Associations of physical activity with quality of life and functional ability in breast cancer patients during active adjuvant treatment: the Pathways Study
- 372 Downloads
Physical activity can improve quality of life (QOL) in breast cancer survivors but little is known about associations of physical activity and QOL during active cancer therapy. We examine associations between activity levels and QOL in a large cohort of breast cancer patients. Women with invasive, non-metastatic breast cancer (n = 2,279) were enrolled between 2006 and 2009 from a managed care organization; assessment were done during active therapy. A physical activity frequency questionnaire was used to calculate the average weekly metabolic equivalent task (MET) hours spent in moderate and vigorous activity during active treatment. QOL was measured by the Functional Assessment of Cancer Therapy-Breast Cancer. Linear regression models tested cross-sectional associations of QOL and functional well-being with physical activity and covariates [socio-demographics, comorbidity, body mass index (BMI), clinical variables, social support, and assessment timing]. Physical activity had a significant positive unadjusted association with all QOL sub-scales (except emotional well-being) (all P values < 0.01). Overall QOL was 4.6 points higher for women in the highest quartile of moderate and vigorous activity versus women in the lowest quartile (P < 0.001). In regression models, higher activity was associated with better overall QOL and functional well-being, controlling for covariates (P < 0.05). Increasing BMI was also independently but inversely associated with overall QOL (P < 0.001) but did not explain the relationship of activity and QOL. White women reported the higher levels of activity than minority women and activity was associated with QOL for Whites but not for minority women. Greater physical activity is associated with small but clinically meaningful increases in QOL during active breast cancer care therapy for Whites but this effect is not seen for minority women. If confirmed in longitudinal analyses, these differences may have implications for disparities research.
KeywordsBreast cancer Physical activity Quality of life
This research was supported, in part by National Cancer Institute Grants R01 CA105274 and R01 CA124924 to LK; BC043120 (Department of Defense) to LK; National Cancer Institute Grants RO1 CA 127617, U10 CA 84131, RO1 CA124924, and KO5 CA96940 to JSM; R21 CA 149996 to LAC, and the Biostatistics and Bioinformatics Shared Resources at Lombardi Comprehensive Cancer Center under National Cancer Institute Grant #P30 CA51008 covering GL.
Conflict of interest
- 14.Oehrli M, Quesenberry C, Leyden W (2006) Annual report on trends, incidence, and outcomes. Kaiser Permanente NCCRGoogle Scholar
- 28.van Waart H, Stuiver MM, van Harten WH, Sonke GS, Aaronson NK (2010) Design of the Physical exercise during Adjuvant Chemotherapy Effectiveness Study (PACES): a randomized controlled trial to evaluate effectiveness and cost-effectiveness of physical exercise in improving physical fitness and reducing fatigue. BMC Cancer 10:673−683PubMedCrossRefGoogle Scholar
- 42.Baum M, Buzdar A, Cuzick J, Forbes J, Houghton J, Howell A et al (2003) Anastrozole alone or in combination with tamoxifen versus tamoxifen alone for adjuvant treatment of postmenopausal women with early-stage breast cancer: results of the ATAC (arimidex, tamoxifen alone or in combination) trial efficacy and safety update analyses. Cancer 98(9):1802–1810PubMedCrossRefGoogle Scholar
- 48.Patterson RE, Saquib N, Natarajan L, Rock CL, Parker BA, Thomson CA, Pierce JP (2010) Improvement in self-reported physical health predicts longer survival among women with a history of breast cancer. Breast Cancer Res Treat. doi: 10.1007/s10549-010-1236-x