Randomized Trial of Exercise Therapy in Women Treated for Breast Cancer

2007 ◽  
Vol 25 (13) ◽  
pp. 1713-1721 ◽  
Author(s):  
Amanda J. Daley ◽  
Helen Crank ◽  
John M. Saxton ◽  
Nanette Mutrie ◽  
Robert Coleman ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Therapy ◽  
Aerobic Exercise ◽  
Usual Care ◽  
Exercise Therapy ◽  
Functional Assessment ◽  
Psychological Health ◽  
Well Being ◽  
Exercise Interventions

Purpose To examine the effects of aerobic exercise therapy on quality of life (QoL) and associated outcomes in women treated for breast cancer. Evidence suggests that exercise may be beneficial, but no trial has included an exercise-placebo and a usual-care group to control for the attention effects that might be associated with aerobic exercise interventions in cancer patients. Patients and Methods A total of 108 women who had been treated for breast cancer 12 to 36 months previously were randomly assigned to supervised aerobic exercise therapy (n = 34), exercise-placebo (body conditioning; n = 36), or usual care (n = 38). Exercise therapy and exercise-placebo sessions took place three times per week for 8 weeks. Outcomes included QoL, depression, exercise behavior, aerobic fitness; outcomes were assessed at baseline and at the 8- and 24-week follow-up. Results Analyses of covariance revealed a significant mean difference of 9.8 units in Functional Assessment of Cancer Therapy–General (primary outcome) favoring aerobic exercise therapy at 8 weeks, relative to usual care. Significant differences that favored aerobic exercise therapy relative to usual care were recorded for Functional Assessment of Cancer Therapy–Breast, social/family well-being, functional well-being, and breast cancer subscale scores at 8-week follow-up. Psychological health outcomes improved modestly for both intervention groups; these improvements were sustained for several end points. Conclusion Exercise therapy had large, clinically meaningful, short-term beneficial effects on QoL in women treated for breast cancer; this finding cannot be attributable to attention, given that the exercise-placebo group did not report similar effects relative to usual care.

Reliability and validity of the Functional Assessment of Cancer Therapy-Breast quality-of-life instrument.

1997 ◽  
Vol 15 (3) ◽  
pp. 974-986 ◽  
Author(s):  
M J Brady ◽  
D F Cella ◽  
F Mo ◽  
A E Bonomi ◽  
D S Tulsky ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Cancer Therapy ◽  
Functional Assessment ◽  
Performance Status ◽  
Well Being ◽  
Self Report ◽  
Sensitivity To Change ◽  
Validity And Reliability

PURPOSE This is the first published report on the validation of the Functional Assessment of Cancer Therapy-Breast (FACT-B), a 44-item self-report instrument designed to measure multidimensional quality of life (QL) in patients with breast cancer. The FACT-B consists of the FACT-General (FACT-G) plus the Breast Cancer Subscale (BCS), which complements the general scale with items specific to QL in breast cancer. The FACT-B was developed with an emphasis on patients' values and brevity and is available in nine languages. METHODS AND RESULTS Two validation samples were used for this report. The first (n = 47) was tested twice over a 2-month period to assess sensitivity to change. Significant sensitivity to change in performance status rating (PSR) was demonstrated for the FACT-B total score, the Physical Well-Being (PWB) subscale, the Functional Well-Being (FWB) subscale, and the BCS. Sensitivity to change in QL as measured by the Functional Living Index-Cancer (FLIC) was documented in the FACT-B total score, PWB, FWB, and Emotional Well-Being (EWB). Additional validity and reliability data were obtained from a larger sample (n = 295). The alpha coefficient (internal consistency) for the FACT-B total score was high (alpha = .90), with subscale alpha coefficients ranging from .63 to .86. Evidence supported test-retest reliability, as well as convergent, divergent, and known groups validity. CONCLUSION The FACT-B is appropriate for use in oncology clinical trials, as well as in clinical practice. It demonstrates ease of administration, brevity, reliability, validity, and sensitivity to change.

