scholarly journals Chronic Fatigue in Cancer, Brain Connectivity and Reluctance to Engage in Physical Activity: A Mini-Review

2021 ◽  
Vol 11 ◽  
Author(s):  
Nathalie André ◽  
Steven Gastinger ◽  
Amélie Rébillard
Keyword(s):  
Physical Activity ◽  
Decision Making ◽  
Cancer Patients ◽  
Cancer Diagnosis ◽  
Default Mode Network ◽  
Brain Connectivity ◽  
Chronic Fatigue ◽  
Activation Patterns ◽  
Cancer Related Fatigue ◽  
Physical Activity Interventions

A large amount of evidence shows that after a cancer diagnosis, patients significantly reduce their level of physical activity. Usually, this reduction is attributed to cancer-related fatigue. However, to our knowledge, no study has clearly demonstrated that fatigue alters effort-based decision-making in cancer. This mini-review aimed to provide evidence that chronic fatigue in cancer patients causes changes in brain connectivity that impact effort-based decision-making. Indeed, three patterns of activation to compensate for dysfunctional networks have been reported: greater variability in the executive network and hyperactivation in the executive network, which account for less efficient and costly processes in the frontal cortex, and reduced deactivation in the default mode network. Nevertheless, these activation patterns are also observed with other factors, such as anticipatory stressors (worry, rumination or sleep loss), that might also cause reluctance to engage in physical activity. Effort-based decision-making involving weighing costs against benefits and physical activity interventions should increase immediate benefits to facilitate engagement in effortful activities.

S-Adenosylmethionine Supplementation May Reduce Cancer-Related Fatigue: A Prospective Evaluation Using the FACIT-F Questionnaire in Colon Cancer Patients Undergoing Oxaliplatin-Based Chemotherapy Regimens

Chemotherapy ◽  
2021 ◽  
pp. 1-8
Author(s):  
Angelo Onorato ◽  
Andrea Napolitano ◽  
Silvia Spoto ◽  
Lorena Incorvaia ◽  
Antonio Russo ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Cancer Patients ◽  
Chronic Fatigue ◽  
University Campus ◽  
Cancer Related Fatigue ◽  
Number Of Patients ◽  
Significant Difference ◽  
The University ◽  
Oncologic Treatment

<b><i>Background:</i></b> Fatigue is a common distressing symptom for patients living with chronic or acute diseases, including liver disorders and cancer (<i>Cancer-Related Fatigue</i>, CRF). Its etiology is multifactorial, and some hypotheses regarding the pathogenesis are summarized, with possible shared mechanisms both in cancer and in chronic liver diseases. A deal of work has investigated the role of a multifunctional molecule in improving symptoms and outcomes in different liver dysfunctions and associated symptoms, including chronic fatigue: S-adenosylmethionine (SAM; AdoMet). The aim of this work is actually to consider its role also in oncologic settings. <b><i>Patients and Methods:</i></b> Between January 2006 and December 2009, at the University Campus Bio-Medico of Rome, 145 patients affected by colorectal cancer in adjuvant (<i>n</i> = 91) or metastatic (<i>n</i> = 54; <i>n</i> = 40 with liver metastases) setting and treated with oxaliplatin-based regimen (FOLFOX for adjuvant and bevacizumab + XELOX for metastatic ones), 76 of which with the supplementation of S-adenosylmethionine (AdoMet; 400 mg b.i.d.) (57% of adjuvant patients and 44% of metastatic ones) and 69 without AdoMet supplementation, were evaluated for fatigue prevalence using the Functional Assessment of Chronic Illnesses Therapy-Fatigue (FACIT-F) questionnaire, at 3 and 6 months after the beginning of oncologic treatment. Notably, the number of patients with liver metastases was well balanced between the group of patients treated with AdoMet and those who were not. <b><i>Results:</i></b> Among patients receiving oxaliplatin-based chemotherapy, both in adjuvant and in metastatic settings, after just 3 months from the beginning of chemotherapy, mean scores from questionnaire domains like FACIT-F subscale (7.9 vs. 3.1, <i>p</i> = 0.006), FACIT physical (6.25 vs. 3.32, <i>p</i> = 0.020), FACIT emotional (4.65 vs. 2.19, <i>p</i> = 0.045), and FACIT-F total score (16.5 vs. 8.27, <i>p</i> = 0.021) were higher in those receiving supplementation of AdoMet, resulting in reduced fatigue; a significant difference was maintained even after 6 months of treatment. <b><i>Discussion and Conclusions:</i></b> Mechanisms and strategies for managing CRF are not fully understood. This work aimed at investigating the possible role of S-adenosylmethionine supplementation in improving fatigue scores in a specific setting of cancer patients, using a FACIT-F questionnaire, a well-validated quality of life instrument widely used for the assessment of CRF in clinical trials.

