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Campbell EK, Campbell TM, Culakova E, Blanchard L, Wixom N, Guido JJ, Fetten J, Huston A, Shayne M, Janelsins MC, Mustian KM, Moore RG, Peppone LJ. A whole food, plant-based randomized controlled trial in metastatic breast cancer: feasibility, nutrient, and patient-reported outcomes. Breast Cancer Res Treat 2024; 206:273-283. [PMID: 38553649 DOI: 10.1007/s10549-024-07284-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 02/07/2024] [Indexed: 05/01/2024]
Abstract
PURPOSE Quality of life (QOL) is among the most important outcomes for women with metastatic breast cancer (MBC), and it predicts survival. QOL is negatively impacted by cognitive impairment, fatigue, and weight gain. We assessed whether a whole food, plant-based (WFPB) diet-promoting weight loss is feasible and might improve QOL. METHODS Women with MBC on stable systemic treatments were randomized 2:1 to 1) WFPB dietary intervention (n = 21) or 2) usual care (n = 11) for 8 weeks. Participants attended weekly education visits and consumed an ad libitum WFPB diet (3 prepared meals/day provided). Patient-reported outcomes and 3-day food records were assessed at baseline and 8 weeks. The effects of WFPB diet on changes in outcomes were assessed by analysis of covariance model controlling for baseline. RESULTS 20 intervention and 10 control participants completed the trial. Intervention participants were highly adherent to the WFPB diet (94.3 % total calories on-plan). Intervention group nutrient intakes changed significantly including dietary fat (35.8 % to 20.4 % percent calories from fat, p < 0.001) and fiber content (12.7 to 30.8 g fiber/1000 kcal, p < 0.001). Perceived cognitive function (FACT-Cog total + 16.1; 95 % confidence interval [CI] = 0.8-31.7; p = 0.040) and emotional well-being (FACT-B emotional well-being subscale + 2.3; CI = 0.5-4.1; p = 0.016) improved in the WFPB versus the control group. Fatigue, measured by the BFI, improved within the WFPB group for fatigue severity (M = 4.7 ± 2.5[SD] to 3.7 ± 2.3, p = 0.047) and fatigue at its worst (5.8 ± 2.8 to 4.4 ± 2.4, p = 0.011). CONCLUSIONS Significant dietary changes in this population are feasible and may improve QOL by improving treatment-related symptoms. Additional study is warranted. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT03045289. Registered 7 February 2017.
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Affiliation(s)
- Erin K Campbell
- Department of Public Health Sciences, University of Rochester Medical Center, 265 Crittenden Blvd, Rochester, NY, 14642, USA.
| | - Thomas M Campbell
- Department of Family Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Eva Culakova
- Department of Surgery, Cancer Control, University of Rochester Medical Center, Rochester, NY, USA
| | - Lisa Blanchard
- Department of Family Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Nellie Wixom
- Clinical Research Center, University of Rochester Medical Center, Rochester, NY, USA
| | - Joseph J Guido
- Department of Surgery, Cancer Control, University of Rochester Medical Center, Rochester, NY, USA
| | - James Fetten
- Memorial Sloan Kettering Cancer Center, Westchester, NY, USA
| | - Alissa Huston
- Department of Medicine, Hematology/Oncology, University of Rochester Medical Center, Rochester, NY, USA
| | - Michelle Shayne
- Department of Medicine, Hematology/Oncology, University of Rochester Medical Center, Rochester, NY, USA
| | - Michelle C Janelsins
- Department of Surgery, Cancer Control, University of Rochester Medical Center, Rochester, NY, USA
| | - Karen M Mustian
- Department of Surgery, Cancer Control, University of Rochester Medical Center, Rochester, NY, USA
| | - Richard G Moore
- Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY, USA
| | - Luke J Peppone
- Department of Surgery, Cancer Control, University of Rochester Medical Center, Rochester, NY, USA
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Wernhart S, Rassaf T. Relevance of Cardiovascular Exercise in Cancer and Cancer Therapy-Related Cardiac Dysfunction. Curr Heart Fail Rep 2024; 21:238-251. [PMID: 38696059 PMCID: PMC11090948 DOI: 10.1007/s11897-024-00662-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/03/2024] [Indexed: 05/14/2024]
Abstract
PURPOSE OF THE REVIEW Cancer therapy-related cardiac dysfunction (CTRCD) has been identified as a threat to overall and cancer-related survival. Although aerobic exercise training (AET) has been shown to improve cardiorespiratory fitness (CRF), the relationship between specific exercise regimens and cancer survival, heart failure development, and reduction of CTRCD is unclear. In this review, we discuss the impact of AET on molecular pathways and the current literature of sports in the field of cardio-oncology. RECENT FINDINGS Cardio-oncological exercise trials have focused on variations of AET intensity by using moderate continuous and high intensity interval training, which are applicable, safe, and effective approaches to improve CRF. AET increases CRF, reduces cardiovascular morbidity and heart failure hospitalization and should thus be implemented as an adjunct to standard cancer therapy, although its long-term effect on CTRCD remains unknown. Despite modulating diverse molecular pathways, it remains unknown which exercise regimen, including variations of AET duration and frequency, is most suited to facilitate peripheral and central adaptations to exercise and improve survival in cancer patients.
