Clinical Oncology Society of Australia position statement on exercise in cancer care

Cormie, Prue; Atkinson, Morgan; Bucci, Lucy; Cust, Anne E.; Eakin, Elizabeth G.; Hayes, Sandra C.; McCarthy, Alexandra; Murnane, Andrew; Patchell, Sharni; Adams, Diana

doi:10.5694/mja18.00199

Cited by 310 publications

(266 citation statements)

References 40 publications

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“…To date, very few studies have used elements of EIM in the oncology care setting, but there is ample scope and a need to examine integration into cancer care. The evidence base strongly supports adoption of the EIM approach for all patients with chronic conditions, including people living with and beyond cancer . Therefore, we propose the EIM approach as a way forward in the oncology setting.…”

Section: What Oncology Clinicians Can Do Now: Assess Advise and Refermentioning

confidence: 95%

“…The current article, the third in this triad, identifies and uses elements from the ACSM's Exercise Is Medicine (EIM) initiative to propose solutions to overcoming barriers to exercise referrals by oncology clinicians …”

Section: Introductionmentioning

confidence: 99%

“…Multiple US and international organizations have published exercise recommendations for patients living with and beyond cancer, including the American Cancer Society (ACS), 1 the American College of Sports Medicine (ACSM), 2 Exercise and Sports Science Australia, 3 Cancer Care Ontario, 4 and the Clinical Oncology Society of Australia. 5 In March 2018, the ACSM convened a Second Roundtable on Exercise and Cancer Prevention and Control. This second Roundtable included 17 organizations from multiple disciplines (see Supporting Table 1) and set out to review and update prior recommendations on cancer prevention and control.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Exercise is medicine in oncology: Engaging clinicians to help patients move through cancer

Schmitz

Campbell

Stuiver

et al. 2019

CA A Cancer J Clinicians

532

465

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Multiple organizations around the world have issued evidence‐based exercise guidance for patients with cancer and cancer survivors. Recently, the American College of Sports Medicine has updated its exercise guidance for cancer prevention as well as for the prevention and treatment of a variety of cancer health‐related outcomes (eg, fatigue, anxiety, depression, function, and quality of life). Despite these guidelines, the majority of people living with and beyond cancer are not regularly physically active. Among the reasons for this is a lack of clarity on the part of those who work in oncology clinical settings of their role in assessing, advising, and referring patients to exercise. The authors propose using the American College of Sports Medicine's Exercise Is Medicine initiative to address this practice gap. The simple proposal is for clinicians to assess, advise, and refer patients to either home‐based or community‐based exercise or for further evaluation and intervention in outpatient rehabilitation. To do this will require care coordination with appropriate professionals as well as change in the behaviors of clinicians, patients, and those who deliver the rehabilitation and exercise programming. Behavior change is one of many challenges to enacting the proposed practice changes. Other implementation challenges include capacity for triage and referral, the need for a program registry, costs and compensation, and workforce development. In conclusion, there is a call to action for key stakeholders to create the infrastructure and cultural adaptations needed so that all people living with and beyond cancer can be as active as is possible for them.

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Section: What Oncology Clinicians Can Do Now: Assess Advise and Refermentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Exercise is medicine in oncology: Engaging clinicians to help patients move through cancer

Schmitz

Campbell

Stuiver

et al. 2019

CA A Cancer J Clinicians

532

465

View full text Add to dashboard Cite

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“…[1][2][3] Randomized controlled trials have strengthened the foundation in efficacy data for exercise in oncology; however, experimental designs can lack generalizability to a clinical setting (eg, homogeneity of the sample, exclusion of comorbid conditions, or willingness to be randomized). [1][2][3] Randomized controlled trials have strengthened the foundation in efficacy data for exercise in oncology; however, experimental designs can lack generalizability to a clinical setting (eg, homogeneity of the sample, exclusion of comorbid conditions, or willingness to be randomized).…”

Section: Introductionmentioning

confidence: 99%

Development, implementation, and effects of a cancer center's exercise‐oncology program

