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  • Writer's pictureRiley Stephens

Colon cancer and Exercise

Colon cancer, or colorectal cancer is the third most common cancer in men and the third most common cancer in women (1) . Over the last decade the prognosis for 5-year survival of colon cancer has risen to between 64-72% depending on the stage of cancer and how far it has spread, with survival even being reported in 91% if the cancer is diagnosed at the localised stage (meaning it has not spread to surrounding tissues) (2) . This increased rate of survival has meant there has been a real shift in how to allow colon cancer patients to maintain their treatment, mitigate the side effects of their cancer and related treatment, and maintain their quality of life as much as possible.


One of the biggest side-effects colon cancer patients report during chemotherapy treatment is fatigue with 46% of patients reporting moderate to vigorous levels of fatigue during their chemotherapy treatment cycles with 27% of those with fatigue during treatment experiencing persistent fatigue years after their treatment (3,4) . This is only one of the many side effects that negatively impact the quality of life for those experiencing colon cancer with others including:

- Weight loss/ Cachexia (loss of fat and muscle)

- Diarrhoea

- Cognitive impairments “Chemo-Brain”

- Lymphodema

- Loss of sensation in arms and legs

- Nausea

- Required bowel/colon surgeries including removal


Fortunately, exercise has been shown to mitigate these side effects associated with colon cancer and its treatment. Exercise has been shown to significantly reduce cancer related fatigue during treatment and for those that continued exercise post treatment/cancer general fatigue was lower than those who ceased exercise once they entered remission (3) .

Current recommendations consist of (5,6) :

- 150 min/week of moderate-intensity or 75 min/week of vigorous-intensity aerobic activity,

or a combination of both

- Muscle-strengthening exercises of moderate-intensity on at least 2 non-consecutive days of the week for each of the major muscle groups.


Exercise in general has been proven safe and feasible to be completed by those with colon cancer, however there are conditions depending if a person has undergone permanent or temporary colon surgery (Stoma).


Such considerations for those trying to exercise with a stoma bag include (5,6) :

- Limit excess abdominal pressure if an individual has a Stoma bag

- Risk of herniation (progressions in resistance-based exercises must be slower and start at

lower resistance)

- Swimming and the possible risk of infection (Make sure stoma site is healed and well sealed)

- Hygiene (exercise causes sweating which might contaminate the stoma site, more frequent change of bag may be required)

- Incontinence (specialised exercises can aid in retraining muscles impacted by surgery to

mitigate incontinence)


No matter how daunting it might seem to get started with exercise there is help available. If you currently have or have had colon cancer and you are interested in how exercise may help you, an Exercise Physiologist can help you get started. Exercise Physiologist’s are experts in exercise prescription for a vast range of conditions including cancer and can help guide you along the right path for your health.


Written by Riley Stephens (Accredited Exercise Physiologist)



References:

1. Ferlay, J., Soerjomataram, I., Dikshit, R., Eser, S., Mathers, C., Rebelo, M., Parkin, D. M.,

Forman, D., & Bray, F. (2015). Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. International journal of cancer, 136(5), E359–E386. https://doi.org/10.1002/ijc.29210


2. https://www.canceraustralia.gov.au/cancer-types/bowel-cancer/statistics


3. Van Vulpen, J. K., Velthuis, M. J., Bisschop, C. N. S., Travier, N., Van den Buijs, B. J., Backx, F.

J., ... & May, A. M. (2016). Effects of an exercise program in colon cancer patients

undergoing chemotherapy. Medicine & Science in Sports & Exercise, 48(5), 767-775.


4. Wang, X. S., Zhao, F., Fisch, M. J., O'Mara, A. M., Cella, D., Mendoza, T. R., & Cleeland, C. S. (2014). Prevalence and characteristics of moderate to severe fatigue: a multicenter study in cancer patients and survivors. Cancer, 120(3), 425-432.


5. Wolin, K. Y., Schwartz, A. L., Matthews, C. E., Courneya, K. S., & Schmitz, K. H. (2012).

Implementing the exercise guidelines for cancer survivors. The journal of supportive

oncology, 10(5), 171–177. https://doi.org/10.1016/j.suponc.2012.02.001


6. Hayes, S. C., Newton, R. U., Spence, R. R., & Galvão, D. A. (2019). The Exercise and Sports Science Australia position statement: exercise medicine in cancer management. Journal of

science and medicine in sport, 22(11), 1175-1199.

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