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Published in: Supportive Care in Cancer 9/2016

01-09-2016 | Original Article

Randomized pilot trial of yoga versus strengthening exercises in breast cancer survivors with cancer-related fatigue

Authors: Daniela L. Stan, Katrina A. Croghan, Ivana T. Croghan, Sarah M. Jenkins, Stephanie J. Sutherland, Andrea L. Cheville, Sandhya Pruthi

Published in: Supportive Care in Cancer | Issue 9/2016

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Abstract

Purpose

Fatigue is one of the most common and bothersome refractory symptoms experienced by cancer survivors. Mindful exercise interventions such as yoga improve cancer-related fatigue; however, studies of yoga have included heterogeneous survivorship populations, and the effect of yoga on fatigued survivors remains unclear.

Methods

We randomly assigned 34 early-stage breast cancer survivors with cancer-related fatigue (≥4 on a Likert scale from 1–10) within 1 year from diagnosis to a 12-week intervention of home-based yoga versus strengthening exercises, both presented on a DVD. The primary endpoints were feasibility and changes in fatigue, as measured by the Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF). Secondary endpoint was quality of life, assessed by the Functional Assessment of Cancer Therapies-Breast (FACT-B).

Results

We invited 401 women to participate in the study; 78 responded, and we enrolled 34. Both groups had significant within-group improvement in multiple domains of the fatigue and quality of life scores from baseline to post-intervention, and these benefits were maintained at 3 months post-intervention. However, there was no significant difference between groups in fatigue or quality of life at any assessment time. Similarly, there was no difference between groups in adherence to the exercise intervention.

