Monday 17 March 2014

Integrating Exercise on the Cancer Care Pathway

Growing Evidence Supports the Role of Physical Activity During and After Cancer Treatment

Research indicates that with tailored programs, exercise is likely to have a positive effect on cancer patients
In a Macmillan Cancer Support Review of the evidence for integrating the promotion of physical activity within the cancer care pathway, a team of medical researchers* found that if exercise prescriptions are individually tailored to each individual and the potential for side effects taken into account, exercise is likely to have a positive effect on cancer patients.

The review reports that exercise during treatment prevents a decline in functional outcomes without increasing fatigue. One study within the review highlighted the fact that the loss of physical function experienced by cancer survivors apply to longer-term survivors, not just patients who have just completed treatment:
“Limitations in physical functioning were reported by a significantly higher proportion of both short-term (54%) and long-term (53%) cancer survivors… The commonest problems experienced (crouching, kneeling, standing for long periods, walking short distances and lifting/carrying a load) are all vital for carrying out basic daily activities…”

 General Exercise Safety Precautions During and After Cancer Treatment

It is important to see a rehab professional with special training in cancer-related physiotherapy techniques for help in deciding what and how much exercise is recommended both during and after treatment. Below are some potentially adverse events associated with physical activity and cancer, with precautions you can take to avoid them:*

To prevent the exacerbation of symptoms (eg pain, fatigue, nausea, dyspnea) - Avoid high-intensity exercise; monitor symptoms; modify exercise type based on site of treatment (eg avoid exercise bike after prostate/rectal surgery).

To prevent immunosuppression – If patient has low white blood cell counts, avoid high intensity/volume of exercise (keep to light – moderate intensity).

To prevent falls – If patient has dizziness, frailty, peripheral sensory neuropathy: incorporate balance and coordination exercises (eg tai chi) and avoid activities needing considerable balance/coordination (eg treadmill).

To prevent bone fracture – If patient has bone metastases/osteoporosis risk avoid high impact or contact activities.

To prevent lymphedema – Progress resistance exercises in small and gradual increments. To avoid exacerbation of lymphedema, avoid strenuous repetitive exercise with affected limb;  wear compression garment.

* Written by Dr. Anna Campbell, University of Dundee; Jo Foster, Macmillan Cancer Support; Dr. Clare Stevinson, Loughborough University; and Dr. Nick Cavill (Cavill Associates Ltd).

A current Canadian study hopes to inspire health-care professionals to incorporate exercise into standard cancer care programs.

To find a Cancer Rehab Canada location near you, please see our list of British Columbia, SaskatchewanOntario, and Nova Scotia locations.

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