Sunday, February 6, 2011

Our presentation to Oncologists at Sunnybrook

Last Thursday Sara-Clare, Lisa (one of our clients dealing with cancer) and I went to speak to a group of oncologists at Sunnybrook regarding our experience working with people dealing with cancer.
We put much thought and energy into our presentation and truly hope that somehow we can influence the future of exercise as it applies to cancer patients. I could just burst at the seams in terms of my belief that regular exercise tailored to the individual can be a determining factor in someone's response to treatment and prevention of recurrence.

Over the next few years we are going to be seeing a major paradigm shift in the way people deal with treatment. The idea that people dealing illness in treatment should rest is being tossed out the window. This following is taken from an article last June 2010.

"New guidelines are urging survivors to exercise more, even -- hard as it may sound -- those who haven't yet finished their treatment.

There's growing evidence that physical activity improves quality of life and eases some cancer-related fatigue. More, it can help fend off a serious decline in physical function that can last long after therapy is finished.

Consider: In one year, women who needed chemotherapy for their breast cancer can see a swapping of muscle for fat that's equivalent to 10 years of normal aging, says Dr. Wendy Demark-Wahnefried of the University of Alabama at Birmingham.

In other words, a 45-year-old may find herself with the fatter, weaker body type of a 55-year-old."

So when I called Dr. Ellen Warner at Sunnybrook and told her what we were offering at Urbanfitt, she was gracious enough to invite us to speak. Dr. Warner headed up a study that looked at the impact of monitored exercise programs on people during treatment. Can't wait until those results are published! Apparently, the prelim very positive.

Here's a summary of our presentation for those of you interested in what we talked about.

WARRIOR WITHIN: fitness professionals' perspectives on exercise during treatment and bridging the gap between the medical community and the fitness industry

Exercise guidelines during and after treatment from June 2/10 AGM lead by Kathryn Schmitz, Ph.D., M.P.H., FACSM, associate professor of Epidemiology and Biostatistics and a member of the Abramson Cancer Center

1) Cancer patients and survivors should adhere to the 2008 federal Physical Activity Guidelines for Americans, which recommend at least 150 minutes
per week of moderate-intensity aerobic activity.
2) Clinicians should advise cancer survivors to avoid inactivity, even for patients with existing disease or who are undergoing difficult treatments.
3) Exercise recommendations should be tailored to the individual cancer survivor to account for exercise tolerance and specific diagnosis
4) Clinicians and fitness professionals should pay close attention to cancer survivors responses to physical activity, in order to safely progress exercise programs and avoid injuries.
5) Although more research should be done on the effects of strength training on cancer survivors, the practice generally appears to be beneficial.

Barriers to exercise for cancer patients

Fear of engaging in activity that might compromise treatment and old paradigms regarding exercise and illness
Physician concerns regarding liability (PAR Med ex can cover liability both directions)
Accessibility: LOCATION, income, lack of specialized classes and coaching in mainstream fitness environments
Lack of coaching and lifestyle change support in health care system: services exist but people don’t know about them
Lack of collaboration between medical community and fitness professionals

Our approach to exercise for cancer patients

Upper body joint mobility and fascial stretching before and after surgery
Myofascial release to relieve pscyhosomatic tension and calm the CNS - assist with sleep issues
Proprioception to keep neural pathways strong - chemotherapy can impact/damage proprioception
Light strength work to prevent osteoporosis
Create an opportunity to connect the mind and body and feel WHAT IS WORKING WELL IN THE BODY

What we have witnessed

Help clients manage potential depression during treatment and forget about their illness
Women in their 60s doing pull ups post treatment and hanging onto bone density
Even people undergoing chemo can maintain fitness levels
Cancer survivors feel more in control of their destiny and reach remarkable levels of fitness post treatment

Case in point - Sara-Clare and her client Lisa

Pre treatment phase
Treatment phase
Post treatment phase

The future of exercise during cancer treatment

Blue skying it

Build more opportunities within health care system to capitalize on the window of receptivity to lifestyle change. When someone becomes ill, they are more likely to be motivated to make changes to their lifestyle habits.

Exercise coach on staff that is included in treatment plan (cheaper than docs and with different skill set in terms of lifestyle change management)

Every patient with some form of monitored exercise program

That's the general framework of what we talked about. It is clear that the fitness industry is at the early stages of understanding how to work with cancer patients in mainstream environments. Ultimately, we feel that we have been applying very effective exercise prescription for our clients with cancer that helps them move through their treatment and recovery with hope, combat the effects of chemotherapy on the body and ultimately empower people to feel more in control of their future health.

And to those of you in the fitness industry who are afraid to work with people in treatment, it's time to stop being so chicken shit about it. They are people with limitations who need help more than the people looking to get nicer bums and flatter stomachs. One of the docs at the presentation shared a story about a few patients actually getting turned away from their regular gyms. The gym requested a detailed explanation of the members' limitations out of fear of getting sued for what exactly? Ever heard of a Parmed X people? Not to mention it's just very short sighted to be afraid of working with people dealing with an illness. If anyone would be willing to invest in their fitness and health, it's someone who is faced with their mortality.

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