scholarly journals Awareness of Diagnosis and Decision-Making Preferences of Greek Cancer Patients

2020 ◽  
pp. 5-12
Author(s):  
Despoina G Alamanou ◽  
Konstantinos Giakoumidakis ◽  
Dimosthenis G Theodosiadis ◽  
Nikolaos V Fotos ◽  
Elissavet Patiraki ◽  
...  
Keyword(s):  
Decision Making ◽  
Cancer Patients ◽  
Cancer Diagnosis ◽  
Active Role ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Medical Encounter ◽  
The Mean ◽  
The Impact ◽  
The City

Objective: In Greece, the old phenomenon of hiding cancer diagnosis and depriving cancer patients of their right to participate in decisionmaking remains a reality. The aim of this study was to assess the decision-making preferences of Greek cancer patients and their awareness of diagnosis. Methods: It was a cross-sectional study. The sample consisted of 229 adult Greek patients diagnosed with cancer, attending the oncology outpatient department (outpatients) or being hospitalized (inpatients), in one general hospital in Athens. Patients who were aware of cancer diagnosis (n=209) were administered at the Control Preference Scale (CPS), a tool, designed to elicit decision-making preferences. The IBM SPSS program, version 21.0 was used for statistical analysis. Results: One hundred and one patients (52.8%) were males. The mean [±standard deviation (SD)] age was 64.8 (±11.2) years. The vast majority of patients knew they suffered from cancer (n=209, 91.3%). Older patients (p=0.003), those who lived in suburbs of the city (p=0.01), those who had lower educational level (p=0.001), those with lower personal income (p=0.001) and shorter disease duration (p=0.001) stated that were unaware of cancer diagnosis. Seventy five (36.2%) patients chose the shared-decision role in decision-making procedures. Lower age (OR 1.04, 95%, CI: 1.00-1.08, p= 0.05) and higher education level (OR 2, 63, 95%, CI: 1.11-6.29, p=0.03) were significantly associated with the preference of patients to actively participate in decision-making regarding treatment. Conclusions: Although Greek cancer patients are aware of cancer diagnosis and treatment, nowadays, they still seem to hesitate in playing a more active role in the decision-making procedures, which portrays the impact of the dominating paternalistic model of doctor-patient relationship in the Greek medical encounter

Changes in physical activity from pre-diagnosis to first five years post-diagnosis: A prospective cohort study in Chinese breast cancer patient.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e24121-e24121
Author(s):  
Yuanyuan Lei ◽  
Winnie Yeo ◽  
Suzanne C. Ho ◽  
Ashley Chi Kin Cheng ◽  
Carol Kwok
Keyword(s):  
Breast Cancer ◽  
Physical Activity ◽  
Cohort Study ◽  
Cancer Patients ◽  
Cancer Diagnosis ◽  
Prospective Cohort ◽  
Chinese Women ◽  
Breast Cancer Patients ◽  
After Cancer

e24121 Background: The diagnosis of cancer can motivate patients to change their physical activity habits. No data has reported level of physical activity before and after breast cancer diagnosis in Chinese women. Methods: In an on-going prospective cohort study which involved 1462 Chinese women with early-stage breast cancer, a validated modified Chinese Baecke questionnaire was used to assess physical activity at baseline, 18-, 36- and 60-month after diagnosis. At baseline, patients recalled their habitual physical activity in the preceding 12 months before cancer diagnosis. At 18-, 36- and 60-month follow-up, patients reported their habitual physical activity over the previous 12 months. The level of physical activity at post-diagnosis was defined as the average value assessed at 18-, 36- and 60-month follow-up. Results: Breast cancer patients significantly increased level of physical activity, with median value of 0.6, 5.3, 4.4 and 3.9 MET-hours/week at baseline, 18-, 36- and 60-month follow-up. The average level of physical activity at post-diagnosis was also significantly higher than that at pre-diagnosis ( P < 0.001), with median value of 5.8 MET-hours/week. However, there was no significant difference between any two follow-ups at post-diagnosis. The proportions of participant who met the exercise recommendation (according to WCRF/AICR, 10 MET-hours/week) were low at pre- and post-diagnosis, being 20.7% and 35.1%, respectively. Compared to pre-diagnosis, most of the patients improved or had no change on level of recreational physical activity at post-diagnosis, with the respective proportion being 48.2% and 43.8%. Multivariate analysis showed that higher increase in physical activity after cancer diagnosis was observed among breast cancer patients who were married or cohabitation, unemployed (compared to full time) and had no comorbidity (compared to patients who had one comorbidity). Conclusions: Chinese breast cancer patients reported significant and long-term changes in physical activity after cancer diagnosis, which was in line with current recommendation. However, the proportion of patients who met the exercise recommendation for cancer survivors was still low. Empowering patients on the importance of durable high level of physical activity in breast cancer survivorship is warranted.

