Effects of Energy Conservation Strategies on Cancer Related Fatigue and Health Promotion Lifestyle in Breast Cancer Survivors: a Randomized Control Trial

Sadeghi, Elham,Gozali, Nahid,Tabrizi, Fatemeh Moghaddam Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.10

Purpose: Cancer-related fatigue is frequently experienced by patients during and after therapy. The present study was conducted to assess the impact of energy conservation strategies and health promotion in breast cancer survivors. Methods: A randomized controlled trial was carried out to compare the intervention effect (n=69.0) with controls (n=66.0) based on routine oncology ward care. The intervention was five weekly sessions for groups of 6-8 breast cancer survivors. Data on fatigue and health promotion lifestyle were obtained before and after completion the intervention and then 8 weeks later for analysis of variance (ANOVA) with repeated measures. Results: Our findings showed cancer-related fatigue to be reduced in the intervention group from pre- to post-intervention, and this persisted over the 8-weeks follow-up period (F = 69.8, p<0.001). All subscales of the cancer fatigue scale demonstrated statistically significant effects with partial eta-squared values ranging from 0.15 (the smallest effect in cognitive fatigue) to 0.21 (the largest for affective fatigue). Changes in the health promotion life style indicated a significant promotion from pre- to post-intervention, and this again continued after 8-weeks follow-up (F = 41.6, p < 0.001). All six domains of a health promoting life style featured significantly elevated values, the largest effect being seen in the interpersonal relations subscale (F=57.7, partial ${\eta}^2=0.21$, p<0.001) followed by physical activity (F=51.9, partial ${\eta}^2=0.18$, p<0.001). Conclusions: The program was effective in decreasing cancer related fatigue and promoting a healthy lifestyle.

Depression, Rather Than Cancer-Related Fatigue or Insomnia, Decreased the Quality of Life of Cancer Patients

여성욱,이주희,김규민,김화정,정석훈 대한암학회 2021 Cancer Research and Treatment Vol.53 No.3

Purpose Cancer-related fatigue is a common and distressing symptom that occurs during cancer treatment. This study aimed to find factors that are related to cancer-related fatigue, and its effect on patients’ quality of life. Materials and Methods This study included 159 patients who completed questionnaires and interviews during their initial examination at the sleep clinic for cancer patients, Asan Medical Center, between December 2018 and January 2020. Their medical reports were reviewed retrospectively. Questionnaire data about depression, anxiety, insomnia, fear of disease progression, and dysfunctional beliefs about sleep, pain, and quality of life, were reviewed. Additionally, patient sleep structure data were analyzed. Results Factors such as depression (p < 0.001), anxiety (p < 0.001), fear of cancer progression (p < 0.001), fatigue (p=0.027), and time in bed during 24 hours (p=0.037) were significant expecting variables for low quality of life from logistic regression analysis. In pathway analysis, depression (p < 0.001), not cancer-related fatigue (p=0.537), act as a direct risk factor on quality of life. And also, depression was an overall risk factor for insomnia, fatigue, and daily activity of cancer patients. Conclusion Cancer-related fatigue did not show significant effect on patient’s quality of life in this study. However, the result of pathway analysis highlights the importance of assessing depression in the process of cancer treatment and providing appropriate interventions.

