New research trial tests benefit of exercise before and after cancer surgery

A national research trial has been launched to see if patients can benefit from a structured exercise programme before and after major abdominal surgery for colorectal cancer, also known as bowel cancer.

The Colorectal Cancer Unit at Norfolk and Norwich University Hospital (NNUH) in partnership with the Norwich Clinical Trials Unit at the University of East Anglia (UEA) and Northumbria University, Newcastle are leading a National Institute of Health Research funded multi-centre trial, called PREPARE ABC. The trial’s Chief Investigators are Professor John Saxton, an expert in clinical exercise physiology from Northumbria University, Newcastle and Mr James Hernon, consultant surgeon at the Norfolk and Norwich University Hospital.

Colorectal cancer is the fourth commonest cancer in the UK and each year in the UK 40,000 new patients are affected. While an operation offers the best chance of cure, it can result in significant complications or patients no longer experiencing the same quality of life as they did before surgery.

The trial will involve 1,400 patients at up to 20 hospitals from across the country. The patients will have their baseline fitness assessed using a cardiopulmonary exercise test – a fitness test that measures heart and lung fitness. They will continue to be cared for locally as part of the trial and be randomly allocated to receive either supervised exercise at their local hospital, a home based exercise programme with telephone support from a physiotherapist or the current standard care, which does not include an exercise programme. Patients will be monitored by their local clinicians in the trial and will recommend suitable patients for the trail.

The exercise programme will be performed in the three to four weeks leading up to surgery and begin again six weeks after surgery. Research nurses will assess patients at regular intervals to determine if any complications occur within 30 days of their surgery and use special questionnaires to determine their quality of life 12 months after starting the study.

John Saxton, a Professor in Clinical Exercise Physiology and Head of the Department of Sport Exercise and Rehabilitation at Northumbria University, said: "I am delighted to be involved in this prestigious trial. It is the largest intervention study of its kind in the UK and has real potential to establish exercise as an important and effective adjunctive treatment for NHS patients living with and beyond cancer. Observational evidence suggests that physical fitness before cancer surgery influences how well patients recover from the surgery; and maintaining a physically active lifestyle after treatment enhances quality of life and may improve survival."

John will lead on the exercise components of the study. He has carried out similar studies with cancer patients and survivors, patients with heart disease and people with multiple sclerosis. His research focuses on the role of exercise and other lifestyle factors in the prevention and management of long-term conditions.

Prof Ann Marie Swart Director of the Norwich Clinical Trials Unit said “PREPARE ABC is an exciting collaboration between UEA, Northumbria University and NNUH. We are delighted to be part of the multi-disciplinary team helping to improve outcomes for patients in East Anglia and throughout the UK.”

The trial is expected to finish in 2020 when the results will be published. The researchers hope that by using this approach they will be able to produce clear evidence as to the benefits of exercise before and after surgery and determine if this is a cost effective way to reduce complications and improve quality of life in patients undergoing colorectal cancer surgery.

For more information about Northumbria University’s Department of Sport, Exercise and Rehabilitation visit www.northumbria.ac.uk