Una aproximación a la relación entre el sueño y el cáncer
DOI:
https://doi.org/10.17533/udea.iatreia.351Palabras clave:
Calidad del Sueño, Neoplasias, Privación de Sueño, Ritmo Circadiano, SueñoResumen
Introducción: el sueño cumple una función reparadora en el organismo, tanto en humanos como en otros animales, por lo que su calidad puede tener una relación bidireccional con el cáncer. Las alteraciones del sueño y del ciclo circadiano pueden influir en el desarrollo y la progresión del cáncer, mientras que estas neoplasias también pueden contribuir a esos trastornos.
Objetivos: describir la relación bidireccional entre sueño y cáncer mediante una revisión narrativa.
Métodos: se revisaron 181 artículos publicados durante la última década en cuatro bases de datos científicas.
Resultados: las alteraciones del sueño (p. ej. privación por realización de turnos laborales) están asociadas con el desarrollo y la progresión del cáncer. A la vez, los mecanismos biológicos de estas neoplasias (p. ej. procesos inflamatorios), el tratamiento oncológico (específicamente la quimioterapia) y algunas condiciones psicológicas, como el distrés, precipitan trastornos del sueño.
Conclusiones: hay evidencia de la relación bidireccional entre el cáncer y el sueño. Promover hábitos saludables de sueño puede contribuir tanto a prevenir el desarrollo y progresión del cáncer, como a mejorar la percepción de calidad de vida entre los pacientes con neoplasias malignas.
Descargas
Citas
(1) Chen YC, Lin CY, Strong C, Li CY, Wang JS, Ko WC, et al. Sleep disturbances at the time of a new diagnosis: a comparative study of human immunodeficiency virus patients, cancer patients, and general population controls. Sleep Med [Internet]. 2017;36:38-43. https://doi.org/10.1016/j.sleep.2017.04.005
(2) Balachandran DD, Miller MA, Faiz SA, Yennurajalingam S, Innominato PF. Evaluation and Management of Sleep and Circadian Rhythm Disturbance in Cancer. Curr Treat Options Oncol [Internet]. 2021;22(9):81. https://doi.org/10.1007/s11864-021-00872-x
(3) Palesh O, Zeitzer JM, Conrad A, Giese-Davis J, Mustian KM, Popek V, et al. Vagal Regulation, Cortisol, and Sleep Disruption in Women with Metastatic Breast Cancer. J Clin Sleep Med [Internet]. 2008;4(5):441-449. Available from: https://pubmed.ncbi.nlm.nih.gov/18853702/
(4) Yennurajalingam S, Balachandran D, Pedraza-Cardozo SL, Berg EA, Chisholm GB, Reddy A, et al. Patient-reported sleep disturbance in advanced cancer: frequency, predictors and screening performance of the Edmonton Symptom Assessment System sleep item. BMJ Support Palliat Care [Internet]. 2017;7(3):274-80. https://doi.org/10.1136/bmjspcare-2015-000847
(5) Aernout E, Benradia I, Hazo JB, Sy A, Askevis-Leherpeux F, Sebbane D, et al. International study of the prevalence and factors associated with insomnia in the general population. Sleep Med [Internet]. 2021;82:186-192. https://doi.org/10.1016/j.sleep.2021.03.028
(6) Berisha A, Shutkind K, Borniger JC. Sleep Disruption and Cancer: Chicken or the Egg? Front Neurosci [Internet]. 2022;16:856235. https://doi.org/10.3389/fnins.2022.856235
(7) Irwin MR, Olmstead R, Carroll JE. Sleep Disturbance, Sleep Duration, and Inflammation: A Systematic Review and Meta-Analysis of Cohort Studies and Experimental Sleep Deprivation. Biol Psychiatry [Internet]. 2016;80(1):40-52. https://doi.org/10.1016/j.biopsych.2015.05.014
