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Cancer Rehab
Gets Moving
One of the latest trends in cancer
care mirrors a change seen decades ago in cardiac care. Years
ago, at least a month of bed rest was mandated before heart attack
patients were allowed to walk even short distances. Today, many
patients are ready for programs involving significant daily walking
within as little as two weeks following hospital discharge. Similarly,
advice to cancer patients once emphasized plenty of bed rest,
trying to minimize the fatigue that is so common. Yet now, cancer
treatment centers are among the fastest growing spots promoting
regular physical activity.
Extended bed rest normally leads
to muscle loss. Research shows that for cancer patients, substances
released by cancer cells and the side effects of medications
may magnify the loss of muscle. Studies link reduced physical
activity and strength in cancer survivors with greater fatigue.
It’s not always clear which is the cause and which is the
effect, but it looks as though programs to increase activity
may bring several benefits.
One review of such programs found
inconsistent but potentially important improvements in aerobic
fitness during cancer treatment, with strong evidence of moderate
to large improvement in post-treatment programs. In a later
study, cancer survivors at least three months past treatment
who went through an aerobic and strength-training program showed
8 to 10 percent improvement in aerobic fitness in 12 weeks. |
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Increasingly, cancer rehab programs
focus on the loss of muscle that reduces cancer survivors’
ability to participate in activities of daily living. Some traditional
guidelines have recommended cancer survivors use lower weight
loads than those used in programs for the healthy population.
However, in a study of an 18-week supervised high-intensity strength-training
program, muscle strength improved significantly, as did quality
of life. And improved muscle strength was maintained a year later.
A significant area of research
is the impact of increased physical activity on the fatigue so
common in cancer survivors. Important long-term questions also
involve how physical activity might lower the risk of cancer
recurrence.
We are clearly just at the beginning
of getting the research needed to answer questions about who
might benefit from physical activity in cancer rehab programs
and the optimum types, intensity and timing of physical activity.
Many cancer centers throughout
the country now offer programs in aerobics and strength training.
Cancer survivors with anemia, decreased immune function, nerve
damage or radiation therapy may require certain adjustments to
an exercise program. But with potential for benefit and no sign
of drawbacks as long as people with expertise in cancer treatment
plan them, cancer rehab programs are a trend will likely keep
growing more active. |
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