Beyond the Clinical Setting: The Role of Technology in Managing Cancer Side Effects

Through Exercise, Nutrition, and Mindfulness

Cathy Skinner, MA

This information is the property of Cathy Skinner, MA and should not be copied or otherwise used without express written permission of the author.2018 * All Rights Reserved

Financial Disclosure: Cathy Skinner has financial ties to a business called Thrivors as described in this presentation.

The Role of Technology in Managing Cancer Side Effects Through Exercise, Nutrition, and MindfulnessCathy Skinner, MA

All Rights Reserved * 2018

Research on Digital Health Platforms for Cancer Patients

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5671545/https://www.ncbi.nlm.nih.gov/pubmed/28561647

• Systematic review and meta-analyses of 15 studies

• Digital behavior change interventions (DBCIs) have the potential to reach large numbers of cancer survivors.

• Showed significance for reduced fatigue and no significant change in cancer-specific measures of quality of life (QoL).

• Narrative synthesis revealed mixed evidence for effects on diet, generic QoL measures and self-efficacy and no evidence of an effect on mental health.

• Two studies suggested improved sleep quality.

• DBCIs may improve PA and BMI among cancer survivors, and there is mixed evidence for diet.

• Digital technologies offer a promising approach to encourage health behavior change among cancer survivors.

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The Role of Technology in Managing Cancer Side Effects Through Exercise, Nutrition, and MindfulnessCathy Skinner, MA

All Rights Reserved * 2018

Examples of Digital Health Cancer Services

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https://canceraid.com

http://savorhealth.com http://www.noona.com/

https://www.thrivors.com *

https://www.patientpower.info

* disclosure of conflict of interest

The Role of Technology in Managing Cancer Side Effects Through Exercise, Nutrition, and MindfulnessCathy Skinner, MA

All Rights Reserved * 2018

Fulfilling the Promise of Personalized Medicine 4

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The Role of Technology in Managing Cancer Side Effects Through Exercise, Nutrition, and MindfulnessCathy Skinner, MA

All Rights Reserved * 2018

Multiple Options

An Intuitive Tool for Cancer Patients and their Families

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The Role of Technology in Managing Cancer Side Effects Through Exercise, Nutrition, and MindfulnessCathy Skinner, MA

All Rights Reserved * 2018

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Exercise

Customized exercise protocol based on a patient’s pain and energy

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The Role of Technology in Managing Cancer Side Effects Through Exercise, Nutrition, and MindfulnessCathy Skinner, MA

All Rights Reserved * 2018

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Nutrition

Curated recipes

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The Role of Technology in Managing Cancer Side Effects Through Exercise, Nutrition, and MindfulnessCathy Skinner, MA

All Rights Reserved * 2018

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Tracking

“How are you feeling?”

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The Role of Technology in Managing Cancer Side Effects Through Exercise, Nutrition, and MindfulnessCathy Skinner, MA

All Rights Reserved * 2018

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Addressing Side Effects Together

Coaching

ThrivorsConnecting

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The Role of Technology in Managing Cancer Side Effects Through Exercise, Nutrition, and MindfulnessCathy Skinner, MA

All Rights Reserved * 2018

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Curated Resource Registry

TOPICS• Education• Services• People• Places• Products• Treatments• Tests• Medications

Trusted, quality content for patients and their families

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The Role of Technology in Managing Cancer Side Effects Through Exercise, Nutrition, and MindfulnessCathy Skinner, MA

All Rights Reserved * 2018

BIBLIOGRAPHY• https://www.cancer.org/research/cancer-facts-statistics/all-cancer-facts-figures/cancer-facts-figures-2017.html• Nekhlyudov L, Ganz P, Arora N. et al. Going Beyond Being Lost In Transition: A decade of progress in Cancer Survivorship. Joural of

Clinical Oncology, Vol 35, No 18(June 20), 2017: pp 1978-81• DeLisa, J. A History of Cancer Rehabilitation. Cancer Supplement. Aug 15 2001. (92:4): 970-974• Cheville AL, Beck LA, Peterson TL, et. al. The detection and treatment of cancer-related functional problems in an outpatient setting.

Support Care Cancer. 2009 Jan;17(1):61-7. doi: 10.1007/s00520-008-0461-x. Epub 2008 May 14.• Trille KK, Johansen C, Ibfelt E, et al. Impact of symptom burden on health related quality of life of cancer survivors in a Danish cancer

rehabilitation program: A longitudinal study. Acta Oncologica, 2011; 50: 223-232• https://www.nccn.org/professionals/physician_gls/recently_updated.aspx• Weis, J. Cancer-related fatigue: prevalence, assessment and treatment strategies. Expert Review of Pharmacoeconomics & Outcomes

Research. 2011, (11;4): 441-446• https://www.cancer.gov/about-cancer/treatment/side-effects/fatigue/fatigue-pdq• Mustian K, Alfano C, Heckler C, et al. Comparison of Pharmaceutica, Psychological and Exercise Treatments for Cancer-Related

Fatigue: A Meta-analysis. JAMA Oncol. 2017;3(7):961-968• http://www.acsm.org/about-acsm/media-room/acsm-in-the-news/2011/08/01/new-guidelines-strongly-recommend-exercise-for-cancer-

patients-survivors• Cammisuli S, Cavazzi E, Baldissarro E, Leandri M. Rehabilitation of balance disturbances due to chemotherapy-induced peripheral

