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Cancer survivors – of which there are more and more, thanks to improvements in screening and treatment – still have big hurdles to face.
Not only the effects of the disease itself, but also the treatments, frequently leave patients with unwanted side effects that impact on their quality of life.These include changes in physical body composition, loss of muscle tone and strength, fatigue, nausea and depression. Commonly patients also report reduced sleep, poor posture, decreased energy levels, decreased range of motion in their joints, reduced fitness and decreased overall body confidence.
A large body of research exists showing the positive effects of exercise and physical activity in cancer survivors, in terms of reducing those side effects and improving a patient’s ability to function and quality of life, regardless of the stage or prognosis of the cancer. There is also evidence that exercise may have a positive impact on survival rates and cancer recurrence in those suffering from breast, prostate and colorectal cancer. Health professionals involved in the care of cancer patients generally have a good understanding of the positive effects of exercise. But information about exercise is often not given out in the early stages of cancer care. Recommendations often remain quite generalised – such as advice to “stay active”, but with no guidelines about what this actually means. The ball is largely passed to physiotherapists who have specific training in exercise and physical rehabilitation post-cancer diagnosis.
The type of exercise involved depends on the individual – it is often a combination of fitness work such as walking, core stability strengthening work, light weights for muscle toning, and stretches for regaining joint movement. A number of the women we see following a mastectomy have very limited shoulder movement – so a combination of stretches and hands-on work, followed by strengthening and stability exercise for the shoulder is a typical treatment regime. For men who have had prostate surgery, pelvic floor and abdominal strengthening exercises, in combination with cardio work and general muscle toning is a common exercise regime prescribed.
Independent analysis of one of the cancer rehabilitation programmes offered by physiotherapists found that participants report increased cardiovascular fitness, strength and decreased fatigue. Notably, the biggest reported improvement was in areas of psychological well-being.
