title: Patient Activation through Counseling and Exercise – Acute Leukemia (PACE-AL) – a randomized controlled trial Direct improvement of quality of life using a tailored quality of life diagnosis and therapy pathway: randomised trial in 200 women with breast cancer Adherence to moderate-intensity exercise during breast cancer therapy. Recovery of overall exercise ability, quality of life, and continence after 12-week combined exercise intervention in elderly patients who underwent radical prostatectomy: a randomized controlled study. Home-based exercise to alleviate fatigue and improve functional capacity among breast cancer survivors. A randomized trial of a lifestyle intervention in obese endometrial cancer survivors: quality of life outcomes and mediators of behavior change Increased telomerase activity and comprehensive lifestyle changes: a pilot study. Physical activity for men receiving androgen deprivation therapy for prostate cancer: benefits from a 16-week intervention Structured exercise improves physical functioning in women with stages I and II breast cancer: results of a randomized controlled trial. Changes in prostate gene expression in men undergoing an intensive nutrition and lifestyle intervention Exercise program improves therapy-related side-effects and quality of life in lymphoma patients undergoing therapy. Multimodal exercise improves quality of life of women being treated for breast cancer, but at what cost? Randomized trial with economic evaluation Effects of an exercise and hypocaloric healthy eating program on biomarkers associated with long-term prognosis after early-stage breast cancer: a randomized controlled trial Randomised controlled trial to determine the benefit of daily home-based exercise in addition to self-care in the management of breast cancer-related lymphoedema: a feasibility study Upper limb progressive resistance training and stretching exercises following surgery for early breast cancer: a randomized controlled trial Weight lifting in women with breast-cancer-related lymphedema. [Effects of a home-based exercise program for patients with stomach cancer receiving oral chemotherapy after surgery]. Randomized Controlled Trial of a Behavior Change Intervention to Increase Physical Activity and Quality of Life in Prostate Cancer Survivors A pilot randomized controlled trial of a commercial diet and exercise weight loss program in minority breast cancer survivors. Recreational physical activity and risk of prostate cancer: A prospective population-based study in Norway (the HUNT study). Inflammation and psychosocial factors mediate exercise effects on sleep quality in breast cancer survivors: pilot randomized controlled trial. Determinants of adherence to exercise in women treated for breast cancer. Survivors of uterine cancer empowered by exercise and healthy diet (SUCCEED): a randomized controlled trial. Effectiveness of water physical therapy on pain, pressure pain sensitivity, and myofascial trigger points in breast cancer survivors: a randomized, controlled clinical trial. Intensive lifestyle changes may affect the progression of prostate cancer. Lifestyle Intervention in Men with Advanced Prostate Cancer Receiving Androgen Suppression Therapy: A Feasibility Study Effect of exercise on the caloric intake of breast cancer patients undergoing treatment. Randomized Controlled Trial of a Structured Training Program in Breast Cancer Patients with Tumor-Related Chronic Fatigue Exercise for health: a randomized, controlled trial evaluating the impact of a pragmatic, translational exercise intervention on the quality of life, function and treatment-related side effects following breast cancer Effects of supervised exercise on progression-free survival in lymphoma patients: an exploratory follow-up of the HELP Trial Exercise and quality of life during and after treatment for breast cancer: results of two randomized controlled trials. Qualitative analysis of patients’ feedback from a PROMs survey of cancer patients in England Randomized Controlled Trial of Aerobic Exercise on Insulin and Insulin-like Growth Factors in Breast Cancer Survivors: The Yale Exercise and Survivorship Study Improving sexual health in men with prostate cancer: randomised controlled trial of exercise and psychosexual therapies Effects of a short-term differently dosed aerobic exercise on maximum aerobic capacity in breast cancer survivors: a pilot study. Main outcomes of the Move More for Life Trial: a randomised controlled trial examining the effects of tailored-print and targeted-print materials for promoting physical activity among post-treatment breast cancer survivors. Effects of exercise on fatigue, physical functioning, and emotional distress during radiation therapy for breast cancer. A randomized trial to increase physical activity in breast cancer survivors. Home-based exercise among cancer survivors: adherence and its predictors. Effects of nonlinear aerobic training on erectile dysfunction and cardiovascular function following radical prostatectomy for clinically localized prostate cancer. Effects of exercise training on exercise capacity in patients with non-small cell lung cancer receiving targeted therapy A Randomized Trial of Aerobic Exercise and Sleep Quality in Lymphoma Patients Receiving Chemotherapy or No Treatments Benefits of supervised group exercise programme for women being treated for early stage breast cancer: pragmatic randomised controlled trial Physical activity and survival after breast cancer diagnosis. The effectiveness of a deep water aquatic exercise program in cancer-related fatigue in breast cancer survivors: a randomized controlled trial. Safety and efficacy of resistance training in germ cell cancer patients undergoing chemotherapy: a randomized controlled trial Home-based physical activity intervention for colorectal cancer survivors. Randomized trial of exercise therapy in women treated for breast cancer. A nursing rehabilitation program for women with breast cancer receiving adjuvant chemotherapy. Maintenance of effects of a home-based physical activity program among breast cancer survivors Effects of a home-based walking program on perceived symptom and mood status in postoperative breast cancer women receiving adjuvant chemotherapy. Main outcomes of the FRESH START trial: a sequentially tailored, diet and exercise mailed print intervention among breast and prostate cancer survivors. Effect of exercise on bone structural traits, physical performance and body composition in breast cancer patients--a 12-month RCT. Efficacy of a multiprofessional rehabilitation programme in radical cystectomy pathways: A prospective randomized controlled trial Randomized controlled trial of the effects of high intensity and low-to-moderate intensity exercise on physical fitness and fatigue in cancer survivors: results of the Resistance and Endurance exercise After ChemoTherapy (REACT) study Effectiveness of Core Stability Exercises and Recovery Myofascial Release Massage on Fatigue in Breast Cancer Survivors: A Randomized Controlled Clinical Trial Physical Activity and Survival after Diagnosis of Invasive Breast Cancer Efficacy of walking exercise in promoting cognitive-psychosocial functions in men with prostate cancer receiving androgen deprivation therapy Effect of upper extremity exercise on secondary lymphedema in breast cancer patients: a pilot study. Efficacy of a training program for long-term disease- free cancer survivors as health partners: a randomized controlled trial in Korea. A randomized trial to promote physical activity among breast cancer patients. Dance and Movement Program Improves Quality‐of‐Life Measures in Breast Cancer Survivors A pilot investigation of a multidisciplinary quality of life intervention for men with biochemical recurrence of prostate cancer. Effect of exercise on biomarkers, fatigue, sleep disturbances, and depressive symptoms in older women with breast cancer receiving hormonal therapy. Effectiveness of a Multidimensional Physical Therapy Program on Pain, Pressure Hypersensitivity, and Trigger Points in Breast Cancer Survivors: A Randomized Controlled Clinical Trial Evaluation of an early exercise intervention after thoracotomy for non-small cell lung cancer (NSCLC), effects on quality of life, muscle strength and exercise tolerance: randomised controlled trial. A pilot phase II RCT of a home-based exercise intervention for survivors of AML Exercise prevents fatigue and improves quality of life in prostate cancer patients undergoing radiotherapy. Effect of active resistive exercise on breast cancer-related lymphedema: a randomized controlled trial. Caffeine, alcohol, smoking, and the risk of incident epithelial ovarian cancer Exercise training and cytokines in breast cancer survivors. High-intensity training following lung cancer surgery: a randomised controlled trial A pilot study of a supervised group exercise programme as a rehabilitation treatment for women with breast cancer receiving adjuvant treatment. Effects of a Physical Activity Behavior Change Intervention on Inflammation and Related Health Outcomes in Breast Cancer Survivors Football training improves lean body mass in men with prostate cancer undergoing androgen deprivation therapy. Effects of Nia exercise in women receiving radiation therapy for breast cancer. Psychological and fitness changes associated with exercise participation among women with breast cancer. Active for Life After Cancer: a randomized trial examining a lifestyle physical activity program for prostate cancer patients. Adherence to a randomized controlled trial of aerobic exercise in breast cancer survivors: the Yale exercise and survivorship study Restorative yoga for women with breast cancer: findings from a randomized pilot study. Tai Chi Chuan for breast cancer survivors. Safety and Feasibility of an Exercise Intervention for Patients Following Lung Resection Randomized controlled trial of weight training and lymphedema in breast cancer survivors. [Effects of a comprehensive rehabilitation program for mastectomy patients]. Differential effects of cardiovascular and resistance exercise on functional mobility in individuals with advanced cancer: a randomized trial. Pilot, randomized trial of resistance exercise during radiation therapy for head and neck cancer. Feasibility and effectiveness of a lifestyle intervention program in obese endometrial cancer patients: a randomized trial. Nutritional Symptom and Body Composition Outcomes of Aerobic Exercise in Women With Breast Cancer The effect of resistance inspiratory muscle training in the management of breathlessness in patients with thoracic malignancies: a feasibility randomised trial Exercise maintains sexual activity in men undergoing androgen suppression for prostate cancer: a randomized controlled trial Pragmatic lifestyle intervention in patients recovering from colon cancer: a randomized controlled pilot study. A randomized trial of exercise on well-being and function following breast cancer surgery: the RESTORE trial The effects of an individualized exercise intervention on body composition in breast cancer patients undergoing treatment. A randomised controlled trial testing the feasibility and efficacy of a physical activity behavioural change intervention in managing fatigue with gynaecological cancer survivors. Effects of Home-Based Walking on Quality of Life and Fatigue Outcomes in Early Stage Breast Cancer Survivors: A 12-Week Pilot Study. Effects of the BEAT Cancer physical activity behavior change intervention on physical activity, aerobic fitness, and quality of life in breast cancer survivors: a multicenter randomized controlled trial The effect of combined aerobic and resistance exercises on quality of life of women surviving breast cancer The effect of weight training on bone mineral density and bone turnover in postmenopausal breast cancer survivors with bone loss: a 24-month randomized controlled trial Peers promoting physical activity among breast cancer survivors: A randomized controlled trial. The effect of seated exercise on fatigue and quality of life in women with advanced breast cancer. Patient satisfaction with participation in a randomized exercise trial: Effects of randomization and a usual care posttrial exercise program A randomized trial of exercise and quality of life in colorectal cancer survivors. Yoga of Awareness program for menopausal symptoms in breast cancer survivors: results from a randomized trial The effects of a physical exercise programme after radical cystectomy for urinary bladder cancer. A pilot randomized controlled trial Cardiopulmonary Responses and Adherence to Exercise in Women Newly Diagnosed With Breast Cancer Undergoing Adjuvant Therapy Safety of weightlifting among women with or at risk for breast cancer-related lymphedema: musculoskeletal injuries and health care use in a weightlifting rehabilitation trial. Moderate exercise training and natural killer cell cytotoxic activity in breast cancer patients. A Web-based self-management exercise and diet intervention for breast cancer survivors: pilot randomized controlled trial. Effect of exercise training on functional capacity & quality of life in head & neck cancer patients receiving chemoradiotherapy Effect of supervised and home exercise training on bone mineral density among breast cancer patients. A 12-month randomised controlled trial Resistance exercise in men receiving androgen deprivation therapy for prostate cancer. Home-based physical activity intervention for breast cancer patients. Adherence to prescribed exercise time and intensity declines as the exercise program proceeds: findings from women under treatment for breast cancer Impact of a mixed strength and endurance exercise intervention on insulin levels in breast cancer survivors. Contribution of early intensive prolonged pelvic floor exercises on urinary continence recovery after bladder neck-sparing radical prostatectomy: results of a prospective controlled randomized trial. 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Intervention Components Promoting Adherence to Strength Training Exercise in Breast Cancer Survivors With Bone Loss Combined aerobic and resistance training in breast cancer survivors: A randomized, controlled pilot trial. A pilot study of a randomized controlled trial to evaluate the effects of progressive resistance exercise training on shoulder dysfunction caused by spinal accessory neurapraxia/neurectomy in head and neck cancer survivors. Design and implementation of the Exercise for Health trial -- a pragmatic exercise intervention for women with breast cancer. Effect of a vigorous aerobic regimen on physical performance in breast cancer patients — a randomized controlled pilot trial Exercise improves body fat, lean mass, and bone mass in breast cancer survivors. Effects of self-directed stress management training and home-based exercise on stress management skills in cancer patients receiving chemotherapy. The effect of a varied exercise program (VEP) on shoulder function and lymphedema (LE) in breast cancer survivors (BCs): A pilot study. Hemoglobin and Aerobic Fitness Changes with Supervised Exercise Training in Breast Cancer Patients Receiving Chemotherapy Effect of postoperative physical training on activity after curative surgery for non-small cell lung cancer: a multicentre randomised controlled trial. Motivational Interviewing to Increase Physical Activity in Long-Term Cancer Survivors: A Randomized Controlled Trial A couple-based intervention for patients and caregivers facing end-stage cancer: outcomes of a randomized controlled trial. Feasibility of an Exercise Program for Puerto Rican Women who are Breast Cancer Survivors High-intensity training and cardiopulmonary exercise testing in patients with chronic obstructive pulmonary disease and non-small-cell lung cancer undergoing lobectomy. Facilitating exercise adherence for patients with multiple myeloma. Effectiveness of a 12-month exercise program on physical performance and quality of life of breast cancer survivors. A diet, physical activity, and stress reduction intervention in men with rising prostate-specific antigen after treatment for prostate cancer. Biobehavioral factors mediate exercise effects on fatigue in breast cancer survivors. Improving muscular endurance with the MVe Fitness Chair™ in breast cancer survivors: a feasibility and efficacy study. The Effect of Yoga Exercise on Improving Depression, Anxiety, and Fatigue in Women With Breast Cancer: A Randomized Controlled Trial Can a Multimodal Mind–Body Program Enhance the Treatment Effects of Physical Activity in Breast Cancer Survivors With Chronic Tumor-Associated Fatigue? A Randomized Controlled Trial Clinical events in prostate cancer lifestyle trial: results from two years of follow-up. Improved physical fitness of cancer survivors: A randomised controlled trial comparing physical training with physical and cognitive-behavioural training Effects of Aerobic Interval Training on Cancer Patients' Functional Capacity A progressive postresection walking program significantly improves fatigue and health-related quality of life in pancreas and periampullary cancer patients. Randomized controlled trial of the Breast Cancer Recovery Program for women with breast cancer-related lymphedema. Exercise manages fatigue during breast cancer treatment: a randomized controlled trial. Weight lifting for women at risk for breast cancer-related lymphedema: a randomized trial. Recruiting and retaining breast cancer survivors into a randomized controlled exercise trial Effect of physical activity and body size on survival after diagnosis with colorectal cancer Randomized controlled trial of resistance or aerobic exercise in men receiving radiation therapy for prostate cancer. Safety and efficacy of aerobic training in patients with cancer who have heart failure: an analysis of the HF-ACTION randomized trial. Randomized exercise trial of aromatase inhibitor-induced arthralgia in breast cancer survivors. Effects of exercise during adjuvant chemotherapy on breast cancer outcomes. The effects of a six-week supervised multimodal exercise intervention during chemotherapy on cancer-related fatigue. Lifestyle changes for improving disease-specific quality of life in sedentary men on long-term androgen-deprivation therapy for advanced prostate cancer: a randomised controlled trial.
abstract: Background Patients with acute leukemia experience a substantial symptom burden and are at risk of developing infections throughout the course of repeated cycles of intensive chemotherapy . Physical activity in recent years has been a strategy for rehabilitation in cancer patients to remedy disease and treatment related symptoms and side effects . To date , there are no clinical practice exercise guidelines for patients with acute leukemia undergoing induction and consolidation chemotherapy . A r and omized controlled trial is needed to determine if patients with acute leukemia can benefit by a structured and supervised counseling and exercise program . Methods / design This paper presents the study protocol : Patient Activation through Counseling and Exercise – Acute Leukemia ( PACE-AL ) trial , a two center , r and omized controlled trial of 70 patients with acute leukemia ( 35 patients / study arm ) following induction chemotherapy in the outpatient setting . Eligible patients will be r and omized to usual care or to the 12 week exercise and counseling program .  The intervention includes 3 hours + 30 minutes per week of supervised and structured aerobic training ( moderate to high intensity 70 - 80 % ) on an ergometer cycle , strength exercises using h and weights and relaxation exercise . Individual health counseling sessions include a self directed home walk program with a step counter . The primary endpoint is functional performance/exercise capacity ( 6 minute walk distance ) . The secondary endpoints are submaximal VO2 max test , sit to st and and bicep curl test , physical activity levels , patient reported outcomes ( quality of life , anxiety and depression , symptom prevalence , intensity and interference ) . Evaluation of clinical outcomes will be explored including incidence of infection , hospitalization days , body mass index , time to recurrence and survival . Qualitative exploration of patients ’ health behavior and experiences . Discussion PACE-AL will provide evidence of the effect of exercise and health promotion counseling on functional and physical capacity , the symptom burden and quality of life in patients with acute leukemia during out patient management . The results will inform clinical practice exercise guidelines and rehabilitation programs for patients undergoing treatment for acute leukemia . Optimizing the treatment and care pathway may ease the transition for patients from illness to the resumption of everyday activities . Trial registration Clinical Trials.gov Identifier : NCT01404520 Background : Despite thous and s of papers , the value of quality of life ( QoL ) in curing disease remains uncertain . Until now , we lacked tools for the diagnosis and specific treatment of diseased QoL. We approached this problem stepwise by theory building , modelling , an exploratory trial and now a definitive r and omised controlled trial ( RCT ) in breast cancer , whose results we report here . Methods : In all , 200 representative Bavarian primary breast cancer patients were recruited by five hospitals and treated by 146 care professionals . Patients were r and omised to either ( 1 ) a novel care pathway including diagnosis of ‘ diseased ’ QoL ( any QoL measure below 50 points ) using a QoL profile and expert report sent to the patient 's coordinating practitioner , who arranged QoL therapy consisting of up to five st and ardised treatments for specific QoL defects or ( 2 ) st and ard postoperative care adhering to the German national guideline for breast cancer . The primary end point was the proportion of patients in each group with diseased QoL 6 months after surgery . Patients were blinded to their allocated group . Results : At 0 and 3 months after surgery , diseased QoL was diagnosed in 70 % of patients . The QoL pathway reduced rates of diseased QoL to 56 % at 6 months , especially in emotion and coping , compared with 71 % in controls ( P=0.048 ) . Relative risk reduction was 21 % ( 95 % confidence interval ( CI ) : 0–37 ) , absolute risk reduction 15 % ( 95 % CI : 0.3–29 ) , number needed to treat (NNT)=7 ( 95 % CI : 3–37 ) . When QoL therapy finished after successful treatment , diseased QoL often returned again , indicating good responsiveness of the QoL pathway . Conclusion : A three-component outcome system including clinician-derived objective , patient-reported subjective end points and qualitative analysis of clinical relevance was developed in the last 10 years for cancer as a complex intervention . A separate QoL pathway was implemented for the diagnosis and treatment of diseased QoL and its effectiveness tested in a community-based , pragmatic , definitive RCT . While the pathway was active , it was effective with an NNT of 7 PURPOSE The aims of this pilot study were the following : 1 ) to examine patterns of adherence to a brisk walking program in women receiving adjuvant chemotherapy or radiation therapy for newly diagnosed breast cancer using a prospect i ve , r and omized , controlled experimental design ; 2 ) to examine the influence of disease symptoms and treatment side effects on exercise levels ; and 3 ) to suggest methods that may improve future clinical trials of moderate-intensity exercise in similar population s. DESCRIPTION OF STUDY Fifty-two patients with newly diagnosed breast cancer were r and omly assigned to one of two treatment arms : usual care or usual care plus exercise . Those assigned to the exercise group received a st and ardized , self-administered , home-based brisk walking intervention in addition to usual care . Each day subjects completed self-report diary forms that elicited information about activity levels , and the occurrence of symptoms and side effects during cancer treatment . RESULTS Analyses of self-reported daily activity levels revealed a diffusion of treatment effect . Fifty percent of the usual-care group reported maintaining or increasing their physical activity to a moderate-intensity level , while 33 % of the exercise group did not exercise at the prescribed levels . Analyses of self-reported disease symptoms and treatment side effects did not reveal clinical ly meaningful differences between the two groups . CLINICAL IMPLICATION S The results of this study suggest that women who exercised regularly before receiving a breast cancer diagnosis attempted to maintain their exercise programs . Women who lead sedentary lifestyles may benefit from a structured exercise program that includes information and support related to exercise adherence strategies OBJECTIVE To examine the changes from a combined exercise intervention after radical prostatectomy ( RP ) in elderly patients with prostate cancer , because r and omized controlled trials addressing exercise intervention after RP have been lacking . METHODS From May 2009 to May 2010 , all patients who underwent laparoscopic RP were assessed for eligibility . A total of 66 patients were r and omized to an exercise or a control group . The exercise group received a combined exercise intervention ( resistance , flexibility , and Kegel exercises ) twice a week for 12 weeks , and the control group received only Kegel exercises . The primary outcome was physical function , and the secondary outcomes were continence status and quality of life after the exercise intervention . RESULTS A total of 49 patients completed follow-up to the end of study . After the 12-week exercise intervention , except for grip strength , all physical functions were better in the exercise group than in the control group . The 24-hour pad test results ( 12.2 g in the exercise group , 46.2 g in the control group ) and continence rate ( 73.1 % in exercise group , 43.5 % in the control group ) recovered more promptly in the exercise group . On a question naire study using the International Consultation on Incontinence question naire , Beck Depression Inventory , and Medical Outcomes Study 36-item short-form health survey , only the exercise group showed improvement at the last follow-up visit . CONCLUSION A 12-week combined exercise intervention after RP results in improvement of physical function , continence rate , and quality of life . These results could help with prompt recovery of daily activities This pilot study examined the efficacy of two home-based exercise programs on alleviating fatigue and improving functional capacity in breast cancer survivors . Participants were r and omly assigned into one of three groups : aerobic exercise ( AE ) , resistance exercise ( RE ) , or usual care control ( CON ) . After receiving individualized instruction and training , participants assigned to the AE and RE groups were asked to perform the prescribed exercise(s ) 3 times per week for 12 weeks at home . Both groups were instructed to keep their perceived exercise intensity in the " fairly light " to " somewhat hard " range using the Borg Perceived Exertion Scale . All participants completed the revised Piper Fatigue Scale ( PFS ) and the 6-minute walk test ( 6MWT ) at baseline and 12-week post-exercise program . Analysis of pre- and post-training data revealed a significant reduction in fatigue levels on the PFS among participants in the AE group ( Z=2.521 , one-tailed P=0.006 ) , and a significant improvement in the distance of the 6MWT for the RE group ( Z=2.366 , one-tailed P=0.009 ) at the end of 12-week study period . No significant changes in fatigue or functional status were observed in the CON group . Findings provide preliminary support for RE as a viable strategy for improving functional capacity in breast cancer survivors , while AE may be more effective in attenuating cancer-related fatigue . Incorporating RE training for future research may help advance the growing body of knowledge in symptom management for breast cancer survivors Background To examine the effects of a 6 month lifestyle intervention on quality of life , depression , self-efficacy and eating behavior changes in overweight and obese endometrial cancer survivors . Methods Early stage endometrial cancer survivors were r and omized to intervention ( n = 23 ) or usual care ( n = 22 ) groups . Chi-square , Student 's t-test and repeated measures analysis of variance were used in intent-to-treat analyses . Outcomes were also examined according to weight loss . Results Morbidly obese patients had significantly lower self-efficacy , specifically when feeling physical discomfort . There was a significant improvement for self-efficacy related to social pressure ( p = .03 ) and restraint ( p = .02 ) in the LI group . There was a significant difference for emotional well-being quality of life ( p = .02 ) , self-efficacy related to negative emotions ( p < .01 ) , food availability ( p = .03 ) , and physical discomfort ( p = .01 ) in women who lost weight as compared to women who gained weight . Improvement in restraint was also reported in women who lost weight ( p < .01 ) . Conclusion This pilot lifestyle intervention had no effect on quality of life or depression but did improve self-efficacy and some eating behaviors . Trial Registration http://www . clinical trials.gov ; BACKGROUND Telomeres are protective DNA-protein complexes at the end of linear chromosomes that promote chromosomal stability . Telomere shortness in human beings is emerging as a prognostic marker of disease risk , progression , and premature mortality in many types of cancer , including breast , prostate , colorectal , bladder , head and neck , lung , and renal cell . Telomere shortening is counteracted by the cellular enzyme telomerase . Lifestyle factors known to promote cancer and cardiovascular disease might also adversely affect telomerase function . However , previous studies have not addressed whether improvements in nutrition and lifestyle are associated with increases in telomerase activity . We aim ed to assess whether 3 months of intensive lifestyle changes increased telomerase activity in peripheral blood mononuclear cells ( P BMC ) . METHODS 30 men with biopsy-diagnosed low-risk prostate cancer were asked to make comprehensive lifestyle changes . The primary endpoint was telomerase enzymatic activity per viable cell , measured at baseline and after 3 months . 24 patients had sufficient P BMC s needed for longitudinal analysis . This study is registered on the Clinical Trials.gov website , number NCT00739791 . FINDINGS P BMC telomerase activity expressed as natural logarithms increased from 2.00 ( SD 0.44 ) to 2.22 ( SD 0.49 ; p=0.031 ) . Raw values of telomerase increased from 8.05 ( SD 3.50 ) st and ard arbitrary units to 10.38 ( SD 6.01 ) st and ard arbitrary units . The increases in telomerase activity were significantly associated with decreases in low-density lipoprotein ( LDL ) cholesterol ( r=-0.36 , p=0.041 ) and decreases in psychological distress ( r=-0.35 , p=0.047 ) . INTERPRETATION Comprehensive lifestyle changes significantly increase telomerase activity and consequently telomere maintenance capacity in human immune-system cells . Given this finding and the pilot nature of this study , we report these increases in telomerase activity as a significant association rather than inferring causation . Larger r and omised controlled trials are warranted to confirm the findings of this study Goals of workProstate cancer patients receiving and rogen deprivation therapy ( ADT )  are vulnerable to a number of potentially debilitating side effects , which can significantly impact quality of life . The role of alternate therapies , such as physical activity ( PA ) , in attenuating these side effects is largely understudied for such a large population . Thus , the purpose of this study was to investigate the effects of PA intervention for men receiving ADT on PA behavior , quality of life , and fitness measures . Patients and methods One hundred participants were r and omized into an intervention ( n = 53 ) or a wait-list control group ( n = 47 ) , with 11 dropping out of the intervention group and 23 dropping out of the wait-list control group prior to post-testing . The intervention consisted of both an individually tailored home-based aerobic and light resistant training program and weekly group sessions .  PA , quality of life , fitness , and physiological outcomes were assessed pre and post the 16-week intervention . Results Significant increases in PA , supported by changes in girth measures and blood pressure , support the beneficial impact of the intervention . Positive trends were also evident for depression and fatigue . However , due to the high dropout rate , these results must be interpreted with caution . Conclusions PA effectively attenuates many of the side effects of ADT and should be recommended to prostate survivors as an alternate therapy . Determining the maintenance of this behavior change will be important for underst and ing how the long-term benefits of increased activity levels may alleviate the late effects of ADT PURPOSE Self-directed and supervised exercise were compared with usual care in a clinical trial design ed to evaluate the effect of structured exercise on physical functioning and other dimensions of health-related quality of life in women with stages I and II breast cancer . PATIENTS AND METHODS One hundred twenty-three women with stages I and II breast cancer completed baseline evaluations of generic and disease- and site-specific health-related quality of life , aerobic capacity , and body weight . Participants were r and omly allocated to one of three intervention groups : usual care ( control group ) , self-directed exercise , or supervised exercise .  Quality of life , aerobic capacity , and body weight measures were repeated at 26 weeks . The primary outcome was the change in the Short Form-36 physical functioning scale between baseline and 26 weeks . RESULTS Physical functioning in the control group decreased by 4.1 points , whereas it increased by 5.7 points and 2.2 points in the self-directed and supervised exercise groups , respectively ( P = .04 ) . Post hoc analysis showed a moderately large ( and clinical ly important ) difference between the self-directed and control groups ( 9.8 points ; P = .01 ) and a more modest difference between the supervised and control groups ( 6.3 points ; P = .09 ) . No significant differences between groups were observed for changes in quality of life scores . In a secondary analysis of participants stratified by type of adjuvant therapy , supervised exercise improved aerobic capacity ( + 3.5 mL/kg/min ; P = .01 ) and reduced body weight ( -4.8 kg ; P < .05 ) compared with usual care only in participants not receiving chemotherapy . CONCLUSION Physical exercise can blunt some of the negative side effects of breast cancer treatment , including reduced physical functioning .  