Tailored Exercise plans

Exercise is not a one-size-fits-all plan for cancer patients. How it is prescribed in terms of dosage and frequency can have vast differences in benefits, according to Professor Rob Newton.

The co-director of the Exercise Medicine Research Institute at Edith Cowan University says the form of cancer and the type of therapy patients undertake have an impact on what kind of exercise works best. Each person must be assessed to figure out the issues affecting their survival and the exercise should then be tailored to fit.

“One of the greatest problems with radiation and chemotherapy is overwhelming fatigue,” Professor Newton says.

“Patients report that is the most difficult thing, harder than the nausea, harder than the pain because you just have this overwhelming disability in terms of fatigue, so the exercise prescription has to be very careful in terms of design in order to manage that.”

This could mean focusing the exercise more on resistance or high intensity intermittent training.

Professor Newton says sometimes clinicians recognise that exercise is good and advise patients to go out for gentle walks. However, continuous low-level exercise tends to exacerbate fatigue.

“We found that if we get the patients in the clinic and put them on a stationary cycle and have them do two to three repetitions of flat-out cycling for only 10-12 seconds they get enormous benefit but it doesn’t exacerbate their fatigue — it suppresses the nausea and suppresses the fatigue,” he says.

One example where different exercise delivers different benefits is in a trial of men with prostate cancer who undergo testosterone suppression. Professor Newton says these patients tend to suffer bone loss.

“We gave them aerobic and resistance exercise; in every other population that I have worked with that would totally stop the bone loss but in men on androgen deprivation therapy it has totally no effect at all on bone loss,” he says. “It was only when we gave them impact loading that we actually stopped the bone loss.”

Another example is in women with breast cancer who suffer the relatively common side effect of lymphoedema, where a build-up of fluid causes swelling. “Only about four to five years ago exercise was contraindicated for lymphoedema and the therapist would advise against it, and in particular any type of resistance training,” Professor Newton says.

“But work from our team, which was a world first, showed that resistance training didn’t exacerbate and in fact it greatly improved the strength and function of these women with breast cancer.”

The West Australian

http://health.thewest.com.au/news/2994/fit-to-beat-cancer

Here are a couple of newspaper articles on how exercise helps fight cancer.

I’ve noticed that some forum members have HCC and may have been told to rest and not exert themselves. Current research suggests they do the opposite.

Work out the best way to survive cancer
PETA RASDIEN
July 06, 2016

Exercise is a potent medicine in the fight against cancer, delivering results equal to some of the best therapies. The latest evidence shows getting the right exercise prescription can halve the chance of dying Rob Newton, co-director of the Exercise Medicine Research Institute at Edith Cowan University, says this does not mean people should forgo traditional treatments such as chemotherapy but instead use exercise to amplify their survival chances.

“The chemo will obviously give them a survival advantage then, if they exercise, they are going to more than double their relative rate of survival,” he says.

Professor Newton says most patients were not being told of the evidence. Patients contact him quite upset because in the whole of their cancer journey they had never been advised to exercise, rather they were told to rest and not exert themselves. But lots of high quality research clearly demonstrates exercise is not only safe but one of the most highly effective synergistic medicines a patient can take.

“There is no evidence it will cure cancer but it will greatly slow the progression of most cancers because it actually rallies the body’s internal mechanisms to defend itself,” he says. This highly effective medicine to manage cancer can start immediately after diagnosis, with the right guidance.

“Where it comes into its real benefit is when it is given synergistically with other therapies such as chemotherapy, for example,” he says. “Chemotherapy in most cases will cure the cancer, it will obliterate the tumour, but of course there are enormous side effects from that.
“Many people will develop other conditions due to the chemotherapy which may in fact kill them.”

Exercise helps to reduce the risk of many of those treatment side effects. Professor Newton says drug developers are now pouring millions of dollars into researching immunotherapy, looking for new drugs that could wake up and supercharge the body’s own immune system. This is because, when it worked at its optimum, the immune system is highly effective at locating tumour cells or pre-cancerous cells and killing them.

“The interesting thing is exercise already does that very, very effectively and at the moment it does it more effectively than any drug we currently have available. The problem is getting people to do the exercise,” he says. And, exercise is not just for cancer patients who are relatively well. In fact, the biggest gains can be made for the sickest patients.

There are generic recommendations for all cancer patients to strive for 70-150 minutes of aerobic exercise each week. But many would not be able to achieve anywhere near that, Professor Newton says. “We would be happy if we could just get two reasonable resistance training sessions per week to try to stem the catastrophic loss of muscle. Patients with pancreatic cancer and mesothelioma, they just waste away. “We are trying to maintain muscle and keep them functional – so it is highly tailored exercise medicine.”

The Cancer Council WA has been a leader in promoting exercise among cancer patients, offering classes since 2007 and funding research into its effects to the tune of $1.1 million.

Sandy McKiernan, the council’s information and support services director, says exercise could deliver a range of other benefits alongside physical ones: Helping patients better cope with the side effects from treatment as well as the emotional fallout.

“The global benefits of exercise are still being understood and the research is really starting to delve deeper,” she says. “We’re starting to see the benefits of exercise during cancer itself.” Ms McKiernan adds the side effects of chemotherapy and radiotherapy can be debilitating so it seems to make sense for people to go home and rest “but the evidence now suggests the complete opposite.”

The West Australian
http://health.thewest.com.au/news/2993/work-out-the-best-way-to-survive-cancer

Hi Ariel

Here’s a picture of Penelope Pitstop for you.

Thanks for the EOT well wishes.

Thanks Cheese. I’d rather go for a ride on one of your bikes than go on a treadmill … riding in the Thai traffic will get your heart rate up …

I loved the surfing clip Ariel. Sharks are a hot topic over here at the moment. Opinions are divided on what to do. All I can say without sparking it up, is that we never worried about sharks when we were kids, and now lives are lost all too frequently. Reverse the current fishing restrictions to what they were for decades through the ‘60s to ‘90s, and problem solved.

Cute little race car Pat. EOT is a wonderful feeling. Thanks for your fine tuning tips along the journey.

Great photo of a GT2 Fitz. It’s better than the one I have for my avatar … I might have to steal it … but then again, it’s not polite to stick your rear end out in people’s faces.

Thanks Re_roll. I agree, Dr Freeman’s body shop is the best in the world … we come in all banged up to various degrees and he puts us back on the road in a relatively short time with a new lease on life. As I said in my original post, it’s his virtual garage …

Cheers
GT2