Supportive Care in Cancer

, Volume 26, Issue 5, pp 1515–1523 | Cite as

Vigorous intensity aerobic interval exercise in bladder cancer patients prior to radical cystectomy: a feasibility randomised controlled trial

  • Srijit Banerjee
  • Kate Manley
  • Barnabas Shaw
  • Liane Lewis
  • Gabriel Cucato
  • Robert Mills
  • Mark Rochester
  • Allan Clark
  • John M. Saxton
Original Article



Strategies to improve pre-operative cardiopulmonary fitness could positively impact recovery after surgery. This study investigated the feasibility of vigorous intensity aerobic interval exercise in bladder cancer patients prior to radical cystectomy (RC).


A total of 60 patients were randomised (1:1) to exercise or control following a cardiopulmonary exercise test (CPET). The exercise group was offered twice-weekly pre-operative supervised vigorous intensity aerobic interval exercise in addition to standard treatment. The controls received standard treatment only. A repeat CPET was undertaken before surgery and post-operative recovery outcomes were recorded.


Over half of the 112 eligible patients approached in the clinic were recruited to the study (53.5%), with recruited patients attending a median of 8 (range 1–10) exercise sessions over a pre-operative period of 3–6 weeks. Improvements in peak values of oxygen pulse (P = 0.001), minute ventilation (P = 0.002) and power output (P < 0.001) were observed at the follow-up CPET in the exercise group versus controls and there were no adverse events. Although this feasibility study was not powered to detect changes in post-operative recovery outcomes, there were marginal (non-significant) differences in favour of the exercise group in post-operative Clavien-Dindo score and need for high dependency unit inotropic support.


Bladder cancer patients respond well to pre-surgical aerobic interval exercise, and the improvements in cardiopulmonary fitness variables could have important implications for post-operative recuperation after RC. These findings provide a strong foundation for an adequately powered randomised controlled trial.


Pre-operative care Exercise Urinary bladder neoplasms 



analysis of covariance


anaerobic threshold


body mass index


cardiopulmonary exercise test


high dependency unit


length of stay


National Health Service


radical cystectomy


ratings of perceived exertion

\( \dot{V}E \)

minute ventilation

\( \dot{V} \)O2

oxygen consumption per minute


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2017

Authors and Affiliations

  • Srijit Banerjee
    • 1
  • Kate Manley
    • 1
  • Barnabas Shaw
    • 2
  • Liane Lewis
    • 3
  • Gabriel Cucato
    • 4
  • Robert Mills
    • 1
  • Mark Rochester
    • 1
  • Allan Clark
    • 5
  • John M. Saxton
    • 6
  1. 1.Department of UrologyNorfolk and Norwich University HospitalNorwichUK
  2. 2.School of Health Sciences, Faculty of Medicine and Health SciencesUniversity of East AngliaNorwichUK
  3. 3.Department of Computer and Information SciencesUniversity of StrathclydeGlasgowUK
  4. 4.School of Physical Education and SportUniversity of Sao PauloSao PauloBrazil
  5. 5.Norwich Medical School, Faculty of Medicine and Health SciencesUniversity of East AngliaNorwichUK
  6. 6.Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life SciencesNorthumbria UniversityNewcastle upon TyneUK

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