Objective To evaluate the safety, feasibility, and preliminary effectiveness of implementing supervised exercise programming into the clinical care of individuals with advanced cancer. Design Single group implementation feasibility study using a pre–posttest design. Setting Exercise Oncology Unit of the Spanish Cancer Association (a cancer-specific community facility outside the hospital setting). Participants Adult individuals with advanced cancer profile involving advanced local cancer or distant metastases. Intervention A 12-week, twice-weekly, supervised, clinic-based multi-component exercise program. Main Measure Paired t-tests were used to assess pre–post changes and analyses of covariance were used to compare effects based on selected participant characteristics. Results Eighty-four individuals with advanced cancer completed the baseline assessment, with six participants withdrawing prior to the start of the program. Of the 78 participants, 17 dropped out, thus, a total of 61 completed the final assessment. Mean adherence was 82.5%. No serious adverse events occurred. Exercise significantly improved VO2max by 5.2 mL·kg·min ( p < 0.001), chest strength ( p < 0.001), leg strength ( p < 0.001), lean body mass ( p  =  0.003), skeletal muscle mass ( p < 0.002), % body fat ( p  =  0.02), quality of life by 5.3 points ( p  =  0.009), fatigue by 3.2 points ( p  =  0.012), and physical activity by 1680 METs/week ( p < 0.001). Conclusions Our clinically supervised and tailored exercise program involving moderate to vigorous intensity exercise was found to be feasible, safe, and effective for individuals with advanced cancer. Implications for Cancer Survivors With proper screening and supervision, individuals with advanced cancer can benefit from tailored exercise oncology support as part of an overall therapeutic care plan.

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Tener un solo apartado para agradecimientos en una tesis dice mucho de lo que significa este proceso. Cuando terminas el camino, (o lo empiezas, depende desde donde y hacia donde mires) te das cuenta de que tienes tantas cosas que agradecer que, cada parte de la tesis, llevaría una nota al pie de agradecimiento. Pero solo tenemos un pequeño apartado para ello, así que ahí va.

Introduction: Cardiorespiratory Fitness (CRF) has been described as an independent factorassociated with better survival in Breast Cancer Survivors (BCS). In addition, an altered BodyComposition (BodComp) impacts in a worst prognosis and increase treatment side effects.Despite this, BCS present lower levels of CRF than women without previous history of breastcancer (BC) and around 3% of BCS are obese, with an average of 1.8 to 5.0 kg of weight gainduring chemotherapy treatments and weight keeps rising during hormonotherapy.Exercise has been proved as an effective tool to help BCS not only to reduce treatments sideeffects improving significantly CRF, but also, to allow controlling and improving BodCom duringand after treatments.However, it is not clear if active BCS could achieve similar values of CRF and BodCom than activehealthy women and the impact of a sedentary behavior in them. Purpose: To establish the impact of physical exercise in CRF and BodComp recovery in BCS withinthe last five years compared to women without a BC diagnosis. Material and Methods: in this cross-sectional study, women with and without BC were invitedinto a sport centre in Madrid, (Spain) to evaluate their general physical condition and bodycomposition. Participants were classified into four different groups: sedentary-BC, active-BC,sedentary healthy and active healthy (Sed-BCW, Act-BCW, Sed-HW, Act-HW, respectively).VO2max, speed level, isometric strength, lower body maximum strength, explosive strength andbalance were assessed with different physical test. Body composition was measured bybioimpedance.In terms of statistical analysis, analyses of variance (ANOVA) were used with continuousvariables to compare groups and post- hoc comparisons used Bonferroni test. Results: A total of ninety two women were recruited (23 in each group).In terms of VO2max, significant differences were found between active and sedentary BC (Difmean (ΔM)= 5.86, IC 95% 3.16 - 8.55; p&lt;0.001). No differences in VO2max were observed betweenthe active groups (ΔM = 0.42, IC 95% -2.26 to 3.12; p= 0.753). In terms of BodCom, it wasobserved significant differences in FM% comparing Act-BCW with Act-HW (ΔM= -11.57; IC 95%-16.80 - -6.33), Sed-BC (ΔM= -6.78; IC 95% -12.52 to -1.54) and Sed-HW (ΔM= -12.07; IC 95% -17.31 to -6.83). In terms of percentage lean mass (LM%), results are presented in (table 1).Active-BC showed significant better results than sedentary groups in other parameters of thephysical condition compared with sedentary women, but not with the Active healthy group(Table 1).Significant differences between Active-BC and sedentary groups were found regarding totalweight, water and visceral mass (p&lt;0,01 for all). Table 1. Mean differences, significance and CI 95% in physical and body composition variablesbetween groups.Act-BCW- Sed-BCWAct-BCW - Act-HWAct-BCW - Sed-HW6MWT (m)71.52**37.36 -105.68-3.04-37.20 - 31.1176.57**42.41 - 110.7235m (sec)-1.87*-3.44 - 0.300.17-1.40 - 1.74-2.39**-3.96 - -0.82Jump (cm)5.48**1.47 - 9.49-2.87-6.88 - 1.144.91*0.90 - 8.92Strength Index0.63**0.31 - 0.95-0.09-0.40 - 0.210.376*0.07 - 0.68LM(%)5.20*-1.62 - 8.780.72-2.86 - 4.38.59**3.72 - 13.45*=p&lt;0,05; **=p&lt;0,01. Conclusions: This study provide two main contributions related to the importance of physicalactivity in BC survivors: BC women who maintain an active lifestyle can achieve the same valuesin physical condition as active healthy women, and significant better values than the sedentarygroups. These results suggest than physical exercise might be a stronger determinant of bodycomposition than a previous history of BC. Citation Format: Lucía Gil Herrero, Marina Pollán Santamaría, Miguel Martín Jimenez, Sara López Tarruella, Mónica Castellanos Montealegre, Soraya Casla Barrio. The importance of physical exercise in cardiovascular fitness in breast cancer survivors. A cross sectional study: WIM 2.0 [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P4-11-26.

PurposeTo compare the cardiovascular fitness of breast cancer (BC) survivors with an active lifestyle to those with a sedentary lifestyle. MethodsA cross-sectional study was conducted. Participants were classified into four different groups: sedentary with BC (Sed-BCW), active with BC (Act-BCW), sedentary without BC (Sed-HW) and active without BC (Act-HW). VO2max was estimated by the 6-minute walking test (6MWT); speed was measured by the 35-meter test; isometric strength was measured by dynamometry tests; lower body maximum strength was measured by the squat test; explosive strength was measured by the Sargent Jump Test; balance was measured by the 30-second balance test; and body composition was measured by bioimpedance. ANOVA was used to analyze group differences and post hoc comparisons were developed with the Bonferroni test. ResultsA total of 92 women were recruited. Significant differences were found in VO2max between the Act-BCW and Sed-BCW groups (MeanDif=5.86, p<0.001). No differences in VO2max were observed between the active groups (MeanDif= 0.42, p= 0.753). Related body composition and fat mass levels were significantly lower in the Act-BCW group than in the sedentary groups (Sed-BCW MeanDif= -6.78; p= 0.012 and Sed-HW MeanDif= -12.07; p<0.001) ConclusionsWomen who are Act-BCW can achieve similar values in physical condition as women who are Act-HW and have better values than women in who are sedentary. Moreover, physical exercise might be a stronger determinant of body composition than a previous history of BC.