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Adherence to the American Cancer Society Guidelines for Cancer Survivors and Health-Related Quality of Life among Breast Cancer Survivors.

ABSTRACT: The development and validation of guidelines for breast cancer survivors are of importance due to the increased survival rate for breast cancer. In this cross-sectional study, we aimed to examine the association between adherence to the American Cancer Society (ACS) guidelines for cancer survivors and health-related quality of life (HRQoL). A total of 618 breast cancer survivors aged 30 to 81 years who had been diagnosed with stage I to III primary breast cancer and had surgery at least a year before enrollment were included. The participants completed the 36 Item Short-Form Health Survey (SF-36) to evaluate HRQoL, and adherence scores were calculated based on the Nutrition and Physical Activity Guidelines for Cancer Survivors, which were released by the ACS. Increasing adherence scores were associated with increasing scores on the physical component summary (PCS) and the physical functioning (PF), bodily pain (BP), and vitality (VT) domains (p for trend <0.001 for PCS and PF, 0.01 for BP, and 0.02 for VT); these scores were mainly driven by the associations among survivors with stage II-III cancer. Further prospective studies are needed to evaluate whether adherence to these guidelines improves HRQoL scores among breast cancer survivors.

SUBMITTER: Koh D

PROVIDER: S-EPMC6950022 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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Adherence to the American Cancer Society Guidelines for Cancer Survivors and Health-Related Quality of Life among Breast Cancer Survivors.

Koh Dahye D Song Sihan S Moon Sang-Eun SE Jung So-Youn SY Lee Eun Sook ES Kim Zisun Z Youn Hyun Jo HJ Cho Jihyoung J Yoo Young Bum YB Lee Se Kyung SK Lee Jeong Eon JE Nam Seok Jin SJ Lee Jung Eun JE

Nutrients 20191203 12

The development and validation of guidelines for breast cancer survivors are of importance due to the increased survival rate for breast cancer. In this cross-sectional study, we aimed to examine the association between adherence to the American Cancer Society (ACS) guidelines for cancer survivors and health-related quality of life (HRQoL). A total of 618 breast cancer survivors aged 30 to 81 years who had been diagnosed with stage I to III primary breast cancer and had surgery at least a year b ...[more]

PMID: 31816813

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Project description:Maintaining weight is important for better prognosis of breast cancer survivors. The associations between weight and cancer-related symptoms are not known. We examined associations among weight, weight change, inflammation, cancer-related symptoms, and health-related quality of life (HRQOL) in a cohort of stage 0-IIIA breast cancer survivors. Participants were recruited on average 6 months (2–12 months) after diagnosis. Height, weight, and C-reactive protein (CRP) were assessed at approximately 30 months post-diagnosis; cancer-related symptoms (chest wall and arm symptoms, vasomotor symptoms, urinary incontinence, vaginal symptoms, cognition/mood problems, sleep, sexual interest/function), and HRQOL (SF-36) were assessed at approximately 40 months post-diagnosis. Weight was measured at baseline in a subset. Data on 661 participants were evaluable for body mass index (BMI); 483 were evaluable for weight change. We assessed associations between BMI (<25.0, 25.0–29.9, ?30.0 kg/m2), post-diagnosis weight change (lost ?5 %, weight change <5 %, gained ?5 %), and CRP (tertile) with cancer-related symptoms and HRQOL using analysis of covariance. Higher symptoms scores indicate more frequent or severe symptoms. Higher HRQOL scores indicate better HRQOL. Compared with those with BMI <25 kg/m2, women with BMI ?30 kg/m2 had the following scores: increased for arm symptoms (+25.0 %), urinary incontinence (+40.0 %), tendency to nap (+18.9 %), and poorer physical functioning (?15.6 %, all p < 0.05). Obese women had lower scores in trouble falling asleep (?9.9 %; p < 0.05). Compared with weight change <5 %, participants with ?5 % weight gain had lower scores in physical functioning (?7.2 %), role-physical (?15.5 %) and vitality (?11.2 %), and those with weight loss ?5 % had lower chest wall (?33.0 %) and arm symptom scores (?35.5 %, all p < 0.05). Increasing CRP tertile was associated with worse scores for chest wall symptoms, urinary incontinence, physical functioning, role-physical, vitality and physical component summary scores (all P trend < 0.05). Future studies should examine whether interventions to maintain a healthy weight and reduce inflammation could alleviate cancer-related symptoms and improve HRQOL.

