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Older Adults Getting Active
After Cancer Treatment
Let’s make physical activity a fun and safe
part of their new healthy life
Overview
 A few statistics
 What the research says
 What you can do
Incidence is highest in older adults
(Canadian Cancer Statistics, 2008)
Statistics
 Estimated 167,000 new cases in 2008
 115,000 cases over the age of 60 (69%)
 61,000 deaths (over age 60) (72% of deaths)
 1 in 4 Canadians will die from cancer
 Mortality Rates declining
 5 year survival rate averaging 62% as high as
87%
Side Effects of Treatment
AFTER Treatment:
Rest
↓ muscle strength,
↓ functional capacity,
↓ ability to perform activities of daily living
↓ Quality of life
Research
 200 abstracts screened
 80 short listed
 49 published articles selected
The authors concluded:
“…that a supervised high intensity strength
training programs seems to be an effective
means to improve muscle strength,
cardiopulmonary function, and health related
quality of life and should be incorporated into
cancer rehab programs.”
Backer, I.C., Van Breda, E., Vreugdenhil, A., et al. (2007). High-intensity strength training improves quality of life in
cancer survivors. 46:1143-1151. Acta Oncolgica. Doi:10.1080/02841860701418838
The authors concluded:
“… that a 6-month intervention of resistance
exercise did not increase the risk for or
exacerbate symptoms of lymphedema.”
(swelling)
Ahmed, R.L., Thomas, W., Yee, D., and Schmitz, K.H. 2006. Randomized controlled trial of weight training and
lymphedema in breast cancer survivors. Journal of Clinical Oncology. Vol. 24: No.18: 2765-2771. DOI:
10.1200/JCO.2005.03.6749.
The authors concluded:
“…that increased physical activity, especially
after cancer, was consistently related to better
physical functioning and to reduced fatigue
and bodily pain, underscoring the need for
physical activity promotion among survivors.”
Alfano, C.M., Smith, A.W., Irwin, M.L., Bowen, D.J., et al. 2007. Physical activity, long- term symptoms, and physical
health-related quality of life among breast cancer survivors: a prospective analysis. J. Cancer Surviv. 1:116-128.
DOI: 10.1007/s11764-007-0014-1.
The authors concluded:
“…that an 8-week full-body resistance and
aerobic exercise program … no incidents of
lymphedema. …breast cancer survivors can
safely benefit from engaging in a full body
exercise regime.”
Cheema, B.S., and Gaul, C.A. 2006. Full-body exercise training improves fitness and quality of life in survivors of
breast cancer. Journal of Strength and Conditioning Research. 20(1): 14-21
The authors concluded:
“…yoga offers a promising alternative choice
as physical activity for cancer survivors,
promoting a number of similar psychological
benefits…”
Culos-Reed, S.N., Carlson, L.E., Darous, L.M., Hately-Aldous, S., 2006. A pilot study of yoga for breast cancer
survivors: physical and psychological benefits. Psycho-Oncology 15:891. DOI10.1002/pon.1021.)
The authors concluded:
“..there is a need for health professionals to
carefully address the cancer survivor’s
exercise needs in an attempt to help improve
quality of life.”
Alfano, C.M., Smith, A.W., Irwin, M.L., Bowen, D.J., et al. 2007. Physical activity, long- term symptoms, and physical
health-related quality of life among breast cancer survivors: a prospective analysis. J. Cancer Surviv. 1:116-128.
DOI: 10.1007/s11764-007-0014-1.
The authors concluded:
“…that there is sufficient evidence that
exercise is a safe and well–tolerated
supportive intervention that physicians can
recommend to their patients following the
completion of primary therapy.”
Denmark-Wahnefried, W. and Jones L.W. (2008) Promoting healthy lifestyle among cancer surivivors. Hematol
Oncol Clin N Am 22:319-342
The authors concluded:
Benefits of physical activity post-treatment:
 Feel less tired
 Recover faster
 Have more energy
 Have better posture and balance
 Manage their weight
 Develop stronger muscles and bones
 Relax and reduce stress
 Improve their heart health
 Improved Quality of Life
(A review of 38 studies)
Schwartz, A.L. (August) 2008. Physical Activity. Seminars in Oncology Nursing. Vol. 24, No 3, 164-170.
The authors concluded:
Preliminary evidence suggests that exercise
may:
 prolong survival for individuals with breast,
prostate and colon cancer
 may reduce risk of getting cancer again
The authors concluded:

Giovannucci, E.L., Liu, Y., Leitzmann, M.F., et al.2005. A prospective study of physical activity and incident and
fatal prostate cancer. Arch. Intern. Med. 165: 1005-1010.

Holmes, M.D., Chen, W.Y., Feskanich, D. et al. 2005. Physical activity and survival after breast cancer diagnosis.
JAMA 293: 2479-2486.

Meyerhardt, J.A., Giovannucci, E.L., Holmes, M.D., et al. 2006. Physical activity and survival after colorectal
cancer diagnosis. J. Clin. Oncol. 24: 3527-3534.

Meyerhardt, J.A., Heseltine, D., Niedzwiecki, et al. 2006. Impact of physical activity on cancer recurrence and
survival in patients with stage III colon cancer: findings from CALGB 89803. J. Clin. Oncol. 24: 3535-3541.

Pierce, J., Stefanick, M., Flatt, S., et al. 2007. Greater survival after breast cancer in physically active women
with high vegetable-fruit intake regardless of obesity. J. Clin. Oncol. 25: 2345-2351.

Abrahamson, P., Gammon, M., Lund, M., et al. 2005. recreational physical activity and survival among young
women with breast cancer. Cancer. 107: 1777-1785.
Precautions
 Neurological complications affecting
coordination or balance:
►require stable exercises (e.g., stationary
reclining bicycle rather than walking on a
treadmill.)
 Severe anemia:
► should delay exercise until the anemia is
improved.
Precautions
 Limited arm mobility following surgery or
radiation treatment:
► will be unlikely to fully exercise their upper
body
 Compromised immune function:
► should avoid public gyms and other public
places until their white blood cell counts
return to safe levels
Precautions
 Fatigue as a result of their therapy:
► to start, encourage alternate programs such
as short bouts of stretching or suggest taking
up Tai Chi Chuan
 Should not exercise:
► when they are at risk of infection, are in pain,
or experiencing other side effects that are not
well-controlled.
Precautions
 Any concerns:
► should ask their doctor before starting a
‘high-intensity’ exercise program.
 Survivors with physical challenges:
► referred to physical therapy or exercise
professionals if necessary to learn to exercise
within their ability (eg. Cardiac patients)
The authors concluded:
The growing research suggests that physical
activity (during or) after completion of
treatment is safe and results in improved
outcomes such as cardio respiratory fitness,
reduction in fatigue, symptoms, quality of life,
mental health, and/or change in body size.
What can you do?
 Distribute ALCOA brochure
 Give them permission
 Invite them to participate
 Encourage them
 Welcome them
 Make them feel safe
What can older adults do?
 Group fitness programs
 Walking programs
 Weight training programs
 Yoga classes
 Tai chi chuan classes
 Dragon boat races
 Etc., etc., etc.
In Conclusion:
Let’s make physical activity a fun
and safe part of a new healthy
life for older adult cancer
survivors!
Video Presentation
University of Waterloo
WELL-FIT Program
Thank you
Active Living Coalition for Older Adults
P.O. Box 143, Shelburne, ON, L0N 1S0
Tel: 1-800-549-9799
Fax: 519-925-3955
Email: [email protected]
Web: www.alcoa.ca