Abar L, Balducci K, Cariolou M, Nanu N, Vieira R, Anifowoshe YO, Greenwood DC, Clinton SK, Giovannucci EL, Gunter MJ, Jackson A, Kampman E, Lund V, McTiernan A, Riboli E, Allen K, Brockton NT, Croker H, Katsikioti D, McGinley-Gieser D, Mitrou P, Wiseman M, Velikova G, Demark-Wahnefried W, Norat T, Tsilidis KK, Chan DSM. Physical Activity and Health-Related Quality of Life in Women With Breast Cancer: A Meta-Analysis. JNCI Cancer Spectr 2022; 6:pkac072. [PMID: 36474321 PMCID: PMC9727071 DOI: 10.1093/jncics/pkac072] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 06/27/2022] [Accepted: 09/16/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Physical activity (PA) is associated with improved health-related quality of life (HRQoL) among women with breast cancer; however, uncertainty remains regarding PA types and dose (frequency, duration, intensity) and various HRQoL measures. A systematic review and meta-analysis of randomized controlled trials was conducted to clarify whether specific types and doses of physical activity was related to global and specific domains of HRQoL, as part of the Global Cancer Update Programme, formerly known as the World Cancer Research Fund-American Institute for Cancer Research Continuous Update Project. METHODS PubMed and CENTRAL databases were searched up to August 31, 2019. Weighted mean differences (WMDs) in HRQoL scores were estimated using random effects models. An independent expert panel graded the evidence. RESULTS A total of 79 randomized controlled trials (14 554 breast cancer patients) were included. PA interventions resulted in higher global HRQoL as measured by the Functional Assessment of Cancer Therapy-Breast (WMD = 5.94, 95% confidence intervals [CI] = 2.64 to 9.24; I2 = 59%, n = 12), Functional Assessment of Cancer Therapy-General (WMD = 4.53, 95% CI = 1.94 to 7.13; I2 = 72%, n = 18), and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (WMD = 6.78, 95% CI = 2.61 to 10.95; I2 = 76.3%, n = 17). The likelihood of causality was considered probable that PA improves HRQoL in breast cancer survivors. Effects were weaker for physical function and mental and emotional health. Evidence regarding dose and type of PA remains insufficient for firm conclusions. CONCLUSION PA results in improved global HRQoL in breast cancer survivors with weaker effects observed for physical function and mental and emotional health. Additional research is needed to define the impact of types and doses of activity on various domains of HRQoL.
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Affiliation(s)
- Dagfinn Aune
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Department of Nutrition, Bjørknes University College, Oslo, Norway
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Georgios Markozannes
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Leila Abar
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Katia Balducci
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Margarita Cariolou
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Neesha Nanu
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Rita Vieira
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Yusuf O Anifowoshe
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Darren C Greenwood
- Leeds Institute for Data Analytics, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Steven K Clinton
- The Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - Edward L Giovannucci
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Harvard Medical School, Brigham and Women’s Hospital, Boston, MA, USA
| | - Marc J Gunter
- Section of Nutrition and Metabolism, International Agency for Research on Cancer-World Health Organization, Lyon, France
| | - Alan Jackson
- National Institute for Health Research, Southampton Biomedical Research Centre, Southampton, UK
| | - Ellen Kampman
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, the Netherlands
| | - Vivien Lund
- World Cancer Research Fund International, London, UK
| | - Anne McTiernan
- Division of Public Health Sciences, Program in Epidemiology, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- School of Public Health, Department of Epidemiology, University of Washington, Seattle, WA, USA
- School of Medicine, Department of Medicine (Geriatrics), University of Washington, Seattle, WA, USA
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Kate Allen
- World Cancer Research Fund International, London, UK
| | | | - Helen Croker
- World Cancer Research Fund International, London, UK
| | | | | | | | | | - Galina Velikova
- School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | | | - Teresa Norat
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Konstantinos K Tsilidis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Doris S M Chan
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
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21
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Kokkonen K, Kellokumpu-Lehtinen PL, Kankaanpää M, Nikander R, Penttinen HM, Utriainen M, Vehmanen L, Huovinen R, Kautiainen H, Blomqvist C, Saarto T. Factors predicting long-term physical activity of breast cancer survivors. 5-year-follow-up of the BREX exercise intervention study. Acta Oncol 2022; 61:1200-1208. [PMID: 35881067 DOI: 10.1080/0284186x.2022.2103388] [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: 11/12/2022]
Abstract
BACKGROUND The benefits of exercise training are well documented among breast cancer (BC) survivors. Patients decrease their physical activity during treatment, and many fail to regain their previous exercise levels. There is therefore a need to define factors supporting long-term physical activity behavior in this patient group, to target supporting interventions aimed at preventing the decline in physical activity (PA). AIM The aim of this study was to determine physical and psychosocial factors explaining long-term physical activity after the adjuvant treatments in BC survivors. METHODS Four-hundred forty-six BC survivors followed for 5-years within a randomized exercise trial participated. Factors explaining (1) physical activity after the adjuvant treatments and (2) changes in physical activity in long-term were analyzed using linear regression models and general estimating equation models. Pretreatment leisure-time physical activity (LTPA), demographic, and treatment factors, physical fitness, and quality of life (Qol) at baseline were independent factors. RESULTS Exercise levels increased during the first year, and thereafter remained mostly stable. Higher LTPA, higher fitness level, better Qol and older age at baseline were associated with higher physical activity level after adjuvant treatments (p < .001) in multivariate analysis. Higher levels of fatigue (p < .008) and better emotional functioning (p = .017) at baseline were the main factors associated with increased physical activity during the follow-up. CONCLUSION Previous exercise habits and Qol after adjuvant chemo-, and radiotherapy were the strongest determinants of long-term physical activity levels in breast cancer survivors. Patients with better emotional functioning increased their exercise activity most as did those patients with higher fatigue levels at baseline. Patients suffering from fatigue after adjuvant treatment managed to increase their exercise levels, in contrast to patients with low emotional functioning, and may benefit from physical exercise interventions. Emotionally deprived patients may benefit from psychosocial support to regain their previous exercise levels.
