Effect of Exercise on Biomarkers, Fatigue, Sleep Disturbances, and Depressive Symptoms in Older Women With Breast Cancer Receiving Hormonal Therapy

Abstract

PURPOSE/OBJECTIVES: To compare the effectiveness of a prescribed home-based walking exercise intervention with usual care in older women receiving hormonal treatment for breast cancer, and to examine relationships among levels of the cortisol, serotonin, interleukin-6, and bilirubin biomarkers and fatigue, sleep disturbances, and depressive symptoms. DESIGN: Longitudinal randomized clinical trial. SETTING: A National Cancer Institute-designated cancer center in the southeastern United States. SAMPLE: 20 women (aged 55 years or older) with breast cancer receiving hormonal treatment. METHODS: Participants were randomized to a walking exercise intervention or usual care. Laboratory samples and the Pittsburgh Sleep Quality Index (PSQI), the Piper Revised Fatigue Scale, and the Center for Epidemiological Studies-Depression Scale were collected at the initial clinic visit and at 12 weeks from the groups. Questionnaires also were collected at weeks 2 and 14. MAIN RESEARCH VARIABLES: Fatigue, sleep disturbances, depressive symptoms, biomarkers, and exercise. FINDINGS: Effect of the exercise intervention on sleep scores was highly significant between groups. Exercise group scores on the PSQI decreased significantly over time (indicating improved sleep quality), although scores did not change significantly within the control group. Sleep actigraphy also showed significantly shorter actual wake time and less movement in the exercise group. Serotonin levels also were significantly affected by the intervention. CONCLUSIONS: Data suggest that a walking exercise intervention improves sleep in older women receiving hormonal treatment for their breast cancer. Serotonin levels may be a useful biomarker when assessing sleep disturbances in this group. IMPLICATIONS FOR NURSING: Clinicians need to be aware that older women receiving hormonal treatment for their breast cancer may experience fatigue, sleep disturbances, and depressive symptoms. Homebased walking activity may reduce symptom severity in this group.