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Lemétayer F, Reinert P, Asselin M, Rotonda C. Relationship between negative emotions and physical activity engagement after colorectal cancer: a network analysis study. Support Care Cancer 2025; 33:437. [PMID: 40304803 DOI: 10.1007/s00520-025-09439-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2024] [Accepted: 04/06/2025] [Indexed: 05/02/2025]
Abstract
BACKGROUND From the moment of diagnosis, colorectal cancer patients face negative emotions, which can persist into the post-cancer period. Maintaining physical activity during and after colorectal cancer is increasingly recommended to preserve both physical and psychological health. This study aims to examine the links between negative emotions and motivation to engage in physical activity (PA) in the post-colorectal cancer recovery period, using network analysis. METHODS Sixty-three people in the post-colorectal cancer recovery period and 62 people with no cancer history completed questionnaires on generalized anxiety disorder, the Perceived Stress Scale, the Illness Worry Scale, the Life Engagement Test, and the Physical Activity Motivation Scale in Health Context. RESULTS Network analyses revealed that anxiety and health-related worries were the strongest nodes and played a major role in the networks. In the post-cancer recovery group, anxiety had positive links with both intrinsic and extrinsic motivation to engage in PA, while health-related worries had positive links with extrinsic motivation to engage in PA, and life engagement had positive links with intrinsic motivation to engage in PA. In the group with no cancer history, only health-related worries had positive links with external regulation of PA. CONCLUSION These preliminary findings remain exploratory but emphasize that experiencing negative emotions does not necessarily hinder engagement in physical activity.
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Affiliation(s)
- Fabienne Lemétayer
- University of Lorraine, 2LPN, Bâtiment SHS, Ile du Saulcy, 57000, Metz, France.
| | - Priscille Reinert
- University of Lorraine, 2LPN, Bâtiment SHS, Ile du Saulcy, 57000, Metz, France
| | - Marine Asselin
- University of Lorraine, Campus Bridoux, 2LPN, Rue du Général Delestraint, 57000, Metz, France
| | - Christine Rotonda
- INSPIIRE UMR1319 (APEMAC), University of Lorraine, Espace Rabelais, SHS Building, Ile du Saulcy, 57000, Metz, France
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Färnqvist K, Mälberg K, Johar A, Schandl A, Olsén MF, Lagergren P. Exploring the impact of physical exercise regimens on health-related quality of life following oesophageal or gastric cancer surgery: a systematic review and meta-analysis of randomized controlled trials. BMC Sports Sci Med Rehabil 2025; 17:64. [PMID: 40158140 PMCID: PMC11955135 DOI: 10.1186/s13102-025-01089-3] [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: 07/04/2024] [Accepted: 02/19/2025] [Indexed: 04/01/2025]
Abstract
PURPOSE To assess the effectiveness and adverse events of postoperative physical exercise on health-related quality of life (HRQL) in patients who have undergone surgery for oesophageal or gastric cancer. METHODS We conducted a systematic review and meta-analysis and reported it according to the preferred reporting items for systematic reviews and meta-analyses. (PRISMA) guidelines. Randomised controlled trials (RCT) that investigated HRQL factors following physical exercise interventions in patients undergoing oesophageal or gastric cancer surgery were included. Studies including participants who had undergone oesophagectomy or gastrectomy for cancer, of either sex and were 18 years or older were included. Participants with other cancers were excluded. Medline, Embase, CINAHL, Cochrane Library, PEDro, and trial registries were searched for studies from inception until February 2025. Results were synthesised using meta-analyses. Two independent reviewers assessed the risk of bias using the Cochrane risk of bias tool 2.0, and the grading of recommendations assessment, development and evaluation (GRADE) was used to evaluate the overall certainty of the evidence. PROSPERO ID CRD42022358493. RESULTS Three studies enrolling 284 patients undergoing oesophagectomy were included, of which two were assessed at high risk of bias and one at some concerns. The global quality of life score from the European Organisation for Research and Rreatment of Cancer (EORTC) quality of life questionnaire Cancer QLQ-C30 was used to assess HRQL in all the included studies. The score ranges from 0 to 100, with higher scores indicating a better HRQL. Physical exercise therapy had no discernible impact on HRQL compared to the control group (mean difference 0.77 [95% CI -4.36, 5.90]. However, the quality of evidence was very low, which should be considered when interpreting the results as they can differ substantially from the true effects. CONCLUSION We found a significant lack of information about the effects of post-surgery physical exercise compared to standard care in patients who have undergone oesophagectomy or gastrectomy for cancer. Based on the current very low certainty evidence, the effectiveness on HRQL and the safety of postoperative physical exercise in patients treated with oesophagectomy for cancer is uncertain. We found no studies investigating gastric cancer and exercise.
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Affiliation(s)
- Kenneth Färnqvist
- Surgical Care Science, Department of Molecular Medicine and Surgery, Karolinska Institute, Retzius väg 13A, 4th floor, Stockholm, 171 77, Sweden
| | - Kalle Mälberg
- Surgical Care Science, Department of Molecular Medicine and Surgery, Karolinska Institute, Retzius väg 13A, 4th floor, Stockholm, 171 77, Sweden
| | - Asif Johar
- Surgical Care Science, Department of Molecular Medicine and Surgery, Karolinska Institute, Retzius väg 13A, 4th floor, Stockholm, 171 77, Sweden
| | - Anna Schandl
- Surgical Care Science, Department of Molecular Medicine and Surgery, Karolinska Institute, Retzius väg 13A, 4th floor, Stockholm, 171 77, Sweden
- Department of Anaesthesia and Intensive Care, Södersjukhuset, Stockholm, 118 83, Sweden
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institute, Stockholm, 118 83, Sweden
| | - Monika Fagevik Olsén
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Pernilla Lagergren
- Surgical Care Science, Department of Molecular Medicine and Surgery, Karolinska Institute, Retzius väg 13A, 4th floor, Stockholm, 171 77, Sweden.
- Department of Surgery & Cancer, Imperial College London, London, UK.
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Faraji H, Banakar F, Sadri A, Ebrahim-Habibi A. Dead-End protein expression, function, and mutation in cancer: a systematic review. Mol Biol Rep 2025; 52:291. [PMID: 40053212 DOI: 10.1007/s11033-025-10325-5] [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: 11/10/2024] [Accepted: 01/31/2025] [Indexed: 05/13/2025]
Abstract
Cancer incidence is rising globally, particularly in aging populations. Understanding the genetic, cellular, and molecular mechanisms underlying cancer is crucial for developing effective interventions. Dead-end protein 1 (DND1), an RNA-binding protein, plays a pivotal role in germ cell regulation and tumorigenesis. This systematic review investigates DND1's multifaceted roles in cancer progression and evaluates its interactions and potential as a therapeutic target. A systematic search of four databases (Web of Science, MEDLINE via PubMed, Scopus, and Embase) yielded 436 unique records. After screening, 38 studies were included for data extraction. STRING-based network analysis identified key interactors-including NANOS1-3, TDRD7, DAZL, and EIF2S2- and pathways associated with RNA binding, translational regulation, and apoptosis. DND1 demonstrates dual, context-dependent roles as both a tumor suppressor and promoter. Its regulation of miRNAs and interaction with germ cell-specific proteins emerged as critical mechanisms in tumor suppression and progression. This study highlights DND1's central role in cancer biology, with significant implications for diagnostics and therapeutics. The findings provide a robust foundation for experimental validation of key interactions and further exploration of DND1's molecular mechanisms. The dual functionality of DND1 as a tumor suppressor and promoter underscores its potential as a target for novel cancer therapies, particularly for germ cell tumors and other cancers.
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Affiliation(s)
- Homa Faraji
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Biosensor Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, 10 Jalal-Al-Ahmad Street, Tehran, 1411713137, Iran
| | - Farnaz Banakar
- Biosensor Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, 10 Jalal-Al-Ahmad Street, Tehran, 1411713137, Iran.
| | - Arash Sadri
- Biosensor Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, 10 Jalal-Al-Ahmad Street, Tehran, 1411713137, Iran
- Interdisciplinary Neuroscience Research Program (INRP), Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Azadeh Ebrahim-Habibi
- Biosensor Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, 10 Jalal-Al-Ahmad Street, Tehran, 1411713137, Iran.
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Viskochil RH, Lin T, Gigic B, Himbert C, Bandera VM, Skender S, Holowatyj AN, Schrotz-King P, Steindorf K, Strehli I, Mutch MG, Chao D, Toriola AT, Shibata D, Siegel EM, Li CI, Hardikar S, Peoples AR, Figueiredo JC, Schneider M, Ulrich CM, Ose J. Sedentary behavior and physical activity one year after colorectal cancer diagnosis: results from the ColoCare Study. J Cancer Surviv 2025:10.1007/s11764-025-01756-x. [PMID: 39985691 DOI: 10.1007/s11764-025-01756-x] [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: 12/17/2024] [Accepted: 01/28/2025] [Indexed: 02/24/2025]
Abstract
PURPOSE Physical activity plays key roles in colorectal cancer survivorship; however, the impact of different clinicodemographic outcomes on cross-sectional and longitudinal objectively measured physical activity 12 and 24 months post-diagnosis are unclear. METHODS ColoCare study participants (n = 165) wore an Actigraph GT3x accelerometer for 4-10 consecutive days to objectively assess activity levels 12 and 24 months after colorectal cancer diagnosis and resection. Associations between these clinical/demographic exposures and physical activity outcomes and longitudinal changes were determined using t-test, ANOVA F-test, and linear regression modeling, adjusting for common confounders (e.g., sex, age, stage). RESULTS Key physical activity and sedentary behavior variables significantly differed by demographic status, including minutes of weekly exercise by sex and age (age < 50: 364 min ± 303 min; age 50-70: 232 min ± 263 min; age > 70: 93 min ± 135 min, p < 0.001) and (%) daily sedentary time by age (age < 50: 64 ± 10%; age 50-70: 67 ± 7%; age > 70: 71 ± 7%, p = 0.003). Within the multivariate model, age was the primary measure consistently associated with activity differences. Participants who wore accelerometers 12- and 24-month post-resection (n = 52) significantly increased weekly exercise minutes (214 min ± 208 min vs. 288 min ± 316 min, p = 0.04). CONCLUSION Age is the primary clinicodemographic determinant separating physical activity levels in colorectal cancer survivors, and increases in exercise from 12 to 24 months are likely due to consolidation of sporadic daily physical activity into bouts of exercise. IMPLICATIONS FOR CANCER SURVIVORS Colorectal cancer survivors experience different volumes and changes in accelerometer-derived physical activity based on some (e.g., age) but not all (e.g., stage) clinicodemographic variables.
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Affiliation(s)
- Richard H Viskochil
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- University of Massachusetts Boston, Boston, MA, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Tengda Lin
- Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Biljana Gigic
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Caroline Himbert
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
- Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Victoria M Bandera
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Stephanie Skender
- National Center for Tumor Diseases , (NCT), Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Andreana N Holowatyj
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt-Ingram Cancer Center, Nashville, TN, USA
| | - Petra Schrotz-King
- National Center for Tumor Diseases , (NCT), Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Karen Steindorf
- Division of Physical Activity, Prevention and Cancer, National Center for Tumor Diseases (NCT) and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Ildiko Strehli
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Matthew G Mutch
- Department of Surgery, Washington University School of Medicine , St. Louis, MO, USA
| | - Dante Chao
- Division of Public Health Science, Department of Surgery, Washington University School of Medicine and Siteman Cancer Center St. Louis, St. Louis, MO, USA
| | - Adetunji T Toriola
- Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA
| | - David Shibata
- Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Erin M Siegel
- Cancer Epidemiology Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Christopher I Li
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Sheetal Hardikar
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Anita R Peoples
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Jane C Figueiredo
- Cedars-Sinai Medical Center, Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA, USA
| | - Martin Schneider
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
- Department of General, Visceral, Thoracic, Transplantation and Pediatric Surgery, Giessen University Hospital, Giessen, Germany
| | - Cornelia M Ulrich
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Jennifer Ose
- Huntsman Cancer Institute, Salt Lake City, UT, USA.
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA.
- Department of Media, Information and Design, University of Applied Sciences and the Arts, Hannover, Germany.
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5
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Smit KC, Derksen JWG, Stellato RK, VAN Lanen AS, Wesselink E, Belt EJT, Balen MCVAN, Coene PPLO, Dekker JWT, DE Groot JW, Haringhuizen AW, VAN Halteren HK, VAN Heek TT, Helgason HH, Hendriks MP, DE Hingh IHJT, Hoekstra R, Houtsma D, Janssen JJB, Kok N, Konsten JLM, Los M, Meijerink MR, Mekenkamp LJM, Peeters KCMJ, Polée MB, Rietbroek RC, Schiphorst AHW, Schrauwen RWM, Schreinemakers J, Sie MPS, Simkens L, Sonneveld EJA, Terheggen F, Iersel LVVAN, Vles WJ, Wasowicz-Kemps DK, DE Wilt JHW, Kok DE, Winkels RM, Kampman E, VAN Duijnhoven FJB, Koopman M, May AM. Determinants of Physical Activity among Patients with Colorectal Cancer: From Diagnosis to 5 Years after Diagnosis. Med Sci Sports Exerc 2024; 56:623-634. [PMID: 38079324 DOI: 10.1249/mss.0000000000003351] [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: 03/16/2024]
Abstract
INTRODUCTION Physical activity (PA) is associated with higher quality of life and probably better prognosis among colorectal cancer (CRC) patients. This study focuses on determinants of PA among CRC patients from diagnosis until 5 yr postdiagnosis. METHODS Sociodemographic and disease-related factors of participants of two large CRC cohort studies were combined. Moderate-to-vigorous PA during sport and leisure time (MVPA-SL) was measured at diagnosis (T0) and 6, 12, 24, and 60 months (T6 to T60) postdiagnosis, using the SQUASH questionnaire. Mixed-effects models were performed to identify sociodemographic and disease-related determinants of MVPA-SL, separately for stage I-III colon (CC), stage I-III rectal cancer (RC), and stage IV CRC (T0 and T6 only). Associations were defined as consistently present when significant at ≥4 timepoints for the stage I-III subsets. MVPA-SL levels were compared with an age- and sex-matched sample of the general Dutch population. RESULTS In total, 2905 CC, 1459 RC and 436 stage IV CRC patients were included. Patients with higher fatigue scores, and women compared with men had consistently lower MVPA-SL levels over time, regardless of tumor type and stage. At T6, having a stoma was significantly associated with lower MVPA-SL among stage I-III RC patients. Systemic therapy and radiotherapy were not significantly associated with MVPA-SL changes at T6. Compared with the general population, MVPA-SL levels of CRC patients were lower at all timepoints, most notably at T6. CONCLUSIONS Female sex and higher fatigue scores were consistent determinants of lower MVPA-SL levels among all CRC patients, and MVPA-SL levels were lowest at 6 months postdiagnosis. Our results can inform the design of intervention studies aimed at improving PA, and guide healthcare professionals in optimizing individualized support.
