Physical Activity In Cancer Patients Research Articles

Conditions for adherence to videoconference-based programs promoting adapted physical activity in cancer patients: a realist evaluation

BackgroundAlthough moderate physical activity (PA) during cancer treatment has been associated with improved quality of life, reduced side effects, and even lower mortality, many barriers to successful implementation remain. Digital technology has been perceived as an effective lever for overcoming access and motivational issues but few studies have been performed to confirm this assumption. The “VISIO-AJUST” study explored the factors affecting the conditions of adherence to video-conference-based PA programs in patients undergoing cancer treatment.MethodsThe VISIO-AJUST study was based on a qualitative successive case approach, guided by the principles of the realist evaluation, and applied to two French programs of PA, following three main steps: (1) Identification of factors likely to influence conditions of patients’ adherence; (2) Elaboration and testing of explanatory “Context-Mechanism-Outcome (CMO)” configurations; (3) Refinement of CMO configurations, in order to understand what, how, for whom, and under what circumstances video-conference-based PA programs work.ResultsFive main CMO configurations were found to be associated with adherence to video-conferencing-based PA programs, promoting (i) accessibility and a supportive environment for adapted physical activity, (ii) a setting conducive to sociability despite distance, (iii) Confidence and security of practice, (iv) a combination of several motivational levers in favor of continuity of effort and progress, (v) regularity of the sessions, progressiveness in the effort and evaluation of progress as a basis for the adoption of a regular physical practice.ConclusionThis study provides original insights into the use of videoconferencing to enable patients to improve their PA during cancer treatment. Future research with long-term follow-up would allow for a better understanding of the key conditions promoting sustainable behavior change.

Welcome to a new journal in exercise and cancer

In this letter to the Editor, the author discusses the historical evolution of the practice of physical activity in cancer patients and the paradigm shift in this respect.

Diet-driven microbiome changes and physical activity in cancer patients

Exploring the role of the gut microbiome in oncology is gaining more attention, mainly due to its ability to shape the immune system in cancer patients. A well-balanced microbial composition forms a symbiotic relationship with the host organism. Mounting evidence supports the potential of modifiable lifestyle factors, such as diet and physical activity, in restoring intestinal dysbiosis related to cancer development and treatment. In this Minireview, we describe the host-microbiome interplay following different dietary patterns, including a high-fat diet, fiber-rich diet, diet rich in rice and beans, Mediterranean diet, ketogenic diet, and physical activity in preclinical findings and clinical settings. According to the results, nutrition is a critical factor influencing the composition of gut microbial communities. Therefore, knowledge about the patient’s nutritional status in pre-treatment and treatment becomes crucial for further management. A combination of individualized dietary habits and professional training plans might help to maintain gut homeostasis, potentially improving the response to anti-cancer therapy and the quality of life in cancer survivors. However, a deep understanding of underlying mechanisms and large clinical trials are needed to uncover clinically relevant correlations for personalized treatment approaches leading to better outcomes for cancer patients.

PO-2303 Evaluation of physical activity in cancer patients receiving radiation therapy

PO-2303 Evaluation of physical activity in cancer patients receiving radiation therapy

Usage of Complementary and Alternative Methods, Lifestyle, and Psychological Variables in Cancer Care.

People who are undergoing cancer treatment often ask themselves what they can do in addition to conventional medical therapy with regard to nutrition, activity, and complementary methods. However, we know little about the motivation why people opt for one or the other measure. The aim of this study was therefore to examine the extent of physical activity (PA), healthy nutrition, and the use of complementary methods in relation to both demographic and psychological data. A questionnaire was used to collect data on demographic data, resilience, coherence, self-efficacy, spirituality, satisfaction, and complementary and alternative medicine (CAM) behavior, PA, and diet. Between March and July 2021, data from 446 patients were collected. Regression models and correlation analyzes were used to examine the associations between CAM use, diet and PA with the other variables surveyed. CAM usage could only be predicted based on the patient's spirituality. Women used CAM more often and ate more healthily. Healthy eating was also related to younger age, shorter medical history, resilience, satisfaction, and coherence. In addition, the results showed that daily PA was related to the level of resilience, spirituality, and self-efficacy. Which people or why patients use CAM remains a question to be further investigated. Our data suggest that CAM seeks to address similar needs that others find in spirituality. In order to promote a healthy diet and PA in cancer patients in the future, various psychological variables seem conceivable. Resilience stands out, which is related to an overall healthier lifestyle.

