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Herrero López B, Cardeña-Gutiérrez A, Godoy Ortiz A, Gonzaga López A, Grueso López AM, Nuño Alves A, Ramírez Daffós P, Rodríguez Sánchez CA, Rodríguez Pérez ÁR, Sacristán Santos V, Saura Grau S, Sebio García R, Seguí Palmer MÁ. Exercise in cancer patients: assistance levels and referral pathways-a position statement from the Spanish Society of Medical Oncology. Clin Transl Oncol 2024:10.1007/s12094-024-03546-w. [PMID: 38909323 DOI: 10.1007/s12094-024-03546-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Accepted: 06/03/2024] [Indexed: 06/24/2024]
Abstract
There is growing evidence about how physical activity can improve cancer care. Unfortunately, exercise is still not widely prescribed to oncology patients, despite the benefit it brings. For this to occur, it is necessary for a multidisciplinary approach involving different types of healthcare professionals, given that each treatment be tailored for each single case. Besides incorporating appropriate infrastructures and referral pathways, we need to integrate exercise into healthcare practice, which ameliorates patients' quality of life and treatment side effects. From the Spanish Society of Medical Oncology (SEOM), and through the Exercise and Cancer Working Group, we indicate considerations, analyze patient care scenarios, and propose a referral pathway algorithm for exercise prescription, taking in account the patient's needs. In later sections of this paper, we describe how this algorithm could be implemented, and how the exercise programs should be built, including the physical activity contents, the settings, and the delivery mode. We conclude that professionals, infrastructures, and organizations should be available at every assistance level to create programs providing adequate exercise training for cancer patients.
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Affiliation(s)
- Blanca Herrero López
- Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón. Madrid (España), Madrid, Spain.
| | - Ana Cardeña-Gutiérrez
- Hospital Universitario Nuestra Señora de Candelaria. Santa Cruz de Tenerife (España), Santa Cruz de Tenerife, Spain
| | - Ana Godoy Ortiz
- UGCI Oncología Médica Hospitales Universitarios Regional y Virgen de La Victoria, Málaga, Málaga, Spain
| | | | | | | | | | | | | | | | - Salvador Saura Grau
- Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | | | - Miguel Ángel Seguí Palmer
- Parc Taulí Consorci Corporació Sanitaria. Sabadell. Servicio de Oncologia. Institut d'Investigació I Innovació Parc Taulí, Universitat Autònoma de Barcelona, Barcelona, Spain
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Santagnello SB, Martins FM, de Oliveira Junior GN, de Sousa JDFR, Nomelini RS, Murta EFC, Orsatti FL. Resistance Training-Induced Gains in Muscle Strength and Power Mediate the Improvement in Walking Speed in Middle-Aged Women Who Are Breast Cancer Survivors. J Strength Cond Res 2024; 38:773-782. [PMID: 38354372 DOI: 10.1519/jsc.0000000000004020] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
ABSTRACT Santagnello, SB, Martins, FM, de Oliveira Junior, GN, de Sousa, JdeFR, Nomelini, RS, Murta, EFC, and Orsatti, FL. Resistance training-induced gains in muscle strength and power mediate the improvement in walking speed in middle-aged women who are breast cancer survivors. J Strength Cond Res 38(4): 773-782, 2024-(a) Ascertain whether lower muscle mass, strength (1 repetition maximum [1RM]), and power (Pmax) in middle-aged women who are breast cancer survivors (BCS), when compared with women of a similar age never diagnosed with cancer (WNC), are related with lower walking speed (WS). (b) Ascertain whether changes in WS are associated with changes in muscle mass, 1RM, and (or) Pmax after resistance training (RT) in middle-aged BCS. A cross-section study was performed. Twenty WNC and 21 BCS were evaluated for lean mass of legs (LLM), 1RM (knee extension), muscle quality index (MQI = 1RM/LLM), Pmax (maximum muscle power-knee extension), and fast WS (10 and 400-meters). Randomized clinical trial was performed. The BCS were randomly divided into the control group ( n = 9) and the RT group ( n = 11). Breast cancer survivors exhibited lower 1RM (24.2%, p ˂ 0.001), Pmax (30.6%, p ˂ 0.001), MQI (22.2%, p = 0.001), and WS (10-m = 17.0%, p ˂ 0.001 and 400-m = 10.5%, p = 0.002) than WNC. Resistance training increased 1RM (31.6%, p = 0.001), MP (29.0%, p = 0.012), MQI (28.5%, p = 0.008), and WS (10-m = 9.4%, p = 0.009 and 400-m = 6.2%, p = 0.006) in BCS. The changes in WS were positively associated with 1RM (10-m = 68%, p = 0.001 and 400-m = 37%, p = 0.036) and Pmax (10-m = 56%, p = 0.005 and 400-m = 40%, p = 0.027) and MQI (10-m = 63%, p = 0.043 and 400-m = 37%, p = 0.035). Resistance training-induced gains in muscle strength and power mediate the improvement in WS in middle-aged BCS. Resistance training is an effective strategy to improve WS in middle-aged BCS.
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Affiliation(s)
- Samarita Beraldo Santagnello
- Exercise Biology Research Group (BioEx, Institute of Health Sciences, Federal University of Tricângulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil)
| | - Fernanda Maria Martins
- Exercise Biology Research Group (BioEx, Institute of Health Sciences, Federal University of Tricângulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil)
| | - Gersiel Nascimento de Oliveira Junior
- Exercise Biology Research Group (BioEx, Institute of Health Sciences, Federal University of Tricângulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil)
| | - Jairo de Freitas Rodrigues de Sousa
- Exercise Biology Research Group (BioEx, Institute of Health Sciences, Federal University of Tricângulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil)
| | - Rosekeila Simões Nomelini
- Research Institute of Oncology, Department of Gynecology and Obstetrics, Federal University of Triângulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil; and
| | - Eddie Fernando Candido Murta
- Research Institute of Oncology, Department of Gynecology and Obstetrics, Federal University of Triângulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil; and
| | - Fábio Lera Orsatti
- Exercise Biology Research Group (BioEx, Institute of Health Sciences, Federal University of Tricângulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil)
- Department of Sport Sciences, Federal University of Triângulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil
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Petrigna L, Zanghì M, Maugeri G, D'Agata V, Musumeci G. Methodological consideration for a physical activity intervention in breast cancer population: An umbrella review. Heliyon 2023; 9:e17470. [PMID: 37455988 PMCID: PMC10338308 DOI: 10.1016/j.heliyon.2023.e17470] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 06/16/2023] [Accepted: 06/19/2023] [Indexed: 07/18/2023] Open
Abstract
Objective Breast cancer patients and survivors are increasing in the last years such as their mean age. A feasible and useful complementary intervention to improve physical and psychological health, and decrease some disease symptoms seems to be physical activity. Consequently, this umbrella review wanted to analyze the protocols of different physical activity interventions and to eventually propose a standard operating procedure for possible exercise training in breast cancer patients.Design, Data sources, Eligibility criteria. The electronic databases PubMed, Scopus, and Web of Science were searched till 25 March 2022 to detect all systematic review and meta-analysis of randomized controlled trials on this topic. The studies were analyzed narratively and evaluated with a scale to assess their quality. Results The studies presented heterogeneity in their population included in terms of disease stage and treatments, intervention protocols and outcomes evaluated. This made difficult to synthesize the findings. Conclusion It was not possible to propose a standard operating procedure but some indications were proposed to provide feedback for future studies. Ideally, an intervention should be composed of combined training (aerobic and resistance training) with a component of a mindfulness intervention, with an intensity from moderate to high, and 3 times a week. The intervention should be supervised in the first period and then it could be home-based. Exercise training should be personalized to the patients treated.
