Exercise for treating cancer

Cancer treatment may involve surgery, chemotherapy, radiotherapy, immunotherapy or a combination of any of these. The treated patient usually suffers both physical and psychological side effects. These include fatigue, muscle weakness, reduced aerobic capacity, and mental health issues like depression and anxiety. Quality of life is often severely effected. One emerging and increasingly supported approach to overcoming these challenges is the use of exercise programs tailored to the needs of cancer patients.

Over the past few decades, numerous studies have examined the role of physical activity in cancer care. Exercise has been found to provide a multitude of benefits, ranging from improvements in physical fitness, enhanced emotional well-being and improved prognosis.

The Benefits of Exercise for Cancer Patients

1. Improved Physical Function and Reduced Fatigue

Fatigue is one of the most common and debilitating side effects of cancer treatment, affecting up to 90% of cancer patients undergoing chemotherapy and radiation therapy. This fatigue can severely impact a patient’s ability to perform daily activities and significantly decreases their quality of life. Exercise has been shown to help mitigate this fatigue by improving cardiovascular fitness, muscle strength, and endurance.

A review of studies published in the Journal of Clinical Oncology found that exercise, particularly aerobic and resistance training, helped reduce cancer-related fatigue in a variety of cancer types, including breast, colon, and prostate cancer. Regular physical activity helps to improve energy levels by enhancing circulation, increasing oxygen delivery to tissues, and promoting the release of endorphins, which naturally boost energy and mood.

2. Enhanced Psychological Well-Being

Cancer diagnosis and treatment can take a toll on mental health, leading to feelings of depression, anxiety, and stress. The mental burden of cancer can sometimes be as debilitating as the physical effects. Exercise has been shown to have a positive impact on mental health by reducing levels of anxiety and depression and improving overall mood.

In a meta-analysis of randomized controlled trials, researchers found that exercise led to significant improvements in the mental health of cancer patients, with reductions in depression and anxiety symptoms and improved quality of life. Exercise appears to be effective not only in reducing psychological distress but also in improving patients’ sense of control over their health and boosting self-esteem. This psychological benefit is often linked to the sense of accomplishment and empowerment that comes with regaining physical strength and endurance.

3. Better Immune Function

Cancer treatments such as chemotherapy and radiation therapy often weaken the immune system, making patients more susceptible to infections and illnesses. While exercise is commonly associated with boosting immune function in healthy individuals, it has also been shown to improve immune response in cancer patients, potentially aiding in the body’s ability to fight cancer and prevent infections.

Regular moderate exercise has been found to enhance the production of immune cells such as T-cells and natural killer cells, which play a crucial role in defending the body against tumours and infections. Some studies suggest that exercise enhances the effectiveness of cancer treatments by boosting the body’s ability to recognize and destroy cancer cells. However, excessive or intense exercise can suppress immune function, so it is important that cancer patients follow tailored exercise regimens to avoid overtraining.

4. Reduction in Cancer Recurrence and Mortality

There is growing evidence that exercise may not only help alleviate symptoms but also play a role in improving long-term survival outcomes for cancer patients. Several studies have found that regular physical activity after cancer treatment is associated with a lower risk of cancer recurrence and improved survival rates.

A landmark study published in the Journal of the National Cancer Institute found that breast cancer survivors who engaged in regular moderate-to-vigorous physical activity had a 40% lower risk of cancer recurrence and a 35% lower risk of death from any cause compared to those who were less active. Similar findings have been reported for colon cancer survivors, with research indicating that those who participate in regular physical activity are less likely to experience cancer recurrence and have a higher rate of survival.

The potential protective effects of exercise on cancer recurrence are thought to stem from its ability to regulate hormones, reduce inflammation, improve metabolic function, and increase circulation, which together help inhibit the growth and spread of cancer cells.

Types of Exercise for Cancer Patients

Not all types of exercise are appropriate for all cancer patients. The intensity, duration, and form of exercise must be tailored to each individual’s physical condition, treatment phase, and cancer type. However, a combination of aerobic, resistance, and flexibility exercises is usually recommended to improve overall fitness and well-being.

• Aerobic Exercise: Activities such as walking, cycling, swimming, or light jogging improve cardiovascular fitness and help reduce fatigue. Aerobic exercise also has the benefit of improving mental health and boosting energy levels, which is crucial for cancer patients who experience significant tiredness due to their treatments.

• Resistance Training: Weight training or exercises that use resistance bands help build muscle strength, improve endurance, and prevent muscle wasting, which is common in cancer patients undergoing chemotherapy. Resistance exercises have been shown to improve physical function, especially in terms of daily activities like climbing stairs or lifting objects.

• Flexibility and Balance Exercises: Activities like yoga or Pilates can improve flexibility, balance, and coordination. These exercises are particularly beneficial for cancer patients who may experience joint pain, stiffness, or loss of mobility as a result of treatment.

Exercise Program Considerations

While exercise can be remarkably beneficial for cancer patients, it is important that exercise programs be individualised and carefully managed. Health care providers, including oncologists, physical therapists, and exercise physiologists, should be involved in designing and overseeing exercise regimens to ensure they are safe and effective. Additionally, exercise should be adjusted to account for the patient’s current physical status, type of cancer, and stage of treatment.

Patients should begin with low-intensity exercise and gradually increase the intensity as their physical condition improves. It’s also crucial to monitor for any adverse effects, such as pain, dizziness, or shortness of breath, and modify exercise accordingly.

Conclusion

Exercise plays a vital role in the rehabilitation and ongoing well-being of cancer patients. The benefits are multifaceted, ranging from physical improvements such as reduced fatigue and increased strength, to psychological benefits like reduced anxiety and improved mood. Furthermore, emerging evidence suggests that regular physical activity may enhance cancer survival and reduce the risk of recurrence. By incorporating tailored exercise programs into cancer treatment, healthcare providers can help patients reclaim control over their health and quality of life, making exercise an invaluable tool in the fight against cancer.

Next time

At the moment I am minded to have another look at the current annual winter crisis in the NHS –  precipitated by the flu epidemic.

In the meantime: