Impact of a Mixed Strength and Endurance Exercise Intervention on Insulin Levels in Breast Cancer Survivors

2008 ◽  
Vol 26 (6) ◽  
pp. 907-912 ◽  
Author(s):  
Jennifer A. Ligibel ◽  
Nancy Campbell ◽  
Ann Partridge ◽  
Wendy Y. Chen ◽  
Taylor Salinardi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Body Composition ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Exercise Intervention ◽  
Exercise Group ◽  
Control Group ◽  
Fasting Insulin ◽  
Insulin Levels ◽  
Glucose Levels

Purpose Accumulating data suggest that exercise may affect breast cancer risk and outcomes. Studies have demonstrated that high levels of insulin, often seen in sedentary individuals, are associated with increased risk of breast cancer recurrence and death. We sought to analyze whether exercise lowered insulin concentrations in breast cancer survivors. Methods One hundred one sedentary, overweight breast cancer survivors were randomly assigned either to a 16-week cardiovascular and strength training exercise intervention or to a usual care control group. Fasting insulin and glucose levels, weight, body composition, and circumference at the waist and hip were collected at baseline and 16 weeks. Results Baseline and 16-week measurements were available for 82 patients. Fasting insulin concentrations decreased by an average of 2.86 μU/mL in the exercise group (P = .03), with no significant change in the control group (decrease of 0.27 μU/mL, P = .65). The change in insulin levels in the exercise group seemed greater than the change in controls, but the comparison did not reach statistical significance (P = .07). There was a trend toward improvement in insulin resistance in the exercise group (P = .09) but no change in fasting glucose levels. The exercise group also experienced a significant decrease in hip measurements, with no change in weight or body composition. Conclusion Participation in an exercise intervention was associated with a significant decrease in insulin levels and hip circumference in breast cancer survivors. The relationship between physical activity and breast cancer prognosis may be mediated, in part, through changes in insulin levels and/or changes in body fat or fat deposition.

Impact of physical activity on insulin levels in breast cancer survivors

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 555-555
Author(s):  
J. A. Ligibel ◽  
N. Campbell ◽  
H. Chen ◽  
T. Salinardi ◽  
W. Chen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Physical Activity ◽  
Cancer Survivors ◽  
Strength Training ◽  
Breast Cancer Survivors ◽  
Exercise Group ◽  
Control Group ◽  
Insulin Levels ◽  
Glucose Levels ◽  
Increased Risk

555 Background: Accumulating data suggest that body weight and physical activity may affect breast cancer risk and outcomes. Biological mechanisms underlying these relationships are not clear. Studies have demonstrated that high levels of insulin, often seen in obese and sedentary individuals, are also associated with an increased risk of breast cancer recurrence and breast cancer-related death. We sought to analyze whether exercise lowers insulin levels in a population of breast cancer survivors. Methods: Inactive women with early stage breast cancer who had completed adjuvant treatment were randomized to a 16 week, mixed cardiovascular and strength training exercise intervention, or to a normal care control group. Target exercise goals included 2 supervised strength training sessions and 90 minutes of unsupervised cardiovascular exercise each week. Fasting insulin and glucose levels, as well as measurement of weight, body composition, and circumference at the waist and hip, were collected at baseline and after 16 weeks in both groups, and changes in these measures were assessed. Results: One hundred and one women were randomized. Comparison of changes in anthropometric measures are presented in Table 1 . Baseline insulin levels were similar in the 2 groups. After the 16-week exercise or control period, insulin levels decreased by 2.86 μIU/ml in the exercise group (p=0.03), and by 0.27 μIU/ml in the control group (p=0.65). A comparison of the change in insulin levels across time in the 2 groups approached statistical significance (p=0.07). There was also a trend toward improvements in insulin sensitivity in the exercise group (p=0.09), with no change seen in fasting glucose levels. Conclusions: Physical activity was associated with a decrease in insulin levels and in hip circumference in breast cancer survivors. The relationship between physical activity and breast cancer prognosis may be mediated, at least partially, through changes in insulin levels and/or changes in fat mass or deposition. [Table: see text] No significant financial relationships to disclose.

