NCCN Guidelines Insights: Survivorship, Version 2.2019

Sanft, Tara; Denlinger, Crystal S.; Armenian, Saro H.; Baker, K. Scott; Broderick, Gregory A.; Demark‐Wahnefried, Wendy; Friedman, Debra L.; Goldman, Mindy; Hudson, Melissa M.; Khakpour, Nazanin; Koura, Divya; Lally, Robin M.; Langbaum, Terry S.; McDonough, Allison L.; Melisko, Michelle; Mooney, Kathi; Moore, Halle C. F.; Moslehi, Javid; O’Connor, Tracey; Overholser, Linda; Paskett, Electra D.; Peterson, Lindsay L.; Pirl, William F.; Rodriguez, Maria Alma; Ruddy, Kathryn J.; Smith, Sophia K.; Syrjala, Karen L.; Tevaarwerk, Amye J.; Urba, Susan G.; Zee, Phyllis C.; McMillian, Nicole R.; Freedman-Cass, Deborah A.

doi:10.6004/jnccn.2019.0034

Cited by 66 publications

(64 citation statements)

References 76 publications

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“…This discrepancy might be related to the sample size and the classification of a survivorship period in the studies. Overall, given the low guideline adherence rate on MHB in cancer survivors and the role of health behaviors in reducing medical and psychological effects during the survivorship period, results from the current study suggest that appropriately timed advice and continuous support for survivors' behavior change during the course of the survivorship period are required. Moreover, lifestyle modification needs to be a core component of cancer survivorship care.…”

Section: Discussionmentioning

confidence: 92%

“…The recent National Comprehensive Cancer Network (NCCN) guideline also suggests the need for a considerable scope of behavior change interventions in the oncology context . Health behaviors are processes and practices embedded in social life and the possible compensatory health belief effect (ie, a belief that a risk of an unhealthy behavior compensated by a healthy behavior) makes changing many health behaviors together more difficult than changing any individually.…”

Section: Discussionmentioning

confidence: 99%

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Multiple health behaviors before and after a cancer diagnosis among women: A repeated cross‐sectional analysis over 15 years

et al. 2020

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Background: Cancer diagnosis may be a cue for health behavior change. Previous research that assessed the impact of a cancer diagnosis on multiple health behavior (MHB) change is limited by small sample size, cross-sectional study design, and a focus on individual rather than multiple behaviors. This study investigated the impact of a cancer diagnosis on compliance with MHB recommendations. Methods: Data from Australian Longitudinal Study on Women's Health (ALSWH) were utilized. Compliance with MHB was assessed by cancer survivorship period; 0-3 years pre-diagnosis, 0-3 years postdiagnosis, 4-12 years postdiagnosis, and compared to controls. A MHB score based on the WCRF/AICR guidelines was calculated for six behaviors (physical activity, smoking, alcohol, BMI, fruit, and vegetable intake); scores ranged from 0 to 6, with a higher score indicating higher compliance. Generalized estimating equation (GEE) was used for statistical analysis. Results: Participants comprised 7585 women from the 2001 ALSWH survey, of whom 2285 developed cancer during 15 years of follow-up. Compared to controls, the mean MHB score was slightly lower (Mean Difference (MD) = −0.015, P > .05) in survivors pre-diagnosis, after adjusting for confounders; however, the compliance score increased during postdiagnosis, with the mean difference score being significantly higher in recent survivors (0-3 years post diagnosis; MD = 0.055, P < .01). Likewise, within cancer survivors, the mean compliance score significantly increased 0-3 years postdiagnosis (MD = 0.07, P < .05) compared to pre-diagnosis, but this significant improvement was not maintained over the longer term (MD = 0.037, P > .05). Conclusion: In this sample, survivors had higher MHB score than controls. A cancer diagnosis may provide a teachable moment for health behavior change in the period immediately following diagnosis, but this effect was not sustained during longerterm survivorship. K E Y W O R D S cancer survivors, multiple health behaviors (MHB), survivorship period | 3225 TOLLOSA eT AL.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Multiple health behaviors before and after a cancer diagnosis among women: A repeated cross‐sectional analysis over 15 years

et al. 2020

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“…walking, jogging, cycling, swimming) each week; and two to three resistance exercise (i.e. lifting weights) sessions each week involving moderate to vigorous-intensity exercises targeting the major muscle groups [41,42].…”

