A randomized controlled trial of a multiple health behavior change intervention delivered to colorectal cancer survivors: effects on sedentary behavior.

Background: Sedentary behavior may independently contribute to morbidity and mortality among survivors of colorectal cancer. In the current study, the authors assessed whether a telephone-delivered multiple health behavior change intervention had an effect on the sedentary behavior of recently diagnosed colorectal cancer survivors.

Methods: A total of 410 participants were recruited through the Queensland Cancer Registry and randomized to the health coaching (intervention) or usual-care (control) group.

Correlates of resistance training in post-treatment breast cancer survivors.

Purpose: To explore demographic, health, social-cognitive and behavioural correlates of resistance training among post-treatment breast cancer survivors.

Methods: A sample of 330 post-treatment breast cancer survivors recruited from across Australia completed a mailed questionnaire. A multivariate logistical regression model was used to test associations between independent variables and meeting the resistance training guidelines.

Effects of a multiple health behavior change intervention for colorectal cancer survivors on psychosocial outcomes and quality of life: a randomized controlled trial.

Background: Multiple health behavior change can ameliorate adverse effects of cancer.

Purpose: The purpose of this study was to determine the effects of a multiple health behavior change intervention (CanChange) for colorectal cancer survivors on psychosocial outcomes and quality of life.

Methods: A total of 410 colorectal cancer survivors were randomized to a 6-month telephone-based health coaching intervention (11 sessions using acceptance and commitment therapy strategies focusing on physical activity, weight management, diet, alcohol, and smoking) or usual care.

Randomized controlled trial to evaluate the effects of combined progressive exercise on metabolic syndrome in breast cancer survivors: rationale, design, and methods.

Background: Metabolic syndrome (MetS) is increasingly present in breast cancer survivors, possibly worsened by cancer-related treatments, such as chemotherapy. MetS greatly increases risk of cardiovascular disease and diabetes, co-morbidities that could impair the survivorship experience, and possibly lead to cancer recurrence. Exercise has been shown to positively influence quality of life (QOL), physical function, muscular strength and endurance, reduce fatigue, and improve emotional well-being; however, the impact on MetS components (visceral adiposity, hyperglycemia, low serum high-density lipoprotein cholesterol, hypertriglyceridemia, and hypertension) remains largely unknown.

Effects of exercise during adjuvant chemotherapy on breast cancer outcomes.

Unlabelled: Observational studies suggest that physical activity after a breast cancer diagnosis is associated with improved cancer outcomes; however, no randomized data are available. Here, we report an exploratory follow-up of cancer outcomes from the Supervised Trial of Aerobic versus Resistance Training (START).

Methods: The START was a Canadian multicenter trial that randomized 242 breast cancer patients between 2003 and 2005 to usual care (n = 82), supervised aerobic (n = 78), or resistance (n = 82) exercise during chemotherapy.

Associations between objectively measured physical activity and quality of life in cancer patients with brain metastases.

Context: Physical activity has demonstrated benefits for quality of life (QoL) and cancer-related fatigue earlier in the cancer trajectory; however, less is known regarding its role in patients with end-stage cancer.

Objectives: The primary aim of this study was to examine the association between objectively measured physical activity and QoL in cancer patients with brain metastases.

Methods: Patients diagnosed with brain metastases, aged 18 years or older, cognitively intact, and with Palliative Performance Scale scores greater than 30%, were recruited from a multidisciplinary brain metastases clinic.

A multicenter randomized trial of the effects of exercise dose and type on psychosocial distress in breast cancer patients undergoing chemotherapy.

Background: Exercise may improve psychosocial distress in patients with cancer; however, few studies have examined the effects of different types or doses of exercise, or whether exercise effects are related to baseline depression levels.

Methods: In a multicenter trial in Canada, we randomized 301 patients with breast cancer initiating chemotherapy to thrice weekly, supervised exercise consisting of either a standard dose of 25 to 30 minutes of aerobic exercise (STAN; n = 96), a higher dose of 50 to 60 minutes of aerobic exercise (HIGH; n = 101), or a combined dose of 50 to 60 minutes of aerobic and resistance exercise (COMB; n = 104). The primary endpoint was depression assessed by the Center for Epidemiological Studies-Depression scale at baseline, twice during chemotherapy, and postchemotherapy.

Effects of exercise dose and type on sleep quality in breast cancer patients receiving chemotherapy: a multicenter randomized trial.

To examine the effects of different doses and types of exercise on sleep quality in breast cancer patients receiving chemotherapy. A multicenter trial in Canada randomized 301 breast cancer patients between 2008 and 2011 to thrice weekly, supervised exercise during chemotherapy consisting of either a standard dose of 25-30 min of aerobic exercise (STAN; n = 96), a higher dose of 50-60 min of aerobic exercise (HIGH; n = 101), or a combined dose of 50-60 min of aerobic and resistance exercise (COMB; n = 104). The secondary sleep outcomes in the trial were assessed by the Pittsburgh Sleep Quality Index (PSQI) at baseline, twice during chemotherapy, and postchemotherapy.

