ECSS Paris 2023: OP-MH21
INTRODUCTION: With increasing survival rates, a growing number of women live with the long-term effects of breast cancer and its treatments, including reduced muscle mass and strength, impaired upper-limb function, diminished cardiorespiratory fitness, lower quality of life, and risk of lymphedema. Evidence suggests that exercise, particularly combining resistance and aerobic training, can help mitigate these effects. The primary aim of the EFICAN trial was to evaluate the effects of a 12-week combined training program on muscle strength in breast cancer survivors. Secondary outcomes included shoulder-arm volume and disability, body composition, cardiorespiratory fitness, quality of life, cancer-related fatigue, and depression. METHODS: A randomized trial was conducted with 60 women who had completed surgery, chemotherapy, and/or radiotherapy within the past ten years. Participants were randomized to exercise (EG; two weekly resistance training sessions + 10,000 daily steps) or control (CG; 10,000 daily steps). Baseline and post-intervention assessments included muscle strength, shoulder-arm volume and disability, body composition, cardiorespiratory fitness, quality of life, cancer-related fatigue, and depression. RESULTS: The EG (32 participants) showed significant improvements in overall muscle strength (0.718; 95%CI: 0.361–1.074, P<0.001, d-Cohen=1.04), upper-limb strength (0.727; 95%CI: 0.294–1.160, P=0.001, d=0.87), and lower-limb strength (0.709; 95%CI: 0.324–1.094, P=0.001, d=0.96) compared to the CG (28 participants). Secondary analyses indicated that surgical and treatment characteristics did not influence the intervention’s effects on lymphedema or upper-limb problems. However, increased upper-limb strength was associated with reduced shoulder-arm problems (-0.429; P=0.020). Regarding body composition, chemotherapy was linked to increased fat mass (B=2.313, P=0.034), fat percentage (B=3.282, P=0.003), and visceral fat (B=1.434, P=0.011) in the CG. No significant differences were observed in other variables. CONCLUSION: A 12-week combined training intervention improved muscle strength without compromising shoulder-arm volume and disability, regardless of the surgical and treatment history. Although no significant changes were seen in other variables, risk factors for lymphedema did not impact training outcomes, reinforcing the recommendation to exercise the affected limb. Additionally, chemotherapy was associated with worsened body composition in the CG, suggesting that exercise may help counteract these adverse effects, which are critical for long-term prognosis. The findings indicate that increased upper-limb strength may help alleviate shoulder-arm problems, further supporting the integration of combined training into post-cancer rehabilitation programs. This study underscores the importance of exercise in reducing the negative effects of cancer treatment, reinforcing its role as a key component in breast cancer survivorship care.
Read CV Alba Esteban SimónECSS Paris 2023: OP-MH21
INTRODUCTION: Physical exercise programs has been demonstrated to reduce many of the side effects of cancer and its treatments, primarily by addressing alterations in body composition, CRF, and fatigue, all of which are associated with quality of life and survival [1, 2]. Despite these benefits, it is estimated that only 36% of breast cancer survivors adhere to the exercise recommendations for cancer survivors set by the World Health Organization (WHO) [3]. In this Randomized Control Trial (RCT), we examined the impact of a face-to-face oncological exercise program compared with an online oncological exercise program on body composition, CRF, fatigue, and quality of life in patients with breast cancer in stage IA to IIIB. METHODS: Women diagnosed with primary breast cancer (stages IA to IIIB); aged 18 years or older were included in this study. Patients assigned to the intervention group underwent a multimodal exercise program intervention for 16 weeks. This intervention was conducted both in-person at the training center and online to enhance participant adherence. Both oncological exercise programs included resistance, endurance, balance, and proprioception exercises, with intensity ranging from 55% to 95% of heart rate reserve (HRR). Each session lasted 75 minutes and was structured as follows: 10 minutes of warm-up involving joint mobilities, balance exercises, and aerobic exercise. This was followed by two 20-minute bouts of combined endurance and resistance exercises at an average