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Cancer Epidemiology, Biomarkers & Prevention
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Research Articles

Associations between Exercise and Quality of Life in Bladder Cancer Survivors: A Population-Based Study

Kristina H. Karvinen, Kerry S. Courneya, Scott North and Peter Venner
Kristina H. Karvinen
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Kerry S. Courneya
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Scott North
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Peter Venner
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DOI: 10.1158/1055-9965.EPI-06-0680 Published May 2007
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Tables

  • Table 1.

    Demographic profile of bladder cancer survivors (N = 525)

    Demographic variableMean ± SD or %
    Age (N = 525), y70.2 ± 11.2
        <6530.9
        ≥6569.1
    Sex (N = 525)
        Male74.7
        Female25.3
    Marital status (N = 525)
        Married/common law79.8
        Divorced/separated6.1
        Widowed11.8
        Never married2.3
    Education (N = 525)
        Some elementary school5.5
        Completed elementary school8.2
        Some high school27.8
        Completed high school24.0
        Some university/college14.3
        Completed university/college16.2
        Some graduate school1.1
        Completed graduate school2.9
    Annual family income (data missing: N = 424), US$
        <20,00013.7
        20,000-39,00036.3
        40,000-59,00021.7
        60,000-79,99912.5
        80,000-99,9995.9
        >100,0009.9
    Employment status (N = 525)
        Retired70.9
        Disability4.4
        Employed full/part-time23.2
        Temporarily unemployed1.5
    Ethnicity (N = 525)
        Caucasian98.1
        Native/Metis1.3
        Asian0.6
    Smoking status (N = 525)
        Never smoked23.4
        Ex smoker59.2
        Occasional smoker6.8
        Regular smoker10.6
  • Table 2.

    Medical profile of bladder cancer survivors (N = 525)

    Medical variableMean ± SD or %
    Body mass index (N = 525)27.3 ± 4.1
        <25.04.6
        25.0-29.956.2
        30.0-34.914.5
        ≥35.04.8
    Months since diagnosis (N = 525)72.4 ± 42.2
        <6048.6
        ≥6051.4
    Tumor grade (N = 525)
        122.3
        238.5
        314.9
        411.0
        Unknown13.3
    Degree of invasiveness (N = 525)
        Superficial65.0
        Invasive35.0
    Surgery (N = 525)
        Yes97.9
        No2.1
    Cystectomy (N = 525)
        Yes20.2
        No79.8
    Immunotherapy (N = 525)
        Yes57.7
        No42.3
    Chemotherapy (N = 525)
        Yes11.8
        No88.2
    Radiation (N = 525)
        Yes6.7
        No93.3
    Any adjuvant therapy (N = 525)
        Yes64.8
        No35.2
    Ostomy appliance (N = 525)
        Yes11.8
        No88.2
    Recurrence (N = 525)
        Yes37.9
        No62.1
    Current status (N = 525)
        Cancer-free89.5
        Still has bladder cancer10.5
  • Table 3.

    Exercise behavior and quality of life in bladder cancer survivors (N = 525)