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Affiliation(s)
- Karel C Smit
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, THE NETHERLANDS
| | - Jeroen W G Derksen
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, THE NETHERLANDS
| | - Rebecca K Stellato
- Department of Data Science and Biostatistics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, THE NETHERLANDS
| | - Anne-Sophie VAN Lanen
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, THE NETHERLANDS
| | - Evertine Wesselink
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, THE NETHERLANDS
| | - Eric J Th Belt
- Department of Surgery, Albert Schweitzer Hospital, Dordrecht, THE NETHERLANDS
| | | | | | | | | | | | - Henk K VAN Halteren
- Department of Medical Oncology, Admiraal de Ruyter Hospital, Goes, THE NETHERLANDS
| | - Tjarda T VAN Heek
- Department of Surgery, Ziekenhuis Gelderse Vallei, Ede, THE NETHERLANDS
| | - Helgi H Helgason
- Department of Medical Oncology, Haaglanden Medical Center, Den Haag, THE NETHERLANDS
| | - Mathijs P Hendriks
- Department of Medical Oncology, Northwest Clinics, Alkmaar, THE NETHERLANDS
| | | | - Ronald Hoekstra
- Department of Medical Oncology, Ziekenhuisgroep Twente, Hengelo, THE NETHERLANDS
| | - Danny Houtsma
- Department of Medical Oncology, Haga Hospital, Den Haag, THE NETHERLANDS
| | - Johan J B Janssen
- Department of Medical Oncology, Canisius Wilhelmina Hospital, Nijmegen, THE NETHERLANDS
| | - Niels Kok
- Department of Gastrointestinal Oncology, Antoni Van Leeuwenhoek-Netherlands Cancer Institute, Amsterdam, THE NETHERLANDS
| | | | - Maartje Los
- Department of Medical Oncology, St. Antonius Hospital, Nieuwegein, THE NETHERLANDS
| | - Martijn R Meijerink
- Department of Radiology and Nuclear Medicine, VU Medical Center, Amsterdam, THE NETHERLANDS
| | - Leonie J M Mekenkamp
- Department of Medical Oncology, Medisch Spectrum Twente, Enschede, THE NETHERLANDS
| | - Koen C M J Peeters
- Department of Surgery, Leiden University Medical Center, University of Leiden, Leiden, THE NETHERLANDS
| | - Marco B Polée
- Department of Medical Oncology, Medical Center Leeuwarden, Leeuwarden, THE NETHERLANDS
| | - Ron C Rietbroek
- Department of Medical Oncology, Rode Kruis Hospital, Beverwijk, THE NETHERLANDS
| | | | - Ruud W M Schrauwen
- Department of Gastroenterology and Hepatology, Bernhoven Hospital, Uden, THE NETHERLANDS
| | | | - Mark P S Sie
- Department of Medical Oncology, ZorgSaam Hospital, Terneuzen, THE NETHERLANDS
| | - Lieke Simkens
- Department of Medical Oncology, Maxima Medical Center, Eindhoven, THE NETHERLANDS
| | | | - Frederiek Terheggen
- Department of Medical Oncology, Bravis Hospital, Roosendaal, THE NETHERLANDS
| | - Liselot Valkenburg-VAN Iersel
- Maastricht University Medical Center, Department of Internal Medicine, Division of Medical Oncology, GROW, Maastricht University, Maastricht, THE NETHERLANDS
| | - Wouter J Vles
- Department of Surgery, Ikazia Hospital, Rotterdam, THE NETHERLANDS
| | | | - Johannes H W DE Wilt
- Department of Surgery, Radboud University Medical Center, University of Nijmegen, Nijmegen, THE NETHERLANDS
| | - Dieuwertje E Kok
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, THE NETHERLANDS
| | - Renate M Winkels
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, THE NETHERLANDS
| | - Ellen Kampman
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, THE NETHERLANDS
| | | | - Miriam Koopman
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, THE NETHERLANDS
| | - Anne M May
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, THE NETHERLANDS
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Abdul Razak N, Azhar AR, Baharuddin IH, Ismail Z, Azman ZAM, Abdul Manap SA, Ramli N. Does Exercise Improve Health-Related Quality of Life of Colorectal Cancer Survivors? A Systematic Review and Meta-Analysis. Asian Pac J Cancer Prev 2024; 25:379-391. [PMID: 38415522 PMCID: PMC11077098 DOI: 10.31557/apjcp.2024.25.2.379] [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: 08/04/2023] [Accepted: 02/16/2024] [Indexed: 02/29/2024] Open
Abstract
INTRODUCTION Early diagnostic and treatment advances have resulted in prolonged cancer survivorship. Therefore, exercise intervention in survivorship management is essential for enhancing cancer survivors' health-related quality of life (HRQoL). OBJECTIVE The systematic review and meta-analysis in this study aimed to explore the effect of exercise intervention on health-related quality of life of colorectal cancer survivors. METHODS The current study followed guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 (PRISMA 2020) to identify relevant literature. Comprehensive searches were conducted using EBSCOhost, Web of Science (WOS), Scopus, Science Direct, and PubMed. The inclusion criteria included are randomised control trials studies written in English, with no restrictions for the time of publication that reported the effects of exercise intervention on health-related quality of live among colorectal cancer survivors. Meta-analysis was conducted by pooling the mean and standard deviation of post-intervention scores across randomised control trial studies using a random effects model. RESULT A total of 467 articles were identified but only seven articles were randomised control trials (RCT) (n = 7) with PEDro scores ranging from 6 to 9 showing good internal validity were included in the review. The results of the meta-analysis of pooled data from six RCTs studies on HRQoL showed no significant effect of exercise intervention on HRQoL in the intervention group compared to control group [SMD = 0.25; 95% CI; -0.0, 0.51; Z = 1.88; p = 0.06; I2 = 30.8%]. CONCLUSION This meta-analysis provides key insights into the effect of exercise on the health-related quality of life (HRQoL) of colorectal cancer (CRC) survivors. Therefore, more experimental studies should be carried out with rigorous methodology to evaluate the effectiveness of exercise interventions before it is recommended as a routine activity in post-treatment management for CRC survivors.
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Affiliation(s)
- Najibah Abdul Razak
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Jalan Hospital, 47000 Sungai Buloh, Selangor, Malaysia.
| | - Abdul Razak Azhar
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Jalan Hospital, 47000 Sungai Buloh, Selangor, Malaysia.
| | - Izyan Hazwani Baharuddin
- Faculty of Dentistry, Universiti Teknologi MARA, Sungai Buloh Campus, Jalan Hospital, 47000 Sungai Buloh, Selangor, Malaysia.
| | - Zaliha Ismail
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Jalan Hospital, 47000 Sungai Buloh, Selangor, Malaysia.
| | | | - Shaiful Amir Abdul Manap
- Department of Surgery Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Selangor, Malaysia.
| | - Nurhidayu Ramli
- Physiotherapy Unit, Department of Medical Rehabilitation Services, Hospital Canselor Tuanku Muhriz, Cheras, Kuala Lumpur, Malaysia.
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7
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Aly SM, Genena D, Bateman LB, Shikany JM, Fouad MN, Arafat WO, Abdelmoniam SE, Bae S, Scarinci IC, Hussien M, Alaa M, Hansen B, Hegazy Y, Rogers LQ. Physical Activity among Colorectal Cancer Patients and Survivors in Egypt. Asian Pac J Cancer Prev 2023; 24:3117-3123. [PMID: 37774063 PMCID: PMC10762757 DOI: 10.31557/apjcp.2023.24.9.3117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 09/16/2023] [Indexed: 10/01/2023] Open
Abstract
INTRODUCTION Understanding physical activity (PA) levels is important when developing tertiary cancer prevention interventions, especially in Egypt where colorectal cancer (CRC) is more often diagnosed at later stages and at a younger age of onset (≤40 years). METHODS We assessed PA levels among CRC patients and survivors in Alexandria, Egypt. All participants completed two self-reported PA assessments: Global Physical Activity Questionnaire (GPAQ) and Godin Leisure-Time Exercise Questionnaire (GLTEQ). Participants could opt to wear an accelerometer for seven days. Results were compared against WHO recommendations of ≥150 minutes or ≥600 metabolic equivalents of tasks (METs) of moderate-to-vigorous PA weekly. RESULTS Of 86 participants enrolled, all completed the surveys and 29 agreed to accelerometer use. Prevalence of meeting PA recommendations was 62.8% based on the GPAQ, 14.0% based on GLTEQ, and 41% based on accelerometer. Based on the GPAQ, very few respondents reported vigorous occupational, vigorous recreational, or moderate recreational activity (median = 0 with interquartile range [IQR] of 0 - 0 weekly minutes for all three) while most activity resulted from moderate occupational and transportation (median [IQR] of 60 [0-840] and 60 [0-187.5] weekly minutes, respectively). Participants meeting PA recommendations were less likely to be married (p = 0.043) according to GPAQ and more likely to be female (p=0.047) and early cancer stage (p=0.007) by GLTEQ. CONCLUSION Non-leisure free-living PA is a major contributor to meeting PA recommendations while leisure-time PA is a potential target for future interventions that increase PA in this population.
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Affiliation(s)
- Salma M. Aly
- Community Medicine department, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
| | - Doaa Genena
- Medical Research Institute, Alexandria University, Alexandria, Egypt.
| | - Lori Brand Bateman
- Department of Preventive Medicine, The University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL, United States.
| | - James M. Shikany
- Department of Preventive Medicine, The University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL, United States.
| | - Mona N. Fouad
- Department of Preventive Medicine, The University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL, United States.
- Preventive Medicine, The University of Alabama at Birmingham School of Medicine, Birmingham, AL, United States.
| | - Waleed O. Arafat
- Department of Clinical Oncology, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
| | - Salah-Eldin Abdelmoniam
- Department of Clinical Oncology, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
| | - Sejong Bae
- Department of Preventive Medicine, The University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL, United States.
| | - Isabel C. Scarinci
- Global and Rural Health, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL, U.S.
| | - Marwa Hussien
- Department of Obstetrics and Gynecology, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
| | - Mariam Alaa
- Community Medicine department, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
| | - Barbara Hansen
- Department of Preventive Medicine, The University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL, United States.
| | - Yassmin Hegazy
- Department of Preventive Medicine, The University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL, United States.
| | - Laura Q. Rogers
- Department of Preventive Medicine, The University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL, United States.
- Department of Medicine, the University of Alabama at Birmingham, Birmingham, Alabama
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8
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Ordille AJ, Phadtare S. Intensity-specific considerations for exercise for patients with inflammatory bowel disease. Gastroenterol Rep (Oxf) 2023; 11:goad004. [PMID: 36814502 PMCID: PMC9940700 DOI: 10.1093/gastro/goad004] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 11/02/2022] [Accepted: 12/22/2022] [Indexed: 02/22/2023] Open
Abstract
The rising prevalence of inflammatory bowel disease (IBD) necessitates that patients be given increased access to cost-effective interventions to manage the disease. Exercise is a non-pharmacologic intervention that advantageously affects clinical aspects of IBD, including disease activity, immune competency, inflammation, quality of life, fatigue, and psychological factors. It is well established that exercise performed at low-to-moderate intensity across different modalities manifests many of these diseased-related benefits while also ensuring patient safety. Much less is known about higher-intensity exercise. The aim of this review is to summarize findings on the relationship between strenuous exercise and IBD-related outcomes. In healthy adults, prolonged strenuous exercise may unfavorably alter a variety of gastrointestinal (GI) parameters including permeability, blood flow, motility, and neuro-endocrine changes. These intensity- and gut-specific changes are hypothesized to worsen IBD-related clinical presentations such as diarrhea, GI bleeding, and colonic inflammation. Despite this, there also exists the evidence that higher-intensity exercise may positively influence microbiome as well as alter the inflammatory and immunomodulatory changes seen with IBD. Our findings recognize that safety for IBD patients doing prolonged strenuous exercise is no more compromised than those doing lower-intensity work. Safety with prolonged, strenuous exercise may be achieved with adjustments including adequate hydration, nutrition, drug avoidance, and careful attention to patient history and symptomatology. Future work is needed to better understand this intensity-dependent relationship so that guidelines can be created for IBD patients wishing to participate in high-intensity exercise or sport.
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Affiliation(s)
- Andrew J Ordille
- Department of Biomedical Sciences, Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Sangita Phadtare
- Department of Biomedical Sciences, Cooper Medical School of Rowan University, Camden, NJ, USA
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9
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Zhou W, Veliz PT, Smith EML, Chen W, Reddy RM, Larson JL. Comparison of Pre-Diagnosis Physical Activity and Its Correlates between Lung and Other Cancer Patients: Accelerometer Data from the UK Biobank Prospective Cohort. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1001. [PMID: 36673757 PMCID: PMC9859178 DOI: 10.3390/ijerph20021001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 12/29/2022] [Accepted: 12/30/2022] [Indexed: 06/17/2023]
Abstract
Purpose: Physical activity (PA) plays an important role in health outcomes for people with cancer, and pre-diagnosis PA influences PA behaviors after cancer treatment. Less is known about the PA of lung cancer patients, and the strong history of smoking could influence pre-diagnosis levels of PA and place them at risk for health problems. This study aimed to compare pre-diagnosis PA and its correlates in patients with lung cancer and other types of cancer (female breast, colorectal, and prostate cancer) and examine the relationship between pre-diagnosis PA and all-cause mortality. Methods: This study used data from the UK Biobank, which is a national cohort study with accelerometry data. We included 2662 participants and used adjusted linear regressions and survival analyses. Results: Male and female lung cancer groups spent a mean of 78 and 91 min/day in pre-diagnosis moderate to vigorous PA (MVPA), respectively; this is lower than the 3 other types of cancer (p < 0.001). Younger age and faster walking pace had a strong association with PA in all the four types of cancer (p < 0.01). Smoking status had a strong association with PA in the lung cancer group, while obesity had a strong association with PA in female breast, colorectal, and prostate cancer (p < 0.01). Higher levels of pre-diagnosis MVPA (≥1.5 h/day) were associated with a significantly lower all-cause mortality risk. Conclusions: The present study suggests that lung cancer patients are the most inactive population before diagnosis. The identified difference in correlates of PA suggest that cancer-specific approaches are needed in PA research and practices. This study also highlights the importance of high PA for individuals with high cancer risk.
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Affiliation(s)
- Weijiao Zhou
- School of Nursing, University of Michigan, Ann Arbor, MI 48109, USA
- School of Nursing, Peking University, Beijing 100191, China
| | - Philip T. Veliz
- School of Nursing, University of Michigan, Ann Arbor, MI 48109, USA
| | | | - Weiyun Chen
- School of Kinesiology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Rishindra M. Reddy
- Department of Thoracic Surgery, University of Michigan Medical Center, Ann Arbor, MI 48109, USA
| | - Janet L. Larson
- School of Nursing, University of Michigan, Ann Arbor, MI 48109, USA
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10
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Révész D, van Kuijk SMJ, Mols F, van Duijnhoven FJB, Winkels RM, Kant IJ, van den Brandt PA, Smits LJ, Breukink SO, Kampman E, Beijer S, Weijenberg MP, Bours MJL. External validation and updating of prediction models for estimating the 1-year risk of low health-related quality of life in colorectal cancer survivors. J Clin Epidemiol 2022; 152:127-139. [PMID: 36220623 DOI: 10.1016/j.jclinepi.2022.09.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 08/30/2022] [Accepted: 09/30/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Timely identification of colorectal cancer (CRC) survivors at risk of experiencing low health-related quality of life (HRQoL) in the near future is important for enabling appropriately tailored preventive actions. We previously developed and internally validated risk prediction models to estimate the 1-year risk of low HRQoL in long-term CRC survivors. In this article, we aim to externally validate and update these models in a population of short-term CRC survivors. STUDY DESIGN AND SETTING In a pooled cohort of 1,596 CRC survivors, seven HRQoL domains (global QoL, cognitive/emotional/physical/role/social functioning, and fatigue) were measured prospectively at approximately 5 months postdiagnosis (baseline for prediction) and approximately 1 year later by a validated patient-reported outcome measure (European Organization for Research and Treatment of Cancer Quality of life Questionnaire-Core 30). For each HRQoL domain, 1-year scores were dichotomized into low vs. normal/high HRQoL. Performance of the previously developed multivariable logistic prediction models was evaluated (calibration and discrimination). Models were updated to create a more parsimonious predictor set for all HRQoL domains. RESULTS Updated models showed good calibration and discrimination (AUC ≥0.75), containing a single set of 15 predictors, including nonmodifiable (age, sex, education, time since diagnosis, chemotherapy, radiotherapy, stoma, and comorbidities) and modifiable predictors (body mass index, physical activity, smoking, anxiety/depression, and baseline fatigue and HRQoL domain scores). CONCLUSION Externally validated and updated prediction models performed well for estimating the 1-year risk of low HRQoL in CRC survivors within 6 months postdiagnosis. The impact of implementing the models in oncology practice to improve HRQoL outcomes in CRC survivors needs to be evaluated.
