Physical Therapy and Research in Patients with Cancer

Preface
Contents
Part I: Physical Function and Health Related Quality of Life
	1: Physical Function and Health-Related QOL in Cancer Survivors
		1.1	 Introduction
		1.2	 Quality of Life
		1.3	 Physical Function of Cancer Survivors
			1.3.1	 Body Weight
			1.3.2	 Sarcopenia
			1.3.3	 Exercise Capacity
			1.3.4	 Hand Grip Strength
			1.3.5	 Knee Extension Strength
			1.3.6	 Fall and Balance Function
			1.3.7	 Sensory Disturbance Peripheral Neuropathy
		1.4	 Physical Therapy
			1.4.1	 Resistance Training
			1.4.2	 Aerobic Exercise
			1.4.3	 Combined Resistance Training and Aerobic Exercise
		1.5	 Relationship Between Physical Function and Mortality
		1.6	 Conclusions
		References
	2: Physical Function and Health-Related Quality of Life After Breast Cancer Surgery
		2.1	 Introduction
		2.2	 Assessment
			2.2.1	 Quality of Life Assessments
				2.2.1.1	 Short Form with 36 Questions
				2.2.1.2	 European Organisation for Research and Treatment of Cancer QLQ-C30
				2.2.1.3	 European Organisation for Research and Treatment of Cancer QLQ-BR23
				2.2.1.4	 Functional Assessment of Cancer Therapy-Breast
				2.2.1.5	 Breast-Q
				2.2.1.6	 World Health Organization Quality of Life
				2.2.1.7	 Lymphedema Functioning, Disability and Health Questionnaire for Upper Limb Lymphedema
			2.2.2	 Depression and Anxiety Assessments
				2.2.2.1	 Hospital Anxiety and Depression Scale
				2.2.2.2	 Distress and Impact Thermometer
				2.2.2.3	 Self-Rating Depression Scale
				2.2.2.4	 Self-Rating Anxiety Scale
				2.2.2.5	 General Distress, Measured by the Symptom Checklist-90-Revised
				2.2.2.6	 Centers for Epidemiological Studies-Depression
			2.2.3	 Assessments of Upper Extremity Function
				2.2.3.1	 Disabilities of the Arm, Shoulder, and Hand
				2.2.3.2	 Shortened Disabilities of the Arm, Shoulder, and Hand Questionnaire
			2.2.4	 Muscle Strength Assessments
				2.2.4.1	 Manual Muscle Testing
				2.2.4.2	 Handheld Dynamometer
				2.2.4.3	 Grip Strength
			2.2.5	 Assessment of Axillary Web Syndrome
			2.2.6	 Assessment of Lymphedema
				2.2.6.1	 Circumference Measurements
				2.2.6.2	 Bioelectrical Impedance Analysis
			2.2.7	 Pain Assessment
				2.2.7.1	 Visual Analog Pain Scale
				2.2.7.2	 Numerical Rating Scale
				2.2.7.3	 McGill Pain Questionnaire
				2.2.7.4	 Brief Pain Inventory
		2.3	 Rehabilitation
			2.3.1	 Preoperative Rehabilitation
			2.3.2	 Early Rehabilitation
			2.3.3	 Resistance Exercise
			2.3.4	 Home-Based Multidimensional Survivorship Programs
			2.3.5	 Water-Based Exercise
			2.3.6	 Complex Decongestive Physical Therapy
			2.3.7	 Psychoeducational Group Interventions
			2.3.8	 Tai Chi Chuan
		2.4	 Factors Affecting Quality of Life
			2.4.1	 Factors Affecting the Quality of Life After Breast Cancer
			2.4.2	 Our Study: Investigation of Factors Affecting Early Quality of Life of Patients After Breast Cancer Surgery [6]
				2.4.2.1	 Time Course of Quality of Life
				2.4.2.2	 Factor Affecting Quality of Life
