QOL In Cancer Survivors Research Articles

Quality of Life Among Cancer Survivors in South Asia

Background: Cancer survivorship has increased in South Asia, negatively impacting their health and wellbeing in terms of mental, social, emotional, physical, and economic well-being. Several factors, including sociodemographic, clinical, treatment-related, behavioral, and psychosocial aspects, all have an substantial effect on of QOL of cancer survivors. Our aim is to determine QOL among cancer survivors in South Asia, challenges faced by cancer survivors, factors enhancing and deteriorating QOL, and measures that can be taken to improve QOL. Method: We conducted a systematic literature review and systematically assessed the literature to identify relevant research about South Asian cancer survivors' quality of life in English only. We searched two databases (Google Scholar, and PubMed), In each of which we searched and selected all the articles and research having the keywords: Cancer survivors, quality of life, and South Asia. After reading the abstract and titles of the study, we read full articles and retrieved data according to PRISMA. The data extracted was compiled through Microsoft Excel. No meta-analysis and quantitative syntheses were done. Results: A total of 20 articles were identified. Of which 60% showed a negative effect on various domains of QOL of cancer survivors in South Asian countries. Most common factors identified were chemotherapy and effects of low of self-esteem, sexual dysfunction, limb impairment and physical restriction. Only 10 % of reviewed articles (2 articles) did not show a decline in QOL in cancer survivors. Conclusion: It has been found that there is a general detrimental influence on the quality living of cancer sufferers in this part of the world. Given the grave consequences, awareness must be raised to combat such dire circumstances and alleviate the overall quality care.

An 8-week exercise study to improve cancer treatment related fatigue and QOL among African American breast cancer patients undergoing radiation treatment: A pilot randomized clinical trial

Cancer treatment related fatigue (CTRF) is one of the most debilitating side effects of adjuvant radiation therapy (RT). Several studies have found that physical activity (PA) may be an effective intervention to decrease fatigue and enhance QOL in cancer survivors. The primary objective of the PEDLAR study is to test the feasibility of an easily administered 8-week structured moderate-intensity PA intervention, delivered concurrently with RT, in reducing CTRF and improving health-related QOL among African-American breast cancer patients. This study is also designed to provide pilot data on the acceptability and adherence of PA interventions in African-American women with breast cancer. It is a prospective, 2-arm, 8-week feasibility trial. Participants are randomized to either a structured, moderate-intensity aerobic training exercise regimen concurrent with radiotherapy or a control group. Participants in intervention group reported high satisfaction with exercise and adherence was >75% for exercise sessions. African-American breast cancer patients in a moderate-intensity 75 min/wk aerobic exercise intervention had marginally lower fatigue at 8-wk follow-up compared to baseline. The control group participants had marginally higher fatigue at 8-wk follow-up compared to baseline. Participants in the intervention group reported slightly better quality of life at 8-wk follow-up compared to baseline (P = 0.06).

Quality of life in "chronic" cancer survivors: a meta-analysis.

Cancer survivors are now living longer giving rise to a new concept-chronic cancer as survivors continue to face long-term consequences of cancer and its treatment. For these survivors, QOL becomes a vital consideration in understanding their survivorship and the long-term impact of cancer and its treatment. The primary aim of this review is to describe QOL in cancer survivors two or more years from diagnosis. A meta-analysis was completed of relevant studies assessing QOL in long-term cancer survivorship using PubMed, CINHAL, and PsycINFO. A total of 64 articles met inclusion criteria and included in the analysis. Standardized effect sizes and errors were calculated using previously published standard QOL pass rates to compare QOL across measurement tools and calculate cumulative effect sizes (CES). Fixed-effect or random-effects models were used based on the presence of significant heterogeneity of ≤ 0.10. Physical health (CES = - 0.894; CI, - 1.472, - 0.316), role-physical health (CES = - 2.039; CI, - 2.643, - 1.435), and mental health (CES = - 0.870; CI, - 1.447, - 0.292) had large, negative cumulative effect sizes signifying worse QOL compared with acceptable QOL rates. Tested moderators, cancer type, average age, country of origin, time since diagnosis, or decade of diagnosis, were not significant to explain heterogeneity between included studies. QOL is significantly impacted 2 to 26years after cancer diagnosis. More research is needed to determine possible moderators of QOL in long-term cancer survivors. QOL continues to be significantly impacted in long-term cancer survivorship. More research is needed to understand the impact of these findings on care needs for survivors with chronic cancer.

