Dr. Matthew Maddocks

Presentation Roadmap/ Summary

This presentation will take into account experimental and clinical evidence to overview the use of exercise in cancer cachexia. Exercise studies targeting cachectic patients have demonstrated that muscle has the capacity to respond to exercise training. Nonetheless, there are challenges in applying therapeutic exercise, particularly once cachexia is established, and not all patients are able or willing to undertake supervised programmes.

Key words: cachexia, muscle mass, therapeutic exercise

At the conclusion of the presentation, the participant will be able to:

1. Understand the impact of cancer and its treatment on cardiorespiratory fitness, physical function and quality of life
2. Identify the evidence for physical activity and exercise in cancer, across the disease trajectory, with a focus on symptom burden and physical function
3. Understand how to prescribe, structure and monitor a safe physical activity and exercise intervention

Key Takeaways/ Fast Facts

• Reduced physical function, incorporating exercise intolerance, physical inactivity and dependency, is a common consequence of cancer and its treatment
• Most physical activity and exercise guidelines for cancer survivors suggest that physical activity should be an integral and continuous part of care for people with cancer
• There is sufficient evidence to promote physical activity and exercise for adult cancer patients before, during, and after cancer treatment, across all cancer types, including those with advanced disease
• Combined aerobic and resistance exercise training, alongside nutritional support, may be particularly relevant in patients with cachexia

Key references

1. Jones LW, Eves ND, Haykowsky M, Freedland SJ, Mackey JR. Exercise intolerance in cancer and the role of exercise therapy to reverse dysfunction. Lancet Oncol. 2009;10(6):598-605.
2. Sasso JP, Eves ND, Christensen JF, Koelwyn GJ, Scott J, Jones LW. A framework for prescription in exercise-oncology research. Journal of cachexia, sarcopenia and muscle. 2015;6(2):115-24.
3. Heywood R, McCarthy AL, Skinner TL. Efficacy of Exercise Interventions in Patients with Advanced Cancer: A Systematic Review. Archives of physical medicine and rehabilitation. 2018;99(12):2595-620.
4. Hall CC, Cook J, Maddocks M, Skipworth RJE, Fallon M, Laird BJ. Combined exercise and nutritional rehabilitation in outpatients with incurable cancer: a systematic review. Support Care Cancer. 2019 Apr 3. doi: 10.1007/s00520-019-04749-6.
5. Maddocks M, Hopkinson J, Conibear J, Reeves A, Shaw C, Fearon KC. Practical multimodal care for cancer cachexia. Current opinion in supportive and palliative care. 2016;10(4):298-305.