Exercise Oncology: How Structured Workouts Help Fight Cancer with APA References
- ruqaiyahlakdawala2
- 2 hours ago
- 4 min read
Cancer treatment is no longer limited to surgery, radiation, chemotherapy, immunotherapy, and targeted drugs. A growing field called exercise oncology studies how structured physical activity can improve treatment tolerance, reduce complications, and possibly influence tumor biology itself.
This does not mean exercise replaces medical treatment. It means prescribed movement may act as a supportive anti-cancer therapy when matched to the person, cancer type, treatment phase, and clinical risks. This article is informational only and should not replace guidance from an oncology care team.
Why structured workouts matter in cancer care
Cancer cachexia and treatments can lead to loss of muscle mass, aerobic capacity, balance, sleep, and confidence in movement capacity. Fatigue is one of the most debilitating symptoms of treatment with very limited benefit from rest.
Evidence is emerging about the benefits on cancer care patients of prescribing exercise as a therapy and it has been associated with:
Reduction in cancer related fatigue
Maintenance of strength
Improvement in mood and sleep
Cardiovascular benefits
Potential for allowing some patients to continue treatment with less treatment interruptions
The most effective protocols have been structured programs that specify what exercises are done with targets set for frequency intensity progression. For most people this likely to include a combination of:
Aerobic activities
Resistance (strength) training
Balance and mobility
Resistance training is critical in preserving strength
How exercise may impact oncology through mechanisms of action
The caveat is in thinking about exercise as a direct anti-cancer therapy. There is limited direct evidence in humans, but there is indirect evidence from cell cultures animal studies and human clinical trials that suggest that exercise can impact several mechanisms that are relevant to cancer.
These include:
Immune surveillance – Exercise increases the circulation of immune cells, which can be critical for identifying and responding to malignant cells. This has potential implications for both immunotherapy and natural anti-cancer defenses. In fact, some studies suggest that acute exercise can even mobilize natural killer cells.
Inflammation and insulin resistance – Exercise lowers markers of inflammation and improves insulin sensitivity throughout the body. Chronic inflammation and insulin resistance are linked to poorer outcomes for some cancers.
Blood flow – Exercise may improve vascular function, which can have implications for the delivery of cancer drugs.
Body composition – Changes in body composition, including the loss of muscle and gain of fat, are associated with increased cancer risk and poorer prognosis. Maintaining muscle is critical since it is metabolically active and impacts the overall physiology.
Aerobic exercise can be individually prescribed with specific clinical targets in mind
What a cancer exercise prescription can entail
A cancer-specific exercise prescription should begin with a discussion with the treating physicians about the contraindications that may need to be taken into account. These can include bone metastases, anemia, peripheral neuropathy, cardiotoxicity, infections, surgical risks, and lymphedema. The oncology exercise specialist will individualize a prescription based on these risks.
It can include:
Aerobic exercise prescription – An aerobic activity like walking or cycling is generally recommended and can be dosed in frequency, intensity, time and volume based on individual needs.
Resistance training prescription – Resistance training can be individually prescribed targeting the major muscle groups and progressing the intensity slowly. It is critical to maintain muscle mass and strength during treatment.
Mobility and balance training – This can be critical for patients undergoing surgery, dealing with neuropathy or other mobility issues or simply being deconditioned for various reasons.
Most guidelines now recommend aiming for at least weekly moderate intensity aerobic and strength training with higher frequency and intensity as tolerated but without causing further fatigue. Dose is critical and the prescription should start conservatively.
Mobility and balance training can be added as needed.
The practical take home
Exercise oncology is about turning the philosophy from “what should the patient not do” to “what should the patient do”. Structured programs can be helpful for most cancer patients to maximize function and tolerance of treatment and improve quality of life. There is also preliminary evidence of anti-cancer effects of exercise through potential mechanisms of action. The most appropriate way to proceed is to design an individualized plan with the treating team and a cancer exercise specialist to determine what the right exercise is for each individual case.
References
Campbell, K. L., Winters-Stone, K. M., Wiskemann, J., May, A. M., Schwartz, A. L., Courneya, K. S., Zucker, D. S., Matthews, C. E., Ligibel, J. A., Gerber, L. H., Morris, G. S., Patel, A. V., Hue, T. F., Perna, F. M., & Schmitz, K. H. (2019). Exercise guidelines for cancer survivors: Consensus statement from international multidisciplinary roundtable. Medicine & Science in Sports & Exercise, 51(11), 2375–2390.
Cormie, P., Zopf, E. M., Zhang, X., & Schmitz, K. H. (2017). The impact of exercise on cancer mortality, recurrence, and treatment-related adverse effects. Epidemiologic Reviews, 39(1), 71–92.
Hojman, P., Gehl, J., Christensen, J. F., & Pedersen, B. K. (2018). Molecular mechanisms linking exercise to cancer prevention and treatment. Cell Metabolism, 27(1), 10–21.
Schmitz, K. H., Campbell, A. M., Stuiver, M. M., Pinto, B. M., Schwartz, A. L., Morris, G. S., Ligibel, J. A., Cheville, A., Galvão, D. A., Alfano, C. M., Patel, A. V., Hue, T., Gerber, L. H., & Sallis, R. (2019). Exercise is medicine in oncology: Engaging clinicians to help patients move through cancer. CA: A Cancer Journal for Clinicians, 69(6), 468–484.