Section: Discussionmentioning

confidence: 99%

Prospective surveillance model in the home for breast cancer-related lymphoedema: a feasibility study

Koelmeyer

Moloney

Boyages

et al. 2020

Breast Cancer Res Treat

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The aim of this study was to assess the feasibility of delivering a prospective surveillance model in the home over 6 months for women at high risk of developing lymphoedema. Methods A single-group, intervention study recruited 20 women who had surgical and medical treatment for confirmed node-positive invasive breast cancer and therefore at high risk of developing arm lymphoedema. Participants received a package including Bioimpedance Spectroscopy (BIS) monitoring, lymphoedema education and support to promote selfmanagement and physical activity. Results Participants adhered to BIS monitoring 74% of the time, and felt extremely confident in using the device. By 6 months, mean BIS L-Dex scores had increased from 3.5 (SD 5.6) to 8.4 (SD 11.1); five women (25%) who experienced > + 6.5 increase in L-Dex score were fitted with a compression garment. Self-reported symptoms and distress decreased by 0.4 out of 10 (95% CI 0.1 to 0.7); number of self-management strategies used increased by 0.6 (95% CI 0.1 to 1.2); and planned exercise increased by 2.8 h/week (95% CI 0.4 to 5.2). Conclusions These findings indicate a prospective surveillance model of care in the home with BIS is feasible and associated with increased self-management. A Phase II randomised trial is warranted as well as research exploring the costs associated with implementing this model of care for high-risk individuals.

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“…The presence and severity of cancer treatment–related symptoms are routinely measured throughout disease treatment. Guidelines from the National Comprehensive Cancer Network, the American Society for Clinical Oncology, and others identify critical thresholds for intervention and suggest evidence‐based pathways for symptom management, often including exercise 59‐61 . Although it is beyond the scope of this article to detail symptom management guidelines and referral thresholds, providers should be aware of these evidence‐based recommendations and use them to objectively execute referrals along this exercise pathway.…”

Section: Clinical Screeningmentioning

confidence: 99%

An exercise oncology clinical pathway: Screening and referral for personalized interventions

Stout

Brown

Schwartz

et al. 2020

Cancer

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INTRODUCTIONThere are approximately 17 million cancer survivors living in the United States, and by 2040, this estimate is predicted to increase to 26.1 million. 1 Exercise provides a myriad of health benefits to individuals during and after cancer treatment by reducing treatment-related symptoms, improving functional status and quality of life, and lowering the risk of disease recurrence. 2,3 Despite the established benefits, an individual's level of physical activity often decreases during treatment and does not return to prediagnosis levels after treatment completion. 4,5 Although exercise is regarded as safe and beneficial for individuals with cancer, promoting exercise for this population is complex. A patient-centered pathway is needed that can guide oncology and primary care professionals in the efficient assessment of an individual's condition and enable personalized referrals for exercise interventions that promote physical activity. The purpose of this article is to provide a framework for clinical decision making that enables personalized condition assessment, risk stratification, and referral to optimal settings for exercise promotion for cancer survivors. Implementation strategies are also offered to support the integration of this model into an oncology clinical workflow.With guidance from their medical provider, individuals are more likely to engage in exercise and maintain levels of physical activity during cancer treatments. 6 However, the number of individuals with cancer who report receiving exercise-specific guidance from their health care providers is low. 7 Of particular concern is the lack of knowledge and training among health care professionals about exercise prescription for this complex population. 8

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NCCN Guidelines Insights: Survivorship, Version 2.2019

Cited by 66 publications

References 76 publications

Multiple health behaviors before and after a cancer diagnosis among women: A repeated cross‐sectional analysis over 15 years

Multiple health behaviors before and after a cancer diagnosis among women: A repeated cross‐sectional analysis over 15 years

Prospective surveillance model in the home for breast cancer-related lymphoedema: a feasibility study

An exercise oncology clinical pathway: Screening and referral for personalized interventions

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