		2.5	 Factors Affecting Psychological Problems
			2.5.1	 Characteristics and Incidence of Psychological Problems
			2.5.2	 Factors Affecting Psychological Problems
			2.5.3	 Our Study: Risk Factors for Early Postoperative Psychological Problems in Breast Cancer Patients After Axillary Lymph Node Dissection [8]
				2.5.3.1	 Incidence of Psychological Problems
				2.5.3.2	 Factors Affecting Psychological Problems
		2.6	 Factors Affecting Shoulder Range of Motion
			2.6.1	 Improvements in Range of Motion
			2.6.2	 Factors Affecting Range of Motion
			2.6.3	 Our Study: Risk Factors of Shoulder Function Impairment After Axillary Dissection for Breast Cancer [123]
				2.6.3.1	 Improvements in Range of Motion
				2.6.3.2	 Factors Affecting Range of Motion
		2.7	 Factors Affecting Axillary Web Syndrome
			2.7.1	 Period of Axillary Web Syndrome Occurrence
			2.7.2	 Clinical Characteristics
			2.7.3	 Factors Affecting Axillary Web Syndrome After Breast Cancer
			2.7.4	 Our Study: Influence of and Risk Factors for Axillary Web Syndrome Following Surgery for Breast Cancer [7]
				2.7.4.1	 Occurrence of Axillary Web Syndrome
				2.7.4.2	 Shoulder Joint Range of Motion Compared Between Patients with and Without Axillary Web Syndrome
				2.7.4.3	 Disabilities of the Arm, Shoulder, and Hand Compared Between Patients with and Without Axillary Web Syndrome
				2.7.4.4	 Quality of Life Compared Between Patients with and Without Axillary Web Syndrome
				2.7.4.5	 Factors Predicting Axillary Web Syndrome
		2.8	 Factors Affecting Lymphedema
			2.8.1	 Clinical Characteristics
			2.8.2	 Incidence of Lymphedema
			2.8.3	 Risk Factors for Lymphedema
			2.8.4	 Our Study: Risk Factors for Lymphedema in Breast Cancer Survivors Following Axillary Lymph Node Dissection [164]
				2.8.4.1	 Incidence of Lymphedema
				2.8.4.2	 Risk Factors for Lymphedema
		2.9	 Factors Affecting Return to Work
			2.9.1	 Incidence of Return to Work
			2.9.2	 Our Study: Factors Associated with Returning to Work for Breast Cancer Patients Following Axillary Lymph Node Dissection [185]
				2.9.2.1	 Incidence of Return to Work
		2.10	 Factors Affecting Participation in Leisure Activities
			2.10.1	 Our Study: Factors Affecting Participation in Leisure Activities After Breast Cancer Surgery [189]
				2.10.1.1	 Factors Affecting Participation in Leisure Activities
		2.11	 Tai Chi Yuttari-Exercise
			2.11.1	 Our Study: Impact of Tai Chi Yuttari-Exercise on Arteriosclerosis and Physical Function in Older People: Subjects Without Cancer [199]
			2.11.2	 Our Study: Investigating the Circulatory-Respiratory Response During Tai Chi Yuttari-Exercise Among Older Adults: Subjects Without Cancer [200]
		2.12	 Future Research Topics
			2.12.1	 Evaluation of Breast Cancer Patients at Home
			2.12.2	 Rehabilitation to Motivate Patients
			2.12.3	 Rehabilitation for Elderly Breast Cancer Patients
		References
	3: Physical Function and Health-Related Quality of Life in Patients with Gastrointestinal Cancer
