Abstract
Aerobic and resistance exercise during and after cancer treatment are important for health-related outcomes, however treatment-specific barriers may inhibit adherence. We explored the effect of lower-frequency exercise training on fitness, body composition, and metabolic markers (i.e. glucose and lipids) in a group of recently diagnosed breast cancer patients. Fifty-two females ≥ 18 years with stage I–IIIB breast cancer were instructed to attend 2 cardiovascular and strength training sessions/week over 12 weeks, but program length was expanded as needed to accommodate missed sessions. Pre- and post-intervention, we measured: (1) cardiovascular fitness, (2) isometric strength, (3) body composition (dual-energy X-ray absorptiometry), and (4) fasting glucose, insulin, c-peptide, and lipids. Pre-intervention, participants were 53 ± 10 years old (mean ± SD) and overweight (BMI: 27.5 ± 5.4 kg m−2, 40.1 ± 6.5% body fat). Forty participants completed the program over a median 20 weeks (range: 13–32 weeks, median frequency: 1.2 sessions/week), over which predicted VO2peak improved by 7% (2.2[0.1–4.4] mL/kg/min) (delta[95% CI]), and strength increased by 7–9% (right arm: 2.3[0.1–4.5] N m; right leg: 7.9[2.1–13.7] N m; left leg: 7.8[1.9–13.7] N m). Body composition and metabolic markers were unchanged. An exercise frequency of 1.2 sessions/week stimulated significant improvements in fitness, and may represent a practical target for patients during active treatment.
Highlights
Aerobic and resistance exercise during and after cancer treatment are important for health-related outcomes, treatment-specific barriers may inhibit adherence
Fifty-two (36%) out of 143 eligible individuals referred to University of Waterloo (UW) START-FIT
In this proof-of-concept single-arm study, we examined the effectiveness of a flexible exercise program, consisting of 24 sessions of combined exercise training with a targeted frequency of 2 sessions per week, on cardiovascular fitness and strength in a group of biological females with recently diagnosed breast cancer
Summary
Aerobic and resistance exercise during and after cancer treatment are important for health-related outcomes, treatment-specific barriers may inhibit adherence. Exercise training prevents deleterious changes in body composition (fat gains and lean tissue losses)[11,12,13,14,15,16], and may help preserve metabolic health during t reatment[17] Based on this body of work, an international panel of experts has recently issued exercise guidelines for cancer patients and survivors[9]. To reduce fatigue as well as optimize physical function and quality-of-life post-diagnosis, the expert panel recommends 8–12 weeks of: (1) ≥ 30 min of moderate-intensity aerobic exercise 3 times per week, and (2) moderate-intensity resistance training (8–15 repetitions for ≥ 2 sets) 2 times per week These guidelines are based on evidence from tightly controlled efficacy (vs effectiveness) studies[18], and the panel acknowledges that individual patient needs may necessitate fewer weekly exercise sessions. Since most studies prescribe frequency-based exercise with firm end-dates, the physiological effects of a flexible patient-oriented exercise program are unclear
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