Exercise is beneficial for breast cancer survivors in alleviating treatment side effects,
improving quality of life, and possibly survival. Exercise guidelines for cancer
survivors recommend 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity
aerobic exercise per week and two days of resistance training. However, the number of
breast cancer survivors meeting those guidelines declines during treatments because of
symptoms such as fatigue, depression, muscle loss, and treatment toxicity. Mobile
applications (apps) are promising tools with the potential to overcome barriers to
exercise, such as cost, accessibility, time, and travel, which may reduce social health
inequalities. Distanced-based interventions, including mobile apps, yield noteworthy
results with favorable responses from cancer survivors. However, the literature provides
few details regarding the content and features of mobile apps, hindering the
understanding of the potential benefits for cancer survivors. The mobile app Cancer
Exercise, developed based on Social-Cognitive Theory incorporating several evidence-based
behavior change techniques, has been freely available to cancer survivors since 2020. No
study to date has examined the efficacy of any existing mobile app for increasing
exercise levels and improving outcomes of breast cancer survivors.
The primary aim of this study is to test the efficacy of the mobile app compared to usual
care in increasing exercise levels in breast cancer survivors. The secondary aims are to
(1) test the efficacy of the app for reducing fatigue and improving quality of life and
physical function, (2) examine the effects of the app on motivation, and (3) determine if
the app performs differently in diverse subgroups based on demographic (e.g., age,
education, ethnicity, and geography) and clinical variables (e.g., disease stage,
previous treatments). It was hypothesized that, compared to usual care, the Cancer
Exercise app would improve exercise, fatigue, quality of life, physical function, and
motivation, similarly across diverse subgroups.
Individuals diagnosed with stage I-III breast cancer (n=200) will be recruited through
the Alberta Cancer Registry and randomly assigned to the app intervention (n=100) or
usual care (n=100) receiving exercise guidelines. The goal of the intervention group will
be to perform at least 90 minutes of aerobic exercise and two days of resistance exercise
per week over 12 weeks. Exercise will be measured the Godin Leisure-Time Exercise
Questionnaire at baseline, 12 weeks, and 6 months. The European Organization for Research
and Treatment of Cancer (EORTC) core 30-item questionnaire (QLQ-C30) will measure quality
of life. Analysis of covariance will compare outcomes between groups while adjusting for
important demographic and clinical variables. Interactions (subgroup analysis) involving
demographic and clinical variables will also be explored.
This research will provide the first evidence of the efficacy of a mobile app for
increasing exercise in breast cancer survivors. The results will contribute to regulation
in designing app-based exercise interventions to minimize the potential risk of injury
and adverse outcomes for breast cancer survivors. With an effective and tested mobile
app, healthcare providers may leverage this resource to facilitate safe and easy exercise
referrals for patients.
