1
|
Hsieh KL, Chang CH, Lin YC, Huang TJ, Chen MY. Lifestyle and risk factors associated with elevated prostate-specific antigen levels in rural men: implications for health counseling. Front Oncol 2024; 14:1451941. [PMID: 39376990 PMCID: PMC11456395 DOI: 10.3389/fonc.2024.1451941] [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: 06/22/2024] [Accepted: 09/03/2024] [Indexed: 10/09/2024] Open
Abstract
Background The use of prostate-specific antigen (PSA) for early detection of prostate cancer (PCa) is common but controversial. In rural areas, PSA is widely used for screening because it is convenient and early-stage PCa often shows no symptoms. Studies suggest that PSA levels are linked to factors like unhealthy lifestyles, obesity, lack of exercise, inflammation, and aging. Proper use and interpretation of PSA are crucial for healthcare providers, especially in primary care settings. This study aims to explore the prevalence and factors linked to higher PSA levels in rural men. Methods We conducted a community-based cross-sectional study from March to December 2023 in the western coastal region of Taiwan. Men aged 40-75 years participated, completing a lifestyle questionnaire and providing blood samples for cardiometabolic biomarkers and PSA levels. PSA levels of ≥ 4.0 ng/mL were considered elevated. We used propensity score matching (PSM) and genetic matching (GM) for analysis, followed by regression analysis. Results In total, 3347 male adults with a mean age of 56.3 years (SD=11.8, range 40-75), and without cancer-related diseases, were enrolled. Findings indicated that 3.9% (n=130) of men aged 40-75 years had a PSA ≥ 4 ng/mL. and many of them did not adopt health-related behaviors, including inadequate servings of vegetables, water intake, and engaging in regular exercise. Furthermore, more than half of the participants had high blood pressure, and over one-quarter exhibited a higher waist-hip ratio and cardiometabolic diseases. After employing propensity score matching (PSM) and genetic matching (GM) with respect to age and education, the multivariate logistic regression model indicated that less water intake (p<0.01), higher waist-hip ratio (> 0.95) (p<0.05), and being diagnosed with cardiometabolic diseases (p<0.05) were significantly associated with a higher serum PSA level. Conclusion This study revealed that inadequate water intake and obesity related diseases are significant risk factors associated with elevated PSA levels among male adults living in rural areas. It is important for frontline healthcare providers to carefully interpret the meaning of a high PSA level. Additionally, launching a longitudinal study is necessary to further investigate its relation to PCa.
Collapse
Affiliation(s)
- Kun-Lu Hsieh
- Department of Family Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Chia-Hao Chang
- Department of Nursing, Chang Gung University of Science and Technology, Chiayi, Taiwan
| | - Yu-Chih Lin
- Department of Family Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Tung-Jung Huang
- Department of Nursing, Chang Gung University of Science and Technology, Chiayi, Taiwan
- Department of Pulmonary and Critical Care, Chang Gung Memorial Hospital, Yunlin, Taiwan
| | - Mei-Yen Chen
- Department of Nursing, Chang Gung University of Science and Technology, Chiayi, Taiwan
- Research Fellow, Department of Cardiology, Chang Gung Memorial Hospital, Chiayi, Taiwan
- School of Nursing, Chang Gung University, Taoyuan, Taiwan
| |
Collapse
|
2
|
Ashton RE, Faghy MA, Roscoe CMP, Aning J. Inclusivity in prostate cancer and exercise research: a systematic review. Support Care Cancer 2024; 32:616. [PMID: 39198292 PMCID: PMC11358357 DOI: 10.1007/s00520-024-08793-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 08/07/2024] [Indexed: 09/01/2024]
Abstract
BACKGROUND Prostate cancer (PCa) is the most prevalent type of cancer in men in the UK. Exercise has been shown to improve the health and quality of life of PCa patients. Exercise should be easily accessible to men with PCa regardless of socioeconomic group or ethnicity. There is a need to better understand whether the current evidence base for exercise interventions is representative and inclusive of racial and ethnic minority men with PCa. METHODS A systematic review of the literature was conducted according to PRISMA guidelines and prospectively registered via Prospero (ID: CRD42022384373). The MEDLINE Ovid, Cochrane Library and PubMed databases were searched from inception to December 2022. The search strategy keywords and MeSH terms used included the following: (1) exercise, (2) training, (3) prostate cancer, (4) ethnic and (5) diversity. RESULTS A total of 778 records were retrieved from database searches, of which 15 records were duplicates. A further 649 were eliminated following the screening of titles and abstracts. After full-text screening of 186 articles, 28 manuscripts were included for review. CONCLUSION This systematic review highlights that there is high heterogeneity in the reporting of participants' ethnicity and there are low numbers of ethnic minority men included in PCa and exercise studies in the UK. Further work is required to understand why representation is lacking within PCa exercise trials in the UK and strategies are needed to achieve representation from all ethnic groups. IMPLICATIONS FOR CANCER SURVIVORS Improved representation and reporting of ethnicity in exercise trials is vital to ensure the results are applicable to all patients.
Collapse
Affiliation(s)
- Ruth E Ashton
- Research Centre for Physical Activity, Sport and Exercise Sciences, Coventry University, Coventry, UK.
- Biomedical and Clinical Science Research Theme, School of Human Sciences, University of Derby, Derby, UK.
