Effect of exercise on quality of life during and after treatment for breast cancer: Results of two randomized controlled trials.

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Due to the combined influences of increased incidence and improved survival, there are an estimated 2.3 million breast cancer (BC) survivors in the US. Many experience unpleasant physical side effects and reduced quality of life (QOL) that may linger for several years or longer. Exercise may be a useful tool to help women rebound psychologically and physically from BC diagnosis and treatment, however, the data from the majority of studies on the effects of physical activity (PA) on psychosocial QOL in this population have limitations such as small sample sizes, non-experimental designs, short intervention periods, poor measurement of adherence, and failure to comprehensively assess QOL. Addressing these issues will allow for a better understanding of the potential role of PA in BC survivorship. PURPOSE: To examine the effect of PA on multiple dimensions of QOL and physical functioning among 125 BC survivors participating in two randomized exercise trials in CT. METHODS: The Yale Exercise and Survivorship (YES) Study is an ongoing trial of supervised PA vs. usual care among 75 BC survivors who have completed adjuvant treatment. The Increasing or Maintaining Physical Activity during Cancer Treatment (IMPACT) Study is an ongoing 6-month trial of home-based PA vs. usual care among 50 recently diagnosed BC survivors. The goal for exercise group participants in both studies is 30 minutes of moderate-intensity PA 5 days/week. Participants completed QOL measures prior to randomization and again 6 months post-randomization. RESULTS: As of Sept. 5, 2006, 59 women have completed 6 months in the YES Study and 34 women have completed 6 months in the IMPACT Study. In pooled analyses, exercisers experienced benefits in happiness (p=.08), SF-36 mental well-being (p<.05), SF-36 physical well-being (p<.001), FACT-B physical well-being (p=.09), and FACT-B physical functioning (p=.08). Other measures, including depression, stress, anxiety, and the emotional, social, and BC subscales of the FACT-B, showed trends suggesting a benefit; these effects are expected to achieve statistical significance once data for all 125 women are available in Nov. 2006. CONCLUSIONS: The methodological strengths of the YES and IMPACT Studies will help improve understanding of which dimensions of QOL may benefit most from PA interventions after a diagnosis of BC. Preliminary evidence from these studies suggests that exercise contributes to QOL in a variety of ways; once the full data are available we will assess how these effects may be modified by demographic factors, stage at diagnosis, baseline PA, treatment choices, and adherence to the intervention. Supported by the American Cancer Society (MRSG-04-006-01), the Susan G. Komen Breast Cancer Foundation (BCTR0201916), and the Lance Armstrong Foundation. Clinical resources provided by the General Clinical Research Center at Yale-New Haven Hospital (NIH M01 RR00125).