Exercise cuts pain and fatigue after cancer

4 minute read

Doing just a little bit of physical activity is still better than nothing, researchers say.

Physical activity may help reduce pain in people with a history of cancer, research suggests.

The Australian and US study, published this month in Cancer, included more than 10,000 older cancer survivors from the US and over 51,000 adults without a history of cancer.

The researchers found that people who did more physical activity were less likely to experience intense pain over two years compared to people who were less active.

Among participants with a history of cancer, those who did no physical activity were 37% more likely to report pain compared to those who did “some” activity.

Participants with a history of cancer were 16% less likely to report moderate-to-severe pain if they exceeded physical activity guidelines, compared to those who did less than the guidelines.

Lead author and University of Melbourne research fellow Dr Chris Swain told Oncology Republic that participants who just did a little bit of physical activity still got benefits from exercise compared to those who did none.

“People who didn’t do anything had worse pain and more intense pain than people who did a little bit,” said Dr Swain, who is also part of Cancer Council Victoria’s epidemiology division.

“Doing something is better than nothing, and doing more than something is better than just doing something.”

Dr Swain said participants who were previously inactive and increased their activity reported less intense pain than those who remained inactive.

Patients were asked to rate their average pain on an intensity scale of 0-10, and to report their average time doing exercise of different intensities.

The University of Melbourne, Cancer Council Victoria and American Cancer Society researchers calculated the participants’ metabolic equivalent of task (MET) hours, which shows the metabolic cost of different kinds of physical activity.

Dr Swain said according to that measure, walking several times a week was approximately the metabolic equivalent to one run a week, although that would vary with duration and difficulty.

Dr Swain said the reasons for the effect of exercise on pain could be due to biochemical, physiological and neuromuscular pathways, or it could indirectly improve fatigue and mood.

Physical activity has also been shown to improve mental health and mood, which in turn can help individuals manage their response to physical pain, he said.

Physical activity may also protect against muscle loss after cancer treatment, helping improve function and protect against the impact of pain, he added.

Dr Swain said the most common activity type reported by participants was walking (reported by more than 70% of participants), followed by weight training or biking (around 20% each).

Just under 20% of participants reported another type of aerobic activity and less than 10% reported jogging or running.

Dr Swain said they did not have data on where participants’ physical pain was located, or how many patients had cancer or were undergoing treatment when they participated in the study.

“It’s likely that a lot of the participants had completed their cancer treatment at the time of participating,” he said.

“While the results are good news for the broader cancer survivor population, we are not able to be specific about effects for specific types of cancer pain.”

The findings come as new research presented at the San Antonio Breast Cancer Symposium showed that patients with metastatic breast cancer experienced significantly reduced fatigue and improved quality of life after participating in an exercise program.

The multinational, randomised controlled PREFERABLE-EFFECT trial assessed the effects of a nine-month supervised exercise program on more than 350 breast cancer patients with stable bone metastases.

After six months, participants in the exercise group reported improvements in fatigue and quality of life five times greater than in the control group, and the benefits lasted after nine months.

There were two fractures in the intervention group, but they were not deemed related to bone metastases.

“My advice to patients is to ask their healthcare providers about exercise, because that will help to get it into clinical practice, said researcher Dr Anne May, professor of clinical epidemiology of cancer survivorship at University Medical Center Utrecht in the Netherlands.

“It’s also important to talk to the nurse or the treating physician about whether exercise is feasible for the patient and then look for an oncology trained physical trainer,” she said.

“For healthcare providers, we know that time is a limiting factor, but we also know that the white coat is one of the most powerful things to get patients [to] exercise, so please … recommend exercise to your patients.

“And perhaps it’s good to look in your centre, whether you can find someone … where you can send patients to, and then they can get more detailed information about their exercise program,” Dr May said. 

Cancer 2024, online 12 February

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