Quality of life is counted before and after chemotherapy in active and inactive patients. Credit: European Society for Medical OncologyIncluding…
Quality of life is counted before and after chemotherapy in active and inactive patients. Credit: European Society for Medical Oncology
Including practice or sport as part of cancer care can significantly improve symptom management, quality of life and fitness during and after treatment, French researchers have included in two presentations to be reported at the ESMO 201
8 Congress in Munich. Even in patients with the highest risk of poor quality of life, exercise can make a difference.
More than 3,500 cancer patients are already participating in training programs each year at more than 80 cancer centers in France at a cost of about 400 euros per patient and the number continues to increase, Dr. Thierry Bouillet, Medical Oncologist, Ile de France, American Hospital of Paris, Neuilly Sur Seine, France, and author of one of the new studies. Classes are powered by specialists in cancer and treatment that can tailor training programs to individual needs.
“We have found that patients have the greatest benefit if they exercise two or three times a week for at least one hour during the six months of their chemotherapy or radiotherapy and then for another six months so that physical activity becomes a part of their life, says Bouillet.
“With 20 years of experience, we have also seen that patients are easier to train in classes on site and feel safer than if we give them exercise information and let them do it themselves or go to classes from the hospital with coaches like do not know about the special needs of cancer patients, “added Bouillet.
In one of the French studies to be presented at ESMO twice a week, 60-minute training and aerobic training classes were significantly reduced pain and fatigue results at 3 and 6 months in 114 patients cancer treatment, 83% for breast cancer and 21% metastatic disease. Fatigue scores fell from 3.3 at baseline one to 2.8 (p
There were also significant decreases in body fat while lean body mass remained stable. In the total group, fat mass decreased from 33.9% at baseline to 33.2% at 3 months (p
“Patients are often tired and have started to lose muscle before diagnosing cancer. It is therefore important to work out as soon as possible after the first consultation. We should see it as” emergency treatment “for the first symptoms and later to help with the side effects of treatment, “says Bouillet.
In a second study presented at ESMO 2018, researchers not only reported the value of exercise for cancer patients, but also showed that it is possible to identify patients at greatest risk of poor quality of life during treatment so that they can get extra help.
In the study of 2525 patients with stage I-III breast cancer who undergone adjuvant chemotherapy, those who took 75 minutes of severe or 150 minutes of moderate exercise per week had significantly better overall quality of life six and 12 months after treatment than those who were inactive ( Table 1). They also had significantly better physical well-being and less fatigue, pain and breathlessness. Strong training included activities like aerobic dance, heavy gardening or quick swimming, while moderate exercise included floating walking, water aerobics or volleyball.
“About 60% of patients were physically active before and after chemotherapy and although their quality of life was negatively affected by chemotherapy, they consistently did better on different physical, emotional and symptom waves than those who were inactive”, explained Dr. Antonio Di Meglio, Study Writer and Medical Oncologist, Institute Gustave Roussy, Villejuif, France.  The study showed that patients who had mastectomy or additional diseases, smoked or low income were particularly vulnerable to poor quality of life after chemotherapy for breast cancer, but they also suffered from exercise.
“Using a new method, we showed that it is possible to identify breast cancer patients whose quality of life will be most affected by chemotherapy so that we can now direct these patents submitted for committed efforts, including those aimed at increasing physical activity to WHO recommended levels, “added Di Meglio.
Commented from ESMO, Dr. Gabe Sonke, Medical Oncologist, Dutch Cancer Institute, Amsterdam, The Netherlands, The Importance of French Studies to Demonstrate The Value of Physical Therapy in Daily Clinical Practice As Viewed in Clinical Trials and Supported by Current ESMO Recommendations for Exercise as part of the Standard Care for all cancer survivors.
“The insight from the new studies in patients with metastatic breast cancer is particularly relevant as a major study is ongoing from the International PREFERABLE Consortium to further investigate the value of exercise in this patient group,” he said.
Sonke pointed out that this and other studies strive to confirm early signs that physical activities can improve compliance with chemotherapy and radiotherapy and thus improve treatment results so that insurance companies are encouraged to pay for exercise initiatives.
“Insurers can ask why they should pay for exercise for cancer patients when they do not pay for it in the general population. However, if we can show that there is improved treatment adhesion and a survival benefit for cancer patients, it will strengthen our case of payment, says Sonke.
He also wants to see more patients routinely asked to participate in training programs, including those who do not usually work out: “We know that patients who are already active enter these training programs but those who do not Active ones are missing, especially those with low income and less healthy living. The new results must encourage us to focus on how to be more inclusive so that all patients can benefit from exercise to improve the quality of life during chemotherapy, “he concluded.
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