Postsurgical physical activity and fatigue-related daily interference in women with non-metastatic breast cancer

Abstract

Purpose Women undergoing surgery for breast cancer experience side effects such as fatigue, reduced quality of life (QOL), and depression. Physical activity (PA) is associated with improved psychological adjustment during treatment and survivorship, yet little is known about how PA relates to fatigue, depression and QOL in the period following surgery for breast cancer. The purpose of the study was to examine the relationships between these constructs in women who recently underwent surgery for breast cancer. Methods At two to ten weeks post-surgery, 240 women with non-metastatic breast cancer reported intensity and duration of moderate and vigorous PA (MVPA), fatigue (intensity and interference), depressed mood, clinician-rated depression, and functional QOL. Results In the path analysis models tested, women that reported greater weekly MVPA reported less fatigue interference, greater functional QOL, less depressed mood, and lower clinician-rated depression. Tests of indirect effects suggested that fatigue interference may be an intermediate pathway by which MVPA relates to functional QOL, clinician-rated depression, and depressed mood. Conclusion Women who are more physically active in the months after breast cancer surgery show greater psychological adaptation in the initial phases of their treatment.

Physical activity, fatigue and quality of life in breast cancer patients

“…It was concluded that women who were more physically active in the months after surgery, psychologically adapted much better in the early stages of treatment, with fewer symptoms of fatigue and higher QOL. 21 Our study showed a significant positive correlation between QOL (EORTC-QLQ-30) and PA (p<0.001). It was observed that the most active women had better rates in all the scales, especially for functional capacity (p<0.001).…”

Objectively Recorded Physical Activity And Perceived Distress At The Beginning Of Oncological Treatment

“…In a randomized-controlled trial a combination of self-directed stress management training and home-based exercise increased self-reported physical activity levels and reduced depression and anxiety among 286 cancer patients, mainly diagnosed with breast and lung cancer, at the start of chemotherapy [13] . A similar tendency was seen in a cross-sectional study among 240 women with breast cancer, where an association between higher self-reported physical activity levels and reduced depression was found 2-10 weeks post-surgery [12] . In a cross-sectional study among 180 colon cancer survivors objectively recorded moderate-to-vigorous intensity physical activity was associated with anxiety but not depression [28] .…”

“…There are indications that physical activity may influence distress positively in cancer patients both during and after oncological treatment [10,11] . For adult cancer patients at the start of treatment, higher self-reported physical activity levels have been associated with reduced anxiety and depression [12,13] . In cohorts and in a retrospective study, it has been suggested that being physically active before cancer diagnosis and during early treatment may result in less depression [14,15,16] .…”

How changes in physical activity relate to fatigue interference, mood, and quality of life during treatment for non-metastatic breast cancer

“…The process by which physical activity reduces these symptoms is less understood [8]. Previously, women with non-metastatic breast cancer reported greater physical activity and had less concurrent perceived daily interference due to fatigue, less clinician- and self-rated depressive symptoms, and better functional QoL following surgery [9]. Moreover, fatigue interference served an intermediary role; greater physical activity was related to less depressive symptoms and better functional QoL via reduced fatigue interference [9].…”

“…Previously, women with non-metastatic breast cancer reported greater physical activity and had less concurrent perceived daily interference due to fatigue, less clinician- and self-rated depressive symptoms, and better functional QoL following surgery [9]. Moreover, fatigue interference served an intermediary role; greater physical activity was related to less depressive symptoms and better functional QoL via reduced fatigue interference [9]. While these findings suggest a potential mechanism relating physical activity to mood outcomes, the relationships must be examined longitudinally for better understanding.…”