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Pfeifer K, Ates G, Pogorzelski M, Zaun G, Rötger A, Schuler M, Schöbel C, Tewes M. Investigation of screening questions to identify insomnia in cancer patients. Sci Rep 2024; 14:18343. [PMID: 39112537 PMCID: PMC11306326 DOI: 10.1038/s41598-024-69086-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 07/31/2024] [Indexed: 08/10/2024] Open
Abstract
The high prevalence of insomnia in cancer patients leads to a significant reduction in the quality of life of those affected. A detailed record of symptoms therefore plays an essential role for further course of treatment. Which screening instruments enable identification of cancer patients with insomnia is the subject of this single-arm nonrandomized study. During the data collection period, cancer patients meeting the following criteria: self-reported tiredness and/or trouble falling or staying asleep or sleeping too much in an electronic patient-reported outcome measurement were enrolled. For further analysis, focus was placed on the Patient Health Questionnaire Depression Scale (PHQ-8), the Minimal Documentation System (MIDOS2) and the Insomnia Severity Index (ISI). Frequency, correlation, and variance analyses were conducted to identify likely predictors of insomnia. Our findings indicate a closer correlation between the screening question pertaining to sleep disorders and the ISI, compared to the question on tiredness and the ISI. The initial recording of sleep-related parameters plays an essential role for cancer patients in order to identify and treat modifiable factors as promptly as possible. For an initial assessment, we recommend asking about trouble falling or staying asleep or sleeping too much.
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Affiliation(s)
- K Pfeifer
- Department of Palliative Medicine, University Hospital Essen, University of Duisburg-Essen, 45147, Essen, Germany
| | - G Ates
- Institute for Digitalization and General Medicine, University Hospital Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - M Pogorzelski
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, 45147, Essen, Germany
| | - G Zaun
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, 45147, Essen, Germany
| | | | - M Schuler
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, 45147, Essen, Germany
- German Cancer Consortium, Partner Site University Hospital Essen, 45147, Essen, Germany
| | - C Schöbel
- Center for Sleep- and Telemedicine, West German-Lung-Center at University Hospital Essen, Ruhrlandklinik, 45239, Essen, Germany
| | - M Tewes
- Department of Palliative Medicine, University Hospital Essen, University of Duisburg-Essen, 45147, Essen, Germany.
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Heinzelmann A, Tewes M, Müller S, Sure U, Herrmann K, Schadendorf D, Warnecke E, Rausch R, Skoda EM, Salvador Comino MR. Determining the cut-off value for the Minimal Documentation System (MIDOS2) screening tool to initiate specialized palliative care based on patient's subjective need for palliative support and symptom burden in inpatients with advanced cancer. J Cancer Res Clin Oncol 2024; 150:360. [PMID: 39046592 PMCID: PMC11269497 DOI: 10.1007/s00432-024-05897-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: 05/25/2024] [Accepted: 07/15/2024] [Indexed: 07/25/2024]
Abstract
PURPOSE The Minimal Documentation System (MIDOS2) is recommended as a systematic screening tool for assessing symptom burden and patient needs in advanced cancer patients. Given the absence of an optimal weighting of individual symptoms and a corresponding cut-off value, this study aims to determine a threshold based on inpatient's subjective need for palliative support. Additionally, we investigate the correlation between symptom burden and subjective need for palliative support collected through a patient-reported outcome measure (PROM) with survival duration of less or more than one year. METHODS Inpatients diagnosed with advanced solid cancer completed an electronic PROM, which included the MIDOS2 questionnaire among other tools. Differences in symptom burden were analysed between patients expressing subjective need for palliative support and those with survival of less or more than one year using ANOVA, Mann-Whitney-U Test, logistic regression, Pearson and Spearman correlation tests. Cut-off analyses were performed using a ROC curve. Youden-Index, sensitivity, and specificity measures were used as well. RESULTS Between April 2020 and March 2021, 265 inpatients were included in the study. Using a ROC curve, the MIDOS2 analysis resulted in an Area under the curve (AUC) of 0.732, a corresponding cut-off value of eight points, a sensitivity of 76.36% and a specificity of 62.98% in assessing the subjective need for palliative support. The MIDOS2, with double weighting of the significant symptoms, showed a cut-off value of 14 points, achieving a sensitivity of 78.18% and a specificity of 72.38%. A total of 55 patients (20.8%) expressed a need for support from the palliative care team. This need was independent of the oncological tumour entity and increased among patients with a survival of less than one year. These patients reported significantly poorer physical (p < 0.001) or mental (p < 0.001) condition. Additionally, they reported higher intensities of pain (p = 0.002), depressive symptoms (p < 0.001), weakness (p < 0.001), anxiety (p < 0.001), and tiredness (p < 0.001). CONCLUSION Using the established MIDOS2 cut-off value with an adjusted double weighting in our study, a large proportion of inpatients may be accurately referred to SPC based on their subjective need for palliative support. Additionally, subjective reports of poor general, mental, and physical condition, as well as pain, depressive symptoms, weakness, anxiety, and tiredness, increase the subjective need for palliative support, particularly in patients with a survival prognosis of less than one year.
