Exercise can counteract treatment side-effects, improve cardiovascular fitness in women with advanced breast cancer


November 2, 2017


The European School of Oncology (ESO)


Taking part in regular exercise can reduce fatigue and
pain, and improve cardiovascular health and quality of life in women being
treated for advanced breast cancer, according to new research.

Taking part in regular exercise can reduce fatigue and pain, and improve
cardiovascular health and quality of life in women being treated for advanced
breast cancer, according to new research presented at the Advanced Breast
Cancer Fourth International Consensus Conference.


Hundreds of thousands of women around the world are being treated for
advanced breast cancer, where the tumour has begun to spread to other parts of
the body. Although treatment can extend women’s lives, it can also cause
fatigue and pain and diminish quality of life.

However, the new research suggests that women with advanced breast cancer
can benefit from a tailored exercise plan, including aerobic and resistance

The study was led by Eduardo Oliveira, professor of exercise physiology at
the University of Porto, Portugal, and an exercise cancer specialist at Mama
Help breast cancer support centre.

Professor Oliveira studied a group of 15 women aged between 34 and 68
years, who were all being treated for metastatic breast cancer and were not
taking part in exercise when they joined the study. Eight women took part in a
12-week exercise programme, which included an hour of exercise twice a week. At
each session, the women did a combination of aerobic exercise, designed to
raise their heart rates, weight-bearing exercise, and arm rehabilitation
exercises. The remaining seven patients continued to receive normal care.

All the women were tested at the beginning and end of the 12-week period to
measure their cardiovascular fitness, defined as the amount of oxygen their
bodies used while doing aerobic exercise (VO2max).

Women who took part in the exercise programme experienced an average
increase in their VO2max of 12.3%, compared to only 2.7% average improvement in
the control group. This suggests the women taking exercise are becoming better
at transporting oxygen around their bodies, with their hearts pumping blood and
their muscles using oxygen more efficiently.

Professor Oliveira also looked at a second cardiovascular measure called
VO2max power, which is the patient’s rate of maximum power during exercise.
Using this measure, he found that women who had been taking regular exercise
improved by 37.2%, compared to 3.9% in the control group. This suggests the
women taking part in the programme were also adapting well to endurance

Pain, fatigue and quality of life were assessed via a questionnaire, which
enabled the researchers to translate these factors into a system of points to
allow comparisons to be made.

Women who were exercising reported an average 21.4-point reduction in pain,
compared to an average 2.6-point reduction for women who were not following the
exercise programme. For fatigue, there was a 14.4-point reduction in women
exercising compared with 2.2 points in women in the control group. For
emotional well-being, there was an improvement of 16.6 points compared to 11.0
points, and for women’s ability to carry out normal daily tasks, there was an
improvement of 14.9 points compared to a 0.1-point deterioration.

All the women taking part in exercise remained in the programme for the
full 12 weeks, suggesting that they tolerated both aerobic and resistance
exercise well.

Professor Oliveira told the conference: “While the benefits of
exercise are generally well established, we know very little about its effects
in patients with advanced breast cancer. These are women who may be suffering
from severe pain and fatigue that make it difficult to live a normal life. It
may also be difficult for them to begin an exercise programme without help and

“In this study, we have demonstrated that these women are able to take
part in a well-planned exercise programme and that there are measurable
benefits to their health and well-being. This is a small group of patients but
the results suggest that this is something worth exploring for a much larger
group of women.

“Unfortunately, there is a lack of awareness among health professionals
about the therapeutic effects of exercise and that needs to change. We also
need more sports scientists studying, working and researching in this

Professor Oliveira plans to continue studying the effects of exercise on
patients with advanced breast cancer to find out which groups are most likely
to benefit and whether some types of exercise have a greater impact than

Chair of the conference, Professor Fatima Cardoso, Director of the Breast
Unit of the Champalimaud Cancer Centre in Lisbon, Portugal, said: “The
effects of exercise in early breast cancer have been well studied, but very
little research around the world has focused on its role in advanced breast
cancer patients, and this is what makes the work by Professor Oliveira and his
colleagues so unique and important.

“The research shows that participating in a moderate exercise
programme for 12 weeks had a good impact on overall quality of life and,
importantly, on control of pain and fatigue, which is a common and
hard-to-control cancer symptom. The findings are excellent news for advanced
breast cancer patients. The fact that it is easy to implement makes these
findings potentially practice-changing when confirmed in larger numbers of

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Materials provided by The European School of Oncology (ESO). Note: Content
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