Physical Activity and Cancer Care

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Survivorship and Quality of Life".

Deadline for manuscript submissions: closed (31 July 2022) | Viewed by 51878

Special Issue Editor


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Guest Editor
Research Center in Physical Activity Health and Leisure, Faculty of Sport, University of Porto, Rua Dr. Plácido Costa 91, 4200-450, Porto, Portugal
Interests: cancer care; physical activity; survivors; quality of life

Special Issue Information

Dear Colleagues,

The number of people living with or beyond cancer is expected to rise as a result of better screening programs and advancements in treatments. In addition to survival, efforts have started to be directed toward improving the quality of life and health of cancer survivors. With this goal in mind, physical activity might have substantial potential to ameliorate short- and long-term effects of cancer treatments such as fatigue, body fat gain, physical fitness loss, prevention of the development of other chronic diseases for which survivors might be at risk such as diabetes and CVD, a reduction in the odds of a recurrence, and increased survival.

Dr. Luisa Soares-Miranda 
Guest Editor

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Keywords

  • cancer care;
  • physical activity;
  • survivors;
  • quality of life

Published Papers (18 papers)

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Research

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15 pages, 1287 KiB  
Article
Feasibility of Implementing Cancer-Specific Community-Based Exercise Programming: A Multi-Centre Randomized Trial
by Margaret L. McNeely, Kirsten Suderman, Janice L. Yurick, Kathryn Nishimura, Christopher Sellar, Paula A. Ospina, Edith Pituskin, Harold Lau, Jacob C. Easaw, Matthew B. Parliament, Anil A. Joy and S. Nicole Culos-Reed
Cancers 2022, 14(11), 2737; https://doi.org/10.3390/cancers14112737 - 31 May 2022
Cited by 3 | Viewed by 2033
Abstract
Background: There is growing recognition of the importance of reporting preliminary work on the feasibility of a trial. The present study aimed to assess the feasibility of (1) a proposed fitness testing battery, and (2) processes related to the implementation of cancer-specific exercise [...] Read more.
Background: There is growing recognition of the importance of reporting preliminary work on the feasibility of a trial. The present study aimed to assess the feasibility of (1) a proposed fitness testing battery, and (2) processes related to the implementation of cancer-specific exercise programming in a community setting. Methods/Design: A randomized controlled implementation feasibility trial was performed in advance of a large-scale implementation study. Eligible participants within 18 months of a cancer diagnosis were randomized to immediate or delayed community-based exercise at YMCA locations in Calgary and Edmonton, Canada for an 8-week period. The primary outcome for the trial was the feasibility of the physical fitness testing battery, defined as a 70% or greater completion rate across the 24-week study period. The Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework was used to evaluate processes related to implementation of the exercise program across the two sites. Results: Eighty participants were recruited, 73 (91%) completed the 8-week trial, and 68 (85%) completed the 16- and 24-week follow-ups. Sixty participants (75%) completed the full physical fitness test battery at each time point, and 59 (74%) completed the patient-reported outcome measures. Statistically significant between-group differences were found in favor of the exercise group for functional aerobic capacity, upper and lower extremity strength, and symptoms. Differences were found between the sites, however, in completion rates and processes related to program implementation. Discussion: Findings suggest the need for minor adaptations to the physical fitness battery and outcome measures to better fit the community context. While findings support feasibility, context-specific challenges related to implementation processes were identified. Full article
(This article belongs to the Special Issue Physical Activity and Cancer Care)
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19 pages, 2574 KiB  
Article
Telehealth Delivery of a Multi-Disciplinary Rehabilitation Programme for Upper Gastro-Intestinal Cancer: ReStOre@Home Feasibility Study
by Louise Brennan, Fatemeh Sadeghi, Linda O’Neill, Emer Guinan, Laura Smyth, Grainne Sheill, Emily Smyth, Suzanne L. Doyle, Claire M. Timon, Deirdre Connolly, Jacintha O’Sullivan, John V. Reynolds and Juliette Hussey
Cancers 2022, 14(11), 2707; https://doi.org/10.3390/cancers14112707 - 30 May 2022
Cited by 12 | Viewed by 2888
Abstract
Background: Telehealth has enabled access to rehabilitation throughout the pandemic. We assessed the feasibility of delivering a multi-disciplinary, multi-component rehabilitation programme (ReStOre@Home) to cancer survivors via telehealth. Methods: This single-arm mixed methods feasibility study recruited participants who had completed curative treatment for oesophago-gastric [...] Read more.