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA.
| | - Mark A Faghy
- Biomedical and Clinical Science Research Theme, School of Human Sciences, University of Derby, Derby, UK
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA
- Department of Physical Therapy, College of Applied Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Clare M P Roscoe
- Biomedical and Clinical Science Research Theme, School of Human Sciences, University of Derby, Derby, UK
| | - Jonathan Aning
- Bristol Urological Institute, North Bristol NHS Trust, Southmead Hospital, Southmead Road, Westbury-On-Trym, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| |
Collapse
|
3
|
Murphy K, Kehoe B, Denieffe S, McGrath A, Hacking D, Fairman CM, Harrison M. 'Just because I have prostate cancer doesn't mean that I can't do things' - men's experiences of the acceptability of an exercise intervention for prostate cancer during treatment. BMC Cancer 2024; 24:949. [PMID: 39095735 PMCID: PMC11297682 DOI: 10.1186/s12885-024-12687-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 07/24/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND Structured exercise has an important role in mitigating the extensive side effects caused by ongoing prostate cancer treatments, specifically androgen deprivation therapy (ADT) and radiation therapy (RT). Little is known about men's experiences of, and preferences for, structured exercise programmes during active cancer treatment. This study aimed to inform the acceptability of a 6-month supervised intervention that emphasised increasing and varied intensities of aerobic and resistance exercise, by exploring the experiences of men who participated. METHODS Individual semi-structured interviews were conducted with an interviewer independent of the exercise study and data was analysed using a descriptive qualitative design. RESULTS Twelve prostate cancer patients were interviewed including participants who completed (n = 9) and withdrew from (n = 3) the intervention. Four main themes captured how men experienced the intervention: (1) Navigating the Unknown: Building confidence amidst vulnerability (subtheme- pushing the limits), (2) Building Trust: The credibility and approach of the exercise instructor (subtheme- appropriateness of supervised vs. independent exercise), (3) Flexibility in Delivery, (4) Finding Purpose: Exercise as a means of escapism and regaining control during treatment. CONCLUSION While an initial lack of self-confidence can be a barrier to exercise participation, exercise programmes have the potential to provide psychosocial benefits, rebuild confidence and empower men throughout their cancer treatment and into recovery. Structured exercise is acceptable during treatment including RT and can offer a form of escapism and sense of control for men navigating their cancer journey. Trust building, flexible delivery and credibility alongside a challenging exercise prescription are important facilitators of acceptability for men. Strategies to embed exercise from the point of diagnosis through ADT and RT should reflect men's experiences of exercise during treatment. TRIAL REGISTRATION The trial has been registered on ClinicalTrials.gov as of the 14th of December 2021 (NCT05156424).
Collapse
Affiliation(s)
- Kira Murphy
- Department of Sport and Exercise Science, South East Technological University, Cork Rd., Waterford, Ireland
- UPMC Hillman Cancer Center, Whitfield Hospital, Waterford, Ireland
| | - Bróna Kehoe
- Department of Sport and Exercise Science, South East Technological University, Cork Rd., Waterford, Ireland
| | - Suzanne Denieffe
- School of Humanities, South East Technological University, Waterford, Ireland
| | - Aisling McGrath
- Department of Sport and Exercise Science, South East Technological University, Cork Rd., Waterford, Ireland
| | - Dayle Hacking
- UPMC Hillman Cancer Center, Whitfield Hospital, Waterford, Ireland
| | - Ciaran M Fairman
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Michael Harrison
- Department of Sport and Exercise Science, South East Technological University, Cork Rd., Waterford, Ireland.
| |
Collapse
|
4
|
Martínez-Vizcaíno V, Fernández-Rodríguez R, Reina-Gutiérrez S, Rodríguez-Gutiérrez E, Garrido-Miguel M, Núñez de Arenas-Arroyo S, Torres-Costoso A. Physical activity is associated with lower mortality in adults with obesity: a systematic review with meta-analysis. BMC Public Health 2024; 24:1867. [PMID: 38997726 PMCID: PMC11245862 DOI: 10.1186/s12889-024-19383-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 07/05/2024] [Indexed: 07/14/2024] Open
Abstract
BACKGROUND Obesity is a complex chronic disease associated with several adverse health outcomes that increase mortality risk. Physical activity (PA) is recommended for the prevention and treatment of obesity and is related to a decreased risk of cardiovascular disease, cancer and all-cause mortality. This systematic review and meta-analysis estimates the effect of PA levels on mortality (cardiovascular, cancer and all-cause mortality) in adults with obesity. METHODS A systematic search was conducted in MEDLINE, Embase, Web of Science and SPORTDiscus from inception to June 2024. Prospective cohort studies that explored the association between PA and mortality in adults with obesity (according to their body mass index, ≥ 30 kg/m2) aged ≥ 18 years were included. Our main outcomes were all-cause mortality, and cardiovascular, and cancer mortality reported in primary studies by hazard ratios or relative risk, which were pooled for the meta-analysis when at least two studies reported the effect estimate for the same outcome. The PRISMA recommendations and the MOOSE guidelines were followed. The reported mortality risk estimates comparing insufficiently active versus active (moderate to very active) adults with obesity were pooled using the DerSimonian and Laird random-effects model. RESULTS A total of 9 prospective cohort studies involving 199,425 adults with obesity (age range: 35-85 years) were included, of which 59,873 were insufficiently active and 84,328 were active. Active individuals had a 21% lower risk of all-cause mortality (HR: 0.79, 95%CI: 0.74 to 0.84; I2 = 38.2%), and a 24% lower risk of cardiovascular mortality (HR: 0.76, 95%CI: 0.66 to 0.87; I2 = 0.0%) than insufficiently active individuals. The HR for cancer mortality was 0.91 (95%CI: 0.80 to 1.02; I2 = 0.0%), and although this was mostly consistent with a benefit, it was based on only two studies. CONCLUSION Our data support that moderate to high levels of PA are associated with a 21% lower risk of all-cause and 24% cardiovascular disease mortality in adults with obesity. Although data from the only two published studies seem to indicate a protective effect of PA on cancer risk, the estimates are not statistically significant. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42022309346.
