The benefits of physical exercise for breast cancer patients: a critical review

Background: Increasingly, more women are being diagnosed with breast cancer in the U.K. (Office of National Statistics 2000). Concurrently, as a result of treatment advances, mortality figures associated with the disease have steadily decreased (Peto et al. 2000). For survivors, quality of life issues such as fatigue, menopausal symptoms, depression, anxiety and social isolation are substantial concerns. A preliminary literature search has identified numerous benefits of regular physical exercise which directly address many of these same problems.
In this presentation key findings from empirical studies associated with exercise and breast cancer will be critically appraised and synthesised. Specific implications for safe nursing practice will be highlighted.
Methods: A systematic literature review was conducted. The search strategy included an electronic database search (Medline, Embase, CINAHL, Cochrane Library) of empirical papers on ‘breast cancer and exercise’, a hand search of cancer journals and citations from retrieved review articles. Methodological qualities of studies were assessed using a predetermined framework (Downs & Black 1997).
Results: The majority of studies relied on small sample sizes within pre-test/post-test designs without random allocation. Despite these methodological
concerns, numerous benefits of aerobic exercise programmes were nevertheless indicated: increased functional capacity, strength and endurance; reduced subcutaneous fat, nausea, sleep disturbances and fatigue; and improved overall mood. Less vigorous forms of physical activities were associated with reductions in anxiety, depression and fatigue and improved well-being, self-esteem and body image.
Conclusions: This review has implications for nursing, research and patient education. It will be emphasised that high quality research is required to strengthen the case for the promotion of exercise for breast cancer patients and to maximise effectiveness for specific patient subgroups. In the meantime, nurses are encouraged to put the best available evidence into practice and promote physical activity for breast cancer patients.