Exercise During or After Intravesical Therapy for Bladder Cancer: A Randomized Feasibility Trial

About 75% of newly diagnosed bladder cancers are non-muscle invasive bladder cancer (NMIBC). NMIBC and its treatments affect patient functioning and quality of life. Exercise is feasible, safe, and beneficial for many cancer patient groups, however, no studies have examined exercise for NMIBC. We aimed to examine the feasibility, safety, and preliminary efficacy of high-intensity interval training (HIIT) for patients with NMIBC during or after intravesical therapy.

The Bladder cancer and exeRcise trAining during or after intraVesical thErapy (BRAVE) trial randomized 25 NMIBC patients scheduled for or on surveillance after intravesical therapy to either usual care (n = 12) or HIIT (n = 13). The HIIT group performed thrice-weekly, supervised HIIT for 12 weeks.

In 39 months, 293 patients were screened, 177 (60.4%) were eligible, and 25 (14.1%) were randomized. Median exercise attendance was 100%. From baseline to 12 weeks, VO_2peak increased by 1.2 mL/kg/min in the HIIT group compared to a decrease of 0.7 mL/kg/min in the usual care group (adjusted between-group difference, 2.0 mL/kg/min; 95% CI: -0.4 to 4.4; P = .10; d = 0.37). Compared to the usual care group at 12 weeks, the HIIT group significantly improved 6-minute walk distance (adjusted between-group difference, 41 meters; 95% CI: 6-77; P = .025; d = 0.32) and the timed 8-foot up-and-go (adjusted between-group difference, -1.0 second; 95% CI: -1.9 to -0.2; P = .019; d = -0.44).

Despite modest accrual, the BRAVE trial demonstrated that HIIT during or after intravesical therapy was safe and feasible for most NMIBC patients and resulted in meaningful improvements in several indicators of physical functioning.

Oncology nurses can inform NMIBC patients that high-intensity interval training may be safe, feasible, and potentially effective in improving physical functioning during or after intravesical therapy.