New guidelines recommend personalized exercise for cancer patients

Exercise guidelines for cancer patients have historically recommended patients take it slow, but a new position statement suggests a personalized exercise program including high-intensity workouts will achieve the best treatment outcome, according to a new position statement published in the Journal of Science and Medicine in Sport.

Previously, the best advice for people with cancer was to follow a generic exercise program of low to moderate intensity, with three to five sessions per week including aerobic, resistance or a mixture of both. But in the past decade, new evidence challenges this advice, according to researchers at the Queensland University of Technology in Brisbane, Australia, who drafted the paper.

Research that has emerged since the release of the first position statement demonstrated the benefit to cancer outcomes, including specific treatment-related side effects, such as lymphoedema and fatigue, which could be achieved with a targeted approach to exercise prescription.

The type, duration, frequency, intensity, and total volume of exercise prescription needs to be tailored to the patient's needs and priorities, researchers say, as no one cancer patient is the same as another. The position statement uses evidence, alongside best practice, to determine who needs what type, intensity, frequency, and duration of exercise and when.

For example, for patients with a low level of fitness, or those with advanced stage disease, a starting exercise prescription may need to involve multiple short bouts of five to ten minutes, to accumulate at least 20 minutes on any given day. As exercise capacity improves, progression towards longer sessions of at least 20 minutes duration on most days of the week is recommended, researchers say.

One of the key changes in the new recommendations is that the guidelines no longer have a generic exercise program recommendation of a specified number of workouts a week. While for many cancer patients, moderate to high intensity exercise will likely be appropriate, there is no set prescription and total weekly dosage that would be considered evidence-based for all cancer patients, said Sandi Hayes, research fellow professor and lead author.

“Precision medicine is about optimizing patient outcomes,” said Hayes. “This position statement allows for precision medicine through exercise."