The role of physical activity and exercise in tertiary prevention of cancer

摘要

Abstract. While cancer mortality decreases, the French cancer incidence rate increases so the number of patients receiving adjuvant cancer therapy and then living with its side-effects is growing. Physical exercise has been associated with the decrease of fatigue, anxiety and depression symptoms as well as the improvement of quality of life in some intervention clinical trials. Therefore, physical activity could fight against cancer treatment side effects, especially in breast and prostate cancers. In addition, physical activity practice could improve survival of patients: a high physical activity level has been associated to significant decreases in all-cause mortality, breast, prostate and colorectal cancer-related mortality and breast cancer recurrence, compared with a lower physical activity level in cohort studies. The American College of Sport Medicine established guidelines for exercise as supportive care in cancer survivors with a B evidence level. Some published studies present methodological weaknesses implying the need of larger sample size clinical trials which would involve patient samples more representative of general population. Daily practice of moderate intensity physical activity mixing aerobic exercise (such as brisk walking, biking, swimming...) with muscular strength exercise is recommended. Physical activity education must be part of a comprehensive care setting involving whole health professional team in which pharmacists play a proximate role.