Preliminary Evidence of Improvement in Adolescent and Young Adult Cancer Survivors’ Brain Health Following Physical Activity: A Proof-of-Concept Sub-Study

Background: Cognitive impairment is common among adolescent and young adult (AYA) cancer survivors. Physical activity (PA) may help mitigate cognitive impairment post- treatment by positively impacting two indicators of general brain health: fractional anisotropy (FA) and functional connectivity (FC). As part of a two-arm, mixed-methods pilot randomized controlled trial (RCT), this sub-study was designed to provide preliminary proof-of-concept evidence for the effects of PA on FA and FC among AYA cancer survivors post-treatment to help inform decisions about proceeding to larger trials. Methods: AYA cancer survivors who had completed cancer treatment and who were enrolled in a larger pilot RCT testing a 12-week PA intervention or waitlist control group, were invited to participate in this sub-study. Sub-study participants completed diffusion tensor imaging and resting-state functional magnetic resonance imaging prior to randomization and post-PA intervention. Data were analyzed with descriptive statistics, independent component analysis, and paired sample t-tests. Results: Post-intervention, participants showed increases in the FA of the bilateral hippocampal cingulum, left anterior corona radiata, middle cingulum, left anterior thalamic radiation, and left cerebellum. A decrease in overall FC of the default mode network and increases in the cerebellar and visual networks were also noted post-intervention (p < .05). Conclusion: Results provide preliminary evidence for the possible positive effects of PA on FA and FC among AYA cancer survivors post-treatment. On the basis of these results, larger trials assessing the effects of PA on specific brain health indicators, as captured by FA and FC, among AYA cancer survivors are appropriate and warranted.

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A Mobile Health and Social Media Physical Activity Intervention Among Adolescent and Young Adult Childhood Cancer Survivors

Case Medical Research ◽

10.31525/ct1-nct04089358 ◽

2019 ◽

Author(s):

Keyword(s):

Physical Activity ◽

Social Media ◽

Young Adult ◽

Cancer Survivors ◽

Childhood Cancer ◽

Mobile Health ◽

Physical Activity Intervention ◽

Childhood Cancer Survivors ◽

Adolescent And Young Adult

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Effects of a structured counselling-based intervention to improve physical activity behaviour of adolescents and young adult cancer survivors – the randomized phase II Motivate AYA – MAYA trial

Clinical Rehabilitation ◽

10.1177/0269215521997974 ◽

2021 ◽

pp. 026921552199797

Author(s):

Jannike Salchow ◽

Barbara Koch ◽

Julia Mann ◽

Julia von Grundherr ◽

Simon Elmers ◽

...

Keyword(s):

Physical Activity ◽

Young Adult ◽

Cancer Survivors ◽

Intervention Group ◽

Physical Activity Behaviour ◽

Post Intervention ◽

Young Adult Cancer Survivors ◽

Adult Cancer Survivors ◽

Young Adult Cancer ◽

Activity Behaviour

Objective: To explore whether a structured counselling-based intervention increases vigorous physical activity behaviour of adolescent and young adult cancer survivors. Design: Randomized controlled phase II trial. Setting: University Cancer Center Hamburg, Germany. Subjects: Eighty-nine participants (mean age 24.1 ± 6.3) were randomized to control ( n = 44) or intervention group ( n = 45). Interventions: The intervention group was consulted about physical activity behaviour via interview (week 0), and telephone counselling (weeks 1, 3 and 12). The control group only received general physical activity guidelines for cancer survivors (week 0). Main measures: The primary outcome was the rate of participants with ⩾9 metabolic equivalent (MET)-hours per week of vigorous activity post-intervention, measured with the International Physical Activity Questionnaire. Secondary outcomes included assessing physical activity behaviour (e.g. amount and type of physical activity) and quality of life. Assessments were completed in weeks 0 (baseline), 12 (post-intervention) and 52 (follow-up). Results: Sixty-nine participants completed the post-intervention- and 47 the follow-up-assessment. The rate of participants performing vigorous physical activity increased from baseline to post-intervention for both without differing significantly ( P = 0.541). Both increased their total metabolic equivalent from baseline to post-intervention (intervention group from 55.2 ± 43.7 to 61.7 ± 29.4, control group from 75.3 ± 81.4 to 88.3 ± 80.2). At follow-up the intervention group (73.7 ± 80.2) was more active than baseline when compared to the control group (78.5 ± 50.0). Conclusions: A structured counselling-based physical activity intervention did not significantly impact the level of vigorous physical activity behaviour in adolescent and young adult cancer survivors.

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Adolescent and Young Adult Cancer Survivors' Valuation of Post-Treatment Recommended Care

Journal of Adolescent and Young Adult Oncology ◽

10.1089/jayao.2016.0054 ◽

2017 ◽

Vol 6 (1) ◽

pp. 127-133 ◽

Cited By ~ 1

Author(s):

Sapna Kaul ◽

Rochelle R. Smits-Seemann ◽

Eduardo R. Zamora ◽

Holly Spraker-Perlman ◽

Kevin J. Boyle ◽

...

