The Effect of Cancer Stage on Physiological and Psychological Parameters Following Supervised Exercise Training

Abstract

Cancer treatments lead to a variety of adverse physiological and psychological effects which may be attenuated with exercise. However, minimal research has been conducted to elucidate the effect cancer stage has on the outcomes of exercise training. PURPOSE: To examine the effect cancer stage has on baseline physiological and psychological parameters, as well as absolute change with exercise training. METHODS: Two hundred cancer survivors were grouped according to their cancer stage, stage 1 (n=69), stage 2 (n=69), stage 3 (n=41), and stage 4 (n=21). An assessment was conducted to measure baseline data. An individualized supervised exercise intervention was implemented followed by a reassessment three months later. The assessment consisted of cardiovascular endurance, pulmonary function, depression, fatigue, and quality of life. Confidence intervals were used to determine significance between cancer stages in both baseline and post exercise data as well as absolute change following the exercise intervention. A family alpha level of 0.10 was used to determine significance. RESULTS: No significant differences were found between cancer stages at baseline and following the exercise intervention, however, all stages improved in at least 3 parameters following the exercise intervention. Results are reported as mean change (post minus pre) and the lower and upper limits to the 98.75% confidence interval. Stage 1 showed significant improvements in FEV1 (6.2 percent of predicted [1.9, 10.4]), treadmill time (1.2 min [0.1, 2.3]), and VO2peak (3.5 ml·kg-1·min-1 [1.6, 5.5]). Stage 2 significantly improved in FEV1 (5.6 [1.3, 9.8]), treadmill time (1.4 [0.3, 2.5]), VO2peak (4.0 [2.1, 5.9]), fatigue (-1.8 [-3.2, -0.5]), and depression (-2.6 [4.6, -0.6]). Treadmill time (1.8 [0.6, 3.1]), VO2peak (4.4, [2.2, 6.6]), fatigue (-1.7 [-3.2, -0.1]), and depression (-4.1 [-6.4, -1.7]) significantly improved following the exercise intervention for cancer survivors in stage 3. Survivors in stage 4 showed significant improvements in treadmill time (2.1 [0.6, 3.6]) and VO2peak (6.9 [4.2, 9.5]). CONCLUSION: Although stage is not a predictor of baseline physiological and psychological status or exercise response, exercise provides significant benefits for cancer survivors across all stages.