Cancer & Exercise
Cancer is a major public health concern in Australia. One in two Australians over the age of 85 years will develop cancer.1 Causes of cancer are multifactorial. Participating in exercise can assist with reducing the likelihood of the development of cancer (particularly breast and colorectal cancers). Exercise has also been associated with benefits during and following treatment of cancer.2
Survival after cancer varies and is influenced by the type of cancer and the stage of the cancer at diagnosis. Significant advances in treatment have led to more effective therapies, however, treatment-related side effects are still common and may persist for long-term survivors.3
Common side effects of treatment are
- - Fatigue
- - Pain
- - Impaired immune function
- - Negative changes to body weight/composition
- - Deterioration in bone health
- - Lymphedema
Why EXERCISE?
Clinical research has established exercise is a safe and effective intervention to counteract many of the adverse physical and psychological effects of cancer and its treatment. Appropriately prescribed and monitored exercise leads to significant benefits during and after treatment, which are outlined below.1
Preventions or improvements |
Reductions |
- Muscle strength, mass and power - Physical functioning - Range of motion - Balance and stability - Immune function - Chemotherapy completion rates - Body image, mood and self esteem |
- Fat Mass - Duration of hospitalisation - Psychological and emotional stress - Depression and Anxiety - Number and severity of symptoms and side effects reported (i.e. pain, fatigue, nausea) |
Evidence indicates cancer patient with either breast, prostate or colorectal cancer are 10-60% less likely to die as a result of cancer or its co-morbidities compared to those that don’t exercise.4
Emerging evidence indicates that regular exercise before, during and after treatment decreases the severity of other adverse side effects and is associated with the reduced risk of developing new cancers and comorbidities such as cardiovascular disease, diabetes and osteoporosis. Epidemiological studies have also highlighted that exercise provides a protective effect against cancer recurrence, cancer-specific mortality and all-cause mortality for some types of cancer (breast, colorectal and prostate).5
Exercise Guidelines
Australians with Cancer do not meet recommended targets. 60-70% do not meet aerobic exercise guidelines and 80-90% do not meet resistance exercise guidelines.5
Exercise Programs need to be individualised according to the clients, physical capacity, previous and planned cancer treatment, disease and treatment-related risk factors, their presence and severity of symptoms, as well as client specific goals.6
Evidenced based guidelines:
· All people with cancer should progress towards and, once achieved maintain 150 minutes of moderate intensity or 75 minutes of vigorous intensity aerobic exercise per week (e.g. walking, jogging, swimming).
· Two to three sessions of resistance exercise (i.e. weights, body weight or resistance bands) each week involving moderate to vigorous intensity exercise targeting the major muscle groups, with a minimum 48 hours recovery between sessions.
Exercise should be embedded as part of standard practice in cancer care and viewed as an adjunct therapy that helps counteract the adverse effects of cancer and the treatment. To maximise safety and therapeutic effects, exercise should be prescribed and delivered under the direction of an Accredited Exercise Physiologist.4
At Advanced Physiotherapy we have both male and female Exercise Physiologists that will work with the client to develop and implement an individualised exercise program, this in turn will assist with achieving the client’s health and wellness goals. Our state-of-the-art facilities are available to all clients whilst under our care.
References
1. Australian Institute of Health and Welfare 2017. Cancer in Australia 2017. Cancer series no.101. Cat. no.CAN 100. Canberra: AIHW.
2. Hayes, S. C., Spence, R. R., Galvão, D. A., & Newton, R. U. (2009). Australian Association for Exercise and Sport Science position stand: optimising cancer outcomes through exercise. Journal of Science and Medicine in Sport, 12(4), 428-434.
3. World Cancer Research Fund / American Institute for Cancer Research. Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective. Washington DC: AICR, 2007
4. Kohl, H. W., LaPorte, R. E., & Blair, S. N. (1988). Physical activity and cancer. Sports Medicine, 6(4), 222-237.
5. Cormie, P., Atkinson, M., Bucci, L., Cust, A., Eakin, E., Hayes, S., ... & Adams, D. (2018). Clinical Oncology Society of Australia position statement on exercise in cancer care. Med J Aust.
6. American College of Sports Medicine. (2013). ACSM's guidelines for exercise testing and prescription. Lippincott Williams & Wilkins.