Background: Telehealth has enabled access to rehabilitation throughout the pandemic. We assessed the feasibility of delivering a multi-disciplinary, multi-component rehabilitation programme (ReStOre@Home) to cancer survivors via telehealth. Methods: This single-arm mixed methods feasibility study recruited participants who had completed curative treatment for oesophago-gastric cancer for a 12-week telehealth rehabilitation programme, involving group resistance training, remotely monitored aerobic training, one-to-one dietetic counselling, one-to-one support calls and group education. The primary outcome was feasibility, measured by recruitment rates, attendance, retention, incidents, acceptability, Telehealth Usability Questionnaire (TUQ) and analysis of semi-structured interviews. Results: Characteristics of the twelve participants were: 65.42 ± 7.24 years; 11 male; 10.8 ± 3.9 months post-op; BMI 25.61 ± 4.37; received neoadjuvant chemotherapy 7/12; received adjuvant chemotherapy 4/12; hospital length of stay 16 days (median). Recruitment rate was 32.4%, and retention rate was 75%. Mean attendance was: education 90%; dietetics 90%; support calls 84%; resistance training 78%. Mean TUQ score was 4.69/5. Adaptations to the planned resistance training programme were required. Participants reported that ReStOre@Home enhanced physical and psychological wellbeing, and online delivery was convenient. Some reported a preference for in-person contact but felt that the online group sessions provided adequate peer support. Conclusion: Telehealth delivery of ReStOre@Home was most feasible in individuals with moderate to high levels of digital skills. Low level of digitals skills was a barrier to recruitment and retention. Participants reported high levels of programme adherence and participant satisfaction. Adaptations to future programmes, including introducing elements of in-person contact, are required. Full article
(This article belongs to the Special Issue Physical Activity and Cancer Care)
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20 pages, 995 KiB  
Article
Development and Evaluation of a Multimodal Supportive Intervention for Promoting Physical Function in Older Patients with Cancer
by Eni Shehu, Sigrid Roggendorf, André Golla, Antonia Koenig, Gabriele I. Stangl, Andrea Diestelhorst, Daniel Medenwald, Dirk Vordermark, Anke Steckelberg and Heike Schmidt
Cancers 2022, 14(11), 2599; https://doi.org/10.3390/cancers14112599 - 24 May 2022
Cited by 2 | Viewed by 1762
Abstract
Physical function (PF) in older patients with cancer may decline during and after oncologic therapy. This study aimed to develop and pilot test an individually tailored unsupervised physical activity (PA) program and dietary recommendations to promote PF in older patients with cancer. Following [...] Read more.
Physical function (PF) in older patients with cancer may decline during and after oncologic therapy. This study aimed to develop and pilot test an individually tailored unsupervised physical activity (PA) program and dietary recommendations to promote PF in older patients with cancer. Following development and pretest, the intervention was pilot tested to explore feasibility, acceptance, adherence and potential benefit. Patients ≥60 years, with heterogeneous cancer diagnoses, starting outpatient radiotherapy were randomized in two study arms: paper-based vs. video-based instructions. Based on assessments of PF, PA, nutrition, cognition, mental health, social support, HRQOL and personal goals, participants received individual recommendations for PA and nutrition. After 12 weeks of intervention (T1), reassessments were performed. The postal 4-week follow-up questionnaire included PA, nutrition and HRQOL. Participants (n = 24, 14 female, mean age 70 ± 7 years) showed comparable characteristics in both study arms. The majority rated the program as helpful. Facilitators and barriers to PA adherence were collected. Both modes of instructions were appreciated equally. PF (EORTC QLQ-C30) declined slightly (not clinically relevant >10 pts.) at group level T0: 76 ± 16, T1: 68 ± 21, T2: 69 ± 24. The intervention was feasible, well accepted, showing potential benefit for the maintenance of PF during outpatient radiotherapy, and should be further tested in a larger sample. Full article
(This article belongs to the Special Issue Physical Activity and Cancer Care)
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13 pages, 312 KiB  
Article
Associations of Physical Activity and Handgrip Strength with Different Domains of Quality of Life in Pediatric Cancer Survivors
by Ankie Tan Cheung, William Ho Cheung Li, Laurie Long Kwan Ho, Wei Xia, Yuanhui Luo, Godfrey Chi Fung Chan and Joyce Oi Kwan Chung
Cancers 2022, 14(10), 2554; https://doi.org/10.3390/cancers14102554 - 23 May 2022
Cited by 1 | Viewed by 1673
Abstract
There is a paucity of evidence about the associations of physical activity (PA) and handgrip strength (HGS) within different domains of quality of life (QoL) in Chinese pediatric cancer survivors. We, therefore, conducted this multicenter cross-sectional study aimed to investigate whether increased PA [...] Read more.
