Physical Activity

Older patients with cancer remain relatively underrepresented in clinical trials in general, let alone in trials examining exercise and its effects. However, a review of the literature did support that older patients who have higher levels of physical activity during their cancer treatment reported lower levels of fatigue, higher levels of functioning, and higher quality-of-life (QOL) evaluations both during and after their treatment.
The first real research linking exercise to improved quality of life (QOL) and management of fatigue was done by Winningham, MacVicar, and Burke (1986) with a population of patients with breast cancer during a time in medical thinking when the typical recommendation for patients with cancer was increased rest. During the 1980s, more than 40 studies demonstrated that physical activity in patients with cancer improves their functioning and QOL (Young-McCaughan et al., 2003). Winningham and colleagues published guidelines for exercise use in the cancer population.
Evidence is strong that exercise in general promotes and enhances health (Fentem, 1994). Additional studies support the concept that exercise may play a protective role in the development of cancer in some populations. Researchers have found that strenuous exercise more than five hours per week lowered the risk of invasive breast cancer, particularly of estrogen receptor–negative invasive breast cancer, when compared with less activity. These findings were supported even as other cancer risks were controlled for in the study population (National Cancer Institute, 2007).
Specific, well-designed goals of an exercise program should drive the interventions, because specific interventions will likely produce specific outcomes. The most common types of exercise are aerobic, strength training, and flexibility regimens. However, given the heterogeneity of cancer types, a one-size-fits-all approach to exercise and cancer is unlikely to be effective. For example, for patients in whom cardiac output may have been compromised, a carefully planned exercise program with the goal of improving cardio-respiratory fitness may be in order.
Specific Effects of Aerobic Exercise Studies of aerobic exercise regimens ranging from supervised treadmill tests to stationary bike programs three times a week for 10–12 weeks showed that participants experienced (Visovsky & Dvorak, 2005)
Although more than one definition can be found, quality of life (QOL) is often defined as a state of well-being in which an individual can perform daily activities, combined with satisfaction with the levels of functioning and control of the disease and/or its symptoms (Hacker, 2009). Key to this definition is patients’ perception of their own QOL versus healthcare providers’ impression of it.
Side effects from cancer treatment can greatly affect the quality of life for many patients. Among the many troubling side effects, patients often describe loss of functional capacity and fatigue as some of the most debilitating (Hanna, Avila, Meteer, Nicholas, & Kaminsky, 2008). Research has found, however, that exercise has proven to be an effective management tool. What Is Important About Exercise and Its Relationship to Cancer?