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Exercise and cancer: a winning combination Research shows exercise improves overall well-being and quality of life for cancer survivors By Cynthia McMurray Decades of research show “taking it easy” is not always the best prescription for healing. While there are obvious contraindications, a new research study is looking at how exercise impacts the overall well-being of cancer patients and survivors. Activating Cancer Communities through an Exercise Strategy for Survivors (ACCESS) is a free exercise program designed to lessen the impact of a cancer diagnosis and its treatments on the health and well-being of individuals confronted with the disease. Launched in September 2018, ACCESS is already having a huge impact, according to Dr. Melanie Keats, a professor with the School of Health and Human Performance at Dalhousie University, affiliate scientist in the Department of Medical Oncology, and a three-time cancer survivor. As one of the principal investigators for ACCESS, Dr. Keats works closely with co-investigator, Dr. Scott Grandy, an associate professor at Dalhousie and affiliate scientist in the Department of Cardiology at the QEII Health Sciences Centre. Together they hope to not only support the current research that irrefutably shows regular exercise is a vital, yet often neglected, piece of the cancer treatment and care journey, but also how it can be feasibly implemented into real-world situations. “ACCESS will help us translate the exercise evidence into care to ensure exercise becomes part of the standard treatment for all cancer patients and survivors,” says Dr. Grandy. One of those patients is
“I may have no control over this cancer — it just does what it wants — but I can help fight it the stronger I am and exercise does that.” Andrea Davidson Andrea Davidson, a Halifax native originally diagnosed with colon cancer in July 2015. Referred by her oncologist, Andrea joined ACCESS in late October 2018. “In December 2017, I fell in the bathtub and broke my arm. That arm healed, but my other arm took up all the phantom pain,” she explains. Andrea also broke her pelvis. “I was in a lot of pain, but exercise got rid of it,” she says. Andrea’s results are not surprising according to both Dr. Keats and Dr. Grandy, which is why they are so passionate about ACCESS. The ACCESS program received funding from the QEII Foundation through Dragon’s Den, part of the Nova Scotia Health Authority Central Zone’s Perioperative Education Day. When the Dragon’s Den opportunity presented itself, they rose to the challenge much like contestants in the TV show. “There was a short proposal sent in advance that included a financial impact statement showing how this would affect cost and patient care and they selected the top four who were invited to pitch to the Dragons,”
Living with colon cancer since 2015, Andrea Davidson joined the new ACCESS program at the QEII in October 2018. ACCESS will help researchers translate exercise evidence into care to ensure physical activity becomes part of the standard treatment and care for all cancer patients and survivors. QEII Foundation
says Dr. Grandy. Ultimately ACCESS won first place, receiving $50,000 over two years. Since launching ACCESS, Dr. Keats says they have had more than 160 referrals — 78 per cent from clinicians with the remainder being self-referrals. Participants attend one of three locations: the QEII’s Victoria General site, the Rath Eastlink Community Centre in Truro, or the Canada Games site in Clayton Park, where they typically attend 24 free sessions over 12 weeks, most coming twice per week. “This trial is different than a standard clinical trial where you say, ‘here is an exercise program. Does it improve fitness markers in this patient population?’ We are still looking at patient outcomes, such as quality of life and reduced fatigue, but with a typical research study, everyone would get the same exercise regimen,” explains Dr. Keats. “Here, every individual works on the same components of the exercise program — cardiovascular fitness, strength, balance, flexibility — but one person might be running on the treadmill, whereas another may be on the bike pedalling slowly or
going for a short walk.” “They are at very different levels that depend on what they are able to do on any given day,” she says. Dr. Keats says participants use the Green-Yellow-Red Light Program. “Green light — great day — let’s go for it. Yellow light? Not quite as good as a green-light day, so we bring it back a bit. Red light doesn’t mean stop, it just means let’s move and do something but at a very low level,” she says. Andrea comes to the QEII at least once per week where she is guided through her personal fitness program that includes the treadmill, exercise bike, free weights, exercise tubing and core strength-building exercises. “I already have more energy. I don’t have hip or arm pain anymore and I can really tell if I haven’t been here. I get wobbly.” Andrea says. “It has given me a real sense of balance again — it makes me feel younger.” “We have 30 years of evidence that says exercise is safe, feasible and we should be doing it. Yet very few places offer exercise programs for cancer survivors,” Dr. Grandy explains. “We need to
make the leap between what we know and what we are doing, and this trial makes that leap.” Participants range from people who believe in exercise, to those that think it is a waste of time but their doctor told them to try it. Dr. Grandy says that no matter where you may fall on that spectrum, the bottom line is that doing anything is better than nothing. “The number of cancer diagnoses in the next 15 years is going to increase by 78 per cent, so the impact on the healthcare system will be astronomical,” says Dr. Keats. “If we can help patients better cope with their treatment, prevent or manage other health conditions, and reduce their time in the hospital, maybe we can help mitigate some of that burden for everyone.” “Exercise really is tremendous. I may have no control over this cancer — it just does what it wants — but I can help fight it the stronger I am and exercise does that,” says Andrea. For more information about ACCESS, look for them on Facebook, Instagram or Twitter @ACCESSforWellness, contact 902 473 2035 or access.wellness@nshealth.ca.
