Exercise as a prescription therapy for breast and colon cancer survivors

Giorgio Galanti, Laura Stefani, Gianfranco Gensini, Giorgio Galanti, Laura Stefani, Gianfranco Gensini

Abstract

Breast and colon tumors are the most common types of cancer in the general population. As a result of improved diagnosis and treatment, more people are now surviving cancer. Lifestyle has been identified as one of the potential risk factors for cancer, and it has been demonstrated recently that physical activity reduces the physiological and psychological symptoms and side effects of chemotherapy. Muscular atrophy, weight changes, decreased aerobic capacity, fatigue, and depression are the most common symptoms in cancer patients. The exact amount of moderate to vigorous physical activity needed to overcome these effects has not yet been established, but an individualized and variable exercise program as prescription therapy could be considered a helpful tool for improving quality of life. This paper proposes a model of lifestyle analysis and dedicated individualized exercise programs for the treatment of cancer patients. The program starts with a preliminary evaluation of the patient's lifestyle using a questionnaire and accelerometer, which provides information on the amount of daily physical activity and number of steps taken, as well as an assessment of aerobic capacity, cardiovascular response, muscle strength, and resistance. Two different levels of aerobic exercise, ie, low-to-moderate (40% of maximal heart rate) to moderate (60% of maximal heart rate) can be prescribed. This model of exercise prescription in patients with cancer offers a flexible program for assisting in the management of this complex disease. It is projected to ensure easier management of medical problems related to cancer, and to attract a greater number of participants over time.

Keywords: breast cancer; colon cancer; lifestyle; physical exercise; therapy.

Figures

Figure 1
Figure 1
Questionnaire canvassing daily level of physical activity.
Figure 2
Figure 2
Accelerometer reports from software dedicated to lifestyle analysis.

