American College of Sports Medicine Roundtable on Exercise Guidelines for Cancer Survivors

Medicine and science in sports and exercise (Impact Factor: 3.98). 07/2010; 42(7):1409-26. DOI: 10.1249/MSS.0b013e3181e0c112
Source: PubMed


Early detection and improved treatments for cancer have resulted in roughly 12 million survivors alive in the United States today. This growing population faces unique challenges from their disease and treatments, including risk for recurrent cancer, other chronic diseases, and persistent adverse effects on physical functioning and quality of life. Historically, clinicians advised cancer patients to rest and to avoid activity; however, emerging research on exercise has challenged this recommendation. To this end, a roundtable was convened by American College of Sports Medicine to distill the literature on the safety and efficacy of exercise training during and after adjuvant cancer therapy and to provide guidelines. The roundtable concluded that exercise training is safe during and after cancer treatments and results in improvements in physical functioning, quality of life, and cancer-related fatigue in several cancer survivor groups. Implications for disease outcomes and survival are still unknown. Nevertheless, the benefits to physical functioning and quality of life are sufficient for the recommendation that cancer survivors follow the 2008 Physical Activity Guidelines for Americans, with specific exercise programming adaptations based on disease and treatment-related adverse effects. The advice to "avoid inactivity," even in cancer patients with existing disease or undergoing difficult treatments, is likely helpful.

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    • "(Courneya & Friedenreich, 2011; Speck, Courneya, Mâsse, Duval, & Schmitz, 2010). Exercise guidelines for cancer patients recommend 150 min of moderate-intensity aerobic exercise per week (Schmitz et al., 2010). While patients generally express motivation to be physically active (e.g. "
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    ABSTRACT: The study examined whether a behavior-change intervention focusing on self-regulatory strategies and emphasizing role model support increases physical activity (PA) among insufficiently active (not meeting PA guidelines of 150 min/week) cancer patients. Ambulatory cancer patients [N = 72; 54% female; M = 56 years, SD = 12.34; most with breast or colon cancer (34, 15%)] were enrolled in the MOTIVACTION-study, a 4-week intervention (1-hr counseling, followed by weekly phone calls), with pretest (T1), posttest (T2) and a 10-week follow-up (T3). Participants were randomized to either an exercise or to a stress management intervention (active control). The exercise intervention emphasized self-regulatory strategies (e.g. action- and coping planning and self-monitoring); patients were also encouraged to contact a physically active same-sex role model as a potential exercise partner. The active control condition consisted of coping and relaxation techniques. Sixty-seven patients remained in the study and completed the SQUASH assessment of PA and a measure of perceived stress. PA was validated by Actigraph accelerometry. At T2, 46% of the patients in the exercise group and 19% of stress management patients increased their activity levels to meet PA guidelines (>150 min/week; χ(2)(1) = 5.51, p = .019). At T3, participants in the exercise intervention maintained their exercise level (46%), but also 31% of the stress management patients met the guidelines. All patients reported reductions in perceived stress. Additional analyses comparing patients in the exercise group by role model contact (63% realized contact) revealed that those who had contact with their role model were significantly more likely to adhere to the recommended guidelines (T2:50%; T3:64%) compared to those who did not have contact with a role model (T2:39%; T3:15%), suggesting the potential of mobilizing role model support to facilitate PA. In sum, cancer patients may not only benefit from an exercise intervention emphasizing self-regulation, but also from stress management, regarding both reducing stress and increasing PA.
    Full-text · Article · Sep 2015 · Psychology Health and Medicine
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    • "den kann, konnten Schmitz et al. [13] zeigen , dass ein intensives Krafttraining sich positiv auf die Symptomatik im Rahmen eines Lymphödems auswirkt. Steindorf et al. [14] beschrieben unlängst weitere positive Einflüsse von Krafttraining sowohl während einer strahlen-als auch während einer chemotherapeutischen Behandlung auf das Fatigue-Syndrom und die Lebensqualität . "
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    ABSTRACT: Exercise therapy is an integral part of today’s oncological rehabilitation. In order to optimize the outcome of exercise programs in consideration of side effects of cancer and cancer therapies, further studies are necessary. Along with aerobic and coordination exercise, resistance training is an essential part of exercise therapy. Resistance training aids to combat side effects of lymphedema, antiandrogen therapy and cachexia among others. The present study investigated whether high load resistance training is superior to moderate resistance training regarding the increase of physical strength. For this purpose, 31 tumor patients without prior resistance training experience (different entities and therapeutic status) were randomized into either a moderate training group (n=17) or a hypertrophy training group (n=14). For the first 8 weeks, all patients trained in a muscular endurance circuit (2 rounds) consisting of 6 machines (20 repetitions on each), covering the big muscle groups. For the following 8 weeks the MT continued to lift at 20 repetitions, whereas the resistance for the HT was increased to a point where only 8–12 repetitions were possible. The maximum force was determined prior to the intervention (t0), after 8 weeks (t1), and after 16 weeks (t2), using a hypothetical one repetition maximum (h1RM) test. While both groups had comparable baseline levels, the results indicate that there was a significant increase in strength from t1 to t2 in the HT in almost all muscle groups. It can be concluded that a HT is vastly superior to MT regarding the increase of strength. When contraindications are absent, high load resistance training can be recommended, especially for increasing muscle mass. Whether solely the increase of strength plays a central or a peripheral role for the treatment of side effects, such as the fatigue syndrome, needs to be investigated by further studies.
    Full-text · Article · Jun 2015 · Deutsche Zeitschrift für Onkologie
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    • "For the CE group individualized exercise programs were prescribed by an ACSM certified Clinical Exercise Specialist®. The program components were based on the participants' individual baseline fitness results, following ACSM guidelines (American College of Sports Medicine 2013), and consistent with the levels of activity as described in the public health guidelines for physical activity for adults (United States Department of Health and Human Services 2008; Haskell et al. 2007) taking into account the participants' breast cancer survivor status (Schmitz et al. 2010; Doyle et al. 2006). CE programs included components of aerobic, resistance and flexibility training focused on three 1-hour sessions per week. "
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    ABSTRACT: Yoga-based exercise has proven to be beneficial for practitioners, including cancer survivors. This study reports on the effect on inflammatory biological markers for 20 breast cancer survivors who participated in a six-month yoga-based (YE) exercise program. Results are compared to a comprehensive exercise (CE) program group and a comparison (C) exercise group who chose their own exercises. “Pre” and “post” assessments included measures of anthropometrics, cardiorespiratory capacity, and inflammatory markers interleukin 6 (IL-6), interleukin 8 (IL-8), tumor necrosis factor alpha (TNFα) and C-reactive protein (CRP). Descriptive statistics, effect size (d), and dependent sample ‘t’ tests for all outcome measures were calculated for the YE group. Significant improvements were seen in decreased % body fat, (−3.00%, d = −0.44, p = <.001) but not in cardiorespiratory capacity or in inflammatory serum markers. To compare YE outcomes with the other two groups, a one-way analysis of co-variance (ANCOVA) was used, controlling for age, BMI, cardiorespiratory capacity and serum marker baseline values. We found no differences between groups. Moreover, we did not see significant changes in any inflammatory marker for any group. Our results support the effectiveness of yoga-based exercise modified for breast cancer survivors for improving body composition. Larger studies are needed to determine if there are significant changes in inflammatory serum markers as a result of specific exercise modalities.
    Full-text · Article · Mar 2015 · SpringerPlus
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