scholarly journals Importance of performance status and physical activity in cancer patients

Author(s):  
David Kiesl

Summary Background This review summarizes current data on the effects of exercise interventions and physical activity in cancer prevention, treatment and related side effect management, as well as on the rehabilitation of cancer patients. Patients and methods The overall quality of patient studies is still poor due to methodological limitations. Major limitations of the interventional exercise studies conducted include their designs, with regard to missing randomization or the absence of control groups, and the use of heterogeneous assessment methods to quantify and objectify physical activity. As a result, there are no specific exercise recommendations in cancer patients as yet that would essentially differ from exercise recommendations for healthy subjects. Nevertheless, due to major findings and empirical data, the field of research into exercise- and physical activity-related effects on disease and therapy-associated aspects is young and rapidly emerging. Conclusion Exercise potentially contributes to the prevention and rehabilitation of cancer and represents a powerful tool in the prevention of various side effects under chemotherapy. Current data from interventional studies show preliminary positive effects for diverse movement programs and especially through specific combinations of endurance and resistance training. Additional randomized controlled trials with standardized assessments and controlling for potential confounders are needed to confirm and expand these findings.

2019 ◽  
Vol 18 ◽  
pp. 153473541989559 ◽  
Author(s):  
Xiaoxu Zhi ◽  
Man Xie ◽  
Yingchun Zeng ◽  
Jun-e Liu ◽  
Andy S. K. Cheng

Background: Cancer and its treatment significantly impact the quality of life (QOL) of adolescent and young adult (AYA) patients. This meta-analysis examined the effects of exercise interventions on the generic and cancer-specific QOL of AYA cancer patients and survivors. Methods: Four databases were searched from January 2010 to September 2019. RevMan 5.3 was used to synthesize the effects of exercise intervention on the QOL of AYA cancer patients and survivors. Results: A total of 11 eligible studies have been included in this paper. Direct outcome comparisons found that pooled overall effects on generic QOL were in favor of exercise interventions, but only with marginal significance (Z= 1.96, P = 0.05). When performing the subscale analysis of the generic QOL, three trials assessed the effects of exercise interventions on the emotional domain of QOL, and the weighted mean difference (WMD) for the overall intervention effect was 3.47 (95% confidence interval [CI] = 0.42 to 6.51). Additionally, exercise interventions increased the minutes of physical activity per week undertaken by AYA cancer patients and survivors (Z= 2.88, P = 0.004). Conclusion: Exercise interventions had positive effects on generic QOL and increased the minutes of physical activity per week undertaken by AYA cancer patients and survivors. In addition, exercise intervention programs appear to be safe, as there were no studies that reported adverse events. Future research, with rigorous methodological standards and larger sample sizes, should be designed to confirm the positive effects of exercise interventions on the QOL of AYA cancer patients and survivors.


Retos ◽  
2021 ◽  
Vol 44 ◽  
pp. 370-385
Author(s):  
Igor Cigarroa ◽  
Estefanía Díaz ◽  
Constanza Ortiz ◽  
Raquel Otero ◽  
Irene Cantarero ◽  
...  

