Cancer Control Research5R21CA114523-02
Lastayo, Paul C.
A RENEW INTERVENTION FOR ELDERLY CANCER SURVIVORS
DESCRIPTION (provided by applicant): Cancer survivors, the majority of whom are 65 and older, report persistent and chronic levels of fatigue that lasts long after treatment. This fatigue, which is often coupled with weakness, ultimately hinders physical ability behaviors, resulting in low levels of enthusiasm for exercise and an amplification of age- related loss of muscle mass, strength, mobility and functional status. Resistance exercise can mitigate (and in many cases reverse) fatigue, muscle wasting and physical mobility/activity impairments in the elderly. The positive impact of physical activity behaviors in elderly cancer survivors also is evident. The benefits of resistance exercise in elderly cancer survivors can only be realized, however, if they have sufficient energy reserves to participate in exercise; heretofore the major reason physical interventions have not been universally employed in this population. The broad objective of this proposal is to determine the effectiveness of an exercise intervention that potentially optimizes muscle growth and strength; increases mobility, activity levels, and functional status; and alleviates fatigue, all while placing the lowest demand on an elderly cancer survivor's energy reserve. Resistance exercise, which induces eccentric (lengthening) muscle activity, may be the ideal intervention as it can stimulate positive muscle changes (due to the high forces) and it is relatively effortless (due to the low energetic cost). This exploratory, prospective, longitudinal, randomized small trial will test the relative efficacy of a 12 week Resistance Exercise via Negative-Eccentric Work (RENEW) intervention in a sample elderly cancer survivor population versus Usual-Care. Participants who are 65 years or older and have survived cancer (and its treatment) will be included if they have fatigue and/or weakness in addition to mobility impairments. The specific aims of this collaborative pilot proposal are to explore if a 12 week RENEW intervention affects: (1) the perception-of, and the patterns-of change in, fatigue, weakness, physical activity level and functional status; (2) muscle structure, function, and mobility; and; (3) the elderly cancer survivor's adherence and satisfaction behaviors relative to this novel exercise regime.