Community-based exercise program effectiveness and safety for cancer survivors
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Clinical trials have demonstrated the benefits of exercise for cancer survivors. This investigation determined the effectiveness and safety of a disseminated community-based exercise program for cancer survivors who had completed treatment.
Personal trainers from regional YMCAs received training in cancer rehabilitation and supervised twice-a-week, 12-week group exercise sessions for survivors. At baseline and post-program, validated measures assessed patient-reported outcomes (PRO) and physiologic measurements.
Data were collected from 221 survivors from 13 YMCA sites and 36 separate classes. All participants had data available at one time point, while matched baseline and post-program PRO and physiologic data were available for 85% (N = 187). Participants with matched data were largely female (82%), with mean age of 58 (range, 28–91 years). Time since diagnosis ranged from 1 to 48 (mean, 5.6 years), and mean time since last treatment was 3.0 (range, 1–33 years). Physiological improvements were significant in systolic (P < 0.001) and diastolic (P = 0.035) blood pressure, upper and lower body strength, the 6-min walk test (P = 0.004), and flexibility (P < 0.001). Participants reported improvements in overall health-related quality of life (P < 0.001), social support (P = 0.019), body pain (P = 0.016), fatigue (P < 0.001), insomnia (P < 0.001), and overall musculoskeletal symptoms (P = <0.001). Few injuries or lymphedema events occurred during classes.
Community-based exercise groups for cancer survivors of mixed diagnoses and ages, who have completed active treatment, have physiologic and psychosocial benefits, and are safe.
Implications for cancer survivors
Survivors may expect significant benefit from participating in a community-based exercise program tailored to meet their individual needs as a survivor.
- Altekruse SF, Kosary CL, Krapcho M, Neyman N, Aminou R, Waldron W et al. SEER Cancer Statistics Review, 1975-2008, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2008/. Accessed 14 Nov 2011.
- Howlader N, Noone AM, Krapcho M, Neyman N, Aminou R, Waldron W et al. SEER Cancer Statistics Review, 1975-2008, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2008/. Accessed 14 Nov 2011.
- Horner MJ, Ries LAG, Krapcho M, Neyman N, Aminou R, Howlader N et al. SEER Cancer Statistics Review, 1975-2006, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2006/. Accessed 14 Nov 2011.
- Stein, KD, Syrjala, KL, Andrykowski, MA (2008) Physical and psychological long-term and late effects of cancer. Cancer 112: pp. 2577-2592 CrossRef
- Brearley, SG, Stamataki, Z, Addington-Hall, J, Foster, C, Hodges, L, Jarrett, N (2011) The physical and practical problems experienced by cancer survivors: a rapid review and synthesis of the literature. Eur J Oncol Nurs 15: pp. 204-212 CrossRef
- Servaes, P, Verhagen, S, Schreuder, B, Veth, R, Bleijenberg, G (2003) Fatigue after treatment for malignant and benign bone and soft tissue tumors. J Pain Symptom Manage 26: pp. 1113-1122 CrossRef
- Hjermstad, SD, Fosså, SD, Oldervoll, L, Holte, H, Jacobsen, AB, Loge, JH (2005) Fatigue in long-term Hodgkin’s disease survivors: a follow-up study. J Clin Oncol 23: pp. 6587-6595 CrossRef
- Bower, JE, Ganz, PA, Desmond, KA, Bernaards, C, Rowland, JH, Meyerowitz, BE (2006) Fatigue in long-term breast carcinoma survivors. A longitudinal investigation. Cancer 106: pp. 751-758 CrossRef
- Servaes, P, Gielissen, MFM, Verhagen, C, Bleijenberg, G (2007) The course of severe fatigue in disease-free breast cancer patients: a longitudinal study. Pycho-Oncol 16: pp. 787-795 CrossRef
- Syrjala, K, Yi, JC, Artherholt, SB, Stover, AC, Abrams, JR (2010) Measuring musculoskeletal symptoms in cancer survivors who receive hematopoietic cell transplantation. J Cancer Surviv 4: pp. 225-235 CrossRef
- Yahalom, J, Portlock, CS (2011) Long-term cardiac and pulmonary complications of cancer therapy. Heart Fail Clin 7: pp. 403-411 CrossRef
- Abouassaly, R, Fossa, SD, Giwercman, A, Kollmannsberger, C, Motzer, RJ, Schmoll, HJ (2011) Sequelae of treatment in long-term survivors of testis cancer. Eur Urol 60: pp. 516-526 CrossRef
- Baker KS, Chow E, Steinberger J. Metabolic syndrome and cardiovascular risk in survivors after hematopoietic cell transplantation. Bone Marrow Transplant. 2011. doi:10.1038/bmt.2011.118.
