“cancer survivors who walked an average of 3 – 5 hours per week at a moderate intensity significantly reduced the risk of the cancer coming back”

shift towards recommending physical activity during and after cancer treatment.

Side effects of cancer treatments Treatment for cancer depends on a number of factors – the cancer type, location, the size of the cancer and how far it has spread. Cancer therapies usually consist of one or more of the following: surgery; chemotherapy; radiotherapy; hormonal therapy and/or immunotherapies. These treatments can cause a number of physical and psychological side effects that affect the quality of life for cancer survivors. Some symptoms such as fatigue, depression, lymphoedema (swelling of arm or leg) or osteoporosis can still be present or suddenly appear years after treatment. Even among cancer survivors who are at least five years post-treatment more than half report physical performance limitations including crouching/kneeling, standing for 2 hours, lifting/carrying 4.5kg and walking 0.4 km. Exercise-based cancer rehabilitation may play a role in helping to treat or prevent these side effects.

Exercise helps prevent or reduce the following side effects: l Cancer related fatigue. This is one of the most common and debilitating side effects of cancer treatment. It has been shown that by incorporating some physical activity daily both during and after treatment significantly reduces fatigue levels and builds up energy levels. l Weight gain/weight loss. Some cancer survivors gain weight due to medicines given during treatment. Regular exercise combined with a healthy diet can control weight gain. Similarly loss of muscle mass due to cancer treatment has been shown to be reversed with an appropriate exercise programme. l Insomnia, anxiety and depression. Exercise has been shown

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to produce a shift to a more positive mood during breast cancer treatment and to reduce levels of anxiety and depression after treatment. l Osteoporosis. The risk of osteoporosis is increased due to hormonal treatments prescribed for certain cancers and being inactive during and after treatment. Weight bearing exercise has been shown to increase bone density in susceptible cancer survivors. l Lymphoedema. It was originally thought that repetitive activity with the effected limb could initiate or exacerbate lymphoedema (swelling of arm or leg). However studies looking at progressive weight-training programmes and exercise aiming to improve range of movement have shown that this is not the case. l Other symptoms. Pain, nausea and constipation also appear to be improved with physical activity.

A recent review of over 60 high-quality studies on the effects of exercise on cancer survivors concluded that regular exercise appears to help with confidence and self-esteem as well as improving physical activity levels, aerobic fitness, muscular strength, and overall quality of life. It was shown to be a positive step in giving patients back a sense of control and with few exceptions, the exercise was well tolerated during and post treatment without adverse events.

Can exercise reduce the risk of the cancer coming back? Cancer patients often ask: “What can I do to stop the cancer coming back?” A number of studies in America have followed thousands of breast cancer and colorectal cancer survivors and monitored the amount of physical activity they undertook on an

The The rEPS Journal 2009;00(Month):00-00 rEPs Journal 2010;18(September):21-23