Sports performance before, during and after chemotherapy. Case report of a personal experience.

To comparatively analyze the sports performance of a patient before, during and after a CMT treatment.

A 55-year-old male patient diagnosed with neuroendocrine bladder cancer, who received 12 sessions (4 cycles) of neoadjuvant CMT with Etoposide and Cisplatin prior to a radical cystectomy. The patient is an experienced amateur athlete (cyclist) and physiotherapist, so he was self-treating. With the authorization and monitoring every three weeks of the treating oncologist, and with the advice of physiotherapists experts in oncology and exercise physiology, a training program was carried out (stationary bicycle, trekking and road cycling) for 16 weeks, from the beginning of the first cycle, until three days before the radical cystectomy. He maintained an average of seven hours of training per week. To quantify his performance, performed road cycling training on flat and safe circuits, individually, in “time trial” mode. The Strava sports app was used to identify and select seven segments, those with the longest distance and highest number of repetitions, and the average speed (km/h) of each was collected. Records in which there were stops were discarded. The data were grouped into four stages. 1° Early Pre CMT (12 - 6 months pre CMT) 2° Immediate Pre CMT (6- months before) 3° CMT stage (9 weeks) and 4° Immediate Post CMT (7 weeks, until radical cystectomy). The average mean of cycling speed of the seven segments in each stage was calculated and compared. Additionally, the volume of training in each stage was quantified. .

The average speed of stages 1 and 2 was 30.35 and 30.37 while in stages 3 and 4  was 28.16 and 27.72, which is equivalent to a decrease of between 7.3% and 8.7% as an effect of CMT, respectively. The training volume of each stage were 9.66, 15.8, 5.28 and 9.42 hours. During the 16 weeks, the patient remained physically active, reported no significant complications, and arrived in optimal condition for definitive surgery.

Compared with his previous performance, during the CMT phase the patient presented a slight decrease in his performance, which became more pronounced in the following seven weeks. The volume of weekly hours during the CMT was approximately half that prior to diagnosis, but in the immediate post-CMT period, values similar to baseline were observed. As an unexpected finding, in stage 2, in which there were first clinical signs of the bladder tumor (urinary clot), performance was similar to that of stage 1, demonstrating the absence of cancer-related fatigue.

This report provides initial evidence to encourage oncology sports patients and treating physicians to continue training during CMT, under controlled conditions and advised by specialist physiotherapists, for physical, functional, emotional and psychosocial benefits.