Physical Activity and Cancer Care-A Review.

Simple SummaryThe aim of this paper is to outline the role and potential benefits of physical activity for cancer patients. We present a review of publications on the subject in order to compare the findings reported in the literature and draw general conclusions that could help clinicians who provide cancer care to develop a more comprehensive treatment approach. This review may also help patients overcome barriers and become more motivated to take up physical activity, which would improve their quality of life. We wish to demonstrate to patients that physical activity should not be regarded as a burdensome medical recommendation but rather as a factor that can reduce the risk of cancer mortality and recurrence.In 2020, 19.3 million new cancer cases were diagnosed, and almost 10 million deaths from cancer were recorded. Cancer patients may experience fatigue, depression, anxiety, reduced quality of life and sleep problems. Cancer treatments cause numerous side effects and have a negative impact on all body systems. Physical activity is important for cancer patients. The aim of this review is to analyse recent studies on the role of physical activity in cancer patients and emphasize its importance. The review included 36 papers published in English between 2017 and 2021. The findings from these studies show that physical activity decreases the severity of side effects of cancer treatment, reduces fatigue, improves quality of life, has a positive impact on mental health and improves aerobic fitness in cancer patients. Moreover, it reduces the risk of cancer recurrence and death. Physical activity is recommended for patients with any type of cancer and at all stages of treatment. The type of physical activity should depend on the condition of the individual patient. It is extremely difficult to determine what type, intensity and duration of physical activity is likely to have the greatest effect.

Nutrition and physical activity in cancer patients: a survey on their information sources

BackgroundMany cancer patients suffer from problems concerning nutrition and physical activity (PA) during and after their treatment. Forwarding reliable health information could help to alleviate severe symptoms. The present study aimed to examine cancer patients’ commonly used information sources on nutrition and PA.MethodsAn anonymous questionnaire was developed and distributed to German cancer patients in different settings. In total, 90 questionnaires have been completed between October 2021 and March 2022. For analysis, descriptive statistics were used and associations between information sources and patients’ lifestyle behaviour explored utilising Spearman’s Rho, Mann–Whitney U, and Pearson’s Chi Square tests.ResultsThe cancer patients received information on nutrition and PA most frequently from physicians (70.9%), family and friends (68%) and browsing the internet (61.3%). Half of the patients (51.1%) had questions concerning these topics during the time of their disease. The majority of those patients (81.8%) reported that their questions were answered. The topics were addressed primarily with outpatient oncologists (60.0%) and in rehabilitation clinics (53.3%). Just about half of the patients (55.3%) felt satisfactorily informed on nutrition and PA in their cancer disease, more so if they talked to their oncologist or family physician (Z = − 2.450, p = 0.014 and Z = − 3.425, p = 0.001 resp.).ConclusionCancer patients receive information on nutrition and PA predominantly after their initial treatment. Since they might be missing significant information to alleviate severe symptoms during their treatment, the importance of nutrition and PA should be emphasised by clinicians early on in treatment.Trial registrationTrial Registration Number (May 7, 2021): 2021-2149-Bef.

Feasibility of a Six Week High Intensity Interval Training Program in Patients with Non- Small Cell Lung Cancer: A Randomized Pilot Study

High Intensity Interval Training (HIIT) has become a mainstream, frequently investigated form of exercise training and has been used as a modality for physical activity in cancer patients. The objective of this study was to determine the feasibility of advanced Non-Small Cell Lung Cancer (NSCLC) patients performing a program of HIIT. To our knowledge, this is the first study to investigate a HIIT program for these patients. Ten participants were recruited for this study.

