Top

Published in:

01-02-2018 | Original Article

Patient preference and timing for exercise in breast cancer care

Authors: Kathleen M. Sturgeon, Carla Fisher, Gina McShea, Susan Kruse Sullivan, Dahlia Sataloff, Kathryn H. Schmitz

Published in: Supportive Care in Cancer | Issue 2/2018

Abstract

Exercise is recommended following cancer diagnosis and may be particularly valuable for women receiving cardiotoxic chemotherapy treatments. We investigated breast cancer patient preference on exercise programming in a prospective manner and retrospectively assessed length of time between diagnosis and chemotherapy initiation. Sixty-seven newly diagnosed breast cancer patients responded to questions regarding exercise programming related to cancer treatment and surveys on current activity level. Additionally, a retrospective chart review was conducted on 500 random breast cancer patients. Age, cancer stage, treatment, and treatment dates were extracted. Women were interested in, or, absolutely wanted to, participate in an exercise program before treatment (76.2%). There was uncertainty regarding willingness to delay treatment; 49.2% were willing to delay their treatment if the program was recommended by their doctors, 41.8% would not, and 9.0% were too unsure to respond. However, women would like to hear information about an exercise program for cancer patients when they are first diagnosed (61.9%). We observed that 64.6% of women were below recommended levels of physical activity; yet, current activity was not associated with an interest in an exercise program or willingness to delay treatment. Retrospectively, we observed an average interval of 72.6 ± 34.6 days between cancer diagnosis and initiation of anthracycline-based chemotherapy treatment, with younger women with more advanced cancer receiving anthracycline-based chemotherapy. Based on patient preference and length of time to chemotherapy initiation, a reasonable next step to promote the current recommendations for exercise could be to integrate exercise into breast cancer care earlier in treatment.

Schmitz KH, Courneya KS, Matthews C, Demark-Wahnefried W, Galvao DA, Pinto BM, Irwin ML, Wolin KY, Segal RJ, Lucia A, Schneider CM, von Gruenigen VE, Schwartz AL (2010) American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc 42(7):1409–1426CrossRefPubMed

Hayes SC, Spence RR, Galvao DA, Newton RU (2009) Australian Association for Exercise and Sport Science position stand: optimising cancer outcomes through exercise. J Sci Med Sport 12(4):428–434CrossRefPubMed

van den Berg JP, Velthuis MJ, Gijsen BC, Lindeman E, van der Pol MA, Hillen HF (2011) guideline “cancer rehabilitation”. Ned Tijdschr Geneeskd 155(51):A4104PubMed

Demark-Wahnefried W, Case LD, Blackwell K, Marcom PK, Kraus W, Aziz N, Snyder DC, Giguere JK, Shaw E (2008) Results of a diet/exercise feasibility trial to prevent adverse body composition change in breast cancer patients on adjuvant chemotherapy. Clin Breast Cancer 8(1):70–79CrossRefPubMed

Vincent F, Labourey JL, Leobon S, Antonini MT, Lavau-Denes S, Tubiana-Mathieu N (2013) Effects of a home-based walking training program on cardiorespiratory fitness in breast cancer patients receiving adjuvant chemotherapy: a pilot study. Eur J Phys Rehabil Med 49(3):319–329PubMed

Segal R, Evans W, Johnson D, Smith J, Colletta S, Gayton J, Woodard S, Wells G, Reid R (2001) Structured exercise improves physical functioning in women with stages I and II breast cancer: results of a randomized controlled trial. J Clin Oncol 19(3):657–665CrossRefPubMed

Hornsby WE, Douglas PS, West MJ, Kenjale AA, Lane AR, Schwitzer ER, Ray KA, Herndon JE 2nd, Coan A, Gutierrez A, Hornsby KP, Hamilton E, Wilke LG, Kimmick GG, Peppercorn JM, Jones LW (2014) Safety and efficacy of aerobic training in operable breast cancer patients receiving neoadjuvant chemotherapy: a phase II randomized trial. Acta Oncol 53(1):65–74CrossRefPubMed

