Life In Breast Cancer Survivors Research Articles

Quality of Life and Sexual Functioning of Women after Breast Cancer Surgery

BACKGROUND: Women with breast cancer can experience changes in sexual functioning and body images that can seriously affect their quality of life. AIM: The aim of this research was to study the quality of life and sexual functioning of women after a mastectomy and after a breast-conserving surgery and to compare post-operative quality of life. SUBJECTS AND METHODS: This cross-sectional study included 204 participants, 101 patients after a mastectomy and 103 patients after a quadrantectomy. The research was conducted using the Croatian version of the questionnaire of the European Organization for Research and Treatment of Breast Cancer, the questionnaire with the breast cancer module EORTC QLQ - BR 23. RESULTS: On the EORTC QLQ –BR23 scale, participants with mastectomy rated their sexual functioning (p < 0.001), sexual pleasure (p < 0.001), and systemic side effects (p = 0.04) lower comparing to women after breast-conserving surgery. The overall functionality scale was significantly lower (p = 0.03) for women who underwent mastectomy compared to those who underwent breast-conserving surgery. Participants under 51 years of age had worse body image 1 month after mastectomy (p = 0.006), while sexual functioning was better (p = 0.03) than in older age groups. In breast-conserving surgery group, 1 month after surgery, participants in the age group of 61 years and older assessed body image better (p = 0.04) than in the younger age group. Sexual functioning was rated better by women aged 51–60 years (p = 0.03). CONCLUSION: Results of this study show that women after breast conserving surgery have better quality of life, better sexual functioning and less side effects of systemic therapy compared to women after mastectomy. The type of surgery, patient’s age and time passed after completion of treatment are important factors which influence sexual functioning and quality of life in breast cancer survivors.

Developing and validating a prediction model for lymphedema detection in breast cancer survivors.

Early detection and intervention of lymphedema is essential for improving the quality of life of breast cancer survivors. Previous studies have shown that patients have symptoms such as arm tightness and arm heaviness before experiencing obvious limb swelling. Thus, this study aimed to develop a symptom-warning model for the early detection of breast cancer-related lymphedema. A cross-sectional study was conducted at a tertiary hospital in Beijing between April 2017 and December 2018. A total of 24 lymphedema-associated symptoms were identified as candidate predictors. Circumferential measurements were used to diagnose lymphedema. The data were randomly split into training and validation sets with a 7:3 ratio to derive and evaluate six machine learning models. Both the discrimination and calibration of each model were assessed on the validation set. A total of 533 patients were included in the study. The logistic regression model showed the best performance for early detection of lymphedema, with AUC=0.889 (0.840-0.938), sensitivity=0.771, specificity=0.883, accuracy=0.825, and Brier scores=0.141. Calibration was also acceptable. It has been deployed as an open-access web application, allowing users to estimate the probability of lymphedema individually in real time. The application can be found at https://apredictiontoolforlymphedema.shinyapps.io/dynnomapp/. The symptom-warning model developed by logistic regression performed well in the early detection of lymphedema. Integrating this model into an open-access web application is beneficial to patients and healthcare providers to monitor lymphedema status in real-time.

Effects of a Yoga-Based Exercise Program on Health-Related Quality of Life in Breast Cancer Survivors

