Survivorship issues in older breast cancer survivors.

PURPOSE: Almost half of breast cancer survivors are aged ≥ 65 years and the proportion is likely to increase due to the aging of the population. The objectives of this article were to review studies of health outcomes among older breast cancer survivors ≥ 65 years to identify gaps in the published literature and offer suggestions for future research. METHODS: The present review is based upon bibliographic searches in PubMed and CINAHL and relevant search terms. Articles published in English from January 1, 1970 through October 1, 2018 were identified using the following MeSH search terms and Boolean algebra commands. RESULTS: This review has revealed that older breast cancer survivors cope with health issues related to cancer treatment and the aging process, including comorbidities, osteoporosis, symptoms, physical functioning, cognitive functioning, nutrition, and physical activity. CONCLUSIONS: Additional research is needed to examine therapeutic interventions to address the health conditions older breast cancer survivors are coping with. Particular focus of further research should be on the nutritional status and physical activity levels of older breast cancer survivors. Individualized nutrition plans and tailored physical activity programs for older survivors are needed that meet people where they are and that form habits.

Advancing Uterine Cancer Survivorship Among African American Women.

BACKGROUND: Few studies have examined health behavior interventions for African American women who are uterine cancer survivors. Black-white differences in uterine cancer survival suggest that there are unmet needs among these survivors. METHODS: This article identifies opportunities to address disparities in uterine corpus cancer survival and quality of life, and thereby to increase uterine cancer survivorship among African American women. RESULTS: For cancer survivors, common side effects, lasting for long periods after cancer treatment, include fatigue, loss of strength, lymphedema, and difficulty sleeping. A variety of interventions have been evaluated to address physical and mental health concerns, including exercise and dietary interventions. Considerable information exists about the effectiveness of such interventions for alleviating distress and improving quality of life among cancer survivors, but few studies have focused specifically on African American women with a uterine corpus cancer diagnosis. Research-tested culturally tailored lifestyle interventions are lacking. CONCLUSIONS: There is a need for a better understanding of uterine cancer survivorship among African American women. Additional evaluations of interventions for improving the quality of life and survival of African American uterine cancer survivors are needed.

Diet quality of adults using intuitive eating for weight loss - pilot study.

As the incidence of obesity and related disease steadily increases, researchers and medical practitioners are continuously examining new approaches to prevent and manage the epidemic. Intuitive eating (IE) is a new and innovative approach that uses an individual's response to internal cues of hunger, satiety, and appetite, and replaces calorie restriction (CR). CR is the standard approach for weight reduction. This study was a randomized controlled trial with two groups in which we accessed records of the dietary intake of obese adults using CR and IE to achieve weight loss. The participants were sedentary obese individuals with no history of chronic diseases. They engaged in physical activity three times per week for 30 min and recorded their daily food intake in a food diary. Instructions were given for CR and IE at the start and midpoint of the study. The duration of the study was six weeks. Weight and waist circumference were measured, and body mass index (BMI) calculated. The CR group's total weight loss was significantly (p = 0.03) lower than that of the IE group. The CR group had consistent weight loss throughout the study, while the IE group's weight loss was significantly less at the endpoint compared to the midpoint. CR is a superior approach to weight management than IE.

Assessing the effectiveness of intuitive eating for weight loss - pilot study.

The obesity epidemic is widely recognized as a major public health issue resulting in chronic diseases. Calorie restriction (CR) is frequently used for most weight loss programs. The intuitive eating (IE) approach uses an individual's response to internal cues of hunger, satiety, and appetite and replaces CR. The study was a randomized controlled trial with two groups that assessed the anthropometric measurements of obese adults using CR and IE to achieve weight loss. The participants were sedentary obese individuals with no history of chronic diseases. They engaged in physical activity three times per week for 30 minutes and recorded their daily food intake in a food diary. Instructions were given for the CR and IE at the start and midpoint of the study. The duration of the study was 6 weeks. Weight and waist circumference were measured and body mass index calculated. total weight loss was significantly (p=0.03) lower in the CR group than in the IE group. The CR group lost weight consistently throughout the study, whereas weight loss in the IE group was significantly less at the endpoint than at the midpoint. Calorie restriction is a superior approach to weight management than IE.

The Augusta, Georgia Breast Cancer Survivor Study.

