Safety and Efficacy of Weight Training in Recent Breast Cancer Survivors to Alter Body Composition, Insulin, and Insulin-Like Growth Factor Axis Proteins Concentrations of IGF-I and IGFBP-3 and pancreatic cancer risk in the European Prospective Investigation into Cancer and Nutrition Randomized controlled trial of exercise and blood immune function in postmenopausal breast cancer survivors. Effects of exercise training on fasting insulin, insulin resistance, insulin-like growth factors, and insulin-like growth factor binding proteins in postmenopausal breast cancer survivors: a randomized controlled trial. Randomized Controlled Trial of Aerobic Exercise on Insulin and Insulin-like Growth Factors in Breast Cancer Survivors: The Yale Exercise and Survivorship Study Correlates of circulating C-reactive protein and serum amyloid A concentrations in breast cancer survivors Effect of exercise on biomarkers, fatigue, sleep disturbances, and depressive symptoms in older women with breast cancer receiving hormonal therapy. Effect of low dose tamoxifen on the insulin-like growth factor system in healthy women Exercise training and cytokines in breast cancer survivors. Impact of a mixed strength and endurance exercise intervention on insulin levels in breast cancer survivors. Impact of a mixed strength and endurance exercise intervention on levels of adiponectin, high molecular weight adiponectin and leptin in breast cancer survivors Effect of exercise training on C-reactive protein in postmenopausal breast cancer survivors: A randomized controlled trial Exercise and lymphocyte activation following chemotherapy for breast cancer.
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 Background : Insulin-like growth factors ( IGFs ) and their binding proteins ( BPs ) regulate cell differentiation , proliferation and apoptosis , and may have a role in the aetiology of various cancers . Information on their role in pancreatic cancer is limited and was examined here in a case – control study nested within the European Prospect i ve Investigation into Cancer and Nutrition . Methods : Serum concentrations of IGF-I and IGFBP-3  were measured using enzyme-linked immunosorbent assays in 422 cases and 422 controls matched on age , sex , study centre , recruitment date , and time since last meal . Conditional logistic regression was used to compute odds ratios ( OR ) and 95 % confidence intervals ( CI ) adjusted for confounding variables . Results : Neither circulating levels of IGF-I ( OR=1.21 , 95 % CI 0.75–1.93 for top vs bottom quartile , P-trend 0.301 ) , IGFBP-3 ( OR=1.00 , 95 % CI 0.66–1.51 , P-trend 0.79 ) , nor the molar IGF-I/IGFBP-3 ratio , an indicator of free IGF-I level ( OR=1.22 , 95 % CI 0.75–1.97 , P-trend 0.27 ) , were statistically significantly associated with the risk of pancreatic cancer . In a cross-classification , however , a high concentration of IGF-I with concurrently low levels of IGFBP-3 was related to an increased risk of pancreatic cancer ( OR=1.72 , 95 % CI 1.05–2.83 ; P-interaction=0.154 ) . Conclusion : On the basis of these results , circulating levels of components of the IGF axis do not appear to be the risk factors for pancreatic cancer . However , on the basis of the results of a sub analysis , it can not be excluded that a relatively large amount of IGF-1 together with very low levels of IGFBP-3 might still be associated with an increase in pancreatic cancer risk The objective was to determine the effects of exercise training on changes in blood immune function in postmenopausal breast cancer survivors . Fifty-three postmenopausal breast cancer survivors were r and omly assigned to an exercise ( n=25 ) or control group ( n=28 ) . The exercise group trained on cycle ergometers three times per week for 15 wk . The control group did not train . The primary end point was change in natural killer cell cytotoxic activity in isolated peripheral blood mononuclear cells . Secondary end points were changes in st and ard hematological variables , whole blood neutrophil function , the phenotypes of isolated mononuclear cells , estimations of unstimulated and phytohemaglutinin-stimulated mononuclear cell function ( rate of [3H]thymidine uptake ) , and the production of proinflammatory [ interleukin (IL)-1alpha , tumor necrosis factor-alpha , IL-6 ] and anti-inflammatory cytokines ( IL-4 , IL-10 , transforming growth factor-beta1 ) . Statistical tests were two-sided ( alpha < 0.05 ) . Fifty-two participants