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Physical activity is associated with clinically important differences in health-related quality of life among rural and small-town breast cancer survivors

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Abstract

Purpose

The primary purpose of this study was to examine differences in health-related quality of life and fatigue between rural and small-town (RST) breast cancer survivors meeting and not meeting public health physical activity (PA) recommendations.

Methods

Using a retrospective survey design, RST breast cancer survivors (N = 524) residing in Southern Alberta, Canada completed a mailed questionnaire assessing self-reported prediagnosis, on treatment, and current PA behavior, and current health-related quality of life and fatigue.

Results

Analyses indicated 44.1%, 13.7%, and 34.7% of RST breast cancer survivors met public health PA recommendations during prediagnosis, on treatment, and post-treatment (i.e., current) time periods, respectively. Multivariate analyses of variance suggested indicated survivors currently meeting PA recommendations reported clinically advantageous differences in health-related quality of life and fatigue symptoms than survivors not currently meeting PA recommendations. Repeated measures analyses also indicated significant differences in PA behavior across the three cancer-related time periods (all p < 0.01).

Conclusions

The results of this study provide evidence that RST breast cancer survivors have similar PA behavior estimates across the cancer trajectory to urban survivors. Being physically active was associated with clinically important advantages with respect to health-related quality of life and fatigue. Strategies designed to facilitate PA behavior in the RST breast cancer survivor population are warranted.

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References

  1. Speck RM, Courneya KS, Masse LC, Duval S, Schmitz KH (2010) An update of controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. J Cancer Surviv 4:87–100

    Article  PubMed  Google Scholar 

  2. Friedenreich CM, Gregory J, Kopciuk KA, Mackey JR, Courneya KS (2009) Prospective cohort study of lifetime physical activity and breast cancer survival. Int J Cancer 124:1954–1962

    Article  PubMed  CAS  Google Scholar 

  3. Holick CN, Newcomb PA, Trentham-Dietz A, Titus-Ernstoff L, Bersch AJ, Stampfer MJ et al (2008) Physical activity and survival after diagnosis of invasive breast cancer. Cancer Epidemiol Biomark Prev 17:379–386

    Article  Google Scholar 

  4. Holmes MD, Chen WY, Feskanich D, Kroenke CH, Colditz GA (2005) Physical activity and survival after breast cancer diagnosis. JAMA 293:2479–2486

    Article  PubMed  CAS  Google Scholar 

  5. Irwin ML, Smith AW, McTiernan A, Ballard-Barbash R, Cronin K, Gilliland FD et al (2008) Influence of pre- and postdiagnosis physical activity on mortality in breast cancer survivors: the Health, Eating, Activity, and Lifestyle study. J Clin Oncol 26:3958–3964

    Article  PubMed  Google Scholar 

  6. Irwin ML, Crumley D, McTiernan A, Bernstein L, Baumgartner R, Gilliland FD et al (2003) Physical activity levels before and after a diagnosis of breast carcinoma: the Health, Eating, Activity, and Lifestyle (HEAL) study. Cancer 97:1746–1757

    Article  PubMed  Google Scholar 

  7. Irwin ML, McTiernan A, Bernstein L, Gilliland FD, Baumgartner R, Baumgartner K et al (2004) Physical activity levels among breast cancer survivors. Med Sci Sports Exerc 36:1484–1491

    PubMed  Google Scholar 

  8. Milne HM, Gordon S, Guilfoyle A, Wallman KE, Courneya KS (2007) Association between physical activity and quality of life among Western Australian breast cancer survivors. Psychooncology 16:1059–1068

    Article  PubMed  Google Scholar 

  9. Rogers LQ, Markwell SJ, Courneya KS, McAuley E, Verhulst S (2009) Exercise preference patterns, resources, and environment among rural breast cancer survivors. J Rural Health 25:388–391

    Article  PubMed  Google Scholar 

  10. Rogers LQ, Markwell SJ, Verhulst S, McAuley E, Courneya KS (2009) Rural breast cancer survivors: exercise preferences and their determinants. Psychooncology 18:412–421

