I counsel patients all the time on the beneficial effects of physical activity on cancer outcomes:
- lower risk of developing cancer
- lower risk of cancer progression
- lower risk of cancer recurrence
- lower risk of dying from cancer
- may even improve the effectiveness of chemotherapy
Read more about the physiology of how exercise improves cancer outcomes in a previous post.
Additionally, physical activity improves other general health outcomes:
- lower risk of diabetes and metabolic syndrome
- lower risk of cardiovascular disease
- lower risk of Alzheimer’s disease
- improved immune function
- reduced systemic inflammation
- improved wound healing
- lower levels of chronic pain
- improved mood and energy levels
- reduced stress
- better sleep
If you want to learn much more about the importance of exercise, the different types we recommend and how to get started, read the IOE’s 4-part series on these topics, here.
Does exercise intensity and duration matter? Yes. Read about this here.
Aerobic vs. Resistance Exercise:
Okay, so we can all agree that if you are healthy enough to exercise, it’s an important thing to do, but is there an advantage of aerobic versus resistance exercise?
These are some of the best studies I’ve seen that help to answer this question.
In this study, 121 prostate cancer patients (who were receiving radiation therapy and androgen deprivation therapy) were randomized into one of three groups (aerobic exercise, resistance exercise, control/usual care group.) The participants remained on their program for 6-months.
- Resistance exercise: Participants exercised three times per week, performing two sets of 8-12 repetitions of 10 different exercises (leg extension, leg curl, seated chest fly, latissimus pulldown, over- head press, triceps extension, biceps curls, calf raises, low back extension, and modified curl-ups) at 60% to 70% of their estimated one-repetition maximum. Resistance was increased by 5 pounds when participants completed more than 12 repetitions.
- Aerobic exercise: Participants exercised three times per week on a cycle ergometer, treadmill, or elliptical trainer beginning at 50% to 60% of their predetermined peak oxygen consumption (VO2 peak) for weeks 1 to 4 and progressing to 70% to 75% for weeks 5 to 24. Exercise duration began at 15 minutes and increased by 5 minutes every 3 weeks until it reached 45 minutes. Exercise intensity was standardized using heart rate monitors.
- Usual care/no exercise group: Participants were asked not to initiate exercise.
What the investigators discovered was:
- Aerobic exercise improved fatigue and quality of life scores compared with the control group who didn’t exercise, at 3 months into the study. These beneficial effects did NOT last, though. At 6 months into the study, there was no difference between theses two groups.
- Resistance exercise improved fatigue and quality of life scores compared with the usual care/no exercise group throughout the entire length of the 6 month study. Furthermore, the participants in the resistance exercise arm developed significantly superior aerobic fitness and body strength, lower triglyceride levels and prevented fat gain.
The bottom line:
- Resistance exercise was superior to aerobic exercise in terms of aerobic fitness levels (this may be due to the fact that some of the patients randomized to the resistance group also admitted to doing aerobic exercises) and preventing gaining body fat (no surprise, since muscle mass burns more calories throughout the day than fat.)
- Resistance exercise has more durable results than aerobic exercise, in terms of quality of life and fatigue.
- Resistance exercise is better at reducing triglyceride levels compared with aerobic exercise.
- Resistance exercise is superior to aerobic exercise in terms of preventing the increase of body fat (a common problem that occurs in prostate cancer patients on androgen deprivation therapy.)
In a smaller study, of 66 prostate cancer patients taking androgen deprivation, investigators randomized these men to receive either resistance exercise or aerobic exercise:
- Resistance exercise: Resistance band exercises for all major muscle groups. 2-3 sets, 8-12 repetitions at 60-80% of their estimated one-repetition maximum, 3-5 days per week, for 6 months.
- Aerobic exercise: Home aerobic exercise routine (patient choice). 30-60 minutes, at 60-80% of their maximum heart rate, 3-5 days per week for 6 months.
The investigators found:
- Resistance-exercise was superior to aerobic exercise in terms of quality of life scores, even though the patients in the aerobic-training group engaged in significantly more physical activity.
In a study of 121 prostate cancer patients on androgen deprivation therapy, participants were randomized into one of three groups: aerobic exercise, resistance exercise or usual care/no exercise.
- Resistance exercise: All major muscle groups. 2 sets, 8-12 repetitions at 60-80% of their estimated one-repetition maximum, 3 days per week, for 6 months.
- Aerobic exercise: Patients choice (cycle, treadmill, elliptical.) Increased up to target of 45 minutes at 70-75% of their predetermined peak oxygen consumption (VO2 peak), 3 days per week, for 6 months.
- Usual care: no exercise
The investigators found:
- Resistance exercise prevented muscle loss (a common problem in patients taking androgen deprivation therapy.)
- Patients who were randomized to either aerobic exercise or no exercise lost muscle mass (on androgen deprivation therapy.)
According to the National Osteoporosis Foundation, when it comes to maintaining bone density, hands down, resistance exercise is the winner.
The Bottom Line:
Any exercise is better than no exercise, but when it comes to maintaining muscle mass and strength, bone density, quality of life scores, preventing gaining body fat and elevations in triglycerides, resistance exercise appears to trump aerobic exercise.
That said, I recommend that you combine both aerobic and resistance exercises in your routine. After all, the vast majority of studies report improvements in cancer and general health outcomes amongst those who consistently get at least 30 minutes per day, 5 days per week of moderate intensity physical activity (which was typically aerobic, in nature.)