Advertisement

Supportive Care in Cancer

, Volume 22, Issue 7, pp 1797–1806 | Cite as

Exercise training in patients with advanced gastrointestinal cancer undergoing palliative chemotherapy: a pilot study

  • Wiebke JensenEmail author
  • Freerk T. Baumann
  • Alexander Stein
  • Wilhelm Bloch
  • Carsten Bokemeyer
  • Maike de Wit
  • Karin Oechsle
Original Article

Abstract

Purpose

This pilot study aimed to investigate the feasibility of two different training programs in patients with advanced gastrointestinal cancer undergoing palliative chemotherapy. Potential effects of training programs on the patients’ quality of life, physical performance, physical activity in daily living, and biological parameters were exploratorily evaluated.

Methods

Patients were randomly assigned to a resistance (RET) and aerobic exercise training group (AET). Both underwent supervised training sessions twice a week for 12 weeks. RET was performed at 60–80 % of the one-repetition maximum and consisted of 2–3 sets of 15–25 repetitions. The AET group performed endurance training at 60–80 % of their predetermined pulse rate (for 10 to 30 min).

Results

A total of 26 gastrointestinal cancer patients could be randomized. Twenty-one patients completed the 12 weeks of intervention. The median adherence rate to exercise training of all 26 patients was 65 %, while in patients who were able to complete 12 weeks, adherence was 75 %. The fatigue score of all patients decreased from 66 to 43 post-intervention. Sleeping duration increased in both groups and muscular strength increased in the RET group. A higher number of steps in daily living was associated with higher levels of physical and social functioning as well as lower scores for pain and fatigue.

Conclusion

RET and AET are feasible in gastrointestinal cancer patients undergoing palliative chemotherapy. Both training programs seem to improve cancer-related symptoms as well as the patient’s physical activities of daily living.

Keywords

Gastrointestinal cancer palliative chemotherapy quality of life resistance exercise training aerobic exercise training physical performance 

Notes

Acknowledgments

We would like to thank the patients who devoted their precious time to participate in the study. We thank the foundation “Stiftung Leben mit Krebs®” for their support.

Conflict of interest

The authors have no conflicts of interest.

