Top

Journal of Cancer Survivorship

Published in:

01-12-2008

Dimensions of physical activity and their relationship to physical and emotional symptoms in breast cancer survivors

Authors: Karen Basen-Engquist, Daniel Hughes, Heidi Perkins, Eileen Shinn, Cindy Carmack Taylor

Published in: Journal of Cancer Survivorship | Issue 4/2008

Abstract

Background

Many breast cancer survivors experience long term sequelae, including fatigue, decreased physical functioning, pain, and psychological distress. Physical activity can ameliorate these problems, but there is little research on how activity should be performed to be most beneficial. This study explores how dimensions of physical activity (total energy expenditure, frequency, and duration) are associated with symptoms among breast cancer survivors.

Methods

We conducted a secondary analysis of data on physical activity behavior and symptoms in a cross-sectional study (n = 148) of breast cancer survivors who were off treatment and had been diagnosed within the past 5 years.

Results

Multivariate analyses showed that total energy expenditure was associated with better general health (p = 0.006) and fewer depressive symptoms (p = 0.014), while frequency of activity was linearly related to physical functioning (p = 0.047), pain (0.057), general health (p < 0.001), and depressive symptoms (p < 0.001). Duration was related to physical functioning, pain, and general health, but the worst outcomes were reported by the participants with the shortest and longest duration of activity (quadratic trend p values = 0.002, 0.003, 0.008, respectively).

Discussion/Conclusions

Greater total energy expenditure, higher physical activity frequency, and moderate duration were associated with better outcomes for most symptoms, although there was no relationship between any of the dimensions of physical activity and fatigue.

Implications for cancer survivors

The association of better outcomes with higher energy expenditure, higher frequency of activity, and moderate duration indicates that increasing activity through multiple short bouts may be the most beneficial for breast cancer survivors. However, randomized studies are needed to confirm this finding.

Ganz PA, Kwan L, Stanton AL, et al. Quality of life at the end of primary treatment of breast cancer: first results from the moving beyond cancer randomized trial. J Natl Cancer Inst. 2004;96(5):376–87.PubMedCrossRef

Ganz PA, Coscarelli A, Fred C, Kahn B, Polinsky ML, Petersen L. Breast cancer survivors: psychosocial concerns and quality of life. Breast Cancer Res Treat. 1996;38:183–99. doi:10.1007/BF01806673.PubMedCrossRef

Dow KH, Ferell BR, Leigh S, Ly J, Gulasekaram P. An evaluation of the quality of life among long-term survivors of breast cancer. Breast Cancer Res Treat. 1996;39:261–73. doi:10.1007/BF01806154.PubMedCrossRef

Polinsky ML. Functional status of long-term breast cancer survivors: demonstrating chronicity. Health Soc Work. 1994;19(3):165–73.PubMed

Ganz PA, Rowland JH, Desmond K, Meyerowitz BE, Wyatt GE. Life after breast cancer: understanding women’s health-related quality of life and sexual functioning. J Clin Oncol. 1998;16(2):501–14.PubMed

Ganz PA, Desmond KA, Leedham B, Rowland JH, Meyerowitz BE, Belin TR. Quality of life in long-term, disease-free survivors of breast cancer: a follow-up study. J Natl Cancer Inst. 2002;94(1):39–49.PubMed

Dorval M, Maunsell E, Deschenes L, Brisson J, Masse B. Long-term quality of life after breast cancer: comparison of 8-year survivors with population controls. J Clin Oncol. 1998;16(2):487–94.PubMed

Vinokur AD, Threatt BA, Caplan RD, Zimmerman BL. Physical and psychosocial functioning and adjustment to breast cancer. Long-term follow-up of a screening population. Cancer. 1989;63:394–405. doi:10.1002/1097-0142(19890115)63:2<394::AID-CNCR2820630233>3.0.CO;2-5.PubMedCrossRef

Hann DM, Garovoy N, Finkelstein B, Jacobsen PB, Azzarello LM, Fields KK. Fatigue and quality of life in breast cancer patients undergoing autologous stem cell transplantation: a longitudinal comparative study. J Pain Symptom Manage. 1999;17(5):311–9. doi:10.1016/S0885-3924(99)00007-X.PubMedCrossRef

10.

Bower JE, Ganz PA, Desmond KA, Rowland JH, Meyerowitz BE, Belin TR. Fatigue in breast cancer survivors: occurrence, correlates, and impact on quality of life. J Clin Oncol. 2000;18(4):743–53.PubMed

11.

Servaes P, Verhagen S, Bleijenberg G. Determinants of chronic fatigue in disease-free breast cancer patients: a cross-sectional study. Ann Oncol. 2002;13:589–98. doi:10.1093/annonc/mdf082.PubMedCrossRef

12.

Meeske K, Smith AW, Alfano CM, et al. Fatigue in breast cancer survivors two to five years post diagnosis: a heal Study report. Qual Life Res. 2007;16(6):947–60. doi:10.1007/s11136-007-9215-3.PubMedCrossRef

13.

Aaronson NK, Meyerowitz BE, Bard M, Bloom JR, Fawzy FI, et al. Quality of life research in oncology. Past achievements and future priorities. Cancer. 1991;67(Suppl 3):839–43. doi:10.1002/1097-0142(19910201)67:3+<839::AID-CNCR2820671415>3.0.CO;2-0.PubMedCrossRef

14.

Saleeba AK, Weitzner MA, Meyers CA. Subclinical psychological distress in long-term survivors of breast cancer: a preliminary communication. J Psychosoc Oncol. 1996;14(1):83–93. doi:10.1300/J077V14N01_05.CrossRef

15.

Wyatt G, Friedman LL. Long-term female cancer survivors: quality of life issues and clinical implications. Cancer Nurs. 1996;19(1):1–7. doi:10.1097/00002820-199602000-00001.PubMedCrossRef

16.

Weitzner MA, Meyers CA, Stuebing KK, Saleeba AK. Relationship between quality of life and mood in long-term survivors of breast cancer treated with mastectomy. Support Care Cancer. 1997;5:241–8. doi:10.1007/s005200050067.PubMedCrossRef

17.

Courneya KS, Friedenreich CM, Quinney HA, Fields AL, Jones LW, Fairey AS. A randomized trial of exercise and quality of life in colorectal cancer survivors. Eur J Cancer Care. 2003;12(4):347–57. doi:10.1046/j.1365-2354.2003.00437.x.CrossRef

18.

Segal R, Evans W, Johnson D, et al. Structured exercise improves physical functioning in women with stage I and II breast cancer: results of a randomized controlled trial. J Clin Oncol. 2001;19(3):657–65.PubMed

19.

Mock V, Dow KH, Meares CJ, et al. Effects of exercise on fatigue, physical functioning, and emotional distress during radiation therapy for breast cancer. Oncol Nurs Forum. 1997;24(6):991–1000.PubMed

20.

Basen-Engquist K, Taylor CLC, Rosenblum C, et al. Randomized pilot test of a lifestyle physical activity intervention for breast cancer survivors. Patient Educ Couns. 2006;64(1–3):225–34. doi:10.1016/j.pec.2006.02.006.PubMedCrossRef

21.

Daley AJ, Crank H, Saxton JM, Mutrie N, Coleman R, Roalfe A. Randomized trial of exercise therapy in women treated for breast cancer. J Clin Oncol. 2007;25(13):1713–21. doi:10.1200/JCO.2006.09.5083.PubMedCrossRef

22.

Dimeo F, Fetscher S, Lange W, Mertelsmann R, Keul J. Effects of aerobic exercise on the physical performance and incidence of treatment-related complications after high-dose chemotherapy. Blood. 1997;90(9):3390–94.PubMed

23.

