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Combined Inpatient Rehabilitation and Spa Therapy for Breast Cancer Patients: Effects on Quality of Life and CA 15-3

Strauss-Blasche, Gerhard PhD; Gnad, Eva MD; Ekmekcioglu, Cem MD; Hladschik, Birgit PhD, MD; Marktl, Wolfgang MD

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The present study investigated the changes of quality of life, mood, and the tumor marker CA 15-3 associated with a 3-week inpatient breast cancer rehabilitation program incorporating spa therapy. One hundred forty-nine women, 32 to 82 years, participated in the study 3 to 72 months after breast cancer surgery. Quality of life (QoL, EORTC QLQ-C30), anxiety, and depression (HADS) were measured 2 weeks before, at the end, and 6 months after rehabilitation; CA 15-3 at the beginning, end, and at 6 months follow-up. Patients received an individualized rehabilitation program incorporating manual lymph drainage, exercise therapy, massages, psychological counseling, relaxation training, carbon dioxide baths, and mud packs. Quality of life and mood improved significantly, the greatest short-term improvements found for mood-related aspects of quality of life, the most lasting improvements found for physical complaints (eg, fatigue). Also, the tumor marker CA 15-3 declined significantly to follow-up. Patient characteristics, as well as the time since surgery, moderated rehabilitation outcome to a limited extent. Older patients, nonobese patients, patients with a greater lymphedema, and patients with an active coping style showed slightly greater improvements. Hot mud packs inducing hyperthermia did not affect CA 15-3. In conclusion, the combination of inpatient rehabilitation with spa therapy provides a promising approach for breast cancer rehabilitation.

From the Center of Physiology and Pathophysiology (Drs Strauss-Blasche, Ekmekcioglu and Marktl) and the Department of Medical Psychology, Medical University of Vienna (Dr Hladschik); Ludwig Boltzmann Institute for Biological Rhythms Research (Drs Strauss-Blasche, Ekmekcioglu, and Marktl); and the Rehabilitation Center Rosalienhof (Dr Gnad).

Corresponding author: Gerhard Strauss-Blasche, PhD, Center of Physiology and Pathophysiology, Medical University of Vienna, Schwarzspanierstrasse 17, 1090 Vienna, Austria (e-mail: gerhard.strauss-blasche@meduniwien.ac.at).

Accepted for publication June 17, 2005

© 2005 Lippincott Williams & Wilkins, Inc.