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Affiliation(s)
- Simon Wernhart
- Department of Cardiology and Vascular Medicine, West German Heart- and Vascular Center, University Hospital Essen, University Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany.
| | - Tienush Rassaf
- Department of Cardiology and Vascular Medicine, West German Heart- and Vascular Center, University Hospital Essen, University Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany
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Marcondes L, Silva LDS, de Oliveira Ribeiro C, Oshiro NN, Nogueira LDA, Guimaraes PRB, Kalinke LP. Anxiety Levels in Brazilian Women with Metastatic Breast Cancer Undergoing Palliative Chemotherapy: A Prospective Study. Asian Pac J Cancer Prev 2024; 25:1135-1141. [PMID: 38679972 PMCID: PMC11162730 DOI: 10.31557/apjcp.2024.25.4.1135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 04/20/2024] [Indexed: 05/01/2024] Open
Abstract
OBJECTIVE This study aimed to assess anxiety levels among women with metastatic breast cancer undergoing palliative chemotherapy. METHODS A descriptive, prospective study was conducted at an oncology hospital in southern Brazil from September 2021 to October 2022. A total of 123 adult women receiving outpatient palliative chemotherapy were included in the study. Anxiety levels were evaluated using the State-Trait Anxiety Inventory at baseline, the fifth week, and the eleventh week of treatment. Data were analyzed using Kruskal-Wallis, Mann-Whitney, and Multiple General Regression Models. RESULTS Women with advanced breast cancer had an average trait-anxiety score of 48.24±5.92. A progressive improvement in anxiety scores was observed throughout the treatment evaluation stages (44.90±5.89; 43.37±5.34; 42.58±5.75), with a significant difference between the evaluations (p=0.008). Significant correlations were found between trait-anxiety and work situation (p=0.010) and ovarian metastasis (p=0.022). The adjusted general regression model also showed statistical significance for baseline evaluation with offspring (p=0.045) and education level (p=0.041). CONCLUSION Women with breast cancer undergoing palliative chemotherapy exhibited high trait-anxiety scores, which decreased significantly over the course of treatment.
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Affiliation(s)
- Larissa Marcondes
- Postgraduate Program in Nursing, Federal University of Paraná, Curitiba, Paraná, Brazil.
| | | | | | - Natalia Naome Oshiro
- Postgraduate Program in Nursing, Federal University of Paraná, Curitiba, Paraná, Brazil.
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Bai L, Shi Y, Zhou S, Gong L, Zhang L, Tian J. Intervention model under the Omaha system framework can effectively improve the sleep quality and negative emotion of patients with mid to late-stage lung cancer and is a protective factor for quality of life. Am J Cancer Res 2024; 14:1278-1291. [PMID: 38590404 PMCID: PMC10998752 DOI: 10.62347/dydo4482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 01/18/2024] [Indexed: 04/10/2024] Open
Abstract
This study aims to evaluate the effects of Omaha System framework interventions on quality of life, emotional well-being, and sleep quality in 507 mid to late-stage lung cancer patients. Retrospectively, we compared data of 294 patients receiving conventional care (conventional group) with 213 patients undergoing Omaha System interventions (intervention group) from January 2019 to January 2023. Key indicators included quality of life (FACT-L), anxiety (SAS), depression (SDS), sleep quality (PSQI), hope (HHS), and dignity (PDI). Post-intervention, the intervention group showed a significant increase in FACT-L scores (P<0.001), indicating enhanced quality of life. There was a notable reduction in PSQI scores (P<0.001), suggesting improved sleep quality. Additionally, their anxiety and depression levels significantly decreased, as evidenced by lower SAS (P<0.001) and SDS scores (P<0.001). Logistic regression revealed that care nursing intervention scheme (P=0.007), age (P=0.008), marital status (P=0.002), per capita monthly household income (P=0.004), SAS after intervention (P=0.002), and PSQI after intervention (P=0.002) had a positive influence on quality of life. In conclusion, the Omaha System interventions markedly improved the quality of life, emotional state, and sleep in lung cancer patients.
