Cancer Related Fatigue And Its Associations After Community-Based Exercise Participation: A Preliminary Analysis

PURPOSE: A preliminary analysis was conducted to assess changes in cancer-related fatigue (CRF) after community-based exercise participation, and to identify associations between CRF and commonly assessed physical and psychological outcomes in early breast cancer survivors (EBCS). METHODS: 29 EBCS (I-III) and 13 sedentary age-matched controls (CON) were included in the analysis (age EBCS: 53.9 + 11.9 years; CON: 53.8 + 8.4 years). Pre- and post-intervention measurements for each group included the PROMIS Fatigue 7a, VO2peak, lower and upper body strength, quality of life, depression/anxiety, pain, sleep quality, self-efficacy for fatigue management, physical function, and self-reported physical activity/outcome exercise expectations. Both groups completed 1-hour bouts of combined exercise training 3 days/week for 1 hour each day for 16-weeks. A mixed model ANOVA was used to assess the change in CRF between and within each group in addition to generating Cohen’s D effect sizes. Univariate linear regressions were conducted and adjusted R2 were obtained to identify associations with CRF. RESULTS: Post-exercise, CRF significantly decreased in EBCS (-2.6, p = 0.001, Cohen’s D = 0.51) but not in CON (0.0, p = 0.942, Cohen’s D = 0.02). Lower CRF in EBCS was also associated with better overall self-reported quality of life (adj R2 = 0.364; p < 0.001), less depression (adj R2 = 0.223; p < 0.01), higher self-efficacy for fatigue self-management (adj R2 = 0.433; p < 0.01), higher outcome expectations for exercise (adj R2 = 0.227; p < 0.01), better balance (adj R2 = 0.136; p < 0.05), 6 MWT performance (adj R2 = 0.163; p < 0.05) and VO2peak (adj R2 = 0.121; p < 0.05). CONCLUSIONS: Community-based exercise is beneficial for alleviating CRF in EBCS. These improvements were primarily associated with psychosocial outcomes, as well as objectively measured physical outcomes. Though encouraging, more research is needed to determine the true efficacy of community-based exercise for CRF management and possible mediators for its observed improvement in EBCS. Supported by funding from the Breast Cancer Research Foundation of New York.