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Fit to fight fatigue

Regular exercise can improve fatigue in cancer patients. An RCN-funded research project investigates the best ways to motivate patients to get moving

Fatigue is one of the most common and lasting side effects of breast cancer treatments, especially for patients who have had both radiation and chemotherapy. It's well known that the simplest way to combat this is through regular physical activity. But finding ways to get patients to start and sustain a good fitness level is anything but simple. 

That is precisely the aim of a new project funded by the RCN’s CQI Research Grants which is  led by Dr. Steven Grover, director of the McGill Comprehensive Health Care Program (CHIP) and Professor in the Department of Medicine at McGill University

"The vast majority of cancer survivors simply never return to full health," says Dr. Grover. "Fatigue is the number one complication for cancer survivors: 70% mention their increased fatigue as their number one health issue." The combination of treatments they receive often causes fatigue as well as sleep problems, which in turn reduces their energy for physical activity. 

"We never doubt the importance of rehabilitation for cardiac patients, and it's exactly the same thing for someone who's recovering from cancer." 

The joint project between the MUHC, St. Mary's and the Centre hopsitalier de l’Université de Montréal (CHUM) will see a total of 50 breast cancer patients enrolled  — via a referral from their physician — in an 8- to 12-week, web-based, Physical Activity Challenge before, during or after their cancer treatment.

This program has been shown to increase physical activity among hospital workers, medical students, physicians, enlisted military personnel, and employees. It has also been tested and proven effective in relieving, stress, improving sleep, and reducing fatigue among patients with many conditions including heart disease, diabetes, and obesity. This version of the program was customized for individuals recovering from cancer with input from 30 cancer survivors (who are eligible to join the study if they choose). 


The ehealth program is accessible online at myhealthcheckup.ca/abc and more information is available on the McGill Comprehensive Health Improvement (CHIP) website (www.chiprehab.com).
Patients will be provided with a pedometer to track their steps (although there is an option of using their own digital tracker or apple health app to sync with a smartphone). Each participant will choose a virtual route on a Google map with a destination they will attempt to arrive at by the end of the challenge. Patients can do any exercise they want, says Dr. Grover, be it walking, swimming, square dancing or cycling. 

The MyHealthCheckup application will translate the chosen physical activity into steps and the patients will be able to track their daily progress, as well as compare their overall progress with other participants on the map.

Dr. Steven Grover is leading an RCN-funded research project evaluating the impact of exercise on alleviating the fatigue of cancer survivors.

"Patients in the study will have an option to come to CHIP once a week and be part of a group exercise class," adds Dr. Grover. Currently there is nowhere in Montreal for cancer survivors to exercise in groups with a trained kinesiologist who understands their specific needs. "And it's the group, either on the digital platform or at the gym, that makes it fun, of course." 

Dr. Grover says the importance of physical activity isn't unique to cancer survivors — it goes for anyone who's been through major surgery or a serious illness. "It's the same thing we do with the cardiac rehab patients or individuals who are trying to manage diabetes, chronic pain, or recover from surgery," he says.

Patients will be followed-up for six months after the end of the program and all of these outcomes will be measured. The hope is that similar benefits to these types of programs with cardiac patients will be seen with the breast cancer patient population.