Nutritional Symptom and Body Composition Outcomes of Aerobic Exercise in Women With Breast Cancer Exercise effects on bone mineral density in women with breast cancer receiving adjuvant chemotherapy. Sarcopenia in ovarian cancer patients, oncologic outcomes revealing the importance of clinical nutrition: review of literature. Reducing breast cancer recurrence with weight loss, a vanguard trial: the Exercise and Nutrition to Enhance Recovery and Good Health for You (ENERGY) Trial. Exercise training improves cardiopulmonary function and quality of life in postmenopausal breast cancer survivors. Home-based physical activity intervention for breast cancer patients. Decline in physical functioning in first 2 years after breast cancer diagnosis predicts 10-year survival in older women Factors perceived to influence exercise adherence in women with breast cancer participating in an exercise programme during adjuvant chemotherapy: a focus group study. Strength training stops bone loss and builds muscle in postmenopausal breast cancer survivors: a randomized, controlled trial Supervised physical exercise improves VO2max, quality of life, and health in early stage breast cancer patients: a randomized controlled trial The Impact of Rehabilitation Support Services on Health-related Quality of Life for Women with Breast Cancer Exercise for health: a randomized, controlled trial evaluating the impact of a pragmatic, translational exercise intervention on the quality of life, function and treatment-related side effects following breast cancer Muscle strength in breast cancer patients receiving different treatment regimes Systematic review of exercise effects on health outcomes in women with breast cancer. Factors influencing participation in a randomized controlled resistance exercise intervention study in breast cancer patients during radiotherapy A cognitive behavioral therapy intervention to promote weight loss improves body composition and blood lipid profiles among overweight breast cancer survivors Exercise and weight gain in breast cancer patients receiving chemotherapy. The impact of an exercise intervention on body composition, fat distribution, and weight in breast cancer survivors. Effects of Recombinant Erythropoietin in Palliative Treatment of Unselected Cancer Patients Adherence to prescribed exercise time and intensity declines as the exercise program proceeds: findings from women under treatment for breast cancer The effects of psychoeducation and telephone counseling on the adjustment of women with early-stage breast cancer. Effects of physical exercise on breast cancer-related secondary lymphedema: a systematic review The effects of an individualized exercise intervention on body composition in breast cancer patients undergoing treatment.
The purpose of this secondary analysis was to examine the nutritional symptoms and body composition outcomes of aerobic exercise in women with breast cancer . A single-blind clinical trial , r and omized to tailored Pro-Self © exercise during and after chemotherapy , after chemotherapy only , or no Pro-Self ( usual care ) .  One hundred women , average age 49.9 years ( SD = 9.6 ) , participated .  Mild taste changes , nausea , constipation , and anorexia were experienced by 47 % to 55 % at baseline and end of treatment but diminished post treatment . No group differences were found in total nutritional symptoms or symptom severity . Intervention group participants maintained lean body mass ; control group participants had nonsignificant lean body mass loss . Issues related to self-report , protocol adherence , and generalizability limit findings . Aerobic exercise is useful in achieving healthy weight and body composition , but the intensity and duration achieved during cancer treatment and recovery did not produce significant changes PURPOSE / OBJECTIVES To test the effects of aerobic and resistance exercise on changes in bone mineral density ( BMD ) in women newly diagnosed with stage I-III breast cancer receiving chemotherapy . DESIGN R and omized clinical trial . SETTING Two National Cancer Institute- design ated cancer centers in metropolitan areas . SAMPLE 66 women with stage I-III breast cancer beginning adjuvant chemotherapy .  METHODS Participants were r and omized to aerobic or resistance exercise and usual care . At the beginning of chemotherapy and at six months , patients completed exercise testing and BMD assessment of the lumbar spine by dual energy x-ray absorptionetry . MAIN RESEARCH VARIABLES BMD , aerobic capacity , and muscle strength . FINDINGS The average decline in BMD was -6.23 % for usual care , -4.92 % for resistance exercise , and -0.76 % for aerobic exercise . Aerobic exercise preserved BMD significantly better compared to usual care . Premenopausal women demonstrated significantly greater declines in BMD than postmenopausal women .  Aerobic capacity increased by almost 25 % for women in the aerobic exercise group and 4 % for resistance exercise . Participants in the usual care group showed a 10 % decline in aerobic capacity . CONCLUSIONS The data suggest that weight-bearing aerobic exercise attenuates declines in BMD and that aerobic and resistance exercise improve aerobic capacity and muscle strength at a time when women generally show marked declines in functional ability . IMPLICATION S FOR NURSING Exercise may prevent or at least minimize bone loss observed during chemotherapy and may prevent or delay the long-term effects of osteoporosis INTRODUCTION Ovarian cancer is the leading cause of death among gynecological malignancies . Its usual clinical manifestation is at advanced stages , with nutritional impairment , weight loss , and a consequent decline in skeletal muscle mass and strength ( defined as sarcopenia ) . The relationship between sarcopenia and decreased survival was demonstrated not only in ovarian cancer but also in other