Cancer was originally believed to be a genetic disease with human behavior responsible only for its occurrence. Research now shows that this is not the case. A recent epidemiologic study revealed that among ten million people across the world who are expected to be diagnosed with cancer, only 5-10% have strong genetic contributors. This presents an opportunity for us to help prevent cancer and assist the treatment of cancer through lifestyle choices.
Among all preventive and therapeutic components in oncology (the study of cancer), exercise is considered an effective tool to change the tumor’s microenvironment and enhance the desired biomarkers following treatment. Exercise medicine during cancer treatment has been shown to help:
- inhibit the rapid reproduction of cancer cells
- encourage apoptosis – the healthy death of abnormal cells, often blocked by cancer cells
- regulate metabolism
- enhance the immune system
It is proven that exercise plays an important role in the intracellular modification of cancer cells, but it is important to note that the cell’s sensitivity to exercise may depend on the type of cancer and the stage of treatment. Using exercise as medicine requires awareness and expertise, as well as the support of health professionals to provide coaching, resources, and motivation to patients who may feel very unwell during treatment. An exercise physiologist can help remove any barriers, including changes to accessibility to help patients adapt to a new way of moving in a healthful way.
Exercise at each stage of treatment
There are three stages of treatment in cancer.
- Neoadjuvant therapy, such as chemotherapy, radiation therapy and endocrine therapy, are used as a pre-operative treatment for tumors to help the tumor shrink and be ready for surgery.
- Adjuvant therapy in cancer will apply after the initial treatment or surgery to inhibit micro-metastasis (spreading)
- Synergistic therapy, or combined cancer care is an amalgamation of multiple treatment methods to reduce drug resistance while inhibiting tumor growth simultaneously.
Pre-surgical treatment benefits
Exercise helps to maintain the blood supply inside the tumors, which plays an essential role in the effectiveness of chemotherapy in the pre-surgical stage of cancer treatment. It also maximizes the patient’s conditioning before surgery or treatment. This consequently reduces post-surgical complications and dysfunctions.
Moreover, exercise boosts the treatment response and optimizes the patient’s condition, which might be the most impactful effect of exercise during pre-chemo or radiotherapy.
Similarly, an appropriate exercise regimen during chemo or radiotherapy can improve physical, immune, and cardiopulmonary systems. Exercise helps to regulate appetite, sleep and other health-related qualities which results in the ability to maintain a healthy body composition throughout treatment.
Post-treatment benefits
Exercise has been shown to prevent or even reverse the side effects of cancer treatments. It has even been shown to help mitigate cancer-related fatigue and pain and, importantly, reduces the risk of cancer recurring in survivors.
Exercise also has positive effects on mental well-being, adding an additional, positive force to cancer treatment and recovery according to several studies.
How much exercise is recommended in cancer care?
Based on the collective information from the World Health Organization (WHO), the American Cancer Society, and the World Cancer Research Fund/American Institute of Cancer Research (WCRF/AICR), exercise is effective on a range of disease risk factors, including cancer.
For those looking to prevent cancer, 150 – 300 minutes of moderate physical activity or 75 – 150 minutes of vigorous physical activity is the standard guideline and will provide an excellent foundation for a healthy individual. For those undergoing cancer treatment, these guidelines will vary based on the individual, type of cancer, and the stage of therapy.
Findings from pre-exercise screening, cardiovascular fitness level, and exercise intolerance play an important role in cancer biochemistry and behaviour with exercise, as in, how it develops and manifests. There is a significant inverse relationship between aerobic fitness and mortality, given that many cancer patients and survivors have very low aerobic capacities.
General exercise prescriptions for cancer and survivors that define frequencies, intensities, duration, and mode are available based on the latest ACSM (American College of Sports Medicine) guideline. The ACSM currently recommends both cardiovascular and resistance exercise to help improve health outcomes in those with cancer. In addition to the intracellular support discussed above, exercise has also been shown to support cancer-related fatigue, physical function, anxiety, depression, lymphedema, bone health and sleep.
Personalize your exercise prescription
As alluded to above, there are many factors at play and exercise interventions for cancer patients need to be individualized for optimal benefits. A program should be designed based on the desired cancer-specific medical and demographic characteristics, type of cancer, the extent of disease, current treatment, or supportive care therapy and concomitant comorbid disease.
This is exactly the approach we take at Harrison Healthcare, across all our disciplines. Our model of care is highly focused on creating personalized programs that best suit each client, no matter their stage of health, or cancer. If you’re looking to optimize your exercise program for prevention, co-therapy, or post-treatment, we’re here to guide you and support your journey.