For decades exercise has been recommended to improve the quality of life. More recently and perhaps more importantly, exercise has been highly recommended for cancer patients.
Most people realize that exercise has a beneficial effect on health in general. Recent studies emphasize the impact exercise has on the quality of life and that exercise is good for overall health. Several recent studies have gone as far as to show the impact regular physical activity has on survival before, during and after cancer treatment.
The AACR Cancer Progress Report reviewed over three thousand papers on the issue and found that exercise has a favorable impact on depression, anxiety, fatigue and general wellbeing.
How Much Exercise is Beneficial?
How much exercise is beneficial for cancer survivors and when should they begin exercising after their diagnosis? Most importantly what type of exercise leads to improvements in the patient’s quality of life?
The most recent studies have provided additional evidence of the well-established benefits of cancer patients participating in physical activities.
When is it Most Beneficial for the Cancer Patient to Begin Exercising?
NCC researchers from the Korean Republic conducted a study of the effect of physical activity immediately following a cancer diagnosis. The team recommended vigorous activity defined as aerobics or running at least two days a week plus strength training.
Both activities improve muscle strength and quality of life as they are known to reduce depression and anxiety. As always, the patient should follow their doctor’s advice prior to making any changes in their daily routine.
The next category is light to moderate physical activity, such as walking or riding a bike for 30 minutes per day five days a week. Over three thousand papers have been written on the subject with many indicating that exercise improves depression, anxiety, and physical wellbeing. According to the 2024 AACR Progress Report, physical activity may lower the recurrence of cancers and increase patient survival.
The questions then are how much exercise is recommended for each cancer patient, what level is most appropriate, and how soon should they begin exercising after receiving a diagnosis. Vigorous physical activity was described as aerobics and running between 75 to 150 minutes each week. Light or moderate physical activity was described as walking or bike riding between 150 to 300 minutes each week. Again, it is advisable for patients to consult with their physician in this regard.
Encouraging Data
According to the AACR Epidemiology journal, 215,191 patients who continued their activity schedules after they had received a diagnosis, were reported to have lowered their risk of death when compared to patients who did not actively participate in physical activities. Researchers found that all-cause mortality risk across every stage of cancer was 18% through 23%. Risk reduction was directly affected by the type of cancer, the stage of the cancer and the patient’s participation in physical activity.
In another peer review study that was also published by the AACR, the NIH reviewed the effect of physical activities on breast cancer patients. The goal of the researchers was to acquire a full understanding of benefits to patients who met the recommended exercise guidelines.
Data, based on 50,689 patients with breast cancer, was collected from 20 previous studies. Compared to those who did minimal exercise, all-cause mortality for those who exercised fell 8%.
Can Cancer Recurrence also be Reduced?
Observational studies were conducted by Canadian Trial Groups. A total of 889 patients were enrolled in a clinical trial called CHALLENGE. The patients had a full resection of high-risk adenocarcinoma of the colon, plus a full range of chemotherapy including “adjuvant chemotherapy” designed to kill any remaining cancer.
From 2009 through 2024 Patients (n889) were assigned to education about the benefits of exercise and diet (n444) while others were in receipt of requisite information as they participated in a three-year supervised exercise program (n445). Patients were assigned to mandatory support sessions that were designed to assist each person in lowering their risk of recurrence.
The stated goal was to encourage trial participants to increase their aerobic exercise time by a minimum of ten metabolic task (MET) hours each week during the first twelve weeks. The patients were to either remain at that level or increase it throughout the remaining time left in the program.
The Follow-up
At a 7.9-year follow-up the research team found that exercise caused a 28% reduction in recurrence, new cancer growth, or patient death. The NEJM journal published an article whereby it was established that disease-free survival was substantially longer in the group that exercised as opposed to the health-education cohort at both the five-year (80.3% v. 73.9%) mark and the eight-year (90.3% vs 83.2%) mark. It was evident that patients who maintained a sufficient exercise program after their diagnosis had a lower risk of death in comparison to those patients who remained inactive.
Does Exercise Affect Sexual Functioning for Cancer Survivors?
Treatments for prostate cancer generally result in sexual dysfunction that can last for years after treatment. JAMA Network Open recently published a story that describes 260 patients out of a total of 485 who participated in a clinical trial at the Peter MacCallum Center in Australia. These patients did show some evidence of improvement. However, it appears that adding self-management and psychosexual education did not result in a substantial benefit.
In conclusion, the fact that these studies found physical activity reduced the risk of pulmonary complications after surgery should encourage patients to find ways to be physically active.
