BACKGROUND Breast cancer survivors (BCS) face risk of recurrence and a higher risk of developing comorbidities like cardiovascular disease compared to the general population. Physical activity (PA) has been shown to reduce such risks. The present analyses sought to identify 1) unique patterns of PA among BCS, and 2) characteristics associated with level of PA. METHODS 548 women reported PA and sociodemographic, health-related and psychosocial factors at three time points, 6 months apart, following primary treatment for breast cancer. Cancer-related factors were obtained from chart reviews. We used finite mixture modeling to examine trajectory groups of moderate-vigorous PA (MVPA) in the early post-treatment period. We then examined the characteristics associated with trajectory group membership. RESULTS We identified three distinct, stable patterns of PA: low (42.5%), medium (45.5%) and high MVPA (12.0%) groups. In a multivariate setting, compared to more active BCS, the least active group had higher BMI, were less likely to report alcohol consumption, were more likely to smoke cigarettes, and had worse physical functioning and vitality scores. Cancer-treatment related factors did not significantly predict group membership. CONCLUSIONS A large proportion of BCS remain physically inactive following treatment, suggesting the need for interventions to improve morbidity and reduce mortality in this population.
BackgroundCapturing and Analyzing Sensor and Self-Report Data for Clinicians and Researchers (COMPASS) is an electronic health (eHealth) platform designed to improve cancer care delivery through passive monitoring of patients’ health status and delivering customizable reports to clinicians. Based on data from sensors and context-driven administration of patient-reported outcome (PRO) measures, key indices of patients’ functional status can be collected between regular clinic visits, supporting clinicians in the delivery of patient care.ObjectiveThe first phase of this project aimed to systematically collect input from oncology providers and patients on potential clinical applications for COMPASS to refine the system.MethodsTen clinicians representing various oncology specialties and disciplines completed semi-structured interviews designed to solicit clinician input on how COMPASS can best support clinical care delivery. Three cancer patients tested a prototype of COMPASS for 7 days and provided feedback. Interview data were tabulated using thematic content analysis to identify the most clinically relevant objective and PRO domains.ResultsThematic content analysis revealed that clinicians were most interested in monitoring vital statistics, symptoms, and functional status, including the physical activity level (n=9), weight (n=5), fatigue (n=9), sleep quality (n=8), and anxiety (n=7). Patients (2 in active treatment and 1 in remission) reported that they would use such a device, were enthusiastic about their clinicians monitoring their health status, especially the tracking of symptoms, and felt knowing their clinicians were monitoring and reviewing their health status provided valuable reassurance. Patients would, however, like to provide some context to their data.ConclusionsClinicians and patients both articulated potential benefits of the COMPASS system in improving cancer care. From a clinician standpoint, data need to be easily interpretable and actionable. The fact that patients and clinicians both see potential value in eHealth systems suggests wider adoption and utilization could prove to be a useful tool for improving care delivery.
BackgroundPhysical activity (PA) is recommended for women with breast cancer (BC); however, data are sparse on the association of PA with quality of life (QOL) and patient‐reported symptoms for women on adjuvant endocrine therapy (AET).MethodsWomen with hormone receptor–positive BC who were taking AET completed standardized surveys about their health‐related QOL, AET‐related symptoms, and levels of PA using validated measures. A Wald chi‐square test and an analysis of variance were used to assess associations with PA and independent variables. Generalized linear regression analyses assessed associations between PA, QOL, and AET‐related symptoms.ResultsThe analytic cohort included 485 Black and White women. Black race, a high body mass index (BMI), and being on aromatase inhibitors (vs tamoxifen) were associated with lower PA in a bivariate analysis. In a multivariate analysis, lower self‐reported PA was associated with a high BMI (P = .02) and chemotherapy uptake (P = .006). Better health‐related QOL (P = .01), less severe overall AET‐related symptoms (P = .02), and less severe gynecological symptoms (P = .03) were associated with increasing levels of moderate PA.ConclusionsAmong women taking AET, moderate levels of PA may be associated with fewer medication‐related symptoms and overall better ratings of health‐related QOL. Because of the low levels of PA observed in the sample overall and particularly for Black women, identifying successful strategies to promote PA are needed.
Objectives To examine and compare changes in strength and physical function from pre-to post-diagnosis among men with prostate cancer (PC, [cases]) and matched non-cancer controls identified from the Health, Aging and Body Composition (Health ABC) study. Materials and methods We conducted a longitudinal analysis of 2 strength and 3 physical function-based measures among both cases and controls, identified from a large cohort of community living older adults enrolled in the Health ABC study. We plotted trajectories for each measure and compared cases vs. controls from the point of diagnosis onwards using mixed-effects regression models. For cases only, we examined predictors of poor strength or physical function. Results We identified 117 PC cases and 453 matched non-cancer controls (50% African Americans). At baseline, there were no differences between cases and controls in demographic factors, comorbidities or self-reported physical function; however, cases had slightly better grip strength (44.6 kg vs. 41.0 kg, p<0.01), quadriceps strength (360.5 Nm vs. 338.7 Nm, p = 0.02) and Health ABC physical performance battery scores (2.4 vs. 2.3, p = 0.01). All men experienced similar declines in strength and physical function over an equivalent amount of time. The loss of quad strength was most notable, with losses of nearly two-thirds of baseline strength over approximately 7 years of follow up.
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