The impact of controlled physical activity on the immune and endocrine system in breast cancer patients after adjuvant chemotherapy

Purpose Anticancer treatment significantly impairs immunity and metabolism leading to the overall decline in patient condition. Regular physical activity is increasingly recognized as an important supportive intervention in oncology, however, optimal exercise protocols and laboratory variables most suitable for monitoring patient outcomes remain undefined. Methods This is a single-center interventional study that compared the effect of a 12-week supervised aerobic activity program (SAPA) and routine physical activity in breast cancer patients receiving adjuvant chemotherapy. Peripheral blood markers, including CD4/CD8 ratio, NLR, IL-6, IL-8, CCL2, CCL4, vitamin D, IGF-1, and TSH were analysed at the baseline, after chemotherapy, and after a 3-month recovery period in parallel with adjuvant radiotherapy. Results Chemotherapy reduced lymphocyte count and CD4/CD8 ratios while increasing NLR and IL-6, with no significant changes in other parameters. SAPA mitigated lymphocyte reduction and NLR increase observed in the BCC group. TSH increased significantly in the control group while remaining stable in the SAPA cohort, highlighting SAPA's potential to maintain metabolic balance during recovery. Conclusion SAPA demonstrates a protective effect on chemotherapy-induced immune and metabolic side effects. NLR and TSH may serve as valuable markers for immune and metabolic monitoring in exercise-based interventions.