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A study of community-based exercise for cancer survivors that focused on strength training found such activity is both safe and effective in terms of physical and psychosocial benefit. The findings are published online in the Journal of Cancer Survivorship.
Corresponding author Dr. Karen Syrjala, co-director of the Fred Hutchinson Cancer Research Center Survivorship Program in the Clinical Research Division, led the study of 221 cancer survivors who took part in a 12-week Exercise and Thrive program offered in conjunction with Seattle-area YMCAs.
Overall, the study found the classes helpful for improving fatigue, insomnia, physical function, musculoskeletal symptoms, mental health, social support and physical activity. Additionally, participants had notable improvement in blood pressure, upper and lower body strength, walking endurance and flexibility.
The program focused on strength building because that is the area of greatest need and potential benefit for many cancer survivors, Syrjala said. "Cancer can cause loss of muscle mass and result in fatigue. Strength training is needed to rebuild this muscle and to generate energy," she said.
Support contributes to high effectiveness
The study found a high rate of effectiveness for those who continued with the exercise classes, and relatively few people dropped out. "When people are tired they tend to want to rest until they feel better, and then resting becomes a habit. The support element is essential to their sticking with an exercise program," Syrjala said.
Learning to stick with an exercise program is important for cancer survivors, Syrjala said, because studies have shown they have a higher rate of being sedentary compared to the general population. "Many people who were active before cancer become inactive afterward, and those where were inactive before are very unlikely to become active after cancer," she said.
A prescription for promoting physical activity
Syrjala said the benefits of exercise for cancer patients have been demonstrated as early as at the time of diagnosis, suggesting that earlier intervention by health care providers to prescribe safe exercise programs may be warranted. However, studies have shown only half of oncologists inquire about their patients' physical activity on some or most visits, with "insufficient time" rated as the highest barrier to promotion of exercise.
Study participants did not lose a significant amount of weight, a finding consistent with those of other exercise programs that focus on strength training.
The Exercise and Thrive program, originally developed by the LIVESTRONG Foundation in conjunction with YMCAs and available in locations across the country, involved group sessions with personal trainers who were given a two-day workshop on cancer-specific exercise needs. The instructors received training that specifically addressed the emotional needs of survivors, as well as potential hazards of strength-building exercise. For example, in some former patients, if weight lifting is unrestrained, such activity can trigger lymphedema, an accumulation of fluid in tissue that causes limb swelling.
The importance of community-based classes
"The most important lesson learned from our study is not the evidence that exercise matters; what’s important is that we saw benefits for a community-based program that was able to use personal trainers who had limited cancer training," Syrjala said. "This made it possible for many more survivors to recover and thrive in a program that was safe, effective and in their communities."
Syrjala said that partnering with regional YMCA facilities proved helpful because cancer survivors were able to access the programs easily, at low cost, and without having to live near a cancer rehabilitation facility. Similar programs for cancer survivors are available in a growing number of states.
Center co-authors included Survivorship Program Co-director Dr. Scott Baker, Emily Jo Rajotte and Jean Yi, all of Clinical Research.
The LIVESTRONG Foundation and the Amgen Foundation of Washington state supported the research.