Hodgkin's Lymphoma in an Elite Endurance Athlete

Individualized 12-week exercise training programs enhance aerobic capacity of cancer survivors

Changes in aerobic capacity were evaluated after 12 weeks of training among a motivated heterogeneous group of cancer survivors (N = 54 [41 women and 13 men]), living at moderate altitude. Changes in power at lactate threshold (PT(lact)), peak power (P(peak)), and peak oxygen uptake (VO(2) peak) were evaluated in this group (average age, 53.8 + or - 10.8 years) that completed a minimum of 12 weeks of an individualized exercise program (on average 5 days x week(-1) for 47.5 + or - 17.2 min x session(-1)). Daily exercise duration was based on the goals and functional capacity of each individual. Training intensity for each subject was based on heart rate (HR) value at lactate threshold (T(lact)) obtained during a symptom-limited cardiopulmonary exercise test. Intensity was categorized into 5 ranges: recovery (60%-80% HR T(lact)); endurance (80%-100% HR T(lact)); threshold (100%-105% HR T(lact)); intervals (105%-115% HR T(lact)); and maximal efforts (> or = 115% HR T(lact)). Overall compliance with the exercise prescription was approximately 72% and subjects reported exercising within the 5 training ranges, 12.1%, 63.9%, 18.6%, 4.2%, and 1.2% of the time, respectively. After training, PT(lact) increased 9.5% (121.8 + or - 43.5 vs 133.2 + or - 34.1 W; P < 0.05), P(peak) increased 12.6% (175.5 + or - 55.6 vs 195.6 + or - 54.2 W; P < 0.05) and VO(2) peak increased 11.4% (33.4 + or - 12.5 vs 37.2 + or - 10.4 mL x kg(-1) x min(-1); P < 0.05). The results of this research indicate that: 1) cardiopulmonary exercise testing with lactate threshold determination was safe and effective in the evaluation and exercise prescription phase for a group of cancer survivors and 2) a training program based on 2 higher intensity workouts per week can elicit significant changes in aerobic capacity of a diverse group of cancer survivors.

Exercise capacity of a breast cancer survivor: a case study

PURPOSE

The processes by which we assess, create an individualized exercise program, and monitor training of a breast cancer survivor who was participating in a fitness plan during and after surgery, chemotherapy, and radiation treatments were examined over a 391-d period.

CASE STUDY

A 57-yr-old female was diagnosed with stage I breast cancer (approximately 1.2 cm diameter, estrogen positive, HER2/neu negative) with no lymph node involvement. After lumpectomy and axillary node dissection, the client completed chemotherapy treatment (cyclophosphamide, methotrexate, 5-fluorouracil (CMF)) followed by 33 bouts of radiation therapy. Assessment (body composition, VO2max, lactate threshold, pulmonary function testing) was measured 4 d postdiagnosis and 2 months after treatments had ended. The client kept a daily log of exercise, average heart rate, and rating of perceived exertion in each exercise session.

RESULTS

Over 391 calendar days, the client exercised 343 days (88%) and completed 424 exercise sessions. The client's body composition (15.1%) and body weight (41.4 kg) remained stable for the entire period. There was a significant decrease in VO2max (-7.8%) before and after treatment (56.4 to 52.0 mL x kg(-1) x min(-1), respectively). During the treatment phase (6.8 months), the client averaged 1.19 exercise sessions per day, with an average duration of 48.1 +/- 25.2 min at approximately 57% of VO2max (approximately 32 mL x kg(-1) x min(-1)). Posttreatment (approximately 6.2 months), the client averaged 1.32 exercise sessions per day, with an average duration of 69.3 +/- 38.5 min at approximately 59.6% VO2max (approximately 31.2 mL x kg(-1) x min(-1)). Pre- and posttreatment exercise durations were significantly different (P < 0.01).

CONCLUSIONS

A cancer survivor who engaged in a medically supervised and proactive fitness plan starting from the day of diagnosis maintained a realistic level of physiologic function during and after cancer treatment.