Exercise and the gut microbiome : implications for supportive care in cancer
- Hart, Nicholas, Wallen, Matthew, Farley, Morgan, Haywood, Darren, Boytar, Alexander, Secombe, Kate, Joseph, Ria, Chan, Raymond, Kenkhuis, Marlou-Floor, Buffart, Laurien, Skinner, Tina, Wardill, Hannah
- Authors: Hart, Nicholas , Wallen, Matthew , Farley, Morgan , Haywood, Darren , Boytar, Alexander , Secombe, Kate , Joseph, Ria , Chan, Raymond , Kenkhuis, Marlou-Floor , Buffart, Laurien , Skinner, Tina , Wardill, Hannah
- Date: 2023
- Type: Text , Journal article , Review
- Relation: Supportive Care in Cancer Vol. 31, no. 12 (2023), p.
- Relation: http://purl.org/au-research/grants/nhmrc/1194051
- Full Text: false
- Reviewed:
- Description: Purpose: Growing recognition of the gut microbiome as an influential modulator of cancer treatment efficacy and toxicity has led to the emergence of clinical interventions targeting the microbiome to enhance cancer and health outcomes. The highly modifiable nature of microbiota to endogenous, exogenous, and environmental inputs enables interventions to promote resilience of the gut microbiome that have rapid effects on host health, or response to cancer treatment. While diet, probiotics, and faecal microbiota transplant are primary avenues of therapy focused on restoring or protecting gut function in people undergoing cancer treatment, the role of physical activity and exercise has scarcely been examined in this population. Methods: A narrative review was conducted to explore the nexus between cancer care and the gut microbiome in the context of physical activity and exercise as a widely available and clinically effective supportive care strategy used by cancer survivors. Results: Exercise can facilitate a more diverse gut microbiome and functional metabolome in humans; however, most physical activity and exercise studies have been conducted in healthy or athletic populations, primarily using aerobic exercise modalities. A scarcity of exercise and microbiome studies in cancer exists. Conclusions: Exercise remains an attractive avenue to promote microbiome health in cancer survivors. Future research should elucidate the various influences of exercise modalities, intensities, frequencies, durations, and volumes to explore dose-response relationships between exercise and the gut microbiome among cancer survivors, as well as multifaceted approaches (such as diet and probiotics), and examine the influences of exercise on the gut microbiome and associated symptom burden prior to, during, and following cancer treatment. © 2023, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Patient navigation across the cancer care continuum : an overview of systematic reviews and emerging literature
- Chan, Raymond, Milch, Vivienne, Crawford-Williams, Fiona, Agbejule, Oluwaseyifunmi, Joseph, Ria, Johal, Jolyn, Dick, Narayanee, Wallen, Matthew, Ratcliffe, Julie, Agarwal, Anupriya, Nekhlyudov, Larissa, Tieu, Matthew, Al-Momani, Manaf, Turnbull, Scott, Sathiaraj, Rahul, Keefe, Dorothy, Hart, Nicholas
- Authors: Chan, Raymond , Milch, Vivienne , Crawford-Williams, Fiona , Agbejule, Oluwaseyifunmi , Joseph, Ria , Johal, Jolyn , Dick, Narayanee , Wallen, Matthew , Ratcliffe, Julie , Agarwal, Anupriya , Nekhlyudov, Larissa , Tieu, Matthew , Al-Momani, Manaf , Turnbull, Scott , Sathiaraj, Rahul , Keefe, Dorothy , Hart, Nicholas
- Date: 2023
- Type: Text , Journal article , Review
- Relation: CA Cancer Journal for Clinicians Vol. 73, no. 6 (2023), p. 565-589
- Relation: http://purl.org/au-research/grants/nhmrc/1194051
- Full Text:
- Reviewed:
- Description: Patient navigation is a strategy for overcoming barriers to reduce disparities and to improve access and outcomes. The aim of this umbrella review was to identify, critically appraise, synthesize, and present the best available evidence to inform policy and planning regarding patient navigation across the cancer continuum. Systematic reviews examining navigation in cancer care were identified in the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Embase, Cumulative Index of Nursing and Allied Health (CINAHL), Epistemonikos, and Prospective Register of Systematic Reviews (PROSPERO) databases and in the gray literature from January 1, 2012, to April 19, 2022. Data were screened, extracted, and appraised independently by two authors. The JBI Critical Appraisal Checklist for Systematic Review and Research Syntheses was used for quality appraisal. Emerging literature up to May 25, 2022, was also explored to capture primary research published beyond the coverage of included systematic reviews. Of the 2062 unique records identified, 61 systematic reviews were included. Fifty-four reviews were quantitative or mixed-methods reviews, reporting on the effectiveness of cancer patient navigation, including 12 reviews reporting costs or cost-effectiveness outcomes. Seven qualitative reviews explored navigation needs, barriers, and experiences. In addition, 53 primary studies published since 2021 were included. Patient navigation is effective in improving participation in cancer screening and reducing the time from screening to diagnosis and from diagnosis to treatment initiation. Emerging evidence suggests that patient navigation improves quality of life and patient satisfaction with care in the survivorship phase and reduces hospital readmission in the active treatment and survivorship care phases. Palliative care data were extremely limited. Economic evaluations from the United States suggest the potential cost-effectiveness of navigation in screening programs. © 2023 The Authors. CA: A Cancer Journal for Clinicians published by Wiley Periodicals LLC on behalf of American Cancer Society.
- Authors: Chan, Raymond , Milch, Vivienne , Crawford-Williams, Fiona , Agbejule, Oluwaseyifunmi , Joseph, Ria , Johal, Jolyn , Dick, Narayanee , Wallen, Matthew , Ratcliffe, Julie , Agarwal, Anupriya , Nekhlyudov, Larissa , Tieu, Matthew , Al-Momani, Manaf , Turnbull, Scott , Sathiaraj, Rahul , Keefe, Dorothy , Hart, Nicholas
- Date: 2023
- Type: Text , Journal article , Review
- Relation: CA Cancer Journal for Clinicians Vol. 73, no. 6 (2023), p. 565-589
- Relation: http://purl.org/au-research/grants/nhmrc/1194051
- Full Text:
- Reviewed:
- Description: Patient navigation is a strategy for overcoming barriers to reduce disparities and to improve access and outcomes. The aim of this umbrella review was to identify, critically appraise, synthesize, and present the best available evidence to inform policy and planning regarding patient navigation across the cancer continuum. Systematic reviews examining navigation in cancer care were identified in the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Embase, Cumulative Index of Nursing and Allied Health (CINAHL), Epistemonikos, and Prospective Register of Systematic Reviews (PROSPERO) databases and in the gray literature from January 1, 2012, to April 19, 2022. Data were screened, extracted, and appraised independently by two authors. The JBI Critical Appraisal Checklist for Systematic Review and Research Syntheses was used for quality appraisal. Emerging literature up to May 25, 2022, was also explored to capture primary research published beyond the coverage of included systematic reviews. Of the 2062 unique records identified, 61 systematic reviews were included. Fifty-four reviews were quantitative or mixed-methods reviews, reporting on the effectiveness of cancer patient navigation, including 12 reviews reporting costs or cost-effectiveness outcomes. Seven qualitative reviews explored navigation needs, barriers, and experiences. In addition, 53 primary studies published since 2021 were included. Patient navigation is effective in improving participation in cancer screening and reducing the time from screening to diagnosis and from diagnosis to treatment initiation. Emerging evidence suggests that patient navigation improves quality of life and patient satisfaction with care in the survivorship phase and reduces hospital readmission in the active treatment and survivorship care phases. Palliative care data were extremely limited. Economic evaluations from the United States suggest the potential cost-effectiveness of navigation in screening programs. © 2023 The Authors. CA: A Cancer Journal for Clinicians published by Wiley Periodicals LLC on behalf of American Cancer Society.
