exerciseIntuitively, most people agree that exercise and nutrition improve health. For cancer survivors, well-documented clinical research supports these claims. As I shared in a previous post, the concept of prescribing exercise for a cancer diagnosis is still a relatively new part of treatment. However, the research showing the value of exercise for cancer recovery started many years ago.

In 2009, Dr. Kathryn H. Schmitz of the University of Pennsylvania published a landmark study called Physical Activity and Lymphedema, also known as the PAL Trial.[1] Schmitz and her team led a randomized controlled trial of 295 breast cancer survivors and measured physical activity, lymphedema, and the safety of progressive strength training. This study received national attention when Dr. Schmitz demonstrated that strength training helped, not hurt, women who had lymphedema. This turned the medical community upside down. For years, physicians had told their patients who were at risk for lymphedema not to lift anything heavier than 5-10 pounds. Dr. Schmitz showed that patients could safely engage in strength training and gain benefits such as reduced lymphedema, increased muscle mass, reduced fatigue, greater range of motion, and improved body image.

The evidence gained by the PAL Trial led Dr. Schmitz to partner with the American College of Sports Medicine (ACSM), the largest sports medicine and exercise science organization in the world. ACSM’s commitment to integrating scientific research into practical applications of exercise science led them to a collaboration with the American Cancer Society (ACSM/ACS) in the development of the Cancer Exercise Trainer (CET) certification. A CET is qualified to design and administer fitness assessments and exercise programs specific to a client's cancer diagnosis, treatment, and current recovery status.

With research evidence regarding the value of strength training and the support from the American College of Sports Medicine, the questions become: How far can a cancer patient progress with strength training? Is there an upper limit to the amount of weight one can lift? An earlier study by I.C. De Backer et al. (2007) discovered that survivors of a variety of cancers—lymphoma, breast, gynecological, testicular, or colorectal—can participate in supervised strength training programs with higher workloads (heavier weights) as long as the increments are added slowly and progressively.[2] In the Journal of Cancer Survivorship, Prue Cormie et al. (2013) conducted a randomized controlled trial that showed no adverse effects when women with lymphedema lifted heavy weights in progressive increments.[3]

Additional research showed that exercise can reduce the recurrence of some cancers. Dr. Jeffrey Meyerhardt of the Dana-Farber Cancer Institute published a study in 2006 with women who had stage I to III colon cancer that found that women who walked for 30 minutes a day at a moderate pace for five days per week had as much as a 50 percent reduced recurrence of disease.[4] Dr. Michelle Holmes of Harvard Medical School led an observational study in 2005 asking if moderate exercise reduced the recurrence of breast cancer.[5] Holmes’s study is known as the “Nurse’s Study,” as she followed almost 3000 registered nurses who had been diagnosed with stage I, II or III breast cancer between 1984 and 1998. Holmes discovered that nurses who had been more physically active, compared to those who were sedentary, had a reduced recurrence of disease

These pioneering studies laid the foundation for numerous other research projects and established the value of adding exercise to cancer treatment.

[1] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2730488/

[2] http://www.ncbi.nlm.nih.gov/pubmed/17851864

[3] http://link.springer.com/article/10.1007%2Fs11764-013-0284-8

[4] http://www.ncbi.nlm.nih.gov/pubmed/16822844

[5] http://www.ncbi.nlm.nih.gov/pubmed/15914748?dopt=Abstract

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