Self-directed exercise is an effective way to improve physical functioning compared with usual care . In participants not receiving chemotherapy  , supervised exercise may increase aerobic capacity and reduce body weight compared with usual care Epidemiological and prospect i ve studies indicate that comprehensive lifestyle changes may modify the progression of prostate cancer . However , the molecular mechanisms by which improvements in diet and lifestyle might affect the prostate microenvironment are poorly understood . We conducted a pilot study to examine changes in prostate gene expression in a unique population of men with low-risk prostate cancer who declined immediate surgery , hormonal therapy , or radiation  and participated in an  intensive nutrition and lifestyle intervention  while undergoing careful surveillance for tumor progression . Consistent with previous studies , significant improvements in weight , abdominal obesity , blood pressure , and lipid profile were observed ( all P < 0.05 ) , and surveillance of low-risk patients was safe . Gene expression profiles were obtained from 30 participants , pairing RNA sample s from control prostate needle biopsy taken before intervention to RNA from the same patient 's 3-month postintervention biopsy . Quantitative real-time PCR was used to vali date array observations for selected transcripts . Two-class paired analysis of global gene expression using significance analysis of microarrays detected 48 up-regulated and 453 down-regulated transcripts after the intervention . Pathway analysis identified significant modulation of biological processes that have critical roles in tumorigenesis , including protein metabolism and modification , intracellular protein traffic , and protein phosphorylation ( all P < 0.05 ) . Intensive nutrition and lifestyle changes may modulate gene expression in the prostate . Underst and ing the prostate molecular response to comprehensive lifestyle changes may strengthen efforts to develop effective prevention and treatment . Larger clinical trials are warranted to confirm the results of this pilot study BACKGROUND Lymphoma patients undergoing therapy must cope with the side-effects of the disease itself , therapy and associated immobility . Peripheral neuropathy ( PNP ) , loss of balance control and weakness not only diminishes patients ' quality of life ( QOL ) , it can also affect planning and the dosage of therapy . Exercise may enable patients to reverse these declines , improving their performance level and QOL . PATIENTS AND METHODS We carried out a r and omized , controlled trial , assigning 61 lymphoma patients either to a  control group ( CG ; N=31 ) or to a 36-week intervention ( IG ; N=30 ) , consisting of sensorimotor- , endurance- and strength training twice a week . Primary end point was QOL ; secondary end points included movement coordination , endurance , strength and therapy-induced side-effects . RESULTS Intergroup comparison revealed improved QOL- ( ΔT1-T0 ; P=0.03 ) and PNP-related deep sensitivity in the IG : 87.5 % were able to reduce the symptom , compared with 0 % in the CG ( P<0.001 ) . Significant differences in the change of balance control could be found between the groups , with the IG improving while the CG steadily declined ( monopedal static ΔT3-T0 ; P=0.03 ; dynamic ΔT3-T0 ; P=0.007 ; perturbed mono-ΔT3-T0 ; P=0.009 and bipedal ΔT3-T0 ; P=0.006 ) , failed attempts ( monopedal static ΔT3-T0 ; P=0.02 , dynamic ΔT3-T0 ; P<0.001 and perturbed ΔT3-T0 ; P=0.006 ) and improved time to regain balance ( ΔT3-T0 ; P=0.04 ) . Moreover , the change in the aerobic performance level ( ΔT3-T0 ; P=0.05 ) and additional amount of exercise carried out per week [ metabolic equivalent ( MET ) ; P=0.02 ] differed significantly across groups . CONCLUSIONS Exercise , especially sensorimotor training , is a feasible and promising method to support cancer patients during therapy . It improves patients QOL , reduces restrictions from side-effects such as PNP and improves patients ' balance control , physical performance level and mobility . GERMAN CLINICAL TRIALS REGISTER NUMBER DRKS00003894 To evaluate the efficacy and economic efficiency of a multimedia , multimodal physical activity program for women undergoing adjuvant therapy following surgery for breast cancer . We conducted a r and omized trial with concurrent incremental cost-effectiveness analysis and blinded baseline , 3 , 6 and 12-month follow-up assessment s amongst women undergoing adjuvant therapy following surgery for breast cancer ( n = 89 ) . The intervention was a multimedia , multimodal exercise program comprising strength , balance and endurance training elements . The control was sham flexibility and relaxation program delivered using similar material s. The primary outcome was health-related quality of life ( EQ-5D & VAS , EORTC C30 , BR23 ) . Economic outcomes included direct health care costs and productivity gains and losses . Participants in the intervention group demonstrated greater improvement in health-related quality of life between baseline and the 3-month assessment [ mean ( sd ) EQ-5D VAS ( 0–100 ) baseline : 72.6 ( 15.6 ) , 3 month : 80.6 ( 11.6 ) ] when compared to control group participants [ baseline : 77.5 ( 13.5 ) , 3 month : 74.1 ( 20.6 ) , P = 0.006 ] and also improved more in terms of physical function [ mean ( sd ) EORTC C30 physical function scale intervention ( 0–100 ) baseline : 84.9 ( 14.8 ) , 3 month : 86.9 ( 10.7 ) , control baseline : 91.3 ( 9.6 ) , 3 month : 86.7 ( 14.9 ) , P = 0.02 ] . These improvements were not sustained beyond this point . Upper limb volumes were also lower amongst intervention group participants . However , there was low probability that the intervention would be both less costly and more effective than the control condition ( range probability = 0.05–50.02 % depending on approach ) . Provision of multimodal exercise programs will improve the short-term health of women undergoing adjuvant therapy for breast cancer but are of question able economic efficiency Excess body weight at diagnosis and weight gain after breast cancer are associated with poorer long-term prognosis . This study investigated the effects of a lifestyle intervention on body weight and other health outcomes influencing long-term prognosis in overweight women ( BMI > 25.0 kg/m2 ) recovering from early-stage ( stage I – III ) breast cancer . A total of 90 women treated 3–18 months previously were r and omly allocated to a 6-month exercise and hypocaloric healthy eating program ( n = 47 , aged 55.6 ± 10.2 year ) or  control group ( n = 43 , aged 55.9 ± 8.9 year ) . Women in the intervention group received three supervised exercise sessions per week and individualized dietary advice , supplemented by weekly nutrition seminars . Body weight , waist circumference , waist/hip ratio [ WHR ] , cardiorespiratory fitness , blood biomarkers associated with breast cancer recurrence and cardiovascular disease risk , and quality of life ( FACT-B ) were assessed at baseline and 6 months . Three-day diet diaries were used to assess macronutrient and energy intakes . A moderate reduction in body weight in the intervention group ( median difference from baseline of −1.09 kg ; IQR −0.15 to −2.90 kg ; p = 0.07 ) was accompanied by significant reductions in waist circumference ( p < 0.001 ) , WHR ( p = 0.005 ) , total ( p = 0.021 ) and saturated fat ( p = 0.006 ) intakes , leptin ( p = 0.005 ) , total cholesterol ( p = 0.046 ) , and resting diastolic blood pressure ( p = 0.03 ) . Cardiopulmonary fitness ( p < 0.001 ) and FACT-B quality of life ( p = 0.004 ) also showed significant improvements in the intervention group . These findings suggest that an individualized exercise and a hypocaloric healthy eating program can positively impact upon health outcomes influencing long-term prognosis in overweight women recovering from early-stage breast cancer Exercise is considered to be a key aspect of lymphoedema treatment , although there is little evidence for the therapeutic effect of exercise in managing breast cancer-related lymphoedema ( BCRL ) . This small r and omised controlled trial ( RCT ) was design ed to determine the feasibility , prior to undertaking a larger RCT , of research ing a daily home-based exercise programme to treat stable BCRL . An experimental design compared the exercise intervention combined with st and ard lymphoedema self-care to self-care alone over a 6-month period . Twenty-three women with stable unilateral BCRL of ≥10 % excess limb volume ( ELV )  were r and omly allocated to a daily home-based exercise programme and self-care ( n = 11 ) or self-care measures alone ( n = 12 ) . The primary objective was to determine difference in limb volume reduction for the two groups . Secondary objectives were to monitor change in other areas that impact BCRL : quality of life , arm function and range of shoulder movement . All 23 women completed the trial , providing full data for each time point . The intervention group showed a clinical ly and statistically significant improvement in relative ELV at week 26 ( 95 % confidence interval ( CI ) −26.57 to −5.12 ) , whereas the control group improvement crossed the line of no effect ( 95 % CI −17.71 to 1.1 ) . This study demonstrated the feasibility of conducting a RCT of exercise as a therapeutic intervention in the management of BCRL . Although the sample was small , the results support the findings of other exercise studies which have shown trends towards improvement The aim of this study was to determine whether an exercise program , commencing 4–6 weeks post-operatively , reduces upper limb impairments in women treated for early breast cancer . Women ( n = 160 ) were r and omized to either an 8-week exercise program ( n = 81 ) or to a control group ( n = 79 ) following stratification for axillary surgery . The exercise program comprised a weekly session and home program of passive stretching and progressive resistance training for shoulder muscles . The control group attended fortnightly assessment s but no exercises were provided . The primary outcome was self-reported arm symptoms derived from the EORTC breast cancer-specific question naire ( BR23 ) , scored out of 100 with a low score indicative of fewer symptoms . The secondary outcomes included physical measures of shoulder range of motion , strength , and swelling ( i.e. , lymphedema ) . Women were assessed immediately following the intervention and at 6 months post-intervention . The change in symptoms from baseline was not significantly different between groups immediately following the intervention or at 6 m post-intervention . The between group difference immediately following the intervention was 4 ( 95 % CI −1 to 9 ) and 6 months post-intervention was 4 ( −2 to 10 ) . However , the change in range of motion for flexion and abduction was significantly greater in the exercise group immediately following the intervention , as was change in shoulder abductor strength . In conclusion , a supervised exercise program provided some , albeit small , additional benefit at 6 months post-intervention to women who had been provided with written information and reminders to use their arm . Both the groups reported few impairments including swelling immediately following the intervention and 6 months post-intervention . Notably , resistance training in the post-operative period did not precipitate lymphedema BACKGROUND Weight lifting has generally been proscribed for women with breast-cancer-related lymphedema , preventing them from obtaining the well-established health benefits of weight lifting , including increases in bone density . METHODS We performed a r and omized , controlled trial of twice-weekly progressive weight lifting involving 141 breast-cancer survivors with stable lymphedema of the arm . The primary outcome was the change in arm and h and swelling at 1 year , as measured through displaced water volume of the affected and unaffected limbs . Secondary outcomes included the incidence of exacerbations of lymphedema , number and severity of lymphedema symptoms , and muscle strength . Participants were required to wear a well-fitted compression garment while weight lifting . RESULTS The proportion of women who had an increase of 5 % or more in limb swelling was similar in the weight-lifting group ( 11 % ) and the control group ( 12 % ) ( cumulative incidence ratio , 1.00 ; 95 % confidence interval , 0.88 to 1.13 ) . As compared with the control group , the weight-lifting group had greater improvements in self-reported severity of lymphedema symptoms ( P=0.03 ) and upper- and lower-body strength ( P<0.001 for both comparisons ) and a lower incidence of lymphedema exacerbations as assessed by a certified lymphedema specialist ( 14 % vs. 29 % , P=0.04 ) . There were no serious adverse events related to the intervention . CONCLUSIONS In breast-cancer survivors with lymphedema , slowly progressive weight lifting had no significant effect on limb swelling and result ed in a decreased incidence of exacerbations of lymphedema , reduced symptoms , and increased strength . ( Clinical Trials.gov number , NCT00194363 . PURPOSE The purpose of this study was to identify the effects of a home based exercise program for patients with stomach cancer who were undergoing oral chemotherapy . METHODS The home-based exercise program was developed from the study findings of Winningham ( 1990 ) and data from the Korea Athletic Promotion Association ( 2007 ) . The home-based exercise program consisted of 8 weeks of individual exercise education and exercise adherence strategy . Participants were 24 patients with stomach cancer who were undergoing oral chemotherapy following surgery in 2007 or 2008 at a university hospital in Seoul . Patients were r and omly assigned to either the experimental group ( 11 ) or control group ( 13 ) . The effects of the home-based exercise program were measured by level of cancer related fatigue , NK cell ratio , anxiety , and quality of life . Data were analyzed using SPSS/WIN 13.0 version . RESULTS The degree of cancer related fatigue and anxiety in the experimental group decreased compared to the control group . The NK cell ratio and the degree of quality of life of experimental group increased while that of the control group decreased . CONCLUSION This study result indicate the importance of exercise and provide empirical evidence for continuation of safe exercise for patients with cancer during their chemotherapy Background Physical activity improves health in prostate cancer survivors ; however , participation rates are low . Purpose This study aims to determine the effects of an implementation intention intervention on physical activity and quality of life in prostate cancer survivors . Methods Prostate cancer survivors ( N = 423 ) were r and omly assigned to a st and ard physical activity recommendation , a self-administered implementation intention , or a telephone-assisted implementation intention .  Physical activity and quality of life were assessed at baseline , 1 , and 3 months . Results Analyses of covariance using multiple imputation showed that physical activity at 1 month increased by 86 min/week in the st and ard physical activity recommendation group compared with 168 min/week in the self-administered implementation intention group ( P = 0.023 ) and 105 min/week in the telephone-assisted implementation intention group ( P = 0.35 ) . Conclusions A self-administered implementation intention intervention result ed in a meaningful short-term increase in physical activity . Supplementation with additional intervention strategies and more frequent intervention may improve longer-term exercise . ( Clinical Trials.gov number NCT01410656 ) OBJECTIVE Obesity is associated with poorer breast cancer outcomes and losing weight postdiagnosis may improve survival . As Hispanic and black women have poorer breast cancer prognosis than non-Hispanic whites diagnosed at similar age and stage , and have higher rates of obesity , effective weight loss strategies are needed . We piloted a r and omized , waitlist-controlled , crossover study to examine the effects and feasibility of the commercial Curves weight loss program among Hispanic , African American and Afro-Caribbean breast cancer survivors . DESIGN AND METHODS Women with stage 0-IIIa breast cancer ≥ 6 months posttreatment , sedentary , and BMI ≥ 25 kg/m(2 ) were r and omized to the immediate arm ( IA ) : 6 months of the Curves program followed by 6 months of observation ; or the waitlist control arm ( WCA ) : 6 months of observation followed by 6 months of the Curves program . The Curves program uses a 30-min exercise circuit and a high-vegetable/low-fat/calorie-restricted diet . RESULTS A total of 42 women enrolled ( 79 % Hispanic , 21 % black ) , mean age 51 ( range 32 - 69 ) and mean BMI 33.2(± 5.9 ) kg/m(2 ) ; 91 % were retained at month 12 . At month 6 , women in the IA lost an average 3.3 % ( ± 3.5 % ) of body weight ( range : 1.7 % gain to 10.6 % loss ) , as compared with 1.8 % ( ± 2.9 % ) weight loss in the WCA ( P = 0.04 ) . At month 12 , on average women in the IA regained some but not all of the weight lost during the first 6 months ( P = 0.02 ) . CONCLUSIONS Minority breast cancer survivors were recruited and retained in a weight loss study . Six months of the Curves program result ed in moderate weight loss , but weight loss was not maintained postintervention . Future interventions should identify methods to increase uptake and maintenance of weight loss behaviors Physical activity has been studied in relation to prostate cancer risk , but the findings have been inconclusive . We prospect ively examined the association between self-reported recreational physical activity and overall risk of prostate cancer , risk of advanced disease and risk of prostate cancer death in a cohort of 29,110 Norwegian men . Incident prostate cancers were obtained from the Norwegian Cancer Registry , and prostate cancer deaths were obtained from the national Cause of Death Registry . During 17 years of follow-up , 957 incident cases were identified , 266 of them were advanced ( i.e. metastases at diagnosis ) and 354 of the incident cases died from prostate cancer . In multivariable analysis , frequency and duration of exercise  were inversely associated with the risk of advanced prostate cancer ( p for trend = 0.04 and 0.02 ) . We computed a summary score that combined frequency , duration and intensity of exercise  , and this score showed inverse associations with advanced prostate cancer risk and mortality ( p for trend = 0.02 and 0.07 ) . Compared to men who reported no activity , the relative risks ( 95 % confidence intervals ) among men in the highest category of physical exercise was 0.64 ( 0.43 - 0.95 ) for advanced prostate cancer and 0.67 ( 0.48 - 0.94 ) for prostate cancer death . We found no association between physical activity and overall risk of prostate cancer . We conclude that recreational physical exercise is associated with reduced risk of advanced prostate cancer and prostate cancer death OBJECTIVE To improve mechanistic underst and ing , this pilot r and omized controlled trial examined mediators of an exercise intervention effects on sleep in breast cancer survivors ( BCS ) . METHODS Forty-six postmenopausal BCS ( ≤Stage II , off primary treatment ) were r and omized to a 3-month exercise intervention or control group . Intervention included 160 min/week of moderate intensity aerobic walking , twice weekly resistance training ( resistance b and s ) , and six discussion groups ( to improve adherence ) . Blinded assessment s at baseline and post-intervention included sleep disturbance ( PSQI and PROMIS ® ) , objective sleep quality ( accelerometer ) , serum cytokines , accelerometer physical activity , cardiorespiratory fitness , body composition , fatigue , and psychosocial factors . Mediation was tested using Freedman-Schatzkin difference-in-coefficients tests . RESULTS When compared with control , the intervention group demonstrated a significant increase in PSQI sleep duration ( i.e. , fewer hours of sleep/night ) ( d = 0.73 , p = .03 ) . Medium to large but non-significant st and ardized effect sizes were noted for PSQI daytime somnolence ( d = -0.63 , p = .05 ) and accelerometer latency ( d = -0.49 , p = .14 ) . No statistically significant mediators were detected for PSQI sleep duration score or accelerometer latency . Daytime somnolence was mediated by tumor necrosis factor-alpha ( mediated 23 % of intervention effect , p < .05 ) , interleukin (IL)-6:IL-10 ( 16 % , p < .01 ) , IL-8:IL-10 ( 26 % , p < .01 ) , and fatigue ( 38 % , p < .05 ) . Mediating or enhancing relationships for several of the sleep outcomes were noted for accelerometer physical activity , PROMIS ® fatigue , exercise social support , and /or physical activity enjoyment . CONCLUSIONS Inflammation and psychosocial factors may mediate or enhance sleep response to our exercise intervention . Further study is warranted to confirm our results and translate our findings into more effective interventions aim ed at improving sleep quality in BCS We describe adherence to a three group r and omised controlled trial that involved aerobic exercise therapy  ( N=34 ) and exercise-placebo intervention  ( N=36 ) or usual care  ( N=38 ) in women treated for breast cancer . We also investigated relationships between routes of trial recruitment , socio-economic characteristics , health behaviours , cancer treatment regimen(s ) and subsequent adherence to the interventions . Women who had completed breast cancer treatment 12 - 36 months previously were r and omised to one of the groups . The intervention groups attended an exercise facility three times per week for eight weeks . A total of 77 % of the aerobic exercise therapy and 88.9 % of the exercise-placebo groups attended at least 70 % of prescribed sessions . The percentage of women achieving 30min of aerobic exercise per session steadily increased during the intervention but many women were not able to achieve this goal . Routes of trial recruitment , socio-economic characteristics , health behaviours and cancer treatment regimen(s ) were not related to intervention . Exercise therapy participants were able to comply with the progressive nature of the aerobic exercise intervention , although some women were not able to achieve 30min of aerobic exercise per session by intervention completion . Research is still required to tease out all the potential determinants of exercise in this population OBJECTIVE The majority of endometrial cancer survivors ( ECS ) are obese and at risk for premature death . The purpose of this study was to evaluate an intervention for ECS to promote weight loss and a healthy lifestyle . METHODS Early stage overweight and obese ( body mass index ≥ 25 ) ECS ( N=75 ) were r and omized to a  6-month lifestyle intervention ( LI ) or usual care ( UC ) . The LI group received education and counseling for six months ( 10 weekly followed by 6 bi-weekly sessions ) . Weight change at 12 months was the primary endpoint . Secondary outcomes included fruit/vegetable servings/day and physical activity ( PA ) . Multiple imputations were used for missing data and mixed models were used to analyze changes from baseline . RESULTS Adherence was 84 % and follow-up data were available from 92 % of participants at 6 months and 79 % at 12 months . Mean [ 95 % CI ] difference in weight change between LI and UC groups at 6 months was -4.4 kg [ -5.3 , -3.5 ] , p<0.001 and at 12 months was -4.6 kg [ -5.8 , -3.5 ] , p<0.001 . Mean [ 95 % CI ] difference in PA minutes between groups at 6 months was 100 [ 6 , 194 ] , p=0.038 and at 12 months was 89 [ 14 , 163 ] , p=0.020 . Mean difference in kilocalories consumed was -217.8 ( p<0.001 ) at 6 months and -187.2 ( p<0.001 ) at 12 months . Mean [ 95 % CI ] difference in fruit and vegetable servings was 0.91 servings/day at 6 months and 0.92 at 12 months ( p<0.001 ) . CONCLUSIONS Behavior change and weight loss are achievable in overweight and obese ECS , however , the clinical implication s of these changes are unknown and require a larger trial with longer follow-up OBJECTIVE To evaluate the effects of an 8-week water physical therapy program on cervical and shoulder pain , pressure sensitivity , and the presence of trigger points ( TrPs ) in breast cancer survivors . DESIGN R and omized , controlled trial . SETTING To date , no study has investigated effects of water therapy in breast cancer . PATIENTS Sixty-six breast cancer survivors were r and omly assigned into two groups : WATER group , who received a water exercise program or CONTROL group who received the usual care treatment for breast cancer . INTERVENTIONS The WATER therapy program consisted of 24 sessions ( 3 times/week over 8 weeks ) of low-intensity exercises in a warm pool ( 32 ° C ) . Each session included 10-minute warm-up period ; 35 minutes of aerobic , low-intensity endurance , and core stability training ; and a 15-minute cool-down period ( stretching and relaxation ) .  OUTCOMES Neck and shoulder pain ( visual analog scale , 0 - 100 mm ) , pressure pain thresholds ( PPTs ) over C5-C6 zygapophyseal joints , deltoid muscles , second metacarpal , and tibialis anterior muscles , and the presence of TrPs in cervical-shoulder muscles were assessed at baseline and after the 8-week program by an assessor blinded to treatment allocation . RESULTS The WATER group demonstrated a between-group improvement for neck pain of -31 mm ( 95 % confidence interval [CI]-49 to -22 , P < 0.001 ; effect size 1.1 , 0.81 - 1.75 ) and for shoulder-axillary of -19 mm ( -40 to -04 , P = 0.046 ; effect size 0.70 , 0.14 - 1.40 ) . Improvements were also noted for PPT levels over C5-C6 joints ( between-group differences , affected side : 27.7 kPa , 95 % CI 3.9 - 50.4 ; unaffected : 18.1 kPa , 95 % CI 6.1 - 52.2 ) . No between-group differences for PPT over the remaining points were observed ( P > 0.05 ) . Finally , patients in the WATER program showed a greater reduction of active TrPs as compared with the CONTROL group ( P < 0.05 ) . CONCLUSIONS An 8-week water therapy program was effective for improving neck and shoulder/axillary pain , and reducing the presence of TrPs in breast cancer survivors as compared with usual care ; however , no significant changes in widespread pressure pain hyperalgesia were found PURPOSE Men with prostate cancer are often advised to make changes in diet and lifestyle , although the impact of these changes has not been well documented . Therefore , we evaluated the effects of comprehensive lifestyle changes on prostate specific antigen ( PSA ) , treatment trends and serum stimulated LNCaP cell growth in men with early , biopsy proven prostate cancer after 1 year . MATERIAL S AND METHODS Patient recruitment was limited to men who had chosen not to undergo any conventional treatment , which provided an unusual opportunity to have a nonintervention r and omized control group to avoid the confounding effects of interventions such as radiation , surgery or and rogen deprivation therapy . A total of 93 volunteers with serum PSA 4 to 10 ng/ml and cancer Gleason scores less than 7 were r and omly assigned to an experimental group that was asked to make comprehensive lifestyle changes or to a usual care control group . RESULTS None of the experimental group patients but 6 control patients underwent conventional treatment due to an increase in PSA and /or progression of disease on magnetic resonance imaging . PSA decreased 4 % in the experimental group but increased 6 % in the control group ( p = 0.016 ) . The growth of LNCaP prostate cancer cells ( American Type Culture Collection , Manassas , Virginia ) was inhibited almost 8 times more by serum from the experimental than from the control group ( 70 % vs 9 % , p < 0.001 ) . Changes in serum PSA and also in LNCaP cell growth were significantly associated with the degree of change in diet and lifestyle . CONCLUSIONS Intensive lifestyle changes may affect the progression of early , low grade prostate cancer in men . Further studies and longer term followup are warranted Background : Healthy lifestyle behaviors could have a role in ameliorating some of the adverse effects of and rogen suppression therapy  ( AST ) in men with prostate cancer . The primary aim of this study was to assess the feasibility of a tapered supervised exercise program in combination with dietary advice in men with advanced prostate cancer receiving AST . Methods : Advanced prostate cancer patients receiving AST for a minimum of 6 months were r and omized to a 12-week lifestyle program comprising aerobic and resistance exercise , plus dietary advice ( n = 25 ) , or st and ard care ( n = 25 ) . Exercise behavior , dietary macronutrient intake , quality of life , fatigue , functional fitness , and biomarkers associated with disease progression were assessed at baseline , after the intervention , and at 6 months . Results : The lifestyle group showed improvements in exercise behavior ( P < 0.001 ) , dietary fat intake ( P = 0.001 ) , total energy intake ( P = 0.005 ) , fatigue ( P = 0.002 ) , aerobic exercise tolerance ( P < 0.001 ) , and muscle strength ( P = 0.033 ) compared with st and ard care controls . Although a high rate of attrition ( 44 % ) was observed at 6 months , the improvements in key health outcomes were sustained . No effects on clinical prostate cancer disease markers were observed . Conclusions : This preliminary evidence suggests that pragmatic lifestyle interventions have potential to evoke improvements in exercise and dietary behavior , in addition to other important health outcomes in men with advanced prostate cancer receiving AST . Impact : This study shows for the first time that pragmatic lifestyle interventions are feasible and could have a positive impact on health behaviors and other key outcomes in men with advanced prostate cancer receiving AST . Cancer Epidemiol Biomarkers Prev ; 20(4 ) ; 647–57 . © 2011 AACR The purpose of this study was to examine the effects of an exercise intervention on the total caloric intake ( TCI ) of breast cancer patients undergoing treatment . A secondary purpose was to determine whether or not a relationship existed between changes in TCI , body fat composition ( % BF ) , and fatigue during the study , which lasted 6 months . Twenty females recently diagnosed with breast cancer , scheduled to undergo chemotherapy or radiation , were assigned r and omly to an experimental ( N = 10 ) or control group ( N = 10 ) . Outcome measures included TCI ( 3-day food diary ) , % BF ( skinfolds ) , and fatigue ( revised Piper Fatigue Scale ) . Each exercise session was conducted as follows : initial cardiovascular activity ( 6 - 12 min ) , followed by stretching ( 5 - 10 min ) , resistance training ( 15 - 30 min ) , and a cool-down ( approximately 8 min ) . Significant changes in TCI were observed among groups ( F1,18 = 8.582 ; P = 0.009 ) , at treatments 2 and 3 , and at the end of the study [ experimental ( 1973 + /- 419 ) , control ( 1488 + /- 418 ) ; experimental ( 1946 + /- 437 ) , control ( 1436 + /- 429 ) ; experimental ( 2315 + /- 455 ) , control ( 1474 + /- 294 ) , respectively ] . A significant negative correlation was found ( Spearman rho(18 ) = -0.759 ; P < 0.001 ) between TCI and % BF and between TCI and fatigue levels ( Spearman rho(18 ) = -0.541 ; P = 0.014 ) at the end of the study . In conclusion , the results of this study suggest that an exercise intervention administered to breast cancer patients undergoing medical treatment may assist in the mitigation of some treatment side effects , including decreased TCI , increased fatigue , and negative changes in body composition Cancer-related fatigue is the most disabling symptom experienced by breast cancer patients following the cancer treatment . The positive effects of physical activity in the rehabilitation of breast cancer patients are documented in several studies . In a r and omized controlled study the effects of a structured physical training program on fatigue and health-related quality of life were evaluated . Patients and Methods : 63 breast cancer patients with cancer-related chronic fatigue were r and omized at the beginning of the inpatient rehabilitation . The control group received the st and ard complex rehabilitation program , the intervention group a structured physical training program and additional muscle strength and aerobic exercises . The effects of the treatment were evaluated by question naires at the start of rehabilitation ( t1 ) , end of rehabilitation ( t2 ) , and 3 months after t2 ( t3 ) . Isometric muscle strength and aerobic capacity were evaluated at t1 and t2 . Results : There was an improvement of muscle strength at the end of rehabilitation for both groups . The increase from t1 to t2 was significantly higher for the training group . The scores for global quality of life , physical well-being , and functionality increased from t1 to t2 , but further improvement in the follow-up ( t3 ) was only observed in the training group . The cancer-related fatigue was significantly reduced in the training group from t1 to t3 , however , not in the control group . Conclusions : Structured physical training programs initiated during inpatient rehabilitation and continuously practice d in the time thereafter can improve symptoms of chronic fatigue and quality of life in breast cancer patients Exercise for Health was a r and omized , controlled trial design ed to evaluate two modes of delivering ( face-to-face [ FtF ] and over-the-telephone [ Tel ] ) an 8-month translational exercise intervention , commencing 6-weeks post-breast cancer surgery ( PS ) . Outcomes included quality of life ( QoL ) , function ( fitness and upper body ) and treatment-related side effects ( fatigue , lymphoedema , body mass index , menopausal symptoms , anxiety , depression and pain ) . Generalised estimating equation modelling determined time ( baseline [ 5 weeks PS ] , mid-intervention [ 6 months PS ] , post-intervention [ 12 months PS ] ) , group ( FtF , Tel , Usual Care [ UC ] ) and time-by-group effects . 