Top

Published in:

Open Access 01-12-2014 | Study protocol

Randomized controlled trial to evaluate the effects of combined progressive exercise on metabolic syndrome in breast cancer survivors: rationale, design, and methods

Authors: Christina M Dieli-Conwright, Joanne E Mortimer, E Todd Schroeder, Kerry Courneya, Wendy Demark-Wahnefried, Thomas A Buchanan, Debu Tripathy, Leslie Bernstein

Published in: BMC Cancer | Issue 1/2014

Abstract

Background

Metabolic syndrome (MetS) is increasingly present in breast cancer survivors, possibly worsened by cancer-related treatments, such as chemotherapy. MetS greatly increases risk of cardiovascular disease and diabetes, co-morbidities that could impair the survivorship experience, and possibly lead to cancer recurrence. Exercise has been shown to positively influence quality of life (QOL), physical function, muscular strength and endurance, reduce fatigue, and improve emotional well-being; however, the impact on MetS components (visceral adiposity, hyperglycemia, low serum high-density lipoprotein cholesterol, hypertriglyceridemia, and hypertension) remains largely unknown. In this trial, we aim to assess the effects of combined (aerobic and resistance) exercise on components of MetS, as well as on physical fitness and QOL, in breast cancer survivors soon after completing cancer-related treatments.

Methods/Design

This study is a prospective randomized controlled trial (RCT) investigating the effects of a 16-week supervised progressive aerobic and resistance exercise training intervention on MetS in 100 breast cancer survivors. Main inclusion criteria are histologically-confirmed breast cancer stage I-III, completion of chemotherapy and/or radiation within 6 months prior to initiation of the study, sedentary, and free from musculoskeletal disorders. The primary endpoint is MetS; secondary endpoints include: muscle strength, shoulder function, cardiorespiratory fitness, body composition, bone mineral density, and QOL. Participants randomized to the Exercise group participate in 3 supervised weekly exercise sessions for 16 weeks. Participants randomized to the Control group are offered the same intervention after the 16-week period of observation.

Discussion

This is the one of few RCTs examining the effects of exercise on MetS in breast cancer survivors. Results will contribute a better understanding of metabolic disease-related effects of resistance and aerobic exercise training and inform intervention programs that will optimally improve physiological and psychosocial health during cancer survivorship, and that are ultimately aimed at improving prognosis.

Trial registration

NCT01140282; Registration: June 10, 2010

Available only for authorised users

SEER Cancer Statistics review, 1975–2004. Edited by: Ries L, Melbert D, Krapcho M, Mariotto A, Miller BA, Feuer EJ, Clegg L, Horner MJ, Howlader N, Eisner MP, Reichman M, Edwards BK. 2006, Bethesda, MD: National Cancer Institute

Hewitt M, Rowland JH, Yancik R: Cancer survivors in the United States: age, health, and disability. J Gerontol A Biol Sci Med Sci. 2003, 58 (1): 82-91. 10.1093/gerona/58.1.M82.CrossRefPubMed

Holmes MD, Chen WY, Feskanich D, Kroenke CH, Colditz GA: Physical activity and survival after breast cancer diagnosis. JAMA. 2005, 293 (20): 2479-2486. 10.1001/jama.293.20.2479.CrossRefPubMed

Irwin ML, Crumley D, McTiernan A, Bernstein L, Baumgartner R, Gilliland FD, Kriska A, Ballard-Barbash R: Physical activity levels before and after a diagnosis of breast carcinoma: the health, eating, activity, and lifestyle (HEAL) study. Cancer. 2003, 97 (7): 1746-1757. 10.1002/cncr.11227.CrossRefPubMedPubMedCentral

Irwin ML, Smith AW, McTiernan A, Ballard-Barbash R, Cronin K, Gilliland FD, Baumgartner RN, Baumgartner KB, Bernstein L: Influence of pre- and postdiagnosis physical activity on mortality in breast cancer survivors: the health, eating, activity, and lifestyle study. J Clin Oncol. 2008, 26 (24): 3958-3964. 10.1200/JCO.2007.15.9822.CrossRefPubMedPubMedCentral

Cadmus LA, Salovey P, Yu H, Chung G, Kasl S, Irwin ML: Exercise and quality of life during and after treatment for breast cancer: results of two randomized controlled trials. Psychooncology. 2009, 18 (4): 343-352. 10.1002/pon.1525.CrossRefPubMedPubMedCentral

Twiss JJ, Waltman NL, Berg K, Ott CD, Gross GJ, Lindsey AM: An exercise intervention for breast cancer survivors with bone loss. J Nurs Scholarsh. 2009, 41 (1): 20-27. 10.1111/j.1547-5069.2009.01247.x.CrossRefPubMed

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): 743-753.PubMed

Burgess C, Cornelius V, Love S, Graham J, Richards M, Ramirez A: Depression and anxiety in women with early breast cancer: five year observational cohort study. BMJ. 2005, 330 (7493): 702-10.1136/bmj.38343.670868.D3.CrossRefPubMedPubMedCentral

10.

Irwin ML, McTiernan A, Baumgartner RN, Baumgartner KB, Bernstein L, Gilliland FD, Ballard-Barbash R: Changes in body fat and weight after a breast cancer diagnosis: influence of demographic, prognostic, and lifestyle factors. J Clin Oncol. 2005, 23 (4): 774-782. 10.1200/JCO.2005.04.036.CrossRefPubMedPubMedCentral

11.

Hack TF, Pickles T, Ruether JD, Weir L, Bultz BD, Mackey J, Degner LF: Predictors of distress and quality of life in patients undergoing cancer therapy: impact of treatment type and decisional role. Psychooncology. 2009, 19 (6): 606-616. 10.1002/pon.1590.CrossRef

12.

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): 1660-1668. 10.1200/JCO.2003.04.093.CrossRefPubMed

13.

Irwin ML, Varma K, Alvarez-Reeves M, Cadmus L, Wiley A, Chung GG, Dipietro L, Mayne ST, Yu H: Randomized controlled trial of aerobic exercise on insulin and insulin-like growth factors in breast cancer survivors: the yale exercise and survivorship study. Cancer Epidemiol Biomarkers Prev. 2009, 18 (1): 306-313. 10.1158/1055-9965.EPI-08-0531.CrossRefPubMedPubMedCentral

14.

Ohira T, Schmitz KH, Ahmed RL, Yee D: Effects of weight training on quality of life in recent breast cancer survivors: the weight training for breast cancer survivors (WTBS) study. Cancer. 2006, 106 (9): 2076-2083. 10.1002/cncr.21829.CrossRefPubMed

15.

Schmitz KH, Ahmed RL, Troxel A, Cheville A, Smith R, Lewis-Grant L, Bryan CJ, Williams-Smith CT, Greene QP: Weight lifting in women with breast-cancer-related lymphedema. N Engl J Med. 2009, 361 (7): 664-673. 10.1056/NEJMoa0810118.CrossRefPubMed

16.

Kushi LH, Doyle C, McCullough M, Rock CL, Demark-Wahnefried W, Bandera EV, Gapstur S, Patel AV, Andrews K, Gansler T: American cancer society guidelines on nutrition and physical activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity. CA Cancer J Clin. 2012, 62 (1): 30-67. 10.3322/caac.20140.CrossRefPubMed

17.

Bernstein L, Henderson BE, Hanisch R, Sullivan-Halley J, Ross RK: Physical exercise and reduced risk of breast cancer in young women. J Natl Cancer Inst. 1994, 86 (18): 1403-1408. 10.1093/jnci/86.18.1403.CrossRefPubMed

18.

McTiernan A, Kooperberg C, White E, Wilcox S, Coates R, Adams-Campbell LL, Woods N, Ockene J: Recreational physical activity and the risk of breast cancer in postmenopausal women: the Women’s health initiative cohort study. JAMA. 2003, 290 (10): 1331-1336. 10.1001/jama.290.10.1331.CrossRefPubMed

19.

Morey MC, Snyder DC, Sloane R, Cohen HJ, Peterson B, Hartman TJ, Miller P, Mitchell DC, Demark-Wahnefried W: Effects of home-based diet and exercise on functional outcomes among older, overweight long-term cancer survivors: RENEW: a randomized controlled trial. JAMA. 2009, 301 (18): 1883-1891. 10.1001/jama.2009.643.CrossRefPubMedPubMedCentral

20.

