Aim and objective: The main objective was to determine the outcome of oncology-specific rehabilitation (OR) exercises in patients of breast cancer in terms of improvement in 6-minute walk test distance (6MWTD) and quality of life (QOL).
Materials and methods: An observational study was performed on patients with breast cancer who underwent OR exercises during their treatment of the disease. The 6MWTD was documented before and after exercises, different parameters were statistically analyzed, and QOL improvement was recorded with a functional assessment of chronic illness therapy (FACIT) questionnaire.
Results: Post-OR exercises, all (n = 46) patients had a statistically significant improvement in 6MWTD (p = 0.0001). Patients not receiving chemotherapy did not show any improvement post-rehabilitation (p = 0.103). Patients of age <55 years did better than ≥55 years in 6MWTD (p = 0.003). Functional assessment of chronic illness therapy questionnaire showed a statistically significant improvement in the physical, emotional, and additional well-being of the patients. No significant benefit was seen in social and functional well-being. The total FACIT score showed a statistically significant improvement in the QOL of all patients (p = 0.01).
Conclusion: With the above experience, OR exercises program for patients with breast cancer has a significant impact on physical endurance and QOL as per our study.
Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. ACS J 2018;68(6):394–424. DOI: 10.3322/caac.21492.
Malvia S, Bagadi SA, Dubey US, et al. Epidemiology of breast cancer in Indian women. Asia Pac J Clin Oncol 2017;13(4):289–295. DOI: 10.1111/ajco.12661.
Saranath D, Khanna A. Current status of cancer burden: global and Indian scenario. Biomed Res J 2014;1(1):1–5. DOI: 10.4103/2349-3666.240996.
Lu G, Li G, Wang S, et al. The fluctuating incidence, improved survival of patients with breast cancer, and disparities by age, race, and socioeconomic status by decade, 1981–2010. Cancer Manag Res 2018;10:4899–4914. DOI: 10.2147/CMAR.S173099.
Fisher B, Anderson S, Bryant J, et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med 2002;347(16):1233–1241. DOI: 10.1056/NEJMoa022152.
Fors EA, Bertheussen GF, Thune I, et al. Psychosocial interventions as part of breast cancer rehabilitation programs? Results from a systematic review. Psycho-oncology 2011;20(9):909–918. DOI: 10.1002/pon.1844.
Silver JK, Baima J, Mayer RS. Impairment-driven cancer rehabilitation: an essential component of quality care and survivorship. CA Cancer J Clin 2013;63(5):295–317. DOI: 10.3322/caac.21186.
Ribeiro Pereira ACP, Koifman RJ, Bergmann A. Incidence and risk factors of lymphedema after breast cancer treatment: 10 years of follow-up. Breast 2017;36:67–73. DOI: 10.1016/j.breast.2017. 09.006.
Mukai A. The future of physiatry: with challenges come opportunities. PM R 2011;3(3):189–192. DOI: 10.1016/j.pmrj.2011.02.002.
Sapkota A, Shrestha S, Sedhain A, et al. Problems of breast cancer survivors living in an urban area of Nepal. Asia Pac J Oncol Nurs 2016;3(3):289–296. DOI: 10.4103/2347-5625.189818.
Lipshultz SE, Colan SD, Gelber RD, et al. Late cardiac effects of doxorubicin therapy for acute lymphoblastic leukemia in childhood. N Engl J Med 1991;324(12):808–815. DOI: 10.1056/NEJM199103213241205.
Ferrante JM, Wu J, Dicicco-Bloom B. Strategies used and challenges faced by a breast cancer patient navigator in an urban underserved community. J Natl Med Assoc 2011;103(8):729–734. DOI: 10.1016/s0027-9684(15)30412-0.
Huang TW, Tseng SH, Lin CC, et al. Effects of manual lymphatic drainage on breast cancer-related lymphedema: a systematic review and meta-analysis of randomized controlled trials. World J Surg Oncol 2013;11(1):15. DOI: 10.1186/1477-7819-11-15.
Banerjee B, Vadiraj HS, Ram A, et al. Effects of an integrated yoga program in modulating psychological stress and radiation-induced genotoxic stress in breast cancer patients undergoing radiotherapy. Integr Cancer Ther 2007;6(3):242–250. DOI: 10.1177/1534735407306214.
Institute of Medicine. Delivering high-quality cancer care: charting a new course for a system in crisis. Washington, DC: National Academies Press; 2013. p. 51.
Mewes JC, Steuten LM, Ijzerman MJ, et al. Effectiveness of multidimensional cancer survivor rehabilitation and cost-effectiveness of cancer rehabilitation in general: a systematic review. Oncologist 2012;17(12):1581–1593. DOI: 10.1634/theoncologist.2012-0151.
Silver JK. Cancer rehabilitation and prehabilitation may reduce disability and early retirement. Cancer 2014;120(14):2072–2076. DOI: 10.1002/cncr.28713.
Mustian KM, Peppone L, Darling TV, et al. A 4-week home-based aerobic and resistance exercise program during radiation therapy: a pilot randomized clinical trial. J Support Oncol 2009;7(5):158–167.
Fontanella C, Bolzonello S, Lederer B, et al. Management of breast cancer patients with chemotherapy-induced neutropenia or febrile neutropenia. Breast Care (Basel) 2014;9(4):239–245. DOI: 10.1159/000366466.
Samuel SR, Maiya AG, Fernandes DJ, et al. Effectiveness of exercise-based rehabilitation on functional capacity and quality of life in head and neck cancer patients receiving chemo-radiotherapy. Support Care Cancer. 2019;27(10):3913-3920. DOI: 10.1007/s00520-019-04750-z.
Schmidt ME, Scherer S, Wiskemann J, et al. Return to work after breast cancer: the role of treatment-related side effects and potential impact on quality of life. Eur J Cancer Care (Engl) 2019;28(4):e13051. DOI: 10.1111/ecc.13051.
Mishra SI, Scherer RW, Snyder C, Geigle PM, et al. Exercise interventions on health-related quality of life for people with cancer during active treatment. Cochrane Database Syst Rev 2012;2012(8):CD008465. DOI: 10.1002/14651858.CD008465.pub2.
Gilliam LAA, St Clair DK. Chemotherapy-induced weakness and fatigue in skeletal muscle: the role of oxidative stress. Antioxid Redox Signal 2011;15(9):2543–2563. DOI: 10.1089/ars.2011.3965.
Klassen O, Schmidt ME, Ulrich CM, et al. Muscle strength in breast cancer patients receiving different treatment regimes. J Cachexia Sarcopenia Muscle 2017;8(2):305–316. DOI: 10.1002/jcsm. 12165.
Derks MGM, De Glas NA, Bastiaannet. E. Physical functioning in older patients with breast cancer: a prospective cohort study in the team trial,. Oncologist 2016;21(8):946–953. DOI: 10.1634/theoncologist.2016-0033.