Physical Activity in Cancer Survivorship. Canadian Blood and Marrow Transplant Group. Patient and Caregiver Symposium

Transcription

1 Physical Activity in Cancer Survivorship Canadian Blood and Marrow Transplant Group Patient and Caregiver Symposium S. Nicole Culos-Reed, PhD June 10, 2017

2 The Health & Wellness Lab is committed to building a clinic-to-community model grounded in evidence-based research to demonstrate the benefits of physical activity for cancer patients and survivors. Research shows that regular exercise can significantly reduce the impact and intensity of the multiple diseases linked to many primary cancer treatments, while simultaneously improving the physical functioning and emotional wellbeing for cancer survivors, during treatment and rehabilitation, and into long-term survivorship

3 What are we talking about?? Exercise Physical Activity Movement 3

4 MOVE MORE!!! 4

5 CANCER & EXERCISE Exercise is both safe and beneficial at any stage of the cancer experience CANCER CONTINUUM SURVIVORSHIP PRE-TREATMENT TREATMENT POST-TREATMENT Including surgery, chemotherapy, radiation therapy, and palliative care as needed Rehabilitation and/ or maintenance therapy as needed PALLIATIVE CARE BENEFICIAL TO EXERCISE 5 5

6 Tug of War CANCER NEGATIVELY AFFECTS: Body Composition Weight management Fatigue management Sleep management Cardiovascular fitness Bone Strength Muscle Loss Loss of Appetite Depression Anxiety Pain Hormone-regulation (i.e. insulin sensitivity) Quality of Life Physical functioning and mobility Survival PA POSITIVELY AFFECTS: Body Composition Weight management Fatigue management Sleep management Cardiovascular fitness Bone Strength Muscle Loss Loss of Appetite Depression Anxiety Pain Hormone-regulation (i.e. insulin sensitivity) Quality of Life Physical functioning and mobility Survival

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9 Research Summary: Benefits of Exercise for Stem Cell Transplant Patients Section Title Improved fitness parameters Increased aerobic capacity Intro copy varius sempdf gid thber Increased strength mame vehicula. Improved physical functioning Activities of daily living Decreased fatigue Faster recovery with exercise vs wtihout Improved quality of life Stress, Anxiety, Depression, Quality of Life

10 Survival Benefits Latest survival research breast, prostate, colorectal, ovarian: Section Title Significantly reduced risk of cancer recurrence Significantly reduced risk of cancer-mortality Intro copy varius sempdf gid thber mame vehicula. Significantly reduced risk of all-cause mortality Modest amount of moderate to vigorous activity (90 minutes 3+ hours per week) Meyerhardt; Kenfield et al., 2011

11 Exercise and Cancer Research Health and Wellness Lab

12 Adding in Physical Activity ALL movement is beneficial SOCIAL SUPPORT: active lifestyles are easier to maintain with outside support Section Title Ask family/friends to get active with you Intro copy varius sempdf gid thber mame vehicula. Ask family/friends to be an accountability partner Adopt a 4-legged friend for motivation Join a group activity program or class Consider potential BARRIERS What do you enjoy? What s accessible? What s sustainable?

13 Additional Considerations Start with less than your mind thinks you can do and gradually build up Section Set SMART(T) goals Title SPECIFIC Intro copy varius sempdf gid thber 10 min of walking, 3 x/wk mame vehicula. MEASURABLE Track your behaviour ATTAINABLE match your fitness level RELEVANT to your lifestyle TIMELY AND TOGETHER Image Source: SXC

14 Smaller bouts of exercise throughout the day may be more realistic (10 min bouts) Mild to moderate activity most days of the week during treatment, depending on fatigue levels Listen to your body 14

15 Types of Physical Activity Find ways to incorporate key types of exercise into a weekly program Section 1. Aerobic Title 2. Resistance/Strength Training Intro copy varius sempdf gid thber 3. Flexibility mame vehicula. Image Sources: SXC

16 1. Aerobic Exercise Activities that use large muscle groups Can be maintained continuously Section Title Rhythmic in nature Works the heart and lungs due to higher oxygen intake Intro copy varius sempdf gid thber mame vehicula. Image Sources: SXC

