Impact Of Multimodal Exercise Intervention On Sarcopenia In Breast, Prostate And Colorectal Cancer Survivors

Sarcopenia is defined as a loss of skeletal muscle mass and function and is prevalent in 14% to 79% of cancer survivors. Furthermore, sarcopenia is associated with lower quality of life and higher risk of mortality in cancer. PURPOSE: The goal of this secondary analysis was to evaluate the effects of a 16-week circuit, interval-based aerobic and resistance exercise intervention on sarcopenia among sedentary, overweight or obese survivors of breast, prostate and colorectal cancer. METHODS: This single center, randomized controlled trial involved 90 survivors of breast, prostate, and colorectal cancers, overweight or obese (body mass index>25.0 kg/m2) and sedentary (<60 mins of exercise per week). Participants were randomized 2:1 to exercise group (n = 60) or usual care (n = 30). The exercise intervention was a supervised, 16-week, thrice-weekly program featuring a circuit interval-based approach. Participants engaged in moderate-to-vigorous aerobic ( 65-85% of VO2 max) and resistance ( 65-85% of 1-repetition maximum) exercise. Sarcopenia was assessed at baseline and post-intervention using a whole body dual-energy X-ray absorptiometry scan to measure appendicular skeletal muscle mass index (ASMI). ASMI was calculated as appendicular skeletal muscle mass (kg) / height (m2). Repeated measure ANCOVA were used to determine the between-group differences pre and post intervention. RESULTS: Participants were 63.2 ± 10.8 years, 55% female, mean body mass index was 34.7 ± 5.9 and 75% had undergone chemotherapy and/or radiation therapy. No differences were reported at baseline between groups. Adherence to the exercise intervention was high (92%). As noted by ASMI, at baseline 75% of the partecipants presented with sarcopenia. Compared to usual care, ASMI significantly improved post-intervention (between group mean difference (2.8 kg/m2, 95% CI, 0.8 to 5.1, p < 0.001). Post-exercise, 35% of the participants in the exercise group presented with sarcopenia. CONCLUSION: A 16-week circuit, interval-based aerobic, and resistance exercise program produces improvements in sarcopenia in overweight or obese breast, prostate, and colorectal cancer survivors. Considering the impact of sarcopenia on quality of life and mortality outcomes in cancer survivors, larger-scale trials are necessary to confirm our findings.