Multimodal prehabilitation in colorectal cancer patients to improve functional capacity and reduce postoperative complications: the first international randomized controlled trial for multimodal prehabilitation The effects of prehabilitation versus usual care to reduce postoperative complications in high-risk patients with colorectal cancer or dysplasia scheduled for elective colorectal resection: study protocol of a randomized controlled trial Design of the Physical exercise during Adjuvant Chemotherapy Effectiveness Study (PACES):A randomized controlled trial to evaluate effectiveness and cost-effectiveness of physical exercise in improving physical fitness and reducing fatigue Supervised physical exercise to improve the quality of life of cancer patients: the EFICANCER randomised controlled trial Quality-of-life and surgical treatments for rectal cancer--a longitudinal analysis using the California Cancer Registry. CRITICS-II: a multicentre randomised phase II trial of neo-adjuvant chemotherapy followed by surgery versus neo-adjuvant chemotherapy and subsequent chemoradiotherapy followed by surgery versus neo-adjuvant chemoradiotherapy followed by surgery in resectable gastric cancer Activities of Daily Living and Quality of Life of Elderly Patients After Elective Surgery for Gastric and Colorectal Cancers Randomised controlled trial of a supervised exercise rehabilitation program for colorectal cancer survivors immediately after chemotherapy: study protocol Iyengar-Yoga Compared to Exercise as a Therapeutic Intervention during (Neo)adjuvant Therapy in Women with Stage I–III Breast Cancer: Health-Related Quality of Life, Mindfulness, Spirituality, Life Satisfaction, and Cancer-Related Fatigue Perioperative rehabilitation in operation for lung cancer (PROLUCA) – rationale and design Randomized controlled trial to evaluate the effects of progressive resistance training compared to progressive muscle relaxation in breast cancer patients undergoing adjuvant radiotherapy: the BEST study EnROL: A multicentre randomised trial of conventional versus laparoscopic surgery for colorectal cancer within an enhanced recovery programme 'Pragmatic randomized controlled trial of individually prescribed exercise versus usual care in a heterogeneous cancer survivor population': A feasibility study PEACH Trial: Prescribed exercise after chemotherapy Safety, feasibility and effects of an individualised walking intervention for women undergoing chemotherapy for ovarian cancer: a pilot study
Background Colorectal cancer ( CRC ) is the second most prevalent type of cancer in the world . Surgery is the only curative option . However , postoperative complications occur in up to 50 % of patients and are associated with higher morbidity and mortality rates , lower health related quality of life ( HRQoL ) and increased expenditure in health care . The number and severity of complications are closely related to preoperative functional capacity , nutritional state , psychological state , and smoking behavior . Traditional approaches have targeted the postoperative period for rehabilitation and lifestyle changes . However , recent evidence shows that the preoperative period might be the optimal moment for intervention . This study will determine the impact of multimodal prehabilitation on patients ’ functional capacity and postoperative complications . Methods / design This international multicenter , prospect i ve , r and omized controlled trial will include 714 patients undergoing colorectal surgery for cancer . Patients will be allocated to the intervention group , which will receive 4 weeks of prehabilitation ( group 1 , prehab ) , or the control group , which will receive no prehabilitation ( group 2 , no prehab ) . Both groups will receive perioperative care in accordance with the enhanced recovery after surgery ( ERAS ) guidelines . The primary outcomes for measurement will be functional capacity ( as assessed using the six-minute walk test ( 6MWT ) ) and postoperative status determined with the Comprehensive Complication Index ( CCI ) . Secondary outcomes will include HRQoL , length of hospital stay ( LOS ) and a cost-effectiveness analysis . Discussion Multimodal prehabilitation is expected to enhance patients ’ functional capacity and to reduce postoperative complications . It may therefore result in increased survival and improved HRQoL. This is the first international multicenter study investigating multimodal prehabilitation for patients undergoing colorectal surgery for cancer . Trial registration Trial Registry : NTR5947 – date of registration : 1 August 2016 Background Of all older patients that opt for elective colorectal surgery , approximately one-third has one or more postoperative complications , particularly those patients with a low cardiorespiratory fitness ( ventilatory anaerobic threshold ( VAT ) < 11 mL/kg/min ) . A physical exercise training program prior to surgery ( prehabilitation ) can improve their cardiorespiratory fitness . It remains to be seen whether prehabilitation also reduces postoperative complications , as most of the studies so far were rather underpowered , heterogeneous , and biased toward selection of patients with a lower risk of postoperative complications . The primary objective of this study is to evaluate the effects of a three-week prehabilitation program on 30-day postoperative complications in patients with a VAT < 11 mL/kg/min planned for elective colorectal resection for colorectal cancer or dysplasia . Methods In this multicenter prospect i ve r and omized controlled trial , patients ≥ 60 years with colorectal cancer or dysplasia grade I , II , or III , planned for elective colorectal resection in two hospitals in the Netherl and s , will be recruited . Eligible patients must have a score ≤ 7 metabolic equivalents on the veterans-specific activity question naire , and should be able to perform a cardiopulmonary exercise test . A total of 86 patients will be r and omized ( block-stratified r and omization ) to prehabilitation ( intervention group ) or usual care ( control group ) . For final inclusion , VAT should be < 11 mL/kg/min . Three times a week for 3 weeks , a 60-min supervised prehabilitation session will be completed in community physical therapy practice s by the 43 patients in the prehabilitation group , consisting of moderate-to-high intensity interval training to improve cardiorespiratory fitness , and resistance training to improve peripheral muscle strength . Additionally , patients perform home exercises twice a week on a moderate intensity level . The 43 patients in the usual care group will receive usual care . Discussion Optimizing preoperative physical fitness may decrease the postoperative complication rate , may lead to fewer reoperations , less intense clinical care , a shorter length of stay , a more effective surgical planning ( process-optimization ) , fewer readmissions , less intense rehabilitation , shorter rehabilitation period , earlier resumption of work , enhance patient perceived health-related quality of life , and promote performance in daily life . Cost-effectiveness should therefore be expected and evaluated . Trial registration Medical Ethics Committee Twente , Enschede , the Netherl and s ( NL45001.044.13 , September 3 , 2013 ) ; Netherl and s Trial Register ( NTR ; NTR4032 , June 14 , 2013 ) Background Cancer chemotherapy is frequently associated with a decline in general physical condition , exercise tolerance , and muscle strength and with an increase in fatigue . While accumulating evidence suggests that physical activity and exercise interventions during chemotherapy treatment may contribute to maintaining cardiorespiratory fitness and strength , the results of studies conducted to date have not been consistent . Additional research is needed to determine the optimal intensity of exercise training programs in general and in particular the relative effectiveness of supervised , outpatient ( hospital- or physical therapy practice -based ) versus home-based programs . Methods This multicenter , prospect i ve , r and omized trial will evaluate the effectiveness of a low to moderate intensity , home-based , self-management physical activity program , and a high intensity , structured , supervised exercise program , in maintaining or enhancing physical fitness ( cardiorespiratory fitness and muscle strength ) , in minimizing fatigue and in enhancing the health-related quality of life ( HRQoL ) .  Patients receiving adjuvant chemotherapy for breast or colon cancer ( n = 360 ) are being recruited from twelve hospitals in the Netherl and s , and r and omly allocated to one of the two treatment groups or to a  ' usual care ' control group .  Performance-based and self-reported outcomes are assessed at baseline , at the end of chemotherapy and at six month follow-up . Discussion This large , multicenter , r and omized clinical trial will provide additional empirical evidence regarding the effectiveness of physical exercise during adjuvant chemotherapy in enhancing physical fitness , minimizing fatigue , and maintaining or enhancing patients ' quality of life . If demonstrated to be effective , exercise intervention programs will be a welcome addition to the st and ard program of care offered to patients with cancer receiving chemotherapy . Trial registration This study is registered at the Netherl and s Trial Register ( NTR 2159 Background The optimal form of exercise for individuals with cancer has yet to be identified , but there is evidence that exercise improves their quality of life . The aim of this study is to assess the efficacy and efficiency of an innovative physical exercise programme , for individuals undergoing chemotherapy for breast , gastrointestinal or non-small cell lung tumours , for improving quality of life , reducing level of fatigue , and enhancing functional capacity over time . Design / Methods We will conduct a clinical trial in 66 patients with stage IV breast , gastrointestinal or non-small cell lung cancer , recruited by the Department of Oncology of the referral hospital from 4 primary care health centres of the Basque Health Service ( Osakidetza ) . These patients will be r and omised to one of two groups . The treatment common to both groups will be the usual care for cancer : optimized usual drug therapies and strengthening of self-care ; in addition , patients in the intervention group will participate in a 2-month exercise programme , including both aerobic and strength exercises , supervised by nurses in their health centre . The principal outcome variable is health-related quality of life , measured blindly with the 30-item European Organization for the Research and Treatment of Cancer Core Quality of Life Question naire and Short Form-36 four times : at baseline , and 2 , 6 and 12 months later . The secondary outcome variables are fatigue ( Functional Assessment of Chronic Illness Therapy-Fatigue question naire ) , functional capacity ( 6-Minute Walk Test and cardiorespiratory test ) , muscle strength ( h and -held dynamometry and sit-to-st and test ) , radiological response to treatment ( Response Evaluation Criteria In Solid Tumors ) and progression-free and overall survival . Age , sex , diagnosis , chemotherapy regimen , Eastern Cooperative Oncology Group performance status and smoking status will be considered as predictive variables . Data will be analysed on an intention-to-treat basis , comparing changes at each time point between groups , adjusting for baseline values by analysis of covariance . Discussion As well as achieving the objectives set , this study will provide us with information on patient perception of the care received and an opportunity to develop a project based on collaborative action between the primary care and oncology professionals . Trial registration Clinical Trials.gov Identifier : NCT01786122 Registration date : 02/05/2013 BACKGROUND Heterogeneous results for research investigating health-related quality of life ( HRQL ) in patients undergoing sphincter-ablating procedures for rectal cancer are likely due to single institution experiences and measurement of HRQL . To address this heterogeneity , we evaluated HRQL in patients with rectal cancer by type of surgery , location of tumor , and receipt of adjuvant therapy using an HRQL instrument that has not been used to address rectal cancer patients in a population -based sample over time . METHODS The Functional Assessment of Cancer Therapy-Colorectal instrument was administered at 9 and 19 months after diagnosis to a consecutive sample of 160 patients in Northern California identified by the California Cancer Registry . A broad multidimensional interpretation of HRQL was used to examine the impact of tumor location and treatment status , stage of disease , age , and gender . RESULTS In general , men had lower social well-being scores , and younger patients had lower physical and emotional well-being scores and colorectal concerns scores . We found no differences in HRQL by either tumor location or type of surgery , at either 9 or 19 months after diagnosis . Lower physical well-being and greater adverse colorectal concerns were reported at 9 months among patients who received adjuvant therapy ; however , only adverse colorectal concerns persisted over time . CONCLUSIONS This study provides additional evidence that sphincter-ablating procedures do not necessarily reduce quality of life in patients with rectal cancer . Distinctive features of this study include a broad multidimensional interpretation of HRQL , the 19 months of longitudinal follow-up , and a prospect i ve population -based study design Background Although radical surgery remains the cornerstone of cure in resectable gastric cancer , survival remains poor . Current evidence -based (neo)adjuvant strategies have shown to improve outcome , including perioperative chemotherapy , postoperative chemoradiotherapy and postoperative chemotherapy . However , these regimens suffer from poor patient compliance , particularly in the postoperative phase of treatment . The CRITICS-II trial aims to optimize preoperative treatment by comparing three treatment regimens : ( 1 ) chemotherapy , ( 2 ) chemotherapy followed by chemoradiotherapy and ( 3 ) chemoradiotherapy . Methods In this multicentre phase II non-comparative study , patients with clinical stage IB-IIIC ( TNM 8th edition ) resectable gastric adenocarcinoma are r and omised between : ( 1 ) 4 cycles of docetaxel+oxaliplatin+capecitabine ( DOC ) , ( 2 ) 2 cycles of DOC followed by chemoradiotherapy ( 45Gy in combination with weekly paclitaxel and carboplatin ) or ( 3 ) chemoradiotherapy . Primary endpoint is event-free survival , 1 year after r and omisation ( events are local and /or regional recurrence or progression , distant recurrence , or death from any cause ) . Secondary endpoints include : toxicity , surgical outcomes , percentage radical ( R0 ) resections , pathological tumour response , disease recurrence , overall survival , and health related quality of life . Exploratory endpoints include translational studies on predictive and prognostic biomarkers . Discussion The aim of this study is to select the most promising among three preoperative treatment arms in patients with resectable gastric adenocarcinoma . This treatment regimen will subsequently be compared with the st and ard therapy in a phase III trial . Trial registration clinical trials.gov NCT02931890 ; registered 13 October 2016 . Date of first enrolment : 21 December 2017 Objective : To establish reliable st and ards for surgical application to elderly patients 75 years old or older with gastric or colorectal cancer with special reference to the postoperative recovery of activities of daily living ( ADL ) and quality of life ( QOL ) . Summary Background Data : ADL and QOL are important outcomes of surgery for the elderly . However , there has been only limited evidence on the natural course of recovery of functional independence . Methods : Two hundred twenty-three patients 75 years old or older with gastric or colorectal cancer were prospect ively examined .  Physical conditions , ADL , and QOL  were evaluated preoperatively and at the first , third , and sixth postoperative month . Results : The mortality and morbidity rates were 0.4 % and 28 % , respectively . Twenty-four percent of patients showed a decrease in ADL at 1 month postoperatively , but most patients recovered from this transient reduction , with only 3 % showing a decline at the sixth postoperative month ( 6POM ) . ADL of these patients was likely to decrease after discharge from the hospital . QOL of the patients showed a recovery to an extent equal to or better than their average preoperative scores . Conclusions : Of the patients 75 years old or older who underwent elective surgery for gastric or colorectal cancer , only a few showed a protracted decline in ADL and most exhibited better QOL after surgery . This indicates that surgical treatment should be considered , whenever needed , for elderly patients 75 years old or older with gastric or colorectal cancer . Estimation of Physical Ability and Surgical Stress is useful for predicting postoperative declines in ADL and protracted disability ; this could aid in establishing a directed rehabilitation program for preventing protracted disability in elderly patients Background Colorectal cancer ( CRC ) diagnosis and the ensuing treatments can have a substantial impact on the physical and psychological health of survivors . As the number of CRC survivors increases , so too does the need to develop viable rehabilitation programs to help these survivors return to good health as quickly as possible . Exercise has the potential to address many of the adverse effects of CRC treatment ; however , to date , the role of exercise in the rehabilitation of cancer patients immediately after the completion of treatment has received limited research attention . This paper presents the design of a r and omised controlled trial which will evaluate the feasibility and efficacy of a 12-week supervised aerobic exercise program ( ImPACT Program ) on the physiological and psychological markers of rehabilitation , in addition to biomarkers of st and ard haematological outcomes and the IGF axis . Methods / Design Forty CRC patients will be recruited through oncology clinics and r and omised to an exercise group or a usual care control group .  