During chemotherapy, physical exercise intervention may be safe, improve long-term cardiorespiratory fitness, and alleviate some of the adverse effects of cancer treatment, according to a novel study published by van der Schoot et al in JACC: CardioOncology. The findings suggested that if exercise isn't feasible during chemotherapy, individuals can participate in an exercise program after their therapy course concludes to recover the same level of function.
ACT Trial
In the ACT trial, researchers examined the efficacy of an exercise intervention during chemotherapy compared with after treatment for 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 curative chemotherapy were eligible for the study. Between February 2013 and November 2018, participants in the trial were randomly assigned to a 24-week exercise intervention initiated either during or after chemotherapy that included moderate to vigorous effort on a stationary bicycle, resistance training using weight machines and free weights, and badminton.
The primary endpoint of the study was the difference in peak oxygen uptake 1 year after the intervention. The secondary endpoints were the difference in peak oxygen uptake after completion of chemotherapy as well as the intervention, muscle strength, health-related quality of life, fatigue, physical activity, and self-efficacy at all time points.
The results of the study showed that directly after chemotherapy, the group that initiated exercise therapy during treatment reported less fatigue and more physical activity, as well as lower declines in the difference in peak oxygen uptake, health-related quality of life, and muscle strength. Three months after chemotherapy, the group that began exercising after treatment showed similar values to the group that exercised during treatment. Both groups were back to their baseline cardiorespiratory fitness 1 year after completing the exercise intervention, irrespective of timing.
"These findings suggest that the most optimal timing of physical exercise is during chemotherapy. However, initiating a physical exercise program after chemotherapy is a viable alternative when exercising during chemotherapy is not possible," said senior study author Annemiek M.E. Walenkamp, MD, PhD, a medical oncologist at the University Medical Center Groningen at the University of Groningen. "We hope our findings motivate health-care providers to guide patients to engage in exercise interventions during anticancer treatment."
Disclosure: For full disclosures of the study authors, visit jacc.org.
