Taking steps to fight cancer – with exercise

Sylvie Audet, release 20121115002, left, Kim Dittus, M.D. Steps to Wellness.

A new report highlights a growing body of evidence showing that regular exercise may help you survive if you have cancer, while also preventing certain types of cancer.

The report, from the American College of Sports Medicine’s Roundtable on Exercise and Cancer, summarizes a “substantial accumulation” of new data over the past decade and concludes that “there is consistent, compelling evidence that physical activity plays a role in preventing many types of cancer and for improving longevity among cancer survivors.”

That’s no surprise for Kim Dittus, MD, a medical oncologist at University of Vermont Medical Center.

For eight years, Dr. Dittus has led the hospital’s Steps to Wellness Program, in which cancer survivors participate in supervised exercise. More than 700 people have completed the program, and Dr. Dittus says participants have shown improved fitness, strength and mobility.

Steps to Wellness was a pioneering program when it started, and Dr. Dittus says it still is.

“I don’t know anybody else who provides exercise to cancer survivors in this way,” she says.

New evidence shows promise

The general idea behind Steps to Wellness – that exercise can be an effective tool in the battle against cancer – has been gaining momentum for years. And the latest report from the American College of Sports Medicine (ACSM) further bolsters that notion.

Specifically, the report found that “physical activity is beneficial for the prevention of a number of different types of cancer including breast, colon, endometrial, kidney, bladder, esophageal and stomach.”

Furthermore, decreasing sedentary time may lower the risk of endometrial, colon and lung cancer, the report says.

Also, the authors say physical activity – both before and after diagnosis – can help patients survive breast, colorectal and prostate cancers.

The report acknowledges that there are still “significant gaps” in understanding the mechanisms that link physical activity to cancer prevention and survival. But the bottom line, the ACSM says, is that “being physically active is one of the most important steps people of all ages and abilities can take for cancer prevention, treatment and control.”

The report’s authors also urge public health officials and health care providers to “spread the message to the general population and cancer survivors to be physically active as their age, abilities and cancer status will allow.”

Success of Steps to Wellness

Dr. Dittus, who is medical director of Steps to Wellness, UVM Medical Center’s oncology rehabilitation program, has seen firsthand how exercise helps cancer survivors who are struggling with the physical and psychological effects of their disease and treatment.

Modeled after cardiac rehabilitation programs, Steps to Wellness features free, supervised group exercise sessions two days a week for 12 weeks. Trainers guide participants through aerobic and resistance workouts.

An initial medical assessment determines whether cancer survivors are healthy enough to participate. But experts say exercise training is generally safe for survivors, and Dr. Dittus says the setting for Steps to Wellness – the hospital’s cardiac rehabilitation facility on Tilley Drive in South Burlington – helps ease fears about starting an exercise program.

“They’re surrounded by health professionals if they’re a little bit nervous, and I think that has definitely helped,” says Dr. Dittus, who also is an associate professor at UVM Larner College of Medicine and a member of the UVM Cancer Center.

The benefits, she adds, are clear. Assessments performed before and after the program show improved strength and improved ability to walk for sustained periods.

For survivors over age 65, the program has shown striking success: Risk of falls declines from 25 percent to 5 percent after the completion of Steps to Wellness.

Dr. Dittus also notes the strong connections that have developed among survivors, and between survivors and trainers. “It has been more about the social support than I ever expected it to be,” she says.

‘Taking it to the next level’

Unfortunately, there’s no shortage of candidates for programs like Steps to Wellness. The American Cancer Society says nearly four out of ten people in the U.S. can expect to develop cancer over the course of their lifetimes.

The ACSM says there are more than 15.5 million cancer survivors nationwide, and that number is “expected to double in the coming decades.”

However, in spite of the demand for rehabilitation and the evidence shown in reports like the ACSM’s, insurers don’t yet pay for exercise therapy for cancer survivors. That means Steps to Wellness relies on fundraising and other financial support, including money from the Victoria Buffum Endowment at UVM Cancer Center.

Dr. Dittus says support is increasing, and Steps to Wellness advocates don’t need to spend as much time raising money as they used to. Despite the ongoing financial challenges, she is motivated by her patients and her belief in the power of exercise.

“Sometimes, I feel like I’m pushing up against brick walls. Keeping the program moving takes a great deal of time and effort,” Dr. Dittus says. “And then someone will say, ‘You know what, this really changed my life.’”

Stories like that underscore the fact that the physical benefit of exercise is “a no-brainer,” Dr. Dittus says. Rather than more studies exploring that topic, she’d like to see explorations of how to expand the reach of programs like Steps to Wellness.

“It’s not going to be the same model,” Dr. Dittus says. “I think that we need to be creative about how to disseminate exercise to cancer survivors. And that would be taking it to the next level.”

Learn more about Steps to Wellness at the UVM Cancer Center.

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