Mocht u kanker-actueel de moeite waard vinden en ons willen ondersteunen om kanker-actueel online te houden dan kunt u ook via uw lidmaatschapsnummer korting krijgen bij enkele bedrijven.

En raadpleeg ook literatuurlijst niet-toxische middelen en behandelingen specifiek bij borstkanker van arts-bioloog drs. Engelbert Valstar

En zie ook onder preventie bij borstkanker bij fysieke activiteiten

19 september 2018: Zie ook deze studie: Physical Activity and Survival After Breast Cancer Diagnosis die de meerwaarde van fysieke activiteit bij borstkanker aantoont. Zoals meerdere studies dit aantonen, zie ook onze literatuurlijst specifiek bij borstkanker van arts-bioloog drs. Engelbert Valstar

17 januari 2017: Bron: Cancer Causes Control. 2011 Mar; 22(3): 427–435.

Fysieke activiteit zoals bewust bewegen en sporten heeft grote invloed op het risico aan overlijden voor borstkankerpatiënten die 1 jaar na hun behandelingen nog in leven zijn. Borstkankerpatienten die bij de start van de studie al veel actief waren en dit door bleven zetten tijdens en na hun behandelingen hadden 52% minder risico op overlijden in vergelijking met borstkankerpatiënten die weinig fysiek actief waren voor en tijdens hun behandelingen en daar ook niets aan deden. Vrouwen die bij de start weinig actief waren maar na hun behandelingen wel fysiek actiever werden reduceerden daarmee hun kans op overlijden met 35% tot 42%. Opvallend was dat de vrouwen die niets veranderden in hun fysieke activiteiten na 1 jaar ook geen wezenlijke veranderingen zagen in hun kans op overlijden. Dus borstkankerpatiënten die toch al wel fysiek actief waren bleven zelfde minder risico op overlijden van ca. 50% te hebben in vergelijking met borstkankerpatienten die weinig fysiek actief waren zowel bij de start als daarna daar niets aan veranderden.

Dit betekent dat op elk moment na behandeling van borstkanker het goed is om fysiek actiever te worden en bv. mee te gaan doen aan bewegingsprogramma's die overal worden aangeboden. Of gewoon zelf meer gaan bewegen, wandelen, sporten enz. Het heeft echt gote invloed op de overall overleving.

Hier de grafiek in overall overleving: (tekst gaat onder grafiek en tabellen verder)

Hier achtereenvolgens wat tabellen uit de studie:

Table 1

Baseline characteristics of WHEL participants (N = 2,361) stratified by adherence to physical activity guidelines

	Meeting guidelines		Not meeting guidelines		p for difference
	N	Mean (SD) or %	N	Mean (SD) or %	p for difference
Age, mean (SD)	1,175	54.3 (9.1)	1,186	53.5 (8.6)	.04
Age group (%)
<44	154	13.1%	155	13.1%	.02
45–54	434	36.9%	499	42.1%
55–65	411	35.0%	395	33.3%
>65	176	15.0%	137	11.6%
Race/ethnicity
Non-Hispanic White	1,055	89.8%	988	83.3%	<.0001
African-American	23	2.0%	47	4.0%
Hispanic-American	40	3.4%	70	5.9%
Asian-American	37	3.2%	45	3.8%
Other	20	1.7%	36	3.0%
College graduate (%)	746	63.5%	562	47.4%	<.0001
BMI, mean kg/m² (SD)	1,175	25.6 (4.7)	1,186	28.5 (6.6)	<.0001
BMI category (%)
<25.0	617	52.5%	422	35.6%	<.0001
25–29.9	375	31.9%	361	30.4%
≥30.0	183	15.6%	403	34.0%
Menopausal status
Post-menopausal	934	79.5%	970	81.8%	<.0001
Pre-menopausal	125	10.6%	107	9.0%
Peri-menopausal	114	9.7%	109	9.2%
Hot flashes (%)	349	29.7%	357	30.1%	.98
Time since diagnosis
<2 years	638	54.3%	652	55.0%	.74
2–4 years	537	45.7%	534	45.0%
Tumor stage (%)
I	514	43.7%	443	37.4%	.003
IIA	378	32.2%	396	33.4%
IIB	121	10.3%	172	14.5%
IIIA	131	11.2%	135	11.4%
IIIC	31	2.6%	40	3.4%
Chemotherapy (%)	759	64.6%	852	71.8%	.0008
Radiation (%)	720	61.3%	734	61.9%	.95
# positive nodes (%)
0	730	62.1%	671	56.6%	.03
1–3	304	25.9%	365	30.8%
>3	141	12.9%	149	12.6%
Anti-estrogen use (%)	836	71.5%	759	65.0%	.0007
Smoking status	636	54.1%	663	55.9%	.01
Never	508	43.2%	468	39.5%
Former	31	2.6%	55	4.6%
Current
Alcohol (%)
0	339	28.9%	380	32.1%	.21
1–19 g/day	786	67.0%	761	64.3%
20+ g/day	48	4.1%	42	3.6%

