Many of us know someone who’s been affected by cancer – and increasingly, we also know someone who’s survived it.
Cancer is becoming more common in Australia, with one in two men and one in three women facing cancer at some point in their life. The good news is, cancer survivorship is also improving. Close to 70 per cent of people now live for at least five years post-cancer.
Providing first-class rehab for cancer survivors has never been more vital.
Exercise as medicine for cancer survivors
For La Trobe PhD candidate and physiotherapist Amy Dennett, physical exercise is crucial.
“Exercise is medicine. If you could have it in a pill, there’d be no side effects except the good ones,” she says.
“For people with cancer, exercise can improve strength, cardiovascular fitness, fatigue and quality of life. It can make them feel better, less tired and maybe make them live longer, too.”
While physiotherapists have always been involved in post-operative recovery following cancer surgery, their role in promoting exercise in rehab for cancer patients is much newer. This new role brings with it the task of dispelling old myths – and Amy’s PhD research is doing just that.
Dispelling the ‘rest is best’ myth
When you’re feeling tired, it can be tricky to know if exercising will lift your energy levels or make things worse. The stakes are higher for people with cancer: increasing tumour growth or worsening someone’s fatigue are real concerns. This gap in knowledge means many clinicians working with cancer patients still assume ‘rest is best’.
To improve the acceptance of exercise-based cancer rehab among patients and clinicians, Amy’s research set out to prove exercise is safe for cancer survivors. To do this, she compared the occurrence of adverse events – things like injury, illness and falls – for two groups of cancer survivors. One group had received standard medical care, while the other group had attended an exercise rehab program.
Her systematic review analysed 42 trials and drew on the experiences of 3,816 cancer patients. Outcomes like inflammation, fatigue, and reduced mobility and endurance were considered for both groups. The results were energising.
“Our meta-analysis of adverse events found there was no difference between the exercise groups and those receiving usual care,” says Amy, “In fact, overall, exercise reduced cancer-related fatigue.”
The ideal dose of exercise for cancer survivors
It’s well-known that regular, moderate-intensity exercise is good for you. What’s fascinating is that the best exercise for cancer survivors is similar.
Amy uncovered the optimal exercise dose by exploring the impact of exercise intensity in reducing fatigue.
“The results make sense. You want to prescribe enough exercise to induce some cardiovascular adaptations and change, but you don’t want too much that you want to wipe someone out with fatigue. It’s about getting the exercise balance right, with moderate intensity,” Amy says.
Moderate-intensity aerobic exercise also had a peak effect for improving walking endurance among cancer survivors. By contrast, exercise duration had little effect.
Brisk walking, swimming, going for a bike ride or doing an aerobics class all counts as moderate aerobic activity. Gardening’s fine, too.
Amy hopes her research will challenge concerns and assumptions around rest, fatigue, safety and exercise dose for cancer rehab. She also hopes it will improve clinicians’ confidence in recommending the right dose of exercise to cancer survivors.
Rehab as a rewarding career
With its history of outstanding physiotherapy courses and great links to clinical placements, Amy believes La Trobe Uni is the perfect place train in cancer rehab.
“La Trobe have always been leaders in physiotherapy, and now we’ve got the La Trobe Sport and Exercise Medicine Research Centre, with professors who are experts in physical activity, chronic disease,” she says.
“The beauty of La Trobe is that we have such strong links with industry, particularly the public health and hospital network. You can really get that nice meshing of clinical and research opportunities, and exposure in a real-world hospital environment.”
“One thing that really sets La Trobe apart is its links to major public hospital networks, to get good exposure to what physiotherapy can offer, and really good rehab clinical experience as well.”
For Amy, returning to La Trobe as a postgrad student has been ‘the best decision I’ve ever made’.
“I studied physio at La Trobe as an undergrad, where I did placements in the Eastern Health clinical school. I went on to work for Eastern Health as a clinician, and now I’m working with professors I studied with as an undergrad,” Amy says.
So next time you’re walking, jogging or cycling around campus, make sure you check in with the pick-me-up punch that exercise brings. Not only can it help you kick uni goals, it can help people kick cancer, too.
Find out how you can improve exercise and rehabilitation, and gain expert knowledge in the science and theories of physiotherapy and clinical practice at La Trobe’s world-class Sport and Exercise Medicine Research Centre.