Cancer researchers in New York are exploring the concept of using step counts for cancer prognosis. If further studies back it up, the technique might help predict outcomes for people with mesothelioma.
The new study involved people with non-small cell lung cancer. The patients wore commercial fitness trackers so doctors could see how much they walked.
The researchers compared step levels with treatment outcomes. They concluded that there is value to using step counts for cancer prognosis. It may even be more effective than some more traditional methods for predicting survival.
Cancer Prognosis and Chemoradiotherapy
Mesothelioma survival usually depends on how well patients respond to standard treatments. Healthier, more active cancer patients tend to have better outcomes.
Chemotherapy and radiation are common pleural mesothelioma treatments. These are powerful therapies with significant effects on the body. In some cases, chemotherapy and/or radiotherapy can make mesothelioma patients sicker.
Doctors may run tests to determine if a mesothelioma patient is fit for a particular type of treatment.
But the New York study suggests that step counts for cancer prognosis may help doctors make that call. Step counts have the added benefits of being inexpensive and non-invasive.
Measuring Step Counts for Cancer Prognosis
To determine how to use step counts for cancer prognosis, researchers gave commercial fitness trackers to 50 lung cancer patients. The patients were part of a clinical trial for advanced non-small cell lung cancer.
During the clinical trial, patients underwent concurrent chemotherapy and radiotherapy. They wore the fitness trackers from enrollment until the end of their first week of radiotherapy.
Researchers classified patients into three categories based on how much they walked. Nine patients (18%) were designated “highly active”. Twenty-three patients (46%) were “moderately active”. The remaining 18 subjects (36%) were inactive.
“Inactive subjects were more likely to be hospitalized during the radiotherapy course than other subjects (50% v. 9%, p=0.004) and less likely to complete radiotherapy without delay,” reports lead study author Nitin Ohri, MD.
Do Higher Step Counts Keep Cancer at Bay?
Using step counts for cancer prognosis may help predict tumor growth, too. It took just 5.3 months for lung tumors to start growing again in the inactive study subjects. But the lung cancer patients who were moderately or highly active lived without cancer progression for a median of 18.3 months.
The more active cancer patients survived longer, too. Most of the inactive group had died by 15 months after treatment. But the other patients were still alive when the study ended.
Performance status (PS) is a score doctors often use to describe how well a mesothelioma patient is functioning overall. But the New York researchers found that PS was not as helpful as step counts for lung cancer prognosis.
The current study focused only on lung cancer. But previous studies have shows a connection between exercise and mesothelioma outcomes.
A study in the European Journal of Clinical Nutrition earlier this year year showed mesothelioma patients with higher muscle mass had a better quality of life. And a 2018 Australian study suggests that mesothelioma patients should aim for at least two-and-a-half hours of moderate intensity aerobic exercise each week.
Ohri, N, et al, “Daily step counts: A new prognostic factor in locally advanced non-small cell lung cancer?”, August 7, 2019, International Journal of Radiation Oncology, https://doi.org/10.1016/j.ijrobp.2019.07.055