Evaluation of a Clinic-Based Exercise Program in Patients with Pancreatic Cancer Undergoing Nonsurgical Treatment

Abstract

IntroductionEvidence regarding the role of exercise in pancreatic cancer (PanCa) is limited and is derived exclusively under tightly controlled research conditions. This study aimed to quantify adherence, adverse events, and changes in physical and psychological outcomes in any patients with PanCa referred to undertake exercise during nonsurgical treatment.MethodsThe study involved 22 patients with localized or metastatic PanCa undertaking a clinic-based exercise program during chemotherapy or chemoradiotherapy. The program included supervised aerobic and resistance exercise undertaken twice weekly for 12 wk and a 12-wk follow-up with supervised exercise optional dependent on patient preference and condition. Patients were monitored for adherence and adverse events. Objective and patient-reported outcomes were assessed at baseline, 12 wk, and 24 wk.ResultsA total of 251 sessions were attended by 19 patients over the first 12 wk (attendance rate, 55%). Complete case analyses indicated significant (P < 0.05) improvements in functional ability (5.2%–17.2%), muscle strength (16.9%–25.1%), and static balance (6.8%). There were no significant changes in body composition or patient-reported outcomes except for sleep quality, which deteriorated; however, at an individual level, several patients had clinically relevant improvements in cancer-related fatigue and quality of life. Patients who continued with supervised exercise to week 24 largely preserved improvements in functional ability, muscle strength, and static balance. No serious adverse events resulted from the exercise program.ConclusionsIndividualized, supervised aerobic and resistance exercise in a clinic-based setting appears to be safe and may improve or maintain physical and psychological health in patients with PanCa undergoing nonsurgical treatment.

Multimodal Exercise in Older Patients with Advanced Pancreatic Cancer Undergoing First-Line Chemotherapy: A Case Series Examining Feasibility and Preliminary Efficacy

“…In Te retention rate of 83% in this study is higher or comparable to previous studies that delivered a supervised exercise program with an equal length (12 weeks) to patients with pancreatic cancer during treatment [19,46]. At an individual-patient level, the attendance rates of cases #2 (83%), #3 (95%), and #6 (75%) are similar to earlier case reports of a 12-week supervised program with an equal frequency (2 sessions/week) in 2 younger patients (≤55 years) with advanced pancreatic cancer undergoing frst-line chemotherapy [23,24].…”

“…A greater number of sessions for each case requiring modifcations to original prescriptions in this study than the earlier case reports that reported equivalent data is not unexpected, given the prescription of a higher training volume and intensity and the inclusion of older patients [23,24]. However, the mean adherence rate in this study (59%) is not diferent from a study researched by our institute that evaluated a supervised program including combined resistance and aerobic exercise at a comparable volume and intensity in patients with diferent stages (including metastatic) of pancreatic cancer (61%) [46].…”

Long-term health-related quality of life in patients with advanced esophagogastric cancer receiving first-line systemic therapy

“…Many factors (modifiable and non-modifiable) have been identified to affect cancerrelated fatigue [21]. Particularly for patients with advanced cancer, earlier intervention (i.e., during systemic therapy) is needed and cognitive behavioral therapy or physical exercise programs during systemic therapy have shown to reduce the severity of cancer-related fatigue [22][23][24][25]. Despite existing guidelines for cancer-related fatigue among cancer survivors after treatment, the most common long-term effect among cancer patients remains cancer-related fatigue (68%) [26,27].…”