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Affiliation(s)
- Luca Petrigna
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology and Movement Science, School of Medicine, University of Catania, Via S. Sofia n°97, 95123, Catania, Italy
| | - Marta Zanghì
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology and Movement Science, School of Medicine, University of Catania, Via S. Sofia n°97, 95123, Catania, Italy
| | - Grazia Maugeri
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology and Movement Science, School of Medicine, University of Catania, Via S. Sofia n°97, 95123, Catania, Italy
| | - Velia D'Agata
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology and Movement Science, School of Medicine, University of Catania, Via S. Sofia n°97, 95123, Catania, Italy
| | - Giuseppe Musumeci
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology and Movement Science, School of Medicine, University of Catania, Via S. Sofia n°97, 95123, Catania, Italy
- Research Center on Motor Activities (CRAM), University of Catania, Via S. Sofia n°97, 95123, Catania, Italy
- Department of Biology, College of Science and Technology, Sbarro Health Research Organization, Temple University, Philadelphia, PA, 19122, USA
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Sequeira M, Luz R, Alvarez MJ. The Practice of Physical Activity After Breast Cancer Treatments: A Qualitative Study Among Portuguese Women. Front Psychol 2022; 13:823139. [PMID: 35369245 PMCID: PMC8965006 DOI: 10.3389/fpsyg.2022.823139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 02/22/2022] [Indexed: 12/24/2022] Open
Abstract
Background Women survivors of breast cancer treatments face significant challenges around initiation or maintenance of physical activity (PA) as they transit to recovery. Embracing their needs and preferences is important to increase adherence. This study aimed to explore the perspectives of Portuguese women survivors of breast cancer regarding regular performance of PA and individual choices and strategies that should be considered in designing effective interventions. Methods The individual semi-structured interviews (N = 20) were analyzed through thematic analysis, following an inductive process, seeking to identify the barriers, facilitators, and particular influencing circumstances associated with regular PA. Results Four themes and several contextual, emotional, physical, and social factors were identified as determinants of regular PA. Guilt, women’s duties, and altruism to help close relatives were identified as emotional and cultural factors that are less-found in the existing literature. PA showed influence both from health professionals’ counseling and from knowledge and beliefs held by these women. Conclusion While confirming the already-known impact of breast cancer diagnosis and treatments on PA, which redefine participants’ availability to be active, the findings highlight beliefs and specific emotional factors that should be considered when planning culturally sensitive interventions.
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Affiliation(s)
- Margarida Sequeira
- CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Lisbon, Portugal.,CIIAS, Escola Superior de Saúde, Instituto Politécnico de Setúbal, Setúbal, Portugal
| | - Rita Luz
- CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Lisbon, Portugal
| | - Maria-João Alvarez
- CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Lisbon, Portugal
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Fraser SF, Gardner JR, Dalla Via J, Daly RM. The Effect of Exercise Training on Lean Body Mass in Breast Cancer Patients: A Systematic Review and Meta-analysis. Med Sci Sports Exerc 2022; 54:211-219. [PMID: 34559724 DOI: 10.1249/mss.0000000000002792] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Reduced lean body mass (LBM) is common during and after treatment for breast cancer, and it is associated with increased treatment-induced toxicity, shorter time to tumor progression, and decreased survival. Exercise training is a potential intervention for maintaining or increasing LBM. We conducted a systematic review and a meta-analysis to investigate the effects of exercise training on LBM in breast cancer. METHODS A comprehensive search was performed to November 2020 for randomized controlled trials reporting the effects of structured exercise training on LBM compared with control in women with breast cancer during or after cancer treatment. A random-effects meta-analysis was completed using the absolute net difference in the change in LBM between intervention and control groups as the outcome measure. Sensitivity and subgroup analyses were also performed. RESULTS Data from 17 studies involving 1743 breast cancer survivors were included in the meta-analysis. Overall, there was a significant benefit of exercise training compared with control on LBM (0.58 kg, 95% confidence interval = 0.27 to 0.88, P < 0.001). Subgroup analysis showed positive effects for resistance training (0.59 kg) and aerobic training (0.29 kg), and for exercise training conducted during (0.47 kg) or after (0.66 kg) cancer treatment. Exercise training was beneficial in studies enrolling postmenopausal women (0.58 kg) as well as in those with participants of mixed menopausal status (1.46 kg). CONCLUSIONS Compared with usual care, exercise training has a beneficial effect on LBM in women with breast cancer, both during and after cancer treatment. Given the physiological and functional importance of LBM in women with breast cancer, oncologists should encourage their patients to engage in regular exercise training, with particular emphasis on resistance training.
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Affiliation(s)
- Steve F Fraser
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, AUSTRALIA
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Kirkham AA, King K, Joy AA, Pelletier AB, Mackey JR, Young K, Zhu X, Meza-Junco J, Basi SK, Hiller JP, Brkin T, Michalowski B, Pituskin E, Paterson DI, Courneya KS, Thompson RB, Prado CM. Rationale and design of the Diet Restriction and Exercise-induced Adaptations in Metastatic breast cancer (DREAM) study: a 2-arm, parallel-group, phase II, randomized control trial of a short-term, calorie-restricted, and ketogenic diet plus exercise during intravenous chemotherapy versus usual care. BMC Cancer 2021; 21:1093. [PMID: 34629067 PMCID: PMC8504029 DOI: 10.1186/s12885-021-08808-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 09/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND An underlying cause of solid tumor resistance to chemotherapy treatment is diminished tumor blood supply, which leads to a hypoxic microenvironment, dependence on anaerobic energy metabolism, and impaired delivery of intravenous treatments. Preclinical data suggest that dietary strategies of caloric restriction and low-carbohydrate intake can inhibit glycolysis, while acute exercise can transiently enhance blood flow to the tumor and reduce hypoxia. The Diet Restriction and Exercise-induced Adaptations in Metastatic Breast Cancer (DREAM) study will compare the effects of a short-term, 50% calorie-restricted and ketogenic diet combined with aerobic exercise performed during intravenous chemotherapy treatment to usual care on changes in tumor burden, treatment side effects, and quality of life. METHODS Fifty patients with measurable metastases and primary breast cancer starting a new line of intravenous chemotherapy will be randomly assigned to usual care or the combined diet and exercise intervention. Participants assigned to the intervention group will be provided with food consisting of 50% of measured calorie needs with 80% of calories from fat and ≤ 10% from carbohydrates for 48-72 h prior to each chemotherapy treatment and will perform 30-60 min of moderate-intensity cycle ergometer exercise during each chemotherapy infusion, for up to six treatment cycles. The diet and exercise durations will be adapted for each chemotherapy protocol. Tumor burden will be assessed by change in target lesion size using axial computed tomography (primary outcome) and magnetic resonance imaging (MRI)-derived apparent diffusion coefficient (secondary outcome) after up to six treatments. Tertiary outcomes will include quantitative MRI markers of treatment toxicity to the heart, thigh skeletal muscle, and liver, and patient-reported symptoms and quality of life. Exploratory outcome measures include progression-free and overall survival. DISCUSSION The DREAM study will test a novel, short-term diet and exercise intervention that is targeted to mechanisms of tumor resistance to chemotherapy. A reduction in lesion size is likely to translate to improved cancer outcomes including disease progression and overall survival. Furthermore, a lifestyle intervention may empower patients with metastatic breast cancer by actively engaging them to play a key role in their treatment. TRIAL REGISTRATION ClinicalTrials.gov, NCT03795493 , registered 7 January, 2019.
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Affiliation(s)
- Amy A Kirkham
- Faculty of Kinesiology & Physical Education, University of Toronto, 422, 100 Devonshire Pl, Toronto, ON, M5S 2C9, Canada.
| | - Karen King
- Cross Cancer Institute, Edmonton, AB, Canada
- University of Alberta, Edmonton, AB, Canada
| | - Anil A Joy
- Cross Cancer Institute, Edmonton, AB, Canada
- University of Alberta, Edmonton, AB, Canada
| | | | - John R Mackey
- Cross Cancer Institute, Edmonton, AB, Canada
- University of Alberta, Edmonton, AB, Canada
| | - Kelvin Young
- Cross Cancer Institute, Edmonton, AB, Canada
- University of Alberta, Edmonton, AB, Canada
| | - Xiaofu Zhu
- Cross Cancer Institute, Edmonton, AB, Canada
- University of Alberta, Edmonton, AB, Canada
| | - Judith Meza-Junco
- Cross Cancer Institute, Edmonton, AB, Canada
- University of Alberta, Edmonton, AB, Canada
| | - Sanraj K Basi
- Cross Cancer Institute, Edmonton, AB, Canada
- University of Alberta, Edmonton, AB, Canada
| | - Julie Price Hiller
- Cross Cancer Institute, Edmonton, AB, Canada
- University of Alberta, Edmonton, AB, Canada
| | - Tina Brkin
- Cross Cancer Institute, Edmonton, AB, Canada
| | | | - Edith Pituskin
- Cross Cancer Institute, Edmonton, AB, Canada
- University of Alberta, Edmonton, AB, Canada
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Lee JT, Wagoner CW, Sullivan SA, Amatuli DJ, Nyrop KA, Hanson ED, Stoner L, Jensen BC, Muss HB, Battaglini CL. Impact of community-based exercise program participation on aerobic capacity in women with and without breast cancer. World J Clin Oncol 2021; 12:468-481. [PMID: 34189070 PMCID: PMC8223710 DOI: 10.5306/wjco.v12.i6.468] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 03/27/2021] [Accepted: 05/27/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Evidence for exercise as an efficacious strategy to improve aerobic capacity of breast cancer survivors (BCS) has come largely from intervention studies conducted in laboratory settings. There is an increasing need to translate to community-type settings, but the efficacy of those interventions using gold standard evaluation is not well-established.
AIM To investigate whether similar improvement in aerobic capacity (maximal oxygen consumption [VO2]) measured with gold standard testing can be achieved through a community-based setting in BCS.