scholarly journals Effects of Scheduled Exercise on Cancer-Related Fatigue in Women with Early Breast Cancer

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Anne Marie Lunde Husebø ◽  
Sindre Mikal Dyrstad ◽  
Ingvil Mjaaland ◽  
Jon Arne Søreide ◽  
Edvin Bru
Keyword(s):  
Breast Cancer ◽  
Physical Activity ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Exercise Intervention ◽  
Activity Level ◽  
Control Group ◽  
Activity Levels ◽  
Breast Cancer Patients ◽  
Cancer Related Fatigue

While physical activity during cancer treatment is found beneficial for breast cancer patients, evidence indicates ambiguous findings concerning effects of scheduled exercise programs on treatment-related symptoms. This study investigated effects of a scheduled home-based exercise intervention in breast cancer patients during adjuvant chemotherapy, on cancer-related fatigue, physical fitness, and activity level. Sixty-seven women were randomized to an exercise intervention group (n=33, performed strength training 3x/week and 30 minutes brisk walking/day) and a control group (n=34, performed their regular physical activity level). Data collection was performed at baseline, at completion of chemotherapy (Post1), and 6-month postchemotherapy (Post2). Exercise levels were slightly higher in the scheduled exercise group than in the control group. In both groups, cancer-related fatigue increased at Post1but returned to baseline at Post2. Physical fitness and activity levels decreased at Post1but were significantly improved at Post2. Significant differences between intervention and control groups were not found. The findings suggest that generally recommended physical activity levels are enough to relief cancer-related fatigue and restore physical capacity in breast cancer patients during adjuvant chemotherapy, although one cannot rule out that results reflect diminishing treatment side effects over time.

scholarly journals Perceived changes to quality of life indicators following a physical activity intervention for recovering cancer patients: A qualitative study.

2016 ◽  
Vol 4 (2) ◽  
pp. 305
Author(s):  
Martyn Queen ◽  
Saul Bloxham ◽  
Phil Brown ◽  
Melissa Coyle ◽  
Ben Jane
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Qualitative Study ◽  
Cancer Patients ◽  
Psychological Health ◽  
Physical Activity Intervention ◽  
Chronic Fatigue ◽  
Theory Approach ◽  
Structured Interviews

The aim of this study was to examine the perceived changes to the quality of life (QoL) for a group of recovering cancer patients, following 6 months of physical activity.Background Evidence suggests that physical activity can improve the QoL of recovering cancer patients, reducing many of the side-effects of cancer and its related treatments, including depression, anxiety, chronic fatigue and improve physical and psychological health. Method A qualitative study with 14 mixed site cancer patients aged 43-70 (12 women, 2 men). The intervention was in 2 parts the first part was an 8-week physical activity programme, the second part related to a period of non-supervised, physical activity for 4 months (6 months in total). The Programme took place at a university in the South West of England. Semi-structured interviews with patients took place 3 times over 6 months. A grounded theory approach was used to analyse the data.Results We found that prior to the 6-month physical activity intervention many of the patients were anxious about being able to complete the initial 8 week programme. Anxieties related to low self-esteem and the chronic fatigue resulting from their cancer treatment. Consequently several patients expressed concerns about their ability to help themselves self-manage their recovery through physical activity. On completion of the intervention the majority of patients reported improvements in their perceived QoL relating to their ability to self-manage, their self-efficacy, energy levels, along with decreases in chronic fatigue.Conclusion Our study has provided valuable insights into how the perceived QoL of a group of recovering cancer patients can be improved through a combined 6-month period of supervised and independent physical activity. These findings serve as further evidence of the effectiveness of a person centred healthcare approach for recovering cancer patients.

Factors and barriers associated with changes in physical activity after cancer diagnosis.