There is a paucity of evidence about the associations of physical activity (PA) and handgrip strength (HGS) within different domains of quality of life (QoL) in Chinese pediatric cancer survivors. We, therefore, conducted this multicenter cross-sectional study aimed to investigate whether increased PA level and HGS are associated with higher scores in different QoL domains (i.e., physical, emotional, social, and school functioning) in pediatric cancer survivors. PA was assessed with a validated self-reported PA rating scale. In total, 191 Chinese pediatric cancer survivors aged 9 to 16 years were included in the analysis. Results showed that engaging in a higher level of PA was significantly associated with improved QoL in different domains, including physical (β = 0.543, p < 0.001), emotional (β = 0.449, p < 0.001), social (β = 0.434, p < 0.001), and school functioning (β = 0.407, p < 0.001). Greater HGS was also associated with better physical (β = 0.230, p ≤ 0.001) and emotional (β = 0.261, p ≤ 0.001) functioning. Findings from this study provide evidence of the significant beneficial impact of regular PA on pediatric cancer survivors’ QoL along their survivorship trajectory. Full article
(This article belongs to the Special Issue Physical Activity and Cancer Care)
15 pages, 1836 KiB  
Article
The Relationship between Exercise Self-Efficacy, Intention, and Structural Barriers for Physical Activity after a Cancer Diagnosis
by Johanna Depenbusch, Alexander Haussmann, Joachim Wiskemann, Angeliki Tsiouris, Laura Schmidt, Monika Sieverding, Nadine Ungar and Karen Steindorf
Cancers 2022, 14(10), 2480; https://doi.org/10.3390/cancers14102480 - 18 May 2022
Cited by 5 | Viewed by 1924
Abstract
Previous research has shown that structural barriers negatively influence the physical activity (PA) behavior of cancer patients, but underlying mechanisms are unclear. The aim of the current study was to explore the potential mediating role of social-cognitive factors, namely PA self-efficacy and PA [...] Read more.
Previous research has shown that structural barriers negatively influence the physical activity (PA) behavior of cancer patients, but underlying mechanisms are unclear. The aim of the current study was to explore the potential mediating role of social-cognitive factors, namely PA self-efficacy and PA intention in this context. A total of 856 cancer patients completed a questionnaire on sociodemographic and medical characteristics, pre- and post-diagnosis PA, PA self-efficacy, PA intention, and PA impediment by structural barriers. A serial mediation model was used to test whether the association between structural barriers and post-diagnosis PA was mediated by PA self-efficacy and/or PA intention, in the overall sample and in subsamples defined by individuals’ pre-diagnosis PA. The results confirmed that structural barriers were not directly (95%CI [−0.45; 0.10]) but indirectly associated with post-diagnosis PA. Higher impediment by structural barriers decreased the likelihood of sufficient post-diagnosis PA via lower PA self-efficacy (95%CI [−0.25; −0.06]) and via the serial pathway of lower PA self-efficacy and lower PA intention (95%CI [−0.19; −0.05]). Investigating differences in these mediations by pre-diagnosis PA yielded significance only among previously active cancer patients. Both structural barriers and PA self-efficacy might hence be relevant target points for interventions aiming to improve PA behavior, especially among pre-diagnosis active cancer patients. Full article
(This article belongs to the Special Issue Physical Activity and Cancer Care)
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11 pages, 927 KiB  
Article
Influence of Esophageal Endoscopic Submucosal Dissection on the Changes of Energy Metabolism during the Perioperative Period
by Sae Kudo, Daisuke Chinda, Tadashi Shimoyama, Kohei Yasuda, Kazuki Akitaya, Tetsu Arai, Kuniaki Miyazawa, Shiro Hayamizu, Miyuki Yanagimachi, Toshiaki Tsukamoto, Masatoshi Kaizuka, Yohei Sawada, Tetsuya Tatsuta, Keisuke Hasui, Hidezumi Kikuchi, Hiroto Hiraga, Hirotake Sakuraba, Tatsuya Mikami and Shinsaku Fukuda
Cancers 2022, 14(8), 2015; https://doi.org/10.3390/cancers14082015 - 15 Apr 2022
Cited by 2 | Viewed by 1553
Abstract
Esophageal endoscopic submucosal dissection (ESD) is considered to be more complex than gastric ESD. This study aimed to assess the physical invasiveness of esophageal ESD during perioperative periods by measuring resting energy expenditure (REE). The factors affecting REE that could be used to [...] Read more.
