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Physical activity and fitness in women with metastatic breast cancer

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Abstract

Purpose

This study aimed to explore differences in physical activity and fitness between women with metastatic breast cancer compared to healthy controls and factors associated with their physical activity levels.

Methods

Seventy-one women with metastatic breast cancer, aged (mean (SD)) 57.7 (9.5) and 2.9 (3.1) years after the onset of metastatic disease, and 71 healthy controls aged 55.0 (9.4) years participated. Of those with metastatic disease, 27 % had bone-only metastases, 35 % visceral-only metastases and 38 % bone and visceral metastases. Patient-reported outcomes and physical measures of muscle strength and aerobic fitness assessments were obtained. Participants wore a SenseWear® physical activity monitor over 7 days, and the average steps/day and the time spent in moderate-to-vigorous intensity physical activity were determined.

Results

Women with metastases were significantly (i) less aerobically fit than the control group (25.3 (5.4) vs. 31.9 (6.1) mL • kg−1 • min−1; P < 0.001); (ii) weaker (e.g. lower limb strength for the metastatic and control groups was 53.5 (23.7) vs. 76.0 (27.4) kg, respectively; P < 0.001); (iii) less active, with the metastatic group attaining only 56 % of the mean daily step counts of the healthy women; and (iv) more symptomatic, reporting higher levels of fatigue and dyspnoea (P < 0.001).

Conclusion

Women living in the community with metastatic breast cancer possessed lower aerobic fitness, reduced muscular strength and less daily physical activity compared to healthy counterparts. They also experienced poorer functioning and higher symptom burden.

Implications for Cancer Survivors

Women living with metastatic breast cancer may benefit from a physical activity programme to address their physical impairments.

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References

  1. Australian Institute of Health and Welfare & Australiasian Association of Cancer Registries 2012. Cancer in Australia: an overview, 2012. Cancer Series. 2012; no 74 (Cat. no. CAN 70): Canberra: AIHW.

  2. Lord SJ, Marinovich ML, Patterson JA, Wilcken N, Kiely BE, Gebski V, et al. Incidence of metastatic breast cancer in an Australian population-based cohort of women with non-metastatic breast cancer at diagnosis. Med J Aust. 2012;196(11):688–92.

    Article  PubMed  Google Scholar 

  3. Tracey EA BH, Chen W, Baker D, Roder D, Jelfs P & Bishop J. Survival from cancer in NSW: 1980 to 2003. Sydney: Cancer Institute NSW. 2007.

  4. Meisel JL, Domchek SM, Vonderheide RH, Giobbie-Hurder A, Lin NU, Winer EP, et al. Quality of life in long-term survivors of metastatic breast cancer. Clin Breast Cancer. 2012;12:119–26.

    Article  PubMed  Google Scholar 

  5. Reed E, Simmonds P, Haviland J, Corner J. Quality of life and experience of care in women with metastatic breast cancer: a cross-sectional survey. J Pain Symptom Manag. 2012;43:747–58.

    Article  Google Scholar 

  6. Cheung WY, Le LW, Zimmermann C. Symptom clusters in patients with advanced cancers. Support Care Cancer. 2009;17:1223–30.

    Article  PubMed  Google Scholar 

  7. Lowe SS, Watanabe SM, Baracos VE, Courneya KS. Physical activity interests and preferences in palliative cancer patients. Support Care Cancer. 2010;18:1469–75.

    Article  PubMed  Google Scholar 

  8. Blaney JM, Lowe-Strong A, Rankin-Watt J, Campbell A, Gracey JH. Cancer survivors’ exercise barriers, facilitators and preferences in the context of fatigue, quality of life and physical activity participation: a questionnaire–survey. Psychooncology. 2013;22:186–94.

    Article  CAS  PubMed  Google Scholar 

  9. Cheville AL, Troxel AB, Basford JR, Kornblith AB. Prevalence and treatment patterns of physical impairments in patients with metastatic breast cancer. J Clin Oncol. 2008;26:2621–9.

    Article  PubMed Central  PubMed  Google Scholar 

  10. Cramp F, Daniel J. Exercise for the management of cancer-related fatigue in adults. Cochrane Database Syst Rev. 2008(2):CD006145.