completed the trial . Intention-to-treat analyses , which included the baseline value as a covariate , showed significant differences between groups for change in percent specific lysis of a target natural killer cell at all five effector-to-target ratios ( adjusted mean between-group change over all 5 effector-to-target ratios = + 6.34 % ; P < 0.05 for all comparisons ) , the lytic activity per cell ( adjusted mean between-group change = -2.72 lytic units ; P=0.035 ) , and unstimulated [3H]thymidine uptake by peripheral blood lymphocytes ( adjusted mean between-group change = + 218 per dpm x 10(6 ) cells ; P = 0.007 ) . There were no significant differences between groups for change in any other end point . Exercise training increased natural killer cell cytotoxic activity and unstimulated [3H]thymidine uptake by peripheral blood lymphocytes in postmenopausal breast cancer survivors Insulin , insulin-like growth factors ( IGFs ) I and II , and IGF binding proteins ( IGFBPs ) 1 and 3 have been implicated in breast cancer outcomes . We conducted a r and omized controlled trial to determine the physiological effects of exercise training on changes in these biological markers in postmenopausal breast cancer survivors . Fifty-three postmenopausal breast cancer survivors were r and omly assigned to an exercise ( n = 25 ) or control group ( n = 28 ) . The exercise group trained on cycle ergometers three times per week for 15 weeks . The control group did not train . End points included changes in fasting insulin , glucose , insulin resistance , IGF-I , IGF-II , IGFBP-1 , IGFBP-3 , and IGF-I : IGFBP-3 molar ratio between baseline and week 15 . All of the statistical tests were two-sided ( alpha = 0.05 ) . Fifty-two participants completed the trial . The exercise group completed 44.3 of 45 ( 98.4 % ) prescribed exercise sessions . Baseline hormone concentrations did not differ between groups except that IGF-II was higher in the exercise group ( P = 0.011 ) . No significant differences between groups were observed for changes in fasting insulin ( + 6.3 pmol/liter ; P = 0.941 ) , glucose ( + 0.09 mmol/liter ; P = 0.824 ) , insulin resistance ( + 0.4 ; P = 0.247 ) , IGF-II ( -40.7 ng/ml ; P = 0.101 ) , or IGFBP-1 ( + 1.4 ng/ml ; P = 0.774 ) . However , significant differences between groups were observed for changes in IGF-I ( -7.4 ng/ml ; P = 0.045 ) , IGFBP-3 ( + 180.5 ng/ml ; P = 0.021 ) , and IGF-I : IGFBP-3 molar ratio ( -0.006 ; P = 0.017 ) . Exercise training had significant physiological effects on IGF-I , IGFBP-3 , and IGF-I : IGFBP-3 molar ratio in postmenopausal breast cancer survivors . The clinical implication s of these findings remain to be defined Background : High insulin and insulin-like growth factor-I ( IGF-I ) levels may be associated with an increased breast cancer risk and /or death . Given the need to identify modifiable factors that decrease insulin , IGF-I , and breast cancer risk and death , we investigated the effects of a 6-month r and omized controlled aerobic exercise intervention versus usual care on fasting insulin , IGF-I , and its binding protein ( IGFBP-3 ) in postmenopausal breast cancer survivors . Methods : Seventy-five postmenopausal breast cancer survivors were identified from the Yale-New Haven Hospital Tumor Registry and r and omly assigned to an exercise ( n = 37 ) or usual care  ( n = 38 ) group . The exercise group participated in 150 minutes per week of moderate-intensity aerobic exercise . The usual care group was instructed to maintain their current physical activity level . A fasting blood sample was collected on each study participant at baseline and 6 months . Blood levels of insulin and IGF were measured with ELISA . Results : On average , exercisers increased  aerobic exercise  by 129 minutes per week compared with 45 minutes per week among usual care participants ( P < 0.001 ) . Women r and omized to exercise experienced decreases in insulin , IGF-I , and IGFBP-3 , whereas women r and omized to usual care had increases in these hormones . Between-group differences in insulin , IGF-I , and IGFBP-3 were 20.7 % ( P = 0.089 ) , 8.9 % ( P = 0.026 ) , and 7.9 % ( P = 0.006 ) , respectively . Conclusions : Moderate-intensity aerobic exercise , such as brisk walking , decreases IGF-I and IGFBP-3 . The exercise-induced decreases in IGF may mediate the observed association between higher levels of physical activity and improved survival in women diagnosed with breast cancer . ( Cancer Epidemiol Biomarkers Prev 2009;18(1):306–13 Introduction Inflammatory status may be an important prognostic factor for breast cancer . Correlates of markers of inflammation in breast cancer survivors have not been thoroughly evaluated . Methods Using data from , the Health , Eating , Activity , and Lifestyle ( HEAL ) Study ( a population -based , multiethnic prospect i ve cohort study of female breast cancer patients ) we evaluated the associations between circulating markers of inflammation ( C-reactive protein [ CRP ] and  serum amyloid A  [ SAA ] , measured ∼31 months after diagnosis ) and several demographic , lifestyle , and clinical characteristics in 741 disease-free breast cancer survivors . Analysis of variance and regression methods were used for statistical analyses of log-transformed values of CRP and SAA . Results After adjusting for age , BMI , ethnicity , and study site , higher concentrations of CRP were associated with increasing concentration of SAA ( P-trend < 0.0001 ) , increasing age ( P-trend < 0.0001 ) , increasing BMI ( P-trend < 0.0001 ) , increasing waist circumference ( P-trend < 0.0001 ) , positive history of heart failure ( P = 0.0007 ) , decreasing physical activity ( P-trend = 0.005 ) , Hispanic ethnicity ( P = 0.05 vs. non-Hispanic white ) , and current smoking ( P = 0.03 vs. never smoking ) . Vitamin E supplementation ( P = 0.0005 ) , tamoxifen use ( P = 0.008 ) , and radiation treatment ( compared to no chemotherapy or radiation ; P = 0.04 ) were associated with reduced CRP . Associations of CRP with clinical characteristics were not significant in the adjusted models . In a multivariate analysis , CRP showed significant associations with waist circumference , BMI , age , history of heart failure , tamoxifen use , and vitamin E supplementation ( R2 = 0.35 ) . Similar , yet fewer , associations were observed for SAA ( R2 = 0.19 ) . Conclusions This study highlights important correlates of inflammatory status in breast cancer patients . Our results are consistent with those from similar studies of healthy women PURPOSE / OBJECTIVES To compare the effectiveness of a prescribed home-based walking exercise intervention with usual care in older women receiving hormonal treatment for breast cancer , and to examine relationships among levels of the cortisol , serotonin , interleukin-6 , and bilirubin biomarkers and fatigue , sleep disturbances , and depressive symptoms . DESIGN Longitudinal r and omized clinical trial . SETTING A National Cancer Institute- design ated cancer center in the southeastern United States . SAMPLE 20 women ( aged 55 years or older ) with breast cancer receiving hormonal treatment . METHODS Participants were r and omized to a walking exercise intervention or usual care . Laboratory sample s and the Pittsburgh Sleep Quality Index ( PSQI ) , the Piper Revised Fatigue Scale , and the Center for Epidemiological Studies -Depression Scale were collected at the initial clinic visit and at 12 weeks from the groups . Question naires also were collected at weeks 2 and 14 . MAIN RESEARCH VARIABLES Fatigue , sleep disturbances , depressive symptoms , biomarkers , and exercise . FINDINGS Effect of the exercise intervention on sleep scores was highly significant between groups . Exercise group scores on the PSQI decreased significantly over time ( indicating improved sleep quality ) , although scores did not change significantly within the control group . Sleep actigraphy also showed significantly shorter actual wake time and less movement in the exercise group . Serotonin levels also were significantly affected by the intervention . CONCLUSIONS Data suggest that a walking exercise intervention improves sleep in older women receiving hormonal treatment for their breast cancer . Serotonin levels may be a useful biomarker when assessing sleep disturbances in this group . IMPLICATION S FOR NURSING Clinicians need to be aware that older women receiving hormonal treatment for their breast cancer may experience fatigue , sleep disturbances , and depressive symptoms . Homebased walking activity may reduce symptom severity in this group The use of tamoxifen as a preventive agent may be limited by the increased risk of endometrial cancer and venous thromboembolic events observed in postmenopausal women . We have recently shown a comparable activity of lower doses of tamoxifen on several surrogate biomarkers of cardiovascular disease and breast cancer , including Insulin-like