Norwegian Cancer Society

Introduction Long-term sickness absence represents a major public health challenge with far-reaching consequences for both individuals and society. Musculoskeletal disorders (MSDs) are among the leading causes of sickness absence. Although mobile apps show promise for supporting self-management of MSDs, high-quality evidence remains limited, and outcomes related to work participation are rarely examined. This trial aims to evaluate whether an individually tailored, app-based self-management intervention (SmaRTWork), provided in addition to usual care, improves return-to-work compared with usual care alone among individuals on sick leave due to MSDs. Methods and analysis We will conduct a randomised controlled trial with two parallel arms: 1) SmaRTWork in addition to usual care and 2) usual care alone. Individuals 20–59 years old who have been sick-listed for <12 weeks due to back, neck or widespread pain will be recruited through clinicians in primary health care. Eligible participants are randomised 1:1 to one of the two arms. We aim to include 298 participants, 149 in each arm. The primary outcome is time to sustainable return-to-work, defined as one consecutive month without receiving medical benefits, assessed over a 12-month period using registry data. Secondary outcomes include health-related measures assessed at baseline, 3, 6 and 12 months. The trial will also incorporate qualitative studies, a process evaluation and a health economic evaluation. Ethics and dissemination The trial is approved by the Committees for Clinical Trials of Pharmaceuticals and Medical Devices (Ref. 563919). Results will be published in peer-reviewed journals and presented at national and international conferences. Trial registration NCT07034040 .

BackgroundCancer surgery is associated with risk of complications and loss of function. Vulnerability factors, such as advanced age, malnutrition, smoking, comorbidity, frailty, and low socioeconomic status increase the risk. Lifestyle intervention prior to surgery, known as prehabilitation, often include physical activity, nutritional support, psychological coaching, and smoking cessation, increase functional reserves and reduce postoperative complications. Most importantly, it prevents loss of functional capacity and dependence.MethodsThe dHOPE study is a three-armed, open-labelled, parallel-group randomized controlled trial (RCT) with non-inferiority design to compare a digital home-based prehabilitation program with a hospital-based program or no organized prehabilitation. In addition, the dHOPE study aims to identify measurable parameters reflecting the effect of prehabilitation, thus preparing for future personalization of the prehabilitation programs.DiscussionThe feasibility of multimodal prehabilitation is threatened by low compliance to hospital-based programs due to burdensome commuting, even in central and metropolitan areas. In sparsely populated countries, this challenge is even more pronounced. To ensure equal healthcare to all citizens regardless of address or economic situation, there is a need to transfer the prehabilitation program to the patients’ homes. Thus, the primary hypothesis of dHOPE is that a digital home-based program is not inferior to a hospital-based program. Moreover, given the patient diversity, prehabilitation must be personalized to meet individual profiles or needs. An exploratory subtask of dHOPE is to confirm the utility of clinical, genetic, and molecular factors in evaluating prehabilitation response ultimately to identify new biomarkers and develop medical software for individual risk stratification and development of personalized prehabilitation programs. Clinical Trial registrationhttps://clinicaltrials.gov/, identifier (NCT06231576).

BackgroundEach year, over 20,000 men are diagnosed with cancer in Norway, and approximately 150,000 men who have previously been diagnosed with cancer are currently alive. Many of these cancer survivors encounter a range of challenges, including fatigue, sexual dysfunction, urinary issues, and pain, all of which can significantly impact their quality of life. Consequently, a substantial number of men seek support beyond conventional healthcare. This study aims to investigate the motivations behind the use of Complementary and Alternative Medicine (CAM) and dietary changes/supplements in men with cancer in Norway, and further explore their communication with healthcare providers, self-reported effects and adverse effects, and the sources of information they rely on regarding these practices.MethodIn collaboration with the Norwegian Cancer Society (NCS), we conducted an online cross-sectional study involving participants of their user panel who have current or past experiences with cancer (n = 706), of whom 218 identified as men. The study was conducted during the autumn of 2021, employing a modified cancer-specific version of the International Questionnaire to Measure Use of Complementary and Alternative Medicine (I-CAM-Q). A total of 153 men agreed to participate, yielding a response rate of 70%.ResultsA large proportion of the respondents used CAM (62%), dietary supplements (65%), and/or adjusted their diet (81%) to boost their immune systems and increase their quality of life. The dietary adjustments involved eating more fruits, vegetables, fish, and whole grains. Many participants also used relaxation techniques and visited CAM providers to enhance quality of life. Most participants reported better health outcomes as a result of these interventions. The Internet and healthcare professionals were the main source of information, although many did not disclose their dietary changes and CAM therapy use with healthcare professionals.ConclusionBy leveraging these insights, healthcare providers, policymakers, and researchers can collectively work towards a more holistic and patient-centred approach to cancer care, ultimately improving the overall well-being and quality of life for male cancer survivors.

Abstract Background Cancer is the leading cause of death in Norway, with prostate, breast, lung, and colon cancers being the most prevalent types. Adopting a healthy and varied diet can help reduce cancer risk and recurrence. However, access to dietary counselling remains limited for cancer patients in Norway. This study aimed to investigate the prevalence of dietary supplement use and dietary changes made by cancer patients and survivors. Additionally, it sought to explore the reason(s) for such practices, communication with healthcare providers, sources of information, and reported benefits and potential harms resulting from these changes and supplement use. Methods Conducted in collaboration with the Norwegian Cancer Society (NCS), this online cross-sectional study targeted members of their user panel who had either current or previous cancer (n = 706). The study took place in September/October 2021, utilizing a modified cancer-specific version of the International Questionnaire to Measure Use of Complementary and Alternative Medicine (I-CAM-Q). Out of 468 participants (315 women and 153 men), 67.2% consented to participate. Between-group analyses were conducted using Pearson chi-square tests and Fisher exact tests for categorical variables, while independent sample t-tests were applied for continuous variables. Results The majority of the participants (97%) reported making changes to their diet (78%) and/or incorporating dietary supplements (73%) in response to their cancer diagnosis. The primary goal of these changes was to strengthen their body and immune system. Almost half of the participants (49%) reported that they found these changes beneficial and discussed them openly with their healthcare providers, with family physicians being the most common point of discussion (25%). Adverse effects were reported by only a few participants, mostly mild. Information about dietary changes and supplements was primarily sourced from the internet or healthcare providers. Conclusions This study highlights that most individuals affected by cancer attribute to dietary adjustment. It also emphasizes the importance of addressing adherence to dietary recommendations and using reliable sources of information. Additionally, the study highlights the potential, yet currently underutilized, role of healthcare professionals in initiating dialogues about dietary interventions to address any unmet needs of patients. Such proactive engagement may contribute to the promotion of reliable sources of information and the prevention of non-evidence-based and potentially harmful diets or supplement adoption.