Christina M Dieli-Conwright1, Frank S Fox2, Debu Tripathy3, Nathalie Sami4, Jessica Van Fleet4, Thomas A Buchanan5, Darcy Spicer4, Kyuwan Lee6, Joanne Mortimer7, Leslie Bernstein8, Wendy Demark-Wahnefried9, Kerry S Courneya10. 1. Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, 375 Longwood Ave., Boston, MA, 02215, USA. ChristinaM_Dieli-Conwright@DFCI.Harvard.edu. 2. Division of Biokinesiology and Physical Therapy, Ostrow School of Dentistry, University of Southern California (USC), Los Angeles, CA, 90033, USA. 3. Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA. 4. Department of Medicine, Keck School of Medicine, USC, Los Angeles, CA, 90033, USA. 5. Division of Endocrinology and Diabetes, Keck School of Medicine, USC, Los Angeles, CA, 90033, USA. 6. Department of Population Sciences, Beckman Research Institute, City of Hope (COH), Duarte, CA, 91010, USA. 7. Division of Medical Oncology and Experimental Therapeutics, COH, Duarte, CA, 91010, USA. 8. Division of Biomarkers of Early Detection and Prevention, Beckman Research Institute, COH, Duarte, CA, 91010, USA. 9. Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, 35294, USA. 10. Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, T6G 2H9, Canada.
Abstract
BACKGROUND: Exercise can profoundly affect physical fitness and quality of life in breast cancer survivors; however, few studies have focused on minorities. This secondary analysis examines Hispanic ethnicity as a moderator of the effects of a 16-week aerobic and resistance exercise intervention on physical fitness and quality of life in breast cancer survivors. METHODS: Eligible breast cancer survivors (n = 100) were randomized to exercise (n = 50) or usual care (n = 50). The exercise intervention consisted of supervised moderate-vigorous aerobic and resistance exercise thrice weekly for 16 weeks. Physical fitness and quality of life were measured at baseline, post-intervention, and 28-week follow-up (exercise only). Linear mixed-models adjusted for baseline value of the outcome, age, disease stage, adjuvant treatment, and recent physical activity were used to evaluate effect modification by ethnicity. RESULTS: The study sample included 57% Hispanic and 43% non-Hispanic breast cancer survivors. Hispanic breast cancer survivors were younger, less fit, and diagnosed with more advanced cancers compared with non-Hispanic breast cancer survivors (p < 0.001). Ethnicity was found to moderate the effects of exercise training on all physical fitness and quality-of-life measures including VO2max (8.4 mL/kg/min; 95% confidence interval (95% CI) 3.2 to 13.4), physical well-being (12.3; 95% CI 4.2 to 18.4), and emotional well-being (11.4; 95% CI 5.9 to 15.5). In all cases, Hispanics experienced larger benefits than non-Hispanics. CONCLUSIONS: Hispanic breast cancer survivors have poorer cardiorespiratory fitness, muscle strength, and quality-of-life and therefore may derive larger benefits from exercise than non-Hispanic breast cancer survivors. Clinical exercise interventions may attenuate existing health disparities among minority breast cancer survivors. IMPLICATION OF CANCER SURVIVORS: Here we report psychosocial and fitness-related disparities among Hispanic breast cancer survivors when compared with their non-Hispanic counterparts. Our exercise intervention highlights the importance of exercise for minority cancer survivors and the need for distinct, culturally tailored exercise intervention approaches to reduce psychosocial and fitness-related disparities among this understudied population of cancer survivors.
BACKGROUND: Exercise can profoundly affect physical fitness and quality of life in breast cancer survivors; however, few studies have focused on minorities. This secondary analysis examines Hispanic ethnicity as a moderator of the effects of a 16-week aerobic and resistance exercise intervention on physical fitness and quality of life in breast cancer survivors. METHODS: Eligible breast cancer survivors (n = 100) were randomized to exercise (n = 50) or usual care (n = 50). The exercise intervention consisted of supervised moderate-vigorous aerobic and resistance exercise thrice weekly for 16 weeks. Physical fitness and quality of life were measured at baseline, post-intervention, and 28-week follow-up (exercise only). Linear mixed-models adjusted for baseline value of the outcome, age, disease stage, adjuvant treatment, and recent physical activity were used to evaluate effect modification by ethnicity. RESULTS: The study sample included 57% Hispanic and 43% non-Hispanic breast cancer survivors. Hispanic breast cancer survivors were younger, less fit, and diagnosed with more advanced cancers compared with non-Hispanic breast cancer survivors (p < 0.001). Ethnicity was found to moderate the effects of exercise training on all physical fitness and quality-of-life measures including VO2max (8.4 mL/kg/min; 95% confidence interval (95% CI) 3.2 to 13.4), physical well-being (12.3; 95% CI 4.2 to 18.4), and emotional well-being (11.4; 95% CI 5.9 to 15.5). In all cases, Hispanics experienced larger benefits than non-Hispanics. CONCLUSIONS: Hispanic breast cancer survivors have poorer cardiorespiratory fitness, muscle strength, and quality-of-life and therefore may derive larger benefits from exercise than non-Hispanic breast cancer survivors. Clinical exercise interventions may attenuate existing health disparities among minority breast cancer survivors. IMPLICATION OF CANCER SURVIVORS: Here we report psychosocial and fitness-related disparities among Hispanic breast cancer survivors when compared with their non-Hispanic counterparts. Our exercise intervention highlights the importance of exercise for minority cancer survivors and the need for distinct, culturally tailored exercise intervention approaches to reduce psychosocial and fitness-related disparities among this understudied population of cancer survivors.
Entities:
Keywords:
Breast cancer survivors; Hispanic; Obesity; Physical fitness; Quality of life
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