For women undergoing adjuvant chemotherapy for breast cancer, a high-intensity physical activity program is most effective, while a low-intensity program offers a viable alternative, according to a study published in the Journal of Clinical Oncology.

Hanna van Waart, from the Netherlands Cancer Institute in Amsterdam, and colleagues randomized 230 patients to a low-intensity, home-based physical activity program (Onco-Move); a moderate- to high-intensity, combined supervised resistance and aerobic exercise program (OnTrack); or usual care (UC).

Outcomes were assessed before randomization, at the end of chemotherapy, and at the six-month follow-up.

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The researchers found that compared with UC, Onco-Move and OnTrack resulted in less decrease in cardiorespiratory fitness, better physical functioning, less nausea and vomiting, and less pain.

Muscle strength and physical fatigue outcomes were better with OnTrack. For all three groups, most outcomes returned to baseline levels at the six-month follow-up.

Compared with those in the UC or Onco-Move groups, a smaller percentage of participants in OnTrack required chemotherapy dose adjustments.

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Compared with the control group, both intervention groups returned to work earlier and for more hours per week.

“We would recommend that women who are able and willing to participate be offered a supervised, moderate- to high-intensity exercise program during adjuvant chemotherapy,” the authors write.

Two authors disclosed financial ties to the pharmaceutical industry.


  1. Waart, Hanna van, et al. “Effect of Low-Intensity Physical Activity and Moderate- to High-Intensity Physical Exercise During Adjuvant Chemotherapy on Physical Fitness, Fatigue, and Chemotherapy Completion Rates: Results of the PACES Randomized Clinical Trial.” Journal of Clinical Oncology. doi: 10.1200/JCO.2014.59.1081. [epub ahead of print]. April 27, 2015.