Clinicians should prescribe physical exercise to patients with cancer, according to new guidelines established by exercise oncology experts that were published in CA: A Cancer Journal for Clinicians.The authors also published a consensus statement on exercise guidelines for cancer survivors in the journal Medicine & Science in Sports & Medicine.
Exercise can prevent and ameliorate fatigue, depression, anxiety and quality of life. But most people living with cancer, and most cancer survivors, are not physically active on a regular basis, the authors noted. The evidence base is now sufficiently mature to allow specific exercise prescriptions, including frequency, intensity, and duration, to patients as treatment for quality of life, fatigue, and pain, Schmitz said.
“With more than 43 million cancer survivors worldwide, we have a growing need to address the unique health issues facing people living with and beyond cancer,” reported study author Kathryn Schmitz, PhD, MPH, of the Department of Public Health Sciences at the Penn State College of Medicine in Hershey, Pennsylvania, in a press release. “For example, if we’re seeing a head and neck cancer patient with a specific set of symptoms, we could give them an exercise prescription personalized to them.”
One reason patients with cancer don’t exercise is a “lack of clarity” on exercise’s benefits by clinicians. The authors proposed use of the American College of Sports Medicine's “Exercise Is Medicine” initiative recommendations to close that information gap, including assessment, advisement, and referral to route patients to home–or community–based exercise or outpatient rehabilitation programs. Reviewing the evidence base and existing exercise guidelines, the authors also called for the development of clinical “infrastructure and cultural adaptations” to encourage patients with cancer and cancer survivors to engage in regular physical exercise.
Implementation involves challenges, including the need for program registries and compensation for triage, referral, and exercise programs. Patients should be assessed for physical activity levels at regular intervals, the authors recommended. Then patients should be advised that “moving matters” and told how their current level of exercise compares to evidence-based goals. Patients should be referred to exercise programs or to other health care professionals for evaluation and referral to such programs.
The Moving Through Cancer website includes an exercise program registry with which clinicians and patients can identify local resources, Schmitz noted.