Efficacy and Feasibility of Pre-surgical Exercise in Bladder Cancer Patients Scheduled for Open Radical Cystectomy.

To examine the feasibility and potential efficacy of pre-surgical exercise in patients with bladder cancer scheduled for open radical cystectomy with follow-up post-surgery.

Prospective single-group design with assessments at baseline, pre-surgery and 3 months post-surgery. Multimodal supervised resistance and aerobic exercise was undertaken 2-3 days/week at moderate intensity for a median of 3.5 (IQR 1.3-5.6) weeks. Feasibility was assessed by recruitment and completion rates, patient safety, program tolerance, adherence, and compliance. Lean and fat mass were assessed by dual-energy X-ray absorptiometry, physical function by a battery of tests [chest press and leg press strength, 6-minute walk test (6MWT), timed up-and-go (TUG), repeated chair rise], and quality of life (QoL), psychological distress and body image by questionnaire. Hospital length of stay (LOS) and complications were assessed by medical records.

Thirty-seven patients were referred with 20 recruited (67.3 ± 12.2 years) and a pre-surgery intervention completion rate of 80% (16 of 20). The individual median program adherence was 100.0% (IQR 89.4-100.0) with compliance of 100.0% (IQR 90.5-100.0) for resistance exercise and 81.8% (IQR 55.0-99.5) for aerobic exercise. There were no exercise-related adverse events. Body composition did not change pre-surgery, however, there were improvements (p < 0.05) in leg press strength (16%), 6MWT distance (8%), TUG (12%), chair rise (10%), and multiple QoL domains including mental health. Median LOS was 8.0 (IQR 7.0, 15.0) days. Post-surgery there were declines in components of QoL and apparent body image dissatisfaction.

A pre-radical cystectomy exercise program is feasible, safe, and well-tolerated with improvements in physical function and QoL. Supervised multimodal exercise in bladder cancer patients prior to cystectomy can enhance physical and mental health potentially buffering the effects of surgery.

Medicine and science in sports and exercise. 2023 Feb 02 [Epub ahead of print]

Dennis R Taaffe, Steve P McCombie, Daniel A Galv√£o, Robert U Newton, Shane La Bianca, Suzanne K Chambers, Nigel Spry, Favil Singh, Pedro Lopez, Oliver Schumacher, Cynthia Hawks, Dickon Hayne

Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, AUSTRALIA.