Exercise for cancer survivors
WHAT ARE THE BENEFITS OF EXERCISE FOR CANCER SURVIVORS?
EXERCISE is encouraged for all people, including cancer survivors. Patients diagnosed with cancer should exercise whenever possible and remain active. Physical activity has not only been shown to reduce the risk of getting cancer, it also improves a patient’s condition during treatment and rehabilitation.
Exercise is known to reduce the risk of cancer, especially breast, colon, prostate, lung, endometrial and ovarian.
For cancer survivors, studies have shown that physical activity can improve quality of life, reduce the side effects of treatment and improve fitness and the general condition of the patient.
There is also evidence that exercise may improve survival and reduce the risk of relapse in cancer patients.
Studies have shown that exercise among cancer survivors will reduce the risk of cancer-specific mortality by 25 per cent, 32 per cent and 45 per cent for breast, colon and prostate respectively.
Exercise is safe and effective in dealing with the adverse effects of cancer treatment.
Strong evidence also indicates that exercise is beneficial to cancer survivors in terms of:
1. Improving physical function, including aerobic capacity, muscle strength and functional capacity.
2. Reducing side effects of treatment such as fatigue.
3. Alleviating psychological distress and improving quality of life.
4. Controlling weight and improving energy balance.
5. Reducing the risk of developing new cancer.
6. Reducing the risk of developing comorbidities such as diabetes and heart disease.
7. Reducing overall risk of mortality.
WHAT ARE THE RECOMMENDED EXERCISES FOR CANCER SURVIVORS?
Exercise is an adjunct treatment for cancer. It should be embedded as part of standard practice in cancer care.
Patients are advised to avoid inactivity and be physically active whenever possible. Discuss with your physician before starting any exercise programme.
Doctors may assess your ability to exercise and other co-morbidities, before allowing you to start any exercise programme.
According to the Clinical Oncology Society of Australia, patients should progress towards, and maintain at least 150 minutes of moderate intensity exercise per week or at least 75 minutes per week of high intensity aerobic exercise.
Examples of aerobic exercise are brisk walking, jogging, cycling, swimming or kayaking.
They should combine this with strength/ resistance training exercises involving major muscle groups two or three times a week.
Patients are also encouraged to do flexibility and balance exercises. They must exercise gradually, starting with low intensity workouts in shorter durations and gradually increase this over weeks or months.
For example, they may start with walking slowly for 15 minutes a day, two to three times a week for a few weeks.
Gradually, increase the intensity from walking to brisk walking for the same amount each week. Then, after a few weeks, increase the duration until 30 minutes per day, five times per week to reach at least 150 minutes per week.
They may even exceed 150 minutes a week to reap more benefits.
Whenever possible, it’s best to exercise in a group, so there’s motivation from team members to gain positive results.
For resistance/strength exercises, get a trainer and exercise in a supervised setting. Always monitor symptoms such as fatigue, pain, weakness or shortness of breath.
Exercise recommendation for cancer survivors:
Frequency: Three to five times per week. Intensity: Moderate or high intensity. Type: Aerobic exercise i.e. brisk walking (moderate intensity) or jogging (high intensity).
Time/duration: 20 to 30 minutes per day.
Progress: Gradually increase intensity, duration and frequency to reach at least 75 minutes per week (high intensity) or 150 minutes per week (moderate intensity). Strength exercise: Two to three times per week
WHAT ARE THE PRECAUTIONS TO BE TAKEN?
Exercise is safe for cancer survivors. Start as early as possible. For patients who have undergone surgery, wait for about eight weeks before starting exercise.
For patients receiving chemotherapy or radiotherapy, wait for symptoms to subside before starting exercise.
Do low intensity exercise like walking to avoid inactivity during chemotherapy or radiotherapy, whenever possible.
Survivors with metastatic disease (to the bone) need to reduce the impact, intensity and volume of exercise to reduce the risk of fractures.
Swimming should be avoided for patients with indwelling catheters or central lines and feeding tubes and those who have had an ostomy or are on immunosuppressant.
In some situations, when the haemoglobin level is too low or other blood indices like white blood cell count or platelet count is too low, exercise may not be allowed.
Don’t exercise if you are:
1. Not feeling well.
2. In pain.
3. Having a fever.
4. Advised by the doctor not to.