Exercise Program Benefits Women with Early Breast Cancer

According to the results of a study published in the British Medical Journal, participation in a 12-week supervised group exercise program provided physical and psychological benefits to women undergoing treatment for early breast cancer.

Early-stage breast refers to cancer that is either confined to the breast or that has not spread beyond the axillary (underarm) lymph nodes. While some early-stage breast cancers are effectively treated with surgery and radiation therapy alone, others (particularly those that have spread to nearby lymph nodes) also require systemic treatments such as chemotherapy, hormonal therapy, or targeted therapy.

Several previous studies have suggested that the risk of developing breast cancer may be reduced by regular physical activity. Some studies have also suggested that exercise during cancer treatment may lessen fatigue and emotional distress.

To further explore the effects of physical activity in women undergoing treatment for early breast cancer, researchers in Scotland conducted a study among 203 women with Stage 0 to Stage III breast cancer. Women were ineligible for the study if they already engaged in regular physical activity. Half the women participated in a 12-week, supervised group exercise program in addition to usual care, and half the women received usual care alone.

The exercise program consisted of two classes and one at-home exercise session each week. The classes lasted for 45 minutes and involved a warm-up period of 5-10 minutes; 20 minutes of exercise such as walking, cycling, or muscle strengthening activities; and a cool-down and relaxation period.

At the three- and six-months assessments, women who had participated in the exercise program were able to walk farther and had better shoulder mobility than the women who did not participate in the exercise program.
Women who participated in the exercise program also scored higher on a measure of positive mood.
Women who participated in the exercise program reported fewer nights in the hospital and fewer visits to their primary care provider than women who did not participate in the exercise program.
There was no significant effect of the exercise program on an overall measure of quality of life.
The researchers conclude that the supervised group exercise program evaluated in this study provided functional and psychological benefits to women undergoing treatment for early breast cancer.

Reference: Mutrie N, Campbell AM, Whyte F et al. Benefit of supervised group exercise programme for women being treated for early stage breast cancer: pragmatic randomised controlled trial. British Medical Journal [online publication]. February 16, 2007.

Doxil®/Paraplatin® Effective in Recurrent Ovarian Cancer

According to an article recently published in the Annals of Oncology, treatment consisting of Doxil® (pegylated liposomal doxorubicin) and Paraplatin® (carboplatin) may improve survival in patients with relapsed ovarian cancer.

Ovarian cancer is the leading cause of gynecologic cancer-related death in the United States. Relapsed ovarian cancer refers to cancer that has returned or progressed following prior therapies. Taxanes and platinums are types of chemotherapy agents commonly used in the treatment of ovarian cancer. Once patients with ovarian cancer have relapsed following taxanes and platinums, treatment options are limited.

Doxil is a class of chemotherapy agents referred to as an anthracycline. Doxil is specifically created to deliver more of the chemotherapy agent to the cancer cells rather than to healthy tissues. As a result, side effects from the active ingredient in Doxil are limited while the agent’s anticancer activity is maintained.

Researchers from France recently conducted a clinical trial to evaluate Doxil plus Paraplatin in the treatment of patients with advanced ovarian cancer that had relapsed following prior platinum and taxane-based regimens.

Anticancer responses occurred in 63% of patients.
Complete disappearances of cancer occurred in 38% of patients.
Median progression-free survival was 9.4 months.
Median overall survival was 32 months.
The researchers concluded that the combination of Doxil/Paraplatin appears highly effective for women with ovarian cancer that has relapsed following prior taxane and platinum-based therapies. The authors stated, “Evaluationof this regimen in Phase III trials is warranted.”

Patients with relapsed ovarian cancer may wish to speak with their physician regarding their individual risks and benefits of participating in a clinical trial further evaluating Doxil/Paraplatin or other novel therapeutic approaches. Two sources of information regarding ongoing clinical trials include the National Cancer Institute (www.cancer.gov) and www.eCancerTrials.com.

Reference: Ferrero J-M, Weber B, Geay J-F, et al. Second-line chemotherapy with pegylated liposomal doxorubicin and carboplatin is highly effective in patients with advanced ovarian cancer in late relapse: a GINECO Phase II trial. Annals of Oncology. 2007; 18: 263-268.

Radiation Therapy May Benefit Patients with MALT Lymphoma Resistant to Antibiotics

According to an article recently published in the Annals of Oncology, radiation therapy may improve outcomes for patients with MALT lymphoma who are not responsive to therapy with antibiotics.

Mucosa-associated lymphoid tissues (MALT) lymphoma is a type of slow-growing non-Hodgkin’s lymphoma (NHL). NHL includes several different types of cancers that originate within the immune system. MALT lymphoma tends to develop outside of the lymph nodes, most commonly in the stomach, salivary glands, lungs, or thyroid.

Infection with Helicobacter pylori (H.pylori) is associated with the development of MALT lymphoma. Results have demonstrated that treatment with antibiotics to eradicate H.pylori can result in a complete disappearance of lymphoma in some patients with early-stage MALT lymphoma of the stomach. Patients with MALT lymphoma who do not respond to or stop responding to antibiotics can be treated with surgery, radiation therapy, and/or chemotherapy.

Researchers from Harvard recently reviewed the outcomes of patients treated with early-stage MALT lymphoma. This study included 66 patients whose cancer progressed despite antibiotic therapy. Patients were treated with the following therapies: 68% were treated with radiation therapy, 22% were treated with surgery followed by radiation therapy, 3% were treated with surgery and chemotherapy, and one patient received chemotherapy.

At five years progression-free survival was 76%.
At five years overall survival was 91%.
Patients who received radiation therapy had improved progression-free survival and overall survival compared with patients who had not received radiation therapy.
The researchers concluded that radiation therapy appears to provide an improvement in survival among patients with early-stage MALT lymphoma who have not responded to or have stopped responding to antibiotic therapy. However, it is noted that this study was not a clinical trial that directly compared treatment options.

Patients with MALT lymphoma who have stopped responding to antibiotic therapy may wish to speak with their physician regarding their individual risks and benefits of radiation therapy as a component of their treatment regimen.

Reference: Tsai HK, Li S, Ng AK, et al. Role of radiation therapy in the treatment of stage I/II mucosa-associated lymphoid tissue lymphoma. Annals of Oncology [published online]. January 11, 2007.