cancer types , such as hepatocellular , pancreatic , lung , colon , cervical , metastatic breast , and renal cancer . The aim of this study is to review the current evidence regarding the relationship between sarcopenia and the surgical and oncological outcomes in ovarian cancer patients . METHODS The systematic search was performed according to the Preferred Reporting Items for Systematic Review s and Meta-Analyses ( PRSIMA ) statement . The terms " SARCOPENIA " AND " OVARIAN CANCER " were systematic ally used to search PubMed and Scopus data bases . Original reports in English language were identified , with the purpose to include all relevant papers regarding the role of sarcopenia and indicators of skeletal muscle quality assessment in gynecological ovarian cancer . RESULTS A total of 9 studies were considered eligible for the present review . The strength of recommendation was moderate and the level of evidence was low in all selected articles . No prospect i ve studies were conducted and most of the papers were case-control series comparing ovarian cancer sarcopenic population vs. non sarcopenic population . CONCLUSIONS Sarcopenia appears to have an important role in oncological outcomes of ovarian cancer patients . However , sarcopenia occurrence during disease history and mechanisms underlying the possible impairment in prognosis should be better investigated . Prospect i ve trials are awaited in order to obtain a better insight in this topic Breast cancer is the most common invasive cancer among women in developed countries . Obesity is a major risk factor for breast cancer recurrence and mortality in both pre- and postmenopausal women . Co-morbid medical conditions are common among breast cancer survivors . The Exercise and Nutrition to Enhance Recovery and Good Health for You ( ENERGY ) study is a 4-year r and omized clinical trial of 693 overweight/obese women aged ≥21years diagnosed with any early stage breast cancer ( stages I[≥1cm]-III ) within the previous five years , design ed to demonstrate the feasibility of achieving sustained weight loss and to examine the impact of weight loss on quality of life and co-morbidities , and to enable future exploration of biochemical mechanisms linking obesity to lower likelihood of disease-free survival . This trial is strategically design ed as a vanguard for a fully-powered trial of women who will be evaluated for breast cancer recurrence and disease-free survival . Participants were recruited between 2010 and 2012 at four sites , had completed initial therapies , and had a body mass index between 25 and 45kg/m(2 ) . The intervention featured a group-based cognitive-behavioral weight loss program with telephone counseling and tailored newsletters to support initial weight loss and subsequent maintenance  , with the goal of 7 % weight loss at two years . This study has high potential to have a major impact on clinical management and outcomes after a breast cancer diagnosis . This trial initiates the effort to establish weight loss support for overweight or obese breast cancer survivors as a new st and ard of clinical care Question : Does exercise training improve cardiopulmonary function and quality of life in postmenopausal breast cancer survivors ? Design : R and omised controlled trial . Setting : Specialised cancer institute Patients : Postmenopausal women who met the following inclusion criteria : histology confirmed early stage breast cancer with no evidence of recurrent or progressive disease ; completed surgery , radiotherapy , and /or chemotherapy with or without current hormone therapy use ; and non-smoking status . Exclusion criteria were : cardiac disease , uncontrolled hypertension , thyroid disease , diabetes , mental illness , infection , immune or endocrine abnormality , or contraindications for exercise . Patients were r and omly allocated to an exercise ( n = 25 ) or control group ( n = 28 ) Interventions : The exercise group received exercise training on bicycle ergometers with a training intensity that corresponded to approximately 70 % to 75 % of maximal oxygen consumption . There were three sessions a week for a period of 15 weeks and the exercise intensity increased systematic ally from 15 minutes in the first three weeks to 35 minutes in the last three weeks . The control group did not exercise . Outcomes : These consisted of cardiopulmonary fitness outcomes as measured with a bicycle test , quality of life as assessed by the Functional Assessment of Cancer Therapy-Breast Scale , and body composition ( body weight , body mass index and subcutaneous sum of skinfolds , all assessed at baseline and post-intervention , ie after 15 weeks follow-up ) . Main results : The exercise group completed 98.4 % of the exercise sessions . The mean difference in peak oxygen consumption was 0.29 L/min in favour of the exercise group ( 95 % CI = 0.18 to 0.40 ; p < 0.01 ) . The mean difference in improvement in quality of life was 8.8 points , which was in favour of the exercise group ( 95 % CI = 3.6 to 14.0 ; p < 0.01 ) . No statistically significant inter-group differences were found for measures of body composition . Conclusion : Exercise training had beneficial effects on cardiopulmonary function and quality of life in postmenopausal breast cancer survivors . PURPOSE The efficacy of a home-based physical activity ( PA ) intervention for early-stage breast cancer patients was evaluated in a r and omized controlled trial . PATIENTS AND METHODS Eighty-six sedentary women ( mean age , 53.14 years ; st and ard deviation , 9.70 years ) who had completed treatment for stage 0 to II breast cancer were r and omly assigned to a PA or contact control group . Participants in the PA group received 12 weeks of PA counseling ( based on the Transtheoretical Model ) delivered via telephone , as well as weekly exercise tip sheets . Assessment s were conducted at