Trends in survival after childhood cancer in Denmark, 1943–1987

Brown, Phyllida; Olsen, Jørn; Hertz, H; Bendixen, Charlotte; Bautz, Andrea

doi:10.1016/0959-8049(94)90711-0

Cited by 3 publications

(9 citation statements)

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“…Increased understanding of cancer biology, improved surgical techniques and intensified risk group‐adapted chemotherapy have led to 5‐year overall survival rates above 80% in childhood cancer (Brown, Olsen, Hertz, Carstensen, & Bautz, ; Gatta et al, ; Smith et al, ). However, this improvement comes at a cost.…”

Section: Introductionmentioning

confidence: 99%

“…This negatively impacts the children's health‐related quality of life (DuHamel, Redd, & Vickberg, ; Gurney et al, ; Mitby et al, ). Moreover, their physical fitness levels diminish due to the sedentary lifestyles imposed by the treatment and lack of physical activity (Braam et al, ; Brown et al, ; Oeffinger et al, ). A long‐term decline in physical fitness can lead to metabolic disease (Jones et al, ; Oeffinger et al, ); however, this can be moderated by physical activity (Oeffinger et al, ; Tai et al, ).…”

Section: Introductionmentioning

confidence: 99%

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Classmates motivate childhood cancer patients to participate in physical activity during treatment: A qualitative study

et al. 2019

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Introduction Children with cancer experience reduced physical fitness and compromised social relationships during and following intensive treatment. This may negatively impact their quality of life. As part of the RESPECT study, we explored the motivations for participation in a physical activity programme during treatment. Methods Thirteen semi‐structured interviews were conducted with seven boys and six girls, diagnosed with paediatric cancer in 2013 and treated with chemotherapy (age 8–16 years; time from diagnosis to interview 6–16 months). Interviews were conducted in the children's homes. Results The qualitative analysis showed that children's motivations for engaging in the physical activity programme during intensive medical treatment were primarily influenced by (a) opportunity for physical activity with a classmate; (b) participation in group physical activity sessions; (c) support from significant others; and (d) improvement of physical well‐being. Main barriers included (a) poor physical well‐being; (b) compliance with medical procedures and being treated in protective isolation; and (c) limited physical activity facilities. Conclusion Despite barriers, it is possible to motivate and engage children with cancer in physical activity during intensive treatment in a paediatric oncology ward. Physical exercise and activity should be recommended and promoted from diagnosis throughout the treatment period and should include psychosocial and professional support.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Classmates motivate childhood cancer patients to participate in physical activity during treatment: A qualitative study

et al. 2019

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“…[1][2][3] However, this improvement comes at a cost. The combination of intensive treatment, severe side effects and isolation regimens, as well as immunosuppression and a treatmentrelated sedentary lifestyle, compromises the activity level of the children.…”

Section: Introductionmentioning

confidence: 99%

Cardiorespiratory fitness and physical function in children with cancer from diagnosis throughout treatment

Thorsteinsson

Larsen

Schmiegelow

et al. 2017

BMJ Open Sport Exerc Med

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BackgroundChildren with cancer experience severe reductions in physical fitness and functionality during and following intensive treatment. This may negatively impact their quality of life.PurposeTo describe the physical capacity and functionality of children with cancer during and after treatment as well as the feasibility of physical activity intervention in the Rehabilitation including Social and Physical activity and Education in Children and Teenagers with Cancer study.Patients and methodsThe study included children diagnosed from January 2013 to April 2016 with paediatric cancer or Langerhans cell histiocytosis, all treated with chemotherapy. Seventy-five of 78 consecutively eligible children (96.2%) were included. Median age was 11 years (range 6‒18). The physical capacity and function were assessed based on testing of physical strength, balance and cardiorespiratory fitness. Children were tested at diagnosis, 3 and 6 months after diagnosis and 1 year after cessation of treatment. The feasibility evaluation was inspired by the criteria for reporting the development and evaluation of complex interventions in healthcare.ResultsAll children participated in the physical intervention programme with no dropouts. Strenuous physical exercise and physiological testing during paediatric cancer treatment was safe and feasible, with only five minor adverse events during the intervention. Cardiorespiratory fitness was significantly lower in children with cancer than norms for healthy age-matched children at diagnosis (difference 19.1 mL/kg/min, 95% CI 15.4 to 22.7; p <0.0001), during treatment 3 and 6 months from diagnosis (difference 21.0 mL/kg/min, 95% CI 17.4 to 24.6; p <0.0001 and difference 21.6 mL/kg/min, 95% CI 17.3 to 25.8; p <0.0001, respectively) and 1 year after cessation of treatment (difference 6.9 mL/kg/min, 95% CI 1.1 to 12.7; p <0.0072). Furthermore, children with cancer experienced a pronounced decline in physical function.ConclusionThis study shows that it is safe and feasible to perform strenuous physical exercise and testing during paediatric cancer treatment and that children with cancer have significantly lower physical capacity and functionality than healthy age-matched norms.Trial registration numberClinicalTrials.gov: NCT01772862.