Knobf MT, Insogna K, DiPietro L, Fennie C, Thompson AS: An aerobic weight-loaded pilot exercise intervention for breast cancer survivors: bone remodeling and body composition outcomes. Biol Res Nurs. 2008, 10 (1): 34-43. 10.1177/1099800408320579.CrossRefPubMedPubMedCentral

21.

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

22.

De Backer IC, Van Breda E, Vreugdenhil A, Nijziel MR, Kester AD, Schep G: High-intensity strength training improves quality of life in cancer survivors. Acta Oncol. 2007, 46 (8): 1143-1151. 10.1080/02841860701418838.CrossRefPubMed

23.

Courneya KS, Segal RJ, Mackey JR, Gelmon K, Reid RD, Friedenreich CM, Ladha AB, Proulx C, Vallance JK, Lane K, Yasui Y, McKenzie DC: Effects of aerobic and resistance exercise in breast cancer patients receiving adjuvant chemotherapy: a multicenter randomized controlled trial. J Clin Oncol. 2007, 25 (28): 4396-4404. 10.1200/JCO.2006.08.2024.CrossRefPubMed

24.

McKenzie DC, Kalda AL: Effect of upper extremity exercise on secondary lymphedema in breast cancer patients: a pilot study. J Clin Oncol. 2003, 21 (3): 463-466. 10.1200/JCO.2003.04.069.CrossRefPubMed

25.

Mutrie N, Campbell AM, Whyte F, McConnachie A, Emslie C, Lee L, Kearney N, Walker A, Ritchie D: Benefits of supervised group exercise programme for women being treated for early stage breast cancer: pragmatic randomised controlled trial. BMJ. 2007, 334 (7592): 517-10.1136/bmj.39094.648553.AE.CrossRefPubMedPubMedCentral

26.

Campbell A, Mutrie N, White F, McGuire F, Kearney N: A pilot study of a supervised group exercise programme as a rehabilitation treatment for women with breast cancer receiving adjuvant treatment. Eur J Oncol Nurs. 2005, 9 (1): 56-63. 10.1016/j.ejon.2004.03.007.CrossRefPubMed

27.

Thomson CA, Thompson PA, Wright-Bea J, Nardi E, Frey GR, Stopeck A: Metabolic syndrome and elevated C-reactive protein in breast cancer survivors on adjuvant hormone therapy. J Womens Health (Larchmt). 2009, 18 (12): 2041-2047. 10.1089/jwh.2009.1365.CrossRef

28.

de Haas EC, Oosting SF, Lefrandt JD, Wolffenbuttel BH, Sleijfer DT, Gietema JA: The metabolic syndrome in cancer survivors. Lancet Oncol. 2010, 11 (2): 193-203. 10.1016/S1470-2045(09)70287-6.CrossRefPubMed

29.

Grundy SM: Metabolic syndrome pandemic. Arterioscler Thromb Vasc Biol. 2008, 28 (4): 629-636. 10.1161/ATVBAHA.107.151092.CrossRefPubMed

30.

Metkus TS, Baughman KL, Thompson PD: Exercise prescription and primary prevention of cardiovascular disease. Circulation. 2010, 121 (23): 2601-2604. 10.1161/CIRCULATIONAHA.109.903377.CrossRefPubMed

31.

Bluher M, Zimmer P: [Metabolic and cardiovascular effects of physical activity, exercise and fitness in patients with type 2 diabetes]. Dtsch Med Wochenschr. 2010, 135 (18): 930-934. 10.1055/s-0030-1253682.CrossRefPubMed

32.

Healy LA, Ryan AM, Carroll P, Ennis D, Crowley V, Boyle T, Kennedy MJ, Connolly E, Reynolds JV: Metabolic syndrome, central obesity and insulin resistance are associated with adverse pathological features in postmenopausal breast cancer. Arterioscler Thromb Vasc Biol. 2010, 22 (4): 281-288.

33.

Emaus A, Veierod MB, Tretli S, Finstad SE, Selmer R, Furberg AS, Bernstein L, Schlichting E, Thune I: Metabolic profile, physical activity, and mortality in breast cancer patients. Breast Cancer Res Treat. 2010, 121 (3): 651-660. 10.1007/s10549-009-0603-y.CrossRefPubMed

34.