Perceived physical fatigability improves after an exercise intervention among breast cancer survivors: A pilot randomized clinical trial.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 12050-12050
Author(s):  
Yujia (Susanna) Qiao ◽  
G J. Van Londen ◽  
Jill Brufsky ◽  
Janette T. Poppenberg ◽  
Rebecca W. Cohen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Trial ◽  
Cancer Survivors ◽  
Randomized Clinical Trial ◽  
Breast Cancer Survivors ◽  
Exercise Intervention ◽  
Exercise Group ◽  
Whole Body ◽  
Control Group ◽  
Patient Reported

12050 Background: Among breast cancer populations, exercise interventions resulted in positive but relatively small improvements on fatigue, which may have been masked by using single-item, non-specific measures of global fatigue. Perceived fatigability – whole-body tiredness anchored to standardized tasks/activities of specific intensity and duration – accounts for self-pacing bias as an individual likely titrates their usual activities and exertion level to avoid exhaustion. We examined whether this novel fatigability measure could replace global fatigue in an exercise intervention trial in breast cancer survivors. Methods: This pilot single-center randomized clinical trial of 49 breast cancer survivors was conducted from 2015-17, among which 41 participants (exercise = 22, control = 19) completed the trial and reported their perceived physical fatigability and global fatigue at the first (V1) and the last visit (V3). Perceived physical fatigability was measured using the 10-item, self-administered Pittsburgh Fatigability Scale (PFS) scored 0-50, higher PFS Physical scores = greater fatigability. Global fatigue was assessed with a single question “I have a lack of energy” scored 0 “not at all” to 4 “very much” from the Functional Assessment of Cancer Therapy-Endocrine Subscale (FACT-ES). The exercise intervention consisted of three one-on-one training sessions over 6-14 weeks, plus two optional email/phone consultations. The trainer developed a personalized, home-based exercise program with a goal of achieving the recommended ≥150 minutes/week of moderate to vigorous exercise based on ACSM guidelines. Those randomized to the control group met the trainer for V1 and again 6-14 weeks later at V3, but no exercise prescription was provided. We computed mean differences in perceived physical fatigability and global fatigue between V3 and V1 and compared by intervention groups. Results: Among the 41 women in the study (mean age = 54.9±9.8 years; 80% white), sociodemographic and clinical characteristics were similar by intervention groups, except for antiestrogen use. Post-intervention changes (mean ± SE) in PFS Physical scores were -4.4±1.4 (-22.5%) in the exercise group and 0.2±1.4 (+1.0%) in the control group (p =.022), whereas change in global fatigue scores were -0.64±0.23 in the exercise group and 0.00±0.22 in the control group (p =.054). Conclusions: These findings add to mounting evidence that an exercise intervention reduces fatigue among breast cancer survivors. Importantly, the PFS showed a clinically meaningful reduction after the exercise intervention that was masked when using global fatigue as the measurement. Therefore, the PFS serves as a more sensitive instrument to measure perceived physical fatigability and can better evaluate patient-reported outcomes in future cancer trials, especially those focused on cancer survivorship. Clinical trial information: NCT 02770781.

Effects of a personal trainer led exercise intervention on physical activity and physical function of breast cancer survivors.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e23053-e23053
Author(s):  
Linda F. Wang ◽  
Yvonne L. Eaglehouse ◽  
Janette T. Poppenberg ◽  
Jill Brufsky ◽  
Emily Geramita ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Physical Activity ◽  
Cancer Survivors ◽  
Physical Function ◽  
Breast Cancer Survivors ◽  
Exercise Intervention ◽  
Exercise Group ◽  
Step Test ◽  
Control Group ◽  
Personal Trainer

e23053 Background: Regular exercise is an important tool to address physical and emotional effects of breast cancer treatment. However, many breast cancer survivors do not meet minimum recommended levels of physical activity. This study examines effects of a personal trainer led exercise intervention on physical activity levels and physical function in breast cancer survivors. Methods: Women who completed active treatment for breast cancer were recruited from oncology clinics and survivorship programs from September 2015-to September 2017. Subjects were randomized to an immediate exercise or a wait-list control group. The intervention included 3 personal training sessions over a period of up to 30 weeks. Physical activity and function were assessed before and after intervention by pedometer (7-day record) and endurance step test (steps in 2 minutes). Results: 60 women were randomized to immediate intervention (n = 31) or wait-list control (n = 29). Subjects were an average of (mean ± SD) 56 ± 10 years old and 2 ± 1 years since breast cancer diagnosis. At baseline, the exercise group averaged (mean ± SD) 5236 ± 2214 steps/day and 101 ± 23 steps on 2-minute step test while the control group averaged 5856 ± 2916 steps/day and 106 ± 23 steps on 2-minute step test. After intervention, change (mean ∆ ± SD) was 143 ± 1842 steps/day in the exercise group and 79 ± 1862 steps/day in the control group ( p= 0.9). On the 2-minute step test, the exercise group increased 18 ± 20 steps and the control group increased 9 ± 12 steps ( p= 0.07). Conclusions: While there was some improvement in physical function after the personal-trainer led intervention, the short duration and intensity of the intervention may have diminished the effects. Our results suggest a multi-faceted approach may be needed to support significant changes in breast cancer survivors’ physical activity. Future efforts employing a multidisciplinary team, which includes a certified personal trainer, and with larger patient samples may help address this possibility. Clinical trial information: NCT02770781.

