Advanced Cancers, Metastatic Disease, and Palliative Care

Abstract

Exercise, at appropriate volumes, shows promise as a strategy to optimize functional capacity, symptom management, and quality of life in those with advanced cancer. Specifically, the research evidence suggests that exercise may prevent or delay declines in aerobic fitness and strength and help the survivor to maintain adequate physical function to perform daily activities. The purpose of this chapter is to outline the role of exercise for survivors with advanced cancer, who have metastatic disease, or who are receiving palliative care. In this setting, the challenges facing the exercise specialist are complex and involve identifying symptoms, functional impairments, and co-pathologies that may impact exercise risk and tolerance. The need for ongoing modification of exercise programming should be anticipated to ensure that exercise participation is safe and effective. The goal of exercise for survivors with terminal cancer and limited life expectancy is to help maintain function as the focus of care shifts to living as well as possible in the short term. At this stage of disease, an interdisciplinary team approach is paramount to address symptom management and optimize independence.