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Affiliation(s)
| | | | - Markku Kankaanpää
- Department of Physiatry and Rehabilitation Medicine, Tampere University Hospital, Tampere, Finland
| | - Riku Nikander
- Faculty of Sport and Health Sciences, University of Jyväskylä; Central Finland Health Care District; GeroCenter Foundation for Aging Research and Development, Jyväskylä, Finland
| | | | - Meri Utriainen
- Helsinki University Hospital, Comprehensive Cancer Centre, and University of Helsinki, Faculty of Medicine, Helsinki, Finland
| | - Leena Vehmanen
- Helsinki University Hospital, Comprehensive Cancer Centre, and University of Helsinki, Faculty of Medicine, Helsinki, Finland
| | - Riikka Huovinen
- Turku University Hospital, Department of Oncology, University of Turku, Faculty of Medicine, Turku, Finland
| | - Hannu Kautiainen
- Primary Health Care Unit, Kuopio University Hospital, Finland and Folkhälsan Research Center, Helsinki, Finland
| | - Carl Blomqvist
- Helsinki University Hospital, Comprehensive Cancer Centre, and University of Helsinki, Faculty of Medicine, Helsinki, Finland
| | - Tiina Saarto
- Helsinki University Hospital, Comprehensive Cancer Centre, and University of Helsinki, Faculty of Medicine, Helsinki, Finland
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22
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Examining the Dose-Response Relationship between Outdoor Jogging and Physical Health of Youths: A Long-Term Experimental Study in Campus Green Space. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095648. [PMID: 35565043 PMCID: PMC9102522 DOI: 10.3390/ijerph19095648] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/02/2022] [Accepted: 05/04/2022] [Indexed: 01/21/2023]
Abstract
Many studies have demonstrated that outdoor physical activity positively affects the physical health of young people. Here, we aimed to examine the extent to which outdoor jogging was associated with the physical health of youths, and then to decipher whether a dose–response relationship exists between them. A total of 2852 youths from a Chinese university were enrolled in a long-term experimental study between September 2018 and September 2019. We conducted two waves of physical health tests for 2852 youths (before and after the jogging interventions in 2018 and 2019, respectively) using China’s National Student Physical Health Standard (NSPHS). Paired t-tests were used to examine statistical differences. A multiple regression model was used to evaluate the associations between jogging and physical health. The results showed that: statistically significant changes in the two waves of physical health outcomes were suggested after jogging interventions; outdoor jogging in campus green space was associated with participants’ physical health after controlling for covariates; and a dose–response relationship between jogging and physical health outcomes was revealed, with 120–140 km/year (approximately 3.43–4 km/week) being the most effective intervention dose. Our findings have implications for promoting physical health in youth groups by encouraging outdoor physical activity.
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23
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das Virgens Aquino MJ, dos Santos Leite PM, Lima Rodrigues IK, DeSantana JM. Feasibility for Using Thermography Throughout an Exercise Program in Mastectomized Patients. Front Oncol 2022; 12:740787. [PMID: 35494013 PMCID: PMC9047824 DOI: 10.3389/fonc.2022.740787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 03/07/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionBreast cancer is the most common in the female population. Physical training is safe and indicated after surgical treatment for breast cancer. During exercise, body temperature changes due to tissue metabolic activity; in this sense, infrared thermography is used to map the thermal patterns of the body surface.ObjectiveThis study aimed to evaluate the feasibility of using thermography during a physical rehabilitation program in mastectomized patients by analyzing the change in body temperature caused by physical exercise in the breast region.MethodologyThis is a simple and covert clinical trial, in which the sample was constituted for convenience. The women were submitted to a supervised physical exercise protocol, three times a week, for 20 sessions. They were evaluated in the first, tenth, and twentieth sessions in relation to changes in body temperature in the breast region (infrared thermography).ResultsTwenty patients who underwent mastectomy surgery were recruited. No patient had drain infection, scar dehiscence, or lymphedema, and only one patient had seroma removed. The mean age was 50.45 ± 2.00 years, and the body mass index (BMI) was 28.95 ± 1.11 kg/m2. In the body thermography of the patients’ breast region, no significant difference was observed when comparing the thermograms of the plastron region of the patients in the first, tenth, and twentieth sessions (p = 0.201). However, when comparing the plastron region with the control breast, a reduction in temperature was observed in the operated region in the first (p = 0.012) and tenth sessions (p = 0.004).ConclusionThrough this study, we can conclude that the use of infrared thermography is viable for the analysis of the body temperature of mastectomized patients during a supervised physical exercise protocol and, therefore, suggest that this instrument is increasingly used in the cancer public.
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Affiliation(s)
- Maria Jane das Virgens Aquino
- Physiotherapy Department, Federal University of Sergipe, São Cristóvão, Brazil
- *Correspondence: Maria Jane das Virgens Aquino, ; Josimari Melo DeSantana,
| | | | | | - Josimari Melo DeSantana
- Physical Therapy Department, Graduate Program in Health Science, Graduate Program in Physiological Science, Federal University of Sergipe, São Cristóvão, Brazil
- *Correspondence: Maria Jane das Virgens Aquino, ; Josimari Melo DeSantana,
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24
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Roscoe CMP, Pringle A, Chandler C, Faghy MA, Barratt B. The Role of Physical Activity in Cancer Recovery: An Exercise Practitioner's Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063600. [PMID: 35329286 DOI: 10.3390/ijerph19063600] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/08/2022] [Accepted: 03/16/2022] [Indexed: 11/16/2022]
Abstract
Less than 20% of cancer patients meet the recommended physical activity (PA) guidelines, partially due to poor knowledge and enforcement/encouragement amongst health-care professionals (HCPs). The primary aim of this study was to explore the perceptions of exercise practitioners on the role of PA and the physiological and psychological benefits to recovering cancer patients; the secondary aim was to understand the barriers and facilitators of promoting PA to cancer survivors. The third aim was to, seek the perspectives on the effectiveness of referral systems between the hospitals and PA structures. A purposive sample of five exercise practitioners' (four male and one female) with experience with cancer patients participated in a semi-structured interview (45-60 min). Interviews addressed five key topics: intervention procedures, patient well-being, patient education on PA, effectiveness of referrals from hospitals, and post-intervention PA. Interviews were transcribed verbatim and analysed via thematic analysis. The participants believed that recovering cancer patients possess a knowledge of the physiological benefits of PA, yet psychological understanding remains unknown. Social environments are key to participation in PA and most HCPs lacked knowledge/awareness of the benefits of engaging in PA. There is a need to improve HCPs knowledge of the benefits of PA, whilst providing standardised training on how PA can improve cancer patients' outcomes.
