{"entity":{"id":"rejuv-access-exercise-programmes","kind":"technology","name":"Exercise is the best-evidenced thing on this front, and most survivors are not doing it","aka":[],"tldr":"Structured exercise has the strongest evidence of any recovery intervention, including a randomised survival benefit in colon cancer. In a population survey of blood cancer survivors, 46 per cent met neither the aerobic nor the strength guideline and 22 per cent met both, and meeting both was associated with having been to university.","summary":"The evidence for exercise after cancer treatment is covered on the existing exercise records and on the body facet of this front. This record is about the distance between that evidence and what happens.\n\nThe measured uptake. In a population-based cross-sectional survey of 606 haematologic cancer survivors in Alberta, with separate assessment of aerobic and strength behaviour, \"22% of HCS met the combined exercise guideline, 22% met aerobic-only, 10% met strength-only, and 46% met neither exercise guideline\". Strength training is the weaker half: only 32 per cent met the strength guideline at all, in either combination. Survivors were more likely to meet the combined guideline than a single guideline if they had completed university, and more likely if they had no children living at home.\n\nWhy the strength half matters here specifically. The things this front describes as recoverable, muscle lost to disuse and treatment, bone lost to endocrine therapy, the physical function that walks somebody up stairs, respond to resistance training specifically. An exercise service that offers only a walking group is not delivering the prescription the trials used.\n\nWhat is actually offered. Australia's national cancer body states that exercise should be part of standard cancer care rather than general advice, which is the clearest national position of its kind. Whether a person can get a supervised programme depends on local commissioning everywhere we looked, and the supervised element is the part that is hard to fund: the exercise consensus work finds supervised programmes better than unsupervised for mood, while for fatigue the two are similar.\n\nThe structural barriers, in the order they bite. Referral: nobody refers if nobody screens for function. Transport and time: a supervised programme twice a week for twelve weeks is a large ask of somebody working, caring or travelling far. Cost: where programmes are not commissioned, they are paid for privately. Confidence: people who have been ill are frightened of exertion and need supervision to start, which is the expensive part. Education, which the Alberta data identify directly, probably stands in for several of these.\n\nWhat would close it. The measurement is cheap, grip strength and a chair stand cost nothing. The prescription is published. The missing piece is a referral pathway attached to the end of treatment and somebody funded to supervise the first weeks, which is the same missing piece as for rehabilitation.","status":"established","asOf":"2026-10-02","wikipedia":"https://en.wikipedia.org/wiki/Exercise_oncology","links":[{"label":"Vallerand et al., Correlates of meeting the combined and independent aerobic and strength exercise guidelines in hematologic cancer survivors (Int J Behav Nutr Phys Act 2017)","url":"https://doi.org/10.1186/s12966-017-0498-7"},{"label":"Clinical Oncology Society of Australia position statement on exercise in cancer care (Med J Aust 2019)","url":"https://doi.org/10.5694/mja2.12043"},{"label":"Vardy et al., Clinical Oncology Society of Australia position statement on cancer survivorship care (Aust J Gen Pract 2019)","url":"https://doi.org/10.31128/AJGP-07-19-4999"}],"tags":["rejuvenation","survivorship","measurement","access","equity"],"related":["rejuv-access-rehabilitation-referral","rejuv-access-survivorship-care-australia"],"cancers":["colorectal","breast-hr-positive","prostate","multiple-myeloma","dlbcl"],"sections":["rejuvenation","supportive-care"],"technologies":["exercise-oncology","structured-exercise-survivorship","exercise-prescription-after-cancer","exercise-during-chemotherapy","prehabilitation","rejuv-access-who-misses-out","rejuv-measure-functional-tests"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":["cancer-related-fatigue","sarcopenia","late-effects"],"trials":[],"people":[],"bottlenecks":["b-survivorship","b-knowledge-diffusion","b-workforce"],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"principle":"An