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Six-Month Follow-up of Patient-Rated Outcomes in a Randomized Controlled Trial of Exercise Training during Breast Cancer Chemotherapy

¹ University of Alberta, ² Cross Cancer Institute, Edmonton, and ³ Alberta Cancer Board, Calgary, Alberta, Canada; ⁴ Ottawa Hospital Regional Cancer Center and ⁵ University of Ottawa Heart Institute, Ottawa, Ontario, Canada; and ⁶ University of British Columbia and ⁷ British Columbia Cancer Agency, Vancouver, British Columbia, Canada

Requests for reprints: Kerry S. Courneya, Faculty of Physical Education and Recreation, University of Alberta, E-488 Van Vliet Center, Edmonton, Alberta, Canada T6G 2H9. Phone: 780-492-1031; Fax: 780-492-8003. E-mail: kerry.courneya{at}ualberta.ca

Background: Few exercise trials in cancer patients have reported longer-term follow-up. Here, we report a 6-month follow-up of exercise behavior and patient-rated outcomes from an exercise trial in breast cancer patients.

Methods: Breast cancer patients initiating adjuvant chemotherapy (n = 242) were randomly assigned to usual care (n = 82), resistance exercise training (RET; n = 82), or aerobic exercise training (AET; n = 78) for the duration of their chemotherapy. At 6-month follow-up, participants were mailed a questionnaire that assessed quality of life, self-esteem, fatigue, anxiety, depression, and exercise behavior.

Results: Two hundred one (83.1%) participants provided 6-month follow-up data. Adjusted linear mixed-model analyses showed that, at 6-month follow-up, the RET group reported higher self-esteem [adjusted mean difference, 1.6; 95% confidence interval (95% CI), 0.1-3.2; P = 0.032] and the AET group reported lower anxiety (adjusted mean difference, –4.7; 95% CI, –0.0 to –9.3; P = 0.049) compared with the usual care group. Moreover, compared with participants reporting no regular exercise during the follow-up period, those reporting regular aerobic and resistance exercise also reported better patient-rated outcomes, including quality of life (adjusted mean difference, 9.5; 95% CI, 1.2-17.8; P = 0.025).

Conclusions: Improvements in self-esteem observed with RET during breast cancer chemotherapy were maintained at 6-month follow-up whereas reductions in anxiety not observed with AET during breast cancer chemotherapy emerged at 6-month follow-up. Moreover, adopting a combined aerobic and resistance exercise program after breast cancer chemotherapy was associated with further improvements in patient-rated outcomes. Exercise training during breast cancer chemotherapy may result in some longer-term and late effects for selected patient-rated outcomes. (Cancer Epidemiol Biomarkers Prev 2007;16(12):2572–8)