What is excercise oncology?
We all know that exercise is an essential component of health and wellness. There’s universal acceptance of the myriad of benefits of exercise, and there is consensus that physical activity improves virtually all aspects of life. Unfortunately, the robust data supporting the therapeutic benefits of exercise for cancer management and treatment has gone relatively unnoticed. Emphasis on and awareness of structured exercise programs in this specific sector of patients is lagging behind the science especially when compared to other medical diagnoses.
Compelling scientific evidence has emerged that moderate daily exercise improves multiple cancer related outcomes such as fatigue, quality of life, survival, and recurrence rates. There is an aerobic exercise goal recommended by the American College of Sports Medicine that patients ideally can strive to hit, but in recent years it has also been found that strength training is an equally important mode of exercise for patients. Incorporating two to three sessions of strength training is a great goal. As reported by the National Institutes of Health, women with breast cancer who met the minimum physical activity guidelines both before diagnosis and at the two-year follow-up (after treatment) had a 55% reduced chance of their cancer returning and a 68% reduced chance of death from any cause (not just breast cancer) compared with those who did not meet the guidelines at both times,” which is enough to motivate any individual to tie up their laces and go outside.
For primary and secondary prevention of cancer as well as moderate to strong effects on fatigue, anxiety, depression, quality of life, physical function, sleep, and bone health the following is prescribed: 150 to 300 weekly minutes of moderate-intensity aerobic exercise or 75 to 150 weekly minutes of vigorous aerobic activity along with twice-weekly progressive resistance exercise, including exercises for all major muscle groups.
Drs. Henderson and Kollmorgen at Oregon Surgical Wellness are committed to learning first-hand how to start a structured program and collect more data about the benefits of exercise in the setting of breast surgical oncology. While there are excellent exerciserelated survivorship programs here in Lane County, such as the LiveStrong program at the YMCA, wide accessibility to structured programs tailored to the cancer patient is still lacking and the development of additional programs is a natural progression towards the enhancement of the multidisciplinary care of patients experiencing cancer at any stage of their treatment journey. Not surprisingly, international guidelines have already been established that recommend counseling cancer patients about healthy lifestyle changes including exercise.
Despite these guidelines, there remains a reluctance from some physicians to prescribe exercise under these circumstances. Perhaps it is uncertainty about patients’ ability to tolerate exertion during treatment or simply a lack of knowledge in regard to the data supporting it.
Oftentimes, traditional expectations are for patients to rest during cancer treatments as they experience increased fatigue and stress. “With early adoption of these recommendations, OSW’s goal will be to facilitate the prescription of exercise as a community standard and it will hopefully become an integral part of our survivorship plan,” says Dr. Kollmorgen. The data is now clear, “promoting an active lifestyle with a focus on exercise while optimizing patient care will increase well-being and save lives by reducing recurrence rates.” The time is now to help facilitate patient and survivor engagement in exercise – there is no need to wait for a prior authorization.
How do we achieve patients’ buy in? There are several proven models to facilitate the implementation of exercise as part of the cancer care plan. These models range from clinically supervised settings to supervised and unsupervised community-based and online settings. Cancer care team members at every level also play an important role in promoting exercise to cancer survivors. Resources and tools are available to help the cancer care team motivate survivors to engage in exercise, such as enhancing enjoyment of the activity, goal setting, self-monitoring, and social support. Looking forward, gaining widespread community support is key to this initiative. In time, exercise oncology themes may even be infused into locally owned gyms and fitness centers. For the sake of our community’s cancer patients – “We like to move it!”