Design and implementation of a standard care programme of therapeutic exercise and education for breast cancer survivors

Abstract Background Breast cancer survivors (BCS) face several symptoms and are at higher risk of weight gain following diagnosis. Current literature shows that both exercise and diet play a key role in recovery of BCS. However, there is a gap between current guidelines and the real-world context. The aim of this article is to describe the process behind a free, not-for-profit community-based therapeutic exercise and education programme (TEEP) for BCS in the clinical setting. Methods The “Onco-Health Club” (OHC) consists of therapeutic exercise (TE) intervention aimed at ameliorating cancer-related fatigue (CRF) and improving QoL and physical function. TE is supplemented with nutritional education, providing information about the Mediterranean diet. To this end, patients are recruited from an oncologist and are referred to a physiotherapist and a nutritionist for baseline assessment. TEEP consists of a 3-month intervention, delivered twice a week in a group format with 1 h of TE and 30 min of nutritional education. BCS then have a final assessment and are advised to continue with a healthy lifestyle. Data about referral, compliance and assessment were collected. Results From May 2017 to February of 2020, a total of 158 patients were recruited from 8 cohorts and 142 initially started the OHC. From 119 that joined the program, 96 patients were considered to have finished it with good adherence (assistance > 80%). BCS significantly improved their QoL, as well as upper and lower limb’s function, and increased their level of physical activity. CRF tended to decrease (p = 0.005). Conclusions This study obtained data on recruitment, compliance, and possible limitations of these kinds of programmes in a real-world context. Further research is needed in order to optimize patient engagement and compliance, as well as to determine the transferability of these programmes in the clinical setting. Trial registration NCT03879096, Registered 18th March 2019. Retrospectively registered.

Download Full-text

Acupuncture In The Real World: Evaluating a 15-Year NADA Auricular Acupuncture Service For Breast Cancer Survivors Experiencing Hot Flushes And Night Sweats As a Consequence of Adjuvant Hormonal Therapies

10.21203/rs.3.rs-1075043/v1 ◽

2021 ◽

Author(s):

Beverley de Valois ◽

Teresa Elaine Young ◽

Pam Thorpe ◽

Tarsem Degun ◽

Karen Corbishley

Keyword(s):

Breast Cancer ◽

Cancer Survivors ◽

Real World ◽

Breast Cancer Survivors ◽

Auricular Acupuncture ◽

Hot Flushes ◽

Usual Practice ◽

Hot Flush ◽

Night Sweats ◽

Service Offering

Abstract PurposeWhile clinical trials provide valuable data about efficacy of interventions, findings often do not translate into clinical settings. We report real world clinical outcomes of a 15-year service offering breast cancer survivors auricular acupuncture to manage hot flushes and night sweats (HFNS) associated with adjuvant hormonal treatments. This service evaluation aims to 1) assess whether usual practice alleviates symptoms in a clinically meaningful way and 2) compare these results with scientific evidence. MethodsData were analysed from 415 referrals to a service offering women eight standardised treatments using the National Acupuncture Detoxification Association (NADA) protocol. Outcome measures administered at baseline, end of treatment (EOT), and four- and 18- weeks after EOT included Hot Flush Diaries, Hot Flush Rating Scale (HFRS) and Women’s Health Questionnaire (WHQ).Results2285 treatments were given to 300 women; 275 (92.3%) completed all eight treatments. Median daily frequency of HFNS reduced from 9.6 (IQR 7.3) to 5.7 (IQR 5.8) at EOT and 6.3 (IQR 6.5) 18 weeks after EOT. HFRS problem rating showed a clinically meaningful reduction of ≥2 points at all measurement points. WHQ showed improvements in several symptoms associated with the menopause. Two adverse events were reported, neither were serious. Results are comparable to published research.ConclusionThis first analysis of a long-term auricular acupuncture service compares favourably with outcomes of other studies for reducing HFNS frequency and associated menopausal symptoms. In day-to-day clinical practice, NADA appears to be a safe effective intervention for breast cancer survivors.

Download Full-text

Systematic review of the effect of aquatic therapeutic exercise in breast cancer survivors

European Journal of Cancer Care ◽

10.1111/ecc.13535 ◽

2021 ◽

Author(s):

Esther Mur‐Gimeno ◽

Paula Postigo‐Martin ◽

Irene Cantarero‐Villanueva ◽

Raquel Sebio‐Garcia

Keyword(s):

Breast Cancer ◽

Systematic Review ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Therapeutic Exercise

Download Full-text

The development of a lifestyle modification mobile application, “Health for You” for overweight and obese breast cancer survivors in Korea

Korean Journal of Women Health Nursing ◽

10.4069/kjwhn.2021.09.14 ◽

2021 ◽

Vol 27 (3) ◽

pp. 243-255

Author(s):

Su-Jin Seo ◽

Ju-Hee Nho ◽

Youngsam Park

Keyword(s):

