Exercise and Cancer Survivors: Lessons Learned from a Multi-Faceted Model for Exercise Prescription

Abstract

Cancer is the second leading cause of death, and the most common diagnosis among the general population is breast and colon cancer. Recently, an increasing number of new cases of invasive breast and colon cancer have been estimated, and more people die from these diseases. In addition to the genetic pattern, diet and lifestyle including smoking, alcohol consumption, and sedentary behaviour have also been identified as potential risks factors. Recent studies of cancer survivors have shown the beneficial effects of regular physical activity to reduce the prevalence of comorbidity, muscle atrophy, weight changes, reduced aerobic capacity, fatigue, depression, and reduced quality of life. Dedicated and individual programs are crucial for achieving the goals of improving quality of life and reducing comorbidities. A multidisciplinary approach is fundamental: lifestyle assessment, including estimating the level of physical activity, as well as nutritional habits, may be the first step. A periodic cardiovascular examination is crucial for detecting asymptomatic early myocardial failure. According to current ACSM guidelines, different levels of exercise (low-moderate 40% and moderate up to 60% of the maximal HR) may be prescribed, and patients enrolled may follow the exercise program if in the absence of contraindications. The current paper reports observations from our clinical practice and provides practical strategies that bridge contemporary, published guidelines into practice within a multi-disciplinary team working with cancer survivors in Italy.

Effects of Short-TermUnsupervisedExercise, Based on Smart Bracelet Monitoring, on Body Composition in Patients Recovering from Breast Cancer

“…Most of them have claimed wearable technology with exercise programs could increase physical activity of cancer survivors, but a few pilot studies have focused on the influences on cancer survivors' body composition. 8,[14][15][16] The aim of the present study was to investigate the effects of unsupervised exercise, based on smart bracelet monitoring, on the body composition and quality of life of breast cancer survivors.…”

Movement and health beyond care, MoviS: study protocol for a randomized clinical trial on nutrition and exercise educational programs for breast cancer survivors

“…Emerging evidence suggests the beneficial effects of the exercise are greater if the exercise is supervised and follows the key components of exercise (i.e., frequency (F), intensity (I), time (T), type (T), volume (V), and progression (P) over time, namely the FITT-VP principle) [ 20 , 42 ]. In this context, it is well known that the adherence of BC survivors to exercise is low [ 43 ] and that engagement to motivation to exercise plays an important role in promoting and adhering to physical activity guidelines in BC survivors [ 44 – 46 ]. Indeed, in the present study, a mixed approach (composed of directly and remotely supervised exercise sessions) will be adopted to evaluate if the direct specialist supervision combined with the education and active involvement of the participants in their training, which will be partially performed autonomously according to personalized indications, can provide beneficial effects and high adherence both in short and long terms.…”

A Mixed-apprOach program To help women wIth breast cancer stay actiVE (MOTIVE program): A pilot-controlled study

“…It is well known that the readiness and adherence of BCSs to exercise may be influenced by several factors, such as clinical complications (i.e., pain, fatigue, and cancer stage) [ 16 ], psychological conditions [ 17 ], social and environmental factors (including the availability or proximity of the training facilities) [ 16 , 18 ], and personal exercise preferences. In addition, knowledge of, engagement with, and motivation to exercise play an important role in promoting PA in BCSs [ 19 , 20 , 21 ]. However, unfortunately, only 40% of oncologists routinely recommend PA to patients [ 22 ], and only 9% of BCSs are referred to exercise professionals [ 15 ].…”