Prospective cohort study of lifetime physical activity and breast cancer survival. Int J Cancer

Division of Population Health, Alberta Cancer Board, Calgary, AB, Canada.
International Journal of Cancer (Impact Factor: 5.09). 04/2009; 124(8):1954-62. DOI: 10.1002/ijc.24155
Source: PubMed


Few studies have examined the association between physical activity and disease outcomes in breast cancer survivors. Here, we report the association between lifetime total physical activity performed prior to diagnosis and disease outcomes in a population-based sample of breast cancer survivors. A cohort of 1,231 women diagnosed with breast cancer between 1995 and 1997 was followed for a minimum of 8.3 years for any cancer progressions, recurrences and new primaries; and a minimum of 10.3 years for deaths. All treatment and follow-up care received was abstracted from medical records. Data on physical activity including type (occupational, household, recreational) and dose (frequency, intensity and duration) performed during the entire lifetime until diagnosis were examined in Cox proportional hazards models as well as with cumulative incidence curves. An average of 126 MET-hr/week were reported for total physical activity (of which 13.9, 46.9 and 65.3 MET-hr/week were, respectively, for recreational, occupational and household activity). A decreased risk of breast cancer death and all deaths was observed among women in the highest versus the lowest quartiles of recreational activity (MET-hr/week/year) (HR = 0.54, 95% CI = 0.36-0.79). Both moderate (0.56, 95% CI = 0.38-0.82) and vigorous intensity recreational activity (0.74, 95% CI = 0.56-0.98) decreased the risk of breast cancer death. Moderate intensity recreational activity decreased the risk of a recurrence, progression or new primary cancer (0.66, 95% CI = 0.48-0.91). No other association with breast cancer survival was observed for other types of physical activity. Prediagnosis recreational activity conferred a benefit for survival after breast cancer. Moderate intensity recreational activity was particularly protective.