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Affiliation(s)
- Clare M P Roscoe
- Human Sciences Research Centre, University of Derby, Derby DE22 1GB, UK
| | - Andy Pringle
- Human Sciences Research Centre, University of Derby, Derby DE22 1GB, UK
| | | | - Mark A Faghy
- Human Sciences Research Centre, University of Derby, Derby DE22 1GB, UK
| | - Ben Barratt
- Human Sciences Research Centre, University of Derby, Derby DE22 1GB, UK
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25
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Poikonen-Saksela P, Kolokotroni E, Vehmanen L, Mattson J, Stamatakos G, Huovinen R, Kellokumpu-Lehtinen PL, Blomqvist C, Saarto T. A graphical LASSO analysis of global quality of life, sub scales of the EORTC QLQ-C30 instrument and depression in early breast cancer. Sci Rep 2022; 12:2112. [PMID: 35136160 PMCID: PMC8826362 DOI: 10.1038/s41598-022-06138-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 01/25/2022] [Indexed: 12/20/2022] Open
Abstract
We aimed to (a) investigate the interplay between depression, symptoms and level of functioning, and (b) understand the paths through which they influence health related quality of life (QOL) during the first year of rehabilitation period of early breast cancer. A network analysis method was used. The population consisted of 487 women aged 35-68 years, who had recently completed adjuvant chemotherapy or started endocrine therapy for early breast cancer. At baseline and at the first year from randomization QOL, symptomatology and functioning by the EORTC QLQ-C30 and BR-23 questionnaires, and depression by the Finnish version of Beck's 13-item depression scale, were collected. The multivariate interplay between the related scales was analysed via regularized partial correlation networks (graphical LASSO). The median global quality of life (gQoL) at baseline was 69.9 ± 19.0 (16.7-100) and improved to 74.9 ± 19.0 (0-100) after 1 year. Scales related to mental health (emotional functioning, cognitive functioning, depression, insomnia, body image, future perspective) were clustered together at both time points. Fatigue was mediated through a different route, having the strongest connection with physical functioning and no direct connection with depression. Multiple paths existed connecting symptoms and functioning types with gQoL. Factors with the strongest connections to gQoL included: social functioning, depression and fatigue at baseline; emotional functioning and fatigue at month 12. Overall, the most important nodes were depression, gQoL and fatigue. The graphical LASSO network analysis revealed that scales related to fatigue and emotional health had the strongest associations to the EORTC QLQ-C30 gQoL score. When we plan interventions for patients with impaired QOL it is important to consider both psychological support and interventions that improve fatigue and physical function like exercise.Trial registration: http://www.clinicaltrials.gov/ (identifier number NCT00639210).
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Affiliation(s)
- Paula Poikonen-Saksela
- Comprehensive Cancer Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
| | - Eleni Kolokotroni
- In Silico Oncology and In Silico Medicine Group, Institute of Communication and Computer Systems, School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | - Leena Vehmanen
- Comprehensive Cancer Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Johanna Mattson
- Comprehensive Cancer Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Georgios Stamatakos
- In Silico Oncology and In Silico Medicine Group, Institute of Communication and Computer Systems, School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | - Riikka Huovinen
- Department of Oncology, Turku University Hospital and Faculty of Medicine, University of Turku, Turku, Finland
| | - Pirkko-Liisa Kellokumpu-Lehtinen
- Faculty of Medicine and Health Technology, Tampere University and Research, Development and Innovation Center, Tampere University Hospital, Tampere, Finland
| | - Carl Blomqvist
- Comprehensive Cancer Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Tiina Saarto
- Comprehensive Cancer Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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Zyzniewska-Banaszak E, Kucharska-Mazur J, Mazur A. Physiotherapy and Physical Activity as Factors Improving the Psychological State of Patients With Cancer. Front Psychiatry 2021; 12:772694. [PMID: 34880794 PMCID: PMC8645643 DOI: 10.3389/fpsyt.2021.772694] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 10/28/2021] [Indexed: 12/16/2022] Open
Abstract
Physiotherapy in oncology is a process closely related to cancer treatment methods. Rehabilitation is based on physical activity in various forms involving the musculoskeletal system but also affects the emotional state. Physical activity influences physical and psychological well-being of people undergoing oncological treatment, in the course of which the most common psychiatric disorders are depression, substance use disorder, sleep disorders, fatigue syndrome, resulting in worsening of the quality of life. Difficulties in implementing physical exercise in cancer patients pose a challenge to treatment teams.
