**5. Physical activity during cancer treatment**

More than 40 studies of randomised trials published since 1980 have evaluated the effects of physical activity during adjuvant cancer treatments. Despite methodological limitations and small samples sizes, all reported that physical activity (light to moderate intensity exercise using bicycle or walking program and/or structured exercise program using treadmill, various other forms aerobic equipment and strength training, at least 3 times a week for 20- 30 minutes) is safe and feasible during cancer treatment. Physical activity can improve functional capacities, cardio-respiratory fitness and decrease the treatment-related

testing physical activity interventions for cancer survivors is growing (Pekmezi et al., 2011). Moreover different research have started examining the impact of physical activity on surrogate/biologic markers of survival. All these studies are needed and are still

**3.3 What type of physical activity is associated with beneficial effect on survival after** 

The review of literature shows that this beneficial effect of physical activity on survival is obtained regardless of the type of training: endurance, strength, or mixed. The intensity from which effects on survival are observed is >9 MET-h/wk which is equivalent to 30 min of brisk walking 5-7 times per week and this regardless of the level of physical activity

It is necessary to take into account the state of fatigue of the patients before prescribing a program of physical activity. In all cases, the prescription must be individualized and implemented very gradually. Indeed, "the AP is well tolerated, without adverse effects and oncologists should recommend physical activity to their patients after treatment" (Irwin et

Cancer survivors are not only at increased risk for progressive disease but also a host of comorbid conditions (other cancers, cardiovascular disease, obesity, diabetes and osteoporosis), functional decline and premature death (Demark-Wahnefried et al., 2006a). The impact of exercise is beyond the effects on cancer survival rate as exercise is also associated with other benefits for cancer survivors: exercise is consistently associated with improved quality of life, and also is effective in improving physical functioning (oxygen capacity, cardiorespiratory fitness, other fitness or strength measures, flexibility and global health), anthropometric measures (weight status, body fat, waist circumference) and healthrelated biomarkers (blood pressure, heart rate, circulating hormonal levels) among cancer

These effects are obtained with the levels of physical activity recommended for cancer

**4. Physical activity recommendations for colon and breast cancer prevention** 

Physical activity recommendations for colon and breast cancer prevention and after cancer

More than 40 studies of randomised trials published since 1980 have evaluated the effects of physical activity during adjuvant cancer treatments. Despite methodological limitations and small samples sizes, all reported that physical activity (light to moderate intensity exercise using bicycle or walking program and/or structured exercise program using treadmill, various other forms aerobic equipment and strength training, at least 3 times a week for 20- 30 minutes) is safe and feasible during cancer treatment. Physical activity can improve functional capacities, cardio-respiratory fitness and decrease the treatment-related

ongoing.

**colon or breast cancer ?** 

al., 2008) (see paragraph 7.2.2).

survivors (Demark-Wahnefried, 2006b).

survivors (Haskell et al., 2007) (Table 1).

treatment are summarized in table 1.

**5. Physical activity during cancer treatment** 

**and for cancer survivors** 

**3.4 Other benefits of physical activity for cancer survivors** 

before the diagnosis.

symptoms (fatigue, nausea). Quality of life and sleep quality are also improved with physical activity (for a review see Kirshbaum, 2007 and Doyle et al., 2007).




Table 1. Recommendations of physical activity (PA: physical activity):

There are few recommendations on the type, duration and intensity of physical activity to be practised during the cancer treatment (chemotherapy and/or radiotherapy). In most of the studies, the proposed physical activity was of light to moderate intensity, at the rate of 3 to 5 times a week with a duration from 20 to 30 minutes by session.

For people who were sedentary before diagnosis, low-intensity activities such as stretching and brief slow walks should be adopted and slowly advanced.
