Cancer and diabetes are the second and seventh leading causes of death in the United States, respectively (Kochanek et al., 2017). When including prediabetes and the entire cancer continuum, both diseases affect over 150 million individuals in the United States each year (Bullard et al., 2018; Siegel et al., 2019). Furthermore, there exists an alarming rise in patients presenting with both type 2 diabetes and obesity-related cancers concurrently, as both diseases share similar risk factors (Vigneri et al., 2009). An aging adult population, physical inactivity and unhealthy eating habits are continuing to rise, and the prevalence of individuals with obesity-related cancers and type 2 diabetes are expected to increase in a parallel manner. Cancer and type 2 diabetes are projected to increase over the next 30 years by greater than 45%. (Smith et al., 2009; Rowley et al., 2017).
Exercise can serve as a modifiable risk factor for multiple chronic diseases, including cancer and diabetes (Booth et al., 2012). Additionally, exercise can optimize the disease prognosis by subduing the physical and psychological hardships that often accompany a diseased state (Pederson et al., 2006). Despite the various health benefits and its role in the primary prevention of chronic disease, studies have found as many as 95% of US adults are considered physically inactive by the US Department of Health and Human Services (Troiano et al., 2008). Even more troublesome, patients of these particular populations also fail to participate in regular physical activity despite its positive effect on disease management and prognosis. It is estimated that as little as 10% of the cancer community is active during their treatment and 60% of the diabetes community are physically inactive in the United States (Garcia et al., 2014; Centers for Disease Control and Prevention, 2017). However, these rates are expected to be inaccurate as many studies quantify physical activity through self-reported questionnaires and are likely overestimated by patients (Schrack et al., 2017).
The relationships that exist between physical activity and multiple chronic diseases are extensively investigated worldwide. Such studies are often in well-funded, controlled, and tightly regulated interventions. Though effective at providing quality research and credible outcomes, the interventions fail to accurately represent the challenges and expected outcomes of cancer patients and individuals with diabetes participating in a community based intervention. Additionally, large high-quality clinical trials make it difficult to translate research interventions into routine clinical practice, as real-world health care systems often do not have extensive funds to provide exquisite care. Our study, a community-based intervention with limited funding, sought to bridge this gap in the research.
This 10-week exercise intervention focused on the physiological, physical, and psychological changes of 157 cancer survivors and 67 non-insulin dependent type 2 diabetes patients. Subjects participated in comprehensive biweekly exercise sessions that included aerobic, resistance, and flexibility training. All participants were evaluated on cardiometabolic risk factors, anthropometric measurements, physical functioning, and psychological well-being prior and succeeding the intervention.
Multiple findings were identified concerning retention trends, and changes in psychological health, anthropometric profiles, cardiometabolic risk factors, and physical functioning among both groups. The diabetes group underwent improvements in HbA1c and Quality of Life (QOL). The cancer group experienced improvements in physical functionality, fatigue, and insomnia. Factors that determined program retention within the cancer group were also determined. Our findings help to demonstrate the expected outcomes of an exercise trial in a community-setting. These outcomes will provide further insight on how to create exercise programs that are most effective for individuals with diabetes and cancer patients in a community setting with limited resources