Abstract P5-13-18: The feasibility of nurse intervention to improve and maintain the BMI of breast cancer survivors over 25 to appropriate levels

Abstract Background: Some studies have shown that women with breast cancer who have a BMI value gain of more than 2.0 kg/m2 after diagnosis have an elevated risk of dying of breast cancer, and likewise breast cancer patients who gained 5 or more kilogramshad a higher mortality rate than those who maintained their weight. Therefore it can be said that weight control is important for women with breast cancer. In addition to the survival benefit, preliminary research suggests that exercise intervention for weight control may also be effective for enhancing the QOL of cancer survivors. Purpose: We designed an exercise intervention study to assess the feasibility of the intervention in maintaining standard weight and also the effect of the excercise in breast cancer patients. Patients and methods: Breast cancer patients aged 20 to 75 years, stage I to IIIA, with no metastases, who had completed chemotherapy, with BMI values greater than 25 kg/m2 are eligible for participation. The intervention will be to have the patients do aerobic exercise 150 minutes per week, and assess the BMI and health-related QOL using the care note questionnaire, at baseline, 6 months, and 12 months later for each participant. We are also planning dietary interventions for the patients. We will calculate the actual calorie consumption of each patient and give dietary advice for optimal calorie intake. Patients will be required to record their exercise in a formatted note so we can check the exercise adherenece. Citation Format: Arakaki M, Tamaki K, Kamada Y, Uehara K, Gushikawa H. The feasibility of nurse intervention to improve and maintain the BMI of breast cancer survivors over 25 to appropriate levels [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P5-13-18.

Associations between morning–evening chronotype, fatigue, and QOL in breast cancer survivors.

246 Background: Emerging evidence suggests that circadian disruption is associated with cancer and cancer treatments. Chronotype is defined as a behaviorally manifested preference for a certain timing of sleep and activity. Previous studies have revealed that living out of sync from one’s innate chronotype can have detrimental effects on one’s health. Although there has been research examining the associations between chronotype and health, not much is known about the relationship between chronotype, fatigue, and QOL in cancer survivors. Methods: 68 Breast cancer survivors completed questionnaires to assess their chronotype (Horne-Ostberg), to rate their fatigue (MDASI), and to evaluate their QOL (FACIT). The Horne-Ostberg questionnaire yields a range of values indicating survivors’ preference for early or late activity. The study sample was divided by terciles according to survivors’ “morningness” or “eveningness” preferences (i.e., chronotypes). Results: Morning chronotype was associated with significantly less severe tiredness and drowsiness as well as significantly better physical well-being and fatigue subscale scores as compared to evening chronotype. Tiredness median (M) scores were highest for evening chronotype (M=5.5), moderate for mid-range chronotype (M=4.5), and lowest for morning chronotype (M=3.0), a significant difference (p=0.046). Drowsiness scores were highest for evening chronotype (median=6.0), moderate for mid-range chronotype (M=4.0), and lowest for morning chronotype (M=3.0), p=0.046. The median score for physical well-being was significantly lower for evening compared to morning chronotypes (22.5 vs. 25.0, p=0.038) and morning types reported significantly better health in respect to fatigue compared to evening types (40.5 vs. 35.5, p=0.045). Conclusions: Survivors with early chronotype (early to bed, early to rise) reported less fatigue, drowsiness, and better overall physical well-being. While chronotype is believed to be genetically driven, certain behavioral, pharmacological, and bright light modifications can be used to help patients shift their circadian rhythm towards earlier morning type and may experience improvements in physical well-being.

Respiratory Muscle Training Improves Dyspnea and Exercise Performance in Cancer Survivors

