The effects of a low- to moderate-intensity balance program for older adults emphasizing self-eff... more The effects of a low- to moderate-intensity balance program for older adults emphasizing self-efficacy information were examined. Participants were assigned to an exercise group with a self-efficacy intervention or as exercise-only controls. Efficacy information focused on mastery experiences and social persuasion. Older adults were pre- and post-tested before a 16-week, self-paced program. Post-testing revealed that adherence was higher for the
During radiation therapy, cancer patients may report cancer- related fatigue (CRF), which impairs... more During radiation therapy, cancer patients may report cancer- related fatigue (CRF), which impairs aerobic capacity, strength, muscle mass, and, ultimately, quality of life (QOL). The purpose of this pilot clinical trial was to examine the feasibility and initial efficacy of a home- based aerobic and progressive resistance exercise intervention for aero- bic capacity, strength, muscle mass, CRF, and QOL. Daily
Fatigue is the most commonly reported symptom in patients with cancer, with a prevalence of over ... more Fatigue is the most commonly reported symptom in patients with cancer, with a prevalence of over 60% reported in the majority of studies. This paper system- atically reviews pharmacologic agents in the treatment of cancer-related fatigue (CRF). We conducted a lit- erature review of clinical trials that assessed pharma- cologic agents for the treatment of CRF. These agents include hematopoietics
Journal of clinical sleep medicine: JCSM: official publication of the American Academy of Sleep Medicine
To determine the relationship between hypothalamic pituitary axis (HPA) dysregulation, vagal func... more To determine the relationship between hypothalamic pituitary axis (HPA) dysregulation, vagal functioning, and sleep problems in women with metastatic breast cancer. Sleep was assessed by means of questionnaires and wrist actigraphy for 3 consecutive nights. The ambulatory, diurnal variation in salivary cortisol levels was measured at 5 time points over 2 days. Vagal regulation was assessed via respiratory sinus arrhythmia (RSA(TF)) during the Trier Social Stress Task. Ninety-nine women (54.6 +/- 9.62 years) with metastatic breast cancer. Longer nocturnal wake episodes (r = 0.21, p = 0.04, N=91) were associated with a flatter diurnal cortisol slope. Sleep disruption was also associated with diminished RSA(TF). Higher RSA baseline scores were significantly correlated with higher sleep efficiency (r = 0.39, p = 0.001, N=68) and correspondingly lower levels of interrupted sleep (waking after sleep onset, WASO; r = -0.38, p = 0.002, N=68), lower average length of nocturnal wake episodes ...
Sexual minority (i.e., lesbian, gay, and bisexual) adults smoke cigarettes at higher rates than h... more Sexual minority (i.e., lesbian, gay, and bisexual) adults smoke cigarettes at higher rates than heterosexual adults. Smoking after receiving a cancer diagnosis is a major health concern, yet risk of continued smoking among sexual minority cancer survivors is as yet unknown. The current study examines current smoking among sexual minority vs. heterosexual adult cancer survivors. Data drawn from the 2010 Behavioral Risk Factor Surveillance System survey in five states (Alaska, California, Massachusetts, New Mexico, and Wisconsin) included items about sexual orientation, cancer diagnosis, and tobacco use. The analytic sample included 124 sexual minority and 248 propensity score matched heterosexual adult cancer survivors. Bivariate analysis showed that sexual minority cancer survivors had twice the odds of current smoking as their heterosexual counterparts (OR=2.03, 95%CI:1.09-3.80). In exploratory analyses stratified by sex, sexual minority disparities in prevalence of smoking post-ca...
Cancer-related fatigue (CRF) is a highly prevalent and debilitating symptom experienced by most c... more Cancer-related fatigue (CRF) is a highly prevalent and debilitating symptom experienced by most cancer patients during, and often for considerable periods after, treatment. This symptom affects patients' overall quality of life and is characterized by persistent exhaustion and a decreased capacity to perform daily social and cognitive tasks. CRF is also one of the most commonly reported side effects of cancer and cancer treatments, including surgery, chemotherapy, radiotherapy, hormonal therapy, and biologic response modification therapy. Pharmacologic methods for treating CRF are not always reliable, and many patients continue to experience this symptom following pharmacologic interventions. Managing CRF is of importance to oncology researchers and clinical service providers. As of March 15, 2006, 76 National Institutes of Health sponsored studies examining CRF were actively recruiting subjects, and 15% of these studies were being conducted through the National Cancer Institute...