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Affiliation(s)
- Dóra Révész
- Department of Epidemiology, GROW - School for Oncology and Reproduction, Maastricht University, P. Debyeplein 1, 6200 MD Maastricht, The Netherlands
| | - Sander M J van Kuijk
- Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre+, P. Debyelaan 25, PO Box 5800, Maastricht 6202 AZ, The Netherlands
| | - Floortje Mols
- CoRPS - Center of Research on Psychology in Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, Warandelaan 2, 5037 AB Tilburg, The Netherlands; Netherlands Comprehensive Cancer Organisation (IKNL), Godebaldkwartier 419, 3511 DT Utrecht, The Netherlands
| | - Fränzel J B van Duijnhoven
- Division of Human Nutrition, Wageningen University & Research, Stippeneng 4, 6708 WE Wageningen, The Netherlands
| | - Renate M Winkels
- Division of Human Nutrition, Wageningen University & Research, Stippeneng 4, 6708 WE Wageningen, The Netherlands
| | - IJmert Kant
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, P. Debyeplein 1, 6200 MD Maastricht, The Netherlands
| | - Piet A van den Brandt
- Department of Epidemiology, GROW - School for Oncology and Reproduction, Maastricht University, P. Debyeplein 1, 6200 MD Maastricht, The Netherlands; Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, P. Debyeplein 1, 6200 MD Maastricht, The Netherlands
| | - Luc J Smits
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, P. Debyeplein 1, 6200 MD Maastricht, The Netherlands
| | - Stéphanie O Breukink
- Department of Surgery, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands
| | - Ellen Kampman
- Division of Human Nutrition, Wageningen University & Research, Stippeneng 4, 6708 WE Wageningen, The Netherlands
| | - Sandra Beijer
- Netherlands Comprehensive Cancer Organisation (IKNL), Godebaldkwartier 419, 3511 DT Utrecht, The Netherlands
| | - Matty P Weijenberg
- Department of Epidemiology, GROW - School for Oncology and Reproduction, Maastricht University, P. Debyeplein 1, 6200 MD Maastricht, The Netherlands
| | - Martijn J L Bours
- Department of Epidemiology, GROW - School for Oncology and Reproduction, Maastricht University, P. Debyeplein 1, 6200 MD Maastricht, The Netherlands.
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11
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Belcher BR, Kang DW, Yunker AG, Dieli-Conwright CM. Interventions to Reduce Sedentary Behavior in Cancer Patients and Survivors: a Systematic Review. Curr Oncol Rep 2022; 24:1593-1605. [PMID: 35829982 DOI: 10.1007/s11912-022-01313-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2022] [Indexed: 01/27/2023]
Abstract
PURPOSE OF REVIEW Sedentary behaviors (SB) after cancer diagnosis are associated with poor prognosis for certain cancers, and cancer patients and survivors report high levels of SB. Reducing SB may be a feasible and effective intervention strategy to improve outcomes. This systematic review aims to identify and evaluate the literature on interventions to reduce SB in cancer patients and survivors. RECENT FINDINGS Studies were identified via database searches in December 2020. Two authors evaluated study eligibility. Data were extracted and checked, and risk of bias was assessed by the study team. Of 1401 records identified, nine studies involving 394 cancer patients or survivors were included in this review. Six were randomized trials, three were non-randomized intervention studies, and almost all (n = 8) focused on feasibility with small sample sizes. All studies were conducted within the previous 5 years in Canada, Australia, USA, and South Korea. Cancer types studied were breast (n = 3), prostate (n = 2), colorectal or peritoneal (n = 1), and mixed types (n = 3). Intervention duration of 12 weeks was most common (n = 7). Five studies had multiple intervention components, and six studies included wearable devices to measure and/or prompt behavior change. There was an overall trend where intervention groups reduced SB vs. control groups, often coupled with an increase in moderate-to-vigorous physical activity. This review suggests that there is some promise for intervention strategies to reduce SB in cancer patients and survivors. There is a need for more high-quality randomized controlled trials to understand how to best decrease SB in cancer patients and survivors.
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Affiliation(s)
- Britni R Belcher
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Dong-Woo Kang
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, 375 Longwood Avenue, MB, Boston, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Alexandra G Yunker
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, 375 Longwood Avenue, MB, Boston, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Christina M Dieli-Conwright
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, 375 Longwood Avenue, MB, Boston, USA.
- Department of Medicine, Harvard Medical School, Boston, MA, USA.
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12
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Amirsasan R, Akbarzadeh M, Akbarzadeh S. Exercise and colorectal cancer: prevention and molecular mechanisms. Cancer Cell Int 2022; 22:247. [PMID: 35945569 PMCID: PMC9361674 DOI: 10.1186/s12935-022-02670-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 08/02/2022] [Indexed: 12/16/2022] Open
Abstract
Exercise and physical activity have been shown to be strongly associated with a decreased incidence rate of various chronic diseases especially numerous human malignancies. A huge number of clinical trials and meta-analysis have demonstrated that exercise is significantly effective in lowering the risk of colorectal cancer. In addition, it is suggested as an effective therapeutic modality against this cancer type. Therefore, in this review, we will review comprehensibly the effects of exercise in preventing, treating, and alleviating the adverse effects of conventional therapeutic options in colorectal cancer. Moreover, the possible mechanisms underlying the positive effects of exercise and physical activity in colorectal cancer, including regulation of inflammation, apoptosis, growth factor axis, immunity, epigenetic, etc. will be also discussed.
Exercise is an effective post-treatment management program in colorectal cancer survivals Exercise improves muscle strength, cardiorespiratory fitness, emotional distress, physical activity, fatigue, and sleep quality in colorectal patients undergoing chemotherapy Targeting and modulating insulin-like growth factor (IGF) system, inflammation, apoptosis, immunity, epigenetic, Leptin and Ghrelin, and signaling pathways are major underlying mechanisms for preventive effects of exercise in colorectal cancer
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Affiliation(s)
- Ramin Amirsasan
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, University of Tabriz, Tabriz, Iran
| | - Maryam Akbarzadeh
- Department of Biology, Faculty of Natural Sciences, University of Tabriz, Tabriz, Iran
| | - Shabnam Akbarzadeh
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, University of Tabriz, Tabriz, Iran.
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13
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Physical activity time and lifestyle correlates of cardiovascular disease status in older adults in Accra. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-022-01712-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Abstract
Aim
The maintenance of physical activity (PA) over the life course is considered a hallmark for ageing well, but individuals who practice PA also often pursue lifestyles (e.g., smoking) that may inhibit the medicinal impact of PA on them. PA is said to protect against cardiovascular diseases (CVDs), but the literature has little to say about the impact of PA on the risk of CVDs when it is associated with lifestyle factors, comorbidities, and personal characteristics. This study aimed to assess the association between PA time and CVDs, with relevant lifestyle factors, comorbidities, and personal characteristics treated as covariates.
Subject and methods
The study’s population was retired and working older people aged 60 years or more in Accra, Ghana. A total of 686 individuals responded to self-reported questionnaires. Pearson’s chi-square test and binary logistic regression were used to present findings.
Results
The study found that the risk of having one or more CVDs increases as time spent in moderate and vigorous PA increases, whereas individuals who drank alcohol a few days a week or most days a week are respectively 2 (OR = 2.415; p = 0.037) and 22 (OR = 21.933; p = 0.000) times more likely to have one or more CVDs compared to those who never drank alcohol.
Conclusion
Health education should not only encourage PA maintenance but should also make individuals aware of the need to avoid unhealthy behaviours to maximize the positive effect of PA on health.
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14
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Yu YQ, Ma L, Wang WJ, Zhao YQ, Xu HF, Cao J, Li L, Hao JQ, Gao JR, Gu XF, Liu YY, Huang JX, Fan YP, Du LB, Cao HL, Feng CY, Zhu Q, Wang XH, Du JC, Bangura MS, Zhang X, Zhang SK, Qiao YL. Health-related quality of life in advanced colorectal cancer patients in China: a nationwide hospital-based survey. ANNALS OF TRANSLATIONAL MEDICINE 2022; 10:328. [PMID: 35433947 PMCID: PMC9011208 DOI: 10.21037/atm-22-991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 03/18/2022] [Indexed: 11/06/2022]
Abstract
Background Colorectal cancer (CRC) is one of the most common cancers in China, and most CRC patients have already reached an advanced stage by the time of initial diagnosis. Due to the loss of health as a result of cancer, it has consequence on the treatment which may affect the psychophysical and social impairment of CRC patients. These indicators (psychophysical, function and social impairment) affect the health-related quality of life (HRQOL). There are limited studies that focus on advanced CRC patients in China. This study aimed to assess the HRQOL and its associated factors of advanced CRC patients in China. Methods This was a cross-sectional, nationwide, hospital-based, and multi-center survey. According to the traditional administrative district definition, we selected 19 hospitals in 7 regions by multi-stage stratified sampling in China. For each eligible CRC patient with stage III or IV in the selected hospitals, socio-demographics, clinical information, and HRQOL were collected based on patients’ self-reporting and/or medical records between March 2020 and March 2021. Patients completed the Functional Assessment of Cancer Therapy Colorectal (FACT-C) plus-traditional Chinese version of the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ)-9. Results A total of 4,589 CRC patients (mean age 60.1 years, including 2,730 males and 1,859 females) were included. The total score of HRQOL in population was 128.2±24.70. There were significant differences in the overall score of HRQOL in gender, education level, occupation, region, disease type, and disease stage (P<0.05). The score of HRQOL was better in males, undergraduates and above, unemployed/laid-off, and southwestern and central China. Multivariate analysis showed that education level, occupation, location, number of hospitals visited and treatment methods, and gender were associated with utilities of CRC patients. Conclusions The HRQOL is an important outcome measure for CRC patients. The HRQOL scores differed according to socio-demographic and clinical characteristics, and findings of these factors were associated with education level, occupation, region, number of visited and treatment methods, and gender.
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Affiliation(s)
- Yan-Qin Yu
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,The Clinical Epidemiology of Research Center, Department of Public Health and Preventive Medicine, Baotou Medical College, Baotou, China
| | - Li Ma
- Public Health School, Dalian Medical University, Dalian, China
| | - Wen-Jun Wang
- School of Nursing, Jining Medical University, Jining, China
| | - Yu-Qian Zhao
- Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Hui-Fang Xu
- Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, China
| | - Ji Cao
- Department of Cancer Prevention and Control Office, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Li Li
- Department of Clinical Research, The First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Jin-Qi Hao
- The Clinical Epidemiology of Research Center, Department of Public Health and Preventive Medicine, Baotou Medical College, Baotou, China
| | - Jing-Ru Gao
- The Clinical Epidemiology of Research Center, Department of Public Health and Preventive Medicine, Baotou Medical College, Baotou, China
| | - Xiao-Fen Gu
- Department of Student Affairs, Affiliated Tumor Hospital, Xinjiang Medical University, Ürümqi, China
| | - Yun-Yong Liu
- Liaoning Office for Cancer Control and Research, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, China
| | - Juan-Xiu Huang
- Department of Gastroenterology, Wuzhou Red Cross Hospital, Wuzhou, China
| | - Yan-Ping Fan
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Ling-Bin Du
- Department of Cancer Prevention, The Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, China
| | - He-Lu Cao
- Department of Preventive Health, Xinxiang Central Hospital, Xinxiang, China
| | - Chang-Yan Feng
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, China
| | - Qian Zhu
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Xiao-Hui Wang
- Department of Public Health, Gansu Provincial Cancer Hospital, Lanzhou, China
| | - Jing-Chang Du
- School of Public Health, Chengdu Medical College, Chengdu, China
| | | | - Xi Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing, China
| | - Shao-Kai Zhang
- Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, China
| | - You-Lin Qiao
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, Henan International Joint Laboratory of Cancer Prevention, Zhengzhou, China.,Center for Global Health, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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15
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de Abreu JM, de Souza RA, Viana-Meireles LG, Landeira-Fernandez J, Filgueiras A. Effects of physical activity and exercise on well-being in the context of the Covid-19 pandemic. PLoS One 2022; 17:e0260465. [PMID: 35081122 PMCID: PMC8791524 DOI: 10.1371/journal.pone.0260465] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 11/10/2021] [Indexed: 12/15/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) was discovered in China and characterized by the World Health Organization as a pandemic in March 2020. Many countries worldwide implemented stringent social isolation as a strategy to contain virus transmission. However, the same physical distancing that protects against the spread of COVID-19 may negatively impact mental health and well-being of the population. The present study sought to shed light on this phenomenon by assessing the relationship between physical activity and subjective well-being (SWB) among individuals who were subjected to social isolation during the COVID-19 pandemic. Data were collected in Brazil between March 31 and April 2, 2020. All of the volunteers agreed to participate by digitally checking the option of agreement after reading consent terms. The inclusion criteria were participants who had been in social isolation for at least 1 week and agreed to the consent terms. Three instruments were applied. A questionnaire was constructed for this study that assessed the participants’ exercise routines. The Psychosocial Aspects, Well-being, and Exercise in Confinement (PAWEC) scale was created by researchers of this study that assessed the relationship between well-being and physical activity during social isolation. The Brazilian Portuguese-adapted version of the Positive and Negative Affect Schedule (PANAS) was also used. A total of 592 participants (371 female, 220 male, 1 transgender), 14–74 years old (M = 32.39 years, SD = 10.5 years), reported being in social isolation for an average of 14.4 days (SD = 3.3 days). Well-being that was related to the practice of physical activity during quarantine was linked to an established routine of physical activity before the social isolation period. Participants who already practiced physical exercises previously and reported continuing the practice during the quarantine period had higher positive affect scores. Participants who engaged in physical activity without direct guidance only during the quarantine period had higher negative affect scores. Participants who already practiced physical activity felt more motivated to continue practicing physical activity during the social isolation period, resulting in positive affect, unlike participants who began exercising only during quarantine. Our results suggest that negative affect can occur among individuals who only just begin exercising during social isolation, indicating that physical activity should be habitual and not only occur during periods of social isolation. Engaging in exercise only during social isolation may contribute to an increase in malaise.
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Affiliation(s)
| | | | | | - J. Landeira-Fernandez
- Departamento de Psicologia, Pontifícia Universidade Católica do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Alberto Filgueiras
- Departamento de Cognição e Desenvolvimento, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
- * E-mail:
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16
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Ng SM, Fung MHY, Chan JSM, Chan CHY, Chan CLW. Physical activity, confidence and quality of life among cancer patient-carer dyads. SPORTS MEDICINE-OPEN 2021; 7:46. [PMID: 34196850 PMCID: PMC8249531 DOI: 10.1186/s40798-021-00333-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 06/01/2021] [Indexed: 01/09/2023]
Abstract
Background Physical activity (PA) has been positively associated with health-related quality of life (HRQoL) among cancer patients and family caregivers. However, there has been no relevant research for patient-caregiver dyads. Methods Path analysis, based on the actor–partner interdependence model (APIM), was used to examine the relationship between physical activity and health-related quality of life and explore the mediating role of emotional distress in 233 dyads. Results In both patients and caregivers, physical activity had a direct positive effect on physical quality of life (QoL) but not on mental. There was a significant indirect effect of physical activity on health-related quality of life via emotional distress for both dyad members. Patients’ and caregivers’ confidence in fighting cancer was negatively associated with their own emotional distress. Caregivers’ confidence in fighting cancer was positively associated with their physical activity and also negatively associated with patients’ emotional distress. Conclusions Physical activity may be considered as a possible behavioral and rehabilitation strategy for improving health-related quality of life in patient-caregiver dyads and reducing negative symptoms. Future research and intervention may consider cancer patient-family caregiver dyad as a unit of care.
