Abstract PS9-39: The day after - a comprehensive rehabilitation program for breast cancer survivors
Authors: Rosengarten Ora Solange , Constantinin Naama , Bertisch Milka 
Published: February 2021

Abstract
“The Day After” a comprehensive rehabilitation program for breast cancer survivors Ora Solange Rosengarten, Naama Constantini, Milka Bertisch, Shaare Zedek Medical Center, Jerusalem Background: The most intensive part of the breast cancer (BC) treatment includes operation, radiation and chemotherapy. After completion of this stage women often are presented with a major deception: prolonged side effects of treatments and added symptoms of endocrine therapies create a physical, psychological and social burden – not allowing them to resume normal life and activities. The lack of supportive system at this point may lead them into deep crisis. Another aspect is the abundant information showing that physical activity is very efficient in controlling treatment side effects. Many studies have also shown benefit in terms of recurrence freedom of disease (HR 0.65-0.79) and overall survival for cancer patients (HR 0.52-0.61), specifically for BC – by adopting lifestyle that includes routine physical activity and healthy nutrition. Methods: The survivorship program for BC patients was designed to help coping with these challenges. The program includes a twice weekly exercise training, consulting and guidance (general and personal) by a dietician, psychologist, menopause symptom expert, sexuality expert, lymphedema physiotherapist and a series of lectures regarding breast cancer. The training is performed in 15 women group each time. Evaluation of the program was made by physical parameters- including 6 minute walk capacity, pressing power using Dynamometer, body fat composition. The results were also compared to the average values in the general population. The total impact on quality of life was evaluated by the FACT-ES (version 4) questionnaire – specifically designed and validated for BC survivors.Results: 3 groups have completed the 6 months program so far. (COVID-19 caused major interference of 3rd group activity). 6 min walking capacity – increased by 13.5%- from 511 m to 579 m (value pre-program in the 3rd quartile, post – 4th quartile). Pressing power increased by 10.5% from 53 kg to 59.2 kg (all values in the intermediate population range). Fat percentage decreased by 3.4% - from 43.52% to 41.8% (all in the obesity range). Quality of life: mild changes (0.5-1.0 point) were noted in 14 parameters – such as energy level, sadness, treatment side effect influence, general condition. Major changes (&gt;1 point each) were detected in weight, arthralgia, hot flashes and vaginal discharge.QoL scores: Total GACT-G – increased from 73.1 to 79.5 (normal range 0-108); Endocrine symptom scores – increased from 49.4 to 51.9 (range 0-76);Total FACT-ES – increased from 120.8 to 131.4 (range 0-180)Conclusion: many reports show the benefit of physical activity in survivors. To our knowledge – this is the first comprehensive rehabilitation program offered to BC survivors – with regard to all aspects of post treatment distress. Both the physical measures and the questionnaires showed significant improvement (though still low). All patients expressed high level of satisfaction and stated that the program allowed faster and better recovery both physical, emotional and functional. Further evaluation can establish the exact needs of the patients. We consider that such a program should be offered to all breast (and other) cancer survivors.References:1.Endocrine related QoL in a randomized trial of exercise on Aromatase Inhibitor induced arthralgia in breast cancer survivors. Baglia M, Cancer 2019 2.Effect of nutrition and physical activity intervention on health behaviors of cancer survivors and carers. James EL, BMC Cancer 2015 3.The risk of metabolic syndrome in postmenopausal breast cancer survivors. Bottros DA, Menopause 2013 4.The impact of exercise on cancer mortality, recurrence and treatment related adverse events, Cormie P, Epidemiologic Reviews 2017
Citation Format: Ora Solange Rosengarten, Naama Constantinin, Milka Bertisch. The day after - a comprehensive rehabilitation program for breast cancer survivors [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS9-39.