Pinto BM, Frierson GM, Rabin C, Trunzo JJ, Marcus BH. Home-based physical activity intervention for breast cancer patients. J Clin Oncol. 2005;23(15):3577–87. doi:10.1200/JCO.2005.03.080.PubMedCrossRef

24.

Segal RJ, Reid RD, Courneya KS, et al. Resistance exercise in men receiving androgen deprivation therapy for prostate cancer. J Clin Oncol. 2003;21(9):1653–59. doi:10.1200/JCO.2003.09.534.PubMedCrossRef

25.

Dimeo FC, Stieglitz R, Novelli-Fischer U, Fetscher S, Keul J. Effects of physical activity on the fatigue and psychologic status of cancer patients during chemotherapy. Cancer. 1999;85(10):2273–77. doi:10.1002/(SICI)1097-0142(19990515)85:10<2273::AID-CNCR24>3.0.CO;2-B.PubMedCrossRef

26.

Courneya KS, Mackey JR, Bell GJ, Jones LW, Field CJ, Fairey AS. Randomized controlled trial of exercise training in postmenopausal breast cancer survivors: cardiopulmonary and quality of life outcomes. J Clin Oncol. 2003;21(9):1660–68. doi:10.1200/JCO.2003.04.093.PubMedCrossRef

27.

Pinto BM, Trunzo J, Rabin C, Bucknam L, Cram R, Marcus B. Moving Forward: a randomized trial of a home-based physical activity program for breast cancer patients. Annals Behav Med. 2003;25(Suppl.):53.

28.

Pinto BM, Clark MM, Maruyama NC, Feder SI. Psychological and fitness changes associated with exercise participation among women with breast cancer. Psycho-Oncol. 2003;12:118–26. doi:10.1002/pon.618.CrossRef

29.

Courneya KS. Exercise interventions during cancer treatment: biopsychosocial outcomes. Exerc Sport Sci Rev. 2001;29(2):60–4. doi:10.1097/00003677-200104000-00004.PubMedCrossRef

30.

Dimeo F, Schmittel A, Fietz T, et al. Physical performance, depression, immune status and fatigue in patients with hematological malignancies after treatment. Ann Oncol. 2004;15(8):1237–42. doi:10.1093/annonc/mdh314.PubMedCrossRef

31.

Paffenbarger RS, Hyde RT, Wing AL, Hsieh C. Physical activity, all-cause mortality, and longevity of college alumni. N Engl J Med. 1986;314:605–13.PubMed

32.

Blair SN, Kohl HW, Gordon NF, Paffenbarger RS. How much physical activity is good for health? Annu Rev Physiol. 1992;13:99–126.

33.

USDHHS. (Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion). Physical activity and health: A report of the Surgeon General. 1996.

34.

Morgan WP. Affective beneficence of vigorous physical activity. Med Sci Sports Exerc. 1985;17(1):94–100. doi:10.1249/00005768-198502000-00015.PubMed

35.

Ware JE, Kosinski M, Bayliss MS, McHorney CA, Rogers WH, Raczek A. Comparison of methods for the scoring and statistical analysis of SF-36 health profile and summary measures: summary of results from the Medical Outcomes Study. Med Care. 1995;33(4):AS264–79.PubMed

36.

Ware JE Jr, Kosinski M, Keller SD. SF-36 Physical and Mental Health Summary Scales: a user’s manual Boston. Massachusetts: The Health Institute, New England Medical Center; 1994.

37.

McHorney CA, Ware JE, Raczek AE. The MOS 36-item short-form health survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care. 1993;31(3):247–63. doi:10.1097/00005650-199303000-00006.PubMedCrossRef

38.

Radloff LS. The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1(3):385–401. doi:10.1177/014662167700100306.CrossRef

39.

Sallis JF, Haskell WL, Wood PD, et al. Physical activity assessment methodology in the Five-City project. Am J Epidemiol. 1985;121:91–106.PubMed

40.

