Wednesday, November 29, 2023

Should cancer patients exercise? Five questions with answers

We republished this article from Jon Irazusta and Ana Rodriguez Larradprofessor and researcher of physiology and associate professor of the Department of Physiology of the University of the Basque Country in The Conversation on April 21, 2023.

Until relatively recently, the rest was a general recommendation for people with cancer. And this seemed logical, since fatigue is a very common symptom of the disease.

However, is becoming more and more accepted that physical exercise is advisable for most patients during cancer treatment. In this article we will explain the reasons for this change.

1. What benefits does physical exercise produce in people with cancer?

exist solid evidence about what relieves fatigue and improves quality of life of those affected. These investigations have also found that reduces sleep disturbances, anxiety and depression that are often associated with its diagnosis and treatment.

Likewise, it is known that exercise is capable of reversing the loss of muscle mass, bone density and physical function due to both the cancer itself and the therapies used against it. This is very relevant to maintain personal autonomy and avoid dependency.

Finally, physical activity can increase tolerance to chemotherapy and, consequently, treatment follow-up. It can also reduce some of its side effects, like neuropathic pain.

2. Does it increase the survival of patients?

This question still don’t have a clear answer. On the one hand, numerous jobs suggest that people diagnosed as physically active do have higher survival rates than inactive ones. However, there are few experimental studies that test the effects of exercise on survival. More research is needed to substantiate the promising results.

3. Is it recommended for all types of cancer?

multiple international organizations agree that exercise should be included in the comprehensive care of any manifestation of the disease. Benefits have even been observed in advanced stages of the disease and in older patients.

In fact, although it is not yet a generalized reality, there are more and more oncology exercise units. In them, specifically trained professionals carry out an initial assessment of each person before beginning a physical activity program.

make a pre-assessment is essentialgiven that some tumors have peculiarities that force you to follow some precautions. This is the case with bone cancer, where impact exercises or postures that can compress the affected bones are not recommended.

In addition, it is essential to know the state of the person to adapt the dose and intensity of the exercises. This includes knowing the power of the different muscle groups, the aerobic capacity and the existence and characteristics of fatigue and pain, to name a few parameters.

Based on these data, design programs with personalized goals, which can prevent or reduce the symptoms of the disease or its treatment. The activity can also be directed to the preparation of said treatment (mainly surgery).

And finally, we must not forget that each person will go through different phases throughout the oncological process, which will define their specific needs at all times.

4. What activities are the most appropriate?

An oncology exercise program includes above all activities to improve aerobic capacity and work on muscle strengthening. Designed specifically for each patient, you will start with simple exercises performed at a light intensity. These will progress until reaching moderate intensities, unless adaptations have to be made due to the course of the disease and its treatment.

The guidelines recommend doing aerobic training at least three days a weekwith a minimum of 30 minutes per session. This includes activities like brisk walking, bicycling, swimming, or dancing.

Regarding the training of strengtheningit is advisable to do it at least two days a week. Sessions would consist of completing a minimum of two sets of weight mobilization exercises with major muscle groups. You can work with external loads or use your own body, such as when doing squats.

It is relevant to comment that until recently strength exercises were not recommended in patients with lymphedema (accumulation of lymphatic fluid), a common complication when lymph nodes are removed or radiated. It occurs mainly in breast cancers, but also in head and neck cancers. However, it is now known that, starting at low intensities and progressing slowly, strength exercises are safe in these cases as well. Especially if they are carried out under supervision.

The goal is that each person, at the end of the program, can be autonomous to lead an active life. This will allow you to maintain your functional capacity and quality of life, as recommended by the World Health Organization. Likewise, it is important that the patient understands the importance of avoiding, as far as possible, prolonged periods of sedentary lifestyle.

5. What can we expect in the future?

Currently, a large number of studies are being carried out to find out the effects of exercise in people with cancer. In the near future there will be more evidence that will make it possible to adapt exercise programs to a greater number of types and stages of this disease.

Likewise, it is probable that oncology exercise units and the offer of programs adapted to patients. For this, it will be necessary to train more professionals capable of evaluating, designing and directing physical activity programs in cancer patients.

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