Skip to main content
SpringerLink
Log in

Replacing sedentary time with physical activity and sleep: associations with quality of life in kidney cancer survivors

  • Original Paper
  • Published:
Cancer Causes & Control Aims and scope Submit manuscript

Abstract

Purpose

Kidney cancer survivors spend large quantities of time sedentary and little time physically active, which negatively impacts quality of life (QoL). This study examined (1) the association of reallocating sedentary time to sleep, light physical activity (PA), or moderate-to-vigorous PA (MVPA) on QoL in kidney cancer survivors and (2) the threshold at which results are clinically meaningful.

Methods

Kidney cancer survivors (N = 463) completed a survey including the Godin Leisure-Time Exercise Questionnaire, sitting time, sleep duration, and Functional Assessment of Cancer Therapy (FACT) scales. Isotemporal substitution analyses estimated associations of reallocating sedentary time to PA and sleep on QoL.

Results

Reallocating 10 min/day of sedentary time to MVPA was significantly associated with higher scores on the Trial Outcome Index-Fatigue (B = 0.60, SE = 0.25, p = 0.02), FACT-Fatigue (B = 0.71, SE = 0.32, p = 0.03), functional well-being (B = 0.18, SE = 0.08, p = 0.02), and fatigue subscales (B = 0.35, SE = 0.15, p = 0.02). Reallocating sedentary time to sleep was significantly associated with higher FACT-General (B = 0.15, SE = 0.08, p = 0.04) and functional well-being subscale (B = 0.06, SE = 0.03, p = 0.049) scores. Reallocating sedentary time to light PA was significantly associated with higher fatigue subscale scores (B = 0.46, SE = 0.23, p = 0.045). Kidney cancer survivors would need to reallocate a minimum of about 83, 200, and 65 min/day of MVPA, sleep, and light PA, respectively, for associations to be clinically meaningful.

Conclusions

Reallocating sedentary time to MVPA, light PA, or sleep at higher doses is associated with better fatigue and physical aspects of QoL. Interventions should consider replacing sedentary time with MVPA or light PA in a gradual manner, and improve sleep quality for kidney cancer survivors.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. World Cancer Research Fund/American Institute for Cancer Research (2018) Continuous Update Project Expert Report 2018. Diet, nutrition, physical activity and kidney cancer. https://www.wcrf.org/dietandcancer/kidney-cancer. Accessed 16 Nov 2018

  2. American Cancer Society (2018) Cancer facts and figures 2018. American Cancer Society. https://www.cancer.org/research/cancer-facts-statistics/all-cancer-facts-figures/cancer-facts-figures-2018.html. Accessed 29 July 2018

  3. Mishra SI, Scherer RW, Snyder C et al (2015) Are exercise programs effective for improving health-related quality of life among cancer survivors? A systematic review and meta-analysis. Oncol Nurs Forum 41:e326–e342. https://doi.org/10.1188/14.ONF.E326-E342

    Article  Google Scholar 

  4. Gerritsen JKW, Vincent AJPE (2016) Exercise improves quality of life in patients with cancer: a systematic review and meta-analysis of randomised controlled trials. Br J Sports Med 50:796–803. https://doi.org/10.1136/bjsports-2015-094787

    Article  PubMed  Google Scholar 

  5. Liu L, Fiorentino L, Rissling M et al (2013) Decreased health-related quality of life in women with breast cancer is associated with poor sleep. Behav Sleep Med 11:189–206. https://doi.org/10.1080/15402002.2012.660589

    Article  PubMed  Google Scholar 

  6. Campbell KL, Winters-Stone KM, Wiskemann J et al (2019) Exercise guidelines for cancer survivors: Consensus Statement from International Multidisciplinary Roundtable. Med Sci Sports Exerc 51:2375–2390. https://doi.org/10.1249/MSS.0000000000002116

    Article  PubMed  PubMed Central  Google Scholar 

  7. Kampshoff CS, Jansen F, van Mechelen W et al (2014) Determinants of exercise adherence and maintenance among cancer survivors: a systematic review. Int J Behav Nutr Phys Act 11:80. https://doi.org/10.1186/1479-5868-11-80

    Article  PubMed  PubMed Central  Google Scholar 

  8. Ormel HL, van der Schoot GGF, Sluiter WJ et al (2018) Predictors of adherence to exercise interventions during and after cancer treatment: a systematic review. Psychooncology 27:713–724. https://doi.org/10.1002/pon.4612

