The landmark CHALLENGE/CO21 randomised controlled trial (RCT) clearly showed that a structured exercise program (SEP) incorporating theoretically-based behaviour change support, initiated soon after completion of adjuvant chemotherapy in people with colon cancer, resulted in increased moderate-intensity aerobic exercise and significant survival benefits (both disease-free and overall), as well as improved quality of life, physical fitness, and physical functioning.
An economic analysis of CHALLENGE has shown that, despite the upfront cost of a 3-year structured exercise program (<$3000 per person), the program improves quality-adjusted life years (QALYs), is cost-saving, and very cost-effective.
There are clear pathways to fund and implement new drugs demonstrating benefits. If the Challenge SEP were a drug (costing thousands of dollars per dose) with these survival benefits and improved quality of life, it would already have been funded and incorporated into routine cancer care. Government funding for an SEP requires application to the Medicare Services Advisory Committee (MSAC), and in addition to demonstrating cost-effectiveness of the SEP, service delivery models, and workforce issues must be demonstrated.
During the period in which an MSAC submission is prepared it is imperative that the oncology community collectively and proactively establishes the infrastructure necessary for widespread implementation. This must include training the exercise workforce in behaviour change, mapping exercise services in local areas, and considering feasibility of group-based and remotely delivered programs to ensure equitable access nationally.
The talk will discuss the process for implementing exercise oncology into routine care, progress made, barriers faced, and the prioritisation of steps to take.