Anxiety, Depression, Pain and Fatigue in Patients with Breast Cancer who Submitted to Combined Training
DOI:
https://doi.org/10.32635/2176-9745.RBC.2022v68n3.2611Keywords:
breast neoplasms, exercise, pain managementAbstract
Introduction: Despite the increase of the survival of patients with breast cancer, many persist with anxiety, depression, fatigue, and pain even after anticancer treatment, factors associated with a worse quality-of-life. Objective: Evaluate the influence of combined training on anxiety, depression, pain and fatigue in breast cancer patients. Method: Randomized controlled trial with 26 patients undergoing chemotherapy, radiotherapy, or clinical follow-up at a referral centre for cancer treatment, aged 30 to 59 years, not practicing physical training in the last three months. The experimental group (EG) (n=13) was submitted to 3 sessions per week of aerobic and resistance training, for 12 weeks, lasting 60 minutes, and 2 sessions per week of flexibility training lasting 20 seconds in 3 sets. The control group (CG) (n=13) submitted only to conventional hospital treatment. All assessments were performed at baseline and after 12 weeks. Results: EG patients showed a significant reduction in anxiety (p=0.0242), pain intensity (p=0.0290) and the behavioral dimension of fatigue (0.0033). No differences were observed in depression (p=0.0803), interference of pain in usual activities (p=0.0933) and affective (p=0.0583) and sensory/cognitive/emotional (p=0.5525) dimensions of fatigue. The GC remained unchanged in all variables. Conclusion: Combined training involving aerobic, resistance and flexibility exercises for 12 weeks has beneficial effects on anxiety, fatigue and pain in breast cancer patients.
Downloads
References
Instituto Nacional de Câncer José Alencar Gomes da Silva. Estimativa 2020: incidência de câncer no Brasil [Internet]. Rio de Janeiro: INCA; 2019 [acesso 2022 fev 12]. Disponível em: https://www.inca.gov.br/sites/ufu.sti.inca.local/files//media/document//estimativa-2020-incidencia-de-cancer-no-brasil.pdf
Rogers LQ, Courneya KS, Anton PM, et al. Effects of a multicomponent physical activity behavior change intervention on fatigue, anxiety, and depressive symptomatology in breast cancer survivors: randomized trial. Psychooncology. 2017;26(11):1901-6. doi: https://doi.org/10.1002/pon.4254 DOI: https://doi.org/10.1002/pon.4254
American Cancer Society. Cancer treatment & survivorship: facts & figures 2019-2021 [Internet]. Atlanta: American Cancer Society; 2019 [cited 2022 Feb 14]. Available from: https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/cancer-treatment-and-survivorship-facts-and-figures/cancer-treatment-and-survivorship-facts-and-figures-2019-2021.pdf
Carayol M, Bernard P, Boiché J, et al. Psychological effect of exercise in women with breast cancer receiving adjuvant therapy: What is the optimal dose needed? Ann Oncol. 2013;24(2):291-300. doi: https://doi.org/10.1093/annonc/mds342 DOI: https://doi.org/10.1093/annonc/mds342
Wong P, Muanza T, Hijal T, et al. Effect of exercise in reducing breast and chest-wall pain in patients with breast cancer: a pilot study. Curr Oncol. 2012;19(3):129-35. doi: https://doi.org/10.3747/co.19.905 DOI: https://doi.org/10.3747/co.19.905
Rethorst CD, Wipfli BM, Landers DM. The antidepressive effects of exercise: a meta-analysis of randomized trials. Sport Med. 2009;39(6):491-511. doi: https://doi.org/10.2165/00007256-200939060-00004 DOI: https://doi.org/10.2165/00007256-200939060-00004
Carayol M, Ninot G, Senesse P, et al. Short- and long-term impact of adapted physical activity and diet counseling during adjuvant breast cancer therapy: the “APAD1” randomized controlled trial. BMC Cancer. 2019;19(1):737. doi: https://doi.org/10.1186/s12885-019-5896-6 DOI: https://doi.org/10.1186/s12885-019-5896-6
