Evaluation Of A State-wide, Community-based Exercise Program In Patients Undergoing Cancer Treatment: A Subgroup Analysis Of The Life Now Exercise Program

Cancer treatment exacerbates cancer-related fatigue, psychological distress, and functional decline, contributing to poor quality of life (QoL) of patients. Although exercise in a well-controlled research setting has been established to improve treatment-related toxicities, real-world data supporting exercise as an adjunct to cancer treatment is scant, hindering the incorporation of exercise into routine clinical care. PURPOSE: To assess the uptake and effectiveness of a community exercise program (Life Now Exercise) in patients during cancer treatment. METHODS: The Life Now Exercise program is designed for people following a cancer diagnosis, delivered on an ongoing basis across Western Australia by Cancer Council Western Australia. In this program, individually tailored, resistance and aerobic exercise is offered to participants twice per week (1 h/session) for 12 weeks, supervised by accredited exercise physiologists. This study involved 316 patients undergoing at least one form of systemic or local cancer therapy, enrolled in the program. Objective and patient-reported outcomes were assessed at baseline (T0), 12 weeks postbaseline (T12), and 24 weeks postintervention (T36). Further, the moderating effects of baseline characteristics on outcomes at T12 were assessed. RESULTS: Nearly 63% of prescribed sessions were recorded being attended by participants (median age 61 years, 71% female, 83% diagnosed with breast, prostate, or bowel cancer). Permanent discontinuation of the program before week 12 occurred in 61 patients (19%). For completers with data at T0, T12, and T36, statistically (P < 0.05) and/or clinically significant improvements from baseline were noted in repeated chair rise (T12 = -13.3%, T36 = -11.7%), 1RM leg press (T12 = +17.6%, T36 = +11.3%) and seated row strength (T12 = +10.0%, T36 = +10.0%), 6 m walk at usual (T12 = -7.1%, T36 = -5.8%) and fast pace (T12 = -3.5%), 6 m backward walk (T12 = -15.1%, T36 = -14.4%), and patient-reported toxicities and QoL. Cancer type, staging, treatment type, excision status, and/or lean body mass affected changes at T12 in physical function and QoL. CONCLUSIONS: The Life Now Exercise program is a promising adjunct to improve physical function and QoL during cancer treatment. Expansion of the program nationally should be considered.