intensity of 70-75% HRR with 30 to 60 second bouts of high-intensity activity of 85% to 100% HRR. Resistance exercises were developed with free weights of 8 exercises of 3x10 or 3x15. RESULTS: 40 patients in the intervention group and 34 in the control group completed the study. In the intervention group, 14 (35.9%) patients participated in the online program, while 25 (64.1%) attended the in-person sessions. The attendance rates for the intervention group were 89.5% in both instances. Specifically, for the online group, 84.02% of the sessions were conducted online, while 15.98% of the attendance occurred in person. Conversely, for the in-person intervention, 76.64% of the sessions were face-to-face, and 23.35% of the attendance was through online classes. No differences in attendance between interventions were observed (p=0.997). In addition, no significant differences between interventions were observed in physical (cardiorespiratory fitness, functional capacity, and body composition) or emotional (fatigue and quality of life) variables. CONCLUSION: The multimodal physical exercise interventions (online and face-to-face) in this study prove to be effective not only in improving fitness and body composition, but also in promoting different exercise strategies, and improving the accessibility of exercise programs for patients far from sports centers. This accessibility is crucial in ensuring high levels of adherence to these programs and adapting the intervention to the personal situation of patients.
Read CV Monica Castellanos-MontealegreECSS Paris 2023: OP-MH21
INTRODUCTION: The benefits of exercise in cancer patients are well established; however, its effectiveness largely depends on proper structuring, supervision, and professional guidance. Poorly designed or inadequately supervised programs may fail to provide optimal outcomes or even pose risks. This study evaluates the impact of a structured and professionally guided 16-week exercise program on health-related quality of life (HRQoL) in cancer patients, using the EQ-5D questionnaire to quantify improvements and their economic implications. METHODS: A total of 195 cancer patients (95% female, mean age 54.30, (SD=15,07) years) participated in this professionally supervised exercise intervention. The sample included patients in different treatment stages: 30% undergoing active treatment, 30% on hormone therapy, 22% metastatic, and 17% without active treatment. The intervention consisted of 16 weeks of high-intensity cardiovascular and strength training, conducted twice per week in a controlled setting with trained professionals ensuring safety, adherence, and individualized adaptation. The EQ-5D questionnaire, a validated tool assessing five health dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression), was administered at baseline and post-intervention. The EQ-5D index score was calculated using Spanish reference values, and quality-adjusted life years (QALYs) were estimated based on HRQoL changes. RESULTS: Following the professionally structured intervention, there was a significant improvement in HRQoL, with the EQ-5D index increasing by 0.061 (SD=0,03) points from baseline (p = 0.02). This corresponds to an annualized gain of 0.061 QALYs per patient, a clinically meaningful enhancement in quality of life. Economic analysis, based on Spain’s willingness-to-pay (WTP) threshold (€20,000–€30,000 per QALY gained), suggests that this structured program generates an estimated economic benefit of €1,220 to €1,830 per patient. Given the cohort size (n = 195), the total potential economic impact ranges between €237,900 and €356,850. CONCLUSION: This study underscores the critical role of structured and professionally supervised exercise programs in maximizing benefits for cancer patients. The significant improvements in HRQoL and economic impact reinforce the need for these interventions to be delivered by trained professionals who can ensure individualized adaptation, safety, and adherence. In contrast, unsupervised or poorly structured programs may fail to provide similar outcomes or even pose risks to vulnerable patients. To fully integrate exercise into oncology care, it is essential to standardize structured programs, ensuring they are led by qualified professionals who can adapt interventions to patients’ clinical status, treatment phase, and physical capacity. Future research should focus on optimizing program scalability while maintaining high safety, efficacy, and cost-effectiveness standards.
Read CV SORAYA CASLA-BARRIOECSS Paris 2023: OP-MH21