A behavior change intervention for breast cancer survivors based on the social cognitive theory is feasible and results in potentially meaningful improvements in physical activity and selected health outcomes. Confirmation in a larger study is warranted.

Most breast cancer survivors (BCS) are not meeting recommended physical activity guidelines. Here, we report the effects of the Better Exercise Adherence after Treatment for Cancer (BEAT Cancer) behavior change intervention on physical activity, aerobic fitness, and quality of life (QoL). We randomized 222 post-primary treatment BCS to the 3-month intervention (BEAT Cancer) or usual care (UC). BEAT Cancer combined supervised exercise, face-to-face counseling, and group discussions with tapering to home-based exercise. Assessments at baseline, immediately post-intervention (month 3; M3), and 3 months post-intervention (month 6; M6) included accelerometer and self-reported physical activity, submaximal treadmill test, and QoL [Functional Assessment of Cancer Therapy (FACT)-Breast scale]. Adjusted linear mixed-model analyses demonstrated significant effects of BEAT Cancer compared to UC on weekly minutes of ≥moderate intensity physical activity at M3 by accelerometer [mean between group difference (M) = +41; 95 % confidence interval (CI) = 10–73; p = 0.010] and self-report (M = +93; CI = 62–123; p < 0.001). Statistical significance remained at M6 for self-reported physical activity (M = +74; CI = 43–105; p < 0.001). BEAT Cancer participants were significantly more likely to meet physical activity recommendations at both time points [accelerometer M3 adjusted odds ratio (OR) = 2.2; CI = 1.0–4.8 and M6 adjusted OR = 2.4; CI = 1.1–5.3; self-report M3 adjusted OR = 5.2; CI = 2.6–10.4 and M6 adjusted OR = 4.8; CI = 2.3–10.0]. BEAT Cancer significantly improved fitness at M6 (M = +1.8 ml/kg/min; CI = 0.8–2.8; p = 0.001) and QoL at M3 and M6 (M = +6.4; CI = 3.1–9.7; p < 0.001 and M = +3.8; CI = 0.5–7.2; p = 0.025, respectively). The BEAT Cancer intervention significantly improved physical activity, fitness, and QoL with benefits continuing 3 months post-intervention.

Resistance exercise is safe and feasible in patients with head and neck cancer receiving radiation; a definitive trial is warranted.

With increasing evidence supporting physical activity benefits during breast cancer treatment, addressing exercise adherence with consideration of the unique exercise barriers, outcome expectations and preferences of cancer patients is needed. Our pilot study aimed to determine the following during breast cancer treatment: (1) exercise barriers, outcome expectations/values and associations with exercise stage of change and (2) exercise preferences. A cross-sectional survey was administered to 23 breast cancer patients during treatment. Participants were primarily aged 50-60 years (52%), Caucasian (91%), with stage I (30%), II (44%) or III (26%) disease. A total of 48% were receiving chemotherapy. In total, 50% were in the pre-contemplation/contemplation stage of change, with 34% in action/maintenance. Common exercise adherence barriers (i.e. lack of priority, self-discipline, procrastination and fatigue) demonstrated statistically significant negative associations with exercise. Frequent outcome expectations included improving heart/lungs, reducing disease risk, building muscle strength and losing weight. Important outcomes included improving state of mind, reducing fatigue and avoiding injury. Outcome expectations (i.e. less depression, boredom and nausea) were positively associated with exercise. The majority preferred walking (100%), moderate-intensity (61%), home-based (78%) exercise. Among breast cancer patients during treatment, exercise adherence barriers are general and disease specific. Outcome expectations are physical benefits, with the most important outcomes being psychological or avoidance of risk (i.e. injury).

Purpose: We previously reported the effectiveness of a 12-week physical activity behavior change intervention for breast cancer survivors postintervention with this report, aiming to determine delayed and/or persistent effects 3 months after intervention completion. Methods: Forty-one sedentary women with stage I, II, or IIIA breast cancer currently receiving hormonal therapy were randomly assigned to receive the 12-week Better Exercise Adherence after Treatment for Cancer intervention or usual care. Assessments occurred at baseline, postintervention, and 3 months postintervention.Results: Weekly minutes of greater than or equal to moderate intensity physical activity measured by accelerometer showed a significant group by time interaction (F = 3.51; P = 0.035; between group difference in the mean change from baseline to 3 months postintervention, 100.1 minute, P = 0.012). Significant group by time interactions also showed sustained improvements from baseline to 3 months postintervention in strength (F = 3.82; P = 0.027; between group difference, 11.2 kg; P = 0.026), waist-to-hip ratio (F = 3.36; P = 0.041; between group difference, À0.04; P = 0.094), and social well-being (F = 4.22; P = 0.023; between group difference, 3.9; P = 0.039). A delayed reduction in lower extremity dysfunction 3 months postintervention was noted (F = 3.24; P = 0.045; between group difference in the mean change from postintervention to 3 months followup; P = À7.6; P = 0.015). No group by time effect was noted for fitness, body mass index, percent fat, bone density, total quality of life (Functional Assessment of Cancer Therapy-General), fatigue, endocrine symptoms, cognitive function, or sleep. Conclusions: The intervention resulted in sustained improvements in physical activity, strength, central adiposity, and social well-being with lower extremity function benefits appearing 3 months after intervention completion. Testing translation in a multisite study is warranted.