Study: Exercise may combat adverse chemotherapy side effects

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Preliminary data indicate that performing mild exercise during chemotherapy infusion may be safe and could potentially combat adverse side effects that patients receive during treatment, said the results of a recent study that is slated to be presented at the 2010 American Society of Clinical Oncology (ASCO) annual meeting in Chicago on June 7.

Eleanor M. Walker, MD, division director of breast services at the department of radiation oncology at Henry Ford Hospital in Detroit and colleagues said that while regular exercise could help with fatigue and nausea, they wrote that “barriers such as access, motivation and co-morbidities prevent many of these patients from beginning and adhering to exercise.”

The researchers selected 10 newly-diagnosed breast cancer patients with an average age of 53 for inclusion in their Exercise and Cancer Integrative Therapy and Education Program (ExCITE) trial at the single-site hospital. By way of the program, the patients were given an opportunity to perform mild exercise on a portable leg ergometry machine while undergoing chemotherapy, in addition to a prescribed outpatient exercise program.  Prior to the start of the exercise program, Henry Ford's Preventative Cardiology Division measured the patients' exercise capacity, skeletal muscle strength and endurance and general blood work, metabolic screens, bone density and inflammatory biomarkers also were obtained.

All exercise sessions-averaging 16.4 minutes in duration- were supervised by a clinical exercise physiologist and differences in adverse clinical events following the infusion exercise session were compared to a standard infusion visit, in which no exercise occurred, the authors explained. Patient heart rate during infusion exercise was maintained at approximately 30-40 percent of heart rate reserve. Within three weeks of each chemotherapy treatment, a nurse, blinded to when the exercise sessions occurred, reviewed the patients’ charts for any significant clinical events.

The authors explained that the 10 patients underwent 55 chemotherapy infusions in total, 18 of which were completed in conjunction with exercise and 37 without exercise. Noting “significant findings,” Walker and colleagues said, “Of those 18 infusion-exercise sessions, two adverse clinical events were reported within three weeks of the chemotherapy infusion (11 percent). In contrast, following standard chemotherapy sessions without exercise, adverse events were reported in 20 out of 37 visits (54 percent).”

While Walker said, "Using exercise as an approach to cancer care has the potential to benefit patients both physically and psychologically, as well as to mitigate treatment side effects,  can be a great alternative to patients combating fatigue and nausea who are considering using supplements which may interfere with medications and chemotherapy they're taking during cancer treatment," she noted that further research is needed to determine if such exercise might lessen chemotherapy-related clinical events.

Walker and colleagues said that the ExCITE program is ongoing, and they plan to continue to investigate the potential benefits of exercise for cancer patients.