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International Journal of Colorectal Disease

, Volume 32, Issue 1, pp 75–81 | Cite as

Cancer Survivor Study (CASUS) on colorectal patients: longitudinal study on physical activity, fitness, nutrition, and its influences on quality of life, disease recurrence, and survival. Rationale and design

  • Luisa Soares-MirandaEmail author
  • Sandra Abreu
  • Marco Silva
  • Armando Peixoto
  • Rosa Ramalho
  • Pedro Correia da Silva
  • Carla Costa
  • João Paulo Teixeira
  • Carla Gonçalves
  • Pedro Moreira
  • Jorge Mota
  • Guilherme Macedo
Original Article

Abstract

Purpose

Evidence suggests that being physically active in combination with a healthy diet contributes to diminish colorectal cancer risk. However, if this is true for colorectal cancer primary prevention, the same is not clear for its recurrence after colorectal cancer treatments. Data on cancer survival are scarce, and there is a need for greater attention on these survivors’ lifestyle behavior. This manuscript describes rationale and design of the Cancer Survival Study (CASUS) on colorectal patients, a longitudinal observational study with the aim of investigating how physical activity, physical fitness, and dietary intake are related with their quality of life, disease recurrence, and survival.

Methods

The CASUS on colorectal patients is a longitudinal cohort study on colorectal survivors, aged 18 years or older, recruited 6, 12, and 24 months after surgery. Upon recruitment, patients fill in a battery of questionnaires about physical activity, dietary intake, and quality of life, donate blood samples, do physical fitness tests, and use an accelerometer during 7 days. Repeated analyses will be performed to assess changes over time in physical activity, physical fitness, dietary intake, and other factors in relation to recurrence and survival.

Conclusions

Results will contribute to highlight the role of physical activity, physical fitness, and nutrition in the quality of life of colorectal cancer survivors, recurrence, and survival. This study will provide important information for policymakers on the potential benefits of future physical activity and nutritional interventions, which are inexpensive, as a way to improve general health of colorectal cancer survivors.

Keywords

Cancer survival Colorectal cancer Diet Exercise Fitness 

Notes

Acknowledgments

Luisa Soares-Miranda is supported by the grant SFRH/BPD/76947/2011 funded by FCT (QREN-POPH-Type 4.1-Advanced Training, subsidized by the European Social Fund and national funds of MEC), PTDC/DES/099018/2008-FCT/FCOMP-01-0124-FEDER-009573, and the Research Centre in Physical Activity Health and Leisure is supported by FCT: UID/DTP/00617/2013. Carla Costa is supported by the grant SFRH/BPD/96196/2013, funded by FCT (QREN-POPH-Type 4.1-Advanced Training, subsidized by the European Social Fund and national funds of MEC).

