A BIG thing is happening today.
New Exercise Oncology guidelines are being released, supporting the efficacy of exercise during cancer treatment.
These recommendations include the following statements:
- Exercise should be embedded as part of standard practice in cancer care and viewed as an adjunct therapy that helps counteract the adverse effects of cancer and its treatment.
- All members of the multi-disciplinary cancer team should promote physical activity and help their patients adhere to exercise guidelines.
- Best practice cancer care should include referral to an accredited exercise physiologist and/or physical therapist with experience in cancer care.
Lets take a closer look at each of these recommendations:
Recommendation Number 1: Exercise should be embedded as part of standard practice in cancer care….
I’ll stop here for a minute. If you have followed us for any length of time, you know that this is my dream. This is why I am committed to expanding Maple Tree across the country.
Right now, there are literally thousands of published studies showing indisputable evidence that exercise results in substantial benefits for patients with a variety of cancers and stages.
However, despite the real and tangible benefits of exercise, nationally less than 5% of patients exercise during cancer treatment.
This means that more than 95% of patients are completely sedentary during cancer treatment.
How will we make exercise a standard part of cancer care?
It starts with papers like the ones that were just published.
But it can’t end here.
Together, we need to advocate for a change. It is no longer enough to simply survive cancer. We need a whole-hearted commitment to helping people THRIVE during cancer.
Right now, Maple Tree operates out of 14 locations across the country. By the end of 2020, I expect this number to more than triple.
On the surface, it seems like more and more hospitals are starting to embrace the idea of exercise oncology.
However, it is a slow process.
It is a looooong process.
It is a difficult process.
I have been in conversations with one very large hospital network for more than 16 months and still don’t have a contract with them.
I was turned away from another network because they felt their patients would not embrace the idea of exercise in the rural setting they lived in.
I am talking with one network — a top 5 cancer network, no less – who really wants to start a Maple Tree program but has no funding for it.
Yes, exercise should be a part of the standard of care.
Maybe the second part of the recommendation will help us get there….Exercise should be viewed as an adjunct therapy that helps counteract the adverse effects of cancer and its treatment.
Adjunct therapy (sometimes called adjuvant therapy) is therapy given in addition to a primary therapy in order to maximize its effectiveness.
In other words, these papers are calling for primary care physicians to view exercise as an adjuvant therapy – that when utilized, will maximize the effectiveness of the cancer treatment.
In order for this to happen, I assert that exercise status should be measured as part of a patient’s vital signs at every doctor’s office visit. Height, weight, resting blood pressure, and activity level should be recorded. Just as physicians make recommendations based on weight that is too high or too low and blood pressure that is too high or too low, they also should guide their patients who have activity levels that are too high or too low!
This leads me to recommendation number 2….
Recommendation Number 2: All members of the multi-disciplinary cancer team should promote physical activity and help their patients adhere to exercise guidelines.
All members of the multi-disciplinary cancer team. Not just the doctors. But also the nurses, social workers, dietitians, physical therapists, and occupational therapists.
Because doctors often report that they barely get to spend enough time with their patients as it is.
Because sometimes people need to hear something more than once to make it stick.
Because it takes a village. And we are all on the same team.
When our patients do better, we all win.
Finally, there is recommendation three.
Recommendation Number 3: Best practice cancer care should include referral to an accredited exercise physiologist and/or physical therapist with experience in cancer care.
This one is huge.
Right now, there are 17 million cancer survivors living in the US. These papers are collectively recommending that all of them exercise.
That is going to require one enormous workforce.
Bear in mind that the needs of a cancer survivor are very different than your average person. There are long term and late effects of treatment. Cardiac problems. Balance abnormalities. Muscle weakness and range of motion limitations due to surgery. Burns from radiation. Nausea from chemotherapy. The list goes on and on.
Therefore, it is absolutely essential that a qualified professional work with these individuals.
At Maple Tree, we require that each of our exercise oncology trainers hold a minimum of a bachelor’s degree in Exercise Science, or related field (or be in their final semester of coursework completing an internship).
We also developed an Exercise Oncology Instructor certification that is accredited through NASM and nationally recognized. Along with this is an intensive training program involving both in person and online modules. Each of our trainers must complete this as well as pass our certification before working with any patients.
Even after they pass our certification, however, they are shadowed initially to ensure they have the skills necessary to provide safe and effective programs for our patients. We continually perform quality checks and stay current with the literature. We are in constant communication with a team of oncologists, nurses, physical therapists, and occupational therapists when a patient’s status changes.
We do all this because we take our responsibility very seriously. When someone trusts us with their care, we want to ensure we are providing the safest and most effective program possible.
You might be surprised to know that not all exercise oncology programs are this stringent with their training.
In fact, there is a national exercise oncology program (one you have probably heard of!) that holds exercise classes taught by cancer survivors who have never even taken a single class in exercise physiology!
In order to ensure the safety of a patient, there absolutely must be best practice guidelines put into place, as well as quality training and certification guidelines for these instructors.
To summarize, I believe that today is a monumental day for the field of exercise oncology. I believe that the release of these papers will have a global impact and collectively, will change the way cancer is treated. Together, we will Be The Change!