# Baseline Characteristics of Individuals with Metastatic Cancer Enrolled in the Alberta Cancer Exercise Study and 12-Week Findings for Symptom-Related and Physical Fitness Measures

## TL;DR

A 12-week community-based exercise program for people with metastatic cancer in Alberta was found to be safe and effective, with most participants completing it and showing improved physical and emotional health.

## Contribution

The study provides evidence that community-based exercise programs can be safely implemented for metastatic cancer patients, with specific insights into subgroups that benefit more.

## Key findings

- Most participants completed the 12-week program with high attendance and low adverse events.
- Participants showed significant improvements in physical activity, symptoms, and quality of life.
- Male participants and those not on chemotherapy experienced greater benefits from the program.

## Abstract

Exercise can help people with advanced cancers feel better and improve their quality of life, but there is limited information on how best to deliver safe and effective programs. This study looked at a 12-week community exercise program in Alberta, Canada, designed for people with cancer, including those with metastatic disease. Most participants with metastatic cancer completed the program and attended regularly. Exercise was well tolerated, with a very low incidence of adverse events. Safety was supported through screening/triage, check-ins, and supervised exercise. Participants experienced meaningful improvements in physical activity levels, symptoms, overall wellbeing, and physical fitness. Some groups, such as people not receiving chemotherapy, male participants, and those in group personal training or online classes, experienced even greater benefits. These findings show that community-based exercise programs are safe and helpful for people with metastatic cancer. This work provides important direction for expanding access to exercise programs and shaping future cancer care.

Exercise has been found to be safe and beneficial for people with advanced cancers, but more research is needed to understand how best to design and implement exercise programming. The Alberta Cancer Exercise (ACE) study examines the effectiveness and implementation of a 12-week community-based exercise program in Alberta, Canada, for people diagnosed with cancer. Here, we describe the characteristics of individuals with metastatic cancer enrolled in the ACE program and report 12-week changes in self-reported and objective outcomes. Of 306 participants, 274 (89.5%) completed the 12-week study. Many participants were female (65.4%), with ≥1 comorbidity (71.9%), and on active cancer treatment (74.8%). Common cancer types included breast (33.7%), genitourinary (16.7%), and digestive (15.0%). Frequent sites of metastasis were bone (44.8%), liver (28.8%), and lung (25.8%). The mean exercise attendance rate was 73.6%. One exercise-related adverse event (0.3%) and one non-exercise-related adverse event (0.3%) occurred, both in individuals with brain metastases. Participants demonstrated strong interest and engagement in exercise, with significant improvements in weekly physical activity, symptoms, quality of life, and physical fitness. Greater benefits were found among subgroups of male participants, those not undergoing chemotherapy, and those receiving group personal training or virtual circuit training. A low rate of adverse events is anticipated.