Researchers have shown that participating in an exercise program may improve pain, fatigue, and the quality of life in patients with metastatic breast cancer, according to a recent study published by Hiensch et al in Nature Medicine.
Background
“Although there’s substantial evidence for the beneficial effects of exercise [in patients] with early-stage cancer, we have seen very little research on exercise in patients with more advanced disease,” stressed co–study author Yvonne Wengström, PhD, of the Department of Neurobiology, Care Sciences and Society at the Karolinska Institutet.
Patients with metastatic cancer often undergo continuous treatment aimed at prolonging their lives, which can lead to a decline in quality of life.
“We need supportive care strategies, like exercise, that make the lives of these patients better,” suggested co–study author Helene Rundqvist, PhD, of the Department of Laboratory Medicine at the Karolinska Institutet.
Study Methods and Results
In the PREFERABLE EFFECT trial, the researchers assigned 357 patients with metastatic breast cancer from eight cancer centers across Europe and Australia to undergo a personalized exercise program (n = 178) or usual care (n = 179). The exercise regimen included sessions of resistance, aerobic, and balance exercises twice per week for 9 months and was supervised by a physiotherapist or exercise physiologist. Both groups were encouraged to remain physically active for at least 30 minutes per day and were provided with activity trackers.
The researchers assessed the patients’ fatigue levels and quality of life at baseline and after 3, 6, and 9 months. They found that the patients who participated in the personalized exercise program experienced improvements in their well-being, experienced less fatigue, and reported a better quality of life compared with those who received usual care. The most significant improvements were observed in female patients under 50 years and those who initially reported pain.
“We don’t know exactly why exercise helps patients [with cancer] who are suffering from fatigue, but we think it could be because exercise reduces inflammation. We have collected blood samples from our trial participants, and studying these samples may tell us more,” Dr. Rundqvist noted.
Conclusions
“Based on these findings, we recommend supervised exercise for all patients with metastatic breast cancer, particularly those experiencing pain, as part of their standard care,” emphasized the study authors.
They noted that while older patients also benefited from the personalized exercise program, the regimen may need adjustments to maximize their benefits.
“If patients are interested in exercising, I recommend [they talk] to their [physician] or nurse first and look for an exercise trainer who is trained in helping patients [with cancer]—as some adjustments to the exercise program may be necessary when the patients have, for example, bone or brain metastases,” Dr. Wengström clarified.
The researchers are currently conducting a cost-effectiveness analysis to persuade policymakers and health insurers to fund exercise programs for patients.
“This research is good news for patients with advanced breast cancer because it shows that they can enjoy a better quality of life with less fatigue and pain if they take part in an exercise program as part of their treatment and care,” concluded Michail Ignatiadis, MD, PhD, Professor at the Institut Jules Bordet in Belgium.
Disclosure: The research in this study was funded by the H2020 program. For full disclosures of the study authors, visit nature.com.
