Predictors of inactive lifestyle among adult survivors of childhood cancer

Ness, Kirsten K.; Leisenring, Wendy M.; Huang, Sujuan; Hudson, Melissa M.; Gurney, James G.; Whelan, Kimberly; Hobbie, Wendy L.; Armstrong, Gregory T.; Robison, Leslie L.; Oeffinger, Kevin C.

doi:10.1002/cncr.24209

Cited by 196 publications

(236 citation statements)

References 47 publications

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“…Among 9301 adult survivors, survivors were less likely than their siblings to meet physical activity requirements (46% versus 52%) and were more likely than their siblings to report a sedentary lifestyle (23% versus 14%). 424 Survivors treated with cranial radiation, amputees, and particularly women are more likely to have sedentary lifestyles. 418,[424][425][426][427] Not surprisingly, survivors who engage in 1 unhealthy risk behavior are more likely to engage in other risky behaviors.…”

Section: Risky Health Behaviorsmentioning

confidence: 99%

Long-term Cardiovascular Toxicity in Children, Adolescents, and Young Adults Who Receive Cancer Therapy: Pathophysiology, Course, Monitoring, Management, Prevention, and Research Directions

Lipshultz¹,

Adams²,

Colan³

et al. 2013

Circulation

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492

436

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Section: Risky Health Behaviorsmentioning

confidence: 99%

Long-term Cardiovascular Toxicity in Children, Adolescents, and Young Adults Who Receive Cancer Therapy: Pathophysiology, Course, Monitoring, Management, Prevention, and Research Directions

Lipshultz¹,

Adams²,

Colan³

et al. 2013

Circulation

Self Cite

492

436

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“…15 After the survival of childhood cancer, the adoption of a healthy lifestyle including physical activity may lower especially the risk of developing late cardiovascular sequelae. 16 Thus, promoting the control of known cardiovascular risk factors, such as obesity, smoking, hypertension, diabetes, and lipid disorders is a crucial aspect of preventive strategies in the long-term follow-up of childhood cancer survivors. 17,18 Similar to childhood cancer survivors, YA cancer survivors have been found to be at high risk to die from malignant diseases followed by non-malignant causes of death such as circulatory and respiratory conditions.…”

mentioning

confidence: 99%

Late mortality among 5‐year survivors of early onset cancer: A population‐based register study

Kero

Järvelä

Arola

et al. 2014

Intl Journal of Cancer

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To date, only few studies have been published documenting late mortality among early onset cancer survivors, especially regarding young adulthood (YA) malignancies. Our nation-wide population-based registry study provides information concerning cause-specific long-term mortality among 16,769 5-year survivors of early onset cancer (aged 0-34 years at diagnosis), with follow-up for death extending from 1971 through 2012. A sibling cohort and population data were used as reference. The overall standardized mortality ratio (SMR) of cancer patients was 4.6-fold, (95% CI 4.4-4.8). Highest SMRs were found for malignancies (12.8,3), infectious (4.8, 95%CI 2.9-6.7) and cardiovascular diseases (1.9, 95% CI 1.7-2.1). Malignancies and cardiovascular diseases accounted for the largest number of deaths. Childhood and YA cancer survivors with the same primary cancer site had a similarly elevated overall SMR with the exception of markedly higher SMRs after childhood Hodgkin lymphoma. The highest cumulative non-malignancy-related mortality was due to cardiovascular disease with a steady rise throughout the follow-up, but strongly dependent on the primary cancer site and age at diagnosis. In childhood cancer survivors, the cumulative cardiovascular mortality did not reduce over time. However, overall and malignancyrelated mortality showed a declining tendency towards the most recent periods after both, childhood and YA cancer. Our findings on non-malignancy-related mortality stress the need to set up long-term individual follow-up with a focus on cardiovascular late effects for early onset cancer survivors, especially for YA cancer survivors still lacking those.Advances in therapies for early onset cancer have lead to a substantial increase in 5-year survival rates. 1-3 Thus far the main focus of late effect research has been on the morbidity and mortality of childhood cancer survivors aged up to 21 years at cancer diagnosis. [4][5][6][7][8][9] Only few studies have investigated those topics for the survivors of young adult (YA) cancer patients aged from 20 to 34 years at cancer diagnosis. [10][11][12] Previous studies have found elevated risks for chronic health conditions which contribute to higher mortality among survivors of childhood cancer patients compared to the general population. 5,9,13,14 Patterns of increased excess mortality after childhood cancer have been shown to be dependent on time from cancer diagnosis and cause of death. 4,7,11 The success of improved cancer survival is overshadowed by the life-threatening chronic health outcomes that cancer survivors are more likely to suffer from. Thus, the growing population of early onset cancer survivors has a strong need for adequate individualized follow-up to detect and possibly reduce treatment-related morbidities and mortality. 15 After the survival of childhood cancer, the adoption of a healthy lifestyle including physical activity may lower especially the risk of developing late cardiovascular sequelae. 16 Thus, promoting the control of known cardiovascular risk fa...

