Impact of exercise on sexual health, body image, and therapy‐related symptoms in women with metastatic breast cancer: The randomized controlled <scp>PREFERABLE</scp>‐<scp>EFFECT</scp> trial

The understanding and treatment of sexual health problems, impaired body image, and other non-life threatening but burdensome symptoms of women with metastatic breast cancer (mBC) is still insufficient. We studied the factors associated with such symptoms and investigated whether these problems could be alleviated by a structured exercise intervention. In the multinational PREFERABLE-EFFECT study, 355 women with mBC were randomly assigned to usual care (n = 178) or a 9-month supervised exercise program (n = 177). Breast cancer-specific functions and symptoms (EORTC QLQ-BR42) were assessed at baseline, 3, 6 (primary timepoint), and 9 months. Linear regression models and linear mixed models for repeated measures were calculated. At baseline, participants were 55.4 ± 11.2 years old, 52.4% were undergoing endocrine therapy, and 25.4% chemotherapy. Baseline sexual functioning was low, with 94.3% reporting no or little sexual activity. Age and depressive symptoms were negatively associated with sexual functioning. Among sexually active women, 46.2% felt no or little sexual enjoyment and 37.3% suffered from vaginal dryness. Body image was reported as low by 23.7%. Exercise significantly improved sexual functioning (6-months between-group difference (BGD) = 5.6, 95% CI [1.9, 9.4], effect size (ES) = 0.28) and vaginal symptoms (BGD = -7.1 [-11.7, -2.5], ES = 0.25), compared to usual care. Effects on body image were marginal (BGD = 4.0 [-0.2, 8.3], ES = 0.14). Among participants undergoing chemotherapy (n = 90), exercise reduced chemotherapy side-effects (BGD = -8.2 [-15.4, -1.0], ES = 0.48). In conclusion, women with mBC often experience sexual and vaginal problems and other treatment-related side-effects. A 9-month supervised exercise program vs. control was effective in improving sexual functioning and vaginal symptoms among women with mBC.

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Publication Details

Journal
International Journal of Cancer
Published
2025-04-03
DOI
https://doi.org/10.1002/ijc.35429
Citations
3
Primary Topic
Cancer survivorship and care
Type
article
Field-Weighted Citation Impact
3.14

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article

Impact of exercise on sexual health, body image, and therapy‐related symptoms in women with metastatic breast cancer: The randomized controlled PREFERABLE‐EFFECT trial

Nerea Ancizar, Mark Trevaskis, Michelle White, Evelyn M. Monninkhof et al.
3 citations
International Journal of Cancer
Cancer survivorship and care
3.14
article

Impact of exercise on sexual health, body image, and therapy‐related symptoms in women with metastatic breast cancer: The randomized controlled PREFERABLE‐EFFECT trial

Nerea Ancizar, Mark Trevaskis, Michelle White, Evelyn M. Monninkhof, Martijn M. Stuiver, Susanne Brandner, Joachim Wiskemann, J.H. Müller, Jon Belloso, Anouk E. Hiensch, Maike G. Sweegers, Andreas Schneweiss, Rhodé M. Bijlsma, Eva M. Zopf, Nadira Gunasekara, Peter Savas, Johanna Depenbusch, Gabe S. Sonke, Elżbieta Senkus, Martina E. Schmidt, Anne M. May, Wilhelm Bloch, Yvonne Wengström, Ander Urruticoechea, Lobke van Leeuwen‐Snoeks, Daan ten Bokkel Huinink, Helene Rundqvist, Renske Altena, Neil K. Aaronson, Karen Steindorf, Elsken van der Wall, Yoland Antill, Dorothea Clauss, Joanna Kufel‐Grabwska
article en
3 citations

Abstract

The understanding and treatment of sexual health problems, impaired body image, and other non-life threatening but burdensome symptoms of women with metastatic breast cancer (mBC) is still insufficient. We studied the factors associated with such symptoms and investigated whether these problems could be alleviated by a structured exercise intervention. In the multinational PREFERABLE-EFFECT study, 355 women with mBC were randomly assigned to usual care (n = 178) or a 9-month supervised exercise program (n = 177). Breast cancer-specific functions and symptoms (EORTC QLQ-BR42) were assessed at baseline, 3, 6 (primary timepoint), and 9 months. Linear regression models and linear mixed models for repeated measures were calculated. At baseline, participants were 55.4 ± 11.2 years old, 52.4% were undergoing endocrine therapy, and 25.4% chemotherapy. Baseline sexual functioning was low, with 94.3% reporting no or little sexual activity. Age and depressive symptoms were negatively associated with sexual functioning. Among sexually active women, 46.2% felt no or little sexual enjoyment and 37.3% suffered from vaginal dryness. Body image was reported as low by 23.7%. Exercise significantly improved sexual functioning (6-months between-group difference (BGD) = 5.6, 95% CI [1.9, 9.4], effect size (ES) = 0.28) and vaginal symptoms (BGD = -7.1 [-11.7, -2.5], ES = 0.25), compared to usual care. Effects on body image were marginal (BGD = 4.0 [-0.2, 8.3], ES = 0.14). Among participants undergoing chemotherapy (n = 90), exercise reduced chemotherapy side-effects (BGD = -8.2 [-15.4, -1.0], ES = 0.48). In conclusion, women with mBC often experience sexual and vaginal problems and other treatment-related side-effects. A 9-month supervised exercise program vs. control was effective in improving sexual functioning and vaginal symptoms among women with mBC.

International Journal of CancerVol. 157(3)
The Royal Melbourne Hospital (AU), Karolinska University Hospital (SE), German Sport University Cologne (DE), The University of Melbourne (AU), German Cancer Research Center (DE), Utrecht University (NL), Heidelberg University (DE), Peter MacCallum Cancer Centre (AU), University Hospital Heidelberg (DE), Karolinska Institutet (SE), The Netherlands Cancer Institute (NL), University Medical Center Utrecht (NL), Elisabeth-Krankenhaus Essen (DE), Cabrini Hospital (AU), Alexander Monro Ziekenhuis (NL), Diakonessenhuis hospital (NL), Oncode Institute (NL), National Center for Tumor Diseases (DE), Greater Poland Cancer Center (PL), Osakidetza (ES), Onkologikoa (ES), Gdańsk Medical University (PL), Australian Catholic University (AU)
Deutsches Krebsforschungszentrum, Australian Catholic University, Karolinska Institutet, Peter MacCallum Cancer Centre, Deutsche Sporthochschule Köln, Universitätsklinikum Heidelberg, Horizon 2020 Framework Programme, Medical Research Council, National Health and Medical Research Council, Centrum fÖr Personcentrerad Vård
Good health and well-being
Openalex Percentile: Top 9%
Cancer survivorship and care
3.14
DOIOpen Access PDFOpenAlex
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