Keyword(s):

Young Adult ◽

Cancer Survivors ◽

Post Treatment ◽

Adolescent And Young Adult ◽

Recommended Care ◽

Young Adult Cancer Survivors ◽

Adult Cancer Survivors ◽

Young Adult Cancer

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Prevalence and correlates of fear of recurrence among adolescent and young adult versus older adult post-treatment cancer survivors

Supportive Care in Cancer ◽

10.1007/s00520-016-3317-9 ◽

2016 ◽

Vol 24 (11) ◽

pp. 4689-4696 ◽

Cited By ~ 22

Author(s):

L. Aubree Shay ◽

Melissa Y. Carpentier ◽

Sally W. Vernon

Keyword(s):

Young Adult ◽

Cancer Survivors ◽

Older Adult ◽

Post Treatment ◽

Adolescent And Young Adult ◽

Fear Of Recurrence

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Exploring the feasibility and acceptability of a mixed-methods pilot randomized controlled trial testing a 12-week physical activity intervention with adolescent and young adult cancer survivors

Pilot and Feasibility Studies ◽

10.1186/s40814-019-0530-6 ◽

2019 ◽

Vol 5 (1) ◽

Cited By ~ 1

Author(s):

Amanda Wurz ◽

Jennifer Brunet

Keyword(s):

Physical Activity ◽

Cancer Survivors ◽

Physical Activity Intervention ◽

Controlled Trial ◽

Intervention Group ◽

Physical Activity Behaviour ◽

Adolescent And Young Adult ◽

Post Intervention ◽

Randomized Controlled ◽

Activity Behaviour

Abstract Background Adolescent and young adult (AYA) cancer survivors (i.e. individuals diagnosed with cancer between 15 and 39 years and who completed treatment) may benefit from physical activity. Yet, few researchers have explored the effects of physical activity on physical and psychological outcomes among AYA cancer survivors. A pilot study exploring the feasibility and acceptability of a physical activity intervention and proposed trial methods to inform a definitive randomized controlled trial (RCT) is therefore necessary to fill this gap. Methods A two-arm, mixed-methods pilot RCT was conducted. Participants were randomized to a wait-list control group or a 12-week physical activity intervention comprised of 4 weekly aerobic and strength training sessions (intervention group). Feasibility measures included: number of AYA cancer survivors referred/self-referred, eligible, and recruited, retention to the trial (i.e. assessment completion), adherence to the physical activity intervention, and percentage of missing data for baseline (week 0), mid- (week 6), and post-intervention assessments (week 12). The acceptability of trial methods (all participants) and the intervention (intervention group only) was assessed via qualitative interviews post-intervention. Results Over a 12-month period, 31 AYA cancer survivors were referred/self-referred and 16 were eligible and consented to participate. Retention to the trial was 94% and adherence to the physical activity intervention ranged from 50 to 92%. With the exception of the assessment of aerobic capacity and directly measured physical activity behaviour, there were no missing data. Participants generally reported being satisfied with the trial methods and intervention; however, issues related to delivery of the physical activity intervention were identified. Conclusions The methods and intervention piloted require modification and further pilot testing in advance of a definitive RCT. Recruitment strategies identifying a greater number of younger AYA cancer survivors who have different types of cancers and who lack motivation to participate in physical activity-based studies should be explored. Refining the assessments of directly measured physical activity behaviour and aerobic capacity and incorporating behavioural support into the intervention may improve feasibility and acceptability. This study highlights the value of doing pilot work and provides critically useful data that can be used to refine studies seeking to assess causation and optimize physical activity interventions for AYA cancer survivors. Trial registration clinicaltrials.gov, NCT03016728. Registered January 11, 2017.

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Building a healthy body after cancer: Results of a focus group with young adult survivors to inform an intervention for exercise after treatment.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.5_suppl.164 ◽

2017 ◽

Vol 35 (5_suppl) ◽

pp. 164-164

Author(s):

Brittany Kimball ◽

Gladys Asiedu ◽

Carrie A. Thompson

Keyword(s):

Physical Activity ◽

Weight Gain ◽

Young Adult ◽

Focus Group ◽

Cancer Survivors ◽

Adult Survivors ◽

Adolescent And Young Adult ◽

Barriers To Exercise ◽

After Cancer ◽

Lymphoma Survivors

164 Background: Adolescent and young adult (AYA) cancer survivors have distinctive and often unmet needs, may lead long lives after treatment, and are a population for whom targeted health supports are limited. Exercise in particular has become increasingly recognized as a vital part of cancer survivors’ health needs, yet, little is known about what interventions would be most appropriate for this population. This ongoing study reports early data on barriers and facilitators to exercise in AYA lymphoma survivors. Methods: We conducted a focus group with five young adult lymphoma survivors. Participants completed questionnaires to assess quality of life, exercise habits, and knowledge about evidence for exercise after cancer treatment. Charts were abstracted for demographic and treatment-related details. The focus group was audio recorded and transcribed. Data is being analyzed thematically to generate applied findings and identify areas for action. Results: Participants were 24-35 years old, 60% male, and an average of 2.97 years from the time of diagnosis. All reported some form of physical activity, with 80% active and 20% moderately active. Preliminary analysis identified fatigue, weight gain, and lack of time as barriers to exercise. Participants identified fatigue particularly in the early survivorship period, and discussed the issue of non-cancer survivor peers not relating with or recognizing fatigue after treatment. 100% of participants reported that someone from their doctor’s office had talked with them about exercise, but indicated during the focus group that this recommendation did not motivate them to exercise. Other themes revolve around the relationship between healthy diet and physical activity. In terms of an intervention, survivors were interested in activity trackers and fitness apps, exercise variety, and fitness groups targeted specifically for AYA survivors. Conclusions: Fatigue, weight gain, and time are barriers to exercise for AYA survivors. Interventions that incorporate fitness tracking technology, provide variety, and/or include other AYA survivors may be successful in this unique population.

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