METHODS A peak cardiopulmonary exercise test (VO2peak), 6-min walk test (6MWT), and timed up and go test (TUG) were assessed pre- and post-16 wk of progressive intensity aerobic and strength training exercise at a community center.
RESULTS The sample consisted of 31 early BCS (< 1 year since treatment completion) and 15 controls (CTLs). Both groups significantly improved VO2peak (+1.2 mL/kg/min; P = 0.030), 6MWT (+35 meters; P < 0.001), and TUG (-0.44 s; P < 0.01) following training. Both groups improved peak cycling power during the cardiopulmonary exercise test with BCS improving by +10 watts more than the CTLs (P = 0.020). Average exercise attendance was 71% (34 of 48 possible days), but compliant days averaged only 60% of total days for aerobic, and < 40% for strength in both groups.
CONCLUSION Community-based exercise programs can be an effective strategy to improve aerobic capacity and physical function for early-stage BCS but potentially not to the same extent observed in laboratory-based randomized controlled trials. Further research is needed to explore barriers and facilitators of exercise engagement in community-based centers to maximize training benefits for adults with cancer.
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Affiliation(s)
- Jordan T Lee
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
| | - Chad W Wagoner
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
| | - Stephanie A Sullivan
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
| | - Dean J Amatuli
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
| | - Kirsten A Nyrop
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
| | - Erik D Hanson
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
| | - Lee Stoner
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
| | - Brian C Jensen
- Department of Medicine, Division of Cardiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
| | - Hyman B Muss
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC 27599, United States
| | - Claudio L Battaglini
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States
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White KR, Lu J, Ibrahim Z, Furth PA. Enabling exercise prescription for survivors of cancer. Sci Rep 2021; 11:9557. [PMID: 33953311 PMCID: PMC8100108 DOI: 10.1038/s41598-021-89021-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 04/14/2021] [Indexed: 12/30/2022] Open
Abstract
Although exercise is widely recommended for survivors of cancer, readily implementable approaches for evaluating exercise tolerance enabling exercise prescriptions at appropriate levels of cardiovascular exertion are not always available. We evaluated the utility of modified Harvard Step tests within the context of a standard physical examination for fitness evaluation and exercise prescription for survivors of cancer across a range of age, BMI and exercise history. While 52% of presenting individuals with a past cancer diagnosis were able to complete a 3-min test at pace with a reduced 9-in. step, adoption of self-determined pacing, test duration and completion on a flat surface enabled relative fitness rating and appropriate exercise prescription for the remaining survivors. Younger age and more vigorous exercise histories correlated with completion of the standard 3-min test at pace, but all 9-in. formats led to exercise prescriptions more vigorous than current activity. The physical examination setting expedited inclusion of core and specific muscle group strength testing. The approach is adaptable to a range of health care settings, providers, and patients, providing a shared opportunity for providers and patients to evaluate exercise tolerance. It can be used to further expand incorporation of exercise testing and prescription into routine care.
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Affiliation(s)
- Katherine R White
- Georgetown University School of Medicine, 3900 Reservoir Rd. NW, Washington, DC, 20007, USA
| | - Jana Lu
- Georgetown University School of Medicine, 3900 Reservoir Rd. NW, Washington, DC, 20007, USA
| | - Zara Ibrahim
- Georgetown University School of Medicine, 3900 Reservoir Rd. NW, Washington, DC, 20007, USA
| | - Priscilla A Furth
- Departments of Oncology and Medicine and Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Georgetown University, 3970 Reservoir Rd. NW, Research Bldg. Room E521, Washington, DC, 20057, USA. .,, 3970 Reservoir Rd NW, Research Building, Room 520A, Washington, DC, 20057, USA.
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Schutz S, Aidar FJ, Souza RLM, dos Santos JL, Voltarelli FA, Vieira Junior RC, Soares NMM, Marçal AC. Different Methods of Physical Training Applied to Women Breast Cancer Survivors: A Systematic Review. Front Physiol 2021; 12:639406. [PMID: 33935799 PMCID: PMC8079809 DOI: 10.3389/fphys.2021.639406] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 03/22/2021] [Indexed: 01/15/2023] Open
Abstract
Objective: The objective of this systematic review was to identify the effects of different training methods in women who have survived breast cancer (WSBC). Data Sources: Studies were identified by searching SportDiscus, Web of Science, PubMed, Scopus, Scielo, and Bireme. Study Selection: The inclusion criteria were articles that addressed only breast cancer in women, were randomized clinical trials, and interventions involving physical training with Consort ≥80. Data Extraction: The PICO and CONSORT strategies were used for the selection of articles and quality assessment of randomized clinical trials, respectively. Two independent reviewers searched for articles among the databases. Disagreements were discussed, and in the case of an impasse, a third reviewer was consulted. Data Synthesis: Evidence that demonstrated the beneficial effects of physical exercise programs carried out by WSBC. Moderate or high-intensity exercise sessions have been shown to benefit women survivors of breast cancer. Among the modalities, the resistance exercise showed effects from 55% of one-repetition maximum (1 RM), exclusively or associated with other training regimes, such as aerobic (from 48% of heart rate), high-intensity interval training (HIIT), or impact. The main benefits include increased muscle strength, promoted by the practice of resistance exercise in combination with other types of exercises or alone; decreased fatigue; improved quality of life; improved psychosocial effects, and increased leisure time. Conclusions: Physical training performed at a moderate or high intensity (aerobic or anaerobic) can reduce fatigue, improve quality of life, improve sleep quality, and increase bone mineral density in women survivors of breast cancer.
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Affiliation(s)
- Silvia Schutz
- Department of Physical Education, Universidade Federal de Sergipe, São Cristóvão, Brazil
| | - Felipe J. Aidar
- Department of Physical Education, Universidade Federal de Sergipe, São Cristóvão, Brazil
- Group of Studies and Research of Performance, Sport, Health, and Paralympic Sports, Universidade Federal de Sergipe, São Cristóvão, Brazil
| | | | - Jymmys Lopes dos Santos
- Department of Physical Education, Universidade Federal de Sergipe, São Cristóvão, Brazil
- Department of Physiology, Universidade Federal de Sergipe, São Cristóvão, Brazil
| | - Fabrício Azevedo Voltarelli
- Graduate Program of Health Sciences, Faculty of Medicine, Universidade Federal de Mato Grosso, Cuiabá, Brazil
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Díaz-Balboa E, González-Salvado V, Rodríguez-Romero B, Martínez-Monzonís A, Pedreira-Pérez M, Palacios-Ozores P, López-López R, Peña-Gil C, González-Juanatey JR. A randomized trial to evaluate the impact of exercise-based cardiac rehabilitation for the prevention of chemotherapy-induced cardiotoxicity in patients with breast cancer: ONCORE study protocol. BMC Cardiovasc Disord 2021; 21:165. [PMID: 33827450 PMCID: PMC8025895 DOI: 10.1186/s12872-021-01970-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 03/29/2021] [Indexed: 12/21/2022] Open
Abstract
Background Anthracyclines and monoclonal antibodies against human epidermal growth factor receptor-2 (HER2) are frequently used to treat breast cancer but they are associated with risk of developing cardiotoxicity. Implementation of cardioprotective strategies as part of breast cancer treatment are needed. To date, a limited number of studies have examined the effectiveness of cardiac rehabilitation programs or exercise programs in the prevention of cardiotoxicity through an integral assessment of cardiac function. The ONCORE study proposes an exercise-based cardiac rehabilitation program as a non-pharmacological tool for the management of chemotherapy-induced cardiotoxicity. Methods The study protocol describes a prospective, randomized controlled trial aimed to determine whether an intervention through an exercise-based CR program can effectively prevent cardiotoxicity induced by anthracyclines and/or anti-HER2 antibodies in women with breast cancer. Three hundred and forty women with breast cancer at early stages scheduled to receive cardiotoxic chemotherapy will be randomly assigned (1:1) to participation in an exercise-based CR program (intervention group) or to usual care and physical activity recommendation (control group). Primary outcomes include changes in left ventricular ejection fraction and global longitudinal strain as markers of cardiac dysfunction assessed by transthoracic echocardiography. Secondary outcomes comprise levels of cardiovascular biomarkers and cardiopulmonary function through peak oxygen uptake determination, physical performance and psychosocial status. Supervised exercise program-related outcomes including safety, adherence/compliance, expectations and physical exercise in- and out-of-hospital are studied as exploratory outcomes. Transthoracic echocardiography, clinical test and questionnaires will be performed at the beginning and two weeks after completion of chemotherapy. Discussion The growing incidence of breast cancer and the risk of cardiotoxicity derived from cancer treatments demand adjuvant cardioprotective strategies. The proposed study may determine if an exercise-based CR program is effective in minimizing chemotherapy-induced cardiotoxicity in this population of women with early-stage breast cancer. The proposed research question is concrete, with relevant clinical implications, transferable to clinical practice and achievable with low risk. Trial registration ClinicalTrials.gov Identifier: NCT03964142. Registered on 28 May 2019. Retrospectively registered. https://clinicaltrials.gov/ct2/show/NCT03964142 Supplementary Information The online version contains supplementary material available at 10.1186/s12872-021-01970-2.
