Exercise and Cancer
Cancer in Canada
Cancer is the leading cause of death for Canadians and is responsible for approximately 30% of all deaths in Canada (statistics gathered pre-COVID) (“Cancer statistics,” n.d.). Globally, cancer is the second leading cause of death, accounting for an estimated 9.6 million deaths in 2018 (“Cancer,” 2018). It is estimated that one in two Canadians will be diagnosed with Cancer at one point in their life and one in four will die from Cancer (“Cancer statistics,” n.d.).
While some risk factors for cancer are non-modifiable, the high rates of cancer in Canada (and globally) are closely tied to the following five modifiable risk factors:
High body mass index (overweight and obesity)
Low fruit and vegetable intake
Lack of physical activity
Tobacco use, and
Alcohol consumption, (“Cancer,” 2018).
While these statistics might be hard to swallow, the good news is that survival rates, five years after diagnosis, appear to be steadily increasing since records in 1992 (“Cancer statistics,” n.d.). With more and more people surviving Cancer, research has been directed at finding ways to help this population improve quality of life after diagnosis. One of the first steps in both a cancer-management plan and a cancer-prevention plan is to identify your own risk factors and work to minimize these. For example, if you are a full-time office/desk worker who does not engage in regular exercise and has a poor diet with low fruit and vegetable intake, these would be high risk factors for cancer that you can aim to improve.
Exercising with Cancer - Up to date research:
There is a great range of research papers that look at the effects of both aerobic exercise programs and resistance-training programs for people post cancer diagnosis, surgery, chemotherapy and radiation therapy (Spencer et al. 2010). Exercise interventions and parameters are different between papers and consensus has not yet been reached on one best form of exercise/parameters for this population group (Spencer et al. 2010). This may be due to the variety of cancers, different stages of diagnosis and large scale differences in presentation between individuals within this population. For example, the optimal exercise program for a 25 year old female with stage one breast cancer probably won’t be ideal for a 60 year old man with stage two lung cancer. Again, these exercise requirements will differ for people who undergo surgical procedure such as lumpectomy when compared with people who are receiving chemotherapy, radiation therapy, hormone replacement therapy or biological or genetic treatments. Other factors such as age, stage of cancer, treatment to date, comorbidities, current health and energy levels, past activity levels, access to facilities, psychological state and friend/family support all need to be taken into consideration when finding an exercise program that will be best suited for an individual.
One thing that all the research papers agree on is that safe exercise will be of benefit to people post cancer diagnosis (Spencer et al. 2010). Research has shown that safe exercise programs will reduce fatigue and improve physical function, strength, physical activity levels, quality of life, immune function and body composition (Spencer et al. 2010). Safe exercise programs are going to differ between individuals and it will be important to work with a health care team to determine how this exercise program can be structured for maximal benefits.
Current exercise Guidelines:
General guidelines for resistance training programs include starting at a light weight, where you can perform two sets of 10-15 reps without pain or fatigue. Progression will involve slow increase in reps and sets before increasing the weight itself. Low-impact aerobic exercise is usually recommended unless high-impact exercises has been approved by your health care team. Exercising at times of peak energy levels such as in the morning or evening is recommended and ensuring you are adequately fed and hydrated before commencing exercise is a must (Spencer et al. 2010). Exercising in loose breathable clothing is important especially if you have lymphedema in one or more of your limbs. Further information on lymphedema can be found in Rebecca Bohem’s article. Finally, it is recommended that you find an exercise that you enjoy so that the experience can be rewarding both physically and mentally. This will aid in exercise becoming a long-term part of your regular lifestyle.
References:
Cancer (2018, September 12). Retrieved from: https://www.who.int/news-room/fact-sheets/detail/cancer
Cancer statistics at a glance. (n.d). Retrieved from: https://www.cancer.ca/en/cancer-information/cancer-101/cancer-statistics-at-a-glance/?region=bc&s_src=grantaccount2020&s_subsrc=sep-google-nw_search&utm_source=sep-google-nw&utm_campaign=grantaccount2020&utm_content=statistics&gclid=cj0kcqjw1ql6brcmarisadv9jtzdgt4d_nbaoxa7lcpu9rhxpxgm_t8bayxb9f734s4vheutx3fmnimaavfcealw_wcb
Spence, R. R., Heesch, K. C., Brown, W. J. (2010). Exercise and cancer rehabilitation: A systematic review. Cancer Treatment Reviews, 36(2), 185-194. https://doi.org/10.1016/j.ctrv.2009.11.003