Safety, feasibility, and effectiveness of implementing supervised exercise into the clinical care of individuals with advanced cancer

Objective: To evaluate the safety, feasibility, and preliminary effectiveness of implementing supervised exercise programming into the clinical care of individuals with advanced cancer.

Design: Single group implementation feasibility study using a pre-posttest design.

Setting: Exercise Oncology Unit of the Spanish Cancer Association (a cancer-specific community facility outside the hospital setting).

Participants: Adult individuals with advanced cancer profile involving advanced local cancer or distant metastases.

Intervention: A 12-week, twice-weekly, supervised, clinic-based multi-component exercise program.

Main measure: Paired t-tests were used to assess pre-post changes and analyses of covariance were used to compare effects based on selected participant characteristics.

Results: Eighty-four individuals with advanced cancer completed the baseline assessment, with six participants withdrawing prior to the start of the program. Of the 78 participants, 17 dropped out, thus, a total of 61 completed the final assessment. Mean adherence was 82.5%. No serious adverse events occurred. Exercise significantly improved VO_2max by 5.2 mL·kg·min (p < 0.001), chest strength (p < 0.001), leg strength (p < 0.001), lean body mass (p = 0.003), skeletal muscle mass (p < 0.002), % body fat (p = 0.02), quality of life by 5.3 points (p = 0.009), fatigue by 3.2 points (p = 0.012), and physical activity by 1680 METs/week (p < 0.001).

Conclusions: Our clinically supervised and tailored exercise program involving moderate to vigorous intensity exercise was found to be feasible, safe, and effective for individuals with advanced cancer.

Implications for cancer survivors: With proper screening and supervision, individuals with advanced cancer can benefit from tailored exercise oncology support as part of an overall therapeutic care plan.