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Open Access 01-08-2020 | Affective Disorder

Effects of dietary and physical activity interventions on generic and cancer-specific health-related quality of life, anxiety, and depression in colorectal cancer survivors: a randomized controlled trial

Authors: Mandy Ho, Judy W. C. Ho, Daniel Y. T. Fong, C. F. Lee, Duncan J. Macfarlane, Ester Cerin, Antoinette M. Lee, Sharron Leung, Wynnie Y. Y. Chan, Ivy P. F. Leung, Sharon H. S. Lam, Natural Chu, Aliki J. Taylor, Kar-Keung Cheng

Published in: Journal of Cancer Survivorship | Issue 4/2020

Abstract

Purpose

To assess the effects of dietary and physical activity (PA) interventions on generic and cancer-specific quality of life (QoL), anxiety, and depression levels among adult Chinese colorectal cancer (CRC) survivors.

Methods

Two-hundred twenty-three adult CRC survivors within 1 year of completion of primary cancer treatment were randomized to receive dietary, PA or combined intervention, or usual care for a 12 monthduration, under a 2 (diet vs usual care) × 2 (PA vs usual care) factorial design. Generic and cancer-specific QoL was assessed using a Chinese version 12-Item Short Form Health Survey (SF-12) and the Functional Assessment of Cancer Therapy-Colorectal (FACT-C) scale, respectively. Anxiety and depression was assessed using the Hospital Anxiety and Depression Scale at baseline, 6, 12, 18, and 24 months. Linear mixed models were used for examining the intervention effects.

Results

Participants receiving dietary intervention experienced a significant improvement in the generic measure of QoL (SF-6D utility scores, mean difference 0.042, 95%CI 0.03 to 0.081) at 12 months, the cancer-specific QoL scores (mean difference 3.09, 95%CI 0.13 to 6.04), and levels of depression (P = 0.015) at both 12 and 24 months follow-up. Participants receiving PA intervention only demonstrated a significant improvement in SF-6D utility index (mean difference 0.039, 95%CI 0.002 to 0.077) and physical functioning (mean difference 2.85, 95%CI 1.00 to 4.70) at 6 months.

Conclusions

Dietary intervention improved the generic and cancer-specific QoL and depression in CRC survivors.

Trial registration

The study was prospectively registered on 17 October 2012 at ClinicalTrials.gov (NCT01708824).

Implications for Cancer Survivors

CRC survivors can benefit from dietary interventions in alleviating depression and improving overall health-related QoL.

World Cancer Research Fund. Colorectal cancer statistics 2019 [cited 2019 16th July 2019]. Available from: https://www.wcrf.org/dietandcancer/cancer-trends/colorectal-cancer-statistics.

Arnold M, Sierra MS, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global patterns and trends in colorectal cancer incidence and mortality. Gut. 2017;66(4):683–91.PubMedCrossRef

Hong Kong Cancer Registry. Cancer facts In: https://www3.ha.org.hk/cancereg/facts.html.

Elliott J, Fallows A, Staetsky L, Smith PWF, Foster CL, Maher EJ, et al. The health and well-being of cancer survivors in the UK: findings from a population-based survey. Br J Cancer. 2011;105:S11.PubMedPubMedCentralCrossRef

Richardson LC, Wingo PA, Zack MM, Zahran HS, King JB. Health-related quality of life in cancer survivors between ages 20 and 64 years. Cancer. 2008;112(6):1380–9.PubMedCrossRef

Weaver KE, Forsythe LP, Reeve BB, Alfano CM, Rodriguez JL, Sabatino SA, et al. Mental and physical health–related quality of life among U.S. cancer survivors: population estimates from the 2010 National Health Interview Survey. Cancer Epidemiology Biomarkers & Prevention. 2012.

Blanchard CM, Courneya KS, Stein K. Cancer survivors’ adherence to lifestyle behavior recommendations and associations with health-related quality of life: results from the American Cancer Society’s SCS-II. J Clin Oncol. 2008;26(13):2198–204.PubMedCrossRef

Mosher CE, Sloane R, Morey MC, Snyder DC, Cohen HJ, Miller PE, et al. Associations between lifestyle factors and quality of life among older long-term breast, prostate, and colorectal cancer survivors. Cancer. 2009;115(17):4001–9.PubMedPubMedCentralCrossRef

Hawkes AL, Pakenham KI, Chambers SK, Patrao TA, Courneya KS. Effects of a multiple health behavior change intervention for colorectal cancer survivors on psychosocial outcomes and quality of life: a randomized controlled trial. Ann Behav Med. 2014;48(3):359–70.PubMedCrossRef

10.

Grimmett C, Simon A, Lawson V, Wardle J. Diet and physical activity intervention in colorectal cancer survivors: a feasibility study. Eur J Oncol Nurs. 2015;19(1):1–6.PubMedPubMedCentralCrossRef

11.

Hawkes AL, Patrao TA, Green A, Aitken JF. CanPrevent: a telephone-delivered intervention to reduce multiple behavioural risk factors for colorectal cancer. BMC Cancer. 2012;12:560.PubMedPubMedCentralCrossRef

12.

Lynch BM, van Roekel EH, Vallance JK. Physical activity and quality of life after colorectal cancer: overview of evidence and future directions. Expert Review of Quality of Life in Cancer Care. 2016;1(1):9–23.CrossRef

13.