References

  1. 1.
    Schmiegel W, Pox C, Arnold D et al (2009) Colorectal carcinoma: the management of polyps, (neo)adjuvant therapy, and the treatment of metastases. Dtsch Arztebl Int 106:843–848PubMedCentralPubMedGoogle Scholar
  2. 2.
    Javier NS, Montagnini ML (2011) Rehabilitation of the hospice and palliative care patient. J Palliat Med 14:638–648. doi: 10.1089/jpm.2010.0125 PubMedCrossRefGoogle Scholar
  3. 3.
    Haydon AM, Macinnis RJ, English DR, Giles GG (2006) Effect of physical activity and body size on survival after diagnosis with colorectal cancer. Gut 55:62–67PubMedCentralPubMedCrossRefGoogle Scholar
  4. 4.
    Meyerhardt JA, Giovannucci EL, Holmes MD et al (2006) Physical activity and survival after colorectal cancer diagnosis. J Clin Oncol 24:3527–3534PubMedCrossRefGoogle Scholar
  5. 5.
    Meyerhardt JA, Heseltine D, Niedzwiecki D, Hollis D, Mayer RJ, Thomas J, Nelson H (2006) Impact of physical activity on cancer recurrence and survival in patients with stage III colon cancer: findings from CALGB 89803. J Clin Oncol 24:3535–3541PubMedCrossRefGoogle Scholar
  6. 6.
    Meyerhardt JA, Giovannucci EL, Ogino S, Kirkner GJ, Chan AT, Willett W, Fuchs CS (2009) Physical activity and male colorectal cancer survival. Arch Intern Med 169:2102–2108PubMedCentralPubMedCrossRefGoogle Scholar
  7. 7.
    Meyerhardt JA, Ogino S, Kirkner GJ, Chan AT, Wolpin B, Ng K, Nosho K, Shima K, Giovannucci EL, Loda M, Fuchs CS (2009) Interaction of molecular markers and physical activity on mortality in patients with colon cancer. Clin Cancer Res 15:5931–5936. doi: 10.1158/1078-0432.CCR-09-0496 PubMedCentralPubMedCrossRefGoogle Scholar
  8. 8.
    Courneya K, Friedenreich CM, Quinney HA, Fields AL, Jones LW, Fairey AS (2003) A randomized trial of exercise and quality of life in colorectal cancer survivors. Eur J Cancer Care 12:347–357CrossRefGoogle Scholar
  9. 9.
    Allgayer H, Nicolaus S, Schreiber S (2004) Decreased interleukin-1 receptor antagonist response following moderate exercise in patients with colorectal carcinoma after primary treatment. Cancer Detect Prev 28:208–213PubMedCrossRefGoogle Scholar
  10. 10.
    Allgayer H, Owen RW, Spiegelhalder B, Streit J, Reichel C, Bartsch H (2008) Short-term moderate exercise programs reduce oxidative DNA damage as determined by high-performance liquid chromatography-electrospray ionization-mass spectrometry in patients with colorectal carcinoma following primary treatment. Scand J Gastroenterol 43:971–978. doi: 10.1080/00365520701766111 PubMedCrossRefGoogle Scholar
  11. 11.
    Na Y, Kim Y, Ha Y, Yoon D (2000) Exercise therapy effect on natural killer cell cytotoxic activity in stomach cancer patients after curative surgery. Arch Phys Med Rehabil 81:777–779PubMedCrossRefGoogle Scholar
  12. 12.
    Lee DH, Kim JY, Lee MK, Lee C, Min JH, Jeong DH, Lee JW, Chu SH, Meyerhardt JA, Ligibel J, Jones LW, Kim NK, Jeon JY (2013) Effects of a 12-week home-based exercise program on the level of physical activity, insulin, and cytokines in colorectal cancer survivors: a pilot study. Support Care Cancer 21:2537–2545. doi: 10.1007/s00520-013-1822-7 PubMedCrossRefGoogle Scholar
  13. 13.
    Lowe SS, Watanabe SM, Courneya KS (2009) Physical activity as a supportive care intervention in palliative cancer patients: a systematic review. J Support Oncol 7:27–34PubMedGoogle Scholar
  14. 14.
    Maddocks M, Mockett S, Wilcock A (2009) Is exercise an acceptable and practical therapy for people with or cured of cancer? A systematic review. Cancer Treat Rev 35:383–390. doi: 10.1016/j.ctrv.2008.11.008 PubMedCrossRefGoogle Scholar
  15. 15.
    Cheville AL, Kollasch J, Vandenberg J, Shen T, Grothey A, Gamble G, Basford JR (2013) A home based exercise program to improve function, fatigue, and sleep quality in patients with stage IV lung and colorectal cancer. A randomized controlled trial. J Pain Symptom Manage 45:811–821. doi: 10.1016/j.jpainsymman.2012.05.006 PubMedCrossRefGoogle Scholar
  16. 16.
    Crevenna R, Schmidinger M, Keilani M et al (2003) Aerobic exercise as an additive palliative treatment for a patient with advanced hepatocellular cancer. Wien Med Wochenschr 153:237–240PubMedCrossRefGoogle Scholar
  17. 17.
    Crevenna R, Schmidinger M, Keilani M et al (2003) Aerobic exercise for a patient suffering from metastatic bone disease. Support Care Cancer 11:120–122PubMedGoogle Scholar
  18. 18.
    Dahele M, Skipworth RJ, Wall L, Voss A, Preston T, Fearon KC (2007) Objective physical activity and self-reported quality of life in patients receiving palliative chemotherapy. J Pain Symptom Manage 33:676–685PubMedCrossRefGoogle Scholar
  19. 19.
    Hwang CL, Yu CJ, Shih JY, Yang PC, Wu YT (2012) Effects of exercise training on exercise capacity in patients with non-small cell lung cancer receiving targeted therapy. Support Care Cancer 20:3169–3177. doi: 10.1007/s00520-012-1452-5 PubMedCrossRefGoogle Scholar