194 women representative of the breast cancer population were r and omised to the FtF ( n = 67 ) , Tel ( n = 67 ) and UC ( n = 60 ) groups . There were significant ( p < 0.05 ) interaction effects on QoL , fitness and fatigue with differences being observed between the treatment groups and the UC group . Trends observed for the treatment groups were similar . The treatment groups reported improved QoL , fitness and fatigue over time and changes observed between baseline and post-intervention were clinical ly relevant . In contrast , the UC group experienced no change , or worsening QoL , fitness and fatigue , mid-intervention . Although improvements in the UC group occurred by 12-months post-surgery , the change did not meet the clinical ly relevant threshold . There were no differences in other treatment-related side effects between groups . This translational intervention trial , delivered either FtF or Tel , supports exercise as a form of adjuvant breast cancer therapy that can prevent declines in fitness and function during treatment and optimise recovery post-treatment Purpose Few r and omized controlled trials in exercise oncology have examined survival outcomes . Here , we report an exploratory follow-up of progression-free survival ( PFS ) from the Healthy Exercise for Lymphoma Patients ( HELP ) Trial . Methods The HELP Trial r and omized 122 lymphoma patients between 2005 and 2008 to either control ( n = 62 ) or 12 weeks of supervised aerobic exercise ( n = 60 ) . PFS events were abstract ed from medical records in 2013 . In addition to the r and omized comparison , we explored the effects of exercise adherence ( < 80 % vs. ≥80 % ) and control group crossover ( no vs. yes ) . Results After a median follow-up of 61 months ( interquartile range 36–67 ) , the adjusted 5-year PFS was 64.8 % for the exercise group compared with 65.0 % for the control group ( Hazard ratio [ HR ] 1.01 , 95 % CI 0.51–2.01 , p = 0.98 ) . In the secondary analysis , the adjusted 5-year PFS was 59.0 % in the control group without crossover compared with 69.2 % for the control group with crossover ( HR 0.68 , 95 % CI 0.22–2.06 , p = 0.49 ) , 67.7 % for the exercise group with < 80 % adherence ( HR 0.72 , 95 % CI 0.28–1.85 , p = 0.50 ) , and 68.4 % for the exercise group with ≥80 % adherence ( HR 0.70 , 95 % CI 0.32–1.56 , p = 0.39 ) . In a post hoc analysis combining the three groups that received supervised exercise , the adjusted 5-year PFS for the supervised exercise groups was 68.5 % compared with 59.0 % for the group that received no supervised exercise ( HR 0.70 , 95 % CI 0.35–1.39 , p = 0.31 ) . Conclusions This exploratory follow-up of the HELP Trial suggests that supervised aerobic exercise may be associated with improved PFS in lymphoma patients . Larger trials design ed to answer this question are needed OBJECTIVE To determine the effect of exercise on quality of life in ( a ) a r and omized controlled trial of exercise among recently diagnosed breast cancer survivors undergoing adjuvant therapy and ( b ) a similar trial among post-treatment survivors . METHODS Fifty newly diagnosed breast cancer survivors were recruited through a hospital-based tumor registry and r and omized to a 6-month , home-based exercise program ( n=25 ) or a usual care group ( n=25 ) . In a separate trial , 75 post-treatment survivors were r and omized to a 6-month , supervised exercise intervention ( n=37 ) or to usual care ( n=38 ) . Participants in both studies completed measures of happiness , depressive symptoms , anxiety , stress , self-esteem , and quality of life at baseline and 6 months . RESULTS Forty-five participants completed the trial for newly diagnosed survivors and 67 completed the trial for post-treatment survivors . Good adherence was observed in both studies . Baseline quality of life was similar for both studies on most measures . Exercise was not associated with quality of life benefits in the full sample of either study ; however exercise was associated with improved social functioning among post-treatment survivors who reported low social functioning at baseline ( p<0.05 ) . CONCLUSIONS Exercise did not affect quality of life in either recently diagnosed or post-treatment breast cancer survivors ; however this may be due in part to relatively high baseline functioning among participants in both studies . Strategies for future research include limiting enrollment to survivors who report reduced quality of life on screening question naires and targeting survivor subgroups known to be at particular risk for quality of life impairment Objective This study examined how free-text comments from cancer survivors  could complement formal patient-reported outcome measures ( PROMs ) , as part of the Engl and PROMs survey programme for cancer . Design A qualitative content analysis was conducted of responses to a single open-ended free-text question placed at the end of the cross-sectional population -based postal question naire . Setting Individuals were identified through three UK Cancer Registries and question naires were posted to their home addresses . Participants A r and om sample of individuals ( n=4992 ) diagnosed with breast , colorectal , non-Hodgkins lymphoma or prostate cancer at 1 , 2 , 3 and 5 years earlier . Results 3300 participants completed the survey ( 68 % response rate ) . Of these 1056 ( 32 % ) completed the free-text comments box , indicating a high level of commitment to provide written feedback on patient experience . Almost a fifth ( 19 % ) related experiences of excellent care during the treatment phase , with only 8 % reporting negative experiences . This contrasted with experiences of care after primary cancer treatment where the majority were negative . Factors impacting negatively upon patient-reported outcomes included the emotional impact of cancer ; poor experiences of treatment and care ; comorbidities , treatment side effects , social difficulties and inadequate preparation for a wide range of sometimes long-lasting on-going physical and psychological problems . Mediating factors assisting recovery incorporated both professional-led factors , such as quality of preparation for anticipated problems and aftercare services , and participant-led factors , such as learning from other cancer survivors and self-learning through trial and error . The support of friends and family was also a factor in participants ' outcomes . Conclusions This analysis of free-text comments complements quantitative analysis of PROMs measure 's by illuminating relationships between factors that impact on quality of life ( QoL ) and indicate why cancer patients may experience significantly worse QoL than the general population . The data suggest more systematic preparation and aftercare for individuals to self-manage post-treatment problems might improve QoL outcomes among cancer survivors Background : High insulin and insulin-like growth factor-I ( IGF-I ) levels may be associated with an increased breast cancer risk and /or death . Given the need to identify modifiable factors that decrease insulin , IGF-I , and breast cancer risk and death , we investigated the effects of a 6-month r and omized controlled aerobic exercise intervention versus usual care on fasting insulin , IGF-I , and its binding protein ( IGFBP-3 ) in postmenopausal breast cancer survivors . Methods : Seventy-five postmenopausal breast cancer survivors were identified from the Yale-New Haven Hospital Tumor Registry and r and omly assigned to an exercise ( n = 37 ) or usual care  ( n = 38 ) group . The exercise group participated in 150 minutes per week of moderate-intensity aerobic exercise . The usual care group was instructed to maintain their current physical activity level . A fasting blood sample was collected on each study participant at baseline and 6 months . Blood levels of insulin and IGF were measured with ELISA . Results : On average , exercisers increased  aerobic exercise  by 129 minutes per week compared with 45 minutes per week among usual care participants ( P < 0.001 ) . Women r and omized to exercise experienced decreases in insulin , IGF-I , and IGFBP-3 , whereas women r and omized to usual care had increases in these hormones . Between-group differences in insulin , IGF-I , and IGFBP-3 were 20.7 % ( P = 0.089 ) , 8.9 % ( P = 0.026 ) , and 7.9 % ( P = 0.006 ) , respectively . Conclusions : Moderate-intensity aerobic exercise , such as brisk walking , decreases IGF-I and IGFBP-3 . The exercise-induced decreases in IGF may mediate the observed association between higher levels of physical activity and improved survival in women diagnosed with breast cancer . ( Cancer Epidemiol Biomarkers Prev 2009;18(1):306–13 Background Despite being a critical survivorship care issue , there is a clear gap in current knowledge of the optimal treatment of  sexual dysfunction in men with prostate cancer . There is sound theoretical rationale and emerging evidence that exercise may be an innovative therapy to counteract sexual dysfunction in men with prostate cancer . Furthermore , despite the multidimensional aetiology of sexual dysfunction , there is a paucity of research investigating the efficacy of integrated treatment models . Therefore , the purpose of this study is to : 1 ) examine the efficacy of exercise as a therapy to aid in the management of sexual dysfunction in men with prostate cancer ; 2 ) determine if combining exercise and brief psychosexual intervention results in more pronounced improvements in sexual health ; and 3 ) assess if any benefit of exercise and psychosexual intervention on sexual dysfunction is sustained long term . Methods / Design A three-arm , multi-site r and omised controlled trial involving 240 prostate cancer survivors will be implemented . Participants will be r and omised to : 1 ) ‘ Exercise ’ intervention ; 2 ) ‘ Exercise + Psychosexual ’ intervention ; or 3 ) ‘ Usual Care ’ . The Exercise group will receive a 6-month , group based , supervised resistance and aerobic exercise intervention . The Exercise + Psychosexual group will receive the same exercise intervention plus a brief psychosexual self-management intervention that addresses psychological and sexual well-being . The Usual Care group will maintain st and ard care for 6 months . Measurements for primary and secondary endpoints will take place at baseline , 6 months ( post-intervention ) and 1 year follow-up . The primary endpoint is sexual health and secondary endpoints include key factors associated with sexual health in men with prostate cancer . Discussion Sexual dysfunction is one of the most prevalent and distressing consequences of prostate cancer . Despite this , very little is known about the management of sexual dysfunction and current health care services do not adequately meet sexual health needs of survivors . This project will examine the potential role of exercise in the management of sexual dysfunction and evaluate a potential best- practice management approach by integrating pharmacological , physiological and psychological treatment modalities to address the complex and multifaceted aetiology of sexual dysfunction following cancer . Trial registration Australian New Zeal and Clinical Trials Registry ACTRN12613001179729 BACKGROUND / AIM Regular physical activity and exercise improves quality of life and possibly reduces risk of disease relapse and prolongs survival in breast cancer survivors . The aim of this study was to evaluate the impact of a 3-week moderate intensity aerobic training , on aerobic capacity ( VO2max ) in breast cancer survivors . METHODS A prospect i ve , r and omized clinical study included 18 female breast cancer survivors in stage I-IIIA , in which the primary treatment was accomplished at least 3 months before the study inclusion . In all the patients  VO2max  was estimated using the Astr and 's protocol on a bicycle-ergometer ( before and after 3 weeks of training ) , while subjective assessment of exertion during training were estimated by the Category-Ratio RPE Scale . Each workout lasted 21 minutes : 3 minutes for warm-up and cool-down each and 15 min of full training , 2 times a week . The workload in the group E1 was predefined at the level of 45 % to 65 % of individual VO2max , and in the group E2 it was based on subjective evaluation of exertion , at the level marked 4 - 6 . Data on the subjective feeling of exertion were collected after each training course in both groups . RESULTS We recorded a statistically significant improvement in VO2max in both groups ( E1 - -11.86 % ; E2 - -17.72 % ) , with no significant differences between the groups . The workload level , determined by the percent of VO2max , was different between the groups E1 and E2 ( 50.47 + /- 7.02 % vs 55.58 + /- 9.58 % ) , as well as subjective perception of exertion ( in the groups E1 and E2 , 11.6 % and 41.6 % of training , respectively , was grade d in the mark 6 ) . CONCLUSION In our group of breast cancer survivors , a 3-week moderate intensity aerobic training significantly improved the level of VO2max BACKGROUND Participation in physical activity can improve the health outcomes of breast cancer survivors . To impact public health , broad-reaching sustainable interventions that promote physical activity are needed . PURPOSE To evaluate the efficacy of two distance-based interventions for promoting physical activity among breast cancer survivors compared with a st and ard recommendation control . METHODS Breast cancer survivors who had finished ' active ' cancer treatment were eligible to participate . Participants ( n = 330 ) were r and omly assigned to receive one of the following mail-delivered interventions : three computer-tailored newsletters , a previously developed breast cancer-specific physical activity booklet or a pamphlet detailing the public health recommendations for physical activity ( control ) . Primary outcomes were self-reported moderate to vigorous aerobic activity and participant 's self-reported resistance training activity at 4 months post-baseline . Secondary outcomes were pedometer step counts , whether or not participants were meeting the physical activity guidelines , time spent in sedentary behaviour , fatigue and health-related quality of life . RESULTS Participants r and omised into the tailored-print intervention group were three times more likely to commence resistance training and meet the resistance-training guidelines immediately after the intervention than participants allocated to the control group . There were no other significant intervention effects . CONCLUSION Computer-tailored newsletters may be an effective strategy for enhancing resistance-based physical activity among breast cancer survivors . The null findings relating to other outcomes may be due to ceiling effects ( in the case of aerobic activity , fatigue and health-related quality of life ) or the sensitivity of the measure used ( in the case of sitting time ) . These issues require further exploration PURPOSE S/ OBJECTIVES To test the hypothesis that women participating in a walking exercise program during radiation therapy treatment for breast cancer would demonstrate more adaptive responses as evidence d by higher levels of physical functioning and lower levels of symptom intensity than women who did not participate . DESIGN Experimental , two-group pretest , post-test . SETTING Two university teaching hospital outpatient radiation therapy departments . SAMPLE 46 women beginning a six-week program of radiation therapy for early stage breast cancer . METHODS Following r and om assignment , subjects in the exercise group maintained an individualized , self-paced , home-based walking exercise program throughout treatment . The control group received usual care . Dependent variables were measured prior to and at the end of radiation therapy . In addition , symptoms were assessed at the end of three weeks of treatment . MAIN RESEARCH VARIABLES Participation in the walking exercise program , physical functioning fatigue , emotional distress , and difficulty sleeping . FINDINGS Hypothesis testing by multivariate analysis of covariance , with pretest scores as covariates , indicated significant differences between groups on outcome measures ( p < 0.001 ) . The exercise group scored significantly higher than the usual care group on physical functioning ( p = 0.003 ) and symptom intensity , particularly fatigue , anxiety , and difficulty sleeping . Fatigue was the most frequent and intense subjective symptom reported . CONCLUSIONS A self-paced , home-based walking exercise program can help manage symptoms and improve physical functioning during radiation therapy . IMPLICATION S FOR NURSING PRACTICE Nurse-prescribed and -monitored exercise is an effective , convenient , and low-cost self-care activity that reduces symptoms and facilitates adaptation to breast cancer diagnosis and treatment PURPOSE Interventions to increase physical activity among breast cancer survivors are needed to improve health and quality of life and possibly to reduce the risk of disease recurrence and early mortality . Therefore , we report the feasibility and preliminary outcomes of a pilot r and omized trial design ed to increase physical activity in sedentary breast cancer survivors receiving hormone therapy . METHODS Forty-one sedentary women on estrogen receptor modulators or aromatase inhibitors for stage I , II , or IIIA breast cancer were r and omly assigned to receive a 12-wk multidisciplinary physical activity behavior change intervention or usual care . RESULTS Recruitment was 34 % , intervention adherence was 99 % , and complete follow-up data were obtained on 93 % . Most participants ( 93 % ) were white with mean age of 53 + /- 9 yr . Differences favoring the intervention group were noted for accelerometer physical activity counts ( mean difference = 72,103 ; 95 % confidence interval ( CI ) = 25,383 - 119,000 ; effect size ( d ) = 1.02 ; P = 0.004 ) , aerobic fitness ( mean difference = 2.9 ; 95 % CI = -0.1 to 5.8 ; d = 0.64 ; P = 0.058 ) , back/leg muscle strength ( mean difference = 12.3 ; 95 % CI = 0.4 - 15.9 ; d = 0.81 ; P = 0.017 ) , waist-to-hip ratio ( mean difference = -0.05 ; 95 % CI = -0.01 to -0.08 ; d = -0.77 ; P = 0.018 ) , and social well-being ( mean difference = 2.0 ; 95 % CI = 0.3 - 3.8 ; d = 0.76 ; P = 0.03 ) . However , the intervention group also reported a greater increase in joint stiffness ( mean difference = 1.1 ; 95 % CI = 0.1 - 2.2 ; d = 0.70 ; P = 0.04 ) . CONCLUSIONS A behavior change intervention for breast cancer survivors based on the social cognitive theory is feasible and results in potentially meaningful improvements in physical activity and selected health outcomes . Confirmation in a larger study is warranted OBJECTIVE Evidence of the benefits of exercise for those treated for cancer has led to exercise interventions for this population . Some have question ed whether cancer patients offered a home-based intervention  adhere to the exercise prescribed . METHOD We examined exercise adherence in a r and omized controlled trial of a 12-week ,  home-based exercise trial for breast cancer patients . Three adherence outcomes were examined : minutes of exercise participation/week , number of steps taken during planned exercise/week  , and whether the participant met her weekly exercise goal . Predictors of adherence ( e.g. demographic and medical variables , Transtheoretical Model variables , history of exercise ) were examined . RESULTS Findings indicate that participants significantly increased their minutes of exercise and steps taken during planned exercise from Week 1 to 12 . The percentage of participants achieving exercise goals was highest in the first few weeks . Exercise self-efficacy significantly predicted each adherence outcome . Baseline PA predicted mean exercise session steps over the 12 weeks . CONCLUSION Adherence to a home-based exercise intervention for breast cancer patients changes over time and may be related to baseline levels of exercise self-efficacy UNLABELLED Erectile dysfunction ( ED ) is a major adverse effect of radical prostatectomy ( RP ) . We conducted a r and omized controlled trial to examine the efficacy of aerobic training ( AT ) compared with usual care ( UC ) on ED prevalence in 50 men ( n=25 per group ) after RP . AT consisted of five walking sessions per week at 55 - 100 % of peak oxygen uptake ( VO2peak ) for 30 - 60 min per session following a nonlinear prescription . The primary outcome was change in the prevalence of ED , as measured by the International Index of Erectile Function ( IIEF ) , from baseline to 6 mo . Secondary outcomes were brachial artery flow-mediated dilation ( FMD ) , VO2peak , cardiovascular ( CV ) risk profile ( eg , lipid profile , body composition ) , and patient-reported outcomes ( PROs ) . The prevalence of ED ( IIEF score ≤ 21 ) decreased by 20 % in the AT group and by 24 % in the UC group ( difference : p=0.406 ) . There were no significant between-group differences in any erectile function subscale ( p>0.05 ) . Significant between-group differences were observed for changes in FMD and VO2peak , favoring AT . There were no group differences in other markers of CV risk profile or PROs . In summary , nonlinear AT does not improve ED in men with localized prostate cancer in the acute period following RP . TRIAL REGISTRATION Clinical trials.gov identifier NCT00620932 Purpose Peak oxygen consumption ( VO2peak ) is an important predictive factor for long-term prognosis in patients with non-small cell lung cancer ( NSCLC ) . The purpose of this study was to investigate whether 8 weeks of exercise training improves exercise capacity , as assessed by VO2peak , and other related factors in patients with NSCLC receiving targeted therapy . Methods A total of 24 participants with adenocarcinoma were r and omly assigned to either the control group ( n = 11 ) or the exercise group ( n = 13 ) . Subjects in the exercise group participated in individualized , high-intensity aerobic interval training of exercise . The outcome measures assessed at baseline and after 8 weeks were as follows : VO2peak and the percentage of predicted VO2peak ( % predVO2peak ) , muscle strength and endurance of the right quadriceps , muscle oxygenation during exercise , insulin resistance as calculated by the homeostasis model , high-sensitivity C-reactive protein , and quality of life ( QoL ) question naire inventory . Results No exercise-related adverse events were reported . After exercise training , VO2peak and % predVO2peak increased by 1.6 mL kg−1 min−1 and 5.3 % ( p < 0.005 ) , respectively ; these changes were associated with improvements in circulatory , respiratory , and muscular functions at peak exercise ( all p = 0.001 ) . The exercise group also had less dyspnea ( p = 0.01 ) and favorably lower fatigue ( p = 0.05 ) than baseline . Conclusions Patients with NSCLC receiving targeted therapy have quite a low exercise capacity , even with a relatively high QoL. Exercise training appears to improve exercise capacity and alleviate some cancer-related symptoms Background : Patients with lymphoma experience sleep problems that may be managed with aerobic exercise but no previous study has examined this issue . Methods : We r and omized 122 patients with lymphoma to usual care ( n = 62 ) or 12 weeks of supervised aerobic exercise training ( AET ; n = 60 ) . Our primary sleep endpoint was global sleep quality assessed by the Pittsburgh Sleep Quality Index ( PSQI ) . Secondary endpoints were the PSQI component scores . Planned subgroup analyses were also conducted . Results : Intention-to-treat analyses indicated that AET result ed in a nonsignificant ( P = 0.16 ) improvement in global sleep quality compared with usual care [ mean group difference = −0.64 ; 95 % confidence interval ( CI ) , −1.56 to + 0.27 ] . In planned subgroup analyses , statistically significant or borderline significant interactions were identified for type of lymphoma ( Pinteraction = 0.006 ) , current treatment status ( Pinteraction = 0.036 ) , time since diagnosis ( Pinteraction = 0.010 ) , body mass index ( Pinteraction = 0.075 ) , and baseline sleep quality ( Pinteraction = 0.041 ) . Specifically , AET  improved global sleep quality in patients with lymphoma who had indolent non – Hodgkin lymphoma ( P = 0.001 ) , were receiving chemotherapy ( P = 0.013 ) , were < 2 years post-diagnosis ( P = 0.005 ) , were obese ( P = 0.025 ) , and were poor sleepers at baseline ( P = 0.007 ) . Conclusions : AET did not significantly improve sleep quality in this heterogeneous sample of patients with lymphoma ; however , clinical ly identifiable subgroups appeared to benefit . Future exercise trials targeting these responsive subgroups are needed to confirm these findings . Impact : If replicated in larger and more focused trials , aerobic exercise may be an attractive option to manage sleep dysfunction in patients with cancer because of its favorable safety profile and other documented health benefits . Cancer Epidemiol Biomarkers Prev ; 21(6 ) ; 887–94 . © 2012 AACR Objectives To determine functional and psychological benefits of a 12 week supervised group exercise programme during treatment for early stage breast cancer , with six month follow-up . Design Pragmatic r and omised controlled prospect i ve open trial . Setting Three National Health Service oncology clinics in Scotl and and community exercise facilities . Participants 203 women entered the study ; 177 completed the six month follow-up . Interventions Supervised 12 week group exercise programme in addition to usual care , compared with usual care . Main outcome measures Functional assessment of cancer therapy ( FACT ) question naire , Beck depression inventory , positive and negative affect scale , body mass index , seven day recall of physical activity , 12 minute walk test , and assessment of shoulder mobility . Results Mixed effects models with adjustment for baseline values , study site , treatment at baseline , and age gave intervention effect estimates ( intervention minus control ) at 12 weeks of 129 ( 95 % confidence interval 83 to 176 ) for metres walked in 12 minutes , 182 ( 75 to 289 ) for minutes of moderate intensity activity reported in a week , 2.6 ( 1.6 to 3.7 ) for shoulder mobility , 2.5 ( 1.0 to 3.9 ) for breast cancer specific subscale of quality of life , and 4.0 ( 1.8 to 6.3 ) for positive mood . No significant effect was seen for general quality of life ( FACT-G ) , which was the primary outcome . At the six month follow-up , most of these effects were maintained and an intervention effect for breast cancer specific quality of life emerged . No adverse effects were noted . Conclusion Supervised group exercise provided functional and psychological benefit after a 12 week intervention and six months later . Clinicians should encourage activity for their patients . Policy makers should consider the inclusion of exercise opportunities in cancer rehabilitation services . Trial registration Current controlled trials IS RCT N12587864 CONTEXT Physical activity has been shown to decrease the incidence of breast cancer , but the effect on recurrence or survival after a breast cancer diagnosis is not known . OBJECTIVE To determine whether physical activity among women with breast cancer decreases their risk of death from  breast cancer  compared with more sedentary women . DESIGN , SETTING , AND PARTICIPANTS Prospect i ve observational study based on responses from 2987 female registered nurses in the Nurses ' Health Study who were diagnosed with stage I , II , or III breast cancer between 1984 and 1998 and who were followed up until death or June 2002 , whichever came first . MAIN OUTCOME MEASURE Breast cancer mortality risk according to  physical activity  category ( <3 , 3 - 8.9 , 9 - 14.9 , 15 - 23.9 , or > or = 24 metabolic equivalent task [ MET ] hours per week ) . RESULTS Compared with women who engaged in less than 3 MET-hours per week of physical activity , the adjusted relative risk ( RR ) of death from breast cancer was 0.80 ( 95 % confidence interval [ CI ] , 0.60 - 1.06 ) for 3 to 8.9 MET-hours per week ; 0.50 ( 95 % CI , 0.31 - 0.82 ) for 9 to 14.9 MET-hours per week ; 0.56 ( 95 % CI , 0.38 - 0.84 ) for 15 to 23.9 MET-hours per week ; and 0.60 ( 95 % CI , 0.40 - 0.89 ) for 24 or more MET-hours per week ( P for trend = .004 ) . Three MET-hours is equivalent to walking at average pace of 2 to 2.9 mph for 1 hour . The benefit of physical activity was particularly apparent among women with hormone-responsive tumors . The RR of breast cancer death for women with hormone-responsive tumors who engaged in 9 or more MET-hours per week of activity compared with women with hormone-responsive tumors who engaged in less than 9 MET-hours per week was 0.50 ( 95 % CI , 0.34 - 0.74 ) . Compared with women who engaged in less than 3 MET-hours per week of activity , the absolute unadjusted mortality risk reduction was 6 % at 10 years for women who engaged in 9 or more MET-hours per week . CONCLUSIONS Physical activity after a breast cancer diagnosis may reduce the risk of death from this disease . The greatest benefit occurred in women who performed the equivalent of walking 3 to 5 hours per week at an average pace , with little evidence of a correlation between increased benefit and greater energy expenditure . Women with breast cancer who follow US physical activity recommendations may improve their survival OBJECTIVE To investigate the effectiveness of an 8-week aquatic program on  cancer-related fatigue , as well as physical and psychological outcomes in breast cancer survivors . DESIGN A r and omized controlled trial . SETTING Outpatient clinic , urban , academic medical center , and a sport university swimming pool . PARTICIPANTS Breast cancer survivors ( N=68 ) were r and omly assigned to either an experimental ( aquatic exercise group in deep water pool ) group or a control ( usual care ) group . INTERVENTIONS The intervention group attended aquatic exercise sessions 3 times per week for 8 weeks in a heated deep swimming pool . Sessions lasted 60 minutes in duration : 10 minutes of warm-up , 40 minutes of aerobic and endurance exercises , and 10 minutes of cool-down exercises . Patients allocated to the usual care group followed the oncologist 's recommendations in relation to a healthy lifestyle . MAIN OUTCOME MEASURES Values for fatigue ( Piper Fatigue Scale ) , mood state ( Profile of Mood States ) , and abdominal ( trunk curl static endurance test ) and leg ( multiple sit-to-st and test ) strength were collected at baseline , after the last treatment session , and at a 6-month follow-up . RESULTS Immediately after discharge , the aquatic exercise group showed a large effect size in total fatigue score ( d=.87 ; 95 % confidence interval , .48 - 1.26 ) , trunk curl endurance ( d=.92 ; 95 % confidence interval , 1.97 - 3.83 ) , and leg strength ( d=1.10 ; .55 - 2.76 ) , but negligible effects in vigor , confusion , and disturbance of mood ( d<.25 ) . At the 6-month follow-up period , the aquatic exercise group maintained large to small effect sizes in fatigue scores , multiple sit-to-st and test , and trunk curl static endurance ( .25>d>.90 ) and negligible effects for the fatigue-severity dimension and different scales of the Profile of Mood States ( d<.25 ) . CONCLUSION An aquatic exercise program conducted in deep water was effective for improving cancer-related fatigue and strength in breast cancer survivors Background : Bleomycin – etoposid – cisplatin ( BEP ) chemotherapy is curative in most patients with disseminated germ cell cancer ( GCC ) but also associated with toxic actions and dysfunction in non-targeted tissues . We investigated changes in muscle function during BEP and the safety and efficacy of resistance training to modulate these changes . Methods : Thirty GCC patients were r and omly assigned to resistance training ( resistance training group ( INT ) , n=15 ) or usual care ( CON , n=15 ) during 9 weeks of BEP therapy . Resistance training consisted of thrice weekly sessions of four exercises , 3–4 sets/exercise of 10–15 repetitions at 12–15 repetition maximum load . The primary endpoint was muscle fibre size , assessed in muscle biopsies from musculus vastus lateralis . Secondary endpoints were fibre phenotype composition , body composition , strength , blood biochemistry and patient-reported endpoints . Healthy age-matched subjects ( REF , n=19 ) performed the same RT-programme for comparison purpose s. Results : Muscle fibre size decreased by −322 μm2 ( 95 % confidence interval ( CI ) : −899 to 255 ; P=0.473 ) in the CON-group and increased by + 206 μm2 ( 95 % CI : −384 to 796 ; P=0.257 ) in the INT-group ( adjusted mean difference ( AMD ) , + 625 μm2 , 95 % CI : −253 to 1503 , P=0.149 ) . Mean differences in type II fibre size ( AMD , + 823 μm2 , P=0.09 ) and lean mass ( AMD , + 1.49 kg , P=0.07 ) in favour of the INT-group approached significance . The REF-group improved all muscular endpoints and had significantly superior changes compared with the INT-group ( P<0.05 ) . Conclusions : BEP was associated with significant reduction in lean mass and strength and trends toward unfavourable changes in muscle fibre size and phenotype composition  . Resistance training was safe and attenuated dysfunction in selected endpoints , but BEP blunted several positive adaptations observed in healthy controls . Thus , our study does not support the general application of resistance training in this setting but larger-scaled trials are required to confirm this finding BACKGROUND The efficacy of a home-based physical activity ( PA ) intervention for colorectal cancer patients versus  contact control was evaluated in a r and omized controlled trial . METHODS Forty-six patients ( mean age = 57.3 years [ SD = 9.7 ] , 57 % female , mean = 2.99 years post-diagnosis [ SD = 1.64 ] ) who had completed treatment for stages 1 - 3 colorectal cancer were r and omized to telephone counseling to support PA ( PA group , n = 20 ) or contact control ( control group , n = 26 ) . PA group participants received 3 months of PA counseling ( based on the transtheoretical model and the social cognitive theory ) delivered via telephone , as well as weekly PA tip sheets . Assessment s of  PA ( Seven-day Physical Activity Recall [ 7-day PAR ] and Community Healthy Activities Model Program for Seniors [ CHAMPS ] ) , submaximal aerobic fitness ( Treadwalk test ) , motivational readiness for PA , and psychosocial outcomes were conducted at baseline , 3 , 6 , and 12 months post-baseline . Objective accelerometer data were collected at the same time points . RESULTS The PA group reported significant increases in minutes of PA at 3 months ( 7-day PAR ) and caloric expenditure ( CHAMPS ) compared with the control group , but the group differences were attenuated over time . The PA group showed significant improvements in fitness at 3 , 6 , and 12 months versus the control group . Improvements in motivational readiness for PA were reported in the PA group only at 3 months . No significant group differences were found for fatigue , self-reported physical functioning , and quality of life at 3 , 6 , and 12 months . CONCLUSION A home-based intervention improved survivors ' PA and motivational readiness at 3 months and increased submaximal aerobic fitness at 3 , 6 , and 12 months PURPOSE To examine the effects of aerobic exercise therapy on quality of life ( QoL ) and associated outcomes in women treated for breast cancer . Evidence suggests that exercise may be beneficial , but no trial has included an exercise-placebo and a usual-care group to control for the attention effects that might be associated with aerobic exercise interventions in cancer patients . PATIENTS AND METHODS A total of 108 women who had been treated for breast cancer 12 to 36 months previously were r and omly assigned to supervised aerobic exercise therapy ( n = 34 ) , exercise-placebo ( body conditioning ; n = 36 ) , or usual care ( n = 38 ) . Exercise therapy and exercise-placebo sessions took place three times per week for 8 weeks . Outcomes included QoL , depression , exercise behavior , aerobic fitness ; outcomes were assessed at baseline and at the 8- and 24-week follow-up . RESULTS Analyses of covariance revealed a significant mean difference of 9.8 units in Functional Assessment of Cancer Therapy-General ( primary outcome ) favoring aerobic exercise therapy at 8 weeks , relative to usual care . Significant differences that favored aerobic exercise therapy relative to usual care were recorded for Functional Assessment of Cancer Therapy-Breast , social/family well-being , functional well-being , and breast cancer subscale scores at 8-week follow-up . Psychological health outcomes improved modestly for both intervention groups ; these improvements were sustained for several end points . CONCLUSION Exercise therapy had large , clinical ly meaningful , short-term beneficial effects on QoL in women treated for breast cancer ; this finding can not be attributable to attention , given that the exercise-placebo group did not report similar effects relative to usual care PURPOSE / OBJECTIVES To examine the effects of a comprehensive rehabilitation program on facilitating physical and psychosocial adaptation of women with breast cancer who are receiving adjuvant chemotherapy . DESIGN Experimental . SETTING Breast evaluation clinics of two New Engl and medical centers with comprehensive cancer treatment programs . SAMPLE 14 women ( mean age = 44 years ) receiving adjuvant chemotherapy for breast cancer ( 86 % stage II ) following surgical treatment . METHODS Subjects were assigned r and omly to the experimental group or the usual care group . Experimental group members began a structured exercise program of walking and attended support group meetings . All subjects were tested before beginning chemotherapy , during the course of chemotherapy , and one month following chemotherapy completion . MAIN RESEARCH VARIABLES Performance status , physical functioning , psychosocial adjustment , self-concept and body image , and 12 symptoms ( e.g. , fatigue , nausea , anxiety ) . FINDINGS Measures of physical performance , psychosocial adjustment , and symptom intensity revealed improved adaptation in subjects who completed the walking/support group program . CONCLUSIONS Physical and psychosocial benefits from a modest walking exercise program and a support group are possible for patients receiving adjuvant chemotherapy . IMPLICATION S FOR NURSING PRACTICE Although more detailed research is necessary to answer some of the questions raised by this study , implementing the walking program and forming a support group are achievable in an outpatient setting Purpose Although physical activity ( PA ) adoption improves fitness and psychological well-being among cancer survivors , PA maintenance has not been examined . This paper presents follow-up of a home-based PA program for women treated for early-stage breast cancer . Material s and methods Eighty-six sedentary women ( mean age = 53.14 years , SD = 9.70 ) were r and omly assigned to a  PA or contact control group . The PA group received a 12-week telephone counseling program to adopt PA . Assessment s were conducted at baseline , end-of-intervention ( 12 weeks ) , 6 , and 9 months post-baseline . Results When comparing change from end-of-intervention ( 12 weeks ) between groups , a significant reduction was observed in minutes of PA at 6 months ( t = −2.10 , p < 0.05 ) , but there was no decrease in intervention effect at 9 months ( t = −0.19 , p = 0.84 ) . Similarly , post-intervention reductions in fatigue were lost at 6 months ( t = 3.27 , p < 0.01 ) , but remained present at 9 months ( t = 1.65 , p = 0.10 ) . PA group ’s fitness improvements were maintained at both follow-ups ( t = 1.04 , p = 0.30 and t = 0.05 , p = 0.96 ) . The previously significant intervention effect on vigor was maintained at 6 months ( t = 1.32 , p = 0.19 ) but was significantly reduced at 9 months ( t = −2.15 , p < 0.05 ) . PA participants were more likely to progress in motivational readiness at 6 ( OR = 5.95 , 95 % CI = 2.30 , 15.36 ) and 9 months ( OR = 4.09 , 95 % CI = 1.69 , 9.87 ) ; however , group differences in meeting PA guidelines were not maintained . ConclusionS ome positive effects of a home-based PA intervention for breast cancer patients were maintained at 6 and 9 months AIM This paper is a report of a study analysing the effect of a home-based walking exercise program on symptoms and mood distress among breast cancer women receiving chemotherapy postoperatively . BACKGROUND Treatment-related symptoms , mood distress and decline in physical activity have been identified as major complaints among cancer patients . Studies on the efficacy of home-based walking exercise for symptoms and mood did not fully describe the exercise prescriptions that could be safe and beneficial for women with breast cancer , especially these receiving adjuvant chemotherapy . METHOD This is a prospect i ve , r and omized clinical trial . In 2008 - 2009 , participants were recruited from the oncology outpatient clinic of a medical center in Taiwan , and were assigned to either the  exercise group ( n=19 ) or the  control group ( n=21 ) . Women in the exercise group participated in a moderate-intensity home-based walking program for 12 weeks during their chemotherapy treatments .  