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Petrasso C, Bayly J, Arculeo S, Bowers M, Costi S, Nottelmann L, Turola E, Vanzulli E, Maddocks M. Non-pharmacological interventions targeting mobility among people with advanced cancer: a systematic review. Support Care Cancer 2024; 32:569. [PMID: 39102127 DOI: 10.1007/s00520-024-08767-x] [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: 01/25/2024] [Accepted: 07/26/2024] [Indexed: 08/06/2024]
Abstract
PURPOSE To synthesise evidence evaluating non-pharmacological interventions targeting mobility among people with advanced cancer, considering the type, efficacy and contextual factors that may influence outcome. METHODS Systematic review of studies of non-pharmacological interventions in adults (≥ 18 years) with advanced (stage III-IV) cancer, and assessing mobility using clinical or patient-reported outcome measures. Searches were conducted across three electronic databases (MEDLINE, EMBASE and CINAHL) up to June 2024. Methodological quality was assessed using Joanna Briggs Institute tools and contextual factors were evaluated through the Context and Implementation of Complex Interventions framework. A narrative synthesis was conducted due to clinical heterogeneity of included studies. RESULTS 38 studies encompassing 2,464 participants were included. The most frequent mobility outcome measure was the 6-min walk test (26/38 studies). Exercise was the most common intervention, (33 studies: 27 aerobic and resistance, 5 aerobic, 1 resistance versus aerobic training) and improvements in mobility were found in 21/33 outcomes. Electrotherapy interventions led to significant improvements in mobility in 3/5 studies. Geographical factors (e.g. distance, transport, parking requirements) potentially limited participation in 18/38 studies. A lack of ethnic diversity among populations was evident and language proficiency was an inclusion criterion in 12 studies. CONCLUSION Exercise and neuromuscular electrical stimulation appear to improve mobility outcomes in advanced cancer. The evaluation of other non-pharmacological interventions targeting mobility should consider access and inclusivity, and be adaptable to the needs of this population.
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Affiliation(s)
- Carmine Petrasso
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation Bessemer Road, London, SE5 9PJ, UK.
| | - Joanne Bayly
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation Bessemer Road, London, SE5 9PJ, UK
| | - Simona Arculeo
- Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Megan Bowers
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation Bessemer Road, London, SE5 9PJ, UK
| | - Stefania Costi
- Physical Medicine and Rehabilitation Unit, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy
- Surgical, Medical and Dental Department of Morphological Sciences, University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | - Lise Nottelmann
- Research Unit for General Practice, Aarhus University, Aarhus, Denmark
- The Research Unit, Department of Palliative Medicine, Bispebjerg Hospital, Copenhagen, Denmark
| | - Elena Turola
- Research and Statistics Infrastructure, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Elisa Vanzulli
- Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Matthew Maddocks
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation Bessemer Road, London, SE5 9PJ, UK
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Balci H, Faydali S. The Effect of Education Performed Using Mobile Application on Supportive Care Needs and Quality of Life in Women with Breast Cancer: Randomized Controlled Trial. Semin Oncol Nurs 2024; 40:151684. [PMID: 38969573 DOI: 10.1016/j.soncn.2024.151684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 05/17/2024] [Accepted: 05/22/2024] [Indexed: 07/07/2024]
Abstract
OBJECTIVES Aimed to determine the effect of education provided with a mobile application on the supportive care needs and quality of life of women undergoing breast-conserving surgery. METHODS The study was conducted in 81 patients. The experimental group received mobile application and the control group received standard education. Fisher's Exact Test, Chi-Square test, Student's t Test, Mann-Whitney U test, mixed design analysis of variance and Bonferroni-Dunn test were used to analyze the data. RESULTS While the pre-study supportive care needs scores of the women were similar in the experimental (85.37 ± 23.58) and control (83.13 ± 23.03) groups, they decreased significantly in the experimental group at the 4th and 8th-week measurements (54.34 ± 27.28; 58.78 ± 16.51) (p < .05). In the 4th and 8th week measurements, the quality of life of the experimental group (72.26 ± 14.12; 71.04 ± 8.12) increased significantly, while no significant change was found in the control group (42.50 ± 14.38; 45.63 ± 8.28). CONCLUSIONS It was found that the supportive care needs of the decreased and their quality of life increased after the education given to women with a mobile application. IMPLICATIONS FOR NURSING PRACTICE This study ensured that women who had a sufficiently intense and exhausting process during the cancer treatment process could comfortably receive care support and education with the mobile application at any time and place they wanted. It also revealed that nurses can provide care and education support to their patients at any time and place they want with the mobile application in their busy work tempo.
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Affiliation(s)
- Hatice Balci
- KTO Karatay University, Medical Services and Techniques Department, Dialysis Program, Konya, Türkiye.
| | - Saide Faydali
- Faculty of Nursing, Necmettin Erbakan University, Konya, Türkiye
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Phillips SM, Starikovsky J, Solk P, Desai R, Reading JM, Hasanaj K, Wang SD, Cullather E, Lee J, Song J, Spring B, Gradishar W. Feasibility and preliminary effects of the Fit2ThriveMB pilot physical activity promotion intervention on physical activity and patient reported outcomes in individuals with metastatic breast cancer. Breast Cancer Res Treat 2024:10.1007/s10549-024-07432-5. [PMID: 39014267 DOI: 10.1007/s10549-024-07432-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 07/05/2024] [Indexed: 07/18/2024]
Abstract
PURPOSE Physical activity research among patients with metastatic breast cancer (MBC) is limited. This study examined the feasibility and potential benefits of Fit2ThriveMB, a tailored mHealth intervention. METHODS Insufficiently active individuals with MBC (n = 49) were randomized 1:1 to Fit2ThriveMB (Fit2ThriveMB app, Fitbit, and weekly coaching calls) or Healthy Lifestyle attention control (Cancer.Net app and weekly calls) for 12 weeks. Fit2ThriveMB aimed to increase daily steps via an algorithm tailored to daily symptom rating and step goal attainment. The primary outcome was feasibility defined as ≥ 80% completion rate. Secondary feasibility metrics included meeting daily step goal and wearing the Fitbit ≥ 70% of study days, fidelity, adherence to intervention features and safety. Secondary outcomes included physical activity, sedentary time, patient reported outcomes (PROs), health-related quality of life (QOL) and social cognitive theory constructs. A subsample (n = 25) completed functional performance tests via video conferencing. RESULTS The completion rate was 98% (n = 1 died). No related adverse events were reported. Fit2ThriveMB participants (n = 24) wore the Fitbit 92.7%, met their step goal 53.1%, set a step goal 84.6% and used the app 94.1% of 84 study days. Intent-to-treat analyses indicated trends toward improvements in activity, QOL, and some PROs, social cognitive theory constructs, and functional performance tests favoring the Fit2ThriveMB group. Significant effects favoring Fit2ThriveMB were observed for self-efficacy and goal-setting. However, some PROs and functional performance improvements favored the control group (p-values > 0.05). CONCLUSIONS Fit2ThriveMB is feasible and safe for patients with MBC and warrants further evaluation in randomized controlled trials with larger sample sizes. Registration Clinicaltrials.gov NCT04129346, https://clinicaltrials.gov/ct2/show/NCT04129346.
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Affiliation(s)
- Siobhan M Phillips
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N Lake Shore Drive, Suite 1400, Chicago, IL, 60611, USA.
| | - Julia Starikovsky
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N Lake Shore Drive, Suite 1400, Chicago, IL, 60611, USA
| | - Payton Solk
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N Lake Shore Drive, Suite 1400, Chicago, IL, 60611, USA
| | - Ria Desai
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N Lake Shore Drive, Suite 1400, Chicago, IL, 60611, USA
| | - Jean M Reading
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N Lake Shore Drive, Suite 1400, Chicago, IL, 60611, USA
| | - Kristina Hasanaj
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N Lake Shore Drive, Suite 1400, Chicago, IL, 60611, USA
| | - Shirlene D Wang
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N Lake Shore Drive, Suite 1400, Chicago, IL, 60611, USA
| | - Erin Cullather
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N Lake Shore Drive, Suite 1400, Chicago, IL, 60611, USA
| | - Jungwha Lee
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N Lake Shore Drive, Suite 1400, Chicago, IL, 60611, USA
| | - Jing Song
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N Lake Shore Drive, Suite 1400, Chicago, IL, 60611, USA
| | - Bonnie Spring
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N Lake Shore Drive, Suite 1400, Chicago, IL, 60611, USA
| | - William Gradishar
- Department of Medicine, Hematology and Oncology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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Lee CY, Laffoon K, Mama SK, Liao Y, Whisenant M, Brewster A, Mendoza T, Mitchell SJ, Tracy PV, Garza GM, Basen-Engquist KM. Outcomes for breast cancer survivors with metastatic disease in a physical activity program for medically underserved cancer survivors. J Cancer Surviv 2024:10.1007/s11764-024-01600-8. [PMID: 38801567 DOI: 10.1007/s11764-024-01600-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 04/10/2024] [Indexed: 05/29/2024]
Abstract
PURPOSE This study examined the effectiveness and feasibility of the Active Living After Cancer (ALAC) program for metastatic breast cancer (MBC) survivors. METHODS ALAC is a 12-session community-based program to help cancer survivors improve their physical functioning and quality of life through increased physical activity. ALAC participants with MBC (stage IV) were compared to survivors with early-stage breast cancer (stages I and II). The International Physical Activity Questionnaire, Godin Leisure-Time Physical Activity, 30-second sit-to-stand test, and PROMIS Global Health were administered at baseline and follow-up. Program satisfaction and retention were assessed at week 12. Repeated-measures mixed models were used to compare changes in outcomes between survivors with early-stage breast cancer and MBC. RESULTS A total of 585 women (59.3 y ± 10.6), most of whom were Hispanic (54%) or non-Hispanic Black (22%), were included (early stage, n = 538; MBC, n = 47). After the ALAC program, a significant increase in physical activity (P < 0.001), improved physical and mental health T-scores (P < 0.001), and more sit-to-stand repetitions (P < 0.001) were observed for both survivors with early-stage breast cancer and MBC. Women with MBC showed significantly lower physical health (P = 0.037) and physical function (P = 0.010) compared to early-stage at baseline. CONCLUSIONS The ALAC program increased physical activity and improved health-related quality of life and physical function among breast cancer survivors with both early-stage and metastatic disease. IMPLICATIONS FOR CANCER SURVIVORS This study emphasizes the importance of incorporating physical activity interventions like the ALAC program into the comprehensive care of cancer survivors, including those with metastatic disease.
