REACH - Research in Exercise And Cancer Health

Patricia is a PhD researcher at Waterford Institute of Technology in Ireland. Patricia is finishing up her dissertation, where she looked at a physical activity program to improve symptoms of cancer-related fatigue.

In this episode, we focus on cancer-related fatigue, what it is, how it’s different from regular tiredness and how it can affect different people. We chat about Patrica’s dissertation work and how physical activity can improve fatigue. We also chat about the state of cancer rehabilitation in Ireland and what services are out there for cancer patients/survivors.

You can find Patricia on twitter @FERNTRI or through email at [email protected]

You can also find the MedEx program in Waterford here: https://www.wit.ie/schools/health_sciences/medexwit.

Find me on twitter at @CiaranFairman or go to reachbeyondcancer.com to find out more about what we do.

This episode doesn’t have an intro, I came down with a devastating case of the man-flu over the weekend, so I’m not able to speak to put one up. This episode is sponsored by Lampstrong.com. The LampStrong Foundation is a non-profit organization founded by Major League Soccer Goalkeeper and Stage Four Hodgkin Lymphoma Survivor Matt Lampson. The mission of The LampStrong Foundation is to provide difference-making financial, emotional and motivational support to cancer patients and families in all the stages of cancer treatment and recovery as well as to fund proven cancer researchers. For more information and regular updates on the LampStrong Foundation follow the LampStrong Foundation on Facebook or visit LampStrong.com.

1.00 – What is Cancer Related Fatigue, what are the symptoms, how long does it last, what causes it etc.

5.00 – Where should exercise advice for cancer patients/survivors come from?

7.00 – Different dimensions of cancer-related fatigue, whether its emotional, cognitive or physical fatigue, and how those patterns fluctuate during treatment.

11.29 – The transition from active treatment to survivorship and how patients/survivors can feel lost and isolated.

15.35 – Patricia’s study looking at physical activity and cancer-related fatigue.

28.45 – Fit and active cancer patients – dealing with exercise tolerance going down.

36.00 – Turning her research into a public service program at Waterford Institute of Technology.

44.00 – State of cancer rehab in Ireland. Where the field is and what is available for patients/survivors.

51.00 – The influence of policy on establishing exercise oncology as a standard of care. 

This is part 2 with Jeff, who is a researcher at Athabasca University who looks a physical activity and sedentary behavior in a variety of cancer populations.    

We talk about the Amber study, a massive study looking at physical activity in 1,500 cancer patients and looking at them up to 10 years after treatment. This study will answer A LOT of important questions about physiological effects of exercise, along with effects of activity on cancer recurrence and mortality. We also chat about how theire trying to develop a central databse of cancer facilities to try and improve the cancer network across the country. Finally, we chat about how we might be putting too many barriers to exercise with cancer patients and survivors – a really important topic. Enjoy!

 You can find Jeff on Twitter @JeffVallance, or at http://fhd.athabascau.ca/faculty/jvallance/. Look for us at reachbeyondcancer.com or find me on twitter @CiaranFairman.   We talk about Mike Lang in the episode and the great things he’s doing with youth cancer survivors. Find him @mikeylang on Twitter or visit https://about.me/mike.lang to find out more. 

Show Notes:

3.45 – Amber Study: Tracking physical activity and health outcomes in cancer survivors up to 10 years after treatment.

9.00 – How biological studies may start to tease out some of the effects of exercise on cancer related outcomes.

14.00 – How the diversity of researchers will drive the field forward.

17.00 – Cancer initiatives up in Canada – trying to develop a central database of cancer centers to help cancer patients/survivors.

28.00 – How cancer studies can be improved.

34.00 – Are we putting too many barriers to exercise with cancer survivors?

37.00 – The power of seeing improvement in Jeff’s first cancer patient and how that empowered him to keep going.

41.00 – Need for more collaboration between academics and health professionals.

45.00 – Where you can find Jeff.

Nicole is a Professor at the University of Calgary who focuses on physical activity for cancer survivors. In this episode, we chat about head and neck cancer, and some of the challenging side effects of the cancer and its treatment. Due to its location, cancer-related cachexia is common concern, along with some of the real difficulties and pain with just eating a meal, and how these affect exercise decisions.

Interestingly, HPV is such a common risk factor for Head and Neck cancer, that there are two separate types of HN cancer – HPV related on non-HPV related. We chat about the implications of this and how to reduce your overall risk.

Finally, we chat about our shared frustration in the translation of research into practice and how our research lines differ from the advice we give in a clinic.

If you’re in the Calgary area and are interested in getting involved in a research study, check out Nicole’s Lab at: https://www.ucalgary.ca/healthandwellnesslab/people/dr-culos-reed

Learn more about Nicole’s Thrive Health Services here: http://thrivehealthservices.com/about-us/ and check out Nicole on twitter @NCulosReed.

