A growing body of evidence suggests physical activity can improve recovery
julia mc adam
The traditional advice during an episode of ill health is simple: take it easy, put your feet up, go to bed. Such suggestions are particularly common during a potentially serious illness, and so few cancer patients will be offered encouragement to move around more. Yet a growing body of evidence suggests physical activity can improve recovery and prognosis for people with the disease.
Jane Maher, joint chief medical officer at Macmillan Cancer Support, argues there is now an “undeniable case” for encouraging greater activity in the two and a half million people living with or beyond the disease. “As healthcare professionals we have an important role in advising people with cancer to get moving,” she says.
But the charity realises clinicians may find it difficult to offer that advice, which is why it runs training sessions on how to broach the topic.
According to Julia McAdam, former Macmillan lung cancer clinical nurse specialist at The Shrewsbury and Telford Hospital NHS Trust, the training emphasises the topic of physical activity should be raised early. However, it is also stressed this is not a one-off discussion.
”If you are more active, it might actually improve things in the long run, and make you feel better in the short term”
“During the training, we talked about how to set the tone, how to deliver information about physical activity, and how to make it an important part of the treatment – if you are more active, it might actually improve things in the long run, and make you feel better in the short term,” explains Ms McAdam, who is now operational manager for oncology and haematology at the trust.
“We found we could use almost a drip feed approach [to talking about physical activity] – making sure it was one of the things we talked about at every contact. We always dropped it into conversation, so it just became part and parcel of what we were delivering to the patient. It didn’t become something on its own, set aside as different and extra. It just became normal: we’re talking about your diet, we’re talking about your fatigue management, we’re talking about smoking, we’re talking about activity levels – it was just one of a list of things we talked about. For us, it was learning how to do that; learning the importance of that.”
”You think: ‘If I’ve got to talk to patients about physical activity, they might think you’re talking about joining a gym’”
It was also learning about how best to describe the idea of becoming more active. “You think: ‘If I’ve got to talk to patients about physical activity, they might think you’re talking about joining a gym’,” explains Ms McAdam.
“You’ve got to explain: ‘No, it’s just about doing stuff that you’re capable of doing, and building on that if you can.’ It’s about keeping active during the day, so walking to the kitchen every half an hour, or something as simple as going upstairs to the loo rather than using the downstairs one. It’s the activity, not sport.”
Professor Maher, meanwhile, says: “We are not telling everyone to go rushing about in Lycra; doing a few exercises or walking more steps each day can make a big difference to people with cancer.”
That difference can include reducing the impact of the side effects of treatment, whether physical or psychological. There is also evidence keeping active can cut the risk of dying from certain cancers, and reduce recurrence. At a basic level, however, Ms McAdam argues the benefit of staying active is the retention of some degree of normality.
“If patients can demonstrate that they’re able to do something for themselves, and then achieve it, I think that helps with their self-esteem and also that they are still that person in there”
“If you’re feeling that you’re completely incapable and dependent on someone else, that can be depressing to somebody who has previously been completely independent and not needed to rely on anybody else for help,” she suggests. “If patients can demonstrate that they’re able to do something for themselves, and then achieve it, I think that helps with their self-esteem and also that they are still that person in there, despite everything else that’s been thrown at them – it helps keep a bit of their identity really.”
For some, it even helps a change of identity. One of Ms McAdam’s patients became such a devotee of physical activity that he has now joined a gym, and advises others with cancer on keeping active. “It gives him a different outlook on life,” she reports, “and allows him to give something back to others.”
Each month, Macmillan runs an online training session on encouraging physical activity in cancer patients. It covers how being more active can help those with the disease, what resources are available to help cancer patients become more active, and how nurses can deliver effective advice on physical activity in less than two minutes. To register, visit http://learnzone.org.uk/macprofs/279