Active lifestyle promotion with home-based exercise in breast cancer survivors

Gabriele Mascherini, Chiara Giannelli, Giulia Ghelarducci, Sonia Degl'Innocenti, Cristian Petri, Giorgio Galanti

Abstract

Background: In cancer survivors, quality of life, weight management and physical activity levels are growing areas of interest, also considering such parameters may offer protection to cancer recurrence. Research question: In this study we aimed to objectively verify whether an home-based exercise program is effective in weight management of a cohort of breast-cancer survivors. Type of study: Experimental cohort observational study. Methods: We enrolled 13 women (age 49.1±5.5, height 163±7.3 cm) and evaluated habitual physical activity levels. Afterwards we compared the baseline aerobic capacity by 6 Minutes Walking Test (6MWT), flexibility, grip and lower limbs strength and body composition, to the same parameters measured after 40 days of unsupervised exercise. Results: At baseline (T0), patients displayed a moderate level of physical activity and were overweight. After  40 days of unsupervised exercise (T1), we observed improvement of all analyzed parameters with statistical significance in waist circumference (T0=0.57±0.1 cm, T1=0.55±0.1 cm; p<0.01), distance walked in 6 MWT (T0445.4±168.1 m, T1=534.6±151.5 m; p<0.05), 30 '' Chair test (T0=14.8±5.6 rep, T1=16.3±4.9 rep; p<0.05). Conclusions: Home-based unsupervised exercise in breast-cancer survivors yielded short-term efficacy in all analyzed parameters. Efficacy at long-term and a possible effect in reducing the risk of tumor relapse remain to be elucidated in larger cohorts with longer and multidisciplinary follow up.


Keywords

Physical activity; Oncology; Unsupervised exercise; Lifestyle

References

Annunziata MA, Muzzatti B, Giovannini L, et. al (2015) Is long-term cancer survivors' quality of life comparable to that of the general population? An italian study. Support Care Cancer; 23(9):2663-8. https://doi.org/10.1007/s00520-015-2628-6

Battaglini, C. L., Mills, R. C., Phillips, B. L., Lee, J. T., Story, C. E., Nascimento, M. G., & Hackney, A. C. (2014). Twenty-five years of research on the effects of exercise training in breast cancer survivors: A systematic review of the literature. World Journal of Clinical Oncology, 5(2), 177–190. https://doi.org/10.5306/wjco.v5.i2.177

Bluethmann SM, Vernon SW, Gabriel KP, 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 Research and Treatment;149(2):331-342. https://doi.org/10.1007/s10549-014-3255-5

Calabró MA, Lee JM, Saint-Maurice PF, et al. (2014) Validity of physical activity monitors for assessing lower intensity activity in adults. Int J Behav Nutr Phys Act. 28;11:119. doi: 10.1186/s12966-014-0119-7. https://doi.org/10.1186/s12966-014-0119-7

Capocaccia R, Gatta G, Dal Maso L. (2015) Life expectancy of colon, breast and testicular cancer patients. An analysis of USSEER population-based data. Ann Oncol. https://doi.org/10.1093/annonc/mdv131

Chyu C, Halnon N (2016) Exercise Training in Cancer Survivors. Curr Oncol Rep.;18(6):38. https://doi.org/10.1007/s11912-016-0520-2

Cramp F, Byron-Daniel J (2012) Exercise for the management of cancer-related fatigue in adults. Cochrane Database of Systematic Reviews;Issue 11. https://doi.org/10.1002/14651858.CD006145.pub3

Dal Maso L, Guzzinati S, Buzzoni C, et a. (2014) Long-term survival and cure of cancer: A population-based estimation for 818,902 Italian patients and 26 cancer types. Ann Oncol; 25:2251-2260. https://doi.org/10.1093/annonc/mdu383

Durnin J.V., Womersley J. (1974) Body fat assessed from total body density and its estimation from skinfold thickness: measurements on 481 men and women aged from 16 to 72 years. Br J Nutr., 32(1):77-97. https://doi.org/10.1079/BJN19740060

