“According to the guidelines…”
“Make sure you follow the guidelines…”
“The guidelines say…”
Ok we get it, we get it… there are guidelines and we need to follow them. But who actually decided on these guidelines? And more importantly what do these guidelines mean and why do they exist?
You will often hear your Exercise Physiologist refer to “the guidelines” when planning your exercise goals and to start we do apologise for sometimes making it feel as though you are back in school being given homework (flashbacks anyone?). But trust us, there are perfectly valid reasons why we constantly talk about and refer to these guidelines.
For a while now clinical research has supported exercise as both a SAFE and EFFECTIVE way to help in counteracting many of the terrible side effects that can accompany a cancer diagnosis and its treatment. But often we hear people asking, “How much exercise is enough exercise?”
Until the past couple of years, there has been some uncertainty on what exactly is the correct “dosage” of exercise that should be prescribed to the cancer population within Australia. Due to this ambiguity, exercise was more than often prescribed in line with the general population exercise recommendations, but it actually turns out that those recommendations were pretty close.
In May 2018 the Clinical Oncology Society of Australia (or COSA) released their position statement on “Exercise in Cancer Care” which highlighted that ALL people living with cancer should progress towards and, once achieved, maintain the following when it comes to weekly exercise:
- AT LEAST 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity AEROBIC exercise (the stuff that makes you huff and puff). This includes brisk walking, jogging, cycling, and swimming.
- Two to three RESISTANCE exercise (the stuff that makes your muscles strong) sessions. These activities should focus on our larger muscle groups.
At this stage these recommendations are exactly the same as the guidelines (those words again) for the general population. But here’s the difference… the COSA guidelines make it very clear that these exercise recommendations need to be tailored to each individual’s physical abilities as well as taking in to account various other factors. These include disease-related adverse effects, side effects due to treatment (this may include surgery, chemo, radiation, or medication being taken), disease trajectory, and also overall health status.
Not only does COSA endorse the importance of exercise for ALL people with cancer, they also recommend that exercise be embedded as part of standard care and to be viewed as an adjunct therapy due to its ability to help with counteracting the various adverse health effects of cancer and its treatment. Basically, what that means is if exercise were a tablet, it would be prescribed to EVERYONE who is diagnosed with cancer.
Despite the above endorsement, disappointingly only 60-70% of people living with cancer are meeting the aerobic exercise guidelines and a bewildering 80-90% do not currently meet the resistance exercise guidelines. In our experience a lot of this comes down to the fact that people living with cancer do not feel safe and/or confident with exercising on their own or just don’t know where to start… but that is where we come in! COSA states that BEST PRACTICE (can’t get better than best) cancer care includes a referral to an Accredited Exercise Physiologist (hey that’s us) and/or physiotherapist with experience in cancer care.
So now you have a better understanding of what your Exercise Physiologist or Oncologist means when we refer to “the guidelines” and why they are so important. We hope that with this knowledge you can feel more confident in starting to plan (or continue planning) your journey towards reaching these guidelines and ultimately reaching a better quality of life – and of course your Accredited Exercise Physiologist will be there to help you every step (or walk) of the way.
Keep an eye out at the beginning of April for our next blog which will explore what the evidence currently says about how exercise can assist with managing the common symptoms linked with cancer and its treatment. We will also simplify what the current research says about the link between regular exercise and cancer prevention/survival.
Written by Michael Czaplowski, Accredited Exercise Physiologist at Movement Against Cancer
Cormie, P., et al., Clinical Oncology Society of Australia position statement on exercise in cancer care. Med J Aust, 2018. 209 (4): p.184-187
Eakin, E.G., et al., Health behaviors of cancer survivors: data from an Australian population-based survey. Cancer Causes Control, 2007. 18(8): p. 881-94. 35.
Galvao, D.A., et al., Compliance to exercise-oncology guidelines in prostate cancer survivors and associations with psychological distress, unmet supportive care needs, and quality of life. Psychooncology, 2015. [Epub ahead of print].
Short, C.E., et al., Main outcomes of theMove More for LifeTrial: a randomised controlled trial examining the effects of tailored-print and targeted-print materials for promoting physical activity among post-treatment breast cancer survivors. Psychooncology, 2015. 24 (7): p. 771-8. 36.