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Affiliation(s)
- Che Young Lee
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd. Unit 1440, Houston, TX, 77030, USA
| | - Kylee Laffoon
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd. Unit 1440, Houston, TX, 77030, USA
| | - Scherezade K Mama
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd. Unit 1440, Houston, TX, 77030, USA
| | - Yue Liao
- Department of Kinesiology, The University of Texas at Arlington, 500 W. Nedderman Dr. 147, Arlington, TX, 76019, USA
| | - Meagan Whisenant
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd. Unit 1330, Houston, TX, 77030, USA
| | - Abenaa Brewster
- Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd. Unit 1360, Houston, TX, 77030, USA
| | - Tito Mendoza
- Office of Patient-Centered Outcomes Research, Center for Cancer Research, National Cancer Institute, 9030 Old Georgetown Road, Bethesda, MD, 20892, USA
| | - Stacy J Mitchell
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd. Unit 1440, Houston, TX, 77030, USA
| | - Patricia V Tracy
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd. Unit 1440, Houston, TX, 77030, USA
| | - Giselle M Garza
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd. Unit 1440, Houston, TX, 77030, USA
| | - Karen M Basen-Engquist
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd. Unit 1440, Houston, TX, 77030, USA.
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Aumaitre A, Gagnayre R, Foucaut AM. Determinants and Factors of Physical Activity After Oncology Treatments (DEFACTO) in Metropolitan France: Protocol of a Mixed Methods Study and Intervention. JMIR Res Protoc 2024; 13:e52274. [PMID: 38753415 PMCID: PMC11140280 DOI: 10.2196/52274] [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: 08/29/2023] [Revised: 04/08/2024] [Accepted: 04/10/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND While the scientific community widely recognizes the benefits of physical activity (PA) in oncology supportive care, cancer survivors who have undergone chemo- or radio-immunotherapy treatments struggle to meet PA recommendations. This underscores the importance of identifying factors influencing active lifestyle adoption and maintenance and proposing a multilevel model (micro-, meso-, and macrolevel) to better understand facilitators and barriers. Currently, no socioecological model explains an active lifestyle in the posttreatment phase of breast, colorectal, prostate, and lung cancers. OBJECTIVE The objective is to identify factors influencing an active lifestyle in cancer survivorship and assess the feasibility of an individualized program targeting an active lifestyle. The objectives will be addressed in 3 stages. Stage 1 aims to elucidate factors associated with the active lifestyle of cancer survivors. Stage 2 involves developing an explanatory model based on previously identified factors to create a tailored health education program for an active lifestyle after oncology treatments. Stage 3 aims to evaluate the feasibility and potential effects of this personalized health education program after its national implementation. METHODS First, the exploration of factors influencing PA (stage 1) will be based on a mixed methods approach, using an explanatory sequential design and multilevel analysis. The quantitative phase involves completing a questionnaire from a socioecological perspective. Subsequently, a subset of respondents will engage in semistructured interviews to aid in interpreting the quantitative results. This phase aims to construct a model of the factors influencing an active lifestyle and develop an individualized 12-week program based on our earlier findings (stage 2). In stage 3, we will implement our multicenter, multimodal program for 150 physically inactive and sedentary cancer survivors across metropolitan France. Program feasibility will be evaluated. Measured PA level by connected device and multidimensional variables such as declared PA and sedentary behaviors, PA readiness, motivation, PA preferences, PA knowledge and skills, and barriers and facilitators will be assessed before and during the program and 52 weeks afterward. RESULTS The institutional review board approved the mixed methods study (phase 1) in April 2020, and the intervention (phase 3) was approved in March 2022. Recruitment and data collection commenced in April 2022, with intervention implementation concluded in May 2023. Data collection and full analysis are expected to be finalized by July 2024. CONCLUSIONS The Determinants and Factors of Physical Activity After Oncology Treatments (DEFACTO) study seeks to enhance our understanding, within our socioecological model, of factors influencing an active lifestyle among cancer survivors and to assess whether a tailored intervention based on this model can support an active lifestyle. TRIAL REGISTRATION ClinicalTrials.gov NCT05354882; https://www.clinicaltrials.gov/study/NCT05354882. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/52274.
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Affiliation(s)
- Albane Aumaitre
- Health Educations and Promotion Laboratory, LEPS, UR 3412, Sorbonne Paris North University, Villetaneuse, France
| | - Rémi Gagnayre
- Health Educations and Promotion Laboratory, LEPS, UR 3412, Sorbonne Paris North University, Villetaneuse, France
| | - Aude-Marie Foucaut
- Health Educations and Promotion Laboratory, LEPS, UR 3412, Sorbonne Paris North University, Villetaneuse, France
- Sports Science Department, Sorbonne Paris North University, Bobigny, France
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Llave K, Cheng KK, Ko A, Pham A, Ericson M, Campos B, Perez-Gilbe HR, Kim JHJ. Promising Directions: A Systematic Review of Psychosocial and Behavioral Interventions with Cultural Incorporation for Advanced and Metastatic Cancer. Int J Behav Med 2024:10.1007/s12529-024-10264-8. [PMID: 38472713 DOI: 10.1007/s12529-024-10264-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2024] [Indexed: 03/14/2024]
Abstract
BACKGROUND Improving quality of life (QOL) in advanced and metastatic cancer is a priority with increasing survivorship. This systematic review synthesizes psychosocial and behavioral interventions incorporating culture with the goal of examining their benefit for understudied and medically underserved populations with advanced and metastatic cancer. METHOD Reports were systematically screened for (1) a focus on advanced and metastatic cancer survivors, (2) psychosocial or behavioral intervention intended to improve QOL, (3) evidence of incorporating the culture(s) of understudied/underserved populations, and (4) availability in English. Bias was evaluated using the JBI Critical Appraisal Checklist and the Methodological index for non-randomized studies. Qualitative synthesis and quantitative meta-analyses were completed. RESULTS Eighty-six reports containing 5981 participants' data were examined. Qualitative synthesis of 23 studies identified four overarching themes relevant for incorporating culture in interventions. Meta-analysis of 19 RCTs and 4 quasi-experimental studies containing considerable heterogeneity indicated greater improvements in QOL (g = 0.84), eudaimonic well-being (g = 0.53), distress (g = -0.49), and anxiety (g = -0.37) for main intervention conditions compared to controls. Meta-analysis of 10 single-arm trials containing minimal to moderate heterogeneity found benefit for anxiety (g = -0.54), physical symptoms (g = -0.39), and depression (g = -0.38). CONCLUSION Psychosocial and behavioral interventions with cultural incorporation appear beneficial for improving QOL-related outcomes in advanced and metastatic cancer. Studies incorporating culture in psychosocial or behavioral interventions offer noteworthy insight and suggestions for future efforts such as attending to deep cultural structure.
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Affiliation(s)
- Karen Llave
- Department of Population Health & Preventive Disease, University of California, Irvine, USA
| | - Karli K Cheng
- Department of Medicine, University of California, 100 Theory, Suite 100, Irvine, CA, 92697, USA
| | - Amy Ko
- Department of Medicine, University of California, 100 Theory, Suite 100, Irvine, CA, 92697, USA
| | - Annie Pham
- Department of Medicine, University of California, 100 Theory, Suite 100, Irvine, CA, 92697, USA
| | - Marissa Ericson
- Institute for Clinical and Translational Science, University of Southern California, Los Angeles, USA
| | - Belinda Campos
- Department of Chicano/Latino Studies, University of California, Irvine, USA
| | | | - Jacqueline H J Kim
- Department of Population Health & Preventive Disease, University of California, Irvine, USA.
- Department of Medicine, University of California, 100 Theory, Suite 100, Irvine, CA, 92697, USA.
- Chao Family Comprehensive Cancer Center, University of California, Irvine, USA.
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Borhani M, Hosseini ZS, Shahabodin N, Mehri A, Kiani M, Abedi M. Empowering Rural Housewives in Iran: Utilizing the Transtheoretical Model to Increase Physical Activity. J Prev Med Public Health 2024; 57:167-175. [PMID: 38374712 PMCID: PMC10999308 DOI: 10.3961/jpmph.23.457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 01/09/2024] [Accepted: 01/11/2024] [Indexed: 02/21/2024] Open
Abstract
OBJECTIVES Rural housewives are integral to household management and family care, yet their sedentary lifestyles present significant health risks. This study used the transtheoretical model (TTM) to investigate strategies that encourage and maintain regular exercise habits among rural housewives. METHODS A semi-experimental study was conducted in 2021 with 114 housewives aged 30 to 59 who attended rural health centers in Gorgan, Iran. Participants were randomly assigned to 1 of 2 groups. Data collection involved a validated questionnaire that gathered demographic information and constructs of the TTM. The intervention group participated in a comprehensive educational program, which included four 60-minute sessions. Data were collected again 6 months post-intervention and analyzed using descriptive and inferential statistics in SPSS version 21. RESULTS The study encompassed women with an average age of 39.75±6.05 years, the majority of whom had educational levels below a diploma, and over 90% were married. We observed strong correlations between the processes of change, self-efficacy, and decisional balance. At the outset, there were no significant differences in demographics or model structures between the 2 groups. However, 6 months post-intervention, the intervention group exhibited statistically significant differences in the mean scores of model structures, stages of change, and body mass index (<>p<0.05). CONCLUSIONS This study highlights the importance of physical activity training for rural housewives. The findings suggest that the educational intervention, which utilized the TTM, significantly impacted the participants' model structures and their stages of change.
