human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background : Substantial numbers of cancer patients use complementary medicine therapies , even without a supportive evidence base . This study aim ed to evaluate in a r and omized controlled trial , the use of Medical Qigong ( MQ ) compared with usual care to improve the quality of life ( QOL ) of cancer patients . Patients and methods : One hundred and sixty-two patients with a range of cancers were recruited .  QOL and fatigue were measured by Functional Assessment of Cancer Therapy — General and Functional Assessment of Cancer Therapy — Fatigue , respectively , and mood status by Profile of Mood State . The inflammatory marker serum C-reactive protein ( CRP ) was monitored serially . Results : Regression analysis indicated that the MQ group significantly improved overall QOL ( t144 = −5.761 , P < 0.001 ) , fatigue ( t153 = −5.621 , P < 0.001 ) , mood disturbance ( t122 = 2.346 , P = 0.021 ) and inflammation ( CRP ) ( t99 = 2.042 , P < 0.044 ) compared with usual care after controlling for baseline variables . Conclusions : This study indicates that MQ can improve  cancer patients  ’ overall QOL and mood status and reduce specific side-effects of treatment . It may also produce physical benefits in the long term through reduced inflammation Background : This r and omized controlled trial assessed the safety and effects of twice-weekly weight training among recent breast cancer survivors . Outcomes included body size and biomarkers hypothesized to link exercise and breast cancer risk . Methods : A convenience sample of 85 recent survivors was r and omized into immediate and delayed treatment groups . The immediate group trained from months 0 to 12 ; the delayed treatment group served as a no exercise parallel comparison group from months 0 to 6 and trained from months 7 to 12 . Measures at baseline , 6 and 12 months included body weight , height , body fat , lean mass , body fat % , and waist circumference , as well as fasting glucose , insulin , insulin resistance , insulin-like growth factor-I ( IGF-I ) , IGF-II , and IGF-binding protein-1 , IGFBP-2 , and IGFBP-3 . Injury reporting was st and ardized . Results : The intervention result ed in significant increases in lean mass ( 0.88 versus 0.02 kg , P < 0.01 ) , as well as significant decreases in body fat % ( −1.15 % versus 0.23 % , P = 0.03 ) and IGF-II ( −6.23 versus 28.28 ng/mL , P = 0.02 ) comparing immediate with delayed treatment from baseline to 6 months . Within-person changes experienced by delayed treatment group participants during training versus no training were similar . Only one participant experienced a study related injury that prevented continued participation . Conclusion : Twice-weekly weight training is a safe exercise program for recent breast cancer survivors that may result in increased muscle mass , as well as decreased body fat % and IGF-II . The implication s of these results on cancer recurrence or survival may become more evident with longer exercise intervention trials among breast cancer survivors Background Women who develop secondary arm lymphoedema subsequent to treatment associated with breast cancer require life-long management for a range of symptoms including arm swelling , heaviness , tightness in the arm and sometimes the chest , upper body impairment and changes to a range of parameters relating to quality of life . While exercise under controlled conditions has had positive outcomes , the impact of yoga has not been investigated . The aim of this study is to determine the effectiveness of yoga in the physical and psycho-social domains , in the hope that women can be offered another safe , holistic modality to help control many , if not all , of the effects of secondary arm lymphoedema . Methods and design A r and omised controlled pilot trial will be conducted in Hobart and Launceston with a total of 40 women receiving either yoga intervention or current best practice care .  Intervention will consist of eight weeks of a weekly teacher-led yoga class with a home-based daily yoga practice delivered by DVD . Primary outcome measures will be the effects of yoga on lymphoedema and its associated symptoms and quality of life . Secondary outcome measures will be range of motion of the arm and thoracic spine , shoulder strength , and weekly and daily physical activity . Primary and secondary outcomes will be measured at baseline , weeks four , eight and a four week follow up at week twelve . Range of motion of the spine , in a self-nominated group , will be measured at baseline , weeks eight and twelve . A further outcome will be the women ’s perceptions of the yoga collected by interview at