		3.1	 Introduction
		3.2	 Influencing Factors of HRQoL in Patients with GIC
		3.3	 Intervention Effect of Physical Therapy on Health-Related QOL of Patients with GIC
		3.4	 What Factors Are Needed to Improve HRQoL Early After Surgery Among Patients with GIC?
		3.5	 Physical Therapy for Patients with GIC in the Future
		3.6	 Conclusion
		References
	4: Physical Function and Health-Related QOL in Surgically Treated Patients with Malignant Pleural Mesothelioma
		4.1	 Introduction
			4.1.1	 Surgical Treatment of Malignant Pleural Mesothelioma
			4.1.2	 Perioperative Rehabilitation of Malignant Pleural Mesothelioma
			4.1.3	 Physiotherapy
		4.2	 Physical Function and Quality-of-Life Assessment
			4.2.1	 Demographic, Clinical, and Diagnostic Data
			4.2.2	 Handgrip Strength
			4.2.3	 Knee Extensor Muscle Strength
			4.2.4	 Submaximal Exercise Capacity
			4.2.5	 Pulmonary Function
			4.2.6	 Health-Related Quality of Life
		4.3	 Physiotherapy Research in the Surgical Field of Malignant Pleural Mesothelioma
		4.4	 Conclusion
		References
	5: Muscle Mass, Cachexia, and Health-Related Quality of Life in Patients with Hematologic Malignancies
		5.1	 Introduction
		5.2	 Muscle Mass and Cachexia
		5.3	 Health-Related Quality of Life
		5.4	 Low-Intensity Exercise Therapy
		5.5	 Behavioral Change Interventions
		5.6	 Neuromuscular Electrical Stimulation and Whole-Body Electromyostimulation
		5.7	 Conclusion
		References
	6: Exercise Capacity and Health-Related Quality of Life in Patients After Lung Resection for Non-small Cell Lung Cancer
		6.1	 Introduction
		6.2	 Physiotherapy in Patients for Non-small Cell Lung Cancer (NSCLC)
		6.3	 Exercise Capacity in Patients with NSCLC
			6.3.1	 Exercise Capacity
			6.3.2	 Impact of Lung Resection on Exercise Capacity After Surgery
			6.3.3	 The Role of Exercise Capacity Tests in Lung Cancer
			6.3.4	 Methods of Exercise Capacity Tests
				6.3.4.1	 Cardiopulmonary Exercise Test
				6.3.4.2	 6-MWT
				6.3.4.3	 Incremental Shuttle Walking Test
			6.3.5	 Research About Postoperative Functional Exercise Capacity
				6.3.5.1	 Methods
				6.3.5.2	 Measurements
				6.3.5.3	 Functional Exercise Capacity
				6.3.5.4	 Skeletal Muscle Strength
				6.3.5.5	 Surgical and Perioperative Management
				6.3.5.6	 Statistical Analysis
				6.3.5.7	 Results
				6.3.5.8	 Conclusion
		6.4	 HRQoL in Patients with NSCLC
			6.4.1	 HRQoL
			6.4.2	 Impact of Lung Resection on HRQoL After Surgery
				6.4.2.1	 Physical Component of HRQoL
				6.4.2.2	 Mental Health Component of HRQoL
				6.4.2.3	 Symptoms of the Disease
				6.4.2.4	 Predictive Factors of Postoperative HRQoL
			6.4.3	 Measurement of HRQoL
				6.4.3.1	 36-Items Short Form
				6.4.3.2	 EuroQOL
				6.4.3.3	 European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Core Questionnaire (QLQ-C30)
				6.4.3.4	 Functional Assessment of Cancer Therapy General
			6.4.4	 Our Research About Postoperative HRQoL
				6.4.4.1	 Methods
				6.4.4.2	 Measurements
					HRQoL Assessment
				6.4.4.3	 Statistical Analysis
				6.4.4.4	 Results
				6.4.4.5	 Conclusion
		6.5	 Conclusions
		References
Part II: Physical Exercise
	7: The Effect of Physical Exercise on Physical Function and Survival Rate in Cancer Patients
		7.1	 Introduction
		7.2	 Physical Function Outcome for Cancer Patients
			7.2.1	 Handgrip Strength
			7.2.2	 Gait Speed
			7.2.3	 6-Minute Walking Test
			7.2.4	 Short Physical Performance Battery
			7.2.5	 Timed Up-and-Go Test
		7.3	 Exercise Therapy for Physical Dysfunction in Cancer Patients
		7.4	 Physical Function and Mortality
		7.5	 Exercise Therapy and Mortality