    VariableMean ± SD
    Weekly exercise Pre-diagnosis (N = 525)
        Mild minutes165.5 ± 288.5
        Moderate minutes64.5 ± 110.2
        Strenuous minutes25.1 ± 77.7
        Strenuous plus moderate minutes89.6 ± 145.7
        % Meeting public health guidelines27.8
    Weekly exercise during adjuvant treatment (n = 340)
        Mild minutes122.2 ± 221.3
        Moderate minutes32.7 ± 83.6
        Strenuous minutes9.4 ± 51.3
        Strenuous plus moderate minutes42.2 ± 101.8
        % Meeting public health guidelines17.4
    Weekly exercise in the past month (N = 525)
        Mild minutes162.7 ± 282.3
        Moderate minutes56.1 ± 108.6
        Strenuous minutes18.5 ± 68.4
        Strenuous plus moderate minutes74.5 ± 133.4
        % Meeting public health guidelines22.3
    QoL (N = 525)
        FACT-Bl (0-152)123.6 ± 19.2
        FACT-G (0-108)88.2 ± 14.5
        TOI (0-104)82.9 ± 14.2
        PWB (0-28)25.4 ± 4.1
        FWB (0-28)22.0 ± 5.9
        EWB (0-24)21.0 ± 3.6
        SWB (0-28)19.7 ± 5.2
        Additional concerns (0-48)35.5 ± 7.1
        Urinary function (0-12)9.7 ± 2.8
        Bowel function (0-8)6.9 ± 1.6
        Sexual interest (0-4)1.8 ± 1.4
        Erectile dysfunction, n = 392 (0-4)1.4 ± 1.4
        Body image (0-4)2.5 ± 1.2
    Fatigue (N = 525)
        Most fatigue (0-10)4.0 ± 2.8
        Least fatigue (0-10)2.0 ± 2.1
        Average fatigue (0-10)2.9 ± 2.4
        Fatigue now (0-10)2.4 ± 2.6
        No. days (0-7)2.8 ± 2.4
        Time fatigued per day (0-10)2.6 ± 2.5
        Interference scale (0-10)1.7 ± 2.0
  • Table 4.

    Exercise patterns of bladder cancer survivors across the cancer experience (n = 340)

    Exercise patternMajor cancer-related time points
    n (%)
    BeforeDuringAfter
    1. MaintainersActiveActiveActive42 (12)
    2.ActiveActiveInactive7 (2)
    3. Temporary relapsersActiveInactiveActive15 (4)
    4. Permanent relapsersActiveInactiveInactive30 (9)
    5.InactiveActiveActive10 (3)
    6.InactiveActiveInactive0 (0)
    7.InactiveInactiveActive6 (2)
    8. NonexercisersInactiveInactiveInactive230 (68)
    Total340 (100)
  • Table 5.

    Differences in quality of life in bladder cancer survivors based on exercise category in the past month

