To assess the effectiveness of the EFICANCER individualized and supervised exercise program for people with gastrointestinal, breast, or non-small cell lung stage IV cancer, in terms of quality of life and functional capacity. Randomized controlled clinical trial with two parallel groups: EFICANCER (n = 47) and control (n = 43). Both groups received standard oncological care. In addition, the EFICANCER group participated in a nurse-supervised exercise program. Primary outcome was cancer-specific (EORTC QLQ-C30 questionnaire) and general quality of life (SF-36) at baseline and after 2, 6, and 12 months. Secondary outcomes were functional capacity (6-minute walking test), strength, and fatigue. The evolution in both groups was compared over 12 months using mixed-effect longitudinal models; 74.47% of patients completed at least one session of the program. At 12 months, EFICANCER group had better scores in cancer-related quality of life, with a difference between groups of 15.7 points (95% confidence interval 4.4 to 25.9) and in functional capacity, with a difference of 4.5 points (95% confidence interval -0.5 to 9.5). No significant differences in any other secondary variables were observed. The EFICANCER primary care nurse supervised exercise program is safe and feasible and improves cancer patient's outcomes. Providing the best care and trying to improve the quality of life of cancer patients are essential parts of nursing practice. Eficancer adds a new dimension to nursing practice by providing greater attention and care to patients during treatment through the supervision of physical exercise, thereby contributing to improve the quality of life of this population.

Background: Despite the established benefits of regular exercise for patients with cancer to counteract the deleterious effects of the disease itself and treatment-related adverse effects, most of them do not engage in sufficient levels of physical activity and there is a paucity of data on the integration of efficacious exercise programs that are accessible and generalizable to a large proportion of patients with cancer into routine cancer care. Objective: We intend to examine the effects attributable to the implementation of a community-based exercise program on cardiorespiratory functional capacity and quality of life for patients with cancer. Methods: This will be a hybrid study. In the first experimental phase, patients diagnosed with any type of cancer will be randomized into two parallel groups. One group immediately performs Bizi Orain, a 3-month supervised exercise program (3 times a week), in addition to behavioral counseling in a primary health care setting; the other is a reference group that starts the exercise program 3 months later (delayed treatment). In the second observational phase, the entire cohort of participants will be followed-up for 5 years. Any person diagnosed with cancer in the previous 2 years is eligible for the program. The program evaluation involves the uptake, safety, adherence, and effectiveness assessed after completion of the program and with follow-ups at 3, 6, 12, 24, 36, 48, and 60 months. The primary outcomes of the experimental study, to be compared between groups, are improved physical function and quality of life, whereas overall survival is the main objective of the prospective study. To analyze the association between changes in physical activity levels and overall survival, longitudinal mixed-effects models will be used for repeated follow-up measures. Results: A total of 265 patients have been enrolled into the study since January 2019, with 42 patients from the hematology service and 223 from the oncology service. Conclusions: Bizi Orain is the first population-based exercise program in Spain that will offer more insight into the implementation of feasible, generalizable, and sustainable supportive care services involving structured exercise to extend survival of patients with cancer, improve their physical function and quality of life, and reverse the adverse effects of their disease and related treatments, thereby reducing the clinical burden. Trial Registration: ClinicalTrials.gov NCT03819595; http://clinicaltrials.gov/ct2/show/NCT03819595 International Registered Report Identifier (IRRID): DERR1-10.2196/24835

Maintaining the physical performance of cancer patients is increasingly considered due to the growing number of cancer patients and the aggressiveness of the treatments. For this reason, bioimpedance is now being used to record patients’ body composition by obtaining the phase angle (PhA). Although there is a direct relationship between PhA, age, sex and disease prognosis, it has not been measured as an analysis of physical performance in oncology patients and is a valid tool in the follow-up of cancer patients. For this purpose, 311 patients were evaluated, and both bioelectrical impedance analysis (BIA) and physical performance measurements were performed. The modification of the results concerning PhA was found to be highly relational, as a variation in one of the variables affected the other. It was concluded that each degree increase in PhA modified −22.57 s [−27.58; −17.53] in 400-m walking test (400 mWT); 13.25 kg [10.13; 16.35] in upper-body strength (UBS); 6.3 [4.95; 7.65] in lower-body strength (LBS); 1.55 mL/kg/min [0.98; 2.12] in VO_2peak; 6.53 Watts [3.83; 9.20] in ventilatory threshold 1 (VT1); 10.36 Watts [7.02; 13.64] in ventilatory threshold 2 (VT2). It was also noted that age was a factor that affected the relationship between PhA and 400 mWT; the older the age, the higher the relationship. PhA data has been shown to be highly correlated with physical performance. This is of great importance in clinical practice because a cancer patient’s physical performance levels can be assessed during treatment.

