Exercise In Breast Cancer Survivors Research Articles

PERCEIVED EXERCISE BELIEFS AND BARRIERS AMONG BREAST CANCER SURVIVORS: A DESCRIPTIVE CROSS-SECTIONAL STUDY

Since the importance of the benefit of physical activity and exercise has been understood especially for cancer patients, efforts are taken to assess belief in exercise to adapt patients to a more physically active environment to create a sustainable health outcome. Thus, this study aimed to assess exercise beliefs and barriers by using a validated metric tool (Exercise Beliefs/Barriers Scale-EBBS) to evaluate beliefs in exercise in breast cancer survivors (BCS). In addition, it was also aimed to assess the relationships among EBBS, sociodemographic, and clinical variables of BCS. A total of 112 BCS were screened and invited to participate in this study. Clinical (type of surgery, adjuvant treatments, etc.), demographic data (age, medication use, etc.), and total sitting time were collected through a simple data form and 7th of the International Physical Activity Questionnaire-Short Form (IPAQ-SF), respectively. All patients were requested to fill out EBBS.96 BCS completed this study. Weak but significant correlations were found between time spent after surgery and perceived belief (r=. -273, p=0.009), and perceived barriers (r=-.239, p=0.022), respectively. Perceived barriers were also significantly correlated with age (r=-.212, p=0.042). No significant effects of the type of breast surgery and axillary procedure as well as medications (Tamoxifen) on perceived beliefs and barriers were found. Factors should be thoroughly investigated to provide a sustainable exercise behavior among BCS. Older BCS should be thoroughly monitored to gain regular exercise behavior. This study also highlighted the emerging need for sensitive, specific, and focused tools to assess beliefs in exercise among the cancer population.

A home-based lifestyle intervention program reduces the tumorigenic potential of triple-negative breast cancer cells

Translational research for the evaluation of physical activity habits and lifestyle modifications based on nutrition and exercise has recently gained attention. In this study, we evaluated the effects of serum samples obtained before and after a 12-week home-based lifestyle intervention based on nutrition and exercise in breast cancer survivors in terms of modulation of the tumorigenic potential of breast cancer cells. The home-based lifestyle intervention proposed in this work consisted of educational counselling on exercise and nutritional behaviors and in 12 weeks of structured home-based exercise. Triple-negative breast cancer cell line MDA-MB-231 was cultured in semi-solid medium (3D culture) with sera collected before (PRE) and after (POST) the lifestyle intervention program. Spheroid formation was evaluated by counting cell colonies after 3 weeks of incubation. Results show a slight but significant reduction of spheroid formation induced by serum collected POST in comparison to those obtained PRE. Moreover, statistical analyses aimed to find physiologic and metabolic parameters associated with 3D cell proliferation revealed the proliferative inducer IGF-1 as the only predictor of cell tumorigenic potential. These results highlight the importance of lifestyle changes for cancer progression control in a tertiary prevention context. Translational research could offer a useful tool to identify metabolic and physiological changes induced by exercise and nutritional behaviors associated with cancer progression and recurrence risk.

Effectiveness of home-based exercise in breast cancer survivors: a randomized clinical trial

BackgroundBreast cancer patients are recommended to engage in regular exercise. In developing countries, where there is a lack of facilities to offer specialized, supervised exercise for this population, regularly exercising might be a challenge. We aimed to evaluate the effectiveness of a home-based intervention in this population.MethodsBreast cancer survivors were randomly assigned to either the home-based exercise program or the usual care group. Exercise intervention included walking, balance, and stretch exercises, along with weekly follow-up telephone calls. Quality of life (QOL) was evaluated using EORTC QLQ-C30 and EORTC QLQ-BR23 questionnaires and the predicted VO2 peak was measured using the Ebbeling submaximal treadmill test.ResultsEighty-nine patients were enrolled in the study. Reported minutes of exercise gradually increased from 40.7 min per week in week 1 to 116.9 min per week in week 12. This intervention improved global QOL (P = 0.001), social functioning (P = 0.04), and the predicted VO2 peak (P = 0.01).ConclusionThis home-based exercise regime effectively increased quality of life and physical activity levels.Trial registryIranian Registry of Clinical Trials identifier: IRCT20140810018746N1, prospectively registered 08/01/2018, https://en.irct.ir/trial/27959.