(8) Al Maqbali M, Al Sinani M, Alsayed A, Gleason AM. Prevalence of Sleep Disturbance in Patients With Cancer: A Systematic Review and Meta-Analysis. Clin Nurs Res [Internet]. 2022;31(6):1107-1123. https://doi.org/10.1177/10547738221092146
(9) Fortner BV, Stepanski EJ, Wang SC, Kasprowicz S, Durrence HH. Sleep and Quality of Life in Breast Cancer Patients. J Pain Symptom Manage [Internet]. 2002;24(5):471-480. https://doi.org/10.1016/s0885-3924(02)00500-6
(10) Otte JL, Carpenter JS, Russell KM, Bigatti S, Champion VL. Prevalence, Severity, and Correlates of Sleep-Wake Disturbances in Long-Term Breast Cancer Survivors. J Pain Symptom Manage [Internet]. 2010;39(3):535-47. https://doi.org/10.1016/j.jpainsymman.2009.07.004
(11) Savard J, Morin CM. Insomnia in the Context of Cancer: A Review of a Neglected Problem. J Clin Oncol [Internet]. 2001;19(3):895-908. https://doi.org/10.1200/jco.2001.19.3.895
(12) Morin CM, Jarrin DC. Epidemiology of Insomnia: Prevalence, Course, Risk Factors, and Public Health Burden. Sleep Med Clin [Internet]. 2022;17(2):173-191. https://doi.org/10.1016/j.jsmc.2022.03.003
(13) Cheng KKF, Lee DTF. Effects of pain, fatigue, insomnia, and mood disturbance on functional status and quality of life of elderly patients with cancer. Crit Rev Oncol Hematol [Internet]. 2011;78(2):127-137. https://doi.org/10.1016/j.critrevonc.2010.03.002
(14) Mao JJ, Armstrong K, Bowman MA, Xie SX, Kadakia R, Farrar JT. Symptom Burden Among Cancer Survivors: Impact of Age and Comorbidity. J Am Board Fam Med [Internet]. 2007;20(5):434-443. https://doi.org/10.3122/jabfm.2007.05.060225
(15) López E, De La Torre-Luque A, Lazo A, Álvarez J, Buela-Casal G. Assessment of sleep disturbances in patients with cancer: Cross-sectional study in a radiotherapy department. Eur J Oncol Nurs [Internet]. 2016;20:71-76. https://doi.org/10.1016/j.ejon.2014.12.008
(16) Santillán ML. Recuento de los Premios Nobel: la importancia del reloj biológico [Internet]. México: Ciencia UNAM; 9 de octubre de 2017. [citado 2024 Jul 29]. Disponible en: https://ciencia.unam.mx/leer/659/recuento-de-los-premios-nobel-la-importancia-del-reloj-biologico
(17) Kelleher FC, Rao A, Maguire A. Circadian molecular clocks and cancer. Cancer Lett [Internet]. 2014;342(1):9-18. https://doi.org/10.1016/j.canlet.2013.09.040
(18) Malaguarnera R, Ledda C, Filippello A, Frasca F, Francavilla VC, Ramaci T, et al. Thyroid Cancer and Circadian Clock Disruption. Cancers [Internet]. 2020;12(11):3109. https://doi.org/10.3390/cancers12113109
(19) Medic G, Wille M, Hemels M. Short- and long-term health consequences of sleep disruption. Nat Sci Sleep [Internet]. 2017;9:151-161. https://doi.org/10.2147/NSS.S134864
(20) Truong T, Liquet B, Menegaux F, Plancoulaine S, Laurent-Puig P, Mulot C, et al. Breast cancer risk, nightwork, and circadian clock gene polymorphisms. Endocr Relat Cancer [Internet]. 2014;21(4):629-638. https://doi.org/10.1530/erc-14-0121
(21) Shi T, Min M, Sun C, Zhang Y, Liang M, Sun Y. Does insomnia predict a high risk of cancer? A systematic review and meta‐analysis of cohort studies. J Sleep Res [Internet]. 2020;29(1):e12876. https://doi.org/10.1111/jsr.12876