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Affiliation(s)
- Siu-Man Ng
- Department of Social Work and Social Administration, The University of Hong Kong, 5/F, Jockey Club Tower, The Centennial Campus, Pokfulam, Hong Kong, China. .,Centre on Behavioral Health, The University of Hong Kong, Pokfulam, Hong Kong, China.
| | - Melody H Y Fung
- Department of Social Work and Social Administration, The University of Hong Kong, 5/F, Jockey Club Tower, The Centennial Campus, Pokfulam, Hong Kong, China.
| | - Jessie S M Chan
- School of Chinese Medicine, Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China.
| | - Celia H Y Chan
- Department of Social Work and Social Administration, The University of Hong Kong, 5/F, Jockey Club Tower, The Centennial Campus, Pokfulam, Hong Kong, China
| | - Cecilia L W Chan
- Department of Social Work and Social Administration, The University of Hong Kong, 5/F, Jockey Club Tower, The Centennial Campus, Pokfulam, Hong Kong, China.,Centre on Behavioral Health, The University of Hong Kong, Pokfulam, Hong Kong, China
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17
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De La Torre S, Spruijt-Metz D, Farias AJ. Associations Among Wearable Activity Tracker Use, Exercise Motivation, and Physical Activity in a Cohort of Cancer Survivors: Secondary Data Analysis of the Health Information National Trends Survey. JMIR Cancer 2021; 7:e24828. [PMID: 33843595 PMCID: PMC8076994 DOI: 10.2196/24828] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 01/17/2021] [Accepted: 02/23/2021] [Indexed: 12/13/2022] Open
Abstract
Background Cancer survivors who meet physical activity (PA) recommendations (≥150 minutes of moderate-to-vigorous physical activity [MVPA] per week) experience better health outcomes. With the growing availability of wearable activity trackers (WATs), it may be easier to track PA. However, it is unknown what motivates survivors to use these devices. Objective The aim of this study is to investigate the associations among motivations for exercise, previous WAT use for tracking a health goal or activity, and meeting the recommended amount of PA among a cohort of cancer survivors. Methods Data on WAT users who reported having a previous cancer diagnosis were analyzed from the National Cancer Institute’s Health Information National Trends Survey 5 Cycle 3. All survivors with complete information on demographics, exercise motivations (internal guilt, external pressure, physical appearance, and exercise enjoyment), previous WAT use (yes or no), and minutes of MVPA per week (N=608) were included. Multivariate logistic regression models were used to test these associations. A separate cluster analysis was conducted to identify the profiles of exercise motivation that were associated with reporting WAT use. Results The mean age of the cohort was 66.9 years (SD 12.1). The majority were non-Hispanic White (473/608, 78.8%) and female (322/608, 54.9%), and skin cancer was the most commonly reported diagnosed cancer (154/608, 27.8%). Survivors who reported using WATs to track a health goal or activity were 1.6 times more likely to meet MVPA recommendations than those who did not use WATs (odds ratio [OR] 1.65, 95% CI 1.03-2.65; P=.04). When exercise motivations were assessed independently, survivors who reported not feeling any internal guilt as an exercise motivation were 73% less likely to report having used a WAT than those who felt any internal guilt (OR 0.27, 95% CI 0.14-0.54; P<.001). A total of 3 distinct motivational profiles emerged from the cluster analysis. WAT users had an increased probability of membership in profile 3, which was characterized as being strongly motivated to exercise by internal guilt, physical appearance, and exercise enjoyment (OR 4.5, 95% CI 2.1-9.7; P<.001). Conclusions Among this cohort, survivors who reported using WATs to track a health goal or activity were significantly more likely to report meeting PA recommendations. Survivors who reported feeling internal guilt as an exercise motivation were significantly more likely to report using WATs to track a health goal or activity. When examining clusters of motivation, survivors who reported previous WAT use were more likely to report being motivated to exercise by a mix of intrinsic and extrinsic motivations, including internal guilt, exercise enjoyment, and physical appearance. Given the health benefits of PA for cancer survivors, technology-focused interventions that use WATs and target exercise motivation may aid in cancer survivors meeting the level of recommended PA.
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Affiliation(s)
- Steven De La Torre
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Donna Spruijt-Metz
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States.,Dornsife Center for Economic and Social Research, University of Southern California, Los Angeles, CA, United States.,Department of Psychology, University of Southern California, Los Angeles, CA, United States
| | - Albert J Farias
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States.,Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
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18
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Leisure and Productivity in Older Adults with Cancer: A Systematic Review. Occup Ther Int 2021; 2021:8886193. [PMID: 33880113 PMCID: PMC8041549 DOI: 10.1155/2021/8886193] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 03/13/2021] [Accepted: 03/20/2021] [Indexed: 01/11/2023] Open
Abstract
Introduction Self-care, leisure, and productivity are important occupational domains for older adults' quality of life, which might be affected by cancer and its treatment. A great number of publications about older adults focus on function or self-care, so we aimed to analyse how cancer and its treatments affect leisure and productivity. Secondary objectives were to identify whether particular clinical and/or sociodemographic factors were associated with occupational disruptions and to assess the impact of rehabilitation approaches on leisure and productivity in this population. Methods A systematic review of the 2009-2019 literature performed on Medline, Embase, and the Cochrane Central Register of Controlled Trials. Results 1471 publications were retrieved: 48 full texts were assessed; seven of these (four cross-sectional studies, two cohort studies, and a case report) were reviewed, including data on 16668 people (12649 healthy controls, 3918 cancer survivors, and 101 ill patients). Older adults with comorbidities and a low level of activity before cancer diagnosis may be more at risk of occupational disruptions. However, studies focused more on physical activity than leisure and productivity. Two studies mentioned occupational therapy. Discussion. As cancer can become a chronic disease, it appears important to also offer occupation-centred assessments and follow-up. Conclusion An occupation-centred approach could be developed; its effectiveness must be assessed.
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19
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Berkovic MC, Cigrovski V, Bilic-Curcic I, Mrzljak A. What is the gut feeling telling us about physical activity in colorectal carcinogenesis? World J Clin Cases 2020. [DOI: 10.12998/wjcc.v8.i23.5843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
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20
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Berkovic MC, Cigrovski V, Bilic-Curcic I, Mrzljak A. What is the gut feeling telling us about physical activity in colorectal carcinogenesis? World J Clin Cases 2020; 8:5844-5851. [PMID: 33344583 PMCID: PMC7723696 DOI: 10.12998/wjcc.v8.i23.5844] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 09/28/2020] [Accepted: 10/20/2020] [Indexed: 02/05/2023] Open
Abstract
In the last decades, more efforts are focused on the prevention and treatment of malignant diseases, given the increase in all cancers incidence A lifestyle change, including healthy eating habits and regular physical activity, has significantly impacted colorectal cancer prevention. The effect of dose-dependent physical activity on mortality and recurrence rates of colorectal carcinoma has been unequivocally demonstrated in observational studies. However, clear recommendations are not available on the frequency, duration, and intensity of exercise in patients with colorectal cancer due to the lack of evidence in randomized clinical trials. Regarding pathophysiological mechanisms, the most plausible explanation appears to be the influence of physical activity on reducing chronic inflammation and insulin resistance with a consequent positive effect on insulin growth factor 1 signaling pathways.
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Affiliation(s)
- Maja Cigrovski Berkovic
- Department for Endocrinology, Diabetes and Metabolism, Clinical Hospital Dubrava, Zagreb 10000, Croatia
- Faculty of Kinesiology, University of Zagreb, Zagreb 10000, Croatia
| | | | - Ines Bilic-Curcic
- Department of Pharmacology, Faculty of Medicine, J J Strossmayer University Osijek, Osijek 31000, Croatia
| | - Anna Mrzljak
- Department of Medicine, Merkur University Hospital, Zagreb 10000, Croatia
- Department of Medicine, School of Medicine, University of Zagreb, Zagreb 10000, Croatia
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21
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Correlates of Physical Activity in Colorectal Cancer Patients Based on Health Promotion Model. Cancer Nurs 2020; 43:E264-E272. [PMID: 32813487 DOI: 10.1097/ncc.0000000000000725] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Increasing attention is being given to physical activity in colorectal cancer patients. Some studies have explored a few correlates of physical activity separately. A contemporary study based on the Health Promotion Model may systematically broaden the understanding of physical activity in colorectal cancer patients. OBJECTIVE To understand the status of physical activity in Chinese colorectal cancer patients and to explore the correlated factors. METHODS A total of 168 adults with colorectal cancer were recruited at 3 tertiary hospitals in China. Participant data were collected on demographics, physical activity, biological factors, anxiety and depression, benefits/barriers to physical activity, self-efficacy, and social support. SAS 8.2 was used for statistical analysis, including descriptive analysis, correlation analysis, single factor analysis, and multiple stepwise regression analysis. RESULTS Only 25.60% of colorectal cancer survivors reached the requirements of the Colorectal Cancer Survivorship Care Guidelines. Employment states, number of complications, fatigue, body image, depression, perception of benefits/barriers, and self-efficacy were closely correlated with physical activity in Chinese colorectal cancer patients. CONCLUSIONS The physical activity status of patients with colorectal cancer is not optimal. The correlated factors that nurses can take measures to improve are fatigue, body image, depression, perception of benefits/barriers, and self-efficacy, which may improve physical activity in colorectal cancer patients in China. Additional research is needed to determine if improving factors correlated with physical activity will assist with directly increasing physical activity. IMPLICATIONS FOR PRACTICE Nurses should evaluate physical activity of colorectal cancer patients timely and play an active role in health promotion programs to improve colorectal cancer patients' physical activity.
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22
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van Roekel EH, Duchâteau J, Bours MJL, van Delden L, Breedveld-Peters JJL, Koole JL, Kenkhuis M, van den Brandt PA, Jansen RL, Kant I, Lima Passos V, Meijer K, Breukink SO, Janssen-Heijnen MLG, Keulen E, Weijenberg MP. Longitudinal associations of light-intensity physical activity with quality of life, functioning and fatigue after colorectal cancer. Qual Life Res 2020; 29:2987-2998. [PMID: 32617891 PMCID: PMC7591443 DOI: 10.1007/s11136-020-02566-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2020] [Indexed: 11/26/2022]
Abstract
Purpose Evidence from cross-sectional studies suggests that higher levels of light-intensity physical activity (LPA) are associated with better health-related quality of life (HRQoL) in colorectal cancer (CRC) survivors. However, these associations have not been investigated in longitudinal studies that provide the opportunity to analyse how within-individual changes in LPA affect HRQoL. We investigated longitudinal associations of LPA with HRQoL outcomes in CRC survivors, from 6 weeks to 2 years post-treatment. Methods Data were used of a prospective cohort study among 325 stage I–III CRC survivors (67% men, mean age: 67 years), recruited between 2012 and 2016. Validated questionnaires were used to assess hours/week of LPA (SQUASH) and HRQoL outcomes (EORTC QLQ-C30, Checklist Individual Strength) at 6 weeks, and 6, 12 and 24 months post-treatment. We applied linear mixed regression to analyse longitudinal confounder-adjusted associations of LPA with HRQoL. Results We observed statistically significant longitudinal associations between more LPA and better global quality of life and physical, role and social functioning, and less fatigue over time. Intra-individual analysis showed that within-person increases in LPA (per 8 h/week) were related to improved HRQoL, including better global quality of life (β = 1.67, 95% CI 0.71; 2.63; total range scale: 0–100) and less fatigue (β = − 1.22, 95% CI − 2.37; − 0.07; scale: 20–140). Stratified analyses indicated stronger associations among participants below the median of moderate-to-vigorous physical activity (MVPA) at diagnosis. Conclusion Higher levels of LPA were longitudinally associated with better HRQoL and less fatigue in CRC survivors up to two years post-treatment. Further prospective studies using accelerometer data are necessary to inform development of interventions targeting LPA. Electronic supplementary material The online version of this article (10.1007/s11136-020-02566-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- E H van Roekel
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
| | - J Duchâteau
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - M J L Bours
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - L van Delden
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - J J L Breedveld-Peters
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - J L Koole
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - M Kenkhuis
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - P A van den Brandt
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - R L Jansen
- Department of Medical Oncology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - I Kant
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - V Lima Passos
- Department of Methodology and Statistics, Maastricht University, Maastricht, The Netherlands
| | - K Meijer
- Department of Human Movement Science, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - S O Breukink
- Department of Surgery, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - M L G Janssen-Heijnen
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
- Department of Clinical Epidemiology, VieCuri Medical Center, Venlo, The Netherlands
| | - E Keulen
- Department of Internal Medicine and Gastroenterology, Zuyderland Medical Centre, Sittard-Geleen, The Netherlands
| | - M P Weijenberg
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
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23
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Eyl RE, Thong MSY, Carr PR, Jansen L, Koch-Gallenkamp L, Hoffmeister M, Chang-Claude J, Brenner H, Arndt V. Physical activity and long-term fatigue among colorectal cancer survivors - a population-based prospective study. BMC Cancer 2020; 20:438. [PMID: 32423448 PMCID: PMC7236466 DOI: 10.1186/s12885-020-06918-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 04/30/2020] [Indexed: 12/31/2022] Open
Abstract
Background Evidence suggests that physical activity (PA) is beneficial for reducing fatigue in colorectal cancer (CRC) survivors. However, little is known regarding long-term effects of PA on fatigue and whether pre-diagnosis PA is associated with less fatigue in the years after diagnosis. Our study aimed to investigate the association of pre- and post-diagnosis PA with long-term fatigue in CRC survivors. Methods This study used a German population-based cohort of 1781 individuals, diagnosed with CRC in 2003–2014, and alive at five-year follow-up (5YFU). Physical activity was assessed at diagnosis and at 5YFU. Fatigue was assessed by the Fatigue Assessment Questionnaire and the EORTC Quality of Life Questionnaire-Core 30 fatigue subscale at 5YFU. Multivariable linear regression was used to explore associations between pre- and post-diagnosis PA and fatigue at 5YFU. Results No evidence was found that pre-diagnosis PA was associated with less fatigue in long-term CRC survivors. Pre-diagnosis work-related PA and vigorous PA were even associated with higher levels of physical (Beta (ß) = 2.52, 95% confidence interval (CI) = 1.14–3.90; ß = 2.03, CI = 0.65–3.41), cognitive (ß = 0.17, CI = 0.05–0.28; ß = 0.13, CI = 0.01–0.25), and affective fatigue (ß = 0.26, CI = 0.07–0.46; ß = 0.21, CI = 0.02–0.40). In cross-sectional analyses, post-diagnosis PA was strongly associated with lower fatigue on all scales. Conclusions In this study, pre-diagnosis PA does not appear to be associated with less fatigue among long-term CRC survivors. Our results support the importance of ongoing PA in long-term CRC survivors. Our findings might be used as a basis for further research on specific PA interventions to improve the long-term outcome of CRC survivors.
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Affiliation(s)
- Ruth Elisa Eyl
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany
| | - Melissa S Y Thong
- Unit of Cancer Survivorship, Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany
| | - Prudence R Carr
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany
| | - Lina Jansen
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany
| | - Lena Koch-Gallenkamp
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany
| | - Michael Hoffmeister
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany
| | - Jenny Chang-Claude
- Unit of Genetic Epidemiology, Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany.,Cancer Epidemiology Group, University Cancer Center Hamburg (UCCH), University Medical Center Hamburg-Eppendorf, Martinistraße 54, 20251, Hamburg, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany.,Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany.,German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - Volker Arndt
- Unit of Cancer Survivorship, Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany.
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24
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Park JH, Lee DH, Kim SI, Kim NK, Jeon JY. Moderate to vigorous physical activity participation associated with better quality of life among breast and colorectal cancer survivors in Korea. BMC Cancer 2020; 20:365. [PMID: 32357850 PMCID: PMC7193341 DOI: 10.1186/s12885-020-06819-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 04/02/2020] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND To investigate the association between physical activity (PA) and quality of life (QoL) among breast and colorectal cancer survivors in Korea. METHODS A total of 224 cancer survivors (151 breast and 73 colorectal cancers) who completed treatments were recruited. We measured PA level with Godin Leisure-Time Exercise Questionnaire and QoL with European Organization for Research and Treatment of Cancer (EORTC) QLQ C-30. RESULTS Moderate to vigorous PA was significantly correlated with global QoL (r = .311, p < 0.01), physical functioning (r = .231, p < 0.01), fatigue (r = -.176, p < 0.05), pain (r = -.154, p < 0.05), and dyspnea (r = -.221, p < 0.01) while no correlation was found between light PA and QoL after controlling for potential confounders. When we further divided our participants into four groups by total PA level, we found a strong linear dose-response relationship between higher total PA and better QoL outcomes (p < .001). Compared with participants in the lowest quartile, those in the highest quartile had significantly better score in global QoL (65.8 ± 2.7 vs. 77.6 ± 2.8, p = 0.003), physical functioning (67.2 ± 2.3 vs. 85.3 ± 2.4, p = 0.007), fatigue (35.9 ± 3.2 vs. 23.6 ± 3.2, p = 0.008), pain (22.7 ± 3.3 vs. 13.0 ± 3.4, p = 0.046), and dyspnea (13.7 ± 2.5 vs. 5.9 ± 2.6, p = 0.034). CONCLUSIONS Higher PA level was associated with better QoL among breast and colorectal cancer survivors in Korea. Increasing PA levels should be included as one of important strategies to improve QoL in cancer survivors.