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Affiliation(s)
- Ling Bai
- Department of Emergency, The Second Affiliated Hospital of Xi’an Jiaotong UniversityNo. 157 Xiwu Road, Xincheng District, Xi’an 710004, Shaanxi, China
| | - Yu Shi
- Department of Emergency, The Second Affiliated Hospital of Xi’an Jiaotong UniversityNo. 157 Xiwu Road, Xincheng District, Xi’an 710004, Shaanxi, China
| | - Shuru Zhou
- Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Xi’an Jiaotong UniversityNo. 157 Xiwu Road, Xincheng District, Xi’an 710004, Shaanxi, China
| | - Li Gong
- Department of Emergency, The Second Affiliated Hospital of Xi’an Jiaotong UniversityNo. 157 Xiwu Road, Xincheng District, Xi’an 710004, Shaanxi, China
| | - Lili Zhang
- Department of Emergency, The Second Affiliated Hospital of Xi’an Jiaotong UniversityNo. 157 Xiwu Road, Xincheng District, Xi’an 710004, Shaanxi, China
| | - Jiayi Tian
- Department of Nursing, Xi’an Innovation College of Yan’an UniversityNo. 2 Zaohe Road, Weiqu Street, Chang’an District, Xi’an 710004, Shaanxi, China
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Campbell EK, Campbell TM, Culakova E, Blanchard LM, Wixom N, Guido J, Fetten J, Huston A, Shayne M, Janelsins M, Mustian K, Moore RG, Peppone LJ. A Whole Food, Plant-Based Randomized Controlled Trial in Metastatic Breast Cancer: Feasibility, Nutrient, and Patient-Reported Outcomes. RESEARCH SQUARE 2023:rs.3.rs-3606685. [PMID: 38045318 PMCID: PMC10690314 DOI: 10.21203/rs.3.rs-3606685/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Purpose Quality of life (QOL) is among the most important outcomes for women with metastatic breast cancer (MBC) and it predicts survival. QOL is negatively impacted by cognitive impairment, fatigue, and weight gain. We assessed whether a whole food, plant-based (WFPB) diet promoting weight loss is feasible and might improve QOL. Methods Women with MBC on stable systemic treatments were randomized 2:1 to 1) WFPB dietary intervention (n = 21) or 2) usual care (n = 11) for 8 weeks. Participants attended weekly education visits and consumed an ad libitum WFPB diet (3 prepared meals/day provided). Patient-reported outcomes and 3-day food records were assessed at baseline and 8 weeks. The effects of WFPB diet on changes in outcomes were assessed by analysis of covariance model controlling for baseline. Results 20 intervention and 10 control participants completed the trial. Intervention participants were highly adherent to the WFPB diet (94.3% total calories on-plan). Intervention group nutrient intakes changed significantly including dietary fat (35.8-20.4% percent calories from fat, p < 0.001) and fiber content (22.1 to 40.8 grams fiber/1000 kcal, p < 0.001). Perceived cognitive function (FACT-Cog total + 16.1; 95% confidence interval [CI] = 0.8-31.7; p = 0.040) and emotional well-being (FACT-B emotional well-being subscale + 2.3; CI = 0.5-4.1; p = 0.016) improved in the WFPB versus the control group. Fatigue, measured by the BFI, improved within the WFPB group for fatigue severity (M = 4.7 ± 2.5[SD] to 3.7 ± 2.3, p = 0.047) and fatigue at its worst (5.8 ± 2.8 to 4.4 ± 2.4, p = 0.011). Conclusions Significant dietary changes in this population are feasible and may improve QOL by improving treatment-related symptoms. Additional study is warranted. Trial registration ClinicalTrials.gov identifier: NCT03045289. Registered 7 February 2017.
