Cancer Care Program - Staff and Physicians

Including physical activity in a cancer patient or survivor's treatment plan enables them to:

• Better manage their disease
• Better manage treatment-related side effects
• Maintain or improve muscle strength and overall functional fitness
• Reduce feelings of fatigue

Although there are possible contraindications, research shows that physical activity is safe for most cancer patients and survivors with appropriate precautions and modifications, as needed.

Physical activity has been shown to have positive effects on physical, social and mental outcomes for those living with and beyond cancer. 

The vision of the Physical Activity and Cancer (PAC) Lab is to optimize the use of exercise in cancer management and recovery. It seeks to enhance the physical well-being of individuals affected by cancer through the power of exercise. 

The PAC Lab is a research lab dedicated to improving quality of life, well-being and activity of daily living through physical activity for those living with and beyond cancer. The PAC lab is interested in patient, provider and system-level changes to promote physical activity as part of the standard of care for those living with and beyond cancer in Nova Scotia. 

Referrals to the PAC Lab: 

• Health care providers can refer patients using the referral form. 
• The PAC Lab team will follow up with the patient directly to: 
  • Discuss the program in more detail
  • Conduct a risk assessment
  • Support the patient in getting set up to participate
• Cancer survivors can also contact the program directly to learn more. 

What is being done:

Nova Scotia Health Cancer Care Program is supporting the creation of an Action Framework that will:

• Detail the current state of exercise programming for individuals living with cancer in Nova Scotia
• Provide recommendations regarding best practices and how to achieve them.

This work is being led by Dr. Stefan Heinze, a post-doctoral fellow funded by a Health System Impact Fellowship (CIHR), and co-hosted between the Cancer Care Program, Nova Scotia Health’s Research, Innovation, and Discovery team, and Dalhousie University.

Dr. Heinze is engaged with research efforts investigating:

• How exercise programs in Nova Scotia positively impact the lives of people living with a cancer diagnosis
• How such programs might positively impact the health care system
• How we can best identify which people will benefit the most from these programs through frailty screening tools

Details and results from available exercise programs and research efforts affiliated with the Cancer Care Program will be included in the Action Framework (to be completed in the summer of 2024), alongside recommendations and best practice guidelines. The Framework will serve as a guiding document for integrating exercise programming as a standard of care for people living with a cancer diagnosis in Nova Scotia.

Why it matters:

Exercise programming in oncology care settings has the potential to positively impact patients and the health care system, although how to best incorporate it into a standard of care is unknown.

• Current guidelines¹ state that oncology health care providers should recommend aerobic and resistance exercise programming for individuals living with a cancer diagnosis. Evidence supporting this recommendation continues to emerge, suggesting that exercise or physical activity programming can improve cancer-related fatigue levels, quality of life, physical functioning, anxiety, and depression.
• Exercise has also been associated with improvements in therapy-related adverse event risk, including during chemotherapy or when preformed prior to surgery.

Current research investigating exercise programming for people living with cancer involves understanding:

• The types and doses of exercise that are best for specific cancers
• Knowing when exercise programming is most effective
• Knowing what individuals would see the most benefit

These questions must be answered to realize the maximum potential of exercise programming as a standard of care in a cancer care setting.

References

1. Ligibel JA, Bohlke K, May AM, et al. Exercise, Diet, and Weight Management During Cancer Treatment: ASCO Guideline. Review. J Clin Oncol. Aug 1 2022;40(22):2491-2507. doi: 10.1200/JCO.22.00687. Epub 2022 May 16.