Cancer Stage Does Not Affect Fatigue or VO2peak Improvements Following an Exercise-Based Cancer Rehabilitation Program

Abstract

INTRO: Cancer stage reflects the severity and extent of the disease, with stage IV reflecting advanced cancer and poorer prognosis. Exercise has been shown to improve a number of psychological and physiological variables in cancer survivors, such as cancer-related fatigue (CRF) and cardiovascular fitness (VO2peak). However, the effect of stage on these improvements is unknown. PURPOSE: To examine whether diagnosed cancer stage affects or modifies improvements in CRF and VO2peak. METHODS: A total of 384 cancer survivors (57 ± 12 years of age) completed initial assessments of CRF and VO2peak via the Piper Fatigue Scale and the University of Northern Colorado Cancer Rehabilitation Institute’s cancer-specific treadmill protocol, respectively. Participants were divided into four groups based on diagnosed cancer stage (I, II, III, and IV). Survivors completed supervised, one-on-one exercise sessions three days per week, 60 minutes per day for 12 weeks. The intervention consisted of individualized and progressive cardiovascular, whole-body strength, balance, and flexibility training. Participants’ CRF and VO2peak were reassessed following the intervention. RESULTS: Collectively, pre-to-post assessments demonstrated significant overall improvements in CRF (-25%) and VO2peak (11%) across all stages (p<0.01). No significant differences in CRF (p=0.92) or VO2peak (p=0.44) improvements occurred between the stages. When evaluating individual cancer stage CRF, significant improvements (p<0.01) were observed with each stage (I, -32%; II, -27%; III, -29%; IV, -29%). Similarly, significant improvements in VO2peak (p<0.01) occurred with each cancer stage (I, 16%; II, 14%; III, 12%, IV, 11%). CONCLUSION: Exercise-based cancer rehabilitation during and following cancer treatment has been shown to have positive effects on CRF and VO2peak, but the effect of stage diagnosis on these improvements has been unclear. We observed no significant differences in improvement of CRF and VO2peak between cancer stages, and all stages experienced significant benefits following a 12-week cancer rehabilitation program. These results suggest that reductions in CRF and improved cardiovascular function are possible in all cancer patients, regardless of cancer stage.