While a lot of articles on the #1 Killer: Cardiovascular Disease are written daily, less is prepared on the Exercise Prescription for Cancer. The 5 Broad Categories for the cause are (1) Environment; (2) Heredity; (3) Oncogenes; (4) Hormones; (5) Impaired Immune System Function. There is a growing opinion that to strengthen the Immune System to fight off Cancer and other chronic disorders, physical activity, and lifestyle changes are essential.

Research has shown that exercise has both acute and chronic benefits to fighting cancer, including improvements in the quality and quantity of the Innate Immune System, Monocytes, Macrophages, Neutrophils, Natural Killer Cells, Acquired or Adoptive Immune System, and Cytotoxic T Lymphocytes.

The following Exercise Prescription is based on affecting the acute exercise response by getting your client to exercise daily or at the very least, 6 days/week.

Exercise Testing

• Maximal Cardiovascular (Medical Professionals Only) Test
• Submaximal Cardiovascular Test
• Muscle Strength and Endurance Test
• Flexibility Test
• PAR-Q

Contraindications to Exercise for Patients with Cancer

• Hemoglobin <10.0g •dl-1
• White Blood Cells <3,000/ml
• Neutrophil count <0.5 •109ml-1
• Platelet Count <50•109ml-1
• Fever >38°C (100.4°F)
• Unsteady gait (ataxia)
• Cachexia or loss of >35% of premorbid weight
• Limiting dyspnea with exertion
• Bone pain
• Severe nausea
• Extensive skeletal metastases

Summary of Exercise Prescription for Patients with Cancer
Training Method: Aerobic

• Mode: Walking, stationary bike, or other exercises that use large muscle groups
• Intensity: 50% to 85% of heart rate reserve or oxygen uptake reserve, or RPE 11 to 14
• Frequency: Three to five times per week
• Duration: ≥150 minutes/week of moderate-intensity or ≥75 minutes/week of vigorous-intensity
• Progression: 30 seconds to 2 minutes per day
• Goals: Increase peak VO2, total work, endurance

Training Method: Resistance

• Mode: Free Weights, Machines, Resistance Bands
• Intensity: 50% to 70% of 1RM for lifts involving the lower body and 40% to 70% of 1RM for lifts involving the upper body
• Frequency: Two or three times per week
• Duration: One set of 8 to 12 reps
• Progression: Gradual increase in resistance (1.1-2.3 kg) following two consecutive symptom-free sessions
• Goals: Increase muscle strength and endurance

Training Method: Flexibility

• Mode: Stretching, Yoga
• Intensity: Stretch maximally but avoid pain, especially in joints
• Frequency: Before and after exercise
• Duration: 15 to 30 seconds per stretch. Repeat one to three times for a total of 60 seconds per stretch.
• Progression: As tolerated
• Goals: Increase flexibility and range of motion

Program Design
Carefully evaluate how the patient feels particularly in regard to their cancer therapy and motivation to exercise. Keep a careful watch for the sudden loss of exercise tolerance, increased shortness of breath with or without exertion, an increase in depression as manifested by difficulty in falling asleep or sleeping through the night, loss of interest in social contacts, and/or sudden changes in nutritional status or loss of appetite. You will also need to be aware that the degenerative effect of cancer can result in other disorders, i.e.: Cardiovascular Disease, Osteoporosis, etc., that can also affect the patient’s ability to exercise and exercise tolerance.

Exercise is the best medicine for the treatment, care, and prevention of cancer and all chronic disorders, but you must find the correct dose. Your goal should be to reach a level of moderate intensity. Low-intensity activity may not provide the dose that the patient needs to provide the many improvements to the immune system and other physiological systems of the Body.

High-intensity exercise can be exhausting and may temporarily depress the immune system and other physiological systems of the body. Your Aerobic and Strength Training Exercise Modes (Types) should be at Moderate Intensity, or an RPE of 11 to 14 on the 20 RPE Scale.

_©July 2022