Abstract
A large and convincing body of evidence demonstrates the benefits of exercise for cancer survivors during and after treatment. Based on that literature, more cancer survivors should be offered exercise support and programming. Unfortunately, exercise programs remain an exception rather than the norm in cancer care. Not surprisingly, common barriers to the implementation of exercise programs in oncology include limited resources, expertise, and awareness of benefits on the part of patients and clinicians. To improve the accessibility and cost-effectiveness of cancer exercise programs, one proposed strategy is to combine the resources of hospital and community-based programs with home-based exercise instruction. The present paper highlights current literature regarding exercise programming for cancer survivors, describes the development of an exercise program for cancer patients in Toronto, Canada, and offers experiential insights into the integration of exercise into oncologic care.
Highlights
Cancer remains a leading cause of death for Canadians of all ages, with incidences increasing since the year 2000, largely because of greater screening in an aging population [1,2]
It is clear that cancer survivors are interested and willing to participate in cancer exercise programs, with reported survivor preferences for exercise interventions in many cancers [30,31,32,33,34,35,36,37,38,39,40,41,42,43,44]
The motivation of patients to follow cancer exercise programs has been explained by their belief that exercise may improve the course of their cancer, which contributes to increased demand for such programs [42,43,45,46]
Summary
Cancer remains a leading cause of death for Canadians of all ages, with incidences increasing since the year 2000, largely because of greater screening in an aging population [1,2]. Beyond the positive impact on side effects, post-treatment exercise has been associated with a survival advantage in breast 24, colorectal 25, and prostate cancer 26 Given this strong and growing body of evidence, it is clear that exercise should become a mainstay of cancer care [15,27,28,29]. Responding to overwhelming scientific literature that describes the benefits of exercise for cancer survivors, evidence-based exercise guidelines were created for cancer prevention and for the treatment and post-treatment periods [47,48,49] To implement those guidelines, clinical and academic organizations developed certification courses to train exercise professionals in the safe and effective training of cancer survivors (for example, http://www.unco.edu/ rmcri/, http://certification.acsm.org/acsm-cancer-exercisetrainer). In the sections that follow, we describe our exercise intervention and integration strategy, and we offer insights about the facilitators and barriers to exercise program implementation within oncology
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