In a UK study funded by the Guy’s and St Thomas’ NHS Foundation Trust, the first evidence has been discovered which proves structured exercise intervention during pre-surgical chemotherapy enhances tumour regression. The study specifically examined the role of exercise prehabilitation in oesophageal cancer treatment.

Patients on the trial showed encouraging results, including a strengthening of the immune system; a partial reversal of chemo-related deconditioning and loss of muscle mass and function, leading to an improvement in quality of life during treatment.

The team behind the study, published in the British Journal of Sports Medicine, said it was an extremely encouraging moment to observe an improved response to chemotherapy treatment in cancer patients following an exercise intervention.

Power of prehab
The team compared two groups of oesophageal cancer patients undergoing chemotherapy prior to surgery. Twenty-one patients were assigned to a structured prehabilitation exercise intervention for 16 weeks, while a second group of 19 patients followed standard care without structured exercise.

The exercise intervention programme was moderate intensity, in line with World Health Organization and UK Chief Medical Officer guidelines for physical activity. It included 150 minutes of moderate-intensity aerobic exercise (ie, walking) and two strength sessions per week.

Biochemical and body composition analyses were performed at multiple times prior to starting, during and following chemotherapy, as well as prior to and following surgery, to measure radiological and pathological markers of disease regression.

The results showed the exercise group demonstrated higher rates of tumour regression and downstaging, as well as improved immune function, reduced inflammation and a reduction in chemotherapy-related reductions in muscle mass and physical deconditioning.

Protect the NHS
Prehabilitation is increasingly seen as a key part of supporting cancer patients during treatment. Andrew Davies, consultant surgeon at Guy’s and St Thomas, and lead author of the study, says the results are exciting: “This is the first time a relationship between exercise and chemotherapy response has been shown in a human trial. It opens up the possibility of benefitting patients with other types of cancer and those in palliative as well as curative settings.”

As the health and fitness sector looks to move closer to the healthcare sector, prehabilitation is one service which could certainly be offered in gyms and leisure centres, such as GM Active’s Prehab4Cancer programme – see NHS feature in this issue.