Symptoms , mood status and physical activity level were measured at baseline , 6- and 12-week follow-up . Data were analysed by two-way repeated- measures analysis of variance . RESULTS Women in the exercise group reported significantly lower symptom severity scores and mood disturbance compared with those in the control group throughout the study period . CONCLUSION Regular moderate-intensity exercise can play an important role in improving treatment-related symptoms and mood in women with breast cancer . A home-based walking exercise program can be easily incorporated into care for women with breast cancer undergoing chemotherapy PURPOSE Cancer survivors are at increased risk for cardiovascular disease , diabetes , osteoporosis , and second primary tumors . Healthful lifestyle practice s may improve the health and well-being of survivors . The FRESH START trial tested the efficacy of sequentially tailored versus st and ardized mailed material s on improving cancer survivors ' diet and exercise behaviors . METHODS Five hundred forty-three individuals with newly diagnosed locoregional breast or prostate cancer were recruited from 39 states and two provinces within North America . Participants were r and omly assigned either to a 10-month program of tailored mailed print material s promoting fruit and vegetable ( F&V ) consumption , reducing total/saturated fat intake , and /or increasing exercise or to a 10-month program of nontailored mailed material s on diet and exercise available in the public domain . Telephone surveys conducted at baseline and 1 year assessed body mass index ( BMI ) , dietary consumption , physical activity , and other psychosocial/behavioral indices . Clinical assessment s were conducted on a 23 % sub sample ; information was used to vali date self-reports . RESULTS Five hundred nineteen participants completed the 1-year follow-up ( 4.4 % attrition ; sample characteristics : 57 + /- 10.8 years old , 83 % white , 56 % female , 64 % overweight/obese , and 0 % underweight ) . Although both arms significantly improved their lifestyle behaviors ( P < .05 ) , significantly greater gains occurred in the FRESH START intervention versus the control arm ( practice of two or more goal behaviors : + 34 % v + 18 % , P < .0001 ; exercise minutes per week : + 59.3 v + 39.2 minutes , P = .02 ; F&V per day : + 1.1 v + 0.6 servings , P = .01 ; total fat : -4.4 % v -2.1 % , P < .0001 ; saturated fat : -1.3 % v -0.3 % , P < .0001 ; and BMI : -0.3 v + 0.1 kg/m2 , respectively , P = .004 ) . CONCLUSION Mailed material interventions , especially those that are tailored , are effective in promoting healthful lifestyle changes among cancer survivors . Further study is needed to determine sustainability , cost to benefit , and generalizability to other cancer population In this 12-month RCT , we examined whether aerobic impact exercise training ( 3x/week ) could facilitate breast cancer survivors ' recovery by enhancing their bone structural strength , physical performance and body composition . After the adjuvant chemo- and / or radiotherapy , 86 patients were r and omly assigned into the training or control group . Structural bone traits were assessed with pQCT at the tibia and with DXA at the femoral neck . Agility ( figure-8 running ) , jump force and power ( force platform ) , grip strength and cardiovascular fitness ( 2-km walk test ) were also assessed . Training effects on outcome variables were estimated by two-way factorial ANCOVA using the study group and menopausal status as fixed factors . Bone structural strength was better maintained among the trainees . At the femoral neck , there was a small but significant 2 % training effect in the bone mass distribution ( p=0.05 ) . At the tibial diaphysis , slight 1 % to 2 % training effects ( p=0.03 ) in total cross-sectional area and bone structural strength were observed ( p=0.03 ) among the postmenopausal trainees . Also , 3 % to 4 % training effects were observed in the figure-8 running time ( p=0.03 ) and grip strength ( p=0.01 ) . In conclusion , vigorous aerobic impact exercise training has potential to maintain bone structural strength and improve physical performance among breast cancer survivors Abstract Introduction . Radical cystectomy with lymph-node dissection is a complex procedure and often followed by high postoperative morbidity and physical impairments leading to prolonged length of stay ( LOS ) . Fast-track principles are st and ard procedure in radical cystectomy . Additional preoperative and postoperative physical exercises and enhanced mobilization may reduce LOS and early complications . Material s and methods . In total , 107 patients were included in a prospect i ve r and omized controlled design , 50 in the intervention group ( nI = 50 ) and 57 in the st and ard group ( ns = 57 ) . The st and ard regimen comprised regular fast-track principles . The intervention included st and ardized preoperative and postoperative strength and endurance exercises and progressive postoperative mobilization . The programme was initiated 2 weeks before surgery . Efficacy was expressed as a reduction in postoperative LOS . Early complications were defined as events occurring at most 90 days postoperatively and grade d using the Clavien – Dindo classification system . Results . Adherence to prehabilitation , i.e. patients who accomplished at least 75 % of the programme , was 59 % . Postoperative mobilization was significantly improved by walking distance ( p ≤ 0.001 ) . The ability to perform personal activities of daily living was improved by 1 day ( p ≤ 0.05 ) . The median LOS was 8 days in both treatment groups ( p = 0.68 ) . There was no significant difference between treatment groups in severity of complications ( p = 0.64 ) . Conclusions . There was no reduction in LOS due to the preoperative and postoperative rehabilitation programme , although enhanced mobilization was achieved . The optimized minimal surgical procedure may have affected the ability to reduce LOS further with available techniques and procedures . Alternative parameters for recovery may offer more precise and relevant information Background International evidence -based guidelines recommend physical exercise to form part of st and ard care for all cancer survivors . However , at present , the optimum exercise intensity is unclear . Therefore , we aim ed to evaluate the effectiveness of a high intensity ( HI ) and low-to-moderate intensity ( LMI ) resistance and endurance exercise program compared with a wait list control ( WLC ) group on physical fitness and fatigue in a mixed group of cancer survivors who completed primary cancer treatment , including chemotherapy . Methods Overall , 277 cancer survivors were r and omized to 12 weeks of  HI exercise ( n = 91 ) , LMI exercise ( n = 95 ) , or WLC ( n = 91 ) . Both interventions were identical with respect to exercise type , duration and frequency , and only differed in intensity . Measurements were performed at baseline ( 4–6 weeks after primary treatment ) and post-intervention . The primary outcomes were cardiorespiratory fitness ( peakVO2 ) , muscle strength ( grip strength and 30-second chair-st and test ) , and self-reported fatigue ( Multidimensional Fatigue Inventory ; MFI ) . Secondary outcomes included health-related quality of life , physical activity , daily functioning , body composition , mood , and sleep disturbances . Multilevel linear regression analyses were performed to estimate intervention effects using an intention-to-treat principle . Results In the HI and LMI groups , 74 % and 70 % of the participants attended more than 80 % of the prescribed exercise sessions , respectively ( P = 0.53 ) . HI ( β = 2.2 ; 95 % CI , 1.2–3.1 ) and LMI ( β = 1.3 ; 95 % CI , 0.3–2.3 ) exercise showed significantly larger improvements in peakVO2 compared to WLC . Improvements in peakVO2 were larger for HI than LMI exercise ( β = 0.9 ; 95 % CI , −0.1 to 1.9 ) , but the difference was not statistically significant ( P = 0.08 ) . No intervention effects were found for grip strength and the 30-second chair-st and test . HI and LMI exercise significantly reduced general and physical fatigue and reduced activity ( MFI subscales ) compared to WLC , with no significant differences between both interventions . Finally , compared to WLC , we found benefits in global quality of life and anxiety after HI exercise , improved physical functioning after HI and LMI exercise , and less problems at work after LMI exercise . Conclusions Shortly after completion of cancer treatment , both HI and LMI exercise were safe and effective . There may be a dose – response relationship between exercise intensity and peakVO2 , favoring HI exercise . HI and LMI exercise were equally effective in reducing general and physical fatigue . Trial registration This study was registered at the Netherl and s Trial Register [ NTR2153 ] on the 5th of January 2010 The purpose of the present paper was to evaluate the effects of an 8-week multimodal program focused on core stability exercises and recovery massage with DVD support for a 6-month period in physical and psychological outcomes in breast cancer survivors . A r and omized controlled clinical trial was performed . Seventy-eight ( n = 78 ) breast cancer survivors were assigned to experimental ( core stability exercises plus massage-myofascial release ) and control ( usual health care ) groups . The intervention period was 8 weeks . Mood state , fatigue , trunk curl endurance , and leg strength were determined at baseline , after the last treatment session , and at 6 months of followup . Immediately after treatment and at 6 months , fatigue , mood state , trunk curl endurance , and leg strength exhibited greater improvement within the experimental group compared to placebo group . This paper showed that a multimodal program focused on core stability exercises and massage  reduced fatigue , tension , depression , and improved vigor and muscle strength after intervention and 6 months after discharge Previous studies suggest that increased physical activity may lower the risk of breast cancer incidence , but less is known about whether levels of physical activity after breast cancer diagnosis can influence survival . We prospect ively examined the relation between postdiagnosis recreational physical activity and risk of breast cancer death  in women who had a previous invasive breast cancer diagnosed between 1988 and 2001 ( at ages 20 - 79 years ) . All women completed a question naire on recent  postdiagnosis physical activity and other lifestyle factors . Among 4,482 women without history of recurrence at the time of completing the question naire , 109 died from breast cancer within 6 years of enrollment .  Physical activity was expressed as metabolic equivalent task-hours per week ( MET-h/wk ) ; hazard ratios ( HR ) and 95 % confidence intervals ( 95 % CI ) were estimated using Cox proportional hazards regression . After adjusting for age at diagnosis , stage of disease , state of residence , interval between diagnosis and physical activity assessment , body mass index , menopausal status , hormone therapy use , energy intake , education , family history of breast cancer , and treatment modality compared with women expending < 2.8 MET-h/wk in physical activity , women who engaged in greater levels of activity had a significantly lower risk of dying from breast cancer ( HR , 0.65 ; 95 % CI , 0.39 - 1.08 for 2.8 - 7.9 MET-h/wk ; HR , 0.59 ; 95 % CI , 0.35 - 1.01 for 8.0 - 20.9 MET-h/wk ; and HR , 0.51 ; 95 % CI , 0.29 - 0.89 for ≥21.0 MET-h/wk ; P for trend = 0.05 ) . Results were similar for overall survival ( HR , 0.44 ; 95 % CI , 0.32 - 0.60 for ≥21.0 versus < 2.8 MET-h/wk ; P for trend < 0.001 ) and were similar regardless of a woman ’s age , stage of disease , and body mass index . This study provides support for reduced overall mortality and mortality from breast cancer among women who engage in physical activity  after breast cancer diagnosis . ( Cancer Epidemiol Biomarkers Prev 2008;17(2):379–86 Background Prostate cancer is the most commonly diagnosed non-melanoma cancer among men .  And rogen deprivation therapy ( ADT ) has been the core therapy for men with advanced prostate cancer . It is only in recent years that clinicians began to recognize the cognitive-psychosocial side effects from ADT , which significantly compromise the quality of life of prostate cancer survivors . The objectives of the study are to determine the efficacy of a simple and accessible home-based , walking exercise program in promoting cognitive and psychosocial functions of men with prostate cancer receiving ADT . Methods A 6-month prospect i ve , single-blinded , r and omized controlled trial will be conducted to compare the Exercise Group with the Control Group .  Twenty men with prostate cancer starting ADT will be recruited and r and omly assigned to one of the two groups : the Exercise Group will receive instructions in setting up an individualized 6-month home-based , walking exercise program , while the Control Group will receive st and ard medical advice from the attending physician . The primary outcomes will be psychosocial and cognitive functions . Cognitive functions including memory , attention , working memory , and executive function will be assessed using a battery of neurocognitive tests at baseline and 6 months . Psychosocial functions including depression , anxiety and self-esteem will be assessed at baseline , 3 and 6 months using the Center for Epidemiological Studies Depression Scale , Spielberger State-Trait Anxiety Inventory , and Rosenberg Self-Esteem Scale . Discussion The significance of the cognitive-psychosocial side effects of ADT in men with prostate cancer has only been recently recognized , and the management remains unclear . This study addresses this issue by design ing a simple and accessible home-based , exercise program that may potentially have significant impact on reducing the cognitive and psychosocial side effects of ADT , and ultimately improving the health-related quality of life in men with prostate cancer receiving ADT.Trial registration PURPOSE To examine the effect of a progressive upper-body exercise program on  lymphedema secondary to breast cancer treatment . METHODS Fourteen breast cancer survivors with unilateral upper extremity lymphedema were r and omly assigned to an exercise ( n = 7 ) or control group ( n = 7 ) . The exercise group followed a progressive , 8-week upper-body exercise program consisting of resistance training plus aerobic exercise using a Monark Rehab Trainer arm ergometer . Lymphedema was assessed by arm circumference and measurement of arm volume by water displacement . Patients were evaluated on five occasions over the experimental period . The Medical Outcomes Trust Short-Form 36 Survey was used to measure quality of life before and after the intervention . Significance was set at alpha < or = 0.01 . RESULTS No changes were found in arm circumference or arm volume as a result of the exercise program . Three of the quality -of-life domains showed trends toward increases in the exercise group : physical functioning ( P = .050 ) , general health ( P = .048 ) , and vitality ( P = .023 ) . Mental health increased , although not significantly , for all subjects ( P = .019 ) . Arm volume measured by water displacement was correlated with calculated arm volume ( r = .973 , P < .001 ) , although the exercise and control group means were significantly different ( P < .001 ) . CONCLUSIONS Participation in an upper-body exercise program caused no changes in arm circumference or arm volume in women with lymphedema after breast cancer , and they may have experienced an increase in quality of life . Additional studies should be done in this area to determine the optimum training program BACKGROUND To determine whether the Health Partner Program is effective in training long-term cancer survivors to be health coaches . MATERIAL S AND METHODS We r and omly assigned cancer survivors who were selected through a rigorous screening process to either the Health Partner Program or the waiting-list control group .  The program consisted of 8 weeks of training in health management , leadership , and coaching . At baseline , 8 , and 16 weeks , we measured primary outcomes using the Seven Habit Profile ( SHP ) , the Korean Leadership Coaching Competency Inventory ( KCCI ) , Ed Diner 's Satisfaction with Life Scale ( SWLS ) , and the Posttraumatic Growth inventory ( PTGI ) and secondary outcomes using the Hospital Anxiety and Depression Scale ( HADS ) , the Impact of Event Scale-Revised ( IES-R ) , and the Medical Outcomes Study ( MOS ) short form 36-item question naire ( SF- 36 ) . RESULTS We recruited 70 subjects and r and omly assigned 34 to the intervention group . The Sharpen the Saw habit of the SHP increased significantly more in intervention group than in the control group ( p = 0.049 ) , as did most PTGI factors . The intervention group also showed a significantly greater enhancement of vitality ( p = 0.015 ) and mental health ( p = 0.049 ) SF-36 scores but no improvement in KCCI , SWLS , HADS , or IES-R scores . The intervention group also showed a greater clinical ly meaningful improvement in the " Think Win-Win " of SHP ( p = 0.043 ) and in the personal strength score ( p = 0.025 ) and total score ( p = 0.015 ) of the PTGI . CONCLUSIONS Long-term cancer survivors can benefit from the Health Partner Program to become health coaches OBJECTIVE  Physical activity ( PA ) has been shown to provide health benefits for breast cancer patients . The effects of augmenting oncology health care provider ( HCP ) advice for PA with 3 months of telephone counseling versus contact control were evaluated in a r and omized trial . METHODS After receiving brief HCP advice to become physically active , 192 women ( age in years : M = 60.0 , SD = 9.9 ) who had completed treatment for Stage 0-IV breast cancer were r and omized to telephone counseling to support PA ( n = 106 ) or contact control ( n = 86 ) . Their PA , motivational readiness , fatigue , and physical functioning were assessed at baseline ( before receiving HCP advice ) , 3 , 6 , and 12 months . RESULTS Telephone counseling produced significant effects on the primary outcome of moderate-intensity PA of about 30 min/week at both 3 months ( 95 % CI = 0.44 , 57.32 ) and 6 months ( 95 % CI = 3.06 , 61.26 ) . Intervention participants were also more than twice as likely as control participants to report improvements in achieving PA guidelines of at least 150 min/week at 3 ( OR = 2.43 , 95 % CI = 1.18 , 4.98 ) and 6 months ( OR = 2.11 , 95 % CI = 1.00 - 4.48 ) . Telephone counseling was significantly more effective than contact control in increasing motivational readiness for PA at all follow-ups ( ORs = 3.93 - 6.28 , all ps < .003 ) . No between-groups differences were found for fatigue , while differential improvements in physical functioning did not remain significant past 3 months ( p = .01 ) . CONCLUSION HCP advice plus telephone counseling improved PA among breast cancer patients at 3 and 6 months and also differentially improved patients ' motivational readiness at all follow-ups , suggesting the potential for exercise promotion in cancer follow-up care A pilot research study was conducted at 2 cancer centers in Connecticut to determine the effect of a dance and movement program on quality of life and shoulder function in breast cancer survivors treated within the prior 5 years . Thirty-five women completed the trial that included a 12-week intervention , using The Lebed Method , Focus on Healing Through Movement and Dance . The study design was a r and omized control trial with a wait list control group crossover to active treatment in weeks 13 to 25 , with the treatment group receiving the program in weeks 1 to 12 , and no program in weeks 13 to 25 . Outcome measures were the Breast Cancer Quality of Life ( FACT-B ) , Shoulder range of motion ( ROM ) , and Body Image Scale . FACT-B significantly improved in the intervention group at 13 weeks from 102.0 ± 15.8 to 116.7 ± 16.9 , compared to the wait list group 108.1 ± 16.4 to 107.1 ± 21.3 ( time × group effect , P = .008 ) . During the crossover phase , the FACT-B score increased in the wait list group and was stable in the treatment group . The overall effect of the training at 26 weeks was significant ( time effect , P = .03 ) , and the order of training was also significant ( P = .015 ) . Shoulder ROM increased in both groups at 13 weeks —15 ° and 8 ° in the intervention and wait list groups ( Time effect , P = .03 ; time × group , P = .58 ) . Body Image improved similarly in both groups at 13 weeks ( time effect , P = .001 ; time × group , P = .25 ) , and at 26 weeks . There was no significant effect of the order of training for these outcome measures . A dance movement program that addressed the physical and emotional needs of women following treatment for breast cancer substantially improved a breast cancer – specific quality -of-life measure . Larger studies are justified to determine the acceptability of this therapy as part of the continuum of care for breast cancer survivors OBJECTIVE This pilot project evaluated the acceptability and estimated the effect size of a tailored multidisciplinary quality of life ( MQOL ) intervention for men who have biochemical recurrence of prostate cancer . METHODS Participants included 57 men with localized prostate cancer with biochemical recurrence ( Median=76 years ; 89 % White ) . Participants were r and omized to wait list control  which offered the intervention upon conclusion of the study ( n=27 ) or to an eight-session group-based , MQOL ( n=30 ) intervention . Assessment s were completed at baseline , end of treatment , and 6 months post-treatment . RESULTS MQOL was acceptable as indicated by favorable participant retention ( 100 % retained ) , treatment compliance ( 97 % attended > 6 treatment sessions ) , and high ratings of helpfulness ( 80 % rated helpfulness > 4 on 5-point scale ) . MQOL had a favorable impact on the mental health composite score of the Short Form-36 at the end of treatment but not at 6 months ( effect size=0.52 and -0.04 ) ; health-related QOL as measured by the Functional Assessment of Cancer Therapy-Prostate at the end of treatment and 6 months ( effect size=0.14 and 0.10 ) ; and prostate cancer specific anxiety as measured by the Memorial Anxiety Scale for Prostate Cancer at the end of treatment and 6 months ( effect size=0.45 and 0.23 ) . CONCLUSIONS This pilot project provides preliminary data supporting the premise that a tailored behaviorally based MQOL intervention for men with biochemical recurrence of prostate cancer is acceptable to men and might reduce prostate cancer specific anxiety and enhance QOL . Further research examining the efficacy of this intervention in a larger r and omized trial is warranted PURPOSE / OBJECTIVES To compare the effectiveness of a prescribed home-based walking exercise intervention with usual care in older women receiving hormonal treatment for breast cancer , and to examine relationships among levels of the cortisol , serotonin , interleukin-6 , and bilirubin biomarkers and fatigue , sleep disturbances , and depressive symptoms . DESIGN Longitudinal r and omized clinical trial . SETTING A National Cancer Institute- design ated cancer center in the southeastern United States . SAMPLE 20 women ( aged 55 years or older ) with breast cancer receiving hormonal treatment . METHODS Participants were r and omized to a walking exercise intervention or usual care . Laboratory sample s and the Pittsburgh Sleep Quality Index ( PSQI ) , the Piper Revised Fatigue Scale , and the Center for Epidemiological Studies -Depression Scale were collected at the initial clinic visit and at 12 weeks from the groups . Question naires also were collected at weeks 2 and 14 . MAIN RESEARCH VARIABLES Fatigue , sleep disturbances , depressive symptoms , biomarkers , and exercise . FINDINGS Effect of the exercise intervention on sleep scores was highly significant between groups . Exercise group scores on the PSQI decreased significantly over time ( indicating improved sleep quality ) , although scores did not change significantly within the control group . Sleep actigraphy also showed significantly shorter actual wake time and less movement in the exercise group . Serotonin levels also were significantly affected by the intervention . CONCLUSIONS Data suggest that a walking exercise intervention improves sleep in older women receiving hormonal treatment for their breast cancer . Serotonin levels may be a useful biomarker when assessing sleep disturbances in this group . IMPLICATION S FOR NURSING Clinicians need to be aware that older women receiving hormonal treatment for their breast cancer may experience fatigue , sleep disturbances , and depressive symptoms . Homebased walking activity may reduce symptom severity in this group Objective To evaluate the effects of an 8-week multidimensional physical therapy program , including strengthening exercises and recovery massage , on neck and shoulder pain , pressure hypersensitivity , and the presence of active trigger points ( TrPs ) in breast cancer survivors . Methods In this r and omized controlled clinical trial , 44 breast cancer survivors were r and omly assigned into 2 groups : CUI DATE group who received a multidimensional physical therapy program ; or CONTROL group who received usual care treatment for breast cancer . CUI DATE program consisted of 24 hours of individual physical training ( aerobic , mobility , stretching , and strengthening exercises ) and 12 hours of physical therapy recovery ( stretching , massage ) interventions ( 3 times/wk , 90 min ) . Outcomes included neck and shoulder pain ( visual analog scale , 0 to 100 ) , pressure pain thresholds over the C5-C6 zygapophyseal joints , deltoid muscles , second metacarpal and tibialis anterior muscles , and the presence of active TrPs in shoulder muscles . Outcomes were assessed at baseline and after the 8-week program by a blinded assessor . Results The CUI DATE group showed an estimated improvement for neck pain of –56 mm [ 95 % confidence interval ( CI ) , −71-–40 , P<0.001 ; effect size 2.72 , 1.94 to 3.44 ] and for shoulder/axillary of –56 mm ( 95 % CI , –74-–38 , P<0.001 ; effect size 2.45 , 1.66 to 3.23 ) . Improvements were also noted for pressure pain thresholds levels : C5-C6 zygapophyseal joints ( between-group differences 101 kPa , 95 % CI , 60 - 143 ; effect size 1.68 , 1.00 to 2.35 ; 92 kPa 55 to 129 ; d : 1.98 , 1.18 to 2.77 ) , deltoid muscles ( 98 kPa , 45 to 149 ; d : 1.34 , 0.62 to 2.04 ; 75 kPa 18 to 132 ; d : 1.12 , 0.27 to 1.96 ) , second metacarpal ( 93 kPa , 45 to 134 ; d : 1.30 , 0.63 to 1.86 ; 99 kPa 59 to 139 ; d : 1.60 , 0.96 to 2.24 ) , and tibialis anterior muscles ( 71 kPa , 40 to 144 ; d : 1.16 , 0.65 to 2.34 ; 118 kPa 57 to 178 ; d : 1.17 , 0.56 to 1.77 ) . Finally , patients within the CUI DATE program showed a greater reduction of active muscle TrPs compared with the CONTROL group ( P<0.01 ) . Conclusions An 8-week multidimensional program including strengthening exercises , and massage as major components was effective for improving neck and shoulder pain and reducing widespread pressure hyperalgesia in breast cancer survivors compared with usual care treatment Deterioration in exercise tolerance and impairment in quality of life ( QoL ) are common consequences of lobectomy . This study evaluates additional exercise and strength training after lung resection on QoL , exercise tolerance and muscle strength .  Fifty-three ( 28 male ) patients attending thoracotomy for lung cancer , mean age , range 64 ( 32 - 82 ) years ; mean pack years ( SD ) 31.9 ( 26.8 ) ; BMI 25.6 ( 4.2 ) ; FEV1 2.0 ( 0.7 ) l were r and omised to control ( usual care ) or intervention ( twice daily training plus usual care ) . After discharge the intervention group received monthly home visits and weekly telephone calls , the control group received monthly telephone calls up to 12 weeks . Assessment pre-operatively , 5 day and 12 weeks post-operatively consisted of quadriceps strength using magnetic stimulation , 6 Minute Walking Distance ( 6MWD ) and QoL-EORTC-QLQ-LC13 . QoL was unchanged over 12 weeks ; 6MWD showed significant deterioration at 5 days post-operatively compared with pre-operatively , mean difference (SD)-131.6 ( 101.8 ) m and -128.0 ( 90.7 ) m in active and control groups respectively ( p=0.89 between groups ) which returned to pre-operative levels by 12 weeks in both groups . Quadriceps strength over the 5 day in-patient period showed a decrease of -8.3 ( 11.3 ) kg in the control group compared to increase of 4.0 ( 21.2 ) kg in the intervention group ( p=0.04 between groups ) . Strength training after thoracotomy successfully prevented the fall in quadriceps strength seen in controls , however , there was no effect on 6MWD or QoL. 6MWD returned to pre-operative levels by 12 weeks regardless of additional support offered Background Fatigue is the most common and disabling symptom affecting quality of life ( QOL ) and daily function in patients who have completed treatment for acute myeloid leukemia ( AML ) . Although trials in patients with various solid tumors have reported improved fatigue and QOL following exercise interventions , there have been no studies in AML patients post treatment . Methods Forty patients aged ≥40 years who had completed treatment for AML were enrolled in a 12-week r and omized phase II exercise intervention to determine feasibility ( recruitment , retention , and adherence ) , efficacy , and safety of the intervention . Patients assigned to the exercise group received an individualized , moderate-intensity , 12-week home-based exercise program with weekly telephone support from a certified exercise physiologist . QOL , fatigue , and fitness outcomes were measured at baseline , 6 weeks , and 12 weeks . Between-group differences in 12-week change scores were calculated using linear regression adjusting for age and baseline function . Results Recruitment and retention rates were 38 % and 91 % , respectively . Adherence was low at 28 % . Analyses did not suggest statistically significant or clinical ly important benefits in QOL , fatigue , or physical fitness with the intervention . The level of adherence did not appear to impact outcomes . There were no adverse events . Conclusion A home-based exercise program for post-treatment AML patients age 40 years or older can be safely delivered with reasonable recruitment and high retention . However , feasibility was hampered by low adherence . Further research and program modification are needed to better underst and and overcome barriers to exercise delivery and adherence in AML survivors OBJECTIVE To show fatigue prevention and quality of life ( QOL ) improvement from cardiovascular exercise during  radiotherapy .  DESIGN Prospect i ve enrollment ( n=21 ) , r and omized to exercise ( n=11 ) and control groups ( n=10 ) , with pre- and post-radiotherapy between- and within-group comparisons . SETTING Academic medical center . PARTICIPANTS Localized prostate cancer patients undergoing radiotherapy . INTERVENTIONS The interventional group received radiotherapy plus aerobic exercise 3 times a week for 8 weeks whereas the control group received radiotherapy without exercise . MAIN OUTCOME MEASURES Pre- and post-radiotherapy differences in cardiac fitness , fatigue , depression , functional status , physical , social , and functional well-being , leg strength , and flexibility were examined within and between 2 groups . RESULTS No significant differences existed between 2 groups at pre-radiotherapy assessment . At post-radiotherapy assessment , the exercise group showed significant within group improvements in : cardiac fitness ( P<.001 ) , fatigue ( P=.02 ) , Functional Assessment of Cancer Therapy-Prostate ( FACT-P ) ( P=.04 ) , physical well-being ( P=.002 ) , social well-being ( P=.02 ) , flexibility ( P=.006 ) , and leg strength ( P=.000 ) . Within the control group , there was a significant increase in fatigue score ( P=.004 ) and a decline in social well-being ( P<.05 ) at post-radiotherapy assessment . Between-group differences at post-radiotherapy assessment were significant in cardiac fitness ( P=.006 ) , strength ( P=.000 ) , flexibility ( P<.01 ) , fatigue ( P<.001 ) , FACT-P ( P=.006 ) , physical well-being ( P<.001 ) , social well-being ( P=.002 ) , and functional well-being ( P=.04 ) . CONCLUSIONS An 8-week cardiovascular exercise program in patients with localized prostate cancer undergoing radiotherapy improved cardiovascular fitness , flexibility , muscle strength , and overall QOL and prevented fatigue OBJECTIVE To investigate the differences between the effects of complex decongestive physiotherapy with and without active resistive exercise for the treatment of patients with breast cancer-related lymphedema ( BCRL ) . DESIGN R and omized control-group study . SETTING An outpatient rehabilitation clinic . PARTICIPANTS Patients ( N=40 ) with diagnosed BCRL . INTERVENTIONS Patients were r and omly assigned to either the active resistive exercise group or the nonactive resistive exercise group . In the active resistive exercise group , after complex decongestive physiotherapy , active resistive exercise was performed for 15min/d , 5 days a week for 8 weeks . The nonactive resistive exercise group performed only complex decongestive physiotherapy . MAIN OUTCOME MEASURES The circumferences of the upper limbs ( proximal , distal , and total ) for the volume changes , and the Short Form-36 version 2 question naire for the quality of life ( QOL ) at pretreatment and 8 weeks posttreatment for each patient . RESULTS The volume of the proximal part of the arm was significantly more reduced in the active resistive exercise group than that of the nonactive resistive exercise group ( P<.05 ) . In the active resistive exercise group , there was significantly more improvement in physical health and general health , as compared with that of the nonactive resistive exercise group ( P<.05 ) . CONCLUSIONS For the treatment of patients with BCRL , active resistive exercise with complex decongestive physiotherapy did not cause additional swelling , and it significantly reduced proximal arm volume and helped improve QOL Smoking , caffeine , and alcohol intake are all potentially modifiable factors that have an unclear association with ovarian cancer risk . Therefore , the associations between these exposures and ovarian cancer risk were prospect ively examined among 110,454 women in the Nurses ' Health Study ( NHS ) for the smoking analyses and 80,253 women for the dietary analyses The purpose of this r and omized controlled trial was to determine the effects of an 8-week ( aerobic+strength ) exercise training program ( 3 sessions/week ) on the circulating cytokine levels of breast cancer survivors . We r and omly allocated 16 female survivors of breast cancer ( mean±SD age : 50±5 years ) to an intervention or usual care ( control ) group ( N=8 in each group ) . The intervention group followed an 8-week exercise program consisting of 3 sessions/week ( session duration : 90 min ) . We measured the levels of the following cytokines before and after the intervention : beta-NGF , CTACK , eotaxin , FGF basic , G-CSF , gmCSFα , HGF , ICAM1 , IFNα2 , IFNγ , IL1α , IL1ß , IL1ra , IL2 , IL2ra , IL3 , IL4 , IL6 , IL7 , IL8 , IL9 , IL10 , IL12 , IL13 , IL15 , IL16 , IL17 , IL18 , IP10 , LIF , MCS-F , MIP1α , MIP1β , MIF , MCP1 , MCP3 , MIG , PDGF bb , SCF , SCGFβ , SDF1α , TRAIL , TNFα , TNFβ , VCAM1 , and VEGF . We only observed a significant interaction ( group*time ) effect for CTACK ( P=0.016 ) , with mean values remaining stable in the intervention group but increasing over time in controls . The intervention program did not induce a significant decrease in the main breast cancer-related cytokines such as IL6 and IL8 . A combined ( aerobic+strength ) 8-week exercise training intervention did not induce major changes in the basal cytokine levels of breast cancer survivors Background Many patients with lung cancer are deconditioned with poor physical fitness . Lung resection reduces physical fitness further , impairing the patient 's ability to function in daily life . Methods We conducted a single-blind r and omised controlled trial of high-intensity endurance and strength training ( 60 min , three times a week , 20 weeks ) , starting 5–7 weeks after surgery . The control group received st and ard postoperative care . The primary outcome was the change in peak oxygen uptake measured directly during walking until exhaustion . Other outcomes included changes in pulmonary function , muscular strength by one-repetition maximum ( 1RM ) , total muscle mass measured by dual energy X-ray absorptiometry , daily physical functioning and quality of life ( QoL ) . Results The intention-to-treat analysis of the 61 r and omised patients showed that the exercise group had a greater increase in peak oxygen uptake ( 3.4 mL/kg/min between-group difference , p=0.002 ) , carbon monoxide transfer factor ( Tlco ) ( 5.2 % predicted , p=0.007 ) , 1RM leg press ( 29.5 kg , p<0.001 ) , chair st and ( 2.1 times p<0.001 ) , stair run ( 4.3 steps , p=0.002 ) and total muscle mass ( 1.36 kg , p=0.012 ) compared with the controls . The mean±SD QoL ( SF-36 ) physical component summary score was 51.8±5.5 and 43.3±11.3 ( p=0.006 ) , and the mental component summary score was 55.5±5.3 and 46.6±14.0 ( p=0.015 ) in the exercise and control groups , respectively . Conclusions In patients recently operated for lung cancer , high-intensity endurance and strength training was well tolerated and induced clinical ly significant improvements in peak oxygen uptake , Tlco , muscular strength , total muscle mass , functional fitness and QoL. This study may provide a basis for exercise therapy after lung cancer surgery . Trial registration number NCT01748981 This pilot study examined whether exercise as an adjunctive rehabilitation therapy could benefit women who have early stage breast cancer and are currently receiving chemotherapy/radiotherapy . The study was design ed as a r and omised controlled trial ( RCT ) . Physical functioning , fatigue and Quality of Life ( QoL ) outcomes were evaluated pre and post a 12-week intervention . The results showed that after 12 weeks the women who participated in the exercise programme ( n = 12 ) displayed significantly higher levels of physical functioning and reported higher QoL scores than the controls ( n = 10 ) . Changes in fatigue and satisfaction with life favoured the intervention group but did not reach significance . These results are encouraging and suggest that a structured group exercise programme during adjuvant treatment is a safe , well tolerated and effective way of providing physical and psychological health benefits to women during treatment for early stage breast cancer . Since this was a pilot study the numbers did not allow appropriately powered analyses of some variables of interest and favoured relatively young and socio-economically advantaged women . Future studies need to address these issues and determine if these short-term benefits can be sustained Background . The goal of this pilot study was to determine the magnitude and direction of intervention effect sizes for inflammatory-related serum markers and relevant health outcomes among breast cancer survivors ( BCSs ) receiving a physical activity behavior change intervention compared with usual care .  