Activity & Cognition After Treatment for Breast Cancer

NCT ID: NCT02592070

Last Updated: 2020-02-10

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 31 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2015-07-31
• Study Completion Date: 2016-04-30

Brief Summary

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.

Detailed Description

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.

Conditions

Breast Cancer; Mild Cognitive Impairment; Physical Activity

Study Design

• Allocation Method: NA
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

30 minute treadmill walking

All participants will walk on the treadmill for 30 minutes and perform a battery of cognitive tasks immediately prior, immediately after, and one hour after completion of the 30 minute walking period.

Group Type: EXPERIMENTAL

Walking

Intervention Type: BEHAVIORAL

Participants will walk on the treadmill for 30 minutes at a moderate intensity.

Interventions

Walking

Participants will walk on the treadmill for 30 minutes at a moderate intensity.

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

• women between 30 and 60 years of age
• diagnosis of breast cancer
• no longer undergoing treatment
• fluent in English
• no history of dementia or organic brain syndrome
• not currently pregnant
• able to walk unassisted
• no health reasons that would prevent ability to exercise
• not currently enrolled in another exercise research study
• reported trouble with memory/concentration
• physician's consent

Exclusion Criteria

• male
• no diagnosis of breast cancer
• outside of 30-60 years of age
• currently undergoing treatment for breast cancer
• inability to communicate in English
• history of dementia or organic brain syndrome
• pregnant
• unable to walk unassisted
• other health reasons that may prevent ability to exercise
• enrolled in another exercise research study
• no reported trouble with memory or concentration
• non-consent of physician

• Minimum Eligible Age: 30 Years
• Maximum Eligible Age: 60 Years
• Eligible Sex: FEMALE
• Accepts Healthy Volunteers: No

Sponsors

University of Illinois at Urbana-Champaign

OTHER

Sponsor Role: lead

Responsible Party

Edward McAuley

Shahid and Ann Carlson Khan Professor in Applied Health Sciences

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Edward McAuley, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Illinois at Urbana-Champaign

Locations

Freer Hall, University of Illinois

Urbana, Illinois, United States

Countries

United States

References

Bray F, McCarron P, Parkin DM. The changing global patterns of female breast cancer incidence and mortality. Breast Cancer Res. 2004;6(6):229-39. doi: 10.1186/bcr932. Epub 2004 Aug 26.

Reference Type: BACKGROUND

PMID: 15535852 (View on PubMed)

Surveillance, Epidemiology, and End Results (SEER) Program (www.seer.cancer.gov) Research Data (2004-2010), National Cancer Institute, DCCPS, Surveillance Research Program, Surveillance Systems Branch, released April 2014, based on the November 2013 submission.

Reference Type: BACKGROUND

van Harten WH, van Noort O, Warmerdam R, Hendricks H, Seidel E. Assessment of rehabilitation needs in cancer patients. Int J Rehabil Res. 1998 Sep;21(3):247-57. doi: 10.1097/00004356-199809000-00001.

Reference Type: BACKGROUND

PMID: 9812254 (View on PubMed)

Goodwin JS, Samet JM, Hunt WC. Determinants of survival in older cancer patients. J Natl Cancer Inst. 1996 Aug 7;88(15):1031-8. doi: 10.1093/jnci/88.15.1031.

Reference Type: BACKGROUND

PMID: 8683633 (View on PubMed)

Pinto AC, de Azambuja E. Improving quality of life after breast cancer: dealing with symptoms. Maturitas. 2011 Dec;70(4):343-8. doi: 10.1016/j.maturitas.2011.09.008. Epub 2011 Oct 19.

Reference Type: BACKGROUND

PMID: 22014722 (View on PubMed)

Kesler S, Hadi Hosseini SM, Heckler C, Janelsins M, Palesh O, Mustian K, Morrow G. Cognitive training for improving executive function in chemotherapy-treated breast cancer survivors. Clin Breast Cancer. 2013 Aug;13(4):299-306. doi: 10.1016/j.clbc.2013.02.004. Epub 2013 May 4.

Reference Type: BACKGROUND

PMID: 23647804 (View on PubMed)

Koppelmans V, Breteler MM, Boogerd W, Seynaeve C, Gundy C, Schagen SB. Neuropsychological performance in survivors of breast cancer more than 20 years after adjuvant chemotherapy. J Clin Oncol. 2012 Apr 1;30(10):1080-6. doi: 10.1200/JCO.2011.37.0189. Epub 2012 Feb 27.

Reference Type: BACKGROUND

PMID: 22370315 (View on PubMed)

Hillman CH, Erickson KI, Kramer AF. Be smart, exercise your heart: exercise effects on brain and cognition. Nat Rev Neurosci. 2008 Jan;9(1):58-65. doi: 10.1038/nrn2298.

Reference Type: BACKGROUND

PMID: 18094706 (View on PubMed)

Schmitz KH, Courneya KS, Matthews C, Demark-Wahnefried W, Galvao DA, Pinto BM, Irwin ML, Wolin KY, Segal RJ, Lucia A, Schneider CM, von Gruenigen VE, Schwartz AL; American College of Sports Medicine. American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc. 2010 Jul;42(7):1409-26. doi: 10.1249/MSS.0b013e3181e0c112.

Reference Type: BACKGROUND

PMID: 20559064 (View on PubMed)

Galantino ML, Greene L, Daniels L, Dooley B, Muscatello L, O'Donnell L. Longitudinal impact of yoga on chemotherapy-related cognitive impairment and quality of life in women with early stage breast cancer: a case series. Explore (NY). 2012 Mar-Apr;8(2):127-35. doi: 10.1016/j.explore.2011.12.001.

Reference Type: BACKGROUND

PMID: 22385567 (View on PubMed)

Baumann, F. T., Drosselmeyer, N., Leskaroski, A., Knicker, A., Krakowski-Roosen, H., Zopf, E. M., & Bloch, W. (2011). 12-week resistance training with breast cancer patients during chemotherapy: Effects on cognitive abilities. Breast Care, 6(2), 142-143.

Reference Type: BACKGROUND

Irwin ML, McTiernan A, Bernstein L, Gilliland FD, Baumgartner R, Baumgartner K, Ballard-Barbash R. Physical activity levels among breast cancer survivors. Med Sci Sports Exerc. 2004 Sep;36(9):1484-91.

Reference Type: BACKGROUND

PMID: 15354027 (View on PubMed)

Mackenzie, M., Zuniga, K., & McAuley, E. (in press). Cognitive impairment in breast cancer survivors: The protective role of physical activity, cardiorespiratory fitness, and exercise training. Exercise-Cognition Interaction: Neuroscience Perspectives.

Reference Type: BACKGROUND

Blacklock R, Rhodes R, Blanchard C, Gaul C. Effects of exercise intensity and self-efficacy on state anxiety with breast cancer survivors. Oncol Nurs Forum. 2010 Mar;37(2):206-12. doi: 10.1188/10.ONF.206-212.

Reference Type: BACKGROUND

PMID: 20189926 (View on PubMed)

Salerno EA, Rowland K, Kramer AF, McAuley E. Acute aerobic exercise effects on cognitive function in breast cancer survivors: a randomized crossover trial. BMC Cancer. 2019 Apr 23;19(1):371. doi: 10.1186/s12885-019-5589-1.

Reference Type: DERIVED

PMID: 31014267 (View on PubMed)

Related Links

http://www.epl.illinois.edu

Exercise Psychology Laboratory website

Other Identifiers

UIUC_IRB_15575

Identifier Type: -

Identifier Source: org_study_id