week eight . Discussion The results of this trial will provide information on the safety and effectiveness of yoga for women with secondary arm lymphoedema from breast cancer treatment . It will also inform methodology for future , larger trials . Trial registration Physical activity is associated with improved breast cancer survival , but the underlying mechanisms , possibly including modification of the inflammatory state , are not well understood . We analyzed changes in interleukin (IL)-6 , C-reactive protein ( CRP ) , and TNF-α in a r and omized controlled trial of exercise in postmenopausal breast cancer survivors . Seventy-five women , recruited through the Yale-New Haven Hospital Tumor Registry , were r and omized to either a six-month aerobic exercise intervention or usual care . Correlations were calculated between baseline cytokines , adiposity , and physical activity measures . Generalized linear models were used to assess the effect of exercise  on IL-6 , CRP , and TNF-α . At baseline , IL-6 and CRP were positively correlated with body fat and body mass index ( BMI ) and were inversely correlated with daily pedometer steps ( P < 0.001 ) . We found no significant effect of exercise  on changes in inflammatory marker concentrations between women r and omized to exercise versus usual care , though secondary analyses revealed a significant reduction in IL-6 among exercisers who reached 80 % of the intervention goal compared with those who did not . Future studies should examine the effect of different types and doses of exercise and weight loss on inflammatory markers in large-scale trials of women diagnosed with breast cancer . Cancer Prev Res ; 6(2 ) ; 109–18 . © 2012 AACR PURPOSE / OBJECTIVES To evaluate the effects of 10 weeks of aerobic exercise on depressive and anxiety symptoms and self-esteem of breast cancer survivors . DESIGN Experimental , crossover . SETTING Midwestern university town . SAMPLE Twenty-four breast cancer survivors ( mean time following surgery 41.8 months ; ranging from 1 to 99 months ) recruited via mail and cancer support groups . The mean age of the sample was 48.9 years . METHODS Subjects were assigned r and omly into exercise ( EX ) , exercise-plus-behavior modification ( EX + BM ) , and control groups . EX and EX + BM groups exercised aerobically four days/week at > or = 60 % of age-predicted maximum heart rate for 10 weeks . Data were collected pretest , post-test , and crossover ( 12 weeks following post-test ) . Because pretest or post-test scores showed no statistical differences between EX and EX + BM groups , data were combined to form one group . MAIN RESEARCH VARIABLES Aerobic exercise ( four days/ week ; 30 - 40 minutes/session ) , depression , ( Beck Depression inventory ) , anxiety ( Speilberger State-Trait Anxiety Inventory ) , and self-esteem ( Rosenberg Self-Esteem Inventory ) . FINDINGS Pre- to post-test analyses revealed that women who exercised had significantly less depression and state and trait anxiety over time compared to controls . After the crossover , the control group demonstrated comparable improvements in both depressive and state anxiety scores . Self-esteem did not change significantly . Subjects who received exercise recommendations from their physicians exercised significantly more than subjects who received no recommendation . CONCLUSIONS Mild to moderate aerobic exercise may be of therapeutic value to breast cancer survivors with respect to depressive and anxiety symptoms but not to self-esteem . A physician 's recommendation to exercise appears to be an important factor in a patient 's exercise adherence . IMPLICATION S FOR NURSING PRACTICE To Improve depressive and anxiety symptoms following breast cancer surgery , healthcare professionals should consider recommending mild to moderate exercise Goals of workOur aim was to compare the effects of l and versus water multimodal exercise programs on body composition and breast cancer-specific quality of life in breast cancer survivors . Patients and methods Ninety-eight breast cancer survivors were assigned to three groups : control , l and exercise , and water exercise . Both exercise groups participated in an 8-week multimodal program . Adiposity was measured by anthropometry ( body mass index , waist circumference ) and bioelectrical impedance ( body fat and muscle lean body mass ) . Incidence of clinical ly significant secondary lymphedema was also assessed . Finally , specific quality of life was assessed using the European Organization for Research and Treatment of Cancer Quality of Life BR-23.Main Results Using ANCOVA , significant group × time interactions for body fat percentage ( F = 3.376 ; P = 0.011 ) and