Individually Tailored Home-based Exercise In Patients With Local And Advanced Cancer

Abstract

Growing evidence underlines that exercise is well tolerated and beneficial during the cancer continuum. While the research focus has been on patients with local disease, less is known regarding the feasibility and effects of exercise in patients with advanced cancer. PURPOSE: To compare the effects of individually tailored aerobic exercise on quality of life, cancer-related fatigue and exercise capacity between patients with local and advanced cancer. METHODS: 158 cancer patients with mixed diagnosis and treatment types (local disease: n = 99, 53±12 yrs, BMI: 24.2±3.3 kg/m2; advanced disease: n =59, 58±10 yrs, BMI: 24.7±3.7 kg/m2) participated in the observational study. TNM-classification and distant metastatic involvement were used to define advanced cancer. At baseline (T0) and follow-up assessments (T1 after 4–6 weeks, T2 after 16–20 weeks) participants performed a maximal stepwise incremental cardiopulmonary exercise test (cycle ergometer) including gas exchange measurements to determine peak oxygen consumption (VO2peak). Quality of life (QoL) and cancer-related fatigue were assessed with the EORTC QLQ-C30 questionnaire. At each visit, patients received individually tailored counselling for home-based aerobic exercise including frequency, duration, and intensity under consideration of their preferences and fitness level. RESULTS: On average, patients with local or advanced cancer were physically active for 183 and 179 minutes/week (median), respectively. Both groups improved significantly (p < .001) in QoL score from T0 to T2 (local: +8.1±20.1; advanced: +12.2±20.7) and VO2peak (local: +2.2±3.7 ml/kg/min; advanced: +1.8±4.1 ml/kg/min) while fatigue scores significantly decreased in both groups (local: -10.9±25.4; advanced: -12.1±23). Group comparisons revealed no significant differences concerning the change in all outcomes (p >.05). CONCLUSION: Both groups improved in all outcomes through the aerobic exercise training. Our results indicate that patients with advanced-stage cancer can realize and benefit from an aerobic exercise program similarly than patients with local disease. Thus, a home-based approach with individually tailored exercise counselling and prescription seem to be a feasible strategy in the outpatient cancer care independent of the disease stage.