Milan, Italy: Taking part in an exercise programme reduced pain and fatigue, and improved quality of life for people with metastatic breast cancer, according to new results of a trial presented at the 14th European Breast Cancer Conference today (Wednesday).

Although patients of all ages benefitted from exercise, researchers saw the greatest improvement among patients aged under 50. However, they say their findings provide strong evidence that all patients with cancer that has spread to other parts of the body (metastatic cancer) should be offered exercise as part of their package of treatment and care.

The research was presented by Dr Anouk Hiensch from the University Medical Center Utrecht in The Netherlands. She said: “Although there’s been quite a lot of research looking at exercise for people with early-stage cancer, we have seen very little research on exercise in patients with more advanced disease.

“Patients with metastatic cancer often undergo continuous treatment that aims to prolong their life. Thanks to these treatments, many patients with metastatic cancer live longer, but many also report a deteriorating quality of life over time. We therefore need supportive care strategies, like exercise, that make the lives of these patients better.”

The trial included 357 patients with metastatic breast cancer with an average age of around 55 years. Patients were recruited at one of eight cancer centres in Germany, Poland, Spain, Sweden, The Netherlands and Australia. Of these patients, 178 were randomly selected to take part in a nine-month exercise programme alongside their usual care with the other 179 given their usual care.

The exercise programme consisted of twice weekly personalised training with resistance, aerobic and balance exercises overseen by a physiotherapist or exercise physiologist. Patients in both groups were encouraged to be physically active for at least 30 minutes every day and given activity trackers.

At the start of the study and after three, six, and nine months, researchers asked patients about their levels of fatigue and their quality of life, including any pain they were suffering.

Overall, the researchers found that patients who took part in the exercise programme suffered less fatigue and had better quality of life. The biggest improvements were for women under the age of 50 and those suffering pain at the beginning of the study.

Dr Hiensch said: “Based on these findings, we recommend supervised exercise for all patients with metastatic breast cancer – particularly those who are experiencing pain – as part of their standard care. Older patients did also benefit from exercise; however the programme might require some additional fine-tuning for them to benefit as much as younger patients.

“If patients are interested in exercising, I recommend talking to their doctor or nurse first and looking for an exercise trainer who is trained in helping cancer patients.

“We don’t know exactly why exercise helps cancer patients who are suffering from pain, but we think it could be because exercise reduces inflammation. We have collected blood samples from our trial participants and studying these samples may tell us more.”

The researchers are also conducting a cost-effectiveness analysis to help convince policymakers and health insurers to fund exercise programmes for patients.

Professor Michail Ignatiadis from the Institut Jules Bordet in Brussels, Belgium, is Chair of the 14th European Breast Cancer Conference and was not involved in the research. He said: “This research is good news for patients with advanced breast cancer because it shows that they can enjoy a better quality of life with less fatigue and pain if they take part in an exercise programme as part of their package of treatment and care. People with metastatic cancer cannot always be cured of their disease but they can live for many months or years, so ensuring they have the best possible quality of life is absolutely vital.”

^{Abstract no: 1, “Effects of exercise on fatigue and health-related quality of life (HRQoL) in patients with metastatic breast cancer (mBC) – do the positive effects apply to all? – the multinational randomized controlled PREFERABLE-EFFECT study”,
Wednesday 20 March, Young Investigator Innovation Award and Oral abstracts, 11.00-12.30 hrs CET, Silver room.}

^{Funding: European Union’s Horizon 2020 research and innovation program (No 825677) and the National Health and Medical Research Council of Australia (2018/GNT1170698).}

^{The following centres are part of the PREFERABLE Consortium: Germany (Heidelberg University Hospital/German Cancer Research Center (DKFZ)/National Center for Tumor Diseases (NCT) Heidelberg and German Sport University Cologne (DSHS)), the Netherlands (University Medical Center Utrecht (UMCU), the Netherlands Cancer Institute (NKI), Diakonessenhuis Utrecht, Alexander Monro Ziekenhuis), Poland (Wielkopolskie Centrum Onkologii (WCO)), Spain (Onkologikoa (ONK)), Sweden (Karolinska Institutet (KI)), and Australia (Australian Catholic University (ACU)).}