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Affiliation(s)
- Estíbaliz Díaz-Balboa
- Cardiology Department, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), University Clinical Hospital of Santiago de Compostela (SERGAS), A Choupana s/n, 15706, Santiago de Compostela, A Coruña, Spain. .,Health Research Institute of Santiago de Compostela (IDIS), A Coruña, Spain. .,Department of Physiotherapy, Medicine and Biomedical Sciences, Faculty of Physiotherapy, University of A Coruña, A Coruña, Spain.
| | - Violeta González-Salvado
- Cardiology Department, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), University Clinical Hospital of Santiago de Compostela (SERGAS), A Choupana s/n, 15706, Santiago de Compostela, A Coruña, Spain.,Health Research Institute of Santiago de Compostela (IDIS), A Coruña, Spain
| | - Beatriz Rodríguez-Romero
- Psychosocial Intervention and Functional Rehabilitation Research Group, Department of Physiotherapy, Medicine and Biomedical Sciences, Faculty of Physiotherapy, University of A Coruña, A Coruña, Spain
| | - Amparo Martínez-Monzonís
- Cardiology Department, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), University Clinical Hospital of Santiago de Compostela (SERGAS), A Choupana s/n, 15706, Santiago de Compostela, A Coruña, Spain.,Health Research Institute of Santiago de Compostela (IDIS), A Coruña, Spain
| | - Milagros Pedreira-Pérez
- Cardiology Department, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), University Clinical Hospital of Santiago de Compostela (SERGAS), A Choupana s/n, 15706, Santiago de Compostela, A Coruña, Spain.,Health Research Institute of Santiago de Compostela (IDIS), A Coruña, Spain
| | - Patricia Palacios-Ozores
- Health Research Institute of Santiago de Compostela (IDIS), A Coruña, Spain.,Medical Oncology Department and Translational Medical Oncology Group, Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Santiago de Compostela University School of Medicine, University Clinical Hospital of Santiago (SERGAS), Santiago de Compostela, A Coruña, Spain
| | - Rafael López-López
- Health Research Institute of Santiago de Compostela (IDIS), A Coruña, Spain.,Medical Oncology Department and Translational Medical Oncology Group, Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Santiago de Compostela University School of Medicine, University Clinical Hospital of Santiago (SERGAS), Santiago de Compostela, A Coruña, Spain
| | - Carlos Peña-Gil
- Cardiology Department, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), University Clinical Hospital of Santiago de Compostela (SERGAS), A Choupana s/n, 15706, Santiago de Compostela, A Coruña, Spain.,Health Research Institute of Santiago de Compostela (IDIS), A Coruña, Spain
| | - José R González-Juanatey
- Cardiology Department, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), University Clinical Hospital of Santiago de Compostela (SERGAS), A Choupana s/n, 15706, Santiago de Compostela, A Coruña, Spain.,Health Research Institute of Santiago de Compostela (IDIS), A Coruña, Spain
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11
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Mazzutti FS, Custódio IDD, Lima MTM, de Carvalho KP, Pereira TSS, Molina MDCB, Canto PPL, Paiva CE, Maia YCDP. Breast Cancer Survivors Undergoing Endocrine Therapy Have a Worrying Risk Factor Profile for Cardiovascular Diseases. Nutrients 2021; 13:nu13041114. [PMID: 33805280 PMCID: PMC8067236 DOI: 10.3390/nu13041114] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 03/17/2021] [Accepted: 03/25/2021] [Indexed: 01/08/2023] Open
Abstract
The increased risk for cardiovascular diseases (CVDs) in breast cancer survivors has been widely discussed in the literature and occurs due to the cardiotoxicity of antineoplastic treatments, and also to the common risk factors between these diseases. Thus, the objective of our study was to evaluate, prospectively, the number of risk factors (NRF) for CVDs in women during endocrine therapy, and to associate the NRF with C reactive protein (CRP) and phase angle (PhA). The following risk factors for CVD were evaluated at three times: anthracycline chemotherapy, radiotherapy, comorbidities, inadequate diet, overweight, abdominal adiposity, alcoholism, smoking, physical inactivity and altered lipid profile. There was inadequacy in the most components of the Brazilian Healthy Eating Index—Revised and inadequate consumption of various types of fats and fibers. Most women in this study presented excessive abdominal fat and overweight, but these parameters have not changed over time (p < 0.005). Moreover, a high frequency of systemic arterial hypertension and physical inactivity was observed. The average NRF for CVDs was above ten, at the three evaluation times. Women with higher NRF had higher levels of CRP (p = 0.003), a predictor of cardiovascular risk, however, there was no significance with PhA (p = 0.256). Thus, intervention is needed to improve lifestyle.
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Affiliation(s)
- Fernanda S. Mazzutti
- Molecular Biology and Nutrition Research Group, School of Medicine, Federal University of Uberlandia, Uberlandia 38405-320, Brazil; (F.S.M.); (I.D.D.C.); (M.T.M.L.); (K.P.d.C.)
| | - Isis D. D. Custódio
- Molecular Biology and Nutrition Research Group, School of Medicine, Federal University of Uberlandia, Uberlandia 38405-320, Brazil; (F.S.M.); (I.D.D.C.); (M.T.M.L.); (K.P.d.C.)
| | - Mariana T. M. Lima
- Molecular Biology and Nutrition Research Group, School of Medicine, Federal University of Uberlandia, Uberlandia 38405-320, Brazil; (F.S.M.); (I.D.D.C.); (M.T.M.L.); (K.P.d.C.)
| | - Kamila P. de Carvalho
- Molecular Biology and Nutrition Research Group, School of Medicine, Federal University of Uberlandia, Uberlandia 38405-320, Brazil; (F.S.M.); (I.D.D.C.); (M.T.M.L.); (K.P.d.C.)
| | - Taísa S. S. Pereira
- Nutrition Science, Department of Health Sciences, University of the Americas Puebla, Cholula 72810, Mexico;
| | - Maria del C. B. Molina
- Graduate Program in Nutrition and Health, Federal University of Espirito Santo, Vitoria 29047-105, Brazil;
- Nutrition Course, Federal University of Espirito Santo, Vitoria 29047-105, Brazil
| | - Paula P. L. Canto
- Department of Clinical Oncology, Clinic’s Hospital, Federal University of Uberlandia, Uberlandia 38405-320, Brazil;
| | - Carlos E. Paiva
- Department of Clinical Oncology, Graduate Program in Oncology, Barretos 14784-400, Brazil;
- Palliative Care and Quality of Life Research Group (GPQual), Pio XII Foundation-Barretos Cancer Hospital, Barretos 14784-400, Brazil
| | - Yara C. de P. Maia
- Molecular Biology and Nutrition Research Group, School of Medicine, Federal University of Uberlandia, Uberlandia 38405-320, Brazil; (F.S.M.); (I.D.D.C.); (M.T.M.L.); (K.P.d.C.)
- Nutrition Course, Medical Faculty, Federal University of Uberlandia, Uberlandia 38405-320, Brazil
- Correspondence: ; Tel.: +55-34-3225-8628
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12
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Community-based exercise programs and cancer-related fatigue: a systematic review and meta-analysis. Support Care Cancer 2021; 29:4921-4929. [PMID: 33751225 DOI: 10.1007/s00520-021-06135-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 03/04/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE To explore the prevalence of cancer-related fatigue (CRF) within community-based exercise programs and to determine the overall impact that participation in community-based exercise programs have on CRF. METHODS Literature searches were performed in March and updated in April of 2020. Studies that were community-based in adult cancer populations and reported CRF outcomes were included. Mean and standard deviations for CRF from 12 studies were extracted in order to compute a pooled effect size via a random effects model. An overall percentage was computed to discern how many community-based exercise programs reported CRF. RESULTS Sample sizes varied among studies with most patients being middle-aged with breast cancer in the post-treatment setting. Most programs implemented aerobic + resistance exercise training interventions (~77%). Only ~42% of programs identified in the review reported CRF outcomes. The random effects model produced a pooled effect size of 0.30 (p < 0.001). CONCLUSIONS Fewer than half of the identified community-based exercise programs reported CRF outcomes (~42%). Of those that did, the random effects model revealed a small yet significant impact on improving CRF after exercise participation, though more research is certainly needed in this area. This review produced promising preliminary evidence for the impact of community-based exercise programs on CRF. As exercise interventions transition to community-based facilities, patients should feel confident that these programs will continue to assist in managing CRF that is commonly experienced across the cancer continuum.
