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Overview of Colorectal Cancer

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The most common types of colorectal cancers are adenocarcinomas and primary lymphomas. Adenocarcinomas begin in the mucosa of the colon and extend into the bowel wall. Progression of the disease affects the lymph nodes of the region, thus leading to metastases of the tumor. Surgical removal of the tumor by adjuvant chemotherapy is the most common treatment. Survival rates of clients diminish when the disease progresses to the lymph nodes. Physical inactivity has been identified as a significant risk factor for developing colorectal cancer.1,2 Clients who develop this condition may already have limited endurance from a sedentary lifestyle.

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Comorbidities to Consider

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  • Cardiovascular disease, hypertension, chronic obstructive pulmonary diseases, and diabetes mellitus are the most common comorbidities.2

  • Clients recovering from colorectal cancer may have pain, fatigue, decreased immune function, and depression, which affects their physical activity level.2

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Client Examination

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Keys to Examination of Clients

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  • Clients with this condition will have undergone endoscopic examinations of the tumor and a blood test for the carcinoembryonic antigen.

  • Assess clients' fatigue level and if clients suffer from other side effects related to their chemotherapy treatments.

  • Discuss with clients the benefits of a regular exercise program as they may be resistant to changing their lifestyle to include exercise activities.3

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Recommended Baseline Testing of Fitness Levels

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  • Use walking or cycle ergometer testing to assess for endurance levels and tolerance activities.

  • Assess for postoperative pain and mobility limitations secondary to tumor removal.

  • Use a behavioral change questionnaire to assess clients' readiness for participation in exercise activities.4

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Exercise Prescription

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Type: Walking, biking, recreational activities

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Intensity: 65%–75% of predicted maximum heart.5

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Duration: 20–30 minutes

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Frequency: Five to six times per week

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Getting Started

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Moderate levels of physical activity have been found to reduce the risk significantly for recurrence of colorectal cancer and overall mortality.6,7 Exercise parameters and reduced caloric intake promote weight loss and may greatly improve quality of life and survival rates.2 Clients should be encouraged to maintain a regular exercise program to improve their quality of life and to prevent the recurrence of colorectal cancer.6,7

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References

1. +
Slattery  ML, Edwards  S, Curtin  K,  et al. Physical activity and colorectal cancer. Am J Epidemiol 158(3):214–224, 2003.  [PubMed: 12882943]
2. +
Harriss  DJ, Cable  T, George  K,  et al. Physical activity before and after diagnosis of colorectal cancer. Sports Med 37(11):947–960, 2007.  [PubMed: 17953466]
3. +
Courneya  KS, Friedenreich  CM, Quinney  HA,  et al. A longitudinal study of exercise barriers in colorectal cancer survivors participating in a randomized controlled trial. ...

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