Recently, I was asked to provide an informed perspective on exercise and cancer treatment and recover.  Exercise has been broadly demonstrated to have positive impact on physical strength, capacity, recuperation, and mortality in cancer patients. Moreover, this positive impact takes place both during and after cancer treatment. This blog offers the reader summaries of credible research, and additional references to discuss with their medical professionals.  A summary of the key research used here follows;

Summary of Findings

Puetz (2012) reaches the conclusion that that exercise reduces cancer-related fatigue and “has a palliative effect in patients during treatment and a recuperative effect post-treatment.”

Cramp and Daniel (2012) report that “aerobic exercise can be regarded as beneficial for individuals with cancer-related fatigue during and post-cancer therapy, specifically those with solid tumors.”

Ballard-Barbash et. al. (2012) finds statistical evidence that physical activity is associated with reduced all-cause, breast cancer–specific, and colon cancer–specific mortality.

Oldervall et. al. (2011) report from their analysis that, for cancer patients with incurable or advanced stages of cancer, “physical performance was significantly improved after 8 weeks of physical exercise.” Their report suggests exercise to be an important factor for these patients to maintain their physical capacity during treatment.

Chen et al. (2011) provides strong evidence that “regular exercise during the first 3 years after cancer diagnosis, particularly at the currently recommended levels for breast cancer survivors of 2.5 hours per week for exercise duration and 8.3 MET-hours per week for exercise-MET score or higher, has a beneficial effect on breast cancer survival.”

Important Reminders

When incorporating exercise into the lives of current or former cancer patients, it is important to take cancer specific issues into account. Based on the evidence from the comprehensive study, Burr et. al. (2012) offer five considerations for incorporation of physical activity into the lives of cancer patients:

1. Physical activity should be recommended for all patients with cancer.
2. The type of physical activity selected should be based on the patient’s individual physical condition, type of cancer, and prescribed treatment.
3. A previous cancer patient seeking to implement an exercise program need only the approval of a qualified health or exercise profession, not an oncologist.
4. Certain ongoing cancer treatments stress the cardiovascular system and may increase the risk of an adverse cardiac event during physical activity. The type of exercise recommended should carefully take this into account.
5. Previous cancer treatment also be associated with cardiovascular complications, sometimes persisting for decades following the initial diagnosis. These also have direct implications for the exercise prescription.

Since cancer is becoming unfortunately common in our society, these findings have substantial impact for those involved in training. These findings are important to discuss with medical professionals, offering partnering opportunities between the trainer and the health professional. As cancer strikes existing clients of the trainer, it is vital to encourage the client to understand the importance of ongoing physical activity during and after treatment. Additionally, formerly inactive cancer patients can be encouraged to pursue an appropriate path of physical activity which takes into account their general level of fitness, cancer diagnosis, and treatment plan.

References

Rachel Ballard-Barbash, Christine M. Friedenreich, Kerry S. Courneya, Sameer M. Siddiqi, Anne McTiernan and Catherine M. Alfano. “Physical Activity, Biomarkers, and Disease Outcomes in Cancer Survivors: A Systematic Review” in Journal of the National Cancer Institute, June 7, 2012.

Jamie F. Burr, Lee Jones, and Roy J. Shephard. “Physical activity for cancer patients: Clinical risk assessment for exercise clearance and prescription” in Canadian Family Physician, September 2012, vol. 58 no. 9, 970-973.

Xiaoli Chen, Wei Lu, Wei Zheng, Kai Gu, Charles E. Matthews, Zhi Chen, Ying Zheng, and Xiao Ou Shu. “Exercise After Diagnosis of Breast Cancer in Association with Survival” in Cancer Prevention Research, September 2011, p. 1409.

Cramp F, Byron-Daniel J. “Exercise for the management of cancer-related fatigue in adults.” Cochrane Database of Systematic Reviews 2012, Issue 11. Art. No.: CD006145. DOI: 10.1002/14651858.CD006145.pub3

Line M. Oldervoll, Jon H. Loge, Stian Lydersen, Hanne Paltiel, May B. Asp, Unni V. Nygaard, Elisabeth Oredalen, Tone L. Frantzen, Ingvild Lesteberg, Lise Amundsen, Marianne J. Hjermstad, Dagny F. Haugena rnulf Paulsenk and Stein Kaasaa. “Physical Exercise for Cancer Patients with Advanced Disease: A Randomized Controlled Trial” in The Oncologist, November 2011, vol. 16, no. 11, 1649-1657.

Puetz, Timothy W. “Differential Effects of Exercise on Cancer-Related Fatigue During and Following Treatment” in American Journal of Preventative Medicine, August 2012, Vol. 43, Issue 2, pp. e1-e24.