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ACSM exercise guidelines

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Recent publications from the American College of Sports Medicine (ACSM) have provided updated guidance on physical activity for cancer survivors (Schmitz et al. CA: Cancer J Clin 2019; Campbell et al. MSSE, 2019; Patel et al. MSSE, 2019).

Here are a few takeaways in breast cancer you should know!

There is moderate scientific evidence that physical activity following a breast cancer diagnosis lowers risk of breast cancer death.

There is strong scientific evidence that physical activity after a breast cancer diagnosis can:

  • reduce anxiety.
  • improve fatigue.
  • reduce depressive symptoms.
  • improve quality of life.
  • improve physical function.
  • prevent exacerbation of upper extremity lymphedema.

After a review of the evidence by experts at the International Multidisciplinary Roundtable, the committee concluded:

  • Exercise training and testing is generally safe for cancer survivors, though medical clearance is advised in certain situations (as outlined in the publication).
  • Breast cancer survivors should avoid inactivity.
  • An exercise prescription should include moderate-intensity activity at least 3x a week for 30 minutes and resistance exercises at least 2x a week.
  • An assessment by a clinician or team should prompt counseling and advice regarding physical activity.

In my mind, these guidelines confirm what we know about the beneficial impact of physical activity for breast cancer survivors. Of note, the importance of resistance exercises and individualizing programs for cancer survivors was stressed. The minimal recommended amount of aerobic exercise was lowered to at least 90 minutes a week (from 150 minutes/wk).

The biggest issue continues to be how, when, and who should provide these recommendations to cancer patients. There is no systematic process in place to integrate physical activity into the care of cancer patients. One thought is to make it part of the multidisciplinary clinic visit when other treatment decisions and plans are being made. This can be overwhelming for some breast cancer patients who are just trying to cope with a new diagnosis and potential chemotherapy.

What are your thoughts on the best way to prescribe and promote physical activity after a breast diagnosis?

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