The REACH podcast (Research in Exercise And Cancer Health) is a new resource created by Ciaran Fairman (@CiaranFairman) that showcases the latest information on exercise, nutrition and lifestyle behaviours to reduce cancer risk and improve survivorship, brought to you by leading researchers, oncologists, health professionals and cancer survivors.
This week, I am featured on the podcast, discussing my experiences working with people with cancer, connecting in to the medical community, exercise modifications for different cancer types and how to get started with exercise if you have cancer.
Check it out here! http://reachformore.libsyn.com/episode-6-sarah-weller-exercise-physiologist-speaks-about-cancer-rehab
Imagine that you are sitting in your doctors office, discussing your treatment options.
Your doctor starts to tell you about a relatively new medicine that is evidence based (there are lots of research studies that support its use), it is used in conjunction to your regular treatment (adjunct therapy) and there are many benefits to taking this medicine. It may help to decrease urinary incontinence, to maintain muscle mass, to minimize fat mass gain during treatment, and to increase energy and decrease fatigue during treatment. The catch is that this medicine requires you to commit to 3-5 hours per week of treatment. It should improve your physical and mental wellbeing, and early evidence suggests that it may improve your survival rate by 50 - 60%.
Would you take it?
[click here] or below to watch the video of this presentation by Sarah Weller at the 2016 Pacific NorthWest Prostate Cancer Conference on Exercise for Prostate Cancer. Find out more about this evidence-based medicine - exercise, the guidelines, current research and how it can help someone with prostate cancer.
Movember... a month where men all over the world put away their razors and let their upper lip sprout all kinds of hairy creations to support mens health. The Movember Canada website says they are "Helping men live happier, healthier, longer lives by funding game-changing men's health projects." In particular, they are raising money for prostate cancer, testicular cancer, mental health and suicide prevention to stop men dying too young. What started as a fun idea from 2 Aussie mates, has developed into an initiative that has engaged over 5-million participants worldwide and raised CAD $759-million!!
What I love about the Movember foundation is that they are using these funds to help directly support the implementation of men's health initiatives across many countries. One of these initiatives has been growing in size across Canada over the last 12-months - TrueNTH. I have been fortunate enough to have been involved in the lifestyle management part of the TrueNTH program in BC as one of the implementation team members. The TrueNTH LM program provides men with prostate cancer with a free 12-week exercise program at many local community centres across Vancouver (and online if you are located elsewhere) and it will soon be in many other communities around BC. While most programs are resistance training & circuit based, some are also focusing on stress reduction and mindfulness through yoga and a nutrition element will be starting in 2017 as well. If you want to find out more about these programs, check out the official website.
In Canada, one in eight men will be diagnosed with prostate cancer in their lifetime. It is the most commonly diagnosed cancer amongst Canadian men. The five-year survival rate is high (>95%), however many men will live with side effects of treatment that can impact function, quality of life, physical capacity and mental health. These exercise programs are important to help manage these issues. Exercise is the most evidence-based non-pharmaceutical intervention to support the reduction of treatment side effects and improve overall survival in men with prostate cancer. In the very near future, exercise will become a part of the standard of care for all types of cancer - meaning, upon diagnosis you will be referred to an exercise program to help manage your cancer, treatment side effects and outcomes, physical function and to enhance overall survival.
So what can you and why should you care? Well, Movember isn't just about growing a MO or supporting someone who is (although, this is a VERY good idea!!). Check out the Movember website to see how you can support this great cause. With 7 days left this month, I encourage you to get out and MOve every day, because let's face it, we can all benefit from a little more activity in our daily lives. If you "don't have time", "don't have energy", think "it's too wet" or come up with some other excuse, take a second to think about those who are fighting this battle everyday. Working as a clinical exercise physiologist in this area over the last 10 years, I have met too many men who are dying too young and this is one of the ways that we can help to raise awareness and implement sustainable programs that will help to change this in the future.
