Exercise as a tool to improve the quality of life of patients after breast cancer treatment

Česká verzia

Authors: M. Crhová; A. Pokorná; I. Hrnčiříková; M. Komzák
Authors place of work: Fakulta sportovních studií, MU Brno
Published in the journal: Klin Onkol 2022; 35(5): 392-400
Category: Original Articles
doi: https://doi.org/10.48095/ccko2022392

Summary

Background: The increasing quality of cancer treatment and early detection of tumors have an impact on the number of patients who survive cancer treatment. Therefore, the attention of physicians as well as scientists is increasingly focused on the consequences of the treatment than just on the treatment itself. One of the ways to positively influence the side effects of oncological treatment seems to be physical activity. Methods: In our research, there were involved 18 women after breast cancer treatment, 17 completed the research (average values of the tested group: 55.9 years, 165.1 cm, 76.9 kg, body mass index (BMI) 28.3). The patients who signed informed consent were divided into 3 groups (SAPA = supervised exercises 3times a week, HAPA = home exercises 3times a week, and a control group without exercises). The whole intervention lasted 12 weeks and the exercise unit itself contained an aerobic-resistant component and a yoga component. During the exercise, the patients‘ heart rate was monitored using a chest belt and sports testers. We used spiroergometry (peak oxygen uptake – VO₂peak), bioelectric impedance, and spectral analysis of the heart rate variability to evaluate changes in the quality of life. Results: VO₂peak increased in training groups by an average of 5 ml/min/kg (P = 0.082). A similar tendency was evident in some body composition values (skeletal muscle: P = 0.005; fat free mass: P = 0.006). Statistical significance did not reach the values of BMI (P = 0.131) and autonomic nervous system (P = 0.513; P = 0.585). Conclusion: Although our results suggest a positive trend in affecting the quality of life of patients after breast cancer treatment by exercises, similar research needs to be repeated in a larger study to confirm our results.

Keywords:

body composition – autonomic nervous system – breast cancer – Physical activity – physical fi tness

Zdroje

1. Mužík J, Šnajdrová L, Gregor J. Epidemiologie karcinomu prsu v ČR. [online]. Dostupné z: http: //www.mamo.cz/index.php?pg=pro-lekare--epidemiologie-karcinomu-prsu.

2. Pokorná A, Střeštíková R, Vychodilová R et al. Cvičební programy pro onkologické pacientky po léčbě rakoviny prsu. [online]. Dostupné z: https: //is.muni.cz/ekurzy/ONK01.

3. Binkley JM, Harris SR, Levangie PK et al. Patient perspectives on breast cancer treatment side effects and the prospective surveillance model for physical rehabilitation for women with breast cancer. Cancer 2012; 118 (S8): 2207–2216. doi: 10.1002/cncr.27469.

4. Odle TG. Adverse effects of breast cancer treatment. Radiol Technol 2014; 85 (3): 297–319.

5. Loprinzi PD, Cardinal BJ. Effects of physical activity on common side effects of breast cancer treatment. Breast Cancer 2012; 19 (1): 4–10. doi: 10.1007/s12282-011-02 92-3.

6. Radbruch L, Strasser F, Elsner F et al. Fatigue in palliative care patients – an EAPC approach. Palliat Med 2008; 22 (1): 13–32. doi: 10.1177/0269216307085183.

7. Diggins AD, Hearn LE, Lechner SC et al. Physical activity in black breast cancer survivors: implications for quality of life and mood at baseline and 6-month follow-up: physical activity, quality of life and mood. Psychooncology 2017; 26 (6): 822–828. doi: 10.1002/pon.4095.

8. de Boer MC, Wörner EA, Verlaan D et al. The mechanisms and effects of physical activity on breast cancer. Clin Breast Cancer 2017; 17 (4): 272–278. doi: 10.1016/j.clbc.2017.01.006.

9. Knols R, Aaronson NK, Uebelhart D et al. Physical exercise in cancer patients during and after medical treatment: a systematic review of randomized and controlled clinical trials. J Clin Oncol 2005; 23 (16): 3830–3842. doi: 10.1200/JCO.2005.02.148.

