Download Breast cancer: summary table

Breast cancer: summary table
Author
Daley 2007a
Study type /
Cites
Randomised trial
Population
Note
Description of PA excerice(s)?
Quantitative outcomes?
Conclusion
Female diagnosed
with breast cancer
Attention:
Psychological health
outcomes improved
modestly for both
intervention groups in
comparison to CAU
See also Daley et al [Daley 2007b, Daley
2004]
Sign. mean difference of 9.8 units in
Functional Assessment of Cancer
Therapy–General (primary outcome)
favoring aerobic exercise therapy at 8
weeks, relative to usual care. Other sign.
differences were recorded for Functional
Assessment of Cancer Therapy–Breast,
social/family well-being, functional wellbeing, and breast cancer subscale
scores at 8-week follow-up.
Psychological health outcomes improved
modestly for both intervention groups;
Breast cancer mortality risk according to
physical activity category (_3, 3-8.9, 914.9, 15-23.9, or_24 metabolic
equivalent task [MET] hours per week)
Exercise therapy had large,
clinically meaningful, shortterm beneficial effects on QoL
in women treated for breast
cancer; this finding cannot be
attributable to attention, given
that the exercise-placebo
group did not report similar
effects relative to usual care
Holmes 2005
Prospective
observational
study from 2987
female
Female diagnosed
with stage I, II, or III
breast cancer
between 1984 and
1998 and who were
followed up until death
or June 2002
Author
Study type /
Cites
Randomized trial
PA and PS
(placebo
stretching)
Population
Note
Description of PA excerice(s)?
Quantitative outcomes?
Females aged 35 to
65 years (small
group!!!)
PA in order to stop
decline in erythrocyte
level during treatment
(radiation)
During radiation (7 weeks), aerobic exercise
(AE) of walking for 20 to 45 minutes, 3 to 5
times per week, at 50% to 70% of measured
maximum heart rates
Yes, but not useful for economic
evaluations
Women had received
breast surgery and
undergoing treatment
(radiotherapy
Excluding women who
were already
exercising vigorously
3x/week for 20 minutes
Intervention: CAU & attended a supervised
exercise programme 2x/week during 12
weeks. Classes consisted of a warm-up, 1020 min. exercise (incl. walking, cycling, low-
Physical functioning (12-min walking
test) and general Qol (FACT-G)
Drouin 2006
Campbell
2005
Pilot study; RCT;
(Intervention
group n=12;
CAU: 10)
Using questionnaire to self-report activities
Physical activity after a breast
cancer diagnosis may reduce
the risk of death from this
disease. The greatest benefit
occurred in women who
performed the equivalent of
walking 3 to 5 hours per week
at an average pace, with little
evidence of a correlation
between increased benefit
and greater energy
expenditure
Conclusion
The results of the current
study suggest that moderate
intensity aerobic exercise
appears to maintain
erythrocyte levels during
radiation treatment of breast
cancer compared with the
declines observed in nontraining individuals.
An important finding was that
the women recruited into the
exercise group were able to
consistently and progressively
Mock 2001
Pilot study; RCT
walking program
or CAU
Segal 2001
RCT; 3 groups;
CAU; a selfdirected
exercise
intervention, or a
supervised
exercise
intervention
/chemotherapy) for
newly diagnosed
breast cancer.
Included at the time of
2nd or 3rd treatment; &
questionnaire and
walking test at
baseline and in week
12.
52 women during
breast cancer
treatment;
measurement at
baseline, midtreatment and end of
treatment
123 women with
stages I and II breast
cancer within 2 weeks
of the initiation of their
prescribed adjuvant
therapy (radiotherapy,
hormonal therapy, or
chemotherapy);
Duration of PA 26
weeks
or more.
level aerobics, muscle-strengthening
erxcises, circuits etc.), a cool down and
relaxation period.
Control: CAU & monitored
increase physical activity
levels over the course of the
treatments whereas the
control group experienced a
progressive decrease in PA
levels.
Intervention: home-based moderate walking
exercise intervention (at least 90
minutes/week on 3 or more days); length?
Symptoms, physical functioning, and
QOL were measured at baseline,
midtreatment, and at the end of
treatment
CAU: general advice from the oncologist
about the benefits of exercise and a
suggestion to participants to exercise if they
felt well enough. 1 to 4 weeks before
beginning therapy.
