Abstract
Recent guidelines concerning exercise for people with cancer provide evidence-based direction for exercise assessment and prescription for clinicians and their patients. Although the guidelines promote exercise integration into clinical care for people with cancer, they do not support strategies for bridging the guidelines with related resources or programs. Exercise program accessibility remains a challenge in implementing the guidelines, but that challenge might be mitigated with conceptual frameworks ("pathways") that connect patients with exercise-related resources. In the present paper, we describe a pathway model and related resources that were developed by an expert panel of practitioners and researchers in the field of exercise and rehabilitation in oncology and that support the transition from health care practitioner to exercise programs or services for people with cancer. The model acknowledges the nuanced distinctions between research and exercise programming, as well as physical activity promotion, that, depending on the available programming in the local community or region, might influence practitioner use. Furthermore, the pathway identifies and provides examples of processes for referral, screening, medical clearance, and programming for people after a cancer diagnosis. The pathway supports the implementation of exercise guidelines and should serve as a model of enhanced care delivery to increase the health and well-being of people with cancer.
Highlights
The safety and benefits of exercise after a cancer diagnosis are well documented
The recommended weekly dose of moderate-to-vigorous exercise or pa is 150 minutes, with the specific caveats that “some physical activity is better than none” (p. 1410) and that “exercise prescriptions should be individualized according to a cancer survivor’s pre-treatment aerobic fitness, medical comorbidities, response to treatment, and the immediate or persistent negative effects of treatment that are experienced at any given time” (p. 1412)[5]
It is with that lens that we present a patient pathway from an oncology-directed clinical setting to exercise programming or pa resources, or both (Figure 1)
Summary
The safety and benefits of exercise after a cancer diagnosis are well documented. For cancer survivors, research has traditionally focused on the relationship between exercise and the various domains of quality of life. ■■ The benefits of specific types of exercise ■■ Recommendations for pre-exercise screening ■■ Participant safety ■■ Advice about models of exercise program delivery for patients throughout the cancer care continuum
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