Methods . This r and omized controlled trial enrolled 28 stage I , II , or IIIA BCSs who were post– primary treatment and not regular exercisers . Participants were assigned to either a 3-month physical activity behavior change intervention group ( ING ) or usual care group ( UCG ) . Intervention included supervised aerobic ( 150 weekly minutes , moderate-intensity ) and resistance ( 2 sessions per week ) exercise that gradually shifted to home-based exercise . Outcomes were assessed at baseline and 3 months . Results . Cardiorespiratory fitness significantly improved in the ING versus the UCG ( between-group difference = 3.8 mL/kg/min ; d = 1.1 ; P = .015 ) . Self-reported sleep latency was significantly reduced in the ING versus the UCG ( between group difference = −0.5 ; d = −1.2 ; P = .02 ) as was serum leptin ( between-group difference = −9.0 ng/mL ; d = −1.0 ; P = .031 ) . Small to medium nonsignificant negative effect sizes were noted for interleukin (IL)-10 and tumor necrosis factor (TNF)-α and ratios of IL-6 to IL-10 , IL-8 to IL-10 , and TNF-α to IL-10 , whereas nonsignificant positive effect sizes were noted for IL-6 and high-molecular-weight adiponectin . Conclusions . Physical activity behavior change interventions in BCSs can achieve large effect size changes for several health outcomes . Although effect sizes for inflammatory markers were often small and not significant , changes were in the hypothesized direction for all except IL-6 and IL-10 And rogen deprivation therapy ( ADT ) remains a cornerstone in the management of patients with prostate cancer ( PCa ) despite adverse effects on body composition and functional parameters . We compared the effects of football training with st and ard care in PCa patients managed with ADT ( > 6 months ) . Fifty-seven men aged 67 ( range : 43 - 74 ) were r and omly assigned to a football group ( FG , n = 29 ) or a usual care control group ( CON , n = 28 ) . The primary outcome was change in lean body mass ( LBM ) assessed by dual-energy X-ray absorptiometry scanning . Secondary outcomes included changes in knee-extensor muscle strength ( one repetition maximum ) , fat percentage , and maximal oxygen uptake ( VO2max ) . Mean heart rate during training was 137.7 ( st and ard deviation 13.7 ) bpm or 84.6 (3.9)% HRmax . In FG , LBM increased by 0.5 kg [ 95 % confidence interval ( CI ) 0.1 - 0.9 ; P = 0.02 ] with no change in CON ( mean group difference 0.7 kg ; 95 % CI 0.1 - 1.2 ; P = 0.02 ) . Also , muscle strength increased in FG ( 8.9 kg ; 95 % CI 6.0 - 11.8 ; P < 0.001 ) with no change in CON ( mean group difference 6.7 kg ; 95 % CI 2.8 - 10.7 ; P < 0.001 ) . In FG , VO2max increased ( 1.0 mL/kg/min ; 95 % CI 0.2 - 1.9 ; P = 0.02 ) and fat percentage tended to decrease ( 0.7 % ; 95%CI 1.3 - 0.0 ; P = 0.06 ) , but these changes were not significantly different from CON . In conclusion , football training over 12 weeks improved LBM and muscle strength compared with usual care in men with prostate cancer receiving ADT PURPOSE / OBJECTIVES To compare a 12-week nontraditional exercise Nia program practice d at home to usual care on fatigue , quality of life ( QOL ) , aerobic capacity , and shoulder flexibility in women with breast cancer undergoing radiation therapy . DESIGN R and omized clinical trial . SETTING Large community-based hospital in the midwestern United States . SAMPLE 41 women with stage I , II , or III breast cancer starting radiation therapy . METHODS 22 women were r and omized to the Nia group and 19 to the usual care group . Those in the Nia group were instructed to practice Nia 20 - 60 minutes three times per week for 12 weeks . Those in the usual care group were instructed to continue normal activities . MAIN RESEARCH VARIABLES Fatigue , QOL , aerobic capacity , and shoulder flexibility . FINDINGS Controlling for baseline scores , change over time between groups was significantly different for the women who practice d Nia at least 13 times during the 12-week period ; those in the Nia intervention reported significantly less fatigue between weeks 6 and 12 , as compared to control group ( p = 0.05 ) . No statistical differences in QOL , aerobic capacity , or shoulder flexibility were found , but trends favoring Nia were identified . CONCLUSIONS For women undergoing radiation therapy for breast cancer , Nia can help relieve fatigue . Additional research in arm and shoulder mobility and preservation also may be beneficial . IMPLICATION S FOR NURSING Oncology nurses are in a unique position to offer suggestions to help manage fatigue , and Nia could be considered as part of a cancer survivorship program . KNOWLEDGE TRANSLATION Exercise is beneficial for women with breast cancer , and interest is growing in nontraditional exercise options . Nia can benefit women with breast cancer undergoing radiation therapy Exercise participation has been shown to improve cardiovascular fitness and reduce psychological distress  among women receiving chemotherapy and /or radiation . The purpose of this pilot study was to examine the changes in distress and body image , and fitness following exercise participation among 24 women who had been diagnosed with breast cancer within the previous 3 years . The women were r and omly assigned to participate in a 12-week supervised aerobic exercise program in a hospital setting or a wait-list control group . Assessment s of distress and body image were conducted at pre- and post-treatment . Data showed that the women in the exercise group improved significantly in body image ( Physical Condition and Weight Concerns subscales ) vs control group participants at post-treatment . Reductions in distress were also noted in the exercise group , but these were nonsignificant . At post-treatment , there were modest improvements in fitness in the exercise group BACKGROUND Active for Life After Cancer is a r and omized trial evaluating the efficacy of a 6-month group-based lifestyle physical activity program ( Lifestyle ) for prostate cancer patients to improve quality of life ( QOL ) including physical and emotional functioning compared to a group-based Educational Support Program and a St and ard Care Program ( no group ) . METHOD A total of 134 prostate cancer patients receiving continuous and rogen-ablation were r and omly assigned to one of the three study conditions . RESULTS Results indicated no significant improvements in QOL at 6 or 12 months . Both group-based programs were positively received and yielded good attendance and retention . Lifestyle participants demonstrated significant improvements in most theoretical mediators proposed by the Transtheoretical Model and Social Cognitive Theory to affect physical activity . Despite these improvements , no significant changes were found for most physical activity measures . CONCLUSIONS Results suggest a lifestyle program focusing on cognitive-behavioral skills training alone is insufficient for promoting routine physical activity in these patients Purpose To examine predictors of exercise adherence in breast cancer survivors . Methods Seventy-five breast cancer survivors were r and omly assigned  to exercise ( n = 37 ) or usual care ( n = 38 ) . Demographic , prognostic , physiologic , and psychosocial information was collected at baseline and 6 months . The exercise goal was 30 min of exercise 5 days/week for 6 months . Results Women r and omized to exercise participated in moderate-intensity recreational exercise for 123 ± 52 min/week ( 81 % of the prescribed 150 min/week ) over 6 months . Baseline variables associated with better adherence were lower body mass index ( BMI ) , smaller waist circumference , higher amounts of physical activity 6 months prior to enrollment , being in the preparation vs. contemplation Stage of Change and higher FACT-B breast cancer subscale score . After adjusting for these variables , lower BMI and higher Stage of Change continued to be associated with better adherence ( p < 0.05 ) . Conclusions Future studies of exercise and breast cancer prognosis should target obese women for participation , as well as women just beginning to contemplate participation and its benefits after a cancer diagnosis OBJECTIVES Restorative yoga ( RY ) is a gentle type of yoga that may be beneficial for cancer patients and post-treatment survivors . Study goals were : to determine the feasibility of implementing a RY intervention for women with breast cancer ; and to examine group differences in self-reported emotional , health-related quality of life , and symptom outcomes . METHODS Women with breast cancer ( n=44 ; mean age 55.8 years ) enrolled in this study ; 34 % were actively undergoing cancer treatment . Study participants were r and omized to the intervention ( 10 weekly 75-minute RY classes ) or a waitlist control group . Participants completed question naires at Week 0 ( baseline ) and Week 10 ( immediately post-intervention for the yoga group ) . RESULTS Group differences favoring the yoga group were seen for mental health , depression , positive affect , and spirituality ( peace/meaning ) . Significant baseline*group interactions were observed for negative affect and emotional well-being . Women with higher negative affect and lower emotional well-being at baseline derived greater benefit from the yoga intervention compared to those with similar values at baseline in the control group . The yoga group demonstrated a significant within-group improvement in fatigue ; no significant difference was noted for the control group . CONCLUSIONS Although limited by sample size , these pilot data suggest potential benefit of RY on emotional outcomes and fatigue in cancer patients . This study demonstrates that a RY intervention is feasible for women with breast cancer ; implication s for study design and implementation are noted with an emphasis on program adoption and participant adherence BACKGROUND / AIMS Treatment for breast cancer produces side effects that diminish functional capacity and quality of life ( QOL ) among survivors .  Tai Chi Chuan ( TCC ) is a moderate form of exercise that may improve functional capacity and QOL in these individuals . Women who completed treatment for breast cancer were r and omized to receive TCC or psychosocial support therapy for 12 weeks ( 60 min ; three times weekly ) . RESULTS The TCC group demonstrated significant improvements in functional capacity , including aerobic capacity , muscular strength , and flexibility , as well as QOL ; the psychosocial support therapy group showed significant improvements only in flexibility , with declines in aerobic capacity , muscular strength , and QOL . CONCLUSIONS The TCC group exhibited significant improvements in functional capacity and QOL . These data suggest that TCC may enhance functional capacity and QOL among breast cancer survivors Purpose . Following surgical lung resection , patients frequently suffer functional decline and reduced activity levels . Despite this exercise interventions are not routinely provided . This study aim ed to establish the safety and feasibility of exercise administered following lung resection in an Australian setting . Method . Pilot r and omized controlled trial . Fifteen individuals ( 53 % male ) , mean ± st and ard deviation age 65.5 ± 16.1 years , undergoing surgery for suspected lung cancer . R and omization occurred postoperatively . Control arm received protocol ized inpatient respiratory physiotherapy . Intervention arm additionally received twice daily exercise until discharge home and twice weekly as outpatient for 8 weeks . Outcome measures ( safety , feasibility , functional capacity , functional mobility , and health-related quality of life [ HRQoL ] ) were assessed preoperatively and 2 and 12 weeks postoperatively . Results . Fifteen participants ( lung cancer n = 10 ) were assigned to control ( n = 8) and intervention ( n = 7 ) groups . Inpatient exercise was delivered on 71 % of occasions ( 35 out of 49 planned sessions ) . Four participants attended outpatient exercise sessions and these participants attended sessions on 81 % of occasions ( 52 out of 64 planned sessions ) . No adverse events occurred . There was a significant between group difference in 6-Minute Walk Test ( 6MWT ; P = .024 ) . In both groups the 6MWT declined from baseline to 2 weeks postoperative and then improved up to 12 weeks ; improvements were greater in the intervention group . Intervention was associated with positive trends of improvement in some HRQoL domains . Conclusions . Exercise intervention performed in the inpatient and outpatient setting s for individuals following lung resection  was safe and feasible . The uptake rate for outpatient exercise was 57 % , similar to previous trials ; however , adherence was excellent within the subgroup of participants who attended . Further research is required to investigate the best setting of exercise delivery and explore ways to improve the uptake rate PURPOSE Lymphedema is a common condition that breast cancer survivors face . Despite a lack of supporting evidence from prospect i ve observational studies , occupational and leisure time physical activity are feared to be possible risk factors for lymphedema onset or exacerbation . We examined effects of supervised upper- and lower-body weight training on the incidence and symptoms of lymphedema in 45 breast cancer survivors who participated in the Weight Training for Breast Cancer Survivors study . METHODS Participants were on average 52 years old , 4 to 36 months post-treatment , and had axillary dissection as part of their treatment . Thirteen women had prevalent lymphedema at baseline . The intervention was twice-a-week weight training over a period of 6 months .  Lymphedema was monitored at baseline and 6 months by measuring the circumference of each arm , and by self-report of symptoms and clinical diagnosis . RESULTS None of the intervention-group participants experienced a change in arm circumferences > or = 2.0 cm after a 6-month exercise intervention .  Self-reported incidence of a clinical diagnosis of lymphedema or symptom changes over 6 months did not vary by intervention status ( P = .40 and P = .22 , respectively ) . CONCLUSION This is the largest r and omized controlled trial to examine associations between exercise and lymphedema in breast cancer survivors . The results of this study support the hypotheses that a 6-month intervention of resistance exercise did not increase the risk for or exacerbate symptoms of lymphedema . These results herald the need to start reevaluating common clinical guidelines that breast cancer survivors avoid upper body resistance activity for fear of increasing risk of lymphedema PURPOSE The purpose of this study was to investigate the effect of a comprehensive rehabilitation program on physical function , immune response , fatigue and quality of life in mastectomy patients . METHOD The subjects included fifty-five patients with breast cancer ( 27 in the control group and 28 in the experimental group ) . The subjects in the experimental group participated in a comprehensive rehabilitation program for 10 weeks , which was composed of 1 session of education , 2 sessions of stress management , 2 sessions of exercise , and 1 session of peer support group activity per week . RESULT The results revealed an increase in shoulder extension , abduction , external rotation , and internal rotation of the affected upper extremity , and in shoulder extension and abduction of the healthy upper extremity . Also an increase in quality of life and a decrease in fatigue were significantly higher in the experimental group than the control group . However , the results revealed that the natural killer cell ratio of the experimental group increased but there was no significant difference from that of the control group . CONCLUSION The 10-week comprehensive rehabilitation program showed a large affirmative effect on physical function , fatigue and quality of life of breast cancer patients after a mastectomy OBJECTIVE To compare the effects of resistance and cardiovascular exercise on functional mobility in individuals with advanced cancer . DESIGN Prospect i ve , 2-group pretest-posttest pilot study with r and omization to either resistance or cardiovascular exercise mode . SETTING Comprehensive community cancer center and a hospital-based fitness facility . PARTICIPANTS Volunteer sample of individuals ( N=66 ; 30 men ; 36 women ; mean age , 62y ) with advanced cancer recruited through the cancer center , palliative care service , rehabilitation department , and a local hospice . INTERVENTIONS Ten weeks of individualized resistance or cardiovascular exercise , prescribed and monitored by oncology-trained exercise personnel . MAIN OUTCOME MEASURES Functional mobility was assessed using the Short Physical Performance Battery ( SPPB ) ; self-reported pain and fatigue were assessed secondarily using visual analog scales . Data were analyzed using a split plot 2 × 2 analysis of variance ( α=.05 ) . RESULTS Fifty-two patients ( 78.8 % ) completed the study : 23 ( 67.7 % ) of 34 patients in the resistance arm and 29 ( 90.6 % ) of 32 patients in the cardiovascular arm . No participant withdrew because of study adverse events . Ten-week outcomes ( n=52 ) included a significant increase in SPPB total score ( P<.001 ) , increase in gait speed ( P=.001 ) , and reduction in fatigue ( P=.05 ) . Although cardiovascular exercise participants had a modestly greater improvement in SPPB total score  than resistance training participants ( F1,49=4.21 , P=.045 ) , the difference was not confirmed in a subsequent intention-to-treat analysis ( N=66 ) . CONCLUSIONS Individuals with advanced cancer appear to benefit from exercise for improving functional mobility . Neither resistance nor cardiovascular exercise appeared to have a strong differential effect on outcome BACKGROUND The purpose of this study was to determine the feasibility of a r and omized trial of resistance exercise in patients with head and neck cancer receiving radiation . METHODS Fifteen patients with head and neck cancer receiving radiation were r and omized to resistance exercise ( using resistance b and s ) or control group . Resistance exercise occurred at the radiation therapy site ( weeks 1 - 6 ) and home ( weeks 7 - 12 ) . RESULTS No serious adverse events occurred related to resistance exercise . Medium to large effect size differences favoring resistance exercise versus control group were noted for perceived fatigue at 6 weeks ( smaller increase in fatigue for resistance exercise group ; 7.4 vs 15.4 , effect size [ d ] = -0.64 ) , quality of life at 6 weeks ( -7.0 vs -14.4 , d = 0.52 ) , and chair rise time ( seconds ) at 6 and 12 weeks ( -1.6 vs 0.4 , d = -.63 and -1.9 vs 0.1 , d = -0.60 , respectively ) . CONCLUSIONS Resistance exercise is safe and feasible in patients with head and neck cancer receiving radiation ; a definitive trial is warranted OBJECTIVE The majority of endometrial cancer survivors ( ECS ) are obese and at risk for premature death . The purpose of this study was to assess feasibility of a lifestyle intervention program for promoting weight loss , change in eating behaviors , and increased physical activity in obese ECS . STUDY DESIGN Early stage ECS ( n=45 ) were r and omized to a  6-month lifestyle intervention  ( LI ; n=23 ) or usual care ( UC ; n=22 ) . The LI group received group and individual counseling for 6 months . The primary endpoint was weight change . Secondary endpoints were physical activity , [ Leisure score index ( LSI ) ] and nutrient intake ( 3-day food records ) . Quantitative vitamin C and folate intake were used to assess fruit/vegetable intake . RESULTS Recruitment was 29 % , adherence ( LI group ) was 73 % and 84 % of participants completed follow-up assessment s. At 12 months , the intervention group lost 3.5 kg compared to a 1.4 kg gain in the control group [ mean difference=-4.9 kg ; 95 % CI : -9.0 to -0.9 kg ; p=.018 ] and had an increased LSI score of 16.4 versus -1.3 in the control group from baseline [ mean group difference=17.8 ; 95 % CI=7.1 to 28.4 ; p=.002 ] . There were no differences in vitamin C and folate intake . The LI group had lower intake of kilocalories , although differences were not significant . CONCLUSION ( S ) A lifestyle intervention program in obese ECS is feasible and can result in sustained behavior change and weight loss over a 1-year period The purpose of this secondary analysis was to examine the nutritional symptoms and body composition outcomes of aerobic exercise in women with breast cancer . A single-blind clinical trial , r and omized to tailored Pro-Self © exercise during and after chemotherapy , after chemotherapy only , or no Pro-Self ( usual care ) .  One hundred women , average age 49.9 years ( SD = 9.6 ) , participated .  Mild taste changes , nausea , constipation , and anorexia were experienced by 47 % to 55 % at baseline and end of treatment but diminished post treatment . No group differences were found in total nutritional symptoms or symptom severity . Intervention group participants maintained lean body mass ; control group participants had nonsignificant lean body mass loss . Issues related to self-report , protocol adherence , and generalizability limit findings . Aerobic exercise is useful in achieving healthy weight and body composition , but the intensity and duration achieved during cancer treatment and recovery did not produce significant changes Objectives Breathlessness in patients with lung cancer is a common and distressing symptom affecting 50–70 % of patients , rising to some 90 % for those with advanced lung cancer . The aim of the current study was to assess how feasible inspiratory muscle training ( IMT ) is in the lung cancer population and explore changes in outcome variables . Material s and methods A pilot feasibility r and omised trial was conducted in patients with clinical ly stable lung cancer . The experimental group received training using a pressure threshold device . Patients were instructed to carry out five IMT sessions weekly for 12 weeks for a total of 30 mins/day . Patients in the control group received st and ard care . Outcome measures were completed at baseline and monthly for 3 months , and included : physiological parameters ( FEV1 , FVC ) ; perceived severity of breathlessness using six 10-point NRS ; modified Borg Scale ; quality of life using the short form Chronic Respiratory Disease Question naire ; Hospital Anxiety and Depression Scale , and safety .  Results Forty-six patients ( M = 37 , F = 9 ) at a mean age of 69.5 years old and a mean of 16 months post-diagnosis who were not currently receiving chemotherapy and /or radiotherapy were recruited . Seventy-percent had NSCLC and advanced disease . Statistical ( area under the curve-AUC ) and clinical ly important differences were seen with regard to distress from breathlessness ( p = 0.03 ) , ability to cope with breathlessness ( p = 0.01 ) , satisfaction with breathlessness management ( p = 0.001 ) , fatigue ( p = 0.005 ) , emotional function ( p = 0.011 ) , breathlessness mastery ( p = 0.015 ) and depression ( p = 0.028 ) . The m-Borg difference between the two groups at 3 months was 0.80 , which is borderline clinical ly significant . Changes were more evident in the 3-month assessment where the effect of the intervention came to its peak . Conclusion This trial shows the IMT is feasible and potentially effective in patients with lung cancer . These findings warrant a fully powered larger r and omised controlled trial Background : Previous research has shown exercise to be an effective method to mitigate many adverse treatment-related effects of and rogen suppression therapy ( AST ) but the potential impact of exercise on sexual activity remains unknown . The purpose of this investigation was to report the effect of a 12-week exercise program on sexual activity in prostate cancer patients undergoing AST . Methods : Fifty-seven prostate cancer patients undergoing AST were r and omly assigned to an exercise program ( resistance and aerobic modes ; n=29 ) or usual care control ( n=28 ) . Sexual activity was assessed by the European Organization for Research and Treatment of Cancer prostate cancer-specific quality of life question naire ( QLQ-PR25 ) . Results : QLQ-PR25 data were log transformed and analysis of covariance was used to compare sexual activity between groups following the intervention adjusted for baseline activity . No differences in sexual activity were observed between the exercise and control groups before the intervention . There was a significant ( P=0.045 ) adjusted group difference in sexual activity following the 12-week intervention . Patients undergoing usual care decreased sexual activity while patients in the exercise program maintained their level of sexual activity . At baseline , 20.6 and 22.2 % of participants in the exercise and control groups reported a major interest in sex ( that is , high libido ) . Following the intervention , the exercise group had a significantly higher percentage of participants reporting a major interest in sex ( exercise=17.2 % vs control=0 % ; P=0.024 ) . Conclusions : Participation in a short-term exercise program result ed in the maintenance of sexual activity in prostate cancer patients undergoing AST OBJECTIVE To investigate the feasibility of a pragmatic lifestyle intervention in patients who had recently completed surgery and chemotherapy for colon cancer and to obtain preliminary data of its impact on important health outcomes . DESIGN A prospect i ve , r and omized , controlled pilot trial . SETTING University rehabilitation facility . PARTICIPANTS Eighteen ( N=18 ) colon cancer survivors ( mean age=69y ; range , 52 - 80y ) , Dukes stage A to C. INTERVENTIONS Participants were r and omized 6 to 24 months postoperatively to either a 12-week program of combined exercise and dietary advice or st and ard treatment . MAIN OUTCOME MEASURES Exercise and dietary behavior , fatigue , health-related quality of life ( QOL ) , aerobic exercise tolerance , functional capacity , muscle strength , and anthropometery were assessed at baseline and immediately after the intervention . RESULTS Adherences to supervised and independent exercise during the intervention were 90 % and 94 % , respectively , and there was low attrition ( 6 % ) . The lifestyle intervention elicited improvements in exercise behavior ( P=.068 ) , fatigue ( P=.005 ) , aerobic exercise tolerance ( P=.010 ) , chair sit-to-st and performance ( P=.003 ) , and waist-to-hip ratio ( P=.002 ) . A positive change in dietary fiber intake ( P=.044 ) was also observed in the intervention group . No change in QOL was observed ( P=.795 ) . CONCLUSIONS These preliminary results suggest that a pragmatic lifestyle intervention implemented 6 to 24 months after primary treatment for colon cancer was feasible . We observed a significant impact on dietary behavior , fatigue , aerobic exercise tolerance , functional capacity , and waist-to-hip ratio . These findings need to be confirmed with a larger-scale definitive r and omized controlled trial Objectives This study aim ed to determine the effect of a moderate , tailored exercise program on health-related quality of life , physical function , and arm volume in women receiving treatment for nonmetastatic breast cancer . Methods Women who were within 4–12 weeks of surgery for stage I – III breast cancer were r and omized to center-based exercise and lymphedema education intervention or patient education .  Functional Assessment of Cancer Therapy – Breast Cancer ( FACT-B ) , 6-min walk , and arm volume were performed at 3-month intervals through 18 months . Repeated measures analysis of covariance was used to model the total meters walked over time , FACT-B scores , and arm volume . Models were adjusted for baseline measurement , baseline affected arm volume , number of nodes removed , age , self-reported symptoms , baseline SF-12 mental and physical component scores , visit , and treatment group . Results Of the recruited 104 women , 82 completed all 18 months . Mean age ( range ) was 53.6 ( 32–82 ) years ; 88 % were Caucasian ; 45 % were employed full time ; 44 % were overweight ; and 28 % obese . Approximately , 46 % had breast-conserving surgery ; 79 % had axillary node dissection ; 59 % received chemotherapy ; and 64 % received radiation . The intervention result ed in an average increase of 34.3 ml ( SD = 12.8 ) versus patient education ( p = 0.01 ) . Changes in FACT-B scores and arm volumes were not significantly different . Conclusions With this early exercise intervention after breast cancer diagnosis , a significant improvement was achieved in physical function , with no decline in health-related quality of life or detrimental effect on arm volume . Implication s for cancer survivorsStarting a supervised exercise regimen that is tailored to an individual 's strength and stamina within 3 months following breast cancer surgery appears safe and may hasten improvements in physical functioning CONTEXT AND OBJECTIVE Changes in metabolism have been reported in the majority of patients undergoing cancer treatment , and these are usually characterized by progressive change in body composition . The effects of aerobic exercise programs to combat the cancer and cancer treatment-related side effects , which include the negative changes in body composition , have been extensively reported in the literature . However , few resistance exercise intervention studies have hypothesized that breast cancer patients might benefit from this type of exercise . The purpose of this study was to determine whether exercise protocol s that emphasize resistance training would change body composition and strength in breast cancer patients undergoing treatment . DESIGN AND SETTING R and omized controlled trial , at the Campus Recreation Center and Rocky Mountain Cancer Rehabilitation Institute of the University of Northern Colorado , and the North Colorado Medical Center . METHODS Twenty inactive breast cancer patients were r and omly assigned to a 21-week exercise group ( n = 10 ) or a control group ( n = 10 ) . The exercise group trained at low to moderate intensity for 60 minutes on two days/week . The primary outcome measurements included body composition ( skinfold method ) and muscle strength ( one repetition maximum ) . RESULTS Significant differences in lean body mass , body fat and strength ( p = 0.004 , p = 0.004 , p = 0.025 , respectively ) were observed between the groups at the end of the study . CONCLUSION The results suggest that exercise emphasizing resistance training promotes positive changes in body composition and strength in breast cancer patients undergoing treatment OBJECTIVE To determine the feasibility and efficacy of a physical activity behavioural change intervention in managing cancer-related fatigue among gynaecological cancer survivors during and post anti-cancer treatments . METHODS A two arm , single blind , r and omised controlled trial was conducted within the Northern Irel and regional Cancer Centre . Thirty three sedentary gynaecological cancer survivors ( stage I-III ; ≤3 years post diagnosis ) , experiencing cancer-related fatigue ( mild-severe ) took part . Participants were r and omly assigned to a behavioural change , moderate intensity physical activity intervention ( n=16 ) or a Contact Control group ( n=17 ) . The primary outcome was fatigue ( Multidimensional Fatigue Symptom Inventory-Short Form and Functional Assessment in Chronic Illness Therapy-Fatigue subscale ) . Secondary outcomes included quality of life , physical functioning , positive and negative affect , depression , body composition , sleep dysfunction and self-reported physical activity . Feasibility was assessed based on the recruitment rate , programme and physical activity adherence and participants ' programme evaluation , including optional focus groups ( n=16 ) . RESULTS Twenty five percent of eligible women took part ( 33/134 ) . Participants were 8.7 ( SD=9.1 ) months post diagnosis , with a mean age of 53 ( SD=10.3 ) years . The majority of the sample had a diagnosis of ovarian ( n=12 ) or endometrial cancer ( n=11 ) . Significant differences favouring the intervention group were observed for fatigue at 12 weeks and 6 months follow-up ( 12 week : mean difference=-11.06 ; 95 % confidence interval (CI)=-21.89 to -0.23 ; effect size (d)=0.13 ; p=0.046 ; 6 month : mean difference=-19.48 ; 95 % CI=-19.67 to -19.15 ; effect size (d)=0.20 ; p=0.01 ) . A mean of 10 calls ( SD=1.2 calls ) were delivered to the Physical Activity Group , and 10 ( SD=1.6 calls ) to the CC group . The intervention was positively perceived based on exit question naire and focus group findings . CONCLUSIONS A physical activity behavioural change intervention for gynaecological cancer survivors is feasible in terms of participants ' programme adherence and evaluation , and the intervention demonstrates improvements in fatigue . However , confirmation in the form of a larger fully powered RCT is warranted BACKGROUND Adjuvant treatment for breast cancer may result in long-lasting , adverse emotional and physical side effects , and reduce quality of life ( QOL ) . This pilot study examined the effects of a home-based walking program on QOL and fatigue in early stage breast cancer survivors and whether changes in walking behavior were associated with changes in outcomes . METHODS Participants ( n = 32 ) were r and omized to a 12-week  home-based walking intervention plus brief telephone counseling  ( n = 20 ) or a wait-list control group  ( n = 12 ) . Self-reported fatigue , QOL , and walking were assessed at baseline and 12-weeks . Results are presented as effect sizes . RESULTS Participants in the intervention had improvements in a majority of fatigue and QOL outcomes , whereas the control group had no change or worsened in many ; effect sizes were generally in the small to medium range . Changes in fatigue/QOL outcomes were associated with changes in walking behavior , with effects generally in the small to medium range . CONCLUSION Home-based physical activity ( walking ) programs may be an appropriate avenue for alleviating the adverse side effects that often accompany adjuvant treatment for breast cancer . These programs have potential for widespread dissemination , which may have considerable impact on the quality of life of women recently completing breast cancer treatment Most breast cancer survivors ( BCS ) are not meeting recommended physical activity guidelines . Here , we report the effects of the Better Exercise Adherence after Treatment for Cancer ( BEAT Cancer ) behavior change intervention on physical activity , aerobic fitness , and quality of life ( QoL ) . We r and omized 222 post- primary treatment BCS to the 3-month intervention ( BEAT Cancer ) or usual care ( UC ) . BEAT Cancer combined supervised exercise , face-to-face counseling , and group discussion s with tapering to home-based exercise . Assessment s at baseline , immediately post-intervention ( month 3 ; M3 ) , and 3 months post-intervention ( month 6 ; M6 ) included accelerometer and self-reported physical activity , submaximal treadmill test , and QoL [ Functional Assessment of Cancer Therapy (FACT)-Breast scale ] . Adjusted linear mixed-model analyses demonstrated significant effects of BEAT Cancer compared to UC on weekly minutes of ≥moderate intensity