Exercise: The Latest Standard of Care for Older Cancer Survivors
For decades, cancer treatment focused primarily on tumor eradication. Now, a paradigm shift is underway, recognizing the critical role of exercise in not just improving survival rates, but similarly enhancing the quality of life for older patients. A recent consensus statement, published in Cancer and spearheaded by Oregon Health & Science University (OHSU) experts, solidifies exercise as an essential component of cancer care for those over 65.
Debunking Myths and Filling a Critical Gap
The expert panel, known as ACES (Advancing Capacity to Integrate Exercise Into the Care of Older Cancer Survivors), addressed a significant oversight in cancer care: a lack of specific exercise guidance tailored to the unique needs of older adults. “We want to put that myth to bed, that older people can’t tolerate exercise during cancer treatment,” explains Dr. Kerri Winters-Stone, Penny and Phil Knight Endowed Professor in Cancer Research Innovation at the OHSU Knight Cancer Institute. “We know that if anything, it’s the opposite.”
With the number of cancer survivors aged 65 and older projected to rise from 15.5 million in 2016 to 26.1 million by 2040, the need for evidence-based exercise recommendations is more urgent than ever. The ACES panel’s work builds upon existing guidelines from organizations like the American College of Sports Medicine, providing a more nuanced approach for this growing demographic.
Practical Recommendations for a Healthier Future
The consensus statement emphasizes that older cancer survivors should avoid inactivity and aim for at least 30 minutes of moderate-intensity aerobic and/or resistance exercise three times a week, progressing towards 150 minutes of aerobic exercise plus twice-weekly resistance training. Although, the guidelines aren’t rigid. Flexibility and adaptation are key.
Healthcare providers are encouraged to monitor patients for signs of poor tolerance – fatigue, pain, dizziness, or weakness – and adjust exercise accordingly. Balance and flexibility training are also recommended, and modifications should be made, or assistance provided, if unsupervised exercise is unsafe. Dr. Winters-Stone highlights the importance of prioritizing functional strength before increasing activity levels. “If mobility issues are a factor, the focus should be on getting stronger with better functioning and greater stability,” she says.
Beyond Physical Health: Maintaining Independence and Dignity
The benefits of exercise extend far beyond physical health. For older adults, maintaining independence is often paramount. Exercise plays a vital role in preserving the ability to perform daily activities – bathing, dressing, eating, shopping, and cleaning – without relying on others. This, in turn, contributes to maintaining dignity and quality of life.
“Staying in your home as long as possible, aging in place, being able to make your own decisions… those are all incredibly important things to older patients with cancer,” Dr. Winters-Stone emphasizes. “A regular exercise program will increase your chances of being able to do those things much longer.”
The Future of Cancer Rehabilitation: Integrated and Accessible
The ACES recommendations signal a move towards a more integrated approach to cancer care, where exercise is not an afterthought, but a fundamental component of treatment and recovery. This requires a concerted effort to make exercise programs accessible to all older cancer survivors.
Dr. Winters-Stone stresses the responsibility of healthcare providers and organizations to ensure that exercise programs are available. Exercise shouldn’t cease once treatment is complete. “There’s a saying that if exercise was a pill, it would be the number-one prescribed medication in the whole wide world,” she states. “I can’t think of a single reason not to prescribe exercise for everybody with cancer, but especially for those patients and survivors who are older.”
Frequently Asked Questions
- Is exercise safe during cancer treatment? Yes, the consensus statement confirms that exercise is generally safe and beneficial for older cancer survivors during treatment, with appropriate monitoring and adjustments.
- What type of exercise is best? A combination of aerobic and resistance exercise is recommended, along with balance and flexibility training.
- How much exercise is enough? Aim for at least 30 minutes of moderate-intensity exercise three times a week, progressing towards 150 minutes of aerobic exercise plus twice-weekly resistance training.
- What if I have mobility issues? Focus on building strength and stability before increasing activity levels.
Pro Tip: Start slowly and gradually increase the intensity and duration of your exercise. Listen to your body and don’t push yourself too hard.
What are your experiences with exercise during or after cancer treatment? Share your thoughts in the comments below!