scholarly journals Mulheres com neoplasia mamária em quimioterapia adjuvante: avaliação da qualidade de vida [Women with breast cancer in adjuvant chemotherapy: assessment of quality of life] [Mujeres con neoplasia mamaria en la quimioterapia adyuvante: evaluación de la calidad de vida]

2018 ◽  
Vol 26 ◽  
pp. e17948
Author(s):  
Laís De Andrade Martins Cordeiro ◽  
Denismar Alves Nogueira ◽  
Clícia Valim Côrtes Gradim
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Adjuvant Chemotherapy ◽  
Cancer Therapy ◽  
Functional Assessment ◽  
Well Being ◽  
Cáncer De Mama ◽  
Arm Morbidity ◽  
Calidad De Vida

Objetivo: avaliar a qualidade de vida de mulheres com neoplasia mamária e em quimioterapia adjuvante. Método: estudo descritivo, transversal e quantitativo desenvolvido com 25 mulheres em tratamento em uma Unidade de Assistência de Alta Complexidade em Oncologia de uma cidade do Brasil, por meio do questionário Functional Assessment of Cancer Therapy – Breast plus Arm Morbidity (FACTB +4). Pesquisa aprovada no Comitê de Ética em Pesquisa da Universidade Federal de Alfenas (UNIFAL-MG), por meio do Protocolo: 208/2011. Resultados: verificaram- se, em âmbito geral, bons resultados de qualidade de vida nos domínios e para o FACT B Total. Encontraram-se menores médias de escores nos domínios preocupações adicionais com o câncer de mama (22,68±4,96/36) e bem-estar funcional (16,92±4,60/28). Conclusão: destaca-se a necessidade de cuidados referentes às modificações da imagem corporal, ao estresse sobre a doença e anseios de um familiar vir a ter câncer.ABSTRACTObjective: to evaluate the quality of life of women with breast cancer in adjuvant chemotherapy. Method: this descriptive, quantitative, cross-sectional study examined 25 women undergoing treatment at a High Complexity Oncology Unit in a Brazilian city, in 2012, using the Functional Assessment of Cancer Therapy - Breast plus Arm Morbidity (FACT B +4) questionnaire. The study was approved by the research ethics committee of Alfenas Federal University (UNIFAL-MG), under Protocol 208/2011. Results: by and large, good quality of life was found in the domains and for Total FACT B. Lower mean scores were observed in the additional concerns with breast cancer (22.68 ± 4.96/36) and functional well-being (16.92 ± 4.60/28) domains. Conclusion: the findings highlighted the need for care relating to changes in body image, disease-related stress and anxiety that a family member may come to have cancer.RESUMENObjetivo: evaluar la calidad de vida de mujeres con neoplasia mamaria y en quimioterapia adyuvante. Método: estudio descriptivo, transversal y cuantitativo desarrollado junto a 25 mujeres en tratamiento en una Unidad de Asistencia de Alta Complejidad en Oncología de una ciudad de Brasil, en 2012; por medio del cuestionario Functional Assessment of Cancer Therapy - Breast plus Arm Morbidity (FACTB +4). Investigación aprobada en el Comité de Ética en Investigación de la Universidad Federal de Alfenas (UNIFAL-MG), a través del Protocolo: 208/2011. Resultados: se verificaron, en general, buenos resultados de calidad de vida en los dominios y para el FACT B Total. Se encontraron menores promedios de escores en los dominios ‘preocupaciones adicionales con el cáncer de mama (22,68/36) y bienestar funcional (16,92/28)’. Conclusión: se destaca la necesidad de cuidados referentes a las modificaciones de la imagen corporal, al estrés sobre la enfermedad y preocupaciones con la posibilidad de que un familiar vaya a tener cáncer.

scholarly journals Effectiveness of Mindfulness-Based Stress Reduction in Mood, Breast- and Endocrine-Related Quality of Life, and Well-Being in Stage 0 to III Breast Cancer: A Randomized, Controlled Trial

