scholarly journals Comparing Outcomes of a Digital Commercial Weight Loss Program in Adult Cancer Survivors and Matched Controls with Overweight or Obesity: Retrospective Analysis

Nutrients ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 2908
Author(s):  
Christine N. May ◽  
Annabell Suh Ho ◽  
Qiuchen Yang ◽  
Meaghan McCallum ◽  
Neil M. Iyengar ◽  
...  
Keyword(s):  
Weight Loss ◽  
Cancer Survivors ◽  
Program Effectiveness ◽  
Weight Loss Program ◽  
Healthy Weight ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Adult Cancer Survivors ◽  
Additional Support ◽  
Program Engagement

Maintaining a healthy weight is beneficial for cancer survivors. However, weight loss program effectiveness studies have primarily been in highly controlled settings. This is a retrospective study exploring real-world outcomes (weight loss and program engagement) after use of a digital commercial weight loss program (Noom) in cancer survivors and matched controls. All participants had voluntarily self-enrolled in Noom. Weight and engagement data were extracted from the program. Cancer-related quality of life was secondarily assessed in a one-time cross-sectional survey for survivors. Controls were a sample of Noom users with overweight/obesity who had no history of cancer but 0–1 chronic conditions. Primary outcomes were weight change at 16 weeks and program engagement over 16 weeks. Engagement included frequency of weight, food, and physical activity logging, as well as number of coach messages. Multiple regression controlling for baseline age, gender, engagement, and BMI showed that survivors lost less weight than controls (B = −2.40, s.e. = 0.97, p = 0.01). Survivors also weighed in less (survivors: 5.4 [2.3]; controls: 5.7 [2.1], p = 0.01) and exercised less (survivors: 1.8 [3.2]; controls: 3.2 [4.1], p < 0.001) than controls. However, survivors sent more coach messages (survivors: 2.1 [2.4]; controls: 1.7 [2.0], p < 0.001). Despite controls losing more weight than cancer survivors (−7.0 kg vs. −5.3 kg), survivors lost significant weight in 4 months (M = −6.2%). Cancer survivors can have success on digital commercial programs available outside of a clinical trial. However, they may require additional support to engage in weight management behaviors.

The unmet needs of cancer survivors and their preferences for discussing them with oncologists and general practitioners (GPs).

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 9602-9602
Author(s):  
Kate Webber ◽  
Afaf Girgis ◽  
Barbara Kaye Bennett ◽  
Antonino Bonaventura ◽  
Frances M. Boyle ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Unmet Needs ◽  
Tertiary Education ◽  
Univariate Analysis ◽  
Female Gender ◽  
Self Report ◽  
Care Needs ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Adult Cancer Survivors

9602 Background: Cancer survivors experience a range of post-treatment issues which are not well met by current services. This study explores the unmet needs of adult cancer survivors and their levels of comfort in addressing issues with oncologists and GPs. Methods: A cross-sectional survey was mailed to adult cancer survivors 4 years from diagnosis from 6 oncology units. Self-report data were obtained ranking physical, psychological and practical areas of importance to survivors; unmet needs in these areas; and the providers with whom they were happy to discuss each issue. Descriptive statistics were obtained regarding needs and preferences. Univariate and multivariate logistic regression analyses assessed demographic and clinical variables associated with 4 or more unmet care needs. Results: 228 surveys were returned (response rate 50.5%). Respondents had a mean age of 59.3 years (range 32-87), 71.5% were female, with most common primary cancers being breast (71.5%), colorectal (13.9%), prostate (4.5%) and ovarian (2.2%). The most commonly reported unmet needs were information about late effects (50.3%), managing fatigue (41.7 %), genetic risk to family (34.7%), reassurance (32.0 %) and diet (31.4 %). The median number of unmet needs was 4 (range 0-23). On univariate analysis, female gender, younger age and tertiary education were associated with greater unmet needs (p<0.001, p=0.01 and p=0.02). On multivariate analysis higher education (p=0.04) remained independently associated. Conclusions: Cancer survivors report significant unmet care needs, and their comfort levels for discussing them varies between providers. Some key issues are not entrusted to either oncologists or GPs. Models of care for survivors must address these potential deficits in care. [Table: see text]

scholarly journals Characterizing the Exercise Behaviour, Preferences, Barriers, and Facilitators of Cancer Survivors in a Rural Canadian Community: A Cross-Sectional Survey

2021 ◽  
Vol 28 (4) ◽  
pp. 3172-3187
Author(s):  
Jenna Smith-Turchyn ◽  
Lisa Allen ◽  
Jennifer Dart ◽  
Deanna Lavigne ◽  
Simran Rooprai ◽  
...  
Keyword(s):  
Rural Communities ◽  
Cancer Survivors ◽  
Post Treatment ◽  
Barriers And Facilitators ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Physical Activity Guidelines ◽  
Exercise Participation ◽  
Exercise Barriers ◽  
Adult Cancer Survivors

Barriers, facilitators, and motivators to exercise for cancer survivors living in urban settings are well described in the literature. However, there is a lack of comparable information for cancer survivors living in rural communities. We describe the exercise behaviours, barriers, facilitators, and motivators to exercise participation of cancer survivors living in a rural Canadian community. Adult cancer survivors with a primary address in a rural region of Ontario, Canada, who had visited a community hospital in the previous five years were mailed a cross-sectional survey assessing current exercise volume (minutes of moderate-to-vigorous aerobic and resistance exercise), as well as exercise preferences, barriers, and facilitators. Seventy-two survivors (mean age 65 years) completed the survey (16% response rate). A majority of respondents were diagnosed with breast cancer (49%) in the last 5 years (61%). Aerobic- and resistance-training guidelines for cancer survivors were met by 38% and 10% of respondents, respectively. Physical side effects were the most common barrier to exercise during treatment (65%) and post-treatment (35%). Being unaware of available exercise programs, time for exercise, distance to exercise services, and cost were commonly reported barriers during and post-treatment (reported by 10–22%). Respondents reported needing information from a qualified exercise professional (46%), access to a gym (33%) and exercise equipment (26%), and social support (25%) to facilitate exercise participation. Consistent with urban-based cancer survivors, most rural survivors surveyed in this study were not meeting the physical-activity guidelines and reported numerous exercise barriers. These findings can serve as a resource for this and similar rural communities when developing community-based exercise-support services for cancer survivors.

scholarly journals Impact of gender and employment type on job loss among cancer survivors

2020 ◽  
Vol 50 (7) ◽  
pp. 766-771
Author(s):  
Miyako Tsuchiya ◽  
Yoshitsugu Horio ◽  
Hatsumi Funazaki ◽  
Kenjiro Aogi ◽  
Kazue Miyauchi ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Cancer Diagnosis ◽  
Job Loss ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Temporary Employees ◽  
Adult Cancer Survivors ◽  
After Cancer ◽  
Response Rate Data ◽  
Balance Treatment

Abstract Objective To identify factors associated with cancer-related job loss following cancer diagnosis. Methods A multicentre cross-sectional survey was conducted among adult cancer survivors employed at the time of cancer diagnosis. Hierarchical multivariate logistic regression was used to examine the association of gender and employment type with job loss after cancer diagnosis and if the interaction between gender and employment type predicted job loss. Results Of 1618 patients recruited, 1483 returned questionnaires (91.7% response rate). Data from 708 patients were eligible for analyses. Approximately 21% of patients had lost their job within 10 years of diagnosis. Patients who had undergone chemotherapy were more likely to lose their jobs than those who had not (OR = 3.24, 95% CI 2.13–4.91). Women were more likely to lose their jobs than men (OR = 2.58, 95% CI 1.48–4.50). Temporary employees were more likely to lose their jobs than regular employees (OR = 2.62, 95% CI 1.72–3.99). After controlling for demographic and clinical characteristics, no interaction effects between gender and employment type were observed (P = 0.44). Conclusions Women and temporary employees are more vulnerable to cancer-related job loss. Clinicians need greater awareness of the risk of patient job loss, and they need to assess patients’ employment types and provide appropriate support to balance treatment schedules and work.

Does Financial Toxicity Exist Amongst Adult Cancer Survivors Treated with Curative-Intent Radiotherapy? A Pilot Study from Singapore

2021 ◽  
Author(s):  
Ivy Weishan Ng ◽  
Kah Hung Yuen ◽  
Tian Meng ◽  
Chuan Chien Tan ◽  
Chong Ming Yeo ◽  
...  
Keyword(s):  
Pilot Study ◽  
Cancer Survivors ◽  
Effective Means ◽  
Population Based ◽  
University Hospital ◽  
Financial Toxicity ◽  
Cross Sectional Survey ◽  
Curative Intent ◽  
Cross Sectional ◽  
Adult Cancer Survivors

