Mónica Castellanos-Montealegre

A Lung Cancer diagnosis can significantly influence a patient's lifestyle, yet there is limited research on these changes among Spanish populations. This study aimed to analyze the differences in lifestyle habits, physical activity (PA) levels, health-related quality of life (HRQoL), and adherence to the 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) recommendations among lung cancer patients in Castilla-La Mancha, prior to and after their diagnosis. This multi-center, descriptive, retrospective, cross-sectional, and observational study included 53 lung cancer patients from three hospitals in Castilla-La Mancha. Participants completed questionnaires assessing their PA, dietary intake, smoking habits, and HRQoL, recalling their habits from one year prior to diagnosis and their current habits. Post-diagnosis, patients showed a significant decrease in cigarette consumption (p < 0.001). However, there were also significant declines in fruit and vegetable intake (p = 0.049), dietary fiber (p = 0.024), and overall HRQoL across multiple domains, including mobility, self-care, usual activities, and pain/discomfort (p < 0.05). PA levels decreased, though not significantly. Overall, adherence to the WCRF/AICR recommendations did not improve. A lung cancer diagnosis is a powerful motivator for smoking cessation but is also associated with a decline in other healthy lifestyle habits and HRQoL. These findings highlight a critical need for targeted interventions at the time of diagnosis to support patients in maintaining healthy diets and physical activity levels, which are crucial for improving long-term outcomes.

Purpose Cancer frequently leads to reduced cardiorespiratory fitness (CRF), altered body composition, and increased fatigue, negatively impacting quality of life. This study aimed to evaluate the effects of a multimodal oncological exercise program on CRF, body composition, functional capacity, fatigue, and quality of life in breast cancer survivors. Methods Seventy-four breast cancer survivors (stages IA–IIIB) were randomized to either an intervention group (n = 40), participating in a 16-week, twice-weekly multimodal exercise program (in-person or online), or a control group (n = 34). CRF was the primary outcome. Measurements were taken at baseline and post-intervention. Results The intervention group showed significant improvements in CRF (+22.4%), fat mass (−10%), and lean mass (+5.24%). Functional capacity and physical activity levels also increased. No significant differences were found between in-person and online delivery formats, suggesting the effectiveness of remote interventions. Conclusions A 16-week structured, multimodal exercise program significantly improved CRF, body composition, and physical function in breast cancer survivors. Comparable outcomes between in-person and online formats support the feasibility and utility of remote exercise programs in oncology care.

The lockdown of the COVID-19 pandemic impacted physical activity (PA) levels around the world, affecting health parameters in young adults with cancer (YAC). To our knowledge, there is no evidence of the impact of the lockdown on the Spanish YAC. To analyse the changes in PA levels before, during, and after the lockdown of the YAC and its impact on health metrics in Spain, in this study, we utilized a self-reported web survey. PA levels decreased during the lockdown, and a significant increase in PA was observed after the lockdown. Moderate PA had the largest reduction (49%). Significant increases in moderate PA were noted after the lockdown (85.2%). Participants self-reported more than 9 h of sitting per day. HQoL and fatigue levels were significantly worse during the lockdown. The impact of the COVID-19 pandemic in this cohort of Spanish YAC showed a decrease in PA levels during the lockdown, affecting sedentarism, fatigue and HQoL. After lockdown, PA levels partially recovered, while HQoL and fatigue levels remained altered. This may have long-term physical effects such as cardiovascular comorbidities associated with sedentarism and psychosocial effects. It is necessary to implement strategies such as cardio-oncology rehabilitation (CORE), an intervention that can be delivered online, potentially improving participants’ health behaviours and outcomes.