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Affiliation(s)
- Mahboobe Borhani
- Health Management and Social Development Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Zakieh Sadat Hosseini
- Department of Public Health, Faculty of Health and Paramedicine, Neyshabur University of Medical Sciences, Neyshabur, Iran
- Department of Health Education, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Najme Shahabodin
- Health Management and Social Development Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Ali Mehri
- Department of Health Education, Faculty of Health, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Mohadese Kiani
- Health Management and Social Development Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Marzieh Abedi
- Health Management and Social Development Research Center, Golestan University of Medical Sciences, Gorgan, Iran
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Noh H, Anota A, Mongondry R, Meyrand R, Dupuis C, Schiffler C, Marijnen P, Rinaldi S, Lachuer J, Keski-Rahkonen P, Gunter MJ, Fléchon A, Fervers B, Pérol O. Impact of a one-year supervised physical activity program on long-term cancer-related fatigue and mediating effects of the gut microbiota in metastatic testicular cancer patients: protocol of the prospective multicentre, randomized controlled phase-III STARTER trial. BMC Cancer 2024; 24:84. [PMID: 38225551 PMCID: PMC10790440 DOI: 10.1186/s12885-024-11824-7] [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: 11/17/2023] [Accepted: 01/02/2024] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND Testicular germ cell tumours (TGCTs) are the most common malignancy in men aged 15-40 years, with increasing incidence worldwide. About 33 ~ 50% of the patients present with metastatic disease at diagnosis. TGCT survivors experience short- and long-term sequelae, including cancer-related fatigue (CRF). Physical activity (PA) has established effects on reducing CRF and other sequelae and improving health-related quality of life (HRQoL). However, its impact on TGCT survivors has so far received little attention. The gut microbiota plays a crucial role in various physiological functions, including cognition and metabolism, and may mediate the effects of PA on CRF and other sequelae, but this has not been investigated in randomized controlled trials. METHODS This national, multicentre, phase-III trial will evaluate the impact of a one-year supervised PA program on CRF and other short- and long-term sequelae in metastatic TGCT patients receiving cisplatin-based chemotherapy combined with etoposide+/-bleomycin. It will also investigate potential mediating effects of the gut microbiota and its metabolites involved in the gut-brain axis on the relationship between PA and CRF and other sequelae. A total of 236 men ≥ 18 years of age with metastatic TGCT (seminoma and non-seminoma) will be enrolled before starting first-line chemotherapy in several French hospitals. The primary (CRF) and secondary (cognitive/psychological/metabolic sequelae, HRQoL, etc.) outcomes and gut microbiota and relevant metabolites will be assessed at inclusion, during and at the end of the one-year intervention, and annually until 10 years since inclusion to assess long-term sequelae, more specifically CRF, cardiovascular toxicities, and second primary cancer occurrence in this population. DISCUSSION This trial will provide comprehensive and novel insights into the effects of a long-term supervised PA program on CRF and other sequelae in metastatic TGCT patients receiving first-line chemotherapy. It will also contribute to understanding the potential role of the gut microbiota and its metabolites in mediating the effects of PA on these outcomes. The findings of this study will help the development of effective PA interventions to improve the health of TGCT survivors and may have implications for other cancer populations as well. TRIAL REGISTRATION The study was registered on ClinicalTrials.gov (NCT05588700) on 20 Oct. 2022.
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Affiliation(s)
- Hwayoung Noh
- Departement of Prevention Cancer Environment, Léon Bérard Cancer Centre, Lyon, France.
- INSERM U1296, Léon Bérard Cancer Centre, Lyon, France.
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC-WHO), Lyon, France.
| | - Amélie Anota
- Direction of Clinical Research and Innovation, Léon Bérard Cancer Centre, Lyon, France
| | - Rodolf Mongondry
- Departement of Prevention Cancer Environment, Léon Bérard Cancer Centre, Lyon, France
| | - Renaud Meyrand
- Departement of Prevention Cancer Environment, Léon Bérard Cancer Centre, Lyon, France
| | - Carmen Dupuis
- Departement of Prevention Cancer Environment, Léon Bérard Cancer Centre, Lyon, France
| | - Camille Schiffler
- Direction of Clinical Research and Innovation, Léon Bérard Cancer Centre, Lyon, France
| | - Philippe Marijnen
- Departement of Prevention Cancer Environment, Léon Bérard Cancer Centre, Lyon, France
| | - Sabina Rinaldi
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Joel Lachuer
- INSERM U1052, Cancer Research Center of Lyon (CRCL), University Lyon 1, Lyon, France
- ProfileXpert, SFR santé Lyon-Est, CNRS UMR-S3453, INSERM US7, Lyon, France
| | - Pekka Keski-Rahkonen
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Marc J Gunter
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC-WHO), Lyon, France
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, W2 1PG, London, UK
| | - Aude Fléchon
- Department of Medical Oncology, Léon Bérard Cancer Centre, Lyon, France
| | - Béatrice Fervers
- Departement of Prevention Cancer Environment, Léon Bérard Cancer Centre, Lyon, France
- INSERM U1296, Léon Bérard Cancer Centre, Lyon, France
| | - Olivia Pérol
- Departement of Prevention Cancer Environment, Léon Bérard Cancer Centre, Lyon, France
- INSERM U1296, Léon Bérard Cancer Centre, Lyon, France
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Quadflieg K, Grigoletto I, Haesevoets S, Cops D, Ramos EMC, Spruit MA, Cavalheri V, Burtin C. Effectiveness of Non-pharmacologic Interventions on Device-measured Physical Activity in Adults With Cancer, and Methodology Used for Assessment: A Systematic Review and Meta-analysis. Arch Phys Med Rehabil 2023; 104:2123-2146. [PMID: 37150425 DOI: 10.1016/j.apmr.2023.04.013] [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: 08/30/2022] [Revised: 03/14/2023] [Accepted: 04/12/2023] [Indexed: 05/09/2023]
Abstract
OBJECTIVE To investigate the effectiveness of different types of interventions aimed at enhancing device-measured physical activity (PA) and summarize the devices and methodologies used to measure PA in adults with cancer. DATA SOURCES A systematic review was prospectively registered on PROSPERO (CRD42020199466). The search was conducted in PubMed, The Cochrane Library, EMBASE (via Ovid), and PEDro from 2005 onward. STUDY SELECTION Prospective interventional studies (randomized controlled trials [RCTs], non-randomized controlled trials, and single-group trials), that included adults within 12 months from cancer diagnosis, and device-measured PA before and after commencement of an intervention were included. Studies were excluded if PA was measured at a single time point. Two independent reviewers screened 3033 records and 30 articles met the inclusion criteria. DATA EXTRACTION Two reviewers independently extracted the data. PEDro scale and GRADE approach were used to assess methodological quality of RCTs and overall quality of evidence, respectively. A meta-analysis of relevant RCTs was conducted. DATA SYNTHESIS Thirty studies were identified, mainly including adults with multiple cancer types. Interventions were behavior change interventions (n=15), exercise training (n=13), neuromuscular electrostimulation (n=1), or a nutritional program (n=1). The meta-analysis showed improvements on moderate-to-vigorous intensity PA (MVPA) in the experimental group (8 studies; standardized mean difference (SMD)=0.23; 95% CI 0.06-0.39); with subgroup analysis showing that findings were mainly driven by behavior change interventions (5 studies; SMD=0.23, 95% CI 0.05-0.41). An uncertain effect on sedentary behavior, daily steps, and light intensity PA was found. PA was measured with medical devices and commercial wearables, quality of the methodology was variable. CONCLUSIONS Behavior change interventions increased device-derived MVPA in adult cancer patients who underwent the intervention within 12 months of the cancer diagnosis. Various devices and methodologies were used to assess PA, which limits comparisons across the studies.
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Affiliation(s)
- Kirsten Quadflieg
- REVAL-Rehabilitation Research Center, BIOMED-Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
| | - Isis Grigoletto
- Department of Physiotherapy, Postgraduate Program in Physiotherapy, São Paulo State University (UNESP), Presidente Prudente, Brazil
| | - Sarah Haesevoets
- REVAL-Rehabilitation Research Center, BIOMED-Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
| | - Dries Cops
- REVAL-Rehabilitation Research Center, BIOMED-Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
| | - Ercy Mara Cipulo Ramos
- Department of Physiotherapy, Postgraduate Program in Physiotherapy, São Paulo State University (UNESP), Presidente Prudente, Brazil
| | - Martijn A Spruit
- CIRO, Center of Expertise for Chronic Organ Failure, Department of Research and Education, Horn, The Netherlands; Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Vinicius Cavalheri
- Curtin School of Allied Health and enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia; Allied Health, South Metropolitan Health Service, Perth, Australia; Exercise Medicine Research Institute, Edith Cowan University, Perth, Australia
| | - Chris Burtin
- REVAL-Rehabilitation Research Center, BIOMED-Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium.
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10
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Keane D, Phillips G, Mitchell N, Connolly RM, Hegarty J. Improving quality of life and symptom experience in patients with metastatic breast cancer: A systematic review of supportive care interventions. Psychooncology 2023; 32:1192-1207. [PMID: 37434307 DOI: 10.1002/pon.6183] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 06/08/2023] [Accepted: 06/10/2023] [Indexed: 07/13/2023]
Abstract
OBJECTIVE The prognosis for individuals with metastatic breast cancer (MBC) has improved in recent decades. This expanding cohort has unique psychological and psychosocial needs, yet targeted supportive care interventions are underdeveloped. This systematic review seeks to summarise the available evidence on the effectiveness of supportive care interventions in improving quality of life and symptom experience of individuals living with MBC so that services can be developed to address the unmet needs of this cohort in future. METHODS Academic Search Complete, CINAHL, ERIC, Medline and SocINDEX were searched for publications investigating the effect of supportive care interventions specifically targeted at addressing the quality of life or symptom experience of individuals living with MBC. Three reviewers independently screened and selected studies. Quality appraisal and assessed risk of bias were carried out. RESULTS The search yielded 1972 citations. Thirteen studies met the inclusion criteria. Interventions included psychological (n = 3), end of life discussion and preparation (n = 2), physical activity (n = 4), lifestyle (n = 2), and medication self-management support (n = 2). Three studies reported significant improvement in quality of life, two of which reported improved symptom experience in at least one symptom. Three further physical activity interventions showed improvement in at least one of the symptoms investigated. CONCLUSION Studies reporting a statistically significant effect on quality of life and improved symptom experience were extremely heterogenous. We can tentatively suggest that multimodal and frequently administered interventions are effective, with physical activity interventions positively impacting on symptom experience, however further research is required.
