The impact of a hospital-based exercise oncology program on cancer treatment–related side effects among rural cancer survivors

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Abstract

Purpose

To assess the impact of the Personal Optimism With Exercise Recovery (POWER) program on cancer treatment–related side effects among rural cancer survivors.

Methods

In this retrospective study of data collected between 2016 and 2019, we assessed change in cardiorespiratory fitness, whole-body muscular endurance, physical function and strength, anthropometrics, fatigue, and quality of life (QoL), after participation in POWER. Descriptive statistics were calculated for demographic and clinical variables. Univariate analysis of variance was carried out with age and BMI at initial assessment as covariates.

Results

A total of 239 survivors, 78% rural residents, completed a follow-up assessment. Among rural cancer survivors, the most prevalent cancer sites were breast (42.5%), prostate (12.4%), and lymphoma (5.9%). The majority of survivors were female (70%), non-Hispanic (94.6%), and white (93.5%), with average age and BMI of 62.1 ± 13.2 years and 28.4 ± 6.7 kg/m ², respectively. Rural cancer survivors with cancer stages I–III exhibited significant improvements in fitness (+ 3.07 ml/kg/min, 95% CI 1.93, 4.21; + 0.88 METS, 95% CI 0.55, 1.20), physical function (30-s chair stand: + 2.2 repetitions, 95% CI 1.3, 3.1), muscular endurance (10-repetition maximum: chest press + 4.1 kg, 95% CI 2.0, 6.3; lateral pulldown + 6.6 kg, 95% CI 4.4, 8.9), self-reported fatigue (FACIT-Fatigue score: + 4.9, 95% CI 1.6, 8.1), and QoL (FACT-G7 score + 2.1, 95% CI, 0.9, 3.4). Among stage IV rural and urban cancer survivors, significant improvements were observed in muscular endurance and physical function.

Conclusion

Participation in POWER was associated with attenuation of cancer treatment–related side effects and may serve as a model exercise oncology program for rural cancer survivors.

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Most cited references 30

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Exercise Guidelines for Cancer Survivors

KRISTIN L. CAMPBELL, KERRI M. WINTERS-STONE, JOACHIM WISKEMANN … (2019)

The number of cancer survivors worldwide is growing, with over 15.5 million cancer survivors in the United States alone-a figure expected to double in the coming decades. Cancer survivors face unique health challenges as a result of their cancer diagnosis and the impact of treatments on their physical and mental well-being. For example, cancer survivors often experience declines in physical functioning and quality of life while facing an increased risk of cancer recurrence and all-cause mortality compared with persons without cancer. The 2010 American College of Sports Medicine Roundtable was among the first reports to conclude that cancer survivors could safely engage in enough exercise training to improve physical fitness and restore physical functioning, enhance quality of life, and mitigate cancer-related fatigue.

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Measuring fatigue and other anemia-related symptoms with the Functional Assessment of Cancer Therapy (FACT) measurement system.

Matthew E Kaplan, D Cella, Lorraine Webster … (1997)