Breast Cancer ◽

Cancer Survivors ◽

Mobile Application ◽

Breast Cancer Survivors ◽

Lifestyle Modification ◽

Healthy Lifestyle ◽

Cancer Recurrence ◽

Bulletin Board ◽

Design Development

Purpose: This study aimed to develop a lifestyle modification (LSM) mobile application based on the Android operating system for overweight and obese breast cancer survivors (BCS) in Korea and evaluate its usability.Methods: The content analysis, design, development, implementation, and evaluation of the LSM intervention mobile application for overweight and obese BCS was conducted by identifying survivors’ needs, searching the literature, and reviewing existing mobile applications. The survey was conducted from June 1 to December 28, 2020 at Jeonju city, Korea.Results: The mobile application for BCS included dietary and exercise information, weight logs, as well as distress and daily achievement check. It also included information and videos on the prevention of breast cancer recurrence and used a communication bulletin board. Expert and user usability evaluation of its content and functions confirmed that it was appropriate and satisfactory for overweight and obese BCS.Conclusion: This LSM mobile application developed for overweight and obese BCS was found to be appropriate for use. It can be applied for further study of effectiveness on improving their health and maintaining a healthy lifestyle, to ultimately improve quality of life.

Download Full-text

Use of real-world data to study health services utilisation and comorbidities in long-term breast cancer survivors (the SURBCAN study): study protocol for a longitudinal population-based cohort study

BMJ Open ◽

10.1136/bmjopen-2020-040253 ◽

2020 ◽

Vol 10 (9) ◽

pp. e040253

Author(s):

Anna Jansana ◽

Isabel Del Cura ◽

Alexandra Prados-Torres ◽

Teresa Sanz Cuesta ◽

Beatriz Poblador-Plou ◽

...

Keyword(s):

Breast Cancer ◽

Cohort Study ◽

Health Services ◽

Cancer Survivors ◽

Real World ◽

Breast Cancer Survivors ◽

Population Based ◽

Real World Data ◽

World Data

IntroductionBreast cancer has become a chronic disease due to survival improvement and the need to monitor the side effects of treatment and the disease itself. The aim of the SURBCAN study is to describe comorbidity, healthcare services use and adherence to preventive recommendations in long-term breast cancer survivors and to compare them with those in women without this diagnosis in order to improve and adapt the care response to this group of survivors.Methods and analysisPopulation-based retrospective cohort study using real-world data from cancer registries and linked electronic medical records in five Spanish regions. Long-term breast cancer survivors diagnosed between 2000 and 2006 will be identified and matched by age and administrative health area with women without this diagnosis. Sociodemographic and clinical variables including comorbidities and variables on the use of health services between 2012 and 2016 will be obtained from databases in primary and hospital care. Health services use will be assessed through the annual number of visits to primary care professionals and to specialists and through annual imaging and laboratory tests. Factors associated with healthcare utilisation and comorbidities will be analysed using multilevel logistic regression models. Recruitment started in December 2018.Ethics and disseminationThis study was approved by the Ethics Committee of Parc de Salut Mar. The results of the study will be published in a peer-reviewed journal and will be presented at national and international scientific conferences and at patient associations.Trial registration numberThis protocol is registered in Clinical Trials.gov (identifier: NCT03846999).

Download Full-text

Real-world experiences with acupuncture among breast cancer survivors: a cross-sectional survey study

Supportive Care in Cancer ◽

10.1007/s00520-020-05442-9 ◽

2020 ◽

Vol 28 (12) ◽

pp. 5833-5838 ◽

Cited By ~ 1

Author(s):

Jacqueline Zayas ◽

Kathryn J. Ruddy ◽

Janet E. Olson ◽

Fergus J. Couch ◽

Brent A. Bauer ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Survivors ◽

Real World ◽

Breast Cancer Survivors ◽

Survey Study ◽

Cross Sectional Survey ◽

Cross Sectional

Download Full-text

Impact of Young and Strong on physical activity in young breast cancer survivors.

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.3_suppl.175 ◽

2016 ◽

Vol 34 (3_suppl) ◽

pp. 175-175

Author(s):

Jennifer A. Ligibel ◽

William Thomas Barry ◽

Kathryn Jean Ruddy ◽

Mary Greaney ◽

Shoshana M. Rosenberg ◽

...

Keyword(s):

