Home-Based Exercise Prehabilitation During Preoperative Treatment for Pancreatic Cancer Is Associated With Improvement in Physical Function and Quality of Life

An Ngo-Huang, Nathan H. Parker, Eduardo Bruera, Rebecca E. Lee, Richard Simpson, Daniel P. O’Connor, Maria Q.B. Petzel, Rhodora C. Fontillas, Keri Schadler, Lianchun Xiao, Xuemei Wang, David Fogelman, Sunil K. Sahai, Jeffrey E. Lee, Karen Basen-Engquist, Matthew H.G. Katz

Research output: Contribution to journalArticle

Abstract

Purpose: To investigate relationships among physical activity, changes in physical function, and health-related quality of life (HRQOL) among patients with pancreatic adenocarcinoma enrolled in a home-based exercise prehabilitation program. Methods: Patients with resectable pancreatic adenocarcinoma receiving preoperative chemotherapy and/or chemoradiation were enrolled on this prospective, single-arm trial and were advised to perform ≥60 minutes each of moderate-intensity aerobic exercise and strengthening exercise weekly. Activity was measured via self-report and accelerometers, including moderate-to-vigorous physical activity (MVPA), light physical activity (LPA), and sedentary activity (SA). Physical function measures at baseline and restaging follow-up included 6-minute walk test (6MWT), 5 times sit-to-stand (5×STS), handgrip strength (HGS), 3-m walk for gait speed (GS), and the PROMIS Physical Function Short Form. HRQOL was measured via the FACT-Hep questionnaire. Results: Fifty participants with mean age 66 years (standard deviation = 8 years) were enrolled. The 6MWT, 5×STS, and GS significantly improved from baseline to restaging follow-up (P=.001, P=.049, and P=.009, respectively). Increases in self-reported aerobic exercise, weekly MVPA, and LPA were associated with improvement in 6MWT (β=.19, P=.048; β=.18, P=.03; and β=.08, P=.03, respectively) and self-reported physical functioning (β=.02, P=.03; β=.03, P=.005; and β=.01, P=.02, respectively). Increased weekly LPA was associated with increased HRQOL (β=.03, P=.02). Increased SA was associated with decreased HRQOL (β=-.02,P=.01). Conclusions: Patients with potentially resectable pancreatic cancer exhibit meaningful improvement in physical function with prehabilitation; physical activity was associated with improved physical function and HRQOL. These data highlight the importance of physical activity during treatment for pancreatic cancer.

Original languageEnglish (US)
JournalIntegrative Cancer Therapies
Volume18
DOIs
StatePublished - 2019

Keywords

  • outcome measures
  • pancreatic cancer
  • physical function
  • prehabilitation
  • preoperative exercise

ASJC Scopus subject areas

  • Oncology
  • Complementary and alternative medicine

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    Ngo-Huang, A., Parker, N. H., Bruera, E., Lee, R. E., Simpson, R., O’Connor, D. P., Petzel, M. Q. B., Fontillas, R. C., Schadler, K., Xiao, L., Wang, X., Fogelman, D., Sahai, S. K., Lee, J. E., Basen-Engquist, K., & Katz, M. H. G. (2019). Home-Based Exercise Prehabilitation During Preoperative Treatment for Pancreatic Cancer Is Associated With Improvement in Physical Function and Quality of Life. Integrative Cancer Therapies, 18. https://doi.org/10.1177/1534735419894061