The effect of a period of combined training on the quality of life, cancer markers, aerobic capacity, in type II diabetic patients after breast cancer surgery

Subject Areas : Journal of Physical Activity and Hormones

pouran Akbari ¹ , Nasibeh Ezeddin ² , mona Mehdizadeh Haghighi ³

1 - MA, Department of Physical Education and Sport Sciences, Rasht Branch, Islamic Azad University, Rasht, Iran
2 - Ph.D. Candidate in Exercise Physiology, Department of Physical Education and Exercise training Science, Rasht Branch, Islamic Azad University, Rasht, Iran
3 - .A. in Physical Education and Sport Sciences, Rasht Branch, Islamic Azad University, Rasht, Iran

Received: 2024-08-29 Accepted : 2024-10-30 Published : 2024-11-07

Keywords: Breast Cancer, Diabetes, Quality of Life, Combined Exercise Training, CA15-3,

Abstract :

Introduction: The principal aim of this study was to investigate the effect of a period of combined exercise training on the quality of life, cancer markers, and aerobic capacity in type II diabetic patients after breast cancer surgery.

Material & Methods: The subjects were 30 women with cancer and type II diabetes (mean age 50.53 ± 7.62 and weight 69.20 ± 19.14) who were selected for initial screening and were divided into two equal experimental, and control groups. The aerobic-resistance training consisted of three sessions per week for 8 weeks. The resistance training was performed using Pilates and aerobic exercises with a maximum heart rate (HR max) of 50-70% and each intervention session lasted 60 minutes. Tumor markers (CA15-3 and CEA), anthropometry characters (weight, body mass index, and body fat percent), Quality of life, and aerobic power were measured. To compare the pre and post-test results in each group, the statistically correlated t-test, and the independent t-test was used to compare the results of the two groups. The significance level was determined as P <0.05.

Results: The results indicated that there is a significant promotion in quality of life between the two groups and in the experimental group (EG) was higher than the control group (CG) (P <0.05). The results also demonstrated that there was a significant decrease in the cancer markers of CA15-3 among the two research groups and there was a significant decrease in the EG (P <0.05), however, this difference was not significant in CEA markers (P >0.05). No significant differences were observed in other variables. (P >0.05).

Conclusion: It can be concluded that eight weeks of combined exercise training in women with type II diabetes after breast cancer surgery were effective in the promotion of quality of life, and decreased BMI and CA15-3 but it was unchanged in CEA, WHR, aerobic power, weight, and fat%. 

References:

[1] Forbes JM, Cooper ME. Mechanisms of diabetic complications. Physiological reviews. 2013;93(1):137-88.
[2] Rosai J. Rosai and Ackerman's surgical pathology e-book: Elsevier Health Sciences; 2011.
[3] Allred DC, Bustamante MA, Daniel CO, Gaskill HV, Cruz AB. Immunocytochemical analysis of estrogen receptors in human breast carcinomas: evaluation of 130 cases and review of the literature regarding concordance with biochemical assay and clinical relevance. Archives of Surgery. 1990;125(1):107-13.
[4] Pertschuk LP, Kim DS, Nayer K, Feldman JG, Eisenberg KB, Carter AC, et al. Immunocytochemical estrogen and progestin receptor assays in breast cancer with monoclonal antibodies. Histopathologic, demographic, and biochemical correlations and relationship to endocrine response and survival. Cancer. 1990;66(8):1663-70.
[5] Hinshelwood RA, Clark SJ. Breast cancer epigenetics: normal human mammary epithelial cells as a model system. Journal of molecular medicine. 2008;86:1315-28.
[6] Kheirolomoom A, Silvestrini MT, Ingham ES, Mahakian LM, Tam SM, Tumbale SK, et al. Combining activatable nanodelivery with immunotherapy in a murine breast cancer model. Journal of Controlled Release. 2019;303:42-54.
[7] Ruddy KJ, Ganz PA. Treatment of nonmetastatic breast cancer. Jama. 2019;321(17):1716-7.
[8] Hupfeld CJ, Courtney CH, Olefsky JM. Type 2 diabetes mellitus: etiology, pathogenesis, and natural history. Endocrinology Adult and Pediatric: Diabetes Mellitus and Obesity E-Book. 2013:223-45.
[9] Shabani R, Jalali Z, Nazari M. Effects of concurrent strength and aerobic training on blood glucose homeostasis and lipid profile in females with overweight and obesity. Zahedan Journal of Research in Medical Sciences. 2018;20(4).
[10] Alberti KGMM, Zimmet P, Shaw J. Metabolic syndrome—a new world‐wide definition. A consensus statement from the international diabetes federation. Diabetic medicine. 2006;23(5):469-80.
[11] Alberti KGMM, Zimmet P, Shaw J. International Diabetes Federation: a consensus on Type 2 diabetes prevention. Diabetic Medicine. 2007;24(5):451-63.
[12] Liao S, Li J, Wei W, Wang L, Zhang Y, Li J, et al. Association between diabetes mellitus and breast cancer risk: a meta-analysis of the literature. Asian Pac J Cancer Prev. 2011;12(4):1061-5.
[13] Larsson SC, Mantzoros CS, Wolk A. Diabetes mellitus and risk of breast cancer: a meta‐analysis. International journal of cancer. 2007;121(4):856-62.
[14] Farhood B, Geraily G, Alizadeh A. Incidence and mortality of various cancers in Iran and compare to other countries: a review article. Iranian journal of public health. 2018;47(3):309.
[15] Shamshirian A, Heydari K, Shams Z, Aref AR, Shamshirian D, Tamtaji OR, et al. Breast cancer risk factors in Iran: a systematic review & meta-analysis. Hormone molecular biology and clinical investigation. 2020;41(4):20200021.
[16] Ronckers CM, Erdmann CA, Land CE. Radiation and breast cancer: a review of current evidence. Breast Cancer Research. 2004;7:1-12.
[17] Tsitsi T, Charalambous A, Papastavrou E, Raftopoulos V. Effectiveness of a relaxation intervention (progressive muscle relaxation and guided imagery techniques) to reduce anxiety and improve mood of parents of hospitalized children with malignancies: A randomized controlled trial in Republic of Cyprus and Greece. European Journal of Oncology Nursing. 2017;26:9-18.
[18] de Souto Barreto P, Delrieu J, Andrieu S, Vellas B, Rolland Y, editors. Physical activity and cognitive function in middle-aged and older adults: an analysis of 104,909 people from 20 countries. Mayo Clinic Proceedings; 2016: Elsevier.
[19] Jeffs E, Wiseman T. Randomised controlled trial to determine the benefit of daily home-based exercise in addition to self-care in the management of breast cancer-related lymphoedema: a feasibility study. Supportive Care in Cancer. 2013;21:1013-23.
[20] Ikeda K, Ogawa Y, Kajino C, Deguchi S, Kurihara S, Tashima T, et al. The influence of axillary reverse mapping related factors on lymphedema in breast cancer patients. European Journal of Surgical Oncology (EJSO). 2014;40(7):818-23.
[21] koulaei m, Ezeddin N, Shabani A, Haghighi mM, Hedayati M. The effect of combined exercise training on Body composition, Upper limb Range of motion, Shoulder pain, and Glucose homeostasis in type II diabetic patients after breast cancer surgery. Journal of Physical Activity and Hormones. 2024;5(2):-.
[22] Barcenas CH, Wells J, Chong D, French J, Looney SW, Samuel TA. Race as an independent risk factor for breast cancer survival: breast cancer outcomes from the medical college of georgia tumor registry. Clinical breast cancer. 2010;10(1):59-63.
[23] Esfahbodi A, Fathi M, Rahimi GRM. Changes of CEA and CA15-3 biomarkers in the breast cancer patients following eight weeks of aerobic exercise. Basic & Clinical Cancer Research. 2017;9(4):4-12.
[24] Koulaei M, Ezeddin N, Shabani A, Hedayati M. The effect of combined exercise training on Body composition, Upper limb Range of motion, Shoulder pain, and Glucose homeostasis in type II diabetic patients after breast cancer surgery.
[25] Dieli-Conwright CM, Fox FS, Tripathy D, Sami N, Van Fleet J, Buchanan TA, et al. Hispanic ethnicity as a moderator of the effects of aerobic and resistance exercise on physical fitness and quality-of-life in breast cancer survivors. Journal of Cancer Survivorship. 2021;15:127-39.
[26] Yu AF, Jones LW. Breast cancer treatment-associated cardiovascular toxicity and effects of exercise countermeasures. Cardio-oncology. 2016;2:1-9.
[27] Schneider CM, Hsieh CC, Sprod LK, Carter SD, Hayward R. Effects of supervised exercise training on cardiopulmonary function and fatigue in breast cancer survivors during and after treatment. Cancer: Interdisciplinary International Journal of the American Cancer Society. 2007;110(4):918-25.
[28] Dieli-Conwright CM, Courneya KS, Demark-Wahnefried W, Sami N, Lee K, Sweeney FC, et al. Aerobic and resistance exercise improves physical fitness, bone health, and quality of life in overweight and obese breast cancer survivors: a randomized controlled trial. Breast Cancer Research. 2018;20:1-10.
[29] Campbell KL, Winters-Stone K, Wiskemann J, May AM, Schwartz AL, Courneya KS, et al. Exercise guidelines for cancer survivors: consensus statement from international multidisciplinary roundtable. Medicine and science in sports and exercise. 2019;51(11):2375.
[30] Mandelblatt JS, Luta G, Kwan ML, Makgoeng SB, Ergas IJ, Roh JM, et al. Associations of physical activity with quality of life and functional ability in breast cancer patients during active adjuvant treatment: the Pathways Study. Breast cancer research and treatment. 2011;129:521-9.
[31] Hong F, Ye W, Kuo C-H, Zhang Y, Qian Y, Korivi M. Exercise intervention improves clinical outcomes, but the “time of session” is crucial for better quality of life in breast cancer survivors: a systematic review and meta-analysis. Cancers. 2019;11(5):706.
[32] Joaquim A, Leao I, Antunes P, Capela A, Viamonte S, Alves AJ, et al. Impact of physical exercise programs in breast cancer survivors on health-related quality of life, physical fitness, and body composition: Evidence from systematic reviews and meta-analyses. Frontiers in oncology. 2022;12:955505.
[33] Yang H, Liu L, Zhang X. Exercise interventions on body composition and quality of life of overweight/obese breast cancer survivors: a meta-analysis. BMC women's health. 2023;23(1):484.
[34] Hamer J, McDonald R, Zhang L, Verma S, Leahey A, Ecclestone C, et al. Quality of life (QOL) and symptom burden (SB) in patients with breast cancer. Supportive Care in Cancer. 2017;25:409-19.