Foster K.F., Lukaski H.C. Whole-body impedance – what does it measure? (1996) Am J Clin Nutr, 64 (suppl):388S–396S. https://doi.org/10.1093/ajcn/64.3.388S

Francisci S, Capocaccia R, Grande E, et al. (2009) EUROCARE Working Group. The cure of cancer: A European perspective. European Journal of Cancer;45:1067-1079. https://doi.org/10.1016/j.ejca.2008.11.034

Gomes PR, Freitas Junior IF, da Silva CB, et al. (2014) Short term changes in handgrip strength, body composition, and lymphedema induced by breast cancer surgery. Rev Bras Ginecol Obstet.;36(6):244-50. https://doi.org/10.1590/S0100-720320140005004

Kyle U.G., Bosaeus I., De Lorenzo A.D., et al. (2004) Bioelectrical impedance analysis – part I: review of principles and methods. Clin Nutr, 23:1226–1243. https://doi.org/10.1016/j.clnu.2004.06.004

Marfell-Jones M.J., Stewart A.D., de Ridder J.H. (2012) International standards for anthropometric assessment. Wellington, New Zealand: International Society for the Advancement of Kinanthropometry.

Markes M, Brockow T, Resch KL (2006) Exercise for women receiving adjuvant therapy for breast cancer Cochrane Database of Systematic Reviews 18;(4). https://doi.org/10.1002/14651858.CD005001.pub2

Mascherini G, Petri C, Galanti G (2015) Integrated total body composition and localized fat-free mass assessment. Sport Sci Health; 11(2): 217-225. https://doi.org/10.1007/s11332-015-0228-y

Mayorga-Vega, D., Merino-Marban, R., & Viciana, J. (2014). Criterion-Related Validity of Sit-and-Reach Tests for Estimating Hamstring and Lumbar Extensibility: a Meta-Analysis. Journal of Sports Science & Medicine, 13(1), 1–14.

McTiernan A (2008) Mechanisms linking physical activity with cancer. Nat Rev Cancer, 8, 205-211. https://doi.org/10.1038/nrc2325

Rossi A, Garber CE, Ortiz M, et al. (2016) Feasibility of a physical activity intervention for obese, socioculturally diverse endometrial cancer survivors. Gynecol Oncol.4. pii: S0090-8258(16)30763-6. https://doi.org/10.1016/j.ygyno.2016.05.034

Schmitz K, Kerry M, Courneya S. et. al. (2010) American College of Sports Medicine Roundtable on Exercise Guidelines for Cancer Survivors Med Sci Sports Exerc. 42(7):1409-26. https://doi.org/10.1249/MSS.0b013e3181e0c112

Schmitz K (2011) Physical activity and breast cancer survivorship. Recent Results Cancer Res, 186:189-215. https://doi.org/10.1007/978-3-642-04231-7_8

Sheean PM, Hoskins K, Stolley M (2012) Body composition changes in females treated for breast cancer: a review of the evidence. Breast Cancer Res Treat.;135(3):663-80. https://doi.org/10.1007/s10549-012-2200-8

Solway S, Brooks D, Lacasse Y, Thomas S. (2001) A qualitative systematic overview of the measurement properties of functional walk tests used in the cardiorespiratory domain. Chest.;119(1):256-70. https://doi.org/10.1378/chest.119.1.256

Torre LA, Siegel RL, Ward EM, Jemal A (2016) Global Cancer Incidence and Mortality Rates and Trends--An Update. Cancer Epidemiol Biomarkers Prev.;25(1):16-27. https://doi.org/10.1158/1055-9965.EPI-15-0578

Welborn T.A., Satvinder S., Dhaliwal, et al. (2003) Waist–hip ratio is the dominant risk factor predicting cardiovascular death in Australia. Med J Aust, 179 (11/12): 580-585.




DOI: https://doi.org/10.14198/jhse.2017.121.10