Breast Cancer ◽

Physical Activity ◽

Cancer Survivors ◽

Young Women ◽

Breast Cancer Survivors ◽

Physical Activity Intervention ◽

Healthy Lifestyle ◽

Randomized Study ◽

Significant Difference ◽

Young Breast Cancer

175 Background: Inactivity is common in breast cancer survivors and has been linked to poor outcomes. Few trials have tested physical activity (PA) interventions in young women with breast cancer, who may face unique PA barriers due to demands of jobs and young families. Methods: Young and Strong was a cluster-randomized study evaluating the effect of education interventions for young breast cancer survivors.Sites were randomized 1:1 to a young women’s intervention (YWI), focused on fertility and other issues facing young women, or to a physical activity intervention (PAI). At PAI sites, providers were instructed to discuss PA with patients, and participants were given materials to encourage PA. PA was measured with the modified Godin Leisure Score Index at baseline, and 3, 6, and 12 months. Medical records were reviewed to assess provider attention to PA. Changes in weekly min of PA were compared between the PAI and YWI groups using general estimating equations to evaluate clustered binary and Gaussian data. Results: 467 patients enrolled between 7/12 -12/13 across 54 sites. Median age at dx was 40yrs (range 22-45). At baseline, participants were moderately active. PA increased in both groups over time (Table); there was no significant difference in PA between groups at any time (all p > 0.1). Provider attention to PA was documented in 74% of participants on PAI and 61% on YWI (p = 0.15), and correlated with PA at 12 months (median 100 min/wk of PA in participants with provider attention to PA vs. 60 min/wk in those without, p = 0.016). Participants who reported reading all or most the PAI materials reported higher levels of PA vs. those who read less (78% vs. 64%, p = 0.05) Conclusions: Young breast cancer survivors assigned to a PA intervention did not increase PA more than those assigned to an intervention focused on young women’s issues. However, the higher levels of PA among women who engaged with the PAI materials and those whose oncology providers addressed PA suggests the importance of enhancing patient and provider engagement with healthy lifestyle information and recommendations. Clinical trial information: NCT01647607. [Table: see text]

Download Full-text

Abstract PD08-10: Breast Cancer Survivors Healthy Lifestyle Study: A Randomised Controlled Pilot To Test the Effects of a Behavioural Intervention (Information and Advice) on Uptake of Physical Activity in Breast Cancer Survivors

10.1158/0008-5472.sabcs10-pd08-10 ◽

2010 ◽

Author(s):

A Pollard ◽

M Henderson ◽

K-A Phillips ◽

G Dutu ◽

A Murnane ◽

...

Keyword(s):

Breast Cancer ◽

Physical Activity ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Healthy Lifestyle ◽

Behavioural Intervention ◽

Randomised Controlled

Download Full-text

A preliminary trial examining a ‘real world’ approach for increasing physical activity among breast cancer survivors: findings from project MOVE

BMC Cancer ◽

10.1186/s12885-019-5470-2 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Cristina M. Caperchione ◽

Catherine M. Sabiston ◽

Sean Stolp ◽

Joan L. Bottorff ◽

Kristin L. Campbell ◽

...

Keyword(s):

Breast Cancer ◽

Physical Activity ◽

Cancer Survivors ◽

Real World ◽

Breast Cancer Survivors ◽

Preliminary Trial

Download Full-text

Healthy Lifestyle Behaviors of Breast Cancer Survivors

Clinical Nursing Research ◽

10.1177/1054773814553298 ◽

2014 ◽

Vol 24 (5) ◽

pp. 504-525 ◽

Cited By ~ 8

Author(s):

Carol DeNysschen ◽

Jean K. Brown ◽

Mark Baker ◽

Gregory Wilding ◽

Sheldon Tetewsky ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Healthy Lifestyle ◽

Lifestyle Behaviors ◽

Healthy Lifestyle Behaviors

Download Full-text

Physical activity and body weight of breast cancer survivors – VICAN national survey

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.1273 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

D Rey ◽

R Touzani ◽

A Monet ◽

M K Bendiane ◽

A D Bouhnik ◽

...

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Healthy Lifestyle ◽

Well Being ◽

Healthy Habits ◽

Mental Well Being

Abstract Background Cancer recurrence and poor quality of life are major challenges of the growing population of breast cancer (BC) survivors. International guidelines encourage survivors to engage in regular physical activity (PA) and to maintain a healthy body weight (BW), as both have a proven benefit on survival. Our aims were (1) to describe PA and BW 5 years after a BC diagnosis and (2) to define the predictors of long-term engagement in healthy lifestyle, in a representative sample of French survivors. Methods The French National VICAN surveys were implemented in 2012 and 2015 among cancer survivors. This analysis focused on 723 women with BC, without progression at 5 years, and who participated in both surveys. The questionnaires dealt with several topics including socioeconomic status, treatments and side effects, psychometric scales and lifestyle habits. Results Five years after diagnosis, 26% of women reported regular PA, 61% occasional PA and 14% no PA. Moreover, 27% reported a weight gain ≥5kg, and 10% a weight loss ≥5kg. Half of the women had decreased or stopped PA since diagnosis. In logistic regression, long-term regular PA was associated with better mental quality of life (aOR=1.04; 1.01-1.07), no depression (aOR=3.42; 1.21-9.65), higher Post Traumatic Growth Inventory score (aOR=1.02; 1.01-1.04), normal arm mobility (aOR=3.7; 1.6-8.4) and healthy and stable BW since diagnosis (aOR=4.47; 1.61-12.37). Weight gain ≥5kg was associated with younger age (aOR=0.96; 0.93-0.99), higher BW at diagnosis (aOR=1.02; 1.01-1.04), and lymphedema 5 years after diagnosis (aOR=1.69; 1.02-2.83). Conclusions For BC survivors, mental well-being is essential for successful long-term investment in healthy habits. More psychological and dietary support, and a better management of sequelae are needed in this population. Key messages For breast cancer survivors, mental well-being is essential for successful long-term investment in healthy habits. More psychological and dietary support, and better sequelae management are needed to help breast cancer survivors to persist in healthy lifestyle.

Download Full-text