Yoga in the Pediatric Oncology Population: A Review of the Literature.

Background: The purpose of this review was to evaluate the current body of literature on yoga in the pediatric oncology population. Considering the increasing number of studies on yoga indicating improvements in health-related quality of life (HRQL) among the adult oncology population, it is important to explore whether similar benefits have been found in pediatric oncology patients. Methods: CINAHL, Ovid MEDLINE, PsycINFO, PubMed, and Scopus were searched from the years 2010 through 2020 for studies assessing the use of yoga in children and adolescents affected by cancer. Considering the benefits of yoga on HRQL in the adult oncology population, the aim of this review was to evaluate the current body of literature on yoga in the pediatric cancer population. Results: Eight studies, all nonrandomized with single-arm designs, were reviewed. Five of the studies were designed as feasibility studies and while recruitment rates ranged from 34% to 55%, retention rates were ∼70%. Qualitative feedback from participants was very positive and themes related to both physical and psychological benefits. Certain measures of HRQL (i.e., anxiety, pain, and physical functioning) were found to be significantly improved following a yoga intervention. Discussion: Although no randomized clinical trials have been conducted to date on this important topic, the studies reviewed showed that delivering yoga to this population is feasible and safe. Additionally, preliminary findings on the impact of yoga for some of the common symptoms and treatment-related side effects experienced by children and adolescents affected by cancer are promising.

Are lifestyle behavioral factors associated with health-related quality of life in long-term survivors of non-Hodgkin lymphoma?

BACKGROUND: The objective of the current study was to determine whether survivors of non-Hodgkin lymphoma are meeting select American Cancer Society (ACS) health-related guidelines for cancer survivors, as well as to examine relationships between these lifestyle factors and health-related quality of life (HRQoL) and posttraumatic stress (PTS). METHODS: A cross-sectional sample of 566 survivors of NHL was identified from the tumor registries of 2 large academic medical centers. Respondents were surveyed regarding physical activity, fruit and vegetable intake, body weight, tobacco use, HRQoL using the Medical Outcomes Study Short Form-36, and PTS using the Posttraumatic Stress Disorder CheckList-Civilian form. Lifestyle cluster scores were generated based on whether individuals met health guidelines and multiple linear regression analysis was used to evaluate relationships between lifestyle behaviors and HRQoL scores and PTS scores. RESULTS: Approximately 11% of participants met all 4 ACS health recommendations. Meeting all 4 healthy recommendations was related to better physical and mental QoL (standardized regression coefficient [ß], .57 [P<.0001] and ß, .47 [P = .002]) and to lower PTS scores (ß, -0.41; P = .01). CONCLUSIONS: Survivors of NHL who met more ACS health-related guidelines appeared to have better HRQoL and less PTS. Unfortunately, many survivors are not meeting these guidelines, which could impact their overall well-being and longevity.

A pilot study of a home-based motivational exercise program for African American breast cancer survivors: clinical and quality-of-life outcomes.

INTRODUCTION: African American breast cancer survivors engage in less physical activity compared with their Caucasian counterparts. There is a need for exercise intervention research that focuses on improving the overall health and long-term survivorship of African American breast cancer survivors, especially because they often have worse outcomes than Caucasian survivors. Study objectives were to determine whether African American participants increase physical activity and explore whether exercise had a positive impact on fitness and health. METHODS: African American breast cancer survivors, stage 0 to IIIA, within 2 years of completing primary cancer treatments were recruited for a 16-week home-based aerobic and resistance training exercise pilot study. Outcome measures assessed at baseline and postintervention included physical activity questionnaires and accelerometry, cardiopulmonary function (VO2peak) with gas exchange, muscle strength, Selective Functional Movement Assessment, and dual energy X-ray absorptiometry scans for body composition analysis. Assessments for fatigue and quality of life (QOL) were also completed at baseline and postintervention. Motivational interviewing was utilized to determine goals and explore exercise facilitators/barriers. Participants completed weekly exercise logs and received weekly phone calls. Wilcoxon signed rank tests were used to detect significant changes in physical activity and also changes in fitness/health parameters, fatigue, and QOL. Spearman correlation coefficients were used to examine relationships between physical activity and health measures. RESULTS: A total of 17 women enrolled; 13 completed the intervention (76%). Mean age of the participants was 51 years. There was a significant increase in total minutes of weekly physical activity postintervention ( : = 271 minutes, S: = 151; : = .001). Significant improvements were found in cardiopulmonary fitness as measured by VO2peak with a mean increase of 2.03 mL/kg/min ( : = .01). Several strength measures significantly increased and also functional movement ( : = .005). Positive correlations existed between physical activity and several physical measures, with significant relationships between functional movement and some strength measures (eg, left arm extension: RS : = 0.61, : = .002). Total QOL and fatigue scores improved, but neither was significant. CONCLUSIONS: The intervention led to increased physical activity. As a result of increased levels of physical activity, improvements on several fitness/health parameters occurred.