It is estimated that up to 70% of survivors experience dyspnea at some point in their recovery. Dyspnea is correlated with functional performance (6 minute walk test, 6MWT) and peak exercise (VO2PEAK), both of which predict survival in lung cancer. Respiratory muscle weakness represents one of the primary mechanisms contributing to exertional dyspnea and reduced exercise performance in cancer survivors. Respiratory muscle training (RMT) protocols have been used to reduce dyspnea in patients with non-malignant lung disease; however, no studies have explored respiratory muscle training to alleviate dyspnea in cancer survivors. PURPOSE: Implement a RMT program to reduce the sensation of dyspnea, as well as to improve exercise capacity, functional performance and QoL in breast and lung cancer survivors. METHODS: Eight participants who have completed all therapies (57.3 ± 6.8 years) performed RMT, 3 sets of 15 repetitions against spring loaded inspiratory and expiratory valves, 3 days/week, for 4 weeks. Pre- and Post-RRMT, subjects performed maximal expiratory (MEP) and inspiratory pressures (MIP), exercise tests (VO2Peak, sub-maximal cycling endurance at 70% of peak and 6MWT) and questionnaires related to dyspnea (Baseline Dyspnea Index) and quality of life (SF-36). RESULTS: Four breast and four lung cancer survivors completed the protocol (mean years ± SD from treatment = 4.1±3.0). At baseline, FVC and FEV1 were 80.3±18.5 and 77.2±18.2% of predicted. MIP and MEP were 51.8±20.0% and 94.8±19.2% of predicted. Post-RMT, MIP and MEP increased 26.5±21.2% and 40.1±32.7%, respectively (p<0.005). Time to peak (8.5±3.5 min vs. 10.1±3.2 min, p=0.015) and submaximal endurance (16.5±7.7 vs. 32.4±8.7 min, p=0.007) exercise and the distance covered in the 6MWT (414±91 m vs. 441±97 m, p=0.03) were all significantly longer. Finally, baseline dyspnea index (p=0.02) and quality of life (p=0.04) improved post-RMT. CONCLUSION: These results suggest that a progressive resistance inspiratory and expiratory respiratory muscle training program helps to improve respiratory muscle strength, the sensation of dyspnea, as well as exercise performance and QoL in cancer survivors.

Impact of current treatment status on QOL in cancer survivors.

9597 Background: Many cancer survivors have been reported to have poor health related quality of life (HRQoL). This could be caused by various symptoms of cancer itself and treatment. For better understanding of cancer treatment and HRQoL, we investigated HRQoL and associating factors according to current treatment status and compared them with general population. Methods: Using national survey data in South Korea (KNHANES IV-V) from 2007 to 2010, we analyzed 14,396 subjects aged over 50years. Cancer survivors were defined as person diagnosed cancer by physician and divided into two groups, with current treatment and no treatment. Euro QOL was measured as HRQoL. Socioeconomic status (age, sex, education, having SSI), number of non-cancer disease, depressive mood, time since diagnosis and health behaviors (smoking, alcohol, physical activity) were collected as risk factors. EQ5D index and EQ_VAS of survivors receiving treatment were compared with no treatment group and general population, respectively. Res...

Yoga Improved Sleep, QOL in Cancer Survivors

Yoga Improved Sleep, QOL in Cancer Survivors

Measurement of the quality of life in cancer survivors.

A QOL instrument was developed to measure the specific concerns of long term cancer survivors. The QOL-CS is based on previous versions of the QOL instrument developed by researchers at the City of Hope National Medical Centre (Grant, Padilla, and Ferrell). This instrument was revised over a one year pilot by Hassey-Dow and Ferrell. The revised instrument included 41 items representing the four domains of quality of life incorporating physical, psychological, social, and spiritual well being. The present study was conducted as a mail survey to the membership (n = 1,200) of the National Coalition for Cancer Survivorship with 686 subjects responding to the survey. This survey included a Demographic tool, QOL-CS and the FACT-G tool developed by Cella. Psychometric analysis, performed on 686 respondents, included measures of reliability and validity. Two measures of reliability included test-retest and internal consistency. The overall QOL-CS tool test-retest reliability was 0.89 with subscales of Physical r = 0.88, Psychological r = 0.88, Social r = 0.81, and Spiritual, r = 0.90. The second measure of reliability was computation of internal consistency using Cronbach's alpha coefficient as a measure of agreement between items and subscales. Analysis revealed an overall r = 0.93. Subscale alphas average ranged from r = 0.71 for spiritual well being, r = 0.77 for physical, r = 0.81 for social, and r = 0.89 for psychological. Several measures of validity were used to determine the extent to which the instrument measured the concept of QOL in cancer survivors. The first method of content validity was based on a panel of QOL researchers and nurses with expertise in oncology. The second measure used stepwise multiple regression to determine factors most predictive of overall QOL in cancer survivors. Seventeen variables were found to be statistically significant accounting for 91% of the variance in overall QOL. The fourth measure of validity used Pearson's correlations to estimate the relationships between the subscales of QOL-CS and the subscales of the established FACT-G tool. There was moderate to strong correlation between associated subscales including QOL-CS physical to FACT physical (r = 0.74), QOL-CS Psych to FACT Emotional (r = 0.65), QOL Social to FACT Social (r = 0.44). The overall QOL-CS correlation with the FACT-G was 0.78. Additional measures of validity included correlations of individual items of the QOL-CS tool, factor analysis, and construct validity discriminating known groups of cancer survivors. Findings demonstrated that the QOL-CS and its subscales adequately measured QOL in this growing population of cancer survivors.