Associations of Recreational Physical Activity and Leisure Time Spent Sitting With Colorectal Cancer Survival

Campbell, Peter T.; Patel, Alpa V.; Newton, Christina C.; Jacobs, Eric J.; Gapstur, Susan M.

doi:10.1200/jco.2012.45.9735

Cited by 202 publications

(201 citation statements)

References 33 publications

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“…Data from the oncology literature would suggest that physical exercise helps to overcome the fatigue during adjuvant therapy for breast cancer 58 and leads to lower mortality following colorectal cancer. 59 It goes without saying that adequate pain relief and minimal sedation facilitate mobilization, and therefore, integration of various elements is a necessity for better outcomes.…”

Section: Mobilizationmentioning

confidence: 99%

Physiologic considerations of Enhanced Recovery After Surgery (ERAS) programs: implications of the stress response

Carli

2014

Can J Anesth/J Can Anesth

158

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Purpose Enhanced Recovery After Surgery (ERAS) programs have increasingly attracted the attention of clinicians who are intent on minimizing postoperative morbidity, decreasing variability in surgical care, and containing hospital costs. The purpose of this review is to discuss the relevant pathophysiology of the surgical stress response and its associated mechanisms that regulate important metabolic changes.

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Section: Mobilizationmentioning

confidence: 99%

Physiologic considerations of Enhanced Recovery After Surgery (ERAS) programs: implications of the stress response

Carli

2014

Can J Anesth/J Can Anesth

158

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“…A diet rich in fruits, vegetables, poultry, fish, whole grain, and poor in red meat and concentrated sweets was associated with better outcomes with regard to cancer recurrence or death. [50][51][52][53][54][55][56][57][58][59][60][61][62][63][64] Another important aspect of survivorship care is health promotion. Evidence suggests that noncancer comorbidities have a negative impact on overall quality of life and long-term survival when compared with the cancer diagnosis itself.…”

Section: Survivorshipmentioning

confidence: 99%

Surveillance and Survivorship after Treatment for Colon Cancer

Makhoul

Alva

Wilkins

2015

Clinics in Colon and Rectal Surgery

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Colorectal cancer is the third most common cancer diagnosed in the United States. Majority of patients have localized disease that is amenable to curative resection. Disease recurrence remains a major concern after resection. In addition, patients are at an increased risk for developing a second or metachronous colon cancer. The principal goal of surveillance following treatment of colon cancer is to improve disease-free and overall survival. Survivorship is a distinct phase following surveillance to help improve quality of life and promote longevity.

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“…The meta-analysis also found that higher post-diagnosis physical activity level was associated with a significantly increased overall survival (HR overall survival = 0.62, 95% CI 0.54 to 0.71; fixed-effects model; p < 0.001). Five [31][32][33][34][35] out of the six individual studies assessing the relationship between physical activity level and overall survival found a statistically significant increase in overall survival among patients with higher post-diagnosis physical activity levels. Pooled relative risks from another meta-analysis 23 among CRC survivors showed inverse associations between post-diagnosis leisure-time physical activity and mortality based on six prospective cohorts.…”

Section: Physical Activity and Survivalmentioning

confidence: 99%

“…Three separate meta-analyses 23,28,29 including the same six observational studies [30][31][32][33][34][35] were published in 2013-14. Owing to different cut-off values for level of physical activity and different statistical analyses used, there is slight variation in the results; what is evident, however, is that all three studies show that a higher level of physical activity is associated with an increase in cancer-specific and overall survival.…”

Section: Physical Activity and Survivalmentioning

confidence: 99%

“…Pooled relative risks from another meta-analysis 23 among CRC survivors showed inverse associations between post-diagnosis leisure-time physical activity and mortality based on six prospective cohorts. [30][31][32][33][34][35] The authors conducted a meta-analysis for exerciser versus not exerciser, moderate level of physical activity versus low physical activity, and high level of physical activity versus low physical activity. Low physical activity (reference group) was defined as 0, < 3 and < 3.5 MET hours per week or sedentary and the highest category was defined as ≥ 18 and ≥ 8.75 MET hours per week or sufficiently active.…”

Section: Physical Activity and Survivalmentioning

confidence: 99%

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The use of cardiac rehabilitation services to aid the recovery of patients with bowel cancer: a pilot randomised controlled trial with embedded feasibility study

Hubbard

Munro

O’Carroll

et al. 2016

Health Serv Deliv Res

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Background: Colorectal cancer (CRC) survivors are not meeting the recommended physical activity levels associated with improving their chances of survival and quality of life. Rehabilitation could address this problem. Objectives: The aims of the Cardiac Rehabilitation In Bowel cancer study were to assess whether or not cardiac rehabilitation is a feasible and acceptable model to aid the recovery of people with CRC and to test the feasibility and acceptability of the protocol design. Design: Intervention testing and feasibility work (phase 1) and a pilot randomised controlled trial with embedded qualitative study (phase 2), supplemented with an economic evaluation. Randomisation was to cardiac rehabilitation or usual care. Outcomes were differences in objective measures of physical activity and sedentary behaviour, self-reported measures of quality of life, anxiety, depression and fatigue. Qualitative work involved patients and clinicians from both cancer and cardiac specialties. Setting: Three colorectal cancer wards and three cardiac rehabilitation facilities. Participants: Inclusion criteria were those who were aged > 18 years, had primary CRC and were post surgery. Results: Phase 1 (single site) – of 34 patient admissions, 24 (70%) were eligible and 4 (17%) participated in cardiac rehabilitation. Sixteen clinicians participated in an interview/focus group. Modifications to trial procedures were made for further testing in phase 2. Additionally, 20 clinicians in all three sites were trained in cancer and exercise, rating it as excellent. Phase 2 (three sites) – screening, eligibility, consent and retention rates were 156 (79%), 133 (67%), 41 (31%) and 38 (93%), respectively. Questionnaire completion rates were 40 (97.5%), 31 (75%) and 25 (61%) at baseline, follow-up 1 and follow-up 2, respectively. Forty (69%) accelerometer data sets were analysed; 20 (31%) were removed owing to invalid data. Qualitative study: CRC and cardiac patients and clinicians were interviewed. Key themes were benefits and barriers for people with CRC attending cardiac rehabilitation; generic versus disease-specific rehabilitation; key concerns of the intervention; and barriers to participation (CRC participants only). Economic evaluation: The average out-of-pocket expenses of attending cardiac rehabilitation were £50. The costs of cardiac rehabilitation for people with cancer are highly dependent on whether it involves accommodating additional patients in an already existing service or setting up a completely new service. Limitations and conclusions: The main limitation is that this is a small feasibility and pilot study. The main novel finding is that cardiac rehabilitation for cancer and cardiac patients together is feasible and acceptable, thereby challenging disease-specific rehabilitation models. Future work: This study highlighted important challenges to doing a full-scale trial of cardiac rehabilitation but does not, we believe, provide sufficient evidence to reject the possibility of such a future trial. We reco...

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Associations of Recreational Physical Activity and Leisure Time Spent Sitting With Colorectal Cancer Survival

Abstract: More recreational physical activity before and after colorectal cancer diagnosis was associated with lower mortality, whereas longer leisure time spent sitting was associated with higher risk of death.

Cited by 202 publications

References 33 publications

Physiologic considerations of Enhanced Recovery After Surgery (ERAS) programs: implications of the stress response

Physiologic considerations of Enhanced Recovery After Surgery (ERAS) programs: implications of the stress response

Surveillance and Survivorship after Treatment for Colon Cancer

The use of cardiac rehabilitation services to aid the recovery of patients with bowel cancer: a pilot randomised controlled trial with embedded feasibility study

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