December 6 - 7, 2007 Advisory Committee Meeting Minutes

General Discussion

Thursday, December 6, 4:30 p.m.

The Chair of the Committee, Dr. Haskell, called for general discussion on the previous topics cancer and mental health.

Mental Health and Quality of Life Indicators
Regarding the mental health presentation a question was asked if quality of life indicators were from clinical populations? Roughly 80% of the studies for psychological well being came from medical groups. Studies on sleep were primarily self-report mechanisms and obesity was not a covariate or a control. For self-esteem approximately 50% of the studies were of individuals deemed healthy.

Lymphedema
A question arose whether the current recommendation relative to women who have lymphedema is not to undertake physical activity. The recommendation from the National Lymphedema Network is very specific to upper body lymphedema in that upper body activity is risky. The literature is weak for lower limb lymphedema. In general, the clinical experience of lymphedema therapists is that people who have had their lymph nodes removed in the lower extremities are given the same recommendation as those who have had their lymph nodes removed in the upper body. Only 4 studies have been done with women with breast cancer that show upper body aerobic or resistance training does not cause an onset or worsening of lyphedema. The lack of data and recommendation on individuals with lower limb lymphedema is frustrating.

Definition of Disabled
One of the limitations in the literature that was reviewed on mental health with patient groups is that there is a discussion as to what extent is their condition disabling. For example an individual with a spinal cord injury may be categorized as disabled but how do you determine which mental health conditions are disabling. While there are a number of emerging issues it may be enough to note those in the first iteration of physical activity guidelines but not to dwell or attempt to tackle those issues in the first round.

Dr. Haskell recessed the meeting and asked members to re-adjourn Friday morning.

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