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An exercise oncology clinical pathway: Screening and referral for personalized interventions

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TLDR
This research highlights the need to understand more fully the role of emotion in the decision-making process and the role that emotion plays in the development of new treatments for depression.
Abstract
There are approximately 17 million cancer survivors living in the United States and by 2040 this estimate is predicted to increase to 26.1 million.1 Exercise provides a myriad of health benefits to individuals during and after cancer treatment by reducing treatment-related symptoms, improving functional status and quality of life, and lowering risk of disease recurrence.2,3 Despite the established benefits, an individual’s level of physical activity often decreases during treatment and does not return to pre-diagnosis levels after treatment completion.4,5 While exercise is regarded as safe and beneficial for individuals with cancer, promoting exercise for this population is complex. A patient-centered pathway is needed that can guide oncology and primary care professionals in efficient assessment of an individual’s condition and enable personalized referrals for exercise interventions that promote physical activity. The purpose of this manuscript is to provide a framework for clinical decision making that enables personalized condition assessment, risk stratification, and referral to optimal settings for exercise promotion for cancer survivors. Implementation strategies are also offered to support the integration of this model into an oncology clinical workflow. With guidance from their medical provider, individuals are more likely to engage in exercise and maintain levels of physical activity during cancer treatments.6 However, the number of individuals with cancer who report receiving exercise-specific guidance from their health care providers is low.7 Of particular concern is the lack of knowledge and training among health care professionals about exercise prescription for this complex population.8

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Citations
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Journal ArticleDOI

A systematic review of rehabilitation and exercise recommendations in oncology guidelines

TL;DR: Findings identify guidelines that recommend rehabilitation services across many cancer types and for various consequences of cancer treatment signifying that rehabilitation is a recognized component of oncology care, at odds with clinical reports of low rehabilitation utilization rates suggesting that guideline recommendations may be overlooked.
References
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Journal ArticleDOI

Reach Out to Enhance Wellness Home-Based Diet-Exercise Intervention Promotes Reproducible and Sustainable Long-Term Improvements in Health Behaviors, Body Weight, and Physical Functioning in Older, Overweight/Obese Cancer Survivors

TL;DR: Older cancer survivors respond favorably to lifestyle interventions and make durable changes in DQ and PA that contribute to sustained weight loss that positively reorient functional decline trajectories during intervention delivery.
Journal ArticleDOI

Physical performance limitations and participation restrictions among cancer survivors: a population-based study.

TL;DR: Deficits were present many years following cancer diagnosis, even among survivors who were not elderly, and cancer survivors may benefit from evaluation for rehabilitation services long after treatment for their original disease.
Journal ArticleDOI

Exercise for people with cancer: a clinical practice guideline

TL;DR: There is sufficient evidence to show that exercise provides benefits in quality of life and muscular and aerobic fitness for people with cancer both during and after treatment, and that it does not cause harm.
Journal ArticleDOI

Molecular Mechanisms of Cardiovascular Toxicity of Targeted Cancer Therapeutics

TL;DR: The cardiotoxicity of targeted therapeutics is examined, focusing on the underlying molecular mechanisms, thereby allowing an understanding of the problem but also allowing the identification of novel, and sometimes surprising, roles played by protein kinases in the heart.
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