Sexual minority (i.e., lesbian, gay, and bisexual) adults smoke cigarettes at higher rates than h... more Sexual minority (i.e., lesbian, gay, and bisexual) adults smoke cigarettes at higher rates than heterosexual adults. Smoking after receiving a cancer diagnosis is a major health concern, yet risk of continued smoking among sexual minority cancer survivors is as yet unknown. The current study examines current smoking among sexual minority vs. heterosexual adult cancer survivors. Data drawn from the 2010 Behavioral Risk Factor Surveillance System survey in five states (Alaska, California, Massachusetts, New Mexico, and Wisconsin) included items about sexual orientation, cancer diagnosis, and tobacco use. The analytic sample included 124 sexual minority and 248 propensity score matched heterosexual adult cancer survivors. Bivariate analysis showed that sexual minority cancer survivors had twice the odds of current smoking as their heterosexual counterparts (OR=2.03, 95%CI:1.09-3.80). In exploratory analyses stratified by sex, sexual minority disparities in prevalence of smoking post-cancer showed a trend toward significance among females, not males. The current study offers preliminary evidence that sexual minority status is one variable among many that must be taken into account when assessing health behaviors post-cancer diagnosis. Future research should identify mechanisms leading from sexual minority status to increased rates of smoking and develop tailored smoking cessation interventions.
Up to 90% of cancer patients report symptoms of insomnia during and after treatment. Symptoms of ... more Up to 90% of cancer patients report symptoms of insomnia during and after treatment. Symptoms of insomnia include excessive daytime sleepiness, difficulty falling asleep, difficulty staying asleep, and waking up too early. Insomnia symptoms are among the most prevalent, distressing and persistent cancer- and cancer treatment-related toxicities reported by patients, and can be severe enough to increase cancer morbidity and mortality. Despite the ubiquity of insomnia symptoms, they are under-screened, under-diagnosed, and under-treated in cancer patients. When insomnia symptoms are identified, providers are hesitant to prescribe, and patients are hesitant to take pharmaceuticals due to polypharmacy concerns. In addition, sleep medications do not cure insomnia. Yoga is a well-tolerated mode of exercise with promising evidence for its efficacy in improving insomnia symptoms among cancer patients. This article reviews existing clinical research on the effectiveness of yoga for treating i...
Cancer and its treatments produce a myriad of burdensome side effects and significantly impair qu... more Cancer and its treatments produce a myriad of burdensome side effects and significantly impair quality of life (QOL). Exercise reduces side effects and improves QOL for cancer patients during treatment and recovery. Exercise prior to, during, and after completion of cancer treatments provides numerous beneficial outcomes. Exercise represents an effective therapeutic intervention for preparing patients to successfully complete treatments, for reducing acute, chronic and late side effects, and for improving QOL during and after treatments. This overview of exercise oncology and side-effect management summarizes existing evidence-based exercise guidelines for cancer patients and survivors.
Cancer-related fatigue is the most common side effect reported by cancer patients during and afte... more Cancer-related fatigue is the most common side effect reported by cancer patients during and after treatment. Cancer-related fatigue significantly interferes with a patient's ability to perform activities of daily living and maintain functional independence and quality of life. Cancer-related fatigue can also interfere with a patient's ability to complete treatments. The purpose of this article is to provide an overview of cancer-related fatigue, its pathopsychophysiology, and the role of exercise in the management of this side effect.
Nausea and vomiting are two of the most troubling side effects patients experience during chemoth... more Nausea and vomiting are two of the most troubling side effects patients experience during chemotherapy. While newly available treatments have improved our ability to manage nausea and vomiting, anticipatory and delayed nausea and vomiting are still a major problem for patients receiving chemotherapy. Many cancer patients will delay or refuse future chemotherapy treatments and contemplate stopping chemotherapy altogether because of their fear of experiencing further nausea and vomiting. The purpose of this article is to provide an overview of the patho-psychophysiology of chemotherapy-induced nausea and vomiting and the recommended guidelines for treatment.
