Abstract
PurposeColorectal cancer and its treatment are associated with debilitating side effects. Exercise may improve the physical and psychological wellbeing of cancer patients; however, evidence in colorectal cancer patients undergoing adjuvant chemotherapy is limited. This pilot study aimed to explore the effects of supervised aerobic exercise on cardiorespiratory fitness and patient-reported health outcomes in colorectal cancer patients undergoing adjuvant chemotherapy.MethodsPatients who had undergone curative resection for colorectal cancer (stages II–III) and were scheduled to receive adjuvant chemotherapy were enrolled into this non-randomized controlled trial. Patients in the intervention group (IG) took part in a 6-month supervised aerobic exercise program, while the control group (CG) received usual care. Cardiorespiratory fitness (measured by peak oxygen consumption) was assessed at baseline and 6 months. Fatigue, quality of life, and physical activity levels were additionally assessed at 3 months.ResultsIn total, 59 patients (33 in IG vs. 26 in CG) were enrolled into this study. Eighteen patients (9 in IG vs. 9 in CG) dropped out of the study prior to the 6-month follow-up. Significant improvements in cardiorespiratory fitness (p = .002) and selected patient-reported health outcomes, such as reduced motivation (p = .015) and mental fatigue (p = .018), were observed in the IG when compared to the CG.ConclusionTo our knowledge, this is the first study to investigate the effects of a supervised aerobic exercise program in colorectal cancer patients undergoing adjuvant chemotherapy. The significant and clinically meaningful improvements in CRF warrant further randomized controlled trials to confirm these findings.Trials registrationGerman Clinical Trials Register Identifier: DRKS00005793, 11/03/2014, retrospectively registered.
Highlights
Colorectal cancer (CRC) is the third most common cancer worldwide and while survival rates continue to improve, it remains the second most common cause of cancer death [1]
A 6-month supervised aerobic exercise program delivered to CRC patients undergoing adjuvant chemotherapy led to significant improvements in cardiorespiratory fitness (CRF) and selected patient-reported health outcomes, such as reduced motivation and mental fatigue, compared to usual care
We focused on aerobic exercise rather than a multimodal intervention, as CRF was our primary outcome and when the study was designed, aerobic exercise showed more beneficial effects on fatigue than other exercise modalities
Summary
Colorectal cancer (CRC) is the third most common cancer worldwide and while survival rates continue to improve, it remains the second most common cause of cancer death [1]. Treatment for CRC is dependent on a variety of factors; one of the most common treatment regimens in patients treated with curative intent is surgical resection in combination with adjuvant chemotherapy [2] This treatment approach has proven to extend survival [3], it is often accompanied by debilitating adverse effects including but not limited to pain, fatigue, nausea, diarrhea, mucositis, and peripheral neuropathy [4,5,6] physical activity levels, physical fitness, and functional capacity have shown to deteriorate during and following CRC treatment, significantly impacting patients’ quality of life (QoL) [7,8,9]. Preliminary evidence suggests beneficial effects of exercise on chemotherapy completion rates in CRC patients [22]
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