The effect of aerobic exercise on metabolic and inflammatory markers in breast cancer survivors—a pilot study

Guinan, Emer; Hussey, Juliette; Broderick, Julie; Lithander, Fiona E; O’Donnell, Dearbhaile M.; Kennedy, Michael J.; Connolly, Elizabeth

doi:10.1007/s00520-013-1743-5

Cited by 51 publications

(79 citation statements)

References 43 publications

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“…In patients with cancer, a cohort from the TEAM trial, which randomized postmenopausal patients to exemestane vs tamoxifen followed by exemestane[66], showed that women (median age 63.6 years) spent 6.3 hours/week in moderate to vigorous activity –an amount similar to our patient group-- but noted a declining trend with age. A smaller trial in younger (mean age 48) post-chemotherapy breast cancer survivors showed no differences in body composition, insulin resistance, CRP, physical activity by accelerometry, and questionnaires between cases and controls at baseline, 8 weeks, and 3 months following an exercise intervention[67]. Our results are also compatible with those found in a study of exercise intervention during adjuvant treatment for younger women (median age 51 years)[68].…”

Section: Discussionsupporting

confidence: 88%

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Impact of chemotherapy on medium-term physical function and activity of older breast cancer survivors, and associated biomarkers

Extermann

Leeuwenburgh

Samiian

et al. 2017

Journal of Geriatric Oncology

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Background Chemotherapy is less often prescribed in older individuals due to concerns about post-treatment morbidity and quality of life. We evaluated the physical performance of breast cancer survivors treated with and without adjuvant chemotherapy. Methods We conducted a case-control study in 56 estrogen receptor positive breast cancer survivors (BCS) on adjuvant aromatase inhibitors 1-2 years after definitive surgery. Cases had received adjuvant chemotherapy (n = 27; age 70.5±3.6 yrs) versus age-matched controls who had not (n = 29; age 70.0±4.3 yrs). Measures of grip strength, physical activity and performance, walking speed, fatigue, and self-reported physical function were collected. Biological correlates of inflammation, frailty and markers of DNA and RNA oxidation were compared. Results Grip strength (Controls: 21±7.4 vs. Cases: 29.7±5.0 kg, p=0.20), physical activity (5403±3204 vs. 6801±9320 steps/day, p=0.45), physical performance (Short Physical Performance Battery score: 10.1±1.8 vs. 10.4±1.1, p=0.52), long-distance walking speed (1.2±0.21 vs. 1.3±0.41 m/sec, p=0.17) were similar between the two groups. Self-reported physical function was marginally lower in cases than controls (Controls: 72±24 vs. Cases: 57±34 AU, p=0.07). Fatigue disruptiveness was not different between groups (Controls: 11.1±13.0 vs. Cases: 15.7±16.2 AUs, p=0.24). Similarly, the inflammation, oxidation, and frailty markers did not present a significant difference between groups, except for vitamin D levels (p=0.04). Conclusion Older women who received chemotherapy reported having slightly lower physical function, but a similar physical performance compared to women who did not. These data suggest that older BCS treated with chemotherapy recover to an extent similar to survivors who only received hormonal therapy.

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Section: Discussionsupporting

confidence: 88%

“…We also excluded patients who needed assistive devices for safety reasons. Similar limitations apply to the two studies mentioned above [67, 68]. Additionally, none of our testing measures addressed maximal performance capacity.…”

Section: Discussionmentioning

confidence: 88%

Impact of chemotherapy on medium-term physical function and activity of older breast cancer survivors, and associated biomarkers

Extermann

Leeuwenburgh

Samiian

et al. 2017

Journal of Geriatric Oncology

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“…A meta-analysis of five trials 30,80,83,97,100 provided high-quality evidence of a non-significant reduction in levels of plasma CRP following exercise when compared with usual care. A metaanalysis of four trials 79,83,90,107 provided moderate-quality evidence that there was no significant difference in plasma IL6 levels; and meta-analysis of two trials 79,107 provided moderate-quality evidence that there was no difference in IL8 or IL10 levels following exercise (Table 5).…”

