How Physiotherapists Get You Moving Throughout the Cancer Journey

Staying Active Helps Patients from Cancer Diagnosis through Post-Treatment

Exercise reduces risk of prostate-specific mortality

In our rehabilitation of cancer patients we have found that exercise helps them in every stage of the cancer journey - whether during cancer treatment, after cancer treatment, or both during and after cancer treatment. In advanced cancer stages as well, physical activity improves well-being as well as independence. One of the most important ways we can support people regarding the recommended amount and type of physical activity is through carefully tailored cancer exercise programs and rehabilitation treatment plans.

Evidence Indicates that Exercise Reduces Cancer Recurrence

The evidence from cohort studies of cancer survivors indicates reduced mortality risk related to leisure-time exercise. A recent Macmillan Cancer Support review reports that with three hours per week of moderate physical activity (such as brisk walking), prostate cancer survivors had a lower risk of prostate-specific mortality of approximately 30%, as well as a lower rate of disease progression of 57%.

How Exercise Helps Cancer Patients During and After Treatment

• During Cancer Treatment - Studies show that if they exercise during cancer treatment, cancer patients are less tired and experience improved physical activity
• After Cancer Treatment - Research also indicates that cancer survivors experience better recovery of physical function if they exercise after cancer treatment
• Both During and After Cancer Treatment - With regular physical activity both during and after treatment, the risk of cancer recurrence or the development of other long-term conditions can be reduced

At Cancer Rehab Canada we tailor our exercise programs to meet the specific needs of each individual patient, taking into account any special precautions they may have based on their diagnosis and medical history. Many modifications can be made that will safely allow individuals to meet their physical activity goals and, in doing so, improve their survival outcomes in addition to increasing their overall health.

Please contact one of our 48 Cancer Rehab locations across Canada. Links will direct to a Cancer Rehab provider in your area.

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When Do I Become a Cancer Survivor?

By DebiLyn Smith www.debilynsmith.com Author of Running From Cancer: a tilted memoir. A breast cancer "treatment survivor" since May 2011, DebiLyn strives to reduce the 50% of life-style induced cancer patients. "You can run, but you can't hide," she says.

What Happens After Cancer Treatment?

When does one begin to say they are a breast cancer survivor? I have finished the treatments. The medical profession has cut, poisoned and nuked the part of me that contained the psychotically rapid dividing cells known as cancer. I did survive that, with some scary moments of wondering involved. Or do I have to wait until the recommended five years of drug therapy is finished to declare "I made it!" If, that is, I do make it?

I don't want to be ridiculed at a cancer march or a run for the cure as they applaud the champions who beat this disease when I have yet to find out if indeed we did "get it all" or if there is some little piece that survived, starting to multiply someplace else as we speak. It's a very real concern. Worse than the nightmare about going to Sunday school without my underwear on.  I don't know what to trust anymore. My body let me down once. Will it do it again?

They say that one third of women with hormone dependent tumors (like mine) will have a recurrence. Better than half of those five years or more after surgery. Because I opted for the adjunct therapy (the chemo and radiation) combined with surgery my chance of the cancer coming back goes down. I think I'm at a 3-5% chance. It's still enough to make you worry. I've beaten lower odds before in the luck-less life lottery.

Beginning Life-Long Learning to Stay Healthy

Saying you're a survivor implies the war is over but for me, the battle has just begun. This is going to be a life-long assault of learning and doing what I can to survive not just now, but for as many years as I can squeak out of this body.

So despite everything that's been done, I'm determined to keep the numbers on my side. It's a betting game with no guarantees and you must do what you can to help. Swallow large fish oil and Green Tea capsules (anti-oxidants), stuff in the blueberries by the handful, drink the green spirulina/algae with your pinched, drag your butt to the swimming pool, fill those lungs with good clean fresh air, drink water not wine and whatever you do... don't sweat the small stuff.

Possibly when I'm on my  last breath, when I have lived a much longer life, I will finally declare myself a breast cancer survivor. Until then... Game On!

To find a Cancer Rehab Canada near you, visit the list of British Columbia, Saskatchewan, Ontario, or Nova Scotia locations.

The Best Treatment for Cancer Related Fatigue

Studies indicate that 80% of people who received chemotherapy or radiotherapy will have some degree of fatigue

Cancer Related Fatigue Remains Number One Problem

The most prevalent side effect of cancer treatment is fatigue. Studies suggest that eighty per cent of individuals who have received chemotherapy or radiotherapy will experience some degree of persistent fatigue. In Dead Tired, Dr. Jane Poulson describes her experience of cancer fatigue as "unlike any fatigue I have ever known, not only in severity and longevity but in its effect on my mood and spirits".