lean body mass ( F = 3.566 ; P = 0.008 ) were found . Breast cancer survivors in the l and exercise group exhibited a greater decrease in percentage of body fat than those in the water exercise ( P < 0.001 ) and control ( P = 0.002 ) groups . The ANCOVA revealed a significant group × time interaction for waist circumference ( F = 4.553 ; P = 0.002 ) : breast cancer survivors in the control group showed a greater waist circumference when compared to water ( P = 0.003 ) and l and ( P < 0.001 ) exercise groups . A significant group × time interaction was also found for breast symptoms ( F = 9.048 ; P < 0.001 ) : participants in the water exercise group experienced a greater decrease of breast symptoms than those in the l and exercise ( P < 0.01 ) and control ( P < 0.05 ) groups . Conclusion L and exercise produced a greater decrease in body fat and an increase in lean body mass , whereas water exercise was better for improving breast symptoms Observational studies demonstrate an association between physical activity and improved outcomes in breast and colon cancer survivors . To test these observations with a large , r and omized clinical trial , an intervention that significantly impacts physical activity in these patients is needed . The Active After Cancer Trial ( AACT ) was a multicenter pilot study evaluating the feasibility of a telephone-based exercise intervention in a cooperative group setting . Sedentary ( engaging in < 60 min of recreational activity/week ) breast and colorectal cancer survivors were r and omized to a telephone-based exercise intervention or usual care control group . The intervention was delivered through the University of California at San Diego ; participants received ten phone calls over the course of the 16-week intervention . All participants underwent assessment of physical activity , fitness , physical functioning , fatigue and exercise self-efficacy at baseline and after the 16-week intervention . One hundred and twenty-one patients were enrolled through ten Cancer and Leukemia Group B ( CALGB ) institutions ; 100 patients had breast cancer and 21 had colorectal cancer . Participants r and omized to the exercise group increased physical activity by more than 100 versus 22 % in controls ( 54.5 vs. 14.6 min , P = 0.13 ) , and experienced significant increases in fitness ( increased 6-min walk test distance by 186.9 vs. 81.9 feet , P = 0.006 ) and physical functioning ( 7.1 vs. 2.6 , P = 0.04 ) as compared to the control group . Breast and colorectal cancer survivors enrolled in a multicenter , telephone-based physical activity intervention  increased physical activity and experienced significant improvements in fitness and physical functioning . Lifestyle intervention research is feasible in a cooperative group setting BACKGROUND AND OBJECTIVES This pilot project assessed the acceptability of a mixed-type , moderate-intensity exercise programme  following breast cancer treatment , and the impact on presence of lymphoedema , fitness , body composition , fatigue , mood and quality of life . METHODS Ten women completed the programme and measures of fitness ( sub-maximal ergometer test ) , body composition ( bio-electrical impedance ) , lympoedema ( bio-electrical impedance and arm circumferences ) , fatigue ( revised Piper Fatigue Scale ) , mood ( Hospital Anxiety and Depression Scale ) , quality of life ( FACT-B ) and general well-being , at baseline , completion of the programme , and 6-week and 3-month follow-up . RESULTS Participation in the programme caused no adverse effect on the presence of lymphoedema . There was a trend towards reduction in fatigue and improved quality of life across the testing phases . Women rated the programme extremely favourably , citing benefits of the support of other women , trained guidance , and the opportunity to experience different types of exercise . CONCLUSIONS A mixed-type , moderate-intensity exercise program in a group format is acceptable to women following breast cancer treatment , with the potential to reduce fatigue and improve quality of life , without exacerbating or precipitating lymphoedema . This pilot work needs to be confirmed in larger r and omised studies PURPOSE The primary purpose of this study was to examine the effect of aerobic exercise on physiological and psychological function in patients rehabilitating from cancer treatment . A second purpose was to evaluate the differential effects of low- and moderate-intensity exercise on these variables . METHODS Eighteen survivors of breast or colon cancer ( 15 female and 3 male , 40 - 65 yr of age ) served as subjects . The subjects were matched by aerobic capacity and scores on a Quality of Life 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background : Substantial numbers of cancer patients use complementary medicine therapies , even without a supportive evidence base . This study aim ed to evaluate in a r and omized controlled trial , the use of Medical Qigong ( MQ ) compared with usual care to improve the quality of life ( QOL ) of cancer patients . Patients and methods : One hundred and sixty-two patients with a range of cancers were recruited .  