The Role of the Environment and Type of Exercise on Acute Adrenal Modulation and Perceived Distress of Breast Cancer Survivors Practising Light-Intensity Physical Exercise Adrenal Modulation & Perceived Distress of BC Survivors

Andrea Di Blasio (1), Teresa Morano (2), Federica Lancia (3), Gianluca Viscioni (4), Ines Bucci (5), Simona Grossi (6), Alessandra Cimini (7), Ettore Cianchetti (8), Sara Verrocchio (9), Pascal Izzcupo (10), Antonino Grassadonia (11), Giorgio Napolitano (12)
(1) Department of Medicine and Aging Sciences, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy, Italy,
(2) Department of Medicine and Aging Sciences, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy, Italy,
(3) Department of Medicine and Aging Sciences, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy, Italy,
(4) Department of Medicine and Aging Sciences, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy, Italy,
(5) Department of Medicine and Aging Sciences, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy, Italy,
(6) Department of General Surgery Specialised in Senology of the "G. Bernabeo" Hospital, Ortona, Italy, Italy,
(7) Department of General Surgery Specialised in Senology of the "G. Bernabeo" Hospital, Ortona, Italy, Italy,
(8) Department of General Surgery Specialised in Senology of the "G. Bernabeo" Hospital, Ortona, Italy, Italy,
(9) Department of Medicine and Aging Sciences, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy; Centre of Advanced Studies and Technology (CAST), "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy , Italy,
(10) Department of Medicine and Aging Sciences, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy, Italy,
(11) Department of Innovative Technologies in Medicine and Dentistry, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy, Italy,
(12) Department of Medicine and Aging Sciences, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy, Italy

Abstract

Background: Distress and adrenal balance of breast cancer survivors (BCS) are key elements of their psychophysical health, and increasing evidence has shown both physical exercise and the natural environment are effective for their modulation. The aim of the study was to evaluate the acute effects of the environment and type of light intensity workouts, on distress, salivary cortisol and dehydroepiandrosterone sulfate (DHEA-S) in BCS.
Methods: Twenty-four BCS participated in six different workouts, each with the same duration and intensity. Three of them were conducted in natural environments – walking (Wnature), canoeing with assistance (Cnature) and a mix of myofascial and yoga exercises (MYnature). The others were conducted in an urban environment, namely walking (Wurban), or an indoor environment, namely mobilisation and light upper body exercises (MCgym) and a mix of myofascial and yoga exercises (MYgym). Before and after each workout, the Distress Thermometer was completed and saliva was collected.
Results: Workouts practised in natural environments elicited a higher reduction in cortisol and the cortisol to DHEA-S ratio and a greater DHEA-S increase compared with workouts practised in urban and indoor environments. Overall, Cnature and MYnature were the best activities; among those practised in urban and indoor environments, MYgym elicited the best results. Distress was not acutely reduced after Wurban and MCgym.
Conclusion: Natural environments seem to provide the best management of distress, cortisol, DHEA-S and their balance when working out at light intensities. The simultaneous presence of forests and rivers seems to be the key element of the observed results.

Full text article

Generated from XML file

References

Agrawal S. Late effects of cancer treatment in breast cancer survivors. South Asian J Cancer. 2014 Apr;03(2):112–5. doi: 10.4103/2278-330X.175956.

Fassier P, Zelek L, Partula V, Srour B, Bachmann P, Touillaud M, et al. Variations of physical activity and sedentary behavior between before and after cancer diagnosis: results from the prospective population-based NutriNet-Santé cohort. Medicine (Baltimore). 2016 Oct;95(40):e4629. doi: 10.1097/MD.0000000000004629.

Wang XS, Woodruff JF. Cancer-related and treatment-related fatigue. Gynecol Oncol. 2015 Mar 1;136(3):446–52. doi: 10.1016/j.ygyno.2014.10.013.

