Person’s with cancer, as well as those who have survived it, may have disease or treatment specific physical limitations that pose challenges to exercise. Pain is common when a tumour involves the musculoskeletal system; shortness of breath is common with lung involvement; neural deficits and seizures are common when the central nervous system and brain are involved; anaemia is common when bone marrow is affected; amputations cause permanent disability; radiation and chemotherapy can cause permanent scar formation in joints, lung and heart tissues; and drug induced cardiomyopathies and anaemia can cause a permanent limitation in cardiovascular function.
Research is continuing to establish the role of exercise as medicine for people living with cancer. People with cancer who exercise regularly demonstrate reduced levels of fatigue, greater body satisfaction, maintenance of body weight, improved mood, increased functional ability, less side effect severity, and a higher quality of life. Research also suggests that exercise may help lower the chances of cancer coming back and may help you live longer.
Exercise may have yet another benefit – the right amount at the right time could make cancer treatments such as radiation and chemotherapy more effective. The reason has to do with blood flow delivery and oxygen. Tumours contain areas of low oxygen, which make them resistant to radiotherapy and more likely to metastasise. Exercise appears to combat this issue by increasing the amount of blood flow to the tumour, resulting in better oxygenation and therefore greater susceptibility to radiation and chemotherapy treatment. Researchers are still investigating the timing and dosage of exercise to validate the overall effectiveness.
What type of exercise should I do?
The recommended exercise guidelines for people living with cancer are the same as those documented in Australia’s Physical Activity and Sedentary Behaviour Guidelines for Adults:
- Doing any physical activity is better than doing none. If you currently do no physical activity, start by doing some, and gradually build up to the recommended amount.
- Be active on most, preferably all, days every week.
- Accumulate 150 to 300 minutes (2 ½ to 5 hours) of moderate intensity physical activity or 75 to 150 minutes (1 ¼ to 2 ½ hours) of vigorous intensity physical activity, or an equivalent combination of both moderate and vigorous activities, each week.
- Do muscle strengthening activities on at least 2 days each week.
As with all populations, the type of exercise, along with frequency, intensity and duration should be individualised according to the person’s current health status. Exercise programming is dependent on a number of dynamic factors, including current and past medical history, current and past exercise history, social history (i.e. occupation, home environment, sports/leisure, alcohol, smoking), family history, medications, baseline measurements (e.g. height, weight, resting heart rate, blood pressure, circumferences), fitness testing results (e.g. ROM, strength, balance, endurance), and the individual’s health and fitness goals.