Chapter 01 - Safeguarding Exercise Capacity Throughout and After Cancer Treatment
Advances in early detection and treatment have improved survival rates of cancer over the past decades, with approximately 60% of patients living more than 5 years after diagnosis. Despite this longevity, cancer and its treatment are often associated with physical and psychosocial side effects, i.e. both long-term effects present during treatment and persisting afterwards, and late effects, which did not occur during treatment but appear later. In the process of destroying cancer cells, radiation therapy and chemotherapy also cause alterations to normal tissue and body functions, resulting in toxicities in many organs and body systems. Also, hormonal therapies such as androgen and oestrogen suppression, while highly effective for treating prostate and breast cancer, respectively, cause considerable side effects. While controlling the cancer, there is significant impact on the patient, including the cardiovascular, pulmonary, gastrointestinal, (neuro)endocrine, immune, and musculoskeletal systems. As a consequence, cancer survivorsa experience reduced cardiorespiratory fitness, reduced muscle mass and strength, increased fat mass, reduced bone health, and fatigue. Furthermore, many cancer survivors are at increased risk for anxiety, depression, sleep disturbances, reduced self-esteem, and lymphoedema. These adverse long-term and late effects severely impact the patient’s quality of life (QoL).
aThe Centers for Disease Control and Prevention defined a cancer survivor as anyone who has been diagnosed with cancer, from the time of diagnosis through the rest of life.