Adrenal Hormone and Metabolic Biomarker Responses to 30 min of Intermittent Cycling Exercise in Breast Cancer Survivors

Abstract

The aim of this study was to explore the effect of one bout of aerobic exercise on epinephrine, norepinephrine, cortisol, glucose, lactate, and free fatty acid (FFA) responses in breast cancer survivors and healthy controls. 9 female breast cancer survivors and 9 women without a history of cancer completed 30 min of cycle ergometry exercise at 60% of VO_2peak. Blood samples were taken pre-exercise, immediately post-exercise, and 2 h post-exercise from which plasma concentrations of study variables were measured. Immediately and 2 h post-exercise, increases were observed in epinephrine (control group only) norepinephrine (both groups), lactate (both groups), and FFA (both groups immediately post-exercise; breast cancer survivor group only at 2 h post-exercise) (p<0.05). Cortisol decreased immediately and 2 h post-exercise in the control group while glucose decreased immediately post-exercise in the breast cancer survivor group (p<0.05). In conclusion, breast cancer survivors appeared to display attenuated epinephrine, cortisol, and lactate responses while displaying larger magnitude changes in glucose and FFA responses compared to controls. These preliminary findings may have implications for the regulation of metabolism during exercise in breast cancer survivors.

Key words

acute aerobic exercise - stress hormones - energy metabolism - oncology patients

• References

• 1 Aragona M, Muscatello MR, Losi E, Panetta S, La Torre F, Pastura G, Bertolani S, Mesiti M. Lymphocyte number and stress parameter modifications in untreated breast cancer patients with depressive mood and previous life stress. J Exp Ther Oncol 1996; 1: 354-360
• 2 Assessing cardiorespiratory fitness. In: Heyward VH. Advanced Fitness Assessment and Exercise Prescription. 5^th edn. Champaign: Human Kinetics; 2006: 55-91
• 3 Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc 1982; 14: 377-381
• 4 Bower JE, Ganz PA, Aziz N. Altered cortisol response to psychologic stress in breast cancer survivors with persistent fatigue. Psychosom Med 2005; 67: 277-280
• 5 Clinical exercise testing. In: Whaley MH, Brubaker PH, Otto RM. (eds.). ACSM’s Guidelines for Exercise Testing and Prescription. 7^th edn. Philadelphia: Lippincott Williams & Wilkins; 2006: 93-114
• 6 Cohen S, Williamson G. Perceived stress in a probability sample of the United States. In: Spacapan S, Oscamp S. (eds.) The Social Psychology of Health. Newberry Park: Sage; 1988: 31-68
• 7 Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav 1983; 24: 385-396
• 8 Demark-Wahnefried W, Case LD, Blackwell K, Marcom PK, Kraus W, Aziz N, Snyder DC, Giguere JK, Shaw E. Results of a diet/exercise feasibility trial to prevent adverse body composition change in breast cancer patients on adjuvant chemotherapy. Clin Breast Cancer 2008; 8: 70-79
• 9 Dill DB, Costill DL. Calculation of percentage changes in volumes of blood, plasma, and red cells in dehydration. J Appl Physiol 1974; 37: 247-248
• 10 Evans ES, Hackney AC, McMurray RG, Randell SH, Muss HB, Deal AM, Battaglini CL. Impact of acute intermittent exercise on natural killer cells in breast cancer survivors. Integr Cancer Ther 2015; 14: 436-445
• 11 Evans ES, Battaglini CL, Groff DG, Hackney AC. Aerobic exercise intensity in breast cancer patients: a preliminary investigation. Integr Cancer Ther 2009; 8: 139-147
• 12 Fairey AS, Courneya KS, Field CJ, Bell GJ, Jones LW, Mackey JR. Effects of exercise training on fasting insulin, insulin resistance, insulin-like growth factors, and insulin-like growth factor binding proteins in post-menopausal breast cancer survivors: a randomized controlled trial. Cancer Epidemiol Biomarkers Prev 2003; 12: 721-727
• 13 Fairey AS, Courneya KS, Field CJ, Mackey JR. Physical exercise and immune system function in cancer survivors: a comprehensive review and future directions. Cancer 2002; 94: 539-551
• 14 Fernandez-de-las-Peñas C, Cantarero-Villanueva I, Fernández-Lao C, Ambite-Quesada S, Díaz-Rodríguez L, Rivas-Martínez I, del Moral-Avila R, Arroyo-Morales M. Influence of catechol-O-methyltransferase genotype (Val158Met) on endocrine, sympathetic nervous and mucosal immune systems in breast cancer survivors. Breast 2012; 21: 199-203
• 15 Galvao DA, Taaffe DR, Spry N, Joseph D, Newton RU. Acute versus chronic exposure to androgen suppression for prostate cancer: impact on the exercise response. J Urol 2011; 186: 1291-1297
• 16 Galvao DA, Taaffe DR, Spry N, Joseph D, Newton RU. Combined resistance and aerobic exercise program reverses muscle loss in men undergoing androgen suppression therapy for prostate cancer without bone metastases: a randomized controlled trial. J Clin Oncol 2010; 28: 340-347
• 17 Galvao DA, Newton RU. Review of exercise intervention studies in cancer patients. J Clin Oncol 2005; 23: 899-909
