Cancer Expert: Working with the Fitness Industry the 'Holy Grail’

Last year, the American College of Sports Medicine (ACSM) brought together experts from 17 organizations—including the American Cancer Society (ACS) and the National Cancer Institute.

This roundtable had two goals:

1. To review the latest scientific evidence; and
2. to offer recommendations about the benefits of exercise for prevention, treatment, recovery, and improved survival.

Later, the roundtable released new guidance urging healthcare and fitness professionals to design and deliver exercise programs through "exercise prescription." The aim is to lower the risk of developing certain cancers and best meet the needs, preferences, and abilities of people with cancer.

One of the experts was Nicole Stout DPT, CLT-LANA, FAPTA, a renowned healthcare researcher and faculty member at West Virginia University Cancer Institute's School of Medicine.

She says it's the same no matter where she goes or who she talks to: Everyone has a cancer story.

This isn't surprising when you consider that the ACS estimates—in the U.S. alone—more than 1.7 million people will have received a new cancer diagnosis in 2019. Everyone's story is different, be it a friend, a coworker, or a family member.

Stout is no exception. When she was in high school, her grandmother went through cancer treatment. Today, she still thinks about her grandmother's perseverance and determination to keep moving.

"My grandmother was a farmer in western Pennsylvania—she didn't have time to be sick," recalls Stout.

Doctors would tell her grandmother and other cancer patients not to exercise or lift more than 5 pounds for the rest of their lives. Stout says we are still seeing ramifications from this even though study after study shows exercising can benefit people currently going through cancer treatment and cancer survivors.

The real challenge is that doctors want to recommend exercise, but aren't equipped to give guidance. Stout and the other experts want to make it easy for them by reducing any barriers.

She recommends healthcare providers refer patients to a specific fitness professional at a trusted facility, instead of just saying go exercise or be more active.

The evidence suggests this type of referral improves the likelihood the patient will follow through with the exercise prescription.

Prescribing Exercise in a Post-COVID-19 World

The coronavirus pandemic disrupted normal life for everyone, and daily exercise and physical activity routines were no exception.

Physical activity levels in the U.S. declined by 48% between March 1 and April 8. This drop is especially alarming when you consider that the World Health Organization (WHO) estimates the lack of physical activity to be the leading cause of approximately 21–25% of breast and colon cancers.

"One of the greatest concerns we are facing through this pandemic is that individuals are forgoing care that they need out of fear of entering a medical clinic or hospital," says Stout. "But even more so, telling folks to stay home and not be in crowded places means they are forgoing things like going to the mall and walking, or to the gym or to their exercise group."

We reached out to Stout for her thoughts on how COVID-19 will affect health and fitness facilities' ability to help their members with cancer.

"The number one way to help folks who are immunocompromised is to encourage meticulous cleaning of equipment and to make available to them the means to clean their hands, the equipment they use, etc.," says Stout.

Gym-goers who are immunocompromised don't always look sick, but their blood counts put them at greater risk of becoming ill. Stout had five suggestions for clubs to help ensure their immunocompromised members not only are safe but feel safe returning to exercise.

1. Be very transparent about the steps you are taking to maintain a clean environment.
2. Put procedures in place to routinely disinfect equipment.
3. Keep the number of individuals in your club to a level that does not allow for crowding.
4. Make disinfectants widely available to members so that they are in control and can clean, wipe down, or scrub anything that they choose to use.
5. If you have the opportunity, initiate or expand outdoor activities and programs, possibly collaborating with a neighborhood group or organization.

She says outdoor activities like walking groups, yoga, and tai chi may be new and interesting things to pursue for cancer patients who are looking to be more active.

It's time we start looking at how we can find new opportunities during this pandemic, whether it's increased virtual group exercise classes or purchasing an advertising slot through your local cable network running 30-60 seconds of low-intensity exercises.

"I think we now have a population that may be more amenable to some of these different mediums for exercise programs," says Stout.

Where the Fitness Industry Can Help

There are a few ways the fitness industry can help. One way is to build relationships with healthcare professionals in your community. Let them know about your club's cancer programming, and that they can trust you to help their patients get active.

Stout says if we could get more health clubs involved and fitness trainers certified in cancer exercise programs, it would be the "Holy Grail."

"It doesn't have to be all or nothing," she adds. "It's about creating a pathway."

Your whole facility does not have to be certified. You could have a few trainers who are interested in cancer programming receive a base level of knowledge on cancer symptoms and working with cancer patients. Then have one staff member who is your certified champion.

Stout says there are two things health club operators can do now.

First, if you already have a cancer program at your club—whether ACSM certified or not—add it to ACSM's Moving Through Cancer searchable registry. This registry helps healthcare providers and patients find programs and trained professionals in their communities. Thereby helping strengthen the network between the fitness and healthcare industries.

Next, if you don't already have a certified trainer, check out the sources on the Move Through Cancer website. They have information on the latest research and resources for fitness professionals and healthcare providers—including a Moving Through Cancer Rx Form.

There will also be model programs that clubs can use based on what gyms are currently doing. So make sure you add your club to the registry.

Stout says it's about building a system of care for the patient that helps them throughout their treatment, and that exercise should not be an afterthought.

For this initiative to work, we need to meet two conditions:

1. Healthcare providers need to buy-in to prescribing exercise.
2. Fitness professionals need to increase their knowledge of how cancer impacts a patient's body to customize workouts to an individual's need.

The fitness industry's involvement is crucial. "If patients don't have somewhere to take the prescription to exercise in their community, this isn't going to work," says Stout.

Clubs Leading the Way

Cancer programming in health clubs is not a new concept.

After former IHRSA board member and co-owner of the West Coast Athletic Clubs Julie Main received her cancer diagnosis in the 1990s, she started the Cancer Well-fit Program. This nonprofit serves thousands of cancer patients and has inspired similar programs across the U.S.

Then there's the six-week Back to Life program for cancer patients and survivors started by Radka Dopitova Willson. Radka—a cancer survivor herself—focused her program on three simple goals: nutrition, exercise, and mind-body.

For the industry to be the "Holy Grail" that Stout believes us to be, we need to get active as an industry to incorporate and promote more cancer exercise programs.