Exercise as medicine in the management of pancreatic cancer: a case study (#305)
Given the poor prognosis for patients diagnosed with pancreatic cancer, therapies that enhance the ability to tolerate adjuvant treatments, reduce the loss of physical functioning and optimize quality of life are critically important. Exercise may provide considerable therapeutic benefit; however, no previous research has investigated the potential impact of exercise on outcomes for pancreatic cancer patients. Aim. To determine the safety and efficacy of a 6-month supervised exercise program for a pancreatic cancer patient undergoing adjuvant treatment. Methods. A case study was performed on a 49 year old male diagnosed with stage IIb pancreatic cancer. The patient had surgery (Whipple resection) followed by adjuvant chemotherapy (Gemcitabine and Fluorouracil) and radiotherapy (45Gy). The patient initiated a supervised exercise program involving twice weekly resistance and aerobic exercise sessions during adjuvant therapy. Outcomes were assessed at baseline and following 3 and 6 months of exercise. Results. The exercise program was well tolerated with 73% attendance throughout the 6 months. No adverse events occurred during the exercise sessions. No treatment toxicities prevented the patient from complying with adjuvant treatment plans. Considerable improvements were observed at both 3- and 6-month assessment points for all measures of physical capacity and functional ability (400m walk, leg press 1RM, repeated chair rise, stair climb, 6m usual pace, fast pace and backwards walk, sensory organisation test for balance: 3-42%), lean mass (DXA: 2.9-8.2%), physical activity levels (40-120 minutes), general health and disease specific quality of life (SF-36 and FACT-Hep: 15-150%), fatigue (FACIT-Fatigue: 350-488%), sleep quality (PSQI: 20%) and psychological distress (BSI-18: 22-100%). Conclusions. In this first reported case study, exercise led to clinically meaningful improvements in a variety of patient outcomes during adjuvant therapy for pancreatic cancer. This initial evidence has important clinical implications, indicating that exercise may be an effective adjunct therapy for the management of pancreatic cancer.