Wellness and Survivorship Center at Huntsman Cancer Institute, and she has seen many patients transform after they begin exercise programs. She says exercise not only helps with physical health, but with the depression, anxiety, fatigue and chronic pain often experienced by cancer patients. In this podcast, she talks about what exercises are best for cancer patients and other tips for being active while you’re being treated or recovering.">

Jul 27, 2015 — Years ago, cancer patients were told to limit physical activity and rest, but new research shows that exercise is the way to go. Dr. Pamela Hansen is the medical director at the Wellness and Survivorship Center at Huntsman Cancer Institute, and she has seen many patients transform after they begin exercise programs. She says exercise not only helps with physical health, but with the depression, anxiety, fatigue and chronic pain often experienced by cancer patients. In this podcast, she talks about what exercises are best for cancer patients and other tips for being active while you’re being treated or recovering.

Interview

Interviewer: How can exercise help during and after cancer treatment? We'll examine that next on The Scope.

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Interviewer: You know, it used to be people with cancer were often told to rest and reduce physical activity, but new research shows that exercise is actually better. Pamela Hansen is a Medical Director of the Wellness Survivorship Center at Huntsman Cancer Institute.

Pamela, first of all, let's start out with a story, because you've seen some amazing transformations that exercise can help with cancer patients as they're going through treatment and after treatment. Tell me one of those stories. We want to motivate people right now.

Pamela: Yeah, so I can tell you a story of a gentleman I saw today for a follow-up visit, his three-month follow-up visit. His initial assessment was three months ago and he was a gentleman who had been treated for prostate cancer, had had surgery and radiation therapy and he was also on hormone therapy.

He was experiencing a lot of the common side effects that occur with treatment, including weight gain, loss of muscle mass, his blood pressure and cholesterol had gone up a little bit. He was quite unhappy with how he was doing. He had put on some weight, which was making his knee arthritis bother him a little bit more and he was also having a little bit of urinary incontinence and was having to wear a pad.

Interviewer: That's terrible. Like a lot of stuff going on there.

Pamela: He had a lot of stuff going on and was frustrated and then looking for some guidance because he wanted to lose some weight and improve his strength and get back to feeling how he used to feel.

Interviewer: Yeah, and so you put him on an exercise program and what happened?

Pamela: We put him on an exercise program and he came in today for a reassessment and he was doing so much better. It was very satisfying to see his results. He had lost 15 pounds, he had doubled the strength in his legs, and this had allowed his knee arthritis to become much better controlled. He was having much less knee pain and was able to actually do a walking program. He hadn't been able to do a walking program previously.

He actually no longer had incontinence and no longer had to wear pads, because his pelvic strength had improved as well. So overall, he was feeling much better. His energy level was up and he was very motivated to continue his exercise program and had built kind of a nice base.

Interviewer: Yeah, and his mood probably improved dramatically as well?

Pamela: His mood, he was a whole different man today.

Interviewer: Yeah, I'd imagine so. So what are some of the other benefits of exercise when you're going through cancer treatment or afterwards? I've heard like depression and some other things as well, talk about that.

Pamela: Probably depression and anxiety and fatigue are the biggest things we see. Pain can be another issue. It sort of depends on what kind of cancer the patient has, what their pre-morbid medical issues are.

Interviewer: So before they had cancer?

Pamela: Before they had cancer. What kind of shape they were in, what kind of medical conditions they had. Did they have heart disease? Did they have arthritis? All of these things. Everyone is so individual what they come into cancer with, what kind of cancer they have, what stage of cancer they have, what their treatment is going to be. So everyone is an individual.

Interviewer: Yeah, and gets different benefits from exercise?

Pamela: Different benefits from different exercise, absolutely.

Interviewer: Understood. So what kinds of exercises should somebody who has cancer do or does that vary as well greatly?

Pamela: That varies as well. However, it's really no different than the general population in terms of what we should be doing to improve our overall health. So aerobic exercise, we like to see people doing moderate intensity aerobic exercise. We recommend 150 minutes per week. Obviously, this changes with people's diagnosis and if they're undergoing chemotherapy or something that's causing a lot of fatigue, we're going to modify that.

Also resistance exercises are very important and we recommend strengthening exercises for all major muscle groups of the body at least twice a week. Sarcopenia or loss of muscle mass is very common as people go through treatment, so this is something that we really try to get on even before they start their treatment, at the time of their diagnosis. It's really helpful to start working on these things to mitigate the effects that we see during their treatment.

Interviewer: Is that just a part of just trying to keep the body as healthy as possible in this time of not being healthy?

Pamela: It makes a big difference how people respond to their treatment, whether they come into their treatment in shape or de-conditioned. People tend to do a lot better, tolerate their therapy much better and get through it with fewer side effects when they are in shape at baseline.

Interviewer: That's interesting. So you said moderate intensity, how intense is moderate intensity?

Pamela: That's something that we can teach patients what moderate intensity means. It's a certain range of your heart rate that you want to be exercising at so that you can still talk, but you're not kind of lollygagging, that you're bringing your heart rate up, you're getting a good workout.

There are also other recommendations, so alternatively you can do 60 minutes of high intensity activity per week, but most of our patients are really not doing high intensity work at the time that they're being treated for cancer.

However, some of our patients are high level athletes and once they're done with their treatment, we do progress them to the higher intensity exercise again.

Interviewer: All right, it sounds like you have a lot of experts who work on this for a lot of people.

Pamela: We do, we've got a great team here at the Power Program.

Interviewer: Yeah. So is there a case when somebody with cancer shouldn't exercise?

Pamela: There are times that people have certain limitations if they're immunosuppress, they shouldn't be exercising in public gyms. There are times when people have open wounds or have healing tissues that they shouldn't be in water. So there are certain things that people shouldn't be doing at certain times, but for the most part, we can always find some kind of exercise that people can be doing to help maintain their function.

Interviewer: How big of a difference does it make if you find a program like the Power Program here at Huntsman to use that as opposed to doing it on your own?

Pamela: I think what we provide is guidance for patients who feel uncertain what they should and shouldn't be doing during their diagnosis. I think some people are at risk for lymphedema. They're not sure what they should be doing with their upper body strength and they want that guidance and that's what we can really do a good job of providing. And really our goal is not to have people come back here and exercise all the time, but really teach independence with an exercise program that they are comfortable and feel like they're safe continuing for the long-term.

Interviewer: And it seems like coming here to a place like this where you are experienced dealing with people that have cancer and exercise would be better than maybe like a personal trainer at a gym or something like that?

Pamela: Yes, we're very familiar with all of the common side effects and issues of cancer survivors. It's also nice because we have group classes as well, so it can be sort of a moving support group, an active support group for patients, which I think is also beneficial.

Interviewer: What's your final thought for our audience listening about this topic?

Pamela: For all of us, not just cancer patients, we should be exercising regularly and I think for cancer patients, I had one cancer patient say, "You can either feel crappy sitting or you can feel crappy walking. You might as well feel crappy walking because you're going to feel a lot better in the long run."

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