• 18 Genazzani AR, Lombardi I, Borgioli G, di Bono I, Casarosa E, Gambacciani M, Palumbo M, Genazzani AD, Luisi M. Adrenal function under long-term raloxifene administration. Gynecol Endocrinol 2003; 17: 159-168
• 19 Harriss DJ, Atkinson G. Ethical standards in sport and exercise research: 2015 update. Int J Sports Med 2016; 36: 1121-1124
• 20 Hercshbach P, Keller M, Knight L, Brandl T, Huber B, Henrich G, Marten-Mittag B. Psychological problems of cancer patients: a cancer distress screening with a cancer-specific questionnaire. Br J Cancer 2004; 91: 504-511
• 21 Hughes DC, Leung P, Naus MJ. Using single-system analyses to assess the effectiveness of an exercise intervention on quality of life for Hispanic breast cancer survivors: a pilot study. Soc Work Health Care 2008; 47: 73-91
• 22 Järvelä LS, Kemppainen J, Niinikoski H, Hannukainen JC, Lähteenmäki PM, Kapanen J, Arola M, Heinonen OJ. Effects of a home-based exercise program on metabolic risk factors and fitness in long-term survivors of childhood acute lymphoblastic leukemia. Pediatr Blood Cancer 2012; 59: 155-160
• 23 Jones LW, Liang Y, Pituskin EN, Battaglini CL, Scott JM, Hornsby WE, Haykowsky M. Effect of exercise training on peak oxygen consumption in patients with cancer: a meta-analysis. Oncologist 2011; 16: 112-120
• 24 Jones LW, Peppercorn J, Scott JM, Battaglini C. Exercise therapy in the management of solid tumors. Curr Treat Options Oncol 2010; 11: 45-58
• 25 Jones LW, Haykowsky M, Pituskin EN, Jendzjowsky NG, Tomczak CR, Haennel RG, Mackey JR. Cardiovascular reserve and risk profile of postmenopausal women after chemoendocrine therapy for hormone receptor-positive operable breast cancer. Oncologist 2007; 12: 1156-1164
• 26 Kim CJ, Kang DH, Smith BA, Landers KA. Cardiopulmonary responses and adherence to exercise in women newly diagnosed with breast cancer undergoing adjuvant therapy. Cancer Nurs 2006; 29: 156-165
• 27 Ligibel JA, Campbell N, Partridge A, Chen WY, Salinardi T, Chen H, Adloff K, Keshaviah A, Winer EP. Impact of a mixed strength and endurance exercise intervention on insulin levels in breast cancer survivors. J Clin Oncol 2008; 26: 907-912
• 28 Makari-Judson G, Katz D, Barham R, Mertens W. Deleterious effect of chemotherapy on measures of insulin resistance in patients with newly-diagnosed invasive breast cancer. Cancer Res 2009; 69: 1054
• 29 McMurray RG, Hackney AC. Interactions of metabolic hormones, adipose tissue, and exercise. Sports Med 2006; 35: 393-412
• 30 McMurray RG, Hackney AC. Endocrine responses to exercise and training. In: Garrett WE, Kirdendall DT. (eds.) Exercise and Sport Science. Philadelphia: Lippincott Williams & Wilkins; 2000: 135-160
• 31 Neural-endocrine control of metabolism. In: Brooks GA, Fahey TD, Baldwin KM. Exercise Physiology: Bioenergetics and its Applications. 4^th edn. New York: McGraw-Hill; 2005: 181-212
• 32 Payne JK, Held J, Thorpe J, Shaw H. Effect of exercise on biomarkers, fatigue, sleep disturbances, and depressive symptoms in older women with breast cancer receiving hormonal therapy. Oncol Nurs Forum 2008; 35: 635-642
• 33 Pre-exercise evaluation. In: Whaley MH, Brubaker PH, Otto RM . (eds.) ACSM’s Guidelines for Exercise Testing and Prescription. 7^th edn. Philadelphia: Lippincott Williams & Wilkins; 2006: 39-54
• 34 Salman S, Kumbasar S, Kumtepe Y, Karaca M, Borekci B, Yildirim K, Alp HH, Cadirci E, Suleyman H. Role of adrenal gland hormones in the anti-inflammatory effect mechanism of tamoxifen, a partial antagonist for oestrogen receptors, and relation with COX levels. Gynecol Endocrinol 2011; 27: 241-247
• 35 Schmitz KH, Courneya KS, Matthews C, Demark-Wahnefried W, Galvão DA, Pinto BM, Irwin ML, Wolin KY, Segal RJ, Lucia A, Schneider CM, von Gruenigen VE, Schwartz AL. American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc 2010; 42: 1409-1426
• 36 Segal RJ, Reid RD, Courneya KS, Sigal RJ, Kenny GP, Prud’Homme DG, Malone SC, Wells GA, Scott CG, Slovinec D’Angelo ME. Randomized controlled trial of resistance or aerobic exercise in men receiving radiation therapy for prostate cancer. J Clin Oncol 2009; 27: 344-351
• 37 Spiegel D, Giese-Davis J, Taylor CB, Kraemer H. Stress sensitivity in metastatic breast cancer: analysis of hypothalamic-pituitary-adrenal axis function. Psychoneuroendocrinology 2006; 31: 1231-1244
• 38 Sprod LK, Janelsins MC, Palesh OG, Carroll JK, Heckler CE, Peppone LJ, Mohile SG, Morrow GR, Mustian KM. Health-related quality of life and biomarkers in breast cancer survivors participating in tai chi chuan. J Cancer Surviv 2012; 6: 146-154
• 39 Terjung R. Endocrine response to exercise. Exerc Sport Sci Rev 1979; 7: 153-180
• 40 Tosti KP, Hackney AC, Battaglini CL, Evans ES, Groff D. Exercise in patients with breast cancer and healthy controls: energy substrate oxidation and blood lactate responses. Integr Cancer Ther 2011; 10: 6-15
• 41 Touitou Y, Bogdan A, Lévi F, Benavides M, Auzéby A. Disruption of the circadian patterns of serum cortisol in breast and ovarian cancer patients: relationships with tumour marker antigens. Br J Cancer 1996; 74: 1248-1252