ASCO makes recommendations for exercising during cancer treatment

Exercise may help with side effects of cancer treatment.

Key Takeaways

• Recent research has shown that exercising may help reduce the side effects of cancer treatment.
• Aerobic and resistance exercise was found to be especially helpful for cancer patients. 
• Experts say that the findings are helpful because there has not been exercise guidance for patients currently undergoing cancer treatments.

The American Society of Clinical Oncology (ASCO) has made new recommendations for exercising for patients undergoing cancer treatment, placing an emphasis on aerobic and resistance exercises.

The guidelines are the first evidence-based recommendations for exercise and weight management during cancer treatments and suggest that physical activity may help with some of the side effects of treatment.1

“There are a lot of guidelines in terms of nutrition, exercise, and weight management in preventing cancer,” lead study author Jennifer Ligibel, MD, a medical oncologist at the Dana-Farber Cancer Institute, told Verywell. “But there’s growing evidence that making changes during treatment might have an effect on how people will do during therapy.”

Exercise Can Reduce Length of Hospital Stay

For the study, which was published in the Journal of Clinical Oncology, the researchers analyzed 52 scientific reviews: 42 related to exercise, nine on diet, and one for weight management. They also included 23 randomized clinical trials in their analysis.

The most common types of cancer included in the studies were breast, prostate, lung, and colorectal cancers.

Overall, the researchers found that exercise during cancer treatment led to patients experiencing improvements in cardiorespiratory fitness, strength, and fatigue, among other benefits.

When lung cancer patients who exercised needed operations, they spent less time in the hospital and had fewer complications than patients who did not exercise.1

Based on these findings, the ASCO decided to use the evidence to create exercise recommendations for patients currently being treated for cancer.

Is Exercise OK for Cancer Patients?

Experts say that the new evidence-based guidelines will help fill a gap in recommendations for people living with cancer.

There’s growing evidence that making changes during treatment might have an effect on how people will do during therapy. — Jennifer Ligibel, MD

“There’s never been a guideline that has specifically focused on people undergoing chemotherapy, radiation, and perioperative treatments,” Ligibel said.

Catherine M. Alfano, PhD, one of the study’s coauthors and the vice-president of Cancer Care Management and Research at the Northwell Health Cancer Institute, told Verywell that this is information patients want—and need—to know.

“Being treated for cancer makes many patients feel like they have no control over their health and that loss of control makes them very anxious,” said Alfano. “Patients are looking for things they can do to take that control back and improve their long-term health and well-being during their treatment.”

Exercise and Diet for Cancer Patients

The new guidelines address both exercise and diet considerations for people currently receiving cancer treatment.

The panel suggested that oncology providers recommend aerobic and resistance exercise for patients during treatment to reduce side effects associated with cancer therapies.

These exercises can have big benefits for those undergoing surgery for lung cancer, in particular.

“[Providers should] recommend preoperative exercise for patients who are scheduled to undergo surgery for lung cancer, as this may reduce [the] length of hospital stay as well as postoperative complications,” Alfano said.

On the diet side, the researchers did not find enough evidence to recommend for or against keto or low-carbohydrate diets, low-fat diets, functional foods, or fasting diets for cancer patients.

Alfano said that there was also “insufficient evidence to support a recommendation for or against intentional interventions focused on weight loss or weight gain prevention during active therapy in patients with cancer.”

How Do Aerobic and Resistance Exercise Help Cancer Patients?

The study did not look at why aerobic and resistance training might be helpful—it only found a link between exercising and fewer side effects and better outcomes for cancer patients.

That said, experts do have some hypotheses about how aerobic and resistance exercise could be beneficial for people who are being treated for cancer.

Nathan Parker, PhD, MPH, a researcher in the Department of Health Outcomes and Behavior at Moffitt Cancer Center, told Verywell that “both exercise modalities are very important and, together, they provide the stimuli that bodies need to improve or maintain health and well-being.”

In general, Parker said that “aerobic exercise is going to contribute more to improvements or maintenance of cardiorespiratory fitness, and resistance training is going to contribute more to muscular strength and maintenance of lean body mass.”

It doesn’t have to be one or the other, though—Parker added that there are definitely “areas in which the benefits of aerobic and resistance training overlap and synergize with one another, which is why both contribute to a well-rounded exercise program.”

Scherezade K. Mama, DrPH, assistant professor of Health Disparities Research at The University of Texas MD Anderson Cancer Center, told Verywell that aerobic and resistance exercise also “helps reduce inflammation, comorbidities such as cardiovascular disease and diabetes, and frailty, which helps manage the side effects of treatment, such as nausea and fatigue, and reduces the likelihood of hospitalization during treatment.”

Why the Guidance Is Needed

Proper exercise is important to offset the negative effects of cancer treatment as much as possible.

“Cancer and cancer treatments can cause losses in aerobic fitness and muscular strength and endurance,” Parker said. “They can also lead to detrimental shifts in body composition—losing lean body mass, sometimes while gaining or maintaining fat—and they involve symptoms and side effects that pose challenges to day-to-day life, like fatigue and neuropathy.”

Exercising to improve outcomes during cancer treatment is empowering. — Nathan Parker, PhD MPH

According to Parker, these changes can make it difficult for people to tolerate cancer treatments. But exercise “can help reverse or mitigate these challenges, helping people tolerate treatments and maintain their quality of life through and beyond cancer treatment.”

Getting physically active may also help patients cope emotionally with cancer treatments.

“Exercising to improve outcomes during cancer treatment is empowering, as it’s something within the individual’s control that can help improve outcomes at a time when many things might feel out of one’s control,” Parker said.

While exercise during cancer treatments is generally recommended, Ligibel said that patients need to talk with their providers about what’s right for them—especially if they’re thinking about starting a new exercise program.

What This Means For You

If you’re currently undergoing cancer therapy, ask your oncologist about exercising while you are having treatment. New research has shown that it may help reduce the side effects of treatment and help you cope.

Fact checked by Nick Blackmer