How common is cancer?

Recent statistics underscore the urgency of proactive cancer care. In 2022 alone, there were approximately 20 million new cancer cases worldwide, with around 10 million deaths. Projections suggest that the incidence could reach 35 million by 2050—an increase of about 80% from current numbers. Lung, breast, colorectal, prostate, and stomach cancers rank among the most diagnosed types, with lung cancer also leading in cancer-related mortality.

What are its risk factors?

Cancer risk factors can be categorized into two groups:

Non-Modifiable Risk Factors:

These include genetics, age, ethnicity, and environmental exposures such as air pollution.

Modifiable Risk Factors:

Lifestyle choices—such as tobacco and alcohol consumption, high-fat diets, increased body mass index (BMI), and, importantly, low levels of physical activity—play a significant role.

The Impact of Cancer and Its Treatments

Cancer and its treatments bring about a host of side effects that can dramatically affect quality of life. These include:

Physical Changes:
Fluctuations in body weight, loss of muscle mass (sarcopenia), increased fat mass, reduced bone mineral density, and a decline in overall muscle strength and cardiorespiratory fitness.

Psychological Effects:
Anxiety, depression, fatigue, sleep disturbances, and even sexual dysfunction can emerge during and after cancer treatment.

Physiological Alterations:
Inflammation tends to increase, while immune and metabolic functions may decline. These changes contribute to a heightened risk of cancer recurrence and increased mortality.

Exercise as a Multifaceted Intervention
Exercise, when properly prescribed and supervised, offers a wide range of benefits:

Physical Improvements:
Regular activity enhances muscle strength, improves cardiorespiratory fitness, and optimizes body composition. This not only helps patients better tolerate cancer treatments (like chemotherapy) but also aids in faster recovery post-treatment.

Psychological Benefits:
Exercise reduces symptoms of anxiety and depression, combats fatigue, and generally improves quality of life.

Enhanced Treatment Efficacy:
Studies have shown that exercise can increase the delivery and efficacy of chemotherapy, improve immune function, and even help in slowing tumor progression.

Exercise Medicine refers to the assessment and prescription of exercise specifically for the prevention or treatment of disease and injury. In the context of cancer, it underscores how movement can serve as a powerful tool in both preventing further complications and enhancing recovery.

Exercise Across the Cancer Continuum
One of the most compelling aspects of exercise in oncology is its applicability at every stage of the cancer journey:

1. Prehabilitation (Neo-Adjuvant Phase)

Before the main treatment—such as surgery—begins, engaging in a structured exercise program can:

Enhance physical and psychological resilience.
Prepare the body for the impending treatment.
Improve postoperative outcomes and reduce recovery time.

2. Active Treatment (Adjuvant Phase)

During treatments like chemotherapy:

Exercise helps increase the efficacy of treatments.
It mitigates side effects such as nausea, fatigue, and loss of muscle strength.
A combination of aerobic and resistance training can improve overall fitness, making patients more capable of enduring intensive therapies.

3. Survivorship

After primary treatment, exercise continues to offer significant benefits:

It aids in restoring physical fitness and improving body composition.
Patients experience a reduction in inflammation and an increase in metabolic health.
Regular physical activity decreases the risk of chronic diseases (e.g., cardiovascular disease, diabetes) and may reduce the likelihood of cancer recurrence.

Two Main Exercise Modes which can be prescribed:

Resistance Training:
Using tools like dumbbells, barbells, or machines, resistance training focuses on:
-Increasing muscle strength and promoting hypertrophy.
-Enhancing bone mineral density.
-Improving lean muscle mass.

Aerobic Training:
Activities such as walking, cycling, swimming, or running are effective in:
-Boosting cardiorespiratory fitness.
Improving metabolic health.
-Reducing fat mass.

Exercise is safe across all stages of cancer care—from diagnosis to advanced disease.
No studies have indicated that physical activity increases mortality risk in cancer patients. In fact, higher physical activity levels have been associated with up to a 40% reduction in mortality risk.
When properly prescribed and supervised, exercise does not exacerbate conditions like lymphedema or cause adverse events such as bone fractures—even in patients with bone metastases.
This safety profile, combined with the myriad benefits, underscores why exercise is rightfully considered a form of medicine in oncology.

Source:
1.  From the lecture ‘Benefits of Exercise in Patients with Cancer’ by Francesco Bettariga