Mary Kennedy, PhD Exercise Physiologist
The days when rest was considered the best option for people with cancer are long past. Decades of research demonstrates clear benefits of exercise to improve health outcomes before, during, and after cancer treatment.
A 2019 review showed exercise has a role in positively impacting eight common side effects of cancer treatment, including improved health-related quality of life and physical function, bone health, and sleep, and decreased cancer related fatigue, anxiety and depression.
Further research supports the role of exercise in the improved survival rates of breast, colon, and prostate cancer.
Yet some clinicians still question the true impact of exercise due to the observational nature of most exercise oncology studies.
A recent randomised controlled trial (889 people, 55 centres primarily in Canada and Australia) investigated if structured exercise could improve survival outcomes for people with stage III or high-risk stage II colon cancer after the completion of surgery and chemotherapy.
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Participants were randomly assigned to either a three-year supervised exercise program (intervention group) or received health education materials only (control group).
The results demonstrated significantly longer disease-free survival for people in the exercise group and were consistent with longer overall survival for exercisers too.
This is the first randomised trial showing that exercise can directly improve survival in people with colon cancer – reinforcing the importance of providing exercise as part of cancer care.
The Clinical Oncology Society of Australia (COSA) calls for exercise to be embedded as a standard part of cancer care. COSA encourages all healthcare professional to talk about exercise, recommend it, and refer patients to accredited exercise physiologists or physiotherapists.
Yet, a recent study found that while 94% of healthcare professionals agree exercise is beneficial, only 35% routinely apply COSA’s recommendations in practice.
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The reason for the low participation rate? Many feel it is not their role, or they lack the time, training, or resources.
But patients report they trust their care team, so even a brief conversation or referral can make a difference. Exercise isn’t just a “nice to have” – it’s evidence-based care, and health professionals need to promote that message.
Helpful resources
Whilst not necessary to upskill as an exercise professional to promote exercise to patients, it is important to start the conversation reinforcing that exercise is an important part of care, not an optional extra.
Exercise is Medicine Australia offers a variety of resources to guide healthcare professionals to incorporate exercise screening, assessments, discussions, and referrals into their practice. The practical tools are free and are designed to be integrated into clinical care.
The Exercise and Sports Science Australia (ESSA) Professional Directory is a practical tool helping locate qualified providers, making referrals easier and more accessible. The tool allows for screening by location and specialty area of the professional.
Cancer Council WA offers the Life Now Exercise program – a free 12-week supervised group program for people diagnosed with cancer and their primary carers.
General practitioners have a particularly important role in providing exercise for people living with and beyond cancer.
A Chronic Disease Management Plan (CDMP), allows eligible patients, including anyone with a cancer diagnosis, to access Medicare-funded exercise sessions.
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People are eager to receive exercise guidance. A recent focus group in Western Australia explored the experience and desires of breast and prostate cancer survivors for receiving exercise information from their health care providers. A key finding from the study: people wanted more.
One breast cancer survivor noted: “I would like to be referred to someone… to help me with everything, like, how to exercise, what kind of exercises.”
Key messages
- Exercise is medicine for people with cancer
- A substantial body of evidence supports integrating exercise into clinical care
- Start the conversation about exercise with your patients today
Author competing interests – the author is supported by a Cancer Council of Western Australia Postdoctoral Fellowship and serves on the ACSM Exercise is Medicine® Moving Through Cancer Task Force.
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