 Exercise Lowers Reported Fatigue Levels by 40 - 50%

Physical exercise has been suggested as helpful in reducing fatigue

Although it seems counter-intuitive to most people, the best cure for fatigue is exercise. The scientific evidence supporting exercise as the best intervention for fatigue is very strong. However it is often difficult for those overwhelmed by fatigue to know how to get themselves going again. They need guidance to start slowly and gradually increase their exercise over weeks and months. Every individual is different and some people have medical precautions which make finding their safe level of exercise more challenging. Appropriate screening and modifications of prescribed exercise is extremely important.

Cancer Exercise in the Community

At Cancer Rehab Canada we encourage you to get out there and get active. We want you to find a safe and engaging way to exercise. For some people this may be doing Yoga or Pilates at a local gym, and for others it might mean walking the dog. Exercising with others in a group setting is often an excellent way to take your mind off your fatigue and motivate you to get going, but you need to be mindful that you are an individual and everyone is unique.

If you have any doubt about your abilities to do certain exercises, please consult with a rehab professional at Cancer Rehab Canada. Starting an exercise program after an illness isn't easy, and often a few simple strategies can get you safely on your way to a full recovery. Before you know it you will be able to enjoy increased energy and much less fatigue.

To find a Cancer Rehab Canada near you, visit the list of British Columbia, Saskatchewan, Ontario, or Nova Scotia locations.

Life as a Cancer Survivor Poses Physical and Emotional Challenges - Wall Street Journal

Cancer Survivorship Care Programs Integrate the Body, Mind and Soul of the Survivor

Cancer rehabilitation services in Canada are rarely received, although they are needed as much as in the US

Cancer physiotherapy, emotional aid and plans for treatment follow-up are becoming the norm at a number of hospitals and community cancer centers in the US where survivorship care programs have an integrated approach that takes care of the body, mind and soul of the survivor. Unfortunately in Canada, these rehabilitation services are still rarely received, although they are needed just the same. (see Oncology Rehabilitation Provision and Practice Patterns Across Canada, Canestro et al, Physio Canada, 2013)

As reported in The Next Front in Cancer Care at the Wall Street Journal, "Chemotherapy and radiation can damage vital organs such as the heart and liver, possibly causing secondary diseases years later. The body can be debilitated, cognitive functions impaired and emotions distressed, making return to normal life and work difficult. Some 70% of cancer survivors experience depression at some point. Patients have higher levels of anxiety years after the disease is cured." The focus of treatment is on curing the cancer, but often there is no care provided for the side effects that occur as a result of the cancer treatment.

Cancer Rehab Canada feels the same rehabilitation services should be offered to Canadians who are living with cancer, whether their impairments are physical or psychological in nature. We have a long way to go to provide the same array of services available to many Americans, but we are working hard to build the same level of rehab care for all Canadian cancer survivorships.

Read the full Wall Street Journal article.

To find a Cancer Rehab Canada near you, visit the list of British Columbia, Saskatchewan, Ontario, or Nova Scotia locations.

Calgary Volunteers Raise Awareness for Cancer at Run for the Cure

by Barb Morrison, Clinical Director, Max Bell Physiotherapy

Run for the Cure Shows Spirit of the Calgary Community

This year, Calgary's Mayor Naheed Nenshi sent out a message to Calgarians about volunteerism. Whether it is bringing this city back to life after the floods or supporting events such as the Run for the Cure, volunteers make it happen. "This is Calgary, folks," he said. "This is the spirit of the Calgary community."

Centric Health's Calgary Region Provide CIBC Run for the Cure Team and Massages to Participants

On October 6, 2013, Centric Health's Calgary Region once again gave back to the community by providing a CIBC Run for the Cure team. For the eighth year in a row, employees provided massages to the participants as well as entered a team that walked or jogged the five kilometre route.

Clinical Director Barb Morrison gets a 'selfie' with Calgary Mayor Nenshi

As Physiotherapists, Chiropractors, Kinesiologists and Massage Therapists, we are fortunate to have a skill set that allows us to provide this service to our community. More than 7,780 registered runners and about 1,000 volunteers took part in this year's CIBC Run for the Cure, which raised more than $1.3 million in Calgary alone. At the start of the race, I took a moment to get a 'selfie' with Mayor Nenshi.

