Assessment and Exercise Prescription Guidelines in Cancer Care

The part starts with an assessment framework: know the cancer type, treatment and stage, prioritize health issues, identify capacity, barriers and facilitators, then prescribe and reassess. Tests include handgrip, 1RM and strength endurance tests, cardiopulmonary exercise testing, the modified Bruce protocol, the 6-minute walk and a battery of physical function tests. 1RM testing is safe without bone metastases, sites with metastases or suspected osteoporosis should not be loaded in testing, and neurotoxic chemotherapy calls for balance and fall-risk checks. Guideline doses follow: resistance training of at least 2 sets of 8 to 15 reps at 60 to 80% 1RM, two days a week, and 150 minutes of moderate or 75 minutes of vigorous aerobic exercise weekly. Francesco gives separate schemes for strength and hypertrophy, using RPE and repetitions in reserve, and for continuous and interval aerobic work. He then matches emphasis to side effects such as sarcopenia, cachexia, osteoporosis, dyspnea, neuropathy, fatigue, obesity and cardiovascular disease.