    Article  PubMed  Google Scholar 

  11. Reid-Arndt SA, Cox CR (2010) Does rurality affect quality of life following treatment for breast cancer? J Rural Health 26:402–405

    Article  PubMed  Google Scholar 

  12. DiSipio T, Hayes S, Newman B, Janda M (2009) What determines the health-related quality of life among regional and rural breast cancer survivors? Aust N Z J Public Health 33:534–539

    Article  PubMed  Google Scholar 

  13. Angell KL, Kreshka MA, McCoy R, Donnelly P, Turner-Cobb JM, Graddy K et al (2003) Psychosocial intervention for rural women with breast cancer: the Sierra–Stanford partnership. J Gen Intern Med 18:499–507

    Article  PubMed  Google Scholar 

  14. Wilson SE, Andersen MR, Meischke H (2000) Meeting the needs of rural breast cancer survivors: what still needs to be done? J Womens Health Gend Based Med 9:667–677

    Article  PubMed  CAS  Google Scholar 

  15. Lawler S, Spathonis K, Masters J, Adams J, Eakin E (2010) Follow-up care after breast cancer treatment: experiences and perceptions of service provision and provider interactions in rural Australian women. Support Care Cancer. doi:10.1007/s00520-010-1041-4

    PubMed  Google Scholar 

  16. Blanchard CM, Courneya KS, Stein K (2008) American Cancer Society’s SCS, II. Cancer survivors’ adherence to lifestyle behavior recommendations and associations with health-related quality of life: results from the American Cancer Society’s SCS-II. J Clin Oncol 26:2198–2204

    Article  PubMed  Google Scholar 

  17. Vallance JK, Courneya KS, Plotnikoff RC, Yasui Y, Mackey JR (2007) Randomized controlled trial of the effects of print materials and step pedometers on physical activity and quality of life in breast cancer survivors. J Clin Oncol 25:2352–2359

    Article  PubMed  Google Scholar 

  18. Haskell WL, Lee IM, Pate RR, Powell KE, Blair SN, Franklin BA et al (2007) Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Circulation 116:1081–1093

    Article  PubMed  Google Scholar 

  19. Nelson ME, Rejeski WJ, Blair SN, Duncan PW, Judge JO, King AC et al (2007) Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc 39:1435–1445

    Article  PubMed  Google Scholar 

  20. Ransdell LB (1996) Maximizing response rate in questionnaire research. Am J Health Behav 20:50–56

    Google Scholar 

  21. Dillman DA (2000) Mail and internet surveys: the tailored design method, 2nd edn. Wiley, London

    Google Scholar 

  22. Godin G, Jobin J, Bouillon J (1986) Assessment of leisure time exercise behavior by self-report: a concurrent validity study. Can J Public Health 77:359–362

    PubMed  CAS  Google Scholar 

  23. Godin G, Shephard RJ (1985) A simple method to assess exercise behavior in the community. Can J Appl Sport Sci 10:141–146

    PubMed  CAS  Google Scholar 

  24. Jacobs DR Jr, Ainsworth BE, Hartman TJ, Leon AS (1993) A simultaneous evaluation of 10 commonly used physical activity questionnaires. Med Sci Sports Exerc 25:81–91

    Article  PubMed  Google Scholar 

  25. Cella DF, Tulsky DS, Gray G, Sarafian B, Linn E, Bonomi A et al (1993) The Functional Assessment of Cancer Therapy scale: development and validation of the general measure. J Clin Oncol 11:570–579

    PubMed  CAS  Google Scholar 

  26. Cella D (1997) The Functional Assessment of Cancer Therapy-anemia (FACT-An) scale: a new tool for the assessment of outcomes in cancer anemia and fatigue. Semin Hematol 34:13–19

    PubMed  CAS  Google Scholar 

  27. Cella D, Eton DT, Lai JS, Peterman AH, Merkel DE (2002) Combining anchor and distribution-based methods to derive minimal clinically important differences on the Functional Assessment of Cancer Therapy (FACT) anemia and fatigue scales. J Pain Symptom Manage 24:547–561