Demark-Wahnefried W, Peterson BL, Winer EP, Marks L, Aziz N, Marcom PK, Blackwell K, Rimer BK: Changes in weight, body composition, and factors influencing energy balance among premenopausal breast cancer patients receiving adjuvant chemotherapy. J Clin Oncol. 2001, 19 (9): 2381-2389.PubMed

35.

Vehmanen L, Saarto T, Blomqvist C, Taskinen MR, Elomaa I: Tamoxifen treatment reverses the adverse effects of chemotherapy-induced ovarian failure on serum lipids. Br J Cancer. 2004, 91 (3): 476-481. 10.1038/sj.bjc.6601979.CrossRefPubMedPubMedCentral

36.

Grundy SM: Drug therapy of the metabolic syndrome: minimizing the emerging crisis in polypharmacy. Nat Rev Drug Discov. 2006, 5 (4): 295-309. 10.1038/nrd2005.CrossRefPubMed

37.

Goodwin PJ, Ligibel JA, Stambolic V: Metformin in breast cancer: time for action. J Clin Oncol. 2009, 27 (20): 3271-3273. 10.1200/JCO.2009.22.1630.CrossRefPubMed

38.

Krentz AJ, Patel MB, Bailey CJ: New drugs for type 2 diabetes mellitus: what is their place in therapy?. Drugs. 2008, 68 (15): 2131-2162. 10.2165/00003495-200868150-00005.CrossRefPubMed

39.

Fairey AS, Courneya KS, Field CJ, Bell GJ, Jones LW, Mackey JR: Effects of exercise training on fasting insulin, insulin resistance, insulin-like growth factors, and insulin-like growth factor binding proteins in postmenopausal breast cancer survivors: a randomized controlled trial. Cancer Epidemiol Biomarkers Prev. 2003, 12 (8): 721-727.PubMed

40.

Ligibel JA, Campbell N, Partridge A, Chen WY, Salinardi T, Chen H, Adloff K, Keshaviah A, Winer EP: Impact of a mixed strength and endurance exercise intervention on insulin levels in breast cancer survivors. J Clin Oncol. 2008, 26 (6): 907-912. 10.1200/JCO.2007.12.7357.CrossRefPubMed

41.

Hayes SC, Spence RR, Galvao DA, Newton RU: Australian association for exercise and sport science position stand: optimising cancer outcomes through exercise. J Sci Med Sport. 2009, 12 (4): 428-434. 10.1016/j.jsams.2009.03.002.CrossRefPubMed

42.

Newton RU, Galvao DA: Exercise in prevention and management of cancer. Curr Treat Options Oncol. 2008, 9 (2–3): 135-146.CrossRefPubMed

43.

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: American college of sports medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc. 2010, 42 (7): 1409-1426.CrossRefPubMed

44.

Neilson HK, Friedenreich CM, Brockton NT, Millikan RC: Physical activity and postmenopausal breast cancer: proposed biologic mechanisms and areas for future research. Cancer Epidemiol Biomarkers Prev. 2009, 18 (1): 11-27. 10.1158/1055-9965.EPI-08-0756.CrossRefPubMed

45.

Sveklina TS, Talantseva MS, Barsukov A: [The metabolic syndrome and inflammation: actual issues of pathogenesis]. Klin Lab Diagn. 2013, 3: 7-10.PubMed

46.

Ebbeling CB, Ward A, Puleo EM, Widrick J, Rippe JM: Development of a single-stage submaximal treadmill walking test. Med Sci Sports Exerc. 1991, 23 (8): 966-973.CrossRefPubMed

47.

Jones LW, Eves ND, Haykowsky M, Joy AA, Douglas PS: Cardiorespiratory exercise testing in clinical oncology research: systematic review and practice recommendations. Lancet Oncol. 2008, 9 (8): 757-765. 10.1016/S1470-2045(08)70195-5.CrossRefPubMed

48.

Brzycki M: Strength testing: predicting a one-rep max from repetition-to-fatigue. JOHPERD. 1993, 64: 88-90.

49.

