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Exercise Levels and Preferences in Cancer Patients: A Cross-Sectional Study.

ABSTRACT: BACKGROUND:Despite the benefits related to physical exercise, large numbers of cancer patients are not sufficiently active. METHODS:To investigate exercise levels and preferences in cancer patients, a cross-sectional study was conducted on a random sample of 392 cancer outpatients who anonymously completed a questionnaire investigating general and medical characteristics, and expressed willingness to participate in exercise programs. Current exercise levels were estimated with the Leisure Score Index (LSI). RESULTS:Most patients (93%) were insufficiently active but 80% declared an interest in exercise programs. Patients preferred oncologist-instructed programs and specified particular exercise needs. Multivariate logistic regression showed that willingness to exercise was associated with education (OR: 1.87; 95% CI: 1.15-3.04 beyond age 14 years vs. up to 14 years) and current physical activity (OR: 1.92; 95% CI: 1.92-3.63 for sweat-inducing activity >2 times/week vs. <1 time/week). Patients given chemotherapy were less inclined to exercise (OR: 0.45; 95% CI: 0.23-0.86) than those who did not. LSI was lower if cancer stage was advanced (?: -0.36; 95% CI: -0.75 to -0.02) than if it was in remission. High LSI was also associated with longer education, lower BMI, and longer time after diagnosis. CONCLUSION:Cancer patients are insufficiently active but are willing to participate in personalized exercise programs. Information from this survey may help in designing personalized interventions so these patients will achieve sufficient exercise.

SUBMITTER: Avancini A

PROVIDER: S-EPMC7432474 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature

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Exercise Levels and Preferences in Cancer Patients: A Cross-Sectional Study.

Avancini Alice A Pala Valeria V Trestini Ilaria I Tregnago Daniela D Mariani Luigi L Sieri Sabina S Krogh Vittorio V Boresta Marco M Milella Michele M Pilotto Sara S Lanza Massimo M

International journal of environmental research and public health 20200724 15

<h4>Background</h4>Despite the benefits related to physical exercise, large numbers of cancer patients are not sufficiently active.<h4>Methods</h4>To investigate exercise levels and preferences in cancer patients, a cross-sectional study was conducted on a random sample of 392 cancer outpatients who anonymously completed a questionnaire investigating general and medical characteristics, and expressed willingness to participate in exercise programs. Current exercise levels were estimated with the ...[more]

PMID: 32722265

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Project description:BackgroundEnd-stage kidney disease is associated with a 10- to 100-fold increase in cardiovascular mortality compared with age-, sex-, and race-matched population. Cardiopulmonary resuscitation (CPR) in this cohort has poor outcomes and leads to increased functional morbidity.ObjectiveThe aim of this study is to assess patients' preferences toward CPR and advance care planning (ACP).Designcross-sectional study design.SettingTwo outpatient dialysis units.PatientsAdults undergoing dialysis for more than 3 months were included. Exclusion criteria were severe cognitive impairment or non-English-speaking patients.MeasurementsA structured interview with the use of Willingness to Accept Life-Sustaining Treatment (WALT) tool.MethodsDemographic data were collected, and baseline Montreal Cognitive Assessment, Patient Health Questionnaire-9, Duke Activity Status Index, Charlson comorbidity index, and WALT instruments were used. Descriptive analysis, chi-square, and t test were performed along with probability plot for testing hypotheses.ResultsSeventy participants were included in this analysis representing a 62.5% response rate. There was a clear association between treatment burden, anticipated clinical outcome, and the likelihood of that outcome with patient preferences. Low-burden treatment with expected return to baseline was associated with 98.5% willingness to accept treatment, whereas high-burden treatment with expected return to baseline was associated with 94.2% willingness. When the outcome was severe functional or cognitive impairment, then 45.7% and 28.5% would accept low-burden treatment, respectively. The response changed based on the likelihood of the outcome. In terms of resuscitation, more than 75% of the participants would be in favor of receiving CPR and mechanical ventilation at their current health state. Over 94% of patients stated they had never discussed ACP, whereas 59.4% expressed their wish to discuss this with their primary nephrologist.LimitationsLimited generalizability due to lack of diversity. Unclear decision stability due to changes in health status and patients' priorities.ConclusionsACP should be incorporated in managing chronic kidney disease (CKD) to improve communication and encourage patient involvement.

