By Dr. Karen Syrjala and Emily Jo Rajotte, Fred Hutchinson Cancer Research Center Survivorship Program
Frequently Asked Questions
As part of our commitment to evidence-based support for cancer survivors, the Survivorship Program conducted a study of community-based exercise for former cancer patients that focused on strength training. We found such exercise is both safe and effective in terms of physical and psychosocial benefit. The findings were published online Jan. 13, 2012, in the Journal of Cancer Survivorship.
Our study followed 221 cancer survivors who took part in a 12-week "Exercise and Thrive" program offered in conjunction with Seattle-area YMCAs. Overall, the study found the classes helpful for improving fatigue, insomnia, physical function, musculoskeletal symptoms, mental health, social support and physical activity. Additionally, participants had notable improvement in blood pressure, upper and lower body strength, walking endurance and flexibility.
The program focused on strength building because that is the area of greatest need and potential benefit for many cancer survivors. Cancer can cause loss of muscle mass and result in fatigue. Strength training is needed to rebuild this muscle and to generate energy.
Our study found a high rate of effectiveness for those who continued with the exercise classes, and relatively few people dropped out. Being accountable to others seems key to staying active. When people are tired they tend to want to rest until they feel better, and then resting becomes a habit. The support element of the classes was essential to people sticking with an exercise program.
Learning to stick with an exercise program is important for cancer survivors because studies have shown they have a higher rate of being sedentary compared to the general population. In our clinic, we see many people who were active before cancer become inactive afterward, and those where were inactive before are very unlikely to become active after cancer.
This tendency toward inactivity is unfortunate, as the benefits of exercise for cancer patients have been demonstrated as early as at the time of diagnosis. This suggests that earlier intervention by health care providers to prescribe safe exercise programs may be warranted. But studies have shown only half of oncologists inquire about their patients’ physical activity on some or most visits with "insufficient time" rated as the highest barrier to promotion of physical activity.
Study participants did not lose a significant amount of weight, a finding consistent with other exercise programs focused on strength training.
The "Exercise and Thrive" program involves group sessions with personal trainers, who attend a two-day workshop on cancer-specific exercise needs. The instructors receive training that addresses the emotional needs of survivors, as well as potential hazards of strength-building exercise. For example, in some former patients, if weight lifting is unrestrained, such activity can trigger lymphedema, an accumulation of fluid in tissue that causes limb swelling.
The most important lesson learned from our study is not the evidence that exercise matters—we’ve known that. What’s important is that we saw benefits for a community-based program using personal trainers who had limited cancer training. This made it possible for many more survivors to recover and thrive in a program that was safe and effective and in their communities.
Our partnership with regional YMCA facilities is helpful because cancer survivors are able to access the programs easily, at low cost – and without having to live near a cancer rehabilitation facility. Similar programs for cancer survivors are available in a growing number of states.
If you’d like to learn more about Exercise and Thrive, please visit our Exercise and Thrive page.
Q: Is it safe to exercise after cancer?
Yes! We now have a compelling body of high quality evidence that exercise after treatment is safe and beneficial for cancer survivors. However, before starting any kind of exercise program, it is best to consult a physician. Some doctors may recommend working with a physical or occupational therapist to help guide correct movement and form an exercise plan. Talking to a physician about the intensity and duration of exercises can be helpful to ensure that no harm is done by exercising too intensely.
Q: Do I have to pay to participate in Exercise and Thrive?
It depends. Many of the YMCA branches offering the Exercise and Thrive program are able to do so at no cost to participants while some branches are charging a fee ranging from $25 to $165. Financial assistance is available through the YMCA for those who have concerns about their ability to pay.
Q: Can I join Exercise and Thrive while I’m still in cancer treatment?
No, the Exercise and Thrive curriculum was established for cancer survivors who are at least 90 days out of cancer treatment with no evidence of active disease. This eligibility criterion was established for the safety and well-being of the program participants.