Randomized pilot test of a lifestyle physical activity intervention for breast cancer survivors.

OBJECTIVE: This paper will report the results of a pilot test of a 6-month, 21-session intervention to increase breast cancer survivors' physical activity by teaching them to incorporate short periods of moderate activity into their daily routines (lifestyle intervention). The effect of the intervention on physical performance, quality of life, and physical activity are reported. METHODS: Sixty breast cancer survivors were randomized to either a lifestyle intervention or a standard care control group. Physical performance, quality of life (Medical outcomes study short form-36 [SF-36]), and physical activity (7-day recall and motivation readiness), were assessed at baseline and 6 months. RESULTS: The lifestyle group had significantly better performance in the 6-min walk task than the controls (p=0.005) at 6 months. The intervention had positive effects on the bodily pain (p=0.020) and general health (p=0.006) subscales from the SF-36. The lifestyle group had a greater motivational readiness for physical activity at 6-month than standard care, but no significant differences were seen between the two in terms of number of minutes of moderate or more intense physical activity or number of days on which they did > or =30 min of moderate or more intense activity. CONCLUSIONS: Despite the small sample size, the lifestyle intervention showed promise for improving physical functioning and quality of life and increasing physical activity, and should be tested in a larger randomized trial. PRACTICE IMPLICATIONS: If the lifestyle approach is shown to be effective in a larger trial, it represents a highly feasible intervention that it can be delivered to cancer survivors by health care institutions or community organizations without dedicated exercise facilities and equipment.

Demographic and past screening behaviors of men attending a free community screening program for prostate cancer.

This study characterizes demographic and past prostate screening behaviors of men who participated in a free screening for prostate cancer. Demographics, past prostate screening behavior, perceived risk, and cancer worry were assessed in 1,680 men. Mean age was 58.2 years, 56% were White, and 76% had health insurance. Men with insurance were more likely to have had a previous prostate-specific antigen (PSA) test and digital rectal exam (DRE). White men were more likely to have had a previous PSA and DRE and to have discussed PSA testing with a physician than African American men. African American men reported greater perceived risk and more worry than White men. Screening differences between African American and White men were explained by insurance status. These results may help guide the development of and promotion for future screening programs. Future efforts should be directed at increasing awareness about screening procedures for prostate cancer.

Effects of maternal versus direct exposure to pulp and paper mill effluent on rainbow trout early life stages.

The acute and chronic effects of secondary-treated effluent from a New Zealand pulp and paper mill were assessed using both long-term adult and early life stage (ELS) laboratory exposures of rainbow trout. The relative impact of maternal exposure versus ELS exposure was assessed by a comparison of directly exposed eggs and larvae with the eggs and larvae of exposed adult trout that were reared in reference water. Rainbow trout were exposed to a secondary-treated mixed thermomechanical/bleached kraft mill effluent at a concentration of 15% or to reference water from the egg through to 320-d-old juveniles. The 2 adult rainbow trout exposures were undertaken with nominal concentrations of 10% and 12% treated effluent, respectively. There was no marked effect of water hardening with 15% effluent on fertility or survival of eggs to 16 d. In a subsequent exposure (with hardening in reference water), no significant effects were found on mortality to hatch, time to hatch, length at hatch, mortality to swim-up, mortality to 320 d, or deformity rate at hatch. At experimental termination (320 d), direct-exposed juveniles had smaller livers and reduced condition factor, likely due to differences in food consumption. In 2 subsequent consecutive experiments, exposure of adult trout to 10% and 12% effluent for 2 mo, followed by incubation of the fertilized eggs in reference water, produced no impact on fertility, survival to hatch, survival to swim-up, or length and weight of fry at swim-up. Exposure of adult trout to 12% treated effluent for 8 mo prior to egg fertilization also did not result in differing rates of fertility, mortality to hatch or mortality to swim-up. However, the 8-mo maternal exposure did result in swim-up fry that were significantly shorter and weighed less than the reference swim-up fry. This difference was directly attributable to smaller eggs in the 8-mo-exposed female trout. These results demonstrate that this pulp and paper mill effluent is more likely to elicit indirect impacts on progeny size through chronic exposure of adults to effluent during gonadal recrudescence rather than through direct exposure of early life stages to effluent.

Cancer worry is associated with abnormal prostate-specific antigen levels in men participating in a community screening program.

An accumulating body of research suggests that psychological factors can affect physiological parameters. We assessed the association between the perceived risk of prostate cancer, prostate cancer-specific worry, and cancer-related symptoms and prostate-specific antigen (PSA) levels or the findings from digital rectal examination (DRE) in a large sample of men undergoing a free prostate cancer screening. Participants (n = 1635) completed a background questionnaire and a questionnaire that assessed their prostate cancer history, screening behavior, perceived risk of prostate cancer, and prostate cancer worry. PSA levels were then determined, and a DRE was conducted. A PSA level of >or=4.0 ng/ml was considered abnormal. The sample size for the multivariate analyses was reduced because of missing data on certain items. Participants who had an abnormal PSA level reported a significantly higher perceived cancer risk (P = 0.02), cancer worry (P = 0.004), and a greater percentage indicated the reason for the current screening was cancer-related symptoms (P = 0.014) than did participants who had normal PSA levels. Multivariate logistic regression analyses controlling for age, past screening behavior, past screening results, and reason for current screening revealed that perceived cancer risk [P = 0.01; odds ratio (OR), 1.5; 95% confidence interval (CI), 1.1-2.1], cancer worry (P = 0.001; OR, 3.3; 95% CI, 1.7-6.5), and cancer-related symptoms (P = 0.05; OR, 3.4; 95% CI, 1.1-10.3) remained significantly associated with an abnormal PSA level. When perceived cancer risk, cancer worry, and cancer-related symptoms were entered in the same multivariate analysis, only cancer worry remained in the model. The present findings suggest that prostate cancer-specific worry was associated significantly with an abnormal PSA level.

In vivo and in vitro assessment of the androgenic potential of a pulp and paper mill effluent.

The androgenic potential of a New Zealand pulp and paper mill effluent was measured by applying a combination of in vitro and in vivo bioassays with mosquitofish (Gambusia affinis) and goldfish (Carassius auratus). The in vivo method assessed the rate of gonopodial development (masculinization) and alterations from normal reproductive behavior in adult female mosquitofish exposed for 21 d to untreated or secondary-treated pulp mill effluent. A second in vivo mosquitofish exposure tested the effect of glass-fiber (type C) filtration of secondary-treated effluent on rates of expression of the same endpoints. Extractable organics analyses of effluents and extracts thereof were conducted. Mosquitofish demonstrated significant masculinization on exposure to either treated or untreated effluent; the frequency of gonopodial development was reduced with effluent secondary-treatment. Male mating behavior was observed in the masculinized adult females. Glass-fiber (type F) filtration of the treated effluent eliminated the masculinizing effect, suggesting that the bioactive compounds were associated with the suspended solids. The in vitro method measured the binding of compounds within a treated thermomechanical/bleached kraft effluent extract to androgen receptors contained in goldfish testis cytosol. Exposure to extracts of either the particulate (glass-fiber filtered) or the dissolved organic fraction of the effluent produced significant binding (as indicated by the displacement of radiolabeled testosterone) to the androgen receptor in goldfish gonadal tissue. Thus, the dissolved organics extract of the treated effluent contained compounds androgenic to goldfish in vitro but not to mosquitofish in vivo. The combined in vitro and in vivo data suggest that the effluent in question could exert effects on the reproductive physiology of fishes through an androgenic mechanism. The androgenic compounds androstenedione and testosterone were not detected in the extracts used for the in vitro component of this study.

Moderator analyses of participants in the Active for Life after cancer trial: implications for physical activity group intervention studies.

BACKGROUND: Prostate cancer patients on hormonal therapy experience significant treatment-related physical and psychological sequelae. PURPOSE: We examined moderator variables to determine whether certain participants demonstrated quality of life (QOL) benefits from a group-based lifestyle physical activity program compared to a group-based educational support program and standard care. METHODS: Participants were 134 prostate cancer patients on continuous androgen ablation in a controlled trial that used adaptive allocation. RESULTS: As reported elsewhere, no significant differences were found between study conditions on primary QOL outcomes following the 6-month interventions. However, in a secondary analysis, several significant interactions indicated that both group programs benefited patients with lower psychosocial functioning at baseline; patients with lower mental health and social support scores had significant improvements in these measures compared with standard care. For those with higher pain, the educational support program resulted in significant improvements compared with the other two conditions. Twelve-month findings indicated lasting effects. CONCLUSIONS: Consistent with existing research, results indicate that group interventions benefit cancer patients with limitations in psychosocial functioning. Findings underscore the importance of physical activity/exercise studies to employ control conditions that consider the attention and support provided by health educators and group members, particularly when examining psychosocial outcomes and pain.

Active for Life After Cancer: a randomized trial examining a lifestyle physical activity program for prostate cancer patients.

BACKGROUND: Active for Life After Cancer is a randomized trial evaluating the efficacy of a 6-month group-based lifestyle physical activity program (Lifestyle) for prostate cancer patients to improve quality of life (QOL) including physical and emotional functioning compared to a group-based Educational Support Program and a Standard Care Program (no group). METHOD: A total of 134 prostate cancer patients receiving continuous androgen-ablation were randomly assigned to one of the three study conditions. RESULTS: Results indicated no significant improvements in QOL at 6 or 12 months. Both group-based programs were positively received and yielded good attendance and retention. Lifestyle participants demonstrated significant improvements in most theoretical mediators proposed by the Transtheoretical Model and Social Cognitive Theory to affect physical activity. Despite these improvements, no significant changes were found for most physical activity measures. CONCLUSIONS: Results suggest a lifestyle program focusing on cognitive-behavioral skills training alone is insufficient for promoting routine physical activity in these patients.

Quality of life intervention for prostate cancer patients: design and baseline characteristics of the active for life after cancer trial.

Prostate cancer patients receiving androgen ablation therapy experience significant physical and psychological sequelae associated with their disease and treatment. Because physical activity improves physical and psychological well-being, a lifestyle physical activity intervention may help slow or reverse the associated decline in quality of life (QOL). No studies have evaluated an intervention to improve multiple QOL domains in patients receiving androgen ablation therapy. Active for Life After Cancer is a three-group randomized controlled trial designed to evaluate the effectiveness of a lifestyle physical activity intervention (Lifestyle Program) in improving QOL. The Lifestyle Program, a 6-month behavioral skills training group, is compared to an Educational Support Program and Standard Care. The purpose of this paper is to describe the design of the randomized trial and present baseline data that will characterize the QOL of the sample. Challenges to recruitment for the trial also will be presented and discussed.