The SoFiT trial: Healthy lifestyle and fatigue after colorectal cancer

​Can a healthier lifestyle reduce chronic fatigue after colorectal cancer? This is the central question of the SoFiT trial, a project by Wageningen University & Research aimed at finding ways to better support former cancer patients.

Colorectal cancer is among the top five most prevalent types of cancer in the Netherlands. Almost one in three former patients suffer from fatigue, which has a major impact on quality of life. Some people, for instance, are no longer able to work. Previous research has shown that most people with cancer do not succeed in adapting to a healthier lifestyle after cancer. Nevertheless, patients who exercise more and eat healthier after colorectal cancer experience a better quality of life than those who do not.

Fatigue after colorectal cancer

The SoFiT trial aims to determine whether a causal link exists between the two and, if so, discover the underlying mechanisms. In addition, the study should provide insight into the effectiveness of the latest techniques for lifestyle change and provide tips on how to better support cancer survivors. Although cancer survivors have expressed a clear need for more support, these patients currently receive little or no information on lifestyle and nutrition.

Healthier lifestyle

A multidisciplinary team of nutrition scientists and behavioural scientists of Wageningen University & Research started the intervention study in January 2022 and the recruitment of new participants is still going on. The participants are colorectal cancer patients who have completed cancer therapy at least 6 months ago but still suffer from fatigue. By the end of 2022, the multidisciplinairy teams aims to include 170 participants in the intervention study.

Half of the participants will be assigned to a personal coach for a period of six months who will help them achieve a healthier lifestyle, in accordance with the recommendations of the World Cancer Research Fund: plenty of vegetables and wholegrains, limited amounts of red or processed meat, preferably no alcohol and half an hour of moderately intensive exercise a day. The other half, the control group, will receive personal support after the intervention period. The participants will regularly fill out questionnaires about their fatigue levels.

Fat infiltration in muscle

Echography will provide insight into any changes among participants in muscle mass, fat percentage and level of fat infiltration in muscle – a process in which more and more fat is deposited between and in the muscle fibres. Previous studies by Wageningen University & Research and others have shown a possible link between fatigue and muscle fattening. 

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Project partners

In addition to Wageningen University & Research, the other project partners are the Nutrition & Healthcare Alliance, The Netherlands Comprehensive Cancer Organisation(IKNL) and the patient organisation Stichting Darmkanker. World Cancer Research Fund International and its Dutch foundation Wereld Kanker Onderzoek Fonds are funding the project.

The recruitment of participants for the six-month intervention study started in early 2022. The hospitals in which this study recruits their participants are Rijnstate Arnhem, Flevoziekenhuis Almere, Slingeland Ziekenhuis Doetinchem, Ziekenhuis Gelderse Vallei Ede and Deventer Ziekenhuis. In addition, the recruitment also take place via the Prospectief Landelijk CRC Cohort (PLCRC). In total, the project, through which two PhD students hope to obtain their PhD degree, will run for four years.