8주간 복합운동프로그램이 혈액암 환자의 신체조성, 체력, CBC, 암 관련 피로도 및 균형능력에 미치는 영향

조광석,지무엽,오재근 한국웰니스학회 2017 한국웰니스학회지 Vol.12 No.4

본 연구는 8주간 복합운동프로그램 실시가 혈액 암 환자들의 신체조성과 체력, 혈액세포 수, 암 관련 피로도 및 균형능력 변화에 미치는 영향을 알아보기 위해 실시하였다. 본 연구의 대상자들은 혈액 암 진단을 받고 항암화학요법으로 치료를 종료하였거나, 조혈모세포이식술을 시행한 환자 19명을 대상으로 선정하여 신체조성(체중, 제지방량, 체질량지수, 체지방률), 체력은 근력(악력, 등속성근력), 유연성(좌전굴. 어깨유연성), 심폐지구력(6분 걷기검사), 균형능력(Biodex balance), 혈액변인(적혈구, 백혈구, 헤마토크릿, 헤모글로빈, 혈소판) 그리고 암 관련 피로도(Cancer related fatigue)를 설문지를 이용하여 측정하였다. 8주간 주2회의 복합운동을 적용한 결과 체지방률(p=.005), 등속성 하지근력(extensors: p<.001, flexors: p=.001), 어깨 유연성(p<.001), 좌전굴(p<.001), 심폐지구력(p<.001), 균형 감각(stage 6: p=.001, stage 9: p=.008, stage 12: p=.038) 유의한 차이가 나타났다. RBC(p=009), Hct(p<.001) 그리고 암 관련 피로도에서 유의한 차이가 나타났다(p=.012). 혈액암 환자의 복합운동 적용이 체지방 감소 및 체력 향상과 함께 암관련 피로의 감소를 나타냈다. The purpose of this study was to investigate the effects of 8 – weeks combined exercise program on body composition and physical fitness, complete blood counts, cancer-related fatigue and balance ability of blood cancer patients. The subjects of this study were selected from whom are diagnosed with blood cancer and treatment was terminated by chemotherapy or underwent stem cell transplantation. The selected 19 patients were measured body composition (body weight, fat mass, BMI, lean body fat percentage), physical fitness (muscle strength, isokinetic strength), flexibility (sit and reach, shoulder flexibility), cardiovascular endurance (6 minutes walking test), balance ability, CBC(RBC, WBC, Hct, Hb, Platelet) and, cancer-related fatigue was measured using questionnaires. The results of applying the combined exercise twice a week for 8 weeks are as follows. Lean body fat percentage (p=.005), isokinetic lower limb strength (extensors: p<.001, flexors: p=.001), shoulder flexibility (p<.001), sit and reach test (p<.001), cardiovascular endurance (p<.001), balance ability (stage 6: p=.001, stage 9: p =.008, stage 12: p=.038) showed significant differences. There were signifiant differences in RBC(p=.009), Hct(p<.001), and cancer-related fatigue(p=.012) was significantly decreased. This result has been shown that the application of combined exercise to patients with blood cancer reduced body fat, improved physical fitness and reduced cancer-related fatigue.

Effects of Acupressure on Fatigue in Patients with Cancer Who Underwent Chemotherapy

Atefeh Ghanbari Khanghah,Moloud Sharifi Rizi,Bahram Naderi Nabi,Masoumeh Adib,Ehsan Kazem Nejad Leili 사단법인약침학회 2019 Journal of Acupuncture & Meridian Studies Vol.12 No.4

Fatigue is the commonest symptom in cancer patients; despite high levels of clinically significant persistent cancer-related fatigue, few treatments are currently available. The aim of this study was to evaluate the efficacy of acupressure on fatigue in patients with cancer who underwent chemotherapy. The study was designed as a randomized and controlled trial. Ninety samples were selected using the convenience sampling method, and random block sampling was used for allocation of groups (30 for each group). The three groups were similar by age and gender. The experimental group underwent acupressure at the Zusanli (ST-36), Hegu (LI-4), and Sanyingjiao (SP-6), whereas sham pressure was used in the placebo group and no intervention was applied in the control group; the level of fatigue of participants in three groups was calculated in three phases, before, during, and after chemotherapy. Data were analyzed using SPSS, version 22. The results showed that the mean of visual analog score of fatigue is significantly different in three groups at the end of chemotherapy (p Z 0.021). The mean visual analog score of fatigue in the acupressure group was meaningfully lower than that in the control group after chemotherapy (p Z 0.028). Results of this investigation showed that acupressure has short-term effectiveness on the cancer-related fatigue of patients undergoing chemotherapy.

