The evidence for Health professionals

The ageing of the population, coupled with substantial improvements in the early detection and treatment of cancer mean that the number of cancer survivors will continue to grow: currently 2% of men and 2.7% of women in the UK are living with cancer.1  As a consequence, attention to long-term aspects of quality of life including physical and psychological functioning will become an important feature of ongoing cancer care for cancer survivors.2

Studies have shown that physical activity levels tend to reduce significantly after cancer diagnosis and remain low for many years after treatment is completed.3 From this low baseline there is great scope for exercise interventions to improve the health and well-being of patients with cancer.  Cancer diagnosis can signal a “teachable moment” with patients often demonstrating an enhanced motivation to change lifestyle behaviours, especially within the year after diagnosis.4

During cancer treatment and rehabilitation, 'rest is best' has been the traditional approach. However, it has been shown that low levels of physical activity in patients with cancer result in further de-conditioning and symptoms of fatigue, loss of functional capacity and reductions in quality of life.5 6 Inactive patients with cancer may also be at higher risk of secondary tumours and a recent study of breast cancer and colorectal cancer survivors has indicated a 50% risk reduction in mortality among those who are regularly active when compared to those who had a sedentary lifestyle. 7 8

More and more evidence points to the fact that even moderate exercise can have very positive results for people with cancer. A systematic review of 33 controlled trials (25 randomised) concluded that exercise interventions during and after cancer treatment can lead to moderate increases in physical function with no evidence of increased symptoms of fatigue or other adverse effects.9 Several other recent reviews also concluded that exercise has a large potential to improve both physical and psycho-social aspects of quality of life in patients with cancer during and after treatment. 10-13

Current guidelines for exercise during and after cancer treatment are being developed with studies analysing different types and intensities of exercise. What appears to be beneficial and without adverse effects is accumulating 30 minutes of moderate intensity exercise at least five times a week. 14-16

The 30 minutes can be divided into smaller 10 minute sessions and can include activities as simple as brisk walking, cycling, gardening, active housework, and taking the stairs instead of elevators.

Focus group studies have also found that exercise has strong psychosocial benefits for cancer patients. 17 As Dr Vicki Conn a leading researcher in the US states in Journal of Clinical Oncology, June 2006 "Exercise also has been shown to give patients the sense that cancer treatment isn't just about surgery, drugs and radiation. It gives them a sense that they can do something for themselves and for some people that is tremendously important".