This is an important topic that needs a lot more attention because cancer patients and clinicians, myself included (with a thyroid cancer history), often are only focused on using medications and nutrition therapy to help manage cancer disease and treatment-induced side effects and symptoms. Additionally, various reported barriers make it extra challenging to convince patients to participate in physical activities. These barriers include financial difficulties, time constraints, psychological challenges, fatigue, the fear of pain and fatigue due to movements, and the belief that cancer care requires rest rather than exercise.
There is a long list of cancer symptoms and treatment-induced side effects. Exercise programs can be personalized based on each patient’s unique situation. Here are a few examples of how physical activity impacts symptom management and cancer outcomes: (Ferioli et al., 2018)
Bone loss and bone disease: Both cancer metastasis and cancer treatment can cause bone loss. Metastatic lesions can cause increased bone resorption, increased bone formation, or both. Many studies have shown that combined aerobic and resistance training programs improved bone density in the spine, hip, and whole body. Physical exercise is essential in reducing bone loss and preventing fracture risk in cancer patients.
Muscle loss and weight imbalance: Cancer patients often experience muscular mass, fat mass, and weight changes due to cancer and/or treatment. Increased fat mass and obesity are significantly associated with increased cardio-metabolic disease risk and cancer mortality while reducing muscular mass could promote cachexia. Resistance/strength training causes an increased synthesis of actin and myosin, reducing muscle weakness and fat mass and improving muscle mass and strength. Furthermore, movement can enhance cardiorespiratory function by lowering blood pressure and the metabolic process by improving insulin sensitivity, glycemic control, and blood lipid levels, reducing cancer comorbidities.
Chemotherapy-induced peripheral neuropathy (CIPN): CIPN prevalence is high in cancer patients due to chemotherapy’s toxic effect and the lack of protection of the peripheral nervous system. Cancer patients suffering from CIPN are at risk of postural instability. Exercise can increase muscular strength and reduce progressive muscle mass atrophy. It’s also associated with improved muscle reinnervation and increased axon regeneration. Exercise, especially strength and balance training, is potentially effective in reducing the neurotoxic effects of chemotherapy.
Fatigue: The systemic inflammation in cancer patients derives from cancer and related treatments due to metabolic imbalance, dysregulated immune system, and increased inflammatory cytokines. About 70-80% of patients experience fatigue during treatments, but about one-third of survivors still suffer fatigue after cancer treatment. Studies show that physical activity alone or combined with alternative approaches, such as yoga, produced positive results in cancer patients and is a feasible, safe, and effective strategy to manage chronic fatigue.
Jenny Noland, MS, CNS, CNGS, CKNS, LDN, MBA
Functional Nutritionist in Eugene, Oregon
Board-Certified Nutrition Specialist
Board-Certified Nutritional Genomics Specialist
Board-Certified Ketogenic Nutrition Specialist
Certified Oncology Nutrition Specialist
Personalized Nutrition Therapy for Metabolic Dysfunction and Cancer Care
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Ferioli, M., Zauli, G., Martelli, A. M., Vitale, M., McCubrey, J. A., Ultimo, S., Capitani, S., & Neri, L. M. (2018). Impact of physical exercise in cancer survivors during and after antineoplastic treatments. Oncotarget, 9(17), 14005. https://doi.org/10.18632/ONCOTARGET.24456