The acute effects of conservative surgery plus radiotherapy on the functional capacity and psychological well being of women with early stage breast cancer


Seven women (54.1 ± 5.2 yrs) diagnosed with Stage I or H breast cancer who were treated with surgery and adjuvant radiotherapy served as subjects in a prospective investigation evaluating functional capacity and psychological well-being before, during, and after therapy. Physical measurements included height, body mass and sum of five skinfolds. Measures of spirometry (FVC, FEV₁, FEF[sub 25%-75%], FEV₁/FVC, MVV) and single breath diffusing capacity of carbon monoxide (DL[sub co], VA, DL[sub co]/VA) were recorded using a Collins DS I System (Warren E. Collins). To determine maximal oxygen consumption (VO₂max), minute ventilation (VE), heart rate (HRmax) and peak power output (PPO), subjects cycled until exhaustion on an electronically-braked cycle ergometer (Lode BV Excalibur V2.0). Percent arterial oxygen saturation (%SaO₂) was monitored with a pulse oximeter (Ohmeda Box 3740). Subjects completed the Self-Esteem Questionnaire (Robson, 1989), a modified Quality of Life Index (Padilla et al, 1983), and the Body Image Visual Analogue Scale (Mock, 1993). Measures were recorded after biopsy, prior to further surgery (Test 1), and repeated three weeks after surgery (Test 2), two weeks after commencement of radiotherapy (Test 3), as well as one week (Test 4) and two months (Test 5) after radiotherapy completion. Surgical, pathological and radiotherapy details were recorded, as was smoking history. In addition to relating pre-diagnostic activity, subjects kept a weekly log to record and subjectively rank their involvement in physical activity during treatment. Repeated measures analysis of variances (RM ANOVAs) were implemented with subsequent Tukey HSD post-hoc analysis. A probability value of <0.05 was considered significant for all tests. All pulmonary function measures, excluding FVC and VA, decreased significantly between Test 1 and Test 5; changes were attributed to pulmonary inflammation. Nevertheless, deviations in spirometry and diffusing capacity were within normal limits, likely contributing to the maintenance of maximal exercise capacity. Body image and quality of life were significantly depressed at mid-radiation, yet self-esteem did not change over the course of treatment. Activity, smoking and age did not appear to play a role in either physiological or psychological health, yet sample size was small.Education, Faculty ofKinesiology, School ofGraduat

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