Considering the existing controversy over the possible role of acute antioxidant vitamins in reducing exercise-induced muscle damage (EIMD), this doubled-blind, randomized and controlled trial aimed to determine whether supplementation with vitamins C and E could mitigate the EIMD in endurance-trained runners (n = 18). The exercise protocol involved a warm-up followed by 6 to 8 bouts of 1 km running at 75% maximum heart rate (HRmax). Two hours before the exercise protocol, participants took the supplementation with vitamins or placebo, and immediately afterwards, blood lactate, rate of perceived exertion and performance were assessed. At 24 h post-exercise, CK, delayed onset muscle soreness and performance were determined (countermovement jump, squat jump and stiffness test). The elastic index and vertical stiffness were calculated using a stiffness test. Immediately after the exercise protocol, all participants showed improved maximum countermovement jump, which only persisted after 24 h in the vitamin group (p < 0.05). In both groups, squat jump height was significantly greater (p < 0.05) immediately after exercise and returned to baseline values after 24 h. The elastic index increased in the vitamin group (p < 0.05), but not in the placebo group. In both groups, lactate levels increased from pre- to immediately post-exercise (p < 0.05), and CK increased from pre- to 24 h post-exercise (p < 0.05). No significant differences between groups were observed in any of the variables (p > 0.05). Vitamin C and E supplementation does not seem to help with EIMD in endurance-trained individuals.

Purpose To compare the cardiovascular fitness of breast cancer (BC) survivors with an active lifestyle to those with a sedentary lifestyle. Methods A cross-sectional study was conducted. Participants were classified into four groups: two groups of active women who performed more than 150 min/week of physical exercise, active with BC (Act-BCW) and active without BC (Act-HW); and two groups of sedentary women who performed less than 90 min/week of physical exercise, sedentary with BC (Sed-BCW) and sedentary without BC (Sed-HW). VO₂max was estimated by the 6-min walking test (6MWT); speed, isometric strength, lower body maximum strength, explosive strength, balance, and body composition were also measured. ANOVA was used to analyze group differences and post hoc comparisons were developed with the Bonferroni test. Results A total of 92 women were recruited. Significant differences were found in VO₂max between the Act-BCW and Sed-BCW groups (MeanDif = 5.86, p < 0.001). No differences in VO₂max were observed between the active groups (MeanDif = 0.42, p = 0.753). Related body composition and fat mass levels were significantly lower in the Act-BCW group than in the sedentary groups (Sed-BCW MeanDif = − 6.78; p = 0.012; and Sed-HW MeanDif = − 12.07; p < 0.001). Conclusions Women who are Act-BCW can achieve similar values in physical condition as women who are Act-HW and have better values than women who are sedentary. Furthermore, our results suggest than physical activity level may have a greater impact in body composition than a previous history of BC.

Introduction: Cardiorespiratory Fitness (CRF) has been described as an independent factorassociated with better survival in Breast Cancer Survivors (BCS). In addition, an altered BodyComposition (BodComp) impacts in a worst prognosis and increase treatment side effects.Despite this, BCS present lower levels of CRF than women without previous history of breastcancer (BC) and around 3% of BCS are obese, with an average of 1.8 to 5.0 kg of weight gainduring chemotherapy treatments and weight keeps rising during hormonotherapy.Exercise has been proved as an effective tool to help BCS not only to reduce treatments sideeffects improving significantly CRF, but also, to allow controlling and improving BodCom duringand after treatments.However, it is not clear if active BCS could achieve similar values of CRF and BodCom than activehealthy women and the impact of a sedentary behavior in them. Purpose: To establish the impact of physical exercise in CRF and BodComp recovery in BCS withinthe last five years compared to women without a BC diagnosis. Material and Methods: in this cross-sectional study, women with and without BC were invitedinto a sport centre in Madrid, (Spain) to evaluate their general physical condition and bodycomposition. Participants were classified into four different groups: sedentary-BC, active-BC,sedentary healthy and active healthy (Sed-BCW, Act-BCW, Sed-HW, Act-HW, respectively).VO2max, speed level, isometric strength, lower body maximum strength, explosive strength andbalance were assessed with different physical test. Body composition was measured bybioimpedance.In terms of statistical analysis, analyses of variance (ANOVA) were used with continuousvariables to compare groups and post- hoc comparisons used Bonferroni test. Results: A total of ninety two women were recruited (23 in each group).In terms of VO2max, significant differences were found between active and sedentary BC (Difmean (ΔM)= 5.86, IC 95% 3.16 - 8.55; pTable 1. Mean differences, significance and CI 95% in physical and body composition variablesbetween groups.Act-BCW- Sed-BCWAct-BCW - Act-HWAct-BCW - Sed-HW6MWT (m)71.52**37.36 -105.68-3.04-37.20 - 31.1176.57**42.41 - 110.7235m (sec)-1.87*-3.44 - 0.300.17-1.40 - 1.74-2.39**-3.96 - -0.82Jump (cm)5.48**1.47 - 9.49-2.87-6.88 - 1.144.91*0.90 - 8.92Strength Index0.63**0.31 - 0.95-0.09-0.40 - 0.210.376*0.07 - 0.68LM(%)5.20*-1.62 - 8.780.72-2.86 - 4.38.59**3.72 - 13.45*=pConclusions: This study provide two main contributions related to the importance of physicalactivity in BC survivors: BC women who maintain an active lifestyle can achieve the same valuesin physical condition as active healthy women, and significant better values than the sedentarygroups. These results suggest than physical exercise might be a stronger determinant of bodycomposition than a previous history of BC. Citation Format: Lucía Gil Herrero, Marina Pollán Santamaría, Miguel Martín Jimenez, Sara López Tarruella, Mónica Castellanos Montealegre, Soraya Casla Barrio. The importance of physical exercise in cardiovascular fitness in breast cancer survivors. A cross sectional study: WIM 2.0 [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P4-11-26.

