About us News Can I exercise during treatment? This month we were delighted to talk to Tom Cowan about physical activity and cancer. Tom is an Exercise Physiologist and Level 4 Cancer Rehabilitation trainer. At the world-leading The Centre for Health and Human Performance (which is a world-leading Harley Street clinic), he works with patients to support them to get active during and after cancer. Tom’s work has been recognised by The Faculty of Sport and Exercise Medicine UK and also Public Health England, who selected him to become a member of their expert panel for their Cancer and Exercise Moving Medicine project. “Fatigue is one of the most commonly reported side effects of treatment and is likely to make you feel reluctant to exercise, but in fact exercise can help to combat fatigue and in the USA, the National Comprehensive Cancer Network recommends exercise as the number one approach for managing cancer-related fatigue” What are the benefits of exercising during treatment? There is a growing body of evidence and awareness of both the physiological and psychological benefits of exercise for patients during treatment and post-treatment. A review by Cormie et al. (2017) (1) suggested that following cancer diagnosis, superior levels of exercise were associated with a 28-44% reduced risk of cancer-specific mortality, 21-35% lower risk of cancer recurrence and a 25-48% decreased risk of all-cause mortality. Exercise can also greatly help to reduce the severity and occurrence of treatment side effects. Fatigue is one of the most commonly reported side-effects of treatment and is likely to make you feel reluctant to exercise but in fact, exercise can help to combat fatigue and in the USA, the National Comprehensive Cancer Network recommends exercise as the number one approach for managing cancer-related fatigue. There are also many psychological benefits to be had from being physically active including helping to combat anxiety and depression and improving quality of life. In summary, exercise is considered to have benefits for both the quantity and quality of life of patients. What should patients consider to ensure they are exercising safely? The key is to manage your exercise intensity and volume according to your current health and fitness status and fatigue/energy levels and also to adapt exercise appropriately to your type of cancer, treatment and side-effects. Moderate intensity exercise is generally recommended and this has the benefit of optimising immune function, which may be compromised by cancer treatments such as chemotherapy, which kill fast dividing immune cells. It is therefore important to avoid overtraining, which can suppress your immune system further. If immune function can be maintained throughout treatment then you are more likely to be able to finish your full course of treatment and help to improve its efficacy. Being active can also help you to maintain a healthy weight and improve your sleep. What types of exercise would you recommend generally? Cardiovascular exercise such as jogging, walking, cycling or swimming is recommended to be included within your exercise regime for its benefits to heart function and cardiorespiratory health and fitness. Patients can be at an increased risk of cardiovascular disease following treatment and in fact cardiovascular disease has been cited as the lead cause of death in prostate cancer patients, so it is important to be physically active to reduce your risk. Strength training also has several benefits, as it helps to not only to develop muscle mass, which is positively associated with better outcomes and improves your body composition but it also helps to maintain muscle strength and function, so that you can continue performing everyday activities. Strength training also helps to improve bone mineral density which is particularly important if you are undergoing hormone therapy which may reduce your bone strength, increasing your risk of fractures. Are there any specific types of exercise you would recommend for certain types of cancer? Specific exercises can be beneficial for patients of a particular cancer type or treatment. For example, pelvic floor strengthening exercises can help to reduce the risk of incontinence for prostatectomy patients, whilst breast cancer patients who have had a mastectomy can perform shoulder specific mobility exercises post-surgery to help to regain full range of motion and function quicker. Patients who are at an increased risk of lymphoedema can perform rhythmical arm movements to encourage the flow of lymph and reduce their risk of developing lymphoedema. Thank you so much for talking to us Tom, and for your great advice on exercising safely during treatment. It is always recommended that you seek the advice of a qualified exercise professional when undertaking an exercise programme as there are many individual factors that need to be considered to ensure that you are training safely and effectively for your condition. Want help to get active and help improve your symptoms and chronic fatigue levels? We're here to help you do just that. Head to our page on physical activity to check out our online exercise and yoga classes to do in the comfort of your own home.