According the ACSM Roundtable report, “exercise prescriptions should be individualized according to a cancer survivor’s pretreatment aerobic fitness, medical comorbidities, response to treatment, and the immediate or persistent negative effects of treatment.”²  There are several goals of exercise prescription for all cancer survivors:

• Regain and improve physical function, aerobic capacity, strength, and flexibility
• Improve quality of life (QOL)
• Improve body composition most importantly muscle mass
• Reduce or delay reoccurrence or a second cancer
• Reduce or prevent the long-term or late effects of cancer treatment

In general, contraindications apply across all cancer sites for starting an exercise program to include:

• Allow adequate time for heal after surgery, this will vary and may be up to eight weeks
• Postpone exercise in individuals with extreme fatigue, anemia, or ataxia until the conditions subside
• Follow the ACSM Guidelines for exercise prescription related to cardiovascular and pulmonary contraindications prior to starting an exercise program⁴

In general, injury risk issues apply across all cancer sites and include:

• Infection risk is higher for individuals currently in chemotherapy or radiation treatment
• Exercise tolerance of individuals currently in treatment and immediately after treatment may vary from sessions
• A known metastatic disease to the bone will require modifications and increased supervision to avoid fractures
• Individuals with cardiac conditions will require modifications and increased supervision for safety
• Avoid the spread of infection through the use of equipment at public gyms

For exercise prescription, “maintaining and increasing muscle mass are recommended for all cancer survivors during and after treatment.”²  Exercise prescription should align with the US Department of HHS PAG for Americans and the ACSM Guidelines for Exercise Testing and Prescription with the individual’s health status and treatment plan taken into consideration.