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 Even though physical activity isn’t routinely prescribed as part of
usual care for cancer patients, the analysis found a variety of
activities such as walking, swimming, cycling and strength or
stability training associated with better physical, mental,
emotional and social functioning.
“Most patients, oncologists and surgical oncologists assume that
patients with cancer should rest, especially if they are treated
with chemotherapy,” said study co-author Dr. Arnaud Vincent, a
neurosurgeon at Erasmus MC in Rotterdam, The Netherlands.
“However, exercise has a lot of beneficial effects in healthy people
as we know by now, so why not for patients treated for cancer?
Exercise can always be adapted to the situation of the patient, and
even aerobic exercise or breathing exercises can be performed in bed
or in a wheelchair,” Vincent added by email.
To assess whether exercise might benefit cancer patients, Vincent
and co-author Jasper Gerritsen examined data from 16 previously
published studies, most of which randomly assigned some participants
to do physical activity and others to receive only usual care.
Cancer types varied across the trials. Five studies involved breast
cancer patients, while two focused on people with lymphoma. Six
included people with a variety of tumor types.
Overall, across all of the studies combined, the 877 patients
assigned to exercise reported significantly better quality of life
than the people in the control groups that didn’t follow the fitness
routines, the researchers report in the British Journal of Sports
Medicine.
Significant improvements were also reported in relation to peak
oxygen consumption, self-esteem, physical functioning, fatigue,
length of hospital stay and general practitioner visits and social
functioning.
The frequency of exercise varied between two and five times a week.
Many of the studies provided patients with supervision during
workouts or gave patients routines to follow at home. Exercising
five times a week didn’t appear significantly better than doing
activities two or three times a week, the analysis found.
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The timing of exercise did matter, however. It appeared to be more
beneficial when patients started fitness routines during treatment
rather than waiting until afterward. Patients who exercised during
treatment experienced improvements in both physical and mental
health, while people who started later had only gains in physical
fitness.
One shortcoming of the analysis is that many of the studies were
small and included a wide variety of exercise options and types of
cancer patients, making it difficult to determine which specific
fitness interventions might benefit people with specific tumor
types.
While patients shouldn’t modify their cancer treatments to make
exercise easier, they can tailor physical activities to their
circumstances and make it more feasible to manage even with the
symptoms of the disease and the side effects of treatment, said
Kerry Courneya, a fitness researcher at the University of Alberta in
Canada who wasn’t involved in the study.
“They can modify their exercise program by reducing the intensity
(e.g. slower walking) or the duration or frequency,” Courneya said
by email. “They can also wait and exercise on days they feel good
rather than push themselves on the days they feel sick.”
SOURCE: bit.ly/1Ry4fxZ British Journal of Sports Medicine, online
December 30, 2015.
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