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Thraen-Borowski KM, Gennuso KP, Cadmus-Bertram L (2017) Accelerometer-derived physical activity and sedentary time by cancer type in the United States. PLoS ONE 12:e0182554. https://doi.org/10.1371/journal.pone.0182554

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Conroy DE, Wolin KY, Blair CK, Demark-Wahnefried W (2017) Gender-varying associations between physical activity intensity and mental quality of life in older cancer survivors. Support Care Cancer 25:3465–3473. https://doi.org/10.1007/s00520-017-3769-6

    Article  PubMed  PubMed Central  Google Scholar 

  11. Blair CK, Morey MC, Desmond RA et al (2014) Light-intensity activity attenuates functional decline in older cancer survivors. Med Sci Sports Exerc 46:1375–1383. https://doi.org/10.1249/MSS.0000000000000241

    Article  PubMed  PubMed Central  Google Scholar 

  12. Blair CK, Robien K, Inoue-Choi M et al (2016) Physical inactivity and risk of poor quality of life among elderly cancer survivors compared to women without cancer: the Iowa Women’s Health Study. J Cancer Surviv 10:103–112. https://doi.org/10.1007/s11764-015-0456-9

    Article  PubMed  Google Scholar 

  13. Sylvester BD, Ahmed R, Amireault S, Sabiston CM (2017) Changes in light-, moderate-, and vigorous-intensity physical activity and changes in depressive symptoms in breast cancer survivors: a prospective observational study. Support Care Cancer 25:3305–3312. https://doi.org/10.1007/s00520-017-3745-1

    Article  PubMed  Google Scholar 

  14. Lynch BM, Dunstan DW, Vallance JK, Owen N (2013) Don’t take cancer sitting down. Cancer 119:1928–1935. https://doi.org/10.1002/cncr.28028

    Article  PubMed  Google Scholar 

  15. Van Roekel EH, Bours MJL, Breedveld-Peters JJL et al (2015) Light physical activity is associated with quality of life after colorectal cancer. Med Sci Sports Exerc 47:2493–2503. https://doi.org/10.1249/MSS.0000000000000698

    Article  CAS  PubMed  Google Scholar 

  16. Füzéki E, Engeroff T, Banzer W (2017) Health benefits of light-intensity physical activity: a systematic review of accelerometer data of the National Health and Nutrition Examination Survey (NHANES). Sport Med 47:1769–1793. https://doi.org/10.1007/s40279-017-0724-0

    Article  Google Scholar 

  17. Trinh L, Plotnikoff RC, Rhodes RE et al (2011) Associations between physical activity and quality of life in a population-based sample of kidney cancer survivors. Cancer Epidemiol Biomark Prev 20:859–868. https://doi.org/10.1158/1055-9965.EPI-10-1319

    Article  Google Scholar 

  18. Trinh L, Plotnikoff RC, Rhodes RE et al (2013) Associations between sitting time and quality of life in a population-based sample of kidney cancer survivors. Ment Health Phys Act 6:16–23. https://doi.org/10.1016/j.mhpa.2012.09.001

    Article  Google Scholar 

  19. Tremblay MS, Aubert S, Barnes JD et al (2017) Sedentary Behavior Research Network (SBRN)— Terminology Consensus Project process and outcome. Int J Behav Nutr Phys Act 14:1–17. https://doi.org/10.1186/s12966-017-0525-8

    Article  Google Scholar 

  20. Lynch BM (2010) Sedentary behavior and cancer: a systematic review of the literature and proposed biological mechanisms. Cancer Epidemiol Biomark Prev 19:2691–2709. https://doi.org/10.1158/1055-9965.EPI-10-0815

    Article  Google Scholar 

  21. Lynch BM, Leitzmann MF (2017) An evaluation of the evidence relating to physical inactivity, sedentary behavior, and cancer incidence and mortality. Curr Epidemiol Rep 4:221–231. https://doi.org/10.1007/s40471-017-0119-7

    Article  Google Scholar 

  22. Van Roekel EH, Winkler EAH, Bours MJL et al (2016) Associations of sedentary time and patterns of sedentary time accumulation with health-related quality of life in colorectal cancer survivors. Prev Med Rep 4:262–269. https://doi.org/10.1016/j.pmedr.2016.06.022

    Article  PubMed  PubMed Central  Google Scholar 

  23. Cleeland CS, Zhao F, Chang VT et al (2013) The symptom burden of cancer: evidence for a core set of cancer-related and treatment-related symptoms from the Eastern Cooperative Oncology Group Symptom Outcomes and Practice Patterns Study. Cancer 119:4333–4340. https://doi.org/10.1002/cncr.28376

