Positive Health Online

One in three of us in the UK will develop cancer at some point in our lives.[1] Although it is predominantly a disease we associate with later life, cancer can strike at any age. As our life expectancy increases so will the incidence of cancer.[1] If current trends continue, Macmillan estimate that four million people will be living with or beyond cancer by 2030. Cancer is a major cause of disability and is the main cause of death nationally both for all age mortality and under 75 years premature mortality. With the most common cancers being breast, prostate, colorectal and lung cancer, which account for more than half of all new cases.

The good news is that over half of all cancers are potentially preventable, yet many of us remain unaware of the simple steps we can take to reduce the risks. Prevention of cancer is something many of us feel is beyond our control. But there is strong clinical evidence that smoking cessation, changing to a healthier diet, weight management and increased physical activity are the most important factors in reducing our risk of developing cancer.[3,4]

Marion Foreman (Class 4 Cancer Rehabilitation Trainer) works with Fiona Doto during one of three circuit sessions
funded by HCCN in Huntingdon, Cambridgeshire. All physical activity counts towards their 10,000-daily step target
using her BuddyBand2 waterproof activity tracker.

Move More

Physical activity has multiple benefits in prevention and it turns-out that it is also vitally important during the treatment for cancer and during recovery stages - so it is important for patients at all stages of the cancer care pathway.[5] The evidence base for the effectiveness of increased physical activity as it influences reoccurrence and health outcomes have been the focus of many clinical studies.

More recently the focus has shifted to explore the effectiveness of physical activity as part of the cancer care pathway. Macmillan commissioned a systematic review of randomised controlled trials (RCT) promoting physical activity during and beyond the treatment of cancer patients in 2010.[6]

Studies that were cited as evidence for specific programmes of physical activity interventions included:

1. Oncologist-recommended exercise programmes with a comparison of those with cancer randomly referred to an exercise specialist. The Oncologist-led group showed significantly higher participation levels to exercise classes at week 5 and this had a direct impact on the source credibility and message framing on exercise intentions, behaviours and attitudes;[7]  
2. Motivational interviewing and other types of behavioural counselling in three RCT’s demonstrated the effectiveness of approaches to encourage increased physical activity measured by either self-assessed recording or minutes of activity measured by accelerometers;[5]
3. Referral to weekly supervised gym sessions with home-based aerobic activities showed an increase from 44-minutes to 129-minutes per week for those enrolled on these sessions over the usual cancer care;[8]
4. Walking, including pedometer programmes from five RCT’s showed clearly the combination of promotion of walking, mainly through counselling, improves daily step counts, particularly where a daily step goal is set.[9]

Despite this evidence, the promotion and advice to be physically active during and after treatment are not routinely being offered as a standard part of patient care in the UK.[10] The clear benefits of participation and the slow increase of physical activity during and after cancer treatment are:

• Easing tiredness and some treatment side effects;
• Reducing anxiety and depression;
• Improving mood and quality of life;
• Strengthening muscles, joints and bones;
• Boosting the immune system;
• Maintaining a healthy weight;
• Moderating the risk of other health problems, including heart and diabetes; and
• Diminishing the risk of certain cancers reoccurring.

The recommendation for people undergoing treatments is now to “avoid inactivity” as “even in cancer patients with existing disease or undergoing difficult treatments, is likely to be beneficial’.[2,4]

Professor Robert Thomas, in his book Lifestyle after Cancer[11] reports that “patients who exercise regularly are associated with a lower risk of their cancer returning and generally surviving longer.” He goes on to say Whichever exercise you decide on, the essential point is that it should not be just a passing fad, but a regular way of life”.

Get Active in Practice

The Hunts Community Cancer Network (HCCN) is a Cambridgeshire-based charity set-up because of this emerging evidence. It is run for people with cancer, by people with cancer and an army of volunteers and supporters. It aims to strengthen interventions along the cancer care pathways and to ensure that people living with and beyond cancer feel supported, are informed, have an awareness of the health benefits of physical activity and have an improved quality of life.

HCCN work with newly diagnosed adults or those recovering from cancer, in conjunction with nurses and other specialists delivering care. It provides qualified personal trainers from Forefront Fitness and uses the Activ8rlives healthcare technology - both local Cambridgeshire companies.

One of the HCCN initiatives is the Get Active programme, where personalised activity plans for those enrolling are designed after face-to-face consultation with a Cancer Exercise Specialist. The programmes include: education, home-based exercises, structured exercise classes or access to a local gym, circuit class and yoga.

HCCN provide its members with an Activ8rlives BuddyBand2 – a wrist-worn waterproof activity and sleep tracker, which enables them to monitor their daily activity levels, uploading data via the Activ8rlives4Wellness and Food Diary App, with the opportunity for remote coaching. Part of the Activ8rlives solution includes a dedicated online group called 'Walking for Wellness' that allows members to stay in touch and celebrate their achievements.

