Physical activity and exercise in the prevention and treatment of cancer
Physical activity and regular exercise are associated with a reduced risk of many types of cancer and cancer reoccurrence. Exercise is also a safe and effective intervention to counteract the adverse physical and psychological effects of cancer and its treatment.
Did you know?
Insufficient physical activity is a key risk factor contributing to disease burden in Australia .
The 2017-2018 Australian National Health Survey found that less than 45% of adults were active enough, with only 41% of women, 50% of men and few older Australians (25% of women, 31% of men over 65 years old) meeting the national guidelines .
In 2017-2018, only 23% of Australian adults (22% of women, 25% of men) met the muscle strength training guidelines of at least 2 days a week .
In 2017-2018, only 15% of adults (14% of women, 17% of men) met both the physical activity and muscle strengthening aspects of the guidelines.
Almost half (43.7%) of Australian adults aged 18-64 years described their work day as ‘mostly sitting’ .
The Cancer Council and Clinical Oncology Society of Australia recognise that exercise has the benefits of reducing side effects with cancer treatments, and lowering the risk of reoccurrence as well as mortality, yet is not routinely prescibed as part of a patient’s routine treatment planm .
PHYSICAL INACTIVITY AND SITTING TIME:
PHYSICAL ACTIVITY BEFORE AND AFTER DIAGNOSIS:
SIDE EFFECTS OF CANCER TREATMENT:
1. EXERCISE HAS ADDITIONAL BENEFITS FOR CANCER PATIENTS 
2. CANCER-RELATED FATIGUE:
3. PHYSICAL FITNESS:
4. PSYCHOLOGICAL FUNCTION:
5. PHYSICAL FUNCTION:
6. QUALITY OF LIFE:
7. TOLERATING TREATMENT:
8. BIOMARKERS ASSOCIATED WITH CANCER PROGRESSION:
9. ADDITIONAL BENEFITS:
BARRIERS AND FACILITATORS:
What can we do about it
TO PREVENT CANCER:
FOR CANCER PATIENTS :
Although generally safe, patients should be screened and appropriate precautions taken.
Individuals diagnosed with cancer should return to normal daily physical activity (as much as their current abilities and conditions allow) as soon as possible after diagnosis, aiming to build up to and maintain participation in:
Exercise programs should be designed around the individual’s specific needs and abilities by an accredited exercise physiologist or physiotherapist.
Physical activity has been clearly shown to improve cancer risk and survival for many types of cancer. Being physically active every day is a vital step that people of all ages and abilities can take to prevent, treat, and control cancer.
1. Australian Institute of Health and Welfare. Australia's health 2018. Canberra: AIHW; 2018.
2. Australian Institute of Health and Welfare. Insufficient physical activity. Internet. Canberra: Australian Institute of Health and Welfare; 2020.
3. Australian Bureau of Statistics. National Health Survey: First Results. Canberra; 2018.
4. Cormie Prue. Every cancer patient should be prescribed exercise medicine2018 [cited 2020 Feb 6 ]. Available from: https://www.cancer.org.au/blog/every-cancer-patient-should-be-prescribed-exercise-medicine
5. Lynch BM, Mahmood S, Boyle T. Sedentary Behaviour and Cancer. 2018 [cited 2020 Feb 6]. In: Sedentary Behaviour Epidemiology [Internet]. Cham: Springer International Publishing, [cited 2020 Feb 6]; [245-98]. Available from: https://doi.org/10.1007/978-3-319-61552-3_10.
6. Rangul V, Sund ER, Mork PJ, Røe OD, Bauman A. The associations of sitting time and physical activity on total and site-specific cancer incidence: Results from the HUNT study, Norway. PLoS One. 2018;13(10):e0206015.
7. Patel AV, Friedenreich CM, Moore SC, Hayes SC, Silver JK, Campbell KL, et al. American College of Sports Medicine Roundtable Report on Physical Activity, Sedentary Behavior, and Cancer Prevention and Control. Med Sci Sports Exerc. 2019;51(11):2391-402.
8. 2018 Physical Activity Guidelines Advisory Committee. 2018 Physical Activity Guidelines Advisory Committee Scientific Report. Washington, DC: U.S. Department of Health and Human Services; 2018.
9. Stout NL, Baima J, Swisher AK, Winters-Stone KM, Welsh J. A Systematic Review of Exercise Systematic Reviews in the Cancer Literature (2005-2017). PM R. 2017;9(9S2):S347-S84.
10. Speck RM, Courneya KS, Masse LC, Duval S, Schmitz KH. An update of controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. J Cancer Surviv. 2010;4(2):87-100.
11. Spence RR, Heesch KC, Brown WJ. Exercise and cancer rehabilitation: a systematic review. Cancer Treat Rev. 2010;36(2):185-94.
12. Cramp F, Byron-Daniel J. Exercise for the management of cancer-related fatigue in adults. Cochrane Database Syst Rev. 2012(11).
13. Van Dijck S, Nelissen P, Verbelen H, Tjalma W, Gebruers N. The effects of physical self-management on quality of life in breast cancer patients: A systematic review. Breast. 2016;28:20-8.
14. Meneses-Echávez JF, González-Jiménez E, Ramírez-Vélez R. Effects of Supervised Multimodal Exercise Interventions on Cancer-Related Fatigue: Systematic Review and Meta-Analysis of Randomized Controlled Trials. Biomed Res Int. 2015;2015:328636.