8주간 복합운동프로그램이 혈액암 환자의 신체조성, 체력, CBS, 암 관련 피로도 및 균형능력에 미치는 영향

조광석(Jo, Kwang-Seok),지무엽(Ji, Mu-Yeop),오재근(Oh, Jae-Keun) 한국웰니스학회 2017 한국웰니스학회지 Vol.12 No.4

본 연구는 주간 복합운동프로그램 실시가 혈액 암 환자들의 신체조성과 8 체력, 혈액세포 수, 암 관련 피로도 및 균형능력 변화에 미치는 영향을 알아보기 위해 실시하였다. 본 연구의 대상자들은 혈액 암 진단을 받고 항암화학요법으로 치료를 종료하였거나, 조혈모세포이식술을 시행한 환자 19명을 대상으로 선정하여 신체조성(체중, 제지방량, 체질량지수, 체지방률), 체력은 근력(악력, 등속성근력), 유연성(좌전굴. 어깨유연성), 심폐지구력(6분 걷기검사), 균형능력(Biodex balance), 혈액변인(적혈구, 백혈구, 헤마토크릿, 헤모글로빈, 혈소판) 그리고 암 관련 피로도(Cancer related fatigue)를 설문지를 이용하여 측정하였다. 8주간 주2회의 복합운동을 적용한 결과 체지방률(p=.005), 등속성 하지근력(extensors: p<.001, flexors: p=.001), 어깨 유연성(p<.001), 좌전굴(p<.001), 심폐지구력(p<.001), 균형 감각(stage 6: p=.001, stage 9: p=.008, stage 12: p=.038) 유의한 차이가 나타났다. RBC(p=009), Hct(p<.001) 그리고 암 관련 피로도에서 유의한 차이가 나타났다(p=.012). 혈액암 환자의 복합운동 적용이 체지방 감소 및 체력 향상과 함께 암관련 피로의 감소를 나타냈다. The purpose of this study was to investigate the effects of 8 – weeks combined exercise program on body composition and physical fitness, complete blood counts, cancer-related fatigue and balance ability of blood cancer patients. The subjects of this study were selected from whom are diagnosed with blood cancer and treatment was terminated by chemotherapy or underwent stem cell transplantation. The selected 19 patients were measured body composition (body weight, fat mass, BMI, lean body fat percentage), physical fitness (muscle strength, isokinetic strength), flexibility (sit and reach, shoulder flexibility), cardiovascular endurance (6 minutes walking test), balance ability, CBC(RBC, WBC, Hct, Hb, Platelet) and, cancer-related fatigue was measured using questionnaires. The results of applying the combined exercise twice a week for 8 weeks are as follows. Lean body fat percentage (p=.005), isokinetic lower limb strength (extensors: p<.001, flexors: p=.001), shoulder flexibility (p<.001), sit and reach test (p<.001), cardiovascular endurance (p<.001), balance ability (stage 6: p=.001, stage 9: p =.008, stage 12: p=.038) showed significant differences. There were signifiant differences in RBC(p=.009), Hct(p<.001), and cancer-related fatigue(p=.012) was significantly decreased. This result has been shown that the application of combined exercise to patients with blood cancer reduced body fat, improved physical fitness and reduced cancer-related fatigue.

Longitudinal Study of Cancer-Related Fatigue in Patients with Colorectal Cancer

Li, Shu-Xia,Liu, Bei-Bei,Lu, Jian-Hua Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.7

Background: Dynamic changes of cancer-related fatigue (CRF) among hospitalized patients with colorectal cancer were determined. Materials and Methods: This longitudinal, descriptive study involved 96 hospitalized patients with colorectal cancer, all recruited from a tertiary general hospital in Guangzhou, China. Patients completed questionnaires three times to assess the degree of fatigue, and measurement points were within one week of admission, at 2 to 3 days after surgery and 3 weeks after surgery. Results: Significant differences among the three measurement points (p<0.01) were observed. The scores of fatigue in the second survey were the highest, followed by the third and first surveys. Colon cancer patient scores were higher than those of rectal cancer patients with a significant difference (p<0.05). Colorectal patients experienced different degrees of fatigue at different periods during hospitalization. Conclusions: This study highlights the importance of interventions that are carefully tailored to patients based on the characteristics at different periods to alleviate fatigue.