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Affiliation(s)
- Anna Heinzelmann
- Department of Palliative Medicine, University Hospital Essen (AöR), 45147, Essen, Germany
| | - Mitra Tewes
- Department of Palliative Medicine, University Hospital Essen (AöR), 45147, Essen, Germany
| | - Sandy Müller
- Department of Palliative Medicine, University Hospital Essen (AöR), 45147, Essen, Germany
| | - Ulrich Sure
- Department of Neurosurgery, University Hospital Essen (AöR), 45147, Essen, Germany
| | - Ken Herrmann
- Department of Nuclearmedicine, University Hospital Essen (AöR), 45147, Essen, Germany
| | - Dirk Schadendorf
- Department of Dermatology, University Hospital Essen (AöR), 45147, Essen, Germany
| | - Eva Warnecke
- Department of Palliative Medicine, University Hospital Essen (AöR), 45147, Essen, Germany
| | - Raya Rausch
- West German Cancer Center, University Hospital Essen (AöR), 45147, Essen, Germany
| | - Eva-Maria Skoda
- Department for Psychosomatic Medicine and Psychotherapy LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro-and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
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Zhou S, Yu M, Zhou Z, Wang L, Liu W, Dai Q. The effects of art therapy on quality of life and psychosomatic symptoms in adults with cancer: a systematic review and meta-analysis. BMC Complement Med Ther 2023; 23:434. [PMID: 38041063 PMCID: PMC10691094 DOI: 10.1186/s12906-023-04258-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 11/14/2023] [Indexed: 12/03/2023] Open
Abstract
BACKGROUND Cancer-related psychological and physical disorders can mean stressful and painful experiences for patients. Art therapy, a form of complementary and alternative medicine, is an increasingly popular way to decrease emotional stress, alleviate somatic symptoms, and improve quality of life in patients with cancer. However, current systematic reviews have not explored the beneficial effects of art therapy. Moreover, there have been inconsistent findings on the effect of this therapy, and there is insufficient evidence to confirm the effects in adults with cancer. The objective of this study was to determine the efficacy of art therapy in improving quality of life and psychosomatic symptoms in adults with cancer. METHODS This systematic review and meta-analysis included adults with all kinds of cancer. Six English-language and three large Chinese-language databases were comprehensively searched for relevant studies. Gray literature and references were also checked. The quality of the included studies was evaluated using the Cochrane risk-of-bias assessment tool. RESULTS Eight eligible randomized controlled trials conducted in four countries were included. Art therapy improved overall quality of life, but had no significant effect on psychological health or physical health sub-dimensions in women with cancer. Moreover, art therapy alleviated anxiety and depression, but had only a tendency toward an effect on somatic symptoms. CONCLUSIONS Moderate-quality evidence shows that art therapy is beneficial for women with cancer in terms of improving the overall quality of life and alleviating emotional symptoms (anxiety and depression). However, more high-quality randomized controlled trials are needed to determine the efficacy of this therapy on somatic symptoms.
