Abstract
The development of evidence-based exercise guidelines for people with cancer represents a major achievement in research and provides direction to programming initiatives. The prevalence of sedentary cancer survivors and the risk posed by inactivity suggests a knowledge-to-action gap for which the evidence has not led to increased exercise levels in that population. To address that gap, researchers continue to explore opportunities to improve the understanding of exercise within the oncologic context—from tumour biology to behaviour-change theories—to drive improved access and participation in exercise and rehabilitative activity. In Canada, such efforts have largely been invested by individuals and small teams across the country rather than by unifying stakeholders to drive nationwide impact. Accordingly, a national group of leading researchers, clinicians, and other stakeholders convened a meeting to discuss and strategize initiatives on how to conduct innovative research into the effects of exercise and rehabilitation in cancer survivors, to increase access to exercise and rehabilitation services in cancer survivors, and to reduce sedentary behaviour in cancer survivors. The 2-day meeting, titled Ex/Cancer, was held April 2017 in Toronto, Ontario, and was attended by 83 stakeholders from across Canada, representing knowledge end-users (cancer survivors), clinicians (oncologists, nurses, counsellors), a provincial cancer care agency, community-based exercise and cancer organizations, and researchers. Attendees participated in networking events, roundtable discussions, and breakout sessions to identify, discuss, and develop clinical and research experiences and opportunities. In addition to knowledge exchange between attendees, the meeting set the foundation for the development of a collaborative network to support the development, dissemination, and support of clinical and research activity in exercise and rehabilitation for cancer survivors. With unanimous support from attendees, a major product of the Ex/Cancer meeting was the formation of the Canadian Oncology Rehabilitation and Exercise Network—COREN.
Highlights
Cancer is a chronic disease that has surpassed cardiovascular disease as the leading cause of mortality and morbidity in Canadians[1]
A public symposium given during the evening of day 1 at the University of Toronto attracted more than 300 attendees, including community partners (16%), health care specialists (13%), patients (8.3%), media representatives (1.3%), and members of the public (61.4%)
One question at the forefront of the field is how to integrate, into usual care, comprehensive programming that focuses on increasing exercise and reducing sedentary behaviour
Summary
Cancer is a chronic disease that has surpassed cardiovascular disease as the leading cause of mortality and morbidity in Canadians[1]. An estimated 60% of all Canadian cancer survivors will live disease-free for more than 5 years after diagnosis[1]. As survival rates continue to rise, attention has shifted to include short- and long-term survivorship issues. Physical and psychological health issues associated with the diagnosis and treatment of cancer have been well documented and include, but are not limited to, fatigue, pain, fear of recurrence, depression, and local or systemic impairments[2,3]. Cancer treatment–related adverse effects and their lingering nature throughout survivorship warrant strategies to prevent or minimize such burdensome outcomes[4]. Exercise, and rehabilitation are safe, feasible, and effective nonpharmacologic strategies that improve health and quality of life from cancer diagnosis to end of life[5,6,7,8]. The evidence has contributed to endorsements, guidelines, and frameworks for exercise in oncology that e615
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