General Exercise Recommendations for the Cancer Population

General Exercise Recommendations for the Cancer Population
Traditionally, it has been recommended that cancer survivors should rest and avoid strenuous exercise, despite the existence of several guidelines from prestigious international institutions such as the American College of Sports Medicine (ACSM) and the Centers for Disease Control and Prevention promoting exercise in the general population (1). However, these guidelines did not specifically address which exercise was recommended – and which was not – in patients with such particular characteristics as cancer survivors. In 2009 the ACSM organised a meeting attended by experts in the clinical and research fields from around the world to discuss whether these general guidelines (which promoted at least 150 minutes of moderate activity or 75 minutes of vigorous activity per week, and two to three sessions of strengthening and stretching exercises per week) could be applicable to cancer survivors. Therefore, the publication of these guidelines (2) was a first step in the field of physical exercise in cancer survivors, as they highlighted the benefits and safety of exercise in this population, and the need to individualise training depending on the specific characteristics of each survivor.

What do the experts say based on evidence? 
There is robust evidence that exercise can represent an effective co-adjuvant therapy for attenuating cancer-related adverse effects, with international experts endorsing that »people living with and beyond cancer should be as active as is possible for them« (3). These recommendations, published in 2019 in the world's leading journal CA: A Cancer Journal for Clinicians (3), indicate that in cases where the survivors can safely exercise unsupervised, they should receive standardised exercise advice. However, when the oncologist feels that unsupervised exercise may not be safe for the patient, the oncologist should contact qualified exercise professionals to individualise the exercise programme to obtain the greatest possible benefit.

Exercise training is generally safe for cancer survivors. The proposed recommendations should serve as a guide for personal trainers, as a goal to be achieved, never forgetting the importance of the principle of individualisation of training, which will determine how the training should begin to achieve these recommendations. In future articles, we will explain how to work these physical components and what benefits each of them provides. Follow us to stay updated. 

Author: Javier S. Morales, UCA

1. Pate, R. R., Pratt, M., Blair, S. N., et al. (1995). Physical activity and public health: a recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. Jama, 273(5), 402-407. 
2. Schmitz, K. H., Courneya, K. S., Mathews, C., et al. (2010). American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Medicine and Science in Sports and Exercise, 42(7), 1409-26  
3. Schmitz, K. H., Campbell, A. M., Stuiver, M. M., et al. (2019). Exercise is medicine in oncology: engaging clinicians to help patients move through cancer. CA: a cancer journal for clinicians, 69(6), 468-484. 

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