Tell us more about yourself and the author team
I am a clinical and translational cancer epidemiologist. My career is dedicated to understanding how modifiable factors like physical activity influence how cancer patients feel, function, and survive. Conducting clinical trials of physical activity in cancer survivors requires a complementary and synergistic team. My co-authors include a talented research coordinator who can communicate the importance of clinical trial participation to patients who are navigating the diagnosis of incurable cancer (thank you, Elizabeth Brighton), an exercise physiologist who can individualize a physical activity program regardless of the logistical, behavioral, or physical challenges (thank you, Nancy Campbell), a physician who understands that not all older adults with advanced cancer are the same (e.g., thank you, geriatric oncologist Nadine McCleary), a team of medical oncology physicians who understand that tomorrow’s standard of care is established by clinical trial participation today (thank you, Thomas Abrams, James Cleary, Peter Enzinger, Kimmie Ng, Douglas Rubinson, Brian Wolpin, and Matthew Yurgelun), and a senior oncology mentor who acknowledged that my interest to understand the benefits of physical activity in older adults with advanced cancer was important and should be investigated (thank you, Jeffrey Meyerhardt).
What is the story behind your study?
We conducted this study to refute the pervasive belief that older adults with metastatic cancer (cancer that has spread to other parts of the body) are not interested or otherwise too ill to engage in physical activity. The benefits of physical activity are established in older adults without cancer and adults with early-stage cancer. Physical activity preserves physical function in older adults without cancer. Physical activity improves the quality of life and reduces common treatment-related side effects among younger adults with early-stage cancer. We, therefore, considered it worthwhile to determine if older adults with metastatic cancer wanted to participate in a physical activity program and could adhere to an evidence-based physical activity prescription.
In your own words, what did you find?
We designed this study to establish critical benchmarks so that we could conduct future physical activity clinical trials in this population. The objectives of our study were to recruit 20 participants in 12 months and deliver a physical activity prescription that could be completed by 50% of the study participants. Both study objectives were achieved: 20 participants were enrolled within 12 months and 67% of participants adhered to at least 50% of the prescribed physical activity program. We measured physical activity using accelerometers, and in 12 weeks, light-intensity and moderate- to vigorous-intensity physical activity increased by 307 and 25 minutes per week, respectively. There were no serious or unexpected adverse events.
What was the main challenge you faced in your study?
When we launched our study, the feasibility of conducting clinical trials of physical activity in older adults with metastatic cancer was uncertain. Although we (the investigative team) were confident that our study would be successful, we had limited data to support our optimism. The results of our study provide data that conducting physical activity clinical trials in older adults with metastatic cancer is feasible.
If there is one take-home message from your study, what would that be?
Patients with advanced cancer desire to live independently, function well, and optimally adhere to anticancer therapies proven to increase their overall survival. We want this study to begin to dispel the stereotype that older adults with metastatic cancer are “not interested” or “too ill” to adhere to lifestyle programs that have the potential to improve their quality and length of life. Older adults with metastatic cancer are interested in physical activity and can adhere to an evidence-based physical activity prescription.