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Australian body promotes exercise as part of cancer treatment

In a position statement published in the Medical Journal of Australia, the Clinical Oncology Society of Australia has said that exercise is an essential component in the treatment of cancer. This statement, endorsed by a group of 25 influential health and cancer organisations, including the Cancer Council Australia, is the first evidence-based approach to making exercise a mandatory part of cancer treatment.

The main recommendations are that exercise is part of standard practice in cancer care and is viewed as adjunct therapy, that all members of the multidisciplinary team promote physical activity and recommend that those with cancer stick to exercise guidelines, and that best practice care includes referral to an accredited exercise physiologist or physiotherapist with experience of cancer care.

The body states that clinical research has established strong evidence that the improvements in physical function as a result of exercise attenuate cancer-related fatigue, alleviate psychological distress and improve quality of life across multiple general health and cancer-specific domains. Emerging evidence suggests that regular exercise before, during and after cancer treatment decreases the severity of treatment side-effects and reduces the risk of developing new cancers and comorbid conditions such as cardiovascular disease, diabetes and osteoporosis.

Comrie P, Atkinson M, Bucci L, et al. Clinical Oncology Society of Australia position statement on exercise in cancer care. Med J Aust 2018 (epub 7 May 2018). https://doi.org/10.5694/mja18.00199

Physical activity reduces the risk of developing depression - at any age

An article published in the American Journal of Psychiatry showed that people with higher levels of physical activity had a 17% lower risk of depression than those with lower physical activity. These protective effects of physical activity were seen in people of all ages. A higher level of physical activity was associated with a 10% reduction in depression in children and adolescents, adults and the elderly.

The large meta-analysis pooled data from 40 prospective cohort studies, including a total of 266 939 people who were free of mental illness at baseline, with an average follow up of 7.4 years.

Researchers were not able to specify an 'optimal dosage' of physical activity because the studies assessed physical activity in different ways. However, a sub-group analysis of the four studies that evaluated the effect of 150 minutes of exercise a week or moderate to vigorous activity showed that this was effective in reducing the risk of new-onset depression.

Schuch FB, Vancampfort D, Firth J, et al. Physical activity and incident depression: A meta-analysis of prospective cohort studies. Am J Psychiatry 2018 (epub 25 April 2018). https://doi.org/10.1176/appi.ajp.2018.17111194

B Farham

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