Physical activity and cancer survivorship: a simple framework for a complex field.

For the field of physical activity (PA) and cancer survivorship to flourish, researchers must demonstrate compelling links between cancer variables and PA. In this article, I propose a simple framework that highlights four major propositions that largely define the field of PA and cancer survivorship. I also provide examples of my own research that have tested each of these propositions.

Testing the utility of three social-cognitive models for predicting objective and self-report physical activity in adults with type 2 diabetes.

Objective: Theory-based interventions to promote physical activity (PA) are more effective than atheoretical approaches; however, the comparative utility of theoretical models is rarely tested in longitudinal designs with multiple time points. Further, there is limited research that has simultaneously tested social-cognitive models with self-report and objective PA measures. The primary aim of this study was to test the predictive ability of three theoretical models (social cognitive theory, theory of planned behaviour, and protection motivation theory) in explaining PA behaviour.

A comparison of physical activity correlates across breast, prostate and colorectal cancer survivors in Nova Scotia, Canada.

Purpose: The purpose of this study was to compare the medical, demographic and social cognitive correlates of physical activity (PA) in breast (BCS), prostate (PCS) and colorectal (CRCS) cancer survivors.

Methods: A stratified random sample of 2062 BC, PC and CRC survivors diagnosed between 2003 and 2011 was identified by the Nova Scotia Cancer Registry (NSCR) and mailed a questionnaire assessing PA, social-cognitive constructs from the theory of planned behaviour (TPB), and demographic and medical variables. Structural equation modelling was used to conduct path analyses of the TPB within each cancer survivor group and an invariance analysis was used to compare the TPB across groups.

Feasibility and preliminary efficacy of adding behavioral counseling to supervised physical activity in kidney cancer survivors: a randomized controlled trial.

Background: Supervised physical activity (PA) improves short-term health outcomes in cancer survivors, but longer-term adherence is rarely achieved.

Objective: The aim of this study was to evaluate the feasibility and preliminary efficacy of adding behavioral counseling to supervised PA in kidney cancer survivors (KCSs).

Methods: Thirty-two KCSs were randomized to a 4-week supervised PA program plus standard exercise counseling (SPA + EC group; n = 16) or a 4-week supervised PA plus behavioral counseling based on the Theory of Planned Behavior (SPA + BC group; n = 16).

Biobehavioral factors mediate exercise effects on fatigue in breast cancer survivors.

Purpose: This study aimed to examine mediators of fatigue response to an exercise intervention for breast cancer survivors in a pilot randomized controlled trial.

Methods: Postmenopausal breast cancer survivors (n = 46; ≤stage 2), off primary treatment, and reporting fatigue and/or sleep dysfunction were randomized to a 3-month exercise intervention (160 min·wk of moderate-intensity aerobic walking, twice weekly resistance training with resistance bands) or control group. Six discussion group sessions provided behavioral support to improve adherence.

Effects of exercise dose and type during breast cancer chemotherapy: multicenter randomized trial.

Background: Exercise improves physical functioning and symptom management during breast cancer chemotherapy, but the effects of different doses and types of exercise are unknown.

Methods: A multicenter trial in Canada randomized 301 breast cancer patients to thrice-weekly supervised exercise during chemotherapy consisting of either a standard dose of 25 to 30 minutes of aerobic exercise (STAN; n = 96), a higher dose of 50 to 60 minutes of aerobic exercise (HIGH; n = 101), or a combined dose of 50 to 60 minutes of aerobic and resistance exercise (COMB; n = 104). The primary endpoint was physical functioning assessed by the Medical Outcomes Survey-Short Form (SF)-36.

African-American breast cancer survivors' preferences for various types of physical activity interventions: a Sisters Network Inc. web-based survey.

Background: Needs assessments are essential to developing lifestyle interventions for minority populations. To our knowledge, no physical activity (PA) needs assessment studies have been conducted for African-American (AA) breast cancer survivors. The purpose of this study was to determine the PA intervention preferences of AA breast cancer survivors and determine whether these preferences differ according to medical and sociodemographic factors.

Predicting OptimaL cAncer RehabIlitation and Supportive care (POLARIS): rationale and design for meta-analyses of individual patient data of randomized controlled trials that evaluate the effect of physical activity and psychosocial interventions on health-related quality of life in cancer survivors.