Self-directed: an exercise specialist provided
detailed information regarding their fitness
assessment during a return visit, within seven
days of the baseline testing. Instructions for
monitoring exercise intensity and completing
an exercise diary were provided. Participants
were shown a standardized series of warm-up
and cool-down exercises and were provided a
progressive walking program at an exercise
intensity of 50% to 60% of the predicted
maximal oxygen uptake. Participants in the
self-directed exercise group received a home
exercise prescription and were asked to
exercise five times per week for a 26-week
period. They received an interim fitness
evaluation at 13 weeks and were contacted
by telephone every 2 weeks during the 26week training period. During the call, the
exercise specialist checked on progress and
worked with the participants to overcome any
Generic health-related quality of life was
measured using the Medical Outcomes
Survey Short Form-36 (MOS SF-36)
Cancer site-specific quality of life using
(FACT-G) and (FACT-B)
Changes in body weight
Women who exercised at
least 90 minutes per week on
3 or more days reported
significantly less fatigue and
emotional distress as well as
higher functional ability and
QOL than women who were
less active during treatment.
This health-promoting selfcare activity needs further
testing in large RCT
In this study of women with
stages I and II breast cancer,
self-directed exercise,
compared with usual care, led
to a moderately large and
clinically significant 9.8-point
improvement in physical
functioning, as measured by
the physical functioning scale
of the SF-36. Supervised
exercise led to a more
moderate 6.3-point
improvement in physical
functioning.
barriers to exercise they were experiencing.
Supervised exercise group participants
received a supervised exercise program three
times per week for 26 weeks in the
rehabilitation area of the Ottawa Regional
Cancer Centre.24 During each exercise class;
the exercise specialist led a 7- to 10-minute
warm-up. Participants then completed walking
exercise at their prescribed pace. The
exercise specialist then led a standard cooldown. Patients were also expected to
exercise at home on at least 2 other days
each week.
Generic and disease-specific health-related
quality of life, aerobic capacity, and body
weight measures were repeated 26 weeks
after the baseline assessment. Participants
not returning for follow-up appointments were
contacted by telephone by the study
coordinator
Note: We found also a meta-analysis by McNeely et al. [McNeely 2006]. They included only randomized controlled trials that examined exercise interventions for breast cancer patients or
survivors with quality of life, cardiorespiratory fitness or physical functioning as primary outcomes. In total 14 studies met all their criteria. Their interpretation of their findings was: “Exercise
is an effective intervention to improve quality of life, cardiorespiratory fitness, physical functioning and fatigue in breast cancer patients and survivors”. But they also concluded that ”larger
trials that have a greater focus on study quality and adverse effects and that examine the long-term benefits of exercise are needed for this patient group”.
Colon or colorectal cancer: summary table
Author
Meyerhardt
2006a,
2006b
Study type / Cites
Observational
studies (832
[Meyerhardt 2006a]
& 573 patients
[Meyerhardt 2006b])
Population
Survivor of stage II
or III colon cancer
who have
completed adjuvant
therapy within the
previous 2-6
months
Courneya
2003
RCT; Participants
were randomly
assigned in a 2:1
ratio to either an
exercise (n = 69) or
control (n = 33)
resected colorectal
cancer survivors
Note
No additional benefit
occurred with an
increase in PA postdiagnosis in women
meeting guidelines
[Meyerhardt 2006b]
Description of PA excerice(s)?
We assessed leisure-time physical activity in
metabolic equivalent task (MET) -hours per
week. Patients reported duration of participation
(ranging from 0 to 11 or more hours per week) in
walking, jogging, running, bicycling, swimming
laps, racket sports, other aerobic exercises,
lower intensity exercise (yoga, toning,
stretching), or other vigorous activities.
Intervention: home-based exercise; Participants
were given a fitness consultation lasting about
30 min that included a personalized exercise
prescription for the next 16 weeks.
Participants were allowed to choose the mode of
exercise they preferred (e.g. swimming, cycling)
Quantitative outcomes?
NO, only disease free
survival (DFS)
Conclusion
Recreational physical activity after the
diagnosis of stages I to III colorectal
cancer may reduce the risk of colorectal
cancer–specific and overall mortality.
