Adherence to a randomized controlled trial of aerobic exercise in breast cancer survivors: the Yale exercise and survivorship study
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
To examine predictors of exercise adherence in breast cancer survivors.
Seventy-five breast cancer survivors were randomly assigned to exercise (n = 37) or usual care (n = 38). Demographic, prognostic, physiologic, and psychosocial information was collected at baseline and 6 months. The exercise goal was 30 min of exercise 5 days/week for 6 months.
Women randomized to exercise participated in moderate-intensity recreational exercise for 123 ± 52 min/week (81% of the prescribed 150 min/week) over 6 months. Baseline variables associated with better adherence were lower body mass index (BMI), smaller waist circumference, higher amounts of physical activity 6 months prior to enrollment, being in the preparation vs. contemplation Stage of Change and higher FACT-B breast cancer subscale score. After adjusting for these variables, lower BMI and higher Stage of Change continued to be associated with better adherence (p < 0.05).
Future studies of exercise and breast cancer prognosis should target obese women for participation, as well as women just beginning to contemplate participation and its benefits after a cancer diagnosis.
- American Cancer Society. Breast Cancer Facts & Figures 2007-2008. Atlanta: American Cancer Society, Inc.
- Thornton AA, Madlensky L, Flatt SW, et al. The impact of a second breast cancer diagnosis on health related quality of life. Breast Cancer Res Treat. 2005;92:25–33. doi:10.1007/s10549-005-1411-7. CrossRef
- Zhang S, Folsom AR, Sellers TA, et al. Better breast cancer survival for postmenopausal women who are less overweight and eat less fat: the Iowa women’s health study. Cancer. 1995;76(2):275–83. doi:10.1002/1097-0142(19950715) 76:2<275::AID-CNCR2820760218>3.0.CO;2-6. CrossRef
- Tretli S, Haldorsen T, Ottestad L. The effect of pre-morbid height and weight on the survival of breast cancer patients. Br J Cancer. 1990;62(2):299–303.
- Chlebowski R, Aiello E, McTiernan A. Weight loss in breast cancer patient management. J Clin Oncol. 2002;20(4):1128–43. doi:10.1200/JCO.20.4.1128. CrossRef
- Dal Maso L, Zucchetto A, Talamini R, et al. Effect of obesity and other lifestyle factors on mortality in women with breast cancer. Int J Cancer. 2008;123(9):2188–94. doi:10.1002/ijc.23747. CrossRef
- Boyd NF, Campbell JE, Germanson T, et al. Body weight and prognosis in breast cancer. J Natl Cancer Inst. 1981;67(4):785–89.
- Kroenke CH, Chen WY, Rosner B, Holmes MD. Weight, weight gain, and survival after breast cancer diagnosis. J Clin Oncol. 2005;23(7):1370–78. doi:10.1200/JCO.2005.01.079. Epub 2005. CrossRef
- Camoriano JK, Loprinzi CL, Ingle JN, et al. Weight change in women treated with adjuvant therapy or observed following mastectomy for node-positive breast cancer. J Clin Oncol. 1990;8(8):1327–34.
- Schwartz AL. Exercise and weight gain in breast cancer patients receiving chemotherapy. Cancer Pract. 2000;8(5):231–37. doi:10.1046/j.1523-5394.2000.85007.x. CrossRef
- Goodwin P, Ennis M, Pritchard K, et al. Adjuvant treatment and onset of menopause predict weight gain after breast cancer diagnosis. J Clin Oncol. 1999;17(1):120–29.
- Irwin ML, McTiernan A, Baumgartner R, et al. Changes in body fat and weight after a breast cancer diagnosis: influence of demographic, prognostic, and lifestyle factors. J Clin Oncol. 2005;23(4):774–82. doi:10.1200/JCO.2005.04.036. CrossRef
- Demark-Wahnefried W, Hars V, Conaway MR, et al. Reduced rates of metabolism and decreased physical activity in breast cancer patients receiving adjuvant chemotherapy. Am J Clin Nutr. 1997;65(5):1495–1501.
- Irwin ML, Crumley D, McTiernan A, et al. Physical activity levels before and after a diagnosis of breast carcinoma: the health, eating, activity, and lifestyle (HEAL) study. Cancer. 2003;97(7):1746–57. doi:10.1002/cncr.11227. CrossRef
- Rock CL, Flatt SW, Newman V, et al. Factors associated with weight gain in women after diagnosis of breast cancer: Women’s healthy eating and living study group. J Am Diet Assoc. 1999;99(10):1212–21. doi:10.1016/S0002-8223(99)00298-9. CrossRef
- Holmes MD, et al. Physical activity and survival after breast cancer diagnosis. J Am Med Assoc. 2005;293:2479–86. doi:10.1001/jama.293.20.2479. CrossRef
- Holick CN, Newcomb PA, Trentham-Dietz A, et al. Physical activity and survival after diagnosis of invasive breast cancer. Cancer Epidemiol Biomark Prev. 2008;17(2):379–86. doi:10.1158/1055-9965.EPI-07-0771. CrossRef
- Pierce JP, Stefanick ML, Flatt SW, et al. Greater survival after breast cancer in physically active women with high vegetable-fruit intake regardless of obesity. J Clin Oncol. 2007;25(17):2345–51. doi:10.1200/JCO.2006.08.6819. CrossRef
- Irwin ML. Influence of pre- and post-diagnosis physical activity on survival in breast cancer survivors: the Health, Eating, Activity, and Lifestyle (HEAL) study. J Clin Oncol. 2008;26(24):1–7. doi:10.1200/JCO.2007.15.9822. CrossRef
- Courneya KS. Exercise in cancer survivors: an overview of research. Med Sci Sports Exerc. 2003;35(11):1846–52. doi:10.1249/01.MSS.0000093622.41587.B6. CrossRef
- Pinto BM, Rabin C, Dunsiger. S.Home-based exercise among cancer survivors: adherence and its predictors. Psycho-Oncology 2009.
