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Lifestyle Modifications and Survival of Cancer Patients

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A special issue of Cancers (ISSN 2072-6694).

Deadline for manuscript submissions: closed (31 October 2022) | Viewed by 20581

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Dr. Saverio Caini

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Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Via Cosimo il Vecchio 2, 50139 Florence, Italy
Interests: melanoma; skin cancer; epidemiology; genetics; risk factors; prevention
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue invites papers on, among other things, the topic of whether quitting smoking, increasing physical activity or abstaining from alcohol after cancer diagnosis (among those who are smokers, physically inactive, or alcohol drinkers at the time of diagnosis) improves the survival rates of cancer patients.

There is already extensive evidence on the association between lifestyle and cancer risk, as well as on the association between lifetime habits and cancer prognosis (e.g., lifetime nonsmokers have a better prognosis than smokers and ex-smokers), but whether a change that occurs after diagnosis produces a gain in survival among cancer patients is much less clear. However, this information would be quite important to obtain as it would potentially change or strengthen the recommendations made to cancer patients, and changes in one’s lifestyle could become a full part of cancer therapy.

Dr. Saverio Caini
Guest Editor

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Published Papers (9 papers)

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10 pages, 429 KiB

Open AccessArticle

Is There a Role of Warburg Effect in Prostate Cancer Aggressiveness? Analysis of Expression of Enzymes of Lipidic Metabolism by Immunohistochemistry in Prostate Cancer Patients (DIAMOND Study)

by Giorgio Ivan Russo, Maria Giovanna Asmundo, Arturo Lo Giudice, Giuseppe Trefiletti, Sebastiano Cimino, Matteo Ferro, Riccardo Lombardo, Cosimo De Nunzio, Giuseppe Morgia, Eliana Piombino, Maria Failla, Rosario Caltabiano and Giuseppe Broggi

Cancers 2023, 15(3), 948; https://doi.org/10.3390/cancers15030948 - 2 Feb 2023

Cited by 5 | Viewed by 1954

Abstract

Prostate Cancer (PCa) is still ranked as the first cancer in the male population and evidences have suggested an alteration of glycemic and lipidic metabolism that are related to its progression and prognosis. The aim of the study is to investigate associations between enzymes’ expression, especially involved in the lipidic pathway, and PCa aggressiveness. We retrospectively analyzed data from 390 patients with PCa or benign prostatic hyperplasia (BPH) at the Department of Urology, University of Catania. Immunohistochemical slides were evaluated for the expression of proteins related to glucose and lipidic metabolism. A total of 286 were affected by PCa while 104 by BPH. We demonstrated that ATP-lyase (odds ratio [OR]: 1.71; p < 0.01), fatty acid synthase (OR: 4.82; p < 0.01), carnitine palmitoyl transferase-1a (OR: 2.27; p < 0.05) were associated with androgen receptor (AR) expression. We found that steaoryl Co-A desaturase expression in PCa patients with total cholesterol ≥ 200 mg/dL was independently associated with ISUP ≥4 (OR: 4.22; p = 0.049). We found that CPT-1a+ was associated with biochemical recurrence (hazard ratio: 1.94; p = 0.03]). Our results support the evidence that the manipulation of lipidic metabolism could serve in the future to contrast PCa progression. Full article

(This article belongs to the Special Issue Lifestyle Modifications and Survival of Cancer Patients)

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18 pages, 510 KiB

Open AccessArticle

Association of Pretreatment Physical and Geriatric Parameters with Treatment Tolerance and Survival in Elderly Patients with Stage I–II Non-Small Cell Lung Cancer: An Evaluation of Usual Care Data

by Melissa J. J. Voorn, Merle F. R. Bootsma, Gerben P. Bootsma, Vivian E. M. van Kampen-van den Boogaart, Geerten J. A. van Riet, Dirk K. de Ruysscher, Bart C. Bongers and Maryska L. G. Janssen-Heijnen

