Main image: (from left) Kinesiologist Deanna Lavigne, SNAP Fitness manager Maddi Stroyan, RECaPS study participant Joan Walton, and SNAP Fitness co-owner Stefan Cox. (Dawn Huddlestone)
Almost one in two people will develop cancer in their lifetime. When a cancer diagnosis arrives, survival is the sole and necessary goal. But when treatment is completed successfully, patients are often left weaker and with less mobility than they had before, and at increased risk of cardiovascular disease caused by the damage cancer therapies can cause to the heart, lungs, blood vessels, and skeletal muscles.There is growing evidence that exercise helps.
A study happening in Huntsville—and for which researchers are seeking a final group of participants—aims to show that not only is a tailored exercise program beneficial to cancer patients and cancer survivors, it can be delivered in more rural areas with as much success as in larger centres.The RECaPS (Rural Exercise for Cancer Patients and Survivors) study began in late 2019, just before the pandemic began. One cohort of participants completed the study’s 12-week exercise program at Motivations Fitness prior to COVID, while a second participated partly online and partly at Reactivate during the pandemic.
The final round will begin soon at SNAP Fitness.“Most of this type of research happens in large urban centres,” notes Dr. Scott Adams, an exercise scientist within the Ted Rogers Cardiotoxicity Prevention Program. “This is the first in a series of studies to assess the feasibility of delivering exercise support services that are safe and effective in rural communities.”The study considers how to protect patients from the deleterious effects of cancer treatment. “Most people survive their diagnosis but the secondary effects can be long-lasting,” says Adams. “[We hope to] show that these programs can be safely delivered with minimal supervision in areas without specialized support services like you typically find in urban settings.”Local kinesiologist Deanna Lavigne is delivering the program in Huntsville.“
Many years ago I took a course on exercise oncology and wondered ‘why can’t we have a program like this in Huntsville?’” says Lavigne. “It took me a while to find a way to get it funded. I didn’t want people to have to pay.”
Through Enliven, a local support organization for cancer patients, survivors, and caregivers, Lavigne connected with the Northern Ontario Academic Medical Association and with the help of Adams got funding for a feasibility study.“I just want people to get stronger, move more, for quality of life and for reducing the risks of all chronic health conditions because it’s not just the cancer you’re dealing with afterwards,” says Lavigne. “There’s the fear of recurrence…and all the side effects. It can affect bone health, it can affect your heart, it can affect neuropathy in your feet. So we’re trying to work around all of those.”
Don’t let the fact that the study takes place in a gym scare you, she adds. Everyone works according to their own ability, and it can be for anyone. “You don’t have to be a weightlifter, you don’t have to be an athlete, you don’t have to be an exerciser to start, but I hope to build their confidence that they can and they can get stronger. When people say ‘my goal isn’t to be an Olympic lifter’, I say no but is it your goal to be able to get off of your toilet for the rest of your life or enjoy gardening or play golf? What is the quality of life that you want to get back to?”
Local physician, Dr. Lindsay MacMillan, is happy to see the study happening in Huntsville.“
The ideas, lifestyle and quality of life in medicine and cancer care and treatment is something that I am very passionate about so it really aligned with my own values,” she says. “There’s lots of research in cancer care in urban settings but the goal was to identify things that are unique to a more rural atmosphere and how can we prove that a program like this would be of benefit with actual numbers so we could use that information from the study to hopefully secure funding for a more long-term option in our community.”
It’s important to offer local services in rural communities, particularly for those undergoing cancer treatments, “because during their treatments inevitably there will be lots of travelling outside the community and to be able to offer something more long-term to help support them in their quality of life without that travel piece and with local people and a community feel I think is incredibly valuable for people who have been on a cancer journey,” says MacMillan.
In addition to the benefits of exercise, a program like RECaPS can have social benefits as well. “What I often hear from patients is a sense of isolation with a cancer diagnosis and having a program like this allows for that connection and those lifestyle changes that can improve their quality of life.”
Among her patients who have completed the program, “the unanimous sentiment is not only increased exercise endurance but more importantly increased energy, an increased feeling of well-being, and increased quality of life. And again the connection piece, being able to connect with people who have been through a similar situation is invaluable when you’re on the cancer journey.”
MacMillan is a proponent for both exercise and mindfulness. “Both of those intuitively made sense to help with mental health in getting through difficult times like cancer treatment, but it’s nice to see that the actual scientific literature is now coming out to support that, the fact that mindfulness and cardiovascular endurance and exercise not only help with physical well-being and health but also mental health.”
Several participants from the study who have already completed the 12-week program agreed to speak with Doppler about their experience.
Drew Hutcheson says he found the program motivating and called Lavigne an “extraordinary” resource. He had been told by doctors that he should never run again, a revelation that was devastating for a regular runner like Hutcheson. But with Lavigne’s help, he was able to return to running, which was beyond the scope of the program but “an incalculable gift”, he says. The individual attention he received during the program enabled him to get the benefits of exercise without overdoing it, allowing him to continue on without supervision.
Andy Harris, a Bracebridge resident, echoes Hutcheson’s positive experience. He says he was fortunate to be able to participate in the “very worthwhile” program. Following his cancer treatments, Harris was detuned from exercise and was concerned about returning to an exercise program, fearing overexertion. “RECaPS was a safe and positive way to test myself,” he says, adding that the program is needed in smaller communities that don’t have the same level of access to specialists like Lavigne. He commends Lavigne for the work she is doing and says he appreciated being part of a group who understood each other’s cancer experiences.
Joan Walton had never been in a gym when she started the RECaPS program, and she too feels fortunate to have participated. In addition to the physical and mental challenge it provided, she says she appreciated sharing the experience with a supportive group. “It took my mind off the disease and gave me a reason to get up in the morning and leave the house,” she says. “It feels like you’re part of a team.” Prior to beginning the program she felt as though her body had let her down, but she was encouraged by her progress and says the program is beneficial. She hopes it will continue so that others can benefit as well.
Betsy Rothwell had been involved in a similar, online program called EXCEL (EXercise for Cancer to Enhance Living well) which offers fitness classes via Zoom and jumped at the chance to participate in an in-person program. She says she loved the discipline of having a class to go to, as well as the community aspect of being with other cancer patients and survivors. She appreciated that the exercises are tailored to each individual’s ability. “It’s been life-changing,” she says, adding that it can take a long time for cancer survivors to regain strength and endurance, and that the daily walking she was doing wasn’t enough. She also hopes the program will become available long-term. “Cancer strikes so many, no matter where you live.”
Stefan Cox, SNAP Fitness co-owner with Jordan Eastman, says that the gym has been “very eager to give back to the cancer community,” noting that their newer equipment is easily adjustable to make the participants’ workouts as effective as possible regardless of where they are starting from. “We’re very proud and honoured to have [Deanna] and her research help us give back to the community. The fact that the research is happening in the community is a big deal.”
Study participants can be either currently in treatment or up to five years post-treatment. All require permission from their physician or primary care provider and must undergo a pre-study assessment. Precautions are in place to keep people as safe as possible as the pandemic continues.
If you are interested in participating in this study, contact firstname.lastname@example.org. Sessions will be held at SNAP Fitness in Huntsville, but participants from surrounding areas who are willing to travel to Huntsville are welcome.
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