Chapter 27: Living with and beyond cancer
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Related theory
Although there is uncertainty regarding the type and quantity of exercise, evidence supports that exercise can be beneficial in improving quality of life after cancer treatment (Mishra et al. [175]). The advantages of physical activity in the short term have also been shown to have enduring long‐term effects after treatment (Mutrie et al. [181]). A review of the evidence to support the role of physical activity at all stages of the cancer care pathway was completed by Macmillan Cancer Support ([164]). The summary of the evidence showed that physical activity can be beneficial in:
- Improving or preventing the decline of physical function without increasing fatigue. Because the majority of cancer therapies have a range of unwanted side‐effects including pain and peripheral neuropathy, cancer patients typically lose cardiovascular fitness, experience fatigue and have a reduced sense of well‐being over the course of their treatment. There has traditionally been an emphasis on the importance of rest and conserving energy which can contribute to a gradual deterioration in function long after treatment has finished. There is good evidence to support the benefit of exercise for cancer fatigue (Cramp and Byron‐Daniel [62]). Although adequate rest is very important during treatment, people should be encouraged to minimize the time that they are inactive and to aim to return to normal activity levels as soon as possible (Chartered Society of Physiotherapy [47], Saxton and Daley [247]).
- Recovering physical function after debilitating treatment. A systematic review of the evidence demonstrates that appropriate levels of exercise during treatment can help to minimize side‐effects and limit functional decline as well as improve psychological well‐being (Macmillan Cancer Support [154]). The evidence also supports the role of exercise after treatment as an effective way to recover physical and mental health (Macmillan Cancer Support [154]). Both anxiety and depression have been shown to be improved by carrying out physical activity.
Emerging evidence supports the role that exercise may play in positively influencing the risk of recurrence for certain cancers (Fong et al. [105], Saxton and Daley [247]). There is also some evidence that it assists in reducing mortality for some cancers as well as reducing the risk of developing other long‐term conditions. The majority of the research regarding the risk of recurrence and mortality is focused on breast cancer and colon cancer[154]. Exercise has also been found to help decrease the rate of cancer progression for men with prostate cancer (Macmillan Cancer Support [154]).