Conclusions

Both DVD-based yoga and strengthening exercises designed for cancer survivors may be good options to address fatigue in breast cancer survivors. Both have reasonable uptake, are convenient and reproducible, and may be helpful in decreasing fatigue and improving quality of life in the first year post-diagnosis in breast cancer patients with cancer-related fatigue.
Literature
2.
go back to reference Potash J, Anderson KC (2014) AACR cancer progress report 2014: transforming lives through research. Clin Cancer Res 20(19):4977CrossRefPubMed Potash J, Anderson KC (2014) AACR cancer progress report 2014: transforming lives through research. Clin Cancer Res 20(19):4977CrossRefPubMed
3.
go back to reference Hofman M et al (2007) Cancer-related fatigue: the scale of the problem. Oncologist 12(Suppl 1):4–10CrossRefPubMed Hofman M et al (2007) Cancer-related fatigue: the scale of the problem. Oncologist 12(Suppl 1):4–10CrossRefPubMed
4.
go back to reference Bower JE, Garet D, Sternlieb B, Ganz PA, Irwin MR, Olmstead R, Greendale G (2012) Yoga for persistent fatigue in breast cancer survivors: a randomized controlled trial. Cancer 118(15):3766–3775. doi:10.1002/cncr.26702 Bower JE, Garet D, Sternlieb B, Ganz PA, Irwin MR, Olmstead R, Greendale G (2012) Yoga for persistent fatigue in breast cancer survivors: a randomized controlled trial. Cancer 118(15):3766–3775. doi:10.​1002/​cncr.​26702
5.
go back to reference Bower JE et al (2006) Fatigue in long-term breast carcinoma survivors: a longitudinal investigation. Cancer 106(4):751–8CrossRefPubMed Bower JE et al (2006) Fatigue in long-term breast carcinoma survivors: a longitudinal investigation. Cancer 106(4):751–8CrossRefPubMed
7.
go back to reference Schmidt, M.E. et al., Effects of resistance exercise on fatigue and quality of life in breast cancer patients undergoing adjuvant chemotherapy: a randomized controlled trial. International Journal of Cancer. Journal international du cancer, 2014 Schmidt, M.E. et al., Effects of resistance exercise on fatigue and quality of life in breast cancer patients undergoing adjuvant chemotherapy: a randomized controlled trial. International Journal of Cancer. Journal international du cancer, 2014
8.
go back to reference Steindorf K et al (2014) Randomized, controlled trial of resistance training in breast cancer patients receiving adjuvant radiotherapy: results on cancer-related fatigue and quality of life. Ann Oncol 25(11):2237–43CrossRefPubMed Steindorf K et al (2014) Randomized, controlled trial of resistance training in breast cancer patients receiving adjuvant radiotherapy: results on cancer-related fatigue and quality of life. Ann Oncol 25(11):2237–43CrossRefPubMed
9.
go back to reference Rogers LQ et al (2015) Effects of the BEAT Cancer physical activity behavior change intervention on physical activity, aerobic fitness, and quality of life in breast cancer survivors: a multicenter randomized controlled trial. Breast Cancer Res Treat 149(1):109–19CrossRefPubMed Rogers LQ et al (2015) Effects of the BEAT Cancer physical activity behavior change intervention on physical activity, aerobic fitness, and quality of life in breast cancer survivors: a multicenter randomized controlled trial. Breast Cancer Res Treat 149(1):109–19CrossRefPubMed
10.
go back to reference Murtezani A et al (2014) The effect of aerobic exercise on quality of life among breast cancer survivors: a randomized controlled trial. J Cancer Res Ther 10(3):658–664PubMed Murtezani A et al (2014) The effect of aerobic exercise on quality of life among breast cancer survivors: a randomized controlled trial. J Cancer Res Ther 10(3):658–664PubMed
11.
go back to reference Milne HM et al (2008) Effects of a combined aerobic and resistance exercise program in breast cancer survivors: a randomized controlled trial. Breast Cancer Res Treat 108(2):279–288CrossRefPubMed Milne HM et al (2008) Effects of a combined aerobic and resistance exercise program in breast cancer survivors: a randomized controlled trial. Breast Cancer Res Treat 108(2):279–288CrossRefPubMed
12.
go back to reference Schmitz KH et al (2009) Weight lifting in women with breast-cancer-related lymphedema. N Engl J Med 361(7):664–73CrossRefPubMed Schmitz KH et al (2009) Weight lifting in women with breast-cancer-related lymphedema. N Engl J Med 361(7):664–73CrossRefPubMed
13.
go back to reference Sagen A, Karesen R, Risberg MA (2009) Physical activity for the affected limb and arm lymphedema after breast cancer surgery. A prospective, randomized controlled trial with two years follow-up. Acta Oncol 48(8):1102–10CrossRefPubMed Sagen A, Karesen R, Risberg MA (2009) Physical activity for the affected limb and arm lymphedema after breast cancer surgery. A prospective, randomized controlled trial with two years follow-up. Acta Oncol 48(8):1102–10CrossRefPubMed
14.