Cognitive Behavioral Therapy in Breast Cancer Patients - a Feasibility Study of an 8 Week Intervention for Tumor Associated Fatigue Treatment

Eichler, Christian,Pia, Multhaupt,Sibylle, Multhaupt,Sauerwald, Axel,Friedrich, Wolff,Warm, Mathias Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.3

Background: Tumor associated fatigue (TAF) or cancer related fatigue (CRF) is not a new concept. Nonetheless, no real headway has been made in the quantitative analysis of its successful treatment via cognitive behavioral therapy. Since 20 to 30% of all breast cancer patients suffer from anxiety and/or depression within the first year of their diagnosis, this issue needs to be addressed and a standard treatment protocol has to be developed. This study focused on developing a simple, reproducible and short (8 weeks) protocol for the cognitive behavioral therapy support of tumor associated fatigue patients. Materials and Methods: Between the year 2011 and 2012, 23 breast cancer patients fulfilled the diagnosis TAF requirements and were introduced into this study. Our method focused on a psycho-oncological support group using a predetermined, highly structured and reproducible, cognitive behavioral therapy treatment manual. Eight weekly, 90 minute sessions were conducted and patients were evaluated before and after this eight session block. Tumor fatigue specific questionnaires such as the multidimensional fatigue inventory (MFI) as well as the hospital anxiety and depression scale (HADS) were used in order to quantitatively evaluate patient TAF. Results: Of the 23 patients enrolled in the study, only 7 patients fulfilled the TAF diagnostic criteria after the psycho-oncological group treatment. This represents a 70% reduction in diagnosable tumor associated fatigue. The HADS analysis showed a 33% reduction in patient anxiety as well as a 57% reduction in patient depression levels. The MFI scores showed a significant reduction in 4 of the 5 evaluate categories. With the exception of the "mental fatigue" MFI category all results were statistically significant. Conclusions: This study showed that a highly structured, cognitive behavioral therapy group intervention will produce significant improvements in breast cancer patient tumor associated fatigue levels after only 8 weeks.

운동의 항암효과와 암 치료를 위한 보조요법으로서 운동처치

정일규(Il Gyu Jeong),오명진(Myung Jin Oh) 한국사회체육학회 2010 한국사회체육학회지 Vol.0 No.40

It has been reported that regular exercise has the effect to reduce the risk of cancer and exercise intervention help the cancer patient to be able to get through the hard treatment procedure. In this study, the author summarized the proposed mechanisms of anti-cancer and anti-fatigue effects of exercise and introduce the exercise intervention researches so for. For the proposed anti-cancer effect of exercise, three major mechanism have been suggested as follows. The first, exercise-induced reactive oxygen species(ROS) might cause the apoptosis of pre-stage of cancer cells. The second, ROS or pro-inflammatory cytokines like IL-1 and TNF-α which can be induced by exercise might activate the signaling pathway to promote the transcription of endogenous anti-oxidant enzymes such as SOD, CAT, GPX and HSP70 and in turn increase the protective capability of our body against various carcinogenic factors. The third, Regular exercise can increase the phase Ⅱ enzymes such as GST and UDP-GT associating with DNA repair system and also increase the activities of proteasome and OGG1 which have the role of eliminating the misfolding protein or oxidized base of DNA, respectively. It also has been reported that cancer-related fatigue(CRF) might be the most common and painful side effect of cancer itself and cancer treatment such as chemical and radiation therapy or transplantation surgery. The increase of pro-inflammatory cytokines during the cancer treatment has been suggested as the most plausible etiology of CRF. The anemia induced by the decreased function of erythropoiesis in red bone marrow and deregulation of HPA axis and the abnormal change of synaptic serotonin level in central nerve system might be caused by chronically increased pro-inflammatory cytokines. Many researches which have investigated the effects of exercise intervention for cancer patients and survivors suggested that exercise might be one of the most effective way to alleviate the cancer-related fatigue and prevent the change of body composition and the decrease of muscle mass and strength, cardiovascular function and improve the pain index and quality of life(QOL). Therefore we need to encourage the cancer specialist to use the exercise intervention for cancer treatment as the most evidence-based intervention and cooperate to improve the treatment effect and quality of life(QOL) of cancer patients and survivors.

