scholarly journals The impact of a hospital-based exercise oncology program on cancer treatment–related side effects among rural cancer survivors

Author(s):  
Adriana M. Coletta ◽  
Nathan B. Rose ◽  
Austin F. Johnson ◽  
D. Scott Moxon ◽  
Stephen K. Trapp ◽  
...  

Abstract Purpose To assess the impact of the Personal Optimism With Exercise Recovery (POWER) program on cancer treatment–related side effects among rural cancer survivors. Methods In this retrospective study of data collected between 2016 and 2019, we assessed change in cardiorespiratory fitness, whole-body muscular endurance, physical function and strength, anthropometrics, fatigue, and quality of life (QoL), after participation in POWER. Descriptive statistics were calculated for demographic and clinical variables. Univariate analysis of variance was carried out with age and BMI at initial assessment as covariates. Results A total of 239 survivors, 78% rural residents, completed a follow-up assessment. Among rural cancer survivors, the most prevalent cancer sites were breast (42.5%), prostate (12.4%), and lymphoma (5.9%). The majority of survivors were female (70%), non-Hispanic (94.6%), and white (93.5%), with average age and BMI of 62.1 ± 13.2 years and 28.4 ± 6.7 kg/m2, respectively. Rural cancer survivors with cancer stages I–III exhibited significant improvements in fitness (+ 3.07 ml/kg/min, 95% CI 1.93, 4.21; + 0.88 METS, 95% CI 0.55, 1.20), physical function (30-s chair stand: + 2.2 repetitions, 95% CI 1.3, 3.1), muscular endurance (10-repetition maximum: chest press + 4.1 kg, 95% CI 2.0, 6.3; lateral pulldown + 6.6 kg, 95% CI 4.4, 8.9), self-reported fatigue (FACIT-Fatigue score: + 4.9, 95% CI 1.6, 8.1), and QoL (FACT-G7 score + 2.1, 95% CI, 0.9, 3.4). Among stage IV rural and urban cancer survivors, significant improvements were observed in muscular endurance and physical function. Conclusion Participation in POWER was associated with attenuation of cancer treatment–related side effects and may serve as a model exercise oncology program for rural cancer survivors.

2013 ◽  
Vol 31 (26_suppl) ◽  
pp. 124-124
Author(s):  
Kaleigh Bulloch ◽  
Melinda Irwin ◽  
Anees B. Chagpar ◽  
Nina Ruth Horowitz ◽  
Brigid K. Killelea ◽  
...  

124 Background: Despite the Institute of Medicine’s recommendation that all cancer survivors be provided with a survivorship care plan (SCP), there is limited information as to whether SCPs improve knowledge. The purpose of this study was to examine the impact of SCPs on patient knowledge regarding tumor stage, cancer treatment and potential risk of long-term side effects, surveillance recommendations, and perceived knowledge of their therapy. Methods: 75 English-speaking women over the age of 18 were enrolled in this prospective study. The participants’ treatment progress was tracked through the electronic medical record and used to create the SCP, which was given to them at the completion of treatment (defined as the time patients had completed radiation and/or chemotherapy treatments and initiated on hormonal therapy, if applicable). Knowledge of stage, treatments, potential side effects, and surveillance recommendations were assessed before receiving the SCP and again two months later. Accuracy of responses was compared using the McNemar test. Results: The median patient age was 56.8 ± 12.5 and 47.1% were stage I, 37.3% were stage II, and 15.7% were stage III. Participants were statistically more accurate in identifying their stage after receiving their SCP than at baseline (72.6% vs. 92.2%, p = 0.0016). While many patients were more accurate in the identification of the cancer treatment they received after SCP, the only significant improvement was in identifying 5-Fluorouracil as chemotherapy received (65.5% vs. 89.7%, p=0.0196). Patients were more accurate in identifying potential side effects but were only statistically more accurate at identifying leukemia as a risk factor (36.0% vs. 46.9%, p=0.0348). At baseline and follow up patients perceived that they had a high level of understanding as it related to their cancer stage (60.4%, and 66.7%), treatment (69.4%, and 71.4%), and surveillance recommendations (61.4%, and 54.6%). Conclusions: SCPs appear to improve patient knowledge in several important areas including basic and specific treatment details, surveillance recommendations, and potential side effects. Delivery of a SCPs is one strategy to improve knowledge of treatments received.


