Chemotherapy and the Exercising Cancer Survivor

Advancements in treatment, such as chemotherapy, have improved survival rates among cancer patients. Today, approximately 67% of patients are at least five-year survivors; however, the combination of cancer and its care often affects the quality of those years. Patients commonly experience psychological symptoms, losses in physical function, and deterioration of cardiovascular health. Exercise ameliorates many of these consequences, but the effect of chemotherapy on exercise outcomes requires further exploration. PURPOSE: To evaluate the effects of chemotherapy on exercising cancer survivors. METHODS: We enrolled cancer survivors in a comprehensive 10-week exercise program; 40 patients had never received chemotherapy (NC), 80 had a history of chemotherapy (HC), 24 were currently undergoing treatment (CC), and 13 failed to report status. During a pre-exercise evaluation, we gathered demographic, morphological, psychological, cardiovascular, and functional data. Following the intervention, we repeated all assessments. We compared baseline data and analyzed pre-to-post differences in the three exposure groups (NC, HC, and CC) using chi-square and multivariate tests; post-hoc analyses measured specific group differences. RESULTS: Patients in the NC group were older (p=0.013), weighed more (p=0.054), and had a higher body mass index (p=0.067); obesity affected 56.7% of NC patients, 39.1% of HC patients, and 19.0% of CC patients (p=0.026). The NC group also had a higher incidence of hyperlipidemia (p=0.058) and worse performances in the six-minute walk (p=0.019), timed up-and-go (p=0.002), chair stand (p=0.043), and epic lift (p=0.029). There were no group differences in exercise adherence (p=0.414). NC patients improved the least in arm curls (p=0.022) and improved the most in VO2 max (p=0.037) and systolic blood pressure (p=0.064). CONCLUSION: Patients who had used chemotherapy in the past or were currently undergoing treatment were younger than those with no history of use; age may explain the differences noted. Our results indicate chemotherapy is not a barrier for exercise participation; as long as it is tolerated, exercise should be encouraged throughout cancer survivorship. While chemotherapy did not affect attrition, our low retention rate overall limits the strength of these findings