Abstract Background Cancer survivors may experience financial toxicity (FT) arising from diagnosis, treatµent, and potential employment loss. The prevalence of FT in the context of Singapore healthcare model is unknown. We investigate if higher out of pocket (OOP) expenditure correlates positively with FT, and if higher FT correlates with a worse quality of life (QoL). Methods In this pilot study, a cross-sectional survey was administered to survivors of nasopharyngeal or breast cancer, at National University Hospital Singapore. Patients’ FT and QOL were measured using the COmprehensive Score on financial Toxicity (COST) and Functional Assessment of Cancer Therapy: General (FACT-G). Two multivariate regression models estimated (i) the association between FT and a range of variables and (ii) FT and QOL. Results 63% of our cohort of 76 patients experienced mild-moderate FT. Overall, the mean COST and FACT-G scores are 18.0 (out of 44) and 68.3 (out of 108), respectively. There was a positive correlation between COST and FACT-G scores (r = 0.45). We did not find any significant association between OOP and FT. Predictors for FT included government-subsidized housing, lower education levels, hiring a formal caregiver, and the need for household members to take on extra employment. Conclusion Greater FT correlates with a decline in QoL. Lower socio-economic patients are at higher risk of FT. OOP was not directed related to FT, likely in view of the effective means-tested subsidies. Additional resources should be considered for this at-risk population. Based on our pilot study, our methodology to quantify FT and OOP can be scaled up to other cancer primaries.

scholarly journals Case reports of new-onset eating disorders in older adult cancer survivors

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Dori Rakusin ◽  
Kate O’Brien ◽  
Michael Murphy
Keyword(s):  
Eating Disorders ◽  
Weight Loss ◽  
Eating Disorder ◽  
Physical Health ◽  
Cancer Survivors ◽  
Cancer Treatment ◽  
Healthy Weight ◽  
Number Of Patients ◽  
Adult Cancer Survivors ◽  
New Onset

Abstract Background It is unusual for a de novo eating disorder to emerge in late adulthood. Across a number of years, a number of patients were identified who experienced severe and unexpected weight loss post curative management of an upper abdominal cancer (i.e., cancer survivors). Each of the patients was readmitted to the tertiary surgical hospital due to complications of severe malnutrition. Each presentation was initially considered to have a major physical health problem (such as cancer recurrence). Each required extensive investigations and multidisciplinary team involvement and were later conceptualised as a new-onset (in later adulthood) eating disorder that emerged post curative cancer treatment. The team wished to better understand this group and/or characterise and/or inform the scientific community of this phenomena if not already well described. Literature review The review identified that the re-emergence of pre-existing eating disorders at the time of cancer treatment was described; however, there was no identification of similar new-onset in later adulthood cases of eating disorders in cancer survivors in the medical literature. Review of the cases Once ethics and consent was obtained, then the clinical course of four complex individuals were reviewed, including the use of a multidisciplinary Delphi review process, to understand commonalities and then plot a common care pathway with potential intervention points. Case presentations Common factors identified among the four patients included the lack of a physical health (organic) cause to the weight loss and ongoing weight loss despite intense multidisciplinary care. All had abnormal attitudes and behaviours relating to food, nutritional rehabilitation and/or recovery. None returned to a healthy weight and/or healthy eating despite extensive team input. The presentations were ultimately conceptualised as having severe disordered eating behaviours and in at least three cases met criteria for a formal eating disorder. The cohort had similar psychosocial characteristics including low socioeconomic status and complex family dynamics. None had prior formal psychiatric care. The outcomes were poor; one patient died, another required admission to a specialist eating disorder admission with a subsequent relapsing remitting course, and the remaining two had complicated chronic courses. Conclusion Similar cases may be underreported. If identified earlier, there may be a role for intervention to prevent high morbidity and mortality and to support clinical teams managing similar complex patients.

Gaps in Nutrition Policy Implementation in Childcare Centres in The Edmonton Metropolitan Region: A Cross-Sectional Survey

2021 ◽  
pp. 1-8
Author(s):  
Marjorie Rafaela Lima Do Vale ◽  
Anna Farmer ◽  
Rebecca Gokiert ◽  
Geoff Ball ◽  
Katerina Maximova
Keyword(s):  
Policy Implementation ◽  
Policy Development ◽  
Statistical Tests ◽  
Nutrition Policy ◽  
Metropolitan Region ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Writing Evaluation ◽  
Additional Support ◽  
Implementation Resources

Purpose: To describe (i) nutrition policies in childcare centres, (ii) the resources and processes used to enable policy implementation, and (iii) the association between policy implementation and childcare centres’ or administrators’ characteristics. Methods: Between October 2018 and June 2019 a web-based survey that addressed nutrition policy, policy implementation, and sociodemographic characteristics was sent to eligible childcare programs (centre-based and provided meals) in the Edmonton (Alberta) metropolitan region. The survey was pretested and pilot tested. Statistical tests examined the relationship between policy implementation with centres’ and administrators’ characteristics. Results: Of 312 childcare centres that received the survey invitation, 43 completed it. The majority of centres had a nutrition policy in place (94%). On average, centres had about 9 of the 17 implementation resources and processes assessed. Most often administrators reported actively encouraging the implementation of the nutrition policy (n = 35; 87%) and least often writing evaluation reports of the implementation of the nutrition policy (n = 9; 22%). Administrator’s education level was associated with implementation total score (p = 0.009; Kruskal-Wallis). Conclusion: Most childcare centres had a nutrition policy in place, but many lacked resources and processes to enable policy implementation. Additional support is required to improve nutrition policy development and implementation.