Esophageal endoscopic submucosal dissection (ESD) is considered to be more complex than gastric ESD. This study aimed to assess the physical invasiveness of esophageal ESD during perioperative periods by measuring resting energy expenditure (REE). The factors affecting REE that could be used to identify patients requiring perioperative management were also investigated. Overall, 75 patients who had undergone esophageal ESD were prospectively enrolled. REE, body weight, and basal energy expenditure were measured on the day of and the day following ESD. The mean REE/body weight was 20.2 kcal/kg/day on the day of ESD and significantly increased to 23.0 kcal/kg/day one day after ESD. The stress factor on the day after ESD was 1.11. White blood cell, neutrophil, and C-reactive protein levels increased on the day after ESD and correlated with the changes in REE. Among the factors including age, body mass index, total resection area, operation time, and sarcopenia, only the total resection area was associated with changes in REE. In conclusion, energy metabolism increases during the perioperative period for esophageal ESD. The increase in the stress factor for esophageal ESD was higher than that in gastric and colorectal ESD. Furthermore, patients with large resection areas require greater attention in perioperative management. Full article
(This article belongs to the Special Issue Physical Activity and Cancer Care)
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14 pages, 697 KiB  
Article
Feasibility and Impact of Adapted Physical Activity (APA) in Cancer Outpatients Beginning Medical Anti-Tumoral Treatment: The UMA-CHAPA Study
by Amélie Lemoine, Marine Perrier, Camille Mazza, Anne Quinquenel, Mathilde Brasseur, Alain Delmer, Hervé Vallerand, Maxime Dewolf, Eric Bertin, Coralie Barbe, Damien Botsen and Olivier Bouché
Cancers 2022, 14(8), 1993; https://doi.org/10.3390/cancers14081993 - 14 Apr 2022
Cited by 2 | Viewed by 1708
Abstract
Adapted physical activity (APA) improves quality of life and cancer outcomes. The aim of this study was to assess the feasibility of an APA program in outpatients beginning medical anticancer treatment. The secondary objective was to assess the impact of APA on fatigue, [...] Read more.
Adapted physical activity (APA) improves quality of life and cancer outcomes. The aim of this study was to assess the feasibility of an APA program in outpatients beginning medical anticancer treatment. The secondary objective was to assess the impact of APA on fatigue, anxiety, depression, and handgrip strength (HGS). This prospective study was conducted between January and July 2017. Among 226 patients beginning treatment in the unit for a digestive, lung, hematological, or dermatological cancer, 163 were included. Adherence to the APA program was defined as more than or equal to one one-hour session per week for 3 months. The first evaluation was conducted at 3 months (M3), and the second evaluation at 6 months (M6). A total of 163 patients were included (mean age 62.5 ± 14.3); 139 (85.3%) agreed to follow the APA program. At M3, 106 of them were evaluated, of which 86 (81.1%) declared that they had followed the program. Improvement in anxiety was observed at M3 (−1.0 ± 3.2; p = 0.002) but there was no significant change in fatigue or depression. HGS decreased significantly (−1.2 ± 5.5; p = 0.04). The APA program was feasible in cancer outpatients beginning medical anticancer treatment. APA should be part of standard support care. Full article
(This article belongs to the Special Issue Physical Activity and Cancer Care)
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17 pages, 2808 KiB  
Article
A Randomised, Comparative, Effectiveness Trial Evaluating Low- versus High-Level Supervision of an Exercise Intervention for Women with Breast Cancer: The SAFE Trial
by Rosalind R. Spence, Carolina X. Sandler, Benjamin Singh, Jodie Tanner, Christopher Pyke, Elizabeth Eakin, Dimitrios Vagenas and Sandra C. Hayes
Cancers 2022, 14(6), 1528; https://doi.org/10.3390/cancers14061528 - 16 Mar 2022
Cited by 6 | Viewed by 2688
Abstract
The aim of this comparative, effectiveness trial was to evaluate the safety, feasibility and effect of an exercise intervention delivered via low-level versus high-level supervision. The target population were women who were diagnosed with ≥stage II breast cancer, had ≥ one comorbidity and/or [...] Read more.
The aim of this comparative, effectiveness trial was to evaluate the safety, feasibility and effect of an exercise intervention delivered via low-level versus high-level supervision. The target population were women who were diagnosed with ≥stage II breast cancer, had ≥ one comorbidity and/or persistent treatment-related side-effects, and were insufficiently physically active. Sixty women (50 ± 9 years) were randomized to the low-supervision group (n = 30) or high-supervision group (n = 30). The low-supervision group participated in a 12-week, individually-tailored exercise intervention supported by five supervised sessions with an exercise professional. The high-supervision group participated in the same exercise intervention but received 20 supervised sessions across the 12-week period. The target weekly dosage of 600 metabolic equivalent minutes of exercise per week (MET-mins/wk) and the session content, such as safety and behaviour change topics, were standardized between the groups. The primary outcomes were intervention safety, defined as the number, type, and severity of exercise-related adverse events (e.g., musculoskeletal injury or exacerbated treatment-related side effects), and feasibility, which was defined as compliance to target exercise dosage. The effect of the intervention on quality of life, physical activity, self-efficacy, fitness, and strength was also assessed (pre- and post-intervention, and at 12-week follow-up). The intervention was safe, with no exercise-related adverse events of grade 3 or above in either group. Both groups reported high compliance to the target exercise dosage (median MET-mins/wk: High = 817; Low = 663), suggesting the exercise intervention was feasible, irrespective of supervision level. Improvements in quality of life, physical activity and fitness were observed post-intervention and maintained at follow-up for both groups (p < 0.05). Only the high-supervision group showed clinically-relevant improvements in strength and self-efficacy at post-intervention (p < 0.05). Individually-targeted exercise delivered under high- or low-levels of supervision is safe, feasible and beneficial for women with stage II+ breast cancer. Future research needs to assess whether the greater gains observed in the group who received higher supervision may contribute to longer term maintenance of physical activity levels and overall health benefits. Australian and New Zealand Clinical Trials Registry: ACTRN12616000547448. Full article
(This article belongs to the Special Issue Physical Activity and Cancer Care)
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9 pages, 276 KiB  
Article
Metabolic Syndrome and Physical Inactivity May Be Shared Etiological Agents of Prostate Cancer and Coronary Heart Diseases
by Antonio Cicione, Aldo Brassetti, Riccardo Lombardo, Antonio Franco, Beatrice Turchi, Simone D’Annunzio, Antonio Nacchia, Andrea Tubaro, Giuseppe Simone and Cosimo De Nunzio
Cancers 2022, 14(4), 936; https://doi.org/10.3390/cancers14040936 - 14 Feb 2022
Cited by 6 | Viewed by 1661
Abstract
As metabolic syndrome (MetS) and a sedentary lifestyle have been associated with an increased risk of developing both prostate cancer (PCa) and cardiovascular diseases (CVDs), the 2 conditions may share a common etiology. We aimed at investigating the association between CVDs and PCa. [...] Read more.
