TOPLINE:
A structured exercise program leads to improvements in sexual health and sexual symptoms caused by endocrine therapy, as well as fatigue and overall quality of life in women with metastatic breast cancer, a randomized controlled trial found.
METHODOLOGY:
- Patients with metastatic breast cancer often experience issues with sexual health. Data on the effectiveness of interventions such as exercise are lacking.
- The PREFERABLE-EFFECT trial enrolled 355 women (mean age, 55.4 years) with metastatic breast cancer; 75% had received first- or second-line treatment at enrollment, and 68% had bone metastases.
- Trial participants were randomly allocated to either usual care or a 9-month (twice weekly) supervised exercise program combining aerobic, resistance, and balance exercises. All participants received general exercise advice and an activity tracker.
- Patients were assessed at baseline and 3, 6, and 9 months. Exercise intervention effects were analyzed on an intent-to-treat basis with mixed models.
TAKEAWAY:
- At baseline, most women showed no interest in sexual activity, and 60% were not sexually active. Nearly half (46%) of sexually active women reported no or little sexual enjoyment. Low sexual function was associated with depression and older age.
- Among patients receiving endocrine therapy, 27% reported vaginal pain and 40% reported vaginal dryness during sexual activity.
- The exercise intervention significantly improved sexual functioning (effect size = 0.28; P = .003) and endocrine sexual symptoms (effect size = 0.25; P = .003) at 6 months, and these effects were sustained at 9 months. Sexual enjoyment also appeared to improve in the exercise group, but due to the small sample size, this was not a statistically significant effect.
- Prior results from the trial showed that the exercise program had significant benefits on fatigue and overall quality of life (primary outcomes).
IN PRACTICE:
Patients with metastatic breast cancer "often suffer from sexual health issues and this topic should be addressed by clinicians," said study presenter Martina Schmidt, PhD, with the German Cancer Research Center, Heidelberg.
"Physical exercise should be a crucial component of the prescription we offer to our patients," said study discussant Matteo Lambertini, MD, PhD, with University of Genova, Genova, Italy.
SOURCE:
The research (abstract 269MO) was presented at the European Society for Medical Oncology Breast Cancer 2024 Annual Congress on May 17, 2024.
LIMITATIONS:
Further research needs to be done to determine the optimal role of exercise in addressing symptom burden.
DISCLOSURES:
This research was funded by the European Union's Horizon 2020 research and innovation program and the National Health and Medical Research Council of Australia. Schmidt has no relevant conflicts of interest. Lambertini has financial relationships with various pharmaceutical companies including Roche, Novartis, AstraZeneca, Lilly, Exact Sciences, Pfizer, and others.