Exercise and melanoma

Patient Guide

Regular aerobic exercise has proven, well established benefits to our general health and mental well-being. Research shows that regular moderate intensity, aerobic exercise for 2.5 – 5 hrs a week can improve our lifespan and lower our risk of chronic diseases.

This includes a reduced risk of heart disease, type 2 diabetes and some forms of cancer [1,2,3,4,5]. In addition, studies into anxiety and depression have shown that exercise can help reduce anxiety symptoms and elevate our mood [1].

What counts as aerobic exercise?

Aerobic exercise is any activity that increases movement and the use of our skeletal muscles so that we raise our heart and breathing rate.

Types of aerobic exercise include:

Brisk walking (from 20 mins a day), running, dancing, cycling, swimming, performing household chores, exercise classes, resistance training (using weights) and taking part in team sports.

Other key lifestyle factors that are also known to prevent chronic disease include a healthy diet, healthy weight, low or no alcohol intake, not smoking, manageable stress and adequate sleep (7-8 hrs per night).

Exercise and health benefits for patients with a diagnosis of melanoma

Always remember to use adequate protection using sunblock, protective clothing and hats if exercising in the sun.
> See our pages on sun safety

Benefits of regular exercise may include:

Recovery from surgery and helping lymphoedema:
Supervised resistance training (with elastic bands) has been shown to reverse lymphoedema in some people with melanoma [6]. This is a side effect that is sometimes experienced after lymph node dissection, where lymph fluid builds up in the limbs, often in the legs.

Reducing side effects of systemic treatment:

There is evidence that maintaining regular physical activity can help reduce fatigue whilst receiving immunotherapy[7]. In one survey study, melanoma patients receiving immunotherapy who exercised regularly quoted reduced fatigue as its most common benefit. The most popular exercises included walking and swimming but participants also did things like lifting weights, yoga and gardening. Patients also mentioned improved levels of sleep, well-being, mental health, and benefits from social interactions [7]. A clinical trial is now looking at the effects of a personalised exercise programme for melanoma patients.

Improving quality of life after completing treatment

Several studies have described a significantly improved quality of life in individuals who have been physically active after a melanoma diagnosis [6,7]. There is also some early research that shows exercise can slow down the pathways involved in melanoma tumour growth, although further studies are needed [8,9].

Summary

Given the overall benefits to health, quality of life and mental well-being, establishing and maintaining a regular moderate exercise routine can provide several advantages to you as a melanoma patient. This includes reducing some side effects from treatment, like fatigue and lymphoedema. Sun protection is essential if exercising outdoors as a melanoma patient.
It is a good idea to talk through an exercise regimen with your healthcare team, who will be able to advise on what activities are best for you.

Examples and more information on moderate exercise from the NHS: https://www.nhs.uk/live-well/exercise/

Relevant References:

[1] Bull FC, Al-Ansari SS, Biddle S, et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med. 2020;54(24):1451-1462. doi:10.1136/bjsports-2020-102955

[2] Zhang YB, Pan XF, Chen J, Cao A, Xia L, Zhang Y, Wang J, Li H, Liu G, Pan A. Combined lifestyle factors, all-cause mortality and cardiovascular disease: a systematic review and meta-analysis of prospective cohort studies. J Epidemiol Community Health. 2021 Jan;75(1):92-99. doi: 10.1136/jech-2020-214050. Epub 2020 Sep 5. PMID: 32892156.

[3] Zhang Y, Pan XF, Chen J, Xia L, Cao A, Zhang Y, Wang J, Li H, Yang K, Guo K, He M, Pan A. Combined lifestyle factors and risk of incident type 2 diabetes and prognosis among individuals with type 2 diabetes: a systematic review and meta-analysis of prospective cohort studies. Diabetologia. 2020 Jan;63(1):21-33. doi: 10.1007/s00125-019-04985-9. Epub 2019 Sep PMID: 31482198.

[4] Zhang YB, Pan XF, Chen J, Cao A, Zhang YG, Xia L, Wang J, Li H, Liu G, Pan A. Combined lifestyle factors, incident cancer, and cancer mortality: a systematic review and meta-analysis of prospective cohort studies. Br J Cancer. 2020 Mar;122(7):1085-1093. doi: 10.1038/s41416-020-0741-x. Epub 2020 Feb 10. PMID: 32037402; PMCID: PMC7109112.

[5] Qiaoyun Wang, Wenli Zhou. Roles and molecular mechanisms of physical exercise in cancer prevention and treatment. Journal of Sport and Health Science. 2021 10 (2); 201-210.doi: 10.1016/j.jshs.2020.07.008.

[6] Carmeli E, Bartoletti R. Retrospective trial of complete decongestive physical therapy for lower extremity secondary lymphedema in melanoma patients. Support Care Cancer. 2011 Jan;19(1):141-7. doi: 10.1007/s00520-009-0803-3. Epub 2010 Jan 12. PMID: 20066550.

[7] Hyatt A, Drosdowsky A, Williams N, et al. Exercise Behaviors and Fatigue in Patients Receiving Immunotherapy for Advanced Melanoma: A Cross-Sectional Survey via Social Media. Integr Cancer Ther. 2019;18:1534735419864431. doi:10.1177/1534735419864431

[8] Warner AB, McQuade JL. Modifiable Host Factors in Melanoma: Emerging Evidence for Obesity, Diet, Exercise, and the Microbiome. Curr Oncol Rep. 2019;21(8):72. Published 2019 Jul 1. doi:10.1007/s11912-019-0814-2

[9] CD Malta, D Siciliano, A Calcagni, et al. Transcriptional activation of RagD GTPase controls mTORC1 and promotes cancer growth Science, 356 (2017), pp. 1188-1192