As metabolic syndrome (MetS) and a sedentary lifestyle have been associated with an increased risk of developing both prostate cancer (PCa) and cardiovascular diseases (CVDs), the 2 conditions may share a common etiology. We aimed at investigating the association between CVDs and PCa. A retrospective analysis was performed. Our dataset on patients undergone systematic prostate biopsy was searched for histopathologic and clinical data. The physical activity (PA) scale for the elderly (PASE) was collected. Coronary heart diseases (CHDs) were recorded. Prognostic Grade Group ≥3 tumors were defined as high-grade (HG). The association between MetS, PA, CHDs and PCa was assessed using logistic regression analyses. Data on 955 patients were collected; 209 (22%) presented with MetS, 79 (8%) with CHDs. PCa was diagnosed in 395 (41.3%) men and 60% (n = 238) presented with an high-grade tumor. CHDs were more common among PCa-patients (9.4% vs. 7.5%; p = 0.302) but the difference was not statistically significant. No difference was observed between low- and high-grade subgroups (9.5% vs. 9.2%; p = 0.874). PASE independently predicted PCa diagnosis (OR: 0.287; p = 0.001) and HG-PCa (OR: 0.165; p = 0.001). MetS was an independent predictor of HG-PCa only (OR: 1.50; 95% CI: 1.100–2.560; p = 0.023). CHDs were not associated with tumor diagnosis and aggressiveness. Full article
(This article belongs to the Special Issue Physical Activity and Cancer Care)
12 pages, 1510 KiB  
Article
Association between CT-Based Preoperative Sarcopenia and Outcomes in Patients That Underwent Liver Resections
by David Martin, Yaël Maeder, Kosuke Kobayashi, Michael Schneider, Joachim Koerfer, Emmanuel Melloul, Nermin Halkic, Martin Hübner, Nicolas Demartines, Fabio Becce and Emilie Uldry
Cancers 2022, 14(1), 261; https://doi.org/10.3390/cancers14010261 - 05 Jan 2022
Cited by 11 | Viewed by 3398
Abstract
This retrospective observational study aimed to evaluate whether preoperative sarcopenia, assessed by CT imaging, was associated with postoperative clinical outcomes and overall survival in patients that underwent liver resections. Patients operated on between January 2014 and February 2020 were included. The skeletal muscle [...] Read more.
This retrospective observational study aimed to evaluate whether preoperative sarcopenia, assessed by CT imaging, was associated with postoperative clinical outcomes and overall survival in patients that underwent liver resections. Patients operated on between January 2014 and February 2020 were included. The skeletal muscle index (SMI) was measured at the level of the third lumbar vertebra on preoperative CT scans. Preoperative sarcopenia was defined based on pre-established SMI cut-off values. The outcomes were postoperative morbidity, length of hospital stay (LOS), and overall survival. Among 355 patients, 212 (59.7%) had preoperative sarcopenia. Patients with sarcopenia were significantly older (63.5 years) and had significantly lower BMIs (23.9 kg/m2) than patients without sarcopenia (59.3 years, p < 0.01, and 27.7 kg/m2, p < 0.01, respectively). There was no difference in LOS (8 vs. 8 days, p = 0.75), and the major complication rates were comparable between the two groups (11.2% vs. 11.3%, p = 1.00). The median overall survival times were comparable between patients with sarcopenia and those without sarcopenia (15 vs. 16 months, p = 0.87). Based on CT assessment alone, preoperative sarcopenia appeared to have no impact on postoperative clinical outcomes or overall survival in patients that underwent liver resections. Future efforts should also consider muscle strength and physical performance, in addition to imaging, for preoperative risk stratification. Full article
(This article belongs to the Special Issue Physical Activity and Cancer Care)
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22 pages, 288 KiB  
Article
Higher Level of Sports Activities Participation during Five-Year Survival Is Associated with Better Quality of Life among Chinese Breast Cancer Survivors
by Yuan-Yuan Lei, Suzanne C. Ho, Ka-Li Cheung, Victoria A. Yeo, Roselle Lee, Carol Kwok, Ashley Cheng, Frankie K. F. Mo and Winnie Yeo
Cancers 2021, 13(23), 6056; https://doi.org/10.3390/cancers13236056 - 01 Dec 2021
Cited by 4 | Viewed by 1709
Abstract
Evidence about the association between the level of sports activities participation post-diagnosis and quality of life (QoL) among Chinese women with early-stage breast cancer is limited. A validated modified Chinese Baecke questionnaire was used to prospectively measure sports activities among a breast cancer [...] Read more.
