Radiation Oncology/Supportive care/Exercise

Exercise and Raditation Therapy

Breast cancer

 * Rochester -- exercise x4 weeks vs. control
 * Randomized. 38 breast or prostate cancer patients. Arm 1) Home-based aerobic and progressive resistance exercise x4 weeks at start of RT vs. Arm 2) control.
 * 2009 PMID 19831159 -- "A 4-week home-based aerobic and resistance exercise program during radiation therapy: a pilot randomized clinical trial." (Mustian KM, J Support Oncol. 2009 Sep-Oct;7(5):158-67.)
 * Outcome: Good adherence to intervention. At 3 months, significantly more daily steps walked, daily minutes of resistance exercise, number of resistance exercise days. Also significantly higher QoL and significantly lower cancer-related fatigue
 * Conclusion: Exercise during RT may be beneficial for cancer patients


 * Bangalore, India -- brief supportive therapy vs. yoga
 * Randomized. 38 patients, Stage II-III breast cancer, who received surgery, adjuvant RT and adjuvant chemotherapy. Arm 1) routine supportive therapy vs. Arm 2) yoga 60 min daily. Evaluated at baseline, after surgery, before/during/after RT and chemotherapy
 * 2009 PMID 19114222 -- "Anxiolytic effects of a yoga program in early breast cancer patients undergoing conventional treatment: a randomized controlled trial." (Rao MR, Complement Ther Med. 2009 Jan;17(1):1-8. Epub 2008 Oct 14.)
 * Outcome: yoga group decreased self-reported anxiety and trait anxiety (SS), positively correlated with symptom severity during RT
 * Conclusion: Yoga can be used for managing treatment-related symptoms and anxiety in BCA patients


 * Sungkyunkwan, Seoul -- moderate intensity exercise vs. observation
 * Randomized. 40 women after adjuvant RT for breast cancer. Arm 1) supervised moderate-intensity exercise (50 min 3x/week x5 weeks, including stretching, shoulder exercises, and aerobic exercise) vs. Arm 2) observation
 * 2008 PMID 18581595 -- "Effects of supervised exercise therapy in patients receiving radiotherapy for breast cancer." (Hwang JH, Yonsei Med J. 2008 Jun 30;49(3):443-50.)
 * Outcome: Exercise group increased QoL, shoulder ROM, decreased fatigue, decreased fatigue. Control group worse than baseline in QoL, shoulder ROM, fatigue, pain
 * Conclusion: Patients receiving RT for breast CA may benefit from supervised moderate-intensity exercise


 * Alberta (2003-2005) -- usual care vs. resistance exercise vs. aerobic exercise
 * Randomized. 242 patients undergoing adjuvant chemo. Arm 1) usual care, vs. Arm 2) supervised resistance exercise vs. Arm 3) supervised aerobic exercise. Adherence 70%
 * 2007 PMID 17785708 -- "Effects of aerobic and resistance exercise in breast cancer patients receiving adjuvant chemotherapy: a multicenter randomized controlled trial." (Courneya KS, J Clin Oncol. 2007 Oct 1;25(28):4396-404.)
 * Outcome: Aerobic exercise significantly superior for self-esteem, fitness, and % body fat. Resistance exercise significantly superior for self-esteem, strength, lean body mass, and chemo completion rate. No difference in cancer-specific QoL
 * Conclusion: No difference in either regimen on cancer-specific QoL, but improvement in self-esteem, physical fitness, and body composition


 * Albert Einstein; 2007 -- yoga vs. observation
 * Randomized. 128 patients (42% black, 31% hispanic), ~50% on treatment. Arm 1) 12-week yoga vs. Arm 2) control
 * 2007 PMID 17785709 -- "Randomized controlled trial of yoga among a multiethnic sample of breast cancer patients: effects on quality of life." (Moadel AB, J Clin Oncol. 2007 Oct 1;25(28):4387-95.)
 * Outcome: yoga group better social well-being (SS). However, limited adherance, worse with increased fatigue, RT, younger age, and no anti-estrogens
 * Conclusion: Yoga associated with beneficial effects on social functioning


 * Birmingham, UK -- supervised aerobic exercise vs. exercise-placebo vs. usual care
 * Randomized. 108 women treated for BCA 1-3 year previously. Assigned to 1) supervised aerobic exercise vs. 2) exercise-placebo vs. 3) usual care. Exercise 3x/week x 8 weeks
 * 2007 PMID 17470863 -- "Randomized trial of exercise therapy in women treated for breast cancer." (Daley AJ, J Clin Oncol. 2007 May 1;25(13):1713-21.)
 * Outcome: Significant benefit in functional outcome and QoL in Arm 1, but not Arm 2 (therefore not result of attention)
 * Conclusion: Exercise had large, clinically meaningful benefit on QoL

Prostate Cancer

 * Perth, Australia (2007-2008) -- exercise x12 weeks vs control
 * Randomized. 57 patients with CaP, undergoing AST. Arm 1) resistance and aerobic exercise x12 weeks vs. Arm 2) usual care. Primary endpoint lean mass
 * 2010 PMID 19949016 -- "Combined resistance and aerobic exercise program reverses muscle loss in men undergoing androgen suppression therapy for prostate cancer without bone metastases: a randomized controlled trial." (Galvao DA, J Clin Oncol. 2010 Jan 10;28(2):340-7. Epub 2009 Nov 30.)
 * Outcome: Patients undergoing exercise improved lean mass (SS), muscle strength (SS), improved walk time (SS), QoL (SS), fatigue (SS), and CRP levels (SS)
 * Conclusion: Relatively brief exposure to exercise significantly improved AST-related adverse effects


 * Rochester -- exercise x4 weeks vs. control
 * Randomized. 38 breast or prostate cancer patients. Arm 1) Home-based aerobic and progressive resistance exercise x4 weeks at start of RT vs. Arm 2) control.
 * 2009 PMID 19831159 -- "A 4-week home-based aerobic and resistance exercise program during radiation therapy: a pilot randomized clinical trial." (Mustian KM, J Support Oncol. 2009 Sep-Oct;7(5):158-67.)
 * Outcome: Good adherence to intervention. At 3 months, significantly more daily steps walked, daily minutes of resistance exercise, number of resistance exercise days. Also significantly higher QoL and significantly lower cancer-related fatigue
 * Conclusion: Exercise during RT may be beneficial for cancer patients


 * Houston VA -- exercise x8 weeks vs. control
 * Randomized. 21 patients with localized PCA, undergoing therapy. Arm 1) RT + aerobic exercise 3x/week x8 weeks vs. Arm 2) RT only
 * 2007 PMID 17964881 -- "Exercise prevents fatigue and improves quality of life in prostate cancer patients undergoing radiotherapy." (Monga U, Arch Phys Med Rehabil. 2007 Nov;88(11):1416-22.)
 * Outcome: Significant benefit in fatigue, cardiac fitness, strength, flexibility, FACT-P, physical well-being, social well-being, and functional well-being
 * Conclusion: 8-week cardiovascular program during RT improves fatigues, well-being, and fitness