New physical activity recommendations for cancer patients have been published in the July 2010 issue of the Medicine & Science in Sports & Exercise.  The guidelines are a result of the ACSM Cancer Roundtable held last June.  Thirteen experts in the fields of cancer, fitness and exercise training, and obesity convened to review and analyze the literature with respect to the safety and efficacy of participation in routine exercise programs for cancer patients.  In brief here is what they concluded:

• Physical activity is safe both during and after cancer treatments for certain cancer groups* (e.g., colon, breast, gynecologic, prostate, and hematologic forms of cancer).
• Cancer patients (e.g., those with colon, breast, gynecologic, prostate, and hematologic forms of cancer) who exercise improve their quality of life, decrease cancer-related fatigue, and increase physical functioning.
• The role of exercise in disease outcomes and survival rates is yet to be determined.

*Guidelines have not been developed for patients with other forms of cancer due to a lack of evidence at this point to support exercise recommendations.

The general goals** of an exercise program for the cancer patient, as outlined by the roundtable, are:

• To restore and increase physical function, aerobic fitness, muscular strength, and flexibility.
• To enhance body image.
• To improve quality of life.
• To improve body composition.
• To improve physiological and psychosocial outcomes.
• Management of anxiety.
• To minimize, alleviate, and counteract side effects of cancer treatment.
• Potentially, to decrease the risk of, and to delay the recurrence of, the existing form of cancer or the development of another type of cancer.

** Note: the goals will be case-dependent.

The findings of the roundtable are great news for cancer patients who, in the past, have been told to rest and avoid exercise.  The guidelines indicate that exercise programs should be individualized based on the cancer patient's form of treatment, physiological response to the medical interventions, presence of comorbidities, and pretreatment fitness level.  For example, patients with metastatic bone disease should participate in low impact exercise due to the increased risk for bone fracture.

As part of the guidelines, the expert panel provides cancer-specific contraindications for beginning an exercise program, as well as reasons for stopping activity.  Cancer patients need to consult their medical team prior to beginning an exercise program, or if they have any concerns about a current routine.

Resources:
Medicine & Science in Sports & Exercise, July 2010, pp. 1409-1426, "American College of Sports Medicine Roundtable on Exercise Guidelines for Cancer Survivors," Schmitz, K.H. et al.,

Medical News Today, July 1, 2010, "Exercise is Good for Cancer Patients and Survivors Say Experts," Paddock, C.