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Affiliation(s)
- ShiShuang Zhou
- School of Nursing, Army Medical University, Chongqing, 400038, China
| | - MeiHong Yu
- Department of Gastroenterology, The Second Xiangya Hospital, Changsha, Hunan, China
- Research Center of Digestive Disease, Central South University, Changsha, Hunan, China
| | - Zhan Zhou
- Departments of Neonatology, People's Hospital (ZhuHai Clinical Medical College of Jinan University), Zhuhai, China
| | - LiWen Wang
- Departments of Neonatology, People's Hospital (ZhuHai Clinical Medical College of Jinan University), Zhuhai, China
| | - WeiWei Liu
- School of Nursing, Army Medical University, Chongqing, 400038, China.
| | - Qin Dai
- Department of Medical Psychology, Army Medical University, Chongqing, 400038, China.
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Skjellerudsveen BM, Omdal R, Hetta AK, Kvaløy JT, Aabakken L, Skoie IM, Grimstad T. Less, but not gone-gluten-free diet effects on fatigue in celiac disease: a prospective controlled study. Front Med (Lausanne) 2023; 10:1242512. [PMID: 37766922 PMCID: PMC10520960 DOI: 10.3389/fmed.2023.1242512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 08/28/2023] [Indexed: 09/29/2023] Open
Abstract
Introduction Fatigue is a frequent complaint in patients with celiac disease. A gluten-free diet is the only established treatment for celiac disease, but how this diet influences fatigue is uncertain. We aimed to investigate fatigue prevalence, severity, and associated factors in patients with celiac disease, at diagnosis and at 1 year after commencing a gluten-free diet. Methods 78 patients with serologically and histologically verified celiac disease, 78 age- and sex-matched healthy subjects. Primary endpoints were Fatigue Visual Analog Scale (fVAS), Fatigue Severity Scale (FSS), and inverted Vitality subscale of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36vs). Clinically relevant fatigue was defined as: FSS score ≥ 4, fVAS score ≥ 50 mm, or inverted SF-36vs score ≥ 65. Higher scores represented more fatigue. Results Fatigue was reduced after a 12-month gluten-free diet. Median scores changed from 3.8 (interquartile range [IQR]: 2.2 to 4.8) to 1.9 (IQR: 1.4 to 3.5) for FSS, from 44.5 (IQR: 18.8 to 66.0) to 15.5 (IQR: 7.8 to 43.3) for fVAS, and from 65 (IQR: 40 to 75) to 35 (IQR: 25 to 55) for inverted SF-36vs (p < 0.001 for all). Fatigue prevalence also declined after treatment. However, scores were significantly higher in patients compared to control subjects. Higher fatigue scores were associated with depression and pain, but not with signs of disease activity or nutritional deficiency. Conclusion At diagnosis, patients with celiac disease frequently had severe fatigue. Fatigue declined after a gluten-free diet, but it remained higher than that observed in healthy subjects. Clinical trial registration ClinicalTrials.gov, Identifier NCT01551563.
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Affiliation(s)
| | - Roald Omdal
- Department of Internal Medicine, Stavanger University Hospital, Stavanger, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Anne Kristine Hetta
- Department of Internal Medicine, Stavanger University Hospital, Stavanger, Norway
| | - Jan Terje Kvaløy
- Department of Mathematics and Physics, University of Stavanger, Stavanger, Norway
- Department of Research, Stavanger University Hospital, Stavanger, Norway
| | - Lars Aabakken
- Department of Transplantation Medicine, Rikshospitalet, Oslo University Hospital, Oslo, Norway
| | - Inger Marie Skoie
- Department of Dermatology, Stavanger University Hospital, Stavanger, Norway
| | - Tore Grimstad
- Department of Internal Medicine, Stavanger University Hospital, Stavanger, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