2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 162-162 ◽  
Author(s):  
Sally A. D. Romero ◽  
Qing Susan Li ◽  
Jun J. Mao
Keyword(s):  
Physical Activity ◽  
Cancer Patients ◽  
Metastatic Disease ◽  
Cancer Diagnosis ◽  
Medical Center ◽  
Academic Medical Center ◽  
Cross Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Logistic Regression Models

162 Background: Cancer patients experience a variety of symptoms (e.g., pain, fatigue) that can impact their ability to maintain physical activity (PA) levels. The objectives of this study were to examine factors associated with decreased levels of PA following cancer diagnosis and to identify barriers to PA. Methods: We recruited cancer patients from one urban academic medical center and 11 affiliated community hospitals to participate in a cross-sectional study. We conducted chi-square tests and multivariate logistic regression models to examine patient demographics, clinical characteristics and self-reported barriers associated with decrease in PA levels since cancer diagnosis. Results: Among 662 participants, mean age (SD) was 59.9 (11.6) years. The majority were female (65%), White (81%), and overweight/obese (65%). Common cancer types were breast (32%), lung/thoracic (15%), and hematological (15%), 53% had non-metastatic disease, and 53% were > 12 months post-cancer diagnosis. The majority received chemotherapy (88%), radiation (53%), and/or surgery (53%). Since their cancer diagnosis, 499 (75%) participants reported decreasing their PA levels, 16% maintained, and 4% increased their PA levels. In multivariate analyses, decreased PA levels were significantly associated with receiving chemotherapy [Adjusted Odds Ratio (AOR) 3.54, 95% CI 2.06-6.06] and having metastatic disease (AOR 1.64, 95% CI 1.07-2.52). For barriers to PA, the most common were fatigue (78%), pain (71%), difficulty getting motivated (68%) and difficulty remaining disciplined (65%). In bivariate analyses, the presence of symptoms (i.e., pain, nausea, fatigue, treatment side effects, or surgical complications), difficulty getting motivated, difficulty remaining disciplined, and sadness were significantly associated (p < 0.05) with decreasing PA levels. Conclusions: The majority of cancer patients, especially those who received chemotherapy and those with advanced disease, decreased their PA levels since cancer diagnosis. In addition, physical and psychological barriers exist that influence PA levels. Interventions targeting these barriers are needed to promote maintenance of PA levels throughout the cancer continuum.

scholarly journals Longitudinal development of cancer‐related fatigue and physical activity in childhood cancer patients

2019 ◽  
Vol 66 (12) ◽  
Author(s):  
Elisabeth M. Van Dijk‐Lokkart ◽  
Lindsay M. H. Steur ◽  
Katja I. Braam ◽  
Margreet A. Veening ◽  
Jaap Huisman ◽  
...  
Keyword(s):  
Physical Activity ◽  
Childhood Cancer ◽  
Cancer Patients ◽  
Longitudinal Development ◽  
Cancer Related Fatigue

scholarly journals Physical Activity after Colorectal Cancer Diagnosis and Mortality in a Nationwide Retrospective Cohort Study

Cancers ◽  
2021 ◽  
Vol 13 (19) ◽  
pp. 4804
Author(s):  
Meesun Lee ◽  
Yunseo Lee ◽  
Doeun Jang ◽  
Aesun Shin
Keyword(s):  
Physical Activity ◽  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Colon Cancer ◽  
Cancer Patients ◽  
Cancer Diagnosis ◽  
Early Stage ◽  
Colorectal Cancer Patient ◽  
Prognostic Impact ◽  
Specific Mortality

Physical activity reduces the risk of colon cancer, but its prognostic impact after cancer diagnosis remains unclear. To evaluate the association between post-diagnosis activity and cause-specific mortality, we reconstructed a colorectal cancer patient cohort from the 2009–16 Korean National Health Insurance Service (NHIS) database. Subgroup analyses were performed by treatment group. In total, 27,143 colon cancer patients and 16,453 rectal cancer patients were included in the analysis (mean follow-up, 4.3 years; median 4.0 years). In the surgically treated group, a high level of activity (the weighted sum of the frequencies for walking, moderate, and vigorous activity greater than or equal to 3 times/week) was inversely associated with all-cause mortality (colon cancer: HR, 0.79; 95% CI, 0.72 to 0.88; rectal cancer: HR, 0.75; 95% CI, 0.66 to 0.86) and colorectal cancer-specific mortality (colon cancer: HR, 0.85; 95% CI, 0.76 to 0.97; rectal cancer: HR, 0.77; 95% CI, 0.66 to 0.90). No significant results were shown for cardiovascular disease-specific mortality. No association was shown in patients who received chemoradiotherapy without surgery. The present study may provide evidence for post-diagnosis physical activity as a prognostic factor in colorectal cancer, particularly in surgically treated early-stage patients.

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