Rogers, L.Q., Courneya, K.S., Anton, P.M., Verhulst, S., Vicari, S.K., Robbs, R.S., & McAuley, E. (2017). Effects of a multicomponent physical activity behavior change intervention on fatigue, anxiety, and depressive symptomatology in breast cancer survivors: Randomized trial. Psycho-Oncology, 26, 1901-1906.

To determine the effectiveness of a three-month intervention which includes a multicomponent physical activity change intervention on the symptoms of fatigue, depressive symptoms, and anxiety

Better Exercise Adherence after Treatment for Cancer (BEAT Cancer). Twelve supervised exercise sessions with an exercise specialist that were tapered over the first six weeks to an exclusively unsupervised home-based program. Face-to-face update counseling session with exercise specialist every two weeks during the final six weeks. Exercise and heart rate monitor sheets were provided to those who were randomized to the intervention. Group sessions for the participants. Those randomized to control received care as usual, which included handouts and publicly available printed materials.

• N = 222   
• MEAN AGE: 54.4 years
• FEMALES: 100%
• CURRENT TREATMENT:  Radiation, Other
• KEY DISEASE CHARACTERISTICS: Breast cancer, finished with adjuvant therapy except for adjuvant hormonal therapy
• OTHER KEY SAMPLE CHARACTERISTICS: 98% non-Hispanic, 84% White, 11% DCIS, 42% stage I, 35% stage II, 12% stage III, 54 mean months since cancer diagnosis, 58% had chemotherapy, 68% had radiation therapy, 50% were on adjuvant hormonal therapy.

• SITE: Multi-site   
• SETTING TYPE: Outpatient    
• LOCATION: Two midwestern and one southeastern academic institutions

PHASE OF CARE: Late effects and survivorship

Randomized control trial

Measurements happened at baseline, immediately postintervention, month 3, 3 months after intervention completion, and month 6. Instruments used were the Fatigue Symptom Inventory and the 14-item Hospital Anxiety and Depression Scale

Adjusted linear mixed‐model analyses demonstrated significant effects of BEAT Cancer versus usual care on fatigue intensity (month 3 mean between group difference [M] = −0.6; 95% confidence interval [CI] [−1, −0.2]; effect size [d] = −0.32; p = 0.004), fatigue interference (month 3 M = −0.8; CI [−1.3, −0.4]; d = −0.4; p < 0.001), depressive symptomatology (month 3 M = −1.3; CI [−2, −0.6]; d = −0.38; p < 0.001), and anxiety (month 3 M = −1.3; CI [−2, −0.5]; d = −0.33; p < 0.001). BEAT Cancer effects remained significant at month 6 for all outcomes.

This intervention reduced fatigue, depressive symptomatology, and anxiety up to three months postintervention compared to treatment as usual.

Intervention expensive, impractical, or training needs

Nurses can safely recommend exercise as tolerated to breast cancer survivors who have completed adjuvant treatment. There are several exercise programs widely available, including Livestrong and STARS Cancer rehabilitation programs.