La práctica de ejercicio físico ha sido asociada a un menor riesgo de desarrollo y recurrencia del cáncer. Asimismo, estudios previos sugieren que el ejercicio es eficaz para reducir el riesgo de desarrollar alteraciones metabólicas. Por lo tanto, esta investigación pretende evaluar los efectos de un programa de ejercicio combinado de 12 semanas sobre la reducción de los niveles de hemoglobina glicada (HbA1c) en pacientes con cáncer. Para ello, 22 pacientes no diabéticos fueron asignados aleatoriamente a una intervención de ejercicio combinado de 12 semanas o al grupo control. Se realizaron evaluaciones iniciales y a los 3 meses para valorar los cambios en los niveles de HbA1c, la grasa y la masa musculoesquelética de los 22 participantes que completaron el estudio. Analizando la muestra hubo mejoras significativas en los niveles de HbA1c (p=0,033). Además, cuando se excluyeron los mayores de 65 años, las diferencias fueron mayores (p=0,017). Aunque no se encontraron diferencias significativas entre las reducciones de los sujetos con diferentes niveles basales de HbA1c, los que tenían niveles más altos redujeron los valores en un 6,8% y los que tenían niveles normales en un 3,6%. Además, no se encontró ninguna correlación entre las reducciones de la HbA1c y los cambios en la composición corporal. Esta intervención de ejercicio combinado de 12 semanas dio lugar a una reducción de los niveles de HbA1c, pero este cambio no se asoció con los cambios en la composición corporal. Palabras clave: Oncología, Ejercicio, Composición Corporal, Entrenamiento Concurrente, Glucosa, Hemoglobina Glicada. Exercise has been associated with lower risk of cancer development and recurrence. Studies suggest that exercise is effective in reducing the risk of developing metabolic alterations. Due to the inconclusive results of previous studies, this research aims to evaluate the effects of a 12-week concurrent exercise programme on the reduction of glycated hemoglobin (HbA1c) levels in cancer patients. 22 non-diabetic patients were randomly assigned to a 12-week combined exercise intervention or to the control group. Baseline and 3-month assessments were performed to evaluate changes in HbA1c, fat and musculoskeletal mass for the 22 participants who completed the study. Analyzing the sample there were significant improvements in HbA1c (p=0.033), when excluding those over 65 years of age, the differences were greater (p=0.017). Although no significant differences were found between the reductions of subjects with different baseline HbA1c levels, those with higher levels reduced values by 6.8% and those with normal levels by 3.6%. Furthermore, no correlation was found between reductions in HbA1c and changes in body composition. This 12-week combined exercise intervention resulted in a reduction in HbA1c levels, but this change was not associated with changes in body composition. Key Words: Oncology, Exercise, Body Composition, Concurrent Training, Glucose, Glycated Hemoglobin.

This study is focused on the fact that in the context of increasing global aging and cancer diagnoses, additional challenges arise in clinical care. Adequate functionality and body composition are key to coping with antineoplastic treatment, which can lead to better treatment tolerance, survival, and quality of life. This is a cross-sectional comparative study focused on the assessment and comparison of body composition and functionality between cancer patients and a reference population, with the aim of establishing meaningful baseline values. Techniques such as manual dynamometry, the Five-Times Sit-to-Stand test, and bioimpedance were used to collect data from 374 oncologic patients and 1244 reference individuals. The results reveal significant disparities in functionality and body composition among participants, and provide age group-specific adjusted baseline values for those diagnosed with cancer. These findings may have crucial clinical implications for applying particular cut-off points designed for this population group, which makes the assessment process faster and more accurate, enhances the capacity of medical personnel to act quickly, and improves the management of frailty in cancer patients.

BACKGROUND Despite the established benefits of regular exercise for patients with cancer to counteract the deleterious effects of the disease itself and treatment-related adverse effects, most of them do not engage in sufficient levels of physical activity and there is a paucity of data on the integration of efficacious exercise programs that are accessible and generalizable to a large proportion of patients with cancer into routine cancer care. OBJECTIVE We intend to examine the effects attributable to the implementation of a community-based exercise program on cardiorespiratory functional capacity and quality of life for patients with cancer. METHODS This will be a hybrid study. In the first experimental phase, patients diagnosed with any type of cancer will be randomized into two parallel groups. One group immediately performs Bizi Orain, a 3-month supervised exercise program (3 times a week), in addition to behavioral counseling in a primary health care setting; the other is a reference group that starts the exercise program 3 months later (delayed treatment). In the second observational phase, the entire cohort of participants will be followed-up for 5 years. Any person diagnosed with cancer in the previous 2 years is eligible for the program. The program evaluation involves the uptake, safety, adherence, and effectiveness assessed after completion of the program and with follow-ups at 3, 6, 12, 24, 36, 48, and 60 months. The primary outcomes of the experimental study, to be compared between groups, are improved physical function and quality of life, whereas overall survival is the main objective of the prospective study. To analyze the association between changes in physical activity levels and overall survival, longitudinal mixed-effects models will be used for repeated follow-up measures. RESULTS A total of 265 patients have been enrolled into the study since January 2019, with 42 patients from the hematology service and 223 from the oncology service. CONCLUSIONS Bizi Orain is the first population-based exercise program in Spain that will offer more insight into the implementation of feasible, generalizable, and sustainable supportive care services involving structured exercise to extend survival of patients with cancer, improve their physical function and quality of life, and reverse the adverse effects of their disease and related treatments, thereby reducing the clinical burden. CLINICALTRIAL ClinicalTrials.gov NCT03819595; http://clinicaltrials.gov/ct2/show/NCT03819595 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/24835