Blood cancers

“Gyms are scary places”: the exercise medicine program helps cancer patients

The founder of Australia’s first dedicated ‘prescription’ exercise program for people with cancer wants to see the initiative rolled out on a national scale under government funding.

Now operating in Victoria, EX-MED Cancer gives cancer patients three months’ access to a free personalised one-hour exercise program carried out three times a week in a small group gym setting.

Launched eight months ago, the Victorian government-subsidised EX-MED Cancer program has delivered to 100 patients across five community-based fitness centres in Melbourne. Its hoped-for expansion would see it rolled out in 100 locations across Australia within a decade.

A/Prof Prue Cormie

The program was founded by Associate Professor Prue Cormie, an exercise physiologist and principal research fellow at the Australian Catholic University. Professor Cormie was involved in developing the Clinical Oncology Society of Australia’s (COSA) recent position statement calling for exercise to be a standard part of cancer care.

The COSA paper also endorses evidence-based guidelines recommending that every person with cancer work towards at least 150 minutes of moderate intensity or 74 minutes vigorous-intensity exercise and two or three resistance sessions per week, noting that exercise plans must be tailored to an individual’s capacity.

While most people with cancer express a desire to exercise, barriers such as time, cost, fatigue, and competing medical appointments mean only about 10% are exercising in line with the guidelines’ recommendations, Professor Cormie says. Fear and lack of knowledge are also major barriers, she tells the limbic.

“People wonder ‘is exercise safe for me? What can I do and how can I do it? Gyms are scary places for everybody, let alone when perhaps you have no hair, you have a wig, you have diarrhoea or nausea, you’re immunosuppressed,” she says.

“All this has informed EX-MED Cancer which is designed to address all those barriers and facilitate best practice exercise medicine which is very simple for clinicians to refer into and patients to access.”

The EX-MED program provides participants with 80% of the recommended “dosage” under the expert guidance of trained exercise physiologists, who take into patient’s individual capacity, condition and the side effects of treatment, she said.

Professor Cormie notes that the COSA guidelines’ recommendations won’t be achievable for people who are going through aggressive treatment or have late stage disease, stressing the importance of tailoring programs to suit individual needs.

Under the program, an exercise physiologist assesses the patient then designs a one-hour program which they undertake in a supervised group setting for three months.

After this, participants can pay to continue, receive a home-based program, or continue their exercise elsewhere.

When it comes to exercise there is a low risk of adverse events, such as muscle soreness, sprain or inflammation of an old injury or cardiac issues.

“But we know when exercise is appropriately prescribed and monitored it is safe.”

The EX-MED program will address the challenge for busy oncologists who don’t know where to refer their patients for safe and effective exercise programs, and it’s garnering positive feedback from patients and clinicians, with 20 new referrals received every week, she says.

Patients describe how the regular exercise is making them feel stronger and more in control of their treatment, while specialists and nurses report the benefits they observe in their patients.

“I got a text message the other day from a surgeon who said just saw two of my patients both have been in EX-MED Cancer, both look amazing, both still exercising.”

Professor Cormie has been reaching out to state and federal politicians seeking support to expand the program nationally.

“In 10 years time 100 sites nationally is what we’re aiming for,” she says.

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