Broderick, J.M., Guinan, E., Kennedy, M.J., Hollywood, D., Courneya, K.S., Culos-Reed, S.N., . . . Hussey, J. (2013). Feasibility and efficacy of a supervised exercise intervention in de-conditioned cancer survivors during the early survivorship phase: The PEACH trial. Journal of Cancer Survivorship: Research and Practice, 7, 551–562. 

DOI Link

Study Purpose

To evaluate the feasibility and efficacy of an eight-week, supervised exercise program in deconditioned cancer survivors within two to six months of chemotherapy completion

Intervention Characteristics/Basic Study Process

Twice-weekly, aerobically-based group sessions in a hospital setting for a duration of eight weeks plus a home exercise program.

Sample Characteristics

N = 38  
AGE RANGE = 21–69 years
MALES: 14% (n = 6), FEMALES: 86% (n = 37)
KEY DISEASE CHARACTERISTICS: Solid tumor or lymphoma (patients with Hodgkin’s or non-Hodgkin’s lymphoma who had completed chemotherapy and/or radiotherapy with curative intent within the preceding two to six months)
OTHER KEY SAMPLE CHARACTERISTICS: Modified Bruce Fitness Test result of average, fair, or poor according to predetermined cut-off points for age and gender; left ventricular ejection fraction (LVEF) of > 50% (assessed by a Multi-Gated Acquisition [MUGA] scan); and a body mass index (BMI) < 35 kg/m2. Medical clearance was provided by the treating oncologist of each participant prior to trial enrollment.


  • SITE: Single-site    
  • SETTING TYPE: Other    
  • LOCATION: Ireland

Phase of Care and Clinical Applications

  • PHASE OF CARE: Late effects and survivorship

Study Design

Prospective, two-arm, randomized controlled trial

Measurement Instruments/Methods

  • Feasibility: Demand and recruitment rates
  • Adherence: Heart rate monitor, diaries, observation, and attendance
  • Acceptability: Exit participant interviews
  • Fitness: Modified Bruce Protocol (MBP)
  • Quality of Life: Functional Assessment of Cancer Therapy–General (FACT-G)
  • Fatigue: Functional Assessment of Chronic Illness Therapy–Fatigue (FACIT-F)
  • Physical Health: Physical Function Scale (PFS) of the Short Form (SF) 36
  • Physical Activity (PA): RT3 triaxial accelerometer and self-report using the Godin Leisure Time Exercise Questionnaire


Feasibility: 81% eligible patients were recruited to the study. Conflicting data on drop-outs were presented. Exercise intervention was positively received as noted in exit interviews with subjects. Adherence to supervised and home-based exercise intervention was good (76% to 105%, respectively). There were no statistically significant differences between the groups for any health-related fitness outcomes. Total FACIT and fatigue subscale scores were better in the exercise group at three months (mean difference = 6.2, 95%, CI 1.4–11.0).


Home-based and supervised exercise interventions in carefully-screened, non-older adult patients begun in the early survivorship phase appear to be safe and feasible, possibly lead to improvements in QOL and fatigue. 


  • Small sample size (< 100)
  • Baseline sample/group differences of import: Gender, treatment, and stage of cancer
  • Risk of bias (sample characteristics): Gender, treatment, and stage of cancer
  • Key sample group differences that could influence results: Majority of sample was female; there was a disproportionate distribution of radiation/chemotherapy-treated patients and patients with late/early-stage in exercise and control groups.
  • Findings not generalizable
  • Intervention expensive, impractical, or training needs
  • Subject withdrawals ≥ 10%: The explanation of withdrawals and reasons do not match the number of subjects that completed assessments at each phase.
  • Other limitations/explanation: Variability of activities for home exercise program.

Nursing Implications

Data support the benefit of exercise to address cancer-related fatigue in the early survivorship period. However, sample was “healthy” with few co-morbidities and, although deconditioned, did not include older adults (> 65 years of age), which raises questions about safety and which type and dose of exercise should be recommended to the large group of cancer survivors who continue to experience cancer-related fatigue.