"I was always looking outside myself for strength and confidence, but it comes from within. It was there all the time" – Anna Freud

Like most Americans, I had took great pride in the victory of Lance Armstrong in last year's Tour de France. His victory was especially taken to heart because I understood the seriousness of his [testicular] cancer diagnosis, and his subsequent return to competitive athletics. Over the past five years, the Santa Barbara Athletic Club has instructed an exercise and wellness program whereby persons diagnosed with cancer can participate in small group exercise sessions with their peers and lift weights, perform yoga, train on aerobic machines, and relax with meditation sessions. The results have been as remarkable as a Tour de France win.

Participants on average improved strength and endurance by over 25% over their initial ten weeks of exercise. They improved their fatigue levels by over 30%, and reduced pain by over 20%. More importantly, they improved their quality of life scores (well-being, daily-living scores) by almost 40%. This is important, because according to many oncologists, survivability and quality of life ARE the two most important areas of cancer treatment today. Dr Kerry Courneya from the University of Alberta in Canada has done some of the best research on the effects of exercise and quality of life. His recent review of over 20 studies concludes that three quarters of these reports had significant results in quality of life improvements for patients. That means that most published reports favor the use of exercise to improve quality of life.

A very recent report presented by Dr. Barbara Anderson from the Ohio State University found that patients who attended regular support groups actually increased their survivability significantly. Unlike previous psychosocial interventions, the OSU group looked at stress hormones such as cortisol, and proteins such as Mucin (MUC1) and their relationship to breast cancer progression. It now seems that support and regular physical activity (which was also monitored) have a tremendous impact on survivorship by regulating hormones and proteins that may have deleterious effects on the immune system.

So why don't we hear more about exercise and cancer in the media?

One reason is that a guy like Lance Armstrong doesn't come along every day. Whether he knows it or not, he is now considered an international spokesperson for using exercise as part of the cancer recovery process.

The second reason is basic awareness. Most oncologists are familiar with clinical trials and medical treatments. They think of exercise as perhaps just routine physical therapy (which it is not). For years many patients never mentioned their disease to family and friends. Recently, however, with the diagnosis and treatment of skaters Scott Hamilton (testicular cancer) and Peggy Fleming (breast cancer), 100 meter hurdler Ludmila Enquist (breast cancer), and miler Steve Scott (testicular cancer), we are now seeing that indeed athletes can resume their training regimes after their diagnosis and treatment. In many cases the exercise reduces the nausea and crushing fatigue that happens during chemotherapy regimes.

Is being an athlete a guarantee of a full cancer recovery? Of course not. One is reminded of the severity of cancer prognoses when reading about WNBA Kim Perrot of the champion Houston Comets, who passed away from on August 19, 1999 after a seven month battle with cancer at the age of 29.

However, awareness on the benefits of therapeutic exercise has already crossed the threshold in the area of cardiac rehabilitation when doctors such as Ken Cooper spoke out in favor of aerobic training for post-heart attack patients. Now it is standard therapy. Doctors Andrew Weil and Dean Ornish have given America awareness on the effects of alternative medical procedures for stress management and heart disease prevention and treatment. Today thousands of heart patients take heed of these new medical recommendations.

Lance Armstrong has raised the awareness of people internationally that cancer patients whose prognosis (long term health survivability) is not good and use exercise as part of their recovery. Add this to nutrition, stress management, support groups, and better medicine, and we may see a new generation of cancer survivors build their repertoire for recovery.

Remember that the Surgeon General recommends exercise for all Americans anyway, so there should be acceptance with physicians who wish to refer to cancer wellness programs, just as there is with the Santa Barbara wellness program, where oncologists from the entire community now refer their patients. As more research and published literature on protocols and benefits appears, the awareness will grow throughout the medical and fitness communities, so more patients than ever before can benefit from regular exercise to build strength, endurance, and self efficacy to increase their odds for survival.

It is also my opinion that exercise programming will see a huge growth in acceptance in the coming years. This is in part because cancer survivors want to get better. Having a community program where they can exercise helps them out even more. Will it be a revolution? Perhaps – but it is for now a victory, just like in the Tour de France.

References

Resources in Cancer Wellness

Copyright © 1999-2012, CompWellness Network, Fairfield NJ USA, Eric P Durak & Medical Health and Fitness. Reprinted with permission.

Eric Durak, MSc is the nationwide Director of Cancer Wellness Programs in Santa Barbara, CA. This exercise program has serviced over 200 cancer survivors over the past five years, and was awarded the IHRSA Institute "best practice" award at the 1999 international annual conference. Eric's book on exercise and cancer survivorship is available at www.medhealthfit.com.

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