Six-Month Follow-up of Patient-Rated Outcomes in a Randomized Controlled Trial of Exercise Training during Breast Cancer Chemotherapy
- Kerry S. Courneya1,
- Roanne J. Segal4,
- Karen Gelmon6,7,
- Robert D. Reid5,
- John R. Mackey1,2,
- Christine M. Friedenreich3,
- Caroline Proulx4,
- Kirstin Lane6,
- Aliya B. Ladha1,
- Jeffrey K. Vallance1,
- Qi Liu1,
- Yutaka Yasui1 and
- Donald C. McKenzie6
- 1University of Alberta, 2Cross Cancer Institute, Edmonton, and 3Alberta Cancer Board, Calgary, Alberta, Canada; 4Ottawa Hospital Regional Cancer Center and 5University of Ottawa Heart Institute, Ottawa, Ontario, Canada; and 6University of British Columbia and 7British 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
Abstract
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)
Footnotes
-
Grant support: This research study was funded by the Canadian Breast Cancer Research Alliance. Canada Research Chairs Program (K.S. Courneya and Y. Yasui); Research Team Grant from the National Cancer Institute of Canada with funds from the Canadian Cancer Society and the National Cancer Institute of Canada/Canadian Cancer Society Sociobehavioral Cancer Research Network (K.S. Courneya, R.J. Segal, D.C. McKenzie, J.R. Mackey, and C.M. Friedenreich); New Investigator Award from the Heart and Stroke Foundation of Canada (R.D. Reid); New Investigator Award from the Canadian Institutes of Health Research and a Health Scholar Award from the Alberta Heritage Foundation for Medical Research (C.M. Friedenreich); Canada Graduate Scholarship from the Canadian Institutes of Health Research and an Incentive Award from the Alberta Heritage Foundation for Medical Research (J.K. Vallance); and Senior Health Scholar Award from the Alberta Heritage Foundation for Medical Research (Y. Yasui).
-
The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked advertisement in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
-
Note: K.S. Courneya had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: Courneya, Segal, McKenzie, Mackey, Friedenreich, Gelmon, Reid. Analysis and interpretation of data: Courneya, Liu, Yasui, Segal, McKenzie, Mackey, Friedenreich, Gelmon, Reid, Ladha, Proulx, Vallance, Lane. Drafting of the manuscript: Courneya. Critical revision of the manuscript for important intellectual content: Segal, McKenzie, Mackey, Friedenreich, Gelmon, Reid, Ladha, Proulx, Vallance, Lane, Liu, Yasui. Statistical analysis: Liu, Yasui, Courneya. Obtained funding: Courneya, Segal, McKenzie, Mackey, Friedenreich, Gelmon, Reid. Administrative, technical, or material support: Courneya, Segal, McKenzie, Mackey, Gelmon, Yasui.
-
Role of the funding source: The Canadian Breast Cancer Research Alliance had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript.
-
- Accepted September 17, 2007.
- Received May 4, 2007.
- Revision received September 10, 2007.