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Affiliation(s)
- Danielle Keane
- School of Nursing & Midwifery, University College Cork, Cork, Ireland
| | - Grace Phillips
- School of Nursing & Midwifery, University College Cork, Cork, Ireland
| | | | - Roisin M Connolly
- Cancer Research @UCC, College of Medicine & Health, University College Cork, Cork, Ireland
- Department of Medical Oncology, Cork University Hospital, Cork, Ireland
| | - Josephine Hegarty
- School of Nursing & Midwifery, University College Cork, Cork, Ireland
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11
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Piotrowska K, Zgutka K, Tkacz M, Tarnowski M. Physical Activity as a Modern Intervention in the Fight against Obesity-Related Inflammation in Type 2 Diabetes Mellitus and Gestational Diabetes. Antioxidants (Basel) 2023; 12:1488. [PMID: 37627482 PMCID: PMC10451679 DOI: 10.3390/antiox12081488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/18/2023] [Accepted: 07/21/2023] [Indexed: 08/27/2023] Open
Abstract
Diabetes is one of the greatest healthcare problems; it requires an appropriate approach to the patient, especially when it concerns pregnant women. Gestational diabetes mellitus (GDM) is a common metabolic condition in pregnancy that shares many features with type 2 diabetes mellitus (T2DM). T2DM and GDM induce oxidative stress, which activates cellular stress signalling. In addition, the risk of diabetes during pregnancy can lead to various complications for the mother and foetus. It has been shown that physical activity is an important tool to not only treat the negative effects of diabetes but also to prevent its progression or even reverse the changes already made by limiting the inflammatory process. Physical activity has a huge impact on the immune status of an individual. Various studies have shown that regular training sessions cause changes in circulating immune cell levels, cytokine activation, production and secretion and changes in microRNA, all of which have a positive effect on the well-being of the diabetic patient, mother and foetus.
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Affiliation(s)
- Katarzyna Piotrowska
- Department of Physiology, Pomeranian Medical University in Szczecin, al. Powstancow Wlkp. 72, 70-111 Szczecin, Poland
| | - Katarzyna Zgutka
- Department of Physiology in Health Sciences, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, Zolnierska 54, 70-210 Szczecin, Poland
| | - Marta Tkacz
- Department of Physiology in Health Sciences, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, Zolnierska 54, 70-210 Szczecin, Poland
| | - Maciej Tarnowski
- Department of Physiology in Health Sciences, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, Zolnierska 54, 70-210 Szczecin, Poland
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12
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Depenbusch J, Sweegers MG, Aaronson NK, Wengström Y, Backman M, Arraras JI, Schranz M, Büchler B, Lachowicz M, May AM, Steindorf K, Stuiver MM. PERSPECTIVEs on supervised exercise programs in people with metastatic breast cancer- a qualitative study in four European countries. Support Care Cancer 2023; 31:281. [PMID: 37074497 PMCID: PMC10115708 DOI: 10.1007/s00520-023-07739-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 04/06/2023] [Indexed: 04/20/2023]
Abstract
PURPOSE Supervised exercise is a potentially promising supportive care intervention for people with metastatic breast cancer (MBC), but research on the patients' perspective is limited. The aim of the current focus group study was to gain an in-depth understanding of MBC patients' perceived barriers, facilitators, and preferences for supervised exercise programs. METHODS Eleven online focus groups with, in total, 44 MBC patients were conducted in four European countries (Germany, Poland, Spain, Sweden). Main topics of the semi-structured discussions covered attitudes towards participation in supervised exercise programs, perceived facilitators, experienced barriers, and exercise preferences. Interviews were transcribed verbatim, translated into English, and coded based on a preliminary coding framework, supplemented by themes emerging during the sessions. The codes were subsequently examined for interrelations and re-organized into overarching clusters. RESULTS Participants had positive attitudes towards exercise, but experienced physical limitations and insecurities that inhibited their participation. They expressed a strong desire for exercise tailored to their needs, and supervision by an exercise professional. Participants also highlighted the social nature of group training as an important facilitator. They had no clear preference for exercise type, but rather favored a mixture of different activities. Flexible training modules were considered helpful to increase exercise program adherence. CONCLUSIONS MBC patients were generally interested in supervised exercise programs. They preferred group exercise that facilitates social interaction, but also expressed a need for individualized exercise programs. This suggests the relevance to develop flexible exercise programs that are adjusted to the individual's needs, abilities, and preferences.
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Affiliation(s)
- Johanna Depenbusch
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany
| | - Maike G Sweegers
- Center for Quality of Life, Netherlands Cancer Institute, Amsterdam, The Netherlands
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Neil K Aaronson
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Yvonne Wengström
- Division of Nursing, Department of Neurobiology, Care Sciences, and Society, Karolinska Institute and Karolinska Comprehensive Cancer Center, Karolinska University Hospital, Stockholm, Sweden
| | - Malin Backman
- Division of Nursing, Department of Neurobiology, Care Sciences, and Society, Karolinska Institute and Karolinska Comprehensive Cancer Center, Karolinska University Hospital, Stockholm, Sweden
| | - Juan I Arraras
- Oncology Departments, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Melanie Schranz
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Britta Büchler
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Milena Lachowicz
- Department of Oncology and Radiotherapy, Medical University of Gdańsk, Gdańsk, Poland
| | - Anne M May
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Karen Steindorf
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany
| | - Martijn M Stuiver
- Center for Quality of Life, Netherlands Cancer Institute, Amsterdam, The Netherlands.
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands.
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Parkinson J, Bandera A, Crichton M, Shannon C, Woodward N, Hodgkinson A, Millar L, Teleni L, van der Meij BS. Poor Muscle Status, Dietary Protein Intake, Exercise Levels, Quality of Life and Physical Function in Women with Metastatic Breast Cancer at Chemotherapy Commencement and during Follow-Up. Curr Oncol 2023; 30:688-703. [PMID: 36661703 PMCID: PMC9857792 DOI: 10.3390/curroncol30010054] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/06/2022] [Accepted: 12/29/2022] [Indexed: 01/06/2023] Open
Abstract
This study aimed to investigate nutritional status, body composition, dietary protein intake, handgrip strength, 6 min or 4 m walk tests, self-reported physical activity, physical function, and quality of life (QoL-EORTC-QLQc30) at commencement of chemotherapy; to detect changes over time (from commencement of chemotherapy, and after 3, 6, 12, 26 and 52 weeks) in women with metastatic breast cancer (MBC); and to investigate the relationship between nutritional variables. 'Sarcopenia' was defined as low muscle mass and strength, 'myosteatosis' as muscle fat-infiltration (CT scan). Continuous variables were analysed using paired t-tests between baseline and follow-ups. Fifteen women (54y, 95% CI [46.3;61.2]) were recruited. At baseline, malnutrition was present in 3 (20%) participants, sarcopenia in 3 (20%) and myosteatosis in 7 (54%). Thirteen (87%) participants had low protein intake; low handgrip strength was observed in 0, and low walk test distance and physical activity in four (27%) participants. Physical function and QoL were low in 10 (67%) and 9 (60%), respectively. QoL between baseline and 52 weeks decreased by 11.7 (95% CI [2.4;20.9], p = 0.025). Other variables did not significantly change over time. In this small study sample, myosteatosis, low dietary protein intake, low exercise levels and impaired quality of life and physical function are common.
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Affiliation(s)
- Jessica Parkinson
- Bond University Nutrition and Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD 4226, Australia
| | - Amelia Bandera
- Bond University Nutrition and Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD 4226, Australia
| | - Megan Crichton
- Bond University Nutrition and Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD 4226, Australia
| | - Catherine Shannon
- Mater Health, Brisbane, QLD 4101, Australia
- Mater Research Institute, University of Queensland, Brisbane, QLD 4072, Australia
| | - Natasha Woodward
- Mater Health, Brisbane, QLD 4101, Australia
- Mater Research Institute, University of Queensland, Brisbane, QLD 4072, Australia
| | - Adam Hodgkinson
- Mater Research Institute, University of Queensland, Brisbane, QLD 4072, Australia
| | - Luke Millar
- Mater Research Institute, University of Queensland, Brisbane, QLD 4072, Australia
| | - Laisa Teleni
- Bond University Nutrition and Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD 4226, Australia
| | - Barbara S. van der Meij
- Bond University Nutrition and Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD 4226, Australia
- Mater Health, Brisbane, QLD 4101, Australia
- Mater Research Institute, University of Queensland, Brisbane, QLD 4072, Australia
- Department of Nutrition, Dietetics and Lifestyle, HAN University of Applied Sciences, 6525 EN Nijmegen, The Netherlands
- Division of Human Nutrition and Health, Wageningen University and Research, 6708 PD Wageningen, The Netherlands
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14
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Bò MC, Merlo A, Ligabue MB, Bassi MC, Lusuardi M, Campanini I. Self-managed physical activity in breast cancer survivors: A scoping review. PLoS One 2023; 18:e0284807. [PMID: 37093839 PMCID: PMC10124851 DOI: 10.1371/journal.pone.0284807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 04/01/2023] [Indexed: 04/25/2023] Open
Abstract
OBJECTIVE Breast cancer survivors (BCS) experience many issues of rehabilitative concern due to the treatments they have undergone. Given the chronicity of these outcomes, the increasing number of survivors, and the positive results obtained by supervised exercise, professionals should consider offering self-managed physical activity (PA) programs to this population. Our aim was to map the currently available evidence about self-care rehabilitation for BCS. METHODS Medline, CINAHL, and Cochrane databases were searched for primary literature. Scoping review methodological frameworks were used to tackle the heterogeneity of the topic. Studies investigating self-managed PA interventions prescribed to adult BCS were included. RESULTS One hundred-eight studies were included, with sample sizes ranging from 6 to 692 patients. Information was systematically collected in tables displaying study design, type of PA, duration and recommended frequency, professional leading the study, type of supervision, initial training, strategies used to help patients integrate self-care into their daily lives, and self-managed PA efficacy. Tables were produced for every oncological side effect that BCS might experience: lymphedema, arthralgia, cancer-related fatigue, a decline in physical parameters, treatment-related cardiotoxicity, peripheral neurotoxicity, and a possible decline in the quality of life. CONCLUSIONS Self-managed PA has the potential to improve BCS oncological issues. Professionals can adopt many strategies to support patients and empower them with long-lasting self-care competencies. This scoping review provided a comprehensive and easy-to-consult overview of self-managed PA interventions for BCS. We also provided recommendations for future primary studies and secondary synthesis.
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Affiliation(s)
- Maria Chiara Bò
- LAM-Motion Analysis Laboratory, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, San Sebastiano Hospital, Correggio (Reggio Emilia), Italy
- Merlo Bioengineering, Parma, Italy
| | - Andrea Merlo
- LAM-Motion Analysis Laboratory, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, San Sebastiano Hospital, Correggio (Reggio Emilia), Italy
- Merlo Bioengineering, Parma, Italy
| | - Maria Bernadette Ligabue
- Motor Rehabilitation Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, San Sebastiano Hospital, Correggio (Reggio Emilia), Italy
| | - Maria Chiara Bassi
- Medical Library, Azienda USL-IRCCS di Reggio Emilia, Correggio (Reggio Emilia), Italy
| | - Mirco Lusuardi
- Neuromotor and Rehabilitation Department, Azienda USL-IRCCS Reggio Emilia, Correggio (Reggio Emilia), Italy
| | - Isabella Campanini
- LAM-Motion Analysis Laboratory, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, San Sebastiano Hospital, Correggio (Reggio Emilia), Italy
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Campanini I, Ligabue MB, Bò MC, Bassi MC, Lusuardi M, Merlo A. Self-managed physical activity in cancer survivors for the management of cancer-related fatigue: A scoping review. PLoS One 2022; 17:e0279375. [PMID: 36542639 PMCID: PMC9770433 DOI: 10.1371/journal.pone.0279375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 12/06/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE Cancer-related fatigue (CRF) is a disabling chronic condition that cancer survivors could experience during and after recovery and that might benefit from self-managed physical activity (PA) programs. This scoping review aimed to map self-managed PA interventions found in literature for the management of CRF. METHODS Given the heterogeneity of the topic, scoping review methodological frameworks were used. Pubmed, Cinahl and Cochrane databases were searched for primary literature. Inclusion criteria: self-managed PA meant as any exercise program prescribed by a professional either with or without initial supervision and training which then continued independently for a given time frame; patient-reported fatigue assessment included in the outcome measures. Articles dealing with entirely supervised interventions, dietary or psychological-only therapies, and with palliative care were excluded. RESULTS Of the 543 experimental or observational studies screened, 63 were included. Of these forty-three studies were randomized controlled trials. Data were summarized in tables describing self-managed interventions according to: type of self-managed activity, frequency and duration, strategies to promote adherence, professionals supervising the treatment, outcome measures, and efficacy. A narrative synthesis was also added to further explain findings. CONCLUSIONS We collected the available evidence on PA when this was self-managed by patients after prescription by a healthcare provider. Clinicians and researchers should consider incorporating self-care programs in CRF patients' recovery journey gradually, identifying the best strategies to integrate them into daily life. Researchers should specify the characteristics of PA programs when designing new studies. This review highlighted the areas to be investigated for future studies pertaining to self-managed PA.
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Affiliation(s)
- Isabella Campanini
- LAM - Motion Analysis Laboratory, Neuromotor and Rehabilitation Department, San Sebastiano Hospital, Azienda USL-IRCCS di Reggio Emilia, Correggio, Reggio Emilia, Italy
| | - Maria Bernadette Ligabue
- Motor Rehabilitation Unit, Neuromotor and Rehabilitation Department, San Sebastiano Hospital, Azienda USL-IRCCS di Reggio Emilia, Correggio, Reggio Emilia, Italy
| | | | - Maria Chiara Bassi
- Medical Library, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Mirco Lusuardi
- Neuromotor and Rehabilitation Department, Azienda USL-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Andrea Merlo
- LAM - Motion Analysis Laboratory, Neuromotor and Rehabilitation Department, San Sebastiano Hospital, Azienda USL-IRCCS di Reggio Emilia, Correggio, Reggio Emilia, Italy
- Merlo Bioengineering, Parma, Italy
- * E-mail:
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16
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Beenhakker L, Witteveen A, Wijlens KAE, Siemerink EJM, van der Lee ML, Bode C, Siesling S, Vollenbroek‐Hutten MMR. Patient preference attributes in eHealth interventions for cancer-related fatigue: A scoping review. Eur J Cancer Care (Engl) 2022; 31:e13754. [PMID: 36385440 PMCID: PMC9786794 DOI: 10.1111/ecc.13754] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 10/05/2022] [Accepted: 10/09/2022] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Cancer-related fatigue (CRF) is one of the most reported long-term effects breast cancer patients experience after diagnosis. Many interventions for CRF are effective, however, not for every individual. Therefore, intervention advice should be adjusted to patients' preferences and characteristics. Our aim was to develop an overview of eHealth interventions and their (preference sensitive) attributes. METHODS eHealth interventions were identified using a scoping review approach. Eligible studies included breast cancer patients and assessed CRF as outcome. Interventions were categorised as physical activity, mind-body, psychological, 'other' or 'combination'. Information was extracted on various (preference sensitive) attributes, like duration, intensity, peer support and costs. RESULTS Thirty-five interventions were included and divided over the intervention categories. (Preference sensitive) attributes varied both within and between these categories. Duration varied from 4 weeks to 6 months, intensity from daily to own pace. Peer support was present in seven interventions and costs were known for six. CONCLUSION eHealth interventions exist in various categories, additionally, there is much variation in (preference sensitive) attributes. This provides opportunities to implement our overview for personalised treatment recommendations for breast cancer patients struggling with CRF. Taking into account patients' preferences and characteristics suits the complexity of CRF and heterogeneity of patients.
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Affiliation(s)
- Lian Beenhakker
- Department of Biomedical Signals and SystemsUniversity of TwenteEnschedeThe Netherlands
| | - Annemieke Witteveen
- Department of Biomedical Signals and SystemsUniversity of TwenteEnschedeThe Netherlands
| | - Kim A. E. Wijlens
- Department of Biomedical Signals and SystemsUniversity of TwenteEnschedeThe Netherlands
| | | | - Marije L. van der Lee
- Scientific Research DepartmentHelen Dowling InstituteBilthovenThe Netherlands,Department of Medical and Clinical Psychology, Center of Research on Psychology in Somatic diseasesTilburg UniversityTilburgThe Netherlands
| | - Christina Bode
- Department of Psychology, Health and TechnologyUniversity of TwenteEnschedeThe Netherlands
| | - Sabine Siesling
- Department of Health Technology and Services Research, Technical Medical CentreUniversity of TwenteEnschedeThe Netherlands,Department of Research and DevelopmentNetherlands Comprehensive Cancer Organisation (IKNL)UtrechtThe Netherlands
| | - Miriam M. R. Vollenbroek‐Hutten
- Department of Biomedical Signals and SystemsUniversity of TwenteEnschedeThe Netherlands,Board of DirectorsMedisch Spectrum TwenteEnschedeThe Netherlands
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Bouillet T, Joly F, Saghatchian M, Guéroult-Accolas L, Tahar JM, Descotes JM, Krakowski I. Activité Physique Adaptée et cancer métastatique : quels besoins et quelles attentes ? Bull Cancer 2022; 109:1287-1297. [DOI: 10.1016/j.bulcan.2022.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 07/04/2022] [Accepted: 07/25/2022] [Indexed: 11/06/2022]
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Gudmundsson GH, Mészáros J, Björnsdóttir ÁE, Ámundadóttir ML, Thorvardardottir GE, Magnusdottir E, Helgadottir H, Oddsson S. Feasibility of a Digital Therapeutic Program for Cancer Patients During Active Treatment: Analysis of Engagement, Retention and Quality of Life (Preprint). JMIR Form Res 2022; 6:e39764. [PMID: 36227639 PMCID: PMC9614627 DOI: 10.2196/39764] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 08/17/2022] [Accepted: 08/29/2022] [Indexed: 12/01/2022] Open
Abstract
Background Increasing evidence shows that lifestyle interventions can improve the symptoms, quality of life (QoL), and even overall survival of patients with cancer. Digital therapeutics (DTx) can help implement behavioral modifications and empower patients through education, lifestyle support, and remote symptom monitoring. Objective We aimed to test the feasibility of a DTx program for patients with cancer, as measured by engagement, retention, and acceptability. In addition, we explored the effects of the program on cancer-related QoL. Methods We conducted a 4-week single-arm trial in Iceland, where DTx was delivered through a smartphone app. The intervention consisted of patient education about mindfulness, sleep, stress, and nutrition; lifestyle coaching; and the completion of daily missions for tracking physical activity and exercise, reporting patient-reported outcomes (PROs), practicing mindfulness, and logging healthy food intake. Information on program engagement and retention, step goal attainment, as well as PROs were collected throughout the study. QoL was measured using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 at baseline and follow-up. Results In total, 30 patients with cancer undergoing active therapy were enrolled, and 29 registered in the app (23 female, 18 with breast cancer; mean age 52.6, SD 11.5 years). Overall, 97% (28/29) of participants were active in 3 of the 4 weeks and completed the pre- and postprogram questionnaires. The weekly active days (median) were 6.8 (IQR 5.8-6.8), and 72% (21/29) of participants were active at least 5 days a week. Users interacted with the app on average 7.7 (SD 1.9) times per day. On week 1, all 29 participants used the step counter and logged an average of 20,306 steps; 21 (72%) participants reached their step goals of at least 3000 steps per day. On week 4, of the 28 active users, 27 (96%) were still logging their steps, with 19 (68%) reaching their step goals. Of the 28 participants who completed the satisfaction questionnaire, 25 (89%) were likely to recommend the program, 23 (82%) said the program helped them deal with the disease, and 24 (86%) said it helped them remember their medication. QoL assessment showed that the average global health status, functioning, and symptom burden remained stable from baseline to follow-up. In all, 50% (14/28) of participants reported less pain, and the average pain score decreased from 31 (SD 20.1) to 22.6 (SD 23.2; P=.16). There was no significant change in PROs on the quality of sleep, energy, and stress levels from the first to the last week. Conclusions The high retention, engagement, and acceptability found in this study demonstrate that multidisciplinary DTx is feasible for patients with cancer. A longer, full-scale randomized controlled trial is currently being planned to evaluate the efficacy of the intervention.
