Physical activity intervention during chemotherapy is safe, increases long-term cardiorespiratory fitness, and alleviates some of the side effects of cancer treatment, according to research published in JACC: CardioOncology. If exercise is not possible during chemotherapy, the individual can participate in a post-treatment exercise programme to regain function.
One of the most important independent predictors of cardiovascular health is cardiorespiratory fitness, as measured by peak oxygen uptake (VO2peak). VO2peak drops by up to 25% during cancer treatment. Cancer treatment frequently has negative effects on the patient’s health-related quality of life (HRQoL), such as decreased cardiorespiratory fitness, increased fatigue, and cardiovascular morbidity. Physical activity has been shown to reduce these risks.
Exercise therapy has been linked to improved cardiorespiratory fitness, increased VO2peak, and a reduction in cardiovascular morbidity, cancer mortality, and overall mortality.
“Exercise is widely recognised as beneficial to cancer patients. However, there is insufficient evidence on the best time to start exercising for improving long-term cardiorespiratory fitness in cancer patients “Annemiek M.E. Walenkamp, MD, PhD, senior author of the study and a medical oncologist at University Medical Center Groningen in Groningen, the Netherlands, said
The ACT trial looked at the efficacy of exercise intervention during chemotherapy versus after treatment for improving long-term cardiorespiratory fitness.
The study included adult patients who had recently been diagnosed with breast cancer, colon cancer, testicular cancer, or B-cell non-Hodgkin lymphoma and were scheduled to receive curative chemotherapy. Between February 2013 and November 2018, trial participants were randomly assigned to a 24-week exercise intervention that began either during or after chemotherapy.
Moderate to vigorous effort on a stationary bicycle, resistance training with weight machines and free weights, and badminton were all types of exercise. The difference in VO2peak one year after the intervention was the primary endpoint. At all time points, the secondary endpoints were VO2peak after chemotherapy and intervention, muscle strength, HRQoL, fatigue, physical activity, and self-efficacy.
The researchers discovered that the group that began exercise therapy during treatment reported less fatigue and increased physical activity, as well as a decrease in VO2peak, HRQoL, and muscle strength. Three months after chemotherapy, the group that started exercising after treatment had similar values to the group that started exercising during treatment. Regardless of timing, both groups returned to their baseline cardiorespiratory fitness one year after completing the exercise intervention.
“These findings suggest that the best time to exercise is during chemotherapy. When exercising during chemotherapy is not possible, starting a physical exercise programme after chemotherapy is a viable option “Walenkamp explained. “We hope that our findings will encourage health-care providers to advise patients on exercise interventions during anti-cancer treatment.”
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