A significant negative association was found between aerobic exercise intensity and fatigue reduction .
A peak effect was found for moderate-intensity aerobic exercise for improving walking endurance .
No dose-response relationship was found between exercise and markers of inflammation or exercise duration and outcomes .
Rates of adherence were typically high and few adverse events were reported .
Exercise is safe , reduces fatigue and increases endurance in cancer survivors .
QUESTION Is there a dose-response effect of exercise on inflammation , fatigue and activity in cancer survivors ?
Elevated biomarkers of inflammation are associated with reduced survival among breast cancer patients.
PURPOSE Chronic inflammation is believed to contribute to the development and progression of breast cancer . Systemic C-reactive protein ( CRP ) and serum amyloid A ( SAA ) are measures of low- grade chronic inflammation and potential predictors of cancer survival . PATIENTS AND METHODS We evaluated the relationship between circulating markers of inflammation and breast cancer survival using data from the Health , Eating , Activity , and Lifestyle ( HEAL ) Study ( a multiethnic prospect i ve cohort study of women diagnosed with stage 0 to IIIA breast cancer ) . Circulating concentrations of CRP and SAA were measured approximately 31 months after diagnosis and tested for associations with disease-free survival ( approximately 4.1 years of follow-up ) and overall survival ( approximately 6.9 years of follow-up ) in 734 disease-free breast cancer survivors . Cox proportional hazards models were used with adjustment for potential confounding factors to generate hazard ratios ( HRs ) and 95 % CIs . Results Elevated SAA and CRP were associated with reduced overall survival , regardless of adjustment for age , tumor stage , race , and body mass index ( SAA P trend < .0001 ; CRP P trend = .002 ) . The HRs for SAA and CRP tertiles suggested a threshold effect on survival , rather than a dose-response relationship ( highest v lowest tertile : SAA HR = 3.15 ; 95 % CI , 1.73 to 5.65 ; CRP HR = 2.27 ; 95 % CI , 1.27 to 4.08 ) . Associations were similar and still significant after adjusting for self-reported history of cardiovascular events and censoring cardiovascular disease deaths . Elevated CRP and SAA were also associated with reduced disease-free survival , although these associations were of borderline significance ( SAA P trend = .04 ; CRP P trend = .07 ) . CONCLUSION Circulating SAA and CRP  may be important prognostic markers for long-term survival  in breast cancer patients , independent of race , tumor stage , and body mass index
A significant negative association was found between aerobic exercise intensity and fatigue reduction .
A peak effect was found for moderate-intensity aerobic exercise for improving walking endurance .
No dose-response relationship was found between exercise and markers of inflammation or exercise duration and outcomes .
Rates of adherence were typically high and few adverse events were reported .
Exercise is safe , reduces fatigue and increases endurance in cancer survivors .
QUESTION Is there a dose-response effect of exercise on inflammation , fatigue and activity in cancer survivors ?