Effect of a lifestyle intervention during chemotherapy for breast cancer on quality of life

TL;DR

A lifestyle intervention with nutrition and exercise during breast cancer chemotherapy did not improve quality of life more than usual care, but anxiety improved over time.

Contribution

This study is the first to evaluate lifestyle interventions during chemotherapy for breast cancer on quality of life.

Findings

The intervention did not reduce declines in physical and mental health during chemotherapy compared to usual care.

Most quality of life scores returned to baseline levels by one year, except for improved anxiety.

More research is needed to identify who benefits from lifestyle interventions during treatment.

Abstract

Chemotherapy-induced side effects can diminish physical and psychological well-being for women with breast cancer. Although nutrition and exercise improve quality of life (QoL) posttreatment, their ability to attenuate treatment-related declines in QoL during chemotherapy remains underexplored.

Women diagnosed with stage I-III breast cancer initiating chemotherapy were randomized to a yearlong nutrition and exercise intervention (I; n = 87) or usual care (UC; n = 86). Patient-Reported Outcomes Measurement Information System (PROMIS)-29, PROMIS Cognitive Function, and PROMIS Global Health scales were assessed at diagnosis (baseline), postchemotherapy (PC), 1-year, and 2-years postrandomization.

Participants (N = 173) were on average 52.8 ± 11.1 years of age and 51% had stage I breast cancer. At diagnosis, PROMIS scores were comparable to the general US population, except for heightened anxiety. PROMIS scores worsened from diagnosis to PC for physical function (I = −5.5 (1.0); UC = −5.4 (1.0)), fatigue (I = 5.4 (1.1); UC = 6.2 (1.1)), social roles (I = −5.4 (1.0); UC = −7.1 (1.0)), cognitive function (I = −4.8 (1.0); UC = −4.3 (1.1)), global physical health (I = −10.9 (0.8); UC = −10.1 (0.8)), and global mental health (I = −11.2 (1.1); UC = −9.7 (1.2)), with anxiety improving (I = −5.1 (0.9); UC = −3.7 (0.9)). No between-arm differences were observed. By 1 year, most scores returned to baseline levels and remained stable through 2 years, except anxiety, which remained improved.

Despite improving nutrition and exercise, the intervention did not attenuate declines in QoL compared with UC. This study fills a gap on interventions with nutrition and exercise components during chemotherapy and highlights needing more research to identify those most likely to have benefits in QoL from lifestyle interventions delivered during active treatment.

NCT03314688

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