Activity & Cognition After Treatment for Breast Cancer
Condition: Breast Cancer; Mild Cognitive Impairment; Physical Activity
MeSH terms: Breast Neoplasms; Cognitive Dysfunction
Study type: Interventional

Summary: 
      This study addresses an important public health concern; impoverished cognitive function
      associated with treatment of breast cancer. Due to increased awareness of breast cancer
      combined with advances in medical care, there are over 2.8 million women living with a
      history of breast cancer in the U.S. alone. Chemotherapy and adjuvant therapy to remove
      cancerous tissue can result in deficits in attention, speed of processing, memory, and
      quality of life. Physical activity has been associated with a number of health benefits for
      breast cancer survivors including improvements in cognitive function. However, most of the
      literature is cross-sectional and it is unclear whether acute (single) bouts of physical
      activity affect cognition and, if they do, how long this effect lasts. This study will be the
      first, to the investigators' knowledge, to examine the effects of an acute bout of aerobic
      exercise on cognitive functioning in breast cancer survivors. Specifically, the investigators
      will determine the effects of a 30-minute moderate intensity aerobic exercise session
      (treadmill walking) on immediate and one hour follow up changes in measures of processing
      speed, memory, and executive function. Additionally, accelerometer cut-points for physical
      activity intensities in breast cancer survivors will be assessed. Finally, the investigators
      will examine the association of cardiorespiratory fitness and physical activity with changes
      in cognitive function. Findings from this study will allow researchers to determine whether
      any acute effects of exercise on cognition are retained over time and therefore have real
      meaning in the context of one's daily life.
    

Detailed description: 
      This study addresses an important public health concern: impoverished cognitive function
      associated with treatment of breast cancer. Due to increased awareness of breast cancer
      combined with advances in medical care, the 5-year survival rate has climbed to 89.2% with
      over 2.8 million women living with a history of breast cancer in the U.S. alone.

      Unfortunately, the treatment of breast cancer is not without its consequences. Chemotherapy
      and adjuvant therapy to remove cancerous tissue can result in deficits in attention, speed of
      processing, memory, and quality of life. While past studies have identified memory and
      executive function as valuable, important determinants of long-term survival and quality of
      life in survivors of different types of cancer, it is unclear if standard care methods alone
      prove successful in attenuating declines in these variables. Previous research in breast
      cancer populations has found that executive function difficulties, namely in working memory,
      cognitive flexibility, and processing speed, as well as fatigue, are the most commonly
      described deficits. Furthermore, evidence suggests impairments in cognitive functioning may
      persist in up to 35% of breast cancer survivors years after treatment ends.

      A behavioral and lifestyle modality known to improve physical and mental health status and
      protect against health declines is physical activity. Not only is physical activity known to
      protect against a host of diseases, but it also has been shown to provide many health
      benefits to breast cancer survivors. While the extant literature suggests that physical
      activity can lead to improvements in varying cognitive domains in breast cancer survivors,
      another study concluded that only 32% of these survivors meet the recommended guidelines for
      physical activity. Additionally, while benefits from physical activity for breast cancer
      survivors are well known, there is currently no scientifically recognized physical activity
      training program aimed at improving cognitive function in this cohort.

      As such, a review chapter examining cognitive impairment in breast cancer survivors suggests
      more comprehensive studies examining the relationship between objective measures of physical
      activity, cardiorespiratory fitness, and cognitive performance are warranted to gain a better
      understanding of the potentially protective effects of fitness and physical activity on
      cognitive functioning in breast cancer survivors for better survival along the cancer
      continuum. In addition, other research has shown that subjective memory impairment, fatigue,
      and anxiety plague breast cancer survivors and suggests that breast cancer survivors may
      suffer from poorer quality of life as a result. Furthermore, it has been shown that breast
      cancer survivors have longer reaction time to working memory tasks compared to healthy,
      age-matched controls, and those survivors with higher levels of physical activity had shorter
      reaction times for more difficult tasks. A recent study also measured levels of objective
      physical activity and found those with higher levels displayed more positive measures of
      global cognition.

      Despite this evidence, it is unknown if acute (single) bouts of exercise can provide benefits
      in varying cognitive domains. Previous research has shown that acute bouts of aerobic
      physical activity, of both light and moderate intensity, decrease state anxiety in breast
      cancer survivors. However, it is not known if these benefits extend to cognitive functioning.
      Furthermore, most of these results are founded in cross-sectional research and it is unclear
      whether acute bouts of physical activity improve cognition and, if they do, how long this
      effect lasts. This has implications for real world contexts in that, if benefits are present,
      breast cancer survivors can find relief in cognitive symptoms quickly by simply engaging in a
      bout of physical activity. This study will be the first, to the investigators' knowledge, to
      examine the effects of an acute bout of aerobic exercise on cognitive functioning in breast
      cancer survivors.
    

Intervention name(s): Walking
Intervention type(s): Behavioral
Intervention description(s): Participants will walk on the treadmill for 30 minutes at a moderate intensity.
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment