Abstract:The goal of cancer treatment is to arrest or eradicate the tumor while minimizing the often toxic effects of treatment. While oncologic diagnostics and treatments are improving and survival rates are increasing, it is critical to provide additional patient management that appears to affect long-term survival. Epidemiologic evidence suggests patients diagnosed with cancer tend to fair better after treatment when following a comprehensive rehabilitation program aimed at achieving an ideal body weight through dietary and exercise interventions while also increasing cardiorespiratory fitness, strength, mobility, neuromuscular integrity and psycho-social wellbeing. Additionally, it is now being tested whether exercise during cancer treatment and possibly prior to the start of treatment may increase post treatment outcomes by altering body weight, having direct effects on tumorigenesis, reducing oxidative stress and inflammation, and perhaps increasing chemotherapy delivery efficacy. The purpose of this review is to outline an evidence based model to evaluate cancer patients and provide guidelines for post-cancer treatment rehabilitation programs. Additionally, strategies aimed at changing lifestyle habits such as smoking and poor dietary habits will be addressed.

Findings support the hypothesis that cardiorespiratory deconditioning may play a role in the development and persistence of cancer-related fatigue following treatment. Future research into the use of exercise training to reduce cardiorespiratory deconditioning as a treatment for cancer-related fatigue is warranted to confirm these preliminary findings.

The purpose of this study was to identify physiological determinants of sprint (91.4 m) swimming velocity that discriminated between performance levels in male children (n = 12, age = 10.26 ± 1.00) and in young adult (n = 16, age = 19.78 ± 1.61) competitors. Independent variables included stature, arm length, body mass, body density, body fat, muscularity, leg power, and measures taken during swimming, which included arm stroke force, leg kick force, peak oxygen consumption rate, stroke rate, and stroke efficiency. Discriminant analysis revealed that in the children, higher levels of leg-kick force, peak VO2, stroke efficiency, and muscularity were the most potent variables contributing to the classification of the faster swimmers. In the young adults, higher levels of stroke efficiency, body density, and muscularity, served as the significant discriminators of the faster swimmers. When compared across age groups, these results indicated that substantial differences in stroke efficiency and muscularity significantly accounted for higher performance in these children versus young adult sprint swimmers.

The efficacy of an 8-minute field test to prescribe exercise intensity and assess changes in fitness was evaluated before and after 8 weeks of indoor cycling, and the results were confirmed by laboratory assessment. Changes in maximal steady-state power (MSSP), power at lactate threshold (PT(lact)), maximal power (Pmax), and maximal oxygen uptake (VO2max) were measured on 56 participants (20 women, 36 men; mean +/- SD. 46.5 +/- 10.0 years) who completed 1-hour, biweekly indoor stationary cycling classes on their own road bike outfitted with a Power Tap Pro power meter. The MSSP was defined as the average power during an 8-minute field test, which was administered at the beginning (pre) and end (post) of the training intervention. Individual training ranges were calculated from the pre-MSSP in accordance with Carmichael Training Systems. Laboratory assessments of PT(lact), Pmax, and VO2max were made on 24 of the participants the same weeks MSSP was evaluated. After training, MSSP increased 9.2% (195.4 +/- 56.6 vs. 213.8 +/- 57.2 W; p < 0.05), and PT(lact) increased 12.9% (178.3 +/- 47.1 vs. 201.5 +/- 47.6 W; p < 0.05). The MSSP was approximately 7.5 % higher than PT(lact). Pmax increased approximately 6.7% (315.2 +/- 65.1 to 336.5 +/- 65.9 W), and VO2max increased approximately 6.5% (46.2 +/- 10.7 to 49.1 +/- 10.5 ml x kg(-1) x min(-1)). The MSSP and PT(lact) were highly correlated (r = 0.98) as was MSSP and VO2max (r = 0.90). The results of this research indicated that (a) the field test is a valid measure of fitness and changes in fitness, (b) it provided data for the establishment of training ranges, and (c) a biweekly power-based training program can elicit significant changes in fitness.

Adoption of cancer rehabilitation as a standard part of oncology care may improve cancer survivors' health and well-being.