Development of Educational Print Materials for Physical Activity in Cancer: Evaluation of Readability and Suitability

Educational health materials may be important tools to increase physical activity in cancer patients. Nevertheless, most of the available resources regarding physical activity for cancer patients were found not suitable, had a low grade of readability, and thus, represent a significant barrier to behavior change. To date, little data about development criteria and evaluation of physical activity resources for cancer before their spread exist. The purposes of this study were (i) to describe the development of a physical activity guidebook designed for cancer patients and (ii) to test its readability and suitability. The guidebook was developed through multi-step passages, including group discussions, a literature review, identification of a motivational theory, and using previous research on exercise preferences, barriers, and facilitators to target the information. Two validated formulae were used to assess the readability, whereas thirty-four judges completed the Suitability of Assessment Materials questionnaire to evaluate the suitability of the guidebook. The guidebook was found readable for patients having at least a primary education, and the judges scored it as “superior” material. Our guidebook, following a rigorous method in the development phase, was considered to be suitable and readable. Further evaluations through clinical trials could investigate its effectiveness for behavior change and its impact on cancer patients.

Relationship Between Cancer Related Fatigue, Physical Activity Related Health Competence, and Leisure Time Physical Activity in Cancer Patients and Survivors.

Background: A large body of evidence supports the positive effects of leisure time physical activity (LTPA) and exercise on cancer survivors. However, only a fraction of survivors manages to attain international PA recommendations. This can be attributed to several external and internal barriers toward PA those patients seem to encounter, with cancer related fatigue (CRF) being the most reported internal barrier. Nevertheless, self-efficacy and knowledge about the utilization of LTPA can serve as facilitators of PA, which also correspond to certain constituents of physical activity related health competence (PAHCO). Since PAHCO is not investigated in cancer survivors we investigated if PAHCO can mediate the negative relationship between CRF and LTPA.Methods: We surveyed 398 cancer survivors with different cancer types and therapy status. The patients completed the EORTC QLQ-FA12 (EORTC FA12) to assess CRF, the PAHCO questionnaire to assess PAHCO and the SQUASH to assess LTPA. We followed a two-step structural equation modeling approach. The first step established the measurement model, in the second step we fitted the mediation model. Since 163 patients chose not to answer the SQUASH, the mediation model was only fitted to the data of the remaining 235 participants.Results: The proposed measurement model of the PAHCO offered an excellent fit. We found small to moderate positive associations between the PAHCO dimensions and the LTPA, and negative moderate relationships between the PAHCO and the EORTC FA12 dimensions. We did not observe a relationship between the EORTC FA12 dimensions and the LTPA (p > 0.05). The hypothesized mediation models did not display an appropriate fit.Conclusion: The PAHCO confirmed its factorial validity; furthermore, it appears to have a positive relationship to LTPA. Therefore, integrating psycho-educational aspects can be beneficial in order to increase the PAHCO in exercise interventions. Because of the cross-sectional character of this study, causal conclusions are not suitable, therefore the longitudinal relationships of LTPA, CRF, and PAHCO require further investigation.

Importance of performance status and physical activity in cancer patients

SummaryBackgroundThis review summarizes current data on the effects of exercise interventions and physical activity in cancer prevention, treatment and related side effect management, as well as on the rehabilitation of cancer patients.Patients and methodsThe overall quality of patient studies is still poor due to methodological limitations. Major limitations of the interventional exercise studies conducted include their designs, with regard to missing randomization or the absence of control groups, and the use of heterogeneous assessment methods to quantify and objectify physical activity. As a result, there are no specific exercise recommendations in cancer patients as yet that would essentially differ from exercise recommendations for healthy subjects. Nevertheless, due to major findings and empirical data, the field of research into exercise- and physical activity-related effects on disease and therapy-associated aspects is young and rapidly emerging.ConclusionExercise potentially contributes to the prevention and rehabilitation of cancer and represents a powerful tool in the prevention of various side effects under chemotherapy. Current data from interventional studies show preliminary positive effects for diverse movement programs and especially through specific combinations of endurance and resistance training. Additional randomized controlled trials with standardized assessments and controlling for potential confounders are needed to confirm and expand these findings.

The role of physical activity in cancer patients: a narrative review

Physical activity plays an important role in the proper functioning of the human body and it is recommended in the prevention and treatment of many disease syndromes. The importance of physical activity in cancer patients has been highlighted in recent years. Physical activity has a positive impact on the course of the disease as well as on the condition of patients after anticancer treatment. It also reduces the risk of developing some types of cancer. Physical activity can be recommended to patients during and after cancer treatment. This narrative review presents current knowledge regarding the indications, applicability, and efficacy of physical activity in cancer patients, based on the recommendations of the American College of Sports Medicine International Multidisciplinary Roundtable on Exercise and Cancer. The paper discusses the role of physical activity in cancer patients receiving palliative care on the basis of the available systematic reviews.

