ANN ARBOR---Breast cancer survivors who regularly work up a light to moderate sweat on an exercise bike, stair climber or in any other aerobic activity not only get into better physical condition but also feel significantly less depressed and anxious, according to a preliminary study from the University of Michigan Division of Kinesiology.
Furthermore, the sooner survivors start exercising after they have recovered from surgery, the greater the impact on the mental health.
The research team, led by Victor L. Katch, professor of movement science in the Division of Kinesiology, and graduate student Michelle L. Segar, studied the effect of exercise on depression and anxiety levels among 30 breast cancer survivors. Their study appears in the January/February issue of Oncology Nursing Forum.
''Depression and anxiety are not uncommon after breast cancer surgery,'' Katch said, ''and can linger for years. Research suggests that 20 percent to 40 percent of breast cancer survivors are depressed one year following surgery, and one study of eight-year survivors found that 64 percent were still anxious and 45 percent felt depressed because of their breast cancer.''
''One out of every eight women in the United States develops breast cancer at some point in her life,'' Segar added, ''so it is encouraging to discover that the women in our study said they felt 'stronger,' 'physically better,' more able to 'handle stress' and more 'in control' of their lives while they were exercising.''
The women in the study were 40 to 56 years of age. The mean time since surgery was three years and five months but the months since surgery ranged from one to 99 months. All of the women had been sedentary non-exercisers until the study began.
The survivors were divided into two groups. The exercisers worked out 30 minutes four times a week for 10 weeks and then either continued for another 10 weeks or became sedentary again. A control group of non-exercisers were sedentary for 10 weeks and then rotated into an exercise program for the following 10 weeks.
All the women took standard psychological tests for depression, state anxiety (anxiety at the moment) and trait anxiety (anxiety levels in general) at the beginning and end of the 10-week exercise program. They also took standard self-esteem tests.
The researchers found that:
- Depression scores decreased 44 percent for the exercisers and increased 13 percent for the non-exercisers after the first 10 weeks. However, after the non-exercisers finished their exercise program in the second 10 weeks, their depression scores decreased by 42 percent.
- Similarly, state and trait anxiety scores improved with exercise. Among the exercisers, state anxiety decreased by 16 percent and trait anxiety decreased by 9 percent. Once the non-exercisers finished their exercise program after the second 10 weeks, their state anxiety declined by 26 percent and trait anxiety declined by 9 percent.
- Notably, the depression scores for the 10 exercisers who stopped exercising in the second 10 weeks increased 44 percent while their state and trait anxiety scores remained the same.
- Depression and anxiety levels for women who began the exercise program within two years of their surgeries improved significantly more than did those who began two or more years after surgery.
- Women whose physicians recommended that they exercise were much more likely to exercise regularly than those who did not get a physician recommendation. ''Physicians may be reluctant to prescribe exercise to 'ill' patients, but a sedentary lifestyle may prolong recovery and increase emotional difficulties,'' Segar said.
- Self-esteem levels in either groups were not affected by the exercise program.
The U-M research team also included Randy S. Roth, lecturer, Department of Anesthesiology and Physical Medicine; Anne W. Garcia, assistant professor of sports management and communication, Division of Kinesiology; Sally Haslanger, associate professor of women's studies; Dr. Edwin G. Wilkins, Department of Surgery, Medical School; and kinesiology graduate students Toby I. Portner and Scott G. Glickman. The study was funded by the Michigan Initiative for Women's Health at the U-M.
Journal
Oncology Nursing Forum