Factors Influencing Quality of Life in Breast Cancer Survivors Before Beginning Exercise and Recreation Therapy

Abstract

Cancer patients who have undergone treatment often experience negative changes in physical and psychological function; all of which may influence quality of life (QoL). Understanding the degree of impact of various physiological and psychological parameters on a cancer survivor's QoL is of fundamental importance when designing individualized rehabilitation programs. PURPOSE: To investigate how select physiological and psychological parameters may influence QoL in a group of breast cancer survivors prior to enrollment in a combined exercise and recreation therapy rehabilitation program. METHODS: Seventy-nine women diagnosed with stages I-III breast cancer who had completed major treatment within 6 months underwent physiological and psychological testing upon enrollment in the rehabilitation program. Physical and psychological parameters included Aerobic Fitness (VO2max) using the Modified Bruce submaximal treadmill protocol, Percent Body Fat (%BF) via skinfolds, Total Physical Activity (MET-minutes per week) using the International Physical Activity Questionnaire (IPAQ) short form, Fatigue using the Revised Piper Fatigue Scale, and Depression using the Center for Epidemiological Studies Depression Scale (CES-D), NIMH. QoL was measured using the Functional Assessment of Cancer Therapy-Breast (FACT-B). The associations between VO2max, %BF, Total Physical Activity, Fatigue, Depression, and QoL were examined using Pearson correlations and multiple linear regression models. RESULTS: Fatigue was negatively associated with QoL (r = -0.702; p < 0.0005) as was Depression (r = -0.654; p < 0.0005). When examining multiple linear regression models characterizing the effects of all select physiological and psychological parameters on QoL, only Fatigue and Depression significantly affected QoL (r2=0.638; unstandardized Beta weights = -4.496 and -0.852 respectively; p < 0.0005). CONCLUSIONS: Fatigue and Depression appear to have the most influence on QoL in breast cancer survivors who have recently completed major cancer treatment. Therefore, rehabilitation programs aimed at improving overall QoL in this cancer population should encompass both physical and psychological improvement strategies. Supported by the Lineberger Comprehensive Cancer Center UCRF