    Article  PubMed  Google Scholar 

  24. Strollo SE, Fallon EA, Gapstur SM, Smith TG (2020) Cancer-related problems, sleep quality, and sleep disturbance among long-term cancer survivors at 9-years post diagnosis. Sleep Med 65:177–185. https://doi.org/10.1016/j.sleep.2019.10.008

    Article  PubMed  Google Scholar 

  25. Slade AN, Waters MR, Serrano NA (2020) Long-term sleep disturbance and prescription sleep aid use among cancer survivors in the United States. Support Care Cancer 28:551–560. https://doi.org/10.1007/s00520-019-04849-3

    Article  PubMed  Google Scholar 

  26. Clevenger L, Schrepf A, DeGeest K et al (2013) Sleep disturbance, distress, and quality of life in ovarian cancer patients during the first year after diagnosis. Cancer 119:3234–3241. https://doi.org/10.1002/cncr.28188

    Article  PubMed  Google Scholar 

  27. Loh KP, Pandya C, Zittel J et al (2017) Associations of sleep disturbance with physical function and cognition in older adults with cancer. Support Care Cancer 25:3161–3169. https://doi.org/10.1007/s00520-017-3724-6

    Article  PubMed  PubMed Central  Google Scholar 

  28. Lehrer S, Green S, Ramanathan L, Rosenzweig KE (2013) Obesity and deranged sleep are independently associated with increased cancer mortality in 50 US states and the District of Columbia. Sleep Breath 17:1117–1118. https://doi.org/10.1007/s11325-013-0811-x

    Article  PubMed  Google Scholar 

  29. Grgic J, Dumuid D, Gargia Bengoechea E et al (2018) Health outcomes associated with reallocations of time between sleep, sedentary behaviour, and physical activity: a systematic scoping review of isotemporal substitution studies. Int J Behav Nutr Phys Act 15:69. https://doi.org/10.1186/s12966-018-0691-3

    Article  PubMed  PubMed Central  Google Scholar 

  30. Mekary RA, Willett WC, Hu FB, Ding EL (2009) Isotemporal substitution paradigm for physical activity epidemiology and weight change. Am J Epidemiol 170:519–527. https://doi.org/10.1093/aje/kwp163

    Article  PubMed  PubMed Central  Google Scholar 

  31. Boyle T, Vallance JK, Buman MP, Lynch BM (2016) Reallocating time to sleep, sedentary time, or physical activity: associations with waist circumference and body mass index in breast cancer survivors. Cancer Epidemiol Biomark Prev 26:254–260. https://doi.org/10.1158/1055-9965.EPI-16-0545

    Article  Google Scholar 

  32. Ehlers DK, Fanning J, Salerno EA et al (2018) Replacing sedentary time with physical activity or sleep: effects on cancer-related cognitive impairment in breast cancer survivors. BMC Cancer 18:685. https://doi.org/10.1186/s12885-018-4603-3

    Article  PubMed  PubMed Central  Google Scholar 

  33. Van Roekel EH, Bours MJL, Breedveld-Peters JJL et al (2016) Modeling how substitution of sedentary behavior with standing or physical activity is associated with health-related quality of life in colorectal cancer survivors. Cancer Causes Control 27:513–525. https://doi.org/10.1007/s10552-016-0725-6

    Article  PubMed  PubMed Central  Google Scholar 

  34. Vallance JK, Buman MP, Lynch BM, Boyle T (2017) Reallocating time to sleep, sedentary, and active behaviours in non-Hodgkin lymphoma survivors: associations with patient-reported outcomes. Ann Hematol 96:749–755. https://doi.org/10.1007/s00277-017-2942-9

    Article  PubMed  Google Scholar 

  35. Welch WA, Ehlers D, Gavin KL et al (2019) Effects of reallocating sedentary time with physical activity on quality of life indicators in breast cancer survivors. Psychooncology 28:1430–1437. https://doi.org/10.1002/pon.5091

    Article  PubMed  PubMed Central  Google Scholar 

  36. Yost KJ, Eton DT (2005) Combining distribution- and anchor-based approaches to determine minimally important differences: the FACIT experience. Eval Heal Prof 28:172–191. https://doi.org/10.1177/0163278705275340

    Article  Google Scholar 

  37. Trinh L, Strom DA, Wong JN, Courneya KS (2018) Modality specific exercise guidelines and quality of life in kidney cancer survivors: a cross-sectional study. Psychooncology 27:2419–2426. https://doi.org/10.1002/pon.4844