Van Blarigan EL, Meyerhardt JA. Role of physical activity and diet after colorectal cancer diagnosis. J Clin Oncol. 2015;33(16):1825.PubMedPubMedCentralCrossRef

14.

Lee C, Ho JW, Fong DY, Macfarlane DJ, Cerin E, Lee AM, et al. Dietary and physical activity interventions for colorectal cancer survivors: a randomized controlled trial. Sci Rep. 2018;8(1):5731.PubMedPubMedCentralCrossRef

15.

Ho JW, Lee AM, Macfarlane DJ, Fong DY, Leung S, Cerin E, et al. Study protocol for “moving bright, eating smart”–a phase 2 clinical trial on the acceptability and feasibility of a diet and physical activity intervention to prevent recurrence in colorectal cancer survivors. BMC Public Health. 2013;13(1):487.PubMedPubMedCentralCrossRef

16.

Shu XO, Yang G, Jin F, Liu D, Kushi L, Wen W, et al. Validity and reproducibility of the food frequency questionnaire used in the Shanghai women’s health study. Eur J Clin Nutr. 2004;58(1):17–23.PubMedCrossRef

17.

Bull FC, Maslin TS, Armstrong T. Global physical activity questionnaire (GPAQ): nine country reliability and validity study. J Phys Act Health. 2009;6(6):790–804.PubMedCrossRef

18.

Ajzen I. The theory of planned behavior. Organ Behav Hum Decis Process. 1991;50(2):179–211.CrossRef

19.

Schwarzer R, Luszczynska A. How to overcome health-compromising behaviors: the health action process approach. Eur Psychol. 2008;13(2):141–51.CrossRef

20.

Lam CL, Eileen Y, Gandek B. Is the standard SF-12 health survey valid and equivalent for a Chinese population? Qual Life Res. 2005;14(2):539–47.PubMedCrossRef

21.

Yu CL, Fielding R, Chan CL, Tse VK, Choi PH, Lau W, et al. Measuring quality of life of Chinese cancer patients: a validation of the Chinese version of the functional assessment of cancer therapy–general (FACT-G) scale. Cancer. 2000;88(7):1715–27.PubMedCrossRef

22.

Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361–70.CrossRef

23.

Leung C, Ho S, Kan C, Hung C, Chen C. Evaluation of the Chinese version of the hospital anxiety and depression scale: a cross-cultural perspective. Int J Psychosom. 1993.

24.

Ware JE Jr, Kosinski M, Keller SD. A 12-item short-form health survey: construction of scales and preliminary tests of reliability and validity. Med Care. 1996:220–33.

25.

Lam CL, Brazier J, McGhee SM. Valuation of the SF-6D health states is feasible, acceptable, reliable, and valid in a Chinese population. Value Health. 2008;11(2):295–303.PubMedCrossRef

26.

Morgan MA, editor Cancer survivorship: history, quality-of-life issues, and the evolving multidisciplinary approach to implementation of cancer survivorship care plans. Oncology Nursing Forum; 2009.

27.

Husson O, Mols F, van de Poll-Franse LV. The relation between information provision and health-related quality of life, anxiety and depression among cancer survivors: a systematic review. Ann Oncol. 2011;22(4):761–72.PubMedCrossRef

28.

Brazier JE, Roberts J. The estimation of a preference-based measure of health from the SF-12. Med Care. 2004:851–9.

29.

Bourke L, Thompson G, Gibson DJ, Daley A, Crank H, Adam I, et al. Pragmatic lifestyle intervention in patients recovering from colon cancer: a randomized controlled pilot study. Arch Phys Med Rehabil. 2011;92(5):749–55.PubMedCrossRef

30.

Courneya K, Friedenreich C, Quinney H, Fields A, Jones L, Fairey A. A randomized trial of exercise and quality of life in colorectal cancer survivors. Eur J Cancer Care. 2003;12(4):347–57.CrossRef

31.

Eakin EG, Lawler SP, Winkler EA, Hayes SC. A randomized trial of a telephone-delivered exercise intervention for non-urban dwelling women newly diagnosed with breast cancer: exercise for health. Ann Behav Med. 2011;43(2):229–38.CrossRef

Title: Effects of dietary and physical activity interventions on generic and cancer-specific health-related quality of life, anxiety, and depression in colorectal cancer survivors: a randomized controlled trial
Authors: Mandy Ho
Judy W. C. Ho
Daniel Y. T. Fong
C. F. Lee
Duncan J. Macfarlane
Ester Cerin
Antoinette M. Lee
Sharron Leung
Wynnie Y. Y. Chan
Ivy P. F. Leung
Sharon H. S. Lam
Natural Chu
Aliki J. Taylor
Kar-Keung Cheng
Publication date: 01-08-2020
Publisher: Springer US
Keywords: Affective Disorder
Affective Disorder
Anxiety
Colorectal Cancer
Colorectal Cancer
Published in: Journal of Cancer Survivorship / Issue 4/2020
Print ISSN: 1932-2259
Electronic ISSN: 1932-2267
DOI: https://doi.org/10.1007/s11764-020-00864-0

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Abstract

Purpose

Methods

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Conclusions

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Implications for Cancer Survivors

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