- Pliarchopoulou, K, Pectasides, D (2010) Late complications of chemotherapy in testicular cancer. Cancer Treat Rev 36: pp. 262-267 CrossRef
- Sharma N, Hansen CH, O'Connor M, Walker J, Kleiboer A, Murray G, et al. Sleep problems in cancer patients: prevalence and association with distress and pain. Psycho-Oncol. 2011. doi:10.1002/pon.2004.
- Farquhar-Smith, P (2011) Chemotherapy-induced neuropathic pain. Curr Opin Support Palliat Care 5: pp. 1-7 CrossRef
- Harrington, S, Padua, D, Battaglini, C, Michener, LA, Giuliani, C, Myers, J (2011) Comparison of shoulder flexibility, strength, and function between breast cancer survivors and healthy participants. J Cancer Surviv 5: pp. 167-174 CrossRef
- Jansen, L, Hermann, A, Stegmaier, C, Singer, S, Brenner, H, Arndt, V (2011) Health-related quality of life during the 10 years after diagnosis of colorectal cancer: a population-based study. J Clin Oncol 29: pp. 3263-3269 CrossRef
- Bencová, V, Bella, V, Svec, J (2011) The dynamics of psychosocial burden development in breast cancer survivors: clinical success with psychosocial consequences. Klin Onkol 24: pp. 203-208
- Oerlemans, S, Mols, F, Nijziel, MR, Lybeert, M, Poll-Franse, LV (2011) The impact of treatment, socio-demographic and clinical characteristics on health-related quality of life among Hodgkin's and non-Hodgkin's lymphoma survivors: a systematic review. Ann Hematol 90: pp. 993-1004 CrossRef
- Ness, K, Wall, MM, Oakes, JM, Robison, LL, Gurney, JG (2006) Physical performance limitations and participation restrictions among cancer survivors: a population-based study. Ann Epidemiol 16: pp. 197-205 CrossRef
- Drake, D, Falzer, P, Xistris, D, Robinson, G, Roberge, M (2004) Physical fitness training: outcomes for adult oncology patients. Clin Nurs Res 13: pp. 245-264 CrossRef
- Curt, GA, Breitbart, W, Cella, D, Groopman, JE, Horning, SJ, Itri, LM (2000) Impact of cancer-related fatigue on the lives of patients: new findings from the Fatigue Coalition. Oncologist 5: pp. 353-360 CrossRef
- Pekmezi, D, Demark-Wahnefried, W (2011) Updated evidence in support of diet and exercise interventions in cancer survivors. Acta Oncol 50: pp. 167-178 CrossRef
- Demark-Wahnefried, W (2006) Cancer survival: time to get moving? Data accumulate suggesting a link between physical activity and cancer survival. J Clin Oncol 24: pp. 3517-3518 CrossRef
- Brown, J, Huedo-Medina, TB, Pescatello, LS, Pescatello, SM, Ferrer, RA, Johnson, BT (2011) Efficacy of exercise interventions in modulating cancer-related fatigue among adult cancer survivors: a meta-analysis. Cancer Epidemiol Biomarkers Prev 20: pp. 123-133 CrossRef
- Hede, K (2011) Supportive care: large studies ease yoga, exercise into mainstream oncology. J Natl Cancer Inst 103: pp. 11-12 CrossRef
- Kim, D, Sim, YJ, Jeong, HJ, Kim, GC (2010) Effect of active resistive exercise on breast cancer-related lymphedema: a randomized controlled trial. Arch Phys Med Rehabil 91: pp. 1844-1848 CrossRef
- Schmitz, K, Ahmed, R, Troxel, A, Cheville, A, Smith, R, Lewis-Grant, L (2009) Weight lifting in women with breast-cancer-related lymphedema. N Engl J Med 361: pp. 664-673 CrossRef
- Winters-Stone, K, Dobek, J, Nail, L, Bennett, JA, Leo, MC, Naik, A (2011) Strength training stops bone loss and builds muscle in postmenopausal breast cancer survivors: a randomized, controlled trial. Breast Cancer Res Treat 127: pp. 447-456 CrossRef
