Exercise Program for Cancer

(ACE Trial)

Recruiting at 1 trial location

Overseen By Christopher Sellar, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Alberta

Disqualifiers: Unsafe for physical activity

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 26

2570 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests an exercise program designed to improve physical well-being and overall quality of life for people with cancer. The goal is to determine if exercise can help prevent new cancers from developing after treatment. Participants will attend group exercise sessions twice a week for 12 weeks. This trial suits those diagnosed with cancer who can perform low-level exercise and are either currently receiving treatment or have completed treatment within the last three years. As an unphased trial, it offers a unique opportunity to contribute to research that may enhance cancer recovery and prevention strategies.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It focuses on exercise for cancer patients, so it's best to discuss your medications with the trial coordinators or your doctor.

What prior data suggests that this exercise program is safe for cancer survivors?

Research shows that exercise is generally safe for people who have had cancer. Studies have found that exercise can lessen the side effects of cancer treatments, such as fatigue, and improve the overall well-being of cancer survivors. Clinical trials have demonstrated that exercise is both effective and safe for cancer survivors.

However, uncertainty remains about possible risks, especially for those currently receiving cancer treatment. There is not enough information to fully understand any potential harms. Overall, exercise is usually well-tolerated and can be a helpful part of cancer care. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about exercise programs for cancer patients because they offer a non-invasive, holistic approach that can complement traditional treatments like chemotherapy and radiation. Unlike medications that often come with side effects, exercise has the potential to improve physical fitness, boost mood, and enhance overall quality of life. This program is unique as it provides structured, group-based sessions under professional supervision, which may encourage better adherence and outcomes compared to exercising alone. Additionally, this approach empowers patients by actively involving them in their own recovery process, making it an appealing option in cancer care.

What evidence suggests that this exercise program is effective for cancer survivors?

Research shows that exercise can greatly benefit cancer survivors. Studies indicate that physical activity can reduce side effects of cancer treatment, such as fatigue, and improve overall quality of life. In one study, participants who followed a structured exercise program had an 80% chance of remaining cancer-free for five years, compared to 74% for those who only received health education materials. Another study found that 90.3% of those who exercised were still alive, while the rate was 83.2% for those who did not exercise. Exercise has also been shown to lower the risk of cancer recurrence and can be more effective than drugs in preventing cancer from returning. These findings suggest that exercise is crucial for recovery and long-term health in cancer survivors. Participants in this trial will engage in an exercise intervention, which includes group sessions supervised by a community-based exercise specialist. ^{1 2 6 7 8}

Who Is on the Research Team?

Nicole Culos-Reed, PhD

Principal Investigator

University of Calgary

Margaret L McNeely, PT, PhD

Principal Investigator

University of Alberta

Are You a Good Fit for This Trial?

This trial is for adults over 18 with a cancer diagnosis who can do low-intensity exercise. It's open to those pre-treatment, currently receiving treatment, or up to 3 years post-treatment. Participants must be able to consent and understand English.

Inclusion Criteria

I am over 18 years old.

I have been diagnosed with cancer.

I am currently undergoing cancer treatment, have had treatment in the last 3 years, or need supportive exercise due to cancer or its treatment.

Exclusion Criteria

I cannot safely do physical activities.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

1 visit (in-person)

Fitness Testing and Triage

Participants undergo fitness testing and are triaged to appropriate exercise programming

1-2 weeks

1 visit (in-person)

Exercise Intervention

Participants engage in aerobic, resistance, balance, and flexibility exercises twice weekly for 8-to-12 weeks

8-12 weeks

24 visits (in-person or virtual)

Follow-up

Participants are monitored for effectiveness outcomes such as physical fitness, quality of life, and healthcare utilization

One year

Optional Extension

Participants may continue with the exercise program on a fee-for-service basis after the initial 12 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Exercise

Trial Overview The study tests the Alberta Cancer Exercise (ACE) Program across clinics in Alberta. It aims to see if this community-based exercise program improves physical well-being and quality of life for cancer survivors and helps prevent secondary cancers.

How Is the Trial Designed?

Group I: Exercise Intervention Experimental Treatment 1 Intervention

Participant exercise sessions will be conducted in groups of 10-15 under the direct supervision of the community-based exercise specialist. Sessions will be twice a week for 12-weeks. Participants will have the option to continue with the exercise program after the 12-weeks on a fee-for-service basis.

Who Is Running the Clinical Trial?

