The effect of a therapeutic exercise program "life in balance" on the quality of life in a patient with metastatic breast cancer: A case report

Background and Purpose: Because of the increasing number of incurable but not terminally ill patients with cancer around the world, there is a growing need for care and treatment of the side effects of the disease. The Elkerliek Hospital in The Netherlands, a medium sized community hospital in Helmond, The Netherlands, developed a 9-week exercise program specifically aimed at incurable patients with cancer, called "Life in Balance." This case report aims to illustrate the effects of the program on the quality of life of a patient with incurable breast cancer. Case Description: We describe a 41-year-old woman with breast cancer and spine-metastases who participated in the program. Outcome: Outcome measures were exercise capacity (6 minute walking test) and Quality of Life (RAND-36). After the intervention there were improvements in all 3 main dimensions of the RAND-36: "functional status," "well-being," and "general health evaluation." The 6 minute walk test (6MWT) also showed a clinically relevant improvement (42%) from baseline. For the patient described in this report, the results of the Life In Balance-program showed a reasonable improvement in self-reported quality of life and walking ability. Discussion: The positive results described in this case report may in part be attributable to the exercise program, but also to factors unrelated to exercise, such as attention and support from fellow patients in the program. The program could be further improved in terms of frequency and duration. Randomized controlled trials are needed to establish efficacy of multimodal programs for incurable patients with cancer.