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ACU telehealth exercise program helps palliative cancer patients with cachexia

An eight-week telehealth exercise program tailored to palliative cancer patients with the muscle wasting syndrome cachexia is looking at how exercise can improve their quality of life, physical function, and strength.

The Advanced Cancer and Cachexia Exercise (ACE) Trial delivers three 30-minute telehealth sessions, supervised remotely by an exercise physiologist, to explore the effectiveness of “virtually supervised” exercise sessions.

Led by Kelcey Bland, who is completing her PhD with the Mary MacKillop Institute for Health Research, the study involves patients with metastatic or incurable cancer, many of whom have a life expectancy of two years of less.

All have a syndrome called cachexia which can affect up to 80% of patients with an advanced cancer diagnosis. Signs of cachexia include unexplained weight loss or lack of appetite which can lead to a loss of muscle mass.

“The cachexia syndrome is quite complex and not fully understood but essentially an aggressive cancer diagnosis as well as certain cancer treatments can disrupt our body’s normal metabolism and affect our appetite,” Ms Bland said.

“This can lead to weight loss and muscle wasting. We now have scientific evidence that this loss of muscle mass in people with cancer is quite strongly associated with decreased life expectancy.”

Ms Bland said patients experiencing cachexia tend to feel weaker and more fatigued.

“They often experience both a greater number and more severe symptoms, relative to people who have not experienced weight loss, so it is a very vulnerable population,” she said.

There is no treatment for cachexia itself, but experts believe a combination of diet, exercise, and medical treatment may be the best way to support patients.

“Seeing a dietician is an important first step to address appetite changes and to increase food and protein intake but to really build back that lost muscle mass and strength, we need to add exercise to the mix,” Ms Bland said.

Ms Bland said the trial is one of the first to deliver this type of exercise program specifically to advanced cancer patients with many already reporting positive changes.

“Before the program I didn't have much strength because of the chemo but as I progressed through it and as I'm finishing my chemo, I've built up a lot more strength and I find that I'm a lot more active now. I'll go for a walk, or I'm able to actually mow the front lawn. Before the exercise program, I wouldn't have had the energy to do it,” a 70-year-old lymphoma patient reported.

In addition to feeling physically stronger, Ms Bland said participants also highlighted the benefits of receiving exercise guidance from a professional using Zoom.

“During the COVID-19 lockdown in Victoria, the telehealth format has allowed us to continue the program giving everyone something to do and look forward to.”

Studies led by the exercise oncology research team at ACU’s Mary MacKillop Institute for Health Research have contributed to global research that has changed the thinking on exercise for people with cancer.

Current national and international guidelines recommend people living with and beyond cancer engage in exercise to support them during and after their cancer treatments.

While research among people with more advanced or incurable cancer diagnoses is more limited, Ms Bland hopes the trial will highlight the important role exercise may have for this group.

For more information about taking part in the trial, please email kelcey.bland@acu.edu.au