Alberta Cancer Foundation

The Wonders of Working Out

By: Derek Clouthier

Illustration by Sabina Fenn

Exercise should be on everyone’s weekly to-do list, but for some, getting into a regular cardio or weightlifting routine is easier said than done.

Patients undergoing cancer treatments, from chemotherapy to experimental drugs, surgery and radiation, more often than not, face side-effects that make being active difficult, if not impossible.

But, as Dr. Nicole Culos-Reed, professor, faculty of kinesiology and director, Health and Wellness Lab and Thrive Centre at the University of Calgary, explains, there are ways to overcome treatment-related side-effects and cancer-related fatigue.

“The beauty of exercise is we know how we need to tailor it to address such needs,” says Culos-Reed. “Exercise is one of our best evidence-based tools, and with tailoring, we can address and help to alleviate most issues, both physical and mental.

“Cancer treatments are hard — both physically and mentally — and it’s not about just jumping right into it.”

Another hurdle cancer patients face when looking to start a fitness program is not knowing what exercises and what intensity is safe for their specific situation.

“Individuals newly diagnosed with cancer are overwhelmed by the health-care system, and there is not a focus on wellness, or building back the control that cancer takes away,” says Culos-Reed.

Alberta Cancer Exercise Program

One of the most important ways Culos-Reed and her team have helped patients take back their physical and mental control is through the Alberta Cancer Exercise (ACE) program. ACE is a study completed last year that included approximately 2,300 participants, designed to implement and gather data in real-world settings on the role exercise plays on individuals living with and beyond cancer.

Funded for five years by Alberta Innovates, with further support from the Alberta Cancer Foundation, data collected from the ACE program is now beginning to be examined to determine individual health benefits and the cost of delivering such a program.

“Our goal with ACE is to build exercise into standard cancer care,” says Culos-Reed. “We have support within the cancer-care system for nutrition, for psychosocial well-being, but we don’t for exercise — yet we have the evidence (very clear), and we know individuals want it.”

The ACE program spanned 12 weeks, with two classes per week. Participants were screened to ensure safety and to tailor the program to their individual needs. Classes were one hour, offering aerobic, strength, balance and flexibility exercises. Instructors were trained specifically in exercise oncology and the Health and Wellness Lab’s “exercise and educate” model, which includes nutrition.

Illustration by Sabina Fenn

Physical and Mental Impact on Patients

Chuck Curry was diagnosed with multiple myeloma in June 2019, and was recommended to participate in the ACE program to assist in his recovery.

After initially being unable to participate due to extreme fatigue and an inability to walk without assistance, Curry took part in the program in the fall of 2021.

“At the end of the first 24 sessions, there was a review of my progress, and in several abilities, I had improved, and in some, remarkably so,” says Curry. “I am stronger, more stable in movements and have more knowledge of exercises I can do for my physical health.”

In addition to the physical benefits, Curry says the ACE program helped him in other ways, as well.

“In the initial class I took last fall, there was time in most sessions for us to share our stories, which was a very important part of our healing,” he says. “Participants in these sessions form bonds during the term, and that is very special. We support each other.”

Lisa Makinen also took part in the program and echoes Curry’s sentiment on the importance of the emotional bond participants built during the 12-week session — including with her instructor, Tanya Williamson.

“She is incredible. She made our group feel welcome and valued,” says Makinen. “There was a special energy in our group. We relied on Tanya to provide safe and effective instructions, but it was her quirky humour and kindness that made such a difference for us. She made the class fun and that helped take our minds off of our illnesses.”

Diagnosed with breast cancer in October 2020, Makinen’s treatment included eight rounds of chemo followed by a double mastectomy and 16 rounds of radiation. She also had axillary lymph nodes removed during surgery, which impacted one of her arms, and developed scar tissue from the radiation.

“Exercise is a vital component of treatment, and I believe programs like ACE should automatically be included for every cancer patient,” Makinen says. “Through this, I have been able to recover faster and return to work and my life with improved energy and physical strength.”