Courneya KS, McKenzie DC, Mackey JR, Gelmon K, Friedenreich CM, Yasui Y, Reid RD, Cook D, Jespersen D, Proulx C, Dolan LB, Forbes CC, Wooding E, Trinh L, Segal RJ (2013) Effects of exercise dose and type during breast cancer chemotherapy: multicenter randomized trial. J Natl Cancer Inst 105(23):1821–1832CrossRefPubMed

Sturgeon KM, Ky B, Libonati JR, Schmitz KH (2014) The effects of exercise on cardiovascular outcomes before, during, and after treatment for breast cancer. Breast Cancer Res Treat 143(2):219–226CrossRefPubMed

10.

Blair SN, Kampert JB, Kohl HW 3rd, Barlow CE, Macera CA, Paffenbarger RS Jr, Gibbons LW (1996) Influences of cardiorespiratory fitness and other precursors on cardiovascular disease and all-cause mortality in men and women. JAMA 276(3):205–210CrossRefPubMed

11.

Vigen R, Ayers C, Willis B, DeFina L, Berry JD (2012) Association of cardiorespiratory fitness with total, cardiovascular, and noncardiovascular mortality across 3 decades of follow-up in men and women. Circ Cardiovasc Qual Outcomes 5(3):358–364CrossRefPubMedPubMedCentral

12.

Lee DC, Sui X, Artero EG, Lee IM, Church TS, McAuley PA, Stanford FC, Kohl HW 3rd, Blair SN (2011) Long-term effects of changes in cardiorespiratory fitness and body mass index on all-cause and cardiovascular disease mortality in men: the aerobics center longitudinal study. Circulation 124(23):2483–2490CrossRefPubMedPubMedCentral

13.

Jones LW, Courneya KS, Mackey JR, Muss HB, Pituskin EN, Scott JM, Hornsby WE, Coan AD, Herndon JE 2nd, Douglas PS, Haykowsky M (2012) Cardiopulmonary function and age-related decline across the breast cancer survivorship continuum. J Clin Oncol 30(20):2530–2537CrossRefPubMedPubMedCentral

14.

Bovelli D, Plataniotis G, Roila F (2010) Cardiotoxicity of chemotherapeutic agents and radiotherapy-related heart disease: ESMO clinical practice guidelines. Ann Oncol 21(Suppl 5):v277–v282CrossRefPubMed

15.

Minotti G, Menna P, Salvatorelli E, Cairo G, Gianni L (2004) Anthracyclines: molecular advances and pharmacologic developments in antitumor activity and cardiotoxicity. Pharmacol Rev 56(2):185–229CrossRefPubMed

16.

Zhang S, Liu X, Bawa-Khalfe T, Lu LS, Lyu YL, Liu LF, Yeh ET (2012) Identification of the molecular basis of doxorubicin-induced cardiotoxicity. Nat Med 18(11):1639–1642CrossRefPubMed

17.

Chung WB, Yi JE, Jin JY, Choi YS, Park CS, Park WC, Song BJ, Youn HJ (2013) Early cardiac function monitoring for detection of subclinical doxorubicin cardiotoxicity in young adult patients with breast cancer. J Breast Cancer 16(2):178–183CrossRefPubMedPubMedCentral

18.

Tan-Chiu E, Yothers G, Romond E, Geyer CE Jr, Ewer M, Keefe D, Shannon RP, Swain SM, Brown A, Fehrenbacher L, Vogel VG, Seay TE, Rastogi P, Mamounas EP, Wolmark N, Bryant J (2005) Assessment of cardiac dysfunction in a randomized trial comparing doxorubicin and cyclophosphamide followed by paclitaxel, with or without trastuzumab as adjuvant therapy in node-positive, human epidermal growth factor receptor 2-overexpressing breast cancer: NSABP B-31. J Clin Oncol 23(31):7811–7819CrossRefPubMed

19.

Hequet O, Le QH, Moullet I, Pauli E, Salles G, Espinouse D, Dumontet C, Thieblemont C, Arnaud P, Antal D, Bouafia F, Coiffier B (2004) Subclinical late cardiomyopathy after doxorubicin therapy for lymphoma in adults. J Clin Oncol 22(10):1864–1871CrossRefPubMed

20.