Cancer-related fatigue (CRF) is a highly prevalent and debilitating symptom experienced by most c... more Cancer-related fatigue (CRF) is a highly prevalent and debilitating symptom experienced by most cancer patients during, and often for considerable periods after, treatment. This symptom affects patients' overall quality of life and is characterized by persistent exhaustion and a decreased capacity to perform daily social and cognitive tasks. CRF is also one of the most commonly reported side effects of cancer and cancer treatments, including surgery, chemotherapy, radiotherapy, hormonal therapy, and biologic response modification therapy. Pharmacologic methods for treating CRF are not always reliable, and many patients continue to experience this symptom following pharmacologic interventions. Managing CRF is of importance to oncology researchers and clinical service providers. As of March 15, 2006, 76 National Institutes of Health sponsored studies examining CRF were actively recruiting subjects, and 15% of these studies were being conducted through the National Cancer Institute...
... Gary R. Morrow, Joseph A. Roscoe, Maralyn E. Kaufman, Christopher Bole, Colmar Figueroa-Mosel... more ... Gary R. Morrow, Joseph A. Roscoe, Maralyn E. Kaufman, Christopher Bole, Colmar Figueroa-Moseley ... GR Morrow, PhD, MS Professor of Radiation Oncology, Professor of Psychiatry, Direc-tor, URCC ... 2293) 7. Morrow GR, Shelke AR, Roscoe JA et al (2005) Manage-ment of ...
Recent studies have highlighted disparities in cancer diagnosis between lesbian, gay, bisexual an... more Recent studies have highlighted disparities in cancer diagnosis between lesbian, gay, bisexual and transgender (LGBT) and heterosexual adults. Studies have yet to examine disparities between LGBT and heterosexual cancer survivors in prevalence of psychological distress. Data for the current study were drawn from the LIVESTRONG dataset, a US national survey that sampled 207 LGBT and 4899 heterosexual cancer survivors (all cancer types, 63.5% women, mean age 49) in 2010. Symptoms of psychological distress were assessed with dichotomous yes/no items in three symptom clusters (depression related to cancer, difficulties with social relationships post-cancer, fatigue/energy problems). We selected a sample of 621 heterosexual survivors matched by propensity score to the 207 LGBT survivors and assessed disparities in count of symptoms using Poisson regression. We also performed subgroup analyses by self-reported sex. Relative to heterosexuals, LGBT cancer survivors reported a higher number ...
The effects of a low- to moderate-intensity balance program for older adults emphasizing self-eff... more The effects of a low- to moderate-intensity balance program for older adults emphasizing self-efficacy information were examined. Participants were assigned to an exercise group with a self-efficacy intervention or as exercise-only controls. Efficacy information focused on mastery experiences and social persuasion. Older adults were pre- and post-tested before a 16-week, self-paced program. Post-testing revealed that adherence was higher for the
During radiation therapy, cancer patients may report cancer- related fatigue (CRF), which impairs... more During radiation therapy, cancer patients may report cancer- related fatigue (CRF), which impairs aerobic capacity, strength, muscle mass, and, ultimately, quality of life (QOL). The purpose of this pilot clinical trial was to examine the feasibility and initial efficacy of a home- based aerobic and progressive resistance exercise intervention for aero- bic capacity, strength, muscle mass, CRF, and QOL. Daily
Fatigue is the most commonly reported symptom in patients with cancer, with a prevalence of over ... more Fatigue is the most commonly reported symptom in patients with cancer, with a prevalence of over 60% reported in the majority of studies. This paper system- atically reviews pharmacologic agents in the treatment of cancer-related fatigue (CRF). We conducted a lit- erature review of clinical trials that assessed pharma- cologic agents for the treatment of CRF. These agents include hematopoietics
Journal of clinical sleep medicine: JCSM: official publication of the American Academy of Sleep Medicine
To determine the relationship between hypothalamic pituitary axis (HPA) dysregulation, vagal func... more To determine the relationship between hypothalamic pituitary axis (HPA) dysregulation, vagal functioning, and sleep problems in women with metastatic breast cancer. Sleep was assessed by means of questionnaires and wrist actigraphy for 3 consecutive nights. The ambulatory, diurnal variation in salivary cortisol levels was measured at 5 time points over 2 days. Vagal regulation was assessed via respiratory sinus arrhythmia (RSA(TF)) during the Trier Social Stress Task. Ninety-nine women (54.6 +/- 9.62 years) with metastatic breast cancer. Longer nocturnal wake episodes (r = 0.21, p = 0.04, N=91) were associated with a flatter diurnal cortisol slope. Sleep disruption was also associated with diminished RSA(TF). Higher RSA baseline scores were significantly correlated with higher sleep efficiency (r = 0.39, p = 0.001, N=68) and correspondingly lower levels of interrupted sleep (waking after sleep onset, WASO; r = -0.38, p = 0.002, N=68), lower average length of nocturnal wake episodes ...
