Effects of Exercise on Biobehavioral Outcomes of Fatigue During Cancer Treatment

2014 ◽  
Vol 17 (1) ◽  
pp. 40-48 ◽  
Author(s):  
Sadeeka Al-Majid ◽  
Lori D. Wilson ◽  
Cyril Rakovski ◽  
Jared W. Coburn

Cancer treatment is associated with decreased hemoglobin (Hb) concentration and aerobic fitness (VO2 max), which may contribute to cancer-related fatigue (CRF) and decreased quality of life (QoL). Endurance exercise may attenuate CRF and improve QoL, but the mechanisms have not been thoroughly investigated. Objectives. To (a) determine the feasibility of conducting an exercise intervention among women receiving treatment for breast cancer; (b) examine the effects of exercise on Hb and VO2 maxand determine their association with changes in CRF and QoL; and (c) investigate changes in selected inflammatory markers. Methods. Fourteen women receiving chemotherapy for Stages I–II breast cancer were randomly assigned to exercise ( n = 7) or usual care ( n = 7). Women in the exercise group performed supervised, individualized treadmill exercise 2–3 times/week for the duration of chemotherapy (9–12 weeks). Data were collected 4 times over 15–16 weeks. Results. Recruitment rate was 45.7%. Sixteen women consented and 14 completed the trial, for a retention rate of 87.5%. Adherence to exercise protocol was 95–97%, and completion of data collection was 87.5–100%. Exercise was well tolerated. VO2 maxwas maintained at prechemotherapy levels in exercisers but declined in the usual-care group ( p < .05). Hb decreased ( p < .001) in all participants as they progressed through chemotherapy. Exercise did not have significant effects on CRF or QoL. Changes in inflammatory markers favored the exercise group. Conclusions. Exercise during chemotherapy may protect against chemotherapy-induced decline in VO2 maxbut not Hb concentration.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 10067-10067 ◽  
Author(s):  
Sandra Christine Hayes ◽  
Megan Steele ◽  
Rosa Spence ◽  
Christopher Pyke ◽  
Christobel Saunders ◽  
...  

10067 Background: Exercise for Health was a randomised, controlled trial designed to evaluate an 8-month translational exercise intervention, commencing 6-weeks post-surgery for newly diagnosed breast cancer. Outcomes for this follow-up exploratory analysis were overall- and disease-free survival. Methods: Consenting urban-based women (n = 194) were randomized to one of two exercise groups (intervention delivered either face-to-face or over the telephone) or a usual care group, while consenting rural/regional women (n = 143) were randomised to either the telephone-delivered exercise group or usual care group. For the purposes of these analyses, exercise groups and usual care groups were combined (exercise group, n = 207; usual care group, n = 130). Analyses were done on an intention-to-treat basis and trials were registered with the Australian New Zealand Clinical Trials Registry (ACTRN12606000233527; 12609000809235). Results: Participant disease and treatment characteristics were similar to the wider breast cancer population in Queensland, Australia, and 42% of the sample resided in rural or regional areas. After a median follow-up of 101 months, there were 15/130 (11.5%) survival events in the usual care group, compared with 11/207 (5.3%) events in the exercise group. Disease-free events for the usual care versus exercise group were 23/130 (17.7%) and 25/207 (12.1%), respectively. The corresponding unadjusted hazard ratio for the exercise group for overall survival was 0.45 (95% CI = 0.21-0.97; p = 0.037), and for disease-free survival was 0.66 (95% CI = 0.38-1.17; p = 0.155). Conclusions: Epidemiological evidence consistently shows a positive relationship between physical activity and survival post-breast cancer, but is unable to establish causality. These exploratory findings suggest that an exercise intervention delivered during and beyond conventional treatment for breast cancer and that was designed to cater for all women, irrespective of place of residence and access to medical services, has clear potential to influence survival. Clinical trial information: ACTRN12606000233527; 12609000809235.


2007 ◽  
Vol 125 (1) ◽  
pp. 22-28 ◽  
Author(s):  
Claudio Battaglini ◽  
Martim Bottaro ◽  
Carolyn Dennehy ◽  
Logan Rae ◽  
Edgar Shields ◽  
...  