Duregon F, Vendramin B, Bullo V, Gobbo S, Cugusi L, Di Blasio A, et al. Effects of exercise on cancer patients suffering chemotherapy-induced peripheral neuropathy undergoing treatment: A systematic review. Crit Rev Oncol Hematol. 2018 Jan;121:90–100. doi: 10.1016/j.critrevonc.2017.11.002.

Di Blasio A, Morano T, Cianchetti E, Gallina S, Bucci I, Di Santo S, et al. Psychophysical health status of breast cancer survivors and effects of 12 weeks of aerobic training. Complement Ther Clin Pract. 2017 May;27:19–26. doi: 10.1016/j.ctcp.2017.01.004.

Fabi A, Bhargava R, Fatigoni S, Guglielmo M, Horneber M, Roila F, et al. Cancer-related fatigue: ESMO Clinical Practice Guidelines for diagnosis and treatment. Ann Oncol Off J Eur Soc Med Oncol. 2020 Jun;31(6):713–23. doi: 10.1016/j.annonc.2020.02.016.

Fallone F, Deudon R, Muller C, Vaysse C. [Breast cancer, obesity and adipose tissue: a high-risk combination]. Med Sci MS. 2018 Dec;34(12):1079–86. doi: 10.1051/medsci/2018298.

Samuelsson LB, Bovbjerg DH, Roecklein KA, Hall MH. Sleep and circadian disruption and incident breast cancer risk: an evidence-based and theoretical review. Neurosci Biobehav Rev. 2018 Jan 1;84:35–48. doi: 10.1016/j.neubiorev.2017.10.011.

Patel AV, Friedenreich CM, Moore SC, Hayes SC, Silver JK, Campbell KL, et al. American College of Sports Medicine Roundtable Report on Physical Activity, Sedentary Behavior, and Cancer Prevention and Control. Med Sci Sports Exerc. 2019 Nov;51(11):2391–402. doi: 10.1249/MSS.0000000000002117.

Campbell KL, Winters-Stone KM, Wiskemann J, May AM, Schwartz AL, Courneya KS, et al. Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable. Med Sci Sports Exerc. 2019 Nov;51(11):2375–90. doi: 10.1249/MSS.0000000000002116.

Di Blasio A, Morano T, Lancia F, Viscioni G, Di Iorio A, Grossi S, et al. Effects of activity tracker-based counselling and live-web exercise on breast cancer survivors during Italy COVID-19 lockdown. J Funct Morphol Kinesiol. 2021 Jun;6(2):50. doi: 10.3390/jfmk6020050.

Di Blasio A, Morano T, Lancia F, Viscioni G, Di Iorio A, Grossi S, et al. Effects of activity tracker-based counselling and live-web exercise on breast cancer survivors’ sleep and waking time during Italy’s COVID-19 lockdown. Home Health Care Serv Q. 2021 Oct 15;1–19. doi: 10.1080/01621424.2021.1984362.

Di Blasio A, Morano T, Bucci I, Di Santo S, D’Arielli A, Castro CG, et al. Physical exercises for breast cancer survivors: effects of 10 weeks of training on upper limb circumferences. J Phys Ther Sci. 2016 Oct;28(10):2778–84. doi: 10.1589/jpts.28.2778.

Di Blasio A, Morano T, Napolitano G, Bucci I, Di Santo S, Gallina S, et al. Nordic walking and the Isa method for breast cancer survivors: effects on upper limb circumferences and total body extracellular water - a pilot study. Breast Care Basel Switz. 2016 Dec;11(6):428–31. doi: 10.1159/000453599.

Hilfiker R, Meichtry A, Eicher M, Nilsson Balfe L, Knols RH, Verra ML, et al. Exercise and other non-pharmaceutical interventions for cancer-related fatigue in patients during or after cancer treatment: a systematic review incorporating an indirect-comparisons meta-analysis. Br J Sports Med. 2018 May;52(10):651–8. doi: 10.1136/bjsports-2016-096422.

Sánchez-Lastra MA, Torres J, Martínez-Lemos I, Ayán C. Nordic walking for women with breast cancer: a systematic review. Eur J Cancer Care (Engl). 2019;28(6):e13130. doi: 10.1111/ecc.13130.

Kuo M. How might contact with nature promote human health? Promising mechanisms and a possible central pathway. Front Psychol. 2015;6:1093. doi: 10.3389/fpsyg.2015.01093.

Twohig-Bennett C, Jones A. The health benefits of the great outdoors: a systematic review and meta-analysis of greenspace exposure and health outcomes. Environ Res. 2018 Oct;166:628–37. doi: 10.1016/j.envres.2018.06.030.

Lesser IA, Nienhuis CP, Belanger L. Active by nature: exploring cancer survivors’ exercise barriers, facilitators, preferences, and psychosocial benefits of engaging in outdoor physical activity. Support Care Cancer. 2021 Jul;29(7):4095–103. doi: 10.1007/s00520-020-05938-4.

Triguero-Mas M, Gidlow CJ, Martínez D, de Bont J, Carrasco-Turigas G, Martínez-Íñiguez T, et al. The effect of randomised exposure to different types of natural outdoor environments compared to exposure to an urban environment on people with indications of psychological distress in Catalonia. PLoS One. 2017;12(3):e0172200. doi: 10.1371/journal.pone.0172200.

Godoy LD, Rossignoli MT, Delfino-Pereira P, Garcia-Cairasco N, de Lima Umeoka EH. A comprehensive overview on stress neurobiology: basic concepts and clinical implications. Front Behav Neurosci. 2018;12:127. doi: 10.3389/fnbeh.2018.00127.

Carlson LE, Speca M, Patel KD, Goodey E. Mindfulness-based stress reduction in relation to quality of life, mood, symptoms of stress and levels of cortisol, dehydroepiandrosterone sulfate (DHEAS) and melatonin in breast and prostate cancer outpatients. Psychoneuroendocrinology. 2004 May;29(4):448–74. doi: 10.1016/s0306-4530(03)00054-4.

Gallicchio L, MacDonald R, Wood B, Rushovich E, Helzlsouer KJ. Androgens and musculoskeletal symptoms among breast cancer patients on aromatase inhibitor therapy. Breast Cancer Res Treat. 2011 Nov 1;130(2):569–77. doi: 10.1007/s10549-011-1611-2.

Li H, Marsland AL, Conley YP, Sereika SM, Bender CM. Genes involved in the HPA axis and the symptom cluster of fatigue, depressive symptoms, and anxiety in women with breast cancer during 18 months of adjuvant therapy. Biol Res Nurs. 2020 Apr;22(2):277–86. doi: 10.1177/1099800419899727.

Bulli F, Miccinesi G, Maruelli A, Katz M, Paci E. The measure of psychological distress in cancer patients: the use of Distress Thermometer in the Oncological Rehabilitation Center of Florence. Support Care Cancer. 2009 Jul 1;17(7):771–9. doi: 10.1007/s00520-008-0543-9.

Riba MB, Donovan KA, Andersen B, Braun Ii, Breitbart WS, Brewer BW, et al. Distress Management, Version 3.2019, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Cancer Netw JNCCN. 2019 Oct 1;17(10):1229–49. doi: 10.6004/jnccn.2019.0048.

Mayers A. Introduction to statistics and SPSS in psychology. Harlow: Pearson; 2013.

Lee J, Park B-J, Tsunetsugu Y, Ohira T, Kagawa T, Miyazaki Y. Effect of forest bathing on physiological and psychological responses in young Japanese male subjects. Public Health. 2011 Feb 1;125(2):93–100. doi: 10.1016/j.puhe.2010.09.005.

Tsunetsugu Y, Lee J, Park B-J, Tyrväinen L, Kagawa T, Miyazaki Y. Physiological and psychological effects of viewing urban forest landscapes assessed by multiple measurements. Landsc Urban Plan. 2013 May 1;113:90–3. doi: 10.1016/j.landurbplan.2013.01.014.