Collapse
Affiliation(s)
- Vicente Martínez-Vizcaíno
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Faculty of Health Sciences, Universidad Autónoma de Chile, Talca, Chile
| | - Rubén Fernández-Rodríguez
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain.
- Research Network On Chronicity, Primary Care and Health Promotion (RICAPPS), Cuenca, Spain.
| | - Sara Reina-Gutiérrez
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Research Network On Chronicity, Primary Care and Health Promotion (RICAPPS), Cuenca, Spain
| | - Eva Rodríguez-Gutiérrez
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Research Network On Chronicity, Primary Care and Health Promotion (RICAPPS), Cuenca, Spain
| | - Miriam Garrido-Miguel
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Research Network On Chronicity, Primary Care and Health Promotion (RICAPPS), Cuenca, Spain
- Faculty of Nursing, Universidad de Castilla-La Mancha, Albacete, Spain
| | | | - Ana Torres-Costoso
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Research Network On Chronicity, Primary Care and Health Promotion (RICAPPS), Cuenca, Spain
- Faculty of Physiotherapy and Nursing, Universidad de Castilla-La Mancha, Toledo, Spain
| |
Collapse
|
5
|
Cornford P, Robijn E, Rogers E, Wassersug R, Fleure L. Fatigue in Prostate Cancer: A Roundtable Discussion and Thematic Literature Review. EUR UROL SUPPL 2024; 63:119-125. [PMID: 38596782 PMCID: PMC11001642 DOI: 10.1016/j.euros.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2024] [Indexed: 04/11/2024] Open
Abstract
Context Cancer and its treatments cause fatigue in up to 90% of men with advanced prostate cancer. As men with prostate cancer are surviving longer, cancer-related fatigue is becoming increasingly important for clinicians to understand and proactively manage. Objective The aim of this work is to identify knowledge gaps that may support healthcare professionals to recommend personalised fatigue management strategies. Evidence acquisition This manuscript is based on a roundtable discussion held during the European Association of Urology 2022 Annual Symposium, combined with a review of the literature. Five core themes were generated from the roundtable: (1) meaning of fatigue in prostate cancer patients, (2) impact of fatigue, (3) association between fatigue and treatment selection, (4) benefits of managing fatigue, and (5) barriers to exercise. Evidence synthesis Cancer-related fatigue has complex underlying aetiology and is a subjective experience that may be under-reported. Some studies have shown that techniques such as education, cognitive behavioural therapy, guided imagery, and progressive muscle relaxation can result in clinically meaningful improvements in fatigue. However, the largest body of evidence, and a theme echoed in the roundtable discussions, was the benefit of exercise on fatigue. Despite the benefits of exercise, for some men, objective barriers to exercise exist and knowledge of benefits does not automatically translate into implementation and adherence. Conclusions Understanding the specific health needs of individual patients and their desired health outcomes is essential to identify personalised strategies for minimising fatigue. As an outcome of the roundtable meeting, we developed a quick reference guide for healthcare providers. A high-resolution copy can be downloaded from https://patients.uroweb.org/library/fatigue-in-prostate-cancer-patients-guide/. Patient summary This article is based on dialogue between a group of specialists, patients, and caregivers, which took place at a roundtable meeting during the European Association of Urology 2022 Annual Symposium. The group discussed how healthcare providers can best support their patients who experience fatigue. The group subsequently developed a guide to help healthcare providers during appointments.