10. Novotná V, Čechovská I, Bunc V. Fit programy pro ženy: průvodce kondiční přípravou: 258 ilustrovaných cviků: 12 komplexních pohybových programů. Praha: Grada 2006.

11. Líška D, Rutkowski S. Breast cancer rehabilitation. Klin Onkol 2021; 34 (1): 14–19. doi: 10.48095/ccko202114.

12. Bower JE, Bak K, Berger A et al. Screening, assessment, and management of fatigue in adult survivors of cancer: an American Society of Clinical oncology clinical prac- tice guideline adaptation. J Clin Oncol 2014; 32 (17): 1840–1850. doi: 10.1200/JCO.2013.53.4495.

13. Vigo C, Gatzemeier W, Sala R et al. Evidence of altered autonomic cardiac regulation in breast cancer survivors. J Cancer Surviv 2015; 9 (4): 699–706. doi: 10.1007/s11764-015-0445-z.

14. Mishra SI, Scherer RW, Geigle PM et al. Exercise interventions on health-related quality of life for cancer survivors. Cochrane Database Syst Rev 2012; 2012 (8): CD007566. doi: 10.1002/14651858.CD007566.pub2.

15. Peterson LL, Ligibel JA. Physical activity and breast cancer: an opportunity to improve outcomes. Curr Oncol Rep 2018; 20 (7): 50. doi: 10.1007/s11912-018-0702-1.

16. Courneya KS, Segal RJ, Mackey JR et al. Effects of aerobic and resistance exercise in breast cancer patients receiving adjuvant chemotherapy: a multicenter randomized controlled trial. J Clin Oncol 2007; 25 (28): 4396–4404. doi: 10.1200/JCO.2006.08.2024.

17. May AM, Bosch MJC, Velthuis MJ et al. Cost-effectiveness analysis of an 18-week exercise programme for patients with breast and colon cancer undergoing adjuvant chemotherapy: the randomised PACT study. BMJ Open 2017; 7 (3): e012187. doi: 10.1136/bmjopen-2016-012 187.

18. Wiskemann J, Schmidt ME, Klassen O et al. Effects of 12-week resistance training during radiotherapy in breast cancer patients. Scand J Med Sci Sports 2017; 27 (11): 1500–1510. doi: 10.1111/sms.12777.

19. Casla S, López-Tarruella S, Jerez Y et al. Supervised physical exercise improves VO2max, quality of life, and health in early stage breast cancer patients: a randomized controlled trial. Breast Cancer Res Treat 2015; 153 (2): 371–382. doi: 10.1007/s10549-015-3541-x.

20. Daley AJ, Crank H, Saxton JM et al. Randomized trial of exercise therapy in women treated for breast cancer. J Clin Oncol 2007; 25 (13): 1713–1721. doi: 10.1200/JCO. 2006.09.5083.

21. Guinan E, Hussey J, Broderick JM et al. The effect of aerobic exercise on metabolic and inflammatory markers in breast cancer survivors – a pilot study. Support Care Cancer 2013; 21 (7): 1983–1992. doi: 10.1007/s00520-013-1743-5.

22. Rahnama N, Nouri R, Rahmaninia F et al. The effects of exercise training on maximum aerobic capacity, resting heart rate, blood pressure and anthropometric variables of postmenopausal women with breast cancer. J Res Med Sci 2010; 15 (2): 78–83.

23. Drouin JS, Young TJ, Beeler J et al. Random control clinical trial on the effects of aerobic exercise training on erythrocyte levels during radiation treatment for breast cancer. Cancer 2006; 107 (10): 2490–2495. doi: 10.1002/cncr.22267.

24. Hornsby WE, Douglas PS, West MJ et al. Safety and efficacy of aerobic training in operable breast cancer patients receiving neoadjuvant chemotherapy: a phase II randomized trial. Acta Oncol 2014; 53 (1): 65–74. doi: 10.3109/0284186X.2013.781673.