Benefits of supportive strategies for carers of people with high-grade glioma : a systematic review : strategies for addressing the needs of high-grade glioma carers
- Jones, Diana, Pinkham, Mark, Wallen, Matthew, Hart, Nicolas, Joseph, Ria, Strodl, Esben, Ownsworth, Tamara, Beesley, Vanessa, Crichton, Megan, Chan, Raymond
- Authors: Jones, Diana , Pinkham, Mark , Wallen, Matthew , Hart, Nicolas , Joseph, Ria , Strodl, Esben , Ownsworth, Tamara , Beesley, Vanessa , Crichton, Megan , Chan, Raymond
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Supportive Care in Cancer Vol. 30, no. 12 (2022), p. 10359-10378
- Relation: http://purl.org/au-research/grants/nhmrc/1194051
- Full Text:
- Reviewed:
- Description: Purpose: To systematically review and examine current evidence for the carer-reported benefits of supportive care strategies for carers of adults with high-grade glioma (HGG). Methods: Four databases (CINAHL, EMBASE, PubMed, PsycINFO) were searched for articles published between January 2005 and April 2022 that assessed strategies for addressing the supportive care needs of carers of adults with HGG (WHO grade 3–4). Study selection and critical appraisal were conducted independently by three authors (DJ/MC, 2021; DJ/RJ 2022). Data extraction was conducted by one author (DJ) and checked by a second author (RJ). Results were synthesised narratively. Results: Twenty-one studies involving 1377 caregivers were included, targeting the carer directly (n = 10), the patient-carer dyad (n = 3), or focused on people with HGG + /
- Authors: Jones, Diana , Pinkham, Mark , Wallen, Matthew , Hart, Nicolas , Joseph, Ria , Strodl, Esben , Ownsworth, Tamara , Beesley, Vanessa , Crichton, Megan , Chan, Raymond
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Supportive Care in Cancer Vol. 30, no. 12 (2022), p. 10359-10378
- Relation: http://purl.org/au-research/grants/nhmrc/1194051
- Full Text:
- Reviewed:
- Description: Purpose: To systematically review and examine current evidence for the carer-reported benefits of supportive care strategies for carers of adults with high-grade glioma (HGG). Methods: Four databases (CINAHL, EMBASE, PubMed, PsycINFO) were searched for articles published between January 2005 and April 2022 that assessed strategies for addressing the supportive care needs of carers of adults with HGG (WHO grade 3–4). Study selection and critical appraisal were conducted independently by three authors (DJ/MC, 2021; DJ/RJ 2022). Data extraction was conducted by one author (DJ) and checked by a second author (RJ). Results were synthesised narratively. Results: Twenty-one studies involving 1377 caregivers were included, targeting the carer directly (n = 10), the patient-carer dyad (n = 3), or focused on people with HGG + /
Diet and exercise advice and referrals for cancer survivors : an integrative review of medical and nursing perspectives
- Joseph, Ria, Hart, Nicolas, Bradford, Natalie, Agbejule, Oluwaseyifunmi, Koczwara, Bogda, Chan, Alexandre, Wallen, Matthew, Chan, Raymond
- Authors: Joseph, Ria , Hart, Nicolas , Bradford, Natalie , Agbejule, Oluwaseyifunmi , Koczwara, Bogda , Chan, Alexandre , Wallen, Matthew , Chan, Raymond
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Supportive Care in Cancer Vol. 30, no. 10 (2022), p. 8429-8439
- Full Text:
- Reviewed:
- Description: Purpose: To examine the perspectives of medical and nursing health professionals concerning their roles and responsibilities in providing dietary and exercise advice to cancer survivors, and referrals to allied health professionals. Methods: An integrative review. PubMed, CINAHL, PsycINFO, Embase, Web of Science databases, and bibliographies of relevant studies were searched from December 2011 to June 2021. All studies were eligible for inclusion. The Mixed-Methods Appraisal Tool (MMAT) was used to critically appraise included studies. Data were extracted and synthesised regarding the perspectives of medical and nursing health professionals on their roles, responsibilities, barriers, and facilitators. Results: Twenty-one studies involving 3401 medical and nursing health professionals and 264 cancer survivors of diverse cancer types were included. Ten quantitative, nine qualitative, and two mixed-methods studies were eligible. All included studies met at least 80% of the quality criteria in the MMAT. Major findings include the following: (1) medical and nursing health professionals were unclear on their roles in providing dietary and exercise advice to cancer survivors but agreed they play a key role in referrals to dietitians and exercise professionals; (2) most cancer survivors valued the involvement of their general practitioner when receiving dietary and exercise advice. Conclusion: Although medical and nursing health professionals understand that referrals to allied health professionals form part of their role, there is a lack of clarity regarding their roles to provide dietary and exercise advice to cancer survivors. Future studies should address barriers and facilitators of dietary and exercise advice and referral by medical and nursing health professionals. © 2022, Crown.
