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Teach exercise to counter side effects of treatment
Lessons make cancer patients 'Fit for Survival'
The benefits of exercise are varied. Regular physical activity can prevent certain diseases, such as type 2 diabetes, help manage weight, boost energy levels, and promote better sleep. When the Shaw Cancer Center in Edwards, CO, found studies showed exercise helped cancer patients manage the side effects of treatment, it implemented a program called "Fit for Survival."
"There are many side effects as a result of cancer treatment, and we address as many as we can. We make sure each patient gets an individualized program that suits their needs and goals," says Dustin Buttars, exercise physiologist at Fit for Survival at Shaw Cancer Center.
Patients learn what exercise is beneficial for their particular cancer type and treatment to increase energy, reduce fatigue, maintain muscle mass, reduce weight gain, or address problems with balance. For example, prostate cancer patients might undergo hormone therapy that reduces their testosterone levels impacting their strength and lean tissue maintenance. Their exercise program would include strength training to slow down the loss of muscle mass and try to maintain the patient's strength through treatment, explains Buttars.
In addition to learning what exercise would be beneficial during treatment, patients learn how to properly execute the regimen. For example, those lifting weights are taught how to properly progress from lifting a five pound weight to 10 pounds.
Also patients are taught the most appropriate intensities at which to work out. Buttars says the appropriate exercise intensity helps patients keep their immune system strong during treatment. This intensity is calculated with the aid of a rating of perceived exertion scale, heart rate range, or metabolic equivalent tasks, he adds. "We use any one of those three markers to teach patients moderate intensity to build their immune system," says Buttars.
Once a patient's immune system has rebounded, patients are taught the appropriate exercise intensity to help with weight gain from treatment and weight maintenance. "Research shows that obesity and a high BMI [body mass index] have a strong effect on cancer occurrence, so when a patient goes through treatment and gains 30 pounds, there is a strong correlation to that excess weight gain and cancer recurrence," says Buttars.
Thirty minutes of exercise, six days each week, are recommended by the American College of Sports Medicine to reduce cancer risk and recurrence, he says. "The more active a person is, the lower the risk of cancer. Losing weight reduces the risk of cancer recurrence, so we try to focus on both," says Buttars.
While there is no one set routine applied to every patient with a particular cancer, frequently they have similar needs. For example, many women who have undergone breast cancer surgery will need rotator cuff or upper back strengthening to work on their posture, so they are taught exercises for good posture.
To create an exercise program that fits the needs of each patient, Buttars or a second exercise physiologist on staff consults with the patient. Both were certified as cancer exercise specialists by the Rocky Mountain Cancer Rehab Institute in Greeley, CO.
During the consultation, patients are asked about their cancer history, exercise history, medical issues, their current medication regimen, and future treatment. Also the patient's fitness level is assessed. Tests on the treadmill help determine the appropriate working heart rate and anaerobic threshold. Also measured are strength, balance, range of motion, flexibility, and body fat percentage.
"Based on the assessment results and the consultation, we put together an appropriate fitness program patients can do with us in our gym, or we can develop a program they can do at home or at their local gym whatever is most appropriate for the patient," says Buttars.
The two exercise physiologists work with two dietitians, a social worker, and a physical therapist. These team members refer cancer patients to one another. For example, if a patient needs help with weight loss, a dietitian and an exercise physiologist might work together. A patient with emotional issues might be referred to the social worker. Buttars says the social worker often will refer patients for exercise because it is one aspect of many cancer patients' lives where they can have some control.
Fit for Survival was implemented at Shaw Cancer Center about four years ago following a patient survey to determine what complementary and alternative therapies might be helpful. The survey results showed patients would benefit from an exercise program, says Buttars. "There are many side effects that come with cancer treatment, and we address as many of them as we can. We make sure each patient gets an individualized program that suits their needs and goals," says Buttars.
For more information about creating an exercise program for patients to address the side effects of cancer treatment, contact:
Dustin Buttars, Exercise Physiologist, Fit for Survival, Shaw Cancer Center, P.O. Box 2559, 322 Beard Creek Road, Edwards, CO 81632. Telephone: (970) 569-7493. E-mail: firstname.lastname@example.org.