Many years ago the advice given to people with cancer was to rest.
Today people with a cancer diagnosis are encouraged to move! Exercise and physical activity assists in cancer prevention, recovery and survival.
The American College of Sports Medicine, the Department of Health and Human Services, and the journal Oncology, all recommend exercise for people with cancer. You should be as physically active as your condition and abilities allow.1
Thanks to advances in modern treatment, many cancers are moving from a terminal illness diagnosis to a chronic disease. Thus exercise rehabilitation in overall cancer management is gaining prominence.
Unfortunately there are many cancer treatment side effects. Some last only a short period of time, others persist and others appear long after cancer treatment has ended (late effects).
Many of the side effects of chemotherapy, surgery, radiation and hormone therapy include:
. reduced quality of life
. sarcopenia (increase in body fat and decrease in muscle mass)
. increased risk of heart disease
. bone loss
. reduce range of movement
. pelvic floor issues
. Increased incidence of falls due to peripheral neuropathy and deconditioning.
These effects, combined with general deconditioning due to a sedentary lifestyle and the ageing process create a perfect storm of loss of condition during cancer treatment.
Exercise has been found in many clinical studies to have a positive effect on all of the side effects listed above. Conditioning exercises help reverse the deconditioning process. The type of exercise and physical activity benefits vary with each modality. Resistance, cardiovascular, flexibility, balance, functional, range of movement, and targeted exercises such as those for the pelvic floor, each have their own physical and psychological benefits.
A recent review article published in the prominent cancer journal Oncology looks at the positive role physical activity and exercise plays in reducing cancer risk, decreasing treatment side effects, speeding recovery after diagnosis and enhancing survival. 2
One common late effect for breast cancer survivors is lymphedema. It can cause considerable discomfort due to severe local swelling. When prescribed correctly, exercise does not increase the incidence of lymphedema, 3, 4 and in fact exercise has been found to be an effective therapy in the treatment of lymphedema.5
Fatigue can be a major barrier to commencing an exercise program. A Cochrane systematic review found that a properly prescribed and monitored exercise program can reduce cancer related fatigue.6
It was stated in a recent article in Oncology that “Among the most interesting advances in the field of exercise and cancer in the last decade are several observational studies showing that colon, breast, and prostate cancer survivors who exercise enjoy reduced cancer-specific mortality.” 2
When prescribing an exercise program, the Exercise Physiologists at Melbourne Exercise Physiology Group apply the principles of evidenced based medicine in cancer rehabilitation. We individually tailor a program, according to a patient’s specific health status and response to treatment, being mindful of issues such as lymphedema, cardiomyopathy, peripheral neuropathy, wound healing, limitations placed on range of movement by cancer operations, cancer related fatigue and “Chemo-brain”, a phenomenon of cognitive impairment caused by chemotherapy treatment effecting memory, attention and co-ordination.
Our cancer clients are reassured by recent research and enjoy the feeling of being in control and empowered through exercising, a feeling they are often lacking. Our clients at Melbourne Exercise Physiology Group feel safe, confident and well informed to “move beyond cancer.”
We recommend getting a medical clearance prior to the commencement of any new exercise program.
1. Schmitz KH, Courneya KS, Matthews C, et al. American College of Sports Medicine
roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc
2. Lemanne D, Cassileth B, Gubili J. The role of physical activity in cancer prevention, treatment, recovery, and survivorship. Oncology (Williston Park) 2013; 27(6):580-5.
3. Schmitz KH, Troxel AB, Cheville A, et al. Physical Activity and Lymphedema (the PAL trial): assessing the safety of progressive strength training in breast cancer survivors. Contemp Clin Trials 2009; 30(3):233-45.
4. Schmitz KH, Ahmed RL, Troxel AB, et al. Weight lifting for women at risk for breast cancer-related lymphedema: a randomized trial. JAMA 2010; 304(24):2699-705.
5. Chang CJ, Cormier JN. Lymphedema interventions: exercise, surgery, and compression devices. Semin Oncol Nurs 2013; 29(1):28-40.
6. Cramp F, Byron-Daniel J. Exercise for the management of cancer-related fatigue in adults. Cochrane Database Syst Rev 2012; 11:CD006145.