John S. Kennedy

Bio: John S. Kennedy is an academic researcher. The author has contributed to research in topics: Quality of life & Test validity. The author has an hindex of 4, co-authored 4 publications receiving 456 citations.

Do adults change their lifestyle behaviors after a cancer diagnosis

Abstract: OBJECTIVE To examine changes in lifestyle behaviors after a cancer diagnosis and medical and demographic influences on such changes. METHODS Adult cancer survivors (n = 352) completed a survey including demographic, medical, and lifestyle behavior change questions. RESULTS Results showed that since cancer diagnosis, 46% of smokers quit smoking, 47% improved their dietary habits, and 30.1% exercised less. Adult cancer survivors who changed their lifestyle behaviors varied, depending on various demographic and medical variables and physician recommendation. CONCLUSION It appears from our data that cancer diagnosis in adults may have a positive influence on smoking and diet and a negative influence on exercise.

Factor structure and concurrent validity of the Satisfaction with Life Domains Scale for Cancer (SLDS-C).

Abstract: The Satisfaction with Life Domains Scale for Cancer (SLDS-C) is a brief self-report measure of quality of life that uses a familiar and easily understood graphic response format of smiling and frowning faces. This article explores the factor structure and further examines the validity of the SLDS-C compared with another cancerspecific quality-of-life measure, the Functional Assessment of Cancer Therapy Scale-General (FACT-G), in a sample of patients with a variety of cancer diagnoses. A self-administered questionnaire containing the SLDS-C and the FACT-G was completed by 352 adult cancer survivors who were at various points post diagnosis. Three SLDS-C factor subscales were derived from analyses of these data: “Life as a Whole,” “Daily Activities,” and “Social Relationships.” Evidence for the concurrent validity of the SLDS-C is presented, including its correlation with the total score of the FACT-G (r =.76) and its correlation with subscale scores of this widely used cancer quality-of-life measu...

Riding the Crest of the Teachable Moment: Promoting Long-Term Health After the Diagnosis of Cancer

Abstract: Purpose Cancer survivors are at increased risk for several comorbid conditions, and many seek lifestyle change to reduce dysfunction and improve long-term health. To better understand the impact of cancer on adult survivors' health and health behaviors, a review was conducted to determine (1) prevalent physical health conditions, (2) persistent lifestyle changes, and (3) outcomes of previous lifestyle interventions aimed at improving health within this population. Methods Relevant studies from 1966 and beyond were identified through MEDLINE and PubMed searches. Results Cancer survivors are at increased risk for progressive disease but also for second primaries, osteoporosis, obesity, cardiovascular disease, diabetes, and functional decline. To improve overall health, survivors frequently initiate diet, exercise, and other lifestyle changes after diagnosis. However, those who are male, older, and less educated are less likely to adopt these changes. There also is selective uptake of messages, as evidenced ...

Exercise interventions on health related quality of life for people with cancer during active treatment

Abstract: Background People with cancer undergoing active treatment experience numerous disease- and treatment-related adverse outcomes and poorer health-related quality of life (HRQoL). Exercise interventions are hypothesized to alleviate these adverse outcomes. HRQoL and its domains are important measures of cancer survivorship, both during and after the end of active treatment for cancer. Objectives To evaluate the effectiveness of exercise on overall HRQoL outcomes and specific HRQoL domains among adults with cancer during active treatment. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed MEDLINE, EMBASE, CINAHL, PsycINFO, PEDRO, LILACS, SIGLE, SportDiscus, OTSeeker, Sociological Abstracts from inception to November 2011 with no language or date restrictions. We also searched citations through Web of Science and Scopus, PubMed's related article feature, and several websites. We reviewed reference lists of included trials and other reviews in the field. Selection criteria We included all randomized controlled trials (RCTs) and quasi-randomized controlled clinical trials (CCTs) comparing exercise interventions with usual care or other type of non-exercise comparison intervention to maintain or enhance, or both, overall HRQoL or at least one distinct domain of HRQoL. Included trials tested exercise interventions that were initiated when adults with cancer were undergoing active cancer treatment or were scheduled to initiate treatment. Data collection and analysis Five paired review authors independently extracted information on characteristics of included trials, data on effects of the intervention, and assessed risk of bias based on predefined criteria. Where possible, we performed meta-analyses for HRQoL and HRQoL domains for the reported difference between baseline values and follow-up values using standardized mean differences (SMDs) and a random-effects model by length of follow-up. We also reported the SMD at follow-up between the exercise and control groups. Because investigators used many different HRQoL and HRQoL domain instruments and often more than one for the same domain, we selected the more commonly used instrument to include in the SMD meta-analyses. We also report the mean difference for each type of instrument separately. Main results We included 56 trials with 4826 participants randomized to an exercise (n = 2286) or comparison (n = 1985) group. Cancer diagnoses in trial participants included breast, prostate, gynecologic, hematologic, and other. Thirty-six trials were conducted among participants who were currently undergoing active treatment for their cancer, 10 trials were conducted among participants both during and post active cancer treatment, and the remaining 10 trials were conducted among participants scheduled for active cancer treatment. Mode of exercise intervention differed across trials and included walking by itself or in combination with cycling, resistance training, or strength training; resistance training; strength training; cycling; yoga; or Qigong. HRQoL and its domains were assessed using a wide range of measures. The results suggest that exercise interventions compared with control interventions have a positive impact on overall HRQoL and certain HRQoL domains. Exercise interventions resulted in improvements in: HRQoL from baseline to 12 weeks' follow-up (SMD 0.33; 95% CI 0.12 to 0.55) or when comparing difference in follow-up scores at 12 weeks (SMD 0.47; 95% CI 0.16 to 0.79); physical functioning from baseline to 12 weeks' follow-up (SMD 0.69; 95% CI 0.16 to 1.22) or 6 months (SMD 0.28; 95% CI 0.00 to 0.55); or when comparing differences in follow-up scores at 12 weeks (SMD 0.28; 95% CI 0.11 to 0.45) or 6 months (SMD 0.29; 95% CI 0.07 to 0.50); role function from baseline to 12 weeks' follow-up (SMD 0.48; 95% CI 0.07 to 0.90) or when comparing differences in follow-up scores at 12 weeks (SMD 0.17; 95% CI 0.00 to 0.34) or 6 months (SMD 0.32; 95% CI 0.03 to 0.61); and, in social functioning at 12 weeks' follow-up (SMD 0.54; 95% CI 0.03 to 1.05) or when comparing differences in follow-up scores at both 12 weeks (SMD 0.16; 95% CI 0.04 to 0.27) and 6 months (SMD 0.24; 95% CI 0.03 to 0.44). Further, exercise interventions resulted in a decrease in fatigue from baseline to 12 weeks' follow-up (SMD -0.38; 95% CI -0.57 to -0.18) or when comparing difference in follow-up scores at follow-up of 12 weeks (SMD -0.73; 95% CI -1.14 to -0.31). Since there is consistency of findings on both types of measures (change scores and difference in follow-up scores) there is greater confidence in the robustness of these findings. When examining exercise effects by subgroups, exercise interventions had significantly greater reduction in anxiety for survivors with breast cancer than those with other types of cancer. Further, there was greater reduction in depression, fatigue, and sleep disturbances, and improvement in HRQoL, emotional wellbeing (EWB), physical functioning, and role function for cancer survivors diagnosed with cancers other than breast cancer but not for breast cancer. There were also greater improvements in HRQoL and physical functioning, and reduction in anxiety, fatigue, and sleep disturbances when prescribed a moderate or vigorous versus a mild exercise program. Results of the review need to be interpreted cautiously owing to the risk of bias. All the trials reviewed were at high risk for performance bias. In addition, the majority of trials were at high risk for detection, attrition, and selection bias. Authors' conclusions This systematic review indicates that exercise may have beneficial effects at varying follow-up periods on HRQoL and certain HRQoL domains including physical functioning, role function, social functioning, and fatigue. Positive effects of exercise interventions are more pronounced with moderate- or vigorous-intensity versus mild-intensity exercise programs. The positive results must be interpreted cautiously because of the heterogeneity of exercise programs tested and measures used to assess HRQoL and HRQoL domains, and the risk of bias in many trials. Further research is required to investigate how to sustain positive effects of exercise over time and to determine essential attributes of exercise (mode, intensity, frequency, duration, timing) by cancer type and cancer treatment for optimal effects on HRQoL and its domains.