Project description:OBJECTIVES:Although many secondary effects of high levels of vanadium (V) and chromium (Cr) overlap with symptoms seen in paediatric patients with chronic kidney disease (CKD), their plasma V and Cr levels are understudied. DESIGN:Ancillary cross-sectional study to a prospective, longitudinal, randomised controlled trial. SETTING:Children's Hospital of Western Ontario, London Health Sciences Centre, London, Ontario, Canada. PARTICIPANTS:36 children and adolescents 4-18 years of age with CKD. INTERVENTIONS:1-6 trace element measurements per patient. Cystatin C (CysC) estimated glomerular filtration rate (eGFR) was calculated using the Filler formula. Plasma V and Cr levels were measured using high-resolution sector field inductively coupled mass spectrometry. Anthropomorphic data and blood parameters were collected from our electronic chart programme. Water Cr and V data were obtained from the Ontario Water (Stream) Quality Monitoring Network. PRIMARY AND SECONDARY OUTCOME MEASURES:Primary outcomes: plasma Cr and V. SECONDARY OUTCOMES:age, season, CysC, CysC eGFR, and Cr and V levels in environmental water. RESULTS:The median (IQR) eGFR was 51?mL/min/1.73?m2 (35, 75). The median V level was 0.12?µg/L (0.09, 0.18), which was significantly greater than the 97.5th percentile of the reference interval of 0.088?µg/L; 32 patients had at least one set of V levels above the published reference interval. The median Cr level was 0.43?µg/L (0.36, 0.54), which was also significantly greater than the established reference interval; 34 had at least one set of Cr levels above the published reference interval. V and Cr levels were moderately correlated. Only some patients had high environmental exposure. CONCLUSIONS:Our study suggests that paediatric patients with CKD have elevated plasma levels of V and Cr. This may be the result of both environmental exposure and a low eGFR. It may be necessary to monitor V and Cr levels in patients with an eGFR <30?mL/min/1.73?m2. TRIAL REGISTRATION NUMBER:NCT02126293; HC#172241.

Project description:Background: Efforts in reproductive preservation for cancer patients have become one of the important aspects of cancer management. In fact, decline in reproductive function is known to occur after exposure to anti-cancer treatments. Measuring anti-Müllerian hormone (AMH) levels is known to be the best parameter in predicting ovarian reserves, which indicates reproductive function. In total, 68% of cancer survivors of reproductive age who underwent anti-cancer treatments suffer from infertility. Meanwhile, ovarian reserves also decrease with increasing age. There is ongoing debate on whether the ovarian reserves of cancer patients could be reduced long before exposure to anti-cancer therapy. Therefore, it is important to know whether ovarian reserves in cancer patients decrease before or after anti-cancer therapy. This can help predict the reproductive function in such cases and the effectiveness of ovarian preservation efforts. Methods: A cross-sectional study was conducted, comparing the AMH levels of 44 female cancer patients of reproductive age before cancer therapy, to 44 non-cancer patients of reproductive age (age matched) . The AMH was determined from blood.The biological ages from both groups were adjusted using the Indonesian Kalkulator of Oocytes. Results: The median age in both groups was 28 years old. The AMH levels in the blood of the cancer group were found to be significantly lower in contrast to those in the non-cancer group (1.11 [0.08-4.65] ng/ml vs. 3.99 [1.19- 8.7]; p- value <0.001). Therefore, the biological age in the cancer group was 10 years older than that of the non-cancer group, indicating that ovarian aging occurs earlier in cancer patients. Conclusions: AMH levels of cancer patients of reproductive age were already reduced before cancer therapy, given an older biological age, in contrast to that of the non-cancer patients. Proper counseling and implementation of fertility-preserving methods is highly recommended in this group of patients.

Dataset Information

Exercise Levels and Preferences in Cancer Patients: A Cross-Sectional Study.

Publications

Exercise Levels and Preferences in Cancer Patients: A Cross-Sectional Study.

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