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Randomized Trial of Exercise Therapy in Women Treated for Breast Cancer

Amanda J. Daley, Helen Crank, John M. Saxton, Nanette Mutrie, Robert Coleman, Andrea Roalfe

From the Department of Primary Care and General Practice, The Medical School, University of Birmingham, Birmingham; The Centre for Sport and Exercise Science, Sheffield Hallam University, Sheffield; Sport Culture and the Arts, University of Strathclyde, Glasgow; and Clinical Oncology, Weston Park Hospital, Sheffield, United Kingdom

Address reprint requests to Amanda Daley, PhD, The Department of Primary Care and General Practice, Medical School, Clinical Sciences Building, University of Birmingham, Birmingham, B15 2TT United Kingdom; e-mail: a.daley{at}bham.ac.uk

Purpose To examine the effects of aerobic exercise therapy on quality of life (QoL) and associated outcomes in women treated for breast cancer. Evidence suggests that exercise may be beneficial, but no trial has included an exercise-placebo and a usual-care group to control for the attention effects that might be associated with aerobic exercise interventions in cancer patients.

Patients and Methods A total of 108 women who had been treated for breast cancer 12 to 36 months previously were randomly assigned to supervised aerobic exercise therapy (n = 34), exercise-placebo (body conditioning; n = 36), or usual care (n = 38). Exercise therapy and exercise-placebo sessions took place three times per week for 8 weeks. Outcomes included QoL, depression, exercise behavior, aerobic fitness; outcomes were assessed at baseline and at the 8- and 24-week follow-up.

Results Analyses of covariance revealed a significant mean difference of 9.8 units in Functional Assessment of Cancer Therapy–General (primary outcome) favoring aerobic exercise therapy at 8 weeks, relative to usual care. Significant differences that favored aerobic exercise therapy relative to usual care were recorded for Functional Assessment of Cancer Therapy–Breast, social/family well-being, functional well-being, and breast cancer subscale scores at 8-week follow-up. Psychological health outcomes improved modestly for both intervention groups; these improvements were sustained for several end points.

Conclusion Exercise therapy had large, clinically meaningful, short-term beneficial effects on QoL in women treated for breast cancer; this finding cannot be attributable to attention, given that the exercise-placebo group did not report similar effects relative to usual care.

Supported by Grant No. CE8304 from Cancer Research UK.

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

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