267P Ultrasound-guided injection with or without rehabilitation exercise in breast cancer survivors with subacromial-deltoid bursitis: Long-term results of a pilot randomized clinical study

267P Ultrasound-guided injection with or without rehabilitation exercise in breast cancer survivors with subacromial-deltoid bursitis: Long-term results of a pilot randomized clinical study

Abstract P5-08-08: Ultrasound-guided injection with or without rehabilitation exercise in breast cancer survivors with sub-acromion-deltoid bursitis: a pilot randomized clinical study

Abstract BACKGROUND: Due to the increasing overall survival of breast cancer (BC) patients, a growing interest has been raised in the current literature on disabling consequences of cancer and its treatment [1,2]. In particular, after radical surgery for BC, patients might frequently be affected by functional limitation of the shoulder joint, potentially related to the immobilization, surgical scar tensions, axillary web syndrome, subpectoral prostheses or expanders, or peripheral nerve damage [3]. In this scenario, several challenges are still open in the therapeutic approach to this disabling condition and the optimal management of shoulder dysfunction in breast cancer patients is far from being fully characterized. Therefore, the aim of this study was to assess the effects of a comprehensive rehabilitation program including ultrasound-guided injection of the sub-acromion deltoid bursa (SAD) followed by a rehabilitation exercise protocol in terms of feasibility, pain relief, upper limb function, quality of life, and safety. METHODS: In this study, we recruited consecutive breast cancer women referring to a Physical Medicine and Rehabilitation in Northern Italy and suffering from SAD bursitis in the absence of tendon lesions. Patients were assessed for eligibility and subsequently randomly assigned 1:1 to two groups. Group A received ultrasound-guided percutaneous injection of the SAD bursa (lidocaine and triamcinolone acetate) followed by a rehabilitation exercise program of 5 sessions lasting 1 hour each., while Group B received ultrasound-guided percutaneous injection only. Patients were assessed at baseline (T0), after a week (T1), and after 3 months (T2). The outcomes were numerical pain rating scale (NPRS), handgrip strength (HGS) test, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), the Oxford Shoulder Score (OSS), Global Perceived Effect (GPE), and safety. RESULTS: Thirty-seven patients were enrolled and randomly assigned to Group A (n=19; mean age: 56.05 ± 10.30 years; body mass index (BMI): 23.58 ± 2.79 kg/m2) and Group B (n=18; mean age: 58.39 ± 12.09 years; BMI: 22.72 ± 3.16 kg/m2). No major or minor adverse events were reported after this multidisciplinary intervention. Statistically significant within-group differences were found in both groups in terms of NPRS after the treatment (p < 0.05) and after the follow-up (p < 0.05). The between-group analysis showed significant differences in pain intensity (NRS: 2.16 ± 1.39 vs 4.78 1.77; p < 0.05), isometric muscle strength (25.11 3.20 vs 20.33 4.92; p< 0.001), shoulder function (OSS: 17.00 3.27 vs 33.11 6.471; p< 0.0001), and EORTC QLQ-C30 (Functional subscale: 88.74 7.71 vs 77.67 13.64; p=0.017; Symptom subscale: 11.43 8.56 vs 19.61 13.72; p=0.048; Global Health subscale: 79.36 13.72 vs 70.56 8.26; p=0.022) of the after the follow-up. However, no significant differences (p > 0.05) were reported at T1. CONCLUSION: Our findings showed that a comprehensive rehabilitation approach including ultrasound-guided injection combined with rehabilitation exercise might be safe, well-tolerated, and effective in breast cancer patients with SAD bursitis. These data emphasized the positive role of an interdisciplinary rehabilitation management in pain management and improving overall well-being of breast cancer patients. Further studies with larger samples and longer follow-ups are needed to confirm our data. REFERENCES: 1. Nardin S et al. Breast Cancer Survivorship, Quality of Life, and Late Toxicities. Front Oncol 2020, 10, 864. 2. D’Egidio V et al. Counseling interventions delivered in women with breast cancer to improve health-related quality of life: a systematic review. Qual Life Res 2017, 26, 2573-2592, doi:10.1007/s11136-017-1613-6. 3. Hidding JT et al. Treatment related impairments in arm and shoulder in patients with breast cancer: a systematic review. PLoS One. 2014 May 9;9(5):e96748. Citation Format: Lorenzo Lippi, Alessandro de Sire, Arianna Folli, Francesco D’Abrosca, Alessio Turco, Giuseppina Bonizzi, Nicola Fusco, Marco Invernizzi. Ultrasound-guided injection with or without rehabilitation exercise in breast cancer survivors with sub-acromion-deltoid bursitis: a pilot randomized clinical study [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P5-08-08.

