Promoting physical activity among people living with advanced cancer

Matthew Maddocks1

1King’s College London, London, UK

Abstract

Strong evidence supports physical activity and/or exercise as a safe and effective treatment among patients with early stage cancer during or following treatment for their illness. The potential for benefit is increasingly recognised among those living with advanced cancer. In this group the emphasis is on proactive intervention to maintain or slow down the decline in function. This role for physical activity will become ever more important as with improved treatments the number of survivors living with cancer will increase. This presentation will provide an overview of the rationale, efficacy and practical implementation of physical activity programmes for people living with advanced cancer.

Physical activity and exercise may attenuate the adverse effects of cancer and its treatment via modulating metabolism, body composition and levels of inflammation. By targeting skeletal muscle function and cardiorespiratory fitness, exercise may impact favourably on meaningful patient outcomes such as the ability to exercise, levels of physical activity and functional dependency. Programmes offered alongside cancer treatment have led to favourable changes in patients' symptoms, function and quality of life. Nonetheless, most studies are small and provide limited data to understand which patients respond best to which type of programme. Further, there are practical challenges in offering exercise and intensive programmes are not acceptable to all patients, particularly those with a poor performance status. In this group a focus on specific transfers and basic activities of daily living may be most relevant. Strategies to make physical activity more widely accessible could also include offering programmes earlier in the course of illness, at lower intensities, or in home or local community settings.