If exercise were a cancer drug, it would be a blockbuster, appears to be the conclusion of a new review on the benefits of physical activity to people surviving and living beyond cancer. In a report released today, 8 August, the leading UK charity Macmillan Cancer Support, firmly sweeps aside the tradition that cancer patients should “rest up” and “take it easy”, and urges doctors and nurses to prescribe physical activity to patients “at all stages of cancer from initial diagnosis through to the later stages”. However, despite the emergence of this evidence, many health professionals are failing to tell their cancer patients about the benefits of exercise, they added.

Ciaran Devane, Chief Executive of Macmillan Cancer Support, told the press that the evidence in the report, whose short title is “Move More”, shows how important physical activity is to recovery from cancer, yet “very little attention to its benefits is given by health professionals or by those commissioning health services”.

He urged that services to promote and offer exercise should not only be available, but that they should be “prescribed” to cancer patients.

Devane said cancer patients would be “shocked” if they knew how much physical activity could help their recovery and long term health, in some cases even reducing the chance of having to undergo repeat treatment.

The report, which describes a review of over 60 studies and a survey of 400 health professionals who deal with cancer patients, finds that not being physically activite enough could be putting as many as 1.6 million cancer survivors in the UK at greater risk of long terms health problems and some at greater risk of recurrence.

Here are some its key findings:

  • Doing recommended levels of physical activity can cut risk of recurrence and dying from breast cancer by up to 40% and from prostate cancer by up to 30%.
  • For bowel cancer patients, doing significant amounts of physical activity can cut the the risk of recurrence and dying from the disease by as much as 50%.
  • Following recommended levels of exercise after cancer treatment can cut the risk of side effects, such as depression, fatigue, osteoporosis and heart disease.

Yet despite this strong evidence, Macmillan say they found that many health professionals were not aware of it and most of them are not telling their patients about it. They found 56% of GPs, practice nurses, cancer doctors and cancer nurses do not discuss the benefits of physical activity with their patients.

Jane Maher is a leading clinical oncologist. She also happens to be Chief Medical Officer of Macmillan Cancer Support, and said once upon a time she would have advised patients to “take it easy”. Now, the advice is totally different, because we have come to realize “if physical exercise were a drug, it would be hitting the headlines”.

Maher said what we need is a “cultural change”, so that doctors and other health professionals stop viewing physical activity as an “add-on” and treat it instead as an integral part of cancer after-care.

Devane emphasized that physical activity does not mean strenuous exercise, it can be gardening, going for a brisk walk or a swim, these all count towards being physically active.

“Health professionals can refer patients to a variety of services such as physiotherapy, specialist exercise programmes at leisure centres or walking groups,” he urged.

The report favours bringing activity levels up to that recommended by the Department of Health’s 2011 Start Active, Stay Active report, which contains guidelines from the UK Chief Medical Officers. This recommends that adults should do 150 minutes of moderate intensity activity a week.

The advice also breaks down according to age and level of physical activity that people are already doing. For example, older adults (aged 65 and over) should aim to be active daily, and their 150 minutes a week should be in bouts of no less than 10 minutes of moderate intense activity, ideally as 30 minutes on at least five days a week. However, for those who are already exercising regularly at a moderate level, then they should also do some vigorous activity throughout the week, combined with moderate activity.

Older adults should also aim to improve muscle strength, (and if at risk of falls, balance and coordination as well), at least two days a week, and minimize the amount of time spent sitting for extended periods.

In a statement, Macmillan describe the case of Jane, a 57-year-old woman from Christchurch, near Bournemouth in the south of England. Jane received a “prescription” for exercise after undergoing treatment for breast cancer. She said:

“Before I was diagnosed with breast cancer I didn’t really do much exercise. I felt pretty down and exhausted after my treatment — it really knocked it out of me.”

Jane was prescribed an exercise programme that included 12 weeks free use of a gym and regular meetings with a trained instructor who recommended she join a dragon boat racing group for women who have had breast cancer.

“I loved it so much, I’m still taking part.” said Jane, adding that she is like “a completely different person”, she feels “so much better”, “more confident”, and “much less tired”.

“Who could have imagined me being so full of life after everything I’ve been through?” she added.

Written by Catharine Paddock PhD