Letter
Cancer Sports medicine
Volume 210 - Issue 1

Clinical Oncology Society of Australia position statement on exercise in cancer care

Authors:  Robert U Newton, Dennis R Taaffe and Daniel A Galvao

Med J Aust 2019; 210 (1): 54. || doi: 10.5694/mja2.12043
Published online: 14 January 2019
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To the Editor: We write to express our concerns regarding the Clinical Oncology Society of Australia (COSA) position statement on exercise in cancer care published in the MJA1 and promoted in media outlets as a “world‐first” position statement that calls for exercise to be prescribed for all patients with cancer.2 The guideline replicates those first published in Australia in 20093 and in the United States in 20104 as well as by other organisations,5 and are the same as public health recommendations for healthy adults.6 Given the array of cancers, disease stages and treatments and their combinations, it is somewhat surprising that the same general guideline is being prescribed for all patients with cancer and is not differentiated from that for healthy adults — especially, given patient health and comorbidity status and the challenges that a cancer diagnosis and treatment entail. Research in exercise oncology has progressed over the past 9 years, and more targeted and tailored guidelines reflecting the developing evidence base are now required for implementation in this population.

Moreover, the majority of patients with cancer are unable to meet the COSA recommendation of at least 150 minutes of aerobic exercise and two to three resistance exercise sessions due to time availability and physical, psychological and financial capacity as well as access, let alone the level of care required for those with advanced disease. It is significant that the COSA recommendation has not been refined through clinical trials in patients with cancer and has the potential to create considerable angst for the patient and raise concerns for clinicians, who know that their patients may not be able to achieve such goals. Moreover, we highlight that there is minimal financial support for patients with cancer to undertake ongoing exercise, making the COSA recommendation somewhat superfluous.

When exercise is prescribed, it must be evidenced‐based and tailored to specifically ameliorate adverse health problems, while recognising that certain modes and dosages of exercise may be detrimental. We agree that there is considerable potential for exercise medicine in the management of cancer; however, a more considered approach needs to be implemented rather than the generic exercise recommendations of the COSA statement.

Authors

  • Robert U Newton1
  • Dennis R Taaffe1
  • Daniel A Galvao1
  • 1. Exercise Medicine Research Institute, Edith Cowan University, Perth, WA.

Correspondence: r.newton@ecu.edu.au

Competing interests

No relevant disclosures.

References

Linked content

  • MJA Position Statement Summary: Clinical Oncology Society of Australia position statement on exercise in cancer care

  • MJA Letter: Clinical Oncology Society of Australia position statement on exercise in cancer care

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