There is a discrepancy about the characteristics and effects of exercise-based programs in older cancer survivors (OCS). Therefore, this scoping review aimed to identify the characteristics and effects of physical activity programs in OCS health. This scoping review followed the PRISMA guidelines and included randomized clinical trials and clinical trials from MEDLINE by PubMed, Scopus, Scielo, and PEDro, published between 2010 and 2020. Results suggest that physical programs were carried out in health centers (54.2%) and were based on physical exercise (74.4%). The length of the exercise interventions was between 3–6 months (87.5%) was performed 2–3 times per week (73.1%) with a duration between 20–60 minutes (78.2%) and was run by health professionals (94.4%). The health outcomes with the most positive effects were physical activity, depression, and quality of life. In conclusion, physical programs for OCS based on aerobic exercises are safe and could be a therapeutic strategy to improve different health markers in OCS.  Resumen. En la literatura existe discrepancia sobre las características y los efectos de los programas basados en el ejercicio físico en sobrevivientes de cáncer (SC) de edad avanzada. Por lo tanto, esta revisión de alcance tuvo como objetivo identificar las características y los efectos de los programas de actividad física en la salud de personas SC de edad avanzada. Esta revisión de ensayos clínicos aleatorizados y ensayos clínicos, se realizó considerando las siguientes bases de datos: MEDLINE (de Pubmed), Scopus, Scielo y PEDro, entre los años 2010 y 2020. Los resultados indican que los programas de ejercicio se realizaron en centros de salud (54.2%), y se basaron en ejercicio físico principalmente (74.4%). La extensión de las intervenciones físicas fue entre 3–6 meses (87.5%), se realizaron 2–3 veces por semana (73.1%) con una duración entre 20–60 minutos, y fueron dirigidas por profesionales de salud (94.4%). El impacto sobre la salud con mayores efectos positivos fueron la actividad física, la depresión y la calidad de vida. En conclusión, los programas de ejercitación física para personas SC en edad avanzada, basados en ejercicios aeróbicos son seguros y podrían ser una estrategia terapéutica para mejorar diferentes variables de salud en este grupo de personas.


2016 ◽  
Vol 2016 ◽  
pp. 1-13 ◽  
Author(s):  
Philipp Zimmer ◽  
Freerk T. Baumann ◽  
Max Oberste ◽  
Peter Wright ◽  
Alexander Garthe ◽  
...  

This systematic review analyzes current data on effects of exercise interventions and physical activity behavior on objective and subjective cancer related cognitive impairments (CRCI). Out of the 19 studies which met all inclusion criteria, five RCTs investigated rodents, whereas the other 14 trials explored humans and these included six RCTs, one controlled trial, two prospective noncontrolled trials, one case series, one observational study, and three cross-sectional studies. The results from animal models revealed positive effects of exercise during and after chemotherapy or radiation on structural alterations of the central nervous system, physiological as well as neuropsychological outcomes. The overall study quality in patient studies was poor. The current data on intervention studies showed preliminary positive effects of Asian-influenced movement programs (e.g., Yoga) with benefits on self-perceived cognitive functions as well as a reduction of chronic inflammation for breast cancer patients in the aftercare. Exercise potentially contributes to the prevention and rehabilitation of CRCI. Additional RCTs with standardized neuropsychological assessments and controlling for potential confounders are needed to confirm and expand preliminary findings.


2017 ◽  
Vol 5 (2) ◽  
pp. 225
Author(s):  
Martyn Queen ◽  
Diane Crone ◽  
Andrew Parker ◽  
Saul Bloxham

Rationale: There is a growing body of evidence that supports the use of physical activity during and after cancer treatment, although activity levels for patients remain low. As more cancer patients are treated successfully and treatment costs continue to escalate, physical activity may be a promising adjunct to a person-centered healthcare approach to recovery.Aim: The aim was to further understand how physical activity may enhance the recovery process for a group of mixed-site cancer patients.Objectives: The research investigated longitudinal changes in physical activity and perceived quality of life between 2 and 6 month’s post-exercise interventions. It also investigated support systems that enabled patients to sustain these perceived changes.Method: The respondent cohort comprised 14 mixed-site cancer patients aged 43-70 (11 women, 3 men), who participated in a 2-phase physical activity intervention that took place at a university in the South West of England, UK. Phase 1 consisted of an 8 week structured physical activity programme; Phase 2 consisted of 4 months of non-supervised physical activity. Semi-structured interviews took place 3 times over 6 months with each participant. Grounded theory informed the data collection and analysis which, in turn, facilitated theoretical development.Findings: Our findings propose 3 theories on the impact of physical activity for recovering cancer patients: (1) Knowledge gained through a structured exercise programme can enable recovering cancer patients to independently sustain physical activity to 4 month follow-up. (2) Sustaining physical activity for 6 months promotes positive changes in the quality of life indicators of chronic fatigue, self-efficacy, ability to self-manage and energy levels & (3) Peer support from patients facilitates adherence to a structured exercise programme and support from a spouse or life partner facilitates independently sustained physical activity to 4 month follow-up.Conclusions: This study demonstrates that qualitative research can provide an evidence base that could be used to support future care plans for cancer patients. Our findings also demonstrate that a physical activity intervention can be effective at helping cancer patients recover from the side effects of their treatment and we recommend that physical activity should become an adjunct therapy alongside traditional cancer treatments.