2012 ◽  
Vol 30 (12) ◽  
pp. 1335-1342 ◽  
Author(s):  
Caroline J. Hoffman ◽  
Steven J. Ersser ◽  
Jane B. Hopkinson ◽  
Peter G. Nicholls ◽  
Julia E. Harrington ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Cancer Therapy ◽  
Functional Assessment ◽  
Stress Reduction ◽  
Standard Care ◽  
Controlled Trial ◽  
Well Being ◽  
Related Quality

Purpose To assess the effectiveness of mindfulness-based stress reduction (MBSR) for mood, breast- and endocrine-specific quality of life, and well-being after hospital treatment in women with stage 0 to III breast cancer. Patients and Methods A randomized, wait-listed, controlled trial was carried out in 229 women after surgery, chemotherapy, and radiotherapy for breast cancer. Patients were randomly assigned to the 8-week MBSR program or standard care. Profile of Mood States (POMS; primary outcome), Functional Assessment of Cancer Therapy–Breast (FACT-B), Functional Assessment of Cancer Therapy–Endocrine Symptoms (FACT-ES) scales and the WHO five-item well-being questionnaire (WHO-5) evaluated mood, quality of life, and well-being at weeks 0, 8, and 12. For each outcome measure, a repeated-measures analysis of variance model, which incorporated week 0 measurements as a covariate, was used to compare treatment groups at 8 and 12 weeks. Results There were statistically significant improvements in outcome in the experimental group compared with control group at both 8 and 12 weeks (except as indicated) for POMS total mood disturbance (and its subscales of anxiety, depression [8 weeks only], anger [12 weeks only], vigor, fatigue, and confusion [8 weeks only]), FACT-B, FACT-ES, (and Functional Assessment of Cancer Therapy subscales of physical, social [8 weeks only], emotional, and functional well-being), and WHO-5. Conclusion MSBR improved mood, breast- and endocrine-related quality of life, and well-being more effectively than standard care in women with stage 0 to III breast cancer, and these results persisted at three months. To our knowledge, this study provided novel evidence that MBSR can help alleviate long-term emotional and physical adverse effects of medical treatments, including endocrine treatments. MBSR is recommended to support survivors of breast cancer.

scholarly journals Randomized Exercise Trial of Aromatase Inhibitor–Induced Arthralgia in Breast Cancer Survivors

2015 ◽  
Vol 33 (10) ◽  
pp. 1104-1111 ◽  
Author(s):  
Melinda L. Irwin ◽  
Brenda Cartmel ◽  
Cary P. Gross ◽  
Elizabeth Ercolano ◽  
Fangyong Li ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Strength Training ◽  
Aerobic Exercise ◽  
Usual Care ◽  
Repeated Measures ◽  
Joint Pain ◽  
Breast Cancer Survivors ◽  
Pain Scores ◽  
The Impact

Purpose Arthralgia occurs in up to 50% of breast cancer survivors treated with aromatase inhibitors (AIs) and is the most common reason for poor AI adherence. We conducted, in 121 breast cancer survivors receiving an AI and reporting arthralgia, a yearlong randomized trial of the impact of exercise versus usual care on arthralgia severity. Patients and Methods Eligibility criteria included receiving an AI for at least 6 months, reporting ≥ 3 of 10 for worst joint pain on the Brief Pain Inventory (BPI), and reporting < 90 minutes per week of aerobic exercise and no strength training. Participants were randomly assigned to exercise (150 minutes per week of aerobic exercise and supervised strength training twice per week) or usual care. The BPI, Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index, and Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire were completed at baseline and at 3, 6, 9, and 12 months. Intervention effects were evaluated using mixed-model repeated measures analysis, with change at 12 months as the primary end point. Results Over 12 months, women randomly assigned to exercise (n = 61) attended 70% (± standard deviation [SD], 28%) of resistance training sessions and increased their exercise by 159 (± SD, 136) minutes per week. Worst joint pain scores decreased by 1.6 points (29%) at 12 months among women randomly assigned to exercise versus a 0.2-point increase (3%) among those receiving usual care (n = 60; P < .001). Pain severity and interference, as well as DASH and WOMAC pain scores, also decreased significantly at 12 months in women randomly assigned to exercise, compared with increases for those receiving usual care (all P < .001). Conclusion Exercise led to improvement in AI-induced arthralgia in previously inactive breast cancer survivors.

scholarly journals Right Ventricular Dysfunction in Patients Experiencing Cardiotoxicity during Breast Cancer Therapy

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Anna Calleja ◽  
Frédéric Poulin ◽  
Ciril Khorolsky ◽  
Masoud Shariat ◽  
Philippe L. Bedard ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Therapy ◽  
Right Ventricular ◽  
Prognostic Value ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Breast Cancer Patients ◽  
Lv Dysfunction ◽  
Her2 Breast Cancer

Background. Right ventricular (RV) dysfunction during cancer therapy related cardiotoxicity and its prognostic implications have not been examined.Aim. We sought to determine the incidence and prognostic value of RV dysfunction at time of LV defined cardiotoxicity.Methods. We retrospectively identified 30 HER2+ female patients with breast cancer treated with trastuzumab (± anthracycline) who developed cardiotoxicity and had a diagnostic quality transthoracic echocardiography. LV ejection fraction (LVEF), RV fractional area change (RV FAC), and peak systolic longitudinal strain (for both LV and RV) were measured on echocardiograms at the time of cardiotoxicity and during follow-up. Thirty age balanced precancer therapy and HER2+ breast cancer patients were used as controls.Results. In the 30 patients with cardiotoxicity (mean ± SD age 54 ± 12 years) RV FAC was significantly lower (42 ± 7 versus 47 ± 6%,P=0.01) compared to controls. RV dysfunction defined by global longitudinal strain (GLS < −20.3%) was seen in 40% (n=12). During follow-up in 16 out of 30 patients (23 ± 15 months), there was persistent LV dysfunction (EF < 55%) in 69% (n=11). Concomitant RV dysfunction at the time of LV cardiotoxicity was associated with reduced recovery of LVEF during follow-up although this was not statistically significant.Conclusion. RV dysfunction at the time of LV cardiotoxicity is frequent in patients with breast cancer receiving trastuzumab therapy. Despite appropriate management, LV dysfunction persisted in the majority at follow-up. The prognostic value of RV dysfunction at the time of cardiotoxicity warrants further investigation.

scholarly journals Managing Cancer and Living Meaningfully (CALM) Intervention on Chemotherapy-Related Cognitive Impairment in Breast Cancer Survivors

2020 ◽  
Vol 19 ◽  
pp. 153473542093845
Author(s):  
Ke Ding ◽  
Xiuqing Zhang ◽  
Jingjing Zhao ◽  
He Zuo ◽  
Ziran Bi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cognitive Impairment ◽  
Psychological Distress ◽  
Cognitive Function ◽  
Cancer Therapy ◽  
Cancer Patients ◽  
Functional Assessment ◽  
Breast Cancer Survivors ◽  
Breast Cancer Patients ◽  
Before And After

Objective: To evaluate the effectiveness and feasibility of Managing Cancer and Living Meaningfully (CALM), which is used to reduce chemotherapy-related cognitive impairment (CRCI), relieve psychological distress, and improve quality of life (QOL) in Chinese breast cancer survivors (BCs). Methods: Seventy-four BCs were enrolled in this study. All patients were randomly assigned to either the CALM group or the care as usual (CAU) group. All patients were evaluated by the Functional Assessment of Cancer Therapy–Cognitive Function (FACT-Cog), Distress Thermometer (DT), and the Functional Assessment of Cancer Therapy–Breast (FACT-B) before and after CALM or CAU application to BCs with CRCI. We compared the differences in all these scores between the CALM group and the control group and analyzed the correlation between cognitive function and QOL. Results: Compared with the CAU group, the performance of the CALM group on the FACT-Cog, DT, and FACT-B showed significant differences before and after CALM ( t = −18.909, −5.180, −32.421, P = .000, .000, .000, respectively). Finally, there was a positive correlation between cognitive function and QOL in breast cancer patients before ( r = 0.579, P = .000) and after ( r = 0.797, P = .000) treatment. Conclusions: The present results indicated that CALM has salutary effects on the improvement of cognitive impairment and QOL and relieves psychological distress in breast cancer patients, which may be due to a positive correlation between psychological distress and cognitive function or QOL.

