There are more than 120,000 new cases of cancer diagnosed yearly in Australia. The burden of cancer is well known in Australia with current predictions indicating that 1 in 2 men and 1 in 3 women will be diagnosed with cancer by the age of 85 years.
Due to improvements in diagnosis and treatment, we are now seeing cancer survival rates exceeding 90% for some types of cancer. However, with the advances in treatment and improvement in survivorship we are now focussing more on the side-effects experienced by cancer survivors including:
Cancer related fatigue (CRF) affects over 10 million people worldwide. CRF does not resolve with rest and rarely presents as an isolated symptom. CRF is multidimensional and often a cluster of symptoms including sleep disturbance, pain and emotional stress. CRF is categorised as either central fatigue originating from neurological impairments within the cerebrum or peripheral fatigue originating from impairment within the musculoskeletal system.
There is now strong compelling evidence to recommend exercise as a first line intervention for CRF. The benefit of exercise to reduce CRF may be associated with a ‘positive sense of fatigue’ derived from peripheral factors Vs the ‘negative sense of fatigue’ related to central fatigue. ‘Positive sense of fatigue’ after exercise correlates with a perception of increasing strength, energy level and a state of well-being.
The benefits of exercise during and after treatment include improvements in:
Furthermore, reductions are seen in:
Prue Cormie, Principal Research Fellow in Exercise & Cancer at ACU says, “Every cancer patient should be prescribed exercise medicine.”
An exercise program needs to be individualised to meet past and current fitness levels, previous and planned cancer treatment, disease and treatment-related risk factors, presence and severity of symptoms and the general interest of modality of exercise.
The aim is to have exercise engagement meet the recommended current physical activity guidelines for general population. These guidelines may however be too unrealistic for some people due to recent surgeries or other associated treatments. Therefore, encouragement of the following is a good starting point remembering ‘some exercise is better than no exercise’.
YES!!
Exercise is considered safe when commenced at an appropriate level and progressed gradually. There are standard guidelines that should be followed particularly for people who have heart and lung problems. There is some extra care and considerations that must be addressed for some cancer survivors whom may be at higher risk of heart attack or cardiovascular events. Also, consideration must be given for chosen exercise modalities, prescription and the location of exercise engagement particularly for those with suppressed immune systems.
Contraindications to exercise for cancer survivors are the same as for the general population. Cancer survivors face the unique challenge of the risk of cancer recurrence and development of chronic diseases. Common side effects associated with cancer survivorship such as pain, nausea and fatigue make regular exercise adherence difficult. A well-designed program should take into consideration these struggles. An accredited exercise physiologist (AEP) or physiotherapist can help address common barriers to exercise, assist with goal-setting and appropriate program prescription, ensure contraindications are addressed, assist to manage risk factors of chronic disease development, supervise to ensure exercise is done safely and potentially assist to find you a supportive group exercise environment where you can engage in regular physical activity with other cancer survivors.
