Daily Physical-Rest Activities in Relation to Nutritional State, Metabolism, and Quality of Life in Cancer Patients with Progressive Cachexia

Abstract

Purpose: To evaluate daily physical-rest activities in cancer patients losing weight in relation to disease progression. Experimental Design: Physical activity-rest rhythms were measured (ActiGraph, armband sensor from BodyMedia) in relation to body composition (dual-energy X-ray absorptiometry), energy metabolism, exercise capacity (walking test), and self-scored quality of life (SF-36, Hospital Anxiety and Depression Scale) in weight-losing outpatients with systemic cancer (71 F 2 years, n = 53). Well-nourished, age-matched, and previously hospitalized non^cancer patients served as controls (74 F 4 years, n = 8). Middle-aged healthy individuals were used as reference subjects (49 F 5 years, n = 23).Results: Quality of life was globally reduced in patients with cancer (P < 0.01), accompanied by significantly reduced spontaneous physical activity during both weekdays and weekends compared with reference subjects (P < 0.01). Spontaneous physical activity declined over time during follow-up in patients with cancer (P < 0.05). However, overall physical activity and the extent of sleep and bed-rest activities did not differ between patients with cancer and age-matched non^cancer patients. Spontaneous physical activity correlated weakly with maximum exercise capacity in univariate analysis (r = 0.41, P < 0.01). Multivariate analysis showed that spontaneous physical activity was related to weight loss, blood hemoglobin concentration, C-reactive protein, and to subjectively scored items of physical functioning and bodily pain (SF-36; P < 0.05-0.004). Anxiety and depression were not related to spontaneous physical activity. Patient survival was predicted only by weight loss and serum albumin levels (P < 0.01), although there was no such prediction for spontaneous physical activity. Conclusions: Daily physical-rest activities represent variables which probably reflect complex mental physiologic and metabolic interactions. Thus, activity-rest monitoring provides a new dimension in the evaluation of medical and drug interventions during palliative treatment of patients with cancer.

Cancer cachexia: Physical activity and muscle force in tumour-bearing rats

“…Conversely, slow and fast movement times were significantly decreased as tumour presence increased, the difference being more marked in the dark phase. Similar results have been described in humans under cancer cachexia (24,25). In experimental animals, similar results have also been found using the C26 adenocarcinoma model (26).…”

New cancer cachexia rat model generated by implantation of a peritoneal dissemination-derived human stomach cancer cell line

“…In addition to body weight loss and anorexia, patients with cancer cachexia also exhibit a reduction in physical activity corresponding to daytime activities (22,61). Similarly, locomotor activity in the "active period" or dark phase was substantially lower in 85As2-induced cachectic rats than in control rats, whereas locomotor activity was not different between these groups during the daytime period.…”

Effects by daily long term provision of ghrelin to unselected weight‐losing cancer patients

“…[1][2][3]5 In addition, our patients could not have diabetes and could not be receiving steroid treatment or any other pharmacologic or nutritional support that had any importance with regard to outcomes in the current study. In fact, these kinds of patients are comparatively rare, even in a large surgical and oncologic institution.…”