Here is a news release I found on imploring cancer patients to keep moving!

Exercise Is Good For Cancer Patients And Survivors Say Experts
July 1, 2010

A panel of US experts, including specialists in cancer, exercise training, fitness and obesity are urging cancer patients and survivors to avoid inactivity, even while undergoing treatment, as more and more research shows that continuing to exercise has a significant impact on their physical functioning and quality of life.

This is the message embodied in a new set of guidelines from a panel of 13 experts that the American College of Sports Medicine (ACSM) convened last year to consider what exercise advice to give cancer patients and survivors.

The guidelines appear in the July issue of the journal Medicine & Science in Sports & Exercise and follow the 2008 release of the Physical Activity Guidelines for Americans, published by the US Department of Health and Human Services. The lead author is Dr Kathryn Schmitz of the University of Pennsylvania’s Abramson Cancer Center in Philadelphia.

Early detection and improved treatment means more and more people are surviving cancer: there are some 12 million alive in the US today, writes the panel, explaining that this growing population faces unique health challenges posed by cancer recurrence, risk of other diseases, and side effects of their cancer and/or treatment.

Until recently, doctors advised cancer patients to rest and avoid physical activity: but an emerging body of evidence now challenges this view, so the panel reviewed the published evidence and gave recommendations.

They concluded that exercise training is safe during and after cancer treatment and improves physical functioning, quality of life and cancer-related fatigue.

And although they said it’s not yet clear what effect exercise has on survival and disease outcomes, the benefits to physical functioning and quality of life are so great that they recommend cancer survivors and patients with existing disease or undergoing difficult treatment “avoid inactivity” and follow the 2008 Physical Activity Guidelines for Americans, adapted to their particular situation, for example to take into account increased risk of bone fracture or cardiac side effects.

Schmitz told the press that:

“Our hope is that there will be more conversations about the need for formalized exercise programs for patients during and right after treatment — programs that will be the cancer equivalent to cardiac rehab.”

Schmitz said for a number of cancers, the benefits of exercise are well documented, particularly in reducing fatigue and improving physical functioning, both of which affect quality of life.

Co-author Dr Kerry Courneya from the University of Alberta, who has led a number of clinical trials examining how physical activity may or may not benefit cancer patients, said the strongest evidence is for people who have completed treatment, but because of differences in study designs they couldn’t compare evidence involving patients undergoing active treatment with patients who had finished their treatment.

During an education session at the annual American Society of Clinical Oncology (ASCO) meeting in June, he said:

“We’re finding that patients can do a lot more than we originally thought they could do, even when they’re on chemotherapy or radiation therapy.”

They found that even a small amount of exercise like regular brief walks showed gains compared to doing nothing.

The new guidelines point out that patients with different cancers have different treatments and they and their fitness adviser should take this into account when designing fitness programs.

For example, trainers instructing prostate cancer patients whose treatment included androgen deprivation should be aware of increased fracture risk. Another example is a woman who has undergone surgery to remove a breast cancer tumor may have a very weak shoulder and her fitness program should probably include exercises to stabilize and strengthen the surrounding muscle.

For some patients, there will be days when they are just to sick to exercise, in which case they should just decrease activity for a while, or wait a few days and then start again, said the panel.

But the guidelines only include specific recommendations, such as objectives and goals for a prescription for exercise (including potential contraindications), for patients with prostate, breast, colon, gynecologic, and hematologic cancers. This is because the panel felt there was not enough evidence to give detailed recommendations for patients with other cancers.

The guidelines also include the important need to improve body image. Many cancer patients have to have surgery or treatment that alters their appearance. This can result in loss of confidence, including feelings that they are no longer sexually attractive, said Schmitz.

However, she said there is good evidence that “physical activity can improve body image, and that may be one mechanism through which exercise can improve quality of life”.

Another important goal of exercise recommended in the guidelines is to improve body composition, which can change as a result of treatment, depending on the type of cancer. For example gastrointestinal and head and neck cancers can result in loss of weight and loss of muscle mass to the extent that patients can’t even get out a chair. For such patients, programs that help them build lean muscle would be really helpful.

However, almost the opposite problem occurs with breast cancer, for which there is the most abundant evidence, said the panel. For patients and survivors of breast cancer, the treatment they receive can often cause them to gain a lot of weight, and for them, exercise goals should focus on “controlling body weight, losing fat and getting back to a healthy BMI”, said Schmitz.

Although the evidence is not conclusive (Courneya described the emerging data as “exciting” but “still experimental”), the guidelines mention the possibility that for breast and colorectal cancer survivors, exercise after treatment could also reduce the likelihood of cancer recurrence and increase overall survival.

The guidelines also emphasize the importance of addressing a number of preparation issues before going ahead and implementing exercise programs for cancer patients and survivors. For example there is a need to educate oncologists, cancer specialists and patients about the benefits and the dos and don’ts of exercise during and after cancer treatment, there is a need to ensure there is appropriate insurance cover, and to increase the number of fitness professionals who understand the needs and concerns of cancer patients and survivors.

Marilyn McAllister, a trainer from Boise, Idaho, works with breast cancer survivors, privately and at a local hospital. She said while she has seen a lot of progress on the issues, a lot more needs to be done. For example, doctors don’t have time to talk to their patients about exercise because they are swamped with dealing with the details of the care issues, and patients are often too overwhelmed with information, and just giving them another leaflet about the benefits of yoga or strength training just “isn’t very helpful”.

McAllister is a cancer-certified trainer who gained her certification through a program developed jointly by the ACSM and the American Cancer Society (ACS). Other organizations also offer certification programs. For example, Schmitz helped ACSM develop a six-session cancer exercise trainer certification Webinar, and the Lance Armstrong Foundation has helped to train fitness staff at nationwide YMCA centers to work with cancer survivors.
McAllister said she found it deeply rewarding to work with cancer patients and survivors because while everyone benefits from exercise, the impact is more dramatic for cancer patients:

“It doesn’t take much training to produce big results in their lives,” she said.

Source: NCI.

Amen! Feel good, keep smiling and please keep moving! Pat


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