1. Survivorship in Oncology
Dr. Julie Broderick
Assistant Professor, Physiotherapy
@jubroderick

2. Exercise in Cancer Survivorship
Do physical activity levels influence recurrence/survival?
Does physical activity influence cancer treatment decisions, completion rates, and/or response?
What is the optimal physical activity prescription for cancer survivors?

3. Do physical activity levels influence recurrence/survival?
Least Active
30%-40% reduction
Most Active
Evidence consistent across: ≥ 20 breast cancer studies ≥ 15 colorectal cancer studies

4. CAUTION At least 3 hours of moderate/vigorous activity per week
How much is needed for recurrence/survival benefits?
At least 3 hours of moderate/vigorous activity per week
‘’Dose-response relationship’’
CAUTION
‘Self-report’ physical activity measures used
No RCT evidence to back this up
Little evidence in other cancer sites

5. 8-year disease-free survival
Exercise Group
82.7%
Control Group
75.6%
7% survival advantage
Subgroup analysis-this survival advantage who were overweight/obese (HR, 0.59; 95% CI, 0.27–1.27), had stage II/III cancer (HR, 0.61;
95% CI, 0.31–1.20), estrogen receptor-positive tumors (HR, 0.58; 95% CI, 0.26–1.29), human epidermal growth factor receptor 2-positive
tumors (HR, 0.21; 95% CI, 0.04–1.02), received taxane-based chemotherapies (HR, 0.46; 95% CI, 0.19–1.15), and Q85% of their planned
chemotherapy (HR, 0.50; 95% CI, 0.25–1.01).
8-year disease-free survival

6. Does physical activity influence cancer treatment decisions, completion rates, and/or response?
Treatment decisions partly based on overall health and physical condition
Implies cancer survivors in poor physical condition may not be offered intensive treatments which could improve survival

7. What is the optimal physical activity prescription for cancer survivors?
Recommendations
Avoid inactivity
Return to normal activities ASAP
Follow guidelines for aerobic & strength exercise
150 minutes of moderate or vigorous exercise per week

8. Safety concerns with exercise
Immune compromise
Advanced disease
Safety screening
Specific contra-indications to exercise
Haemoglobin <8.0g/dL
Absolute neutrophil count ≤0.5 X109/μL
Fever >38°C
Severe cachexia (>35% body weight)
Severe nausea
Severe fatigue

9. These papers were from the first and second studies of my PhD.

10. Study III was an RCT, I published the protocol of this as well as the main paper relating to this study

11. Also my work was picked up in the print media

12. Exercise, Prostate Cancer and Circulating Tumour Cells