P3118CMR Fast-SENC intramyocardial LV & RV segmental strain detects cardiotoxicity during oncology treatment and impact of cardioprotection therapy before echocardiography

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
H Steen ◽  
M Montenbruck ◽  
P Wuelfing ◽  
S Esch ◽  
A K Schwarz ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Therapy ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Lower Sensitivity ◽  
Pharmacological Agents ◽  
Ventricular Ejection Fraction ◽  
The Impact

Abstract Background The incidence of cardiotoxicity during cancer therapy is underestimated due to limitations of current diagnostic tests. Current biomarkers (BNP, NT-pro-BNP, hs-Troponin, etc.) and imaging calculations (e.g. echocardiography) such as left ventricular ejection fraction (LVEF) are currently included in the guidelines to designate cardiotoxicity during cancer therapy. Unfortunately, these diagnostics identify systemic damage in symptomatic patients after the heart is unable to compensate for regional dysfunction. Fast-SENC segmental intramyocardial strain (fSENC) is a unique cardiac magnetic resonance imaging (CMR) test that regionally detects subclinical intramyocardial dysfunction in 1 heartbeat. Methods This single center, prospective Prefect Study was used to evaluate cardiotoxicity and the impact of cardioprotective therapy in Breast Cancer and Lymphoma patients (NCT03543228). fSENC was acquired with a 1.5T MRI and processed with the software to quantify intramyocardial strain. Segmental strain was measured in three short axis scans (basal, midventricular, apical) with 16 LV/6 RV longitudinal segments & three long axis scans (2-, 3-, 4-chamber) with 21 LV/5 RV circumferential segments. fSENC CMR was performed before chemotherapy, during and after anthracycline/taxane therapy, at 1 year follow-up, and as needed in between designated follow-up periods. Cardioprotective therapy was offered to patients meeting the definition of cardiotoxicity by the ESC Guidelines on Cardiotoxicity and/or ESMO Clinical Practice Guidelines or those observing a substantial decline in cardiac function. Results Two hundred eight (208) CMRs were performed in fifty-two (52) patients (44 female). Patients had an average (± stdev) age of 53 (15) yrs, BMI of 26 (5) kg/m2; 77% had breast cancer, 23% had Lymphoma. fSENC CMRs required 11 (2) min total exam time. The % of normal fSENC (segmental stain <−17%) with a threshold of 65% showed a sensitivity of 87% and specificity of 89% in detecting cardiotoxicity while echocardiography GLS with a threshold of −17% observed a sensitivity of 20% and specificity of 88%. Figure 1 shows receiver operating characteristic curves for fSENC based on the percent of normal myocardium, and echocardiography global longitudinal strain (GLS) respectively. Global fSENC had substantially lower sensitivity than segmental fSENC despite having higher accuracy than the other global metrics. Figure 1 Conclusion Segmental fSENC intramyocardial strain detects subclinical dysfunction due to cardiotoxic response of chemotherapy before other biomarkers and imaging modalities. The ability to detect the subclinical cardiotoxicity of chemotherapy agents, or other pharmacological agents that cause or worsen heart failure, enables proactive prescription of cardioprotective medications to avoid tissue remodeling that precedes systemic cardiac dysfunction and worsening of global measures such as LVEF and current biomarkers.

Sign in / Sign up

Export Citation Format

Share Document