- Authors: Joseph, Ria , Hart, Nicolas , Bradford, Natalie , Agbejule, Oluwaseyifunmi , Koczwara, Bogda , Chan, Alexandre , Wallen, Matthew , Chan, Raymond
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Supportive Care in Cancer Vol. 30, no. 10 (2022), p. 8429-8439
- Full Text:
- Reviewed:
- Description: Purpose: To examine the perspectives of medical and nursing health professionals concerning their roles and responsibilities in providing dietary and exercise advice to cancer survivors, and referrals to allied health professionals. Methods: An integrative review. PubMed, CINAHL, PsycINFO, Embase, Web of Science databases, and bibliographies of relevant studies were searched from December 2011 to June 2021. All studies were eligible for inclusion. The Mixed-Methods Appraisal Tool (MMAT) was used to critically appraise included studies. Data were extracted and synthesised regarding the perspectives of medical and nursing health professionals on their roles, responsibilities, barriers, and facilitators. Results: Twenty-one studies involving 3401 medical and nursing health professionals and 264 cancer survivors of diverse cancer types were included. Ten quantitative, nine qualitative, and two mixed-methods studies were eligible. All included studies met at least 80% of the quality criteria in the MMAT. Major findings include the following: (1) medical and nursing health professionals were unclear on their roles in providing dietary and exercise advice to cancer survivors but agreed they play a key role in referrals to dietitians and exercise professionals; (2) most cancer survivors valued the involvement of their general practitioner when receiving dietary and exercise advice. Conclusion: Although medical and nursing health professionals understand that referrals to allied health professionals form part of their role, there is a lack of clarity regarding their roles to provide dietary and exercise advice to cancer survivors. Future studies should address barriers and facilitators of dietary and exercise advice and referral by medical and nursing health professionals. © 2022, Crown.
Dietary supplements in people with metastatic cancer who are experiencing malnutrition, cachexia, sarcopenia, and frailty : a scoping review
- Johal, Jolyn, Han, Chad, Joseph, Ria, Munn, Zachary, Agbejule, Oluwaseyifunmi, Crawford‐Williams, Fiona, Wallen, Matthew, Chan, Raymond, Hart, Nicolas
- Authors: Johal, Jolyn , Han, Chad , Joseph, Ria , Munn, Zachary , Agbejule, Oluwaseyifunmi , Crawford‐Williams, Fiona , Wallen, Matthew , Chan, Raymond , Hart, Nicolas
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Nutrients Vol. 14, no. 13 (2022), p.
