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Cardiorespiratory fitness and muscle strength in pancreatic cancer patients

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Abstract

Purpose

Cancer patients frequently experience reduced physical fitness due to the disease itself as well as treatment-related side effects. However, studies on physical fitness in pancreatic cancer patients are missing. Therefore, we assessed cardiorespiratory fitness and muscle strength of pancreatic cancer patients.

Methods

We included 65 pancreatic cancer patients, mostly after surgical resection. Cardiorespiratory fitness was assessed using cardiopulmonary exercise testing (CPET) and 6-min walk test (6MWT). Hand-held dynamometry was used to evaluate isometric muscle strength. Physical fitness values were compared to reference values of a healthy population. Associations between sociodemographic and clinical variables with patients’ physical fitness were analyzed using multiple regression models.

Results

Cardiorespiratory fitness (VO2peak, 20.5 ± 6.9 ml/min/kg) was significantly lower (−24%) compared to healthy reference values. In the 6MWT pancreatic cancer patients nearly reached predicted values (555 vs. 562 m). Maximal voluntary isometric contraction (MVIC) of the upper (−4.3%) and lower extremities (−13.8%) were significantly lower compared to reference values. Overall differences were larger in men than those in women. Participating in regular exercise in the year before diagnosis was associated with greater VO2peak (p < .05) and MVIC of the knee extensors (p < .05).

Conclusions

Pancreatic cancer patients had significantly impaired physical fitness with regard to both cardiorespiratory function and isometric muscle strength, already in the early treatment phase (median 95 days after surgical resection). Our findings underline the need to investigate exercise training in pancreatic cancer patients to counteract the loss of physical fitness.

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Acknowledgements

We would like to thank the patients who participated in this clinical trial. We also thank Friederike Scharhag-Rosenberger, PhD for her expertise and assistance in determining the VT, Martina Schmidt, PhD and Sabine Holzmeier for the support in data management and statistics and Jens Werner, MD for clinical advice on designing the trial.

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Authors and Affiliations

  1. Division of Physical Activity, Prevention and Cancer, National Center for Tumor Diseases and German Cancer Research Center, Im Neuenheimer Feld 460, 69120, Heidelberg, Germany

    Dorothea Clauss & Karen Steindorf

  2. Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany

    Christine Tjaden, Thilo Hackert & Lutz Schneider

  3. Division of Preventive Oncology, National Center for Tumor Diseases and German Cancer Research Center, Im Neuenheimer Feld 460, 69120, Heidelberg, Germany

    Cornelia M. Ulrich

  4. Department of Population Health Sciences, Huntsman Cancer Institute and University of Utah, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA

    Cornelia M. Ulrich

  5. Division of Medical Oncology, National Center for Tumor Diseases and Heidelberg University Hospital, Im Neuenheimer Feld 460, 69120, Heidelberg, Germany

    Joachim Wiskemann

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  1. Dorothea Clauss
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  2. Christine Tjaden
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  3. Thilo Hackert
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  4. Lutz Schneider
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  7. Karen Steindorf
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Correspondence to Karen Steindorf.

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Conflict of interest

The authors declare that they have no conflict of interest.

Disclosure of funding

The research was funded by a grant of the German Cancer Aid (SUPPORT-Study Grant No. 110513 and 110552) as well as by additional financial support of the German Cancer Research Center (Division of Physical Activity, Prevention and Cancer) and the University Hospital Heidelberg (Divisions of Medical Oncology and General, Visceral and Transplantation Surgery).

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Informed consent was obtained from all individual participants included in the study. This process was supervised by the local ethics committee.

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Joachim Wiskemann and Karen Steindorf shared last authorship

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Clauss, D., Tjaden, C., Hackert, T. et al. Cardiorespiratory fitness and muscle strength in pancreatic cancer patients. Support Care Cancer 25, 2797–2807 (2017). https://doi.org/10.1007/s00520-017-3694-8

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