(22) Hansen AM, Garde AH, Hansen J. Diurnal Urinary 6‐Sulfatoxymelatonin Levels among Healthy Danish Nurses during Work and Leisure Time. Chronobiol Int [Internet]. 2006;23(6):1203-1215. https://doi.org/10.1080/07420520601100955
(23) Menegaux F, Truong T, Anger A, Cordina‐Duverger E, Lamkarkach F, Arveux P, et al. Night work and breast cancer: A population‐based case–control study in France (the CECILE study). Int J Cancer [Internet]. 2013;132(4):924-931. https://doi.org/10.1002/ijc.27669
(24) Touitou Y. Pollution de l’horloge interne par la lumière la nuit, un problème de santé publique. Bull Acad Natl Med [Internet]. 2015;199(7):1081-1098. https://doi.org/10.1016/S0001-4079(19)30852-0
(25) Wang F, Yeung KL, Chan WC, Kwok CCH, Leung SL, Wu C, et al. A meta-analysis on dose–response relationship between night shift work and the risk of breast cancer. Ann Oncol [Internet]. 2013;24(11):2724-2732. https://doi.org/10.1093/annonc/mdt283
(26) Orešković D, Kaštelančić A, Raguž M, Dlaka D, Predrijevac N, Matec D, et al. The vicious interplay between disrupted sleep and malignant brain tumors: a narrative review. Croat Med J [Internet]. 2021;62(4):376-386. https://doi.org/10.3325/cmj.2021.62.376
(27) International Agency for Research on Cancer. 2020. IARC Monographs Volume 124: Night Shift Work [Internet]. 2020. Available from: https://iarc.who.int/news-events/iarc-monographs-volume-124-night-shift-work/
(28) Wang X, Ji A, Zhu Y, Liang Z, Wu J, Li S, et al. A meta-analysis including dose-response relationship between night shift work and the risk of colorectal cancer. Oncotarget [Internet]. 2015;6(28):25046-25060. https://doi.org/10.18632/oncotarget.4502
(29) Bhatti P, Mirick DK, Randolph TW, Gong J, Buchanan DT, Zhang JJ, et al. Oxidative DNA damage during sleep periods among nightshift workers. Occup Environ Med [Internet]. 2016;73(8):537-544. https://doi.org/10.1136/oemed-2016-103629
(30) Czeisler CA, Shanahan TL, Klerman EB, Martens H, Brotman DJ, Emens JS, et al. Suppression of Melatonin Secretion in Some Blind Patients by Exposure to Bright Light. N Engl J Med [Internet]. 1995;332(1):6-11. https://doi.org/10.1056/nejm199501053320102
(31) Haque M, Yau A. Shift Work Association with Cardiovascular Diseases and Cancers among Healthcare Workers: A Literature Review. Medeni Med J [Internet]. 2019;34(4):387-395. https://doi.org/10.5222/mmj.2019.54775
(32) Lewy AJ, Wehr TA, Goodwin FK, Newsome DA, Markey SP. Light Suppresses Melatonin Secretion in Humans. Science [Internet]. 1980;210(4475):1267-1269. https://doi.org/10.1126/science.7434030
(33) Reiter RJ. The melatonin rhythm: both a clock and a calendar. Experientia [Internet]. 1993;49(8):654-664. https://doi.org/10.1007/bf01923947
(34) Fu L, Kettner NM. Chapter nine-The Circadian Clock in Cancer Development and Therapy. In: Progress in Molecular Biology and Translational Science [Internet]. Vol 119. Illinois: Academic Press; 2013. p. 221-82. Available from: https://linkinghub.elsevier.com/retrieve/pii/B9780123969712000099
(35) Sancar A, Lindsey-Boltz LA, Gaddameedhi S, Selby CP, Ye R, Chiou YY, et al. Circadian Clock, Cancer, and Chemotherapy. Biochemistry [Internet]. 2015;54(2):110-123. https://doi.org/10.1021/bi5007354
