Exercise initiated during chemotherapy is feasible, prevents fatigue, and is associated with other beneficial outcomes, according to results of a study published in JACC: CardioOncology.

Cancer treatments can cause adverse effects that may reduce quality of life and survival. Evidence has indicated that physical exercise during and after treatment can mitigate some risk for adverse effects.

This trial was designed to evaluate whether a 24-week exercise program initiated during cancer treatment (group A) was superior to initiation after treatment (group B). To that end, 266 patients were recruited at 3 sites in the Netherlands between 2013 and 2018 for the Optimal Timing of Physical Activity in Cancer Treatment (ACT; ClinicalTrials.gov Identifier: NCT01642680) study. The primary outcome was peak oxygen uptake (VO2peak) at 1 year postintervention.

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The cohorts were mean age 45.8 and 48.3 years, 57% and 58% were women, and had a mean BMI of 25.4 and 26.3 kg/m2 in groups A and B, respectively. Patients’ diagnoses were breast cancer (139 patients), testicular cancer (95), colon cancer (30), and B-cell non-Hodgkin lymphoma (2).

The median adherence rate to supervised exercise in group A was 75.0% compared with 83.3% in group B. Of the 215 patients who completed the home-based exercise intervention, 141 kept training logs. Adherence to the home-based intervention was 82% in group A and 83% in group B.

Compared with baseline, VO2peak changed among groups A and B by −2.8 and −5.8 mL/kg/min postchemotherapy, +0.2 and +0.6 mL/kg/min postintervention, and +0.5 and +0.2 mL/kg/min at 1 year, respectively. The rate of VO2peak decline was smaller in group A than B at postchemotherapy (P <.001).

Similar trends were observed for adjusted mean health-related quality of life scores and adjusted mean general fatigue scores, in which scores were more greatly maintained postchemotherapy in group A than group B (both P ≤.019) with similar effects observed at postintervention and 1 year.

This study may have been limited by not including a nonexercise control.

These data indicated that physical exercise during cancer treatment was feasible and better prevented decline in VO2peak and quality of life.

Disclosure: Some authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.


van der Schoot GGF, Ormel HL, Westerink N-DL, et al. Optimal timing of a physical exercise intervention to improve cardiorespiratory fitness: during or after chemotherapy. JACC CardioOnc. Published online October 18, 2022. doi:10.1016/j.jaccao.2022.07.006

This article originally appeared on Oncology Nurse Advisor