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Affiliation(s)
| | | | - Aleksandra Mazur
- Department of Social Sciences, Institute of Psychology, University of Gdańsk, Gdańsk, Poland
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27
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Effect of Physical Therapy Modalities on Quality of Life of Head and Neck Cancer Survivors: A Systematic Review with Meta-Analysis. J Clin Med 2021; 10:jcm10204696. [PMID: 34682818 PMCID: PMC8539984 DOI: 10.3390/jcm10204696] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/05/2021] [Accepted: 10/11/2021] [Indexed: 12/16/2022] Open
Abstract
The objective was to describe the effectiveness of different physical therapy modalities to improve Quality of Life (QoL) in Head and Neck Cancer (HNC) survivors. PubMed, Scopus, Web of Science, CINAHL and Cochrane Library were searched for randomized clinical controlled trials published until 30 April 2020. Risk of bias assessment and meta-analysis were conducted using the Cochrane tools. A total of 251 records were retrieved, and 10 met the inclusion criteria. Interventions whose parameters focus on a 12-week exercise programs of aerobic activity (walking) or Progressive Resistance Training (PRT) for the whole body are effective and safe modalities improving QoL in HNC survivors. Electrophysical agents did not show significant results between groups. As for the assessment of methodological quality, 4 of the 10 articles included had a high risk of overall bias. Only five articles provided sufficient information to conduct a meta-analysis for exercise program intervention on QoL, showing a tendency in favor of intervention group, even when the global results did not show statistically significant improvements (pooled Cohen's d 0.15; 95% CI: -0.25 to 0.54; I2 45.87%; p heterogeneity = 0.10). The present review and meta-analysis identified meaningful benefits of exercise on QoL of HNC survivors; this has been confirmed in a meta-analysis. This review adds evidence supporting exercise interventions on Head and Neck Cancer population whose opportunities for successful recovery after medical treatment are more limited.
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28
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Interventions to Improve Sexual Health in Women Living with and Surviving Cancer: Review and Recommendations. Cancers (Basel) 2021; 13:cancers13133153. [PMID: 34202477 PMCID: PMC8268945 DOI: 10.3390/cancers13133153] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 06/17/2021] [Accepted: 06/20/2021] [Indexed: 01/15/2023] Open
Abstract
Sexual health concerns, both physical and psychological, are common and represent an unmet need among women with and surviving cancer. Sexual challenges and conditions negatively impact body image, satisfaction, relationships, well-being, and quality of life, yet are widely reported to be under-recognized and undertreated. To guide clinical care and future research on sexual function in women with cancer, we performed a scoping review of interventions for sexual health concerns, including sexual function, body image, genitourinary symptoms, and hot flashes. Relevant publications between 2005 and 2020 were identified by searching PubMed with a combination of medical subject headings and keywords. Articles were included if they focused on the aforementioned topics, were primary research publications, and included female cancer survivors. Studies focusing on women receiving hormone therapy for breast cancer were also included. A total of 91 investigations conducted in the US and abroad were reviewed. Most commonly, interventions included a component of psychoeducation, although pharmacologic, exercise, and other approaches have been evaluated. Many studies have focused on survivors of breast or gynecologic cancer, among other sampling and methodological limitations. These limitations underscore the need for more work on this vital survivorship issue. Recommendations for future research in this area are also offered.
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29
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Integrating Self-determination Theory and Upper Limb Factors to Predict Physical Activity in Patients With Breast Cancer During Chemotherapy. Cancer Nurs 2021; 45:52-60. [PMID: 33883475 DOI: 10.1097/ncc.0000000000000951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Some empirical investigations try to describe the factors that affect the physical activity of breast cancer survivors, but these investigations rarely focus on the basic psychological needs or motivation regulation of breast cancer survivors in physical activity. OBJECTIVE The aim of this study was to construct structural equation modeling of the self-determination theory and upper limb factors to predict the physical activity of breast cancer patients during chemotherapy. METHODS A total of 236 breast cancer survivors completed measures of basic psychological needs, behavioral regulation in exercise, symptoms and dysfunction of upper limb factors, and physical activity. Path analyses structured the direct and indirect effects (via motivational orientations) of basic psychological needs and upper limb factors on physical activity. RESULTS A total of 216 (91.5%) participants met the standard physical activity metabolic equivalent recommended. The final model has a good degree of fit (χ2 = 809.363, df = 391, χ2/df ≤ 2.07 [1-3]; root-mean-square error of approximation, 0.067 [<0.008]). The competence (0.309) of basic psychological needs and amotivation (-0.38) of motivation regulations have the greatest effect on physical activity. CONCLUSIONS Competence is the most important basic psychological need of breast cancer patients during chemotherapy, and amotivation is the most important motivation regulation. IMPLICATIONS FOR PRACTICE Nurses need to pay more attention to the basic psychological needs and the motivation regulation in breast cancer patients during chemotherapy. Randomized controlled trials of breast cancer survivor interventions based on the self-determination theory are needed.
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30
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Aho S, Vuoristo MS, Raitanen J, Mansikkamäki K, Alanko J, Vähä-Ypyä H, Luoto R, Kellokumpu-Lehtinen PL, Vasankari T. Higher number of steps and breaks during sedentary behaviour are associated with better lipid profiles. BMC Public Health 2021; 21:629. [PMID: 33789632 PMCID: PMC8010961 DOI: 10.1186/s12889-021-10656-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 03/18/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Physical activity (PA) is known to be associated with lipid profiles and the risk of both cardiovascular diseases and cancer. The aim of this study was to evaluate the association of objectively measured PA, sedentary behaviour (SB), amount of breaks during SB and number of daily steps with serum lipids in a healthy, Finnish, middle-aged, female population. METHODS The participants (571) were recruited at mammography screening, target group was women aged 50-60 years. A measurement of PA was done with accelerometer, blood lipid profile was assessed, and questionnaires of participants characteristics were sent to participants. RESULTS The participants with the highest number of daily breaks during SB (≥ 41) had the highest mean concentration of HDL-cholesterol (high density lipoprotein cholesterol, HDL-c) (1.9 mmol/l, standard deviation (SD) 0.4) and the lowest mean concentration of triglycerides (1.0 mmol/l, SD 0.5). HDL-c level was 0.16 mmol/l higher (p < 0.001) in the group with 28-40.9 breaks/day and 0.25 mmol/l higher (p < 0.001) among participants with ≥41 breaks/day than in the group with the fewest breaks during SB (< 28). Those with the most daily steps (≥ 9100) had the highest mean HDL-c level (1.9 mmol/l). HDL-c level was 0.16 mmol/l higher (p < 0.001) among the participants with 5600-9099 steps/day and 0.26 mmol/l higher (p < 0.001) among participants with ≥9100 steps/day than those with the fewest steps (< 5600). The number of daily steps was inversely associated with the triglyceride concentration. From wake-time, participants spent 60% in SB, 18% standing, 14% in light PA, and 9% in moderate-to-vigorous PA (MVPA). PA was associated with serum total cholesterol (TC), HDL-c and triglyceride levels. The mean HDL-c level was the highest in the lowest quartile of SB and in the highest quartile of MVPA. CONCLUSIONS To our knowledge, this is the first study showing a high number of objectively measured breaks during SB is associated with a favourable effect on the level of serum lipids, which may later translate into cardiovascular health among middle-aged women. TRIAL REGISTRATION This study was registered and approved by the Regional Ethics Committee of Tampere University Hospital in Finland (approval code R15137 ).
