Exercise for cancer rehabilitation

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I just got back from the Oncology Nursing Society's annual congress in Boston, and I always feel overwhelmed by all the material that is covered at the conference.

Because oncology nurses provide such a variety and depth of care to patients and survivors, the list of topics at this conference is huge. From the specifics of targeted therapies to the details of genetic testing, from electronic medical records to supportive care issues, the range of subjects is vast.

Since it is impossible to attend every lecture, I try to at least attend the ones on nutrition and exercise, subjects I cover for CURE. On Sunday, I attended an informative session called "Exercise Across the Survivorship Continuum" hosted by three physical therapists: Lisa VanHoose, PT, PhD, of the University of Kansas; Leslie Bell, PT, CLT, of Belisse, a physical therapy clinic; and Mary Calys, PT, DPT, of the North Kansas City Hospital.

The therapists discussed how the role of oncology rehabilitation has expanded to the point that it needs to be a standard component of comprehensive oncology care. Research has shown exercise may decrease the risk of some cancers, that it can increase survival for breast and colon cancer survivors and that it may prevent and treat psychological and physiological challenges faced by survivors.

Exercise addresses many side effects of cancer treatment, such as fatigue, neuropathy, lymphedema, radiation fibrosis, sleep disturbances, depression, weight loss and weight gain. The therapists demonstrated some simple exercises that can be used by most patients, such as breathing and massage, even sitting then standing up. But they emphasized that patients and survivors should have exercise programs designed to their specific, individual needs and goals.

Often, the therapists are asked to provide a general exercise program or protocol for patients of a specific tumor type. But, they said, you can't have a "recipe" for all patients. Each patient or survivor needs to be assessed on his or her level of wellness, impairments and goals of therapy. The therapists showed how the goal of therapy influences the prescription. One patient had walking limitations and wanted to bass fish again. Another survivor was a concert violinist who was unable to play because of chemo-induced neuropathy. And yet, another patient wanted to go sky-diving. With different goals in mind, you could see how their exercise plans would differ.So, make sure you discuss your exercise goals and objectives with your nurse or healthcare provider.

If you are fortunate enough to have a physical therapist or oncology rehabilitation specialist on staff at your hospital, take advantage of their expertise in reaching your fitness goals. Also, for more on cancer rehabilitation, check out Julie Silver's blog here.

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Dr. Kelly Stratton
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