Khan NF, Mant D, Carpenter L, Forman D, Rose PW (2011) Long-term health outcomes in a British cohort of breast, colorectal and prostate cancer survivors: a database study. Br J Cancer 105(Suppl 1):S29–S37CrossRefPubMedPubMedCentral

21.

Ascensao A, Magalhaes J, Soares J, Ferreira R, Neuparth M, Marques F, Oliveira J, Duarte J (2005) Endurance training attenuates doxorubicin-induced cardiac oxidative damage in mice. Int J Cardiol 100(3):451–460CrossRefPubMed

22.

Ascensao A, Magalhaes J, Soares JM, Ferreira R, Neuparth MJ, Marques F, Oliveira PJ, Duarte JA (2005) Moderate endurance training prevents doxorubicin-induced in vivo mitochondriopathy and reduces the development of cardiac apoptosis. Am J Phys Heart Circ Phys 289(2):H722–H731

23.

Kavazis AN, Smuder AJ, Min K, Tumer N, Powers SK (2010) Short-term exercise training protects against doxorubicin-induced cardiac mitochondrial damage independent of HSP72. Am J Physiol Heart Circ Physiol 299(5):H1515–H1524CrossRefPubMedPubMedCentral

24.

Chicco AJ, Schneider CM, Hayward R (2005) Voluntary exercise protects against acute doxorubicin cardiotoxicity in the isolated perfused rat heart. Am J Physiol Regul Integr Comp Physiol 289(2):R424–R431CrossRefPubMed

25.

Wonders KY, Hydock DS, Schneider CM, Hayward R (2008) Acute exercise protects against doxorubicin cardiotoxicity. Integr Cancer Ther 7(3):147–154CrossRefPubMed

26.

Prochaska JO, DiClemente CC (1983) Stages and processes of self-change of smoking: toward an integrative model of change. J Consult Clin Psychol 51(3):390–395CrossRefPubMed

27.

Godin G, Shephard RJ (1985) A simple method to assess exercise behavior in the community. Can J Appl Sport Sci Journal canadien des sciences appliquees au sport 10(3):141–146PubMed

28.

Amireault S, Godin G, Lacombe J, Sabiston CM (2015) The use of the Godin-Shephard leisure-time physical activity questionnaire in oncology research: a systematic review. BMC Med Res Methodol 15:60CrossRefPubMedPubMedCentral

29.

Belanger LJ, Plotnikoff RC, Clark A, Courneya KS (2012) A survey of physical activity programming and counseling preferences in young-adult cancer survivors. Cancer Nurs 35(1):48–54CrossRefPubMed

30.

Lawson PJ, Flocke SA (2009) Teachable moments for health behavior change: a concept analysis. Patient Educ Couns 76(1):25–30CrossRefPubMed

31.

Vassbakk-Brovold K, Berntsen S, Fegran L, Lian H, Mjaland O, Mjaland S, Seiler S, Kersten C (2015) Individualized comprehensive lifestyle intervention in patients undergoing chemotherapy with curative or palliative intent: who participates? PLoS One 10(7):e0131355CrossRefPubMedPubMedCentral

32.

Jones LW, Courneya KS (2002) Exercise counseling and programming preferences of cancer survivors. Cancer Pract 10(4):208–215CrossRefPubMed

33.

Henriksson A, Arving C, Johansson B, Igelstrom H, Nordin K (2016) Perceived barriers to and facilitators of being physically active during adjuvant cancer treatment. Patient Educ Couns 99(7):1220–1226CrossRefPubMed

34.

Demark-Wahnefried W, Peterson B, McBride C, Lipkus I, Clipp E (2000) Current health behaviors and readiness to pursue life-style changes among men and women diagnosed with early stage prostate and breast carcinomas. Cancer 88(3):674–684CrossRefPubMed

35.