Susan Moore, Chairperson of HCCN said: “It takes more than just prescribing medicines and rehabilitation. Recovering from cancer can be a lonely process. By working together and through understanding our own journeys, we can help and teach other ways of coping with recovery and re-introducing a sense of joy, by having a bit of a laugh together too!”

Case Study: Cancer Changed My Life ...

But Cancer did not take my life, it gave me a new one.[12] Uninvited and unwanted it changed the way my body looked and it changed the way I thought about everything.

But I met the most beautiful people that I would not have otherwise met, I joined Pilates and Yoga classes that I would not have otherwise joined, I was supported by HCCN and trialled the Activ8rlives BuddyBand2 and I love every day and every day is now a good day.

So, me and my Buddy go everywhere together, and along with my Personal Trainer to be always there, encourage and guide my appropriate activity levels and my thoughts towards maintaining an active and healthy life it’s a great combination.

Pre-cancer, I had for years always maintained an active lifestyle, this consisted of walking – usually 5 miles per day, also supplemented by frequent visits to the Lake District where I walked happily for up to 16 miles, up and over the fells.

But my activity levels, which I felt were good, were not at all measured or recorded.

The Activ8rlives BuddyBand2 is a waterproof activity and sleep tracker connected by Bluetooth to the free comprehensive Activ8rlives4 Wellness and Food Diary App, that is a versatile and customisable app for self-care and recording vital health parameters [left]. Alison Crane, cancer survivor and self-professed lover of every active day, is a
member of the HCCN Get Active programme.

Post-cancer, I struggled with motivation, concentration and the want to go forward.  My BuddyBand2 really helped me regain that motivation and to find the ‘new normal’ it was my constant companion. Buddy was my gentle reminder that if I had been inactive (sitting on my bum) for 60 mins to get up and get moving. The Activ8rlives4 Wellness and Food Diary App also measured and recorded my daily food diary, every step, calories burnt and distance travelled on my own Activ8rlives personal account. This I found extremely interesting, encouraging and motivational.

Assistance and advice has always been at hand in the form of a dedicated, personal and friendly helpline. In addition, I was blessed with the support from the most fabby Marion, my own personal understanding and supportive trainer and coach. She would regularly check my Activ8rlives account, communicate with me to see what I was up to, how I was doing and to offer any help, guidance and encouragement along the way.

Go Buddy – together we can do it! Cancer Survivor and lover of every active day!

Follow this link to read another case study.

References

1. Office for National Statistics. Cancer Registration Statistics, England, 2011. 26 June 2013. http://www.ons.gov.uk/ons/dcp171778_315795.pdf [Accessed 07/06/2017]
2. Macmillan Cancer Support. The Importance of Physical Activity for People Living with and Beyond Cancer: a concise evidence review. England, 2011. June 2012 MAC 13820.
3. World Cancer Research Fund. Cancer preventability statistics, 2014. [Accessed 25/1/17]
4. Cancer Research UK. Can cancer be prevented? http://www.cancerresearchuk.org/about-cancer/causes-of-cancer/can-cancer-be-prevented?_ga=2.186552617.1612171805.1496838768-187879331.1496838768 [Accessed 07/06/2017]
5. Macmillan Cancer Support. Interventions to Promote Physical Activity for People Living with and Beyond Cancer: evidence based guidance. England, 2010. June 2012 MAC 13821.
6. Davies, N.J., et al. Lifestyle-Related Health Behaviour Change: Physical Activity and Diet: Theory and Evidence on Developing Lifestyle-related Behaviour Change Training for Cancer Clinicians. London, 2010.
7. Jones, L.SW., et al. The effects of source credibility and message framing on exercise intentions, behaviours, and attitudes: An integration of the Elaboration Likelihood Model and Prospect Theory. Journal of Applied Social Psychology 33:179-96. 2003.
8. Irwin, M.L. et al. Recruiting and retaining breast cancer survivors into a randomized controlled exercise trial: the Yale Exercise and Survivorship Study. Cancer 112(11 Suppl):2593-2606. 2008.
9. Knols, R.H., et al. Physical activity interventions to improve daily walking activity in cancer survivors. BMC Cancer 10:406. 2010.
10. Daley, A.J., et al. What advice are oncologists and surgeons in the United Kingdom giving to breast cancer patients about physical activity? International Journal of Behavioural Nutrition and Physical Activity. 5.:46. 2008
11. Thomas, R. Lifestyle after Cancer: The Facts. Learn how to live stronger for longer. Health Education Publications. 145-160. ISBN 978-0-9558212-4-0. 2011.
12. Crane, A. Cancer changed my life. [Accessed http://www.activ8rlives.com/information/case-studies/me-and-my-mate-buddy.html 7/6/17]