IMPACT OF PHYSICAL ACTIVITY ON FATIGUE AND QUALITY OF LIFE OF CANCER PATIENTS

ABSTRACT Introduction: Physical exercise has been considered an important non-pharmacological treatment for reducing tiredness, pain, low self-esteem and increases in body mass in individuals diagnosed with cancer. Objective: To verify the relationship between fatigue, quality of life and levels of physical activity in cancer patients undergoing chemotherapy. Methods: Observational, cross-sectional study. The sample consisted of 85 adult patients undergoing cancer treatment at a university hospital. Physical activity was assessed by the IPAQ, and fatigue and quality of life by the PFS and EORTC QLQ-C30 questionnaires, respectively. Student's t and the Fisher's Exact tests were used to identify differences between active and physically inactive patients for the variables fatigue and quality. Additionally, covariance analysis (ANCOVA) was used, in which simple (outcome and exposure) and adjusted models (age, time of diagnosis and type of cancer) were tested. Results: The study included 85 cancer patients, with a mean of 51.78 years of age (±11.72). Most were female and not physically active. Patients classified as physically inactive had higher scores for “total fatigue” (p=0.01), “behavioral” (p=0.01), “affective” (p=0.02) and psychological/sensory fatigue (p=0.04), compared to the physically active patients (p=0.01). Patients classified as physically not very active presented poorer quality of life in the dimensions: “overall” quality of life (p=0.05) and “functional” (p=0.04), “appetite” (p=0.02), “insomnia” (p=0.0 2), “diarrhea” (p=0.04), “fatigue” (p=0.01), “pain” (p=0.01) and “nausea” (p=0.03), when compared to the physically active patients in both analyses; simple and adjusted. Conclusion: The practice of physical activity during treatment can be a determining factor for increasing quality of life and reducing fatigue in cancer patients, minimizing the adverse effects of chemotherapy. Level of evidence II; retrospective study.

Health Care Professionals' Knowledge and Attitudes Toward Physical Activity in Cancer Patients: A Systematic Review.

The purpose of this study was to, combine current available literature across health professionals to determine commonalities and differences between knowledge and attitudes of physical activity (PA) and its importance within the cancer population. It aimed to identify any gaps in the literature to inform future study directions to enhance PA participation and improve health outcomes and quality of life. Design: systematic review. Google Scholar, EBSCO, PubMed, Scopus, Web of Science. survey-based studies specifically reporting PA levels for both cancer patients and survivors from the perspective of oncology health care professionals. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) was used to guide this review. The initial search highlighted 15,342 articles and returned 190 articles with relevant titles, of which 20 met the eligibility criteria; 15.8% of cancer patients reported to meeting PA guidelines during treatment and 36.5% after treatment. On average 58.1% of health care professionals self-reported discussing PA with their cancer patients, with the average referral rate to an exercise specialist or rehabilitation program being 18.3%. Only a limited number of health care professionals are initiating a discussion about PA with their cancer patients. Some health care professionals reported limited knowledge of PA guidelines for cancer patients. Their own personal PA levels do not seem to be associated with whether they discuss PA with their patients. Common barriers to providing PA advice were experienced across all health care professions such as time, limited referral pathways, and patient interest. Future research should be carried out to substantiate these barriers and discover which strategies could be implemented to improve the levels of PA discussions and referrals within clinical practice. Given the position nurses hold within the health care system, it would be beneficial to upskill and improve their understanding of PA and exercise as medicine for the cancer population. This has enormous potential that could enhance PA advice and boost referrals to exercise professionals improving the health and quality of life of the cancer population.