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The Role of Technology in Managing Cancer Side Effects Through Exercise, Nutrition, and MindfulnessCathy Skinner, MA

All Rights Reserved * 2018

BIBLIOGRAPHY CONTINUED• Am Soc Clin Oncol Educ Book. 2017;37:128-137. doi: 10.14694/EDBK_173841. Social Media and Mobile Technology for Cancer Prevention and

Treatment.Prochaska JJ1, Coughlin SS1, Lyons EJ1.https://www.ncbi.nlm.nih.gov/pubmed/28561647• J Cancer Surviv. 2017; 11(6): 704–719. Published online 2017 Aug 4. doi: 10.1007/s11764-017-0632-1 PMCID: PMC5671545 Digital health behaviour change

interventions targeting physical activity and diet in cancer survivors: a systematic review and meta-analysis Anna L. Roberts,1 Abigail Fisher,1 Lee Smith,2 Malgorzata Heinrich,1 and Henry W. W. Potts3 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5671545/

• Effect of a Digital Health Intervention on Receipt of Colorectal Cancer Screening in Vulnerable Patients: A Randomized Controlled Trial. David P. Miller Jr., MD, MS; Nancy Denizard-Thompson, MD; Kathryn E. Weaver, PhD, MPH; L. Doug Case, PhD; Jennifer L. Troyer, PhD; John G. Spangler, MD, MPH; Donna Lawler; Michael P. Pignone, MD, MPH. http://annals.org/aim/fullarticle/2674679/effect-digital-health-intervention-receipt-colorectal-cancer-screening-vulnerable-patients.

• Physical Activity and Survival After Breast Cancer Diagnosis. Michelle D. Holmes, MD, DrPH; Wendy Y. Chen, MD; Diane Feskanich, ScD; et al. Candyce H. Kroenke, ScD; Graham A. Colditz, MD, DrPH. JAMA. 2005;293(20):2479-2486. doi:10.1001/jama.293.20.2479. https://epi.grants.cancer.gov/survivor-cohort-resources/nhs.html

• Prev Med Rep. 2018 Feb 2;9:118-123. doi: 10.1016/j.pmedr.2018.01.003. eCollection 2018 Mar. Physical activity and annual medical outlay in U.S. colorectal, breast and prostate cancer survivors. Yan AF1, Wang Y2, Ng AV3.. https://www.ncbi.nlm.nih.gov/pubmed/29527464

• Cancer Causes Control. 2018 Mar 6. doi: 10.1007/s10552-018-1017-0. [Epub ahead of print]. Muscle-strengthening and aerobic activities and mortality among 3+ year cancer survivors in the U.S. Tarasenko YN1, Linder DF2, Miller EA3. https://www.ncbi.nlm.nih.gov/pubmed/29511931

• Neuropsychiatr Dis Treat. 2018 Feb 9;14:479-494. doi: 10.2147/NDT.S150464. eCollection 2018. The effect of exercise on cancer-related fatigue in cancer survivors: a systematic review and meta-analysis. Kessels E1,2, Husson O3, van der Feltz-Cornelis CM1,2.https://www.ncbi.nlm.nih.gov/pubmed/29445285

• J Clin Oncol. 2015 Jun 1;33(16):1825-34. doi: 10.1200/JCO.2014.59.7799. Epub 2015 Apr 27.Role of physical activity and diet after colorectal cancer diagnosis. Van Blarigan EL1, Meyerhardt JA2. https://www.ncbi.nlm.nih.gov/pubmed/25918293

• Physical activity and survival in male colorectal cancer survivors Jeffrey A. Meyerhardt,1 Edward L. Giovannucci,2,3 Shuji Ogino,1,2,4 Gregory J. Kirkner,2 Andrew T. Chan,2,5 Walter Willett,2,3 and Charles S. Fuchs.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2852183/

• POSITIVE study: physical exercise program in non-operable lung cancer patients undergoing palliative treatment. Joachim Wiskemann,# Simone Hummler,# Christina Diepold, Melanie Keil, Ulrich Abel, Karen Steindorf, Philipp Beckhove, Cornelia M. Ulrich, Martin Steins, and Michael Thomas. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4949758/

• Cancer, Physical Activity, and Exercise Justin C. Brown,1 Kerri Winters-Stone,2 Augustine Lee,1 and Kathryn H. Schmitz1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4122430/

• Twenty-five years of research on the effects of exercise training in breast cancer survivors: A systematic review of the literature. Claudio L Battaglini, Robert C Mills, Brett L Phillips, Jordan T Lee, Christina E Story, Marcelo GB Nascimento, and Anthony Carl Hackneyhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4014791/

• Protein Intake and Breast Cancer Survival in the Nurses’ Health Study. Michelle D. Holmes, Jun Wang, Susan E. Hankinson, Rulla M. Tamimi, and Wendy Y. Chen. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5456374/

• Maximizing patient adherence to prehabilitation: what do the patients say? Ferreira V1,2, Agnihotram RV3, Bergdahl A4, van Rooijen SJ5, Awasthi R2, Carli F2, Scheede-Bergdahl C. https://www.ncbi.nlm.nih.gov/pubmed/29478189

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