Exercise interventions on health related quality of life for cancer survivors

Abstract: There is a steady increase in the number of cancer survivors, that is people diagnosed with cancer (Aziz 2003), worldwide. This is due, in a large part, to the dramatic advances in cancer treatment and management (Aziz 2002; Aziz 2003), growing attention to multidisciplinary post-treatment care (Demark-Wahnefried 2000; Stull 2007), and healthier lifestyles (Demark-Wahnefried 2005; Stull 2007). These factors and trends especially when considered in light of an aging population (Aziz 2008; Stewart 2003), suggest that we can continue to expect increasing numbers of cancer survivors with greater expected length of survival. Ensuring the quality of that survival thus becomes a key priority. The objectives are as follows: To evaluate the effectiveness of exercise on overall HRQoL outcomes and specific HRQoL domains (e.g. physical, psychological, economic, social, and spiritual well-being, and key disease and/or treatment symptoms such as sexual functioning, neuropathy or cognitive changes, and chronic fatigue) among adult post-treatment cancer survivors (i.e. people with a history of cancer who are beyond active treatment, excluding those who are terminally ill and receiving hospice). We will focus on post-treatment cancer survivors so that we can evaluate the effectiveness of exercise on HRQoL without having to adjust for the adverse effects of cancer and/or its treatment on HRQoL. 1. A secondary objective is to examine the effectiveness of exercise on HRQoL outcomes among adult post-treatment cancer survivors stratified by the following: 2. Age at diagnosis (i.e. less than 65 years or greater than or equal to 65 years); 3. Age at trial enrolment (i.e. less than 65 years or greater than or equal to 65 years); 4. Sex; 5. Type of prescribed exercise (i.e. aerobic, anaerobic, combination); 6. Physical condition prior to cancer treatment (i.e. obesity, heart disease, smoking status, asthma); 7. Intensity of exercise (i.e. mild, moderate, vigorous); and Format of exercise (i.e. individual or group, professionally led or not, home or group facility).

The Risk of Second Primary Malignancies up to Three Decades after the Treatment of Differentiated Thyroid Cancer

Abstract: Background: The 10-yr survival rate of patients with differentiated thyroid cancer exceeds 90%. These patients may be at elevated risk for secondary cancers. Methods: The risk of nonthyroid second primary malignancies after differentiated thyroid cancer was determined in 30,278 patients diagnosed between 1973 and 2002 from centers participating in the National Cancer Institute’s Surveillance, Epidemiology, and End Results program. Median follow-up was 103 months (range, 2–359 months). Risk was further assessed for the addition of radioisotope therapy, gender, latency to development of secondary cancer, and age at thyroid cancer diagnosis. Results: There were 2158 patients who developed a total of 2338 nonthyroid second primary malignancies, significantly more than that expected in the general population [observed/expected (O/E) = 1.09; 95% confidence interval (CI), 1.05–1.14; P < 0.05; absolute excess risk per 10,000 person-years (AER) = 6.39]. A significantly greater risk of second primary malignancies o...