Exercise Rehabilitation for Cancer

Overseen By Lynda C Robey

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: VA Office of Research and Development

Disqualifiers: Metastatic cancer, Life expectancy < 6 months, Musculoskeletal conditions, others

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: 12

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores whether exercise can reduce persistent nerve pain in Veterans who have had lung cancer. The goal is to determine if regular exercise can serve as a new pain management method for cancer survivors, potentially reducing their reliance on pain medications like opioids. Participants are divided into two groups: one will maintain their usual activities, while the other will regularly engage in Exercise Rehabilitation (also known as Physical Activity Therapy or Exercise Therapy) both at a facility and at home. Individuals who have undergone lung cancer treatment, can walk on a treadmill, and still experience nerve pain might be suitable for this study. As an unphased trial, this study provides a unique opportunity to contribute to innovative pain management strategies for cancer survivors.

Do I need to stop my current medications for the trial?

The trial protocol does not specify whether you need to stop taking your current medications.

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

Research shows that exercise programs are generally safe for people with cancer. Studies have found that exercise can help reduce tiredness and pain, strengthen bones, and improve overall health. One study found that participants experienced fewer side effects from their treatment, suggesting that exercise is well-tolerated. While exercise might cause some discomfort, reports of serious problems are rare. Many health organizations recommend exercise for cancer patients, supporting its safety. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about exercise rehabilitation for cancer because it offers a holistic approach to recovery that differs from traditional methods like surgery, chemotherapy, and radiation. Unlike these standard treatments, exercise rehabilitation focuses on enhancing physical activity to improve overall well-being and recovery. This method encourages participants to engage in structured exercises both at training facilities and at home, potentially boosting energy levels, reducing fatigue, and improving quality of life. By integrating regular exercise into cancer recovery, this approach aims to support not just physical health but also mental and emotional resilience, offering a well-rounded path to healing.

What evidence suggests that exercise rehabilitation is effective for reducing neuropathic pain in lung cancer survivors?

Research shows that exercise can greatly benefit cancer patients. Studies have found that exercise aids recovery and may improve survival rates after cancer surgery. Being active is also linked to reduced pain, improved movement, and stronger muscles in cancer patients. One study found that breast cancer patients improved their thinking skills by 12% after a 12-week exercise program. In this trial, participants in the Exercise Rehabilitation arm will engage in regular exercise sessions, which may help manage symptoms like nerve pain in lung cancer survivors. ^{1 2 6 7 8}

Who Is on the Research Team?

Alice S. Ryan, PhD

Principal Investigator

Baltimore VA Medical Center VA Maryland Health Care System, Baltimore, MD

Are You a Good Fit for This Trial?

This trial is for Veteran cancer survivors aged 60-80 with a history of lung cancer treatment, either surgery or chemotherapy. They must be able to walk on a treadmill, have moderate functional ability (Karnofsky >70), and experience neuropathic pain (Pain Scale score >1). Those with stage IV cancer, life expectancy under 6 months, or conditions preventing exercise can't join.

Inclusion Criteria

I am able to care for myself and perform normal activities with minimal assistance.

I have had surgery on my chest or chemotherapy that affects the nerves.

I am between 60 and 80 years old.

Exclusion Criteria

My cancer has spread to other parts of my body.

I do not have any health issues that prevent me from exercising.

Life expectancy < 6 months

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Control

Participants maintain their current activity level for 6 weeks

6 weeks

Measured at baseline and after 6 weeks

Exercise Rehabilitation

Participants will exercise 2x/week at training facilities and at home one day a week

6 weeks

Measured at baseline and after 6 weeks

Follow-up

Participants are monitored for changes in fitness, strength, physical function, fatigue, and quality of life

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Exercise Rehabilitation

Trial Overview The study is testing if exercise rehabilitation can help reduce chronic neuropathic pain in Veterans who survived lung cancer compared to those who don't receive this intervention. It aims to find an alternative to opioid treatments by improving care through physical activity.

How Is the Trial Designed?

Group I: Control Experimental Treatment 1 Intervention

Participants maintain their current activity level.

Group II: Exercise Rehabilitation Active Control 1 Intervention

Participants will exercise 2x/week at training facilities and at home one day a week.

Exercise Rehabilitation is already approved in United States for the following indications:

Approved in United States as Exercise Rehabilitation for:

• Peripheral Artery Disease (PAD)
• Claudication
• Vascular Health Improvement

Who Is Running the Clinical Trial?

VA Office of Research and Development

Lead Sponsor

Trials

1,691

Recruited

3,759,000+

Baltimore VA Medical Center

Collaborator

Trials

33

Recruited

3,000+

Published Research Related to This Trial

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]

Physical activity and targeted exercise therapy can significantly improve outcomes for cancer patients, helping to manage side effects like fatigue and depression, especially when introduced right after diagnosis.

