JACC: Physical activity intervention during chemotherapy is safe, increases long-term cardiorespiratory fitness, and reduces some of the side effects of cancer treatment, according to research published in Cardiooncology.
If exercise is not possible during chemotherapy, the person may engage in a post-treatment exercise program to regain the same level of function. Cardiorespiratory fitness as measured by peak oxygen uptake (VO2peak) is considered one of the most important independent predictors of cardiovascular health.
During cancer treatment, VO2peak drops by 25%. Cancer treatment often has adverse effects that impair a patient’s health-related quality of life (HRQoL), including decreased cardiorespiratory fitness, increased fatigue, and cardiovascular morbidity. Physical activity is proven to reduce these risks.
Exercise therapy is associated with increased cardiorespiratory fitness, improved VO2peak, and a decline in cardiovascular morbidity, cancer mortality, and overall mortality. “The benefits of exercise for cancer patients are widely accepted. However, there is insufficient evidence on the optimal timing of exercise interventions to improve long-term cardiorespiratory fitness in cancer patients,” says Anemic ME Wallenkamp, MD, PhD, senior. The author said. Studying and a medical oncologist at the Department of Medical Oncology, University Medical Center Groningen in Groningen, Netherlands.
In the ACT trial, researchers examined the efficacy of an exercise intervention during chemotherapy compared to after treatment in improving long-term cardiorespiratory fitness. Adult patients recently diagnosed with breast cancer, colon cancer, testicular cancer, or B-cell non-Hodgkin lymphoma who were scheduled to receive palliative chemotherapy were eligible for the study.
Between February 2013 and November 2018, participants in the trial were randomized to a 24-week exercise intervention initiated during or after chemotherapy. Types of exercise include moderate to vigorous effort on a stationary bicycle, resistance training using weight machines and free weights, and badminton.
The primary endpoint was the difference in VO2 peak one year after the intervention. Secondary endpoints were VO2peak after completion of chemotherapy and intervention, muscle strength, HRQoL, fatigue, physical activity and self-efficacy at all time points.
The researchers found that immediately after chemotherapy, the group who started exercise therapy during treatment reported less fatigue and greater physical activity and had less declines in VO2peak, HRQoL, and muscle strength. Three months after chemotherapy, the post-treatment exercise group showed similar values to the post-treatment exercise group.
Both groups were back to their baseline cardiorespiratory fitness one year after completing the exercise intervention, regardless of timing. “These findings suggest that the most optimal time for physical exercise is during chemotherapy. However, starting a physical exercise program after chemotherapy is a viable option. When it is not possible to exercise during chemotherapy, we anticipate that our findings motivate health care providers to guide patients to engage in exercise interventions during anticancer treatment.” Wallenkamp said.
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