Is exercise safe for patients undergoing treatment for cancer?
For most patients with cancer or undergoing treatment for cancer, exercise is safe when prescribed by an exercise professional. Depending on the type of cancer and/or cancer treatment being undertaken, there are certain precautions that need to be considered. These precautions are specific to each person, but examples include the following:
• In patients with low bone mineral density, exercise choice must consider any risk of fracture. Most forms of weight bearing exercise such as walking and resistance training carry very low risk when done correctly, but some forms of exercise where there is a risk of falls or significant impact should be avoided. Examples of patients who may have reduced bone strength include those who have had cancers of the bone, as well as those who have undergone hormone therapy as a treatment.
• In patients who have had lymph nodes removed, which is common in some breast cancer and gynaecological cancer surgeries, care must be taken to avoid oedema (swelling) in the affected limb and the patient may need to wear a compression sleeve during certain forms of exercise.
• In patients who have peripheral neuropathy (reduced sensation in their extremities) from chemotherapy treatment, care must be taken to avoid activities where the patient may drop weights due to impaired sensation of the hands or lose balance due to impaired sensation of the feet.
• In patients who have had cardiac toxicity from chemotherapy (impaired heart function), as well as patients with existing cardiovascular disease, certain precautions must be taken. See our page on exercise in cardiovascular disease to find out more.
• In patients who have a colostomy after surgery for colorectal cancer, care must be taken to avoid strenuous trunk movement that may increase the risk of a hernia around the stoma.
What type of exercise is best for patients with cancer?
The recommendations for people with cancer or undergoing treatment for cancer are based on the Australian physical activity guidelines, with a few individual considerations. People should be aiming for:
• 150 minutes of moderate intensity aerobic exercise per week. This includes any exercise that leads to a modest increase in your breathing and heart rate and equates to at least 30minutes, 5 days per week.
• In addition to this, it is recommended to participate in 20 minutes of strength-based exercise (such as weights, resistance bands or bodyweight exercises) twice per week.
At Glebe Physio, we have exercise physiologists that offer both one-on-one sessions as well as classes for people with cancer or undergoing treatment for cancer.
Can exercise reduce my risk of cancer coming back?
In many cases yes. There is strong evidence in breast cancer, colorectal cancer (bowel cancer, colon cancer, rectal cancer) and prostate cancer that regular exercise can reduce the risk of cancer recurrence and improve a person’s survival rate. This is likely to be the case in many other forms of cancers too, but the research so far has focused on these three:
• In breast cancer survivors, studies have shown that physical activity is consistently linked to a lower risk of breast cancer recurrence, and moderate exercise (equivalent to walking 3-5 hours per week) reduced the risk of cancer recurrence by 40-50%.
• In colorectal cancer, physical activity is also significantly associated with a lower risk of recurrence and survival rate was linked to the amount of regular physical activity a person performed.
• In prostate cancer, there have been studies demonstrating a 61% lower risk of prostate cancer death in men who exercised three or more hours per week compared to those who exercised less than one hour per week.
It is clear that exercise is very beneficial for people who have been diagnosed with cancer. As well as reducing the side effects of cancer treatments, exercise can significantly improve a person’s quality of life and even reduce the risk of cancer recurrence. Despite these clear benefits, we know that fewer than 10% of people are physically active during cancer treatment and only 20-30% are active after treatment. Exercise is a medicine that should be routinely given as part of any cancer treatment.