Research Objectives To examine the impact of six months of exercise on a Health Related Quality of Life (HR-QOL) outcomes in post treatment breast cancer survivors in the San Antonio area in Texas. Design Randomized Controlled Trial. Setting The exercise program was run at a comprehensive cancer care facility. Participants Women with breast cancer (n=94) were randomized into one of three groups: yoga-based exercise (YE; n=31); “conventional” comprehensive exercise (aerobic, resistance and flexibility; CE; n=31); or a comparison group allowing participants to choose their own preferred exercise activities (C; n=32). 72 participants completed the 6 month long exercise program (YE: n=20; CE: n=26 and C: n=26). One year retention testing was completed by 64 participants (YE: n=17; CE: n=21, C: n=24). Interventions All groups exercised three hours weekly over six months. The YE group had a structured Hatha yoga exercise program emphasizing breath awareness and postures. The exercise program for the CE group included aerobic, resistance, and flexibility training. The C group could choose from a variety of activities including aerobics, strength training, Tai Chi, and water aerobics. Main Outcome Measures The SF-36 Physical and Mental Component Scales [PCS, MCS] were used to evaluate HrQoL. Sleep quality was assessed using Pittsburgh Sleep Quality Index (PSQI). SF-36 data was collected at baseline, post and retention. PSQI data was collected baseline and post-intervention only. Results At retention testing, PCS scores improved significantly in the YE group compared C and CE groups (p < 0.025). All participants improved PCS and MCS scores with no between group differences. No change was seen in PSQI scores. Conclusions A yoga-based exercise program can positively impact the physical component of HR-QOL in breast cancer survivors, particularly after completion of the intervention. Whether the HR-QOL continues to improve beyond one year needs further research. Author(s) Disclosures The authors would like to acknowledge all the participants for their commitment to the study and support of Dr. Amy Lang, the ThriveWell Cancer Foundation, and the START Center for Cancer Care. The authors have no other conflicts of interest to declare. To examine the impact of six months of exercise on a Health Related Quality of Life (HR-QOL) outcomes in post treatment breast cancer survivors in the San Antonio area in Texas. Randomized Controlled Trial. The exercise program was run at a comprehensive cancer care facility. Women with breast cancer (n=94) were randomized into one of three groups: yoga-based exercise (YE; n=31); “conventional” comprehensive exercise (aerobic, resistance and flexibility; CE; n=31); or a comparison group allowing participants to choose their own preferred exercise activities (C; n=32). 72 participants completed the 6 month long exercise program (YE: n=20; CE: n=26 and C: n=26). One year retention testing was completed by 64 participants (YE: n=17; CE: n=21, C: n=24). All groups exercised three hours weekly over six months. The YE group had a structured Hatha yoga exercise program emphasizing breath awareness and postures. The exercise program for the CE group included aerobic, resistance, and flexibility training. The C group could choose from a variety of activities including aerobics, strength training, Tai Chi, and water aerobics. The SF-36 Physical and Mental Component Scales [PCS, MCS] were used to evaluate HrQoL. Sleep quality was assessed using Pittsburgh Sleep Quality Index (PSQI). SF-36 data was collected at baseline, post and retention. PSQI data was collected baseline and post-intervention only. At retention testing, PCS scores improved significantly in the YE group compared C and CE groups (p < 0.025). All participants improved PCS and MCS scores with no between group differences. No change was seen in PSQI scores. A yoga-based exercise program can positively impact the physical component of HR-QOL in breast cancer survivors, particularly after completion of the intervention. Whether the HR-QOL continues to improve beyond one year needs further research.

Sustained effects of mantra meditation compared to music listening on neurocognitive outcomes of breast cancer survivors: A brief report of a randomized control trial

ObjectiveCancer-related cognitive impairment is common following the end of adjuvant treatment and there are limited treatment options for it. We compared the sustained cognitive (primary) and psychological (secondary) effects of mantra meditation to classical music listening 8 weeks after interventions ended (Time 3) compared to baseline (Time 1). MethodsA two-group parallel random assignment experimental design was used in a community setting. Thirty one breast cancer survivors (ages 21 to 75, received chemotherapy, and reported cognitive complaints) were randomly assigned to practice mantra meditation (n = 16) or listen to classical music (n = 15) 12 min a day for 8 weeks. No blinding was used. Repeated measures analysis of variance models were used to compare Time 1 and Time 3 data for the 26 survivors (13 per group) who completed the interventions and Time 3 data collection. ResultsVerbal fluency (p < .001, ηp2 = 0.58), attention (p = .002, ηp2 = 0.33), immediate memory recall (p < .001, ηp2 = 0.38), perceived cognitive impairment (p < .001, ηp2 = 0.39), and quality of life (p = .001, ηp2 = 0.35) improved significantly across time for both groups. The two conditions did not differ significantly in changes across time. There were no adverse effects. ConclusionDaily mantra meditation or classical music listening may be beneficial for cognitive outcomes and quality of life of breast cancer survivors with cancer-related cognitive impairment. The cognitive benefits appear to be sustained beyond the initial intervention period.Clinical Trials Registration number: NCT03696056, recruitment status completed.The study details can be accessed at: https://clinicaltrials.gov/ct2/show/NCT03696056 Key messageThere are limited treatment options for managing cancer-related cognitive impairments. Daily mantra meditation or classical music listening for 12 min a day may improve cognitive outcomes and quality of life for cancer survivors, with no negative side effects.

