Effects of physical activity on depressive symptoms during breast cancer survivorship: a meta-analysis of randomised control trials

Patsou, Efrossini D.; Alexias, George; Anagnostopoulos, Fotios; Karamouzis, Michalis V.

doi:10.1136/esmoopen-2017-000271

Cited by 61 publications

(77 citation statements)

References 55 publications

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“…Remarkable improvements in patient-reported outcomes were observed for quality of life, fatigue, and depressive symptoms. While our results align with those reported in the literature [ 15 , 16 ], the exercise-induced reductions in fatigue (effect size d = 0.91) and depressive symptomology (effect size d = 0.97) are unparalleled with substantially larger effect sizes than the 0.30 and 0.38 reported from recent meta-analyses examining exercise and fatigue [ 16 ] and depressive symptoms [ 17 ], respectively, in cancer survivors. The marked reduction in these two domains may be due to the inclusion of women within a short period (6 months) of concluding cancer-related treatment, the physically inactive and obese nature of the participants upon enrollment, and the ethnically diverse sample.…”

Section: Discussionsupporting

confidence: 90%

Aerobic and resistance exercise improves physical fitness, bone health, and quality of life in overweight and obese breast cancer survivors: a randomized controlled trial

et al. 2018

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BackgroundExercise is an effective strategy to improve quality of life and physical fitness in breast cancer survivors; however, few studies have focused on the early survivorship period, minorities, physically inactive and obese women, or tested a combined exercise program and measured bone health. Here, we report the effects of a 16-week aerobic and resistance exercise intervention on patient-reported outcomes, physical fitness, and bone health in ethnically diverse, physically inactive, overweight or obese breast cancer survivors.MethodsOne hundred breast cancer survivors within 6 months of completing adjuvant treatment were assessed at baseline, post-intervention, and 3-month follow-up (exercise group only) for physical fitness, bone mineral density, serum concentrations of bone biomarkers, and quality of life. The exercise intervention consisted of moderate-vigorous (65–85% heart rate maximum) aerobic and resistance exercise thrice weekly for 16 weeks. Differences in mean changes for outcomes were evaluated using mixed-model repeated measure analysis.ResultsAt post-intervention, the exercise group was superior to usual care for quality of life (between group difference: 14.7, 95% CI: 18.2, 9.7; p < 0.001), fatigue (p < 0.001), depression (p < 0.001), estimated VO2max (p < 0.001), muscular strength (p < 0.001), osteocalcin (p = 0.01), and BSAP (p = 0.001). At 3-month follow-up, all patient-reported outcomes and physical fitness variables remained significantly improved compared to baseline in the exercise group (p < 0.01).ConclusionsA 16-week combined aerobic and resistance exercise program designed to address metabolic syndrome in ethnically-diverse overweight or obese breast cancer survivors also significantly improved quality of life and physical fitness. Our findings further support the inclusion of supervised clinical exercise programs into breast cancer treatment and care.Trial registrationThis trial is registered on ClinicalTrials.gov: NCT01140282 as of June 9, 2010.

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Section: Discussionsupporting

confidence: 90%

Aerobic and resistance exercise improves physical fitness, bone health, and quality of life in overweight and obese breast cancer survivors: a randomized controlled trial

et al. 2018

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“…Performing specific forms of regular exercise and maintaining an active lifestyle can play an important role in survivorship, 15 since they help survivors to increase survival rates and decrease the risk of cancer recurrence. 16 Major health organizations recommend that cancer survivors should perform at least 150 minutes of moderate or 75 minutes of high-intensity aerobic exercise combined with a minimum of two strengthening exercise sessions on a weekly basis.…”

Section: Introductionmentioning

confidence: 99%

Physical activity and sociodemographic variables related to global health, quality of life, and psychological factors in breast cancer survivors