QOL and fatigue were measured by Functional Assessment of Cancer Therapy — General and Functional Assessment of Cancer Therapy — Fatigue , respectively , and mood status by Profile of Mood State . The inflammatory marker serum C-reactive protein ( CRP ) was monitored serially . Results : Regression analysis indicated that the MQ group significantly improved overall QOL ( t144 = −5.761 , P < 0.001 ) , fatigue ( t153 = −5.621 , P < 0.001 ) , mood disturbance ( t122 = 2.346 , P = 0.021 ) and inflammation ( CRP ) ( t99 = 2.042 , P < 0.044 ) compared with usual care after controlling for baseline variables . Conclusions : This study indicates that MQ can improve  cancer patients  ’ overall QOL and mood status and reduce specific side-effects of treatment . It may also produce physical benefits in the long term through reduced inflammation Background : This r and omized controlled trial assessed the safety and effects of twice-weekly weight training among recent breast cancer survivors . Outcomes included body size and biomarkers hypothesized to link exercise and breast cancer risk . Methods : A convenience sample of 85 recent survivors was r and omized into immediate and delayed treatment groups . The immediate group trained from months 0 to 12 ; the delayed treatment group served as a no exercise parallel comparison group from months 0 to 6 and trained from months 7 to 12 . Measures at baseline , 6 and 12 months included body weight , height , body fat , lean mass , body fat % , and waist circumference , as well as fasting glucose , insulin , insulin resistance , insulin-like growth factor-I ( IGF-I ) , IGF-II , and IGF-binding protein-1 , IGFBP-2 , and IGFBP-3 . Injury reporting was st and ardized . Results : The intervention result ed in significant increases in lean mass ( 0.88 versus 0.02 kg , P < 0.01 ) , as well as significant decreases in body fat % ( −1.15 % versus 0.23 % , P = 0.03 ) and IGF-II ( −6.23 versus 28.28 ng/mL , P = 0.02 ) comparing immediate with delayed treatment from baseline to 6 months . Within-person changes experienced by delayed treatment group participants during training versus no training were similar . Only one participant experienced a study related injury that prevented continued participation . Conclusion : Twice-weekly weight training is a safe exercise program for recent breast cancer survivors that may result in increased muscle mass , as well as decreased body fat % and IGF-II . The implication s of these results on cancer recurrence or survival may become more evident with longer exercise intervention trials among breast cancer survivors Background Women who develop secondary arm lymphoedema subsequent to treatment associated with breast cancer require life-long management for a range of symptoms including arm swelling , heaviness , tightness in the arm and sometimes the chest , upper body impairment and changes to a range of parameters relating to quality of life . While exercise under controlled conditions has had positive outcomes , the impact of yoga has not been investigated . The aim of this study is to determine the effectiveness of yoga in the physical and psycho-social domains , in the hope that women can be offered another safe , holistic modality to help control many , if not all , of the effects of secondary arm lymphoedema . Methods and design A r and omised controlled pilot trial will be conducted in Hobart and Launceston with a total of 40 women receiving either yoga intervention or current best practice care .  Intervention will consist of eight weeks of a weekly teacher-led yoga class with a home-based daily yoga practice delivered by DVD . Primary outcome measures will be the effects of yoga on lymphoedema and its associated symptoms and quality of life . Secondary outcome measures will be range of motion of the arm and thoracic spine , shoulder strength , and weekly and daily physical activity . Primary and secondary outcomes will be measured at baseline , weeks four , eight and a four week follow up at week twelve . Range of motion of the spine , in a self-nominated group , will be measured at baseline , weeks eight and twelve . A further outcome will be the women ’s perceptions of the yoga collected by interview at week eight . Discussion The results of this trial will provide information on the safety and effectiveness of yoga for women with secondary arm lymphoedema from breast cancer treatment . It will also inform methodology for future , larger trials . Trial registration Physical activity is associated with improved breast cancer survival , but the underlying mechanisms , possibly including modification of the inflammatory state , are not well understood . We analyzed changes in interleukin (IL)-6 , C-reactive protein ( CRP ) , and TNF-α in a r and omized controlled trial of exercise in postmenopausal breast cancer survivors . Seventy-five women , recruited through the Yale-New Haven Hospital Tumor Registry , were r and omized to either a six-month aerobic exercise intervention or usual care . Correlations were calculated between baseline cytokines , adiposity , and physical activity measures . Generalized linear models were used to assess the effect of exercise  on IL-6 , CRP , and TNF-α . At baseline , IL-6 and CRP were positively correlated with body fat and body mass index ( BMI ) and were inversely correlated with daily pedometer steps ( P < 0.001 ) . We found no significant effect of exercise  on changes in inflammatory marker concentrations between women r and omized to exercise versus usual care , though secondary analyses revealed a significant reduction in IL-6 among exercisers who reached 80 % of the intervention goal compared with those who did not . Future studies should examine the effect of different types and doses of exercise and weight loss on inflammatory markers in large-scale trials of women diagnosed with breast cancer . Cancer Prev Res ; 6(2 ) ; 109–18 . © 2012 AACR PURPOSE / OBJECTIVES To evaluate the effects of 10 weeks of aerobic exercise on depressive and anxiety symptoms and self-esteem of breast cancer survivors . DESIGN Experimental , crossover . SETTING Midwestern university town . SAMPLE Twenty-four breast cancer survivors ( mean time following surgery 41.8 months ; ranging from 1 to 99 months ) recruited via mail and cancer support groups . The mean age of the sample was 48.9 years . METHODS Subjects were assigned r and omly into exercise ( EX ) , exercise-plus-behavior modification ( EX + BM ) , and control groups . EX and EX + BM groups exercised aerobically four days/week at > or = 60 % of age-predicted maximum heart rate for 10 weeks . Data were collected pretest , post-test , and crossover ( 12 weeks following post-test ) . Because pretest or post-test scores showed no statistical differences between EX and EX + BM groups , data were combined to form one group . MAIN RESEARCH VARIABLES Aerobic exercise ( four days/ week ; 30 - 40 minutes/session ) , depression , ( Beck Depression inventory ) , anxiety ( Speilberger State-Trait Anxiety Inventory ) , and self-esteem ( Rosenberg Self-Esteem Inventory ) . FINDINGS Pre- to post-test analyses revealed that women who exercised had significantly less depression and state and trait anxiety over time compared to controls . After the crossover , the control group demonstrated comparable improvements in both depressive and state anxiety scores . Self-esteem did not change significantly . Subjects who received exercise recommendations from their physicians exercised significantly more than subjects who received no recommendation . CONCLUSIONS Mild to moderate aerobic exercise may be of therapeutic value to breast cancer survivors with respect to depressive and anxiety symptoms but not to self-esteem . A physician 's recommendation to exercise appears to be an important factor in a patient 's exercise adherence . IMPLICATION S FOR NURSING PRACTICE To Improve depressive and anxiety symptoms following breast cancer surgery , healthcare professionals should consider recommending mild to moderate exercise Goals of workOur aim was to compare the effects of l and versus water multimodal exercise programs on body composition and breast cancer-specific quality of life in breast cancer survivors . Patients and methods Ninety-eight breast cancer survivors were assigned to three groups : control , l and exercise , and water exercise . Both exercise groups participated in an 8-week multimodal program . Adiposity was measured by anthropometry ( body mass index , waist circumference ) and bioelectrical impedance ( body fat and muscle lean body mass ) . Incidence of clinical ly significant secondary lymphedema was also assessed . Finally , specific quality of life was assessed using the European Organization for Research and Treatment of Cancer Quality of Life BR-23.Main Results Using ANCOVA , significant group × time interactions for body fat percentage ( F = 3.376 ; P = 0.011 ) and lean body