Clinical Implementation of Exercise Guidelines for Cancer Patients: Adaptation of ACSM’s Guidelines to the Italian Model

Abstract

Abstract:The goal of cancer treatment is to arrest or eradicate the tumor while minimizing the often toxic effects of treatment. While oncologic diagnostics and treatments are improving and survival rates are increasing, it is critical to provide additional patient management that appears to affect long-term survival. Epidemiologic evidence suggests patients diagnosed with cancer tend to fair better after treatment when following a comprehensive rehabilitation program aimed at achieving an ideal body weight through dietary and exercise interventions while also increasing cardiorespiratory fitness, strength, mobility, neuromuscular integrity and psycho-social wellbeing. Additionally, it is now being tested whether exercise during cancer treatment and possibly prior to the start of treatment may increase post treatment outcomes by altering body weight, having direct effects on tumorigenesis, reducing oxidative stress and inflammation, and perhaps increasing chemotherapy delivery efficacy. The purpose of this review is to outline an evidence based model to evaluate cancer patients and provide guidelines for post-cancer treatment rehabilitation programs. Additionally, strategies aimed at changing lifestyle habits such as smoking and poor dietary habits will be addressed.

Considerations for Exercise Prescription in Patients With Bone Metastases: A Comprehensive Narrative Review

“…Studies prescribing exercise for patients receiving palliative radiation treatment report no adverse events [20,76,77]. The only documented precaution specific to exercise prescription in patients after radiotherapy is severe tissue reactions such as dryness, itching, blistering, or peeling, leading to increased risk of infection [78].…”

“…One randomized trial assigned 66 patients with metastatic cancer, including patients with bone metastases, to a program of either individualized resistance (n = 34) or aerobic exercise (n = 32) [78]. Resistance exercise was completed twice weekly on a circuit of weight training equipment, while aerobic training was completed twice weekly for 30‐60 minutes on >1 machine (eg, bike, treadmill).…”

Indications to Promote Physical Activity during Pregnancy

“…In clinical practice, the amount of PA is easily established by using the 6-min walk test performed in association with the CR10 effort scale to estimate maximum perceived effort. This model for personalizing the amount of exercise prescribed has been proposed recently and tested in other clinical conditions such as cancer or chronic metabolic diseases [8]. Heart rate at the end of the test can be accepted as an adequate level of moderate intensity effort.…”

Gene therapy as advanced technology for the treatment of Leukemia: CAR-T therapy

“…Lump formation is the primary sign of cancer and other includes abnormal bleeding, unexpected weight loss, alteration in bowel movement and prolonged cough. There are about more than hundred kinds of cancer affecting the people worldwide (Stefani et al, 2017). At the early stage it is difficult to detect but there are some possible signs that the cells show when they are going become malignant.…”