Professional Documents
Culture Documents
ABOUT CANCER
characterized as the uncontrolled proliferation of cells
not a single disease; highly variable because it can develop in any type of cell and involve any organ
system
can be:
- benign: cells multiply but do not invade other tissues
- grow but does do much.
- malignant: cells invade local tissues or migrate to other parts of the body (metastasis)
- matastisist matastisize = end up in tisues they didnt originate in.
other types depend on cells of origin
- carcinomas: from endothelial cells (forming the lining of organs)
- sarcomas: from connective tissues bones and muscles
- lymphomas: form in tissues responsible for immune functions
- leukemias: originate in cells that form white blood cells
in 2007 cancer passed CV disease as most frequent cause of mortality /morbidity in Canada
RISK FACTORS
specific to types
smoking
poor diet
inactivity (has surpassed all others as the most common risk)
genetics = ppl can get this through genetics
**carcinogens too little attention, but a growing controversy to treat or prevent? - limited research
funds compared to treatment funding. (pervasive role of drug companies is a growing policy
controversy)
often a trigger; exist in low levels in society; not enough info for it
paid attention to treating it, not preventing.
GENERAL EFFECTS
for the disease itself - depends on type and stage
localized disease - often no compromise of lifestyle until advanced stages
some systemic forms and forms with pain which may alter lifestyle immediately
TREATMENTS
considerable therapeutic advances in recent years:
- early detection
- new treatments
5 year survival rates now exceed 60% for all cancers; more patients living with cancer as a chronic
disease
traditional oncology treatment regimens:
- chemotherapy
- surgery can be a prolonged process (3 yrs +)
- radiation
more recently, structured exercise programs added
significant deconditioning effects recognized
due to prolonged bed rest or reduced activity
Surgery effects
- local and central effects leading to decreased strength, endurance, ROM, decline in other organ functions
(i.e. lung cancer lobe removal compromised pulmonary function)
Chemotherapy effects
- fatigue nausea vomiting insomnia weight gain anemia
- agents not always specific: tissue destruction can be systemic with side effects
Radiation effects
- fatigue
- tissue scar formation in treated area
- also can have long lasting damage to other adjacent tissues
General effects of treatment and the disease
- generalized fatigue is the most common complaint among patients and survivors
- limits activity
- potential long term health effects of deconditioning leads to secondary health issues - low aerobic
fitness, fat gain and loss of lean mass ending with all the usual associated diseases
- complete recovery requires reconditioning as part of extended treatment
EXERCISE TESTING
- protocols and comprehensive test batteries have been developed to assess oncology patients at all stages
- very complex based on individual disease and varied treatment protocols - changes in all areas of
physical fitness are monitored - (body composition, aerobic fitness, strength, and muscular endurance,
flexibility) (and also quality of life psychological data)
- provides important clinical information
prior to treatment
- to establish functional baseline
- to identify other diseases which may alter treatment
- to help track side effects of treatment
- the many effects of the treatments and exercise interactions are not well studied:
o radiotherapy for lung cancer causes fibrosis exercise effects on whether this is transient or
permanent are unclear
o radiotherapy for breast cancer often results in shoulder adhesive capsulitis; will exercise prevent
of alter this?
during active treatment
- to allow individualized treatments including exercise prescriptions
post treatment / recovery phase
- to track reconditioning and the exercise program
- to assess patients abilities to do specific tasks including daily living and work related (especially in
demanding physical jobs where safety is a concerns
Precautions and contraindications to testing:
- patients with good prognosis and cancer survivors are tested regularly
- maximal tests are not advised with:
- metastatic cancer
- in advanced disease
EXERCISE PRESCRIPTION
guidelines and protocols for monitoring are in development
a challenging, complex area of exercise research
efficacy of exercise prescription for patients undergoing treated for, or recovering from cancer not well
studied
current literature difficult to interpret due to
- methodological issues and variations (i.e., self reports of exercise, incomplete data (no records of
intensity etc), small sample sizes, no control groups etc)
- variations in the status of subjects (i.e., type of cancer, stage of treatment, training regimen
variations
Trends
aerobic exercise for patients with good prognosis produces:
- improved quality of life
- less fatigue (not more)
- improved functional capacity
- fewer hospital days
- reduced bowel disturbances (diarrhea, etc
- less pain
- better body composition
- higher hemoglobin levels
little research about resistance training; but very preliminary evidence shows:
- reduced cachexia (muscle wasting)
- strength retention
- restoration of losses after treatment