		7.6	 Conclusions
		References
	8: Exercise Therapy on Muscle Mass and Physical Function in Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplantation
		8.1	 Introduction
		8.2	 Allo-HSCT Rehabilitation
		8.3	 Procedure
		8.4	 Types of Allo-HSCT and Intensity of Preconditioning Treatment
		8.5	 After Hospitalization for Allo-HSCT
		8.6	 Treatment Environment
		8.7	 Assessment
			8.7.1	 Assessment Items
		8.8	 Exercise Therapy
			8.8.1	 Strength Training
			8.8.2	 Endurance (Aerobic) Training
			8.8.3	 Stretching
			8.8.4	 Balance Exercise
			8.8.5	 ADL Exercise
			8.8.6	 Self-Directed Exercise
		8.9	 Approach to Exercise Therapy
			8.9.1	 Pre-HSCT Treatment Period
			8.9.2	 Day of Allo-HSCT to Engraftment
			8.9.3	 Engraftment to Discharge
			8.9.4	 Important Considerations to Keep in Mind on a Given Day of Exercise Therapy
		8.10	 Complications in Allo-HSCT Treatment
		8.11	 Exercise During Complications
			8.11.1	 Influence of Pre-conditioning Treatment
		8.12	 GvHD
			8.12.1	 Skin GvHD
			8.12.2	 Gastrointestinal GvHD
			8.12.3	 Liver GvHD
		8.13	 Viral Infections
			8.13.1	 Cytomegalovirus Infection
			8.13.2	 Hemorrhagic Cystitis Caused by Adenovirus
			8.13.3	 Steroid Myopathy
		8.14	 Risk Management
			8.14.1	 Cytopenia
			8.14.2	 Leukopenia
			8.14.3	 Red Blood Cell Depletion
			8.14.4	 Thrombocytopenia
			8.14.5	 Rehabilitation During Blood Transfusion
		8.15	 Nutritional Support
		8.16	 Elderly Patients
		8.17	 Long-Term Follow-Up; LTFU
			8.17.1	 Medical Interview
			8.17.2	 Physical Activity
			8.17.3	 Three-Month Follow-Up
			8.17.4	 Six-Month Follow-Up
			8.17.5	 One-Year Follow-Up
		8.18	 Conclusion
		References
	9: Physical Exercise and Immune Function in Patients with Hematological Malignancies
		9.1	 Introduction: Patients with Hematological Malignancies and an Outline of the Immune System
			9.1.1	 Exercise in Healthy Subjects and Infection Epidemiology
			9.1.2	 Hematological Malignancy and Exercise
		9.2	 Relationship Between the Function of Immune Cells and Exercise
			9.2.1	 Neutrophils
			9.2.2	 Lymphocytes (T Cell)
			9.2.3	 Lymphocytes (B Cell)
			9.2.4	 Lymphocytes (Natural Killer Cell)
		9.3	 Relationship Between the Function of the Endocrine System and Movement
			9.3.1	 Catecholamines
			9.3.2	 Carbohydrate Corticoids
		9.4	 Relationship Between Cytokine Function and Exercise
		9.5	 Effect of Exercise on Immune Function in Patients with Hematological Malignancies
		9.6	 Effects and Challenges of Exercise on the Treatment of Patients with Hematological Malignancies
			9.6.1	 Is Exercise a Treatment Tool for Hematological Malignancies?
			9.6.2	 Does Exercise Promote the Treatment of Hematological Malignancies?
			9.6.3	 Effects of Exercise on Immune Cells in Patients with Hematopoietic Stem Cell Transplantation
		9.7	 Conclusion
		References
	10: Exercise Protocols for Counteracting Cancer Cachexia-Related Declines in Muscle Mass and Strength and the Clinical Assessment of Skeletal Muscle
		10.1	 Introduction
		10.2	 Physiology
			10.2.1	 Cancer Cachexia
			10.2.2	 Physical Exercise in Cancer Patients
			10.2.3	 Chemotherapy-Induced Toxicity in Skeletal Muscle
		10.3	 Effects of Training Protocols on Muscle Strength and Mass in Cancer Cachexia
			10.3.1	 Resistance Training
			10.3.2	 Aerobic Training
			10.3.3	 Combined Training
			10.3.4	 High-Intensity Interval Training
			10.3.5	 Neuromuscular Electrical Stimulation
		10.4	 Assessment of Skeletal Muscle in Clinical Practice
			10.4.1	 Skeletal Muscle Strength
			10.4.2	 Skeletal Muscle Mass
				10.4.2.1	 Imaging-Based Muscle Mass Assessment