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13
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Salerno EA, Saint-Maurice PF, Willis EA, Moore SC, DiPietro L, Matthews CE. Ambulatory Function and Mortality among Cancer Survivors in the NIH-AARP Diet and Health Study. Cancer Epidemiol Biomarkers Prev 2021; 30:690-698. [PMID: 33664017 DOI: 10.1158/1055-9965.epi-20-1473] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 12/11/2020] [Accepted: 01/15/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND There is limited evidence describing associations between cancer and function in diverse cancer types and its relationship with mortality. We investigated the relationship between cancer and poor ambulatory function and associations between ambulatory function and subsequent mortality. METHODS Participants included 233,135 adults (n = 30,403 cancer and n = 202,732 cancer free) in the NIH-American Association of Retired Persons Diet and Health Study (1994-1996) who self-reported ambulatory function (e.g., walking pace and mobility disability: being unable to walk or walking at the slowest pace) in 2004-2006. Participants were followed for mortality from the assessment of ambulatory function through 2011. Multinomial logistic regression quantified the association between cancer and ambulatory function. We then explored the independent effects of walking pace and mobility disability in cancer survivors, and the joint effects of both a cancer diagnosis and poor ambulatory function on mortality using Cox proportional hazards models. Models explored type-specific associations across 15 cancer types. RESULTS Survivors had 42% greater odds of walking at the slowest pace [OR, 1.42 (confidence interval (CI), 1.30-1.54)] and 24% greater odds of mobility disability [OR, 1.24 (CI, 1.17-1.31)], compared with cancer-free participants, adjusting for baseline demographics, health indicators, and cancer type. Survivors reporting the slowest pace were at increased hazards than those who walked the fastest: all-cause mortality [HR, 2.22 (CI, 2.06-2.39)] and cancer mortality [HR, 2.12 (CI, 1.83-2.45)]. Similar trends emerged for mobility disability (HRs > 1.64). All-cause mortality associations were significant for more than nine cancer types. CONCLUSIONS A diagnosis of cancer is associated with poorer ambulatory function, which is subsequently associated with increased mortality. IMPACT Widespread efforts should target ambulatory function during cancer survivorship for survival benefits.
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Affiliation(s)
- Elizabeth A Salerno
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri. .,Cancer Prevention Fellowship Program, Division of Cancer Prevention, NCI, Rockville, Maryland.,Metabolic Epidemiology Branch, Division of Cancer Epidemiology & Genetics, NCI, Bethesda, Maryland
| | - Pedro F Saint-Maurice
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology & Genetics, NCI, Bethesda, Maryland
| | - Erik A Willis
- Children's Healthy Weight Research Group, Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, North Carolina
| | - Steven C Moore
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology & Genetics, NCI, Bethesda, Maryland
| | - Loretta DiPietro
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University, Washington, D.C
| | - Charles E Matthews
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology & Genetics, NCI, Bethesda, Maryland
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14
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Mascherini G, Tosi B, Giannelli C, Ermini E, Osti L, Galanti G. Adjuvant Therapy Reduces Fat Mass Loss during Exercise Prescription in Breast Cancer Survivors. J Funct Morphol Kinesiol 2020; 5:jfmk5030049. [PMID: 33467265 PMCID: PMC7739281 DOI: 10.3390/jfmk5030049] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 07/10/2020] [Accepted: 07/11/2020] [Indexed: 01/23/2023] Open
Abstract
Improvements in cancer care over the years have increased the numbers of cancer survivors. Therefore, quality of life, fat mass management and physical activity are growing areas of interest in these people. After the surgical removal of a breast cancer, adjuvant therapy remains anyway a common strategy. The aim of this study was to assess how adjuvant therapy can affect the effectiveness of an unsupervised exercise program. Forty-two women were enrolled (52.0 ± 10.1 years). Assessments performed at baseline and after six months of exercise prescription were body composition, health-related quality of life, aerobic capacity by Six-Minute Walk Test, limbs strength by hand grip and chair test and flexibility by sit and reach. Statistical analyses were conducted by ANOVA tests and multiple regression. Improvements in body composition, physical fitness and quality of life (physical functioning, general health, social functioning and mental health items) were found. The percentage change in fat mass has been associated with adjuvant cancer therapy (intercept = -0.016; b = 8.629; p < 0.05). An unsupervised exercise prescription program improves body composition, physical fitness and health-related quality of life in breast cancer survivors. Adjuvant therapy in cancer slows down the effectiveness of an exercise program in the loss of fat mass.
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15
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Santagnello SB, Martins FM, de Oliveira Junior GN, de Freitas Rodrigues de Sousa J, Nomelini RS, Murta EFC, Orsatti FL. Improvements in muscle strength, power, and size and self-reported fatigue as mediators of the effect of resistance exercise on physical performance breast cancer survivor women: a randomized controlled trial. Support Care Cancer 2020; 28:6075-6084. [PMID: 32306100 DOI: 10.1007/s00520-020-05429-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 03/23/2020] [Indexed: 01/20/2023]
Abstract
PURPOSE To gain more knowledge about the mechanism (i.e., mediators) of resistance exercise (RE)-induced improvements in physical performance (PP), we seek to investigate whether improvements in muscle strength (MS), muscle power (MP), and lean body mass (LBM) and (or) self-reported fatigue (SRF) are mediators of the effect of RE on PP in breast cancer survivor women (BCSW). METHODS The volunteers were randomly divided into two groups: control group (CT; n = 9) and resistance exercise (RE; n = 11). The RE protocol consisted of three sets in each exercise (leg extension, leg curl, 45° leg press, and calf raise), between 8 and 12 repetitions per set, with an estimated load of 80% of one-repetition maximum (1RM), and three times a week on non-consecutive days for 12 weeks. The CT group performed only stretching exercises twice a week. SRF, maximal muscle power (Pmax), MP, LBM, and PP were assessed using the Brief Fatigue Inventory Questionnaire; 1RM test; isoinertial dynamometer; DXA; and walking speed, sit-to-stand (STS), and timed up and go (TUG) test, respectively. RESULTS Following 12 weeks, the RE group reduced SRF and increased MP, Pmax, LBM, and performance in all tests (walking speed, STS, and TUG) when compared with the CT group. There were significant associations of the changes in LBM, MS, Pmax, and SRF with changes in physical performance tests only in the RE group. CONCLUSION Our findings suggest that improvements in LBM, MS, MP, and self-reported fatigue mediate the effect of resistance exercise on physical performance in BCSW.
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Affiliation(s)
- Samarita Beraldo Santagnello
- Exercise Biology Research Group (BioEx), Federal University of Triângulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil.
| | - Fernanda Maria Martins
- Exercise Biology Research Group (BioEx), Federal University of Triângulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil
| | | | | | - Rosekeila Simões Nomelini
- Research Institute of Oncology (IPON) and Gynecology and Obstetrics course, Federal University of Triângulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil
| | - Eddie Fernando Candido Murta
- Research Institute of Oncology (IPON) and Gynecology and Obstetrics course, Federal University of Triângulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil
| | - Fábio Lera Orsatti
- Exercise Biology Research Group (BioEx), Federal University of Triângulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil.,Department of Sport Sciences, Federal University of Triângulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil
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16
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The Assessment and Relationship Between Quality of Life and Physical Activity Levels in Greek Breast Cancer Female Patients under Chemotherapy. Sports (Basel) 2020; 8:sports8030032. [PMID: 32168786 PMCID: PMC7183086 DOI: 10.3390/sports8030032] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 02/25/2020] [Accepted: 03/09/2020] [Indexed: 01/04/2023] Open
Abstract
A growing body of evidence suggests that physical activity (PA) can be a complementary intervention during breast cancer (BCa) treatment, contributing to the alleviation of the chemotherapy-related side-effects. The purpose of this study was to assess physical activity (PA) levels and quality of life (QoL) parameters of BCa patients undergoing chemotherapy and compare them with healthy controls. A total of 94 BCa female patients and 65 healthy women were recruited and self-reported QoL and PA levels. The results reveal that women suffering from BCa spent only 134 ± 469 metabolic equivalents (MET)/week in vigorous PAs compared with the healthy females who spent 985±1508 MET/week. Also, BCa patients were spending 4.62±2.58 h/day sitting, contrary to the 2.34±1.05 h/day of the controls. QoL was scored as 63.43±20.63 and 70.14±19.49 while physical functioning (PF) as 71.48±23.35 and 84.46±15.48 by BCa patients and healthy participants, respectively. Negative correlations were found between QoL and fatigue, PF and pain, and fatigue and dyspnea, while a positive correlation was found between QoL and PF. This study indicated that the BCa group accumulated many hours seated and refrained from vigorous Pas, preferring PAs of moderate intensity. Additionally, BCa patients' levels of functioning and QoL were moderate to high; however, they were compromised by pain, dyspnea and fatigue.
