title: Individualized Comprehensive Lifestyle Intervention in Patients Undergoing Chemotherapy with Curative or Palliative Intent: Who Participates?
abstract: OBJECTIVE
  Knowledge about determinants of participation in lifestyle interventions in cancer patients undergoing chemotherapy, particularly with palliative intent, remains poor. The objective of the present study was to identify determinants of participating in a 12 month individualized, comprehensive lifestyle intervention, focusing on diet, physical activity, mental stress and smoking cessation, in cancer patients receiving chemotherapy with curative or palliative intent. The secondary objective was to identify participation determinants 4 months into the study.
  
  
  METHODS
  Newly diagnosed cancer patients starting chemotherapy at the cancer center in Kristiansand/Norway (during a 16 month inclusion period) were screened. Demographic and medical data (age, sex, body mass index, education level, marital status, smoking status, Eastern Cooperative Oncology Group performance status (ECOG), diagnosis, tumor stage and treatment intention) was analyzed for screened patients.
  
  
  RESULTS
  100 of 161 invited patients participated. There were more females (69 vs. 48%; P = 0.004), breast cancer patients (46 vs. 25%; P = 0.007), non-smokers (87 vs. 74%; P = 0.041), younger (mean age 60 vs. 67 yrs; P < 0.001) and fitter (82 vs. 64% with EGOC 0; P = 0.036) participants vs. non-participants included. In multivariate logistic regression analyses, age (Odds Ratio 0.94, 95% Confidence Interval 0.91, 0.97) and smoking (0.42, 0.18, 0.99) were negatively associated with participation. After 4 months, 63 participants were still participating. Cancer type, smoking and age increased the probability of dropping out. Multivariate logistic regression revealed that age was the only significant determinant of 4 month participation (0.95, 0.91, 0.99). Patients aged >70 years were less likely to participate at baseline and 4 months.
  
  
  CONCLUSIONS
  Individualized lifestyle interventions in cancer patients undergoing chemotherapy appear to facilitate a high participation rate that declines with increasing age; both during the enrollment process and completing the intervention. Neither oncologic nor socioeconomic variables deterred participation.
authors.affiliation: Department of Oncology, Southern Hospital Trust, Kristiansand, Norway; Department of Public Health, Sport and Nutrition, Faculty of Health Sport Sciences, University of Agder, Kristiansand, Norway.
authors.forename: Karianne
authors.initials: K
authors.lastname: Vassbakk-Brovold
authors.affiliation: Department of Public Health, Sport and Nutrition, Faculty of Health Sport Sciences, University of Agder, Kristiansand, Norway.
authors.forename: Sveinung
authors.initials: S
authors.lastname: Berntsen
authors.affiliation: Department of Health and Nursing Sciences, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway.
authors.forename: Liv
authors.initials: L
authors.lastname: Fegran
authors.affiliation: Department of Physical Medicine and Prevention, Southern Hospital Trust, Kristiansand, Norway.
authors.forename: Henrik
authors.initials: H
authors.lastname: Lian
authors.affiliation: Department of Surgery, Southern Hospital Trust, Kristiansand, Norway.
authors.forename: Odd
authors.initials: O
authors.lastname: Mjåland
authors.affiliation: Department of Oncology, Southern Hospital Trust, Kristiansand, Norway.
authors.forename: Svein
authors.initials: S
authors.lastname: Mjåland
authors.affiliation: Department of Public Health, Sport and Nutrition, Faculty of Health Sport Sciences, University of Agder, Kristiansand, Norway.
authors.forename: Stephen
authors.initials: S
authors.lastname: Seiler
authors.affiliation: Department of Oncology, Southern Hospital Trust, Kristiansand, Norway.
authors.forename: Christian
authors.initials: C
authors.lastname: Kersten
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000628:therapy*; D015179:Colorectal Neoplasms / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D057285:Precision Medicine; D011471:Prostatic Neoplasms / Q000628:therapy*; D016540:Smoking Cessation
chemical_list: D000970:Antineoplastic Agents