Promoting Physical Activity in Childhood Cancer Survivors Results From the Childhood Cancer Survivor Study

Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee 38105-2794, USA.
Cancer (Impact Factor: 4.89). 02/2009; 115(3):642-54. DOI: 10.1002/cncr.24043
Source: PubMed

ABSTRACT Eleven directly observed, independent variables were associated significantly with recent physical activity as covariates in the final analytical models. All were self-reported by survivors: 1) their primary-care physician's (PCP's) familiarity with cancer-related problems (1 = familiar, 2 = not familiar); 2) current pain resulting from cancer or its treatment (1 = no pain, 5 = excruciating pain); 3) frequency of fatigue (1 = all the time, 6 = none of the time); 4) whether survivors had discussed the risk of recurrent cancer with their PCP (1 = yes, 2 = no); 5) baseline frequency of aerobic exercise (defined as sufficient to induce sweating or breathing hard, lasting ≥20 minutes 0 days per week or 7 days per week); 6) age at diagnosis; 7) current anxiety as a result of cancer or its treatment (1 = no anxiety, 5 = extreme anxiety); 8) current highest school grade completed; 9) whether the survivor had seen a primary care physician since cancer treatment ended (1 = yes, 2 = no); 10) modified from the Multidimensional Health Locus of Control Scales,24 for intrinsic motivation, survivors rated 4 items (eg, “I am in control of my health.” “The main thing that affects my health is what I myself do”) on a 6-point Likert scale (1 = strongly disagree, 6 = strongly agree; α = .79); 11) for extrinsic motivation, survivors rated 4 items (eg, “Health professionals control my health”; “Regarding my health, I can only do what my physician tells me to do”) on a 6-point Likert scale (1 = strongly disagree, 6 = strongly agree; α = .80).

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Available from: Wendy Leisenring, Sep 28, 2015
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    • "Given their susceptibility to certain health problems, the high prevalence of overweight and obesity that we observed among survivors of childhood cancer, although similar to the general population, is of concern. Diet, nutrition, and physical activity guidelines for cancer survivors have been developed by the American Cancer Society [47], yet most exercise and diet interventions for childhood cancer survivors have had a modest impact on behavior [48] [49]. Thus, childhood cancer survivors can benefit from access to resources to help them maintain a healthy weight and to minimize their risk for late effects. "
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    ABSTRACT: Background. Population-based studies are needed to estimate the prevalence of underweight or overweight/obese childhood cancer survivors. Procedure. Adult survivors (diagnosed ≤20 years) were identified from the linked Utah Cancer Registry and Utah Population Database. We included survivors currently aged ≥20 years and ≥5 years from diagnosis (N = 1060), and a comparison cohort selected on birth year and sex (N = 5410). BMI was calculated from driver license data available from 2000 to 2010. Multivariable generalized linear regression models were used to calculate prevalence relative risks (RR) and 95% confidence intervals (95% CI) of BMI outcomes for survivors and the comparison cohort. Results. Average time since diagnosis was 18.5 years (SD = 7.8), and mean age at BMI for both groups was 30.5 (survivors SD = 7.7, comparison SD = 8.0). Considering all diagnoses, survivors were not at higher risk for being underweight or overweight/obese than the comparison. Male central nervous system tumor survivors were overweight (RR = 1.12, 95% CI 1.01-1.23) more often than the comparison. Female survivors, who were diagnosed at age 10 and under, had a 10% higher risk of being obese than survivors diagnosed at ages 16-20 (P < 0.05). Conclusion. While certain groups of childhood cancer survivors are at risk for being overweight/obese, in general they do not differ from population estimates.
    Journal of Cancer Epidemiology 01/2014; 2014:531958. DOI:10.1155/2014/531958
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    • "The importance of families as facilitators of physical activity in this study is supported by Norris et al. who noted that a link exists between social support and physical activity and that family is the most important social influence in the promotion of healthy behaviours [23]. Therefore family education on the importance of physical activity and strategies to integrate physical activity into the busy day-to-day lives of these children both during and following treatment should be a standard of care [30]. Recognition of inactive survivors those and maintaining physical activity participation into older adolescence and adulthood is essential. "
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    ABSTRACT: The purpose of this study was to examine physical activity levels and influencing individual and environmental factors in a group of adolescent survivors of cancer and a comparison group. Methods. The study was conducted using a "mixed methods" design. Quantitative data was collected from 48 adolescent survivors of cancer and 48 comparison adolescents using the Godin Leisure-Time Exercise Questionnaire, the Fatigue Scale-Adolescents, and the Amherst Health and Activity Study-Student Survey. Qualitative data was collected in individual semistructured interviews. Results. Reported leisure-time physical activity total scores were not significantly different between groups. Physical activity levels were positively correlated with adult social support factors in the group of adolescent survivors of cancer, but not in the comparison group. Time was the primary barrier to physical activity in both groups. Fatigue scores were higher for the comparison but were not associated with physical activity levels in either group. The qualitative data further supported these findings. Conclusions. Barriers to physical activity were common between adolescent survivors of cancer and a comparative group. Increased knowledge of the motivators and barriers to physical activity may help health care providers and families provide more effective health promotion strategies to adolescent survivors of pediatric cancer.
    09/2013; 2013:592395. DOI:10.1155/2013/592395
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    • "This survey and others have found that some long-term childhood survivors may be unable to comply with these guidelines as a result of the physical limitations incurred by their cancer-related surgery or treatment-related cardiac damage. Hopefully, interventions that lead to appropriate and safe increases in the physical activity of long-term survivors may decrease risk of atherosclerotic disease and its associated negative health outcomes [107]. "
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    ABSTRACT: Anthracyclines are commonly used to treat childhood leukemias and lymphomas, as well as other malignancies, leading to a growing population of long-term childhood cancer survivors. However, their use is limited by cardiotoxicity, increasing survivors' vulnerability to treatment-related complications that can markedly affect their quality of life. Survivors are more likely to suffer from heart failure, coronary artery disease, and cerebrovascular accidents compared to the general population. The specific mechanisms of anthracycline cardiotoxicity are complex and remain unclear. Hence, determining the factors that may increase susceptibility to cardiotoxicity is of great importance, as is monitoring patients during and after treatment. Additionally, treatment and prevention options, such as limiting cumulative dosage, liposomal anthracyclines, and dexrazoxane, continue to be explored. Here, we review the cardiovascular complications associated with the use of anthracyclines in treating malignancies in children and discuss methods for preventing, screening, and treating such complications in childhood cancer survivors.
    Cardiology Research and Practice 02/2011; 2011(13):134679. DOI:10.4061/2011/134679
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