title: Effect of the LIVESTRONG at the YMCA exercise program on physical activity, fitness, quality of life, and fatigue in cancer survivors.
abstract: BACKGROUND
  Physical activity (PA) has been linked to a lower risk of developing and dying of cancer, yet many cancer survivors do not exercise. In the current study, the authors evaluated the impact of the LIVESTRONG at the YMCA exercise program, available at Young Men's Christian Associations (YMCAs) across the United States, on PA, fitness, quality of life, fatigue, body composition, serum biomarkers, and program safety in cancer survivors.
  
  
  METHODS
  Cancer survivors were recruited through the Yale Cancer Center and the Dana-Farber Cancer Institute and randomized to a 12-week, twice-weekly LIVESTRONG at the YMCA exercise program at YMCAs in Connecticut or Massachusetts or to a control group. Questionnaires, dual-energy x-ray absorptiometry scans, 6-minute walk tests (6MWTs), and a fasting blood draw were completed at baseline and at 12 weeks. Intervention effects were evaluated using mixed model repeated measures analysis, with changes at 12 weeks in PA and 6MWT as the primary endpoints.
  
  
  RESULTS
  A total of 186 participants were randomized (95 to the exercise group and 91 to the control group). The majority of patients were diagnosed with AJCC stage I to II cancer and 53% had breast cancer. Participants randomized to the LIVESTRONG at the YMCA program experienced increases in PA (71% exercising at ≥ 150 minutes/week vs 26% of controls; P<.05) and improvements in the 6MWT (group difference: 28.9 meters [95% confidence interval, 0.3-49.0; P = .004]) and quality of life (group difference: 2.6 [95% confidence interval, 0.1-5.0; P = .04]). No adverse events were reported.
  
  
  CONCLUSIONS
  The LIVESTRONG at the YMCA exercise program has the potential to impact thousands of survivors across the YMCA network and could lead to improvements in disease and psychosocial outcomes in the growing population of cancer survivors. Cancer 2017;123:1249-1258. © 2016 American Cancer Society.
authors.affiliation: Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut.|Department of Internal Medicine, Section of Medical Oncology, Yale School of Medicine, New Haven, Connecticut.
authors.forename: Melinda L
authors.initials: ML
authors.lastname: Irwin
authors.affiliation: Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut.|Department of Internal Medicine, Section of Medical Oncology, Yale School of Medicine, New Haven, Connecticut.
authors.forename: Brenda
authors.initials: B
authors.lastname: Cartmel
authors.affiliation: Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut.
authors.forename: Maura
authors.initials: M
authors.lastname: Harrigan
authors.affiliation: Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut.
authors.forename: Fangyong
authors.initials: F
authors.lastname: Li
authors.affiliation: Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut.|Department of Internal Medicine, Section of Medical Oncology, Yale School of Medicine, New Haven, Connecticut.
authors.forename: Tara
authors.initials: T
authors.lastname: Sanft
authors.affiliation: Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.
authors.forename: Laura
authors.initials: L
authors.lastname: Shockro
authors.affiliation: Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.
authors.forename: Keelin
authors.initials: K
authors.lastname: O'Connor
authors.affiliation: Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.
authors.forename: Nancy
authors.initials: N
authors.lastname: Campbell
authors.affiliation: Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.
authors.forename: Sara M
authors.initials: SM
authors.lastname: Tolaney
authors.affiliation: Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.
authors.forename: Erica L
authors.initials: EL
authors.lastname: Mayer
authors.affiliation: Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.
authors.forename: Rachel
authors.initials: R
authors.lastname: Yung
authors.affiliation: Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.
authors.forename: Rachel A
authors.initials: RA
authors.lastname: Freedman
authors.affiliation: Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.
authors.forename: Ann H
authors.initials: AH
authors.lastname: Partridge
authors.affiliation: Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Ligibel
mesh_terms: D000368:Aged; D015415:Biomarkers; D001823:Body Composition; D016022:Case-Control Studies; D015444:Exercise; D005221:Fatigue; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D063868:Patient Outcome Assessment; D010809:Physical Fitness; D011159:Population Surveillance; D011788:Quality of Life; D012307:Risk Factors; D057566:Self Report; D017741:Survivors
chemical_list: D015415:Biomarkers
keywords: cancer; fatigue; obesity; physical activity; quality of life