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Exercise and Cancer: Indications, Safety, and Evidence-Based Interventions

presented by Nicole L. Stout, DPT, CLT-LANA, FAPTA

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Financial — Nicole Stout is a Key Opinion Consultant: BSN Medical Consultant to the National Institutes of Health, Rehabilitation Medicine Department* Consultant to Survivorship Solutions LLC Nonfinancial — Chair, Oncology Specialty Council of the American Board of Physical Therapy Specialties

Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.

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Video Runtime: 68 Minutes; Learning Assessment Time: 42 Minutes

The physiological effects of exercise are well-accepted as beneficial to the population of cancer survivors. Although a robust body of evidence demonstrates the safety and efficacy of exercise during and after cancer treatment, exercise has struggled to achieve prominent attention alongside disease-mitigating cancer therapies. This course will review indications for exercise at any stage of cancer and at any point along the continuum of cancer care. Individualized exercise prescription for medically complex patients, regular reassessment, and modifications to treatment planning will be reviewed in order to optimize care planning to adequately impact function through exercise prescription.

Meet Your Instructor

Nicole L. Stout, DPT, CLT-LANA, FAPTA

Dr. Nicole L. Stout is a research assistant professor in the School of Medicine, Department of Hematology/Oncology at West Virginia University Cancer Institute and with the School of Public Health, Department of Health Policy, Management, and Leadership. She also serves as the associate director of the WVU Cancer Institute's Survivorship Program, where she coordinates the…

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1. Exercise Evidence Review: Time Course During Phases of Cancer Treatment and Survivorship

Cancer treatment occurs over a protracted time period, often months to years. The need for exercise varies depending on where on the care continuum the patient is. Evidence will be reviewed to guide interventions during the prehabilitation time period, postoperative time period, through adjuvant treatment, and throughout the duration of the survivor’s life span.

2. Exercise Evidence Review: Disease-Specific Considerations

Exercise prescription requires an understanding of the evidence across different disease states. Specific nuances of cancer type and treatment regimens warrant different considerations to achieve individualized and impactful exercise prescription.

3. Exercise Evidence Review: Functional Morbidity and Targeted Exercise Prescription

Evidence for exercise interventions that target common functional impairments related to cancer treatment and its side effects is strong. Issues such as fatigue, lymphedema, depression, myelosuppression, bone density loss, joint arthralgias, lean mass depletion, and others require targeted exercise prescription to achieve optimal outcomes.

4. Exercise Dosing: Frequency, Intensity, Time, and Type

The exercise prescription should be dosed appropriate to the individual’s needs and with consideration for disease type and treatment side effects. Indications for aerobic conditioning or resistive exercise as well as the level of intensity of exercise interventions may differ based on presenting treatment factors.

5. Safety Considerations With Exercise Prescription

Safety considerations are paramount to implementing effective exercise prescription for the individual undergoing cancer treatment or with a history of cancer. Altered blood counts, osseous fragility, deconditioning, and a host of other treatment-related factors should be considered in designing a safe exercise program.

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