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Forward Motion

BY LENA HUANG
PUBLISHED THURSDAY, JUNE 12, 2008
Ben Lauderdale has lost a lot to cancer. Ten years ago, he lost his wife to lymphoma, and in 2001, he lost a kidney to metastatic bladder cancer. But at age 80, plagued by gout and neuropathy, Lauderdale says he found some hope in the strangest of places—in a small, simple room filled with equipment at the First Christian Church in Tyler, Texas. But it wasn’t religion he found—it was exercise.  

“It gives me incentive. It helps my circulation and my balance. And I can’t tell you how, but it aids my day. If I miss one day, I don’t feel as well,” Lauderdale says.

As the physical and mental benefits of exercise are being realized by survivors like Lauderdale and are being confirmed through scientific studies and research, exercise programs across the country are emerging to meet the unique needs of people with cancer.

The Tyler program, developed by the nonprofit Cancer Foundation For Life, or CFFL, is a free exercise program to rehabilitate cancer patients in and out of treatment. While patients often come to CFFL to alleviate side effects or to rehabilitate from chemotherapy or radiation, they often leave with much more—a positive mental outlook and a sense of empowerment, says founder Gary Kimmel, MD.

“You can’t take someone who is debilitated, bald, with neuropathy, and put them in a fitness center with a bunch of young, fit people,” says Dr. Kimmel, a retired oncologist who established CFFL in 2001. “Cancer patients have to have the right environment. They have to have ownership because that way, they can share their experiences together. They are able to empower each other, to achieve levels of activity perhaps never conceived of because they are next to someone who has been through chemotherapy and radiation, who regained their strength, vitality, and quality of life. This program model is extremely effective.” 

In Seattle at the Swedish Cancer Institute, ACTIVE (Addressing Cancer Through Individualized Exercise) medical director David Zucker, MD, PhD, sees how personal empowerment through exercise can help patients rehabilitate from cancer.

“When someone gets cancer, it is often the first time that person realizes, ‘Mortality applies to me.’ … Some people describe it as being in a free fall,” says Dr. Zucker. “Often, the only thing that person has to hang on to is the cancer diagnosis. And while it is important for patients to pay attention to treatment, it is equally important for them to pay attention to the billions and billions of healthy cells in their body. Exercise gives those healthy cells attention.”

As a rehabilitation physician and clinical psychologist for patients with cancer, Dr. Zucker says most of his patients experience fatigue, alone or with other side effects, such as pain, nausea, anxiety, and depression. And while treatments exist for each side effect, exercise is one treatment that spans over several side effects.

“We have seen a physical confidence in our patients, an understanding of the side effects of treatment and how to use exercise to cope with them well,” Dr. Zucker says, adding participants also report improved tolerance to treatment, reduced fatigue, improved mood, better sleep, less pain, and improved tolerance or ability to participate in everyday activities since attending the program.

Since its inception in 2005, the ACTIVE program has seen over 400 patients, says Dr. Zucker. The program starts with a physician referral and initial consultation with Dr. Zucker, who reviews the patient’s medical, functional, psychological, and social history. The patient then visits with a physical therapist for a musculoskeletal evaluation and aerobic-capacity assessment. The findings are reviewed and an individualized program is created.

Program length varies from patient to patient and is covered by some insurance, although Swedish Cancer Institute offers charity support to patients in need through its nonprofit foundation. Dr. Zucker’s goal is to support patients with “whatever activity goals they have.” For some patients, the benefits of exercise are realized within a few visits. For others with chronic cancer or who are debilitated, the process may take longer.

“Rather than view exercise as an act of performance, I ask patients to view exercise as an act of self-care and kindness,” says Dr. Zucker. 

Researchers are confirming what exercise program leaders are discovering—not only does exercise build up self-esteem in cancer patients but it may also improve survival.

Two recent studies with colorectal cancer patients resulted in similar findings: Patients who added exercise to their lifestyle after diagnosis cut their chances for recurrence and death in half.

More than 800 stage 3 colorectal cancer patients were examined in one study that concluded patients who engaged in at least six hours of walking at an average pace per week (or an equivalent exercise) had a 47 percent improvement in disease-free survival. The other study, based on results of the Nurses’ Health Study, revealed a 50 percent reduction in both colorectal cancer-specific and all-cause mortality in physically active individuals.

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