Background: Effective interventions to improve quality of life of cancer survivors are essential. Numerous randomized controlled trials have evaluated the effects of physical activity or psychosocial interventions on health-related quality of life of cancer survivors, with generally small sample sizes and modest effects. Better targeted interventions may result in larger effects.

Longitudinal changes in IGF-I and IGFBP-3, and mammographic density among postmenopausal women.

A relation between the breast cancer risk factors, insulin-like growth factor-I (IGF-I) and mammographic density, is biologically plausible, but results from cross-sectional epidemiologic studies have been mixed. Our objective was to examine the relation in a longitudinal manner, that is, between the change in circulating IGF-I concentrations and the change in mammographic measures over one year. Data from an exercise intervention trial conducted in 302 postmenopausal women ages 50 to 74 years were used.

Case-control study of lifetime alcohol consumption and endometrial cancer risk.

Purpose: Alcohol consumption is hypothesized to increase the risk of endometrial cancer by increasing circulating estrogen levels. This study sought to investigate the association between lifetime alcohol consumption and endometrial cancer risk.

Methods: We recruited 514 incident endometrial cancer cases and 962 frequency age-matched controls in this population-based case-control study in Alberta, Canada, from 2002 to 2006.

Patient satisfaction with participation in a randomized exercise trial: effects of randomization and a usual care posttrial exercise program.

Background: Participation in an exercise trial is a major commitment for cancer survivors, but few exercise trials have evaluated patient satisfaction with trial participation.

Purpose: To examine patient satisfaction with participation in the Healthy Exercise for Lymphoma Patients (HELP) Trial and to explore possible determinants.

Methods: The HELP Trial randomized 122 lymphoma patients to 12 weeks of supervised aerobic exercise training (AET; n = 60) or to usual care (UC; n = 62), with the option of participating in a 4-week posttrial exercise program.

Perceived benefits and barriers to exercise for recently treated patients with multiple myeloma: a qualitative study.

Background: Understanding the physical activity experiences of patients with multiple myeloma (MM) is essential to inform the development of evidence-based interventions and to quantify the benefits of physical activity. The aim of this study was to gain an in-depth understanding of the physical activity experiences and perceived benefits and barriers to physical activity for patients with MM.

Methods: This was a qualitative study that used a grounded theory approach.

Randomized controlled trial of a behavior change intervention to increase physical activity and quality of life in prostate cancer survivors.

Background: Physical activity improves health in prostate cancer survivors; however, participation rates are low.

Purpose: This study aims to determine the effects of an implementation intention intervention on physical activity and quality of life in prostate cancer survivors.

Methods: Prostate cancer survivors (N = 423) were randomly assigned to a standard physical activity recommendation, a self-administered implementation intention, or a telephone-assisted implementation intention.

Feasibility and efficacy of a supervised exercise intervention in de-conditioned cancer survivors during the early survivorship phase: the PEACH trial.

Purpose: This study aims to evaluate the feasibility and efficacy of an 8-week supervised exercise program in de-conditioned cancer survivors within 2-6 months of chemotherapy completion.

Methods: Participants were randomly assigned to an 8-week, twice-weekly, supervised aerobic exercise training regime (n = 23) or a usual care group (n = 20). Feasibility was assessed by recruitment rate, program adherence and participant feedback.

Type I and II endometrial cancers: have they different risk factors?

Purpose: Endometrial cancers have long been divided into estrogen-dependent type I and the less common clinically aggressive estrogen-independent type II. Little is known about risk factors for type II tumors because most studies lack sufficient cases to study these much less common tumors separately. We examined whether so-called classical endometrial cancer risk factors also influence the risk of type II tumors.

Case-control study of inflammatory markers and the risk of endometrial cancer.

Chronic inflammation may be important in endometrial cancer etiology. Several established endometrial cancer risk factors, particularly obesity, are hypothesized to operate through this pathway by increasing proinflammatory cytokines such as tumor necrosis factor α (TNF-α), interleukin-6 (IL-6), and acute-phase protein C-reactive protein (CRP). This study sought to investigate the association between inflammatory markers and the risk of endometrial cancer (types I and II).

Effects of a telephone-delivered multiple health behavior change intervention (CanChange) on health and behavioral outcomes in survivors of colorectal cancer: a randomized controlled trial.

Purpose: Colorectal cancer survivors are at risk for poor health outcomes because of unhealthy lifestyles, but few studies have developed translatable health behavior change interventions. This study aimed to determine the effects of a telephone-delivered multiple health behavior change intervention (CanChange) on health and behavioral outcomes among colorectal cancer survivors.

Methods: In this two-group randomized controlled trial, 410 colorectal cancer survivors were randomly assigned to the health coaching intervention (11 theory-based telephone-delivered health coaching sessions delivered over 6 months focusing on physical activity, weight management, dietary habits, alcohol, and smoking) or usual care.