Impact of Physical Rehabilitation on Bone Biomarkers in Non-Metastatic Breast Cancer Women: A Systematic Review and Meta-Analysis.

Rehabilitation might improve bone health in breast cancer (BC) patients, but the effects on bone biomarkers are still debated. Thus, this meta-analysis of randomized controlled trials (RCTs) aims at characterizing the impact of rehabilitation on bone health biomarkers in BC survivors. On 2 May 2022, PubMed, Scopus, Web of Science, Cochrane, and PEDro were systematically searched for RCTs assessing bone biomarker modifications induced by physical exercise in BC survivors. The quality assessment was performed with the Jadad scale and the Cochrane risk-of-bias tool for randomized trials (RoBv.2). Trial registration number: CRD42022329766. Ten studies were included for a total of 873 patients. The meta-analysis showed overall significant mean difference percentage decrease in collagen type 1 cross-linked N-telopeptide (NTX) serum level [ES: -11.65 (-21.13, -2.17), p = 0.02)] and an increase in bone-specific alkaline phosphatase (BSAP) levels [ES: +6.09 (1.56, 10.62). According to the Jadad scale, eight RCTs were considered high-quality studies. Four studies showed a low overall risk of bias, according to RoBv.2. The significant effects of rehabilitation on bone biomarkers suggested a possible implication for a precision medicine approach targeting bone remodeling. Future research might clarify the role of bone biomarkers monitoring in rehabilitation management of cancer treatment induced bone-loss.

181P A randomized controlled trial on the efficacy of supervised exercise training in reducing IGF-1 levels in breast cancer survivors of the Movis’ cohort

The main hypothesis on the positive effects of exercise in oncological patients has been focusing on lowering the basal systemic levels of cancer risk factors such as insulin-like growth factor-1 (IGF-1) and its binding proteins (IGFBP). However, there is a paucity of data and a remarkable heterogeneity when considering the response of the IGF-1 system to exercise in breast cancer survivors (BCS). In this study we tested the hypothesis that aerobic exercise training might normalize the IGF-1 system in BCS patients with normal to high level of IGF-1. Non physically active BCS women (n=30, age 52.7 ± 7.6 years), enrolled in the MoviS ‘Movement and Health Beyond Care’ study (clinicaltrial.gov identifier: NCT04818359), at high metabolic and hormonal risk of BC recurrences performed 3-month aerobic training (2 d/week of supervised and 1 d/week of unsupervised exercise) with increase of exercise intensity (40-70% HRR) and duration (20-60 min). Circulating IGF-1 and IGFBP3 levels were measured before and after the intervention. VO2max increased by 10.1 % (mL·min-1·kg−1: before=30.7±5.7, after=33.4±6.8; p<0.001) while body mass index (kg/m2: before=26.0±5.0, after=25.5±4.7; p=0.035), glycemia (mg/dL: before=100.8±11.4, after=91.7±11.0; p<0.001) and insulin resistance (HOMA-IR score: before =2.07±1.54, after =1.53±1.11; p=0.005) decreased after training. Mean IGF-1 level did not change after training (ng/mL: before=164.3±70.9, after=166.8±57.6) while IGFBP3 level decreased (μg/mL: before=6.1±1.4, after=4.2±1.5). There was a negative correlation between pre-training IGF-1 levels and individual changes in IGF-1 after training (r=- 0.62, p<0.001). Accordingly, the IGF-1 coefficient of variation (CV) decreased after training (%: before=43.2, after=34.5). Finally, the correlation between IGF-1 and IGFBP3 levels was reduced after training (r: before=0.74, after 0.45, p<0.001). The exercise intervention modulates the IGF-1 system lowering the circulating IGF-1 variability, the IGFBP3 level and the relationship between IGF-1 and IGFBP3 among BCS patients.