- Loprinzi, C, Wolf, SL, Barton, DL, Laack, NN (2008) Symptom management in premenopausal patients with breast cancer. Lancet Oncol 9: pp. 993-1000 CrossRef
- Ferrer, R, Huedo-Medina, TB, Johnson, BT, Ryan, S, Pescatello, LS (2011) Exercise interventions for cancer survivors: a meta-analysis of quality of life outcomes. Ann Behav Med 41: pp. 32-47 CrossRef
- Speck, R, Courneya, KS, Mâsse, LC, Duval, S, Schmitz, KH (2010) An update of controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. J Cancer Surviv 4: pp. 87-100 CrossRef
- Ibrahim, E, Al-Homaidh, A (2011) Physical activity and survival after breast cancer diagnosis: meta-analysis of published studies. Med Oncol 28: pp. 753-765 CrossRef
- Wiggins, M, Simonavice, EM (2010) Cancer prevention, aerobic capacity, and physical functioning in survivors related to physical activity: a recent review. Cancer Manag Res 2: pp. 157-164 CrossRef
- Holmes, MD, Chen, WY, Feskanich, D, Kroenke, CH, Colditz, GA (2005) Physical activity and survival after breast cancer diagnosis. JAMA 293: pp. 2479-2486 CrossRef
- Meyerhardt, JA, Giovannucci, EL, Holmes, MD, Chan, AT, Chan, JA, Colditz, GA (2006) Physical activity and survival after colorectal cancer diagnosis. J Clin Oncol 24: pp. 3527-3534 CrossRef
- Meyerhardt, JA, Heseltine, D, Niedzwiecki, D, Hollis, D, Saltz, LB, Mayer, RJ (2006) Impact of physical activity on cancer recurrence and survival in patients with stage III colon cancer: findings from CALGB 89803. J Clin Oncol 24: pp. 3535-3541 CrossRef
- Irwin, ML, McTiernan, A, Manson, JE, Thomson, CA, Sternfeld, B, Stefanick, ML (2011) Physical activity and survival in postmenopausal women with breast cancer: results from the Women's Health Initiative. Cancer Prev Res 4: pp. 522-529 CrossRef
- Kirkegaard H, Johnsen NF, Christensen J, Frederiksen K, Overvad K, Tjønneland A. Association of adherence to lifestyle recommendations and risk of colorectal cancer: a prospective Danish cohort study. BMJ. 2010. doi:10.1136/bmj.c5504.
- Demark-Wahnefried, W, Peterson, B, McBride, C, Lipkus, I, Clipp, E (2000) Current health behaviors and readiness to pursue life-style changes among men and women diagnosed with early stage prostate and breast carcinomas. Cancer 88: pp. 674-684 CrossRef
- Irwin, ML, McTiernan, A, Bernstein, L, Gilliland, FD, Baumgartner, R, Baumgartner, K (2004) Physical activity levels among breast cancer survivors. Med Sci Sports Exerc 36: pp. 1484-1491
- Irwin, M, Crumley, D, McTiernan, A, Bernstein, L, Baumgartner, R, Gilliland, FD (2003) Physical activity levels before and after a diagnosis of breast carcinoma: the Health, Eating, Activity, and Lifestyle (HEAL) study. Cancer 97: pp. 1746-1757 CrossRef
- Jones, LW, Courneya, KS (2002) Exercise counseling and programming preferences of cancer survivors. Cancer Pract 10: pp. 208-215 CrossRef
- Fink, B, Weiner, JG, Jordan, TR, Thompson, AJ, Salvage, TC, Coman, M (2010) Early stage breast cancer and its association with diet and exercise-related perceptions and behaviors to prevent recurrence. Breast Cancer 4: pp. 65-72
- Haines, TP, Sinnamon, P, Wetzig, NG, Lehman, M, Walpole, E, Pratt, T (2010) Multimodal exercise improves quality of life of women being treated for breast cancer, but at what cost? Randomized trial with economic evaluation. Breast Cancer Res Treat 124: pp. 163-175 CrossRef
- ATS Statement: Guidelines for the six-minute walk test. Am J Respir Crit Care Med 166: pp. 111-117