Gladwell VF, Brown DK, Barton JL, Tarvainen MP, Kuoppa P, Pretty J, et al. The effects of views of nature on autonomic control. Eur J Appl Physiol. 2012 Sep;112(9):3379–86. doi: 10.1007/s00421-012-2318-8.

Brown DK, Barton JL, Gladwell VF. Viewing nature scenes positively affects recovery of autonomic function following acute-mental stress. Environ Sci Technol. 2013 Jun 4;47(11):5562–9. doi: 10.1021/es305019p.

Berto R. Exposure to restorative environments helps restore attentional capacity. J Environ Psychol. 2005 Sep 1;25(3):249–59. doi: 10.1016/j.jenvp.2005.07.001.

Alvarsson JJ, Wiens S, Nilsson ME. Stress recovery during exposure to nature sound and environmental noise. Int J Environ Res Public Health. 2010 Mar;7(3):1036–46. doi: 10.3390/ijerph7031036.

Franco LS, Shanahan DF, Fuller RA. A Review of the Benefits of Nature Experiences: More Than Meets the Eye. Int J Environ Res Public Health. 2017 Aug 1;14(8):E864. doi: 10.3390/ijerph14080864.

Suzuki S, Yanagita S, Amemiya S, Kato Y, Kubota N, Ryushi T, et al. Effects of negative air ions on activity of neural substrates involved in autonomic regulation in rats. Int J Biometeorol. 2008 Jul 1;52(6):481–9. doi: 10.1007/s00484-007-0143-2.

Barton J, Pretty J. What is the best dose of nature and green exercise for improving mental health? A multi-study analysis. Environ Sci Technol. 2010 May 15;44(10):3947–55. doi: 10.1021/es903183r.

Annerstedt M, Jönsson P, Wallergård M, Johansson G, Karlson B, Grahn P, et al. Inducing physiological stress recovery with sounds of nature in a virtual reality forest — results from a pilot study. Physiol Behav. 2013 Jun 13;118:240–50. doi: 10.1016/j.physbeh.2013.05.023.

Gerritsen RJS, Band GPH. Breath of life: the respiratory vagal stimulation model of contemplative activity. Front Hum Neurosci. 2018;12:397. doi: 10.3389/fnhum.2018.00397.

Mazgelytė E, Chomentauskas G, Dereškevičiūtė E, Rekienė V, Jakaitienė A, Petrėnas T, et al. Association of salivary steroid hormones and their ratios with time-domain heart rate variability indices in healthy individuals. J Med Biochem. 2021 Mar 12;40(2):173–80. doi: 10.5937/jomb0-26045.

Kaplan R, Kaplan S. The Experience of Nature: A Psychological Perspective. CUP Archive; 1989.

Ulrich RS, Simons RF, Losito BD, Fiorito E, Miles MA, Zelson M. Stress recovery during exposure to natural and urban environments. J Environ Psychol. 1991 Sep 1;11(3):201–30. doi: 10.1016/S0272-4944(05)80184-7.

Authors

Andrea Di Blasio
andrea.diblasio@unich.it (Primary Contact)
Teresa Morano
Federica Lancia
Gianluca Viscioni
Ines Bucci
Simona Grossi
Alessandra Cimini
Ettore Cianchetti
Sara Verrocchio
Pascal Izzcupo
Antonino Grassadonia
Giorgio Napolitano
1.
Di Blasio A, Morano T, Lancia F, Viscioni G, Bucci I, Grossi S, Cimini A, Cianchetti E, Verrocchio S, Izzcupo P, Grassadonia A, Napolitano G. The Role of the Environment and Type of Exercise on Acute Adrenal Modulation and Perceived Distress of Breast Cancer Survivors Practising Light-Intensity Physical Exercise: Adrenal Modulation & Perceived Distress of BC Survivors. Arch Breast Cancer [Internet]. 2022 Mar. 4 [cited 2024 Apr. 22];9(2):152-61. Available from: https://archbreastcancer.com/index.php/abc/article/view/514

Article Details