CONTEXT AND OBJECTIVE: Changes in metabolism have been reported in the majority of patients undergoing cancer treatment, and these are usually characterized by progressive change in body composition. The effects of aerobic exercise programs to combat the cancer and cancer treatment-related side effects, which include the negative changes in body composition, have been extensively reported in the literature. However, few resistance exercise intervention studies have hypothesized that breast cancer patients might benefit from this type of exercise. The purpose of this study was to determine whether exercise protocols that emphasize resistance training would change body composition and strength in breast cancer patients undergoing treatment. DESIGN AND SETTING: Randomized controlled trial, at the Campus Recreation Center and Rocky Mountain Cancer Rehabilitation Institute of the University of Northern Colorado, and the North Colorado Medical Center. METHODS: Twenty inactive breast cancer patients were randomly assigned to a 21-week exercise group (n = 10) or a control group (n = 10). The exercise group trained at low to moderate intensity for 60 minutes on two days/week. The primary outcome measurements included body composition (skinfold method) and muscle strength (one repetition maximum). RESULTS: Significant differences in lean body mass, body fat and strength (p = 0.004, p = 0.004, p = 0.025, respectively) were observed between the groups at the end of the study. CONCLUSION: The results suggest that exercise emphasizing resistance training promotes positive changes in body composition and strength in breast cancer patients undergoing treatment.


2020 ◽  
Author(s):  
Kyuwan Lee ◽  
Nathalie Sami ◽  
Debu Tripathy ◽  
Wendy Demark-Wahnefried ◽  
Mary K. Norris ◽  
...  

Abstract Background: Breast cancer survivors have double the risk of mortality from cardiovascular disease than age-matched women without a cancer history. Reynolds risk score (RRS) is a validated algorithm for the assessment of cardiovascular disease risk. This secondary analysis sought to examine the effects of a 16-week aerobic and resistance exercise intervention on RRS in overweight or obese breast cancer survivors. Methods and Results: One hundred overweight or obese (BMI>25kg/m2) breast cancer survivors were randomized to exercise or usual care. The exercise group underwent aerobic and resistance exercise sessions for 16 weeks. RRS was calculated using a validated equation. Group differences in mean change for RRS were evaluated using repeated-measures analyses of variance. Post-intervention, RRS was significantly reduced (7.9±0.9% to 1.0±0.5%, p<0.001) in the exercise group compared to a significant increase (9.0±0.8% to 11.6±1.2%; p=0.002%) in the usual care group (P<0.01). RRS was significantly reduced in exercise vs usual care (between group difference, -10.6; 95% CI, -16.3 to -7.4; p<0.001). Conclusion: A 16-week aerobic and resistance exercise intervention is an effective approach to reduce the risk of cardiovascular disease in breast cancer survivors. Exercise during cancer survivorship should be considered to reduce the risk for cardiovascular disease risk in overweight women breast cancer survivors.Trial registration: ClinicalTrials.gov: NCT01140282. Registered 9 June 2010, https://clinicaltrials.gov/ct2/show/NCT01140282?term=NCT01140282&draw=2&rank=1


2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Kyuwan Lee ◽  
Nathalie Sami ◽  
Debu Tripathy ◽  
Wendy Demark-Wahnefried ◽  
Mary K. Norris ◽  
...  

Abstract Background Breast cancer survivors have double the risk of mortality from cardiovascular disease than age-matched women without a cancer history. Reynolds risk score (RRS) is a validated algorithm for the assessment of cardiovascular disease risk. This secondary analysis sought to examine the effects of a 16-week aerobic and resistance exercise intervention on RRS in overweight or obese breast cancer survivors. Methods and results One hundred overweight or obese (BMI > 25 kg/m2) breast cancer survivors were randomized to exercise or usual care. The exercise group underwent aerobic and resistance exercise sessions for 16 weeks. RRS was calculated using a validated equation. Group differences in mean change for RRS were evaluated using repeated-measures analyses of variance. Post-intervention, RRS was significantly reduced (7.9 ± 0.9% to 1.0 ± 0.5%; p < 0.001) in the exercise group compared to a significant increase (9.0 ± 0.8% to 11.6 ± 1.2%; p = 0.002%) in the usual care group (p < 0.01). RRS was significantly reduced in exercise vs usual care (between group difference, − 10.6; 95% CI, − 16.3 to − 7.4; p < 0.001). Conclusion A 16-week aerobic and resistance exercise intervention is an effective approach to reduce the risk of cardiovascular disease in breast cancer survivors. Exercise during cancer survivorship should be considered to reduce the risk for cardiovascular disease risk in overweight women breast cancer survivors. Trial registration ClinicalTrials.gov: NCT01140282. Registered 9 June 2010


2020 ◽  
Author(s):  
Christina Dieli-Conwright ◽  
Kyuwan Lee ◽  
Nathalie Sami ◽  
Debu Tripathy ◽  
Wendy Demark-Wahnefried ◽  
...  

