Breast Cancer Cases

Roughly 217,440 new cases of invasive breast cancer will be diagnosed in 2004, resulting in nearly 40,580 deaths (3). Those newly diagnosed with breast cancer often have the choice of several different treatments. The treatments include chemotherapy and radiation. Fatigue related from cancer is defined as "a persistent, subjective sense of tiredness related to cancer or cancer treatment that interferes with usual functioning" (1). This helps contribute to physical inactivity in these patients, leading to deconditioning and decreased functional capacity (1).

Physical inactivity and an increase in rest have generally been recommended for cancer patients (1). However, recent research has shown that physical activity helps with the management of fatigue and improves quality of life (1-4). In addition, 50% of patients prefer nonpharmacologic interventions in order to manage fatigue (4). The current recommendations for breast cancer patients are low to moderate physical activity, such as brisk walking, to manage fatigue and, in turn, improve quality of life (3,4).

Several studies support the recommendations for physical activity in breast cancer patients. These studies prescribed a home-based walking programs to women who were going to receive chemotherapy or radiation treatment for Stage I to III breast cancer (1,2). The walking programs were based on the duration of the radiation (6 weeks) or chemotherapy (3 months) treatment (1,2). The subjects were put into two groups, usual care or usual care and the walking program (1,2). Both of the walking programs prescribed working up to 30 minutes of brisk walking, 5 to 6 days per week and approximately 50-70% of maximum heart rate (1,2). These meet the ACSM's standards for positive health benefits. Mock, et al studied fatigue and functional capacity in participation in a home-based walking program (1). They concluded that exercise during treatment of cancer increased functional capacity and decreased fatigue in sedentary women subjected to chemotherapy or radiation (1). The subjects who adhered to the program had significantly lower fatigue levels than those who did not participate (1). The adherence rate of those participating in the exercise program was 72% (1). Since these women were sedentary prior to this study, this suggests an urgency and desire to benefit their overall health. They see the importance of being physically fit, not only to reduce fatigue during treatment, but to improve it after treatment as well. Pickett, et al reported on the adherence rate to a home-based walking program (2). They found a 52 to 89% adherence rate to the exercise program (2). Adherence to the walking program leads to decreased fatigue and increased functional capacity, as found by Mock, et al. This study also reported 50% of the usual care group maintained or increased their physical activity, while 33% of the exercise group did not meet the standards set by the prescription (2). This may be due to previous exercise already integrated into the subject's lifestyle or a sedentary lifestyle before the study (2).