The primary outcome was
Qol (FACT-C).
Other outcomes: leisure
score index;
The main findings: no differences
between groups in changes in QOL or
fitness using an intention-to-treat
analysis. According to authors this
“failure resulted primarily from the high
contamination rate in the control group
group
but if they had no preference they were
prescribed walking. The goal was to have
participants exercising at least 3–5 times per
week, for 20–30 min, at 65% to 75% of the
predicted heart rate maximum.
Control group: were not prescribed
a home-based, personalized exercise
programme and were asked not to initiate any
structured exercise over the course of the
intervention
(51.6%) but also from the less than
optimal adherence rate in the exercise
group (75.8%)”.
Prostate cancer: summary table
Author
Galvao 2007
Study type /
Cites
Review
Population
Note
Prostate cancer, older
mens, treated with
ADT
Side effects
accompanying
androgen deprivation
therapy (ADT),
including sarcopenia,
loss of bone mass and
reduction in muscle
strength,
Segal 2003
155 men in two-site
trial randomly
selected, exercise
group and control
group (waiting list)
Galvao 2006
10 men
Description of PA excerice(s)?
Quantitative outcomes?
Conclusion
Preliminary results suggest
that resistance exercise
might help, but more work
is required to confirm
results, and to investigate
the role of progressive
resistance training to
combat treatment-related
side-effects
Training intensity was set at 60-70% of
resistance exercise program 3 times per week
for 12 weeks. Resistance exercise consisted of
a 12-week program of nine strength-training
exercises carried out under supervision three
times per week, at 60% to 70% of onerepetition maximum (1-RM; the maximum
amount of weight that can be lifted once),
estimated from the standard load test. Two sets
of eight to 12 repetitions of the following nine
exercises were performed: leg extension, calf
raises, leg curl, chest press, latissimus
pulldown, overhead press, triceps extension,
biceps curls, and modified curl-ups. Sixty
percent of the participant’s 1-RM was used as
the starting resistance. Patients were instructed
to increase the resistance by 5 lb when they
were able to complete more than 12 repetitions.
In fitness center
20 wk at 6- to 12-repetition maximum (RM) for
No. Self-reported questionnaire: less
interference from fatigue on activities of
daily living and higher quality of life.
Higher levels of upper body and lower
body muscular fitness than men in the
control group. BUT no improved body
composition as measured by changes in
body weight, body mass index, waist
circumference, or subcutaneous skinfolds.
No.
Progressive resistance
12 upper- and lower-body exercises
in a university exercise rehabilitation clinic.
Muscle strength (chest press, 40.5%;
seated row, 41.9%; leg press, 96.3%; P G
0.001) and muscle endurance (chest
press, 114.9%; leg press, 167.1%; P G
0.001) increased significantly after
training. Significant improvement (P G
0.05) occurred in the 6-m usual walk
(14.1%), 6-m backwards walk (22.3%),
chair rise (26.8%), stair climbing (10.4%),
400-m walk (7.4%), and balance (7.8%).
Muscle thickness increased (PG 0.05) by
15.7% at the quadriceps site. Whole-body
lean mass was preserved with no change
in fat mass. There were no significant
changes in PSA, testosterone, GH,
cortisol, or hemoglobin.
exercise has beneficial
effects on muscle strength,
functional performance and
balance in older men
receiving androgen
deprivation for prostate
cancer and should be
considered to preserve
body composition and
reduce treatment side
effects
Others: summary table
Author
Stevinson
2006
Study type /
Cites
Aim was to
evaluate
feasibility and
acceptability of
group-based
exercise
Population
Note
Description of PA excerice(s)?
Quantitative outcomes?
Conclusion
Adult cancer patients
(n=11)
Probably bias, and
more motivated people
included
During 10 weeks; supervised onsite exercise
(warm-up & AE & cool-down and relaxation)
once per week & encouragement of
participants to supplement the exercise class
with home-based activity (booklet) &
pedometer as additional motivation tool
No
Incl. onsite exercise, on
average 5.1 day active per
week at the end;
Pedometer was not
considered as being
motivating. They either lost
interest or found it
unreliable and frustrating,
and all had ceased using it.