A Perspective on 20 years of Cancer and Exercise Programs

FEB 2014.  In the mid 1980s Dr. Meryl Winningham was the first sports medicine professional who pushed the envelope on the topic of exercise and cancer.  She developed interval training program for cancer patients (the WAIT protocol), and even though many in the oncology profession were not amused by her research, none the less admitted over time that the premise of exercise showed promise for improving quality of life in cancer care.
 

Dr. Meryl Winningham - the first pioneer of research into exercise and its effects on cancer status, fatigue, and fitness.

Dr. Meryl Winningham - the first pioneer of research into exercise and its effects on cancer status, fatigue, and fitness.

In the early 1990s epidemiology research in prevention began to show a strong association between regular physical activity and the lowering of risk of specific types of cancers, such as breast and prostate.  The role of exercise has shown up to a 50% reduction in these types of cancers in large population studies.  This was the turning point in the use of physical activity and its application to cancer care.  
 
In that same decade, the work of Dr.
Kerry Courneya from University of Alberta, Canada began to show even more positive effects of exercise on the behavioral aspects of cancer recovery.  Dr. Courneya published work on colon cancer, senior exercise, specific long term recovery issues, and the effects of exercise selection on survivorship.  Dr. Courneya also penned one of the most profound quotes on the effects of exercise in cancer care: “If there were no more research in the field – the results of reports to date show would not alter the positive effects of exercise on the majority of cancer patients and survivors”.  His statement rings true, 15 years after he wrote it.  
 
So now we find ourselves at a cross-roads.  As of 2015, there are thousands of certified Cancer Exercise and Wellness Specialists in the US alone.  However, there is still a modicum of interest on the part of oncology professionals on the application of wellness and exercise (independent of physical therapy).  So our greatest challenge in this decade is to push the envelope of acceptance for wellness and survivorship programs through a few means. One is technology.  The use of the specific measuring programs and fitness related tools would go far to show improvement both individually, and as collective groups (such as age-group breast cancer reports).  
 
 The second is relationships with health plans.  Although this discussion as been on the table for over a decade, with the advent of Obamacare, the rise of accountable care organizations (ACOs), and value-based reimbursement models, the timing for contracts may be now.
 
This blog is the first in a series of looking at the value of exercise for long term survivorship in cancer, but also topics such as reducing health care costs, reducing the odds of a cancer recurrence, and developing a sustainable wellness model for cancer care.  As we explore these new models, we should have a clearer vision of what the next 20 years should be.  Let us know your thoughts.