Physical activity program benefits patients with cancer, survivors
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A program that combined physical activity with psychological therapy appeared to improve mental and physical health, as well as quality of life, among patients with cancer and survivors.
The findings, presented at European Breast Cancer Conference, also showed psychological therapy alone did not confer a significant benefit, researchers concluded.
Background and methods
“It is widely known that physical activity is important for a healthy body,” Astrid Lahousse, a PhD student in the department of physiotherapy, human physiology and anatomy at Vrije Universiteit Brussel and a PhD fellow at Research Foundation-Flanders in Brussels, told Healio. “Physical activity not only lowers cancer risk but also prevents many other chronic diseases and cancer-associated side effects. Therefore, more research is needed to find the best intervention that keeps individuals, patients with cancer and cancer survivors physically active in the long term.”
Guidelines recommend at least 150 minutes of moderate-intensity aerobic activity and 2 days of muscle strength training, Lahousse said, but most patients with cancer and survivors face barriers to becoming more physically active.
“Advising these individuals to be more physically active and start an exercise program without further support is not enough,” she said. “We believe individuals need to be guided and informed throughout this process, and maladaptive thoughts about being physically active should be adjusted by their health care provider before starting an exercise program. The idea is that patients should have a behavioral change.”
The systemic review and meta-analysis included 33 randomized controlled trials including 4,330 patients with cancer and survivors that compared behavioral-graded activity and psychological therapies vs. waiting lists for treatment, usual care, or psychological therapies only or behavioral-graded activity only.
Researchers combined the effects of the research and summarized the data as a standardized mean difference (SMD).
Findings
Results showed significant improvements in anxiety (SMD, 1.29), fatigue (SMD, 0.86), depression (SMD, 0.79), ability to manage everyday tasks (SMD, 0.72), psychological distress (SMD, 0.58), physical activity (self-reported SMD, 0.58; objectively measured SMD, 0.51), quality of life (SMD, 0.38) and social impairment (SMD, 0.33) among patients with cancer and survivors who received behavioral graded activity combined with psychological support vs. those who received nothing.
“Of note, when comparing psychological support combined with behavioral graded activity to no intervention, the effect could only be observed after 3 months for psychological distress,” Lahousse said.
Researchers also reported medium improvements in symptoms of anxiety (SMD, 0.47), depression (SMD, 0.46), fatigue (SMD, 0.35) and physical activity (SMD, 0.26) among those who received psychological support combined with behavioral graded activity vs. those who received usual standard of care. After 1 to 3 months, researchers found the benefit remained significant for anxiety (SMD, 1.54), depression (standard mean difference, 1.43) and fatigue (standard mean difference, 0.34).
Moreover, researchers observed no statistically significant benefit with psychological therapies combined with behavioral-graded activity only or psychological therapies only.
“The results went in the expected direction. However, for pain, a nonsignificant effect was found when comparing psychological support combined with behavioral-graded activity to no intervention,” Lahousse said. “This is unexpected because various studies have already demonstrated a reduction in pain by being physically active.”
This result was based on two studies; therefore, more studies are needed to make stronger conclusions about pain, she added.
“We faced the same problem for the long-term effects as few studies reported long-term results,” Lahousse said. “When comparing psychological support combined with behavioral-graded activity to no intervention, the effect could only be observed with psychological distress in the long term and was significant.”
Implications
The findings underline the importance of further studying nondrug interventions, such as psychological support and physical activity, in the continuum of cancer care, Lahousse told Healio.
“Physicians should switch toward a nonpharmacological intervention, which is a less expensive treatment for society than any drug treatment. In addition, being physically active not only helps with the debilitating side effects of cancer treatment, but also prevents cancer recurrence and other chronic diseases,” she said.
Physicians should inform their patients about the importance of being physically active and, if needed, refer patients to the appropriate health care provider who will remove barriers and provide guidance, Lahousse added.
“Psychological support with behavioral-graded activity can be used during each cancer stage because it adapts to patient’s goals,” she said. “This research underlines once more the importance of an interdisciplinary approach. Collaboration between physicians, psychologists and physical therapists is required for effective intervention.”
References:
- Gradual increase in daily activity with psychological therapies can improve mental health for cancer patients and survivors (press release). Available at: www.eurekalert.org/news-releases/971057. Published Nov. 15, 2022. Accessed Dec. 20, 2022.
- Lahousse A, et al. Abstract 23. Presented at: European Breast Cancer Conference; Nov. 16-18, 2022; Barcelona, Spain.
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Lahousse A, et al. Abstract 23. Presented at: European Breast Cancer Conference; Nov. 16-18, 2022; Barcelona, Spain.
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