Abstract P4-10-21: High-intensity interval training in breast cancer survivors: A systematic review

Abstract Background: To review the settings and outcomes of high-intensity interval training (HIIT) interventions for breast cancer survivors, and to explore the feasibility of prescribing exercise for breast cancer survivors. Methods: A systematic search of electronic databases was conducted for studies published up to May 31, 2020. Eligibility criteria included randomized controlled trials of HIIT intervention in breast cancer survivors. Studies were grouped by whether the intervention was conducted during or after breast cancer treatment, and intervention methods and outcomes were reviewed within each group. Results: Twenty-six studies were identified, and 13 satisfied the inclusion criteria. Intervention was conducted during treatment in 8 studies, and after treatment in 5. Intervention duration ranged from 3 to 16 weeks, with 2 or 3 sessions per week, for a total of 9 to 36 sessions. All interventions were supervised; 12 were lab-based, and 1 was community-based. One of most promising outcomes was improvement of cardiorespiratory fitness by HIIT. Conclusion: This review found that all studies on HIIT for breast cancer survivors investigated lab-based, supervised interventions, but not home-based or unsupervised. HIIT is a time-efficient method for increasing cardiovascular function in breast cancer survivors, but further research is necessary to determine its effects on other outcomes. Table 1.Characteristics of the included studies with intervention during treatmentStudySample sizeDuration and frequency (total times)ModeIntensityInterval and recovery durationsSupervised. OR. UnsupervisedLab-based. OR. Home and community-basedLee et al.308 weeks, 3×/week (24)Cycle ergometer90% Peak Power Output7×1 min cycling, 2 min active recovery, total 19 minSupervised by exercise trainerLab-basedMijwel et al.18216 weeks, 2×/week (32)Cycle ergometer16-18 RPE3×3 min cycling, 1 min passive recovery, total 11 minSupervised by exercise physiologist or oncology nurseLab-basedMijwel et al.2316 weeks, 2×/week (32)Cycle ergometer16-18 RPE3×3 min cycling, 1 min passive recovery, total 11 minSupervised by exercise physiologist or oncology nurseLab-basedMijwel et al.20616 weeks, 2×/week (32)Cycle ergometer16-18 RPE3×3 min cycling, 1 min passive recovery, total 11 minSupervised by exercise physiologist or oncology nurseLab-basedSchulz et al.166 weeks, 2×/week (12)Cycle ergometer85-100%VO2peak10×1 min cycling, 1 min load-less recovery, total 19 minSupervised by professionalLab-based Table 2.Characteristics of the included studies with intervention after treatmentStudySample sizeDuration and frequency (total times)ModeIntensityInterval and recovery durationsSupervised . or . UnsupervisedLab-based. or. Home and community-basedAlizadeh AM et al.5212 weeks, 3×/week (36)Treadmill90-95% HRmax4×4 min running, 3 min passive recovery, total 25 minSupervised by exercise physiologistLab-basedAlizadeh S et al.8012 weeks, 3×/week (36)Treadmill90-95% HRmax4×4 min running, 3 min passive recovery, total 25 minSupervised by exercise physiologistLab-basedNorthey et al.1712 weeks, 3×/week (36)Cycle ergometerMaximal effort4×30 s, 2 min rest, total 10 minSupervised, supervisor not describedLab-basedDolan et al.336 weeks, 3×/week (18)TreadmillInitial: 65% VO2peak, Interval 50% VO2peak. Last: 95% VO2peak, Interval: &amp;lt; 60% VO2peakFirst week: 4-6×4 min, 3 min interval, total 25-39 min. last week: 4-6×2 min, 2 min interval, total 25-39 minSupervised, supervisor not describedLab-based Citation Format: Katsunori Tsuji, Yutaka J Matsuoka, Eisuke Ochi. High-intensity interval training in breast cancer survivors: A systematic review [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P4-10-21.

Systematic review of the effect of aquatic therapeutic exercise in breast cancer survivors.