The Impact Of Sports Science-based Prehabilitation On Spontaneous Physical Activity After Major Abdominal Cancer Surgery

Complex surgery for abdominal cancer often leads to postoperative complications that may prevent post-surgical rehabilitation in old, frail, or malnourished patients. Prehabilitation is an emerging alternative strategy that has the potential to speed recovery and may be analogous to athletic preparations for gameday. For optimal physiological improvement to occur in a limited time period prior to the surgery, cancer patients undergoing prehabilitation interventions must work closer to their maximal physiological capacity (albeit a very low level) in a manner similar to that of competitive athletes. PURPOSE: To determine the effect of a 4-week sports science-based prehabilitation program on spontaneous physical activity in cancer patients who undergo major abdominal surgery. METHODS: Twenty-two cancer patients (63±11 years) who underwent major abdominal surgery were studied. Fourteen patients participated in a 4-week exercise and nutrition prehabilitation program prior to abdominal surgery. The sport-science based program comprised of an interdisciplinary approach, including blood flow restriction exercise and a daily sports nutrition supplement containing L-citrulline, creatine monohydrate, and whey protein. The remaining 8 patients served as controls. Physical activity of both groups was monitored for 5 days after surgery. Accelerometers were used to quantify number of steps, energy expenditure, and sedentary time. RESULTS: The prehabilitation group recorded 47.4% more total steps for 5 days after abdominal surgery than the control group (16,032±5,194 vs.10,877±5,182 total steps/5 days, p=0.037). The prehabilitation group had a greater amount of total energy expenditure than the control group (5,555±3,400 vs. 2,971±1,572 total kcal/5 days, p=0.028). There was no significant difference in total sedentary time between the two groups (5,064±597 vs. 5,414±514 min/5 days). CONCLUSIONS: This prehabilitation program composed of cutting-edge sports science practices significantly improved spontaneous physical activity after major surgery in older patients with abdominal cancers.

Perceções e comportamentos dos médicos oncologistas relativos à promoção de atividade física

Objetivo Descrever e explorar determinantes da promoção de Atividade Física (AF) por parte dos oncologistas, analisar a perceção de capacidade, oportunidade e motivação dos médicos quanto à promoção de AF, e analisar as preocupações relacionadas com a prática de exercício físico dos doentes oncológicos. Método Um total de 76 oncologistas preencheram um questionário constituído por demografia, questões sobre a promoção da AF ligadas às perceções de capacidade, oportunidade, motivação, comportamento, e necessidades. Foram realizadas análises de correlação de Pearson e Spearman, regressão linear múltipla, teste-t paramétrico e não paramétrico. Resultados Foram detetadas perceções de capacidade e oportunidade baixas e uma motivação elevada. A grande maioria promove atividade física, mas não promove exercício físico estruturado, contudo, reconhecem a sua importância. A capacidade é a variável mais preponderante no comportamento, mas as restantes variáveis estão associadas ao mesmo. É reportada uma necessidade de melhoria de condições para a promoção de AF. Conclusão Os resultados devem ser analisados com cautela devido à amostra reduzida, no entanto, sugerem que os médicos valorizam a prática de AF dos seus doentes mas não se sentem capazes para promovê-la, o que legitima a presença de fisiologistas do exercício nos serviços de saúde. A presença do fisiologista do exercício pode ser um fator desencadeador da promoção de AF e exercício físico.

Factors Influencing Physical Activity in Cancer Patients During Oncological Treatments: A Qualitative Study.

Introduction:Although the literature supports the importance of physical activity in the oncological context, in Italy a large number of patients are not sufficiently active.Methods:The present study aimed to explore factors influencing an active lifestyle in cancer patients during oncological treatments. Semi-structured focus groups, including 18 patients with different cancer types, were conducted at the Oncology Unit in the University Hospital Trust of Verona (Italy). The interviews were audio-recorded, transcribed verbatim, and analyzed with content analysis.Results:According to the Health Belief Model, transcripts were categorized into the following themes: benefits, barriers, and cues to action. Patients reported a series of physical, physiological, and psychological benefits deriving from an active lifestyle. The main barriers hampering the physical activity participation were represented by treatment-related side effects, advanced disease, and some medical procedures, for example, ileostomy. Several strategies that can trigger patients to exercise were identified. Medical advice, social support from family and friends, features such as enjoyment, setting goals, and owning an animal can motivate patients to perform physical activity. At the same time, an individualized program based on patients’ characteristics, an available physical activity specialist to consult, more detailed information regarding physical activity in the oncological setting, and having accessible structures were found important facilitators to implementing active behavior.Conclusions:Overall, patients have a positive view regarding physical activity, and a variety of obstacles and cues to action were recognized. Considering this information may help to improve adherence to a physical activity program over time, consequently increasing the expected benefits.