25. Schmidt ME, Wiskemann J, Armbrust P et al. Effects of resistance exercise on fatigue and quality of life in breast cancer patients undergoing adjuvant chemotherapy: a randomized controlled trial. Int J Cancer 2015; 137 (2): 471–480. doi: 10.1002/ijc.29383.

26. Schmidt ME, Meynköhn A, Habermann N et al. Resistance exercise and inflammation in breast cancer patients undergoing adjuvant radiation therapy: mediation analysis from a randomized, controlled intervention trial. Int J Radiat Oncol Biol Phys 2016; 94 (2): 329–337. doi: 10.1016/j.ijrobp.2015.10.058.

27. Steindorf K, Schmidt ME, Klassen O et al. Randomized, controlled trial of resistance training in breast cancer patients receiving adjuvant radiotherapy: results on cancer-related fatigue and quality of life. Ann Oncol 2014; 25 (11): 2237–2243. doi: 10.1093/annonc/mdu374.

28. Chaoul A, Milbury K, Spelman A et al. Randomized trial of Tibetan yoga in patients with breast cancer undergoing chemotherapy. Cancer 2018; 124 (1): 36–45. doi: 10.1002/cncr.30938.

29. Taso CJ, Lin HS, Lin WL et al. The effect of yoga exercise on improving depression, anxiety, and fatigue in women with breast cancer: a randomized controlled trial. J Nurs Res 2014; 22 (3): 155–164. doi: 10.1097/jnr.00000 00000000044.

30. Armer JS, Lutgendorf SK. The impact of yoga on fatigue in cancer survivorship: a meta-analysis. JNCI Cancer Spectr 2020; 4 (2): pkz098. doi: 10.1093/jncics/pkz098.

31. Schwartz AL, Winters-Stone K, Gallucci B. Exercise effects on bone mineral density in women with breast cancer receiving adjuvant chemotherapy. Oncol Nurs Forum 2007; 34 (3): 627–633. doi: 10.1188/07.ONF.627- 633.

32. Mostarda C, Castro-Filha J, Reis AD et al. Short-term combined exercise training improves cardiorespiratory fitness and autonomic modulation in cancer patients receiving adjuvant therapy. J Exerc Rehabil 2017; 13 (5): 599–607. doi: 10.12965/jer.1735048.524.

33. De Luca V, Minganti C, Borrione P et al. Effects of concurrent aerobic and strength training on breast cancer survivors: a pilot study. Public Health 2016; 136: 126–132. doi: 10.1016/j.puhe.2016.03.028.

34. Sturgeon KM, Dean LT, Heroux M et al. Commercially available lifestyle modification program: randomized controlled trial addressing heart and bone health in BRCA1/2+ breast cancer survivors after risk-reducing salpingo-oophorectomy. J Cancer Surviv 2017; 11 (2): 246–255. doi: 10.1007/s11764-016-0582-z.

35. Thomas GA, Cartmel B, Harrigan M et al. The effect of exercise on body composition and bone mineral density in breast cancer survivors taking aromatase inhibitors. Obesity 2017; 25 (2): 346–351. doi: 10.1002/oby.21729.

36. Buffart LM, Backer ICD, Schep G et al. Fatigue mediates the relationship between physical fitness and quality of life in cancer survivors. J Sci Med Sport 2013; 16 (2): 99–104. doi: 10.1016/j.jsams.2012.05.014.

37. Murtezani A, Ibraimi Z, Bakalli A et al. The effect of aerobic exercise on quality of life among breast cancer survivors: a randomized controlled trial. J Cancer Res Ther 2014; 10 (3): 658–664. doi: 10.4103/0973-1482.137985.

38. Sehl M, Lu X, Silliman R et al. Decline in physical functioning in first 2 years after breast cancer diagnosis predicts 10-year survival in older women. J Cancer Surviv 2013; 7 (1): 20–31. doi: 10.1007/s11764-012-0239-5.

39. Thomas GA, Cartmel B, Harrigan M et al. The effect of exercise on body composition and bone mineral density in breast cancer survivors taking aromatase inhibitors. Obesity 2017; 25 (2): 346–351. doi: 10.1002/oby.21729.