Exercise, Rehab Prove Feasible Additions to Breast Cancer Care, Study Finds
A pilot study found that the CORE Program offers a promising model for integrating exercise and rehab in breast cancer treatment
Exercise is increasingly recognized as a critical part of cancer treatment — not just for recovery, but for survival. Now, a new study highlights the potential of the Comprehensive Oncology Rehabilitation and Exercise (CORE) program, which connects breast cancer patients to personalized exercise and rehabilitation services — an important step, given that few healthcare models currently integrate both services into a single system of care, according to the study’s authors.
The 24-week, early-stage study – published by Wiley online in Cancer, a peer-reviewed journal of the American Cancer Society – took place at the Huntsman Cancer Institute in Salt Lake City, Utah. It involved 72 women (median age 58) who were newly diagnosed with stage I–III breast cancer and plan to undergo surgery as first-line treatment with needed exercise and rehabilitation services from diagnosis and throughout care. They were then randomly assigned either to the CORE program or standard care, with about twice as many placed in the CORE group. The assignment also factored in whether they were already meeting national exercise guidelines.
After getting permission from the participants, researchers had them fill out a questionnaire about their physical activity. The team checked on the participants’ physical function, quality of life and exercise habits at three points: at their surgical consultation, after their surgery and again 24 weeks later. Based on their responses to the questionnaires, participants were placed into one of three pathways: exercise service, rehabilitation service (both of which required referral by clinical staff) or exercise self-management (not a service). Exercise programs for people with breast cancer were designed to improve strength, fitness and physical abilities, while rehabilitation services treated problems like limited shoulder movement or nerve damage. Depending on where a patient is in their cancer treatment journey, they might need both exercise and rehab services at the same time or one after the other.
Participants who were placed in the standard care group (25 people) continued with their usual medical care and were told to keep up their normal daily activities throughout the study.
Ultimately, the study showed that CORE was practical and worked well for patients. About 93% of the women in the CORE group completed the triage tool at their surgery consultation, and 62% followed through by starting the exercise or rehab services. At the first follow-up visit after surgery, almost 95% of patients completed the triage tool again, with about 68% going on to complete their referrals. Focus group feedback was also encouraging, with over half of the comments across all areas being positive.
“CORE may serve as a model workflow algorithm aimed to integrate both exercise and rehabilitation services from time of diagnosis and beyond,” said senior author Adriana M. Coletta, PhD, MS, RD, an investigator at Huntsman Cancer Institute at the University of Utah in a release.
“Findings from this trial support national efforts led by the American College of Sports Medicine to integrate exercise and rehabilitation services as part of routine cancer care,” she added. “If other cancer centers and clinics do not have exercise or rehabilitation services embedded in their institution, they could use the algorithm and triaging tool in coordination with the American College of Medicine’s Moving Through Cancer Exercise Program Directory.”