Ramírez-Vélez R, Zambom-Ferraresi F, García-Hermoso A, et al. Evidence-based exercise recommendations to improve mental wellbeing in women with breast cancer during active treatment: a systematic review and meta-analysis. Cancers (Basel). 2021;13(2):264. doi: https://doi.org/10.3390/cancers13020264 DOI: https://doi.org/10.3390/cancers13020264
Travier N, Velthuis MJ, Steins Bisschop CN, et al. Effects of an 18-week exercise programme started early during breast cancer treatment: a randomised controlled trial. BMC Med. 2015;13:121. doi: http://doi.org/10.1186/s12916-015-0362-z DOI: https://doi.org/10.1186/s12916-015-0362-z
Furmaniak AC, Menig M, Markes MH. Exercise for women receiving adjuvant therapy for breast cancer. Cochrane Database Syst Rev. 2016;9(9):CD005001. doi: https://doi.org/10.1002/14651858.CD005001.pub3 DOI: https://doi.org/10.1002/14651858.CD005001.pub3
Conselho Nacional de Saúde (BR). Resolução nº 466, de 12 de dezembro de 2012. Aprova as diretrizes e normas regulamentadoras de pesquisas envolvendo seres humanos [Internet]. Diário Oficial da União, Brasília, DF. 2013 jun 13 [acesso 2014 jan 1]; Seção 1:59. Disponível em: https://conselho.saude.gov.br/resolucoes/2012/Reso466.pdf
Botega NJ, Bio MR, Zomignani MA, et al. Transtornos do humor em enfermaria de clínica médica e validação de escala de medida (HAD) de ansiedade e depressão. Rev Saúde Pública. 1995;29(5):355-63. doi: https://doi.org/10.1590/S0034-89101995000500004 DOI: https://doi.org/10.1590/S0034-89101995000500004
Vin-Raviv N, Akinyemiju TF, Galea S, et al. Depression and anxiety disorders among hospitalized women with breast cancer. PLoS One. 2015;10(6):e0129169. doi: https://doi.org/10.1371/journal.pone.0129169 DOI: https://doi.org/10.1371/journal.pone.0129169
Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361-70. doi: https://doi.org/10.1111/j.1600-0447.1983.tb09716.x DOI: https://doi.org/10.1111/j.1600-0447.1983.tb09716.x
Ferreira KA, Teixeira MJ, Mendonza TR, et al. Validation of brief pain inventory to Brazilian patients with pain. Support Care Cancer. 2011;19(4):505-11. doi: https://doi.org/10.1007/s00520-010-0844-7 DOI: https://doi.org/10.1007/s00520-010-0844-7
Cantarero-Villanueva I, Fernández-Lao C, Díaz-Rodríguez L, et al. The piper fatigue scale-revised: translation and psychometric evaluation in Spanish-speaking breast cancer survivors. Qual Life Res. 2014;23(1):271-6. doi: https://doi.org/10.1007/s11136-013-0434-5 DOI: https://doi.org/10.1007/s11136-013-0434-5
Mota DDCF, Pimenta CAM, Piper BF. Fatigue in Brazilian cancer patients, caregivers, and nursing students: a psychometric validation study of the Piper Fatigue Scale-Revised. Support Care Cancer. 2009;17(6):645-52. doi: https://doi.org/10.1007/s00520-008-0518-x DOI: https://doi.org/10.1007/s00520-008-0518-x
Fontoura AS, Formentin C, Abech EA. Guia prático de avaliação física: uma abordagem didática, abrangente e atualizada. 2. ed. rev. ampl. São Paulo: Phorte; 2013.
Sobin LH, Wittekind C, editors. TNM: classificação de tumores malignos [Internet]. Eisenberg ALA, tradução. 6.ed. Rio de Janeiro: INCA; 2004 [acesso 2022 Mar 3]. Disponível em: https://bvsms.saude.gov.br/bvs/publicacoes/inca/tnm2.pdf
Benedetti TB, Antunes PC, Rodriguez-Añez CR, et al. Reprodutibilidade e validade do Questionário Internacional de Atividade Física (IPAQ) em homens idosos. Rev Bras Med Esporte. 2007;13(1):11-6. doi: https://doi.org/10.1590/S1517-86922007000100004 DOI: https://doi.org/10.1590/S1517-86922007000100004
Stringuetta-Belik F, Shiraishi FG, Oliveira e Silva VR, et al. Greater level of physical activity associated with better cognitive function in hemodialysis in end stage renal disease. Braz J Nephrol. 2012;34(4):378-86. doi: https://doi.org/10.5935/0101-2800.20120028 DOI: https://doi.org/10.5935/0101-2800.20120028
Karvonen MJ, Kentala E, Mustala O. The effects of training on heart rate; a longitudinal study. Ann Med Exp Biol Fenn. 1957;35(3):307-15. Cited in: PubMed; PMID 13470504.