Accessing MRI when it matters most By David Pretty In March 2019, the QEII Health Sciences Centre received delivery of the Evry* MRI machine, a unique instrument designed to provide point-of-care diagnostic information for patients in the emergency department. Funding for this project includes $700,000 from Atlantic Canada Opportunities Agency, $1.26 million from the Research Nova Scotia Trust and $1.4 million of in-kind contributions from Synaptive Medical, Evry’s manufacturer. Currently, due to safety and design restrictions, MRIs are often housed far away from emergency departments. But according to Dr. Steven Beyea, scientific director for the Biomedical Translational Imaging Centre (BIOTIC) at the QEII, these same limitations are precisely what inspired Synaptive Medical to design the Evry device. “They’ve attempted to re-engineer what an MRI looks like,” he says. “For example, they’ve gotten rid of the requirement for thousands of litres of liquefied helium, a limitation requiring expensive and specialized building ventilation, improving the ability for the machine to sit within the point of care.” This collaborative research partnership with Synaptive Medical will allow Dr. Beyea’s
“Synaptive Medical is seeking a collaborative partnership with our healthcare system, and in doing so they’re investing in Nova Scotia.” Dr. Steven Beyea
A collaborative research partnership with Synaptive Medical, including Michelle MacPherson (left), director of MRI Product Development, Synaptive Medical, and Alex Panther (right), director of MRI Research & Development, Synaptive Medical, will allow Dr. Steven Beyea (centre) and his team at BIOTIC to be the first in the world to evaluate the potential impact this new technology could have on emergency medicine patients at the QEII, and beyond. Contributed
team to be the first in the world to evaluate the potential impact this new technology could have on emergency medicine patients at the QEII, and beyond. “This partnership is about being the first to access this technology,” he says. “Synaptive Medical is seeking a collaborative partnership with our healthcare system, and in doing so they’re investing in Nova Scotia.” While giving local healthcare professionals an opportunity to work hands-on with leading-edge technology, as well as the economic development opportunities, Dr. Beyea believes the province could see a broad spectrum of benefits. Evry is expected to be up and running by early fall. After the installation, BIOTIC will begin research to evaluate the value the instrument could have to physicians and patients at the
QEII’s Charles V. Keating Emergency and Trauma Centre, and to the healthcare system more broadly. “Given that this is a brand new form of MRI, the goal is to make evidence-informed decisions about whether this should or should not someday become a standard of care within the emergency medicine department,” Dr. Beyea says. This will involve working in close conjunction with Synaptive Medical. “We’ve worked with the company and various clinical partners to develop a four-year collaborative research program specifically aimed at evaluating whether, or if, this new technology provides value to the healthcare system in a variety of different ways,” Dr. Beyea explains. For Dr. Matthias Schmidt, a neuroradiologist at the QEII, the potential advancement of MRI technology is an exciting prospect.
“MRI gives me an opportunity to learn about tissue structure detail and function,” Dr. Schmidt says. “It’s a very versatile procedure that can get into anatomy, physiology and biochemistry and be very sensitive for subtle diseases.” This in turn, makes MRI an ideal point-of-care device.
“When a patient comes in with an acute neurological symptom the question is: Is this because of a stroke or an inner ear problem?” says Dr. Schmidt. “If it’s a stroke, the patient should be admitted and treated by neurology, but if it’s an inner ear problem then they can be treated
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