Exercise Training in Elderly Cancer Patients: A Systematic Review

Giallauria, Francesco; Testa, Crescenzo; Cuomo, Gianluigi; Lorenzo, Anna Di; Venturini, Elio; Lauretani, Fulvio; Maggio, Marcello; Iannuzzo, Gabriella; Vigorito, Carlo

doi:10.3390/cancers15061671

Cited by 11 publications

(5 citation statements)

References 138 publications

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“…This presents an opportunity for timely interventions to identify and mitigate frailty in older adults, promoting health and cancer outcomes. Mitigating frailty has received increasing attention in recent years because of its significant social, health, and well-being implications [24]. Given frailty is not a permanent state – it can potentially be reversed with appropriate interventions [25].…”

Section: Evidence On Exercise Interventions For Frail Older Adults Wi...mentioning

confidence: 99%

Exercise interventions for frail older adults with cancer

Sattar,

Haase,

Lee

et al. 2024

Current Opinion in Supportive &Amp; Palliative Care

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Purpose of review Frailty is prevalent in older adults with cancer and can lead to complications during cancer treatment and poor health outcomes. Exercise has been shown to be a promising strategy to mitigate frailty and slow the accumulation of functional impairment in the general geriatric population. In this review, we present a discussion on the state of the science of exercise interventions for frail older adults with cancer. This review is timely and relevant given the aging of the population and corresponding increase in proportion of older adults living with cancer. Recent findings Existing research related to exercise interventions for frail older adults with cancer appear to show some promise in feasibility and efficacy in both surgical and systemic treatment settings. Summary More research on this topic and testing rigorously structured exercise interventions for older adults with cancer may help inform cancer-specific guidelines and create a foundation of evidence to enable implementation of exercise interventions. These interventions can support cancer care to attenuate frailty-related outcomes while extending its benefit to overall health of this population.

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Section: Evidence On Exercise Interventions For Frail Older Adults Wi...mentioning

confidence: 99%

Exercise interventions for frail older adults with cancer

Sattar,

Haase,

Lee

et al. 2024

Current Opinion in Supportive &Amp; Palliative Care

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“…In addition, exercise training is a key component of multidimensional cardio-oncology strategies that can be used at any stage of cancer, especially in frail patients. 102–104 Notably, approaching the elderly population highlights several aspects that should be carefully considered: frailty, social isolation, malnutrition, cognitive decline, dementia, disability, other geriatric syndromes, and overall QOL. 102 , 103 …”

Section: Core Effectivenessmentioning

confidence: 99%

“… 102–104 Notably, approaching the elderly population highlights several aspects that should be carefully considered: frailty, social isolation, malnutrition, cognitive decline, dementia, disability, other geriatric syndromes, and overall QOL. 102 , 103 …”

Section: Core Effectivenessmentioning

confidence: 99%

Cardio-oncology rehabilitation: are we ready?

Bisceglia,

Venturini,

Canale

et al. 2024

European Heart Journal Supplements

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Cardio-oncology rehabilitation (CORE) is not only an essential component of cancer rehabilitation but also a pillar of preventive cardio-oncology. Cardio-oncology rehabilitation is a comprehensive model based on a multitargeted approach and its efficacy has been widely documented; when compared with an ‘exercise only’ programme, comprehensive CORE demonstrates a better outcome. It involves nutritional counselling, psychological support, and cardiovascular (CV) risk assessment, and it is directed to a very demanding population with a heavy burden of CV diseases driven by physical inactivity, cancer therapy-induced metabolic derangements, and cancer therapy-related CV toxicities. Despite its usefulness, CORE is still underused in cancer patients and we are still at the dawning of remote models of rehabilitation (tele-rehabilitation). Not all CORE is created equally: a careful screening procedure to identify patients who will benefit the most from CORE and a multidisciplinary customized approach are mandatory to achieve a better outcome for cancer survivors throughout their cancer journey. The aim of this paper is to provide an updated review of CORE not only for cardiologists dealing with this peculiar population of patients but also for oncologists, primary care providers, patients, and caregivers. This multidisciplinary team should help cancer patients to maintain a healthy and active life before, during, and after cancer treatment, in order to improve quality of life and to fight health inequities.

