The effect of exercise on body composition and bone mineral density in breast cancer survivors taking aromatase inhibitors

Thomas, Gwendolyn A.; Cartmel, Brenda; Harrigan, Maura; Fiellin, Martha; Capozza, Scott; Zhou, Yang; Ercolano, Elizabeth; Gross, Cary P.; Hershman, Dawn L.; Ligibel, Jennifer A.; Schmitz, Kathryn H.; Li, Fangyong; Sanft, Tara; Irwin, Melinda L.

doi:10.1002/oby.21729

Cited by 83 publications

(83 citation statements)

References 39 publications

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“…43 Another randomized trial compared a combined aerobic and resistance exercise program versus usual care among 121 breast cancer survivors taking aromatase inhibitors and reported significant increases in lean body mass and decreases in body fat over 12 months. 44 Finally, in an exploratory study, 20 subjects were randomized to either a 16 week aerobic and resistance training program versus delayed control. Exercise participants experienced significant improvements in lean body mass, percent body fat, and fat mass.…”

Section: Intervention Studies On Body Composition Among Breast Cancermentioning

confidence: 99%

Clinical implications of low skeletal muscle mass in early-stage breast and colorectal cancer

Feliciano

Chen

2018

Proc. Nutr. Soc.

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Although obesity has now been widely accepted to be an important risk factor for cancer survival, the associations between body mass index and cancer mortality have not been consistently linear. Although morbid obesity has clearly been associated with worse survival, some studies have suggested a U-shaped association with no adverse association with overweight or lower levels of obesity. This “obesity paradox” may be due to the fact that body mass index likely incompletely captures key measures of body composition, including distribution of skeletal muscle and adipose tissue. Fat and lean body mass can be measured using clinically acquired CT scans. Many of the earlier studies focused on patients with metastatic cancer. However, skeletal muscle loss in the metastatic setting may reflect end stage disease processes. Therefore, this article focuses on the clinical implication of low skeletal muscle mass in early stage non-metastatic breast and colorectal cancer where measures of body composition have been shown to be strong predictors of disease-free survival and overall survival and also chemotherapy toxicity and operative risk.

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Section: Intervention Studies On Body Composition Among Breast Cancermentioning

confidence: 99%

Clinical implications of low skeletal muscle mass in early-stage breast and colorectal cancer

Feliciano

Chen

2018

Proc. Nutr. Soc.

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“…Moreover the athlete's blood, independently tested at the laboratory of a national hospital for a panel of biochemical indicators (including transferrin, ferritin, luteinizing hormone, follicle stimulating hormone, delta‐4‐androstenedione, 17‐alfa hydroxyl progesterone, dehydroepiandrosterone, and 17‐betaestradiol), resulted normal, and a physical examination, including the calculation of BMI (22.7), body surface area (BSA) (1.66 m 2 , method Du Bois ) and seven skinfold measurements according to Jackson Pollock Formula (fat mass: 16.22%) did not reveal any effects of letrozole or other AIs capable of decreasing fat body mass or giving muscle definition. According to previous studies, AI consumption is responsible for a significant increase in lean mass and a decrease of fat mass in treated postmenopausal women with respect to controls …”

Section: Discussionmentioning

confidence: 91%

Hair analysis to discriminate voluntary doping vs inadvertent ingestion of the aromatase inhibitor letrozole

Favretto

Snenghi

Pértile

et al. 2018

Drug Testing and Analysis

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Letrozole is an aromatase inhibitor, used to treat postmenopausal women with hormone receptor‐positive or unknown advanced breast cancer. It is prohibited in sport because it is used together with androgen anabolizing steroids to avoid their adverse effects. In the case of an adverse analytical finding, it may be important to distinguish between repetitive use due to voluntary administration and occasional use, possibly due to involuntary intake. With the objective to identify the dose capable of producing a positive hair test, and to apply these results to the scenarios of inadvertent letrozole ingestion by an athlete, this study investigates the urinary excretion and incorporation into hair of single doses of letrozole. Seven subjects were recruited for an excretion study of letrozole and its metabolite bis(4‐cyanophenyl) methanol (M1) in urine, after the consumption of 0.62 mg, 1.25 mg, and 2.5 mg of letrozole, and to investigate the incorporation in hair after ingestion of 0.62 mg and 2.5 mg of letrozole. Urine and hair samples were also obtained from two women in chronic therapy. Urinary concentrations of letrozole and its metabolite M1 were lower in subjects administered once with 0.62 mg, 1.25 mg, or 2.5 mg letrozole than in women in regular therapy with 2.5 mg/day. In hair collected after a single dosage, concentrations of 16–60 pg/mg were detected while in women in chronic therapy concentrations were higher than 160 pg/mg all along the hair shaft. Hair analysis turned to be a promising possibility for the discrimination of letrozole repetitive use vs occasional/inadvertent administration.

