Background: The Clinical Oncology Society of Australia exercise guidelines recognises the growing evidence for the benefits of exercise in patients with cancer. Since opening in April 2017, The Adem Crosby Centre has embraced a holistic cancer-care model, including an integrated exercise physiology (EP) clinic and gymnasium, focussed on patient pre- and rehabilitation throughout all phases of treatment.
Aim: To evaluate the characteristics and patterns of care for patients reviewed in the EP clinic. To describe initial EP assessments and interventions prescribed.
Methods: We performed a retrospective review of all EP clinic patients (April 2017 to May 2018). Baseline characteristics including performance status (PS), body mass index (BMI), tumour stream and treatment details (including intent) were recorded. We audited interventions prescribed and use of validated EP and quality of life assessment tools [FACIT fatigue scales, sit-to-stand scores (STS) and timed up and go (TUG)]. Descriptive statistics were used to analyse data.
Results: There were 398 evaluable patients with median age 63 years (range 17-88). The most common streams were gastrointestinal (24%) and breast (21%), and 52% (n=208) had curative intent treatment. At baseline, PS was better in curative vs palliative patients (ECOG 0; 57% vs 36%), but median BMI were similar (27.2 vs 26.6). Curative-intent patients performed no better on STS (median 10) or TUG (median 9.7 v 8.8secs) but were more likely to be receiving chemotherapy (58% vs 49%) or radiotherapy (27% vs 12%) and 8% were referred for pre-habilitation. Palliative patients had poorer baseline fatigue scores (median FACIT 33 vs 38). Interventions included home exercises (100%), supervised gymnasium sessions (23%) and community-based exercise programs (19%).
Conclusion: Our integrated EP service has been widely embraced by a wide range of patients undergoing cancer treatment. EP interventions are aligned with guidelines and future work will evaluate outcomes and refine the service