physical activity at M3 by accelerometer [ mean between group difference ( M ) = + 41 ; 95 % confidence interval ( CI ) = 10–73 ; p = 0.010 ] and self-report ( M = + 93 ; CI = 62–123 ; p < 0.001 ) . Statistical significance remained at M6 for self-reported physical activity ( M = + 74 ; CI = 43–105 ; p < 0.001 ) . BEAT  Cancer participants were significantly more likely to meet physical activity recommendations at both time points [ accelerometer M3 adjusted odds ratio ( OR ) = 2.2 ; CI = 1.0–4.8 and M6 adjusted OR = 2.4 ; CI = 1.1–5.3 ; self-report M3 adjusted OR = 5.2 ; CI = 2.6–10.4 and M6 adjusted OR = 4.8 ; CI = 2.3–10.0 ] . BEAT Cancer significantly improved fitness at M6 ( M = + 1.8 ml/kg/min ; CI = 0.8–2.8 ; p = 0.001 ) and QoL at M3 and M6 ( M = + 6.4 ; CI = 3.1–9.7 ; p < 0.001 and M = + 3.8 ; CI = 0.5–7.2 ; p = 0.025 , respectively ) . The BEAT Cancer intervention  significantly improved physical activity , fitness , and QoL with benefits continuing 3 months post-intervention Background : Breast cancer is one of the most common cancers amongst women in developed and developing countries . It is associated with the highest mortality rate in low to average-income countries . Breast cancer investigation amongst Iranian women reveals that the number of its incidence is yet the highest in all cancer types . Despite recent longer survival time of women with breast cancer , most of the patients suffer from long term physical and mental distress due to combined treatments . Exercise interventions are among new approaches to promote the better quality of life of the patients , which has only recently been considered by research ers . This study aim ed to investigate the effect of exercise intervention on the quality of life of breast cancer survivors . Material s and Methods : This is a clinical trial conducted on 80 women with I-III breast cancer , at 18 - 55 years of age mostly two years after the completion of their treatment in Seyed al Shohada hospital in Isfahan . They were r and omly divided into two groups of study and control . Exercise intervention went on for 8 weeks in the study group ( three sessions a week , 60 minutes ) . Quality of life in both groups was measured a day before , and at the end of the eight weeks period by the instrument of the National Medical Center and Beckman Research Institute . The data were analyzed by descriptive and inferential statistical tests of X2 , t-test and Mac Hammer test . Findings : Results showed that there was no significant difference in the mean score of the physical dimension of quality of life in the study group before and after intervention while the score of physical health was significantly better in the control group ( p < 0.00).The mean score of mental dimension had increased in the study group , while it had decreased in the control group . The mean score of social health showed no significant difference before and after intervention . The mean score of spiritual health had significantly decreased in the control group , while it had significantly increased in the study group ( p = 0.004 ) . Generally , the total mean score of the quality of life showed no significant difference before and after intervention . However , the percentage of the quality of life score increased in the study group , but decreased in the control group . Conclusions : The results of this study showed that exercise interventions can promote a better quality of life for the patients , and increase the total score of quality of life . Although , the total score of quality of life was not significantly different , it was concluded that exercise can promote the quality of life amongst patients with breast cancer Summary This study examined whether 24 months of weight training exercises enhanced the effectiveness of risedronate , calcium , and vitamin D in maintaining or improving bone mineral density ( BMD ) in 223 postmenopausal breast cancer survivors . Subjects who were ≥50 % adherent to exercise had no improvement in BMD but were less likely to lose BMD . Introduction This study examined whether ( 1 ) postmenopausal breast cancer survivors ( BCS ) with bone loss taking 24 months of risedronate , calcium , and vitamin D had increased bone mineral density ( BMD ) at the total hip , femoral neck , L1-L4 spine , total radius and 33 % radius , and decreased bone turnover ; ( 2 ) subjects who also participated in strength/weight training ( ST ) exercises had greater increases in BMD and greater decreases in bone turnover ; and ( 3 ) subjects who also exercised were more likely to preserve ( at least maintain ) BMD . Methods Postmenopausal BCS ( 223 ) were r and omly assigned to exercise plus medication or medication only groups . Both groups received 24 months of 1,200 mg of calcium and 400 IU of vitamin D daily and 35 mg of risedronate weekly , and the exercise group additionally had ST exercises twice weekly . Results After 24 months , women who took medications without exercising had significant improvements in BMD at the total hip ( + 1.81 % ) and spine ( + 2.85 % ) and significant decreases in Alkphase B ( −8.7 % ) and serum NTx ( −16.7 % ) . Women who also exercised had additional increases in BMD at the femoral neck ( + 0.29 % ) , total hip ( + 0.34 % ) , spine ( + 0.23 % ) , total radius ( + 0.30 % ) , and additional decreases in Alkphase B ( −2.4 % ) and Serum NTx ( −6.5 % ) . Additional changes in BMD and bone turnover with exercise were not significant . Subjects who were ≥50 % adherent to exercise were less likely to lose BMD at the total hip ( chi-square [ 1 ] = 4.66 , p = 0.03 ) and femoral neck ( chi-square [ 1 ] = 4.63 , p = 0.03 ) . ConclusionS trength/weight training exercises may prevent loss of BMD in postmenopausal BCS at risk for bone loss OBJECTIVE Although studies have shown that physical activity ( PA ) can reduce some treatment-related side effects of breast cancer , there is a need to offer PA programs outside of research setting s to reach more cancer survivors . We partnered with the American Cancer Society 's Reach to Recovery ( RTR ) program to train their volunteers ( breast cancer survivors ) to deliver a 12-week PA intervention to other breast cancer survivors . METHOD We conducted a r and omized controlled trial to compare the PA intervention delivered by  RTR volunteers ( PA plus RTR ) with contact control ( RTR control ) .  Eighteen RTR volunteers/coaches ( Mage = 54.9 years ; Mtime since diagnosis = 7.0 years ) delivered the contact control condition or the PA intervention .  Seventy-six breast cancer survivors in New Engl and ( Mage = 55.6 years ; Mtime since diagnosis = 1.1 years ) were r and omized to 1 of the 2 groups . At baseline , 12 weeks ( postintervention ) , and at 24 weeks , participants wore an  accelerometer  for 7 days , were interviewed about their PA , and reported their motivational readiness for PA . RESULTS Adjusted , mixed-effects longitudinal regression models showed significant group differences favoring the PA plus RTR group in minutes of moderate to vigorous PA at 12 weeks ( Mdifference = 103 min/week , p < .001 ) and at 24 weeks ( Mdifference = 34.7 min/week , p = .03 ) . Results were corroborated with significant group differences in accelerometer data favoring the PA plus RTR group at both time points . CONCLUSION Peer volunteers were able to significantly increase PA among cancer survivors relative to contact control . Partnerships with existing volunteer programs can help to widen the reach of behavioral interventions among cancer survivors . ( PsycINFO Data base PURPOSE / OBJECTIVES To examine the effects of a seated exercise program on fatigue and quality of life ( QOL ) in women with metastatic breast cancer . DESIGN R and omized , controlled , longitudinal trial . SETTING Outpatient clinic of a comprehensive cancer center . SAMPLE Convenience sample of 38 women who were beginning outpatient chemotherapy . METHODS Subjects were r and omized to a control or intervention group ; the intervention was performance of a seated exercise program using home videotape three times per week for four cycles of chemotherapy . All subjects completed the Functional Assessment of Chronic Illness Therapy Fatigue Version IV ( FACIT F ) at baseline and at the time of the next three cycles . Subjects were asked to document the frequency , duration , and intensity of all exercise participation on monthly calendars . MAIN RESEARCH VARIABLES Exercise , fatigue , and QOL . FINDINGS 32 subjects , 16 per group , completed the study follow-up . With a mixed modeling approach , total FACIT F scores for the entire sample declined at a significant rate ( p = 0.003 ) beginning with cycle 3 but at a slower rate for the experimental group ( p = 0.02 ) . Fatigue scores indicated less increase and physical well-being subscale scores showed less decline for the experimental group ( p = 0.008 and p = 0.02 , respectively ) . CONCLUSIONS Women with advanced breast cancer r and omized to the seated exercise intervention had a slower decline in total and physical well-being and less increase in fatigue scores starting with the third cycle of chemotherapy . IMPLICATION S FOR NURSING Seated exercise may be a feasible exercise program for women with advanced cancer for controlling fatigue and improving physical well-being Background Participation in an exercise trial is a major commitment for cancer survivors , but few exercise trials have evaluated patient satisfaction with trial participation . Purpose To examine patient satisfaction with participation in the Healthy Exercise for Lymphoma Patients ( HELP ) Trial and to explore possible determinants . Methods The HELP Trial r and omized 122 lymphoma patients to 12 weeks of supervised aerobic exercise training ( AET ; n = 60 ) or to usual care ( UC ; n = 62 ) , with the option of participating in a 4-week posttrial exercise program . At the 6-month follow-up assessment , participants evaluated their overall trial satisfaction . Results Personal satisfaction with trial participation was strongly influenced by group assignment with participants r and omized to AET reporting participation to be more rewarding ( p < 0.001 ) and personally useful ( p < 0.001 ) than participants r and omized to UC . UC participants who completed the optional 4-week posttrial exercise program reported participation to be more rewarding ( p = 0.008 ) and personally useful ( p < 0.001 ) than UC participants who declined the program . Limitations The study is limited by the lack of a vali date d measure of participant satisfaction , and the fact that the offer of participation in the posttrial exercise program to the UC group was not r and omized . Conclusions Lymphoma patients r and omized to UC viewed it as less rewarding and personally useful despite being offered a 4-week posttrial exercise program . UC participants who completed the 4-week program reported personal satisfaction levels similar to the AET group ; however , the causal direction of this association is unknown . Research ers should continue to evaluate participant satisfaction in exercise trials We conducted a r and omized controlled trial to determine the effects of a home-based exercise intervention on change in quality of life ( QOL ) in recently resected colorectal cancer survivors , most of whom were receiving adjuvant therapy . Participants were r and omly assigned in a 2:1 ratio to either an  exercise ( n = 69 ) or control ( n = 33 ) group . The exercise group was asked to perform moderate intensity exercise 3 - 5 times per week for 20 - 30 min each time . The primary outcome was change in QOL as measured by the Functional Assessment of Cancer Therapy-Colorectal ( FACT-C ) scale . Adherence in the exercise group was good ( 75.8 % ) but contamination in the control group was problematic ( 51.6 % ) . Intention-to-treat analysis revealed no significant differences between groups for change in the FACT-C ( mean difference , -1.3 ; 95 % CI , -7.8 to 5.1 ; P = 0.679 ) . In an ' on-treatment ' ancillary analysis , we compared participants who decreased versus increased their cardiovascular fitness over the course of the intervention . This analysis revealed significant differences in favour of the increased fitness group for the FACT-C ( mean difference , 6.5 ; 95 % CI , 0.4 - 12.6 ; P = 0.038 ) . These data suggest that increased cardiovascular fitness is associated with improvements in QOL in colorectal cancer survivors but better controlled trials are needed Goal of workBreast cancer survivors have limited options for the treatment of hot flashes and related symptoms . Further , therapies widely used to prevent recurrence in survivors , such as tamoxifen , tend to induce or exacerbate menopausal symptoms . The aim of this preliminary , r and omized controlled trial was to evaluate the effects of a yoga intervention on menopausal symptoms in a sample of survivors of early-stage breast cancer ( stages IA – IIB ) . Material s and methods Thirty-seven disease-free women experiencing hot flashes were r and omized to the 8-week Yoga of Awareness program ( gentle yoga poses , meditation , and breathing exercises ) or to wait-list control . The primary outcome was daily reports of hot flashes collected at baseline , posttreatment , and 3 months after treatment via an interactive telephone system . Data were analyzed by intention to treat . Main results At posttreatment , women who received the yoga program showed significantly greater improvements relative to the control condition in hot-flash frequency , severity , and total scores and in levels of joint pain , fatigue , sleep disturbance , symptom-related bother , and vigor . At 3 months follow-up , patients maintained their treatment gains in hot flashes , joint pain , fatigue , symptom-related bother , and vigor and showed additional significant gains in negative mood , relaxation , and acceptance . Conclusions This pilot study provides promising support for the beneficial effects of a comprehensive yoga program for hot flashes and other menopausal symptoms in early-stage breast cancer survivors Objective : Assessment of feasibility and effects of an exercise training programme in patients following cystectomy due to urinary bladder cancer . Design : Single-blind , pilot , r and omized controlled trial . Setting : University hospital , Sweden . Subjects : Eighteen patients ( 64–78 years ) , of 89 suitable , cystectomized due to urinary bladder cancer , were r and omized after hospital discharge to intervention or control . Interventions : The 12-week exercise programme included group exercise training twice a week and daily walks . The control group received only st and ardized information at discharge . Main outcome measures : Trial eligibility and compliance to inclusion were registered . Assessment s of functional capacity , balance , lower body strength and health-related quality of life ( HRQoL ) with SF-36 . Results : Out of 122 patients 89 were eligible , but 64 did not want to participate/were not invited . Twenty-five patients were included , but 7 dropped out before r and omization . Eighteen patients were r and omized to intervention or control . Thirteen patients completed the training period . The intervention group increased walking distance more than the control group , 109 m ( 75–177 ) compared to 62 m ( 36–119 ) ( P = 0.013 ) , and role physical domain in SF-36 more than the control group ( P = 0.031 ) . Ten patients were evaluated one year postoperatively . The intervention group had continued increasing walking distance , 20 m ( 19–36 ) , whereas the control group had shortened the distance −15.5 m ( −43 to −5 ) ( P = 0.010 ) . Conclusions : A 12-week group exercise training programme was not feasible for most cystectomy patients . However , functional capacity and the role-physical domain in HRQoL increased in the short and long term for patients in the intervention group compared with controls Cardiopulmonary responses to an 8-week moderate-intensity aerobic exercise intervention and adherence to exercise during and after intervention were assessed in 41 women newly diagnosed with breast cancer undergoing adjuvant therapy .  The intervention was primarily aim ed at minimizing deconditioning . Women were r and omly assigned to the intervention or control group , completed grade d exercise tests before and after intervention , and encouraged to continue their exercise postintervention . Over time , only the intervention group showed significant decreases in resting heart rate , resting systolic blood pressure ( SBP ) , P < .05 each , and maximum SBP , P < .02 , and an increase in VO2 peak , P < .001 , although resting SBP was higher in the intervention group at both timepoints , P < .05 . The adherence rate to 8-week exercise intervention was 78.3 % with average weekly attendance of 2.4 sessions and 42.7 minutes ( 27.8 minutes within target heart rate ) exercise per session . Overall physical activity levels over 16 weeks postintervention did not differ between 2 groups . However , the within-group analysis indicated that only the intervention group showed a significant increase in voluntary activity , P < .02 , and energy expenditure , P < .02 , and a decrease in sedentary activity , P < .02 . These findings indicate that moderate-intensity aerobic exercise is beneficial in reducing deconditioning of cardiopulmonary responses in newly diagnosed breast cancer women undergoing adjuvant therapy INTRODUCTION It has been noted that only 14 % of all clinical trials are translated into practice . The objective of this paper is to promote translation of an efficacious rehabilitative exercise program for breast cancer survivors by clarifying for clinicians the safety profile of participants ( e.g. , rates of musculoskeletal injury and referral to medical professionals ) , and to use this evidence to make recommendations on the appropriate training of health and fitness staff who would be capable of safely , effectively , and sustainably delivering the program . METHODS Breast cancer survivors with and at risk for lymphedema were r and omized to twice-weekly weightlifting or st and ard care for 1 year . An injury survey and health care evaluation were administered after 1 year and in 3-month intervals , respectively . RESULTS The cumulative incidence and rate of injury were higher in the weightlifting than in the control group . The injury rates were 2.3 and 0.3 per 1,000 bouts of weightlifting among breast cancer survivors with and at risk for lymphedema , respectively . Among breast cancer survivors with or at risk for lymphedema , 20.9 % in the weightlifting group had an encounter with a health care provider that required cessation or dose modification of weightlifting . CONCLUSION Despite the demonstrated efficacy of weightlifting , musculoskeletal injuries and other health problems did occur . Therefore , for the successful translation of this rehabilitative intervention into clinical practice , health and fitness professionals working with breast cancer survivors need the knowledge , skills , and abilities that clarify their scope of practice to address these health care needs Sixteen female breast cancer patients who had been diagnosed ( 3.0 + /- 1.2 years previous to the study ) and undergone surgery , chemotherapy , and /or radiation treatment were r and omly assigned to exercise and nonexercise groups . Pre- and post- study measurements were taken for aerobic performance , leg strength , and concentrations of circulating lymphocyte subsets and natural killer cell cytotoxic activity ( NKCA ) .  Exercise training consisted of 60 minutes of supervised weight training and aerobic activity three times each week for eight weeks . Although subjects in the exercise groups demonstrated some modest improvement in the various aerobic and strength tests , NKCA and concentrations of circulating T and NK cells were not significantly altered relative to the nonexercise group . This study suggests that moderate exercise over an eight-week period has no significant effect on the function of in vitro natural killer cells in breast cancer patients BACKGROUND Regular exercise and dietary practice s have been shown to affect the health-related quality of life ( HRQOL ) and survival of breast cancer patients . OBJECTIVE The current study aim ed to investigate whether the WSEDI was a feasible and primarily effective method for promoting exercise and dietary behaviours for breast cancer patients . DESIGN A 12-week r and omized , controlled trial . SETTING Oncology outpatient treatment clinics at 3 university hospitals and 1 National Cancer Center in South Korea . PARTICIPANTS Fifty-nine breast cancer patients who had received curative surgery and completed primary cancer treatment within 12 months prior to the study and who had been diagnosed with stage 0-III cancers within 2 years prior to the study were recruited . METHODS Participants were r and omly assigned to either the intervention group , which used a Web-based self-management exercise and diet intervention program incorporating transtheoretical model (TTM)-based strategies ( n=29 ) , or to the control group , which used a 50-page educational booklet on exercise and diet ( n=28 ) . The intervention efficacy was measured at the baseline and 12 weeks via a Web-based survey that addressed the promotion of exercise and consumption of 5 servings of fruits and vegetables ( F&V ) per day , dietary quality , HRQOL , anxiety , depression , fatigue , motivational readiness , and self-efficacy . RESULTS The proportion of subjects who performed at least moderate-intensity aerobic exercise for at least 150 min per week ; ate 5 servings of F&V per day ; and had overall improvements in dietary quality , physical functioning and appetite loss ( HRQOL ) , fatigue , and motivational readiness was greater in the intervention group than in the control group . The self-efficacy with respect to exercise and F&V consumption was greater in the intervention group than in the control group . A Web-based program that targets changes in exercise and dietary behaviours might be effective for breast cancer survivors if the TTM theory has been used to inform the program strategy , although further research with a larger sample size is required to enable definitive conclusions Background & objectives : Patients with head and neck cancer ( HNC ) undergoing chemoradiotherapy ( CRT ) suffer from fatigue causing a decrease in functional capacity and quality of life ( QoL ) . Limited research in the field of exercise training among these patients dem and ed the need for this study to assess the effects of exercise training on functional capacity and quality of life . Methods : A r and omized controlled trial was conducted on 48 patients with HNC undergoing CRT . The exercise group received an individually tailored , supervised , exercise programme for six weeks , while the control group did not receive any form of exercise .  Functional capacity and QoL were assessed at baseline and at the end of the intervention using the six minute walk distance ( 6MWD ) and medical outcomes survey short form 36 ( SF 36 ) . Results : The mean age of patients was 52 yr with 42 males . After six weeks , the 6MWD improved by 42 metres ( P<0.05 ) in the exercise group while the control group showed a decrease by 96 metres ( P<0.001 ) . There was an improvement on the mental component score ( MCS ) of SF36 for the exercise group ( 4.8 ; P<0.05 ) and the physical component score ( PCS ) remained almost the same , while a decrease in PCS and MCS was seen in the control group ( -5.9 ; P=0.064 and -17.3 ; P<0.05 ) . When 6MWD and SF36 were compared between the groups , there was a statistically significant difference ( P<0.001 ) seen after six weeks . Interpretation & conclusions : Our results showed that the functional capacity and QoL decreased among those not receiving a supervised exercise program , while exercise training improved functional capacity and QoL in HNC patients undergoing CRT Summary The ability of combined step aerobic- and circuit-training to prevent bone loss after breast cancer treatments was related to skeletal site and patients ’ menopausal status . Among premenopausal breast cancer survivors , a 12-month exercise intervention completely prevented bone loss at the femoral neck , whereas no exercise effect was seen at lumbar spine or at neither site in postmenopausal women . Introduction The primary objective of this r and omised clinical trial was to determine the preventive effect of supervised weight-bearing jumping exercises and circuit training on bone loss among breast cancer patients . Methods Of 573 breast cancer survivors aged 35–68 years r and omly allocated into  exercise  or  control group after adjuvant treatments , 498 ( 87 % ) were included in the final analysis . The 12-month exercise intervention comprised weekly supervised step aerobic- and circuit-exercises and similar home training . Bone mineral density ( BMD ) at lumbar spine and femoral neck were measured by dual-energy X-ray absorptiometry . Physical performance was assessed by 2-km walking and figure-8 running tests , and the amount of physical activity was estimated in metabolic equivalent-hours/week . Results In premenopausal women  , bone loss at the femoral neck was prevented by exercise , the mean BMD changes being −0.2 % among the trainees vs. −1.4 % among the controls ( p = 0.01 ) . Lumbar bone loss could not be prevented ( −1.9 % vs. −2.2 % ) . In postmenopausal women , no significant exercise-effect on BMD was found either at the lumbar spine ( −1.6 % vs. −2.1 % ) or femoral neck ( −1.1 % vs. −1.1 % ) . Conclusions This 12-month aerobic jumping and circuit training intervention completely prevented femoral neck bone loss in premenopausal breast cancer patients , whereas no effect on BMD was seen in postmenopausal women PURPOSE And rogen deprivation therapy is a common treatment in men with prostate cancer that may cause fatigue , functional decline , increased body fatness , and loss of lean body tissue . These physical changes can negatively affect health-related quality of life .  Resistance exercise may help to counter some of these side effects by reducing fatigue , elevating mood , building muscle mass , and reducing body fat . METHODS In a two-site study , 155 men with prostate cancer who were scheduled to receive and rogen deprivation therapy for at least 3 months after recruitment were r and omly assigned to an intervention group that participated in a resistance exercise program three times per week for 12 weeks ( 82 men ) or to a waiting list control group ( 73 men ) . The primary outcomes were fatigue and disease-specific quality of life as assessed by self-reported question naires after 12 weeks . Secondary outcomes were muscular fitness and body composition . RESULTS Men assigned to resistance exercise had less interference from fatigue on activities of daily living ( P = .002 ) and higher quality of life ( P = .001 ) than men in the control group . Men in the intervention group demonstrated higher levels of upper body ( P = .009 ) and lower body ( P < .001 ) muscular fitness than men in the control group . The 12-week resistance exercise intervention did not improve body composition as measured by changes in body weight , body mass index , waist circumference , or subcutaneous skinfolds . CONCLUSION Resistance exercise reduces fatigue and improves quality of life and muscular fitness in men with prostate cancer receiving and rogen deprivation therapy .  This form of exercise can be an important component of supportive care for these patients PURPOSE The efficacy of a home-based physical activity ( PA ) intervention for early-stage breast cancer patients was evaluated in a r and omized controlled trial . PATIENTS AND METHODS Eighty-six sedentary women ( mean age , 53.14 years ; st and ard deviation , 9.70 years ) who had completed treatment for stage 0 to II breast cancer were r and omly assigned to a PA or contact control group . Participants in the PA group received 12 weeks of PA counseling ( based on the Transtheoretical Model ) delivered via telephone , as well as weekly exercise tip sheets . Assessment s were conducted at baseline , after treatment ( 12 weeks ) , and 6 and 9 month after baseline follow-ups . The post-treatment outcomes are reported here . RESULTS Analyses showed that , after treatment , the PA group reported significantly more total minutes of PA , more minutes of moderate-intensity PA , and higher energy expenditure per week than controls . The PA group also out-performed controls on a field test of fitness . Changes in PA were not reflected in objective activity monitoring . The PA group was more likely than controls to progress in motivational readiness for PA and to meet PA guidelines . No significant group differences were found in body mass index and percent body fat . Post-treatment group comparisons revealed significant improvements in vigor and a reduction in fatigue in the PA group . There was a positive trend in intervention effects on overall mood and body esteem . CONCLUSION The intervention successfully increased PA and improved fitness and specific aspects of psychological well-being among early-stage breast cancer patients . The success of a home-based PA intervention has important implication s for promoting recovery in this population Purpose Adherence to prescribed exercise is a challenge for cancer patients undergoing treatment . The changing pattern of exercise adherence over time can not be fully understood by an overall measure of adherence . This study was aim ed to identify the trajectory of exercise adherence and its predictors for women with breast cancer during their chemotherapy . Methods Participants were 78 women with breast cancer assigned to the exercise arm of a r and omized control trial . Based on the weekly adherence rates in time and intensity , patients were classified as good ( > 100 % ) , acceptable ( 80–100 % ) , and poor ( < 80 % ) adherents . Data were analyzed using ordinal logistic hierarchical linear modeling . Results The trajectories for both time and intensity adherence declined significantly . The decline in  exercise-time adherence  was significantly slower in women who reported higher interest in exercise . Women with higher perceived importance of exercise , early disease stage , and employed were more likely to be classified as good intensity adherents . Poorer weekly adherence for both exercise time and intensity was associated with higher fatigue level for that week . Conclusions  Adherence to exercise adherence in breast cancer patients declined as the dose of exercise prescription increased . Factors influencing overall adherence and adherence trend were identified PURPOSE Accumulating data suggest that exercise may affect breast cancer risk and outcomes . Studies have demonstrated that high levels of insulin , often seen in sedentary individuals , are associated with increased risk of breast cancer recurrence and death . We sought to analyze whether exercise lowered insulin concentrations in breast cancer survivors . METHODS One hundred one sedentary , overweight breast cancer survivors were r and omly assigned either to a 16-week cardiovascular and strength training exercise intervention or to a usual care control group .  Fasting insulin and glucose levels , weight , body composition , and circumference at the waist and hip were collected at baseline and 16 weeks . RESULTS Baseline and 16-week measurements were available for 82 patients .  Fasting insulin concentrations decreased by an average of 2.86 microU/mL in the exercise group ( P = .03 ) , with no significant change in the control group ( decrease of 0.27 microU/mL , P = .65 ) . The change in insulin levels in the exercise group seemed greater than the change in controls , but the comparison did not reach statistical significance ( P = .07 ) . There was a trend toward improvement in insulin resistance in the exercise group ( P = .09 ) but no change in fasting glucose levels . The exercise group also experienced a significant decrease in hip measurements , with no change in weight or body composition . CONCLUSION Participation in an exercise intervention was associated with a significant decrease in insulin levels and hip circumference in breast cancer survivors . The relationship between physical activity and breast cancer prognosis may be mediated , in part , through changes in insulin levels and /or changes in body fat or fat deposition AIMS In this prospect i ve controlled r and omized trial we assessed the effects of early , intensive , prolonged pelvic floor exercises ( PFE ) on urinary incontinence following bladder neck ( BN ) sparing RRP . METHODS A sample of 152 patients with localized prostate cancer underwent RRP with BN preservation . Out of this group we r and omized 107 incontinent patients into 2 groups . We considered incontinent patients with 24 hr Pad test > 2 g. The T group received instructions regarding an intensive program of PFE , from 7 days after catheter removal for as long as any degree of incontinence persisted , within a period of 1 year . The control ( C ) group did not receive instructions . The outcome was assessed using the 24 hr Pad test , a visual analogue scale ( VAS ) and a single question of QoL. Results at baseline and at 1 , 3 , 6 , and 12 months were available for 54 and 40 patients , respectively . RESULTS The overall spontaneous continence rate after catheter removal was 23.6 % . The proportion of men still incontinent was significantly higher in the C group than treatment ( T ) group at 1 ( 97.5 % vs. 83.3 % ; P = 0.04 ) , 3 ( 77.5 % vs. 53.7 % ; P = 0.03 ) , 6 ( 60 % vs. 33.3 % ; P = 0.01 ) , and 12 months ( 52.5 % vs. 16.6 % ; P < 0.01 ) . Similarly , the VAS and the response to the QoL question at 12 months significantly differed between the two groups ( P = 0.01 and 0.03 , respectively ) . CONCLUSIONS Our study suggests that early intensive prolonged PFE can further increase the number of continent patients and this improvement persists in the first 12 months . The second 6 months following surgery are still useful to recovery Cancer treatment is associated with decreased hemoglobin ( Hb ) concentration and aerobic fitness ( VO2 max ) , which may contribute to cancer-related fatigue ( CRF ) and decreased quality of life ( QoL ) .  Endurance exercise may attenuate CRF and improve QoL , but the mechanisms have not been thoroughly investigated . Objectives . To ( a ) determine the feasibility of conducting an exercise intervention among women receiving treatment for breast cancer ; ( b ) examine the effects of exercise on Hb and VO2 max and determine their association with changes in CRF and QoL ; and ( c ) investigate changes in selected inflammatory markers . Methods . Fourteen women receiving chemotherapy for Stages I – II breast cancer were r and omly assigned to exercise ( n = 7 ) or usual care ( n = 7 ) . Women in the exercise group performed supervised , individualized treadmill exercise 2–3 times/week for the duration of chemotherapy ( 9–12 weeks ) . Data were collected 4 times over 15–16 weeks . Results . Recruitment rate was 45.7 % . Sixteen women consented and 14 completed the trial , for a retention rate of 87.5 % . Adherence to exercise protocol was 95–97 % , and completion of data collection was 87.5–100 % . Exercise was well tolerated . VO2 max was maintained at prechemotherapy levels in exercisers but declined in the usual-care group ( p < .05 ) . Hb decreased ( p < .001 ) in all participants as they progressed through chemotherapy . Exercise did not have significant effects on CRF or QoL. Changes in inflammatory markers favored the exercise group . Conclusions . Exercise during chemotherapy may protect against chemotherapy-induced decline in VO2 max but not Hb concentration PURPOSE Participating in regular physical activity is encouraged after treatment for breast cancer , with exception of those who have subsequently developed lymphedema . The purpose of this project was to investigate , in a r and omized controlled trial , the effect of participating in a supervised , mixed-type exercise program on lymphedema status among women with lymphedema after breast cancer . METHODS Women younger than 76 yr , who completed breast cancer treatment at least 6 months prior and had subsequently developed unilateral , upper-limb lymphedema , were r and omly allocated to an intervention ( n = 16 ) or control ( n = 16 ) group . The intervention group ( IG ) participated in 20 supervised , group , aerobic and resistance exercise sessions over 12 wk , whereas the control group ( CG ) was instructed to continue habitual activities .  