Exercise and Cancer: The Evidence to Date and Future Direction

Hussey J.¹, Walsh J.¹, Feeney C.², Mc Neely M.³, Kilbreath S.⁴

¹Trinity College Dublin, Discipline of Physiotherapy, School of Medicine, Dublin, Ireland, ²St James's Hospital, Department of Physiotherapy, Dublin, Ireland, ³University of Alberta, Department of Physical Therapy, Edmonton, Canada, ⁴University of Sydney, Clinical and Rehabiltation Sciences, Sydney, Australia

Learning objectives:

1. Understand the evidence for physical activity /exercise in the prevention of cancer, the management of the side-effects from its treatment and in increasing physical performance in order to improve medical and surgical outcomes. 2. Understand the specific challenges in implementing exercise programs for patients with cancer and survivors 3. Discuss how the evidence presented can be used to guide future research, clinical practice and education of physical therapists working in the cancer area. 

Description:

Cancer management poses an enormous global challenge. Estimates predict that cancer will to be the biggest worldwide killer by 2010. While some cancers such as lung cancer are still associated with significant morbidity, developments in screening and medical management have improved the longevity of many persons with cancer to such an extent that in many cases this disease is now considered in terms of its chronicity. For example, five year survival for breast cancer is now almost 90%. Medical management for cancer ranges from active monitoring of the disease to surgery, radiotherapy, chemotherapy, and hormone treatment. Both the surgery and the adjuvant therapies used in treatment of the disease can cause short and long-term physical and psychosocial side-effects. These impairments can be local, such as pain around the area of surgery, or systemic such as fatigue associated with chemotherapy.

Physical activity and exercise are important throughout cancer care. The benefits of exercise range from prevention up to and including management of symptoms in palliative care. There is a significant role for physical therapists throughout the cancer trajectory. This is particularly so with regard to symptom management of the side-effects experienced as a result of both primary and adjuvant treatments such as lymphoedema, pain, weakness, fatigue and reduced functional status.  

Implications / Conclusions:

As specialists in exercise assessment and prescription, physical therapists are well placed to prescribe exercise programmes for patients with cancer and cancer survivors. Specifically-tailored exercise programmes can be beneficial in managing some of the psychosocial symptoms often associated with diagnosis and treatment of cancer such as anxiety and depression. Engaging in regular physical activity is important in the prevention of obesity and secondary diseases such as cardiovascular disease and osteoporosis, which may occur as a result of sedentary behaviour or reduced physical functioning following cancer treatment. Other emerging roles for physical therapists include health promotion in the prevention of this disease, assessment of physical performance and function to aid clinical decision making, ´prehabilitation´ to optimise physical capacity prior to surgery/medical management in order to improve outcome.

Keywords:

Cancer; Physical activity; Exercise

Funding acknowledgements:

None

Relevance to WCPT and expected audience:

This symposium will be relevant to physical therapists/physiotherapists working in hospital settings, primary care and rehabltation units.

Target audience:

Physical therapists interested in exercise rehabiltation of chronic disease.

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