Check out www.reachbeyondcancer.com for our services or find me on twitter @CiaranFairman.

Show Notes.

0:30 – What is Head and Neck cancer and who is defined and a Head and Neck cancer patient/survivor.

2:15 – How is HPV puts you at a heightened risk of Head and Neck Cancer. There’s no screening for Head and Neck Cancer.

7.30 – Screening for HPV is part of the treatment for H/N cancer.

9.00 - Other risk factors for Head and Neck cancer.

9.30 – Side effects of treatment that’s unique to H/N cancer – Cancer-related cachexia, eating, hearing etc.

14.00 – How treatment needs to change for H/N cancer – more than just nutrition.

16.15 – The role of physicians vs. exercise physiologist in cancer care.

19.00 – How long and painful meals can be for H/N cancer patients/survivors and how that affects their exercise.

24.00 – Timing of exercise in H/N cancer – it may be better to wait until after treatment and what this means.

26.00 – How just moving can be helpful – worrying about structured exercise later.

28.00 – What we research vs. how we translate that to actionable advice.

33.00 – The importance of having trained professionals in this area that have a background in cancer.

36.00 – How weight training is an important, low-calorie tool to help H/N cancer.

38.00 – Common modifications with H/N cancer – balance issues, functional impairment.

40.00 – The importance of strategies aimed at long term adherence to exercise as opposed to short term improvements. Stoplight program to modify exercise.

44.00 – The importance as exercise oncologists establishing a line of communication with medical professionals.

Darcey Wion is a trainer at System of Strength, an incredible gym and community in Columbus Ohio. In this episode, we chat about Darcey’s journey from being diagnosed with Hodgkin’s Lymphoma fresh out of college, to now being the on the cover of women’s health magazine. Darcey gives an incredibly honest and refreshing insight into what her treatment looked like, how her chemotherapy worked, along with some of the brutal side effects that she still struggles over 7 years later. Darcey also talks about feeling guilt as a younger patient, the value of having a strong support system and things such as losing her hair as a young woman. We also talk about how brutal Carella’s classes are at SOS. I can’t thank Darcey enough for her honesty and vulnerability in this interview, I think it will help a lot of people as a result.

Most importantly, Darcey is the finalist for Women's Health Next Fitness Star. The winner is selected based on votes and I can't think of anyone more deserving. You have unlimited votes from now until August 4th so please go to the link below, vote, refresh, vote, refresh and repeat as many times as necessary.

Vote for Darcey here: http://www.womenshealthmag.com/fitness/next-fitness-star-finalists?utm_source=facebook.com&utm_medium=social&utm_campaign=sharebutton

Check out System of Strength at: https://systemofstrength.com/

Check us out at reachbeyondcancer.com or go to @CiaranFairman on Twitter.

Show Notes.

1:03     Darcey’s Background and personal experience with exercise prior to treatment

4:33     Diagnosis of Hodgkin’s lymphoma  and the month between diagnosis and treatment

9:03     First experience with chemotherapy

12:03   Feeling guilt as a cancer patient

13:03   How a session of chemotherapy looks

14:33   The aftermath and side effects of a chemo session

17:33   Exercise during treatment     

21:03   Her experience with Exercise and Nutrition advice from oncologists/physicians   

25:33   The tail end of treatment // Radiation

29:03   Finding her new normal and dealing with side effects post-treatment      

31:33   Getting back her level of fitness while dealing with the side effects

34:33   What Darcey is currently doing

38:03   Being on the cover of Women’s Health

40:03   What is System of Strength about    

43:03   Darcey’s advice for cancer patients

Jeff is a researcher at Athabasca University who looks a physical activity and sedentary behavior in a variety of cancer populations.

We chat about reallocating time to physical activity in Non-Hodgkin’s Lymphoma, how rock-climbing might be beneficial to gynecological cancer survivors and how getting a dog could help with increasing activity! We also have an interesting chat about how increasing cancer patient’s/survivor’s activity is less about the activity we deem is “optimal” and more just providing them with choices and options of activity that they can look to integrate into their lifestyle.

You can find Jeff on Twitter @JeffVallance, or at http://fhd.athabascau.ca/faculty/jvallance/. Look for us at reachbeyondcancer.com or find me on twitter @CiaranFairman.

We talk about Mike Lang in the episode and the great things he’s doing with youth cancer survivors. Find him @mikeylang on Twitter or visit https://about.me/mike.lang to find out more.

Show Notes.

3.00 – NHL – those who meet PA guidelines vs those who don’t  have higher quality of life and reduced fatigue

6.00 – How dangerous sedentary time can be and how to go about changing it.

10.00 – Making smaller changes in activity throughout the day instead of a complete overhaul may  be better to increasing overall levels of activity.

