Available online at www.sciencedirect.com
Journal of Science and Medicine in Sport 12 (2009) 428–434
Australian Association for Exercise and Sport Science position stand:Optimising cancer outcomes through exercise
Sandra C. Hayes
, Rosalind R. Spence
, Daniel A. Galvão
, Robert U. Newton
Institute of Health and Biomedical Innovation, School of Public Health, Queensland University of Technology, Australia
School of Human Movement Studies, University of Queensland, Australia
Vario Health Institute, Edith Cowan University, Western Australia, Australia
Received 19 November 2008; received in revised form 20 March 2009; accepted 20 March 2009
Cancer represents a major public health concern in Australia. Causes of cancer are multifactorial with lack of physical activity beingconsidered one of the known risk factors, particularly for breast and colorectal cancers. Participating in exercise has also been associatedwith beneﬁts during and following treatment for cancer, including improvements in psychosocial and physical outcomes, as well as bettercompliancewithtreatmentregimens,reducedimpactofdiseasesymptomsandtreatment-relatedside-effects,andsurvivalbeneﬁtsforparticularcancers.Thegeneralexerciseprescriptionforpeopleundertakingorhavingcompletedcancertreatmentisoflowtomoderateintensity,regularfrequency (3–5times/week) for at least 20min per session, involving aerobic, resistance or mixed exercise types. Future work needs to pushthe boundaries of this exercise prescription, so that we can better understand what constitutes optimal, desirable and necessary frequency,duration,intensityandtype,andhowspeciﬁccharacteristicsoftheindividual(e.g.,age,cancertype,treatment,presenceofspeciﬁcsymptoms)inﬂuence this prescription. What follows is a summary of the cancer and exercise literature, in particular the purpose of exercise followingdiagnosis of cancer, the potential beneﬁts derived by cancer patients and survivors from participating in exercise programs, and exerciseprescription guidelines and contraindications or considerations for exercise prescription with this special population. This report representsthe position stand of the Australian Association of Exercise and Sport Science on exercise and cancer recovery and has the purpose of guidingexercise practitioners in their work with cancer patients.© 2009 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
Exercise; Neoplasms; Rehabilitation; Survival; Quality of life; Cancer
1. Exercise and cancer prevention
One in three Australian men and one in four womenwill be directly affected by cancer before the age of 75,with melanoma, prostate, colorectal, breast and lung can-cers comprising the most common types.
There are anestimated 108,000 new cancer cases and 41,000 registeredcancer deaths each year in Australia, and consequently can-cer represents a major public health concern.
While thecauses for many cancers remain unknown, lifestyle factorsincludingphysicalactivitylevelsareconsideredcontributoryand modiﬁable for some.
Since the ﬁrst report linkingphysical activity and cancer risk was published in 1922,morethan190reportsfromepidemiologicalstudiesandover
10 reviews have examined this relationship.
The scientiﬁcevidence supporting physical activity as a means of can-cer prevention is now considered ‘strong’ and ‘convincing’for particular cancers including colon/colorectal and breast,‘probable’ for prostate and ‘possible’ for lung and endome-trial cancers, with risk ratios or odds ratios reported for thephysicallyactivegroupsrangingfrom0.3to0.8(representingrisk reductions of 25% to more than three-fold).
Evidenceto date is considered preliminary and insufﬁcient to makeany causal inferences for melanoma, testicular, ovarian, kid-ney, pancreatic and thyroid cancers.
A review and analysisof the potential biological mechanisms underlying the possi-ble anti-carcinogenic effects of physical activity has recentlybeen published and gives the relationship more credibility.
However, since exercise prescription in this set-
1440-2440/$ – see front matter © 2009 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.doi:10.1016/j.jsams.2009.03.002