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Report of a Multidisciplinary Expert Panel: Cancer Treatment Plans Should Include Tailored Exercise Prescriptions

Oct 16, 2019

Media Contacts:
Meagen Arensdorff: marensdorff@aapmr.org (American Academy of Physical Medicine and Rehabilitation) 
Phyllis Anderson: panderson@foundationforpmr.org (Foundation for Physical Medicine and Rehabilitation)
Lisa Ramage: Lramage@acsm.org (American College of Sports Medicine) 

Individualized exercise prescriptions can improve survival from cancer, reduce cancer symptoms and lower risks for recurrence. New guidance published today from exercise oncology experts recommend systematic use of an “exercise prescription” by health care workers and fitness professionals in designing and delivering exercise programs that aim to lower the risk of developing certain cancers and best meet the needs, preferences and abilities of people with cancer. The American College of Sports Medicine (ACSM) convened a roundtable of experts from 17 partner organizations, including physiatrists who are members of the American Academy of Physical Medicine (AAPM&R). Other sponsors included the American Cancer Society and the National Cancer Institute—part of the National Institutes of Health.

The group reviewed the latest scientific evidence in order to provide recommendations about the benefits of exercise for prevention, treatment, recovery and improved survival for cancer survivors.

“With more than 43 million cancer survivors worldwide, we have a growing need to address the unique health issues facing people living with and beyond cancer and better understand how exercise may help prevent and control cancer,” said ACSM Immediate Past President Katie Schmitz, Ph.D., FACSM, who co-chaired the roundtable. “This esteemed, multidisciplinary group of leaders on the forefront of exercise oncology aimed to translate the latest scientific evidence into practical recommendations for clinicians and the public and to create global impact through a unified voice.”

Members of the American Academy of Physical Medicine and Rehabilitation (AAPM&R), the primary medical society for the specialty of PM&R, were active participants in the Roundtable process. This included planning, presenting and summarizing findings and vetting recommendations. Physicians represented by AAPM&R are physiatrists and are essential medical experts in value-based evaluation, diagnosis, and management of neuromusculoskeletal and disabling conditions. They are leaders in directing rehabilitation and recovery, preventing injury and disease. Physiatrists are vital in optimizing outcomes and function early and throughout the continuum of patient care and fill a critical role in the management of cancer rehabilitation.

The Foundation for PMR funds physiatric research to increase our understanding of the underlying mechanisms of disability, and determine the best interventions to maximize health and improve function for people with disabilities.

AAPM&R Physiatrist members participating in the roundtable included: Dr. Lynn H. Gerber, MD who served on the executive planning committee; Dr. Leighton Chan, MD, MPH; Dr. Andrea Cheville, MD, MS; Dr. Julie Silver, MD; Jonas Sokolof, DO; Dr. David Zucker, PhD MD.

AAPM&R members are actively engaged in cancer rehabilitation research, education, outreach and advocacy and have recently assembled a group of interested cancer rehabilitationists (Cancer Rehabilitation Physicians Consortium) under its aegis.

The Clinical Practice Guidelines (CPG) Committee of the AAPM&R reviewed the preliminary recommendations and supports the papers published by the expert panel.

The new evidenced-based guidance and recommendations include:

  • For all adults, exercise is important for cancer prevention and specifically lowers risk of seven common types of cancer: colon, breast, endometrial, kidney, bladder, esophagus and stomach
  • For cancer survivors, incorporate exercise to help improve survival after a diagnosis of breast, colon and prostate cancer
  • Exercising during and after cancer treatment improves fatigue, anxiety, depression, physical function, quality of life and does not exacerbate lymphedema
  • Continue research that will drive the integration of exercise into the standard of care for cancer
  • Translate into practice the increasingly robust evidence base about the positive effects of exercise for cancer patients

The comprehensive review and recommendations are outlined in three academic papers published today in two scientific journals. “Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable” and “American College of Sports Medicine Roundtable Report on Physical Activity, Sedentary Behavior, and Cancer Prevention and Control” published in Medicine & Science in Sports & Exercise®, ACSM’s flagship research journal. The third paper, “Exercise Is Medicine in Oncology: Engaging Clinicians to Help Patients Move Through Cancer,” was published in CA: A Cancer Journal for Clinicians, a flagship journal of the American Cancer Society.

Health care and fitness professionals should use the new recommendations when creating exercise programs for cancer patients and survivors. This includes formally and systematically using custom exercise prescriptions that best meet the needs, preferences and abilities of individuals living with and beyond cancer. Fitness professionals can obtain the Cancer Exercise Trainer certification collaboratively developed by ACSM and the American Cancer Society. Additionally, professionals and scientists should continue research that will drive the integration of exercise into the standard of care for cancer.

To implement the recommendation for translating evidence into practice, ACSM and its Exercise is Medicine (EIM) initiative also introduced a new program, Moving Through Cancer. The clinician-focused program aims to ensure that all people living with and beyond cancer are assessed, advised, referred to and engaged in appropriate exercise and rehabilitation programming as a standard of care. Resources are available for oncology clinicians and patients, including a global, searchable registry of exercise programs at www.exerciseismedicine.org/movingthroughcancer.

Partner organizations that participated in the roundtable include: ACSM, American Cancer Society, the National Cancer Institute—part of the National Institutes of Health,  American Academy of Physical Medicine and Rehabilitation, American College of Lifestyle Medicine, American Physical Therapy Association, American Society of Clinical Oncology, Canadian Society of Exercise Physiology, Centers for Disease Control and Prevention, Commission on Accreditation for Rehabilitation Facilities, German Union for Health Exercise, Exercise and Sport Science Australia, Macmillan Cancer Support, National Comprehensive Cancer Network, Royal Dutch Society for Physical Therapy, Society of Behavioral Medicine, Society of Surgical Oncology and Sunflower Wellness.