2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 152-152
Author(s):  
Keerti Murari ◽  
Jordonna Brown ◽  
Juan P. Wisnivesky ◽  
Jenny J Lin

152 Background: Cancer survivors often experience cancer and treatment-related side effects and may also have comorbidities that may further impact their quality of life. Little is known about how cancer-related side effects and health status impact survivors’ beliefs and management of comorbidities. We undertook this study to assess the relationship between cancer-related side effects and diabetes (DM) self-management behaviors (SMB) and beliefs in cancer survivors with comorbid diabetes. Methods: We recruited diabetes patients recently diagnosed with early-stage breast or prostate cancer who were taking at least one oral hypoglycemic agent. Side effects for prostate cancer survivors were assessed using the Expanded Prostate Cancer Index Composite; side effects for breast cancer survivors were assessed using a standardized questionnaire for hormonal therapy-related side effects. Patients were asked to rate their overall health status and about the perceived impact of cancer treatment on DM. We measured DM medication adherence using the 8-item Morisky Medication Adherence Scale, and DM SMB were evaluated using the Summary of Diabetes Self-Care Activities. Descriptive and univariate analyses were used to assess factors associated with DM SMB. Results: Of the 52 patients recruited, 32 (62%) were male. Twenty-four (46%) patients reported cancer or treatment related side effects, with most (21, 88%) being moderately or severely bothered by these symptoms. Of these patients, 20 (83%) reported non-adherence to their DM medications and 18 (71%) reported checking their fingersticks < 5 times a week. Yet most patients (20, 84%) felt that their diabetes care was at least equally as important as their cancer care. Neither the presence nor severity of side effects was associated with DM SMB. However, patients who reported poorer overall health status were more likely to be worried about the impact of cancer treatment on diabetes management (75% vs. 25%, p < 0.01). Conclusions: Many cancer survivors report moderate to severe treatment-related side effects, although severity of side effects was not found to be associated with DM SMB. Further effort should focus on addressing survivors’ concerns about the impact of cancer treatment on comorbid disease management.


2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e24080-e24080
Author(s):  
Eva Battaglini ◽  
David Goldstein ◽  
Susanna Park

e24080 Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a major yet poorly understood side effect of cancer treatment, leading to symptoms including numbness, tingling and pain. It can lead to cessation of effective treatment, long-term functional disability and reduced quality of life. Despite this, there is currently little understanding of its impact. Methods: The aim of the study was to investigate the impact of neurotoxic chemotherapy side effects on the lives of cancer survivors. Data was collected via an online survey covering demographics, cancer diagnosis and treatment, CIPN and other side effects of chemotherapy, using standardised measures to assess comorbidities, quality of life, physical activity, pain and CIPN symptoms. Results: Data was analysed from 986 respondents who were treated with neurotoxic therapies (83% female, 16% male), with mean age 59 years ( SD 10.7 years). A majority of respondents were treated for breast cancer (59%), 14% for colorectal cancer and 11% for multiple myeloma. Chemotherapy types received included paclitaxel (32%), docetaxel (32%) and oxaliplatin (13%), and respondents completed treatment a mean of 3.6 years ago. The majority of respondents (80%) reported experiencing neuropathic symptoms after finishing chemotherapy, with 77% reporting current CIPN. Those with CIPN reported functional impacts, with 23% reporting moderate to severe problems with hand function and 28% reporting moderate to severe walking difficulties. CIPN was second most commonly rated as the treatment side effect having the greatest impact, following fatigue. Respondents with high levels of current CIPN symptoms had poorer quality of life, more comorbid health conditions, higher BMI and more often received multiple neurotoxic chemotherapies than those with low levels of CIPN symptoms. In addition, respondents who reported meeting government physical activity guidelines had lower CIPN and higher quality of life scores than those who did not meet the guidelines. Regression analyses investigating the association between quality of life and clinical and sociodemographic characteristics resulted in a model with comorbid health conditions, CIPN symptoms, years since treatment, age and physical activity as significant predictors of quality of life. Conclusions: These findings suggest that CIPN has a lasting impact on cancer survivors, leading to decreases in quality of life, often occurring alongside poorer general health. This impact supports the need for further research to improve assessment, prevention and treatment.


