Exercise during treatment for advanced cervical cancer.

Cervical cancer (CCa) is the fourth most common type of tumour diagnosed in women. Its treatment-related side effects affect patients' quality of life and physical condition. It is known that physical activity (PA) is beneficial to patients with cancer. However, there is a gap in research on this topic in patients with CCa during the treatment phase. In this report, a case is presented to assess the feasibility of a PA programme during chemoradiotherapy in a woman diagnosed with CCa. It is possible to develop PA programmes for patients with advanced CCa. However, no improvement was seen in the physical and functional variables analysed.

Cancer survivor inspiratory muscle training: systematic review and Bayesian meta-analysis.

BACKGROUND: The long-term impact of cancer treatment is associated with respiratory dysfunction and physical fitness impairment. Although inspiratory muscle training (IMT) has been shown as an effective exercise therapy in cancer survivors, there is no evidence on the optimal dose, application moment nor specific population effects of this intervention. The main objective of this meta-analysis is to analyse the effects of IMT on pulmonary function, physical fitness and quality of life (QoL) in cancer survivors. METHODS: This systematic review and meta-analysis was preregistered in the International Prospective Register of Systematic Reviews (PROSPERO) register and conducted according to the Preferred Reporting for Systematic Reviews and Meta-analysis statement. We used a Bayesian multilevel random-effects meta-analysis model to pool the data. Multilevel metaregression models were used to examine the conditional effects of our covariates. Convergence and model fit were evaluated through specific model parameters. Sensitivity analyses removing influential cases and using a frequentist approach were carried out. RESULTS: Pooled data showed that IMT intervention is effective to improve pulmonary function (standardised mean difference=0.53, 95% credible interval 0.13 to 0.94, SE=0.19). However, IMT did not present statistically significant results on physical fitness and QoL. Metaregression analyses found that the type of cancer, the moment of application and the evaluation tool used had significant moderation effects on pulmonary function. CONCLUSION: IMT could be an important part in the management of side effects suffered by cancer survivors. Considering the current evidence, this intervention is highly recommended in patients diagnosed with oesophageal and lung cancers. IMT may provide superior benefits before the biological treatment and after the surgery. PROSPERO REGISTRATION NUMBER: 304909.

Fatiga relativa al cáncer: factores desencadenantes y función del ejercicio físico / Cancer-related fatigue: trigger factors and physical exercise role

Introducción: Diversas publicaciones han teorizado sobre los desencadenantes de la fatiga relativa al cáncer, uno de losefectos secundarios de la enfermedad y sus tratamientos que más estresa a los supervivientes de esa enfermedad. Por otrolado, el ejercicio físico ha sido analizado como terapia para reducir el impacto de esta secuela, y diversas instituciones apoyansu inclusión dentro de los programas de cuidado para población oncológica. No obstante, la fatiga en cáncer y el papel queel entrenamiento tiene para su control, se ha expuesto sin realizar una valoración global que muestre su complejidad y porqué el ejercicio físico resulta de tanto valor para reducirla.Objetivos: El objetivo de este trabajo fue revisar la evidencia existente sobre los desencadenantes de fatiga en cáncer, paraexponer en qué modo el ejercicio físico actúa sobre cada uno de ellos para controlar su sintomatología y conseguir un efectoterapéutico integral.Material y método: Se realizaron diversas búsquedas bibliográficas que permitieran conocer cuáles eran los desencadenantesde fatiga propuestos por la investigación, cómo se desarrollan y afectan al paciente oncológico y, por último, en qué gradoel ejercicio físico sería una herramienta viable para controlar sus efectos.Resultados: Expuestos más de una veintena de desencadenantes y agravantes de la fatiga relativa al cáncer, encontramosque la mayoría de ellos podrían ser prevenidos o al menos controlados a través del ejercicio físico.Conclusiones: Resulta imposible aislar unos desencadenantes de otros, existiendo, además, algunos de ellos que son inevita-bles al ser parte del tratamiento médico de la enfermedad. Entender las relaciones que se producen entre desencadenantes yconocer los efectos positivos del ejercicio físico sobre cada uno de ellos, es claramente útil para controlar este efecto secundario.(AU)

Introduction: Several publications have theorized about the triggers of cancer-related fatigue, one of the side effects ofthe disease and its treatments that most stress cancer survivors. On the other hand, physical exercise has been analyzedas a therapy to reduce the impact of this sequel, and several institutions support its inclusion within care programs for theoncological population. However, cancer fatigue and the role that exercise plays in its control has been exposed without anoverall assessment that shows its complexity and why physical exercise is so valuable to reducing it.Objectives: The objective of this work was to review the existing evidence about triggers of fatigue in cancer, to expose howphysical exercise acts on each of them to control their symptoms and achieve a comprehensive therapeutic effect.Material and method: Several bibliographic searches were carried out to find out which were the triggers of fatigue proposedby the research, how they develop and affect the oncological patient and, finally, to what extent physical exercise would bea viable tool to control its effects.Results: Exposed to more than twenty triggers and aggravating factors of cancer-related fatigue, we found that most of themcould be prevented or at least controlled through physical exercise.Conclusions: It is impossible to isolate some triggers from others, and some of them are inevitable as they are part of themedical treatment of the disease. Understanding the relationships between triggers and knowing the positive effects ofphysical exercise on each one of them is clearly useful to control this side effect.(AU)

