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A/Prof Prue Cormie PhD AEP [email protected] Breast Cancer Outcomes Managing Side Effects Breast Cancer Outcomes Exercise may reduce the risk of breast cancer death* Breast Cancer Mortality: Highest vs. Lowest Exercise Categories Breast Cancer Tumour Growth Breast Cancer Mortality: Meeting vs. Not Meeting Exercise Guidelines Breast Cancer Tumour Growth (including chemo) Lahart et al. Acta Oncologica 2015 Betof et al. J Natl Cancer Inst 2015 Exercise may reduce the risk of breast cancer recurrence* Breast Cancer Recurrence: Highest vs. Lowest Exercise Categories (post-diagnosis exercise levels) Breast Cancer Recurrence: Exercise vs. Usual Care During Adjuvant Chemotherapy Hazard Ratio: 0.61 (0.31-1.21) Exercise (n = 160): 12.5% recurrence Control (n = 82): 20.7% recurrence Breast Cancer Recurrence: Highest vs. Lowest Exercise Categories (pre-diagnosis exercise levels) Lahart et al. Acta Oncologica 2015 Courneya et al. Med Sci Sports Exerc 2014 Exercise may improve breast cancer treatment tolerance Supervised Res + Aer Exercise Home-based Exercise Usual Care Patients requiring a dose reduction 12%* 34% 34% Magnitude of dose reduction 10% 10% 25% Supervised Resistance Exercise Supervised Aerobic Exercise Usual Care Relative dose intensity 90%* 87% 84% Proportion of patients who received 85% of the planned dosage 78%* 74% 66% Chemotherapy dosage van Waart et al. J Clin Oncol 2015 Chemotherapy dosage Courneya et al. J Clin Oncol 2007 Managing Side Effects Breast cancer and its treatment may lead to… Exercise counteracts impairments in physical function Cardiorespiratory Fitness Muscular Strength Speck et al. J Cancer Surviv 2010 Upper Body Lower Body Markes et al. Cochrane Database Syst Rev 2006 Cheema et al. Breast Cancer Res Treat 2014 Exercise helps manage cancer-related fatigue Physical Fatigue van Vulpena et al. Maturitas 2016 Supervised Exercise Cramp et al. Cochrane Database Syst Rev 2012 Meneses-Echávez et al. BMC Cancer 2015 Exercise doesn’t initiate lymphoedema or exacerbate established lymphoedema Established Lymphoedema Singh et al. Arch Phys Med Rehabil 2016 Incidence/Exacerbation Volume & Symptom Severity Cheema et al. Breast Cancer Res Treat 2014 Cheema et al. Breast Cancer Res Treat 2014 Exercise mitigates musculoskeletal issues Shoulder Function Arthralgia Worst pain Shoulder Range of Motion McNeely et al. Cochrane Database Syst Rev 2010 Severity p < 0.001 p < 0.001 Interference Pain McNeely et al. Cochrane Database Syst Rev 2010 Speck et al. J Cancer Surviv 2010 p < 0.001 Irwin et al. J Clin Oncol 2014 Exercise Scott et al. Circulation 2011 Modulation of cardiotoxicity Exercise helps modulate chemotherapy induced cardiotoxicity Exercise helps manage psychological distress Breast = 65% of patients Craft et al. Cancer Epidemiol Biomarkers Prev 2012 26 studies (n = 1796) Brown et al. PLoS One 2012 Craft et al. Cancer Epidemiol Biomarkers Prev 2012 Exercise can improve health-related quality of life Post Tx During Tx Speck et al. J Cancer Surviv 2010 Cheema et al. Breast Cancer Res Treat 2014 Additionally, exercise may… …reduce the risk of comorbid conditions* …attenuate cognitive impairment* …counteract negative changes to body composition Mackenkie et al. Neuro Perspectives 2016; Casla et al. Clin Transl Oncol 2015; Crowgey et al. Appl Physiol Nutr Metab 2014; Schmitz Recent Results Cancer Res 2011; Fardell et al. Clin Pharmacol Ther 2011; Schmitz et al. Med Sci Sports Exerc 2010; Speck et al. J Cancer Surviv 2010; Breast Cancer Outcomes Managing Side Effects A/Prof Prue Cormie PhD AEP [email protected]
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