Evidence about the association between the level of sports activities participation post-diagnosis and quality of life (QoL) among Chinese women with early-stage breast cancer is limited. A validated modified Chinese Baecke questionnaire was used to prospectively measure sports activities among a breast cancer cohort at four time-points: baseline and 18, 36, and 60 months after diagnosis (sports activities during the previous 12 months before each interview); QoL was measured at the same time. In total, 1289, 1125, and 1116 patients were included in the analyses at 18-, 36- and 60-month follow-up, respectively. The percentages of patients who belonged to no (0 metabolic equivalent of task (MET)-hours per week), low-level (<10 MET-hours/week), and high-level (≥10 MET-hours/week) sports activities group were 20.7%, 45.5%, and 33.8% at 18-month follow-up, respectively; the corresponding figures at 36 and 60 months differed slightly. Using data from the three follow-ups, generalized estimating equation (GEE) analyses showed that higher levels of sports activities participation were associated with better QoL in several items as well as fewer symptoms. The present findings in Chinese women with breast cancer provide important evidence on the beneficial effect of regular participation in sports activities following cancer diagnosis on patients’ QoL. Full article
(This article belongs to the Special Issue Physical Activity and Cancer Care)
10 pages, 983 KiB  
Article
Can the Six-Minute Walk Test Be Used to Individualize Physical Activity Intensity in Patients with Breast Cancer?
by Nicole Tubiana-Mathieu, Thibault Cornette, Stephane Mandigout, Sophie Leobon, François Vincent, Laurence Venat and Elise Deluche
Cancers 2021, 13(22), 5851; https://doi.org/10.3390/cancers13225851 - 22 Nov 2021
Cited by 3 | Viewed by 2125
Abstract
Background: Adapted physical activity (APA) aids breast cancer patients. It is necessary to use an adapted target heart rate (HR) when prescribing exercise intensity. Methods: In total, 138 patients previously included in two published randomized clinical trials underwent the CPET and 6MWT before [...] Read more.
Background: Adapted physical activity (APA) aids breast cancer patients. It is necessary to use an adapted target heart rate (HR) when prescribing exercise intensity. Methods: In total, 138 patients previously included in two published randomized clinical trials underwent the CPET and 6MWT before and after adjuvant therapy. Of these patients, 85 had performed APA, and 53 had received only the usual therapy. HRs were recorded during the two tests. Results: Before starting chemotherapy, good agreement (intraclass correlation (ICC) 0.69; confidence interval at 95% IC0.95 (0.591–0.769); p < 0.001) and a moderate correlation were evident between the 6MWT-HR and ventilatory threshold HR of the CPET (r = 0.70; p < 0.001). Good agreement and a high positive correlation were noted only in the group who engaged in APA (ICC 0.77; IC0.95 (0.659–0.848); p < 0.001; r = 0.8; p < 0.01); moderate agreement and a moderate positive correlation were apparent in the control group (ICC 0.57; IC0.95 (0.329–0.74); p < 0.001; r = 0.6; p < 0.01). The correlations were independent of age and body mass index. Conclusions: The 6MWT-HR can be used to prescribe exercise intensity for breast cancer patients both before and after specific treatment with concomitant APA. Full article
(This article belongs to the Special Issue Physical Activity and Cancer Care)
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Review

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43 pages, 2814 KiB  
Review
Physical Activity as the Best Supportive Care in Cancer: The Clinician’s and the Researcher’s Perspectives
by Cécile Torregrosa, Frédéric Chorin, Eva Ester Molina Beltran, Cindy Neuzillet and Victoire Cardot-Ruffino
Cancers 2022, 14(21), 5402; https://doi.org/10.3390/cancers14215402 - 02 Nov 2022
Cited by 11 | Viewed by 6971
Abstract
Multidisciplinary supportive care, integrating the dimensions of exercise alongside oncological treatments, is now regarded as a new paradigm to improve patient survival and quality of life. Its impact is important on the factors that control tumor development, such as the immune system, inflammation, [...] Read more.
