Abstract
BackgroundThere is limited knowledge regarding the potential benefits of physical activity in patients with metastatic breast cancer.ObjectiveThe Advanced stage Breast cancer and Lifestyle Exercise (ABLE) Trial aimed to assess the feasibility of a physical activity intervention in women with metastatic breast cancer and to explore the effects of physical activity on functional, psychological, and clinical parameters.MethodsThe ABLE Trial was a single-arm, 6-month intervention study with a home-based, unsupervised, and personalized walking program using an activity tracker. At baseline and 6 months, we assessed anthropometrics, functional fitness, physical activity level, sedentary behavior, quality of life, fatigue, and tumor progression. Paired proportions were compared using the McNemar test and changes of parameters during the intervention were analyzed using the Wilcoxon signed-rank test, the Mann-Whitney test, and Spearman rank correlations.ResultsOverall, 49 participants (mean age 55 years; recruitment rate 94%) were enrolled and 96% adhered to the exercise prescription (attrition rate 2%). Statistically significant improvements in the 6-minute walking distance test (+7%, P<.001) and isometric quadriceps strength (+22%, P<.001), as well as decreases in body mass index (-2.5%, P=.03) and hip circumference (-4.0%, P<.001) were observed at 6 months. Quality of life remained stable and a nonstatistically significant decrease (-16%, P=.07) in fatigue was observed.ConclusionsThe high recruitment and adherence rates suggest the willingness of patients with metastatic breast cancer to participate in a physical activity program. The beneficial outcomes regarding physical fitness and anthropometry of this unsupervised physical activity program may encourage these patients to maintain a physically active lifestyle. Future randomized controlled trials with larger sample sizes are warranted.Trial RegistrationClinicalTrials.gov NCT03148886; https://clinicaltrials.gov/ct2/show/NCT03148886
Highlights
Metastatic breast cancer remains an incurable disease, but treatments help maintain or improve quality of life and prolong overall survival through the control of symptoms [1,2,3]
The high recruitment and adherence rates suggest the willingness of patients with metastatic breast cancer to participate in a physical activity program
There is limited knowledge regarding the potential benefits of physical activity in patients with metastatic breast cancer despite patients’ needs and their desires to engage in exercise [9,10]
Summary
Metastatic breast cancer remains an incurable disease, but treatments help maintain or improve quality of life and prolong overall survival through the control of symptoms [1,2,3]. A decrease in quality of life in patients with metastatic breast cancer between 2005 and 2015 has been reported [4]. Several domains of quality of life are affected from the time of diagnosis, with a decrease in physical, social, and role functioning and an increase in symptom burden, such as insomnia, fatigue, and pain, that deteriorate in advanced and palliative cancer [5]. In early-stage breast cancer, physical activity has been shown to reduce fatigue and side effects of treatments, increase quality of life, and limit physical deconditioning [6,7,8]. There is limited knowledge regarding the potential benefits of physical activity in patients with metastatic breast cancer despite patients’ needs and their desires to engage in exercise [9,10]. There is limited knowledge regarding the potential benefits of physical activity in patients with metastatic breast cancer
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