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Exercise for Cancer Survivors

by Claudio Battaglini, PhD, and Denise Spector, PhD, RN

It has been estimated that the number of cancer survivors in the United States exceeds 13 million and is continually growing thanks to improvements in both early detection and cancer treatments. This is great news! However, cancer survivors often have unique healthcare needs that can significantly affect their quality of life, both physically and emotionally.

In addition to the physical and psychological effects from diagnosis and treatment, some cancer survivors are at increased risk for recurrence and comorbidities, such as weight gain, cardiovascular disease, diabetes, osteoporosis, and secondary malignancies. Many cancer survivors are motivated to make positive life changes and often ask their doctors what they can do to help improve their health during and after cancer treatments. Part of the answer may be exercise.

The Benefits
Exercise has long been recognized in many areas of medicine as an effective way to promote health and prevent disease. Over the past several years, there has been an accumulation of supportive evidence on the benefits of physical activity among cancer survivors, during active treatment and beyond. Exercise training among cancer survivors appears to be safe, is well tolerated, and has been shown to improve physical function, cardiorespiratory fitness, body composition, fatigue, anxiety, depression, and overall quality of life. Some studies have shown that physical activity after a cancer diagnosis is associated with a reduced risk for recurrence.

Some studies have shown that physical activity after a cancer diagnosis is associated with a reduced risk for recurrence.

Physical Activity Guidelines
Both the American Cancer Society and the American College of Sports Medicine have published exercise guidelines for cancer survivors based on scientific evidence of the safety and efficacy of exercise interventions. For adult cancer survivors, both these organizations support the United States Department of Health and Human Services 2008 Physical Activity Guidelines for Americans. These guidelines include the following:

• Avoid inactivity and return to normal daily activities as soon as possible.
• Engage in at least 150 minutes of moderate intensity aerobic physical activity a week or 75 minutes of vigorous intensity activity a week.
• Engage in strength-training exercises involving all major muscle groups two to three days a week.

In addition to these general guidelines, the American College of Sports Medicine has developed cancer site-specific guidance for exercise training prescriptions. Within these guidelines, there are specific precautions that should be followed for those individuals with severe anemia, fatigue, immune dysfunction, and other chronic diseases. You should consult with your doctor prior to beginning any new exercise program to determine whether you need to follow any specific precautions.

Tips for Getting Started
Combining strength and aerobic training is the best way to reap the multiple benefits of exercise. For aerobic training, a simple (brisk) walking routine may be the best way to start – it’s easy and it’s free! For resistance training, you can start with latex resistance bands or lightweight dumbbells. Consider beginning with 10 to 20 minutes of intermittent or continuous activity, and gradually increase to 30 minutes of continuous activity at least 5 days a week (progression will be slower for those who are deconditioned and those experiencing severe side effects). Start with light to moderate intensity. Initially increase frequency and duration, and then increase intensity.

There is no evidence that one type of exercise is superior. For aerobic activity, some may prefer swimming, and others may opt for biking. The key is to be flexible – modify exercise based on your physical condition each day.

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