(36) Piotrowski I, Kulcenty K, Suchorska W. Interplay between inflammation and cancer. Rep Pract Oncol Radiother [Internet]. 2020;25(3):422-427. https://doi.org/10.1016/j.rpor.2020.04.004
(37) Zielinski MR, Gibbons AJ. Neuroinflammation, Sleep, and Circadian Rhythms. Front Cell Infect Microbiol [Internet]. 2022;12:853096. https://doi.org/10.3389/fcimb.2022.853096
(38) Mogavero MP, DelRosso LM, Fanfulla F, Bruni O, Ferri R. Sleep disorders and cancer: State of the art and future perspectives. Sleep Med Rev [Internet]. 2021;56:101409. https://doi.org/10.1016/j.smrv.2020.101409
(39) Loosen S, Krieg S, Krieg A, Leyh C, Luedde T, Vetter C, et al. Are sleep disorders associated with the risk of gastrointestinal cancer?—A case–control study. J Cancer Res Clin Oncol [Internet]. 2023;149(13):11369-71138. https://doi.org/10.1007/s00432-023-05009-1
(40) Sillah A, Peters U, Watson NF, Tykodi SS, Hall ET, Silverman A, et al. Associating sleep problems with advanced cancer diagnosis, and immune checkpoint treatment outcomes: a pilot study. Support Care Cancer [Internet]. 2022;30(5):3829-3838. https://doi.org/10.1007/s00520-022-06825-w
(41) Rockstrom MD, Chen L, Taishi P, Nguyen JT, Gibbons CM, Veasey SC, et al. Tumor necrosis factor alpha in sleep regulation. Sleep Med Rev [Internet]. 2018;40:69-78. https://doi.org/10.1016/j.smrv.2017.10.005
(42) Cao Y, Song Y, Ning P, Zhang L, Wu S, Quan J, et al. Association between tumor necrosis factor alpha and obstructive sleep apnea in adults: a meta-analysis update. BMC Pulm Med [Internet]. 2020;20(1):215. https://doi.org/10.1186/s12890-020-01253-0
(43) Zhang Z, Duolikun D, Dang T, Wang Y, Ma L, Ma X, et al. Association of tumor necrosis factor-α-308G/A polymorphism with the risk of obstructive sleep apnea: A meta-analysis of 14 case-control studies. PLOS ONE [Internet]. 2023;18(8):e0290239. https://doi.org/10.1371/journal.pone.0290239
(44) Walker WH, Borniger JC. Molecular Mechanisms of Cancer-Induced Sleep Disruption. Int J Mol Sci [Internet]. 2019;20(11):2780. https://doi.org/10.3390/ijms20112780
(45) Jakobsen G, Gjeilo KH, Hjermstad MJ, Klepstad P. An Update on Prevalence, Assessment, and Risk Factors for Sleep Disturbances in Patients with Advanced Cancer—Implications for Health Care Providers and Clinical Research. Cancers [Internet]. 2022;14(16):3933. https://doi.org/10.3390/cancers14163933
(46) Bardwell WA, Profant J, Casden DR, Dimsdale JE, Ancoli‐Israel S, Natarajan L, et al. The relative importance of specific risk factors for insomnia in women treated for early‐stage breast cancer. Psychooncology [Internet]. 2008;17(1):9-18. https://doi.org/10.1002/pon.1192
(47) Berger AM. Patterns of fatigue and activity and rest during adjuvant breast cancer chemotherapy. Oncol Nurse Forum [Internet]. 1998;25(1):51-62. Available from: https://pubmed.ncbi.nlm.nih.gov/9460773/
(48) Costa AR, Fontes F, Pereira S, Gonçalves M, Azevedo A, Lunet N. Impact of breast cancer treatments on sleep disturbances – A systematic review. Breast [Internet]. 2014;23(6):697-709. https://doi.org/10.1016/j.breast.2014.09.003
(49) Stein KD, Jacobsen PB, Hann DM, Greenberg H, Lyman G. Impact of Hot Flashes on Quality of Life Among Postmenopausal Women Being Treated for Breast Cancer. J Pain Symptom Manage [Internet]. 2000;19(6):436-445. https://doi.org/10.1016/s0885-3924(00)00142-1