En hier de tabel met de verschillen in kans op overlijden en recidief verdeeld in vier kwarten:

Table 2

Adjusted analyses for physical activity, change in activity level additional breast cancer events, and death from all causes in a cohort of women with a history of breast cancer (n = 2,361)

Physical activity (MET-h/week)	N	n	Additional breast cancer events			n	All-cause mortality		p (trend)
Physical activity (MET-h/week)	N	n	HR (95% CI)	p	p (trend)	n	HR (95% CI)	p	p (trend)
Baseline activity level
Total PA (continuous)	2,361	295	0.99 (0.99, 1.00)	.21		163	0.98 (0.96, 0.99)	.003
Total PA (categorical)
Quintile 1 [0–2.5]	481	69	Reference		.58	43	Reference		.08
Quintile 2 (2.5–7.5]	485	65	0.91 (0.64, 1.28)	.58		43	1.01 (0.66, 1.55)	.97
Quintile 3 (7.5–14.9]	451	53	0.85 (0.59, 1.22)	.38		32	0.85 (0.53, 1.35)	.48
Quintile 4 (14.9–24.7]	472	60	0.97 (0.68, 1.39)	.87		27	0.75 (0.46, 1.23)	.26
Quintile 5 (24.7–107]	472	48	0.74 (0.50, 1.10)	.13		18	0.47 (0.26, 0.84)	.01
Mod-vig PA (continuous)	2,361	295	0.99 (0.98, 1.00)	.13		163	0.98 (0.96, 0.99)	.002
Mod-vig PA (categorical)
Quintile 1 [0–1.3]	474	70	Reference		.30	45	Reference		.02
Quintile 2 (1.3–6.3]	473	64	0.97 (0.68, 1.36)	.84		38	1.00 (0.64, 1.55)	.99
Quintile 3 (6.3–12.5]	474	64	0.98 (0.69, 1.38)	.89		41	0.99 (0.64, 1.54)	.96
Quintile 4 (12.5–22.9]	470	53	0.91 (0.62, 1.31)	.60		24	0.71 (0.42, 1.19)	.19
Quintile 5 (22.9–107]	470	44	0.67 (0.45, 1.00)	.04		15	0.39 (0.21, 0.72)	.003
Meeting PA guideline^a
No	1,186	161	Reference			102	Reference
Yes	1,175	134	0.89 (0.70, 1.14)	.36		61	0.65 (0.47, 0.91)	.01
Baseline-to-1-year change
Meeting PA guideline
No → No	899	112	Reference			75	Reference
No → Yes	287	49	1.44 (1.02, 2.03)	.04		27	1.21 (0.77, 1.90)	.42
Yes → No	213	31	1.22 (0.81, 1.83)	.34		17	1.04 (0.61, 1.77)	.89
Yes → Yes	962	103	0.93 (0.70, 1.24)	.62		44	0.60 (0.40, 0.88)	.01
Δ Total PA (continuous)	2,361	295	1.01 (1.00, 1.02)	.26		163	1.00 (0.98, 1.01)	.59
Δ Total PA (categorical)
Quintile 1 [−68.8, −5.5]	474	52	Reference		.60	23	Reference		.70
Quintile 2 (−5.5, −0.3]	473	58	0.95 (0.64, 1.42)	.81		39	1.24 (0.71, 2.16)	.45
Quintile 3 (−0.3, 2.3]	474	65	1.24 (0.82, 1.87)	.31		40	1.23 (0.69, 2.20)	.49
Quintile 4 (2.3, 7.5]	470	57	1.10 (0.73, 1.65)	.66		35	1.17 (0.66, 2.09)	.60
Quintile 5 (7.5, 92.3]	470	63	1.19 (0.80, 1.77)	.39		26	0.89 (0.49, 1.64)	.71
Δ Mod-vig PA (continuous)	2,361	295	1.01 (1.00, 1.02)	.23		163	0.99 (0.98, 1.01)	.48
Δ Mod-vig PA (categorical)^b
Quintile 1 [−63.8, −5.3]	476	54	Reference		.58	24	Reference		.84
Quintile 2 (−5.3, 0]	805	99	0.95 (0.65, 1.40)	.76		69	1.17 (1.69, 1.97)	.56
Quintile 3 (0, 1.3]	147	18	1.00 (0.57, 1.75)	.99		9	0.90 (0.40, 2.02)	.81
Quintile 4 (1.3, 7)	563	55	0.99 (0.66, 1.49)	.97		32	1.06 (0.60, 1.89)	.84
Quintile 5 [7, 92.3]	470	69	1.23 (0.83, 1.80)	.30		29	0.92 (0.51, 1.66)	.78