유방암 생존자의 증상, 불확실성이 삶의 질에 미치는 영향

Purpose: This study was to identify the effect of symptom experience and uncertainty on the quality of life in breast cancer survivors. Methods: Data were collected from 151 breast cancer survivors who participated actively in a self-help group from May 1st to 30th, 2015. Data were analyzed using Pearson correlation and stepwise multiple regression. Results: The severity of symptom experience, uncertainty, and quality of life of breast cancer survivors were moderate. Symptom experience, uncertainty, and quality of life showed a significant correlation. The most influential factor on quality of life was symptom experience which showed 66.0% of explanatory power. When uncertainty was added, the explanatory power increased to 74%. Conclusion: The finding showed the symptom and uncertainty affected the quality of life of breast cancer survivors. In order to improve the quality of life of breast cancer survivors, it is necessary to develop an intervention program that can reduce uncertainty and the symptoms experienced by breast cancer survivors.

The Influence of Rehabilitation on Quality of Life in Breast Cancer Survivors: A Clinical Study.

Background: Breast cancer survivors report negative impacts of cancer, augmented by specific vulnerabilities to body changes, negative self-assessment, and quality-of-life concerns. The main objective of our work was to test the effect of a rehabilitation program on breast cancer patients by evaluating the change in their physical well-being during an outpatient rehabilitation setting and, subsequently, in a home rehabilitation setting, considering the individual personality profile. Methods: Patients who underwent total mastectomy with breast prostheses or tissue expanders were enrolled. Outcome assessments (Pain, Quality of Life, Personality traits for the Minnesota Multiphasic Personality Inventory-2) before treatment (T0), at the end of the rehabilitative treatment (T1 = 10 sessions 2/week, one hour/each), and after two months of follow-up (T2) were performed. Results: The data of 38 included patients were analyzed. The quadratic trend of the Visual Analogue Scale can be explained by the fact that patients have a strong reduction in the perceived pain immediately after rehabilitation in the clinic. This reduction remains constant for the home period of the rehabilitation. The personality profiles of all the participants were substantially valid. Only three patients obtained scores higher than 65 points. Conclusions: The study evidenced that in the initial phase of the rehabilitation, psychological traits such as anxiety, depression, and preoccupation could have a strong association especially with the autonomous functions and the perceived physical symptoms. However, during the therapeutic process, this association decreased and these decrements were higher when patients performed their rehabilitation at home, in a more familiar and comfortable setting.

PH-0220 Long-term quality of life in breast cancer survivors 10 years after radiotherapy

PH-0220 Long-term quality of life in breast cancer survivors 10 years after radiotherapy

Physical activity domains are differently related with quality of life in breast cancer survivors: a cross-sectional study.

Treatments for breast cancer (BC) can lead to physical and mental impairments which may affect quality of life (QoL). Physical activity (PA) is highly recommended for this population due to its protective effect against BC relapse and its ability to reduce the health impact of treatment. However, it is not clear whether the different domains of PA are associated with better QoL of BC survivors. The current study aimed to verify the relationship between different PA domains with QoL of BC survivors. The sample consisted of 128 women BC survivors, with a mean age of 58.2 ± 9.7 years. QoL was assessed using the Short-Form Health Survey questionnaire (SF-36) and PA was verified through the Baecke questionnaire, in domains of occupation, sports practice, and leisure time/commuting. The relationship between QoL and different PA domains was verified by linear regression, adjusted by age, marital status, and socioeconomic condition. Occupational PA was negatively related to physical limitations [β= -15.36 (-29.04 to -1.68] and body pain [β=-6.61 (-14.53 to 1.31) marginal association]. Sports practice was positively related to functional capacity [β= 4.24 (0.60 to 7.88)]. Leisure time/commuting PA was positively related to functional capacity [β = 7.17 (3.09 to 11.26)], vitality [β = 4.30 (0.39 to 8.22)], social aspects [β= 5.47 (0.80 to 10.15)], and mental health [β = 4.08 (0.40 to 7.75)]. Sports practice and leisure time/commuting PA were positively related to QoL in BC survivors, while occupational PA was negatively related to QoL, independently of age, marital status, and socioeconomic condition.