Growth Factor-I ( IGF-I ) . To provide further insight into the effect of tamoxifen at low doses on the IGF system , we have correlated the drug serum levels attained after 2 months of either placebo  ( n=32 ) , tamoxifen 20mg/day ( n=26 ) , 10mg/day ( n=23 ) or 10mg/every other day ( n=29 ) with the changes in IGF-I , Insulin-like Growth Factor-II ( IGF-II ) , Insulin-like Growth Factor Binding Protein-1 ( IGFBP-1 ) , Insulin-like Growth Factor Binding Protein-3 ( IGFBP-3 ) , and IGF-I/IGFBP-3 ratio . Compared with placebo , tamoxifen induced a mean±st and ard error ( SE ) reduction of IGF-I of 16.9±7.8 % , p≤0.05 , a non-significant increase of 22.9±12.2 % in IGF-II , an increase in IGFBP-1 of 49.3±22.7 % , p≤0.05 , and a non-significant change of IGFBP-3 ( −4.0%±9.2 ) . No significant concentration-response relationship was observed between  serum tamoxifen concentrations and the biomarker changes except for the ratio of IGF-I/IGFBP-3 , which decreased by 1.53±0.68 % for any increase by 10ng/ml of serum tamoxifen concentration ( p=0.02 ) . Although low tamoxifen concentrations induce a comparable modulation of the IGF family relative to the conventional dose , the lower decrements in the IGF-I/IGFBP-3 ratio observed at low drug concentrations might be associated with a reduced preventive activity . Further studies on the search of the minimal active dose of tamoxifen are warranted The purpose of this r and omized controlled trial was to determine the effects of an 8-week ( aerobic+strength ) exercise training program ( 3 sessions/week ) on the circulating cytokine levels of breast cancer survivors . We r and omly allocated 16 female survivors of breast cancer ( mean±SD age : 50±5 years ) to an intervention or usual care ( control ) group ( N=8 in each group ) . The intervention group followed an 8-week exercise program consisting of 3 sessions/week ( session duration : 90 min ) . We measured the levels of the following cytokines before and after the intervention : beta-NGF , CTACK , eotaxin , FGF basic , G-CSF , gmCSFα , HGF , ICAM1 , IFNα2 , IFNγ , IL1α , IL1ß , IL1ra , IL2 , IL2ra , IL3 , IL4 , IL6 , IL7 , IL8 , IL9 , IL10 , IL12 , IL13 , IL15 , IL16 , IL17 , IL18 , IP10 , LIF , MCS-F , MIP1α , MIP1β , MIF , MCP1 , MCP3 , MIG , PDGF bb , SCF , SCGFβ , SDF1α , TRAIL , TNFα , TNFβ , VCAM1 , and VEGF . We only observed a significant interaction ( group*time ) effect for CTACK ( P=0.016 ) , with mean values remaining stable in the intervention group but increasing over time in controls . The intervention program did not induce a significant decrease in the main breast cancer-related cytokines such as IL6 and IL8 . A combined ( aerobic+strength ) 8-week exercise training intervention did not induce major changes in the basal cytokine levels of breast cancer survivors 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 Evidence suggests that exercise affects breast cancer risk and outcomes , but little is known about the mechanisms through which this effect may be mediated . This study examines the impact of exercise upon levels of adiponectin , high molecular weight adiponectin ( HMWA ) , and leptin in breast cancer survivors . Methods One hundred and one sedentary , overweight breast cancer survivors were r and omized to a 16-week exercise intervention or usual care control group . Anthropometric measurements were taken and fasting levels of adiponectin , HMWA and leptin were collected at baseline and 16 weeks . Results Baseline and week-16 measurements were available for 81 patients . The exercise group experienced a significant decrease in hip measurements , with no change in weight or body composition . There were no significant changes in adiponectin , HMWA , or leptin in either group . Modeling analyses demonstrated a significant inverse relationship between changes in leptin and adiponectin , but no relationship between changes in BMI , waist or hip circumference , or body fat percentage and change in leptin or adiponectin . Conclusions This study did not demonstrate a significant change in adipocytokine levels in breast cancer survivors participating in an exercise intervention  , suggesting that further work is needed to explore the mechanisms through which exercise may impact breast cancer The objective of this study was to determine the effects of exercise training on changes in C-reactive protein ( CRP ) and other cardiovascular risk factors in postmenopausal breast cancer survivors . Fifty-three postmenopausal breast cancer survivors were r and omly assigned to an exercise ( n = 25 ) or control group ( n = 28 ) . The exercise group trained on cycle ergometers 3 times per week for 15 weeks . The control group did not train . The primary end point was change in CRP between baseline and week 15 . Secondary end points were changes in RHR , HRR , SBP , DBP , TC , LDL-C , HDL-C , TG , and TC : HDL-C ratio .  Fifty-two participants completed the trial . Baseline values did not differ between groups except that TG ( p = .007 ) and TC : HDL-C ratio ( p = .023 ) were higher in the exercise group . Intention-to-treat analysis showed that CRP decreased by 1.39 mg/L in the exercise group whereas it increased by 0.10 mg/L in the control group ( mean between group change , -1.49 mg/L ; 95 % CI , -3.09 to 0.10 mg/L ; p = .066 ) . Intention-to-treat analysis also showed a clinical ly and statistically significant difference between groups for change in HRR ( mean change , + 10.6 beats/min ; 95 % CI , + 3.4 to + 17.7 beats/min ; p = .004 ) and clinical ly but not statistically significant differences between groups for change in RHR ( mean change , -5.5 beats/min ; 95 % CI , -11.5 to + 0.5 beats/min ; p = .073 ) , SBP ( mean change , -5.5 mmHg ; 95 % CI , -14.5 to + 3.4 mmHg ; p = .218 ) , DBP ( mean change,-3.6 mmHg ; 95 % CI , -9.3 to + 2.1 mmHg ; p = .214 ) , and HDL-C ( mean change , + 0.05 mmol/L ; 95 % CI , -0.03 to 0.14 mmol/L ; p = .214 ) . These data suggest that exercise training may have beneficial effects on CRP and other cardiovascular risk factors in postmenopausal breast cancer survivors . Larger r and omized controlled trials are warranted PURPOSE To determine whether exercise training would increase lymphocyte activation in patients with breast cancer following chemotherapy . Activation was determined by the presence of CD4(+)CD69(+ ) T-helper lymphocytes , mitogen-induced proliferation , and levels of cytokines produced by mitogen-stimulated lymphocytes and in the patients ' plasma . METHODS Patients with breast cancer ( N = 28 ) who participated in a 6-month exercise program were compared with patients ( N = 21 ) who did not exercise .  Following chemotherapy , and 3 and 6 months later , patients underwent fitness evaluations and had blood drawn . The exercise program consisted of resistance training and aerobic activity at 60 - 75 % functional capacity three times a week with a personal trainer . Immunochemistry and flow cytometry were used to measure the number of CD4(+)CD69(+ ) blood lymphocytes . Whole blood was stimulated with concanavalin A ( ConA ) , phytohemagglutin ( PHA ) , or pokeweed mitogen ( PWM ) to determine proliferation potential . Enzyme-linked immunosorbent assays ( ELISA ) were used to determine the concentration of interferon-gamma ( IFN-gamma ) and interleukin-6 ( IL-6 ) in the culture medium of mitogen-stimulated lymphocytes as well as the plasma concentrations of IL-6 , soluble IL-6 receptor , soluble gp130 , and IFN-gamma . Analysis of groups across time was done using the Wilcoxon signed rank test , and comparisons of groups were done using the Mann-Whitney U test . RESULTS The exercising patients showed increases in maximal oxygen uptake and upper body strength . This group also showed a greater percentage of CD4(+)CD69(+ ) cells and a greater level of tritiated thymidine incorporation ( DNA synthesis ) when stimulated with ConA , PHA , and PWM at the end of the intervention . Plasma and mitogen-stimulated IL-6 and IFN-gamma production were similar in both groups . CONCLUSION Exercise may improve immune function by increasing lymphocyte activation in patients with breast cancer following treatment
Breast cancer is the most common cancer among women .
The number of breast cancer survivors has increased due to screening and improved treatment methods , which makes it important to increase knowledge on their health and well-being .
Physical activity has been reported to improve quality of life , decrease fatigue and reduce all-cause and breast cancer-specific mortality in breast cancer survivors .
The beneficial effects of physical activity may manifest themselves in circulating levels of insulin , insulin-growth factors ( IGFs ) I and II and their binding proteins ( IGFBPs ) , or inflammatory biomarkers .
The aim of this report was to review available r and omized controlled trials ( RCTs ) on the effects of physical activity on biomarkers in breast cancer survivors .