Author(s):  
Yuk Yee Karen Lee ◽  
◽  
Kin Yin Li ◽  

"Breast cancer is a major concern in women’s health in Mainland China. Literatures demonstrates that women with breast cancer (WBC) need to pay much effort into resisting stigma and the impact of treatment side-effects; they suffer from overwhelming consequences due to bodily disfigurement and all these experiences will be unbeneficial for their mental and sexual health. However, related studies in this area are rare in China. The objectives of this study are 1) To understand WBC’s treatment experiences, 2) To understand what kinds of support should be contained in a transdisciplinary intervention framework (TIP) for Chinese WBC through the lens that is sensitive to gender, societal, cultural and practical experience. In this study, the feminist participatory action research (FPAR) approach containing the four cyclical processes of action research was adopted. WBC’s stories were collected through oral history, group materials such as drawings, theme songs, poetry, handicraft, storytelling, and public speech content; research team members and peer counselors were involved in the development of the model. This study revealed that WBC faces difficulties returning to the job market and discrimination, oppression and gender stereotypes are commonly found in the whole treatment process. WBC suffered from structural stigma, public stigma, and self-stigma. The research findings revealed that forming a critical timeline for intervention is essential, including stage 1: Stage of suspected breast cancer (SS), stage 2: Stage of diagnosis (SD), stage 3: Stage of treatment and prognosis (ST), and stage 4: Stage of rehabilitation and integration (SRI). Risk factors for coping with breast cancer are treatment side effects, changes to body image, fear of being stigmatized both in social networks and the job market, and lack of personal care during hospitalization. Protective factors for coping with breast cancer are the support of health professionals, spouses, and peers with the same experience, enhancing coping strategies, and reduction of symptom distress; all these are crucial to enhance resistance when fighting breast cancer. Benefit finding is crucial for WBC to rebuild their self-respect and identity. Collaboration is essential between 1) Health and medical care, 2) Medical social work, 3) Peer counselor network, and 4) self-help organization to form the TIF for quality care. The research findings are crucial for China Health Bureau to develop medical social services through a lens that is sensitive to gender, societal, cultural, and practical experiences of breast cancer survivors and their families."


2019 ◽  
Vol 2019 ◽  
pp. 1-10
Author(s):  
Michał Wiciński ◽  
Bartosz Malinowski ◽  
Oskar Puk ◽  
Karol Górski ◽  
Dawid Adamkiewicz ◽  
...  

For their being considered safe and as over-the-counter (OTC) drugs, proton pump inhibitors (PPI) are one of the most frequently used medicines nowadays. However, for the last couple of years, many researches analyzing PPI were conducted and these studies shed light on PPI side effects and mechanisms of these processes. Particularly, interesting is the impact of PPI on hearing loss development. However, this side effect seems to be local and its mechanisms are complex and systemic and involve changes in the whole body. This paper summarizes how through, inter alia, alterations in circulatory system, respiratory system, central nervous system, and metabolic changes PPI can cause hearing impairment, which can occur at every age and is connected with long-term use of this group of drugs. Another important finding is the role of PPI in acceleration of presbycusis development which is disturbing with regard to the fact that elders are the group who most frequently use PPI in the long term. Hearing loss is the factor which gravely decreases life quality, especially among elders who are the most afflicted group; thus, administration of PPI should be considered carefully, taking under consideration all benefits and all potential side effects.


2006 ◽  
Vol 24 (32) ◽  
pp. 5125-5131 ◽  
Author(s):  
Wendy Demark-Wahnefried ◽  
Bernardine M. Pinto ◽  
Ellen R. Gritz

Cancer survivors are at increased risk, not only for progressive and recurrent disease, but also other cancers, cardiovascular disease, diabetes, osteoporosis, and functional decline. Lifestyle interventions to improve dietary and physical activity behaviors, and smoking cessation, have the potential to improve the overall health and quality of life of this vulnerable population. Studies on overall health and physical function from 1966 and beyond regarding the impact of behavioral interventions that used randomized and controlled designs were identified through MEDLINE and PubMed searches. Published reports currently exist for 22 exercise interventions, 11 diet-related interventions (excluding those limited to dietary supplements or single nutrients), two diet and exercise interventions, and 10 behavioral-based smoking cessation interventions. Although many interventions have been successful in promoting behavioral change and have resulted in improvements in various health-related outcomes, more research is needed to determine the key components of interventions that are able to produce the greatest behavioral change and the most favorable health-related benefits. The oncology care provider can play a pivotal role in improving the long-term health of cancer survivors by (1) being aware of opportunities to encourage healthful behaviors (ie, smoking cessation, weight control, and increased physical activity); (2) vigilantly tracking long-term effects among cancer survivors and exploring whether they are amenable to intervention; (3) staying abreast of current health behavior guidelines for cancer survivors and existing resources for professional and patient education; and (4) supporting and contributing to efforts aimed at primary and tertiary prevention research.