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Neves MBM, Neves YCS, Bomonetto JVB, Matos PPC, Giglio AD, Cubero DDIG. Evaluation of factors predicting the benefit from systemic oncological treatment for severely ill hospitalized patients: a retrospective study. BMC Palliat Care 2023; 22:131. [PMID: 37674155 PMCID: PMC10481478 DOI: 10.1186/s12904-023-01256-8] [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: 07/03/2023] [Accepted: 09/01/2023] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND Patients with cancer in the disease's end-stage with poor performance represent a challenging clinical scenario, as they have high chance of a fatal outcome due to clinical conditions, oncological emergencies, and/or metastatic disease. This study examines the factors predicting the potential benefit of "urgent" chemotherapy during hospitalization in this setting, thus addressing a research gap. METHODS This retrospective observational study was conducted in the largest cancer center in the outskirts of São Paulo. It identified factors predicting the benefit from antineoplastic treatment in severe in-hospital patients admitted during 2019-2020, considering post-chemotherapy survival time as the main dependent variable. Data were retrieved from medical records. All patients aged ≥ 18 years, with an ECOG-PS score ≥ 2, and undergoing non-elective systemic cancer treatment were included. RESULTS This study evaluated 204 records, of which 89 were included in the final analysis. A statistically significant association with the worse outcome (death within 30 days of chemotherapy) was found with higher ECOG performance status; chemotherapy dose reduction; lower values of serum albumin, hemoglobin, and creatinine clearance; and higher values of leukocytes, neutrophils, direct bilirubin, urea, and C-reactive protein. In the multivariate analysis, only albumin remained statistically associated with the outcome (hazard ratio = 0.35; confidence interval: 0.14, 0.90; p = 0.034). CONCLUSIONS Serum albumin and other clinical and laboratory variables might be associated with early post-treatment deaths in patients with cancer. The study data might help guide the decision to administer systemic treatment in this scenario and manage critically ill patients. This study adds to our knowledge of the factors predicting the objective benefits from "heroic" or "urgent" chemotherapy for hospitalized and severely ill patients with cancer.
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Affiliation(s)
- Milena Brachmans Mascarenhas Neves
- Centro Universitário Faculdade de Medicina do ABC (FMABC), Santo André, SP, Brazil.
- Hospital Alemão Oswaldo Cruz, 212. Vila Mariana, 0412601, São Paulo, SP, Brazil.
| | - Yuri Costa Sarno Neves
- Instituto de Radiologia (InRad), Faculdade de Medicina, Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | | | | | - Auro Del Giglio
- Centro Universitário Faculdade de Medicina do ABC (FMABC), Santo André, SP, Brazil
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van Eckert S, Seidel N, Stölzel F, Wolff M, Glausch M, Spallek J. [Living Actively with Cancer - Recommendations for a Healthy Life Style: Needs Assessment and Design of Multimedia Patient Information]. DAS GESUNDHEITSWESEN 2023; 85:227-233. [PMID: 35073593 PMCID: PMC11248723 DOI: 10.1055/a-1709-0939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The positive effects of a healthy lifestyle on the holistic physical condition and quality of life of cancer survivors is scientifically proven. The National Comprehensive Cancer Network (NCCN) Guidelines for Survivorship specifically highlight the need for support in these areas. The lack of specialised offers for cancer patients in predominantly rural areas, however, represents a high level of assistance needed in terms of the development and implementation of a healthy lifestyle. Following a needs assessment, our aim was to conceptualise and design an easily accessible multi-media patient information system on the basis of a social-cognitive process model on health behaviour (Health Action Process Approach - HAPA). A higher level of health literacy represents, inter alia, the basis for informed choice and, as such, forms an important resource for the aftercare of cancer patients. Further studies are recommended on the acceptance, use and effects of patient information with regard to intended longer-term changes of health behaviour.