Introduction: eHealth programs is an emerging area because of the restricted measures for controlling COVID19 pandemic a such as avoiding close contact or group activities, especially indoor. For these reasons, Spanish Cancer Association of Madrid (AECCmad), transformed all exercise-oncology programs into online version with the objective of maintaining the exercise attention to the breast cancer patients (BCP). This abstract shows the first results from this adapted intervention, evaluating the effectiveness in physical outcomes as well as the feasibility of the new model. Methodology: Since 1st of September of 2020 a total of 64 patients with breast cancer (BC) in different stages were attended in the exercise-oncology unit of the AECCmad using the online model. Firstly, a specialized nurse checked that all patients fulfilled the inclusion criteria to ensure BCP safeness. After this, all women had a one-to-one interview with the exercise-oncology professionals, face-to-face (F-F) or online, where anthropometrics (weight and high in virtual and bioimpedance in F-F interview) and functional capacity (6 minutes walking test, sit and stand in online interview, and that two as well as cardiorespiratory fitness, maximal strength and bioimpedance in F-F interview) were assessed to individualized exercise interventions. Then, BCP were enrolled in a 8-weeks online program adapted to their characteristics, where a specialist in exercise-oncology supervised each session, performing a combined exercise intervention from 50 to 90% of maximal heart rate. At the end, a final assessment was carried out with a twofold purpose: to inform patients of the achieved changes and to give them a personalized final report that would help women to continue exercising. Adherence of the program and physical variables collected in pre-post tests were analyzed. T test of related samples were used to compare pre-post assessments. Results 59 BCP with a mean of 45.7(10.03) years old completed the online program: 31.3% were survivors, 56.7% were under treatment and 12.5% had metastatic disease and 59% of the women had a F-F assessment, while the 41% were online. Related to the feasibility, program adherence was 92.2% (only 5 patients doped out the program) and classes assistance rate was 81%. BCP showed significant improvements in cardiorespiratory fitness (DifMean (ΔM): 8.56 ml.kg.min; CI95% 5.76 - 11.37; p=0.0001), strength in upper limbs (DifMean:11.38 kg; CI95%: 8.97 - 13.79; p=0.0001), and in legs (ΔM: 29.37 kg; CI95%: 23.93 - 34.82; p=0.0001) and in sit and stand test (ΔM: 4.53 squats; CI95%: 2.19 - 6.88; p=0.0001); and almost significant in distance of six minutes walking test (ΔM: 76.70 meters; CI95%: -4.80 - 158.21; p=0.064) Conclusions: Exercise-oncology online programs adapted to BCP characteristics are feasible and effective to significantly improve cardiorespiratory fitness and functional capacity. In addition, this type of programs might be a useful tool to achieve a healthy balance in BCP’s body composition. This new model of intervention not only presents high levels of adherence, but also, allows patients to access supervised exercise programs that otherwise would not be possible. Online intervention in exercise oncology might be a feasible, safe, and effective tool not only to improve BCP’s health but also for other cancer patients, in any stage of cancer. Citation Format: Soraya Casla-Barrio, Lucia Gil-Herrero, Monica Castellanos. Effectiveness and feasibility of exercise-oncology programs in breast cancer patients using new technologies adapted to the COVID 19 new normality [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P4-10-10.