Aquatic therapeutic exercise can be equally effective or even superior to land-based exercise in improving several clinical variables. However, there is still a lack of knowledge on the effects compared to land-based interventions particularly in breast cancer (BC) patients. The objective of this study is to examine the effects of aquatic therapeutic exercise on pain, shoulder mobility, lymphedema, cardiorespiratory fitness, muscle strength, body composition, pulmonary function, cancer-related fatigue (CRF) and health-related quality of life (HRQoL) and which parameters are effective compared to similar land-based interventions. The databases used were PubMed, Scopus, Web of Science, Cochrane Library and CINAHL, retrieving 145 articles. Eleven studies were included. Aquatic therapeutic exercise is feasible, safe, well tolerated and achieved high percentages of adherence. As for the assessed outcomes, moderate to large improvements were found compared to usual care or to land-based physical exercise interventions in pain, shoulder range of motion, pulmonary function, HRQoL, cardiorespiratory fitness and muscle strength. Inconclusive results were found for lymphedema, body composition and CRF. Aquatic therapeutic exercise interventions using a combination of endurance, strength, mobility, stretching and breathing exercises resulted in improvements in common side effects of BC and its treatments. More studies on CRF, body composition and lymphedema need to be done to further evaluate the impact of the intervention on these outcomes.

Appetite and Exercise in Breast Cancer Survivors

Appetite and Exercise in Breast Cancer Survivors

Benefits of Aerobic Exercise for Breast Cancer Survivors: A Systematic Review of Randomized Controlled Trials.

Background:Physical exercise may be beneficial to breast cancer (BC) survivors. Here, we systematically summarized the effects of aerobic exercise in BC survivors. We conducted a systematic review of randomized controlled trials (RCTs). Methods:We searched PubMed, Web of knowledge, Scopus, Cochrane Central, Virtual Health Library and PEDRO databases for relevant RCTs, comparing aerobic exercise with usual care among BC survivors. Data were extracted and evidence was synthesized narratively. Results:Twelve studies were included in this systematic review. Studies reported that aerobic exercise can significantly improve the quality of life in BC survivors. Moreover, aerobic exercise alleviated the symptoms of depression and anxiety. However, current evidence from the included studies showed that there was no significant benefit for aerobic exercise in terms of weight loss. Conclusion: Our study suggests that aerobic exercise is beneficial to BC survivors. Clinical Relevance:Aerobic exercise should be recommended in the therapeutic and rehabilitative regimens of BC survivors.

Differences by Activity Level in Barriers and Benefits of Exercise in Breast Cancer Survivors

Physical activity is a critical component of treatment for breast cancer survivors that prevents additional cancer recurrence, comorbid chronic disease and body composition changes. However, recommended physical activity guidelines are rarely met. PURPOSE: This study examined how barriers and benefits of exercise differ between breast cancer survivors who are not engaging in any moderate or vigorous physical activity, those doing physical activity but not meeting physical activity guidelines, and those meeting recommended physical activity guidelines. METHODS: 392 breast cancer survivors were recruited through the Susan Love/Army of Women, a national non-profit breast cancer organization, and completed the Exercise Barriers and Benefits Survey, the International Physical Activity Questionnaire and questions on resistance exercise activities. RESULTS: Multivariate ANOVAs examined whether exercise groups differed in types of exercise benefits and barriers they reported. 267 of the women (69.6%) did not meet recommended guidelines (150 minutes/week of aerobic activity and twice per week resistance exercise). The greatest perceived benefits were for physical performance and the lowest were for social interaction. There were significant differences between groups on benefits (F= 18.981; df = 2, 16; p=.000; ŋ2=.090). Exercise benefits were not significantly different between the some exercise and exercise guidelines groups. The greatest perceived barriers were for physical exertion and the lowest were for the exercise milieu. There were significant differences between groups on barriers (F= 54.807; df = 2, p=.000; ŋ2=.222). The some exercise group had significantly higher barriers than the exercise guidelines group (p=.047). CONCLUSIONS: Despite recommendations, the majority of breast cancer survivors do not meet physical activity guidelines. Understanding which barriers and benefits are relevant to different groups of exercisers is an important avenue to prescribing exercise in an at risk population. Personalized approaches may promote exercise initiation in those not currently exercising; while targeting different barriers may help those already exercising to meet recommended physical activity guidelines. Supported by Robert E. Leet and Clara Guthrie Patterson Trust (PI: Thomas)

Hypothalamic‐Pituitary‐Adrenal Axis Responses to an Acute Bout of Moderate Intensity Aerobic Exercise in Breast Cancer Survivors