INTRODUCTION: Several studies have provided important information about health conditions and other challenges faced by women diagnosed with breast cancer and how they can improve their quality of life and reduce their risk of cancer recurrence. Although African American and Hispanic breast cancer patients have a poorer survival than their white counterparts, few studies have compared the experiences of African American, Hispanic, and non-Hispanic white breast cancer survivors. OBJECTIVES: To facilitate collaborative studies on breast cancer survivorship in a multicultural population, including future intervention research on nutrition, and physical activity, and clinical substudies. METHODS: This cohort study consists of a postal survey of up to 1,000 women with a history of a breast cancer diagnosis who reside in Augusta-Richmond County, Georgia, USA, and a repeat survey in 4 to 5 years to obtain longitudinal data. The follow-up survey in 4 to 5 years will allow for longitudinal changes in health to be assessed. CONCLUSION: The survey will provide a comprehensive picture of the health of breast cancer survivors, across the lifespan, in a large Southern city. A broad range of health issues will be addressed including physical activity, diet, nutrition, personal and family history of cancer, quality-of-life, psychosocial concerns, and beliefs about cancer recurrence risk reduction through lifestyle changes. Through its longitudinal design, the study will also provide important information about changes in physical and mental health as breast cancer survivors advance in age.

Healthy lifestyle intervention for adult clinic patients with type 2 diabetes mellitus.

BACKGROUND: Diet and exercise therapy have been reported to be effective in improving blood glucose control and are an important part of treatment of type 2 diabetes mellitus. OBJECTIVE: The goal of this study is to examine the efficacy of a healthy lifestyle intervention for adult clinic patients with type 2 diabetes mellitus, as measured by Hgb-A1c, cardiovascular indicators, physical activity, weight, and BMI. Also of interest are optimal strategies for subject recruitment, the number of intervention sessions attended, and participant use of the Fitbit watch to monitor their physical activity and track food and beverage consumption. METHODS: A pre/post-test design will be used in this pilot study. Non-institutionalized adult patients (n=50) aged 18-65 years who have been seen at the Augusta Health outpatient clinics (General Internal Medicine or Family Medicine) for type 2 diabetes in the past 12 months, and who are interested in reducing their risk of disease recurrence through healthy lifestyle behaviors, will be eligible to participate. At orientation visit, eligible individuals will be asked to provide written informed consent. Consenting volunteers (n=50) will be asked to complete the baseline and 6-month follow-up questionnaire and to participate in 12 weekly group sessions of 90 min duration, involving physical activity and to meet with a dietitian (baseline, one month, 90 days) to receive individualized advice on diet and nutrition. The technology-based intervention will use wrist-worn Fitbit Blaze physical activity monitoring devices. CONCLUSIONS: This pilot study will provide important information about the feasibility and preliminary efficacy of a healthy lifestyle intervention for adult clinic patients with type 2 diabetes mellitus. The use of consumer-facing devices such as the Fitbit watch has the potential advantage over the use of research accelerometers, pedometers, or actigraphs in increasing the likelihood that the intervention will be sustainable after the study ends.

Healthy lifestyle intervention for African American uterine cancer survivors: Study protocol.

BACKGROUND: Cancer of the uterine corpus is the most common gynecologic malignancy and the fourth most common cancer in U.S. women. There is a racial disparity in the survival from endometrial cancer and this may be addressed by culturally-tailored lifestyle interventions to help African American (AA) endometrial cancer survivors lose weight or maintain a healthy weight. OBJECTIVE: The overall purpose of this pilot study is to develop and evaluate a culturally-tailored lifestyle intervention to help AA uterine cancer survivors reduce their risk of cancer recurrence and improve their quality of life through healthy eating, physical activity, and weight management. While many interventions have been evaluated to assist cancer survivors through diet and physical activity, few have focused on AA women with a uterine cancer diagnosis. METHODS: Community-engaged research principles are being followed. This study was developed with input from the Augusta University (AU) College of Nursing Community Advisory Board (CAB) and the Division of Gynecologic Oncology at the Georgia Cancer Center at AU. Weekly sessions throughout a 12-week intervention will include physical activity and lectures on improving nutritional status. The pre/post-test design includes baseline and 6-month follow-up, where participants will complete a questionnaire that assesses knowledge and attitudes about physical activity, nutrition, uterine cancer, social support, and quality of life. CONCLUSIONS: From this pilot study, we will learn more about the feasibility and integration of healthy lifestyle interventions in this patient population, and the results can provide an opportunity for a larger-scale, multi-center study with a randomized controlled design.