Multidisciplinary supportive care, integrating the dimensions of exercise alongside oncological treatments, is now regarded as a new paradigm to improve patient survival and quality of life. Its impact is important on the factors that control tumor development, such as the immune system, inflammation, tissue perfusion, hypoxia, insulin resistance, metabolism, glucocorticoid levels, and cachexia. An increasing amount of research has been published in the last years on the effects of physical activity within the framework of oncology, marking the appearance of a new medical field, commonly known as “exercise oncology”. This emerging research field is trying to determine the biological mechanisms by which, aerobic exercise affects the incidence of cancer, the progression and/or the appearance of metastases. We propose an overview of the current state of the art physical exercise interventions in the management of cancer patients, including a pragmatic perspective with tips for routine practice. We then develop the emerging mechanistic views about physical exercise and their potential clinical applications. Moving toward a more personalized, integrated, patient-centered, and multidisciplinary management, by trying to understand the different interactions between the cancer and the host, as well as the impact of the disease and the treatments on the different organs, this seems to be the most promising method to improve the care of cancer patients. Full article
(This article belongs to the Special Issue Physical Activity and Cancer Care)
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20 pages, 485 KiB  
Review
Prehabilitation in Modern Colorectal Cancer Surgery: A Comprehensive Review
by Augustinas Bausys, Marius Kryzauskas, Vilius Abeciunas, Austeja Elzbieta Degutyte, Rimantas Bausys, Kestutis Strupas and Tomas Poskus
Cancers 2022, 14(20), 5017; https://doi.org/10.3390/cancers14205017 - 13 Oct 2022
Cited by 13 | Viewed by 2994
Abstract
Colorectal cancer remains the third most prevalent cancer worldwide, exceeding 1.9 million new cases annually. Surgery continues to be the gold standard treatment option. Unfortunately, colorectal cancer surgery carries significant postoperative morbidity and mortality. Moreover, most rectal cancer patients and some patients with [...] Read more.
Colorectal cancer remains the third most prevalent cancer worldwide, exceeding 1.9 million new cases annually. Surgery continues to be the gold standard treatment option. Unfortunately, colorectal cancer surgery carries significant postoperative morbidity and mortality. Moreover, most rectal cancer patients and some patients with locally advanced colon cancer require preoperative neoadjuvant therapy. It improves long-term outcomes but impairs patients’ physical fitness and thus further increases surgical risk. Recently, prehabilitation has gained interest as a novel strategy to reduce treatment-related morbidity for patients undergoing colorectal cancer surgery. However, the concept is still in its infancy, and the role of prehabilitation remains controversial. In this comprehensive review, we sum up present evidence on prehabilitation before colorectal cancer surgery. Available studies are very heterogenous in interventions and investigated outcomes. Nonetheless, all trials show at least some positive effects of prehabilitation on patients’ physical, nutritional, or psychological status or even reduced postoperative morbidity. Unfortunately, the optimal prehabilitation program remains undetermined; therefore, this concept cannot be widely implemented. Future studies investigating optimal prehabilitation regimens for patients undergoing surgery for colorectal cancer are necessary. Full article
(This article belongs to the Special Issue Physical Activity and Cancer Care)
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14 pages, 1006 KiB  
Review
Physical Activity and Cancer Care—A Review
by Weronika Misiąg, Anna Piszczyk, Anna Szymańska-Chabowska and Mariusz Chabowski
Cancers 2022, 14(17), 4154; https://doi.org/10.3390/cancers14174154 - 27 Aug 2022
Cited by 18 | Viewed by 3536
Abstract
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 [...] Read more.
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. Full article
(This article belongs to the Special Issue Physical Activity and Cancer Care)
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16 pages, 593 KiB  
Review
The Role of Prehabilitation in Modern Esophagogastric Cancer Surgery: A Comprehensive Review
by Augustinas Bausys, Morta Mazeikaite, Klaudija Bickaite, Bernardas Bausys, Rimantas Bausys and Kestutis Strupas
Cancers 2022, 14(9), 2096; https://doi.org/10.3390/cancers14092096 - 22 Apr 2022
Cited by 12 | Viewed by 2655
Abstract
Esophagogastric cancer is among the most common malignancies worldwide. Surgery with or without neoadjuvant therapy is the only potentially curative treatment option. Although esophagogastric resections remain associated with major surgical trauma and significant postoperative morbidity. Prehabilitation has emerged as a novel strategy to [...] Read more.
