A world-first study has revealed that two hours of supervised exercise per week significantly benefits people with metastatic breast cancer, improving quality of life while reducing healthcare costs.
The PREFERABLE-EFFECT trial, involving 357 participants worldwide, including 135 Australians, is the most extensive exercise study conducted for this population. Participants completed a nine-month program of supervised aerobic, resistance, and balance exercises twice a week, compared to those following general activity advice. Participants in the supervised exercise program experienced significant improvements in quality of life, with reductions in debilitating symptoms such as fatigue, pain, and emotional distress, enabling them to lead fuller, more active lives.
Metastatic breast cancer is an advanced stage of the disease where cancer has spread beyond the breast. While treatable, it remains incurable and presents unique challenges for both treatment and quality of life. As the number of individuals diagnosed with metastatic breast cancer increases, so too do the associated costs, exceeding $1 billion annually in Australia. Investing in supportive care strategies, such as supervised exercise programs, is crucial for managing the cancer burden and mitigating disease- and treatment-related side effects. These findings published in the Journal of Clinical Oncology highlight the potential of such programs to alleviate both economic and healthcare challenges related to metastatic breast cancer lead Australian researcher, Melbourne exercise Physiologist Dr. Eva Zopf, emphasised the study's significance:
"These unique findings from our multinational PREFERABLE-EFFECT study are particularly important for healthcare providers, policymakers, and insurers. They demonstrate that supervised exercise for patients with metastatic breast cancer is not only beneficial in improving quality of life and reducing treatment-related side effects but also reduces healthcare costs."
Economic Benefits of Supervised Exercise
The study revealed cost-effectiveness benefits of the nine-month supervised exercise program compared to general activity advice. Cost savings were achieved through reductions in home care, day treatments, hospital admissions, and productivity losses. Notably, 44% of participants in the study were in paid employment, and the exercise group demonstrated lower productivity losses due to reduced absenteeism and presenteeism compared to the control group. Group-based programs delivered the greatest savings, approximately AUD 1,998 per patient, compared to AUD 261 for individual supervision.
"By demonstrating both clinical and economic benefits, we provide a compelling case for integrating these programs into standard care practices," said Dr. Zopf.
Advocacy for Evidence-Based Care
Breast Cancer Network Australia (BCNA) welcomed the findings, emphasising the need to prioritise people living with metastatic breast cancer by addressing their unmet needs.
"For people living with metastatic breast cancer, symptom management is a critical priority," said Vicki Durston, BCNA's Director of Policy, Advocacy & Support Services. "Managing symptoms such as fatigue, pain, and emotional distress is essential for improving quality of life. This study highlights that supportive care, like supervised exercise, needs to go beyond being recommended guidelines—it must become an integral part of clinical practice and care to address the unmet needs of people with an incurable disease."
A Call to Action
The study underscores the urgent need for national data collection and tailored care. Recent data from New South Wales revealed a higher number of people living with metastatic breast cancer than previously estimated, yet they remain underserved in research and healthcare planning.
By demonstrating both clinical and economic benefits, including reductions in productivity losses, the PREFERABLE-EFFECT trial provides a robust foundation for integrating supervised exercise programs into standard care practices. This approach offers a sustainable and cost-effective solution to manage the growing cancer care costs, improving outcomes for patients and reducing the financial burden on healthcare systems.
