Cancer survivorship

Watching the Olympics over the weekend has been inspiring, but also fascinating. Behind the scenes our athletes work hard with their coaches in preparation for their events and this behind the scenes view can be as interesting TV as the sprint finish or rugby sevens. What has been thought-provoking is that athletes have teams of coaches and supporters and this preparation is now seen as essential for a good team. The athletes themselves understand their bodies, know what makes them perform at their best, what to eat and how to prepare both physically and mentally. This sports science and coaching approach is now a substantive science but could we learn from this approach for health care? Why is it we don’t do the same preparation when people have a major illness or survive cancer which is a much harder race. Is our focus less holistic than that for our athletes? Traditionally in healthcare we have tended to focus on the medicine rather than what the person can do for themselves or what support we can add to maximise performance. Cost and pressure of work is often the response from hard stretched services with limited rehabilitation provision, but the consequences of cancer treatment and the subsequent symptoms can be costlier if not addressed. Maybe healthcare professionals need to become more like coaches and address this health challenge from a preventative stance just like the athletes.

We know that improving physical activity, changing behaviours and lifestyle can be as important as medicine in some diseases, but how do we get this as part of the preparation and recovery? In last week’s report from Macmillan about cancer survivorship which compared the needs of survivors to those in the 1970s to 2016, the chief executive stressed how different things are to 40 years ago. A bit like sports we have become better at what we do, improving diagnosis and treatment so we have more winners. Furthermore, getting beyond the treatment is not the end of the race, it’s gone from a 100-meter sprint to a marathon, as more than 60% of cancer suffers live 10 years or more and for some 80% survival is the norm. The intractable nature of some long-term health problems, a life time of maintenance therapy suggests the need for a more personalised approach. We want as nurses patients to live as good a life as possible after cancer, but once we finish supporting them through the treatment, we often leave it up to the patient to find the best road to recovery. The True NTH exercise and diet research team at Surrey have found that there is a real appetite from the public about getting fitter after cancer treatment. Taking a leaf out of sports and exercise science approach we are working with men with prostate cancer to provide a personalised exercise and diet package provided through community pharmacies. Changes to the body after cancer treatment can leave individuals feeling fat and frail but this can be reversed. We know that physical activity and changes in weight can reduce risks from cancer recurrence and improve health overall but activity also improves how people feel. What we don’t know is how best to get men to make these changes and improve their fitness. Let’s hope the Olympic spirit will prevail and we will be able to improve men’s physical health and fitness through this intervention, so subsequently improve men’s lives. In our own small way, we are the supporters and coaches that cheer on the athletes, the men with prostate cancer need this support.

Professor Sara Faithfull and one of her patients, John Marshall were recently interviewed about this study for Eagle radio, hear what they had to say during these 4 brief clips: