Effects of prehabilitation by physical activity on fatigue after surgery for colorectal cancer. Results from the randomized controlled trial PHYSSURG C

Abstract Introduction After cancer surgery it is common for patients to experience fatigue and evidence suggest physical activity habilitation can alleviate this. Method PHYSSURG C was a multicentre, controlled, randomized trial. Patients diagnosed with colorectal cancer were randomized to additional unsupervised moderate physical exercise in or usual care two weeks before and four weeks after surgery. Trial specific questionnaires were used at baseline, four weeks and 12 months. Outcomes were self-reported fatigue as well as quality of life, pain and mental recovery at the postoperative follow-ups. The aim was to investigate self-reported fatigue by RAND-36 at 4 week and 12 months after surgery in colorectal cancer patients undergoing a pre- and postoperative exercise intervention compared to standard care in a randomized trial. Result 518 patients were included in this analysis. At four weeks there was a difference in fatigue (mean difference 3.75 (CI 0.01,7.49), p=0.049) with intention to treat approach, and at both four weeks and 12 months there were differences in a per protocol analysis (mean difference 4.04 (CI 0.14,7.93), p=0.04) and (mean difference 4.29 (CI 0.44, 8.14) p=0.03) respectively. There were no differences between the intervention and control groups regarding quality of life, pain and mental recovery. Discussion The group who performed unsupervised exercise before and after surgery experienced reduced fatigue following surgery for colorectal cancer.