This paper shows that our PREFERABLE exercise intervention resulted in significant positive effects fatigue and quality of life: Physical fatigue was significantly lower and quality of life significantly higher in the exercise group than in the control group at 6 months. In addition, beneficial effects on clinically relevant outcomes such as physical functioning, role functioning, physical fitness, dyspnea and pain were observed. These results demonstrate that supervised exercise has positive effects in patients with metastatic breast cancer and should be recommended as part of supportive care.

The first results from the PREFERABLE-EFFECT trial were unveiled at the San Antonio Breast Cancer Symposium (SABCS), held December 5-9, 2023. This publication contains the press release about this presentation, as well as the abstract submitted by Anne May. It was presented that, among patients with metastatic breast cancer, those who took part in a nine-month structured exercise program reported less fatigue and an improved quality of life compared to those who did not undergo the exercise program. We also found that the nine-month intervention was not only effective but may have encouraged longer-term compliance as well. Based on these findings, we suggest that physicians and nurses should routinely recommend supervised exercise to patients with metastatic breast cancer and that policymakers and insurance companies should ensure cost coverage for exercise programs.

The aim of the PERSPECTIVE survey was to identify patient’s perspectives on exercise and exercise programming. A total of 420 patients from Germany, Sweden, Poland, Spain and The Netherlands participated in a survey. The survey included questions about exercise knowledge and skills, outcome expectations, barriers to and facilitators of participation in exercise programs. Respondents expected exercise to have multiple physical benefits, but also experienced barriers to engage in exercise programs. Patients with metastatic breast cancer may benefit from personalized advice and appropriate training facilities to overcome these barriers.

In a case study, of one of our EFFECT participants, published in the October 2023 issue of Medicine & Science in Sports & Exercise, we describe that exercise trainers by the nature of their profession can detect small but important changes in motor function that patients, relatives or clinicians themselves may not be able to detect in the early stages of brain metastases. This highlights the value of adding supervised exercise to the treatment of patients with metastatic disease. Please find more details in the publication.

In July 2022, we published the study design of the multinational randomized controlled PREFERABLE-EFFECT study in Trials. The aim of this study is to assess the effects of a structured and individualized 9-month exercise intervention in patients with metastatic breast cancer on quality of life, fatigue, and other cancer- and treatment-related side effects. In this paper, you can read details on the study population, recruitment procedures, the primary and secondary outcomes and the design of the exercise intervention. This large randomized controlled trial will provide evidence regarding the (cost-) effectiveness of exercise during treatment of metastatic breast cancer.

The aim of the PERSPECTIVE focus group study was to gain a better understanding of the views of people with metastatic breast cancer on exercise programs. For this purpose, we conducted 11 group discussions with a total of 44 individuals from five European countries. The study revealed that patients with metastatic breast cancer were generally interested in supervised exercise, but experienced physical limitations and insecurities that inhibited their participation. Their individual conditions and needs, as well as varying preferences regarding exercise type and setting suggested that a one-size-fits-all approach to exercise is not advisable for this patient group. Instead, exercise programs should be adjusted to patients’ abilities and preferences and allow for flexibility.

This is the first exercise intervention study in cancer patients with spinal metastases at high risk of fracture. The intervention proved safe and feasible, given adaptations due to pain, immobility and weakness. Now, larger studies are needed to confirm safety and investigate exercise effects on clinical endpoints. @Patients: Please do not try these exercises alone but under 1:1 supervision by a qualified and experienced exercise professional only!