Sexual minority (i.e., lesbian, gay, and bisexual) adults smoke cigarettes at higher rates than h... more Sexual minority (i.e., lesbian, gay, and bisexual) adults smoke cigarettes at higher rates than heterosexual adults. Smoking after receiving a cancer diagnosis is a major health concern, yet risk of continued smoking among sexual minority cancer survivors is as yet unknown. The current study examines current smoking among sexual minority vs. heterosexual adult cancer survivors. Data drawn from the 2010 Behavioral Risk Factor Surveillance System survey in five states (Alaska, California, Massachusetts, New Mexico, and Wisconsin) included items about sexual orientation, cancer diagnosis, and tobacco use. The analytic sample included 124 sexual minority and 248 propensity score matched heterosexual adult cancer survivors. Bivariate analysis showed that sexual minority cancer survivors had twice the odds of current smoking as their heterosexual counterparts (OR=2.03, 95%CI:1.09-3.80). In exploratory analyses stratified by sex, sexual minority disparities in prevalence of smoking post-ca...
Cancer-related fatigue (CRF) is a highly prevalent and debilitating symptom experienced by most c... more Cancer-related fatigue (CRF) is a highly prevalent and debilitating symptom experienced by most cancer patients during, and often for considerable periods after, treatment. This symptom affects patients' overall quality of life and is characterized by persistent exhaustion and a decreased capacity to perform daily social and cognitive tasks. CRF is also one of the most commonly reported side effects of cancer and cancer treatments, including surgery, chemotherapy, radiotherapy, hormonal therapy, and biologic response modification therapy. Pharmacologic methods for treating CRF are not always reliable, and many patients continue to experience this symptom following pharmacologic interventions. Managing CRF is of importance to oncology researchers and clinical service providers. As of March 15, 2006, 76 National Institutes of Health sponsored studies examining CRF were actively recruiting subjects, and 15% of these studies were being conducted through the National Cancer Institute...
Sexual minority (i.e., lesbian, gay, and bisexual) adults smoke cigarettes at higher rates than h... more Sexual minority (i.e., lesbian, gay, and bisexual) adults smoke cigarettes at higher rates than heterosexual adults. Smoking after receiving a cancer diagnosis is a major health concern, yet risk of continued smoking among sexual minority cancer survivors is as yet unknown. The current study examines current smoking among sexual minority vs. heterosexual adult cancer survivors. Data drawn from the 2010 Behavioral Risk Factor Surveillance System survey in five states (Alaska, California, Massachusetts, New Mexico, and Wisconsin) included items about sexual orientation, cancer diagnosis, and tobacco use. The analytic sample included 124 sexual minority and 248 propensity score matched heterosexual adult cancer survivors. Bivariate analysis showed that sexual minority cancer survivors had twice the odds of current smoking as their heterosexual counterparts (OR=2.03, 95%CI:1.09-3.80). In exploratory analyses stratified by sex, sexual minority disparities in prevalence of smoking post-cancer showed a trend toward significance among females, not males. The current study offers preliminary evidence that sexual minority status is one variable among many that must be taken into account when assessing health behaviors post-cancer diagnosis. Future research should identify mechanisms leading from sexual minority status to increased rates of smoking and develop tailored smoking cessation interventions.
Up to 90% of cancer patients report symptoms of insomnia during and after treatment. Symptoms of ... more Up to 90% of cancer patients report symptoms of insomnia during and after treatment. Symptoms of insomnia include excessive daytime sleepiness, difficulty falling asleep, difficulty staying asleep, and waking up too early. Insomnia symptoms are among the most prevalent, distressing and persistent cancer- and cancer treatment-related toxicities reported by patients, and can be severe enough to increase cancer morbidity and mortality. Despite the ubiquity of insomnia symptoms, they are under-screened, under-diagnosed, and under-treated in cancer patients. When insomnia symptoms are identified, providers are hesitant to prescribe, and patients are hesitant to take pharmaceuticals due to polypharmacy concerns. In addition, sleep medications do not cure insomnia. Yoga is a well-tolerated mode of exercise with promising evidence for its efficacy in improving insomnia symptoms among cancer patients. This article reviews existing clinical research on the effectiveness of yoga for treating i...
