Physical activity and fitness in women with metastatic breast cancer.

Abstract

Purpose This study aimed to explore differences in physical activity and fitness between women with metastatic breast cancer compared to healthy controls and factors associated with their physical activity levels. Methods Seventy-one women with metastatic breast cancer, aged (mean (SD)) 57.7 (9.5) and 2.9 (3.1)years after the onset of metastatic disease, and 71 healthy controls aged 55.0 (9.4) years participated. Of those with metastatic disease, 27 % had bone-only metastases, 35 % visceral-only metastases and 38 % bone and visceral metastases. Patient-reported outcomes and physical measures of muscle strength and aerobic fitness assessments were obtained. Participants wore a SenseWear® physical activity monitor over 7 days, and the average steps/ day and the time spent in moderate-to-vigorous intensity physical activity were determined. Results Women with metastases were significantly (i) less aerobically fit than the control group (25.3 (5.4) vs. 31.9 (6.1)mL•kg; P<0.001); (ii) weaker (e.g. lower limb strength for the metastatic and control groups was 53.5 (23.7) vs. 76.0 (27.4)kg, respectively; P<0.001); (iii) less active, with the metastatic group attaining only 56 % of the mean daily step counts of the healthy women; and (iv) more symptomatic, reporting higher levels of fatigue and dyspnoea (P<0.001). Conclusion Women living in the community with metastatic breast cancer possessed lower aerobic fitness, reduced muscular strength and less daily physical activity compared to healthy counterparts. They also experienced poorer functioning and higher symptom burden. Implications for Cancer Survivors Women living with metastatic breast cancer may benefit from a physical activity programme to address their physical impairments.

Design and methods of a national, multicenter, randomized and controlled trial to assess the efficacy of a physical activity program to improve health-related quality of life and reduce fatigue in women with metastatic breast cancer: ABLE02 trial

“…Patients with MBC are a specific population with significant functional limitations and needs [6,7,14,69]. A large majority of the ABLE Trial participants were interested (89%) and felt able (93%) to participate at moderate intensity in a walking PA program designed specifically for patients with MBC [68].…”

Considerations for Exercise Prescription in Patients With Bone Metastases: A Comprehensive Narrative Review

“…When measured using objective methods, physical activity levels are considerably lower. In a cross‐sectional analysis of 71 patients with metastatic breast cancer (n = 19 bone‐only metastases), those with metastatic disease achieved only 56% of the steps completed by controls each day (5434 [3174] vs 9635 [3327] of steps/d, P < .001) [21]. Objectively measured physical activity levels in patients receiving radiotherapy for bone pain are comparable with physical activity levels in patients receiving chemotherapy [35].…”

“…A small number of cohort studies have reported suboptimal muscle strength in patients with metastatic bone disease [20]. In one example in metastatic breast cancer (n = 71), both relative and adjusted grip strength (26.6 [6.0] vs 30.2 [6.4] kg, P = .001, and 0.38 [0.09] vs 0.46 [0.11] kg.kg ‐1 , P < .001, respectively) and leg strength [53.5 23.7] vs 76.0 [27.4] kg, P < .001, and 0.76 [0.31] vs 1.15 [0.45] kg.kg –1 , P < .001) were significant lower than matched healthy controls [21]. Hand grip strength is negatively associated with physical frailty and low scores are predictive of disability in older people [22].…”

Cancer‐ and Chemotherapy‐Induced Musculoskeletal Degradation

“…In another study, again not stratified by tumor type or treatment, 24 months of strength and weight training showed improved balance and muscle strength in breast cancer survivors . In metastatic breast cancer patients (65% of whom had bone metastases), reduced muscle strength and lower physical activity was reported compared with healthy age‐matched women . There are limited studies during chemotherapy to provide conclusive evidence on the effectiveness of exercise during chemotherapy to preserve bone health.…”