Counseling your cancer patients, survivors about exercise

Do you counsel your cancer patients and cancer survivors about exercise? If you don't, why not? If you do, how much and how often and what kind?

For me, we were not taught about this very important part of cancer survivorship in either residency or fellowship. We have a survivorship plan document for colorectal cancer survivors, which I find very useful when patients are completing their adjuvant therapy and are left asking, "what next?" The plan includes a prompt to discuss exercise. I generally tell patients that regular moderate exercise is helpful in preventing some cancer recurrences, in addition to being beneficial to their overall health and maintenance of a healthy weight. Here is an article which I cite for my patients that shows a particular benefit for colorectal cancer patients.

A recent study published in this month's Journal of Supportive Oncology highlights the ways we do and do not counsel our patients on physical activity. I was happy to see that 95% of oncologists (radiation and medical oncologists) inquired about physical activity with their patients at least some of the time. Older and longer practicing physicians, those who are physically active themselves and medical oncologists were most likely to recommend physical activity. The most common factors cited in not discussing physical activity recommendations are a lack of time, lack of patient interest and being unclear on the recommendations for activity. I find that recommending exercise only takes a minute or two, and for those who heed your suggestions can have some very positive benefits.