References

    1. Peel JB, Sui X, Adams SA, Hébert JR, Hardin JW, Blair SN. A prospective study of cardiorespiratory fitness and breast cancer mortality. Med Sci Sports Exerc. 2009;41:742–748.
    1. Schmitz KH, Courneya KS, Matthews C, et al. American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc. 2011;42:1409–1426.
    1. Kraus WE, Torgan CE, Duschan BD, et al. Studies of a targeted risk reduction intervention through defined exercise (STRIDE) Med Sci Sports Exerc. 2001;33:1774–1784.
    1. Hainaut P, Plimoth A. Cancer as metabolic disease. Curr Opin Oncol. 2012;24:56–57.
    1. Burnham TR, Wilcox A. Effects of exercise on physiological and psychological variables in cancer survivors. Med Sci Sports Exerc. 2002;34:1863–1867.
    1. McTiernan A. Mechanisms linking physical activity with cancer. Nat Rev Cancer. 2008;8:205–211.
    1. Dimeo F, Rumberg BG, Keul J. Aerobic exercise as therapy for cancer fatigue. Med Sci Sports Exerc. 1998;30:475–478.
    1. Patterson RE, Flatt SW, Saquib N, et al. Medical comorbidities predict mortality in women with a history of early stage breast cancer. Breast Cancer Res Treat. 2010;122:859–865.
    1. Mock V, Dow KH, Meares CJ, et al. Effects of exercise on fatigue, physical functioning, and emotional distress during radiation therapy for breast cancer. Oncol Nurs Forum. 1997;24:991–1000.
    1. Stout NL, Binkley JM, Schmitz KH, et al. A prospective surveillance model for rehabilitation for women with breast cancer. Cancer. 2012;15:2191–2200.
    1. Schwartz AL, Mori M, Gao R, Nail LM, King ME. Exercise reduces daily fatigue in women with breast cancer receiving chemotherapy. Med Sci Sports Exerc. 2001;33:718–723.
    1. Campbell KL, Neil SE, Winters-Stone KM. Review of exercise studies in breast cancer survivors: attention to principles of exercise training. Br J Sports Med. 2012;46:909–916.
    1. Haskell WL, Lee MI, Pate RR, et al. Physical Activity and Public Health: Updated Recommendation for Adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc. 2007
    1. Courneya KS. Exercise in cancer survivors: an overview of research. Med Sci Sports Exerc. 2003;35:1846–1852.
    1. American College of Sports Medicine . Guidelines for Exercise Testing and Prescription. 8th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2010.
    1. Galvão DA, Newton RU. Review of exercise intervention studies in cancer patients. J Clin Oncol. 2005;23:899–909.
    1. Speck RM, Courneya KS, Mâsse LC, Duval S, Schmitz KH. An update controlled physical activity trials in cancer survivors: a systematic review and meta analysis. J Cancer Surviv. 2010;4:87–100.
    1. Maone A, Stefani L, Mascherini G, Galanti G. La prescrizione dell’esercizio fisico esperienza di un modello applicativo per la popolazione generale. [A model of exercise as prescription for the general population] Medicina Dello Sport. 2011;64:351–364. Italian.
    1. Coates AS, Fischer-Dillenbeck C, McNeil DR, et al. On the receiving end II. Linear analogue self-assessment (LASA) in evaluation of aspects of the quality of life of cancer patients receiving therapy. Eur J Clin Oncol. 1983;19:1633–1637.
    1. American Thoracic Society Statement Guidelines for the Six-Minute Walk Test. Am J Respir Crit Care Med. 2002;166:111–117.
    1. Reis JP, Dubose KD, Ainsworth BE, Macera CA, Yore MM. Reliability and validity of the occupational physical activity questionnaire. Med Sci Sports Exerc. 2005;37:2075–2083.
    1. Schag CC, Heinrich RL, Ganz PA. Karnofsky performance status revisited: reliability, validity, and guidelines. J Clin Oncology. 1984;2:187–193.
    1. Pollock ML, Gaesser GA, Butcher JD, et al. ACSM position stand: The Recommended Quantity and Quality of Exercise for Developing and Maintaining Fitness in Healthy Adults Department of Health and Human Services. Physical Activity Guidelines for Americans Washington, DC: ODPHP Publication No U0036; Available from: Accessed March 12, 2013
    1. Hsieh CC, Sprod LK, Carter SD, Hayward R, Schneider CM. Effects of treatment regimen on muscular fitness and quality of life in breast cancer survivors. Med Sci Sports Exerc. 2009;41:162.
    1. Garber CE, Blissmer B, Deschenes MR, et al. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Position stand. Med Sci Sports Exerc. 2011;43:1334–1359.
    1. Robertson RJ, Goss LF, Dubè J, et al. Validation of the adult OMNI scale of perceived exertion for cycle ergometer exercise. Med Sci Sports Exerc. 2004;36:102–108.
    1. Hollen PJ, Gralla RJ. Measurement of quality of life in patients with lung cancer in multicenter trials of new therapies. Cancer. 1994;73:2087–2098.
    1. Swank AM. Exercise Physiology: Human Bioenergetics and its Application. Med Sci Sports Exerc. (2nd ed) 1996;28:1442–1443.
    1. Schmitz KH, Courneya KS, Matthews C, et al. American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc. 2011;42:1409–1426.
    1. Owen N, Healy GN, Matthews CE, Dunstan DW. Too much sitting: the population health science of sedentary behaviour. Exerc Sport Sci Rev. 2010;38:105–113.
    1. Gupta D, Lis GC, Dahlk SL, et al. The relationship between bioelectrical impedance phase angle and subjective global assessment in advanced colorectal cancer. Nutr J. 2008;7:19.
    1. Jones CJ, Rikli RE, Max J, Noffal G. The reliability and validity of a chair sit-and-reach test as a measure of hamstring flexibility in older adults. Res Q Exerc Sport. 1998;69:338–343.

Source: PubMed

3
購読する