Exercise should now be a part of the standard of care in treating all patients with cancer, according to a new position statement from the Clinical Oncology Society of Australia (COSA), the country’s leading organization for cancer professionals.
Oncologists and other cancer care professionals should discuss exercise as an adjunct treatment with patients, prescribe it routinely, and refer patients to exercise specialists, according to the guidance.
The document was published online in the Medical Journal of Australia and on COSA’s website.
Exercise should “be viewed as an adjunct therapy that helps counteract the adverse effects of cancer and its treatment,” write the statement authors, led by Prue Cormie, PhD, from the Peter MacCallum Cancer Centre at the Royal Melbourne Hospital.
Exercise should be tailored to the individual’s abilities, treatment-related adverse effects, anticipated disease trajectory, and health status, it adds.
“The notion that we must protect a patient, wrap them in cotton wool, is old-fashioned and not supported by the research,” David Speakman, MD, the chief medical officer at the MacCallum Cancer Centre, said in an Australian news report.
“We’re at a point where the level of evidence is really indisputable and withholding exercise is probably harmful,” said Cormie in the same news story.
The new Australian guidance comments that the “strongest evidence” for the use of exercise is in improving physical function (such as aerobic fitness, muscular strength, and functional ability), attenuating cancer-related fatigue, alleviating psychological distress, and improving quality of life.
“Emerging evidence” indicates that regular exercise before, during, and/or after cancer treatment decreases the severity of other adverse side effects (in addition to fatigue and distress) and is associated with reduced risk of developing new cancers, say the guideline authors.
Furthermore, epidemiologic research “suggests” that physical activity protects against cancer recurrence, cancer-specific mortality, and all-cause mortality for some types of cancer. The Australian authors point out that this research is mostly in breast, colorectal, and prostate cancers.
Ongoing clinical trials will more definitively evaluate the effects of exercise on cancer survival.
REFERENCE: Cormie et al: Clinical Oncology Society of Australia position statement on exercise in cancer care; https://www.mja.com.au/journal/2018/209/6/clinical-oncology-society-australia-position-statement-exercise-cancer-care