Nivel de Actividad Física en supervivientes de cáncer de mama españolas. Aplicación del HUNT 1-Physical Activity Questionnaire / Nível de Atividade Física em sobreviventes espanholas de cancro de mama. Aplicação do HUNT 1-Physical Activity Questionnaire / Physical Activity Levels in Spanish Breast Cancer Survivors. Implementation of the HUNT1-Physical Activity Questionnaire

Objetivo: El objetivo de este estudio fue analizar los niveles de actividad física en supervivientes de cáncer de mama españolas a través de un cuestionario autoadministrado. Asimismo, se estudió la relación entre variables personales y clínicas, variables del entrenamiento y calidad de vida.Método: La presente investigación es de tipo no experimental, descriptiva y transversal. De una muestra significativa (n=386) de mujeres supervivientes de cáncer de mama, se registraron, mediante encuesta autoadministrada: datos antropométricos, sociodemográficos y clínicos; niveles de actividad física mediante cuestionario HUNT1-Physical Activity Questionnaire; y calidad de vida, mediante cuestionario específico para cáncer de mama Functional Assessment Cancer Theraphy-Breast (FACT-B).Resultados: El patrón de entrenamiento más habitual fue de 2-3 veces por semana (40.9%), a intensidad ligera (41.7%) en sesiones de 30-60 minutos (51%). La puntuación media en calidad de vida fue de 93±20 puntos (escala 0-148). El índice de masa corporal resultó influir tanto en nivel de actividad física, como en calidad de vida (p<0.001). Respecto a variables clínicas, se encontró relación entre administración de quimioterapia y frecuencia de entrenamiento (p<0.05); estadio de diagnóstico con puntuación total FACT-B (p<0.05); y existencia de comorbilidades sobre subescala física del test de calidad de vida (p<0.05).Conclusiones: Los resultados indicaron que la mayoría de supervivientes de cáncer de mama españolas no cumplen actualmente los niveles de actividad física recomendados. Del mismo modo sugieren que, aunque el estadio de diagnóstico no parece ser determinante en dicho hábito, sí afecta a su calidad de vida. (AU)

Objective: The objective of this study was to analyze the levels of physical activity in Spanish breast cancer survivors through a self-administered questionnaire, and to assess the relationship between personal and clinical variables, training variables and quality of life.Methods: The present research is non-experimental, descriptive and transversal. From a significant sample (n=386) of breast cancer survivors, the following were recorded by self-administered survey: anthropometric, sociodemographic and clinical data; physical activity levels by means of the HUNT1-Physical Activity Questionnaire; and quality of life, by means of the specific Functional Assessment Cancer Theraphy-Breast (FACT-B).Results: The most common training pattern was 2-3 times per week (40.9%), at light intensity (41.7%) in 30-60 minutes sessions (51%). The average quality of life score was 93±20 points (scale 0-148). The body mass index was found to influence both the level of physical activity and quality of life (p<0.001). Regarding clinical variables, we found a relationship between chemotherapy administration and training frequency (p<0.05); diagnostic stage with FACT-B total score (p<0.05); and existence of comorbidities on the physical subscale of the quality of life test (p<0.05).Conclusions: The results indicated that the majority of Spanish breast cancer survivors do not currently meet the recommended levels of physical activity. They also suggest that, although the stage of diagnosis does not seem to be a determining factor in this habit, it does affect their quality of life. (AU)

Objectivo: O objectivo deste estudo foi analisar os níveis de actividade física dos sobreviventes espanhóis do cancro da mama através de um questionário auto-administrado e avaliar a relação entre as variáveis pessoais e clínicas, as variáveis de treino e a qualidade de vida.Métodos: A presente investigação é não experimental, descritiva e transversal. A partir de uma amostra significativa (n=386) de sobreviventes de cancro da mama, foram registados, por inquérito auto-administrado: dados antropométricos, sociodemográficos e clínicos; níveis de actividade física, através do questionário HUNT1-Physical Activity Questionnaire; e qualidade de vida, através do questionário específico Functional Assessment Cancer Theraphy-Breast (FACT-B).Resultados: O padrão de treino mais comum foi 2-3 vezes por semana (40.9%), com intensidade luminosa (41.7%) em sessões de 30-60 minutos (51%). A pontuação média da qualidade de vida foi de 93±20 pontos (escala 0-148). O índice de massa corporal influenciou tanto o nível de actividade física como a qualidade de vida (p<0.001). Em relação às variáveis clínicas, encontramos uma relação entre a administração da quimioterapia e a frequência do treino (p<0.05); fase de diagnóstico com pontuação total FACT-B (p<0.05); e existência de comorbidades na subescala física do teste de qualidade de vida (p<0.05).Conclusões: Os resultados indicaram que a maioria dos sobreviventes espanhóis de cancro da mama não atinge actualmente os níveis recomendados de actividade física. Sugerem também que, embora a fase do diagnóstico não pareça ser um factor determinante neste hábito, ela afecta a sua qualidade de vida. (AU)