Safety, feasibility, and effectiveness of implementing supervised exercise into the clinical care of individuals with advanced cancer

Abstract

Objective To evaluate the safety, feasibility, and preliminary effectiveness of implementing supervised exercise programming into the clinical care of individuals with advanced cancer. Design Single group implementation feasibility study using a pre–posttest design. Setting Exercise Oncology Unit of the Spanish Cancer Association (a cancer-specific community facility outside the hospital setting). Participants Adult individuals with advanced cancer profile involving advanced local cancer or distant metastases. Intervention A 12-week, twice-weekly, supervised, clinic-based multi-component exercise program. Main Measure Paired t-tests were used to assess pre–post changes and analyses of covariance were used to compare effects based on selected participant characteristics. Results Eighty-four individuals with advanced cancer completed the baseline assessment, with six participants withdrawing prior to the start of the program. Of the 78 participants, 17 dropped out, thus, a total of 61 completed the final assessment. Mean adherence was 82.5%. No serious adverse events occurred. Exercise significantly improved VO2max by 5.2 mL·kg·min (p < 0.001), chest strength (p < 0.001), leg strength (p < 0.001), lean body mass (p = 0.003), skeletal muscle mass (p < 0.002), % body fat (p = 0.02), quality of life by 5.3 points (p = 0.009), fatigue by 3.2 points (p = 0.012), and physical activity by 1680 METs/week (p < 0.001). Conclusions Our clinically supervised and tailored exercise program involving moderate to vigorous intensity exercise was found to be feasible, safe, and effective for individuals with advanced cancer. Implications for Cancer Survivors With proper screening and supervision, individuals with advanced cancer can benefit from tailored exercise oncology support as part of an overall therapeutic care plan.