, Volume 28, Issue 2, pp 105-113

Effects of an oncologist’s recommendation to exercise on self-reported exercise behavior in newly diagnosed breast cancer survivors: a single-blind, randomized controlled trial

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Background: Increased attention has focused on exercise as a quality of life intervention for breast cancer survivors during and after adjuvant therapy.Purpose: Our objective was to examine the effects of an oncologist’s recommendation to exercise on self-reported exercise behavior in newly diagnosed breast cancer survivors attending their first adjuvant therapy consultation.Methods: Using a single-blind, 3-armed, randomized controlled trial, 450 breast cancer survivors were randomly assigned to receive an oncologist exercise recommendation only, an oncologist exercise recommendation plus referral to an exercise specialist, or usual care. The primary outcome was self-reported total exercise (in metabolic equivalent [MET] hours per week) at 5 weeks postconsultation.Results: The follow-up assessment rate was 73% (329 of 450). Intention-to-treat analysis based on participants with follow-up data indicated a significant difference in total exercise in favor of the recommendation-only group over the usual care group (mean difference, 3.4 MET hr per week; 95% confidence interval [CI], 0.7–6.1 MET hr per week; p = .011). There was no significant difference between the recommendation-plus-referral group and the usual care group (mean difference, 1.5 MET hr per week; 95% CI, −1.0 to 4.0 MET hr per week; p = .244). Ancillary on-treatment analyses showed that participants who recalled an exercise recommendation reported significantly more total exercise than participants who did not recall an exercise recommendation (mean difference, 4.1 MET hr per week; 95% CI, 1.9–6.4 MET hr per week; p < .001).Conclusions: Our findings suggest that an oncologist recommendation may increase exercise behavior in newly diagnosed breast cancer survivors, particularly if it is recalled 1 week after the recommendation.

At the time of this study, Lee W. Jones was supported by an Alberta Heritage Foundation for Medical Research studentship. Kerry S. Courneya is supported by an Investigator Award from the Canadian Institutes of Health Research. Adrian S. Fairey was supported by an Izaak Walton Killiam Memorial Scholarship. This study was funded by a Research Team Grant from the National Cancer Institute of Canada (NCIC) with funds from the Canadian Cancer Society (CCS) and the CCS/NCIC Sociobehavioral Cancer Research Network.
We gratefully acknowledge the Northern Alberta Breast Cancer Program at the Cross Cancer Institute; Blair St. Martin, B.S., Neil Eves, M.S., and BenWilson for their assistance in assessment and data management. We also acknowledge doctoral dissertation committee members Ron Plontikoff, Ph.D., John Spence, Ph.D., and Cameron Wild, Ph.D. for feedback on an earlier version of this article.
Papers were presented in part at the 38th annual meeting of the American Society of Clinical Oncology, Orlando, Florida (May 2002) and the 24th annual meeting of the Society of Behavioral Medicine, Salt Lake City, Utah (2003).