A randomized trial of exercise and quality of life in colorectal cancer survivors

Abstract

We conducted a randomized controlled trial to determine the effects of a home-based exercise intervention on change in quality of life (QOL) in recently resected colorectal cancer survivors, most of whom were receiving adjuvant therapy. Participants were randomly assigned in a 2:1 ratio to either an exercise (n = 69) or control (n = 33) group. The exercise group was asked to perform moderate intensity exercise 3-5 times per week for 20-30 min each time. The primary outcome was change in QOL as measured by the Functional Assessment of Cancer Therapy-Colorectal (FACT-C) scale. Adherence in the exercise group was good (75.8%) but contamination in the control group was problematic (51.6%). Intention-to-treat analysis revealed no significant differences between groups for change in the FACT-C (mean difference, -1.3; 95% CI, -7.8 to 5.1; P = 0.679). In an 'on-treatment' ancillary analysis, we compared participants who decreased versus increased their cardiovascular fitness over the course of the intervention. This analysis revealed significant differences in favour of the increased fitness group for the FACT-C (mean difference, 6.5; 95% CI, 0.4-12.6; P = 0.038). These data suggest that increased cardiovascular fitness is associated with improvements in QOL in colorectal cancer survivors but better controlled trials are needed.

Effects of a Telephone-Delivered Multiple Health Behavior Change Intervention (CanChange) on Health and Behavioral Outcomes in Survivors of Colorectal Cancer: A Randomized Controlled Trial

“…Also, HC participants were more likely to be sufficiently active (16.4%) than UC participants (9.2%). In comparison, earlier behavior change studies have reported no intervention effect on PA, 15,51,52 or the group differences have been attenuated by 12 months. 16 We did not observe a significant intervention effect at 6 months, and our magnitude of change was slightly lower than those in some previous reports.…”

“…[9][10][11][12][13][14] It is difficult to generalize results across cancer survivor groups because each cancer is unique in terms of natural history and pathology of disease, treatment protocols, disease and treatment adverse effects, and demographic, medical, and lifestyle characteristics of survivors. 15 There have been just three published randomized controlled trials (RCTs) of health behavior interventions specifically for CRC survivors. Two were limited by small sample sizes, methodologic weaknesses, and an exclusive focus on exercise.…”

“…Two were limited by small sample sizes, methodologic weaknesses, and an exclusive focus on exercise. 15,16 Moreover, Campbell et al 17 targeted only older CRC survivors and limited their assessment to fruit/vegetable intake and PA. These data are promising, although larger definitive trials are needed to determine the effects of improvements in PA and other health behaviors on a range of health outcomes in representative samples of CRC survivors.…”

“…These data are promising, although larger definitive trials are needed to determine the effects of improvements in PA and other health behaviors on a range of health outcomes in representative samples of CRC survivors. 14, 15 Health behaviors are interrelated in terms of the psychological, social, and environmental factors that reinforce them, and multiple unhealthy behaviors often co-occur. 18 Previous investigators have shown that change in one health behavior may serve as a stimulus for change in other health behaviors.…”

Exercise Barriers in Korean Colorectal Cancer Patients

“…Also, a recent article concluded through previous literatures that the effect of physical activity on the cancer risk is particularly stronger for colon cancer than other types of cancers (Kruk and Czerniak, 2013). In this respect, many studies have showed positive impact of exercise and physical activity participation on quality of life and other psychological health of cancer survivors (Cadmus et al, 2009;Courneya et al, 2003;Maryam et al, 2010;Peddle et al, 2008;Shariati et al, 2010;Sherman et al, 2010). In addition, exercise positively improves physical function and biomarkers related to colorectal cancer, such as insulin resistance, insulin-like growth factor (IGF)-1, tumor necrosis factor (TNF)-alpha, and adiponectin (Cheville et al, 2013;.…”