Lymphedema status was assessed by bioimpedance spectroscopy ( impedance ratio between limbs ) and perometry ( volume difference between limbs ) , and independent t-tests ( two-tailed P < 0.05 ) were used to determine statistical significance of observed changes . RESULTS Mean ratio and volume measures at baseline were similar for the IG ( 1.13 + /- 0.15 and 337 + /- 307 mL , respectively ) and the CG ( 1.13 + /- 0.19 and 377 + /- 416 mL , respectively ) , and no changes were observed over time for either group . Although no group change was observed between preintervention and 3-month follow-up for the IG ( ratio and volume change = 0.02 + /- 0.07 and 2 + /- 71 mL , respectively ) , two women in this group no longer had evidence of lymphedema by study end . Average attendance was more than 70 % of supervised sessions , there were no withdrawals , and several qualitative comments from participants support the program acceptability . CONCLUSIONS The results from this pilot study indicate that , at minimum , exercise does not exacerbate secondary lymphedema .  Women with secondary lymphedema should be encouraged to be physically active , optimizing their physical and psychosocial recovery OBJECTIVES To assess the impact of lifestyle on health-related quality of life ( HR-QOL ) , perceived stress , and self-reported sexual function in men with early-stage prostate cancer electing active surveillance . METHODS A total of 44 intervention and 49 usual-care control participants were enrolled in a r and omized clinical trial examining the effects of lifestyle changes on prostate cancer progression . The intervention consisted of a low-fat , vegan diet , exercise , and stress management . Participants completed the Medical Outcomes Study Short Form-36 Health Status Survey ( a measure of mental and physical HR-QOL ) , the Perceived Stress Scale , the Sexual Function subscale of the University of California , Los Angeles , Prostate Cancer Index , and  measures of lifestyle behaviors  ( to yield an overall lifestyle  index ) at baseline and 12 months . The data were analyzed using analysis of variance for repeated measures . The relationship between lifestyle and QOL was also analyzed using multiple linear regression analyses . RESULTS Intervention participants had significantly improved their lifestyle compared with controls at 12 months . The quality -of-life scores were high across groups and time points . However , a healthier lifestyle was related to better QOL at baseline . Participants in both groups who reported a healthier lifestyle also reported better mental and physical HR-QOL and sexual function . Furthermore , participants whose lifestyle improved over time showed enhanced physical HR-QOL and decreased perceived stress . CONCLUSIONS Men who choose active surveillance for early-stage prostate cancer are able to make comprehensive lifestyle changes . Although the average QOL was already high in this sample , individuals who improved their lifestyle enhanced their QOL further BACKGROUND And rogen deprivation therapy ( ADT ) has significant deleterious effects on body composition that may be accompanied by unfavourable changes in adipokine levels . While exercise has been shown to improve a number of side effects associated with ADT for prostate cancer , no studies have assessed the effect of exercise on adiponectin and leptin levels , which have been shown to alter the mitogenic environment . METHODS Twenty-six men with prostate cancer treated with ADT were r and omized to home-based aerobic exercise training or resistance exercise training for 24 weeks . Adiponectin , leptin , insulin-like growth factor 1 ( IGF-1 ) , insulin-like growth factor binding protein 3 ( IGFBP-3 ) were analyzed by ELISA ( enzyme-linked immunosorbent assay ) , in addition to physical activity volume , peak aerobic capacity , and anthropometric measurements , at baseline , 3 months and 6 months . RESULTS Resistance exercise significantly reduced IGF-1 after 3 months ( p = 0.019 ) ; however , this change was not maintained at 6 months . At 6 months , IGFBP-3 was significantly increased compared to baseline for the resistance training group ( p = 0.044 ) . In an exploratory analysis of all exercisers , favourable changes in body composition and aerobic fitness were correlated with favourable levels of leptin , and favourable leptin : adiponectin and IGF-1:IGFBP-3 ratios at 3 and 6 months . CONCLUSIONS Home-based exercise is correlated with positive changes in adipokine levels and the IGF-axis that may be related to healthy changes in physical fitness and body composition . While the improvements of adipokine markers appear to be more apparent with resistance training compared to aerobic exercise , these findings must be considered cautiously and require replication from larger r and omized controlled trials to clarify the role of exercise on adipokines and IGF-axis proteins for men with prostate cancer Evidence suggests that exercise affects breast cancer risk and outcomes , but little is known about the mechanisms through which this effect may be mediated . This study examines the impact of exercise upon levels of adiponectin , high molecular weight adiponectin ( HMWA ) , and leptin in breast cancer survivors . Methods One hundred and one sedentary , overweight breast cancer survivors were r and omized to a 16-week exercise intervention or usual care control group . Anthropometric measurements were taken and fasting levels of adiponectin , HMWA and leptin were collected at baseline and 16 weeks . Results Baseline and week-16 measurements were available for 81 patients . The exercise group experienced a significant decrease in hip measurements , with no change in weight or body composition . There were no significant changes in adiponectin , HMWA , or leptin in either group . Modeling analyses demonstrated a significant inverse relationship between changes in leptin and adiponectin , but no relationship between changes in BMI , waist or hip circumference , or body fat percentage and change in leptin or adiponectin . Conclusions This study did not demonstrate a significant change in adipocytokine levels in breast cancer survivors participating in an exercise intervention  , suggesting that further work is needed to explore the mechanisms through which exercise may impact breast cancer PURPOSE This study , theoretically based on the Exercise Self-Esteem Model , EXSEM , examined effects of exercise modality on physical and global self-esteem ( PSE , GSE ) in breast cancer survivors . The EXSEM posits GSE at the apex with PSE feeding into GSE . PSE has three subdomains : physical condition ( PC ) , attractive body ( AB ) , and physical strength ( PS ) . The goals were to compare the effect of combination modality versus single-modality exercise on PSE and GSE and to explore the relationship between exercise modality and the subdomains of PSE . METHODS Survivors were r and omly allocated to flexibility ( F ) , aerobic ( A ) , resistance ( R ) , or aerobic plus resistance ( AR ) , 12-wk , individualized , home-based exercise program . Pre/posttesting included submaximal treadmill test , six-repetition maximum chest press and leg press , YMCA bench press , shoulder/hip flexibility , and bioelectric impedance analysis body composition . Esteem measures were the Physical Self-Perception Profile and the Rosenberg Self-Esteem Scale . RESULTS Forty-two women completed the study ( F = 12 , A = 10 , R = 9 , and AR = 11 ) . Fitness improvements congruent with exercise modality were seen in all groups . PSE and GSE outcomes did not reveal a greater effect from the combination modality program , AR , compared with the single-modality programs A and R. The relationships between the single-modality groups and the subdomains of PC , PS , and AB were supported in the R group ( PS and AB increased ) and were partially supported in the A group ( PC , not AB , increased ) . CONCLUSIONS A single-modality R program significantly improved all domains of PSE , and participation in the A program improved the PC subdomain . The combination exercise program did not enhance PSE greater than the single-modality programs . EXSEM was a useful framework for exploring esteem in breast cancer survivors Objective : Mechanisms for cancer related fatigue suggest that exercise but “ not too much and not too little ” could be effective . This study aim ed to investigate feasibility and estimate the potential effects of a walking exercise program in people with advanced cancer and fatigue . Design : A pilot r and omized trial . Setting : McGill University Health Centre ( MUHC ) , Montreal , Canada . Subjects : People with advanced cancer undergoing interdisciplinary assessment and rehabilitation with a fatigue level of 4 to 10 on a visual analogue scale . Interventions : An 8-week fatigue-adapted , walking intervention , facilitated using a pedometer ( STEPS ) , and offered at the same time as or after rehabilitation . Measures : Measures of fatigue , physical function and well-being were administered at entry , and 8 , 16 and 24 weeks . Generalized estimating equations ( GEE ) estimated the odds of response for people receiving the STEPS program in comparison to the odds of response in the controls ( odds ratio , OR ) . Results : Twenty-six persons were r and omized to three groups : during rehabilitation , after rehabilitation , and usual care . For the fatigue measures the OR for STEPS offered at any time using an intention-to-treat approach was 3.68 ( 95%CI : 1.05 - 12.88 ) ; for the physical function measures , the OR was 1.40 ( 95%CI : 0.41- 4.79 ) and 2.36 ( 95%CI : 0.66 - 8.51 ) for the well-being measures . Conclusion : Fifty percent of eligible people were able to participate . This small trial suggests that a personalized exercise program reduces fatigue and that 100 people are needed in a full strength trial Prostate cancer patients receiving and rogen ablation therapy  experience significant physical and psychological sequelae associated with their disease and treatment . Because physical activity improves physical and psychological well-being , a lifestyle physical activity intervention may help slow or reverse the associated decline in quality of life ( QOL ) . No studies have evaluated an intervention to improve multiple QOL domains in patients receiving and rogen ablation therapy . Active for Life After Cancer is a three-group r and omized controlled trial design ed to evaluate the effectiveness of a lifestyle physical activity intervention ( Lifestyle Program ) in improving QOL . The Lifestyle Program , a 6-month behavioral skills training group , is compared to an Educational Support Program and St and ard Care . The purpose of this paper is to describe the design of the r and omized trial and present baseline data that will characterize the QOL of the sample . Challenges to recruitment for the trial also will be presented and discussed PURPOSE Physically active individuals have a lower risk of developing colorectal cancer but the influence of exercise on cancer survival is unknown . PATIENTS AND METHODS By a prospect i ve , observational study of 573 women with stage I to III colorectal cancer , we studied colorectal cancer-specific and overall mortality according to predefined physical activity categories before and after diagnosis and by change in activity after diagnosis . To minimize bias by occult recurrences , we excluded women who died within 6 months of their postdiagnosis physical activity assessment . RESULTS Increasing levels of exercise after diagnosis of nonmetastatic colorectal cancer reduced cancer-specific mortality ( P for trend = .008 ) and overall mortality ( P for trend = .003 ) . Compared with women who engaged in less than 3 metabolic equivalent task [ MET ] -hours per week of physical activity , those engaging in at least 18 MET-hours per week had an adjusted hazard ratio for colorectal cancer-specific mortality of 0.39 ( 95 % CI , 0.18 to 0.82 ) and an adjusted hazard ratio for overall mortality of 0.43 ( 95 % CI , 0.25 to 0.74 ) . These results remained unchanged even after excluding women who died within 12 and 24 months of activity assessment . Prediagnosis physical activity was not predictive of mortality . Women who increased their activity ( when comparing prediagnosis to postdiagnosis values ) had a hazard ratio of 0.48 ( 95 % CI , 0.24 to 0.97 ) for colorectal cancer deaths and a hazard ratio of 0.51 ( 95 % CI , 0.30 to 0.85 ) for any-cause death , compared with those with no change in activity . CONCLUSION Recreational physical activity after the diagnosis of stages I to III colorectal cancer may reduce the risk of colorectal cancer-specific and overall mortality Numerous studies have reported that exercise is safe and beneficial for breast cancer survivors ; however , long-term adherence to exercise programs is not easy to accomplish . This secondary analysis examined the demographic and clinical characteristics , adherence to exercise , and cognitive — behavioral intervention components data collected on 120 postmenopausal women with a history of breast cancer and bone loss who had been r and omized to the exercise group in a 24-month study . Hierarchical regression was used to identify variables that predicted adherence to  exercise . Mean adherence to  exercises  was 61.89 % .  Feedback and support were the most frequently used cognitive — behavioral intervention components . In hierarchical regression , predictors for adherence to exercise were feedback ( β = .40 , p < .001 ) and adherence to exercise  in the previous time period ( β = .31 , p < .001 ) . Participants receiving more frequent feedback had higher adherence to exercise The purpose of this pilot study was to examine the effects of a combined cardiorespiratory and resistance exercise training program of short duration on the cardiorespiratory fitness , strength endurance , task specific functional muscle capacity , body composition and quality of life ( QOL ) in women breast cancer survivors . Sixteen subjects were r and omly assigned to either a training ( n = 8 ; age : 50 + /- 5 yrs ) or control non-exercising group ( n = 8 ; age : 51 + /- 10 yrs ) . The training group followed an 8-week exercise program consisting of 3 weekly sessions of 90-min duration , supervised by an experienced investigator and divided into resistance exercises and aerobic training . Before and after the intervention period , all of the subjects performed a cardiorespiratory test to measure  peak oxygen uptake ( VO2peak ) , a dynamic strength endurance test ( maximum number of repetitions for chest and leg press exercise at 30 - 35 % and 100 - 110 % of body mass , respectively ) and a sit-st and test . Quality of life was assessed using the European Organization for Research and Treatment of Cancer QLQ-C30 ( EORTC-C30 ) question naire . In response to training , QOL , VO2peak ( mean 3.9 ml/kg/min ; 95 % CI , 0.93 , 6.90 ) performance in leg press ( 17.9 kg ; 95 % CI , 12.8 , 22.4 ) and sit-st and test ( - 0.67 s ; 95 % CI , - 0.52 , - 1.2 ) improved ( p < or = 0.05 ) . We observed no significant changes in the control group . Combined cardiorespiratory and resistance training , even of very brief duration , improves the QOL and the overall physical fitness of women breast cancer survivors BACKGROUND Shoulder dysfunction remains a frequent complication after neck dissection procedures for head and neck cancer . METHODS We conducted a pilot study to evaluate the effects of progressive resistance exercise training ( PRET ) on shoulder dysfunction caused by spinal accessory neurapraxia/neurectomy in patients with head and neck cancer . Twenty patients ( mean age , 61 + /- 7.7 years ) were r and omly assigned to PRET or st and ard care intervention . Subjects assigned to the PRET group exercised three times per week for 12 weeks . The goal of the exercise program was to enhance scapular stability and strength of the upper extremity . The resistance-training program was progressive in terms of number of sets and repetitions performed , as well as the amount of weight lifted , depending on performance status . RESULTS The completion rate for the trial was 85 % ( 17 of 20 ) . The exercise group completed 93 % of scheduled exercise sessions . Significant improvements were found in favor of the PRET group in active shoulder external rotation ( p = .001 ) , shoulder pain ( p = .038 ) , and overall score for shoulder pain and disability ( p = .045 ) . CONCLUSIONS The study results demonstrate a high rate of completion and adherence with our PRET program among patients with head and neck cancer . The preliminary findings , although limited , also suggest a potential therapeutic role for resistance exercise as an adjunct to st and ard physical therapy treatment BACKGROUND Exercise for Health was a pragmatic , r and omised , controlled trial comparing the effect of an eight-month exercise intervention on function , treatment-related side effects and quality of life following breast cancer , compared with usual care . The intervention commenced six weeks post-surgery , and two modes of delivering the same intervention was compared with usual care . The purpose of this paper is to describe the study design , along with outcomes related to recruitment , retention and representativeness , and intervention participation . METHODS Women newly diagnosed with breast cancer and residing in a major metropolitan city of Queensl and , Australia , were eligible to participate . Consenting women were r and omised to a face-to-face-delivered exercise group  ( FtF , n = 67 ) , telephone-delivered exercise group ( Tel , n = 67 ) or usual care group ( UC , n = 60 ) and were assessed pre-intervention ( 5-weeks post-surgery ) , mid-intervention ( 6 months post-surgery ) and 10 weeks post-intervention ( 12 months post-surgery ) . Each intervention arm entailed 16 sessions with an Exercise Physiologist . RESULTS Of 318 potentially eligible women , 63 % ( n = 200 ) agreed to participate , with a 12-month retention rate of 93 % . Participants were similar to the Queensl and breast cancer population with respect to disease characteristics , and the r and omisation procedure was mostly successful at attaining group balance , with the few minor imbalances observed unlikely to influence intervention effects given balance in other related characteristics . Median participation was 14 ( min and max : 0 and 16 ) and 13 ( min and max : 3 and 16 ) intervention sessions for the FtF and Tel , respectively , with 68 % of those in Tel and 82 % in FtF participating in at least 75 % of sessions . DISCUSSION Participation in both intervention arms during and following treatment for breast cancer was feasible and acceptable to women . Future work , design ed to inform translation into practice , will evaluate the quality of life , clinical , psychosocial and behavioural outcomes associated with each mode of delivery This r and omized , controlled pilot trial was carried out to assess the feasibility and efficacy of an aerobic exercise in enhancing physical performance of breast cancer patients after adjuvant treatments . The potential of the training regimen to prevent accompanying bone loss was also assessed . Thirty patients , 41–65 years of age , were r and omly assigned into training or control  groups shortly after adjuvant chemo- or radiotherapy . The 12-week training included a guided aerobic exercise session once a week ( the effective part being either step aerobic- or circuit-training in alternate weeks ) and similar home exercise sessions twice a week . Adherence to the guided sessions was 78 % , while home training was performed an average 2.1 times per week . Agility assessed with figure-8 running test and peak jumping power showed significant between-group treatment-effects ( ∼5 % and ∼10 % , respectively ) . Judged from the accelerometer data , reaction forces up to six times body weight occurred during the training , which implies that the training could also have potential to affect bone mass . The present exercise regimen turned out to be feasible and effective among breast cancer patients in terms of physical performance . Large controlled trials are necessary to confirm these findings Given the negative effects of a breast cancer diagnosis and its treatments on body weight and bone mass , we investigated the effects of a 6-month r and omized controlled aerobic exercise intervention vs. usual care on body composition in breast cancer survivors . Secondary aims were to examine the effects stratified by important prognostic and physiologic variables . Seventy-five physically inactive postmenopausal breast cancer survivors were recruited through the Yale-New Haven Hospital Tumor Registry and r and omly assigned to an exercise ( n = 37 ) or usual care ( n = 38 ) group . The exercise group participated in 150 min/week of supervised gym- and home-based moderate-intensity aerobic exercise . The usual care group was instructed to maintain their current physical activity level . Body composition was assessed at baseline and 6-months through dual-energy X-ray absorptiometry ( DXA ) by one radiologist blinded to the intervention group of the participants . On an average , exercisers increased moderate-intensity aerobic exercise by 129 min/week over and above baseline levels compared with 45 min/week among usual care participants ( P < 0.001 ) . Exercisers experienced decreases in percent body fat ( P = 0.0022 ) and increases in lean mass ( P = 0.047 ) compared with increases in body fat and decreases in lean mass in usual care participants . Bone mineral density ( BMD ) was also maintained among exercisers compared with a loss among usual care participants ( P = 0.043 ) . In summary , moderate-intensity aerobic exercise , such as brisk walking , produces favorable changes in body composition that may improve breast cancer prognosis Although exercise may be used by some to decrease distress , little is known about how it may contribute to stress management ( SM ) among patients receiving chemotherapy . We evaluated whether exercise separately or in combination with SM training is effective at increasing perceived ability to manage stress .  Patients receiving chemotherapy ( N = 391 ) were r and omized to receive usual care only ( UCO ) , SM , exercise ( EX ) , or stress management and exercise ( SMEX ) .  They completed the Measure of Current Status prior to receiving chemotherapy and 12 weeks after the first infusion . We hypothesized that participants r and omized to an intervention condition would report improvements in relaxation , awareness of tension , getting needs met and coping confidence compared with those receiving UCO . Results indicated significant group-by-time interactions for the following : relaxation ( UCO versus SM , p = 0.008 ) , awareness of tension ( UCO versus SMEX , p = 0.029 and UCO versus EX , p < 0.001 ) , getting needs met ( UCO versus SMEX , p = 0.020 ) and Measure of Current Status total score ( UCO versus SMEX , p = 0.007 and UCO versus EX , p = 0.016 ) . There were no group-by-time interactions for coping confidence ( p-values > 0.05 ) . This study provides support for including an exercise component in SM interventions for cancer patients receiving chemotherapy ( clinical trials.gov identifier : NCT00740038 ) 82 Background : A common physical sequel after adjuvant therapy is a decrease in shoulder movement of the upper-limb of the affected side and the development of LE . Resistance exercise is known to be safe and does not increase the risk of LE . The objective of this study is to evaluate the effect of a VEP on shoulder range of motion and upper-limb LE after adjuvant therapy in BCs . METHODS 22 BCs treated with surgery and adjuvant therapy  were r and omly assigned to the VEP ( n=12 ) or the control ( n=10 ) . The VEP aim ed at improving aerobic endurance , joint mobility and muscle strength . The frequency of the VEP was 2 times a week , during 3 months , with a total of 30 sessions . Primary endpoints included the range shoulder motion and arm volumes of both arms . The secondary outcome was quality of life ( QoL ) as measured by the EORTC QLQ-C30 . All outcome measures were assessed at baseline and after 3 months . RESULTS After ending the VEP , in the exercise group , the movements such as abduction ( p=0.04 ) , external rotation ( p=0.02 ) , extension ( p=0.03 ) and flexion ( p=0.01 ) of the affected arm increased significantly but there was no change for internal rotation ( 0.27 ) . No significant changes in arm volume ( p=0.06 ) were found after 3 months compared to baseline , whereas the quality of life did improve significantly ( p=0.01 ) . After 3 months the range of motion of the shoulder of the affected arm ( sum of abduction , external rotation , extension and flexion ) in the exercise group tended to be better although this was not significant ( p=0.50 ) . The arm volume difference between the two groups was not significant ( p=0.10 ) but it was for the QoL ( p=0.02 ) . CONCLUSIONS A VEP lead to significant specific improvements in arm mobility compared to baseline . These BCs also compared favourably to the control cohort , but this was not significant . The study confirms that exercising the ipsilateral arm and shoulder has no detrimental effect on LE and has a positive impact on the QoL. St and ard guidelines concerning physical therapy to ameliorate shoulder function and LE are not available . Additional patients will be enrolled to develop st and ard recommendations for physical therapy to improve shoulder and limb function in BCs Background : Aerobic exercise training ( AET ) is known to increase RBC production ; however , this has not been evaluated in breast cancer patients undergoing adjuvant chemotherapy . The purpose of this study was to examine the changes in hemoglobin ( Hb ) levels in the Supervised Trial of Aerobic versus Resistance Training ( START ) and to determine its association with changes in VO2peak . Methods : Two hundred and forty-two breast cancer patients initiating chemotherapy were r and omized to usual care ( n = 82 ) , resistance exercise ( RET , n = 82 ) , or AET ( n = 78 ) groups for the duration of their chemotherapy ( median , 17 weeks ) . Supervised exercise was thrice weekly based on st and ard AET and RET prescriptions .  Aerobic fitness ( VO2peak ) and Hb concentration were measured at baseline and end of chemotherapy . Results : Regardless of the exercise group , Hb declined over the course of chemotherapy ( 13.4 ± 10.0 to 11.8 ± 11.5 g/dL , P < 0.01 ) . Both AET and RET groups had significant , moderate correlations between the change in VO2peak and Hb ( AET : r = 0.49 , P < 0.001 ; RET : r = 0.39 , P = 0.001 ) . Conclusion : The results indicate that regular exercise does not protect against the decline in Hb associated with chemotherapy in breast cancer patients , but result ed in a stronger association between Hb and VO2peak . Impact : Even with the chemotherapy-induced decline in Hb , breast cancer patients can maintain their aerobic capacity by participating in regular aerobic exercise . Further studies are required to determine safe intensity levels that may stimulate the maintenance of Hb levels in breast cancer patients . Cancer Epidemiol Biomarkers Prev ; 19(11 ) ; 2826–32 . © 2010 AACR OBJECTIVE To evaluate the effect of a combined hospital plus home exercise programme following curative surgery for non-small cell lung cancer ( NSCLC ) . DESIGN R and omised controlled trial . SETTING Teaching hospital . PARTICIPANTS One hundred and thirty-one subjects with NSCLC admitted for curative surgery . INTERVENTIONS Participants were r and omised to usual care or a hospital plus home exercise programme . OUTCOMES The primary outcome was the between-group difference in physical activity 4 weeks after surgery . Secondary outcomes were the difference in quadriceps strength , exercise tolerance and quality of life [ Short Form-36 ( SF-36 ) and European Organisation for Research and Treatment of Cancer ( EORTC ) QLQ-LC13 ] from pre-operatively ( baseline ) to 4 weeks after surgery . RESULTS The participants ( n=131 ) had a mean age of 68 [ st and ard deviation ( SD ) 11 ] years and mean forced expiratory volume in 1 second of 2.4 ( SD 1.1)l . There were no significant differences in physical activity between the groups 4 weeks after surgery [ mean difference adjusted for baseline 12minutes/day , 95 % confidence interval ( CI ) -20.2 to 44.1 ] . In addition , there were no significant differences in total SF-36 or EORTC QLQ-LC13 scores from baseline to 4 weeks after surgery . Both groups had recovered their pre-operative walking distance 4 weeks after surgery , and there were no differences between the groups ( mean difference in Incremental Shuttle Walk Test from baseline to 4 weeks after surgery ( -26 m , 95 % CI -94.2 to 42.3 ) . CONCLUSIONS A hospital plus home exercise programme showed little benefit in unselected patients with NSCLC following surgery . Regardless of group allocation , the patients had recovered their pre-operative exercise tolerance levels by 4 weeks after surgery Background : Physical activity can confer many benefits on cancer survivors , including relief of persistent symptoms related to cancer treatment . Objectives : To evaluate the effect of a motivational interviewing ( MI ) intervention on increasing physical activity ( Community Healthy Activities Model Program for Seniors question naire ) and improving aerobic fitness ( 6-minute walk ) , health ( Medical Outcomes Study Short-Form 36 ) , and fatigue ( Schwartz Cancer Fatigue Scale ) in cancer survivors . A secondary purpose was to evaluate whether the effect of MI on physical activities depended on self-efficacy . Methods : Fifty-six physically inactive adult cancer survivors ( mean = 42 months since completion of treatment ) were assigned r and omly to intervention and control groups . The MI intervention consisted of one in-person counseling session followed by two MI telephone calls over 6 months . Control group participants received two telephone calls without MI content . Outcomes were measured at baseline , 3 months , and 6 months , and were analyzed using multilevel modeling . Results : The results of the MI intervention explained significant group differences in regular physical activities ( measured in caloric expenditure per week ) , controlling for time since completion of cancer treatment ( p < .05 ) . Aerobic fitness , physical and mental health , and fatigue were not different between groups . In the intervention group , individuals with high self-efficacy for exercise at baseline increased their physical activity more than those with low self-efficacy ( p < .05 ) . In the control group , increases in physical activity did not depend on self-efficacy . Discussion : Use of MI may increase physical activity in long-term cancer survivors , especially in persons with high self-efficacy for exercise . Multilevel modeling analysis revealed individual changes that would not have been shown by analysis of group means . Future studies with larger sample s or more intense MI interventions may show changes in aerobic fitness , physical and mental health , and fatigue BACKGROUND We evaluated the effect of Emotionally Focused Therapy ( EFT ) [ intervention ( INT ) ] , modified for the advanced cancer population versus st and ard care [ control ( CTL ) ] , on marital functioning and psychosocial outcomes among distressed couples .  EFT examines the ways couples process patterns of interaction , facilitating change . METHODS Forty-two patients with metastatic cancer and their caregivers were assigned r and omly to receive eight sessions of EFT delivered by one EFT-trained psychologist or st and ard care provided by multidisciplinary clinicians . Partners completed measures of marital functioning , depression , hopelessness , empathic caregiving ( patient ) , and caregiver burden ( caregiver ) before r and omization at baseline ( T0 ) , post-intervention ( T1 ) , and 3-month post-intervention ( T2 ) . Data were analyzed using three-way analyses of covariance ; main effects were treatment , patient status , and sex . Multilevel modeling was also employed . RESULTS At T1 , INT group led to significant improvement in marital functioning ( p ≤ 0.0001 ) and patients ' experience of caregiver empathic care ( p = 0.02 ) versus CTL group . Effect sizes for these differences were in the large range ( d = 1.00 ) . In both groups , patients showed a marginally higher mean score for marital functioning compared with caregivers [ INT : M = 56.3 , st and ard deviation ( SD ) = 4.6 vs M = 54.3 , SD = 4.5 ; CTL group : M = 43.4 , SD = 10.3 vs M = 42.4 , SD = 6.8 , respectively ] . At T2 , results were maintained . CONCLUSIONS The effectiveness of and adherence to the EFT couple intervention for patients facing advanced cancer were demonstrated in this study . Larger r and omized control trials are needed to confirm these findings . Qualitative studies may help to further underst and the mechanism by which such an intervention may act ABSTRACT The primary objective of this pilot study was to explore the feasibility of implementing two exercise programs for female patients who are breast cancer survivors and residents of the metropolitan area of San Juan , Puerto Rico . Potential benefits and complications of participating in a gym‐exercise program or a home‐exercise program , as opposed to st and ard care , were identified . Participants were r and omly assigned to 1 of 3 groups : a gym‐exercise group , a home‐exercise group , or a non‐exercise group . Interventions consisted of exercise programs with both aerobic and strengthening components , offered for a 26‐week period . Outcome measures consisted of functional evaluation , shoulder range of motion , 12‐minute walk test , h and grip strength , body mass index , and quality of life . The results of this study showed that it is feasible for Puerto Rican women to participate in a moderate intensity exercise program without developing complications . Participation in the exercise programs studied here minimized the side effects after cancer treatment , such as reduced physical functional ability and restricted shoulder mobility . Improvements were found in the measures of shoulder range of motion , upper extremity related physical function , and distance walked OBJECTIVES Peak VO2 , as measure of physical performance is central to a correct preoperative evaluation in patients with both non-small-cell lung cancer ( NSCLC ) and chronic obstructive pulmonary disease ( COPD ) because it is closely related both to operability criteria and the rate of postoperative complications . Strategies to improve peak VO2 , as a preoperative pulmonary rehabilitation programme ( PRP ) , should be considered favourably in these patients . In order to clarify the role of pulmonary rehabilitation , we have evaluated the effects of 3-week preoperative high-intensity training on physical performance and respiratory function in a group of patients with both NSCLC and COPD who underwent lobectomy . METHODS We studied 40 patients with both NSCLC and COPD , age < 75 years , TNM stages I-II , who underwent lobectomy . Patients were r and omly divided into two groups ( R and S ) : Group R underwent an intensive preoperative PRP , while Group S underwent only lobectomy . We evaluated peak VO2 in all patients at Time 0 ( T0 ) , after PRP/before surgery in Group R/S ( T1 ) and 60 days after surgery , respectively , in both groups ( T2 ) . RESULTS There was no difference between groups in peak VO2 at T0 , while a significant difference was observed both at T1 and T2 . In Group R , peak VO2 improves significantly from T0 to T1 : 14.9 ± 2.3 - 17.8 ± 2.1 ml/kg/min ± st and ard deviation ( SD ) , P < 0.001 ( 64.5 ± 16.5 - 76.1 ± 14.9 % predicted ± SD , P < 0.05 ) and deteriorates from T1 to T2 : 17.8 ± 2.1 - 15.1 ± 2.4 , P < 0.001 ( 76.1 ± 14.9 - 64.6 ± 15.5 , P < 0.05 ) , reverting to a similar value to that at T0 , while in Group S peak VO2 did not change from T0 to T1 and significantly deteriorates from T1 to T2 : 14.5 ± 1.2 - 11.4 ± 1.2 ml/kg/min ± SD , P < 0.00001 ( 60.6 ± 8.4 - 47.4 ± 6.9 % predicted ± SD , P < 0.00001 ) . CONCLUSIONS PRP was a valid preoperative strategy to improve physical performance in patients with  both NSCLC and COPD and this advantage was also maintained after surgery Physical exercise is becoming an accepted part of therapy for many patients with cancer .  