Long-Term and Late Effects of Cancer Treatments on Prescribing Physical Activity

Exercise prescription for cancer survivors following treatment must account for ongoing long-term and late effects of cancer treatment and their interaction with other comorbid conditions that individuals may experience. Healthcare professionals should inquire about physical activity and exercise at every patient encounter and be prepared to refer to either a clinically based or community-based exercise program. Evaluating baseline aerobic capacity and muscle strength is important to tailoring an exercise prescription to the survivor and modifying the exercise prescription, depending on how the survivor is tolerating it and progressing. In general, the exercise dose should be at least 30 minutes of aerobic exercise 3 times a week and at least 2 nonconsecutive days of resistance exercise targeting the large muscle groups. For resistance training, individuals should perform at least 2 sets of 8-15 repetitions. Some survivors will not be able to meet these guidelines at first. The exercise dose may need to be modified for individuals with significant debilitation, i.e., start low and go slow. Adaptations to an exercise prescription should be based on side effects and symptoms not only related to cancer treatment but also considering the interplay of other comorbidities. Gradual progression of aerobic and resistance exercise is key to success with the goal for survivors to optimize recovery of physical functioning to a level that enables the survivor to engage in activities of daily living and to participate in activities that are meaningful. Exercise is critical to improving health and preventing disease for cancer survivors.