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Affiliation(s)
- Sonja Aho
- Faculty of Medicine and Health Technology, Tampere University and TAYS Cancer Center, Tampere University Hospital, Tampere, Finland. .,Department of Oncology, Tampere University Hospital, P. O. Box 2000, 33521, Tampere, Finland.
| | - Meri-Sisko Vuoristo
- Faculty of Medicine and Health Technology, Tampere University and TAYS Cancer Center, Tampere University Hospital, Tampere, Finland.,Department of Oncology, Tampere University Hospital, P. O. Box 2000, 33521, Tampere, Finland
| | - Jani Raitanen
- The UKK Institute for Health Promotion Research, Tampere, Finland.,Tampere University, Faculty of Social Sciences (Health Sciences), Tampere, Finland
| | - Kirsi Mansikkamäki
- Tampere University of Applied Sciences, Biomedical Laboratory Science, Tampere, Finland
| | - Johanna Alanko
- Faculty of Medicine and Health Technology, Tampere University and TAYS Cancer Center, Tampere University Hospital, Tampere, Finland
| | - Henri Vähä-Ypyä
- The UKK Institute for Health Promotion Research, Tampere, Finland
| | - Riitta Luoto
- Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland
| | - Pirkko-Liisa Kellokumpu-Lehtinen
- Faculty of Medicine and Health Technology, Tampere University and TAYS Cancer Center, Tampere University Hospital, Tampere, Finland.,Tampere University Hospital, Research, Development and Innovation Center, Tampere, Finland
| | - Tommi Vasankari
- The UKK Institute for Health Promotion Research, Tampere, Finland.,Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland
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31
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Rutherford Z, Zwolinsky S, Kime N, Pringle A. A Mixed-Methods Evaluation of CARE (Cancer and Rehabilitation Exercise): A Physical Activity and Health Intervention, Delivered in a Community Football Trust. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3327. [PMID: 33807112 PMCID: PMC8004656 DOI: 10.3390/ijerph18063327] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 03/15/2021] [Accepted: 03/17/2021] [Indexed: 11/30/2022]
Abstract
With increasing cancer survivorship has come an increased necessity to support people living with cancer (PLWC) to have a good quality of life including being physically active. Using mixed methods, the current study aimed to use the RE-AIM evaluation framework (Reach, Effectiveness, Adoption, Implementation and Maintenance) to determine how the football community trust delivered CARE (Cancer and Rehabilitation Exercise) intervention was able to increase participants' physical activity in order to improve their quality of life and regain physiological and psychological function. Quantitative outcome data were collected at baseline, 3 and 6 months using the Cancer Physical Activity Standard Evaluation Framework questionnaire. Semi-structured focus groups (n = 5) captured participants' (n = 40) lived experience of the reach, effectiveness, adoption, implementation, and maintenance of CARE. Questionnaire data were analysed using repeated measures ANOVAs and qualitative data were thematically analysed. Following diagnosis, CARE was successful in providing participants with a unique and accessible opportunity to become or restart physically activity, by providing a local, socially supportive, and inclusive environment. This resulted in significant increases in physical activity (F(1.58, 23) = 5.98, p = 0.009), quality of life (QoL) (F(2,36) = 13.12, p = 0.000) and significant reductions in fatigue (F(1.57,31) = 11.19, p = 0.000) over 6 months. Participants also reported becoming more active, recovering physical function, regaining independence, and enhanced psychological well-being as a result of attending CARE. Key design features of CARE were also identified across RE-AIM. CARE, a football community trust delivered physical activity intervention was successful in significantly improving participants' QoL and in regaining the physical and psychological functioning of people living with cancer. Results suggest that maintaining engagement in CARE for 6 months and beyond can support people to maintain these changes. Engaging in robust evaluations such as this can help organizations to successfully secure future funding for their programs.
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Affiliation(s)
- Zoe Rutherford
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD 4006, Australia
- Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Brisbane, QLD 4072, Australia
| | - Stephen Zwolinsky
- West Yorkshire & Harrogate Cancer Alliance, White Rose House, West Parade, Wakefield WF1 1LT, UK;
| | - Nicky Kime
- Bradford Institute for Health Research, Temple Bank House, Bradford Royal Infirmary, Bradford BD9 6RJ, UK;
| | - Andy Pringle
- Department of Sport, Outdoor and Exercise Science, School of Human Sciences & Human Sciences Research Centre, University of Derby, Kedleston Road, Derby DE22 1GB, UK;
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Aydin M, Kose E, Odabas I, Meric Bingul B, Demirci D, Aydin Z. The Effect of Exercise on Life Quality and Depression Levels of Breast Cancer Patients. Asian Pac J Cancer Prev 2021; 22:725-732. [PMID: 33773535 PMCID: PMC8286684 DOI: 10.31557/apjcp.2021.22.3.725] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Indexed: 11/25/2022] Open
Abstract
Introduction: The aim of this study is to determine the effects of aerobic and stretching exercises on quality of life and depression levels of breast cancer patients. Methods: A total of 48 women (mean age 45.0±2.2 years) who were previously diagnosed with breast cancer and completed their treatment with no metastasis, were included in the study. Of these, 24 women who received the exercise program were assigned as the study group, while the remaining 24 women who did not receive the exercise program were assigned as the control group. The study group received a 12-week aerobic exercise program at the fitness club and home-based resistance exercise program designed by a sport scientist at the doctoral level. The control group was encouraged to maintain their normal level of physical activity and exercise habits throughout the study. The WHOQOL-BREF, EORTC-QLQ-C30 quality of life assessments and Beck depression inventory (BDI) were used to evaluate quality of life and the severity of depression before and after 12-week exercise programs. Results: EORTC QLQ-C30 scoring showed that in the study group aerobic exercise positively impacted quality of life on the functional scales (physical p=0.001, role p=0.039, emotional p=0.031, social functioning p=0.010) and symptoms (fatigue p=0.001, pain p=0.001, sleep disturbance p=0.038 and financial impact p=0.015). WHOQOL-BREF assessment areas, (general p=0.001, physical p=0.02, mental p=0.001 and social health p=0.017) relationships also improved as a result of exercise. BDI showed that severity of depression in the study group decreased significantly (p=0.001). Conclusion: This study showed that aerobic and resistance exercises improved quality of life and decreased depression levels of women who previously received breast cancer treatments.