Join Exercise Physiologist, Sarah Weller, and Occupational Therapist, Karen Gilbert, for this FREE 2-hour workshop on fatigue management for cancer survivors.
TO REGISTER ONLINE, click here or visit http://fatiguecancer.eventbrite.com
Approximately 80% of all cancer survivors will experience fatigue at some point in their journey. This workshop will provide you with evidence-based practical skills, tools and education so that you can learn how to reduce your cancer-related fatigue and increase your overall energy levels.
In this free 2-hour workshop, learn practical strategies to:
1. Manage persistant fatigue
Be guided through practical tools and strategies to help achieve more energy and reduce fatigue
2. Develop a self-management plan
Specific to you and your needs, this plan will help you to manage and track your energy and daily tasks
3. Use exercise to improve energy
Learn the evidence-based guidelines for how to use exercise as a tool to improve your energy. Understand the specifics of what you need to do physically and how to do this safely.
4. Optimize sleep
Understand the key factors that set your internal clock and create the drive for restful, restorative sleep. Learn strategies to calm your mind and give your body the cues it needs to sleep well.
5. Increase overall daily function
By integrating the tools and knowledge learnt during this workshop, you should be able to improve your overall daily function and learn how to make the most of your energy to optimize function.
TO REGISTER ONLINE, click here or visit http://fatiguecancer.eventbrite.com
Are you looking for a way to start exercising and stay motivated? Treloar Physio's small group exercise classes are a great way to achieve your fitness goals!
These classes are individualized (you have your own program) with the benefit of a group-based setting, so you get to work towards your goals and have fun at the same time! We cap our classes at 4 people max to ensure you are always getting the specialized attention that you require.
Classes are run by our Exercise Physiologists & Cancer Exercise Specialists and are suitable for people with a cancer diagnosis and their spouses at any stage of survivorship (pre/post surgery, during and after treatments, cancer prevention and long-term survivorship).
To sign up or ask questions, phone Treloar Physio on 604-875-6207 or contact Sarah.
* Cost: $35 per class or $150 for a 5-pack.
* Frequency: 1-3 sessions per week is recommended.
* Times: 10am - 11am on Monday, Wednesday, Friday & Saturday.
5pm - 6pm on Tuesday & Thursday.
* Registration is required before attending and new patients will require an assessment.
* Exercise program is tailored to your needs and goals and will involve a mixture of aerobic exercise, resistance training, flexibility and balance exercises.
* Suitable for anyone with a cancer diagnosis and also for their spouse/carer.
* Suitable during treatments (e.g. chemotherapy, radiation, hormone therapy) and before and after treatments and surgeries.
Sedentary behaviour refers to any activity where you are awake in a sitting or reclined posture with a very low energy expenditure (<1.5 METS). Common sedentary behaviours include watching TV, screen time/computer use, driving, reading, seated at a desk etc.
More than every before, Canadians are engaging in sedentary behaviours across all age groups.
Not surprisingly, recent research shows that high levels of sedentary behaviour negatively impacts health independent of other risk factors (e.g. weight, physical activity and diet).
This means that even if you are active for some of your day, if you engage in high levels of sedentary behaviour you are at an increased risk of death and disability from things such as cardiovascular disease, diabetes and cancer. (Owen et al, 2010).
What can you do to reduce sedentary behaviour?
1. Work out how much sedentary time you engage in per day. Understanding when you are sedentary will help you change this behaviour. Questionnaire link.
2. Choose to stand or move instead of sitting. This applies to any situation where this is possible - at work or school, during meetings, on public transit, reading, watching TV, etc.
3. Limit sitting time where possible. Again, this applies to any situation where you have to sit. Can you convert your desk to a standing desk? Can you read standing up? Can you park further away to get less sitting time and more movement? Can you stand up during a phone-call? Can you walk around or march on the spot during the TV ad-break? Can you take the stairs instead of the elevator or escalator. Can you limit your recreational screen-time and do something active instead?
4. If you can't change the time you are sitting for, try to add in movement breaks. These are very effective during work, school and even when watching TV and help to break up extended periods of sitting.