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Affiliation(s)
- Sandra van Eckert
- Gesundheitswissenschaften, Brandenburgische Technische Universität Cottbus-Senftenberg Fakultät 4 Soziale Arbeit Gesundheit und Musik, Senftenberg, Germany
| | - Nadja Seidel
- Nationales Centrum für Tumorerkrankungen Dresden (NCT/UCC), Präventionszentrum, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - Friederike Stölzel
- Nationales Centrum für Tumorerkrankungen Dresden (NCT/UCC), Präventionszentrum, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - Michaela Wolff
- Nationales Centrum für Tumorerkrankungen Dresden (NCT/UCC), Präventionszentrum, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - Melanie Glausch
- Nationales Centrum für Tumorerkrankungen Dresden (NCT/UCC), Präventionszentrum, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - Jacob Spallek
- Gesundheitswissenschaften, Brandenburgische Technische Universität Cottbus-Senftenberg Fakultät 4 Soziale Arbeit Gesundheit und Musik, Senftenberg, Germany
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Kröz M, Quittel F, Reif M, Zerm R, Pranga D, Bartsch C, Brinkhaus B, Büssing A, Gutenbrunner C. Four-year follow-up on fatigue and sleep quality of a three-armed partly randomized controlled study in breast cancer survivors with cancer-related fatigue. Sci Rep 2023; 13:2705. [PMID: 36792620 PMCID: PMC9931714 DOI: 10.1038/s41598-022-25322-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 11/28/2022] [Indexed: 02/17/2023] Open
Abstract
Cancer-related fatigue (CRF) is a frequent long-term symptom in non-metastasized breast cancer patients (BC). This 4-year follow-up intended to compare the long-term effects of a 10-week multimodal therapy (MT: sleep education, psychoeducation, eurythmy- and painting therapy) and combination therapy [CT: MT plus aerobic training (AT)] to AT-control. BC-patients were randomized or allocated by preference to three arms in a comprehensive cohort study. Primary outcome was a composite score including Pittsburgh Sleep Quality Index (PSQI) and Cancer Fatigue Scale (CFS-D), captured at baseline, after 10 weeks of intervention (T1), 6 months later (T2), and after 4 years (T3). We exploratively tested for superiority of MT and CT versus AT after 4 years (T3) based on the statistical model of the main analysis. Of 126 (65 randomized) BC-patients included, 105 started treatments and 79 were re-assessed for long-term effects (T3). MT and CT were superior over AT after 4 years regarding PSQI/CFS-D and PSQI sum-score, respectively (all p < 0.05), but not for CFS-D. The multimodal and combination treatment for breast cancer patients with CRF indicates sustainable long-term superiority over aerobic training for the outcomes sleep quality and combined sleep quality/fatigue. A confirmative randomized controlled trial is warranted.
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Affiliation(s)
- M Kröz
- Research Institute Havelhöhe (FIH), Kladower Damm 221, 14089, Berlin, Germany.
- Department of Research and Somnology, Arlesheim Hospital, Arlesheim, Switzerland.
- Institute for Integrative Medicine, University of Witten/Herdecke, Witten, Herdecke, Germany.
| | - F Quittel
- Research Institute Havelhöhe (FIH), Kladower Damm 221, 14089, Berlin, Germany
- Institute for Integrative Medicine, University of Witten/Herdecke, Witten, Herdecke, Germany
| | - M Reif
- Society for Clinical Research, Berlin, Germany
| | - R Zerm
- Research Institute Havelhöhe (FIH), Kladower Damm 221, 14089, Berlin, Germany
- Department of Internal Medicine, Havelhöhe Hospital, Berlin, Germany
| | - D Pranga
- Research Institute Havelhöhe (FIH), Kladower Damm 221, 14089, Berlin, Germany
| | - C Bartsch
- Center for Research in Medical and Natural Sciences, University of Tübingen, Tübingen, Germany
| | - B Brinkhaus
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute for Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - A Büssing
- Institute for Integrative Medicine, University of Witten/Herdecke, Witten, Herdecke, Germany
| | - C Gutenbrunner
- Clinic for Rehabilitative Medicine, Hannover Medical School, Hannover, Germany
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Keramida K, Kostoulas A, Kostoulas A. Dyspnea in Oncological Patients: a Brain Teaser. Eur Cardiol 2023; 18:e03. [PMID: 36844934 PMCID: PMC9947930 DOI: 10.15420/ecr.2021.62] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 08/14/2022] [Indexed: 02/05/2023] Open
Abstract
Dyspnea is one of the most common symptoms in oncological patients with greater prevalence in lung cancer and advanced disease states. Causes of dyspnea can be directly or indirectly associated with cancer, anti-neoplastic therapies and comorbidities unrelated to cancer. Routine screening of dyspnea is suggested for all oncological patients by using unidimensional, simple scales and multidimensional tools to capture more domains affected by this symptom and to assess the effectiveness of interventions. The first step in the treatment algorithm of dyspnea is the identification of potentially reversible causes; if no specific cause is depicted, symptomatic treatment with non-pharmacological and pharmacological interventions is suggested. Referral to palliative care and continuous palliative sedation are the last resort in patients with a very limited life expectancy of not more than a few days for symptomatic relief and to decrease of the distress of patients and caregivers.
