Balance in Childhood Cancer Survivors who were Treated with Cisplatin (A Pilot Study)

Background:: Inadequate physical activity (PA) in childhood cancer survivors may lead to compromised health outcomes. The purpose of this pilot study was to evaluate the feasibility and effect of a PA intervention in childhood cancer survivors ages 8–12 who report < 1 hour of moderate-to-vigorous physical (MVPA) per day.Methods:Twenty survivors were randomized to a 6-month group PA intervention or to a control group. A pre/post measure of MVPA was completed by all participants, and a pre/post measure of self-efficacy was completed by the intervention group. Analysis included measures of feasibility, change in percentage of awake time spent in MVPA, self-efficacy scores, and correlations in MVPA and self-efficacy.Results:All feasibility parameters were confirmed. Increases in percent of awake time spent in MVPA were seen in 67% of the intervention group and 14% of the control group. A medium effect size (r = 0.55) was calculated for the correlation between change in MVPA and change in total self-efficacy scores; the largest effect size (r = 0.62) was found for the subscale for adequacy.Conclusions:Increases in MVPA can be seen in childhood cancer survivors who participate in a group intervention that includes support of self-efficacy.

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Design and Rationale for a Parent-Led Intervention to Increase Fruit and Vegetable Intake in Young Childhood Cancer Survivors (Reboot): Protocol for a Pilot Study (Preprint)

10.2196/preprints.9252 ◽

2017 ◽

Author(s):

Lauren Touyz ◽

Jennifer Cohen ◽

Claire Wakefield ◽

Allison Grech ◽

Sarah Garnett ◽

...

Keyword(s):

Pilot Study ◽

Cancer Survivors ◽

Cancer Treatment ◽

Childhood Cancer ◽

Vegetable Intake ◽

Childhood Cancer Survivors ◽

Fruit And Vegetable Intake ◽

Evidence Based ◽

Fruit And Vegetable ◽

Booster Session

BACKGROUND Poor dietary habits are common among childhood cancer survivors, despite increasing their risk of cardio metabolic complications after cancer treatment. Here, we describe the design and rationale for a pilot telephone-based, parent-led intervention aimed at increasing fruit and vegetable intake in young cancer survivors (Reboot). OBJECTIVE This pilot study aims to assess the feasibility and acceptability of delivering evidence-based telephone support to parents of childhood cancer survivors. A secondary aim includes assessing the effect of Reboot on improving childhood cancer survivors’ dietary quality by increasing child fruit and vegetable intake and variety and its contribution to overall nutrient intake. METHODS We aim to recruit parents of 15 young cancer survivors aged 2 to 12 years who have completed cancer treatment less than five years ago. The intervention comprises of 4 weekly 45-minute telephone sessions led by a health professional and one booster session 6 weeks later. Sessions address the effects of cancer treatment on children’s diets, recommended fruit and vegetable intake for children, and evidence-based strategies to promote the consumption of fruit and vegetables as well as to manage fussy eating. RESULTS Reboot is based on an existing, evidence-based parent nutrition intervention and modified for childhood cancer survivors following extensive collaboration with experts in the field. Primary outcomes of feasibility and acceptability will be measured by the number of participants who complete all five sessions, average session length (minutes), length between sessions (days) and parent Likert ratings of the usefulness and impact of the intervention collected after the booster session. Of the 15 participants we aim to recruit, 3 have completed the intervention, 1 declined to participate, 11 are actively completing the intervention and 2 participants are providing written consent. The remaining 3 participants will be recruited via telephone follow-up calls. The intervention is due to be completed by July 2018. CONCLUSIONS Reboot aims to support healthy dietary behaviors in childhood cancer survivors who are at increased risk of developing serious cardiometabolic complications after their cancer treatment. Results will inform the development and implementation of future evidence-based dietary interventions delivered to childhood cancer survivors, particularly those living in rural and remote areas. REGISTERED REPORT IDENTIFIER RR1-10.2196/9252

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Insulin and glucose homeostasis in childhood cancer survivors treated with abdominal radiation: A pilot study.

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.3_suppl.108 ◽

2016 ◽

Vol 34 (3_suppl) ◽

pp. 108-108 ◽

Cited By ~ 1

Author(s):

Danielle Novetsky Friedman ◽

Suzanne L. Wolden ◽

Zoltan Antal ◽

Chaya S. Moskowitz ◽

Patrick Hilden ◽

...

Keyword(s):

Insulin Resistance ◽

Pilot Study ◽

Glucose Tolerance ◽

Cancer Survivors ◽

Childhood Cancer ◽

Hemoglobin A1c ◽

Fasting Glucose ◽

Childhood Cancer Survivors ◽

Type I ◽

Matsuda Index

108 Background: Previous reports have suggested an increased risk of Type I and Type II diabetes mellitus (DM) in childhood cancer survivors exposed to abdominal radiotherapy (RT). The mechanisms leading to DM in this population, however, remain unknown. We sought to clarify the pathophysiology leading to these derangements by performing dynamic testing of glucose and insulin in survivors previously treated with abdominal RT. Methods: Cross-sectional pilot study of 2-year survivors of childhood cancer treated with abdominal RT at Memorial Sloan Kettering between 1975 – 2009. Eligible participants were < 21 years of age at exposure to abdominal RT; those with a known diagnosis of DM or prior exposure to brain or total body RT were excluded. Survivors underwent formal 2-hour glucose tolerance testing; auto-antibodies (insulin auto-antibodies, islet cell autoantibody, glutamic acid decarboxylase) typically present in patients with Type I DM and hemoglobin A1c levels were assessed. Insulin resistance was calculated by the homeostasis model assessment of insulin resistance (HOMA-IR) and Matsuda index. Results: 21 survivors were enrolled (male: 47.6%; median age at RT: 3.3 years; median age at study: 14.4 years [range: 8.3 – 46.9]; median time from abdominal RT: 10.7 years). Primary diagnoses included neuroblastoma (n = 15), rhabdomyosarcoma (n = 3), Wilms (n = 1), Hodgkin lymphoma (n = 1), rhabdoid tumor (n = 1). None of the participants were obese (body mass index [BMI] range: 14.7 – 23.2 kg/m2). Five participants (23.8%, 95% confidence interval: 8% – 47%) had glucose derangements at a median of 8.4 years after RT (one with impaired fasting glucose [fasting glucose ≥ 100 mg/dl) and four with impaired glucose tolerance [2-hour glucose 140-199 mg/dl]). Two additional participants with normal glucose tolerance had impaired insulin sensitivity based on an abnormal Matsuda Index and HOMA-IR. None of the participants had abnormal autoantibodies, insulinopenia, or hemoglobin A1c levels. Conclusions: These findings suggest that nonobese childhood cancer survivors treated with abdominal RT may be at high-risk for subclinical derangements of glucose and insulin. Further study is warranted in larger survivor cohorts. Clinical trial information: NCT02248779.

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