Patterns and perceived efficacy of herbal medicine for weight loss and maintenance: A cross-sectional survey from Jordan

2020 ◽  
Vol 35 ◽  
pp. 101086
Author(s):  
Amal Akour ◽  
Violet Kasabri ◽  
Nailya Bulatova ◽  
Suha Al Muhaissen ◽  
Ruba Al Tarawneh ◽  
...  
Keyword(s):  
Weight Loss ◽  
Herbal Medicine ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Perceived Efficacy

scholarly journals A Descriptive Study Identifying Gaps in the Effective Implementation of Mercury-containing Device Phase-out in Selected DOH-retained Hospitals

2018 ◽  
Vol 52 (5) ◽  
Author(s):  
Zenith DLT Zordilla
Keyword(s):  
Program Implementation ◽  
Program Effectiveness ◽  
Mercury Exposure ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Exposure Risks ◽  
Logistic Support ◽  
The One ◽  
Implementation Status ◽  
Phase Out

Background and Objective. After the 2008 phase-out of mercury-containing medical devices, the implementation status was evaluated by this study to know the program effectiveness in removing mercury exposure risks in health facilities. Methods. A cross-sectional survey was done to determine the amount of mercury stored in ten selected Department of Health (DOH)-retained hospitals. Key informant interviews were also performed with Pollution Control Officers to determine their program implementation status, strengths, and areas for improvement. Results and Discussion. All hospitals initiated the mercury minimization program but none has fully implemented it. The total amount recorded is 213.5 kg for mercury-containing materials. A discrepancy of 31.4% exists compared to the initial 2008 inventory of 312.7 kg. The main strength identified by the key informants was the one-time collection of mercury devices in hospitals. Hospitals need administrative and logistic support to properly implement mercury phase-out, particularly on monitoring of temporary storage. Disposal protocols should also be created to fully eliminate mercury exposure in the hospitals.

Prevalence of fertility discussions between young adult colorectal cancer survivors and their providers.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 3518-3518
Author(s):  
Julia Stal ◽  
Serena Yi ◽  
Sally Cohen-Cutler ◽  
Phuong Gallagher ◽  
Afsaneh Barzi ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Young Adult ◽  
Cancer Therapy ◽  
Cancer Survivors ◽  
Reproductive Potential ◽  
Tumor Location ◽  
Care Providers ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Delivery Of Care

3518 Background: Clinical guidelines indicate that oncologists should discuss potential treatment-induced infertility with patients with reproductive potential. Due to tumor location and use of multimodal therapies, young adults with colorectal cancer (CRC) are at heightened risk for treatment-related infertility. Methods: An online, cross-sectional survey was administered in collaboration with a national patient advocacy organization for young adult CRC survivors (currently under age 50). Survivors were asked to indicate if a doctor had ever talked to them about potential problems with their ability to have children after treatment and if they banked eggs/embryos (females) or sperm (males) prior to their cancer therapy. Those who reported that they did not preserve fertility were asked to indicate why ( not sure; I chose not to; I did not know this was an option; I wanted to, but could not afford it; and I wanted to, but my treatment would not allow it). Results: A total of 234 colon (N=86) or rectal (N=148) cancer survivors were included in the study (male [61.9%] and White [77.9%; table]). Most respondents were diagnosed with stage 2 cancer (55.8% colon, 61.6% rectal). Over half of male and female survivors reported that their doctor did not talk to them about problems with their ability to have children after treatment, and 75% did not bank eggs/embryos or sperm prior to their cancer therapy. Of those, over 20% endorsed ‘I wanted to, but could not afford it’ and over 20% endorsed ‘I did not know this was an option’. Conclusions: Most CRC survivors in this study reported never having a fertility discussion with their provider, suggesting that survivors are not receiving, or cannot recall, comprehensive and guideline-concordant cancer care. In addition, one-fifth were not aware of preservation options, suggesting potential healthcare and/or provider-level barriers to appropriate fertility counseling. Fertility preservation cost is another barrier to the appropriate delivery of care. Providers must ensure that patients receive timely fertility discussions covering options to preserve fertility to mitigate this late effect of cancer treatment to ensure optimal quality of life for CRC patients with reproductive potential.[Table: see text]

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