2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e12524-e12524
Author(s):  
Be Saito ◽  
Cathryn Johnson ◽  
Lina Sizer ◽  
Catherine Carruthers ◽  
Elena Lamb ◽  
...  

e12524 Background: The introduction of Oncotype Dx set the stage for targeting chemotherapy treatment to only patients who would derive a benefit. RxPONDER trial then demonstrated that postmenopausal women with 1-3 positive lymph nodes, could forego chemotherapy if the recurrence score (RS) was ≤25. The most common chemotherapy regimens for breast cancer are taxotere and cytoxan or dose dense adriamycin/cytoxan followed by taxol. Chemotherapy can have many side effects and can increase risk of hospitalization due to complications. In addition, the financial cost can be considerable. Four cycles of TC will approximately cost $59,000, and most patients likely receive doses of growth factor support (neulasta is $12,565 per dose), totaling at minimum to $100,000 per patient. The purpose of this study was to look at the impact of RxPONDER on our patients. We reviewed patients who had RS at our institution in the last 5 years to see if we were appropriately treating patients with chemotherapy and hormonal therapy, or if a large group could be treated with hormonal therapy alone. Methods: This was an IRB approved retrospective chart review of patients at an academic-community hospital from 2015-2019. We identified patients ≥50 years old diagnosed with ER+/HER2- node positive breast cancer. Exclusion criteria included: M1, pN2, pN3. Univariate analysis used to compare patients that had RS vs those that did not. Student’s t-test was used to analyze whether there was a difference in rate of patients getting chemotherapy based on RS. Results: 216 patients were identified with ER+/Her2- breast cancer and 1-3 positive lymph nodes. 142 had RS (65.7%). Of those with RS, 140 were T1-T2 (98.6%), 131 had 1-2 positive LNs (92.3%), 115 had RS≤25 (80.9%), and 56 received chemotherapy (39.4%). Of the 74 patients without RS, 60 were T1-T2 (94.6%), 69 had 1-2 positive LNs (93.2%), and 51 received chemotherapy (68.9%). 30 patients who met the RxPONDER criteria (postmenopausal, 1-3 positive lymph nodes, and RS ≤25) still received chemotherapy. Conclusions: If we apply the RxPONDER trial recommendations, 30 patients would have been spared chemotherapy. In addition, 54.2% RxPONDER patients had RS ≤25. Extrapolated by percentage, 40 of the 74 patients who did not get RS in our study may have also been spared the side effects and cost of chemotherapy. This would be a savings of at least $3-7 million dollars to the health care system. RxPONDER makes a significant impact, not only in appropriately deescalating breast cancer treatment, but also to counter the increasing cost of medical care.[Table: see text]


2018 ◽  
Vol 56 (2) ◽  
pp. 96-101
Author(s):  
Maria Alexandra Barbu ◽  
Cornelia Niţipir ◽  
Theodor Voiosu ◽  
Călin Giurcăneanu

Abstract Introduction. Skin toxicity in patients receiving novel therapeutic cancer agents has become a very important marker in determining drug activity, but it can also severely impact their quality of life. About half of the patients receiving this type of oncologic treatment will develop cutaneous reactions, that is why adequate understanding and management of these side effects is very important for drug adherence and patients’ quality of life. Materials and methods. We conducted a prospective study of consecutive patients who received oncologic treatment in our institution and presented with dermatologic side effects. The severity of skin toxicity was assessed using the DLQI score and patients were prospectively followed to evaluate response to therapy. Univariate analysis of factors influencing the impact of skin toxicity on patient QOL was conducted. Results. 52 patients were enrolled in the study. Patients who developed grade 3 and 4 skin toxicity had a higher DLQI score, with a greater impact on quality of life, but with better clinical outcome at 3 months follow-up, based on RECIST. Patients with moderate or severe cutaneous AE were more likely to achieve complete or partial response to therapy than those with mild AE (16/33 vs. 3/19, p = 0.035). Interestingly, female patients had a significantly poorer quality of life than male patients as assessed by the DLQI score (7.28 ± 7 vs. 3.7 ± 3.6, p = 0.038). Conclusion. Cutaneous side effects are often encountered in cancer patients and their severity can be a surrogate marker for a positive clinical tumor response to therapy.


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