Practice and Outcome of Exercise Intervention on Breast Cancer-Specific Quality of Life of Breast Cancer Survivors in Nigeria

Background: Lifestyle modification like exercise is an essential rehabilitation measure that improves the quality of life (QoL) of women with breast cancer and helps in preventing cancer related complications. This study assessed the practice and outcome of exercise interventions on breast cancer-specific quality of life of survivors in Delta State, Nigeria. Methods: Experimental design was applied with intervention (47) and control (47) groups. This design involved a pre-test, an intervention, and a post-test. Exercise intervention (aerobic, resistance and flexibility exercises, including warm-up with Swiss ball and dance, climbing of stairs, treadmill, stationary exercise bicycle, shoulder, and arm exercises) was administered to the intervention group for twelve weeks. The assessment of breast cancer survivors' specific quality of life in the two groups was done with the English version of The European Organization for Research and Treatment of Cancer Breast Cancer-Specific Quality of Life Questionnaire (QLQ- EORTC-BR23) before and after the exercise intervention. Results: The overall pre and post-intervention breast cancer-specific functional quality of life was 65.4±22.7 (intervention group); 71.3±23.4 (control group) and 75.05 ±10.4 (intervention group); 58.65±12.9 (control group) while the pre and post breast cancer-specific symptoms QoL was 22.2±6.2 (intervention group); 24.1±9.6 (control group) and 11.8±13.0 (intervention group); 30.9±21.2 (control group), respectively. All the women in the intervention group practiced exercise only at mild/moderate intensity and no notable side effects were observed during the practice by many of them (n=39). Significant differences existed in the overall post-intervention breast cancer-specific functional and symptoms QoL between the two groups (p&lt;0.001) and no significant differences were observed among most of the specific QoL scales in relation to age, duration of diagnosis, and stage of the cancer diagnosis. Conclusion: Exercise remains beneficial to women with breast cancer and has proven to be one of the necessary means to improve their overall well-being. Therefore, healthcare providers that manage these patients in different hospitals should always counsel and support them to initiate the recommended exercises for cancer survivors to enhance their survival.

Patient and health care professional co-development of an Acceptance and Commitment Therapy intervention to support hormone therapy decision-making and well-being in women with breast cancer

Objectives The aim of this work was to co-develop an Acceptance and Commitment Therapy (ACT) intervention to support medication adherence and quality of life in breast cancer survivors (BCSs). The research approach was intervention co-development. Methods The sample consisted of BCS focus groups (n = 24), health care provider (HCP) interviews (n = 10), and a co-development workshop (BCSs, n = 12; HCPs, n = 9).We conducted 6 BCS focus groups and 10 HCP interviews to understand the acceptability of ACT. We co-designed the intervention in a workshop. Results Participants reported high acceptability of an ACT intervention. BCSs preferred ACT exercises focused on values and self-compassion. Both groups recommended face-to-face intervention delivery, by a clinical psychologist, with a mixture of individual and group sessions. BCSs requested advice on side-effect management. Conclusions We effectively used patient and HCP co-design to configure an ACT intervention to support medication adherence and quality of life for BCSs. If feasible and efficacious, this ACT-based intervention could support breast cancer survivorship.

Pain-related Prescribing Patterns and Associated Factor in Breast Cancer Patients

Other SectionsAbstractBody대상 및 방법연구 결과고 찰결 론감사의 말씀이해상충TableReferenceBackground: With an increase in the number of breast cancer survivors, greater importance is attached to health-related quality of life, particularly pain and symptom control. This study aimed to identify the factors that are associated with pain in cancer patients based on the patterns of prescribing opioid, non-opioid, and adjuvant analgesics. Methods: This analysis included new patients who had developed breast cancer between 2003 and 2012. The degree of pain was analyzed based on the socio-demographic (age, income quintile, number of hospitalizations, and duration of disease), indicator (Body Mass Index; BMI, Charlson Comorbidity Index; CCI, Cumulative Analgesic Consumption Score; CACS), operation (mastectomy, lymph node dissection), and therapy (chemotherapy, radiation therapy), as well as complication-related variable (lymphedema). Results: As for the patterns of prescribing analgesics by stages, non-opioid and opioid analgesics constituted 30.7 and 69.3%, respectively. The mean value and variance of CACS were 5.596 and 12.567, respectively. The factors that significantly affected the degree of pain were age (≥50; IRR: 1.848, 95% CI 1.564- 2.184, p=0.000), income quintile (IRR: 0.964, 95% CI 0.938-0.991, p=0.008), BMI (≥ 25; IRR: 1.479, 95% CI 1.222-1.795, p= 0.000), CCI (≥ 4; IRR: 1.649, 95% CI 1.344-2.036, p=0.000), and lymphedema (yes; IRR: 1.267, 95% CI 1.006-1.610, p=0.047). Conclusions: It is necessary to develop systematic and comprehensive pain control measures to improve the quality of life for breast cancer survivors, especially for those who are 50 years or older, lie in the lower-income quintile, have BMI of ≥25 and CCI score ≥ 4, or have lymphedema.Keywords : Breast neoplasms, cancer pain, comorbidity, analgesics, prescriptions

