Aerobic and resistance exercise should be recommended to the growing ranks of cancer patients - both during and after treatment - to reduce pain and improve physical function, fatigue, and mood, according to new research.

Palliative care and pain experts at HammondCare’s Greenwich Hospital evaluated the results of 23 randomised controlled trials globally – taking in 1954 patients – and found aerobic and resistance exercise “tolerable and effective as adjunct therapies” for cancer-related pain in adults with and surviving cancer.

The research, published in the latest edition of Heliyon journal, highlights that management of cancer-related pain is becoming an increasing challenge for patients and treating oncologists as cancer detection and treatments improve and the number of survivors increases.

HammondCare released the research this week as Australia marks Palliative Care Week.

About 50 per cent of cancer survivors experience pain during treatment or in its aftermath. Anxiety and depression with poor social support are common among cancer patients and can increase pain severity and pain-related disability.

“Our findings show that aerobic and resistance exercise programs are not only effective for reducing cancer-related pain but are also well tolerated with very low drop-out rates both during after anti-cancer treatments,” the researchers found.

“Based on our review, exercise programs should be recommended for people with cancer-related pain both during and after treatments.”

The results of the meta-analysis, involving patients with an average age of 58, showed that exercise therapy was associated with “small to moderate decreases” compared to control groups.

The research team, including Philip Austin, Wei Lee, Daniel Costa, Alison Ritchie and Melanie Lovell, note that cancer pain is often inadequately managed and the multifactorial causes mean options other than pharmacological pain management are being pursued.

An analysis of secondary outcomes in the studies was a moderate effect for improvements in physical function, fatigue, and psychological symptoms.

An encouraging outcome was that just three patients cited exercise for withdrawal.

The researchers recommend clinicians refer patients to exercise professionals.

Two cancer patients, Jacqueline Fifer, 47, and Beverley George, 82, shared their exercises experiences to back the findings.

Jacqui, who has a background in film and documentary production, said exercise was central to her recovery since the shock of diagnosis with a glioblastoma, or inoperable brain tumour, last July.

Fitness, including working with a personal trainer, had always been a part of Jacqui’s life – in fact, the first sign of the tumour was a seizure during warm up stretches in the gym in May 2023.

Brain inflammation from an initial treatment combination of chemotherapy and radiation left her using a wheelchair when she first started rehabilitation at Greenwich Hospital.

Jacqui, of Mosman, is working her way through routines of 20-40 metre run bursts, leg strength building through mini tramp and stair exercises, steadily lengthening how far she can walk. At home, there is work with resistance bands.

“I would definitely say exercise has played a big role in how I’ve felt during treatment and recovery. As I have always seen fitness as key to wellbeing, this makes sense to me,” she said.

Some challenges are motivation, fatigue and remembering to exercise. After a round of chemotherapy, “You are left with a brain fog. Working with my physio or another person makes it a lot easier,” she said.

Beverley, of Riverview is living with stage 4 colorectal/liver cancer diagnosed in March 2023. A fall while walking in August 2023, brought on by dizziness from chemotherapy, is causing her more discomfort than her cancer.

Exercise sessions includes physio and the hydrotherapy pool and at home resistance bands. She hopes extending her walking as her hip improves.

“When diagnosed with cancer, it’s quite overwhelming and an entirely new world you thought you’d never have to enter,” Beverley said.

“However, there are some ways you can empower yourself and one of those ways is exercise, which, at least for me helps promote feelings that I’m contributing in some small way to my treatment, thus creating feelings of positivity, wellbeing and confidence,” she said.

The Cancer Pain Book and Free App provides proven pain management techniques including exercise, relaxation, meditation and psychological tools that help to build mental resilience, self-compassion and positive thinking.