- Enright, PL (2003) The six-minute walk test. Respir Care 48: pp. 783-785
- Kraemer, WJ, Fry, AC Strength testing: development and evaluation of methodology. In: Maud, PJ, Foster, C eds. (1995) Physiological assessment of human fitness. Human Kinetics, Champaign, IL
- Shaw, CE, McCully, KK, Posner, JD (1995) Injuries during the one repetition maximum assessment in the elderly. J Cardiopulm Rehabil 15: pp. 283-287 CrossRef
- Barnard, KL, Adams, KJ, Swank, AM, Mann, E, Denny, DM (1999) Injuries and muscle soreness during the one repetition maximum assessment in a cardiac rehabilitation population. J Cardiopulm Rehabil 19: pp. 52-58 CrossRef
- Wells, KF, Dillon, EK (1952) The sit and reach. A test of back and leg flexibility. Res Q 23: pp. 115-118
- Ware, JE, Kosinski, M, Dewey, JE (2000) How to score version 2 of the SF-36 health survey. QualityMetric Incorporated, Lincoln, RI
- Hawthorne, G, Osborne, RH, Taylor, A, Sansoni, J (2007) The SF36 version 2: critical analyses of population weights, scoring algorithms and population norms. Qual Life Res 16: pp. 661-673 CrossRef
- Hann, DM, Jacobsen, PB, Azzarello, LM, Martin, SC, Curran, SL, Fields, KK (1998) Measurement of fatigue in cancer patients: development and validation of the fatigue symptom inventory. Qual Life Res 7: pp. 301-310 CrossRef
- Hann, DM, Denniston, MM, Baker, F (2000) Measurement of fatigue in cancer patients: further validation of the fatigue symptom inventory. Qual Life Res 9: pp. 847-854 CrossRef
- Enhancing recovery in coronary heart disease (ENRICHD): baseline characteristics. Am J Cardiol 88: pp. 316-322 CrossRef
- Pagoto S, Schneider KL, Oleski JL, Luciani JM, Bodenlos JS, Whited MC. Male inclusion in randomized controlled trials of lifestyle weight loss interventions. Obesity. 2011. doi:10.1038/oby.2011.140.
- Adamsen, L, Rasmussen, JM, Pedersen, LS (2001) “Brothers in arms”: how men with cancer experience a sense of comradeship through group intervention which combines physical activity with information relay. J Clin Nurs 10: pp. 528-537 CrossRef
- Rogerino, A, Grant, LL, Wilcox, H, Schmitz, KH (2009) Geographic recruitment of breast cancer survivors into community-based exercise interventions. Med Sci Sports Exerc 41: pp. 1413-1420 CrossRef
- Blaney, J, Lowe-Strong, A, Rankin, J, Campbell, A, Allen, J, Gracey, J (2010) The cancer rehabilitation journey: barriers to and facilitators of exercise among patients with cancer-related fatigue. Phys Ther 90: pp. 1135-1147 CrossRef
- Karvinen, K, DuBose, KD, Carney, B, Allison, RR (2010) Promotion of physical activity among oncologists in the United States. J Support Oncol 8: pp. 35-41
- Ahmed, RL, Thomas, W, Yee, D, Schmitz, K (2006) Weight training does not increase incidence of lymphedema in breast cancer survivors. J Clin Oncol 24: pp. 2765-2772 CrossRef
- Community-based exercise program effectiveness and safety for cancer survivors
Journal of Cancer Survivorship
Volume 6, Issue 2 , pp 219-228
- Cover Date
- Print ISSN
- Online ISSN
- Springer US
- Additional Links
- Cancer survivors
- Physical activity
- Industry Sectors
- Author Affiliations
- 1. Clinical Research Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, D5-220, P.O. Box 19024, Seattle, WA, 98109, USA
- 2. YMCA of Greater Seattle, Seattle, WA, USA
- 3. Oncology Physical Therapy, Eugene, OR, USA
- 4. Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA