Study shows home exercise benefits cancer survivors regardless of BMI

Intervention improves overall quality of life for endometrial cancer survivors

MD Anderson News Release 04/07/2014

Endometrial cancer survivors, who also happen to be overweight or obese and adopted an exercise routine, experienced similar benefits as non-obese cancer survivors. Those benefits included cardiorespiratory fitness, quality of life and mental health, according to a study published in the journal of Gynecologic Oncology.

A team of researchers led by Karen Basen-Engquist, Ph.D., professor of Behavioral Science at MD Anderson, conducted a secondary analysis on a six-month longitudinal study to determine differences between obese and non-obese endometrial cancer survivors throughout the duration of the home-based exercise program. Researchers examined the participants’ exercise behavior, fitness, heart rate, blood pressure, body size and quality of life to determine differences between the two survivor groups.

“Obesity and inactivity are important risk factors that survivors can control through lifestyle changes,” said Basen-Engquist, lead investigator on the study.  “Exercise after cancer treatment can speed up a survivor’s recovery and improve overall health.”
Endometrial cancer is the fourth most common cancer among women in the United States, and more than 52,000 new cases will be diagnosed this year. Basen-Engquist says approximately 59 percent of the cancers could be prevented by being physically active and maintaining a healthy body weight, and yet many are not aware of the link between cancer and obesity.
Fitting in fitness improves quality of life

This study collected data from 100 endometrial cancer survivors who were at least six months post-treatment. Survivors diagnosed with stage I, II and III endometrial cancer were assessed at the beginning of the exercise program and again at two, four and six month touch points. Survivors also wore an accelerometer – a device that detects and measures movement – for the first seven days of the program. Along with a laboratory assessment, participants completed questionnaires at the designated intervals and recorded exercise with handheld computers.

Obese cancer survivors (those with a BMI of 30 or greater) accounted for 64 percent of the participants. While this group of survivors had more problematic symptoms than non-obese participants at the start of the exercise program – less active, lower fitness, poorer quality of life and higher systolic blood pressure – significant improvements were shown throughout the program.

“This is the first study to report data on cardiorespiratory fitness levels comparing obese and non-obese endometrial cancers survivors,” said Basen-Engquist.

Study results revealed survivors had improvements in physical activity, fitness and some quality of life aspects including physical functioning, energy levels and pain. The data also showed no differences in improvements for quality of life between the groups. Both non-obese and obese survivors experienced benefits. For example, among obese survivors there was an 18 percent improvement in pain, a 16 percent improvement in fatigue, and a 15 percent decrease in emotional distress about recurrence.

“This is important because it indicates that even small increases in physical activity can be beneficial no matter your weight,” said Basen-Engquist.

Basen-Engquist says overall, home-based interventions benefit endometrial cancer survivors whose BMI is in the obese range, and exercise should be encouraged in all endometrial cancer survivors to improve their health and quality of life.

As director of MD Anderson’s Center for Energy Balance in Cancer Prevention and Survivorship, Basen-Engquist is leading the way in addressing the role of physical activity, nutrition, obesity and cancer by developing interventions to modify unhealthy lifestyles, reduce cancer risk and improve cancer outcomes. The center is funded by MD Anderson and the Duncan Family Institute for Cancer Prevention and Risk Assessment.

Co-authors with Basen-Engquist are Cindy Carmack, Ph.D., Mathew Cox, M.D.,  Maria Swartz, M.D. and George Baum, M.D., of Behavioral Science; Jubilee Brown, M.D., of Gynecologic Oncology and Reproductive Medicine; Anuja Jhingran, M.D., of Radiation Oncology; Jae Song, M.D., of Biostatistics, and Karen Lu, M.D., of Gynecologic Oncology.
This research was funded by grants from the National Cancer Institute of the National Institutes of Health (R01CA109919, R25TCA057730, R25ECA056452, and P30 CA016672; PROSPR Shared Resource), the Center for Energy Balance in Cancer Prevention and Survivorship, Duncan Family Institute for Cancer Prevention and Risk Assessment.