				10.4.2.2	 Dual-Energy X-Ray Absorptiometry
				10.4.2.3	 Bioelectric Impedance Analysis
				10.4.2.4	 Ultrasound Diagnostic Imaging
			10.4.3	 Methods for Qualitative Assessment of Skeletal Muscles
				10.4.3.1	 Measurement of Intramuscular Noncontractile Tissue in CT Imaging
				10.4.3.2	 Phase Angle
				10.4.3.3	 Muscle Echo Intensity
		10.5	 Conclusions and Future Perspectives
		References
	11: Physical Exercise and Skeletal Muscle Adaptation in Cancer Cachexia
		11.1	 Introduction
		11.2	 Animal Model of Cancer Cachexia
		11.3	 Colon 26 Adenocarcinoma Model
		11.4	 Lewis Lung Carcinoma Model
		11.5	 Walker 256 Carcinoma Model
		11.6	 Yoshida Ascites Hepatoma AH-130 Model
		11.7	 Other Tumor Transplantation Models
		11.8	 Genetic Model of Cancer Cachexia
		11.9	 Regulatory Mechanism of Muscle Mass During Cancer Cachexia
		11.10	 Proteolysis System During Cancer Cachexia
		11.11	 Alteration of Protein Synthesis During Cancer Cachexia
		11.12	 Abnormal Oxidative Metabolism and Muscle Wasting During Cancer Cachexia
		11.13	 Exercise Intervention for Cancer Cachexia
		References
	12: Physical Function and Physical Activity in Patients with Advanced Lung Cancer
		12.1	 Introduction
		12.2	 Clinical Practice in Physical Therapy for Advanced Lung Cancer Patients
			12.2.1	 Bone Metastasis
			12.2.2	 Brain Metastasis
			12.2.3	 Pulmonary Dysfunction
			12.2.4	 Cancer Cachexia
			12.2.5	 Physical Therapy to Improve Quality of Life
		12.3	 Previous Studies on Physical Function, Exercise Capacity, Physical Activity, and Exercise Intervention in Patients with Advanced Lung Cancer
			12.3.1	 Physical Function at the Time of Diagnosis
			12.3.2	 Relationship Between Exercise Capacity and Survival
			12.3.3	 Relationship Between Physical Activity and Survival
			12.3.4	 Exercise Intervention
		12.4	 Physical Therapy Research for Patients with Advanced Lung Cancer
			12.4.1	 Study Design
			12.4.2	 Protocol Design
		12.5	 Conclusion
		References
	13: Physical Activity in Patients with Breast Cancer
		13.1	 Introduction
		13.2	 Traditional Physical Therapy Regarding Physical Activity in Patients with Breast Cancer
			13.2.1	 The Effect of Physical Activity on Patients with Breast Cancer
				13.2.1.1	 Physical Activity and Breast Cancer Risk
				13.2.1.2	 Physical Activity and Recurrence
				13.2.1.3	 Physical Activity and Survival
			13.2.2	 Promoting Physical Activity Among Patients
				13.2.2.1	 Promote Physical Activity Before Diagnosis of Breast Cancer
				13.2.2.2	 Promoting Physical Activity During and After Breast Cancer Treatment
			13.2.3	 The Determinants of Physical Activity Among Cancer Patients with Breast Cancer
			13.2.4	 Assessment Tools of Physical Activity and Clinical Applications
				13.2.4.1	 Assessment of Physical Activity Using Questionnaires
				13.2.4.2	 Assessment of Physical Activity Using Pedometers and  Accelerometers
				13.2.4.3	 Clinical Indications
		13.3	 Research Trend for Physical Activity for Patients with  Breast Cancer
			13.3.1	 Lymphedema After Breast Cancer Surgery
			13.3.2	 Hormone Therapy
				13.3.2.1	 Bone-Related Events: Physical Activity
				13.3.2.2	 Joint Pain: Physical Activity
			13.3.3	 Chemotherapy
			13.3.4	 Herceptin for HER2-Positive Molecular Target Drugs
		13.4	 Further Research
			13.4.1	 Assessment of Physical Activity
			13.4.2	 Myokine
		13.5	 Conclusion
		References
Part III: Physical Function and Other Symptom
	14: Multiple Frailty in Elderly Patients with Cancer
		14.1	 Introduction
		14.2	 Section 1
			14.2.1	 Epidemiology of Older Cancers
			14.2.2	 Frailty in Geriatrics
			14.2.3	 Frailty in Oncology
			14.2.4	 Assessment Tools of Frailty (Table 14.1)
			14.2.5	 Frailty in Elderly Cancer Patients
		14.3	 Section 2
			14.3.1	 Multiple Frailty
				14.3.1.1	 Physical Frailty
				14.3.1.2	 Cognitive Frailty
				14.3.1.3	 Social Frailty
		14.4	 Section 3
			14.4.1	 Relationship Between Cancer Incidence and Frailty
			14.4.2	 Impact of Frailty in the Perioperative Period
				14.4.2.1	 Before Treatment
				14.4.2.2	 During Treatment
				14.4.2.3	 After Treatment
			14.4.3	 Summary of the Section
		14.5	 Section 4
			14.5.1	 Prehabilitation
			14.5.2	 Outpatient Cancer Rehabilitation
			14.5.3	 The Multidimensional Concept of Frailty
		14.6	 Conclusion
		References
	15: Postoperative Complications in Patients with Esophageal Cancer
		15.1	 Introduction
		15.2	 Problems Following Esophagectomy
			15.2.1	 Risk Factors of Postoperative Complications in Esophagectomy
			15.2.2	 Postoperative Pulmonary Complications in Esophagectomy
				15.2.2.1	 Incidence Rate
				15.2.2.2	 Pathogenesis Mechanism
					Respiratory System and Esophagectomy
					Lung Volumes and Atelectasis
					Respiratory Muscle Dysfunction
					Pneumonia and Its Causes
			15.2.3	 Sarcopenia and Esophagectomy Outcomes
			15.2.4	 Cardiopulmonary Function and Esophagectomy Outcomes
			15.2.5	 Clinical Practice of Rehabilitation in Esophagectomy
				15.2.5.1	 Preoperative Rehabilitation (Prehabilitation)
					Definition and Components of Prehabilitation
					Efficacy of Prehabilitation in Esophagectomy
				15.2.5.2	 Perioperative Rehabilitation
					Notable Postoperative Complications in Esophagectomy
						Delirium
						ICU-Acquired Weakness (ICU-AW)
					Postoperative Symptom Management
					Early mobilization
			15.2.6	 Multidisciplinary Medical Team Approach in Esophagectomy
		15.3	 Conclusion
		References
	16: Cancer-Related Lymphedema and Obesity
		16.1	 Edema
		16.2	 Causes and Characteristics of Edema
		16.3	 Lymphedema
		16.4	 Diagnosis and Evaluation of Lymphedema
		16.5	 Lymphedema Treatment
		16.6	 Lymphedema and Weight Gain (Obesity)
		16.7	 Mechanisms of Obesity and Lymphedema Development
		16.8	 Role of Fat
		16.9	 Case Study
		16.10	 Future Policy
		References
	17: Cancer-Related Pain and Effects of Non-pharmacologic Intervention
		17.1	 Introduction
		17.2	 Classification of Pain by Pathology
			17.2.1	 Nociceptive Pain
			17.2.2	 Neuropathic Pain
			17.2.3	 Psychogenic Pain
			17.2.4	 Immobilization-Induced Pain
		17.3	 Classification of Cancer-Related Pain
			17.3.1	 Visceral Pain
			17.3.2	 Bone Pain
			17.3.3	 Neuropathic Pain
		17.4	 Continuous and Breakthrough Pain
			17.4.1	 Continuous Pain
			17.4.2	 Breakthrough Pain
		17.5	 Methods of Pain Assessment
		17.6	 Pharmacologic Interventions for Cancer-Related Pain
			17.6.1	 Opioids Rotation and Conversion Ratio
		17.7	 Non-pharmacologic Intervention for Cancer-Related Pain
		17.8	 Physical Exercise for Cancer-Related Pain
		17.9	 Thermal Therapy for Cancer-Related Pain
		17.10	 Massaging for Cancer-Related Pain
		17.11	 Transcutaneous Electrical Nerve Stimulation (TENS) for Cancer-Related Pain
			17.11.1 Safety of TENS for Cancer Patients
			17.11.2 Mechanism of Effect of TENS for Pain
			17.11.3 Introduction of Research on the Effect of TENS for Cancer-Related Pain
				17.11.3.1	 TENS Application Protocol
				17.11.3.2	 Effect of Pain Relief by TENS
			17.11.4 Meta-Analysis on the Effect of TENS for Cancer-Related Pain
			17.11.5 Treatment of Cancer-Related Symptoms Other Than Pain Using TENS
		17.12	 Other Treatments in Physical Therapy for Cancer Patients