Collapse
Affiliation(s)
- Philip Cornford
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Esther Robijn
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Eamonn Rogers
- European Association of Urology, Arnhem, The Netherlands
| | | | - Louisa Fleure
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| |
Collapse
|
6
|
Christie DRH, Sharpley CF, Bitsika V. A Systematic Review of the Association between Psychological Resilience and Improved Psychosocial Outcomes in Prostate Cancer Patients. Could Resilience Training Have a Potential Role? World J Mens Health 2024; 42:42.e39. [PMID: 38606864 DOI: 10.5534/wjmh.230319] [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: 11/08/2023] [Revised: 12/31/2023] [Accepted: 01/22/2024] [Indexed: 04/13/2024] Open
Abstract
PURPOSE A high incidence of psychosocial problems in prostate cancer patients has been reported including anxiety, depression and distress. These can add to the patients' disease burden and have been associated with unfavorable cancer treatment outcomes. Interventions designed to address them have found limited success, but psychological resilience (PR) training has never been formally tested. The measurement of PR in prostate cancer patients has been described and has been associated with more favorable psychosocial outcomes in these patients but it has never been systematically reviewed. The aim of this study was to conduct the first systematic review of those studies that have measured it using standardized scales and to determine the potential for resilience training to help overcome the significant psychosocial problems faced by prostate cancer patients. MATERIALS AND METHODS We searched the literature to identify articles that measured PR among prostate cancer patients. RESULTS Of 384 articles identified by the search criteria, there were 19 studies suitable for inclusion regarding 5,417 patients. The most commonly-used scale was the original Connor-Davidson Resilience Scale, or an abbreviated version of it. Possible scores range from 0 to 100, mean scores from these studies ranged from 72.9 to 87.1 (standard deviations varied between 13.2 and 16.3). PR was consistently associated with improved psychological outcomes including depression, anxiety and distress, although these were measured with a wide variety of methods making it difficult to quantify the effects. There was also evidence of PR mediating the physical effects of prostate cancer and treatment including urinary symptoms, fatigue and insomnia. CONCLUSIONS As resilience training has been successful in other cancer settings, it seems likely that it could improve the significant adverse psychosocial outcomes that have been reported in prostate cancer patients and trials designed to objectively test it should be encouraged.
Collapse
Affiliation(s)
- David Robert Harry Christie
- GenesisCare, Tugun, Australia
- Brain-Behaviour Research Group, University of New England, Armidale, Australia.
| | | | - Vicki Bitsika
- Brain-Behaviour Research Group, University of New England, Armidale, Australia
| |
Collapse
|
7
|
Daniels JP, Freedland SJ, Gresham G. The growing implications of obesity for prostate cancer risk and mortality: where do we go from here? J Natl Cancer Inst 2023; 115:1448-1450. [PMID: 37587090 PMCID: PMC10699795 DOI: 10.1093/jnci/djad140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 07/13/2023] [Indexed: 08/18/2023] Open
Affiliation(s)
| | - Stephen J Freedland
- Department of Urology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Durham VA Medical Center, Durham, NC, USA
| | - Gillian Gresham
- Division of Population Sciences, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| |
Collapse
|
8
|
Steenstrup B, Cartier M, Cornu JN. What more comprehensive physiotherapy techniques than pelvic floor muscles training should be investigated in the context of post-prostatectomy? A narrative review. Prog Urol 2023; 33:1092-1100. [PMID: 37798160 DOI: 10.1016/j.purol.2023.09.017] [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: 07/17/2023] [Revised: 09/04/2023] [Accepted: 09/14/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND In a previous article, we have underlined the emerging level of evidence for the effectiveness of a more comprehensive functional physical therapy than solely pelvic floor muscles training (PFMT) for men after radical prostatectomy (RP). More and more authors suggest that physiotherapy programs should not focus only on the side effect of continence, but more generally on the interaction of continence disorders with all other side effects related to patient's physical and emotional functioning. RESEARCH QUESTION The aims of this narrative review are to highlight rehabilitation approaches unrelated to analytical PFMT that would seem relevant to consider in the future for post-RP men. METHOD Our narrative review sought to map the body of literature relevant to the primary objective (non-PFMT), supplementing the data from our previous review with additional recent articles that were not eligible due to not meeting the inclusion criteria for a systematic review. RESULTS After full text screening, 13 interventional studies have been selected. Intervention strategies were based on five major type of exercises: flexibility, synergism & co-activation, coordination & movement control, strength & endurance, aerobic & games therapy. Most of the studies of this narrative review focused on synergies, co-activations and movement control techniques that emphasized the deep abdominal muscles and PFMs reflexive activation. The wide variety of countries represented in the 13 studies with consistent results point to the potential effectiveness and replicability across various socio-cultural, ethnical, or religious contexts. CONCLUSION We found 13 studies from 9 different countries that provide a more complete rehabilitation approach than PFMT alone in men post-RP. Intervention strategies were built around five main types of exercises, with the majority of them emphasizing synergies, co-activations, and movement control techniques. In light of these data, we hope that future research will enable us to offer the most relevant and patient-centered physiotherapy treatment.
Collapse
Affiliation(s)
- B Steenstrup
- Rouen University Hospital, Department of Urology, Rouen, France; La Musse Physiotherapy Training Institute, Saint-Sébastien-de-Morsent, France.
| | - M Cartier
- La Musse Physiotherapy Training Institute, Saint-Sébastien-de-Morsent, France
| | - J N Cornu
- Rouen University Hospital, Department of Urology, Rouen, France
| |
Collapse
|
9
|
Geng L, Li X, Guo L, Zhang R, Yue S. The content and effectiveness of physical activity for cancer-related fatigue among colorectal cancer survivors: Systematic review and meta-analysis. Nurs Open 2023; 10:4274-4285. [PMID: 37029592 PMCID: PMC10277440 DOI: 10.1002/nop2.1725] [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: 06/07/2022] [Revised: 11/09/2022] [Accepted: 03/05/2023] [Indexed: 04/09/2023] Open
Abstract
AIMS To review the content and efficacy of physical activity (PA) for cancer-related fatigue (CRF) among colorectal cancer survivors. DESIGN Systematic review. METHODS A comprehensive search for randomized controlled trials from inception to April 1, 2022, of the following database was performed: EMBASE, PubMed, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Data and China Biology Medicine (CBM). RevMan5.4 software was used for performing meta-analysis. RESULTS A total of eight qualified randomized controlled trials that included 542 survivors were included. PA interventions significantly reduced the CRF (SMD = -0.46; 95% CI: [-0.76, -0.15], Z = 2.67, p = 0.003); Subgroup analysis showed that fatigue was significantly improved when the length of interventions was at least 6 months and the weekly duration of PA was less than 150 min/week (SMD = -0.54; 95% CI: [-0.81, -0.27], Z = 3.87 and p = 0.0001; SMD = -0.67; 95% CI: [-1.15, -0.19], Z = 2.74 and p = 0.006); PA intervention with the length of <6 months and the volume of ≥150 min/week did not reduce fatigue (p > 0.05).
