Effects of Supervised Exercise Training on Cardiopulmonary Function and Fatigue in Breast Cancer Survivors During and After Treatment

Abstract Context Insulin resistance is a risk factor for breast cancer recurrence. How exercise training changes fasting and postglucose insulin resistance in breast cancer survivors is unknown. Objective To evaluate exercise-induced changes in postglucose ingestion insulin concentrations, insulin resistance, and their associations with cancer-relevant biomarkers in breast cancer survivors. Setting The University of Massachusetts Kinesiology Department. Participants 15 postmenopausal breast cancer survivors not meeting the physical activity guidelines (150 min/week of exercise). Intervention A supervised 12-week aerobic exercise program (60 min/day, 3–4 days/week). Main outcome measures Postglucose ingestion insulin was determined by peak insulin and area under the insulin curve (iAUC) during a 5-sample oral glucose tolerance test. Insulin sensitivity was estimated from the Matsuda composite insulin sensitivity index (C-ISI). Changes in fitness and body composition were determined from submaximal VO2peak and dual energy X-ray absorptiometry. Results Participants averaged 156.8 ± 16.6 min/week of supervised exercise. Estimated VO2peak significantly increased (+2.8 ± 1.4 mL/kg/min, P < .05) and body weight significantly decreased (–1.1 ± 0.8 kg, P < .05) following the intervention. There were no differences in fasting insulin, iAUC, C-ISI, or peak insulin following the intervention. Insulin was only significantly lower 120 min following glucose consumption (68.8 ± 34.5 vs 56.2 ± 31.9 uU/mL, P < .05), and there was a significant interaction with past/present aromatase inhibitor (AI) use for peak insulin (–11.99 non-AI vs +13.91 AI uU/mL) and iAUC (-24.03 non-AI vs +32.73 AI uU/mL). Conclusions Exercise training had limited overall benefits on insulin concentrations following glucose ingestion in breast cancer survivors but was strongly influenced by AI use.

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Updated systematic review of exercise studies in breast cancer survivors: attention to the principles of exercise training

British Journal of Sports Medicine ◽

10.1136/bjsports-2017-098389 ◽

2017 ◽

Vol 53 (8) ◽

pp. 504-512 ◽

Cited By ~ 31

Author(s):

Sarah E Neil-Sztramko ◽

Kerri M Winters-Stone ◽

Kelcey A Bland ◽

Kristin L Campbell

Keyword(s):

Breast Cancer ◽

Systematic Review ◽

Exercise Training ◽

Cancer Survivors ◽

Randomised Controlled Trials ◽

Breast Cancer Survivors ◽

Exercise Prescription ◽

Controlled Trials ◽

Exercise Interventions ◽

Randomised Controlled

ObjectivesTo update our previous evaluation of the exercise interventions used in randomised controlled trials of breast cancer survivors in relation to (1) the application of the principles of exercise training in the exercise prescription; (2) the reporting of the components of the exercise prescription; and (3) the reporting of adherence of participants to the prescribed interventions.DesignSystematic review.Data sourcesThe OVID Medline, Embase, CINAHL and SPORTDiscus electronic databases were searched from January 2010 to January 2017.Eligibility criteriaRandomised controlled trials of at least 4 weeks of aerobic and/or resistance exercise in women diagnosed with breast cancer, reporting on physical fitness or body composition outcomes.ResultsSpecificity was appropriately applied by 84%, progression by 29%, overload by 38% and initial values by 67% of newly identified studies. Reversibility was reported by 3% anddiminishing returns by 22% of newly identified studies. No studies reported all components of the exercise prescription in the methods, or adherence to the prescribed intervention in the results. Reporting of reversibility has increased from 2010, but no other improvements in reporting were noted from the previous review.Summary/ConclusionNo studies of exercise in women with breast cancer attended to all principles of exercise training, or reported all components of the exercise prescription in the methods, or adherence to the prescription in the results. Full reporting of the exercise prescribed and completed is essential for study replication in research and translating research findings into the community, and should be prioritised in future trials.

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Twenty-five years of research on the effects of exercise training in breast cancer survivors: A systematic review of the literature

World Journal of Clinical Oncology ◽

10.5306/wjco.v5.i2.177 ◽

2014 ◽

Vol 5 (2) ◽

pp. 177 ◽

Cited By ~ 68

Author(s):

Claudio L Battaglini

Keyword(s):

Breast Cancer ◽

Systematic Review ◽

Exercise Training ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Review Of The Literature

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The effect of aerobic exercise on the metabolic risk profile of breast cancer survivors 2-6 months post chemotherapy.

Journal of Clinical Oncology ◽

10.1200/jco.2011.29.27_suppl.244 ◽

2011 ◽

Vol 29 (27_suppl) ◽

pp. 244-244

Author(s):

E. M. Guinan ◽

J. M. Hussey ◽

J. M. Walsh ◽

M. J. Kennedy ◽

E. M. Connolly

Keyword(s):

Breast Cancer ◽

Cancer Survivors ◽

Aerobic Exercise ◽

Breast Cancer Survivors ◽

Exercise Intervention ◽

Risk Profile ◽

Control Group ◽

Metabolic Risk ◽

Model Assessment ◽

Supervised Exercise

244 Background: Current literature suggests that weight gain during treatment for breast cancer is associated with a poorer prognosis and an increased risk of developing secondary health problems such as the metabolic syndrome (MetSyn). Physical activity (PA) can alter features of the MetSyn and improve body composition by reducing abdominal adiposity. We report metabolic results of a prospective randomized controlled trial (PEACH trial; Walsh JM, et al. [2010] BMC Cancer. 10[42]) which examines the effect of an exercise intervention on the metabolic risk profile of breast cancer survivors 2-6 months post chemotherapy. Methods: All subjects gave written informed consent and were randomized to an 8-week, twice weekly aerobic exercise intervention programme or a usual care control group consisting of routine medical advice about PA. The five clinical features of the MetSyn were measured: waist circumference (WC), resting blood pressure (BP), triglycerides, high-density lipoprotein cholesterol (HDL-C) and fasting glucose. Insulin resistance was estimated by the homeostatic model assessment (HOMA). Statistical analysis was carried out using independent sample t-tests with significance set at p < 0.05. Results: Twenty-six breast cancer survivors participated (mean (± SD) age 48.13 (8.75) years). At baseline, 50% (n = 13) of subjects were overweight and 23.1% (n = 6) were obese, with 73.1% (n = 19) centrally obese. 34.6% (n = 9) of subjects were classified with the MetSyn. There were no significant differences between groups at baseline. Intention-to-treat analysis showed no significant changes, however, analysis of those who adhered to > 70% of the supervised exercise intervention showed a significant improvement in WC when compared to the control group (p < 0.05). Conclusions: Results show that an 8-week aerobic exercise intervention significantly reduced WC but did not modify other features of the MetSyn. The decrease in WC demonstrated by this short intervention may have important implications in terms of improving survival and the metabolic risk profile of breast cancer survivors. Final follow-up assessments are ongoing and will enable change in WC over time to be evaluated further.

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