Tuesday, February 5, 2013

Fitness Pros: Change the Culture of Cancer Care


Cancer touches all of us. We all know someone who has been diagnosed with cancer:  a friend, family member or perhaps even you.

The numbers are sobering: 1 in 26 Americans is a cancer survivor. In other words, 1 in 2 men and 1 in 3 women who will be diagnosed with cancer in their lifetime. In 2013, about 580,350 Americans are expected to die of cancer, almost 1,600 people per day.

Cancer is the second most common cause of death in the US, exceeded only by heart disease. Advances in treatment, including laparoscopic surgery and image-guided radiation therapy, have led to a growing population of over 14 million survivors.

The increasing number of cancer survivors has brought more attention to quality-of-life issues for these patients, who may end treatment with physical and cognitive limitations related to inactivity, surgery, radiation or chemotherapy. Inactivity related to cancer and its treatment can contribute to systemic problems, including loss of strength and muscle torque as well as negative effects on the respiratory and cardiovascular systems.

As an exercise physiologist I have worked with many different types of clients ranging from healthy to chronically ill. In particular, many were diagnosed with cancer. But despite long awaited advances in fitness protocols and treatment options, the culture of post-treatment care never felt quite “right”.

Why were clients of mine who began medical treatment for cancer told to go home and rest? Their medical team never even mentioned how they can participate in their healing while dealing with the acute and sometimes chronic side effects of their cancer treatment.

Not only did I witness my clients diminish in function, but they became vulnerable, anxious and weak, with no support net once they were home from the hospital or treatment center. They lost time at work, which led to financial worries; they were too weak to care for their own family or drive a car. They needed help with everyday tasks such as cooking, cleaning, event taking a bath.

This treatment cycle, based more on history than good science, was repeated until the treatment was complete.

From Passive Recipient to Active Participant

Since therapeutic exercise can improve in digestion, fatigue, sleep patterns, anxiety, and helps patients stay on the course of treatment; why weren't their doctors recommending exercise? What is even more interesting to note; in recent studies physical activity has been shown to increase disease-free survival especially in breast and colon cancer (the two cancers most studied at this time). This is something of great significance in cancer.

In fact, walking for three to five hours a week at a moderate pace has been shown to reduce recurrence risk by up to 40 percent  in women with breast cancer. It has also become well established that exercise is not only helpful but can be very safe for patients.

This recognition has created an evolving focus on the cancer survivorship period with respect to:
  • Living cancer free (decrease recurrence).
  • Managing ongoing cancer treatment.
  • Reducing the risk of developing other diseases secondary to cancer treatment.
  • Optimizing quality of life

Standards of Practice Must Change

Perhaps the reason that the medical community isn’t referring patients to participate in physical activity is that they don’t know WHO or WHERE to send them? A valid concern. However, that’s changing as exemplified by major certifying bodies: The American College of Sports Medicine, just over the past few years, has set exercise guidelines for people living with cancer during and after treatment.

As my interest has grown from working with people living with cancer in a one-on-one environment, I came to realize that there is power in the group. The support and companionship is second to none when it comes to participation rate. After all, if you’re not doing it, you’re not benefiting from it.

I have a goal: to provide an environment where all people touched by cancer may enhance their quality of life through physical activity programs that complement medical care and focus on the mind, body and spirit.

Despite advances in recognizing the importance of therapeutic exercise after a cancer diagnosis, the vast majority of patients and survivors are still grossly under-treated for deficits common with cancer treatment. This is due, in part, to the lack of training fitness professionals receive about the needs of cancer patients.

Now it’s time to teach fitness professionals how to do just that.


Make a PACT for Life!® is a culmination of my two decades of experience working with people living with cancer. PACT is a program for all fitness levels to help rebalance, rebuild and revive. PACT focuses on a series of movements to put the body in optimal functional alignment and improve strength and balance

PACT hopes to provide an environment where all people touched by cancer may enhance their quality of life through physical activity programs that complement medical care and focus on the mind, body and spirit. PACT is designed to provide all people newly diagnosed to long-term survivors with tools to withstand the consequences of a cancer diagnosis and treatment.  My goal is to make this exercise-related approach a routine practice in cancer care.

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