17 2. Resistance Training Muscles work against weights or other resistance (i.e., tubing, Section gravity, body weight) Title Designed to build lean muscle Intro copy varius sempdf gid thber mame vehicula. Increases strength in muscle groups and increases maximum muscle force Can easily integrate functional movements and balance exercises to reduce risk of falls Image Source: SXC

18 3. Flexibility Training Gentle, stretching movements Performed separately or after aerobic/resistance training Lengthens connective tissue surrounding muscle Image Source: SXC

19 How much and how hard? Same guidelines as healthy population: Aerobic: 150 mins/wk Moderate-Vigorous Intensity Resistance Training: Exercises involving all major muscle groups at least 2 days/wk Flexibility: 7x/wk Static stretch or yoga-based Pelvic Floor: As recommended by a physiotherapist

20 How are we empowering survivors?

21 RESEARCH TEAM - CALGARY Dr. Nicole Culos-Reed, PhD Co-Principle Investigator University of Calgary Tanya Williamson, BKin, CSEP-CEP Research Coordinator/Certified Exercise Physiologist (CEP), University of Calgary

22 RESEARCH TEAM - EDMONTON Dr. Margaret McNeely, PhD, PT Co-Principle Investigator University of Alberta Dr. Chris Sears, PhD, CSEP-CEP Research Coordinator/Certified Exercise Physiologist (CEP), and Post-doctoral Fellow, University of Alberta

23 Alberta Cancer Exercise (ACE) Program ACE is for all cancer survivors Up to 3 years post-treatment N=1000 Hybrid implementation and effectiveness study Cost analysis Exercise as standard cancer care

24 KEY FEATURES Screening & Referral Screening cancer survivors for safety Triage to appropriate programming Community Integration Close to survivor s home Supported programming Address barriers and facilitators Professional Training Provide cancer specific training to communitybased exercise specialists

25 SCREENING PROCESS Screening for safety (Intake form) Physician approval / notification Once into ACE Program: o Physical Fitness Assessment o Triage to appropriate programming in community, o bridging or rehab services 12-week FREE exercise program Maintenance programming Follow-up assessments: 12 weeks, 24 weeks and 1 year (option for yearly follow-up)

26 PATIENT ELIGIBILITY Diagnosis of cancer (all tumor groups included) Pretreatment, or receiving active cancer treatment, or have received cancer treatment within the past three years Able to participate in low-intensity PA at minimum Over the age of 18 years and able to provide written informed consent in English Patients beyond the three years post treatment may be accepted if physician deemed them appropriate as still struggling with cancer-related side effects

27 CALGARY PROGRAM OFFERINGS ACE (Free Programs) City of Calgary - Killarney City of Calgary - Sir Winston Churchill City of Calgary - Southland Leisure Centre City of Calgary - Village Square YMCA South Health Campus Holy Cross Campus REACH Centre Wellspring Carma House NW Wellspring Fountain Court SE Killarney Winston Churchill UofC Thrive Wellspring Village Square Drop-In Programs (Free Classes) Wellspring Exercise and Educate UofC Thrive Centre (Free Open Gym) Contact for hours Free fitness facility for survivors at the University of Calgary S&S PCC Holy Cross Southland Wellspring SHC YMCA

28 RURAL SITES Red Deer Medicine Hat Lethbridge Grande Prairie Fort McMurray Other sites: partnering with AHS, Active Living, PCNs and Community Rehab

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30 Yoga Thrive is 12 week, research based, yoga program for cancer survivors and their support persons. No previous yoga experience is required. We offer a Level 1 and a Level 2 class and the classes are progressive. Classes are 75 minutes and held at various locations throughout Calgary.

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32 Get Moving! Summary Start slowly and take precautions Some is better than none! Section Title Try to incorporate all 4 types of activity into your life: Intro copy varius sempdf gid thber mame vehicula. Aerobic, Strength, and Flexibility Exercises Find ways to make everyday routines more active Remember, a gradual increase in activity = HUGE health benefits! Image Source: SXC Seek out community programs, like ACE, to help start and maintain a healthy lifestyle

33 CONNECT WITH US thriveforcancersurvivors.com E: T: Twitter Instagram (coming soon!) E: T: Twitter Instagram Dr. S. Nicole Culos-Reed E:

34 CLINIC TO COMMUNITY PROGRAMS THANK YOU Funding for the ACE Program is provided by Alberta Innovates Health Solutions (AIHS), in partnership with the University of Calgary and the University of Alberta 19