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Affiliation(s)
- Mensure Aydin
- Physical Education and Sport, Halic University, Istanbul, Turkey
| | - Elif Kose
- Department of Public Health, Sakarya University School of Medicine, Sakarya, Turkey
| | - Ilhan Odabas
- Physical Education and Sport, Halic University, Istanbul, Turkey
| | | | - Deniz Demirci
- Faculty of Health Sciences, Uskudar
University, Istanbul, Turkey
| | - Zeki Aydin
- Darica Farabi Training and Research Hospital. Department of Nephrology, University of Health
Sciences, Kocaeli, Turkey
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Xie Y, Wu Z, Sun L, Zhou L, Wang G, Xiao L, Wang H. The Effects and Mechanisms of Exercise on the Treatment of Depression. Front Psychiatry 2021; 12:705559. [PMID: 34803752 PMCID: PMC8602192 DOI: 10.3389/fpsyt.2021.705559] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 10/05/2021] [Indexed: 12/12/2022] Open
Abstract
Background: It is necessary to seek alternative therapies for depression, because side effects of medications lead to poor adherence and some patients do not achieve a clinical treatment effect. Recently the role of exercise as a low-cost and easy-to-use treatment for depression has gained attention with a number of studies showing that exercise is effective at reducing depressive symptoms and improving body functions such as cardiorespiratory system and cognitive function. Because of the heterogeneity of exercise therapy programs, there is no standardized and unified program. Few studies have summarized the specific properties of exercise programs (type, intensity, duration, and frequency) and clinical prescriptions for exercise are not mentioned in most articles. Aims: This study aimed to investigate the feasibility and efficacy of exercise therapy for patients with depression, in order to appraise the evidence and outline accepted guidelines to direct individualized treatment plans for patients with depression based on their individual situations. Methods: A systematic review of English language literature including papers published from 2010 to present in PubMed was performed. Given the feasibility of prescribing exercise therapy for patients with depression, nearly 3 years of clinical studies on the treatments of depressive symptoms with exercise were first reviewed, comparing the exercise programs utilized. Conclusions: Exercise has therapeutic effects on depression in all age groups (mostly 18-65 years old), as a single therapy, an adjuvant therapy, or a combination therapy, and the benefits of exercise therapy are comparable to traditional treatments for depression. Moderate intensity exercise is enough to reduce depressive symptoms, but higher-dose exercise is better for overall functioning. Exercise therapy has become more widely used because of its benefits to the cardiovascular system, emotional state, and systemic functions. Recommendations: Aerobic exercise/mind-body exercise (3-5 sessions per week with moderate intensity lasting for 4-16 weeks) is recommended. Individualized protocols in the form of group exercise with supervision are effective at increasing adherence to treatment.
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Affiliation(s)
- Yumeng Xie
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Zuotian Wu
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Limin Sun
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Lin Zhou
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Gaohua Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Ling Xiao
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Huiling Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
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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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Roine E, Sintonen H, Kellokumpu-Lehtinen PL, Penttinen H, Utriainen M, Vehmanen L, Huovinen R, Kautiainen H, Nikander R, Blomqvist C, Saarto T. Health-related Quality of Life of Breast Cancer Survivors Attending an Exercise Intervention Study: A Five-year Follow-up. In Vivo 2020; 34:667-674. [PMID: 32111767 DOI: 10.21873/invivo.11821] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 12/03/2019] [Accepted: 12/10/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND/AIM As the number of breast cancer survivors is increasing, their long-term health-related quality of life (HRQoL) has become an important issue. The aim of the study is to follow up the HRQoL of breast cancer survivors (BCS) in a prospective randomized exercise intervention study and to compare HRQoL to that of the age-matched general female population. PATIENTS AND METHODS Following adjuvant treatment, 537 patients aged 35-68 and capable of exercise training were randomized to a 12-month exercise trial. In 182 of those patients, HRQoL was measured by the generic 15D at baseline and followed up for five years. Furthermore, the HRQoL of all BCS answering the 15D at five-year follow-up (n=390) was compared to that of a representative sample of the general population. RESULTS After five years, the BCS' mean HRQoL demonstrated a statistically and clinically significant impairment compared to that of the general population (difference -0.023, p<0.001). The mean HRQoL of BCS followed up from baseline until five years did not improve significantly (change=0.007, p=0.27), whereas the dimensions of usual activities (0.043, p=0.004), depression (0.038, p=0.007), distress (0.030, p=0.036), and sexual activity (0.057, p=0.009) did. CONCLUSION The HRQoL of BCS was still impaired five years following treatment.
