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Cancer and cardiac patients to join up in new study

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PEOPLE with bowel cancer are being given the chance to join exercise classes with cardiac patients.

They are taking part in a new study, looking at whether joint-rehabilitation sessions can be more sustainable in rural areas and improve the outcomes for both sets of patients.

The new trial - led by the University of Stirling working with the NHS - is starting next month (July) in Inverness, Stirling and Cardiff. 

The study will last 21 months and has been funded by the National Institute for Health Research Health Services and Delivery Research (NIHR HS&DR) Programme. It’s thought to be the first time cancer patients have been offered rehabilitation alongside people who have suffered a heart attack.

If successful, the results could mean the roll out of a larger scheme around the country.  

Gillian Sweetman, from Edinburgh, who was diagnosed with bowel cancer in 2008, said: “After finishing treatment for bowel cancer, you are on your own. Life has changed in so many ways but there is no map to help you. 

“Many years ago, patients who suffered a heart attack started to be offered a specific rehabilitation programme including exercise and health advice. 

“Research shows that exercise can help bowel cancer patients too and reduce the risk of the cancer recurring. I’m glad to help with this study seeing whether bowel cancer patients and cardiac patients can join together in cardiac rehab for exercise and health advice.  Hopefully bowel cancer patients will gain the same benefits of less symptoms, better outlook and a better quality of life.”

Professor Steve Leslie, cardiac consultant  at NHS Highland - one of the clinicians leading this study – said: “Cardiac rehabilitation plays an important role in the recovery of patients after a cardiac event and their return to a normal life. Some of the benefit comes from having peer support and group participation in the cardiac rehabilitation educational classes, physical activity and psychological support.

“In a remote area like the Highlands of Scotland, due to the dispersed population, many patients have to travel significant distances to attend a class. Within the cardiac department we are very excited about this project where patients with different chronic conditions are brought together.

“This has the potential to make remote services more sustainable and to be offered closer to home if there is a significant critical mass of patients.

“Furthermore, there may be additional as yet unknown benefits to patients with different diseases attending rehabilitation together. This exciting research project demonstrates excellent collaboration between universities and the NHS.”

Dr Gill Hubbard, Reader and Co-Director of the Cancer Care Research Centre at the University of Stirling, said: “Around 2 million people are living with cancer in the UK. The NHS has a responsibility to help patients to recover from hospital treatment. One of the ways of doing this is through rehabilitation.

“Cardiac rehabilitation programmes are already routinely offered to people who have had a heart attack. It is likely that people with cancer could benefit from a similar type of rehabilitation and support.

“However, before carrying out a large study to test this, it is important to assess whether the existing cardiac programme meets the needs of patients recovering from bowel cancer and learn about their experience of participating in cardiac rehabilitation. Before we carry out a larger and more expensive study, we need to know: if it is possible to refer cancer patients to cardiac rehabilitation, whether the rehabilitation programme works in the way intended - and if the programme is viewed as acceptable and helpful by patients and clinicians?”


  1. This project was funded by the National Institute for Health Research Health Services and Delivery Research (NIHR HS&DR) Programme (project number 12/5001/09).
  2. The study is called CRIB (Cardiac Rehabilitation in Bowel Cancer).
  3. The Principal Investigator (study lead) is Dr Gill Hubbard, Reader and co-director of the Cancer Care Research Centre, University of Stirling.
  4. The study will start in June 2013 and run for 21 months in Inverness, Stirling and Cardiff.
  5. Photographs of Professor Stephen Leslie and Gillian Sweetman are attached to the release.
  6. It is estimated that there are 165,000 individuals who have been diagnosed with cancer over the last 20 years in Scotland and who are still alive. This is approximately 3 per cent of the population of Scotland. Source: Information Services Division (ISD).
  7. It is estimated that over 270,000 people in Scotland are living with coronary heart disease (Source: British Heart Foundation).
  8. Summary of the study:

    • The service is a 12 week post-hospital cardiac rehabilitation programme delivered by trained cardiac rehabilitation physiotherapists who will receive additional training from a cancer-exercise specialist. The mixed classes of cancer and cardiac patients will have some components tailored to meet the needs of cancer patients. Patients will attend for 1 or 2 hours each week for exercise training and education (e.g. stress management, diet, smoking cessation, benefits of exercise and relaxation). Some sessions on cardiac disease will be replaced with sessions about cancer and will be delivered by a cancer nurse to cancer patients separately.
    •  The study will take place in three hospitals in Inverness, Stirling and Cardiff and will be conducted in two stages:
    • Stage 1: Twelve colorectal cancer patients will be recruited from one out-patient clinic and invited to attend a cardiac rehabilitation programme. They will complete a questionnaire about their health and levels of physical activity and wear an accelerometer (similar to a wrist-watch) for 7 days to record the level of exercise. They will do this twice - at the start and then at the end of the programme. Views about participation in the programme, completing the questionnaire and wearing the accelerometer will be collected in face-to-face interviews with patients and their nominated family member. In addition, 6 cardiac patients and 6 clinicians will be recruited to participate in an interview to determine their views on involving cancer patients in cardiac rehabilitation. The programme and research instruments and procedures will be modified in light of the findings from this stage.
    • Stage 2: Approximately 66 colorectal cancer patients will be recruited from 3 out-patient clinics and randomly divided into two groups to receive either cardiac rehabilitation or a leaflet about recovering from colorectal surgery. Questionnaire data on health and physical activity and accelerometer data will be collected three times – immediately before starting rehabilitation, on completion of the programme and 3 months later. 24 patients will be interviewed about their experience of taking part in the programme. 12 clinicians will also be interviewed about their views of involving cancer patients in a cardiac rehabilitation programme and their views on running the study. Finally, we will work out how much this rehabilitation programme would cost the NHS if it was going to be offered to cancer patients.
  9. For further information about the study contact Dr Gill Hubbard, Cancer Care Research Centre, School of Nursing, Midwifery and Health, University of Stirling, Highland Campus, Centre for Health Science, Old Perth Road, INVERNESS, IV2 3JH, Tel: + 44 (0) 1463 255649, Tel direct line: + 44 (0) 1463 255646, Email:,  Web:
  10. The National Institute of Health Research Health Services and Delivery Research (NIHR HS&DR) Programme was established to fund a broad range of research. It builds on the strengths and contributions of two NIHR research programmes: the Health Services Research (HSR) programme and the Service Delivery and Organisation (SDO) programme, which merged in January 2012. The programme aims to produce rigorous and relevant evidence on the quality, access and organisation of health services, including costs and outcomes. The programme will enhance the strategic focus on research that matters to the NHS. The HS&DR Programme is funded by the NIHR with specific contributions from the CSO in Scotland, NISCHR in Wales and the HSC R&D Division, Public Health Agency in Northern Ireland. 
  11. The National Institute for Health Research (NIHR) is funded by the Department of Health to improve the health and wealth of the nation through research. Since its establishment in April 2006, the NIHR has transformed research in the NHS. It has increased the volume of applied health research for the benefit of patients and the public, driven faster translation of basic science discoveries into tangible benefits for patients and the economy, and developed and supported the people who conduct and contribute to applied health research. The NIHR plays a key role in the Government’s strategy for economic growth, attracting investment by the life-sciences industries through its world-class infrastructure for health research. Together, the NIHR people, programmes, centres of excellence and systems represent the most integrated health research system in the world. For further information, visit the NIHR website (
  12. This article/paper/report presents independent research funded by the National Institute for Health Research (NIHR). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.

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