All analyses adjusted for age at randomization, race, fruit and vegetable consumption, BMI at randomization, menopausal status, tumor type, tumor grade, tumor stage, anti-estrogen use, clinical site, time from diagnosis to randomization, hot flashes, and study group

^aTo approximate guideline of 150 min/wk, we used a cutoff of 10 MET-h/week of moderate-to-vigorous PA

^bQuintiles are uneven due to a large number of participants with change scores of exactly 0

Het volledige studierapport: Physical activity, additional breast cancer events, and mortality among early-stage breast cancer survivors: findings from the WHEL Study is gratis in te zien.

Aan andere meta analyse van 33 gerandomiseerde studies inclusief 2659 borstkankerpatienten: Effects of exercise intervention in breast cancer survivors: a meta-analysis of 33 randomized controlled trails recent gepubliceerd bevestigd de conclusies uit bovenvermelde studie:

Conclusie:

Onze studie suggereert dat het vergroten van fysieke activiteiten voor borstkankerpatienten een positieve invloed heeft op de overall overleving en kwaliteit van leven. Daarom is bevorderen van fysieke activiteiten voor borstkankerpatienten aan te raden.

Hieronder de abstracten van de studies met referentielijst:

Higher baseline (post-treatment) physical activity was associated with improved survival. However, change in activity over the following year was not associated with outcomes. These data suggest that long-term physical activity levels are important for breast cancer prognosis.

. 2011 Mar; 22(3): 427–435.

Published online 2010 Dec 24. doi: 10.1007/s10552-010-9714-3

PMCID: PMC3042101

Physical activity, additional breast cancer events, and mortality among early-stage breast cancer survivors: findings from the WHEL Study

Lisa A. Cadmus Bertram,¹ Marcia L. Stefanick,² Nazmus Saquib,¹ Loki Natarajan,¹ Ruth E. Patterson,¹ Wayne Bardwell,¹ Shirley W. Flatt,¹ Vicky A. Newman,¹ Cheryl L. Rock,¹ Cynthia A. Thomson,³ and John P. Pierce¹

Abstract

Objective

Research suggests that physical activity is associated with improved breast cancer survival, yet no studies have examined the association between post-diagnosis changes in physical activity and breast cancer outcomes. The aim of this study was to determine whether baseline activity and 1-year change in activity are associated with breast cancer events or mortality.

Methods

A total of 2,361 post-treatment breast cancer survivors (Stage I–III) enrolled in a randomized controlled trial of dietary change completed physical activity measures at baseline and one year. Physical activity variables (total, moderate–vigorous, and adherence to guidelines) were calculated for each time point. Median follow-up was 7.1 years. Outcomes were invasive breast cancer events and all-cause mortality.

Results

Those who were most active at baseline had a 53% lower mortality risk compared to the least active women (HR = 0.47; 95% CI: 0.26, 0.84; p = .01). Adherence to activity guidelines was associated with a 35% lower mortality risk (HR = 0.65, 95% CI: 0.47, 0.91; p < .01). Neither baseline nor 1-year change in activity was associated with additional breast cancer events.

Conclusions

Higher baseline (post-treatment) physical activity was associated with improved survival. However, change in activity over the following year was not associated with outcomes. These data suggest that long-term physical activity levels are important for breast cancer prognosis.

Discussion

We found a robust association between level of physical activity at baseline and breast cancer mortality. We did not observe a statistically significant association between baseline physical activity and additional breast cancer events, suggesting that the results for mortality may have been driven by prognosis after an additional event (including a possible effect on type of recurrence) rather than a direct reduction in recurrences or new primaries. Although our analyses used all-cause rather than breast cancer–specific mortality, more than 80% of deaths in the WHEL Study were due to breast cancer [16]; therefore, the observed association between higher baseline physical activity and lower mortality was largely driven by a reduction in breast cancer–related deaths.

Contrary to expectations, changes in physical activity from baseline to 1 year were not associated with survival. It is possible that our 1-year measure of behavior change did not provide a sufficiently long period for the metabolic and physiologic changes associated with increased or decreased physical activity to impact cancer outcomes. Likewise, we observed that the majority of women who adopted physical activity between enrollment and year 1 did not maintain their new activity level over the long term.

