Every four minutes an Australian is diagnosed with cancer, with one in two Australian men and women diagnosed with cancer by the age of 85. This means there is a large portion of our population who are undergoing treatment for cancer or who have a medical history that includes a cancer diagnosis. Therefore, enhancing cancer survivorship with a focus on improving health outcomes and quality of life needs to be front of mind for all medical and health professionals.
An extensive and growing body of scientific research has established exercise as a safe and essential component of cancer treatment and survivorship. Based on the level of evidence available, many national and international organisations have published guidelines and position statements that support the inclusion of exercise as part of standard cancer care. The Clinical Oncology Society of Australia (COSA) released a position statement in 2019 that encourages all health professionals involved in the care of people with cancer to discuss the role of exercise in cancer recovery, recommend their patients adhere to the exercise guidelines and refer their patients to a health professional who specialises in the prescription and delivery of exercise for people with cancer.
Recent research shown that exercise is a safe and effective intervention that assists in counteracting some of the adverse physical and psychological effects of cancer and its treatment. Currently, the strongest evidence exists for improving physical function, attenuating cancer-related fatigue, alleviating psychological distress and improving quality of life. It has also been reported that regular exercise before, during and following cancer treatment decreases the severity of other adverse side effects, such as nausea, and is associated with reduced risk of developing new cancers and comorbid conditions such as cardiovascular disease, diabetes and osteoporosis. Additionally, epidemiological research indicates that being physically active can provide a protective effect against cancer recurrence, cancer-specific mortality and all-cause mortality for some types of cancer (breast, colorectal and prostate cancers).
In line with evidence-based guidelines, COSA identifies that these recommendations should be tailored to the individual’s abilities, noting that specific exercise programming adaptations may be required based on disease- and treatment-related adverse effects, anticipated disease trajectory and the patient’s health status. Best practice cancer care should include referral to an accredited exercise physiologist or physiotherapist with experience in cancer care. While not all people with cancer will require ongoing supervision, these practitioners will allow for exercise to be prescribed in line with evidence-based guidelines. Specifically, exercise physiologists and physiotherapists with experience in cancer care will appropriately tailor exercise recommendations to the individual needs of each patient.
Important messages about exercise for cancer survivors:
· Exercise is safe and recommended during all stages of cancer treatment and recovery.
· When starting exercising for the first time, the guidance by an exercise specialist in cancer can ensure it is personalised to them and their situation.
· During treatment, exercise can help manage many of the side effects such as fatigue, nausea and pain.
· Post treatment, exercise can help with weight management, psychological distress, fatigue, chemotherapy induced peripheral neuropathy, loss of fitness and strength and much more
· Regular exercise can help reduce the relative risk of a cancer reoccurrence and cancer-related death for people diagnosed with breast, prostate and colorectal cancer.
· Avoid inactivity and be as physically active as current abilities and conditions allow
· Progress towards and, once achieved, maintain participation in at least:
150 minutes of moderate intensity or 75 minutes of vigorous intensity aerobic exercise each week, and two to three resistance exercise sessions each week involving moderate to vigorous intensity exercises targeting the major muscle groups.
Written by Hope Spencer
Cancer Rehabilitation & Lymphoedema Physiotherapist
ESSA – Cancer & Exercise eBook
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