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Affiliation(s)
| | - Judit Mészáros
- Medical and Research Department, Sidekick Health, Berlin, Germany
| | | | | | | | | | - Halla Helgadottir
- Medical and Research Department, Sidekick Health, Kopavogur, Iceland
| | - Saemundur Oddsson
- Medical and Research Department, Sidekick Health, Kopavogur, Iceland
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Dimauro I, Grazioli E, Antinozzi C, Duranti G, Arminio A, Mancini A, Greco EA, Caporossi D, Parisi A, Di Luigi L. Estrogen-Receptor-Positive Breast Cancer in Postmenopausal Women: The Role of Body Composition and Physical Exercise. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9834. [PMID: 34574758 PMCID: PMC8467802 DOI: 10.3390/ijerph18189834] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/15/2021] [Accepted: 09/17/2021] [Indexed: 12/14/2022]
Abstract
Breast cancer (BC) is the most commonly diagnosed cancer among women worldwide and the most common cause of cancer-related death. To date, it is still a challenge to estimate the magnitude of the clinical impact of physical activity (PA) on those parameters producing significative changes in future BC risk and disease progression. However, studies conducted in recent years highlight the role of PA not only as a protective factor for the development of ER+ breast cancer but, more generally, as a useful tool in the management of BC treatment as an adjuvant to traditional therapies. In this review, we focused our attention on data obtained from human studies analyzing, at each level of disease prevention (i.e., primary, secondary, tertiary and quaternary), the positive impact of PA/exercise in ER+ BC, a subtype representing approximately 70% of all BC diagnoses. Moreover, given the importance of estrogen receptors and body composition (i.e., adipose tissue) in this subtype of BC, an overview of their role will also be made throughout this review.
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Affiliation(s)
- Ivan Dimauro
- Unit of Biology and Genetics of Movement, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Piazza Lauro de Bosis 15, 00135 Rome, Italy;
| | - Elisa Grazioli
- Unit of Physical Exercise and Sport Sciences, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Piazza Lauro de Bosis 15, 00135 Rome, Italy; (E.G.); (A.P.)
| | - Cristina Antinozzi
- Unit of Endocrinology, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Piazza Lauro de Bosis 15, 00135 Rome, Italy; (C.A.); (A.A.); (E.A.G.); (L.D.L.)
| | - Guglielmo Duranti
- Unit of Biocheminstry and Molecular Biology, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Piazza Lauro de Bosis 15, 00135 Rome, Italy;
| | - Alessia Arminio
- Unit of Endocrinology, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Piazza Lauro de Bosis 15, 00135 Rome, Italy; (C.A.); (A.A.); (E.A.G.); (L.D.L.)
| | - Annamaria Mancini
- Dipartimento di Scienze Motorie e del Benessere (DISMeB), Università Degli Studi di Napoli “Parthenope”, Via F. Acton, 38, 80133 Naples, Italy;
- CEINGE-Biotecnologie Avanzate s.c.ar.l., Via Gaetano Salvatore 482, 80145 Naples, Italy
| | - Emanuela A. Greco
- Unit of Endocrinology, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Piazza Lauro de Bosis 15, 00135 Rome, Italy; (C.A.); (A.A.); (E.A.G.); (L.D.L.)
- Department of Health Science, University “Magna Graecia” of Catanzaro, Viale Europa, 88100 Catanzaro, Italy
| | - Daniela Caporossi
- Unit of Biology and Genetics of Movement, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Piazza Lauro de Bosis 15, 00135 Rome, Italy;
| | - Attilio Parisi
- Unit of Physical Exercise and Sport Sciences, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Piazza Lauro de Bosis 15, 00135 Rome, Italy; (E.G.); (A.P.)
| | - Luigi Di Luigi
- Unit of Endocrinology, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Piazza Lauro de Bosis 15, 00135 Rome, Italy; (C.A.); (A.A.); (E.A.G.); (L.D.L.)
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Touillaud M, Fournier B, Pérol O, Delrieu L, Maire A, Belladame E, Pérol D, Perrier L, Preau M, Leroy T, Fassier JB, Fillol F, Pascal S, Durand T, Fervers B. Connected device and therapeutic patient education to promote physical activity among women with localised breast cancer (DISCO trial): protocol for a multicentre 2×2 factorial randomised controlled trial. BMJ Open 2021; 11:e045448. [PMID: 34518245 PMCID: PMC8438826 DOI: 10.1136/bmjopen-2020-045448] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 07/27/2021] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION Despite safety and benefits of physical activity during treatment of localised breast cancer, successful exercise strategies remain to be determined. The primary objective of the 'dispositif connecté', that is, connected device in English trial is to evaluate the efficacy of two 6-month exercise interventions, either single or combined, concomitant to adjuvant treatments, on the physical activity level of patients with breast cancer, compared with usual care: an exercise programme using a connected device (activity tracker, smartphone application, website) and a therapeutic patient education intervention. Secondary objectives are to evaluate adherence to interventions, their impact at 6 and 12 months, representations and acceptability of interventions, and to assess the cost-effectiveness of the interventions using quality-adjusted life-years. METHODS AND ANALYSIS This is a 2×2 factorial, multicentre, phase III randomised controlled trial. The study population (with written informed consent) will consist of 432 women diagnosed with primary localised invasive breast carcinoma and eligible for adjuvant chemotherapy, hormonotherapy and/or radiotherapy. They will be randomly allocated between one of four arms: (1) web-based connected device (evolving target number of daily steps and an individualised, semisupervised, adaptive programme of two walking and one muscle strengthening sessions per week in autonomy), (2) therapeutic patient education (one educational diagnosis, two collective educational sessions, one evaluation), (3) combination of both interventions and (4) control. All participants will receive the international physical activity recommendations. Assessments (baseline, 6 and 12 months) will include physical fitness tests, anthropometrics measures, body composition (CT scan, bioelectrical impedance), self-administered questionnaires (physical activity profile (Recent Physical Activity Questionnaire), quality of life (European Organization for Research and Treatment of Cancer Quality-Of-Life Questionnaire-30, EQ-5D-5L), fatigue (Piper Fatigue Scale-12), social deprivation (Evaluation of Deprivation and Inequalities in Health Examination Centres), lifestyle, physical activity barriers, occupational status) and biological parameters (blood draw). ETHICS AND DISSEMINATION This study was reviewed and approved by the French Ethics Committee. The findings will be disseminated to the scientific and medical community via publications in peer-reviewed journals and conference presentations. TRIAL REGISTRATION NUMBER NCT03529383; Pre-results.
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Affiliation(s)
- Marina Touillaud
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France
- INSERM-Centre Léon Bérard-Ministère des Armées "Radiations: Defense, Health and Environment", UMR1296, Lyon, France
| | - Baptiste Fournier
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France
- INSERM-Centre Léon Bérard-Ministère des Armées "Radiations: Defense, Health and Environment", UMR1296, Lyon, France
| | - Olivia Pérol
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France
- INSERM-Centre Léon Bérard-Ministère des Armées "Radiations: Defense, Health and Environment", UMR1296, Lyon, France
| | - Lidia Delrieu
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France
- Inter-University Laboratory of Human Movement Biology EA7424, Université Claude Bernard Lyon 1, Villeurbanne, France
| | - Aurélia Maire
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France
| | - Elodie Belladame
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France
| | - David Pérol
- Department of of Clinical Research and Innovation, Centre Léon Bérard, Lyon, France
| | - Lionel Perrier
- Department of of Clinical Research and Innovation, Centre Léon Bérard, Lyon, France
- UMR-CNRS 5824, University of Lyon, GATE, Ecully, France
| | - Marie Preau
- GRePS EA4163 Institute of Psychology, Lumière University Lyon 2, Bron, France
| | - Tanguy Leroy
- GRePS EA4163 Institute of Psychology, Lumière University Lyon 2, Bron, France
| | - Jean-Baptiste Fassier
- UMRESTTE UMR T9405, Université Claude Bernard Lyon 1, Hospices Civils de Lyon, Lyon, France
| | | | | | - Thierry Durand
- Department of Hospital Information, Centre Léon Bérard, Lyon, France
| | - Béatrice Fervers
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France
- INSERM-Centre Léon Bérard-Ministère des Armées "Radiations: Defense, Health and Environment", UMR1296, Lyon, France
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Impact of Physical Activity on Oxidative Stress Markers in Patients with Metastatic Breast Cancer. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2021; 2021:6694594. [PMID: 34326920 PMCID: PMC8302399 DOI: 10.1155/2021/6694594] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 06/03/2021] [Accepted: 06/26/2021] [Indexed: 11/18/2022]
Abstract
Purpose Regular physical activity (PA) can affect oxidative stress, known to be involved in carcinogenesis. The objective of this study was to evaluate the associations between a six-month PA intervention and oxidative stress biomarkers, PA, and clinical outcomes in patients with metastatic breast cancer. Methods Forty-nine newly diagnosed patients with metastatic breast cancer were recruited for a single-arm, unsupervised, and personalized six-month walking intervention with activity tracker. PA level and PA fitness, plasma concentrations of DNA oxidation (8OhdG), lipid peroxidation (MDA), and protein oxidation (AOPP), plasma activities of superoxide dismutase (SOD), glutathione peroxidase (GPX), and catalase, plasma and leucocyte activities of myeloperoxidase (MPO) and NADPH oxidase (NOX), and clinical markers of tumor progression (RECIST criteria) were measured at baseline and after the six-month intervention. Results GPX activity (+17%) and MDA (+9%) significantly increased between baseline and the end of the intervention. Changes in PA level and fitness were significantly positively correlated with changes in plasma GPX and significantly negatively with changes in NOX in the leucocytes. Plasma MDA was significantly higher (+20%) whereas plasma AOPP was lower (-46%) for patients with tumor progression or that died during the six months as compared to patients without progression. Conclusion A six-month PA intervention may be potentially beneficial in metastatic breast cancer patients for enhancing antioxidant enzyme activity and decreasing prooxidant enzyme activity. Moreover, AOPP and MDA could also be favorable and unfavorable biomarkers, respectively, since they are associated with disease progression and fitness level in this population. This trial is registered with NCT number: NCT03148886.