2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e24033-e24033
Author(s):  
Nathalie Dauphin McKenzie ◽  
Nnamdi Ifekandu Gwacham ◽  
Julie W. Pepe ◽  
Sarfraz Ahmad ◽  
James Erasmus Kendrick ◽  
...  

e24033 Background: General health related factors such as obesity, unhealthy diets disproportionate with sugary and highly processed foods, inactivity, and smoking have repeatedly been shown to negatively impact survival and quality of life outcomes in cancer survivors. The Healthy Eating Active Lifestyle (HEAL) – GYN “rehabilitation” cancer program was developed to provide intensive group lifestyle training on exercise, nutrition, sleep, social integration, and stress management via a telemedicine platform. The aim of this study was to determine the feasibility of such an intervention and its tolerability, in addition to its impact on short-term quality of life for gynecologic cancer patients. Methods: HEAL – GYN consists of 8 weekly group sessions offering experiential instruction and personalized goal setting for patients with diagnosis of gynecologic cancer. Components are drawn from the tenets of lifestyle medicine. An oncologist certified in lifestyle medicine along with a multidisciplinary rehabilitation team addressed diet, physical activity, strategies for sleep and stress management, smoking cessation, and alcohol intake. The intervention included training to address unmet psychologic, emotional, physical, sexual, social, and spiritual needs common to cancer survivors. American College of Lifestyle Medicine questionnaires were administered, utilizing Likert scales (1-5) in a pre- and post- fashion to assess improvements in physical activity levels, dietary habits, sleep hygiene, and quality of life. Medical records were reviewed including anthropometric data. Results: 26 patients have enrolled thus far, and we report outcomes on the first 20 participants. The mean age was 58.8 years; 22 were Caucasian, and 7 were on maintenance therapies for gynecologic cancers. Average total severity of reported symptoms (scale = 100 points) on a general medical symptom questionnaire (MSQ) decreased by 22% (61 vs 48). Eight patients reported increased perceived levels of health and 6 had stable perception of health. There were also notable improvements from baseline in item assessments of eating behavior (34%), perceived stress (20%), and resilience (21%). Patients also reported a notable trend towards improvement in anxiety (35%) and depression (34%), as well as social integration and connectedness (30%). 100% of participants would “highly recommend the program” and none complained of stress or altered mood associated with online instruction. Conclusions: The telemedicine HEAL – GYN peri-habilitation program is feasible and well tolerated. In addition, the program may improve quality of life and may prevent further decline for those on treatment or maintenance therapy. These preliminary findings support continued investigation of a telemedicine healthy lifestyle peri-habilitative program.


Author(s):  
Mohammad Hassan Dashty Khavidaki ◽  
Mahmood Kamali Zarch ◽  
Naser Mohammadi Ahmadabadi ◽  
Haider Hosseini

Introduction: Numerous important factors such as physical and mental condition affect the quality of life Job stress is one of the key factors in decreasing productivity in organizations. Given the positive effects of physical activity on quality of life, this study aimed to compare the quality of life between active and inactive workers (case study). Methods: This study was a cross-sectional comparative study.190 tile and cement-manufacturing workers who were eligible for the study were selected completely voluntarily, based on a convenience sampling. Of these, according to Beck questionnaire, 88 were selected in inactive and 64 in active groups; Weir and Sherborn questionnaire was used for assessing the quality of life (SF-36). For analysis the data, independent T-test and SPSS 23 software were used for analysis (P≤0.05). Results: The results showed that physical, psychological and quality of life components in the active group of cement factory workers were (p = 0.012) (p = 0.001) (p = 0.005) and tile workers (p = 0.012) (P = 0.005) (p = 0.014) was a significant and more compare to the inactive group, but there was no significant difference between active and inactive workers of the two tile and cement factories. Conclusion: The results of this study showed the positive role of exercise and physical activity on the quality of life of people working in cement and tile factories. It seems easier physical activity and sports are related to the quality of life of workers and have nothing to do with the workplace.  