Abstract Background: Breast cancer survivors have double the risk of mortality from cardiovascular disease than age-matched women without a cancer history. Reynolds risk score (RRS) is a validated algorithm for the assessment of cardiovascular disease risk. This secondary analysis sought to examine the effects of a 16-week aerobic and resistance exercise intervention on RRS in overweight or obese breast cancer survivors. Methods and Results: One hundred overweight or obese (BMI>25kg/m2) breast cancer survivors were randomized to exercise or usual care. The exercise group underwent aerobic and resistance exercise sessions for 16 weeks. RRS was calculated using a validated equation. Group differences in mean change for RRS were evaluated using repeated-measures analyses of variance. Post-intervention, RRS was significantly reduced (7.9±0.9% to 1.0±0.5%, p<0.001) in the exercise group compared to a significant increase (9.0±0.8% to 11.6±1.2%; p=0.002%) in the usual care group (P<0.01). RRS was significantly reduced in exercise vs usual care (between group difference, -10.6; 95% CI, -16.3 to -7.4; p<0.001). Conclusion: A 16-week aerobic and resistance exercise intervention is an effective approach to reduce the risk of cardiovascular disease in breast cancer survivors. Exercise during cancer survivorship should be considered to reduce the risk for cardiovascular disease risk in breast cancer survivors.Trial registration: ClinicalTrials.gov: NCT01140282. Registered 9 June 2010, https://clinicaltrials.gov/ct2/show/NCT01140282?term=NCT01140282&draw=2&rank=1


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Christina M. Dieli-Conwright ◽  
Nathalie Sami ◽  
Mary K. Norris ◽  
Junxiang Wan ◽  
Hiroshi Kumagai ◽  
...  

AbstractMOTS-c is a mitochondrial derived peptide with exercise mimetic activity that elicits beneficial effects on metabolism and exercise capacity. Furthermore, MOTS-c effects in humans are affected by race, potentially via ethnic-specific mtDNA variations. Women treated for breast cancer are at an increased risk for cardiovascular disease, diabetes and obesity, due to side effects of cancer-treatments. We conducted a secondary analysis of the effects of a 16-week aerobic and resistance exercise intervention on MOTS-c in Hispanic and Non-Hispanic White breast cancer survivors (BCS). BCS (Stage I–III) were randomized to exercise or standard care. The intervention promoted aerobic and resistance exercise for 16 weeks. MOTS-c was analyzed in fasting plasma using an in-house ELISA. Within and between group differences were assessed by paired t-test and repeated measures ANOVA. Pearson’s correlation was computed to assess the association between MOTS-c and metabolic biomarkers at baseline and post-exercise. Twenty-five Hispanic-BCS and 24 non-Hispanic White BCS were included. Hispanic BCS were younger, of greater adiposity, had higher stage cancers, and had worse metabolic profiles at baseline compared to non-Hispanic White BCS (p < 0.001). Post-exercise, MOTS-c levels significantly increased when compared to baseline and the usual care group among non-Hispanic White BCS (p < 0.01) but not among Hispanic breast cancer survivors (p > 0.01). Post-exercise levels of MOTS-c among non-Hispanic White BCS were significantly associated with reductions in fat mass, body weight, HOMA-IR, CRP, and an increase in lean mass (p < 0.01). A 16-week aerobic and resistance intervention increased MOTS-c levels among non-Hispanic White BCS. Trial registration: This trial is registered on ClinicalTrials.gov: NCT01140282 as of June 9, 2010. https://clinicaltrials.gov/ct2/show/NCT01140282.


Nutrients ◽  
2019 ◽  
Vol 11 (1) ◽  
pp. 137 ◽  
Author(s):  
Young-Gyun Seo ◽  
Hyunjung Lim ◽  
YoonMyung Kim ◽  
Young-Su Ju ◽  
Hye-Ja Lee ◽  
...  

