Special CME Issue - West Virginia State Medical Association

substantially reduce cancer-related
fatigue and improve quality of
life in cancer patients. Exercise
may improve functional capacity
(VO 2max
) and mood states in patients
while possibly countering some of
the negative effects of treatment
(i.e. nausea and weakness). 29
Exercise can present a unique
challenge to patients still undergoing
therapy. Loss of muscle mass and
strength combined with a general
state of fatigue make daily exercise
even more challenging. Despite these
factors, many cancer patients can
greatly benefit from exercise training
because much of the improvement
occurs at the skeletal muscle level.
Unfortunately, there is very little
research on the optimal type(s) or
amount of exercise for which cancer
patients should engage. However,
a similar exercise prescription
used with patients who have other
chronic disease (i.e. heart disease)
may be appropriate if used with
caution. According to the American
College of Sports Medicine, aerobic
exercise training should be done
3-4 days per week, 20-40 minutes
per session at 40-85% VO 2max
or HR
reserve. The mode of exercise should
use large muscle activities (i.e.,
walking, cycling). Strength training
could be performed 2-3 days per
week, at 40-50% maximal voluntary
contractions, using 1-3 sets with 10-15
repetitions per set. Resistance should
be gradually increased over time and
reflect more of a circuit-type training.
Upper and lower body range-ofmotion
activities could be used 2-3
days per week to increase flexibility.
Conclusions
It is important for health care
providers to address preventive
measures of prostate cancer and
work to improve the quality of life in
patients with the disease. It is unclear
if exercise training has any effect on
the prevention of prostate cancer,
but it may limit the development
of advanced disease. Exercise has
also been shown to ameliorate the
side effects inflicted from hormonal
and/or radiation treatment.
Considering that side effects include
fatigue, immunosuppression,
osteoporosis and an increased risk of
cardiovascular disease and diabetes,
any measure taken to reduce or delay
these effects should be considered a
top priority in patient care. Exercise
programs, when performed under
the guidance of the patient’s medical
team, represent an excellent way
to improve health and reduce side
effects. We believe that a program
of exercise training may help to
attenuate complications of prostate
cancer, ultimately improving
quality of life, and possibly disease
progression and survival as well.
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46 West Virginia Medical Journal