intervention that requires sustained behaviour, supervision to begin safely, transport, time and often payment will be taken up in proportion to the resources a person has, regardless of how strong the evidence for it is. Evidence strength and uptake are independent, and nothing about the first fixes the second.","strengths":["The strongest evidence base of anything on this front, including a randomised survival benefit in colon cancer","Uptake is measurable and has been measured in population surveys","At least one country states exercise as part of standard cancer care","Measuring who needs it costs almost nothing"],"limitations":["Nearly half of survivors in the surveyed population met neither guideline","Strength training, the half that rebuilds what treatment took, is the less met half","Supervision is the effective and expensive component","Uptake tracks education, which no amount of evidence changes"]},"route":"/technologies/rejuv-access-exercise-programmes/","neighbours":{"technology":[{"id":"rejuv-access-survivorship-care-australia","kind":"technology","name":"After treatment in Australia: a stated model of survivorship care","route":"/technologies/rejuv-access-survivorship-care-australia/"},{"id":"rejuv-measure-cardiopulmonary-exercise-testing","kind":"technology","name":"Cardiopulmonary exercise testing: the hardest number in recovery","route":"/technologies/rejuv-measure-cardiopulmonary-exercise-testing/"},{"id":"exercise-oncology","kind":"technology","name":"Exercise & lifestyle oncology","route":"/technologies/exercise-oncology/"},{"id":"exercise-during-chemotherapy","kind":"technology","name":"Exercise during chemotherapy and radiotherapy","route":"/technologies/exercise-during-chemotherapy/"},{"id":"prehabilitation","kind":"technology","name":"Prehabilitation before cancer surgery","route":"/technologies/prehabilitation/"},{"id":"rejuv-access-rehabilitation-referral","kind":"technology","name":"Referral to rehabilitation: the service most people who need it never see","route":"/technologies/rejuv-access-rehabilitation-referral/"},{"id":"structured-exercise-survivorship","kind":"technology","name":"Structured exercise programmes after curative treatment","route":"/technologies/structured-exercise-survivorship/"},{"id":"exercise-prescription-after-cancer","kind":"technology","name":"The exercise prescription after cancer: the dose the guidelines state","route":"/technologies/exercise-prescription-after-cancer/"},{"id":"rejuv-measure-functional-tests","kind":"technology","name":"Walking, gripping and standing up: the tests that take five minutes","route":"/technologies/rejuv-measure-functional-tests/"},{"id":"rejuv-access-who-misses-out","kind":"technology","name":"Who misses out on recovery care, measured","route":"/technologies/rejuv-access-who-misses-out/"}],"cancer":[{"id":"colorectal","kind":"cancer","name":"Colorectal cancer","route":"/cancers/colorectal/"},{"id":"dlbcl","kind":"cancer","name":"Diffuse large B-cell lymphoma","route":"/cancers/dlbcl/"},{"id":"breast-hr-positive","kind":"cancer","name":"HR-positive / HER2-negative breast cancer","route":"/cancers/breast-hr-positive/"},{"id":"multiple-myeloma","kind":"cancer","name":"Multiple myeloma","route":"/cancers/multiple-myeloma/"},{"id":"prostate","kind":"cancer","name":"Prostate cancer","route":"/cancers/prostate/"}],"section":[{"id":"rejuvenation","kind":"section","name":"Recovery & Rejuvenation","route":"/fronts/rejuvenation/"},{"id":"supportive-care","kind":"section","name":"Supportive Care & Survivorship","route":"/fronts/supportive-care/"}],"term":[{"id":"cancer-related-fatigue","kind":"term","name":"Cancer-related fatigue (tiredness)","route":"/terms/cancer-related-fatigue/"},{"id":"late-effects","kind":"term","name":"Late effects and survivorship toxicity","route":"/terms/late-effects/"},{"id":"sarcopenia","kind":"term","name":"Sarcopenia","route":"/terms/sarcopenia/"}],"bottleneck":[{"id":"b-knowledge-diffusion","kind":"bottleneck","name":"Knowledge reaches practice too slowly","route":"/bottlenecks/b-knowledge-diffusion/"},{"id":"b-workforce","kind":"bottleneck","name":"Not enough oncologists, nurses, pathologists, physicists","route":"/bottlenecks/b-workforce/"},{"id":"b-survivorship","kind":"bottleneck","name":"Survivorship and late effects are neglected","route":"/bottlenecks/b-survivorship/"}]}}