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Affiliation(s)
- Eija Roine
- Comprehensive Cancer Center, Helsinki University Hospital, and Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Harri Sintonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | | | - Heidi Penttinen
- Comprehensive Cancer Center, Helsinki University Hospital, and Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Meri Utriainen
- Comprehensive Cancer Center, Helsinki University Hospital, and Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Leena Vehmanen
- Comprehensive Cancer Center, Helsinki University Hospital, and Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Riika Huovinen
- Department of Oncology, Turku University Hospital, and Faculty of Medicine, University of Turku, Turku, Finland
| | - Hannu Kautiainen
- Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland.,Folkhälsan Research Center, Helsinki, Finland
| | - Riku Nikander
- Department of Sport and Health Sciences, University of Jyväskylä and GeroCenter Foundation for Aging Research & Development, Jyväskylä, Finland.,Department of Research & Education, Central Hospital District of Finland, Jyväskylä, Finland
| | - Carl Blomqvist
- Comprehensive Cancer Center, Helsinki University Hospital, and Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Tiina Saarto
- Comprehensive Cancer Center, Helsinki University Hospital, and Faculty of Medicine, University of Helsinki, Helsinki, Finland
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Effectiveness of an Adapted Physical Activity Protocol for Upper Extremity Recovery and Quality of Life Improvement in a Case of Seroma after Breast Cancer Treatment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217727. [PMID: 33105793 PMCID: PMC7660058 DOI: 10.3390/ijerph17217727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 10/19/2020] [Accepted: 10/21/2020] [Indexed: 12/16/2022]
Abstract
Growing evidence indicates that physical activity (PA) interventions may reduce upper limb function-limiting side effects of treatments and improve quality of life (QoL) of breast cancer (BC) survivors. However, the possible effectiveness of PA in cases developing seroma after BC treatment has yet to be demonstrated. Here, we describe for the first time the impact of a structured PA pathway (i.e., two cycles of eight-week adapted PA followed by eight-week adapted fitness) on upper limb disability and QoL in a peculiar case of chronic seroma as complication of reconstructive plastic surgery after left breast mastectomy and lymphadenectomy. A 56-year-old female BC survivor underwent a functional test battery (i.e., shoulder–arm mobility, range of motion, back flexibility and indirect assessment of pectoralis minor muscle) at baseline, during and after ending the structured PA pathway. Upper limb and back pain intensity and QoL were evaluated by numerical rating scale and Short Form-12 questionnaire, respectively. A relevant seroma reduction, an improvement in upper limb mobility and pain perception, and an overall increase in QoL were achieved after the structured PA intervention. Our findings suggest that an adapted PA intervention may represent an effective strategy for seroma treatment in BC survivors.
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Sheppard VB, Dash C, Nomura S, Sutton AL, Franco RL, Lucas A, Ross M, Adams-Campbell L. Physical activity, health-related quality of life, and adjuvant endocrine therapy-related symptoms in women with hormone receptor-positive breast cancer. Cancer 2020; 126:4059-4066. [PMID: 32614992 PMCID: PMC8018708 DOI: 10.1002/cncr.33054] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 06/03/2020] [Accepted: 06/03/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Physical activity (PA) is recommended for women with breast cancer (BC); however, data are sparse on the association of PA with quality of life (QOL) and patient-reported symptoms for women on adjuvant endocrine therapy (AET). METHODS Women with hormone receptor-positive BC who were taking AET completed standardized surveys about their health-related QOL, AET-related symptoms, and levels of PA using validated measures. A Wald chi-square test and an analysis of variance were used to assess associations with PA and independent variables. Generalized linear regression analyses assessed associations between PA, QOL, and AET-related symptoms. RESULTS The analytic cohort included 485 Black and White women. Black race, a high body mass index (BMI), and being on aromatase inhibitors (vs tamoxifen) were associated with lower PA in a bivariate analysis. In a multivariate analysis, lower self-reported PA was associated with a high BMI (P = .02) and chemotherapy uptake (P = .006). Better health-related QOL (P = .01), less severe overall AET-related symptoms (P = .02), and less severe gynecological symptoms (P = .03) were associated with increasing levels of moderate PA. CONCLUSIONS Among women taking AET, moderate levels of PA may be associated with fewer medication-related symptoms and overall better ratings of health-related QOL. Because of the low levels of PA observed in the sample overall and particularly for Black women, identifying successful strategies to promote PA are needed.
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Affiliation(s)
- Vanessa B. Sheppard
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, VA
- Massey Cancer Center Office of Health Equity and Disparities Research Virginia Commonwealth University, Richmond, VA
| | - Chiranjeev Dash
- Department of Oncology, Georgetown University, Washington, DC
| | - Sarah Nomura
- Department of Oncology, Georgetown University, Washington, DC
| | - Arnethea L. Sutton
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, VA
| | - Robert Lee Franco
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University College of Humanities and Sciences, Richmond, VA
| | - Alexander Lucas
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, VA
| | - Masey Ross
- Department of Internal Medicine, Virginia Commonwealth University Health System, Richmond, VA
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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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Tailored Sailing Experience to Reduce Psychological Distress and Improve the Quality of Life of Breast Cancer Survivors: A Survey-Based Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124406. [PMID: 32575442 PMCID: PMC7345345 DOI: 10.3390/ijerph17124406] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/15/2020] [Accepted: 06/16/2020] [Indexed: 01/03/2023]
Abstract
Background: Growing evidence indicates that physical/sporting activities may improve the health outcomes and quality of life (QoL) of breast cancer (BC) survivors. Since recent reports have suggested that sailing can improve the psychophysical well-being and QoL of people with disabilities, this pilot study evaluated the effectiveness of a tailored sailing experience on the QoL and psychological distress (PD) of BC survivors. Methods: A group of 19 breast cancer survivors, who were attending the Cancer Rehabilitation Center in Florence, were invited to participate in a sailing school and completed a survey based on a structured online questionnaire assessing QoL and PD both on departure (baseline) and one week after returning (follow-up). The survey comprised a first part (i.e., sociodemographic characteristics and the practice of physical/sporting activities at baseline; sailing experience satisfaction at follow-up) and a second part (i.e., Short Form-12 (SF-12), State/Trait-Anxiety Inventory form Y (STAI-Y), distress thermometer questionnaires). A paired Student's t-test was used to compare the baseline versus follow-up QoL and PD scores. Results: A statistically significant improvement in SF-12 mental component scores and a reduction in both STAI-Y state/trait components and distress thermometer scores were found after the sailing experience. Conclusions: We conclude that sailing practice could be a feasible intervention to increase the psychophysical well-being of BC survivors.
