Physical activity: Battle against cancer

In the last decade there has been a significant accumulation of new epidemiologic evidence showing that low level of sedentary physical activity is associated with many more types of cancer than previously thought, and that exercise may improve survival in diagnosed cancer patients^2,3.

In a study pooling data from 1447 cancer survivors, it was found that cancer survivors engage in a few minutes of moderate to vigorous physical activity and spend much of their day sitting¹

Evidence supports that there are a number of biologically plausible mechanisms by which physical activity may affect cancer risk and that physical activity is beneficial in preventing many types of cancer, including breast, colon, endometrial, kidney , bladder, esophagus and stomach.

In addition, physical activity before and after a cancer diagnosis is also likely to be associated with improved survival for those diagnosed with breast and colon cancer.

Furthermore, it appears that post-diagnosis physical activity may provide greater benefits than pre-diagnosis physical activity². In other words, one does not necessarily need to have had a sporting routine prior to the diagnosis. It’s never too late to start incorporating physical activity into your life and reap the anti-cancer benefits.

In addition to preventing and improving survival, exercise leads to improvement in common side effects of a cancer diagnosis and treatment, specifically helping with anxiety, depressive symptoms, fatigue, broader health-related quality of life, and physical function, along with exercise safety.

Is exercise safe for cancer survivors?

Exercise is generally safe for cancer survivors. However, it is worth noting, among others, certain conditions⁴.

1. Before starting exercise programs, subjects enrolled in exercise research models are screened for eligibility criteria for age, comorbidities, physical ability, etc.
2. In addition, the conduct of the exercise programs is largely based on academic and/or medical centers, which may face complications in the health of the participants.

Thus far in most centers where exercise for cancer survivors is conducted, the greater proportion of participants have satisfactory physical function and exercise motivation, which may not be fully generalizable to the broader population of cancer survivors. Depending on the nature and extent of the problems a survivor presents they may not be able to adequately and/or safely participate in exercise. In these cases, we obey and apply NCCN [National Comprehensive Cancer Network] recommendations and guidelines. Physical therapy and medical evaluation can be a bridge to finding and implementing appropriate modifications to a person’s exercise program.

Patients will respond positively to a training stimulus by improving individual components of fitness, including cardiorespiratory fitness, muscular strength and endurance, and body composition. However, an individual’s response to a given exercise stimulus may vary due to:

• direct effects of cancer treatments on physiological systems (eg, anemia),
• side effects of cancer treatment (eg, cancer-related fatigue can reduce exercise endurance)
• demographic factors (eg age)
• individual ability to withstand exercise, which can vary from day to day or from week to week, depending on the active treatment that the cancer patient receives.

Collectively, there is strong, compelling evidence that physical activity plays a role in preventing and controlling many types of cancer and improving longevity among cancer survivors. Fitness and public health professionals and healthcare providers worldwide are encouraged to raise awareness and spread the message to the general population and cancer survivors to be physically active as their age, ability and condition allows of cancer^2,3.

The next generation of cancer exercise prescription could evolve sufficiently to move exercise oncology toward the same goal as surgical and pharmaceutical oncology where treatment is precisely matched to the specific characteristics of an individual’s cancer.

1. Sweegers MG, Boyle T, Vallance JK, Chinapaw MJ, Brug J, Aaronson NK, D’Silva A, Kampshoff CS, Lynch BM, Nollet F, Phillips SM, Stuiver MM, van Waart H, Wang X, Buffart LM, Altenburg TM. Which cancer survivors are at risk for a physically inactive and sedentary lifestyle? Results from pooled accelerometer data of 1447 cancer survivors. Int J Behav Nutr Phys Act. 2019 Aug 16;16(1):66. doi: 10.1186/s12966-019-0820-7. PMID: 31420000; PMCID: PMC6698042.
2. Patel AV, Friedenreich CM, Moore SC, Hayes SC, Silver JK, Campbell KL, Winters-Stone K, Gerber LH, George SM, Fulton JE, Denlinger C, Morris GS, Hue T, Schmitz KH, Matthews CE. American College of Sports Medicine Roundtable Report on Physical Activity, Sedentary Behavior, and Cancer Prevention and Control. Med Sci Sports Exerc. 2019 Nov;51(11):2391-2402. doi: 10.1249/MSS.0000000000002117. PMID: 31626056; PMCID: PMC6814265.
3. Friedenreich CM, Ryder-Burbidge C, McNeil J. Physical activity, obesity and sedentary behavior in cancer etiology: epidemiologic evidence and biologic mechanisms. Mol Oncol. 2021 Mar;15(3):790-800. doi: 10.1002/1878-0261.12772. Epub 2020 Aug 18. PMID: 32741068; PMCID: PMC7931121.
4. Campbell KL, Winters-Stone KM, Wiskemann J, May AM, Schwartz AL, Courneya KS, Zucker DS, Matthews CE, Ligibel JA, Gerber LH, Morris GS, Patel AV, Hue TF, Perna FM, Schmitz KH. Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable. Med Sci Sports Exerc. 2019 Nov;51(11):2375-2390. doi: 10.1249/MSS.0000000000002116. PMID: 31626055; PMCID: PMC8576825.

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