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Hispanic ethnicity as a moderator of the effects of aerobic and resistance exercise on physical fitness and quality-of-life in breast cancer survivors

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Abstract

Background

Exercise can profoundly affect physical fitness and quality of life in breast cancer survivors; however, few studies have focused on minorities. This secondary analysis examines Hispanic ethnicity as a moderator of the effects of a 16-week aerobic and resistance exercise intervention on physical fitness and quality of life in breast cancer survivors.

Methods

Eligible breast cancer survivors (n = 100) were randomized to exercise (n = 50) or usual care (n = 50). The exercise intervention consisted of supervised moderate-vigorous aerobic and resistance exercise thrice weekly for 16 weeks. Physical fitness and quality of life were measured at baseline, post-intervention, and 28-week follow-up (exercise only). Linear mixed-models adjusted for baseline value of the outcome, age, disease stage, adjuvant treatment, and recent physical activity were used to evaluate effect modification by ethnicity.

Results

The study sample included 57% Hispanic and 43% non-Hispanic breast cancer survivors. Hispanic breast cancer survivors were younger, less fit, and diagnosed with more advanced cancers compared with non-Hispanic breast cancer survivors (p < 0.001). Ethnicity was found to moderate the effects of exercise training on all physical fitness and quality-of-life measures including VO2max (8.4 mL/kg/min; 95% confidence interval (95% CI) 3.2 to 13.4), physical well-being (12.3; 95% CI 4.2 to 18.4), and emotional well-being (11.4; 95% CI 5.9 to 15.5). In all cases, Hispanics experienced larger benefits than non-Hispanics.

Conclusions

Hispanic breast cancer survivors have poorer cardiorespiratory fitness, muscle strength, and quality-of-life and therefore may derive larger benefits from exercise than non-Hispanic breast cancer survivors. Clinical exercise interventions may attenuate existing health disparities among minority breast cancer survivors.

Implication of Cancer Survivors

Here we report psychosocial and fitness-related disparities among Hispanic breast cancer survivors when compared with their non-Hispanic counterparts. Our exercise intervention highlights the importance of exercise for minority cancer survivors and the need for distinct, culturally tailored exercise intervention approaches to reduce psychosocial and fitness-related disparities among this understudied population of cancer survivors.

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Funding

This study was funded by grants K07CA160718 from the National Cancer Institute, UL1TR001855 and UL1TR000130 from the National Center for Advancing Translational Science (NCATS) of the US National Institutes of Health.

Author information

Authors and Affiliations

  1. Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, 375 Longwood Ave., Boston, MA, 02215, USA

    Christina M. Dieli-Conwright

  2. Division of Biokinesiology and Physical Therapy, Ostrow School of Dentistry, University of Southern California (USC), Los Angeles, CA, 90033, USA

    Frank S. Fox

  3. Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA

    Debu Tripathy

  4. Department of Medicine, Keck School of Medicine, USC, Los Angeles, CA, 90033, USA

    Nathalie Sami, Jessica Van Fleet & Darcy Spicer

  5. Division of Endocrinology and Diabetes, Keck School of Medicine, USC, Los Angeles, CA, 90033, USA

    Thomas A. Buchanan

  6. Department of Population Sciences, Beckman Research Institute, City of Hope (COH), Duarte, CA, 91010, USA

    Kyuwan Lee

  7. Division of Medical Oncology and Experimental Therapeutics, COH, Duarte, CA, 91010, USA

    Joanne Mortimer

  8. Division of Biomarkers of Early Detection and Prevention, Beckman Research Institute, COH, Duarte, CA, 91010, USA

    Leslie Bernstein

  9. Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, 35294, USA

    Wendy Demark-Wahnefried

  10. Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, T6G 2H9, Canada

    Kerry S. Courneya

Authors
  1. Christina M. Dieli-Conwright
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  2. Frank S. Fox
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  8. Kyuwan Lee
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  9. Joanne Mortimer
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  10. Leslie Bernstein
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  11. Wendy Demark-Wahnefried
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Corresponding author

Correspondence to Christina M. Dieli-Conwright.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

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Informed consent was obtained from all individual participants included in the study.

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Dieli-Conwright, C.M., Fox, F.S., Tripathy, D. et al. Hispanic ethnicity as a moderator of the effects of aerobic and resistance exercise on physical fitness and quality-of-life in breast cancer survivors. J Cancer Surviv 15, 127–139 (2021). https://doi.org/10.1007/s11764-020-00918-3

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