The Benefits of Exercise After CancerBy ANAHAD O'CONNOR
Joe Fornabaio for The New York TimesMany people who have had cancer may be inclined to rest and take it easy after treatment, but a new report by a leading British cancer charity is strongly urging some patients to increase, not reduce, their levels of physical activity.
The report, called Move More, reviewed the findings of 60 studies on the effects of exercise on cancer and reached some conclusions that may seem contrary to the conventional wisdom that prevailed only a decade or two ago, when recovering cancer patients were often given mixed advice on physical activity or outright warned against it. Saying some patients should view light exercise almost as a form of treatment itself, the report noted that two and a half hours of exercise a week could lower a breast cancer patient’s risk of dying or cancer recurrence by 40 percent, and could reduce a prostate cancer patient’s risk of dying from the disease by about 30 percent.
The group that published the report, Macmillan Cancer Support, one of the largest British charities, provides health care and financial support to cancer survivors and works in partnership with the National Cancer Research Institute in Britain.
As part of its report, the group questioned more than 400 doctors and nurses in Britain and found that more than half knew “little or nothing about the benefits of activity in preventing or managing long-term effects” of cancer, and that one in 10 believed it was important to encourage cancer patients to “rest up” rather than attempt any physical activity at all. Cancer experts in the United States have also sought in recent years to spread the word among oncologists that light exercise, in many cases, should be encouraged.
Just last year, the American College of Sports Medicine convened a panel of cancer and exercise researchers, which developed a set of guidelines on physical activity for people who are undergoing or have recently completed treatment. The panel recommended adaptations for exercise in people based on their specific cancers and the side effects of their treatment, like strength-building routines for patients who have lost muscle mass and shoulder-stabilizing exercises in breast cancer survivors who have had operations that debilitate the joints in their shoulders.
But the panel also noted that some patients will at times be just too sick to exercise — particularly at the height of their treatment — and said that in those cases there was nothing wrong with waiting a few days before attempting activity. The American Cancer Society also promotes moderate exercise but encourages patients to discuss their exercise plans with their oncologists first, and lists on its Web site a set of precautions. Among them: avoiding exercise if you have anemia, and steering clear of heavy weights or strenuous exercise if you have developed osteoporosis, nerve damage or cancer that has spread to the bone.
For those who can handle it, though, a light or moderate exercise regimen could help reduce some side effects of treatment, the new report stated. Studies have shown, for example, that arm extensions and other range-of-motion exercises can help relieve lymphedema, a painful swelling of the arm stemming from breast cancer surgery. It can also help patients who gained weight during treatment slim down and regain some physical function, and combat some of the exhaustion stemming from chemotherapy.
“The evidence review shows that physical exercise does not increase fatigue during treatment, and can in fact boost energy after treatment,” the report stated.
For patients looking for help with starting a new regimen, the American College of Sports Medicine and the American Cancer Society introduced a program that educates and certifies trainers to work specifically with cancer patients, so they understand their goals and limitations. The college’s Web site explains how patients can find a certified cancer exercise trainer in their area.