Is Cardiorespiratory Fitness Related to Quality of Life in Survivors of Breast Cancer?

Liverpool Hope University, Liverpool, England, United Kingdom
The Journal of Strength and Conditioning Research (Impact Factor: 2.08). 09/2006; 20(3):535-40. DOI: 10.1519/00124278-200608000-00013
Source: PubMed


The purpose of this study was to investigate whether indices of cardiorespiratory fitness are related to quality of life (QOL) in women survivors of breast cancer. Using the European Organization for Research and Treatment of Cancer QLQ-30 questionnaire, we assessed the QOL of 16 participants (age, 50 +/- 9 years; body mass, 66.6 +/- 9.6 kg). All participants performed incremental cycle ergometer exercise to determine several indices of cardiorespiratory fitness (e.g., peak oxygen uptake [.V(O2)peak, in L.min(-1),]), peak power output (PPO, in W), PPO/ body mass (, peak heart rate (HRpeak, b.min(-1), peak ventilation (VEpeak), and .V(O2) and heart rate (HR) at the ventilatory (VT) and respiratory compensation (RCT) thresholds. Relationships between QOL and variables were assessed using Spearman rank-difference correlation tests. A significant inverse relationship (p < 0.05) was found for QOL scores and values for age (years) and body mass (kg) ( = -0.53), %HRpeak@VT ( = -0.59) and %VEpeak@VT ( = -0.61). A significant positive relationship (p < 0.05) was found for QOL and PPO/body mass ( = 0.59) and HRpeak ( = 0.78), .V(O2)@RCT ( ( = 0.51), power output (PO, expressed as either W or at RCT, and HR at RCT ( = 0.54). No other significant relationship was found between QOL and variables obtained from the tests. In conclusion, these findings highlight possible relationships between cardiorespiratory fitness and well-being in survivors of breast cancer. From a practical point of view, our data emphasize the need for this population to engage in programmed cardiorespiratory exercise training, mainly designed to improve VT and RCT. The improvement of both submaximal indices can have a beneficial effect on QOL.

