Search

Observational studies suggest that physical activity after a breast cancer diagnosis is associated with improved cancer outcomes; however, no randomized data are available. Here, we report an exploratory follow-up of cancer outcomes from the Supervised Trial of Aerobic versus Resistance Training (START). Methods: The START was a Canadian multicenter trial that randomized 242 breast cancer patients between 2003 and 2005 to usual care (n = 82), supervised aerobic (n = 78), or resistance (n = 82) exercise during chemotherapy. The primary end point for this exploratory analysis was disease-free survival (DFS). Secondary end points were overall survival, distant DFS, and recurrence-free interval. The two exercise arms were combined for analysis (n = 160), and selected subgroups were explored. Results: After a median follow-up o f 89 months, there were 25/160 (15.6%) DFS events in the exercise groups and 18/82 (22.0%) in the control group. Eight-year DFS was 82.7% for the exercise groups compared with 75.6% for the control group (HR, 0.68; 95% confidence interval (Cl), 0.37-1.24; log-rank, P = 0.21). Slightly stronger effects were observed for overall survival (HR, 0.60; 95% Cl, 0.27-1.33; log-rank, P = 0.21), distant DFS (HR, 0.62; 95% Cl, 0.32—1.19; log-rank, P = 0.15), and recurrence-free interval (HR, 0.58; 95% Cl, 0.30-1.11; Gray test, P = 0.095). Subgroup analyses suggested potentially stronger exercise effects on DFS for women who were overweight/obese (HR, 0.59; 95% Cl, 0.27-1.27), had stage II/III cancer (HR, 0.61; 95% Cl, 0.31-1.20), estrogen receptor-positive tumors (HR, 0.58; 95% Cl, 0.26-1.29), human epidermal growth factor receptor 2-positive tumors (HR, 0.21; 95% Cl, 0.04-1.02), received taxane-based chemotherapies (HR, 0.46; 95% Cl, 0.19-1.15), and ≥85% o f their planned chemotherapy (HR, 0.50; 95% Cl, 0.25-1.01). Conclusions: This exploratory follow-up o f the START provides the first randomized data to suggest that adding exercise to standard chemotherapy may improve breast cancer outcomes. A definitive phase III trial is warranted. [ABSTRACT FROM AUTHOR]

The article investigates the predictors of supervised exercise adherence in breast cancer patients initiating adjuvant chemotherapy in Edmonton, Ottawa and Vancouver, Canada. Objective attendance records were used to evaluate the adherence of the patients. Findings of univariate and multivariate analysis reveal that supervised exercise adherence has significant relations to the training location, disease stage and depression as well as patients' muscular strength, percent body fat and education. It was concluded that breast cancer patients' exercise adherence was not driven by motivational variables but by unique factors such as location, fitness and depression.

The article cites a study that identifies key demographic and health factors associated with physical activity (PA) participation in adults diagnosed with type 1 or type 2 diabetes recruited from the Canadian Diabetes Association of Alberta, Canada. The study uses multiple and logistic regression models to identify demographic and health factors related to PA levels, and the analyses were conducted separately for type 1 and type 2 groups. The study shows that a 63.7% of those with type 1 and 71.9% for those with type 2 diabetes were not achieving recommended PA levels.