		17.13	 Clinical Recommendation and Conclusion
		17.14	 Conclusion
		References
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	18: Nutrition and Daily Activities in Older Patients After Gastrectomy
		18.1	 Introduction
		18.2	 Nutrition and Gastric Cancer
		18.3	 Physical Activity, Exercise, and Gastric Cancer
		18.4	 Malnutrition in Patients with Gastric Cancer Who Underwent Gastrectomy
			18.4.1	 BMI
			18.4.2	 GNRI
			18.4.3	 Patient-Generated Subjective Global Assessment (PG-SGA)
			18.4.4	 Prealbumin
			18.4.5	 Other Nutritional Indicators
		18.5	 Malnutrition and Clinical Outcomes
			18.5.1	 Mortality and Complication After Gastrectomy
			18.5.2	 Quality of Life (QOL)
			18.5.3	 Activities of Daily Living (ADL)
			18.5.4	 Malnutrition and Nonsurgical Treatments
		18.6	 Sarcopenia in Patients with Gastric Cancer
			18.6.1	 Sarcopenia and Clinical Outcomes in Patients with Gastric Cancer
		18.7	 Frailty in Patients with Gastric Cancer
			18.7.1	 Prevalence of Frailty in Patients with Gastric Cancer
			18.7.2	 Frailty and Clinical Outcomes in Patients with Gastric Cancer
		18.8	 Perioperative Nutrition and Rehabilitation Intervention
			18.8.1	 ERAS
			18.8.2	 Pre-rehabilitation
			18.8.3	 Pre-rehabilitation in Physical Aspects
			18.8.4	 Perioperative Nutritional Intervention
			18.8.5	 Combination Intervention of Nutritional Management and Rehabilitation After Gastrectomy
		18.9	 Conclusion
		References
	19: Frailty and Mental Health in Older Patients with Gastrointestinal Cancer
		19.1	 Introduction
			19.1.1	 Gastrointestinal Cancer and Frailty
			19.1.2	 Gastrointestinal Cancer and Psychiatric Symptoms
		19.2	 Impact of Psychiatric Distress on Physical Function, Activities of Daily Living, and Quality of Life
		19.3	 Physical Therapy Evaluation of Physical Frailty and Mental Health
			19.3.1	 Physical Frailty
				19.3.1.1	 Frailty Index
				19.3.1.2	 Cardiovascular Health Study
				19.3.1.3	 Geriatric8
				19.3.1.4	 Vulnerable Elders Survey-13
			19.3.2	 Mental Health
				19.3.2.1	 Hospital Anxiety and Depression Scale
				19.3.2.2	 The Center for Epidemiologic Studies Depression Scale
				19.3.2.3	 Geriatric Depression Scale-15
				19.3.2.4	 Distress and Impact Thermometer
		19.4	 Rehabilitation for Gastrointestinal Cancer Patients
			19.4.1	 Early Postoperative Rehabilitation
			19.4.2	 Rehabilitation Before Discharge
			19.4.3	 Pre-rehabilitation
		19.5	 Exercise and Mental Health
			19.5.1	 Effects of Exercise on Mental Health
			19.5.2	 Mechanisms for the Effects of Exercise on Mental Health
		19.6	 Our Research Topics: Social Frailty and Mental Health
			19.6.1	 Social Frailty
			19.6.2	 Social Frailty in Patients with Cancer
			19.6.3	 Social Frailty and Mental Health
		19.7	 Future Physical Therapy Research in This Field
		References
	20: Physical Function and Nutrition in Patients with Hematological Malignancies
		20.1	 Introduction
		20.2	 Physical Function and Nutritional Status in Adults Who Undergo Allogeneic Hematopoietic Stem Cell Transplantation
			20.2.1	 Pretransplantation Physical Function and Nutritional Status Assessment
			20.2.2	 Interventions for Physical Function and Nutrition After Transplantation
		20.3	 Physical Function and Nutritional Interventions in Adults Administered Chemotherapy
			20.3.1	 Pre-chemotherapy Physical Function and Nutritional Status Assessment
			20.3.2	 Exercise Intervention and Motor Function Changes During Chemotherapy
		References
	21: Physical Function and Nutrition in Patients with Esophageal Cancer and Head and Neck Cancer