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“…We conducted a randomized exercise trial in 121 breast cancer survivors who were randomized to either an exercise intervention or usual care. We previously reported that exercise led to a significant 30% improvement in AI‐associated arthralgias and improved body composition among previously inactive breast cancer survivors . We also reported that long‐term exercise adherence was feasible among women with breast cancer who were experiencing pain because of AI‐associated arthralgia .…”

Section: Introductionmentioning

confidence: 91%

“…17,18 We also reported that longterm exercise adherence was feasible among women with breast cancer who were experiencing pain because of AI-associated arthralgia. 18 To our knowledge, the impact of exercise on endocrine-related QOL among women who are receiving an AI for the treatment of early stage breast cancer and are experiencing arthralgia have not been reported to date. We hypothesized that exercise would have a positive effect on endocrinerelated QOL among these women.…”

Section: Introductionmentioning

confidence: 93%

“…We previously reported that exercise led to a significant 30% improvement in AI‐associated arthralgias and improved body composition among previously inactive breast cancer survivors . We also reported that long‐term exercise adherence was feasible among women with breast cancer who were experiencing pain because of AI‐associated arthralgia . To our knowledge, the impact of exercise on endocrine‐related QOL among women who are receiving an AI for the treatment of early stage breast cancer and are experiencing arthralgia have not been reported to date.…”

Section: Introductionmentioning

confidence: 95%

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Endocrine‐related quality of life in a randomized trial of exercise on aromatase inhibitor–induced arthralgias in breast cancer survivors

Baglia

Lin

Cartmel

et al. 2019

Cancer

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Background The objective of this study was to evaluate the role of a 12‐month exercise intervention on endocrine‐related quality of life (QOL) and overall QOL among breast cancer survivors with aromatase inhibitor (AI)‐induced arthralgia in the Hormones and Physical Exercise (HOPE) Study. Methods This was a randomized controlled trial of 121 breast cancer survivors who were currently receiving AIs and experiencing at least mild arthralgia. QOL was assessed using the Functional Assessment of Cancer Therapy (FACT) questionnaires and the 36‐Item Short Form Survey (SF‐36) at baseline, 6 months, and 12 months. Participants were randomized to either a 1‐year gym‐based, supervised exercise intervention group (150 minutes of aerobic exercise and 2 strength‐training sessions each week) or a usual care group. Effects of the intervention on QOL were assessed using mixed‐model, repeated‐measures analysis. Results At 12 months, the exercise group had greater improvement in the overall QOL measures as well as the breast cancer‐specific (scores, 2.2 vs 0.7; P = .02), endocrine‐specific (scores, 5.6 vs 1.6; P < .001), and fatigue‐specific (score, 5.8 vs 0.5; P < .001) subscales compared with the usual care group. The results indicated a stronger effect at 12 months versus 6 months after the intervention. Conclusions Combined aerobic and resistance exercise, such as treadmill walking and strength training, improved endocrine‐related and overall QOL among breast cancer survivors who were experiencing adverse side effects from AIs. Because adverse side effects associated with AI use are quite common and this is the main reason for treatment discontinuation, this nonpharmacologic intervention could benefit many breast cancer survivors and increase successful adherence to AIs in breast cancer treatment.

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The effect of exercise on body composition and bone mineral density in breast cancer survivors taking aromatase inhibitors

Cited by 83 publications

References 39 publications

Clinical implications of low skeletal muscle mass in early-stage breast and colorectal cancer

Clinical implications of low skeletal muscle mass in early-stage breast and colorectal cancer

Hair analysis to discriminate voluntary doping vs inadvertent ingestion of the aromatase inhibitor letrozole

Endocrine‐related quality of life in a randomized trial of exercise on aromatase inhibitor–induced arthralgias in breast cancer survivors

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