Collapse
Affiliation(s)
- Liangrong Geng
- School of NursingBeijing University of Chinese MedicineBeijingChina
| | - Xiaoyu Li
- School of NursingBeijing University of Chinese MedicineBeijingChina
| | - Liqun Guo
- School of NursingBeijing University of Chinese MedicineBeijingChina
| | - Rui Zhang
- School of NursingBeijing University of Chinese MedicineBeijingChina
| | - Shujin Yue
- School of NursingBeijing University of Chinese MedicineBeijingChina
| |
Collapse
|
10
|
Graham LS, Lin JK, Lage DE, Kessler ER, Parikh RB, Morgans AK. Management of Prostate Cancer in Older Adults. Am Soc Clin Oncol Educ Book 2023; 43:e390396. [PMID: 37207299 DOI: 10.1200/edbk_390396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
The majority of men with prostate cancer are diagnosed when they are older than 65 years; however, clinical trial participants are disproportionately younger and more fit than the real-world population treated in typical clinical practices. It is, therefore, unknown whether the optimal approach to prostate cancer treatment is the same for older men as it is for younger and/or more fit men. Short screening tools can be used to efficiently assess frailty, functional status, life expectancy, and treatment toxicity risk. These risk assessment tools allow for targeted interventions to increase a patient's reserve and improve treatment tolerance, potentially allowing more men to experience the benefit of the significant recent treatment advances in prostate cancer. Treatment plans should also take into consideration each patient's individual goals and values considered within their overall health and social context to reduce barriers to care. In this review, we will discuss evidence-based risk assessment and decision tools for older men with prostate cancer, highlight intervention strategies to improve treatment tolerance, and contextualize these tools within the current treatment landscape for prostate cancer.
Collapse
Affiliation(s)
- Laura S Graham
- Division of Medical Oncology, University of Colorado, Aurora, CO
| | - John K Lin
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | | | - Ravi B Parikh
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
- Coporal Michael J. Crescenz VA Medical Center, Philadelphia, PA
| | | |
Collapse
|
11
|
Capela A, Antunes P, Coelho CA, Garcia CL, Custódio S, Amorim R, Costa T, Vilela E, Teixeira M, Amarelo A, Silva J, Joaquim A, Viamonte S, Brito J, Alves AJ. Effects of walking football on adherence, safety, quality of life and physical fitness in patients with prostate cancer: Findings from the PROSTATA_MOVE randomized controlled trial. Front Oncol 2023; 13:1129028. [PMID: 37025594 PMCID: PMC10070742 DOI: 10.3389/fonc.2023.1129028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 03/10/2023] [Indexed: 04/08/2023] Open
Abstract
Aims To analyze the feasibility and impact of a walking football (WF) program on quality of life (QoL), cardiorespiratory fitness (CRF), muscle strength, and balance program in men with prostate cancer under androgen deprivation therapy (ADT). Methods Fifty patients with prostate cancer (stages IIb-IVb) under ADT were randomized to a 16-week WF program plus usual care (n=25) or usual care control group (n=25). The WF program consisted of three 90-minute sessions per week. Recruitment, withdrawal, adherence, enjoyment rate, and safety of the intervention were recorded throughout the study. Cardiorespiratory fitness was assessed before and after the interventions, while handgrip strength, lower limb muscle strength, static balance, and QoL were assessed before, during (week 8), and after (week 16) the interventions. Adverse events during sessions were also recorded. Results The WF group showed high levels of adherence (81.6 ± 15.9%) and enjoyment rate (4.5 ± 0.5 out of 5 points). In the intention-to-treat analysis, the WF group showed an improvement in chair sit-to-stand (p=0.035) compared to the control group. Within-group comparisons showed that handgrip strength in the dominant upper limb (p=0.024), maximal isometric muscle strength in the non-dominant lower limb (p=0.006), and balance in the dominant limb (p=0.009) improved over time in the WF group but not in the usual care group. The results obtained from the per-protocol analysis indicate that CRF improved significantly in the WF group as compared to the control group (p=0.035). Within-group analysis revealed that CRF (p=0.036), muscle strength in dominant (p=0.006) and non-dominant (p=0.001) lower limbs, and balance in the non-dominant lower limb (p=0.023) improved after 16 weeks of WF, but not in the control group. One major traumatic injury (muscle tear) was reported with a complete recovery before the end of the intervention. Conclusion This study suggests that WF is feasible, safe, and enjoyable in patients with prostate cancer under hormonal therapy. Furthermore, patients who adhere to the WF program can expect cardiorespiratory fitness, muscle strength, and balance improvements. Clinical trials registration clinicaltrials.gov, identifier NCT04062162.