Neil SE, Klika RJ, Garland J, et al. Cardiorespiratory and neuromuscular deconditioning in fatigued and non-fatigued breast cancer survivors, Support Care Cancer. 2013;21(3):873-81. doi: https://doi.org/10.1007/s00520-012-1600-y DOI: https://doi.org/10.1007/s00520-012-1600-y
Weineck J. Treinamento ideal. 9. ed. São Paulo: Manole; 2003.
Guedes DP, Guedes JERP. Manual prático para avaliação em educação física. São Paulo: Manole; 2006. DOI: https://doi.org/10.5628/rpcd.06.03.265
Battaglini C, Bottaro M, Dennehy C, et al. The effects of resistance training on muscular strength and fatigue levels in breast cancer patients. Rev Bras Med Esporte. 2006;12(3):153-8. doi: https://doi.org/10.1590/S1517-86922006000300009 DOI: https://doi.org/10.1590/S1517-86922006000300009
Andersen BL, DeRubeis RJ, Berman BS, et al. Screening, assessment, and care of anxiety and depressive symptoms in adults with cancer: an American Society of Clinical Oncology guideline adaptation. J Clin Oncol. 2014;32(15):1605-19. doi: https://doi.org/10.1200/JCO.2013.52.4611 DOI: https://doi.org/10.1200/JCO.2013.52.4611
Li XM, Zhou KN, Yan H, et al. Effects of music therapy on anxiety of patients with breast cancer after radical mastectomy: a randomized clinical trial. J Adv Nurs. 2012;68(5):1145-55. doi: https://doi.org/10.1111/j.1365-2648.2011.05824.x DOI: https://doi.org/10.1111/j.1365-2648.2011.05824.x
Zhu G, Zhang X, Wang Y, et al. Effects of exercise intervention in breast cancer survivors: a meta-analysis of 33 randomized controlled trails. Onco Targets Ther. 2016;9:2153-68. doi: https://doi.org/10.2147/OTT.S97864 DOI: https://doi.org/10.2147/OTT.S97864
McArdle WD, Katch FI, Katch VL. Fisiologia do exercício: nutrição, energia e desempenho humano. 7. ed. Rio de Janeiro: Guanabara Koogan; 2011.
Valim V, Natour J, Xiao Y, et al. Efeitos do exercício físico sobre os níveis séricos de serotonina e seu metabólito na fibromialgia: um estudo piloto randomizado. Rev Bras Reumatol. 2013;53(6):538-41. doi: https://doi.org/10.1016/j.rbr.2013.02.001 DOI: https://doi.org/10.1016/j.rbr.2013.02.001
Rogers LQ, Vicari S, Trammell R, et al. Biobehavioral factors mediate exercise effects on fatigue in breast cancer survivors. Med Sci Sports Exerc. 2014;46(6):1077-88. doi: https://doi.org/10.1249/MSS.0000000000000210 DOI: https://doi.org/10.1249/MSS.0000000000000210
Davis MP, Walsh D. Mechanisms of fatigue. J Support Oncol. 2010;8(4):164-74. Cited in: PubMed; PMID 20822034.
Deminice R, Rezende LFM, Rosa DD, et al. Physical activity recommendations for cancer prevention and control: a Brazilian consortium. Braz J Oncol. 2022;18:e-20220311. doi: https://doi.org/10.5935/2526-8732.20220311 DOI: https://doi.org/10.5935/2526-8732.20220311
Rock CL, Thomson CA, Sullivan KR, et al. American Cancer Society nutrition and physical activity guideline for cancer survivors. 2022;3:230-62. doi: https://doi.org/10.3322/caac.21719 DOI: https://doi.org/10.3322/caac.21719
Kwan ML, Sternfeld B, Ergas IJ, et al. Change in physical activity during active treatment in a prospective study of breast cancer survivors. Breast Cancer Res Treat. 2012;131(2):679-90. doi: https://doi.org/10.1007/s10549-011-1788-4 DOI: https://doi.org/10.1007/s10549-011-1788-4
Backman M, Wengström Y, Johansson B, et al. A randomized pilot study with daily walking during adjuvant chemotherapy for patients with breast and colorectal cancer. Acta Oncol. 2014;53(4):510-20. doi: https://doi.org/10.3109/0284186X.2013.873820 DOI: https://doi.org/10.3109/0284186X.2013.873820
Published
How to Cite
Issue
Section
License
Os direitos morais e intelectuais dos artigos pertencem aos respectivos autores, que concedem à RBC o direito de publicação.
This work is licensed under a Creative Commons Attribution 4.0 International License.