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22
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Sarcopenia is associated with poor prognosis after chemoradiotherapy in patients with stage III non-small-cell lung cancer: a retrospective analysis. Sci Rep 2021; 11:11882. [PMID: 34088965 PMCID: PMC8178326 DOI: 10.1038/s41598-021-91449-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 05/26/2021] [Indexed: 12/25/2022] Open
Abstract
We intended to investigate whether muscle and adipose masses were associated with prognosis among patients with stage III non-small-cell lung cancer (NSCLC) who were undergoing chemoradiotherapy (CCRT). We retrospectively explored data of patients with stage III NSCLC who underwent definitive CCRT (≥ 60 Gy) between January 2004 and March 2018 at our hospital. We examined the relationship of overall survival (OS) with body mass index (BMI), skeletal muscle index (SMI), psoas muscle index (PMI), visceral adipose tissue index (VAI), subcutaneous adipose tissue index (SAI), and visceral-to-subcutaneous adipose tissue area ratio (VSR) using log-rank tests for the univariate analysis and Cox proportional hazard models for the multivariate analysis. Overall, 16, 32, and 12 patients had stage IIIA, IIIB, and IIIC NSCLC, respectively. The total radiotherapy dose ranged from 60 Gy/30 fractions to 66 Gy/33 fractions. In the univariate analysis, the performance status (PS), BMI, and SMI were associated with OS, whereas the PMI, VAI, SAI, and VSR were not. In the multivariate analysis, the PS and SMI were associated with OS. The hazard ratios and 95% confidence intervals were 2.91 and 1.28–6.64 for PS, and 2.36 and 1.15–4.85 for SMI, respectively. The 1, 3, and 5-year OS rates were 92.1%, 59.6%, and 51.0% in patients with high SMI, and 63.6%, 53.8%, and 17.9% in patients with low SMI, respectively. The SMI correlated with prognosis in our study population, whereas adipose mass did not. Therefore, sarcopenia should be considered while predicting the OS in such patients.
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Khoo S, Mohbin N, Ansari P, Al-Kitani M, Müller AM. mHealth Interventions to Address Physical Activity and Sedentary Behavior in Cancer Survivors: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115798. [PMID: 34071342 PMCID: PMC8198944 DOI: 10.3390/ijerph18115798] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 05/19/2021] [Accepted: 05/25/2021] [Indexed: 12/25/2022]
Abstract
This review aimed to identify, evaluate, and synthesize the scientific literature on mobile health (mHealth) interventions to promote physical activity (PA) or reduce sedentary behavior (SB) in cancer survivors. We searched six databases from 2000 to 13 April 2020 for controlled and non-controlled trials published in any language. We conducted best evidence syntheses on controlled trials to assess the strength of the evidence. All 31 interventions included in this review measured PA outcomes, with 10 of them also evaluating SB outcomes. Most study participants were adults/older adults with various cancer types. The majority (n = 25) of studies implemented multicomponent interventions, with activity trackers being the most commonly used mHealth technology. There is strong evidence for mHealth interventions, including personal contact components, in increasing moderate-to-vigorous intensity PA among cancer survivors. However, there is inconclusive evidence to support mHealth interventions in increasing total activity and step counts. There is inconclusive evidence on SB potentially due to the limited number of studies. mHealth interventions that include personal contact components are likely more effective in increasing PA than mHealth interventions without such components. Future research should address social factors in mHealth interventions for PA and SB in cancer survivors.
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Affiliation(s)
- Selina Khoo
- Centre for Sport and Exercise Sciences, University of Malaya, Kuala Lumpur 50603, Malaysia;
- Correspondence: (S.K.); (A.M.M.)
| | - Najihah Mohbin
- Centre for Sport and Exercise Sciences, University of Malaya, Kuala Lumpur 50603, Malaysia;
| | - Payam Ansari
- DCU Business School, Dublin City University, Dublin, Ireland;
| | - Mahfoodha Al-Kitani
- Physical Education and Sports Sciences Department, College of Education, Sultan Qaboos University, Muscat 123, Oman;
| | - Andre Matthias Müller
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117549, Singapore
- Correspondence: (S.K.); (A.M.M.)
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Sarcopenia and serum biomarkers of oxidative stress after a 6-month physical activity intervention in women with metastatic breast cancer: results from the ABLE feasibility trial. Breast Cancer Res Treat 2021; 188:601-613. [PMID: 34013451 PMCID: PMC8272711 DOI: 10.1007/s10549-021-06238-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 04/20/2021] [Indexed: 01/04/2023]
Abstract
Purpose Sarcopenia has been identified as an important prognostic factor for patients with cancer. This study aimed at exploring the potential associations between a 6-month physical activity intervention and muscle characteristics, sarcopenia, oxidative stress and toxicities in patients with metastatic breast cancer. Methods Women newly diagnosed with metastatic breast cancer (N = 49) participated in an unsupervised, personalized, 6-month physical activity intervention with activity tracker. Computerized tomography images at the third lumbar vertebra were analysed at baseline, three months and six months to assess sarcopenia (muscle mass index < 40 cm2/m2) and muscle quality (poor if muscle attenuation < 37.8 Hounsfield Units). Oxidative markers included plasma antioxidant enzymes (catalase, glutathione peroxidase and superoxide dismutase activities), prooxidant enzymes (NADPH oxidase and myeloperoxidase activities) and oxidative stress damage markers (advanced oxidation protein products, malondialdehyde (MDA) and DNA oxidation. Results At baseline 53% (mean age 55 years (SD 10.41)) were sarcopenic and 75% had poor muscle quality. Muscle cross sectional area, skeletal muscle radiodensity, lean body mass remained constant over the six months (p = 0.75, p = 0.07 and p = 0.75 respectively), but differed significantly between sarcopenic and non-sarcopenic patients at baseline and 6-months. Sarcopenic patients at baseline were more likely to have an increase of MDA (p = 0.02) at 6 months. Being sarcopenic during at least one moment during the 6-month study was associated with a higher risk of developing severe toxicities (grade > 2) (p = 0.02). Conclusions This study suggests potential benefits of physical activity for maintenance of muscle mass. Sarcopenia can alter many parameters and disturb the pro and antioxidant balance. Supplementary Information The online version contains supplementary material available at 10.1007/s10549-021-06238-z.
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Effect of Wearable Technology-Based Physical Activity Interventions on Breast Cancer Survivors' Physiological, Cognitive, and Emotional Outcomes: A Systematic Review. J Clin Med 2021; 10:jcm10092015. [PMID: 34066752 PMCID: PMC8125804 DOI: 10.3390/jcm10092015] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/09/2021] [Accepted: 05/05/2021] [Indexed: 12/12/2022] Open
Abstract
This systematic review synthesized all randomized controlled trials (RCTs) and controlled trials examining the effects of wearable health technology-based physical activity interventions on physiological, cognitive, and emotional outcomes in breast cancer survivors (BCS). We searched NCBI, Academic Search Premier, EMBASE, Web of Science, PubMed, and Medline from inception to March 2021. We included studies which: (1) were RCTs or controlled trials ≥8 weeks in duration; (2) were peer-reviewed and published in English; (3) sampled BCS in full remission and had not received treatment for at least six months; (4) utilized wearable health technology (e.g., Fitbit, Garmin xGC30); and (5) examined physiological, emotional, and/or cognitive outcomes. Sixty-six studies were identified and 14 were included in the review. Most of the observed effects were statistically significant and those which employed multi-component interventions generally yielded greater effects. Overall, the use of wearable health technology reduced sedentary behavior and increased moderate-to-vigorous intensity physical activity. Further, increased moderate-to-vigorous intensity physical activity was observed to be associated with increased perceived cognition and higher cognitive performance. Multiple studies also observed significant improvements in attitude, worry, and anxiety. Overall, findings suggested wearable health technology-based physical activity interventions to be effective for improving physical activity, attitude, and cognitive functions and for reducing sedentary behavior, anxiety, and worry in BCS.
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Blount DS, McDonough DJ, Gao Z. Effect of Wearable Technology-Based Physical Activity Interventions on Breast Cancer Survivors' Physiological, Cognitive, and Emotional Outcomes: A Systematic Review. J Clin Med 2021. [PMID: 34066752 DOI: 10.3390/jcm10092015.4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2023] Open
Abstract
This systematic review synthesized all randomized controlled trials (RCTs) and controlled trials examining the effects of wearable health technology-based physical activity interventions on physiological, cognitive, and emotional outcomes in breast cancer survivors (BCS). We searched NCBI, Academic Search Premier, EMBASE, Web of Science, PubMed, and Medline from inception to March 2021. We included studies which: (1) were RCTs or controlled trials ≥8 weeks in duration; (2) were peer-reviewed and published in English; (3) sampled BCS in full remission and had not received treatment for at least six months; (4) utilized wearable health technology (e.g., Fitbit, Garmin xGC30); and (5) examined physiological, emotional, and/or cognitive outcomes. Sixty-six studies were identified and 14 were included in the review. Most of the observed effects were statistically significant and those which employed multi-component interventions generally yielded greater effects. Overall, the use of wearable health technology reduced sedentary behavior and increased moderate-to-vigorous intensity physical activity. Further, increased moderate-to-vigorous intensity physical activity was observed to be associated with increased perceived cognition and higher cognitive performance. Multiple studies also observed significant improvements in attitude, worry, and anxiety. Overall, findings suggested wearable health technology-based physical activity interventions to be effective for improving physical activity, attitude, and cognitive functions and for reducing sedentary behavior, anxiety, and worry in BCS.
