Hey Georgian Life readers, with summer upon us it’s time to enjoy the sun, go for a walk or hike, or get the bikes out and go for a ride. It’s time to get moving! 

Everyone has heard about the benefits of exercise: the shopping list reads exercise helps fight obesity, protects against cardiovascular issues, improves heart and immune function, helps stabilize diabetes, and reduces depression and anxiety.  Now, developing studies are emerging that suggest exercise is beneficial to people with cancer and recovering from cancer treatment. Dr. Karol Sikora, a British oncologist and leading world authority on cancer, mentions “Exercise as cancer therapy” recently published in CA: A Cancer Journal for Clinicians as one of his top picks for cancer highlights in 2019.

On average, over 600 Canadians are diagnosed with cancer every day!  Even more shocking, two thirds of people living with cancer are completely inactive and give up on exercise.  Dr. Sikora writes, “Cancer patients become overweight, they do less, and this is not good.”

The report, co-authored by a global coalition of 40 leaders from 17 organizations, spearheaded by the American College of Sports Medicine, published exercise recommendations for patients living with and beyond cancer. The report cites peer reviewed evidence from the American Cancer Society, Cancer Care Ontario, and the Clinical Oncology Society of Australia that exercise is associated with a lower risk of developing cancer and improved survival after a cancer diagnosis. In summary, the scientific evidence supports exercise, and clinicians generally agree that patients should be exercising throughout their cancer therapy and survivorship.

The report continues with an outline for clinical oncologists to refer patients into an exercise regime. The authors describe an assess-advise-refer algorithm with two easy questions for the patient: 1. How many days during the past week have you performed physical activity where your heart beats faster and your breathing is harder than normal for 30 minutes or more?  2. How many days during the past week have you performed physical activity to increase muscle strength?  Based on how the questions are answered, the physician can assess if the patient would be safe exercising without medical supervision, and advice the patient into exercise

therapy performing activities such as walking, hiking, cycling and weight lifting or refer the patient to follow up with a rehabilitation healthcare professional for further evaluation.  If you are capable of safe physical exercise without medical supervision, clinicians advise moderate intensity aerobic exercise for up to 30 minutes three times a week and resistance exercise two times a week for 20-30 minutes.

The lead author, Dr. Kathryn Schmitz of Penn State Cancer Institute claims about exercise, “A drug with similar benefit would likely be prescribed broadly.” The author argues, “Exercise prescriptions should now be standard of care for all appropriate oncology patients and physical activity should become a vital sign, similar to blood pressure, recorded at each patient visit.” 

For years, the cardiac community has recognized the benefits of exercise in cardiac rehabilitation.  Cardiac rehabilitation involves improving cardiovascular fitness through physical activity including low impact activities at least three times a week. Cardiac research shows that exercise is as good as many drugs in adjuvant therapy, but although programs exist for networked cardiac rehabilitation the same programs do not exist for cancer patients.

The benefits of exercise from a well-designed exercise plan are able to reduce side effects associated with cancer treatment such as fatigue, neuropathy, osteoporosis and nausea. For cancer survivors, exercise has been shown to decrease the amount of time in hospital, makes treatment more effective at destroying tumor cells thus reducing relative risk of cancer recurrence and mortality.  Importantly for all of us, exercise will keep you independent, mobile and improves quality of life. 

Like I said Georgian Life readers, enjoy the summer, it’s time to get moving!

Submitted by: Dr. Oliver Kent, Scientific Associate and cancer researcher at the Princess Margaret Cancer Centre.

Do you have an idea or question you would like to read about in the Cancer Chat? Email (kent.uhn@gmail.com) or text (416-707-6546) and let me know!