Section: Inflammationmentioning

confidence: 99%

“…Trials included aerobic exercise (19 trials), 30 68,69,74,80,88,89,96 four by a fitness trainer, 70,83,93,99,102 one by a kinesiotherapist and physician, 101 and one by a trained research assistant. 63 The duration of the intervention ranged from 15 days 65 to 1 year, 89,93 with most trials of at least 12 weeks duration.…”

Section: Interventionmentioning

confidence: 99%

Moderate-intensity exercise reduces fatigue and improves mobility in cancer survivors: a systematic review and meta-regression

Dennett

Peiris

Shields

et al. 2016

Journal of Physiotherapy

134

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“…15,16 Interestingly, results from a pilot study by our research group demonstrated a decrease in waist circumference (WC) (P,0.05) in a group of breast cancer survivors 2-6 months post-chemotherapy who adhered to .90% of a prescribed supervised and home-based moderate intensity aerobic exercise protocol. 17,18 The decrease in WC occurred in the absence of significant change in other anthropometric measures. While there were no accompanying changes in measures of insulin resistance or inflammatory markers, these results provide a meaningful target for designing a larger study and suggest that rigorous adherence to an appropriate aerobic intervention over a short period of time may decrease WC.…”

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confidence: 96%

Response to commentary on: ‘Exercise training in breast cancer survivors: a review of trials examining anthropometric and obesity-related biomarkers of breast cancer risk’

Guinan

Connolly

Hussey

2013

Physical Therapy Reviews

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The authors would like to thank Campbell and Neil for their commentary 1 on a recently published review by Guinan, Connolly and Hussey 2 which explores the effect of exercise training in breast cancer survivors on anthropometric and obesity-related biomakers of breast cancer risk outcomes. We welcome discussion on this topic which, due to the increasing number of breast cancer survivors, is becoming a public health issue that needs to be addressed by physical therapists with proficient skills in prescribing exercise in clinical populations. Of course, the issues addressed explore the impact of physical activity on many diseases where obesity and inactivity are risk factors, e.g. cardiovascular disease. Breast cancer survivors however, characterize a unique group for whom physical activity may impact on not only chronic disease risk factors but also breast cancer-specific outcomes including risk of recurrence and mortality. Data from our research group have described breast cancer survivors, in the first number of years following adjuvant treatment, as largely overweight or obese and/or centrally obese and physical inactive, 3,4 which led to the need to implement exercise interventions in addition to healthy weight strategies early in the cancer trajectory.Campbell and Neil correctly point out that exercise alone, in the absence of diet modification, is not sufficient to produce meaningful, long-lasting weight loss. The end-points examined in the review by Guinan et al. 2 were termed 'obesity-related biomakers' and were therefore inherently related to adiposity. Campbell and Neil discuss the results of a recent four-arm randomized control trial by Foster-Schubert and colleagues, 5 comparing the effect of four different interventions: (i) aerobic exercise; (ii) weight loss (calorie restriction); (iii) exercise and weight loss (calorie restriction); and (iv) usual care control group on selected biomarkers. The results of this trial are similar to others 6-8 in suggesting that the benefits to be gained from exercise combined with weight loss through calorie restriction are superior to those stimulated by either exercise or diet modification alone.In relation to breast cancer, both physical activity and maintenance of a healthy body weight are associated with improved survival and breast cancerrelated outcomes. 9,10

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The effect of aerobic exercise on metabolic and inflammatory markers in breast cancer survivors—a pilot study

Cited by 51 publications

References 43 publications

Impact of chemotherapy on medium-term physical function and activity of older breast cancer survivors, and associated biomarkers

Impact of chemotherapy on medium-term physical function and activity of older breast cancer survivors, and associated biomarkers

Moderate-intensity exercise reduces fatigue and improves mobility in cancer survivors: a systematic review and meta-regression

Response to commentary on: ‘Exercise training in breast cancer survivors: a review of trials examining anthropometric and obesity-related biomarkers of breast cancer risk’

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