| Eligibility |
Inclusion Criteria:
- Participants must have Lynch syndrome defined as meeting any of the following: (1)
Mutation-positive Lynch syndrome: carriers or obligate carriers (by pedigree) of a
pathogenic mutation in one of the deoxyribonucleic acid (DNA) mismatch repair (MMR)
genes (i.e. MLH1, MSH2/EPCAM, MSH6, or PMS2) or (2) Mutation-negative Lynch syndrome:
patients with a personal history of a non-sporadic MMR deficient premalignant lesion
(i.e. polyp) or a non sporadic MMR deficient malignant tumor (where non-sporadic MMR
deficient is defined by: microsatellite instability high by either
immunohistochemistry or microsatellite instability (MSI) testing or both, but no
evidence of MLH1 promoter methylation in cases with loss of both MLH1 and PMS2, and/or
no evidence of BRAF mutation in cases with loss of both MLH1 and PMS2) but germline
MMR genetic testing showed either a variant of unknown significance or mutation
negative result or had declined germline MMR genetic testing.
- Participants must not have evidence of active/recurrent malignant disease for a
minimum of 6 months.
- Participants must be at least 6 months from any prior cancer-directed treatment (such
as surgical resection, chemotherapy, immunotherapy, hormonal therapy or radiation).
- Participants must have endoscopically accessible distal colon and/or rectal mucosa
(i.e. participants must have at least part of the descending/sigmoid colon and/or
rectum intact).
- Participants must consent to two standard of care lower gastro-intestinal GI endoscopy
(flexible sigmoidoscopy or colonoscopy) with biopsies that will be 12 months (+/-21
days) apart.
- Ability to understand and the willingness to sign a written informed consent document.
- Must have normal cardiopulmonary exercise test prior to exercise participation.
Exclusion Criteria:
- Individuals who are status post total proctocolectomy (i.e. removal of all colon and
rectum).
- Individuals with history of myocardial infarction, stroke, coronary-artery bypass
draft, invasive coronary revascularization, arrhythmia requiring treatment such as
atrial fibrillation, congestive heart failure, peripheral vascular disease, pulmonary
embolism, or deep venous thrombosis.
- Uncontrolled intercurrent illness including, but not limited to, ongoing or active
infection, uncontrolled hypertension, symptomatic congestive heart failure, unstable
angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that
would limit compliance with study requirements.
- Individuals with a history of diabetes, hypertension, or have smoked cigarettes in the
last 12 months.
- Individuals who are unable to participate in cycling due to musculoskeletal
limitations.
- Individuals who are unable to identify cycling classes in their community for
exercise.
|