		21.1	 Esophageal Cancer
			21.1.1	 Introduction
			21.1.2	 Treatments and Complications
				21.1.2.1	 Endoscopic Resection
				21.1.2.2	 Surgery
				21.1.2.3	 Chemotherapy
				21.1.2.4	 Radiation Therapy (RT)
			21.1.3	 Physical Function and Rehabilitation
				21.1.3.1	 Skeletal Muscle Mass
				21.1.3.2	 Muscle Strength and Physical Performance
				21.1.3.3	 Exercise Capacity
				21.1.3.4	 Rehabilitation
					Preoperative Period
					Postoperative Period
					During Chemotherapy and RT
			21.1.4	 Nutritional Status
				21.1.4.1	 Pretreatment Malnutrition
				21.1.4.2	 Postsurgery Malnutrition
				21.1.4.3	 Malnutrition During and After Radiotherapy
				21.1.4.4	 Malnutrition During Chemotherapy
				21.1.4.5	 Intervention
					Pretreatment Intervention
					Nutritional Interventions During CRT for Esophageal Cancer
					Perioperative Nutritional Interventions
						Parenteral and Enteral Nutrition
						Oral Intake
			21.1.5	 Combined Therapy
		21.2	 Head and Neck Cancer
			21.2.1	 Introduction, Treatment, and Complications
			21.2.2	 Physical Function and Rehabilitation
				21.2.2.1	 Shoulder Dysfunction and Rehabilitation
				21.2.2.2	 Exercise Intervention During RT or CRT
			21.2.3	 Nutritional Status
				21.2.3.1	 Assessment
				21.2.3.2	 Intervention
					Pretreatment Nutritional Intervention
					Nutritional Intervention During Treatment
					Swallowing Interventions
					Oral Mucositis and Oral Care
					Posttreatment Nutrition Support
		References
Part IV: Skeletal Muscle
	22: Skeletal Muscle Oxygenation in Patients with Malignant Hematopoietic Disease
		22.1	 Introduction
		22.2	 NIRS Measurements
			22.2.1	 Experimental Protocol in a Sterile Isolation Room
			22.2.2	 Experimental Protocol in a Physical Therapy Room
			22.2.3	 Creatine Kinase (CK) Activity
		22.3	 Comparison of the Muscle Oxidative Metabolism in Patients and Age-Matched Healthy Controls
		22.4	 Hematological Malignancy: Muscle Oxygen Saturation (StO2)
		22.5	 Relationship Between StO2 and Exercise Load in Patients with Hematological Malignancy
		22.6	 Hematological Malignancy Following Hematopoietic Cell Transplantation
		22.7	 Transplantation Protocol
		22.8	 Physical Therapy Intervention
		22.9	 Hematological Malignancy During Exercise Tolerance Test (Ramp Protocol)
		22.10	 Exercise Tolerance Test
		22.11	 Exercise Protocols
		References
	23: Sarcopenia and Physical Performance in Patients with Cancer
		23.1	 Introduction
			23.1.1	 What Is Sarcopenia?
			23.1.2	 Definition of Sarcopenia
			23.1.3	 Prevention of Sarcopenia
			23.1.4	 Treatment of Sarcopenia
		23.2	 Sarcopenia in Cancer
			23.2.1	 Epidemiology of Sarcopenia in Cancer
			23.2.2	 Impact of Sarcopenia on Clinical Outcomes in Cancer
			23.2.3	 Impact of Sarcopenia on Clinical Outcomes in Non-small Cell Lung Cancer
			23.2.4	 Disease Specificity
			23.2.5	 Prevention and Treatment of Sarcopenia in Cancer
			23.2.6	 Nutrition and Exercise Treatment for Advanced Cancer (NEXTAC) Program
			23.2.7	 Our Recent Activities
			23.2.8	 Future Perspectives
		23.3	 Conclusion
		References
	24: Cachexia and Postoperative Outcomes in Elderly Patients with Gastrointestinal Cancer
		24.1	 Introduction
		24.2	 Definitions and Classifications
		24.3	 Epidemiology
		24.4	 Treatment
			24.4.1	 Nutritional Interventions
				24.4.1.1	 Dietary Counseling
				24.4.1.2	 Parenteral Nutrition (PN) or Enteral Nutrition (EN)
				24.4.1.3	 Omega-3 Fatty Acids
				24.4.1.4	 Vitamins, Minerals, and Other Dietary Supplements
			24.4.2	 Pharmacological Interventions
				24.4.2.1	 Megestrol Acetate (MA) and Corticosteroids
				24.4.2.2	 Anamorelin
				24.4.2.3	 Enobosarm
				24.4.2.4	 Nonsteroidal Anti-inflammatory Drugs (NSAIDs)
				24.4.2.5	 Other Pharmacologic Agents
			24.4.3	 Psychosocial Interventions
			24.4.4	 Multimodal Interventions
		24.5	 Impact of Cachexia on Patient Outcomes
		24.6	 Assessment of Cachexia
			24.6.1	 Nutritional Assessment
			24.6.2	 Muscle Mass and Strength
			24.6.3	 QOL and Psychosocial Assessment
			24.6.4	 Biomarkers
		24.7	 Research About Physical Therapy for Cachexia
		24.8	 Cachexia and Postoperative Outcomes
		24.9	 Conclusion
		References
	25: Mechanism of Skeletal Muscle Atrophy Using a Mice Cancer Cachexia Model
		25.1	 Relationship Between Cancer Cachexia and Skeletal Muscle Atrophy
		25.2	 Relationship Between Inflammatory Cytokines and Skeletal Muscle Atrophy in Cancer Cachexia Obtained from Autopsy Cases
		25.3	 Skeletal Muscle Atrophy and Energy Production in a Mouse Cancer Cachexia Model
		25.4	 Carbohydrate-Induced Nutritional Intervention and Skeletal Muscle Atrophy in Cancer-Bearing Mice
		25.5	 MCFA-Induced Nutritional Intervention and Skeletal Muscle Atrophy in Cancer-Bearing Mice
		25.6	 Vitamin B and Vitamin E Metabolism and Skeletal Muscle Atrophy in a Mouse Cancer Cachexia Model
		25.7	 Myocardial Damage Due to Cancer Cachexia
		References