scholarly journals Effects of exercise in breast cancer patients: implications of the trials within cohorts (TwiCs) design in the UMBRELLA Fit trial

2021 ◽  
Author(s):  
Roxanne Gal ◽  
Evelyn M. Monninkhof ◽  
Carla H. van Gils ◽  
Rolf H. H. Groenwold ◽  
Sjoerd G. Elias ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Physical Activity ◽  
Beneficial Effect ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Exercise Intervention ◽  
Intervention Group ◽  
Control Group ◽  
Physical Fatigue ◽  
Trials Within Cohorts

Abstract Purpose The Trials within Cohorts (TwiCs) design aims to overcome problems faced in conventional RCTs. We evaluated the TwiCs design when estimating the effect of exercise on quality of life (QoL) and fatigue in inactive breast cancer survivors. Methods UMBRELLA Fit was conducted within the prospective UMBRELLA breast cancer cohort. Patients provided consent for future randomization at cohort entry. We randomized inactive patients 12–18 months after cohort enrollment. The intervention group (n = 130) was offered a 12-week supervised exercise intervention. The control group (n = 130) was not informed and received usual care. Six-month exercise effects on QoL and fatigue as measured in the cohort were analyzed with intention-to-treat (ITT), instrumental variable (IV), and propensity scores (PS) analyses. Results Fifty-two percent (n = 68) of inactive patients accepted the intervention. Physical activity increased in patients in the intervention group, but not in the control group. We found no benefit of exercise for dimensions of QoL (ITT difference global QoL: 0.8, 95% CI = − 2.2; 3.8) and fatigue, except for a small beneficial effect on physical fatigue (ITT difference: − 1.1, 95% CI = − 1.8; − 0.3; IV: − 1.9, 95% CI = − 3.3; − 0.5, PS: − 1.2, 95% CI = − 2.3; − 0.2). Conclusion TwiCs gave insight into exercise intervention acceptance: about half of inactive breast cancer survivors accepted the offer and increased physical activity levels. The offer resulted in no improvement on QoL, and a small beneficial effect on physical fatigue. Trial registration Netherlands Trial Register (NTR5482/NL.52062.041.15), date of registration: December 07, 2015.

scholarly journals The effects of an individualized exercise intervention on body composition in breast cancer patients undergoing treatment

2007 ◽  
Vol 125 (1) ◽  
pp. 22-28 ◽  
Author(s):  
Claudio Battaglini ◽  
Martim Bottaro ◽  
Carolyn Dennehy ◽  
Logan Rae ◽  
Edgar Shields ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Body Composition ◽  
Resistance Training ◽  
Cancer Treatment ◽  
Cancer Patients ◽  
Exercise Intervention ◽  
Exercise Group ◽  
Moderate Intensity ◽  
Control Group ◽  
Breast Cancer Patients

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.

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

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.

scholarly journals Polyunsaturated Fatty Acids, Exercise, and Cancer-Related Fatigue in Breast Cancer Survivors

2021 ◽  
Vol 12 ◽  
Author(s):  
Yutaka Matsuoka ◽  
Katsunori Tsuji ◽  
Eisuke Ochi
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Exercise Group ◽  
Control Group ◽  
Omega 3 ◽  
Pufa Supplementation ◽  
Exercise Interventions ◽  
Cancer Related Fatigue ◽  
Omega 6