Mina

Auger

et al. 2019

Cancer

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BACKGROUND: National and international bodies acknowledge the benefit of exercise for people with cancer, yet limited accessibility to related programing remains. Given their involvement in managing the disease, cancer centers can play a central role in delivering exercise-oncology services. The authors developed and implemented a clinically integrated exercise-oncology program at a major cancer center and evaluated its effectiveness and participant experience. METHODS: A hospital-based program with prescribed at-home exercise was developed and accepted referrals over a 42-month period (3.5 years). Implementation was conducted in 2 phases: a pilot phase for women with breast cancer and men with genitourinary cancer and a roll-out phase for all patients with cancer. Enrolled patients were assessed and received an exercise prescription as well as a program manual, resistance bands, and a stability ball from a kinesiologist. Program participation and effectiveness were evaluated up to 48 weeks after the baseline assessment using intention-to-treat analyses. Participants in the roll-out phase were asked to complete a program experience questionnaire at the completion of the 48-week follow-up. RESULTS: In total, 112 participants enrolled in the pilot, and 150 enrolled in the roll-out phase. Program attrition to 48 weeks was 48% and 65% in the pilot and roll-out phases, respectively. In participants who consented to research evaluation of their performance, objective and patient-reported measures of functional capacity improved significantly from baseline in both phases. Participants were highly satisfied with the program. CONCLUSIONS: Despite significant drop-out to program endpoints, our cancer-exercise program demonstrated clinically relevant improvement in functional outcomes and was highly appreciated by participants. Cancer 2019;125:3437-3447.

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“…Specific exercise recommendations for men with prostate cancer on androgen deprivation therapy exist in the United Kingdom . The United States also have physical activity and nutrition guidelines for cancer survivors, and the Clinical Oncology Society of Australia recommends that exercise is embedded as an adjunct to therapy . Nevertheless, studies using self‐reported and accelerometry assessed physical activity suggest that the majority of men living with prostate cancer remain inactive, with less than 23% reaching recommended levels and levels of obesity rising after treatment …”

Section: Introductionmentioning

confidence: 99%

Creating a teachable moment in community pharmacy for men with prostate cancer: A qualitative study of lifestyle changes

et al. 2019

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Objective It is well established that exercise and lifestyle behaviours improve men's health outcomes from prostate cancer. With 3.8 million men living with the disease worldwide, the challenge is creating accessible intervention approaches that lead to sustainable lifestyle changes. We carried out a phase II feasibility study of a lifestyle intervention delivered by nine community pharmacies in the United Kingdom to inform a larger efficacy study. Qualitative interviews explored how men experienced the intervention, and these data are presented here. Methods Community pharmacies delivered a multicomponent lifestyle intervention to 116 men with prostate cancer. The intervention included a health, strength, and fitness assessment, immediate feedback, lifestyle prescription with telephone support, and reassessment 12 weeks later. Three months after receiving the intervention, 33 participants took part in semistructured telephone interviews. Results Our framework analysis identified how a teachable moment can be created by a community pharmacy intervention. There was evidence of this when men's self‐perception was challenged and coupled to a positive interaction with a pharmacist. Our findings highlight the social context of behaviour change with men identifying how their lifestyle choices were negotiated within their household. There was a ripple effect as lifestyle behaviours made a positive impact on friends and family. Conclusions The teachable moment is not a serendipitous opportunity but can be created by an intervention. Our study adds insight into how community pharmacists can support cancer survivors to make positive lifestyle behaviour changes and suggests a role for doing rather than just telling.

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Clinical Oncology Society of Australia position statement on exercise in cancer care

Cited by 310 publications

References 40 publications

Exercise is medicine in oncology: Engaging clinicians to help patients move through cancer

Exercise is medicine in oncology: Engaging clinicians to help patients move through cancer

Development, implementation, and effects of a cancer center's exercise‐oncology program

Creating a teachable moment in community pharmacy for men with prostate cancer: A qualitative study of lifestyle changes

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