Bourke L, Thompson G, Gibson DJ, Daley A, Crank H, Adam I, Shorthouse A, Saxton J. Pragmatic lifestyle intervention in patients recovering from colon cancer: a randomized controlled pilot study.
To investigate the feasibility of a pragmatic lifestyle intervention in patients who had recently completed surgery and chemotherapy for colon cancer and to obtain preliminary data of its impact on important health outcomes.
A prospective, randomized, controlled pilot trial.
University rehabilitation facility.
Eighteen (N=18) colon cancer survivors (mean age=69y; range, 52–80y), Dukes stage A to C.
Participants were randomized 6 to 24 months postoperatively to either a 12-week program of combined exercise and dietary advice or standard treatment.
Main Outcome Measures
Exercise and dietary behavior, fatigue, health-related quality of life (QOL), aerobic exercise tolerance, functional capacity, muscle strength, and anthropometery were assessed at baseline and immediately after the intervention.
Adherences to supervised and independent exercise during the intervention were 90% and 94%, respectively, and there was low attrition (6%). The lifestyle intervention elicited improvements in exercise behavior (P=.068), fatigue (P=.005), aerobic exercise tolerance (P=.010), chair sit-to-stand performance (P=.003), and waist-to-hip ratio (P=.002). A positive change in dietary fiber intake (P=.044) was also observed in the intervention group. No change in QOL was observed (P=.795).
These preliminary results suggest that a pragmatic lifestyle intervention implemented 6 to 24 months after primary treatment for colon cancer was feasible. We observed a significant impact on dietary behavior, fatigue, aerobic exercise tolerance, functional capacity, and waist-to-hip ratio. These findings need to be confirmed with a larger-scale definitive randomized controlled trial.
List of Abbreviations:CRC (colorectal cancer), FACT-C (Functional Assessment of Cancer Therapy—Colorectal), FACT-F (Functional Assessment of Cancer Therapy—Fatigue), MDT (multidisciplinary team), MVT (maximum voluntary torque), QOL (quality of life), RCT (randomized controlled trial), RPE (ratings of perceived exertion), RMS (root mean square), sEMG (surface electromyography), delta sEMG (change in rectified surface electromyography amplitude)
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- High risk groups for bowel cancer.(2010)http://www.cancerhelp.org.uk/type/bowel-cancer/about/risks/high-risk-groups-for-bowel-cancer#incidence(Accessed October 15, 2009)
- Quality-of-life management of patients with colorectal cancer.CA Cancer J Clin. 1997; 47: 198-206
- Postoperative fatigue: a review.World J Surg. 2009; 33: 738-745
- A randomized trial of exercise and quality of life in colorectal cancer survivors.Eur J Cancer Care. 2003; 12: 347-357
- Postoperative physical training following colorectal surgery: a randomised, placebo-controlled study.Scand J Surg. 2006; 95: 17-22
- “It makes you feel so full of life”: LiveWell, a feasibility study of a personalised lifestyle programme for colorectal cancer survivors.Support Cancer Care. 2010; 18: 409-415
- A telephone-delivered lifestyle intervention for colorectal cancer survivors “CanChange”: a pilot study.Psychooncology. 2009; 18: 449-455
- Physical activity and survival after colorectal cancer diagnosis.J Clin Oncol. 2006; 24: 3527-3533
- Association of dietary patterns with cancer recurrence and survival in patients with stage III colon cancer.JAMA. 2007; 298: 754-764
- Psychophysiological bases of perceived exertion.Med Sci Sports Exerc. 1982; 14: 377-381
- Study protocol to investigate the effect of a lifestyle intervention on body weight, psychological health status and risk factors associated with disease recurrence in women recovering from breast cancer treatment.BMC Cancer. 2006; 6: 35
- Assessment of leisure time exercise behaviour by self-report: a concurrent validity study.Can J Public Health. 1986; 77: 359-361
- Measuring fatigue and other anemia-related symptoms with the Functional Assessment of Cancer Therapy (FACT) measurement system.J Pain Symptom Manage. 1997; 13: 63-74
- Reliability and validity of the Functional Assessment of Cancer Therapy-Colo-rectal (FACT-C) quality of life instrument.Qual Life Res. 1999; 8: 181-195
- Evaluation of a new standardized ramp protocol: the BSU/Bruce Ramp Protocol.J Cardiopulm Rehabil. 1998; 18: 438-444
- Sit to stand test for measuring performance of lower extremity muscles.Percept Mot Skills. 1995; 80: 163-166
- Analysing controlled trials with baseline and follow up measurements.BMJ. 2001; 323: 1123-1124
- The revised CONSORT statement for reporting randomized trials: explanation and elaboration.Ann Inter Med. 2001; 134: 663-694
- Minimally important differences were estimated for the Functional Assessment of Cancer Therapy-Colorectal (FACT-C) instrument using a combination of distribution- and anchor-based approaches.J Clin Epidemiol. 2005; 58: 1241-1251
- Randomized controlled trial of resistance or aerobic exercise in men receiving radiation therapy for prostate cancer.J Clin Oncol. 2009; 27: 344-351
- Randomised trial of exercise therapy in women treated for breast cancer.J Clin Oncol. 2007; 25: 1713-1721
- Recruitment of community-dwelling older adults for nursing research: a challenging process.Can J Nurs Res. 2002; 33: 171-184
- Patient recruitment to a randomised clinical trial of behavioural therapy for chronic heart failure.BMC Med Res Methodol. 2004; 4: 8
- Systematic review of barriers to the recruitment of older patients with cancer onto clinical trials.J Clin Oncol. 2005; 23: 3112-3124
- Fatigue and quality of life outcomes of exercise during cancer treatment.Cancer Pract. 2001; 9: 119-127
- Exercise counselling and programming preferences of cancer survivors.Cancer Pract. 2002; 10: 208-215
- Combining anchor and distribution-based methods to derive minimal clinically important differences on the Functional Assessment of Cancer Therapy (FACT) anemia and fatigue scales.J Pain Symptom Manage. 2002; 24: 547-561
- Exercise prevents fatigue and improves quality of life in prostate cancer patients undergoing radiotherapy.Arch Phys Med Rehabil. 2007; 88: 1416-1422
- Three versus six months of exercise training in breast cancer survivors.Breast Cancer Res Treat. 2010; 121: 413-419
- Effects of a supervised exercise intervention on recovery from treatment regimens in breast cancer survivors.Oncol Nurs Forum. 2008; 35: 909-915
- Beta-adrenergic-mediated improvement in left ventricular function by exercise training in older men.Am J Physiol. 1998; 274: 397-404
- Rate and amplitude of adaptation to two intensities of exercise in men aged 65-75 yr.Med Sci Sports Exerc. 2004; 36: 1811-1818
- Non cancer mortality among people diagnosed with cancer (Australia).Cancers Causes Control. 2006; 17: 287-297
- The relationships between FACT-Fatigue (FACT-F) scores and physical function (PF) in patients (pts) with chemotherapy-induced anemia treated with darbepoetin alfa (DA).J Clin Oncol. 2004; 22 (abstract): 8062
Supported by Sheffield Hallam University.
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© 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.