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Exploring the impact of exercise and mind–body prehabilitation interventions on physical and psychological outcomes in women undergoing breast cancer surgery

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Abstract

Purpose

To compare the impact of exercise and mind–body prehabilitation interventions on changes in quality of life and cancer treatment-related symptoms in women with newly diagnosed breast cancer.

Methods

The following describes a secondary analysis of a randomized window of opportunity trial (The Pre-Operative Health and Body Study). Forty-nine women were randomized to participate in either an exercise prehabilitation intervention or a mind–body prehabilitation intervention from the time of enrollment to surgery. Participants (N = 47) completed measures of quality of life, anxiety, depression, and stress at the time of enrollment (T1), post-intervention/surgery (T2), and one-month post-surgery (T3). Changes in outcome measures between groups were compared over time using longitudinal models.

Results

Mind–body group participants experienced significant improvements in cognitive functioning in comparison to exercise group participants between T1 and T3 (difference in average change: -9.61, p = 0.04, d = 0.31), otherwise, there were no significant differences between groups. Within group comparisons demonstrated that both groups experienced improvements in anxiety (exercise: average change = -1.18, p = 0.03, d = 0.34; mind–body: average change = -1.69, p = 0.006, d = 0.43) and stress (exercise: average change = -2.33, p = 0.04, d = 0.30; mind–body: average change = -2.59, p = 0.05, d = 0.29), while mind–body group participants experienced improvements in insomnia (average change = -10.03, p = 0.04, d = 0.30) and cognitive functioning (average change = 13.16, p = 0.0003, d = 0.67).

Conclusions

Both prehabilitation interventions impacted cancer treatment-related symptoms. Further work in larger groups of patients is needed to evaluate the efficacy of prehabilitation interventions on quality of life in women with breast cancer. Pre-operative exercise and mind–body interventions may impact physical and/or psychological effects of cancer diagnosis and treatment in women with breast cancer.

Trial registration

ClinicalTrials.gov Identifier: NCT01516190. Registered January 24, 2012.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors would like to acknowledge Laura Shockro and Nancy Campbell for their assistance with data collection and implementation of the study interventions.

Funding

Funding was provided by the Susan G. Komen Foundation (in collaboration with the Society for Women's Health Research) and the American Institute for Cancer Research. Susan G. Komen Foundation (Society for Women's Health): SPSWHR1001 (principal investigator: J.A. Ligibel, co-principal investigator: M.L. Irwin; to J.A. Ligibel, M.L. Irwin, N. Campbell, D. Dillon, and A. Giobbie-Hurder); American Institute for Cancer Research (no grant number; principal investigator: J.A. Ligibel; to J.A. Ligibel, D. Dillon, N. Campbell, and A. Giobbie-Hurder).

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Author notes

  1. Robert Knoerl

    Present address: University of Michigan School of Nursing, 400 North Ingalls St, Office 2350, Ann Arbor, MI, 48109, USA

Authors and Affiliations

  1. Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, MA, 02215, Boston, USA

    Robert Knoerl

  2. Division of Biostatistics, Department of Data Sciences, Dana-Farber Cancer Institute, Boston, MA, USA

    Anita Giobbie-Hurder

  3. Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, MA, Boston, USA

    Timothy S. Sannes

  4. Department of Surgery, Yale University School of Medicine, New Haven, CT, USA

    Anees B. Chagpar & Mehra Golshan

  5. Department of Pathology, Brigham and Women’s Hospital, Boston, MA, USA

    Deborah Dillon

  6. Department of Surgery, Dana-Farber/Brigham and Women’s Cancer Center, Boston, MA, USA

    Laura Stewart Dominici & Esther Rhei

  7. Division of Women’s Cancers, Dana-Farber Cancer Institute, Boston, MA, USA

    Elizabeth S. Frank, Sara M. Tolaney & Eric P. Winer

  8. Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    Anne McTiernan

  9. Department of Medicine, School of Medicine, University of Washington, Seattle, WA, USA

    Anne McTiernan & Rachel L. Yung

  10. Yale School of Public Health, New Haven, CT, USA

    Melinda L. Irwin

  11. Medical Oncology, Dana-Farber Cancer Institute, 44 Binney St, YC1250, Boston, MA, 02115, USA

    Jennifer A. Ligibel

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Contributions

All authors contributed to the study conception and design of the primary study and/or secondary analysis. Data analysis was performed by Anita Giobbie-Hurder. The first draft of the manuscript was written by Robert Knoerl and all authors provided feedback on subsequent versions. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Jennifer A. Ligibel.

Ethics declarations

Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Dana-Farber/Harvard Cancer Center Office for Human Research Studies (Protocol: 11–182; 7/14/2011).

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Consent for publication

Not applicable.

Conflict of interest

SMT has served as a paid adviser/consultant for AstraZeneca, Lilly, Merck, Nektar, Novartis, Pfizer, Eisai, NanoString, Puma, Immunomedics, Genentech/Roche, Bristol Myers Squibb, Sanofi, Paxman, Seattle Genetics, Athenex, and Celldex; and has received research funding from AstraZeneca, Lilly, Merck, Nektar, Novartis, Pfizer, Eisai, Genentech/Roche, Exelixis, Immunomedics, Cyclacel, and Bristol Myers Squibb. DD is on the Advisory Board of Oncology Analytics and consults for Novartis. EW has received personal fees (consulting) from Athenex, Carrick Therapeutics, G1 Therapeutics, Genentech/Roche, Genomic Health, GSK, Jounce, Leap, Lilly, Novartis, Seattle Genetics, Syros, and Zymeworks; has received research funding from Astra Zeneca and Genentech/Roche; and serves on the scientific advisory board of Leap. RK has received personal fees (consulting) from Strategy Inc, Spark Healthcare, and System Analytic; and serves on the scientific advisory board of Wellium.

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Knoerl, R., Giobbie-Hurder, A., Sannes, T.S. et al. Exploring the impact of exercise and mind–body prehabilitation interventions on physical and psychological outcomes in women undergoing breast cancer surgery. Support Care Cancer 30, 2027–2036 (2022). https://doi.org/10.1007/s00520-021-06617-8

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