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Mandelblatt JS, Zhai W, Ahn J, Small BJ, Ahles TA, Carroll JE, Denduluri N, Dilawari A, Extermann M, Graham D, Hurria A, Isaacs C, Jacobsen PB, Jim HSL, Luta G, McDonald BC, Patel SK, Root JC, Saykin AJ, Tometich DB, Zhou X, Cohen HJ. Symptom burden among older breast cancer survivors: The Thinking and Living With Cancer (TLC) study. Cancer 2019; 126:1183-1192. [PMID: 31860135 DOI: 10.1002/cncr.32663] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 09/27/2019] [Accepted: 10/15/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Little is known about longitudinal symptom burden, its consequences for well-being, and whether lifestyle moderates the burden in older survivors. METHODS The authors report on 36-month data from survivors aged ≥60 years with newly diagnosed, nonmetastatic breast cancer and noncancer controls recruited from August 2010 through June 2016. Symptom burden was measured as the sum of self-reported symptoms/diseases as follows: pain (yes or no), fatigue (on the Functional Assessment of Cancer Therapy [FACT]-Fatigue scale), cognitive (on the FACT-Cognitive scale), sleep problems (yes or no), depression (on the Center for Epidemiologic Studies Depression scale), anxiety (on the State-Trait Anxiety Inventory), and cardiac problems and neuropathy (yes or no). Well-being was measured using the FACT-General scale, with scores from 0 to 100. Lifestyle included smoking, alcohol use, body mass index, physical activity, and leisure activities. Mixed models assessed relations between treatment group (chemotherapy with or without hormone therapy, hormone therapy only, and controls) and symptom burden, lifestyle, and covariates. Separate models tested the effects of fluctuations in symptom burden and lifestyle on function. RESULTS All groups reported high baseline symptoms, and levels remained high over time; differences between survivors and controls were most notable for cognitive and sleep problems, anxiety, and neuropathy. The adjusted burden score was highest among chemotherapy-exposed survivors, followed by hormone therapy-exposed survivors versus controls (P < .001). The burden score was related to physical, emotional, and functional well-being (eg, survivors with lower vs higher burden scores had 12.4-point higher physical well-being scores). The composite lifestyle score was not related to symptom burden or well-being, but physical activity was significantly associated with each outcome (P < .005). CONCLUSIONS Cancer and its treatments are associated with a higher level of actionable symptoms and greater loss of well-being over time in older breast cancer survivors than in comparable noncancer populations, suggesting the need for surveillance and opportunities for intervention.
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Affiliation(s)
| | - Wanting Zhai
- Department of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University, Washington, DC
| | - Jaeil Ahn
- Department of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University, Washington, DC
| | - Brent J Small
- School of Aging Studies, University of South Florida, and Senior Member, H. Lee Moffitt Cancer Center, Tampa, Florida
| | - Tim A Ahles
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Judith E Carroll
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, Los Angeles, California
| | | | - Asma Dilawari
- Department of Medicine, Georgetown University, Washington, DC
| | - Martine Extermann
- Department of Medicine, H. Lee Moffitt Cancer Center, Tampa, Florida.,Department and Oncology, H. Lee Moffitt Cancer Center, Tampa, Florida
| | - Deena Graham
- John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, New Jersey
| | - Arti Hurria
- Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, California
| | - Claudine Isaacs
- Department of Oncology, Georgetown University, Washington, DC.,Department of Medicine, Georgetown University, Washington, DC
| | - Paul B Jacobsen
- Healthcare Delivery Research Program, National Cancer Institute, Bethesda, Maryland
| | - Heather S L Jim
- Health Outcomes and Behavior Department, H. Lee Moffitt Cancer Center, Tampa, Florida
| | - George Luta
- Department of Biostatistics, Bioinformatics, and Biomathematics, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC
| | - Brenna C McDonald
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Indiana
| | - Sunita K Patel
- Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, California.,Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, California
| | - James C Root
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, Los Angeles, California
| | - Andrew J Saykin
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Indiana
| | - Danielle B Tometich
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indiana
| | - Xingtao Zhou
- Department of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University, Washington, DC
| | - Harvey J Cohen
- John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, New Jersey
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Adherence to the American Cancer Society Guidelines for Cancer Survivors and Health-Related Quality of Life among Breast Cancer Survivors. Nutrients 2019; 11:nu11122924. [PMID: 31816813 PMCID: PMC6950022 DOI: 10.3390/nu11122924] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Revised: 11/22/2019] [Accepted: 11/23/2019] [Indexed: 12/24/2022] Open
Abstract
The development and validation of guidelines for breast cancer survivors are of importance due to the increased survival rate for breast cancer. In this cross-sectional study, we aimed to examine the association between adherence to the American Cancer Society (ACS) guidelines for cancer survivors and health-related quality of life (HRQoL). A total of 618 breast cancer survivors aged 30 to 81 years who had been diagnosed with stage I to III primary breast cancer and had surgery at least a year before enrollment were included. The participants completed the 36 Item Short-Form Health Survey (SF-36) to evaluate HRQoL, and adherence scores were calculated based on the Nutrition and Physical Activity Guidelines for Cancer Survivors, which were released by the ACS. Increasing adherence scores were associated with increasing scores on the physical component summary (PCS) and the physical functioning (PF), bodily pain (BP), and vitality (VT) domains (p for trend <0.001 for PCS and PF, 0.01 for BP, and 0.02 for VT); these scores were mainly driven by the associations among survivors with stage II–III cancer. Further prospective studies are needed to evaluate whether adherence to these guidelines improves HRQoL scores among breast cancer survivors.
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