(50) Desai K, Mao JJ, Su I, DeMichele A, Li Q, Xie SX, et al. Prevalence and risk factors for insomnia among breast cancer patients on aromatase inhibitors. Support Care Cancer [Internet]. 2013;21(1):43-51. https://doi.org/10.1007/s00520-012-1490-z
(51) Rand KL, Otte JL, Flockhart D, Hayes D, Storniolo AM, Stearns V, et al. Modeling hot flushes and quality of life in breast cancer survivors. Climacteric [Internet]. 2011;14(1):171-180. https://doi.org/10.3109/13697131003717070
(52) Fontes F, Severo M, Gonçalves M, Pereira S, Lunet N. Trajectories of sleep quality during the first three years after breast cancer diagnosis. Sleep Med [Internet]. 2017;34:193-199. https://doi.org/10.1016/j.sleep.2017.03.022
(53) Palmer AC, Zortea M, Souza A, Santos V, Biazús JV, Torres ILS, et al. Clinical impact of melatonin on breast cancer patients undergoing chemotherapy; effects on cognition, sleep and depressive symptoms: A randomized, double-blind, placebo-controlled trial. PLOS ONE [Internet]. 2020;15(4):e0231379. https://doi.org/10.1371/journal.pone.0231379
(54) Rissling M, Liu L, Youngstedt SD, Trofimenko V, Natarajan L, Neikrug AB, et al. Preventing Sleep Disruption With Bright Light Therapy During Chemotherapy for Breast Cancer: A Phase II Randomized Controlled Trial. Front Neurosci [Internet]. 2022;16:815872. https://doi.org/10.3389/fnins.2022.815872
(55) Dong ST, Butow PN, Costa DSJ, Lovell MR, Agar M. Symptom Clusters in Patients With Advanced Cancer: A Systematic Review of Observational Studies. J Pain Symptom Manage [Internet]. 2014;48(3):411-450. http://dx.doi.org/10.1016/j.jpainsymman.2013.10.027
(56) Muzyka M, Tagliafico L, Serafini G, Baiardini I, Braido F, Nencioni A, et al. Neuropsychiatric Disorders and Frailty in Older Adults over the Spectrum of Cancer: A Narrative Review. Cancers [Internet]. 2022;14(1):258. https://doi.org/10.3390/cancers14010258
(57) Slatore CG, Goy ER, O’Hearn DJ, Boudreau EA, O’Malley JP, Peters D, et al. Sleep Quality and Its Association With Delirium Among Veterans Enrolled in Hospice. Am J Geriatr Psychiatry [Internet]. 2012;20(4):317-326. https://doi.org/10.1097/jgp.0b013e3182487680
(58) Davies A. Sleep problems in advanced disease. Clin Med [Internet]. 2019;19(4):302-305. https://doi.org/10.7861/clinmedicine.19-4-302
(59) Götze H, Ernst J, Brähler E, Romer G, Von Klitzing K. Predictors of quality of life of cancer patients, their children, and partners. Psychooncology [Internet]. 2015;24(7):787-795. https://doi.org/10.1002/pon.3725
(60) Salca A, Checiches A, Irsay L. The Approach of Cancer Related Fatigue in Rehabilitation Medicine: Part I – mechanisms, symptoms, clinical evaluation and screening. Balneo Res J [Internet]. 2015;6(2):79-85. http://dx.doi.org/10.12680/balneo.2015.1091
(61) Xiao P, Ding S, Duan Y, Li L, Zhou Y, Luo X, et al. Effect of Light Therapy on Cancer-Related Fatigue: A Systematic Review and Meta-Analysis. J Pain Symptom Manage [Internet]. 2022;63(2):e188-202. https://doi.org/10.1016/j.jpainsymman.2021.09.010
(62) Grassi L, Caruso R, Riba MB, Lloyd-Williams M, Kissane D, Rodin G, et al. Anxiety and depression in adult cancer patients: ESMO Clinical Practice Guideline. ESMO Open [Internet]. 2023;8(2):101155. https://doi.org/10.1016/j.esmoop.2023.101155