15.00 – How it can be easy to forget what cancer patients/survivors have gone through I terms of treatment and some of the complicaitons that may affect their physical activity habits. Some of the challenges of being a fitness professional and trying to put yourself in the shoes of a patient going through treatment.

18.00 – How that type of people who volunteer for cancer studies can affect the results and our interpretation.

21.00 Some of the challenges with research in this area (funding, review boards etc.).

23.00 – Gynacological cancer survivors, wall climbing and the value of providing choice in terms of how people select a type of exercise.

34.00 – Should we treat cancer survivors different from the general population?

37.00 – Do we need to have a “usual care” group in our exercise interventions with cancer patients/survivors?

In the second part of my interview with Lamps, we chat about his journey from college to professional soccer player, some of the long term side effect of treatment he still suffers from today and some of the challenges he faces. We chat about the importance of him having coaches at Chicago Fire who understand what he’s been through and the value of having the support system. Most importantly, we talk about his amazing foundation www.lampstrong .com, and everything he’s doing to help cancer patients and survivors.

If you want to get in touch with Matt or hear about the great work he’s doing, go to www.lampstrong.com or find him on twitter @LampStrong.

You can find me on twitter @CiaranFairman or go to www.reachbeyondcancer.com to find out more about REACH.

Show Notes:

3.00 – Best pizza in Columbus

4.00 – Changing his focus to really take turning professional seriously.

5.00 – Having a degree in biology and Latin, a family of physicians and their support of his professional soccer dreams.

8.00 – How his support system in different teams has influenced him.

14.00 – Using humor to deal with his diagnosis.

18.00 – Some of the long-term side effects of his treatment.

20.00 – The Lampstrong Foundation and what Matt’s doing to help others. The hero program and being a source of inspiration to childhood cancer patients/survivors.

29.00 – Setting up a healthy living program at Luries’s children hospital in Chicago.

Titch is an assistant professor at Elon University, where he investigates the effects of different exercise interventions on cancer survivors.

In today’s show, we talk about Titch’s dissertation research, where he looked at the effects of protein supplementation in combination with weight training in breast cancer survivors. We have a great chat about the study itself, the results and some of the practical applications and take home points. We also chat about some common side effects experienced by cancer survivors, such as lymphedema and peripheral neuropathy and how exercise can be modified to account for these.

You can find Titch on twitter @TitchMadzima, or contact him directly via email at [email protected]. You can find me on twitter @CiaranFairman, or go to reachbeyondcancer.com to find out more about REACH and our services.

Enjoy!

Show Notes

4.30 – Intro to the study and rationale for using a protein supplement with breast cancer survivors.

6.50 – The exercise prescription, how the groups were broken up and what the protein supplement looked like.

9.30 – How to progress resistance exercise.

10.45 – Exercise progression can look different in a survivor 3-4 years’ post treatment, than someone who’s going through active treatment and experience severe side effects.

15.30 – What lymphedema is, how it’s measures and the effects of the weight training on its symptoms. The importance of educating breast cancer survivors on how weight training can lymphedema.

20.15 – Peripheral Neuropathy. What it is and some exercise modifications that can be made around it.

26.00 – Details of the protein supplementation given to participants and how that affected participants normal protein intake.

32.00 – Improvements in strength and body composition as a result of the 12-week weight training program.

34.00 – The difference between advice given to a participant in a study vs. those in a clinical setting.

35.45 – The value of small changes across time vs. trying to change everything at once.

36.50 – Seeing improvements in strength and body composition with an average age of 60. Changing the stigma of working out as an older female.

39.30 – Having two exercise groups in a research study vs. an exercise group vs. a group that doesn’t exercise.

42.00 – The challenges of recruiting for research studies in this area.

46.00 – Advice for professionals interested in working with cancer survivors.

48.00 – Advice for cancer survivors looking to get started with an exercise program.

Kristin is an assistant professor at the University of British Columbia in Canada researching how physical activity can benefit cancer patients and survivors. In this episode, we talk about some of the most important questions to answer in the realm of physical activity and cancer. For those interested in this area, this will be one of the most comprehensive views you get of the field, past, present and future.

You can find Kristin on Twitter @KLCampbellPhD along with her lab @CEPL_UBC. Keep up with their research or get in touch with Kristin through the department of Physical Therapy at the University of British Columbia.

http://physicaltherapy.med.ubc.ca/person/kristin-campbell/

Show notes

1:55 – Introduction to Kristin.

3.45 – History of the field of exercise oncology, starting in the late 80’s

8.15 – Does Physical activity reduce the risk of cancer risk and survival?

11.45 – Does physical activity have an effect on cancer treatment decisions, treatment completion rate or response.

15.15 – What is the optimal exercise prescription for cancer survivors?