This study aimed to develop a multidisciplinary lifestyle intervention program targeted at children and adolescents with moderate to severe obesity, and assess the additional effects of exercise intervention when compared to usual care. Overall, the 103 enrolled participants were ≥85th percentile of age and sex-specific body mass index (BMI). Participants were divided into groups that received 16 weeks of either usual care or exercise intervention. The BMI z-score of the overall completers decreased by about 0.05 after the 16-week intervention (p = 0.02). After the intervention, only the exercise group had a significantly lower BMI z-score than the baseline score by about 0.1 (p = 0.03), but no significant group by time interaction effects were observed. At the 16-week follow-up, significant group by time interaction effects were observed in percentage body fat (%BF) (β = −1.52, 95%CI = −2.58–−0.45), lean body mass (LM) (β = 1.20, 95%CI = 0.12–2.29), diastolic blood pressure (β = −5.24, 95%CI = −9.66–−0.83), high-sensitivity C-reactive protein (β = −1.67, 95%CI = −2.77–−1.01), and wall sit test score (β = 50.74, 95%CI = 32.30–69.18). We developed a moderate-intensity intervention program that can be sustained in the real-world setting and is practically applicable to both moderate and severe obesity. After interventions, the exercise group had lower %BF and cardiometabolic risk markers, and higher LM and leg muscle strength compared to the usual care group.


2011 ◽  
Vol 29 (26) ◽  
pp. 3517-3522 ◽  
Author(s):  
Julienne E. Bower ◽  
Patricia A. Ganz ◽  
Michael R. Irwin ◽  
Lorna Kwan ◽  
Elizabeth C. Breen ◽  
...  

Purpose Fatigue, depression, and sleep disturbance are common adverse effects of cancer treatment and frequently co-occur. However, the possibility that inflammatory processes may underlie this constellation of symptoms has not been examined. Patients and Methods Women (N = 103) who had recently finished primary treatment (ie, surgery, radiation, chemotherapy) for early-stage breast cancer completed self-report scales and provided blood samples for determination of plasma levels of inflammatory markers: soluble tumor necrosis factor (TNF) receptor II (sTNF-RII), interleukin-1 receptor antagonist, and C-reactive protein. Results Symptoms were elevated at the end of treatment; greater than 60% of participants reported clinically significant problems with fatigue and sleep, and 25% reported elevated depressive symptoms. Women treated with chemotherapy endorsed higher levels of all symptoms and also had higher plasma levels of sTNF-RII than women who did not receive chemotherapy (all P < .05). Fatigue was positively associated with sTNF-RII, particularly in the chemotherapy-treated group (P < .05). Depressive symptoms and sleep problems were correlated with fatigue but not with inflammatory markers. Conclusion This study confirms high rates of behavioral symptoms in breast cancer survivors, particularly those treated with chemotherapy, and indicates a role for TNF-α signaling as a contributor to postchemotherapy fatigue. Results also suggest that fatigue, sleep disturbance, and depression may stem from distinct biologic processes in post-treatment survivors, with inflammatory signaling contributing relatively specifically to fatigue.


2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 89-89 ◽  
Author(s):  
Ilana Graetz ◽  
Caitlin N McKillop ◽  
Edward J. Stepanski ◽  
Gregory A. Vidal ◽  
Lee Steven Schwartzberg

89 Background: For postmenopausal women with hormone receptor-positive breast cancer, long-term use of aromatase inhibitors (AI) significantly reduces the risk of cancer recurrence and improves disease free and overall survival. Despite the known benefits of AIs, many patients are nonadherent due to adverse side effects. We conducted a pilot randomized controlled trial of a web-enabled application (app) to provide real-time monitoring and better management of treatment-related adverse symptoms among patients with hormone-receptor positive breast cancer and a new AI prescription. Methods: Eligible patients who agreed to participate were randomized into either: App: had access to the app and received weekly reminders to use it; or Usual Care: had access to the app but did not receive reminders. Concerning responses and trends triggered email alerts to the patient’s providers, who then could review responses to manage ongoing treatment and make therapeutic adjustments. The main analyses compared overall AI adherence using the Morisky Medication Adherence Scale and quality of life using the Functional Assessment of Cancer Therapy Endocrine Symptoms (FACT-ES). Results: We enrolled 44 patients, 21 in the App and 23 in the Usual Care groups; 83% of patients approached agreed to participate, 23% were African-American, and 32% were over the age of 65. Overall, 74% of participants in the App group used the app at least once per week compared with 38% in the Usual Care group (p<0.01). Reported AI adherence at 8 weeks after initiation was significantly higher among App compared with the Usual care group at 8 weeks (100% vs. 72%, p=0.01). Using a differences-in-differences analysis, we found a substantially larger decrease in quality of life in the Usual Care group compared with the App (-11.5 vs. -3.9, p=0.191), although this difference did not reach statistical significance. Conclusions: App use with weekly reminders significantly improved short-term AI adherence. If short-term gains in adherence persist, this low-cost intervention could improve survival outcomes for women with hormone-receptor positive breast cancer.


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