University of Alberta

Lead Sponsor

Trials

957

Recruited

437,000+

Cross Cancer Institute

Collaborator

Trials

62

Recruited

19,200+

Tom Baker Cancer Centre

Collaborator

Trials

30

Recruited

8,900+

University of Calgary

Collaborator

Trials

827

Recruited

902,000+

Alberta Health services

Collaborator

Trials

168

Recruited

658,000+

Published Research Related to This Trial

The ADVANCE study aims to evaluate how adverse events (AEs) are reported in exercise oncology trials, which is crucial for assessing the safety of exercise interventions for cancer patients.

By reviewing published trials and using a standardized checklist for reporting AEs, the study seeks to identify gaps in current practices and inform future research on improving the consistency and transparency of AE reporting in this field.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Adverse Events Reporting of Clinical Trials in Exercise Oncology Research (ADVANCE): Protocol for a Scoping Review. Luo, H., Schumacher, O., Galvão, DA., et al.[2022]

Community-based exercise programs for cancer survivors have been shown to significantly improve quality of life, reduce fatigue, and enhance overall well-being.

Engaging in regular physical activity may also lower the risk of recurrence for certain cancers, such as breast and colon cancer, highlighting the importance of exercise in cancer recovery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Community-Based Exercise Programs for Cancer Survivors. Musanti, R., Murley, B.[2018]

Exercise training has been shown to be safe and feasible for over 50,000 cancer patients across nearly 700 unique intervention trials, demonstrating significant benefits for both physical and psychosocial outcomes.

There is growing evidence that exercise not only promotes general health but also has direct positive effects on cancer progression and treatment, suggesting that it should be integrated into standard cancer care practices.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Exercise Training in Cancer Control and Treatment. Christensen, JF., Simonsen, C., Hojman, P.[2019]

Strength training (ST) significantly improves maximal strength in cancer survivors, with increases ranging from 20% to 50%, demonstrating its effectiveness in countering treatment-related declines in strength.

While ST also enhances physical function by 7% to 38%, improvements in body composition and psychosocial parameters were less consistent, indicating that strength gains are the most reliable benefit across various cancer types.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Independent Effects of Strength Training in Cancer Survivors: a Systematic Review. Hanson, ED., Wagoner, CW., Anderson, T., et al.[2018]

Engaging in physical activity before and after a cancer diagnosis significantly reduces the risk of total and cancer-specific mortality among breast and colorectal cancer survivors, with a notable decrease in risk observed for those who increased their activity levels post-diagnosis.

For every 10 metabolic equivalent task-hours per week of post-diagnosis physical activity, breast cancer survivors experienced a 24% reduction in total mortality risk, while colorectal cancer survivors saw a 28% reduction, highlighting the importance of maintaining an active lifestyle during and after treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Association between physical activity and mortality among breast cancer and colorectal cancer survivors: a systematic review and meta-analysis. Schmid, D., Leitzmann, MF.[2023]

Exercise therapy significantly improves cardiorespiratory fitness (CRF) in patients with adult-onset cancer, with an average increase of 2.80 mL O2 × kg-1 × min-1 compared to no change in control groups, based on a review of 48 randomized controlled trials involving 3,632 patients.

The study found that exercise therapy is safe, with only 44 adverse events reported across 30 trials, and high adherence rates (88%) suggest that patients are likely to stick with the program.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Efficacy of Exercise Therapy on Cardiorespiratory Fitness in Patients With Cancer: A Systematic Review and Meta-Analysis. Scott, JM., Zabor, EC., Schwitzer, E., et al.[2022]

In a systematic review of 129 trials with 12,044 participants, exercise during systemic cancer treatment was associated with a higher risk of serious adverse events, thromboses, and fractures compared to control groups.

Despite these risks, exercise also correlated with a lower incidence of fever and a higher relative dose intensity of systemic treatment, indicating potential benefits, but the overall certainty of evidence regarding the harms and benefits of exercise in this context is very low.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Harms of exercise training in patients with cancer undergoing systemic treatment: a systematic review and meta-analysis of published and unpublished controlled trials. Thomsen, SN., Lahart, IM., Thomsen, LM., et al.[2023]

The HEALTh program, a customized cardiac rehabilitation model for female breast cancer survivors, significantly improved cardiorespiratory fitness by 14% and enhanced quality of life and reduced depressive symptoms after 22 sessions.