We all have very busy lives and we may question whether we have the time to volunteer, but having the opportunity to participate in events such as Run for the Cure is very rewarding. At the end of the event, a woman in a pink 'Survivor' shirt came over and gave me a hug. She said "Thank you for what you... I am still here because of people like you who volunteer to raise awareness about the impact of cancer."

A huge thank you goes out to all of the Centric Health employees and family members who participated. Every year Centric Health has a strong presence at this event and we are recognized as a key player in the Calgary Run for the Cure.

See you next year!

Barb Morrison
Clinical Director, Max Bell Physiotherapy

What Causes Lymphedema?

Lymphedema is Experienced as a Side Effect of Cancer Treatment by Many Cancer Survivors

Anything that damages lymph nodes or vessels can cause lymphedema.

As a side effect experienced by many cancer survivors who have undergone cancer treatment, secondary lymphedema can be caused by surgery, sentinel node biopsy, radiation therapy, or infection. Primary lymphedema is genetic in nature and is caused by problems in the lymph system from birth.

According to the Canadian Lymphedema Framework, which was put together in 2009 to construct a national strategy on lymphedema, it is an "under-recognized and undertreated condition that affects many cancer survivors." They identified some of the reasons for this as being:

• Lack of awareness among medical professionals about the condition
• Insufficient education about the lymphatic system
• Limited access to lymphedema treatment
• Lack of research

Since the lymphatic system can spread cancer through the body, sometimes the cancerous lymph nodes are removed as part of cancer treatment. And in radiation therapy, while the cancerous cells in lymph nodes or vessels become destroyed, the vessels and nodes can become damaged. It is important to recognize this damage to the lymphatic system and work to minimize the impact through careful monitoring, early intervention and good management of the subsequent swelling that may result.

Early Physiotherapy Intervention Can Be Effective in Prevention of Lymphedema Following Breast Cancer Surgery

There is evidence to suggest that early physiotherapy intervention could be effective in the prevention of secondary lymphedema in women following surgery for breast cancer. Judy Boivin, a physiotherapist working with all types of cancer patients states "We are monitoring cancer patients closely for lymphedema throughout the first year following treatment, at the same time as we are ensuring full range of motion of the limbs and providing education regarding regular exercise and skin care." It is important to minimize the risk factors and identify lymphedema in the early stages.

So although the damage of the lymph system from cancer treatment may be inevitable, there is a great deal that can be done to minimize the impact. Consulting with a cancer rehab professional in the early stages following cancer treatment is recommended.

For related information, read Lymphedema - Canadian Strategy for Management, and our post on What is Lymphedema?

To find a Cancer Rehab Canada near you, visit the list of British Columbia, Saskatchewan, Ontario, or Nova Scotia locations.

Cancer Rehabilitation Improves Cancer Survivors' Quality of Life

Cancer Rehabilitation Benefits Optimal Recovery

Why aren't cancer patients routinely offered cancer rehabilitation services to help them return to normal life? These services are regularly provided for recovering cardiac patients and patients who had joint replacement surgery. Yet those people who have had cancer treatments such as chemotherapy, radiation or surgeries such as masectomy, are often not receiving cancer therapy or rehabilitation service despite the growing scientific evidence that it is very beneficial in obtaining optimal recovery.

Cancer Survivors Often Suffer From Disabilities Associated With Cancer Treatments

Cancer survivors benefit from client centered, active rehabilitation & empowerment

Cancer survivors often suffer from the side effects of their diagnosis and related treatment. Their functional impairments may include persistent fatigue, radiation fibrosis, chemotherapy fog, lymphedema, frozen shoulder and pain. Many of these conditions can be improved with interventions from a rehabilitation professional with specialized training, such as a physiotherapist, occupational therapist or massage therapist.

According to the Canadian Partners Against Cancer, there is estimated to be 1 million cancer survivors in Canada today, with that number expected to increase to over 2 million by 2020. Physical disability is a leading cause of distress in this population. It is critical that this population be appropriately screened and treated for their impairments, so that we minimize their disabilities and maximize their quality of life.

Cancer C.A.R.E. Provides Client Centered, Active Rehabilitation & Empowerment for Cancer Survivors

Judy Boivin, a registered physiotherapist and cancer survivor, will be blogging about ways that cancer survivors can feel better, stronger and happier. Judy has recently developed and implemented an evidence based cancer rehabilitation program at 24 LifeMark/Centric Health locations across Ontario. The program provides Client centered, Active, Rehabilitation and Empowerment for cancer survivors. This service is appropriate for anyone who has received a cancer diagnosis and is receiving or recovering from cancer treatment.