Physical Exercise in Cancer Patients During and After Medical Treatment: A Systematic Review of Randomized and Controlled Clinical Trials

2005 ◽  
Vol 23 (16) ◽  
pp. 3830-3842 ◽  
Author(s):  
Ruud Knols ◽  
Neil K. Aaronson ◽  
Daniel Uebelhart ◽  
Jaap Fransen ◽  
Geert Aufdemkampe

Purpose To systematically review the methodologic quality of, and summarize the evidence from trials examining the effectiveness of physical exercise in improving the level of physical functioning and psychological well-being of cancer patients during and after medical treatment. Methods Thirty-four randomized clinical trials (RCTs) and controlled clinical trials were identified, reviewed for substantive results, and assessed for methodologic quality. Results Four of 34 trials met all (seven of seven) methodologic criteria on the Delphi criteria list. Failure to conceal the sequencing of treatment allocation before patient recruitment, failure to blind the outcome assessor, and failure to employ an intention-to-treat analysis strategy were the most prevalent methodologic shortcomings. Various exercise modalities have been applied, differing in content, frequency, intensity, and duration. Positive results have been observed for a diverse set of outcomes, including physiologic measures, objective performance indicators, self-reported functioning and symptoms, psychological well-being, and overall health-related quality of life. Conclusion The trials reviewed were of moderate methodologic quality. Together they suggest that cancer patients may benefit from physical exercise both during and after treatment. However, the specific beneficial effects of physical exercise may vary as a function of the stage of disease, the nature of the medical treatment, and the current lifestyle of the patient. Future RCTs should use larger samples, use appropriate comparison groups to rule out the possibility of an attention-placebo effect, use a comparable set of outcome measures, pay greater attention to issues of motivation and adherence of patients participating in exercise programs, and examine the effect of exercise on cancer survival.

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 9640-9640
Author(s):  
M. de la Cruz ◽  
D. Hui ◽  
H. A. Parsons ◽  
P. Lynn ◽  
C. Parker ◽  
...  

9640 Background: We have previously reported significant placebo response in randomized controlled treatment trials for cancer related fatigue (CRF). We conducted a retrospective study to determine the frequency and predictors of response to placebo and nocebo effect in patients with CRF. Methods: We reviewed patients that received placebo in two previous randomized clinical trials conducted by our group and determined the proportion of patients who demonstrated clinical response to fatigue using an increase (ΔFACIT-F score) > 7 from baseline to day 8, and those with nocebo response as those who reported side effects. Baseline patient characteristics and symptoms recorded from the Edmonton Symptom Assessment Scale (ESAS) were analyzed to determine their association with placebo and nocebo effects. Results: A total of 105 advanced cancer patients received placebo. 59 (56%) patients responded to placebo (median Δ FACIT-F score of 22). Worse baseline anxiety and well-being subscale score (univariate) and well-being (multivariate, MR) were significantly associated with placebo response. Common side effects reported were insomnia (79%), anorexia (53%), nausea (38%) and restlessness (34%). MR analysis showed that worse baseline (ESAS) sleep, appetite, nausea, and restless are associated with increased reporting of these side effects ( Table ). Conclusions: Nearly half of advanced cancer patients enrolled in the fatigue trials responded to placebo. Worse physical well-being score was associated with placebo response. Patients experiencing specific symptoms at baseline were more likely to report these as side effects of the medication. These findings should be considered in fatigue clinical trial design. [Table: see text] No significant financial relationships to disclose.


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.


2019 ◽  
Vol 25 (2) ◽  
pp. 201-213
Author(s):  
Thalia Bellali ◽  
Georgios Manomenidis ◽  
Eirini Meramveliotaki ◽  
Evgenia Minasidou ◽  
Petros Galanis

1989 ◽  
Vol 7 (7) ◽  
pp. 959-968 ◽  
Author(s):  
K Donovan ◽  
R W Sanson-Fisher ◽  
S Redman

The diagnosis and management of cancer can have a major impact on every aspect of a patient's quality of life. Despite its importance, quality of life is rarely a reported outcome in randomized clinical trials in cancer patients. Failure to collect quality-of-life information may reflect a lack of information among researchers and clinicians about the adequacy and relative merits of measures available for assessing quality of life. We reviewed the adequacy of the 17 existing scales for assessing quality of life in cancer patients against characteristics needed for an adequate measure. None of the existing measures met all of the criteria. Recommendations about the relative adequacy of existing scales were made.


2004 ◽  
Vol 22 (21) ◽  
pp. 4418-4424 ◽  
Author(s):  
Liz Roffe ◽  
Katja Schmidt ◽  
Edzard Ernst

Purpose The aim of this systematic review was to summarize and evaluate the evidence available for oral supplementation with coenzyme Q10 (CoQ10) to improve the tolerability of cancer treatments. Materials and Methods Searches for all published and unpublished controlled trials were carried out on seven databases. Manufacturers of CoQ10 were identified and contacted. Controlled clinical trials of monopreparations of CoQ10 administered orally to cancer patients were included. No language restrictions were imposed. Data were extracted independently by two authors according to predefined criteria. Results Six studies were included in the review, including three randomized clinical trials and three nonrandomized clinical trials. Patients in five of six studies received anthracyclines. The results suggested that CoQ10 provides some protection against cardiotoxicity or liver toxicity during cancer treatment. However, because of inadequate reporting and analysis, as well as questionable validity of outcome measures, the results are not conclusive. Conclusion Suggestions that CoQ10 might reduce the toxicity of cancer treatments have not been tested by rigorous trials. Further investigations are necessary to determine whether CoQ10 can improve the tolerability of cancer treatments.


Author(s):  
Cecile J. Proctor ◽  
◽  
Danie A. Beaulieu ◽  
Anthony J. Reiman ◽  
Lisa A. Best ◽  
...  

"It is now recognized that the ""cancer experience"" extends beyond diagnosis, treatment, and end-of-life care. Relative to individuals who have not faced a cancer diagnosis, cancer survivors report increased mental health concerns and lowered physical and psychological well-being (Langeveld et al., 2004). Health-related quality of life encompasses overall physical (e.g., energy, fatigue, pain, etc.) and psychological functioning (e.g., emotional well-being, etc.), as well as general health perceptions (Hays & Morales, 2001). Nayak and colleagues (2017) reported that 82.3% of cancer patients had below-average quality of life scores, with the lowest scores found in the general, physical, and psychological well-being domains. Research suggests that various positive lifestyle variables, including social connectedness, leisure activity, and mindfulness practices are associated with increased quality of life in cancer patients (Courtens et al., 1996; Fangel et al., 2013; Garland et al., 2017). In this study, 350 cancer survivors completed an online questionnaire package that included a detailed demographic questionnaire with medical and online support and leisure activity questions. Additional measures were included to assess quality of life (QLQ-C30; Aaronson et al., 1993), social connectedness (Social and Emotional Loneliness Scale for Adults, SELSA-S; DiTommaso et al., 2004), and mindfulness (Adolescent and Adult Mindfulness Scale, AAMS; Droutman et al., 2018). Results show that increased QOL is predicted by increased medical support, lower family loneliness, self-acceptance, and engaging in a variety of leisure activities. Encouraging family support, including the patient in the decision-making process, encouraging a variety of physically possible leisure activities, and normalizing negative emotions surrounding diagnosis and disease symptoms are all ways that overall QoL can be improved."


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