Cancers 2022, 14(23), 5994; https://doi.org/10.3390/cancers14235994 - 5 Dec 2022

Cited by 2 | Viewed by 1752

Abstract

In this study, the association of pretreatment physical and geriatric parameters with treatment tolerance and survival in elderly patients with stage I–II NSCLC was evaluated. Retrospective data for patients aged ≥70 years, diagnosed between 2016 and 2020 with stage I–II NSCLC, and who underwent surgery or stereotactic ablative radiotherapy (SABR) in a large Dutch teaching hospital were retrieved from medical records. Associations of pretreatment physical and geriatric parameters with treatment tolerance and survival were analyzed. Of 160 patients, 49 of 104 (47%) patients who underwent surgery and 21 of 56 (38%) patients who received SABR did not tolerate treatment. In univariable analysis, World Health Organization (WHO) performance status ≥ 2, short nutritional assessment questionnaire score > 1, short physical performance battery score ≤ 9, and geriatric-8 score ≤ 14 were significantly associated with postoperative complications. Forced expiratory volume of one second < 80% of predicted was significantly associated with intolerance of SABR. In multivariable analysis, WHO performance status ≥ 2 and diffusing capacity for carbon monoxide < 80% were significantly associated with decreased overall survival. This is the first study that investigated the association between pretreatment physical and geriatric parameters and treatment outcomes in patients with stage I–II NSCLC. Evaluation of physical and geriatric parameters before treatment initiation seems highly recommended to select patients who might benefit from preventive interventions before and/or during treatment. Full article

(This article belongs to the Special Issue Lifestyle Modifications and Survival of Cancer Patients)

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15 pages, 1654 KiB

Open AccessArticle

Association of Physical Activity Intensity with All-Cause Mortality in Cancer Survivors: A National Prospective Cohort Study

by Qiguang Li, Xueqiang Pan, Xiao Li and Wei Huang

Cancers 2022, 14(23), 5760; https://doi.org/10.3390/cancers14235760 - 23 Nov 2022

Cited by 6 | Viewed by 1699

Abstract

We designed this study to investigate the associations between physical activity (PA) and the risk of all-cause mortality in cancer survivors using a nationally representative cohort of US adults. This cohort study included 13 cycles of the National Health Interview Surveys, and by matching participants with the National Death Index (2015), survival status was determined. The main outcome was all-cause mortality during follow-up. A total of 20,088 participants aged 62.2 (15.9) years (62.4% women) were analyzed. After an average follow-up of 117.5 months, 7214 (35.9%) participants died. Compared with inactive cancer survivors, we observed a 25% lower all-cause mortality risk among participants performing PA 10 min to 1 h/week (hazard ratio [HR] = 0.75, 95% confidence interval [CI] = 0.67–0.85), a 28% lower risk among those performing PA 1–2.5 h/week (HR = 0.72, 95% CI = 0.67–0.78), a 34% lower risk among those performing PA 2.5–5 h/week (HR = 0.66, 95% CI = 0.60–0.72), a 37% lower risk among those performing PA 5–7.5 h/week (HR = 0.63, 95% CI = 0.56–0.70), a 47% lower risk among those performing PA 7.5–13.3 h/week (HR = 0.53, 95% CI = 0.47–0.61), and a 43% lower risk among those performing PA 13.3–24 h/week (adjusted HR = 0.53, 95% CI = 0.49–0.66). In cancer survivors, leisure-time PA was associated with a lower all-cause mortality. Inactive cancer survivors should be encouraged to perform more PA to reduce the risk of all-cause mortality. Full article

(This article belongs to the Special Issue Lifestyle Modifications and Survival of Cancer Patients)

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10 pages, 255 KiB

Open AccessArticle

Feasibility and Effectiveness of the Exercise Program in Endometrial Cancer; Feasibility and Acceptability Survivorship Trial (EPEC-FAST)

by Anke Smits, Khadra Galaal, Steve Winnan, Alberto Lopes and Ruud L. M. Bekkers

Cancers 2022, 14(22), 5579; https://doi.org/10.3390/cancers14225579 - 14 Nov 2022

Cited by 1 | Viewed by 1651

Abstract

To evaluate the feasibility of an individualized exercise program in the standard care for endometrial cancer patients aimed to improve quality of life and other health outcomes. This was a single-arm prospective intervention trial to assess the feasibility of an individualized exercise intervention in endometrial cancer patients after treatment. The exercise intervention consisted of weekly individualized training sessions, for 10 weeks, at a local gym facility. The program started six weeks post-operatively. Primary outcomes were feasibility aspects including number of eligible patients, recruitment and adherence rates. Secondary outcomes included quality of life outcomes and anthropometric measures. A total of 54 women were eligible for participation, of which 22 (41%) consented to the study. Overall attendance was 86%, and there were no adverse events. There was a significant improvement in quality of life outcomes, including role (p = 0.02), emotional (p = 0.02) and cognitive functioning (p = 0.04). In addition, there was a significant improvement in visceral fat percentage (p = 0.039) and physical fitness (six-minute walk test p < 0.001). The maximum weight loss achieved was 6.0 kg after 3 months and 8.4 kg after 6 months. An individualized one-to-one exercise intervention in endometrial cancer patients is feasible in terms of recruitment, adherence and safety. Full article

(This article belongs to the Special Issue Lifestyle Modifications and Survival of Cancer Patients)

