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Exercise Capacity of a Breast Cancer Survivor: A Case Study

KLIKA, RIGGS J.; CALLAHAN, KATHLEEN E.; GOLIK, KATHARINA S.

Medicine & Science in Sports & Exercise: October 2008 - Volume 40 - Issue 10 - pp 1711-1716
doi: 10.1249/MSS.0b013e31817e30b6
CLINICAL SCIENCES: Clinical Case Studies

Purpose: The processes by which we assess, create an individualized exercise program, and monitor training of a breast cancer survivor who was participating in a fitness plan during and after surgery, chemotherapy, and radiation treatments were examined over a 391-d period.

Case Study: A 57-yr-old female was diagnosed with stage I breast cancer (~1.2 cm diameter, estrogen positive, HER2/neu negative) with no lymph node involvement. After lumpectomy and axillary node dissection, the client completed chemotherapy treatment (cyclophosphamide, methotrexate, 5-fluorouracil (CMF)) followed by 33 bouts of radiation therapy. Assessment (body composition, V˙O2max, lactate threshold, pulmonary function testing) was measured 4 d postdiagnosis and 2 months after treatments had ended. The client kept a daily log of exercise, average heart rate, and rating of perceived exertion in each exercise session.

Results: Over 391 calendar days, the client exercised 343 days (88%) and completed 424 exercise sessions. The client's body composition (15.1%) and body weight (41.4 kg) remained stable for the entire period. There was a significant decrease in V˙O2max (−7.8%) before and after treatment (56.4 to 52.0 mL·kg−1·min−1, respectively). During the treatment phase (6.8 months), the client averaged 1.19 exercise sessions per day, with an average duration of 48.1 ± 25.2 min at approximately 57% of V˙O2max (~32 mL·kg−1·min−1). Posttreatment (~6.2 months), the client averaged 1.32 exercise sessions per day, with an average duration of 69.3 ± 38.5 min at approximately 59.6% V˙O2max (~31.2 mL·kg−1·min−1). Pre- and posttreatment exercise durations were significantly different (P < 0.01).

Conclusions: A cancer survivor who engaged in a medically supervised and proactive fitness plan starting from the day of diagnosis maintained a realistic level of physiologic function during and after cancer treatment.

Cancer Survivor Center for Health and Wellbeing, Aspen, CO

Address for correspondence: Riggs J. Klika, Ph.D.,1450 Crystal Lake Road, Aspen, CO 81611; E-mail: rklika@aspencancer.org.

Submitted for publication October 2007.

Accepted for publication April 2008.

©2008The American College of Sports Medicine