- Full Text:
- Reviewed:
- Description: Cancer‐associated malnutrition, or cachexia, stemming from cancer or its treatments, is particularly prevalent in metastatic cancers, and is often interrelated with sarcopenia and frailty. Evidence suggests that dietary supplements play a role in managing these conditions. As metastatic cancer cells are associated with notable genomic and phenotypic alterations, response to dietary supplements may differ between metastatic and non‐metastatic cancers. However, research in this area is lacking. This scoping review aims to identify the dietary supplements that have been studied in patients with metastatic cancers and malnutrition‐related conditions, along with their proposed effects, mechanisms, outcome measures, and tools used. A systematic search was conducted across databases, including MEDLINE, EMBASE, CINAHL, and clinical trial registries. Of the initial 6535 records screened, a total of 48 studies were included, covering a range of dietary supplements— vitamins, minerals, antioxidants, proteins, amino acids, fatty acids, fiber, and others. While the types of dietary supplements included varied across cancer types, omega‐3 and carnitine were investigated most often. Proposed relevant attributes of dietary supplements included their antioxidant, anti‐inflammatory, anti‐cancer, and immunomodulatory properties. Overall, there was a paucity of interventional studies, and more randomized controlled trials are warranted. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
- Authors: Johal, Jolyn , Han, Chad , Joseph, Ria , Munn, Zachary , Agbejule, Oluwaseyifunmi , Crawford‐Williams, Fiona , Wallen, Matthew , Chan, Raymond , Hart, Nicolas
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Nutrients Vol. 14, no. 13 (2022), p.
- Full Text:
- Reviewed:
- Description: Cancer‐associated malnutrition, or cachexia, stemming from cancer or its treatments, is particularly prevalent in metastatic cancers, and is often interrelated with sarcopenia and frailty. Evidence suggests that dietary supplements play a role in managing these conditions. As metastatic cancer cells are associated with notable genomic and phenotypic alterations, response to dietary supplements may differ between metastatic and non‐metastatic cancers. However, research in this area is lacking. This scoping review aims to identify the dietary supplements that have been studied in patients with metastatic cancers and malnutrition‐related conditions, along with their proposed effects, mechanisms, outcome measures, and tools used. A systematic search was conducted across databases, including MEDLINE, EMBASE, CINAHL, and clinical trial registries. Of the initial 6535 records screened, a total of 48 studies were included, covering a range of dietary supplements— vitamins, minerals, antioxidants, proteins, amino acids, fatty acids, fiber, and others. While the types of dietary supplements included varied across cancer types, omega‐3 and carnitine were investigated most often. Proposed relevant attributes of dietary supplements included their antioxidant, anti‐inflammatory, anti‐cancer, and immunomodulatory properties. Overall, there was a paucity of interventional studies, and more randomized controlled trials are warranted. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
Stubborn exercise responders–where to next?
- Bell, Leo, Gabbett, Tim, Davis, Gregory, Wallen, Matthew, O’Brien, Brendan
- Authors: Bell, Leo , Gabbett, Tim , Davis, Gregory , Wallen, Matthew , O’Brien, Brendan
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Sports Vol. 10, no. 6 (2022), p.
- Full Text:
- Reviewed:
- Description: There is a wide variance in the magnitude of physiological adaptations after resistance or endurance training. The incidence of “non” or “poor” responders to training has been reported to represent as high as 40% of the project’s sample. However, the incidence of poor responders to training can be ameliorated with manipulation of either the training frequency, intensity, type and duration. Additionally, global non‐response to cardio‐respiratory fitness training is eliminated when evaluating several health measures beyond just the target variables as at least one or more measure improves. More research is required to determine if altering resistance training variables results in a more favourable response in individuals with an initial poor response to resistance training. Moreover, we recommend abandoning the term “poor” responders, as ultimately the magnitude of change in cardiorespiratory fitness in response to endurance training is similar in “poor” and “high” responders if the training frequency is subsequently increased. Therefore, we propose “stubborn” responders as a more appropriate term. Future research should focus on developing viable physiological and lifestyle screening tests that identify likely stubborn responders to conventional exercise training guidelines before the individual engages with training. Exerkines, DNA damage, metabolomic responses in blood, saliva and breath, gene sequence, gene expression and epigenetics are candidate biomarkers that warrant investigation into their relationship with traina-bility. Crucially, viable biomarker screening tests should show good construct validity to distinguish between different exercise loads, and possess excellent sensitivity and reliability. Furthermore “red flag” tests of likely poor responders to training should be practical to assess in clinical settings and be affordable and non‐invasive. Early identification of stubborn responders would enable op-timization of training programs from the onset of training to maintain exercise motivation and optimize the impact on training adaptations and health. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
- Authors: Bell, Leo , Gabbett, Tim , Davis, Gregory , Wallen, Matthew , O’Brien, Brendan
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Sports Vol. 10, no. 6 (2022), p.
