Testing the ‘teachable moment’ premise: does physical activity increase in the early survivorship phase?

Broderick, Julie; Hussey, Juliette; Kennedy, M. John; O’Donnell, Dearbhaile M.

doi:10.1007/s00520-013-2064-4

Cited by 40 publications

(30 citation statements)

References 47 publications

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“…A 50% reduction in activity level was noted in those treated with chemotherapy, surgery and radiation, compared to a drop of 24% in those treated with surgery alone. Broderick found weight gain and high levels of sedentary behavior in a study of 24 women at completion of chemotherapy with no improvement one year later [49] . Patients may need encouragement to exercise since chemotherapy treatment may foster a more sedentary lifestyle.…”

Section: Compositionmentioning

confidence: 99%

Weight gain following breast cancer diagnosis: Implication and proposed mechanisms

Makari-Judson

Braun

Jerry

et al. 2014

WJCO

130

106

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Weight gain occurs in the majority of women following breast cancer treatment. An overview of studies describing weight gain amongst women treated with early to modern chemotherapy regimens is included. Populations at higher risk include women who are younger, closer to ideal body weight and who have been treated with chemotherapy. Weight gain ranges between 1 to 5 kg, and may be associated with change in body composition with gain in fat mass and loss in lean body mass. Women are unlikely to return to pre-diagnosis weight. Possible mechanisms including inactivity and metabolic changes are explored. Potential interventions are reviewed including exercise, dietary changes and pharmacologic agents. Although breast cancer prognosis does not appear to be significantly impacted, weight gain has negative consequences on quality of life and overall health. Future studies should explore change in body composition, metabolism and insulin resistance. Avoiding weight gain in breast cancer survivors following initial diagnosis and treatment should be encouraged.© 2014 Baishideng Publishing Group Inc. All rights reserved.Key words: Breast cancer; Weight gain; Exercise; Survivorship; Insulin resistance Core tip: Weight gain occurs in the majority of women following breast cancer treatment, especially those who are younger, closer to ideal body weight and who have been treated with chemotherapy. Although weight gain may be modest, changes are consistent with sarcopenic obesity. Women are unlikely to return to pre-diagnosis weight. Although the degree of weight gain does not appear to significantly alter prognosis, associated changes in metabolism and inactivity are of concern. Interventions should be promoted to avoid weight gain. INTRODUCTIONWeight gain following a diagnosis of breast cancer has been reported consistently in women treated for breast cancer, but was an unexpected finding when first described Dixon and colleagues in 1978 [1] . After subsequent reports confirmed this observation, weight gain was included as a known side effect of adjuvant chemotherapy [2] . Despite this, most women appear to be inadequately informed about this possibility, as demonstrated by one study reporting concern about treatment-associated weight gain in only 27% of survivors prior to therapy [3] . WHY IS POST-TREATMENT WEIGHT GAIN OF CONCERN?Obesity is a global issue associated with increased risk of developing post-menopausal breast cancer [4] and a worse prognosis at the time of diagnosis [5] . However, the effect of weight gain following a diagnosis of breast cancer is less well understood. While weight gain following diagnosis does not necessarily lead to obesity or its consequences, any impact on breast cancer prognosis and overall health, patient self-image, or quality of life (QoL) would be an undesirable outcome. These outcomes may be interrelated: weight gain can influence other medical conditions such as diabetes, heart disease, hypertension and hypercholesterolemia that may impact overall survival. For example, Erick...

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Section: Compositionmentioning

confidence: 99%

Weight gain following breast cancer diagnosis: Implication and proposed mechanisms

Makari-Judson

Braun

Jerry

et al. 2014

WJCO

130

106

View full text Add to dashboard Cite

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“…For example, breast cancer patients experience increased fatigue and lower physical function and activity during and after chemotherapy, neither of which improve significantly without intervention [66]. Additionally, patients self-report a lower quality of life during the first year of being disease free compared to their perception of quality of life prior to disease onset, as well as compared to 5-years after being diagnosed with cancer [67].…”

Section: Introductionmentioning

confidence: 99%

The Intersection of Oncology Prognosis and Cancer Rehabilitation

Smith

Zheng

2017

Curr Phys Med Rehabil Rep

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Purpose of reviewThis review examines the delivery of rehabilitation care to cancer patients with relation to disease prognosis. This includes the evaluation when patients are referred for rehabilitation services and the effectiveness of rehabilitation interventions across the cancer continuum.Recent findingsAlthough prognosticating life expectancy is difficult, referrals for rehabilitation interventions appear to be affected by physician attitudes towards patients with advanced disease, in part because of misconceptions about the nature of rehabilitation for oncology patients. Rehabilitation may also be underutilized in long-term survivors with no evidence of disease. Despite this, our review found that rehabilitation in advanced disease, end-of-life, geriatric cancer patients, and in long-term survivors can be beneficial. There is a relative dearth in studies on rehabilitation interventions specifically at the end-of-life.SummaryCancer rehabilitation can be helpful to patients along the spectrum of cancer prognoses. Examining more accurate ways to prognosticate life expectancy, improving communication and education between oncologists and rehabilitation team members, and modifying survivorship plans to include patient education on functional changes over time may improve the delivery of rehabilitation care.

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“…The notion that a health event can be a cue for behavior change, often referred to as the 'teachable moment (TM),' has had considerable conceptual appeal [1][2][3][4][5]. As a result, innumerous observational and intervention studies have been timed to coincide with health events ranging from low threat (e.g., pregnancy, dental visits, and identification of abnormal test results) [1,6,7] to higher threat events (e.g., emergency room visits, hospitalization, cancer diagnosis, and heart attack) [8][9][10] as a means to promote relevant health behavior change. Results of these studies have been mixed, with some finding improvements in behavior and others finding null effects [2,6,9,11].…”

Section: Introductionmentioning

confidence: 99%

Patient's lung cancer diagnosis as a cue for relatives' smoking cessation: evaluating the constructs of the teachable moment

et al. 2015

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Background To understand whether patient-reported experiences with lung cancer may create teachable moments (TM) for their relatives as evidenced by shifts in their risk perceptions, affective response, and self-image and in turn, motivation to quit smoking. Methods Patients at a comprehensive cancer center (n = 152) completed a survey within 6 months of lung cancer diagnosis to assess their cancer-related symptoms and openness and enumerated relatives who were smokers. Relative smokers (n = 218) then completed a survey assessing their risk perceptions, affective response, and self-image as a smoker related to the patient’s diagnosis (TM mechanisms), and their motivation to quit smoking. Cross-sectional mediation and moderation analyses were conducted to explore the links between patient-reported experiences, and relatives’ TM mechanisms, and motivation to quit smoking. Results Relative-reported affect was a significant mediator of the association between patient-reported symptoms and relative smoker’s desire to quit. Relatives’ self-image was a significant moderator of the association between patient-reported symptoms and relative smoker’s desire to quit, such that patients’ reported symptoms were associated with relatives’ desire to quit only when the relative smoker reported a generally positive self-image as a smoker. No evidence was found for moderated mediation. However, the link between symptoms and negative affect was moderated by perceptions of risk. Conclusion Whether smokers experience a family member’s lung cancer as a TM is influenced by multiple interrelated cognitive and affective factors that warrant further exploration. Clearer understanding of these factors could inform how to re-invigorate and sustain this motivation to promote concrete actions toward smoking cessation.

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Testing the ‘teachable moment’ premise: does physical activity increase in the early survivorship phase?

Abstract: This study highlighted the unchanging sedentary behaviour and weight gain of breast cancer survivors during the first year after completion of chemotherapy, which may inform rehabilitation models in this population.

Cited by 40 publications

References 47 publications

Weight gain following breast cancer diagnosis: Implication and proposed mechanisms

Weight gain following breast cancer diagnosis: Implication and proposed mechanisms

The Intersection of Oncology Prognosis and Cancer Rehabilitation

Patient's lung cancer diagnosis as a cue for relatives' smoking cessation: evaluating the constructs of the teachable moment

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