Baseline assessment will take place within 4 weeks of the patient completing adjuvant chemotherapy treatment . The exercise program for patients in the intervention group will commence a week after the baseline assessment . The program consists of three supervised moderate-intensity aerobic exercise sessions per week for 12 weeks . All participants will have assessment s at baseline ( 0 wks ) , mid-intervention ( 6 wks ) , post-intervention ( 12 wks ) and at a 6-week follow-up ( 18 wks ) . Outcome measures include cardio-respiratory fitness , biomarkers associated with health and survival , and indices of fatigue and quality of life . Process measures are participants ' acceptability of , adherence to , and compliance with the exercise program , in addition to the safety of the program . Discussion The results of this study will provide valuable insight into the role of supervised exercise in improving life after CRC . Additionally , process analyses will inform the feasibility of implementing the program in a population of CRC patients immediately after completing chemotherapy . Trial registration This study aims to test the effects of yoga on health-related quality of life , life satisfaction , cancer-related fatigue , mindfulness , and spirituality compared to conventional therapeutic exercises during (neo)adjuvant cytotoxic and endocrine therapy in women with breast cancer . In a r and omized controlled trial 92 women with breast cancer undergoing oncological treatment were r and omly enrolled for a yoga intervention ( YI ) ( n = 45 ) or for a physical exercise intervention ( PEI ) ( n = 47 ) . Measurements were obtained before ( t 0 ) and after the intervention ( t 1 ) as well as 3 months after finishing intervention ( t 2 ) using st and ardized question naires . Life satisfaction and fatigue improved under PEI ( p < 0.05 ) but not under YI ( t 0 to t 2 ) . Regarding quality of life ( EORTC QLQ-C30 ) a direct effect ( t 0 to t 1 ; p < 0.001 ) of YI was found on role and emotional functioning , while under PEI only emotional functioning improved . Significant improvements ( p < 0.001 ) were observed at both t 1 and t 2 also for symptom scales in both groups : dyspnea , appetite loss , constipation , and diarrhea . There was no significant difference between therapies for none of the analyzed variables neither for t 1 nor for t 2 . During chemotherapy , yoga was not seen as more helpful than conventional therapeutic exercises . This does not argue against its use in the recovery phase Background The purpose of the PROLUCA study is to investigate the efficacy of preoperative and early postoperative rehabilitation in a non-hospital setting in patients with operable lung cancer with special focus on exercise . Methods Using a 2x2 factorial design with continuous effect endpoint ( Maximal Oxygen Uptake ( VO2peak ) ) , 380 patients with non-small cell lung cancer ( NSCLC ) stage I-IIIa referred for surgical resection will be r and omly assigned to one of four groups : ( 1 ) preoperative and early postoperative rehabilitation ( starting two weeks after surgery ) ; ( 2 ) preoperative and late postoperative rehabilitation ( starting six weeks after surgery ) ; ( 3 ) early postoperative rehabilitation alone ; ( 4 ) today ’s st and ard care which is postoperative rehabilitation initiated six weeks after surgery . The preoperative rehabilitation program consists of an individually design ed , 30-minute home-based exercise program performed daily . The postoperative rehabilitation program consists of a supervised group exercise program comprising cardiovascular and resistance training two-hour weekly for 12 weeks combined with individual counseling . The primary study endpoint is VO2peak and secondary endpoints include : Six-minute walk distance ( 6MWD ) , one-repetition-maximum ( 1RM ) , pulmonary function , patient-reported outcomes ( PROs ) on health-related quality of life ( HRQoL ) , symptoms and side effects of the cancer disease and the treatment of the disease , anxiety , depression , wellbeing , lifestyle , hospitalization time , sick leave , work status , postoperative complications ( up to 30 days after surgery ) and survival . Endpoints will be assessed at baseline , the day before surgery , pre-intervention , post-intervention , six months after surgery and one year after surgery . Discussion The results of the PROLUCA study may potentially contribute to the identification of the optimal perioperative rehabilitation for operable lung cancer patients focusing on exercise initiated immediately after diagnosis and rehabilitation shortly after surgery . Trial Registration Background Cancer-related fatigue ( CRF ) is one of the most common and distressing side effects of cancer and its treatment . During and after radiotherapy breast cancer patients often suffer from CRF which frequently impairs quality of life ( QoL ) . Despite the high prevalence of CRF in breast cancer patients and the severe impact on the physical and