5. Use an activity tracker to show you how much activity you are doing, how much sedentary behaviour you engage in and to remind you to move (they will often vibrate after a period of inactivity). Research link.
6. Encourage others to change their behaviour too as it will make it easier for you to stick with it!
Good luck and get moving!
20 years ago, a group of 24 women put their hand up to take part in a study and to give something new a go: Dragon Boating. The catch - they were all breast cancer survivors and this kind of exercise had not been shown to be safe yet. They called themselves "Abreast in A Boat" and they had their first race at the Vancouver Dragon Boat Festival in 1996.
Dr. Don McKenzie's study was able to prove that repetitive, intense upper body exercise in breast cancer survivors did not cause lymphedema, and these women helped start a movement that has now helped thousands of others share in something really unique. This also was the start of new research into exercise and lymphedema (links to research by McKenzie and Schmitz and a 2016 review).
Dragon boating has grown tremendously in the last 20 years, especially the Abreast In A Boat teams. You pay a high price to qualify for the team (everyone is a breast cancer survivor), but once you are in, you are part of something so wonderful and unique - a team that embraces each other, loves and supports you for who you are and has a lot of fun along the way. There is no denying the spirit and camaraderie that these ladies bring to the water. They are amazing and their energy is contagious.
This year, history has repeated itself, with a slight twist.
30 prostate cancer survivors answered the call and put their hand up to be part of something new - a "survivor showdown" race where they would race against the Abreast in a boat team at the Dragon Boat festival. The catch? They had never done this before. The guys were named "Butts in A Boat" and most of them had no idea what they had just signed themselves up for!
When I first heard about this challenge, I loved the idea, but the risk aversion side of me screamed "DANGER! Putting 30 inactive men into a competition again highly trained competitive women leads to disaster". So I put my hand up to be involved in leading their land-based fitness training to try to prepare them for what was ahead. We had some gym sessions and they also had some water-based sessions (lead by the extraordinary Vince S.)focusing on paddling technique and form in the water.
The guys who had signed up were amazing and were up for a challenge. We knew they would have the strength to go out strong at the start, but could they keep it going for the whole 2.5 minutes?
It turns out that they could go the distance! When we first saw who was leading, the crowd roared. Everyone loves the underdog coming through! The "Butts in A Boat" guys held strong and won by over a boats length. The message of the day is not about winning, but it is about giving something new a go and supporting everyone along the way. All 30 men and 50 women were brave enough to put up their hand and try something new. Their partners, families and friends came out to cheer them on (one flew from the US just to support his dad!). They became a team. They supported each other. They gave each other a reason to turn up. They believed in themselves and in their bodies.
In the 10+ years I have been working with cancer survivors, I haven't seen a group of men embrace and support each other as strongly as the Butts in A Boat team did.
After the guys won by a convincing margin, it became quite clear that next year it was going to be "game on". The AIAB women don't like to be beaten!! Look out guys, they are coming for you and next year is going to be a blood bath! My hope is that some of the men continue paddling. It is a great way to connect as a team, to do something physical, and to learn to trust in your body again.
20 years ago when the Abreast in a boat women started dragon boating, they never dreamed that it would grow into an international movement that would support thousands of women. Last week I was lucky enough to chat to a few of the original AIAB women who were describing to me how proud it makes them feel to be a part of this movement, how being involved has helped them as breast cancer survivors and how great it is to assist the guys in being a part of something special as it reminds them of when they started out in 1996. Without the AIAB women, this survivor showdown would not have happened - they are an amazing group of ladies who do not take no for an answer. When our team had an issue (boats, numbers, drummers, steers, etc), they were our problem solvers (as well as Vince, Richard, Leah and the rest of the butts crew)! Their team spirit and camaraderie continued to shine through and it has been an amazing experience being around them.