    Article  PubMed  Google Scholar 

  28. Cella D, Hahn EA, Dineen K (2002) Meaningful change in cancer-specific quality of life scores: differences between improvement and worsening. Qual Life Res 11:207–221

    Article  PubMed  Google Scholar 

  29. Cohen J (1992) Statistical power analysis in the behavioral sciences, 2nd edn. Lawrence Erlbaum, Hillsdale

    Google Scholar 

  30. Gilmour HG (2007) Physically active Canadians. Health Rep 18:45–65

    PubMed  Google Scholar 

  31. Eton DT, Cella D, Yost KJ, Yount SE, Peterman AH, Neuberg DS et al (2004) A combination of distribution- and anchor-based approaches determined minimally important differences (MIDs) for four endpoints in a breast cancer scale. J Clin Epidemiol 57:898–910

    Article  PubMed  Google Scholar 

  32. Osoba D, Rodrigues G, Myles J, Zee B, Pater J (1998) Interpreting the significance of changes in health-related quality-of-life scores. J Clin Oncol 16:139–144

    PubMed  CAS  Google Scholar 

  33. Courneya KS, Karvinen KH, Campbell KL, Pearcey RG, Dundas G, Capstick V et al (2005) Associations among exercise, body weight, and quality of life in a population-based sample of endometrial cancer survivors. Gynecol Oncol 97:422–430

    Article  PubMed  Google Scholar 

  34. Karvinen KH, Courneya KS, North S, Venner P (2007) Associations between exercise and quality of life in bladder cancer survivors: a population-based study. Cancer Epidemiol Biomark Prev 16:984–990

    Article  Google Scholar 

  35. Peddle CJ, Au HJ, Courneya KS (2008) Associations between exercise, quality of life, and fatigue in colorectal cancer survivors. Dis Colon Rectum 51:1242–1248

    Article  PubMed  Google Scholar 

  36. Stevinson C, Faught W, Steed H, Tonkin K, Ladha AB, Vallance JK et al (2007) Associations between physical activity and quality of life in ovarian cancer survivors. Gynecol Oncol 106:244–250

    Article  PubMed  Google Scholar 

  37. Vallance JK, Courneya KS, Jones LW, Reiman T (2005) Differences in quality of life between non-Hodgkin’s lymphoma survivors meeting and not meeting public health exercise guidelines. Psychooncology 14:979–991

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

Dr. Jeff Vallance is supported by a Population Health Investigator Award from Alberta Innovates—Health Solutions and a New Investigator Award from the Canadian Institutes of Health Research. Dr. Nicole Culos-Reed is supported by a Population Health Investigator Award from Alberta Innovates—Health Solutions. The principal author would like to acknowledge Melissa McCall for the courage, strength, and inspiration she provided and continues to provide to family, friends, and cancer survivors across Southern Alberta.

Sources of support

This study was supported by a Project Interface Grant from Alberta Health Services—Cancer Corridor.

Author information

Authors and Affiliations

  1. Faculty of Health Disciplines, Athabasca University, 1 University Drive, Athabasca, AB, T9S-3A3, Canada

    Jeff K. Vallance & Celeste M. Lavallee

  2. Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada

    Nicole S. Culos-Reed

  3. Department of Oncology, University of Calgary, Calgary, AB, Canada

    Marc G. Trudeau

  4. Medicine Hat Cancer Centre, Medicine Hat, AB, Canada

    Marc G. Trudeau

Authors
  1. Jeff K. Vallance
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  2. Celeste M. Lavallee
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  3. Nicole S. Culos-Reed
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  4. Marc G. Trudeau
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Corresponding author

Correspondence to Jeff K. Vallance.

Additional information

The original report was revised and resubmitted to Supportive Care in Cancer.

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Vallance, J.K., Lavallee, C.M., Culos-Reed, N.S. et al. Physical activity is associated with clinically important differences in health-related quality of life among rural and small-town breast cancer survivors. Support Care Cancer 20, 1079–1087 (2012). https://doi.org/10.1007/s00520-011-1188-7

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  • DOI: https://doi.org/10.1007/s00520-011-1188-7

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