Exercise Improves Cardiorespiratory Fitness During and After Chemotherapy

During chemotherapy, physical exercise intervention is safe, improves long-term cardiorespiratory fitness, and alleviates some of the adverse effects of cancer treatment, according to a study published Oct. 18 in JACC: CardioOncology. If exercise isn't feasible during chemotherapy, the individual can participate in an exercise program afterward to recover the same level of function.

In the ACT trial, researchers examined the efficacy of 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 randomized to a 24-week exercise intervention initiated either during or after chemotherapy. Types of exercise included moderate to vigorous effort on a stationary bicycle, resistance training using weight machines and free weights, and badminton.

The primary endpoint was the difference in peak oxygen uptake (VO2peak) one year after the intervention. The secondary endpoints were VO2peak after completion of chemotherapy and intervention, muscle strength, health related quality of life (HRQoL), fatigue, physical activity, and self-efficacy at all time points.

Results showed that directly after chemotherapy, the group that initiated exercise therapy during treatment reported less fatigue and more physical activity and declined less in VO2peak, HRQoL, and muscle strength. Three months after chemotherapy, the group that began exercising after treatment showed similar values to the group that exercised during. Both groups were back to their baseline cardiorespiratory fitness one 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 Annemiek M.E. Walenkamp, MD, PhD, senior author of the study. "We hope our findings motivate health care providers to guide patients to engage in exercise interventions during anti-cancer treatment."

Clinical Topics: Cardiovascular Care Team, Prevention, Sports and Exercise Cardiology, Exercise, Cardio-Oncology

Keywords: Quality of Life, Cardiorespiratory Fitness, Breast Neoplasms, Testicular Neoplasms, Exercise Therapy, Oxygen Consumption, Lymphoma, Non-Hodgkin, Colonic Neoplasms

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