Specialists call for mandatory physical activity in oncology

Specialists state that physical exercise must be mandatory in cancer treatment, not optional. Evidence from studies highlights benefits like reduced cardiac toxicity and fatigue. The recommendation was emphasized at the Onco in Rio congress in Rio de Janeiro.

At the Onco in Rio congress, hosted by Rede D’Or in Rio de Janeiro, experts argued that physical exercise should be mandatorily prescribed for cancer patients. Physician Marina Rondinelli, an anesthesiologist and pain medicine specialist, stated: "Physical exercise is no longer an option; it is a prescription".

A study published in July 2025 in the British Journal of Sports Medicine, reviewing 80 articles, found that physical activity significantly reduces cardiac toxicity, cognitive impairment, and neuropathy in cancer patients. It also modulates body composition and biomarkers like insulin and C-reactive protein, while improving sleep quality, psychological well-being, and social interaction.

Rondinelli noted that 75% of chemotherapy patients experience cognitive impairment, such as memory and concentration issues, and 80% report muscle fatigue. Exercises like walking, weight training, and functional training alleviate fatigue, while aerobic and strength exercises benefit cognition. Even one minute of daily exercise is better than none, tailored to the patient's condition.

National Comprehensive Cancer Network data show 59% of patients in active treatment experience pain, rising to 64% in advanced cases and 33% in remission.

Oncologist Paulo Hoff emphasized that such prescriptions are not yet widespread, but strong evidence—like a study of 800 patients where the exercise group had half the cancer recurrences compared to the non-exercise group—matches chemotherapy's impact. Yoga is effective for sleep disturbances in women with breast cancer.

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A woman undergoing chemotherapy performs home exercises in her living room to ease chemo brain symptoms.
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Home-based exercise program may ease “chemo brain” symptoms during chemotherapy, Phase II trial suggests

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A Phase II randomized trial found that a six-week, home-based walking and resistance program improved attention test performance and reduced reports that others noticed cognitive problems among patients receiving chemotherapy. Low-dose ibuprofen improved some attention measures but showed mixed results on memory outcomes. The study was published in Cancer.

A major review of 217 clinical trials has identified aerobic exercises like walking, cycling and swimming as the most effective for reducing pain and improving function in knee osteoarthritis. The study, published in The BMJ, recommends these activities as the first-line intervention. Other exercises provide benefits but work best alongside aerobics.

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About 90 to 120 minutes of strength (resistance) training a week was associated with the lowest long-term risk of death in an analysis of 147,374 U.S. adults followed for up to 30 years, with the biggest gains seen when strength work was combined with aerobic exercise, researchers report in the British Journal of Sports Medicine.

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