Transcript 16.10-Dr-Julie-Brode.. - the Future Health Summit

Survivorship in Oncology
Dr. Julie Broderick
Assistant Professor, Physiotherapy
@jubroderick
[email protected]
Exercise in Cancer Survivorship
Do physical activity levels influence
recurrence/survival?
Does physical activity influence cancer
treatment decisions, completion rates,
and/or response?
What is the optimal physical activity
prescription for cancer survivors?
Trinity College Dublin, The University of Dublin
Do physical activity levels influence
recurrence/survival?
Least Active
30%-40%
reduction
Evidence consistent across:
≥ 20 breast cancer studies
≥ 15 colorectal cancer studies
Most Active
Trinity College Dublin, The University of Dublin
How much is needed for
recurrence/survival benefits?
‘’Dose-response
relationship’’
Trinity College Dublin, The University of Dublin
‘Self-report’ physical
activity measures used
CAUTION
At least 3 hours of
moderate/vigorous
activity per week
No RCT evidence to
back this up
Little evidence in other
cancer sites
Exercise Group
Control Group
82.7%
75.6%
8-year
disease-free
survival
Trinity College Dublin, The University of Dublin
Does physical activity influence cancer
treatment decisions, completion rates,
and/or response?
• Treatment decisions partly
based on overall health and
physical condition
• Implies cancer survivors in poor
physical condition may not be
offered intensive treatments
which could improve survival
Trinity College Dublin, The University of Dublin
What is the optimal physical activity
prescription for cancer survivors?
Recommendations
Avoid
inactivity
Return to
normal
activities
ASAP
Trinity College Dublin, The University of Dublin
Follow
guidelines
for aerobic
& strength
exercise
150
minutes of
moderate
or vigorous
exercise
per week
Safety concerns with exercise
Specific contraindications to
exercise
Haemoglobin <8.0g/dL
Absolute neutrophil
count ≤0.5 X109/μL
Fever >38°C
Severe cachexia (>35%
body weight)
Severe nausea
Severe fatigue
Trinity College Dublin, The University of Dublin
Immune
compromise
Advanced
disease
Safety
screening
Trinity College Dublin, The University of Dublin
Trinity College Dublin, The University of Dublin
Trinity College Dublin, The University of Dublin
Exercise, Prostate Cancer and
Circulating Tumour Cells
Trinity College Dublin, The University of Dublin