scholarly journals Reach Out to Enhance Wellness Home-Based Diet-Exercise Intervention Promotes Reproducible and Sustainable Long-Term Improvements in Health Behaviors, Body Weight, and Physical Functioning in Older, Overweight/Obese Cancer Survivors

2012 ◽  
Vol 30 (19) ◽  
pp. 2354-2361 ◽  
Author(s):  
Wendy Demark-Wahnefried ◽  
Miriam C. Morey ◽  
Richard Sloane ◽  
Denise C. Snyder ◽  
Paige E. Miller ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Exercise Intervention ◽  
Short Form ◽  
Functional Decline ◽  
The United States ◽  
Telephone Counseling ◽  
Exercise Interventions ◽  
Intervention Delivery ◽  
Prostate Cancer Survivors

Purpose Diet and exercise interventions have been tested in cancer survivors as a means to reduce late effects and comorbidity, but few have assessed adherence and health outcomes long term. Methods Between July 2005 and May 2007, the Reach Out to Enhance Wellness (RENEW) trial accrued 641 locoregionally staged, long-term (≥ 5 years from diagnosis) colorectal, breast, and prostate cancer survivors in the United States (21 states), Canada, and the United Kingdom. All participants were sedentary (< 150 minutes of physical activity [PA] a week), overweight or obese (body mass index, 25 to 40 kg/m2), and over age 65 years. The trial tested a diet-exercise intervention delivered via mailed print materials and telephone counseling. RENEW used a wait-list control, cross-over design (ie, participants received the year-long intervention immediately or after a 1-year delay), which allowed the opportunity to assess program efficacy (previously reported primary outcome), durability, and reproducibility (reported herein). Measures included diet quality (DQ), PA, BMI, and physical function (PF). Results No significant relapse was observed in the immediate-intervention arm for DQ, PA, and BMI; however, rates of functional decline increased when the intervention ceased. From year 1 to year 2, significant improvements were observed in the delayed-intervention arm; mean change scores in behaviors and BMI and PF slopes were as follows: DQ score, 5.2 (95% CI, 3.4 to 7.0); PA, 45.8 min/wk (95% CI, 26.9 to 64.6 min/wk); BMI, −0.56 (95% CI, −0.75 to −0.36); and Short Form-36 PF, −1.02 versus −5.52 (P < .001 for all measures). Overall, both arms experienced significant improvements in DQ, PA, and BMI from baseline to 2-year follow-up (P < .001). Conclusion Older cancer survivors respond favorably to lifestyle interventions and make durable changes in DQ and PA that contribute to sustained weight loss. These changes positively reorient functional decline trajectories during intervention delivery.

scholarly journals Riding the Crest of the Teachable Moment: Promoting Long-Term Health After the Diagnosis of Cancer

2005 ◽  
Vol 23 (24) ◽  
pp. 5814-5830 ◽  
Author(s):  
Wendy Demark-Wahnefried ◽  
Noreen M. Aziz ◽  
Julia H. Rowland ◽  
Bernardine M. Pinto
Keyword(s):  
Cancer Survivors ◽  
Behavioral Interventions ◽  
Fruits And Vegetables ◽  
Functional Decline ◽  
Adult Survivors ◽  
Lifestyle Changes ◽  
Prostate Cancer Survivors ◽  
Increased Risk ◽  
The Impact

Purpose Cancer survivors are at increased risk for several comorbid conditions, and many seek lifestyle change to reduce dysfunction and improve long-term health. To better understand the impact of cancer on adult survivors' health and health behaviors, a review was conducted to determine (1) prevalent physical health conditions, (2) persistent lifestyle changes, and (3) outcomes of previous lifestyle interventions aimed at improving health within this population. Methods Relevant studies from 1966 and beyond were identified through MEDLINE and PubMed searches. Results Cancer survivors are at increased risk for progressive disease but also for second primaries, osteoporosis, obesity, cardiovascular disease, diabetes, and functional decline. To improve overall health, survivors frequently initiate diet, exercise, and other lifestyle changes after diagnosis. However, those who are male, older, and less educated are less likely to adopt these changes. There also is selective uptake of messages, as evidenced by findings that only 25% to 42% of survivors consume adequate amounts of fruits and vegetables, and approximately 70% of breast and prostate cancer survivors are overweight or obese. Several behavioral interventions show promise for improving survivors' health-related outcomes. Oncologists can play a pivotal role in health promotion, yet only 20% provide such guidance. Conclusion With 64% of cancer patients surviving > 5 years beyond diagnosis, oncologists are challenged to expand their focus from acute care to managing the long-term health consequences of cancer. Although more research is needed, opportunities exist for oncologists to promote lifestyle changes that may improve the length and quality of life of their patients.

scholarly journals Long-Term Employment Outcomes among Female Cancer Survivors

2020 ◽  
Vol 17 (8) ◽  
pp. 2751 ◽  
Author(s):  
Christine C. Ekenga ◽  
Eunsun Kwon ◽  
BoRin Kim ◽  
Sojung Park
Keyword(s):  
Cancer Survivors ◽  
Employment Status ◽  
The United States ◽  
Employment Outcomes ◽  
Hours Worked ◽  
Professional Workers ◽  
Working Age ◽  
The Impact ◽  
Female Cancer Survivors