emotional well-being , effective treatment methods are scarce . Physical activity for breast cancer patients has been reported to decrease fatigue , to improve emotional well-being and to increase physical strength . The pathophysiological and molecular mechanisms of CRF and the molecular-biologic changes induced by exercise , however , are poorly understood . In the BEST trial we aim to assess the effects of resistance training on fatigue , QoL and physical fitness as well as on molecular , immunological and inflammatory changes in breast cancer patients during adjuvant radiotherapy . Methods / design The BEST study is a prospect i ve r and omized , controlled intervention trial investigating the effects of a 12-week supervised progressive resistance training compared to a 12-week supervised muscle relaxation training in 160 patients with breast cancer undergoing adjuvant radiotherapy .  To determine the effect of exercise itself beyond potential psychosocial group effects , patients in the control group perform a group-based progressive muscle relaxation training . Main inclusion criterion is histologically confirmed breast cancer stage I-III after lumpectomy or mastectomy with indication for adjuvant radiotherapy . Main exclusion criteria are acute infectious diseases , severe neurological , musculosceletal or cardiorespiratory disorders . The primary endpoint is cancer-related fatigue ; secondary endpoints include immunological and inflammatory parameters analyzed in peripheral blood , saliva and urine . In addition , QoL , depression , physical performance and cognitive capacity will be assessed . Discussion The BEST study is the first r and omized controlled trial comparing progressive resistance training with muscle relaxation training in breast cancer patients during adjuvant radiotherapy . Based on the analysis of physiological , immunological and inflammatory parameters it will contribute to a better underst and ing of the physiological and psychosocial effects and the biological mechanisms of resistance training . The ultimate goal is the implementation of optimized intervention programs to reduce fatigue , improve quality of life and potentially the prognosis after breast cancer . Trial registration Clinical Trials.gov Background During the last two decades the use of laparoscopic resection and a multimodal approach known as an enhanced recovery programme , have been major changes in colorectal perioperative care . Clinical outcome improves using laparoscopic surgery to resect colorectal cancer but until recently no multicentre trial evidence had been reported regarding whether the benefits of laparoscopy still exist when open surgery is optimized within an enhanced recovery programme . The EnROL trial ( Enhanced Recovery Open versus Laparoscopic ) examines the hypothesis that laparoscopic surgery within an enhanced recovery programme will provide superior postoperative outcomes when compared to conventional open resection of colorectal cancer within the same programme . Methods / design EnROL is a phase III , multicentre , r and omised trial of laparoscopic versus open resection of colon and rectal cancer with blinding of patients and outcome observers to the treatment allocation for the first 7 days post-operatively , or until discharge if earlier . 202 patients will be recruited at approximately 12 UK hospitals and r and omised using minimization at a central computer system in a 1:1 ratio . Recruiting surgeons will previously have performed > 100 laparoscopic colorectal resections  and > 50  open total mesorectal excisions to minimize conversion . Eligible patients are those suitable for elective resection using either technique . Excluded patients include : those with acute intestinal obstruction and patients in whom conversion from laparoscopic to open procedure is likely . The primary outcome is physical fatigue as measured by the physical fatigue domain of the multidimensional fatigue inventory 20 ( MFI-20 ) with secondary outcomes including postoperative hospital stay ; complications ; reoperation and readmission ; quality of life indicators ; cosmetic assessment s ; st and ardized performance indicators ; health economic analysis ; the other four domains of the MFI-20 . Pathological assessment of surgical quality will also be undertaken and compliance with the enhanced recovery programme will be recorded for all patients . Discussion Should this trial demonstrate that laparoscopic surgery confers a significant clinical and /or health economic benefit this will further support the transition to this type of surgery , with implication s for the training of surgeons and re source allocation . Trial registration