Fentanyl Sublingual Spray or Morphine for the Control of Shortness of Breath During or After Physical Activity in Cancer Patients

Fentanyl Sublingual Spray or Morphine for the Control of Shortness of Breath During or After Physical Activity in Cancer Patients

CN96 - Level of physical activity and nutritional status in cancer patients with fatigue: An exploratory cross-sectional study

BackgroundCancer-related fatigue (CRF) is one of the most common side effects and leads to a significant impairment of quality of life (QoL). At the same time many cancer patients suffer from malnutrition. Studies show that both physical activity and a good nutritional status reduce CRF. Until now this has only been considered in isolation. This study aims a comprehensive view to evaluate the relation of fatigue with malnutrition and level of activity. Methods18 patients of the oncological sports and exercise therapy at the University Hospital Halle (Saale) were examined in a cross-sectional design. Outcome measures were the relevant values of body composition, such as body mass [% of fat-free mass] (BCM [% of FFM]), extracellular mass to body cell mass (ECM / BCM) and phase angle ϕ, which were determined by bioelectrical impedance analysis (BIA). Moreover CRF with EORTC QLQ FA12, Nutritional related QoL with FAACT, History and Current Level of Activity (Questionnaire from Woll) and Malnutrition with Subjective Global Assessment (SGA). The statistical analysis was made with description and Pearson’s correlations. Following, a linear regression analysis was supplemented with an ANOVA. ResultsThe correlation between physical fatigue and habitual physical activity had a correlation coefficient of -0.641 (p=0.004). Between the physical fatigue and FAACT Total Score a negative linear correlation (correlation coefficient = -0.739, p<0.01) could be found. The correlation of the physical fatigue and the values from the BIA did not show any significant results. The linear regression analysis showed that 47.8 % of the total fatigue could be explained by the Functional Assessment of Anorexia/Cachexia Therapy (corr. R2 = 0.478, p=0.001) and that ECM/BCM and BCM [% of FFM] do not provide additional explanatory power. ConclusionsIt could be confirmed that the QoL of cancer patients is strongly limited by the CRF. The negative correlation between habitual activity and physical fatigue supports the hypothesis of the so-called "prehabilitation". It has been shown that it is a legitimate strategy to present nutritional status and level of physical activity in cancer patients with CRF at the same time. Legal entity responsible for the studyThe authors. FundingHas not received any funding. DisclosureP. Jahn: Research grant / Funding (institution): Chugai. C. Leithold: Honoraria (self): Fresenius. All other authors have declared no conflicts of interest.

A Systematic Review of Electronic Health (eHealth) interventions to improve physical activity in patients with breast cancer.

Electronic Health (eHealth) may have a positive effect on healthcare, such as patient education and decreasing the costs of healthcare services. Evidence suggests that such interventions can also improve physical activity (PA) of patients. This systematic review aimed to investigate the effects of PA interventions provided through eHealth on breast cancer patients. This study was conducted through a search in electronic databases up to July 2018. PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Web of Science, Scopus, Science Direct, and Google Scholar databases were searched without time limitation. In total, 2187 articles were retrieved and finally 16 articles remained. Five were pre/post and 11 were randomized trial studies. Different platforms were used in these studies including web-based, mobile-based, both web-and-mobile-based and email. In total, these articles comprise 2304 breast cancer patients with the mean age of 51years and 50% were conducted in the USA. Four studies measured PA using wearable devices such as accelerometers and pedometers. All studies reported an increase in PA level at least in one of moderate or vigorous PA, although not all these results were significant. The results show that eHealth interventions can improve the level of PA in breast cancer patients. Although there are numerous eHealth interventions focusing on PA in cancer patients, there is still an essential need for eHealth interventions to be tailored for breast cancer patients specifically. Clinical trials with appropriate methodology, enough intervention time and follow-up are needed to make evidence-based results more generalizable. PROSPERO CRD42018092422; https://www.crd.york.ac.uk/PROSPERO/.