Physical exercise during adjuvant chemotherapy

This thesis evaluates the effect of physical exercise during chemotherapy. In chapter two the study design, rationale and methods of the Physical exercise during Adjuvant Chemotherapy Study (PACES) are described. Chapter three presents the effects of the randomized controlled trial evaluating a home-based, low-intensity physical activity program (Onco-Move) and a supervised, moderate-to-high intensity, combined resistance and aerobic exercise program (OnTrack) on physical fitness, fatigue, chemotherapy completion rates and other psychosocial outcomes in patients undergoing chemotherapy for their breast cancer. Chapter four describes the cost-effectiveness of both interventions in the PACES trial in patients with breast cancer. Chapter five reports the effect of adherence on the primary outcome measures, adherence to, factors associated with, and satisfaction with both physical activity programs. Psychosocial health and attitudes towards physical activity between participants in the PACES trial and non-participants are compared in chapter six. Chapter seven reports the recruitment of participants with colon cancer in the PACES trial, provides insight in the non-participants and shares the outcome measures of the pilot randomized controlled trial in patients with colon cancer on physical fitness, fatigue, chemotherapy completion rates and other psychosocial outcome measures. This thesis ends with a general discussion of the research of this thesis and its context in and an overall summary.