Physical Activity, Exercise and Sports in Young Cancer Patients

Abstract Introduction Physical activity may reduce the development of breast cancer. Whereas hypercoagulability has been linked to adverse outcomes in breast cancer patients, the effects of physical activity on their hemostatic factors are unknown. The study aimed to assess whether long-term (1 year) physical activity can affect hemostatic factors in breast cancer patients. Methods Fifty-five women (35–75 years) with invasive breast cancer stage I/II were randomized to a physical activity intervention (n = 29) lasting 1 year or to a control group (n = 26), and analyzed as intention to treat. Fibrinogen, factor VII antigen, tissue factor pathway inhibitor, and von Willebrand factor (VWF) antigen as well as prothrombin fragment 1 + 2, the endogenous thrombin potential and D-dimer, were measured in plasma before intervention (baseline), and then after 6 and 12 months. Results Maximal oxygen uptake (measure of cardiorespiratory fitness) decreased the first 6 months among the controls, but remained stable in the intervention group. We found no significant differences between the two study groups regarding any of the hemostatic factors, except a significantly higher increase in factor VII antigen in the intervention group. The effect of the intervention on VWF was, however, significantly affected by menopausal stage, and a significant effect of the intervention was found on VWF among postmenopausal women, even after adjustment for dietary intake. Conclusion Long-term physical activity had no effect on the majority of the hemostatic factors measured, but led to increased plasma concentrations of factor VII antigen and prevented an increase in VWF concentration after breast cancer treatment in postmenopausal women. The clinical impact of these findings for risk of vascular thrombosis warrants further studies.

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Changes in fatigue, barriers, and predictors towards physical activity in advanced cancer patients over a period of 12 months—a comparative study

Supportive Care in Cancer ◽

10.1007/s00520-021-06020-3 ◽

2021 ◽

Author(s):

J. Frikkel ◽

M. Beckmann ◽

N. De Lazzari ◽

M. Götte ◽

S. Kasper ◽

...

Keyword(s):

Physical Activity ◽

Cancer Patients ◽

Advanced Cancer ◽

Physical Functioning ◽

Comprehensive Cancer Center ◽

Cancer Center ◽

Advanced Cancer Patients ◽

Psychological Conditions ◽

Patient Reported

Abstract Purpose Physical activity (PA) is recommended to improve advanced cancer patients’ (ACP) physical functioning, fatigue, and quality of life. Yet, little is known about ACPs’ attitude towards PA and its influence on fatigue and depressiveness over a longer period. This prospective, non-interventional cohort study examined ACPs’ fatigue, depression, motivation, and barriers towards PA before and after 12 months of treatment among ACP Methods Outpatients with incurable cancer receiving treatment at a German Comprehensive Cancer Center reporting moderate/severe weakness/tiredness during self-assessment via MIDOS II were enrolled. Fatigue (FACT-F), depression (PHQ-8), cancer-related parameters, self-assessed PA behavior, motivation for and barriers against PA were evaluated (T0). Follow-up data was acquired after 12 months (T1) using the same questionnaire. Results At follow-up, fatigue (p=0.017) and depressiveness (p=0.015) had increased in clinical relevant extent. Physically active ACP did not show significant progress of FACT-F (p=0.836) or PHQ-8 (p=0.799). Patient-reported barriers towards PA remained stable. Logistic regression analyses identified motivation as a positive predictor for PA at both time points (T0, β=2.152, p=0.017; T1, β =2.264, p=0.009). Clinically relevant depression was a negative predictor for PA at T0 and T1 (T0, β=−3.187, p=0.044; T1, β=−3.521, p=0.041). Conclusion Our findings emphasize the importance of psychological conditions in physical activity behavior of ACP. Since psychological conditions seem to worsen over time, early integration of treatment is necessary. By combining therapy approaches of cognitive behavioral therapy and exercise in interdisciplinary care programs, the two treatment options might reinforce each other and sustainably improve ACPs’ fatigue, physical functioning, and QoL. Trial registration German Register of Clinical Trials, DRKS00012514, registration date: 30.05.2017

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The impact of supervised exercise intervention on short-term postprogram leisure time physical activity level in cancer patients undergoing chemotherapy: 1- and 3-month follow-up on the body & cancer project

Palliative & Supportive Care ◽

10.1017/s1478951506060044 ◽

2006 ◽

Vol 4 (1) ◽

pp. 25-35 ◽

Cited By ~ 14

Author(s):

JULIE MIDTGAARD ◽

ANDERS TVETERÅS ◽

MIKAEL RØRTH ◽

REINHARD STELTER ◽

LIS ADAMSEN

Keyword(s):

Physical Activity ◽

Cancer Patients ◽

Physical Activity Level ◽

Leisure Time Physical Activity ◽

Exercise Adherence ◽

The Body ◽

Activity Level ◽

Supervised Exercise ◽

Cancer Project

Background:Exercise is becoming an important component of cancer rehabilitation programs. A consistent finding across studies is that patients experience improved physical fitness and reduced fatigue. However, sustained physical activity is essential if the benefits are to be preserved over the course of cancer survivorship.Objective:This study examined self-reported short-term exercise adherence following a 6-week, supervised exercise program (muscle strength, cardiovascular fitness, relaxation, body awareness, and massage) in a heterogeneous group of 61 cancer patients (mean age 42.9 years, 82% oncological and 18% haematological) from the Body & Cancer Project.Methods:Semistructured interviews were used to quantitatively assess leisure time physical activity level 1 and 3 months after completion of the program. The study furthermore included 3-month follow-up assessment of psychological distress (Hospital Anxiety and Depression Scale—HADS). Patient statements were selected that best illustrated trends found in the statistical material.Results:There was a significant postprogram reduction in physical activity from 6 to 10 weeks and from 6 to 18 weeks. However, the patients (half of whom were still undergoing treatment at the time of follow-up) reported a higher physical activity level postprogram compared to their baseline levels. The analyses showed a positive association between the 3-month postprogram physical activity level and pre-illness physical activity level, treatment, and postprogram changes in depression.Significance of research:Given the significant decrease in postprogram PA level, especially in subjects still undergoing cancer treatment, the study suggests that continuous supervised programs may be required in order to encourage and support exercise adherence in this population. However, randomized clinical controlled trials and more follow-up studies are needed to establish the optimal program length and content for sustained exercise adherence in cancer patients.

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