Collapse
Affiliation(s)
- Andreia Capela
- ONCOMOVE® – Associação de Investigação de Cuidados de Suporte em Oncologia (AICSO), Vila Nova de Gaia, Portugal
- Centro Hospitalar Vila Nova de Gaia – Espinho, Entidade pública empresaríal (EPE), Vila Nova de Gaia, Portugal
| | - Pedro Antunes
- ONCOMOVE® – Associação de Investigação de Cuidados de Suporte em Oncologia (AICSO), Vila Nova de Gaia, Portugal
- Research Center in Sport Sciences, Health and Human Development (CIDESD), Sport Sciences Department, University of Beira Interior, Covilhã, Portugal
| | - César André Coelho
- ONCOMOVE® – Associação de Investigação de Cuidados de Suporte em Oncologia (AICSO), Vila Nova de Gaia, Portugal
| | - Catarina Laranjeiro Garcia
- ONCOMOVE® – Associação de Investigação de Cuidados de Suporte em Oncologia (AICSO), Vila Nova de Gaia, Portugal
- Research Center in Sport Sciences, Health and Human Development (CIDESD), Physical Education and Sport Sciences Department, University of Maia, Maia, Portugal
| | - Sandra Custódio
- ONCOMOVE® – Associação de Investigação de Cuidados de Suporte em Oncologia (AICSO), Vila Nova de Gaia, Portugal
- Centro Hospitalar Vila Nova de Gaia – Espinho, Entidade pública empresaríal (EPE), Vila Nova de Gaia, Portugal
| | - Rui Amorim
- Centro Hospitalar Vila Nova de Gaia – Espinho, Entidade pública empresaríal (EPE), Vila Nova de Gaia, Portugal
| | - Telma Costa
- ONCOMOVE® – Associação de Investigação de Cuidados de Suporte em Oncologia (AICSO), Vila Nova de Gaia, Portugal
- Centro Hospitalar Vila Nova de Gaia – Espinho, Entidade pública empresaríal (EPE), Vila Nova de Gaia, Portugal
| | - Eduardo Vilela
- Centro Hospitalar Vila Nova de Gaia – Espinho, Entidade pública empresaríal (EPE), Vila Nova de Gaia, Portugal
| | - Madalena Teixeira
- Centro Hospitalar Vila Nova de Gaia – Espinho, Entidade pública empresaríal (EPE), Vila Nova de Gaia, Portugal
| | - Anabela Amarelo
- ONCOMOVE® – Associação de Investigação de Cuidados de Suporte em Oncologia (AICSO), Vila Nova de Gaia, Portugal
- Centro Hospitalar Vila Nova de Gaia – Espinho, Entidade pública empresaríal (EPE), Vila Nova de Gaia, Portugal
| | - Joana Silva
- ONCOMOVE® – Associação de Investigação de Cuidados de Suporte em Oncologia (AICSO), Vila Nova de Gaia, Portugal
- Centro Hospitalar Vila Nova de Gaia – Espinho, Entidade pública empresaríal (EPE), Vila Nova de Gaia, Portugal
| | - Ana Joaquim
- ONCOMOVE® – Associação de Investigação de Cuidados de Suporte em Oncologia (AICSO), Vila Nova de Gaia, Portugal
- Centro Hospitalar Vila Nova de Gaia – Espinho, Entidade pública empresaríal (EPE), Vila Nova de Gaia, Portugal
| | - Sofia Viamonte
- ONCOMOVE® – Associação de Investigação de Cuidados de Suporte em Oncologia (AICSO), Vila Nova de Gaia, Portugal
- Centro Hospitalar Vila Nova de Gaia – Espinho, Entidade pública empresaríal (EPE), Vila Nova de Gaia, Portugal
| | - João Brito
- Portugal Football School, Federação Portuguesa de Futebol, Oeiras, Portugal
| | - Alberto J. Alves
- ONCOMOVE® – Associação de Investigação de Cuidados de Suporte em Oncologia (AICSO), Vila Nova de Gaia, Portugal
- Research Center in Sport Sciences, Health and Human Development (CIDESD), Physical Education and Sport Sciences Department, University of Maia, Maia, Portugal
| |
Collapse
|
12
|
Overkamp M, Houben LHP, van der Meer S, van Roermund JGH, Bos R, Kokshoorn APJ, Larsen MS, van Loon LJC, Beelen M, Beijer S. Onset of androgen deprivation therapy leads to rapid deterioration of body composition, physical performance, cardiometabolic health and quality-of-life in prostate cancer patients. Scand J Urol 2023; 57:60-66. [PMID: 36703515 DOI: 10.1080/21681805.2023.2168050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVES To assess the adverse impact of the first 5 months of androgen deprivation therapy on body composition, physical performance, cardiometabolic health and health-related quality-of-life in prostate cancer patients. MATERIALS AND METHODS Thirty-four prostate cancer patients (70 ± 7 years) were assessed shortly after initiation of androgen deprivation therapy and again 5 months thereafter. Measurements consisted of whole-body dual-energy x-ray absorptiometry (body composition), computed tomography scanning of the upper leg (muscle mass), one-repetition maximum leg press (muscle strength), cardiopulmonary exercise testing (aerobic capacity), blood draws (metabolic parameters), accelerometry (habitual physical activity) and questionnaires (health-related quality-of-life). Data were analyzed with Student's paired t-tests. RESULTS Over time, whole-body fat mass (from 26.2 ± 7.7 to 28.4 ± 8.3 kg, p < 0.001) and fasting insulin (from 9.5 ± 5.8 to 11.3 ± 6.9 mU/L, p < 0.001) increased. Declines were observed for quadriceps cross-sectional area (from 66.3 ± 9.1 to 65.0 ± 8.5 cm2, p < 0.01), one-repetition maximum leg press (from 107 ± 27 to 100 ± 27 kg, p < 0.01), peak oxygen uptake (from 23.2 ± 3.7 to 20.3 ± 3.4 mL/min/kg body weight, p < 0.001), step count (from 7,048 ± 2,277 to 5,842 ± 1,749 steps/day, p < 0.01) and health-related quality-of-life (from 84.6 ± 13.5 to 77.0 ± 14.6, p < 0.001). CONCLUSIONS Androgen deprivation therapy induces adverse changes in body composition, muscle strength, cardiometabolic health and health-related quality-of-life already within 5 months after the start of treatment, possibly largely contributed by diminished habitual physical activity. Prostate cancer patients should, therefore, be stimulated to increase their habitual physical activity immediately after initiation of androgen deprivation therapy, to limit adverse side-effects and to improve health-related quality-of-life.
