Colorectal Cancer and Exercise

Colorectal Cancer (CRC) – sometimes referred to as Bowel Cancer – is the third most commonly diagnosed cancer in Australia. Diagnosis of CRC often correlates with lifestyle factors such as physical inactivity, obesity, smoking, alcohol consumption and chronic disease. CRC occurs when abnormal cells in the colon or rectum grow and multiply out of control, forming a tumour.

Treatments and Side Effects

Treatment for CRC depends on disease progression and may include surgery, chemotherapy and/or radiotherapy.  There are some side effects to all treatment options, with 60% of all individuals reporting fatigue as a symptom. Some other side effects may include; pain, peripheral neuropathy (tingling sensations in hands and feet), swelling, bloating, lymphedema, sleep difficulties and/or psychological distress.


Health Benefits of Exercise

More than 40% of individuals diagnosed with CRC have other associated comorbid conditions such as Diabetes, obesity, or Chronic Obstructive Pulmonary Disease (COPD). Research has demonstrated the high level of benefit that exercise has on all these conditions. One study showed that physical activity may prevent approximately 15% of CRC.  Other health benefits to exercise for CRC:

  • Improve management of fatigue
  • Improve psychological wellbeing
  • Improve surgery recovery
  • Improve general conditioning and muscular strength
  • Improve quality of life and ability to perform activities of daily living (ADL)
  • Reduce the frequency and severity of treatment related symptoms
  • Decrease risk of recurrence of cancer
  • Decrease all-cause mortality

What Type of Exercise?

Physical activity guidelines recommend:

  • 150 minutes per week of moderate intensity aerobic exercise (fast walking, cycling)
  • Two resistance-based exercise sessions/ week

Initial exercise intensity and duration is determined based on functional capacity, with thorough medical screening of the individual to identify the disease progression, comorbid conditions and any contraindications to exercise participation.   

Contraindications to exercise affect those who have; heart failure and/or acute infectious disease and metabolic disease (thyrotoxicosis and myxoedema). It is still safe to exercise with a colostomy bag; however, some modifications may be required to ensure the individual feels comfortable.

It is essential that exercise progressions are slow and steady to avoid exacerbations of symptoms post exercise sessions.  It is also essential that the individual enjoys the modality of exercise to ensure adherence to the program whilst facilitating improved psychological wellbeing.

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References

Oruç, Z et al. (2019). Effect of exercise on colorectal cancer prevention and treatment. World Journal Of Gastrointestinal Oncology

Sheard, R et al, (2019) Understanding Bowel Cancer. Cancer Council Australia

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