References

  1. 1.
    May MT, Ingle SM, Costagliola D, Justice AC, de Wolf F, Cavassini M, D’Arminio Monforte A, Casabona J, Hogg RS, Mocroft A, Lampe FC, Dabis F, Fatkenheuer G, Sterling TR, del Amo J, Gill MJ, Crane HM, Saag MS, Guest J, Brodt HR, Sterne JA, Antiretroviral Cohort C (2014) Cohort profile: antiretroviral therapy cohort collaboration (ART-CC. Int J Epidemiol 43(3):691–702. doi: 10.1093/ije/dyt010 CrossRefPubMedGoogle Scholar
  2. 2.
    Pinto CG, Paquete AT, Pissarra I (2010) Colorectal cancer in Portugal. The European journal of health economics : HEPAC : health economics in prevention and care 10 Suppl 1:S65–S73. doi: 10.1007/s10198-009-0187-9 CrossRefPubMedGoogle Scholar
  3. 3.
    De Angelis R, Sant M, Coleman MP, Francisci S, Baili P, Pierannunzio D, Trama A, Visser O, Brenner H, Ardanaz E, Bielska-Lasota M, Engholm G, Nennecke A, Siesling S, Berrino F, Capocaccia R, Group E-W (2014) Cancer survival in Europe 1999-2007 by country and age: results of EUROCARE—5-a population-based study. The Lancet Oncology 15(1):23–34. doi: 10.1016/S1470-2045(13)70546-1 CrossRefPubMedGoogle Scholar
  4. 4.
    Lajous M, Mozaffarian D, Mozaffarian R, Schrag D, Adami HO (2011) Lifestyle prescriptions for cancer survivors and their communities. J Intern Med 269(1):88–93. doi: 10.1111/j.1365-2796.2010.02273.x CrossRefPubMedGoogle Scholar
  5. 5.
    Moller T, Lillelund C, Andersen C, Ejlertsen B, Norgaard L, Christensen KB, Vadstrup E, Diderichsen F, Hendriksen C, Bloomquist K, Adamsen L (2013) At cancer diagnosis: a ‘window of opportunity’ for behavioural change towards physical activity. A randomised feasibility study in patients with colon and breast cancer. BMJ Open 3(11):e003556. doi: 10.1136/bmjopen-2013-003556 CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Wolin KY, Colditz GA (2011) Implementing chronic disease prevention amongst cancer survivors. J Intern Med 269(1):85–87. doi: 10.1111/j.1365-2796.2010.02295.x CrossRefPubMedGoogle Scholar
  7. 7.
    Jansen L, Herrmann A, Stegmaier C, Singer S, Brenner H, Arndt V (2011) Health-related quality of life during the 10 years after diagnosis of colorectal cancer: a population-based study. Journal of clinical oncology : official journal of the American Society of Clinical Oncology 29(24):3263–3269. doi: 10.1200/jco.2010.31.4013 CrossRefGoogle Scholar
  8. 8.
    Jansen L, Koch L, Brenner H, Arndt V (2010) Quality of life among long-term (>/=5 years) colorectal cancer survivors—systematic review. European journal of cancer (Oxford, England : 1990) 46(16):2879–2888. doi: 10.1016/j.ejca.2010.06.010 CrossRefGoogle Scholar
  9. 9.
    Mosher CE, Sloane R, Morey MC, Snyder DC, Cohen HJ, Miller PE, Demark-Wahnefried W (2009) Associations between lifestyle factors and quality of life among older long-term breast, prostate, and colorectal cancer survivors. Cancer 115(17):4001–4009. doi: 10.1002/cncr.24436 CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Phipps E, Braitman LE, Stites S, Leighton JC (2008) Quality of life and symptom attribution in long-term colon cancer survivors. J Eval Clin Pract 14(2):254–258. doi: 10.1111/j.1365-2753.2007.00842.x CrossRefPubMedGoogle Scholar
  11. 11.
    Harrington CB, Hansen JA, Moskowitz M, Todd BL, Feuerstein M (2010) It’s not over when it’s over: long-term symptoms in cancer survivors—a systematic review. Int J Psychiatry Med 40(2):163–181CrossRefPubMedGoogle Scholar
  12. 12.
    Alfano CM, Rowland JH (2006) Recovery issues in cancer survivorship: a new challenge for supportive care. Cancer J 12(5):432–443CrossRefPubMedGoogle Scholar
  13. 13.
    Caswell S, Anderson AS, Steele RJ (2008) Diet and physical activity in patients with colorectal adenomas: directions for intervention programmes. Journal of human nutrition and dietetics : the official journal of the British Dietetic Association 21(5):494–501. doi: 10.1111/j.1365-277X.2008.00884.x CrossRefGoogle Scholar
  14. 14.
    Weston A, Harris CC (2003) Chemical carcinogenesis. In: Kufe DW, Holland JF (eds) Cancer medicine. Hamilton, Ont., CanadaGoogle Scholar
  15. 15.
