An Exercise of the Will
M. D. Anderson News Release 07/17/06
Researchers at The University of Texas M. D. Anderson Cancer Center have found that exercise decreases pain and helps breast cancer survivors feel healthier and increase participation in daily activities.
The Active for Life after Breast Cancer Study, published Friday in the journal, Patient Education and Counseling, evaluated the effect of exercise on former cancer patients' physical well-being.
Approximately 60 breast cancer survivors, randomly placed in a lifestyle intervention group or a standard care control group, participated in the six-month, 21-session study. Researchers taught participants to incorporate short periods of moderate exercise into their daily routines, which included 30 minutes of physical exercise at least five days per week.
According to Karen Basen-Engquist, Ph.D., principal investigator of the study and associate professor of behavioral science at M. D. Anderson Cancer Center, study leaders informed participants that they should still be able to talk while exercising at a moderate level, but they should not be able to sing during the activity. Lifestyle intervention participants met weekly for four months and then semi-weekly for two months to learn cognitive and behavioral skills to support effective behavioral change.
Study leaders emphasized that physical activity need not be an organized, lengthy endeavor, but rather a lifestyle activity that could include vacuuming, brisk walking or climbing stairs rather than taking the elevator.
"The wonderful take-away message from this study is that simple exercises, such as walking during coffee breaks or parking further away from work, can have beneficial effects on physical health and functioning," said Basen-Engquist. "Exercise doesn't need to be a daunting activity or even an organized outing to reap significant rewards for breast cancer survivors."
The study examined barriers to increasing physical activity, including time restraints, other commitments, fatigue, pain or muscle problems, incontinence, hot flashes and premature menopause due to chemotherapy.
"We found that exercise improved participants' ability to perform certain physical tasks, increased self reports of feeling healthy and decreased pain and the degree to which their activities were limited by physical health problems," said Basen-Engquist.
She notes that study leaders invited participation from a pool of breast cancer survivors who had recently completed both radiation and chemotherapy. Women who maintained primarily sedentary lifestyles were chosen as ideal candidates "because we wanted to see if through the study they would integrate exercise into their daily lives," said Basen-Engquist.
Researchers at M. D. Anderson Cancer Center partnered with the Kelsey Research Foundation, a non-profit organization dedicated to improving the quality of patient care and health outcomes through research and education; Kelsey-Seybold, a large, multi-specialty health care clinic; the Houston chapter of the Sisters' Network, a support and advocacy group for African-American breast cancer survivors; and The Rose, a Houston non-profit agency that sponsors support groups for breast cancer survivors, in recruiting study participants.
"One of the goals of our cancer program is to improve the quality of life of our cancer survivors," said Anthony Greisinger, Ph.D., executive director of the Kelsey Research Foundation. "Our staff was encouraged by Dr. Basen-Engquist's positive findings and we hope to evaluate this exercise intervention in a larger study with M. D. Anderson Cancer Center."
At baseline and again six months later, researchers administered physical and emotional assessments using self-report questionnaires, five physical performance tests and seven-day physical activity recall interviews.
At the conclusion of the study, researchers asked both the lifestyle intervention group and the standard care control group to walk as far as possible in six minutes. Participants who received lifestyle intervention training showed significant physical improvement, walking an average of 100 feet further than their control group peers.
Additionally, those in the intervention group made substantial progress incorporating exercise as a habit throughout the day, while the control group only began to make such changes.
Roslyn Smith, a study participant and M. D. Anderson Cancer Center employee, reports improved post-treatment physical health and quality of life. "I learned about exercises I could do at my desk, as well as the benefits of walking around the institution for added fitness. The fight to maintain a healthy life style is an ongoing one, but one that I must pursue. After attending recent lectures on the great advantages of yoga, I'm excited about having another avenue to help me stay active," said Smith.
Basen-Engquist is encouraged by the study's positive findings and notes that - if the lifestyle approach is shown to be effective in a larger randomized trial - it represents a highly practical intervention that easily can be delivered to breast cancer survivors by health care institutions or community organizations without dedicated exercise facilities and equipment.