Critical Appraisal of Exercise in Cancer Care of Patients Undergoing Frontline Chemotherapy

Abstract

Background: Physical activity (exercise) can be adjuvant palliative for cancer patients who are on frontline therapies. This could have cost-effective and quality outcome implications on the target population.This study aimed to critically appraise the economic viability of physical activity in adjuvant cancer treatment (PACT) in a breast and colon cancer sub-population.Methodology: This was a critical appraisal of a multi-centred randomized controlled study on colon and breast cancer patients. The Critical Appraisal Skills Program economic evaluation checklist was used as a guideline for critical appraisal. The various components in the checklist were used in critical appraisal namely the study validity, the validity of the economic evaluation, comparative cost-effective analysis of the consequences in the test and control population, study results (outcomes), study usefulness, and its application to practice.Results: Exercise reduced cancer-related fatigue in colon cancer cohorts on adjuvant chemotherapy as evidenced by cost savings of Euro4321 and quality-adjusted life years improvement of 0.03 over an 18-week exercise-research oncology study. However, it was not a cost-effective intervention for the breast cancer group that lost Euro2912 with a QALY improvement of 0.01 (An incremental cost-effective ratio of 0.02 is required to certify cost-effective intervention).Conclusion: This study has addressed the importance of behavioural activity such as exercise in improving the quality of life of cancer patients on adjuvant chemotherapy. While it is a cost-effective intervention for colon cancer, it is not for breast cancer. Physical activity is a recommendable palliative care intervention in cancer management when all confounding factors are excluded. Exercise can increase cancer patients' ICER and QALY, improving their life expectancy.