Long-term health-related quality of life of breast cancer survivors remains impaired compared to the age-matched general population especially in young women. Results from the prospective controlled BREX exercise study

ObjectiveTo investigate long-term health-related quality of life (HRQoL) changes over time in younger compared to older disease-free breast cancer survivors who participated in a prospective randomized exercise trial. MethodsSurvivors (aged 35–68 years) were randomized to a 12-month exercise trial after adjuvant treatment and followed up for ten years. HRQoL was assessed with the generic 15D instrument during follow-up and the younger (baseline age ≤ 50) and older (age >50) survivors’ HRQoL was compared to that of the age-matched general female population (n = 892). The analysis included 342 survivors. ResultsThe decline of HRQoL compared to the population was steeper and recovery slower in the younger survivors (p for interaction < 0.001). The impairment was also larger among the younger survivors (p = 0.027) whose mean HRQoL deteriorated for three years after treatment and started to slowly improve thereafter but still remained below the population level after ten years (difference −0.017, 95% CI: −0.031 to −0.004). The older survivors’ mean HRQoL gradually approached the population level during the first five years but also remained below it at ten years (difference −0.019, 95% CI: −0.031 to −0.007). The largest differences were on the dimensions of sleeping and sexual activity, on which both age groups remained below the population level throughout the follow-up. ConclusionsHRQoL developed differently in younger and older survivors both regarding the most affected dimensions of HRQoL and the timing of the changes during follow-up. HRQoL of both age groups remained below the population level even ten years after treatment.

The Promise of Nutrient-Derived Bioactive Compounds and Dietary Components to Ameliorate Symptoms of Chemotherapy-Related Cognitive Impairment in Breast Cancer Survivors.

One of the most burdensome symptoms reported by breast cancer patients is chemotherapy-related neurocognitive impairment. It is estimated that of the 11 million cancer survivors in the USA, 22% of them are breast cancer patients. The National Cancer Institute classified chemotherapy-related cognitive impairment (CRCI) as one of the most debilitating sequelae of cancer therapy, limiting this patient population from recommencing their lives prior to the diagnosis of breast cancer. Currently, there are no strategies that are established to prevent, mitigate, or treat CRCI. In addition to surviving cancer, quality of life is critical to cancer survivors. Based on the multiple and complex biological and psychosocial etiology, the varying manifestation and extent of cognitive decline documented in breast cancer survivors, possibly attributed to varying combinations of chemotherapy and dose and duration of therapy, multimodal interventions combining promising nutrient-derived bioactive compounds with antioxidant and anti-inflammatory properties, in addition to structured cognitive training and exercise regimens, can work synergistically to reduce inflammation and oxidative stress with significant improvement in cognitive function resulting in improvements in quality of life of breast cancer survivors.

Development and validation of a guideline on sexual and reproductive health of breast cancer survivors in Iran: a mixed methods study protocol

BackgroundSexual and reproductive health problems significantly decrease quality of life in survivors of breast cancer. The best approach is to provide services according to evidence-based guidelines developed based on their practical context. Here, we aim to develop and validate a guideline on the sexual and reproductive health of breast cancer survivors in Iran.MethodsThe guideline will be developed and validated using an exploratory sequential mixed methods approach in three phases: (1) describing sexual and reproductive health needs of survivors of breast cancer in Iran and the health services they receive in this regard, (2) performing a systematic review of existing guidelines, resources, and documents on the sexual and reproductive health of breast cancer survivors worldwide, and (3) developing and validating a guideline on the sexual and reproductive health of women who survived breast cancer in Iran based on the results of phases 1 and 2 through multiple steps.DiscussionA comprehensive and practical guideline on the sexual and reproductive health of breast cancer survivors in Iran will be developed which will be compatible with their specific needs and culture, considering the limited resources available. This guideline can significantly improve the quality of life in breast cancer survivors in Iran. In addition, the approach we will use here can be utilized to develop guidelines on sexual and reproductive health of female cancer survivors in general.

