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Physical activity and dietary considerations for prostate cancer patients: future research directions
- Andrew J Hamblen, James W Bray, Mohan Hingorani, John M Saxton
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- Journal:
- Proceedings of the Nutrition Society / Volume 82 / Issue 3 / September 2023
- Published online by Cambridge University Press:
- 06 January 2023, pp. 298-304
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This review considers current evidence on physical activity and dietary behaviours in the context of prostate cancer prevention and survivorship outcomes. Prostate cancer is the second most common cancer amongst men, with over 1⋅4 million newly diagnosed cases globally each year. Due to earlier detection via screening and advances in treatments, survival rates are amongst the highest of all cancer populations. However, hormone treatments (i.e. androgen deprivation therapy) can lead to undesirable body composition changes, increased fatigue and reduced health-related quality of life, which can impair the overall wellbeing of men living with and beyond prostate cancer. Existing research has only provided limited evidence that physical activity and nutrition can impact a man's risk of prostate cancer but cohort studies suggest they can influence survival outcomes after diagnosis. Additionally, data from observational and intervention studies suggest that habitual physical activity (or structured exercise) and healthy diets can help to ameliorate hormone-related treatment side-effects. Current physical activity guidelines state that prostate cancer patients should complete at least three sessions of moderate-intensity aerobic exercise per week, along with two resistance exercise sessions, but dietary guidelines for prostate cancer patients are less well defined. In conclusion, regular physical activity and nutritional interventions may improve survival outcomes and attenuate some adverse side-effects of hormone treatments in men with prostate cancer. However, further research is required to improve our understanding of the health impacts of physical activity (including structured exercise) and nutrition in relation to prostate cancer prevention and survivorship.
Diet, physical activity and energy balance and their impact on breast and prostate cancers
- John M. Saxton
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- Journal:
- Nutrition Research Reviews / Volume 19 / Issue 2 / December 2006
- Published online by Cambridge University Press:
- 01 December 2006, pp. 197-215
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Obesity, physical activity status and circulating levels of sex steroid hormones and growth factor proteins are intrinsically linked to energy balance. Epidemiological studies have previously reported associations between these factors and the risk of hormone-related cancers such as prostate and breast cancer in men and postmenopausal women. An increasing number of intervention studies in ‘at-risk’ populations and cancer survivors are now investigating the effects of lifestyle interventions that promote negative energy balance on circulating levels of sex hormones and growth factor proteins as surrogate markers of cancer risk. Evidence from these studies suggests that lifestyle interventions can improve insulin sensitivity, alter the balance of circulating sex steroid hormones and insulin-like growth factor (IGF) axis proteins (including IGF-1 and the IGF binding proteins 1 and 3) and change the functioning of immune cells in peripheral blood. Such changes could influence the risk of developing hormone-related cancers, as well as having the potential to improve disease-free survival in patients recovering from cancer treatment. However, despite promising results, the methodological quality of most intervention studies has been limited due to small subject numbers, lack of adequate control groups or non-randomised designs and the absence of long-term follow-up measures. More intervention studies with randomised controlled designs, higher numbers of subjects and longer-term follow-up measures are needed to establish which combination of specific dietary and physical activity interventions work best for reducing risk in ‘at-risk’ populations and survivors, optimal dose–response relationships and the magnitude of change in surrogate markers of cancer risk that is required to induce a protective effect.
4 - Pursuing organizational and cultural change
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- By Michael A. Geheb, Professor of Medicine and Vice President Institutional Advancement at Oregon Health & Science University, Mark L. Penkhus, Senior Vice President and Chief Development Officer Sheridan Healthcorp, Peter O. Kohler, President Oregon Health & Science University, Arthur Garson, Vice President and Dean of the School of Medicine University of Virginia, Jonathan F. Saxton, Health Policy Analyst Emory University, Michael M. E. Johns, Executive Vice President Health Affairs at Emory University; Chief Executive Officer Robert W. Woodruff Health Sciences Center, George F. Sheldon, Professor of Surgery and Social Medicine and former Chair of Surgery University of North Carolina
- Edited by Don Detmer, University of Virginia, Elaine Steen, University of Virginia
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- Book:
- The Academic Health Center
- Published online:
- 12 November 2009
- Print publication:
- 12 May 2005, pp 119-187
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Summary
Introduction
The academic physician, academic medicine, and the health professions in general are in the midst of an extended period of organizational and professional turbulence. Beginning with the explosive growth of managed care in the 1980s, the relatively closed, professionally self-regulated health services sector has been pushed into a more classically competitive marketplace. The 1990s brought additional impetus for change with shifting public policy, changing demographics, increasing consumerism, and the growing influence of information technologies. Further, the turn of the century brought renewed public concern with deficiencies and inconsistencies in the quality of health care services.
The health care sector is clearly laboring under the strains of this changing and demanding environment. The new marketplace is squeezing the financial resources and compensation available to health professionals and organizations. Societal needs, expectations, and aspirations for the health care system have changed and are growing. Academic health centers (AHCs), in particular, continue to face great challenges in adapting their multiple service and academic missions to changing societal, financial, and service requirements.
Academic health centers have adopted measures to improve service, cut costs, and increase productivity. They are learning how to do more with less. They have also worked to develop new capabilities and revenue streams in an attempt to shore-up strained academic and clinical resources. These efforts increase the service and performance expectations for faculty and staff who find it increasingly difficult to pursue research and teaching goals.