15. Mustian KM, Alfano CM, Heckler C, Kleckner AS, Kleckner IR, Leach CR, et al. Comparison of Pharmaceutical, Psychological, and Exercise Treatments for Cancer-Related Fatigue: A Meta-analysis. JAMA Oncol. 2017;3(7):961-8.
16. Bourke L, Homer KE, Thaha MA, Steed L, Rosario DJ, Robb KA, et al. Interventions for promoting habitual exercise in people living with and beyond cancer. Cochrane Database Syst Rev. 2013(9):CD010192.
17. Sebio Garcia R, Yáñez Brage MI, Giménez Moolhuyzen E, Granger CL, Denehy L. Functional and postoperative outcomes after preoperative exercise training in patients with lung cancer: a systematic review and meta-analysis. Interact Cardiovasc Thorac Surg. 2016;23(3):486-97.
18. Fong DY, Ho JW, Hui BP, Lee AM, Macfarlane DJ, Leung SS, et al. Physical activity for cancer survivors: meta-analysis of randomised controlled trials. BMJ. 2012;344:e70.
19. Craft LL, Vaniterson EH, Helenowski IB, Rademaker AW, Courneya KS. Exercise effects on depressive symptoms in cancer survivors: a systematic review and meta-analysis. Cancer Epidemiol Biomarkers Prev. 2012;21(1):3-19.
20. Cramer H, Lauche R, Klose P, Dobos G, Langhorst J. A systematic review and meta-analysis of exercise interventions for colorectal cancer patients. Eur J Cancer Care (Engl). 2014;23(1):3-14.
21. Pozuelo-Carrascosa DP, Alvarez-Bueno C, Cavero-Redondo I, Morais S, Lee IM, Martínez-Vizcaíno V. Cardiorespiratory fitness and site-specific risk of cancer in men: A systematic review and meta-analysis. Eur J Cancer. 2019;113:58-68.
22. Cheema B, Gaul CA, Lane K, Fiatarone Singh MA. Progressive resistance training in breast cancer: a systematic review of clinical trials. Breast Cancer Res Treat. 2008;109(1):9-26.
23. Carvalho AP, Vital FM, Soares BG. Exercise interventions for shoulder dysfunction in patients treated for head and neck cancer. Cochrane Database Syst Rev. 2012(4):CD008693.
24. McNeely ML, Campbell K, Ospina M, Rowe BH, Dabbs K, Klassen TP, et al. Exercise interventions for upper-limb dysfunction due to breast cancer treatment. Cochrane Database Syst Rev. 2010(6):CD005211.
25. Visser WS, Te Riele WW, Boerma D, van Ramshorst B, van Westreenen HL. Pelvic floor rehabilitation to improve functional outcome after a low anterior resection: a systematic review. Ann Coloproctol. 2014;30(3):109-14.
26. Mishra SI, Scherer RW, Snyder C, Geigle PM, Berlanstein DR, Topaloglu O. Exercise interventions on health-related quality of life for people with cancer during active treatment. Cochrane Database Syst Rev. 2012;2012(8):CD008465.
27. Cormie P, Zopf EM, Zhang X, Schmitz KH. The Impact of Exercise on Cancer Mortality, Recurrence, and Treatment-Related Adverse Effects. Epidemiol Rev. 2017;39(1):71-92.
28. Meneses-Echávez JF, Correa-Bautista JE, González-Jiménez E, Schmidt Río-Valle J, Elkins MR, Lobelo F, et al. The Effect of Exercise Training on Mediators of Inflammation in Breast Cancer Survivors: A Systematic Review with Meta-analysis. Cancer Epidemiol Biomarkers Prev. 2016;25(7):1009-17.
29. De Backer IC, Schep G, Backx FJ, Vreugdenhil G, Kuipers H. Resistance training in cancer survivors: a systematic review. Int J Sports Med. 2009;30(10):703-12.
30. Wang Y, Jin B, Paxton RJ, Yang W, Wang X, Jiao Y, et al. The effects of exercise on insulin, glucose, IGF-axis and CRP in cancer survivors: Meta-analysis and meta-regression of randomised controlled trials. Eur J Cancer Care (Engl). 2020;29(1):e13186.
31. Bertram LA, Stefanick ML, Saquib N, Natarajan L, Patterson RE, Bardwell W, et al. Physical activity, additional breast cancer events, and mortality among early-stage breast cancer survivors: findings from the WHEL Study. Cancer Causes Control. 2011;22(3):427-35.
32. Friedenreich CM, Neilson HK, Farris MS, Courneya KS. Physical Activity and Cancer Outcomes: A Precision Medicine Approach. Clin Cancer Res. 2016;22(19):4766-75.
33. Bergenthal N, Will A, Streckmann F, Wolkewitz KD, Monsef I, Engert A, et al. Aerobic physical exercise for adult patients with haematological malignancies. Cochrane Database Syst Rev. 2014(11).
34. Yannitsos D, Murphy RA, Pollock P, Di Sebastiano KM. Facilitators and barriers to participation in lifestyle modification for men with prostate cancer: A scoping review. Eur J Cancer Care (Engl). 2020;29(1):e13193.
35. Cormie P, Atkinson M, Bucci L, Cust A, Eakin E, Hayes S, et al. Clinical Oncology Society of Australia position statement on exercise in cancer care. Med J Aust. 2018;209(4):184-7.
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