Exercise and nutrition for head and neck cancer patients: a patient oriented, clinic-supported randomized controlled trial

Abstract

BackgroundResearch on physical activity and nutrition interventions aimed at positively impacting symptom management, treatment-related recovery and quality of life has largely excluded head and neck (HN) cancer populations. This translates into a lack of clinical programming available for these patient populations. HN cancer patients deal with severe weight loss, with more than 70% attributed to lean muscle wasting, leading to extended recovery times, decreased quality of life (QoL), and impaired physical functioning. To date, interventions to address body composition issues have focused solely on diet, despite findings that nutritional therapy alone is insufficient to mitigate changes. A combined physical activity and nutrition intervention, that also incorporates important educational components known to positively impact behaviour change, is warranted for this population. Our pilot work suggests that there is large patient demand and clinic support from the health care professionals for a comprehensive program.Methods/DesignTherefore, the purpose of the present study is to examine the impact and timing of a 12-week PA and nutrition intervention (either during or following treatment) for HN cancer patients on body composition, recovery, serum inflammatory markers and quality of life. In addition, we will examine the impact of a 12-week maintenance program, delivered immediately following the intervention, on adherence, patient-reported outcomes (i.e., management of both physical and psychosocial treatment-related symptoms and side-effects), as well as return to work.DiscussionThis research will facilitate advancements in patient wellness, survivorship, and autonomy, and carve the path for a physical-activity and wellness-education model that can be implemented in other cancer centers.Trial registrationCurrent Controlled Trials NCT01681654

Physical Activity and Quality of Life in Head and Neck Cancer Survivors: A Literature Review

“…Given their success with these pilot trials, larger studies using rigorous RCT methodology are needed to discern the true magnitude of the benefi ts of exercise in these patients and its impact on QOL both during and after treatment. The upcoming trial involving HNC patients in Calgary [ 5 ] , which plans to randomise 80 patients to begin the PA intervention either at the time of treatment initiation or following treatment completion, has the potential to further enrich our understanding of the role of PA in these patients. It is unknown whether exercise will reduce the risk of HNC recurrence or extend overall survival after a HNC diagnosis.…”

A turning point: Head and neck cancer patients’ exercise preferences and barriers before and after participation in an exercise intervention

“…There is growing evidence to support physical activity (PA) as a means to decrease fatigue, improve body composition, functional well-being and overall quality of life in HNC survivors (Capozzi, Nishimura, McNeely, Lau, & Culos-Reed, 2015). Additionally, there is preliminary evidence to suggest that engaging in exercise may help the recovery, and possibly diminish the severity, of HNC and treatment-related side effects (Capozzi, Boldt, et al, 2015;Capozzi et al, 2012;Lonbro et al, 2013).…”

Physical activity and patient-reported outcomes: enhancing impact

“…This model has been implemented in our work in both neuro-oncology and head and neck cancer survivors [2,3].…”