Advances in early detection and treatment have led to a growing population of female cancer survivors, many of whom are of working age. We examined the relationship between cancer and long-term (>5 years) employment outcomes in a nationally representative sample of working-age women in the United States. Data from nine waves of the Health and Retirement Study were used to examine employment status and weekly hours worked among cancer survivors (n = 483) and women without cancer (n = 6605). We used random slope regression models to estimate the impact of cancer and occupation type on employment outcomes. There was no difference in employment status between cancer survivors and women without cancer at baseline; however, during follow-up, cancer survivors were more likely to be employed than women without cancer (odds ratio (OR) = 1.33, 95% confidence interval (CI): 1.11–1.58). Among 6–10-year survivors, professional workers were less likely (OR = 0.40, 95% CI: 0.21–0.74) to be employed than manual workers. Among >10-year survivors, professional workers averaged fewer weekly hours worked (−2.4 h, 95% CI: −4.4–−0.47) than manual workers. The impact of cancer on long-term employment outcomes may differ by occupation type. Identifying the occupation-specific mechanisms associated with the return to work will be critical to developing targeted strategies to promote employment in the growing female cancer survivor population.

scholarly journals Effect of self-regulatory behaviour change techniques and predictors of physical activity maintenance in cancer survivors: a 12-month follow-up of the Phys-Can RCT

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anne-Sophie Mazzoni ◽  
Hannah L. Brooke ◽  
Sveinung Berntsen ◽  
Karin Nordin ◽  
Ingrid Demmelmaier
Keyword(s):  
Physical Activity ◽  
Cancer Survivors ◽  
Cancer Treatment ◽  
Tobacco Use ◽  
Exercise Intervention ◽  
Behaviour Change Techniques ◽  
Exercise Motivation ◽  
History Of

Abstract Background Current knowledge about the promotion of long-term physical activity (PA) maintenance in cancer survivors is limited. The aims of this study were to 1) determine the effect of self-regulatory BCTs on long-term PA maintenance, and 2) identify predictors of long-term PA maintenance in cancer survivors 12 months after participating in a six-month exercise intervention during cancer treatment. Methods In a multicentre study with a 2 × 2 factorial design, the Phys-Can RCT, 577 participants with curable breast, colorectal or prostate cancer and starting their cancer treatment, were randomized to high intensity exercise with or without self-regulatory behaviour change techniques (BCTs; e.g. goal-setting and self-monitoring) or low-to-moderate intensity exercise with or without self-regulatory BCTs. Participants’ level of PA was assessed at the end of the exercise intervention and 12 months later (i.e. 12-month follow-up), using a PA monitor and a PA diary. Participants were categorized as either maintainers (change in minutes/week of aerobic PA ≥ 0 and/or change in number of sessions/week of resistance training ≥0) or non-maintainers. Data on potential predictors were collected at baseline and at the end of the exercise intervention. Multiple logistic regression analyses were performed to answer both research questions. Results A total of 301 participants (52%) completed the data assessments. A main effect of BCTs on PA maintenance was found (OR = 1.80, 95%CI [1.05–3.08]) at 12-month follow-up. Participants reporting higher health-related quality-of-life (HRQoL) (OR = 1.03, 95%CI [1.00–1.06] and higher exercise motivation (OR = 1.02, 95%CI [1.00–1.04]) at baseline were more likely to maintain PA levels at 12-month follow-up. Participants with higher exercise expectations (OR = 0.88, 95%CI [0.78–0.99]) and a history of tobacco use at baseline (OR = 0.43, 95%CI [0.21–0.86]) were less likely to maintain PA levels at 12-month follow-up. Finally, participants with greater BMI increases over the course of the exercise intervention (OR = 0.63, 95%CI [0.44–0.90]) were less likely to maintain their PA levels at 12-month follow-up. Conclusions Self-regulatory BCTs improved PA maintenance at 12-month follow-up and can be recommended to cancer survivors for long-term PA maintenance. Such support should be considered especially for patients with low HRQoL, low exercise motivation, high exercise expectations or with a history of tobacco use at the start of their cancer treatment, as well as for those gaining weight during their treatment. However, more experimental studies are needed to investigate the efficacy of individual or combinations of BCTs in broader clinical populations. Trial registration NCT02473003 (10/10/2014).

EXERCISE INTERVENTIONS FOR PRESERVING PHYSICAL FUNCTION AMONG CANCER SURVIVORS IN MIDDLE TO LATE LIFE

2016 ◽  
pp. 1-11
Author(s):  
C.W. DAUM ◽  
S.K. COCHRANE ◽  
J.D. FITZGERALD ◽  
L. JOHNSON ◽  
T.W. BUFORD
Keyword(s):  
Cancer Survivors ◽  
Randomized Controlled Trials ◽  
Functional Status ◽  
Physical Function ◽  
Literature Search ◽  
Exercise Intervention ◽  
Controlled Trials ◽  
Middle Aged ◽  
Exercise Interventions ◽  
Randomized Controlled

The purpose of this review was to evaluate randomized controlled trials aiming to preserve the functional status, i.e. physical capabilities, of middle-aged and older cancer survivors through a structured, physical exercise intervention. The study team performed a thorough search of the literature using six online databases. This literature search limited included studies to randomized controlled trials which implemented a structured physical activity intervention for middle- and older-aged adults diagnosed with cancer. Studies were also required include at least one objective measure of physical function as a dependent outcome. This literature search yielded thirty-eight studies. The majority of the literature reviewed was successful in improving several functional outcomes including time needed to rise from a chair or distance covered during the six-minute walk test. A large number of published trials also suggest that exercise is effective in decreasing fatigue. However, a lack of trials investigating outcomes in older populations (≥ 65 years) was noted in this review. The results of this review suggest that a structured exercise program may be physically beneficial for middle-aged to older cancer survivors. Particularly, such interventions could preserve the functional status of cancer patients and, consequently, improve their long-term health outcomes. Future implications include further investigation into strictly older cancer patient populations, as outcomes related to exercise might differ between older and middle-aged adults.

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