Effect of an e-home based symptom management and mindfulness training program on quality of life in breast cancer survivors: A randomized clinical trial.

12080 Background: The first five years post-treatment for breast cancer are a critical phase, when the survivors may face a multitude of physical and psychosocial problems. We aimed to develop an e-home based symptom management and mindfulness training program to support women with breast cancer in transition to survivorship and to determine its effect on the endpoints including quality of life, symptom distress, psychosocial adjustment, and psychological morbidity. Methods: This parallel 4-arm, superiority randomized clinical trial together with a process evaluation using semi-structured interview recruited women who had completed cancer treatment for stage 0 to 3 breast cancer between 6 months to 5 years previously, from November 2016 through March 2020 at two tertiary hospitals. A total of 593 women were eligible, of these, 402 refused to participate and 191 women were randomized. However, 19 subjects withdrew from the study without completion of baseline assessments. Hence, 172 subjects were included in the intention-to-treat analysis (e-home based breast cancer survivorship program, experimental group; n = 44), comparison group 1 (online symptom management program only; n = 41), comparison group 2 (online mindfulness training program only; n = 44) or the usual care group (n = 43). The e-home based breast cancer survivorship program involved 5 weekly online education module regarding self-management strategies of common symptoms + various online self-administered mindfulness exercises. The primary endpoint included change of Quality of Life-Cancer Survivor Scale (QoL-CS) score measured at 8, 12 and 24 weeks from baseline. Secondary endpoints were changes of Social Support Questionnaire, Breast Cancer Survivor Self-Efficacy Scale, Memorial Symptom Assessment Scale, Psychosocial Adjustment to Illness Scale, Fear of Recurrence Scale, Hospital and anxiety Depression Scale, and Five Facet Mindfulness Questionnaire scores. Results: Of 172 subjects, mean ± SD age was 51.2 ± 9.4 years; 118 (77.7%) were in the first two years of cancer treatment completion; 165 (98.2%) underwent surgery; and 111 (73.5%) treated with adjuvant chemotherapy. All demographic and clinical characteristics were comparable among the four groups ( p&gt;.05). There was no between-group difference in the primary endpoint; QoL-CS scores among groups at 8, 12 and 24 weeks from baseline ( p&gt;.05). Secondary endpoints were also not different among groups ( p&gt;.05). Two main themes; positive impact and gap/barrier, emerged from process evaluation data. Conclusions: In women who were in the first five years post-breast cancer treatment, an e-home based multidimensional cancer survivorship program did not affect outcomes. Nevertheless, the interview data revealed a positive experience in regards to the home-based approach in cancer survivorship care program. Clinical trial information: NCT02931864.

Experiences of breast cancer survivors during the COVID-19 pandemic: a qualitative study

PurposeThis study aimed to explore the impacts of the COVID-19 pandemic on the quality of life of breast cancer survivors.MethodsThis qualitative descriptive study included 18 breast cancer survivors who completed cancer treatment within the last five years in Istanbul, Turkey. A directed content analysis was performed using the quality-of-life domains as guiding themes.ResultsThe mean age was 51 ± 5.9, and the average months since active treatment were 26.5 ± 9.8 (9–48). Six themes and associated categories are as follows: Physical functioning; Changes in physical activity and weight, new physical symptoms, Role functioning; Work-life, changes in household chores, Emotional functioning; Emotional changes, fear of having the COVID-19 infection, Cognitive Functioning; Risk Perception about the COVID-19 infection, reactions to the COVID-19 pandemic’ measures, Social Functioning; Familial relationship changes, social interactions, General Health/Utilization of Healthcare services; Changes in routine follow-ups, changes in diet.ConclusionBreast cancer survivors had different challenges causing new physical and psychological symptoms such as lymphedema, pain, burnout, and anxiety that may have long-term effects on their quality of life.

