New research trial tests benefits of exercise before and after cancer surgery

Picture caption:  The Clinical Trials Unit team with patient Nigel Slaymaker.  From the right, Helen Darby, admin assistant; Adele Cooper, senior research nurse; patient Nigel Slaymaker from Long Stratton; Jodie Graham, research nurse; Catherine Wright, clinical research nurse; Edward Malone and Michael Cornwell, data managers.

A national research trial has been launched in Norfolk to see if patients can benefit from a structured exercise programme before and after major abdominal surgery for colorectal cancer, also known as bowel cancer.

The Colorectal Cancer Unit at Norfolk and Norwich University Hospital (NNUH) in partnership with the Norwich Clinical Trials Unit at the University of East Anglia and Northumbria University are leading a National Institute of Health Research funded multi-center trial, called PREPARE ABC. The trial’s Chief Investigators are Mr James Hernon, consultant surgeon at the Norfolk and Norwich University Hospital and Professor John Saxton,  an expert in clinical exercise physiology, from Northumbria University.

Colorectal cancer is the fourth commonest cancer in the UK. Each year in the UK 40,000 new patients are affected, and approximately 250 are treated with surgery at NNUH. While an operation offers the best chance of cure, it can result in significant complications or patients no longer experiencing the same quality of life as they did before surgery.

Mr. Richard Wharton, NNUH Consultant Surgeon and Chief of Service for the Colorectal Unit said, “The Colorectal Unit is delighted to be leading this important area of research. A number of small studies have shown that patients who start to undertake regular exercise in the short period of time between their diagnosis of cancer and their operation can increase their fitness and this may result in improved recovery.

“After an operation for cancer it is also thought that patients who continue to exercise may recover better in the long term.”

Prof Ann Marie Swart Director of the Norwich Clinical Trials Unit said “PREPARE ABC is an exciting collaboration between UEA, Northumbria University and NNUH. We are delighted to be part of the multi-disciplinary team helping to improve outcomes for patients in East Anglia and throughout the UK”

Alan Stephens the patient representative for the study said “This extensive research trial will, hopefully, prove what I felt were the benefits of keeping up a twice weekly visit to the gym during my treatment 10 years ago”.

Patients baseline fitness will be assessed using a cardiopulmonary exercise test in the respiratory department led by Louise Bailey, Chief Clinical Physiologist at NNUH. Patients will then be randomly allocated to receive either supervised exercise in the clinical trials unit at the hospital, a home based exercise programme with telephone support from a physiotherapist or the current standard care. The hospital physiotherapists with Lynne Cox Senior Physiotherapist as the physiotherapy lead will supervise the exercise sessions.

The exercise will be performed in the 3 to 4 weeks leading up to surgery and begin again 6 weeks after surgery. The NNUH research nurses will assess patients at regular intervals to determine if any complications occur within 30 days of their surgery and use special questionnaires to determine their quality of life 12 months after starting the study.

The trial will recruit over 1400 patients from at least 13 hospitals across the country and is expected to finish in 2020 when the results will be published. The researchers hope that by using this approach they will be able to produce clear evidence as to the benefits of exercise before and after surgery and determine if this is a cost effective way to reduce complications and improving the quality of life in patients undergoing colorectal cancer surgery.

For further information, go to:

• http://www.uea.ac.uk/prepare-abc

• https://www.uea.ac.uk/norwichctu

World Cancer Day

This research comes in alignment with World Cancer Day on February 4th.

Louise Cook, NNUH Fundraising Manager will be marking this day further by raising awareness of the hospital charity and the importance it has in supporting cancer patients.

“Our hospital is at the forefront of the fight against cancer in both treatment and research. Charitable funding plays an important role in ensuring that staff can deliver a level of care that is over and above what the NHS alone can fund. Thanks to the generous support of grateful patients, their families, staff and the local community, the hospital charity continues to fund state-of-the-art equipment, and cancer research studies”.

For more information on how you can assist with hospital fundraising, please email fundraising@nnuh.nhs.uk.