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Available from: Karen Kopciuk, Sep 23, 2014
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    • "This is supported by a Danish randomized controlled trial with 269 cancer patients (different diagnoses) according to which patients receiving chemotherapy tolerate intensive physical exercise and experience reduced fatigue, depression, and nausea [25]. In general, rehabilitation in cancer patients based on physical exercise perioperatively has been shown to increase HRQoL and physical activity, and at the same time reduce the side effects of the treatment [24,26-33]. There is consistent evidence from 27 observational studies that physical activity is associated with reduced all-cause, breast cancer-specific, and colon cancer-specific mortality [34]. "
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    ABSTRACT: Background: The purpose of the PROLUCA study is to investigate the efficacy of preoperative and early postoperative rehabilitation in a non-hospital setting in patients with operable lung cancer with special focus on exercise. Methods: Using a 2 x 2 factorial design with continuous effect endpoint (Maximal Oxygen Uptake (VO2peak)), 380 patients with non-small cell lung cancer (NSCLC) stage I-IIIa referred for surgical resection will be randomly assigned to one of four groups: (1) preoperative and early postoperative rehabilitation (starting two weeks after surgery); (2) preoperative and late postoperative rehabilitation (starting six weeks after surgery); (3) early postoperative rehabilitation alone; (4) today's standard care which is postoperative rehabilitation initiated six weeks after surgery. The preoperative rehabilitation program consists of an individually designed, 30-minute home-based exercise program performed daily. The postoperative rehabilitation program consists of a supervised group exercise program comprising cardiovascular and resistance training two-hour weekly for 12 weeks combined with individual counseling. The primary study endpoint is VO2peak and secondary endpoints include: Six-minute walk distance (6MWD), one-repetition-maximum (1RM), pulmonary function, patient-reported outcomes (PROs) on health-related quality of life (HRQoL), symptoms and side effects of the cancer disease and the treatment of the disease, anxiety, depression, wellbeing, lifestyle, hospitalization time, sick leave, work status, postoperative complications (up to 30 days after surgery) and survival. Endpoints will be assessed at baseline, the day before surgery, pre-intervention, post-intervention, six months after surgery and one year after surgery. Discussion: The results of the PROLUCA study may potentially contribute to the identification of the optimal perioperative rehabilitation for operable lung cancer patients focusing on exercise initiated immediately after diagnosis and rehabilitation shortly after surgery. Trial registration: NCT01893580.
    BMC Cancer 06/2014; 14(1):404. DOI:10.1186/1471-2407-14-404 · 3.36 Impact Factor
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    • "Health Record Technicians from the Alberta Cancer Registry will use standardized forms and methods to abstract the medical charts for all of the participants at regular intervals during the cohort study. The form was previously developed and tested for our past PA and breast cancer cohort study that evolved from a population-based case–control study that we conducted in Alberta [41]. Medical variables to be abstracted will include pathologic and clinical disease stage (TNM), type of surgery, and all treatment and follow-up care including data on chemotherapy, radiation therapy, and hormone therapy. "
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    ABSTRACT: Background Limited research has examined the association between physical activity, health-related fitness, and disease outcomes in breast cancer survivors. Here, we present the rationale and design of the Alberta Moving Beyond Breast Cancer (AMBER) Study, a prospective cohort study designed specifically to examine the role of physical activity and health-related fitness in breast cancer survivorship from the time of diagnosis and for the balance of life. The AMBER Study will examine the role of physical activity and health-related fitness in facilitating treatment completion, alleviating treatment side effects, hastening recovery after treatments, improving long term quality of life, and reducing the risks of disease recurrence, other chronic diseases, and premature death. Methods/Design The AMBER Study will enroll 1500 newly diagnosed, incident, stage I-IIIc breast cancer survivors in Alberta, Canada over a 5 year period. Assessments will be made at baseline (within 90 days of surgery), 1 year, and 3 years consisting of objective and self-reported measurements of physical activity, health-related fitness, blood collection, lymphedema, patient-reported outcomes, and determinants of physical activity. A final assessment at 5 years will measure patient-reported data only. The cohort members will be followed for an additional 5 years for disease outcomes. Discussion The AMBER cohort will answer key questions related to physical activity and health-related fitness in breast cancer survivors including: (1) the independent and interactive associations of physical activity and health-related fitness with disease outcomes (e.g., recurrence, breast cancer-specific mortality, overall survival), treatment completion rates, symptoms and side effects (e.g., pain, lymphedema, fatigue, neuropathy), quality of life, and psychosocial functioning (e.g., anxiety, depression, self-esteem, happiness), (2) the determinants of physical activity and health-related fitness including demographic, medical, social cognitive, and environmental variables, (3) the mediators of any observed associations between physical activity, health-related fitness, and health outcomes including biological, functional, and psychosocial, and (4) the moderators of any observed associations including demographic, medical, and biological/disease factors. Taken together, these data will provide a comprehensive inquiry into the outcomes, determinants, mechanisms, and moderators of physical activity and health-related fitness in breast cancer survivors.
    BMC Cancer 11/2012; 12(1):525. DOI:10.1186/1471-2407-12-525 · 3.36 Impact Factor
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    • "They concluded that the benefits of physical activity are similar in patients with cancer and persons without cancer, and that exercise during or shortly after treatment appears to be safe [3]. Additionally , it has been demonstrated that the risk of breast cancer recurrence and mortality is reduced by physical activity [5] [6] [7] [8]. "
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    ABSTRACT: OBJECTIVES: To describe changes in physical activity levels related to health-enhancing physical activity guidelines during and after adjuvant chemotherapy in a cohort of Swedish patients with breast cancer. DESIGN: Exploratory clinical prospective longitudinal study with 6 and 12 months of follow-up. PARTICIPANTS: Forty women treated for breast cancer with adjuvant chemotherapy were included, and 33 women completed the study. MAIN OUTCOME MEASURES: The primary outcome was the proportion of participants meeting the health-enhancing physical activity guidelines, both in relative terms (perceived exertion using Borg's rate of perceived exertion scale) and absolute terms (metabolic equivalent). RESULTS: The proportion of participants meeting the guidelines when leisure-time physical activity was measured in terms of absolute intensity was 81 (25/31) to 94% (31/33) during chemotherapy, 93% (29/31) at 6-month follow-up and 87% (26/30) at 12-month follow-up. Women who had been physically active before their cancer diagnosis and women who had received information about physical activity were more physically active during chemotherapy. CONCLUSIONS: Swedish patients with breast cancer are generally more physically active during adjuvant chemotherapy than has been reported previously in international studies. Physical activity habits prior to cancer diagnosis and information about the benefits of physical activity appear to be important factors for higher levels of physical activity during and after chemotherapy.
    Physiotherapy 09/2012; 99(3). DOI:10.1016/ · 1.91 Impact Factor
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