Tertiary Prevention by Exercise in Colorectal Cancer Therapy

Apart from a genetic predisposition lifestyle factors (low physical activity, nutrition, and obesity) increase the risk of colorectal cancer. Furthermore, in observational studies increased physical activity has shown to improve the prognosis in patients after the diagnosis of colorectal cancer. However, there are currently no prospective randomized controlled trials which prove the causal relationship between exercise and prognosis in colorectal cancer patients. The long-term aim of this study is to evaluate whether physical activity of ≥ 18 MET-h (Metabolic equivalent task-hours) per week significantly improves disease free survival in colorectal cancer survivors (stage UICC II/III). In the first instance, structure-, process- as well as outcome-characteristics need to be investigated within a feasibility study (F-PROTECT). Essential aims are to establish collaborations with clinics and training centres, to achieve the required recruitment numbers, and to conduct the training intervention.

Inclusion criteria

• histologically confirmed nonhereditary primary Stage II or III colon cancer diagnosis or rectal cancer
• written informed consent in German
• histopathologically confirmed R0-resection
• start of guideline conformed adjuvant chemotherapy within 12 weeks after R0-resection in Stage III colon cancer diagnosis (if necessary in Stage III colon cancer diagnosis)

Exclusion criteria

• hereditary colon cancer diagnosis
• R1 and R2 resection
• clinically relevant complications during recovery
• secondary neoplasm
• non-continuance of guideline conformed therapy
• uncontrolled infection
• manifest cardiac disease (e.g. unstable CAD, heart failure (NYHA IV), malignant hypertension)
• clinical relevant respiratory disease (GOLD IV)
• musculoskeletal disorders severely restricting the patients mobility (e.g. gonarthrosis, coxarthrosis)
• cirrhosis of the liver (Child B and C)
• Karnofsky performance status scale ≤ 60%
• maximal exercise capacity ≤ 50 watt
• clinically relevant lab factors (leukocyte count ≤ 3000/μl, thrombocyte count ≤ 20.000/μl, hemoglobin < 8 g/dl)
• physical activity level ≥ 18 MET-h/ week at screening