- •
Cancer survivors are physically and mentally vulnerable because of the emotional strain caused by a cancer diagnosis and the physical and mental side effects of oncologic therapies.
- •
Alternative exercise traditions (AETs) offer the potential to improve diverse outcomes among cancer survivors by reducing adverse symptoms and mood disorders, and by enhancing function.
- •
AETs’ affordability and accessibility, as well as their capacity to simultaneously span social, physical, and psycho-emotional
Physical Medicine and Rehabilitation Clinics of North America
Alternative Exercise Traditions in Cancer Rehabilitation
Section snippets
Key points
How alternative exercise traditions can benefit cancer populations
Cancer survivors are physically and mentally vulnerable because of the emotional strain caused by a cancer diagnosis and the physical and mental side effects of oncologic therapies. Arduous treatments, such as surgery, chemotherapy, and radiation, often cause a variety of symptoms that can interfere with functioning and cause distress. Strong associations have been reported between functional degradation and specific symptoms, including fatigue, sleep disturbance, hormonally induced symptoms,
Alternative exercise traditions may be an accessible means of addressing function-degrading symptoms and impairments
Current health care delivery models, with their disproportionate emphasis on disease management, either neglect function-degrading symptoms or promote referrals to multiple specialists. The former is clearly unsatisfactory, and the latter approach is costly, not patient-centric, disjointed, and often ineffective in realizing the lasting behavioral changes that are required for functional restoration and symptom control. The consequences of our current system’s shortcomings are not trivial, as
Current limitations to the clinical integration of alternative exercise traditions
Why are all cancer survivors not systematically directed to AETs? One obstacle is the extensive heterogeneity across and even within AETs. Yoga, for example, may involve the passive and supported maintenance of static reclining postures, as in restorative Iyengar yoga, or the profoundly strenuous and dynamic movements of Ashtanga yoga. The potential benefits and harms of these 2 extremes of the yogic spectrum differ radically. The variance of other AETs may not be as marked as yoga; however,
Evidence in cancer
Most of the concerns regarding the pragmatic delivery of AETs are likely remediable through relatively inexpensive training and standardization approaches. However, such remediation would not be a trivial undertaking, and the allocated resources should be commensurate with the probability that standardized, high-quality AETs will improve key outcomes among cancer survivors. At this juncture, an extensive literature of inconsistent quality that spans diverse cancer populations frustrates efforts
The physician’s role in counseling, directing, and prescribing alternative exercise traditions
Integrative oncology is both a science and a philosophy that focuses on the complex health of patients with cancer and proposes an array of approaches to accompany the conventional therapies to facilitate health and promote overall wellness in patients with cancer.56 Many patients with cancer ask their oncology providers about complementary therapies that may improve their cancer-related prognoses or health-related QOL. Most oncologists feel comfortable recommending exercise, but the focus of
References (58)
- et al.
Performance of an item response theory-based computer adaptive test in identifying functional decline
Arch Phys Med Rehabil
(2012) - et al.
Insights into the reluctance of patients with late-stage cancer to adopt exercise as a means to reduce their symptoms and improve their function
J Pain Symptom Manag
(2012) - et al.
Upper body pain and functional disorders in patients with breast cancer
PM R
(2014) Radiation fibrosis syndrome: neuromuscular and musculoskeletal complications in cancer survivors
PM R
(2011)- et al.
Radiation-induced neuropathy in cancer survivors
Radiother Oncol
(2012) - et al.
Psychological effect of exercise in women with breast cancer receiving adjuvant therapy: what is the optimal dose needed?
Ann Oncol
(2013) - et al.
Effects of acupuncture, tuina, tai chi, qigong, and traditional Chinese medicine five-element music therapy on symptom management and quality of life for cancer patients: a meta-analysis
J pain symptom Manag
(2016) - et al.
Effects of yoga interventions on fatigue in cancer patients and survivors: a systematic review of randomized controlled trials
Explore (NY)
(2013) Pilates to pit
Lancet
(2004)- et al.
Improving muscular endurance with the MVe Fitness Chair in breast cancer survivors: a feasibility and efficacy study
J Sci Med Sport
(2013)