In this E-Learning module, the authors elaborate on physical activity and exercise from the domains of cancer prevention, preparation for treatment, its efficacy and safety during treatment, and as a part of the rehabilitation programme after treatment. They underline that exercise can be safely performed before, during and after treatment for cancer, considering individual limitations, and encourage all cancer survivors, to at least avoid being sedentary.
After tackling the historical context, the authors provide definitions of physical activity, physical exercise and physical fitness and then move to different aspects of evaluation of physical activity level, physical capacity, risk factors, body composition, chronic diseases / incapacity and furthermore elaborate on evaluation and testing in terms of patient goals and preferences.
In the next chapter, the authors give recommendations for physical activity and exercise from the domains of primary and secondary prevention of cancer. This is followed by a chapter on the importance, multimodal intervention and building on the evidence in terms of prehabilitation. In the following chapter, they consider the efficacy and safety of physical activity and exercise during treatment, providing examples in patients with different cancer types and settings.
At the end of the module, the authors focus on exercise as part of the rehabilitation after treatment in terms of rehabilitation needs and individualised exercise. They provide instructions for physical exercise by cancer survivors, highlight its benefit in case of high cardiovascular risk in cancer survivors, address the challenges and future perspectives.
This module brings an important message for the current and future oncology practice: to re-evaluate and modify the programme to address changes in medical status, physical fitness and functioning. It urges practitioners to perform a global comprehensive previous assessment, consider specific rehabilitation needs, individualise exercise programmes based on the information gathered from exercise testing and other assessments, like balance, strength, frailty, to consider patient goals and exercise preferences, as well as to identify barriers, including long-term treatment and disease related side effects, that may compromise the ability of exercise.