    Friedberg EC, McDaniel LD, Schultz RA (2004) The role of endogenous and exogenous DNA damage and mutagenesis. Current Opinion in Genetics & Development 14(1):5–10. doi: 10.1016/j.gde.2003.11.001 CrossRefGoogle Scholar
  16. 16.
    Loft S, Poulsen HE (1996) Cancer risk and oxidative DNA damage in man. J Mol Med (Berl) 74(6):297–312CrossRefGoogle Scholar
  17. 17.
    De Bont R, van Larebeke N (2004) Endogenous DNA damage in humans: a review of quantitative data. Mutagenesis 19(3):169–185CrossRefPubMedGoogle Scholar
  18. 18.
    Valko M, Izakovic M, Mazur M, Rhodes CJ, Telser J (2004) Role of oxygen radicals in DNA damage and cancer incidence. Mol Cell Biochem 266(1–2):37–56CrossRefPubMedGoogle Scholar
  19. 19.
    Hartmann A, Plappert U, Raddatz K, Grunert-Fuchs M, Speit G (1994) Does physical activity induce DNA damage? Mutagenesis 9(3):269–272CrossRefPubMedGoogle Scholar
  20. 20.
    Radak Z, Chung HY, Koltai E, Taylor AW, Goto S (2008) Exercise, oxidative stress and hormesis. Ageing Res Rev 7(1):34–42. doi: 10.1016/j.arr.2007.04.004 CrossRefPubMedGoogle Scholar
  21. 21.
    Cash SW, Beresford SA, Vaughan TL, Heagerty PJ, Bernstein L, White E, Neuhouser ML (2014) Recent physical activity in relation to DNA damage and repair using the comet assay. J Phys Act Health 11(4):770–776. doi: 10.1123/jpah.2012-0278 CrossRefPubMedGoogle Scholar
  22. 22.
    Tseng M, Satia JA (2010) 14.21—diet and cancer. In: McQueen CA (ed) Comprehensive toxicology, Second edn. Elsevier, Oxford, pp. 433–448. doi: 10.1016/B978-0-08-046884-6.01422-6 CrossRefGoogle Scholar
  23. 23.
    Magalhaes B, Peleteiro B, Lunet N (2012) Dietary patterns and colorectal cancer: systematic review and meta-analysis. Eur J Cancer Prev 21(1):15–23. doi: 10.1097/CEJ.0b013e3283472241 CrossRefPubMedGoogle Scholar
  24. 24.
    Sesink AL, Termont DS, Kleibeuker JH, Van der Meer R (1999) Red meat and colon cancer: the cytotoxic and hyperproliferative effects of dietary heme. Cancer Res 59(22):5704–5709PubMedGoogle Scholar
  25. 25.
    Davies NJ, Batehup L, Thomas R (2011) The role of diet and physical activity in breast, colorectal, and prostate cancer survivorship: a review of the literature. Br J Cancer 105 Suppl 1:S52–S73. doi: 10.1038/bjc.2011.423 CrossRefPubMedGoogle Scholar
  26. 26.
    Winkels RM, Heine-Broring RC, van Zutphen M, van Harten-Gerritsen S, Kok DE, van Duijnhoven FJ, Kampman E (2014) The COLON study: colorectal cancer: longitudinal, observational study on nutritional and lifestyle factors that may influence colorectal tumour recurrence, survival and quality of life. BMC Cancer 14:374. doi: 10.1186/1471-2407-14-374 CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Garber CE, Blissmer B, Deschenes MR, Franklin BA, Lamonte MJ, Lee IM, Nieman DC, Swain DP, American College of Sports M (2011) American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc 43(7):1334–1359. doi: 10.1249/MSS.0b013e318213fefb CrossRefPubMedGoogle Scholar
  28. 28.
    Ballard-Barbash R, Friedenreich CM, Courneya KS, Siddiqi SM, McTiernan A, Alfano CM (2012) Physical activity, biomarkers, and disease outcomes in cancer survivors: a systematic review. J Natl Cancer Inst 104(11):815–840. doi: 10.1093/jnci/djs207 CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Smith WA, Nolan VG, Robison LL, Hudson MM, Ness KK (2011) Physical activity among cancer survivors and those with no history of cancer—a report from the National Health and nutrition examination survey 2003-2006. Am J Transl Res 3(4):342–350PubMedPubMedCentralGoogle Scholar
  30. 30.
    Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, Filiberti A, Flechtner H, Fleishman SB, de Haes JC et al (1993) The European Organization for Research and Treatment of cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85(5):365–376CrossRefPubMedGoogle Scholar
  31. 31.
    Fayers P AN, Bjordal K, Groenvold M, Curran D, Bottomley A, on behalf of the European Quality of Life Group: (2001) The EORTC QLQ-C30 scoring manual. In 3rd edition.Google Scholar
  32. 32.
    Postma TJ, Aaronson NK, Heimans JJ, Muller MJ, Hildebrand JG, Delattre JY, Hoang-Xuan K, Lanteri-Minet M, Grant R, Huddart R, Moynihan C, Maher J, Lucey R, Group EQoL (2005) The development of an EORTC quality of life questionnaire to assess chemotherapy-induced peripheral neuropathy: the QLQ-CIPN20. Eur J Cancer 41(8):1135–1139. doi: 10.1016/j.ejca.2005.02.012 CrossRefPubMedGoogle Scholar