Prior BM, Cureton KJ, Modlesky CM, Evans EM, Sloniger MA, Saunders M, Lewis RD: In vivo validation of whole body composition estimates from dual-energy X-ray absorptiometry. J Appl Physiol. 1997, 83 (2): 623-630.PubMed

50.

Valentinuzzi ME: Bioelectrical impedance techniques in medicine. Part I: Bioimpedance measurement. First section: general concepts. Crit Rev Biomed Eng. 1996, 24 (4–6): 223-255.PubMed

51.

Harrington S, Padua D, Battaglini C, Michener LA: Upper extremity strength and range of motion and their relationship to function in breast cancer survivors. Physiother Theory Pract. 2013

52.

Taylor R, Jayasinghe UW, Koelmeyer L, Ung O, Boyages J: Reliability and validity of arm volume measurements for assessment of lymphedema. Phys Ther. 2006, 86 (2): 205-214.PubMed

53.

Kriska AM, Knowler WC, LaPorte RE, Drash AL, Wing RR, Blair SN, Bennett PH, Kuller LH: Development of questionnaire to examine relationship of physical activity and diabetes in Pima Indians. Diabetes Care. 1990, 13 (4): 401-411. 10.2337/diacare.13.4.401.CrossRefPubMed

54.

Irwin ML, Tworoger SS, Yasui Y, Rajan B, McVarish L, LaCroix K, Ulrich CM, Bowen D, Schwartz RS, Potter JD, McTiernan A: Influence of demographic, physiologic, and psychosocial variables on adherence to a yearlong moderate-intensity exercise trial in postmenopausal women. Prev Med. 2004, 39 (6): 1080-1086. 10.1016/j.ypmed.2004.04.017.CrossRefPubMed

55.

Neuhouser ML, Kristal AR, McLerran D, Patterson RE, Atkinson J: Validity of short food frequency questionnaires used in cancer chemoprevention trials: results from the prostate cancer prevention trial. Cancer Epidemiol Biomarkers Prev. 1999, 8 (8): 721-725.PubMed

56.

Snyder DC, Morey MC, Sloane R, Stull V, Cohen HJ, Peterson B, Pieper C, Hartman TJ, Miller PE, Mitchell DC, Demark-Wahnefried W: Reach out to ENhancE wellness in older cancer survivors (RENEW): design, methods and recruitment challenges of a home-based exercise and diet intervention to improve physical function among long-term survivors of breast, prostate, and colorectal cancer. Psychooncology. 2009, 18 (4): 429-439. 10.1002/pon.1491.CrossRefPubMedPubMedCentral

57.

Brady MJ, Cella DF, Mo F, Bonomi AE, Tulsky DS, Lloyd SR, Deasy S, Cobleigh M, Shiomoto G: Reliability and validity of the functional assessment of cancer therapy-breast quality-of-life instrument. J Clin Oncol. 1997, 15 (3): 974-986.PubMed

58.

Andresen EM, Malmgren JA, Carter WB, Patrick DL: Screening for depression in well older adults: evaluation of a short form of the CES-D (center for epidemiologic studies depression scale). Am J Prev Med. 1994, 10 (2): 77-84.PubMed

59.

Harrington S, Padua D, Battaglini C, Michener LA, Giuliani C, Myers J, Groff D: Comparison of shoulder flexibility, strength, and function between breast cancer survivors and healthy participants. J Cancer Surviv. 2011, 5 (2): 167-174. 10.1007/s11764-010-0168-0.CrossRefPubMed

60.

Leggin BG, Michener LA, Shaffer MA, Brenneman SK, Iannotti JP, Williams GR: The Penn shoulder score: reliability and validity. J Orthop Sports Phys Ther. 2006, 36 (3): 138-151. 10.2519/jospt.2006.36.3.138.CrossRefPubMed

61.

Denke MA, Pasternak RC: Defining and treating the metabolic syndrome: a primer from the adult treatment panel III. Curr Treat Options Cardiovasc Med. 2001, 3 (4): 251-253. 10.1007/s11936-001-0087-5.CrossRefPubMed

62.

Nuver J, Smit AJ, Postma A, Sleijfer DT, Gietema JA: The metabolic syndrome in long-term cancer survivors, an important target for secondary preventive measures. Cancer Treat Rev. 2002, 28 (4): 195-214. 10.1016/S0305-7372(02)00038-5.CrossRefPubMed

63.

Redig AJ, Munshi HG: Care of the cancer survivor: metabolic syndrome after hormone-modifying therapy. The American journal of medicine. 2010, 123 (1): 87-e81-86CrossRefPubMedPubMedCentral

64.

Cowey S, Hardy RW: The metabolic syndrome: a high-risk state for cancer?. Am J Pathol. 2006, 169 (5): 1505-1522. 10.2353/ajpath.2006.051090.CrossRefPubMedPubMedCentral

65.

Dai DF, Hwang JJ, Chen CL, Chiang FT, Lin JL, Hsu KL, Tseng CD, Tseng YZ: Effect of physical activity on the prevalence of metabolic syndrome and left ventricular hypertrophy in apparently healthy adults. J Formos Med Assoc. 2010, 109 (10): 716-724. 10.1016/S0929-6646(10)60116-7.CrossRefPubMed

66.

Nguyen TH, Tang HK, Kelly P, van der Ploeg HP, Dibley MJ: Association between physical activity and metabolic syndrome: a cross sectional survey in adolescents in Ho Chi Minh City, Vietnam. BMC Public Health. 2010, 10: 141-10.1186/1471-2458-10-141.CrossRefPubMedPubMedCentral

67.

Harralson TL, Uplinger N, McLaughlin M: Increasing physical activity: a step toward controlling metabolic syndrome. Diabetes Educ. 2010, 36 (1): 70-71. 10.1177/0145721709358461.CrossRefPubMed

68.

van Waas M, Neggers SJ, van der Lelij AJ, Pieters R, van den Heuvel-Eibrink MM: The metabolic syndrome in adult survivors of childhood cancer, a review. J Pediatr Hematol Oncol. 2010, 32 (3): 171-179. 10.1097/MPH.0b013e3181d419c3.CrossRefPubMed

69.

Bao PP, Zheng Y, Nechuta S, Gu K, Cai H, Peng P, Shu XO, Lu W: Exercise after diagnosis and metabolic syndrome among breast cancer survivors: a report from the shanghai breast cancer survival study. Cancer Causes Control. 2013, 24 (9): 1747-1756. 10.1007/s10552-013-0252-7.CrossRefPubMed

70.

Leon AS, Sanchez OA: Response of blood lipids to exercise training alone or combined with dietary intervention. Medicine and science in sports and exercise. 2001, 33 (6 Suppl): S502-515. discussion S528-509CrossRefPubMed

71.

Byberg L, Zethelius B, McKeigue PM, Lithell HO: Changes in physical activity are associated with changes in metabolic cardiovascular risk factors. Diabetologia. 2001, 44 (12): 2134-2139. 10.1007/s001250100022.CrossRefPubMed

72.

Moreau KL, Degarmo R, Langley J, McMahon C, Howley ET, Bassett DR, Thompson DL: Increasing daily walking lowers blood pressure in postmenopausal women. Med Sci Sports Exerc. 2001, 33 (11): 1825-1831.CrossRefPubMed

73.

Irwin ML, Mayer-Davis EJ, Addy CL, Pate RR, Durstine JL, Stolarczyk LM, Ainsworth BE: Moderate-intensity physical activity and fasting insulin levels in women: the cross-cultural activity participation study. Diabetes Care. 2000, 23 (4): 449-454. 10.2337/diacare.23.4.449.CrossRefPubMed

74.

Ibanez J, Izquierdo M, Martinez-Labari C, Ortega F, Grijalba A, Forga L, Idoate F, Garcia-Unciti M, Fernandez-Real JM, Gorostiaga EM: Resistance training improves cardiovascular risk factors in obese women despite a significative decrease in serum adiponectin levels. Obesity (Silver Spring). 2010, 18 (3): 535-541. 10.1038/oby.2009.277.CrossRef

75.

Dipietro L, Yeckel CW, Dziura J: Progressive improvement in glucose tolerance following lower-intensity resistance versus moderate-intensity aerobic training in older women. J Phys Act Health. 2008, 5 (6): 854-869.PubMed

76.

