Abstract 581P
Background
Although colorectal cancer (CRC) survivors often suffer from defecation related symptoms (DRS), there are very few treatment options to improve DRS. Strengthening of abdominal muscles to increase intra-abdominal pressure and pelvic floor exercises to improve pelvic floor dyssynergia may improve DRS in colorectal cancer patients. However, the effects of exercise on DRS have not been studied fully. Therefore, the purpose of this study is to investigate the efficacy of exercise on DRS in CRC.
Methods
A total of 120 CRC who completed surgery and adjuvants therapy were recruited out of 441 approached. 120 participants were randomly assigned to either exercise (EG) or usual care group (CG). The combined weekly supervised and home-based exercise program (12 weeks) includes increase in physical activity (PA) levels to meet the ACSM guideline as well as daily calisthenics exercises. Calisthenics exercises include a total of 12 movements aimed to increase whole body muscle strengths which focused on core and pelvic floor muscles. The primary outcome was DRS score assessed the sum of blood and mucus in stool, stool frequency, abdominal pain, buttock pain, bloating, flatulence, fecal incontinence and embarrassment in EOTRC-QLQ-CR29. A two-way ANOVA repeated measures were used determine group and time interaction. Table: 581P
Effects of exercise on defecatory symptoms
Control | Exercise | p-value | |||
Pre | Post | Pre | Post | ||
Blood in stool | 4.7 ± 9.7 | 4.4 ± 9.1 | 7.2 ± 15.5 | 3.1 ± 8.9 | 0.05 |
Stool frequency | 26.3 ± 27.0 | 20.1 ± 20.5 | 28.7 ± 25.1 | 23.4 ± 23.8 | 0.91 |
Abdominal pain | 14.4 ± 22.4 | 11.7 ± 19.2 | 18.3 ± 24.9 | 10.0 ± 16.6 | 0.21 |
Buttock pain | 12.2 ± 21.2 | 12.8 ± 25.4 | 18.9 ± 30.3 | 12.8 ± 26.1 | 0.08 |
Bloating | 22.8 ± 22.5 | 25.0 ± 25.8 | 34.4 ± 30.7 | 22.8 ± 27.1 | 0.01 |
Flatulence | 21.0 ± 26.0 | 17.7 ± 23.3 | 28.3 ± 33.5 | 21.5 ± 25.1 | 0.42 |
Fecal incontinence | 13.5 ± 20.5 | 13.1 ± 20.5 | 16.9 ± 24.8 | 12.9 ± 25.3 | 0.26 |
Embarrassment | 20.4 ± 26.8 | 16.7 ± 20.8 | 27.6 ± 32.0 | 18.0 ± 25.5 | 0.16 |
Bolds were statistically significant different between pre and post (p<.05), p= Difference between control vs. exercise
Results
Among the 120 participants enrolled, 100 (96.6%) completed the trial with supervised exercise compliance rate of 95%. PA levels increased and fitness levels improved only in the exercise group. Exercise significantly decreased DRS score (6 week - 0 week: CG= -14.0 ± 54.7 vs. EG= - 56.1 ± 99.5, p for group and time interaction = 0.02). Symptom scores in EG include blood and mucus in stool, abdominal pain, buttock pain, bloating, flatulence and embarrassment were improved.
Conclusions
It is concluded that both combined supervised and home-based exercise significantly reduced bowel and defecatory problems in colorectal cancer patients.
Clinical trial identification
This study was approved by The Institutional Review Board of Severance Hospital (IRB No. 4-2018-0841).
Editorial acknowledgement
This study was funded by the National R&D Program for Cancer Control, Ministry of Health and Welfare, Republic of Korea (HA16C0012020020) and Yonsei Signature Research Cluster Program of 2021-22-0009.
Legal entity responsible for the study
The authors.
Funding
The National R&D Program for Cancer Control, Ministry of Health and Welfare, Republic of Korea, Yonsei Signature Research Cluster Program.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
592P - The role of early change in circulating tumor DNA as a potential predictor of response to chemotherapy in patients with metastatic colorectal cancer
Presenter: Jinjia Chang
Session: Poster session 10
594P - The efficacy of anti-EGFR therapy for RAS mutant metastatic colorectal cancer (mCRC) patients with RAS mutation negative in circulating-tumor DNA (ctDNA) after 1st- or 2nd-line chemotherapy
Presenter: Naoki Izawa
Session: Poster session 10
595P - The DUREC trial: Durvalumab plus total neoadjuvant therapy in locally advanced rectal cancer - a multicenter, single-arm, phase II study (GEMCAD-1703)
Presenter: Jaume Capdevila Castillon
Session: Poster session 10
597P - Surgical quality for patients (pts) treated with neoadjuvant chemotherapy vs chemoradiation for locally advanced rectal cancer (LARC): PROSPECT (NCCTG N1048, alliance)
Presenter: Martin Weiser
Session: Poster session 10
598P - Influence of the early stoma closure after low rectal cancer resection on completeness of adjuvant chemotherapy (CoCStom): A randomized, controlled multicentre trial of the AIO (AIO KRK 0113)
Presenter: Flavius Sandra-Petrescu
Session: Poster session 10
599P - R-IMMUNE: A phase Ib/II study to evaluate safety and efficacy of atezolizumab combined with radio-chemotherapy in a preoperative setting for patients with locally advanced rectal cancer (LARC)
Presenter: Javier Carrasco
Session: Poster session 10