Safety and Efficacy of Weight Training in Recent Breast Cancer Survivors to Alter Body Composition, Insulin, and Insulin-Like Growth Factor Axis Proteins Effect of Exercise on Markers of Inflammation in Breast Cancer Survivors: The Yale Exercise and Survivorship Study Effects of an exercise and hypocaloric healthy eating program on biomarkers associated with long-term prognosis after early-stage breast cancer: a randomized controlled trial Effects of a Weight Loss Intervention on Body Mass, Fitness, and Inflammatory Biomarkers in Overweight or Obese Breast Cancer Survivors Changes in vitamin and mineral supplement use after breast cancer diagnosis in the Pathways Study: a prospective cohort study Effects of a Physical Activity Behavior Change Intervention on Inflammation and Related Health Outcomes in Breast Cancer Survivors The effect of weight training on bone mineral density and bone turnover in postmenopausal breast cancer survivors with bone loss: a 24-month randomized controlled trial Strength training stops bone loss and builds muscle in postmenopausal breast cancer survivors: a randomized, controlled trial Impact of a mixed strength and endurance exercise intervention on insulin levels in breast cancer survivors. Long-term dietary outcomes of the FRESH START intervention for breast and prostate cancer survivors. Health-related quality of life and biomarkers in breast cancer survivors participating in tai chi chuan A diet, physical activity, and stress reduction intervention in men with rising prostate-specific antigen after treatment for prostate cancer. A multicentre year-long randomised controlled trial of exercise training targeting physical functioning in men with prostate cancer previously treated with androgen suppression and radiation from TROG 03.04 RADAR.
Background : This r and omized controlled trial assessed the safety and effects of twice-weekly weight training among recent breast cancer survivors . Outcomes included body size and biomarkers hypothesized to link exercise and breast cancer risk . Methods : A convenience sample of 85 recent survivors was r and omized into immediate and delayed treatment groups . The immediate group trained from months 0 to 12 ; the delayed treatment group served as a no exercise parallel comparison group from months 0 to 6 and trained from months 7 to 12 . Measures at baseline , 6 and 12 months included body weight , height , body fat , lean mass , body fat % , and waist circumference , as well as fasting glucose , insulin , insulin resistance , insulin-like growth factor-I ( IGF-I ) , IGF-II , and IGF-binding protein-1 , IGFBP-2 , and IGFBP-3 . Injury reporting was st and ardized . Results : The intervention result ed in significant increases in lean mass ( 0.88 versus 0.02 kg , P < 0.01 ) , as well as significant decreases in body fat % ( −1.15 % versus 0.23 % , P = 0.03 ) and IGF-II ( −6.23 versus 28.28 ng/mL , P = 0.02 ) comparing immediate with delayed treatment from baseline to 6 months . Within-person changes experienced by delayed treatment group participants during training versus no training were similar . Only one participant experienced a study related injury that prevented continued participation . Conclusion : Twice-weekly weight training is a safe exercise program for recent breast cancer survivors that may result in increased muscle mass , as well as decreased body fat % and IGF-II . The implication s of these results on cancer recurrence or survival may become more evident with longer exercise intervention trials among breast cancer survivors Physical activity is associated with improved breast cancer survival , but the underlying mechanisms , possibly including modification of the inflammatory state , are not well understood . We analyzed changes in interleukin (IL)-6 , C-reactive protein ( CRP ) , and TNF-α in a r and omized controlled trial of exercise in postmenopausal breast cancer survivors . Seventy-five women , recruited through the Yale-New Haven Hospital Tumor Registry , were r and omized to either a six-month aerobic exercise intervention or usual care . Correlations were calculated between baseline cytokines , adiposity , and physical activity measures . Generalized linear models were used to assess the effect of exercise  on IL-6 , CRP , and TNF-α . At baseline , IL-6 and CRP were positively correlated with body fat and body mass index ( BMI ) and were inversely correlated with daily pedometer steps ( P < 0.001 ) . We found no significant effect of exercise  on changes in inflammatory marker concentrations between women r and omized to exercise versus usual care , though secondary analyses revealed a significant reduction in IL-6 among exercisers who reached 80 % of the intervention goal compared with those who did not . Future studies should examine the effect of different types and doses of exercise and weight loss on inflammatory markers in large-scale trials of women diagnosed with breast cancer . Cancer Prev Res ; 6(2 ) ; 109–18 . © 2012 AACR Excess body weight at diagnosis and weight gain after breast cancer are associated with poorer long-term prognosis . This study investigated the effects of a lifestyle intervention on body weight and other health outcomes influencing long-term prognosis in overweight women ( BMI > 25.0 kg/m2 ) recovering from early-stage ( stage I – III ) breast cancer . A total of 90 women treated 3–18 months previously were r and omly allocated to a 6-month exercise and hypocaloric healthy eating program ( n = 47 , aged 55.6 ± 10.2 year ) or  control group ( n = 43 , aged 55.9 ± 8.9 year ) . Women in the intervention group received three supervised exercise sessions per week and individualized dietary advice , supplemented by weekly nutrition seminars . Body weight , waist circumference , waist/hip ratio [ WHR ] , cardiorespiratory fitness , blood biomarkers associated with breast cancer recurrence and cardiovascular disease risk , and quality of life ( FACT-B ) were assessed at baseline and 6 months . Three-day diet diaries were used to assess macronutrient and energy intakes . A moderate reduction in body weight in the intervention group ( median difference from baseline of −1.09 kg ; IQR −0.15 to −2.90 kg ; p = 0.07 ) was accompanied by significant reductions in waist circumference ( p < 0.001 ) , WHR ( p = 0.005 ) , total ( p = 0.021 ) and saturated fat ( p = 0.006 ) intakes , leptin ( p = 0.005 ) , total cholesterol ( p = 0.046 ) , and resting diastolic blood pressure ( p = 0.03 ) . Cardiopulmonary fitness ( p < 0.001 ) and FACT-B quality of life ( p = 0.004 ) also showed significant improvements in the intervention group . These findings suggest that an individualized exercise and a hypocaloric healthy eating program can positively impact upon health outcomes influencing long-term prognosis in overweight women recovering from early-stage breast cancer Background Obesity is characterized by chronic mild inflammation and may influence the risk and progression of cancer . Purpose The current study is an exploratory analysis of the effect of a weight loss intervention that emphasized increased physical activity on inflammatory cytokines ( tumor necrosis factor-α [ TNF-α ] , interleukin-6 [ IL-6 ] , interleukin-8 [ IL-8 ] , and vascular endothelial growth factor [ VEGF ] ) at the end of the 16-week intervention period in overweight breast cancer survivors . Methods Study participants averaged 56 years of age ( N = 68 ) . Intervention participants ( n = 44 vs. 24 controls ) participated in a cognitive behavioral therapy-based weight management program as part of an exploratory r and omized trial . The intervention incorporated strategies to promote increased physical activity and diet modification . Baseline and 16-week data included height , weight , body composition , physical activity level , and biomarkers IL-6 , IL-8 , TNF-α , and VEGF . Results Weight loss was significantly greater in the intervention group than controls ( −5.7 [ 3.5 ] vs. 0.2 [ 4.1 ] kg , P < 0.001 ) . Paired t tests noted favorable changes in physical activity level ( P < 0.001 intervention , P = 0.70 control ) , marginally lower IL-6 levels ( P = 0.06 intervention , P = 0.25 control ) at 16 weeks for participants in the intervention group , and lower TNF-α levels for participants in the intervention ( P < 0.05 ) and control groups ( P < 0.001 ) . Increased physical activity was associated with favorable changes in IL-6 for participants in the intervention group ( R2 = 0.18 ; P < 0.03 ) . Conclusion Favorable changes in cytokine levels were observed in association with weight loss in this exploratory study with overweight breast cancer survivors Background Vitamin and mineral supplement use after a breast cancer diagnosis is common and controversial . Dosages used and the timing of initiation and /or discontinuation of supplements have not been clearly described . Methods We prospect ively examined changes in use of 17 vitamin/mineral supplements in the first six months following breast cancer diagnosis among 2,596 members ( 28 % non-white ) of Kaiser Permanente Northern California . We used multivariable logistic regression to examine demographic , clinical , and lifestyle predictors of initiation and discontinuation . Results Most women used vitamin/mineral supplements before ( 84 % ) and after ( 82 % ) diagnosis , with average doses far in excess of Institute of Medicine reference intakes . Over half ( 60.2 % ) reported initiating a vitamin/mineral following diagnosis , 46.3 % discontinuing a vitamin/mineral , 65.6 % using a vitamin/mineral continuously , and only 7.2 % not using any vitamin/mineral supplement before or after diagnosis . The most commonly initiated supplements were calcium ( 38.2 % ) , vitamin D ( 32.01 % ) , vitamin B6 ( 12.3 % ) and magnesium ( 11.31 % ) ; the most commonly discontinued supplements were multivitamins ( 17.14 % ) , vitamin C ( 15.97 % ) and vitamin E ( 45.62 % ) . Higher education , higher intake of fruits/vegetables , and receipt of chemotherapy were associated with initiation ( p-values < 0.05 ) . Younger age and breast-conserving surgery were associated with discontinuation ( p-values < 0.05 ) . Conclusions In this large cohort of ethnically diverse breast cancer patients , high numbers of women used vitamin/mineral supplements in the 6 months following breast cancer diagnosis , often at high doses and in combination with other supplements . The immediate period after diagnosis is a critical time for clinicians to counsel women on supplement use Background . The goal of this pilot study was to determine the magnitude and direction of intervention effect sizes for inflammatory-related serum markers and relevant health outcomes among breast cancer survivors ( BCSs ) receiving a physical activity behavior change intervention compared with usual care .  Methods . This r and omized controlled trial enrolled 28 stage I , II , or IIIA BCSs who were post– primary treatment and not regular exercisers . Participants were assigned to either a 3-month physical activity behavior change intervention group ( ING ) or usual care group ( UCG ) . Intervention included supervised aerobic ( 150 weekly minutes , moderate-intensity ) and resistance ( 2 sessions per week ) exercise that gradually shifted to home-based exercise . Outcomes were assessed at baseline and 3 months . Results . Cardiorespiratory fitness significantly improved in the ING versus the UCG ( between-group difference = 3.8 mL/kg/min ; d = 1.1 ; P = .015 ) . Self-reported sleep latency was significantly reduced in the ING versus the UCG ( between group difference = −0.5 ; d = −1.2 ; P = .02 ) as was serum leptin ( between-group difference = −9.0 ng/mL ; d = −1.0 ; P = .031 ) . Small to medium nonsignificant negative effect sizes were noted for interleukin (IL)-10 and tumor necrosis factor (TNF)-α and ratios of IL-6 to IL-10 , IL-8 to IL-10 , and TNF-α to IL-10 , whereas nonsignificant positive effect sizes were noted for IL-6 and high-molecular-weight adiponectin . Conclusions . Physical activity behavior change interventions in BCSs can achieve large effect size changes for several health outcomes . Although effect sizes for inflammatory markers were often small and not significant , changes were in the hypothesized direction for all except IL-6 and IL-10 Summary This study examined whether 24 months of weight training exercises enhanced the effectiveness of risedronate , calcium , and vitamin D in maintaining or improving bone mineral density ( BMD ) in 223 postmenopausal breast cancer survivors . Subjects who were ≥50 % adherent to exercise had no improvement in BMD but were less likely to lose BMD . Introduction This study examined whether ( 1 ) postmenopausal breast cancer survivors ( BCS ) with bone loss taking 24 months of risedronate , calcium , and vitamin D had increased bone mineral density ( BMD ) at the total hip , femoral neck , L1-L4 spine , total radius and 33 % radius , and decreased bone turnover ; ( 2 ) subjects who also participated in strength/weight training ( ST ) exercises had greater increases in BMD and greater decreases in bone turnover ; and ( 3 ) subjects who also exercised were more likely to preserve ( at least maintain ) BMD . Methods Postmenopausal BCS ( 223 ) were r and omly assigned to exercise plus medication or medication only groups . Both groups received 24 months of 1,200 mg of calcium and 400 IU of vitamin D daily and 35 mg of risedronate weekly , and the exercise group additionally had ST exercises twice weekly . Results After 24 months , women who took medications without exercising had significant improvements in BMD at the total hip ( + 1.81 % ) and spine ( + 2.85 % ) and significant decreases in Alkphase B ( −8.7 % ) and serum NTx ( −16.7 % ) . Women who also exercised had additional increases in BMD at the femoral neck ( + 0.29 % ) , total hip ( + 0.34 % ) , spine ( + 0.23 % ) , total radius ( + 0.30 % ) , and additional decreases in Alkphase B ( −2.4 % ) and Serum NTx ( −6.5 % ) . Additional changes in BMD and bone turnover with exercise were not significant . Subjects who were ≥50 % adherent to exercise were less likely to lose BMD at the total hip ( chi-square [ 1 ] = 4.66 , p = 0.03 ) and femoral neck ( chi-square [ 1 ] = 4.63 , p = 0.03 ) . ConclusionS trength/weight training exercises may prevent loss of BMD in postmenopausal BCS at risk for bone loss Targeted exercise training could reduce risk factors for fracture and obesity-related diseases that increase from breast cancer treatment , but has not been sufficiently tested . We hypothesized that progressive , moderate-intensity resistance + impact training would increase or maintain hip and spine bone mass , lean mass and fat mass and reduce bone turnover compared to controls who participated in a low-intensity , non-weight bearing stretching program . We conducted a r and omized , controlled trial in 106 women with early stage breast cancer who were > 1 year post-radiation and /or chemotherapy , ≥50 years of age at diagnosis and postmenopausal , free from osteoporosis and medications for bone loss , resistance and impact exercise naïve , and cleared to exercise by a physician . Women were r and omly assigned to participate in 1 year of thrice-weekly progressive , moderate-intensity resistance + impact ( jump ) exercise or in a similar frequency and length control program of progressive , low-intensity stretching . Primary endpoints were bone mineral density ( BMD ; g/cm2 ) of the hip and spine and whole body bone-free lean and fat mass ( kg ) determined by DXA and biomarkers of bone turnover — serum osteocalcin ( ng/ml ) and urinary deoxypyrodiniline cross-links ( nmol/mmolCr ) . Women in the resistance + impact training program  preserved BMD at the lumbar spine ( 0.47 vs. −2.13 % ; P = 0.001 ) compared to controls . The resistance + impact group had a smaller increase in osteocalcin ( 7.0 vs. 27 % , P = 0.03 ) and a larger decrease in deoxypyrodinoline ( −49.9 vs. −32.6 % , P = 0.06 ) than controls . Increases in lean mass from resistance + impact training were greatest among women currently taking aromatase inhibitors compared to controls not on this therapy ( P = 0.01 ) . Our combined program of resistance + impact exercise  reduced risk factors for fracture among postmenopausal breast cancer survivors ( BCS ) and may be particularly relevant for BCS on aromatase inhibitors ( AIs ) because of the additional benefit of exercise on muscle mass that could reduce falls PURPOSE Accumulating data suggest that exercise may affect breast cancer risk and outcomes . Studies have demonstrated that high levels of insulin , often seen in sedentary individuals , are associated with increased risk of breast cancer recurrence and death . We sought to analyze whether exercise lowered insulin concentrations in breast cancer survivors . METHODS One hundred one sedentary , overweight breast cancer survivors were r and omly assigned either to a 16-week cardiovascular and strength training exercise intervention or to a usual care control group .  Fasting insulin and glucose levels , weight , body composition , and circumference at the waist and hip were collected at baseline and 16 weeks . RESULTS Baseline and 16-week measurements were available for 82 patients .  Fasting insulin concentrations decreased by an average of 2.86 microU/mL in the exercise group ( P = .03 ) , with no significant change in the control group ( decrease of 0.27 microU/mL , P = .65 ) . The change in insulin levels in the exercise group seemed greater than the change in controls , but the comparison did not reach statistical significance ( P = .07 ) . There was a trend toward improvement in insulin resistance in the exercise group ( P = .09 ) but no change in fasting glucose levels . The exercise group also experienced a significant decrease in hip measurements , with no change in weight or body composition . CONCLUSION Participation in an exercise intervention was associated with a significant decrease in insulin levels and hip circumference in breast cancer survivors . The relationship between physical activity and breast cancer prognosis may be mediated , in part , through changes in insulin levels and /or changes in body fat or fat deposition BACKGROUND Cancer survivors are at increased risk for secondary cancers and other diseases . Healthy dietary practice s may improve cancer survivors ' health and well-being . OBJECTIVE The durability of the effects of the FRESH START intervention , a program of sequentially tailored mailed material s , and st and ardized mailed material s ( for controls ) on cancer survivors ' dietary outcomes was assessed over a 2-year period . Greater dietary gains were expected for FRESH START participants relative to controls . DESIGN Participants were r and omized to receive tailored vs st and ardized 10-month mailed print interventions promoting diet and exercise behaviors . Data were collected at baseline and 1- and 2-year follow-ups . PARTICIPANTS / SETTING Breast and prostate cancer survivors ( n=543 ) were recruited from 39 states and two provinces within North America . A total of 489 participants completed the 2-year follow-up assessment ( 10 % attrition ) . INTERVENTION Participants were r and omly assigned to either a 10-month program of tailored mailed print material s promoting fruit and vegetable consumption , reduced total and saturated fat intake , and /or increased exercise or to a 10-month program of publicly available mailed material s on diet and exercise . MAIN OUTCOME MEASURES Telephone surveys ( supported with blood biomarkers ) assessed dietary habits at baseline and 1- and 2-year follow-ups . STATISTICAL ANALYSES PERFORMED Paired- sample s t tests were conducted to examine the durability of the intervention 's effects on dietary outcomes within each study arm . Arm differences in follow-up outcomes were then tested with the general linear model , controlling for the baseline value of the outcomes . RESULTS Both arms reported decreased saturated fat intake , increased servings of fruits and vegetables , and better overall diet quality at year 2 relative to baseline . However , FRESH START participants reported better overall diet quality and lower total and saturated fat intake compared to controls at the 2-year follow-up . CONCLUSIONS Results suggest that mailed material interventions , especially those that are tailored , can produce long-term dietary improvement among cancer survivors Introduction Breast cancer survivors experience diminished health-related quality of life ( HRQOL ) . We report on the influence of tai chi chuan exercise ( TCC ) on HRQOL and explore associations between changes in HRQOL and biomarkers . Methods Breast cancer survivors ( N = 21 ) were r and omly assigned to TCC or st and ard support therapy ( SST ) for 12 weeks ( three times/week ; 60 min/session ) . Interleukin-6 , interleukin-8 ( IL-8 ) , insulin-like growth factor-1 ( IGF-1 ) , insulin-like growth factor-binding protein (IBFBP)-1 , IGFBP-3 , glucose , insulin , and cortisol were measured pre- and postintervention . Overall HRQOL and subdomains were assessed at preintervention ( T1 ) , midintervention ( T2 ) and postintervention ( T3 ) and biomarkers at T1 and T3 . Results The TCC group improved in total HRQOL ( T1–T2:CS = 8.54 , P = 0.045 ) , physical functioning ( T1–T2:CS = 1.89 , P = 0.030 ) , physical role limitations ( T1–T2 CS = 1.55 , P = 0.023 ) , social functioning ( T1–T3:CS = 1.50 , P = 0.020 ) , and general mental health ( T1–T2:CS = 2.67 , P = 0.014 ; T1–T3:CS = 2.44 , P = 0.019 ) . The SST  improved in social functioning ( T1–T2:CS = 0.64 , P = 0.043 ) and vitality ( T1–T2:CS = 0.90 , P = 0.01 ) . There were relationships between changes in IGF-1 and overall HRQOL ( r = −0.56 ; P < 0.05 ) , physical role limitation ( r = −0.68 ; P < 0.05 ) , and social functioning ( r = −0.56 ; P < 0.05 ) . IGFBP-1 changes were associated with physical role limitations changes ( r = 0.60 ; P < 0.05 ) . IGFBP-3 changes were associated with physical functioning changes ( r = 0.46 ; P ≤ 0.05 ) . Cortisol changes were associated with changes in physical role limitations ( r = 0.74 ; P < 0.05 ) and health perceptions ( r = 0.46 ; P < 0.05 ) . Glucose changes were associated with emotional role limitation changes ( r = −0.70 ; P < 0.001 ) . IL-8 changes were associated with emotional role limitation changes ( r = 0.59 ; P < 0.05 ) . Discussion / conclusions TCC may improve HRQOL by regulating inflammatory responses and other biomarkers associated with side effects from cancer and its treatments . Implication s for cancer survivorsTCC may be an intervention capable of improving HRQOL in breast cancer survivors BACKGROUND Nearly 35 % of men treated for prostate cancer ( PrCA ) will experience biochemically defined recurrence , noted by a rise in PSA , within 10 years of definitive therapy . Diet , physical activity , and stress reduction may affect tumor promotion and disease progression . METHODS A r and omized trial of an intensive diet , physical activity , and meditation intervention was conducted in men with rising post-treatment PSA after definitive treatment for PrCA . Intention-to-treat methods were used to compare usual care to the intervention in 47 men with complete data . Signal detection methods were used to identify dietary factors associated with PSA change . RESULTS The intervention and control groups did not differ statistically on any demographic or disease-related factor . Although the intervention group experienced decreases of 39 % in intakes of saturated fatty acid ( SFA as percent of total calories ) ( p<0.0001 ) and 12 % in total energy intake ( 218 kcal/day , p<0.05 ) ] , no difference in PSA change was observed by intervention status . Signal detection methods indicated that in men increasing their consumption of fruit , 56 % experienced no rise in PSA ( vs. 29 % in men who did not increase their fruit intake ) . Among men who increased fruit and fiber intakes , PSA increased in 83 % of participants who also increased saturated fatty acid intake ( vs. 44 % in participants who decreased or maintained saturated fatty acid intake ) . CONCLUSION Results are discussed in the context of conventional treatment strategies that were more aggressive when this study was being conducted in the mid-2000s . Positive health changes in a number of lifestyle parameters were observed with the intervention , and both increased fruit and reduced saturated fat intakes were associated with maintaining PSA levels in men with biochemically recurrent disease BACKGROUND Long-term prostate cancer ( PCa ) survivors are at increased risk for comorbidities and physical deconditioning . OBJECTIVE To determine the effectiveness of a year-long r and omised controlled trial of exercise training in PCa survivors > 5 yr postdiagnosis on physical functioning . DESIGN , SETTING , AND PARTICIPANTS Between 2010 and 2011 , 100 long-term PCa survivors from Trans-Tasman Radiation Oncology Group 03.04 R and omised And rogen Deprivation and Radiotherapy previously treated with and rogen-deprivation therapy and radiation therapy were r and omly assigned to 6 mo of supervised exercise followed by 6 mo of a home-based maintenance programme ( n=50 ) or printed educational material about physical activity ( n=50 ) for 12 mo across 13 university-affiliated exercise clinics in Australia and New Zeal and . INTERVENTION Supervised resistance and aerobic exercise or printed educational material about physical activity . OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS The primary end point was a 400-m walk as a measure of cardiovascular fitness . Secondary end points were physical function , patient-reported outcomes , muscle strength , body composition , and biomarkers . Analysis of covariance was used to compare outcomes for groups at 6 and 12 mo adjusted for baseline values . RESULTS AND LIMITATIONS Participants undergoing supervised exercise showed improvement in cardiorespiratory fitness performance at 6 mo ( -19 s [ p=0.029 ] ) and 12 mo ( -13 s [ p=0.028 ] ) and better lower-body physical function across the 12-mo period ( p<0.01 ) . Supervised exercise also improved self-reported physical functioning at 6 ( p=.006 ) and 12 mo ( p=0.002 ) , appendicular skeletal muscle at 6 mo ( p=0.019 ) , and objective measures of muscle strength at 6 and 12 mo ( p<0.050 ) . Limitations included the restricted number of participants undertaking body composition assessment , no blinding to group assignment for physical functioning measures , and inclusion of well-functioning individuals . CONCLUSIONS Supervised exercise training in long-term PCa survivors is more effective than physical activity educational material for increasing cardiorespiratory fitness , physical function , muscle strength , and self-reported physical functioning at 6 mo . Importantly , these benefits were maintained in the long term with a home-based programme with follow-up at 12 mo . CLINICAL TRIAL REGISTRY The effect of an exercise intervention on cardiovascular and metabolic risk factors in prostate cancer patients from the RADAR study , ACTRN : ACTRN12609000729224
The number of people living with and beyond cancer is at an all time high .
These survivors are not necessarily living well , as adverse side effects from cancer and its treatment can last up to 5 years and leave patients at a higher risk of developing secondary cancers and other chronic illnesses .
Exercise has been proven to be a safe and effective method of intervention to decrease mortality and overall improve health outcomes .
The biological mechanism through which this occurs is an area of research that is in its infancy and not well defined .