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Ammitzbøll G, Andersen KG, Bidstrup PE, Johansen C, Lanng C, Kroman N, Zerahn B, Hyldegaard O, Andersen EW, Dalton SO. Effect of progressive resistance training on persistent pain after axillary dissection in breast cancer: a randomized controlled trial. Breast Cancer Res Treat 2019; 179:173-183. [PMID: 31605312 DOI: 10.1007/s10549-019-05461-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 09/25/2019] [Indexed: 11/12/2022]
Abstract
PURPOSE Persistent pain is a known challenge among breast cancer survivors. In secondary analyses of a randomized controlled trial, we examined the effect of progressive resistance training on persistent pain in the post-operative year in women treated for breast cancer with axillary lymph node dissection. METHODS We randomized 158 women after BC surgery with Axillary Lymph Node Dissection (ALND) (1:1) to usual care or a 1-year, supervised and self-administered, progressive resistance training intervention initiated 3 weeks after surgery. A questionnaire at baseline, 20 weeks and 12 months assessed the intensity and frequency of pain, neuropathic pain and influence of pain on aspects of daily life. We analysed the effect using linear mixed models and multinomial logistic regression models for repeated measures. RESULTS A high percentage of participants experienced baseline pain (85% and 83% in the control and intervention groups respectively) and by the 12 month assessment these numbers were more than halved. A high proportion of participants also experienced neuropathic pain (88% and 89% in control and intervention group respectively), a finding that was stable throughout the study period. The effect on intensity of pain indicators favoured the exercise group, although most estimates did not reach statistical significance, with differences being small. CONCLUSION For women who had BC surgery with ALND, our progressive resistance training intervention conferred no benefit over usual care in reducing pain. Importantly, it did not increase the risk of pain both in the short and long term rehabilitative phase.
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Affiliation(s)
- Gunn Ammitzbøll
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark. .,Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Næstved, Denmark.
| | - Kenneth Geving Andersen
- Department of Anaesthesiology and Intensive Care, Zealand University Hospital, Køge, Denmark.,Section for Surgical Pathophysiology, Rigshospitalet, Copenhagen, Denmark
| | | | - Christoffer Johansen
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark.,CASTLE Late Effects Unit, Department of Oncology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Charlotte Lanng
- Department of Breast Surgery, Copenhagen University Hospital Herlev/Rigshospitalet, Copenhagen, Denmark
| | - Niels Kroman
- Department of Breast Surgery, Copenhagen University Hospital Herlev/Rigshospitalet, Copenhagen, Denmark.,Danish Cancer Society, Copenhagen, Denmark
| | - Bo Zerahn
- Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital Herlev, Copenhagen, Denmark
| | - Ole Hyldegaard
- Section for Hyperbaric Oxygen Treatment, Department for Anaesthetics and Operations, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | | | - Susanne Oksbjerg Dalton
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark.,Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Næstved, Denmark
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KIRKHAM AMYA, BLAND KELCEYA, ZUCKER DAVIDS, BOVARD JOSHUA, SHENKIER TAMARA, MCKENZIE DONALDC, DAVIS MARGOTK, GELMON KARENA, CAMPBELL KRISTINL. “Chemotherapy-periodized” Exercise to Accommodate for Cyclical Variation in Fatigue. Med Sci Sports Exerc 2019; 52:278-286. [DOI: 10.1249/mss.0000000000002151] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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19
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SCHLÜTER KATHRIN, SCHNEIDER JUSTINE, SPRAVE TANJA, WISKEMANN JOACHIM, ROSENBERGER FRIEDERIKE. Feasibility of Two High-Intensity Interval Training Protocols in Cancer Survivors. Med Sci Sports Exerc 2019; 51:2443-2450. [DOI: 10.1249/mss.0000000000002081] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Bao Y, Chen S, Jiang R, Li Y, Chen L, Li F, Tai J. The physical activity of colorectal cancer survivors during chemotherapy : Based on the theory of planned behavior. Support Care Cancer 2019; 28:819-826. [PMID: 31154534 DOI: 10.1007/s00520-019-04873-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 05/14/2019] [Indexed: 12/27/2022]
Abstract
PURPOSE The purpose of this study was to investigate the physical activity (PA) of colorectal cancer (CRC) survivors during chemotherapy and to explain it based on the theory of planned behavior (TPB). In addition, the effects of planning, past physical activity (P-PA), and self-efficacy on the PA of CRC survivors were analyzed. METHODS CRC survivors were recruited in a third-grade hospital of Changchun via a convenience sampling method. All survivors were asked to complete self-report questionnaires assessing medical and demographic variables, PA, constructs from the TPB, P-PA, planning, and self-efficacy. RESULTS A total of 174 CRC survivors were included in this study. Only 7.5% (13) of these CRC survivors had sufficient PA, and 32.2% (56) of CRC survivors were completely sedentary. Gender, education level, working status, residential location, method of payment for medical expenses, and cancer stage were all associated with PA in these patients (P < 0.05). The path model was able to explain 54% (R2 = 0.54) of the PA variance in these CRC survivors. P-PA had the greatest impact on PA during chemotherapy, and P-PA affected PA both directly and indirectly through planning. CONCLUSIONS Insufficient PA in CRC survivors was associated with a variety of factors, with P-PA having the greatest impact on this outcome. The results of this study suggest that attention must be paid to survivors who had exhibited insufficient PA prior to initial diagnosis.
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Affiliation(s)
- Yinan Bao
- School of Nursing, Jilin University, Changchun, Jilin province, China.,School of Nursing, Inner Mongolia Medical College, Hohhot, Inner Mongolia, China
| | - Si Chen
- The First Hospital of Jilin University, Changchun, Jilin province, China
| | - Ruxin Jiang
- School of Nursing, Jilin University, Changchun, Jilin province, China
| | - Yuewei Li
- School of Nursing, Jilin University, Changchun, Jilin province, China
| | - Lei Chen
- The First Hospital of Jilin University, Changchun, Jilin province, China
| | - Feng Li
- School of Nursing, Jilin University, Changchun, Jilin province, China.
| | - Jiandong Tai
- The First Hospital of Jilin University, Changchun, Jilin province, China.
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dos Santos WDN, Vieira A, de Lira CAB, Mota JF, Gentil P, de Freitas Junior R, Battaglini CL, Bottaro M, Vieira CA. Once a Week Resistance Training Improves Muscular Strength in Breast Cancer Survivors: A Randomized Controlled Trial. Integr Cancer Ther 2019; 18:1534735419879748. [PMID: 31561728 PMCID: PMC6767726 DOI: 10.1177/1534735419879748] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 07/31/2019] [Accepted: 09/07/2019] [Indexed: 12/24/2022] Open
Abstract
Background: Exercise has been shown to reduce adverse outcomes related to breast cancer. However, the rate of adherence to physical exercise is very low among breast cancer survivors (BCS). This study investigated the effects of high supervision ratio resistance training (RT), once a week for 8 weeks, on changes in body composition and muscular strength in BCS. Methods: Twenty-five female BCS undergoing hormone therapy were randomized into resistance training group (TG, n = 12) or control (CG, n = 13) group. The TG performed 8 weeks of supervised RT, with 1 trainer per volunteer, once a week. Body composition was evaluated by dual-energy X-ray absorptiometry, and muscle strength was evaluated by 10 repetition maximum (10 RM) for leg press (45°) and bench press exercises. A 1-way analysis of variance was used to compare within-group effects at pre- and post-intervention. An analysis of covariance test was used to compare post-intervention values, using pre-intervention measures as covariates. The effect size (ES) was calculated by Cohen's d. Results: The TG improved muscle strength in 10 RM leg press (45°; Δ 33.75 ± 11.51 kg, P = .02; ES = 0.96) and bench press (Δ 4.08 ± 1.83 kg, P = .01; ES = 1.15). Adherence to training was more than 99%. Changes in body composition were not detected. There were no changes in the CG for any assessment. Conclusion: Once-weekly supervised RT could be an alternative to increase the adherence to exercise and improve muscular strength in BCS.
