“Physical activity can be difficult for patients with advanced colorectal cancer, but this study shows that even a small amount of exercise may make a big difference,” said ASCO Expert Nancy Baxter, MD, FRCSC, FACS, PhD, moderator of today’s presscast. “It’s important to help our patients find ways to incorporate moderate exercise into their daily lives – regardless of the stage of their disease.”
ALEXANDRIA, Va. – A new analysis suggests that people with metastatic colorectal cancer who are more physically active fare better than those who are less active. In a large clinical trial, patients who at the time of starting chemotherapy reported engaging in physical activity equivalent to 30 or more minutes of moderate exercise daily had a 19% reduction in mortality and a 16% reduction in cancer progression. The study will be presented at the upcoming 2017 Gastrointestinal Cancers Symposium in San Francisco.
According to the authors, this analysis is the first evidence of such a link in patients with colorectal cancer involving distant (non-local) metastases. Prior studies have consistently shown a link between regular exercise and improved outcomes in patients with earlier-stage colorectal cancer (without distant metastases).
“These findings suggest that it doesn’t take a lot of physical activity to improve outcomes,” said lead study author Brendan John Guercio, MD, a resident physician at Brigham & Women’s Hospital in Boston, MA. “While exercise is by no means a substitute for chemotherapy, patients can experience a wide range of benefits from as little as 30 minutes of exercise a day.”
The analysis included 1,231 patients enrolled in a federally funded phase III trial of chemotherapy for metastatic colorectal cancer. At the time they began receiving chemotherapy, patients self-reported their physical activity through a questionnaire. Based on their responses, the researchers determined the level of physical activity for each patient using a standard measure called metabolic equivalent task (MET)-hours per week, which assesses energy expended during physical activity.
The patients that were most physically active engaged in 18 or more MET-hours per week, equivalent to 30 or more minutes each day of moderate physical activity, such as walking, cleaning, or gardening. The group that was the least physically active engaged in less than 3 MET-hours per week, equivalent to 30 minutes of physical activity per week. Researchers adjusted for factors that may affect patient ability to participate in physical activity, such as age, general health, body weight change, other chronic illnesses, and type of cancer therapy received.
Overall, patients who spent more time being physically active had reduced rates of cancer progression and death. In a secondary exploratory analysis, more time spent in non-vigorous physical activity, such as walking or lawn mowing, was linked to improved survival. People who spent five or more hours per week engaged in non-vigorous activity had a 25% reduction in mortality. However, there was no association between vigorous physical activity, such as running and playing sports, and cancer outcomes.
Randomized controlled trials and more prospective clinical studies are needed to confirm the associations between physical activity and outcomes in metastatic colorectal cancer. A randomized clinical trial that is currently ongoing and compares patients who exercise during treatment and those who do not might prove that physical activity leads to longer survival.
This study was supported by grants from the National Institutes for Health.
View the full abstract.
For your readers:
2017 Gastrointestinal Cancers Symposium News Planning Team
Nancy Baxter, MD, FRCSC, FACS, PhD, American Society of Clinical Oncology (ASCO); Laura Dawson, MD, American Society for Radiation Oncology (ASTRO); and Kenneth Cardona, MD, FACS, Society of Surgical Oncology (SSO).
Click here to view the disclosures for the News Planning Team.
ATTRIBUTION TO THE 2017 GASTROINTESTINAL CANCERS SYMPOSIUM IS REQUESTED IN ALL NEWS COVERAGE.
About the American Gastroenterological Association Institute:
The American Gastroenterological Association (AGA) is the trusted voice of the GI community. Founded in 1897, the AGA has grown to include more than 16,000 members from around the globe who are involved in all aspects of the science, practice and advancement of gastroenterology. The AGA, a 501(c6) organization, administers all membership and public policy activities, while the AGA Institute, a 501(c3) organization, runs the organization's practice, research and educational programs. On a monthly basis, the AGA Institute publishes two highly respected journals, Gastroenterology and Clinical Gastroenterology and Hepatology, and has recently launched a third journal, Cellular and Molecular Gastroenterology and Hepatology. The organization's annual meeting is Digestive Disease Week®, which is held each May and is the largest international gathering of physicians, researchers and academics in the fields of gastroenterology, hepatology, endoscopy, and gastrointestinal surgery. The AGA Research Foundation provides digestive disease research grants on behalf of the AGA Institute.
For more information and to join, visit gastro.org/membership.
About the American Society for Radiation Oncology:
The American Society for Radiation Oncology (ASTRO) is the premier radiation oncology society in the world, with more than 10,000 members who are physicians, nurses, biologist, physicists, radiation therapists, dosimetrists and other health care professionals that specialize in treating patients with radiation therapies. As the leading organization in radiation oncology, the Society is dedicated to improving patient care through professional education and training, support for clinical practice and health policy standards, advancement of science and research, and advocacy. ASTRO publishes three medical journals, International Journal of Radiation Oncology, Biology, Physics, Practical Radiation Oncology, and Advances in Radiation Oncology, developed and maintains an extensive patient website; and created the Radiation Oncology Institute, a non-profit foundation to support research and education efforts around the world that enhance and confirm the critical role of radiation therapy in improving cancer treatment. Learn more about ASTRO.
Founded in 1964, the American Society of Clinical Oncology, Inc. (ASCO®) is committed to making a world of difference in cancer care. As the world’s leading organization of its kind, ASCO represents more than 40,000 oncology professionals who care for people living with cancer. Through research, education, and promotion of the highest-quality patient care, ASCO works to conquer cancer and create a world where cancer is prevented or cured, and every survivor is healthy. ASCO is supported by its affiliate organization, the Conquer Cancer Foundation. Learn more at www.ASCO.org, explore patient education resources at www.Cancer.Net, and follow us on Facebook, Twitter, LinkedIn, and YouTube.
About the Society of Surgical Oncology:
The Society of Surgical Oncology (SSO) is the premier organization for surgeons and health care providers dedicated to advancing and promoting the science and treatment of cancer. The Society’s focus on all solid-tumor disease sites is reflected in its Annual Cancer Symposium, monthly scientific journal (Annals of Surgical Oncology), educational initiatives, and committee structure. The Society’s mission is to improve multidisciplinary patient care by advancing the science, education, and practice of cancer surgery worldwide. SSO’s 2016-2017 President is Daniel G. Coit, MD, Professor of Surgery with Weill Cornell Medical College and surgical oncologist with Memorial Sloan Kettering Cancer Center. For more information, visit surgonc.org or SSO2016.org.