go back to reference Holmes MD et al (2005) Physical activity and survival after breast cancer diagnosis. JAMA 293(20):2479–86CrossRefPubMed Holmes MD et al (2005) Physical activity and survival after breast cancer diagnosis. JAMA 293(20):2479–86CrossRefPubMed
15.
go back to reference de Glas NA et al (2014) Physical activity and survival of postmenopausal, hormone receptor-positive breast cancer patients results of the Tamoxifen Exemestane Adjuvant Multicenter Lifestyle study. Cancer 120(18):2847–2854CrossRefPubMed de Glas NA et al (2014) Physical activity and survival of postmenopausal, hormone receptor-positive breast cancer patients results of the Tamoxifen Exemestane Adjuvant Multicenter Lifestyle study. Cancer 120(18):2847–2854CrossRefPubMed
16.
go back to reference Wanchai A, Armer JM, Stewart BR (2010) Complementary and alternative medicine use among women with breast cancer: a systematic review. Clin J Oncol Nurs 14(4):E45–55CrossRefPubMed Wanchai A, Armer JM, Stewart BR (2010) Complementary and alternative medicine use among women with breast cancer: a systematic review. Clin J Oncol Nurs 14(4):E45–55CrossRefPubMed
17.
go back to reference Stan DL et al (2012) The evolution of mindfulness-based physical interventions in breast cancer survivors. Evid Based Complement Alternat Med 2012:758641CrossRefPubMedPubMedCentral Stan DL et al (2012) The evolution of mindfulness-based physical interventions in breast cancer survivors. Evid Based Complement Alternat Med 2012:758641CrossRefPubMedPubMedCentral
18.
go back to reference Greenlee H et al (2014) Clinical practice guidelines on the use of integrative therapies as supportive care in patients treated for breast cancer. J Natl Cancer Inst Monogr 2014(50):346–58CrossRefPubMedPubMedCentral Greenlee H et al (2014) Clinical practice guidelines on the use of integrative therapies as supportive care in patients treated for breast cancer. J Natl Cancer Inst Monogr 2014(50):346–58CrossRefPubMedPubMedCentral
19.
go back to reference Bower JE et al (2005) Yoga for cancer patients and survivors. Cancer Control 12(3):165–71PubMed Bower JE et al (2005) Yoga for cancer patients and survivors. Cancer Control 12(3):165–71PubMed
20.
go back to reference Vadiraja HS et al (2009) Effects of yoga program on quality of life and affect in early breast cancer patients undergoing adjuvant radiotherapy: a randomized controlled trial. Complement Ther Med 17(5-6):274–80CrossRefPubMed Vadiraja HS et al (2009) Effects of yoga program on quality of life and affect in early breast cancer patients undergoing adjuvant radiotherapy: a randomized controlled trial. Complement Ther Med 17(5-6):274–80CrossRefPubMed
21.
go back to reference Chandwani KD et al (2010) Yoga improves quality of life and benefit finding in women undergoing radiotherapy for breast cancer. J Soc Integr Oncol 8(2):43–55PubMed Chandwani KD et al (2010) Yoga improves quality of life and benefit finding in women undergoing radiotherapy for breast cancer. J Soc Integr Oncol 8(2):43–55PubMed
22.
go back to reference Banasik J et al (2011) Effect of Iyengar yoga practice on fatigue and diurnal salivary cortisol concentration in breast cancer survivors. J Am Acad Nurse Pract 23(3):135–42CrossRefPubMed Banasik J et al (2011) Effect of Iyengar yoga practice on fatigue and diurnal salivary cortisol concentration in breast cancer survivors. J Am Acad Nurse Pract 23(3):135–42CrossRefPubMed
23.
go back to reference Moadel AB et al (2007) Randomized controlled trial of yoga among a multiethnic sample of breast cancer patients: effects on quality of life. J Clin Oncol 25(28):4387–95CrossRefPubMed Moadel AB et al (2007) Randomized controlled trial of yoga among a multiethnic sample of breast cancer patients: effects on quality of life. J Clin Oncol 25(28):4387–95CrossRefPubMed
24.
go back to reference Littman AJ et al (2012) Randomized controlled pilot trial of yoga in overweight and obese breast cancer survivors: effects on quality of life and anthropometric measures. Support Care Cancer 20(2):267–77CrossRefPubMed Littman AJ et al (2012) Randomized controlled pilot trial of yoga in overweight and obese breast cancer survivors: effects on quality of life and anthropometric measures. Support Care Cancer 20(2):267–77CrossRefPubMed
25.
go back to reference Kiecolt-Glaser JK et al (2014) Yoga’s impact on inflammation, mood, and fatigue in breast cancer survivors: a randomized controlled trial. J Clin Oncol 32(10):1040–9CrossRefPubMedPubMedCentral Kiecolt-Glaser JK et al (2014) Yoga’s impact on inflammation, mood, and fatigue in breast cancer survivors: a randomized controlled trial. J Clin Oncol 32(10):1040–9CrossRefPubMedPubMedCentral
26.
27.
