Physical exercise and therapy in terminally ill cancer patients: a retrospective feasibility analysis.

PURPOSE: Physical exercise (PE) and/or therapy (PT) shows beneficial effects in advanced cancer patients and is increasingly implemented in hospice and palliative care, although systematic data are rare. This retrospective study systematically evaluated the feasibility of PE/PT in terminally ill cancer patients and of different modalities in correspondence to socio-demographic and disease- and care-related aspects.
METHODS: All consecutive terminally ill cancer patients treated in a palliative care inpatient ward during a 3.5-year period were included. The modalities were chosen according to the therapists' and patients' appraisal of current performance status and symptoms.
RESULTS: PE/PT were offered to 572 terminally ill cancer patients, whereof 528 patients (92 %) were able to perform at least one PE/PT unit (average 4.2 units/patient). The most frequently feasible modalities were physical exercises in 50 %, relaxation therapy in 22 %, breathing training in 10 %, and positioning and lymph edema treatment in 6 % each. Physical exercise and positioning treatment were performed significantly more often in older patients (p=0.009 and p=0.022, respectively), while relaxation (p=0.05) and lymph edema treatment (p=0.001) were used more frequently in younger. Breathing training was most frequently performed in head and neck cancer (p=0.002) and lung cancer (p=0.026), positioning treatment in brain tumor patients (p=0.021), and lymph edema treatment in sarcoma patients (p=0.012).
CONCLUSIONS: PE/PT were feasible in >90 % of terminally ill cancer patients to whom PE/PT had been offered. Physical exercises, relaxation therapy, and breathing training were the most frequently applicable methods. Prospective trials are needed to evaluate the efficacy of specific PE/PT programs in terminally ill cancer patients.