Exercise Prescription for People With Metastatic Cancer of the Skeleton

Abstract

ABSTRACT Exercise is increasingly accepted as a therapy in the management of cancer, and is now described as a medicine, giving rise to a new discipline in clinical practice and research termed exercise oncology. Exercise medicine has been evaluated in clinical trials and implemented in patient care at all phases of disease and treatment trajectory. Advanced disease involving bone metastases presents considerable challenges in terms of patient assessment and exercise prescription. Over the past decade research evidence has accumulated attesting to the safety and efficacy of appropriately designed exercise medicine interventions. Combined with a need for well-developed guidelines, an expert consensus has been developed. Through a rigorous process the overarching recommendation was that exercise professionals should work with the patient and their health care team to balance the risk of adverse events due to participation in exercise therapy against the risk of more rapid patient decline through not exercising, as well as the potential loss of health benefits that could be realized through exercise. This is the basic tenet of health care and withholding or not offering a therapy that is likely to provide greater benefit than the potential risk it may cause for fear of that risk is untenable.