Piloting the effect of aerobic exercise during chemotherapy infusion in patients with cancer

Exercise in cancer patients is safe and can improve a range of outcomes including cancer-related fatigue, physical functioning and quality of life. Preclinical trials suggest an acute exercise bout during chemotherapy infusion may improve the treatment efficiency. It would also present an additional opportunity for supervised exercise. However, there are currently no published human trials of such an intervention. PURPOSE: To determine the safety and feasibility of delivering an aerobic exercise intervention to cancer patients during chemotherapy infusion. METHODS: A randomised crossover trial has commenced with eligible patients receiving either usual care or performing 20 minutes of low intensity cycling during infusion. Data collection includes patient uptake, physiological exercise response, perceived exertion, patient experience and a daily symptom diary for 1 week subsequent. RESULTS: Exercise has been safely delivered with neither adverse events nor interference to usual care reported for all subjects (N=3, Female, 52 ± 8 yrs). 60% of patients approached agreed to participate, and all reported that the exercise was no less comfortable, no more difficult, and less boring than usual care. Heart rate rose to the target 30%-40%HRR within 5-8 minutes and was steady during exercise, recovering to within 10 beats of resting rates in 4.7 ± 4.6 min. On average, systolic blood pressure rose 15% during exercise, with a maximum reading of 153mmHg, and full recovery to resting levels within 15 minutes. Oxygen saturation remained above 95% at all times. Rated perceived exertion during exercise ranged from 9-13 on the Borg scale. Reported daily symptom data was similar after both exercise and usual care. CONCLUSIONS: Exercise during chemotherapy infusion may be a safe and feasible addition to chemotherapy. Larger data collection is required to evaluate drug delivery efficiency, symptom reduction and opportunity for physical activity increase.