Exercise is not dangerous for patients
There are now literally hundreds of clinical trials of various types of exercise interventions in people with cancer including those with advanced disease and none of them report serious adverse events. Across the world there are tens if not hundreds of thousands of people with cancer exercising regularly and again there are no reports of the exercise is causing serious injury or illness. Yes, there are minor injuries occurring such as strains and sprains, but the incidence is no higher in cancer patients than anyone else exercising including apparently healthy adults.
Time to start exercising
A cancer diagnosis is a life changing event, but it is also an opportunity to greatly improve your lifestyle to be healthier and to beat the disease. The current recommendation is that anyone with cancer should try and maintain the current physical activity if they are active but if they are currently sedentary then they need to take up an exercise program as soon as possible. Being sedentary greatly diminishes your ability to overcome the disease and to tolerate the treatments.
Exercise is now being applied as a medicine at all phases of cancer management. It is very important as a therapy to prepare you for any surgery as it is important to be as resilient as possible so that outcomes from the surgery are improved and to recover more quickly. In the same manner, exercises being prescribed in the weeks leading to the commencement of chemotherapy or radiation therapy. Again, this is to make the patient more resilient so that they tolerate these therapies better and have less side effects.
Over the course of chemotherapy or radiation therapy it is important to be physically active and here at this phase targeted exercise medicine has an important role as it has been demonstrated to reduce the side effects of these therapies in particular fatigue and there is early evidence that exercising over the course of therapy may even increase effectiveness of chemotherapy and radiation therapy. In fact, there are many clinical trials around the world testing the safety and efficacy of patients exercising immediately before, during and after receiving a chemotherapy infusion and other studies are applying an exercise program immediately before the patient goes in for radiation therapy.
After surgery or completing chemotherapy or radiation therapy, exercise has an important role to rehabilitate the patient to help build muscle and reduce the risk of fat gain as well as increase cardiorespiratory capacity. In the longer term, maintaining the recommended level of physical activity is very important to reduce the risk of recurrence or the development of other chronic diseases such as type II diabetes and cardiovascular disease.
Exercise and worries about lymphoedema
Lymphoedema is a condition which affects cancer patients whereby surgery or radiation therapy damages the lymph vessels and nodes which drain fluid from the limbs. It is a particularly debilitating condition and many patients are very fearful that exercise may cause lymphoedema or make it worse. The research evidence does not support this fear and in fact appropriate exercise is likely to reduce the risk of lymphoedema, ameliorate existing lymphoedema, and help to maintain function of the affected limb.
Exercise Types for cancer treatment
For most people with cancer in particular those who have completed treatment in a relatively well the current recommendation is to complete both aerobic exercise (for example walking, jogging, swimming, cycling et cetera) as well as resistance training (lifting weights or working again some other resistance). However, for patients with specific cancer and treatment related health issues the exercise prescription should be tailored to address those problems which are causing the greatest morbidity and mortality risk for the patient.
For example, loss of muscle mass (sarcopenia) is a major problem for people with cancer if they are receiving chemotherapy or hormone therapies. Low muscle mass has been implicated as a factor in lower chemotherapy tolerance and greater side-effects as well as compromising function and quality of life. The only way to maintain or increase muscle mass is resistance training and a large volume of aerobic exercise such as walking may be contraindicated. The more severe the health issues facing the patient the more important it is to seek the advice of a qualified exercise professional for a targeted exercise prescription.