baseline , after treatment ( 12 weeks ) , and 6 and 9 month after baseline follow-ups . The post-treatment outcomes are reported here . RESULTS Analyses showed that , after treatment , the PA group reported significantly more total minutes of PA , more minutes of moderate-intensity PA , and higher energy expenditure per week than controls . The PA group also out-performed controls on a field test of fitness . Changes in PA were not reflected in objective activity monitoring . The PA group was more likely than controls to progress in motivational readiness for PA and to meet PA guidelines . No significant group differences were found in body mass index and percent body fat . Post-treatment group comparisons revealed significant improvements in vigor and a reduction in fatigue in the PA group . There was a positive trend in intervention effects on overall mood and body esteem . CONCLUSION The intervention successfully increased PA and improved fitness and specific aspects of psychological well-being among early-stage breast cancer patients . The success of a home-based PA intervention has important implication s for promoting recovery in this population Purpose Breast cancer patients often experience a decline in physical functioning following cancer diagnosis . Although most patients recover after treatment , some patients do not . These changes may be magnified in older women with comorbid conditions and could impact survival outcomes . Methods We used longitudinal data from a prospect i ve cohort study of women 65 + years of age , recruited shortly after diagnosis of early stage breast cancer , to examine changes in self-reported physical functioning measured with the  Physical Function Index ( PF-10 ) of the Medical Outcomes Study Short Form-36 . Outcomes were constructed for small ( 0.2 SD ) , medium ( 0.5 SD ) , and large ( 0.8 SD ) declines in the PF-10 measurement over two intervals : ( 1 ) 3 to 15 months following cancer diagnosis , encompassing treatment and early recovery , and ( 2 ) 3 to 27 months following cancer diagnosis , in order to detect sustained recovery versus persistent decline . Cox-proportional hazards regression was used to examine association between survival and decline in PF-10 scores . Results A large ( > 0.8 SD ) decline in PF-10 scores from 3 to 27 months predicted shorter 10-year survival ( hazard ratio = 1.34 , 95 % confidence interval 1.1–1.6 ) . Persistent decline at 27 months was associated with less education , higher baseline PF-10 , increased comorbidity , and higher body mass index . Conclusions Older women with breast cancer who experience a large and persistent decline in PF-10 are at increased mortality risk . Future research should examine the value of clinical assessment of physical function as a marker for mortality and test interventions to prevent decline in physical function to improve post-treatment survival outcomes . Implication s for Cancer SurvivorsMany breast cancer survivors experience a decline in physical functioning in the year following their cancer diagnosis . While the majority of patients recover in the year after treatment is completed , individuals who experience a persistent decline in physical functioning without recovery are at risk of functional decline and early mortality . Our results highlight the importance of assessing functional status to identify those at risk for functional decline , and suggest a potential role for early intervention in these individuals AIMS AND OBJECTIVES To explore factors influencing exercise adherence  among women with breast cancer while following an exercise programme .  BACKGROUND Earlier research shows that women with breast cancer decrease physical activity following the cancer diagnosis and that adhering to exercise interventions can be a challenge . Research is needed to identify motivational factors and barriers for exercise adherence among women during treatment for breast cancer . DESIGN This was a qualitative study to explore patient 's perceptions of the challenges to exercise adherence during a r and omised , controlled trial . METHODS Twenty-seven women with early-stage breast cancer were purposively sample d for focus group interviews during 2011 - 2012 from their participation in the exercise intervention group during 2010 - 2012 . Five focus groups were performed , and data analysis was completed using the systematic text condensation method . RESULTS During the focus group study , five main themes were identified , which described factors participants perceived to influence their adherence to exercise during chemotherapy : ' side effects of breast cancer treatment as a barrier to exercise ' , ' restoring and maintaining normality in daily life motivates exercise ' , ' other valued activities compete with exercise ' , ' constructive support enhances exercise ' and ' positive beliefs about efficacy and outcomes motivate exercise ' . CONCLUSION Adherence to exercise in women with breast cancer is challenged by internal and external conditions and may be improved by attention to the impact of treatment side effects and by supporting patient self-efficacy towards changing health behaviour . RELEVANCE TO CLINICAL PRACTICE Nurses should be aware that exercise adherence could be a challenge among women with breast cancer . They should help identify obstacles to exercise for women and ways to overcome them , as well as support them in their beliefs that they are capable of changing their health behaviour Targeted exercise training could reduce risk factors for fracture and obesity-related diseases that increase from breast cancer treatment , but has not been sufficiently tested . We hypothesized that progressive , moderate-intensity resistance + impact training would increase or maintain hip and spine bone mass , lean mass and fat mass and reduce bone turnover compared to controls who participated in