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Exercise reduces some chemotherapy-related side effects
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An exercise intervention conducted during adjuvant chemotherapy improved physical activity levels and reduced physical fatigue 4 years later among patients with colon or breast cancer, according to results of the randomized multicenter PACT study scheduled for presentation at the Cancer Survivorship Symposium.
“Cancer-related fatigue is one of the most distressing side effects of treatment and it can persist for many years after treatment,” Anne M. May, PhD, associate professor of epidemiology at University Medical Center in Utrecht, Netherlands, said during a press conference. “That was why we wanted to study whether exercise during chemotherapy would prevent patients from developing severe fatigue.”
Results of the PACT study showed an 18-week supervised exercise program had a positive short-term impact on fatigue and physical fitness during adjuvant treatment for patients with stage I to stage III colon (n = 33) or breast (n = 204) cancer treated with curative intent. All patients received chemotherapy, and about 70% also received radiotherapy.
May and colleagues surveyed 128 of the study participants (breast cancer, n = 110; colon cancer, n = 18) 4 years later to determine if the program also had long-term benefits.
Seventy of these patients (mean age, 51.1 years; 91.4% women) had been assigned the exercise program, which included 60 minutes of combined moderate- to high-intensity aerobic and strength training twice a week guided by a physical therapist, plus 30 minutes of home-based physical activity 3 days a week. The program also included cognitive behavioral elements to increase patients’ confidence to be physically active, and the physical therapies discussed maintenance of sport engagement following the intervention.
“This is important because from several observation studies, we know being physically active after diagnosis of breast or colon cancer is associated with better prognosis,” May said.
The other 58 patients (mean age, 51.6 years; 91.4% women) received usual care alone.
Researchers assessed fatigue using the Multidimensional Fatigue Inventory and physical activity levels using the Short Questionnaire to Assess Health – Enhancing Physical Activity.
At 4 years, patients in the intervention arm experienced less physical fatigue than the usual care arm (–1.13; 95% CI, –2.45 to 0.2; effect size, 0.22); however, this did not reach statistical significance.
Patients in the intervention group also reported significantly more moderate-to-vigorous total physical activity levels (141.77 min/week; 95% CI, 1.31-281.61; effect size, 0.22). On average, patients in the intervention group exercised for 90 minutes a day, compared with 70 minutes in the usual care group.
“The exercise program was designed to keep patients physically active long term, so we’re really pleased to see that even 4 years later, people who received the intervention were still more active,” May said in a press release.
Because women treated for breast cancer are at increased risk for cardiovascular disease, researchers of the PACT trial next plan to evaluate whether exercise during chemotherapy also is protective against this risk by combining data with the PACES study, also conducted in the Netherlands.
“We think that offering exercise during cancer treatment, including chemotherapy, is recommended and has short- and long-term effects on health,” May said during the press conference. – by Alexandra Todak
Reference:
May AM, et al. Abstract 99. Scheduled for presentation at: Cancer Survivorship Symposium; Feb. 16-17, 2018; Orlando, Florida.
Disclosure: The authors report no relevant financial disclosures.
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Timothy Gilligan, MD, MSc, FASCO
Exercise literature is consistent in showing benefits. The public sometimes gets data showing that the nutritional recommendations seem to change every year. But, if you look at the research on health and the many positive benefits — in this case with fatigue, and there also is evidence that exercise has benefits for reducing risk for cancer and heart disease — it is interesting how consistent the data are that exercise really is good for us, if only we could get people to do it. It is encouraging here that there was a long-term impact on physical activity level.
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