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Available from: Fernando Herrero, Apr 18, 2014
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    • "However, over the past decade, there has been increased recognition and acceptance of the importance of therapy late effects (e.g., cardiovascular disease, type 2 diabetes, fatigue, deconditioning, etc.) as a major but underappreciated area in breast cancer management[10]. Emerging research evidence indicates that poor cardiorespiratory fitness may be of central importance for certain adverse late effects including impaired left ventricular ejection fraction, elevated cardiovascular disease (CVD) risk profile, poor quality of life, and fatigue following the completion of adjuvant therapy for operable breast cancer[11-13]. Further, recent landmark observational studies report that regular self-reported physical activity (e.g., brisk walking, ≥ 30 min.d-1, 5 d.wk-1), a major determinant of cardiorespiratory fitness, is associated with 30% to 50% reductions in breast cancer-specific mortality and all-cause mortality following the completion of adjuvant therapy[14,15]. "
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    ABSTRACT: The Exercise Intensity Trial (EXcITe) is a randomized trial to compare the efficacy of supervised moderate-intensity aerobic training to moderate to high-intensity aerobic training, relative to attention control, on aerobic capacity, physiologic mechanisms, patient-reported outcomes, and biomarkers in women with operable breast cancer following the completion of definitive adjuvant therapy. Using a single-center, randomized design, 174 postmenopausal women (58 patients/study arm) with histologically confirmed, operable breast cancer presenting to Duke University Medical Center (DUMC) will be enrolled in this trial following completion of primary therapy (including surgery, radiation therapy, and chemotherapy). After baseline assessments, eligible participants will be randomized to one of two supervised aerobic training interventions (moderate-intensity or moderate/high-intensity aerobic training) or an attention-control group (progressive stretching). The aerobic training interventions will include 150 mins.wk⁻¹ of supervised treadmill walking per week at an intensity of 60%-70% (moderate-intensity) or 60% to 100% (moderate to high-intensity) of the individually determined peak oxygen consumption (VO₂peak) between 20-45 minutes/session for 16 weeks. The progressive stretching program will be consistent with the exercise interventions in terms of program length (16 weeks), social interaction (participants will receive one-on-one instruction), and duration (20-45 mins/session). The primary study endpoint is VO₂peak, as measured by an incremental cardiopulmonary exercise test. Secondary endpoints include physiologic determinants that govern VO₂peak, patient-reported outcomes, and biomarkers associated with breast cancer recurrence/mortality. All endpoints will be assessed at baseline and after the intervention (16 weeks). EXCITE is designed to investigate the intensity of aerobic training required to induce optimal improvements in VO₂peak and other pertinent outcomes in women who have completed definitive adjuvant therapy for operable breast cancer. Overall, this trial will inform and refine exercise guidelines to optimize recovery in breast and other cancer survivors following the completion of primary cytotoxic therapy. NCT01186367.
    Full-text · Article · Oct 2010 · BMC Cancer
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    • "In the current study, the average of maximal oxygen consumption, VO 2peak , attained during the cardiorespiratory endurance test was 5.81 ± 1.26 METs for all the survivors (CATotal). These results were similar to previous studies (Cheema & Gaul, 2006; Courneya et al., 2003; Fairey et al., 2005; Herrero et al., 2006; L. W. Jones et al., 2007); however, other studies have included survivors with other comorbidities in addition to controlled hypertension (Courneya et al., 2003; L. W. Jones et al., 2007). According to the physical activity compendium, activities of daily living such as sweeping a garage or sidewalk of a house would require a MET of approximately 4 METs (Lucia et al., 2003). "
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    ABSTRACT: This study compared VO(2peak), treatment frequency and dosage, and QOL between 22 post-treated breast cancer survivors (CATotal) and 22 apparently healthy, age-matched women (CO). The CATotal group included 11 with no history of any other co-morbidities (CA) and 11 with controlled hypertension (CA + H). VO(2peak) was measured using the Bruce Protocol. QOL was measured using the SF-36 survey. Significant differences were observed in VO(2peak) between CATotal and CO (p = 0.014), CA and CA + H (p = 0.001), and CA + H and CO (p = 0.001). Physical, emotional, and mental health domains of the SF-36 were significantly different between CATotal and CO (p = 0.006, 0.001, and 0.05 respectively). These results suggest that breast cancer survivors with controlled hypertension can experience a significant reduction in VO(2peak) when compared to apparently healthy, age-matched controls. Also, treatment frequency and dosage affected QOL in this group of survivors.
    Full-text · Article · Jul 2010 · Journal of Psychosocial Oncology
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    • "Subjects participated in 2 resistance or weight training sessions and 3 aerobic sessions per week. Herrero and associates found aerobic capacity measures (expressed in both ventilatory and respiratory compensation thresholds) significantly related to QOL scores in 16 untrained breast cancer participants.45 The authors also reported VO2 peak values (ie, maximal testing scores) related to QOL as approaching a significant level. "
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    ABSTRACT: According to recent published reports, over 12 million new cases of cancer were estimated worldwide for 2007. Estimates from 2008 predict that cancer will account for 22.8% of all deaths in the US. Another report stated 50% to 75% of cancer deaths in the US are related to smoking, poor dietary choices, and physical inactivity. A 2004 report indicated obesity and/or a sedentary lifestyle increases the risk of developing several types of cancer. Conversely, several large-scale cohort studies point to the positive relationship between physical activity and a reduction in cancer risk. In addition, research over the last few years has clearly shown cardiorespiratory benefits, increases in quality of life (QOL), and increases in physical functioning for cancer survivors who engage in exercise programs. Thus, the purpose of this review is to highlight three areas related to cancer and physical activity. First, information concerning the prevention of cancer through physical activity is addressed. Second, recent studies identifying changes in volume of oxygen uptake (VO(2)) and/or cardiorespiratory functioning involving exercise with cancer survivors is presented. Third, studies identifying changes in cancer survivors' physical functional capacity and QOL are presented. Finally, a summary of the review is offered.
    Preview · Article · Jun 2010 · Cancer Management and Research
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