  11. Speck RM, Courneya KS, Masse LC, Duval S, Schmitz KH. An update of controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. J Cancer Surviv. 2010;4:87–100.

    Article  PubMed  Google Scholar 

  12. Adamsen L, Quist M, Andersen C, Moller T, Herrstedt J, Kronborg D, et al. Effect of a multimodal high intensity exercise intervention in cancer patients undergoing chemotherapy: randomised controlled trial. BMJ. 2009;339:b3410.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Courneya KS, McKenzie DC, Mackey JR, Gelmon K, Friedenreich CM, Yasui Y, et al. Effects of exercise dose and type during breast cancer chemotherapy: multicenter randomized trial. J Natl Cancer Inst. 2013;105:1821–32.

    Article  PubMed  Google Scholar 

  14. Mock V. Evidence-based treatment for cancer-related fatigue. J Natl Cancer Inst Monogr. 2004;32:112–8.

    Article  PubMed  Google Scholar 

  15. Oldervoll LM, Loge JH, Paltiel H, Asp MB, Vidvei U, Wiken AN, et al. The effect of a physical exercise program in palliative care: a phase II study. J Pain Symptom Manag. 2006;31:421–30.

    Article  Google Scholar 

  16. Headley JA, Ownby KK, John LD. The effect of seated exercise on fatigue and quality of life in women with advanced breast cancer. Oncol Nurs Forum. 2004;31:977–83.

    Article  PubMed  Google Scholar 

  17. Oken MM, Creech RH, Tormey DC, Horton J, Davis TE, McFadden ET, et al. Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol. 1982;5:649–55.

    Article  CAS  PubMed  Google Scholar 

  18. Thomas S, Reading J, Shephard RJ. Revision of the Physical Activity Readiness Questionnaire (PAR-Q). Can J Sport Sci. 1992;17:338–45.

    CAS  PubMed  Google Scholar 

  19. Godin G, Shephard RJ. A simple method to assess exercise behavior in the community. Can J Appl Sport Sci. 1985;10:141–6.

    CAS  PubMed  Google Scholar 

  20. Gionet N, Godin G. Self-reported exercise behavior of employees: a validity study. J Occup Med. 1989;31:969–73.

    Article  CAS  PubMed  Google Scholar 

  21. Courneya KS, Segal RJ, Mackey JR, Gelmon K, Reid RD, Friedenreich CM, et al. Effects of aerobic and resistance exercise in breast cancer patients receiving adjuvant chemotherapy: a multicenter randomized controlled trial. J Clin Oncol. 2007;25:4396–404.

    Article  PubMed  Google Scholar 

  22. Courneya KS, Friedenreich CM, Sela RA, Quinney HA, Rhodes RE, Handman M. The group psychotherapy and home-based physical exercise (group-hope) trial in cancer survivors: physical fitness and quality of life outcomes. Psychooncology. 2003;12:357–74.

    Article  PubMed  Google Scholar 

  23. Jones LW, Courneya KS, Mackey JR, Muss HB, Pituskin EN, Scott JM, et al. Cardiopulmonary function and age-related decline across the breast cancer survivorship continuum. J Clin Oncol. 2012;30:2530–7.

    Article  PubMed Central  PubMed  Google Scholar 

  24. St-Onge M, Mignault D, Allison DB, Rabasa-Lhoret R. Evaluation of a portable device to measure daily energy expenditure in free-living adults. Am J Clin Nutr. 2007;85:742–9.

    CAS  PubMed  Google Scholar 

  25. Mackey DC, Manini TM, Schoeller DA, Koster A, Glynn NW, Goodpaster BH, et al. Validation of an armband to measure daily energy expenditure in older adults. J Gerontol A Biol Sci Med Sci. 2011;66:1108–13.

    Article  PubMed  Google Scholar 

  26. Johannsen DL, Calabro MA, Stewart J, Franke W, Rood JC, Welk GJ. Accuracy of armband monitors for measuring daily energy expenditure in healthy adults. Med Sci Sports Exerc. 2010;42:2134–40.

    Article  PubMed  Google Scholar 

  27. Brazeau AS, Karelis AD, Mignault D, Lacroix MJ, Prud’homme D, Rabasa-Lhoret R. Test-retest reliability of a portable monitor to assess energy expenditure. Appl Physiol Nutr Metab. 2011;36:339–43.