mass ( F = 3.566 ; P = 0.008 ) were found . Breast cancer survivors in the l and exercise group exhibited a greater decrease in percentage of body fat than those in the water exercise ( P < 0.001 ) and control ( P = 0.002 ) groups . The ANCOVA revealed a significant group × time interaction for waist circumference ( F = 4.553 ; P = 0.002 ) : breast cancer survivors in the control group showed a greater waist circumference when compared to water ( P = 0.003 ) and l and ( P < 0.001 ) exercise groups . A significant group × time interaction was also found for breast symptoms ( F = 9.048 ; P < 0.001 ) : participants in the water exercise group experienced a greater decrease of breast symptoms than those in the l and exercise ( P < 0.01 ) and control ( P < 0.05 ) groups . Conclusion L and exercise produced a greater decrease in body fat and an increase in lean body mass , whereas water exercise was better for improving breast symptoms Observational studies demonstrate an association between physical activity and improved outcomes in breast and colon cancer survivors . To test these observations with a large , r and omized clinical trial , an intervention that significantly impacts physical activity in these patients is needed . The Active After Cancer Trial ( AACT ) was a multicenter pilot study evaluating the feasibility of a telephone-based exercise intervention in a cooperative group setting . Sedentary ( engaging in < 60 min of recreational activity/week ) breast and colorectal cancer survivors were r and omized to a telephone-based exercise intervention or usual care control group . The intervention was delivered through the University of California at San Diego ; participants received ten phone calls over the course of the 16-week intervention . All participants underwent assessment of physical activity , fitness , physical functioning , fatigue and exercise self-efficacy at baseline and after the 16-week intervention . One hundred and twenty-one patients were enrolled through ten Cancer and Leukemia Group B ( CALGB ) institutions ; 100 patients had breast cancer and 21 had colorectal cancer . Participants r and omized to the exercise group increased physical activity by more than 100 versus 22 % in controls ( 54.5 vs. 14.6 min , P = 0.13 ) , and experienced significant increases in fitness ( increased 6-min walk test distance by 186.9 vs. 81.9 feet , P = 0.006 ) and physical functioning ( 7.1 vs. 2.6 , P = 0.04 ) as compared to the control group . Breast and colorectal cancer survivors enrolled in a multicenter , telephone-based physical activity intervention  increased physical activity and experienced significant improvements in fitness and physical functioning . Lifestyle intervention research is feasible in a cooperative group setting BACKGROUND AND OBJECTIVES This pilot project assessed the acceptability of a mixed-type , moderate-intensity exercise programme  following breast cancer treatment , and the impact on presence of lymphoedema , fitness , body composition , fatigue , mood and quality of life . METHODS Ten women completed the programme and measures of fitness ( sub-maximal ergometer test ) , body composition ( bio-electrical impedance ) , lympoedema ( bio-electrical impedance and arm circumferences ) , fatigue ( revised Piper Fatigue Scale ) , mood ( Hospital Anxiety and Depression Scale ) , quality of life ( FACT-B ) and general well-being , at baseline , completion of the programme , and 6-week and 3-month follow-up . RESULTS Participation in the programme caused no adverse effect on the presence of lymphoedema . There was a trend towards reduction in fatigue and improved quality of life across the testing phases . Women rated the programme extremely favourably , citing benefits of the support of other women , trained guidance , and the opportunity to experience different types of exercise . CONCLUSIONS A mixed-type , moderate-intensity exercise program in a group format is acceptable to women following breast cancer treatment , with the potential to reduce fatigue and improve quality of life , without exacerbating or precipitating lymphoedema . This pilot work needs to be confirmed in larger r and omised studies PURPOSE The primary purpose of this study was to examine the effect of aerobic exercise on physiological and psychological function in patients rehabilitating from cancer treatment . A second purpose was to evaluate the differential effects of low- and moderate-intensity exercise on these variables . METHODS Eighteen survivors of breast or colon cancer ( 15 female and 3 male , 40 - 65 yr of age ) served as subjects . The subjects were matched by aerobic capacity and scores on a Quality of Life 
    Output:
    