A Randomized Trial to Examine Effects of Exercise on Bone Density in Cancer Patients Receiving Chemotherapy and Catabolic Steroids

Muscle wasting and declines in bone density are commonly observed in patients receiving high dose catabolic steroids, drugs commonly included in cancer treatment protocols. The combination of catabolic steroids, and chemotherapy increase the potential for significant physical debilitation, and predispose patients to osteoporosis. The purpose of the preliminary analysis is to examine differences in functional ability, strength, and bone density (BMD) in cancer patients actively receiving chemotherapy and catabolic steroids. Thirty-six newly diagnosed cancer patients beginning chemotherapy regimens with catabolic steroids were randomized to aerobic exercise (AE) (N = 11), resistance exercise (RE) (N = 10), or usual care (CG) (N = 15). Exercising subjects followed a home-based program 4 days/wk. All subjects returned for exercise follow-up at 3 months intervals and had dexa scans of the L-spine at baseline and 6 months. The AE and RE groups both demonstrated increases of functional ability 16% and 4% respectively. The CG group showed a 10% decline in functional ability. Upper and lower body muscle strength increased in both the AE and RE groups. CG demonstrated significant declines in muscle stregth of the lower extremities. Only 3 subjects demonstrated stable or improved BMD (M = 2.04 SD = .96). The average decline in BMD was −6.5% (SD = 4.9, range = 1.4 to −16.4). AE demonstrated less declines in BMD than RE or CG. These preliminary data suggest that 1) AE and RE may improve functional ability and muscle strength, 2) substantial declines in BMD are observed over a short period during chemotherapy, and 3) more time is needed to determine effects of exercise on BMD.