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Enhancing an oncologist’s recommendation to exercise to manage fatigue levels in breast cancer patients: a randomized controlled trial



Fatigue is a troublesome symptom for breast cancer patients, which might be mitigated with exercise. Cancer patients often prefer their oncologist recommend an exercise program, yet a recommendation alone may not be enough to change behavior. Our study determined whether adding an exercise DVD to an oncologist’s recommendation to exercise led to better outcomes than a recommendation alone.


Ninety breast cancer patients, at varying phases of treatment and stages of disease, were randomized to receive the following: an oncologist verbal recommendation to exercise (REC; n = 43) or REC plus a cancer-specific yoga DVD (REC + DVD; n = 47). Fatigue, vigor, and depression subscales of the Profile of Mood States, and physical activity levels (MET-min/week), exercise readiness, and self-efficacy were assessed at baseline, 4, and 8 weeks. Analyses controlled for age, time since diagnosis, and metastatic disease.


Over 8 weeks, women in REC + DVD used the DVD an average of twice per week. The REC + DVD group had greater reductions in fatigue (− 1.9 ± 5.0 vs. − 1.0 ± 3.5, p = 0.02), maintained exercise readiness (− 0.1 ± 1.1 vs. − 0.3 ± 1.3; p = 0.03), and reported less of a decrease in physical activity (− 420 ± 3075 vs. − 427 ± 5060 MET-min/week, p = 0.06) compared to REC only.


A low-cost, easily distributed, and scalable yoga-based DVD could be a simple booster to an oncologist’s advice that motivates breast cancer patients, even those with advanced disease and/or in treatment, to engage in self-care, e.g., exercise, to manage fatigue.

Trial registration Identifier: NCT03120819

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We acknowledge the contributions of Jessica Scott, MD, Rachel Wood, MD, Britta Torgrimson, PhD, Jessica Sitemba, and Ms. Laurie Iverson McMahon to the conduct of the study.


This project was supported by the OHSU Knight Cancer Institute (P30 CA069533) to Dr. Winters-Stone and in part by an Agency for Healthcare Research & Quality-funded PCOR K12 award (K12 HS019456 01) to Dr. Moe. Dr. Winters-Stone is funded by NIH Grants 1R01CA163474, 1R21HL115251, and P30CA069533.

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Correspondence to Kerri M. Winters-Stone.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the OHSU Institutional Review Board.

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Informed consent was obtained from all individual participants included in the study. All patients provided verbal consent prior to participating in study activities.

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Winters-Stone, K.M., Moe, E.L., Perry, C.K. et al. Enhancing an oncologist’s recommendation to exercise to manage fatigue levels in breast cancer patients: a randomized controlled trial. Support Care Cancer 26, 905–912 (2018).

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  • Physical activity
  • Cancer survivor
  • Behavior change
  • Symptom management
  • Self-management