Perceived exercise barriers and facilitators among ethnically diverse breast cancer survivors.

PURPOSE/OBJECTIVES: To determine whether women with breast cancer were meeting current physical activity recommendations and to describe perceptions of exercise self-efficacy, exercise benefits and barriers, and perceptions of environmental supports for physical activity by race or ethnicity. DESIGN: Cross-sectional survey. SETTING: Community wellness workshops held in various locations in central and eastern North Carolina. SAMPLE: 65 breast cancer survivors in treatment or post-treatment. Caucasian women comprised 46% of the sample followed by African Americans (34%) and Hispanics/Latinas (16%). METHODS: Descriptive statistics were used to determine the percentage of women meeting physical activity guidelines and for comparing exercise-related perceptions. Spearman's rho correlation coefficient tests were conducted to identify associations between physical activity and exercise-related perceptions. MAIN RESEARCH VARIABLES: Physical activity, perceived exercise self-efficacy, exercise barriers, and benefits. FINDINGS: Hispanic/Latina women were least likely to meet physical activity recommendations. Hispanic/Latina women were more likely than Caucasian and African American women to report lack of enjoyment from exercise, lack of knowledge on how to exercise, feeling self-conscious because of looks, and discouragement as exercise barriers. CONCLUSIONS: In a sociocultural context, exercise beliefs need to be considered in the development of culturally responsive exercise interventions that may enhance the health of breast cancer survivors. IMPLICATIONS FOR NURSING: Considering the increasing number of breast cancer survivors from diverse racial or ethnic backgrounds, a need exists for culturally competent nursing interventions aimed at increasing exercise. When educating breast cancer survivors, nurses should address sociocultural factors that may hinder or facilitate engagement in exercise. KNOWLEDGE TRANSLATION: Most women were not meeting physical activity recommendations, particularly Hispanic/Latina women. Perceptions of exercise-related beliefs differed, although not significantly, across racial and ethnic groups. More perceived exercise barriers existed for Hispanic/Latina women compared to Caucasian and African American women, which may indicate sociocultural differences.

Women's recovery experiences after breast cancer reconstruction surgery.

Many women with early-stage breast cancer choose breast reconstruction following mastectomy with the goal to improve physical and psychological quality of life. Breast reconstruction procedures vary in surgical complexity, types of postsurgical complications, and time to recovery, all of which can affect a women's well-being. Although there is a growing body of literature on the satisfaction with aesthetic outcomes following breast reconstruction, there is little research addressing the recovery process. This qualitative study explores woman's physical and emotional recovery experiences. Findings may be useful for improving educational and counseling services for women who undergo breast cancer reconstructive surgeries.

Lifestyle behaviors in black and white women with a family history of breast cancer.

OBJECTIVES: To examine lifestyle behaviors among non-Hispanic black and white women with a family history of breast cancer and determine the extent to which they meet American Cancer Society (ACS) Nutrition and Physical Activity Recommendations for Breast Cancer Prevention. METHOD: Cross-sectional data from 44,364 women enrolled in the Sister Study (2009), a study of sisters of women with breast cancer within the U.S., were analyzed. Descriptive statistics and chi-square analyses were used to examine body mass index and lifestyle behaviors (e.g., exercise, diet, and smoking) and to determine percentages of women meeting ACS recommendations. RESULTS: Black women consumed a lower percentage of calories from fat (mean 36.90% vs. 37.17%) and were more likely to meet ACS alcohol recommendations than whites. White women consumed more fruits and vegetables/day (mean 4.81 vs. 4.41) than black women and were more likely to meet ACS guidelines for physical activity (26.4% vs. 18.2%) and body mass index (42.5% vs. 16.7%). CONCLUSION: Despite an elevated risk for breast cancer due to a family history of breast cancer, the majority of women were no more likely than women in the general population to engage in healthy lifestyle behaviors. These women may benefit from lifestyle behavior risk-reduction counseling.

