Physical Activity and Cancer Rehabilitation Introduction Flashcards
Do cancer survivors meet the Healthy People 2030 Target of physical activity?
PA rates are improving in cancer survivors but it still doesn’t meet the Healthy People 2030 Target (21.2%)
How do young cancer survivors activity numbers differ from the general population?
No significant differences in younger survivors compared to age matched general population
How do older adult cancer survivors activity numbers differ from the general population?
Significantly less activity in older ages, especially 65+ years
How do cancer survivors compare from 1997 until 2022? Is further change needed?
Cancer survivors get more physically active overall throughout the years. But we still have a long way to go
What were past history and ideas individuals had on PA and cancer rehabilitation?
- Cancer survivors were told to rest
- Many stayed in hospitals during treatment
- Breast cancer survivors told to avoid upper body exercise to avoid lymphedema
What research was done with cancer survivors to improve aerobic capacity?
- Cancer survivors on an 8 week long training program
- Significant improvements in aerobic capacity
What research was done with breast cancer survivors and aerobic capacity?
- Chemo breast cancer survivors on a 10 week, cycle ergometer 3 times per week
- Exercise group improved aerobic capacity by 20.7%
- Control group decreased aerobic capacity by 1.8%
What is a Gold Standard Study?
Randomized Controlled Trial
What is a Randomized Controlled Trial?
- Participants randomly assigned to conditions
- Control group, one or more treatment groups
What are some Hallmarks of Good Studies?
- Sufficiently large sample size
- Following certain standards put out by CONSORT
What did early studies understand about physical activity related to cancer survivors?
Benefits them to improve their survival, quality of life and increased fitness
What can insufficient physical activity do?
5 times higher risk of all-cause and noncancer mortality
What can PA increase following diagnosis and treatment?
Increase quality of life, physical health, mental health
What kinds of tumour types have the strongest evidence supporting physical activity benefiting quality of life, fitness levels, etc?
- Breast
- Prostate
- Colorectal
What other kinds of tumours have suggestive evidence of the benefits of physical activity?
- Hematologic
- Head and Neck
- Childhood Cancers
What kinds of physical activity interventions have been tested?
- Aerobic training
- Resistance training
- Combined programs
- Several times per week
- Wide range of durations per session
- Varying intensity (often moderate)
How does physical activity affect mortality rate? What intensity is best?
Reduces mortality risk by 40-50%. Moderate PA is associated with longer survival rate
What does PA do for side effects from treatment?
Chemo and radiation side effects reduce/decrease with physical activity
How does PA affect fatigue? What cancer types benefit most? How long after intervention?
- PA combined with proper diet decreases fatigue
- Fatigue remained decreased one year after intervention
- PA specifically decreases with patients among breast and colorectal cancer
How does PA affect physical fitness, muscular strength and body weight?
- PA improves aerobic fitness and upper-body strength, reducing BMI and body fat
What kind of PA improves physical fitness, muscular strength and body weight in breast cancer patients?
Aerobic and resistance training combined is associated with superior upper and lower body muscle endurance in breast cancer patients
How does PA affect mental health?
PA has a positive impact on mental health of cancer patients
- reduces anxiety ab depression, improving happiness
How does PA affect quality of life?
PA improves overall quality of life
How does Aerobic and resistance training improve quality of life?
Reduces depression, fatigue and physical deconditioning
Who does aerobic and resistance training work best for during chemo and how?
Best for breast and colorectal cancer patients because it improves quality of sleep, reduces anxiety and depression while increasing happiness
How does PA affect reoccurence?
Aerobic and resistance exercise reduces the incidence of metabolic syndrome in cancer survivors, which is a risk factor for cancer reoccurence
Is PA safe for cancer patients?
Yes, it’s considered safe for on and off treatment survivors
What is Cardiotoxcity?
Irreversible damage to the heart and cardiac function
What can cause Cardiotoxicity?
- Anthracyclines - common chemo drug class
- Chemo agents passing through the heart during exercise
Is cardiotoxicity incidence increased in exercisers?
No evidence indicates more risk towards exercisers
Why is immune function a concern for cancer patients being physically active?
- PA can compromise immune function
Is it true that physical activity can affect immune function?
Yes, but guidelines developed that can help ensure safety based on blood counts
What are some concerning factors to consider when cancer survivors are being physically active?
- Cardiotoxicity
- Immune function
- Survivor compliance
- Faster Tumour Growth
- Pathological blood fractures
- Lymphedema
Why is survivor compliance a concern for PA levels in cancer patients?
Survivors who won’t comply with PA as there is too much else to cope with, meaning their PA levels go down
Why is survivor compliance important, what are some positive effects PA can have?
Improve:
- Coping
- Fatigue
- “Normalcy” in life
- Anxiety/depression reduction
What causes faster tumour growth?
More blood flow/nutrients to the tumour
Is there evidence that PA causes faster tumour growth?
No
What causes pathological bone fractures?
Weakened bones from chemotherapy
Is there any studies that prove PA increases rate of bone fractures?
No, none to date
What is Lymphedema?
Slow, progressive swelling of a limb following removal of lymph node or radiation
How does PA affect Lymphedema?
Risk of worsening lymphedema through upper body PA
How can we adjust PA to safely reduce risk of worsening lymphedema?
Under controlled circumstances, PA does not exacerbate lymphedema
