Exercise may reduce depression but not anxiety in self-referred cancer patients undergoing chemotherapy. Post-hoc analysis of data from the ‘Body & Cancer’ trial

Figures & data

Table I. Multimodal exercise intervention, weekly schedule. Values are hours.

	Monday	Tuesday	Wednesday	Thursday	Friday
High intensity training^a	1.5		1.5		1.5
Low intensity training
Body awareness		1.5
Relaxation	0.5	0.5	0.5		0.5
Massage	0.5				0.5

^aComprising: Warm-up exercises, heavy resistance- and cardiovascular training.

Figure 1. Flow chart of participants through trial.

Table II. Demographic characteristics for all patients (n=209) and by group assignment. Values are numbers (percentages) of patients unless stated otherwise.

	Control group (n = 103)	Intervention group (n = 106)
DEMOGRAPHIC CHARACTERISTICS
Age, years
Mean (SD)	48.0 (10.1)	47.0 (10.8)
Range	20–65	21–65
Married, living together or in a relationship	73 (70.9)	76 (71.7)
Gender
Male	30 (29.1)	22 (20.8)
Female	73 (70.9)	84 (79.3)
Completed secondary school or higher	84 (81.6)	82 (77.4)
Current smoker	14 (13.6)	16 (15.1)
BASELINE VO2MAX MEAN (SD)^a	1.9 (0.5)	1.8 (0.4)
PRE-ILLNESS PHYSICAL ACTIVITY LEVEL^b
I	3 (2.9)	6 (5.7)
II	27 (26.5)	34 (32.1)
III	62 (60.8)	59 (55.7)
IV	10 (9.8)	7 (6.6)
BASELINE PHYSICAL ACTIVITY LEVEL^b
I	17 (16.7)	18 (17.3)
II	41 (40.2)	59 (56.7)
III	39 (38.2)	24 (23.1)
IV	5 (4.9)	3 (2.9)
BASELINE ANXIETY SCORE
Non-cases (≤7)	83 (78.3)	77 (74.7)
Borderline (8–10)	14 (13.2)	19 (18.5)
Cases (≥11)	9 (8.5)	7 (6.8)
BASELINE DEPRESSION SCORE
Non-cases (≤7)	98 (92.5)	87 (84.5)
Borderline (8–10)	3 (2.8)	10 (9.7)
Cases (≥11)	5 (4.7)	6 (5.8)

^aStated in l/min. Vo₂max was indirectly estimated by use of a stepwise work capacity on a stationary exercise cycle and calculated using the formula VO₂max = 0.16 + (0.0117xMPO) where maximal power out (MPO) was measured in watts.

^bI = sedentary; II = walking or cycling for pleasure; III = regular physical exercise at least three hours/week; IV = intense physical activity more than four hours/week.

Table III. Medical characteristics for all patients (n = 209) and by group assignment. Values are numbers (percentages) of patients unless stated otherwise.

	Control group (n = 103)	Intervention group (n = 106)
MEDICAL CHARACTERISTICS
Cancer of breast* (NED/ED)	49 (42/7)	53 (45/8)
Cancer of bowel* (NED/ED)	15 (9/6)	13 (9/4)
Other oncological malignancies (NED/ED)
Cancer of ovaries	8 (3/5)	10 (2/8)
Cancer of testes	6 (0/6)	7 (0/7)
Cancer of lungs	4 (2/2)	3 (0/3)
Cancer of cervix uteri	0	3 (0/3)
Cancer of brain	2 (0/2)	0
Cancer of pancreas	1 (0/1)	1 (0/1)
Cancer of stomach	2 (0/2)	0
Other diagnoses (NED/ED)	6 (1/5)	5 (0/5)
Haematological malignancies (NED/ED)
Mb. Hodgkin	2 (1/1)	6 (0/6)
Non Hodgkin lymphoma	4 (0/4)	5 (0/5)
Acute leukaemia	3 (3/0)	0
Chronic leukaemia	1 (0/1)	0
Relapsed disease	18 (17.5)	11 (10.4)
Mean (SD) B-Haemaglobin, mmol/l	7.92 (0.8)	7.93 (0.8)
Days since diagnosis (median)	90	78.5
Number of Chemotherapy Cycles	2.9 (2.3)	2.5 (1.9)
No Evidence of Disease (NED) Baseline	61 (59.2)	56 (52.8)
Evidence of Disease (ED) Baseline	42 (40.8)	50 (47.2)

*Based on diagnose groups used for the stratification (cancer of breast, cancer of bowel, other oncological malignancies, haematological malignancies).

Table IV. Hospital Anxiety and Depression Scale (HADS) outcome variables and intervention effect estimates (95% confidence intervals) for all patients.

	Mean (SD)		Test (reference: control)
Outcome variable	Baseline	6 weeks	Effect estimate (95% CI)	P-value^a
Psychological Morbidity (HADS-T)
Control	9.39 (6.04)	8.63 (5.90)
Intervention	8.78 (5.89)	7.23 (5.42)	−0.99	0.06
Anxiety (HADS-A)
Control	5.31 (3.55)	4.79 (3.42)
Intervention	5.39 (3.56)	4.47 (3.43)	−0.37 (−0.98 to −0.24)	0.23
Depression (HADS-D)
Control	4.08 (3.32)	3.84 (3.15)
Intervention	3.43 (2.90)	2.74 (2.43)	−0.7 (−1.27 to −0.14)	0.015

^aAdjusted general linear model.

Table V. Hospital Anxiety and Depression Scale (HADS) outcome variables and intervention effect estimates (95% confidence intervals) for patients with HADS-defined anxiety and depression at baseline (scores ≥8).

	Mean (SD)		Test (reference: control)
Outcome variable	Baseline	6 weeks	Effect estimate (95% CI)	P-value^a
Anxiety ≥8 (n = 49)
Control	10 (2.62)	10.05 (2.58)
Intervention	10.48 (2.59)	9.39 (2.23)	−0.89 (−2.56 to −0.79)	0.29
Depression ≥8 (n = 24)
Control	10.5 (2.16)	10.25 (2.49)
Intervention	10.63 (1.51)	8.8 (1.3)	−2.53 (−0.64 to −0.42)	0.021

^aAdjusted general linear model.