What are the ACS guidelines for exercise in cancer survivors?

Updated: Feb 28, 2018
  • Author: Winston W Tan, MD, FACP; more...
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The ACS exercise recommendations are as follows:

  • Exercise is safe and feasible during cancer treatment and may improve physical functioning, fatigue, and multiple aspects of quality of life

  • The decision regarding when to initiate and how to maintain physical activity should be individualized to the patient's condition and personal preferences

  • Persons receiving chemotherapy and/or radiation therapy who are already on an exercise program may need to exercise at a lower intensity and/or for a shorter duration during their treatment

  • For those who were sedentary before diagnosis, low-intensity activities such as stretching and brief, slow walks should be adopted and slowly advanced

  • For older individuals and those with bone metastases or osteoporosis, or significant impairments such as arthritis or peripheral neuropathy, careful attention should be given to balance and safety to reduce the risk of falls and injuries

  • Physical therapy during bed rest is advisable to maintain strength and range of motion and can help to counteract fatigue and depression

Long-term disease-free living or stable disease

The ACS recommendations are as follows [19] :

  • Achieve and maintain a healthy weight

  • Engage in regular physical activity

  • Avoid inactivity and return to normal daily activities as soon as possible following diagnosis

  • Aim to exercise at least 150 minutes per week

  • Include strength-training exercises at least 2 days per week

  • Achieve a dietary pattern that is high in vegetables, fruits, and whole grains

Physical activity in cancer survivors

Despite the many benefits of exercise for cancer survivors, the effects of treatment may also increase the risk of exercise-related injuries and adverse effects. Therefore, specific precautions may be advisable, including the following [19] :

  • Survivors with severe anemia should delay exercise until the anemia improves

  • Survivors with compromised immune function should avoid public gyms and public pools until their white blood cell counts return to safe levels; survivors who have completed a bone marrow transplant are advised to avoid such exposures for 1 year after transplantation

  • Survivors experiencing severe fatigue from their therapy may be encouraged to do 10 minutes of light exercises daily

  • Survivors undergoing radiation therapy should avoid chlorine exposure to irradiated skin (eg, from swimming pools)

  • Survivors with indwelling catheters or feeding tubes should avoid microbial exposures (eg, pool, lake, or ocean water), as well as resistance training of muscles in the area of the catheter to avoid dislodgment

  • Survivors with peripheral neuropathies or ataxia may have a reduced ability to use the affected limbs because of weakness or loss of balance; use of a stationary reclining bicycle may be an alternative to walking on a treadmill

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