The Role and Efficacy of Exercise in Persons With Cancer

Abstract

Improvements in cancer screening, diagnosis, and treatment have resulted in an increasing population of cancer survivors with impairments in physical function, cancer-related symptoms, and reduced quality of life. Exercise and physical activity have therapeutic value at multiple points along the cancer disease continuum, spanning disease prevention, treatment, survivorship, prognostic outcomes, and end-of-life issues. Molecular mechanisms for the influence of exercise in persons with cancer include altering tumor initiation pathways and affecting hormonal, inflammatory, immune, and insulin pathways. Physical activity has been found to play a role in the prevention of certain malignancies, including breast, colon, and other cancers. An increasing amount of evidence indicates that physical activity may affect prognostic outcomes in certain cancer diagnoses, especially breast cancer. Structured exercise and physical activity interventions can be helpful in addressing specific survivorship issues, including overall quality of life, cardiorespiratory impairment, cancer-related fatigue, and lymphedema. Exercise also may be helpful during the palliative care phase to alleviate symptoms and increase physical well-being. This article will familiarize physiatrists with the current state of evidence regarding the role and efficacy of exercise in persons with cancer.

Physical activity, fatigue and quality of life in breast cancer patients

“…This being said, both being diagnosed with cancer and its treatment can diminish QOL and may cause a number of symptoms during and after treatment: physical weakness, weight loss, and decreased endurance, all negatively impact several domains of QOL. 2,3 Physical activity (PA), with its contributions towards health, QOL and disease prevention has been well documented in previous studies. 4 It has been shown to improve muscle strength, health and energy, influence mood, body image and self-esteem, thus reducing the physical and emotional symptoms experienced during cancer treatment.…”

“…This also indirectly benefits the patient by increasing the adaptability of both muscular and cardiac functional capacity. 3,5 These physical alterations occur as acute responses and adaptations to the higher energy expenditure, as well as the stress on multiples organs and the enzyme system. 5 Thus, a seden-tary lifestyle for post cancer patients seems to cause additional decline of functional capacity, and should be avoided as much as possible.…”

“…Likewise, exercise during cancer treatment greatly contributes to strengthening immunity. 1,3 Treatment for BC includes surgery, radiotherapy, chemotherapy, and hormone therapy. All are employed to increase patient survival, but are unfortunately also associated with morbidity and reduced QOL.…”

“…Besides being a multifactorial and subjective symptom, one's definition and understanding of fatigue can complicate matters since not only biological, but also cognitive and psychological aspects are involved. [1][2][3][4][5] Studies show that feeling tired and weak causes suffering, poses limitations on functionality and impairs QOL. Unlike normal or daily fatigue, cancer-related fatigue persists despite getting adequate rest and sleep.…”

“…2,6 Studies indicate that BC is most frequently diagnosed in the years during and after menopause. 3 Symptoms can be aggravated by antineoplastic therapy, especially during chemotherapy, which can induce a short-term or permanent state of estrogen deficiency, thus worsening the diagnosis. 2 Recent studies show a significant increase in the occurrence of the disease among young women.…”