Not what I expected: informational needs of women undergoing breast surgery.

In 2008, approximately 500,000 women in the United States underwent breast surgery, either cosmetic surgery or reconstruction following mastectomy for breast cancer. There is a growing body of literature on women's motivations to have these types of surgical procedures and on satisfaction with the aesthetic outcomes, but little is known about the information needs and expectations of women who choose to undergo these procedures. Therefore, the purpose of this qualitative study was to gain a better understanding of the informational needs of women who underwent breast augmentation, breast reduction, or breast reconstruction following breast cancer surgery.

Breast cancer risk perception and lifestyle behaviors among White and Black women with a family history of the disease.

Although researchers have investigated the relationships between perceived risk and behavioral risk factors for breast cancer, few qualitative studies have addressed the meaning of risk and its impact on decision making regarding lifestyle behaviors. This qualitative study explored factors involved in the formulation of perceived breast cancer risk and associations between risk perception and lifestyle behaviors in white and black women with a family history of breast cancer. Eligible participants were North Carolina residents in the Sister Study, a nationwide study of risk factors for breast cancer among women who have at least 1 sister diagnosed with breast cancer. Personal interviews were conducted with 32 women. Although most had heightened perceived risk, almost 20% considered themselves below-to-average risk. Participants with moderate-to-high perceived risk were more likely to report an affected sister and mother, a first-degree relative's diagnosis within 4 years, and death of a first-degree relative from breast cancer. Many women were unaware of associations between lifestyle behaviors and breast cancer risk. Only one-third of the women reported healthy lifestyle changes because of family history; dietary change was most frequently reported. Findings may be important for cancer nurses involved in developing breast cancer education programs for women with a family history of breast cancer.

Lifestyle behaviors in women with a BRCA1 or BRCA2 genetic mutation: an exploratory study guided by concepts derived from the Health Belief Model.

Lifestyle behaviors have not been adequately addressed as potential cancer risk-reduction strategies in women with BRCA1 or BRCA2 genetic mutations. The aims of this qualitative pilot study were to explore current lifestyle practices among these women and to assess perceptions regarding risk as well as perceived benefits and perceived barriers to engage in healthy behaviors. Qualitative descriptive methodology was used with research questions derived from key Health Belief Model concepts. Interviews were conducted with 10 women recruited through a cancer genetics clinic. Interviews were tape-recorded and transcribed for content analysis of common themes and patterns. All of the participants expressed that they were at high risk for cancer; however, 5 of the women had prophylactic surgery, which decreased their sense of risk. Most women made some healthy behavior change as a result of their elevated risk awareness. Perceived benefits to healthy lifestyles included increased energy and improved mood. Perceived barriers were related to the expense and inconvenience of preparing healthy meals and lack of time to exercise. The findings reveal that there is a need for nursing interventions that may improve education and enhance motivation regarding potential lifestyle risk-reduction behaviors in women with a genetic predisposition for breast and ovarian cancer.

Soy consumption and colorectal cancer.

We explored the postulated association between soy foods and colorectal cancer incidence by analyzing 13 epidemiological studies: 3 ecological, 1 cohort, and 9 case control. Seven case-control studies evaluated the association between soy intake and colon or colorectal cancer (2,008 cases). Point estimates generally suggest an inverse association between higher soy consumption and colon cancer onset, although nearly all of the confidence intervals overlap 1.0. Two of the nine case-control studies focused on adenomas as the outcome (675 total cases), and results for these studies also showed inverse associations. Of the six case-control studies that evaluated the association between soy consumption and rectal cancer (732 cases), the point estimates generally suggest an inverse association with unfermented soy consumption and rectal cancer onset but not fermented soy products. These studies have many limitations, particularly with regard to dietary measurement issues, such as incomplete assessment of soy intake, inadequate quantification, and inappropriate time period for cancer prevention as well as inadequate adjustment for confounders. Most of these issues would contribute to underestimations of any association. In spite of the methodological issues, the available evidence is compelling enough to warrant further study utilizing stronger methodology.