Hopefully, this is not the last that you see of the Butts in A Boat guys. Hopefully, this is the start of a much larger movement, that helps provide another way for prostate cancer survivors to find support, be part of a team and learn to have fun with exercise! With 1 in 8 Canadian men being diagnosed with prostate cancer in their lifetime, let's hope we can start something wonderful and have a Butts in A Boat team in every community.
Below is a video that aired recently on ABC Australia's "Catalyst" program that looks into how targeted exercise can help to fight cancer. It explores a unique cancer gym in Australia that is based inside an Oncology centre, where patients exercise (supervised by an Exercise Physiologist) on the same day as treatments (chemo, radiation, etc). They also have a separate facility where these same patients can exercise on non-treatment days.
Prof. Rob Newton and his team are leading cancer and exercise researchers at ECU's Exercise Medicine Research Institute.
If you want to understand what an Exercise Physiologist can do in the Oncology setting and understand more about exercise medicine in cancer care, watch this video. In 20 years time, this will be the norm in all cancer centres.
This video shows what I do daily with my patients and highlights the value of exercise during treatment (and beyond) for anyone living with cancer.
What services are available?
In Canada, over 800,000 people diagnosed in the last 10 years are living with cancer. Many of these are of working age, with plans to return to work once their treatment has completed and when they are physically ready. Cancer treatments and surgeries have a whole range of side effects that you may experience that can impact your overall level of physical functioning and capacity to return to work. Many patients that I meet that intend to return to work have difficulty knowing where to start.
If you live in BC and are looking to return to work, many supportive services are available to you and some of these are free and the others may be able to be funded by your Extended Medical Insurance provider (E.g. Great West Life, Blue Cross, etc). A great place to start is through the BC Cancer Vocational Rehabilitation services (more info on their website) where you will get information on return to work programs and assessments.
If you need physical conditioning for return to work (e.g. suffering from high levels of cancer-related fatigue, mobility and range of motion issues, strength and muscle building), an Exercise Physiologist will be able to help you. I regularly work with patients on their return to work conditioning who have complex physical needs due to cancer. Your extended medical insurer may be able to fund these sessions. If you would like to find out how to access this service, call your provider and speak to them about your desire to return to work and the issues that you are currently facing physically. You may be approved for a funded initial assessment where a comprehensive plan and report will be designed that outlines your physical barriers for return to work and details how exercise-based rehabilitation and training can address this. Many people receive additional funding for one-on-one and group-based sessions, however, it depends on your specific circumstances.
What specific side effects can an exercise program help with?
The simple answer: all types of jobs. Even if you plan to return to a reasonably sedentary job or something part-time, exercise conditioning can help you to have more energy and feel better during your return to work phase (and beyond). If you are returning to a physical job, exercise conditioning prior to return to work is essential to ensure you are physically ready.
Tips on getting started & finding the right people to work with:
1. Ensure they are an Exercise Physiologist as they will have a greater amount of clinical knowledge and rehab-specific exercise training.
2. If possible, work with a Cancer Exercise Specialist. Practitioners with these qualifications exist in Vancouver, across the lower mainland, Vancouver Island and in the Okanagan.
3. If you are staring an exercise program, ensure it is "cancer-specific" when you are in this stage of recovery.
4. If you are currently in-treatment and not considering returning to work in the next 3-6 months, start moving and slowly begin to build up your exercise capacity (it will make things easier later on). If you are happy to fund some exercise yourself, you can start Exercise Physiology now.
5. Speak with your extended medical provider (case manager or rehabilitation co-ordinator) about your desire to begin a physical conditioning program to ensure that your return to work is successful.
This is a great video on how exercise can be used in the management of cancer, from one of the leading Exercise & Cancer researchers in Australia. I LOVE the wording of the last 2 minutes of this presentation about using Exercise as Medicine (and of course how the accent reminds me of home...).
Dr. Prue Cormie is an Accredited Exercise Physiologist whose research program seeks to understand the application of exercise as medicine for the management of cancer. This video is her presentation from TEDxPerth, 2015.
For more information on Dr. Cormie's published research, click here.