Patsou¹,

Alexias²,

Anagnostopoulos³

et al. 2018

PRBM

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BackgroundBreast cancer is one of the most common cancers affecting women worldwide and depression and anxiety are disturbing side effects of cancer diagnosis and treatment. The aim of this study was to examine the associations of physical activity in global health, quality of life (QoL), and psychological factors (depressive symptoms, self-esteem, and anxiety) in breast cancer survivors after completing cancer treatment and through survivorship. Demographic variables (marital status, education, income), medical status (cancer stage), and level of physical activity (metabolic equivalent of task [MET]) were tested as predictors of depressive mood, anxiety, self-esteem, and QoL in younger and older breast cancer survivors.Materials and methodsOne hundred and seventy-one Greek breast cancer survivors, who had completed cancer treatment at least one and a half years ago, were included in this study. Demographic and medical information, self-reported and objective physical activity levels, global health, QoL, depressive symptoms, self-esteem, and anxiety were assessed in all participants.ResultsActive women had lower depressive symptoms, less anxiety, higher self-esteem, and better global health and QoL, compared to the inactive ones, even in the long term after completing treatment through survivorship. Exercise had significant positive correlations with self-esteem, global health, and QoL (physical, role, emotional, cognitive, and social aspects). Moreover, significant negative correlations with anxiety and depressive symptoms were found. Multiple regression analysis revealed that MET and covariates such as income, education, and stage of cancer were significant predictors of depressive symptoms, self-esteem, anxiety, global health, and QoL in younger survivors, while MET, income, education, stage of cancer, and marital status were significant predictors of dependent variables for the older ones.ConclusionIt can be concluded that exercise should be recommended to cancer survivors even after treatment completion and through survivorship to achieve higher self-esteem, better QoL, and decreased anxiety and depressive symptoms.

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“…Care and drug therapies for alleviating these physical symptoms should be provided in the long term as required. Patients should be encouraged to engage in more physical activity [ 49 ]. Depression is closely related to QOL and it has been reported that depression interventions including psychoeducational interventions improve QOL [ 19 , 50 ].…”

Section: Discussionmentioning

confidence: 99%

Association between chronological depressive changes and physical symptoms in postoperative pancreatic cancer patients

Sato

Hasegawa

Saito

et al. 2018

BioPsychoSocial Med

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BackgroundPancreatic cancer (PC) has poorer prognosis and higher surgical invasiveness than many other cancers, with associated psychiatric symptoms including depression and anxiety. Perioperative depression has not been investigated in PC patients regarding surgical stress and relevant interventions.MethodsWe evaluated chronological depressive changes and subjective physical symptoms in surgically treated PC patients preoperatively and at 3 and 6 months postoperatively.Enrolled patients undergoing pancreatic tumor surgery completed questionnaires based on the Self-Rating Depression Scale (SDS) and Functional Assessment of Cancer Therapy for Patients with Hepatobiliary Cancer (FACT-Hep) preoperatively, and at 3 and 6 months postoperatively. Responses were analyzed with JMP® Pro using one-way and two-way ANOVA, Spearman’s rank correlation coefficient, and multiple regression analysis.ResultsMalignancy was diagnosed in 73 of 101 patients postoperatively; SDS score was significantly higher in these patients than in those with benign tumors at all timepoints: malignant/benign, 41.8/37.9 preoperatively (p = 0.004); 43.5/37.8 3 months postoperatively (p = 0.006); and 42.9/37.7 6 months postoperatively (p = 0.020). SDS scores were significantly higher in patients < 65 years old with malignancy at 3 months than at 6 months postoperatively (44.6/42.5, p = 0.046) and in patients with malignancy who underwent pancreaticoduodenectomy at 3 months postoperatively than preoperatively (43.4/41.1; p = 0.028). SDS scores moderately correlated with 8 physical symptom-related FACT-Hep items 3 months postoperatively (p < 0.05), showing low-to-moderate correlation with 16 physical symptom-related FACT-Hep items at 6 months postoperatively (p < 0.05). Multiple regression analysis of FACT-Hep symptoms significantly correlated with SDS scores revealed the following significant variables: “lack of energy” (p < 0.000) and “pain” (p = 0.018) preoperatively (R2 = 0.43); “able to perform usual activities” (p = 0.031) and “lack of energy” (p < 0.000) at 3 months postoperatively (R2 = 0.51); and “stomach swelling or cramps” (p = 0.034) and “bowel control” (p = 0.049) at 6 months postoperatively (R2 = 0.52).ConclusionsPC patients experience persistently high levels of depression preoperatively through 6 months postoperatively, with associated subjective symptoms including pain and gastrointestinal symptoms.Trial registrationUMIN Clinical Trials Registry 000009592, Registered 20 December 2012.

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Effects of physical activity on depressive symptoms during breast cancer survivorship: a meta-analysis of randomised control trials

Cited by 61 publications

References 55 publications

Aerobic and resistance exercise improves physical fitness, bone health, and quality of life in overweight and obese breast cancer survivors: a randomized controlled trial

Aerobic and resistance exercise improves physical fitness, bone health, and quality of life in overweight and obese breast cancer survivors: a randomized controlled trial

Physical activity and sociodemographic variables related to global health, quality of life, and psychological factors in breast cancer survivors

Association between chronological depressive changes and physical symptoms in postoperative pancreatic cancer patients

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