Subclinical disease was detected in 35% of the sample, with 28.6% of the women having diastolic dysfunction. Women scored lower than men in health-related quality of life measures and had more symptoms (bloating and diarrhea). Of those with subclinical disease, women were more likely to report pain, numbness in hands or feet, and shortness of breath.
These results demonstrate the need for assessment of symptoms that could uncover subclinical disease and lead to timely referral for follow-up and treatment.
Interventions to Improve Cardiac Health
Nurses can promote heart health by teaching their patients about the benefits of exercise. Increasing physical activity can decrease the modifiable cardiac risk factors of inactivity and excess weight.
The best treatment identified to reduce fatigue and to improve psychological distress in cancer survivors is increased physical activity. Regular physical activity prolongs overall survival and disease-free intervals, improves quality of life, mood, fitness, physical function, and decreases fatigue.
More work is needed to determine the best approach to increasing physical activity in cancer survivors. Information is needed to determine the specifics of interventions for cancer survivors including the best type, duration, frequency, and intensity.
What Works Best for Survivors?
A recent Cochrane review of 14 randomized clinical trials of exercise interventions in sedentary cancer survivors3
found that although none achieved an adherence of 75% or greater to the recommended 150 minutes of moderate to strenuous aerobic activity per week, three did achieve 75% adherence to a lower goal, resulting in improved exercise tolerance.
The most successful interventions involved components such as setting program goals, encouraging practice and self-monitoring, and teaching participants to use skills learned in supervised exercise environments in other areas of their day-to-day life.
Additional research is needed to determine the best approach to deliver comprehensive and coordinated follow-up care for cancer survivors. Assessment of cardiac risk is needed in future programs, along with evidence-based interventions to decrease modifiable risk factors. Nurses as researchers, clinicians, advocates, and teachers are in a prime position to lead these efforts. Cancer survivors need our continued care!
- Institute of Medicine and National Research Council. From Cancer Patient to Cancer Survivor: Lost in Transition. Washington, DC: The National Academies Press; 2005.
- Reilly C, Esiashvili N, Parashar S, Higgins M. Subclinical cardiovascular disease in lymphoma survivors by gender [published March 23, 2016]. J Obstet Gynecol Neonatal Nurs.
- Bourke L, Homer KE, Thaha MA, et al. Interventions for promoting habitual exercise in people living with and beyond cancer. Cochrane Database Syst Rev. 2013;9:CD010192.