Blair SN, Haskell WL, Ho P, et al. Assessment of habitual physical activity by seven-day recall in a community survey and controlled experiments. Am J Epidemiol. 1985;122:794–804.PubMed

41.

Dishman RK, Steinhardt M. Reliability and concurrent validity for a 7-d re-call of physical activity in college students. Med Sci Sports Exerc. 1988;20(1):14–25. doi:10.1249/00005768-198802000-00003.PubMedCrossRef

42.

Rauh MJ, Hovell MF, Hofstetter CR, Sallis JF, Gleghorn A. Reliability and validity of self-reported physical activity in Latinos. Int J Epidemiol. 1992;21(5):966–71. doi:10.1093/ije/21.5.966.PubMedCrossRef

43.

United States Department of Health and Human Services. (US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion). Physical Activity and Health: A Report of the Surgeon General. 1996.

44.

Kruger J, Kohl HW III, Miles IJ. Prevalence of regular physical activity among adults—United States, 2001 and 2005. Morb Mortal. 2007;56(46):1209–212.

45.

Brown DW, Brown DR, Heath GW, et al. Associations between physical activity dose and health-related quality of life. Med Sci Sports Exerc. 2004;36(5):890–96. doi:10.1249/01.MSS.0000126778.77049.76.PubMedCrossRef

46.

Alfano CM, Smith AW, Irwin ML, et al. Physical activity, long-term symptoms, and physical health-related quality of life among breast cancer survivors: a prospective analysis. J Cancer Surviv. 2007;1:116–28. doi:10.1007/s11764-007-0014-1.PubMedCrossRef

47.

Jakicic JM, Wing RR, Butler BA, Robertson RJ. Prescribing exercise in multiple short bouts versus one continuous bout: Effects on adherence, cardiorespiratory fitness, and weight loss in overweight women. Int J Obes. 1995;19:893–901.

48.

DeBusk RF, Stenestrand U, Sheehan M, Haskell WL. Training effects of long versus short bouts of exercise in healthy subjects. Am J Cardiol. 1990;65(15):1010–13. doi:10.1016/0002-9149(90)91005-Q.PubMedCrossRef

49.

Schmitz KH, Holtzman J, Courneya KS, Masse LC, Duval S, Kane R. Controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. Cancer Epidemiol Biomark Prev. 2005;14(7):1588–95. doi:10.1158/1055-9965.EPI-04-0703.CrossRef

50.

Cramp F, Daniel J. Exercise for the management of cancer-related fatigue in adults. Cochrane Database of Systematic Reviews (Online: Update Software), (2), CD006145, 2008.

Title: Dimensions of physical activity and their relationship to physical and emotional symptoms in breast cancer survivors
Authors: Karen Basen-Engquist
Daniel Hughes
Heidi Perkins
Eileen Shinn
Cindy Carmack Taylor
Publication date: 01-12-2008
Publisher: Springer US
Published in: Journal of Cancer Survivorship / Issue 4/2008
Print ISSN: 1932-2259
Electronic ISSN: 1932-2267
DOI: https://doi.org/10.1007/s11764-008-0067-9

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

Background

Methods

Results

Discussion/Conclusions

Implications for cancer survivors

Please log in to get access to this content

Other articles of this Issue 4/2008

Distress persists in long-term brain tumor survivors with glioblastoma multiforme

Breast self-examination in long-term breast cancer survivors

Predicting recreational difficulties and decreased leisure activities in women 6–12 months post breast cancer surgery

Arm/hand swelling and perceived functioning among breast cancer survivors 12 years post-diagnosis: CALGB 79804

Cognitive effects of Tamoxifen in pre-menopausal women with breast cancer compared to healthy controls

Hot flashes, fatigue, treatment exposures and work productivity in breast cancer survivors

Keynote webinar | Spotlight on antibody–drug conjugates in cancer