Esophagogastric cancer is among the most common malignancies worldwide. Surgery with or without neoadjuvant therapy is the only potentially curative treatment option. Although esophagogastric resections remain associated with major surgical trauma and significant postoperative morbidity. Prehabilitation has emerged as a novel strategy to improve clinical outcomes by optimizing physical and psychological status before major surgery through exercise and nutritional and psychological interventions. Current prehabilitation programs may be unimodal, including only one intervention, or multimodal, combining the benefits of different types of interventions. However, it still is an investigational treatment option mostly limited to clinical trials. In this comprehensive review, we summarize the current evidence for the role of prehabilitation in modern esophagogastric cancer surgery. The available studies are very heterogeneous in design, type of interventions, and measured outcomes. Yet, all of them confirm at least some positive effects of prehabilitation in terms of improved physical performance, nutritional status, quality of life, or even reduced postoperative morbidity. However, the optimal interventions for prehabilitation remain unclear; thus, they cannot be standardized and widely adopted. Future studies on multimodal prehabilitation are necessary to develop optimal programs for patients with esophagogastric cancer. Full article
(This article belongs to the Special Issue Physical Activity and Cancer Care)
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16 pages, 1189 KiB  
Review
Physical Exercise Restrains Cancer Progression through Muscle-Derived Factors
by Argyro Papadopetraki, Maria Maridaki, Flora Zagouri, Meletios-Athanasios Dimopoulos, Michael Koutsilieris and Anastassios Philippou
Cancers 2022, 14(8), 1892; https://doi.org/10.3390/cancers14081892 - 08 Apr 2022
Cited by 11 | Viewed by 6825
Abstract
A growing body of in vitro and in vivo studies suggests that physical activity offers important benefits against cancer, in terms of both prevention and treatment. However, the exact mechanisms implicated in the anticancer effects of exercise remain to be further elucidated. Muscle-secreted [...] Read more.
A growing body of in vitro and in vivo studies suggests that physical activity offers important benefits against cancer, in terms of both prevention and treatment. However, the exact mechanisms implicated in the anticancer effects of exercise remain to be further elucidated. Muscle-secreted factors in response to contraction have been proposed to mediate the physical exercise-induced beneficial effects and be responsible for the inter-tissue communications. Specifically, myokines and microRNAs (miRNAs) constitute the most studied components of the skeletal muscle secretome that appear to affect the malignancy, either directly by possessing antioncogenic properties, or indirectly by mobilizing the antitumor immune responses. Moreover, some of these factors are capable of mitigating serious, disease-associated adverse effects that deteriorate patients’ quality of life and prognosis. The present review summarizes the myokines and miRNAs that may have potent anticancer properties and the expression of which is induced by physical exercise, while the mechanisms of secretion and intercellular transportation of these factors are also discussed. Full article
(This article belongs to the Special Issue Physical Activity and Cancer Care)
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16 pages, 705 KiB  
Systematic Review
Benefits of Physical Activity during and after Thyroid Cancer Treatment on Fatigue and Quality of Life: A Systematic Review
by Margherita Ferrante, Giulia Distefano, Carlo Distefano, Chiara Copat, Alfina Grasso, Gea Oliveri Conti, Antonio Cristaldi and Maria Fiore
Cancers 2022, 14(15), 3657; https://doi.org/10.3390/cancers14153657 - 27 Jul 2022
Cited by 3 | Viewed by 2103
Abstract
Background: Several epidemiological studies have provided evidence of the usefulness of physical activity for cancer prevention, increased survival and quality of life (QoL), but no comprehensive review is available on the effects on thyroid cancer. The present systematic review provides an overview of [...] Read more.
Background: Several epidemiological studies have provided evidence of the usefulness of physical activity for cancer prevention, increased survival and quality of life (QoL), but no comprehensive review is available on the effects on thyroid cancer. The present systematic review provides an overview of the effects of physical activity on fatigue, QoL and health-related quality of life (HRQoL) in patients with thyroid cancer diagnosis both during and after treatment, with a focus on sex. Methods: A literature search was conducted in the PubMed and Scopus databases. We included studies investigating the impact of physical activity during and after thyroid cancer treatment, including fatigue, QoL and/or HRQoL among the outcomes. Review articles, conference papers, short communications and articles written in a language other than English articles were excluded. Study selection followed the preferred reporting items for systematic reviews and meta-analyses guidelines (PRISMA). Two reviewers independently selected the studies and assessed their eligibility. The same two reviewers independently screened studies, extracted data and assessed the risk of bias. Outcomes of interest were fatigue, QoL and HRQoL. The Newcastle–Ottawa Scale was used to assess the quality of the selected studies. We compared the outcomes between groups of patients with subclinical hyperthyroidism undergoing a physical activity program and a sedentary group, evaluating the possible presence of sex differences. Results and Discussion: We found five studies eligible for inclusion in our review; only two were prospective studies including an exercise training program. One study was a quasi-experimental study with a non-equivalent control group. Three out of five studies comprised low-quality evidence with a high risk of bias. Conclusion: The level of confidence in the available evidence is very low. A close association between physical activity and fatigue, QoL and HRQoL in patients with thyroid cancer diagnosis with a focus on sex can neither be supported nor refuted. Future studies are needed to understand which training programs are optimal, both in terms of beneficial effects and to avoid potential adverse responses, in addition to focusing on gender differences. The protocol of this systematic review was registered with PROSPERO: CRD42022322519. Full article
(This article belongs to the Special Issue Physical Activity and Cancer Care)
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