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The latest international evidence-based guidelines include recommendations on physical exercise both during and after curative cancer treatment to reduce side effects. However, these same guidelines acknowledge that, in the context of metastatic breast cancer (MBC), evidence of the effects of physical activity is lacking.

The latest international evidence-based guidelines include recommendations on physical exercise both during and after curative cancer treatment to reduce side effects. However, these same guidelines recognize that, in the context of metastatic breast cancer (MBC), Evidence of the effects of physical activity is scarceso there is insufficient material to develop recommendations in this field.

Patients, meanwhile, experience debilitating side effects Disease- and treatment-related side effects, including fatigue, decreased fitness, anxiety and depression, neuropathy and pain, among others, may be addressed with structured exercise, suggests a large-scale study published in Nature Medicine that investigates the effects of exercise in this patient population and builds on a growing body of research showing that such activity may be a valuable adjunct to cancer treatment, in this case breast cancer.

“Breast cancer treatment has a negative impact on people’s lives, causing serious health problems that compromise physical and mental well-being, including fatigue, nausea, pain and shortness of breath. Supervised exercise during palliative treatment of metastatic breast cancer was found to have significant beneficial effects on patients’ fatigue, quality of life and common side effects.“, indicated the Dr. Eva Zopf, from Australian Catholic University and the Mary MacKillop Institute for Health Research, who led the study in collaboration with the Peter MacCallum Cancer Centre, Melbourne Health and Cabrini Health. At the international level, it was led by the prof. Anne May, from the Julius Center for Health Sciences and Primary Care at the University Medical Center of the Netherlands.

Recommended activity

“Previous research has focused primarily on the effects of exercise programs in patients with less advanced cancer and found them to be beneficial (particularly increasing patients’ energy levels and improving their quality of life), but patients with metastatic disease have not been rigorously studied to see if they experience the same benefits.“, Dr. Zopf added.

Study participants were given a fitness tracker and generic exercise advice, but 178 patients were randomly assigned to a nine-month supervised exercise program that included balance, resistance and aerobic exercises.

The first six months included two supervised one-hour exercise sessions per week. In the last three months, one supervised session was replaced by one unsupervised exercise session, which was supported by an exercise app. Patients exercised at moderate to high intensity levels under the supervision of qualified exercise physiologists.

“Patients said they not only felt better and stronger being part of the trial, but it also helped them better understand what they needed to do in terms of exercise.”according to Dr. Zopf.

“This important randomized trial has shown that regular supervised exercise also significantly reduces fatigue and improves quality of life in patients with metastatic breast cancer. In addition, beneficial effects of exercise on physical functioning and pain were observed.”added the prof. Prue Francis, co-author of the study and co-clinical director of Breast Medical Oncology at the Peter MacCallum Cancer Centre.

Researchers have therefore recommended that Aerobic exercises are routinely prescribed and resistance monitored for patients with metastatic breast cancer as part of supportive cancer care.