High-intensity exercise best for people with cancer say ESSA guidelines

High-intensity exercise is best for people with cancer ESSA recommends in new exercise guidelines for people with cancer contrary to earlier guidance.

The Exercises and Sports Science Australia's (ESSA) Position Statement on Exercise Medicine in Cancer Management that has been published in the Journal of Science and Medicine in Sport. The new guidelines are recommending a personalised exercise program including high-intensity workouts to achieve the best treatment outcome in cancer instead of earlier recommendation for people with cancer to take a "slowly slowly" approach.

Director of ECU's Exercise Medicine Research Institute and co-author of the statement Professor Daniel Galvão said: "No one cancer patient is the same as another. Therefore, there is no 'one size fits all' exercise prescription."

"The type, duration, frequency, intensity and total volume of exercise prescription needs to be tailored to the patient's needs and priorities," Professor Galvão said.

"This position statement uses evidence, alongside best practice, to determine who needs what type, intensity, frequency and duration of exercise and when.

"For example, for patients with a low level of fitness, or those with advanced stage disease, a starting exercise prescription may need to involve multiple short bouts of five to ten minutes, to accumulate at least 20 minutes on any given day.

"As exercise capacity improves, progression towards longer sessions of at least 20 minutes duration on most days of the week is recommended."

Professor Hayes said ten years ago, in the ESSA's first position statement on the topic, the best advice for people with cancer was to follow a generic exercise program of low to moderate intensity, with three to five sessions per week including aerobic, resistance or a mixture of both.

But in the past decade evidence has challenged that advice.

Professor Hayes said the research that had emerged since the release of the first position statement demonstrated the benefit to cancer outcomes _ including specific treatment-related side effects, such as lymphoedema and fatigue which could be achieved with a targeted approach to exercise prescription.

One of the key changes in the new recommendations is that the guidelines no longer have a generic exercise program recommendation of a specified number of workouts a week.

"Research in this space has exponentially grown and consequently, the updated position stands now provides the foundation for Accredited Exercise Physiologists to ensure their exercise prescription is targeted towards improving cancer outcomes," Professor Hayes said.

"While for the majority of cancer patients, moderate to high-intensity exercise will likely be appropriate, there is no set prescription and total weekly dosage that would be considered evidence-based for all cancer patients."

"Precision medicine is about optimising patient outcomes. This position statement allows for precision medicine through exercise."