Rehabilitation for People With Advanced Cancer

Inclusion Criteria:

• Age 18 years or older

• Diagnosed with locally advanced incurable or metastatic breast or colorectal cancer

• Eastern Cooperative Oncology Group (ECOG) performance status of 0-2

• Fully independent with ambulation and transfers with or without ambulatoryassistance

• Palliative Performance score of >70 (moderate predictive power estimating lifeexpectancy >6 months)

• Receiving first or second line anti-cancer treatments in the metastatic / incurablesetting (a relative proxy for expected survival >6 months)

• Medical clearance to participate from treating physician

Exclusion Criteria:

• Wheelchair level community ambulation

• Moderate or severe non-cancer pain (>6 out of 10 on visual analog scale)

• Moderate or severe cancer bone pain (>Gr 2 bone pain (i.e., moderate pain limitinginstrumental ALDs or worse) as measured on CTCAE (see below))

• Severe or uncontrolled depressive symptoms (>20 on PHQ-9)

• Known neurological conditions influencing cognition and preventing safe orappropriate engagement with self-management and exercise recommendations (e.g.,dementia, traumatic brain injury, or brain metastasis influencing cognition orcausing moderate-to-severe motor-sensory-coordination). Best determined by thereferring physician or nurse practitioner.

• Unable to communicate sufficiently in English to complete intervention,questionnaires, and consent.

• Unwillingness to be randomized, participate in a group intervention, or attendindividual physical assessments.

• Inability to operate videoconferencing if preference is virtual programming.