Cedars-Sinai leverages fitness trackers to monitor cancer patients
Cedars-Sinai Medical Center has successfully used wearable fitness trackers to monitor patients with advanced cancer in order to assess their quality of life and daily functioning during treatment.
Because patients with advanced cancer spend the majority of their time outside of the clinic, obtaining ongoing and timely data about their physical status when receiving therapy is often difficult, according to Andrew Hendifar, MD, medical director for pancreatic cancer at the Cedars-Sinai Samuel Oschin Comprehensive Cancer Institute.
However, Hendifar contends that the availability of commercial fitness trackers has made it possible to collect real-time and objective patient activity data, including daily step counts, calories, heart rate, as well as sleep.
To assess the technology, Cedars-Sinai conducted a study of 37 patients undergoing treatment for advanced cancer who wore wrist-mounted Fitbit devices. Results were recently published online in the journal npj Digital Medicine.
“Our trial demonstrates the feasibility of using wearable activity monitors to assess (patient performance status) in advanced cancer patients and suggests their potential use to predict clinical and patient-reported outcomes,” conclude the study’s authors. “These findings should be validated in larger, randomized trials.”
Data gathered from the Fitbits was also compared in the study with patients’ assessments of their own symptoms, such as pain, fatigue, and sleep quality.
“We got a ballpark idea of what a cancer patients’ life is like outside of the clinic,” says Hendifar, who was the principal investigator of the study. “We found that there was a very strong association between the physician’s score and the number of steps per day the patient was doing. The more that they walked the less issues they had in a number of measures.”
In particular, the study found that increased daily step and stair activity correlated with lower rates of adverse events and hospitalization. For instance, an increase of 1,000 steps per day—on average—was associated with significantly lower odds of hospitalizations, reduced grade 3 or 4 adverse events, and increased survival.
On average, patients in the study walked about 3,700 steps per day, climbed three flights of stairs per day, and slept 8 hours per night, while the average resting heart rate was 68 beats per minute. Overall, patients described their participation in the study as a positive experience, and they indicated that the Fitbit was easy to use.
“Data gathered through advancements in technology has the potential to help physicians measure the impact of a particular treatment on a patient’s daily functioning,” adds Gillian Gresham, the first author of the study and a postdoctoral scientist at the Cedars-Sinai Samuel Oschin Comprehensive Cancer Institute. “Furthermore, continuous activity monitoring may help predict and monitor treatment complications and allow for more timely and appropriate interventions.”
“Our hope is that findings from future studies with wearable activity monitors could lead to development of individualized treatment and exercise plans that may result in increased treatment tolerability and improved survival outcomes for patients,” adds Hendifar, who notes that he is overseeing two ongoing studies in which pancreatic cancer patients are using the devices.