Twenty-three years ago, I underwent radiation therapy and surgery to treat my cancer. At the time, physical therapy for rehabilitation purposes was not considered an option, neither during nor following treatment. For recent and current cancer patients, however, exercise is becoming a more common element in treatment regimens and rehabilitation plans.
Many people engage in regular exercise as a way of helping to prevent cancer. If the prevention of a first cancer is not an option, as was the case of my childhood diagnosis, then regular exercise can still improve prognosis or even prevent a reoccurrence of a second. Research has demonstrated that during and after standardized treatment, exercise can decrease the chance of developing cancer.
Exercise has been proven to play a role in reducing the risk of breast, colon, prostate, lung, and endometrial cancers.
According to Dr. Daniel Santa Mina, Assistant Professor at the University of Toronto and scientist at the Princess Margaret Cancer Centre, “Exercise, as a therapeutic modality, has established itself in the scientific literature across a broad spectrum of clinical scenarios… Exercise in the post-cardiac injury and diabetes has somewhat paved the way for the examination of exercise in other chronic diseases, like cancer.”
Santa Mina, who has published a number of papers detailing the effects of exercise on chronic disease, adds, “With mounting evidence describing the benefit of exercise across a variety of cancers and treatment settings, clinical care has shifted to adopt recommendations, if not comprehensive programming, for exercise.”
Exercise slows tumour growth, increases treatment effectiveness, and benefits prognosis, but Santa Mina feels there is still a need for more definitive trials within this branch of cancer research. An example of this type of research is a recent article in The Journal of the National Cancer Institute, which assessed tumour growth; delivery of blood to bodily tissues or ‘perfusion’; lack of oxygen or ‘hypoxia’; new blood vessel formation, known as ‘angiogenesis’; and cell death, known as ‘apoptosis’, in two groups of mice implanted with breast cancer cells that were randomly assigned to exercise or sedentary control groups. Quantitative results concluded that exercise significantly reduced tumour growth and hypoxia, and it was associated with an increase in apoptosis, microvessel density, and perfusion.
Furthermore, the efficacy of chemotherapy was evaluated when combined with exercise and shows prolonged growth delay compared to chemotherapy alone. The study suggests that exercise may play a role in cancer treatment when combined with conventional treatments in patients with solid tumours.
Incorporating exercise with conventional treatments into a patient’s treatment plan has been put into practice by facilities such as Wellspring’s Cancer Support Network. Kate Smith, program manager of the four GTA locations and exercise facilitator comments, “There is substantial evidence that exercise can improve physical abilities, balance, activities of daily living (ADLs) performance, self-esteem, and quality of life while decreasing muscle atrophy, risk of osteoporosis or blood clots, anxiety, depression, treatment related side effects, and risk of recurrence. The psychosocial support is also beneficial to patients; to interact with others who are going through a similar experience, they are able to discuss issues and support each other through this difficult time.”
While “research indicates a number of cancers, but not all, are significantly reduced among those with the highest volume of physical activity,” Smith emphasizes the importance of being cautious when beginning a new exercise regime. “We suggest a supervised program like Wellspring’s Cancer Exercise program with health care professionals with expertise in oncological emergencies, side effects of treatment and who can make accommodations for this population.”
The role of exercise in preventative medicine and conventional cancer treatments has progressed greatly. Exercise as a therapeutic strategy to dramatically reduce incidences of cancer may have even more of an impact than what has already been discovered.