a low-intensity , non-weight bearing stretching program . We conducted a r and omized , controlled trial in 106 women with early stage breast cancer who were > 1 year post-radiation and /or chemotherapy , ≥50 years of age at diagnosis and postmenopausal , free from osteoporosis and medications for bone loss , resistance and impact exercise naïve , and cleared to exercise by a physician . Women were r and omly assigned to participate in 1 year of thrice-weekly progressive , moderate-intensity resistance + impact ( jump ) exercise or in a similar frequency and length control program of progressive , low-intensity stretching . Primary endpoints were bone mineral density ( BMD ; g/cm2 ) of the hip and spine and whole body bone-free lean and fat mass ( kg ) determined by DXA and biomarkers of bone turnover — serum osteocalcin ( ng/ml ) and urinary deoxypyrodiniline cross-links ( nmol/mmolCr ) . Women in the resistance + impact training program  preserved BMD at the lumbar spine ( 0.47 vs. −2.13 % ; P = 0.001 ) compared to controls . The resistance + impact group had a smaller increase in osteocalcin ( 7.0 vs. 27 % , P = 0.03 ) and a larger decrease in deoxypyrodinoline ( −49.9 vs. −32.6 % , P = 0.06 ) than controls . Increases in lean mass from resistance + impact training were greatest among women currently taking aromatase inhibitors compared to controls not on this therapy ( P = 0.01 ) . Our combined program of resistance + impact exercise  reduced risk factors for fracture among postmenopausal breast cancer survivors ( BCS ) and may be particularly relevant for BCS on aromatase inhibitors ( AIs ) because of the additional benefit of exercise on muscle mass that could reduce falls Breast cancer patients suffer impairment in cardiorespiratory fitness after treatment for primary disease , affecting patients ’ health and survival . The aim of this study was to evaluate the ability of a pragmatic exercise intervention to improve cardiorespiratory fitness of breast cancer patients after primary treatment . Between February 2013 and December 2014 , 94 women with early stage ( I – III ) breast cancer , 1–36 months post-chemotherapy , and radiotherapy were r and omly assigned to an intervention program ( EX ) combining supervised aerobic and resistance exercise ( n = 44 ) or usual care ( CON ) ( n = 45 ) for 12 weeks . Primary study endpoint was VO2max . Secondary endpoints were muscle strength , shoulder range of motion , body composition , and quality of life ( QoL ) . Assessment s were undertaken at baseline , 12-week , and 6-month follow-ups . Eighty-nine patients aged 29–69 years were assessed at baseline and 12 weeks . The EX group showed significant improvements in VO2max , muscle strength , percent fat , and lean mass ( p ≤ 0.001 in all cases ) and QoL compared with usual care ( CON ) . Apart from body composition , improvements were maintained for the EX at 6-month follow-up . There were no adverse events during the testing or exercise intervention program . A combined exercise intervention produced considerable improvement in cardiorespiratory fitness , physical function , and quality of life in breast cancer patients previously treated with chemotherapy and radiation therapy . Importantly , most of these benefits were maintained 6 months after ceasing the supervised exercise intervention As the number of women surviving breast cancer increases , with implication s for the health system , research into the physical and psychosocial sequelae of the cancer and its treatment is a priority . This research estimated self-reported health-related quality of life ( HRQoL ) associated with two rehabilitation interventions for breast cancer survivors , compared to a non-intervention group . Women were selected if they received an early home-based physiotherapy intervention ( DAART , n = 36 ) or a group-based exercise and psychosocial intervention ( STRETCH , n = 31 ) . Question naires on HRQoL , using the Functional Assessment of Cancer Therapy – Breast Cancer plus Arm Morbidity module , were administered at pre- , post-intervention , 6- and 12-months post-diagnosis . Data on a  non-intervention group ( n = 208 ) were available 6- and 12-months post-diagnosis . Comparing pre/post-intervention measures , benefits were evident for functional well-being , including reductions in arm morbidity and upper-body disability for participants completing the DAART service at one-to-two months following diagnosis . In contrast , minimal changes were observed between pre/post-intervention measures for the STRETCH group at approximately 4-months post-diagnosis . Overall , mean HRQoL scores ( adjusted for age , chemotherapy , hormone therapy , high blood pressure and occupation type ) improved gradually across all groups from 6- to 12-months post-diagnosis , and no prominent differences were found . However , this obscured declining HRQoL scores for 20–40 % of women at 12 months post-diagnosis , despite receiving supportive care services . Greater awareness and screening for adjustment problems among breast cancer survivors is required throughout the disease trajectory . Early physiotherapy after surgery has the potential for short-term functional , physical and overall HRQoL benefits Exercise for Health was a r and omized , controlled trial design ed to evaluate two modes of delivering ( face-to-face [ FtF ] and over-the-telephone [ Tel ] ) an 8-month translational exercise intervention , commencing 6-weeks post-breast cancer surgery ( PS ) . Outcomes included quality of life ( QoL ) , function ( fitness and upper body ) and treatment-related side effects ( fatigue , lymphoedema , body mass index , menopausal symptoms , anxiety , depression and pain ) . Generalised estimating equation modelling determined time ( baseline [ 5 weeks PS ] , mid-intervention [ 6 months PS ] , post-intervention [ 12 months PS ] ) , group ( FtF , Tel , Usual Care [ UC ] ) and time-by-group effects . 