  20. 20.
    Headley JA, Ownby KK, John LD (2004) The effect of seated exercise on fatigue and quality of life in women with advanced breast cancer. Oncol Nurs Forum 31:977–983PubMedCrossRefGoogle Scholar
  21. 21.
    Jones L, Fitzgerald G, Leurent B, Round J, Eades J, Davis S, Gishen F, Holman A, Hopkins K, Tookman A (2012) Rehabilitation in advanced, progressive, recurrent cancer: a randomized controlled trial. J Pain Symptom Manage 46:315–325. doi: 10.1016/j.jpainsymman.2012.08.017 PubMedCrossRefGoogle Scholar
  22. 22.
    Kelm J, Ahlhelm R, Weissenbach P et al (2003) Physical training during intrahepatic chemotherapy. Arch Phys Med Rehabil 84:687–690PubMedCrossRefGoogle Scholar
  23. 23.
    Lowe SS, Watanabe SM, Baracos VE, Courneya KS (2009) Associations between physical activity and quality of life in cancer patients receiving palliative care: a pilot survey. J Pain Symptom Manage 38:785–796. doi: 10.1016/j.jpainsymman.2009.03.006 PubMedCrossRefGoogle Scholar
  24. 24.
    Lowe SS, Watanabe SM, Baracos VE, Courneya KS (2010) Physical activity interests and preferences in palliative cancer patients. Support Care Cancer 18:1469–1475. doi: 10.1007/s00520-009-0770-8 PubMedCrossRefGoogle Scholar
  25. 25.
    Lowe SS (2011) Physical activity and palliative cancer care. Recent Results Cancer Res 186:349–365. doi: 10.1007/978-3-642-04231-7_15 PubMedCrossRefGoogle Scholar
  26. 26.
    Maddocks M, Armstrong S, Wilcock A (2011) Exercise as a supportive therapy in incurable cancer: exploring patient preferences. Psychooncology 20:173–178. doi: 10.1002/pon.1720 PubMedCrossRefGoogle Scholar
  27. 27.
    Oechsle K, Jensen W, Schmidt T et al (2011) Physical activity, quality of life, and the interest in physical exercise programs in patients undergoing palliative chemotherapy. Support Care Cancer 19:613–619. doi: 10.1007/s00520-010-0862-5 PubMedCrossRefGoogle Scholar
  28. 28.
    Oldervoll LM, Loge JH, Paltiel H et al (2005) Are palliative cancer patients willing and able to participate in a physical exercise program? Palliat Support Care 3:281–287PubMedGoogle Scholar
  29. 29.
    Oldervoll LM, Loge JH, Paltiel H et al (2006) The effect of a physical exercise program in palliative care: a phase II study. J Pain Symptom Manage 31:421–430PubMedCrossRefGoogle Scholar
  30. 30.
    Oldervoll LM, Loge JH, Lydersen S, Paltiel H, Asp MB, Nygaard UV, Oredalen E, Frantzen TL, Lesteberg I, Amundsen L, Hjermstad MJ, Haugen DF, Paulsen Ø, Kaasa S (2011) Physical exercise for cancer patients with advanced disease: a randomized controlled trial. Oncologists 6:1649–1657. doi: 10.1634/theoncologist.2011-0133 CrossRefGoogle Scholar
  31. 31.
    Porock D, Kristjanson LJ, Tinnelly K et al (2000) An exercise intervention for advanced cancer patients experiencing fatigue: a pilot study. J Palliat Care 16:30–36PubMedGoogle Scholar
  32. 32.
    Segal RJ, Reid RD, Courneya KS et al (2003) Resistance exercise in men receiving androgen deprivation therapy for prostate cancer. J Clin Oncol 21:1653–1659PubMedCrossRefGoogle Scholar
  33. 33.
    Borg G (1998) Borg’s perceived exertion and pain scales. Human Kinetics, ChampaignGoogle Scholar
  34. 34.
    Aaronson NK, Ahmedzai S, Bergman B et al (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85:365–376PubMedCrossRefGoogle Scholar
  35. 35.
    Landers J (1985) Maximums based on reps. Nat Strength Cond 6:60–61Google Scholar
  36. 36.
    Malavolti M, Pietrobelli A, Dugoni M et al (2005) A new device for measuring daily total energy expenditure in free living individuals. Int J Body Compos Res 3:63Google Scholar
  37. 37.
    Patel SA, Slivka WA, Sciurba FC (2004) Validation of a wearable body monitoring device in COPD. Am J Respir Crit Care Med 30:A771Google Scholar
  38. 38.
    Frey I, Berg A, Grathwohl D, Keul J (1999) Freiburger questionnaire of physical activity- development, evaluation and application. Soz Praventivmed 44:55–64PubMedCrossRefGoogle Scholar
  39. 39.
    Ainsworth BE, Haskell WL, Whitt MC, Irwin ML, Swartz AM, Strath SJ, O’Brien WL, Bassett DR, Schmitz KH, Emplaincourt PO, Jacobs DR, Leon AS (2000) Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc 32:498–504CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Wiebke Jensen
    • 1
    Email author
  • Freerk T. Baumann
    • 2
  • Alexander Stein
    • 1
  • Wilhelm Bloch
    • 2
  • Carsten Bokemeyer
    • 1
  • Maike de Wit
    • 3
  • Karin Oechsle
    • 1
  1. 1.Department of Oncology/Hematology/Bone marrow Transplantation/PneumologyUniversity Medical Center Hamburg-EppendorfHamburgGermany
  2. 2.Department of Molecular and Cellular Sport MedicineInstitute of Cardiovascular Research and Sport Medicine German Sport University CologneCologneGermany
  3. 3.Department of Internal Medicine, Hematology and OncologyVivantes Klinikum NeukoellnBerlinGermany

Personalised recommendations