The benefits of exercise for women during and after gynaecological cancer treatment
Research shows that exercise will benefit most people with cancer both, during and after treatment. Exercise can help manage some side effects of cancer treatment, help with gaining a speedy recovery and overall improve quality of life.
Most of this evidence is based on studies with breast, prostate, and colorectal cancers. To assess the evidence of exercise interventions in gynaecological cancer patients our medical research team conducted a systematic review recently published in the journal Supportive Cancer Care. A systematic review provides a summary and critical appraisal of the medical literature.
In the review, we assessed 11 studies to evaluate the evidence of physical exercise interventions and their effect on physical and psychosocial outcomes during and following treatment for gynaecological cancer. This included patients treated for cancer of the ovaries, uterus, cervix, vagina, vulva, and fallopian tubes. The 11 studies included 640 participants, with 407 allocated to intervention groups (meaning they received the exercise intervention).
On average, participants were aged 57 years (range 51-64 years) and more than half were categorised as being obese according to BMI. These figures are consistent with demographics that I normally see in my practice. Across all studies, most participant were ovarian cancer patients (52%). On average, participants were approximately two years post-diagnosis at time of participation. Most studies were completed following cancer treatment and included combined aerobic and resistance exercises.
Overall, our researchers found the greatest benefit of exercise in cancer patients was seen in the improvement of their muscular strength, exercise capacity, and agility. In the 11 studies reported here, there was insufficient evidence for exercise resulting in changes to flexibility, balance, stress, sleep, mental wellbeing, and fatigue.
There was no evidence to support exercise could worsen health outcomes after treatment for cancer.
Overall, the results from this systematic review support the inclusion of exercise training, including low to moderate gym, group, or home-based aerobic and strength exercise among women with gynaecological cancer. This is likely to improve aerobic capacity, muscular strength, and agility.
How do I start exercising after cancer?
The Clinical Oncology Society of Australia (COSA) position statement reports exercise is safe for people with cancer and the risk of complications is very low.
When appropriately prescribed and monitored, exercise should be prescribed to all cancer patients as a standard part of their cancer care to help manage the effects of cancer and its treatment. Exercise & Sport Science Australia (ESSA) also encourages people with cancer to exercise.
Aim for 150 minutes of planned exercise per week, and aim for moderate intensity exercise that involves increasing the heart rate to be huffing and puffing. However, be guided by your symptoms and be as physically active as your current ability and conditions allow. For example, if prior to the cancer you were not active and in a sedentary state often, don’t start with 150 minutes per week. Instead, start with low intensity exercise and build this up.
Mix it up with a minimum of two resistance exercise sessions each week. Resistance training (also called weight training) increases muscle strength. The review found there was benefit found in exercise programs that include combined aerobic and resistance activities.
While getting this much exercise may sound hard at first, I work with exercise physiologists who specialise in exercise programs for cancer patients and who are experts in their fields.
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