A Personalized, Dynamic Physical Activity Intervention Is Feasible and Improves Energetic Capacity, Energy Expenditure, and Quality of Life in Breast Cancer Survivors.

PurposeDespite survival and quality of life benefits associated with physical activity, many breast cancer survivors remain inactive. Effective, sustainable interventions must account for individual differences in capability, motivation, and environment. Here, we evaluate the feasibility, mechanics, and efficacy of delivering an individualized, dynamic intervention to increase energetic capacity and energy expenditure.MethodsStage 0–III breast cancer patients who had completed primary treatment were enrolled. Prior to the intervention, detailed movement data was collected with a wearable GPS and accelerometer for 3 weeks to establish baseline activity. Movement data was collected continuously throughout the 12-week intervention, during which patients received electronically delivered, tailored, dynamic activity “prescriptions”, adjusted based on demonstrated individual capability, daily movement in their environment, and progress.ResultsOf 66 enrolled, 57 participants began and completed the intervention. The intervention resulted in significant improvements in average steps (+558 steps/day, p = 0.01), energetic capacity measured by power generation on a stationary bicycle (1.76 to 1.99 W/kg lean mass, p < 0.01), and quality of life (FACT-B TOI, 72.8 to 74.8, p = 0.02). The greatest improvement in functional energetic capacity was seen in the lowest performing tertile at baseline (0.76 to 1.12 W/kg, p < 0.01).DiscussionWearable technology delivery of personalized activity prescriptions based on individual capability and movement behaviors demonstrates feasibility and early effectiveness. The high variability seen in baseline activity and function, as well as in response to the intervention, supports the need for future work in precision approaches to physical activity (NCT03158519).

The effect of progressive aerobic, resistance and stretching exercise combined with education on body weight among breast cancer survivors

Introduction Breast cancer survivors have a high prevalence of excess body weight (65%) [1], which contributes to several comorbidities [2] and decrease in quality of life (QoL) [3]. The purpose of this study is to verify the effects of an exercise and education program on body weight, physical activity levels and quality of life of breast cancer survivors. Materials and methods Thirteen breast cancer survivors took part of this case series study. They had a mean age of 69.8 (63–84) years, a body mass index (BMI) of 28.1 (24.4–32.3) kg/m2 and were lastly treated 7,6 (4-10) years ago. The program included a biweekly moderate-intensity aerobic, resistance and stretching exercise program, for 12 weeks, and educational sessions once a week for the first 4 weeks, regarding excess body weight and physical activity. The primary outcome was body weight and secondary outcomes were body fat, lean mass, knowledge of the topics discussed in the educational sessions, QoL (Global State Subscale of EORTC QLQ-C30), physical activity level (IPAQ), and program satisfaction. An informed consent was obtained from all participants. Results Five of the eight eligible participants (62.5%) completed the study. All participants (5, 100%) decreased body weight, with a decrease in body fat and increase in lean mass. All of them also remained in the same physical activity levels, and all except one (4, 80%) improved QoL. Participants either maintained (1, 50%) or decreased (1, 50%) their knowledge on body weight, and either increased (2, 50%), maintained (1, 25%) or decreased (1, 25%) their knowledge on physical activity. All participants (5, 100%) were “highly satisfied” with the program. Discussion and conclusions The authors conclude that 12 weeks of moderate-intensity aerobic, resistance and stretching exercise program improves loss of body weight, body composition and QoL, and helps maintaining physical activity levels, which is in accordance with previous literature. Effects on knowledge improvement were not observed, since there were only 2 educational sessions per topic, on a 4-week span, and the literature shows effects with longer programs. Furthermore, the collaborative methodology of the sessions led participants to interpret those as a moment to share experiences, instead of a moment to learn. These educational results may negatively influence the maintenance of the other results achieved. Similar programs should be provided, promoting these results to wider groups of breast cancer survivors, with educational sessions given more frequently and in a more informal setting, allied to exercise sessions.

