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Exercise and Cancer

What have we learned the past 20 years?

by Claudio Battaglini, PhD, FACSM, and Erik Hanson, PhD, CSCS

Wellness image

There is no evidence that one type of exercise is superior to another, so you should choose activities that you find enjoyable and that you’ll be more likely to stick with.

Since the first studies examining the effects of exercise in cancer survivors began to be published in the mid-80s, the interest in this in­triguing area of research has grown exponentially. Because exercise is non-invasive, effective, and can be done by cancer survivors in the comfort and convenience of their own homes, the medical community has started to give more attention to the use of exercise as a complementary intervention in cancer rehabilitation. The key benefits of exercise during and after cancer treatment include the alleviation of certain cancer treatment-related side effects, a reduced risk for cancer recur­rence, and improvements in overall functionality, health, and longevity of cancer survivors.

With the field of exercise oncology now entering its third decade, what have we learned during the past two decades of investigating the role of exercise in cancer survivorship? Many excellent scientific reviews on the topic, focusing on traditional exercise interventions with at least one objective measurement of fitness, have been pub­lished in the last few years. All of them show evidence that exercise provides many benefits to cancer survivors. Let’s take a closer look.

Overall Study Characteristics
♦ From the mid-80s to 1999: Most studies had low participant enrollment, the exercise interventions were only aerobic-based training programs, and most studies were conducted in people undergoing active treatment.
♦ From early 2000 to the mid-2000s: Larger sample sizes with different modes of exercise, including resis­tance training, began to be explored, and about half of the studies were conducted in people undergoing active treatment, with the other half includ­ing cancer survivors who had finished treatment.
♦ From the mid-2000s to today: A greater proportion of studies had improved methodological designs, with approximately 70 percent of the studies being randomized clinical trials in a supervised setting. Other types of cancers besides breast and prostate cancer were increasingly studied, and the studies focused on evaluating specific outcomes, for example body composition, immune responses, and exercise adherence.

Throughout the years, the most noticeable effects of exercise training were improvements in fatigue and depression.

Author of Article photo

Dr. Claudio Battaglini

Overall Study Results
Throughout the years, the most noticeable effects of exercise training were improvements in fatigue and depression. Modest but clinically relevant increases have also been ob­served for cardiorespiratory capacity, strength, and lean body mass, as well as decreases in body fat percentage.
For trials that examined the inde­pendent effects of strength training, significant and consistent gains in overall strength have been documented.
Minimal adverse events due to exer­cise have been reported. When adverse events were reported, lightheadedness, low blood pressure, nausea, and weak­ness during exercise were the most common.

Author of Article photo

Dr. Erik Hanson

Based on all of the exercise oncol­ogy studies to date, regular exercise appears to promote many benefits that outweigh the potential adverse events for cancer survivors who are able to safely engage in regular physical activ­ity during and after the completion of cancer treatments. Additional evidence is also available on the importance of being physically active in reducing the risk of cancer recurrence.

It is therefore recommended, according to guidelines set forth by the American College of Sports Medicine, that cancer survivors should engage in at least 150 minutes of moderate inten­sity exercise or 75 minutes of vigorous intensity exercise per week. This would equal to around 30 minutes of comfort­ably paced walking five times a week or about 25 minutes of faster paced walking three times a week.

Important!

Consult your doctor before beginning any type of exercise, even one that you participated in regularly prior to your cancer diagnosis. For those survivors with immune dysfunction, severe fatigue, or other co-morbidities, it is even more imperative that you consult with your doctor before you begin your exercise program.

Cancer survivors should include both aerobic and strength training as part of their exercise routines, as these modes of exercise promote specific benefits that can help survivors improve their overall stamina, functionality, physical and mental health, and quality of life. Still, there is no evidence that one type of exercise is superior to an­other, so you should choose activities that you find enjoyable and that you’ll be more likely to stick with. Consis­tency is the key to reaping the benefits of exercise during and after cancer treatment.

What you are waiting for? Check with your doctor and start your exercise training today. You can also consult with an exercise science specialist to help you design a personalized exercise routine that is both effective and safe for cancer survivors.

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Dr. Claudio Battaglini is a professor in the Department of Exercise and Sport Science at the University of North Carolina at Chapel Hill, full member of the Cancer Prevention and Control program at the UNC Lineberger Comprehensive Cancer Center, director of the UNC Get REAL & HEEL Breast Cancer Exercise Program, codirector of the UNC Exercise Oncology Research Laboratory, and an American College of Sports Medicine fellow. Dr. Erik Hanson is a Kulynych/Story Fellow assistant professor in the Department of Exercise and Sport Science at the Univer­sity of North Carolina at Chapel Hill, as well as a certified strength and conditioning specialist and codirector of the UNC Exercise Oncology Research Laboratory, along with Dr. Battaglini.

This article was published in Coping® with Cancer magazine, September/October 2016.