1989 ◽  
Vol 75 (6) ◽  
pp. 619-625 ◽  
Author(s):  
Vittorio Ventafridda ◽  
Franco De Conno ◽  
Antonio Viganò ◽  
Carla Ripamonti ◽  
Michele Gallucci ◽  
...  

Treatment and care of terminal cancer patients are conducted in different ways, according to the cultural, social, political and economical situations of the countries which have progressively adopted and developed them. In Italy there are no specialized structures such as « hospices » or the « palliative care units » like in the Anglo-Saxon world: the care of terminal cancer patients is carried out either in a general hospital or at their own home. In Milan and elsewhere there are home care teams in which doctors, nurses, social workers and volunteers, all work in connection with hospital structures. In this way, patients can receive specialized care for physical, psycological and social problems at home too. To evaluate costs and effectiveness of this program, a comparison was made between the home care and the conventional treatment carried out in general hospitals. Two groups of thirty terminal cancer patients have been studied: the first group was composed of hospital patients in Desio and the second one included patients cared for by the home care service organized by the Floriani Foundation and the Italian League against Cancer (Milan Section). We evaluated intensity and duration of pain, hours of sleep and hours of standing, sitting and lying, presence of side-effects, performance status and therapies. Data were also collected on the quality of life (Spitzer QLI), social and economical needs of the patients, type and quality of care, degree of awareness of the diagnosis by the patient and the family. This data were collected by the nurse who looked after the patient. Care costs were also quantified. The comparison between the two groups significantly favours the home care group as shown by the performance status after 2 weeks of care, the « health scale » and the Total Index of the Spitzer QLI and in general the greater satisfaction of the care received. Home care produces results equivalent to those achieved in hospitals as far as clinical parameters are concerned. An approximate quantification of the costs shows that an average cost for a day's home care was about Lit. 52,500 as compared with Lit. 360,000 for a day's hospitalization.


BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Florence Joly ◽  
Claudia Lefeuvre-Plesse ◽  
Claire Garnier-Tixidre ◽  
Carole Helissey ◽  
Nathalie Menneveau ◽  
...  

Abstract Background Currently, oral targeted therapies are known to be effective and are frequently used to treat metastatic cancer patients, but fatigue is a frequently reported early side effect of these treatments. This fatigue may impact the patient’s treatment adherence and result in a negative impact on quality of life. Physical exercise significantly improved the general well-being and quality of life of advanced cancer patients. However, there is no specific physical activity program adapted for patients with advanced disease. Methods QUALIOR is a two-part, randomized, open-label, and multicenter with two arms phase II/III trial. Patients (phase II: n = 120; phase III: n = 312) with metastatic cancer (breast cancer, kidney cancer, lung cancer, and other cancers [including but not limited to colon cancer, melanoma, sarcoma, or hepatocarcinoma]) treated with a first- or second-line oral targeted therapy without chemotherapy will be included. Patients will be randomized (2:1) to a 3-month supervised home-based standardized physical activity program or to a recommended adapted physical activity (via a booklet). The primary objective of the phase II is to evaluate the feasibility of the supervised program. The primary objective of the phase III is the evaluation of the benefit of the supervised home-based program compare to the recommended program in terms of fatigue and quality of life at 3 months. The secondary objectives aim to evaluate the impact of the supervised program on fatigue over time, pain, physical capacities, psychosocial and cognitive functions, general quality of life, frequency of dose reduction and patients’ adherence to the targeted therapy, overall survival, and progression-free survival. This study will also evaluate the medico-economic impact of supervised program compared to the recommended adapted physical activity program. Discussion The aim of this study is to evaluate home-based physical exercise program for metastatic cancer patients treated with oral targeted therapies to help patients to cope with fatigue and improve quality of life. Trial registration This trial was registered in ClinicalTrials.gov since May 2017 (NCT03169075).


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