Anjali Sibley, Clinical Associate Professor of Medicine (Oncology) at Stanford University School of Medicine, Director of Stanford Health Care, shared on LinkedIn:
“Staying Strong During Cancer Treatment – We have more support now!
The CoC (ACS’ Commission on Cancer) Standard 4.9 calls for assessment and referral for exercise oncology services for patients on cancer therapy!
This standard will go into effect on January 1, 2028.
The standard calls for proper assessment for exercise oncology services and then proper referral (and follow through) for services including physical therapy. It doesn’t provide insurance or financial coverage. Acknowledging the need is the first step! This conversation belongs at the start of treatment.
My team and I are expanding exercise oncology programming Stanford University School of Medicine. I want to thank them for their hard work and dedication to the cause!
Cancer treatment can tire your body and make everyday tasks unexpectedly difficult. Things like climbing stairs, carrying groceries, or getting out of a chair previously may have been easy but now aren’t. It’s important to realize that muscle strength can be protected during cancer therapy. This isn’t just about preserving independence. It’s about improving mood (anxiety and depression), fatigue, and overall quality of life. All the things that exercise during cancer therapy does!
Exercise is the best way to manage cancer – related fatigue, above medications and other therapies. The functional goal is to make everyday activities less demanding relative to your available capacity. For someone already struggling with daily tasks, preserving strength may be as meaningful as increasing it. Chemotherapy and immunotherapy can weaken muscle, secondary to effects from prolonged sedentary behavior, direct damage to mitochondria and muscle tissue from chemo or immunotherapy, and direct damage to nerves from chemotherapy and commonly used medications such as steroids. Immunotherapy can make your immune system attack joints and occasionally muscles, and aggravate the thyroid gland, pituitary gland, and adrenal gland. All of the above can lead to fatigue and weakness. Occasionally, there are disruptions between nerves and muscles. Negative blood flow changes occur at a molecular level in muscle tissue. Cancer therapies cause decreases in muscle strength and mass. These are biological changes.
Muscle tissue can respond well to exercise during cancer therapy. Multiple studies have shown less decline or improvement in muscle strength with resistance therapy and aerobic therapy during cancer therapy. ASCO recommends it for early – stage cancers. There is no absolute right way to do it. It helps to formulate a plan at the beginning. Review any weakness with your oncologist. Ask your oncology team for a recommendation for an initial assessment, including a virtual assessment.”