Our findings with regard to mortality are generally consistent with previous reports [7, 8]. Similar to the Nurses’ Health Study, the Collaborative Women’s Longevity Study, and the Life after Cancer Epidemiology cohorts, we found that a substantial amount of physical activity was required to improve breast cancer outcomes. An exception is the HEAL Study, which observed a benefit for even very modest levels of physical activity. There are a number of potential explanations for between-study differences in the level of physical activity that is associated with reduced mortality. The cohorts vary somewhat with regard to clinical and other participant characteristics. Perhaps more importantly, the specific approach to physical activity measurement and quantification also varies. For example, the Canadian study assessed a wide variety of physical activity settings (recreational, household, occupational) and categorized results by setting type, whereas some other studies focused only on recreational or leisure-time activity and categorized results by intensity (mild, moderate, vigorous, total). Due to these variations, it is difficult to directly compare studies with regard to the dose of physical activity that is necessary to observe a protective effect on outcomes.

A strength of the WHEL Study was that we assessed physical activity at two time points, allowing us to assess the potential effect of changes in physical activity on breast cancer outcomes. Other strengths included excellent cohort maintenance (health status confirmed at study end confirmed for >95% of participants) and a multi-site, geographically diverse sample of breast cancer survivors.

A limitation of the WHEL Study was the use of self-report of physical activity, which is known to include random error. However, the study used a standardized physical activity questionnaire that was validated against both a physical activity recall procedure and an objective physical activity measure (7-day accelerometer) within a subset of WHEL Study participants [22]. The physical activity questionnaire had good agreement (73%) with the accelerometer measure and had 100% sensitivity for meeting the physical activity guideline. Another limitation is that the WHEL cohort was a fairly racially and ethnically homogenous sample. Thus, findings may not apply to women who are not non-Hispanic White.

Consistent with previous reports, our findings suggest that adherence to physical activity guidelines may improve overall survival among breast cancer survivors. We also present the first examination of post-diagnosis change in physical activity. We observed a 42% reduction in risk mortality among those women who were adhering to physical activity guidelines at both baseline and 1-year relative to those who did not meet the guideline at either time point. However, we did not find that 1-year change in physical activity was associated with breast cancer mortality. These findings highlight the importance of sustained post-diagnosis physical activity and suggest that a 1-year period may be too short for even relatively large increases in physical activity to affect breast cancer outcomes. Long-term exposure appears to be the most important determinant of the relationship between physical activity and breast cancer mortality. To improve breast cancer outcomes, women should be encouraged to maintain an active lifestyle over time, aiming to meet or exceed current physical activity guidelines. Toward this goal, physical activity promotion should be incorporated into breast cancer prevention and control programs. Future studies are needed to further examine the potential effect of long-term post-diagnosis change in physical activity on breast cancer outcomes.

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Acknowledgments

The Women’s Healthy Eating and Living (WHEL) Study was initiated with the support of the Walton Family Foundation and continued with funding from National Cancer Institute Grant CA 69375. Some of the data were collected from General Clinical Research Centers, National Institute of Health grants M01-RR00070, M01-RR00079, and M01-RR00827.

Open Access This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

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Our study suggested that exercise intervention was beneficial to breast cancer survivors. Therefore, exercise should be recommended to this patient group.

. 2016; 9: 2153–2168.

Published online 2016 Apr 13. doi: 10.2147/OTT.S97864

PMCID: PMC4835133

Effects of exercise intervention in breast cancer survivors: a meta-analysis of 33 randomized controlled trails

Guoqing Zhu,¹ Xiao Zhang,¹ Yulan Wang,¹ Huizi Xiong,² Yinghui Zhao,¹ and Fenyong Sun¹

Abstract

Background

Exercise is associated with favorable outcomes in cancer survivors. The purpose of this meta-analysis is to comprehensively summarize the effects of exercise intervention in breast cancer survivors.

Methods

A systematic search of PubMed, Elsevier, and Google scholar was conducted up to March 2015. References from relevant meta-analyses and reviews were also checked.

Results

Thirty-three randomized controlled trials were included in this meta-analysis, including 2,659 breast cancer survivors. Compared with the control group, quality of life was significantly improved in exercise intervention group, especially in mental health and general health subscales of short form 36 questionnaire, as well as emotion well-being and social well-being subscales of the Functional Assessment of Cancer Therapy. Besides, exercise alleviated the symptoms of depression and anxiety in the exercise group. Furthermore, exercise was also associated with positive outcomes in body mass index, lean mass, and muscle strength. In addition, the serum concentration of insulin, insulin-like growth factor-II, and insulin-like growth factor binding protein-1 was significantly reduced in exercise intervention group. However, based on the current data of this meta-analysis, there were no significant differences in sleep dysfunction or fatigue between groups.

Conclusion

Our study suggested that exercise intervention was beneficial to breast cancer survivors. Therefore, exercise should be recommended to this patient group.

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