Abstract
BackgroundAdjuvant therapy may cause multiple sideeffects on long term health, including reduced cardiorespiratory fitness (CRF) in patients with breast cancer (1, 2). However, there is currently limited knowledge regarding the effect of different types of adjuvant cancer treatment on CRF in other cancer populations. The primary objective of the present study was to assess whether previously known correlates (age, diagnosis, initial CRF, physical activity level), type of adjuvant treatment and cancer-related fatigue were associated with changes in dot{V}{O}_2mathit{max} in patients with breast, prostate or colorectal cancer.MethodsProspective study with two time points of assessment, 85 patients scheduled for adjuvant cancer treatment were included. Cardiorespiratory fitness was assessed by dot{ V}{O}_2mathit{max} during a maximal incremental exercise test on a treadmill before start of adjuvant therapy and again six months later. Physical activity level was recorded with a physical activity monitor (Sense Wear™ Mini) at baseline as average minutes of moderate-to-vigorous intensity physical activity (MVPA) per day. Physical fatigue at baseline was reported using the Multidimensional Fatigue Inventory-20 questionaire.ResultsIn multivariate linear regression analysis, 30 min higher daily MVPA at baseline was associated with a 5% higher dot{V}{O}_2mathit{max} at six months follow up when adjusted for adjuvant treatment (P = 0.010). Patients receiving adjuvant chemotherapy had a mean decline in dot{V}{O}_2mathit{max} of 10% (− 19, − 1; 95% confidence interval) compared to patients receiving adjuvant endocrine treatment (P = 0.028). Adjuvant radiotherapy, fatigue, age and diagnosis were not significantly associated with changes in dot{V}{O}_2mathit{max} .ConclusionThe results of the present study indicate that adjuvant chemotherapy is associated with a subsequent reduction in dot{V}{O}_2mathit{max} in patients with cancer whereas MVPA before start of adjuvant treatment is positively associated with a higher dot{V}{O}_2mathit{max} after end of adjuvant treatment.
Highlights
Adjuvant therapy may cause multiple sideeffects on long term health, including reduced cardiorespiratory fitness (CRF) in patients with breast cancer (1, 2)
In a recent meta-analysis it is implied that CRF in patients with breast cancer decreases with approximately 10% during cancer treatment and that reduced CRF can be measured even seven years after end of chemotherapy treatment [7]
The results indicate that time spent in moderate-to-vigorous intensity physical activity (MVPA) before start of adjuvant treatment is associated with higher levels of V Oxygen uptake (O2) max six months later
Summary
Adjuvant therapy may cause multiple sideeffects on long term health, including reduced cardiorespiratory fitness (CRF) in patients with breast cancer (1, 2). The primary objective of the present study was to assess whether previously known correlates (age, diagnosis, initial CRF, physical activity level), type of adjuvant treatment and cancer-related fatigue were associated with changes in V O2 max in patients with breast, prostate or colorectal cancer. Althought cancer treatments have documented effects on survival, they can be invasive and toxic and cause multiple potential negative sideeffects on long term health including reduced physical functioning, impaired quality of life, chronic fatigue and reduced cardiorespiratory fitness (CRF) [1, 2]. In a recent meta-analysis it is implied that CRF in patients with breast cancer decreases with approximately 10% during cancer treatment and that reduced CRF can be measured even seven years after end of chemotherapy treatment [7]. Sufficient V O2 max is related to fewer toxic effects of radiotherapy, chemotherapy, and endocrine therapy on the cardiovascular system, respiratory system, and skeletal muscles [10,11,12,13,14,15], and higher physical activity level and daily functioning in patients with cancer [16]
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