    Article  PubMed  Google Scholar 

  38. Godin G, Shephard RJ (1985) A simple method to assess exercise behavior in the community. Can J Appl Sport Sci 10:141–146

    CAS  PubMed  Google Scholar 

  39. Chau JY, Van Der Ploeg HP, Dunn S et al (2012) Validity of the occupational sitting and physical activity questionnaire. Med Sci Sports Exerc 44:118–125. https://doi.org/10.1249/MSS.0b013e3182251060

    Article  PubMed  Google Scholar 

  40. Marshall AL, Miller YD, Burton NW, Brown WJ (2010) Measuring total and domain-specific sitting: a study of reliability and validity. Med Sci Sports Exerc 42:1094–1102 

    PubMed  Google Scholar 

  41. Miller R, Brown W (2004) Steps and sitting in a working population. Int J Behav Med 11:219-224. https://doi.org/10.1207/s15327558ijbm1104_5

    Article  Google Scholar 

  42. Boyle T, Lynch BM, Courneya KS, Vallance JK (2015) Agreement between accelerometer-assessed and self-reported physical activity and sedentary time in colon cancer survivors. Support Care Cancer 23:1121–1126. https://doi.org/10.1007/s00520-014-2453-3

    Article  PubMed  Google Scholar 

  43. Courneya KS, Vallance JK, Culos-Reed SN et al (2012) The Alberta Moving Beyond Breast Cancer (AMBER) Cohort Study: a prospective study of physical activity and health-related fitness in breast cancer survivors. BMC Cancer 12:1–13. https://doi.org/10.1186/1471-2407-12-525

    Article  Google Scholar 

  44. Cella DF, Tulsky DS, Gray G et al (1993) The functional assessment of cancer therapy scale: development and validation of the general measure. J Clin Oncol 11:570–579. https://doi.org/10.1200/JCO.1993.11.3.570

    Article  CAS  PubMed  Google Scholar 

  45. Yellen SB, Cella DF, Webster K et al (1997) Measuring fatigue and other anemia-related symptoms with the Functional Assessment of Cancer Therapy (FACT) measurement system. J Pain Symptom Manag 13:63–74

    Article  CAS  Google Scholar 

  46. Welch WA, Lloyd GR, Awick EA et al (2018) Measurement of physical activity and sedentary behavior in breast cancer survivors. J Community Support Oncol 15:e21–e29. https://doi.org/10.12788/jcso.0387

    Article  Google Scholar 

  47. Bélanger LJ, Plotnikoff RC, Clark A, Courneya KS (2011) Physical activity and health-related quality of life in young adult cancer survivors: a Canadian provincial survey. J Cancer Surviv 5:44–53. https://doi.org/10.1007/s11764-010-0146-6

    Article  PubMed  Google Scholar 

  48. Bourke L, Homer KE, Thaha MA et al (2014) Interventions to improve exercise behaviour in sedentary people living with and beyond cancer: a systematic review. Br J Cancer 110:831–841. https://doi.org/10.1038/bjc.2013.750

    Article  CAS  PubMed  Google Scholar 

  49. Keadle SK, Conroy DE, Buman MP et al (2017) Targeting reductions in sitting time to increase physical activity and improve health. Med Sci Sports Exerc 49:1572–1582. https://doi.org/10.1249/MSS.0000000000001257

    Article  PubMed  PubMed Central  Google Scholar 

  50. Thraen-Borowski KM, Trentham-Dietz A, Edwards DF et al (2013) Dose–response relationships between physical activity, social participation, and health-related quality of life in colorectal cancer survivors. J Cancer Surviv 7:369–378. https://doi.org/10.1007/s11764-013-0277-7

    Article  PubMed  PubMed Central  Google Scholar 

  51. Xu S, Thompson W, Ancoli-Israel S et al (2018) Cognition, quality-of-life, and symptom clusters in breast cancer: using Bayesian networks to elucidate complex relationships. Psychooncology 27:802–809. https://doi.org/10.1002/pon.4571

    Article  PubMed  Google Scholar 

  52. Van Mill JG, Vogelzangs N, Van Someren EJW et al (2014) Sleep duration, but not insomnia, predicts the 2-year course of depressive and anxiety disorders. J Clin Psychiatry 75:119–126. https://doi.org/10.4088/JCP.12m08047

    Article  PubMed  Google Scholar 

  53. Espie C, Fleming L, Cassidy JW et al (2008) Randomized controlled clinical effectiveness trial of cognitive behavior therapy compared with treatment as usual for persistent insomnia in patients with cancer. J Clin Oncol 26:4651–4658. https://doi.org/10.1200/JCO.2007.13.9006

