Think Beyond Cancer
PHYSICAL EXERCISE

With the rising number of cancer survivors, there is an increasing awareness of maintaining optimal health in this group. Cancer survivors are often highly motivated to seek information about food choices, physical activity, dietary supplement use, and complementary nutritional therapies to improve their treatment outcomes, quality of life, and survival.

Although treatment of other cancer- or treatment-related symptoms such as nausea and pain has improved considerably during the last decades, there is still no accepted treatment for complaints of fatigue. Sixty to 96% of (former) cancer patients report complaints of fatigue during and/or after treatment . Although levels of fatigue decrease gradually in disease-free survivors, 30% of cancer survivors still report serious complaints of fatigue three years after completion of medical treatment. Fatigue is expected to lead to decreased quality of life, decreased levels of physical activity and increased episodes of sick leave and production loss.

Cancer-related fatigue is an abstract, multidimensional, subjective experience affecting 70% to 100% of patients with cancer and can persist for months to years after completion of treatment, but there are limited data about its cause, pattern, and relieving and exacerbating factors. Factors such as pain, emotional distress, and comorbidities have been identified as causative. Activity enhancement, in addition to treating underlying factors, has been shown to be effective in reducing cancer-related fatigue and its associated emotional and mental impact.

During and after the treatment, the practice of most of the sports is possible, on condition that the general state of the patient permits it. If practiced moderately and regularly, sport is always physically and psychologically beneficial. Cancer patients who've been told to rest and avoid exercise can -- and should -- find ways to be physically active both during and after treatment.

Depending on the type of cancer, the treatments and their repercussions on the patient's general state and level of physical activity is going to be more or less difficult and sometimes impossible during the treatment period. However, compelling body of high quality evidence suggests that exercise during and after treatment is safe and beneficial for these patients, even those undergoing complex procedures such as stem cell transplants.

After the end of the treatment, some after effects lead to an interdiction or a limitation of the physical practice. However, with the help of the doctor, the patient can find a soft sport adapted to his physical state. Though evidence indicates that most types of physical activity - from swimming to yoga to strength training -- are beneficial for cancer patients, clinicians should tailor exercise recommendations to individual patients, taking into account their general fitness level, specific diagnosis and factors about their disease that might influence exercise safety. There is a still a prevailing attitude out there that patients shouldn't push themselves during treatment, but the message -- avoid inactivity -- is essential.

Cancer patients and survivors should strive to get the same 150 minutes per week of moderate-intensity aerobic exercise that is recommended for the general public. Cancer patients with weakened ability to fight infection, for instance, may be advised to avoid exercise in public gyms.

In general, a while after the end of the treatment, the patient is not limited anymore in his physical exercise, and more over sport can help him to regain a good physical state and thus participate to the recovery.

One persistent area of concern for cancer patients is change in body mass -- both weight gain and weight loss tied to disease symptoms and treatment side effects. Patients with hormone-based tumors, breast and prostate cancers, tend to gain weight during treatment and frequently have difficulty losing it. Other patients, especially those with gastrointestinal tumors, suffer from weight loss brought on by loss of appetite and changes in their ability to swallow and properly digest food, exercise for weight control and reduction in body mass may actually reduce the risk of recurrence for breast cancer patients, and ultimately decrease breast cancer mortality. For patients suffering from cancer-related weight loss, physical activity helps to maintain lean body mass, which can contribute to increased strength and well being. although there are specific risks associated with cancer treatment that need to be considered when patients exercise, there is consistent evidence that exercise training can lead to improvements in aerobic fitness, muscular strength, quality of life and fatigue in breast, prostate, and hematologic cancer patients and survivors.

Thus it is also important that along with healthcare professionals, fitness professionals also enhance their capacity to serve the unique needs of cancer survivors.

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