The day after-a comprehensiverehabilitation program for breast cancer survivors
Authors: O. S. Rosengarten, N. Constantinin, M. Bertisch
Journal: Cancer Research (2021)

“The Day After” a comprehensive rehabilitation program for breast cancer survivors Ora SolangeRosengarten Naama Constantini, Milka Bertisch, Shaare Zedek Medical Center, Jerusalem Background: The mostintensive part of the breast cancer (BC) treatment includes operation, radiation and chemotherapy  After completionof this stage women often are presented with a major deception: prolonged side effects of treatments and addedsymptoms of endocrine therapies create a physical, psychological and social burden - not allowing them to resumenormal life and activities  The lack of supportive system at this point may lead them into deep crisis  Another aspectis the abundant information showing that physical activity is very efficient in controlling treatment side effects  Manystudies have also shown benefit in terms of recurrence freedom of disease (HR 0 65-0 79) and overall survival forcancer patients (HR 0 52-0 61), specifically for BC - by adopting lifestyle that includes routine physical activity andhealthy nutrition  Methods: The survivorship program for BC patients was designed to help coping with thesechallenges  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 aseries of lectures regarding breast cancer  The training is performed in 15 women group each time  Evaluation of theprogram 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 totalimpact on quality of life was evaluated by the FACT-ES (version 4) questionnaire - specifically designed andvalidated for BC survivors Results: 3 groups have completed the 6 months program so far  (COVID-19 caused major , interference of 3 group activity)  6 min walking capacity - increased by 13 5%- from 511 m to 579 m (value pre-program in the 3 quartile, post - 4 quartile)  Pressing power increased by 10 5% from 53 kg to 59 2 kg (all valuesin the intermediate population range)  Fat percentage decreased by 3 4% - from 43 52% to 41 8% (all in the obesityrange)  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 (>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 to131 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 posttreatment distress  Both the physical measures and the questionnaires showed significant improvement (though stilllow)  All patients expressed high level of satisfaction and stated that the program allowed faster and better recoveryboth physical, emotional and functional  Further evaluation can establish the exact needs of the patients  Weconsider that such a program should be offered to all breast (and other) cancer survivors