What is ExMed For Cancer?
ExMed is an evidence-based exercise treatment plan for cancer patients. It is a charitable trust that funds patients for six months of exercise treatment.
The aim is to improve outcomes for cancer patients through the prescription of exercise at registered clinical exercise physiology centres.
Exercise studies on cancer patients have revealed that in addition to standard medical care prescribed exercise is the best medicine someone with cancer can receive. It could be considered non-negotiable medicine because exercise lowers the relative risk of cancer reoccurring, and the risk of dying from cancer. It also improves the patient’s ability to tolerate the medical treatment (e.g., chemotherapy, radiation, and surgery) so that they experience fewer and less severe side effects.
The long-term goal with the ExMed charity is to get exercise embedded as a standard component of cancer care in NZ. The data generated out of this project will provide scientific evidence to support the creation of exercise treatment funding for cancer patients across New Zealand.
Exercise is the missing link between cancer treatment and living well.
Why Should I Exercise?
We understand
Exercise is the last thing cancer patients going through intense medical treatment want to think about.
So why exercise?
Minimum levels of fitness are required to survive cancer treatment. Cancer treatment is harsh; brutal is sometimes an appropriate description. Coping with the treatment procedures is physiologically taxing and has, in medical terms, an O2-recovery cost. After chemotherapy, surgery and radiation the body enters an inflammatory state, as part of the recovery process. Inflammation raises body temperature, accelerates ventilation rate, heart rate and resting blood pressure levels due to higher demands for oxygen and nutrients at treatment sites.
A minimum level of cardiovascular fitness is, consequently, needed to deal with the recovery O2-cost; not only to optimise recovery but also to ensure survival. For borderline patients (e.g., fitness levels just below or above the cut-off level) exercise treatment is essential to be eligible for treatment. Exercise can lift the fitness and strength levels before starting treatment and help to maintain those levels during treatment. Patients that exercise during medical treatment also recover faster afterward.
Other exercise benefits for cancer patients
Decades of scientific investigations have established exercise as a must-have, as opposed to a nice-to-have for cancer patients. Exercise is internationally considered an invaluable tool to counteract the adverse effects of cancer and its treatment. Research has confirmed the benefits of exercise for cancer patients including
Increased longeivity. People with breast, prostate and colorectal cancer who exercise are 60% less likely to die from their cancer.
A reduced risk of cancer re-occurrence.
Tolerate higher doses of cancer treatment medicine.
Less severe physical decline during the treatment process due to improvements in strength, fitness and balance.
Manage activities of daily living better.
Less severe pain and physical discomfort after chemotherapy treatment.
Faster recovery from surgery and radiation.
Better weight management and less muscle loss during treatment.
Higher levels of energy and vitality.
The risk of developing other health problems like heart disease, COPD, hypertension, diabetes, peripheral arterial disease and elevated lipid levels as a consequence of cancer treatment.
Better mental health and demonstrate improved ability to fight depression and deal with anxiety and psychological stress.
Improved mood, due to lower levels of tiredness and fatigue after and between treatments.
There is international acceptance in medical and scientific circles that appropriately prescribed, well monitored/supervised exercise significantly improves the quality of life of cancer patients.
So how can exercise do all of this?
Exercise is effective medicine because it improves the structure and function of most of the body's systems simultaneously. No other treatment or drug can affect as many bodily systems and functions as exercise. If we can put the benefits of exercise into pill form it would be the most widely prescribed medicine in the world. Even if this pill had just a fraction of the benefits of exercise it would be viewed as a miracle drug.
However, just like medicine, the effects of exercise improve dramatically the more precise the prescription and the more meticulous the treatment monitoring process. This is why, as a charity, we prefer to use the services of registered clinical exercise physiologists.
How to Get on The Program
Program Breakdown
Patients can either self-fund (e.g., enter the program as a private paying patient) or apply for charity support. The number of patients that can be funded per year will be based on the amount raised by the charity. Self-funding allows program entry independent of funds raised by the charity.
Medical clearance for the program
Patients need to obtain medical clearance. That is essentially confirmation by medical specialists that it is safe for the participant to exercise. Medical clearance is embedded in the enrolment process (see below - How to get on the program).
How to get on the program
Please note that funding for this program is only available for patients living in the Manawatū/Palmerston North/Horowhenua. Regions gain access to the program follow the three steps below:
Step 1: Contact the ExMed for cancer charity to start the process.
Telephone: 021 66 3115 Email: admin@exmed.co.nz
The charity will need confirmation of cancer diagnosis. Have relevant medical notes/reports that can confirm the diagnosis and the name and contact details of your general practitioner or oncologist to hand.
Step 2: Referral to MidCentral Oncology
The charity will refer you to MidCentral Oncology for eligibility screening. This is a necessary step to ensure patient safety. The clinical exercise rehabilitation team will need clinical background information that can only be provided by the MidCentral Oncology specialists.
Step 3 – Referral to a registered clinical exercise physiologist
Upon confirmation that patients can safely engage in supervised exercise, patients will be referred to a registered clinical exercise physiologist. The financial arrangements for payment of training sessions will be managed by the charity.
What is an Exercise Physiologist?
What is an Exercise Physiologist?
Referral to an appropriate health professional is essential to ensure patients receive a safe and effective exercise regime.
That health professional is an exercise physiologist. Clinical exercise physiologists or CEPs are university-qualified allied health professionals who specialise in the delivery of exercise for clinical populations. CEP’s use exercise as medicine to help manage the disease and to improve the health and well-being of patients. To realise the therapeutic effects of exercise targeted exercise prescriptions are utilised based on the physiological changes required to improve health.
Understanding what happens inside our bodies when we exercise allows the CEP to prescribe exercise in a similar way that medical professionals prescribe medicine. These prescriptions involve specific types of exercise performed at precise intensities and volumes based on the mechanisms of action and the dosage needed to elicit a targeted adaptation.
Clinical Exercise Physiologists
Clinical Exercise Physiologists (CEPs) are also trained to facilitate long-term behaviour change and help patients to overcome barriers to participate in the exercise. CEP’s differ from physiotherapists who instead specialise in the rehabilitation of functions from acute issues such as injuries or surgical procedures. Clinical exercise physiology is a relatively new profession in New Zealand but well established in Palmerston North, Wellington, Kāpiti, certain parts of Auckland, Hamilton, and Hawkes Bay. Read more about the CEP scope of practice and practice standards on the CEPNZ website.
Patients looking for a CEP can contact the New Zealand clinical physiology society: CEPNZ.
Information For Clinical Exercise Physiologists
Our charity funds cancer patients for up to six months of tailored and supervised exercise rehabilitation with registered clinical exercise physiologists (RCEP).
Registered clinical exercise physiologists (RCEP) who meet certain criteria of service delivery and who are involved with the delivery of exercise rehab can contact us to register as treatment providers. The RCEP service delivery criteria include:
Having an established rehabilitation clinic with suitable equipment.
CEPNZ and CPRB registered staff.
Adequate testing equipment and ACSM recommended testing protocols that allow precise exercise prescription.
Clear referral pathways and proof of established collaboration with medical professionals (e.g., cardiologists, oncologists, GP’s, nutritionists and clinical psychologists).
We only fund cancer patients/RCEP’s in the Manawatū region. The exercise rehabilitation services are delivered in CEP practices/clinics to ensure tailor-made exercise prescription based on a comprehensive pre-testing process and a safe supervised training environment.