The purpose of this investigation was to examine the effect of one 30‐minute bout of moderate intensity aerobic exercise on hypothalamic‐pituitary‐adrenal (HPA) axis hormone responses in women with and without a history of breast cancer. Study participants included 21 women between the ages of 40–75 years, 11 of whom had completed treatments for Stage I–III invasive breast cancer (breast cancer survivors) and 10 of whom did not have a history of cancer diagnosis or treatment (controls). Participants completed a 30‐minute session of aerobic exercise on the cycle ergometer at a workload corresponding to 60% of VO2peak. Blood samples were taken pre‐exercise, immediately post‐exercise, and 30 minutes post‐exercise. Plasma concentrations of corticotropin releasing hormone (CRH), adrenocorticotropic hormone (ACTH), and cortisol were measured at each time point using enzyme‐linked immunosorbent assay (ELISA) techniques (Biotang, Inc., Lexington, MA). Data were compared between groups using Mann‐Whitney U tests and across time using Wilcoxon Signed‐Rank tests. Physical characteristics (e.g. age, height, body mass, BMI, percent body fat and VO2peak) were similar between breast cancer survivors and controls (56 ± 8 years vs. 56 ± 7 years; 163.1 ± 5.3 cm vs. 165.7 ± 5.7 cm; 66.8 ± 9.9 kg vs. 77.0 ± 19.0 kg; 25.1 ± 4.1 kg/m2 vs. 28.1 ± 7.3 kg/m2; 31.1 ± 5.3% vs. 33.4 ± 6.6%; and 21.7 ± 6.8 mL/kg/min vs. 24.3 ± 9.8 mL/kg/min, respectively; p = 0.193–0.973). Cortisol was somewhat elevated immediately post‐exercise in breast cancer survivors relative to controls (Table 1, p = 0.085). CRH decreased significantly at 30 minutes post‐exercise relative to immediately post‐exercise values in breast cancer survivors (Table 1, p= 0.003). ACTH decreased somewhat at 30 minutes post‐exercise relative to immediately post‐exercise values in both groups (p = 0.091 and 0.059 for breast cancer survivors and controls, respectively). All other CRH, ACTH, and cortisol responses were similar between groups and across time (p = 0.114–0.929). These results suggest that one 30‐minute session of moderate intensity aerobic exercise has largely similar effects on hormonal responses of the HPA axis in women with and without a history of breast cancer. These preliminary findings continue to demonstrate that moderate aerobic exercise is well tolerated in breast cancer survivors, thus supporting current exercise recommendations for this population.Support or Funding InformationThis work was supported by Elon University Faculty Research and Development funds.This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Comparative Study of Aerobic Exercise and Weight training on Metabolic Syndrome among Breast Cancer Survivors

Introduction: Breast cancer is the most frequent-occurring cancer among women and the leading cause deaths. Despite this Breast cancer treatments still have side effects that may negatively impact recovery and quality of life (QOL) after initial treatments. BCRL is a chronic swelling of the arm, hand and associated trunk quadrant. It usually develops after damage to the axillary lymph nodes due to breast cancer therapies. Methods: Participants who had fulfilled the eligibility criteria were randomized to either the aerobic exercise group (n = 20) and weight training group (n = 20). Exercise program was divided into a warm-up period, moderate intensity of aerobic exercises, and cool-down period. Weight-training exercise of low to moderate intensity with relatively slow progression significantly improved the upper limb strength, lower limb strength and incidence of breast cancer-related lymphoedema. Outcomes were assessed at baseline and post intervention. Results: Outcome were assessed by the functional assessment of cancer therapy-breast (FACT-B) scale and 6 min walk test (6MWT) Depressive symptoms are assessed using the CES-D scale. Upper limb musculoskeletal disorders is assessed using the DASH (Disabilities of the Arm, Shoulder, and Hand) The results confirmed the hypothesis that 12 week of moderate-intensity aerobic exercise program significantly reduces BCRL. Conclusion: There have been many studies of resistance exercise in breast cancer survivors, Findings of this trial revels that aerobic exercise will contribute to the reduction of metabolic syndrome in best cancer survivors.

Clinicians Should Actively Promote Exercise in Survivors of Breast Cancer

Breast cancer is the most common cancer affecting women, causing 29% of all female cancers and afflicting 14% of all female cancer-related deaths worldwide. It remains a significant clinical, psychological, and financial burden. Exercise has been suggested to reduce cancer recurrence and cancer-related mortality from research in the past decade. Recent American and European guidelines advise on exercise for breast cancer survivors, not only to improve quality of life and decrease fatigue, but also to aid in decreasing recurrence and improve breast cancer related mortality. Nonetheless, adherence to guidelines remains low, with lack of awareness and fatigue related to chemotherapy as the most common barriers. It remains to be elucidated whether a particular type of exercise, or whether group or individualized activity is most effective. The importance of exercise in avoiding recurrence and improving quality of life needs to be recognized and taken into account in the management of breast cancer survivors. Further patient awareness and education is essential towards this goal, and the role of group exercise should be further explored.