Cancer-related Fatigue in Patients with Advanced Cancer Treated with Autonomic Nerve Pharmacopuncture

유화승,박지혜,전형준,강휘중,정인숙,조종관 사단법인약침학회 2015 Journal of Acupuncture & Meridian Studies Vol.8 No.3

The purpose of this study was to observe the effects of autonomic nerve pharmacopuncture (ANP) treatment on cancer-related fatigue (CRF) in patients with advanced cancer. This observational case study was conducted at the East West Cancer Center of Daejeon University's Dunsan Korean Medical Hospital. Two patients were observed. One patient was diagnosed with left thymic cancer metastatic to the left pleura. The other patient had terminal-stage cervical cancer with iliac bone and lumbar 5 metastases. We injected mountain ginseng pharmacopuncture (MGP) into acupoints alongside the spine (Hua-Tuo-Jia-Ji-Xue, EX B2). We examined the patients for CRF using the Korean version of the Revised Piper Fatigue Scale (RPFS-K), which is a self-assessment tool. The scores on the RPFS-K for both patients tended to decrease during the treatment. Laboratory findings, including hematological changes, were also checked. Liver and renal function tests showed that the treatment was safe. Although further large-population studies are necessary, this case study suggests that ANP has a favorable effect on CRF in patients with advanced cancer.

비진행성 암환자의 암성 피로에 대한 바나듐수의 효능 : 무작위배정 이중맹검 대조군 시험

정홍매(Hong-Mei Zheng),김동희(Dong-Hee Kim),이석훈(Suk-Hoon Lee),박유경(Yoo Kyoung Park),유화승(Hwa-Seung Yoo) 한국식품영양과학회 2010 한국식품영양과학회지 Vol.39 No.12

본 연구는 1일 1.5 L씩 4주간의 바나듐수 음용이 비진행성 암환자의 피로감 개선에 긍정적인 효과를 미치는 지 확인하기 위하여 수행되었다. 본 연구 결과 4주간의 바나듐수 음용은 비진행성 암환자의 피로감 개선을 위해 통계적으로 경계선상의 유의성을 보였으므로 향후에는 탐색형 연구로부터 확증형 연구를 통하여 피험자 수가 증가할 경우 통계학적으로 유의성을 보일 것이라고 예상되므로 근거 확보를 위한 진일보한 연구가 이루어져야 할 것이다. 즉 1일 1.5 L씩 4주간의 바나듐수 음용은 비진행성 암환자의 피로감 개선에 대해 유의수준 10%에서 통계적으로 유의한 차이가 나타났다. 이는 바나듐수가 암 환자의 피로에 도움이 되고 또한 참여자 수가 늘어날 경우 통계학적으로 유의성을 보일 것이라는 최소한의 근거를 보여주는 것이다. 향후에는 피험자수의 증가를 비롯하여 성별, 암종별 피험자수를 매치하고 피로감 개선을 포함한 기타 추가 기능에 대한 연구 수행을 기대할 수 있겠다. This study was conducted to evaluate the efficacy and safety of vanadium water (VW) on cancer-related fatigue of non-advanced cancer patients. For the experimental group administration, participants consumed three 500 mL/bottle bottles of Jeju Island’s VW, which contained 15~20 ppb of vanadium, three times a day (morning, afternoon, evening) for 4 weeks (28 days) without any additional treatments for fatigue improvement. The control group participants consumed three 500 mL/bottle bottles of ordinary water (0 ppb of vanadium) three times a day for the same period of time without any additional treatments for fatigue improvement. After 4 weeks of VW consumption, total score of Revised Piper Fatigue Scale (RPFS) was reduced 30% compared to the basal score after Fisher’s Exact Test which resulted in a statistical borderline significance (p=0.0799) and result of t-test of comparison between two groups’ RPFS total score and fatigue cognitive/mood changes resulted in a statistical significance (p=0.0112). In detail, only 36.4% of control group (N=11) showed improvement while 77.8% of treatment group (N=9) showed fatigue improvement. No other lab measures, including thyroid hormone level indicated any significant differences between two groups. In conclusion, daily consumption of 1.5 L of vanadium water for 4 weeks showed improvement of non-advanced cancer patients’ fatigue.