The effect of exercise on chemotherapy completion rates in cancer patients receiving adjuvant chemotherapy - The ChemoFit Study

Exercise intervention Participants will be offered two supervised exercise sessions/week throughout the course of their chemotherapy treatment plus 2 weeks (max. 8 months). The exercise sessions will be conducted in small groups under the direct supervision of an exercise physiologist (EP) and last approximately 60 minutes. Prior to commencing the program, each participant will receive a consultation with the EP (as part of their baseline assessment) in order to individualise the exercise prescription to their specific needs according to their cancer and general health history, and physical abilities. The individualised prescription (i.e. specific exercise selection, intensity and progression) will be designed in accordance with national and international guidelines for best practice in exercise prescription for people with cancer, involving a combination of aerobic, resistance, and balance exercise (American College of Sports Medicine, Clinical Oncology Society of Australia, Exercise and Sports Science Australia). Specifically, the aerobic exercise component will include 20 to 25 minutes of moderate intensity continuous to vigorous intensity cardiovascular exercise (~60-85% of estimated maximum heart rate) using a variety of modes such as walking or jogging on a treadmill or cycling on a stationary ergometer. Participants will be encouraged to undertake additional home-based aerobic exercise with the goal of achieving a total of at least 150 minutes of moderate to vigorous intensity aerobic exercise each week. The resistance exercise component will last approximately 25 minutes and involve 4-6 exercises that target the major upper and lower body muscle groups (e.g. chest press, leg press). Intensity will be manipulated from 6-12 repetition maximum (RM; i.e. the maximal weight that can be lifted 6 to 12 times which is equivalent to ~60-85% of 1RM) using 2-3 sets per exercise. Exercise prescription will be progressive and modified according to individual response. The aim will be for patients to exercise with an intensity that they perceive as being “somewhat hard” to “hard” (rating between 12 and 15 on The Borg Rating of Perceived Exertion Scale). The balance exercise component will last 5 to 10 minutes, include exercises that involve a variety of different stances (e.g., single leg, tandem balance) and will be progressed by including more challenging tasks. Exercise session frequency (i.e. attendance) as well as adherence to supervised aerobic and resistance exercise (i.e. prescribed vs completed training volume) will be recorded. This includes early session terminations, exercise or dose (e.g. number of sets, repetitions, or load reductions) modifications but also dose escalations. Reasons for any missed exercise sessions (e.g. conflicting appointment) and changes in exercise prescription (e.g. fatigue) will be documented by study team members.