Patients newly diagnosed with breast cancer often experience symptoms such as fatigue, depression, and poor sleep quality even before treatments such as chemotherapy or radiation. However, recommendations for managing symptoms often ignore the immediate period after diagnosis and instead focus on symptoms caused by cancer treatment.
“Breast cancer can begin to impact a patient’s symptoms and quality of life even before difficult treatment begins,” says Kelly Corneya, professor in the Department of Kinesiology, Sport and Recreation.
Dr. Corneya led a study investigating the association between patients’ fitness levels within 90 days of diagnosis and patient-reported symptoms of fatigue, depression, and poor sleep quality. The patients in the study had undergone initial surgery but had not yet started additional treatments, such as chemotherapy, radiation therapy, or hormone therapy. Approximately 51.5% of study participants reported poor sleep quality, 26.5% experienced significant fatigue, and 10.4% experienced moderate depression.
These symptoms not only affect patients immediately after diagnosis, but can also negatively impact treatment outcomes and survival rates, so they are targeted in what Kurneya calls “continuation of cancer treatment.” This is an important element.
“Patients have a long treatment road ahead of them, and this can be very daunting for them. They have high anxiety and fear about how these treatments will make them feel. There are many challenges during the newly diagnosed period, as patients may be infected.
The study looked at health-related fitness in three main categories: cardiorespiratory fitness, maximal strength and endurance, and body composition. While many other studies have used relatively simple assessment methods, Courneya chose gold standard measures for each category to gain a more accurate perspective on how to better manage symptoms. did.
Peak cardiorespiratory fitness (referred to as VO2 max) is measured using gas exchange analysis rather than a simple treadmill test, and replaces a standard hand-grip dynamometer to more accurately measure muscle strength and endurance. A maximal strength chest test and a leg press test were performed. Also, while most other studies looked at height, weight, and BMI to determine body composition, this recent study used DEXA (dual X-ray absorptiometry) scans. This is a more accurate approach that allows you to measure everything from lean body mass (total body weight, not including weight). from fat content) to bone mineral content (a measure of bone health).
Patients with low VO2 peaks are more likely to report all three symptoms, so addressing specific fitness metrics can be highly beneficial for this patient population, Corneja says.
“Cardiorespiratory fitness is very important, and this study found that patients in the top third or quartile of fitness were at lower risk.”
Researchers also found that patients with weaker upper body strength were more likely to report significant fatigue, and patients with higher body weight were more likely to report poor sleep quality.
In addition to using more comprehensive fitness metrics, Courneya’s study included data from a larger number of patients than is typical for this type of study: the 1,458 patients who participated in the Alberta Moving Beyond Breast Cancer (AMBER) Cohort Study. data was used.
“About 1,500 breast cancer patients is a very large cohort, and these fitness metrics are the gold standard,” Courneya says. “Therefore, we will be able to consider many questions that previous studies have not been able to answer.”
The results of this study could help healthcare professionals create personalized exercise programs for each patient that target the symptoms that bother them most.
“We thought that with this comprehensive fitness assessment, we could identify the type, amount, and intensity of exercise that would be best to treat a specific condition,” Corneja says.
Kurneya and his collaborators plan to follow this particular cohort through all stages of the cancer treatment continuum. They plan to follow this paper with additional studies that will evaluate patients at one, three, and five years after diagnosis. Next, they plan to see how the fitness level of the cohort affects treatment duration.
“Previous studies have found that patients who are healthier and more fit when they start these treatments are more likely to complete their chemotherapy and finish their treatment on time.”
Corneya said that patients often don’t have much time to build up their fitness between diagnosis and the start of treatment, so building up their fitness while they’re healthy is invaluable. He points out that building fitness doesn’t just help prevent some diseases. His research shows it can also help reduce symptoms in newly diagnosed patients.
“Even though exercise and fitness may not prevent breast cancer, they can help you get in the best possible shape and health to survive breast cancer diagnosis, treatment, and recovery.”