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“…In a study of 1607 pediatric brain tumor survivors who were compared with sibling controls, 4.6% of cases had one or more persistent motor problems following treatment, but with the greatest deficits occurring during treatment [57]. Motor deficits contribute to decreased physical activity among patients and survivors and as such should be considered when making therapy choices [58,59]. Specifically, platinum-based chemotherapeutic agents and vinca alkaloids are associated with peripheral neuropathy that can persist for years after treatment [60].…”

Section: Neurological Impairmentsmentioning

confidence: 99%

Clinical trials in pediatric neuro-oncology: what is missing and how we can improve

2016

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Brain tumors are the most common solid tumor in childhood, yet outcomes vary dramatically. High-grade gliomas have dismal outcomes with poor survival. By contrast, low-grade gliomas, have high survival rates, but children suffer from morbidity of tumor burden and therapy-associated side effects. In this article, we discuss how current trial designs often miss the opportunity to include end points beyond tumor response and thus fail to offer complete assessments of therapeutic approaches. Quality of life, neurocognitive function and neurofunctional deficits need to be considered when assessing overall success of a therapy. Herein, we identify specific end points that should be included in the interpretation of clinical trial results and accordingly, offer a more comprehensive approach to treatment decision-making. • As a whole, treatment for pediatric brain tumors has greatly improved survival; however, patients can suffer from a myriad of treatment-related morbidities.• In particular, pediatric patients with low-grade tumors frequently go on to survive their tumor, but carry substantial burden related to prior treatments.• Quality of life (QoL), decreased neurocognitive ability and neurofunctional impairments are notable concerns for long-term survivors of pediatric brain tumors and these domains should be assessed when determining treatment strategies.• Historically, clinical trials have not adequately assessed QoL, neurocognition and neurofunctioning. These parameters deserve more attention and should be included as primary or secondary end points of clinical trials.• The Pediatric Quality of Life scales have been validated in the pediatric population and can effectively assess QoL in pediatric brain tumor patients.• Validated neurocognitive assessments such as CogState and the NIH Toolbox can play an important role in the evaluation of neurocognition in pediatric brain tumor patients.• Long-term motor, vision and hearing impairments may occur as a result of tumor and treatment in pediatric brain tumor patients and should be included in pediatric brain tumor clinical trial outcomes. BackgroundIn the USA, the number of adult survivors of pediatric brain tumors has been steadily increasing over recent years. The average 5-year survival rate for all-comers of pediatric brain cancers has risen to approximately 73% [1]. However, there is a broad range of survivorship depending on tumor type. Pure germinomas and pilocytic astrocytomas have 5-year survival rates greater than 90%; however, for diffuse intrinsic pontine glioma and other high-grade gliomas, outcomes remain extremely poor [2][3][4][5]. The main clinical trial objective for brain tumors with poor prognoses is to improve survival; however, quality of life (QoL) remains an important aspect for these children -especially if median survival is relatively short. Though, the current article is not focusing on explicit recommendations for highly aggressive tumors, QoL measures should still be addressed in trials for this group given the conceivably higher impor...

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Predictors of inactive lifestyle among adult survivors of childhood cancer

Cited by 196 publications

References 47 publications

Long-term Cardiovascular Toxicity in Children, Adolescents, and Young Adults Who Receive Cancer Therapy: Pathophysiology, Course, Monitoring, Management, Prevention, and Research Directions

Long-term Cardiovascular Toxicity in Children, Adolescents, and Young Adults Who Receive Cancer Therapy: Pathophysiology, Course, Monitoring, Management, Prevention, and Research Directions

Late mortality among 5‐year survivors of early onset cancer: A population‐based register study

Clinical trials in pediatric neuro-oncology: what is missing and how we can improve

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