- Full Text:
- Reviewed:
- Description: There is a wide variance in the magnitude of physiological adaptations after resistance or endurance training. The incidence of “non” or “poor” responders to training has been reported to represent as high as 40% of the project’s sample. However, the incidence of poor responders to training can be ameliorated with manipulation of either the training frequency, intensity, type and duration. Additionally, global non‐response to cardio‐respiratory fitness training is eliminated when evaluating several health measures beyond just the target variables as at least one or more measure improves. More research is required to determine if altering resistance training variables results in a more favourable response in individuals with an initial poor response to resistance training. Moreover, we recommend abandoning the term “poor” responders, as ultimately the magnitude of change in cardiorespiratory fitness in response to endurance training is similar in “poor” and “high” responders if the training frequency is subsequently increased. Therefore, we propose “stubborn” responders as a more appropriate term. Future research should focus on developing viable physiological and lifestyle screening tests that identify likely stubborn responders to conventional exercise training guidelines before the individual engages with training. Exerkines, DNA damage, metabolomic responses in blood, saliva and breath, gene sequence, gene expression and epigenetics are candidate biomarkers that warrant investigation into their relationship with traina-bility. Crucially, viable biomarker screening tests should show good construct validity to distinguish between different exercise loads, and possess excellent sensitivity and reliability. Furthermore “red flag” tests of likely poor responders to training should be practical to assess in clinical settings and be affordable and non‐invasive. Early identification of stubborn responders would enable op-timization of training programs from the onset of training to maintain exercise motivation and optimize the impact on training adaptations and health. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
- Wallen, Matthew, Hennessy, Declan, Brown, Stephen, Evans, Luke, Rawstorn, Jonathan, Wong Shee, Anna, Hall, Adrian
- Authors: Wallen, Matthew , Hennessy, Declan , Brown, Stephen , Evans, Luke , Rawstorn, Jonathan , Wong Shee, Anna , Hall, Adrian
- Date: 2020
- Type: Text , Journal article , Review
- Relation: European Journal of Cancer Care Vol. 29, no. 4 (2020), p.
- Full Text: false
- Reviewed:
- Description: Objective: The primary objective of this systematic review and meta-analysis was to compare the effects of high-intensity interval training (HIIT) versus moderate-intensity continuous training (MICT) and usual care (UC) on cardiorespiratory fitness (peak V̇O2) in cancer patients and survivors. Secondary objectives were to compare the effects of HIIT versus MICT and UC on other cardiopulmonary exercise testing (CPET) indices. Safety and adherence to HIIT were also evaluated. Methods: A systematic review and meta-analysis of controlled trials were undertaken using eligible studies from electronic database searching (inception—December 2019). Mean differences (MD) with 95% confidence intervals (CI) were compared and heterogeneity assessed using Cochran's Q and I2 statistic. Results: Twelve eligible studies included 516 participants with post-intervention CPET data. No serious adverse events occurred. Adherence to HIIT ranged between 71.2% and 95.6%. HIIT had significantly higher peak V̇O2 compared with UC (MD = 2.11 ml kg−1 min−1, 95% CI 0.75–3.47, p =.002). No significant difference was found between HIIT and MICT (MD = 2.03 ml kg−1 min−1, 95%CI −0.75–4.83, p =.15). HIIT was more effective than UC to improve peak oxygen pulse (MD = 1.59 ml/beat, 95%CI 0.06–3.12, p =.04). Conclusions: Quantitative assessment of HIIT studies indicates good compliance, with a significant effect on peak V̇O2 and peak oxygen pulse compared with UC in cancer patients and survivors. HIIT demonstrates a comparable effect with MICT to improve peak V̇O2. © 2020 John Wiley & Sons Ltd
- Description: Western Alliance Academic Health Science Centre , WA-739501
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