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When exercise really is the best medicine


In 1997 a study was published in “Blood”, arguably the most respected medical journal on blood cancers on planet earth.  The study was about the effect of exercise on treatment related fatigue after a type of bone marrow transplant called a peripheral blood stem cell transplant.  The study peaked my interest, not just because of the positive benefits of exercise on reducing fatigue, but because it also showed a benefit in other somewhat more unexpected areas.  It also reduced the length of time a patient’s white blood cell count is low after transplant, the severity of diarrhoea and the severity of pain.  Of these the one that interested me most at the time, was the effect on the white blood cell count.  The white cells are the part of your blood system which fight infection; without them the body is more prone to getting nasty bugs and less able to fight them off.

So, what was so interesting about this finding?  In the early 80’s a medication, granulocyte-colony stimulating factor (G-CSF), which reduced the length of time a patient’s white blood cell count was low after chemotherapy, was discovered and developed right here in Australia.  Clinical use of G-CSF reduced the likelihood of a dangerous infections in susceptible patients.  It was a magnificent achievement, and history has proven that it has been one of the most significant advances in the supportive care of cancer patients in our life-time.

Now back to the 1997 study (you’ve got to stay with me on this one 😊).  Although this was a small study, the magnitude of the effect of exercise on improving white cell counts was about the same as G-CSF.  Yet no one in the hospitals I worked in got excited and started “prescribing” exercise.  I’ve always felt that this was a large oversight by traditional medicine.

During the time in-between 1997 and now, however, a growing body of information and research from the non-traditional or non-western medicine areas has been building.  Yesterday on my Facebook feed a post by Chandrika Gibson of the Suyra Health-Yoga Studio popped up.  It was a review which combined the results on all the available published studies on exercise and other non-pharmaceutical interventions for cancer-related fatigue in patients during or after cancer treatment.

They looked at 112 studies reporting on 13 different activities which included relaxation, massage, cognitive behavioural therapy alone or combined with physical activity, resistance training, aerobic exercise, yoga, healing touch, dance, music and Tai-Chi.

The good news was that many of the above activities improved cancer-related fatigue.  They found:
  • During cancer treatment the most useful activities were relaxation, massage, cognitive behavioural therapy combined with physical activity, resistance training, aerobic activity and yoga; and
  • After cancer treatment had finished the most useful activities were yoga, cognitive behavioural therapy alone or combined with physical therapy, tai-chi, resistance training and aerobic exercise. 

More and more specialists are now recommending various integrative oncology practises.  Integrative oncology is a term used to describe the use of mind and body practices, natural products, and/or lifestyle modifications from different traditions alongside conventional cancer treatments.  Importantly like the above recently published study integrative oncology is based on evidence to support the effectiveness of the activity.


For too long, however, health services have ignored the psychological and physical impacts of going to hospital for treatment.  So many of our patients have said that they found attending hospitals for treatment confronting, stressful and chaotic.  They say that sitting around waiting for treatment, spending most of the day in a busy hospital does nothing to improve their physical or their mental status.  What they say that want and need is to be able to live a “normal” active life with peace and calm.  chemo@home offers patients the choice of having their treatment in the most relaxing, calm environment possible – the patient’s own home. And with the growing body of research mounting on the benefits of integrative medicine AND the benefits of home chemotherapy, the future of cancer care is likely to be very different to what it has been in the past.  It will be fascinating to see maybe some more unexpected benefits in both areas!


Julie

Read more on the article discussed at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5931245/pdf/bjsports-2016-096422.pdf
Read more on integrative oncology at https://integrativeonc.org/
Read more about the research done by chemo@home at http://chemoathome.com.au/research/

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