Expert Panel: Cancer Treatment Plans Should Include Tailored Exercise Prescriptions
Individualised exercise prescription can improve survival and side effects, lower risks


New guidance published today from exercise oncology experts recommend systematic use of an “exercise prescription” by health care workers and exercise professionals in designing and delivering exercise programs that aim to lower the risk of developing certain cancers and best meet the needs, preferences and abilities of people with cancer.

The American College of Sports Medicine (ACSM) convened a roundtable of experts from 17 partner organisations, which included Exercise & Sports Science Australia (ESSA), the American Cancer Society and the National Cancer Institute—part of the National Institutes of Health, to review the latest scientific evidence and offer recommendations about the benefits of exercise for prevention, treatment, recovery and improved survival. 

“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 and better understand how exercise may help prevent and control cancer,” said ACSM Immediate Past President Katie Schmitz, Ph.D., FACSM, who co-chaired the roundtable.

“This esteemed, multidisciplinary group of leaders on the forefront of exercise oncology aimed to translate the latest scientific evidence into practical recommendations for clinicians and the public and to create global impact through a unified voice.”

Professor Sandra Hayes, Senior Research Fellow, Menzies Health Institute Queensland, Griffith University, who was one of the experts on the roundtable echoed these sentiments.

“The importance of including exercise as treatment for cancer can no longer be ignored – it is fundamental to ensuring people live as well as possible during and beyond their treatment, and potentially live longer. The ESSA and ACSM cancer position statements provide the necessary tools to ensure Australian allied health professionals can prescribe appropriate, targeted exercise to ensure maximum benefit.”

Director of the Exercise Medicine Research Institute at Edith Cowan University and co-author of the ACSM guidelines Professor Daniel Galvão said, “There has been an important evolution in exercise guidelines for cancer patients – from patients being recommended to rest by their clinician, to today being prescribed targeted exercise. The new ACSM guidelines aligns with the recent ESSA exercise in cancer management guidelines by providing Accredited Exercise Physiologists (AEPs) and clinicians a comprehensive framework to tailor exercise prescription to patients’ needs and priorities.”

“The evidence is clear, exercise is medicine and is an essential part of prevention and management of cancer. Accredited Exercise Physiologists (AEPs) remain best-placed to prescribe targeted exercise advice and we will continue to promote their role in the healthcare system,” says Anita Hobson-Powell, Exercise & Sports Science Australia (ESSA) CEO.

The new evidenced-based guidance and recommendations include:

  • For all adults, exercise is important for cancer prevention and specifically lowers risk of seven common types of cancer: colon, breast, endometrial, kidney, bladder, esophagus and stomach
  • For cancer survivors, incorporate exercise to help improve survival after a diagnosis of breast, colon and prostate cancer
  • Exercising during and after cancer treatment improves fatigue, anxiety, depression, physical function, quality of life and does not exacerbate lymphedema
  • Continue research that will drive the integration of exercise into the standard of care for cancer
  • Translate into practice the increasingly robust evidence base about the positive effects of exercise for cancer patients

The comprehensive review and recommendations are outlined in three academic papers published today in two scientific journals. “Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable ” and “American College of Sports Medicine Roundtable Report on Physical Activity, Sedentary Behavior, and Cancer Prevention and Control ” published in Medicine & Science in Sports & Exercise®, ACSM’s flagship research journal. The third paper, “Exercise Is Medicine in Oncology: Engaging Clinicians to Help Patients Move Through Cancer ,” was published in CA: A Cancer Journal for Clinicians, a flagship journal of the American Cancer Society.

Health care and fitness professionals should use the new recommendations when creating exercise programs for cancer patients and survivors. This includes formally and systematically using custom exercise prescriptions that best meet the needs, preferences and abilities of individuals living with and beyond cancer. Fitness professionals can obtain the Cancer Exercise Trainer certification collaboratively developed by ACSM and the American Cancer Society. Additionally, professionals and scientists should continue research that will drive the integration of exercise into the standard of care for cancer.

To implement the recommendation for translating evidence into practice, ACSM and its Exercise is Medicine (EIM) initiative also introduced a new program, Moving Through Cancer. The clinician-focused program aims to ensure that all people living with and beyond cancer are assessed, advised, referred to and engaged in appropriate exercise and rehabilitation programming as a standard of care. Resources are available for oncology clinicians and patients, including a global, searchable registry of exercise programs at www.exerciseismedicine.org/movingthroughcancer .

Partner organisations that participated in the roundtable include: ACSM, American Cancer Society, the National Cancer Institute—part of the National Institutes of Health,  American Academy of Physical Medicine and Rehabilitation, American College of Lifestyle Medicine, American Physical Therapy Association, American Society of Clinical Oncology, Canadian Society of Exercise Physiology, Centers for Disease Control and Prevention, Commission on Accreditation for Rehabilitation Facilities, German Union for Health Exercise, Exercise & Sports Science Australia, Macmillan Cancer Support, National Comprehensive Cancer Network, Royal Dutch Society for Physical Therapy, Society of Surgical Oncology and Sunflower Wellness.

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