    Article  PubMed  Google Scholar 

  28. Haskell WL, Lee IM, Pate RR, Powell KE, Blair SN, Franklin BA, et al. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc. 2007;39:1423–34.

    Article  PubMed  Google Scholar 

  29. Weller IM, Thomas SG, Gledhill N, Paterson D, Quinney A. A study to validate the modified Canadian Aerobic Fitness Test. Can J Appl Physiol. 1995;20:211–21.

    Article  CAS  PubMed  Google Scholar 

  30. Weller IM, Thomas SG, Corey PN, Cox MH. Prediction of maximal oxygen uptake from a modified Canadian Aerobic Fitness Test. Can J Appl Physiol. 1993;18:175–88.

    Article  CAS  PubMed  Google Scholar 

  31. Canadian Society for Exercise Physiology (CSEP). Canadian Physical Activity, Fitness and Lifestyle Approach (CPAFLA). 3rd edn. Ottawa: 2003.

  32. Pescatello L, Arena R, Riebe D, Thompson P. ACSM’s guidelines for exercise testing and prescription. 9th ed. Philadelphia: Lippincott, Williams and Wilkins; 2014.

    Google Scholar 

  33. Abizanda P, Navarro JL, Garcia-Tomas MI, Lopez-Jimenez E, Martinez-Sanchez E, Paterna G. Validity and usefulness of hand-held dynamometry for measuring muscle strength in community-dwelling older persons. Arch Gerontol Geriatr. 2012;54:21–7.

    Article  PubMed  Google Scholar 

  34. Savva C, Giakis G, Efstathiou M, Karagiannis C. Test-retest reliability of handgrip strength measurement using a hydraulic hand dynamometer in patients with cervical radiculopathy. J Manipulative Physiol Ther. 2014;37:206–10.

    Article  PubMed  Google Scholar 

  35. Peolsson A, Hedlund R, Oberg B. Intra- and inter-tester reliability and reference values for hand strength. J Rehabil Med. 2001;33:36–41.

    Article  CAS  PubMed  Google Scholar 

  36. Savva C, Karagiannis C, Rushton A. Test-retest reliability of grip strength measurement in full elbow extension to evaluate maximum grip strength. J Hand Surg Eur. 2013;38:183–6.

    Article  CAS  Google Scholar 

  37. Coldwells A, Atkinson G, Reilly T. Sources of variation in back and leg dynamometry. Ergonomics. 1994;37:79–86.

    Article  CAS  PubMed  Google Scholar 

  38. Chandrasekaran B, Ghosh A, Prasad C, Krishnan K, Chandrasharma B. Age and anthropometric traits predict handgrip strength in healthy normals. J Hand Microsurg. 2010;2:58–61.

    Article  PubMed Central  PubMed  Google Scholar 

  39. Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, et al. The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst. 1993;85:365–76.

    Article  CAS  PubMed  Google Scholar 

  40. Hjermstad MJ, Fossa SD, Bjordal K, Kaasa S. Test/retest study of the European Organization for Research and Treatment of Cancer Core Quality-of-Life Questionnaire. J Clin Oncol. 1995;13:1249–54.

    CAS  PubMed  Google Scholar 

  41. Yellen SB, Cella DF, Webster K, Blendowski C, Kaplan E. Measuring fatigue and other anemia-related symptoms with the Functional Assessment of Cancer Therapy (FACT) measurement system. J Pain Symptom Manag. 1997;13:63–74.

    Article  CAS  Google Scholar 

  42. Webster K, Cella D, Yost K. The Functional Assessment of Chronic Illness Therapy (FACIT) Measurement System: properties, applications, and interpretation. Health Qual Life Outcome. 2003;1:79.

    Article  Google Scholar 

  43. Cella D, Lai JS, Chang CH, Peterman A, Slavin M. Fatigue in cancer patients compared with fatigue in the general United States population. Cancer. 2002;94:528–38.

    Article  PubMed  Google Scholar 

  44. Butt Z, Lai JS, Rao D, Heinemann AW, Bill A, Cella D. Measurement of fatigue in cancer, stroke, and HIV using the Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F) scale. J Psychosom Res. 2013;74:64–8.

