Rehabilitation in Advanced, Progressive, Recurrent Cancer: A Randomized Controlled Trial

Jones, Louise; Fitzgerald, G.; Leurent, Baptiste; Round, Jeff; Eades, Jane; Davis, Sarah; Gishen, Faye; Holman, Amanda; Hopkins, Katherine; Tookman, Adrian

doi:10.1016/j.jpainsymman.2012.08.017

Cited by 58 publications

(68 citation statements)

References 24 publications

(12 reference statements)

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“…A recent randomized clinical trial in patients at the end of treatment for advanced recurrent hematologic or breast cancer showed that a rehabilitation intervention delivered by a multidisciplinary team in combination with usual care was superior to usual care alone in reducing psychological, physical, and patient care needs and in improving the patient's self-reported health state 16 . The intervention was tailored to the patient and lasted approximately 3 months, but it was not clear which health professionals constituted the care team and which specific interventions they provided.…”

Section: Discussionmentioning

confidence: 99%

A Prospective Evaluation of an Interdisciplinary Nutrition–Rehabilitation Program for Patients with Advanced Cancer

et al. 2013

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Background: Cancer can affect many dimensions of a patient’s life, and in turn, it should be targeted using a multimodal approach. We tested the extent to which an interdisciplinary nutrition–rehabilitation program can improve the well-being of patients with advanced cancer. Methods: Between January 10, 2007, and September 29, 2010, 188 patients with advanced cancer enrolled in the 10–12-week program. Body weight, physical function, symptom severity, fatigue dimensions, distress level, coping ability, and overall quality of life were assessed at the start and end of the program. Results: Of the enrolled patients, 70% completed the program. Patients experienced strong improvements in the physical and activity dimensions of fatigue (effect sizes: 0.8–1.1). They also experienced moderate reductions in the severity of weakness, depression, nervousness, shortness of breath, and distress (effect sizes: 0.5–0.7), and moderate improvements in Six Minute Walk Test distance, maximal gait speed, coping ability, and quality of life (effect sizes: 0.5–0.7) Furthermore, 77% of patients either maintained or increased their body weight. Conclusions: Interdisciplinary nutrition–rehabilitation can be advantageous for patients with advanced cancer and should be considered an integrated part of standard palliative care.

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Section: Discussionmentioning

confidence: 99%

A Prospective Evaluation of an Interdisciplinary Nutrition–Rehabilitation Program for Patients with Advanced Cancer

et al. 2013

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“…Physical therapy and exercise have been shown to be a feasible modality for terminally ill patients [62], and patients who participated in a specific combination palliative rehabilitation program did show improvement in physical performance and symptom severity [63]. Rehabilitation services provided in a hospice day care unit for individuals with advanced, recurrent, or progressive breast or hematological malignancy also showed significant reduced need for health service resources along with corresponding improvement in QOL [64]. Furthermore, early integration of palliative care in the oncology care continuum may result in particularly meaningful healthcare cost reductions, as this approach improved both survival rates and QOL [65].…”

Section: Advancing Collaborative Interdisciplinary Care Coordinationmentioning

confidence: 99%

Cancer rehabilitation and palliative care: critical components in the delivery of high-quality oncology services

Silver

Raj

et al. 2015

Support Care Cancer

172

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Palliative care and rehabilitation practitioners are important collaborative referral sources for each other who can work together to improve the lives of cancer patients, survivors, and caregivers by improving both quality of care and quality of life. Cancer rehabilitation and palliative care involve the delivery of important but underutilized medical services to oncology patients by interdisciplinary teams. These subspecialties are similar in many respects, including their focus on improving cancer-related symptoms or cancer treatment-related side effects, improving health-related quality of life, lessening caregiver burden, and valuing patient-centered care and shared decision-making. They also aim to improve healthcare efficiencies and minimize costs by means such as reducing hospital lengths of stay and unanticipated readmissions. Although their goals are often aligned, different specialized skills and approaches are used in the delivery of care. For example, while each specialty prioritizes goal-concordant care through identification of patient and family preferences and values, palliative care teams typically focus extensively on using patient and family communication to determine their goals of care, while also tending to comfort issues such as symptom management and spiritual concerns. Rehabilitation clinicians may tend to focus more specifically on functional issues such as identifying and treating deficits in physical, psychological, or cognitive impairments and any resulting disability and negative impact on quality of life. Additionally, although palliative care and rehabilitation practitioners are trained to diagnose and treat medically complex patients, rehabilitation clinicians also treat many patients with a single impairment and a low symptom burden. In these cases, the goal is often cure of the underlying neurologic or musculoskeletal condition. This report defines and describes cancer rehabilitation and palliative care, delineates their respective roles in comprehensive oncology care, and highlights how these services can contribute complementary components of essential quality care. An understanding of how cancer rehabilitation and palliative care are aligned in goal setting, but distinct in approach may help facilitate earlier integration of both into the oncology care continuum-supporting efforts to improve physical, psychological, cognitive, functional, and quality of life outcomes in patients and survivors.

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“…34 Another trial shows that rehabilitation in a hospice day care unit reduced the unmet needs for psychological support for patients with advanced, recurrent, or progressive cancer. 35 Future intervention studies are needed to investigate the most optimal means to improve care for patients with recurrent cancer and to overcome barriers to integration of palliative care. 36,37 In contrast to earlier studies and to our hypothesis, our study indicated that having a recurrence does not change overall satisfaction with information provision.…”

Section: Discussionmentioning

confidence: 99%

Recurrent Cancer Is Associated With Dissatisfaction With Care—A Longitudinal Analysis Among Ovarian and Endometrial Cancer Patients

Rooij

Ikiz

Boll

et al. 2018

Int J Gynecol Cancer

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Rehabilitation in Advanced, Progressive, Recurrent Cancer: A Randomized Controlled Trial

Abstract: This intervention significantly reduced the unmet needs of cancer survivors and it is likely that it is cost-effective. Despite small numbers, the main effect size was robust. We recommend implementation alongside evaluation in wider clinical settings and patient populations.

Cited by 58 publications

References 24 publications

A Prospective Evaluation of an Interdisciplinary Nutrition–Rehabilitation Program for Patients with Advanced Cancer

A Prospective Evaluation of an Interdisciplinary Nutrition–Rehabilitation Program for Patients with Advanced Cancer

Cancer rehabilitation and palliative care: critical components in the delivery of high-quality oncology services

Recurrent Cancer Is Associated With Dissatisfaction With Care—A Longitudinal Analysis Among Ovarian and Endometrial Cancer Patients

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