Exercise medicine across the cancer trajectory

Abstract

Physical exercise is essential to maintaining human health and is now recognised by the American College of Sports Medicine and the American Heart Association as an essential component for both the prevention and management of chronic disease, injury and other illnesses. Previously, the recommendation for cancer treatment-related adverse effects had been rest; however, research on exercise has challenged this recommendation. It has become increasingly clear that exercise plays an important role in the management of many cancer patients and survivors across the disease trajectory (e.g. pre-, during and post-treatment). We have demonstrated clinical benefits of resistance training for improving physical and muscle function in prostate cancer survivors undergoing androgen deprivation therapy with significant improvements in muscle strength, physical function, balance, and cardiorespiratory fitness. We have also reported the rapid loss of bone and lean mass and increased total body fat due to androgen deprivation for prostate cancer and established the efficacy of exercise as medicine to reverse muscle loss, improve physical function and quality of life including general health, and reduce fatigue and low-grade systemic inflammation. This work has been further expanded in older cancer survivors who had completed primary therapy and in those with advanced bone disease. In addition, preliminary work indicates improved physical function post-surgery in patients with lung, colorectal and prostate cancer involved in prehabilitation programs. Exercise has also been shown to have numerous positive effects in breast cancer survivors during and following treatment including potential increase in chemotherapy completion. Evidence from large observational studies also suggests that regular exercise post-diagnosis is associated with increased survival in patients with breast, colorectal and prostate cancer. This presentation will cover clinical studies in exercise oncology across the cancer continuum from prehabilitation to long-term survivorship.