In a groundbreaking randomized controlled trial conducted in the United Arab Emirates (UAE), researchers have demonstrated that a structured, two-month physical rehabilitation program significantly enhances cardiorespiratory fitness and health-related quality of life (HRQoL) among breast cancer survivors. This pivotal study, published in BMC Cancer, highlights a crucial step toward addressing the often overlooked cardiovascular challenges faced by breast cancer survivors, a group whose treatment success rates have dramatically improved but who continue to confront long-term health complications.
Breast cancer treatments, including chemotherapy and radiotherapy, have evolved remarkably, contributing to a five-year relative survival rate of 99% for localized disease. However, such life-saving interventions often leave survivors dealing with weakened cardiovascular fitness and diminished quality of life, a consequence seldom tackled in routine post-treatment care. This study specifically fills a knowledge gap in the UAE, where targeted interventions for post-cancer cardiovascular rehabilitation have been scarce, despite the country’s growing number of breast cancer survivors.
The trial enrolled 62 participants aged between 18 and 65 years, all breast cancer survivors who had completed chemotherapy and/or radiotherapy and were medically stable to engage in physical activity. Recruited from Al Tawam Hospital and Dubai Hospital—both prominent oncology referral centers—the participants were randomly assigned to either an intervention group (IG) that underwent the supervised physical rehabilitation or a control group (CG) that received standard care without specialized exercise guidance.
The intervention was meticulous and evidence-based, comprising a structured aerobic training program lasting two months. Patients in the intervention group attended two supervised sessions weekly at Thumbay Physical Therapy and Rehabilitation Hospital, supplemented by three at-home sessions each week. The exercise regimen was developed to optimize cardiovascular function while accommodating the unique needs and limitations of breast cancer survivors recovering from intensive treatments.
Outcomes were rigorously measured and included primary assessments of cardiorespiratory fitness using peak oxygen uptake (VO₂peak) during a standardized 2-kilometer walk test, conducted with Cosmed fitmate Pro technology. Additionally, Peak Expiratory Flow Rate (PEFR) was monitored using a peak flow meter to assess pulmonary function. Importantly, the study also incorporated patient-reported outcomes by evaluating HRQoL across multiple domains using the validated QLQ-C30 questionnaire, a comprehensive tool widely used in oncology research.
Results revealed a substantial benefit for the intervention group. After the two-month program, VO₂peak rose by an average of 8.3 ml/kg/min, reflecting a marked enhancement in aerobic capacity, whereas the control group experienced a decrease of approximately 1.1 ml/kg/min. Similarly, PEFR increased significantly in the intervention group by 81 L/min, signaling improved pulmonary function, while the control group showed a slight decline. These physiological improvements were statistically significant, underscoring the efficacy of the rehabilitation strategy.
Beyond the objective fitness metrics, the intervention had a profound impact on the survivors’ quality of life. Participants in the rehabilitation program reported significant improvements in physical, role, emotional, and global functioning domains, alongside a reduction in debilitating symptoms such as fatigue, breathlessness (dyspnea), pain, and sleep disturbances. These improvements were not fleeting; the benefits persisted at a three-month follow-up, demonstrating the durability of the intervention’s effects.
The study’s design incorporated rigorous methodological safeguards. Randomization and allocation were double-blinded, managed by a third party to minimize selection bias, though blinding of participants was inherently impossible due to the nature of the intervention. Crucially, outcome assessors remained blinded to group assignments, strengthening the validity of the findings.
This research takes on heightened significance within the Middle East context, where breast cancer incidence is rising and healthcare systems are striving to integrate survivorship care into oncology pathways. The UAE, with its blend of advanced medical infrastructure and diverse population, provides a compelling backdrop for such trials. The success of this physical rehabilitation model opens avenues for scalable, culturally attuned post-treatment interventions region-wide.
Cardiorespiratory deconditioning is a well-documented sequela among cancer survivors worldwide, yet its management remains suboptimal, particularly in regions where supportive care services are limited. This study pioneers an approach combining clinical exercise physiology with oncology care protocols, establishing a blueprint that can be adapted and expanded at other centers.
While the research emphasizes aerobic exercise, it also implicitly calls for multidimensional rehabilitation that could incorporate strength training, flexibility exercises, and psychosocial support to tackle the multifaceted challenges of cancer recovery. Future studies could explore tailored programs that address cognitive and social functioning, areas where the present intervention showed less impact, thus enhancing holistic care.
The trial’s outcomes are a compelling argument for healthcare policymakers to prioritize structured rehabilitation services within national cancer control plans. Incorporation of supervised exercise programs could mitigate long-term cardiovascular morbidity and improve survivorship quality, ultimately reducing healthcare burdens and enhancing patient well-being.
Moreover, the use of accessible, non-invasive measurement tools such as the 2 km walk test and peak flow meters demonstrates practical models for clinical settings without requiring extensive resources. This lowers barriers to implementation, especially in community and outpatient environments.
This evidence-based intervention also shines a light on the importance of multidisciplinary collaboration among oncologists, physiotherapists, rehabilitation specialists, and patient educators. By fostering integrative care networks, healthcare systems can better nurture survivors’ return to active, fulfilling lives.
In sum, this landmark study deepens our understanding of survivorship care by validating a targeted, reproducible physical rehabilitation program that markedly improves cardiovascular health and quality of life metrics in breast cancer survivors. These findings call for transformative changes in post-cancer care paradigms, emphasizing physical activity as a key therapeutic strategy.
As global cancer survivorship numbers climb, such interventions become integral not only to prolonging life but enriching it. Translating these successes beyond UAE borders may catalyze a shift toward universal standards of comprehensive survivorship rehabilitation, ultimately transforming outcomes for millions of women worldwide.
The study was officially registered under ClinicalTrials.gov (NCT06013527) and reflects a significant collaborative effort rooted in clinical innovation and patient-centered care. It stands as a testament to the potential of science-driven rehabilitation programs to address unmet needs in oncology recovery, heralding a new era of integrated survivorship health management.
Subject of Research: Physical rehabilitation effects on cardiorespiratory fitness and health-related quality of life in breast cancer survivors
Article Title: Physical rehabilitation program for cardiorespiratory health and quality of life among breast cancer survivors in UAE: a randomized control trial
Article References:
Rashid, F.A., Anwar, W., Kandakurti, P.K. et al. Physical rehabilitation program for cardiorespiratory health and quality of life among breast cancer survivors in UAE: a randomized control trial. BMC Cancer 25, 705 (2025). https://doi.org/10.1186/s12885-025-14005-2
Image Credits: Scienmag.com
