A new rehabilitation programme aimed at survivors of oesophagogastric cancer has proven to be successful, with participants recording a significant improvement in cardiorespiratory fitness and overall wellbeing, a new study has shown.

In the past, cancer patients were recommended to rest and avoid physical activity. However, in recent years, increasing evidence has demonstrated that physical activity is not only safe for people who have survived cancer, it is also very beneficial.

It has been shown to improve health-related quality of life and also reduce levels of depression, anxiety and fatigue.

Cancer treatments, such as chemotherapy and radiation, can impact health-related quality of life. Patients with oesophagogastric cancer often struggle with loss of appetite, difficulty eating, sarcopenia, fatigue and post-operative weight loss.

Furthermore, they often have poor cardiorespiratory fitness, so there is a strong rationale to provide rehabilitation programmes for these patients.

This latest study looked at the impact of the recently developed multidisciplinary 12-week programme ReStOre (Rehabilitation Strategies following Oesophagogastric Cancer), from researchers at the Trinity St James’ Cancer Institute and partners.

ReStOre aims to incorporate exercise rehabilitation with 1:1 dietary counselling and patient education sessions for patients with oesophagogastric cancer. Exercise rehabilitation strategies need to prevent excess weight loss in these patients.

The study found that the cardiorespiratory fitness of those involved improved, with participants experiencing better physical, mental and social wellbeing, as well as higher levels of confidence.

Adherence to exercise was reflected in cardiorespiratory fitness levels measured by VO2 peak, which were consistently higher in the intervention cohort compared to the control group.

The study also showed that the exercise-based intervention improved some of the measured blood biomarkers, which are involved in inflammation and cancer metastasis.

“The study was powered to examine the impact on fitness, but also provided the opportunity to explore the impact of the intervention on a range of circulating serum proteins. Significant changes were found in a number of biomarkers involved in inflammation and metastasis,” explained one of ReStOre’s lead researchers, Prof Juliette Hussey, of Trinity College Dublin.

The study provided the data and justification for a definitive intervention – the ReStOre II clinical trial - which is recruiting 120 patients who have curative treatment for upper gastrointestinal and hepatopancreaticobiliary cancer.

ReStOre II includes an upper gastrointestinal cancer survivorship biobank, which will support further collaborative translational research in this area.

“This initial work has been crucial in exploring changes in biomarkers in the blood as a result of a rehabilitation intervention where the main focus was on increasing fitness. The exercise intervention, which included aerobic and resistance components, lasted for 12 weeks, and it is possible that a longer time may be needed to lead to a more significant change in inflammation.

“Our findings will provide a strong background for future studies focused on examining how interventions with exercise can change the inflammatory blood profiles in patients with these types of cancer,” Prof Hussey said.

Details of these findings are published in the journal, Frontiers in Oncology, and can be viewed here.