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“…However, the evidence on the effectiveness of prehabilitation in frail surgical patients of advanced age is sparse. Recent systematic reviews found that the main focus of current trials in frail surgical patients lies in the prevention of disability (13)(14)(15). Positive effects were found on the reduction of the length of stay and complications, as well as on the improvement of post-surgical functional capacity.…”

Section: Introductionmentioning

confidence: 99%

“…Overall, the available body of evidence often focuses on cancer (10,12,16,14,17,18) or orthopaedic surgeries (11,19), and is predominantly of low quality. Moreover, recent systematic reviews did not identify any cost-effectiveness studies of prehabilitation in frail surgical patients of advanced age (20,15).…”

Section: Introductionmentioning

confidence: 99%

Cost-effectiveness of prehabilitation of elderly frail or pre-frail patients prior to elective surgery (PRAEP-GO) versus usual care – Protocol for a health economic evaluation alongside a randomized controlled trial

Eckhardt,

Quentin,

Silzle

et al. 2023

Preprint

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Background Prehabilitation aims to improve patients' functional capacity before surgery to reduce perioperative complications, promote recovery and decrease probability of disability. The planned economic evaluation is performed alongside a large German multi-centre pragmatic, two-arm parallel-group, randomized controlled trial on prehabilitation for frail elderly patients before elective surgery compared to standard care (PRAEP-GO RCT). The aim is to determine the cost-effectiveness and cost-utility of prehabilitation for frail elderly before an elective surgery. Methods The planned health economic evaluation comprises cost-effectiveness, cost-utility, and cost-minimisation analyses. Analyses are conducted in the German context from different perspectives including the payer perspective, i.e. the statutory health insurance, the societal perspective and the health care provider perspective. Data on outcomes and costs, are collected alongside the ongoing PRAEP-GO RCT. The trial population includes frail or pre-frail patients aged ≥70 years with planned elective surgery. The intervention consists of frailty screening (Fried phenotype), a shared decision-making conference determining modality (physiotherapy and unsupervised physical exercises, nutrition counselling, etc.) and setting (inpatient, day care, outpatient etc.) of a 3-week individual multimodal prehabilitation prior to surgery. The control group receives standard preoperative care. Costs include the intervention costs, the costs of the index hospital stay for surgery, and health care resources consumed during a 12-month follow-up. Clinical effectiveness outcomes included in the economic evaluation are the level of care dependency, the degree of disability as measured by the WHO Disability Assessment Schedule 2.0 (WHODAS 2.0), quality-adjusted life years (QALY) derived from the EQ-5D-5L and the German utility set, and complications occurring during the index hospital stay. Each adopted perspective considers different types of costs and outcomes as outlined in the protocol. All analyses will feature Intention-To-Treat analysis. To explore methodological and parametric uncertainties, we will conduct probabilistic and deterministic sensitivity analyses. Subgroup analyses will be performed as secondary analyses. Discussion The health economic evaluation will provide insights into the cost-effectiveness of prehabilitation in older frail populations, informing decision-making processes and contributing to the evidence base in this field. Potential limitation includes a highly heterogeneous trial population. Trial registration PRAEP-GO RCT: NCT04418271; economic evaluation: OSF (https://osf.io/swn79/ registration initiated on 29.06.2023).

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Exercise Training in Elderly Cancer Patients: A Systematic Review

Cited by 11 publications

References 138 publications

Exercise interventions for frail older adults with cancer

Exercise interventions for frail older adults with cancer

Cardio-oncology rehabilitation: are we ready?

Cost-effectiveness of prehabilitation of elderly frail or pre-frail patients prior to elective surgery (PRAEP-GO) versus usual care – Protocol for a health economic evaluation alongside a randomized controlled trial

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