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“…Each year 200 children and adolescents in Denmark are diagnosed with cancer. Over recent decades the increased understanding of cancer biology, improved surgery and chemotherapy, and generally intensified treatment, have resulted in 5-year survival rates above 80% [ 1 - 3 ]. However, the disadvantages of this improvement include severe acute and late effects [ 2 - 4 ], often involving isolation for long periods of time, both when in hospital and at home.…”

Section: Introductionmentioning

confidence: 99%

“…However, the disadvantages of this improvement include severe acute and late effects [ 2 - 4 ], often involving isolation for long periods of time, both when in hospital and at home. This isolation reduces participation in activities with peers at school and in sporting activities [ 1 , 5 , 6 ]. As a result, important social interactions and the natural development of social skills with classmates are disrupted [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Study protocol: rehabilitation including social and physical activity and education in children and teenagers with cancer (RESPECT)

et al. 2013

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BackgroundDuring cancer treatment children have reduced contact with their social network of friends, and have limited participation in education, sports, and leisure activities. During and following cancer treatment, children describe school related problems, reduced physical fitness, and problems related to interaction with peers.Methods/designThe RESPECT study is a nationwide population-based prospective, controlled, mixed-methods intervention study looking at children aged 6-18 years newly diagnosed with cancer in eastern Denmark (n = 120) and a matched control group in western Denmark (n = 120). RESPECT includes Danish-speaking children diagnosed with cancer and treated at pediatric oncology units in Denmark. Primary endpoints are the level of educational achievement one year after the cessation of first-line cancer therapy, and the value of VO2max one year after the cessation of first-line cancer therapy. Secondary endpoints are quality of life measured by validated questionnaires and interviews, and physical performance. RESPECT includes a multimodal intervention program, including ambassador-facilitated educational, physical, and social interventions. The educational intervention includes an educational program aimed at the child with cancer, the child’s schoolteachers and classmates, and the child’s parents. Children with cancer will each have two ambassadors assigned from their class. The ambassadors visit the child with cancer at the hospital at alternating 2-week intervals and participate in the intervention program. The physical and social intervention examines the effect of early, structured, individualized, and continuous physical activity from diagnosis throughout the treatment period. The patients are tested at diagnosis, at 3 and 6 months after diagnosis, and one year after the cessation of treatment. The study is powered to quantify the impact of the combined educational, physical, and social intervention programs.DiscussionRESPECT is the first population-based study to examine the effect of early rehabilitation for children with cancer, and to use healthy classmates as ambassadors to facilitate the normalization of social life in the hospital. For children with cancer, RESPECT contributes to expanding knowledge on rehabilitation that can also facilitate rehabilitation of other children undergoing hospitalization for long-term illness.Trial registrationClinical Trials.gov: file. NCT01772849 and NCT01772862

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Trends in survival after childhood cancer in Denmark, 1943–1987

Cited by 3 publications

References 0 publications

Classmates motivate childhood cancer patients to participate in physical activity during treatment: A qualitative study

Classmates motivate childhood cancer patients to participate in physical activity during treatment: A qualitative study

Cardiorespiratory fitness and physical function in children with cancer from diagnosis throughout treatment

Study protocol: rehabilitation including social and physical activity and education in children and teenagers with cancer (RESPECT)

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