Physical activity to maintain quality of life in breast cancer survivors in the Dutch Tamoxifen Exemestane Adjuvant Multicentre (TEAM) trial.

Abstract

Abstract Abstract #4089 Background: Lifestyle habits such as physical activity frequently change after a breast cancer diagnosis and may unfavorably affect quality of life (QoL) as well as breast cancer outcome.
 Patients and Methods: In the Lifestyle side study of the TEAM trial, lifestyle and QoL questionnaires were filled out at approximately one year after starting hormonal therapy (T1) and again one year later (T2). The T1 questionnaire also included a retrospective assessment of pre-diagnosis lifestyle. Level of recreational physical activity was assessed as time engaged in walking, bicycling, gardening, and sports. Intensity values (METs) were assigned to each activity. The overall level of recreational physical activity was calculated by summing the MET-hours/week of all activities. QoL was assessed using the EORTC C30 and BR23 questionnaires, supplemented with FACT-ES questions covering endocrine symptoms.
 Results: A total of 543 breast cancer patients returned the first questionnaire (response 73%), of whom 454 patients also returned the second questionnaire. Relatively high levels of pre-diagnosis recreational physical activity were observed (mean±SD: 10.4±8.0 hours/week), with approximately one hour per day spent on walking or cycling. The level of recreational physical activity decreased to 8.6±7.2 hrs/wk at T1 and was partly restored at T2 (mean±SD; 9.7±7.4 hrs/wk; p<0.01 for pre-diagnosis vs T1 and T1 vs T2).
 Individuals in the lowest quartile of physical activity at T1 had a significantly worse QoL at T1 with respect to the domains of physical functioning, role functioning and sexual functioning, as compared to individuals in highest quartile of physical activity (difference of 9-15 points on a 0-100 scale; p<0.01). Similarly, individuals with a decrease of ≥15 MET-hrs/wk (equivalent to 1 hr/day of moderate-intensity activities on 5 days of the week) from pre-diagnosis to T1 also had a significantly worse QoL at T1 with respect to physical and role functioning, as compared to individuals with stable levels of physical activity (difference of 12-15 points; p<0.01). The least active group and the individuals with a strong decrease in physical activity also scored worse on fatigue (difference of 15 points on a 0-100 scale; p<0.01).
 Overall, no clinically significant changes in QoL were observed from T1 to T2. However, individuals who increased their level of physical activity from T1 to T2 more frequently experienced improved physical functioning (p=0.03) and a decrease in fatigue (p=0.12).
 Conclusions: In this population of relatively active postmenopausal breast cancer patients, being physically active is associated with better QoL. The temporal sequence of changes in both physical activity and QoL needs to be further studied, since physical activity may affect QoL and vice versa. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 4089.