Family Function Support and Quality of Life For Breast Cancer Survivors

Post-treatment care and ongoing care plans for breast cancer sufferers can reduce the quality of life. Breast cancer patients who are hospitalized have negative factors, such as being away from their family and loved ones, unfamiliar hospital environment, getting diagnosis and treatment that is difficult so that the patient feels afraid of every procedure that will be given to him and makes quality his life was getting low. This study aims to identify the domains of quality of life in breast cancer patients. This study uses a type of correlation research with the sampling technique in this study using purposive sampling. The number of samples was 40 respondents in the age range 24-68 years. This study used a family function support instrument and WHO QoL BREF. Based on the results of the Fisher exact test, the four family functions showed a significant relationship to the quality of life of the study subjects with a p-value less than 0.001. The protection function showed the greatest impact in affecting the quality of life of the subjects with OR = 41,600 (95% CI = 4,219-410,222). The function of love shows OR = 6,400 (95% CI = 2,861-14,317), the economic function shows OR = 5,500 (95% CI = 2,667-11,342), and the religious function with OR = 4,857 (95% CI = 2,510-9,399). Therefore, it is very important that the family can provide support for the protective function of breast cancer survivors. Perawatan pasca pengobatan dan rencana perawatan berkelanjutan penderita kanker payudara dapat menurunkan kualitas hidup. Pasien kanker payudara yang dirawat di rumah sakit memiliki faktor negatif, seperti jauh dari keluarga dan orang-orang yang dicintainya, lingkungan rumah sakit yang tidak dikenal, mendapatkan diagnosis dan perawatan yang sulit sehingga membuat pasien merasa takut setiap prosedur yang akan diberikan kepadanya serta membuat kualitas hidupnya semakin rendah. Penelitian ini bertujuan untuk mengidentifikasi domain dalan kualitas hidup pada penderita kanker payudara. Penelitian ini menggunakan jenis penelitian Korelasi dengan teknik pengambilan sampel dalam penelitian ini menggunakan purposive sampling. Jumlah sampel adalah 40 responden dalam rentang usia 24-68 tahun. Penelitian ini menggunakan instrument dukungan fungsi keluarga dan WHO QoL BREF. Berdasarkan hasil uji fisher exact tes, ke empat fungsi keluarga menunjukkan hubungan yang signifikan terhadap kualitas hidup subyek penelitian dengan p value kurang dari 0,001. Fungsi perlindungan menunjukkan dampak yang paling besar dalam mempengaruhi kualitas hidup subyek dengan OR=41,600 (95% CI= 4,219-410,222). Fungsi cinta kasih menunjukkan OR=6,400 (95% CI= 2,861-14,317), fungsi ekonomi menunjukkan OR=5,500 (95% CI= 2,667-11,342), dan fungsi keagamaan dengan OR= 4,857 (95% CI= 2,510-9,399). Oleh Karena itu sangat penting keluargga dapat memberikan dukungan fungsi perlindungan kepada survivor kanker payudara.

Effects of a personal trainer-led exercise intervention on physical activity, physical function, and quality of life of breast cancer survivors.

Exercise is important to address physical and emotional effects of breast cancer treatment. This study examines effects of a personal trainer led exercise intervention on physical activity levels, physical function and quality of life (QoL) in breast cancer survivors. Women post active breast cancer treatment were recruited from 2015 to 2017, randomized to immediate exercise or wait-list control, and received three personal training sessions for up to 30weeks. Physical activity and function were assessed by pedometer, and tests of endurance, strength, and flexibility. Self-reported physical activity, physical activity self-efficacy, and QoL were also assessed. 60 women were randomized to immediate intervention (n = 31) or wait-list control (n = 29). Subjects were aged (mean ± SD) 56 ± 10years. On the endurance test, the exercise group significantly improved (increase of 18 ± 20 steps vs control 9 ± 12 steps) (p = 0.036). On the strength test, the exercise group significantly improved (increase of 4 ± 3 curls vs control 1 ± 3 curls) (p = 0.002). After intervention, change (mean ∆ ± SD) in the FACT-ES physical well-being subscale score was 1 ± 2 in the exercise group and - 1 ± 2 in the control group (p = 0.023). Improvement in Self-efficacy and Physical Activity (SEPA) score was significant with a change (mean ∆ ± SD) of 2 ± 5 for exercise vs 0 ± 5 for control (p = 0.047). The number of steps/day, back scratch test, weight, and self-reported physical activity did not significantly improve with intervention. The intervention yielded significant improvements in endurance and strength but not physical activity or quality of life. Future efforts to explore feasible ways to support patient's physical activity efforts need to be undertaken.