Broderick JM, Hussey J, Kennedy MJ, O'Donnell DM (2014) Testing the 'teachable moment' premise: does physical activity increase in the early survivorship phase? Support Care Cancer : Off J Multinational Assoc Support Care Cancer 22(4):989–997CrossRef

36.

Millen AM, Norton GR, Avidon I, Woodiwiss AJ (2013) Effects of short-term exercise-training on aortic systolic pressure augmentation in overweight and obese individuals. Eur J Appl Physiol 113(7):1793–1803CrossRefPubMed

37.

Montero D, Roche E, Martinez-Rodriguez A (2014) The impact of aerobic exercise training on arterial stiffness in pre- and hypertensive subjects: a systematic review and meta-analysis. Int J Cardiol 173(3):361–368CrossRefPubMed

38.

Hambrecht R, Wolf A, Gielen S, Linke A, Hofer J, Erbs S, Schoene N, Schuler G (2000) Effect of exercise on coronary endothelial function in patients with coronary artery disease. N Engl J Med 342(7):454–460CrossRefPubMed

39.

Gomez-Cabrera MC, Domenech E, Vina J (2008) Moderate exercise is an antioxidant: upregulation of antioxidant genes by training. Free Radic Biol Med 44(2):126–131CrossRefPubMed

40.

Ren J, Pulakat L, Whaley-Connell A, Sowers JR (2010) Mitochondrial biogenesis in the metabolic syndrome and cardiovascular disease. J Mol Med (Berl) 88(10):993–1001CrossRef

41.

Radak Z, Chung HY, Koltai E, Taylor AW, Goto S (2008) Exercise, oxidative stress and hormesis. Ageing Res Rev 7(1):34–42CrossRefPubMed

42.

Radak Z, Naito H, Kaneko T, Tahara S, Nakamoto H, Takahashi R, Cardozo-Pelaez F, Goto S (2002) Exercise training decreases DNA damage and increases DNA repair and resistance against oxidative stress of proteins in aged rat skeletal muscle. Pflugers Arch 445(2):273–278CrossRefPubMed

43.

Jones LW, Haykowsky MJ, Swartz JJ, Douglas PS, Mackey JR (2007) Early breast cancer therapy and cardiovascular injury. J Am Coll Cardiol 50(15):1435–1441CrossRefPubMed

44.

Patnaik JL, Byers T, DiGuiseppi C, Dabelea D, Denberg TD (2011) Cardiovascular disease competes with breast cancer as the leading cause of death for older females diagnosed with breast cancer: a retrospective cohort study. Breast Cancer Res 13(3):R64CrossRefPubMedPubMedCentral

45.

Mazzoni AS, Nordin K, Berntsen S, Demmelmaier I, Igelstrom H (2017) Comparison between logbook-reported and objectively-assessed physical activity and sedentary time in breast cancer patients: an agreement study. BMC Sports Sci Med Rehabil 9:8CrossRefPubMedPubMedCentral

Title: Patient preference and timing for exercise in breast cancer care
Authors: Kathleen M. Sturgeon
Carla Fisher
Gina McShea
Susan Kruse Sullivan
Dahlia Sataloff
Kathryn H. Schmitz
Publication date: 01-02-2018
Publisher: Springer Berlin Heidelberg
Published in: Supportive Care in Cancer / Issue 2/2018
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-017-3856-8

Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras

Prof. Fabrice Barlesi

Developed by: Springer Medicine

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 2/2018

The implementation of web-based cognitive rehabilitation in adult cancer survivors: examining participant engagement, attrition and treatment fidelity

Patient and provider perceptions of Internet-delivered cognitive behavior therapy for recent cancer survivors

Geriatric assessment with management intervention in older adults with cancer: a randomized pilot study

What type and dose of antidepressants are cancer and non-cancer inpatients being prescribed: a retrospective case-control study at an Australian tertiary hospital

Development and feasibility of a web application to monitor patients’ cancer-related pain

An investigation of the prevalence of swallowing difficulties and impact on quality of life in patients with advanced lung cancer

Keynote webinar | Spotlight on antibody–drug conjugates in cancer