Cancer and Exercise

By Alex McGeoch Physiotherapist

 Cancer represents a major public health concern in Australia. One in three Australian men and one in four women will be directly affected by cancer before the age of 75, with melanoma, prostate, colorectal, breast and lung cancers comprising the most common types. Causes of cancer are multifactorial, with lack of physical activity being considered one of the known risk factors. The scientific evidence supporting physical activity as a means of cancer prevention is now considered ‘strong’ for particular cancers including colon/colorectal and breast, ‘probable’ for prostate and ‘possible’ for lung and endometrial cancers.

 What are the benefits of exercise in Cancer?
Participating in exercise has been associated with benefits during and following cancer treatment, including improvements in psychosocial outcomes, physical outcomes, compliance with treatment regimens, as well as reduced impact of disease symptoms, treatment-related side-effects, and improved survival rates for some cancers. The potential and expected benefits derived from participation in exercise will vary according to the diagnosis of the cancer and timing of treatment.

 Over 70 exercise intervention trials have been conducted in recent years. This literature found strong evidence that exercise during and/or following treatment had the following effects to some degree:

  • Slowed/prevented physical decline
  • Improved cardiorespiratory and cardiovascular function
  • Improved body composition (preservation or increase in muscle mass, loss of fat mass)
  • Improved immune function
  • Improved strength and flexibility
  • Improved body image, self-esteem and mood
  • Reduced the number and severity of side-effects including nausea, fatigue and pain,
  • Reduced hospitalisation duration
  • Improved chemotherapy completion rates
  • Allowed for better adjustment to illness, and reduces stress, depression and anxiety

 All of these factors allow for improvements in quality of life and often overall prognosis. A change in activity level from pre- to post diagnosis has been found to be important, with those who increased their activity levels following cancer diagnosis reducing their risk of death, while those who decreased their activity levels increasing their risk four-fold.

 So, what exercise do I need to do?
 The general exercise prescription for people undertaking or having completed cancer exercise 2treatment is of low to moderate intensity exercise, 3–5 times/week, for at least 20 minutes per session.

 What sort of exercise is best?
 The best exercise program is one which combines aerobic and resistance training methods and is tailored to the individual. Before starting a moderate to vigorous exercise program, you should consult your doctor for medical clearance.

 The following types of exercise can help cancer patients (and everyone else) to get back in shape:

Flexibility exercises (stretching).
Virtually everyone can do flexibility exercises. Stretching is important to keep moving, and to maintain mobility. If you’re not yet ready for more vigorous exercise, you should at least stay flexible. Specific muscle to target include hamstrings, calves, gluteals and pectorals.

Aerobic exercise
Aerobic exercise includes such activities as brisk walking, jogging, and swimming. This kind of exercise uses  large muscle groups, thereby enabling you to burns calories whilst maintaining muscle mass and tone. Aerobic exercise also builds cardiovascular fitness, which lowers the risk of heart attack, stroke, and diabetes. Exercise progression should be slower and more gradual for deconditioned patients or those who are experiencing severe side-effects of treatment. Of note, progression for some could actually mean maintenance of weekly activity levels or slower declines in total physical activity levels. That is, declines in activity may be inevitable during certain treatment periods, but an exercise program can assist in minimising these declines.

Resistance Exercise
Resistance exercises should be dynamic in nature using both concentric (lifting and Exercise 1pushing/pulling phase) and eccentric (controlled lowering/returning phase) muscle contractions. Resistance exercises using machine-weights, free weights, body weight and/or therabands that involve major  muscle groups are appropriate. During periods of increased risk of infection, avoidance of the use of public facilities such as machine-weights in gymnasiums is recommended.

  • Frequency 1–3 times/week, with rest days between sessions
  • Intensity – 10-15 repetitions to fatigue
  • Duration 6–10 exercises, 1–4 sets per muscle group
  • Progression – as per described for aerobic exercise.

 An example of a basic resistance program is set out below. Resistance exercise combination to be performed 3-4 times per week, altering routine A & B:

Program A

Program B

Chest Press

Leg Press or Squat

Lat Pull Down

Leg Extension

Shoulder Press

Leg Curl

Lateral Arm Raise

Hip Extension

Seated Row

Calf Raise

Biceps Curl

Core Stability Exercises

Triceps Extension

 

 If you like an individualised program to be developed for you, please call Rathmines Physiotherapy and Sports Injury Centre on (02) 49751622 to book a Physiotherapy app