20 pages, 3418 KiB

Open AccessArticle

Immunoprotecting Effects of Exercise Program against Ovarian Cancer: A Single-Blind, Randomized Controlled Trial

by Jong-Kyun Lee, Sihwa Park and Yong-Seok Jee

Cancers 2022, 14(11), 2808; https://doi.org/10.3390/cancers14112808 - 5 Jun 2022

Cited by 3 | Viewed by 2883

Abstract

Exercise is known to help the immune function of cancer survivors after cancer cell removal, but there is little information about the effect of exercise on ovarian cancer survivors. We conducted this study to investigate the effects of exercise training on the physical fitness and innate immunity of ovarian cancer survivors (OCS). Twenty-seven OCS between forty-two and sixty-one years of age volunteered for this study. The participants were divided into a control group (COG, n = 15) and an exercise group (EXG, n = 12). The mean (SD) age was 51.07 (5.67) years, and the mean post-operation period was 45.96 (5.88) months. EXG participated in regular exercise training 6 days a week for 12 weeks. Body weight, fat mass, and body mass index of EXE were significantly decreased compared with those of COG. The muscle mass in EXE was increased compared to that of COG. Physical fitness factors showed positive changes in EXG compared to COG. We found that exercise training enhanced lymphocyte and neutrophil counts of leucocytes and total natural killer (NK) and natural killer T (NKT) cell counts of lymphocytes through improved body composition and physical fitness after 12 weeks. Moreover, we found that improved innate immune cells through the exercise program were achieved through an increase in NKG₂D+NK receptors and a decrease in KIR₂DL₃+NK receptors in OCS. Full article

(This article belongs to the Special Issue Lifestyle Modifications and Survival of Cancer Patients)

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15 pages, 794 KiB

Open AccessArticle

Feasibility of Rehabilitation during Chemoradiotherapy among Patients with Stage III Non-Small Cell Lung Cancer: A Proof-of-Concept Study

by Melissa J. J. Voorn, Bart C. Bongers, Vivian E. M. van Kampen-van den Boogaart, Elisabeth J. M. Driessen and Maryska L. G. Janssen-Heijnen

Cancers 2022, 14(10), 2387; https://doi.org/10.3390/cancers14102387 - 12 May 2022

Cited by 5 | Viewed by 1921

Abstract

Rehabilitation during chemoradiotherapy (CHRT) might (partly) prevent reduction in physical fitness and nutritional status and could improve treatment tolerance in patients with stage III non-small cell lung cancer (NSCLC). The aim of this proof-of-concept study was to investigate the feasibility of a multimodal program for rehabilitation during CHRT. A home-based multimodal rehabilitation program (partly supervised moderate-intensity physical exercise training and nutritional support) during CHRT was developed in collaboration with patients with stage III NSCLC and specialized healthcare professionals. A predetermined number of six patients with stage III NSCLC (aged > 50 years) who underwent CHRT and participated in this program were monitored in detail to assess its feasibility for further development and optimization of the program. The patient’s level of physical functioning (e.g., cardiopulmonary exercise test, six-minute walking test, handgrip strength, body mass index, fat free mass index, energy and protein intake) was evaluated in order to provide personalized advice regarding physical exercise training and nutrition. The program appeared feasible and well-tolerated. All six included patients managed to perform the assessments. Exercise session adherence was high in five patients and low in one patient. The performed exercise intensity was lower than prescribed for all patients. Patients were motivated to complete the home-based rehabilitation program during CHRT. Preliminary effects on physical and nutritional parameters revealed relatively stable values throughout CHRT, with inter-individual variation. Supervised and personalized rehabilitation in patients with stage III NSCLC undergoing CHRT seems feasible when the intensity of the physical exercise training was adjusted to the possibilities and preferences of the patients. Future research should investigate the feasibility of a supervised and personalized rehabilitation program during CHRT with a low-to-moderate exercise intensity with the aim to prevent physical decline during CHRT. Full article

(This article belongs to the Special Issue Lifestyle Modifications and Survival of Cancer Patients)

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12 pages, 800 KiB

Open AccessSystematic Review

Prognostic Impact of Post-Diagnosis Smoking Cessation among Bladder Cancer Patients: A Systematic Literature Review and Meta-Analysis

by Saverio Caini, Marco Del Riccio, Virginia Vettori, Giulio Francolini, Oriana D’Ecclesiis, Tommaso Cai, Aurora Gaeta, Guglielmo Bonaccorsi, Ines Zanna, Domenico Palli and Sara Gandini

Cancers 2022, 14(16), 4022; https://doi.org/10.3390/cancers14164022 - 20 Aug 2022