Project description:Importance:The American Cancer Society Nutrition and Physical Activity Guidelines for Cancer Survivors (ACS guidelines) include maintaining (1) a healthy body weight; (2) physical activity; and (3) a diet that includes vegetables, fruits, and whole grains. It is not known whether patients with colon cancer who follow these guidelines have improved survival. Objective:To examine whether a lifestyle consistent with the ACS guidelines is associated with improved survival rates after colon cancer. Design, Setting, and Participants:This prospective cohort study included 992 patients with stage III colon cancer who were enrolled in the CALGB 89803 randomized adjuvant chemotherapy trial from 1999 through 2001. Data for the present study were analyzed between November 2016 and December 2017. Exposures:We assigned an ACS guidelines score for each included patient based on body mass index; physical activity; and intake of vegetables, fruits, whole grains, and red/processed meats (score range, 0-6, with higher score indicating healthier behaviors). Secondarily, we examined a score that also included alcohol intake in addition to the other factors (range, 0-8). Lifestyle was assessed during and 6 months after chemotherapy. Main Outcomes and Measures:Hazard ratios (HRs) and 95% confidence intervals (CIs) for disease-free, recurrence-free, and overall survival. Results:Of the 992 patients enrolled in the study, 430 (43%) were women, and the mean (SD) age was 59.6 (11.2) years (range, 21-85 years). Over a 7-year median follow-up, we observed 335 recurrences and 299 deaths (43 deaths without recurrence). Compared with patients with a 0 to 1 ACS guidelines score (n = 262; 26%), patients with a 5 to 6 score (n = 91; 9%) had a 42% lower risk of death during the study period (HR, 0.58; 95% CI, 0.34-0.99; P = .01 for trend) and improved disease-free survival (HR, 0.69; 95% CI, 0.45-1.06; P = .03 for trend). When alcohol consumption was included in the score, the adjusted HRs comparing patients with scores of 6 to 8 (n = 162; 16%) vs those with scores of 0 to 2 (187; 91%) were 0.49 for overall survival (95% CI, 0.32-0.76; P = .002 for trend), 0.58 for disease-free survival (95% CI, 0.40, 0.84; P = .01 for trend), and 0.64 for recurrence-free survival (95% CI, 0.44-0.94; P = .05 for trend). Conclusions and Relevance:Having a healthy body weight, being physically active, and eating a diet rich in vegetables, fruits, and whole grains after diagnosis of stage III colon cancer was associated with a longer survival. Trial Registration:clinicaltrials.gov Identifier: NCT00003835.

Project description:ObjectiveWe aimed to investigate the associations between diabetes and quality of life (QOL) among breast cancer survivors.MethodsA cross-sectional survey was conducted at 34 Cancer Recovery Clubs across China from May 2014 to January 2015. Quality of life was measured by the Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) and the Quality of Life Questionnaire-Breast Cancer Module 23 (QLQ-BR23, simplified Chinese version). Information on social-demography, diagnosis and treatment of tumors, and diabetes mellitus were collected by self-reported questionnaires. Univariate analyses of covariance (ANCOVA) was performed to assess the difference in QOL between patients with or without diabetes mellitus, and multiple linear regression models were used to examine the associations after controlling for confounders.ResultsDiabetes, both of type 1 diabetes (T1DM) and type 2 diabetes (T2DM) significantly reduced QOL. This effect of diabetes on QOL is independent of tumor size, regional lymph node metastasis, distant metastasis and tumor stage index (TNM). After adjusting for different social-demography, diagnosis and treatment of the tumor, the tumor's stage and other chronic comorbidities, breast cancer survivors with diabetes got significantly lower scores in functional dimensions (including physical, role, emotional and social functionings measured by EORTC QLQ-C30; body image (BRBI) and future perspective (BRFU) measured by QLQ-BR23, as well as economic difficulties than those without diabetes (Padjusted<0.05). Diabetic patients also obtained higher scores in symptom dimensions, including fatigue, nausea and vomiting, pain, dyspnoea, insomnia, constipation and diarrhoea measured by EORTC QLQ-C30; side effects, breast symptoms and upset by hair loss measured by QLQ-BR23 (Padjusted<0.05). Compared to patients with T1DM, those with T2DM are likely to suffer more by loss of functioning.ConclusionsDiabetes was associated with the decreased QOL for breast cancer survivors.

Dataset Information

Adherence to the American Cancer Society Guidelines for Cancer Survivors and Health-Related Quality of Life among Breast Cancer Survivors.

Publications

Adherence to the American Cancer Society Guidelines for Cancer Survivors and Health-Related Quality of Life among Breast Cancer Survivors.

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