Moderate endurance training combined with individualized strength training is particularly effective and can be recommended for all cancer patients, regardless of cancer type, while ensuring contraindications are considered.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Physical activity and exercise therapy in oncology]. Zoth, N., Böhlke, L., Theurich, S., et al.[2023]

In a study involving breast cancer survivors at risk for lymphedema, weightlifting showed a higher rate of musculoskeletal injuries compared to standard care, with injury rates of 2.3 per 1,000 bouts for the weightlifting group.

Despite the efficacy of weightlifting as a rehabilitative exercise, 20.9% of participants required medical attention that led to modifications in their exercise regimen, highlighting the need for well-trained health and fitness professionals to safely implement such programs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Safety of weightlifting among women with or at risk for breast cancer-related lymphedema: musculoskeletal injuries and health care use in a weightlifting rehabilitation trial. Brown, JC., Troxel, AB., Schmitz, KH.[2021]

A study of 350 cancer patients receiving physical therapist-led exercise counseling showed significant reductions in global distress and fatigue, indicating that exercise counseling can effectively improve symptoms related to cancer treatment.

Patients reported notable improvements in overall health and well-being after counseling, suggesting that exercise may play a crucial role in enhancing quality of life for cancer patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Physical Therapist-Led Exercise Assessment and Counseling in Integrative Cancer Care: Effects on Patient Self-reported Symptoms and Quality of Life. Lopez, G., Eddy, C., Liu, W., et al.[2023]

A 6-week supervised exercise program for 61 cancer patients improved their physical activity levels compared to baseline, but there was a significant drop in activity levels during the follow-up period, indicating the need for ongoing support.

The study found that patients who maintained higher levels of physical activity three months after the program were those who had been more active before their illness and experienced less psychological distress, suggesting that pre-illness activity and mental health are important for sustaining exercise adherence.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The impact of supervised exercise intervention on short-term postprogram leisure time physical activity level in cancer patients undergoing chemotherapy: 1- and 3-month follow-up on the body & cancer project. Midtgaard, J., Tveterås, A., Rørth, M., et al.[2019]

Rehabilitation can help cancer survivors maintain physical, cognitive, and psychological functioning, but providers must understand the complex side effects of cancer treatments to ensure safety during interventions.

This review highlights the need for rehabilitation providers to stay informed about the latest cancer treatments and their side effects, as well as to follow safety guidelines to effectively support patients throughout their cancer care journey.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Focused Review of Safety Considerations in Cancer Rehabilitation. Maltser, S., Cristian, A., Silver, JK., et al.[2023]

Exercise therapy significantly improves cardiorespiratory fitness in cancer patients and helps reduce the cardiotoxic effects of cancer treatments, making it a crucial part of cardiac rehabilitation programs.

Starting exercise early after a cancer diagnosis and continuing throughout survivorship is generally safe and beneficial for heart health in cancer survivors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Exercise Training for Cancer Survivors. Tong, CKW., Lau, B., Davis, MK.[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]

Regular physical exercise is associated with a reduced risk of developing colorectal and breast cancer, and may also lower the risk for prostate, endometrial, and lung cancers, based on a review of recent literature.

Exercise is beneficial for cancer survivors, aiding in recovery from treatment and potentially extending survival, although specific guidelines on the optimal amount, type, and intensity of exercise are still being developed.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Exercise in cancer. Rajarajeswaran, P., Vishnupriya, R.[2021]

Citations

1. 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.

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12314216/

Exploring the Impact of Physical Therapy on Patient ... (2021) reported a 12% improvement in cognitive function in 70 breast cancer patients after a 12-week exercise program [39]. Psychosocial ...

3. bmccancer.biomedcentral.com bmccancer.biomedcentral.com/articles/10.1186/s12885-024-12348-w

Effect of exercise-based cancer rehabilitation via telehealth This meta-analysis showed that telehealth exercise cancer rehabilitation could significantly increase cardiorespiratory fitness and physical activity levels ...

4. sciencedirect.com sciencedirect.com/science/article/pii/S0003999322001654

Systematic Review of Functional Outcomes in Cancer ... These findings provide evidence supporting the efficacy of rehabilitative interventions for individuals with a cancer history.

5. nature.com nature.com/articles/s41598-023-35503-y

Exercise-based rehabilitation on functionality and quality of ... Exercise can be used during cancer treatment to improve function, including pain relief, increase range of motion and muscle strength, and reduce cancer- ...

6. sciencedirect.com sciencedirect.com/science/article/pii/S1040842825001064

Physical activity guidelines in oncology: A systematic ... This review aims to summarize the recommendations endorsed by scientific societies regarding physical activity for patients with cancer.

7. journals.lww.com journals.lww.com/rehabonc/fulltext/2025/07000/the_safety_and_feasibility_of_exercise.2.aspx

The Safety and Feasibility of Exercise Intervention for... Physical fatigue, pain, and bone density improved significantly with exercise training for the studied individual participants with spine ...

8. ascopubs.org ascopubs.org/doi/10.1200/EDBK_349635

Exercise Across the Cancer Care Continuum: Why It ... Exercise across the cancer care continuum attenuates treatment-related adverse effects among various cancer types and reduces cancer-specific and overall ...