Cancer and its treatments produce a myriad of burdensome side effects and significantly impair qu... more Cancer and its treatments produce a myriad of burdensome side effects and significantly impair quality of life (QOL). Exercise reduces side effects and improves QOL for cancer patients during treatment and recovery. Exercise prior to, during, and after completion of cancer treatments provides numerous beneficial outcomes. Exercise represents an effective therapeutic intervention for preparing patients to successfully complete treatments, for reducing acute, chronic and late side effects, and for improving QOL during and after treatments. This overview of exercise oncology and side-effect management summarizes existing evidence-based exercise guidelines for cancer patients and survivors.
Cancer-related fatigue is the most common side effect reported by cancer patients during and afte... more Cancer-related fatigue is the most common side effect reported by cancer patients during and after treatment. Cancer-related fatigue significantly interferes with a patient's ability to perform activities of daily living and maintain functional independence and quality of life. Cancer-related fatigue can also interfere with a patient's ability to complete treatments. The purpose of this article is to provide an overview of cancer-related fatigue, its pathopsychophysiology, and the role of exercise in the management of this side effect.
Nausea and vomiting are two of the most troubling side effects patients experience during chemoth... more Nausea and vomiting are two of the most troubling side effects patients experience during chemotherapy. While newly available treatments have improved our ability to manage nausea and vomiting, anticipatory and delayed nausea and vomiting are still a major problem for patients receiving chemotherapy. Many cancer patients will delay or refuse future chemotherapy treatments and contemplate stopping chemotherapy altogether because of their fear of experiencing further nausea and vomiting. The purpose of this article is to provide an overview of the patho-psychophysiology of chemotherapy-induced nausea and vomiting and the recommended guidelines for treatment.
Cancer-related fatigue (CRF) is a highly prevalent and debilitating symptom experienced by most c... more Cancer-related fatigue (CRF) is a highly prevalent and debilitating symptom experienced by most cancer patients during, and often for considerable periods after, treatment. This symptom affects patients' overall quality of life and is characterized by persistent exhaustion and a decreased capacity to perform daily social and cognitive tasks. CRF is also one of the most commonly reported side effects of cancer and cancer treatments, including surgery, chemotherapy, radiotherapy, hormonal therapy, and biologic response modification therapy. Pharmacologic methods for treating CRF are not always reliable, and many patients continue to experience this symptom following pharmacologic interventions. Managing CRF is of importance to oncology researchers and clinical service providers. As of March 15, 2006, 76 National Institutes of Health sponsored studies examining CRF were actively recruiting subjects, and 15% of these studies were being conducted through the National Cancer Institute...
... Gary R. Morrow, Joseph A. Roscoe, Maralyn E. Kaufman, Christopher Bole, Colmar Figueroa-Mosel... more ... Gary R. Morrow, Joseph A. Roscoe, Maralyn E. Kaufman, Christopher Bole, Colmar Figueroa-Moseley ... GR Morrow, PhD, MS Professor of Radiation Oncology, Professor of Psychiatry, Direc-tor, URCC ... 2293) 7. Morrow GR, Shelke AR, Roscoe JA et al (2005) Manage-ment of ...
Recent studies have highlighted disparities in cancer diagnosis between lesbian, gay, bisexual an... more Recent studies have highlighted disparities in cancer diagnosis between lesbian, gay, bisexual and transgender (LGBT) and heterosexual adults. Studies have yet to examine disparities between LGBT and heterosexual cancer survivors in prevalence of psychological distress. Data for the current study were drawn from the LIVESTRONG dataset, a US national survey that sampled 207 LGBT and 4899 heterosexual cancer survivors (all cancer types, 63.5% women, mean age 49) in 2010. Symptoms of psychological distress were assessed with dichotomous yes/no items in three symptom clusters (depression related to cancer, difficulties with social relationships post-cancer, fatigue/energy problems). We selected a sample of 621 heterosexual survivors matched by propensity score to the 207 LGBT survivors and assessed disparities in count of symptoms using Poisson regression. We also performed subgroup analyses by self-reported sex. Relative to heterosexuals, LGBT cancer survivors reported a higher number ...
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