Collapse
Affiliation(s)
- Maarten Overkamp
- Netherlands Comprehensive Cancer Organisation (IKNL), Department of Research & Development, Utrecht, The Netherlands.,NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands.,TiFN, Wageningen, The Netherlands
| | - Lisanne H P Houben
- Netherlands Comprehensive Cancer Organisation (IKNL), Department of Research & Development, Utrecht, The Netherlands.,NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands.,TiFN, Wageningen, The Netherlands
| | - Saskia van der Meer
- Department of Urology, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands
| | - Joep G H van Roermund
- Department of Urology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Ronald Bos
- Department of Urology, Zuyderland Medical Center, Heerlen, The Netherlands
| | - Arjan P J Kokshoorn
- Sports Medical Center, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands
| | | | - Luc J C van Loon
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands.,TiFN, Wageningen, The Netherlands
| | - Milou Beelen
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands.,TiFN, Wageningen, The Netherlands
| | - Sandra Beijer
- Netherlands Comprehensive Cancer Organisation (IKNL), Department of Research & Development, Utrecht, The Netherlands.,TiFN, Wageningen, The Netherlands
| |
Collapse
|
13
|
Martín-Núñez J, Heredia-Ciuró A, Valenza-Peña G, Granados-Santiago M, Hernández-Hernández S, Ortiz-Rubio A, Valenza MC. Systematic review of self-management programs for prostate cancer patients, a quality of life and self-efficacy meta-analysis. PATIENT EDUCATION AND COUNSELING 2023; 107:107583. [PMID: 36459830 DOI: 10.1016/j.pec.2022.107583] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 11/25/2022] [Accepted: 11/26/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVE To investigate the efficacy of self-management interventions on quality of life and/or self-efficacy in patients diagnosed with prostate cancer through a systematic review with meta-analysis. METHODS A search was conducted from database inception to March 2022 across three databases. Randomized controlled trials were included. Two reviewers performed independent data extraction and methodologic quality assessment of the studies. RESULTS A total of fifteen studies were included in the study. Self-management interventions were identified by the Practical Reviews in Self-Management Support. The meta-analysis showed that self-management interventions have a significant effect on self-efficacy CONCLUSION: Self-management programs could have positive effects on quality of life and improve self-efficacy in prostate cancer patients. PRACTICE IMPLICATIONS Self-management components may be heterogeneous but show positive results in improving self-efficacy in prostate cancer survivors. Including self-management components in the rehabilitation of prostate survivors can improve their quality of life.
Collapse
Affiliation(s)
- Javier Martín-Núñez
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Spain.
| | | | | | | | | | - Araceli Ortiz-Rubio
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Spain.
| | - Marie Carmen Valenza
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Spain.
| |
Collapse
|
14
|
Saha A, Hamilton-Reeves J, DiGiovanni J. White adipose tissue-derived factors and prostate cancer progression: mechanisms and targets for interventions. Cancer Metastasis Rev 2022; 41:649-671. [PMID: 35927363 PMCID: PMC9474694 DOI: 10.1007/s10555-022-10056-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 07/27/2022] [Indexed: 12/01/2022]
Abstract
Obesity represents an important risk factor for prostate cancer, driving more aggressive disease, chemoresistance, and increased mortality. White adipose tissue (WAT) overgrowth in obesity is central to the mechanisms that lead to these clinical observations. Adipose stromal cells (ASCs), the progenitors to mature adipocytes and other cell types in WAT, play a vital role in driving PCa aggressiveness. ASCs produce numerous factors, especially chemokines, including the chemokine CXCL12, which is involved in driving EMT and chemoresistance in PCa. A greater understanding of the impact of WAT in obesity-induced progression of PCa and the underlying mechanisms has begun to provide opportunities for developing interventional strategies for preventing or offsetting these critical events. These include weight loss regimens, therapeutic targeting of ASCs, use of calorie restriction mimetic compounds, and combinations of compounds as well as specific receptor targeting strategies.
