moderate physical activity in helping patients recover physically and emotionally from stage ii or stage iii colorectal cancer

Conditions: Anxiety Disorder; Colorectal Cancer; Depression; Psychosocial Effects of Cancer and Its Treatment

Summary: rationale: physical activity may prevent or lessen depression and anxiety and improve quality of life and immune function in patients with colorectal cancer. purpose: this randomized clinical trial is studying how well physical activity helps patients with stage ii or stage iii colorectal cancer recover from cancer.

objectives: primary * assess the effect of moderate physical activity interventions in ameliorating quality of life (as measured by the functional assessment of cancer therapy-colon questionnaire) in patients undergoing or who have previously received chemotherapy for stage ii or iii colorectal cancer. secondary * assess the effect of different moderate physical activity interventions in ameliorating depression (as measured by the beck depression inventory) and anxiety (as measured by the spielberger state-trait anxiety inventory) in these patients. * assess the effect of these interventions on attitudes related to physical activity (as measured by the american council on exercise history questionnaire) in these patients. * characterize serum levels and patterns of immune function (cytokines, neutrophils, t cells, b cells, natural killer \[nk\] cells, and immunoglobulin) in these patients. * correlate serum levels and patterns of immune function (cytokines, neutrophils, t cells, b cells, nk cells, and immunoglobulin) with the patients' physical activity levels. outline: this is a randomized study. patients are randomized to 1 of 3 treatment arms. * arm i: patients participate in individual walking sessions once a week for 8 weeks. the sessions include a fitness-related discussion, warm-up and stretch, 45 minutes of physical activity consisting of walking (progressing in intensity), and a cool-down period. * arm ii: patients participate in a group walking sessions once a week for 8 weeks. the sessions include a fitness-related discussion, warm-up and stretch, 45 minutes of physical activity consisting of walking (progressing in intensity as in arm i), and a cool-down period. * arm iii: patients participate in self-directed physical activity sessions (1½ hours) once a week for 8 weeks. the sessions include warm-up and stretch followed by 45 minutes of progressively intensified physical activity that integrates fundamentals of movement, dance, and exercise principles from established movement methods (i.e., yoga) and a relaxation session/cool-down period. all patients complete self-reported questionnaires (spielberger state-trait anxiety inventory, beck depression inventory, functional assessment of cancer therapy-colon, and american council on exercise history questionnaires). patients also undergo blood collection at baseline, at 4 weeks, upon completion of study treatment, and at 4 months after completion of study treatment for correlative studies. blood is examined by flow cytometry for immune function and cytokines. projected accrual: a total of 45 patients will be accrued for this study.

Eligibility criteria:
disease characteristics: * diagnosis of stage ii-iii colorectal cancer meeting 1 of the following criteria: * undergoing concurrent chemotherapy * completed chemotherapy within the past 2 years patient characteristics: * no physical or emotional impairment that would limit study compliance * no prior or current chronic substance abuse prior concurrent therapy: * see disease characteristics

Keywords: depression anxiety disorder psychosocial effects of cancer and its treatment stage ii colon cancer stage iii colon cancer stage ii rectal cancer stage iii rectal cancer