This paper reports the development and validation of a questionnaire assessing fatigue and anemia-related concerns in people with cancer. Using the 28-item Functional Assessment of Cancer Therapy-General (FACT-G) questionnaire as a base, 20 additional questions related to the symptoms and concerns of patients with anemia were developed. Thirteen of these 20 questions dealt with fatigue, while the remaining 7 covered other concerns related to anemia. Using semi-structured interviews with 14 anemic oncology patients and 5 oncology experts, two instruments were produced: The FACT-Fatigue (FACT-F), consisting of the FACT-G plus 13 fatigue items, and the FACT-Anemia (FACT-An), consisting of the FACT-F plus 7 nonfatigue items. These measures were, in turn, tested on a second sample of 50 cancer patients with hemoglobin levels ranging from 7 to 15.9 g/dL. The 41-item FACT-F and the 48 item FACT-An scores were found to be stable (test-retest r = 0.87 for both) and internally consistent (coefficient alpha range = 0.95-0.96). The symptom-specific subscales also showed good stability (test-retest r range = 0.84-0.90), and the Fatigue subscale showed strong internal consistency (coefficient alpha range = 0.93-0.95). Internal consistency of the miscellaneous nonfatigue items was lower but acceptable (alpha range = 0.59-0.70), particularly in light of their strong relationship to patient-rated performance status and hemoglobin level. Convergent and discriminant validity testing revealed a significant positive relationship with other known measures of fatigue, a significant negative relationship with vigor, and a predicted lack of relationship with social desirability. The total scores of both scales differentiated patients by hemoglobin level (p < 0.05) and patient-rated performance status (p < 0.0001). The 13-item Fatigue subscale of the FACT-F and the 7 nonfatigue items of the FACT-An also differentiated patients by hemoglobin level (p < 0.05) and patient-rated performance status (p < or = 0.001). The FACT-F and FACT-An are useful measures of quality of life in cancer treatment, adding more focus to the problems of fatigue and anemia. The Fatigue Subscale may also stand alone as a very brief, but reliable and valid measure of fatigue.

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Author and article information

Contributors

Adriana M. Coletta:

ORCID: http://orcid.org/0000-0002-2503-2792

adriana.coletta@hci.utah.edu

Journal

Journal ID (nlm-ta): Support Care Cancer

Journal ID (iso-abbrev): Support Care Cancer

Title: Supportive Care in Cancer

Publisher: Springer Berlin Heidelberg (Berlin/Heidelberg )

ISSN (Print): 0941-4355

ISSN (Electronic): 1433-7339

Publication date (Electronic): 27 January 2021

Publication date PMC-release: 27 January 2021

Pages: 1-10

Affiliations

[1 ]GRID grid.223827.e, ISNI 0000 0001 2193 0096, Department of Health & Kinesiology, , The University of Utah, ; Salt Lake City, UT USA

[2 ]GRID grid.479969.c, ISNI 0000 0004 0422 3447, The Huntsman Cancer Institute at the University of Utah, ; 2000 Circle of Hope Drive, Rm 4747, Salt Lake City, UT 84112 USA

[3 ]GRID grid.413886.0, George E Wahlen, Department of Veterans Affairs Medical Center, ; Salt Lake City, UT USA

[4 ]GRID grid.223827.e, ISNI 0000 0001 2193 0096, Department of Population Health Sciences, , The University of Utah, ; Salt Lake City, UT USA

[5 ]GRID grid.223827.e, ISNI 0000 0001 2193 0096, Department of Internal Medicine, , The University of Utah, ; Salt Lake City, UT USA

[6 ]GRID grid.223827.e, ISNI 0000 0001 2193 0096, Division of Physical Medicine and Rehabilitation, , The University of Utah, ; Salt Lake City, UT USA

Author information

Adriana M. Coletta http://orcid.org/0000-0002-2503-2792

Article

Publisher ID: 6010

DOI: 10.1007/s00520-021-06010-5

PMC ID: 7838462

PubMed ID: 33502590

SO-VID: b839b995-571b-4bb5-889c-e6b737293a29

License:

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

History

Date received : 7 October 2020

Date accepted : 19 January 2021

Funding

Funded by: FundRef http://dx.doi.org/10.13039/100000054, National Cancer Institute;

Award ID: P30CA042014

Award ID: U01CA206110

Award ID: R01CA211705

Award Recipient : Cornelia M. Ulrich

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The impact of a hospital-based exercise oncology program on cancer treatment–related side effects among rural cancer survivors

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Karger: Oncology

Most cited references 30

The Timed “Up & Go”: A Test of Basic Functional Mobility for Frail Elderly Persons

Exercise Guidelines for Cancer Survivors

Measuring fatigue and other anemia-related symptoms with the Functional Assessment of Cancer Therapy (FACT) measurement system.

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