Multinational Consensus Panel Confirms Benefits of Exercise, Updates Recommendations for Cancer Survivors

There is one prescription that is applicable to almost everyone, healthy or not: Exercise. “Use it or lose it,” we say. “Movement is life,” we hear.

Exercise is especially helpful to cancer survivors — a population that is happily ever increasing. There are now more than 15.5 million cancer survivors in this country, and that number continues to rise.¹ However, although the benefits of exercise are becoming increasingly clear, actually putting it into practice can be difficult for someone who is fatigued, older, or returning to work while continuing to cope with their disease as well as comorbidities.

Although in the past cancer patients were advised to rest and remain inactive, that changed in 2010 when guidelines advising the opposite were drawn up by experts in exercise and oncology. At that time, the American College of Sports Medicine (ACSM) met with oncology specialists and concluded that studies of survivors of breast and prostate cancers showed clear benefit from participating in exercise programs. These experts found that such programs improved survivors’ physical functioning and fitness, helped with their cancer-related fatigue, and generally enhanced their quality of life. Those preliminary recommendations have been updated by subsequent research; since then, results of more than 2500 randomized controlled trials on the importance of exercise have been published.

The 2018 ACSM International Multidisciplinary Roundtable on Physical Activity and Cancer Prevention and Control convened international exercise and rehabilitation professionals to update current evidence-based recommendations. Forty representatives from 20 worldwide organizations were in attendance. Their goals were to cover: 1) the role of exercise in cancer prevention and control; 2) the efficacy of exercise to improve cancer-related health outcomes (acute, late, and long-term effects); and 3) the translation of evidence into clinical and community settings. Attendees provided new evidence-based prescriptions for exercise testing and training using the acronym FITT — frequency, intensity, time, type.

The program included safety precautions and other considerations specifically for cancer survivors. The guidelines based each exercise prescription on research that identified the optimal type, intensity, or frequency of exercise, and classified FITT prescriptions based on whether the supporting evidence was strong, moderate, or insufficient.