Breast cancer patients benefit from telephone-monitored exercise

Home-based activity program can prevent treatment-related weight gain

Getting more exercise may be the last thing a breast cancer patient feels like doing while undergoing the rigors of chemotherapy and radiation. However, new research by scientists in the Susan F. Smith Center for Women’s Cancers has found that weekly phone consultations enabled patients to step up their physical activity, improve their quality of life, and prevent weight gain that often occurs during breast cancer treatment.

Jennifer Ligibel, MD, and colleagues are studying the impact of exercise in breast cancer patients with the eventual goal of conducting a study that can definitively identify whether exercise can reduce a woman’s risk of dying from breast cancer.

Researchers are testing ways to motivate breast cancer patients to  exercise, which may be beneficial for reducing cancer risk. While in  treatment, Helene Maichle walks her dog Buster as a way to stay  healthy.Researchers are testing ways to motivate breast cancer patients to exercise, which may be beneficial for reducing cancer risk. While in treatment, Helene Maichle walks her dog Buster as a way to stay healthy.

Preliminary evidence suggests that women who exercise and control their weight appear to be at lower risk for breast cancer. Women who are active after diagnosis also appear to have lower risk of breast cancer recurrence, although further work needs to be done to determine if these benefits are a result of exercise or other factors.

As a preliminary step, “we needed to determine how much exercise people are already doing, what is the best group of patients to target, and how do you get them to exercise and stick with it,” say Ligibel.

The Dana-Farber scientists carried out a small pilot study on the effectiveness of a home-based exercise program monitored by weekly phone conversations with an exercise specialist. The results, reported in the Journal of Women’s Health in August, were encouraging.

For the pilot study, the researchers sought women who had had surgery for stage 1, 2, or 3 breast cancers, were not exercising regularly, and were receiving chemotherapy or radiation. A total of 41 patients were recruited from the Dana-Farber Breast Oncology clinic. Most were premenopausal, and on average they exercised about 13 minutes a week before participating in the study.

In an initial meeting with exercise physiologist Nancy Campbell, the patients were evaluated for height, weight, body fat percentage, and waist and hip circumference. They were asked about their current level of activity, their quality of life, body image, and amount of fatigue. Each volunteer was given a heart rate monitor, a pedometer, a moderate-intensity training protocol, and – if they preferred not to exercise at home – a three-month membership to a gym.

The only supervision was a series of weekly phone calls from an exercise physiologist who asked about their progress and symptoms, and helped them set weekly goals. The overall goal was 150 minutes of aerobic activity per week.

The 34 women who completed the study significantly improved their physical activity. While they didn’t reach the target, they did increase to an average of 105 minutes. Their cardiorespiratory fitness was significantly better, and they maintained their starting weight and body fat percentage, even though they were at high risk for gaining weight during treatment. The participants reported enhanced quality of life and slightly less fatigue by the end of the study, whose authors also included Ann Partridge, MD, MPH, and Eric Winer, MD.

Encouraged by this success, Ligibel designed a larger, randomized study using a similar, but longer (four months) phone-supervised exercise program that is currently being tested on 121 breast and colon cancer patients.

Ligibel continues to probe the question of what may be happening in the body that is helping to cut breast cancer risk for active women who keep their weight under control. Leads from previous research point to the effect of exercise on several hormones, chiefly insulin, that have been implicated in cancer susceptibility.

Courtesy of Dana=Farber Cancer Institute Newsletter

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