194 women representative of the breast cancer population were r and omised to the FtF ( n = 67 ) , Tel ( n = 67 ) and UC ( n = 60 ) groups . There were significant ( p < 0.05 ) interaction effects on QoL , fitness and fatigue with differences being observed between the treatment groups and the UC group . Trends observed for the treatment groups were similar . The treatment groups reported improved QoL , fitness and fatigue over time and changes observed between baseline and post-intervention were clinical ly relevant . In contrast , the UC group experienced no change , or worsening QoL , fitness and fatigue , mid-intervention . Although improvements in the UC group occurred by 12-months post-surgery , the change did not meet the clinical ly relevant threshold . There were no differences in other treatment-related side effects between groups . This translational intervention trial , delivered either FtF or Tel , supports exercise as a form of adjuvant breast cancer therapy that can prevent declines in fitness and function during treatment and optimise recovery post-treatment Abstract Background Muscle dysfunction and sarcopenia have been associated with poor performance status , an increased mortality risk , and greater side effects in oncologic patients . However , little is known about how performance is affected by cancer therapy . We investigated muscle strength in breast cancer patients in different adjuvant treatment setting s and also compared it with data from healthy individuals . Methods Breast cancer patients ( N = 255 ) from two r and omized controlled exercise trials , staged 0–III and aged 54.4 ± 9.4 years , were categorized into four groups according to their treatment status . In a cross‐sectional design , muscle function was assessed bilaterally by isokinetic dynamometry ( 0 ° , 60 ° , 180 ° /s ) as maximal voluntary isometric contraction ( MVIC ) and maximal isokinetic peak torque ( MIPT ) in shoulder rotators and knee flexors and extensors .  Additionally , muscular fatigue index ( FI% ) and shoulder flexibility were evaluated . Healthy women ( N = 26 ) , aged 53.3 ± 9.8 years , were tested using the same method . Analysis of covariance was used to estimate the impact of different cancer treatments on skeletal muscle function with adjustment for various clinical and socio‐demographic factors . Results Consistently , lower muscle strength was measured in shoulder and knee strength in patients after chemotherapy . On average , patients had up to 25 % lower strength in lower extremities and 12–16 % in upper extremities in MVIC and MIPT during cancer treatment compared with healthy women . No substantial difference between patient groups in shoulder strength , but significantly lower shoulder flexibility in patients with radical mastectomy was measured . Chemotherapy‐treated patients had consistently higher FI% . No serious adverse events were reported . Conclusions Breast cancer patients showed markedly impaired muscle strength and joint dysfunctions before and after anticancer treatment . The significant differences between patients and healthy individuals underline the need of exercise therapy as early as possible in order to prevent or counteract the loss of muscle function after curative surgery as well as the consequences of neo‐/adjuvant chemotherapy PURPOSE Exercise is commonly recommended to women after breast cancer surgery , yet it is difficult for patients and health professionals to adopt safe and beneficial types and modes of exercise . Thus studies on exercise interventions targeting women with breast cancer treatment were systematic ally review ed . METHODS The review process and quality assessment of the studies followed the guideline of the National Evidence -based Healthcare Collaborating Agency . Relevant studies were obtained from electronic data bases , and two trained review ers independently analyzed the studies . Of the 902 articles sorted , 11 were selected . Then , quality assessment for each study was carried out with the Scottish Intercollegiate Guideline Network ( SIGN ) checklist . RESULTS Seven different types of  exercise interventions were identified from 3 quasi-experimental and 8 r and omized controlled trial studies . The interventions varied in duration from several days to 13 weeks , and tended to show significant effects on psychological outcomes and upper body functions within a short-term period and were effective in alleviating lymphedema at a longer 1-year point . Supervised , professional intervention had significant effects on health indicators and a higher adherence rate . CONCLUSION Well- design ed exercises are effective and beneficial for improving women 's physical , physiological , and psychological health outcomes after breast cancer treatment as well as to facilitate changes in exercise behaviors . The feasibility of applying intervention protocol s , efficiency of interventions , and strengths of exercise protocol s should be further examined Background Over the past years knowledge about benefits of physical activity after cancer is evolving from r and omized exercise intervention trials . However , it has been argued that results may be biased by selective participation . Therefore , we investigated factors influencing participation in a r and omized exercise intervention trial for breast cancer patients . Methods Non-metastatic breast cancer patients were systematic ally screened for a r and omized exercise intervention trial on cancer-related fatigue . Participants and non participants were compared concerning sociodemographic characteristics ( age , marital status , living status , travel time to the training facility ) , clinical data ( body-mass-index , tumor stage , tumor size and lymph node status , comorbidities , chemotherapy ) , fatigue , and physical activity . Reasons for