Exercise Therapy in Radiation Therapy (EXERT)
Metastatic Cancer
About this trial
This is an interventional supportive care trial for Metastatic Cancer
Eligibility Criteria
Inclusion Criteria:
- Males and females ≥18 years of age
- Fluent in written and spoken English
- Must be able to provide and understand informed consent
- Must have an ECOG PS of ≤ 2
- Diagnosed with metastatic disease
- Cancer patients (stage 1-4)
- Treatment to primary site or metastatic disease
- Scheduled to receive radiation therapy at Penn State Cancer Institute
- Absence of absolute contraindications for exercise according to the American Heart Association (see below)
- Primary attending oncologist approval
- Receiving treatment as an outpatient
Exclusion Criteria:
- Receiving radiation therapy at a location other than Penn State Cancer Institute
- Not fluent in written and spoken English
- Evidence in the medical record of an absolute contraindication for exercise
- Performing > 90 minutes/week of physical activity at the time of initial evaluation
Cardiac exclusion criteria:
- Class II, III or IV heart failure as defined by the New York Heart Association (NYHA) functional classification system
- History of acute coronary syndromes (including myocardial infarction and unstable angina), coronary angioplasty or stenting within the past 6 months prior to the start of radiation therapy
- Uncontrolled arrhythmias; patients with rate controlled atrial fibrillation for >1 month prior to start of radiation therapy may be eligible
- syncope
- acute myocarditis, pericarditis, or endocarditis
- acute pulmonary embolus or pulmonary infarction
- thrombosis of lower extremities
- suspected dissecting aneurysm
- pulmonary edema
- respiratory failure
- acute non-cardiopulmonary disorder that may affect exercise performance or be aggravated by exercise
- mental impairment leading to inability to cooperate
- Pregnant women
- In-patient receiving radiation therapy for a radiation emergency (e.g. cord compression, SVC syndrome, brain metastases)
- High risk of fracture or spine instability (Mirels score ≥7, SINS ≥7)
- Children (the protocol will only include individuals 18 and older)
Sites / Locations
- Penn State Cancer Institute
Arms of the Study
Arm 1
Experimental
Exercise
The exercise intervention will utilize the "Moving Through Cancer: A Guide to Exercise for Cancer Survivors" framework. A certified cancer exercise physiologist will work through this guide at radiation therapy visits, with at least 1 visit per week, per the study schema. The cancer exercise physiologist will teach participants proper: warm ups, use of equipment, exercise form, modes of activity, intensity of exercise, flexibility exercises, and cool down. The cancer exercise physiologist will tailor the instruction to convey special considerations for exercise based on treatment and cancer type. The patient will perform supervised exercise in the Exercise Medicine Unit under the guidance of the cancer exercise specialist. The exercise done will be educational in nature (i.e. learning about proper walking form, proper intensity for a warmup/cool down, proper techniques for resistance exercises).