Cited by 4 | Viewed by 1978

Abstract

We reviewed the studies examining whether quitting smoking at or around diagnosis favourably affects the prognosis of bladder cancer (BC) patients, who are often active smokers at diagnosis. We found only nine eligible articles published until 31 January 2022, which encompassed around 5500 BC in total, the majority of which were nonmuscle invasive BC (only one paper included muscle-invasive BC). We used random effects meta-analysis to obtain a summary hazard ratio (SHR) and 95% confidence intervals (CI). The median proportion of smokers who quit at or around diagnosis was 29.8% (range 8.4–43.1%). For the overall, BC-specific, and progression-free survival, the studies were limited in number (n = 3) and provided conflicting results. At the same time, quitters did not appear to have a lower risk of recurrence than continued smokers (SHR 0.99, 95% CI 0.61–1.61). In conclusion, while the evidence is currently not sufficient to draw firm conclusions (especially for patients with muscle-invasive BC), physicians should not refrain from educating smoking BC patients about the benefits of smoking cessation and provide the necessary support. Full article

(This article belongs to the Special Issue Lifestyle Modifications and Survival of Cancer Patients)

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11 pages, 587 KiB

Open AccessSystematic Review

The Prognostic Impact of Quitting Smoking at or around Diagnosis on the Survival of Patients with Gastrointestinal Cancers: A Systematic Literature Review

by Saverio Caini, Marco Del Riccio, Virginia Vettori, Sara Raimondi, Melania Assedi, Silvano Vignati, Guglielmo Bonaccorsi, Maria Sofia Cattaruzza, Federica Bellerba, Giulia Vagnoni, Giacomo Duroni and Sara Gandini

Cancers 2022, 14(16), 3857; https://doi.org/10.3390/cancers14163857 - 9 Aug 2022

Cited by 3 | Viewed by 2284

Abstract

Cigarette smoking is a strong risk factor for the occurrence of gastrointestinal cancers, and a substantial proportion of newly diagnosed patients is made up of active smokers, yet the impact of smoking cessation at or around diagnosis on the clinical course of these cancers (whose prognosis is often unfavourable) has never been summarized to date. We reviewed studies published until 30 April 2022 that investigated whether smoking cessation at or around diagnosis favourably affects the clinical course of gastrointestinal cancers patients. Six studies were included for colorectal cancer patients, which provided limited yet suggestive evidence that quitters may have longer disease-specific survival compared to continued smokers. Only one study each focused on patients with gastric or HBV-positive liver cancer (both reporting a survival advantage for quitters vs. continued smokers), while we found no eligible studies for patients with cancer at other sites within the digestive system. More research is urgently needed to expand the evidence on the topic, given the potentially major clinical implications for these patients. Moreover, health professionals should provide the necessary smoking cessation support to any smoker who is undergoing diagnostic work-up or treatment for gastrointestinal cancer. Full article

(This article belongs to the Special Issue Lifestyle Modifications and Survival of Cancer Patients)

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13 pages, 1664 KiB

Open AccessSystematic Review

Prehabilitation to Improve Outcomes of Patients with Gynaecological Cancer: A New Window of Opportunity?

by Joëlle Dhanis, Nathaniel Keidan, Dominic Blake, Stuart Rundle, Dieuwke Strijker, Maaike van Ham, Johanna M. A. Pijnenborg and Anke Smits

Cancers 2022, 14(14), 3448; https://doi.org/10.3390/cancers14143448 - 15 Jul 2022

Cited by 11 | Viewed by 3120

Abstract

The literature evaluating the effect of prehabilitation programmes on postoperative outcomes and quality of life of patients with gynaecological cancer undergoing surgery was reviewed. Databases including Pubmed, Medline, EMBASE (Ovid) and PsycINFO were systematically searched to identify studies evaluating the effect of prehabilitation programmes on patients with gynaecological cancer. Both unimodal and multimodal prehabilitation programmes were included encompassing physical exercise and nutritional and psychological support. Primary outcomes were surgical complications and quality of life. Secondary outcomes were anthropometric changes and adherence to the prehabilitation programme. Seven studies fulfilled the inclusion criteria, comprising 580 patients. Included studies were nonrandomised prospective studies (n = 4), retrospective studies (n = 2) and one case report. Unimodal programmes and multimodal programmes were included. In patients with ovarian cancer, multimodal prehabilitation resulted in significantly reduced hospital stay and time to chemotherapy. In patients with endometrial and cervical cancer, prehabilitation was associated with significant weight loss, but had no significant effects on surgical complications or mortality. No adverse events of the programmes were reported. Evidence on the effect of prehabilitation for patients with gynaecological cancer is limited. Future studies are needed to determine the effects on postoperative complications and quality of life. Full article

(This article belongs to the Special Issue Lifestyle Modifications and Survival of Cancer Patients)

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