participation or declination were recorded . Results 117 patients ( 52 participants , 65 non participants ) were evaluable for analysis . Multiple regression analyses revealed significantly higher odds to decline participation among patients with longer travel time ( p = 0.0012 ) , living alone ( p = 0.039 ) , with more comorbidities ( 0.031 ) , previous chemotherapy ( p = 0.0066 ) , of age ≥ 70 years ( p = 0.025 ) , or being free of fatigue ( p = 0.0007 ) . No associations were found with BMI or physical activity . By far the most frequently reported reason for declination of participation was too long commuting time to the training facility . Conclusions Willingness of breast cancer patients to participate in a r and omized exercise intervention study differed by sociodemographic factors and health status . Neither current physical activity level nor BMI appeared to be selective for participation . Reduction of personal inconveniences and time effort , e.g. by de central ized training facilities or flexible training schedules , seem most promising for enhancing participation in exercise intervention trials . Trial registration Registered at Clinical Trials.gov : NCT01468766 ( October 2011 ) Overweight or obesity is an established negative prognostic factor in breast cancer . Co-morbidities associated with obesity , including cardiovascular disease ( CVD ) , may negatively impact quality of life and survival in this population . Our purpose was to determine the effect of a cognitive behavioral therapy ( CBT ) intervention for weight loss through exercise and diet modification on risk factors for recurrence of breast cancer , and risks for CVD associated with obesity . Eighty-five overweight or obese breast cancer survivors were r and omly assigned to a once weekly , 16-week intervention or wait-list control group . The intervention incorporated elements of CBT for obesity , addressing a reduction in energy intake , as well exercise , with a goal of an average of 1 h a day of moderate to vigorous activity .  Body weight , total and regional body fat ( by dual energy X-ray absorptiometry ) , waist and hip circumference , and blood lipids were assessed at baseline and following 16 weeks of intervention . Results : Seventy six women ( 89.4 % ) completed the intervention . Independent t-test to evaluate group differences at 16 weeks showed significant differences in weight , body mass index , percent fat , trunk fat , leg fat , as well as waist and hip circumference between intervention and control groups ( P ≤ 0.05 ) . Furthermore , levels of triglycerides and total cholesterol/high density lipoprotein cholesterol levels were also significantly reduced following the intervention . These results indicate that 16 weeks of a CBT program for weight management may reduce obesity and CVD risk in overweight breast cancer survivors PURPOSE Weight gain is a common side effect for women receiving adjuvant chemotherapy  and may have negative long-term implication s for survival . The purpose of this study was to examine the effects of aerobic exercise on weight gain in women with breast cancer receiving adjuvant chemotherapy .  DESCRIPTION OF STUDY Seventy-eight women who had recently received a diagnosis of breast cancer and who were beginning adjuvant chemotherapy  were enrolled in a home-based exercise study during the first four cycles of chemotherapy .  Weight change , body mass index , anorexia , nausea , fatigue , caloric expenditure during exercise , and functional ability were recorded . RESULTS Women who adhered to the exercise program maintained their body weight , while nonexercisers steadily gained weight ( P < .05 ) . There were no differences in incidence or intensity of nausea or anorexia between the exercisers and nonexercisers . Women who exercised over the four cycles of chemotherapy improved their functional ability ( mean 23 % ) compared to the nonexercisers who showed significant declines in functional ability ( mean -15 % ) . CLINICAL IMPLICATION S Exercise may be an effective intervention to minimize weight gain in women with breast cancer who are receiving adjuvant chemotherapy .  Preventing weight gain in these patients may be important in preventing recurrent disease and other comorbidities associated with excess weight 590 Background : Recent research has demonstrated that obesity increases a woman 's risk of breast cancer recurrence . Although the mechanism is not well understood , it is known that obese women have higher levels of insulin and other hormones related to energy balance . In this study , we sought to explore the impact of an exercise intervention on body composition , fat distribution , weight , and insulin levels in a population of breast cancer survivors . METHODS Inactive women with early stage breast cancer who had completed adjuvant chemotherapy and /or radiation were r and omized to a 16-week exercise intervention or a normal care control group . The exercise intervention consisted of supervised strength training and unsupervised cardiovascular exercise , with a goal of 2 strength training sessions and 90 minutes of cardiovascular exercise each week . Measurement of weight , body composition , and circumference at the waist and hip , were collected at baseline and after 16 weeks in both groups . Fasting blood sample s were also collected at these two time points for insulin and glucose levels , so that changes in these levels between the intervention and control groups could be compared . RESULTS Eighty-five women have been r and omized ; complete anthropometric data are presently available for 51 . Women in the exercise group experienced a nonsignificant decrease in body weight , body fat , and circumference at the waist and hip , as compared to control patients . Participants completed a median of 84 % of scheduled strength training sessions and 80 % of recommended cardiovascular sessions .  