Exercise prescription during cancer treatment
Worldwide cancer rates are on the rise, with colorectal cancers being in the top 4 most common cancers.
Thus, the need for cancer treatment is on the rise, but so is the need for improving the effectiveness of cancer treatment, and minimizing the adverse and severe side-effects associated with treatment.
Exercise is a treatment modality that has been considered for supporting cancer treatment effectiveness (via improving vascularisation and allowing drugs to be delivered at a more effective rate), as well as improving quality of life and functional decline during aggressive drug therapies.
The researchers of this article utilize an exercise program during neoadjuvant chemoradiotherapy (NACRT) to investigate if this improved cardiovascular function, quality of life, treatment response and possibly survival rate and reduced surgical complications.
For this study, 60 participants with colorectal cancer will be selected, who are going for NACRT before they have surgical resections of the tumour and bowel. They will be randomly assigned into a treatment or control group, with the treatment group engaging in high intensity interval training (HIIT) 3 times a week, as well as engaging in 150 minutes or more of unsupervised and moderate to vigorous continuous exercise after the completion of NACRT to surgery. The control group will be asked not to increase their exercise from baseline.
Outcome measures are both subjective and objective, including Quality of Life outcome measures by European Organisation of Research and Treatment of Cancer, VO2 max testing at the end of the program, functional fitness assessed by the Senior’s Fitness Test and symptom management assessed by a medical doctor.
The first results of this ongoing study establish that an exercise program during NACRT helps limit expected declines in function from treatment. Based on the outcome benchmarks, the participants report they perceive a higher level of physical fitness, quality of life and self-esteem.
Neverthless, some participants have worse fatigue and skin irritation. The authors conclude from this, that moderate exercise doses could be further explored. The next phases of this study, investigating positive and negative side effects of exercise, clinical efficacy and the effective therapeutic dose will shed more light on this matter.
The current study is unique in that sense, that most exercise prescription during cancer treatment has been targeted to high-volume and steady-state exercise. The rationale behind exploring HIIT as a mode of exercise during cancer treatment, is that HIIT offers a more rapid improvement in VO2max. This may improve quality of life and elicit greater and faster cardiovascular gains which may help for drug effectiveness.
> From: Morielli et al., Trials 19 (2018) 35. All rights reserved to The Author(s). Click here for the online summary.