A moderate exercise plan could improve the success of chemotherapy treatment in oesophageal cancer patients, according to results from a study at Guy’s and St Thomas’ NHS Foundation Trust.
Oesophageal cancer is discovered anywhere in the oesophagus, sometimes called the food pipe. How serious oesophageal cancer is, depends on where it is in the oesophagus, how big it is, if it has spread and the state of your general health. Symptoms can be hard to spot, but they can include problems with swallowing, a hoarse voice and throat pain.
The research, which involved 40 oesophageal cancer patients, showed that exercise can be safely included as part of cancer treatment. It was published in the British Journal of Sports Medicine.
Exercise and chemotherapy
Chemotherapy is a standard treatment for many cancers, including oesophageal cancer. Chemotherapy presents side effects that can negatively affect patients; this includes tiredness, sickness and risk of infection. Due to this, clinicians will weigh up the positive and negative effects of each patient before using this treatment.
The trial looked at the impact of ‘prehabilitation’ exercise- a guided exercise programme in which patients received regular training sessions before and during their chemotherapy treatment. They were also provided with instructions on how to continue the exercise programme at home.
The patients were compared with a group of patients who had similar age and clinical status before the chemotherapy. The team looked at tumour samples, CT scans and immune markers from the patients. They found that those who had taken part in the exercise programme showed a better response to the chemotherapy, with their tumours shrinking more, and being more likely to be ‘down-graded’ – assessed as being less advanced.
The study was led by Mr Andrew Davies, consultant in upper gastrointestinal surgery at Guy’s and St Thomas’. He said: “This is a small study, but a promising one, as it shows how a moderate exercise programme could help to improve the success of chemotherapy treatment. We want to confirm this effect in further studies, but conceivably this may benefit patients with other types of cancer and be a cost-effective way to improve the effectiveness of treatment.”
Living with oesophageal cancer
Alan Holman, 70, was a participant in the study funded by Guy’s and St Thomas’ Charity. Alan was diagnosed with oesophageal cancer in December 2016, soon after he retired from his role as Facilities Manager at a shopping mall.
He took part in guided exercise sessions once a week and did exercises at home around once a week. These sessions took place when he was also having chemotherapy and in the run-up to an operation in May 2017. He then had sessions closer to his home in Forest Hill and is still leading an active life since he finished his treatment.
Alan said: “Once I started the chemotherapy, it was tiring, but doing an hour with the trainer, you come out feeling better. It helped to get me back to my pre-op weight and got me through the chemotherapy. I’m not one for sitting indoors all day. When I was working, I had a very active job and was walking a lot every day. Now I try to get to the gym once a week and get out for a walk at least once every day.”
However, the authors cautioned that the study had limitations. It was a relatively small study, and rather than being randomly assigned to either the exercise or the control group, patients were allocated based on whether they lived in the region where the exercise sessions took place. This was because the team felt that requiring patients to travel long distances would be too much of a burden. The team were careful to check for any effect this may have had on the study population and adjusted their analysis accordingly.