    QoL variableCS (n = 324), mean ± SDIA (n = 86), mean ± SDMG (n = 115), mean ± SDBetween-group comparisons: mean difference (95% CI), P
    IA vs CSMG vs IAMG vs CS
    FACT-Bl (0-152)121.2 ± 20.4125.8 ± 15.2128.8 ± 17.54.6 (0.1, 9.1), 0.0463.0 (−2.3, 8.3), 0.2667.6 (3.6, 11.7), <001
        Adjusted121.7124.8128.23.1 (−1.4, 7.6), 0.1783.4 (−1.7, 8.6), 0.1936.5 (2.5, 10.5), 0.001
    FACT-G (0-108)86.5 ± 15.190.0 ± 11.991.6 ± 13.73.5 (0.1, 6.9), 0.0431.6 (−2.5, 5.6), 0.4475.1 (2.0, 8.1), 001
        Adjusted86.789.491.32.7 (−0.7, 6.1), 0.1151.9 (−2.0, 5.7), 0.3524.6 (1.5, 7.6), 0.003
    TOI (0-104)81.0 ± 15.384.8 ± 11.087.0 ± 12.33.9 (0.5, 7.2), 0.0242.2 (−1.7, 6.1), 0.2696.1 (3.1, 9.1), <001
        Adjusted81.483.986.42.4 (−0.9, 5.7), 0.1502.5 (−1.3, 6.4), 0.1925.0 (2.0, 7.9), 0.001
    PWB (0-28)25.0 ± 4.626.4 ± 2.426.1 ± 3.81.5 (0.5, 2.4), 0.004−0.3 (−1.4, 0.9), 0.6261.2 (0.3, 2.0), 0.009
        Adjusted25.026.226.01.2 (0.3, 2.2), 0.0110.2 (−0.9, 1.3), 0.7121.0 (0.2, 1.9), 0.018
    FWB (0-28)21.3 ± 6.322.6 ± 5.323.6 ± 4.91.3 (−0.1, 2.7), 0.0651.0 (−0.6, 2.7), 0.2142.3 (1.1, 3.6), <0.001
        Adjusted21.522.323.40.8 (−0.6, 2.2), 0.2471.2 (−0.4, 2.8), 0.1552.0 (0.7, 3.2), 0.002
    EWB (0-24)20.9 ± 3.820.9 ± 3.521.5 ± 3.10.0 (−0.8, 0.9), 0.9390.6 (−0.3, 1.5), 0.2130.6 (−0.2, 1.4), 134
        Adjusted20.921.021.40.1 (−0.7, 1.0), 0.7420.3 (−0.6, 1.3), 0.4990.5 (−0.3, 1.2), 0.214
    SWB (0-28)19.3 ± 5.419.9 ± 4.520.5 ± 4.90.6 (−0.6, 1.8), 0.3520.5 (−0.9, 2.0), 0.4711.1 (0.0, 2.2), 0.047
        Adjusted19.419.920.40.5 (−0.7, 1.8), 0.4230.6 (−0.9, 2.0), 0.4461.1 (−0.0, 2.3), 0.060
    Additional concerns (0-48)34.7 ± 7.335.8 ± 6.437.3 ± 7.11.1 (−0.6, 2.8), 0.2061.5 (−0.5, 3.4), 0.1482.6 (1.0, 4.1), 0.001
        Adjusted35.035.337.00.4 (−1.3, 2.1), 0.6671.6 (−0.4, 3.5), 0.1102.0 (0.5, 3.5), 0.011
    Urinary (0-12)9.6 ± 2.49.4 ± 2.49.8 ± 1.9−0.2 (−0.7, 0.4), 0.5410.4 (−0.2, 1.1), 0.1990.3 (−0.2, 0.7), 0.315
        Adjusted9.69.49.8−0.2 (−0.8, 0.3), 0.4610.4 (−0.2, 1.1), 0.1900.2 (−0.3, 0.8), 0.383
    Bowel (0-8)6.9 ± 1.56.9 ± 1.57.0 ± 1.50.0 (−0.3, 0.4), 0.9180.1 (−0.4, 0.5), 0.7990.1 (−0.3, 0.4), 0.653
        Adjusted6.96.97.00.0 (−0.3, 0.4), 0.8840.1 (−0.4, 0.5), 0.7610.0 (−0.3, 0.4), 0.817
    Sex interest (0-4)1.6 ± 1.32.0 ± 1.32.2 ± 1.30.4 (0.1, 0.7), 0.0130.3 (−0.1, 0.7), 0.1430.7 (0.4, 1.0), <0.001
        Adjusted1.61.82.10.2 (−0.1, 0.5), 0.2890.3 (0.0, 0.7), 0.0710.5 (0.2, 0.8), <0.001
    Erectile dysfunction (0-4)1.2 ± 1.31.4 ± 1.41.8 ± 1.40.2 (−0.2, 0.6), 0.2500.4 (−0.1, 0.8), 0.0880.6 (0.3, 0.9), <0.001
        Adjusted1.31.21.7−0.1 (−0.4, 0.2), 0.5830.5 (0.1, 0.9), 0.0100.4 (0.1, 0.7), 0.006
    Body image (0-4)2.3 ± 1.32.6 ± 1.12.8 ± 0.90.3 (0.0, 0.5), 0.0360.3 (−0.1, 0.6), 0.1240.5 (0.3, 0.8), <0.001
        Adjusted2.32.62.80.3 (0.0, 0.6), 0.0360.3 (−0.1, 0.6), 0.1220.6 (0.3, 0.8), <0.001
    • Abbreviations: 95% CI, 95% confidence interval; CS, completely sedentary; IA, insufficiently active; MG, meeting guidelines.

  • Table 6.