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Affiliation(s)
- Kalliopi Keramida
- Cardiology Department, General Anti-Cancer Oncological Hospital, Agios SavvasAthens, Greece
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Tewes M. In Reply. DEUTSCHES ARZTEBLATT INTERNATIONAL 2021; 118:758. [PMID: 35101169 PMCID: PMC8830350 DOI: 10.3238/arztebl.m2021.0286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Mitra Tewes
- West German Cancer Center, Department of Medical Oncology, University Hospital of Essen, University Duisburg-Essen, Essen, Germany
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10
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Sonnhoff M, Graff M. WHO Recommendation Should Be Critically Discussed. DEUTSCHES ARZTEBLATT INTERNATIONAL 2021; 118:758. [PMID: 35101168 PMCID: PMC8830349 DOI: 10.3238/arztebl.m2021.0285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
| | - Mandy Graff
- Zentrum für Strahlentherapie Bremen, Germany
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De Lazzari N, Niels T, Tewes M, Götte M. A Systematic Review of the Safety, Feasibility and Benefits of Exercise for Patients with Advanced Cancer. Cancers (Basel) 2021; 13:cancers13174478. [PMID: 34503288 PMCID: PMC8430671 DOI: 10.3390/cancers13174478] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 08/27/2021] [Accepted: 09/01/2021] [Indexed: 12/15/2022] Open
Abstract
Simple Summary Most advanced cancer patients suffer from severe symptoms due to cancer and medical treatment. Common symptoms are physical weakness, mental problems, and tiredness. Research has shown that exercise positively influences cancer-related side effects during and after treatment and longevity in cancer survivorship. However, exercise as a supportive therapy in advanced cancer patients is still not recommended in oncological guidelines. Therefore, the aim of this systematic review was to assess the safety, feasibility, and benefits of exercise for patients with advanced cancer. Based on the results of 14 included exercise intervention studies, we conclude that exercise is safe and feasible, seems to improve physical performance, and may lower symptoms like chronic tiredness. Early integration of exercise for advanced cancer patients should be considered as usual care as a supportive strategy. Abstract Exercise therapy is a common supportive strategy in curative cancer treatment with strong evidence regarding its positive effects on, for example, cancer-related fatigue, health- related quality of life, and physical function. In the field of advanced cancer patients, knowledge about exercise as a useful supportive strategy is missing. The aim of this systematic review was to evaluate the feasibility and safety of exercise interventions as well as its effects on lowering the symptom burden. We included randomized controlled trials and nonrandomized controlled trials with advanced cancer patients receiving any type of exercise intervention. After an extensive literature search (in accordance to PRIMSA guidelines) in PubMed, Cochrane Library, and SPORTDiscus, 14 studies including 940 participants with different cancer entities were eligible. The results indicated the safety of exercise. In total, 493 participants received exercise interventions, with nine adverse events and no severe adverse events. The median recruitment rate was 68.33%, and adherence to exercise intervention was 86%. Further research with a high-quality and larger sample size is needed to clarify the potential of exercise with advanced cancer patients. Different advanced cancer entities have distinguished symptoms, and future research should construct entities-specific trial populations to figure out the best supportive exercise interventions.
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Affiliation(s)
- Nico De Lazzari
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, 45147 Essen, Germany;
- Correspondence:
| | - Timo Niels
- Department I of Internal Medicine, Center of Integrated Oncology Aachen Bonn Cologne Düsseldorf, University Hospital of Cologne, 50937 Cologne, Germany;
| | - Mitra Tewes
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, 45147 Essen, Germany;
| | - Miriam Götte
- Department of Pediatric Hematology/Oncology, Clinic for Pediatrics 3, Center for Child and Adolescent Medicine, West German Cancer Center, University Hospital Essen, 45147 Essen, Germany;
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