Transcript
Announcer:
You’re listening to Heart Matters on ReachMD. On this episode, Dr. Stephanie Dixon will explain how we can implement cardiovascular risk prevention strategies for adult survivors of childhood cancer in real-world care. She’s a pediatric oncologist and an Assistant Member in the Division of Cancer Survivorship in the Department of Oncology at St. Jude Children’s Research Hospital. Here’s Dr. Dixon now.
Dr. Dixon:
It is difficult for many survivors who are experiencing fatigue or have limitations related to their cancer treatment; perhaps they have neuropathy, and the way that they are able to exercise now differs from how they could before treatment.
One way that we have approached it as a group is there's really great literature and effort in exercise science to adapt and tailor exercise-focused interventions to cancer survivors. In childhood cancer survivorship, we're a little bit more disease agnostic and focusing more on tailoring to the needs of the survivor based on their complications after cancer, whether that’s neuropathy, low lean muscle mass, heart failure, or heart dysfunction. And in the adult space, there's been a lot of exercise interventions that are specific to diagnosis groups. So in the breast cancer space, there's a lot of tailored exercise interventions. So I think that's been one way to go about it.
The difficulty with that, though, is then how do you scale that up so that when I'm seeing the patient in clinic today who's experiencing cancer-related fatigue and has neuropathy in their feet, how do I tell them to exercise? And we don't have a perfect answer for that yet, but there are many people who are working on ways to better scale, implement, and deliver these recommendations to cancer survivors or specific training programs.
But I think you use the tools you have where you're at. So I think you can counsel any cancer survivor that they should be exercising, and you can start there by saying, "Well, what are you doing now for exercise? Well, if you were going to do more for exercise, what are some things that you think might be a problem? What are barriers you have? What are some of the symptoms that you're having?” And work through those together in the way that you might counsel other patients with other chronic conditions as well, like diabetic patients may have neuropathy, or you may have other patients who have physical limitations for other reasons. And so I think working with the patient in front of you to try to get them to meet the goals is important.
And then the other thing is thinking about what resources or tools they have or you might have available. So maybe you're more likely to refer them to physical therapy to come up with adapted ways to do strength training because they've never done it before and they're telling you that they really have struggled ever since their cancer treatment to do certain simple tasks or with back pain, and so you think that you need to get them into someone else. And so even though it may not be cancer specific, it still may be helpful to them to see another specialist.
Announcer:
That was Dr. Stephanie Dixon discussing real-world strategies for cardiovascular risk prevention in adult survivors of childhood cancer. To access this and other episodes in this series, visit Heart Matters on ReachMD.com, where you can Be Part of the Knowledge. Thanks for listening!
