title: Effect of exercise on biomarkers, fatigue, sleep disturbances, and depressive symptoms in older women with breast cancer receiving hormonal therapy.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  Longitudinal randomized clinical trial.
  
  
  METHODS
  A National Cancer Institute-designated cancer center in the southeastern United States.
  
  
  METHODS
  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.
  
  
  METHODS
  Fatigue, sleep disturbances, depressive symptoms, biomarkers, and exercise.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: School of Nursing, Duke University Medical Center, Durham, NC, USA. payne031@mc.duke.edu
authors.forename: Judith K
authors.initials: JK
authors.lastname: Payne
authors.forename: Joanne
authors.initials: J
authors.lastname: Held
authors.forename: Josh
authors.initials: J
authors.lastname: Thorpe
authors.forename: Heather
authors.initials: H
authors.lastname: Shaw
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects / Q000627:therapeutic use; D001663:Bilirubin / Q000097:blood; D015415:Biomarkers / Q000097:blood*; D001943:Breast Neoplasms / Q000097:blood / Q000150:complications / Q000188:drug therapy; D003863:Depression / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D005081:Exercise Therapy / Q000379:methods*; D005221:Fatigue / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008137:Longitudinal Studies; D008875:Middle Aged; D009859:Oncology Nursing; D010865:Pilot Projects; D012701:Serotonin / Q000097:blood; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D015144:Southeastern United States; D016896:Treatment Outcome; D016138:Walking
chemical_list: D018931:Antineoplastic Agents, Hormonal; D015415:Biomarkers; D015850:Interleukin-6; D012701:Serotonin; D001663:Bilirubin; D006854:Hydrocortisone