Short-term Effectiveness Of Home Based Exercise To Change Lifestyle In Not Communicable Disease

PURPOSE: Supervised exercise has shown remarkable effectiveness, but is associated to poor compliance at long term. In this study, we aimed to verify whether a home-based exercise program is effective in physical fitness related to health parameters management of a cohort of breast cancer survivors. METHODS: Experimental cohort observational study. We enrolled 13 women (age 49.1±5.5, height 163±7.3 cm) survivors to a breast cancer. At baseline were assessed the lifestyle in term of physical activity with accelerometer (Sensewear Bodymedia) and physical fitness related to health in term of aerobic capacity by 6 Minutes Walking Test (6MWT), flexibility (Sit & Reach), grip and lower limbs strength (Hand Grip and 30” Chair Test) and body composition (anthropometrics parameters, skinfold thickness and bio impedance). Home based exercise was prescribe for 40 days with two target: - Fast walking activity in terms of weekly session, minutes per session and intensity with heart rate, rate of perceived exertion (CR10) and steps per minute; - Individually daily steps target Parameters of physical fitness related to health before and after 40 days of unsupervised exercise were compared (t-test for paired data). RESULTS: At baseline (T0), patients displayed a moderate level of physical activity (PAL=1.5±0.1, daily steps=8569.3±2107.1) and were overweight (BMI=26.5±3.6 kg/m2). After 40 days of unsupervised exercise (T1), we observed improvement of all analyzed parameters with statistical significance in waist circumference (T0=92.4±8.5 cm, T1=89.5±7.9 cm; p<0.01), distance walked in 6 MWT (T0445.4±168.1 m, T1=534.6±151.5 m; p<0.05), 30 ‘’ Chair test (T0=14.8±5.6 rep, T1=16.3±4.9 rep; p<0.05). CONCLUSION: Home-based unsupervised exercise in breast cancer survivors yielded short-term efficacy in all analyzed parameters. To change the lifestyle in terms of physical activity it is necessary to create a model that allows long-term therapeutic efficacy. Unsupervised approach, in comparison with supervised one, allow a reduction of the cost related to the treatment of not communicable disease with exercise therapy. Efficacy at long-term and a possible effect in reducing the risk of tumor relapse remain to be elucidated in larger cohorts with longer and multidisciplinary follow up.

Active lifestyle promotion with home-based exercise in breast cancer survivors

Background: In cancer survivors, quality of life, weight management and physical activity levels are growing areas of interest, also considering such parameters may offer protection to cancer recurrence. Research question: In this study we aimed to objectively verify whether an home-based exercise program is effective in weight management of a cohort of breast-cancer survivors. Type of study: Experimental cohort observational study. Methods: We enrolled 13 women (age 49.1±5.5, height 163±7.3 cm) and evaluated habitual physical activity levels. Afterwards we compared the baseline aerobic capacity by 6 Minutes Walking Test (6MWT), flexibility, grip and lower limbs strength and body composition, to the same parameters measured after 40 days of unsupervised exercise. Results: At baseline (T0), patients displayed a moderate level of physical activity and were overweight. After 40 days of unsupervised exercise (T1), we observed improvement of all analyzed parameters with statistical significance in waist circumference (T0=0.57±0.1 cm, T1=0.55±0.1 cm; p<0.01), distance walked in 6 MWT (T0445.4±168.1 m, T1=534.6±151.5 m; p<0.05), 30 '' Chair test (T0=14.8±5.6 rep, T1=16.3±4.9 rep; p<0.05). Conclusions: Home-based unsupervised exercise in breast-cancer survivors yielded short-term efficacy in all analyzed parameters. Efficacy at long-term and a possible effect in reducing the risk of tumor relapse remain to be elucidated in larger cohorts with longer and multidisciplinary follow up.

Metabolic syndrome in breast cancer survivors with high carbohydrate consumption: The first report in community setting

This study was conducted to examine the prevalence of and lifestyle factors associated with the metabolic syndrome in breast cancer survivors and to compare those factors with controls without cancer in a community setting. This study included 584 female breast cancer survivors ≥3 years after the initial diagnosis and 2336 age-matched cancer-free female controls from 39 community health examination centers located in 14 urban areas in Korea. The prevalence of the metabolic syndrome is shown. Factors associated with the metabolic syndrome were analyzed as odds ratios (ORs) in cancer survivors and controls; differences between the two groups in the ORs of associated factors were evaluated by calculating p-heterogeneity values. The prevalence of metabolic syndrome in breast cancer survivors and age-matched controls were 26.8% and 26.9%, respectively. Higher percentage of caloric intake from carbohydrates was associated with increased metabolic syndrome only in the breast cancer survivors (OR for the highest vs. lowest quartile for survivors=2.48 [95% CI=1.20-5.14]; OR for controls=1.11 [95% CI=0.81-1.51]; P-heterogeneity=0.046). Sweat-inducing exercise for ≥150min/week was associated with a lower risk of metabolic syndrome only in controls (controls: OR=0.72 [95% CI=0.58-0.89]; survivors: OR=0.88 [95% CI=0.57-1.36]). Older age, higher body mass index, and a lower education level (≤12 years) was associated with an increased prevalence of metabolic syndrome in both groups. Our results suggest that, in regions with excess carbohydrate intake, the association of the metabolic syndrome with percentage of caloric intake from carbohydrate might be more prominent than exercise in breast cancer survivors, compared with general population.

The insulin-like growth factor system is modulated by exercise in breast cancer survivors: a systematic review and meta-analysis.

BackgroundInsulin-like growth factors (IGF´s) play a crucial role in controlling cancer cell proliferation, differentiation and apoptosis. Exercise has been postulated as an effective intervention in improving cancer-related outcomes and survival, although its effects on IGF´s are not well understood. This meta-analysis aimed to determine the effects of exercise in modulating IGF´s system in breast cancer survivors.MethodsDatabases of PuMed, EMBASE, Cochrane Central Register of Controlled Trials, EMBASE, ClinicalTrials.gov, SPORTDiscus, LILACS and Scopus were systematically searched up to November 2014. Effect estimates were calculated through a random-effects model of meta-analysis according to the DerSimonian and Laird method. Heterogeneity was evaluated with the I2 test. Risk of bias and methodological quality were evaluated using the PEDro score.ResultsFive randomized controlled trials (n = 235) were included. Most women were post-menopausal. High-quality and low risk of bias were found (mean PEDro score = 6.2 ± 1). Exercise resulted in significant improvements on IGF-I, IGF-II, IGFBP-I, IGFBP-3, Insulin and Insulin resistance (P < 0.05). Non-significant differences were found for Glucose. Aerobic exercise improved IGF-I, IGFBP-3 and Insulin. No evidence of publication bias was detected by Egger´s test (p = 0.12).ConclusionsExercise improved IGF´s in breast cancer survivors. These findings provide novel insight regarding the molecular effects of exercise on tumoral microenvironment, apoptosis and survival in breast cancer survivors.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-016-2733-z) contains supplementary material, which is available to authorized users.

Adrenal Hormone and Metabolic Biomarker Responses to 30 min of Intermittent Cycling Exercise in Breast Cancer Survivors.

The aim of this study was to explore the effect of one bout of aerobic exercise on epinephrine, norepinephrine, cortisol, glucose, lactate, and free fatty acid (FFA) responses in breast cancer survivors and healthy controls. 9 female breast cancer survivors and 9 women without a history of cancer completed 30 min of cycle ergometry exercise at 60% of VO2peak. Blood samples were taken pre-exercise, immediately post-exercise, and 2 h post-exercise from which plasma concentrations of study variables were measured. Immediately and 2 h post-exercise, increases were observed in epinephrine (control group only) norepinephrine (both groups), lactate (both groups), and FFA (both groups immediately post-exercise; breast cancer survivor group only at 2 h post-exercise) (p<0.05). Cortisol decreased immediately and 2 h post-exercise in the control group while glucose decreased immediately post-exercise in the breast cancer survivor group (p<0.05). In conclusion, breast cancer survivors appeared to display attenuated epinephrine, cortisol, and lactate responses while displaying larger magnitude changes in glucose and FFA responses compared to controls. These preliminary findings may have implications for the regulation of metabolism during exercise in breast cancer survivors.