Breast Cancer Clinical Trial
Official title:
Activity & Cognition After Treatment (ACT) for Breast Cancer
This study addresses an important public health concern; impoverished cognitive function associated with treatment of breast cancer. Due to increased awareness of breast cancer combined with advances in medical care, there are over 2.8 million women living with a history of breast cancer in the U.S. alone. Chemotherapy and adjuvant therapy to remove cancerous tissue can result in deficits in attention, speed of processing, memory, and quality of life. Physical activity has been associated with a number of health benefits for breast cancer survivors including improvements in cognitive function. However, most of the literature is cross-sectional and it is unclear whether acute (single) bouts of physical activity affect cognition and, if they do, how long this effect lasts. This study will be the first, to the investigators' knowledge, to examine the effects of an acute bout of aerobic exercise on cognitive functioning in breast cancer survivors. Specifically, the investigators will determine the effects of a 30-minute moderate intensity aerobic exercise session (treadmill walking) on immediate and one hour follow up changes in measures of processing speed, memory, and executive function. Additionally, accelerometer cut-points for physical activity intensities in breast cancer survivors will be assessed. Finally, the investigators will examine the association of cardiorespiratory fitness and physical activity with changes in cognitive function. Findings from this study will allow researchers to determine whether any acute effects of exercise on cognition are retained over time and therefore have real meaning in the context of one's daily life.
This study addresses an important public health concern: impoverished cognitive function
associated with treatment of breast cancer. Due to increased awareness of breast cancer
combined with advances in medical care, the 5-year survival rate has climbed to 89.2% with
over 2.8 million women living with a history of breast cancer in the U.S. alone.
Unfortunately, the treatment of breast cancer is not without its consequences. Chemotherapy
and adjuvant therapy to remove cancerous tissue can result in deficits in attention, speed of
processing, memory, and quality of life. While past studies have identified memory and
executive function as valuable, important determinants of long-term survival and quality of
life in survivors of different types of cancer, it is unclear if standard care methods alone
prove successful in attenuating declines in these variables. Previous research in breast
cancer populations has found that executive function difficulties, namely in working memory,
cognitive flexibility, and processing speed, as well as fatigue, are the most commonly
described deficits. Furthermore, evidence suggests impairments in cognitive functioning may
persist in up to 35% of breast cancer survivors years after treatment ends.
A behavioral and lifestyle modality known to improve physical and mental health status and
protect against health declines is physical activity. Not only is physical activity known to
protect against a host of diseases, but it also has been shown to provide many health
benefits to breast cancer survivors. While the extant literature suggests that physical
activity can lead to improvements in varying cognitive domains in breast cancer survivors,
another study concluded that only 32% of these survivors meet the recommended guidelines for
physical activity. Additionally, while benefits from physical activity for breast cancer
survivors are well known, there is currently no scientifically recognized physical activity
training program aimed at improving cognitive function in this cohort.
As such, a review chapter examining cognitive impairment in breast cancer survivors suggests
more comprehensive studies examining the relationship between objective measures of physical
activity, cardiorespiratory fitness, and cognitive performance are warranted to gain a better
understanding of the potentially protective effects of fitness and physical activity on
cognitive functioning in breast cancer survivors for better survival along the cancer
continuum. In addition, other research has shown that subjective memory impairment, fatigue,
and anxiety plague breast cancer survivors and suggests that breast cancer survivors may
suffer from poorer quality of life as a result. Furthermore, it has been shown that breast
cancer survivors have longer reaction time to working memory tasks compared to healthy,
age-matched controls, and those survivors with higher levels of physical activity had shorter
reaction times for more difficult tasks. A recent study also measured levels of objective
physical activity and found those with higher levels displayed more positive measures of
global cognition.
Despite this evidence, it is unknown if acute (single) bouts of exercise can provide benefits
in varying cognitive domains. Previous research has shown that acute bouts of aerobic
physical activity, of both light and moderate intensity, decrease state anxiety in breast
cancer survivors. However, it is not known if these benefits extend to cognitive functioning.
Furthermore, most of these results are founded in cross-sectional research and it is unclear
whether acute bouts of physical activity improve cognition and, if they do, how long this
effect lasts. This has implications for real world contexts in that, if benefits are present,
breast cancer survivors can find relief in cognitive symptoms quickly by simply engaging in a
bout of physical activity. This study will be the first, to the investigators' knowledge, to
examine the effects of an acute bout of aerobic exercise on cognitive functioning in breast
cancer survivors.
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