(63) Nakhlband A, Farahzadi R, Saeedi N, Barzegar H, Montazersaheb S, Soofiyani SR. Bidirectional Relations Between Anxiety, Depression, and Cancer: A Review. Curr Drug Targets [Internet]. 2023;24(2):118-130. https://doi.org/10.2174/1389450123666220922094403
(64) Dickerson SS, Connors LM, Fayad A, Dean GE. Sleep-wake disturbances in cancer patients: narrative review of literature focusing on improving quality of life outcomes. Nat Sci Sleep [Internet]. 2014;6:85-100. https://doi.org/10.2147/nss.s34846
(65) Vena C, Parker K, Cunningham M, Clark J, McMillan S. Sleep-Wake Disturbances in People With Cancer Part I: An Overview of Sleep, Sleep Regulation, and Effects of Disease and Treatment. Oncol Nurs Forum [Internet]. 2004;31(4):735-746. https://doi.org/10.1188/04.onf.735-746
(66) Wu WY, Cheng Y, Liang KC, Lee RX, Yen CT. Affective mirror and anti-mirror neurons relate to prosocial help in rats. IScience [Internet]. 2023;26(1):105865. https://doi.org/10.1016/j.isci.2022.105865
(67) Han J, Cheng HL, Bi LN, Molasiotis A. Mind-body therapies for sleep disturbance among patients with cancer: A systematic review and meta-analysis. Complement Ther Med [Internet]. 2023;75:102954. https://doi.org/10.1016/j.ctim.2023.102954
(68) Lempesis IG, Georgakopoulou VE, Papalexis P, Chrousos GP, Spandidos DA. Role of stress in the pathogenesis of cancer (Review). Int J Oncol [Internet]. 2023;63(5):124. https://doi.org/10.3892/ijo.2023.5572
(69) Collatuzzo G, Pelucchi C, Negri E, Kogevinas M, Huerta JM, Vioque J, et al. Sleep Duration and Stress Level in the Risk of Gastric Cancer: A Pooled Analysis of Case-Control Studies in the Stomach Cancer Pooling (StoP) Project. Cancers [Internet]. 2023;15(17):4319. https://doi.org/10.3390/cancers15174319
(70) Matthews EE, Wang SY. Cancer-Related Sleep Wake Disturbances. Semin Oncol Nurs [Internet]. 2022;38(1):151253. https://doi.org/10.1016/j.soncn.2022.151253
(71) Bultz BD, Carlson LE. Emotional distress: the sixth vital sign in cancer care. J Clin Oncol [Internet]. 2005;23(26):6440-6441. https://doi.org/10.1200/jco.2005.02.3259
(72) Holland JC, Bultz BD; National comprehensive Cancer Network (NCCN). The NCCN Guideline for Distress Management: A Case for Making Distress the Sixth Vital Sign. J Natl Compr Canc Netw [Internet]. 2007;5(1):3-7. Available from: https://jnccn.org/view/journals/jnccn/5/1/article-p3.xml
(73) Herschbach P, Britzelmeir I, Dinkel A, Giesler JM, Herkommer K, Nest A, et al. Distress in cancer patients: Who are the main groups at risk? Psychooncology [Internet]. 2020;29(4):703-710. https://doi.org/10.1002/pon.5321
(74) Sharma N, Hansen CH, O’Connor M, Thekkumpurath P, Walker J, Kleiboer A, et al. Sleep problems in cancer patients: prevalence and association with distress and pain. Psychooncology [Internet]. 2012;21(9):1003-1009. https://doi.org/10.1002/pon.2004
(75) Williamson TJ, Garon EB, Irwin MR, Choi AK, Goldman JW, Stanton AL. Sleep Disturbance as a Mediator of Lung Cancer Stigma on Psychological Distress and Physical Symptom Burden. Psychosom Med [Internet]. 2024;86(4):334-341. https://doi.org/10.1097/psy.0000000000001299