Exercise may alleviate patients ' fatigue and improve physical performance and psychological outlook . Much of the research is limited to women with breast cancer and excludes patients with bone metastases . This article reports on the authors ' work in facilitating exercise adherence for patients with multiple myeloma ( MM ) and bone lesions while they were enrolled in a feasibility/pilot exercise study as they were receiving treatment for their disease in an outpatient treatment program . The exercise program for these patients receiving high-dose chemotherapy and stem cell transplantation consisted of aerobic and strength-building components . The program was home based , and patients performed exercises without direct supervision . On average , the patients completed the six-month exercise prescription 75 % of the time . Overall trends showed that all 14 patients in the exercise group  improved in several areas of testing , and the test results of all 10 patients in the usual-care group declined . Flexibility and simplicity are essential when design ing exercise programs for patients , and encouragement and support also are needed to help patients adhere to prescribed exercise AIM The study aim ed at determining whether physical exercise training improves the quality of life ( QoL ) and physical fitness of breast cancer survivors . PATIENTS AND METHODS A total of 573 breast cancer survivors were r and omized into an exercise or a control group , 12-months after adjuvant treatments . EORTC QLQ-C30 and BR-23 question naires were used for evaluation of QoL , FACIT-F for fatigue and the Finnish modified version of Beck 's 13-item depression scale ( RBDI ) for depression . Physical fitness was assessed by a 2-km walking test , and a figure-8 running test and physical activity ( PA )  by metabolic equivalent ( MET ) hours per week ( MET-h/wk ) . RESULTS Figure-8 running time improved significantly among the patients of the intervention group compared with the controls ( p<0.001 ) . No significant between-group differences were observed in 2-km walking time , in PA , EORTC-QLQ-C30 , BR-23 , FACIT-F or BDI . However , there was a linear relationship between increased PA and improved QoL ( p=0.006 ) , irrespective of the intervention . CONCLUSION Increase in physical activity was associated with improved QoL , but no effect of the exercise intervention was observed BACKGROUND Nearly 35 % of men treated for prostate cancer ( PrCA ) will experience biochemically defined recurrence , noted by a rise in PSA , within 10 years of definitive therapy . Diet , physical activity , and stress reduction may affect tumor promotion and disease progression . METHODS A r and omized trial of an intensive diet , physical activity , and meditation intervention was conducted in men with rising post-treatment PSA after definitive treatment for PrCA . Intention-to-treat methods were used to compare usual care to the intervention in 47 men with complete data . Signal detection methods were used to identify dietary factors associated with PSA change . RESULTS The intervention and control groups did not differ statistically on any demographic or disease-related factor . Although the intervention group experienced decreases of 39 % in intakes of saturated fatty acid ( SFA as percent of total calories ) ( p<0.0001 ) and 12 % in total energy intake ( 218 kcal/day , p<0.05 ) ] , no difference in PSA change was observed by intervention status . Signal detection methods indicated that in men increasing their consumption of fruit , 56 % experienced no rise in PSA ( vs. 29 % in men who did not increase their fruit intake ) . Among men who increased fruit and fiber intakes , PSA increased in 83 % of participants who also increased saturated fatty acid intake ( vs. 44 % in participants who decreased or maintained saturated fatty acid intake ) . CONCLUSION Results are discussed in the context of conventional treatment strategies that were more aggressive when this study was being conducted in the mid-2000s . Positive health changes in a number of lifestyle parameters were observed with the intervention , and both increased fruit and reduced saturated fat intakes were associated with maintaining PSA levels in men with biochemically recurrent disease PURPOSE This study aim ed to examine mediators of fatigue response to an exercise intervention for breast cancer survivors in a pilot r and omized controlled trial . METHODS Postmenopausal breast cancer survivors ( n = 46 ; ≤stage 2 ) , off primary treatment , and reporting fatigue and /or sleep dysfunction were r and omized to a 3-month exercise intervention ( 160 min·wk of moderate-intensity aerobic walking , twice weekly resistance training with resistance b and s ) or control group . Six discussion group sessions provided behavioral support to improve adherence . Fatigue , serum cytokines , accelerometer physical activity , cardiorespiratory fitness , sleep dysfunction , and psychosocial factors were assessed at baseline and 3 months . RESULTS The exercise intervention effect sizes for fatigue were as follows : fatigue intensity d = 0.30 ( P = 0.34 ) , interference d = -0.38 ( P = 0.22 ) , and general fatigue d = -0.49 ( P = 0.13 ) . Using the Freedman-Schatzkin difference-in-coefficients tests , increase in fatigue intensity was significantly mediated by interleukin 6 ( IL-6 ) ( 82 % ) , IL-10 ( 94 % ) , IL-6/IL-10 ( 49 % ) , and tumor necrosis factor-α (TNF-α):IL-10 ( 78 % ) with reduced sleep dysfunction increasing the relationship between intervention and fatigue intensity rather than mediating intervention effects ( -88 % ) . Decrease in fatigue interference was mediated by sleep dysfunction ( 35 % ) , whereas IL-10 and pro-anti-inflammatory cytokine ratios increased the relationship between intervention and interference ( -25 % to -40 % ) . The reduction in general fatigue was significantly mediated by minutes of physical activity ( 76 % ) , sleep dysfunction ( 45 % ) , and physical activity enjoyment ( 40 % ) , with IL-10 ( -40 % ) and IL-6/IL-10 ( -11 % ) increasing the intervention-fatigue relationship . In the intervention group , higher baseline fatigue , anxiety , depression , and perceived exercise barrier interference predicted a greater decline in fatigue interference and /or general fatigue during the intervention . CONCLUSIONS Biobehavioral factors mediated and enhanced intervention effects on fatigue , whereas psychosocial factors predicted fatigue response . Further study is warranted to confirm our results and to improve underst and ing of relationships that mediate and strengthen the intervention-fatigue association OBJECTIVES To assess the feasibility and efficacy of delivering Pilates exercises for resistance training to breast cancer survivors using the MVe Fitness Chair ™ . DESIGN Pilot r and omized controlled trial . METHODS Twenty-six female breast cancer survivors were r and omized to use the MVe Fitness Chair ™ ( n=8 ) , traditional resistance training ( n=8 ) , or a control group ( no exercise ) ( CO ) ( n=10 ) . The MVe Fitness Chair ™ and traditional resistance training groups completed 8 weeks of exercise . Muscular endurance was assessed pre and post-test for comparisons within and between groups using push ups , curl ups , and the Dynamic Muscular Endurance Test Battery for Cancer Patients of Various Ages . RESULTS Feasibility of the MVe Fitness Chair ™ was good , evidence d by over 80 % adherence for both exercise groups and positive narrative feedback . Significant improvements in muscular endurance were observed in the MVe Fitness Chair ™ ( p<0.002 ) and traditional resistance training groups ( p<0.001 ) , but there were no differences in improvement between the MVe Fitness Chair ™ and traditional resistance training groups ( p<0.711 ) indicating that Pilates and traditional resistance training may be equally effective at improving muscular endurance in this population . CONCLUSIONS The MVe Fitness Chair ™ is feasible for use in breast cancer survivors . It appears to promote similar improvements in muscular endurance when compared to traditional resistance training , but has several advantages over traditional resistance training , including cost , logistics , enjoyment , and ease of learning Background : Depression , anxiety , and fatigue are among the most significant problems that influence the quality of life of patients with breast cancer who receive adjuvant chemotherapy . Although evidence has shown yoga to decrease anxiety , depression , and fatigue in patients with cancer , few studies on the effects of yoga have targeted patients with breast cancer .  Yoga interventions should be tested to promote the psychological and physical health of women with breast cancer . Purpose : This study examines the effectiveness of an 8-week yoga exercise program in promoting the psychological and physical health of women with breast cancer undergoing adjuvant chemotherapy in terms of depression , anxiety , and fatigue . Methods : A sample of 60 women with nonmetastatic breast cancer was recruited . Participants were r and omly assigned into either the experimental group ( n = 30 ) or the control group ( n = 30 ) . A 60-minute , twice-per-week yoga exercise was implemented for 8 weeks as the intervention for the participants in the experimental group . The control group received st and ard care only . Results : Analysis using the Johnson – Neyman procedure found that the yoga exercise  reduced overall fatigue and the interference of fatigue in everyday life for the experimental group participants . Significant reductions were obtained after 4 weeks of intervention participation for those experimental group patients with relatively low starting baseline values ( baseline item mean value < 3.31 and 3.22 , respectively ) and after 8 weeks for most patients ( approximately 75 % ) with moderate starting baseline values ( baseline item mean value < 7.30 and 5.34 , respectively ) . The 8-week intervention did not significantly improve the levels of depression ( F = 1.29 , p > .05 ) or anxiety ( F = 2.7 , p > .05 ) . Conclusions / Implication s for Practice : The 8-week yoga exercise program developed in this study effectively reduced fatigue in patients with breast cancer but did not reduce depression or anxiety . Oncology nurses should strengthen their clinical health education and apply yoga to reduce the fatigue experienced by patients with breast cancer who undergo adjuvant chemotherapy Background . Chronic fatigue is one of the most restricting symptoms following primary breast cancer treatment , but clinical studies on symptom management are rare . The objective was to evaluate the impact of a multimodal mind – body program ( MMMT ) , including moderate physical activity as compared with a walking intervention alone , on chronic fatigue symptoms of women with stage I to IIIA breast cancer . Patients and Methods . Sixty-four women ( mean age = 56.7 years ) suffering from chronic fatigue after active tumor treatment were r and omly assigned to either an experimental or a control ( n = 32 each ) intervention ( 10 weeks ) . Fatigue , quality of life ( QoL ) , functional well-being , anxiety , and depression were measured with st and ard question naires at baseline , after 10 weeks , and after 3 months . Results . Compared with baseline , both groups had reduced fatigue scores after treatment without any significant difference between groups ( posttreatment , Δ = −0.3 , confidence interval = −1.6 to 1.0 , P = .678 ; follow-up , Δ = −0.4 , confidence interval = −1.8 to 0.9 , P = .510 ) . All patients also improved regarding QoL and general functional well-being . Conclusion . Since both interventions reduced fatigue symptoms and enhanced QoL to a similar extent , we observed no verifiable add-on effect of the MMMT  regarding fatigue symptoms . Considering the higher costs with additional expenditure related to MMMT , home-based walking intervention is recommended OBJECTIVES Previous research has demonstrated that patients with prostate cancer participating in the Prostate Cancer Lifestyle Trial had a reduction in prostate-specific antigen ( PSA ) levels , inhibition of LNCaP cell growth , and fewer prostate cancer-related clinical events at the end of 1 year compared with controls . The aim of this study was to examine the clinical events in this trial during a 2-year period . METHODS The Prostate Cancer Lifestyle Trial was a 1-year r and omized controlled clinical trial of 93 patients with early-stage prostate cancer ( Gleason score < 7 , PSA 4 - 10 ng/mL ) undergoing active surveillance . The patients in the experimental arm were encouraged to adopt a low-fat , plant-based diet , to exercise and practice stress management , and to attend group support sessions . The control patients received the usual care . RESULTS By 2 years of follow-up , 13 of 49 ( 27 % ) control patients and 2 of 43 ( 5 % ) experimental patients had undergone conventional prostate cancer treatment ( radical prostatectomy , radiotherapy , or and rogen deprivation , P < .05 ) . No differences were found between the groups in other clinical events ( eg , cardiac ) , and no deaths occurred . Three of the treated control patients but none of the treated experimental patients had a PSA level of > or=10 ng/mL , and 1 treated control patient but no treated experimental patients had a PSA velocity of > 2 ng/mL/y before treatment . No significant differences were found between the untreated experimental and untreated control patients in PSA change or velocity at the end of 2 years . CONCLUSIONS Patients with early-stage prostate cancer choosing active surveillance might be able to avoid or delay conventional treatment for at least 2 years by making changes in their diet and lifestyle We compared the effect of a group-based 12-week supervised exercise programme , i.e. aerobic and resistance exercise , and group sports , with that of the same programme combined with cognitive-behavioural training on physical fitness and activity of cancer survivors . One hundred and forty seven cancer survivors ( all cancer types , medical treatment ≥3 months ago ) were r and omly assigned to physical training ( PT , n=71 ) or PT plus cognitive-behavioural training ( PT+CBT , n=76 ) . Maximal aerobic capacity , muscle strength and physical activity were assessed at baseline and post-intervention . Analyses using multilevel linear mixed-effects models showed that cancer survivors ’ physical fitness increased significantly in PT and PT+CBT from baseline to post-intervention . Changes did not differ between PT and PT+CBT . Physical fitness of cancer survivors was improved following an intensive physical training programme . Adding a structured cognitive-behavioural intervention did not enhance the effect The effect of a 10-week aerobic interval-training cycle ergometer protocol on the functional capacity ( VO2Lmax ) of 45 women receiving chemotherapy for treatment of Stage II breast cancer was studied . Subjects were stratified by baseline functional capacity ( ± 1 MET ) and r and omized to experimental ( EX ) , placebo ( PL ) , and control ( CO ) groups . EX subjects completed a 10-week , 3 times/week exercise training program ; PL subjects participated in 10 weeks of nonaerobic stretching and flexibility exercises ; the CO group maintained normal activities . The EX group showed significant , p < .05 , improvement on pre- to posttest VO2Lmax as well as workload and test time compared to the PL and CO groups . The interval-training exercise intervention was effective in improving the functional capacity of Stage II breast cancer patients on adjuvant chemotherapy BACKGROUND As patients with pancreas and periampullary cancer ( PPC ) experience improved survival rates and longevity , the focus shifts toward living life while surviving cancer . Fatigue is the most commonly reported symptom in all cancer patients .  Exercise has been found to effectively decrease fatigue levels and improve physical functioning in cancer patients . STUDY DESIGN One hundred two patients with resected PPC consented to participate in this study and were r and omized to either an intervention group ( IG ) or a usual care group ( UCG ) . Subjects completed visual analog scales , the FACIT-Fatigue Scale and the Short Form-36v2 after surgery and again 3 to 6 months after hospital discharge . RESULTS Patients in the IG and UCG were comparable with regard to demographics , comorbidities , cancer type and staging , type of resection , preoperative fatigue and pain levels , adjuvant therapy , and baseline walking distance . Patients in the IG had significantly improved scores on the FACIT-Fatigue Scale at study completion , improved fatigue and pain scores , as well as overall physical functioning and mental health composite scores . At study completion , participants in the IG were walking twice as far and were significantly more likely to have continued walking or another form of exercise as compared with the UCG . Using hierarchical cluster analysis , 3 mutually exclusive symptom groupings were identified in the cohort . Kaplan-Meier survival analysis did not indicate an overall survival benefit for the IG . CONCLUSIONS This is the first prospect i ve , r and omized controlled trial to report that participation in a home walking program confers a significant benefit in resected PPC patients with regard to fatigue levels , physical functioning , and health-related quality of life Evidence -based exercise and relaxation recommendations for people with breast cancer-related lymphedema ( BCRL ) are needed . We report a r and omized controlled study of one program , design ed to achieve synergistic improvements in physical and emotional BCRL symptoms . People in the treatment group received an exercise and relaxation program , The Breast Cancer Recovery Program ( N=16 ) . The  control participants ( N=16 )  continued with health professionals ' recommendations .  Participants were tested at entry , 2.5 weeks , 5 weeks , and 3 months . Treatment group participants , compared with control participants , demonstrated significant treatment effects for improved bioimpedance z , arm flexibility , quality of life , mood at 3 months , and weight loss . Adherence was high for this safe and effective program , which improved lymphedema physical and emotional symptoms Fatigue is the most prevalent and debilitating symptom experienced by breast cancer patients receiving adjuvant chemotherapy or radiation therapy and few evidence -based treatments are available to manage this distressing side-effect . The purpose of this multi-institutional r and omized controlled trial was to determine the effects of exercise on fatigue levels during treatment for breast cancer . Sedentary women ( N=119 ) with Stage 0-III breast cancer receiving outpatient adjuvant chemotherapy or radiation therapy were r and omized to a home-based moderate-intensity walking exercise program or to usual care for the duration of their cancer treatment . Of participants r and omized to exercise , 72 % adhered to the exercise prescription ; 61 % of the usual care group adhered . The intention-to-treat analysis revealed no group differences in part because of a dilution of treatment effect as 39 % of the usual care group exercised and 28 % of the exercise group did not . When exercise participation was considered using the data analysis method of instrumental variables with principal stratification , a clinical ly important and statistically significant ( p=0.03 ) effect of exercise on pretest-to-posttest change in fatigue levels was demonstrated . Adherence to a home-based moderate-intensity walking exercise program may effectively mitigate the high levels of fatigue prevalent during cancer treatment CONTEXT Clinical guidelines for breast cancer survivors without lymphedema advise against upper body exercise , preventing them from obtaining established health benefits of weight lifting . OBJECTIVE To evaluate lymphedema onset after a 1-year weight lifting intervention vs no exercise ( control ) among survivors at risk for breast cancer-related lymphedema ( BCRL ) . DESIGN , SETTING , AND PARTICIPANTS A r and omized controlled equivalence trial ( Physical Activity and Lymphedema trial ) in the Philadelphia metropolitan area of 154 breast cancer survivors 1 to 5 years postunilateral breast cancer , with at least 2 lymph nodes removed and without clinical signs of BCRL at study entry . Participants were recruited between October 1 , 2005 , and February 2007 , with data collection ending in August 2008 . INTERVENTION Weight lifting intervention included a gym membership and 13 weeks of supervised instruction , with the remaining 9 months unsupervised , vs no exercise . MAIN OUTCOME MEASURES Incident BCRL determined by increased arm swelling during 12 months ( ≥5 % increase in interlimb difference ) . Clinician-defined BCRL onset was also evaluated . Equivalence margin was defined as doubling of lymphedema incidence . RESULTS A total of 134 participants completed follow-up measures at 1 year . The proportion of women who experienced incident BCRL onset was 11 % ( 8 of 72 ) in the weight lifting intervention group and 17 % ( 13 of 75 ) in the control group ( cumulative incidence difference [ CID ] , -6.0 % ; 95 % confidence interval [ CI ] , -17.2 % to 5.2 % ; P for equivalence = .04 ) . Among women with 5 or more lymph nodes removed , the proportion who experienced incident BCRL onset was 7 % ( 3 of 45 ) in the weight lifting intervention group and 22 % ( 11 of 49 ) in the control group ( CID , -15.0 % ; 95 % CI , -18.6 % to -11.4 % ; P for equivalence = .003 ) . Clinician-defined BCRL onset occurred in 1 woman in the weight lifting intervention group and 3 women in the control group ( 1.5 % vs 4.4 % , P for equivalence = .12 ) . CONCLUSION In breast cancer survivors at risk for lymphedema , a program of slowly progressive weight lifting compared with no exercise did not result in increased incidence of lymphedema . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00194363 Given observational findings that physical activity reduces breast cancer risk , improves survival , and improves quality of life in breast cancer survivors , a need has been identified for r and omized controlled trials that testthe efficacy of exercise on biological mechanisms associated with breast cancer survival . The primary aims of the Yale Exercise and Survivorship Study were to 1 ) determine the feasibility of recruiting breast cancer survivors into a r and omized controlled trial of the effects of exercise on biological markers and /or mechanisms associated with survival , 2 ) compare the effectiveness of various recruitment strategies on accrual rates and baseline characteristics , and 3 ) report adherence to the exercise trial Background : Physical inactivity and obesity increase the risk of  colorectal cancer  but little is known about whether they influence prognosis after diagnosis . Methods : Incident cases of colorectal cancer were identified among participants of the Melbourne Collaborative Cohort Study , a prospect i ve cohort study of 41 528 Australians recruited from 1990 to 1994 . Participants diagnosed with their first colorectal cancer between recruitment and 1 August 2002 were eligible . At the time of study entry , body measurements were taken and participants were interviewed about their physical activity . Information on tumour site and stage , treatments given , recurrences , and deaths were obtained from systematic review of the medical records . Results : A total of 526 cases of colorectal cancer were identified . Median follow up among survivors was 5.5 years , and 208 deaths had occurred , including 181 from colorectal cancer . After adjusting for age , sex , and tumour stage , exercisers had an improved disease specific survival ( hazard ratio 0.73 ( 95 % confidence interval ( CI ) 0.54–1.00 ) ) . The benefit of exercise was largely confined to stage II – III tumours ( hazard ratio 0.49 ( 95 % CI 0.30–0.79 ) ) . Increasing per cent body fat result ed in an increase in disease specific deaths ( hazard ratio 1.33 per 10 kg ( 95 % CI 1.04–1.71 ) ) . Similarly , increasing waist circumference reduced disease specific survival ( hazard ratio 1.20 per 10 cm ( 95 % CI 1.05–1.37 ) ) . Conclusions : Increased central adiposity and a lack of regular physical activity prior to the diagnosis of colorectal cancer is associated with poorer overall and disease specific survival PURPOSE Radiotherapy for prostate cancer ( PCa ) may cause unfavorable changes in fatigue , quality of life ( QOL ) , and physical fitness . We report results from the Prostate Cancer Radiotherapy and Exercise Versus Normal Treatment study examining the effects of 24 weeks of resistance or aerobic training versus usual care on fatigue , QOL , physical fitness , body composition , prostate-specific antigen , testosterone , hemoglobin , and lipid levels in men with PCa receiving radiotherapy . PATIENTS AND METHODS Between 2003 and 2006 , we conducted a r and omized controlled trial in Ottawa , Canada , where 121 PCa patients initiating radiotherapy with or without and rogen deprivation therapy  were r and omly assigned to usual care ( n = 41 ) , resistance ( n = 40 ) , or aerobic exercise ( n = 40 ) for 24 weeks . Our primary end point was fatigue assessed by the Functional Assessment of Cancer Therapy-Fatigue scale . RESULTS The follow-up assessment rate for our primary end point of fatigue was 92.6 % . Median adherence to prescribed exercise was 85.5 % . Mixed-model repeated measures analyses indicated both resistance ( P = .010 ) and aerobic exercise ( P = .004 ) mitigated fatigue over the short term . Resistance exercise also produced longer-term improvements ( P = .002 ) . Compared with usual care , resistance training improved QOL ( P = .015 ) , aerobic fitness ( P = .041 ) , upper- ( P < .001 ) and lower-body ( P < .001 ) strength , and triglycerides ( P = .036 ) , while preventing an increase in body fat ( P = .049 ) . Aerobic training also improved fitness ( P = .052 ) . One serious adverse event occurred in the group that performed aerobic exercise . CONCLUSION In the short term , both resistance and aerobic exercise mitigated  fatigue in men with PCa receiving radiotherapy  . Resistance exercise generated longer-term improvements and additional benefits for QOL , strength , triglycerides , and body fat PURPOSE To investigate the efficacy and safety of aerobic training ( AT ) in patients with cancer with medically stable heart failure ( HF ) . PATIENTS AND METHODS A retrospective analysis of 90 patients with cancer who have HF and who were r and omly assigned to AT ( n = 47 ) or guideline -based usual care ( UC ; n = 43 ) was performed . AT consisted of three supervised sessions per week at 20 to 45 minutes per session at 60 % to 70 % of heart rate reserve for 12 weeks followed by home-based sessions for 4 to 12 months . The primary end point was all-cause mortality and hospitalization . Secondary end points were other clinical events , safety , and change in exercise capacity ( VO(2peak ) ) and health-related quality of life ( HRQOL ) . RESULTS Median follow-up was 35 months . In intention-to-treat ( ITT ) analyses , all-cause mortality or hospitalization at 2 years was 74 % in the AT group compared with 67 % in the UC group ( adjusted hazard ratio [ HR ] , 1.11 ; 95 % CI , 0.69 to 1.77 ; P = .676 ) . The incidence of cardiovascular mortality or cardiovascular hospitalization was significantly higher in the AT group compared with the UC group ( 41 % v 67 % ; adjusted HR , 1.94 ; 95 % CI , 1.12 to 3.16 ; P = .017 ) . There were no differences in any VO(2peak ) or HRQOL end points . In post hoc analyses based on adherence to AT , all-cause mortality and hospitalization was 66 % in adherent patients ( ≥ 90 minutes per week ) compared with 84 % in nonadherent patients ( < 90 minutes per week ) . CONCLUSION In ITT analyses , AT did not improve clinical outcomes in patients with cancer who had HF . Post hoc analyses suggested that patients not capable of adhering to the planned AT prescription may be at increased risk of clinical events PURPOSE Arthralgia occurs in up to 50 % of breast cancer survivors treated with aromatase inhibitors ( AIs ) and is the most common reason for poor AI adherence . We conducted , in 121 breast cancer survivors receiving an AI and reporting arthralgia , a yearlong r and omized trial of the impact of exercise versus usual care on arthralgia severity . PATIENTS AND METHODS Eligibility criteria included receiving an AI for at least 6 months , reporting ≥ 3 of 10 for worst joint pain on the Brief Pain Inventory ( BPI ) , and reporting < 90 minutes per week of aerobic exercise and no strength training . Participants were r and omly assigned to exercise ( 150 minutes per week of aerobic exercise and supervised strength training twice per week ) or usual care . The BPI , Western Ontario and McMaster Universities Osteoarthritis ( WOMAC ) index , and Disabilities of the Arm , Shoulder and H and ( DASH ) question naire were completed at baseline and at 3 , 6 , 9 , and 12 months . Intervention effects were evaluated using mixed-model repeated measures analysis , with change at 12 months as the primary end point . RESULTS Over 12 months , women r and omly assigned to exercise ( n = 61 ) attended 70 % ( ± st and ard deviation [ SD ] , 28 % ) of resistance training sessions and increased their exercise by 159 ( ± SD , 136 ) minutes per week . Worst joint pain scores decreased by 1.6 points ( 29 % ) at 12 months among women r and omly assigned to exercise versus a 0.2-point increase ( 3 % ) among those receiving usual care ( n = 60 ; P < .001 ) . Pain severity and interference , as well as DASH and WOMAC pain scores , also decreased significantly at 12 months in women r and omly assigned to exercise , compared with increases for those receiving usual care ( all P < .001 ) . CONCLUSION Exercise led to improvement in AI-induced arthralgia in previously inactive breast cancer survivors UNLABELLED Observational studies suggest that physical activity after a breast cancer diagnosis is associated with improved cancer outcomes ; however , no r and omized data are available . Here , we report an exploratory follow-up of cancer outcomes from the Supervised Trial of Aerobic versus Resistance Training ( START ) . METHODS The START was a Canadian multicenter trial that r and omized 242 breast cancer patients between 2003 and 2005 to usual care ( n = 82 ) , supervised aerobic ( n = 78 ) , or resistance ( n = 82 ) exercise during chemotherapy .  The primary end point for this exploratory analysis was disease-free survival ( DFS ) . Secondary end points were overall survival , distant DFS , and recurrence-free interval . The two exercise arms were combined for analysis ( n = 160 ) , and selected subgroups were explored . RESULTS After a median follow-up of 89 months , there were 25/160 ( 15.6 % ) DFS events in the exercise groups and 18/82 ( 22.0 % ) in the control group . Eight-year DFS was 82.7 % for the exercise groups compared with 75.6 % for the control group ( HR , 0.68 ; 95 % confidence interval ( CI ) , 0.37 - 1.24 ; log-rank , P = 0.21 ) . Slightly stronger effects were observed for overall survival ( HR , 0.60 ; 95 % CI , 0.27 - 1.33 ; log-rank , P = 0.21 ) , distant DFS ( HR , 0.62 ; 95 % CI , 0.32 - 1.19 ; log-rank , P = 0.15 ) , and recurrence-free interval ( HR , 0.58 ; 95 % CI , 0.30 - 1.11 ; Gray test , P = 0.095 ) . Subgroup analyses suggested potentially stronger exercise effects on DFS for women who were overweight/obese ( HR , 0.59 ; 95 % CI , 0.27 - 1.27 ) , had stage II/III cancer ( HR , 0.61 ; 95 % CI , 0.31 - 1.20 ) , estrogen receptor-positive tumors ( HR , 0.58 ; 95 % CI , 0.26 - 1.29 ) , human epidermal growth factor receptor 2-positive tumors ( HR , 0.21 ; 95 % CI , 0.04 - 1.02 ) , received taxane-based chemotherapies ( HR , 0.46 ; 95 % CI , 0.19 - 1.15 ) , and ≥85 % of their planned chemotherapy ( HR , 0.50 ; 95 % CI , 0.25 - 1.01 ) . CONCLUSIONS This exploratory follow-up of the START provides the first r and omized data to suggest that adding exercise to st and ard chemotherapy may improve breast cancer outcomes . A definitive phase III trial is warranted PURPOSE Cancer related fatigue ( CRF ) is a common problem for cancer patients across diagnoses during chemotherapy  and is associated with physical inactivity , lower functional level and lack of energy . Few RCT exercise intervention studies have included cancer patients undergoing chemotherapy . The objective of this study is to evaluate whether a six-week supervised multimodal exercise intervention , adjunct to chemotherapy and st and ard care , can reduce the patient 's CRF level . METHODS Data is based on analyses of a prospect i ve r and omised controlled trial ' The Body & Cancer Trial ' . 213 cancer patients with different diagnoses were r and omised into an intervention group or wait-list control group . The primary outcome , Fatigue score ( CRF ) , was evaluated by the Functional Assessment of Cancer Therapy-Anaemia Question naire ( FACT-An- ) ( FACT-G score & FACT-An Anemia subscale ) . INTERVENTION Supervised exercise , comprising high-intensity cardiovascular and heavy resistance training , relaxation- and body awareness training and massage , 9 h weekly for 6 weeks . RESULTS CRF was significantly reduced in the intervention group , corresponding to a Fatigue score reduction of 3.04 ( effect size of 0.44 , 95 % CI 0.17 - 0.72 ) ( P = .002 ) , the FACT-An score by 5.40 ( P = .015 ) , the FACT-An Toi score by 5.22 ( P = .009 ) and the Anaemia-ANS by 3.76 ( P = .002 ) . There was no statistically significant effect on the General Quality of Life score ( FACT-G ) or on any of the individual wellbeing scores ; Physical ( P = .13 ) , Emotional ( P = .87 ) , Social ( P = .83 ) and Functional ( P = .26 ) . CONCLUSION In summary , this six-week supervised multimodal exercise intervention can lead to significant reduction in self-reported CRF in cancer patients undergoing chemotherapy BACKGROUND Prostate cancer is a key driver of cancer-related global disability-adjusted life-years . And rogen-deprivation therapy ( ADT ) for advanced disease is linked to fatigue , reduced physical function , and quality of life ( QoL ) . OBJECTIVE To evaluate the effect of a lifestyle intervention on disease-specific QoL , diastolic blood pressure , and cancer-related fatigue in sedentary men receiving long-term ADT for advanced prostate cancer . DESIGN , SETTING , AND PARTICIPANTS A total of 100 hundred sedentary men with locally advanced or metastatic prostate cancer on long-term ADT were r and omised to an intervention or usual care group . INTERVENTION A 12-wk lifestyle intervention consisting of aerobic and resistance exercise with parallel dietary advice . OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Disease-specific QoL was measured using the Functional Assessment of Cancer Therapy-Prostate ( FACT-P ) and Functional Assessment of Cancer Therapy-Fatigue ( FACT-F ) question naires at 12 wk postintervention and at 6 mo following withdrawal of support . Analysis of covariance and mixed regression were conducted . RESULTS AND LIMITATIONS Clinical ly relevant improvements in FACT-P were seen at 12 wk in the intervention group compared with controls ( mean difference : 8.9 points ; 95 % confidence interval [ CI ] , 3.7 - 14.2 ; adjusted p=0.001 ) . No difference was apparent at 6 mo ( mean difference : 3.3 points ; 95 % CI , -2.6 to 9.3 ; adjusted p=0.27 ) . No difference in diastolic blood pressure was seen at either follow-up ( all p > 0.05 ) . Clinical ly relevant improvements in FACT-F were seen at 12 wk ( mean difference : 5.3 points ; 95 % CI , 2.7 - 7.9 ; adjusted p<0.001 ) and maintained following withdrawal of supervision ( mean difference : 3.9 points ; 95 % CI , 1.1 - 6.8 ; adjusted p=0.007 ) . Improvements in exercise tolerance and behaviour were maintained at 6 mo ( adjusted p<0.001 and 0.038 ) . CONCLUSIONS A lifestyle intervention result ed in a clinical ly meaningful improvement in disease-specific QoL that was not maintained postintervention . No effect on blood pressure occurred . Durability of response was seen in fatigue and exercise behaviour . Further evaluation of support structures is essential . TRIAL REGISTRATION IS RCT N88605738
target: Interventions to promote exercise in cancer survivors who report better levels of adherence share some common behaviour change techniques .
  These involve setting programme goals , prompting practise and self-monitoring and encouraging participants to attempt to generalise behaviours learned in supervised exercise environments to other , non-supervised context s. However , expecting most sedentary survivors to achieve current guideline recommendations of at least 150 minutes per week of aerobic exercise is likely to be unrealistic .
background: BACKGROUND The beneficial effects of regular exercise for people living with or beyond cancer are becoming apparent .
  However , how to promote exercise behaviour in sedentary cancer cohorts is not as well understood .
  A large majority of people living with or recovering from cancer do not meet exercise recommendations .
  Hence , review ing the evidence on how to promote and sustain exercise behaviour is important .
  OBJECTIVES To assess the effects of interventions to promote exercise behaviour in sedentary people living with and beyond cancer and to address the following questions : Which interventions are most effective in improving aerobic fitness and skeletal muscle strength and endurance ?
  What adverse effects are attributed to different exercise interventions ?
  Which interventions are most effective in improving exercise behaviour amongst patients with different cancers ?
  Which interventions are most likely to promote long-term ( 12 months or longer ) exercise behaviour ?
  What frequency of contact with exercise professionals is associated with increased exercise behaviour ?
  What theoretical basis is most often associated with increased exercise behaviour ?
  What behaviour change techniques are most often associated with increased exercise behaviour ?