Effects of Aerobic and Resistance Exercise in Breast Cancer Patients Receiving Adjuvant Chemotherapy: A Multicenter Randomized Controlled Trial

Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Alberta, Canada.
Journal of Clinical Oncology (Impact Factor: 18.43). 10/2007; 25(28):4396-404. DOI: 10.1200/JCO.2006.08.2024
Source: PubMed


Breast cancer chemotherapy may cause unfavorable changes in physical functioning, body composition, psychosocial functioning, and quality of life (QOL). We evaluated the relative merits of aerobic and resistance exercise in blunting these effects.
We conducted a multicenter randomized controlled trial in Canada between 2003 and 2005 that randomly assigned 242 breast cancer patients initiating adjuvant chemotherapy to usual care (n = 82), supervised resistance exercise (n = 82), or supervised aerobic exercise (n = 78) for the duration of their chemotherapy (median, 17 weeks; 95% CI, 9 to 24 weeks). Our primary end point was cancer-specific QOL assessed by the Functional Assessment of Cancer Therapy-Anemia scale. Secondary end points were fatigue, psychosocial functioning, physical fitness, body composition, chemotherapy completion rate, and lymphedema.
The follow-up assessment rate for our primary end point was 92.1%, and adherence to the supervised exercise was 70.2%. Unadjusted and adjusted mixed-model analyses indicated that aerobic exercise was superior to usual care for improving self-esteem (P = .015), aerobic fitness (P = .006), and percent body fat (adjusted P = .076). Resistance exercise was superior to usual care for improving self-esteem (P = .018), muscular strength (P < .001), lean body mass (P = .015), and chemotherapy completion rate (P = .033). Changes in cancer-specific QOL, fatigue, depression, and anxiety favored the exercise groups but did not reach statistical significance. Exercise did not cause lymphedema or adverse events.
Neither aerobic nor resistance exercise significantly improved cancer-specific QOL in breast cancer patients receiving chemotherapy, but they did improve self-esteem, physical fitness, body composition, and chemotherapy completion rate without causing lymphedema or significant adverse events.

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Available from: Caroline Proulx, Oct 08, 2015
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    • "The findings also suggest that study participants can be successfully recruited into a resistance exercise program during chemotherapy for breast cancer. In a trial of combined aerobic and resistance exercise for women receiving adjuvant chemotherapy for breast cancer,Courneya et al (2007)reported a recruitment rate of 33%, whileMilne et al (2007)was able to recruit 44.3% of women who had already completed chemotherapy into a similar exercise program. The 85% recruitment rate for this study was quite high. "

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    • "Small feasibility studies have demonstrated that the combination of exercise with a diet intervention could be more effective in reducing weight in breast cancer survivors [106] [107]. Exercise training during chemotherapy or radiation treatment for breast cancer at minimum can prevent the peak VO 2 decline occurring in usual care controls [71], or improve peak VO 2 [70] [72] [91] [108] [109]. Exercise training following completion of breast cancer treatment improves peak VO 2 [106] [110] [111]. "
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    ABSTRACT: Thanks to increasingly effective treatment, breast cancer mortality rates have significantly declined over the past few decades. Following the increase in life expectancy of women diagnosed with breast cancer, it has been recognized that these women are at an elevated risk for cardiovascular disease due in part to the cardiotoxic side effects of treatment. This paper reviews evidence for the role of exercise in prevention of cardiovascular toxicity associated with chemotherapy used in breast cancer, and in modifying cardiovascular risk factors in breast cancer survivors. There is growing evidence indicating that the primary mechanism for this protective effect appears to be improved antioxidant capacity in the heart and vasculature and subsequent reduction of treatment-related oxidative stress in these structures. Further clinical research is needed to determine whether exercise is a feasible and effective nonpharmacological treatment to reduce cardiovascular morbidity and mortality in breast cancer survivors, to identify the cancer therapies for which it is effective, and to determine the optimal exercise dose. Safe and noninvasive measures that are sensitive to changes in cardiovascular function are required to answer these questions in patient populations. Cardiac strain, endothelial function, and cardiac biomarkers are suggested outcome measures for clinical research in this field.
    Full-text · Article · Sep 2015 · Journal of Oncology
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    • "Exercise intervention is increasingly being promoted in cancer patients, as numerous trials have proven safe, feasible and efficient in improving functional capacity, fitness, lean mass and strength, as well as psychosocial parameters [7], [18], [19]. Most studies have been performed in patients with breast and prostate cancer, yet studies in patient groups receiving cisplatin-based therapy are emerging [20], [21], [21]–[23]. "
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