PracticeUpdate: Haematology & Oncology

ASCO GI 2017 23

Physical activity is linked to longer survival in advanced colorectal cancer P hysically active patients with metastatic colorectal cancer may fare better than distant metastases. Prior studies have consistently shown a link between regular exercise and improved outcomes in patients with earlier-stage colorectal cancer.

progression and death. In a sec- ondary exploratory analysis, more time spent in nonvigorous phys- ical activity, such as walking or lawn mowing, was linked to improved survival. Patients who spent at least 5 h per week engaged in nonvigor- ous activity experienced a 25% reduction in mortality. No asso- ciation was observed, however, between vigorous physical activ- ity, such as running and playing sports, and cancer outcomes. Randomised controlled trials and more prospective clinical stud- ies are needed to confirm the associations between physical activity and outcomes in meta- static colorectal cancer. An ongoing randomised clinical trial is comparing patients who exercise during treatment vs those who do not. The trial may prove that physical activity leads to longer survival in patients with metastatic colorectal cancer.

task-hours per week, which assesses energy expended dur- ing physical activity. Patients who were most phys- ically active engaged in 18 or more metabolic equivalent task hours per week, equivalent to 30 or more minutes daily of mod- erate physical activity, such as walking, cleaning, or gardening. The least physically active group engaged in fewer than 3 meta- bolic equivalent task hours per week, equivalent to 30 minutes of physical activity per week. Researchers adjusted for factors that may have affected patients’ ability to participate in physi- cal activity, such as age, general health, body weight change, other chronic illnesses, and type of cancer therapy received. Overall, patients who spent more time in physical activity experi- enced reduced rates of cancer

those who are less active. This conclusion is based on results of a federally funded Alliance for Clinical Trials in Oncology, Cancer and Leukemia Group B phase III trial of first-line chemo- therapy for metastatic colorectal cancer. Brendan John Guercio, MD, of Brigham & Women’s Hospital, Boston, explained that in this large clinical trial, patients who reported engaging in physical activity equivalent to 30 or more minutes of moderate exercise daily when they started chemo- therapy experienced a 19% reduction in mortality and 16% reduction in cancer progression. This outcome is the first evi- dence of such a link in patients with colorectal cancer involving

Dr Guercio said, “These findings suggest that it doesn’t take a lot of physical activity to improve outcomes. While exercise is by no means a substitute for chemo- therapy, patients can experience a wide range of benefits from as little as 30 minutes of exercise a day.” The analysis included 1231 patients. When they began receiving chemotherapy, patients self-reported their physical activ- ity through a questionnaire. Based on their responses, the researchers determined the level of physical activity for each patient using a standard meas- ure, the metabolic equivalent

PracticeUpdate Editorial Team

© ASCO/Todd Buchanan 2017

VOL. 2 • NO. 2 • 2017