19.15 – What are some safety concerns of exercise in cancer patients or survivors.

24.45 – How do we translate the research into a clinical or community setting.

25.45 – How can exercise improve side effects of cancer?

28.45 – Is there a role for physical activity in people with advanced/terminal cancer

29.45 – What are the challenges in setting up an “ideal” cancer rehab center

35.45 – What do we need to do to accelerate the progress in establishing exercise oncology as a standard of care.

38.45 – When is the best time to exercise (before, during or after treatment).

40.45 – What are some misconceptions about exercise that cancer patients/survivors have?

44.45 – Advice for survivors interested in getting started with a program.

45.45 – Advice for professionals interested in working in this area.

In today’s episode I speak to Sarah Weller, an exercise physiologist in Vancouver, Canada. Sarah has over 10 years of experience working with a variety of cancer patients and survivors at varying times of treatment. We chat about Sarah’s wealth of experience in the field, the difficulty of setting up a cancer rehabilitation center and establishing relationships with oncologists, along with a discussion about working with different cancer populations including glioblastoma and terminal cancers. It was a fascinating discussion with someone who has a phenomenal amount of experience in the trenches in exercise oncology.

You can find Sarah on her website sarahweller.ca, or find her on twitter @_sarahweller.

Head over to our website reachbeyondcancer to find out more, or catch me on twitter @ciaranfairman.

*We had some microphone issues on my end in this episode. You’ll be able to hear the difference in quality in my voice compared to other episodes, but I felt the content was so valuable, it was better to get it out there than try to re-record it. I appreciate your patience as I work through the technical aspects of the show to get better each week.

Show notes

3:35     Sarah’s Background/Current work in the field

5:05     Starting her own private cancer rehabilitation program/utilizing exercise as medicine to fill a gap in cancer care

6:50     How did patients find you and the care offered/ referrals

8:35     Making connections and building relationships with physicians to support her mission

10:05   The importance of outreach and education to professionals to show them the power of exercise and research to back it up

12:05   Stressing the idea that patients can generate change in the way care is administered

13:35   Finding the issues with standard care that needed to be addressed, directly from the patients themselves

15:05   How to start and help establish a business in clinical exercise physiology/ Sarah’s ultimate goal for exercise prescription; similar to cardiac rehab

18:35   Effectively structuring an individual’s program/ the significance of initial assessment

20:05   Why the Cardiac Rehab model is powerful and what we can learn from it

22:05   The importance of understanding the details of cancer and the modifications that need to be made to their programs based on their specific circumstances

23:35   What stages and types of cancer does Sarah treat

25:35   Common modifications to exercise based on their type of cancer/treatment

• 24:05 Limited Range of Motion

• 25:05 Handling Fatigue

• 26:35 Peripheral Neuropathy

• 28:05 Prostate Cancer

• 29:35 Glioblastoma

36:35   What exactly does the initial consultation of a patient look like

• 36:35 The importance and effectiveness of integrating the patient’s individual goals

• 39:05 Flexibility in consultation and training protocols

42:05   Sarah’s transition into research and what gaps she wants to cover

• 42:05 Effectively changing behavior

45:35   Sarah’s Advice for upcoming professionals in the field

48:05   Sarah’s advice for patients wanting to start an exercise program

Matt was diagnosed with stage IV Hodgkin's Lymphoma a week after graduating high school. Instead of going on to play college soccer, Matt had to stay in Ohio and go through a brutal regimen of chemotherapy and radiation. This episode is part 1 of a two part series covering Matt's journey from his diagnosis, to where he is now, an MLS star, with a successful cancer foundation dedicated to help making the lives of childhood cancer survivors better. Lamps is as tough as they get, and he gave a great insight into the devastating effects of treatment, some of which he still battles today. You can find more about Matt's foundation at www.lampstrong.com. You can also find him on twitter @LampStrong. 

Please subscribe, review and rate the podcast. Let me know how we can improve!

You can find more about reach at www.reachbeyondcancer.com or follow me on twitter @ciaranfairman. 

Show notes:

4.45 - His diagnosis, how he found out and breaking down. 

10.00 - His odds of survival. Playing a tournament the week he found out, and coming back straight into chemo. 

14.00 - Staying in Columbus to go through treatment instead of going to college to play football. Dealing with the pain and side effects of treatment. 

22.00 - How the side effects of treatment got worse over the course of his cycles. Dealing with weight gain, stomach ulcers, bone pain and nausea. 

29.00 - How going through cancer treatment at such a young age affected him psychologically. Feeling like he lost a lot of friends, being hurt and angry. How treatment shaped his goals and values. 

34.00 - Getting extra cycles of treatment, despite being free of cancer.

39.00 - Long term effects of radiation

44.00 - Finishing treatment and the recovery to get back playing.