  33. 33.
    Lavoie Smith EM, Barton DL, Qin R, Steen PD, Aaronson NK, Loprinzi CL (2013) Assessing patient-reported peripheral neuropathy: the reliability and validity of the European Organization for Research and Treatment of cancer QLQ-CIPN20 questionnaire. Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation 22(10):2787–2799. doi: 10.1007/s11136-013-0379-8 CrossRefGoogle Scholar
  34. 34.
    Ferreira PL (2000) Development of the Portuguese version of MOS SF-36. Part I. Cultural and linguistic adaptation. Acta medica portuguesa 13(1–2):55–66PubMedGoogle Scholar
  35. 35.
    Ferreira PL (2000) Development of the Portuguese version of MOS SF-36. Part II—validation tests. Acta medica portuguesa 13(3):119–127PubMedGoogle Scholar
  36. 36.
    Marques MDGV, Gouveia MJ, Cordeiro A, Leal I, Maes S (2013) Psychometric properties of the Portuguese version of the checklist of individual strength (CIS20-P). Psychology, Community & Health 2(1):11–18CrossRefGoogle Scholar
  37. 37.
  38. 38.
    Rikli RE, Jones CJ (1999a) Development and validation of a functional fitness test for community-residing older adults. J Aging Phys Act 6:127–159Google Scholar
  39. 39.
    Schmidt K, Vogt L, Thiel C, Jager E, Banzer W (2013) Validity of the six-minute walk test in cancer patients. Int J Sports Med 34(7):631–636. doi: 10.1055/s-0032-1323746 CrossRefPubMedGoogle Scholar
  40. 40.
    American Thoracic S, American College of Chest P (2003) ATS/ACCP statement on cardiopulmonary exercise testing. Am J Respir Crit Care Med 167(2):211–277. doi: 10.1164/rccm.167.2.211 CrossRefGoogle Scholar
  41. 41.
    Lopes C, Aro A, Azevedo A, Ramos E, Barros H (2007) Intake and adipose tissue composition of fatty acids and risk of myocardial infarction in a male Portuguese community sample. J Am Diet Assoc 107(2):276–286. doi: 10.1016/j.jada.2006.11.008 CrossRefPubMedGoogle Scholar
  42. 42.
    Willett W (1998) Food frequency methods in nutritional epidemiology. Oxford University Press, New YorkCrossRefGoogle Scholar
  43. 43.
    McKenna DJ, McKeown SR, McKelvey-Martin VJ (2008) Potential use of the comet assay in the clinical management of cancer. Mutagenesis 23(3):183–190CrossRefPubMedGoogle Scholar
  44. 44.
    Collins AR, Dobson VL, Dusinska M, Kennedy G, Stetina R (1997) The comet assay: what can it really tell us? Mutat Res 375(2):183–193CrossRefPubMedGoogle Scholar
  45. 45.
    Smith CC, O’Donovan MR, Martin EA (2006) hOGG1 recognizes oxidative damage using the comet assay with greater specificity than FPG or ENDOIII. Mutagenesis 21(3):185–190. doi: 10.1093/mutage/gel019 CrossRefPubMedGoogle Scholar
  46. 46.
    Costa S, Coelho P, Costa C, Silva S, Mayan O, Santos LS, Gaspar J, Teixeira JP (2008) Genotoxic damage in pathology anatomy laboratory workers exposed to formaldehyde. Toxicology 252:40–48CrossRefPubMedGoogle Scholar
  47. 47.
    Raghunathan TE (2004) What do we do with missing data? Some options for analysis of incomplete data. Annu Rev Public Health 25:99–117. doi: 10.1146/annurev.publhealth.25.102802.124410 CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Luisa Soares-Miranda
    • 1
    Email author
  • Sandra Abreu
    • 1
  • Marco Silva
    • 2
  • Armando Peixoto
    • 2
  • Rosa Ramalho
    • 2
  • Pedro Correia da Silva
    • 3
  • Carla Costa
    • 4
    • 5
  • João Paulo Teixeira
    • 4
    • 5
  • Carla Gonçalves
    • 6
  • Pedro Moreira
    • 1
    • 6
  • Jorge Mota
    • 1
  • Guilherme Macedo
    • 2
  1. 1.Research Center in Physical Activity Health and Leisure, Faculty of SportUniversity of PortoPortoPortugal
  2. 2.Gastroenterology DepartmentCentro Hospitalar São JoãoPortoPortugal
  3. 3.Department of SurgeryCentro Hospitalar São JoãoPortoPortugal
  4. 4.Environmental Health DepartmentNational Institute of Public HealthPortoPortugal
  5. 5.EPIUnit, Institute of Public HealthUniversity of PortoPortoPortugal
  6. 6.Faculty of Nutrition and Food SciencesUniversity of PortoPortoPortugal

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