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Effects of Preoperative Exercise on Physical Fitness and Body Composition in Pancreatic Cancer Survivors Receiving Neoadjuvant Therapy: A Case Series

Effects of Preoperative Exercise on Physical Fitness and Body Composition in Pancreatic Cancer... Background and Purpose: Poor preoperative physical fitness and muscle mass are associated with increased morbidity and mortality in pancreatic cancer survivors. While neoadjuvant therapy improves viability for and effectiveness of a surgical resection in patients with borderline-resectable pancreatic adenocarcinoma, it also reduces preoperative fitness and muscle mass. The purpose of this investigation was to prevent fitness and muscle mass declines in this population with a supervised, preoperative exercise program. Methods: Patients recently diagnosed with borderline-resectable pancreatic adenocarcinoma and prescribed neoadjuvant therapy were recruited. Assessments of body composition, physical fitness, and health-related quality of life were assessed at baseline (<4 weeks from diagnosis), preoperatively, and 6 weeks after hospital discharge. Participants attended 2 to 3 supervised exercise sessions per week for the duration of neoadjuvant therapy. Sessions consisted of aerobic, resistance, and flexibility exercises tailored to the individual. Adherence to the exercise program was recorded to assess feasibility. Results: Only 3 participants were recruited in an 8-month window, primarily due to location limitations, and are presented as a case series. All participants increased lean muscle mass and physical fitness after the exercise program. Two participants met cancer cachexia diagnostic criteria at baseline but not after the exercise program. One participant developed metastatic disease and did not receive surgery. Neither of the participants who underwent surgery was readmitted to the hospital after discharge. Conclusion: This study provides preliminary evidence that a preoperative exercise program during neoadjuvant therapy may be effective at maintaining or improving muscle mass and physical fitness in pancreatic cancer survivors. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Rehabilitation Oncology Wolters Kluwer Health

Effects of Preoperative Exercise on Physical Fitness and Body Composition in Pancreatic Cancer Survivors Receiving Neoadjuvant Therapy: A Case Series

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Publisher
Wolters Kluwer Health
Copyright
© 2018 Oncology Section, APTA.
ISSN
2168-3808
eISSN
2381-2427
DOI
10.1097/01.REO.0000000000000122
Publisher site
See Article on Publisher Site

Abstract

Background and Purpose: Poor preoperative physical fitness and muscle mass are associated with increased morbidity and mortality in pancreatic cancer survivors. While neoadjuvant therapy improves viability for and effectiveness of a surgical resection in patients with borderline-resectable pancreatic adenocarcinoma, it also reduces preoperative fitness and muscle mass. The purpose of this investigation was to prevent fitness and muscle mass declines in this population with a supervised, preoperative exercise program. Methods: Patients recently diagnosed with borderline-resectable pancreatic adenocarcinoma and prescribed neoadjuvant therapy were recruited. Assessments of body composition, physical fitness, and health-related quality of life were assessed at baseline (<4 weeks from diagnosis), preoperatively, and 6 weeks after hospital discharge. Participants attended 2 to 3 supervised exercise sessions per week for the duration of neoadjuvant therapy. Sessions consisted of aerobic, resistance, and flexibility exercises tailored to the individual. Adherence to the exercise program was recorded to assess feasibility. Results: Only 3 participants were recruited in an 8-month window, primarily due to location limitations, and are presented as a case series. All participants increased lean muscle mass and physical fitness after the exercise program. Two participants met cancer cachexia diagnostic criteria at baseline but not after the exercise program. One participant developed metastatic disease and did not receive surgery. Neither of the participants who underwent surgery was readmitted to the hospital after discharge. Conclusion: This study provides preliminary evidence that a preoperative exercise program during neoadjuvant therapy may be effective at maintaining or improving muscle mass and physical fitness in pancreatic cancer survivors.

Journal

Rehabilitation OncologyWolters Kluwer Health

Published: Oct 1, 2018

References