Weight lifting in women with breast-cancer-related lymphedema. Longitudinal impact of yoga on chemotherapy-related cognitive impairment and quality of life in women with early stage breast cancer: a case series. Acute exercise improves motor memory: Exploring potential biomarkers A randomized trial to increase physical activity in breast cancer survivors. Yoga and self-reported cognitive problems in breast cancer survivors: a randomized controlled trial. Effects of tamoxifen and exemestane on cognitive functioning of postmenopausal patients with breast cancer: results from the neuropsychological side study of the tamoxifen and exemestane adjuvant multinational trial. Feasibility and efficacy of speed-feedback therapy with a bicycle ergometer on cognitive function in elderly cancer patients in Japan. Neuroelectric adaptations to cognitive processing in virtual environments: an exercise-related approach Effect of exercise on biomarkers, fatigue, sleep disturbances, and depressive symptoms in older women with breast cancer receiving hormonal therapy. Effect of medical Qigong on cognitive function, quality of life, and a biomarker of inflammation in cancer patients: a randomized controlled trial Cognitive function and quality of life after surgery for early breast cancer in North Jutland, Denmark Effects of Patient Centered Interventions on Persistent Urinary Incontinence after Prostate Cancer Treatment: A Randomized, Controlled Trial. Tai Chi effects on neuropsychological, emotional, and physical functioning following cancer treatment: a pilot study.
BACKGROUND Weight lifting has generally been proscribed for women with breast-cancer-related lymphedema , preventing them from obtaining the well-established health benefits of weight lifting , including increases in bone density . METHODS We performed a r and omized , controlled trial of twice-weekly progressive weight lifting involving 141 breast-cancer survivors with stable lymphedema of the arm . The primary outcome was the change in arm and h and swelling at 1 year , as measured through displaced water volume of the affected and unaffected limbs . Secondary outcomes included the incidence of exacerbations of lymphedema , number and severity of lymphedema symptoms , and muscle strength . Participants were required to wear a well-fitted compression garment while weight lifting . RESULTS The proportion of women who had an increase of 5 % or more in limb swelling was similar in the weight-lifting group ( 11 % ) and the control group ( 12 % ) ( cumulative incidence ratio , 1.00 ; 95 % confidence interval , 0.88 to 1.13 ) . As compared with the control group , the weight-lifting group had greater improvements in self-reported severity of lymphedema symptoms ( P=0.03 ) and upper- and lower-body strength ( P<0.001 for both comparisons ) and a lower incidence of lymphedema exacerbations as assessed by a certified lymphedema specialist ( 14 % vs. 29 % , P=0.04 ) . There were no serious adverse events related to the intervention . CONCLUSIONS In breast-cancer survivors with lymphedema , slowly progressive weight lifting had no significant effect on limb swelling and result ed in a decreased incidence of exacerbations of lymphedema , reduced symptoms , and increased strength . ( Clinical Trials.gov number , NCT00194363 . PURPOSE Adjuvant chemotherapy for women with breast cancer has significantly improved the cure rate ; however , it has been associated with chemotherapy-related cognitive impact ( CRCI ) . The literature provides preliminary support for the feasibility and efficacy of yoga interventions for the general cancer population , however , controlled trials are scarce and no studies have examined the effect of yoga on cognition for women with breast cancer during chemotherapy . This case series aims to identify the impact of yoga on measures of cognition , functional outcomes , and quality of life ( QOL ) for breast cancer survivors ( BCS ) . METHODS Four women with a diagnosis of early-stage breast cancer prior to chemotherapy treatment were administered the following physiologic measures at baseline , 6 , and 12 weeks during chemotherapy , and at one and three months after the conclusion of the study : Functional Reach test ( balance ) and Sit and Reach test ( flexibility ) , and QOL , POMS ( Mood ) and FACT-B ( QOL ) , at baseline . Primary outcomes of cognition were measured with the Perceived Cognition Question naire ( PCQ ) and CogState , a computerized measurement of cognition . Women attended an Iyengar-inspired yoga program twice a week for 12 weeks . Qualitative question naires were administered after