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Affiliation(s)
| | | | | | | | - Paulo Gentil
- Federal University of Goias—UFG,
Goiania, Brazil
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Who Is the Best Exercise Professional to Provide an Exercise Training Programs in an Oncology Rehabilitation Setting—It Depends! REHABILITATION ONCOLOGY 2018. [DOI: 10.1097/01.reo.0000000000000120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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de Paulo TRS, Winters-Stone KM, Viezel J, Rossi FE, Aro BL, Trindade ACAC, Codogno JS, Freitas Junior IF. Comparing exercise responses to aerobic plus resistance training between postmenopausal breast cancer survivors undergoing aromatase inhibitor therapy and healthy women. Disabil Rehabil 2018; 41:2175-2182. [DOI: 10.1080/09638288.2018.1460877] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Thais R. S. de Paulo
- School of Technology and Sciences, State University (UNESP), Presidente Prudente, Sao Paulo, Brazil
- Institute of Biosciences, State University (UNESP), Sao Paulo, Brazil
- University Federal do Amazonas, UFAM, Parintins, Brazil
| | - Kerri M. Winters-Stone
- School of Nursing, Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
| | - Juliana Viezel
- School of Technology and Sciences, State University (UNESP), Presidente Prudente, Sao Paulo, Brazil
- Institute of Biosciences, State University (UNESP), Sao Paulo, Brazil
| | - Fabricio E. Rossi
- School of Technology and Sciences, State University (UNESP), Presidente Prudente, Sao Paulo, Brazil
- Institute of Biosciences, State University (UNESP), Sao Paulo, Brazil
| | - Bruna L. Aro
- School of Technology and Sciences, State University (UNESP), Presidente Prudente, Sao Paulo, Brazil
| | | | - Jamile S. Codogno
- School of Technology and Sciences, State University (UNESP), Presidente Prudente, Sao Paulo, Brazil
- Institute of Biosciences, State University (UNESP), Sao Paulo, Brazil
| | - Ismael F. Freitas Junior
- School of Technology and Sciences, State University (UNESP), Presidente Prudente, Sao Paulo, Brazil
- Institute of Biosciences, State University (UNESP), Sao Paulo, Brazil
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Reis AD, Pereira PTVT, Diniz RR, de Castro Filha JGL, Dos Santos AM, Ramallo BT, Filho FAA, Navarro F, Garcia JBS. Effect of exercise on pain and functional capacity in breast cancer patients. Health Qual Life Outcomes 2018; 16:58. [PMID: 29625622 PMCID: PMC5889570 DOI: 10.1186/s12955-018-0882-2] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 03/25/2018] [Indexed: 01/12/2023] Open
Abstract
PURPOSE To assess the influence of combined training on pain, fatigue, maximal oxygen uptake (VO2 max), body mass index (BMI), flexibility, and strength in patients with breast cancer. METHODS A controlled pilot study with 28 patients undergoing chemotherapy, radiation therapy, and clinical observation in a renowned cancer treatment center; the patients were aged from 30 to 59 years old and were not engaged in physical training for three months previously. The Study Group (SG) underwent 12 weeks of training, including three 60-min sessions of aerobic exercise and resistance training, and two sessions of flexibility training per week; each flexibility exercise lasted 20 s and was performed in sets of three repetitions. The Control Group (CG) received only the standard hospital treatment. Participants were evaluated at the beginning of the study to establish a baseline and reevaluated at the end of 12 weeks. RESULTS Patients in the SG showed a significant decrease in total pain points (p = 0.0047), pain intensity (p = 0.0082), and the extent to which pain interfered with their daily life (p = 0.0047). There was an increase in maximum oxygen uptake (p = 0.0001), flexibility (p = 0.0001), and strength on both sides (right p = 0.0001 and left p = 0.0008). No significant differences were observed in fatigue (p = 0.0953) or BMI (p = 0.6088). CONCLUSION Combined training was effective in decreasing pain and increasing VO2 max, flexibility and static strength in patients with breast cancer. TRIAL REGISTRATION NCT03061773 . Registered on February 19, 2017, 'retrospectively registered'.
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Affiliation(s)
- Andréa Dias Reis
- Post-Graduate Program in Adult and Child Health, Federal University of Maranhão (Universidade Federal do Maranhão - UFMA), unit 203, street 4, n° 8, Cidade Operária, São Luis, MA, Brazil.
| | - Paula Tamara Vieira Teixeira Pereira
- Post-Graduate Program in Adult and Child Health, Federal University of Maranhão (Universidade Federal do Maranhão - UFMA), unit 203, street 4, n° 8, Cidade Operária, São Luis, MA, Brazil
| | | | | | - Alcione Miranda Dos Santos
- Post-Graduate Program in Health Sciences (Federal University of Maranhão - UFMA), São Luís, Brazil.,Post-Graduate Program in Collective Health (Federal University of Maranhão - UFMA), São Luís, Brazil
| | | | | | - Francisco Navarro
- Post-Graduate Program in Adult and Child Health, Federal University of Maranhão (Universidade Federal do Maranhão - UFMA), unit 203, street 4, n° 8, Cidade Operária, São Luis, MA, Brazil.,Department of Physical Education (Federal University of Maranhão - UFMA), São Luís, Brazil
| | - João Batista Santos Garcia
- Post-Graduate Program in Adult and Child Health, Federal University of Maranhão (Universidade Federal do Maranhão - UFMA), unit 203, street 4, n° 8, Cidade Operária, São Luis, MA, Brazil.,Post-Graduate Program in Health Sciences (Federal University of Maranhão - UFMA), São Luís, Brazil
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Effects of combined and resistance training on the inflammatory profile in breast cancer survivors: A systematic review. Complement Ther Med 2018; 36:73-81. [DOI: 10.1016/j.ctim.2017.11.023] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 11/14/2017] [Accepted: 11/29/2017] [Indexed: 12/18/2022] Open
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Short CE, Finlay A, Sanders I, Maher C. Development and pilot evaluation of a clinic-based mHealth app referral service to support adult cancer survivors increase their participation in physical activity using publicly available mobile apps. BMC Health Serv Res 2018; 18:27. [PMID: 29338722 PMCID: PMC5771037 DOI: 10.1186/s12913-017-2818-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 12/22/2017] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Participation in regular physical activity holds key benefits for cancer survivors, yet few cancer survivors meet physical activity recommendations. This study aimed to develop and pilot test a mHealth app referral service aimed at assisting cancer survivors to increase their physical activity. In particular, the study sought to examine feasibility and acceptability of the service and determine preliminary efficacy for physical activity behaviour change. METHODS A systematic search identified potentially appropriate Apple (iOS) and Android mHealth apps. The apps were audited regarding the type of physical activity encouraged, evidence-based behavioural strategies and other characteristics, to help match apps to users' preferences and characteristics. A structured service was devised to deliver the apps and counselling, comprising two face-to-face appointments with a mid-week phone or email check-up. The mHealth app referral service was piloted using a pre-post design among 12 cancer survivors. Participants' feedback regarding the service's feasibility and acceptability was sought via purpose-designed questionnaire, and analysed using inductive thematic analysis and descriptive statistics. Change in physical activity was assessed using a valid and reliable self-report tool and analysed using paired t-tests. In line with recommendations for pilot studies, confidence intervals and effect sizes were reported to aid interpretation of clinical significance, with an alpha of 0.2 used to denote statistical significance. RESULTS Of 374 mHealth apps identified during the systematic search, 54 progressed to the audit (iOS = 27, Android = 27). The apps consistently scored well for aesthetics, engagement and functionality, and inconsistently for gamification, social and behaviour change features. Ten participants completed the pilot evaluation and provided positive feedback regarding the service's acceptability and feasibility. On average, participants increased their moderate-vigorous physical activity by 236 min per week (d = 0.73; 95% CI = -49 to 522; p = 0.09). CONCLUSION This study offered initial evidence that a mHealth app referral service for cancer survivors is feasible and acceptable and may increase physical activity levels. The large increase in physical activity is promising, but should be interpreted with caution given the small sample size and lack of control group. Further research is warranted on a larger scale to investigate generalisability, long-term compliance and application in clinical settings.
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Affiliation(s)
- Camille E. Short
- School of Medicine, Freemasons Foundation Centre for Men’s Health, University of Adelaide, Adelaide, Australia
| | - Amy Finlay
- School of Medicine, Freemasons Foundation Centre for Men’s Health, University of Adelaide, Adelaide, Australia
| | - Ilea Sanders
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute, School of Health Sciences, University of South Australia, Adelaide, Australia
| | - Carol Maher
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute, School of Health Sciences, University of South Australia, Adelaide, Australia
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Hirschey R, Kimmick G, Hockenberry M, Shaw R, Pan W, Lipkus I. Protocol for Moving On: a randomized controlled trial to increase outcome expectations and exercise among breast cancer survivors. Nurs Open 2018; 5:101-108. [PMID: 29344401 PMCID: PMC5762707 DOI: 10.1002/nop2.119] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 10/21/2017] [Indexed: 01/08/2023] Open
Abstract
Aim The aim of this study was to test the feasibility and fidelity of an intervention, Moving On, aimed to increase outcome expectations OEs (i.e. what one expects to obtain or avoid as a result of a behaviour) and exercise among breast cancer survivors. Design Randomized controlled trial. Methods Intervention arm participants will be given a theory-guided booklet that was co-created by the research team and three physically active breast cancer survivors who exercise to manage late and long-term treatment effects. Attention control arm participants will be given a similar booklet focused on diet. Participants will have 1 week to complete reading, writing and reflecting activities in the booklets. Study outcomes will be measured through online surveys; exercise will also be measured objectively with a Fitbit®. Four weeks postintervention, participants' thoughts about the usefulness, strengths and weakness of the intervention booklet will be assessed. OEs and exercise will be measured at baseline, 4-, 8- and 12-week postintervention.