Strength increased by an average of 40 % during the exercise intervention . Prior studies have demonstrated significant inter-assay variability in biomarker testing , thus insulin and glucose testing will be performed when all patients have completed the protocol . CONCLUSIONS Compliance with the exercise intervention was good . Women in the exercise group experienced non-significant changes in anthropometric measures , and increased strength during the 16-week intervention . Final strength and anthropometric data from the entire cohort will be available for presentation . This project was supported by an ASCO Career Development Award and funding from the Lance Armstrong Foundation . No significant financial relationships to disclose Purpose : The purpose is to evaluate relationships between objective ly assessed exercise capacity and subjectively assessed scoring of physical functioning and well-being after erythropoietin treatment  in cancer patients on palliative care . Experimental Design : Unselected cancer patients ( n = 108 ) who experienced progressive cachexia were r and omized to receive either anti-inflammatory treatment alone ( indomethacin ) or recombinant erythropoietin plus indomethacin to prevent the appearance of disease-induced anemia and thereby protect patients ’ exercise capacity . Follow-up investigations of nutritional status , exercise capacity , and health-related quality of life assessed by SF-36 and the European Organization for Research and Treatment of Cancer QLQ-C30 were compared . Results : Effective treatment by erythropoietin on top of basal whole body anti-inflammatory treatment was confirmed and indicated by time course changes of biochemical , physiologic , and nutritional objectives , whereas individual self-reported scoring of physical functioning and general health did not indicate a clear-cut effectiveness , particularly at moderately subnormal hemoglobin levels . Conclusions : Discrepancies between objective and subjective self-reported measures may be either fundamental or indicate scoring limitations for evaluation of therapeutic results . Present results demonstrate a clinical benefit of erythropoietin treatment in cancer patients with subnormal to normal hemoglobin levels , whereas the patients ’ own subjective scoring was insufficient to sense such improvements . The discrepancy may be either fundamental or method ological but emphasizes the importance to document therapeutic outcome in both subjective and objective perspectives in palliative care of cancer patients Purpose Adherence to prescribed exercise is a challenge for cancer patients undergoing treatment . The changing pattern of exercise adherence over time can not be fully understood by an overall measure of adherence . This study was aim ed to identify the trajectory of exercise adherence and its predictors for women with breast cancer during their chemotherapy . Methods Participants were 78 women with breast cancer assigned to the exercise arm of a r and omized control trial . Based on the weekly adherence rates in time and intensity , patients were classified as good ( > 100 % ) , acceptable ( 80–100 % ) , and poor ( < 80 % ) adherents . Data were analyzed using ordinal logistic hierarchical linear modeling . Results The trajectories for both time and intensity adherence declined significantly . The decline in  exercise-time adherence  was significantly slower in women who reported higher interest in exercise . Women with higher perceived importance of exercise , early disease stage , and employed were more likely to be classified as good intensity adherents . Poorer weekly adherence for both exercise time and intensity was associated with higher fatigue level for that week . Conclusions  Adherence to exercise adherence in breast cancer patients declined as the dose of exercise prescription increased . Factors influencing overall adherence and adherence trend were identified BACKGROUND Throughout the illness trajectory , women with breast cancer experience issues that are related to physical , emotional , and social adjustment . Despite a general consensus that state-of-the-art treatment for breast cancer should include educational and counseling interventions to reduce illness or treatment-related symptoms , there are few prospect i ve , theoretically based , phase-specific r and omized , controlled trials that have evaluated the effectiveness of such interventions in promoting adjustment . PURPOSE The aim of this study is to examine the physical , emotional , and social adjustment of women with early-stage breast cancer who received psychoeducation by videotapes , telephone counseling , or psychoeducation plus telephone counseling as interventions that address the specific needs of women during the diagnostic , postsurgery , adjuvant therapy , and ongoing recovery phases of breast cancer . DESIGN Primary data from a r and omized controlled clinical trial . SETTING Three major medical centers and one community hospital in New York City . METHODS A total of 249 patients were r and omly assigned to either the control group receiving usual care or to one of the three intervention groups . The interventions were administered at the diagnostic , postsurgery , adjuvant therapy , and ongoing recovery phases . Analyses were based on a mixed model analysis of variance . MAIN RESEARCH VARIABLES AND MEASUREMENT : Physical adjustment was measured by the side effects incidence and severity subscales of the Breast Cancer Treatment Response Inventory ( BCTRI ) and the overall health status score of the Self-Rated Health Subscale of the Multilevel Assessment Instrument . Emotional adjustment was measured using the psychological well-being subscale of the Profile of Adaptation to Life Clinical Scale and the side effect distress subscale of BCTRI . Social adjustment was measured by the domestic , vocational , and social environments subscales of the Psychosocial Adjustment to Illness Scale . FINDINGS Patients in all groups showed improvement over time in overall health , psychological well-being , and social adjustment . There were no significant group differences in physical adjustment , as measured by side effect incidence , severity , or overall health . There was poorer emotional adjustment over time in the usual care ( control ) group as compared to the intervention groups on the measure of side effect distress . For the telephone counseling group , there was a marked decline in psychological well-being from the adjuvant therapy phase through the ongoing recovery phase . There were no significant group differences in the dimensions of social adjustment . CONCLUSION The longitudinal design of this study has captured the dynamic process of adjustment to breast cancer , which in some aspects and at various phases has been different for the control and intervention groups . Although patients who received the study interventions improved in adjustment , the overall conclusion regarding physical , emotional , and social adjustment is that usual care , which was the st and ard of care for women in both the  usual care (  control ) and intervention groups , supported their adjustment to breast cancer , with or without additional interventions . IMPLICATION S FOR NURSING The results are important to evidence -based practice and the determination of the efficacy and cost-effectiveness of interventions in improving patient outcomes . There is a need to further examine adjustment issues that continue during the ongoing recovery phase . KEY POINTS Psychoeducation by videotapes and telephone counseling decreased side effect distress and side effect severity and increased psychological well-being during the adjuvant therapy phase . All patients in the control and intervention groups improved in adjustment . Adjustment issues are still present in the ongoing recovery phase Purpose The aim of this systematic review is to assess the effect of different types of exercise on  breast cancer-related lymphedema ( BCRL ) in order to eluci date the role of exercise in this patient group . Methods A systematic data search was performed using PubMed ( December 2016 ) . The review is focused on the rehabilitative aspect of BCRL and undertaken according to the PRISMA statement with Levels of Evidence ( LoE ) assessed . Results 11 r and omized controlled trials ( 9 with LoE 1a and 2 with LoE 1b ) that included 458 women with breast cancer in aftercare were included . The different types of exercise consisted of aqua lymph training , swimming , resistance exercise , yoga , aerobic , and gravity-resistive exercise . Four of the studies measured a significant reduction in BCRL status based on arm volume and seven studies reported significant subjective improvements . No study showed adverse effects of exercise  on BCRL . Conclusion The evidence indicates that exercise can improve subjective and objective parameters in  BCRL patients , with dynamic , moderate , and high-frequency exercise appearing to provide the most positive effects CONTEXT AND OBJECTIVE Changes in metabolism have been reported in the majority of patients undergoing cancer treatment , and these are usually characterized by progressive change in body composition . The effects of aerobic exercise programs to combat the cancer and cancer treatment-related side effects , which include the negative changes in body composition , have been extensively reported in the literature . However , few resistance exercise intervention studies have hypothesized that breast cancer patients might benefit from this type of exercise . The purpose of this study was to determine whether exercise protocol s that emphasize resistance training would change body composition and strength in breast cancer patients undergoing treatment . DESIGN AND SETTING R and omized controlled trial , at the Campus Recreation Center and Rocky Mountain Cancer Rehabilitation Institute of the University of Northern Colorado , and the North Colorado Medical Center . METHODS Twenty inactive breast cancer patients were r and omly assigned to a 21-week exercise group ( n = 10 ) or a control group ( n = 10 ) . The exercise group trained at low to moderate intensity for 60 minutes on two days/week . The primary outcome measurements included body composition ( skinfold method ) and muscle strength ( one repetition maximum ) . RESULTS Significant differences in lean body mass , body fat and strength ( p = 0.004 , p = 0.004 , p = 0.025 , respectively ) were observed between the groups at the end of the study . CONCLUSION The results suggest that exercise emphasizing resistance training promotes positive changes in body composition and strength in breast cancer patients undergoing treatment
There is evidence that exercise , such as low intensity aerobics walking , Tai Chi , or cycling , results in an overall decrease in fatigue levels over the course of cancer treatment .
Additionally , there is evidence that regular physical activity or exercise can decrease emotional stress , blood pressure , the duration of neutropenia , thrombocytopenia , and pain .
Exercise also has been shown to increase quality of life and improve the maximal oxygen uptake during exertion , sleep patterns , and cognition .
Disease and cancer treatment-related side effects such as decreased energy level , muscle weakness , and declines in functional status and body mass have been well documented .
However , the majority of studies of exercise and cancer have been conducted with women with early stage breast cancer , limiting the generalizability of these studies to other cancer population s. The purpose of this systematic review is to provide a synthesis of the extant research evidence about th e benefits of exercise related to cancer recovery