the completion of the study to determine perceived benefits and challenges of the yoga program . RESULTS Four women with Stage II breast cancer ranged in age from 44 - 65 years . CogState computerized testing showed changes in varying domains of cognition through treatment and follow-up . Improved balance , flexibility , and QOL were also noted over time . No adverse events were observed . Analysis of qualitative data revealed the yoga classes were helpful and subjects continued the practice elements of yoga including relaxation , breathing , and stretching . The most challenging aspect of the study was physical limitations due to various medical complications and included fatigue , decreased range of motion , and pain . CONCLUSION This case series suggests that yoga may impact various aspects of cognition during and after chemotherapy administration as noted through quantitative measures . Women describe yoga as improving various domains of QOL through the treatment trajectory . This mind-body intervention may stave off CRCI ; however , further investigation is needed for additional r and omized controlled trials on the effects of yoga on cognition for women with breast cancer undergoing adjuvant chemotherapy treatment We have recently shown that a single bout of acute cardiovascular exercise improves motor skill learning through an optimization of long-term motor memory . Here we exp and this previous finding , to explore potential exercise-related biomarkers and their association with measures of motor memory and skill acquisition .  Thirty-two healthy young male subjects were r and omly allocated into either an exercise or control group . Following either an intense bout of cycling or rest subjects practice d a visuomotor tracking task .  Motor skill acquisition was assessed during practice and retention 1 h , 24 h and 7 days after practice . Plasma levels of brain-derived neurotrophic factor ( BDNF ) , vascular endothelial growth factor ( VEGF ) , insulin-like growth factor ( IGF-1 ) , epinephrine , norepinephrine , dopamine and lactate were analyzed at baseline , immediately after exercise or rest and during motor practice . The exercise group showed significantly better skill retention 24h and 7 days after acquisition . The concentration of all blood compounds increased significantly immediately after exercise and remained significantly elevated for 15 min following exercise except for BDNF and VEGF . Higher concentrations of norepinephrine and lactate immediately after exercise were associated with better acquisition . Higher concentrations of BDNF correlated with better retention 1 h and 7 days after practice . Similarly , higher concentrations of norepinephrine were associated with better retention 7 days after practice whereas lactate correlated with better retention 1h as well as 24 h and 7 days after practice . Thus , improvements in motor skill acquisition and retention induced by acute cardiovascular exercise are associated with increased concentrations of biomarkers involved in memory and learning processes . More mechanistic studies are required to eluci date the specific role of each biomarker in the formation of motor memory PURPOSE Interventions to increase physical activity among breast cancer survivors are needed to improve health and quality of life and possibly to reduce the risk of disease recurrence and early mortality . Therefore , we report the feasibility and preliminary outcomes of a pilot r and omized trial design ed to increase physical activity in sedentary breast cancer survivors receiving hormone therapy . METHODS Forty-one sedentary women on estrogen receptor modulators or aromatase inhibitors for stage I , II , or IIIA breast cancer were r and omly assigned to receive a 12-wk multidisciplinary physical activity behavior change intervention or usual care . RESULTS Recruitment was 34 % , intervention adherence was 99 % , and complete follow-up data were obtained on 93 % . Most participants ( 93 % ) were white with mean age of 53 + /- 9 yr . Differences favoring the intervention group were noted for accelerometer physical activity counts ( mean difference = 72,103 ; 95 % confidence interval ( CI ) = 25,383 - 119,000 ; effect size ( d ) = 1.02 ; P = 0.004 ) , aerobic fitness ( mean difference = 2.9 ; 95 % CI = -0.1 to 5.8 ; d = 0.64 ; P = 0.058 ) , back/leg muscle strength ( mean difference = 12.3 ; 95 % CI = 0.4 - 15.9 ; d = 0.81 ; P = 0.017 ) , waist-to-hip ratio ( mean difference = -0.05 ; 95 % CI = -0.01 to -0.08 ; d = -0.77 ; P = 0.018 ) , and social well-being ( mean difference = 2.0 ; 95 % CI = 0.3 - 3.8 ; d = 0.76 ; P = 0.03 ) . However , the intervention group also reported a greater increase in joint stiffness ( mean difference = 1.1 ; 95 % CI = 0.1 - 2.2 ; d = 0.70 ; P = 0.04 ) . CONCLUSIONS A behavior change intervention for breast cancer survivors based on the social cognitive theory is feasible and results in potentially meaningful improvements in physical activity and selected health outcomes . Confirmation in a larger study is warranted OBJECTIVES Cancer survivors often report cognitive problems . Furthermore , decreases in physical activity typically occur over the course of cancer treatment . Although physical activity benefits cognitive function in noncancer population s , evidence linking physical activity to cognitive function in cancer survivors is limited . In our recent r and omized controlled trial , breast cancer survivors who received a yoga intervention  had lower fatigue and inflammation following the trial compared with a wait list control group . This secondary analysis of the parent trial addressed yoga 's impact on cognitive complaints . METHODS Posttreatment stage 0-IIIA breast cancer survivors ( n = 200 ) were r and omized to a 12-week , twice-weekly Hatha yoga intervention or a wait list control group . Participants reported cognitive complaints using the Breast Cancer Prevention Trial Cognitive Problems Scale at baseline , immediately postintervention , and 3-month follow-up . RESULTS Cognitive complaints did not differ significantly between groups immediately postintervention ( p = 0.250 ) . However , at 3-month follow-up , yoga participants ' Breast Cancer Prevention Trial Cognitive Problems Scale scores were an average of 23 % lower than wait list participants ' scores ( p = 0.003 ) . These group differences in cognitive complaints remained after controlling for psychological distress , fatigue , and sleep quality . Consistent with the primary results , those who practice d yoga more frequently reported significantly fewer cognitive problems at 3-month follow-up than those who practice d less frequently ( p < 0.001 ) . CONCLUSIONS These findings suggest that yoga can effectively reduce breast cancer survivors ' cognitive complaints and prompt further research on mind-body and physical activity interventions for improving cancer-related cognitive problems PURPOSE To evaluate the influence of adjuvant tamoxifen and exemestane on cognitive functioning in postmenopausal patients with breast cancer ( BC ) . PATIENTS AND METHODS Neuropsychological assessment s were performed before the start ( T1 ) and after 1 year of adjuvant endocrine treatment ( T2 ) in Dutch postmenopausal patients with BC , who did not receive chemotherapy .  Patients participated in the international Tamoxifen and Exemestane Adjuvant Multinational trial , a prospect i ve r and omized study investigating tamoxifen versus exemestane as adjuvant therapy for hormone-sensitive BC . RESULTS Participants included 80 tamoxifen users ( mean age , 68.7 years ; range 51 to 84 ) , 99 exemestane users ( mean age , 68.3 years ; range , 50 to 82 ) , and 120 healthy controls ( mean age , 66.2 years ; range , 49 to 86 ) . At T2 , after adjustment for T1 performance , exemestane users did not perform statistically significantly worse than healthy controls on any cognitive domain . In contrast , tamoxifen users performed statistically significantly worse than healthy controls on verbal memory ( P < .01 ; Cohen 's d = .43 ) and executive functioning ( P = .01 ; Cohen 's d = .40 ) , and statistically significantly worse than exemestane users on information processing speed ( P = .02 ; Cohen 's d = .36 ) . With respect to visual memory , working memory , verbal fluency , reaction speed , and motor speed , no significant differences between the three groups were found . CONCLUSION After 1 year of adjuvant therapy , tamoxifen use is associated with statistically significant lower functioning in verbal memory and executive functioning , whereas exemestane use is not associated with statistically significant lower cognitive functioning in postmenopausal patients with BC . Our results accentuate the need to include assessment s of cognitive effects of adjuvant endocrine treatment in long-term safety studies OBJECTIVE We conducted this study with the aim of demonstrating the feasibility and efficacy of speed-feedback therapy with a bicycle ergometer on cognitive function  in elderly cancer patients . METHODS The subjects were patients with breast or prostate cancer who were 65 years of age or over . Among 146 patients , 78 were r and omly assigned to the intervention group ( n = 38 ) or the