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Affiliation(s)
| | | | | | - Ryan Shaw
- Duke University School of NursingDurhamNCUSA
| | - Wei Pan
- Duke University School of NursingDurhamNCUSA
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Hughes DC, Cox MG, Serice S, Baum G, Harrison C, Basen-Engquist K. Using rating of perceived exertion in assessing cardiorespiratory fitness in endometrial cancer survivors. Physiother Theory Pract 2017; 33:758-765. [PMID: 28820332 PMCID: PMC6087665 DOI: 10.1080/09593985.2017.1357150] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
For cancer survivors, who also often present with co-existing health conditions, exercise testing is often performed using submaximal protocols incorporating linear heart rate response for estimating the cardiorespiratory capacity and assessing exercise tolerance. However, use of beta-blocker medications, during sub-maximal protocols based on linear HR response can be problematic. Rating of perceived exertion (RPE), which takes into account an individual's overall perception of effort, can be used as a complementary tool that does not rely solely on the heart rate response to increased workload. We compared heart rate response (VO2HR) and self-rating of perceived exertion (VO2RPE) in a graded submaximal exercise test (GXT) in 93 endometrial cancer survivors. The results of the GXT were stratified according to whether participants were taking beta-blocker (BB) medications or not (non-BB). Among non-BB participants, there was no difference between the mean VO2HR and the mean VO2RPE estimates of cardiorespiratory capacity (mlO2//kg/min) (20.4 and 19.3, respectively; p = 0.166). Among BB participants, the mean VO2HR approached significant difference than the mean VO2RPE (21.7 mlO2//kg/min and 17.6 mlO2//kg/min, respectively; p = 0.087). Bland-Altman plots for both methods showed a proportional bias for the non-BB group; but not the BB group. Our results suggest that sub-maximal protocols based on Borg's Rating of Perceived exertion (RPE) produce differing results from sub-maximal protocols based on HR response when applied to clinical population taking BB medications. Using RPE instead of HR for participants on BB medications may be a better method for assessing the exercise tolerance for estimating the cardiorespiratory capacity in sub-maximal exercise testing.
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Affiliation(s)
- Daniel C. Hughes
- Institute for Health Promotion Research, University of Texas Health Science Center – San Antonio, 7411 John Smith Dr., Suite 1000, San Antonio, TX 78229
| | - Matthew G. Cox
- Adult and Child Consortium for Health Outcomes Research and Delivery Science University of Colorado
| | - Susan Serice
- Department of Behavioral Science, University of Texas, M.D. Anderson Cancer Center
| | - George Baum
- Department of Behavioral Science, University of Texas, M.D. Anderson Cancer Center
| | - Carol Harrison
- Department of Behavioral Science, University of Texas, M.D. Anderson Cancer Center
| | - Karen Basen-Engquist
- Department of Behavioral Science, University of Texas, M.D. Anderson Cancer Center
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Chronic Effects of Resistance Training in Breast Cancer Survivors. BIOMED RESEARCH INTERNATIONAL 2017; 2017:8367803. [PMID: 28835898 PMCID: PMC5557266 DOI: 10.1155/2017/8367803] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 06/15/2017] [Accepted: 06/28/2017] [Indexed: 01/05/2023]
Abstract
Objective. To analyse effects of resistance training (RT) in breast cancer survivors (BCS) and how protocols and acute variables were manipulated. Methods. Search was made at PubMed, Science Direct, and LILACS. All articles published between 2000 and 2016 were considered. Studies that met the following criteria were included: written in English, Spanish, or Portuguese; BCS who have undergone surgery, chemotherapy, and/or radiotherapy; additional RT only; analysis of muscle performance, body mass composition (BMC), psychosocial parameters, or blood biomarkers. Results. Ten studies were included. PEDro score ranged from 5 to 9. Rest interval and cadence were not reported. Two studies reported continuous training supervision. All reported improvements in muscle strength, most with low or moderate effect size (ES), but studies performed with high loads presented large ES. Five described no increased risk or exacerbation of lymphedema. Most studies that analysed BMC showed no relevant changes. Conclusions. RT has been shown to be safe for BCS, with no increased risk of lymphedema. The findings indicated that RT is efficient in increasing muscle strength; however, only one study observed significant changes in BMC. An exercise program should therefore consider the manipulation of acute and chronic variables of RT to obtain optimal results.
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Keats MR, Cui Y, Grandy SA, Parker L. Cardiovascular disease and physical activity in adult cancer survivors: a nested, retrospective study from the Atlantic PATH cohort. J Cancer Surviv 2016; 11:264-273. [PMID: 27854007 DOI: 10.1007/s11764-016-0584-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 11/09/2016] [Indexed: 01/19/2023]
Abstract
PURPOSE The study aimed to examine the relationship between cardiovascular disease (CVD) and physical activity (PA) levels in cancer survivors (CS). METHODS Using a nested, retrospective follow-up design, this study presents the self-reported prevalence of CVD in an Atlantic Canadian population-based cohort of 1526 CS and 6034 age-sex matched, non-cancer controls ranging from 35 to 69 years of age. Univariate and multiple logistic regression models were used to explore the association between CVD and PA. RESULTS Overall, CS were 30% more likely to have ever experienced a CVD event than controls (OR = 1.3; 95% CI 1-1.7, p = .07). Survivors were also significantly more likely to report having hypertension (OR = 1.60; 95% CI 1.03-1.3, p = .02) and diabetes (OR = 1.27; 95% CI 1.03-1.16, p = .02). Compared to controls, CS were significantly less likely to engage in high levels of PA. For survivors, compared to those who were least physically active, the odds of having a CVD risk factor was 35% lower for those who were moderately active (OR = 0.65; 95% CI 0.48-0.88) and 45% lower in the most highly active group (OR = 0.55; 95% CI 0.4-0.73). For controls, the odds of having a CVD risk factor was 25% lower for those in the moderately active group (OR = 0.75; 95% CI 0.64-0.88) and 30% lower for those in the high active group (OR = 0.70; 95% CI 0.6-0.81). CONCLUSION Low active survivors appear to be at a high risk of CVD-related comorbidity. IMPLICATIONS FOR CANCER SURVIVORS PA is associated with lower CVD-related comorbidity in CS, suggesting that interventions directed at increasing PA should be implemented to improve long-term health outcomes.
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Affiliation(s)
- Melanie R Keats
- School of Health and Human Performance, Dalhousie University, 6230 South Street, Halifax, NS, B3H 4R2, Canada.
| | - Yunsong Cui
- Population Cancer Research Program, Dalhousie University, 1494 Carlton Street, Halifax, NS, B3H 3B7, Canada
| | - Scott A Grandy
- School of Health and Human Performance, Dalhousie University, 6230 South Street, Halifax, NS, B3H 4R2, Canada
| | - Louise Parker
- Population Cancer Research Program, Dalhousie University, 1494 Carlton Street, Halifax, NS, B3H 3B7, Canada
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Abdelmagid SA, MacKinnon JL, Janssen SM, Ma DWL. Role of n-3 Polyunsaturated Fatty Acids and Exercise in Breast Cancer Prevention: Identifying Common Targets. Nutr Metab Insights 2016; 9:71-84. [PMID: 27812288 PMCID: PMC5089819 DOI: 10.4137/nmi.s39043] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 08/18/2016] [Accepted: 08/23/2016] [Indexed: 12/21/2022] Open
Abstract
Diet and exercise are recognized as important lifestyle factors that significantly influence breast cancer risk. In particular, dietary n-3 polyunsaturated fatty acids (PUFAs) have been shown to play an important role in breast cancer prevention. Growing evidence also demonstrates a role for exercise in cancer and chronic disease prevention. However, the potential synergistic effect of n-3 PUFA intake and exercise is yet to be determined. This review explores targets for breast cancer prevention that are common between n-3 PUFA intake and exercise and that may be important study outcomes for future research investigating the combined effect of n-3 PUFA intake and exercise. These lines of evidence highlight potential new avenues for research and strategies for breast cancer prevention.
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Affiliation(s)
- Salma A Abdelmagid
- Department of Human Health and Nutritional Sciences, College of Biological Science, University of Guelph, Guelph, Ontario, Canada
| | - Jessica L MacKinnon
- Department of Human Health and Nutritional Sciences, College of Biological Science, University of Guelph, Guelph, Ontario, Canada
| | - Sarah M Janssen
- Department of Human Health and Nutritional Sciences, College of Biological Science, University of Guelph, Guelph, Ontario, Canada
| | - David W L Ma
- Department of Human Health and Nutritional Sciences, College of Biological Science, University of Guelph, Guelph, Ontario, Canada
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