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Sweegers MG, Depenbusch J, Kampshoff CS, Aaronson NK, Hiensch A, Wengström Y, Backman M, Gunasekara N, Clauss D, Pelaez M, Lachowicz M, May AM, Steindorf K, Stuiver MM. Perspectives of patients with metastatic breast cancer on physical exercise programs: results from a survey in five European countries. Support Care Cancer 2023; 31:694. [PMID: 37955790 PMCID: PMC10643348 DOI: 10.1007/s00520-023-08124-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 10/18/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND To successfully implement exercise programs for patients with metastatic breast cancer (MBC), services and patient education should consider patients' knowledge, preferences, values, and goals. Hence, gaining insight into their perspectives on exercise and exercise programming is important. METHOD In this cross-sectional survey, we recruited patients with MBC from the Netherlands, Germany, Poland, Spain, and Sweden. We collected data on patients' knowledge and skills about exercise and outcome expectations. We identified barriers to and facilitators of participation in exercise programs, and patients' preferences for program content and modes of exercise delivery. RESULTS A total of 420 patients participated in the survey. Respondents were, on average, 56.5 years old (SD 10.8) and 70% had bone metastases. Sixty-eight percent reported sufficient skills to engage in aerobic exercise, but only 35% did so for resistance exercise. Respondents expected exercise to have multiple physical benefits, but a few patients expected exercise to worsen their pain (5%). Not having access to an exercise program for cancer patients (27%), feeling too tired (23%), and/or weak (23%) were the most often reported barriers. Facilitators for exercising regularly were previous positive physical (72%) and emotional (68%) experiences with exercising, and receiving personalized advice from a physiotherapist or sport/fitness instructor (62%). Patients were most interested in walking and preferred exercising at a public gym, although there were differences by country. Fifty-seven percent did not know whether their insurance company reimburses exercise programs and only 9% would be willing to pay more than €50 per month to participate. CONCLUSION A large percentage of patients with MBC lack the skills to engage in regular exercise as recommended by exercise guidelines for people with cancer. Patients may benefit from personalized advice and appropriate training facilities to overcome barriers. When implementing exercise interventions, attention should be given to reimbursement and the relatively low willingness-to-pay.
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Affiliation(s)
- Maike G Sweegers
- Center for Quality of Life, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
- Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Johanna Depenbusch
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Caroline S Kampshoff
- Center for Quality of Life, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
- Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Neil K Aaronson
- Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Anouk Hiensch
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Yvonne Wengström
- Division of Nursing, Department of Neurobiology, Care Sciences, and Society, Karolinska Institute, and Karolinska Comprehensive Cancer Center, Karolinska University Hospital, Stockholm, Sweden
| | - Malin Backman
- Division of Nursing, Department of Neurobiology, Care Sciences, and Society, Karolinska Institute, and Karolinska Comprehensive Cancer Center, Karolinska University Hospital, Stockholm, Sweden
| | - Nadira Gunasekara
- Department for Molecular and Cellular Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - Dorothea Clauss
- Department for Molecular and Cellular Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - Mireia Pelaez
- R&D department, Fundación Onkologikoa, Donostia-San Sebastian, Spain and Faculty of Health Sciences, Universidad Europea del Atlántico, Santander, Spain
| | - Milena Lachowicz
- Department of Oncology and Radiotherapy, Medical University of Gdańsk, Gdańsk, Poland
| | - Anne M May
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Karen Steindorf
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Martijn M Stuiver
- Center for Quality of Life, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
- Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
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PELAEZ MIREIA, STUIVER MARTIJNM, BROEKMAN MARIKE, SCHMITZ KATHRYNH, ZOPF EVAM, CLAUSS DOROTHEA, WENGSTRÖM YVONNE, ROSENBERGER FRIEDERIKE, STEINDORF KAREN, URRUTICOECHEA ANDER, MAY ANNEM. Early Detection of Brain Metastases in a Supervised Exercise Program for Patients with Advanced Breast Cancer: A Case Report. Med Sci Sports Exerc 2023; 55:1745-1749. [PMID: 37170950 PMCID: PMC10487390 DOI: 10.1249/mss.0000000000003213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
INTRODUCTION Around 25% of metastatic breast cancer (mBC) patients develop brain metastases, which vastly affects their overall survival and quality of life. According to the current clinical guidelines, regular magnetic resonance imaging screening is not recommended unless patients have recognized central nervous system-related symptoms. PATIENT PRESENTATION The patient participated in the EFFECT study, a randomized controlled trial aimed to assess the effects of a 9-month structured, individualized and supervised exercise intervention on quality of life, fatigue and other cancer and treatment-related side effects in patients with mBC. She attended the training sessions regularly and was supervised by the same trainer throughout the exercise program. In month 7 of participation, her exercise trainer detected subtle symptoms (e.g., changes in movement pattern, eye movement or balance), which had not been noticed or reported by the patient herself or her family, and which were unlikely to have been detected by the oncologist or other health care providers at that point since symptoms were exercise related. When suspicion of brain metastases was brought to the attention of the oncologist by the exercise trainer, the response was immediate, and led to early detection and treatment of brain metastases. CONCLUSION AND CLINICAL IMPLICATIONS The brain metastases of this patient were detected earlier due to the recognition of subtle symptoms detected by her exercise trainer and the trust and rapid action by the clinician. The implementation of physical exercise programs for cancer patients requires well-trained professionals who know how to recognize possible alterations in patients and also, good communication between trainers and the medical team to enable the necessary actions to be taken.