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Affiliation(s)
- Ji-Hye Park
- Department of Sport Industry Studies, Yonsei University, 50 Yonsei-ro, Seodaemun-Gu, Seoul, South Korea
- Frontier research institute of Convergence Sports Science, Yonsei University, Seoul, South Korea
| | - Dong Hoon Lee
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Seung Il Kim
- Department of Surgery, Yonsei University College of Medicine, Yonsei University, 50 Yonsei-ro, Seodaemun-Gu, Seoul, South Korea.
| | - Nam Kyu Kim
- Department of Surgery, Yonsei University College of Medicine, Yonsei University, 50 Yonsei-ro, Seodaemun-Gu, Seoul, South Korea
| | - Justin Y Jeon
- Department of Sport Industry Studies, Yonsei University, 50 Yonsei-ro, Seodaemun-Gu, Seoul, South Korea.
- Frontier research institute of Convergence Sports Science, Yonsei University, Seoul, South Korea.
- Cancer Prevention Center, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea.
- The Institute of Convergence Science, Yonsei University, Seoul, South Korea.
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25
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Eyl RE, Koch-Gallenkamp L, Jansen L, Walter V, Carr PR, Hoffmeister M, Chang-Claude J, Brenner H, Arndt V. Physical Activity and Long-term Quality of Life among Colorectal Cancer Survivors-A Population-based Prospective Study. Cancer Prev Res (Phila) 2020; 13:611-622. [PMID: 32253267 DOI: 10.1158/1940-6207.capr-19-0377] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 12/23/2019] [Accepted: 03/30/2020] [Indexed: 12/24/2022]
Abstract
Evidence suggests that physical activity (PA) is positively associated with (health-related) quality of life (QOL) in colorectal cancer survivors. However, little is known regarding long-term effects of PA on QOL and if prediagnosis PA is associated with QOL in the years after diagnosis. Our study aimed to investigate the association of prediagnosis and postdiagnosis PA with long-term QOL in colorectal cancer survivors.This study is based on a population-based cohort from Germany of 1,781 newly diagnosed colorectal cancer survivors over a 5-year period. PA was assessed at diagnosis and at 5-year follow-up (5YFU). Quality of life was assessed by the European Organisation for Research and Treatment of Cancer C Quality of Life Questionnaire QLQ-C30 at 5YFU. Multivariable linear regression was used to explore associations between prediagnosis and postdiagnosis PA and QOL at 5YFU.No evidence of a positive association between higher levels of prediagnosis PA and better long-term QOL was found. Higher levels of prediagnosis work-related PA and vigorous PA were even associated with decreased QOL in domains such as cognitive [Beta(β) = -2.52, 95% confidence interval (CI) = -3.77, -1.27; β = -1.92, CI = -3.17, -0.67) and emotional functioning (β = -2.52, CI = -3.84, -1.19; β = -2.12, CI = -3.44, -0.80). In cross-sectional analyses, higher postdiagnosis PA was strongly associated with higher QOL. Survivors physically active at both prediagnosis and postdiagnosis as well as survivors who increased their PA between prediagnosis and postdiagnosis reported significantly higher long-term QOL compared with survivors who remained inactive at prediagnosis and postdiagnosis. In this study, higher prediagnosis PA does not appear to be associated with higher QOL among long-term colorectal cancer survivors but our results support the importance of ongoing PA throughout survivorship.
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Affiliation(s)
- Ruth Elisa Eyl
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Medical Faculty Heidelberg, University of Heidelberg, Heidelberg, Germany
| | - Lena Koch-Gallenkamp
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Lina Jansen
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Viola Walter
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Prudence R Carr
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Michael Hoffmeister
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jenny Chang-Claude
- Unit of Genetic Epidemiology, Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany.,German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Volker Arndt
- Unit of Cancer Survivorship, Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.
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Kim J, Kim J, Han A. The impact of leisure time physical activity on mental health and health perception among people with cancer. Health Promot Perspect 2020; 10:116-122. [PMID: 32296623 PMCID: PMC7146045 DOI: 10.34172/hpp.2020.19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 02/29/2020] [Indexed: 01/04/2023] Open
Abstract
Background: People with cancer often report high levels of negative psychological symptoms and poor perception of health due to cancer treatment and activity limitations. Prior studies have suggested that participation in leisure time physical activity (LTPA) can reduce negative psychological symptoms and improve health perception. However, a few studies have examined the contribution of LTPA to health benefits among people with cancer. Thus, we aimed to examine how a different level of LTPA engagement contributed to mental health and health perceptions among people with cancer. Methods: Using the 2017 Health Information National Trends Survey (HINTS) data, cross sectional data of 504 respondents diagnosed with any types of 22 cancers listed in the survey questionnaire were analyzed. A multivariate analysis of variance (MANOVA) was used to test for mean differences in mental health and health perception among the three different LTPA groups(i.e., inactive, moderately active, and vigorously active groups). Results: Results indicated that people with cancer who reported higher levels of LTPA scored higher on mental health and health perception than those with lower levels of LTPA (Pillai’s trace= 0.060, F (4,944) = 15.06, P < 0.001). Conclusion: This finding suggests that individuals with cancer gained more health benefits through high engagement in LTPA. Moreover, we suggested that LTPA can be used as an important therapeutic intervention to promote health quality and wellbeing among people with cancer. Implications for practical suggestions are further discussed.
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Affiliation(s)
- Jaehyun Kim
- Department of Health and Human Performance, Texas State University, San Marcos, TX, USA
| | - Junhyoung Kim
- School of Public Health, Indiana University, Bloomington, IN, USA
| | - Areum Han
- Department of Physical Education, Dongduk Women's University, Seoul, South Korea
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27
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Martin D, Romain B, Pache B, Vuagniaux A, Guarnero V, Hahnloser D, Demartines N, Hübner M. Physical Activity and Outcomes in Colorectal Surgery: A Pilot Prospective Cohort Study. Eur Surg Res 2020; 61:23-33. [DOI: 10.1159/000507578] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Abstract
<b><i>Background:</i></b> Mobilization after surgery is recommended to reduce the risk of adverse effects and to improve recovery. The aim of this study was to examine the associations between perioperative physical activity and postoperative outcomes in colorectal surgery. <b><i>Methods:</i></b> The daily number of footsteps was recorded from preoperative day 5 to postoperative day 3 in a prospective cohort of patients using wrist accelerometers. Timed Up and Go Test (TUGT), 6 Min Walking Test (6MWT), and peak expiratory flow (PEF) were assessed preoperatively. ROC curves were used to assess the performance of physical activity as a diagnostic test of complications and prolonged length of stay (LOS) of more than 5 days. <b><i>Results:</i></b> A total of 50 patients were included. Patients with complications were significantly older (67 years) than those without complications (53 years, <i>p</i> = 0.020). PEF was significantly lower in the group with complications (mean flow 294.3 vs. 363.6 L/min, <i>p</i> = 0.038) while there was no difference between groups for the other two tests (TUGT and 6MWT). The tests had no capacity to discriminate the occurrence of complications and prolonged LOS, except the 6MWT for LOS (AUC = 0.746, <i>p</i> = 0.004, 95% CI: 0.604–0.889). There was no difference in the mean number of preoperative footsteps, but patients with complications walked significantly less postoperatively (mean daily footsteps 1,101 vs. 1,243, <i>p</i> = 0.018). <b><i>Conclusions:</i></b><i></i>Colorectal surgery patients with complications were elderly, had decreased PEF, and walked less postoperatively. The 6MWT could be used preoperatively to discriminate patients with potentially increased LOS and foster mobilisation strategies.
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Olsen A, Keogh J, Sargeant S. Investigating How Bowel Cancer Survivors Discuss Exercise and Physical Activity Within Web-Based Discussion Forums: Qualitative Analysis. J Med Internet Res 2019; 21:e13929. [PMID: 31841117 PMCID: PMC6937542 DOI: 10.2196/13929] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 10/01/2019] [Accepted: 10/02/2019] [Indexed: 01/29/2023] Open
Abstract
Background Online cancer support group discussions enable patients to share their illness experience with others. The sharing of technical and emotional support information and the ability to ask for advice are some of the primary discussions shared online. People with bowel cancer can also use these forums to support each other by sharing information based on personal experiences. This type of support provides newly diagnosed patients with advice about several topics, including exercise from those who have been there. Information gathered from online discussion boards may complement the advice received by health professionals. Objective This study aimed to explore the nature of information related to exercise and physical activity exchanged online for cancer survivors. Methods A public open access bowel cancer discussion board was searched for threads containing information related to physical activity or exercise. Keywords such as exercise, physical activity, moving, walking, lifting, weights training, and resistance were used to search for threads (online conversations) related to exercise or physical activity. Only threads initiated by bowel cancer patients or survivors were included. From more than 6000 posts, the inclusion criteria yielded 75 threads for analysis. Inductive thematic analysis was conducted across all included threads. Results Analysis yielded 3 main themes: level of exercise competence, beneficial dimensions of exercise, and faith in the knowledge. Level of exercise competence illustrated the varying definitions of exercise that members of the forum discussed in the forum. Beneficial dimensions of exercise revealed that forum members shared both the spiritual benefits associated with exercise as well as the physical benefits or goodness that they feel exercise or physical activity provides them. Faith in the knowledge of exercise demonstrated that forum members were aware of the general benefits of exercise but felt disappointed that it did not keep the cancer at bay. However, members also had faith that exercise would keep them healthy after diagnosis and treatment. Conclusions The analysis revealed that people with bowel cancer discuss exercise and physical activity online and that they view exercise as having a mostly positive influence on their cancer journey. However, personal definitions of exercise became a source of conflict within the group. People with bowel cancer seeking information about exercise may benefit from participating in online support groups as it appears that there are many similar others willing to share their personal experiences with exercise. In addition, health care professionals responsible for caring for people with bowel cancer may use these findings to discuss exercise with their patients while being mindful of how they may view exercise.
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Affiliation(s)
- Alicia Olsen
- Faculty of Health Sciences and Medicine, Bond University, Robina, Australia
| | - Justin Keogh
- Faculty of Health Sciences and Medicine, Bond University, Robina, Australia.,Human Potential Centre, Auckland University of Technology, Auckland, New Zealand.,Cluster for Health Improvement, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Sunshine Coast, Australia.,Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Sally Sargeant
- School of Health and Human Sciences, Southern Cross University, Bilinga, Australia
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Steindorf K, Depenbusch J, Haussmann A, Tsiouris A, Schmidt L, Hermann S, Sieverding M, Wiskemann J, Ungar N. Change patterns and determinants of physical activity differ between breast, prostate, and colorectal cancer patients. Support Care Cancer 2019; 28:3207-3218. [PMID: 31720802 DOI: 10.1007/s00520-019-05097-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 09/20/2019] [Indexed: 12/13/2022]
Abstract
PURPOSE The purpose of this study was to examine and compare pre- to post-diagnosis change patterns of physical activity (PA) among breast, prostate, and colorectal cancer patients. Moreover, the study aimed to investigate sociodemographic and medical determinants of post-diagnosis PA and to identify patient subgroups at increased risk of inactivity. METHODS A total of 912 cancer patients (457 breast, 241 prostate, 214 colorectal cancer) completed a questionnaire assessing their pre- and post-diagnosis PA behavior, and sociodemographic and medical variables. Age-adjusted regression and classification tree analyses were used to investigate PA determinants and detect subgroups that were most likely to meet or not meet PA guidelines. RESULTS Across cancer types, we found that PA yet decreased from pre- to post-diagnosis, but that 54.1% of participants still reported to be meeting PA guidelines after the diagnosis. While post-diagnosis PA was strongly affected by previous PA behavior among individuals of all patient groups, other sociodemographic and medical determinants played different roles depending on cancer type. The results yielded that previously active, longer diagnosed patients with higher education levels were most likely to be meeting PA guidelines post-diagnosis, whereas specifically previously inactive prostate cancer patients had an increased likelihood of insufficient activity. CONCLUSIONS An encouragingly high number of cancer patients indicated sufficient PA levels. For those having difficulties to maintain or adopt PA post-diagnosis, interventions should be tailored to the specific characteristics of each cancer type, as different factors are associated with PA for each patient group.
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Affiliation(s)
- Karen Steindorf
- Division of Physical Activity, Prevention and Cancer, National Center for Tumor Diseases (NCT) Heidelberg and German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany.
| | - Johanna Depenbusch
- Division of Physical Activity, Prevention and Cancer, National Center for Tumor Diseases (NCT) Heidelberg and German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany
- Medical Faculty, University of Heidelberg, Im Neuenheimer Feld 672, 69120, Heidelberg, Germany
| | - Alexander Haussmann
- Division of Physical Activity, Prevention and Cancer, National Center for Tumor Diseases (NCT) Heidelberg and German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany
- Institute of Psychology, Heidelberg University, Hauptstraße 47-51, 69117, Heidelberg, Germany
| | - Angeliki Tsiouris
- Division of Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg and University Clinic Heidelberg, Im Neuenheimer Feld 460, 69120, Heidelberg, Germany
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Johannes Gutenberg University Mainz, Untere Zahlbacher Straße 8, 55131, Mainz, Germany
| | - Laura Schmidt
- Institute of Psychology, Heidelberg University, Hauptstraße 47-51, 69117, Heidelberg, Germany
| | - Silke Hermann
- Epidemiological Cancer Registry Baden-Württemberg, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany
| | - Monika Sieverding
- Institute of Psychology, Heidelberg University, Hauptstraße 47-51, 69117, Heidelberg, Germany
| | - Joachim Wiskemann
- Division of Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg and University Clinic Heidelberg, Im Neuenheimer Feld 460, 69120, Heidelberg, Germany
| | - Nadine Ungar
- Institute of Psychology, Heidelberg University, Hauptstraße 47-51, 69117, Heidelberg, Germany
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Sweegers MG, Boyle T, Vallance JK, Chinapaw MJ, Brug J, Aaronson NK, D'Silva A, Kampshoff CS, Lynch BM, Nollet F, Phillips SM, Stuiver MM, van Waart H, Wang X, Buffart LM, Altenburg TM. Which cancer survivors are at risk for a physically inactive and sedentary lifestyle? Results from pooled accelerometer data of 1447 cancer survivors. Int J Behav Nutr Phys Act 2019; 16:66. [PMID: 31420000 PMCID: PMC6698042 DOI: 10.1186/s12966-019-0820-7] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 07/18/2019] [Indexed: 12/22/2022] Open
Abstract
Background Physical activity has beneficial effects on the health of cancer survivors. We aimed to investigate accelerometer-assessed physical activity and sedentary time in cancer survivors, and describe activity profiles. Additionally, we identify demographic and clinical correlates of physical activity, sedentary time and activity profiles. Methods Accelerometer, questionnaire and clinical data from eight studies conducted in four countries (n = 1447) were pooled. We calculated sedentary time and time spent in physical activity at various intensities using Freedson cut-points. We used latent profile analysis to identify activity profiles, and multilevel linear regression analyses to identify demographic and clinical variables associated with accelerometer-assessed moderate to vigorous physical activity (MVPA), sedentary time, the highly active and highly sedentary profile, adjusting for confounders identified using a directed acyclic graph. Results Participants spent on average 26 min (3%) in MVPA and 568 min (66%) sedentary per day. We identified six activity profiles. Older participants, smokers and participants with obesity had significantly lower MVPA and higher sedentary time. Furthermore, men had significantly higher MVPA and sedentary time than women and participants who reported less fatigue had higher MVPA time. The highly active profile included survivors with high education level and normal body mass index. Haematological cancer survivors were less likely to have a highly active profile compared to breast cancer survivors. The highly sedentary profile included older participants, males, participants who were not married, obese, smokers, and those < 12 months after diagnosis. Conclusions Cancer survivors engage in few minutes of MVPA and spend a large proportion of their day sedentary. Correlates of MVPA, sedentary time and activity profiles can be used to identify cancer survivors at risk for a sedentary and inactive lifestyle. Electronic supplementary material The online version of this article (10.1186/s12966-019-0820-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- M G Sweegers
- Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - T Boyle
- Australian Centre for Precision Health, School of Health Sciences, University of South Australia Cancer Research Institute, Adelaide, Australia
| | - J K Vallance
- Faculty of Health Disciplines, Athabasca University, Athabasca, Canada
| | - M J Chinapaw
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - J Brug
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - N K Aaronson
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - A D'Silva
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - C S Kampshoff
- Department of Medical Oncology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - B M Lynch
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global health, The University of Melbourne, Melbourne, Australia.,Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia
| | - F Nollet
- Department of Rehabilitation, Amsterdam Movement Sciences institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - S M Phillips
- Department of Behavioural Medicine, Northwestern University, Chicago, USA
| | - M M Stuiver
- Center for Quality of Life, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - H van Waart
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands.,Department of Anesthesiology, University of Auckland, Auckland, New Zealand
| | - X Wang
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - L M Buffart
- Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Medical Oncology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - T M Altenburg
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
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Oruç Z, Kaplan MA. Effect of exercise on colorectal cancer prevention and treatment. World J Gastrointest Oncol 2019; 11:348-366. [PMID: 31139306 PMCID: PMC6522766 DOI: 10.4251/wjgo.v11.i5.348] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Revised: 04/17/2019] [Accepted: 05/06/2019] [Indexed: 02/05/2023] Open
Abstract
In recent years, because of improved cancer screening, detection and treatment modalities, a rapid increase in the population of colorectal and other cancer survivors has been observed. The increasing population has justified the requirement of preventive strategies such as lifestyle modifications with regard to obesity, physical activity, diet and smoking. Physical activity may prevent approximately 15% of the colon cancers. Furthermore, several observational studies have demonstrated the efficacy and dose-dependent and anti-cancer effects of exercise on decreasing the mortality and risk of recurrence before and after the colorectal cancer (CRC) diagnosis. However, the required exercise dose, type and intensity are yet unclear. The results of randomised prospective studies are expected to determine the optimal amount, type and intensity of exercise and formulate the most appropriate exercise plan and guidelines, according to the requirements and comorbidities of the patients. In addition, recent studies have focused on the molecular and genetic mechanisms underlying the effect of physical activity on disease outcomes and recurrence rates. This review aimed to investigate the effects of physical activity and the biological basis of these effects in preventing the risk and recurrence of CRC and decreasing the hazards of cancer and cancer treatment.
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Affiliation(s)
- Zeynep Oruç
- Department of Medical Oncology, Mersin City Hospital, Mersin 33000, Turkey
| | - Muhammed Ali Kaplan
- Department of Medical Oncology, Faculty of Medicine, Dicle University, Diyarbakır 21280, Turkey
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Tabaczynski A, Strom DA, Wong JN, McAuley E, Larsen K, Faulkner GE, Courneya KS, Trinh L. Demographic, medical, social-cognitive, and environmental correlates of meeting independent and combined physical activity guidelines in kidney cancer survivors. Support Care Cancer 2019; 28:43-54. [PMID: 30980259 DOI: 10.1007/s00520-019-04752-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 03/15/2019] [Indexed: 01/07/2023]
Abstract
PURPOSE Guidelines for cancer survivors recommend both aerobic physical activity (PA) and strength training (ST). Few kidney cancer survivors (KCS) are meeting single-activity or combined guidelines; therefore, examining factors influencing PA participation is warranted. The purpose of this study is to examine demographic, medical, social-cognitive, and environmental correlates of meeting independent (i.e., aerobic-only, strength training (ST)-only) and combined guidelines (i.e., aerobic and ST) in KCS. METHODS KCS (N = 651) completed self-reported measures of PA and demographic, medical, social-cognitive, and perceived environmental factors. Built environment was assessed using the geographic information systems (GIS). Multinomial logistic regressions were conducted to determine the correlates of meeting the combined versus independent guidelines. RESULTS Compared with meeting neither guideline, meeting aerobic-only guidelines was associated with higher intentions (p < .01) and planning (p < .01); meeting ST-only guidelines was associated with higher intentions (p = .02) and planning (p < .01), lower perceived behavioral control (PBC) (p = .03), healthy weight (p = .01), and older age (p < .01); and meeting the combined guidelines were associated with higher intentions (p < .01), planning (p = .02), higher instrumental attitudes (p < .01), higher education (p = .04), better health (p < .01), and localized cancer (p = .05). Additionally, compared with neither guideline, meeting aerobic-only (p < .01) and combined (p < .01) guidelines was significantly associated with access to workout attire. Compared with neither guideline, meeting aerobic-only guidelines was associated with proximity to retail (p = .02). CONCLUSION PA participation correlates may vary based on the modality of interest. Interventions may differ depending on the modality promoted and whether KCS are already meeting single-modality guidelines.
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Affiliation(s)
- Allyson Tabaczynski
- Faculty of Kinesiology and Physical Education, University of Toronto, 55 Harbord Street, Toronto, ON, M5S 2W6, Canada
| | - Dominick A Strom
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 906 South Goodwin Avenue, Urbana, IL, 61801, USA
| | - Jaime N Wong
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 906 South Goodwin Avenue, Urbana, IL, 61801, USA
| | - Edward McAuley
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 906 South Goodwin Avenue, Urbana, IL, 61801, USA
| | - Kristian Larsen
- CAREX Canada, Faculty of Health Sciences, Simon Fraser University, 105-515 West Hastings Street, Vancouver, BC, V6B 5K3, Canada.,Department of Geography and Planning, University of Toronto, 100 St. George Street, Toronto, ON, M5S 2W6, Canada
| | - Guy E Faulkner
- School of Kinesiology, University of British Columbia, 2259 Lower Mall, Vancouver, British Columbia, V6T 1Z4, Canada
| | - Kerry S Courneya
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, 113 University Hall, Edmonton, Alberta, T6G 2H9, Canada
| | - Linda Trinh
- Faculty of Kinesiology and Physical Education, University of Toronto, 55 Harbord Street, Toronto, ON, M5S 2W6, Canada.
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Mhaidat NM, Al-Wedyan TJ, Alzoubi KH, Al-Efan QM, Al-Azzam SI, Balas QA, Bataineh ZA. Measuring quality of Life among Colorectal Cancer Patients in Jordan. J Palliat Care 2018. [DOI: 10.1177/082585971403000302] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Quality of life among colorectal cancer (CRC) patients was evaluated using the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ) C30 and EORTC QLQ-CR29. We interviewed 74 CRC patients, and our results indicated lower anxiety functional scores and higher abdominal pain and embarrassment symptom scores among patients aged 55 and under. Patients with disease metastasis showed significantly lower global health scores and higher fatigue, loss of appetite, hair loss, and change in taste symptom scores. Scores for emotional functioning were significantly lower among patients with stage IV disease. Fatigue, nausea and vomiting, loss of appetite, abdominal pain, and change in taste symptom scores were significantly higher in patients treated with a combination of surgery and chemotherapy compared to surgery alone. Age, disease metastasis, late disease stage, and combined treatment modalities were associated with lower scores on health-related quality-of-life scales; patients likely to have low scores on these measures should receive special attention from healthcare providers and be targeted by supportive care strategies. Nous avons évalué la qualité de vie de patients atteints du cancer colorectal à l'aide du Questionnaire C30 et EORTC QLQ-CR29 de l'Organisation européenne pour la recherche et le traitement du cancer. Nous avons interviewé 74 patients et nos résultats indiquent que les patients agés de 55 ans et moins éprouvent un moindre niveau d'anxiété alors que le niveau de douleurs abdominales et du sentiment de gêne est élevé. Les patients atteints de métastases ont démontré lors des tests que leur état général de santé était plutôt mauvais et qu'ils souffraient de fatigue accrue, de perte de cheveux et de la perte du goût L'état émotionel était à son plus bas chez les patients au stade IV de la maladie. La fatigue, la nausée, le vomissement, la perte d'appétit, les douleurs abdominales, et la perte de goût étaient significativement plus élevés chez les patients ayant été traités par chirurgie et chimiothérapie comparativement à ceux qui n'avaient subi que la chirurgie. L'âge, les métastases et le stade avancé de la maladie combinés à divers traitements médicaux sont les facteurs ayant contribué aux scores plus bas observés sur l'échelle de qualité de vie. Les patients susceptibles de démontrer de faibles résultats devraient recevoir une attention spéciale de la part des soignants et être la cible de soins de soutien appropriés à leur état.
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Affiliation(s)
- Nizar M. Mhaidat
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, 22110, PO Box 3030, Jordan
| | - Tahani J. Al-Wedyan
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Karem H. Alzoubi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Qais M. Al-Efan
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Sayer I. Al-Azzam
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Qosay A. Balas
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Ziad A. Bataineh
- Department of Surgery, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
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Kim JY, Lee MK, Lee DH, Kang DW, Min JH, Lee JW, Chu SH, Cho MS, Kim NK, Jeon JY. Effects of a 12-week home-based exercise program on quality of life, psychological health, and the level of physical activity in colorectal cancer survivors: a randomized controlled trial. Support Care Cancer 2018; 27:2933-2940. [DOI: 10.1007/s00520-018-4588-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 12/05/2018] [Indexed: 12/17/2022]
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Troeschel AN, Leach CR, Shuval K, Stein KD, Patel AV. Physical Activity in Cancer Survivors During "Re-Entry" Following Cancer Treatment. Prev Chronic Dis 2018; 15:E65. [PMID: 29806579 PMCID: PMC5985854 DOI: 10.5888/pcd15.170277] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
INTRODUCTION The transition from active cancer treatment into survivorship, known as re-entry, remains understudied. During re-entry, clinicians can educate survivors on the benefits of healthy behaviors, including physical activity, as survivors adjust to life after cancer. We examine the prevalence of adherence to established aerobic physical activity guidelines (≥150 minutes of moderate-intensity physical activity per week) in addition to related medico-demographic factors among cancer survivors during re-entry. METHODS Data from 1,160 breast, colorectal, and prostate cancer survivors participating in the American Cancer Society's National Cancer Survivor Transition Study were examined. Multinomial logistic regression was used to calculate adjusted odds ratios (AOR) for various medico-demographic variables in relation to 4 established levels of physical activity (inactive, insufficiently active, 1-<2 times the guideline level, and ≥2 times the guideline level [referent group]). RESULTS Overall, 8.1% were inactive, 34.1% were insufficiently active, 24.3% were within 1 to less than 2 times the guidelines, and 33.4% exceeded guidelines by 2 or more times. Inactive people had significantly higher odds of being women (AOR, 1.88; 95% confidence interval [CI], 1.10-3.23) and having lower education levels (AOR, 2.02; 95% CI, 1.21-3.38) compared with those who exceeded guidelines by 2 or more times. Each additional comorbidity was associated with a 26% increase in odds of inactivity (AOR, 1.26; 95% CI, 1.08-1.47). CONCLUSION Patient education on the benefits of regular physical activity is important for all cancer survivors and may be especially important to review after treatment completion to promote healthy habits during this transition period. Survivors who are women, are less educated, and have comorbid conditions may be less likely to be compliant with physical activity guidelines.
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Affiliation(s)
- Alyssa N Troeschel
- Intramural Research Department, American Cancer Society, 250 Williams St, Atlanta, GA 30303.
| | - Corinne R Leach
- Intramural Research Department, American Cancer Society, Atlanta, Georgia
| | - Kerem Shuval
- Intramural Research Department, American Cancer Society, Atlanta, Georgia
| | - Kevin D Stein
- Intramural Research Department, American Cancer Society, Atlanta, Georgia
| | - Alpa V Patel
- Intramural Research Department, American Cancer Society, Atlanta, Georgia
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36
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Buffart LM, de Bree R, Altena M, van der Werff S, Drossaert CHC, Speksnijder CM, van den Brekel MW, Jager-Wittenaar H, Aaronson NK, Stuiver MM. Demographic, clinical, lifestyle-related, and social-cognitive correlates of physical activity in head and neck cancer survivors. Support Care Cancer 2018; 26:1447-1456. [PMID: 29151175 PMCID: PMC5876272 DOI: 10.1007/s00520-017-3966-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 11/09/2017] [Indexed: 12/16/2022]
Abstract
PURPOSE The purpose of the study is to identify demographic, clinical, lifestyle-related, and social-cognitive correlates of physical activity (PA) intention and behavior in head and neck cancer (HNC) survivors using the theory of planned behavior (TPB). METHODS Data from two cross-sectional studies on correlates of PA in HNC survivors were pooled. Both studies used self-reports to assess PA and social-cognitive correlates. Potential correlates were collected via self-report or medical records. Univariable and multivariable multilevel linear mixed-effects models were built to identify correlates of PA intention and PA behavior (Z scores). Structural equation model analyses were conducted to study the full TPB model in one analysis, taking into account relevant covariates. RESULTS In total, 416 HNC survivors were surveyed. Their mean (SD) age was 66.6 (9.4) years; 64% were men, and 78% were diagnosed with laryngeal cancer. The structural equation model showed that PA intention was significantly higher in HNC survivors with a history of exercising, who had a more positive attitude, subjective norm, and perceived behavioral control. Patients with higher PA intention, higher PBC, a lower age, and without unintentional weight loss or comorbidities had higher PA behavior. The model explained 22.9% of the variance in PA intention and 16.1% of the variance in PA behavior. CONCLUSIONS Despite significant pathways of the TPB model, the large proportion variance in PA intention and behavior remaining unexplained suggests the need for better PA behavior (change) models to guide the development of PA promotion programs, particularly for the elderly. Such programs should be tailored to comorbidities and nutritional status.
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Affiliation(s)
- Laurien M Buffart
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, De Boelelaan 1089a, 1081 HV, Amsterdam, The Netherlands.
- Department of Medical Oncology, Cancer Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Australia.
| | - Remco de Bree
- UMC Utrecht Cancer Center, Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands
| | - Martine Altena
- Center of eHealth and Wellbeing Research, University of Twente, Enschede, The Netherlands
| | - Sophie van der Werff
- Department of Physical Therapy, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | | | - Caroline M Speksnijder
- Physical Therapy Science, Program in Clinical Health Sciences, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Oral-Maxillofacial Surgery, Prosthodontics and Special Dental Care, University Medical Center Utrecht, Utrecht, The Netherlands
- Julius Center Sciences, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Michiel W van den Brekel
- Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Harriët Jager-Wittenaar
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands
- Department of Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Neil K Aaronson
- Division of Psychosocial Research & Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Martijn M Stuiver
- Department of Physical Therapy, Netherlands Cancer Institute, Amsterdam, The Netherlands
- Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands
- ACHIEVE Centre of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
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Mangia AS, Coqueiro NLDO, Azevedo FC, Araujo HTDS, Amorim EDO, Alves CNR, Camargo C, Fonseca AJD. What clinical, functional, and psychological factors before treatment are predictors of poor quality of life in cancer patients at the end of chemotherapy? ACTA ACUST UNITED AC 2018; 63:978-987. [PMID: 29451662 DOI: 10.1590/1806-9282.63.11.978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 03/12/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To correlate physical activity level (PAL), functional capacity and psychological state with quality of life (QoL) in cancer patients undergoing chemotherapy (CT). METHOD Observational cohort study. Patients (n=121) with any primary cancer site with indications of chemotherapy with palliative or curative intent were evaluated at three moments: 1) patient admission (week 0), before chemotherapy; 2) week 8; 3) end of CT. Data were collected regarding QoL, PAL, clinical data, functional capacity (short walking distance test, sitting-rising test, isometric manual gripping force), and anxiety and depression tests. RESULTS There was significant improvement at the end of CT for: level of physical activity; walk test (> 500 meters); sitting-rising test (> 20x). There was a significant reduction in the prevalence of moderate/severe depression. The prevalence of high QoL showed a significant increase in evaluation 3 (42.4% vs. 40.0% vs. 59.2%, p=0.02). Education up to high school level, low PAL, walking < 300 meters, sitting and rising < 20 times, having depression (moderate to severe) and QoL that was not high at the start of treatment (week 0) all proved to be risk factors for low quality of life at week 16. Conversely, early staging, curative intent chemotherapy and low-grade symptoms were shown to be protective factors. CONCLUSION Performing less than 20 movements in the sitting-rising test and low PAL at the start of chemotherapy represent independent risk factors for low quality of life at the end of chemotherapy.
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Affiliation(s)
- Ariella Sebastião Mangia
- Physical Educator. MSc in Health Sciences from Universidade Federal de Roraima (UFRR), Boa Vista, RR, Brazil
| | - Nara Lisiane de Oliveira Coqueiro
- Psychologist at the Oncology High Complexity Assistance Unit in Roraima. MSc Student, Health Sciences Graduate Program, UFRR, Boa Vista, RR, Brazil
| | - Fernanda Cabral Azevedo
- Oncology Physiotherapist at the Oncology High Complexity Assistance Unit, Boa Vista, RR, Brazil
| | | | | | - Cibelli Navarro Rodrigues Alves
- MD, Clinical Oncologist at the Oncology High Complexity Assistance Unit. MSc in Health Sciences from UFRR, Boa Vista, RR, Brazil
| | - Calvino Camargo
- Psychologist. PhD in Social Psychology from Universidade de São Paulo. Professor in the Health Sciences Graduate Program, UFRR, Boa Vista, RR, Brazil
| | - Allex Jardim da Fonseca
- MD, Clinical Oncologist. PhD in Medicine from Universidade do Estado do Amazonas. Professor in the Health Sciences Graduate Program, UFRR, Boa Vista, RR, Brazil
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Taylor K, Scruggs PW, Balemba OB, Wiest MM, Vella CA. Associations between physical activity, resilience, and quality of life in people with inflammatory bowel disease. Eur J Appl Physiol 2018; 118:829-836. [PMID: 29411129 DOI: 10.1007/s00421-018-3817-z] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 01/26/2018] [Indexed: 12/21/2022]
Abstract
AIM Research has shown that moderate-to-vigorous physical activity (MVPA) is associated with higher health-related quality of life (HRQOL) in healthy individuals. Recent studies have suggested that low- to moderate-intensity physical activity can be beneficial to HRQOL in people with inflammatory bowel diseases (IBD); however, studies investigating associations between MVPA and HRQOL in this population are lacking. PURPOSE To understand the relationships among walking, MVPA, resilience, and HRQOL in people with IBD. METHODS People with IBD (n = 242) completed questions about physical activity, resilience and HRQOL. Pearson product-moment correlations and multiple regression analyses were used to identify associations between physical activity and HRQOL. Analysis of covariance was used to compare HRQOL over quartiles of walking and MVPA with demographic variables as covariates. RESULTS Both walking and MVPA were independently associated with physical (β = 0.21 and β = 0.26, respectively; p ≤ 0.001) but not mental HRQOL (p > 0.05). Higher volumes of MVPA were significantly associated with physical HRQOL (quartile 1 40.3 ± 9.0 vs. quartile 4 47.4 ± 9.0; p < 0.001) while higher volumes of walking were associated with both physical and mental HRQOL (p ≤ 0.01). CONCLUSIONS The findings suggest that engaging in higher volumes of MVPA above 150 min/week and walking, particularly above 60 min/week, are associated with improved HRQOL in people with IBD. Research would benefit from investigating participation in MVPA as a coping strategy, in a longitudinal manner, to determine which modes of activity may be most beneficial to people with IBD.
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Affiliation(s)
- Katrina Taylor
- Department of Physical Education, Health and Recreation, Eastern Washington University, 200 Physical Education Building, Cheney, WA, 99004, USA.
| | - Philip W Scruggs
- Department of Movement Sciences, University of Idaho, Moscow, ID, USA
| | - Onesmo B Balemba
- Department of Biological Sciences, University of Idaho, Moscow, ID, USA
| | - Michelle M Wiest
- Department of Statistical Science, University of Idaho, Moscow, ID, USA
| | - Chantal A Vella
- Department of Movement Sciences, University of Idaho, Moscow, ID, USA
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Hoedjes M, de Kruif A, Mols F, Bours M, Beijer S, Winkels R, Westerman MJ, Seidell JC, Kampman E. An exploration of needs and preferences for dietary support in colorectal cancer survivors: A mixed-methods study. PLoS One 2017; 12:e0189178. [PMID: 29253011 PMCID: PMC5734680 DOI: 10.1371/journal.pone.0189178] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 11/21/2017] [Indexed: 01/01/2023] Open
Abstract
PURPOSE To describe the proportion of colorectal cancer (CRC) survivors who perceive a need for dietary support; to examine which socio-demographic, cancer-related, and health-related characteristics are associated with this need; to explore reasons for (not) needing support; and to explore CRC survivors' specific needs and preferences with regard to lifestyle (i.e., dietary, exercise, and/or weight management) support. METHODS This mixed-methods study comprised a cross-sectional survey among 1774 Dutch CRC survivors and three focus groups (n = 16). To examine associations, logistic regression analyses were conducted. Focus groups were audio-taped, transcribed verbatim, and analyzed using a thematic approach. RESULTS Of 1458 respondents (82%), 1198 (67.5%) were included for analyses. 17.5% reported a need for dietary support. Characteristics associated with this need were: being younger, living without a partner, having a stoma, having diabetes, and being overweight or obese. The main reason for needing support was being unable to initiate and maintain lifestyle changes without support. CRC survivors preferred receiving information soon after diagnosis to make an autonomous, informed decision on improving their lifestyle. They preferred to receive individually-tailored lifestyle support in an autonomy-supportive environment, preferably with involvement of their family and fellow-sufferers. CONCLUSIONS This study has provided knowledge on appropriate support for CRC survivors in need for dietary support to improve health outcomes by promoting adherence to lifestyle and body weight recommendations. Findings can be used to better identify CRC survivors in need for dietary support, and to tailor lifestyle support to their needs and preferences in order to promote uptake, adherence, and effectiveness.
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Affiliation(s)
- Meeke Hoedjes
- Department of Health Sciences and the EMGO+ Institute for Health and Care Research, VU University Amsterdam, Amsterdam, the Netherlands
- Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands
- * E-mail:
| | - Anja de Kruif
- Department of Health Sciences and the EMGO+ Institute for Health and Care Research, VU University Amsterdam, Amsterdam, the Netherlands
- Division of Human Nutrition, Wageningen University, Wageningen, the Netherlands
| | - Floortje Mols
- Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands
| | - Martijn Bours
- Department of Epidemiology, GROW-School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands
| | - Sandra Beijer
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands
| | - Renate Winkels
- Division of Human Nutrition, Wageningen University, Wageningen, the Netherlands
| | - Marjan J. Westerman
- Department of Health Sciences and the EMGO+ Institute for Health and Care Research, VU University Amsterdam, Amsterdam, the Netherlands
| | - Jaap C. Seidell
- Department of Health Sciences and the EMGO+ Institute for Health and Care Research, VU University Amsterdam, Amsterdam, the Netherlands
| | - Ellen Kampman
- Division of Human Nutrition, Wageningen University, Wageningen, the Netherlands
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van Nieuwenhuizen AJ, Buffart LM, van Uden-Kraan CF, van der Velden LA, Lacko M, Brug J, Leemans CR, Verdonck-de Leeuw IM. Patient-reported physical activity and the association with health-related quality of life in head and neck cancer survivors. Support Care Cancer 2017; 26:1087-1095. [PMID: 29164375 PMCID: PMC5847044 DOI: 10.1007/s00520-017-3926-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 10/09/2017] [Indexed: 12/17/2022]
Abstract
Purpose This study aimed to assess patient-reported levels of physical activity (PA) and its associations with health-related quality of life (HRQoL) adjusted for important demographic, lifestyle-related, and clinical factors, among head and neck (HNC) survivors. Methods This cross-sectional study included 116 HNC survivors. PA was assessed with the Physical Activity Scale for the Elderly (PASE) and HRQoL with the EORTC-QLQ-C30 and EORTC-HN35. Associations were studied using univariable and multivariable regression analyses. Results Median PASE score was 100.3 (interquartile range 65.1;170.8) of which 54% were household, 34% leisure-time, and 12% occupational activities. Younger HNC survivors had higher levels of PA. Higher PA was significantly associated with higher global QoL (p < 0.05). Findings for physical function, role function, social function, fatigue, and pain were in line, but not statistically significant (0.05 ≤ p < 0.10). Conclusions Among HNC survivors, a large proportion of PA consists of household activities. Younger HNC survivors had higher PA levels, and higher PA levels were associated with higher HRQoL.
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Affiliation(s)
- Annette J van Nieuwenhuizen
- Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, PO BOX 7057, 1007 MB, Amsterdam, The Netherlands
| | - Laurien M Buffart
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands.,Department of Medical Oncology, Cancer Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Cornelia F van Uden-Kraan
- Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, PO BOX 7057, 1007 MB, Amsterdam, The Netherlands.,Department of Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Lilly-Ann van der Velden
- Department of Otolaryngology-Head and Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands.,Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Martin Lacko
- Department of Otolaryngology-Head and Neck Surgery, University Medical Centre of Maastricht, Maastricht, The Netherlands
| | - Johannes Brug
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - C René Leemans
- Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, PO BOX 7057, 1007 MB, Amsterdam, The Netherlands
| | - Irma M Verdonck-de Leeuw
- Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, PO BOX 7057, 1007 MB, Amsterdam, The Netherlands. .,Department of Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
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41
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Brandenbarg D, Korsten JHWM, Berger MY, Berendsen AJ. The effect of physical activity on fatigue among survivors of colorectal cancer: a systematic review and meta-analysis. Support Care Cancer 2017; 26:393-403. [PMID: 29058127 PMCID: PMC5752739 DOI: 10.1007/s00520-017-3920-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 10/02/2017] [Indexed: 12/24/2022]
Abstract
PURPOSE Favorable health outcomes among cancer survivors are increasingly being attributed to lifestyle factors like physical activity, which is now promoted in clinical guidelines. However, the available evidence indicates that physical activity may also reduce fatigue in this patient group. In this systematic review, we aimed to examine whether physical activity could reduce fatigue among survivors of colorectal cancer. METHODS The databases of Medline, CINAHL, and PsycINFO were systematically searched, using combinations of MeSH and free-text terms for colorectal cancer, physical activity, and fatigue. Randomized controlled trials and cohort studies with longitudinal data collection were included. We performed a random-effect meta-analysis. RESULTS Seven studies were included, five were randomized controlled trials, and two were cohort studies. A meta-analysis of the randomized controlled trials, which comprised 630 survivors in total, failed to show that physical activity had a significant effect on fatigue (standardized mean difference = 0.21 (- 0.07 to 0.49)); however, reduced levels of fatigue were observed in all studies. The results for the cohort studies were inconclusive: one showed that increasing levels of physical activity were significantly associated with decreasing levels of fatigue; the other showed that decreasing levels of fatigue were not associated with increasing levels of physical activity. CONCLUSIONS Based on the data reviewed, we cannot draw definitive conclusions about the effects of physical activity on fatigue. None of the included studies were performed among fatigued survivors of colorectal cancer. More research is needed in this population, ensuring that the trials are appropriately powered to find differences in fatigue.
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Affiliation(s)
- D Brandenbarg
- Department of General Practice, University of Groningen, University Medical Center Groningen, P.O. Box 196, 9700 AD, Groningen, The Netherlands.
| | - J H W M Korsten
- Department of General Practice, University of Groningen, University Medical Center Groningen, P.O. Box 196, 9700 AD, Groningen, The Netherlands
| | - M Y Berger
- Department of General Practice, University of Groningen, University Medical Center Groningen, P.O. Box 196, 9700 AD, Groningen, The Netherlands
| | - A J Berendsen
- Department of General Practice, University of Groningen, University Medical Center Groningen, P.O. Box 196, 9700 AD, Groningen, The Netherlands
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Kalter J, Kampshoff CS, Chinapaw MJM, VAN Mechelen W, Galindo-Garre F, Schep G, Verdonck-DE Leeuw IM, Brug J, Buffart LM. Mediators of Exercise Effects on HRQoL in Cancer Survivors after Chemotherapy. Med Sci Sports Exerc 2017; 48:1859-65. [PMID: 27128668 DOI: 10.1249/mss.0000000000000976] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE We investigated the hypothesis that combined resistance and endurance exercise improves cardiorespiratory fitness and muscle strength, thereby reducing fatigue and improving global quality of life (QoL) and physical function among cancer survivors who completed curative treatment including chemotherapy. METHODS Cancer survivors were assigned to a 12-wk exercise intervention (n = 186) or a wait list control group (n = 91). Data were collected at baseline and after 12 wk. Path analyses using follow-up values adjusted for baseline values, age, and gender were conducted to test if the exercise effects on global QoL and physical function (European Organization Research and Treatment of Cancer Quality of Life questionnaire-Core 30) were mediated by changes in cardiorespiratory fitness (peak V˙O2), hand-grip strength, lower body muscle function (30-s chair stand test), and fatigue (Multidimensional Fatigue Inventory). RESULTS Compared with the wait list control, exercise increased cardiorespiratory fitness (β = 1.8; 95% confidence interval (CI), 1.0-2.6 mL·kg·min) and reduced general (β = -1.0; 95% CI, -1.8 to -0.2) and physical fatigue (β = -1.5; 95% CI, -2.3 to -0.6). The exercise effect on physical fatigue was mediated by change in cardiorespiratory fitness (β = -0.2; 95% CI, -0.4 to -0.1). Higher hand-grip strength was significantly associated with lower physical fatigue and better lower body muscle function with lower physical and general fatigue. Lower general fatigue and physical fatigue were significantly associated with higher global QoL (β = -1.6; 95% CI, -2.2 to -1.1; and β = -1.7; 95% CI, -2.3 to -1.1, respectively) and physical function (β = -1.0; 95% CI, -1.3 to -0.7; and β = -1.2; 95% CI, -1.6 to -0.9, respectively). The models explained 44%-61% of the variance in global QoL and physical function. CONCLUSION Beneficial effects of exercise on global QoL and physical function in cancer survivors were mediated by increased cardiorespiratory fitness and subsequent reductions in fatigue.
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Affiliation(s)
- Joeri Kalter
- 1Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, THE NETHERLANDS; 2Department of Public and Occupational Health and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, THE NETHERLANDS; 3Department of Sports Medicine, Máxima Medical Center, Veldhoven, THE NETHERLANDS; 4Department of Clinical Psychology, VU University, Amsterdam, THE NETHERLANDS; and 5Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, Amsterdam, THE NETHERLANDS
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Song J, Karlsten M, Yamal JM, Basen-Engquist K. Health-related quality of life factors associated with completion of a study delivering lifestyle exercise intervention for endometrial cancer survivors. Qual Life Res 2017; 26:1263-1271. [PMID: 27796772 PMCID: PMC8409014 DOI: 10.1007/s11136-016-1441-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE The aim of this study was to examine associations between participants' quality of life and study completion. This is a secondary analysis of an exercise intervention study for endometrial cancer survivors. METHODS We considered data for one-hundred post-treatment endometrial cancer survivors from a single-arm, six-month longitudinal exercise study. Participants received a home-based intervention consisting of exercise recommendations and telephone counseling sessions to encourage adherence. In addition to monitoring adherence to physical exercise recommendations, participants completed multiple psychological assessments, including health-related quality of life. Associations between study completion and health-related quality of life factors were analyzed using generalized additive models, to allow for possibly nonlinear associations. RESULTS Measures of bodily pain contributed to the odds of study completion in a nonlinear way (p = 0.025), suggesting that improvements in these factors were associated with study completion, especially for individuals reporting very high levels of pain. In addition, association between participants' levels of anxiety and study completion showed an inverse U-shaped relation: Whereas increase in anxiety was associated with higher odds of completion for individuals with low anxiety score (0-4), increase in anxiety contributed to lower odds of study completion for individuals with anxiety scores of approximately 5-10 (p = 0.035). CONCLUSIONS Results from this study indicate that baseline health-related quality of life factors may be associated with study completion in exercise intervention studies. In order to increase study completion rates, individually tailored study strategies may be prepared based on the baseline quality of life responses.
