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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