A  preeminent group of clinical researchers studied the effects of home-based exercise and weight loss programs on breast cancer-related lymphedema (BCRL) outcomes among overweight breast cancer survivors. Known as the WISER Survivor randomized clinical trial, the team recently produced some interesting results that were published in JAMA Oncology. They suggest that the patients with BCRL are more effectively cared for at supervised, facility-based care programs over home-based programs.

The Study

A randomized clinical trial, the substantially sized research team evaluated 351 overweight breast cancer survivors with BCRL from the Women in Steady Exercise Research (WISER) Survivor clinical trial. 87 of the participants were placed in an exercise intervention group that, according to a press release in docwire news, comprised strength and resistance training twice per week and 180 minutes of walking per week; 87 were also placed in a weight loss intervention group that consisted of 20 weeks of meal replacements as well as 52 weeks of lifestyle alternation counseling; 87 were selected to participate in combined exercise and weight loss intervention group, while 90 were randomly allocated to a control group of facility-based lymphedema care with no home-based exercise or weight loss intervention.

The programs were administered in conference rooms at academic community hospitals from 2012 to 2016, and subsequent follow-ups were performed for one year from the start of the intervention. The primary endpoint of this study was the 12-month change in the percentage of inter-limb volume difference.

The Results

The research team found that supervised programs yield better outcomes. They showed that among study participants, the median time since breast cancer diagnosis was six years. The average total upper extremity score changes from the objective clinical evaluation were −1.40 (11.10) in the control group, −2.54 (13.20) in the exercise group, −3.54 (12.88) in the weight loss group, and −3.84 (10.09) in the combined group. Score changes from the self-report survey were −0.39 (2.33) in the control group, −0.12 (2.14) in the exercise group, −0.57 (2.47) in the weight loss group, and −0.62 (2.38) in the combined group. Moreover, the research found that weight loss from baseline was −0.55% (95% CI, −2.22% to 1.11%) in the control group, −8.06% (95% CI, −9.82% to 6.29%) in the combined group, −7.37% (95% CI, −8.90% to −5.84%) in the weight loss group, and −0.44% (95% CI, −1.81% to 0.93%) in the exercise group.

The Sponsor

Milton S. Hershey Medical Center

Lead Research/Investigator

Kathryn H. Schmitz, MPH, PhD, Penn State University

Source: JAMA Network

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