Effect of Exercise on Symptom Burden and Quality of Life in Patients With Metastatic Breast Cancer

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Taking part in an exercise program may improve pain, fatigue, and quality of life in patients with metastatic breast cancer, according to recent findings presented by Hiensch et al at the 2024 European Breast Cancer Conference (EBCC; Abstract 1).


“Although there’s been quite a lot of research looking at exercise for [patients] with early-stage cancer, we have seen very little research on exercise in patients with more advanced disease,” explained lead study author Anouk Hiensch, MSc, of the University Medical Center Utrecht. “Patients with metastatic cancer often undergo continuous treatment that aims to prolong their life. Thanks to these treatments, many patients with metastatic cancer live longer, but many also report a deteriorating quality of life over time. We therefore need supportive care strategies, like exercise, that make the lives of these patients better,” she added.

Study Methods and Results

In the PREFERABLE-EFFECT study, the researchers recruited 357 patients (average age, 55 years) with metastatic breast cancer from eight cancer centers across Germany, Poland, Spain, Sweden, the Netherlands, and Australia. The patients were then randomly assigned to partake in a 9-month exercise program—consisting of twice weekly personalized training with resistance, aerobic, and balance exercises overseen by a physiotherapist or exercise physiologist—in addition to usual care (n = 178) or usual care alone (n = 179). The patients in both groups were encouraged to be physically active for at least 30 minutes every day and given activity trackers.

At baseline and after follow-up at 3, 6, and 9 months, the researchers asked the patients about their levels of fatigue and their quality of life, including any pain they were experiencing.

Overall, the patients who engaged in the exercise program experienced less fatigue and had a better quality of life. The researchers found that patients of all ages seemed to benefit from the exercise program but observed the greatest improvements among female patients younger than 50 as well as those experiencing pain at baseline. However, they emphasized, all patients with metastatic cancer should be offered exercise as part of their cancer care.

“Older patients did also benefit from exercise; however, the program might require some additional fine-tuning for them to benefit as much as younger patients,” suggested Dr. Hiensch.


“Based on these findings, we recommend supervised exercise for all patients with metastatic breast cancer—particularly those who are experiencing pain—as part of their standard care. If patients are interested in exercising, [we] recommend talking to their [physician] or nurse first and looking for an exercise trainer who is trained in helping patients [with cancer],” emphasized Dr. Hiensch. “We don’t know exactly why exercise helps [these] patients who are suffering from pain, 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,” she underlined.

The researchers plan to conduct a cost-effectiveness analysis to help encourage policymakers and health insurers to fund exercise programs for patients with cancer.

“This research is good news for patients with advanced breast cancer, because it shows 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 package of treatment and care. [Patients] with metastatic cancer cannot always be cured of their disease, but they can live for many months or years, so ensuring they have the best possible quality of life is absolutely vital,” concluded Michail Ignatiadis, MD, PhD, of the Institut Jules Bordet in Brussels and Chair of the 2024 EBCC, who was not involved in the research.

Disclosure: The research in this study was funded by the European Union’s Horizon 2020 Research and Innovation Program and the National Health and Medical Research Council of Australia.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.