Fenicchia LM, Kanaley JA, Azevedo JL, Miller CS, Weinstock RS, Carhart RL, Ploutz-Snyder LL: Influence of resistance exercise training on glucose control in women with type 2 diabetes. Metabolism. 2004, 53 (3): 284-289. 10.1016/j.metabol.2003.10.007.CrossRefPubMed

77.

Rogers LQ, Markwell SJ, Verhulst S, McAuley E, Courneya KS: Rural breast cancer survivors: exercise preferences and their determinants. Psychooncology. 2009, 18 (4): 412-421. 10.1002/pon.1497.CrossRefPubMed

78.

Milne HM, Guilfoyle A, Gordon S, Wallman KE, Courneya KS: Personal accounts of exercise and quality of life from the perspective of breast cancer survivors. Qual Life Res. 2007, 16 (9): 1473-1481. 10.1007/s11136-007-9251-z.CrossRefPubMed

79.

State & County Quick Facts: State & County Quick Facts. [http://quickfacts.census.gov/qfd/states/06/0656000.html]

80.

Demark-Wahnefried W, Aziz NM, Rowland JH, Pinto BM: Riding the crest of the teachable moment: promoting long-term health after the diagnosis of cancer. J Clin Oncol. 2005, 23 (24): 5814-5830. 10.1200/JCO.2005.01.230.CrossRefPubMedPubMedCentral

81.

McBride CM, Clipp E, Peterson BL, Lipkus IM, Demark-Wahnefried W: Psychological impact of diagnosis and risk reduction among cancer survivors. Psychooncology. 2000, 9 (5): 418-427. 10.1002/1099-1611(200009/10)9:5<418::AID-PON474>3.0.CO;2-E.CrossRefPubMed

82.

Spark LC, Reeves MM, Fjeldsoe BS, Eakin EG: Physical activity and/or dietary interventions in breast cancer survivors: a systematic review of the maintenance of outcomes. J Cancer Surviv. 2013, 7 (1): 74-82. 10.1007/s11764-012-0246-6.CrossRefPubMed

83.

Latka RN, Alvarez-Reeves M, Cadmus L, Irwin ML: Adherence to a randomized controlled trial of aerobic exercise in breast cancer survivors: the Yale exercise and survivorship study. J Cancer Surviv. 2009, 3 (3): 148-157. 10.1007/s11764-009-0088-z.CrossRefPubMed

84.

Irwin ML, Cadmus L, Alvarez-Reeves M, O’Neil M, Mierzejewski E, Latka R, Yu H, Dipietro L, Jones B, Knobf MT, Chung GG, Mayne ST: Recruiting and retaining breast cancer survivors into a randomized controlled exercise trial: the yale exercise and survivorship study. Cancer. 2008, 112 (11 Suppl): 2593-2606.CrossRefPubMed

The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2407/14/238/prepub

Title: Randomized controlled trial to evaluate the effects of combined progressive exercise on metabolic syndrome in breast cancer survivors: rationale, design, and methods
Authors: Christina M Dieli-Conwright
Joanne E Mortimer
E Todd Schroeder
Kerry Courneya
Wendy Demark-Wahnefried
Thomas A Buchanan
Debu Tripathy
Leslie Bernstein
Publication date: 01-12-2014
Publisher: BioMed Central
Published in: BMC Cancer / Issue 1/2014
Electronic ISSN: 1471-2407
DOI: https://doi.org/10.1186/1471-2407-14-238

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/Design

Discussion

Trial registration

Please log in to get access to this content

Other articles of this Issue 1/2014

The effects of psychological interventions on depression and anxiety among Chinese adults with cancer: a meta-analysis of randomized controlled studies

Prognostic implications of ezrin and phosphorylated ezrin expression in non-small cell lung cancer

Irreversible electroporation of unresectable soft tissue tumors with vascular invasion: effective palliation

A case-control study of glycemic index, glycemic load and dietary fiber intake and risk of adenocarcinomas and squamous cell carcinomas of the esophagus: the Australian Cancer Study

Prognostic significance of glypican-3 in hepatocellular carcinoma: a meta-analysis

Keynote webinar | Spotlight on antibody–drug conjugates in cancer