go back to reference Cheville AL et al (2013) A home-based exercise program to improve function, fatigue, and sleep quality in patients with stage IV lung and colorectal cancer: a randomized controlled trial. J Pain Symptom Manag 45(5):811–21CrossRef Cheville AL et al (2013) A home-based exercise program to improve function, fatigue, and sleep quality in patients with stage IV lung and colorectal cancer: a randomized controlled trial. J Pain Symptom Manag 45(5):811–21CrossRef
28.
29.
go back to reference Donovan KA, Jacobsen PB (2010) The Fatigue Symptom Inventory: a systematic review of its psychometric properties. Support Care Cancer 19(2):169–85CrossRefPubMed Donovan KA, Jacobsen PB (2010) The Fatigue Symptom Inventory: a systematic review of its psychometric properties. Support Care Cancer 19(2):169–85CrossRefPubMed
30.
go back to reference Hann DM et al (1998) Measurement of fatigue in cancer patients: development and validation of the Fatigue Symptom Inventory. Qual Life Res 7(4):301–10CrossRefPubMed Hann DM et al (1998) Measurement of fatigue in cancer patients: development and validation of the Fatigue Symptom Inventory. Qual Life Res 7(4):301–10CrossRefPubMed
31.
go back to reference Stein KD et al (2004) Further validation of the multidimensional fatigue symptom inventory-short form. J Pain Symptom Manag 27(1):14–23CrossRef Stein KD et al (2004) Further validation of the multidimensional fatigue symptom inventory-short form. J Pain Symptom Manag 27(1):14–23CrossRef
32.
go back to reference Stein KD et al (1998) A multidimensional measure of fatigue for use with cancer patients. Cancer Pract 6(3):143–52CrossRefPubMed Stein KD et al (1998) A multidimensional measure of fatigue for use with cancer patients. Cancer Pract 6(3):143–52CrossRefPubMed
33.
go back to reference Cella DF et al (1993) The Functional Assessment of Cancer Therapy scale: development and validation of the general measure. J Clin Oncol 11(3):570–9PubMed Cella DF et al (1993) The Functional Assessment of Cancer Therapy scale: development and validation of the general measure. J Clin Oncol 11(3):570–9PubMed
34.
go back to reference Coster S, Poole K, Fallowfield LJ (2001) The validation of a quality of life scale to assess the impact of arm morbidity in breast cancer patients post-operatively. Breast Cancer Res Treat 68(3):273–82CrossRefPubMed Coster S, Poole K, Fallowfield LJ (2001) The validation of a quality of life scale to assess the impact of arm morbidity in breast cancer patients post-operatively. Breast Cancer Res Treat 68(3):273–82CrossRefPubMed
35.
go back to reference Beaulac SM et al (2002) Lymphedema and quality of life in survivors of early-stage breast cancer. Arch Surg 137(11):1253–7CrossRefPubMed Beaulac SM et al (2002) Lymphedema and quality of life in survivors of early-stage breast cancer. Arch Surg 137(11):1253–7CrossRefPubMed
36.
go back to reference Eton DT et al (2004) A combination of distribution- and anchor-based approaches determined minimally important differences (MIDs) for four endpoints in a breast cancer scale. J Clin Epidemiol 57(9):898–910CrossRefPubMed Eton DT et al (2004) A combination of distribution- and anchor-based approaches determined minimally important differences (MIDs) for four endpoints in a breast cancer scale. J Clin Epidemiol 57(9):898–910CrossRefPubMed
37.
go back to reference Clark MM et al (2013) Randomized controlled trial of maintaining quality of life during radiotherapy for advanced cancer. Cancer 119(4):880–7CrossRefPubMed Clark MM et al (2013) Randomized controlled trial of maintaining quality of life during radiotherapy for advanced cancer. Cancer 119(4):880–7CrossRefPubMed
38.
go back to reference Adams R et al (2015) Cancer survivors’ uptake and adherence in diet and exercise intervention trials: an integrative data analysis. Cancer 121(1):77–83CrossRefPubMed Adams R et al (2015) Cancer survivors’ uptake and adherence in diet and exercise intervention trials: an integrative data analysis. Cancer 121(1):77–83CrossRefPubMed
39.
go back to reference Bluethmann SM et al (2015) Taking the next step: a systematic review and meta-analysis of physical activity and behavior change interventions in recent post-treatment breast cancer survivors. Breast Cancer Res Treat 149(2):331–42CrossRefPubMedPubMedCentral Bluethmann SM et al (2015) Taking the next step: a systematic review and meta-analysis of physical activity and behavior change interventions in recent post-treatment breast cancer survivors. Breast Cancer Res Treat 149(2):331–42CrossRefPubMedPubMedCentral
Metadata
Title
Randomized pilot trial of yoga versus strengthening exercises in breast cancer survivors with cancer-related fatigue
Authors
Daniela L. Stan
Katrina A. Croghan
Ivana T. Croghan
Sarah M. Jenkins
Stephanie J. Sutherland
Andrea L. Cheville
Sandhya Pruthi
Publication date
01-09-2016
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 9/2016
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-016-3233-z

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