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Affiliation(s)
- MIREIA PELAEZ
- R&D Department, Fundación Onkologikoa, Donostia-San Sebastian, SPAIN
| | - MARTIJN M. STUIVER
- Center for Quality of Life and Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, THE NETHERLANDS
- Center of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, THE NETHERLANDS
| | - MARIKE BROEKMAN
- Department of Neurosurgery, Haaglanden Medical Center, The Hague, the Netherlands and Department of Neurosurgery, Leiden University Medical Center, Leiden, THE NETHERLANDS
| | | | - EVA M. ZOPF
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, AUSTRALIA
- Cabrini Cancer Institute, Department of Medical Oncology, Cabrini Health, Malvern, Victoria, AUSTRALIA
| | - DOROTHEA CLAUSS
- Department of Molecular and Cellular Sports Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne, Cologne, GERMANY
| | | | - FRIEDERIKE ROSENBERGER
- Working Group Exercise Oncology, Department of Medical Oncology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, Heidelberg, GERMANY
| | - KAREN STEINDORF
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, GERMANY
| | | | - ANNE M. MAY
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, THE NETHERLANDS
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Depenbusch J, Sweegers MG, Aaronson NK, Wengström Y, Backman M, Arraras JI, Schranz M, Büchler B, Lachowicz M, May AM, Steindorf K, Stuiver MM. PERSPECTIVEs on supervised exercise programs in people with metastatic breast cancer- a qualitative study in four European countries. Support Care Cancer 2023; 31:281. [PMID: 37074497 PMCID: PMC10115708 DOI: 10.1007/s00520-023-07739-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 04/06/2023] [Indexed: 04/20/2023]
Abstract
PURPOSE Supervised exercise is a potentially promising supportive care intervention for people with metastatic breast cancer (MBC), but research on the patients' perspective is limited. The aim of the current focus group study was to gain an in-depth understanding of MBC patients' perceived barriers, facilitators, and preferences for supervised exercise programs. METHODS Eleven online focus groups with, in total, 44 MBC patients were conducted in four European countries (Germany, Poland, Spain, Sweden). Main topics of the semi-structured discussions covered attitudes towards participation in supervised exercise programs, perceived facilitators, experienced barriers, and exercise preferences. Interviews were transcribed verbatim, translated into English, and coded based on a preliminary coding framework, supplemented by themes emerging during the sessions. The codes were subsequently examined for interrelations and re-organized into overarching clusters. RESULTS Participants had positive attitudes towards exercise, but experienced physical limitations and insecurities that inhibited their participation. They expressed a strong desire for exercise tailored to their needs, and supervision by an exercise professional. Participants also highlighted the social nature of group training as an important facilitator. They had no clear preference for exercise type, but rather favored a mixture of different activities. Flexible training modules were considered helpful to increase exercise program adherence. CONCLUSIONS MBC patients were generally interested in supervised exercise programs. They preferred group exercise that facilitates social interaction, but also expressed a need for individualized exercise programs. This suggests the relevance to develop flexible exercise programs that are adjusted to the individual's needs, abilities, and preferences.
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Affiliation(s)
- Johanna Depenbusch
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany
| | - Maike G Sweegers
- Center for Quality of Life, Netherlands Cancer Institute, Amsterdam, The Netherlands
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Neil K Aaronson
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Yvonne Wengström
- Division of Nursing, Department of Neurobiology, Care Sciences, and Society, Karolinska Institute and Karolinska Comprehensive Cancer Center, Karolinska University Hospital, Stockholm, Sweden
| | - Malin Backman
- Division of Nursing, Department of Neurobiology, Care Sciences, and Society, Karolinska Institute and Karolinska Comprehensive Cancer Center, Karolinska University Hospital, Stockholm, Sweden
| | - Juan I Arraras
- Oncology Departments, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Melanie Schranz
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Britta Büchler
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Milena Lachowicz
- Department of Oncology and Radiotherapy, Medical University of Gdańsk, Gdańsk, Poland
| | - Anne M May
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Karen Steindorf
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany
| | - Martijn M Stuiver
- Center for Quality of Life, Netherlands Cancer Institute, Amsterdam, The Netherlands.
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands.
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