- Courneya KS, Segal RJ, Gelman K, et al. Predictors of supervised exercise adherence during breast cancer chemotherapy. Med Sci Sports Exerc. 2008;40(6):1180–87. doi:10.1249/MSS.0b013e318168da45. CrossRef
- Irwin ML, Alvarez-Reeves M, Cadmus L, et al. Recruiting and retaining breast cancer survivors into a randomized controlled exercise trial: the yale exercise and survivorship study. Cancer. 2008;112(11):S2593–S2605. doi:10.1002/cncr.23446. CrossRef
- Cadmus L, Alfano C, Irwin ML, et al. Predictors of adherence to a yearlong exercise intervention among previously sedentary adults. Obesity (Silver Spring, Md.), Personal communication.
- Irwin ML, Tworoger SS, Yasui Y, et al. Influence of demographic, physiologic, and psychosocial variables on adherence to a yearlong moderate-intensity exercise trial in postmenopausal women. Prev Med. 2004;39(6):1080–86. doi:10.1016/j.ypmed.2004.04.017. CrossRef
- Bassett D, Ainsworth B, Leggett S, et al. Accuracy of five electronic pedometers for measuring distance walked. Med Sci Sports Exerc. 1996;28:1071–77. doi:10.1097/00005768-199608000-00019.
- Van Loan MD, Mayclin P. L. Body composition assessment: dual energy x-ray absorptiometry for total body and regional bone mineral and soft tissue composition. Eur J Clin Nutr. 1992;46:174–78.
- Radloff L. The CES-D Scale: A self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1:385–401. doi:10.1177/014662167700100306. CrossRef
- Fordyce MW. A reivew of research on happiness measures: a sixty second index of happiness and mental health. Soc Indic Res. 1988;20:355–81. doi:10.1007/BF00302333. CrossRef
- Rosenberg M, editor. . Society and the adolescent self-image, Revised edition, ed. Middletown, CT: Wesleyan University Press; 1989.
- Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983;24(4):385–96. doi:10.2307/2136404. CrossRef
- Cella DF, Tulsky DS, Gray G, Sarafian B, Linn E, Bonomi A. The functional assessment of cancer therapy scale: development and validation of the general measure. J Clin Oncol. 1993;39:939–50.
- Marcus BH, Simkin LR. The transtheoretical model: applications to exercise behavior. Med Sci Sports Exerc. 1994;26:1400–04. doi:10.1249/00005768-199411000-00016.
- Pate R, Ettinger W, Heath GW, King AC, Kriska A, Leon AS, et al. Physical activity and public health: a recommendation from the centers for disease control and prevention and the american college of sports medicine. J Am Med Assoc. 1995;273:402–07. doi:10.1001/jama.273.5.402. CrossRef
- Irwin ML, McTiernan A, Bernstein L, et al. Physical activity levels among breast cancer survivors. Med Sci Sports Exerc. 2004;36(9):1484–91.
- Irwin ML, Alvarez-Reeves M, Cadmus L, et al. Randomized controlled trial of exercise on body fat, lean mass, and bone mass in breast cancer survivors. Obesity (Silver Spring, Md.). 2009.
- Irwin ML, Varma K, Alvarez-Reeves M, et al. Randomized controlled trial of aerobic exercise on insulin and insulin-like growth factors in breast cancer survivors: the yale exercise and survivorship study. Cancer Epidemiol Biomark Prev. 2009;18(1):306–13. doi:10.1158/1055-9965.EPI-08-0531. CrossRef
- Martin KA, Sinden AR. Who will stay and who will go? A review of older adults’ adherence to randomized controlled trials of exercise. J Aging Phys Act. 2001;9:91–114.
- Irwin ML. Physical Activity Interventions for Cancer Survivors. Br J Sports Med. 2008.
- Demark-Wahnefried W, Aziz NM, Rowland JH, Pinto BM. Riding the crest of the teachable moment: promoting long-term health after the diagnosis of cancer. J Clin Oncol. 2005;23(24):5814–30. doi:10.1200/JCO.2005.01.230. CrossRef
- Adherence to a randomized controlled trial of aerobic exercise in breast cancer survivors: the Yale exercise and survivorship study
Journal of Cancer Survivorship
Volume 3, Issue 3 , pp 148-157
- Cover Date
- Print ISSN
- Online ISSN
- Springer US
- Additional Links
- Physical activity
- Industry Sectors
- Author Affiliations
- 1. Yale School of Public Health, New Haven, CT, USA
- 2. Dana Farber Cancer Institute, Boston, MA, USA
- 3. Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- 4. Department of Epidemiology and Public Health, Yale School of Public Health, P.O. Box 208034, New Haven, CT, 06520-8034, USA