(76) Mansano-Schlosser TC, Ceolim MF, Valerio TD. Poor sleep quality, depression and hope before breast cancer surgery. Appl Nurs Res [Internet]. 2017;34:7-11. https://doi.org/10.1016/j.apnr.2016.11.010
(77) Elamin N, Althebity N, Alkhamisi TA, Al-Foheidi M. Sleep quality and psychological disorders in breast cancer female patients receiving radiotherapy at a tertiary oncology center in West Saudi Arabia. Support Care Cancer [Internet]. 2024;32(3):163. https://doi.org/10.1007/s00520-024-08368-8
(78) Oh PJ, Cho JR. Changes in Fatigue, Psychological Distress, and Quality of Life After Chemotherapy in Women with Breast Cancer: A Prospective Study. Cancer Nurs [Internet]. 2020;43(1):E54-60. https://doi.org/10.1097/ncc.0000000000000689
(79) Grusdat NP, Stäuber A, Tolkmitt M, Schnabel J, Schubotz B, Wright PR, et al. Routine cancer treatments and their impact on physical function, symptoms of cancer-related fatigue, anxiety, and depression. Support Care Cancer [Internet]. 2022;30(5):3733-3744. https://doi.org/10.1007/s00520-021-06787-5
(80) Büttner-Teleagă A, Kim YT, Osel T, Richter K. Sleep Disorders in Cancer—A Systematic Review. Int J Environ Res Public Health [Internet]. 2021;18(21):11696. https://doi.org/10.3390/ijerph182111696
(81) Aquil A, El Kherchi O, El Azmaoui N, Mouallif M, Guerroumi M, Chokri A, et al. Body image dissatisfaction and lower self-esteem as major predictors of poor sleep quality in gynecological cancer patients after surgery: cross-sectional study. BMC Womens Health [Internet]. 2021;21(1):229. https://doi.org/10.1186/s12905-021-01375-5
(82) Covrig VI, Lazăr DE, Costan VV, Postolică R, Ioan BG. The Psychosocial Role of Body Image in the Quality of Life of Head and Neck Cancer Patients. What Does the Future Hold?—A Review of the Literature. Medicina (Kaunas) [Internet]. 2021;57(10):1078. https://doi.org/10.3390/medicina57101078
(83) Ettridge K, Scharling-Gamba K, Miller C, Roder D, Prichard I. Body image and quality of life in women with breast cancer: Appreciating the body and its functionality. Body Image [Internet]. 2022;40:92-102. https://doi.org/10.1016/j.bodyim.2021.11.001
(84) Galvão DA, Newton RU, Chambers SK, Spry N, Joseph D, Gardiner RA, et al. Psychological distress in men with prostate cancer undertaking androgen deprivation therapy: modifying effects of exercise from a year-long randomized controlled trial. Prostate Cancer Prostatic Dis [Internet]. 2021;24(3):758-66. https://doi.org/10.1038/s41391-021-00327-2
(85) Phoosuwan N, Lundberg PC. Life satisfaction, body image and associated factors among women with breast cancer after mastectomy. Psychooncology [Internet]. 2023;32(4):610-618. https://doi.org/10.1002/pon.6106
Descargas
Publicado
Cómo citar
Número
Sección
Licencia
Derechos de autor 2025 Iatreia
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-CompartirIgual 4.0.
Los artículos publicados en la revista están disponibles para ser utilizados bajo la licencia Creative Commons, específicamente son de Reconocimiento-NoComercial-CompartirIgual 4.0 Internacional.
Los trabajos enviados deben ser inéditos y suministrados exclusivamente a la Revista; se exige al autor que envía sus contribuciones presentar los formatos: presentación de artículo y responsabilidad de autoría completamente diligenciados.
