On your mark, get set, go!! The runners are neck and neck … Timmy Tumour is edging slightly ahead of Lily Lymphocyte, but that girl has game! The new diet and lifestyle are paying off as she kicks into overdrive and edges past Tumour who combusts and craps out just shy of the finish line. Lily Lymphocyte is the winner! And the fans go wild!…
Yes, very goofy. But it’s ironic… when you have cancer, you’re in the race of a lifetime. Every second counts. You’re racing against the clock. And tripping could be fatal.
So what’s with the big race story? Well, for active treatment cancer survivors, those in remission and those who just want to avoid this whole shit show altogether, a.k.a., cancer prevention advocates, exercise is one of the most important mechanisms for better outcomes, discouraging recurrence and avoiding the Big C altogether.
As a survivor, admittedly, I should be much better at exercising. I know better. However, I’m not going to blow wind up your ass and pretend to be the paragon of the perfect cancer survivor without a care in the world. That bitch is always biting at your heels in the form of fear of recurrence. And we’re all human and have our moments of weakness, or laziness, or procrastination, or overwhelm. Pick your poison.
But I digress, back to exercise. Exercise is indeed like a magic pill for cancer survivors. No side effects. Low cost. And you’ll have a much better chance of fitting into that little black dress for that high school reunion you’ve been dreading. Bonus!
So what does this mean for you? As a fellow survivor, my goal is to ensure that you know exactly how exercise fits into your cancer journey and beyond. So let’s dive in…
What’s the Big Deal About Exercise and Cancer?
Exercise oncology. What the heck is that, you ask? Well, the best description I read was the application of exercise as medicine for the management of cancer (Exercise Oncology, Mary MacKillop Institute for Health Research). Short and to the point. But what does one have to do with the other?
Well, according to recent research, offering exercise during cancer treatment has both short-term and long-term health benefits. In fact, researchers conducting an 18-week study involving newly diagnosed breast or colon cancer patients found that exercise had beneficial effects on fatigue.
I don’t know about you, but when an expert says that exercise during treatment can make a “significant impact on survivors’ health and quality of life over the long term”, I’m listening.
In the media release by the Clinical Oncology Society of Australia (COSA), Associate Professor Prue Cormie, lead author of the 2018 COSA Position Statement on Exercise in Cancer Care, says that if it were possible for exercise to be prescribed as a pill it would be demanded by all cancer patients, prescribed by every specialist, and subsidized by governments, and COSA along with other supporting organizations are now calling for exercise to be prescribed to all cancer patients as part of routine care. It all comes down to the research which she says tells us that:
[E]xercise is the best medicine people with cancer can take, in addition to their cancer treatments, to reverse treatment-related side-effects, slow the progression of their cancer, increase quality of life and improve the chances of survival.
Now that’s huge.
The COSA position statement is ground breaking. It goes further than suggesting that exercise is merely beneficial during cancer treatment. The statement doesn’t pull any punches. It calls for exercise to be included as a routine part of cancer care. In fact, it calls on health professionals who are treating cancer patients to:
Discuss exercise as part of their cancer treatment plan
Prescribe exercise to all people with cancer
Refer patients to an exercise physiologist and/or physiotherapist with experience in cancer care 
So exercise as a prescription isn’t so far-fetched after all and the potential benefits are backed by solid research. So what exactly are some of these benefits?
Evidence-Based Benefits of Exercising During and After Treatment
Through the years, studies upon studies have been completed on the benefits of exercise on our health. From decreased risk of mortality to lower risk of cancer incidence and recurrence, the important role exercise plays in the cancer arena is becoming clearer every day. Aside from the obvious noted above, where can exercise be a magic pill for you?
Lowers Cancer-Related Fatigue
I’m sure that you’re no stranger to feeling like you’ve had the life sucked out of you by cancer fatigue. It’s a feeling of fatigue that is like no other and can bring you to the verge of tears. Well, how about this for awesome -- cancer-related fatigue, which is said to be the most common and distressing side effect, can be lowered by including exercise in your routine.
A very recent study disclosed that “[I]ncreasing evidence suggests that exercise interventions delivered during adjuvant cancer treatment have beneficial short-term effects on fatigue in cancer patients.”
And for those of you who, like me, are well into your after-treatment survivorship, the study also indicated continuing to live a physically active lifestyle into survivorship may have a positive effect on fatigue in the long run. This is good news if you are finding that, even though you’ve finished your treatment, you just can’t seem to get back to where you were energetically pre-treatment.
Let’s face it, treatment kicks your immune system’s butt and, if someone told you that there’s a chance you can beef up your own immune system, wouldn’t you want to try it? And, depending on what type of exercise you choose, have some fun to boot? Of course you would!
There’s a lot of research out there on the role of exercise therapy and cancer treatment. Many of the benefits of exercise on immunity are said to relate to the improvement in Natural Killer cells, which are the body’s special assassins against cancer cells. A 2017 study revealed that “[E]xercise in humans mobilizes NK cells, and human NK cells are efficient cancer cell killers—and, therefore, could play a protective or therapeutic role in cancer.”
An earlier study in 2013 also suggested:
Many of the health benefits of regular exercise are thought to be related to its short-term boost of the immune system and long-term anti-inflammatory effects. In this systematic review, we found that Natural Killer cytotoxic activity increased after exercise in cancer patients, along with lymphocyte proliferation and granulocyte cell counts.
These NK cells are rock stars. And the more we can do to increase them and give our immune systems an overall boost, the better.
What You Can Do to Make the Most of this Magic Pill
According to the Clinical Oncology Society of Australia, all individuals with cancer should get back to normal daily activities as soon as possible following diagnosis. It suggests that the following levels of activity should be achieved and maintained by cancer survivors:
At least 150 minutes of moderate-intensity or 75 minutes of vigorous intensity aerobic exercise (e.g. walking, jogging, cycling, swimming) each week; and
Two to three resistance exercise (i.e., lifting weights) sessions each week involving moderate to vigorous-intensity exercises targeting the major muscle groups.
They further suggest that recommendations should be tailored to individual abilities and adaptations may be necessary depending on an individual’s health status. While it is always advisable to speak with your health professional prior to commencing any exercise program, it is even more critical under these circumstances as this level of activity may be out of reach for those going through cancer treatment. As noted in the COSA statement, this is where an exercise specialist with cancer experience comes in. But, first things first, speak to your oncologist or healthcare professional about implementing “exercise medicine” as part of your cancer treatment plan.
So that’s just a little snapshot of what exercise can do for you on your cancer journey. Helping to build a better immune system AND lessening the effects of cancer fatigue are just two massive benefits to implementing an exercise regimen.
Associate Professor Cormie says it best:
Cancer patients who exercise regularly experience fewer and less severe side effects from treatments. They also have a lower relative risk of cancer recurrence and a lower relative risk of dying from their cancer, as well as lower relative risk of recurrence and from dying from their cancer. 
So hand over that exercise prescription because that definitely has to be worth a 30-minute walk around the block or a trip to your local gym.
As always, today’s choices create tomorrow’s results.
 Witlox L, Hiensch AE, Velthuis MJ, et al. Four-year effects of exercise on fatigue and physical activity in patients with cancer. BMC Med. 2018;16(1):86. Published 2018 Jun 8. doi:10.1186/s12916-018-1075-x
 Kruijsen-Jaarsma, Mirjam & Révész, Dóra & Bierings, M.B. & Buffart, Laurien & Takken, T. (2013). Effects of Exercise on Immune Function in Patients with Cancer: a Systematic Review. Exercise immunology review. 19. 120-43