    Article  PubMed Central  PubMed  Google Scholar 

  45. Baker PS, Bodner EV, Allman RM. Measuring life-space mobility in community-dwelling older adults. J Am Geriatr Soc. 2003;51:1610–4.

    Article  PubMed  Google Scholar 

  46. Peel C, Sawyer Baker P, Roth DL, Brown CJ, Brodner EV, Allman RM. Assessing mobility in older adults: the UAB Study of Aging Life-Space Assessment. Phys Ther. 2005;85:1008–119.

    PubMed  Google Scholar 

  47. Phillips JL, Lam L, Luckett T, Agar M, Currow D. Is the Life Space Assessment applicable to a palliative care population? Its relationship to measures of performance and quality of life. J Pain Symptom Manag. 2013. doi:10.1016/j.jpainsymman.2013.06.017.

    Google Scholar 

  48. Paterson DH, Cunningham DA, Koval JJ, St Croix CM. Aerobic fitness in a population of independently living men and women aged 55-86 years. Med Sci Sports Exerc. 1999;31:1813–20.

    Article  CAS  PubMed  Google Scholar 

  49. Shephard R. Physical activity and aging. London: Croom-Helm; 1987.

    Google Scholar 

  50. Cramp F, Byron-Daniel J. Exercise for the management of cancer-related fatigue in adults. Cochrane Database Syst Rev. 2012;11:CD006145.

    PubMed  Google Scholar 

  51. Efficace F, Biganzoli L, Piccart M, Coens C, Van Steen K, Cufer T, et al. Baseline health-related quality-of-life data as prognostic factors in a phase III multicentre study of women with metastatic breast cancer. Eur J Cancer. 2004;40:1021–30.

    Article  CAS  PubMed  Google Scholar 

  52. Niikura N, Liu J, Hayashi N, Palla SL, Tokuda Y, Hortobagyi GN, et al. Treatment outcome and prognostic factors for patients with bone-only metastases of breast cancer: a single-institution retrospective analysis. Oncologist. 2011;16:155–64.

    Article  PubMed Central  PubMed  Google Scholar 

  53. Ewald B, Attia J, McElduff P. How many steps are enough? Dose-response curves for pedometer steps and multiple health markers in a community-based sample of older Australians. J Phys Act Health. 2014;11:509–18.

    Article  PubMed  Google Scholar 

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Acknowledgments

This project was supported by a grant from the National Breast Cancer Foundation, Australia. SLK is a National Breast Cancer Foundation Career Research Fellow. We like to acknowledge Register4 for the assistance with recruitment and the Primary Care Collaborative Cancer Clinical Trials Group for the assistance in design.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Faculty of Health Sciences, The University of Sydney, Lidcombe, Australia

    Jasmine Yee, Glen M. Davis & Sharon L. Kilbreath

  2. The Chris O’Brien Lifehouse, Camperdown, Australia

    Jane M. Beith & Michelle Harrison

  3. Westmead Cancer Care Centre, Westmead Hospital, The University of Sydney, Sydney, Australia

    Nicholas Wilcken & Rina Hui

  4. Faculty of Health Sciences, Flinders University, Daw Park, Australia

    David Currow

  5. General Practice and Primary Care Academic Centre, University of Melbourne, Parkville, Australia

    Jon Emery

  6. Department of General Practice, University of Western Australia, Crawley, Australia

    Jon Emery

  7. Cunningham Centre for Palliative Care, The University of Notre Dame Australia, Darlinghurst, Australia

    Jane Phillips

  8. Clinical Trials Centre, The University of Sydney, Camperdown, Australia

    Andrew Martin

  9. St Vincent’s Clinical School, University of New South Wales, Darlinghurst, Australia

    Eva Segelov

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  1. Jasmine Yee
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Correspondence to Sharon L. Kilbreath.

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Yee, J., Davis, G.M., Beith, J.M. et al. Physical activity and fitness in women with metastatic breast cancer. J Cancer Surviv 8, 647–656 (2014). https://doi.org/10.1007/s11764-014-0378-y

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  • DOI: https://doi.org/10.1007/s11764-014-0378-y

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