Exercise in elderly cancer survivors

Aging is a universal experience that leads to declines in functional performance, sarcopenia, loss of flexibility, muscle weakness and decreased bone density. Cancer and its treatment accelerate these declines and lead to accelerated aging and disability. Cancer treatment can cause muscle wasting and declines in cardiopulmonary function that do not reverse in the recovery period following treatment. Many of these declines can be mitigated with exercise. A limited number of resistance exercise studies have been conducted focusing on improving body composition in elderly cancer survivors. These studies have demonstrated that resistance exercise is safe and improves muscle strength and cardiovascular function. Aerobic exercise studies are more numerous and also demonstrate the safety of exercise and the benefits on cardiopulmonary function, muscle strength, maintenance of body weight, body fat, balance, and bone density. Prevention of sarcopenia and muscle development in elderly cancer survivors should focus on increasing protein intake to approximately 40 g/day and include leucine. Being overweight at the time of diagnosis is associated with an increased overall and cancer-specific mortality for cancers of the breast, esophagus, colorectum, cervix, uterus, liver, gallbladder, stomach, pancreas, prostate, kidney, non-Hodgkin's lymphoma and multiple myeloma, as well as all cancers combined. Weight gain, overweight and obesity following treatment is associated with greater risks for recurrence and cancer-related death. Given the growing body of evidence of the adverse effects of cancer treatment on body composition and the negative consequences for overall health and physical function, exercise and weight management should be a high priority for cancer survivors; especially for elderly cancer survivors who may already have multiple co-morbid conditions that may be improved with exercise.