gms | German Medical Science

Objective: Regular physical activity has been shown to be very important for functional health and participation of cancer patients. However, not all cancer patients need the same form of regular physical activity.

Material/Methods: In this survey, experiences of the outpatient clinic and of the special exercise program for cancer patients of the Department PM&R (Medical University of Vienna) are presented. A review about own clinical experiences, clinical studies and case reports is given – for all described conditions we cite and present our studies and reports from the literature.

Results: Experiences from our outpatient clinic show, that regular physical activity of cancer patients can include the application of neuromuscular electrical stimulation (in form of a “passive training”), biofeedback-assisted exercises, aerobic exercise, strength exercise, and even sports and competitions, for example, Marathon running and Triathlon (Iron man). Yes, there are really cancer patients who are willing to perform sports with regular participation in competitions! Of whom, the case of a prostate cancer patient who performed a Triathlon (Ironman) within 14h 35’ is presented.

Nevertheless, physical activity of cancer patients typically and in most cases is represented by aerobic exercise. This form of exercise – individually prescribed – has been described to improve functional health of cancer patients with benefits for physical performance, mental health, quality of life, and – in some types of cancer – survival. Our own experiences show that female breast cancer patients can benefit from aerobic exercise during adjuvant chemotherapy in a central hospital, and that even patients suffering from metastatic bone disease can reach excellent endurance capacities up to 150% and maintain independency from others help. Cancer patients suffering from very severe concomitant diseases (myocardial infarction, stroke, peripheral vascular disease, amputation) are also able to perform supervised aerobic exercise – and to benefit. Patients under very modern oncologic treatment (Sunitinib), which is known to be very effective and to significantly increase survival of metastatic cancer, but which can be a danger during exercise due to its cardio toxicity, are able to perform active aerobic exercise and to reach excellent endurance capacities.

To increase muscular strength, cancer patients are performing strength training even in cases of metastatic bone disease. Some patients suffering from advanced multiple myeloma can only increase strength in a safe way by using biofeedback-assisted exercise.

Cancer patients with metastatic brain disease or brain tumours can also benefit from regular active exercise, but also from neuromuscular stimulation.

For those patients, who are not allowed to perform active exercise, neuromuscular electrical stimulation (NMES) is an option. NMES is performed with the intention to prevent loss of skeletal muscle mass in patients who are not able and/or not allowed to perform active exercise, but also to increase muscular strength and endurance capacity in some patients suffering from very advanced cancer who want to increase their (social) participation.

Conclusion: Regular physical activity has been described to be an important part in the treatment and rehabilitation of cancer patients, but it can differ in its motivations and goals. Nevertheless, most of cancer patients should start as soon as possible to be physically active, but under the supervision of specialized physicians and within their individual “right” setting. This setting should be planned according their individual (medical) risk factors and according their individual (sportive) goals, to find the right way for the individual cancer patient.