Exercise for older cancer patients: feasible and helpful?

Older adults are at high risk for functional decline after a cancer diagnosis. Physiologic changes of aging which negatively impact body composition, strength, and fitness increase vulnerability to the development of short- and long-term disability when stressed with cancer burden and treatments. Treatment-associated physical disability impairs quality of life, limits therapeutic options, and contributes to the social and economic burden of cancer care in the elderly. Despite this, few clinical trials capture disability as an outcome or focus on whether it can be ameliorated in this population. Exercise has multiple positive effects on physical health and well-being in non-cancer elderly populations and holds promise as a supportive care intervention to improve physical function and symptoms during and after cancer treatments. The majority of studies supporting the positive benefits of exercise among cancer survivors have been performed in younger patients. Results from limited elderly-specific trials suggest that physical activity interventions are safe and effective in older cancer survivors, with prostate cancer survivors representing the best studied cohort of older persons with cancer. Many questions remain unanswered with respect to optimal timing, mode, intensity, and delivery of exercise interventions for older patients. While available data support the potential benefit of exercise for elders with cancer, recommendations will need to be individualized to optimize participation, safety, and efficacy.