Cancer-related fatigue (CRF) is one of the most frequently reported and disabling symptoms in cancer survivors. With its negative impact on the activities of daily living, work, social activities, and mood, CRF causes severe impairment of quality of life. A previous study showed that omega-6 polyunsaturated fatty acid (PUFA) supplementation unexpectedly reduced CRF compared with omega-3 PUFA supplementation and that omega-6 PUFA supplementation reduced pro-inflammatory serum markers in fatigued American breast cancer survivors. Meanwhile, a recent meta-analysis of individual patient data revealed significant benefits of exercise interventions on CRF. Recently, we completed our randomized controlled trial among early-stage Japanese breast cancer survivors, in which we examined the effect of baseline blood PUFA characteristics on change in CRF during the 12-week trial by exercise group and confirmed that increased Cancer Fatigue Scale (CFS) was associated with both docosahexaenoic acid (DHA) (p = 0.06) and omega-3 index (p = 0.08) at baseline in all participants (n = 46, omega-6/omega-3 ratio = 6.79, SD = 1.90). On the contrary, DHA at baseline was positively correlated with change in CRF (r = 0.40, p = 0.06) in the control group (n = 24, omega-6/omega-3 ratio = 7.0). Moreover, eicosapentaenoic acid (EPA) at baseline was positively correlated with leg strength (r = 0.39, p = 0.10) in the exercise group. In conclusion, blood PUFA balance might be associated with the effect of exercise on CRF. In addition, higher EPA in individuals who conducted exercise likely has a beneficial effect on muscle strength. Further investigation is needed to clarify the interaction between PUFAs and exercise for alleviating CRF.

scholarly journals OR-052 Effects of Exercise Intervention on Cancer-Related Fatigue in Breast Cancer Survivors

2018 ◽  
Vol 1 (2) ◽  
Author(s):  
Zhiling Xie ◽  
Weibing Ye
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Aerobic Exercise ◽  
Breast Cancer Survivors ◽  
Exercise Intervention ◽  
Moderate Intensity ◽  
Control Group ◽  
Short Term ◽  
Cancer Related Fatigue ◽  
Significant Difference

Objective cancer-related fatigue(CRF) is the most commonly reported and most distressing symptom in cancer patient.The purpose of this study was to review the effect of exercise intervention on cancer-related fatigue in breast cancer survivors. Methods From 1998 to 2018 in Chinese and English literature of Wanfang Database, Pubmed, SportDiscus and Springer databases, picked out the randomized controlled trials which up to standard. Keywords cancer, exercise, fatigue, etc. were used for systematic search and tracking. 12 experiments were reviewed to analyze the effect differences between exercise intervention and exercise-related fatigue. Results Most interventions use aerobic exercise as the primary form of exercise. Generally, exercise interventions are effective for cancer-related fatigue, but some findings are not. Many studies have shown that moderate intensity aerobic exercise has a significant effect on cancer-related fatigue, with 50-70% heart rate reserve and 3-5 times of exercise per week for at least 30 minutes each time. Exercise methods mainly include walking, yoga, cycling and tai chi. Firstly, Supervised aerobic exercise was statistically more effective than conventional care in improving CRF among breast cancer survivors. It has been shown that group-based, supervised exercise produces positive psychosocial‘side-effects’ due to social interactions, improved self-efficacy, and attention from a trainer. Secondly, Cancer fatigue is divided into acute and chronic fatigue, 18 weeks of exercise intervention can reduce the short-term fatigue, at 36 weeks, baseline levels of fatigue index responses and contrast on the issue of the multivariate statistics. Thirdly, usual-care group were reported that they had been actively engaged in regular exercise before study enrollment. During the exercise intervention, most studies on the control ways are according to the daily life or to take care of, but studies have reported, before intervention, to a high level of 40% in the control group often exercise, exercise also as usual during the intervention, which causes the control to the baseline level is higher, but the intervention group and control group will be difference, no significant difference, lead to the result is invalid. Conclusions First, the exercise intervention of cancer-related fatigue needs to be supervised; second, the exercise intervention is effective for short-term cancer-related fatigue; third, the daily exercise level of the control group will affect the intervention effect.

scholarly journals Aerobic and Resistance Exercise Improves Reynolds Risk Score in Overweight or Obese Breast Cancer Survivors

2020 ◽  
Author(s):  
Kyuwan Lee ◽  
Nathalie Sami ◽  
Debu Tripathy ◽  
Wendy Demark-Wahnefried ◽  
Mary K. Norris ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cardiovascular Disease ◽  
Resistance Exercise ◽  
Cancer Survivors ◽  
Usual Care ◽  
Breast Cancer Survivors ◽  
Exercise Intervention ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Exercise Group

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

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