Advanced Cancer and Palliative Care

“Palliative care is care that helps people live their life as fully and as comfortably as possible when living with a life-limiting or terminal illness.” – Palliative Care Australia

Exercise in Advanced Cancer (Palliative Care)

The role of exercise professionals in palliative care is diverse and patient specific. Those working in palliative care adapt and tailor a wide range of techniques from other areas of allied health.

Exercise is safe and effective in improving physical function, QOL, fatigue, body composition, psychosocial function and sleep quality in patients with advanced cancer.

Where possible, aim for 3x 30 minutes of exercise per week, building to 150 minutes of exercise. This may not be achievable for all people with advanced cancer, especially those towards end of life care. In this case, encourage patients to avoid inactivity and sedentary behaviour.

  • Ensure a comprehensive medical history is taken to account for co-morbidities and prognosis
  • Patient goal setting is important
  • Important to also consider prognosis and disease trajectory
  • Aim often to maintain current level of function or reduce rate of deterioration
  • Complete a comprehensive assessment of function including activities of daily living, falls risk, and gait.
  • For patients admitted to a palliative care unit, often assessment of function needs to be gathered over a number of time points to get an accurate reflection of a patient’s function (which may fluctuate over time)
  •  Limited guidance exists for exercise in advanced cancer. However, benefits of exercise in advanced cancer do not appear to depend on the exercise mode (ie aerobic vs strength). Choose modality based on clients goals and preferences.
  • A function-based exercise approach may be warranted depending on individual needs
  • Multidisciplinary input from the broader team, including palliative care physician, occupational therapy, dietitian, pastoral care, nursing staff and social worker is frequently required when working with people with advanced cancer. In addition, working with family members and carers is also important.

Functional Mobility

Functional decline is common in patients approaching the end of life. There are many contributing factors to functional decline and decreased mobility, including generalised de-conditioning (weakness and endurance), depressed mood, pain and fatigue. Other co-morbidities, the disease process and treatment effects can also contribute to this loss of function.

Patients who have an element of functional decline are often at a higher risk of falling- falls prevention strategies are an important element of rehabilitation in this population.


Fatigue is common symptom in patients with a life- limiting or chronic diseases. There is a wealth of evidence that shows that exercise is effective in managing cancer-related fatigue throughout the cancer journey.


Breathlessness is a common complaint in patients particularly those with lung cancer. While breathlessness in patients with advanced cancer is often managed pharmacologically, there is some evidence that using a hand held fan can reduce the sensation of breathlessness.

Pulmonary rehabilitation programmes can help reduce breathlessness in patients with lung cancer through improving function and teaching strategies to manage breathlessness.