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Affiliation(s)
- Jaejoon Song
- Department of Biostatistics, University of Texas MD Anderson Cancer Center, Pickens Academic Tower, 1400 Pressler St., Floor 4, FCT4.5009, Houston, TX, 77030, USA.
- Department of Biostatistics, School of Public Health, University of Texas Health Science Center, Houston, TX, USA.
| | - Melissa Karlsten
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - José-Miguel Yamal
- Department of Biostatistics, University of Texas MD Anderson Cancer Center, Pickens Academic Tower, 1400 Pressler St., Floor 4, FCT4.5009, Houston, TX, 77030, USA
| | - Karen Basen-Engquist
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center, Houston, TX, USA
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van Zutphen M, Winkels RM, van Duijnhoven FJB, van Harten-Gerritsen SA, Kok DEG, van Duijvendijk P, van Halteren HK, Hansson BME, Kruyt FM, Bilgen EJS, de Wilt JHW, Dronkers JJ, Kampman E. An increase in physical activity after colorectal cancer surgery is associated with improved recovery of physical functioning: a prospective cohort study. BMC Cancer 2017; 17:74. [PMID: 28122534 PMCID: PMC5264442 DOI: 10.1186/s12885-017-3066-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2015] [Accepted: 01/18/2017] [Indexed: 03/09/2023] Open
Abstract
BACKGROUND The influence of physical activity on patient-reported recovery of physical functioning after colorectal cancer (CRC) surgery is unknown. Therefore, we studied recovery of physical functioning after hospital discharge by (a) a relative increase in physical activity level and (b) absolute activity levels before and after surgery. METHODS We included 327 incident CRC patients (stages I-III) from a prospective observational study. Patients completed questionnaires that assessed physical functioning and moderate-to-vigorous physical activity shortly after diagnosis and 6 months later. Cox regression models were used to calculate prevalence ratios (PRs) of no recovery of physical functioning. All PRs were adjusted for age, sex, physical functioning before surgery, stage of disease, ostomy and body mass index. RESULTS At 6 months post-diagnosis 54% of CRC patients had not recovered to pre-operative physical functioning. Patients who increased their activity by at least 60 min/week were 43% more likely to recover physical function (adjusted PR 0.57 95%CI 0.39-0.82), compared with those with stable activity levels. Higher post-surgery levels of physical activity were also positively associated with recovery (P for trend = 0.01). In contrast, activity level before surgery was not associated with recovery (P for trend = 0.24). CONCLUSIONS At 6 month post-diagnosis, about half of CRC patients had not recovered to preoperative functioning. An increase in moderate-to-vigorous physical activity after CRC surgery was associated with enhanced recovery of physical functioning. This benefit was seen regardless of physical activity level before surgery. These associations provide evidence to further explore connections between physical activity and recovery from CRC surgery after discharge from the hospital.
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Affiliation(s)
- Moniek van Zutphen
- Division of Human Nutrition, Wageningen University & Research, P.O Box 17, 6700 AA, Wageningen, The Netherlands
| | - Renate M Winkels
- Division of Human Nutrition, Wageningen University & Research, P.O Box 17, 6700 AA, Wageningen, The Netherlands.
| | - Fränzel J B van Duijnhoven
- Division of Human Nutrition, Wageningen University & Research, P.O Box 17, 6700 AA, Wageningen, The Netherlands
| | | | - Dieuwertje E G Kok
- Division of Human Nutrition, Wageningen University & Research, P.O Box 17, 6700 AA, Wageningen, The Netherlands
| | | | - Henk K van Halteren
- Department of Internal Medicine, Admiraal de Ruyter Hospital, Goes/Vlissingen, The Netherlands
| | - Bibi M E Hansson
- Department of Surgery, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
| | - Flip M Kruyt
- Department of Surgery, Gelderse Vallei Hospital, Ede, The Netherlands
| | | | - Johannes H W de Wilt
- Department of Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Jaap J Dronkers
- Department of Physical Therapy, Gelderse Vallei Hospital, Ede, The Netherlands
| | - Ellen Kampman
- Division of Human Nutrition, Wageningen University & Research, P.O Box 17, 6700 AA, Wageningen, The Netherlands
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Efficacy, feasibility, and acceptability of a novel technology-based intervention to support physical activity in cancer survivors. Support Care Cancer 2016; 25:1291-1300. [DOI: 10.1007/s00520-016-3523-5] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 12/05/2016] [Indexed: 11/24/2022]
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46
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Do cancer survivors develop healthier lifestyle behaviors than the cancer-free population in the PLCO study? J Cancer Surviv 2016; 11:233-245. [PMID: 27837443 DOI: 10.1007/s11764-016-0581-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 10/24/2016] [Indexed: 12/25/2022]
Abstract
BACKGROUND Current studies report mixed results in health status and health behaviors after a diagnosis of cancer. The aim of our study is to investigate potential differences in lifestyle factors among cancer survivors and cancer-free individuals in a prospective cohort study conducted in the United States. METHODS Using data from the Prostate, Lung, Colorectal and Ovarian (PLCO) Trial, 10,133 cancer survivors were identified and compared to 81,992 participants without cancer to evaluate differences in body mass index (BMI), smoking, NSAID use, and physical activity. RESULTS Cancer survivors, compared to the cancer-free, were significantly less likely to engage in physical activity (odds ratio (OR) = 0.82, 95% CI = 0.77-0.88). Compared to those who were obese at baseline, cancer survivors were more likely to be at normal BMI at follow-up compared to the cancer-free (OR = 1.90, 95% CI = 1.42-2.54). Cancer survivors were less likely to report regular aspirin use as compared to the cancer-free population (OR = 0.86, 95 % CI = 0.82-0.92). Of the current smokers, cancer survivors were more likely to be former smokers at follow-up compared to the cancer-free (OR = 1.50, 95% CI = 1.30-1.74). CONCLUSION Upon stratification by baseline health markers, cancer survivors practice healthier lifestyle habits such as smoking cessation and maintenance of a healthy weight. However, cancer survivors are less likely to be physically active as compared to cancer-free individuals, regardless of baseline practices. IMPLICATIONS FOR CANCER SURVIVORS For cancer survivors who reported poor health status and behaviors at baseline, a cancer diagnosis may encourage the practice of healthier lifestyle behaviors.
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Husson O, Denollet J, Ezendam NPM, Mols F. Personality, health behaviors, and quality of life among colorectal cancer survivors: Results from the PROFILES registry. J Psychosoc Oncol 2016; 35:61-76. [DOI: 10.1080/07347332.2016.1226227] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Olga Husson
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Johan Denollet
- Department of Medical and Clinical Psychology, CoRPS-Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, The Netherlands
| | - Nicole P. M. Ezendam
- Department of Medical and Clinical Psychology, CoRPS-Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, The Netherlands
- Comprehensive Cancer Centre the Netherlands, Eindhoven Cancer Registry, Eindhoven, The Netherlands
| | - Floortje Mols
- Department of Medical and Clinical Psychology, CoRPS-Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, The Netherlands
- Comprehensive Cancer Centre the Netherlands, Eindhoven Cancer Registry, Eindhoven, The Netherlands
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Güler H, Yildizgören MT, Üstün N, Paksoy H, Turhanoğlu AD. Isokinetic Assessment of the Wrist Muscles in Females With Fibromyalgia. Arch Rheumatol 2016; 31:215-220. [PMID: 29900934 PMCID: PMC5827845 DOI: 10.5606/archrheumatol.2016.5908] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 02/25/2016] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES This study aims to evaluate wrist muscle strength and muscle fatigue in females with fibromyalgia syndrome (FMS) and compare the results with those of healthy controls. PATIENTS AND METHODS Thirty consecutive female FMS patients (mean age 39.8±6.7 years; range 25 to 49 years) and 50 age and body mass index similar healthy females (mean age 35.4±7.9 years; range 27 to 48 years) were enrolled. Patients' clinical characteristics were recorded and symptoms were evaluated by the Fibromyalgia Impact Questionnaire. In addition to the demographic characteristics, physical activities of all subjects were questioned, isokinetic muscle performance was measured, and fatigue index was calculated by endurance test. RESULTS The peak torque values of the wrist extensor and flexor muscles (at an angular velocity of 90°/second) were higher in the control group than in the FMS group (both p<0.01). There were no differences between the groups in terms of the fatigue indexes of the flexor and extensor muscles of the wrist (both p>0.05). While there were differences between the groups regarding weekly hours of walking (p=0.01) and house cleaning (p<0.001), no differences were determined for weekly hours of bicycling, gardening, doing sports, or total physical activity. There was no correlation between the peak torque values and clinical characteristics in FMS group. CONCLUSION Patients with FMS had decreased muscle strength compared to healthy controls. Further studies with larger participants are needed to explain the relationship between upper limb muscle performance and FMS, as well as the underlying pathogenesis.
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Affiliation(s)
- Hayal Güler
- Department of Physical and Rehabilitation, Medical Faculty of Mustafa Kemal University, Hatay, Turkey
| | | | - Nilgun Üstün
- Department of Physical and Rehabilitation, Medical Faculty of Mustafa Kemal University, Hatay, Turkey
| | - Hacer Paksoy
- Department of Physical and Rehabilitation, Medical Faculty of Mustafa Kemal University, Hatay, Turkey
| | - Ayşe Dicle Turhanoğlu
- Department of Physical and Rehabilitation, Medical Faculty of Mustafa Kemal University, Hatay, Turkey
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van Roekel EH, Winkler EAH, Bours MJL, Lynch BM, Willems PJB, Meijer K, Kant I, Beets GL, Sanduleanu S, Healy GN, Weijenberg MP. Associations of sedentary time and patterns of sedentary time accumulation with health-related quality of life in colorectal cancer survivors. Prev Med Rep 2016; 4:262-9. [PMID: 27419042 PMCID: PMC4941044 DOI: 10.1016/j.pmedr.2016.06.022] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 06/14/2016] [Accepted: 06/27/2016] [Indexed: 11/29/2022] Open
Abstract
Sedentary behavior (sitting/lying at low energy expenditure while awake) is emerging as an important risk factor that may compromise the health-related quality of life (HRQoL) of colorectal cancer (CRC) survivors. We examined associations of sedentary time with HRQoL in CRC survivors, 2–10 years post-diagnosis. In a cross-sectional study, stage I–III CRC survivors (n = 145) diagnosed (2002−2010) at Maastricht University Medical Center+, the Netherlands, wore the thigh-mounted MOX activity monitor 24 h/day for seven consecutive days. HRQoL outcomes were assessed by validated questionnaires (EORTC QLQ-C30, WHODAS II, Checklist Individual Strength, and Hospital Anxiety and Depression Scale). Confounder-adjusted linear regression models were used to estimate associations with HRQoL outcomes of MOX-derived total and prolonged sedentary time (in prolonged sedentary bouts ≥ 30 min), and usual sedentary bout duration, corrected for waking wear time. On average, participants spent 10.2 h/day sedentary (SD, 1.6), and 4.5 h/day in prolonged sedentary time (2.3). Mean usual sedentary bout duration was 27.3 min (SD, 16.8). Greater total and prolonged sedentary time, and longer usual sedentary bout duration were associated with significantly (P < 0.05) lower physical functioning, and higher disability and fatigue scores. Greater prolonged sedentary time and longer usual sedentary bout duration also showed significant associations with lower global quality of life and role functioning. Associations with distress and social functioning were non-significant. Sedentary time was cross-sectionally associated with poorer HRQoL outcomes in CRC survivors. Prospective studies are needed to investigate whether sedentary time reduction is a potential target for lifestyle interventions aiming to improve the HRQoL of CRC survivors.
Sedentary time may negatively affect health outcomes in colorectal cancer survivors. Thigh-worn accelerometers provided objective and accurate estimates of sedentary time. Colorectal cancer survivors spent on average 10.2 h/day in sedentary time. Sedentary time was associated with worse quality of life, fatigue, and disability. Decreasing sedentary time could be a relevant target for lifestyle intervention.
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Key Words
- BMI, body mass index
- CI, confidence interval
- CIS, Checklist Individual Strength
- CRC, colorectal cancer
- Colorectal Neoplasms
- EORTC QLQ-C30, European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire-Core 30
- EnCoRe study, Energy for life after ColoRectal cancer study
- HADS, Hospital Anxiety and Depression Scale
- HRQoL, health-related quality of life
- ICF, International Classification of Functioning, Disability and Health
- MET, metabolic equivalent
- MVPA, moderate-to-vigorous physical activity
- Quality of Life
- SD, standard deviation
- Sedentary Lifestyle
- Survivors
- WHO, World Health Organization
- WHODAS II, 12-item World Health Organization Disability Assessment Schedule II
- β, unstandardized regression coefficient
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Affiliation(s)
- Eline H van Roekel
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Elisabeth A H Winkler
- The University of Queensland, School of Population Health, Herston Road, Herston, Qld 4006, Australia
| | - Martijn J L Bours
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Brigid M Lynch
- Cancer Epidemiology Centre, Cancer Council Victoria, 615 St Kilda Road, Melbourne, Vic 3004, Australia; Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, 207 Bouverie Street, Melbourne, Vic 3010, Australia; Physical Activity Laboratory, Baker IDI Heart and Diabetes Institute, P.O. Box 6492, Melbourne, Vic 3004, Australia
| | - Paul J B Willems
- Department of Human Movement Science, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Kenneth Meijer
- Department of Human Movement Science, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Ijmert Kant
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Geerard L Beets
- Department of Surgery, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center+, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands
| | - Silvia Sanduleanu
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center+, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands
| | - Genevieve N Healy
- The University of Queensland, School of Population Health, Herston Road, Herston, Qld 4006, Australia; Physical Activity Laboratory, Baker IDI Heart and Diabetes Institute, P.O. Box 6492, Melbourne, Vic 3004, Australia; School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth, Western Australia 6845, Australia
| | - Matty P Weijenberg
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
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Quality of Life and Mortality of Long-Term Colorectal Cancer Survivors in the Seattle Colorectal Cancer Family Registry. PLoS One 2016; 11:e0156534. [PMID: 27253385 PMCID: PMC4890809 DOI: 10.1371/journal.pone.0156534] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 05/15/2016] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND AND AIM Because most colorectal cancer patients survive beyond five years, understanding quality of life among these long-term survivors is essential to providing comprehensive survivor care. We sought to identify personal characteristics associated with reported quality of life in colorectal cancer survivors, and sub-groups of survivors potentially vulnerable to very low quality of life. METHODS We assessed quality of life using the Veterans RAND 12-item Health Survey within a population-based sample of 1,021 colorectal cancer survivors in the Seattle Colorectal Cancer Family Registry, approximately 5 years post-diagnosis. In this case-only study, mean physical component summary scores and mental component summary scores were examined with linear regression. To identify survivors with substantially reduced ability to complete daily tasks, logistic regression was used to estimate odds ratios for "very low" summary scores, defined as a score in the lowest decile of the reference US population. All cases were followed for vital status following QoL assessment, and mortality was analyzed with Cox proportional hazards regression. RESULTS Lower mean physical component summary score was associated with older age, female sex, obesity, smoking, and diabetes or other co-morbidity; lower mean mental component summary score was associated with younger age and female sex. Higher odds of very low physical component summary score was associated with older age, obesity, less education, smoking, co-morbidities, and later stage at diagnosis; smoking was associated with higher odds of very low mental component summary score. A very low physical component score was associated with higher risk of mortality (hazard ratio (95% confidence interval): 3.97 (2.95-5.34)). CONCLUSIONS Our results suggest that identifiable sub-groups of survivors are vulnerable to very low physical components of quality of life, decrements that may represent meaningful impairment in completing everyday tasks and are associated with higher risk of death.
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