    Article  PubMed  Google Scholar 

  54. Alfano CM, Lichstein KL, Vander Wal GS et al (2011) Sleep duration change across breast cancer survivorship: associations with symptoms and health-related quality of life. Breast Cancer Res Treat 130:243–254. https://doi.org/10.1007/s10549-011-1530-2

    Article  PubMed  PubMed Central  Google Scholar 

  55. Savard J, Simard S, Ivers H, Morin CM (2005) Randomized study on the efficacy of cognitive-behavioral therapy for insomnia secondary to breast cancer, Part I: sleep and psychological effects. J Clin Oncol 23:6083–6096. https://doi.org/10.1200/JCO.2005.09.548

    Article  PubMed  Google Scholar 

  56. Courneya KS, Segal RJ, Mackey JR et al (2014) Effects of exercise dose and type on sleep quality in breast cancer patients receiving chemotherapy: a multicenter randomized trial. Breast Cancer Res Treat 144:361–369. https://doi.org/10.1007/s10549-014-2883-0

    Article  CAS  PubMed  Google Scholar 

  57. Garland SN, Johnson JA, Savard J et al (2014) Sleeping well with cancer: a systematic review of cognitive behavioral therapy for insomnia in cancer patients. Neuropsychiatr Dis Treat 10:1113–1123

    PubMed  PubMed Central  Google Scholar 

  58. Mishra SI, Scherer RW, Snyder C et al (2012) Exercise interventions on health-related quality of life for people with cancer during active treatment. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD008465.pub2

    Article  PubMed  PubMed Central  Google Scholar 

  59. Van Vulpen JK, Peeters PHM, Velthuis MJ et al (2016) Effects of physical exercise during adjuvant breast cancer treatment on physical and psychosocial dimensions of cancer-related fatigue: a meta-analysis. Maturitas 85:104–111

    Article  PubMed  Google Scholar 

  60. Velthuis MJ, Agasi-Idenburg SC, Aufdemkampe G, Wittink HM (2010) The effect of physical exercise on cancer-related fatigue during cancer treatment: a meta-analysis of randomised controlled trials. Clin Oncol 22:208–221. https://doi.org/10.1016/j.clon.2009.12.005

    Article  CAS  Google Scholar 

  61. Kim RB, Phillips A, Herrick K et al (2013) Physical activity and sedentary behavior of cancer survivors and non-cancer individuals: results from a national survey. PLoS ONE 8:e57598. https://doi.org/10.1371/journal.pone.0057598

    Article  CAS  Google Scholar 

  62. Vallance JKH, Courneya KS, Plotnikoff RC, Mackey JR (2008) Analyzing theoretical mechanisms of physical activity behavior change in breast cancer survivors: results from the Activity Promotion (ACTION) Trial. Ann Behav Med 35:150–158. https://doi.org/10.1007/s12160-008-9019-x

    Article  PubMed  Google Scholar 

  63. Phillips SM, Awick EA, Conroy DE et al (2015) Objectively measured physical activity and sedentary behavior and quality of life indicators in survivors of breast cancer. Cancer 121:4044–4052. https://doi.org/10.1002/cncr.29620

    Article  PubMed  Google Scholar 

  64. Ainsworth B, Cahalin L, Buman M, Ross R (2015) The current state of physical activity assessment tools. Prog Cardiovasc Dis 57:387–395. https://doi.org/10.1016/j.pcad.2014.10.005

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

KSC is supported by the Canada Research Chairs Program. We would like to thank Carol Russell and Lorraine Cormier from the Alberta Cancer Registry for their assistance in conducting this study.

Author information

Authors and Affiliations

  1. Faculty of Kinesiology and Physical Education, University of Toronto, 55 Harbord Street, Toronto, ON, M5S 2W6, Canada

    Allyson Tabaczynski & Linda Trinh

  2. Faculty of Kinesiology, Sport, and Recreation, University of Alberta, 113 University Hall, Edmonton, AB, T6G 2H9, Canada

    Kerry S. Courneya

Authors
  1. Allyson Tabaczynski
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kerry S. Courneya
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Linda Trinh
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Linda Trinh.

Ethics declarations

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the Ethical Standards of the Institutional and/or National Research Committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tabaczynski, A., Courneya, K.S. & Trinh, L. Replacing sedentary time with physical activity and sleep: associations with quality of life in kidney cancer survivors. Cancer Causes Control 31, 669–681 (2020). https://doi.org/10.1007/s10552-020-01308-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10552-020-01308-x

Keywords

Search

Navigation