With a program adherence rate of 66.6%, the study involved 152 breast cancer survivors, demonstrating that structured exercise and education can effectively support physical and mental health in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Cardiac Rehabilitation Model Improves Fitness, Quality of Life, and Depression in Breast Cancer Survivors. Dolan, LB., Barry, D., Petrella, T., et al.[2019]

Exercise interventions during and after cancer treatment, particularly resistance training, show promising physiological and psychological benefits, as highlighted in a review of 26 studies, mostly involving breast cancer patients.

Despite the positive outcomes, many studies lack robust designs, such as randomized controlled trials, and often have small sample sizes, indicating a need for more comprehensive research across various cancer types to better understand the dose-response effects of exercise.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Review of exercise intervention studies in cancer patients. Galvão, DA., Newton, RU.[2022]

A case study of a breast cancer patient who underwent two mastectomies and subsequent treatments showed that a 6-month exercise intervention significantly improved her muscular strength and cardiovascular function.

The exercise program also helped reduce cancer-related fatigue and depression, highlighting the importance of collaborative health efforts to enhance the quality of life for cancer patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A case study: prescriptive exercise intervention after bilateral mastectomies. Carter, SD., Drum, SN., Hayward, R., et al.[2004]

In a study involving 577 participants undergoing cancer treatment, exercise was found to be safe, with 20% of adverse events (AEs) reported by coaches and 28% by participants, mostly being minor musculoskeletal issues.

High-intensity exercise was associated with a higher likelihood of AEs compared to low-to-moderate exercise, but both forms of exercise are recommended for patients if there are no medical contraindications, as serious complications like lymphedema and PICC issues were low and not significantly different across exercise intensities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Is it safe to exercise during oncological treatment? A study of adverse events during endurance and resistance training - data from the Phys-Can study. Henriksson, A., Johansson, B., Radu, C., et al.[2021]

In a study of 35,110 exercise interventions for pediatric cancer patients and survivors, serious adverse events (AEs) were rare, with only six Grade 2-3 AEs reported, resulting in an incidence of 17 per 100,000 interventions, indicating that supervised exercise programs are generally safe.

While Grade 1 AEs, such as muscle soreness and circulatory problems, were more common (2,800 per 100,000 interventions), these were typically mild and likely not directly caused by the exercise, suggesting that exercise can be safely integrated into cancer care for children.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Adverse Events During Supervised Exercise Interventions in Pediatric Oncology-A Nationwide Survey. Gauß, G., Beller, R., Boos, J., et al.[2021]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9454950/

Physical Activity and Cancer Care—A Review - PMC The findings from these studies show that physical activity decreases the severity of side effects of cancer treatment, reduces fatigue, improves quality of ...

2. asco.org asco.org/about-asco/press-center/news-releases/movement-medicine-structured-exercise-program-challenge

Structured Exercise Program May Lower Risk of Cancer ... At five years, the disease-free survival rate was 80% in the structured exercise program and 74% in the health education materials group.

3. ysph.yale.edu ysph.yale.edu/news-article/how-exercise-increases-cancer-survival/

How Exercise Increases Cancer Survival The overall survival was 90.3% in the exercise group versus 83.2% in the group that received educational materials alone. Dr. Melinda Irwin, PhD ...

4. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12165538/

A novel approach to cancer rehabilitation - PubMed Central This article examines the influence of exercise intervention on the recovery and survival rates of cancer patients after surgery.

5. theguardian.com theguardian.com/society/2025/jun/01/exercise-better-than-drugs-after-cancer-treatment-international-trial-finds

Exercise 'better than drugs' to stop cancer returning after ... Exercise can reduce the risk of cancer patients dying by a third, stop tumours coming back and is even more effective than drugs, according to the results of a ...

6. cancer.gov cancer.gov/about-cancer/causes-prevention/risk/obesity/physical-activity-fact-sheet

Physical Activity and Cancer Fact Sheet - NCI A fact sheet that summarizes evidence linking physical activity (including exercise) to reduced cancer risk and sedentary behavior ...

7. sciencedirect.com sciencedirect.com/science/article/pii/S2589537023001141

Harms of exercise training in patients with cancer ... The harms of exercise in patients with cancer undergoing systemic treatment are uncertain, and there is currently insufficient data on harms to make evidence- ...

8. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC4821160/

Community-based exercise program effectiveness and ... Clinical trials have demonstrated the benefits of exercise for cancer survivors. This investigation determined the effectiveness and safety of a ...