Tuesday 12th June 2012
Anna Binks, Macmillan Survivorship Programme Manager, on the success of a 12-week exercise programme for people living with cancer.
‘At the end of the course, the same measurements were carried out as in the first week and I was amazed at the progress I made. At the age of 56 I feel fitter than I have in years.’
This positive quote came from a man who took part in a 12-week exercise programme following treatment for leukaemia. The programme is now offered as part of the wider Macmillan and Hull and East Yorkshire Hospitals NHS Trust survivorship programme [PDF, 73Kb], which has been running for around one year. It’s designed to meet the individual needs of people with cancer and their carers, and to focus on recovery, health and well-being after cancer treatment.
We work with Trust staff and services, and partner with health, social, welfare, voluntary and independent providers, both in the hospital setting and the community.
A unique part of our service is our association with local sports rehabilitation experts Hansford and Crocker. People living with cancer are able to access a free training programme to help them gain a sense of normality after treatment. Some people are literally training for a marathon, while others just want to make it comfortably up the stairs.
The programme is funded by Macmillan and is available to anyone in the area who has completed cancer treatment. Hansford and Crocker. People living with cancer are able to access a free training programme to help them gain a sense of normality after treatment. Some people are literally training for a marathon, while others just want to make it comfortably up the stairs. The programme is funded by Macmillan and is available to anyone in the area who has completed cancer treatment.
Each person’s programme is tailored using three different areas:
- the individual’s aims and goals
- addressing issues of fatigue caused by chemotherapy and radiotherapy
- making everyday activities more achievable.
Alex Hansford of Hansford and Crocker, says, ‘Some clients are recently out of treatment, while others three or four years out and sometimes longer, so it’s important to listen to the client and to provide a programme suitable to these three areas.’
‘We first look at individual goals and aims. The majority of clients want to be treated like they have never had cancer, and therefore we have found the majority of aims are the same as people who have never had cancer.
‘Aims and goals are usually split between specific and general ones. For example, losing weight might be the general aim, and strengthening the left shoulder the specific aim. These aims will depend on what type of cancer the client had.’
The trainers then look at any fatigue and muscle weakness caused by chemotherapy and radiotherapy or from being relatively immobile for a period of time. Clients often find it hard to manage stairs or walk for even a short period. The two main areas usually affected are leg strength and balance or proprioception. The strength of the lower body is vital to take part in everyday activities, so it’s important to improve the endurance of these muscles and to create the strength that once was there.
This can all be integrated into the programme and once areas of weakness have been outlined, specific exercises can be prescribed. With this, proprioception can be improved allowing the client to become more confident and able to do more vigorous exercise.
Hansford and Crocker have also devised a fitness test with a fatigue and breathlessness scale that enables them to build up the intensity without pushing people too hard. There are two parts to the test – cardio and resistance. This gives them a good idea of how much exercise a client can manage and any weaknesses that are present.
Once in the gym setting, clients work on strengthening specific muscles and improving stamina in a controlled environment, without having the worry of getting halfway to the shops or halfway up the stairs and running out of energy. Fatigue in general activities can hinder confidence and create a reluctance to get involved in social environments and meeting new people. The exercise programme can be seen as the middle stage between a hospital environment and the outside world.
Confidence and well-being
Alex says, ‘It’s important that the client feels confident and comfortable in the gym environment and with us. This is why we have integrated a quality of life questionnaire at the initial assessment and again at the end of the programme so we can see the progress in confidence and psychological wellbeing. We also carry out a six-week assessment to see if we need to change or enhance the programme.
‘We believe, with the clients we have already worked with, that we have made a significant impact on their lives and enhanced their quality of life. We feel this is such a worthwhile stepping stone on getting people back on track.’
‘Having spent the last five years with the shadow of leukaemia over me every day, I thought I had done a pretty good job in having a positive attitude and achieving all that I had.
‘It was almost five years to the date that I was offered the opportunity through Macmillan to take part in a 12-week rehabilitation course.
‘The experience was delivered in a safe and secure environment, yet relaxed enough so as not to be threatening as some gyms can be. No two weeks were the same and the variation maintained the interest. As the course unfolded this variation was all part of the individually based plan pulled together in order to meet your goals.
‘In addition to the physical goals, guidance was given on nutrition and all round lifestyle, which enriched the whole experience.
‘At no point during the course was I made to do anything that was not within my capability, but it was stretching enough to ensure a real difference was made at the end.
‘At the end of the course, the same measurements were carried out as in the first week and I was amazed at the progress I made. At the age of 56 I feel fitter than I have in years.'
We have more information about physical activity and cancer. This information is also available in our booklet, Physical activity and cancer, which you can order at Be.Macmillan or by calling 0800 500 800.
We have several videos about physical activity and cancer.
Contact Anna Binks, Macmillan Survivorship Programme Manager at The Queen’s Centre for Oncology and Haematology, Castle Hill Hospital, East Yorkshire, on 01482 461091 or email Anna.