“Keeping young people fit, healthy and strong during treatment is something I see as not only important, but essential.”
- Claire Munsie, Exercise Physiologist
Sony Foundation caught up with Exercise Physiologist, Claire Munsie who is leading some very exciting research into the benefits of physical activity during and after treatment in adolescent and young adult cancer patients. The 3-year research study, funded by Sony Foundation, is taking place at the Perth You Can Centre.
What do we know already about exercise during cancer treatment and what gap is there relating to adolescent cancer patients?
Over the last three or so decades, research into the benefits of exercise in cancer cohorts has primarily been conducted in breast, prostate and colorectal cancer patients with really positive outcomes. This early research has shown that exercise is not only safe and tolerable during cancer treatment, but can actually mitigate some of the known side effects such as fatigue and physical deconditioning as well as improve quality of life. Given the distinctly different diagnoses and treatments that young people are likely to experience, it is risky to make assumptions about previous findings from other populations when applying them to the AYA (Adolescent & Young Adult) cohort. The recent review that I conducted revealed that there is a limited amount of research exploring the benefits of exercise in AYA cancer patients. Much of the existing research is of poor quality with limited participant numbers. However, the review determined that exercise looks to be feasible and may have benefits on physical functioning and quality of life in AYA cancer survivors, though needs to be explored in a more robust manner. The outcomes of this review support the need for the prospective randomised controlled trial which forms the basis of my PhD research.
You've already enrolled 30 AYAs in the study, what does it generally consist of?
Following consent from the treating teams and patients, participants complete a series of baseline functional and psychosocial assessments and are randomised to begin exercise immediately or delay exercise for a 10 week period. The exercise group completes two supervised tailored exercise sessions per week in the hospital gym. Patients are reassessed at 10-weeks and 20-weeks. I am now two thirds the way into my recruitment and have a bit of a mix of patients. Of the recruited patients there are a number of sarcomas, CNS, Hodgkin Lymphoma, Leukaemia and Germ Cell tumour diagnoses which is really a pretty good representation of the range of diagnoses young people often face.
What are you hoping the research will show?
Our primary research question is exploring whether a structured exercise program can mitigate the functional decline associated with cancer and its treatment. I am really hoping to see that we are able to preserve some strength and/or fitness while patients undergo their often-rigorous treatment regimens.
As you are only midway through the research, we know you can't comment on definitive research outcomes and findings, but can you share with us perhaps a case study or two of where you believe the exercise had great outcomes for the patient?
At this stage, unfortunately, it is too early to comment on the outcomes of the study. However, anecdotally we have seen some amazing benefits so far. Last year, we had a few young patients who not only juggled their cancer treatment and this program, but also managed to squeeze in and finish their year 12 studies. Exercise was a huge part of their lives before they were diagnosed, and being able to keep active during their treatment helped them maintain their physical health as much as possible. Patients reported the program helped them manage their fatigue and also gave them an outlet to escape from the stress of school and treatment.
If the findings of the program and research prove to be beneficial, what's your hope for future treatment plans for AYA's?
My hope is that we can show that exercise is absolutely non-negotiable and that all young people have access to supervised, tailored exercise during their cancer treatment. In the future, I’d like to explore specific AYA tumour groups to help better understand what kind of exercise is most beneficial across different diagnoses.
We eagerly anticipate the outcome of Claire’s research in 2021!