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Affiliation(s)
- Daphne S Blount
- College of Biological Science, University of Minnesota-Twin Cities, 1445 Gortner Ave, Saint Paul, MN 55108, USA
| | - Daniel J McDonough
- School of Kinesiology, University of Minnesota-Twin Cities, 208 Cooke Hall, 1900 University Ave SE, Minneapolis, MN 55455, USA
| | - Zan Gao
- School of Kinesiology, University of Minnesota-Twin Cities, 208 Cooke Hall, 1900 University Ave SE, Minneapolis, MN 55455, USA
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Phillips S, Solk P, Welch W, Auster-Gussman L, Lu M, Cullather E, Torre E, Whitaker M, Izenman E, La J, Lee J, Spring B, Gradishar W. A Technology-Based Physical Activity Intervention for Patients With Metastatic Breast Cancer (Fit2ThriveMB): Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2021; 10:e24254. [PMID: 33890857 PMCID: PMC8105756 DOI: 10.2196/24254] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 01/28/2021] [Accepted: 02/15/2021] [Indexed: 01/19/2023] Open
Abstract
Background Increased incidence and life expectancy have resulted in a growing population of patients with metastatic breast cancer, and these patients experience high rates of morbidity and premature mortality. Increased physical activity (PA) is consistently associated with improved health and disease outcomes among early-stage survivors. However, there is a paucity of research on PA in patients with metastatic breast cancer, and existing PA interventions have exhibited low feasibility because of their focus on intense PA and/or requirement of on-site visits. Mobile health (mHealth)–based PA interventions may be particularly useful for patients with metastatic breast cancer because they allow for remote monitoring, which facilitates individual tailoring of PA recommendations to patients’ abilities and may minimize participant burden. However, no studies have examined mHealth PA interventions in patients with metastatic breast cancer. Objective We aim to address these critical research gaps by testing a highly tailored technology-based intervention to promote PA of any intensity (ie, light, moderate, or vigorous) by increasing daily steps in patients with metastatic breast cancer. The primary aim of this study is to test the feasibility and acceptability of the Fit2ThriveMB intervention. We will also examine outcome patterns suggesting the efficacy of Fit2ThriveMB on symptom burden, quality of life, and functional performance. Methods The Fit2ThriveMB trial is a two-arm pilot randomized controlled trial that will compare the effects of a smartphone-delivered, home-based PA intervention and an attention-control education condition on PA and quality of life in low-active female patients with metastatic breast cancer. A subsample (n=25) will also complete functional performance measures. This innovative trial will recruit 50 participants who will be randomized into the study’s intervention or control arm. The intervention will last 12 weeks. The Fit2ThriveMB intervention consists of a Fitbit, coaching calls, and the Fit2ThriveMB smartphone app that provides self-monitoring, a tailored goal-setting tool, real-time tailored feedback, app notifications, and a group message board. Assessments will occur at baseline and post intervention. Results The Fit2ThriveMB study is ongoing. Data collection ended in February 2021. Conclusions Data from this study will provide the preliminary effect sizes needed to assemble an intervention that is to be evaluated in a fully powered trial. In addition, these data will provide essential evidence to support the feasibility and acceptability of using a technology-based PA promotion intervention, a scalable strategy that could be easily integrated into care, among patients with metastatic breast cancer. Trial Registration ClinicalTrials.gov NCT04129346; https://clinicaltrials.gov/ct2/show/NCT04129346 International Registered Report Identifier (IRRID) DERR1-10.2196/24254
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Affiliation(s)
- Siobhan Phillips
- Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Payton Solk
- Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Whitney Welch
- Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Lisa Auster-Gussman
- Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Marilyn Lu
- Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Erin Cullather
- Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Emily Torre
- Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Madelyn Whitaker
- Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Emily Izenman
- Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Jennifer La
- Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Jungwha Lee
- Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Bonnie Spring
- Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - William Gradishar
- Northwestern University Feinberg School of Medicine, Chicago, IL, United States
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Katsui K, Ogata T, Watanabe K, Yoshio K, Kuroda M, Yamane M, Hiraki T, Kiura K, Toyooka S, Kanazawa S. Sarcopenia is related to poor prognosis in patients after trimodality therapy for locally advanced non-small cell lung cancer. Int J Clin Oncol 2021; 26:1450-1460. [PMID: 33880655 DOI: 10.1007/s10147-021-01927-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 04/13/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND The association between sarcopenia and prognosis in patients with locally advanced non-small cell lung cancer (NSCLC) undergoing trimodality therapy, consisting of preoperative concurrent chemoradiotherapy and surgery, has not been reported. Therefore, we aimed to investigate the association of sarcopenia and fat mass with prognosis after trimodality therapy. METHODS To assess sarcopenia, the psoas muscle mass was measured. Using computed tomography data, including third lumbar vertebra level images, psoas muscle mass and visceral and subcutaneous fat mass were measured. Additionally, body mass indices, and visceral/subcutaneous fat ratio, obtained by dividing the visceral fat index by the subcutaneous fat index, were calculated. We investigated the relationship between these parameters and overall survival. RESULTS Ninety-nine eligible patients were included. In the univariate analysis, age, clinical stage, tumor location, psoas muscle index, and visceral/subcutaneous fat ratio were significant prognostic factors for overall survival (P = 0.008, P = 0.04, P = 0.04, P = 0.02, and P = 0.02, respectively). In the multivariate analysis, age and psoas muscle index were significant prognostic factors for overall survival (P = 0.01 and P = 0.03, respectively). The 5-year overall survival rates for the high and low psoas muscle index groups were 79.6% [95% confidence interval (CI), 67.1-94.5%] and 66.2% (95% CI, 54.1-81.1%), respectively; whereas, the 10-year overall survival rates were 61.9% (95% CI, 42.0-91.4%) and 25.3% (95% CI, 8.6-74.2%), respectively. CONCLUSION Sarcopenia was related to poor overall survival in patients with locally advanced NSCLC undergoing trimodality therapy. Assessment of body composition prior to treatment may provide important information for formulating rational therapeutic strategies.
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Affiliation(s)
- Kuniaki Katsui
- Department of Proton Beam Therapy, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
| | - Takeshi Ogata
- Department of Radiology, Iwakuni Clinical Center, 1-1-1 Atagomachi, Iwakuni,, Yamaguchi, 740-8510, Japan
| | - Kenta Watanabe
- Department of Radiology, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Kotaro Yoshio
- Department of Radiology, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Masahiro Kuroda
- Department of Radiological Technology, Graduate School of Health Sciences, Okayama, University, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Masaomi Yamane
- Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Takao Hiraki
- Department of Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Katsuyuki Kiura
- Department of Allergy and Respiratory Medicine, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Shinichi Toyooka
- Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Susumu Kanazawa
- Department of Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
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Lim JY, Kim JK, Kim Y, Ahn SY, Yu J, Hwang JH. A Modular Mobile Health App for Personalized Rehabilitation Throughout the Breast Cancer Care Continuum: Development Study. JMIR Form Res 2021; 5:e23304. [PMID: 33847589 PMCID: PMC8080147 DOI: 10.2196/23304] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 11/04/2020] [Accepted: 03/15/2021] [Indexed: 12/18/2022] Open
Abstract
Background Although many mobile health (mHealth) apps have evolved as support tools for self-management of breast cancer, limited studies have developed a comprehensive app and described the algorithms for personalized rehabilitation throughout the breast cancer care continuum. Objective This study aimed to develop a comprehensive mobile app and to describe an algorithm that adjusts personalized content to facilitate self-management throughout the breast cancer care continuum. Methods The development process of the modular mHealth app included the following 4 steps: (1) organizing expert teams, (2) defining evidence-based fundamental content and modules, (3) classifying user information for algorithms to personalize the content, and (4) creating the app platform and connectivity to digital health care devices. Results We developed a modular mHealth app service, which took 18 months, including a review of related literature and guidelines and the development of the app and connectivity to digital health care devices. A total of 11 functionalities were defined in the app with weekly analysis. The user information classification was formulated for personalized rehabilitation according to 5 key criteria: general user information, breast operation type, lymph node surgery type, chemotherapy and hormonal therapy use, and change in treatment after surgery. The main modules for personalized content included a self-monitoring screen, personalized health information, personalized exercise, and diet management. Conclusions The strength of this study was the development of a comprehensive mHealth app and algorithms to adjust content based on user medical information for personalized rehabilitation during the breast cancer care continuum.
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Affiliation(s)
- Ji Young Lim
- Department of Physical Therapy, General Graduate School of Medical Sciences, Konyang University, Daejeon, Republic of Korea
| | | | - Yoon Kim
- Department of Rehabilitation Medicine, National Rehabilitation Center, Seoul, Republic of Korea
| | - So-Yeon Ahn
- Kangbuk Samsung Hospital, Seoul, Republic of Korea
| | - Jonghan Yu
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ji Hye Hwang
- Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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30
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Roesch E, Abraham J. Reflection on Supportive Care Elements During the Metastatic Breast Cancer Journey. JCO Oncol Pract 2021; 17:184-185. [PMID: 33529061 DOI: 10.1200/op.20.01036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Erin Roesch
- Cleveland Clinic Taussig Cancer Center, Cleveland, OH
| | - Jame Abraham
- Cleveland Clinic Taussig Cancer Center, Cleveland, OH
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