Collapse
Affiliation(s)
- Achinto Saha
- Division of Pharmacology and Toxicology, College of Pharmacy, The University of Texas at Austin, Austin, TX, 78723, USA
- Center for Molecular Carcinogenesis and Toxicology, The University of Texas at Austin, Austin, TX, 78723, USA
- Livestrong Cancer Institutes, Dell Medical School, The University of Texas at Austin, Austin, TX, 78723, USA
| | - Jill Hamilton-Reeves
- Departments of Urology and Dietetics & Nutrition, University of Kansas Medical Center, Kansas City, KS, 66160, USA
| | - John DiGiovanni
- Division of Pharmacology and Toxicology, College of Pharmacy, The University of Texas at Austin, Austin, TX, 78723, USA.
- Center for Molecular Carcinogenesis and Toxicology, The University of Texas at Austin, Austin, TX, 78723, USA.
- Livestrong Cancer Institutes, Dell Medical School, The University of Texas at Austin, Austin, TX, 78723, USA.
- Division of Pharmacology and Toxicology, College of Pharmacy, The University of Texas at Austin, Dell Pediatric Research Institute, 1400 Barbara Jordan Blvd, Austin, TX, 78723, USA.
| |
Collapse
|
15
|
Safran EE, Mutluay F, Uzay A. Effects of neuromuscular electrical stimulation combined with resistance exercises on muscle strength in adult hematological cancer patients: A randomized controlled study. Leuk Res 2022; 121:106932. [PMID: 36027848 DOI: 10.1016/j.leukres.2022.106932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 08/12/2022] [Accepted: 08/18/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVE We compared the effects of resistance exercise (REx) and resistance exercise combined with neuromuscular electrical stimulation (NMES+REx) on muscle strength, functional lower extremity strength, and mobility in hematological cancer patients during chemotherapy. METHODS Forty-three adult patients were recruited and randomized into the REx group versus personalized and progressive NMES+REx. The lower extremity muscle strength (digital hand dynamometer) test and functional and mobility tests [30-s sit-to-stand test, Timed Up and Go test (TUG)] were performed pre-and postintervention. RESULTS The Eastern Cooperative Oncology Group-Performance Score (ECOG-PS) of 90% of all patients was ≥2. Increases in steroid dose after transplantation were associated with decreases in hip flexion and knee extension muscle strength values (respectively; rs:-0.468, p:0.008; rs:-0.527, p: 0.002). There was a significant improvement in strength measurement, functional and mobility tests, and ECOG-PS in both groups (p<0.05). The NMES+REx group had significantly higher hip flexion and knee extension values than the REx group (respectively; p=0.001; p=0.048). CONCLUSION REx training given to hematological cancer patients receiving intensive chemotherapy after hematopoietic stem cell transplantation improved muscle weakness. The combination of NMES training with resistance exercises resulted in significant results comparable to REx training alone in adult hematological patients with moderate-low ECOG-PS.
Collapse
Affiliation(s)
- Elif Esma Safran
- Institute of Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul Medipol University, Istanbul, Turkey; Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey.
| | - Fatma Mutluay
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul Medipol University, Istanbul, Turkey
| | - Ant Uzay
- Department of Hematology, Bone Marrow Transplant Unit-Adult, Acibadem University Hospital Atakent, Istanbul, Turkey
| |
Collapse
|
16
|
Exercise Counteracts the Deleterious Effects of Cancer Cachexia. Cancers (Basel) 2022; 14:cancers14102512. [PMID: 35626116 PMCID: PMC9139714 DOI: 10.3390/cancers14102512] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 05/12/2022] [Accepted: 05/17/2022] [Indexed: 02/04/2023] Open
Abstract
Simple Summary This review provides an overview of the effects of exercise training on the major mechanisms related to cancer cachexia (CC). The review also discusses how cancer comorbidities can influence the ability of patients/animals with cancer to perform exercise training and what precautions should be taken when they exercise. The contribution of other factors, such as exercise modality and biological sex, to exercise effectiveness in ameliorating CC are also elaborated in the final sections. We provide meticulous evidence for how advantageous exercise training can be in patients/animals with CC at molecular and cellular levels. Finally, we emphasise what factors should be considered to optimise and personalise an exercise training program in CC. Abstract Cancer cachexia (CC) is a multifactorial syndrome characterised by unintentional loss of body weight and muscle mass in patients with cancer. The major hallmarks associated with CC development and progression include imbalanced protein turnover, inflammatory signalling, mitochondrial dysfunction and satellite cell dysregulation. So far, there is no effective treatment to counteract muscle wasting in patients with CC. Exercise training has been proposed as a potential therapeutic approach for CC. This review provides an overview of the effects of exercise training in CC-related mechanisms as well as how factors such as cancer comorbidities, exercise modality and biological sex can influence exercise effectiveness in CC. Evidence in mice and humans suggests exercise training combats all of the hallmarks of CC. Several exercise modalities induce beneficial adaptations in patients/animals with CC, but concurrent resistance and endurance training is considered the optimal type of exercise. In the case of cancer patients presenting comorbidities, exercise training should be performed only under specific guidelines and precautions to avoid adverse effects. Observational comparison of studies in CC using different biological sex shows exercise-induced adaptations are similar between male and female patients/animals with cancer, but further studies are needed to confirm this.
Collapse
|