Resilience and Exercise in Advanced Cancer Treatment

A growing body of evidence suggests host resilience (lack of frailty, skeletal muscle
reserve, etc.) may impact early healing, recovery following neoadjuvant therapy and surgery,
and long-term cancer-free survival. It is well-recognized that resilience is enhanced in
individuals with proper diet, sleep habits, and exercise. However, it is unknown whether
such resilience can be enhanced by training programs initiated at the time of cancer
diagnosis. Although exercise interventions may contribute to these improvements, it is
unknown how willing and able these patients are to comply with an exercise regimen during
the neoadjuvant therapy period. The aim of this study, therefore, is to evaluate compliance
with and the efficacy of Band Together, an exercise program combining strength-training and
aerobic exercise, in patients with aggressive GI malignancies undergoing neoadjuvant
therapy.

Inclusion Criteria:

1. Age 18 years or older

2. New diagnosis of potentially resectable or borderline resectable pancreatic
adenocarcinoma, gastric adenocarcinoma, or adenocarcinoma of the gastroesophageal
junction.

3. Patients must be evaluated at the Penn State Hershey Medical Center prior to
receiving neoadjuvant chemotherapy or chemoradiation.

4. Patients must be deemed appropriate for neoadjuvant therapy by their treating health
care providers.

5. The ability to speak and read English.

6. The ability to provide informed consent.

Exclusion Criteria:

1. Angina (stable or unstable)

2. Paraplegia or quadriplegia

3. Joint or muscle conditions that prevent the patient from being able to grip and or
lift resistance bands.

4. Patients who have already started neoadjuvant chemotherapy at other institutions.

5. Presence of metastatic disease.

6. Gastric or pancreatic histologies other than adenocarcinoma.

7. Pregnant women.

8. Prisoners

9. Patients screening positive on the Physical Activity Readiness Questionnaire (PAR-Q)