control group ( n = 40 ) . The intervention group received speed-feedback therapy with a bicycle ergometer once a week for four successive weeks . The control group was advised to spend the 4-week period engaged in their routine activities . Evaluations were carried out at the baseline and 4 weeks after the baseline ( week 4 ) using the Frontal Assessment Battery , the Barthel Index , the Lawton and Brody Instrumental Activities of Daily Living , and the Functional Assessment of Cancer Therapy-General ver.4 . Data were analyzed by a two-way repeated- measures analysis of variance . RESULTS The mean score of Frontal Assessment Battery for the intervention group was higher than that for the control group at week 4 . In addition to significant main effects of time and group , we also found a significant interaction between the two groups ( p = 0.006 ) . Moreover , all of the subjects in the intervention group could complete all the four sessions of therapy without any pain or distress . CONCLUSION These results suggest that speed-feedback therapy with a bicycle ergometer may be feasible as well as effective for improving the cognitive function in elderly cancer patients Recently , virtual environments ( VEs ) are suggested to encourage users to exercise regularly . The benefits of chronic exercise on cognitive performance are well documented in non-VE neurophysiological and behavioural studies . Based on event-related potentials ( ERP ) such as the N200 and P300 , cognitive processing may be interpreted on a neuronal level . However , exercise-related neuroelectric adaptation in VE remains widely unclear and thus characterizes the primary aim of the present study . Twenty-two healthy participants performed active ( moderate cycling exercise ) and passive ( no exercise ) sessions in three VEs ( control , front , surround ) , each generating a different sense of presence . Within sessions , conditions were r and omly assigned , each lasting 5 min and including a choice reaction-time task to assess cognitive performance . According to the international 10:20 system , EEG with real-time triggered stimulus onset was recorded , and peaks of N200 and P300 components ( amplitude , latency ) were exported for analysis . Heart rate was recorded , and sense of presence assessed prior to and following each session and condition . Results revealed an increase in ERP amplitudes ( N200 : p < 0.001 ; P300 : p < 0.001 ) and latencies ( N200 : p < 0.001 ) that were most pronounced over fronto- central and occipital electrode sites relative to an increased sense of presence ( p < 0.001 ) ; however , ERP were not modulated by exercise ( each p > 0.05 ) . Hypothesized to mirror cognitive processing , decreases of cognitive performance ’s accuracy and reaction time failed significance . With respect to previous research , the present neuroelectric adaptation gives reason to believe in compensative neuronal re sources that balance dem and ing cognitive processing in VE to avoid behavioural inefficiency 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 Purpose Cancer patients often experience diminished cognitive function ( CF ) and quality of life ( QOL ) due to the side effects of treatment and the disease symptoms . This study evaluates the effects of medical Qigong ( MQ ; combination of gentle exercise and meditation ) on CF , QOL , and inflammation in cancer patients . Methods Eighty-one cancer patients recruited between October 2007 and May 2008 were r and omly assigned to two groups : a control group ( n = 44 ) who received the usual health care and an intervention group ( n = 37 ) who participated in a 10-week MQ program .  Self-reported CF was measured by the European Organization for Research and Treatment of Cancer ( EORTC-CF ) and the Functional Assessment of Cancer Therapy — Cognitive ( FACT-Cog ) . The Functional Assessment of Cancer Therapy — General ( FACT-G ) was used to measure QOL . C-reactive protein ( CRP ) was assessed as a biomarker of inflammation . Results The MQ group self-reported significantly improved CF ( mean difference ( MD ) = 7.78 , t51 = −2.532 , p = 0.014 ) in the EORTC-CF and all the FACT-Cog subscales [ perceived cognitive impairment ( MD = 4.70 , t43 = −2.254 , p = 0.029 ) , impact of perceived cognitive impairment on QOL ( MD = 1.64 , t45 = −2.377 , p = 0.024 ) , and perceived cognitive abilities ( MD = 3.61 , t45 = −2.229 , p = 0.031 ) ] compared to controls . The MQ group also reported significantly improved QOL ( MD = 12.66 , t45 = −5.715 , p < 0.001 ) and had reduced CRP levels ( MD = −0.72 , t45 = 2.092 , p = 0.042 ) compared to controls . Conclusions Results suggest that MQ benefits cancer patients ’ self-reported CF , QOL , and inflammation . A larger r and omized controlled trial including an objective assessment of CF is planned Objective . The aim of this study was to assess cognitive function , quality of life , and psychological distress after  surgery for early breast cancer but before initiation of adjuvant treatment . Material and methods . We performed a population -based study in the county of North Jutl and , Denmark , including 124 women aged less than 60 years who had surgery for early breast cancer from 2004 – 2006 . They were compared with an aged-matched group of 224 women without previous cancer selected r and omly from the same population . The cognitive function of patients and controls was tested using a revised battery from the ISPOCD study . Data were collected on quality of life ( EORTC QLQ-C30 ) and psychological distress ( POMS ) . Result . The neuropsychological tests did not reveal significant differences between patients and controls . Compared to the control group , breast cancer patients had a significantly 3 – 4 fold increased risk of experiencing cognitive impairment . Quality of life and psychological distress were also significantly poorer among patients . Conclusion . This study demonstrated that women diagnosed with breast cancer experience a significant deterioration of their perceived cognitive functioning , quality of life and of psychological well being PURPOSE We examined whether an intervention combining pelvic floor muscle exercise and symptom self-management would improve urinary continence and quality of life in patients with prostate cancer . MATERIAL S AND METHODS In a r and omized , controlled , longitudinal clinical trial 279 patients with prostate cancer with persistent urinary incontinence were r and omized to 1 of 3 groups , including biofeedback pelvic floor muscle exercise plus a support group , the biofeedback exercise plus telephone contact and usual care without intervention . The biofeedback plus support and plus telephone groups received 1 session of biofeedback assisted exercise and 6 biweekly sessions of problem solving therapy . This delivered symptom management skills through a peer support group or telephone contacts for 3 months . All subjects were assessed in blinded fashion at baseline , and 3 and 6 months for urinary leakage frequency , leakage amount and disease specific quality of life . RESULTS A total of 244 subjects completed the study . The biofeedback plus support and biofeedback plus telephone groups had a lower frequency of daily urinary leakage than the group with usual care without intervention at 3 months ( p=0.019 and p≤0.001 , respectively ) but not at 6 months . The biofeedback plus support group but not the biofeedback plus telephone group had 13.3 gm lower leakage at 6 months than the usual care group ( p=0.003 ) . Overall the biofeedback plus support and plus telephone groups reported less symptom severity ( p≤0.001 ) and fewer incontinence problems ( p≤0.01 ) than the usual care group at 6 months . CONCLUSIONS Study findings show that pelvic floor muscle exercise practice plus symptom self-management in a peer support setting can significantly improve urinary continence and quality of life in patients with prostate cancer OBJECTIVE To examine the effects of a 10-week Tai Chi ( TC ) program on neuropsychological , psychological , and physical health of female cancer survivors . DESIGN Twenty-three women with a history of cancer participated in 60-min TC classes two times/week for 10-weeks . MAIN OUTCOME MEASURES Before and after the intervention , participants completed neuropsychological tests ( memory , executive functioning , language , and attention ) ; 5 tests of balance ; and self-report question naires of neuropsychological complaints , stress and mood , and fatigue . RESULTS After the 10-week session , participants evidence d fewer neuropsychological complaints and enhanced neuropsychological functioning . They also demonstrated improved balance and reported better psychological functioning . CONCLUSIONS Results suggest that TC may promote gains in neuropsychological functioning , in addition to previously demonstrated improvements in physical and psychological health . These findings support the need for controlled trials examining the potential benefits of TC on neuropsychological functioning after cancer
This systematic review analyzes current data on effects of exercise interventions and physical activity behavior on objective and subjective cancer related cognitive impairments ( CRCI ) .