    Fatigue differences in bladder cancer survivors based on exercise category in the past month

    Fatigue variableCS (n = 324), mean ± SDIA (n = 84), mean ± SDMG (n = 117), mean ± SDBetween-group comparisons: mean difference (95% CI), P
    IA vs CSMG vs IAMG vs CS
    Most fatigue (0-10)4.0 ± 2.94.5 ± 2.73.6 ± 2.70.5 (−0.2, 1.1), 0.163−0.9 (−1.7, −0.1), 0.027−0.4 (−1.0, 0.2), 0.180
        Adjusted4.04.53.60.5 (−0.2, 1.2), 0.157−0.9 (−1.7, −0.1), 0.021−0.4 (−1.0, 0.2), 0.165
    Least fatigue (0-10)2.2 ± 2.22.0 ± 2.01.5 ± 1.8−0.3 (−0.8, 0.3), 0.309−0.4 (−1.0, 0.2), 0.163−0.7 (−1.1, −0.2), 0.003
        Adjusted2.12.11.60.0 (−0.5, 0.5), 0.850−0.5 (−1.0, 0.1), 0.125−0.5 (−0.9, −0.1), 0.029
    Average fatigue (0-10)3.0 ± 2.43.2 ± 2.32.4 ± 2.10.2 (−0.3, 0.8), 0.442−0.8 (−1.5, −0.2), 0.012−0.6 (−1.1, −0.1), 0.014
        Adjusted3.03.32.50.4 (−0.2, 0.9), 0.201−0.9 (−1.5, −0.2), 0.008−0.5 (−1.0, 0.0), 0.047
    Fatigue now (0-10)2.6 ± 2.72.7 ± 2.51.9 ± 2.30.1 (−0.5, 0.7), 0.775−0.8 (−1.5, −0.1), 0.026−0.7 (−1.3, −0.2), 0.009
        Adjusted2.52.81.90.2 (−0.4, 0.8), 0.502−0.9 (−1.6, −0.1), 0.018−0.7 (−1.2, −0.1), 0.022
    Days fatigued (0-7)2.9 ± 2.52.7 ± 2.12.5 ± 2.3−0.3 (−0.8, 0.3), 0.378−0.2 (−0.9, 0.5), 0.561−0.5 (−1.0, 0.1), 0.081
        Adjusted2.92.72.5−0.1 (−0.7, 0.4), 0.671−0.2 (−0.9, 0.4), 0.475−0.4 (−0.9, 0.1), 0.163
    Time fatigued/day (0-10)2.8 ± 2.72.4 ± 1.82.1 ± 2.0−0.4 (−1.0, 0.2), 0.155−0.3 (−1.0, 0.4), 0.446−0.7 (−1.2, −0.2), 0.010
        Adjusted2.82.52.2−0.2 (−0.8, 0.4), 0.406−0.3 (−1.0, 0.4), 0.350−0.6 (−1.1, 0.0), 0.033
    Interference (0-10)1.8 ± 2.21.5 ± 1.71.3 ± 1.7−0.3 (−0.8, 0.2), 0.252−0.2 (−0.8, 0.3), 0.398−0.5 (−0.9, 0.1), 0.017
        Adjusted1.81.61.3−0.2 (−0.7, 0.3), 0.422−0.3 (−0.8, 0.3), 0.305−0.5 (−0.9, −0.1), 0.027
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Cancer Epidemiology Biomarkers & Prevention: 16 (5)
May 2007
Volume 16, Issue 5
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Associations between Exercise and Quality of Life in Bladder Cancer Survivors: A Population-Based Study
Kristina H. Karvinen, Kerry S. Courneya, Scott North and Peter Venner
Cancer Epidemiol Biomarkers Prev May 1 2007 (16) (5) 984-990; DOI: 10.1158/1055-9965.EPI-06-0680

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Associations between Exercise and Quality of Life in Bladder Cancer Survivors: A Population-Based Study
Kristina H. Karvinen, Kerry S. Courneya, Scott North and Peter Venner
Cancer Epidemiol Biomarkers Prev May 1 2007 (16) (5) 984-990; DOI: 10.1158/1055-9965.EPI-06-0680
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