Does exercise help older patients going through cancer
treatments? What are the benefits and risks?
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Regular physical activity reduces the risk of developing many
chronic conditions, such as coronary artery disease, hypertension,
osteoporosis, type II diabetes , obesity, and chronic obstructive pulmonary
disease, while playing a role in the management of anxiety, depression,
dementia, and pain. The American College of Sports Medicine (ACSM) recommends
that older adults, even those with chronic medical conditions, participate in
regular aerobic exercise training (150-300 minutes per week) and resistance
exercise training (at least 2 days a week). Evidence also supports the use of
exercise for side-effect and symptom management in cancer survivors. In elders,
especially those who are frail, physical activity intervention programs have
resulted in improved muscular mass and strength, improved aerobic capacity,
fall reduction, and improved perceived health status.
Exercise is a promising behavioral intervention with the potential to mitigate multiple symptoms and improve physical functioning in older cancer patients during and after cancer treatment. Physiologic changes of aging which negatively impact body composition, strength, and fitness increase vulnerability to the development of short- and long-term disability when stressed with cancer burden and treatments. Treatment-associated physical disability impairs quality of life, limits therapeutic options, and contributes to the social and economic burden of cancer care in the elderly.Results from limited elderly-specific trials suggest that physical activity interventions are safe and effective in older cancer survivors, with prostate cancer survivors representing the most well studied cohort of older persons with cancer. Many questions remain unanswered with respect to optimal timing, mode, intensity, and delivery of exercise interventions for older patients. It is generally accepted that both aerobic and resistance components are beneficial in any exercise program. While available data supports the potential benefit of exercise for elders with cancer, recommendations will need to be individualized to optimize participation, safety, and efficacy.No safety concerns have been reported in clinical trials evaluating exercise interventions among cancer patients, including those limited trials focused specifically on an elderly cohort. Most trials, however, excluded patients with significant comorbidity such as cardiovascular disease. This limits generalizability of findings to many older adults treated for cancer who suffer from multi-morbidity. In addition, most have studied longer term cancer survivors rather than newly diagnosed patients and no elderly-specific trials have investigated exercise as an adjunct to aggressive therapy (i.e., chemotherapy). Further studies among frail older cancer patients are needed to guide recommendations for this cohort in particular. At this point, much more information is needed but this should not discourage motivated patients from exercising during treatment. It is imperative that any older patient with cancer who is starting a new exercise regimen discuss the risks and benefits with their physician. Physical therapy may be helpful initially to develop low impact stretching, resistance training, and exercise programs for more frail older adults. Fit older adults may benefit from visiting with an ACSM-certified exercise physiologist who can help provide guidelines for exercise.
Exercise is a promising behavioral intervention with the potential to mitigate multiple symptoms and improve physical functioning in older cancer patients during and after cancer treatment. Physiologic changes of aging which negatively impact body composition, strength, and fitness increase vulnerability to the development of short- and long-term disability when stressed with cancer burden and treatments. Treatment-associated physical disability impairs quality of life, limits therapeutic options, and contributes to the social and economic burden of cancer care in the elderly.Results from limited elderly-specific trials suggest that physical activity interventions are safe and effective in older cancer survivors, with prostate cancer survivors representing the most well studied cohort of older persons with cancer. Many questions remain unanswered with respect to optimal timing, mode, intensity, and delivery of exercise interventions for older patients. It is generally accepted that both aerobic and resistance components are beneficial in any exercise program. While available data supports the potential benefit of exercise for elders with cancer, recommendations will need to be individualized to optimize participation, safety, and efficacy.No safety concerns have been reported in clinical trials evaluating exercise interventions among cancer patients, including those limited trials focused specifically on an elderly cohort. Most trials, however, excluded patients with significant comorbidity such as cardiovascular disease. This limits generalizability of findings to many older adults treated for cancer who suffer from multi-morbidity. In addition, most have studied longer term cancer survivors rather than newly diagnosed patients and no elderly-specific trials have investigated exercise as an adjunct to aggressive therapy (i.e., chemotherapy). Further studies among frail older cancer patients are needed to guide recommendations for this cohort in particular. At this point, much more information is needed but this should not discourage motivated patients from exercising during treatment. It is imperative that any older patient with cancer who is starting a new exercise regimen discuss the risks and benefits with their physician. Physical therapy may be helpful initially to develop low impact stretching, resistance training, and exercise programs for more frail older adults. Fit older adults may benefit from visiting with an ACSM-certified exercise physiologist who can help provide guidelines for exercise.
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