Exercise Guidelines

Exercise Guidelines; A decade old treatment recommendation for people with cancer to take a “slowly slowly” approach to exercise has been replaced with new guidelines recommending a personalised exercise program including high-intensity workouts to achieve the best treatment outcome.

Led by QUT Research Fellow Professor Sandi Hayes, researchers from QUT and Edith Cowan University (ECU) have just published the Exercise and Sports Science Australia’s (ESSA) Position Statement on Exercise Medicine in Cancer Management in the Journal of Science and Medicine in Sport.

Best advice for people

Professor Hayes said ten years ago, in the ESSA’s first position statement on the topic, 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.

Professor Hayes said the research that had emerged since the release of the first position statement demonstrate 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. One of the key changes in the new recommendations is that the guidelines no longer; so have a generic exercise program recommendation of a specify number of workouts a week.

Research in this space has exponentially grown and consequently; so the update position stand now provides the foundation for Accredited Exercise Physiologists; so to ensure their exercise prescription is target towards improving cancer outcomes, Professor Hayes said. While for the majority of cancer patients, moderate to high intensity exercise will likely be appropriate; there is no set prescription and total weekly dosage that be consider evidence based for all cancer patients.

Optimising patient outcomes

Precision medicine is about optimising patient outcomes. This position statement allows for precision medicine through exercise. Director of ECU’s Exercise Medicine Research Institute and co author of the statement Professor Daniel Galvão said: No one cancer patient is the same as another. Therefore, there is no ‘one size fits all’ exercise prescription.

The type, duration, frequency, intensity and total volume of exercise prescription; which needs to be tailor to the patient’s needs and priorities, Professor Galvão said. This position statement uses evidence, alongside best practice; so 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 advance stage disease; hence a starting exercise prescription may need to involve multiple short bouts of five to ten minutes; so to accumulate at least 20 minutes on any given day. As exercise capacity improves; hence progression towards longer sessions of at least 20 minutes duration on most days of the week is recommended.