IS RCT N48516968 Background Many cancer survivors suffer a range of physical and psychological symptoms which may persist for months or years after cessation of treatment . Despite the known benefits of exercise and its potential to address many of the adverse effects of treatment , the role of exercise as well as optimum duration , frequency , and intensity in this population has yet to be fully eluci date d. Many cancer rehabilitation programmes presented in the literature are very long and have tight eligibility criteria which make them non-applicable to the majority of cancer survivors . This paper presents the protocol of a novel 8-week intervention which aims to increase fitness , and address other physical symptoms in a heterogeneous cancer survivor population . Methods / design The aim is to recruit 64 cancer survivors 2 - 6 months after completion of chemotherapy , usually adjuvant , with curative intent . Subjects will be recruited through oncology clinics in a single institution and r and omised to usual care or an exercise intervention .  The exercise intervention consists of two specifically tailored supervised moderate intensity aerobic exercise sessions weekly over 8-weeks . All participants will be assessed at baseline ( 0 weeks ) , at the end of the intervention ( 8 weeks ) , and at 3-month follow-up . The primary outcome measure is fitness , and secondary patient-related outcome measures include fatigue , quality of life , and morphological outcomes . A further secondary outcome is process evaluation including adherence to and compliance with the exercise program . Discussion This study will provide valuable information about the physical outcomes of this 8-week supervised aerobic programme . Additionally , process information and economic evaluation will inform the feasibility of implementing this program in a heterogeneous population post cessation of chemotherapy . Trial Registration Background Exercise interventions during adjuvant cancer therapy have been shown to increase functional capacity , relieve fatigue and distress and may assist rates of chemotherapy completion . These studies have been limited to breast , gastric and mixed cancer groups and it is not yet known if a similar intervention is even feasible among women with ovarian cancer . We aim ed to assess safety , feasibility and potential effect of a walking intervention in women undergoing chemotherapy for ovarian cancer . Methods Women newly diagnosed with ovarian cancer were recruited to participate in an individualised walking intervention throughout chemotherapy and were assessed pre- and post-intervention .  Feasibility measures included session adherence , compliance with exercise physiologist prescribed walking targets and self-reported program acceptability . Changes in objective physical functioning ( 6-minute walk test ) , self-reported distress ( Hospital Anxiety and Depression Scale ) , symptoms ( Memorial Symptom Assessment Scale - Physical ) and quality of life ( Functional Assessment of Cancer Therapy - Ovarian ) were calculated , and chemotherapy completion and adverse intervention effects recorded . Results Seventeen women were enrolled ( 63 % recruitment rate ) . Mean age was 60 years ( SD = 8 years ) , 88 % were diagnosed with FIGO stage III or IV disease , 14 women underwent adjuvant and three neo-adjuvant chemotherapy . On average , women adhered to > 80 % of their intervention sessions and complied with 76 % of their walking targets , with the majority walking four days a week at moderate intensity for 30 minutes per session . Meaningful improvements were found in physical functioning , physical symptoms , physical well-being and ovarian cancer-specific quality of life . Most women ( 76 % ) completed ≥85 % of their planned chemotherapy dose . There were no withdrawals or serious adverse events and all women reported the program as being helpful . Conclusions These positive preliminary results suggest that this walking intervention for women receiving chemotherapy for ovarian cancer is safe , feasible and acceptable and could be used in development of future work . Trial registration
Endurance training alone was found to increase both lower extremity strength and endurance capacity .
Colorectal cancer surgery results in considerable postoperative morbidity , mortality and reduced quality of life .
As many patients will undergo additional (neo)adjuvant therapy , it is imperative that each individual optimize their physical function .
To eluci date the potential of exercise in patient optimization , we investigated the evidence for an exercise program before and after surgical treatment in colorectal cancer patients .